IL-1β对豚鼠离体小肠平滑肌的影响

目的研究白细胞介素-1β（IL-1β）对豚鼠小肠平滑肌的影响及机制。方法在距回盲部10cm处取回肠平滑肌标本,分为4组：不同浓度IL-1β剂量对照组;ACH＋IL-1β组;TTX＋IL-1β组;ICC破坏＋IL-1β组。结果IL-1β对豚鼠离体小肠平滑肌收缩的基础张力和振幅有抑制作用,呈浓度依赖性;ACH作用后加入IL-1β（3ng／mL）对ACH收缩无明显抑制作用（P〉0．05）,预加IL-1β（3ng／mL）后加入ACH的收缩振幅与ACH直接作用相比无显著差异（P〉0．05）。TTX阻断肠神经后加入IL-1β（3ng／mL）,小肠平滑肌的收缩无明显变化（P〉0．05）。破坏小肠ICC,收缩幅度和频率与正常小肠收缩幅度和频率比较有显著性差异（P〈0．01）,加入IL-1β（3ng／mL）无显著性差异（P〉0．05）。结论IL-1β对豚鼠小肠平滑肌的收缩活动有抑制作用,对小肠平滑肌的主要神经兴奋物质ACH无明显急性抑制作用,对ACH的反应性无急性影响。IL-1β舒张小肠的作用主要是通过肠神经元介导,对兴奋神经递质释放有抑制作用。ICC是IL-1β对平滑肌抑制途径一个不可缺少的中间环节。     

促结肠动力中药筛选及其机制

目的:探讨中药生白术、小茴香、蒲公英、莱菔子、大腹皮、莪术的促结肠动力作用,以筛选出具有开发价值的促结肠动力药物,并探讨其初步机制.方法:制备豚鼠结肠纵肌,以9g/L氯化钠溶液和乙酰胆碱为对照,观察6味中药对离体结肠肌条收缩活性的效应.实验结果以振幅(g)、时间(s)和曲线下面积(g·s)表示.分析对象为加药后5min内出现的最大波形.结果:该6味中药对肌条均有不同程度的兴奋效应,中药组(依次为大腹皮、莱菔子、蒲公英、小茴香、莪术、生白术)与生理盐水组相比,振幅峰值(0.97±0.40,0.95±0.26,0.87±0.49,0.85±0.26,0.78±0.39,0.60±0.25vs0.03±0.04,P<0.01)和曲线下面积(1.40±1.00,0.75±0.79,0.62±0.54,0.64±0.59,0.40±0.37,0.29±0.15vs0.11±0.06,P<0.05或P<0.01)均有显著性差异,以大腹皮作用最强,时间长达175±238.07s.在阿托品和维拉帕米分别预孵育情况下,加入各中药后与单独中药组的肌条收缩幅度增强的幅度明显减弱,两组间差异有显著性(中药 拮抗剂组vs中药组,P<0.05).结论:该6味中药对结肠平滑肌均有不同程度的兴奋效应,引起的收缩效应可被M受体阻断剂阿托品部分阻断,通过细胞外Ca2 内流介导.     

皱皮木瓜总黄酮松弛胃肠平滑肌的效应机制

目的:探讨皱皮木瓜总黄酮(FLC)松弛胃肠平滑肌作用机制及其与Ca~(2 )的关系.方法:采用家兔离体空肠、回肠和结肠带生物测定法,在离体标本灌流槽中以Tyrode's液平衡家兔空肠、回肠和结肠带,分别观察FLC对空肠自律性收缩、对Ach诱导空肠收缩、对高钾所致结肠带收缩、以及CaCl2诱导回肠平滑肌收缩的影响.结果:FLC和Ver对高K~ 去极化所致结肠带收缩呈剂量依赖性松弛作用,压低最大效应(Emax);FLC(8g/L)对空肠自律性收缩(频率:5.83±2.64 vs 12.52±0.41,P<0.01;张力:0.76±0.26 g vs 2.13±0.21g,P<0.01)和Ach诱导的收缩反应(频率:7.00±2.44 vs 13.10±0.90,P<0.01;张力:0.87±0.34 g vs 3.47±0.57g,P<0.01)均具抑制作用;FLC剂量依赖性抑制Ca~(2 )诱导回肠收缩作用,4、8 g/L时收缩幅度显著低于对照组(2.53±0.45,1.35±0.57 mm vs 5.41±0.64mm,P<0.01).结论:FLC抑制胃肠平滑肌的功能与阻断电压依赖性的钙通道有关.     

莪术对大鼠结肠平滑肌收缩的促进作用及机制

目的:观察莪术对离体大鼠结肠平滑肌收缩运动的影响,并初步探讨其作用机制.方法:制备大鼠结肠平滑肌肌条,以9 g/LNaCl溶液(NS)为对照组,观察不同浓度莪术对结肠平滑肌的收缩效应;以莪术为对照组.分别观察酚妥拉明、维拉帕米和阿托品3种阻断剂孵育肌条后,莪术对肌条的收缩效应.结果:莪术高浓度组对离体大鼠结肠平滑肌的促进作用明显,与NS对照组比较,莪术1g/L、10 g/L组引起的肌条最大收缩振幅和曲线下面积均有统计学意义(63.92±2.06,76.27±2.28vs100%;44.09±11.10,55.66±10.29vs100%,P<0.05或<0.01);与单独莪术组比较,阻断剂维拉帕米和阿托品对莪术引起的肌条收缩有抑制作用,其最大收缩振幅和曲线下面积均有统计学意义(87.35%±50.49%,73.80%±9.37%vs 100%,33.97%±15.18%,27.55%±11.56% vs 100%,P<0.05或<0.01).结论:莪术对大鼠结肠平滑肌的收缩活动有兴奋作用,且与剂量呈正相关,其引起的收缩效应可被阿托品和维拉帕米阻断,而未能被酚妥拉明阻断.     

防风对大鼠结肠平滑肌收缩的抑制作用及其机制

目的: 观察防风(RS)对离体大鼠结肠平滑肌的影响,并探讨其机制.方法: 制备大鼠结肠平滑肌肌条,以9 g/LNaCl溶液为对照,观察防风对肌条自发收缩以及对乙酰胆碱(Ach)引起的肌每收缩的影响.并观察防风对用3种工具药,即纳络酮(NLT)、心得安(XDA)和酚妥拉明(FTLM)充分孵育后的平滑肌肌条的抑制作用.结果: RS各组较NS组均对离体大鼠结肠平滑肌收缩有一定程度的抑制(振幅:F=8.388,P<0.01;面积:F=33.390,P<0.01),在10-40 g/L范围内随浓度的增大而增强.RS可以抑制Ach引起的离体大鼠结肠平滑肌收缩,加入Ach后加入不同浓度的RS平滑肌收缩振幅和面积均可部分抑制(F=6.093,P<0.0l:F=15.383,P<0.01).与对照组(NS RS)比较,FTLM组对平滑肌收缩的振幅(88.92%±9.93%)和面积(91.5%±12.59%)均可抑制(均P<0.01),NIT RS组面积有差异(72.6%±15.26%,P<0.05),而XDA组振幅和面积均无统计学意义.结论: 防风能够抑制离体大鼠结肠平滑肌收缩,其机制与肾上腺素能α-受体、M胆碱受体有关.     

17β-雌二醇对去卵巢豚鼠结肠平滑肌的作用

目的:观察17β-雌二醇对去卵巢豚鼠结肠平滑肌的作用.方法:将豚鼠分为A组(去卵巢7 d)、B组(去卵巢+雌二醇3 d)、C组(去卵巢+雌二醇7 d).利用张力换能器记录豚鼠离体结肠平滑肌肌条对胆囊收缩素(cholecystokinin,CCK)的反应.结果:加入CCK后,三组平滑肌肌条收缩幅度均增加.增加幅度分别为0.096 g±0.015 g、0.134 g±0.026 g、0.179 g±0.027 g.B、C两组增加幅度较A组更为明显(P＜0.05),差别有统计学意义.结论:雌二醇能增强结肠平滑肌对CCK的敏感性.     

P物质NK1受体对大鼠结肠动力的调节作用

[目的]探讨P物质(substance P,SP)不同受体对大鼠结肠动力的调节作用。[方法]取大鼠近端结肠制备纵行肌(LMS)及环形肌(CMS)肌条,用张力换能器及多通道生理信号采集处理系统观察SP及其受体拮抗剂对SP诱导的LMS和CMS收缩活动的影响。[结果]SP显著促进大鼠结肠LMS和CMS自发性收缩活动[LMS:正常(0.85±0.06)g∶SP(1.02±0.05)g;CMS:正常(0.22±0.03)g∶SP(0.81±0.07)g,P0.01];CMS孵育河豚毒素TTX后加入SP收缩幅度显著增加[正常(1.15±0.11)g∶SP(2.25±0.18)g,P0.05];NK1受体特异性阻断剂L-703孵育肌条后加入SP,平滑肌收缩无显著增强,NK2受体特异性阻断剂GR159孵育后,SP能显著诱导平滑肌收缩增强(P0.05)。[结论]NK1和NK2受体均参与SP对结肠动力的调节,且对CMS的调节过程中,NK1受体发挥更重要的作用,SP对LMS的调节可能主要通过肠神经系统。     

胆囊收缩素对胆固醇结石豚鼠离体胆囊肌条的影响

目的:建立胆固醇结石实验动物模型,探讨胆囊收缩素(cholecystokinin,CCK)对胆固醇结石豚鼠离体胆囊肌条收缩的影响,并研究胆道动力因素在胆固醇结石形成中的作用.方法:喂养致石饲料构建豚鼠胆固醇结石模型.采用灌流法加药,利用张力换能器记录豚鼠离体胆囊肌条张力的变化,观察10-9、10-8、10-7 mol/L的CCK-8对正常豚鼠离体胆囊肌条(A组)、喂养致石饲料4 wk(B组)、8 wk(C组)豚鼠离体胆囊肌条及正常豚鼠损伤Caial间质细胞(interstitial cell of cajal,ICC)后离体胆囊肌条(D组)的影响.结果:A组无结石发生,B组及C组共有13例结石发生:A组、B组及C组加入CCK后收缩振幅均增加,呈浓度依赖性:B、C两组振幅加入CCK后的效应值同A组相比变小,起作用时间慢(P<0.05);损伤胆囊ICC后,收缩幅度增加不明显,与CCK浓度无显著差异,而与A组相比效应值有显著性差异(10-9mol/L:0.461±0.071 vs 1.461±0.252:10-8mol,L:0.608±0.118 vs 2.484±0.283:10-7mol/L:0.641±0.129 vs 3.312±0.311,均P<0.01).结论:离体胆囊肌条肌张力降低及对CCK的效应性降低在胆囊结石病的发生发展中有重要作用;而损伤ICC后,胆囊离体肌条对CCK的效应性明显降低,ICC可能在胆囊结石等胆囊动力性疾病中发生作用.     

针刺对结肠吻合术后Cajal间质细胞修复与再生的影响

目的:探讨针刺促进术后肠道动力恢复的机制.方法:30只SD大鼠随机分为空白组、模型组(行结肠吻合术)、针刺组.针刺组予每日针刺双侧足三针(足三里、三阴交、太冲),连续3d.观察大鼠排便情况,测量小肠推进率,观察结肠组织Cajal间质细胞(interstitial cells of Cajal,ICC)超微结构和胆碱能神经-ICC-平滑肌细胞网络结构.结果:针刺组术后首次排便时间较模型组提前,小肠推进率提高(2.00d±0.47d vs 2.50d±0.53d,66.30%±4.21% vs 46.33%±5.56%,P<0.05).与空白组比较,模型组ICC超微结构损伤明显,胆碱能神经-ICC-平滑肌细胞网络结构紊乱,ICC和小泡乙酰胆碱转移体(VAChT)阳性神经纤维数量明显减少(18.67±6.11 vs 32.33±5.51,18.67±3.79 vs 20.67±3.21,P<0.05)荧光强度减弱(35.00±9.54 vs 58.67±10.21,20.33±5.13 vs 34.67±6.81,P<0.05).而针刺组ICC超微结构损伤较模型组轻,网络样结构维持,ICC和VAChT阳性神经纤维的...     

白芍总甙对豚鼠结肠平滑肌作用机制的研究

目的 :探讨白芍总甙 (TGP)对离体豚鼠结肠平滑肌的作用方式及对结肠平滑肌中 P物质 (SP)和血管活性肠肽 (VIP)释放的影响。方法 :观察不同剂量 TGP及工具药对离体结肠肌收缩活性的效应及利用 SABC法检测结肠平滑肌中 SP和血管 VIP的变化。结果 :TGP使豚鼠结肠离体平滑肌收缩积分和时间显著性增加 ,且收缩效应的改变具有剂量依赖性。平滑肌中 SP的反应显著性增强。结论 :TGP可通过延长结肠收缩时间 ,增强结肠收缩幅度而调节结肠运动 ,SP是 TGP作用的递质之一。     

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.     

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。