氟哌噻吨美利曲辛片对非糜烂性反流病患者血清超氧化物歧化酶及脂质过氧化物的影响

目的探讨氟哌噻吨美利曲辛片对非糜烂性反流病患者血清超氧化物歧化酶(SOD)及脂质过氧化物(LPO)的影响。方法选取100例伴心理障碍的非糜烂性反流病患者作为研究对象,随机分为对照组与观察组。对照组采用埃索美拉唑镁肠溶片加维生素B1、维生素B6治疗。结果治疗后,两组患者的反酸、胃灼热、胸痛等症状均有一定程度的改善,观察组患者改善为显著(P<0.05)。Hamilton抑郁量表积分显示观察组积分有明显下降,与对照组相比差异显著(P<0.05)。观察组患者的治疗有效率为92%,明显高于对照组(78%)(P<0.01)。治疗后,观察组SOD水平为(27.08±3.25)kU/L,高于对照组的(23.75±2.98)kU/L(P<0.01)。治疗后,观察组LPO水平为(4.15±1.37)mol/L,低于对照组的(4.84±1.26)mol/L(P<0.01)。结论氟哌噻吨美利曲辛片治疗老年非糜烂性反流病伴心理障碍患者的疗效可靠,并具有明显改善自由基代谢紊乱的作用。     

冠状动脉慢血流现象与血清脂质过氧化水平的关系

目的: 观察冠状动脉慢血流现象（CSF）患者血清脂质过氧化水平的变化,并探讨CSF的影响因素。方法: 采用TIMI帧计数（TFC）法作为测定CSF的指标,将入选病例分为两组:CSF组35例,正常对照组35例,均排除既往冠心病、心肌病及其他类型心脏病。采用生化法测定血清中超氧化物歧化酶（SOD）,谷胱甘肽过氧化物酶（GSH-PX）,丙二醛（MDA）,过氧化脂质（LPO）的含量。结果: CSF组的血清MDA、LPO明显高于对照组［MDA:（18.9±2.0）μmol/L vs.（10.5±1.3）μmol/L,P<0.01］,［LPO:（2.8±0.4）μmol/L vs.（1.9±0.2）μmol/L,P<0.01］;CSF组血清GSH-PX明显高于对照组［GSH-PX:（0.22±0.04）μmol/L vs.（0.20±0.03）μmol/L,P<0.05］。CSF组血清SOD明显低于对照组［SOD:（72±11）kU/L vs.（79±10）kU/L,P<0.01］。在校正体质量指数、总胆固醇、尿素氮等后CSH-PX、MDA、LPO是CSF的危险因素（分别OR=3.987、4.782、3.381;分别为P<0.05、P<0.01、P<0.01）。SOD则是其保护因素（OR=0.892,P<0.05）。结论: CSF患者血清SOD下降,MDA、LPO、GSH-PX上升,体内氧化应激增强。     

血浆P物质和血管活性肠肽在糖尿病伴胃食管反流病中表达及意义

目的:探讨了糖尿病伴胃食管反流病(gastroesophageal reflux disease,GERD)患者血浆中P物质(substance P,SP)和血管活性肠肽(vasoactive intestinal peptide,VIP)表达状况,并分析其表达的临床意义.方法:选取2012-01/2013-12海南省农垦总医院40例糖尿病伴胃食管反流病患者为A组,40例糖尿病患者为B组,40例胃食管反流病患者为C组,另外选取同期医院体检健康的40名作为D组,对4组血浆中SP与VIP进行测定,观察其表达并分析其临床意义.结果:A、B、C组血浆中SP含量均明显低于D组(46.2 ng/L±6.8 ng/L,62.4 ng/L±7.5 ng/L,61.7 ng/L±7.3 ng/L vs 86.2 ng/L±9.5 ng/L,P0.05),而VIP均明显高于D组(84.6 ng/L±11.5 ng/L,68.9 ng/L±8.6n g/L,70.4 n g/L±8.4 n g/L vs 47.9 n g/L±5.8 ng/L,P0.05).A组SP含量明显低于B组和C组(P0.05),但VIP含量明显高于B组和C组(P0.05).A组病程时间≤10年的S P明显低于病程时间10年的患者(36.2 ng/L±4.6 ng/L vs 56.3 ng/L±7.3 ng/L,P0.05);而VIP则高于病程时间10年的患者(91.4n g/L±10.2 n g/L v s 70.5 n g/L±9.5 n g/L,P0.05).S P与糖尿病病程呈负相关性(r=-0.35,P0.05);VIP则呈正相关性(r=0.41,P0.05).结论:糖尿病伴胃食管反流病患者血浆中SP呈低表达,VIP呈高表达,二者的表达均与糖尿病伴胃食管反流病的发生发展有着密切的联系,在临床中具有重要的意义.     

康复新液联合美沙拉嗪治疗溃疡性结肠炎的疗效及对患者炎性因子和氧化应激水平的影响

目的:探讨康复新液灌肠联合美沙拉嗪口服治疗溃疡性结肠炎(ulcerative colitis,UC)的疗效及对患者炎性因子和氧化应激水平的影响.方法:160例符合纳入标准的UC患者按治疗方法分为对照组(n=80)和观察组(n=80).对照组给予美沙拉嗪口服治疗,观察组在对照组的基础上联合应用康复新液灌肠治疗.疗程结束后,比较两组患者疗效、炎性因子及血清超氧化物歧化酶(superoxide dismutase,SOD),一氧化氮(nitric oxide,NO),过氧化脂质(lipid peroxidase,LPO)的水平改变情况.结果:观察组的总治疗有效率为96.2%,明显高于对照组的85.0%(P0.05).治疗后,与对照组相比,观察组肿瘤坏死因子α(tumor necrosis factorα,TNF-α)、白介素6(i n terleukin 6,I L-6)和I L-8水平明显下降(127.8 ng/m L±21.4 ng/m L vs 190.7 ng/m L±22.4 ng/m L,81.7 ng/m L±11.3 ng/m L vs125.6 ng/m L±10.7 ng/m L,0.4 ng/m L±0.1ng/m L vs 0.6 ng/m L±0.2 ng/m L,P0.05),SOD水平明显升高(51.7 U/m L±3.9 U/m L vs34.4 U/m L±3.2 U/m L,P0.05),NO和LPO水平明显降低,比较差异有统计学意义(8.2 U/m L±1.8 U/m L vs 12.5 U/m L±2.1 U/m L,5.8mol/L±0.4 mol/L vs 6.5 mol/L±0.3 mol/L,均P0.05).结论:康复新液灌肠联合美沙拉嗪口服是U C的一种有效治疗方案,可以提高治疗有效率,减轻炎性反应,增强氧自由基清除能力,临床上值得进一步研究.     

银杏天宝对大鼠实验性结肠炎抗氧化作用的影响

目的:在三硝基苯磺酸灌肠诱导大鼠实验性结肠炎模型中,研究银杏天宝(EGB)的治疗作用及其抗氧化损伤作用的机制.方法:应用三硝基苯磺酸(TNBS)/乙醇灌肠制备大鼠实验性结肠炎模型.实验设正常对照组,三硝基苯磺酸模型组,阳性药物对照组(5-ASA group,100 mg/kg),EGB组(200 mg/kg) 4组.观察大鼠肠组织大体形态和组织学评分.生化法检测大鼠肠组织超氧化物歧化酶(SOD),谷胱苷肽过氧化物酶(GSH-Px)活性及丙二醛(MDA),一氧化氮(NO)含量.免疫组化检测肠组织诱导型一氧化氮合酶(iNOS)蛋白的表达.结果:与模型组相比,EGB组结肠组织iNOS表达明显减少,NO、MDA明显降低(iNOS:19.60%±3.17% vs 81.36%±1.71%;NO:9.20±0.81μmol/g vs 14.77±1.34μmol/g;MDA:3.96±0_35 umol/g vs 6.06±0.39 umol/g;P<0.01):SOD、GSH-Px活性明显升高(SOD:32.52±1.82 kU/g vs 21.90±2.22 kU/g;GSH- Px:49.91±2.59 kU/g vs 41.26±2.90 kU/g;P<0.01).EGB能明显减少大鼠实验性结肠炎模型组大体形态和组织学评分(2.10±0.57vs 3.10±0.57:3.50±0.85 vs 4.7±0.82;P<0.01).结论:EGB可能通过抑制氧自由基反应,抗氧化损伤,抑制NO生成,来减轻结肠炎炎症反应.     

抗反流治疗联合噻托溴铵对慢性阻塞性肺病伴胃食管反流病的临床疗效

目的:探讨抗反流治疗联合噻托溴铵对伴有胃食管反流的慢性阻塞性肺病(chonic obstructive pulmonary disease,COPD)患者的临床疗效.方法:选取2014-01/2014-12在沧州和平医院就诊的48例COPD合并胃食管反流病(gastroesophageal reflux disease,GERD)患者作为研究对象,随机分为观察组和对照组,各24例,观察组给予埃索美拉唑、莫沙必利及噻托溴铵粉吸入剂治疗,对照组单纯给予噻托溴铵粉吸入剂治疗,比较两组患者治疗前后胃食管反流病评分量表(Gastroesophageal Reflux Disease-Q,GERD-Q)评分、慢性阻塞性肺病急性发作(AECOPD)次数以及临床疗效.结果:两组患者治疗1年后,GERD-Q评分:观察组明显下降(9.83±2.65 vs 15.23±3.75,P0.001),对照组下降不显著(13.32±3.02 vs 14.98±3.64,P0.05);两组患者AECOPD次数较治疗前均下降:观察组(1.08±0.30 vs 1.59±0.34),对照组(1.33±0.31 vs 1.60±0.41).而观察组较对照组下降更明显(1.08±0.30 vs 1.33±0.31,P0.01);临床疗效:两组COPD症状改善比较(91.6%vs 87.50%,P0.05),观察组GERD症状显著优于对照组(95.83%vs 66.67%,P0.01).结论:临床中对稳定期COPD合并GEGD患者给予抗反流治疗联合噻托溴铵是可行的,可有效改善GERD-Q评分、降低AECOPD次数、临床疗效显著.     

三梗降气汤联合针灸治疗非糜烂性胃食管反流病患者疗效观察

目的观察三梗降气汤联合针灸治疗非糜烂性胃食管反流病的临床疗效。方法选取2016年7月至2017年7月我院收治非糜烂性胃食管反流病患者92例,运用随机数字表法分为对照组与观察组,每组46例。对照组患者采用三梗降气汤治疗,观察组患者采用三梗降气汤联合针灸治疗,疗程12周。比较两组患者的临床疗效;检测比较两组患者治疗前后的血清胃肠激素水平、血管活性肠肽水平以及两组患者治疗后食管内24 h p H值的变化情况。结果治疗12周,观察组患者的临床疗效优于对照组,观察组患者的治疗总有效率(95.65%)显著高于对照组(78.36%),差异有统计学义(P0.05);治疗后观察组患者餐前、餐后的胃动素以及胃泌素水平均显著高于对照组,血管活性肠肽水平显著低于对照组,差异均有统计学意义(P0.01);观察组患者24 h内食管内p H值的变化情况优于对照组(P0.01)。结论三梗降气汤联合针灸治疗非糜烂性胃食管反流病患者,可提高患者的胃动素和胃泌素水平,降低血管活性肠肽水平,抑制胃酸分泌,提升胃动力,提高治疗效果,值得在临床推广应用。     

早发型与晚发型帕金森病患者血浆抗氧化应激指标分析

目的研究早发型与晚发型帕金森病(Parkinsons disease,PD)患者血浆抗氧化应激指标的差异性,并探讨其与临床特点的相关性。方法入选原发性PD患者62例(PD组),PD组根据发病年龄,分为早发型PD组35例和晚发型PD组27例;另入选健康体检者20例(对照组)。使用ELISA检测血浆谷胱甘肽(GSH)、过氧化氢酶(CAT)、超氧化物歧化酶(SOD)和谷胱甘肽过氧化物酶(GPX)水平,比较各组间差异,并对发病年龄与血浆抗氧化应激指标进行相关性分析。结果 PD组患者血浆GSH[(18.42±14.64)μmol/L vs(79.32±64.48)μmol/L]、CAT[(160.87±10.49)kU/L vs(171.11±4.00)kU/L]、SOD[(93.58±24.17)kU/L vs(122.33±22.83)kU/L]水平明显低于对照组(P<0.01);早发型PD组患者血浆GSH水平明显高于晚发型PD组(P<0.05)。发病年龄与血浆GSH呈负相关(P<0.01)。结论 PD患者血浆GSH、CAT、SOD水平异常下降,提示PD患者存在抗氧化能力缺陷;早发型与晚发型PD患者血浆GSH水平具有显著差异性,发病年龄愈晚,血浆GSH水平愈低。     

酒精性肝病患者淋巴细胞染色体损伤与氧化应激的关系

目的:探讨酒精性肝病(alcoholic liver disease,ALD)患者外周血淋巴细胞染色体损伤与体内氧化应激之间的关系.方法:采用胞质分裂阻滞法微核实验、硫代巴比妥酸显色法和黄嘌呤氧化酶法分别检测31例ALD患者和22例健康体检者外周血淋巴细胞染色体损伤情况、血浆丙二醛(MDA)含量及超氧化物歧化酶(SOD)活性.结果:病例组与对照组血浆MDA含量分别为5.88 μmol/L±2.62 μmol/L和2.89 μmol/L±1.33 μmol/L,SOD活性分别为49.28 kU/L±6.03 kU/L和57.35 kU/L±4.96 kU/L,血浆MDA含量随着SOD活性的降低而增高,两组各指标之间有显著性差异(P<0.01),且病例组MDA含量与SOD活性变化之间呈负相关(r=-0.454,P<0.05).此外,病例组微核率高于对照组,两组相比有显著性差异(P<0.01).病例组MDA含量与微核率存在正相关(r=0.493,P<0.01),而SOD活性与微核率存在负相关(r=-0.422,P<0.05).结论:ALD患者体内氧化应激在外周血淋巴细胞染色体损伤中起重要作用,提示ALD患者体内的氧化应激是其外周血淋巴细胞染色体损伤的机制之一.     

伴抑郁老年胃食管反流病的联合治疗研究

目的 调查伴抑郁老年胃食管反流病患者在联合治疗中加用舒肝解郁胶囊的疗效。方法 回顾性选择2020年5月至2022年4月在河南科技大学第五附属医院治疗的伴抑郁老年胃食管反流病患者64例,在老年科、综合内科接受莫沙必利+泮托拉唑联合治疗的32例为对照组,同期在精神科治疗的32例为观察组,观察组患者在对照组用药的基础上加用舒肝解郁胶囊。比较两组治疗效果、胃食管动力学指标、不良反应发生率及抑郁情绪改善情况等。结果 治疗后观察组患者食管括约肌松弛率、蠕动收缩比及食管括约肌压力等胃食管动力学指标均优于对照组(P<0.05),观察组不良反应总发生率(6.25%)显著低于对照组(25.00%),临床总有效率和安全性均显著增高(P<0.05),且治疗后观察组患者HAMD评分显著降低(P<0.05)。结论 伴抑郁老年胃食管反流病患者在莫沙必利+泮托拉唑治疗的基础上加用舒肝解郁胶囊,既可促进胃食管反流病缓解,又能改善抑郁症状,取得了良好的综合治疗效果。     

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.     

Angiographic diagnosis of the degree of serosal invasion of carcinoma of the colon

Angiography using Prostaglandin El^® was performed on 38 patients with carcinoma of the colon in order to diagnose the degree of serosal cancer invasion. The findings at angiography were classified into four groups:1) AG-S3, abnormal change (irregularity and/or encasement) up to marginal vessels; 2) AG-S2, abnormality up to vasa recta; 3) AG-S1, abnormality of penetrating branches of vasa recta within the wall of the colon; and 4) AG-S0, no distinct findings of abovementioned vessels. These angiographic findings were compared with both macroscopic and microscopic serosal cancer invasion. Angiographic diagnosis is in accord with the macroscopic findings in 84.2 percent of cases. Angiographic diagnosis is in accord with the microscopic findings in 32.4 percent of cases. Macroscopic findings confirm the angiographic diagnosis precisely but the conflict with microscopic findings should not be overlooked. This may be the result of inflammatory change, adhesion, and fibrosis around carcinoma of the colon.