慢性浅表性胃炎脾胃湿热证胃黏膜G、D细胞变化及胃泌素、生长抑素的表达

目的:探讨慢性浅表性胃炎脾胃湿热证患者胃黏膜G、D细胞的变化及胃泌素和生长抑素表达的意义.方法:2004-05/2005-03北京市东直门医院消化科门诊或住院的慢性浅表性胃炎患者70例,其中脾胃湿热证38例,脾胃虚弱证32例.用免疫组化的方法检测患者胃黏膜中G、D细胞的数目和胃泌素和生长抑素表达的量值.结果:与脾虚组比较,湿热组胃黏膜G细胞数目,D细胞数目,G、D细胞比值,G细胞总面积即Gas表达量,D细胞总面积即SS的表达量有显著性差异(130.54±35.62 vs 111.13±23.79,54.98±19.63 vs 67.01±21.56,2.74±1.36 vs1.87±1.36,34.72±17.24 vs 27.72±14.23,13.90±7.22 vs 19.23±7.96,P<0.05或0.01).结论:G细胞增多,胃黏膜Gas增多,D细胞减少,胃黏膜SS减少,可能是湿热证的病理基础;而D细胞增多,胃黏膜SS分泌亢进,G细胞减少,胃黏膜Gas水平低下,可能是脾虚证的病理基础.     

脾胃湿热证与水通道蛋白4基因表达的关系

目的:从水液代谢来研究脾胃湿热证与水通道蛋白4(AQP4)基因的关系.方法:慢性浅表性胃炎患者25例,其中脾胃湿热证15例,脾气虚证10例,另10例健康志愿者为对照.荧光定量PCR法检测AQP4在各组胃粘膜组织中的mRNA表达量.结果:脾胃湿热证组胃粘膜组织中AQP4 mRNA表达量为(10.00±8.83)×106 cps/ml,显著高于脾气虚证组(1.28±2.93)×106 cps/ml(P＜0.01);而脾气虚证组则明显低于对照组[(2.99±3.33)×106 cps/ml,P<0.05].结论:AQP4基因表达的异常可能是脾胃湿热证的发生机制之一.     

慢性胃炎患者胃黏膜三叶因子1与细胞间黏附分子1蛋白表达

[目的]在幽门螺杆菌(Hp)阴性慢性浅表性胃炎(CSG)中探讨脾胃湿热证与三叶因子1(TFF1)、细胞间黏附分子1(ICAM-1)蛋白表达的相关性。[方法]Hp阴性CSG患者(脾胃湿热组27例,脾虚组10例)及对照组10例,经临床检查、胃镜取标本、病理学及免疫组化SP法检测胃黏膜炎症程度及TFF1、ICAM-1的蛋白表达情况。[结果]胃镜下脾胃湿热组胃黏膜充血水肿较脾虚证明显。炎症程度:脾胃湿热组>对照组(P<0.01),脾虚组>对照组(P<0.05),脾胃湿热组稍重于脾虚组。TFF1蛋白表达:脾胃湿热组>脾虚组>对照组。ICAM-1蛋白表达:脾胃湿热组>脾虚组稍高于对照组。ICAM-1蛋白表达与炎症程度呈正相关(P<0.01)。TFF1与ICAM-1蛋白表达呈正相关(P<0.01)。[结论]脾胃湿热证时TFF1、ICAM-1蛋白均呈高表达。提示脾胃湿热证中TFF1可能与机体正气抗邪状态有关;ICAM-1可能参与湿邪致病的分子机制。     

参苓白术散对脾虚湿困型溃疡性结肠炎大鼠血清EGF、SOD、MDA的影响

目的:观察参苓白术散对脾虚湿困型溃疡性结肠炎(UC)大鼠表皮生长因子(EGF)、超氧化物歧化酶(SOD)、丙二醛(MDA)的影响,以期探明其治疗脾虚湿困型UC大鼠的部分作用机制.方法:参照文献复制脾虚湿困型UC模型,将大鼠随机分为正常对照组、模型对照组、参苓白术散组,每组10只,观察大鼠一般情况、结肠病理改变,检测各组大鼠血清EGF、SOD、MDA含量.结果:参苓白术散组大鼠症状、体征及结肠黏膜病理变化较模型对照组明显改善.模型对照组大鼠EGF含量与正常对照组比较,差异有统计学意义(1.67±0.17 vs 1.92±0.23,P<0.05),S O D、M DA含量与正常对照组比较的差异有非常显著性(1.11±0.13 vs 1.40±0.14,16.42±1.77 vs 13.26±0.99,P<0.01);参苓白术散组大鼠EGF含量与模型对照组比较,差异有统计学意义(1.89±0.19 vs 1.67±0.17,P<0.05),SOD、MDA水平的差异有非常显著性(1.38±0.15 vs 1.11±0.13,13.40±1.25 vs16.42±1.77,P<0.01).结论:参苓白术散能显著改善脾虚湿困型UC大鼠血清EGF、SOD、MDA的水平,可能是其发挥临床疗效的重要作用机制之一.     

慢性浅表性胃炎不同证候胃黏膜神经内分泌免疫调节的研究

[目的]研究慢性浅表性胃炎不同证候与胃黏膜神经内分泌免疫调节的关系。[方法]90例慢性浅表性胃炎根据中医辨证标准分为脾胃虚弱证、脾胃痰湿证及脾胃湿热证3组,采用放免法检测3组胃黏膜促胃液素(Gas)、降钙素基因相关肽(CGRP),采用免疫组化ABC染色法检测胃黏膜辅助T淋巴细胞(CD4)和抑制T淋巴细胞(CD8)水平,并与正常对照组比较。[结果]与脾胃虚弱证比较,脾胃湿热证Gas明显升高(P<0.05),脾虚痰湿证也显示了升高的趋势;脾虚痰湿证CGRP明显升高(P<0.05);脾虚痰湿证和脾胃湿热证CD4明显升高,该两组之间及其他各组之间CD8无明显差异。[结论]胃黏膜神经内分泌、T淋巴细胞免疫在慢性胃病及其不同证候的发展形成演变过程中起着重要作用。     

乳酸杆菌对蒙古沙鼠幽门螺杆菌感染性胃炎的疗效及其机制

目的: 观察乳酸杆菌对蒙古沙土鼠H Pylori 感染性胃炎的治疗作用,探讨乳酸杆菌防治H pylori感染的作用机制.方法: 通过接种H pylori,建立蒙古沙土鼠H pylori感染性胃炎动物模型,将造模成功的32只蒙古沙土鼠随机分为4组,每组8只.第1组(抗生素加质子泵抑制剂干预治疗组)、第2组(乳酸杆茵治疗组)、第3组(乳酸杆菌加质子泵抑制剂治疗组)、第4组(生理盐水对照组),用相应干扰剂分别连续灌胃治疗10 d.另8只正常蒙古沙土鼠为第5组(空白对照组).最后1次灌胃4 wk后处死沙鼠,HE染色判断鼠胃黏膜组织学损伤,并用快速尿素酶试验、Giemsa染色和细菌培养进行Hpylori的检测,免疫组化检测胃黏膜中IL-6、COX-2、和TNF-α蛋白的表达.结果: 第1组、第2组和第3组之间蒙古沙土鼠的H pylori根除率无显著差异,但均比第4组的根除率低,之间差异有显著性(87.5%,75%,75%vs100%,均P<0.05).第1组、第2组和第3组蒙古沙土鼠的胃体、胃窦和十二指肠各部位组织胃黏膜慢性炎症评分与第4组相比显著下降(胃体:1.8±0.54,2.0±0.48,1.9±0.50vs4.2±1.06,均P<0.05;胃窦:1.5±0.27,1.4±0.33,1.7±0.46vs4.6±0.74,均P<0.05:十二指肠:1.4±0.41,1.7±0.29,1.6±0.52vs4.1±0.83,均P<0.05).第1组、第2组和第3组蒙古沙土鼠三种炎症因子表达与第4组相比显著下降(COX-2:3.57±0.32,3.89±0.51,2.95±0.76vs6.79±1.68,均P<0.05:IL-6:2.42±0.60,2.28±0.7l,1.93±0.52vs5.61±0.28,均P<0.05;TNF-α:3.30±0.52,3.65±0.35,2.84±0.20vs6.76±1.63,均P<0.05).结论: 乳酸杆菌治疗蒙古沙鼠Hpylori感染性胃炎模型的疗效与PPI加抗生素三联疗法相当;并可显著降低沙鼠胃黏膜的COX-2、IL-6、TNF-α的表达.     

促愈颗粒对大鼠乙酸胃溃疡愈合质量的影响

目的:观察促愈颗粒对大鼠乙酸胃溃疡愈合质量的影响.方法:用冰醋酸制备大鼠慢性胃溃疡模型,所有大鼠随机分为4组(空白模型组、促愈颗粒组、雷尼替丁组和正常对照组).HE染色观察大鼠愈合性胃溃疡再生黏膜腺体成熟度和炎症细胞浸润情况;硝酸还原法检测血清NO含量;放射免疫法检测血浆PGE2含量;免疫组织化学技术检测大鼠胃黏膜EGF的表达情况;透射电镜观察大鼠再生黏膜超微结构的变化.结果:给药28d后与模型组和雷尼替丁组比较,促愈颗粒组再生黏膜囊性扩张腺体数量及炎细胞数量明显减少(再生黏膜囊性扩张腺体数量:1.43±0.53 vs 3.84±1.08.2.36±0.79,P<0.01和P<0.05;炎细胞数量:9.92±2.66 vs 28.32±6.96,17.92±4.76,P<0.01和P<0.05);血清NO及血浆PGE2含量显著增高(NO:105.41±8.02μmol/g vs 67.35±16.85,79.1 8±28.05μmol/g,P<0.0 1或P<0.05;PGE2:125.50±11.95 ng/L vs 97.33±11.84,118.83±13.25 ng/L,P<0.01和P>0.05);胃黏膜EGF表达明显增强(25.38±5.17 vs 16.82±2.13,21.12±6.08,P<0.05和P<0.05);促愈颗粒组超微结构的恢复亦优于模型组和雷尼替丁组.结论:促愈颗粒能提高溃疡再生黏膜结构,功能成熟度及电镜下成熟度,从而提高溃疡愈合质量.     

艾灸足三里、梁门穴对应激性溃疡大鼠胃黏膜细胞凋亡的干预作用

目的:探讨艾灸足三里、梁门穴对应激性溃疡胃黏膜细胞凋亡的影响,分析其与血浆多巴胺(DA)、胃黏膜内皮素(ET)的关系,揭示艾灸足三里、梁门穴对抗应激性损伤,进而保护胃黏膜的机制.方法:SD大鼠60只随机分为4组,即束缚对照组、模型组、艾灸足三里和梁门穴组、艾灸非穴点对照组,每组15只.束缚水浸应激法造模,免疫组化方法测定细胞凋亡指数(×10-6个/μm2).采用生物信号分析仪检测胃黏膜血流量(GMBF),高效液相色谱法测定血浆DA含量,放射免疫法测定胃黏膜ET含量.结果:预先艾灸足三里、梁门穴可显著降低随后的应激性胃黏膜损伤指数,降低胃黏膜ET和血浆DA含量,增加胃黏膜血流量,降低胃黏膜细胞凋亡指数.造模后,B组UI值(26.80±9.81vs12.00±5.94,P<0.01)、血浆DA(9.97±3.69μg/Lvs4.54±2.61μg/L,P<0.01)、胃黏膜ET(361.469±98.080ng/Lvs149.205±94.1425ng/L,P<0.01)以及凋亡指数(9.65±4.19vs4.36±2.60,P<0.01)显著高于A组,而GMBF低于A组(139.489±33.133mL/minvs377.090±85.840mL/min,P<0.01);C组UI值、凋亡指数显著低于B组和D组(UI:14.10±5.42vs26.80±9.81,26.20±7.23,P<0.01;凋亡指数:3.00±1.58vs9.65±4.19,8.20±5.17,P<0.01),而GMBF高于B组和D组(316.552±85.469mL/minvs139.489±33.133,141.512±58.450mL/min,P<0.01);C组血浆DA含量及胃黏膜ET显著低于B组(DA:4.41±2.48μg/Lvs9.97±3.69μg/L,P<0.01;148.271±69.113ng/Lvs361.469±98.080ng/L,P<0.01),但与D组比较无显著性差异(P>0.05).结论:艾灸足三里、梁门穴预处理可减轻束缚水浸应激所造成大鼠胃黏膜的损伤程度,这一作用可能是通过降低血浆DA和胃黏膜ET含量,增加胃黏膜血流量,抑制细胞凋亡实现的.     

隆起糜烂性胃炎证型与幽门螺杆菌感染及热休克蛋白60和70表达的相关性

[目的]探讨隆起糜烂性胃炎(Raised Erosive Gastritis,REG)中医证型与幽门螺杆菌(Hp)感染和病理组织学及热休克蛋白60(HSP60)、热休克蛋白70(HSP70)表达的关系,以期指导中西医结合防治REG。[方法]选择131例REG患者按中医辨证分为脾胃湿热证32例(Hp阳性19例,阴性13例),脾胃气虚证52例(Hp阳性者34例,阴性18例),脾虚湿热证47例(Hp阳性者33例,阴性14例)。所有受试者均行胃镜检查,取胃窦部活检标本行快速尿素酶试验及组织染色法检测Hp;病理组织学检查及免疫组织化学检测HSP60,其中63例免疫组织化学检测HSP70。并设正常对照(正常)组18例。[结果]REG脾虚湿热证组的萎缩、肠化生(IM)程度均高于脾胃湿热证及脾胃气虚证组(P0.05),而后2组之间比较以及3组中Hp阳性者与阴性者比较差异均无统计学意义(P0.05)。3组HSP60表达均较正常组增加(P0.01),而3组之间比较均P0.05;脾胃湿热证及脾虚湿热证组中Hp阳性者的HSP60表达均高于Hp阴性者(P0.05),而脾胃气虚组中的Hp阳性与Hp阴性者比较P0.05。3组的HSP70表达均较正常组增加(P0.01);而3组的HSP70阳性表达情况分别比较均P0.05;脾胃湿热证组中Hp阴性的HSP70表达高于Hp阳性者(P0.05),而脾胃气虚证组与脾虚湿热证组中Hp阳性者与阴性者HSP70表达比较均P0.05。REG Hp阳性者胃黏膜HSP60的表达明显高于Hp阴性(P0.01);REG Hp阳性者胃黏膜HSP70的表达与Hp阴性者比较P0.05。[结论]REG脾虚湿热证患者胃黏膜萎缩、IM程度均高于脾胃气虚证及脾胃湿热证。REG3组胃黏膜HSP60及HSP70的表达均较正常组增强。Hp感染可诱导胃黏膜HSP60的高表达。HSP60表达既与Hp感染有关,又与湿热之邪有关。     

湿疹不同分期中医证候的分布规律

目的探讨湿疹不同分期中医证候的分布规律。方法客观记录97例湿疹患者的临床症状,包括局部皮损、全身症状以及舌、脉象等资料,分析湿疹不同分期的中医证候分布规律。结果 97例湿疹患者中湿热困阻型所占比例最高(39.18%),其中湿重于热14例,热重于湿型24例;其次是风湿热困型(23.71%)。97例患者中包括急性湿疹27例,亚急性湿疹25例,慢性湿疹22例,急性发作23例。27例急性湿疹患者证型频率分布排列:湿热困阻型14例,风湿热困型10例,脾虚湿困型1例,风湿热夹脾虚型1例,督虚血瘀型1例;25例亚急性湿疹患者证型频率分布排列:湿热困阻型10例,脾虚湿困型7例,风湿热困型4例,脾肾两虚夹血瘀型2例,血虚风燥型1例,血热风燥型1例;22例慢性湿疹患者证型频率分布排列:脾虚血燥型7例,脾虚湿困型6例,湿热困阻型4例,风湿热困型2例,血虚风燥型2例,湿熟瘀结型1例;23例急性发作湿疹患者证型频率分布排列:湿热困阻型10例,风湿热困型7例,脾虚湿困型4例,脾虚血燥型1例,风湿热夹脾虚型1例。在四种主要证型中性别构成无明显差异(χ2=0.72,P>0.05),不同年龄段的分布无明显差异(χ2=0.26,P>0.05),但在不同病程的分布有明显差异(χ2=4.02,P<0.05)。其中风湿热困型出现的频率随着病程增加呈现上升趋势,其他证型则在0.5～5年的出现频率较高。结论湿疹主要的中医证候有风湿热困、湿热困阻(湿重于热、热重于湿)、脾虚湿困和脾虚血燥四种,在不同病程中分布的频率不同。     

Medical and Psychology Students' Knowledge and Attitudes Regarding Aging and Sexuality

The current study surveys medical and doctoral psychology students (N = 100) from an urban northeastern university regarding knowledge and attitudes toward elderly sexuality and aging using the Facts on Aging Quiz, the Aging Sexuality Knowledge and Attitudes Scale, and measures of interest in gerontology, academic/clinical exposure to aging and sexuality, and contact with elders. The current study found that psychology students demonstrated greater aging knowledge than medical students; however, both groups showed gaps in knowledge about sexuality. Married students had greater academic/clinical exposure and greater knowledge about aging but less permissive attitudes toward elderly sexuality. Generally, knowledge about aging was the strongest correlate of knowledge about sexuality. Level of knowledge about sexuality was not associated with attitudes. Attitudes toward sexuality and aging may be more strongly tied to demographic variables reflective of religious beliefs or adherence to sociocultural norms.     

Cement and Concrete Nanoscience and Nanotechnology

Concrete science is a multidisciplinary area of research where nanotechnology potentially offers the opportunity to enhance the understanding of concrete behavior, to engineer its properties and to lower production and ecological cost of construction materials. Recent work at the National Research Council Canada in the area of concrete materials research has shown the potential of improving concrete properties by modifying the structure of cement hydrates, addition of nanoparticles and nanotubes and controlling the delivery of admixtures. This article will focus on a review of these innovative achievements.     

Leptin and cellular and innate immunity in abstinent alcoholics and controls

BACKGROUND: Basic studies indicate that in vitro and in vivo doses of leptin modulate cellular immune responses. Given evidence that concentrations of leptin are altered in alcoholics who also show immune abnormalities, this study examined the relationships between circulating levels of leptin and markers of cellular and innate immunity. METHODS: Circulating levels of leptin, natural killer cell (NK) activity, interleukin-2 (IL-2)-stimulated NK activity, and concanavalin A-stimulated production of IL-2, IL-6, IL-10, and IL-12 were compared between abstinent DSM-IV alcohol-dependent men (n = 27) and age- and gender-matched controls (n = 34). RESULTS: As compared with controls, alcoholics showed lower NK activity (p < 0.01) and a trend for lower levels of leptin (p = 0.055). In the total sample, leptin predicted NK activity (beta = 0.33; p < 0.05) after controlling for the confounding influence of body mass index, alcohol intake, and smoking. Leptin was not correlated with any of the cytokine measures. To examine whether the effects of leptin were mediated by its direct action on NK, additional studies examined in vitro effects of leptin on NK activity in healthy volunteers (n = 10); leptin doses (0.1, 1, and 10 nM) yielded levels of NK activity comparable to those with media alone. CONCLUSIONS: These data show that circulating levels of leptin are associated with NK activity in humans and suggest that abnormal in vivo concentrations of leptin may contribute to the declines of NK activity in alcoholics who are at risk for infectious diseases.     

慢性饮酒、吸烟与骨质疏松的相关性研究

目的 探讨长期大量慢性饮酒、吸烟等不良生活方式与骨质疏松的关系.方法 以乏力、腰背痛、双下肢酸困为主诉,且有长期大量慢性饮酒史、吸烟史,无其他慢性疾病史的年轻男性患者45例为观察对象,测定其血钙(Ca)、血磷(P)和血肌酐(Cr)、尿素氮(BUN)、血糖(Glu)、天门冬酸氨基转移酶(AST)、丙氨酸基转移酶(ALT)、血清碱性磷酸酶(ALP)、甲状腺功能、全段甲状旁腺激素(iPTH)、1,25-二羟维生素D3[1,25-(OH) 2D3]、双能X线骨密度仪测定腰椎L1-4及左侧股骨近段(包括颈、股骨颈上部、大粗隆)骨密度(BMD),分析饮酒、吸烟对骨量的影响.以感冒发热就诊、年龄相当、无饮酒、吸烟史及慢性疾病史的45例男性为对照组.结果 观察组1,25(OH)2D3水平均降低,血钙水平偏低,血磷正常,碱性磷酸酶呈不同程度地升高,骨密度T值提示观察组27例骨质疏松,12例骨量减少,6例正常骨量;而对照组仅有6例为骨量减少,1例骨质疏松,38例为正常骨量,两组比较差异有统计学意义(P＜0.05).结论 长期慢性大量饮酒吸烟影响骨量,甚至易导致骨质疏松.     

自身免疫与动脉粥样硬化的发生发展

在动脉粥样硬化的发生发展过程中,自身免疫具有重要作用,本文就近年有关动脉粥样硬化的免疫机制的研究进展作一简要综述.     

Neutropenia and agranulocytosis in England and Wales: incidence and risk factors

The objectives of this study were to estimate the incidence of idiosyncratic neutropenia and agranulocytosis in England and Wales and to evaluate their risk factors and outcomes. The study was conducted using data from the General Practice Research Database. All cases of idiosyncratic neutropenia or agranulocytosis were identified and the incidence was estimated. This was followed by a nested case-control study, estimating odds ratios with drug exposure from conditional logistic regression. From 1987 to 1999, 3,224 patients with idiosyncratic neutropenia (50 with agranulocytosis) were identified. The incidences of neutropenia and agranulocytosis were estimated to be 120 and 7 cases per million people per year, respectively. The adjusted odds ratios for neutropenia were 34.7 (95% confidence interval 12.0-99.7) for current users of thyroid inhibitors, 9.5 (4.4-20.8) for users of disease-modifying antirheumatic drugs, and 7.6 (4.9-11.9) for users of aminosalicylates. Other drugs with statistically significantly increased risks of neutropenia included antibacterial drugs, non-opioid analgesics, NSAIDs, antidepressants, ulcer-healing drugs, and anti-epileptics. The increase in risk of neutropenia predominantly occurred during the first months of treatment. For most drugs investigated in this study, there was no relationship to daily dose. The excess 1-year mortality was low among neutropenia and agranulocytosis cases and mostly explained by the underlying disease state. In conclusion, the highest risks of neutropenia were generally found in patients starting treatment. The excess 1-year mortality was low among neutropenia and agranulocytosis cases and can be mostly explained by the underlying disease state.     

中青年超重和肥胖与高血压及高同型半胱氨酸血症的相关性研究

目的探讨中青年超重和肥胖与高血压及高同型半胱氨酸血症的相关性。方法选取2012年1月—2013年10月在我院进行常规健康体检者750例,测量受试者血压、身高、体质量及血清同型半胱氨酸(Hcy)水平。结果男性超重、肥胖检出率分别为36.87%(198/537)和13.97%(75/537),均高于女性的16.43%(35/213)和7.50%(16/213)(P0.05)。超重者和肥胖者高血压和高同型半胱氨酸血症检出率分别为21.03%(49/233)和11.16%(26/233)、46.12%(42/91)和41.76%(38/91),均高于正常者的9.16%(37/404)和2.23%(9/404),肥胖者高于超重者(P0.01)。收缩压(SBP)、舒张压(DBP)及血清Hcy与BMI呈正相关(r值分别为0.639、0.515、0.497,P0.01)。结论中青年尤其是男性超半数存在超重或肥胖,高血压及高同型半胱氨酸血症与BMI呈正相关,超重和肥胖者高血压及高同型半胱氨酸血症的发生率高,应积极防治。