孟河医家新探

明末至近代 ,江苏孟河名医辈出 ,逐渐形成以费、马、巢、丁四大家族为主的孟河医派。以四大家为核心的孟河医派 ,以其高深的学术造诣 ,丰富的临床经验 ,对中国医学的发展作出了卓越的功绩。广泛收集的资料涉及中国各大图书馆及欧洲、美国、港台图书馆馆藏的有关孟河医学的著作、方志、家谱百十余种 ,采访孟河医家的子孙、传人、学生或门徒 2 0 0余人。由此说明 ,孟河医派似一颗灿烂的明星 ,照耀在清代末年、民国初年的医坛上 ,学术相传 ,至今未衰。     

细胞色素P450c 17α基因启动子区Msp AI多态性与上海市汉族男性骨量、骨大小的关系

目的探讨细胞色素P450c 17α(CYP17)基因启动子区Msp AI多态性与上海市汉族男性骨量、骨大小的关系.方法应用聚合酶链反应-限制性片段长度多态性检测上海市397例46～80岁无亲缘关系的汉族男性(其中324例健康男性,73例骨质疏松患者)CYP17基因Msp AI多态性,并用双能X线吸收仪检查研究对象腰椎1～4和股骨近端股骨颈、大转子区及Ward's三角部位骨密度(BMD)、骨矿含量(BMC)和骨截面大小(CSA).结果397例男性CYP17 Msp AI基因型频率分布依次为TC(51.1%)、CC(33.8%)和TT(15.1%),等位基因T和C频率分布分别为40.7%和59.3%,等位基因频率分布符合Hardy-Weinberg定律.未发现该多态性在73例骨质疏松患者和324例健康男性之间频率分布的差异.通过协方差分析,在397例受试者、73例骨质疏松患者或324例健康男性中,均未显示CYP17基因Msp AI多态性与腰椎1～4和股骨近端各部位BMD、BMC和CSA的相关性.结论CYP17基因MspAI多态性不是影响上海市汉族男性骨量和骨大小变异的遗传因素.     

Sulfated polymannuroguluronate, a novel anti-acquired immune deficiency syndrome (AIDS) drug candidate, targeting CD4 in lymphocytes

Sulfated polymannuroguluronate (SPMG), a marine sulfated polysaccharide, has entered the Phase II clinical trial in China as the first anti-acquired immune deficiency syndrome (AIDS) drug candidate obtained from marine organisms. To determine the binding site(s) (receptors) of SPMG in lymphocytes mediating its anti-AIDS activities, fluorescein-5-isothiocyanate (FITC)-labeled SPMG was used to investigate SPMG binding to lymphocytes. Flow cytometry (FCM) and fluorescence microscopy analysis showed that the SPMG binds to lymphocytes in a rapid, specific, reversible, and saturable fashion. Several SPMG binding proteins were purified by affinity chromatography from lymphocyte membrane preparations. Sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) and Western blotting analysis revealed that a 55kDa lymphocyte membrane protein is CD4. To characterize the SPMG and CD4 interaction, inhibition assay and surface plasmon resonance (SPR) assay were carried out. SPMG bound to CD4 in a multivalent fashion with specificity. The binding of SPMG to human lymphocyte CD4 was competitively inhibited by human soluble CD4 (hsCD4). Likewise, the binding between hsCD4 and immobilized SPMG was blocked by excess free SPMG. These results indicate that CD4 is one of the specific SPMG binding sites (receptors) in lymphocytes. The interaction between SPMG and CD4 may provide a mechanistic explanation of the immunopotentiating and anti-AIDS activities of SPMG in human immunodeficiency virus (HIV) infected individuals.     

D609 induces vascular endothelial cells and marrow stromal cells differentiation into neuron-like cells

AIM: To investigate the effect of tricyclodecane-9-yl-xanthogenate (D609) on cell differentiation in vascular endo- thelial cells (VECs) and marrow stromal cells (MSCs). METHODS: Morphological changes were observed under phase contrast microscope. Electron microscope and immunostaining were used for VECs identification. The expressions of neuron-specific enolase (NSE) and glial fibrillary acidic protein (GFAP) were examined by immunohistochemistry. RESULTS: After 6 h of induc…     

针刺对肥胖大鼠下丘脑神经肽含量的影响

目的 :探讨针刺对肥胖机体下丘脑神经肽含量的影响。方法 :观察针刺治疗前后肥胖大鼠体重、Lee’s指数和体脂量以及下丘脑β 内啡肽 ( β EP)、α 促黑激素 (α MSH)、铃蟾肽 (BOM )、神经肽Y(NPY)、血管紧张素Ⅱ (ATⅡ )、心房肽 (ANP)、降钙素基因相关肽 (CGRP)的含量的变化。结果 :肥胖大鼠体重、Lee’s指数、体脂以及下丘脑β EP、NPY和AngⅡ的含量均显著高于正常大鼠水平 ,而下丘脑α MSH、BOM、ANP和CGRP的含量均显著低于正常大鼠水平。相关分析显示 ,下丘脑 β EP、NPY和AngⅡ的含量与肥胖指标呈正相关 ;而下丘脑α MSH、BOM、ANP和CGRP的含量与肥胖指标呈负相关。针刺治疗取得良好减肥疗效的同时 ,肥胖大鼠下丘脑 β EP、NPY和AngⅡ的含量明显回降 ,而下丘脑α MSH、BOM、ANP和CGRP的含量明显回升。结论 :生物机体下丘脑β EP、NPY和AngⅡ水平异常增高和下丘脑α MSH、BOM、ANP和CGRP的水平异常低下可能是产生肥胖的重要因素。针刺对肥胖机体下丘脑神经肽的良性调整作用可能是针刺减肥的重要作用机制。     

Characterization of salvicine-resistant lung adenocarcinoma A549/SAL cell line

Salvicine is a diterpenoid quinone derived from a traditional Chinese medication that has been shown to possess potent in vitro and in vivo antitumor effects. This compound, which inhibits the activity of Topoisomerase II, was found to equipotently kill various multidrug-resistant tumor cells and their corresponding parental counterparts in vitro and to inhibit mdr1/P-gp expression in multidrug-resistant K562/A02 cells. To examine the features of tumor resistance to salvicine, we established a salvicine-resistant tumor cell subline of A549 lung adenocarcinoma cells. Compared with parental cells, A549/SAL cells displayed 8.91-fold resistance to salvicine and an average of 6.70-fold resistance to the antimetabolites. A549/SAL cells, however, were not resistant to alkylating agents, platinum compounds and other naturally-derived antineoplastics. RT-PCR analysis showed that the expression of mRNAs from the mdr-1, MRP, PCNA, topoisomerase II alpha and beta, GSTpi, p21 and GADD45 genes was not altered in the salvicine-resistant subline. In contrast, expression of p53 and bax mRNA was significantly lower, and expression of mdm2 mRNA was significantly higher, in A549/SAL cells compared to A549 cells. A549/SAL cells grew more slowly, and in a more scattered pattern, than A549 cells. In addition, the A549/SAL cells showed enhanced ability to migrate and invade in comparison to the parental cells. These results indicate that exposure to salvicine does not induce a tumor multidrug-resistant phenotype.     

Trends in the etiology of infectious corneal ulcers at the F. I. Proctor Foundation

OBJECTIVE: We analyzed laboratory results from corneal ulcers seen from 1976 to 1999 at the Francis I. Proctor Foundation, a referral center in San Francisco, to determine the relative frequencies of pathogens and to analyze for trends in frequencies of the most common pathogens. The results were compared with a previous study of corneal ulcers seen from 1948 to 1976 at the same institution. METHODS: Ulcers presenting to the Proctor Foundation were Gram stained and cultured using standard techniques. Herpetic corneal ulcers were excluded from the study. RESULTS: Organisms were isolated from 427 ulcers, 38% of all cases. Two hundred seventy-eight (59%) isolates were gram-positive bacteria, 145 (31%) gram-negative bacteria, 16 (3%) Acanthamoeba spp., and 36 (8%) fungi. Staphylococcus aureus was the most common organism, composing 20% of all isolates, followed by viridans group streptococci (12%), Streptococcus pneumoniae (11%), Pseudomonas aeruginosa (6%), Moraxella spp. (5%), and Serratia marcescens (4%). Over the 24-year study period the proportion of positive cultures decreased and the incidence of S. marcescens increased significantly. Comparing the period of 1948-1976 to 1976-1999, the frequency of S. pneumoniae and P. aeruginosa decreased, and that of S. marcescens increased significantly. CONCLUSION: The common pathogens associated with corneal ulcers have changed over the past 50 years in Northern California, with S. pneumoniae and P. aeruginosa being isolated relatively less often and S. marcescens being isolated with increasing frequency. The decrease in isolation of organisms over the 1976-1999 period may have resulted from increasing empiric antibiotic treatment by referring ophthalmologists.     

Endoscopic stent for palliating malignant and benign biliary obstruction

Objective: To study the techniques of placement of memory alloy plating gold biliary stent and plastic stent for palliation of malignant and benign biliary obstruction, and to assess its clinical effectiveness. Methods: The patients in plastic stent group included papliila of duodenum inflamational strictures (n=24), common bile duct inflammational inferior segment strictures (n=4),choledocholithiasis (n=5), bile leak (n=11), bile duct surgery injurey (n=7) and pancreatic carcinoma (n=1).The patients in plating gold stent group included common bile duct carcinoma (n=5) and pancreatic carcinoma (n=6). Under fluoroscopic guidance the stent was inserted into biliary obstruction sites from oral cavity in all cases. Complications, liver function and blood serum amylase were investigated during the study period. Results: Successful stent placement was achieved in all cases. After operation of 7 days, in gold biliary stent groups, the rates of decrease of blood serum total bilirubin, glutamic-pyruvic transaminase, r-glutamyl transpeptidase and alkaline phosphatase were 67.16%,58.37%, 40.63% and 41.54% respectively. In plastic stent group, the rates of decrease of STB, ALT, r-GT and AKP were 53.24%, 55.03%, 37.15%, 34.12% respectively.Early complication included post-ERCP panereatitis and eholangititis. Occlusion of stent was the major late complication. Conclusion: Memory alloy plating gold biliary stent and plastic stent were safe and efficacious methods for malignant and benign biliary obstruction, and could improve patient‘s living quality. Plastic stent was an efficient complement for therapy of bile leak and bile duct injury.     

急性坏死性胰腺炎合并念珠菌感染

目的 探讨急性坏死性胰腺炎(ANP)合并念珠菌感染的诊治方法。方法 回顾分析78例ANP患者的临床资料,诊断由手术发现或cT检查确定,其中62例接受预防性抗生素治疗,16例未接受。每例均行血、尿、便、痰和创口引流液的培养和涂片镜检,检出念珠菌。结果78例ANP中共有14例发生念珠菌感染,发病率17．9％,死亡4例,死亡率28．6％;使用预防性抗生素组发病率19．4％,死亡率25．0％;未用预防性抗生素组的发病率12．5％,死亡率50．0％。结论 资料证明ANP合并念珠菌感染是一个值得重视的临床问题,预防性使用抗生素治疗ANP可预防严重继发性感染的发牛．但也同时会合并念珠菌感染。