脑利钠肽与糖尿病大鼠胃肠排空的关系

目的观察糖尿病大鼠血浆、胃窦平滑肌中脑利钠肽(BNP)的变化并探讨其与胃肠排空的关系。方法将大鼠随机分为糖尿病组、单纯肥胖组和对照组,通过高糖高脂饮食结合腹腔注射小剂量链脲佐菌素的方法建立糖尿病大鼠动物模型;用葡萄糖酚红溶液灌胃30 min后处死大鼠,取胃和小肠近、中、远各段留取内容物后使用分光光度计测定胃肠各段酚红残留率;放射免疫法测定血浆N-末端脑利钠肽原(NT-pro BNP)的浓度;免疫组化检测胃窦平滑肌内BNP的表达。结果糖尿病组大鼠胃和近段小肠内酚红残留率均多于对照组和单纯肥胖组(P<0.05),而中段和远段小肠酚红残留率均少于对照组和单纯肥胖组(P<0.05);12周后糖尿病组大鼠血浆NT-pro BNP的浓度较对照组和单纯肥胖组显著升高(P<0.05);胃窦平滑肌层中BNP免疫反应阳性细胞各组间比较无明显差异;糖尿病大鼠血浆NT-pro BNP浓度与胃内、近段小肠内酚红残留率呈正相关。结论糖尿病大鼠液体胃肠排空减慢可能与血浆NT-pro BNP浓度增加有关。     

黄褐斑的皮肤镜学特征

目的描述黄褐斑的皮肤镜表现。方法使用皮肤镜观察临床表现典型的20例黄褐斑患者的黄褐斑区域及其周围正常皮肤的特征。结果病变区域在镜下表现为淡黄褐色均匀一致的斑片,其中19例为深褐色斑片/点、14例有毛细血管改变、6例的毳毛增粗变黑。正常皮肤的镜下表现为:未见淡黄褐色均匀一致斑片、10例为深褐色斑片/点、12例有毛细血管改变、2例的毳毛增粗变黑。病变部位与正常皮肤在背景颜色和深褐色斑点/片方面的差异有统计学意义(P均<0.001),在毛细血管分布和毳毛特征方面的差异无统计学意义(P均>0.05)。结论淡黄褐色均匀一致的斑片及深褐色斑片/点是黄褐斑的两大皮肤镜特征。     

二炮某部军人心理应激水平与心理弹性、认知偏向和积极情绪的关系

目的 探讨军事心理应激水平与军人心理弹性、认知偏向及积极情绪的关系.方法 采用军事心理应激自评问卷(PSET)、心理弹性量表(CD-RISC)中文版正负性情绪量表(PANAS-C)和正负性认知偏向量表(APNIS)对536名二炮某部官兵进行抽样调查.结果 ①心理应激总分与负性情绪、负性认知偏向呈显著正相关(r值分别为0.44、0.41,P＜0.01);与正性情绪、心理弹性和正性认知偏向均呈显著负相关(r值分别为-0.29、-0.30、-0.27,P＜0.01).②心理应激高分组与低分组在心理弹性、正负性情绪、正负性认知偏向上均存在显著差异(P＜0.01).③负性情绪、负性认知偏向、正性认知偏向和积极情绪可有效预测军事心理应激水平,总解释率为36％.④积极情绪在正性认知偏向对心理应激水平的影响中起部分中介作用,在心理弹性与心理应激水平之间起完全中介作用.结论 军人心理应激水平与其心理弹性、正负性情绪和认知偏向密切相关.积极的情绪、合理的认知以及心理弹性的增加都有助于缓减军人心理应激症状,促进心理健康.     

降钙素在伴高血钙慢性肾脏病矿物质和骨异常血透患者的疗效分析

目的探讨降钙素在长期血透并慢性肾脏病矿物质和骨异常(chronic kidney disease-mineral and bone disorder,CKD-MBD)伴高血钙患者的应用价值.方法选取昆明医科大学附属延安医院维持血透2 a以上伴高血钙CKD-MBD患者64例,随机分为2组,对照组:口服骨化三醇0~0.5μg/d治疗,实验组:加用依降钙素20μg/周,肌肉注射治疗,3周、6周后观察2组骨关节疼痛评分、血清钙(Ca)、磷(P)、钙磷乘积[Ca]×[P]、甲状旁腺素(PTH)、骨钙素(BGP)、降钙素(CT)变化.结果治疗3周后、6周后实验组与对照组、治疗前比较,骨关节疼痛评分、Ca、[Ca]×[P]有不同程度下降(P<0.05),CT有不同程度升高(P<0.05);6周后血清PTH、P明显下降(P<0.05).结论降钙素能短期内改善CKD-MBD血透患者的高血钙状态,为继发性甲状旁腺功能亢进、高磷血症的治疗创造了有利条件,同时对改善骨关节疼痛症状有明显效果.     

Effect of synthetic porcine neuropeptide Y (NPY) on splanchnic blood flows and Exocrine pancreatic secretion in dogs

This study examined the effect of synthetic porcine neuropeptide Y on the splanchnic blood flows and the exocrine pancreatic secretion in dogs. Graded doses of neuropeptide Y (0.1–5 g/kg, intravenous) caused dose-dependent reduction of the secretin-stimulated exocrine pancreatic secretion and of the blood flows in the superior mesenteric artery, the portal vein, and the pancreatic tissue. Neuropeptide Y at 5 g/kg reduced the blood flows to 45.9±13.3% (superior mesenteric artery), 63.0±10.5% (portal vein), and 77.9±4.8% (pancreatic tissue), respectively. This dose also reduced secretin-stimulated pancreatic juice volume and CCK-8 plus secretin-stimulated protein output to 65.2±9.3 and 63.3±14.0%, respectively. This study shows a potent vasoconstrictor effect of neuropeptide Y on splanchnic vessels. Neuropeptide Y also inhibited exocrine pancreatic secretion in a significant correlation with the reduction in pancreatic tissue blood flow, which suggests that reduction in the blood flow may be one of the possible mechanisms of the inhibitory action of neuropeptide Y on exocrine secretion.This work was supported by a grant from the Ministry of Education, Japan (A-61440060).     

Clinical application of wireless capsule endoscopy

BACKGROUND: Diagnostic modalities for identifying lesions within the small bowel have been quite limited. Wireless capsule endoscopy (WCE) is a new, innovative technique that can detect very small mucosal lesions in the entire small bowel and can be used in the outpatient setting. The present study explored the diagnostic value, tolerance and safety of WCE in the identification of small bowel pathology that was not detected with conventional small bowel imaging studies. METHODS: From May through September 2002, 15 patients with suspected small bowel diseases were prospectively examined, Of them, 12 presented with persistent obscure gastrointestinal bleeding and negative findings on upper endoscopy, colonoscopy, small bowel radiography, and bleeding‐scan scintig‐raphy or mesenteric angiography. RESULTS: Wireless capsule endoscopy identified pathologic small bowel findings in 11 of the 15 patients (73%): angioectasias, Dieulafoy's lesion, polypoid lesion, submucosal mass, Crohn's disease, carcinoid tumor, lipoma, aphthous ulcer, and hemorrhagic gastritis; four of the patients had two lesions. The images displayed were considered to be good. The capsule endoscopes remained in the stomach for an average of 82 min (range 6?311 min) and the mean transit time in the small bowel was 248 min (range 104?396 min). The mean time of recording was 7 h 29 min (from 5 h to 8 h 30 min). The mean time to reach the cecum was 336 min (180?470 min). The average number of the images transmitted by the capsule was 57 919 and the average time the physician took to review the images transmitted by the capsule was 82 min (range 30?120 min). The average time of elimination of the capsule was 33 h (range 24?48 h). All 15 patients reported that the capsule was easy to swallow, painless, and preferable to conventional endoscopy. No complications were observed. CONCLUSIONS: Wireless capsule endoscopy is safe, well tolerated, and useful for identifying occult lesions of the small bowel, especially in patients who present with obscure gastrointestinal bleeding.     

球囊拉伤致家兔动脉粥样硬化斑块破裂及血栓形成

为建立动脉粥样硬化的兔模型并用药物触发造成斑块破裂及血栓形成，将60只雄性纯种新西兰兔随机平均分成三组：球囊损伤 高脂(1％胆固醇)组、高脂喂养组及普通饲料喂养组．喂养3个月后分别给予鲁塞尔蝰蛇毒和组胺药物触发以造成斑块破裂及血栓形成。结果发现，球囊损伤 高脂组与高脂喂养组均形成动脉粥样硬化斑块，其中球囊损伤 高脂组所形成的粥样斑块为具有较大脂质核的软斑块；药物触发后球囊损伤 高脂组存活的18只中有11只共15处发生斑块破裂及血栓形成；高脂喂养组中的19只经药物触发后仅5只共7处发生斑块破裂及血栓形成；普通饲料喂养组中未见斑块破裂及血栓形成。结果提示，在构建的动脉粥样硬化斑块的动物模型基础上，应用药物触发后能够造成斑块破裂及血栓形成。     

南京市区老年人便秘患病率及其与亚健康症状关系的调查

目的 为了解南京市老年人便秘现状，以及探讨便秘与亚健康的关系。方法 采用整群抽样方法，对南京市2个街道(20个居委会)和1个老年公寓60岁以上3731名老年人进行便秘与亚健康调查。结果 南京市老年人便秘患病率为24.0％，并随年龄增长其患病率增高(P＜0．01)。根据32项亚健康症状调查，便秘组(男性：28项；女性：23项)亚健康症状的发生率均高于非便秘组；前10位亚健康症状中，皮肤瘙痒和皮肤干燥为便秘者易发生的亚健康症状；便秘者平均个体有3种以上亚健康症状者(64．6％)明显高于非便秘组(42.7％，P＜0.01)。结论 老年人便秘的患病率较高，便秘者较易发生亚健康症状。防治老年人便秘，对预防亚健康症状的发生及增进老年人健康非常重要。