亚铁氰化铜法示乙酰胆碱酯酶方法的改进

目的　探讨周围神经乙酰胆碱酯酶及髓鞘同时染色。方法　将劳克坚牢蓝染髓鞘与亚铁氰化铜染乙酰胆碱酯酶两方法结合并给于改进。结果　乙酰胆碱酯酶活性处呈红棕色颗粒 ,髓鞘呈蓝色。结论　此方法简单易行 ,可用于周围神经纤维性质的鉴别及运动神经纤维再生的研究。     

关于胆碱酯酶的检验

生化特性及病理生理 人体有两种胆碱酯酶(hlolinesterase,ChE),乙酰胆碱酯酶和酯酰胆碱酯酶,两者都能水解乙酰胆碱,但生成组织和生理功能各有不同. AChE主要用于诊断有机磷农药中毒和神经性化学武器中毒.中毒后,AChE被抑制,使乙酰胆碱蓄积,引起乙酰胆碱样中毒症状,实验室检测此酶,可以判断中毒轻重,指导治疗及判定疗效.病情严重时,AChE活力可降至"0";治疗有效时,酶活力可迅速恢复.此酶升高还见于精神分裂症、溶血性贫血和巨幼细胞性贫血等.AChE活性在孕育神经管缺陷胎儿的羊水中显著增高.     

人胎胸腺乙酰胆碱酯酶阳性反应细胞的形态观察

应用乙酰胆碱酯酶组织化学方法在光镜下观察了５￣６个月胎儿胸腺实质中乙酰胆碱酯酶阳性反应细胞的分布及形态结构。结果表明：乙酰胆碱酯酶阳性反应细胞主要分布于胸腺的髓质中，这些细胞可能是淋巴细胞，上皮性网状细胞及上皮性网状细胞－淋巴细胞复合体。就此种细胞的功能进行了讨论。     

DDVP对德国小蠊乙酰胆碱酯酶和谷胱甘肽S-转移酶活性的影响

目的:了解不同浓度敌敌畏(DDVP)对德国小蠊乙酰胆碱酯酶和谷胱甘肽S-转移酶活性的影响,为探讨德国小蠊抗性机制及建立抗性生化检测方法提供理论依据。方法:采用分光光度法和微量板酶动力学法分别测定不同浓度DDVP作用下德国小蠊乙酰胆碱酯酶和谷胱甘肽S-转移酶的活性,应用SAS软件进行统计分析。结果:随着施药浓度增加,乙酰胆碱酯酶和谷胱甘肽S-转移酶活性逐渐降低,施药浓度在0.01％及以上各组的乙酰胆碱酯酶酶活性与对照组有显著性差异:施药浓度在0.02％及以上各组的谷胱甘肽S-转移酶活性与对照组有显著性差异。结论:乙酰胆碱酯酶是DDVP的主要靶标酶之一。谷胱甘肽S-转移酶是DDVP的重要代谢酶。     

舒胃方对功能性消化不良患者胃动力的影响

目的观察舒胃方对功能性消化不良患者胃动力影响。方法 90例功能性消化不良患者随机分为3组。治疗组30例给予舒胃方汤剂治疗;中成药组30例给予木香顺气丸治疗;西药组30例给予枸橼酸莫沙必利片治疗。治疗4周后,检测各组治疗前后患者血清胃动素、乙酰胆碱酯酶及胃排空情况。结果治疗组在改善功能性消化不良患者胃排空、血清胃动素及乙酰胆碱酯酶含量明显优于其他两组(P0.05)。结论舒胃方改善胃肠动力,可能与改善血清胃动素、乙酰胆碱酯酶等胃肠激素水平有关。     

6-氟硫色满酮Mannich碱的乙酰胆碱酯酶抑制活性及动力学研究

目的研究6-氟硫色满酮Mannich碱对乙酰胆碱酯酶的抑制活性及作用类型。方法在体外采用Ellman方法对6-氟硫色满酮Mannich碱进行乙酰胆碱酯酶抑制实验和动力学实验。结果该化合物浓度为10-6mol/L时对乙酰胆碱酯酶的抑制率是51%,活性优于对照组利伐司替明,动力学实验初步证明是混合型竞争抑制。结论 6-氟硫色满酮Mannich碱作为乙酰胆碱酯酶抑制剂具有进一步研究价值。     

卡那霉素对豚鼠耳蜗外毛细胞数量及乙酰胆碱酯酶表达的影响

【目的】观察卡那霉素对豚鼠耳蜗外毛细胞损害及乙酰胆碱酯酶表达的影响。【方法】24只豚鼠随机分为3组：正常对照组、卡那霉素给药3d组和卡那霉素给药6d组。应用耳蜗基底膜铺片AgNO3染色检测外毛细胞,耳蜗免疫组化染色观察乙酰胆碱酯酶表达,并结合听觉脑于反应监测耳毒性损伤的发生。【结果】给药3d组ABR阈值无明显改变,外毛细胞数量无明显减少,乙酰胆碱酯酶表达增加;给药6d组ABR阈值升高,外毛细胞数量明显减少,乙酰胆碱酯酶表达进一步增加。【结论】卡那霉素可损伤外毛细胞并影响乙酰胆碱酯酶的表达。     

羊水总胆硷酯酶的测定及临床意义

作者采用改良血清胆硷酯酶测定的方法测定了103例羊水标本中的总胆硷酯酶的活性。结果表明:孕28周之前,正常胎儿清亮羊水中90％以上的酶活性均低于14mU/ml,28周以后羊水总胆硷酯酶活性逐渐下降,到35周时则不能测得。胎儿如合并神经管畸形、宫内死胎或胎儿濒死状态时,羊水中的总胆硷酯酶的活性明显升高。当羊水有胎血或母血污染,其浓度高于6×10~5/ml时,酶的活性亦明显升高。作者认为,羊水中总胆硷酯酶活性的测定对诊断胎儿神经系统畸形及中枢神经系统的成熟情况有一定价值,本法与羊水中甲胎蛋白的测定及B超联合应用,可提高其诊断的准确性。     

胆碱酯酶染色技术

胆碱酯酶分为两类,一类为乙酰胆碱酯酶,又称真性胆碱酯酶;另一类为假性胆碱酯酶。利用乙酰胆碱酯酶染色法观察该酶在疾病时的改变,对病理诊断及科研方面都有重要作用。 乙酰胆碱酯酶的显示方法,过去常用的有Koelle氏法,Gomori氏法,Snell和Garrett氏法,Gerebtzoff氏改进的Snell和Garrett氏法等,但结果皆不够理想,或需经离心沉淀等     

淡豆豉提取物抑制乙酰胆碱酯酶活性的研究

目的：研究淡豆豉提取物对乙酰胆碱酯酶活性的抑制能力。方法：单因素考察淡豆豉在不同乙醇浓度,不同固液比,不同浸提时间和不同浸提温度下提取物对乙酰胆碱酯酶的抑制能力,采用Ellman法测定不同条件下的提取物对乙酰胆碱酯酶抑制率。结果：淡豆豉提取物的提取工艺为浸提时间60min,乙醇浓度100%,温度70℃,固液比1∶20时,对乙酰胆碱酯酶的抑制效果最佳,且古法炮制淡豆豉提取物对乙酰胆碱酯酶活性的抑制率比市购淡豆豉高。结论：古法炮制淡豆豉提取物对乙酰胆碱酯酶的活性有很好的抑制效果。     

Antenatal diagnosis of neural tube defects in Canada: extension of a collaborative study.

Experience with the diagnosis of neural tube defects from alpha1-fetoprotein (AFP) concentrations in amniotic fluid is reported from a prospective study of five laboratories testing for 13 Canadian genetic centres. The results of the study indicate that antenatal diagnosis of open neural tube defects is being carried out effectively in Canada (in 99.2% of cases the AFP measurements were interpreted correctly). Amniocentesis should be recommended to women at high risk for having a child with a neural tube defect (i.e., those who have a child, a parent or a sibling with a neural tube defect). The rate of neural tube defects in 182 high-risk pregnancies was 2.2% for an open defect and 1.1% for a closed defect, whereas the rate in 673 pregnancies in which amniocentesis was being performed for other reasons was 0.3%. This suggests that the AFP concentration should be measured in any sample of amniotic fluid collected for other reasons (usually fetal karyotyping). There were three instances of false-negative results, for a rate of 0.4%. Two closed neural tube defects were not detected; this limitation of the test has also been found by others. One of the six fetuses with an open neural tube defect, who died in utero, had a large myelocele in the neck that was not recognized. There were also four instances of false-positive results, for a rate of 0.5%. The findings suggest that AFP values that are more than 2 but less than 7 standard deviations (SDs) above the mean may indicate a neural tube defect, and that values 7 or more SDs above the mean very likely indicate such a defect, although other reasons for such high values (e.g., fetal erythrocytes in the amniotic fluid, intrauterine death and mistaken gestational age) must be ruled out by other methods.     

PRENATAL DIAGNOSIS Ⅱ. AMNIOTIC FLUID ACETYLCHOLINESTERASE ISOENZYME PATTERNS AND ALPHA-FETOPROTEIN FOR PRENATAL DIAGNOSIS

Both amniotic fluid (AF) alphafetoprotein (AFP) and acetylcholinesterase isoenzyme patterns (AChEI) were used for prenatal diagnosis. 721 samples were analyzed. The results obtained from AChEI analysis by gel electrophoresis of AF were much more accurate than those from AFP. In 58 pregnancies with uncertain gestational age, assessment became difficult because its values decreased significantly after the 16th week of gestation but AChEI was not influenced by gestational ages. Both methods are reliable in the diagnosis of open neural tube defects (NTDs) in early pregnancy.     

Antenatal diagnosis of neural tube defects.

One hundred women with pregnancies at risk for the recurrence of neural tube defects have entered our monitoring programme of echography and alphafetoprotein estimation (AFP) on amniotic fluid and maternal serum during the second trimester. The results of these pregnancies, the application of the programme, sources of error, and the reliability of alphafetoprotein levels are discussed. Conclusions regarding the value of the tests and routine antenatal screening are made.     

PRENATAL DIAGNOSIS Ⅰ. EARLY DIAGNOSIS OF OPEN NEURAL TUBE DEFECTS BY QUALITATIVE ACETYLCHOLINESTERASE ISOENZYME IN AMNIOTIC FLUID

The measurement of amniotic fluid (AF) acetylcholinesterase isoenzyme (AChEI) is a relatively new method for early diagnosis of open neural tube defects (NTDs). As quantitative methods are of unproven reliability at present, the authors used a high resolving power qualitative method-vertical slab polyaerylamide gel electrophoresis. The benefits of this technique are: simplicity of operation, accuracy, unsophisticated equipment, and easily available reagents. Combined results of 9 NTDs studies revealed that samples from early pregnancy gave more accurate results than those from late pregnancy.     

Prenatal detection of neural tube defects. VI. Experience with 20,000 pregnancies

Neural tube defects (NTDs) are among the most common major congenital malformations in the United States. Prenatal detection is possible in about 95% of cases by assaying amniotic fluid for alpha-fetoprotein (AFP), which leaks from open lesions. In 20,000 pregnancies, 334 (1.7%) had a raised level of AFP. Of these, 136 (40.7%) had open NTDs, 90 (26.9%) had other fetal defects or conditions, and 108 (32.3%) almost invariably had admixed fetal blood. Pregnancy was electively terminated in 11 cases in which the AFP concentration was thought to be elevated but in which the fetus was apparently normal (0.06%), but in only two of these cases was there no explanation for the raised level of AFP. The practical false-positive rate was considerably below 0.06%. Patients at risk for bearing children with NTDs should be counseled and offered prenatal diagnosis.     

神经管缺陷畸形的B型超声诊断(附62例分析)

本文报道我科62例神经管缺陷畸形的B型超声检查,其中无脑儿38例,单纯脊柱裂2例,无脑儿合并脊柱裂11例,脑积水4例,脑膜及脑脊髓脊膜膨出7例。62例神经管缺陷中有32例在本院分娩,得以证实均为神经管缺陷几,其余30例失访。本文对B型超声诊断神经管缺陷的要点,羊水量与神经管缺陷的关系及脑积水儿双顶间径的大小对诊断的意义进行了探讨。     

妊娠合并糖尿病时羊水糖浓度与羊水容积关系的研究

目的与正常孕妇比较评价妊娠合并糖尿病时孕妇羊水糖浓度与羊水指数(AFI)的关系.方法采取B超测定羊水指数并羊膜腔穿刺抽取羊水测定羊水糖浓度,对41例妊娠合并糖尿病(研究组)及35例正常孕妇(对照组)进行监测比较.结果研究组孕妇体重显著高于对照组,差异有显著性.研究组孕妇AFI为166±50mm、羊水糖浓度为39±17mg/dl,均较对照组高,差异有显著性.结论羊水体积与母-胎-羊水糖水乎动态一致.当发现AFI值高时应警惕妊娠合并糖尿病.     

Estimation of gestational age from study of amniotic fluid and clinical assessment.

Study of 108 samples of amniotic fluid obtained between 28 and 42 weeks' gestation from 101 patients revealed that in normal pregnancies the creatinine concentration, lecithin/sphingomyelin (L/S) ratio and percentage of fat cells correlated better with the gestational age of the newborn--assessed by clinical criteria--than did the bilirubin and sodium concentrations. A creatinine concentration of 1.75 mg/dL or more, an L/S ratio of 4 or more and a fat cell percentage of 10 or more correlated significantly with a gestational age of 37 weeks or more. In abnormal pregnancies (those with obstetric or medical complications, or both) the mean creatinine concentration in the amniotic fluid was significantly less than expected for gestational age in fetal dysmaturity and greater than expected when the mother had diabetes. The mean L/S ratio in the amniotic fluid was elevated when the mother had hypertension or smoked and in cases of fetal dysmaturity or long interval between rupture of the membranes and delivery, whereas it was significantly lower than normal when the mother had diabetes. The mean bilirubin concentration in the amniotic fluid was significantly lower than normal when the mother had hypertension. When the mother had diabetes, maturity of the fetal lung, liver, skin and brain appeared to be delayed, according to the values for the amniotic fluid constituents.     

胰岛素样生长因子与胎儿宫内生长受限的相关性研究

目的探讨胰岛素样生长因子（IGF）与胎儿生长发育的关系。方法抽取20例分娩宫内生长受限（IUGR）胎儿（IUGR组）及25例分娩正常儿（对照组）产妇肘静脉血、新生儿脐静脉血及羊水和胎盘组织,采用放射免疫法及免疫放射法分别测定其IGF-Ⅰ、IGF-Ⅱ水平和RT-PCR法检测胎盘组织中mRNA含量。结果IU-GR组产妇血清IGF-Ⅰ水平低于对照组,IGF-Ⅱ水平差异无统计学意义;IUGR组脐血及羊水中IGF-Ⅰ、IGF-Ⅱ水平较对照组显著降低;IGF-Ⅰ、IGF-Ⅱ的mRNA水平较正常对照组低。结论检测母血及羊水中IGF-Ⅰ、IGF-Ⅱ水平可监测胎儿生长发育,早期诊断IUGR,IGF与IUGR的发病密切相关。     

延期妊娠并发羊水过少对母婴的影响96例临床观察

目的 探讨延期妊娠并发羊水过少对母婴的影响。方法 采用回顾性分析方法,对延期妊娠分娩的产妇羊水正常组244例及羊水过少组96例进行对比分析。结果 羊水过少组中羊水Ⅱ度以上粪染、胎盘成熟Ⅲ^ 级及胎盘钙化、胎儿宫内窘迫、新生儿窒息率、产后出血率及剖宫产率明显高于羊水正常组。结论 羊水过少是胎儿宫内慢性缺氧最敏感的特异性指标,无论是延期妊娠还是过期妊娠一经确珍,应积极引产,估计短时间内不能分娩,宜行剖宫产结束妊娠。