黄参膏对胃癌癌前病变细胞凋亡及BCL—2蛋白表达的影响

目的:探讨黄参膏对胃癌癌前病变细胞凋亡及相关基因表达的影响。方法:将47例胃癌癌前病变患者随机分为2组,治疗组24例,口服黄参膏60ml/天,对照组23例,口服维酶素片12片/天,疗程2月,治疗前后检测细胞凋亡指数和 Bcl-2蛋白的表达。采用原位末端标记法(TUNEL)检测细胞凋亡,采用免疫组化检测 Bcl-2蛋白的表达。结果:黄参膏组服药前后细胞凋亡指数分别为19.8±9.6%和32.8±10.2%,服药后细胞凋亡指数显著高于服药前(P<0.05)。Bcl-2蛋白阳性率治疗前后分别为54.2%和25.0%,治疗前后比较具有显著性差异(P<0.05)。而对照组治疗前后细胞凋亡指数分别为18.9±8.5%和20.1±9.8%,治疗前后 BCL-2蛋白阳性率分别为52.5%和43.5%,对照组细胞凋亡指数和 BCL-2蛋白阳性率在服药前后比较均无显著性差异(P>0.05)。结论:黄参膏可诱导胃癌癌前病变细胞凋亡。     

阻癌胃泰对胃癌前病变Bcl-2及P53 基因蛋白的影响

[目的]探讨胃癌前病变(PLGC)Bcl-2、P53基因蛋白的表达及阻癌胃泰的治疗机制.[方法]N-甲基-N'-硝基-N-亚硝基胍溶液加胃黏膜机械损伤诱发Wistar大鼠PLGC状态.用阻癌胃泰与维酶素预防和治疗,观察对病变黏膜组织中P53、Bcl-2基因蛋白水平的影响.[结果]中药组能明显阻断化学致癌物对黏膜的炎症损伤,改善PLGC组织黏膜不典型增生程度;同时中药组治疗后Bcl-2、P53基因蛋白阳性指数亦明显低于病理对照组(P＜0.05).[结论]益气化瘀为主的阻癌胃泰通过改善PLGC大鼠气虚血瘀的病理基础,降低病变组织增殖水平,诱导细胞正常凋亡,从而对PLGC细胞的增殖有良好的阻断作用.     

阻癌胃泰对胃癌前病变Bcl-2及P53 基因蛋白的影响

[目的]探讨胃癌前病变(PLGC)Bcl-2、P53基因蛋白的表达及阻癌胃泰的治疗机制.[方法]N-甲基-N'-硝基-N-亚硝基胍溶液加胃黏膜机械损伤诱发Wistar大鼠PLGC状态.用阻癌胃泰与维酶素预防和治疗,观察对病变黏膜组织中P53、Bcl-2基因蛋白水平的影响.[结果]中药组能明显阻断化学致癌物对黏膜的炎症损伤,改善PLGC组织黏膜不典型增生程度;同时中药组治疗后Bcl-2、P53基因蛋白阳性指数亦明显低于病理对照组(P＜0.05).[结论]益气化瘀为主的阻癌胃泰通过改善PLGC大鼠气虚血瘀的病理基础,降低病变组织增殖水平,诱导细胞正常凋亡,从而对PLGC细胞的增殖有良好的阻断作用.     

盐酸小檗碱抗大鼠胃癌前病变及其作用机制

[目的]探讨盐酸小檗碱对实验性大鼠胃癌前病变的影响及与细胞凋亡和P53、Bcl-2蛋白、mRNA表达水平的关系.[方法]采用N-甲基-N-亚硝基胍饮水法建立大鼠胃癌前病变模型,用盐酸小檗碱预防和大、中、小3种剂量干预治疗,观察大鼠的一般情况,以光镜观察胃癌前病变的发生率,并运用末端DNA标记法检测凋亡率(AI),免疫组化法检测细胞中P53和Bcl-2蛋白表达,逆转录多聚酶链式反应检测P53和Bcl-2的mRNA水平.[结果]经盐酸小檗碱干预大鼠,其癌前病变的发生率明显降低,与模型组比较P＜0.05,AI显著提高,3种剂量组与模型组比较均P＜0.05,并伴有Bcl-2、突变型P53基因蛋白表达水平降低,野生型P53基因mRNA水平升高,Bcl-2基因mRNA水平下调,其中以大剂量组尤为显著,与模型组比较P＜0.01.[结论]盐酸小檗碱能预防和治疗实验性大鼠胃癌前病变,其机制与提高细胞凋亡率和调控基因表达有关.     

黄参膏对胃癌癌前病变细胞凋亡及BCL-2蛋白表达的影响

目的:探讨黄参膏对胃癌癌前病变细胞凋亡及相关基因表达的影响。方法:将46例胃癌癌前病变患者随机分为2组,治疗组28例,口服黄参膏60ml/天,对照组18例,口服维酶素片2.4g/天,疗程2月,治疗前后检测细胞凋亡指数和Bcl-2蛋白的表达。采用原位末端标记法(TUNEL)检测细胞凋亡,采用免疫组化检测Bcl—2蛋白的表达。结果:黄参膏组服药前后细胞凋亡指数分别为19.8±9.6％和32.8±16.2％,服药后细胞凋亡指数显著高于服药前(P<0.05)。Bcl-2蛋白阳性率治疗前后分别为53.6％和28.6％,治疗前后比较具有显著性差异(P<0.05)。而对照组细胞凋亡指数和Bel-2蛋白阳性率在服药前后比较均无显著性差异(P>0.05)。结论:黄参膏可诱导胃癌癌前病变细胞凋亡。     

乐胃煎对大鼠胃粘膜上皮异型增生细胞凋亡及调控基因的影响*

目的研究乐胃煎对大鼠胃粘膜上皮异型增生细胞凋亡及调控基因(Bcl-2、Fas、ICE)蛋白表达的影响,探讨乐胃煎治疗胃粘膜癌前病变的作用机制.方法用N-甲基-N-硝基-N-亚硝基胍(MNNG)建立大鼠胃粘膜异型增生模型,对大鼠胃粘膜用TUNEL法检测细胞凋亡,免疫组织化学法检测Bcl-2、Fas蛋白表达水平.结果治疗组癌前病变发生率与造模组和对照组比较,均有显著性差异(P＜0.05).Bc1-2蛋白表达率及过量表达率,治疗组与造模组比较,均有显著性差异(P＜0.05);治疗组与造模组比较,Fas蛋白表达率亦有显著性差异(P＜0.05),过表达率无显著性差异(P＞0.05).结论乐胃煎治疗可抑制大鼠胃粘膜Bcl-2基因蛋白的表达,促进Fas基因蛋白的表达,从而使胃粘膜上皮细胞发生正常凋亡,逆转或阻止胃癌的发生.     

老年急性心肌梗死猝死者心肌细胞凋亡与p53和Bcl—2蛋白表达的相关性研究

目的探讨p53和Bcl-2蛋白在老年急性心肌梗死(AMI)猝死者心肌细胞凋亡中的作用.方法用TUNEL法检测15例猝死者和10例心脏正常的车祸死亡者的心肌细胞凋亡,用免疫组化法检测p53和Bcl-2蛋白在心肌中的表达水平,并探讨它们之间的相互关系.结果 TUNEL法发现,猝死者梗死区的心肌细胞凋亡千分数老年组(663.00±117.12‰)明显高于正常对照(34.30±20.68‰)(P=0.00);p53蛋白表达阳性千分率(462.12±237.58‰)明显高于正常对照者(39.45±24.67‰)(P=0.000),且与梗死区心肌细胞凋亡数成明显的正相关性(r为0.701,P＜0.005);Bcl-2蛋白表达阳性率(40.83±31.29‰)明显低于正常对照(120.76±66.67‰)(P=0.0037),且与梗死区心肌细胞凋亡数成明显的负相关性(r为-0.840,P＜0.001);梗死区心肌细胞内p53和Bcl-2蛋白表达数之间呈明显的负相关性(r=-0.829,P＜0.001).结论 AMI猝死者梗死区心肌细胞存在明显的凋亡现象,且受p53蛋白上调、Bcl-2蛋白下调,两者相反调节其凋亡.     

胃癌及其癌前病变中转化生长因子β1、细胞周期蛋白A表达与细胞凋亡关系的研究

目的探讨转化生长因子(TGF)-β1、细胞周期蛋白(cyclin)A表达与细胞凋亡的关系及其在正常胃粘膜、非萎缩性胃炎、萎缩性胃炎、不典型增生及胃癌演化序列中的规律和可能作用。方法用免疫组化法检测TGF-β1和cyclinA的表达,用DNA原位末端标记法(TUNEL)检测细胞凋亡。结果正常胃粘膜、非萎缩性胃炎、萎缩性胃炎、不典型增生和胃癌组织的细胞凋亡指数分别为1.7％±1.6％、4.7％±5.0％、5.2％±4.7％、3.0％±3.5％和1.6％±2.5％,非萎缩性胃炎、萎缩性胃炎和不典型增生组织的凋亡指数明显高于胃癌(P＜0.05);TGF-β1的阳性表达率分别为10.0％(1/10)、25.0％(4/16)、25.0％(11/44)、60.7％(17/28)和59.5％(25/42),正常胃粘膜、非萎缩性胃炎和萎缩性胃炎组织的阳性率与不典型增生和胃癌组织相比有显著差异(P＜0.05);cyclinA的阳性表达率分别为0、6.2％(1/16)、20.5％(9/44)、46.4％(13/28)和85.7％(36/42),不典型增生和胃癌组织的阳性率有显著差异,但两者均显著高于正常胃粘膜、非萎缩性胃炎和萎缩性胃炎(P＜0.05)。结论在胃癌演化过程中,从正常胃粘膜到萎缩性胃炎,凋亡指数逐渐上升;从不典型增生期开始,凋亡指数逐渐下降。在胃癌和不典型增生组织中,TGF-β1和cyclinA的阳性表达率均显著高于正常胃粘膜、非萎缩性胃炎和萎缩性胃炎。提示TGF-β1和cyclinA的表达可能与细胞凋亡有关并在胃癌的发生、发展中具有重要作用。     

幽门螺杆菌对GC及癌前病变抑癌基因和抑制细胞凋亡基因的影响

目的 探讨幽门螺杆菌(Hp)在胃癌(GC)和癌前病变中的作用及其与抑癌基因p53、抑制细胞凋亡基因Bcl-2表达的关系.方法 选取胃镜活检标本107例,其中GC28例,异型增生(DYS)14例,肠上皮化生(IM)16例,慢性萎缩性胃炎(CAG)34例,慢性浅表性胃炎(CSG)15例.尿素酶试验和Warthin-Starry银染色检测Hp,免疫组化SP法检测p53、Bcl-2基因蛋白的表达.结果 Hp感染阳性组中GC和癌前病变的发生率高于Hp感染阴性组(P<0.05),p53、Bcl-2的阳性表达率在GC、DYS和IM中明显高于CSG(P均<0.05).结论 Hp与GC发生关系密切,持续Hp感染所致的慢性炎症可引起胃黏膜损伤,促进了p53基因的突变和Bcl-2基因的表达.     

Bowen病细胞凋亡的原位检测及p53、Bcl-2的表达

目的探讨细胞凋亡及p53、Bcl-2蛋白在Bowen病发生、发展及转归中的作用。方法运用TUNEL技术和免疫组织化学技术原位观察15例Bowen病患者的细胞凋亡及凋亡调控基因p53、Bcl-2的表达。结果Bowen病细胞凋亡指数为(15.3±9.01);P53蛋白表达阳性率为73.3%;Bcl-2蛋白表达阳性率为53.3%,且均高于对照组(P<0.01)。结论Bowen病的发病可能与细胞凋亡降低有关。     

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。     

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。     

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.     

Study of constancy of hydrogen-consuming flora of human colon

The constancy of the hydrogen consuming flora of the human colon was studied in 15 healthy subjects via two measurements obtained 18 to 36 months apart. Hydrogen disappearance rate and the major products of H₂-consuming bacteria, methane and sulfide, were measured during incubation of fecal homogenates with excess hydrogen and sulfate. In 11/15, the hydrogen consumption rate and the predominant hydrogen-consuming pathway (methanogenesis, sulfate reduction, or neither) remained constant. However, major shifts in these pathways were observed in four subjects, with two losing and two gaining the ability to produce methane. Methanogenesis was associated with the highest hydrogen consumption rate. This study demonstrates that clinically unrecognizable, major alterations of the colonic flora occur in healthy subjects. Understanding of the factors responsible for these alterations might allow for therapeutic manipulation of the colonic flora.Supported in part by the Department of Veterans Affairs and NIDDKD RO1 DK 13309-25.