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。     

丹龙醒脑片对脑血栓形成大鼠脑血管通透性及对花生四烯酸代谢的影响

目的探讨丹龙醒脑片(DLXNP)对实验性脑血栓形成大鼠保护作用及对花生四烯酸(AA)代谢的影响.方法用结扎颈外动脉同时颈内动脉注射复合血栓诱导剂的方法建立实验性脑血栓形成大鼠模型.用伊文思兰法检测脑血栓形成后伊文思兰的渗出量,用放免法(RIA)检测血浆血栓素B2(TXB2)、6-酮前列腺素F1α(6-Keto-PGF1α)含量.结果模型组与空白组相比,脑组织伊文思兰吸光度值(A620)、血浆TXB2、6-Keto-PGF1α含量明显升高(P<0.05或P＜0.01).与模型组相比,丹龙醒脑片大剂量组脑组织伊文思兰吸光度值A620、血浆6-Keto-PGF1α含量明显降低(P<0.05),丹龙醒脑片中剂量组脑组织伊文思兰吸光度值A620、血浆TXB2、6-Keto-PGF1α含量亦明显降低(P<0.05或P＜0.01).结论丹龙醒脑片对血栓诱导剂诱导的脑血栓形成具有抑制作用,可防止脑血栓形成后血脑脊液屏障通透性的增加.     

体外循环前后血小板功能变化的临床研究

分时段测定20例心脏直视手术患者体外循环(CPB)前后血小板计数、血浆α-颗粒膜蛋白(GMP-140)、血栓烷B2(TXB2)、6-酮-前列腺素F1α(6-K-PGF1α)变化值.结果血小板计数、GMP-140、TXB2测值随着CPB进行均逐渐增加,停机后1h与肝素化10min相比,GMP-140极显著增加(P＜0.01),TXB2显著增加(P＜0.05),血小板计数极明显降低(P＜0.001),而6-K-PGF1α在CPB前后变化不明显.认为体外循环中血小板功能受到明显损害,GMP-140和TXB2是从分子水平反映血小板功能损害的敏感指标.     

非瓣膜病心房颤动患者血小板活化状态的研究

目的了解非瓣膜病心房颤动(房颤)患者血小板的活化状态。方法观察92例非瓣膜病持续性房颤患者(房颤组)与60例窦性心律者(对照组)血小板功能状态的分子标记物水平,用酶联免疫吸附双抗体夹心法测定血浆血小板α颗粒膜糖蛋白-140(GMP-140)水平,用放射免疫分析法测定血栓素B2(TXB2)和6-酮-前列腺素F1α(6-k-PGF1α)水平。结果房颤组GMP-140和TXB2水平显著高于对照组,6-k-PGF1α水平显著低于对照组,TXB2/6-k-PGF1α比值也显著高于对照组。调整其他影响因素后,房颤组GMP-140和TXB2水平仍显著高于对照组,6-k-PGF1α水平仍显著低于对照组。GMP-140水平在合并糖尿病和合并高甘油三酯血症的房颤患者进一步升高。结论非瓣膜病房颤患者处于血小板激活状态。     

玉竹水提物对大鼠血栓形成的影响

目的探讨玉竹水提物抗血栓形成的作用及机制。方法利用大鼠动-静脉旁路血栓形成模型测定给予玉竹水提物后血栓湿重和干重,同时测定大鼠血浆血栓烷B2(TXB2)和6-酮-前列腺素F1α(6-keto-PGF1α)的含量。结果玉竹水提物可明显抑制大鼠动-静脉旁路血栓形成,减轻血栓湿重和干重,同时降低血浆中TXB2的含量,增加血浆中6-keto-PGF1α的含量。结论玉竹水提物可明显抑制大鼠血栓形成,其机制可能与降低血浆中TXB2的含量和增加血浆中6-keto-PGF1α的含量有关。     

欣怡胶囊对血瘀证大鼠血液流变学及血小板功能的影响

目的探讨欣怡胶囊抗血栓形成及治疗冠心病的作用及机制。方法选用Wistar大鼠48只,随机分为空白组、阳性药组、模型组、欣怡胶囊治疗组(高、中、低剂量组)。每日灌胃2次,连续7d。末次给药后,除空白组外,均复制血瘀证模型。造模次晨,腹主动脉取血,检测血液流变学指标及血浆血小板α颗粒膜蛋白-140、(GMP-140)、血栓烷B2(TXB2)和6-酮-前列腺素(6-keto-PGF1α)。结果欣怡胶囊能显著改善血瘀证大鼠血液流变学各项指标,降低血浆GMP-140及TXB2,升高6-keto-PGF1α。结论欣怡胶囊治疗冠心病的机制,可能与其改善血液流变性,降低血液黏度,提高红细胞变形能力,增加冠状动脉流量;抑制血小板聚集、活化,增加纤溶活性,促进纤维蛋白溶解,抗血栓形成,改善冠状动脉供血有关。     

蒺藜果总皂苷对实验性脑缺血作用的研究

目的 (1)研究蒺藜果总皂苷对实验性脑缺血大脑血流量、脑血管阻力的作用，(2)研究蒺藜果总皂苷对实验性脑缺血大鼠血浆内皮素含量、脑梗死面积的作用。方法 (1)采用结扎家犬一例颈外动脉及推动脉的方法，制备脑缺血模型。给予蒺藜果总皂苷15mmg/kg、30mg/kg，观察药物对血压、心率、脑血流量和脑血管阻力的影响。(2)通过结扎大鼠大脑中动脉，建立脑缺血模型。给予蒺藜果总皂苷25mg/kg、50mg/kg、100mg/kg，观察药物对大鼠内皮素含量、脑梗死面积的影响。结果 蒺藜果总皂苷能减慢心率，降低血压，增加脑血流量，降低脑血管阻力，降低内皮素含量，减少脑梗死面积。结论 蒺藜果总皂苷能够改善脑血液循环，对实验性脑缺血动物模型有明显的治疗作用。     

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.     

中医“热毒血瘀证”模型大鼠血管内皮损伤及血小板功能障碍研究

目的 研究具有中医"热毒血瘀证"表征的大鼠血管内皮细胞(VEC)损伤和血小板功能的病理变化,以阐释中医"热毒血瘀证"的现代生物医学基础.方法 大鼠腹腔注射内毒素即脂多糖(LPS),连续8周,在不同时间点进行行为学分析、检测舌血氧饱和度基础上,检测血浆内皮素(ET)、热休克蛋白-70(HSP70)、血栓烷B2(TXB2)和6-酮-前列腺素(6-Keto-PGF1α)的变化.结果 注射毒素后大鼠活动减少,舌血氧饱和度降低.早期血浆ET、HSP70和TXB2 /6-Keto-PGF1α增高,晚期TXB2/6-Keto-PGF1α降低.结论 具有舌体组织血氧饱和度下降的中医"热毒血瘀证"存在血管内皮细胞损伤及血小板功能障碍,VEC损伤在中医"热毒血瘀证"发展过程可能起着重要作用.     

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.     

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.     

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。     

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。     

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     

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。     

南通市老年人生命质量影响因素的因子分析

目的 了解南通市老年人的生命质量及其影响因素.方法 2010年7月应用欧洲五维健康量表(EQ-5D)对南通市994例＞60岁的老年人进行问卷调查,探索性因子分析生命质量的影响因素.结果 英国权重计算城市老年人生命质量指数得分均数(0.590±0.092)高于农村老年人(0.560±0.115),农村老年人得分高于养老院老年人(0.447 ±0.154).社会经济因素、闲暇生活方式、慢性病、睡眠食欲、婚姻家庭和社会支持是影响老年人生命质量的主要因子.结论 政府应完善养老保险和医疗保险制度,加强老年人慢性病的健康管理,促进居家养老服务体系建设.     

胆囊腺肌增生症23例临床分析

目的探讨胆囊腺肌增生症的病因、诊断和治疗方法。方法在1046例胆囊切除术中,对病理检查确诊的23例胆囊腺肌增生症的临床资料进行回顾性分析,患者术前均行超声、CT或MRI检查。结果23例胆囊腺肌增生症临床表现与慢性胆囊炎胆石症类似。病变大体形态:局限型13例(均位于胆囊底部)、节段型7例和弥漫型3例。23例均行胆囊切除,合并胆囊结石6例,合并胆囊炎14例。结论胆囊腺肌增生症是一种好发于成年人的胆囊壁增生性病变,此病常与慢性胆囊炎、胆石症并存,临床诊断困难,确诊需依赖病理检查。联合超声、CT和MRI等影像学检查可提高术前诊断准确度。目前手术是治疗的最好方法。     

糖尿病肾病血液透析护理效果分析

目的探讨糖尿病肾病血液透析中不同护理模式的护理效果。方法选择该院2018年3月—2019年3月收治的糖尿病肾病患者72例。该次选取的病例均拟行血液透析治疗,按照随机数表将患者分为对照组(35例)和观察组(37例),其中对照组在患者血液透析期间行常规基础护理,观察组行优质护理干预,观察两种不同的护理模式对患者血液透析的影响。结果观察组患者因低血压等中断透析的发生率低于对照组,差异有统计学意义(P<0.05)。观察组透析期间并发症发生率低于对照组,差异有统计学意义(P<0.05)。观察组患者的生活质量SF-36评分均高于对照组患者,差异有统计学意义(P<0.05)。结论在糖尿病肾病患者透析期间行优质护理,有助于保障血液透析的顺利开展,同时降低各种并发症的风险,使得患者的生活质量有最基本的保障。     

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.