槲皮素及异鼠李素对人血管平滑肌细胞胶原合成的影响

目的 观察槲皮素、异鼠李素和去甲肾上腺素对人血管平滑肌细胞胶原蛋白合成的影响。方法利用培养的人主动脉血管平滑肌细胞，在培养基中加入不同浓度的槲皮素、异鼠李素、去甲肾上腺素及酚妥拉明，孵育不同时间。采用^3H-脯氨酸掺入法检测胶原蛋白的合成量。结果10μmol／L去甲肾上腺素有促进血管平滑肌细胞胶原蛋白合成的作用，72h达高峰，去甲肾上腺素的促进作用能被酚妥拉明所阻滞。槲皮素和异鼠李素有抑制血管平滑肌细胞胶原蛋白合成的作用，在1．200μmol／L的浓度范围内其抑制作用有剂量依赖关系，200μmol／L浓度时发挥最大的抑制作用。槲皮素和异鼠李素均对去甲肾上腺素促血管平滑肌细胞胶原蛋白合成有明显的剂量依赖抑制效应，72h抑制作用最强。槲皮素和异鼠李素在抑制去甲肾上腺素的刺激作用方面具有明显的协同作用。槲皮素和异鼠李素对去甲肾上腺素促血管平滑肌细胞胶原蛋白合成的抑制作用，明显大于未受去甲肾上腺素作用的血管平滑肌细胞。槲皮素和异鼠李素对去甲肾上腺素刺激作用的抑制也明显强于酚妥拉明的作用。结论槲皮素和异鼠李素对人主动脉血管平滑肌细胞的胶原蛋白合成，尤其是对去甲肾上腺素刺激的血管平滑肌细胞胶原蛋白合成有很强的抑制作用。     

槲皮素及异鼠李素对人血管平滑肌细胞增殖的抑制作用

目的观察槲皮素(QUE)及异鼠李素(ISOR)对培养人血管平滑肌细胞增殖的影响。方法本实验利用培养的人主动脉平滑肌细胞(VSMC),采用细胞计数、3H-胸腺嘧啶核苷酸(3H-TdR)掺入法,观察QUE、ISOR、去甲肾上腺素(NE)对VSMC增殖、DNA合成的影响,以及QUE、ISOR、酚托拉明(Ph)对NE促VSMC增殖、DNA合成的的影响。结果①QUE有明显抑制VSMC增殖、DNA合成的作用,而ISOR作用较弱。在所观察的1～200(滋mol/L的浓度范围内,QUE和ISOR均在200滋mol/L浓度发挥了最大的抑制作用,其抑制作用有剂量依赖关系。②NE有促进VSMC增殖、DNA合成的作用,而这些促进作用能被Ph所阻滞。③QUE和ISOR均剂量依赖地抑制NE促VSMC增殖和DNA合成的作用,且QUE和ISOR有明显的协同作用。④QUE和ISOR对NE刺激作用的抑制明显强于Ph的作用。⑤QUE和ISOR对VSMC无细胞毒作用。结论QUE和ISOR是细胞毒性很低,对VSMC的增殖、DNA合成尤其是对NE刺激的VSMC增殖、DNA合成有很强的抑制作用的天然黄酮类物质。     

D_1类多巴胺受体对肾上腺素α受体介导的促动脉平滑肌细胞增殖作用的影响

目的观察D1类多巴胺受体对肾上腺素α受体介导的血管平滑肌(VSM)细胞增殖的影响。方法以去甲肾上腺素(NE)10-6~10-9mol/L刺激Sprague-Dawley(SD)大鼠主动脉分离的VSM细胞,观察在D1类多巴胺受体激动剂(Fenoldopam)10-5~10-8mol/L存在的情况下,NE促细胞增殖作用的变化,细胞增殖用3H-TdR掺入量表示。结果NE呈浓度依赖性的促进SD大鼠VSM细胞的增殖,该作用由肾上腺素α受体介导,酚妥拉明存在的情况下可消除NE的促增殖作用。Fenoldopam本身对VSM细胞增殖无影响,但Fenoldopam可通过D1类多巴胺受体减弱NE(10-6mol/L)介导的VSM细胞增殖;该实验结果得到了人VSM细胞实验结果的印证。结论D1类多巴胺受体对NE介导的促VSM细胞增殖具有抑制作用,该作用可能在高血压的发生、发展中发挥一定的作用。     

D1类多巴胺受体对肾上腺素α受体介导的促动脉平滑肌细胞增殖作用的影响

目的 观察D1类多巴胺受体对肾上腺素α受体介导的血管平滑肌(VSM)细胞增殖的影响.方法 以去甲肾上腺素(NE)10-6～10-9 mol/L刺激Sprague-Dawley(SD)大鼠主动脉分离的VSM细胞,观察在D1类多巴胺受体激动剂(Fenoldopam)10-5～10-8 mol/L存在的情况下,NE促细胞增殖作用的变化,细胞增殖用3H-TdR掺入量表示.结果 NE呈浓度依赖性的促进SD大鼠VSM细胞的增殖,该作用由肾上腺素α受体介导,酚妥拉明存在的情况下可消除NE的促增殖作用.Fenoldopam本身对VSM细胞增殖无影响,但Fenoldopam可通过D1类多巴胺受体减弱NE(10-6 mol/L)介导的VSM细胞增殖;该实验结果得到了人VSM细胞实验结果的印证.结论 D1类多巴胺受体对NE介导的促VSM细胞增殖具有抑制作用,该作用可能在高血压的发生、发展中发挥一定的作用.     

亮氨酸脑啡肽抑制血管平滑肌细胞增殖和c-fos基因表达

为探讨脑啡肽与去甲肾上腺素一起参与血管运动的局部调节机制，用MTT法、氚标胸腺嘧啶脱氧核苷掺入法和斑点杂交技术发现亮氨酸脑啡肽可抑制SD大鼠胸主动脉平滑肌细胞的增殖、DNA合成和c-fos基因的表达；阿片受体阻断剂纳洛酮无上述抑制作用，但可拮抗亮氨酸脑啡肽的上述抑制作用；上述作用还可被去甲肾上腺素所拮抗。结果提示，脑啡肽通过影响血管平滑肌细胞功能来参与血管运动的局部调节，这种调节可能是通过阿片受体介导的。     

生物导向药物转化生长因子α-皂草毒素蛋白Saporin对增殖血管平滑肌细胞具有特异性的生长抑制作用

目的 :证实导向药物转化生长因子α 皂草毒素蛋白Saporin (TGFα SAP)对增殖血管平滑肌细胞特异性的生长抑制作用。　　方法 :用SPDP化学联结的方法合成了导向药物TGFα SAP ,并以四唑盐 (MTS)比色法和3 H 胸腺嘧啶掺入法进一步探讨了TGFα SAP对血管平滑肌细胞增殖的作用 ,及对血管平滑肌细胞和内皮细胞DNA合成的影响。　　结果 :实验显示TGFα SAP对血管平滑肌细胞的增殖有明显抑制作用 ,并可使其3 H 胸腺嘧啶掺入量降低 ,而皂草毒素蛋白Saporin显示的细胞毒性作用则很弱 ;同时TGFα SAP对增殖的内皮细胞的DNA合成几乎未显示明显的细胞毒性作用。　　结论 :TGFα SAP通过表皮生长因子 (EGF)受体介导较皂草毒素蛋白Saporin具有了明显增强的细胞毒性作用 ,可选择性抑制血管平滑肌细胞的增殖而对内皮细胞未显示出明显的毒性作用。     

葛根素对血管平滑肌细胞增殖及Bcl-2蛋白和凝血酶受体mRNA表达的影响

目的观察葛根素对凝血酶诱导的血管平滑肌细胞增殖及Bcl-2蛋白和凝血酶受体mRNA表达的影响,旨在认识葛根素作用的分子机制。方法以细胞计数法和流式细胞仪DNA含量测定,细胞周期分析法观察凝血酶及葛根素对血管平滑肌细胞增殖和DNA合成的影响。凝血酶及葛根素等各处理因素作用24 h后,用免疫印迹法检测Bcl-2蛋白表达,以半定量逆转录聚合酶链反应检测凝血酶受体mRNA的表达。结果凝血酶对血管平滑肌细胞有明显促增殖作用,促增殖效应在24 h末达峰值,且凝血酶浓度在0.1~1.0 u/L之间有剂量依赖关系;葛根素呈剂量依赖性地抑制凝血酶诱导的细胞增殖、DNA合成及血管平滑肌细胞Bcl-2蛋白的表达;高浓度(1.5×10-3mol/L)葛根素可显著抑制凝血酶诱导的凝血酶受体mRNA上调。结论葛根素能抑制凝血酶诱导的血管平滑肌细胞增殖,这可能与其抑制Bcl-2蛋白有关,并部分与其抑制凝血酶受体mRNA表达有关。     

黄芪和当归对血管平滑肌细胞表型标志基因表达和细胞增殖的影响

为了观察黄芪和当归对血管平滑肌细胞表型转化和增殖的影响，采用体外培养的血管平滑肌细胞，以碱性成纤维细胞生长因子诱导其表型转化和增殖，在此基础上，通过Northern和Western印迹法检测平滑肌细胞表型标志基因表达的变化，研究黄芪和当归注射液对碱性成纤维细胞生长因子上述效应的抑制作用。结果发现，碱性成纤维细胞生长因子可明显下调分化型标志基因平滑肌α-肌动蛋白的表达，上调去分化型标志基因平滑肌胚胎型肌球蛋白重链和骨桥蛋白表达，诱导原癌基因c-jun表达及促进血管平滑肌细胞DNA合成。黄芪和当归可上调分化型标志基因的表达活性，下调去分化型标志基因的表达，不同程度地抑制碱性成纤维细胞生长因子诱导的血管平滑肌细胞表型转化和DNA合成，有效抑制血管平滑肌细胞增殖，其作用机制可能与抑制碱性成纤维细胞生长因子诱导的c-jun基因表达有关。二者相比，当归的作用大于黄芪。结果提示，黄芪和当归可从多位点上拮抗碱性成纤维细胞生长因子促血管平滑肌细胞表型转化及细胞增殖。     

丙丁酚对氧化型低密度脂蛋白和氧自由基促血管平滑肌细胞增殖的影响

本文用细胞计数和ＭＴＴ快速比色计量法观察到体外培养的半主动脉平滑肌细胞分别与氧化型低密度脂蛋白和黄嘌呤－黄嘌呤氧化酶共厕培养后，前者明显增殖（Ｐ＜０．０１）。抗氧化剂丙丁酚（１００μｍｏｌ·Ｌ－１）能抑制氧化型低密度脂蛋白和黄嘌呤－黄嘌呤氧化酶促平滑肌细胞增殖作用；一氧化氮合成酶抑制剂ＮＧ－硝基－Ｌ－精氨酸对两者促平滑肌细胞增殖的作用无影响，同时也不能阻断丙丁酚的抑制两者促细胞增殖作用．这一结果提示，丙丁酚能抑制氧化型低密度脂蛋白和外源性氧自由基促平滑肌细胞增殖，这一作用可能与血管平滑肌细胞中一氧化氮的合成及释放无关。     

半边莲生物碱抑制内皮素诱导的大鼠主动脉平滑肌细胞增殖

目的研究半边莲生物碱对内皮素诱导的血管平滑肌细胞增殖的作用。方法用内皮素1剌激大鼠主动脉平滑肌细胞增殖,以细胞计数试剂盒计数细胞个数、氚标胸腺嘧啶脱氧核苷掺入检测DNA的合成量、免疫细胞化学技术观察增殖细胞核抗原的表达活性作为细胞增殖的指标,并应用台盼兰拒染、乳酸脱氢酶检测观察半边莲生物碱的细胞毒性反应。结果内皮素1(10-7mol/L)可明显促进细胞增殖(与对照组相比,P<0.01);半边莲生物碱和BQ-123均可抑制内皮素1所诱导的细胞增殖(与内皮素1组相比,P<0.05);半边莲生物碱的抑制作用与浓度存在明显的依赖关系,但对活细胞数目和乳酸脱氢酶释放量均没有影响(P>0.05)。结论半边莲生物碱(50~200 mg/L)可浓度依赖性地抑制内皮素1所诱导的大鼠主动脉平滑肌细胞增殖,且此抑制作用并非是通过细胞毒性作用实现的。     

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.     

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。     

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     

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。