胰腺外分泌不足病人的胰酶替代治疗

胰酶主要用于胰腺外分泌功能不足的病人,如囊性纤维化、胰切除术后、全胃切除术后以及慢性胰腺炎.该文作者就胰酶的替代治疗作如下综述,主要包括胰腺外分泌功能的评估,胰腺外分泌不足的发病机制,胰酶制剂的多种形式及其疗效,胰酶使用的剂量,肠内营养与胰酶替代治疗的关系以及使用胰酶的不良反应等.     

固定化辣根过氧化物酶催化活性研究

目的:基于已有的研究成果,对固定化辣根过氧化物酶的催化活性,包括不同介质中固定化酶催化活性进行深入研究。同时研究了催化动力学参数Km。方法:通过固定化辣根过氧化物酶在水体系中的催化活性研究,分析了酶载量、各种常见金属离子、有机溶剂对HRP活性的影响,以及对酶促动力学参数进行了研究。结果:最佳催化条件下,酶载量%为91.7%,金属离子Cu2+、Ag+、Zn2+和有机溶剂乙醇、甲醇、丙酮对固定化辣根过氧化物酶催化活性显示出抑制作用。游离辣根过氧化物酶和固定化辣根过氧化物酶米氏常数Km值分别为2.89 mmol/L和3.65 mmol/L。结论:与游离酶相比,固定化酶具有优良的催化活性和对抑制剂良好忍耐性。     

介绍一种免疾酶最新技术——PAP

PAP是一种最新发明的较为先进的超微量的免疫酶的免疫化学试剂,它的应用技术称为PAP技术。PAP是辣根过氧化物酶(horseradish peroaidase)和抗辣根过氧化物酶动物血清相结合的可溶性酶——抗酶复合物,PAP是取     

辣根过氧化物酶标记抗-HBe方法探讨

酶标记物是 EL ISA方法中最为关键的试剂 ,其质量的优劣 ,直接关系到检测结果的特异性及灵敏度 ,EL ISA常用酶为辣根过氧化物酶 ,标记方法为过碘酶钠氧化法 ,在制备酶标记物时 ,酶与抗体 (抗原 )的比例资料介绍多为 1∶ 2 ,但在各个实验室里 ,往往因原材料不同而有所差异 ,故酶与抗体 (抗原 )之间的比例没有固定的模式。我们根据本室条件将辣根过氧化物酶 ( HRP)标记单克隆 e抗体以 1∶ 1、1∶ 2、1∶ 3的比例进行标记 ,在检测 HBe Ag的试验中进行比较 ,结果以 1∶ 3比例标记效果最好。现将结果报道如下。1　材料与方法1.1　材料HRP…     

肝内HBVDNA与血清HBV复制标志及肝细胞坏死关系的探讨

目的 分析探讨HBVDNA在肝内的表达与肝细胞坏死的关系。方法 采用原位分子杂交的方法检测了肝炎患者肝细胞内HBVDNA，辣根过氧化物酶--抗辣根过氧化物酶(PAP)法检测肝内HBsAg、HBcAg。结果 胞浆型HBVDNA与HBV复制标志及肝细胞坏死密切相关；肝内HBVDNA检出率显著高于HBV非复制组(81％)，且往往与肝内HBsAg、HBcAg阳性部位对应，其分布与肝细胞坏死灶一致，多位于肝细胞坏死灶中间或毗邻。结论 提示HBV活动性复制是肝细胞持续破坏的重要原因。     

淀粉酶·脂肪酶与胰腺炎

胰腺是重要的消化腺体,主要分泌胰酶。胰酶在胰腺中呈酶原状态(无活性),因此不会消化自身胰腺组织。当酶原进入十二指肠后,被激活成胰蛋白酶以消化食物。患有胆道疾病或酗酒、暴饮暴食使胰管内压力增加,如果酶原在胰腺内被激活,胰腺自身被消化可引起急性胰腺炎。急性胰腺炎是常见的五大急腹症之一。它是由于胰腺腺泡受损伤,胰酶在胰腺内被激活并溢出胰管,使胰腺以及邻近组织被消化,造成胰腺水肿、出血和坏死。临床症状主要有上腹剧痛,常伴有恶心、呕吐甚至休克等表现。临床上通常以淀粉酶和脂肪酶作为     

急性胰腺炎的非手术治疗

急性胰腺炎的诊断确立后,应立即开始内科治疗,由于急性胰腺炎的主要发病机制是胰液对胰腺及其周围器官组织自体消化(Autodigestion)的结果,所以治疗的重要原则是抑制胰腺分泌,在抑酶同时要解痉止痛、抗休克、抗感染、纠正水电紊乱等治疗,本病既要考虑局部又要照顾全身,兹分述如下: 一、抑制胰腺分泌 1.禁食及胃肠减压,因食物和胃酸进入十二指肠后,刺激肠粘膜分泌促胰胆液素,促胰胆液素刺激胰腺分泌胰酶。禁食和吸出胃液后,可减少胰酶分泌,从而降低胰酶对胰腺的自溶作用,使胰腺有修复的机会。一般主张持续胃肠吸引至腹痛和腹部压痛消失为止。 2.氟脲嘧啶:Johnson(1973)在动物实     

中医肛俞穴麻醉在肛肠科的应用

目的 探讨与分析中医肛俞穴麻醉在肛肠科的应用.方法 选取2011年6月到2013年6月我院收治的肛肠疾病患者86例,依照治疗标准把患者随机分成观察组与对照组两组,每组43例.通过中医肛俞穴麻醉法治疗观察组,运用中医腰俞穴麻醉方式治疗对照组,观察两组的临床治疗效果.结果 在总优良率上,观察组明显优于对照组（P＜0.05）.结论 中医肛俞穴是一种新观点和新方法,它既延续了张氏肛门局部神经阻滞麻醉术的优点,又在此基础上进行了创新,有着很长的麻醉时间（5h左右）,治疗效果显著,值得临床推广.     

闭合性胰十二指肠损伤诊治体会

目的探讨闭合性胰十二指肠损伤的诊断和治疗方法,以提高临床疗效。方法回顾性分析29例闭合性胰十二指肠损伤的临床资料,胰腺损伤16例,十二指肠损伤13例,其中包括联合胰十二指肠损伤3例,根据损伤部位、损伤程度及患者全身情况,合理采用单纯胰腺、十二指肠修补,远段胰腺切除,胰一空肠Roux—y吻合,带血管蒂空肠间置十二指肠修补,十二指肠二段与空肠吻合,胰十二指肠切除等。结果全组治愈,并发胰腺坏死化脓1例,胰瘘1例,十二指肠瘘1例。结论早期诊断,及时合理手术是取得有效治疗的关键。     

背俞穴与背俞穴的应用

背俞穴与背俞穴的应用开封化肥厂医院高军英朱广丽孟彦李松背俞穴是脏腑经气输注于背腰部的俞穴，共十二穴，位于背腰部足太阳膀胱经的第一侧线上，大体依脏腑位置而上下排列，分别冠以脏腑之名。即：肺俞穴、厥阴俞穴、心俞穴、肝俞穴、胆俞穴、胃俞穴、三焦俞穴、肾俞穴...     

Uncomplicated selenium deficiency produced in chicks fed a corn-soy-based diet

Day-old chicks were fed a practical-type diet based on corn- and soybean meal produced in a severely Se-deficient area of northeastern China. The diet contained 0.007 ppm Se and resulted in marked decreases in the activities of Se-dependent glutathione peroxidase in plasma and pancreas within 6 days of feeding. Chicks fed this basal diet showed histological signs of acinar atrophy of the pancreas, hyaline body formation, vacuolation and cytoplasmic shrinkage by 18 days and significantly elevated activities of amylase in plasma by 30 days. Each of these changes was prevented by supplementing the basal diet with Se to bring it to a level of 0.20 ppm. Chicks fed a Se-deficient purified diet based on crystalline amino acids also showed decreased Se-dependent glutathione peroxidase activities in plasma and pancreas, pancreatic damage as evidenced by histological examination and increases in plasma amylase activities. However, these signs of nutritionally induced pancreatic atrophy occurred sooner and were of greater magnitude than those observed in Se-deficient chicks fed the practical diet within the 30-day experimental period. These results, therefore, constitute the first report of nutritionally induced pancreatic atrophy in Se-deficient chicks fed a diet containing intact protein, and we suggest that a factor(s) associated with the practical diet acts to partially protect the chicks from this pathological consequence of severe Se deficiency.     

Effect of excess dietary zinc on pancreatic exocrine function in the chick

The effects of excess dietary zinc (Zn) on exocrine pancreatic function were studied in chicks. A purified diet based on crystalline amino acids and sucrose was employed in several experiments, and a practical type of diet based on corn and soybean meal was used in one experiment for the purpose of comparison. Additions of as little as 100 mg Zn/kg as ZnO to the purified diet markedly elevated pancreatic Zn concentration, whereas liver and plasma Zn were moderately increased. Histological examination of the pancreas showed alterations in acinar structure due to Zn intoxication. The activities of the pancreatic exportable enzymes amylase, lipase, trypsinogen and chymotrypsinogen were each decreased by such levels of Zn feeding. Reductions of pancreatic enzyme activities were associated with reductions in the digestibility of dietary starch and in tissue alpha-tocopherol concentrations. Chicks fed the nonpurified (i.e., soy-containing) diet accumulated much less Zn in the pancreas (about one-tenth as compared with the purified diet); the addition of as much as 2000 mg Zn/kg as ZnO to this diet produced only a small increase in pancreas Zn concentration, and did not affect exportable pancreatic enzyme activities or tissue alpha-tocopherol concentrations. These results indicate that dietary factors that reduce Zn availability may also reduce Zn toxicity. Chicks fed the purified diet with excess Zn had slightly higher liver selenium (Se) concentrations, but this effect was not associated with changes in the activity of Se-dependent glutathione peroxidase in that organ. Nutritional deprivation of Se did not affect the extent of Zn-induced acinar damage.(ABSTRACT TRUNCATED AT 250 WORDS)     

Perforant pathway lamination in the dentate gyrus is unaffected by prenatal ethanol exposure

The entorhinal (perforant path) projection to the dentate gyrus was labeled with an anterograde horseradish peroxidase method to test whether prenatal exposure to ethanol affected the normal development of afferent lamination. Mean ethanol consumption of the ethanol-consuming dams was 12.7 g/kg +/- 0.3 g per day during days 1-21 of gestation. Adult offspring of normal and pair-fed controls as well as ethanol-exposed rats were analyzed. Computer-assisted image analysis of the entorhinal terminal field organization revealed no permanent changes in the development of the afferent lamination pattern in the dentate gyrus molecular layer in spite of the heavy in utero ethanol exposure.     

Synthesis, characterization and antidiabetic properties of N(1)-2,4-dihydroxybenzylidene-N(4)-2-hydroxybenzylidene-S-methyl-thiosemicarbazidato-oxovanadium(IV)

A new oxovanadium(IV) chelate [VOL] (L: N(1)-2,4-dihydroxybenzylidene-N(4)-2-hydroxybenzylidene-S-methyl-thiosemicarbazidato) was synthesized and characterized by elemental analysis, conductivity and magnetic measurements, UV-vis, IR, EPR spectroscopy and mass spectrometry. The biochemical and immunohistochemical effects of the administration of the vanadium complex (VOL) into the pancreas of normal and streptozotocin-induced diabetic rats were profoundly investigated. The animals were randomly divided into four groups. Group I: control (intact) animals. Group II: control animals administered with VOL. Group III: STZ-induced diabetic animals. Group IV: STZ-induced diabetic animals administered with VOL. VOL was given to some of the experimental animals by gavage at a dose of 0.2mM/kg every day for 12 days. Blood samples were collected from animals, on 0 and 1, 6 and 12 days after STZ injection. On day 12, the pancreatic tissues were taken from the animals. The tissue sections were labelled with streptavidin biotin peroxidase technique for insulin. In the diabetic group, the blood glucose levels, aspartate and alanine transaminases, alkaline phosphatase activities were increased. But, in the diabetic+VOL groups, the blood glucose levels, aspartate and alanine transaminases, alkaline phosphatase activities were reduced. In the diabetic group, a decrease in the pancreatic glutathione levels, glutathione peroxidase and superoxide dismutase activities and an increase in the pancreatic lipid peroxidation level and catalase activities were observed. The administration of VOL to the diabetic rats reversed this diabetic effect due to its insulinomimetic effects. According to the immunohistochemical and biochemical results obtained, it was concluded that VOL can regenerate B cells of the pancreas in experimental diabetes and has an antidiabetic and protective effects on the pancreas.     

Organization of the commissural projection to the dentate gyrus is unaltered by heavy ethanol exposure during gestation

The anterograde horseradish peroxidase method was used to determine if prenatal exposure to ethanol affected the development of the characteristic afferent lamination pattern of the commissural projection to the dentate gyrus. Mean ethanol consumption for the ethanol-consuming dams was 12.7 g/kg +/- 0.3 g per day. Adult offspring of rats that consumed a liquid diet containing 35% ethanol-derived calories during days 1-21 of gestation, and both pair-fed and normal controls were examined. Brain weights and volumes of the ethanol and pair-fed control rats did not differ significantly from normal controls. However, body weights of ethanol-exposed rats were significantly reduced compared to normal controls. Computer-assisted image analysis of the HRP-labeling revealed that in spite of the heavy ethanol exposure there was no evidence of alterations in the spatial distribution of the commissural terminal field.     

Influence of dietary vitamin E on nutritional pancreatic atrophy in selenium-deficient chicks

Studies were conducted to determine the relationship between dietary vitamin E (VE) and the development of nutritional pancreatic atrophy (NPA) in selenium (Se)-deficient chicks. Selenium- and VE-depleted chicks reared on a low Se, amino acid-based diet containing 100 IU VE (as all-rac-alpha-tocopheryl acetate) per kilogram were found to have exceedingly low pancreatic activities of Se-dependent glutathione peroxidase (SeGSHpx) at 8 d of age. Supplementation of the purified diet with 500 or 1,000 IU VE/kg prevented both NPA and the associated growth depression. Use of graded dietary VE levels showed that addition of at least 300 IU/kg was required to overcome the growth depression associated with severe Se deficiency. Although tissue alpha-tocopherol concentrations increased linearly with increasing dietary levels of VE, the response in pancreas was less than (about one-half of) those in liver and heart and, unlike the response in heart, was not affected by dietary Se level. That protection against NPA involved the antioxidant action of VE was suggested by results showing that NPA is promoted by high dietary levels of linoleic acid, that high VE levels correct membrane unsaturated fatty acid losses due to Se deficiency and that NPA is prevented by high levels of other antioxidants. It is suggested that the normally low activities of SeGSHpx and concentrations of alpha-tocopherol in the pancreas may predispose that organ to lesions due to oxidative stress under conditions of severe nutritional Se deficiency that results in further depletion of SeGSHpx. This situation may be overcome by feeding VE at 15-20-fold excesses over the levels normally regarded as nutritionally required.     

胰腺癌细胞线粒体DNA突变的检测和分析

目的 研究胰腺癌细胞线粒体DNA调控序列（D-loop）区突变情况.方法 用PCR与直接测序相结合的方法,对比分析二株胰腺癌细胞株SW1990,JF-305和1例原代培养的正常胰腺细胞的线粒体DNA D-loop区的突变位点.结果 二株胰腺癌细胞系和正常胰腺细胞的线粒体DNA D-loop区均存在不同程度的点突变,SW1990共检测到8个突变位点,JF-305共检测9个突变位点,其中73位A-G,16223位C-T,16358位C-T这三个突变位点在二株癌细胞和正常胰腺细胞中均检测到,考虑为多态性变化,其中16211位C-T,16311位T-C两个相同的突变位点在二株胰腺癌细胞中均检测到,考虑为特征性突变.结论 胰腺癌细胞线粒体DNA D-loop区具有多态性和突变性,其特征性突变有望成为新的分子标记.     

胰腺癌三维适形放疗计划剂量学的比较与研究

目的：探讨胰腺癌三维适形放疗中三野、四野、三野交叉3种不同治疗计划的优缺点。方法：10例胰腺癌患者采用3D-CRT方法,在同一治疗计划系统中,设计三野、四野、三野交叉等3种适形放疗方案,总剂量60 Gy,应用剂量-体积直方图（DVH）评价PTV、正常组织受量、对比研究3种治疗计划的特点。结果：3种治疗方法在靶区适形度及受量上差异不显著,但三野技术在保护脊髓上优于其他2种照射方法,在肝脏及脾脏的保护上无明显差异,在保护双肾上与其他2种方法相比有所欠缺。结论：根据靶体积及肿瘤部位的不同,采用不同的计划方法。胰头部肿瘤因离肠道及肝脏较近,一般采用三野或四野技术;而胰尾部肿瘤因离胃部较近,一般采用三野交叉技术。     

The failure of long-term feeding of raw soy flour, in the presence or absence of azaserine, to induce carcinogenic changes in the mouse pancreas

The effects of feeding mice raw or heated soy flours or casein in the presence and absence of injected azaserine were investigated over a period of 18 months. Although the feeding of raw soy flour (compared with heated soy flour or casein) caused a significant inhibition of growth and an enlargement of the pancreas, there was no macroscopic evidence of pancreatic nodules in any of the six experimental groups. Microscopic examination of the pancreas revealed a somewhat higher (not significant) incidence of atypical acinar cell nodules in all animals injected with azaserine, but this difference was little influenced by the diets themselves. We concluded that raw soy flour itself has no carcinogenic effect on the mouse pancreas and does not enhance the sensitivity of the mouse pancreas to azaserine. Thus, it cannot be assumed that the appearance of pancreatic nodules constitutes an obligatory sequela of pancreatic hypertrophy and/or hyperplasia in all species of animals.     

退行性腰椎管狭窄症的手术效果评价

目的探讨老年退行性腰椎管狭窄症手术方法的选择及效果。方法回顾性分析2009年2月～2011年2月我院收治的66例退变性腰椎管狭窄症患者行腰椎后路全椎板切除或开窗减压植骨融合、椎弓根钉内固定术,男35例,女31例。年龄55～72岁,平均年龄62.4岁。结果 62例获随访,时间8个月～38个月,平均18.3个月,治疗效果用日本矫形外科协会(JOA)下腰痛治疗评分标准,本组术后优良率为87.1%。结论腰椎后路开窗或全椎板切除减压、植骨融合、椎弓根钉内固定术是治疗退行性腰椎管狭窄症的一种有效术式。