生长抑素受体亚型在人鼻咽癌细胞株CNE2中表达

背景与目的：生长抑素受体（somatostatin receptor SSTR）在许多肿瘤组织均有表达，为生长抑素类似物如奥曲肽用于这些肿瘤的治疗提供了生物学基础，但对生长抑素受体在鼻咽癌中表达情况的研究甚少。本研究旨在了解生长抑素受体基因在鼻咽癌细胞中的表达情况，为生长抑素类似物用于鼻咽癌治疗的进一步研究提供试验基础。方法：采用RT—PCR法和SP免疫组化法联合检测体外培养的人鼻咽癌细胞株CNE2的SSTRs表达，并对PCR mRNA产物测序以鉴定结果。结果：RT—PCR提示人鼻咽癌细胞株CNE2分别表达生长抑素受体亚型SSTR1、SSTR2、SSTR4；免疫组化结果：人鼻咽癌细胞株CNE2表达SSTR1、SSTR2A为强阳性（〉60％），表达SSTR4为弱阳性、SSTR2介于两者之间、SSTR3和SSTR5则无表达。结论：我们的研究证实人鼻咽癌细胞株CNE2有多种生长抑素受体亚型基因表达，且以表达SSTR1、SSTR2较多。     

A 2-year prospective follow-up study of children and adolescents with disruptive behavior disorders. Prediction by cerebrospinal fluid 5-hydroxyindoleacetic acid, homovanillic acid, and autonomic measures?

A 2-year prospective follow-up study of 100% (N = 29) of a sample of children and adolescents with disruptive behavior disorders found that the baseline lumbar cerebrospinal fluid monoamine metabolite concentration and autonomic nervous system activity predicted some subsequent outcomes. The 5-hydroxyindoleacetic acid concentration significantly predicted severity of physical aggression during follow-up. The skin conductance level significantly predicted institutionalization. Correlations were in predicted directions with lower cerebrospinal fluid 5-hydroxyindoleacetic acid concentrations and autonomic activity correlated with poor outcome. Moreover, in multivariate analyses, which included nonlaboratory measures as predictors, cerebrospinal fluid and autonomic measures still contributed significantly to the prediction. However, hypothesized predictions of cerebrospinal fluid 5-hydroxyindoleacetic acid concentrations for suicide attempts and of low autonomic nervous system activity for arrests were not supported thus far. Patients are still at risk; consequently, these results must be considered preliminary. Nonetheless, the results suggest that further investigation of relationships between biological factors and outcome of children with disruptive behavior disorders is warranted.     

Protein kinase C activity in blood vessels from normotensive and spontaneously hypertensive rats.

This study investigates the effects of phorbol dibutyrate (PDB) on protein kinase C (PKC) activation, as assessed by the translocation of PKC activity from the cytosolic to the particulate fraction, in aortas and mesenteric arteries from spontaneously hypertensive rats (SHR) and Wistar-Kyoto rats (WKY). The basal distribution of PKC activity between the cytosolic and particulate fractions of SHR and WKY aortas, and mesenteric arteries, was not significantly different. PDB induced a concentration-dependent decrease in cytosolic PKC activity in SHR and WKY aortas. PDB (0.01 microM) decreased cytosolic PKC activity to a greater magnitude in SHR aorta as compared to WKY aorta, while 1.0 microM PDB decreased cytosolic PKC activities to similar magnitudes in SHR and WKY aortas, and mesenteric arteries. These results suggest that the increased sensitivity of SHR vessels to contraction by phorbol esters may be due, at least in part, to the greater sensitivity of PKC in these vessels to phorbol ester activation.     

Cerebrospinal fluid cholinesterases in aging and in dementia of the Alzheimer type

Protein concentration and acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) activities were assayed in the cerebrospinal fluid (CSF) of 26 healthy normal subjects (20-86 years old), 27 patients with dementia of the Alzheimer type (DAT), and 10 patients with dementia of the Alzheimer type with extrapyramidal signs (EDAT). In normal subjects, there was an age-related increase in CSF protein and AChE activity and a significant correlation (p less than 0.001) between CSF protein and BChE activity. In the DAT and EDAT groups, CSF AChE activities (mean +/- SD = 17.5 +/- 3.6 and 15.3 +/- 4.4 nmol/min/ml, respectively) were significantly lower (p less than 0.05) than in 13 age-matched control subjects (21.5 +/- 5.6 nmol/min/ml). In contrast, neither CSF protein concentration, BChE activity, nor the ratio of AChE/BChE differed significantly between groups. In patients with DAT, CSF AChE activity was significantly lower (p less than 0.05) in subjects with an early onset compared to those with a late onset (16.4 +/- 3.4 and 19.7 +/- 2.8 nmol/min/ml, respectively), and activity in the latter group did not differ significantly from control values. CSF AChE activity was not related to dementia severity and did not change significantly over an 18-month period. Although these results confirm a cholinergic deficit in patients with DAT, the considerable overlap of CSF AChE activity between groups and the nonsignificant correlation between AChE activity and dementia severity limit the usefulness of CSF AChE as a diagnostic marker of this disorder.     

Adrenalectomy or metyrapone-pretreatment abolishes cerebral metabolic responses to the serotonin agonist 1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane (DOI) in the hippocampus.

1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane (DOI), a serotonin type 2 (5-HT2) agonist, elevates plasma corticosterone levels and reduces the cerebral metabolic rate for glucose (rCMRglc) in the hippocampus, a structure which possesses few 5-HT2 receptors but a large number of steroid receptors. To explore the hypothetical interaction between 5-HT and steroid mechanisms in the hippocampus, we measured rCMRglc in intact, adrenalectomized and metyrapone-pretreated rats after saline or DOI administration. Metyrapone pretreatment alone had no significant effect on rCMRglc, but adrenalectomy produced widespread rCMRglc increases in the cortex, hippocampus and monoaminergic brainstem nuclei. In intact rats, DOI 10 mg/kg reduced rCMRglc in limbic areas and increased it in the interanteromedial and paracentral thalamic nuclei. Metyrapone pretreatment and adrenalectomy abolished rCMRglc responses to DOI in hippocampal areas and enhanced those in thalamic nuclei. These results indicate that brain responses to DOI are dependent upon the functional state of the hypothalamus-pituitary-adrenal cortex axis.     

重型肝炎急性肝衰竭肝移植手术指征探讨

目的总结重型肝炎实施急诊肝移植的经验,探讨其手术指征。方法回顾性分析34例拟行急诊肝移植治疗的重型肝炎并急性肝衰竭患者的临床资料,其中11例实施急诊肝移植手术。结果34例患者中,14例在等待供体中死亡,另9例在转入我科时已丧失手术机会,于3d内死亡。11例急诊肝移植均采用改良背驮式肝移植,其中1例术后7d死于肺部感染、急性呼吸窘迫综合征(ARDS),1例术后20d死于原发性移植肝功能不良合并肾功能衰竭,其他9例术后均恢复顺利。随访6~29个月,1例于术后12个月死于慢性排斥反应,余8例情况良好。结论急诊肝移植是治疗重型肝炎合并急性肝功能衰竭移植的有效方法,其指征为:(1)Ⅱ级及Ⅱ级以上的进行性脑病;(2)PT延长15 s以上(或凝血酶原活动度<30%);(3)血清TBIL(300μmol/L(17.5mg/dl)或TBIL进行性升高(每天>17.1μmol/L)。     

精神分裂症患者氯氮平使用现况调查

目的:了解精神分裂症患者氯氮平的使用现状。方法:按一定的抽样比例,抽取10个省市46家专科医院或综合医院精神科,于2002年4月22日至24日,采用自制问卷对4779例门诊和住院精神分裂症患者进行氯氮平使用情况调查。结果:39.0%(1863/4779)的患者使用氯氮平治疗,平均剂量为(216±133)mg/d;其中41.2%的患者为联合用药,合并使用抗胆碱能药物者为19.2%。与未使用氯氮平的患者比较,使用氯氮平的患者病程较长、家庭收入较低;男性及住院患者更多使用氯氮平,氯氮平治疗者疗效指数低于非氯氮平治疗者。患者的性别、就诊部门、家庭收入和是否首次住院以及抑郁和攻击症状为是否使用氯氮平治疗的影响因素。结论:精神分裂症患者氯氮平使用率为39.0%,其中41.2%为联合用药。是否使用氯氮平治疗与患者的经济状况和临床特征等因素有关。     

缬沙坦与吲达帕胺联合用药对原发性高血压患者动态血压及胰岛素敏感性的影响

目的：探讨缬沙坦与吲达帕胺联合应用对原发性高血压（EH）患者动态血压及胰岛素敏感性的影响。方法：对65例EH患者于治疗前和治疗24周后分别进行动态血压监测（ABPM）和胰岛素敏感性测定。结果：治疗后24h平均pSB、pDB，血压负荷较治疗前均显著降低（P＜0．01）。治疗后血压昼夜节律消失者8例，较治疗前42例显著减少（P＜0．01）。治疗后各时点胰岛素与血糖比值（I／G）均明显下降（P＜0．01），治疗后胰岛素敏感指数（ISD）显著增高（P＜0．01）；治疗后葡萄糖 耐量试验120min和180min两个时点C／I比值比治疗前显著增高（P＜0．01－0．05）。结论：缬沙坦与吲达帕胺联合应用可显著降低EH患者动态血压水平和血压负荷，改善血压昼夜节律，显著改善胰岛素敏感性。