健胃口服液抗消化性溃疡的药理研究

目的：探讨健胃口服液抗消化性溃疡的药理作用。方法：采用水浸应激、幽门结扎、利血平诱发及乙酸损伤等方法造成急慢性胃溃疡模型,观察药物对这些模型的影响。结果：健胃口服液对大白鼠急性应激性溃疡、幽门结扎型溃疡、乙酸损伤型溃疡、小白鼠利血平诱发型溃疡的形成均具有显著的抑制作用（P＜0．05,P＜0．01）,能显著减少胃酸及胃蛋白酶的分泌（P＜0．05）。结论：健胃口服液具有防治消化性溃疡的作用。     

胃克星对消化道功能的药效学研究

目的：胃克星对消化道功能的药效学研究。方法：采用无水乙醇灌胃方法制造小鼠急性胃粘膜损伤模型，观察胃克星对胃粘膜损伤的保护作用；乙酸化学性刺激疼痛的方法观察胃克星的镇痛作用；碳末推进实验观察胃克星对小鼠肠推进性运动的影响。结果：胃克星中，高剂量组对无水乙醇所致胃粘膜损伤的保护作用与生理盐水组比有显著性差异（P＜0．05）；胃克星低，中，高剂量组的镇痛作用与生理盐水组有显著性差异（P＜0．05）；胃克星低剂量组对肠推进性运动的影响与生理盐水组有显著性差异（P＜0．05）。结论：胃克星对消化道损伤有明显保护功能。     

胃痛灵对大鼠胃粘膜血流量及脾虚大鼠模型的影响

为深入探讨胃癌灵保护胃粘膜的作用机制，研究了胃痛灵（WTL）对无水乙醇损伤大鼠胃粘膜血流量（GMBF）、脾虚大鼠D-木糖吸收率、胃壁结合粘液量以及胃酸分泌和胃蛋白酶活性的影响。结果显示WTL能够明显增加大鼠GMBF（P＜0．05）、胃壁结合粘液量（P＜0．05），提高脾虚大鼠D-木糖吸收率（P＜0．05），增强胃粘膜防御机能，但对脾虚大鼠胃酸的分泌和胃蛋白酶活性均无明显影响。在体外也无中和胃酸的能力。     

幽门螺杆菌相关性消化性溃疡的细胞凋亡研究

目的：探讨幽门螺杆菌（Helicobacter pylori,HP)诱导胃上皮细胞凋亡的机制及细胞凋亡在HP相关性消化性溃疡（PU）中的作用。方法：内镜下胃粘膜活检取材,应用TUNEL法检测胃上皮细胞凋亡,免疫组化法检测凋亡调控蛋白bak、bcl-2的表达。结果：HP阳性胃溃疡（GU）和十二指肠（DU）患者细胞凋亡指数（AI）明显高于HP阴性非溃疡性消化不良（NUD）患者（P＜0．01）。根除HP后,AI在DU明显下降（P＜0．01）,在GU无明显改变（P＞0．05）。HP阳性DU溃疡活动期AI明显高于愈合期和瘢痕期（P＜0．05）,而HP阳性和GU溃疡三期AI无差异（P＞0．05）。bak蛋白表达在HP阳性PU明显高于HP阴性NUD患者（P＜0．05）。根除HP后,DU患者bak蛋白表达明显降低（P＜0．05）。GU患者虽有下降,但无统计学差异。bcl-2蛋白表达在HP阳性PU与HP阴性NUD之间无显著差异,HP根除前后亦无明显改变。结论：HP诱导胃上皮细胞凋亡在十二指肠溃疡发病中起重要的作用,HP诱导胃上皮细胞凋亡可能是通过bak路径实现的。     

溃疡宁治疗和维持治疗消化性溃疡的临床研究

用中药溃疡宁对70例消化性溃疡患者进行治疗及维持治疗，并与雷尼替丁及灭滴灵联用组对照，结果两组经过4～8周的治疗后，溃疡愈合率相似（P＞0．05）；而幽门螺杆菌的清除率治疗组明显优于对照组（P＜0．01）；维持治疗1年内消化性溃疡的复发率治疗组显著低于对照组（P＜0．05）。结果提示溃疡宁是治疗和维持治疗消化性溃疡的有效药物。     

胃康冲剂防治大鼠胃溃疡的作用

目的：探讨胃康冲剂促进溃疡愈合的作用和机制。方法：用乙酸浸渍的滤纸片腐蚀胃壁复制大鼠胃溃疡模型,测定胃粘膜表面粘液厚度,胃液中的表皮生长因子（EGF）,胃组织的一氧化氮（NO）与血浆6－酮－前列腺素F1α（6－K－PGF1α）水平。结果：造模后各组与正常对照组比较,胃粘膜表面粘液厚度显著降低（P＜0．01）,胃液中EGF、胃组织中NO与血浆6－K－PGF1α－水平平均显著降低（均P＜0．01）,胃饲不同剂量胃康冲剂使胃粘膜表面粘液厚度显著增加（P＜0．01）,胃液中EGF、胃组织NO水平,血浆6－K－PGF1α均显著升高（P＜0．05）。结论：胃康冲剂对胃粘膜具有明显的保护作用,其机制是增加胃粘膜表面粘液厚度与提高EGF、NO6－K－PGF1α细胞保护因子的水平。     

寿星宝抗衰老作用的实验研究

寿星宝系延缓衰老药，实验证明它能够延长家蝇的平均寿命和家蚕的生长时间（P＜0.01，P＜0．05）；提高老龄大鼠红细胞内SOD含量（P＜0.05～0．01），并降低血浆中LPO及心、脑组织中LPF的水平（P＜0．05～0．01）；增加大鼠红细胞C3b受体花环率、淋巴细胞转化率、IgG及胸腺体重系数（P＜0.05～0．01）;对东莨菪碱及乙醇致小鼠的记忆获得和记忆再现障碍有改善作用（P＜0．05～0．01）；还能延长小鼠的抗疲劳时间（P＜0．01）及夹闭小鼠气管后的心电消失时间（P＜0．01）．     

消溃异功散合雷尼替丁治疗消化性溃疡48例疗效观察

采用消溃异功散合雷尼替丁治疗消化性溃疡48例，并与西药对照组（32例）．比较，结果两组缓解疼痛疗效相近（P＞0．05），溃疡愈合率治疗组为91．6％，对照组65．5％（P＜0．05）；1年复发率治疗组22．9％，对照组81．2％（P＜0．01）；治疗组在缓解其他症状方面亦优于对照组。提示中西医结合疗法是提高消化性溃疡疗效的有效途径之一。     

消费灵治疗消化性溃疡的临床研究

目的：探讨中药复方消溃灵治疗消化性溃疡的作用机制,方法：以放射免疫法检测血浆及胃粘膜匀浆前列腺素E2（PGE2）含量,血清热休克蛋白（HSPS）测量采用Western斑点印迹法,SABC免疫组织化学方法用于观察胃粘膜HSPs并进行图像分析,结果：治愈率与总有效率,中西药组明显高于西药组和中药组（均P＜0．05）,溃疡指数,中西药组显著低于西药组和中药组（均P＜0．0）,血浆及胃粘膜匀浆PGE2含量,血清及胃粘膜HSPS水平,中药组及中西药组显著高于西药组（ P＜0．01）,结论：消溃灵可提高消化性溃疡患者血清,血浆及溃疡周边胃粘膜PGE2及HSPs水平。     

消化性溃疡患者血管活性肠肽与十二指肠胃反流和幽门螺杆菌感染关系的研究

背景：消化性溃疡（PU）和十二指肠胃反流（DGR）患者的血浆血管活性肠肽（VIP）含量常高于正常水平，而幽门螺杆菌（H.pylori)感染可能参与PU的发病。目的：探讨PU患者的VIP和DGR和H.pylori感染的关系。方法：采用放射免疫测定（RIA）检测34例胃溃疡（GU）患者、42例十二指肠球部溃疡（DU）患者和30例健康人的血浆VIP含量；放射性核素^99mTc-EHIDA显像法测定DGR；双抗体夹心酶联免疫吸附测定（ELISA）检测血清H.pylori IgG抗体，Giemsa染色检测胃黏膜H.pylori。结果：GU组的血浆VIP含量显著高于DU组和正常对照组（P＜0．01）；DGR阳性率亦显著高于DU组（P＜0．05）。DGR阳性组的血浆VIP含量显著高于DGR阴性组（P＜0．01）。H.pyori阳性组的血浆VIP含量显著低于H.pylori阴性组（P＜0．05）。结论：PU患者血浆VIP含量升高可能是DGR发生的重要因素之一。     

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.     

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.