还原型谷胱甘肽合抗震止痉胶囊对帕金森病细胞保护作用的实验研究

目的 :观察还原型谷胱甘肽 (GSH)合抗震止痉胶囊对帕金森病 (PD )大鼠模型的异常行为、黑质抗氧化系统、线粒体呼吸链功能的影响 ,并探讨其作用机制。方法 :应用 6-羟基多巴胺立体定向注射制作PD大鼠模型。将 2 4只大鼠随机分为 3组 :模型组、GSH合抗震止痉胶囊组、假手术组 ,每组 8只 ,分别给予相应处理 ,共45d ,给药前后均进行行为学测试 ,并测定各组大鼠黑质区GSH -Px、MDA、活性氧及线粒体呼吸链酶复合体Ⅰ水平。结果 :①GSH合抗震止痉胶囊可明显改善大鼠旋转行为(P <0 .0 5 ) ;②GSH合抗震止痉胶囊能减轻黑质区氧化应激损伤 ;③GSH合抗震止痉胶囊能增强黑质呼吸链酶复合体Ⅰ活性。结论 :GSH合抗震止痉胶囊能部分改善大鼠旋转行为 ,减轻PD模型大鼠黑质区氧化应激损伤 ,并对线粒体呼吸链具有一定保护作用。     

6-羟基多巴胺所致帕金森病大鼠模型稳定性的研究

目的 探讨立体定向注射6-羟基多巴(6-OHDA)建立帕金森病(PD)大鼠模型的方法及其稳定性.方法 利用脑立体定向技术将6-OHDA 注入大鼠右侧黑质致密部(SNc)及中脑腹侧被盖(VTA),经阿朴吗啡(APO)诱导表现为恒定左侧旋转且旋转圈数大于210 r/30 min,视为成功PD大鼠模型.免疫组化方法观察黑质、纹状体区酪氨酸羟化酶(TH)阳性神经元的形态及数量变化,以及高效液相法检测黑质纹状体多巴胺(DA)含量的变化.结果 ①旋转实验检测:80只大鼠中32只旋转圈数大于210 r/30 min,成功率为40%,并且至少可以维持12 w.②免疫组化结果:大鼠模型毁损侧黑质区和纹状体区TH阳性的神经元较对侧及对照组减少(P＜0.01).③高效液相法检测结果:4和12 w模型鼠右侧黑质纹状体中DA 含量均较对照组减少(P＜0.05).结论 6-OHDA 毁损法可有效建立模拟人类PD中晚期的大鼠模型,并且至少可以维持12 w,为研究PD治疗提供稳定的模型.     

单点注射6-羟基多巴胺成功建立帕金森病大鼠模型的实验研究

目的探讨成功建立帕金森病(Parkinson’s disease,PD)大鼠模型的快速有效方法。方法将Wistar大鼠92只,随机分为实验组(80只)及对照组(12只),采用脑立体定向术,实验组在大鼠右侧中脑腹侧被盖区(ventral tegmental area,VTA)注入6-OHDA,经阿朴吗啡(Apomorphine,APO)诱导表现为恒定左侧旋转且旋转圈数210 r/30 min的视为成功PD大鼠模型,对照组则在脑部相应位置注入生理盐水。免疫组化法观察成功模型毁损侧黑质酪氨酸羟化酶(TH)阳性神经元的形态及数量变化。结果 (1)行为学检测:模型组与对照组手术后分别死亡2只及1只,实验组78只大鼠中36只左侧恒定旋转圈数210 r/30 min,造模成功率为46.2%,并且维持时间长。(2)免疫组化:成功大鼠模型毁损侧黑质区TH阳性的神经元较对侧及对照组明显减少(P0.01)。结论大鼠中脑VTA单点注射6-OHDA制作PD大鼠模型,易于定位,操作简单,动物死亡率低,模型成功率较高,成本较低,是较快建立稳定PD大鼠模型的可行方法。     

补肾止颤方联合埋针疗法对帕金森病模型大鼠Bcl-2及Bax表达的影响

目的观察补肾止颤方联合埋针疗法对帕金森病(PD)模型大鼠中脑黑质区Bcl-2及Bax蛋白的影响,探讨补肾止颤方联合埋针疗法对PD大鼠神经元细胞凋亡的保护作用。方法采用蛋白酶抑制因子(PSI)皮下注射法制作慢性PD大鼠模型,HE染色观察各组大鼠中脑黑质区病理形态学改变,免疫组织化学方法检测Bcl-2及Bax蛋白在中脑黑质区表达的变化。结果 PD模型组大鼠Bcl-2及Bax表达均较假手术组明显增高,中脑黑质区病理改变严重;补肾止颤方联合埋针疗法治疗后的PD大鼠Bcl-2表达明显增高,Bax表达明显降低,中脑黑质区病理变化明显改善。结论补肾止颤方联合埋针疗法能明显提高PD模型大鼠中脑黑质区Bcl-2蛋白的表达及抑制Bax蛋白激活,从而抑制黑质细胞凋亡以发挥脑保护作用。     

补肾止颤方联合埋针对帕金森病大鼠TH、GFAP表达的影响

目的观察补肾止颤方联合埋针对帕金森病(PD)大鼠中脑黑质区酪氨酸羟化酶(TH)、胶质纤维酸性蛋白(GFAP)的影响,探讨补肾止颤方联合埋针对PD大鼠神经元细胞的保护作用。方法采用蛋白酶抑制因子(PSI)皮下注射法制作慢性PD大鼠模型,免疫组织化学方法及蛋白印迹法检测各组大鼠中脑黑质区TH、GFAP表达的变化。结果经补肾止颤方联合埋针治疗后的PD大鼠TH蛋白表达明显增加,TH阳性细胞明显增多,GFAP表达明显降低,GFAP阳性细胞明显减少,与模型组相比较有统计学意义(P0.05);而针药结合组与多巴丝肼组相比较,亦有统计学意义(P0.05)。结论补肾止颤方联合埋针可显著增加PD大鼠中脑黑质区TH阳性细胞表达,并有效减少GFAP阳性细胞表达,保护大鼠神经元细胞,增加脑内多巴胺(DA)含量,促进PD大鼠运动功能的恢复。     

粉防己碱对还原型谷胱甘肽脑保护作用的影响研究

目的观察还原型谷胱甘肽（GSH）合用粉防己碱对帕金森病大鼠的脑保护作用并分析机制。方法应用定向注射6一羟基多巴胺的方法制作PD大鼠模型，将模型分五组给予不同药物50天，另设正常对照组，给药前后观察大鼠的旋转行为，给药结束后测定黑质谷胱甘肽、纹状体丙二醛、活性氧水平。结果（1）GSH合用粉防己碱能显著改善PD大鼠的旋转行为。（2）GSH合用粉防己碱能减轻PD大鼠的氧化应激损伤。（3）GSH合用粉防己碱能显著减轻左旋多巴的副作用。结论粉防己碱能增加GSH的神经保护作用。     

补肾止颤方联合埋针对帕金森病大鼠行为学及黑质区自由基清除的影响

目的观察补肾止颤方联合埋针对帕金森病(PD)大鼠行为学、中脑黑质区自由基清除的影响。方法将40只SD雄性大鼠随机分为假手术组(10只)和造模组(30只),造模组采用蛋白酶抑制因子皮下注射法制作PD模型后,随机分为模型组、多巴丝肼组、针药结合组,各10只。模型组、假手术组均予生理盐水1mL/(100g·d)灌胃;多巴丝肼组予多巴丝肼200mg/(kg·d)灌胃;针药结合组予补肾止颤方1mL/(100g·d)灌胃,并结合埋针。各组均予隔天(每周一、周三、周五)治疗,治疗3周后观察大鼠行为学及中脑黑质区谷胱甘肽(GSH)、过氧化脂质(LPO)含量及谷胱甘肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)活性的变化。结果与假手术组比较,模型组GSH含量和GSH-Px、SOD活性均明显降低(P <0.01);LPO含量显著升高(P <0.01);且模型组大鼠的网格试验和平衡杆试验移动潜伏期及过杆时间均显著延长(P <0.01)。与模型组比较,多巴丝肼组和针药结合组GSH含量和GSH-Px、SOD活性均明显升高(P <0.01),针药结合组GSH含量和GSH-Px、SOD活性均高于多巴丝肼组(P <0.05);多巴丝肼组和针药结合组LPO含量均明显降低(P <0.01),针药结合组LPO含量低于多巴丝肼组(P <0.05);多巴丝肼组和针药结合组的网格试验及平衡杆试验移动潜伏期和过杆时间均明显缩短(P <0.01),针药结合组网格试验及平衡杆试验移动潜伏期及过杆时间均较多巴丝肼组显著缩短(P <0.05)。结论补肾止颤方联合埋针能使PD大鼠的行为学明显改善;并能显著增强中脑黑质区自由基清除能力,从而保护黑质区多巴胺能神经元细胞。     

绿茶多酚对帕金森病大鼠黑质多巴胺能神经元的保护作用及机制

目的探讨绿茶多酚对偏侧帕金森病（PD）大鼠黑质多巴胺能神经元的保护作用及机制,为其临床应用提供依据。方法将SD大鼠随机分为对照组、6-羟多巴胺（6-OHDA）组和绿茶多酚组各12只,后两组于纹状体内立体定向注射6-OHDA制作PD模型,绿茶多酚组在造模前5d予绿茶多酚（400mg／kg）灌胃,共2周。造模4周后免疫组化法观察黑质多巴胺能神经元数量,比色法观察中脑氧化应激水平。结果绿茶多酚组、6-OHDA组损毁侧黑质致密部多巴胺能神经元数量显著减少,但绿茶多酚组显著高于6-OHDA组（P〈0．01）;6-OHDA组损毁侧氧化应激水平明显高于绿茶多酚组（P〈0．01）。结论绿茶多酚对偏侧PD大鼠模型的多巴胺神经元损伤有明显保护作用,其机制可能为抑制氧化应激反应。     

一氧化氮合酶抑制剂对帕金森病模型大鼠神经损伤的影响

目的　探讨一氧化氮合酶 (NOS)抑制剂对帕金森病 (PD)模型大鼠所起的作用 ,旨在为帕金森病的发病机制及治疗提供有价值的理论依据。　方法　应用立体定向技术建立大鼠PD模型 ,并给予NOS抑制剂L 硝基 精氨酸 (L NNA) ,通过测试大鼠旋转行为 ,免疫组织化学方法观察大鼠黑质酪氨酸羟化酶 (TH)阳性神经元和纹状体神经元型一氧化氮合酶 (nNOS)阳性神经元的变化。　结果　 (1)L NNA明显减少大鼠旋转行为 ;(2 )L NNA使黑质损毁侧TH阳性神经元〔(5 9 9±9 0 )个〕较对照组明显增多〔(2 4 0± 6 8)个〕 ,差异有显著性 ;(3)双侧纹状体nNOS阳性神经元数目差异无显著性。　结论　NO可能介导 6 羟基多巴胺 (6 OHDA)的多巴胺能神经元神经毒性作用 ,nNOS阳性神经元可能对其具有抵抗作用 ,NOS抑制剂对多巴胺能神经元可能有保护作用。     

电针对鱼藤酮诱导的帕金森病模型大鼠黑质GDNF mRNA表达的影响

目的 探讨电针对鱼藤酮诱导的帕金森病(PD)模型大鼠黑质GDNF mRNA表达的影响及作用机制.方法 40只大鼠按照随机分组的原则分为空白组、假手术组、模型组、电针组,每组10只.持续4w给模型组和电针组大鼠颈背部皮下注射鱼藤酮(2mg·kg-1·d-1)以诱导其黑质多巴胺能神经元丢失,电针组选取“风府”、“太冲”两穴,频率20 Hz,电压2～4V,连续波,每日1次,每次20 min,7d为1疗程,连续治疗3个疗程;其余各组不行针刺.采用半定量RT-PCR方法检测,观察黑质GDNF mRNA表达变化.结果 长期低剂量颈背部皮下注射鱼藤酮可诱导大鼠出现行为学的改变;模型组大鼠黑质GDNF mRNA表达减少,与空白组、假手术组比较有显著差异(P＜0.01);电针组大鼠黑质GDNF mRNA表达增加,与模型组比较有显著差异(P＜0.01).结论 电针治疗不仅可以减轻鱼藤酮引起的大鼠行为学异常,而且可以促进PD模型大鼠黑质GDNF mRNA的表达,修复营养DA能神经元,延缓PD的发病进程.     

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.