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.     

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。     

益气化瘀利水方对骨关节炎兔前列腺素代谢的影响

目的观察益气化瘀利水方及复方消炎镇痛药氨糖美辛对实验性骨关节炎兔血浆和局部组织前列腺素代谢的影响。方法按Colombo法建立家兔膝骨关节炎模型,将20只新西兰大白兔随机分为正常组、模型组、西药组(氨糖美辛)和中药组(益气化瘀利水方)。抽取家兔血清及局部组织匀浆,采用放射免疫法测定血清及组织匀浆液内PGE2、6-Keto-PGF1α和TXB2含量。结果益气化瘀利水方和氨糖美辛对实验性骨关节炎家兔血清PGE2、6-Keto-PGF1α和TXB2含量无明显影响(P>0.05),益气化瘀利水方对局部组织PGE2、6-Keto-PGF1α和TXB2有明显抑制作用(P<0.05)。结论在骨关节炎的治疗中,益气化瘀利水方能抑制前列腺素等炎症介质;改善关节软骨的微循环,并可能调节缺血区的血管紧张度。     

银杏叶提取物对血栓闭塞性脉管炎患者TXB_2和6-Keto-PGF_(1α)含量的影响

目的 观察银杏叶提取物对血栓闭塞性脉管炎患者血栓素B2(TXB2)和6-酮-前列腺素(6-Keto-PGF1α)含量的影响.方法 126例血栓闭塞性脉管炎患者随机分为两组.治疗组64例,采用银杏叶提取物制剂金纳多注射液治疗;对照组62例,采用脉络宁注射液治疗,2个月后观察患者治疗前后血清TXB2和6-Keto-PGF1α的变化,并判断疗效.结果两组治疗后血清6-酮-前列腺素1α含量较治疗前显著升高,TXB2含量均较治疗前显著降低(P＜0.05或P＜0.01);与对照组治疗后比较,治疗组治疗后血清TXB2和6-Keto-PGF1α含量均有统计学意义(P<0.05).治疗组临床总有效率为93.8%,对照组为77.4%,两组比较有统计学意义(P<0.05).结论 银杏叶提取物可显著升高患者6-Keto-PGF1α含量,降低TXB2含量,抑制血栓形成,疗效优于脉络宁注射液.     

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。     

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。     

丹龙醒脑片对拟血管性痴呆大鼠脑组织AchE、ATP酶活性的影响

目的 :研究丹龙醒脑片(DLXNP)对拟血管性痴呆 (vasculardementia ,VD)模型大鼠脑组织乙酰胆碱酯酶 (AchE)、三磷酸腺苷酶 (AT Pase)活性的影响。方法 :用双侧颈总动脉反复夹闭再灌注同时腹腔注射硝普钠方法建立拟VD大鼠模型 ,取脑组织测AchE、ATPase的活性。结果 :造模后模型组脑组织内Na+ -K+ -ATPase、Ca2 + -Mg2 + -ATPase活性明显降低 (P <0 .0 1) ,AchE活性明显升高 (P <0 .0 1)。与模型组相比 ,小剂量丹龙醒脑片组AchE活性明显降低 (P <0 .0 1) ,Ca2 + -Mg2 + -ATPase活性明显升高 (P <0 .0 5 ) ,丹龙醒脑片大、中剂量组Na+ -K+ -ATPase、Ca2 + -Mg2 + -ATPase活性显著升高(P <0 .0 1～P <0 .0 5 ) ,AchE活性明显降低 (P <0 .0 1)。结论 :丹龙醒脑片能改善脑缺血再灌注后诱导的拟VD大鼠脑组织的能量代谢障碍 ,防止ATPase活性降低 ,并可维持乙酰胆碱 (Ach)的正常水平 ,这些作用可能与其抗血管性痴呆有关。     

针刺对中风先兆证的干预机制探讨

目的探讨针剌对中风先兆证治疗的机制.方法对30例中风先兆病人(治疗组)针刺治疗后血浆TXB2、6-Keto-PGF1α含量进行检测,并与健康同龄人作对照(对照组).结果中风先兆证病人血TXB2含量明显升高,6-Keto-PGF1α含量明显下降,与对照组比较差异有显著意义(P＜0.01).提示中风先兆证病人的二者含量有改变,经针刺治疗后对此能做明显的调整,这种作用与临床疗效呈正相关.结论针刺能治疗中风先兆证,其机制可能与调整其血浆TXB2、6-Keto-PGF1α之间的平衡,改善脑血流量,提高脑代谢率有关.     

针刺风池穴对原发性高血压的临床疗效观察

目的观察针刺风池穴对原发性高血压(EH)的临床疗效及对血栓素B2(TXB2)、6-酮-前列腺素F1α(6-Keto-PGF1α)的影响。方法将60例EH病人随机分为治疗组和对照组,每组30例,分别采用针刺风池穴和口服美托洛尔(倍他乐克)治疗,观察治疗前后两组血压、血清TXB2及6-Keto-PGF1α的变化。结果治疗后治疗组血压明显下降,血清TXB2水平降低,而6-Keto-PGF1α浓度升高,与治疗前及对照组比较,差异均有统计学意义(P<0.05)。结论针刺风池穴降压效果明显,且对血清TXB2及6-Keto-PGF1α有一定的调节作用。     

骨盆骨折患者手术前后血浆ET、TXB2、6-Keto-PGF1α水平变化及意义

目的 观察骨盆骨折患者手术前后血浆内皮素(ET)、血栓素B2(TXB2)和6酮前列腺素F1α(6-Keto-PGF1α)的水平变化,并探讨其临床意义.方法 100例骨盆骨折患者分别于术前24 h及术后24、72 h留取血液样本,用ELISA法检测血浆中的ET、TXB2、6-Keto-PGF1α;记录患者术后深静脉血栓(DVT)发生情况,分析血浆ET、TXB2、6-Keto-PGF1α在预测DVT发生中的作用.结果 100例骨盆骨折患者术后15例并发DVT,其术后24、72 h血浆ET、TXB2、6-Keto-PGF1α水平均高于术前24 h(P均＜0.05);并发DVT者术后24、72 h血浆ET、TXB2、6-Keto-PGF1α水平高于未并发DVT者(P均＜0.05).结论 骨盆骨折术后并发DVT者血浆ET、TXB2、6-Keto-PGF1α水平升高,动态监测这些指标有助于预测术后并发DVT.     

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.     

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.     

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.     

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。     

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。     

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     

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.