Preptin对人成骨细胞增殖和分化的影响及机制研究

目的 探讨preptin对人成骨细胞增殖和分化的影响及其信号途径.方法 体外培养人成骨细胞,用10-10、10-9、10-8和10-7mol/L preptin干预24 h,以[3H]脱氧胸腺嘧啶苷掺入法分析细胞增殖,用分光光度计法测定细胞碱性磷酸酶(ALP)活性判断细胞分化程度.Western印迹法检测细胞外信号调节激酶(ERK)、p38丝裂原活化蛋白激酶(p38MAPK)和c-Jun氨基末端激酶(JNK)的磷酸化水平.并在preptin干预前以ERK抑制剂(PD98059)、p38 MAPK抑制剂(SB203580)和JNK抑制剂(SP600125)预处理,观察preptin诱导人成骨细胞增殖和分化的途径.结果 Preptin剂量依赖地增加人成骨细胞的增殖和ALP活性,10-9mol/L浓度时达最大效应(均P<0.01).Preptin刺激人成骨细胞ERK的磷酸化,对p38MAPK和JNK无作用.PD98059阻断preptin刺激的成骨细胞增殖及ALP活性增加(均P<0.05),而SP600125和SB203580无此效应.结论 Preptin通过ERK途径促进人成骨细胞的增殖和分化.     

尾加压素Ⅱ诱导巨噬细胞分泌巨噬细胞集落刺激因子

目的探索尾加压素Ⅱ(UⅡ)能否促进小鼠单核巨噬细胞系RAW264.7细胞分泌巨噬细胞集落刺激因子(M-CSF),并探讨相关的信号机制。方法培养小鼠单核巨噬细胞系RAW264.7细胞,以Real-time PCR法和ELISA法分别检测细胞的M-CSF mRNA和蛋白表达水平,用细胞免疫印迹法检测p38MAPK和ERK的磷酸化水平。结果 UⅡ呈浓度依赖性和时间依赖性促进RAW264.7细胞中M-CSF mRNA和蛋白水平的表达,最大效应时间均为刺激12 h,M-CSF mRNA水平是对照组水平的2.73倍,蛋白表达水平显著高于对照组水平[(50.04±4.28)pg/ml比(20.39±2.75)pg/ml,P0.01],是对照组水平的2.45倍;最大效应浓度均为10-8mol/L和10-7mol/L,以10-8mol/L UⅡ刺激12 h,M-CSF的mRNA和蛋白表达水平较对照组分别增加了97.3%和80.8%。采用UⅡ受体(UT)阻断剂Urantide、ERK阻断剂PD98059和p38MAPK阻断剂SB203580分别预处理细胞后,M-CSF蛋白水平较UⅡ组显著降低,分别为[(45±4.04)pg/ml比(57.47±2.93)pg/ml]、[(42.13±4.28)pg/ml比(57.47±2.93)pg/ml]和[(44±5.34)pg/ml比(57.47±2.93)pg/ml],差异均有统计学意义(均P0.05)。10-8mol/L UⅡ刺激细胞3 min显著促进ERK和p38MAPK蛋白磷酸化,5 min时ERK磷酸化水平达到峰值,至15 min仍持续高值,而p38MAPK在15 min时磷酸化达到峰值;30 min时,两者的磷酸化水平均减弱。结论UⅡ可通过与受体结合活化ERK和p38MAPK信号通路促进RAW264.7细胞中M-CSF的表达。     

吡格列酮对L6肌细胞脂联素和葡萄糖转运蛋白4表达的影响及其机制研究

建立棕榈酸诱导的大鼠L6肌细胞胰岛素抵抗模型后,以吡格列酮、c-Jun氨基末端激酶(JNK)抑制剂SP600125、p38丝裂原活化蛋白激酶(p38MAPK)抑制剂SB203580进行干预.应用Western 印迹法检测脂联素、葡萄糖转运蛋白4(GLUT4)蛋白表达和JNK、p38MAPK磷酸化水平.结果显示,吡格列酮可显著增加胰岛素抵抗状态下L6细胞p38MAPK磷酸化、脂联素和GLUT4蛋白表达(P＜0.05或P＜0.01),降低JNK磷酸化水平(P＜0.01).阻断p38MAPK信号通路后,吡格列酮上调L6细胞GULT4蛋白表达的效应显著降低(P＜0.01),而阻断JNK信号通路却无显著影响(P＞0.05).     

盐酸小檗碱通过抑制PKCα磷酸化抑制机械牵张力诱导的血管平滑肌细胞增殖和凋亡

[目的]观察机械牵张力(SS)是否通过激活PKCα诱导小鼠血管平滑肌细胞(VSMC)增殖和凋亡,并探讨盐酸小檗碱(BBR)对它的作用及机制。[方法]实验共分6组：正常对照组、BBR组、PKCα抑制剂(Go6976)组、SS组、SS+BBR组、SS+Go6976组。静息培养的细胞给予BBR或Go6976预处理1 h,继而予10%强度的SS刺激15 min后收集细胞,Western blot检测PKCα和MAPK(ERK、JNK、p38)磷酸化水平。BBR或Go6976预处理1 h,牵拉时间为1 h,继续培养23 h,免疫荧光法检测细胞增殖(Ki67)和凋亡(TUNEL)。[结果] Western blot与免疫荧光结果显示,与正常对照组相比较,SS可升高PKCα和MAPK(ERK、JNK和p38)磷酸化水平(P<0.05),并增加VSMC的增殖和凋亡水平(P<0.05)。BBR可抑制PKCα和ERK、JNK、p38磷酸化水平(P<0.05),同时抑制VSMC增殖和凋亡(P<0.05);Go6976可抑制PKCα和ERK、JNK磷酸化水平(P<0.05),但对...     

软脂酸通过丝裂原活化蛋白激酶通路促进血管内皮细胞凋亡

目的探讨软脂酸(PA)诱导的血管内皮细胞凋亡中丝裂原活化蛋白激酶(MAPK)通路的作用。方法将人脐静脉内皮细胞(HUVEC)分对照组、PA组、MAPK通路干预组[分别先用p38抑制剂SB203580、氨基末端激酶(JNK)抑制剂PD98059、细胞外信号调节激酶(ERK)抑制剂SP600125干预]再分为PA+SB组、PA+PD组、PA+SP组。流式细胞仪检测细胞凋亡率;Western blot法检测caspase-3、磷酸化p38、JNK和ERK1/2表达水平;分光光度法检测caspase-3的活性。结果与对照组比较,PA组、PA+SB组、PA+PD组、PA+SP组HUVEC凋亡及caspase-3表达和活性明显增加,PA组磷酸化p38MAPK表达明显增加(P<0.05)。与PA组比较,PA+SB组HUVEC细胞凋亡率、caspase-3表达和活性明显降低(P<0.05);而PA+PD组和PA+SP组HUVEC凋亡率、caspase-3表达和活性无明显变化(P>0.05)。结论 PA通过p38MAPK通路促进内皮细胞凋亡。     

Preptin对成骨细胞结缔组织生长因子表达的影响及其机制研究

目的 探讨Preptin对成骨细胞结缔组织生长因子(CTGF)表达的影响及其机制.方法采用人重组preptin干预人原代成骨细胞,CTGF蛋白水平用Western印迹法检测.丝裂原活化蛋白激酶p38(p38MAPK)、细胞外信号调节激酶(ERK1/2)、c-Jun氨基端激酶(JNK)及其磷酸化水平用Western印迹法检测.在preptin干预前用细胞信号阻断剂(PD98059、SP600125或SB203580)预处理阻断人成骨细胞MAPK信号转导,以分析preptin诱导人成骨细胞CTGF表达的作用机制.结果 Preptin可呈时间和剂量依赖性地促进人成骨细胞CTGF的分泌,并且preptin可诱导人成骨细胞ERK的活化,对p38MAPK或JNK无激活作用;人成骨细胞用ERK抑制剂PD98059预处理可使preptin诱导的CTGF分泌降低.结论Preptin增加CTGF的表达,并通过ERK/MAPK信号途径来介导.     

乳酸杆菌对幽门螺旋杆菌脂多糖作用下的SGC-7901细胞p38MAPK磷酸化水平和凋亡率的影响

目的:探讨保加利亚乳酸杆菌(lactobacillus bulgaricus,LBG)对幽门螺旋杆菌悉尼株脂多糖(H pyloriSS1-LPS)作用下SGC-7901细胞的p38有丝分裂原活化蛋白激酶(p38MAPK)磷酸化水平和凋亡率的影响.方法:使用LBG(1×1013CFU/L)或p38MAPK通路阻滞剂SB203580(10 μmol/L)预处理SGC-7901细胞,1 h后分别加入2.5×103,2.5×104,2.5×105EU/L的H pyloriSS1-LPS,干预2 h后使用免疫细胞化学方法检测各组细胞磷酸化p38MAPK(P-p38MAPK)的水平,4,5,6 h后使用MTT法检测细胞活性,6 h后使用流式细胞仪检测各组细胞凋亡率.结果:与对照组比较,H pyloriSS1-LPS直接干预后,SGC-7901细胞的活性明显下降(0.1 64±0.028 vs 0.622±0.068,P＜0.05),凋亡率(10.000%±0.510% vs 4.175%±0.206%,P＜0.05)和P-p38MAPK水平明显上升(79.771±1.424 vs 4.075±0.135,P＜0.01),呈剂量依赖性;LBG预处理各组的细胞凋亡率和P-p38MAPK水平无明显改变;SB203580预处理各组的细胞活性和细胞凋亡率无明显改变.结论:HpyloriSS1-LPS可诱导SGC-7901细胞凋亡,其机制可能包括诱导生成P-p38MAPK;而LBG能对抗H pyloriSS1-LPS的促凋亡作用,其机制可能抑制H pyloriSS1-LPS诱导生成P-p38MAPK.     

山豆根通过MAPK信号通路调节乳腺癌细胞增殖、凋亡

目的 探究山豆根对乳腺癌细胞生长的影响，并从调控丝裂原活化蛋白激酶(MAPK)信号通路的角度探讨其可能的机制。方法 体外培养人乳腺癌MCF-7、MDA-MB-231细胞，采用四甲基偶氮唑盐比色法(MTT)检测山豆根提取液对MCF-7细胞增殖的影响；并设置对照组、20 mg/ml山豆根组、SP600125(JNK抑制剂)+山豆根组、PD98059(ERK1/2抑制剂)+山豆根组、SB203580(p38MAPK抑制剂)+山豆根组(20 mg/ml山豆根+10μmol/L抑制剂),分别采用MTT法和流式细胞术检测各组细胞增殖与凋亡情况，Western印迹检测MAPKs通路相关调控蛋白[c-Jun氨基末端激酶(JNK)、细胞外调节蛋白激酶(ERK)1/2、p38 MAPK及其磷酸化蛋白]的表达。结果 不同浓度的山豆根提取液呈浓度依赖性地抑制MCF-7、MDA-MB-231细胞的生长；与对照组相比，20 mg/ml山豆根组细胞增殖抑制率、凋亡率显著升高(P<0.05);与20 mg/ml山豆根组相比，联用相应的抑制剂后，细胞增殖抑制率、凋亡率明显降低(P<0.05);且p-JNK/...     

丹参酚酸B盐对转化生长因子β1活化的大鼠肝星状细胞内p38丝裂原活化蛋白激酶通路及其转录因子的影响

目的 探讨丹参酚酸B盐(SA-B)对转化生长因子β1(TGFβ1)活化的大鼠肝星状细胞(HSC)内p38丝裂原活化蛋白激酶(MAPK)信号传导通路的影响. 方法 分离并培养正常大鼠HSC,将TGFβ1和SA-B直接添加于原代HSC的无血清培养液中,用p38信号通路特异性阻断剂SB203580和细胞外信号调节激酶(ERK)信号通路特异性阻断剂PD98059分别阻断HSC内p38MAPK和ERK信号通路.细胞内总的P38蛋白、MKK3/6蛋白及MEF2A、MEF2C的测定分为空白对照组、SA-B组、SA-B+ TGF β1组和TGFβ1组;磷酸化P38蛋白、MKK3/6蛋白和α-SMA蛋白的测定分为空白对照组、SA-B组、SA-B+ TGF β1组、TGFβ1组、PD98059、PD98059+ SA-B组、PD98059+ TGFβ1组和SA-B+ PD98059+ TGFβ1组;SA-B对TGFβ1刺激的HSC内MEF2和Ⅰ型胶原报道基因的影响分为突变型(mt)对照组、野生型(wt)对照组、TGFβ1组、SA-B+ TGF β1组、SA-B组、SB203580+ TGF β1组、SB203580组.Western blot法检测HSC内磷酸化和总P38蛋白、MAPK激酶3/6 (MKK3/6)蛋白、肌细胞增强因子2(MEF2)A、MEF2C、α-平滑肌肌动蛋白(α-SMA)的表达;荧光素酶报道基因测定法检测MEF2报道基因和Ⅰ型胶原启动子的活性.多组间数据的多重比较用q检验.结果 SA-B组磷酸化P38蛋白相对表达量为0.33±0.05,明显低于空白对照组(q=7.08,P＜0.01); SA-B +TGF β1组的磷酸化P38蛋白相对表达量为0.46±0.04,明显低于TGFβ1组(q=10.45,P＜0.01);SA-B组磷酸化MKK3/6蛋白相对表达量为0.11±0.07,明显低于空白对照组(q=3.944,P＜0.05);SA-B+ TGF β1组磷酸化MKK3/6蛋白相对表达量为0.28±0.07,明显低于TGFβ1组(q=7.91,P＜0.01);SA-B+ TGFβ1组和SB203580+ TGF β1组MEF2报道基因的相对荧光素酶活性分别为2.93±0.09和2.50±0.05,均明显低于TGFβ1组(q值分别为35.35和37.2,P值均＜0.01);SA-B组MEF2C及MEF2A的相对表达量分别为15.82±0.97和13.00±0.40,均明显低于空白对照组(q值分别为5.18和13.32,P值均＜0.01);SA-B+ TGF β1组MEF2C及MEF2A的相对表达量分别为13.40±0.72和20.47±0.83,均明显低于TGF β1组(q值分别为43.93和12.52,P值均＜0.01); SA-B+ TGFβ1组α-SMA相对表达量为8.76±0.44,明显低于TGFβ1组(q=20.35,P＜0.01); SA-B+ SB203580+TGF β1组α-SMA相对表达量仅为3.57±0.49,明显低于TGFβ1组(q=39.78,P＜0.01);SA-B+ TGF β1组和SB203580+ TGF β1组Ⅰ型胶原报道基因的相对荧光素酶活性分别为1.61±0.05和1.42±0.07,较TGFβ1组明显降低(q值分别为26.4和27.62,P值均＜0.01).结论 SA-B可能通过抑制原代HSC内TGFβ 1的p38MAPK信号传导通路,抑制HSC的活化.     

机械应力对MG63成骨样细胞结缔组织生长因子表达的影响

目的 观察力学刺激对MG63成骨样细胞的结缔组织生长因子(CTGF)表达的影响以及丝裂原活化蛋白激酶(MAPK)信号途径在这一过程中的作用.方法 应用Western印迹法检测MG63细胞CTGF蛋白表达及细胞外信号调节激酶(ERK)、c-Jun氨基末端激酶(JNK)、p38磷酸化水平,应用RT-PCR检测CTGF mRNA表达.结果 环状应力刺激可显著上调CFGF蛋白及mRNA表达,3～6 h达高峰,升高2～3倍;并且激活ERK及JNK信号途径,刺激10 min开始活化,ERK在60 min达高峰,而JNK在15～30min达高峰,对p38信号途径没有明显活化作用.JNK信号通路阻断剂SP600125能够阻断应力刺激对CTGF的上调作用,而ERK信号阻断剂PD98059及p38信号阻断剂SB203580却无此作用.结论 环状机械应力通过JNK依赖的途径上调了MG63细胞的CTGF表达.     

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.     

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.     

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.     

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     

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。     

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。