舒肺颗粒对大鼠低氧性肺动脉高压的影响

目的观察舒肺颗粒对大鼠低氧性肺动脉高压的影响。方法将30只雄性Wistar大鼠分为常压对照组、低氧对照组和低氧/中药给药组。以常压低氧复制肺动脉高压模型。观察右心室肥厚指数、肺小动脉管壁厚度的变化。结果低氧/中药给药组应用舒肺颗粒后大鼠肺血管厚度、右心室肥厚指标显著低于低氧对照组(P<0.05),并可抑制低氧所致的大鼠右心室肥厚(P<0.05)。结论舒肺颗粒在防治低氧性肺动脉高压中具有一定的应用前景。     

间歇性低压低氧预适应延缓大鼠低氧性肺动脉高压发展并改善肺动脉舒张

目的 观察间歇性低压低氧预适应对大鼠低氧性肺动脉高压（HPH）及肺动脉舒张功能的影响。方法 将24只雄性SD大鼠随机分为:对照组、HPH组、间歇性低压低氧预适应组,每组8只。对照组动物常规饲养10周;HPH组动物先在同一室内常规饲养6周,然后按低压低氧法建立HPH模型（给予持续低压低氧4周）;间歇性低压低氧预适应组动物先给予预适应实验:HPH 1周,再放置同一室内常规饲养1周,如此重复循环3个周期共6周,然后按低压低氧法建立HPH模型（方法同HPH组）。分组模型建立后,用右心导管法测定肺动脉平均压（mPAP）、右心室平均压（mRVP）;称重测量右心室/（左心室+室间隔）〔RV/(LV+S)〕、右心室/体质量（RV/BW）;HE染色高倍镜下观察肺小动脉显微结构改变;取大鼠左、右肺动脉干制备血管环,行离体血管灌流实验,观察不同浓度乙酰胆碱和硝普钠的舒张血管作用。结果 与对照组比,HPH组大鼠的mPAP、mRVP、RV/(LV+S)、RV/BW均显著增高（P<0.01）;病理切片显示低氧后大鼠肺动脉平滑肌和弹力纤维层增生,血管壁增厚,管腔狭窄、变形;且低氧后大鼠肺动脉血管环对乙酰胆碱的舒张作用显著降低（P<0.01）。与HPH组比,经间歇性低压低氧预适应处理的大鼠mPAP、mRVP、RV/(LV+S)、RV/BW均显著降低（P<0.05）;病理切片显示肺动脉平滑肌和弹力纤维层增生及血管壁增厚有所缓解;且肺动脉血管环对乙酰胆碱的舒张作用显著增强（P<0.05）。结论 间歇性低压低氧预适应可增强大鼠肺动脉对低压低氧环境的耐受能力,延缓肺动脉高压和右心重构的发展,并改善肺动脉内皮功能。     

基质金属蛋白酶-2在低氧性肺动脉高压大鼠肺血管中的表达及辛伐他汀对其影响

目的观察基质金属蛋白酶-2(MMP-2)在低氧性肺动脉高压大鼠肺血管中的表达,及辛伐他汀对其表达的调节作用。方法采用随机分组方法将30只雄性SD大鼠分为对照组、低氧组和预防组,每组10只,低氧组和预防组给予低氧处理,建立大鼠低氧性肺动脉高压模型,且预防组于低氧前给予辛伐他汀灌胃,对照组不做任何处理。3周后观察大鼠平均肺动脉压(mPAP)、右心室肥厚指数即右心室/(左心室+室间隔)和肺血管形态学指标的变化。采用免疫组织化学染色方法检测大鼠肺小动脉MMP-2表达。结果低氧组大鼠mPAP、右心室肥厚指数、肺血管形态学指标和肺小动脉MMP-2染色强度均高于对照组,差异有统计学意义(P<0.01);而预防组上述指标低于低氧组,差异有统计学意义(P<0.01)。结论 MMP-2在低氧性肺动脉高压大鼠肺血管中的表达增加,辛伐他汀可抑制其表达,预防低氧性肺动脉高压的形成。     

P130cas在低压低氧肺动脉高压大鼠中的表达

目的探究P130cas(Crk associated substrate)在低压低氧肺动脉高压大鼠血清及组织中的表达。方法将20只大鼠随机分为正常对照组和低压低氧组。正常对照组在正常环境下饲养28天,低压低氧组在低压低氧舱(低压低氧舱模拟海拔5000米高度)饲养28天。右心导管方法测定各组大鼠肺动脉压力,ELISA方法测定每组大鼠血清中P130cas表达,免疫组化检测肺动脉中P130cas的表达,应用Western blot测定大鼠肺组织中P130cas蛋白表达量。结果低压低氧组大鼠平均肺动脉压力较正常对照组明显升高,且达到肺动脉高压诊断标准;低压低氧组P130cas在大鼠血清及肺组织中的表达较对照组明显升高。结论P130cas可能参与了低压低氧肺动脉高压的形成。     

低氧大鼠肺内硝基酪氨酸的变化研究

目的 观察在低氧大鼠肺组织中氧化产物硝基酪氨酸(nitrotryrosine,NT)表达的变化,探讨氧化应激机制在低氧性肺动脉高压形成中的作用.方法 将14只雄性Wistar大鼠随机分为对照组、低氧组.以常压低氧3周制备肺动脉高压模型,测量各组大鼠平均肺动脉压(mean pulmonary arterial pressure,mPAP)和右心肥厚指数(right ventricle hypertrophy index,RVHI);图像技术测定管壁厚度占血管外径的百分比(wall thickness %,WT %)和管壁面积占总面积的百分比(wall area%,WA%);采用免疫组织化学法观察两组大鼠肺小动脉管壁NT的表达.结果 ①低氧组大鼠mPAP(22.84±1.79)mm Hg和RVHI(29.78±1.07)%与对照组mPAP(16.67±0.97)mm Hg和RVHI(24.22±0.48)%相比,差异有统计学意义(P均＜0.01).②低氧组WT%(24.96±3.70)%和WA%(73.31 ±6.51)%与对照组WT%(14.19±2.61)%和WA%(46.67±7.42)%相比,差异有统计学意义(P均＜0.01).③低氧组大鼠近端肺小动脉管壁的NT染色强度(1.52±0.07)与对照组(1.00±0.00)相比,差异有统计学意义(P＜0.01).两组大鼠远端肺小动脉管壁NT染色强度无明显变化(P＞0.05).低氧组大鼠近端肺小动脉管壁NT表达强度与mPAP值呈正相关(r=0.867,P＜0.05).结论 低氧可诱导大鼠mPAP增高及肺组织内NT产生增加,其作用机制可能与低氧诱导氧化应激有关.     

Apelin及其受体在大鼠慢性低氧性肺动脉高压发生发展中的作用

目的 观察Aplin-APJ系统在大鼠肺动脉高压发生发展中的变化,初步探讨Apelin在肺动脉高压发生发展中可能的作用.方法 复制不同时间的常压低氧性肺动脉高压的动物模型,分为正常对照组(NC组),低氧1周组(1H组),低氧2周组(2H组)、低氧4周组(4H组).采用免疫组化检测Apelin、APJ蛋白在肺小血管中的组织定位.结果 Apelin-36蛋白在肺细小动脉的表达主要在血管内膜与外膜上表,中层平滑肌细胞基本无表达.NC组肺内肌型动脉Apelin蛋白的表达内膜比外膜强(P<0.05);肺内肌型动脉内膜低氧1H组、低氧2H组与外膜1H组,2H组Apelin蛋白的表达无统计学意义(P>0.05);低氧4H组肺细小动脉外膜表达明显强于内膜(P<0.05);肺内细小动脉APJ表达.正常时照组肺内肌型动脉内膜表达强于外膜(P<0.05).1H组、2H组、4H组肺内肌型动脉内膜与外膜APJ蛋白表达积分值无统计学意义(P>0.05).结论 肺细小动脉内、外膜Apelin分布的改变可能与肺动脉高压、肺血管重建的发生、发展有关.     

低压低氧对SD大鼠肺动脉压及肺组织骨桥蛋白表达的影响

目的观察不同时间低压低氧刺激下SD大鼠肺动脉压及肺组织骨桥蛋白(OPN)表达的变化,探讨OPN在肺动脉高压发病机制中的作用。方法将30只SD大鼠随机分成5组:对照组(海拔2 260 m)、低压低氧(低压氧舱模拟5 000 m海拔)1天组、7天组、14天组、21天组,每组动物均测定平均肺动脉压(m PAP)和右心室肥厚指数[RV/(LV+S)];并分别采用RT-PCR法检测各组大鼠肺组织中OPN m RNA的水平,Western blot技术检测各组大鼠肺组织中OPN蛋白表达水平。结果低压低氧1天、7天、14天、21天组动物m PAP均高于对照组(P0.05),1天、7天、14天组呈逐渐增高趋势、21天组m PAP下降,差异有显著性(P0.05);低压低氧7天组、14天组、21天组动物呈现随低氧时间延长RV/(LV+S)逐渐增高的趋势、均高于对照组和1天组(P0.05),但1天组、7天组和对照组间差异无显著性(P0.05);RT-PCR法和Western blot法结果显示低压低氧1天、7天、14天、21天组动物肺组织中OPNm RNA、OPN蛋白表达水平与对照组比较均增高(P0.05)。结论低压低氧刺激可使m PAP和RV/(LV+S)增高并促进大鼠肺组织OPN的表达增高,因此OPN可能参与高原性心脏病形成中肺动脉压的增高和右心室重塑。     

硫化氢对低氧性肺动脉高压大鼠P47phox表达的影响

目的观察硫化氢H2S对低氧性肺动脉高压(HPH)大鼠P47phox表达的影响。方法 36只体重(180±20)g健康成年雄性SD大鼠,随机分为常氧组、低氧组、低氧+硫氢化钠(Na HS)组,每组12只。低氧16 d后分别检测其平均肺动脉压(m PAP)、右心室肥厚情况和肺血管形态学指标的变化。采用Western印迹检测肺动脉组织P47phox的表达水平。结果与常氧组比较,低氧组m PAP明显升高,右室/(左室+室间隔)比值显著增加(P<0.01);部分肌型动脉百分比明显升高,非肌型动脉百分比明显降低(P<0.05);肺动脉组织P47phox表达升高(P<0.05)。与低氧组比较,低氧+Na HS组m PAP、右室/(左室+室间隔)比值均明显降低(P<0.01);肺小血管中肌型动脉、部分肌型动脉百分比明显降低,非肌型动脉百分比明显升高(P<0.05);肺动脉组织P47phox表达明显降低(P<0.01)。结论 H2S可能通过抑制大鼠肺动脉组织P47phox表达而调节低氧性肺血管结构重建和HPH的形成。     

慢性痛导致低氧性肺动脉功能异常

目的 研究慢性病理性神经痛对低氧性肺动脉高压发生发展的影响及可能机制。方法 30只SD大鼠随机分为5组:常氧组、慢性痛＋常氧组、低氧组、慢性痛+低氧组和慢性痛+低氧+Alda1（乙醛脱氢酶2特异性激动剂）组，每组6只。慢性痛采用经典的大鼠背根节慢性压迫(chronic compression of dorsal root ganglia,CCD)模型。造模成功后用间断性低压低氧法建立大鼠低氧性肺动脉高压模型，然后分离大鼠三级肺小动脉，检测不同组大鼠的肺血管环舒张、收缩功能变化，同时测定各组大鼠血液循环中4-羟基壬烯酸（4-hydroxy-2-nonenal,4-HNE）的水平和肺动脉上乙醛脱氢酶(Aldehyde dehydrogenase,ALDH)2的表达。结果 低氧导致肺小动脉的舒张功能减弱(P<0.05)，收缩功能亢进；但是在慢性痛状态下，低氧组大鼠肺小动脉舒张功能进一步减弱(P<0.01)，而肺小动脉收缩功能更加亢进(P<0.01)。与此同时，低氧促进大鼠血液中4-HNE的水平升高(P<0.01)，而慢性痛+低氧组大鼠循环血液中4-HNE的水平增高更为显著(P<0.01)，提示慢性痛+低氧组大鼠肺动脉舒缩、功能异常可能是由长期慢性神经痛产生大量的4-HNE造成的。使用ALDH2的激动剂Alda1后能够显著改善慢性痛和低氧导致的肺小动脉舒张、收缩功能异常，促进肺小动脉舒张(P<0.01)，抑制收缩(P<0.01)，而且Alda-1能够显著上调慢性痛和低氧降低的ALDH2的表达(P<0.01)，减少循环血中4-HNE的水平(P<0.01)。结论 慢性病理性神经痛促进循环中4-HNE的水平增高，加重肺小动脉舒张、收缩功能异常，降低ALDH2的表达，促进低氧性肺动脉高压的发生发展。慢性神经痛可能是促进、加重低氧性肺动脉高压发生发展的诱因之一。     

整合素连接激酶在低氧诱导肺动脉高压发病机制中的作用

目的:通过了解整合素连接激酶(ILK)及心肌素(myocardin)在低氧性肺动脉高压(PAH)大鼠肺组织及肺血管中的表达,探讨ILK在低氧性肺动脉高压发病机制中的作用。方法:48只SD大鼠按随机数字表法分为常氧对照组和低氧1周、2周、4周组,低氧干预大鼠置于低氧仓内,氧浓度控制在(10.5±0.5)%,每日间断低氧8h(8:00~16:00)。测定各组大鼠肺动脉平均压(mPAP)、计算右室肥厚指数[右室/(左室+室间隔),RV/(LV+S)]、管壁厚度占血管外径的百分比(WT%)和管壁面积占血管总面积的百分比(WA%);采用髓鞘碱性蛋白为底物通过液体闪烁仪测定ILK活性;实时定量PCR法测定肺动脉内ILK、糖原合成激酶3β(GSK-3β)及myocardin mRNA相对表达量;Western印迹法检测肺动脉及培养的肺动脉平滑肌细胞(PASMC)胞质内ILK、GSK-3β及myocardin蛋白相对表达量。结果:低氧2周组mPAP、右室肥厚指数、WT%、WA%均显著高于常氧对照组(均P0.05),低氧4周组差异更为显著。低氧1周组肺动脉内ILK活性即明显下降达36%(P0.05),低氧2周、4周组ILK活性均较常氧对照组明显降低(均P0.05)。低氧4周组ILK mRNA和蛋白相对表达量均显著低于常氧对照组(均P0.05),myocardin mRNA和蛋白表达变化与ILK相似(均P0.05),而GSK-3β的mRNA和蛋白表达量则呈相反趋势,显著高于常氧对照组(均P0.05)。低氧培养PASMC 24h后ILK及myocardin蛋白表达明显低于常氧对照组,而GSK-3β蛋白水平则呈相反趋势,低氧可促进其表达增加(均P0.05)。结论:慢性低氧引起ILK活性和表达下调,使其下游靶点GSK-3β表达上调,进而降低myocardin表达水平,可能是导致PAH形成的重要机制。     

Pathogenesis of carcinoma of the papilla of Vater

Most adenomas and carcinomas of the small intestine and extrahepatic bile ducts arise in the region of the papilla of Vater. In familial adenomatous polyposis (FAP) it is the main location for carcinomas after proctocolectomy. In many cases symptoms due to stenosis lead to diagnosis at an early tumor stage. In about 80%, curative intended resection is possible. Operability is the most relevant prognostic factor. Most ampullary carcinomas resp. carcinomas of the papilla of Vater develop from adenomatous or flat dysplastic precursor lesions. They can be sited in the ampulloduodenal part of the papilla of Vater, which is lined by intestinal mucosa. They also can develop in deeper parts of the ampulla, which are lined by pancreaticobiliary duct mucosa. Intestinal-type adenocarcinoma and pancreaticobiliary-type adenocarcinoma represent the main histological types of ampullary carcinoma. Furthermore, there exist unusual types and undifferentiated carcinomas. Many carcinomas of intestinal type express the immunohistochemical marker profile of intestinal mucosa (keratin 7?, keratin 20+, MUC2+). Carcinomas of pancreaticobiliary type usually show the immunohistochemical profile of pancreaticobiliary duct mucosa (keratin 7+, keratin 20?, MUC2?). Even poorly differentiated carcinomas, as well as unusual histological types, may conserve the marker profile of the mucosa they developed from. These findings underline the concept of histogenetically different carcinomas of the papilla of Vater which develop either from intestinal- or from pancreaticobiliary-type mucosa of the papilla of Vater. Molecular alterations in ampullary carcinomas are similar to those of colorectal as well as pancreatic carcinomas, although they appear at different frequencies. In future studies, molecular alterations in ampullary carcinomas should be correlated closely with the different histologic tumor types. Consequently, the histologic classification should reflect the histogenesis of ampullary tumors from the two different types of papillary mucosa.     

Demonstration of the mechanism of action of biguanides

Summary Palmitic acid oxidation in rat diaphragm homogenate is depressed by biguanide concentrations that are still incapable of inhibiting oxidative phosphorylation. Glucose oxidation is not directly effected by the same biguanide concentrations: however, the inhibitory effect of palmitic acid on glucose oxidation is partly removed by biguanides. Inhibition of fatty acid oxidation, which accounts for most of the metabolic effects caused by these drugs, can be regarded as the fundamental mechanism of action of biguanides. There is some evidence suggesting that these drugs might interact with carnitine, thus preventing long-chain fatty acids from being transported across the mitochondrial membrane to the site of oxidation. Traduzione a cura degli AA.     

氯硝柳胺悬浮剂的毒性评价

目的评价氯硝柳胺悬浮剂的毒性，为现场大规模应用灭螺提供依据。方法按照中华人民共和国国家标准GB 15670-1995《农药登记毒理学试验方法》和鱼类毒性试验方法进行。结果经口、经皮肤的LDso雌、雄性大鼠均>5 000 mg/kg，经呼吸道的LCso雌、雄性大鼠均>5 000mg/m3，该药经口、经皮肤、经呼吸道毒性均属微毒类药物；兔眼用药后，观察期内无不良反应，对眼无刺激性；皮肤用药后对皮肤无刺激性。与氯硝柳胺原药、氯硝柳胺乙醇胺盐原药和氯硝柳胺乙醇胺盐可湿性粉剂相比，氯硝柳胺悬浮剂对鱼急性毒性最低。结论氯硝柳胺悬浮剂属微毒类药物，对鱼的毒性低于其乙醇胺盐可湿性粉剂，适合于现场应用。     

胰岛素瘤的解剖分布特点分析

目的胰岛素瘤是最常见的胰腺神经内分泌肿瘤，因其临床表现多样，导致诊断困难。影像学诊断尤其是超声内镜(EUS)在胰岛素瘤的诊断中起着重要作用，拥有较高的敏感性和特异性。本研究拟通过明确胰岛素瘤的解剖分布特点，以期有助于提高影像学的诊断准确率和降低漏诊率，尤其是在教育和培训实践中对于EUS的学习者更具有指导价值。 方法回顾性分析解放军总医院第一医学中心病案资料数据库1993年1月至2019年11月经外科手术、病理确诊为胰岛素瘤的患者的临床资料，检索方法采取搜索术后病理诊断为"胰岛素瘤"的病例，通过查阅病例的方法，提取出胰岛素瘤的大小和解剖分布等数据，进一步分析其特点。 结果共检索到确诊为胰岛素瘤的患者116例，其中，男45例、女71例，年龄13～76岁，平均年龄(44.4±14.85)岁。胰岛素瘤单发110例(94.8%)、多发6例(5.2%)。位置分布：头颈部46例(39.7%)，单发45例、多发1例；体尾部68例(58.6%)，单发65例、多发3例；全胰腺多发2例(1.7%)。病变大小特点：最大径0.4～3.4 cm，平均大小(1.53±0.58)cm。≤1 cm 29例、>1 cm而≤1.5 cm41例、>1.5 cm而≤2.0 cm28例，≤3 cm 15例，>3 cm 3例。年龄与肿瘤的大小相关，≤44岁患者肿瘤平均大小为(1.36±0.51)cm、>44岁患者肿瘤平均大小为(1.70±0.60)cm，P<0.05。头颈部的肿瘤大于体尾部的肿瘤，头颈部肿瘤平均大小(1.66±0.63)cm，体尾部(1.42±0.52)cm，P<0.05。 结论胰岛素瘤在胰腺体尾部较头颈部更好发；绝大多数单发，但可以全胰腺多发；多数小于1.5 cm，肿瘤的大小与患者年龄和肿瘤的解剖分布相关。     

Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease

BACKGROUND AND AIM: Both the clinical presentation and the degree of mucosal damage in coeliac disease vary greatly. In view of conflicting information as to whether the mode of presentation correlates with the degree of villous atrophy, we reviewed a large cohort of patients with coeliac disease. PATIENTS AND METHODS: We correlated mode of presentation (classical, diarrhoea predominant or atypical/silent) with histology of duodenal biopsies and examined their trends over time. RESULTS: The cohort consisted of 499 adults, mean age 44.1 years, 68% females. The majority had silent coeliac disease (56%) and total villous atrophy (65%). There was no correlation of mode of presentation with the degree of villous atrophy (p=0.25). Sixty-eight percent of females and 58% of males had a severe villous atrophy (p=0.052). There was a significant trend over time for a greater proportion of patients presenting as atypical/silent coeliac disease and having partial villous atrophy, though the majority still had total villous atrophy. CONCLUSIONS: Among our patients the degree of villous atrophy in duodenal biopsies did not correlate with the mode of presentation, indicating that factors other than the degree of villous atrophy must account for diarrhoea in coeliac disease.     

CagA-Hp抗体IgG与胃炎的组织学分析

研究幽门螺杆菌(Hp)感染与胃炎的关系。方法对204例慢性胃炎患者胃粘膜进行观察分析,并测定其中137例Hp阳性患者血清CagA-Hp抗体IgG水平,与组织学对照。结果慢性萎缩性胃炎伴肠上皮化生患者血清CagA抗体IgG明显高于对照组(P＜0.01);其他类型胃炎患者血清CagA抗体IgG水平无明显增高(P＞0.05)。结论CagA-Hp可能是导致慢性萎缩性胃炎伴肠上皮化生的因素之一,对这类患者应密切随访观察。     

慢阻肺急性加重期患者预后的影响因素分析

目的探讨慢性阻塞性肺病急性加重期(AECOPD)患者预后的相关危险因素。方法回顾性调查、收集58例AECOPD患者可能影响其预后的相关因素,并对其分别进行单因素分析。并进行Logistic多元逐步回归进行多因素分析,筛选影响AECOPD患者预后的独立危险因素。结果单因素分析后将结果 P0.1的因素纳入多因素Logistic回归,分析发现是否合并呼吸衰竭、气促程度、白细胞计数、APACHEⅡ、应用抗氧化剂、慢阻肺治疗依从性为影响AECOPD患者预后不佳的独立因素(P0.05)。结论根据AECOPD患者预后的独立危险因素,及早判断,选择合适的后续治疗方案,对提高其生存率及生存质量具有重要意义。     

Results of treatment of fistula-in-ano

To evaluate the application of Parks' classification in the management of patients with fistula-in-ano, a study was undertaken to assess the outcome of surgery, especially with respect to the recurrence rate and alteration of continence. A retrospective analysis of 160 consecutive patients who were classified at the time of operation was conducted. The distribution of fistulas was as follows: intersphincteric, 41.9 percent, transsphincteric, 52.1 percent, suprasphincteric, 1.3 percent, extrasphincteric, 0. A horseshoe extension occurred in 8.8 percent of the fistulas and 3.8 percent did not exactly conform to the classification as they were either complex or combinations of more than one type of fistula. The sole immediate postoperative complication was bleeding, which occurred one week postoperatively and ceased spontaneously (0.7 percent). Alteration in continence occurred in 6 percent of patients with 2.6 percent experiencing temporary incontinence to flatus, 1.3 percent to liquid stool, and 0.7 percent to solid stool. Permanent loss of control for flatus occurred in one patient (0.7 percent) and for liquid stool in one patient (0.7 percent). No patients suffered loss of control for solid stool. Recurrence developed in 6.3 percent of patients, all between five and 25 months postoperatively. Classifcation was found to be a useful guide in the operative management of patients with fistula-in-ano. Read at the joint meeting of the American Society of Colon and Rectal Surgeons with the Section of Colo-Proctology, Royal Society of Medicine, and the Section of Colonic and Rectal Surgery, Royal Australasian College of Surgeons, New Orleans, Louisiana, May 6 to 11, 1984.     

血吸虫童虫生长发育及其机制的研究进展

血吸虫童虫是宿主免疫系统攻击的重要靶标,包括皮肤型、肺型和肝门型童虫。宿主分子对童虫生长发育具有重要作用。童虫生长发育机制包括免疫调节、信号转导、性别发育及凋亡等。肌动蛋白、组织蛋白酶、烯醇化酶和葡萄糖基转移酶等分子为血吸虫童虫生长发育的重要分子。本文对血吸虫童虫生长发育及其机制的研究进展做一综述。     

Intake of energy drinks in association with alcoholic beverages in a cohort of students of the School of Medicine of the University of Messina

BACKGROUND: Energy drinks (ED) are a widely used group of beverages known for their stimulant effects on central nervous system (CNS). The main components of ED are caffeine, taurine, carbohydrates, glucuronolactone, inositol, niacin, pantenol, and beta-complex vitamins. The studies evaluating the effects of ED describe improvements in attention and/or reaction times and indices of alertness. It has been also shown that combination of caffeine and glucose, fundamental constituents of ED, can ameliorate deficits in cognitive performance and subjective fatigue during extended periods of cognitive demand. Moreover, the associated ingestion of alcohol and ED has recently been observed to be becoming more and more widespread. METHODS: With the aim to know the habits and uses of students, we administered a questionnaire containing questions regarding ED drinking alone or in association with alcoholic beverages. Five hundred students of the School of Medicine of the University of Messina were interviewed, and 450 filled the questionnaire. RESULTS: A total of 56.9% of students declared using ED. A great part of users (48.4%) associate frequently ED and alcohol. In particular, 35.8% of ED + alcohol users have used ED + alcohol more than 3 times in the last month. Distinguishing the users into 2 groups (users of ED + alcohol and users of both ED and ED + alcohol), we observed in the second group a major use of cocktail containing a mix of ED and alcoholic beverages. This difference between the 2 groups is less represented about the ingestion of ED + alcohol in the night. CONCLUSIONS: Our data indicate that association of ED + alcohol is very popular among students. This behavior can be dangerous. In fact, the combination of ED + alcoholic drinks can reduce adversive symptoms of alcohol intoxication including the depressant effects. As consequence, users of ED + alcoholic beverages might not feel the signs of alcohol intoxication, thus increasing the probability of accidents and/or favoring the possibility of development of alcohol dependence.