白萝卜提取物对实验动物胃肠动力的促进作用及其可能的机制

目的探讨白萝卜提取物（Raphanus sativus roots extract,Rex）对实验动物胃肠运动的影响并探讨其可能的作用机制。方法灌胃给药（剂量10、30、100 mg/kg）后,测定小鼠胃内容物的残留率、小肠中阿拉伯胶活性炭粉混合物的推进距离;制作豚鼠回肠离体肠段标本,测定给药前后肠段平滑肌收缩强度和频率的变化情况;多导生理记录仪检测大鼠胃及十二指肠电活动;放射免疫法测定大鼠血浆胃动素含量变化。结果与阴性对照组相比,白萝卜提物在10-100 mg/kg时可使胃残留率明显减少,小肠推进百分比明显增加;并剂量依赖性地使离体豚鼠回肠平滑肌收缩;大鼠胃及十二指肠电活动的慢波频率和振幅明显增加,血浆胃动素水平明显升高（P〈0.05或P〈0.01）。结论白萝卜提取物可明显促进实验动物胃肠运动,该作用的发挥可能与胃动素水平升高及促进胃十二指肠电活动有关。     

白萝卜提取物对大鼠小肠动力作用的影响

[目的]研究白萝卜提取物(Raphanus sativus L extract,Ecr)和西沙比利对大鼠小肠动力作用的影响,并进行对比观察,为开发Ecr促胃肠动力作用的药用价值提供理论依据。[方法]采用旋转蒸发的方法制备Ecr后,以1 ml/kg(每1 ml折合生药约57 g)的剂量灌胃给药,同时设立西沙比利对照组和0.85%氯化钠对照组。应用小肠肌电测定和胃肠内标记物葡聚糖蓝2000进行标记的方法,测定给药前后大鼠小肠消化间期移行性复合肌电活动(Interdigestive myoelectrical complex,IMC)的变化和小肠推进比。[结果]Ecr对小肠推进有明显促进作用,IMC周期显著缩短,活动期单位时间内快波数明显增加,且与西沙比利组没有显著性差异,但与0.85%氯化钠对照组相比差异有统计学意义。[结论]Ecr对大鼠小肠动力具有显著的促进作用,其作用效果与西沙比利相近。     

白萝卜提取物促胃动力作用机制

目的探讨白萝卜提取物（Raphanus sativus L extract，Ecr）促胃肠动力作用机制。方法20只SD大鼠随机分为A（Ecr）组、B（0．9％氯化钠对照）组，分别灌服Ecr和等体积0．9％氯化钠，1h后，免疫组织化学方法和放免法分别观察胃电起搏区P物质（SP）、降钙素基因相关肽（CGRP）表达的变化。结果sP免疫阳性神经及产物的表达明显增加（P〈0．05）；CGRP免疫阳性神经及产物的表达明显减少（P〈0．05）。结论白萝卜提取物的促胃肠动力作用可能与局部及血浆中SP、CGRP量的变化有密切关系。     

白萝卜提取物促胃动力作用中Cajal间质细胞与P物质的变化

目的探讨白萝卜提取物（raphanus sativus 1 extract，Ecr）通过Cajal间质细胞促胃肠动力作用机制。方法40只SD大鼠随机分为A（Ecr）组、B（0．9％氯化钠对照）组分别灌服等体积Ecr和0．9％氯化钠，1h后用双重免疫荧光组织化学标记的方法观察胃电起搏区Cajal间质细胞（interstitial cells of Cajal，ICC）与P物质（SP）阳性神经及产物表达的变化。结果肌间神经丛中ICC与SP阳性神经呈网络样分布，二者紧密毗邻；肌间神经丛及肌层内与ICC结合的SP阳性神经产物表达明显增加（P〈0．01）。结论白萝卜提取物的促胃肠动力作用可能与胃体ICC上结合的SP阳性神经产物表达增高有密切关系。     

白萝卜提取物对胃电起搏区缝隙连接的影响

目的探讨白萝卜提取物（Raphanus sativus L extract,Ecr）促胃肠动力作用机制。方法20只SD大鼠随机平均分为A（Ecr）组、B（0．9％氯化钠对照）组,分别灌服Ecr和等体积0．9％氯化钠。1h后用免疫组织化学方法观察胃体胃电起搏区肌间神经丛铺片缝隙连接蛋白Cx43表达的变化。并用透射电镜观察缝隙连接超微结构的特征。结果缝隙连接蛋白Cx43表达明显增加（P〈0．05）;Cajal间质细胞与平滑肌之间有明显的缝隙连接结构,且观察到一种与平滑肌细胞之间形成的类似突触样结构的特殊联系。结论白萝卜提取物促胃肠动力作用可能与胃电起搏区缝隙连接蛋白Cx43表达增加及缝隙连接功能增强有关。     

莱菔提取物对胃肠运动的影响

目的采用电生理学的实验方法,观察莱菔提取物（Raphanus sativus.L extract,Rex）对胃电活动和小肠消化期间移行性运动复合波（Migrating motility complex,MMC）的影响,并与促进胃肠道运动的经典药物吗丁啉和西沙比利进行对比,探讨莱菔提取物的促胃肠动力作用。方法采用旋转蒸发的方法,制备莱菔提取物。采用电生理学的方法,记录给予不同的药物对胃肠电活动的影响。结果莱菔提取物对胃电的波幅和频率的影响,与吗丁啉组相比,没有显著性差异。莱菔提取物对小肠MMC的影响与西沙比例相比差异不显著。结论莱菔提取物对胃肠道运动的影响,与经典促胃肠动力药物的作用相当。     

化癥口服液对荷瘤小鼠p53突变及内皮素表达的影响

目的：探讨化瘢口服液对荷H22小鼠的抗肿瘤作用和可能的机制。方法：75只健康小鼠随机分为5组，即空白对照组、荷瘤模型组、化瘕口服液高、中剂量组（简称高、中剂量组）和阳性对照组。除空白对照组外，其余4组小鼠均以皮下注射瘤细胞悬液，0．2ml／只造模。于造模第2天，空白对照组和荷瘤模型组小鼠以生理盐水（NS）灌胃。高、中剂量组小鼠分别予100％、50％浓度的化瘢口服液10ml／kg灌胃，2次／d，共10天。阳性对照组小鼠以CTX 10ml／kg腹腔内注射，隔日1次，共5次。免疫组化方法检测瘤体内突变的p53蛋白；放射免疫法测定小鼠血浆内皮素（ET）水平。结果：荷瘤模型组小鼠的突变型p53表达水平明显高于其他3组（P〈0．05），3个治疗组小鼠突变型p53表达都有不同程度的下降，3组间比较差异无显著性意义（P〉0．05）；模型组小鼠血浆ET水平明显高于空白对照组（P〈0．001），其余各组的比较，ET水平均有不同程度下降，尤以高剂量组接近空白对照组水平，且与中剂量组和阳性对照组相比，差异有显著性意义（P〈0．05）。结论：化瘢口服液可以降低突变型p53蛋白表达，降低血浆ET水平并减少肿瘤的血供，这可能是其发挥抗肿瘤作用的机制之一。     

复方褐藻胶囊对大鼠胃排空及小肠推进功能的作用

目的研究复方褐藻胶囊对大鼠胃肠动力功能的作用。方法将16只大鼠分为2组。复方褐藻胶囊组（n=8）大鼠经导管灌入胃内复方褐藻＋美兰＋131碘－碘马尿酸，测定初始放射性剂量和45min后胃内的放射性剂量，计算胃排空率．量取幽门括约肌至美兰最前端及盲肠的距离，其比值为小肠推进比．对照组（n＝8）只用美兰及131碘-碘马尿酸．结果复方褐藻胶囊组胃排空率为89．7％±3．43％，显著高于对照组的67．5％±4．18％（P＜0．01）．复方褐藻胶囊组的小肠推进比为80．7％±6．40％，也显著高于对照组的62．5％±6．49％（P＜0．01）．结论复方褐囊胶囊有促进大鼠胃排空和小肠推进功能的作用．     

从血液流变学的改变分析肾上腺素致血瘀证大鼠模型的建立

目的以肾上腺素（Adr）皮下注射法建立大鼠血瘀模型,对比不同的给药剂量、给药方式和给药周期对大鼠血液流变学的影响,确定最佳的血瘀证动物模型的建立方法。方法将实验大鼠随机分为6组,即空白对照组（不造模）、急瘀1d组（Adr 1．8mg／kg皮下注射加冰水浸泡1d）、急瘀2d组（Adr 1．8mg／kg注射加冰水浸泡2d）、慢瘀小剂量组（Adr0．1mg／kg注射7d）、慢瘀中剂量组（Adr3．3mg／kg注射7d）、慢瘀大剂量组（Adr0．9mg／kg注射7d）。用血液黏度仪检测全血黏度和血浆黏度;用红细胞变形／聚集仪检测红细胞变形和聚集指数;用血凝仪检测血浆纤维蛋白原含量。结果与对照组相比,慢瘀小、中剂量组可见大鼠全血黏度、纤维蛋白原含量明显升高（P〈0．05或P〈0．01）;急瘀1d组可见低切变下全血黏度升高（P〈0．05）,急瘀1d组和急瘀2d组可见血浆黏度和纤维蛋白原增加（P〈0．01）,急瘀2d组和慢瘀大剂量组可见红细胞变形指数明显降低（P〈0．05）。结论血瘀证动物模型戍功与否与所用的肾上腺素剂量、给药周期和给药方式密切相关。Adr0．3mg／kg注射7d和Adr1．8mg／kg注射加冰水浸泡2d大鼠出现血液流变学变化更加明显,可分别作为气郁血瘀证和气滞血瘀证的动物模型。     

叶下珠提取物抗乙肝病毒及乙肝病毒X基因的研究

目的：研究叶下珠提取物在体外抗HBV以及抑制HBX表达的作用。方法：选用2．2．15细胞以及建立HepG2X、HepG2X-HIV-1-LTR-luciferase细胞系，用不同浓度的叶下珠药液进行细胞培养试验。确定药液对试验细胞的药物最大无毒浓度（TC0）以及半数药物有效浓度（IC50）。实验时，将细胞分空白对照组、HepG2CAT-HIV-1-LTR-luciferase细胞对照组，以及不同药物浓度的试验组（15mg／ml，7．5mg／ml，3.75mg／m1），并以β—action作为内参照。用real time-PCR、RT-PCR，以及抑制荧光素酶（luciferase）等方法，定量检测HBV DNA含量以及HBX表达量。结果：叶下珠提取物最大无毒剂量是15mg／ml，对HepG2．2．15细胞HBVDNA和HepG2-X细胞HBX半数有效量皆为3．75mg／ml（P〈0．05）。而7．5mg／ml、15mg／ml剂量与空白对照组相比较，分别为P〈0．01，P〈0．001。对HBX的抑制荧光素酶试验，叶下珠对细胞对照组及空白对照组抑制不明显，而高剂量用药组（15mg／ml），用药72小时与24小时比较，抑制率上升了10倍。结论：叶下珠不仅对全基因的HBV有抑制作用，还可能直接时X基因表达有抑制作用。     

胰岛素瘤的解剖分布特点分析

目的胰岛素瘤是最常见的胰腺神经内分泌肿瘤，因其临床表现多样，导致诊断困难。影像学诊断尤其是超声内镜(EUS)在胰岛素瘤的诊断中起着重要作用，拥有较高的敏感性和特异性。本研究拟通过明确胰岛素瘤的解剖分布特点，以期有助于提高影像学的诊断准确率和降低漏诊率，尤其是在教育和培训实践中对于EUS的学习者更具有指导价值。 方法回顾性分析解放军总医院第一医学中心病案资料数据库1993年1月至2019年11月经外科手术、病理确诊为胰岛素瘤的患者的临床资料，检索方法采取搜索术后病理诊断为"胰岛素瘤"的病例，通过查阅病例的方法，提取出胰岛素瘤的大小和解剖分布等数据，进一步分析其特点。 结果共检索到确诊为胰岛素瘤的患者116例，其中，男45例、女71例，年龄13～76岁，平均年龄(44.4±14.85)岁。胰岛素瘤单发110例(94.8%)、多发6例(5.2%)。位置分布：头颈部46例(39.7%)，单发45例、多发1例；体尾部68例(58.6%)，单发65例、多发3例；全胰腺多发2例(1.7%)。病变大小特点：最大径0.4～3.4 cm，平均大小(1.53±0.58)cm。≤1 cm 29例、>1 cm而≤1.5 cm41例、>1.5 cm而≤2.0 cm28例，≤3 cm 15例，>3 cm 3例。年龄与肿瘤的大小相关，≤44岁患者肿瘤平均大小为(1.36±0.51)cm、>44岁患者肿瘤平均大小为(1.70±0.60)cm，P<0.05。头颈部的肿瘤大于体尾部的肿瘤，头颈部肿瘤平均大小(1.66±0.63)cm，体尾部(1.42±0.52)cm，P<0.05。 结论胰岛素瘤在胰腺体尾部较头颈部更好发；绝大多数单发，但可以全胰腺多发；多数小于1.5 cm，肿瘤的大小与患者年龄和肿瘤的解剖分布相关。     

Pathogenesis of carcinoma of the papilla of Vater

Most adenomas and carcinomas of the small intestine and extrahepatic bile ducts arise in the region of the papilla of Vater. In familial adenomatous polyposis (FAP) it is the main location for carcinomas after proctocolectomy. In many cases symptoms due to stenosis lead to diagnosis at an early tumor stage. In about 80%, curative intended resection is possible. Operability is the most relevant prognostic factor. Most ampullary carcinomas resp. carcinomas of the papilla of Vater develop from adenomatous or flat dysplastic precursor lesions. They can be sited in the ampulloduodenal part of the papilla of Vater, which is lined by intestinal mucosa. They also can develop in deeper parts of the ampulla, which are lined by pancreaticobiliary duct mucosa. Intestinal-type adenocarcinoma and pancreaticobiliary-type adenocarcinoma represent the main histological types of ampullary carcinoma. Furthermore, there exist unusual types and undifferentiated carcinomas. Many carcinomas of intestinal type express the immunohistochemical marker profile of intestinal mucosa (keratin 7?, keratin 20+, MUC2+). Carcinomas of pancreaticobiliary type usually show the immunohistochemical profile of pancreaticobiliary duct mucosa (keratin 7+, keratin 20?, MUC2?). Even poorly differentiated carcinomas, as well as unusual histological types, may conserve the marker profile of the mucosa they developed from. These findings underline the concept of histogenetically different carcinomas of the papilla of Vater which develop either from intestinal- or from pancreaticobiliary-type mucosa of the papilla of Vater. Molecular alterations in ampullary carcinomas are similar to those of colorectal as well as pancreatic carcinomas, although they appear at different frequencies. In future studies, molecular alterations in ampullary carcinomas should be correlated closely with the different histologic tumor types. Consequently, the histologic classification should reflect the histogenesis of ampullary tumors from the two different types of papillary mucosa.     

Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease

BACKGROUND AND AIM: Both the clinical presentation and the degree of mucosal damage in coeliac disease vary greatly. In view of conflicting information as to whether the mode of presentation correlates with the degree of villous atrophy, we reviewed a large cohort of patients with coeliac disease. PATIENTS AND METHODS: We correlated mode of presentation (classical, diarrhoea predominant or atypical/silent) with histology of duodenal biopsies and examined their trends over time. RESULTS: The cohort consisted of 499 adults, mean age 44.1 years, 68% females. The majority had silent coeliac disease (56%) and total villous atrophy (65%). There was no correlation of mode of presentation with the degree of villous atrophy (p=0.25). Sixty-eight percent of females and 58% of males had a severe villous atrophy (p=0.052). There was a significant trend over time for a greater proportion of patients presenting as atypical/silent coeliac disease and having partial villous atrophy, though the majority still had total villous atrophy. CONCLUSIONS: Among our patients the degree of villous atrophy in duodenal biopsies did not correlate with the mode of presentation, indicating that factors other than the degree of villous atrophy must account for diarrhoea in coeliac disease.     

Demonstration of the mechanism of action of biguanides

Summary Palmitic acid oxidation in rat diaphragm homogenate is depressed by biguanide concentrations that are still incapable of inhibiting oxidative phosphorylation. Glucose oxidation is not directly effected by the same biguanide concentrations: however, the inhibitory effect of palmitic acid on glucose oxidation is partly removed by biguanides. Inhibition of fatty acid oxidation, which accounts for most of the metabolic effects caused by these drugs, can be regarded as the fundamental mechanism of action of biguanides. There is some evidence suggesting that these drugs might interact with carnitine, thus preventing long-chain fatty acids from being transported across the mitochondrial membrane to the site of oxidation. Traduzione a cura degli AA.     

血吸虫童虫生长发育及其机制的研究进展

血吸虫童虫是宿主免疫系统攻击的重要靶标,包括皮肤型、肺型和肝门型童虫。宿主分子对童虫生长发育具有重要作用。童虫生长发育机制包括免疫调节、信号转导、性别发育及凋亡等。肌动蛋白、组织蛋白酶、烯醇化酶和葡萄糖基转移酶等分子为血吸虫童虫生长发育的重要分子。本文对血吸虫童虫生长发育及其机制的研究进展做一综述。     

124例耐多药结核分枝杆菌基因突变特征分析

目的对临床分离的耐多药结核分枝杆菌相关基因的突变特征进行分析。方法对124例耐多药结核分枝杆菌以及50株敏感株的耐药相关基因(包括异烟肼inh A、kat G、oxyR-ahp C间隔区以及利福平rpo B)进行序列测定,分析其基因突变情况。结果异烟肼耐药inh A基因突变率为14.5%;kat G基因突变率为70.2%(87/124),主要位于315位;oxyR-ahp C间隔区突变率为15.3%;inh A、kat G两种基因同时突变率75.0%,三种基因同时突变率为89.5%。利福平rpo B基因突变的检出率高达95.2%,突变主要发生在531、526、516位点。结论我省耐多药菌异烟肼耐药相关基因最常见突变为kat G 315、inh A C-T(-15)、axyR-ahp C间隔区(-10)C-T,利福平为rpo B531、526、516。结合MDR-TB耐药相关基因的特征分析,可以建立一种快速、准确、特异的适合于我省的检测结核菌耐多药性的新方法。     

Assessment of quality of life of parents of children with juvenile chronic arthritis

The aim of the study was to assess the quality of life (QOL) and the psychological status of parents of children with juvenile chronic arthritis (JCA). The QOL, anxiety and depression of the parents of 28 children with JCA were evaluated and compared to those of the parents of 28 healthy children. Mothers of JCA children and mothers of healthy children reported similar QOL. The reported anxiety and depression levels were similar for mothers and fathers in both groups. The parents of children with pauciarticular-type JCA reported lower QOL and higher levels of anxiety and depression than the parents of children with other types, namely polyarticular and systemic JCA. These findings may be explained by the fact that the pauciarticular patients had shorter disease duration and were less frequently seen in the outpatient clinic. The QOL of mothers of children with JCA was found to be slightly impaired in the group of children with pauciarticular JCA. Future larger studies are needed to confirm these results, as the number of subjects in the three groups was rather low. Received: 26 September 2001 / Accepted: 8 February 2002     

氯硝柳胺悬浮剂的毒性评价

目的评价氯硝柳胺悬浮剂的毒性，为现场大规模应用灭螺提供依据。方法按照中华人民共和国国家标准GB 15670-1995《农药登记毒理学试验方法》和鱼类毒性试验方法进行。结果经口、经皮肤的LDso雌、雄性大鼠均>5 000 mg/kg，经呼吸道的LCso雌、雄性大鼠均>5 000mg/m3，该药经口、经皮肤、经呼吸道毒性均属微毒类药物；兔眼用药后，观察期内无不良反应，对眼无刺激性；皮肤用药后对皮肤无刺激性。与氯硝柳胺原药、氯硝柳胺乙醇胺盐原药和氯硝柳胺乙醇胺盐可湿性粉剂相比，氯硝柳胺悬浮剂对鱼急性毒性最低。结论氯硝柳胺悬浮剂属微毒类药物，对鱼的毒性低于其乙醇胺盐可湿性粉剂，适合于现场应用。     

Numerical Simulation of the Effect of Rate of Change of Glucose on Measurement Error of Continuous Glucose Monitors

Background

A 5-day in-patient study designed to assess the accuracy of the FreeStyle Navigator® Continuous Glucose Monitoring System revealed that the level of accuracy of the continuous sensor measurements was dependent on the rate of glucose change. When the absolute rate of change was less than 1 mg•dl⁻¹•min⁻¹ (75% of the time), the median absolute relative difference (ARD) was 8.5%, with 85% of all points falling within the A zone of the Clarke error grid. When the absolute rate of change was greater than 2 mg•dl⁻¹•min⁻¹ (8% of the time), the median ARD was 17.5%, with 59% of all points falling within the Clarke A zone.

Method

Numerical simulations were performed to investigate effects of the rate of change of glucose on sensor measurement error. This approach enabled physiologically relevant distributions of glucose values to be reordered to explore the effect of different glucose rate-of-change distributions on apparent sensor accuracy.

Results

The physiological lag between blood and interstitial fluid glucose levels is sufficient to account for the observed difference in sensor accuracy between periods of stable glucose and periods of rapidly changing glucose.

Conclusions

The role of physiological lag on the apparent decrease in sensor accuracy at high glucose rates of change has implications for clinical study design, regulatory review of continuous glucose sensors, and development of performance standards for this new technology. This work demonstrates the difficulty in comparing accuracy measures between different clinical studies and highlights the need for studies to include both relevant glucose distributions and relevant glucose rate-of-change distributions.     

治疗高血压药物的经济学评价

重视高血压治疗中的经济学评价,对利用我国有限的卫生资源来遏制高血压对人民群众的危害有着重要的现实意义。药物经济学对于药物治疗的成本和治疗的结果给予同样的关注。因为治疗高血压的费用,不仅涉及药物价格,还包括患者的危险水平,降压疗效和对临床终点事件的影响,以及治疗的依从性和安全性。因此药物经济学更强调整体成本和价-效比。低危病人,若非药价低廉,治疗的价-效比不够理想。而在高危的患者,价-效比越小越经济而不是药费越便宜越好。