不同的脂肪酸对人血管内皮细胞增殖和凋亡的影响

目的 了解游离脂肪酸（FFAs）对体外培养的人脐静脉内皮细胞（human umbilical veinen dothelialcells，HUVEC）凋亡及生长周期的影响。方法 用不同种类，不同浓度的FFAs培养人血管内皮细胞（VEC），然后应用流式细胞术（FCM）对培养的人VEC生长周期及细胞凋亡进行分析。结果 饱和脂肪酸（SFA）（C16：0，C18：0，C24：0），使培养的人VEC生长受到抑制，随浓度升高细胞凋亡率升高；不饱和脂肪酸（USFA）（C18：1，C18：2），当低浓度时，VEC凋亡率较低（P〉0．05，P〉0．01），而当达400或600μmol／L时凋亡率升高（P〈0．05，P〈0．01）。结论 SFA对培养的人VEC具有抑制增殖及诱导凋亡的作用。低浓度USFA对VEC凋亡及生长周期的影响不大，但高浓度时，其诱导凋亡的作用增强。     

中药对血管内皮细胞功能障碍保护作用的研究进展

血管内皮细胞(VEC)不仅是一个机械屏障,而且是人体最大的内分泌器官,VEC的损伤是多种疾病发生、发展的基础.中药在保护、减轻和逆转VEC方面起着重要作用.     

罗格列酮对胰岛素抵抗大鼠内皮细胞内分泌功能的影响

用罗格列酮（RSG）处理果糖诱导的胰岛素抵抗（IR）大鼠，探讨其对血管内皮细胞（VEC）内分泌功能的作用。结果表明RSG可改善IR大鼠VEC内分泌功能，可能是通过提高主动脉一氧化氮合酶活性和机体抗氧化应激所致。     

阿魏酸钠对TNF-α致血管内皮细胞凋亡的作用

目的 探讨阿魏酸钠（sodium femlate，SF）对TNF-α引起的血管内皮细胞（VEC）凋亡的作用及机制。方法 以培养的人脐静脉内皮细胞（HUVEC）为实验模型，采用电镜、TUNEL法观察凋亡细胞，用免疫组化技术检测bcl-2和bax的表达。结果 电镜观察TNF-α组可见VEC凋亡典型特征；TUNEL法检测TNF-α组VEC凋亡率为35．2％，显著高于对照组，SF组和TNF-d＋SF组（JD〈0．01）；TNF-α组bcl-2表达聪显减少，同时加入SF后bcl-2表达明显上升，而TNF-α可诱导bax表达增加，加入SF后明显降低。结论 TNF-d能诱导VEC凋亡，SF可抑制细胞凋亡，同时SF可使TNF-α诱导的VEC中bcl-2表达明显恢复，而对bax表达明显降低。     

血管内皮细胞损伤在糖尿病肾病中的作用

内皮细胞是村贴于所有心血管内腔面的单层扁平细胞，在许多疾病的病理生理机制中具有重要价值。我们以循环内皮细胞（CEC）增高作为血管内皮细胞（VEC）损伤的指标，对不同程度糖尿病肾病（DN）患者进行检测，旨在探讨VEC损伤在DN发生发展过程中所起的作用。对象和方法一、病例     

血液剪切力诱导的血管内皮细胞形态学变化和信号通路

近年来，对血管内皮细胞（ VEC ）的研究已从静态转移到模拟人体血液剪切力的动态上来。目前研究成果表明，剪切力把信号传递到VEC内引起细胞的反应，对血液凝固、纤维蛋白溶解、血管重建有重要意义。血液剪切力发生变化时，VEC会做出一系列应答，从而可能引发一些心血管疾病［1］。因此，通过对剪切力影响下VEC的形态和分子水平的研究，可为心血管疾病的预防、治疗及生物工程血管内皮细胞培养提供新的思路［2，3］。本文就剪切力和VEC的作用关系作一综述。     

Ang-2对血管内皮细胞内皮素分泌的影响及茶多酚的保护作用

目的探讨血管紧张素-2（Ang-2）对血管内皮细胞（VEC）内皮素（ET）分泌的影响及茶多酚的保护作用。方法将培养的VEC分为4组,每组8个样本。空白对照组仅加入细胞培养液（I组）,Ⅱ组单纯加入Ang-2使终浓度为10^-5。mol／L,Ⅲ组在Ⅱ组的基础上加入茶多酚使终浓度为50mg／L,Ⅳ组使茶多酚终浓度为25mg／L,用放射免疫法测定Ang-2作用前、作用后0．5、6、24h各组ET含量。结果Ⅱ组较Ⅰ组各时间ET含量显著增高（P〈0．01）,Ⅲ组在6h、24h较Ⅱ组,Ⅳ组在0．5h、6h、24h较Ⅱ组ET含量均有显著差异（P均〈O．01）。结论Ang-2使VEC分泌ET的功能增强,茶多酚能显著抑制Ang-2促VEC分泌ET的作用,且低浓度优于高浓度茶多酚。     

氧化低密度脂蛋白诱导血管内皮细胞损伤的条件培养基对血管平滑肌细胞增殖的作用

目的观察氧化低密度脂蛋白（OX—LDL）损伤血管内皮细胞（VEC）的条件培养基对血管平滑肌细胞（VSMC）生长状态的影响。方法在培养的大鼠胸主动脉平滑肌细胞上，分别采用MTT染色法、流式细胞术及增殖细胞核抗原免疫组化方法等，检测OX—LDL诱导VEC损伤的条件培养基对VSMC生长率、细胞周期及PCNA表达的影响。结果OX—LDL可呈浓度依赖性损伤VEC的形态、减少上清液中NO含量、升高上清液中ET-1含量。终浓度为1001μg,／ml的ox-LDL与VEC共同孵育24h制备的条件培养基，能明显促进VSMC生长、提高PCNA表达及增加细胞周期S期细胞数。结论血管内皮细胞受到OX—LDL损伤时，制备的条件培养基能促进血管平滑肌细胞增殖，这可能是氧化低密度脂蛋白致动脉粥样硬化形成的原因之一。     

复原胶囊对气虚血瘀证冠心病血液TXB2、6-Keto-PGF1a、NO、ROS的干预作用及相关机制研究

目的 研究气虚血瘀证冠心病血液血栓素B2（TXB2）、6-酮-前列环素F1a（6-Keto-PGF1a）、一氧化氮（NO）、活性氧（ROS）的变化及复原胶囊对其作用机制。方法 气虚血瘀证冠心病患者共42例随机抽取24例作为治疗组、18例作为对照组，另设14例健康人为青年对照组。采用化学比色法及放射免疫法（RAI）检测治疗组服复原胶囊2月前后血液NO、ROS、TXB2、6-Keto-PGF1a水平；并与对照组及健康对照组进行比较。结果 治疗组、对照组血液TXB2、ROS显著高于健康对照组（P〈0．01）；而6-Keto-PGF1a、NO显著低于健康对照组（P〈0．01）。治疗组服药2月后，血浆TXB2、ROS显著降低（P〈0．01）；但仍高于健康对照组（P〉0．05）；6-Keto-PGF1a、NO显著升高（P〈0．01）。但仍低于健康对照组（P〉0．05）。结论 中药复原胶囊升高血液6-Keto-PGF1a、NO水平，降低TXB2、ROS水平，这可能与复原胶囊改善血管内皮细胞（vessel endothelial cell，VEC）功能、恢复VEC的正常结构和功能有关。     

高原地区健康老年人同型半胱氨酸水平与血管内皮细胞功能的相关性

血管内皮细胞（VEC）功能损伤是冠心病发病机制之一。同型半胱氨酸（Hcy）是冠状动脉疾病、脑血管疾病、外周血管闭塞性疾病的独立危险因素。我们在临床观察中发现，长期居住在高原缺氧环境下的健康人群，特别是中老年人是心、脑血管疾病和外周血管闭塞性疾病发病的高危人群。我们对高原地区健康老年人血液中Hcy水平与代表VEC功能指标的可溶性血管内皮细胞黏附分子-1（sVCAM-1）、一氧化氮（NO）含量和一氧化氮合酶（NOS）活性进行检测分析，旨在为该地区健康老年人心脑血管疾病的发生、发展提供研究依据。     

Cinedefecography and electromyography in the diagnosis of nonrelaxing puborectalis syndrome

A prospective study was undertaken to assess the correlation between electromyography (EMG) and cinedefecography (CD) for the diagnosis of nonrelaxing puborectalis syndrome (NRPR). Clinical criteria for NRPR included straining, incomplete evacuation, tenesmus, and the need for enemas, suppositories, or digitation. EMG criteria included failure to achieve a significant decrease in electrical activity of the puborectalis (PR) during attempted evacuation. CD criteria included either paradoxical contraction or failure of relaxation of the PR along with incomplete evacuation. In addition, other etiologies for incomplete evacuation, such as rectoanal intussusception or nonemptying rectocele, were excluded by proctoscopy and defecography in all cases. One hundred twelve patients with constipation, 81 females and 31 males, with a mean age of 59 (range, 12–83) years were studied by routine office evaluation, CD, and EMG. Forty-two patients (37 percent) had evidence of NRPR on CD (rectal emptying: none, 24; incomplete, 18). Twenty-eight of these patients (67 percent) also had evidence of NRPR on EMG. EMG findings of NRPR were present in 12 of 70 patients (17 percent) with normal rectal emptying. Conversely, 14 of 72 patients (19 percent) with normal PR relaxation on EMG had an NRPR pattern on CD. The sensitivity and specificity for the EMG diagnosis of NRPR were 67 percent and 83 percent, and the positive and negative predictive values were 70 percent and 80 percent, respectively. Conversely, if EMG is considered as the ideal test for the diagnosis of NRPR, CD had a sensitivity of 70 percent, a specificity of 80 percent, and positive and negative predictive values of 66 percent and 82 percent, respectively. In summary, sensitivity, specificity, and predictive values of EMG and CD are suboptimal. Therefore, a combination of these two tests is suggested for the diagnosis of NRPR.Poster presentation at the meeting of The American Society of Colon and Rectal Surgeons, San Francisco, California, June 7 to 12, 1992.Dr. Ger was a visiting colorectal surgeon from the Section of Colon and Rectal Surgery, Department of Surgery, National Defense Medical Center and Tri-Service General Hospital, Taipei, Taiwan, R.O.C.     

Les allergènes de l’arachide et des fruits à coque

The foods contain several hundreds of proteins for which only a small number, called allergens, is responsible for allergic reactions. The edible tree nuts (almond, walnut, cashew, Brazil nut, macadamia nut, pecan, Nangai nut, pistachio, pine nut, chestnut and coconut) consist of approximately, 15% of proteins. The objective of this review is to present, from a biochemical point of view, the allergens of these nuts known at the present time and to discuss what this type of information can bring in the comprehension of the mechanisms of cross reaction.     

Étiologies et orientation diagnostique devant un flush

The flush is a transient and recurrent erythema of the upper region of the body, due to a sudden arterial dilatation. First, physicians should confirm the flush and ascertain the location and timing of skin manifestations. The rapid onset and location of the skin rash to the face and anterior chest are the main characteristics of flush. In most of the cases, the flush is emotional, but this should remain a diagnosis of exclusion, as flush may be the presenting manifestation of many systemic or neoplastic disorders. Therefore, a comprehensive diagnostic work-up is necessary, including clinical, biological, and imaging testing. Neoplastic and endocrine causes of flush include VIPoma, carcinoid syndrome, medullary thyroid cancer, mastocytosis, renal cell carcinoma, and pheochromocytoma. Mast cell activation syndrome has been recently described, but it remains a diagnosis of exclusion. This review will first present the different causes of flush, and then will propose a diagnostic algorithm for the physician.     

Normativa sobre el tratamiento de las bronquiectasias en el adulto

In 2008, the Spanish Society of Pulmonology (SEPAR) published the first guidelines in the world on the diagnosis and treatment of bronchiectasis. Almost 10 years later, considerable scientific advances have been made in both the treatment and the evaluation and diagnosis of this disease, and the original guidelines have been updated to include the latest therapies available for bronchiectasis. These new recommendations have been drafted following a strict methodological process designed to ensure quality of content, and are linked to a large amount of online information that includes a wealth of references. The guidelines are focused on the treatment of bronchiectasis from both a multidisciplinary perspective, including specialty areas and the different healthcare levels involved, and a multidimensional perspective, including a comprehensive overview of the specific aspects of the disease. A series of recommendations have been drawn up, based on an in-depth review of the evidence for treatment of the underlying etiology, the bronchial infection in its different forms of presentation using existing therapies, bronchial inflammation, and airflow obstruction. Nutritional aspects, management of secretions, muscle training, management of complications and comorbidities, infection prophylaxis, patient education, home care, surgery, exacerbations, and patient follow-up are addressed.     

Polypharmacy prevalence among older adults based on the survey of health,ageing and retirement in Europe

Polypharmacy, a common condition among the elderly, is associated with adverse outcomes, including increased healthcare costs, due to higher mortality, falls and hospitalizations rates, adverse drug reactions, drug–drug reactions and medication nonadherence. This study aims to evaluate the prevalence and factors related to polypharmacy in older adults across 17 European countries, plus Israel.In this cross-sectional analysis, we used data from participants aged 65 or more years from Wave 6 of the Survey of Health, Ageing, and Retirement in Europe (SHARE) database. Polypharmacy was defined as the concurrent use of five or more medications. Age, gender, education, physical inactivity, number of limitations with activities of daily living, network satisfaction, quality of life, depression, number of chronic diseases and difficulty taking medication variables were found to be associated with polypharmacy.Our results showed a prevalence of polypharmacy ranging from 26.3 to 39.9%. Switzerland, Croatia and Slovenia were the countries with the lowest prevalence, whereas Portugal, Israel and the Czech Republic were the countries where the prevalence of polypharmacy was the highest. Age, gender, number of limitations with activities of daily living, number of chronic diseases, quality of life, depression, physical inactivity, network satisfaction, difficulty in taking medications, years of education and shortage of money were significant variables associated with polypharmacy.Polypharmacy is a highly prevalent condition in the elderly population. Identification of variables associated with polypharmacy, such as those identified in this study, is important to identify and monitor elderly groups, which are most vulnerable to polypharmacy.     

Evaluation of enzyme-linked immunosorbent assay (ELISA) and enzyme-linked immunoelectrotransfer blot (EITB) for immunodiagnosis of hydatid diseases in sheep

This study was undertaken to investigate antigenic characteristics of hydatid cyst fluid in sheep by SDS-PAGE method, to evaluate sensitivity and specificity of Enzyme-linked immunosorbent assay (ELISA) and Enzyme-linked immunoelectrotransfer blot (EITB) assay for diagnosis of sheep hydatidosis, and to determine seroprevalance of hydatidosis in sheep population in Elazig, Turkey. SDS-PAGE analysis of hydatid cyst fluids indicated that 6 specific-protein bands were detected at molecular weights of 29, 45, 58, 68, 98 and 116 kDa. EITB analysis showed presence of 29, 38, 42, 58, 62, 68, 98, 116, 120, 150 and 205 kDa bands in positive sheep sera, while 38, 58, 62, 68, 116 and 205 kDa bands were detected in negative sheep sera. Therefore, it was concluded that the 116 kDa band was specific for diagnosis of sheep hydatid disease by EITB assay. Sensitivity and specificity of EITB assay were determined as 88% and 84%, respectively, whereas corresponding rates for ELISA were 60% and 94%, respectively. Sensitivity of ELISA was 47.3% in hepatic cysts, 60% in pulmonary cysts, 69.2% in hepato-pulmonar cysts. Sensitivity ratios of ELISA were 67.8%, 75%, and 38.4% for fertile, sterile, and under-growth cysts, respectively. Sensitivity of EITB was found 84.2% in hepatic cysts, 80% in pulmonary cysts, and 92.3% in hepato-pulmonar cysts. Corresponding ratios for sensitivity of EITB for fertile, sterile, calcified, and under growth cysts were 92.8%, 75%, 100%, and 84.6%, respectively. In addition, seroprevalance of hydatidosis in sheep was found as 62% by ELISA and 66.4% by EITB in Elazig, Turkey and seroprevalance increased by age.     

Infecciones relacionadas con el uso de los catéteres vasculares

Venous catheter-related infections are a problem of particular importance, due to their frequency, morbidity and mortality, and because they are potentially preventable clinical processes. At present, the majority of hospitalized patients and a considerable number of outpatients are carriers of these devices. There has been a remarkable growth of knowledge of the epidemiology of these infections, the most appropriate methodology for diagnosis, the therapeutic and, in particular, the preventive strategies. Multimodal strategies, including educational programs directed at staff and a bundle of simple measures for implementation, applied to high-risk patients have demonstrated great effectiveness for their prevention. In this review the epidemiology, the diagnosis, and the therapeutic and preventive aspects of these infections are updated.     

Clustering of colorectal cancer in families of probands under 40 years of age

Although sporadic colorectal cancer (CRC) is relatively uncommon in the young, it may constitute an elevated genetic risk for CRC in these individuals. PURPOSE: This study was designed to determine extent of colorectal cancer in families of probands under 40 years of age. METHODS: Medical records of all consecutive patients, 40 years of age or younger at the time of CRC surgery, during the time period 1986 to 1994 were examined. Cases of familial adenomatous polyposis and ulcerative colitis were excluded.Via interviews of surviving probands or nearest relatives, dates of birth and death, causes of death, and diagnosis of cancer were recorded on all first-degree relatives (parents, siblings, and offspring), second-degree relatives (grandparents, aunts, and uncles), and any other relatives. RESULTS: A total of 128 patients, 40 years of age or less at time of CRC resection, were identified. Of these, 45 probands/families were reached by phone, and 45 detailed family histories were obtained. Age range of these 45 probands was 19 to 40 (mean, 33.1) years. In 25 families there was no history of CRC in first-degree, second-degree, or third-degree relatives. Eight of 45 probands (17.8 percent) had at least one first-degree relative with CRC, and three of these eight families fulfilled the Amsterdam criteria for hereditary nonpolyposis colorectal cancer (HNPCC). In all three families, inheritance of CRC appeared to segregate with the maternal side of the family. In addition, 5 of 43 non-HNPCC probands had at least one first-degree, second-degree, or third-degree relative less than 40 years of age, at time of CRC diagnosis. CONCLUSION: Ascertainment of a detailed family history in early age of onset CRC patients identifies frequent familial clustering of CRC and HNPCC in 17.8 percent of cases.Dr. Guillem is recipient of a Career Development Award from the American Cancer Society and a research grant from The New York District Council of Carpenters Benefits Fund.Poster presentation at the meeting of The American Society of Colon and Rectal Surgeons, Montreal, Quebec, Canada, May 7 to 12, 1995.     

Bactericidal and anti-adhesive properties of culinary and medicinal plants against Helicobacter pylori

AIM: To investigate the bactericidal and anti-adhesive properties of 25 plants against Helicobacter pylori (H pylori). METHODS: Twenty-five plants were boiled in water to produce aqueous extracts that simulate the effect of cooking. The bactericidal activity of the extracts was assessed by a standard kill-curve with seven strains of H pylori. The anti-adhesive property was assessed by the inhibition of binding of four strains of FITC-labeled H pylori to stomach sections. RESULTS: Of all the plants tested, eight plants, including Bengal quince, nightshade, garlic, dill, black pepper, coriander, fenugreek and black tea, were found to have no bactericidal effect on any of the isolates. Columbo weed, long pepper, parsley, tarragon, nutmeg, yellow-berried nightshade, threadstem carpetweed, sage and cinnamon had bactericidal activities against H pylori, but total inhibition of growth was not achieved in this study. Among the plants that killed H pylori, turmeric was the most efficient, followed by cumin, ginger, chilli, borage, black caraway, oregano and liquorice. Moreover, extracts of turmeric, borage and parsley were able to inhibit the adhesion of H pylori strains to the stomach sections. CONCLUSION: Several plants that were tested in our study had bactericidal and/or anti-adhesive effects on H pylori. Ingestion of the plants with anti-adhesive properties could therefore provide a potent alternative therapy for H pylori infection, which overcomes the problem of resistance associated with current antibiotic treatment.     

Sexually transmitted diseases of the colon,rectum, and anus

During the past two decades, an explosive growth in both the prevalence and types of sexually transmitted diseases has occurred. Up to 55 percent of homosexual men with anorectal complaints have gonorrhea; 80 percent of the patients with syphilis are homosexuals. Chlamydia is found in 15 percent of asymptomatic homosexual men, and up to one third of homosexuals have active anorectal herpes simplex virus. In addition, a host of parasites, bacterial, viral, and protozoan are all rampant in the homosexual population. Furthermore, the global epidemic of AIDS has produced a plethora of colorectal manifestations. Acute cytomegalovirus ileocolitis is the most common indication for emergency abdominal surgery in the homosexual AIDS population. Along with cryptosporidia and isospora, the patient may present to the colorectal surgeon with bloody diarrhea and weight lossbefore the diagnosis of human immunodeficiency virus (HIV) disease. Other patients may present with colorectal Kaposi's sarcoma or anorectal lymphoma, and consequently will be found to have seropositivity for HIV. However, in addition to these protean manifestations, one third of patients with AIDS consult the colorectal surgeon with either condylomata acuminata, anorectal sepsis, or proctitis before the diagnosis of HIV disease. Although aggressive anorectal surgery is associated with reasonable surgical results in some asymptomatic HIV positive patients, the same procedures in AIDS (symptomatic HIV positive) patients will often be met with disastrous results. It is incumbent upon the surgeon, therefore, to recognize the manifestations of HIV disease and diagnose these conditions accordingly.Read at the meeting of The American Society of Colon and Rectal Surgeons, St. Louis, Missouri, April 29 to May 4, 1990.