利用小鼠炎症模型评价苯扎氯铵的黏膜毒性

目的利用小鼠黏膜炎症因子模型,研究不同浓度苯扎氯铵(BZK)对生殖道黏膜的刺激毒性,以探究BZK作为黏膜用药物的安全性和应用前景。方法连续三天用浓度为0.02%、0.2%和2%的BZK凝胶处理小鼠阴道黏膜,每天收集小鼠阴道灌洗液,用多指标流式蛋白定量技术(Cytometric Bead Array,CBA)检测其中的6种炎症因子[白介素(Interleukin,IL)-2、IL-4、IL-6、IL-17A和肿瘤坏死因子(Tumor necrosis factor,TNF)-α、γ干扰素(Interferonγ,IFN)-γ]的表达情况;利用苏木紫-伊红(Hematoxylin-Eosin,HE)染色法对小鼠阴道黏膜的病理学损伤情况进行观察。结果 2%的BZK凝胶诱导了较为明显的小鼠阴道黏膜上皮损伤,0.02%和0.2%的BZK与安慰剂组相比无明显病理改变;但是0.2%的BZK显著上调了IL-6和TNF-α在阴道灌洗液中的表达,而0.02%和2%的BZK诱导的各炎症因子与安慰剂组相比差异无统计学意义。结论 2%和0.2%的BZK具有一定的黏膜毒性;0.02%的BZK展现了较好的安全性,该浓度下BZK的病原体感染抑制能力需要进一步研究确认。     

利用小动物活体成像技术检测心肌梗死后炎症的进程

目的:利用小动物活体成像技术连续动态评估,同一只鼠心肌梗死后心脏炎症进程的方法。方法:40只成年雄性用荧光素酶标记转录因子NF-κB(NFκB-RE-luc)小鼠,按随机数字表分为对照组和心肌梗死组,每组各20只;心肌梗死组开胸结扎小鼠冠状动脉前降支,对照组只给予开胸处理。分别于术前及术后1天、3天、5天、7天、14天及28天检测NF-κB的转录活性。于3天时,收10只对照组小鼠,CBA检测外周血清中炎症因子MCP-1、TNF-α及IL-6的表达,荧光定量PCR检测心肌梗死后心脏组织中的炎症因子MCP-1、TNF-α及IL-6的表达。手术后28天,超声心动检测小鼠心功能;心脏组织病理切片,Masson三原色法检测心肌梗死后28天心脏胶原沉积。结果:28天心肌梗死组的病理切片染色和超声心动结果均证明心肌梗死模型造模成功。利用小动物活体成像检测到NF-κB转录活性的动态变化:心肌梗死后1天、3天、5天及7天后NF-κB表达水平与心肌梗死前相比明显升高[(255 400 000±31 280 000),(459 300 000±64 210 000),(461 000 000±73 830 000),(380 000 000±41 000 000)vs.(77 280 000±10 750 000)p/s,P<0.005)。心肌梗死术后3天心脏组织炎症因子MCP-1、TNF-α及IL-6的mRNA表达和血浆中的炎症因子MCP-1、TNF-α及IL-6的水平均明显升高。结论:利用小动物活体成像技术可以活体检测小鼠心肌梗死后心脏炎症过程。     

姜黄素对脂多糖联合干扰素γ诱导的巨噬细胞炎症因子表达的影响及其机制

目的探讨姜黄素对脂多糖联合干扰素γ诱导的巨噬细胞表达炎症因子的影响及其相关机制。方法用脂多糖联合干扰素γ诱导巨噬细胞构建炎症细胞模型并设立不同浓度的姜黄素干预组和对照组,通过实时荧光定量PCR及酶联免疫吸附法测定不同分组中肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)及白细胞介素12B(IL-12B)三种炎症因子的表达。Western blot检测各组细胞TLR4-MAPK/NF-κB信号通路的表达。结果实时荧光定量PCR显示,与对照组相比,姜黄素对脂多糖联合干扰素γ诱导的巨噬细胞TNF-α、IL-6及IL-12B m RNA的表达均具有明显抑制作用(P0.001),酶联免疫吸附法也证实姜黄素能抑制以上炎症因子的分泌(P0.01)。Western blot检测显示,姜黄素能明显抑制TLR4的表达及下游MAPK(p38、ERK1/2及JNK1/2)和NF-κB(IκBα及p65)通路的磷酸化(P0.05)。结论姜黄素可通过抑制TLR4-MAPK/NF-κB信号通路抑制脂多糖联合干扰素γ诱导的巨噬细胞中TNF-α、IL-6及IL-12B这三种炎症因子的表达。     

IL-33缺陷调节小鼠抗弓形虫感染的CD8+ T细胞应答

目的 探讨IL-33缺陷(IL-33^-/-)对弓形虫感染小鼠的炎症反应和CD8⁺ T细胞功能的影响。方法 C57BL/6野生型(Wild-type, WT)和IL-33^-/-小鼠分别设感染组和对照组，建立弓形虫感染模型，记录小鼠死亡时间，绘制生存曲线；分别取感染后48 h、96 h各组小鼠外周血及肝、脾组织，HE染色观察组织病理变化；微量样本多指标流式蛋白定量技术(cytometric bead array, CBA)及ELISA检测血浆炎症因子(IL-12P70、TNF-α、IFN-γ、MCP-1、IL-6及IL-4)水平；qPCR检测小鼠脾细胞中弓形虫速殖子表面抗原-1(SAG-1)的mRNA水平；流式细胞术分析脾脏CD8⁺ T细胞穿孔素、颗粒酶和IFN-γ水平。结果 与WT感染组小鼠比较，96 h时IL-33^-/-感染组小鼠脾脏SAG-1 mRNA表达降低(F=13.96,P<0.05),肝、脾组织的炎症改变较轻，生存时间延长(χ²=6.87,...     

从克罗恩病患者肠黏膜分离出的1株黏附侵袭性大肠杆菌对IL-10基因敲除结肠炎小鼠的影响

目的探讨从克罗恩病患者肠黏膜分离出的1株黏附侵袭性大肠杆菌(adherent-invasive Escherichia coli, AIEC)对白细胞介素10基因敲除(IL-10 knockout, IL-10 KO)小鼠肠道炎症的影响。方法将IL-10 KO小鼠和野生(WT)小鼠各分为3组。野生型组:对照组(WT+PBS)、普通大肠杆菌组(WT+K-12)、AIEC组(WT+AIEC);IL-10基因敲除模型组:对照组(KO+PBS)、普通大肠杆菌菌组(KO+K-12)、AIEC组(KO+AIEC),对各组小鼠灌胃2周,同时喂养4周后取各组小鼠结肠,行炎症评分,RT-PCR法检测TNF-α、IFN-γ和IL-12 mRNA的表达。结果 KO+AIEC组小鼠发生的肠道炎症最重,其炎症水平较其他KO组明显升高(P0.05),其细胞因子mRNA表达水平,如TNF-α、IFN-γ、IL-12也较其他组明显升高(P0.01)。结论 AIEC能加重IL-10 KO小鼠结肠炎,使其与巨噬细胞和Th1细胞介导的相关炎症因子TNF-α、IFN-γ和IL-12水平上调。提示AIEC细菌感染是IBD发生肠炎的重要机制之一。     

缺氧诱导因子-2α在小鼠DSS结肠炎中的作用及其机制研究

背景:对炎症性肠病(IBD)发病机制的研究发现微循环缺氧是IBD的重要特征之一,转录因子缺氧诱导因子(HIFs)在缺血缺氧损伤的调节中起关键作用。目的:探讨HIF-2α在小鼠葡聚糖硫酸钠(DSS)结肠炎中的作用及其可能机制。方法:以Mx-Cre/LoxP重组方法获得HIF-2α基因条件性敲除(HIF-2α-/-)小鼠,将C57BL/6、HIF-2α+/+和HIF-2α-/-小鼠分别随机分入DSS模型组和饮水对照组,前者予4%DSS溶液自由饮用7 d制作结肠炎模型,造模过程中每天评估疾病活动指数(DAI)。各组小鼠分别于造模开始后第1、3、5、7 d处死,取结肠组织观察组织病理学变化,real-time PCR检测HIF-2α、肿瘤坏死因子-α(TNF-α)mRNA表达。结果:造模过程中,C57BL/6和HIF-2α+/+DSS模型组小鼠结肠黏膜HIF-2αmRNA表达明显升高,DAI和结肠黏膜炎症评分显著高于C57BL/6饮水对照组(第5、第7 d,P0.05)。HIF-2α-/-DSS模型组小鼠结肠黏膜炎症损伤较HIF-2α+/+DSS模型组进一步加重,DAI和炎症评分进一步升高(除第7 d炎症评分外,P均0.05),结肠黏膜TNF-αmRNA表达亦较HIF-2α+/+DSS模型组显著升高(第5、第7 d,P0.05)。结论:HIF-2α可能通过抑制TNF-α表达发挥减轻小鼠DSS结肠炎炎症损伤的作用。     

miR-301a调节小鼠巨噬细胞中炎症因子的表达

目的探讨miR-301a对巨噬细胞炎症因子表达水平的影响,从microRNA角度阐明动脉粥样硬化的发病机制,为动脉粥样硬化的防治提供新的思路。方法高脂喂养Apo E-/-小鼠建立动脉粥样硬化模型,收集小鼠主动脉血管,利用real-time PCR检测组织中miR-301a的表达水平;利用脂质体在RAW264.7细胞中转染miR-301a mimic和miR-301a inhibitor,用real-time PCR检测细胞中miR-301a水平,并检测肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)和单核细胞趋化蛋白1(MCP-1)的表达水平,用Western blot检测NF-κB抑制因子(NKRF)蛋白水平,用免疫荧光染色检测p65细胞定位。结果在高脂喂养的Apo E-/-小鼠主动脉血管壁组织中miR-301a的表达水平升高;在RAW264.7细胞中过表达miR-301a可抑制NKRF蛋白水平,促进p65细胞核定位,升高细胞中TNF-α、IL-6和MCP-1的mRNA表达;在RAW264.7细胞中低表达miR-301a可升高NKRF蛋白水平,促进p65细胞质定位,减少细胞中TNF-α、IL-6和MCP-1的mRNA表达。结论在高脂喂养的Apo E-/-小鼠主动脉血管壁组织中miR-301a表达水平升高;在RAW264.7细胞中miR-301a通过调节NKRF的表达影响p65活性进而调控TNF-α、IL-6和MCP-1的mRNA表达,提示microRNA在动脉粥样硬化发病的炎症机制中具有重要作用。     

脂肪干细胞抑制老年类风湿关节炎小鼠的炎症反应

目的探讨脂肪干细胞对类风湿关节炎小鼠模型炎症反应的抑制作用。方法用鸡Ⅱ型胶原诱导法构建小鼠类风湿关节炎模型,用脂肪干细胞进行治疗,采用数码相机采集模型后肢图像,苏木素-伊红(HE)染色观察关节病理变化,实时荧光定量-聚合酶链反应检测组织肿瘤坏死因子(TNF)-α、白细胞介素(IL)-1β、IL-6及IL-10的表达,酶联免疫吸附试验检测外周血中TNF-α、IL-1β及IL-10的水平。结果采用鸡Ⅱ型胶原能够成功构建小鼠类风湿关节炎模型,脂肪干细胞治疗后能够有效降低关节切片中炎性浸润,维持关节局部组织完整性,降低关节局部炎症因子的表达,并减少血清中炎症因子的含量。结论脂肪干细胞治疗能够有效减缓类风湿关节炎小鼠模型局部和整体炎症反应水平,改善关节组织水肿。     

NF-κB p65反义寡核苷酸对TNBS结肠炎小鼠肠黏膜细胞因子和NF-κB表达的影响

目的:探讨NF-κB p65反义寡核苷酸对实验性结肠炎BALB/c小鼠肠黏膜NF-κB表达的抑制作用和对黏膜肿瘤坏死因子(TNF-α)、白细胞介素(IL-10、IL-1β)表达的影响,研究其对肠道炎症的治疗作用.方法:将50只BALB/c小鼠均分为模型对照组(UC组)、NF-κB p65反义寡核苷酸组(ASODN组)、错义寡核苷酸组(MSODN组)和正义寡核苷酸组(SODN组),采用2,4,6-三硝基苯磺酸(TNBS)灌肠造模.造模后24h后对各组进行相应灌肠治疗,灌肠后第7天处死小鼠,行光镜下观察肠黏膜炎症并评分,免疫组化检测各组小鼠肠黏膜CTNF-α、IL-1β、IL-10和NF-κB表达.结果:ASODN组小鼠在结肠炎症评分较UC组、MSODN组和SODN组明显改善(均P<0.05).ASODN组小鼠TNF-α、IL-1β、NF-κB表达较UC组、MSODN组和SODN组明显减少(82.68±14.30 VS 168.48±11.89,166.49±11.63,176.49±12.33, P<0.05;42.42±5.77 VS 168.48±11.89,120.43±28.21,131.43±30.601, P<0.01;62.66±11.32 VS 158.38±12.49,161.09±12.73,168.64±11.83, P<0.01),而IL-10表达则显著增多(146.68±6.02 VS 62.50±11.57,58.44±10.92,54.24±10.64, P<0.01).结论:NF-κB p65反义寡核苷酸可抑制NF-κB的活化,降低TNF-α、IL-1β表达,升高IL-10的表达,减轻小鼠结肠炎症,可用于治疗实验性结肠炎.     

甘草酸铵通过抑制HMGB1的表达减轻ConA诱导的免疫性肝损伤

目的探讨甘草酸铵对刀豆蛋白A(Concanavalin A,ConA)诱导的免疫性肝损伤的保护作用及其可能的分子机制。方法在小鼠尾静脉注射ConA(20 mg/kg)前30 min,腹腔注射甘草酸铵(100 mg/kg)。ConA注射后8 h,检测血清转氨酶水平及肝组织学以评估肝损伤程度,应用酶联免疫法(ELISA)检测肝组织肿瘤坏死因子α(TNF-α)、干扰素γ(IFN-γ)、白介素-10(IL-10)水平。同时,分别采用实时荧光定量PCR和免疫组化检测肝组织高迁移率族蛋白-1(HMGB1)mRNA与蛋白的表达。结果预防性应用甘草酸铵有效地保护ConA诱导的小鼠免疫性肝损伤,表现为血清转氨酶水平与肝脏组织炎症坏死程度明显减轻;与ConA模型组相比,甘草酸铵对肝脏内的促炎症细胞因子TNF-α和IFN-γ并无影响,但增加了抗炎症因子IL-10水平(P<0.01);同时,甘草酸铵预防组肝组织HMBG1基因与蛋白的表达均明显低于模型组(P均<0.01)。结论甘草酸铵有效改善ConA诱导的小鼠免疫性肝损伤,其发挥作用的分子机制与抑制HMBG1表达有关。     

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。