葛根粗提物、葛根素对肺癌H446细胞增殖的抑制作用及其机制

目的 观察葛根粗提物(CP)和葛根素纯品(SP)对小细胞肺癌H446细胞增殖的影响,并探讨其机制.方法 用含不同浓度的SP和CP培养H446细胞,用MTT法检测细胞生长抑制率.用流式细胞术检测细胞周期和凋亡率、细胞免疫化学技术检测Bel-2和Bax蛋白.另设空白对照组和溶剂对照组.结果 CP作用72 h的半数抑制浓度(ICSO)为435μg/ml,SP为1 403μg/ml.此浓度作用72 h,细胞凋亡率分别为14.71%和2.61%,两组相比P<0.05;G0/G1期细胞构成比分别为79.20%和72.20%,G2/M期细胞构成比分别为8.94%和10.50%,与对照组相比P均<0.05;CP作用于H446细胞后,细胞内Bel-2蛋白表达量降低,Bax的蛋白表达量增加,与对照组相比P均<0.05.结论 SP和CP对小细胞肺癌H446细胞具有增殖抑制作用,呈浓度相关性;SP和CP可诱导细胞凋亡且CP强于SP,其机制可能与阻滞细胞周期于G0/G1期、上调Bax表达、下调Bel-2表达有关.     

旋毛虫肌幼虫虫体蛋白对小细胞肺癌H446细胞凋亡的影响

目的 探讨旋毛虫肌幼虫虫体蛋白对小细胞肺癌H446细胞凋亡的影响及其作用的可能机制。方法 将H446细胞与0.2 mg/mL、0.4 mg/mL、0.6 mg/mL、0.8 mg/mL、1.0 mg/mL、1.2 mg/mL虫体蛋白分别培养并设为实验组,不处理的H446细胞设为对照组,采用噻唑兰(MTT)比色法检测旋毛虫肌幼虫虫体蛋白对H446细胞增殖活性的抑制作用;采用流式细胞术(FCM)检测旋毛虫肌幼虫虫体蛋白诱导H446细胞株凋亡的情况;采用Real-timePCR及Western blot法检测细胞色素C(cytochrome C,Cyt-C)和凋亡蛋白酶活化因子(apoptotic protease activating factor 1,Apaf-1) mRNA及蛋白的表达。结果 MTT比色法结果表明虫体蛋白能够抑制H446细胞增殖活性;流式细胞术结果表明虫体蛋白作用于H446细胞24 h后,有明显的促凋亡作用;Real-timePCR及Western blot法结果显示,与阴性对照组相比,促凋亡基因Cyt-C和Apaf-1表达均上调。结论 旋毛虫肌幼虫虫体蛋白能够抑制H446细胞增殖活性,并诱导细胞凋亡,其作用可能与Cyt-C和Apaf-1表达上调有关。     

热疗联合旋毛虫肌幼虫排泄分泌蛋白对小细胞肺癌H446凋亡及S期阻滞的影响北大核心CSCD

目的观察热疗联合旋毛虫肌幼虫排泄分泌蛋白对小细胞肺癌H446凋亡及周期阻滞的影响。方法将对数生长期的H446细胞随机分为4组。对照组:H446细胞培养过程中不作任何处理;热处理组:将细胞消化后放置离心管中42℃水浴加热2 h;ESPs处理组:将提取的旋毛虫肌幼虫ESPs(0.30 mg/ml)与H446细胞共培养;热处理联合ESPs组:先经水浴处理后加入ESPs(0.30 mg/ml)与H446细胞共培养。采用流式细胞术(FCM)检测各组细胞凋亡率,分析细胞周期变化情况;采用Western blot法检测各组细胞凋亡相关蛋白Bax、Bcl-2、周期蛋白Cyclin D1、p27的表达情况。结果流式细胞术(FCM)检测显示,对照组细胞总凋亡率为11.39%,ESPs处理组细胞总凋亡率为15.94%,热处理组细胞总凋亡率为22.35%,热疗联合ESPs组细胞总凋亡率为29.32%。组间细胞凋亡率差异有统计学意义(P<0.01)。对照组S期细胞所占比例为27.01%, ESPs处理组S期细胞占39.83%,热处理组S期细胞占51.54%,热疗联合ESPs组S期细胞占51.83%。ESPs处理组、热处理组、热疗联合ESPs组S期细胞所占比例与对照组比较差异均有统计学意义(P<0.01)。Western blot检测热处理联合ESPs组与对照组比较Bax、Cyclin D1、p27蛋白表达上调,Bcl-2蛋白表达下调。结论热疗联合旋毛虫肌幼虫排泄分泌蛋白可诱导小细胞肺癌H446凋亡,存在S期细胞阻滞,可能与Bax、Cyclin D1、p27蛋白表达上调,Bcl-2蛋白表达下调有关。     

汉防己甲素联合顺铂对 NCI-H446细胞的影响及相关机制分析

目的：研究汉防己甲素(tetrandrine,TET)联合顺铂(cisplatin,DDP)对人小细胞肺癌细胞株 NCI-H446体外抗肿瘤效果,探讨 TET 增强 NCI-H446细胞对 DDP 敏感性的可能机制。方法体外培养人小细胞肺癌株 NCI-H446;药物作用48 h 后,采用 CCK-8法测定各组细胞活力;Edu 染色观察各组细胞增殖情况;Hoechst 染色检测各组细胞凋亡情况;Western blot 检测各组磷酸化Akt、Bax、Bcl-2、cleaved-caspase-3、LC3等蛋白表达水平变化。结果低浓度的 TET 与 DDP 联合后可有效抑制 NCI-H446细胞株的增殖,诱导其凋亡;联合组半数抑制浓度较单药组显著降低;联合组磷酸化 Akt 表达显著下降,Bax、cleaved-caspase-3表达显著提高,抗凋亡蛋白 Bcl-2表达下降;自噬相关蛋白 LC3表达明显上调。结论低浓度 TET 与顺铂具有协同效应,其机制可能是通过上调促凋亡蛋白 Bax,下调抗凋亡蛋白 Bcl-2来诱导细胞凋亡;并且自噬可能在其中发挥重要作用。     

MiR-21对肺癌细胞增殖与凋亡的影响

目的探讨miR-21对肺癌细胞增殖与凋亡的影响。方法培养人肺癌细胞HBE、H460、A549和H446,将实验分为miR-21 inhibitor组、miRNA scramble组、空白对照组。荧光定量检测肺癌细胞H460、A549和H446 miR-21的表达;荧光定量PCR检测将miR-21 inhibitor和miRNA scramble转染到培养至对数生长期的人肺癌细胞H460后,对照组不转染的各组细胞的表达量;MTT实验检测转染miR-21 inhibitor后对细胞增殖的影响;流式细胞仪检测转染miR-21 inhibitor后对细胞凋亡的影响;Western印迹检测与凋亡相关蛋白的活性。结果肺癌细胞H460、A549和H446miR-21的表达显著高于正常肺癌细胞HBE(P<0.01),由于肺癌细胞株H460的miR-21表达在3个细胞株中高表达,因此选择肺癌细胞株H460做后续研究;将miR-21 inhibitor组和miRNA scramble组转染到肺癌细胞株H460后,荧光定量PCR显示,miR-21 inhibitor组的miR-21的相对表达量为显著低于空白对照组(P<0.01),miRNA scramble组的相对表达量与空白对照组无差异(P>0.05);MTT结果显示,转染4 d后,miRNA scramble组与空白对照组细胞增殖率无差异(P>0.05),而miR-21 inhibitor组显著低于空白对照组(P<0.05),且随时间延长,细胞增殖率逐渐下降;流式结果显示,与空白对照组和miRNA scramble组比较,miR-21 inhibitor组细胞的凋亡率显著升高(P<0.01);Western印迹显示,miR-21 inhibitor组Cleaved-caspase-3和Bax蛋白的表达显著高于miRNA scramble组和空白对照组,而miR-21 inhibitor组Bcl-2蛋白的表达显著低于miRNA Scramble组和空白对照组(P<0.05)。结论下调miR-21的表达,可抑制肺癌细胞H460的生长,增加细胞的凋亡,其作用机制可能与Bcl-2家族的调节有关。     

内质网应激激活剂通过上调GRP78增加肺癌A549细胞对顺铂的敏感性

目的探讨内质网应激激活剂(TM)增加肺癌A549细胞对顺铂(DDP)敏感性的机制。方法 DDP和TM处理肺癌A549细胞,MTT法检测肺癌A549细胞存活率,流式细胞术检测细胞凋亡水平,Western印迹检测凋亡相关蛋白Cleaved Caspase-7表达。结果不同浓度的DDP(0,10,20,50μmol/L)作用于肺癌A549细胞24 h,细胞存活率以剂量依赖的方式下降;TM诱导内质网应激后,提高了DDP(20μmol/L)诱导的细胞凋亡率(55.23%±2.31%,P0.05);同时检测到凋亡相关蛋白Caspase-7表达增加。结论 DDP能够诱导肺癌A549细胞凋亡,但是TM通过上调GRP78增加了肺癌A549细胞对DDP敏感性,联合应用TM和DDP有望成为治疗肺癌的新策略。     

茉莉酸甲酯对人胰腺癌细胞株HS766T抑制作用的研究

[目的]观察茉莉酸甲酯对人胰腺癌细胞株HS766T的抑制增殖及诱导凋亡的作用。[方法]用0~10mmol/L浓度的茉莉酸甲酯体外处理人胰腺癌细胞株HS766T,分别在24h、48h、72h、96h用MTT法检测其细胞生长活性;PI单染色法检测其细胞周期;Annexin V/PI双染色法检测其细胞凋亡;RT-PCR、Western Blot检测基因Bcl-2、Bax及其蛋白的表达量。[结果]用0~10mmol/L茉莉酸甲酯处理胰腺癌细胞24h、48h、72h、96h后,细胞抑制率分别为:14.40%~71.41%、23.62%~89.68%、29.30%~94.76%、37.50%~94.74%;经0.001、0.01mmol/L的茉莉酸甲酯分别作用24h、48h后,与对照组相比,茉莉酸甲酯处理组处于G0/G1/S期的比例升高,G2/M期的比例降低;同时人胰腺癌细胞在0.001、0.01 mmol/L茉莉酸甲酯处理24h、48h后,对照组凋亡率为1.2%、1.6%,0.001mmol/L浓度组凋亡率为12.3%、16.8%,0.01mmol/L浓度组凋亡率为14.5%、23.2%;RTPCR检测显示Bax和Bcl-2在不同浓度和时间的扩增倍数分别为:1.18~1.48、0.92~0.33;Western Blot检测结果显示,Bax表达呈递增而Bcl-2表达呈递减的规律。[结论]不同浓度的茉莉酸甲酯对人胰腺癌细胞株HS766T细胞均有抑制作用,且呈明显的浓度依赖性,48h前细胞抑制率与药物浓度呈正相关,并可降低抑凋亡基因Bcl-2及升高促凋亡基因Bax的表达,从而抑制该细胞株体外生长和促进其凋亡。     

川芎嗪、顺铂对人小细胞肺癌NCI-H446细胞凋亡的影响及机制探讨

目的观察川芎嗪、顺铂对小细胞肺癌NCI-H446细胞凋亡的影响,并探讨其机制。方法将对数生长期的NCI-H446细胞分为A、B、C、D组。A组常规培养,B组加入川芎嗪培养液100μg/ml,C组加入顺铂培养液2μg/ml,D组加入上述浓度的川芎嗪及顺铂培养液,均继续培养72 h。流式细胞仪检测各组细胞凋亡率,Westernblot法检测各组细胞中的Bcl-2、p53。结果 A组NCI-H446细胞凋亡率为5.23%±1.01%、Bcl-2蛋白为0.87±0.003 5、p53蛋白为0.19±0.002 3,B组分别为16.37%±1.23%、0.58±0.004 8、0.31±0.001 4,C组分别为19.2%±1.51%、0.32±0.003 9、0.46±0.002 5,D组分别为21.2%±1.79%、0.23±0.001 9、0.62±0.002 7。B、C、D组与A组相比,P均〈0.05;D组与B、C组相比,P均〈0.05。结论川芎嗪、顺铂联合应用可诱导小细胞肺癌NCI-H446细胞凋亡,可能与其降低Bcl-2表达水平、升高p53表达水平有关。     

姜黄素对人肺癌细胞凋亡相关蛋白Survivin表达的影响

目的研究姜黄素对人肺癌细胞诱导凋亡的作用机制。方法用10、20μM两种浓度姜黄素分别作用于SPC-A1细胞12h和24h,用末端标记法检测细胞凋亡率,原位杂交检测姜黄素作用24h后SPC-A1细胞凋亡相关蛋白Survivin表达。结果20μM姜黄素作用24h组凋亡率达43.7％,明显高于其他组;20μM姜黄素作用24h组凋亡相关蛋白Survivin mRNA表达明显降低。结论姜黄素可诱导人肺癌细胞SPC-A1凋亡,其作用机制可能与凋亡相关蛋白Survivin mRNA表达降低有关。     

热疗联合旋毛虫肌幼虫排泄分泌蛋白对小细胞肺癌H446凋亡及S期阻滞的影响

目的观察热疗联合旋毛虫肌幼虫排泄分泌蛋白对小细胞肺癌H446凋亡及周期阻滞的影响。方法将对数生长期的H446细胞随机分为4组。对照组:H446细胞培养过程中不作任何处理;热处理组:将细胞消化后放置离心管中42℃水浴加热2 h;ESPs处理组:将提取的旋毛虫肌幼虫ESPs(0.30 mg/ml)与H446细胞共培养;热处理联合ESPs组:先经水浴处理后加入ESPs(0.30 mg/ml)与H446细胞共培养。采用流式细胞术(FCM)检测各组细胞凋亡率,分析细胞周期变化情况;采用Western blot法检测各组细胞凋亡相关蛋白Bax、Bcl-2、周期蛋白Cyclin D1、p27的表达情况。结果流式细胞术(FCM)检测显示,对照组细胞总凋亡率为11.39%,ESPs处理组细胞总凋亡率为15.94%,热处理组细胞总凋亡率为22.35%,热疗联合ESPs组细胞总凋亡率为29.32%。组间细胞凋亡率差异有统计学意义(P0.01)。对照组S期细胞所占比例为27.01%, ESPs处理组S期细胞占39.83%,热处理组S期细胞占51.54%,热疗联合ESPs组S期细胞占51.83%。ESPs处理组、热处理组、热疗联合ESPs组S期细胞所占比例与对照组比较差异均有统计学意义(P0.01)。Western blot检测热处理联合ESPs组与对照组比较Bax、Cyclin D1、p27蛋白表达上调,Bcl-2蛋白表达下调。结论热疗联合旋毛虫肌幼虫排泄分泌蛋白可诱导小细胞肺癌H446凋亡,存在S期细胞阻滞,可能与Bax、Cyclin D1、p27蛋白表达上调,Bcl-2蛋白表达下调有关。     

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。