蚤莲合剂对DEN所致大鼠肝癌前病变的影响

目的:观察蚤莲合剂对诱发大鼠原发性肝癌的抗促癌作用及其机理。方法:以含100ppm的二乙基亚硝胺(DEN)饮水造模,采用蚤莲合剂灌胃给药,观察其对大鼠肝组织病理学、免疫组化、血清和肝组织生物化学指标的影响。结果:蚤莲合剂对大鼠肝组织癌前病变有抑制作用。大鼠肝癌形成率相对减少,血清ALT、ALb、ALP、TNF水平及肝匀浆γ-GT活性明显低于模型组(P<0.01),其免疫组化AFP阳性细胞数也较模型组为少(P<0.05)。结论:蚤莲合剂有明显抑制DEN所致大鼠肝癌前病变的作用,其抑癌作用可能与其护肝、抗炎和控制变异细胞过度合成有关。     

蚤莲合剂对二乙基亚硝胺所致大鼠肝硬变及癌变的防治作用

目的:观察蚤莲合剂(由白蚤体、半枝莲、虎杖、姜黄、黄芪、白术、茯苓、玫瑰花等8味中药组成)对肝硬化和肝癌前病变的预防作用。方法:以二乙基亚硝胺(DEN)诱发大鼠肝硬化伴癌前病变为模型,观察内容包括病理形态的生物化学指标。结果:中药组与模型组比较:①肝功能指标ALT、ALB等明显改善(P<0.01);②肝羟脯氨酸(HyP)含量及肝纤维化或肝硬化程度明显降低;③血清碱性磷酸酶(ALP)和肝组织匀浆γ-GT水平明显降低(P<0.01);血清肿瘤坏死因子(TNF)水平降低(P<0.01);④AFP阳性细胞数减少(P<0.05)。结论:蚤莲合剂对DEN所致大鼠肝硬化和肝癌前病变有明显防治作用。     

人参鳖甲丸对肝硬变大鼠肝细胞异常增殖的影响

目的:研究人参鳖甲丸对肝硬变大鼠肝细胞增殖的影响及其作用机理。方法:以DMN诱导大鼠肝硬变、肝癌的动物模型,检测用药后血清及肝组织相关指标的变化。结果:DMN可诱导大鼠肝硬变、肝癌的发生,表现为ALT、ALP、γ-GT,AFP增加,Alb含量下降,肝细胞异常增生,肝癌结节形成,肝癌组织TGF-β_1、TGF-β_2R的表达减少:人参鳖甲丸具有保护肝细胞、抗肝纤维化、抑制肝细胞异常增生的作用,并能使癌组织周围表达低下的TGF-β_1、TGF-β_2含量显著增加。结论:人参鳖甲丸具有保护肝细胞、抗肝纤维化、抑制肝细胞异常增生及提高TGF-β_1、TGF-β_2R表达的作用。     

复方半枝莲防治二乙基亚硝胺诱发大鼠肝癌的研究

目的 :研究复方半枝莲 (SBC)对二乙基亚硝胺 (DEN)诱发大鼠肝癌的防治作用。方法 :利用免疫组化、流式细胞仪、血清和组织生化等检测方法 ,分别在第 14周和第 2 4周观察 SBC对 DEN诱发的肝癌形成过程的影响。结果 :中药组 14周时大鼠肝脏异型性增生灶明显较模型组少 ,2 4周时形成的肝癌结节小而少 ,模型组、中药组肝癌发生率分别为 75 .0 %、5 0 .0 % ;免疫组化显示中药组大鼠肝组织谷胱甘肽 - S-转移酶胎盘型阳性灶面积明显低于模型组 ;肝组织匀浆上清液谷胱甘肽 - S-转移酶含量以及血清 λ-谷氨酰转移酶、碱性磷酸酶、谷丙转氨酶含量也明显低于模型组 ;流式细胞仪检测结果显示 ,中药组大鼠肝细胞 G0 - G1 期比例下降 ,G2 - M期比例升高。结论 :SBC能抑制癌前病变 ,延缓肝癌的形成 ,降低肝癌发病率 ,其作用机制之一可能为阻滞 G2 - M期细胞进展 ,从而抑制DEN引起的肝细胞的去分化和恶性增殖     

复方半枝莲防治二乙基亚硝胺诱发大鼠肝癌的研究

目的研究复方半枝莲(SBC)对二乙基亚硝胺(DEN)诱发大鼠肝癌的防治作用.方法利用免疫组化、流式细胞仪、血清和组织生化等检测方法,分别在第14周和第24周观察SBC对DEN诱发的肝癌形成过程的影响.结果中药组14周时大鼠肝脏异型性增生灶明显较模型组少,24周时形成的肝癌结节小而少,模型组、中药组肝癌发生率分别为75.0%、50.0%;免疫组化显示中药组大鼠肝组织谷胱甘肽-S-转移酶胎盘型阳性灶面积明显低于模型组;肝组织匀浆上清液谷胱甘肽-S-转移酶含量以及血清λ-谷氨酰转移酶、碱性磷酸酶、谷丙转氨酶含量也明显低于模型组;流式细胞仪检测结果显示,中药组大鼠肝细胞G0-G1期比例下降,G2-M期比例升高.结论SBC能抑制癌前病变,延缓肝癌的形成,降低肝癌发病率,其作用机制之一可能为阻滞G2-M期细胞进展,从而抑制DEN引起的肝细胞的去分化和恶性增殖.     

养阴解毒方与健脾理气方预防肝硬化伴癌前病变的实验研究

目的：观察养阴解毒、健脾理气法则对肝硬化及肝癌的防治作用。方法：采用0.7％DEN液对大鼠灌胃方法造模，设正常组、模型组、养阴组和健脾组，于造模前2周起分别灌以蒸馏水、养阴液与健脾液至实验结束。结果：9周时形成肝纤维化伴癌前期病变，18周后形成肝硬化，癌前期变加重。与模型组相比，两中药组肝纤维化、肝硬化与肝癌前期病变较轻；DNA含量明显降低；肝细胞GGT阳性灶与AFP阳性细胞数减少；肝组织GGT比活性及Hyp含量下降。两中药组相比似以养阴组为优。结论：养阴解毒方与健脾理气方均能减缓大鼠肝硬化的形成，在一定程度上抑制其癌变进程。     

健脾理气方预防肝硬化及癌变的实验研究

目的:观察健脾理气方对肝硬化及癌变的预防作用。方法:以DEN诱发大鼠肝硬化伴癌前期病变为模型,生理盐水为对照。观察项目包括病理形态与生化学指标。结果:用中药后肝纤维化程度减轻;肝细胞增生灶与假小叶减少,肝组织GGT阳性灶和AFP阳性细胞、肝组织Hyp和肝细胞DNA含量均减少;肝组织GGT比活性降低。结论:健脾理气方能同时延缓肝硬化的形成与阻制癌前期的病变,其防癌机制可能在于药物抑制了肝细胞DNA的复制。     

健脾活血方对大鼠急性酒精性肝损伤的干预作用

目的:研究健脾活血方对大鼠急性酒精性肝损伤的防护作用.方法:将36只SD大鼠随机分为正常组、急性酒精性肝损伤模型组和中药干预组.模型组和中药干预组每日白酒灌胃连续5天,复制大鼠急性酒精性肝损伤模型.中药干预组予健脾活血方灌胃.实验结束处死大鼠,收集血清和肝脏组织,检测血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、肝组织γ-谷氨酰转肽酶(γ-GT)活性和肝组织甘油三酯(TG)含量.肝组织行HE染色和油红O染色,检测肝脏病理改变.结果:健脾活血方显著降低大鼠肝脏/体重比,降低血清ALT、AST和肝组织γ-GT活性,减少肝组织TG含量,明显减轻模型大鼠肝内脂肪沉积,改善肝细胞的脂肪性病理改变.结论:健脾活血方干预对大鼠急性酒精性肝损伤有较好的防护作用.     

养阴方对实验性肝癌诱癌过程的影响

以DEN与AFB1诱发大鼠肝癌为模型，通过病理形态与重化指标的观察，发现养阴方能养活模型鼠肝细胞异型性增生灶，降低肝组织GGT、GST与血清ALP活性升高的幅度，提示药物对癌前期病变形成有较明显的抑制作用。     

复方牛胎肝提取物对二甲基亚硝胺致大鼠肝纤维化的干预作用

目的:观察复方牛胎肝提取物(安珐特)对二甲基亚硝胺(DMN)诱导大鼠肝纤维化的干预作用。方法:雄性Wistar大鼠29只,随机分为正常组(9只)、模型组(10只)、安珐特组(10只)。后两组大鼠行腹腔注射4周DMN复制肝纤维化模型。造模结束后,安珐特组大鼠按照成人用药量的8倍剂量灌胃,共4周,正常组和模型组大鼠灌胃等剂量的0.5%羧甲基纤维素钠(CMC)。8周末处死大鼠,留取标本。全自动生化仪检测血清丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)、总胆红素(TBil)、γ-谷氨酰转肽酶(γ-GT)、血清白蛋白(Alb);检测各组大鼠肝组织羟脯氨酸Hyp的含量;采用HE染色和天狼猩红染色法观察肝组织形态学。结果:与正常组比较,模型组大鼠血清TBi L、ALT、AST、γ-GT水平明显升高(P0.05),Alb水平明显下降(P0.05);大鼠肝组织HE染色可见肝脏内有大量炎性细胞浸润,肝窦狭窄,汇管区扩大,肝细胞排列紊乱,出现肿胀、变性坏死,肝组织内有明显出血现象;天狼猩红染色可见大鼠肝脏胶原增生明显,大量纤维间隔,向肝小叶伸展,分割包绕肝组织,形成假小叶;肝组织Hyp含量明显升高(P0.05)。与模型组比较,安法特组大鼠血清TBi L、ALT、AST均显著降低降低(P0.05),γ-GT水平有所降低,Alb水平有所升高,但差异无统计学意义;肝组织HE染色可见肝细胞变性坏死、出血、炎症细胞浸润等病理变化有不同程度的改善;天狼猩红染色可见纤维化程度有明显改善;肝组织Hyp含量明显降低(P0.05)。结论:安珐特对DMN诱导的大鼠肝纤维化形成有显著的抑制作用。     

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.     

治疗高血压药物的经济学评价

重视高血压治疗中的经济学评价,对利用我国有限的卫生资源来遏制高血压对人民群众的危害有着重要的现实意义。药物经济学对于药物治疗的成本和治疗的结果给予同样的关注。因为治疗高血压的费用,不仅涉及药物价格,还包括患者的危险水平,降压疗效和对临床终点事件的影响,以及治疗的依从性和安全性。因此药物经济学更强调整体成本和价-效比。低危病人,若非药价低廉,治疗的价-效比不够理想。而在高危的患者,价-效比越小越经济而不是药费越便宜越好。