丹酚酸B对大鼠心室肌细胞瞬时外向钾电流和L型钙电流的阻滞作用

目的研究从丹参中分离提取的药物单体——丹酚酸B对大鼠心肌细胞上的瞬时外向钾电流(Ito)、内向整流钾电流(IK1)和L型钙电流(ICa,L)的电生理学作用。方法用酶解法分离大鼠心室肌细胞,全细胞膜片钳技术记录Ito、IK1和ICa,L。每个细胞采用加药前后自身对照,用含100μmol/L丹酚酸B的细胞外液灌流心室肌细胞,记录加药前、后的电流,所有数据均在细胞破膜后20min内完成。结果 100μmol/L的丹酚酸B对Ito和ICa,L具有抑制作用,使Ito和ICa,L最大激活峰值电流密度下降,电流密度-电压曲线下移;且丹酚酸B主要抑制Ito的快速电流成分Itof,而对Ito的缓慢电流成分Itos无明显作用。在60mV测试电压下,Itof的最大激活峰值电流密度从23.51±3.29pA/pF降为16.85±2.36pA/pF,抑制率为28.31%±10.6%(n=8,P0.05)。在-10mV测试电压下,100μmol/L丹酚酸B作用后ICa,L的最大激活峰值电流密度从-8.66±-2.40pA/pF降为-5.91±-2.14pA/pF,抑制率为31.84%±10.23%(n=11,P0.05)。丹酚酸B使Ito通道失活后的恢复减慢,但不改变ICa,L的通道动力学。丹酚酸B对IK1无显著作用。结论丹酚酸B对Ito和ICa,L具有阻滞作用,而对IK1无显著作用。     

地黄低聚糖对骨骼肌成肌细胞瞬时外向钾电流的影响

目的从细胞瞬时外向钾电流(Ito)角度,探讨地黄低聚糖(RGOs)对骨骼肌成肌细胞(SMs)电生理特性的影响。方法分离成年大鼠心肌细胞和SMs,运用膜片钳技术研究心肌细胞和SMs以及0.625g·L-1RGOs干预后,SMs与心肌细胞Ito的差异。结果两种细胞Ito均从-40mV时开始激活,RGOs对大鼠SMsIto有增加作用,从-30mV到30mV,经过0.625g·L-1RGOs预处理的SMs组Ito密度〔(7.3±0.7)to(65.3±2.3)pA/pF(n=5)〕显著高于心肌组〔(0.9±0.1)to(28.8±0.9)pA/pF(n=5)〕和SMs组〔(4.5±0.5)to(23.7±2.0)pA/pF(n=5)〕的电流密度。结论RGOs能显著提高SMs的Ito密度,影响移植的SMs的电生理特性。这为今后在提高干细胞移植有效性同时,增加其安全性提供了一个新的思路。     

兔界嵴细胞离子通道特性研究

目的研究生理状态下及异丙肾上腺素灌流对兔界嵴(CT)与梳状肌(PM)细胞动作电位(AP)及钠电流(INa)、短暂外向钾电流(Ito)、L型钙电流(ICa-L)、延迟整流钾电流(IK)及内向整流性钾电流(IK1)的影响,探讨CT与房性心律失常的关系。方法酶解法分离兔CT及PM细胞,利用全细胞膜片钳技术,记录生理状态下及异丙肾上腺素灌流后CT与PM细胞AP及INa、Ito、ICa-L、IK及IK1的变化。结果①生理状态下,CT细胞动作电位时程(APD)较长,可见明显的平台期;PM细胞AP形态与普通心房肌细胞相似,1期复极迅速,平台期短,类似三角形。②生理状态下,CT细胞Ito电流密度比PM细胞明显降低(7.13±0.38 pA/pF vs 10.70±0.62 pA/pF,n=9,P<0.01),而INa、Ito、ICa-L、IK及IK1则无明显差别。③异丙肾上腺素灌流时CT与PM细胞APD20、APD50、APD90均延长(n=8,P<0.01);指令电位+50 mV时,CT与PM细胞Ito电流密度均减少(n=9,P<0.01)而IK均增加(n=8,P<0.05);指令电位+10 mV时,CT与PM细胞ICa-L电流密度均增加(n=9,P<0.01);IK1在两种心肌细胞均无明显差异。结论 CT与PM细胞AP差异与Ito有关。异丙肾上腺素灌流时ICa-L与IK增强,Ito抑制使CT与PM细胞APD延长,触发机制可能是CT参与房性心律失常的机制之一。     

糖尿病对大鼠心肌细胞动作电位和瞬时外向钾电流的影响

目的探讨糖尿病对大鼠心室肌细胞动作电位(AP)和瞬时外向钾电流(Ito)的影响。方法通过链脲佐菌素诱导糖尿病大鼠模型,双酶法急性分离出对照组和糖尿病组心室肌细胞,全细胞膜片钳技术分别观察心肌细胞AP和Ito电流密度变化以及Ito动力学改变。结果与对照组比较,糖尿病组心肌细胞AP形态明显增宽,AP复极20%、50%和90%的时程均明显延长(64.3±7.5 ms vs 29.7±9.2 ms;174.3±6.8 ms vs 98.9±4.2 ms;276.7±8.3 ms vs 173.7±7.2 ms,P均<0.01,n=12);在钳制电位为+50mV时,与对照组比较,糖尿病组心肌细胞Ito的电流密度显著降低(11.51±1.37 pA/pF vs 17.43±1.98 pA/pF,P<0.05,n=12);与对照组比较,糖尿病组心肌细胞Ito的I-V曲线明显下移;失活曲线显著左移(P<0.01,n=12);失活恢复曲线明显减慢。结论糖尿病引起了心肌细胞AP时程延长,Ito幅度降低,并使Ito的失活加快以及失活后恢复减慢。     

急性心肌梗死后一周对心室肌细胞瞬间外向钾电流的影响

研究急性心肌梗死 (AMI)心室肌细胞瞬间外向钾电流 (Ito)的变化。采用结扎兔冠状动脉左前降支的方法建立AMI动物模型 ,应用膜片钳全细胞记录方法 ,研究AMI后 1周心外膜梗死区心肌细胞Ito的变化。结果 :正常对照组 (n =16 )心肌细胞在 - 30mV激活 ,心肌梗死 (简称心梗 )组细胞在 - 2 0mV激活 ,均呈线性电压依赖性。心梗组梗死区细胞 (n =12 )Ito的电流密度明显下降 ,I V曲线明显下移。心梗组Ito电流密度 (去极化电位 +6 0mV时 )明显低于对照组 (7.4 7± 2 .39vs 17.39± 5 .2 4pA/pF ,P <0 .0 1)。结论 :AMI可引起心室肌细胞Ito电流密度下降 ,导致梗死区细胞动作电位平台期相对延长 ,复极异常 ,造成心肌细胞之间动作电位及不应期离散度增大 ,容易形成折返 ,此可能是导致心肌梗死后出现折返性室性心律失常的原因。     

增强型绿色荧光蛋白转染小鼠心脏后瞬时外向钾电流及钠钙交换电流的变化

目的探讨绿色荧光蛋白(GFP)转染对心脏瞬时外向钾电流(Ito)及钠钙交换电流(INCX)的影响。方法20只雄性小鼠等量随机分为对照组和增强型GFP(EGFP)组。EGFP组小鼠采用8点注射法均匀注射100μl腺病毒于左室游离壁上,对照组注射等量无菌生理盐水。一周后分离单个心室肌细胞,用膜片钳记录Ito及INCX。结果与对照组相比,EGFP组几乎所有测定电压下,Ito电流密度显著减小[如+60 mV时为8.40±1.55 pA/pF(n=9)vs 36.77±8.12 pA/pF(n=11),P<0.05]。INCX的前向模式不因转染EGFP变化[如-80 mV时为-0.35±0.05 pA/pF(n=8)vs-0.42±0.08 pA/pF(n=10),P>0.05],但反向模式电流显著增大[如+80 mV时为1.47±0.10 pA/pF(n=8)vs 0.72±0.05 pA/pF(n=10),P<0.05]。结论 EGFP转染可使心脏Ito显著减小,而INCX仅反向模式电流增大,其综合效应可能导致细胞内钙增加。     

人参皂苷Rb1对大鼠心室肌细胞L型钙电流和瞬时外向钾电流的调控作用

目的 研究参松养心胶囊的药物单体-人参皂苷Rb1对大鼠心室肌细胞L型钙电流(Ica,L)和瞬时外向钾电流(Ito)的调控作用.方法 Langendroff灌流装置、胶原酶和蛋白酶混合急性分离大鼠心室肌细胞,用含40μmol/L的人参皂苷Rb1的细胞外液灌流心室肌细胞,每个细胞采用给药前后自身对照,标准的全细胞膜片钳技术记录Ica,L,Ito,所有数据均在细胞破膜后20min内完成,观察人参皂苷Rb1对Ica,L和Ito通道电流的影响.结果 40 μmol/L的人参皂苷Rb1对Ica,L和Ito均有抑制作用.在-10mV测试电压下,40 μmol/L的人参皂苷Rb1可使Ica,L的最大激活峰值电流密度从(- 11.423±-3.125)pA/pF下降至(-5.786±-2.976)pA/pF,抑制率为49.34％±9.78％(n=7,p＜0.05),电流密度-电压(I-V)曲线上移,但不改变激括电位、峰电位、反转电位以及曲线的形状;在+60mV测试电压下,40μ mol/L的人参皂苷Rb1 可使Itof的最大激活峰值电位从 35.342±3.126pA/pF下降至26.783±4.153pA/pF,抑制率为24.21％±8.35％ (n=8,p ＜0.05),I-V曲线下移.两通道电流经Boltemann方程拟合的稳态激活曲线给药前后无明显影响,但药物可使稳态失活增快以及失活后恢复减慢(n=7,p＜ 0.05),且人参皂苷Rb1主要抑制Ito的快速电流成分Itof(峰电位),对慢电流成分Itos(维持电位)无明显影响.结论 人参皂苷Rb1对Ica,L和Ito通道的电流有显著抑制作用,但不改变Ica,L的通道动力学.     

糖尿病大鼠心室肌细胞钾通道的改变

目的研究糖尿病大鼠心室肌细胞钾通道的改变及增加葡萄糖代谢对其的作用。方法取体重150～200g的雄性SpragueDawley大鼠,腹腔注射链脲菌素(STZ)建立糖尿病模型,采用酶解法获得单个心室肌细胞,应用膜片钳全细胞记录技术记录钾电流。结果糖尿病大鼠心室肌细胞瞬间外向性钾流(Ito)密度较对照组显著降低[ 60mV时,分别为(15.90±1.19)pA/pF(n=25)和(28.55±0.97)pA/pF(n=12),P<0.001];分别用100nmol/L胰岛素及1.5mmol/L二氯乙酸在体外预处理心室肌细胞4～5h和3～4h使Ito密度恢复至对照组水平[ 60mV时,分别为(29.40±0.38)pA/pF(n=20)和(27.35±0.97)pA/pF(n=12)]。结论糖尿病大鼠心室肌细胞钾通道功能发生改变,增加葡萄糖代谢可逆转这一改变,提示葡萄糖代谢与Ito功能间存在一定关系。     

肺动脉平滑肌细胞钾电流记录方法的建立

目的 在肺动脉平滑肌细胞(pulmonary arterial smooth muscle cells,PASMCs)上建立钙离子激活钾通道(calcium-activated potassium channel,KCa)电流、电压门控钾通道(voltage-gated potassium channel,Ky)电流和内向整流钾通道(Inward rectifier channel,Ku)电流的记录方法 .方法 用急性酶解的方法 分离出单个大鼠PASMC,利用全细胞膜片钳方法 记录钾电流.结果 ①急性酶解分离得到高质量的单个大鼠PASMC,呈梭形,边界清楚,胞浆均匀透亮.②Kv电流可以被5 mmol/L4-AP明显抑制,使电流-电压关系曲线明显下移,在55 mV时,Kv电流密度从(133.86±7.36)pA/pF减少到(59.09±3.35)pA/pF(n=6,P<0.05).③1 mmol/L TEA对KCa电流有明显抑制作用,使电流-电压关系曲线明显下移,在55 mV时,KCa电流密度从(9.03±1.42)pA/pF减少到(2.12±0.52)pA/pF(n=7,P<0.05).④KATP电流可以被10 μmol/L尼可地尔激活,使电流-电压关系曲线明显上移,在50 mV时,Kv电流密度从(29.08±5.90)pA/pF增加到(88.90±7.98)pA/pF(n=10,P<0.05).结论 在肺动脉平滑肌细胞上成功地建立了KCa、Kv和Kir电流的记录方法 ,可以为肺动脉相关疾病的发病机制和治疗方案的探索,提供有效的细胞模型基础.     

C-JNK信号通路对糖尿病大鼠心肌Ito钾通道重构的影响

目的研究c-JNK信号通路在糖尿病(DM)大鼠左室心肌细胞电压门控钾通道(Kv)重构中的作用和内在调控机制。方法将50只健康SD大鼠随机分为DM组[n=25,采用链尿佐菌素(STZ)诱导成模]和对照组(sham)(n=25)。应用全细胞膜片钳方法记录DM组与sham组大鼠心室肌瞬时外向钾电流(Ito);使用非放射性JNK激酶分析kit进行c-Jun活性测定。应用JNK抑制剂SP600125(10M)对DM大鼠心肌细胞进行体外孵育,观察孵育前后心肌细胞Ito的变化。用硫氧还蛋白还原酶(TrxR)抑制剂金诺芬(AF)对经JNK抑制剂SP600125孵育的大鼠心肌细胞进行处理,观察处理前后心肌细胞Ito的变化。应用抗Kv4.2抗体对Kv4.2的含量进行检测,检测结果使用UVP生物成像系统进行分析。结果DM组心肌JNK活性显著升高超过1倍,而Ito显著降低[Sham组:(31.2±3.4)pA/pF,n=16;DM组:(15.4±3.1)pA/pF,n=17;P<0.05]。DM大鼠心室肌细胞经JNK抑制剂SP600125(10 M)处理4 h后,Ito电流密度可恢复至Sham组水平[DM+SP600125组:(31.9±3.8)pA/pF,n=18;Sham组:(31.2±3.4)pA/pF,n=16;P<0.05];且sham组经SP600125处理后的最大Ito电流强度[(29.8±3.4)pA/pF,n=9]和未经处理的sham组无统计学差异。DM心肌经膜渗透性蛋白抑制剂JNKI-1(10 M)处理后,Ito密度也有显著增加,而sham组经相同处理后无改变。TrxR抑制剂AF显著抑制了SP600125对DM大鼠心肌Ito电流的增大作用[DM+AF+SP600125:(15.5±3.2)pA/pF,n=17],而AF对sham组Ito无明显影响。JNK抑制剂SP600125治疗后DM大鼠心肌的Kv4.2蛋白表达量显著增大,尽管未完全恢复到sham组心肌水平,但与先前在DM大鼠心肌所观察到的Ito电流改变一致。而JNK抑制并没有明显改变sham组心肌的Kv4.2蛋白表达量。结论DM大鼠心肌钾通道重构是氧化还原敏感的,可能通过持续性激活c-JNK信号通路促进Ito重构。在DM心肌中,JNK活性显著增高,Kv通道的电流密度降低;抑制JNK信号通路后可显著改善Kv通道重构,这一过程可能被硫氧还原蛋白系统所调控。     

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.