腺苷蛋氨酸治疗药物性淤胆型肝炎的疗效观察

目的：探讨腺苷蛋氨酸对药物性淤胆型肝炎的疗效。方法：将46例药物性淤胆型肝炎患者分为两组,治疗组和对照组各23例。对照组用综合治疗（不加用任何退黄的药物）,治疗组在综合治疗的基础上加用腺苷蛋氨酸1000mg,溶于5％葡萄糖溶液20mL中静脉推注,每日1次,疗程均为4周。结果：两组患者症状、体征的恢复无明显差异（P〉0．05）。治疗组皮肤瘙痒、粪便灰白的有效率分别为82．6％（19／23）、100％（23／23）,对照组为39．1％（9／23）、52．2％（12／23）,治疗组肝功能损害恢复情况优于对照组,两组差异有显著性（P〈0．01）。结论：腺苷蛋氮酸在治疗药物性淤胆型肝炎上对促进肝脏代谢、修复损伤的肝细胞、缓解瘙痒和改善肝功能有明显疗效。腺苷蛋氨酸是目前临床治疗药物性淤胆型肝炎比较理想安全的药物。     

Morphometric characteristics of coronary atherosclerosis in different ethnic groups of Andizhan population]

A gross morphometric study of coronary atherosclerosis was performed in 554 native males aged 20-59 years and 142 migrant males of the same age from Andizhan according to the WHO Expert Programme (Bull, WHO, 1976, vol. 53, p. 485). The migrants over 40 years displayed a greater extent of atherosclerosis (except lipid streaks) than did the natives; but there were small differences between the comparable groups of young persons under 40 years. A histometric study of the coronary arteries was made in 81 apparently healthy males indicated that fine-dropped (mainly intracellular) lipid deposits were more common in the natives, mixed (fine- and coarse-dropped) and coarse-dropped lipid deposits occurring with cell breakdown were seen in the migrants. The thickness of atherosclerotic lesions in the coronary arteries was greater in the migrants. Varying degrees of coronary intimal hyperplasia were found in individuals from the comparable ethnic groups. The hyperplasia was more profound in the migrants. There was a direct relationship between its degree and the development of atherosclerotic lesions.     

Evolution of atherosclerosis of the aorta and coronary arteries in practically healthy men in Moscow for a 40-year period

AIM: To assess 40 years evolution of atherosclerosis of the aorta and coronary arteries among practically healthy Moscow men. METHODS: We compared results of 2 studies of prevalence and extent (area) of atherosclerotic lesions in thoracic and abdominal aorta and 2 main coronary arteries. The studies were conducted in 1963-1965 and 2002-2003 according to WHO program. RESULTS: Prevalence of coronary artery stenoses as well as prevalence and area of raised lesions in these arteries were higher among violent death victims studied in 2002-2003. Raised lesions in both parts of aorta and in left anterior descending coronary artery were more pronounced also in men studied in 2002-2003.     

Trends in 25-year evolution of coronary atherosclerosis in males fom some cities of Europe and Asia]

AIM: Detection of changes in the course of coronary atherosclerosis (CA) which took place for 25 years of observation in male population in different cities. MATERIAL AND METHODS: Epidemiological surveys of coronary AS by autopsy data according to WHO program were conducted in 1963-1966 (trial 1) and 1985-1989 (trial 2) in 9 cities: Ashkhabad (Turkmenistan), Bishkek (Kirghizia), Irkutsk, Yakutsk (Russia), Riga (Latvia), Tallinn, Tartu (Estonia), Kharkov, Yalta (Ukraine), Malme (Sweden), Prague (Czechia). The surveys enrolled males aged 20-59 years: 7470 males entered trial 1 and 9600 entered trial 2. AS was assessed visually-plan-imetrically in the three major coronary arteries (CA). By the data from Ashkhabad, Bishkek, Irkutsk, Kharkov, Yakutsk, AS in healthy males was also characterized. RESULTS: In 9 CIS countries' cities CS for 25 years has undergone noticeable changes: according to trial 2 atherosclerotic process accelerated, especially in males over 40, in healthy males as well. CA AS had the same features in both trials in Prague and was less pronounced in males from Malme. National differences between native population and immigrants in AS were evident in Ashkhabad, Bishkek and Yakutsk in both trials. In trial 2 CA stenoses were encountered more frequently in all the cities under study. Coronary arteries were more calcified. There was a direct relationship between severity of preatherosclerotic CA changes in young males (20-39-year-old) and speed of AS progression in older males. CONCLUSION: For 25 years there was a tendency to more severe course of coronary AS in CIS countries, in Prague males AS has undergone minimal changes, in Malme the situation with AS severity has improved. Severity of AS in males from different cities and CHD male mortality were correlated.     

Hyperplasia of coronary intima in young males in relation to development of coronary heart disease in adults

The aim of the investigation was to study structural features of coronary arteries in young males which may influence the development of stenosing coronary atherosclerosis in older age. We studied the coronary arteries from 84 males, 10-39 years old, who died from accidents in Moscow, Malmo and Riga, and 98 males aged 40 and above from Moscow who died from coronary heart disease (71 cases) or other diseases (27 cases). In children and young males from all three cities, musculo-elastic hyperplasia of the coronary intima took place constantly but with different degrees of expression; a strict relationship of the intimal thickness and age was observed. Histometric investigations of the right coronary artery showed that in young males of Riga, in comparison with those of Malmo, the intima was significantly thicker both outside (69.6+/-2.8 and 58. 2+/-2.5 microm) and within the area of cushion like thickening (118. 8+/-4.0 and 101.9+/-3.8 microm), they had more extended cushion-like thickening of intima (42.6+/-3.0 and 30.8+/-3.3% to the length of the artery circumference) and destroyed parts of the internal elastic lamina (28.3+/-1.9 and 19.1+/-1.7% of its length). In males older than 40 years, severe coronary atherosclerosis and stenosis was also significantly more common in Riga than in Malmo. Our data indicate that with age the intimal musculo-elastic hyperplasia in the coronary arteries is transformed to a fibro-elastic layer. The thickness of this layer in the presence of stenosing plaques (>75% of arterial lumen) was much greater than in the presence of plaques with stenoses less than 50% (188.1+/- 7.3 and 69.8+/-4.5 microm, respectively). CONCLUSION: The development of stenosing coronary atherosclerosis is closely related to the degree of musculo-elastic intimal hyperplasia in childhood and young age. The formation of a fibro-elastic layer in the coronary intima decreases the ability of the artery to dilate during the development of atherosclerosis.     

Functional differences between two Fc receptor ITAM signaling motifs

Most Ig receptors exist as multi-subunit complexes with a unique ligand binding alpha chain and a common signaling FcR gamma-chain. The myeloid Fc gamma RIIa (CD32) appears unique among FcR because both ligand- binding and signaling capacity are found in the alpha chain. Within the cytoplasmic tails of Fc gamma RIIa and FcR gamma-chain similar, but not identical, activatory motifs (ITAMs) have been defined, in which tyrosines play an important role. Previously, Fc gamma RIIa-ITAM was shown to be critical for both proximal and distal activatory functions in IIA1.6 B-cell transfectants. Triggering of interleukin-2 (IL-2) release and antigen presentation was absent in Fc gamma RIIa, but not in FcR gamma-chain receptor complexes. We now assessed the capacity of Fc gamma RIIa wild-type and Fc gamma RIIa/gamma chimeric molecules to trigger IL-2 production and antigen presentation by B cells. Both of these functions could solely be triggered by receptors containing the FcRIIa was capable of functional interaction with FcR gamma-chain, thus reconstituting the capacity to trigger IL-2 release and antigen presentation. These data document qualitative differences between Fc receptor ITAMs.     

Oestrogen receptor gene polymorphisms and ovarian stimulation for in- vitro fertilization

Experimental evidence has shown that mice lacking the oestrogen receptor (ESR) gene are infertile with cystic ovaries and follicular arrest. In humans, several polymorphisms and mutations in the ESR gene have been identified. In this study we have analysed a common PvuII and a rare BstUI polymorphism in the ESR gene. Analysis was carried out on DNA samples from women undergoing ovarian stimulation for in-vitro fertilization (IVF) and embryo transfer and controls having at least one pregnancy. Comparisons were done between the three PvuII genotypes, concerning the mean numbers of follicles and oocytes and the mean ratios of follicles to oocytes harvested in two consecutive cycles. Significantly lower ratios were identified in the group lacking the PvuII polymorphism, compared with the groups with heterozygous or homozygous PvuII polymorphisms (P > 0.05 and P > 0.01 respectively). The rare haplotype having both PvuII and BstUI restriction sites on one chromosome was present only in the IVF group. Pregnancies from IVF were significantly rarer in patients who were homozygous for the PvuII polymorphism (P > 0.05). Our results suggest that genetic variability in the ESR has a role in the quality of the ovarian follicles as judged by the ovarian response to stimulation and may also affect implantation.      

Comparative studies of the evolution of aortic and coronary atherosclerosis in Moscow, Ryazan, and Yakutsk males over 40 years

Repeated epidemiological morphological investigations of atherosclerosis of the aorta and coronary arteries were performed in apparently healthy men aged 20-59 years in Moscow, Ryazan and Yakutsk at a 40-year interval. More severe atherosclerosis and different rates of its progression were revealed in males of these towns over 40 years.     

Large paraesophageal varices on endosonography predict recurrence of esophageal varices and rebleeding

BACKGROUND & AIMS: Recurrence of varices and rebleeding after endoscopic therapy is very common. Data on the prediction of recurrent varices after initial obliteration by endoscopic therapy are few. The aim of this study was to correlate the presence and the size of paraesophageal varices (PEVs) in patients after endoscopic variceal ligation with recurrent varices and rebleeding. METHODS: Forty patients who underwent endoscopic banding ligation for esophageal variceal bleeding were studied by endosonography within 4 weeks after obliteration of varices. PEVs were classified as none, small, or large (maximum diameter, > or =0.5 cm). Esophagoscopy and endosonography were then repeated every 6 months for up to 1 year. RESULTS: Two patients (5%) were not detected to have PEVs. Small and large PEVs were identified in 24 (60%) and 14 (35%) patients, respectively. During the follow-up period of 1-year, recurrent submucosal esophageal varices were detected in 24 patients, including 13 patients (93%) with large PEVs and 11 patients (46%) with no or small PEVs (P = 0.0019). Recurrent bleeding occurred in 6 patients (43%) with large PEVs and in 3 patients (12%) with small PEVs (P = 0.044). CONCLUSIONS: Patients with large PEVs have a higher risk of developing recurrent varices and rebleeding. (Gastroenterology 1997 Jun;112(6):1811-6)