猕猴桃果仁油对小鼠非酒精性脂肪性肝病的作用

目的:观察猕猴桃果仁油对小鼠非酒精性脂肪性肝病(nonalcoholic fatty liver disease,NAFLD) 的保护作用,并初步探讨其作用机制. 方法:健康,♂小鼠50 只,随机分为:对照组、模型组和果仁油低、中、高剂量组[90 、180 、270 mg/(kg·d)]5 组. 除对照组用普通饲料喂养外,其余各组均给予高脂饲料喂养. 实验6 wk 后处死全部小鼠,比较各组之间血清和肝脏生化以及肝脏组织病理学特征. 结果:与对照组相比,模型组小鼠血清TG 、TC 、ALT 、AST 和肝组织MDA 显著升高(均P<0.01),肝组织SOD 和GSH-Px 显著降低(均P<0.01);果仁油中、高剂量组小鼠血清TC 、TG 、ALT 、AST 及肝组织MDA 显著低于模型组(TC:3.05±0.32 mmol/L,2.55±0.43 mmol/L vs 4.55±0.23 mmol/L;TG:1.62± 0.68 mmol/L,1.56±0.57 mmol/L vs 1.90±0.55 mmol/L;ALT:76.91±16.32 U/L,64.54±11.32 U/L vs 170.34±9.32 U/L;AST:128.26±20.15 U/L,112.74±21.37 U/L vs 158.86±18.45 U/L;MDA:5.16±0.97 U/mg,5.01±1.14 U/mg vs 5.88±1.07 U/mg,P <0.05 或0.01),肝组织SOD 和GSH-Px 的显著高于对照组(均P<0.05);模型组小鼠肝脏脂肪变性严重,并伴有炎细胞浸润及坏死,而果仁油中、高剂量组小鼠肝脏脂肪变性程度轻,无明显炎细胞浸润及坏死. 结论:猕猴桃果仁油对高脂饲料诱导的小鼠非酒精性脂肪性肝病有明显的保护作用.     

高脂血症和高脂血症性脂肪肝大鼠肾上腺髓质素2的变化

目的:研究高脂血症、高脂血症性脂肪肝大鼠血浆及肝组织ADM2/IMD的变化,探讨ADM2/IMD在高脂血症、高脂血症性脂肪肝病理过程中的意义.方法:雄性SD大鼠16只,随机均分为对照组与高脂组.大鼠被高脂喂食造模4 wk后,观察大鼠肝脏病理学变化,测定血脂(TG,TC,HDL-C,LDL-C)及肝功能(ALT,AKP);放免法测定血浆及肝组织匀浆ADM2/IMD含量.结果:高脂组体质量、肝质量及肝指数(肝质量/体质量)均显著高于对照组(P<0.01)肝组织呈轻中度脂肪变.高脂组TG、TC、LDL-C、ALT及AKP均显著高于对照组(0.29±0.05 mmol/L vs 0.18±0.09 mmol/L.2.49±0.35 mmol/L vs 1.25±0.16 mmol/L.1.69±0.18 mmol/L vs 0.49±0.06 mmol/L.25.46±5.14 kU/ L vs 13.15±2.83 kU/L,416.1±42.7 U/L vs 281.2±47.3 U/L;P<0.01).HDL-C则低于对照(0.65±0.11 mmol/L vs 0.75±0.10 mmol/L,P<0.01).血浆ADM2/IMD水平两组间差异无统计学意义(P>0.05);但高脂组肝组织匀浆ADM2/IMD水平较对照组高115%(26.21±11.2 pg/mg·pro vs 12.18±2.9 pg/mg·pro,P<0.01).结论:ADM2/IMD可能与大鼠饮食性高脂血症和高脂血症性脂肪肝病理进程有关.     

代谢综合征小鼠肝脏过氧化物增殖体受体γ共同作用因子-1的表达

目的:探讨代谢综合征小鼠肝脏过氧化物增殖体受体γ共同作用因子-1(PGC-1)表达.方法:进正常食C57BL/6J小鼠10只、进高脂高糖食8 wk小鼠5只及16 wkd小鼠10只.测定血脂、血清胰岛素(INS)及空腹血糖、肝功、肝脏重质量、腹部瘦肉及瘦肉含量,肝脏脂质含量及PGC-1蛋白表达采用Western blot免疫印迹,并做肝脏病理.结果:进高脂高糖食16 wk的小鼠腹部脂肪量、血清甘油三酯(TC)和空腹血糖(FBG)均明显高于正常小鼠(腹部脂肪量:3.63±0.62 vs 2.99±0.31.P<0.01:TC:2.31±0.16 mmol/L vs 2.04±0.15 mmol/L.P<0.01:FBG:6.90±1.84 mmol/L vs 5.11±1.86 mmol/L.P<0.05).高脂高糖食的动物血清TP、ALB及A/G低于正常动物,其中进食16 wk的动物ALB及A/G有显著差异(ALB:18.12±2.63 g/L vs 21.64±3.38 g/L,P<0.05;A/G:0.89±0.15 vs 1.06±0.18,P<0.05).血清ALT,ALP及AST高于正常动物,其中进食16wk的动物的ALP有显著差异(103.80±8.72 U/L vs 64.60±10.67 U/L,P<0.05).高脂高糖食小鼠肝脏有明显脂肪变性,16 wk重于8 wk的小鼠.16 wk进高脂高糖食的小鼠肝脏的TC和TG含量显著高于正常动物,达到正常的2倍以上(TC:0.0582±0.0251 mnlol/g干重vs 0.0275±0.0114 mmol/g干重,P<0.01;TG:0.1566±0.0166 mmol/g干重vs 0.063 1±0.0232 mmol/g干重,P<0.01).高脂高糖食小鼠肝脏PGC-1表达高于正常动物,16 wk强于8wk的小鼠.结论:高脂高糖食C57BL/6J小鼠可作为代谢综合征动物模型,其存在脂肪肝,肝脏的PGC-1蛋白表达量高于正常食小鼠,可能其参与脂肪肝的形成.     

罗格列酮对高脂饮食诱导非酒精性脂肪肝大鼠胰岛素抵抗及脂联素的影响

目的:探讨罗格列酮对高脂饮食所致的非酒精性脂肪肝大鼠模型胰岛素抵抗及脂联素的影响.方法:30只大鼠随机分为3组,即模型组(高脂饮食 蒸馏水ig),空白对照组(正常饲料 蒸馏水ig)和罗格列酮组[高脂饮食 罗格列酮3 mg/(kg·d)ig].观察各组血脂、肝功、胰岛素抵抗指数(HOMA-IR)的变化和各组肝组织HE染色与脂肪特异性的苏丹Ⅲ染色的变化.采用实时荧光定量聚合酶链式反应(PCR)和免疫印迹(western blot)检测各组肝组织的脂联素水平.结果:模型组与空白对照组相比,甘油三酯(TG)(1.51±0.37 mmol/L vs 0.98±0.51 mmol/L,P<0.01),总胆固醇(TC)(2.74±0.65 mmol/L vs 1.71±0.37 mmol/L,P<0.05),ALT(450.20±244.12 U/L vs 264.56±48.44 U/L,P<0.011,AST(460.30±310.13 U/L vs 196.11±52.23 U/L,P<0.01)和HOMA-IR(3.46±1.16 vs 1.07±0.26,P<0.01)均显著升高.罗格列酮治疗可使TG(1.27±0.50 mmol/L),ALT(360.26±244.37 U/L,AST(300.20±233.13 U/L)以及HOMR- IR(1.44±0.37)得到明显改善(均P<0.05).从组织病理学亦可得到证实.肝组织实时荧光定量PCR及免疫印迹显示罗格列酮组的Adiponectin mRNA(552.40±268.13 vs 215.95±135.87,P<0.05)和蛋白表达均较模型组升高.结论:高脂饮食可诱导大鼠NAFLD和IR发生,并使肝功,血脂异常升高.罗格列酮可以改善高脂饮食大鼠的脂肪肝及IR情况,可能与Adiponectin缓解IR和NAFLD改善有关.     

应用磁共振氢谱技术评价中药肝脂消胶囊治疗非酒精性脂肪肝的疗效

目的:应用磁共振氢谱(~1H-MRS)技术定量评价复方中药肝脂消胶囊治疗非酒精性脂肪肝(NAFLD)的疗效.方法:依中华医学会NAFLD诊断标准入选NAFLD患者22例,并与20例健康人对照.两组均进行常规体检,包括体质量指数(BMI)、腰臀比(WHR)、血压(BP)、血清谷丙转氨酶(ALT)、空腹血糖(FBG)、胆固醇(TC)、三酰甘油(TG)、尿酸(UA)和肝脏~1H-MRS扫描,计算肝内脂质含量(IHCL).NAFLD组患者服用肝脂消胶囊8 wk,检测治疗前后血清生化指标和IHCL的变化.结果:NAFLD组BMI,WHR,DBP,ALT,FBG,TG,UA,IHCL分别较正常组(BMI:28.4±2.4 vs 21.7±2.2.WHR:0.91±0.04 vs 0.83±0.04,DBP:80±10 mmHg vs 72±8 mmHg,ALT:71.5±24.8 U/L vs 20.4±10.1 U/L.FBG:5.67±0.61 mmol/L vs 4.72±0.43 mmol/L.TG:2.48±1.46 mmol/L vs 1.05±0.40 mmol/L.UA:420.7±57.5μmol/L vs 372.1±50.6μmol/L,IHCL:27.49%±12.27%vs 1.34%±0.79%,P<0.05或P<0.01)明显升高,但IHCL和上述指标之间没有明显相关性.经治疗后ALT(54.6±19.9 U/L,P<0.01),TG(2.14±1.38 mmol/L,P<0.05),IHCL(19.7%±12.7%,P<0.01)均明显下降.结论:肝脏~1H-MRS扫描可对肝脏内脂质含量进行准确定量,肝脂消胶囊可有效治疗NAFLD.     

软脉灵对大鼠非酒精性脂肪肝的预防作用

目的:观察软脉灵对非酒精性脂肪性肝病大鼠模型的预防作用.方法:采用高脂膳食喂养方式建立大鼠非酒精性脂肪性肝病模型.♂SD大鼠90只,随机分为模型组、药物组与空白对照组,每组30只.模型组应用高脂饲料喂养,药物组在高脂饲料喂养同时应用软脉灵灌胃,空白对照组应用基础饲料喂养.每组均于8,12及16 wk时各处死10只,观察肝脏指数,血清与肝组织生化指标及肝组织病理改变.结果:16 wk时与模型组相比较,药物组肝脏指数显著降低(F=51.626,P=0.000);血清胆固醇(CHOL)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-c),丙氨酸转氨酶(ALT)及谷草转氨酶(AST)水平明显降低(2.27±0.38 mmol/L VS 3.09±0.45 mmol/L;0.83±0.13 mmol/L vs 1.03±0.18 mmol/L;0.41±0.06 mmol/L vs 1.09±0.27 mmol/L;52.0±6.50 U/L vs 79.0±4.72 U/L;182.9±26.43 U/L vs 326.5±28.21 U/L;均P<0.01),但血清高密度脂蛋白胆固醇(HDL-c)水平提高(0.76±0.17 mmol/L vs 0.55±0.11 mmol/L,P<0.01);肝组织丙二醛(MDA)水平降低明显(167.2±14.00 mmol/g vs 263.6±26.84 mmol/g,P<0.01),超氧化物歧化酶(SOD)活力增加显著(9.95±0.33 U/g vs 4.36±0.46 U/g,P<0.01),肝组织脂肪变性程度(χ~2 =19.828-20.470,均P=0.000)和炎症活动度(F =10.170,P=0.000)明显减轻.结论:软脉灵具有预防大鼠非酒精性脂肪性肝病的作用.     

沙棘与疏肝理气及清热利湿方配伍对脂肪肝大鼠的防治作用

目的:探讨沙棘分别与逍遥散及二妙散配伍对实验性脂肪肝大鼠的防治作用.方法:大鼠随机分为5组:正常组(N)、模型组(M)、西药(东宝肝泰)组(D)、沙棘配逍遥丸组(SA)、沙棘配二妙散组(SB),每组10只.正常组基础饲料喂养,其余各组高脂饲料喂养8wk后行药物干预,并继续高脂每日加250mL/L乙醇12mL/kg,ig,1mo后观察进食量、体质量、肝脾指数、用药前后血清总胆固醇(CHO,mmol/L)、三酰甘油(TG,mmol/L)、低密度脂蛋白(LDL, mmol/L)、极低密度脂蛋白(VLDL,mmol/L),高密度脂蛋白(HDL,mmol/L)及肝脏病理改变.结果:高脂喂养2mo和药物干预后.与N组相比,M组大鼠体质量增长加快,CHO,TG,LDL和VLD明显升高,HDL明显下降;与M组相比,SA和SB组大鼠进食量减少、TG和VLDL下降(TG:3.9±0.2,4.0±O.1vs5.4±0.3;VLDL:2.4±0.1,2.7±0.1vs 3.1±0.2,P＜0.05),D组TG下降(3.3±0.5vs5.4±0.3,P＜0.05).肝脏病理方面,M细肝细胞呈广泛的气球样变,SA和SB组均能明显减少病变的肝细胞数和减轻病变程度.结论:沙棘与逍遥散及二妙散配伍对肝脏损伤有保护作用,以沙棘与逍遥散配伍防治作用更好.     

清肝活血方对乙醇性肝纤维化大鼠肝星形细胞和肝细胞凋亡的影响

目的:观察酒精性肝纤维化大鼠Hsc和肝细胞的凋亡及中药清肝活血方对细胞凋亡的影响.方法:以乙醇为主制备酒精性肝纤维化大鼠模型,将造模大鼠分为清肝活血方低(4.75g/kg)、中(14.25g/kg)和高剂量组(28.5g/kg),每日进行ig药物干预2wk,并设空白对照组、模型对照组及易善复对照组.比色法检测血清ALT,AST,γ-GT;HE和Masson染色观察肝组织炎症和纤维化程度.TUNEL检测肝细胞凋亡,TUNEL-α-SMA双标记检测HSC凋亡.结果:清肝活血方用药组及易善复组能降低大鼠血清ALT(1213±245,1432±253nkat/Lvs2140±428nkat/L,P均<0.05),AST(1671±400,2123±413vs4454±850nkat/L,P均<0.05),γ-GT水平(4539±1847,5509±2430vs8271±3304nkat/L,P均<0.05),减轻纤维化程度(5.5±2.50,6.30±3.16vs9.00±2.27,P<0.05);诱导活化的HSC凋亡(5.25%±2.48%,3.63%±2.04%vs2.30%±1.24%,P<0.05),减少肝细胞凋亡(0.43%±0.11%,0.60%±0.16%vs1.77%±0.49%,P<0.05).结论:清肝活血方能有效减轻大鼠肝纤维化程度,并减少乙醇引起的肝细胞凋亡,诱导活化的HSC凋亡.     

下丘脑STAT3在非酒精性脂肪性肝病大鼠发病中的作用及降脂颗粒的干预

目的:观察非酒精性脂肪肝大鼠下丘脑STAT3蛋白表达和组成性激活的改变,以及中药降脂颗粒对其干预作用.方法:高脂饲料制备非酒精性脂肪肝大鼠模型,待造模成功后将大鼠随机分为模型对照组(n=10)、辛伐他汀组(n=10)、降脂颗粒组(n=10),每日进行ig药物干预,4 wk,并设空白对照组(n=8).比色法检测血清TG、TC;HE染色观察观察肝组织脂肪变和炎症;Western blot检测下丘脑磷酸化STAT3蛋白表达,EMSA检测下丘脑STAT3的组成性激活状态.结果:磷酸化STAT3蛋白表达及其组成性激活在非酒精性脂肪肝大鼠均明显降低,降脂颗粒用药组及辛伐他汀组能下调大鼠血清TG(0.54±0.09 mmol/L,0.68±0.08 mmol/Lvs 0.84±0.09 mmol/L,均P<0.05)、TC(1.85±0.31 mmol/L,2.08±0.30 mmol/L vs 2.84±0.30mmol/L,均P<0.05)水平,减轻肝脂肪变(2.26±0.52,2.57±0.67 vs 3.10±0.57,均P<0.05)和炎症程度(0.68±0.67,0.95±0.6 vs 1.52±0.71,均P<0.05);上调下丘脑组织磷酸化STAT3蛋白表达及其组成性激活.结论:STAT3在非酒精性脂肪肝大鼠下丘脑组织表达和激活明显下降,中药降脂颗粒对非酒精性脂肪肝有很好的治疗作用,并可上调STAT3的表达和组成性激活.     

贞清方对2型糖尿病并发非酒精性脂肪肝大鼠LXRα表达的影响

目的:探讨贞清方对2型糖尿病非酒精性脂肪肝的治疗作用及可能机制.方法:高脂高糖饮食结合小剂量链脲佐菌素(STZ)腹腔注射建立2型糖尿病并发非酒精性脂肪肝大鼠模型.将成模大鼠随机分为模型组、贞清方治疗组和女贞子治疗组( n= 8),并设立正常对照组( n = 10),灌胃治疗8 wk.比较喂养4、8和16 wk时各组大鼠空腹血糖(FBG)、血清甘油三酯(TG)、总胆固醇(TC)、胰岛素(FINs)和胰岛素敏感指数(ISI)的变化.并于喂养16 wk时观察各组大鼠肝脏指数、TG含量和血清丙氨酸转氨酶(ALT)的水平以及病理变化.用PCR法观察大鼠肝X受体(LXRα)及其下游固醇调节元件结合蛋白-1c(SREBP-1c) mRNA的表达,免疫组织化学法观察肝脏LXRα蛋白的表达.结果:灌胃干预8 wk后,与正常组相比,模型组大鼠FBG、血清TG、肝脏指数及肝脏TG含量明显升高(均P<0.01),胰岛素敏感性明显降低( P<0.01),肝脏脂肪变明显加重,肝脏LXRα mRNA、SREBP-1c mRNA和LXRα蛋白的表达明显增多(均P<0.01).与模型组相比,贞清方治疗组大鼠FBG水平、血清TG水平、肝脏指数及肝脏TG含量明显降低(10.94±3.33 mmol/L vs 16.67±4.33 mmol/L; 0.79±0.27 mmol/L vs 1.33±0.33 mmol/L; 5.72±0.81vs 7.61±1.24; 0.041±0.0110 mmol/g vs 0.059±0.0160 mmol/g,均P<0.01),肝脏脂肪变明显改善,肝脏LXRα mRNA、SREBP-1c mRNA和LXRα蛋白的表达明显减少(0.75±0.11 vs1.23±0.17,0.68±0.16 vs 1.07±0.14,0.220±0.071 vs 0.334±0.037,均P<0.01).结论:贞清方对2型糖尿病性非酒精性脂肪肝具有一定的治疗作用,且其治疗作用可能与贞清方能下调非酒精性脂肪肝组织LXRα的表达有关.     

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.     

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.     

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.     

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。     

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     

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。     

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。