胆胰康对慢性胰腺炎大鼠血清超氧化物歧化酶活性、羟脯氨酸含量及胰腺病理的影响

目的:通过观察中药胆胰康(DYK)对慢性胰腺炎(CP)大鼠血清超氧化物歧化酶(SOD)活性、羟脯氨酸(HYP)含量的影响及胰腺病理改变,进而探讨该方药治疗CP的机理。方法:从70只SD大鼠(雌雄各半)中随机抽取20只(雌雄各半)作为正常组大鼠,其余50只大鼠采取腹腔注射L-精氨酸(L-Arg)的方法制造慢性胰腺炎动物模型。3周后抽取正常大鼠10只(雌雄各半)、模型大鼠10只(雌雄各半),分别检测血清SOD活性及HYP含量,镜下观察胰腺组织改变。验证造模成功后,将剩余的40只模型大鼠随机分为4组:模型组(b)、小柴胡汤丸组(c)、胆胰康低剂量组(d)、胆胰康高剂量组(e)。剩余的10只正常大鼠作为空白组(a)。从第4周起给药治疗,治疗4周后,处死全部大鼠,提取血清检测SOD活性及HYP含量,观察胰腺组织病理改变。进行实验数据统计。结果:b血清SOD活性明显低于a(P0.01),HYP含量高于a(P0.01),c、d、e血清SOD活性均明显高于b(P0.01),HYP含量明显低于b(P0.05)。所有治疗组胰腺组织均有不同程度病理改变。结论:采取腹腔注射L-Arg的方法能够成功地复制大鼠CP模型,DYK能够有效地提高CP大鼠血清SOD活性,降低其血清HYP含量,能够有效地对抗CP形成过程中的胰腺组织损伤,从而对CP具有显著的防治作用。     

An autopsy case of pancreatic and ectopic nesidioblastosis

We report an autopsy case of pancreatic and ectopic nesidioblastosis. A five-month-old Japanese girl was born at 35 weeks gestation, and showed clinical symptoms of hyper-insulinemic hypoglycemia before death. At autopsy a tumorous nodule was observed at the portion of the jejunum, 90 cm from Treitz's ligament. The nodule measured 30 × 20 × 20 mm. The ectopic pancreas, also revealed nesidioblastosis histologically. Immunohistologically, both nesidioblastoses were stained positive for chromogranin A, insulin, glucagon and somatostatin. The proliferating cell nuclear antigen (PCNA) and Ki-67 indices were less than 4% in the nesidioblastosis. To our knowledge, this is the first reported case of nesidioblastosis demonstrating proliferating activity with PCNA and Ki-67, and is the third reported case of nesidioblastosis arising in the pancreas and ectopic pancreas.     

Demonstration of A-currents in pancreatic islet cells

Voltage-activated K⁺ currents resistant to TEA but blockable by 4-AP were recorded from mouse pancreatic islet cells. These currents first become observable during depolarizations to voltages more positive than –40 mV, reaching a peak amplitude of 120±34 pA at +6 mV (n=4), display rapid turn on (=3.3±1.1 ms at +6 mV) and inactivate completely within 250 ms (=65±5 at +6 mV). The current is subject to steady-state inactivation. The midpoint (V _h) of the inactivation curve (h) was observed at –72±2 mV. The properties of this current resemble those reported for the A-current in neurons.     

Piretanide-dextran and piretanide-polyethylene glycol interact with high affinity with the Na+ 2 Cl− K+ cotransporter in the thick ascending limb of the loop of Henle

Piretanide blocks the Na⁺ 2Cl^– K⁺ cotransporter protein in the thick ascending limb (TAL) of the loop of Henle reversibly. When tested from the luminal side in isolated perfused cTAL segments it leads to a half maximal inhibition (IC₅₀) of the equivalent short circuit current (I_sc) at a concentration of 10^–6 mol/l. From the basolateral side it has no effect on I_sc up to 10^–4 mol/l. The present study was designed to search for high affinity blockers of the Na⁺ 2Cl^– K⁺ cotransporter with large molecular weight in an attempt to use these macromolecules for antibody-labelling or affinity separation of this transport-protein. Amino-ethyl-dextran or amino-ethyl-polyethylene glycol (M.W. 5kd) were coupled to isothiocyanato-piretanide (ISO-PIR) at room temperature in DMSO. The resulting compounds dextran-sulfonylurea-piretanide (PIR-DEX) and polyethylene glycol-sulfonylurea-piretanide (PIR-PEG) (M.W. 5.38kd) were purified and tested in isolated perfused cTAL segments. IC₅₀ values for ISO-PIR, PIR-DEX and PIR-PEG were estimated from dose response curves after their addition to the lumen or bath perfusate, respectively. ISO-PIR, PIR-DEX and PIR-PEG acted from the lumen side at 3·10^–6, 6·10^–6 and 2·10^–6 mol/l. The inhibitory effect was easily reversible. From the basolateral side no effect for any compound was seen at up to 10^–4 mol/l. In clearance experiments PIR-DEX was given to female Wistar rats as an i.v. bolus (25 mol/kg) and the diuretic urine was collected. After dialysis (exclusion limit 2.5kd) the dialysed urine and the dialysate were tested in isolated perfused cTAL segments. The dialysates had no effect on I_sc, but the dialysed urine inhibited I_sc by 35% from the luminal side. The present data show: High molecular derivatives of piretanide with dextran or polyethylene glycol moieties block the Na⁺ 2Cl^– K⁺ cotransporter in cTAL segments at roughly the same low concentration as piretanide itself. Our data exclude a metabolism of these piretanide compounds in the kidney. Since these macromolecular probes can probably not enter the cell their inhibitory effect indicates that the binding site for piretanide diuretics on the Na⁺ 2Cl^– K⁺ cotransporter is exposed on the surface of the luminal cell membrane.This study was supported by Deutsche Forschungsgemeinschaft Gr 480/9     

Natural infection of duck embryos with duck hepatitis B virus: time and tissue sequence of infection

There have been no studies addressing the detailed sequence of embryonic infection with duck hepatitis B virus (DHBV). Therefore, duck embryos from flocks infected with DHBV were examined to study the sequence of infection by DHBV in various embryonic tissues. Embryos from flocks infected with DHBV were harvested in duplicates from 7 to 25 days of incubation. Whole embryos (to 12 days) or dissected embryonic tissues were fixed, paraffin embedded, and stained for DHBV surface antigen (DHBsAg) using a peroxidase-antiperoxidase technique. Isolated hepatic cells were infected in 7-day-old embryos, and these increased in number until 11 days, when most cells were positive for DHBsAg. Endocrine pancreatic cells were positive from day 10, but only an occasional exocrine pancreatic cell was infected after day 20. Renal tubule cells were positive for DHBV by day 11, increasing in number until about day 18, after which a decline in numbers of infected cells occurred. Renal glomeruli became positive for DHBsAg from day 24. When present in the developing embryo, thymus, bursa of Fabricius, spleen, bone marrow, lung, and duodenum remained negative for DHBsAg. It was concluded that the timing of infection of specific tissues was not necessarily related to cellular maturity but may reflect a need for specific metabolic functions that permit viral replication.     

Early Diagnosis of a Pediatric Pancreatic Tumor by Abdominal Physical Examination: A Case Report

BackgroundDetecting a neoplasm in pediatric patients with acute abdominal pain is difficult, especially when there is no palpable mass. Ihara's maneuver, which allows the physician to apply manual pressure directly on the pancreatic body, is a useful palpation method of diagnosing acute pancreatitis in children. We report a case of solid pseudopapillary neoplasm of the pancreas (SPNP) detected by Ihara's maneuver.Case ReportAn otherwise healthy, 15-year-old male visited our emergency department with acute abdominal pain and nausea. His vital signs were appropriate for his age. A physical examination denied peritoneal signs, but Ihara's maneuver induced strong tenderness. His serum amylase and lipase were normal. A contrast-enhanced computed tomography scan revealed a well-defined, 2.2-cm, nonenhanced mass in the pancreatic tail. Laparoscopic distal pancreatectomy was performed, and the diagnosis of SPNP was confirmed. The patient was well postoperatively without any metastasis. SPNP is a rare neoplasm with low malignant potential. Although it typically occurs in young females, it has also been reported in children. The early diagnosis of SPNP is usually challenging because most patients do not have specific symptoms or laboratory findings. In the present case, the SPNP was difficult to detect by palpation because of its size, but Ihara's maneuver induced strong tenderness of the pancreas and led to a diagnosis.Why Should an Emergency Physician Be Aware of This?Ihara's maneuver has the potential to enable early diagnosis not only of pancreatitis but also of pancreatic tumors, such as SPNP.     

Long-Term Correction of Diabetes in Mice by In Vivo Reprogramming of Pancreatic Ducts

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胰腺导管内乳头状黏液性肿瘤相关浸润性癌临床病理及预后因素分析

目的：探讨胰腺导管内乳头状黏液性肿瘤（intraductal papillary mucinous neoplasm,IPMN）相关浸润性癌患者的临床病理特征及预后特点。方法：回顾性分析52例胰腺IPMN相关浸润性癌患者的临床资料和病理学特征,并随访其生存情况。结果：52例患者的中位发病年龄为65岁;36例患者的肿瘤发生在胰头部,15例发生在胰体尾部,1例为全胰导管内均有病变。IPMN类型包括,23例胃型,12例肠型,9例胆胰型,7例混合型（“胃型”+“胆胰型”）,1例嗜酸细胞型;浸润性癌类型包括37例导管腺癌,13例胶样癌,1例未分化癌和1例腺鳞癌。血清CA19-9升高的情况在导管腺癌患者中更为显著,浸润性癌类型为导管腺癌患者的CA19-9阳性率为67.57%（25/37）,而浸润型癌类型为胶样癌的患者中CA19-9阳性率为30.77%（4/13）。43例获得随访资料的患者中,无淋巴结转移的患者共30例,中位生存时间较13例淋巴结转移患者（39个月比13个月）长,差异有统计学意义（P<0.05）;肿瘤局限于胰腺内的21例患者,其中位生存时间较肿瘤浸润胰腺外的22例患者长（45个月比24个月）,差异有统计学意义（P<0.05）。43例患者获得随访,中位随访时间为16个月（5~57个月）,其中1例复发,17例死亡。结论：胰腺IPMN相关浸润性癌类型以导管腺癌为主,而血清CA19-9升高与浸润性癌类型相关。淋巴结转移及肿瘤胰腺外侵犯是胰腺IPMN相关浸润性癌患者预后不良的危险因素。     

Using technology to advance type 1 diabetes care among women during the reproductive years and in pregnancy

The prevalence of diabetes is increasing globally. Technology to improve care among individuals with diabetes is constantly being developed. Women living with Type 1 Diabetes Mellitus (T1DM) have unique challenges affecting their glucose control relating to menstrual cycles, pregnancy, and menopause. The purpose of this review is to examine the literature related to the use of technology to help women with T1DM manage their diabetes during the reproductive years, pregnancy, and beyond. Continuous subcutaneous insulin infusion (CSII) therapy can provider equivalent or better glucose control when compared with multiple daily injections (MDI), with less hypoglycemia, diabetic ketoacidosis, and weight gain. The CSII therapy has features that could help improve glucose control over the menstrual cycle, menopause, and pregnancy, although the most studied of these stages is pregnancy. Continuous glucose monitoring (CGM) can be combined with any insulin delivery system (MDI or CSII) to provide data on glucose values every few minutes and show glucose trends over time. CGM introduction can highlight glucose variability for women with T1DM, may be beneficial during pregnancy, and can reduce hypoglycemia. Sensor-augmented pump therapy and hybrid artificial pancreas (closed-loop) systems are promising tools that improve outcomes among individuals with diabetes. The use of modern technology to improve glucose and metabolic control among menopausal women with diabetes has not been well studied. Internet and phone-based technologies are emerging as important tools that may help with diabetes self-care for women living with diabetes.     

SD大鼠正常胰腺MRI表现

目的 观察SD大鼠正常胰腺MRI表现.方法 对9只健康SD大鼠行MR平扫及增强扫描,观察胰腺形态、分布、位置毗邻及信号特点.之后处死大鼠,观察其胰腺解剖及组织学表现.结果 共8只大鼠顺利完成MR扫描,1只因麻醉死亡.MRI显示胰腺位于胃、脾脏及左肾之间,分为胃叶、脾叶及十二指肠叶,汇合于胰腺结合部;脾叶信号强度＞十二指...