sp600125对乙醛刺激的大鼠肝星状细胞增殖及bcl-2、c-myc蛋白表达的影响

肝星状细胞（HSC）的活化与增殖是肝纤维化发生的关键环节。乙醛刺激HSC活化与增殖，是导致酒精性肝纤维化发生的关键因素。研究表明，丝裂原活化蛋白激酶（MAPK），包括细胞外信号调节激酶（ERK）、JNK、P38是HSC活化与增殖导致肝纤维化发生的主要信号传导通路之一。乙醛刺激HSC中JNK磷酸化水平随sp600125（JNK信号传导通路特异性阻断剂）浓度增加而减少。本实验用sp600125处理乙醛刺激的HSC，观察sp600125对HSC增殖以及bcl-2、c-myc蛋白表达的影响，以探讨酒精性肝纤维化的发生机制。     

细胞外信号调节激酶调控乙醛对肝星状细胞的影响

目的 观察PD98059(特异性丝裂原细胞外信号反应激酶阻断剂)调控乙醛刺激大鼠肝星状细胞(HSC)周期，影响细胞增殖、Ⅰ型胶原蛋白分泌及转化生长因子(TGF)β1 mRNA表达。方法 不同浓度PD98059对乙醛刺激的HSC进行处理；流式细胞仪检测细胞周期，MTT法检测细胞增殖变化，ELISA法检测HSC内Ⅰ型胶原蛋白分泌，RT-PCR法检测HSC内TGFβ1 mRNA表达。结果 PD98059能剂量依赖性地影响乙醛刺激的HSC周期，使G0／G1期细胞百分比增高，S期细胞减少，从而抑制乙醛刺激的HSC增殖、HSC内Ⅰ型胶原蛋白分泌及TGFβ2mRNA表达。结论 细胞外信号调节激酶信号通路影响乙醛刺激的大鼠HSC增殖Ⅰ型胶原蛋白分泌及TGFβ1mRNA表达。     

钙通道阻滞剂维拉帕米抑制肝星状细胞活化和功能

探讨维拉帕米（Ver）对人肝星状细胞系（HSC）-LX2的活化及分泌转化生长因子（TGF-β）的抑制作用。方法体外用内皮素-1（endothelin,ET-1）刺激HSC-LX2活化建立培养体系,设对照、ET-1和ET-1＋Ver 3组,对照组仅加入培养基,ET-1组加入ET-1和培养基,ET-1＋Ver组加入ET-1、Ver和培养基,分别在（0、12、24、48、72 h）观察HSC分沁α-平滑肌肌动蛋白（α-SMA）和细胞因子的能力,采用细胞爬片和免疫组化技术鉴定活化HSC的细胞形态;流式细胞术分析HSC表达α-SMA水平,ELISA测定不同组HSC分泌TGF-β的浓度。结果与对照组比较,ET-1组HSC活化和分泌TGF-β的能力较强（P〈0.05）;与ET-1组比较,ET-1＋Ver组HSC活化和分泌TGF-β能力较弱（P〈0.05）。结论 Ver体外实验中能抑制HSC的增殖和活化,具有潜在的抗纤维化作用。     

丹参酚酸B对大鼠肝星状细胞中丝裂原激活的蛋白激酶通路的抑制作用

目的 探讨丹参酚酸B(SA-B)对活化的大鼠肝星状细胞(HSC)中丝裂原激活的蛋白激酶(MAPK)信号传导通路的抑制作用。方法 分离大鼠HSC，于无包被塑料培养皿中原代培养7d，继以10^-6mol／L浓度的SA-B孵育，再加10ng／ml的转化生长因子-β1(TGF-β1)刺激。以蛋白印迹法观察SA-B对TGF-β1刺激的HSC内细胞外调节的蛋白激酶(ERK)表达及其磷酸化和对HSC表面TGF-β1 I型受体(TβRI)，Ⅱ型受体(TβRⅡ)表达的影响，观察由此改变致HSC合成Ⅰ型胶原蛋白的变化。ELISA法测定HSC培养液中Ⅰ型胶原的含量。酶谱法观察基质金属蛋白酶2，9、13(MMP-2、MMP-9、MMP-13)的活性。结果 10^-6mol／L浓度的SA-B可抑制原代正常培养9d的HSC及TGF-β1刺激的HSC中ERK1／2的磷酸化，对TβRⅠ和TβRⅡ的表达无影响。SA-B可抑制原代正常培养的HSC合成Ⅰ型胶原，抑制TGF-β1刺激的HSCⅠ型胶原的合成及分泌。SA-B对HSC培养液中MMP-2和MMP-13的活性无明显作用，对MMP-9活性则有明显的促进作用。结论 SA-B抑制了正常原代培养已活化的HSC和经TGF-β1刺激的HSC内ERK信号传导通路，这一抑制作用与HSC的TGF-β1受体表达无关。SA-B通过抑制TGF-β1的信号传导，减少了HSC对Ⅰ型胶原的合成与分泌，此种细胞功能的改变可能与基质金属蛋白酶的降解作用无关。     

粉防己碱对大鼠肝星状细胞跨膜信号转导的影响

粉防己碱（Tet）是抗肝纤维化的有效药物，这一作用可能与Tet对肝星状细胞（HSC）活化的直接抑制作用有关。最近在动物实验发现较低浓度Tet（2.5-5mg/kg）亦有较强的抗肝纤维化作用，为进一步了解低浓度Tet抗肝纤维化的作用机制，本研究观察低剂量Tet对静止期HSC培养活化和转化生长因子β1（TGFβ1）促其活化作用影响，以及此过程中TGFβ和其下游Smads信号蛋白的表达变化。     

人纤维化肝组织中胞外信号调节激酶的表达

目的观察胞外信号调节激酶（ERK1）在人纤维化肝组织中的表达，探讨ERK1在肝纤维化发生中的作用机制。方法采用SABC免疫组化方法，对2001—01～2003—12华中科技大学附属同济医学院及广西壮族自治区人民医院外科手术切除的诊断明确的44例病理存档标本（其中包括12例正常肝组织、32例慢性乙型病毒性肝炎和肝硬化组织）中ERK1的表达及分布进行检测。结果免疫组化显示，ERK1主要表达于肝星状细胞（HSC）中。正常肝组织中，仅在汇管区少量非实质细胞中见ERK1弱阳性表达。在纤维化肝组织中，ERK1表达水平明显增强，与正常肝组织相比差异有显著性（P〈0．01）。结论ERK激活促进了HSC活化增殖，参与了肝纤维化的发生发展过程。     

瘦素促进大鼠肝星状细胞活化及其细胞外信号调节激酶磷酸化

近年研究发现，瘦素在肝纤维化病理形成中具有重要意义，可促进实验性动物肝脏炎症与纤维化病理发展。但是瘦素是否直接促进肝纤维化形成的关键细胞——肝星状细胞（HSC）活化尚不清楚。本实验采用大鼠HSCT6细胞株，观察不同浓度的瘦素对HSC-T6增殖、α-平滑肌肌动蛋白（α-SMA）与Ⅰ型胶原蛋白表达的作用．及其对细胞外信号调节激酶（ERK）磷酸化的影响．探讨瘦素对HSC活化的影响与部分作用机制。     

抗结缔组织生长因子小干扰RNA对鼠原代肝星状细胞增殖的影响

细胞外基质（ECM）积聚与活化肝星状细胞（HSC）数量密切相关，增殖是活化HSC的重要生物学特性之一，也是调控活化HSC数量的一种重要方式，结缔组织生长因子（CTGF）主要由活化HSC产生，是HSC增殖的一个重要刺激因子。     

转化生长因子β对肝星状细胞活化的调控作用

在肝纤维化过程中,TGFβ被认为是引起肝星状细胞(HSC)活化及细胞外基质产生的重要调控因子,因此,靶向TGFβ引起的HSC活化和肝纤维化的治疗策略值得深入研究。介绍了近几年来有关TGFβ对HSC的活化作用及其相关调控、靶向TGFβ活化HSC的治疗策略,以期为肝纤维化的临床治疗提供理论依据与新思路。     

阻断Wnt-β-catenin信号通路对肝星状细胞活化的影响

目的探讨活化的肝星状细胞（HSC）内是否存在功能性的Wnt-β-catenin信号通路的激活，以及阻断该信号通路对HSC活化的影响。方法免疫细胞化学染色检测β-catenin在HSC-T6细胞内的表达。通过转染T细胞因子（T-cellfactor，TCF）依赖的荧光素酶报告质粒（pTOPFI。ASH）测定HSC—T6细胞内的Wnt-β-catenin信号。将TCF的显性负性突变体dnTCF表达质粒转染HSC-T6阻断Wnt-β-catenin信号的转导，用Western印迹法检测α-平滑肌肌动蛋白（α-SMA）及Ⅰ型胶原表达变化。结果HSC-T6细胞核内有β-catenin的表达；转染pTOPFLASH的细胞荧光素酶活性显著高于转染pFOPFLASH的对照组（P〈0．01）；与转染空质粒的对照组相比，转染dnTCF的HSC-T6细胞α-SMA及Ⅰ型胶原表达分别下降52．9％和37．5％（P〈0．05）。结论活化的HSC中存在Wnt-β-catenin信号通路的激活，阻断该信号通路可抑制活化HSC的功能。     

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。