骨形态发生蛋白4 mRNA在低氧大鼠肺血管中的表达

目的观察骨形态发生蛋白4（BMP4）mRNA在低氧性肺动脉高压大鼠肺血管中的表达及其与低氧性肺动脉高压形成的关系。方法将20只雄性SD大鼠随机分为对照组和低氧组,常压低氧3周建立大鼠肺动脉高压模型,以导管法测定平均肺动脉压（mPAP）,分离并分别称量大鼠右心室（RV）和左心室加室间隔（LV＋S）,计算出右心室肥厚指数RV/（LV＋S）。采用图像分析法测定和计算出肺小动脉管壁厚度指标即管壁厚度占外径的百分比（WT%）和管壁面积占总面积的百分比（WA%）,并采用原位杂交方法检测大鼠肺小动脉管壁BMP4 mRNA的表达水平。结果①对照组mPAP为（16.47±1.11）mm Hg,低氧组大鼠为（29.01±0.86）mm Hg,较对照组明显升高（P〈0.01）。低氧组RV/（LV＋S）为（31.13±2.57）%,对照组仅为（23.12±1.38）%（P〈0.01）。②对照组肺小动脉厚度指标为[WT%：（12.63±0.92）%;WA%：（45.24±1.98）%],而低氧组则明显升高,分别为[WT%：（26.06±1.86）%;WA%：（76.07±5.44）%]（P均〈0.01）。③对照组和低氧组大鼠肺小动脉BMP4 mRNA的染色强度分别为（0.16±0.01）、（0.27±0.03）,低氧组BMP4 mRNA表达明显增加（P〈0.01）。结论低氧大鼠肺血管BMP4 mRNA表达明显增加,BMP4可能在低氧性肺动脉高压的形成中具有重要作用。     

二氯醋酸钠对大鼠低氧肺动脉高压的预防作用

目的研究二氯醋酸钠（DCA）对大鼠在高原环境下形成高原低氧性肺动脉高压的预防作用,以及对高原低氧大鼠肺动脉平滑肌细胞（PASMCs）上电压门控性钾通道亚型Kv2.1基因表达的影响和抑制肺动脉重构的作用方法24只雄性SD大鼠随机平均分为正常对照组（N组）、高原组（HA组）及DCA干预组（DCA＋HA组）。N组置于平原处室内喂养,HA组和DCA＋HA组均同时置于模拟的海拔5000 m高原环境,DCA＋HA组大鼠以DCA按70 mg/（k.gd）灌胃。21 d后测量3组大鼠平均肺动脉压（mPAP）,图像分析技术分析肺动脉（50~150μm）形态改变,用实时荧光定量PCR法检测3组大鼠PASMCs Kv2.1 mRNA,免疫组织化学法观察大鼠PASMCsKv2.1蛋白的表达。结果 HA组大鼠mPAP明显高于N组（P〈0.01）,其肺动脉管壁增厚,管腔狭窄,表现为管壁厚度占外径的百分比（WT%）和管壁面积占总面积的百分比（WA%）明显升高（P〈0.01）,HA组大鼠右心室肥厚指数（右心室/左心室＋室间隔,RV/LV＋S）较N组明显升高（P〈0.01）,而DCA＋HA组mPAP则明显比HA组低（P〈0.01）,并表现血管重构减弱,WT%和WA%明显低于HA组（P〈0.01）,RV/LV＋S下降（P〈0.01）。HA组Kv2.1 mRNA明显低于N组（P〈0.01）,DCA＋HA组Kv2.1 mRNA则明显恢复表达（P〈0.01）。HA组肺动脉壁Kv2.1平均光密度低于N组（P〈0.01）,DCA＋HA组则明显高于HA组（P〈0.01）,蛋白表达呈现相似结果。结论 DCA对于大鼠在高原条件下形成的肺动脉高压具有预防作用,同时能够上调大鼠PASMCs上Kv2.1表达,阻止肺动脉和右心室重构的作用。     

低氧大鼠肺内硝基酪氨酸的变化研究

目的 观察在低氧大鼠肺组织中氧化产物硝基酪氨酸(nitrotryrosine,NT)表达的变化,探讨氧化应激机制在低氧性肺动脉高压形成中的作用.方法 将14只雄性Wistar大鼠随机分为对照组、低氧组.以常压低氧3周制备肺动脉高压模型,测量各组大鼠平均肺动脉压(mean pulmonary arterial pressure,mPAP)和右心肥厚指数(right ventricle hypertrophy index,RVHI);图像技术测定管壁厚度占血管外径的百分比(wall thickness %,WT %)和管壁面积占总面积的百分比(wall area%,WA%);采用免疫组织化学法观察两组大鼠肺小动脉管壁NT的表达.结果 ①低氧组大鼠mPAP(22.84±1.79)mm Hg和RVHI(29.78±1.07)%与对照组mPAP(16.67±0.97)mm Hg和RVHI(24.22±0.48)%相比,差异有统计学意义(P均＜0.01).②低氧组WT%(24.96±3.70)%和WA%(73.31 ±6.51)%与对照组WT%(14.19±2.61)%和WA%(46.67±7.42)%相比,差异有统计学意义(P均＜0.01).③低氧组大鼠近端肺小动脉管壁的NT染色强度(1.52±0.07)与对照组(1.00±0.00)相比,差异有统计学意义(P＜0.01).两组大鼠远端肺小动脉管壁NT染色强度无明显变化(P＞0.05).低氧组大鼠近端肺小动脉管壁NT表达强度与mPAP值呈正相关(r=0.867,P＜0.05).结论 低氧可诱导大鼠mPAP增高及肺组织内NT产生增加,其作用机制可能与低氧诱导氧化应激有关.     

葛根素对低氧性肺动脉高压大鼠肺动脉压力及结构的影响

目的观察大鼠在低氧状态下出现的肺动脉高压和肺小动脉结构的重构，以及葛根素对这两个病理变化的干预效应。方法雄性SD大鼠24只，随机分为对照组、低氧组和葛根素干预组。低氧组和葛根素干预组在常压低氧舱内建立肺动脉高压模型，葛根素干预组大鼠每天腹腔注射葛根素500mg／kg，测定各组平均肺动脉压，并取大鼠左肺沿肺门横断取材，石蜡包埋切片，进行苏木素伊红（HE）染色，观察肺小动脉形态学变化。结果①对照组和葛根素干预组大鼠平均肺动脉压均明显低于低氧组[（15．01±1．47）mmHg、（20．43±2．86）mmHg、（29．74±2．32）mmHg，P〈0．01]。②对照组大鼠肺小血管管壁较薄、管腔较大，低氧组大鼠肺小动脉普遍增厚，管腔狭窄，葛根素干预组的肺小动脉管壁及血管管腔狭窄程度较低氧组显著减轻。结论慢性缺氧可导致肺动脉壁增厚、管腔狭窄等血管重构病理改变；葛根素能在一定程度上抑制低氧肺动脉高压的形成和发展及肺血管结构的重构。     

槲皮素对野百合碱诱导的大鼠肺动脉高压的影响

目的:观察槲皮素对野百合碱(MCT)诱导的肺动脉高压大鼠的治疗效果。方法:30只成年雄性SD大鼠随机分成3组:MCT诱导的肺动脉高压组(MCT组)、治疗组和对照组。MCT组和治疗组一次性皮下注射MCT 50mg/kg,饲养21d;对照组一次性皮下注射等量0.9%氯化钠溶液,饲养21d。造模后治疗组以槲皮素100mg.kg-1.d-1灌胃20d;MCT组和对照组以0.9%氯化钠溶液2ml/d灌胃20d。20d后,测定3组大鼠平均肺动脉压(mPAP),计算右心室肥大指数(RVHI);光镜下观察大鼠肺组织形态学的改变及肺血管增殖细胞核抗原(PCNA)增殖度的变化,并计算肺中、小动脉管壁厚度占血管外径的百分比(WT%)和肺动脉管壁面积/管总面积的百分比(WA%)。结果:MCT组的mPAP、RVHI、肺中、小动脉WT%、WA%及PCNA增殖度均显著高于对照组及治疗组。结论:槲皮素可降低MCT所致的大鼠肺血管PCNA表达,抑制MCT诱导的肺部炎症、肺血管重建和肺动脉高压形成,对MCT所致的大鼠肺动脉高压具有治疗作用。     

吡那地尔防治大鼠低氧性肺动脉高压肺血管重建的实验研究

目的研究钾通道开放剂吡那地尔对低氧性肺动脉高压（ＨＰＨ）及其肺血管重建的影响。方法Ｗｉｓｔｅｒ大鼠４６只,随机分为３组：对照组１５只;低氧组１６只;治疗组（低氧＋吡那地尔）１５只。低氧组及治疗组建立低氧性肺动脉高压动物模型,治疗组于每天缺氧前腹腔注射吡那地尔３ｍｇ／ｋｇ。 ４周后测定各组平均肺动脉压（ｍＰＡＰ）、右心室（ＲＶ）／左心室＋室间隔（ＬＶ＋ Ｓ）比值和肺小动脉病理及其形态计量学。结果（１）低氧组ｍＰＡＰ、ＲＶ／（ＬＶ＋Ｓ）分别为（２８．４ ± ２．８）ｍｍＨｇ和（０．３０±０．０３）,明显高于对照组（１６．２±１．８）ｍｍ Ｈｇ和（０．２２±０．０３）（Ｐ＜０．０１）,管壁厚度与血管外径比值（ＭＴ％）、管壁面积与血管总面积比值（ＭＡ％）分别为（２５．７±２．６）％和（７５．３±５．６）％,亦明显高于对照组（１８．５±２．９）％和（５９．９±６．６）％（Ｐ＜０．０１）,管腔面积与血管总面积比值（ＶＡ％）为（２４．３±５．６）％,明显低于对照组（４０．７±８．１）％（Ｐ＜０．０１）。提示慢性缺氧导致大鼠发生明显肺动脉高压及右心室肥厚和肺小动脉管壁增厚、管腔狭窄等肺血管重建等改变。（２）治疗组ｍＰＡＰ、ＲＶ／     

骨形成蛋白在低氧性肺动脉高压发病中的作用

目的观察低氧性肺动脉高压大鼠肺组织中骨形成蛋白2（BMP-2）的变化及BMP在低氧诱导内皮细胞凋亡中的作用，探讨BMP在低氧性肺动脉高压发病中的作用。方法将20只雄性Wistar大鼠随机分为2组，低氧组经常压低氧处理3周，建立大鼠低氧性肺动脉高压模型，采用免疫组织化学染色法观察大鼠肺组织中BMP-2的表达。用图像分析技术检测大鼠肺小动脉形态改变及BMP-2表达强度的变化。建立人脐静脉内皮细胞（HUVEC）低氧培养模型，加入BMP阻断剂Noggin，用流式细胞仪检测细胞凋亡率。结果低氧3周后，大鼠平均肺动脉压（mPAP）为（29．5±0．9）mmHg（1mmHg=0．133kPa），与对照组的（16．3±0．5）mmHg比较明显增加；低氧大鼠肺小动脉管壁增厚、管腔狭窄，表现为管壁厚度占外径的百分比（WT％）和管壁面积占血管总面积的百分比（WA％）明显升高，分别为（27±7）％和（80±8）％，对照组分别为（16±5）％和（54±11）％，两组相比差异有统计学意义（P〈0．01）；低氧组肺小动脉壁BMP-2积分吸光度值（M）为13463±5755，对照组为6124±1199，两组相比差异有统计学意义（P〈0．01），且与WT％和WA％呈明显正相关（r值分别为0．744和0．693，P〈0．01）。低氧诱导内皮细胞凋亡增加，低氧24h时的细胞凋亡率为（14．23±1．01）％，48h时为（25．21±8．58）％；低氧前预先加入Noggin，低氧24h时细胞凋亡率为（11．91±0．57）％，48h时为（15．01±0．15）％，差异有统计学意义（P〈0．01）。结论慢性低氧时BMP-2表达增多；低氧诱导内皮细胞凋亡，BMP阻断剂可抑制低氧诱导的内皮细胞凋亡；BMP在低氧性肺动脉高压发病过程中起一定的作用。     

灯盏花素对低氧大鼠肺动脉压和肺小动脉Rho激酶的影响

目的 观察灯盏花素对低氧大鼠肺动脉压、肺小动脉Rho激酶ROCK Ⅰ和ROCK Ⅱ及Rho激酶mRNA的影响,探讨灯盏花素预防低氧性肺动脉高压的作用和机制.方法 将18只健康雄性SD大鼠分为健康组、低氧组和灯盏花素预防组.以常压低氧法复制肺动脉高压模型,以微导管法测定平均肺动脉压(mPAP).分离大鼠心脏,测量右心室(RV)及左心室加室间隔(LV+S)的重量,以RV/(LV+S)代表右心肥厚指数.应用图像分析技术测定肺小动脉管壁厚度占外径的百分比和管壁面积占总面积的百分比,反映肺血管重塑情况.应用免疫组化法测定肺小动脉Rho激酶蛋白的表达,原位杂交法测定肺小动脉Rho激酶mRNA的表达.结果 低氧组大鼠mPAP为(27.3±5.0)mm Hg(1 mm Hg=0.133 kPa),明显高于健康组的(16.0±0.6)mm Hg(t=6.74,P<0.05),灯盏花素预防组mPAP为(19.83±1.47)mm Hg,明显低于低氧组(t=4.28,P<0.05);低氧组RV/(LV+S)及肺小动脉厚度指数明显高于健康组(t=3.43,P<0.05),灯盏花素预防组低于低氧组(t=2.39,P<0.05);低氧组ROCK Ⅰ和ROCK Ⅱ免疫组织化学阳性染色(1.29±0.08和1.63±0.24)明显高于健康组(1.17±0.09和1.30±0.16),灯盏花素预防组(1.18±0.10和1.30±0.12)明显低于低氧组(t值分别为3.96,5.85,3.90,5.82,均P<0.05);低氧组ROCK Ⅰ mRNA和ROCK Ⅱ mRNA原位杂交阳性染色(分别为1.37±0.13和1.59±0.31)明显高于健康组(1.22±0.09和1.2±10.15),灯盏花素预防组(1.23±0.13和1.22±0.06)明显低于低氧组(t值分别为4.00,6.02,3.94,5.83,均P<0.05).结论 灯盏花素具有明显预防低氧性肺动脉高压和降低Rho激酶及Rho激酶mRNA的作用.     

硫化氢对低氧性肺动脉高压大鼠细胞因子的调节作用

目的探讨硫化氢对低氧性肺动脉高压大鼠细胞因子的调节作用。方法将Wistar大鼠22只随机分为3组。对照组(8只),低氧组(7只),低氧+硫氢化钠(NaHS)组(7只),测定3组大鼠肺动脉平均压(mPAP),观测肺血管结构变化,并用免疫组织化学方法研究α-平滑肌肌动蛋白(-αSM-actin)、弹力蛋白、转化生长因子β(TGF-β)和结缔组织生长因子(CTGF)在肺动脉平滑肌细胞的表达含量。结果低氧组的mPAP明显高于对照组和低氧+NaHS组;低氧组肌型动脉、部分肌型动脉百分比明显高于对照组和低氧+NaHS组,非肌型动脉百分比明显低于对照组和低氧+NaHS组;低氧组肺中、小型肺动脉平滑肌细胞-αSM-actin、弹力蛋白和TGF-β表达含量分别明显高于对照组和低氧+NaHS组;对照组、低氧+NaHS组以及低氧组肺中、小型肺动脉平滑肌细胞CTGF表达含量依次增高,但3组之间无显著差异。结论硫化氢可能通过调节低氧性肺动脉高压大鼠肺小血管肌性动脉TGF-β的表达,进而抑制细胞外基质成分之一的弹力蛋白合成,参与低氧性肺动脉高压的形成。     

大鼠慢性栓塞性肺动脉高压模型的建立和肺血管重构的研究

目的探讨妥善建立大鼠栓塞性肺动脉高压模型的方法,研究肺血管重构和右心室的改变。方法雄性Wistar大鼠141只,随机分为12组,采血加入凝血酶200 U/ml,体外制备栓子,经颈静脉注入栓子,制备肺栓塞模型,2周后同法进行二次栓塞,全程腹腔注射纤溶抑制剂氨甲环酸,达目标时间后用右心导管法测平均肺动脉压（mPAP）;开胸取肺组织,HE染色及弹力纤维染色,观察肺组织和肺血管结构的变化;用病理图像分析软件测定肺动脉相对中膜厚度（PAMT）和管壁面积/管总面积（WA/TA）;取心脏组织测定右心室游离壁（RV）和左心室加室间隔（LV＋S）的重量比即右心室肥大指数（RVHI）。结果①动物模型成功率85.1%（120/141）;②4周组至12周组肺动脉压明显升高（P均〈0.01）,8周后RVHI较对照组明显增高（8周组P〈0.05;12周组P〈0.01）;③8周和12周组肺小动脉结构出现明显变化：中膜平滑肌细胞明显增生,PAMT和WA/TA值明显增大（P均〈0.01）,管壁增厚,管腔狭窄,肺动脉有显著重构;④mPAP、RVHI与PAMT有明显相关性（r分别为0.681和0.690,P均〈0.01）;mPAP、RVHI与WA/TA有明显相关性（r分别为0.677和0.794,P均〈0.01）。结论用二次栓塞并应用氨甲环酸抑制纤溶,成功制备了大鼠栓塞性肺动脉高压模型;模型组大鼠出现明显肺动脉重构,继之出现右心室重构;栓塞时间越长肺动脉高压越明显;肺动脉重构与肺动脉高压之间有显著相关关系。     

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.     

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.