益气活血解毒法对溃疡性结肠炎复发患者血浆血栓烷B2和6-酮-前列腺素F1α水平及比值的影响

[目的]探讨益气活血解毒法对溃疡性结肠炎(UC)复发患者血浆血栓烷B2(TXB2)和6-酮-前列腺素F1α(6-Keto-PGF1α)水平及TXB2/6-Keto-PGF1α比值的影响.[方法]90例UC复发患者随机分为2组,各45例,治疗组给予益气活血解毒立法的中药汤剂,对照组给予柳氮磺吡啶(SASP)治疗,治疗前后分别检测血浆TXB2、6-Keto-PGF1α水平.[结果]治疗前UC患者血浆TXB2、6-Keto-PGF1α水平及TXB2/6一Keto-PGF1α比值均高于正常人(P<0.01);复发者血浆TXB2、6-Keto-PGF1α水平及TXB2/6-Keto-PGF1α比值均高于未复发者(P<0.01,<0.05).治疗组治疗后、随访时血浆TXB2、6-Keto-PGF1α水平及TXB2/6一Keto-PGF1α比值均低于对照组(P<0.01,<0.05).[结论]以益气活血解毒立法的中药对UC复发治疗,与SASP比较,可有效降低血浆TXB2、6-Keto-4-PGF1α水平及TXB2/6-Keto-PGF1α比值,从而阻抑血小板活化,可能是抗UC复发作用机制之一.     

胃炎饮对实验性胆汁反流性胃炎大鼠血浆6-酮-前列腺素F1α和血栓素B2的影响

[目的]探讨胃炎饮对实验性胆汁反流性胃炎大鼠血浆6-酮-前列腺素F1α（6-Keto-PGF1α）和血栓素B2（TXB2）水平的影响。[方法]采用自制反流液灌胃建立实验性胆汁反流性胃炎大鼠模型,以多潘立酮为对照,观察胃炎饮对大鼠胃黏膜病理组织学和血浆6-Keto-PGF1α。TXB2水平的影响。[结果]模型组大鼠胃黏膜出现明显破损、脱落,黏膜下可见大量炎细胞浸润,大部分大鼠胃黏膜可见不典型增生和肠上皮化生,同时血浆6-Keto-PGF1α水平明显下降,TXB2水平明显上升（P〈0．01）;与模型组比较,各治疗组均可明显改善大鼠胃黏膜病理组织学变化,升高6-Keto-PGF1α水平,降低TXB2水平（P〈0．01,〈0．05）。[结论]胃炎饮可调节血浆6-Keto-PGF1α和TXB2水平,提高胃黏膜血流量,加强胃黏膜的黏液-碳酸氢盐屏障,减轻反流液对胃黏膜的损伤。     

乌梅丸对溃疡性结肠炎大鼠结肠组织黏附分子-44的影响

[目的]探讨乌梅丸对大鼠溃疡性结肠炎(UC)结肠组织黏附分子-44(CD44)表达的影响.[方法]采用2,4-二硝基氯苯(DNCB)加醋酸复合法制备大鼠UC模型.84只SD大鼠随机分为正常对照组、模型组、柳氮磺胺吡啶(SASP)组和乌梅丸大、中、小剂量组6组.采用免疫组织化学染色法检测结肠组织CD44的表达.[结果]与正常组相比,模型组大鼠结肠组织中CD44的表达显著增高(P＜0.01),而乌梅丸各剂量组、SASP组则较模型组明显降低(P＜0.01).[结论]CD44参与了UC的发生、发展.乌梅丸可能是通过抑制CD44的表达,达到治疗UC的作用.     

理肠汤灌胃结合溃疡灵灌肠治疗大鼠溃疡性结肠炎实验研究

[目的]观察理肠汤灌胃结合溃疡灵灌肠治疗大鼠实验性溃疡性结肠炎(UC)的疗效。[方法]将动物随机分为正常对照(正常)组、模型组、中药治疗小剂量(小剂量)组、中药治疗大剂量(大剂量)组、柳氮磺吡啶(SASP)组。其中除正常组外,其余4组均采用2,4,6-三硝基苯磺酸(TNBS)溶液制作大鼠模型,成功后大、小剂量组分别予大、小剂量理肠汤灌胃及溃疡灵灌肠;SASP组予SASP溶液灌胃,各组灌药时间均为14 d。[结果]大剂量组肠黏膜组织学损伤评分显著低于模型组(P0.01);小剂量组、SASP组肠黏膜组织学损伤评分亦低于模型组(P0.05),但小剂量组和SASP组疗效相近(P0.05)。[结论]理肠汤灌胃结合溃疡灵灌肠治疗大鼠实验性UC有明显疗效。     

乌梅丸对溃疡性结肠炎大鼠结肠组织白细胞介素8及13含量的影响

[目的]观察乌梅丸对溃疡性结肠炎大鼠结肠组织白细胞介素(IL)-8、IL-13的影响.[方法]84只SD大鼠随机分为正常对照组,模型组,柳氮磺胺吡啶( SASP)组,乌梅丸大、中、小剂量组,每组14只;除正常组外,其他各组大鼠采用2.4-二硝基氯苯(DNCB)加醋酸复合法制备溃疡性结肠炎模型;采用双抗体夹心ELISA法检测各组大鼠结肠组织IL-8、IL-13的含量.[结果]模型组大鼠结肠组织中IL-8含量较正常组显著增高(P＜0.01),乌梅丸各剂量组、SASP组则较模型组明显降低(P＜0.01或P＜0.05);模型组大鼠结肠组织IL-13含量较正常组显著降低(P＜0.01),乌梅丸各剂量组、SASP组较模型组明显升高(P＜0.01或P＜0.05).乌梅丸大剂量组降低IL-8、升高IL-13的效果最显著,其IL-8、IL-13的含量与正常组比较差异无统计学意义.[结论]IL-8、IL-13参与了UC的发生、发展,乌梅丸能通过降低溃疡性结肠炎大鼠结肠组织IL-8的含量、升高IL-13的含量,从而起到治疗UC的作用.     

脑泰方提取物对局灶性脑缺血大鼠血浆TXB_2及6-Keto-PGF_(1α)含量的影响

目的探讨大鼠局灶性脑缺血后脑泰方对其血浆血栓素B2(TXB2)及6-酮-前列腺素F1α(6-Keto-PGF1α)含量的影响。方法线栓大鼠左侧大脑中动脉制作大鼠局灶性脑缺血模型,65只健康SD大鼠随机分为正常对照组、假手术组、模型组和脑泰方组。动态观察脑泰方治疗后1d、3d、5d和7d血浆TXB2和6-Keto-PGF1α含量的变化。结果模型组术后1d、5d、7d血浆TXB2含量和TXB2/6-Keto-PGF1α比值明显高于假手术组(P0.01),与模型组同时点比较,脑泰方组血浆TXB2含量和TXB2/6-Keto-PGF1α明显降低。结论脑泰方能通过降低血浆TXB2及TXB2/6-Keto-PGF1α,达到对局灶性脑缺血大鼠的神经保护作用。     

氢化可的松治疗急性胰腺炎肺损伤的实验研究

目的探讨氢化可的松对实验性急性坏死性胰腺炎(ANP)肺损伤的治疗作用及作用机制。方法54只健康SD大鼠随机分为3组:假手术(SO)组、ANP组及氢化可的松治疗。采用胰胆管逆行注射5%牛磺胆酸钠(1 ml/kg体重)诱导大鼠ANP模型。氢化可的松治疗组于型制作成功后10 min 给予舌下静脉注射氢化可的松(10 mg/kg体重)。各组于术后3 h、6 h和12 h分批处死动物,观察各组大鼠血浆淀粉酶、TNF-α、IL-6、血栓素B2(TXB2)、6酮前列腺素F1α(6-Keto-PGF1α)、TXB2/6-Keto-PGF1α比值、肺组织髓过氧化物酶(MPO)、肺湿干比值及胰腺、肺组织病理变化。结果ANP组血浆淀粉酶、TNF-α、IL-6、TXB2、TXB2/6-Keto-PGF1α比值、肺组织MPO均较SO组明显升高(P<0.05),6 h、12 h肺湿干比值较SO组明显升高(P<0.01);氢化可的松治疗组TNF-α、IL-6、TXB2、TXB2/6 Keto PGF1α比值、肺组织MPO均较ANP组显著降低(P<0.05),6 h、12 h肺湿干比值较ANP组明显降低(P<0.01), 肺组织病理损伤较ANP组明显减轻。结论氢化可的松可减少TXA-2、TNF-α、IL-6等炎症因子的产生而对ANP肺损伤具有重要的保护作用。     

氢化可的松治疗急性胰腺炎肺损伤的实验研究

目的探讨氢化可的松对实验性急性坏死性胰腺炎(ANP)肺损伤的治疗作用及作用机制.方法 54只健康SD大鼠随机分为3组:假手术(SO)组、ANP组及氢化可的松治疗.采用胰胆管逆行注射5%牛磺胆酸钠(1 ml/kg体重)诱导大鼠ANP模型.氢化可的松治疗组于型制作成功后10 min给予舌下静脉注射氢化可的松(10 mg/kg体重).各组于术后3 h、6 h和12 h分批处死动物,观察各组大鼠血浆淀粉酶、TNF-α、IL-6、血栓素B2(TXB2)、6酮前列腺素F1α(6-Keto-PGF1α)、TXB2/6-Keto-PGF1α比值、肺组织髓过氧化物酶(MPO)、肺湿干比值及胰腺、肺组织病理变化.结果 ANP组血浆淀粉酶、TNF-α、IL-6、TXB2、TXB2/6-Keto-PGF1α比值、肺组织MPO均较SO组明显升高(P < 0.05),6 h、12 h肺湿干比值较SO组明显升高(P < 0.01);氢化可的松治疗组TNF-α、IL-6、TXB2、TXB2/6 Keto PGF1α比值、肺组织MPO均较ANP组显著降低(P < 0.05),6 h、12 h肺湿干比值较ANP组明显降低(P < 0.01),肺组织病理损伤较ANP组明显减轻.结论氢化可的松可减少TXA-2、TNF-α、IL-6等炎症因子的产生而对ANP肺损伤具有重要的保护作用.     

益生菌对实验性结肠炎大鼠肠黏膜细胞因子及核因子-κB表达的影响

目的寻找双歧三联活菌治疗大鼠实验性结肠炎的最佳剂量,同时观察双歧三联活菌、柳氮磺胺吡啶(SASP)及两者联用的治疗效果。方法将42只SD大鼠均分为正常对照组、模型组、双歧三联活菌高剂量组(0.210×108CFU/d)、双歧三联活菌中剂量组(0.105×108 CFU/d)、双歧三联活菌低剂量组(0.053×108 CFU/d)、SASP组以及双歧三联活菌中剂量 SASP组。各实验性结肠炎组大鼠采用8%乙酸灌肠造模,各治疗组给予药物干预,并应用免疫组化技术检测大鼠结肠黏膜肿瘤坏死因子(TNF)-α、核因子(NF)-κB、白细胞介素(IL)-10、IL-1β的表达。结果①模型组大鼠结肠黏膜TNF-α、NF-κB、IL-1β表达增多、IL-10表达减少;②中剂量双歧三联活菌即为治疗大鼠实验性结肠炎的最佳剂量,但仅在一定程度上起到治疗大鼠实验性结肠炎的目的,其疗效与SASP相当;③双歧三联活菌联合SASP治疗效果最佳,与正常对照组比较差异无统计学意义(P>0.05)。结论双歧三联活菌可用于治疗大鼠实验性结肠炎,与SASP联用其治疗效果优于两者单独用药。     

柳氮磺吡啶联合白头翁汤灌肠治疗溃疡性结肠炎32例

[目的]观察柳氮磺毗啶(SASP)联合白头翁汤灌肠治疗溃疡性结肠炎(UC)的临床疗效.[方法]62例UC患者随机分为2组,对照组30例,单用SASP治疗,治疗组32例,采用SASP联合白头翁汤灌肠治疗,治疗9周后,2组均行结肠镜检查,观察比较疗效.[结果]治疗组总有效率为93.75%,对照组66.70%,2组比较差异有统讳学意义(P<0.05).[结论]SASP联合白头翁汤灌肠治疗UC比单用SASP更能控制急性发作,维持缓解,巩固和提高疗效的作用.     

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.     

Study of constancy of hydrogen-consuming flora of human colon

The constancy of the hydrogen consuming flora of the human colon was studied in 15 healthy subjects via two measurements obtained 18 to 36 months apart. Hydrogen disappearance rate and the major products of H₂-consuming bacteria, methane and sulfide, were measured during incubation of fecal homogenates with excess hydrogen and sulfate. In 11/15, the hydrogen consumption rate and the predominant hydrogen-consuming pathway (methanogenesis, sulfate reduction, or neither) remained constant. However, major shifts in these pathways were observed in four subjects, with two losing and two gaining the ability to produce methane. Methanogenesis was associated with the highest hydrogen consumption rate. This study demonstrates that clinically unrecognizable, major alterations of the colonic flora occur in healthy subjects. Understanding of the factors responsible for these alterations might allow for therapeutic manipulation of the colonic flora.Supported in part by the Department of Veterans Affairs and NIDDKD RO1 DK 13309-25.