结节性多动脉炎与显微镜下型多血管炎的研究进展

1852年Rokitansky首次描述多血管炎,1866年Kussmaul根据病理特点进一步将其命名为结节性多动脉炎(polyarteritis nodosa,PAN),其特点为血管炎主要侵犯中等动脉,多累及肾脏和心脏,肾脏受累表现为肾梗死,又称之为经典型PAN.     

韦格内肉芽肿

韦格内肉芽肿 (Ｗｅｇｅｎｅｒｇｒａｎｕｌｏｍａｔｏｓｉｓ ,ＷＧ)属非感染性坏死性系统性血管炎性疾患 ,常累及上气道、肺和肾脏。 1931年ＨｅｉｎｚＫｌｉｎｇ首次描述。 80年代初 ,随着抗中性粒细胞胞浆抗体 (ＡＮＣＡ)技术的引入 ,提出了ＡＮＣＡ相关性肺血管炎和肉芽肿病的新概念。将ＡＮＣＡ阳性的ＷＧ和显微镜多血管炎 (ＭＰＡ)称为ＡＮＣＡ相关性血管炎 ,与其它血管炎相区别。本文就ＷＧ的诊断、临床表现及治疗方面的进展作一综述。一、ＷＧ的临床特征1.发病率 :在美国该病的发病率为 3/ 10万 ,男性发病率略高于女性 ,97%为白种人…     

SmaRT快速克隆多药耐药基因（MDR1）cDNA产物

肿瘤细胞在化疗中会对许多药物产生耐药性 ,称多药耐药 (ｍｕｌｔｉｄｒｕｇｒｅｓｉｓｔａｎｃｅ ,ＭＤＲ) ,导致ＭＤＲ的一个重要机制就是细胞膜上一种分子量为170ＫＤａ的Ｐ 糖蛋白 (Ｐ ｇｌｙｃｏｐｒｏｔｅｉｎ ,Ｐ ｇｐ)的过度表达[1] 。Ｐ ｇｐ主要由位于人第 7号染色体 ｑ2 1 1的多药耐药基因ＭＤＲ1编码。研究ＭＤＲ多在信使核糖核酸 (ｍＲＮＡ)和蛋白质水平。ＭＤＲ1ｃＤＮＡ长4 669ｂｐ ,第 179～ 384 0ｂｐ之间为可读区 ,共编码12 80个氨基酸残基 ,其中第 185密码子被认为是编码影响Ｐ ｇｐ药物结合位点的氨基酸残基。把包含185…     

PTEN在恶性肿瘤中的突变与缺失

ＰＴＥＮ ＭＭＡＣｌ ＴＥＰ1基因 1997年由Ｓｔｅｃｋ等 3个研究小组分别发现并命名的一种抑癌基因 (以下简称ＰＴＥＮ)。Ｌｉ等[1 ]设想第 10ｑ2 3丢染色体可能编码一肿瘤抑制基因 ,于是应用代表性差别分析法(ｒｅｐｒｅｓｅｎｔａｔｉｏｎａｌｄｉｆｆｅｒｅｎｃｅａｎａｌｙｓｉｓ ,ＲＤＡ) ,研究原发性乳腺癌第 10ｑ2 3丢失的磷酸酶基因 (ｐｈｏｓｐｈａｔａｓｅａｎｄｔｅｎｓｉｎｈｏｍｏｌｏｇｙｄｅｌｅｔｅｄｏｎｃｈｒｏｍｏｓｏｍｅｔｅｎ ,ＰＴＥＮ)。Ｓｔｅｃｋ等[2 ] 应用外显子俘获法 (ｅｘｏｎｔｒａｐｐｉｎｇ)克隆得到胶…     

ACTA PHARMACEUTICA SINICA,VOL.34,No.1～12SUBJECT INDEX

ＰｈａｒｍａｃｏｌｏｇｙＩｎｈｉｂｉｔｏｒｙＥｆｆｅｃｔｓｏｆＳｈｉｋｉｍｉｃＡｃｉｄｏｎＰｌａｔｅｌｅｔＡｇｇｒａｇａｔｉｏｎａｎｄＢｌｏｏｄＣｏａｇｕｌａｔｉｏｎＭＡＹ ,ＳＵＮＪＮ ,ＸＵＱＰ ,ＧＵＯＹＪ ( 3 )…………ＥｆｆｅｃｔｓｏｆＳｕｌｆｕｒＣｏｍｐｏｕｎｄｓｆｒｏｍＣａｕｃａｓ (ＡｌｌｉｕｍｖｉｃｔｏｒｉａｌｉｓＬ .)ｏｎｔｈｅＳｐｏｎｔａｎｅｏｕｓＢｅａｔｉｎｇｏｆＭｙｏｃａｒｄｉａｌＣｅｌｌＳｈｅｅｔｓｉｎＶｉｔｒｏＺＨＡＯＨＱ ,ＷＡＮＧＸＹ ,ＮＡＭＢＯＴ ( 6)………………………………     

龙牙楤木根皮中新皂苷的结构鉴定

从龙牙木Ａｒａｌｉａｅｌａｔａ(Ｍｉｑ )Ｓｅｅｍ 根皮中最近又分离得到一个新的三萜皂苷 ,通过理化和谱学分析 (ＭＳ、ＮＭＲ) ,确定其结构为 3 Ｏ {[β Ｄ ｇｌｕｃｏｐｙｒａｎｏｓｙｌ(1→ 2 ) ] [β Ｄ ｇｌｕｃｏｐｙｒａｎｏｓｙｌ(1→ 3) β Ｄ ｇｌｕｃｏｐｙｒａｎｏｓｙｌ (1→ 3) ] β Ｄ ｇｌｕｃｏｐｙｒａｎｏｓｙｌ]}ｅｃｈｉｎｏｃｙｓｔｉｃａｃｉｄ[1～3] 。命名为辽东木皂苷ⅩⅤ(ｃｏｎｇｍｕｎｏｓｉｄｅⅩⅤ )。结构见图 1。本皂苷为白色无定形粉末 ,Ｌｉｅｂｅｒｍａｎｎ Ｂｕｒ ｃｈａｒｄ反应和Ｍｏｌｉｓ…     

显微镜下多血管炎一例诊治分析

显微镜下多血管炎(MPA)是一种主要累及小血管的系统性坏死性血管炎,病理主要表现为局灶性坏死性的全层血管炎,新月体肾小球肾炎是其肾脏特征性改变。笔者对我院2010年收治的一例MPA的临床特点及治疗进行分析。     

食物成分影响肿瘤转移的研究进展

肿瘤转移是一个复杂的过程(ｍｅｔａｓｔａｔｉｃｃａｓｃａｄｅ),包括:肿瘤细胞增殖(ｐｒｏｌｉｆｅｒａｔｉｏｎ)与基底膜(ｂａｓｅｍｅｎｔｍｅｍｂｒａｎｅ,ＢＭ)及ＥＣＭ中的一些大分子蛋白质成分粘附(ａｄｈｅｓｉｏｎｓ),向细胞外基质(ｅｘｔｒａｃｅｌｌｕｌａｒｍａｔｒｉｘ,ＥＣＭ)浸润(ｉｎｖａｓｉｏｎｓ)、移动(ｍｉｇｒａｔｉｏｎ)、蛋白水解作用(ｐｒｏｔｅｏｌｙｓｉｓ)和次级生长(ｓｅｃｏｎｄａｒｙｇｒｏｗｔｈ)。1　多不饱和脂肪酸(ＰＵＦＡｓ)对肿瘤转移的影响ＰＵＦＡｓ主要包括:ｎ6ＰＵＦＡｓ(ｐｏｌｙｕｎｓａｔｕ…     

赤芝子实体中灵芝酸类成分的研究

自赤芝［Ｇａｎｏｄｅｒｍａｌｕｃｉｄｕｍ（Ｆｒ．）Ｋａｒｓｔ．］子实体的二氯甲烷提取物中分离得到一个新的四环三萜化合物，命名为灵芝酸ＤＭ（ｇａｎｏｄｅｒｉｃａｃｉｄＤＭ，Ｉ）。根据光谱（ＵＶ，ＩＲ，１ＨＮＭＲ，１３ＣＮＭＲ，ＭＳ２ＤＮＭＲ）分析，确定其结构为Ｉ式。同时还分离得到二个已知的灵芝酸类化合物，即灵芝酸Ａ（ｇａｎｏｄｅｒｉｃａｃｉｄＡ，Ｉ）和灵芝酸Ｃ（ｇａｎｏｄｅｒｉｃａｃｉｄＣ，ＩＩ）。     

原发性系膜增生性肾炎临床分析

对４３例经肾活检确诊的原发性系膜增生性肾小球肾炎进行分析，重点讨论其中２３例非ＩｇＡ系膜增生型肾炎（ｎｏｎ－ＩｇＡ ＭｓＰＧＮ）的临床特点，将其中以肾病综合征为主要表现的ｎｏｎ－ＩｇＡ ＭｓＰＧＮ（１４例）与ＩｇＡ肾病（１１例）相比较，提示ｎｏｎ－ＩｇＡ ＭｓＰＧＮ尿蛋白定量较ＩｇＡ肾病重，而且血尿程度较轻。将１４例ｎｏｎ－ＩｇＡ ＭｓＰＧＮ治疗前后的尿ＮＡＧ及尿酸化功能分别进行比较，均有显著差异     

Concurrent polyarteritis nodosa and temporal arteritis

A patient is described in which features of both giant cell arteritis and polyarteritis nodosa were present simultaneously. The case emphasises our lack of an aetiologic classification for arteritis and that on occasions typical clinical presentations may be misleading.     

Cutaneous polyarteritis nodosa after streptococcal necrotizing fasciitis

Polyarteritis nodosa (PAN) is a necrotizing arteritis of small and medium-sized vessels. It may present with hypertension and/or renal insufficiency. Peripheral neuropathy, myopathy, joint pains, testicular pain, and ischemic myalgias may also be seen. Gastrointestinal involvement may lead to gangrene of the bowel, peritonitis, perforation, intra-abdominal hemorrhage, and pancreatitis. The cutaneous manifestations include tender subcutaneous nodules grouped along the course of superficial arteries of the lower extremities, with or without an overlying livedo reticularis. Although multisystem involvement is characteristic, sometimes only one organ or system may be involved. Associations with viral hepatitis (both B and C) and streptococcal infection have been established for PAN. Recurrent strep infections of the upper respiratory tract, streptococcal glomerulonephritis and rheumatic fever have previously been linked to PAN. This report extends the spectrum of associated streptococcal infections to include necrotizing fasciitis.     

Diclofenac, paracetamol, and vidarabine removal during plasma exchange in polyarteritis nodosa patients.

Since plasma exchange (PE) represents a major treatment for patients suffering from systemic diseases, its influence on the kinetics of three drugs was investigated: vidarabine, used in patients with polyarteritis nodosa associated with hepatitis B virus (eight subjects), and diclofenac and paracetamol for investigative purposes (five subjects). This study confirmed that vidarabine is so rapidly deaminated to form hypoxanthine arabinoside (Hx-Ara) that no detectable concentrations were measured. Hx-Ara levels were used to evaluate vidarabine kinetics; 19.5 +/- 14.6 mg of Hx-Ara were removed by one PE during the first week of treatment (15 mg kg-1 d-1, continuous infusion) and 7.8 +/- 10.2 mg were eliminated by one PE during the second week of treatment (7.5 mg kg-1 d-1, continuous infusion). Based on the vidarabine intake per hour and the resulting quantity of Hx-Ara removed per hour, PE recovery was quite important (ca. 30 per cent), during both the first and second weeks of continuous infusion. Data were subject to large interindividual variability. However, these results do not favor vidarabine dosage supplementation in this indication because the duration of PE is less than 8 per cent of a daily administration period. For paracetamol (1 g, single oral dose) and diclofenac (100 mg, single oral dose), the fractions of drug removed during PE effected within 2 h of drug intake, were respectively 5.0 +/- 3.1 per cent and 13.6 +/- 9.5 per cent, while plasmapheretic clearance reached, respectively, 13.0 +/- 10.7 per cent of the systemic clearance for paracetamol and 23.0 +/- 1.0 per cent for diclofenac.