大蒜素对皮下移植肝癌细胞生长抑制和诱导凋亡的实验研究

目的　评价大蒜素在实验裸小鼠体内抗肝癌的有效性,为临床应用大蒜素对肝癌进行介入治疗提供理论依据。　方法　建立人肝癌细胞BEL 7402裸小鼠皮下移植瘤模型,模拟介入治疗用药方法,对6组移植瘤模型分别注射生理盐水吐温溶液,1、2、5 mg/ml大蒜素,0 .2 mg/ml阿霉素,1 mg/ml大蒜素+0 .2 mg/ml阿霉素,每次注射 0. 1 ml,隔日 1 次,连续 7 次,测量肿瘤体积变化,计算各组抑瘤率,对移植瘤组织作HE染色观察,电镜观察形态改变, TUNEL法检测组织凋亡率,RT PCR技术分析处理前后BEL 7402细胞FasL mRNA表达。　结果　移植瘤生长符合指数曲线规律,各组抑瘤率分别为: 62 .8%、72 .8%、94 .5%、76. 0%和 87 .0%;各组凋亡指数分别为(2. 2±1 .1)%、(17 .2±2. 8)%、(19 .4±2 .1)%、(28. 3±3.0)%、(22. 4±2 .5)%和(37 .6±3 .9)%;大蒜素或阿霉素组FasL mRNA表达均增加,大蒜素+阿霉素组表达上调尤其明显;大蒜素或(和)阿霉素治疗后,移植瘤组织内坏死细胞增加,出现典型凋亡形态细胞。　结论　大蒜素可以有效抑制人肝癌细胞裸小鼠移植瘤生长,且呈剂量效应关系;大蒜素可通过上调FasL mRNA的表达诱导人肝癌细胞凋亡。     

毫米波诱导人肝癌细胞株凋亡的研究

目的　研究 35 .8GHz毫米波照射诱导人肝癌细胞株BEL74 0 4凋亡。方法　选取BEL74 0 4人肝癌细胞体外培养 ,随机分为 4组 ,分别为对照组、毫米波照射 30min组、氟尿嘧啶 (5 FU)组、毫米波联合 5 FU组。用荧光显微镜观察细胞核的变化 ;DNA片段化分析检测染色体断裂情况 ;用流式细胞仪检测凋亡率。结果　BEL74 0 4细胞经毫米波照射后诱发的细胞死亡具有细胞凋亡的形态学特征 ;照射 30min组和 5 FU组诱导细胞凋亡的比例高于对照组 ,分别为 (14 .33± 2 .6 6 ) % ,(18.5 8±2 .5 7) %和 (3.2 1± 1.0 6 ) % ,毫米波与 5 FU联合明显增加细胞凋亡率 ,达 (2 7.91± 3.6 6 ) %。结论　 35 .8GHz毫米波照射可诱导BEL74 0 4肝癌细胞凋亡 ,与 5 FU联合使用可明显增加凋亡比例     

多巴胺对体外培养神经细胞的影响

目的　研究高浓度多巴胺 (DA)对神经细胞的毒性作用。　方法　观察不同浓度、不同时间DA对体外培养神经细胞的毒性 ,并用琼脂糖凝胶电泳、原位末端标记、流式细胞仪进行细胞凋亡的检测。　结果　 (1)高浓度DA引起神经细胞凋亡 ;(2 )给予 80、16 0、32 0 μmol/LDA处理 2 4h后神经细胞凋亡率分别为 (41 49± 1 32 ) %、(6 5 6 7± 1 6 8) %、(84 6 5± 2 2 1) % ,明显高于浓度效应对照组〔(2 0 7± 0 2 6 ) % ,P <0 0 5〕 ;(3)在给予 30 0 μmol/LDA处理的条件下 ,经过 12、2 4、48h后 ,神经细胞的凋亡率分别为 (37 90± 0 39) %、(6 9 34± 3 31) %、(82 0 7± 0 86 ) % ,明显高于时间效应对照组〔(2 30± 0 11) % ,P <0 0 5〕。　结论　高浓度DA对体外培养神经细胞具有细胞毒性 ,诱导神经细胞凋亡 ,具有时间及剂量效应。     

Nimesulide诱导胃癌细胞凋亡的作用机制研究

目的　非甾体抗炎药诱导胃癌细胞凋亡的机制不清楚。通过研究选择性COX 2抑制剂Nimesulide对人胃癌细胞系SGC 790 1的COX 2mRNA表达和c myc、Bcl 2、caspase 3凋亡基因蛋白表达的影响 ,探索其诱导胃癌细胞凋亡的机制。方法　胃癌细胞的凋亡用电子显微镜、AnnexinV FITC染色、流式细胞仪技术测定。COX 2基因表达用RT PCR法测定。c myc、Bcl 2和caspase 3蛋白表达用免疫细胞化学技术测定。结果　Nimesulide在浓度为 50 μmol/L时作用 48、72h和浓度为 1 0 0和2 0 0 μmol/L 时作用 2 4、48、72h均可诱导胃癌细胞凋亡 ,凋亡率分别为 7.51 % ,9.86 % ;1 1 .58% ,1 2 .45 % ,1 6 .66 %和 1 2 .2 1 % ,1 5 .38% ,2 0 .2 8% ,呈浓度和时间依赖性。Nimesulide可降低COX 2mRNA表达和Bcl 2蛋白表达 ,增加c myc和caspase 3蛋白表达。 2 0 0 μmol/LNimesulide作用 72h ,Bcl 2 ,c myc和caspase 3蛋白表达阳性率分别为 (2 0 .2± 7.6) % ,(49.2± 1 5 .1 ) %和 (34 .6± 1 2 .9) % ,对照组为(44.6± 1 2 .1 ) % ,(2 4 .7± 9.5) %和 (1 4 .8± 6 .4) % ,三者对照比较 ,差异有显著性 (P <0 .0 1。)结论　Nimesulide可诱导胃癌细胞SGC 790 1凋亡 ,其机制涉及Bcl 2表达下调、c myc表达上调及caspase 3激活。     

骨髓增生异常综合征T细胞早期激活及可溶性肿瘤坏死因子受体的研究

目的　研究骨髓增生异常综合征 (MDS)外周血CD+ 4 、CD+ 8T细胞早期激活标志CD69的表达及血清、骨髓可溶性肿瘤坏死因子受体 1、2 (sTNF R1、2 )的水平及其意义。方法　在植物血凝素 (PHA) 2 0mg/L条件下进行全血细胞培养 ,于 0h和 4h分别用流式细胞仪对CD+ 4 、CD+ 8T细胞CD69的表达进行分析。用ELISA法检测血清和骨髓sTNF R1、2的水平。结果　PHA刺激前难治性贫血 (RA)与难治性贫血伴环形铁粒幼细胞增多 (RAS)CD+ 4 、CD+ 8细胞CD69的表达率分别为 8 32 %、9 88% ,难治性贫血伴原始细胞增多 (RAEB)与转变中的RAEB(RAEB T)CD+ 8细胞CD69的表达率为7 92 %。PHA刺激后MDS患者CD+ 4 、CD+ 8细胞表达CD69明显增强 ,RA +RAS为 5 3 4 6 %、5 1 6 3% ;RAEB +RAEB T为 4 2 93%、4 1 96 % ,CD+ 4 与CD+ 8细胞CD69的表达率相似。MDS两种sTNF R1水平均明显升高 ,RA +RAS组sTNF R1血清为 (1 5 8± 0 6 8) μg/L ,骨髓为 (2 10± 0 2 6 ) μg/L ;sTNF R2血清为 (1 4 1± 0 5 0 ) μg/L ,骨髓为 (1 95± 0 6 4 ) μg/L ;RAEB +RAEB T组sTNF R1血清为 (2 6 2± 2 5 5 ) μg/L ,骨髓为 (3 12± 0 6 7) μg/L ;sTNF R2血清为 (1 96± 0 5 6 ) μg/L ,骨髓为(3 0 9± 0 6 2 ) μg/L。血清sTNF R2水平与PHA刺激     

老年脑梗死患者蛋白C系统及抗凝血酶系统测定的研究

目的　探讨老年脑梗死患者血浆抗凝系统蛋白C系统及抗凝血酶系统的水平变化及临床意义。方法　酶联免疫吸附测定 (ELISA)法测定蛋白C(PC)、总蛋白S(TPS)、游离蛋白S(FPS)及凝血酶 抗凝血酶Ⅲ复合物 (TAT)的含量 ,发色底物法测定活化蛋白C(APC)和抗凝血酶Ⅲ (ATⅢ )活性。结果　与对照组相比 ,老年脑梗死患者急性期PC、FPS、ATⅢ明显下降 [(2 .89± 1.0 4) μg/ml、(7.85± 2 .2 6 ) μg/ml、(77.2 1± 2 5 .43) % ;(3.42± 1.13) μg/ml、(9.34±3.0 1) μg/ml、(97.2 8± 2 0 .42 ) % ;P <0 .0 5 ],恢复期无差异(P >0 .0 5 ) ;APC、TAT在脑梗死急性期及恢复期明显增高 (P<0 .0 1)。随病情加重PC、FPS显著下降 ,而TAT明显升高 ;有TIA病史的脑梗死患者FPS水平明显低于无TIA病史者 [(6 .5 4± 2 .97) μg/ml,(7.99± 1.13) μg/ml;P<0 .0 1]。PC、FPS与血脂间无相关性。结论　老年脑梗死患者存在凝血的激活 ,抗凝系统的异常参与了老年脑梗死的病理过程     

三氮脒、三氮脒脂质体和复方三氮脒注射液在兔体内的药代动力学和组织残留

目的　研究三氮脒、三氮脒脂质体和复方三氮脒注射液 (TRYPAN)在兔体内的药代动力学和组织残留量。　方法　应用三氮脒、三氮脒脂质体和 TRYPAN给兔单剂量 (3.5 mg/ kg体重 )肌肉注射 ,用反相高效液相色谱法测定给药不同时间后兔体内的血浆药物浓度和组织中的药物残留量 ,并利用 3p87药代动力学软件进行分析。　结果　三氮脒、三氮脒脂质体和 TRYPAN在兔体内的药代动力学均符合一级吸收二室模型 ,其主要药代动力学参数依次分别为 :达峰时间 (Tmax) (0 .4 5± 0 .12 ) h、(3.36± 0 .75 ) h、(2 .4 2± 0 .6 8) h,最高血药浓度 (Cmax) (3.85± 0 .4 1)、(3.0 1± 0 .16 )、(3.4 3± 0 .2 7) μg/ ml,消除相半衰期 (t1 / 2β) (87.0 3± 18.72 ) h、(136 .14± 2 0 .14 ) h、(10 4 .4 0± 32 .18) h,药时曲线下面积(AUC) (2 2 4 .72± 92 .15 )、(44 0 .90± 87.73)、(2 94 .35± 73.92 ) μg/ ml.h。三氮脒脂质体与三氮脒和 TRYPAN相比 ,达峰时间 (Tmax)分别延长了 2 .91h、0 .94 h,峰浓度 (Cmax)分别降低了 0 .84、0 .4 2 μg/ ml,消除相半衰期 (t1 / 2β)分别延长了 4 9.11h、31.74 h,药时曲线下面积 (AUC)分别增大了 2 16 .18、14 6 .5 5μg/ ml.h,因此具有吸收缓慢、毒副作用小、消除缓慢和作用时间     

催乳素对Graves 病甲状腺细胞与自体外周血单个核细胞体外相互作用的影响

目的　研究催乳素对Graves病 (GD)甲状腺细胞与自体外周血单个核细胞 (PBMC)在体外共同培养时相互作用的影响。方法　利用免疫荧光染色和流式细胞仪等 ,测定在不同羊催乳素(oPRL)水平进行共同培养时PBMC的活化、增殖反应和甲状腺细胞对人类白细胞抗原基因复合体(HLA) DR及CD4 0 的表达。结果　oPRL浓度为 2 0 0 μg/L时与GD甲状腺细胞共同培养的PBMC中CD4 CD2 5 细胞百分率 [(13 0 8± 2 5 4) % ,P <0 0 1]和增殖指数 [(17 82± 3 0 2 ) % ,P <0 0 1]及 10 0 0μg/L时的增殖指数 [(16 5 7± 2 5 6 ) % ,P <0 0 5 ]均较 0 [分别 (10 15± 2 6 0 ) %和 (14 38± 2 6 4) % ]、12 5及 5 0 μg/L时有显著增加。在 2 0 0和 10 0 0 μg/L时相应甲状腺细胞中CD4 0 细胞百分率 [(4 8 2 5± 6 6 3) % ,(5 2 2 8± 6 94) % ]和平均荧光强度 (dMF ;42 94± 10 2 4,49 5 1± 12 34)明显低于 0 [(5 8 38± 6 6 2 ) %和 6 7 30± 2 0 2 0 ]、12 5及 5 0 μg/L剂量组。而在 5 0 μg/L时其HLA DR 细胞百分率[(4 6 79± 7 5 1) % ,P <0 0 1]和dMF(2 1 0 2± 5 43 ,P <0 0 1)显著高于 0 [(33 5 1± 8 5 8) %和 13 91±3 88]、12 5、2 0 0及 10 0 0 μg/L剂量组。除此以外 ,oPRL各剂量组间差异均     

胸腹水凝血抑制物的检测及其临床意义

目的　探讨三组疾病胸腹水凝血抑制物的水平及其鉴别诊断意义。方法　组织因子途径抑制物 (TFPI)、凝血酶调节蛋白 (TM )和蛋白C(PC)采用ELISA法测定抗原浓度 ,抗凝血酶Ⅲ(ATⅢ )和肝素辅因子Ⅱ (HCⅡ )采用发色底物法测定活性量。结果　结核病组胸腹水TFPI和PC水平分别为 (3 5 .2 5± 13 .61) μg/L和 (4 6.97%± 2 3 .64 % )、恶性肿瘤组分别为 (3 4.10± 14 .97) μg/L和 (3 7.13 %± 2 3 .19% ) ,明显高于肝硬化组的 (7.84± 5 .45 ) μg/L和 (7.90 %± 4.63 % ) (P <0 .0 1)。ATⅢ肝硬化组 (4 9.5 3 %± 2 4.14 % )明显高于结核病组 (3 1.44 %± 2 0 .72 % ) (P <0 .0 5 )。HCⅡ肝硬化组 (91.5 4%± 9.3 1% )和恶性肿瘤组 (88.80 %± 9.2 4% )均明显高于结核病组 (76.5 7%±11.12 % ) (P <0 .0 1)。恶性肿瘤组TM (5 5 .87± 3 7.16) μg/L高于结核病组 (3 6.76± 18.80 ) μg/L ,结核病组又高于肝硬化组 (12 .2 9± 8.5 2 ) μg/L(P <0 .0 1)。在恶性肿瘤组的 5项凝血抑制物指标中 ,TFPⅠ、ATⅢ和TM三项指标在胸腹水脱落细胞阳性组与阴性组间有明显差异 (P <0 .0 5 )。结论　联合检测多项凝血抑制物有助于不同胸腹水疾病的鉴别 ,了解凝血抑制物与胸腹水病理之间的关系     

益肾降浊汤对脑缺血再灌注大鼠海马EAA含量的影响

目的 :观察益肾降浊汤对脑缺血再灌注大鼠海马组织EAA含量的影响。方法 :用氨基酸自动分析仪测定游离氨基酸浓度。结果 :第 1天模型大鼠海马Glu、Asp含量分别是 ( 8.2 6± 2 .13 ) μmol/g、( 2 .10± 0 .93 ) μmol/g ,第 7天含量分别是 ( 7.2 7± 2 .2 0 ) μmol/g、( 1.87± 2 .0 1) μmol/g ,第 15天含量分别是 ( 9.3 6± 2 .2 4) μmol/g、( 1.42± 1.2 1) μmol/g ,均较正常对照组显著降低 (P <0 .0 5～ 0 .0 1)。而中药组大鼠第 1天脑海马Glu、Asp含量分别是 ( 9.90± 3 .2 0 )μmol/g、( 2 .95± 1.73 ) μmol/g ,第 7天含量分别是 ( 10 .49± 2 .3 4)μmol/g、( 3 .0 3± 1.0 9) μmol/g ,第15天含量分别是 ( 11.0 5± 2 .5 4)μmol/g、( 3 .0 5± 1.41) μmol/g ,均高于同期模型组 (P <0 .0 5 )。结论 :益肾降浊汤可提高缺血再灌注后脑组织细胞内的EAA含量 ,调节突出间隙EAA浓度 ,对缺血神经元有保护作用。     

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.     

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.