肝硬化患者血浆及胃粘膜内血管活性肠肽和生长抑素含量的变化及意义

采用放射免疫测定法研究了肝硬化（ＨＣ）患者血浆及胃粘膜内血管活性肠肽（ＶＩＰ）和生长抑素（ＳＳ）含量变化及其意义。结果表明：肝硬化患者血浆和胃粘膜内的ＶＩＰ含量和ＳＳ含量均显著高于正常对照组（Ｐ＜０．０１）；ＨＣ伴溃疡病患者血浆及胃粘膜中ＳＳ含量显著高于无溃疡的ＨＣ患者（Ｐ＜０．０５）；血浆及胃粘膜中ＶＩＰ的含量随着胃、十二指肠粘膜充血程度的加剧而升高；并且血浆及胃粘膜内ＶＩＰ和ＳＳ含量与肝功能密切相关。提示：在ＨＣ时存在着严重的胃肠激素代谢率乱，并且它在ＨＣ的病理生理机制和ＨＣ时胃肠功能改变和病理变化中起着重要作用。     

肝硬化患者血浆及胃粘膜内血管活性肠肽和生长抑素含量的变化？…

采用放射免疫测定法研究了肝硬化（ＨＣ）患者血浆及胃粘膜内血和活性肠肽（ＶＩＰ）和生长抑素（ＳＳ）含量变化及其意义，结果表明，肝硬化患者血浆和胃粘膜内的ＶＩＰ含量和ＳＳ含量无显著高于正常对照组（Ｐ〈０．０１）；ＨＣ伴溃疡病患者血浆及胃粘膜中ＳＳ含量显著高于无溃疡的ＨＣ患者（Ｐ〈０．０５）；血浆及胃粘膜中的ＶＩＰ的含量随着胃，十二指肠粘膜充血程度的加剧而升高，并且血浆及胃粘膜内ＶＩＰ和ＳＳ含量与肝功能     

肝硬化患者胃,十二指肠粘膜六种胃肠激素含量变化及其临床意义

本文研究了肝硬化（ＨＣ）患者胃、十二指肠粘膜６种胃肠激素含量变化及其意义。结果表明，肝硬化患者胃粘膜血管活性肠肽（ＶＩＰ）含量明显增加（Ｐ＜０．０５）；胃动素明显降低（Ｐ＜０．０１）。十二指肠（Ｄ）、粘膜生长抑素（ＳＳ）、脑啡肽含量明显减少（Ｐ＜０．００５）；血管加压素β－内啡肽（β－ＥＰ）明显增加（Ｐ＜０．０５）、ＶＩＰ含量与胃、Ｄ粘膜充血程度呈正相关（Ｐ＜０５），与有、无腹水及其程度关系不密切（Ｐ＞０．１），与食道静脉曲张程度有一定联系，但不显著（Ｐ＝０．１）。胃粘膜β－ＥＰ、Ｄ粘膜ＳＳ含量随肝功能下降而递增（Ｐ＜０．０５）。提示ＨＣ患者充血性胃肠粘膜病变及消化不良等可能与粘膜胃肠激素含量异常有关。     

胃癌及消化性溃疡患者胃窦粘膜胃肠激素的变化

目的探讨胃癌及消化性溃疡（ＰＵ）患者胃窦粘膜胃肠激素变化的意义．方法内镜及活检确诊的浅表性胃炎（ＣＳＧ）１０例，胃溃疡（ＧＵ）１５例，十二指肠溃疡（ＤＵ）１２例，胃癌（ＧＣ）６例．胃镜下取胃窦粘膜，用ＲＩＡ法测定胃泌素（Ｇａｓ）、生长抑素（ＳＳ）、Ｐ物质（ＳＰ）的含量，各组间进行比较．结果胃窦粘膜ＳＳ含量在ＧＵ，ＤＵ，ＣＳＧ，ＧＣ组分别为２５１ｐｇ／ｍｇ±１９４ｐｇ／ｍｇ（以下同），４７０±１７９，５３２±２１１及１２９３±５２３。其中ＧＵ组低于其余各组（Ｐ＜００５），而ＧＣ时则显著升高（Ｐ＜００１）．ＳＰ含量在ＤＵ组显著降低，与ＧＵ，ＣＳＧ，ＧＣ比较分别为４７９±１５７ｖｓ７６５±４１５，７８９±３９０及８０１±３４６，Ｐ＜００５；ＧＣ患者Ｇａｓ水平显著高于ＣＳＧ组，为４６４５±２９４４，ｖｓ２７６８±１５７２，Ｐ＜００１．结论胃粘膜中Ｇａｓ，ＳＳ，ＳＰ含量的变化可能在ＰＵ及胃癌的发病机理中起重要作用．     

食管癌及胃癌患者血浆和癌中生长抑素含量变化

本文采用放免测定法研究了生长抑素（ｓｏｍａｔｏｓｔａｔｉｎ，ｓｓ）在胃及食管癌患者血浆与癌组织中的变化。结果表明：食管癌和胃癌患者血浆和癌组织中ｓｓ的含量（食管癌：１７．８７±５．３１ｐｇ／ｍｌ，４０．４１±１３．２６ｐｇ／ｍｇ；胃癌：１１．２４±５．１１ｐｇ／ｍｌ，１３０．１８±３７．７３ｐｇ／ｍｇ）显著低于正常人（２６．８３±５．９２，２１２．６２±４７．４６ｐｇ／ｍｇ）Ｐ＜０．０１，提示：ｓｓ的减少可能与上消化道癌肿形成有关。     

肝癌患者血浆和肿瘤组织中PAI-1变化

目的研究纤溶酶原激活物抑制剂（ＰＡＩ－１）与肝癌临床生物学特性的关系。方法用ＰＡＩ－１试剂盒检测３０例肝细胞癌（ＨＣＣ）患者血浆和肿瘤组织中ＰＡＩ－１变化，取正常人血浆和肝组织作对照。结果ＨＣＣ患者血浆和肿瘤组织中ＰＡＩ－１与对照组比明显升高，分别为１２．８±２．７５Ａｕ／ｍｌ比６．８５±２．２１Ａｕ／ｍｌ，０．８１±０．１２Ａｕ／ｍｇ比０．３８±０．１４Ａｕ／ｍｇ（Ｐ均＜０．０５）。侵袭性与非侵袭性ＨＣＣ病例比较，血浆ＰＡＩ－１为１４．９６±１．１１Ａｕ／ｍｌ比１１．４２±１．５９Ａｕ／ｍｌ（Ｐ＜０．０５）。血浆ＰＡＩ－１明显升高的ＨＣＣ患者预后较差。结论ＨＣＣ患者血浆和肿瘤组织中ＰＡＩ－１明显升高，ＰＡＩ－１与ＨＣＣ侵袭性和预后密切相关。     

老年痴呆患者血浆和脑脊液生长抑素样免疫反应物含量的变化

用放射免疫法测定了８例Ａｌｚｈｅｉｍｅｒ型老年性痴呆（ＳＤＡＴ），３０例多发梗塞性痴呆（ＭＩＤ）、３５例无痴呆多发脑梗塞（ＭＣＩ）患者及３０例健康对照组的血浆生长抑素样免疫反应物（ＳＬＩ）的含量，同时测定了１０例ＭＩＤ和１９例ＭＣＩ患者脑脊液（ＣＳＦ）中ＳＬＩ的含量。发现血浆ＳＬＩ含量在ＳＤＡＴ组（７１．１±１０．６ｐｇ／ｍｌ）和ＭＩＤ组（１０３．５±９．５ｐｇ／ｍｌ）比ＭＣＩ组（１４１．９±１２．７ｐｇ／ｍｌ）和对照组（１６０．０±１４．５ｐｇ／ｍｌ）均降低；ＭＩＤ患者ＣＳＦ中ＳＬＩ含量（４７．０±２３．２ｐｇ／ｍｌ）明显低于ＭＣＩ患者（７２．７±２１．３ｐｇ／ｍｌ）。血浆ＳＬＩ下降水平与痴呆程度的相关性有待进一步研究。     

胃、十二指肠溃疡患者内皮素Ⅰ水平初步探讨

本文研究３２例胃、十二指肠溃疡患者血浆、胃液及胃、十二指肠溃疡缘与正常胃粘膜组织中内皮素Ⅰ的水平，并以１９例健康人作对照。结果表明：胃溃疡患者血浆内皮素Ⅰ水平为４．４８±０．７８ｐｇ／ｍｌ，明显高于健康对照组血浆水平２．５６±０．１７ｐｇ／ｍｌ，Ｐ＜０．０５。胃溃疡缘组织中内皮素Ⅰ含量为４１．６３±４．３６ｐｇ／ｍｇ，明显高于自身正常胃粘膜２１．８４±１．７３ｐｇ／ｍｇ和健康对照组内皮素Ⅰ含量２１．７８±１．６８ｐｇ／ｍｇ，Ｐ值均＜０．００１。提示内皮素Ⅰ可能作为局部因素参与胃溃疡的形成，并说明胃溃疡患者有血管收缩和舒张因子的代谢不平衡。而十二指肠溃疡患者血浆、胃液、组织中内皮素Ⅰ水平与健康对照组无明显差异，提示内皮素Ⅰ在十二指肠溃疡发病中并不起重要作用。     

老年非溃疡性消化不良患者血清胃泌素、血浆胃动素及生长抑素的检测及其意义

本文采用放射免疫法对３１例老年非溃疡性消化不良（ＮＵＤ）患者和２０例对照者在空腹状态下进行了血清胃泌素、血浆胃动素及生长抑素的测定。结果显示：老年人ＮＵＤ组胃泌素浓度为８５．７２±２２．０３ｐｇ／ｍｌ，较对照组的９０．４２±１５．０６ｐｇ／ｍｌ，差异无显著性（Ｐ＞０．０５）；胃动素浓度为４２７．７４±９５．８５ｐｇ／ｍｌ，较对照组的５４５．７３±１１５．８０ｐｇ／ｍｌ，差异有显著性（Ｐ＜０．０５）；生长抑素浓度为６９．４７±１８．７５ｐｇ／ｍｌ，较对照组的５４．７６±１３．３２ｐｇ／ｍｌ，差异有显著性（Ｐ＜０．０５）。提示胃动素，生长抑素在老年人ＮＵＤ发病机理中起一定作用，而胃泌素则无明显作用。     

老年慢性阻塞性肺疾病患者血浆内皮素－1含量与PaO_2、PaCO_2及肺动脉压的关系

目的探讨血浆内皮素－１（ｅｎｄｏｔｈｅｌｉｎ－１，ＥＴ－１）在慢性阻塞性肺疾病（ｃｈｒｏｎｉｃｏｂｓｔｒｕｃｔｉｖｅｐｕｌｍｏｎａｒｙｄｉｓｅａｓｅ，ＣＯＰＤ）中的作用。方法应用放射免疫法测定４３例老年ＣＯＰＤ急性发作期患者和１５名健康对照者血浆ＥＴ－１水平，其中８例肺心病患者行右心微导管检测肺动脉压。结果ＣＯＰＤ患者和肺心病患者的血浆ＥＴ－１含量分别为５．２４±０．５０、５．８０±０．６６ｐｇ／ｍｌ，较健康对照组血浆ＥＴ－１含量（４．６５±０．６５ｐｇ／ｍｌ）明显升高（Ｐ值＜０．０１及０．００１）；血浆ＥＴ－１含量与ＰａＯ２呈显著性负相关（ＣＯＰＤ组：ｒ值＝－０．５８３，Ｐ值＜０．０１；肺心病组：ｒ值＝－０．６２７，Ｐ值＜０．００１），与ＰａＣＯ２呈显著性正相关（ＣＯＰＤ组：ｒ值＝－０．５１４，Ｐ值＜０．０５；肺心病组：ｒ值＝０．５９３，Ｐ值＜０．００１）；ＥＴ－１含量与肺动脉收缩压及平均压均存在正相关（ｒ值＝０．７２７及０．６８１，Ｐ值均＜０．０５）。结论血浆ＥＴ－１参与肺心病肺动脉高压的形成，缺氧和二氧化碳潴留是刺激ＥＴ－１释放的重要原因之一     

Glucose and insulin concentration in amniotic fluid and in maternal blood in early and in late pregnancy

Glucose concentration in the amniotic fluid decreases towards the end of gestation, whereas the insulin concentration increases. The ratio between fetal (amniotic fluid) glucose to maternal glucose is reduced by about 50% at the end of pregnancy, whereas the ratio of C peptide is increased four times. The higher glucose concentration in amniotic fluid in early pregnancy could be explained by a lower fetal metabolic rate in the early stage of development and a low insulin activity of the fetus.     

Osteoporosis in celiac disease and in endocrine and reproductive disorders

As the increase in lifespan brings to light diseases that were previously not clinically detectable, osteoporosis has become an issue of worldwide significance. The disease is marked by a loss of bone mass; the bones become less dense, fragile and more prone to fracturing. Because it is regulated by endocrine and environmental factors, osteoporosis presents a multifactorial etiopathogenesis, with the genetic component accounting for 70% of an individual variation in bone mass density （BMD）, the principal determinant, with age, of fracture risk. Pathological conditions such as celiac disease （CD） exacerbate the process of bone loss, so that the occurrence of osteoporosis in celiac subjects is of particular note： indeed, the screening of osteoporosis patients for this disease is advisable, since it may be the only sign of undiagnosed CD. An increase in interleukin IL-1β, of the IL-1 system, in the relatives of celiac patients confirms the genetic predisposition to osteoporosis and its presence is evidence of an association between the two conditions. The direct effect on the bones of CD is secondary to poor absorption of calcium and vitamin D. In women osteoporosis is indirectly associated with early menopause and amenorrhea, and it may follow prolonged breast-feeding and frequent pregnancies, while in men it is associated with hypogonadism and GH deficit. These endocrine and non-endocrine factors exert their effects on bones by modulating the RANK/RANK-L/OPG system. An appropriate lifestyle from adolescence onwards, together with early diagnosis of and treatment for CD and primaryand secondary endocrine pathologies are important for the prevention of damage to the bones.     

Anti-malarial efficacy of pyronaridine and artesunate in combination in vitro and in vivo

Pyronaridine is a Mannich base anti-malarial with demonstrated efficacy against drug resistant Plasmodium falciparum, P. vivax, P. ovale and P. malariae. However, resistance to pyronaridine can develop quickly when it is used alone but can be considerably delayed when it is administered with artesunate in rodent malaria models. The aim of this study was to evaluate the efficacy of pyronaridine in combination with artesunate against P. falciparum in vitro and in rodent malaria models in vivo to support its clinical application. Pyronaridine showed consistently high levels of in vitro activity against a panel of six P. falciparum drug-sensitive and resistant strains (Geometric Mean IC50=2.24 nM, 95% CI=1.20-3.27). In vitro interactions between pyronaridine and artesunate showed a slight antagonistic trend, but in vivo compared to pyronaridine and artesunate administered alone, the 3:1 ratio of the combination, reduced the ED90 of artesunate by approximately 15.6-fold in a pyronaridine-resistant P. berghei line and by approximately 200-fold in an artesunate-resistant line of P. berghei. Complete cure rates were achieved with doses of the combination above or equal to 8 mg/kg per day against P. chabaudi AS. These results indicate that the combination had an enhanced effect over monotherapy and lower daily doses of artesunate could be used to obtain a curative effect. The data suggest that the combination of pyronaridine and artesunate should have potential in areas of multi-drug resistant malaria.     

Differentiation pathways in carcinogenesis and in chemo- and radioresistance

Cancer stem cells (CSCs) share many features with embryonic stem cells (ESCs) such as the ability for self-renewal and differentiation. Signaling pathways that are involved in these processes are also involved in chemo- and radioresistance (e.g. Wnt, Notch and Hedgehog pathways). This review is focused on the influence of three important differentiation pathways on carcinogenesis and on chemo- and radioresistance in ESCs and CSCs.     

Trends and Ethnic Differences in COPD Hospitalization and Mortality in Singapore

Study Objective. COPD mortality alone among major causes of diseases continues to rise in most countries worldwide. We examine trends, and gender and ethnic differences in COPD hospitalization and mortality in Singapore from 1991 to 1998, and examine possible explanations. Design. Analysis of population‐based health administrative data. Setting. Multi‐ethnic (Chinese, Malay and Indian) population of Singapore (3 million population). Method. Data on hospitalizations and deaths due to COPD as the underlying cause (ICD codes 491, 492, 496), extracted from national databases, were used to calculate age‐specific and standardized rates for the population aged 55 + years. COPD accounted for 4.6% of total deaths (5.8% in those aged 55 +), and 1.02% of all hospitalizations (3.1% in those aged 55 +). Results. COPD mortality in 1998 decreased steeply by ? 43.7% from 1991 (a decline that continued a steady trend since 1970), while hospitalization showed little significant change (? 3.3%). Men had 4 and 5 times higher mortality and hospitalization, and also showed less favorable trends than women. Malays, especially males, showed the highest level and least favorable decline of mortality. Conclusion. Exceptionally steady declines in COPD mortality rates, and stable rates of hospitalization are observed in Singapore in the 1990s. Differing levels and trends of hospitalization and mortality by gender and ethnicity are related to known demographic variations and trends of smoking prevalence in the country.