艾灸足三里、梁门穴对应激性溃疡大鼠胃黏膜细胞凋亡的干预作用

目的:探讨艾灸足三里、梁门穴对应激性溃疡胃黏膜细胞凋亡的影响,分析其与血浆多巴胺(DA)、胃黏膜内皮素(ET)的关系,揭示艾灸足三里、梁门穴对抗应激性损伤,进而保护胃黏膜的机制.方法:SD大鼠60只随机分为4组,即束缚对照组、模型组、艾灸足三里和梁门穴组、艾灸非穴点对照组,每组15只.束缚水浸应激法造模,免疫组化方法测定细胞凋亡指数(×10-6个/μm2).采用生物信号分析仪检测胃黏膜血流量(GMBF),高效液相色谱法测定血浆DA含量,放射免疫法测定胃黏膜ET含量.结果:预先艾灸足三里、梁门穴可显著降低随后的应激性胃黏膜损伤指数,降低胃黏膜ET和血浆DA含量,增加胃黏膜血流量,降低胃黏膜细胞凋亡指数.造模后,B组UI值(26.80±9.81vs12.00±5.94,P<0.01)、血浆DA(9.97±3.69μg/Lvs4.54±2.61μg/L,P<0.01)、胃黏膜ET(361.469±98.080ng/Lvs149.205±94.1425ng/L,P<0.01)以及凋亡指数(9.65±4.19vs4.36±2.60,P<0.01)显著高于A组,而GMBF低于A组(139.489±33.133mL/minvs377.090±85.840mL/min,P<0.01);C组UI值、凋亡指数显著低于B组和D组(UI:14.10±5.42vs26.80±9.81,26.20±7.23,P<0.01;凋亡指数:3.00±1.58vs9.65±4.19,8.20±5.17,P<0.01),而GMBF高于B组和D组(316.552±85.469mL/minvs139.489±33.133,141.512±58.450mL/min,P<0.01);C组血浆DA含量及胃黏膜ET显著低于B组(DA:4.41±2.48μg/Lvs9.97±3.69μg/L,P<0.01;148.271±69.113ng/Lvs361.469±98.080ng/L,P<0.01),但与D组比较无显著性差异(P>0.05).结论:艾灸足三里、梁门穴预处理可减轻束缚水浸应激所造成大鼠胃黏膜的损伤程度,这一作用可能是通过降低血浆DA和胃黏膜ET含量,增加胃黏膜血流量,抑制细胞凋亡实现的.     

孤束核、脊髓损毁后艾灸预处理对急性胃黏膜损伤大鼠PGE2与EGF含量的影响

目的:损毁大鼠中枢神经通路中的孤束核和脊髓,观察艾灸预处理对胃黏膜内源性保护物质前列腺素E2(prostaglandin E2,PGE2)和表皮生长因子(epidermal growth factor,EGF)含量的影响,进而探讨艾灸启动内源性保护信息与中枢神经通路的关系.方法:50只SD大鼠随机分5组,即A:空白对照组;B:模型对照组;C:温和灸+模型组;D:温和灸+模型组+孤束核损毁组;E:温和灸+模型组+脊髓损毁组.预先按要求对D、E组大鼠分别实施孤束核、脊髓的损毁手术,再对相应组别进行艾灸处理,最后用无水酒精灌胃造成急性胃黏膜损伤模型.运用酶联免疫吸附法(enzyme linked immunosorbent assay,ELISA)法检测胃黏膜组织中PGE2和EGF的含量.结果:艾灸预处理有上调胃黏膜中PGE2、E G F含量的作用(338.82g/L±19.87g/Lvs279.52g/L±16.53g/L,P<0.01;4037.12g/L±300.20g/L vs2923.73g/L±251.23g/L,P<0.05),孤束核和脊髓被损毁的2组大鼠胃黏膜PGE2和EGF的含量明显低于神经通路未损伤的温和灸组(298.65g/L±12.89g/L,317.56g/L±16.60g/Lvs338.82g/L±19.87g/L;3176.21g/L±242.35g/L,3337.43g/L±249.86g/L vs4037.12g/L±300.20g/L,均P<0.01),且孤束核损毁的大鼠胃黏膜中PGE2的含量较脊髓损毁的低(P<0.05).结论:损毁大鼠中枢神经通路中的孤束核和脊髓对艾灸预处理提高胃黏膜组织中PGE2、EGF含量有影响,提示孤束核和脊髓均参与了艾灸保护胃黏膜信号的传导.其中,艾灸诱导胃黏膜PGE2的产生可能主要受控于孤束核,而其对胃黏膜EGF表达调控则与孤束核和脊髓均有关.     

艾灸足三里和梁门穴诱导热休克蛋白70抗大鼠胃黏膜氧化损伤作用

目的:观察艾灸足三里和梁门穴对应激性溃疡大鼠胃黏膜热休克蛋白70(HSP70)表达的影响,探讨艾灸足阳明经穴抗胃黏膜氧化损伤的作用机制.方法:将SD大鼠60只完全随机平均分为空白组、模型组、艾灸足三里等穴组和艾灸非穴对照点组,采用水浸-束缚应激法制备应激性溃疡模型.按Guth法计算胃黏膜损伤指数(UI),用激光多普勒血流仪测定胃黏膜血流量(GMBF),用免疫组织化学法和硫代巴比妥酸染色法对处理后大鼠检测其胃黏膜HSP70的表达和丙二醛(MDA)的含量.结果:与模型组和艾灸非穴组比较,艾灸足三里等穴可使应激性溃疡大鼠胃黏膜损伤指数明显下降(14.100±5.425vs26.800±9.807,26.200±7.729,P<0.01),HSP70表达上调(0.133±0.035vs0.077±0.057,0.059±0.038,P<0.01)、血流量增高(279.827±172.862mL/minvs139.489±33.133,141.512±58.450mL/min,P<0.05)、MDA含量减少(2.586±0.252μmol/Lvs3.906±0.768,3.464±1.502μmol/L,P<0.05).结论:艾灸足三里和梁门穴能诱导胃黏膜HSP70高表达并降低MDA含量,以达到其抗氧化损伤作用,并有相对的穴位特异性.     

幽门螺杆菌感染对血清及胃组织核组蛋白2/nesfatin-1表达的影响

目的:研究幽门螺杆菌(Helicobacter pylori,H.pylori)感染对人血清及胃组织核组蛋白2(nucleobindin 2,NUCB2)/nesfatin-1表达的影响.方法:收集行胃镜检查的83例无症状体检者的空腹血清及胃窦黏膜,经13C呼气试验、快速尿素酶实验及组织切片Warth-Starry银染色三者共同确认分为H.pylori阳性组与H.pylori阴性组,采用酶联免疫吸附法及实时荧光定量PCR法分别测定血清NUCB2/nesfatin-1蛋白浓度及胃黏膜NUCB2 m RNA的表达量.结果:血清NUCB2/nesfatin-1蛋白浓度在H.pylori阳性组与H.pylori阴性组无明显差异(2.267 ng/m L±0.201 ng/m L vs 2.298 ng/m L±0.275 ng/m L,P0.05);胃黏膜NUCB2 m RNA相对表达量在H.pylori阳性组明显高于H.pylori阴性组(1.336±0.324 vs 0.914±0.171,P0.01).结论:H.pylori感染可导致胃黏膜NUCB2m R N A表达上调,但不影响感染者血清NUCB2/nesfatin-1浓度.     

蛋白酶激活受体-2激动剂在应激性溃疡中的作用

目的:探讨大鼠蛋白酶激活受体-2在应激性溃疡中的作用.方法:建立大鼠水浸束缚应激模型,肉眼计算胃黏膜溃疡指数(UI);取动脉血和胃液做血气分析计算胃黏膜内pH值(pHi);应用分光光度计检测胃黏膜氨基己糖;采用放射免疫方法检测血浆中6-酮前列腺素F1α(6-K)和血栓素B2(TXB2);观察胃组织病理形态学变化.结果:PAR-2激动剂组pHi(4.71±0.23vs4.53±0.11,P<0.05)、氨基己糖(5.26±1.48g/kgvs1.19±0.58g/kg,P<0.05)、6-K(856.92±165.21ng/Lvs654.50±221.31ng/L,P<0.05)高于阴性对照组,TXB2(338.67±12.91ng/Lvs378.89±15.10ng/L,P<0.05)、UI(37.50±24.42vs69.00±33.27,P<0.05)低于阴性对照组.除6-K(856.92±165.21ng/Lvs687.60±219.50ng/L,P<0.05)外,PAR-2激动剂组与奥美拉唑组相比其他参数差异无统计学意义(P>0.05),并且两组病理形态学观察均表现为无明显血栓形成.结论:蛋白激酶受体-2激动剂通过促进胃黏液分泌、舒张血管起到保护胃黏膜的作用,其机制可能是激活辣椒素敏感性感觉神经元.     

血管紧张素Ⅱ拮抗剂在大鼠应激性溃疡中的作用

目的:探讨血管紧张素Ⅱ拮抗剂在大鼠应激性溃疡(SU)中的作用.方法:水浸束缚应激后,肉眼计算胃黏膜溃疡指数(UI);取动脉血和胃液做血气分析计算胃黏膜内pH值;采用放射免疫方法检测血栓素B2(TXB2)和6-酮前列腺素F1α(6-K);观察胃组织病理形态学变化.结果:管紧张素Ⅱ拮抗剂组与阴性对照组比较,pH值、6-K水平显著升高(4.82±0.31vs4.53±0.11,P=0.026;974.95±109.11ng/Lvs654.50±221.31ng/L,P<0.01),而TXB2,UI显著降低(48.53±8.26ng/Lvs98.18±39.24ng/L,P<0.01;36.13±6.49vs69.00±33.27,P<0.01).病理形态学观察,血栓形成减少.血管紧张素Ⅱ拮抗剂组与奥美拉唑组比较,除6-K(974.95±109.11ng/Lvs737.61±96.10ng/L,P<0.05)外,其他数据无统计学差异.结论:血管紧张素Ⅱ拮抗剂通过舒张血管,增加胃黏膜血流量起到保护胃黏膜的作用,其机制可能是减轻肾上腺髓质对应激的反应,抑制由应激引起的儿茶酚胺的合成和释放,促进前列腺素的分泌.     

牛磺酸对大鼠幽门结扎型胃溃疡的影响

目的:探讨牛磺酸对大鼠幽门结扎型胃溃疡的影响及其机制.方法:采用结扎大鼠幽门的方法建立大鼠胃溃疡模型.45只Wistar大鼠随机分为三组,即正常对照组、溃疡模型组和牛磺酸处理组.经6 h后各组大鼠处死,检测三组大鼠胃黏膜溃疡指数(UI)、胃液总酸度、胃蛋白酶活性和壁细胞H~ ,K~ -ATP酶活性.结果:与正常对照组相比,溃疡模型组大鼠UI值(35.3±3.7 vs,P<0.01)和胃液总酸度增大(28.56±3.81 mmol/L vs 20.34±4.40 mmol/L,P<0.01),同时胃液胃蛋白酶活性[7.58±1.58μg/(mL·min)vs 5.83±1.22μg/(mL·min),P<0.01]和壁细胞H~ ,K~ -ATP酶活性升高(8.86±1.50 U/mg vs 6.95±1.03 U/mg,P<0.01);而应用牛磺酸则减轻了大鼠应激性胃黏膜损伤,UI值(15.4±3.6 vs 35.3±3.7,P<0.01)和胃液总酸度减小(19.58±3.68 mmol/L vs 28.56±3.81 mmol/L,P<0.01),胃液胃蛋白酶活性[6.36±1.45μg/(mL·min)vs 7.58±1.58μg/(mL·min),P<0.05]和壁细胞H~ ,K~ -ATP酶活性(7.62±1.46 U/mg vs 8.86±1.50 U/mg,P<0.05)降低.结论:牛磺酸具有抗大鼠幽门结扎型胃溃疡的作用,其机制可能与抑制胃酸及胃蛋白酶分泌有关.     

人源乳酸杆菌对幽门螺杆菌诱导胃上皮细胞炎症反应的调节及可能通路

目的:探讨人源乳酸杆茵对H pylori诱导SGC7901细胞分泌IL-8及p38MAPK酸化水平的影响.方法:实验分为空白对照组、H pylori刺激组、SB203580干预 H pylori 刺激组和Lac15干预 H pylori刺激组.采用免疫细胞化学法观察该人源乳酸杆菌Lac15对H pylori致SGC7901 细胞p38MAPK磷酸化的影响.ELISA法观察该人源乳酸菌对H pylori致SGC7901细胞分泌IL-8的影响结果:H pylori能诱导细胞的p38MAPK磷酸化水平增高(L4:1.90±0.36 vs 14.01±1.12.P<0.01)以及IL-8分泌量明显增高(27.2616±0.27 ng/L vs 46.3691±0.33 ng/L,P<0.01).预先使用一定浓度(3.0×1011cfu/L,3.0×1010 cfu/L,3.0× 109cfu/L)的人源乳酸杆菌Lac15干预后,p38MAPK磷酸化水平明显降低(IA:4.61±1.13,6.11±0.19,8.25±0.56 vs14.01±1.12,均P<0.01),IL-8分泌量明显降低(42.3209±0.24 ng/L,42.1046±0.23 ng/L,43.4636±0.25 ng/L vs 46.3691±0.33 ng/L,均P<0.05或0.01),与 H pylori 刺激组比较,具有统计学意义.结论:p38MAPK磷酸化参与 H pylori诱导的SGC7901细胞分泌IL-8,人源乳酸杆菌三Lac15可能通过抑制p38MAPK磷酸化途径抑制IL-8的分泌,从而抑制炎症反应.     

经胃肠道给予氯化血红素对压力负荷性心衰大鼠氧化应激状态的影响

目的探讨经胃肠道给予氯化血红素后体内血红素氧合酶-1(HO-1)-CO-胆红素的反应和对大鼠慢性压力负荷性心力衰竭进程中氧化应激的影响。方法成年雄性SD大鼠63只,随机分为血红素组、心衰组和对照组,每组21只,各组再分为4、8、12周三个小组,每小组7只。心衰组、氯化血红素组行腹主动脉缩窄术,对照组行假手术。从术后3周开始血红素组以60mg/(kg·d)氯化血红素灌胃,对照组和心衰组同时间灌以同体积生理盐水。各小组在相应的时间点检测血清HO-1、碳氧血红蛋白(COHb)、丙二醛(MDA)、氧化低密度脂蛋白(ox-LDL)的含量,检测血清超氧化物歧化酶(SOD)的活性。结果 (1)氯化血红素组在给药后4、8、12周血清HO-1含量明显高于心衰组,分别是(6.80±0.92)μg/Lvs(2.5±0.22)μg/L;(10.70±0.69)μg/Lvs(4.50±0.28)μg/L;(13.30±0.99)μg/Lvs(6.07±0.71)μg/L(P0.01);COHb含量均明显高于心衰组,分别为(4.34±0.31)%vs(1.68±0.11)%;(6.32±0.44)%vs(2.46±0.20)%;(7.80±0.39)%vs(3.01±0.42)%(P0.01)。(2)氯化血红素组在给药4、8、12周血清MDA含量均低于心衰组,分别为(8.3±1.3)μmol/Lvs(14.2±2.3)μmol/L(P0.05);(9.6±0.5)μmol/Lvs(20.2±3.2)μmol/L(P0.01);(11.8±1.1)μmol/Lvs(26.1±3.7)μmol/L(P0.01);(3)氯化血红素组SOD活性在4、8、12周均高于心衰组,分别是(125±6)kU/Lvs(95±10)kU/L(P0.01);(109±9)kU/Lvs(67±5)kU/L(P0.01);(72±10)kU/Lvs(40±6)kU/L(P0.01)。(4)氯化血红素组ox-LDL含量在4、8、12周均低于心衰组,分别为(1.14±0.16)μmol/Lvs(1.80±0.22)μmol/L;(1.38±0.14)μmol/Lvs(2.34±0.25)μmol/L;(1.83±0.16)μmol/Lvs(3.17±0.31)μmol/L(均P0.01)。结论经胃肠道给予氯化血红素可以对体内的HO-1产生诱导作用;HO/CO-胆红素系统的诱导可改善压力负荷心衰大鼠的体内氧化/抗氧化失衡状态。     

体外循环对血管内皮细胞的急性损伤

目的观察体外循环（CPB）对全身血管内皮的急性损伤/活化。方法实验分组:Ⅰ组:60例先天性心脏病心内畸形矫治术患者;Ⅱ组:60例瓣膜病患者。于术中CPB前、CPB 30 min、CPB后0、4、24、48、72 h共7个时点采集静脉血,动态观察患者血浆中血栓调节蛋白（thrombomodulin,TM）、血管性假血友病因子（von Willebrand factor,vWF）、内皮素-1（endothelin-1,ET-1）和一氧化氮（nitric oxide,NO）的变化。结果与CPB前相比,Ⅰ、Ⅱ组患者TM、vWF在CPB 30 min显著升高,CPB结束时升至最高点[TM:（5.7±1.3）μg/Lvs（6.6±1.0）μg/L;vWF:（18±3）μkat/Lvs（23±4）μkat/L,均P<0.01],而后下降,但CPB后72 h仍未恢复到CPB前水平（P<0.05）。ET-1在整个过程中先降后升,与CPB前相比[Ⅰ组:（92±5）ng/L,Ⅱ组:（106±6）ng/L],CPB后4h降至最低[Ⅰ组:（70±5）ng/L,Ⅱ组:（78±3）ng/L,均P<0.01],而后逐渐上升,CPB后72 h明显高于CPB前[Ⅰ组:（101±7）ng/L,Ⅱ组:（122±7）ng/L,均P<0.01]。NO含量在CPB后4 h降至最低水平[Ⅰ组:（42±6）μmol/L,Ⅱ组:（43±5）μmol/L],CPB后72h NO含量[Ⅰ组:（58±6）μmol/L,Ⅱ组:（62±10）μmol/L]恢复至CPB前水平[Ⅰ组:（57±6）μmol/L,Ⅱ组:（63±7）μmol/L]。结论CPB可导致血管内皮细胞的广泛损伤/活化,这种损伤大约72h恢复。     

Helicobacter pylori eradication lowers serum homocysteine level in patients without gastric atrophy

AIM: To determine whether Helicobacter pylori (H pylori) infection caused hyperhomocysteinemia by altering serum vitamin B_(12), serum folate and erythrocyte folate levels and whether eradication of this organism decreased serum homocysteine level. METHODS: The study involved 73 dyspeptic H pylork positive patients, none of them had gastric mucosal atrophy based on rapid urease test and histology. Out of 73 patients, 41 (56.2%) showed a successful eradication of H pylori 4 wk after the end of treatment. In these 41 patients, fasting serum vitamin B_(12) folate and homocysteine levels, and erythrocyte folate levels before and 4 wk after H pylori eradication therapy were compared. RESULTS: The group with a successful eradication of H pylori had significantly higher serum vitamin B_(12) and erythrocyte folate levels in the post-treatment period compared to those in pre-treatment period (210±97 pg/mL vs 237±94 pg/mL,P＜0.001 and 442±212 ng/mL vs 539±304 ng/mL, P=0.024, respectively), but showed no significant change in serum folate levels (5.6±2.6 ng/mL vs 6.0+2.4 ng/mL, P=0.341). Also, the serum homocysteine levels in this group were significantly lower after therapy (13.1±5.2 μmol/L vs 11.9±6.2 μmol/L, P=0.002). Regression analysis showed that serum homocysteine level was positively correlated with age (P=0.01) and negatively with serum folate level before therapy (P=0.003). CONCLUSION: Eradication of H pylori decreases serum homocysteine even in patients who do not exhibit gastric mucosal atrophy. It appears that the level of homocysteine in serum is related to a complex interaction among serum vitamin B_(12), serum folate and erythrocyte folate levels.     

功能性消化不良患者中幽门螺杆菌感染与胃蛋白酶原水平相关性研究

目的 探讨在功能性消化不良（functional dyspepsia,FD）患者中,胃蛋白酶原（Pepsinogen,PG）水平与幽门螺杆菌（Helicobacter pylori,H.pylori）感染相关性.方法 某部新兵FD患者按H.pylori感染分成H.pylori阳性组与H.pylori阴性组,采用ELISA法对其血清PGⅠ、PGⅡ含量进行检测,血清H.pylori-IgG抗体采用定性分析法.结果 在FD患者中,H.pylori阳性组PGⅠ、PGⅡ、PGⅠ/ PGⅡ水平分别为（137.93±27.73） μg/L、（7.05±3.92） μg/L、24.69±15.5,H.pylori阴性组PGⅠ、PGⅡ、PGⅠ/ PGⅡ水平分别为（131.17±＋26.38） μg/L、（2.85±2.11） μg/L、64.0±76.44,两组相比差异均有统计学意义（tⅠ=2.714,tⅡ=17.432,tⅠ/Ⅱ=5.270,P均〈0.05）.结论 在功能性消化不良患者中,H.pylori感染可能会引起胃蛋白酶原PGⅠ、PGⅡ水平升高,以PGⅡ为主.     

Helicobacter pylori eradication lowers serum homocysteine level in patients without gastric atrophy

AIM: To determine whether Helicobacter pylori ( H pylori)infection caused hyperhomocysteinemia by altering serum vitamin B12, serum folate and erythrocyte folate levels and whether eradication of this organism decreased serum homocysteine level.METHODS: The study involved 73 dyspeptic H pylori-positive patients, none of them had gastric mucosal atrophy based on rapid urease test and histology. Out of 73 patients, 41 (56.2%) showed a successful eradication of Hpylori4 wk after the end of treatment. In these 41 patients, fasting serum vitamin B12, folate and homocysteine levels, and erythrocyte folate levels before and 4 wk after Hpylorieradication therapy were compared.RESULTS: The group with a successful eradication of Hpylori had significantly higher serum vitamin B12 and erythrocyte folate levels in the post-treatment period compared to those in pre-treatment period (210&#177;97 pg/mL vs237&#177;94pg/mL, P&lt;0.O01 and 442&#177;212 ng/mL vs 539&#177;304 ng/mL,P = 0.024, respectively), but showed no significant change in serum folate levels (5.6&#177;2.6 ng/mL vs 6.0&#177;2.4 ng/mL,P= 0.341). Also, the serum homocysteine levels in this group were significantly lower after therapy (13.1&#177;5.2 μmol/L vs 11.9&#177;6.2 μmol/L, P = 0.002). Regression analysis showed that serum homocysteine level was positively correlated with age (P = 0.01) and negatively with serum folate level before therapy (P = 0.003).CONCLUSION: Eradication of H pylori decreases serum homocysteine even in patients who do not exhibit gastric mucosal atrophy. It appears that the level of homocysteine in serum is related to a complex interaction among serum vitamin B12, serum folate and erythrocyte folate levels.     

黄芪、三七及其配伍对萎缩性胃炎大鼠血清PGE2、GAS、PGⅡ和EGF的影响

目的:阐明黄芪、三七及其配伍对萎缩性胃炎大鼠血清前列腺素E2(prostaglandin E2,P G E2)、胃泌素(gastrin,G A S)、胃蛋白酶原Ⅱ(pepsinogenⅡ,PGⅡ)、表皮生长因子(epidermal growth factor,EGF)的影响.方法:清洁级♂Wistar大鼠40只,随机分为空白组、假手术组、模型组、替普瑞酮组、黄芪组、三七组、黄芪+三七组.运用幽门弹簧法制备萎缩性胃炎模型,灌胃治疗1 mo,空白组、假手术组、模型组予生理盐水2 mL/d;黄芪组予黄芪水煎剂3.5 g/(kg d);三七组予三七粉冲剂0.7 g/(kg d);黄芪+三七组予黄芪三七溶液(黄芪3.5 g/(kg d),三七0.7 g/(kg d));替普瑞酮组予替普瑞酮200 mg/(kg d),治疗结束后,放射免疫法测定血清PGE2、GAS、EGF水平,ELISA法测定血清PGⅡ水平,HE染色观察胃黏膜病理改变.结果:血清EGF水平各组间无显著差异.与模型组比较,黄芪+三七组、三七组血清PGE2升高(41.511 ng/L±5.666 ng/L,42.033 ng/L±5.150 ng/L vs 30.896 ng/L±5.964 ng/L,P<0.0 1或P<0.0 5);黄芪组血清G A S升高(99.732 ng/L±16.123 ng/L vs 68.207 ng/L±5.866 n g/L,P<0.01),黄芪、三七组血清P GⅡ升高(9.275μg/L±0.506μg/L,9.268μg/L±0.931μg/L v s 7.026μg/L±0.638μg/L,P<0.01),黄芪组、三七组和黄芪+三七组胃黏膜体积构成比升高(P<0.01),与替普瑞酮比较,差异无统计学差异(P>0.05),三个治疗组间亦无统计学差异(P>0.05).结论:黄芪、三七及其配伍均可改善萎缩性胃炎大鼠胃黏膜萎缩,其治疗机制与升高血清PGE2、GAS、PGⅡ水平相关,但3种组合的治疗机制各有侧重.     

Serum ferritin and Helicobacter pylori infection in children: a sero-epidemiologic study in Korea

BACKGROUND: Helicobacter pylori infection is known to affect iron metabolism and serum ferritin levels, which are reduced in adults with H. pylori infection. The aim of the present study was to investigate the association between H. pylori infection and iron status in healthy Korean children. METHODS: The H. pylori seropositivity in 753 schoolchildren aged 6-12 years was screened for using an ELISA and confirmed by western blot analyses. Serum ferritin levels were measured using an immunoradiometric assay in 36 H. pylori-seropositive children and in 72 age- and gender-matched seronegative controls. RESULTS: The median serum ferritin levels were significantly lower in H. pylori-seropositive children than in seronegative controls (24 vs 39 ng/mL; P < 0.001). The prevalence of iron deficiency (ferritin < 15 ng/mL) in H. pylori-seropositive children was significantly higher (13.9%) than in seronegative children (2.8%). This association persisted after adjusting for age and their socioeconomic status (odds ratio, 5.6; 95% confidence interval, 1.0-30.6). CONCLUSION: Serum ferritin levels are reduced in children with H. pylori infection. The H. pylori infection may lead to iron deficiency in children.     

幽门螺杆菌感染在女性不孕症发病机制中的作用

背景：幽门螺杆菌（H.pylori）感染与多种胃肠道疾病、甲状腺炎、特发性血小板减少性紫癜、冠状动脉硬化性心脏病等疾病相关。H.pylori的鞭毛与精子鞭毛存在抗原同源性,其鞭毛抗体与精子存在交叉反应,从而可能影响女性的生殖功能。目的：探讨H.pylori感染对女性孕育功能的影响。方法：联合应用13C-尿素呼气试验（UBT）和血清H.pylori-IgG测定检测40例不孕症患者和50名正常生育者的H.pylori感染率;应用酶联免疫吸附测定（ELISA）检测不孕症患者卵泡液H.pylori-IgG阳性率以及血清、卵泡液、宫颈黏液抗精子抗体（AsAb）-IgG和AsAb-IgM阳性率。结果：不孕症组和对照组H.pylori感染阳性率分别为52.5%和30.0%,差异有统计学意义（P〈0.05）。不孕症组H.pylori感染和未感染者卵泡液H.pylori-IgG阳性率分别为90.5%和5.3%,差异有统计学意义（P〈0.01）。不孕症组H.pylori感染者血清、卵泡液、宫颈黏液AsAb-IgG、AsAb-IgM阳性率均显著高于未感染者（P〈0.05）。结论：H.pylori感染与女性不孕症之间存在相关性,可能是女性不孕症发生的危险因素之一。     

胱抑素C、嗜铬粒蛋白A在慢性心力衰竭中的作用及相关性

目的：通过检测慢性心力衰竭（CHF）患者血清胱抑素C（CysC）和嗜铬粒蛋白A（CgA）含量的变化,探讨两者之间的相关性及在CHF发生、发展中的作用。方法：选取我院心内科CHF住院患者48例,其中心功能Ⅱ级组15例、Ⅲ级组17例和Ⅳ级组16例。另选正常体检者20例作为正常对照组。观察各组血清CysC和CgA含量变化并进行相关性分析。结果：①与正常对照组比较,CHF患者中CysC[（664.85±14.42）μg/L∶（991.19±108.59）μg/L]和CgA[（67.55±5.987）ng/ml∶（317.79±160.028）ng/ml]水平明显升高（P均〈0.001）;且心功能Ⅳ级的高于Ⅲ级,Ⅲ级的高于Ⅱ级[CysC（1115.5±40.81）μg/L∶（990.12±32.65）μg/L∶（859.8±20.727）μg/L,CgA（522.13±65.958）ng/ml∶（276.88±2.205）ng/ml∶（146.2±3.144）ng/ml,P均〈0.001],②血清CysC和CgA呈正相关（r=0.931,P〈0.001）。结论：慢性心力衰竭患者血清胱抑素C和嗜铬粒蛋白A水平均显著升高,其水平随心功能NYHA分级的加重而升高,且二者呈正相关,可能共同参与了心衰的发生、发展。     

Systemic immune responses to oral administration of recombinant attenuated Salmonella typhimurium expressing Helicobacter pylori urease in mice

AIM: To evaluate whether attenuated Salmonella typhimurium producing Helicobacter pylori(H pylori) urease subunit B (UreB) could induce systemic immune responses against Hpylori infection. METHODS: Attenuated 5. typhimurium SL3261 was used as a live carrier of plasmid pTC01-UreB, which encodes recombinant H pylori UreB protein. Balb/c mice were given oral immunization with two doses of SL3261/pTC01-UreB at a 3-wk interval. Twelve weeks after oral immunization of mice, serum IgG antibodies were evaluated by ELISA assay. Gamma interferon (IFN-γ) and interleukin 10 (IL-10) in the supernatant of spleen cell culture were also assessed by ELISA. RESULTS: After oral immunization of mice, serum specific IgG antibodies against UreB in vaccine group were much higher than that in PBS and native Salmonella SL3261 control groups (A450, 0.373±0.100 vs 0.053±0.022, 0.142±0.039, respectively, P<0.01). Moreover, IFN-γ in vaccine group was on average 167.53±29.93 pg/mL, which showed a significant increase vs that of PBS control group (35.68±3.55 pg/mL, P<0.01). There was also a tremendous increase of IL-10 in vaccine group compared to PBS and SL3261 control groups (275.13±27.65 pg/mL vs 56.00±7.15 pg/mL, 68.02±15.03 pg/mL, respectively, P<0.01). In addition, no obvious side effects in mice and no change in gastric inflammation were observed. CONCLUSION: The multiple oral immunizations with the attenuated 5. typhimurium expressing Hpylori UreB could induce significant systemic immune responses, suggesting it may be used as oral vaccine against H pylori infection.     

心理应激与急性冠状动脉综合征

目的 分析心理应激与急性冠状动脉综合征(ACS)的关系,探讨心理应激是否为诱发ACS发生的危险因素.方法 100例经冠状动脉造影检查及临床表现确诊为冠心病的中青年男性患者,分为ACS组(67例)和稳定性心绞痛(SA)组(33例),进行社会心理应激调查,测定其血清白介素(IL)-6、可溶性细胞间黏附分子(sICAM)-1及C-反应蛋白(CRP)的水平,并对其结果进行对照性分析.结果 (1)心理应激组52例,ACS患者和SA患者分别占78.8%(41例)和21.2%(11例,P=0.009);ACS组有心理应激者明显高于SA组[61.2%(41/67)比33.3%(11/33),P=0.009].(2)心理应激组的血清CRP[(14.82±5.07)g/L比(8.78±4.34)g/L]、IL-6[(101.7±22.2)ng/L比(71.1±23.5)ng/L]及sICAM-1[1(1.41±0.47)mg/L比(0.82±0.37)mg/L]明显高于非心理应激组(均P＜0.01);ACS组血清CRP[(18.91±3.12)g/L比(6.20±2.46)g/L]、IL-6[(114.6±15.2)ng/L比(56.4±15.8)ng/L]及sICAM-1[(1.67±0.39)mg/L比(0.63±0.28)mg/L]水平明显高于SA组(P＜0.01).结论 心理应激可使体内炎症因子分泌增加,从而使动脉粥样硬化斑块由稳定变成不稳定,并通过炎症反应参与了ACS发生、发展.