同型半胱氨酸对血管内皮细胞合成蛋白聚糖的影响

为探讨同型半胱氨酸对血管内皮细胞合成蛋白聚糖的影响，采用400umol／L同型半胱氨酸作用于培养的人脐静脉内皮细胞，以^35S-Na2SO4为示踪物标记细胞合成的蛋白聚糖，通过离子交换层析，凝胶过滤层析分离蛋白聚糖。结果发现，实验组培养液中总蛋白聚糖降低，硫酸乙酰肝素蛋白聚糖及硫酸软骨素-硫酸皮肤素蛋白聚糖含量也降低，但其百分含量未见改变。细胞层中蛋白聚糖未见明显变化。     

Ⅱ型糖尿病患者机体脂质过氧化及抗氧化能力研究

测定了Ⅱ型糖尿病患者及健康对照者红细胞超氧化物歧化酶、血中谷胱甘肽过氧化物酶、过氧化氢酶活力及丙二醛（ＭＤＡ）含量。结果：糖尿病患者病程从～１０年组ＳＯＤ活力开始下降，与对照组比较差异有高度显著性（Ｐ＜０．０１），与病程呈高度负相关。ＧＳＨ－Ｐｘ、ＭＤＡ与对照组比较差异均有高度显著性（Ｐ＜０．０１），并与病程呈高度正相关，ＣＡＴ仅１５年以上组与对照组比较差异有显著性（Ｐ＜０．０１），与病程相关不显著（Ｐ＞０．０５）。结果说明，Ⅱ型糖尿病患者脂质过氧化作用增强及抗氧化能力下降，对心血管系统造成氧化性损伤是心血管并发症的重要原因之一。     

慢性特发性血小板减少性紫癜患者PAIgG、ACAIgG的测定及意义

应用ELISA法对 41例慢性特发性血小板减少性紫癜 (ITP)患者和 2 5例健康对照者进行血浆和 (或 )血清血小板相关抗体 (PAIgG)、抗心磷脂抗体 (ACAIgG)测定 ,并常规血小板计数。发现ITP患者治疗有效组治疗后血小板计数明显升高、PAIgG含量显著降低 ,治疗前较治疗后及对照组均有显著性差异 (P <0 .0 1 ) ,且血小板计数与PAIgG之间呈显著性负相关 (r =- 0 .738,P <0 .0 0 1 )。而治疗无效组血小板计数、PAIgG均无明显变化。ACAIgG治疗前后无明显变化 ,且未发现与血小板及PAIgG相关。PAIgG、ACAIgG含量增高提示ITP患者针对血小板磷脂及其他糖类蛋白等不同抗原产生了自身免疫反应 ,为免疫抑制剂的应用提供了理论依据     

纤溶酶原对星形胶质细胞纤溶酶原激活因子及其抑制的调节作用

目的 探讨纤溶酶原（PGn)对大鼠脑星菜胶质细胞纤溶酶原激活因子（PAI）及其抑制剂(PA)的调节作用。方法 利用大鼠血纤溶酶原对体外培养的星形胶质细胞进行诱导刺激,采用酶谱分析法、反射酶谱分析法、免疫印迹法对所产生的PAs和PAIs进行分析测定。结果 实验所用PGn调uPA和PAI－1,下调tPA活性,并且诱导产生一个28kDa的低分子量的uPA活性分子。结论 在体外,纤溶酶原有调节星形胶质细胞的功能。     

奥替溴铵、匹维溴铵、马来酸曲美布汀和酪酸茵治疗肠易激综合征药物经济学研究

目的 初步探讨奥替溴铵（斯巴敏）、匹维溴铵（得舒特）、马来酸曲美布汀（舒丽启能）和酪酸菌（米雅BM）治疗肠易激综合征的药物经济学。方法 从中国生物医学文献数据库和学术期刊检索相关文献，选择符合标准（随机、双盲、安慰剂对照）的临床试验论文，提取临床试验数据，进行药物经济学评价。结果 服用斯巴敏40mg,tid,2wk药费71.16元；服用得舒特50mg,tid,2wk药费120.12元；服用舒丽启能200mg,tid,2wk药费110.46元；服用米雅BM80mg,tid,2wk药费282.24元。产生单位效果所需的成本分别为斯巴敏80.86；得舒特143.17；舒丽启能135.37；米雅BM351.04。以斯巴敏治疗成本最低。结论 斯巴敏是治疗肠易激综合征最优的选择。     

Advances in Retinal Tissue Engineering

Retinal degenerations cause permanent visual loss and affect millions world-wide. Current treatment strategies, such as gene therapy and anti-angiogenic drugs, merely delay disease progression. Research is underway which aims to regenerate the diseased retina by transplanting a variety of cell types, including embryonic stem cells, fetal cells, progenitor cells and induced pluripotent stem cells. Initial retinal transplantation studies injected stem and progenitor cells into the vitreous or subretinal space with the hope that these donor cells would migrate to the site of retinal degeneration, integrate within the host retina and restore functional vision. Despite promising outcomes, these studies showed that the bolus injection technique gave rise to poorly localized tissue grafts. Subsequently, retinal tissue engineers have drawn upon the success of bone, cartilage and vasculature tissue engineering by employing a polymeric tissue engineering approach. This review will describe the evolution of retinal tissue engineering to date, with particular emphasis on the types of polymers that have routinely been used in recent investigations. Further, this review will show that the field of retinal tissue engineering will require new types of materials and fabrication techniques that optimize the survival, differentiation and delivery of retinal transplant cells.     

LAK／IL－2不同给药途径对肝癌治疗效果的比较研究

应用ＬＡＫ／ＩＬ－２单独或与经肝动脉插管化疗药物灌注或栓塞治疗（ＴＡＣＥ）结合，分别通过肿瘤供血动脉、外周静脉或浆膜腔输注等多种途径，治疗肝癌１６例。Ｂ组、Ｃ组均为Ⅱ期与Ⅲ期病例，结合ＴＡＣＥ治疗有效率达６４．３％（９／１４）；而Ａ组２例Ｉ期小肝癌病例，单纯予以肝动脉插管输注ＬＡＫ／ＩＬ－２等治疗无效。提示这种过继免疫治疗不宜单独使用，而在ＴＡＣＥ术后患者免疫功能开始恢复阶段，作为综合治疗的一项措施是十分有益的。     

Regulation of Intracellular pH in Periportal and Perivenular Hepatocytes Isolated from Ethanol-Treated Rats

The aim of this study was to gain information on intracellular pH (pH_i) regulation in periportal (PP) and perivenular (PV) hepatocytes isolated from rats pair-fed liquid diets with either ethanol (T rats) or isocaloric carbohydrates (C rats). pH_i was analyzed by the pH-sensitive dye BCECF in perfused sub-confluent hepatocyte monolayers. Cells were acid-loaded by pulse exposure to NH₄Cl and were alkali-loaded by suddenly reducing external C0₂ and HC0₃^-(from 10% and 50 mm , respectively, to 5% and 25 mm ) at constant pH_out. In cells from C rats: (a) steady-state pH_i was higher in PP than in PV hepatocytes in the presence, but not in the absence, of bicarbonate; (b) pH_i recovery from an acid load was 35% higher in PP than in PV cells in the presence of HC0₃^-, whereas it was similar in HC0₃^--free experiments; and, on the contrary, (c) pH_i recovery from an alkaline load was 30% higher in PV than in PP cells. In cells from T rats: (a) steady-state pH_i was always lower than in cells isolated from pair-fed animals; (b) steady-state pH_i was similar in PP and PV hepatocytes either in the presence or absence of bicarbonate in the perfusate; (c) pH_i recovery from an acid load was not significantly different in PP and PV cells either in the presence of HC0₃^- or in HC0₃^--free experiments; and (d) pH_i recovery from an alkaline load was similar in PP and PV cells. Our data suggest that chronic ethanol treatment selectively modifies pH, by affecting the activity of ion transport mechanisms regulating pH_i in PP and PV hepatocytes isolated from rat liver.     

阻塞性睡眠呼吸暂停低通气综合征与颈围的相关性研究

目的　研究颈围与阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的相关性。方法　测量92 0例被临床怀疑为OSAHS患者的身体参数(包括颈围、身高和体重) ,并进行夜间睡眠监测。符合OSAHS诊断的有71 9例,为OSAHS组;2 0 1例不符合OSAHS ,为鼾症组,对其颈围、BMI和体重与睡眠呼吸紊乱指数(AHI)进行统计学分析。结果　OSAHS组患者的年龄明显大于鼾症组(P <0 .0 0 1 ) ;两组患者的颈围与BMI、体重均高度相关(P <0 .0 0 1 ) ;除中度OSHAS患者的AHI与体重、BMI和颈围有相关性外,其余OS HAS患者的颈围与AHI无相关关系(P >0 .0 5)。结论　颈围是反映肥胖程度的一项有效指标;颈围粗是OSAHS发病的相关因素;但使用颈围值预测OSAHS患者夜间睡眠呼吸紊乱的严重程度不具有临床意义。OSAHS的影响因素是多方面的,不同程度的OS AHS ,影响因素不同。     

膈肌功能测定及其在慢性阻塞性肺疾病中的应用

目的　比较最大跨膈压 (Pdimax)、最大口腔吸气压 (MIP)、最大吸鼻跨膈压 (Pdisniff)和颤搐性跨膈压(Pdi(t)ele)在评价膈肌功能中的差异及其在慢性阻塞性肺疾病 (COPD)中的应用。方法　对 13例正常者和 7例轻度与 7例重度COPD病人分别测定Pdimax、MIP、Pdisniff和Pdi(t)ele。结果　 (1)正常对照组的Pdimax、MIP、Pdisniff与轻度COPD组比较差异无显著性 ,与重度COPD组比较差异有显著性 (P 分别为 :<0 0 1、0 0 5和 0 0 5 ) ;而正常对照组Pdi(t)ele均比轻度和重度COPD组的高 (P均 <0 0 1)差异显著。 (2 )Pdi(t)ele的个体内变异性在正常对照组中均比Pdimax、MIP、Pdisniff小 (P分别为 :<0 0 1、0 0 1和 0 0 5 ) ;在COPD组中 ,明显比Pdimax小 (P <0 0 1) ,而与MIP和Pdisniff比较差异没有显著性。 (3)Pdi(t)ele与FEV1具有显著相关性 (P <0 0 5 )。结论　Pdi(t)ele能更客观、更敏感地反映膈肌功能。     

血清唾液酸,岩藻糖和急性期蛋白测定对消化道癌症的诊断意义

目的：研究消化道癌症患者血清唾液酸、岩藻糖和急性期蛋白浓度的变化，探讨其对消化道癌症的诊断意义。方法：研究病例包括５５例消化道癌症，对照组包括６１例消化道良性病患者和５８例健康献血员。血清唾液酸用改良Ａｍｉｎｏｆ法，血清岩藻糖用Ｔｓａｙ法测定，５种急性期蛋白用琼脂单向免疫扩散法测定。结果：消化道癌症组血清唾液酸、岩藻糖、α１酸性糖蛋白（α１ＡＧ）、α１抗胰蛋白酶（α１ＡＴ）和结合珠蛋白（ＨＰ）的浓度显著高于正常人组及消化道良性疾病组（Ｐ＜０．０１），并且血清唾液酸、岩藻糖浓度增高与急性期蛋白呈显著正相关（Ｐ＜０．０１）。而癌症组血清前白蛋白（ＰＡ）和转铁蛋白（ＴＦ）与对照组无显著性差异（Ｐ＞０．０５）。结论：研究提示可以将血清唾液酸、岩藻糖、α１ＡＧ、α１ＡＴ和ＨＰ作为消化道癌症的辅助诊断指标，联合检测上述生化指标，特别是检测血清唾液、岩藻糖和α１—ＡＧ可以提高检出的阳性率、减少误诊率     

十二指肠球部溃疡患者胃肠运动功能障碍的动力学研究

目的　观察Du患者胃肠运动功能障碍。方法　通过胃肠测压方法对Du患者进行MMC测定。结果　 49例Du患者11/4 9(2 2 4% )出现MMC3期 ;对照组则高达 14 /2 0 (70 % )出现完整MMC3期。对照组MMC3期波幅明显高于Du组 (P <0 0 1)。结论　Du组患者确实存在MMC异常 ,在其发病机理中有一定作用。     

Chemical dissolution of gallstones in Taiwan: An in vitro study

Abstract To evaluate the potential for the chemical dissolution of gallstones, 480 stones from 214 patients were studied. The stones were obtained via surgery or endoscopically. They were classified into cholesterol-rich mixed stones, brown pigment stones and black stones. The composition of bilirubin and cholesterol was determined by Fourier transformed infrared spectroscopy. Two per cent tetrasodium ethylenediamine acetate (EDTA), dimethylsulfoxide (DMSO) or methyl-tert-butyl-ethylene (MTBE) were used to dissolve the stones. To enhance solubility, surfactant polysorbate-20 was used to mix two of the individual three solvents. Methyl-tert-butyl-ethylene was found to have the best dissolution ability (by dry weight) 94, 13.4 and 20% for mixed, brown and black stones, respectively. Dimethylsulfoxide resulted in 13, 14 and 25% dissolution and EDTA 9.5, 13 and 16.5%. In contrast, pure water dissolved 4, 6 and 10.4% of the stones, respectively. A combination of the dissolution agents did not enhance the dissolution rate. In fact, the combination of solvents unexpectedly reduced the solubility of the stones: EDTA/MTBE was 17.5, 6.7 and 16.0%; DMSO/MTBE 43.2, 21.9 and 18.0%; DMSO/EDTA 9.1, 7.0 and 9.6%. In conclusion, cholesterol-rich mixed stones were able to be dissolved using MTBE but results of contact dissolution for gallstones are still far from satisfactory.     

Commonalities in vasoactive intestinal peptide and peptide N-terminal histidine C-terminal isoleucine stimulation of N-acetyltransferase activity in the rat pineal

Abstract: Exposure of adult rat pineal glands in organ culture to the polypeptides vasoactive intestinal polypeptide (VIP), and peptide N-terminal histidine C-terminal isoleucine (PHI) increases pineal serotonin N-acetyltransferase (NAT) activity and melatonin synthesis. The following research results are taken to indicate that VIP and PHI share common components of the NAT induction system: (1) The effects of the two peptides are additive at concentrations of 10 nM VIP and 100 nM PHI but not at higher peptide concentrations. (2) Pineals from newborns also respond to PHI with a dose dependent increase in NAT activity. NAT responses are additive at the same concentrations as seen with the adult pineals. (3) Light exposure affects the sensitivity of pineals to VIP and PHI stimulation in a similar manner; pineals taken after 3 hr of light are much less sensitive to PHI or VIP than those taken after 13 hr of light. (4) Pineals exposed for 48 hr to either PHI or VIP have a reduced NAT response to either agonist, which is reversible by culture in agonist-free media. (5) Neither VIP nor PHI stimulation of NAT activity is affected by concentrations of the VIP antagonists (N-Ac-Tyr¹, D-Phe²)-GRF(l-29)-NH2 (NAcTDGRF), L-8-K, VIP-Neurotensin Hybrid (VIPNET), or (4Cl-D-Phe⁶, Leu¹⁷)-VIP (4C1PLVIP), which affect VIP binding or function in other tissues.     

转铁蛋白SA阳离子脂质体的合成

目的　制备转铁蛋白ＳＡ 阳离子脂质体,并检测其特性。方法　以Ｎ－ 羟琥珀酰亚胺３（２吡啶二硫代） 丙酸脂ＳＰＤＰ 为交联剂,连接转铁蛋白与ＳＡ 阳离子脂质体,并用受体放射分析法检测转铁蛋白ＳＡ 阳离子脂质体上转铁蛋白的活性。结果　ＨＴｆ（Ｆｅ）２ 与ＳＡ 阳离子脂质体的交联率为７６－５ ％ 。转铁蛋白ＳＡ 阳离子脂质体具有较高的携带ＤＮＡ的能力;转铁蛋白被连接到ＳＡ 阳离子脂质体上后其活性无明显改变。结论　以Ｎ羟琥珀酰亚胺３（２吡啶二硫代） 丙酸脂ＳＰＤＰ 为交联剂制备转铁蛋白ＳＡ 阳离子脂质体是一种连接效率高,能较好的保持转铁蛋白活性的好方法     

Chronic hepatitis C: the virus, its discovery and the natural history of the disease

The identification of hepatitis A and hepatitis B led to the recognition that a third virus was capable of causing blood-borne hepatitis. The pathogen responsible for this nonA, nonB hepatitis was identified in the late 1980s and subsequently named hepatitis C. Since the discovery of hepatitis C there has been a pandemic of research publications describing the natural history of the infection and it is now known that this virus can cause serious liver damage in a proportion of infected patients. It is now clear that the effects of infection with hepatitis C and alcohol misuse are additive and that there is an increased risk of hepatic complications in infected patients who abuse alcohol.     

神经型一氧化氮合酶在慢性心力衰竭患者血浆中的变化及其作用

目的 探讨神经型一氧化氮合酶（nNOS）在慢性心力衰竭（CHF）患者血浆中的变化及其作用。方法 入选患者为2015年11月至2016年4月就诊于延边大学附属医院的失代偿CHF患者共计234例。根据左室射血分数（LVEF）值不同分成3个组：A组（EF 20%～29%）、B组（EF 30%～49%）、C组（EF≥50%）。结果 ①三组患者血浆nNOS浓度比较，差异均有统计学意义（87.7±6.6U/L，178.0±11.5U/L和142.6±8.8U/L；P<0.05），其中，A组患者血浆nNOS浓度明显低于B组（87.7±6.6U/L和178.0±11.5U/L；P<0.01）；C组患者血浆nNOS浓度略低于B组（178.0±11.5U/L和142.6±8.8U/L；P<0.05）；A组患者血浆nNOS浓度低于C组（87.7±6.6U/L和142.6±8.8U/L；P<0.05）。②三组患者E峰值比较，差异均有统计学意义（0.7±0.05m/s，0.9±0.03m/s和0.8±0.03m/s；P<0.05），其中，A组患者E峰值低于B组（0.7±0.05m/s和0.9±0.03m/s；P<0.05）； C组患者E峰值略低于B组（0.8±0.03m/s 和0.9±0.03m/s；P<0.05）；A组患者E峰值略低于C组（0.7±0.05m/s和0.8±0.03m/s；P<0.05）。③用Spearman相关分析对血浆nNOS浓度与抗心衰药物之间进行分析，血浆nNOS浓度与ACEI类、ARB类、地高辛和β-blocker呈正相关。结论 心力衰竭患者增加的神经型一氧化氮合酶是通过对E峰的调节来保护心功能的。     

应激性胃粘膜出血与血浆血栓素、前列环素和胃泌素水平的关系

目的　探讨应激性胃粘膜出血与血浆TXA2 、PGI2 和胃泌素 (G)水平的关系。方法　 2 0只SD大鼠随机分成实验组和对照组 ,每组 10只 ,禁食 2 4小时后 ,实验组放在 2℃冰水中应激 4小时 ,对照组不给刺激。应激结束后麻醉大鼠 ,分别取血 2ml分离血浆 ,放免法测定TXB2 (TXA2 的稳定代谢物 )、6 酮 PGF1a(PGI2 的衍生物 )和G水平 ;另取大鼠胃沿小弯剪开 ,肉眼观察胃粘膜有无出血灶 ,用pH值试纸测定胃液酸碱度。结果　 8只实验鼠胃粘膜见片状出血灶 ,对照组鼠胃粘膜无出血性改变 ;两组鼠胃液pH值测定无明显差异。实验组血浆TXB2 、6 酮 PGF1a和G水平分别为 15 45 11±14 2 89、16 2 80± 42 13和 112 75± 2 3 6 8,对照组分别为 96 6 5 0± 5 18 48、3 5 6 0 0± 91 0 6和 2 47 14± 5 3 6 0 ,两组分别比较均具有显著意义 (P <0 0 1)。结论　大鼠应激性胃粘膜出血与血浆TXA2 水平升高和PGI2 水平降低有关 ;而与胃酸分泌无关。     

重度有机磷中毒致多器官功能障碍综合征30例预后分析

目的:探讨重度有机磷中毒致多器官功能障碍综合征(MODS)的发病机制,临床特点及救治措施。方法:回顾性分析30例重度有机磷中毒(AOPP)并发MODS患者的临床资料。结果:所有患者均在24h内发病,有132个器官系统发生不同程度功能障碍,累及最多的是脑和呼吸系统;30例中死亡10例,总死亡率为33.3%。结论:原发性MODS是重度有机磷中毒常见并发症和主要死因,合理采取综合救治策略是降低病死率的关键。