桂枝汤对高脂血症心肌缺血大鼠血管活性物质的影响

目的探讨桂枝汤对高脂血症心肌缺血大鼠血管内皮活性物质的影响。方法采用高脂饲料、丙硫氧嘧啶及大剂量维生素D3多因素联合诱导高脂血症和动脉粥样硬化早期改变,建立大鼠模型,在此基础上,大剂量腹腔注射垂体后叶素,造成心肌缺血(胸痹)模型。测定6周、12周、18周血清总胆固醇、甘油三酯、高密度脂蛋白胆固醇的含量,并计算低密度脂蛋白胆固醇含量。放射免疫法测定血浆内皮素、6-酮-前列腺素F1α、血栓素B2和血浆血管紧张素Ⅱ。结果桂枝汤使心肌缺血大鼠血脂代谢各项指标明显改善,具有降低总胆固醇、甘油三酯、低密度脂蛋白胆固醇,及升高高密度脂蛋白胆固醇的作用,并可降低血浆中内皮素、血浆血管紧张素Ⅱ、血栓素B2,及升高血浆6-酮-前列腺素F1α含量。结论桂枝汤能调节血管活性物质,保护内皮,抑制动脉粥样硬化的形成。     

脑梗死患者血浆血栓素B2和6-酮-前列腺素F1α变化及其与血脂的关系

为探讨脑梗死患者血中血栓形成相关因素之间的关系,对111例脑梗死患者血中的血栓素B2、6－酮－前列腺素F1α和血脂进行了测定。结果发现,与健康人相比,脑梗死患者血中血栓素B2水平升高,6－酮－前列腺素F1α水平降低,血栓素B2／6－酮－前列腺素F1α升高。低密度脂蛋白胆固醇和载脂蛋白B与血栓素B2和血栓素B2／6－酮－前列腺素F1α都呈正相关。与6－酮－前列腺素F1α呈负相关;高密度脂蛋白胆固醇与6－酮－前列腺素F1α呈正相关;甘油三酯与血栓素B2／6－酮－前列腺素F1α呈正相关。此结果提示,脑梗死患者血中血栓素B2和6－酮－前列腺素F1α－前列腺素F1α变化是脂质代谢紊乱的表现。     

脂肪乳灌胃建立家兔高脂血症模型方法的探讨

采用自制脂肪乳剂给家兔连续灌育2周，观察家兔血清总胆固醇、甘油三酯、载脂蛋白B、血浆血栓素B2和6－酮－前列腺素F1α水平的变化以及主动脉壁动脉粥样硬化斑块形成的情况。结果发现，灌胃后动物体内总胆固醇、甘油三酯、载脂蛋白B和血栓素B2水平明显升高，而6－酮一－列腺素F1α水平明显降低（P＜0.01），其中总胆固醇含量较灌胃前增加14.8倍，甘油三酯较灌胃前增加3.9倍，形态学检查也发现主动脉壁中少许脂肪颗粒沉积，其结果符合实验用动物高脂血症模型的特点，提示采用脂肪乳剂灌胃建立家兔高脂血症模型的方法是可行的。     

血浆凝血因子Ⅶ与代谢综合征

血浆凝血因子Ⅶ (FⅦ )活性升高 ,增加了血液粘度 ,从而促进高凝状态的形成。目前研究发现 ,2型糖尿病及肥胖患者的FⅦ凝血活性 (FⅦc)明显升高 ,且与空腹胰岛素水平、血脂和FⅦ基因型相关 ;血脂异常患者血浆甘油三酯 (TG)和总胆固醇 (TC)与FⅦc存在正相关 ;动脉硬化性心血管病患者及高血压患者血浆FⅦc水平也明显升高 ;FⅦc是冠心病的独立危险因素。通过膳食、药物可降低FⅦc水平 ,从而降低心血管病的危险性并有益于其预后     

血浆凝血因子Ⅶ与代谢综合征

血浆凝血因子Ⅶ（FⅦ）活性升高，增加了血液粘度，从而促进高凝状态的形成。目前研究发现，2型糖尿病及肥胖患者的FⅦ凝血活性（FⅦc)明显升高，且与空腹胰岛素水平、血脂和FⅦ基因型相关；血脂异常患者血浆甘油三酯（TG）和总胆固醇（TC）与FⅦc存在正相关；动脉硬化性血管病患者及高血压患者血浆FⅦc水平也明显升高；FⅦc是冠心病的独立危险因素。通过膳食、药物可降低FⅦc水平，从而降低心血管病的危险性并有益于其预后。     

急性脑梗死患者血脂和尿酸水平测定及其临床意义

目的 探讨急性脑梗死(ACI)患者血清中血脂和尿酸(UA)与脑梗死的关系.方法　测定并分析ACI患者及对照组的血清尿酸(UA)、甘油三酯(TG) 、总胆固醇(TC) 、低密度脂蛋白(LDL) 、高密度脂蛋白(HDL).结果 ACI组UA、TG水平均高于对照组(P<0.01),HDL水平低于对照组(P<0.05),且UA与TG(r=0.378,P<0.01)和TC(r= 0.423,P<0.01)水平呈正相关.结论 高尿酸血症和高脂血症是ACI危险因子,测定ACI患者的UA及血脂有助于判断病情及预后.     

动脉粥样硬化性肾动脉狭窄患者相关危险因素分析

目的观察动脉粥样硬化性肾动脉狭窄患者危险因素、血脂及肾功能的变化,分析各项指标与肾动脉狭窄及其病变程度和范围的关系。方法选取动脉粥样硬化性肾动脉狭窄患者70例,测定其血脂及肾功能,并选择62例肾动脉正常者为对照。结果肾动脉狭窄组与对照组相比高血压、冠心病、慢性肾功能不全及高脂血症的发生率明显增高(P<0.01),两组间血尿素氮、肌酐、总胆固醇、高密度脂蛋白胆固醇及载脂蛋白A1差异显著(P<0.05或P<0.01);不同狭窄组之间血尿素氮、肌酐、总胆固醇差异显著(P<0.01)。结论高血压、冠心病、慢性肾功能不全及高脂血症是动脉粥样硬化性肾动脉狭窄的危险因素。     

兔腹主动脉血管弹性的超声及实验研究

目的应用高分辨率超声检测动脉硬化兔模型腹主动脉弹性，探讨其与高脂血症、血浆同型半胱氨酸的关系。方法雄性新西兰大白兔24只，高胆固醇组12只、高蛋氨酸组12只。应用ATL HD15000彩色多普勒超声检测仪检测以上2组免腹主动脉弹性，并进行病理学检查（光镜和电镜）、血脂（胆固醇、低密度脂蛋白胆固醇）及血浆同型半胱氨酸水平的测定。结果①实验第4周末2组生化指标均有不同程度增高：高胆固醇组血脂水平明显升高（P〈0．05），高蛋氨酸组血浆同型半胱氨酸水平明显升高（P〈0．05）。②8周末高胆固醇组和高蛋氨酸组腹主动脉弹性减低（P〈0．05）。结论高脂血症与高同型半胱氨酸均是引起动脉硬化的危险因素，分别与动脉硬化呈正相关，胆固醇浓度与同型半胱氨酸浓度无显著相关；动脉弹性的变化发生于动脉内膜-中层增厚之前。     

老年高血压患者冠状动脉病变与血浆致动脉粥样硬化指数的关系

<正>高血压可引起血管内皮细胞功能降低,从而形成动脉粥样硬化,而动脉粥样硬化则是冠状动脉病变的主要病理基础。传统上认为冠状动脉病变中最主要的危险因素是脂质代谢紊乱,其中高密度脂蛋白胆固醇(HDL-C)水平降低和低密度脂蛋白胆固醇(LDL-C)水平升高是冠状动脉病变发生的独立危险因素〔1,2〕。2004年有研究〔3〕提出了一个衡量血脂指标的新概念——血浆致动脉粥样硬化指数(AIP),用甘油三酯(TG)与     

广州地区一般人群湿热质与心血管病危险因素的相关性研究

目的探讨广州地区一般人群湿热质、平和质与心血管病危险因素的关系,为基于中医体质角度防治心血管疾病提供理论依据。方法选取广东省中医院体检中心中医体质辨识为湿热质(140人)、平和质(140人)的人群为研究对象,分析两种中医体质之间血压、尿酸、空腹血糖、血清总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、体重指数、高脂血症、高尿酸血症、超重/肥胖等发生率的差异性。结果湿热质组收缩压、舒张压、体重、体重指数、血尿酸、空腹血糖、总胆固醇、低密度脂蛋白胆固醇水平和超重/肥胖率、高尿酸血症率、高脂血症率明显高于平和质组(P0.05),但高密度脂蛋白胆固醇水平明显低于平和质组(P0.05)。结论湿热质是冠心病危险因素较多的危险体质,应加强湿热质人群血压、血糖、血脂、体重、尿酸等危险因素的控制。     

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     

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.     

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。     

Study of constancy of hydrogen-consuming flora of human colon

The constancy of the hydrogen consuming flora of the human colon was studied in 15 healthy subjects via two measurements obtained 18 to 36 months apart. Hydrogen disappearance rate and the major products of H₂-consuming bacteria, methane and sulfide, were measured during incubation of fecal homogenates with excess hydrogen and sulfate. In 11/15, the hydrogen consumption rate and the predominant hydrogen-consuming pathway (methanogenesis, sulfate reduction, or neither) remained constant. However, major shifts in these pathways were observed in four subjects, with two losing and two gaining the ability to produce methane. Methanogenesis was associated with the highest hydrogen consumption rate. This study demonstrates that clinically unrecognizable, major alterations of the colonic flora occur in healthy subjects. Understanding of the factors responsible for these alterations might allow for therapeutic manipulation of the colonic flora.Supported in part by the Department of Veterans Affairs and NIDDKD RO1 DK 13309-25.