幽门螺杆菌对人胃癌细胞株AGS侵袭力的影响

背景：幽门螺杆菌（H．pylori）为人类胃癌的Ⅰ类致癌原,但其在胃癌演进中的作用仍未完全阐明。目的：体外观察Hpylori对人胃癌细胞株AGS侵袭力的影响。方法：将AGS细胞与H．pylori标准菌株NCTC11637共培养72h．光学显微镜观察12—72h时细胞形态变化,扫描电镜观察24h时细胞形态变化。侵袭小室实验检测共培养24h后AGS细胞的侵袭力。结果：AGS细胞与H．pylori共培养12h后,细胞渐出现变形,伪足增多、伸长．24h和48h时细胞间相互离散,伸出细长伪足,呈“蜂鸟”表型,60h和72h时细胞出现空泡样变,死亡逐渐增多;扫描电镜下可见Hpylori黏附于AGS细胞表面,细胞变形明显,伸出细长伪足。侵袭小室实验显示与H．pylori共培养24h的AGS细胞,每200倍视野下穿膜细胞数显著高于PBS对照组（130．4±11．5对87．1±9．3．P〈0．01）。结论：Mpylori感染可影响人胃癌细胞株AGS的细胞形态,增加细胞侵袭力。     

幽门螺杆菌诱导胃黏膜细胞AGS产生IFN-γ的研究

目的用幽门螺杆菌诱导胃黏膜细胞AGS产生IFN-γ,探讨胃黏膜细产生IFN-γ的机制。方法用幽门螺杆菌感染胃黏膜细胞株AGS,用RT-PCR测定细胞表达IFN-γ的RNA,用ELISA法测定细胞产生的IFN-γ蛋白;用幽门螺杆菌的主要毒力CagA阳性质粒转染细胞,ELISA测定细胞产生的IFN-γ;CagA阳性质粒转染细胞后加入MeK/ErK、Src、P38和NF-kB的抑制剂,用ELISA测定细胞产生IFN-γ的变化。结果 AGS细胞感染幽门螺杆菌后可检测到IFN-γRNA和蛋白的表达,CagA阳性质粒转染细胞后引起IFN-γ蛋白的表达,MeK/ErK、P38和NF-kB引起IFN-γ表达量下降。结论幽门螺杆菌感染胃黏膜细胞AGS诱导产生IFN-γ,幽门螺杆菌的主要毒力CagA可诱导IFN-γ的产生,CagA诱导IFN-γ的产生依赖于MeK/ErK、P38和NF-kB三者参与的信号途径。     

幽门螺杆菌对AGS细胞蛋白激酶C同工酶表达的影响

目的研究PKC同工酶在H.pylori感染引起胃癌发生中起作用。方法将幽门螺杆菌和人胃上皮腺癌细胞系AGS细胞共培养（细菌∶细胞=200∶1）,在幽门螺杆菌攻击AGS细胞后的0h、0.5h、1h、4h、6h、12h、24h时间点分别提取AGS细胞的总RNA,同时提取相对应时间点平行培养的未受幽门螺杆菌攻击的AGS细胞的总RNA作为对照组,以Beta-actin为内参照,应用Taq-Man实时荧光定量RT-PCR技术研究这些样品的PKC同工酶的mRNA变化情况。结果与对照组相比,PKCε、PKCγ、PKCι、PKCζ、PKCα mRNA水平呈现增高趋势;PKCθ mRNA水平呈现持续下降趋势;PKCδ mRNA水平与对照组呈现一致表达趋势。结论H.pylori可能通过上调具有肿瘤增殖活性的PKCα、ε、γ、ι、ζ,下调了具有凋亡活性的PKCθ,参与H.pylori引起胃癌的发生过程。H.pylori对PKCδ mRNA水平没有影响。     

幽门螺杆菌CagA C-端功能域特征及其生物学功能研究

目的　克隆源自临床分离的幽门螺杆菌 (Hp)菌株CagADNA序列 ,比较其C 端氨基酸序列与国外菌株的差异 ,并分析其磷酸化能力和转染胃上皮细胞后的生物学功能。方法　从 39株临床分离的HpDNA基因组中用PCR方法扩增cagAC 端DNA ,经琼脂糖凝胶电泳后割胶回收DNA片段进行测序。分别构建cagA的原核细胞和真核细胞表达载体并进行CagAC 端氨基酸磷酸化能力测定。 结果　有 38株菌株检测到CagADNA片段 ,CagA阳性率为 97.4 % (38/ 39)。测序后发现 ,克隆的 38株阳性菌株CagA蛋白均仅含 1个重复序列和 2～ 4个串联的谷氨酸 脯氨酸 异亮氨酸 酪氨酸 丙氨酸(EPIYA)序列 ,且在重复序列的D2区氨基酸序列均为天冬氨酸 苯丙氨酸 天冬氨酸 (DFD)。来自胃癌和非胃癌患者的CagA蛋白串联的EPIYA序列数目差异无显著性。用原核细胞表达的CagA蛋白进行体外磷酸化试验 ,重复序列中的酪氨酸能被磷酸化 ,其余的在EPIYA中的酪氨酸也能被磷酸化 ,但转染的AGS细胞株中仅重复序列中的酪氨酸能被磷酸化。在转染AGS细胞株后少数细胞 (<10 % )因骨架重构而出现典型的“蜂鸟”样改变 ,与直接用Hp感染AGS细胞时类似 ,且对转染的AGS细胞再用Hp感染后 ,其“蜂鸟”样细胞的百分比也无明显增加。结论　源自国人的HpCagA蛋白结构不同于欧美国家     

幽门螺杆菌作用后AGS细胞内钙离子的动态变化研究

背景幽门螺杆菌(Helicobacter pylori,Hp)感染与胃癌发生密切相关,但致病机制尚未清晰。细胞毒素相关蛋白A(CagA)是Ⅰ型Hp的主要毒力因子,在Hp诱导的疾病特别是胃癌的发展中起重要作用。前期的研究发现,Hp作用后人胃腺癌上皮细胞(AGS)的钙离子相关蛋白钙网织蛋白CRT以及钙离子结合蛋白CALNUC磷酸化程度发生改变,提示Hp可能会影响AGS细胞的钙稳态,通过钙离子通路影响细胞的增殖或凋亡。目的研究Hp作用于人胃腺癌上皮细胞后,AGS细胞内钙离子的时序性变化,以及CagA对AGS细胞内钙离子的影响,进一步揭示Hp的致病机制。方法采用钙离子荧光标记示踪法,AGS细胞以Fluo-3/AM荧光指示剂负载,特异性地活体标记AGS内的钙离子,采用激光共聚焦显微镜观察分析Hp26695及其CagA缺失株(Hp26695△CagA)分别作用于AGS细胞1h、2h、3h、4h、5h、6h后,AGS细胞内钙离子的变化情况。结果幽门螺杆菌与AGS细胞相互作用1h,胞内Ca2+部分流失,5h胞内Ca2+大量流失。1～6h内,Hp26695与Hp26695△CagA作用的AGS细胞荧光强度没有显著差异。结论Hp作用会导致AGS细胞内Ca2+剥夺,且与CagA的存在无明显关联性。     

不同疾病来源的幽门螺杆菌菌株对AGS细胞动力学的影响

体内外研究发现，幽门螺杆菌(H.pylori)感染可促进胃黏膜上皮细胞增殖或触发细胞凋亡，从而引起细胞动力学改变，而菌株的差异可导致不同的结果。目的：通过体外实验观察不同疾病来源的H.pylori菌株对人胃癌细胞株AGS的细胞活力、细胞凋亡和细胞周期的影响，以确定不同疾病来源H.pylori菌株的细胞毒性是否存在差异。方法：采用聚合酶链反应(PCR)鉴定分离自胃癌和胃炎患者的H.pylori菌株的毒力基因和相关亚型。将AGS细胞分别与H.pylori菌株共培养，采用四唑蓝(MTT)比色法检测细胞活力，流式细胞仪检测细胞凋亡和细胞周期。结果：cagA、uacA、iceA和babA2基因和相关亚型在胃癌和胃炎H.pylori菌株中呈均匀分布。不同菌株抑制AGS细胞活力和促进细胞凋亡的能力虽有强弱差别，但胃癌菌株与胃炎菌株之间不存在整体上的差别。多数H.pylori菌株能抑制AGS细胞周期的G1/S期转换。结论：不同H．pytori菌株对共培养的AGS细胞动力学的影响存在差异，但胃癌菌株与胃炎菌株的细胞毒性无整体上的差别。     

15-LOX-1基因表达对胃癌细胞增殖的抑制作用

目的研究15-LOX-1基因对人胃癌细胞增殖的影响。方法通过脂质体介导瞬时转染15-LOX-1基因于培养的胃癌细胞株（AGS）中，以转染空载体pcDNA3．1（＋）的细胞及未转染质粒的细胞作为对照；用RT—PCR和Westernblot检测人胃癌细胞的15-LOX-1mRNA及蛋白表达；倒置显微镜观察转染前后AGS形态变化；用MTT法比较转染前后AGS的增殖水平，流式细胞术检测转染后AGS细胞周期的变化。结果胃癌细胞系巾未检测到15-LOX—1mRNA和蛋白的表达，转染后的AGS表达有15-LOX—1的mRNA及蛋白。转染重组质粒绀细胞增殖显著低于未转染组及空质粒转染组（P〈0．05），转染后AGS细胞G0／G1期细胞明显增加，S期细胞明显减少，与未转染组及空质粒转染组相比均有显著性差异（P〈0．05）。结论15-LOX-1基因能抑制胃癌细胞的增殖，为进一步探讨胃痛的发病机制及治疗提供实验依据。     

幽门螺杆菌感染对胃上皮细胞凋亡的影响

本文采用切口末端标记方法前瞻性观察了16例正常胃牯膜标本和31例幽门螺杆菌阳性胃炎患者抗幽门螺杆菌治疗前后胃窦部上皮细胞凋亡的变化。结果表明,幽门螺杆菌感染者的凋亡指数(0.7044)明显高于正常对照者(P<0.005);幽门螺杆菌根除后凋亡指数由0.7624降至0.1159(P<0.005),而持续阳性者则无明显降低;凋亡指数与胃炎程度无关。提示幽门螺杆菌能促进胃上皮细胞凋亡,这可能是幽门螺杆菌引起胃癌和溃疡的重要机理。     

Apaf-1基因转染及其对5-氟尿嘧啶诱导AGS细胞凋亡的影响

目的 Apaf-1是参与激活凋亡过程中Caspase系统的关键因子。研究Apaf-1在化疗药物诱导肿瘤细胞凋亡过程中的作用。方法 利用基因转染技术，将正、反义Apaf-1表达载体转染至AGS细胞系，建立Apaf-1过度表达及减低表达系统，观察在Apaf-1过度表达及减低表达情况下，5－氟尿嘧啶（5－FU）对AGS细胞凋亡过程的影响，并检测正、反义Apaf-1转基因AGS细胞株在5－FU诱导的凋亡过程中细胞色素C信号转导通路相关分子的表达变化。结果 正义Apaf-1基因转染组cyt-c、bax及cas-pase-3基因的表达上调，而在反义Apaf-1基因转染组则相反。bcl-2基因的表达在正、反义Apaf-1基因转染组无明显变化。结论 过度表达Apaf-1基因可以明显增加AGS细胞对化疗药物5－FU的敏感性，而Apaf-1基因减少可使凋亡敏感性降低。     

幽门螺杆菌对AGS细胞DNA错配修复基因表达的影响

目的体外观察幽门螺杆菌对AGS细胞DNA错配修复（mismatch repair，MMR）基因蛋白和mRNA表达的影响，以确定不同疾病来源幽门螺杆菌对MMR基因表达的影响是否存在差异。方法AGS细胞分别与5株分离自胃癌和5株分离自胃炎患者的幽门螺杆菌共培养。逆转录一聚合酶链反应（RT—PCR）和Western印迹法检测hMSH2和hMLH1基因mRNA和蛋白表达，同时以肠道致病性大肠杆菌作为细菌对照。结果胃炎菌株和大肠杆菌基本不影响hMLH1和hMSH2基因mRNA和蛋白表达，而所有胃癌菌株都能下调hMLH1和hMSH2基因mRNA和蛋白表达。结论胃癌菌株与胃炎菌株对胃癌细胞MMR的影响存在差异，提示部分幽门螺杆菌菌株可能通过损害细胞MMR功能促进胃黏膜上皮细胞内DNA突变累积，增加幽门螺杆菌长期感染时胃癌发生的危险性。     

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.