Loss of insulin receptor immunoreactivity from the substantia nigra pars compacta neurons in Parkinson's disease

Immunohistochemistry using both a newly developed polyclonal, and a commercially available monoclonal, anti-insulin receptor antibody was done on the midbrain from cases of idiopathic Parkinson's disease (PD), Alzheimer's disease, amyotrophic lateral sclerosis, vascular parkinsonism and non-neurological controls. Both antibodies gave indentical patterns of neuronal staining. The neurons of the oculomotor nucleus were immunopositive in all the brains. However, the neurons in the pars compacta of the substantia nigra, paranigral nucleus, parabrachial pigmental nucleus, tegmental pedunculopontine nucleus, supratrocheal nucleus, cuneiform nucleus, subcuneiform nucleus and lemniscus medialis, which were positive in other diseases and in non-neurological controls, were not stained by these antibodies in PD brains. These results suggest that, in PD, a dysfunction of the insulin/insulin receptor system may precede death of the dopaminergic neurons.The work in the Kinsmen Laboratory was supported by the MRC of Canada and the Parkinson Society of Canada     

全植入式药泵行肝血管灌注治疗晚期肝癌

对２４例不能切除的晚期肝癌采用完全植入式药泵行肝动脉和门静脉双灌注化疗。结果：部分缓解（ＰＲ）１５例（６２．５％），稳定（Ｓ）８例（３３．３％），进展（Ｐ）１例。平均生存期为９．１７月，半年生存率为６６．７％，１年为２５％。在ＡＦＰ＞４００μｇ／Ｌ的１０例中，５例下降。     

血卟啉衍生物对癌细胞钠泵活性和糖酵解的光动力效应

血卟啉衍生物(YHpD)合并照光对S180瘤细胞摄取~(86)Rb,瘤细胞的钠泵活性及糖酵解具有明显的抑制作用,且抑制程度随YHpD剂量的增大而增强。瘤细胞的总ATP酶和(Na-K)-ATP酶活性对YHpD的光动力效应也较敏感.YHpD对Mg—ATP酶活性有轻度抑制作用。YHpD并用哇巴因,对瘤细胞摄取~(86)Rb的光动力效应比两种药物单独应用的抑制作用大。     

妇产科患者术后使用镇痛泵引发尿路感染的临床探讨

目的 了解留置导尿所致尿路感染的发病率及影响因素。方法 采用前瞻性调查与回顾性调查相结合的方法,对妇产科手术后患者留置尿管而引发泌尿系感染率增高的原因进行调查和分析。结果 使用镇痛泵患者留置导尿后尿路感染率为5.45％,未用镇痛泵者的尿路感染率为0.21％,两者之间差异有高度显著性(P<0.005)。结论 镇痛泵不能滥用,使用时要避免诱发感染的因素。     

The short insulin tolerance test for determination of insulin sensitivity: a comparison with the euglycaemic clamp.

The glucose clamp technique is currently regarded as the standard test for measuring insulin sensitivity against which other methods are compared but is unsuitable for routine screening of patients outside a hospital base. There is thus a need for a simpler test to measure insulin sensitivity. We have therefore compared the glucose disappearance rate KITT in the first 15 min of the insulin tolerance test (ITT) with the M and M/I values derived from the standard euglycaemic clamp in nine normal subjects and eight subjects with Type 2 (non-insulin dependent) diabetes mellitus and coexisting obesity. All subjects underwent the ITT and euglycaemic clamp in random order. Nine subjects later had a repeat ITT to determine the reproducibility of the test. In the ITT, 0.1 U kg-1 body weight, human Actrapid insulin was given as an IV bolus and simultaneous arterialized and venous blood samples were obtained every minute for 15 min. The first order rate constant for the disappearance of glucose KITT over the period 3-15 min was taken as a measure of insulin sensitivity. The euglycaemic clamp was performed with an insulin infusion of 50 mU kg-1 h-1 for 120 min and a variable rate glucose infusion to maintain blood glucose concentration at 0.5 mmol l-1 below fasting level to minimize the effect of endogenous insulin secretion. The ratio of the mean rate of glucose infused (M, mumol kg-1 min-1) to the plasma insulin over the last 30 min of the clamp was taken as a measure of tissue sensitivity to insulin (M/I) assuming endogenous glucose output was suppressed.(ABSTRACT TRUNCATED AT 250 WORDS)     

甜茶素提取物对STZ致高血糖大鼠的降血糖作用研究

目的 :　研究甜茶素提取物对 STZ致高血糖大鼠的降血糖效果及其降糖机制。方法 :　腹腔注射 STZ制备糖尿病大鼠模型 ,取成型的大鼠随机分阳性对照组、甜茶素提取物组和降糖灵组。同时设一正常组。灌胃 3 w后 ,测血糖、果糖胺、胰岛素和 SOD等指标。结果 :　甜茶素提取物能极显著地降低 STZ致高血糖大鼠血糖 ,增强其抗氧化能力 ,同时能刺激胰岛素的分泌。结论 :　甜茶素提取物通过刺激胰岛素的分泌来降低血糖     

细胞因子与2型糖尿病及胰岛素抵抗的相关性研究

目的 研究2型糖尿病及胰岛素抵抗患者白细胞介素6（IL-6）、白细胞介素8（IL-8）及肿瘤坏死因子α（TNF—α）的变化，分析细胞因子与糖尿病及胰岛素抵抗的相关性。方法 采用酶联免疫吸附法测定90例2型糖尿病患者及30例正常人血清各细胞因子浓度，并同时测定空腹血糖（FPG）、糖化血红蛋白、空腹胰岛素（FINS）及空腹C肽（FCP）水平，分析其与细胞因子的相关性。结果 与正常对照组比较2型糖尿病组血清细胞因子的含量均明显增高（P〈0．01、P〈0．05）；胰岛素抵抗组的IL-6、TNF—α升高与非胰岛素抵抗组比较差异有统计学意义（P〈0．05），胰岛素抵抗与细胞因子的增高密切相关。结论 2型糖尿病患者存在着细胞因子的过度激活，并与胰岛素抵抗密切相关，细胞因子在2型糖尿病及胰岛素抵抗的发生发展中起着重要的作用。     

可调节携便式镇痛泵

现有的镇痛泵是用于手术后,为患者解除或者减轻患者的疼痛而设计的。一个特殊的原因,为使镇痛泵能用于长期受疼痛折磨的患者,为适应这类患者要自由活动和长期使用的需要,在现有镇痛泵的基础上,经过研究、改造,成功的研制出可调节携便式镇痛泵,经临床使用获得良好的效果,并获得国家实用新型专利(专利号:200420059087.1)。     

Diabetic and nondiabetic hyperglycemia in the ICU

Hyperglycemia is a common feature in critically ill patients, whether they are diabetic or not, and it is associated with unfavorable outcome. The more severe the underlying disease, the more important the hyperglycemia appears to be although, we still cannot define whether hyperglycemia is just a marker of the severity of the acute illness or rather an active contributor to poor outcome. The review of the literature on this subject published from 2001 up today conveys a massive amount of information the interpretation of which is equivocal, due to the heterogeneity of patients (nondiabetic vs. diabetic, medical intensive care unit (ICU) pts vs. surgical ICU pts) and of interventions (dose and modality of insulin infusion).The association between high glucose level and mortality is strong in critically ill patients without a previous history of diabetes. Admission hyperglycemia seems to be an independent risk factor of in-hospital mortality in patients both with and without diabetes in cardiac, cardiothoracic and neurosurgical ICUs. No data are still available on general surgical ICU patients.Tight control of blood glucose levels has been demonstrated to improve outcome in both diabetic and nondiabetic critically ill patients. In surgical ICUs, tight glucose control improves mortality and reduces morbidity only among patients admitted in ICU for more than 5 days, while outcome is not improved in patients who stay in ICU for less than 3 days.However, it is not yet understood if such favorable effect is secondary to glucose control itself or if insulin plays a part, by means of its nonglucose, anabolic effects. More randomized controlled trials are needed, addressing specific issues—such as the optimal target glucose concentration and the most effective insulin regimen—especially in the general surgical patient.