不同抗高血压药物对自发性高血压大鼠痛阈的影响

目的观察不同抗高血压药物对自发性高血压大鼠(SHR)痛阈的影响,探讨其与血管紧张素Ⅱ(AngⅡ)的关系。方法 12周龄雄性SHR 40只随机分为卡托普利[100 mg/(kg·d)]、氯沙坦[50 mg/(kg·d)]、普萘洛尔[40mg/(kg·d)]、非洛地平组[10mg/(kg·d)]和SHR对照组,并选取对应周龄雄性Wistar-Kyoto(WKY)大鼠作为正常血压对照组,每组8只,灌胃8周。采用无创尾袖法测量大鼠尾动脉收缩压。测量给药前、给药4和8周时大鼠的机械痛阈和热痛阈。应用酶联免疫吸附试验(ELISA)测定大鼠血浆及脊髓组织AngⅡ。结果卡托普利、氯沙坦、普萘洛尔、非洛地平治疗4和8周后,收缩压明显低于SHR对照组[4周:(178±9)、(168±10)、(177±11)、(172±7)比(201±10)mm Hg;8周:(177±9)、(166±10)、(176±7)、(172±8)比(200±11)mm Hg;均P0.01]。SHR治疗前机械痛阈高于WKY,热痛阈低于WKY(P0.01)。卡托普利组和氯沙坦组治疗4和8周末,机械痛阈和热痛阈较给药前明显升高(P0.01);与SHR对照组比较,机械痛阈和热痛阈有不同程度升高(P0.01或P0.05)。卡托普利组和非洛地平组的血浆AngⅡ较SHR对照组减低(P0.05),氯沙坦组血浆AngⅡ明显高于其他组(P0.01);卡托普利组的脊髓AngⅡ较其他各组显著降低(P0.05)。相关分析表明,痛阈改变与脊髓AngⅡ相关(P0.01)。结论卡托普利和氯沙坦治疗高血压可增高SHR痛阈,其原因可能与脊髓水平AngⅡ下降或脊髓AngⅡ痛敏作用被阻滞有关。     

氯沙坦对自发性高血压大鼠肾脏组织Bax、Bcl-2表达的影响情况

目的探讨氯沙坦对自发性高血压(SHR)大鼠肾脏组织Bcl-2相关性蛋白X(Bax)和B细胞淋巴瘤-2(Bcl-2)表达的影响。方法选取近交系雄性SHR大鼠30只和Wistar-Kyoto雄性大鼠15只,SHR大鼠随机分为氯沙坦组(n=15)和SHR阳性对照组(n=15),氯沙坦组按氯沙坦30 mg/kg灌胃,SHR阳性对照组按0.9%氯化钠溶液10 ml/kg灌胃,Wistar-Kyoto大鼠作为正常对照组,按0.9%氯化钠溶液10ml/kg灌胃,每日清晨灌胃,连续灌胃8周。比较各组大鼠尾动脉收缩压,采用免疫组化染色法检测两组Bax和Bcl-2蛋白表达,采用荧光定量聚合酶链反应(PCR)检测Bax和Bcl-2 m RNA表达水平。结果氯沙坦组给药第4周和8周尾动脉收缩压明显低于给药前收缩压水平(P0.05);氯沙坦组给药第4周和8周尾动脉收缩压低于SHR阳性对照组(P0.05);氯沙坦组和正常对照组Bcl-2平均光密度分别为(0.19±0.01)和(0.20±0.02),明显高于SHR阳性对照组(P0.05),而Bax平均光密度分别为(0.12±0.02)和(0.13±0.01),明显低于SHR阳性对照组(P0.05);氯沙坦组和正常对照组Bax和Bcl-2平均光密度比较差异无统计学意义(P0.05);Bcl-2和Bax m RNA相对表达量在氯沙坦组和正常对照组间差异比较无统计学意义(P0.05),SHR阳性对照组患者的Bcl-2相对表达值显著高于氯沙坦组和正常对照组,而Bax m RNA相对表达值显著低于氯沙坦组和正常对照组(P0.05)。结论氯沙坦对SHR大鼠有明显的降压作用,可抑制Bax基因及蛋白表达,而促进Bcl-2基因及蛋白表达。     

奈比洛尔对自发性高血压大鼠主动脉血管反应性的影响

目的观察奈比洛尔对自发性高血压大鼠(SHR)血压、主动脉对不同收缩和舒张药物反应性的影响。方法实验动物随机分成5组,SHR对照组、WKY对照组:等量蒸馏水灌胃;奈比洛尔组:SHR灌胃奈比洛尔8mg/(kg.d);阿替洛尔组:SHR灌胃阿替洛尔80mg/(kg.d);WKY奈比洛尔组:正常血压WKY大鼠灌胃奈比洛尔8mg/(kg.d)。给药8周,每周用无创法测定尾动脉收缩压。实验结束后,处死动物后,取胸主动脉,观察血管对内皮素(ET-1)、血管紧张素Ⅱ(AngⅡ)、苯肾上腺素(PE)、KCl的收缩反应以及对乙酰胆碱(Ach)、硝普钠(SNP)的舒张反应。结果与SHR对照组相比、奈比洛尔,阿替洛尔可明显抑制SHR血压升高(P0.05),且奈比洛尔在用药4周后可使收缩压维持稳定水平。SHR主动脉对KCl、PE、AngⅡ的收缩反应均大于WKY组(P0.05);对Ach的舒张反应明显弱于WKY组(P0.05),但是对ET-1的收缩反应及对SNP的舒张反应在两组无统计学意义。奈比洛尔可以抑制SHR主动脉对KCl、PE、ET-1、AngⅡ的收缩反应(P0.05);增加SHR主动脉对Ach的舒血管效应(P0.05),但对SNP的反应性无显著性影响。结论奈比洛尔可以抑制SHR主动脉对不同收缩药的收缩反应,增加主动脉对Ach的舒张效应,改善SHR血管反应性。     

贝那普利和氯沙坦联合治疗对自发性高血压大鼠左室重构的影响

目的探讨贝那普利和氯沙坦联合应用对自发性高血压大鼠(SHR)左心室重构的作用。方法48只55周龄SHR随机分组(n=12):空白对照组(SHRC)、贝那普利组(SHRB:10mg/kg·d)、氯沙坦组(SHRL:30mg/kg·d)、合用组(SHRB L:贝那普利10mg/kg·d 氯沙坦15mg/kg·d),另设WKY大鼠为对照组,检测尾动脉压(SBP)。12周后:(1)放射免疫法检测血浆肾素活性(PRA)、血管紧张素Ⅱ(AngⅡ)、醛固酮(Ald)水平,化学法检测血浆一氧化氮(NO)水平;(2)免疫组化法检测心肌Ⅰ、Ⅲ型胶原纤维表达;(3)病理及超微结构检测。结果与SHR对照组比较,各药物组尾动脉压显著下降(P<0.01),但用药组间无显著差异(P>0.05);SHR各组间血浆PRA无显著性差异(P>0.05)。SHR对照组血浆AngⅡ低于WKY对照组(P<0.05～0.01),贝那普利组显著降低和氯沙坦组显著升高血浆AngⅡ水平,合用组介于两组之间。与贝那普利组[Ald:(393.9±17.6)pg/mL、NO:(15.2±2.1)μmol/L]、氯沙坦组[Ald:(332.0±17.8)pg/mL、NO:(12.3±1.8)μmol/L]比较,合用组[Ald:(302.4±15.5)pg/mL、NO:(16.5±2.4)μmol/L]更显著的降低血浆Ald和升高NO水平(P<0.01);与贝那普利组(Ⅰ型胶原:6.09±1.12%、Ⅲ型胶原:9.0%±1.2%)、氯沙坦组(Ⅰ型胶原:4.3%±0.7%、Ⅲ型胶原:8.0%±1.3%)比较,合用组(Ⅰ型胶原:2.8%±0.7%、Ⅲ型胶原:6.5%±1.0%)更显著的降低心肌Ⅰ、Ⅲ型胶原纤维的表达(P<0.01);组织病理及电镜显示,合用组更显著的改善SHR左心室重构。结论贝那普利和氯沙坦均能有效的改善高血压左室重构,二者合用时更为明显。     

贝那普利和氯沙坦联合治疗对自发性高血压大鼠左室重构的影响

目的探讨贝那普利和氯沙坦联合应用对自发性高血压大鼠(SHR)左心室重构的作用. 方法 48只55周龄SHR随机分组(n=12):空白对照组(SHR-C)、贝那普利组(SHR-B:10 mg/kg·d)、氯沙坦组(SHR-L:30 mg/kg·d)、合用组(SHR-B L:贝那普利10 mg/kg·d 氯沙坦15 mg/kg·d),另设WKY大鼠为对照组,检测尾动脉压(SBP).12周后:(1)放射免疫法检测血浆肾素活性(PRA)、血管紧张素Ⅱ(Ang Ⅱ)、醛固酮(Ald)水平,化学法检测血浆一氧化氮(NO)水平;(2)免疫组化法检测心肌Ⅰ、Ⅲ型胶原纤维表达;(3)病理及超微结构检测.结果与SHR对照组比较,各药物组尾动脉压显著下降(P<0.01),但用药组间无显著差异(P>0.05);SHR各组间血浆PRA无显著性差异(P>0.05).SHR对照组血浆Ang Ⅱ低于WKY对照组(P<0.05～0.01),贝那普利组显著降低和氯沙坦组显著升高血浆Ang Ⅱ水平,合用组介于两组之间.与贝那普利组[Ald:(393.9±17.6)pg/mL、NO:(15.2±2.1)μmol/L]、氯沙坦组[Ald:(332.0±17.8)pg/mL、NO:(12.3±1.8)μmol/L]比较,合用组[Ald:(302.4±15.5)pg/mL、NO:(16.5±2.4)μmol/L]更显著的降低血浆Ald和升高NO水平(P<0.01);与贝那普利组(Ⅰ型胶原:6.09±1.12%、Ⅲ型胶原:9.0%±1.2%)、氯沙坦组(Ⅰ型胶原:4.3%±0.7%、Ⅲ型胶原:8.0%±1.3%)比较,合用组(Ⅰ型胶原:2.8%±0.7%、Ⅲ型胶原:6.5%±1.0%)更显著的降低心肌Ⅰ、Ⅲ型胶原纤维的表达(P<0.01);组织病理及电镜显示,合用组更显著的改善SHR左心室重构.结论贝那普利和氯沙坦均能有效的改善高血压左室重构,二者合用时更为明显.     

贝那普利与氯沙坦对糖尿病大鼠的心肌保护作用

目的观察贝那普利与氯沙坦对糖尿病大鼠心肌细胞凋亡、纤维化的干预效果,探讨两者对糖尿病大鼠心肌保护的作用机制。方法将40只SD大鼠随机分为空白对照组(n=10)和糖尿病模型组(n=30),糖尿病模型组用链脲佐菌素(STZ)腹腔注射建模,成功后再随机分为糖尿病对照组(n=10)、贝那普利治疗组(n=10)和氯沙坦治疗组(n=10)。贝那普利治疗组给予贝那普利10 mg/(kg·d)灌胃,氯沙坦治疗组给予氯沙坦20 mg/(kg·d)灌胃,糖尿病对照组和空白对照组给予相同体积的生理盐水灌胃。给药9周后,观察各组心肌细胞凋亡、心肌组织Fas蛋白表达,Ⅰ型、Ⅲ型胶原含量,血清转化生长因子-β_1(TGF-β_1)、基质金属蛋白酶-1(MMP-1)、基质金属蛋白酶组织抑制物-1(TIMP-1)蛋白表达的变化。结果与空白对照组比较,糖尿病对照组血管紧张素Ⅱ(AngⅡ)的含量明显增多(P0.05),Fas蛋白表达率、凋亡指数明显升高(P0.05),心肌细胞凋亡明显增多;Ⅰ、Ⅲ型胶原含量明显增多(P0.05),存在间质纤维化,同时TGF-β_1、TIMP-1蛋白表达增多(P0.05),MMP-1表达减少(P0.05)。与糖尿病对照组比较,贝那普利治疗组和氯沙坦治疗组Ⅰ型、Ⅲ型胶原含量明显减少(P0.05),TGF-β_1、TIMP-1蛋白表达减少(P0.05),MMP-1表达增多(P0.05);Fas蛋白表达率、凋亡指数明显降低(P0.05),贝那普利治疗组AngⅡ的含量明显减低(P0.05),氯沙坦治疗组AngⅡ的含量升高但差异无统计学意义。贝那普利治疗组与氯沙坦治疗组组间Fas蛋白表达率、凋亡指数及各项纤维化指标比较差异无统计学意义。结论糖尿病大鼠的心肌细胞凋亡明显增加,间质纤维化增加。贝那普利和氯沙坦均能抑制心肌细胞的凋亡和间质纤维化。     

缬沙坦和贝那普利对高血压大鼠纤溶功能的影响

目的:探讨在整体情况下肾素-血管紧张素系统(RAS)和纤溶系统的关系,为血管紧张素转换酶抑制剂(ACEI)及血管紧张素Ⅱ型受体阻滞剂(ARB)治疗血栓性疾病、预防心血管事件的发生提供理论基础。方法:21只自发性高血压大鼠(SHR)分为对照组、贝那普利(Ben)组和缬沙坦(Val)组,分别用Ben 10 mg/(kg·d)和Val 30 mg/(kg·d)对SHR进行干预5周,观察纤溶指标的变化。血浆和孵育液中纤维酶原激活物抑制剂(PAI-1)、组织型纤溶酶原激活物(t-PA)活性的测定采用发色底物法,心肌组织PAI-1 mRNA的表达采用RT-PCR方法半定量测定。结果:药物干预后,SHR大鼠主动脉条孵浴液中PAI-1活性下降,血浆PAI-1活性受到抑制,Val组、Ben组心肌组织PAI-1 mRNA的表达较SHR组分别下降50.32％、16.94％(P<0.01,<0.05),Val组心肌组织PAI-1 mRNA的表达也低于Ben组(P<0.01)。结论:RAS参与了纤溶系统功能的调节,其过程主要是通过血管紧张素Ⅱ1型受体促进PAI-1的合成与释放而实现的,Val、Ben具有改善大鼠纤溶功能参数指标,提高纤溶系统活性的作用。     

氯沙坦或卡托普利对自发性高血压大鼠心脏纤维化的干预研究

目的探讨在不同水平阻断肾素-血管紧张素系统(RAS)对高血压心肌纤维化的影响.方法 29只自发性高血压大鼠(SHR)随机分成(1) SHR对照组(n=15);(2)氯沙坦组(n=7,30 mg*kg-1*d-1);(3)卡托普利组(n=7,100 mg*kg-1*d-1);(4)WKY(n=12)为非高血压组.治疗组每日灌胃给药,对照组蒸馏水灌胃15周后,获取标本.结果 1.SHR心肌血管紧张素Ⅱ(Ang Ⅱ)和醛固酮(Ald)浓度、羟脯氨酸和Ⅰ/Ⅲ型胶原比值较同龄WKY大鼠明显增高(P<0.01),而心肌胶原单体/二聚体(α/β)比值和基质金属蛋白酶-1(MMPs-1)活力降低(P<0.01),且随病程而进一步升高或降低.2.经氯沙坦或卡托普利干预后,心肌Ang Ⅱ、Ald浓度、心肌羟脯氨酸和Ⅰ、Ⅲ型胶原比值有不同程度的降低(P<0.01),而心肌胶原单体/二聚体(α/β)比值和MMPs-1活性升高(P<0.01),逆转了心肌纤维化.3. 氯沙坦在改善胶原表型、胶原可溶性及提高MMPs-1活性优于卡托普利.结论不同水平阻断肾素血管紧张素系统对纤维化逆转不仅减少胶原含量,还改善表型和交联的异常.     

转化生长因子βⅡ型受体在糖尿病大鼠血管损伤后的表达及氯沙坦对其调节作用

目的　观察转化生长因子 βⅡ型受体 (TGF βⅡR)在糖尿病鼠血管损伤后血管平滑肌细胞 (VSMCs)和血管壁中的表达及血管紧张素Ⅱ 1型受体拮抗剂氯沙坦对其调节作用。方法　 ( 1)Wistar大鼠单次腹腔注射链脲佐菌素成糖尿病模型后被随机分为糖尿病组和氯沙坦组 ,每组 8只。16只正常鼠随机分为正常对照组和手术对照组。除正常对照组外 ,全部动物均行胸主动脉至左髂总动脉球囊损伤 ,氯沙坦组用氯沙坦 2 0mg·kg- 1 ·d- 1 灌胃 ,余两组均用等量蒸馏水灌胃。 ( 2 )观察实验前、后各组血糖变化和测定动脉壁血管紧张素Ⅱ (AngⅡ )含量。 ( 3)用RT PCR及Northern印迹杂交测定VSMCsTGF βⅡR和Ⅰα(Ⅳ )前胶原mRNA的表达。 ( 4)用免疫组化检测TGF βⅡR和Ⅰα(Ⅳ )前胶原在血管壁的表达。结果　 ( 1)与手术对照组相比 ,糖尿病组AngⅡ含量、TGF βⅡR和Ⅰα(Ⅳ )前胶原mRNA和蛋白水平表达均增高 (P <0 0 1) ,而手术对照组又明显高于正常对照组 (P <0 0 1)。 ( 2 )与手术对照组相比 ,氯沙坦治疗后可明显降低动脉壁AngⅡ含量 ,TGF βⅡR和Ⅰα(Ⅳ )前胶原mRNA、蛋白水平的表达分别被抑制达 6 0 %、5 7%、6 2 %、46 %。结论　糖尿病血管损伤后再狭窄的形成与TGF βⅡRmRNA和蛋白的过度表达有关 ,氯沙坦对其有抑制作     

索他洛尔对急性心肌梗死血小板活化及纤溶活性和内皮血管活性物质的影响

目的 :探讨索他洛尔对急性心肌梗死 (AMI)血小板活化、纤溶活性和内皮血管活性物质的影响。方法 :新西兰大白兔 4 0只 ,随机分为 4组 ,每组 10只 ,Ⅰ组 :假手术组 ,Ⅱ组 :AMI组 ,Ⅲ组 :利多卡因组 ,Ⅳ组 :索他洛尔组 ;Ⅱ、Ⅲ、Ⅳ组分别结扎冠状动脉左室支中点 ,4h后取血分别测定血栓素B2 (TxB2 )、6 酮 前列腺素F1α(6 keto PGF1α)、内皮素 (ET)、一氧化氮 (NO)浓度和组织型纤溶酶原激活剂 (t PA)、纤溶酶原激活剂抑制物 (PAI)活性 ;摘取心脏 ,测定心肌梗死范围。结果 :Ⅱ、Ⅲ、Ⅳ组与Ⅰ组比较 ,血浆TxB2 、ET、NO浓度和PAI活性显著升高(P <0 .0 1) ,6 keto PGF1α浓度、t PA活性显著下降 (P <0 .0 1) ,Ⅲ组与Ⅱ组比较 ,差异无显著性意义 ,Ⅳ组与Ⅱ组比较 ,血浆TxB2 、ET、NO浓度和PAI活性明显降低 (P <0 .0 1) ,6 keto PGF1α浓度、t PA活性显著升高 (P <0 .0 1) ,梗死范围减小。结论 :索他洛尔抑制AMI早期血小板活化 ,改善纤溶活性 ,减少ET和NO的释放 ,缩小心肌梗死范围     

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     

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.     

Angiographic diagnosis of the degree of serosal invasion of carcinoma of the colon

Angiography using Prostaglandin El^® was performed on 38 patients with carcinoma of the colon in order to diagnose the degree of serosal cancer invasion. The findings at angiography were classified into four groups:1) AG-S3, abnormal change (irregularity and/or encasement) up to marginal vessels; 2) AG-S2, abnormality up to vasa recta; 3) AG-S1, abnormality of penetrating branches of vasa recta within the wall of the colon; and 4) AG-S0, no distinct findings of abovementioned vessels. These angiographic findings were compared with both macroscopic and microscopic serosal cancer invasion. Angiographic diagnosis is in accord with the macroscopic findings in 84.2 percent of cases. Angiographic diagnosis is in accord with the microscopic findings in 32.4 percent of cases. Macroscopic findings confirm the angiographic diagnosis precisely but the conflict with microscopic findings should not be overlooked. This may be the result of inflammatory change, adhesion, and fibrosis around carcinoma of the colon.     

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.