蓝氏贾第鞭毛虫特异性细胞骨架蛋白——贾第素研究进展

蓝氏贾第鞭毛虫具有由微管、微丝和骨架蛋白构成的高度发达的细胞骨架系统.近年来,贾第虫的细胞骨架与其致病力的密切关系已经得到证实.在参与细胞骨架构成的众多蛋白质中,特异性细胞骨架蛋白——贾第素是其中重要的成分之一.对贾第素的研究不仅可为贾第虫细胞骨架的研究增添新的知识和研究资料,还可为贾第虫病的致病机制及抗贾第虫药物靶点的选择提供实验依据.     

抗蓝氏贾第鞭毛虫药物研究进展

蓝氏贾第鞭毛虫（Giardia lamblia Stile,1915,亦称G．intestinalis或G．duodenalis,简称贾第虫）,是一种厌氧的（anaerobic）寄生性原生生物。其生活史包括滋养体（trophozoite）和包囊（cyst）两个发育阶段。前者为虫体的致病期（或营养和繁殖期）,寄生于人和某些哺乳动物小肠内导致以腹泻和消化不良为主要症状的蓝氏贾第鞭毛虫病（giardiasis,简称贾第虫病）;后者为感染期（或静止期）,     

蓝氏贾第鞭毛虫的能量代谢特征及其酶学研究

蓝氏贾第鞭毛虫（Giardialamblia,或称G．intestinalis或G．duodenalis,简称贾第虫）是一种呈全球分布的寄生于人和哺乳动物肠道内的微需氧原虫。本虫引起以腹泻和消化不良为主要临床表现的贾第虫病（giardiasis）。自20世纪70年代以来,世界各地贾第虫病的流行甚至爆发流行屡有报道。本病已被列为危害人类健康的10种主要寄生虫病之一。贾第虫病也曾在国际旅游者中流行,故又有“旅游者腹泻”之称。近年来,贾第虫已被认为是一种机会致病性原虫,常在同性恋人群中传播并与艾滋病合并感染。     

蓝氏贾第鞭毛虫的基因及基因型

蓝氏贾第鞭毛虫(Giardia lamblia)是一种多鞭毛的单细胞真核生物,其滋养体寄生在人体的小肠,引起以腹泻为主的贾第虫病(giardiasis)。本病世界范围的感染率约为30%,我国感染率各地区不等,约在1%～20%左右(平均约2.54%)。目前,贾第虫病已被列为全世界危害人类健康的十种主要寄生虫病之一[1]。贾第虫在生物进化上处于特殊地位(属“源真核生物”)。随着分子生物学研究技术的发展,国内外学者对本虫的基因及基因型研究不断深入,本文就近年来这方面的研究综述如下。     

蓝氏贾第鞭毛虫的细胞骨架蛋白

蓝氏贾第鞭毛虫是一种重要的肠道致病性原虫,其致病力与细胞骨架密切相关。贾第虫具有高度发达的细胞骨架系统,包括8根鞭毛、1个腹吸盘、中体和funis等,主要由微管蛋白、肌动蛋白、动力蛋白、贾第素及其相关蛋白组成。该文就贾第虫细胞骨架及相关蛋白的结构和功能作一综述。     

蓝氏贾第鞭毛虫遗传多样性研究进展

蓝氏贾第鞭毛虫是全球危害人类健康的重要寄生性原虫之一。由于该虫宿主包括几乎所有脊椎动物,虫种的基因型和表现型变异较大,因而其宿主特异性及人畜共患传播问题尚未完全解决。近年来,贾第鞭毛虫病的广泛流行已引起人们对其遗传多样性的关注。基于PCR的分子鉴定方法及多种分子标志的应用使得对贾第鞭毛虫种群的遗传结构有了更多了解。该文就蓝氏贾第鞭毛虫遗传多样性的研究进展作一综述。     

贾第虫病分子生物学诊断方法及其应用

蓝氏贾第鞭毛虫病（giardiasis）,简称贾第虫病,是由蓝氏贾第鞭毛虫（Giardia lamblia）引起的一种以腹泻为主要症状的肠道疾病,也有人称蓝氏鞭毛虫病（lambliasis）。因贾第虫病曾在国际旅游者中流行,故又称为＂旅游者腹泻＂。自20世纪70年代以来,在世界各地相继发生     

贾第虫病的实验诊断

该文对贾第虫病的病原学、免疫学及分子生物学检查方法的研究进展进行了综述,讨论了影响检查结果的因素,并简要介绍了检测贾第虫粪抗原的商品化试剂盒及包囊活性的鉴定方法。     

蓝氏贾第虫基因转染研究进展

蓝氏贾第虫 (Giardialamblia)是一种单细胞寄生性原虫 ,能够感染包括人在内的多种动物 ,引起的蓝氏贾第虫病 ,以腹泻和消化不良为主要症状。以往认为本病是人类的一种共栖性肠道鞭毛虫病 ,大多数患者为隐性感染 ,近年来很多临床病例和流行病学资料都已证明蓝氏贾虫病是一种重要的人兽共患寄生虫病。蓝氏贾第虫生活周期简单 ,包括包囊和滋养体两个发育阶段 :包囊通过污染的食物、水或粪便经口感染 ,在小肠上部去包囊 ,发育成为滋养体 ,粘附于小肠上段进行分裂 ,从而导致病变。滋养体随宿主肠道内容物下行 ,在结肠形成包囊 ,随粪便排出 ,能在…     

贾第虫病的实验室诊断

贾第虫(Giardia)是一种鞭毛虫,由列文*虎克(Leeuwenhoek)发现于1681年,作为人类一种重要的病原体,贾第虫直至最近40年才被认识[1].贾第虫目前发现存在于40多种动物体内,虽然它的分类还存在争议,但多数学者认为贾第虫分为三大类.其中的蓝氏贾第虫(Giardia lamblia)又称十二指肠贾第虫(G.duodenalis)或小肠贾第虫(G.intestinalis),主要寄生于人类和哺乳动物的小肠,可引起以腹痛、腹泻、吸收不良为临床表现的肠道寄生虫病--贾第虫病[2](giardiasis).     

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。