老年原发性高血压患者尿液TxB_2、6－k－PGF_（1α）及血浆ET－1的临床意义

测定３２例老年原发性高血压患者、９例健康老年人及１０例健康青年人的尿液血栓素Ｂ２（ＴｘＢ２）、尿６－酮－前列腺素Ｆ１α（６－ｋ－ＰＧＦ１α）和血浆内皮素（ＥＴ－１）的浓度。结果表明，健康老年人较健康青年人尿中ＴｘＢ２有升高（ｔ＝４．０７，Ｐ＜０．００１），６－ｋ－ＰＧＦ１α降低（ｔ＝１２．２２，Ｐ＜０．００１），血ＥＴ－１差异无显著性（ｔ＝１．０３７，Ｐ＞０．０５）；而老年原发性高血压组较老年健康组尿液ＴｘＢ２和血浆ＥＴ－１升高，尿液６－ｋ－ＰＧＦ１α则降低，且随病情加重其间差异愈明显。这说明前列腺素和内皮素在高血压的发生、发展中均起重要调节作用。以尿液ＴｘＢ２、６－ｋ－ＰＧＦ１α及血浆ＥＴ－１值观察老年人原发性高血压的病情变化具有一定临床价值。     

老年原发性高血压患者尿液TxB2,6—k—PGF1α及血浆ET—1的…

测定３２例老年原发性高血压患者，９例健康老年人及１０例健康人的尿液血栓素Ｂ２（ＴｘＢ２）尿６－酮－前列腺素Ｆ１α（６－ｋ－ＰＧＦ１α）和血浆内皮素（ＥＴ－１）的浓度。结果表明，健康老年人较健康青年人尿中ＴｘＢ２有升高（ｔ＝４．０７，Ｐ＜０．００１），６－ｋ－ＰＧＦ１α降低（ｔ＝１２．２２，Ｐ＜０．００１），血ＥＴ－１差异无显著性（ｔ＝１．０３７，Ｐ＞０．０５）；而老年原发性高血压组较老年健康组尿液     

血管紧张素Ⅱ诱导肾小球系膜细胞纤维连接蛋白产生？…

目的：观察不同浓度的血管紧张素Ⅱ（ＡｎｇⅡ）刺激后系膜细胞ＡｎｇⅡ受体基因表达和分泌纤维连接蛋白（ＦＮ）的情况，方法：从６日龄人胎肾培养系膜细胞，经ＡｎｇⅡ刺激后用逆转录－聚合酶链反应（ＲＴ－ＰＣＲ）方法检测胎肾系膜细胞ＡＴ１和ＡＴ２受体ｍＲＮＡ的表达情况，分别用ＥＬＩＳＡ和ＲＴ－ＰＣＲ方法检测系膜细胞产生的ＦＮ和基因表达。结果：（１）经１０＾－８，１０＾－７，１０＾－６和１０＾－５ｍｏｌ／Ｌ的Ａ     

胰岛素抵抗状态下HepG2细胞纤维蛋白溶解酶原激活物抑？…

目的 观察胰岛素、胰岛素原对ＨｅｐＧ２细胞纤维蛋白溶解酶原激活物抑制物－１（ＰＡＩ－１）基因表达的影响。方法 将ＨｅｐＧ２细胞置于１０＾－７ｍｏｌ／Ｌ胰岛素培液中２４小时使胰素受体下调将ＨｅｐＧ２细胞导成为胰岛素抵抗的ＨｅｐＧ２细胞,然后分别用胰岛素、胰岛素原（１０＾－９ｍｏｌ／Ｌ）持续刺激ＨｅｐＧ２细胞２４小时,检测培养液中ＰＡＩ的活性、含量及胞浆中ＰＡＩ－１ｍＲＮＡ水平。结果（１）基因状态下胰     

血小板衍生生长因子和钙拮抗剂对大鼠肝细胞胶原合成及？…

目的：观察血小板衍生生长因子（Ｐｌａｔｅｌｅｔ－ｄｅｒｉｖｄｅｇｒｏｗｔｈｆａｃｔｏｒ，ＰＤＧＦ）和钙拮抗剂（Ｃａｌｃｉｕｍａｎｔａｇｏｎｉｓｔ，Ｇａ－Ａ）对原代培养大鼠肝细胞胶原合成及细胞内游离钙浓度（Ｃａ＾２＋）ｉ）的影响，方法：应用＾３Ｈ－脯氨酸掺入率和Ｆｕｒａ－２／ＡＭ荧光示踪法分别测定细胞内胶原含量及（Ｃａ＾２＋）结果：ＰＤＧＦ能促进细胞内胶原合成，提高肝内（Ｃａ＾２＋）ｉ且与浓度呈正相     

G—CSF配合大剂量CTX和VCR动员自体外周血干细胞的研究

本研究对１２例拟行ＡＰＢＳＣＴ的患者予ＶＣＲ１－２ｍｇ／ｍ２，体表面静注及ＣＴＸ７ｇ／＾２体表面积静滴，５－７天后予Ｇ－ＣＳＦ１００μｇ／ｍ＾２体表面积静注５－７天，白细胞升至３．０×１０＾９／Ｌ以上时，用ＣＳ３０００血细胞分离机单次收集单个核细胞ＭＮＣ〉２．８×１０＾８／ｋｇ，ＣＤ＾＋３４〉．６×１０＾６／ｋｇ，ＣＦＵ－ＧＭ〉３．９×１－０＾４／ｋｇ，ＡＰＢＳＣＴ后，全部患者于＋５天－＋１０天白     

实验性动脉粥样硬化兔血小板胞浆游离钙和钙泵的变化

实验观察了食饵性兔动脉粥样硬化形成过程中血小板胞浆游离钙［Ｃａ＾２＋］ｉ、血清钙、红细胞膜钙泵即Ｃａ＾２－Ｍｇ＾２＋－ＡＴＰａｓｅ的活性，主动脉收缩性的变化，与以照组比较结果表明：（１）高脂兔血小板［Ｃａ＾２＋］ｉ水平增高，红细胞膜Ｃａ＾２＋－Ｍｇ＾２＋－ＡＴＰａｓｅ活性及主动脉收缩性降低；（２）主动脉组织光镜可见高脂兔主动脉中层有大量钙沉积；（３）扫描电镜可见血小板粘附于内皮细胞表面。     

细胞外Ba^2＋对双基因内向整流钾通道的阻断作用

目的：研究Ｂａ＾２＋对非洲爪蟾卵母细胞表达的双基因内向整流钾通道（ＩＲＫ１－Ｔ）的阻断作用。方法：采用双微电极电压钳（ＴＥＶ）法。结果：细胞外Ｂａ＾２＋浓度分别为１，３，１０和１００μｍｏｌ／Ｌ，Ｋ＾＋浓度为９０ｍｍｏｌ／Ｌ，可见Ｂａ＾２＋的阻断作用对ＩＲＫ１－Ｔ的瞬间电流（施加电压后１ｍｓ）具有浓度依赖性、时间信赖３性和电压信赖性；快速开通道阻断剂Ｂａ＾２＋对ＩＲＫ１－Ｔ的通道开关特性几乎无影响作用，ＩＲＫ１－Ｔ对之不能透。三级指数拟合表明：细胞外Ｂａ＾２＋低浓度（１和３　ｍｏｌ／Ｌ）时，Ｂａ＾２＋与Ｋ＾＋相互竞争同一结合位点，随着Ｂａ＾２＋浓度的增加，时间常数不增加但拟合的权数却浓度依赖性增加，所以失活过程随Ｂａ＾２＋浓度的增加越来越快；细胞外Ｂａ＾２＋高浓度（１０和１００μｍｏｌ／Ｌ）时，时间常数随Ｂａ＾     

细胞因子与肝脏血吸虫虫卵肉芽肿免疫病理

本综述了血吸虫病病理过程中参与虫卵肉芽肿形成免疫调节的各种细胞因子，即ＣＤ４＾＋两个亚群Ｔｈ１释放出的ＩＬ－２和ＩＦＮ－Ｙ，ＴＨ２释放出的ＩＬ－４，ＩＬ－５和ＩＬ－１０，巨噬细胞释放的ＮＴＦＡ和ＩＬ－１以及其他有关因子各自的作用机制及其相互影响。     

白细胞介素—1β及其受体拮抗剂对系膜细胞增殖及产？…

目的：探讨白细胞介素１β（ＩＬ－１β）及其受体拮抗剂（ＩＬ－１ｒａ）对系膜细胞增殖及产生１ＮＯ的影响。方法 培养 的第１０￣１２代ＳＤ大鼠肾小球系膜细胞（ＧＭＣ）用于实验,分别加入ＩＬ－１β或ＩＬ－１β加ＩＬ－１ｒａ,１２ｈ后用化学方法测定培养上清中亚硝酸盐的含量,用＾３Ｈ－ＴＤＲ掺入率测定ＧＭＣ的增殖,狭缝和Ｎｏｒｔｈｅｒｎ杂交测定细胞ｉＮＳ ｍＲＮＡ表达。结果：ＩＬ－１β组ＧＭＣ出现ｉＮＯＳｍ     

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.     

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。     

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     

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。