体外蓝氏贾第鞭毛虫滋养体的形态学观察

目的观察体外培养的蓝氏贾第鞭毛虫滋养体超微结构,探究贾第虫滋养体的核仁。方法用改良TYI-S-33培养基培养蓝氏贾第鞭毛虫滋养体,姬姆萨(Giemsa)染色和铁苏木素染色后光镜观察虫体的形态结构;以透射电镜观察虫体的超微结构;以核仁特异性抗体作用虫体产生间接免疫荧光,用激光共聚焦显微镜检测核仁。结果光学显微镜下观察姬姆萨染色后的贾第虫胞质为淡监色,可见1对细胞核,核内有分散的染色体,数目为10条;4对鞭毛、1对半月形的中体、轴柱。铁苏木素染色可见1对椭圆形的泡状细胞核内各有1个细小的核仁。透射电镜观察虫体外观颜面状,呈倒置的梨形:质膜下可见单层排列、大小均匀的小囊泡;可见虫体的细胞器:游离核糖体颗粒、内质网;细胞骨架:腹吸盘、鞭毛、基体、中体的微管结构;核结构:核膜、核孔、核仁、染色体。激光共聚焦显微镜观察发现分裂间期虫体细胞核内有绿色荧光并聚集为核仁,在分裂期虫体内绿色荧光呈弥散分布。结论光镜和电镜观察结果显示体外蓝氏贾第鞭毛虫滋养体的形态结构复杂,有典型的核仁、染色体及复杂的细胞骨架结构。     

蓝氏贾第鞭毛虫类高尔基体的研究

目的探讨类高尔基体结构在蓝氏贾第鞭毛虫滋养体和成囊不同时段的存在情况及其动态变化机理。方法用可特异性标记真核细胞高尔基体的荧光染料C6-NBD神经酰胺，标记有活性的蓝氏贾第鞭毛虫滋养体及成囊6、12、18h虫体，并用荧光显微镜观察。同时利用半定量RT—PCR方法检测高尔基体膜结合蛋白golgin245和膜泡融合的调节蛋白Rab1在蓝氏贾第鞭毛虫对数生长期滋养体及成囊6、12、24h的虫体中的表达水平。结果极少数蓝氏贾第鞭毛虫滋养体被C6-NBD神经酰胺标记；多数处于成囊6、12、18h时段的虫体均可见被特异标记成亮绿色的核周围区域。golgin245和Rab1在滋养体及成囊诱导6、12、24h的虫体中的表达水平无显著变化。结论蓝氏贾第鞭毛虫在成囊过程中出现类高尔基体结构．而在对数期滋养体中却没有。在蓝氏贾第鞭毛虫成囊过程中，高尔基体结构成分无大量合成，出现的类高尔基体结构可能是各组分临时组装的结果。     

双氢青蒿素对C2株蓝氏贾第鞭毛虫Alpha-7.3 giardin基因mRNA表达水平的影响

目的 观察双氢青蒿素 (dihydroartemisinin,DHA) 对C2株蓝氏贾第鞭毛虫(Giardia lamblia)Alpha -7.3 giardin (α-贾第素)基因mRNA表达水平的影响,探讨其对蓝氏贾第鞭毛虫骨架蛋白的损伤作用。方法 用双氢青蒿素浓度为100 μg/mL、200 μg/mL的改良TYI-S-33培养基分别培养C2株蓝氏贾第鞭毛虫2 h、4 h、8 h、12 h后,以不含药物组为对照,实时荧光定量RT-PCR检测药物作用后Alpha -7.3 giardin基因mRNA表达水平的变化。结果 双氢青蒿素作用虫体后Alpha -7.3 giardin基因mRNA表达水平明显低于对照组,二者有显著性差异。结论 双氢青蒿素对C2株蓝氏贾第鞭毛虫Alpha -7.3 giardin基因mRNA的表达具有明显的抑制作用,抑制效果与药物浓度和作用时间相关,提示双氢青蒿素对蓝氏贾第鞭毛虫骨架蛋白具有损伤作用。     

双氢青蒿素对C2株蓝氏贾第鞭毛虫Centrin基因mRNA表达水平的影响

目的分析双氢青蒿素（dihydroartemisinin,DHA）对体外C2株蓝氏贾第鞭毛虫（Giardia lamblia）中心体蛋白（Centrin）基因mRNA表达水平的影响,探讨其对蓝氏贾第鞭毛虫的抑制作用。方法采用改良型TYI-S-33培养基培养C2株蓝氏贾第鞭毛虫,培养基内分别加入浓度为100μg/ml、200μg/ml的双氢青蒿素,以不含药物组作为阴性对照,分别培养2、4、8、12h后,收集各组虫体并提取总RNA,以此为模板,反转录合成cDNA,采用实时荧光定量RTPCR检测药物作用后Centrin基因mRNA表达水平的相对变化量。结果实时荧光定量RT-PCR检测显示,经双氢青蒿素作用虫体后Centrin基因mRNA表达水平显著降低,培养2、4、8、12h后100μg/ml药物组Centrin基因mRNA相对表达量分别为0.46、0.43、0.35和0.27,200μg/ml药物组分别为0.42、0.38、0.29和0.25。结论双氢青蒿素对C2株蓝氏贾第鞭毛虫Centrin基因mRNA的表达具有明显的抑制作用,且抑制作用随着药物浓度的增高和作用时间的延长而增强,提示双氢青蒿素对蓝氏贾第鞭毛虫具有明显的损伤作用,可供蓝氏贾第鞭毛虫病防治参考。     

双氢青蒿素对C2株蓝氏贾第鞭毛虫Delta giardin抑制作用的研究

目的 建立实时荧光定量RT-PCR( real- time quantitative, RT- PCR)检测C2株蓝氏贾第鞭毛虫(Giardia lamblia)Delta giardin基因mRNA表达量的方法,分析双氢青蒿素(Dihydroartemisinin, DHA)对体外C2株蓝氏贾第鞭毛虫Delta giardin基因mRNA表达水平的影响。方法 分别采用100 μg/mL、200 μg/mL的双氢青蒿素改良型TYI-S-33培养基培养C2株蓝氏贾第鞭毛虫,以不含药物组作为阴性对照,分别培养2 h、4 h、8 h、12 h,提取总RNA,逆转录合成cDNA,实时荧光定量PCR检测Delta giardin基因mRNA表达情况。结果 100 μg/mL双氢青蒿素培养2 h、4 h、8 h、12 h后,Delta giardin基因mRNA相对表达量分别为0.44、0.26、0.25、0.02;200 μg/mL双氢青蒿素培养2 h、4 h、8 h、12 h后,Delta giardin基因mRNA相对表达量分别为0.30,0.26,0.11,0.02。药物对照组中C2株蓝氏贾第鞭毛虫Delta giardin基因mRNA表达量明显低于阴性对照组。结论 双氢青蒿素对C2株蓝氏贾第鞭毛虫Delta giardin基因mRNA的表达具有明显的抑制作用,提示双氢青蒿素对蓝氏贾第鞭毛虫具有明显的防治效果。     

胃镜活检标本查出蓝氏贾第鞭毛虫2例报道

蓝氏贾第鞭毛虫临床上引起腹泻、腹痛和胃肠功能紊乱。在浅表性胃炎患者胃粘膜中检出蓝氏贾第鞭毛虫未见报道。本院于１９９８年４月和１０月分别从２例门诊患者胃镜活检标本中检出蓝氏贾第鞭毛虫,特予报道。一般资料　例１,男,３３岁。因消化不良,上腹部疼痛、恶心、腹胀、食欲减退来我院作胃镜检查。例２,女,６６岁。因上腹部压痛、嗳气、吐酸、恶心、呕吐,反复发作,来我院作胃镜检查。上述２例胃镜下诊断均为浅表性胃炎。取胃粘膜作活检,均检查出形似蓝氏贾第鞭毛虫样滋养体。虫体鉴定　取活检标本于光学显微镜下,见虫体形似纵…     

苦参对蓝氏贾第鞭毛虫作用及其机理初步研究

目的研究苦参对蓝氏贾第鞭毛虫的作用及其机理. 方法用苦参作用蓝氏贾第鞭毛虫滋养体,观察滋养体脱壁及死亡情况,并用光镜和透射电镜观察其形态和内部结构的变化. 结果在作用 6、8和24 h后,滋养体脱壁率分别为47.4%、70.9%和80.2%,死亡率为 24.5%、36.1%和54.2%;形态观察可见,苦参作用的滋养体收缩,胞质内容物减少,吸盘部分脱离胞体,有的滋养体部分胞膜内陷. 结论苦参在体外能引起滋养体脱壁、死亡,其抗虫作用是肯定的,吸盘脱离、质膜凹陷及胞质减少等,这可能是其对贾第虫作用机理所在.     

商品化的免疫球蛋白制剂中抗肠道原虫的抗休

收集人工培养对数生长期的蓝氏贾第鞭毛虫滋养体和溶组织内阿米巴滋养体,PBS 洗涤3次,并取5个商品化的免疫球蛋白(IgG)制剂和6例贾第虫病人血清和1例阿米巴肝脓肿病人血清,进行凝集试验。取96孔微量凝集板分别加入血清样品或免疫球蛋白制剂及活动的蓝氏贾第鞭毛虫滋养体或溶组织内阿米巴滋养体,室温孵育1h,使之出现凝集反应。并用蓝氏贾第鞭毛虫滋养体和溶组织内阿米巴滋养体来吸附血清和免疫球蛋白制剂,离心沉淀,吸取上清液,贮存在     

核磁共振研究表明丙氨酸是蓝氏贾第鞭毛虫的主要代谢终产物

一般认为蓝氏贾第鞭毛虫主要能量来源是葡萄糖,终产物为乙醇、乙酸和CO_2。本文报道用核磁共振(NMR)对该虫能量代谢的研究,意在探讨体外培养状况下虫体的主要碳源和代谢产物,为进一步研究指出方向。结果出人意外地发现丙氨酸为其主要代谢终产物。将蓝氏贾第鞭毛虫滋养体接种于含灭活     

双氢青蒿素对体外蓝氏贾第鞭毛虫的损伤

目的 探讨双氢青蒿素（DHA）对蓝氏贾第鞭毛虫的损伤作用。 方法 用含不同浓度DHA的TYI-S-33培养基培养蓝氏贾第鞭毛虫滋养体。分别在光镜和电镜下观察药物作用后虫体的形态结构变化。 结果 随着药物作用时间延长和浓度的增加，虫体死亡率增高。在同一时间内随着药物浓度的增高，虫体死亡率升高(P<0.01)。DHA浓度为100 μg/ml, 作用12 h，虫体死亡率为46.6%，浓度增至200 μg/ml时, 虫体死亡率为100%；同一药物浓度随着作用时间延长, 虫体死亡率也升高（P<0.05），当浓度为100 μg/ml,作用12 h，虫体死亡率为46.6%，作用24 h死亡率增至100%。药物作用后24、48和72 h光镜下观察结果显示，虫体变形、肿胀、出现空泡、失去正常的瓢形运动能力；鞭毛摆动迟缓或停止运动。电镜下观察，见虫体变形、肿胀、细胞膜崩解、脱落，表面出现胞质突起；细胞质内核糖体溶解，出现空泡；吸器失去凹状结构，隆起变成大泡；核染色质稀疏，核周间隙变宽，并出现异形核。 结论 DHA对蓝氏贾第鞭毛虫的质膜及细胞骨架有较强的损伤作用。     

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.     

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。     

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。     

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.     

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。     

124例耐多药结核分枝杆菌基因突变特征分析

目的对临床分离的耐多药结核分枝杆菌相关基因的突变特征进行分析。方法对124例耐多药结核分枝杆菌以及50株敏感株的耐药相关基因(包括异烟肼inh A、kat G、oxyR-ahp C间隔区以及利福平rpo B)进行序列测定,分析其基因突变情况。结果异烟肼耐药inh A基因突变率为14.5%;kat G基因突变率为70.2%(87/124),主要位于315位;oxyR-ahp C间隔区突变率为15.3%;inh A、kat G两种基因同时突变率75.0%,三种基因同时突变率为89.5%。利福平rpo B基因突变的检出率高达95.2%,突变主要发生在531、526、516位点。结论我省耐多药菌异烟肼耐药相关基因最常见突变为kat G 315、inh A C-T(-15)、axyR-ahp C间隔区(-10)C-T,利福平为rpo B531、526、516。结合MDR-TB耐药相关基因的特征分析,可以建立一种快速、准确、特异的适合于我省的检测结核菌耐多药性的新方法。     

Assessment of quality of life of parents of children with juvenile chronic arthritis

The aim of the study was to assess the quality of life (QOL) and the psychological status of parents of children with juvenile chronic arthritis (JCA). The QOL, anxiety and depression of the parents of 28 children with JCA were evaluated and compared to those of the parents of 28 healthy children. Mothers of JCA children and mothers of healthy children reported similar QOL. The reported anxiety and depression levels were similar for mothers and fathers in both groups. The parents of children with pauciarticular-type JCA reported lower QOL and higher levels of anxiety and depression than the parents of children with other types, namely polyarticular and systemic JCA. These findings may be explained by the fact that the pauciarticular patients had shorter disease duration and were less frequently seen in the outpatient clinic. The QOL of mothers of children with JCA was found to be slightly impaired in the group of children with pauciarticular JCA. Future larger studies are needed to confirm these results, as the number of subjects in the three groups was rather low. Received: 26 September 2001 / Accepted: 8 February 2002     

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。