川芎嗪-丹参-当归配伍剂与尼莫地平对大鼠脑缺血-再灌注损伤影响的比较

目的探讨川芎嗪-丹参-当归配伍剂（TSA）对大鼠脑缺血-再灌注损伤的神经保护作用。方法取21只成年雄性Wistar大鼠,应用线栓法制作大鼠右侧大脑中动脉阻塞（MCAO）3h模型。剔除模型制作过程中死亡的3只大鼠,随机分成3组,TSA组、尼莫地平组和对照组,每组6只。通过尾静脉给药,对大鼠脑缺血-再灌注模型进行干预。分别给予3组大鼠以下药物：川芎嗪（0．35mg／100g）＋丹参（200mg／100g）＋当归（165mg／100g）、尼莫地平（0．1mg／100g）和等渗盐水1．5ml。给药时间为再灌注前20min、再灌注后12h和36h。在MCAO期间和再灌注后48h,应用脑血流监测仪记录大鼠脑血流量;在再灌注前20rain和再灌注后48h,测评大鼠神经功能缺损评分并计算评分恢复值;再灌注后48h,Trc染色检测大鼠脑梗死体积。结果TSA组、尼莫地平组和对照组：①脑血流量变化相对值为（138±44）、（86±18）和（69±8）％;②神经功能评分恢复值为1．3±0．4,1．2±1．0和0．6±0．7;③大鼠脑梗死体积为（144±38）、（344±92）和（382±93）mm^3。TSA组与尼莫地平组比较,所有观测指标差异均具有统计学意义（P〈0．01或P〈0．05）。结论TSA提高大鼠脑血流量和减少梗死体积的疗效更佳,对大鼠脑缺血-再灌注损伤的保护作用优于尼奠地平。     

纳洛酮对脑局灶性缺血-再灌注大鼠血红素加氧酶-1表达的影响

目的探讨大鼠局灶性脑缺血再灌注后血红素加氧酶1(HO1)蛋白在缺血灶周围区的表达和纳洛酮干预后的影响。方法SD大鼠45只,随机分为三组:即假手术组、缺血再灌注组及纳洛酮组,每组15只。采用线栓法制作大鼠大脑中动脉闭塞(MCAO)局灶性脑缺血再灌注模型,在插入栓线及抽出线栓成功再灌注后,分别给予纳洛酮组大鼠腹腔注射纳洛酮3mg/kg(总量6mg/kg),假手术组及缺血再灌注组腹腔注射等量等渗盐水。以免疫组化法检测HO1的表达,原位末端脱氧核苷酸转移酶标记(TUNEL)法观察脑细胞凋亡细胞数。结果每个高倍视野下,缺血再灌注组HO1阳性细胞数与假手术组相比明显增多,平均为(51.6±10.8)个对(9.8±2.8)个,P<0.05;纳洛酮组与缺血再灌注组比较,缺血灶周围区HO1阳性细胞数平均为(63.5±10.0)个对(51.6±10.8)个,P<0.05。纳洛酮组TUNEL阳性细胞数显著低于缺血再灌注组[(20.5±3.5)个对(29.8±4.0)个],但高于假手术组[平均为(4.2±2.0)个],组间比较,差异有显著性(P<0.05)。结论纳洛酮可减少MCAO局灶性脑缺血再灌注导致的神经细胞凋亡,其机制可能与纳洛酮增加HO1的表达有关。     

井穴放血对大鼠脑梗死缺血再灌注损伤的脑保护作用

目的分析井穴放血治疗对大鼠缺血再灌注损伤的脑保护作用。方法雄性SD大鼠90只中15只为假手术组,其余经线栓法建立脑梗死缺血再灌注损伤模型,随机将建模成功的75只大鼠分为模型组、井穴放血0、1、3、6 h组。假手术组麻醉后仅仅分离右侧大脑中动脉,不将线栓插入;模型组麻醉后,向右侧大脑中动脉插入线栓,血管堵塞60 min后将线栓拔除,血流恢复,制备模型成功;井穴放血各组在建模成功后分别于再灌注后0、1、3、6 h给予井穴放血治疗,并在治疗24 h测定各组神经功能评分,经三苯基四唑氯化物(TTC)染色测定梗死面积,经免疫组化法检测缺血半暗带相关细胞与蛋白表达。结果假手术组脑组织无梗死病灶,无神经功能异常与肢体瘫痪;模型组与井穴放血各组均有不同程度的梗死病灶,出现不同程度的神经功能缺损症状,其中模型组Longa评分最高、梗死面积最大,后由高至低依次为井穴放血6、3、1、0 h组,组间差异有统计学意义(P0.05);假手术组大脑胶质纤维酸性蛋白(GFAP)阳性细胞、Caspase-3阳性细胞、CD11蛋白表达均最低,Neun阳性细胞表达最高;后依次为井穴放血0、1、3、6 h组,模型组GFAP阳性细胞、Caspase-3阳性细胞、CD11蛋白表达均最高,Neun阳性细胞表达最低,组间差异有统计学意义(P0.05)。结论井穴放血治疗能够减少脑梗死缺血再灌注损伤大鼠梗死面积与神经功能损伤,促缺血半暗带小胶质细胞及星形胶质细胞活化增殖,大鼠神经细胞凋亡减少,特别是在再灌注后早期给药,获益更高。     

通心络对大鼠脑缺血-再灌注损伤的保护作用

目的探讨通心络对大鼠脑缺血再灌注损伤的保护作用。方法将31只雄性Wistar大鼠,根据不同给药方案随机分为24h对照组(7只)、24h通心络组(7只)、5d对照组(7只)、5d通心络组(7只)以及假手术组(3只)。各组在造模前用等渗盐水或通心络灌胃预处理7d。依据线栓法建立大鼠大脑中动脉阻塞90min脑缺血再灌注模型。观察不同时间点的神经功能缺失评分,计算2,3,5氯化三苯基四氮唑染色下的梗死体积。结果脑缺血再灌注24h后的梗死体积对照组为(94.4±19.9)mm3,通心络组为(72.1±13.4)mm3;神经功能缺失评分对照组为(3.3±0.6)分,通心络组为(2.6±0.6)分。再灌注5d后的梗死体积对照组为(123.9±18.6)mm3,通心络组为(100.2±12.8)mm3;神经功能缺失评分,对照组为(2.1±0.4)分,通心络组为(1.2±0.4)分,两组比较,差异均有显著意义(P<0.01～0.05)。结论通心络对大鼠大脑中动脉阻塞后的脑缺血再灌注损伤可能具有保护作用。     

脑缺血-再灌注大鼠P-选择素的表达和髓过氧化物酶活性变化的研究

目的探讨脑缺血再灌注损伤不同缺血区域的炎症反应。方法将雄性Wistar大鼠85只,随机分为脑缺血再灌注组(70只)和假手术组(15只)。前者用线栓法建立局灶性脑缺血再灌注模型,脑缺血90min再灌注,将大鼠随机分为7个时间点,分别是再灌注后3、6、12、24、48、72和96h,每个时间点10只大鼠。采用免疫组化法和生化法,观察额顶部皮质和基底核区P选择素表达、髓过氧化物酶(MPO)活性变化。结果①再灌注后缺血侧微血管内皮细胞表面出现P选择素表达,主要分布于额顶部皮质和基底核区:3h额顶部皮质为(13±4)支,基底核区为(11±3)支;12h额顶部皮质为(60±6)支,基底核区为(57±5)支;72h额顶部皮质为(19±4)支,基底核区为(16±4)支。②再灌注后12、24、48、72和96h各时间点MPO活性:额顶部皮质分别是(0.206±0.029)U/g、(0.421±0.030)U/g、(0.369±0.022)U/g、(0.341±0.023)U/g和(0.328±0.028)U/g;基底核区分别是(0.183±0.013)U/g(0.292±0.017)U/g(0.340±0.012)U/g(0.226±0.018)U/g、(0.158±0.022)U/g。假手术组MPO活性:额顶部皮质为(0.033±0.005)U/g、基底核区为(0.031±0.004)U/g,比再灌注组低(P<0.05)。基底核区的MPO活性在再灌注48h达到高峰后下降。额顶部皮质MPO活性在再灌注24h达到高峰后至96h仍维持较高水平。结论脑缺血再灌注损伤时,存在主动炎症反应:出现P选择素表达和中性粒细胞浸润,额顶部皮质比基底核区的炎症反应更强烈和持久。     

心脑舒通对大鼠脑缺血再灌注损伤缺血周边区微血管新生及Ang/Tie系统表达的影响

目的观察心脑舒通胶囊对大鼠局灶性脑缺血再灌注(I/R)损伤缺血周边区脑组织微血管新生及血管生成素(Ang)/酪氨酸激酶受体(Tie)系统表达的影响。方法随机分为假手术组、脑I/R损伤模型组、心脑舒通胶囊(14、28、56 mg/kg)组,采用线栓法制备大鼠大脑中动脉阻塞(MCAO)缺血再灌注模型,缺血90 min后再灌注,分别于造模前30 min、缺血6 h、缺血24 h,每日给药1次,连续7 d。于灌注24 h、7 d后行神经功能评分,末次给药1 h后用水合氯醛(350 mg/kg)麻醉并断头取脑组织,采用Western印迹法测定I/R大鼠皮层缺血周边区Ang1、Ang2、Tie2表达,激光扫描共聚焦显微镜观察脑组织微血管形态及血流灌注量。结果与模型组比较,心脑舒通组大鼠神经功能改善,皮层缺血周边区微血管的数量较多(P0.01,P0.05),Ang1、Tie2蛋白表达量增多(P0.01,P0.05),Ang2蛋白表达量较少(P0.05)。结论心脑舒通可调节大鼠Ang/Tie系统的表达,促进脑缺血后微血管新生,有利于脑缺血后神经功能的恢复。     

脑室注射痛敏素/孤啡肽FQ对局灶性脑缺血大鼠梗死体积和体感诱发电位的影响

目的:观察痛敏素/孤啡肽(N/OFQ)对脑缺血大鼠梗死体积和体感诱发电位(SEP)的影响.方法:41只SD大鼠随机分为大脑中动脉闭塞(MCAO)假手术组(n=5)、缺血组(n=8)、N/OFQ 10μg 组(n=7)、N/OFQ 1 μg组(n=7)、N/OFQ0.1μg组(n=7)和人工脑脊液(ACSF)组(n=7).采用腔内线栓法制作大鼠MCAO模型,MCAO后2 h再灌注.N/OFQ 10μg组、N/OFQ μg组、N/OFQ0.1μg组和ACSF组分别在MCAO后1 h脑室内注射N/OFQ 10μg、N/OFQ 1μg、N/OFQ0.1 μg和体积相同ACSF.检测再灌注24 h后脑梗死体积体,并记录SEP.结果:假手术组SEP PI波幅降低,P1峰潜时间无显著变化.N/OFQ 0.1 μg组SEP波幅、P1峰潜时间和脑梗死体积与ACSF组无显著差异.N/OFQ μg组和N/OFQ10 μg组SEP波幅较ACSF组进一步降低,但P1峰潜时间无显著变化.ACSF组SEP波幅在再灌注后1 h基本恢复至缺血前水平,N/OFQ 1 μg组恢复减慢,N/OFQ10 μg组直到再灌注后3 h仍未恢复.N/OFQ剂量与SEP反应呈量效关系,剂量越大,SEP抑制越显著,恢复越慢.再灌注24 h时,假手术组、ACSF组、N/OFQ0.1 μg组、N/OFQ1 μg组和N/OFQ 10 μg组脑梗死体积分别为0 mm3、(24.180±4.088)mm3、(23.090±4.523)mm3、(35.304±6.824)mm3和(40.806±6.716)mm0.N/OFQ 0.1μg组与ACSF组无显著差异,N/OFQ μg组和N/OFQ 10 μg组与ACSF组均有显著差异(P均＜0.01).结论:脑缺血早期侧脑室注射N/OFQ町使SEP波幅降低、恢复时间延长,梗死体积增大,表明其可加重缺血性脑损伤.     

普萘洛尔和美托洛尔处理对大鼠大脑局灶性缺血再灌注损伤后Bcl-2、Bax和NGF表达的影响

目的 观察普萘洛尔、美托洛尔处理对大鼠大脑局灶性脑缺血再灌注损伤后Bcl -2、Bax和神经生长因子(NGF)表达规律的影响,探讨其脑保护作用的机制.方法 72只成年雄性Wistar大鼠(230 g±10 g)随机分为4组,假手术组、模型组、普秦洛尔给药组、美托洛尔给药组.每组又分为12 h、24 h、48 h三个亚组.采用线栓法制备大鼠大脑中动脉局灶缺血再灌注模型,采用DNA原住末端缺口标记法(TUNEL)检测神经元凋亡;HE染色观察脑组织形态病理学变化;免疫组化法测定大鼠脑缺血再灌注不同时间Bax、Bcl -2与NGF的平均灰度值.结果 与假手术组比较,模型组Bcl-2,Bax和NGF在缺血再灌注组12 h升高,24 h达高峰(P＜0.05).普萘洛尔给药组和美托洛尔给药组的Bcl -2阳性细胞均较模型组明显增加(P＜0.05),而Bax阳性细胞均较模型组则明显减少(P＜0.05),但均多于假手术组(P＜0.05).美托洛尔给药组的NGF阳性细胞与模型组无统计学意义,而普萘洛尔给药组的NGF阳性细胞较模型组显著减少(P＜0.05).结论 普萘洛尔、美托洛尔均可通过抑制Bax和促进Bcl -2表达来对大脑局灶缺血再灌注损伤后的神经元起保护作用.     

SIRT1信号通路在白藜芦醇保护脑缺血再灌注损伤中的作用机制

目的探讨白藜芦醇(Res)对大脑缺血再灌注损伤后大鼠神经元凋亡的影响及其作用机制。方法采用线栓法制作短暂性大脑中动脉栓塞(MCAO)模型。将60只SD大鼠随机分为假手术组(Sham组)、脑缺血再灌注模型组(MCAO组)、白藜芦醇低剂量(10 mg/kg)组(Res 10组)、白藜芦醇高剂量(30 mg/kg)组(Res 30组)。栓塞缺血2 h、再灌注24 h后对各组大鼠进行神经功能损伤评分、脑组织含水量及脑梗死体积评估,TUNEL染色检测细胞凋亡,同时测定缺血再灌注损伤缺血测脑组织中SIRT1、Bax、Caspase-3 mRNA表达水平。结果脑缺血再灌注后24 h,MCAO组脑梗死体积大于Sham组(P0.01),神经功能损伤评分、脑组织含水量、TUNEL(+)细胞数及Bax mRNA、Caspase-3 mRNA表达量均明显高于Sham组(P0.01),而SIRT1 mRNA表达量较Sham组明显降低(P0.01)。与MCAO组比较,Res 10组、Res 30组脑梗死体积明显缩小(P0.01),神经功能损伤评分、脑组织含水量、TUNEL(+)细胞数以及脑组织中Bax mRNA、Caspase-3 mRNA表达量明显降低(P0.01),SIRT1 mRNA表达明显增加(P0.01)。结论白藜芦醇可通过减轻缺血脑组织神经元凋亡对大鼠脑缺血再灌注损伤发挥神经保护作用,其可能通过激活SIRT1信号通路从而抑制或逆转脑缺血再灌注神经损伤的发生。     

脑血流监测对大鼠脑缺血模型制备的评价作用

目的 探讨脑血流监测对线栓法制备大鼠大脑中动脉阻塞(MCAO)局灶性脑缺血模型的评价作用。方法 分别将线栓插入30只SPF级Wistar Han大鼠颈内动脉颅内段(16.0±0.5)、(18.0±0.5)和(20.0±0.5)mm,制备3种局灶性脑缺血模型(各10只),然后将所有实验大鼠依据颅底有无血凝块及2,3,5氯化三苯基四氮(TTC)染色后大脑中动脉供血区有无梗死灶分为不全阻塞组、完全阻塞组及过深阻塞组,对阻塞颈内动脉颅内段前后及拔出线栓再灌注后每只大鼠大脑中动脉供血区脑皮质的血流量以激光多普勒法进行监测记录并进行统计学分析。大脑中动脉供血区脑皮质的血流量以相对流量单位PU值表示;阻塞后及再灌注后的脑皮质血流量变化以与阻塞前脑皮质血流量的百分比表示。结果 模型制作过程中,1只大鼠死亡;不全阻塞组9只,完全阻塞组15只,过深阻塞组5只。不全阻塞组8只大鼠线栓插入深度在(16.0±0.5)mm,不能完全阻止大脑前动脉向大脑中动脉的血流,缺血6 h后大鼠Longa评分0~1分;颅底动脉环周围无血凝块,经TTC染色后无梗死灶。完全阻塞组9只大鼠线栓插入深度在(18.0±0.5)mm,大脑前动脉的血流被完全阻断,缺血6 h后大鼠Longa评分2~3分;颅底动脉环周围无血凝块而TTC染色提示存在大脑中动脉供血区的梗死灶。过深阻塞组5只大鼠线栓插入深度在(20.0±0.5)mm,可完全阻断大脑前动脉血流,缺血6 h后大鼠Longa评分3~4分;解剖可见颅底血凝块,TTC染色后可见中动脉供血区梗死灶。插入线栓后,不全阻塞组、完全阻塞组和过深阻塞组大鼠脑皮质血流量均较阻塞前下降(分别为94±17比256±36、43±9比286±44、44±6比294±46,均P0.05),组间差异有统计学意义(F=56.57,P0.01),完全阻塞组和过深阻塞组血流量明显低于不全阻塞组(均P0.05),完全阻塞组与过深阻塞组间差异无统计学意义(P0.05);3组阻塞后与阻塞前脑皮质血流量的百分比分别为(36.93±0.06)%、(15.09±0.02)%、(15.52±0.04)%,组间差异有统计学意义(F=39.14,P0.01)。再灌注后,不全阻塞组、完全阻塞组和过深阻塞组脑皮质血流量(分别为213±31、147±17、96±14)均较阻塞后有明显回升(均P0.05),组间差异有统计学意义(F=50.05,P0.01),过深阻塞组脑皮质血流量明显低于完全阻塞组(P0.05);3组再灌注后与阻塞前脑皮质血流量水平百分比分别为(83.10±0.02)%、(51.83±0.05)%、(33.49±0.09)%,差异有统计学意义(F=93.23,P0.01)。结论 以激光多普勒对脑血流进行监测,可作为判断线栓法制备大鼠MCAO脑缺血模型成功与否的一种实时、便捷、微创、客观可靠的评价手段。     

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.     

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。     

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。     

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。