克拉玛依地区的利什曼病Ⅶ.大沙鼠体内利什曼原虫前鞭毛体的超微结构观察

在新疆克拉玛依小拐农场,从大沙鼠耳组织内查见的利什曼原虫,经NNN基培养11天,对原虫的前鞭毛体作超微结构观察。前鞭毛体多为柳叶状。其膜下微管数平均为80±9(68～111)个,微管直径为24nm,间距为15～28nm,质膜厚度为8nm,与吴传芬等和王捷等报道的甘肃沙鼠利什曼原虫的前鞭毛体有明显差别;在胞质内广泛分布着内质网,线粒体发达,高尔基体常见于线粒体一动基体复合体附近。在鞭毛基体上部有基板1和基板2。在胞质内还可看到脂滴和空泡。     

利什曼原虫前鞭毛体体外生长动力学研究

目的观察不同种株利什曼原虫前鞭毛体在体外培养条件下的生长增殖情况，确定其最适体外培养条件。方法分别使用RPMI1640和M199复合培养液，观察温度、pH及新生小牛血清对硕大利什曼原虫、热带利什曼原虫、婴儿利什曼原虫、墨西哥利什曼原虫、杜氏利什曼原虫前鞭毛体体外增殖速度与增殖周期的影响。结果当培养温度为26℃时，杜氏利什曼原虫前鞭毛体在含和不含新生小牛血清、pH中性、偏碱和偏酸的PMI1640或M199复合培养基中，早期均能生长，且生长周期相对较长，其他种株利什曼原虫前鞭毛体在无血清或偏碱培养基中生长缓慢，增殖周期缩短；培养温度为37℃时，各种株利什曼原虫前鞭毛体均发生沉积，增殖停滞，不同程度地向无鞭毛体转化并发生死亡。结论使用复合培养液培养利什曼原虫前鞭毛体，温度、pH和新生小牛血清均可显著影响增殖速度和生长周期。各种株利什曼原虫前鞭毛体在相同培养条件下增殖速度和生长周期存在差异，可能与其遗传背景不同有关。     

利什曼原虫无鞭毛体超微结构及其在病犬体内分布的研究

作者用透射电镜研究了四川南坪疫区利什曼病犬肝、脾内无鞭毛体的超微结构。观察到其膜下微管数为81—135,平均101±10。微管平均直径和微管间距分别为31±8.6nm和28±0.65nm。对比文献资料,与从貉和美国Oklahoma犬等动物体内获得的无鞭毛体膜下微管数有明显不同;而与观察人体利什曼原虫所获结果相近。为进一步研究人体利什曼病与病犬的关系提供了线索。研究还发现病犬前肢、耳、鼻皮肤内无鞭毛体数量较多;内脏中以颈淋巴结内数量最多,其次为肝、脾,以下依次为骨髓、胰、睾丸、附睾。肺内仅遇见原虫。由于前肢皮肤原虫数量(3616.3±174.6)可高出骨髓(397±37.7)近10倍,为自多处皮肤取材用于诊断提供了客观依据。另外,首次从病犬延髓印片中查见无鞭毛体,提示其侵犯中枢神经系统的危害性是存在的。     

热带利什曼原虫的特异性单克隆抗体:期及种特异性抗原的特性

本文报道以热带利什曼大型亚种前鞭毛体膜的单克隆抗体对热带利什曼种团及杜氏利什曼种团各10株共20株原虫的膜或完整的前鞭毛期,进行了间接放射免疫,免疫荧光及免疫沉淀等方法的测定。各种原虫的前鞭毛体是用Schneider’s Drosophlia培养基保存的,无鞭毛体则从感染BALB/c雌性小鼠取得。原虫混悬于pH7.3含40mM NaCl,10mM乙二胺四乙     

杜氏利什曼原虫无鞭毛体表达抗原的Western blot和MALDI-TOF/TOF分析

目的鉴定杜氏利什曼原虫无鞭毛体特异表达抗原。方法培养杜氏利什曼原虫前鞭毛体并体外转化无鞭毛体,其总蛋白经2-DE电泳后以小鼠抗杜氏利什曼原虫无鞭毛体血清进行Western blot,对前鞭毛体与无鞭毛体特异表达抗原蛋白进行MALDI-TOF/TOF串联质谱鉴定。重组表达无鞭毛体特异表达抗原编码基因,以Western blot法对重组蛋白进行鉴定。结果等量的杜氏利什曼原虫前鞭毛体与无鞭毛体蛋白经2-DE电泳均可呈现680~742个蛋白点,Western blot及MALDI-TOF/TOF-MS分析甘油醛3-磷酸脱氢酶与延伸因子2为杜氏利什曼原虫前鞭毛体特异表达抗原,核苷二磷酸激酶为无鞭毛体特异表达抗原。重组核苷二磷酸激酶编码基因表达产物经Western blot证实为杜氏利什曼原虫无鞭毛体特异表达强抗原。结论杜氏利什曼原虫前鞭毛体与无鞭毛体抗原表达存在差异,核苷二磷酸激酶为杜氏利什曼原虫无鞭毛体特异表达强抗原。     

不同种株利什曼原虫的比较蛋白质组学分析

目的观察不同种株利什曼原虫前鞭毛体蛋白质表达状况。方法制备杜氏利什曼原虫四川SC6株、杜氏利什曼原虫四川SC10株和硕大利什曼原虫5ASKH株前鞭毛体总蛋白,以pH范围3-10的预制胶条进行双向电泳(2-D),考马斯亮蓝染色,PDQust软件分析凝胶,主要差异蛋白点用电喷雾质谱法进行鉴定。结果等量的杜氏利什曼原虫四川SC6株、杜氏利什曼原虫四川SC10株和硕大利什曼原虫5ASKH株前鞭毛体总蛋白均获近700个蛋白点,不同种株利什曼原虫前鞭毛体蛋白质2-D图谱中,14蛋白点呈恒定差异表达,从中鉴定出10个功能明确的蛋白质,分别具有下列生物功能:糖代谢与磷脂合成(烯醇酶、变旋酶、NADP依耐乙醇脱氢酶、乙醇胺磷酸胞苷酸转移酶),压力反应(细胞内过氧化物酶、锥虫还原蛋白过氧化物酶),细胞膜/细胞骨架(α-微管蛋白、β-微管蛋白),核酸代谢(琥珀酰辅酶A连接酶(GDP形成)、内源性RNA酶L-PSP(pb5)),细胞周期与增殖(延伸因子2)。结论不同种株利什曼原虫前鞭毛体蛋白质的表达存在不同,为理解不同种株利什曼原虫的毒力、免疫原性和代谢特征提供了新的视角。     

胶体金标记杜氏利什曼原虫抗原超微结构定位研究

用低温包埋剂Lowicry1 K4M在-30℃下包埋杜氏利什曼原虫前鞭毛体,切片后在电镜下观察到前鞭毛体结构保存较好。用单克隆抗体2H_6-E_5和1H_7-C_2-E_7分别对它们所识别的杜氏利什曼原虫前鞭毛体抗原进行胶体金标记定位,结果发现保护性抗体2H_6-E_3识别的抗原主要分布于前鞭毛体膜外侧面,为进一步研究该抗原的组成、性质和功能建立了一定基础。同时发现1H_7-C_2-E_7识别的抗原主要分布于前鞭毛体膜内侧面,膜外侧面也有分布。     

克拉玛依地区的利什曼病XIV．硕大白蛉吴氏亚种自然感染前鞭毛体的鉴定

硕大白蛉吴氏亚种是新疆克拉玛依地区的主要蛉种之一，具有强的亲人性，在野外和居民点内常能查见该蛉有前鞭毛体的自然感染。本文结果表明，白蛉自然感染的前鞭毛体能使仓鼠及ＢＡＬＢ／ｃ小鼠发生内脏利什曼病；在感染仓鼠内脏涂片上的无鞭毛体，由蛉体而来的明显较由大沙鼠而来的都兰利什曼原虫为小；白蛉自然感染的前鞭毛体在ＮＮＮ培养基内生长不良；用￣（３２）Ｐ标记的ｇｐ￣（６３）基因为探针，与婴儿利什曼原虫、都兰利什曼原虫及白蛉自然感染的前鞭毛体的ＤＮＡ进行杂交，证实蚌体自然感染的原虫与婴儿利什曼原虫同源。克拉玛依无内脏利什曼病人，但人群中有皮肤利什曼病流行。关于硕大白蛉吴氏亚种自然感染的来源以及当地的皮肤利什曼病究竟是由都兰利什曼原虫抑或婴儿利什曼原虫所致，尚待阐明。     

不同利什曼原虫分离株在培养基中生长繁殖观察

目的　比较我国不同类型内脏利什曼病流行区利什曼原虫前鞭毛体在不同培养基中的生长繁殖情况，为选择合适培养基用于利什曼原虫培养提供实验依据。方法　将3 ×105个KS?2、Cy、JIASHI?5株利什曼原虫前鞭毛体分别接种至1 mL NNN培养基、1 mL M199 + 20%胎牛血清培养基、1 mL M199 + 20%马血清培养基及1 mL 脑心浸液培养基（含血红素）中，22 ℃温箱中无菌静置培养，显微镜下连续观察计数8 d，绘制3株利什曼原虫前鞭毛体的生长曲线。 结果 KS?2、Cy、JIASHI?5株利什曼原虫前鞭毛体均能在NNN培养基、M199 + 20%胎牛血清培养基和M199 + 20%马血清培养基中生长繁殖，在NNN培养基中培养不同时间后的3株利什曼原虫前鞭毛体计数均显著高于M199 + 20%胎牛血清培养基和M199 + 20%马血清培养基（P均 < 0.05），在这3种培养基中培养不同时间后的KS?2株利什曼原虫前鞭毛体计数均显著高于Cy和JIASHI?5株（P均 < 0.05）。KS?2、Cy、JIASHI?5株利什曼原虫前鞭毛体均不能在脑心浸液培养基中生长繁殖。结论　分离自我国不同类型内脏利什曼病流行区的利什曼原虫在同一培养基中生长增殖速度有差异，同一利什曼原虫分离株在不同培养基中的生长繁殖速度亦有差异。NNN培养基是最适合我国内脏利什曼病流行区利什曼原虫分离株的培养基。     

用于免疫诊断的杜氏利什曼种特异性单克隆抗体的生产及鉴定

以杜氏利什曼原虫(WR352,WRI168c或Edmael)前鞭毛体膜伍用弗氏不完全佐剂免疫小鼠的脾细胞与NS-1瘤细胞融合,获16株单克隆抗体。以亲和纯化的~(125)I标记的兔抗鼠抗体的F(ab′)2对利什曼原虫前鞭毛体膜进行间接放射免疫结合试验。前鞭毛体     

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。