超声内镜引导下无水乙醇注射法与外科手术法治疗良性胰岛素瘤的对比研究

目的评估超声内镜(EUS)引导下无水乙醇注射法治疗良性胰岛素瘤的疗效与安全性,并与外科手术治疗法相比较。方法回顾性分析2011年4月-2016年2月在广西医科大学第一附属医院经EUS引导下无水乙醇注射法治疗或外科手术法治疗的38例良性胰岛素瘤临床资料。结果 97.4%(37/38)的患者有典型的Whipple三联征,82.9%(29/35)患者低血糖发作时胰岛素释放指数(I/G)0.3。术前B超、CT、磁共振成像(MRI)、正电子发射计算机断层显像(PET/CT)和EUS定位诊断胰岛素瘤阳性率分别为50.0%、67.6%、66.7%、75.0%和89.7%。18例行EUS引导下无水乙醇注射治疗(EUS-FNI组),20例行外科手术治疗(外科手术组),EUS-FNI组术后均无并发症发生,外科手术组中40.0%(8/20)患者出现并发症。与外科手术组相比,EUS-FNI组在手术时间、术中出血、术后并发症、术后住院时间和住院总费用上均明显降低(P0.05)。所有患者均得到随访,EUS-FNI组最后一次无水乙醇注射治疗后所有患者血糖平稳在正常范围;外科手术组20例患者中,90.0%(18/20)患者术后无低血糖症状再发作,监测血糖在正常范围,10.0%(2/20)患者术后低血糖症状发作较术前减少。结论 EUS引导下无水乙醇注射法治疗良性胰岛素瘤安全、有效。与外科手术法相比,具有微创、经济、并发症少和术后恢复快等优势。     

Pentoxifylline has favorable preventive effects on experimental chronic pancreatitis model

Abstract

Background: To investigate the protective efficacy of pentoxifylline through biochemical parameters and histopathological scores in a caerulein- and alcohol-induced experimental model of chronic pancreatitis in rats.

Methods: A model of chronic pancreatitis with caerulein and alcohol was created in female rats of the genus Sprague Dawley. Pentoxifylline was administered in doses of 25?mg/kg (low dose) and 50?mg/kg (high dose) as a protective agent. Each group contained 8 animals. The groups were: group 1 (control group); caerulein?+?alcohol, group 2 (low-dose pentoxifylline group); caerulein?+?alcohol?+?pentoxifylline 25?mg/kg, group 3 (high-dose pentoxifylline group); caerulein?+?alcohol?+?pentoxifylline 50?mg/kg, group 4 (placebo); caerulein?+?alcohol?+?saline, group 5 (sham group); only saline injection.Rats were sacrificed 12?h after the last injection, and TNF-α, TGF-β, MDA, and GPx concentrations were measured in blood samples. The histopathologic examination was conducted by a pathologist who was unaware of the groups.

Results: The biochemical results of the treatment groups (group 2 and group 3) were statistically significantly lower compared with the control group (group 1) (p?<?.05). The difference between the low-dose treatment group (group 2) and high-dose treatment group (group 3) was significant in terms of biochemical parameters (p?<?.05). The difference between group 2 and the control group was not significant in terms of histopathologic scores (p?>?.05), whereas the difference between the group 3 and the control group was statistically significant (p?<?.05).

Conclusions: As a result, pentoxifylline, which has anti-inflammatory and antioxidant properties, was shown to have protective efficacy in an experimentally generated model of chronic pancreatitis.     

Alcohol Use among Injured Patients Aged 12 to 18 Years

Objective : To examine the scope of alcohol use among a population of injured adolescents.
Methods : A convenience sample of injured patients aged 12–18 years seen at a pediatric ED was tested for the presence of alcohol. Injured patients seen within 6 hours of their injuries were asked to submit urine samples for testing using reagent strips. Data were collected from the patient, out-of-hospital emergency care personnel, and parents regarding the circumstances of the injury.
Results : Of the 243 injured patients who were tested during an 8-month period, 231 were included in the final analysis. Ninety patients (39%) were alcohol-positive. The mean age of the alcohol-positive group was 16.0 ± 1.64 years, compared with 15.3 ± 1.8 years for the alcohol-negative group (p < 0.003). There was no significant difference between the 2 groups based on race, gender, or injury characteristics. A positive urine alcohol test was found for 18 (33%) of the motor vehicle crash victims, 9 (38%) of the motor vehicle drivers, 10 (37%) of the patients who attempted suicide, and 49 (44%) of the assault victims.
Conclusions : A substantial percentage of injured adolescent patients were alcohol-positive. The authors recommend the use of alcohol screening when treating injured adolescents.     

Percutaneous treatment of hydatid cysts under sonographic guidance

Nine patients (five males, four females) with 14 hydatid cysts were treated with albendazole and percutaneous drainage under sonographic guidance. All but two cysts were hepatic. The average cyst diameter was 81.5 mm (range: 42–180 mm). There were eight type 1 cysts, two type 2, three type 3, and a single type 4. Type 1 and 2 cysts were treated by needle aspiration, type 3 and 4 by needle decompression and catheter drainage. The residual cavity was irrigated with 30% hypertonic saline and injected with absolute alcohol. Biliary fistulization contraindicated alcohol use. All cysts were successfully treated. A single episode of reversible anaphylaxis was encountered. Serial sonographic examinations revealed residual cavities ranging from 10 to 35 mm in diameter. No new cysts were noted during an average follow-up of 9.6 months. The mean hospital stay was 48 hr. Percutaneous drainage of hydatid cysts is a relatively safe and cost-effective procedure.     

Gastric cytoprotection by amoxycillin in the rat

Abstract Amoxycillin in combination with anti-ulcer agents has been shown to prolong duodenal ulcer remission. While this effect can be related to the eradication of Helicobacter pylori , it is not known if amoxycillin might possess cytoprotective properties. Protection against ethanol-induced gastric mucosal damage by intragastric instillation of amoxycillin suspension (prepared from capsule form) and solution (from injection form, 100% pure amoxycillin), and by intraperitoneal injection of amoxycillin solution was studied using an ex vivo gastric chamber in the rat. Intragastric and intraperitoneal administration of amoxycillin dose-dependently protected the rat gastric mucosa from damage by absolute ethanol. This protection was lost when the rats were pretreated with indomethacin. Gastric mucosal blood flow as measured by laser Doppler flowmetry and gastric acid output were unaffected by amoxycillin. Amoxycillin imparts gastric cytoprotection, and one possible mechanism is by the release of prostaglandins.     

Mapping of a novel locus for an autosomal recessive form of palmoplantar keratoderma on chromosome 3q27.2‐q29

Many exogenous factors including excessive alcohol consumption have been associated with psoriasis, but the underlying mechanisms still remain elusive. Drinking worsens therapeutic compliance, and decreases the efficacy and increases the toxicity of systemic antipsoriatic treatments. Excess alcohol intake results in compromised immunity and increased risk of infections, but alcohol can induce proinflammatory cytokine production in various cell types and can increase mitogen‐derived lymphocyte proliferation and lymphocyte activation. As we have previously reported, alcohol and one of its metabolites, acetone, induce keratinocyte proliferation and increase the mRNA levels of genes characteristic for proliferating keratinocytes, such as α5 integrin, cyclin D1 and keratinocyte growth factor receptor. Recently the correlation between blood and skin ethanol levels in humans was determined by a transdermal alcohol monitoring device, against the ‘gold standard’ breath alcohol readings. Based on transdermal alcohol measurements it can be concluded that cutaneous alcohol concentrations can reach levels that induce proinflammatory cytokine production and lymphocyte and keratinocyte proliferation in vitro. It is expected that the development of methodologies measuring transdermal ethanol will provide additional tools to evaluate how alcohol influences skin physiology and different dermatological conditions including psoriasis. Our review focuses on the possible link between alcohol misuse and psoriasis, particularly on the possible role of cutaneous ethanol in precipitating the disease.     

正交试验法优选头痛滴丸的提取工艺

目的:优选头痛滴丸的醇提工艺.方法:以阿魏酸和木犀草苷提取率为指标,以乙醇体积分数、提取时间、乙醇用量、提取次数为考察因素,采用L9(34)正交试验法优选头痛滴丸的醇提工艺.结果:最佳提取工艺为8倍量60％乙醇回流提取3次,每次2.0h.结论:该优选工艺合理,稳定可行,有效成分提取率高.     

Role of Corticosterone in Immunosuppressive Effects of Acute Ethanol Exposure on Toll-Like Receptor Mediated Cytokine Production

Acute ethanol (EtOH) exposure causes a stress response in humans, nonhuman primates, and rodents. Previous study results indicate that the suppression of some immunological parameters by EtOH is mediated in part or completely by elevated corticosterone concentrations induced by EtOH. However, initial results suggested that corticosterone is not involved in the modulation of cytokine production by macrophages in response to polyinosinic polycytidylic acid (poly I:C). New studies were conducted to further evaluate the role of corticosterone in EtOH-mediated changes in production of interleukin-6 (IL-6), IL-10, and IL-12 in serum and peritoneal fluid in mice treated with poly I:C or lipopolysaccharide (LPS). Suppression of IL-6, but not IL-12, production by EtOH was found to be mediated by corticosterone. However, poly I:C, LPS, and EtOH all caused similar elevations of corticosterone concentrations; thus, it is not clear if EtOH is required to induce levels or durations of corticosterone needed to mediate the observed effects. The situation with IL-10 was more complicated. Inhibition of corticosterone synthesis with aminoglutethimide prevented the increase in IL-10 production caused by EtOH plus poly I:C as compared to poly I:C only. This indicates that this increase is dependent on corticosterone, but exogenous corticosterone plus poly I:C did not increase IL-10 production. Thus, EtOH and corticosterone are required. However, with LPS inhibition of corticosterone synthesis (using aminoglutethimide) or inhibition of its action (using mifepristone) further increased, or did not affect IL-10 concentrations, suggesting fundamental differences in the signaling pathways leading from poly I:C and LPS to IL-10 production.This work was presented at the annual meeting of the Society for Neuroimmune Pharmacology, Santa Fe, NM, April 2006.     

慢性酒精刺激对大鼠海马胶质源性神经营养因子及其功能性受体c-ret mRNA表达的影响

采用原位分子杂交方法观察了慢性酒精刺激对大鼠海马胶质源性神经营养因子 (GDNF)及其功能性受体 c-ret m RNA表达的影响。结果发现 :慢性酒精刺激 3 0 d时 ,GDNF与 c-retm RNA在海马的表达与对照组相比明显增加 ;慢性酒精刺激 60 d时 GDNF与 c-ret m RNA的表达与 3 0 d时相比显著下降。此结果提示 ,GDNF及其功能性受体 c-ret可能在慢性酒精刺激的早期对海马神经元具有保护作用     

Chronic ethanol tolerance as a result of free-choice drinking in alcohol-preferring rats of the WHP line

The development of tolerance to alcohol with chronic consumption is an important criterion for an animal model of alcoholism and may be an important component of the genetic predisposition to alcoholism. The aim of this study was to determine whether the selectively bred Warsaw High Preferring (WHP) line of alcohol-preferring rats would develop behavioral and metabolic tolerance during the free-choice drinking of ethanol. Chronic tolerance to ethanol-induced sedation was tested. The loss of righting reflex (LRR) paradigm was used to record sleep duration in WHP rats. Ethanol (EtOH)-naive WHP rats received a single intraperitoneal (i.p.) injection of 5.0 g ethanol/kg body weight (b.w.), and sleep duration was measured. Subsequently, rats had access to a 10% ethanol solution under a free-choice condition with water and food for 12 weeks. After 12 weeks of the free-choice intake of ethanol, the rats received another single i.p. injection of 5.0 g ethanol/kg b.w., and sleep duration was reassessed. The blood alcohol content (BAC) for each rat was determined after an i.p. injection of 5 g/kg of ethanol in naive rats and again after chronic alcohol drinking at the time of recovery of the righting reflex (RR). The results showed that the mean ethanol intake was 9.14 g/kg/24 h, and both sleep duration and BAC were decreased after chronic ethanol intake. In conclusion, WHP rats exposed to alcohol by free-choice drinking across 12 weeks exhibited increased alcohol elimination rates. Studies have demonstrated that WHP rats after chronic free-choice drinking (12 weeks) of alcohol develop metabolic tolerance. Behavioral tolerance to ethanol was demonstrated by reduced sleep duration, but this decrease in sleep duration was not significant.