肛瘘术后应用自制新玉红膏换药的体会

目的：观察我院自制新玉红膏用于肛瘘术后换药的临床疗效。方法：治疗组采用我院自制新玉红膏纱夸换药。对照组采用传统换药方法。结果：治愈天数比较，治疗组13-19d，对照组19-24d。结论：新玉红膏用于肛瘘术后换药，比传统换药方法创面愈合快。     

云南白药气雾剂喷洒联合湿热敷治疗血液透析患者动静脉内瘘炎症效果观察

目的 探讨云南白药气雾剂喷洒联合湿热敷治疗血液透析患者动静脉内瘘炎症的效果.方法 选择2007年3月-2008年7月住院行血液透析发生动静脉内瘘炎症的患者120例,采用随机数字表法分为对照组和观察组各60例.从发生内瘘炎症开始.指导患者在透析24 h后,用温水将内瘘处洗净.对照组用33%硫酸镁溶液湿敷4次/d,每次30min,如此反复至下次透析;观察组用40～50℃的温水湿热敷10～15 min后.用云南白药气雾剂喷洒后按摩5～10min,再用保鲜膜包裹,保留3 h,每日4次,如此反复至下次透析.结果 两组动静脉内瘘炎症患者治疗4周后疗效比较,经秩和检验,差异具有统计学意义(u=7.048,P<0.05),观察组疗效明显优于对照组.结论 采用云南白药气雾剂喷洒联合湿热敷治疗动静脉内瘘炎症,疗效较好,值得临床推广.     

Epigenetics and Epigenetic Alterations in Pancreatic Cancer

Pancreatic cancer remains a major therapeutic challenge. In 2008, there will be approximately 37,680 new cases and 34,290 deaths attributable to pancreatic cancer in the United States (U.S.), making it the fourth leading cause of cancer-related death. Recent comprehensive pancreatic cancer genome project found that pancreatic adenocarcinomas harbored 63 intragenic mutations or amplifications/homozygous deletions and these alterations clustered in 12 signaling pathways. In addition to widespread genetic alterations, it is now apparent that epigenetic mechanisms are also central to the evolution and progression of human cancers. Since epigenetic silencing processes are mitotically heritable, they can drive neoplastic progression and undergo the same selective pressure as genetic alterations. This review will describe recent developments in cancer epigenetics and their importance in our understanding of pancreatic adenocarcinomas.     

Role of sirtuin-1 (SIRT1) in hypoxic injury in pancreatic β-cells

Abstract

Islet transplantation (ITx) is being developed as a treatment for type 1 diabetes mellitus, but hypoxic damage to transplanted islet grafts is an important factor affecting successful transplantation. To investigate the role of sirtuin-1 (SIRT1) under hypoxic injury in INS-1 cells, one type of pancreatic β-cell lines, we used SRT1720 and GW4064 for SIRT1 activation. The small interfering RNA SIRT1 (si-SIRT1) was used to suppress SIRT1 gene expression. We measured cell viability, apoptosis, and the levels of inflammatory cytokines, including tumour necrosis factor-α (TNF-α), interleukin-6 (IL-6), and reactive oxygen species (ROS), under hypoxic conditions. Real-time PCR and Western blot analysis were performed. Cell viability was significantly reduced to 71% and 40% after 4 and 6?h of hypoxic conditions, respectively. Apoptosis increased significantly 2.8-fold and 5.3-fold after 4 and 6?h of hypoxia, respectively. SIRT1 expression was significantly reduced at the mRNA and protein levels during hypoxia. Hypoxic damage significantly increased the TNF-α, IL-6 and ROS levels in INS-1 cells. However, the reduced cell viability and increased inflammatory cytokines from hypoxic damage were ameliorated by SIRT1 activation in INS-1 cells. These results suggest that SIRT1 is a potential target for the protection of pancreatic β-cells against hypoxic damage during ITx.     

Glucose metabolism parameters during an oral glucose tolerance test in patients with autosomal dominant polycystic kidney disease

Abstract

Objective. The aim of the study was to estimate the pancreatic beta cell function and insulin resistance indexes in a group of Autosomal Dominant Polycystic Kidney Disease (ADPKD) patients with normal kidney function and no previous diabetes mellitus diagnosis. Methods. A total of 49 adult patients with ADPKD aged 36 ± 11 years, and 50 healthy controls, all of Caucasian origin, were included in the study. Blood glucose, insulin and C-peptide concentrations were measured during an oral glucose tolerance test (OGTT with 75 g glucose) performed according to WHO recommendations in all subjects. Results. The insulin/glucose ratio at the 30th and 120th minute of the OGTT and the insulinogenic index [(insulin at 30 min – insulin at 0 min)/glucose at 30 min] were significantly lower (p = 0.018, p = 0.031 and p = 0.013, respectively) in the ADPKD group. Four other indexes of beta cell function were lower with the borderline statistical significance (p = 0.054–0.076) than in controls. None of the calculated insulin sensitivity indexes differed between the study and control groups. Conclusions. Presence of ADPKD in patients with normal kidney function is associated with impaired beta cell function after an oral glucose load, without a significant decrease in insulin sensitivity.     

The Cephalic Phase of Pancreatic Secretion in Man

Five cases with achlorhydria have been investigated by sham-feeding to establish the existence of a cephalic phase of pancreatic secretion in man. The results of the study showed that as far as the individual enzymes were concerned, the most consistent and greatest response to sham-feeding was found in the concentration and output of trypsin and lipase. A rise in chymotrypsin concentration and output was also found but the amylase response was more variable. Basal volume and bicarbonate concentration was maintained. Sham-feeding would appear to produce a highly concentrated pancreatic juice. The mechanism of the cephalic phase of pancreatic secretion is discussed.     

Hormone-based therapies in the regulation of fuel metabolism and body weight

Background: The integrated central actions of hormones secreted from pancreatic islets, the gut and adipocytes regulate both energy homeostasis and body weight. Dysregulation in these neurohormonal pathways probably contributes to pathogenesis of obesity and type 2 diabetes. Objective: To examine hormone-based therapies targeting these interrelated pathways as potential treatments for obesity and diabetes. Methods: Preclinical and clinical data on therapies based on hormones secreted from the pancreas (glucagon, insulin, amylin and pancreatic polypeptide), gut (glucagon-like peptide-1, glucose dependent insulinotropic polypeptide, cholecystokinin and peptide YY) and adipose tissue (leptin and adiponectin) as potential treatments for diabetes and obesity are reviewed. Results/conclusions: In diabetes, hormone-based treatments have translated into new clinical platforms including insulin analogs, the GLP-1-like peptide receptor agonist exenatide and amylinomimetic pramlintide, which due to their complex interplay and the progressive nature of diabetes, can be utilized in different settings. Various peptide hormones and agonists/antagonists are currently under investigation as new approaches to treatment of obesity and diabetes.     

Pancreatic Cancer in the Faroe Islands: An Epidemiologic Study of Patients with Pancreatic Cancer in the Faroe Islands 1972–82

An epidemiologic study of pancreatic cancer was performed in the Faroe Islands, which have 44,000 inhabitants. All the patients with this diagnosis in the period 1972–82 were reviewed. The material comprised 57 patients. The diagnosis was confirmed microscopically in 67%, by explorative laporatomy in 28%, and by endoscopic retrograde cholangiopancreatography in 5% of the patients. The average annual age-standardized incidence per 100,000 inhabitants (world standard) was 10.7 among men and 7.9 among women. The incidence of pancreatic cancer on the Faroe Islands is at the same high level as in the other Scandinavian countries, suggesting that industrial pollution has no pathogenic role. Nor could diseases or environmental, occupational, or familial factors be identified in the development of pancreatic cancer. High intake of lipids, available carbohydrates, and alcohol can be a contributory cause of developing pancreatic cancer.     

Effects of a marine serine protease inhibitor on viability and morphology of Trypanosoma cruzi, the agent of Chagas disease

It has been reported that serine peptidase activities of Trypanosoma cruzi play crucial roles in parasite dissemination and host cell invasion and therefore their inhibition could affect the progress of Chagas disease. The present study investigates the interference of the Stichodactyla helianthus Kunitz-type serine protease inhibitor (ShPI-I), a 55-amino acid peptide, in T. cruzi serine peptidase activities, parasite viability, and parasite morphology. The effect of this peptide was also studied in Leishmania amazonensis promastigotes and it was proved to be a powerful inhibitor of serine proteases activities and the parasite viability. The ultrastructural alterations caused by ShPI-I included vesiculation of the flagellar pocket membrane and the appearance of a cytoplasmic vesicle that resembles an autophagic vacuole. ShPI-I, which showed itself to be an important T. cruzi serine peptidase inhibitor, reduced the parasite viability, in a dose and time dependent manner. The maximum effect of peptide on T. cruzi viability was observed when ShPI-I at 1 × 10⁻⁵ M was incubated for 24 and 48 h which killed completely both metacyclic trypomastigote and epimastigote forms. At 1 × 10⁻⁶ M ShPI-I, in the same periods of time, reduced parasite viability about 91–95% respectively. Ultrastructural analysis demonstrated the formation of concentric membranar structures especially in the cytosol, involving organelles and small vesicles. Profiles of endoplasmic reticulum were also detected, surrounding cytosolic vesicles that resembled autophagic vacuoles. These results suggest that serine peptidases are important in T. cruzi physiology since the inhibition of their activity killed parasites in vitro as well as inducing important morphological alterations. Protease inhibitors thus appear to have a potential role as anti-trypanosomatidal agents.