PEP-1超氧化物歧化酶融合蛋白对大鼠心肌缺血再灌注细胞凋亡的影响

目的探讨PEP-1超氧化物歧化酶(SOD1)融合蛋白对大鼠心肌缺血再灌注细胞凋亡指数、Bax和Bcl-2蛋白表达的影响。方法 SD大鼠40只,制作心肌缺血再灌注模型,分为假手术组、缺血再灌注组、PEP-1-SOD1 100、300和500 μg组,每组8只。TUNEL法及免疫组织化学法检测心肌细胞凋亡指数(AI)及Bax、Bcl-2蛋白的表达。结果假手术组AI、Bax及Bcl-2蛋白表达水平均较低。PEP-1-SOD1各组AI和Bax蛋白的表达较缺血再灌注组明显降低,Bcl-2蛋白的表达明显增加,Bax/Rcl-2比值明显下降(P<0.05,P<0.01)。结论 PEP-1-SOD1可抑制缺血再灌注心肌细胞凋亡,原因可能为其减轻氧化应激、下调Bax和上调Bcl-2蛋白表达水平。     

参附注射液对缺血/再灌注损伤诱导大鼠心肌细胞凋亡的实验研究

目的:通过观察参附注射液对缺血/再灌注损伤时,心肌细胞超微结构及心肌细胞凋亡参数的影响,探讨参附注射液拮抗心肌缺血/再灌注损伤的作用机制。方法:建立心肌缺血/再灌注损伤模型,结扎大鼠左冠状动脉前降支(LAD)30min,再灌注10min。将46只大鼠随机分为5组,(Ⅰ)假手术组;(Ⅱ)对照组心肌缺血30min+生理盐水;(Ⅲ)对照组心肌缺血30min/再灌注10min+生理盐水;(Ⅳ)给药组心肌缺血30min+参附注射液;(Ⅴ)给药组心肌缺血30min/再灌注10min+参附注射液。以上各组分别采集相同部位的心室肌组织;应用透射电镜观察心肌细胞超微结构,通过CIMAS多功能真彩色病理图像分析CIMAS系统对心肌细胞线粒体进行体视学分析。原位标记TUNEL法凋亡的心肌细胞,免疫组化方法检测心肌细胞Bcl-2、Bax蛋白的表达,病理图像分析系统进行凋亡心肌细胞、Bcl-2及Bax蛋白的表达分析。结果:与假手术组比较,给药组(Ⅳ、Ⅴ)心肌细胞的Bcl-2蛋白表达显著增多(P0.05),Bax蛋白表达略增加(P0.05)和显著降低(P0.05),心肌细胞凋亡明显减少(P0.05);心肌细胞组织结构损害明显减轻;对照组与假手术组比较线粒体有显著变化(P0.01),给药组(Ⅳ、Ⅴ)与假手术组比较线粒体变化程度差异无统计学意义(P0.05)。结论:参附注射液能明显抑制心肌缺血/再灌注损伤引起的心肌细胞凋亡,其作用机制可能与上调Bcl-2蛋白表达,下调Bax蛋白表达和保护线粒体相关。     

卡维地洛对大鼠缺血再灌注心肌细胞凋亡及基因表达的影响

目的 :研究卡维地洛对缺血再灌注心肌细胞凋亡及bcl 2、bax基因表达的影响 ,探讨卡维地洛抑制缺血再灌注心肌细胞凋亡的可能分子机制。方法 :结扎Wistar大鼠左冠状动脉前降支 (LAD) ,建立大鼠缺血再灌注动物模型。 30只大鼠分 3组 (每组 10只 ) :卡维地洛组 (卡维地洛治疗 )、缺血再灌注组和假手术组。用Tunnel法检测心肌细胞凋亡 ,并用光学显微镜进行细胞计数 ,免疫组化和原位杂交法检测bcl 2、bax基因表达 ,并利用图像分析系统检测二者的平均光密度值 (A值 ) ,进行定量分析。结果 :心肌细胞凋亡数在缺血再灌注组、假手术组和卡维地洛组分别为 36 .8± 9.0、0 .2± 0 .1和 9.5± 3.0 ,各组间差异有统计学意义 (P <0 .0 1)。缺血再灌注组、假手术组和卡维地洛组的bcl 2mRNAA值分别为 0 .0 6± 0 .0 1、0 .0 8± 0 .0 1和 0 .0 9± 0 .0 1,bcl 2蛋白平均A值分别为0 .0 8± 0 .0 2、0 .14± 0 .0 1和 0 .15± 0 .0 3,卡维地洛组与缺血再灌注组相比差异无统计学意义 (P >0 .0 5 ) ;缺血再灌注组bax蛋白的平均A值为 0 .13± 0 .0 2 ,假手术组为 0 .0 7± 0 .0 1,卡维地洛组为 0 .0 6± 0 .0 1,卡维地洛组与缺血再灌注组相比差异有统计学意义 (P <0 .0 5 ) ,bcl 2 /bax蛋白比值在缺血再灌注组、假手术组和卡     

人参皂甙Re对大鼠缺血再灌注心肌细胞凋亡及Fas基因表达的影响

目的 :观察人参皂甙Re(以下简称Re)对缺血再灌注心肌细胞凋亡及Fas基因表达的影响 ,探讨Re抑制心肌细胞凋亡的可能机制。方法 :结扎Wistar大鼠左冠状动脉前降支 ,建立大鼠缺血再灌注动物模型 ;采用透射电镜、缺口末端标记法检测心肌凋亡细胞 ,利用光学显微镜进行细胞计数 ;原位杂交及免疫组化分别检测Fas基因mRNA及蛋白的表达 ,并利用图像分析系统测量阳性表达区域平均光密度值 ,进行定量分析。结果 :①透射电镜发现缺血再灌注组缺血区出现心肌凋亡细胞 ,假手术组未发现心肌凋亡细胞 ;②缺血再灌注组心肌细胞凋亡数为 (134.4 5± 4 5 .6 1)个 /视野 ,Re治疗组细胞凋亡数 (90 .6 6± 19.2 2 )个 /视野 ,两组间差异有非常显著性意义 (P<0 .0 1) ;③原位杂交及免疫组化检测均发现Fas基因的表达缺血再灌注组较假手术组明显增加 (P <0 .0 1) ,Re治疗组较缺血再灌注组明显下降 (P <0 .0 5 )。结论 :心肌缺血再灌注诱导心肌细胞凋亡 ,Re治疗则可以显著减少缺血再灌注心肌细胞的凋亡。Re通过抑制Fas基因的表达而抑制心肌细胞凋亡     

竹叶总黄酮抗大鼠心肌细胞凋亡作用的研究

目的研究竹叶总黄酮对大鼠心肌缺血再灌注时心肌细胞凋亡的影响。方法用在体左冠状动脉前降支穿线结扎法制备心肌缺血再灌注模型。将60只SD大鼠分为6组：假手术组，缺血再灌注组，竹叶总黄酮高、中、低剂量组，阳性对照组每组10只。缺血30min，再灌注240min。采用缺口末端标记法（TUNEL）以及免疫组化法，检测心肌细胞凋亡千分率、Bcl-2、Bax、Cyt-c和caspase-3基因蛋白表达。结果TUNEL实验表明竹叶总黄酮能明显降低心肌组织凋亡的发生；与假手术组比较，缺血再灌注组Bax、Cyt-c、Bcl-2和caspase-3阳性表达增强（P〈0．01）；与缺血再灌注组比较，竹叶总黄酮明显抑制了Bax、Cyt-c和caspase-3表达但没有抑制Bcl-2表达。结论竹叶总黄酮对心肌缺血再灌注损伤具有保护作用。     

葛根素后处理对大鼠心肌缺血再灌注心肌细胞的影响

目的观察葛根素后处理对大鼠心肌缺血再灌注心肌细胞凋亡及Bcl-2和Bax蛋白的影响。方法 SD大鼠随机分为假手术组、缺血再灌注组、葛根素后处理组,每组8只。制备大鼠心肌缺血再灌注模型,假手术组只穿线,不结扎左冠状动脉;缺血再灌注组缺血45 min,后再灌注120 min;葛根素后处理组,结扎左冠状动脉45 min,后再灌注120 min。再灌注前3 min和再灌注后2min内静脉注入葛根素1.25 mg/kg。应用免疫组化SP法观察Bcl-2和Bax蛋白表达率,采用TUNEL法观察各组心肌细胞的凋亡率,并在光镜及电镜下观察细胞形态学变化。结果与心肌缺血再灌注组相比,假手术组和葛根素后处理组心肌凋亡细胞数较低(P0.05),Bax表达较低(P0.05),Bcl-2表达较高(P0.05)。结论葛根素后处理可以影响心肌细胞Bcl-2、Bax的表达,抑制心肌细胞的凋亡,对缺血再灌注损伤心肌细胞有保护作用。     

黄芪注射液对肠缺血再灌注肝损伤大鼠bcl-2、Bax蛋白表达影响的实验研究

目的　探讨大鼠肠缺血再灌注肝损伤后肝组织bcl 2、Bax蛋白的表达及黄芪注射液对其表达的影响。方法　通过夹闭肠系膜上动脉建立肠缺血再灌注肝损伤模型 ,采用免疫组织化学方法与医学图像分析检测假手术组、模型组及黄芪注射液组大鼠肝组织bcl 2、Bax蛋白表达的阳性表达指数。结果　①与假手术组比较 ,模型组肝组织bcl 2、Bax蛋白的阳性表达指数升高 (P <0 0 1)。②与模型组比较 ,黄芪注射液组肝组织bcl 2蛋白的阳性表达指数升高 (P <0 0 1) ,Bax蛋白的阳性表达指数降低 (P <0 0 1)。结论　大鼠肠缺血再灌注肝损伤后肝组织bcl 2、Bax的表达明显升高 ;黄芪注射可增强bcl 2的表达、抑制Bax的表达。这可能是黄芪防护大鼠肠缺血再灌注肝损伤的机理之一。     

缺血再灌注对在体兔窦房结细胞Fas-L Bax Bcl-2基因表达的影响

目的 :探讨缺血再灌注对在体兔窦房结细胞Fas L、Bax、Bcl 2表达的影响。方法 :取家兔 90只 ,随机分为对照组、缺血 10、3 0、60、12 0min组及缺血 10、3 0、60、12 0min再灌注 4h组 ,每组 10只。通过结扎及放松右冠状动脉起始部制作在体兔窦房结细胞缺血再灌注损伤模型 ,当达各预定时间点后 ,迅速切取窦房结组织 ,用SABC免疫组化法检测窦房结细胞Fas L、Bax及Bcl 2表达 ,用Tiger 92 0图象分析系统计算Fas L、Bax、Bcl 2表达平均光密度值。结果 :1 缺血 10min组窦房结细胞Fas L、Bcl 2表达与对照组比较无明显差异 ,而Bax表达则较对照组明显增强 (P <0 0 5 ) ;Fas L、Bax表达量随缺血时间延长逐渐增加 ,以缺血 12 0min组表达最强 ;Bcl 2表达则以缺血 60min组最强。 2 缺血再灌注组 ,Fas L、Bax表达随缺血时间延长逐渐增加 ,以缺血 60min再灌注 4h组最强 ;Bcl 2表达以缺血 3 0min再灌注 4h组最强 ,而缺血 12 0min再灌注 4h组已恢复至对照组水平。 3 随缺血时间延长 ,缺血组及缺血再灌注组Bcl 2 Bax比值均逐渐减小 ,而缺血再灌注组Bcl 2 Bax比值均较相同时间缺血组明显降低。结论 :缺血及缺血再灌注均可上调窦房结细胞Fas L、Bax表达 ,下调Bcl 2 Bax比值 ,此作用可能介导了缺血再灌注诱导窦房结细胞?     

芹菜素对缺血再灌注大鼠心肌细胞凋亡相关基因Bcl-2/Bax的影响

目的 探讨芹菜素对缺血再灌注大鼠心肌细胞凋亡相关基因Bcl-2/Bax表达的影响.方法 心肌缺血45 min,再灌注2 h制备缺血再灌注模型.随机分为正常组、假手术组、生理盐水缺血再灌注组、溶剂对照组、美托洛尔阳性对照组及芹菜素低、中、高剂量组,每组8只.除假手术组外,余各组在缺血前10 min分别股静脉给药.再灌注2 h后迅速取出心脏,用RT-PCR测Bcl-2及Bax基因的mRNA表达;实验时记录心率(HR)、平均动脉压(MAP)、心电图S-T段并计算心律失常Lambeth评分.结果 芹菜素组与生理盐水缺血再灌注组比较,Bcl-2 mRNA表达量增加,Bax mRNA表达量减少,均呈剂量依赖性(P＜0.05);心律失常Lambeth评分芹菜素组低于假手术组 (P<0.05);芹菜素能缩短再灌注心律失常持续时间(P<0.05).结论 芹菜素对大鼠心肌缺血再灌注损伤具有良好的保护作用;芹菜素抗心肌凋亡作用的机制可能与其上调Bcl-2基因表达和下调Bax基因表达有关.     

倒卵叶五加总皂甙对大鼠心肌缺血/再灌注损伤后细胞凋亡的作用及机制

目的　探讨倒卵叶五加总皂甙 (SAOH)对大鼠缺血心肌再灌注后细胞凋亡的作用。方法　采用结扎左冠状动脉前降支再灌注复制大鼠心肌缺血再灌注损伤 (IRI)的模型 ,结扎前 10 min舌下静脉注射 SAOH,测定心肌缺血3 0 min后再灌注 6h心肌组织丙二醛 (MDA)和血浆超氧化歧化酶 (SOD)的含量 ,并用末端脱氧核苷酸转移酶介导的带生物素的 d UTP缺口末端标记 (TUNEL)的方法及免疫组化观察左心室心肌细胞凋亡及凋亡相关基因 Bcl- 2和 Bax的蛋白表达。结果　再灌注 6h后 ,SAOH1 组 (5 0 mg/ kg)及 SAOH2 组 (10 0 mg/ kg)较 IRI组 ,心肌组织 MDA含量明显减少 [(4.89± 0 .2 6)、(3 .5 7± 0 .2 1) nm ol/ mg· pro vs(6.97± 0 .3 4) nmol/ mg· pro,P值均 <0 .0 1];血浆 SOD活性明显提高 [(9.88± 0 .18)、(11.40± 0 .3 7)μIU / L vs (3 .3 9± 0 .2 4)μIU / L ,P值均 <0 .0 1];心肌细胞凋亡指数 (AI)显著减少 [(14.67± 3 .0 5 ) %、(7.49± 2 .62 ) % vs(2 1.96± 7.68) % ,P值均 <0 .0 1];Bax蛋白表达明显减少 [(7.73± 1.84) %、(5 .0 2± 1.0 1) % vs (18.5 9± 5 .68) % ,P值均 <0 .0 1];而心肌 Bcl- 2蛋白的表达显著增加 [(12 .5 1± 3 .42 ) %、(17.48± 4.72 ) % vs(7.3 2± 2 .0 5 ) % ,P值 <0 .0 5 ,<0     

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.     

Study of constancy of hydrogen-consuming flora of human colon

The constancy of the hydrogen consuming flora of the human colon was studied in 15 healthy subjects via two measurements obtained 18 to 36 months apart. Hydrogen disappearance rate and the major products of H₂-consuming bacteria, methane and sulfide, were measured during incubation of fecal homogenates with excess hydrogen and sulfate. In 11/15, the hydrogen consumption rate and the predominant hydrogen-consuming pathway (methanogenesis, sulfate reduction, or neither) remained constant. However, major shifts in these pathways were observed in four subjects, with two losing and two gaining the ability to produce methane. Methanogenesis was associated with the highest hydrogen consumption rate. This study demonstrates that clinically unrecognizable, major alterations of the colonic flora occur in healthy subjects. Understanding of the factors responsible for these alterations might allow for therapeutic manipulation of the colonic flora.Supported in part by the Department of Veterans Affairs and NIDDKD RO1 DK 13309-25.