孕妇外周血NKT细胞水平与妊娠期肝内胆汁淤积症发病及病情关系

目的:探究孕妇外周血自然杀伤T(NTK)细胞水平与妊娠期肝内胆汁淤积症(ICP)发病及病情严重程度相关性。方法:选择2016年3月1日-2018年3月1日本院就诊的ICP患者52例(ICP患者组),根据ICP严重程度分为轻度ICP组(n=28)和重度ICP组(n=24),同时随机选择孕周相当的健康产前检查孕妇52例(健康孕妇组),比较各组外周血单个核细胞(PBMC)中NKT细胞水平,分析NKT细胞水平与ICP发生发展相关性。结果:ICP患者组外周血PBMC中NKT细胞含量高于健康孕妇组(P<0.05)。对ICP患者组和健康孕妇组外周血PBMC给予不同刺激物培养后,均显示出NKT细胞含量在正常组与空白组无差异(P>0.05),而在植物血凝素(PHA)组、ICP组、正常组依次降低(P<0.05)。重度ICP组外周血PBMC中NKT细胞含量高于轻度ICP组(P<0.05),NKT细胞含量与ICP病情严重程度呈正相关关系(P<0.05)。结论:ICP发生及进展与孕妇外周血NKT细胞水平呈正相关关系,监测NKT细胞水平可为诊断ICP提供新思路。     

Is there an abnormal fasting duodenogastric reflux in nonulcer dyspepsia?

A quantitatively and/or qualitatively abnormal duodenogastric reflux (DGR) could be involved in the pathogenesis of nonulcer dyspepsia (NUD). The aims of this prospective study were to look for (1) a pathological DGR profile during fasting and (2) an eventual correlation between DGR profile and clinical symptoms. Twenty-six NUD patients were investigated. Seven other operated patients with a surgical procedure facilitating DGR episodes and 27 healthy volunteers served as control groups. A clinical score was determined for each patient from a standardized questionnaire. Gastric aspiration was performed for 6 hr in fasting subjects. The aspirates were pooled into 17 samples. In each sample the concentration and the output of total bile acids was determined. If the concentration was larger than 30 mol/liter in pooled samples, the concentrations of free bile acids and the distribution of the conjugated bile acids was determined. The percentage of aliquots with a total bile acid concentration larger than 50 mol/liter (without upper limit), and the percentage with a concentration larger than 2500 mol/liter was also obtained. No significant difference was demonstrated between the healthy volunteers and NUD patients, whatever the parameter considered. However, there was a significant increase in each of the quantitative parameters for the group of operated patients in comparison with the NUD patient group. No significant correlation was found between the clinical score and the DGR profile in NUD patients. Apparently, DGR episodes do not play a primary role in the pathogenesis of NUD.Part of this work was presented at the 4th European Symposium on Gastrointestinal Motility, Krakow, Poland. September 22–24, 1988.Hepatogastroenterology, 35:178, 1988 (abstract).     

魔芋精粉与几种常用膳食纤维降血脂效果比较及机理探讨

用含胆固醇1％、胆盐0.25％、猪油5％的高脂饲料喂饲健康雄性大鼠,诱发高脂血症的同时分别加入5％的魔芋精粉、果胶、褐藻胶及琼脂,观察此四种膳食纤维对大鼠生长、血清脂质含量、肝脏脂质含量及肝脏组织病理的不同影响,并通过测定粪中酸性固醇的排泄量来观察它们对胆汁酸代谢的影响。结果表明:1)四种膳食纤维均能有效地降低进食高脂膳食大鼠的空腹血清总胆固醇含量,对空腹血甘油三酯水平无影响;2)魔芋精粉能较其余三种膳食纤维更有效地降低肝脏组织脂质含量,包括胆固醇及甘油三酯。肝组织病理学检查亦显示魔芋精粉减轻肝脂变效果最佳;3)四种膳食纤维均能增加粪中胆汁酸尤其是鹅脱氧胆酸的排泄量,推测这可能是它们降低机体脂质的机理之一;4)四种膳食纤维在5％摄入水平对大鼠摄食及生长无不良影响。     

The Effects of Permeation Enhancers on the Surface Morphology of the Rat Nasal Mucosa: A Scanning Electron Microscopy Study

A rat model has been developed to compare relative morphological changes in the nasal mucosa after exposure to potential membrane permeation enhancers. Scanning electron microscopy was used to characterize gross structural and specific cellular changes following exposure. Micrographs of the rat nasal mucosa were scored in four categories: (1) mucosal surface integrity, (2) ciliary morphology, (3) mucus/extracellular debris, and (4) presence of red blood cells. The order of increasing morphological damage resulting from a 5-min exposure to each surfactant was 0.5% Solulan C-24 0.5% Solulan C-24/0.5% sodium tauro-24,25-dihydrofusidate (STDHF) < 0.5% STDHF < 1.0% STDHF 1.0% Laureth-9 < 1.0% sodium taurodeoxycholate 1.0% sodium deoxycholate. The changes observed in the mucosal morphology after exposure to the various surfactants are in general agreement with data in the literature. This model is able to compare rapidly the relative morphological effects on the mucosal membrane of different nasal formulations.     

Bile Salt–Fatty Acid Mixed Micelles as Nasal Absorption Promoters of Peptides. I. Effects of Ionic Strength,Adjuvant Composition,and Lipid Structure on the Nasal Absorption of [D-Arg2]Kyotorphin

Bile salts and synthetic surfactants have been used to promote nasal absorption of peptide drugs. Although a marked increase in nasal absorption has been achieved, this may not be adequate and the possibility of adjuvant-induced membrane toxicity exists. The present study employs a rat in situ nasal perfusion technique and mixed micelles between sodium glycocholate (NaGC) and various lipids as potential nasal absorption enhancers of a stable model dipeptide, [D-Arg²]kyotorphin. NaGC alone enhanced the nasal absorption of the dipeptide in a concentration-dependent manner. When linoleic acid was added to form mixed micelles with NaGC, the absorption was further enhanced (P < 0.01). The effect of mixed micelles was synergistic and much greater than with single adjuvants. Increasing ionic strength was found to increase the adjuvant activity of both NaGC and NaGC–lipid mixed micelles. Structure of the lipid component of the mixed micelles also affected the adjuvant potency. Oleic acid, a cis-unsaturated fatty acid, was more effective than elaidic acid, the trans-isomer, whereas cis-linoleic acid and trans-linolelaidic acid were equally effective ( = 0.05). Mixed micelles of mono-glycerides such as monoolein and monolinolein were also more effective than NaGC alone ( = 0.05). Micellar solubilization of these polar lipids by NaGC appears to be important for nasal absorption enhancement to occur. Reversal of the membrane permeability was also observed within approximately 20–40 min after removal of the adjuvants from the rat nasal cavity. These observations are similar to the effects of mixed micelles on the rectal mucosa and may involve the same mechanism.     

88例肝病患者CHE、TBA以及PT测定结果分析

为了解血清中CHE活性、TBA含量以及PT测定与各类肝脏疾病的关系 ,对 88例经临床确诊为各类型肝病患者血清CHE、TBA以及PT测定结果进行分析 ,结果表明 :各类肝脏疾病TBA、PT均增高 ,CHE活性均降低 ,与正常对照组相比 ,除CHE指标差异无显著性外 ,其余各组差异有高度显著性 (P均 <0 .0 0 1) ,同时可以看到 ,慢性肝炎与肝硬化组的PT测定值差异无显著性 ,其余各组间此三项指标比较差异有显著性 ,P均为 0 .0 5～ 0 .0 0 1,提示血清CHE、TBA及PT测定对肝脏疾病的诊断均有较高的敏感性 ,均可作为评价肝病轻重程度的判断指标     

妊娠肝内胆汁淤积症孕妇血及脐血中一氧化氮水平与胎儿脐血流的关系

目的　了解妊娠肝内胆汁淤积症 (ICP)时 ,孕妇血及脐血中一氧化氮 (NO)水平与胎儿脐动脉血流的关系 ,以进一步探讨ICP时胎盘循环阻力增高的原因。方法　对 35例ICP孕妇 (ICP)组 )及 32例正常孕妇 (对照组 ) ,用镉还原显色法测定母血及脐血NO水平 ;超声多普勒测定胎儿脐血流S/D值。结果　ICP组母血、脐血NO水平均明显低于对照组 (P <0 .0 1,P <0 .0 1) ;两组母血、脐血NO水平均有相关关系 (r =0 .5 481,r =0 .82 0 6 ,P<0 .0 1,P <0 .0 1) ,ICP组脐动脉血流S/D值明显高于对照组 (P <0 .0 1) ,母血、脐血NO水平与S/D值呈负相关(r =- 0 .34 15 ,r=- 0 .42 6 1,P <0 .0 5 ,P <0 .0 1。结论　ICP时母血、脐血NO水平降低对胎儿—胎盘循坏阻力增加有重要的作用     

术中经胆囊管胆道造影的应用价值

目的：探讨胆囊切除术时经胆囊管作胆道造对胆道结石病人的应用价值。方法回顾分析442例患有胆囊胆道结石的病人经胆囊管胆道造影的情况。结果442例病人中,假阳性3例,假阴性1例,诊断准确率达99．1％,结论对胆囊胆道结石病人,特别具有胆总管相对探查指征的病人,常规作术中经胆囊管胆道造影可降低胆道残余结石发生率,减少胆道损务,避免不必要的胆总管探查。     

复发性甲状舌管囊肿(瘘管)的原因探讨和预防措施

目的：探讨甲状舌管囊肿（瘘管）术后复发的原因和提高手术疗效的措施。方法：对３２例甲状舌管囊肿（瘘管）病例（含８例术后复发者）,术前感染病例先行抗炎后再手术,准确判定甲状舌管囊肿与舌骨的关系,处理舌骨;术中衔注美蓝液入囊管内示踪,行Ｓｉｓｔｒｕｋ术式,分离小分支,以手术显微下失去示踪小支,手指接触诊疑为残存病灶处,行环形缝扎或电凝,射频等处理。结果：３２例均获成功,随访１年以上未见复发。结论：对甲状