《中国实用内科杂志》稿约(2000-12-05修订)

1　要求稿件应具有科学性、实用性和先进性。稿件应主题明确、重点突出、资料确实、数据可靠、逻辑严谨、文理通顺。具有理论和实践的指导意义。2　稿件内容提倡少而精。稿件题名应简明、准确,一般以20字以内为宜。中文题名下应附英文题名。作者列于题名下,不同单位作者右上角以1,2等注明(不用半括号),作者单位、邮政编码在首页左下注明。摘要是对文章内容高度准确的概括,必须包括研究目的、方法、结果和结论,在200字以内。关键词每篇论著2～5个,每个关键词之间间隔1字距,不加标点符号。参考文献一般勿超过10条。论著与经验稿件(包括图、表…     

Enhanced plasma ghrelin levels in Helicobacter py/ori-colonized, interleukin-1-receptortype 1-homozygous knockout (IL-1R1-/-) mice

AIM: Ghrelin is an endogenous ligand for the growth hormone secretagogue receptor, and it plays a role in stimulating the growth hormone secretion, food intake, body weight gain and gastric motility. Eradication of Helicobacterpylori (H pylori) was shown to be associated with increase of the body weight. On the other hand, H pylori infection evokes the release of gastric IL-lp. The present study was designed to investigate the involvement of the gastric IL-1 signal in the ghrelin dynamics in Hpylori-colonized mice. METHODS: Twelve-week-old female IL-1-receptor type 1-homozygous-knockout mice (IL-1R1-/-') and their wild-type littermates (WT) were orally inoculated with H pylori (Hp group), while other cohorts received oral inoculation of culture medium (Cont group). Thirteen weeks after the inoculation, the mice were examined. The plasma and stomach ghrelin levels and the gastric preproghrelin mRNA were measured. RESULTS: Although the WT mice with H pylori infection showed a significantly decreased body weight as compared with that of the animals without H pylori infection, H pylori infection did not influence the body weight of the IL-1R1-knockout (IL-1R1-/-) mice. In the H pylori-infected IL-1R1-/-mice, the total and active ghrelin levels in the plasma were significantly increased, and the gastric ghrelin level was decreased. No significant differences were noted in the gastric preproghrelin mRNA expression. CONCLUSION: Ghrelin secretion triggered by H pylori infection might be suppressed by IL-1β, the release of which is also induced by the infection, resulting in the body weight loss of mice with H pylori infection.     

Ang(1-7)通过调节Treg/Th17平衡参与保护NSAIDs相关小肠损伤

背景:非甾体抗炎药(NSAIDs)广泛应用于临床。随着内镜技术的进步,NSAIDs相关小肠损伤越来越多见,但目前尚无明确有效的防治措施。目的:探讨调节性T细胞(Treg细胞)与Th17细胞失衡在NSAIDs相关小肠损伤中的作用以及血管紧张素1-7 [Ang(1-7)]的保护效应。方法:30只雄性Sprague-Dawley大鼠随机分为对照组、模型组和Ang(1-7)治疗组,后两组使用双氯芬酸钠诱导小肠损伤模型。5 d后处死大鼠,取小肠黏膜观察大体和组织学损伤情况;以ELISA法和(或)免疫组化法检测Ang(1-7)以及促炎和抗炎细胞因子水平;流式细胞术分析Treg、Th17细胞占CD4~+ T细胞的比例。结果:模型组大鼠小肠黏膜广泛充血、水肿,散在多发糜烂、小溃疡。Ang(1-7)治疗组小肠损伤明显减轻,黏膜轻度充血、水肿,散在少量小糜烂灶。治疗组小肠组织Ang(1-7)、抗炎细胞因子水平、Treg细胞数量和Treg/Th17比值较模型组显著升高,抗炎细胞因子水平和Th17细胞数量较模型组显著降低(P均0.05)。Pearson相关系数分析显示,小肠黏膜Ang(1-7)含量与Treg/Th17比值呈显著正相关(r=0.847,P0.05)。结论:Treg/Th17失衡可能是NSAIDs相关小肠损伤的重要发病机制,而Ang(1-7)可能通过调节Treg/Th17平衡参与保护NSAIDs相关小肠损伤。     

GLP1-derived nonapeptide GLP1(28-36)amide protects pancreatic β-cells from glucolipotoxicity

Type 2 diabetes, often associated with obesity, results from a deficiency of insulin production and action manifested in increased blood levels of glucose and lipids that further promote insulin resistance and impair insulin secretion. Glucolipotoxicity caused by elevated plasma glucose and lipid levels is a major cause of impaired glucose-stimulated insulin secretion from pancreatic β-cells, due to increased oxidative stress, and insulin resistance. Glucagon-like peptide-1 (GLP1), an insulinotropic glucoincretin hormone, is known to promote β-cell survival via its actions on its G-protein-coupled receptor on β-cells. Here, we report that a nonapeptide, GLP1(28-36)amide, derived from the C-terminal domain of the insulinotropic GLP1, exerts cytoprotective actions on INS-1 β-cells and on dispersed human islet cells in vitro in conditions of glucolipotoxicity and increased oxidative stress independently of the GLP1 receptor. The nonapeptide appears to enter preferably stressed, glucolipotoxic cells compared with normal unstressed cells. It targets mitochondria and improves impaired mitochondrial membrane potential, increases cellular ATP levels, inhibits cytochrome c release, caspase activation, and apoptosis, and enhances the viability and survival of INS-1 β-cells. We propose that GLP1(28-36)amide might be useful in alleviating β-cell stress and might improve β-cell functions and survival.     

Profile of Th17 cytokines (IL-17, TGF-β, IL-6) and Th1 cytokine (IFN-γ) in patients with immune thrombocytopenic purpura

The data on polarization of the immune system towards T helper 1 (Th1) or T helper 2 (Th2) cells in immune thrombocytopenic purpura (ITP) are limited and contradictory. Th17 characterized by the production of Interleukin 17 (IL-17) has been shown to play a crucial part in the induction of autoimmune diseases. To further investigate the role of Th cytokines in the pathogenesis of ITP, we measured the plasma concentration of three Th17-associated cytokines [IL-17, transforming growth factor-ss (TGF-ss), IL-6] and Th1 cytokine interferon-gamma (IFN-gamma) in ITP patients, and evaluated their clinical relevance. The concentration of IL-17, TGF-ss, IL-6, and IFN-gamma in plasma specimens from 29 adults with chronic ITP and 38 controls was analyzed by enzyme-linked immunosorbent assay method. No significant differences of Th17 cytokines (IL-17, TGF-ss, and IL-6) and Th1 cytokine (IFN-gamma) concentration were observed between patients with active ITP and the control group. And the IFN-gamma/IL-17 ratio representing Th1/Th17 cytokine profile was not significantly different between ITP patients and control, either. However, significantly positive correlation between IL-6 and IFN-gamma in ITP patients was observed (r = 0.48, P = 0.01). Among the ITP patients, Plasma IL-17 levels in male were marginally higher than those in female, while similar for TGF-ss, IL-6 or IFN-gamma. There was a significantly positive correlation between age and IL-6 concentration in ITP patients (r = 0.56, P = 0.0002), while no statistical significance between age and the other three cytokines. No significant correlation between cytokine concentrations and platelets or megakaryocytes number was found in ITP patients. In summary, ITP may not be associated with changes of plasma Th17 and Th1 cytokine concentrations relative to control population.     

生活方式对ApoE~(-/-)和LDLR~(-/-)小鼠动脉粥样硬化的影响

<正>动脉粥样硬化(AS)是遗传和环境因素相互作用的慢性炎症性动脉血管疾病,是人类死亡的主要原因之一[1,2]。流行病学研究已经发现了许多AS的危险因素,比如年龄、性别、吸烟、肥胖、糖尿病、高血压、血脂异常、家族史、慢性炎症性疾病等,其中饮食、缺乏运动、睡眠等生活方式也是AS明显的危险因素[3,4]。     

酒精性肝病的随访(附28例11～17年随访)

目的观察ALD的远期预后。方法经统一发信及笔者前往一个专区用电话向患者单位及到生存者家中随访。结果仅获得有反馈信息者28例，占随访病例之20．6％，其中已死亡12人，占有信息病例之42．9％。仅2例再获14年后肝穿活检对比。按2006年2月中华医学会肝脏病学分会脂肪肝和酒精性肝病学组修订诊断标准。①轻症ALD41人获4人复信均健在。②酒精性脂肪肝（AFL）15例有1人复信，继续饮酒（精）100g／d，12年后两次脑出血，已偏瘫。③酒精性肝炎（AH）24例，获信息反馈7例，其中2例已死于肝硬化，另3例已肝硬化，此型最终多合并糖尿病。④45例酒精性肝纤维化（AF）有反馈信息者11例。其中7例已死亡。⑤酒精性肝硬化（AC）11例，有反馈信息者5例，其中3例已死亡。结论轻症ALD远期预后较好。AFL如不戒酒远期效果差，AH、AF预后不良凶险。ALD合并ABV／HCV感染者远期预后不佳，多发展为肝硬化，合并肝癌死亡。     

Células colaboradoras (TH1, TH2, TH17) y reguladoras (Treg,TH3, NKT) en la artritis reumatoide

The immune response foreign antigens require a perfect coordination of cells that participate in its different phases. The objective of the response is the rapid destruction of the microorganisms with a minimum repercussion on self-cells and tissues. The regulation of this process is carried out fundamentally by T lymphocytes. There are two main types of coordinator cells: helper cells, what organize the initial immune response, and regulatory cells, what avoid immune attack against self and once the infection is controlled, disassemble the response. There are three types of helper cells which coordinate answers to intracellular parasites (TH1), helmints (TH2) and extracellular bacteria and fungi (TH17). The hyperfunction of TH17 cells is associated with diseases as reumatoid arthritis, due to the hypersecretion of the proinflammatory citoquine IL17. The condition of helper or regulatory cell is the current object of review. TH1, TH2 and TH17 cells have helper and also regulatory functions.In addition, regulatory T cells play an important role in the coordination of the first moments of the response to viral infection in a direct and indirect way, inducing differentiation of TH17 cells.     

Dis Colon Rectum, Vol. 47, No. 12, December 2004, pp. 2032–2038 (DOI: 10.1007/s10350-004-0718-5)

PURPOSE Sexual dysfunction after total mesorectal excision may be caused by injury to the autonomic nerves. During surgery, nerve identification is not always achieved, and, to date, there has been no method to objectively confirm nerve preservation. The aim of this study was to assess the efficacy of a nerve-stimulating device (CaverMap?) to assist in the intraoperative identification of the autonomic nerves during total mesorectal excision, and objectively confirm nerve preservation after proctectomy is completed. PATIENTS AND METHODS Sexually active consecutive male patients undergoing total mesorectal excision were prospectively enrolled in this study. During pelvic dissection, the surgeon attempted to localize the hypogastric and cavernous nerves. Cavermap? was used to confirm these findings and to facilitate the identification in cases of uncertainty. At the completion of proctectomy, the nerves were restimulated to ensure preservation. Factors that could affect the surgeons ability to localize the nerves and Cavermap? to confirm this were evaluated. RESULTS Twenty-nine male patients with a median age of 58 years were enrolled in this study. An attempt to visualize the hypogastric nerves during dissection was made in 26 patients; the surgeon was able to identify the nerves in 19 (73 percent) patients. Cavermap? successfully identified the nerves in six of the seven remaining patients, and failed to identify them in only one case. An attempt to localize the cavernous nerves during dissection was made in 13 patients, of which localization was successful in 8 (61.5 percent) patients. Cavermap? improved the identification rate in four of the remaining five patients. After proctectomy, Cavermap? successfully confirmed the preservation of both hypogastric and cavernous nerves in 27 of 29 (93 percent) patients. A history of previous surgery statistically correlated with failure to identify the hypogastric nerves by the surgeon (P = 0.005). There were no adverse events related to use of the device. CONCLUSION Cavermap? may be a useful tool to facilitate identification of the pelvic autonomic nerves during total mesorectal excision and to objectively confirm nerve preservation. Due to an electronic error in production, nine paragraphs of the Patients and Methods and Results section were omitted from the print and pdf versions of the article “The Efficacy of a Nerve Stimulator (Cavermap?) to Enhance Autonomic Nerve Identification and Confirm Nerve Preservation During Total Mesorectal Excision” by Giovanna M. da Silva, M.D., Oded Zmora, M.D., Lars B?rjesson, M.D., Nelly Mizhari, M.D., Norma Daniel, R.N., Farah Khandwala, M.S., Jonathan Efron, M.D., Eric G. Weiss, M.D., Juan J. Nogueras, M.D., Anthony M. Vernava III, M.D., Steven D. Wexner, M.D., published in the December 2004 issue of Diseases of the Colon & Rectum (Vol. 47, No. 12, pp 2032–2038, DOI ). The HTML version is correct. Below, the entire article is printed in its entirety with the omitted paragraphs in bold format. Springer regrets the error. Poster presentation at the meeting of The American Society of Colon and Rectal Surgeons, June 3 to 8, 2002, Chicago, Illinois. Poster presentation at the meeting of the Association of Coloproctology of Great Britain and Ireland, July 2 to 5, 2002, Manchester, United Kingdom. Podium presentation at the Tripartite Colorectal meeting, October 27 to 30, 2002, Melbourne, Australia.     

Correlation between IL-17A/F,IL-23, IL-35 and IL-12/-23 (p40) levels in peripheral blood lymphocyte cultures and disease activity in Behcet’s patients

Clinical Rheumatology - Behcet’s disease is a chronic multisystemic disease with remissions and relapses. Several studies have shown that immune mechanisms play an important role in the...     

维生素B_(12)致过敏性休克1例报告

维生素B_(12)是组织代谢及形成正常红细胞、消化道上皮细胞和神经髓鞘所必需的物质,临床常用。但肌注维生素B_(12)致过敏性休克者未见有报道,笔者遇1例。现报告如下。 患者男,40岁,因肋间神经痛于2002年8月23日收住院。入院后肌注维生素B_(12)250μg,约30分钟后患者自觉头晕、恶心、胸闷、憋气、双眼发黑、视力模糊不清,随后四肢软弱无力,出冷汗,倒地。检查:患者面色灰白、呆滞,口唇发绀,全身     

血管紧张素-(1-7)研究进展

血管紧张素-(1-7)是肾素-血管紧张素系统中具有重要生物学作用的终末活性产物,可通过与其特异性受体结合而发挥改善心功能、降低血压、抑制细胞增殖、抗血栓、调节水电解质平衡等作用。现就血管紧张素-(1-7)的生成、生物学作用及其作用的受体作一综述。     

Three novel CYP17A1 gene mutations (A82D, R125X, and C442R) found in combined 17α-hydroxylase/17,20-lyase deficiency

The aim of this study was to analyze the structure and functional consequences of 3 novel mutations (A82D, R125X, and C442R) of the CYP17A1 gene found in 2 patients with combined 17α-hydroxylase/17,20-lyase deficiency (17OHD). Two Chinese 46, XY female patients were diagnosed with 17OHD based on clinical findings and biochemical results. The CYP17A1 gene was analyzed by polymerase chain reaction direct sequencing. An in vitro expression system was performed in HEK293 cells to analyze the mutant P450c17 activity compared with the wild type. Analysis of the CYP17A1 gene sequences in patient 1 showed compound heterozygous mutations A82D (g.417 C > A) in exon 1 and Y329fs (g.4869 T > A, 4871del) in exon 6; DNA sequencing analysis in patient 2 revealed compound heterozygous mutations R125X (g.2045 C > T) in exon 2 and C442R (g.6457 T > C) in exon 8. The mutations A82D, R125X, and C442R have not been reported previously. The functional study demonstrated that the A82D, R125X, and C442R mutations almost completely eliminate enzymatic activity. These results, which indicate that Ala 82 and Cys 442 are crucial for both 17-hydroxylase and 17,20-lyase activities, help define the structure-function relationship of the CYP17A1 gene. The novel mutations A82D, R125X, and C442R further clarify the patients' clinical manifestations of combined 17OHD.     

Distribution of Aedes albopictus (Skuse) in Nuevo León, México, 2001-2004

OBJECTIVE: To determine the distribution of Aedes albopictus (Skuse) in Nuevo Leon between 2001 and 2004. MATERIAL AND METHODS: Standardized methods were used to collect 6371 samples of mosquito's larvae from 167 sites. The proportions of samples positive for Ae. albopictus were obtained by municipality and year, using the software program Excel. RESULTS: There were 1179 samples positive for Ae. albopictus. This species was distributed over 10 municipalities, as follows: Five on the Gulf of Mexico Coastal Plains, which predominantly have a semi-warm, sub-humid climate, and precipitations almost year round (Allende, Montemorelos, Linares, General Teran, and Santiago); two (Sabinas Hidalgo, and Cadereyta) localized on the North American Great Plains, which have a warm, semiarid climate, and scarce precipitations. The final three were Apodaca, San Nicolas, and Escobedo distributed over the metropolitan area of Monterrey City. CONCLUSIONS: Up to January 2004, the second most important epidemiological vector in the transmission cycle of Ae. albopictus worldwide was found in ten municipalities of Nuevo Leon State, Mexico.