天然牛磺酸联合中药对大鼠肝纤维化的影响研究

目的观察天然牛磺酸联合中药对大鼠肝纤维化的影响。方法选取SPF级SD雄性大鼠120只,180~220 g。随机分成6组,即正常对照组、模型对照组、天然牛磺酸联合中药组、天然牛磺酸组、中药组、秋水仙碱组,每组20只。正常对照组给予正常喂养;其余5组制作肝纤维化模型。给予6组大鼠生理盐水或药物干预,4周后处死大鼠取腹主动脉血及肝组织进行检测比较。结果 (1)天然牛磺酸联合中药组大鼠肝纤维化程度显著轻于模型对照组(P0.05),脂质空泡少,肝细胞坏死程度轻、变性不明显,肝细胞索放射状排列,肝小叶结构基本完整。(2)6组大鼠肝组织肝纤维化分期、分级比较差异具有统计学意义(P0.01);天然牛磺酸联合中药组肝纤维化程度明显轻于中药组和天然牛磺酸组(P0.05)。(3)6组大鼠血清HA、LN、PCⅢ、ⅣC含量比较差异有统计学意义(P0.05);天然牛磺酸联合中药组大鼠血清LN、PCⅢ含量显著低于模型对照组、天然牛磺酸和中药组(P0.05)。(4)6组大鼠血清ALT、AST、Alb水平比较差异有统计学意义(P≤0.05);天然牛磺酸联合中药组大鼠血清ALT和AST水平显著低于模型对照组、天然牛磺酸组及中药组,Alb显著高于模型对照组、天然牛磺酸组及中药组(P0.05)。结论天然牛磺酸联合中药在抗肝纤维化方面优于天然牛磺酸或中药。     

川芎嗪抗肝纤维化作用的实验研究

目的:观察川芎嗪的抗肝纤维化作用。方法:用50％四氯化碳油剂腹腔注射6周诱导大鼠肝纤维化模型并用川芎嗪治疗,观察其对肝纤维化各项指标的影响。结果:川芎嗪能显著降低大鼠血清谷丙转氨酶(ALT)、丙二醛(MDA)、透明质酸(HA)、Ⅲ型前胶原(PCⅢ)及肝组织中MDA;提高肝组织中超氧化物歧化酶(SOD)活性;显著减轻肝脏胶原纤维增生程度。结论:川芎嗪有抗脂质过氧化作用及抗肝纤维化作用。     

三草护肝胶囊抗实验性肝纤维化药效学研究

目的:观察三草护肝胶囊对肝纤维化动物血清相关指标(ALT、AST、ALP、TP、Alb、Glb、A/G、LM、HA、PCⅢ)、肝脏羟脯氨酸(Hyp)和肝脏超微结构的影响。方法:以四氯化碳皮下注射复制大鼠化学性肝纤维化模型,与秋水仙碱作比较。结果:三草护肝胶囊能显著降低肝纤维化大鼠血清AST和ALP活性,降低血清HA、LM、PCⅢ及肝组织Hyp含量,超微结构观察亦显示给药组肝纤维化程度较模型组轻。结论:三草护肝胶囊具有较好的抗肝纤维化作用。     

加味复元活血汤防治大鼠肝纤维化研究

[目的]研究加味复元活血汤对实验大鼠肝纤维化预防与治疗作用及其机制.[方法]应用四氯化碳诱导建立大鼠实验性肝纤维化模型,连续11周.造模同时中药组用加味复元活血汤灌胃治疗,西药对照组以秋水仙碱灌胃治疗,空白、模型组则给予等体积0.85%氯化钠液灌胃.于11周末检测大鼠肝功能:血清总蛋白(TP)、白蛋白(Alb)、丙氨酸氨基转移酶(ALT)、天冬氨酸转氨酶(AST);血清及肝组织匀浆肝纤维化指标:透明质酸(HA)、Ⅳ型胶原(C-Ⅳ)、层黏连蛋白(LN)、Ⅲ型前胶原(PCⅢ);并观察肝组织病理形态学改变;免疫组化方法检测肝组织C-Ⅳ、LN、转化生长因子β1(TGF-β1)阳性表达.[结果]加味复元活血汤组与模型组及西药组比较:肝功能TP、Alb明显升高,ALT、AST明显下降,血清HA、C-Ⅳ明显下降,肝组织匀浆HA、LN、PCⅢ明显下降,差异均有统计学意义(P＜0.01或＜0.05);肝组织病理改变明显减轻;肝组织内C-Ⅳ、LN、TGF-β1阳性面积显著降低.[结论]加味复元活血汤能有效地改善肝脏微循环,具有防治实验大鼠肝纤维化,保护肝细胞,恢复肝功能的作用.     

绞股蓝总皂苷对四氯化碳诱导大鼠肝纤维化的防治作用

目的:观察绞股蓝总皂苷对四氯化碳( CCl4)诱导的大鼠肝纤维化的防治作用.方法:采用CCl4诱导的大鼠肝纤维化模型,分为正常组(Z,n=6)、模型组(M,n=8)、绞股蓝总皂苷组(J,n=8)、秋水仙碱(Q,n=8).造模6周末开始给药(股蓝总皂苷200mg/kg体重、秋水仙碱0.1mg/kg体重),给药3周.观察:①大鼠体重、肝脾比值的变化;②血清丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)、谷氨酰转肽酶(GGT)活性、白蛋白( Alb)、总胆红素(TBil)含量、肝组织羟脯氨酸(Hyp)含量;③肝组织超氧化物歧化酶(SOD)活性及丙二醛(MDA)、还原型谷胱甘肽(GSH)、谷胱甘肽过氧化物酶(GSH-Px)含量;④肝组织病理及胶原沉积情况.结果:①M组大鼠血清ALT、AST、GGT、TBil显著升高,Alb显著降低;J和Q组大鼠血清ALT、AST、GGT、TBil显著下降,Alb显著升高;②M组大鼠肝组织Hyp含量显著升高,J组及Q组大鼠肝组织Hyp含量显著下降;③肝组织HE染色显示:M组大鼠肝细胞脂肪变性,大量纤维结缔组织增生,假小叶形成.J组及Q组大鼠肝细胞脂肪变性减轻,纤维增生减少,少见完整假小叶结构.天狼星红染色显示:M组大鼠肝窦周胶原沉积明显,形成较厚汇管区和中央静脉间的纤维间隔,J组和Q组大鼠肝脏汇管区胶原纤维染较M组明显减轻;④M组大鼠肝组织SOD活性及GSH含量明显降低,MDA含量显著升高.J组大鼠肝组织SOD活性显著提高.结论:绞股蓝总皂苷具有显著抗CCl4诱导的大鼠肝纤维化及氧化损伤的作用.     

壮医药线点灸对大鼠肝纤维化组织学及血清学的影响

目的观察壮医药线点灸抑制肝纤维化作用。方法采用CCL4诱导大鼠肝纤维化模型,Wistar大鼠随机分正常对照组、模型组、药线组各10只,应用免疫组化及放射免疫等方法研究壮医药线对肝纤维化大鼠肝组织纤维化程度,肝星状细胞(HSC)凋亡率,超氧化物歧化酶(SOD)、丙二醛(MDA)、转化生长因子!1(TGF-"1)含量以及对血清中谷丙转氨酶(ALT)、透明质酸(HA)、III型前胶原(PCIII)、层粘蛋白(LN)含量的影响。结果与模型组相比,药线组能显著改善大鼠肝组织纤维化程度,促进活化HSC凋亡,提高SOD含量,降低MDA、TGF-#1的含量及血清中ALT、HA、PCIII、LN的水平(P<0.01)。结论壮医药线点灸具有一定的抑制肝纤维化作用。     

肝炎平对大鼠肝纤维化血清学指标的影响

目的:探讨肝炎平对肝纤维化大鼠血清中肝纤维化指标的影响.方法:制备大鼠肝纤维化模型.动物随机分为正常对照组(N组)、肝炎平治疗组(G组)、和络舒肝胶囊治疗组(H)及肝纤维化模型组(M组).采用放射免疫法对大鼠血清肝纤维化指标透明质酸(HA)、Ⅳ型胶原(C-Ⅳ)、板层素(LN)及Ⅲ型前胶原(PCⅢ)进行检测,并观察大鼠肝脏组织学变化.结果:肝炎平组及和络舒肝组能明显降低肝纤维化大鼠的HA、C-Ⅳ、LN及PCⅢ水平,与模型组比较,差异有显著性意义(P＜0.05),两组大鼠肝脏组织病理学变化亦有明显改善.结论:肝炎平具有抗大鼠肝纤维化的作用.     

硒酵母对大鼠慢性肝纤维化的治疗作用

目的观察硒酵母对大鼠慢性肝纤维化的治疗作用。方法用CCl4诱导大鼠肝纤维化形成,给予硒酵母(5μg/ml,0.5ml/100g体重)灌胃4w。检测大鼠血清丙氨酸氨基转换酶(ALT)、天冬氨酸氨基转换酶(AST)、白蛋白/球蛋白比值(A/G)、透明质酸(HA)、Ⅲ型胶原(PCⅢ)及层黏蛋白(LN)的变化。结果肝纤维化组大鼠ALT、AST、HA、LN及PCⅢ均明显高于正常对照组(P0.05),而A/G则明显低于正常对照组(P0.05);硒酵母治疗4w后,大鼠ALT、AST、HA、LN及PCⅢ与未治疗组相比明显降低(P0.05),A/G比值明显升高(P0.05),大鼠肝功能及肝纤维化明显改善。结论硒酵母可降低大鼠肝纤维化程度,改善肝功能。     

养容胶囊保肝及抗肝纤维化的临床作用

[目的]观察养容胶囊保肝及抗肝纤维化的临床作用.[方法]将133例慢性乙型肝炎及肝硬化患者随机分为2组,治疗组(67例)口服养容胶囊,对照组(66例)口服护肝片,疗程均为6个月.观察2组用药后临床疗效结果,肝功能[谷丙转氨酶(ALT)、血清总胆红素(TBil)、血清白蛋白(Alb)]、血清肝纤维化指标[透明质酸酶(HA)、层黏蛋白(LN)、Ⅳ型胶原(Ⅳ-C]等方面的变化.[结果]治疗组治疗后ALT、TBil、Alb及HA、LN、Ⅳ-C较治疗前明显改善(P＜0.05),临床疗效、临床症状改善与对照组比较,差异有统计学意义(P＜0.05).[结论]养容胶囊对慢性乙型肝炎及肝硬化可能具有一定的保肝及抗纤维化作用.     

补肾柔肝方治疗慢性乙型肝炎肝纤维化的临床观察

目的:观察补肾柔肝方治疗慢性乙型肝炎(CHB)肝纤维化的临床疗效。方法:CHB肝纤维化患者60例,分为治疗组30例,对照组30例,疗程均为3个月,分别于治疗前后检测两组患者的肝功能和肝纤维化4项指标,并进行比较。结果:疗程结束后两组患者ALT、AST、TBil均有不同程度下降,同时Alb升高,以治疗组明显。治疗组患者HA、PCⅢ、LN、C-Ⅳ亦明显下降,优于对照组(P<0.05)。结论:补肾柔肝方具有显著的抗肝纤维化作用。     

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。     

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。     

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.     

Angiographic diagnosis of the degree of serosal invasion of carcinoma of the colon

Angiography using Prostaglandin El^® was performed on 38 patients with carcinoma of the colon in order to diagnose the degree of serosal cancer invasion. The findings at angiography were classified into four groups:1) AG-S3, abnormal change (irregularity and/or encasement) up to marginal vessels; 2) AG-S2, abnormality up to vasa recta; 3) AG-S1, abnormality of penetrating branches of vasa recta within the wall of the colon; and 4) AG-S0, no distinct findings of abovementioned vessels. These angiographic findings were compared with both macroscopic and microscopic serosal cancer invasion. Angiographic diagnosis is in accord with the macroscopic findings in 84.2 percent of cases. Angiographic diagnosis is in accord with the microscopic findings in 32.4 percent of cases. Macroscopic findings confirm the angiographic diagnosis precisely but the conflict with microscopic findings should not be overlooked. This may be the result of inflammatory change, adhesion, and fibrosis around carcinoma of the colon.