淫羊藿苷经NF-κB信号通路干预大鼠免疫衰老的作用及机制

目的探讨中药延缓免疫衰老的作用和机制。方法清洁级健康雄性SD大鼠50只,分为4月龄(4 mon)、24月龄(24 mon)、24月龄加PDTC处理(24 mon+PDTC)、24月龄加Ica(icariin,Ica)干预(24 m+Ica)和24月龄加Ica干预再加PDTC处理(24 mon+Ica+PDTC)五组,每组10只。自21月龄满开始,24 mon+Ica组和24 mon+Ica+PDTC组大鼠予Ica灌胃,24 mon组和24 mon+PDTC组给予等量蒸馏水灌胃,均连续3个月。24 mon+PDTC组和24 mon+Ica+PDTC组大鼠在灌胃结束前1 w每2 d腹腔注射PDTC,按200 mg/kg体重分2次注射。处死大鼠分别提取大鼠脾CD4+T淋巴细胞,用流式细胞仪检测细胞凋亡率,电泳迁移率(EMSA)检测细胞NF-κB的活性,Western印迹法检测细胞P65蛋白表达水平。结果 24 mon组大鼠脾CD4+T淋巴细胞凋亡率明显高于4 mon组和24 mon+PDTC组(P0.05),而24 mon+Ica组细胞凋亡率显著降低(P0.05);与24 mon+PDTC组比较,24 mon+Ica+PDTC组脾CD4+T淋巴细胞凋亡率明显降低(P0.05)。与4 mon组大鼠相比,24 mon组大鼠脾CD4+T淋巴细胞中p65蛋白表达显著下调(P0.01);与24 mon组比较,24 mon+Ica组p65蛋白表达明显上调(P0.01),24 mon+PDTC组则显著下调(P0.05)。与24 mon+PDTC组比较,24 mon+Ica+PDTC组p65蛋白表达明显增强(P0.05)。24 mon组大鼠脾CD4+T淋巴细胞NF-κB的活性明显低于4 mon组(P0.01);与24 mon组比较,24 mon+Ica组NF-κB的活性增强(P0.01),24 mon+PDTC组NF-κB活性则降低(P0.01)。相关分析表明,CD4+T淋巴细胞NF-κB活性与细胞凋亡率呈负相关(r=-0.75,P0.01)。结论 NF-κB通过抑制淋巴细胞凋亡参与免疫衰老的调控;Ica可能通过提高NF-κB的活性和诱导P65高表达来抑制淋巴细胞过度凋亡从而延缓免疫衰老。     

抗氧化剂PDTC对肝癌细胞株Hep3B增殖的影响及机制

目的探讨抗氧化剂二硫代氨基甲酸毗咯烷（PDTC）在肝细胞性肝癌化学预防中的作用及机制。方法将不同浓度PDTC、阿霉素及PDTC联用阿霉素作用于Hep3B细胞。采用MTT法检测细胞存活率;流式细胞术（FCM）检测凋亡率;电泳迁移率变动分析（EMSA）检测NF—KB活性。结果PDTC作用后Hep3B存活率明显降低,呈浓度依赖性,P〈0．01。阿霉素联用PDTC的细胞生长抑制率明显高于单用阿霉素（P〈0．01）。PDTC为10μmol／L时的细胞凋亡率明显低于50μmol／L时（P〈0．01）。EMSA示PDTC作用后NF-κB表达降低,不同浓度PDTC作用两两相比P〈0．01。结论PDTC能抑制肝癌细胞株Hep3B的增殖、促进细胞凋亡、增强阿霉素的细胞毒作用;其作用机制主要是抑制NF-κB激活。PDTC可用于肝癌的化学预防,联用阿霉素可进一步提高疗效。     

雷帕霉素减少GK糖尿病大鼠肾脏细胞凋亡及其机制

目的观察糖尿病肾组织肿瘤坏死因子（TNF-α）、核因子（NF-κB）的表达及其与肾组织细胞凋亡关系以及雷帕霉素对其的影响。方法将20只GK大鼠随机分为DM组（n=10）、DMR组（n=10）,10只Wistar大鼠作为NC组。DMR组予以6mg／kg雷帕霉素灌胃,DM与NC组仅给予等量生理盐水灌胃。TUNEL法检测肾组织细胞凋亡。免疫组织化学法（IHC）检测肾组织TNF-α和NF-κB的表达。结果TUNEL法显示,NC组肾组织未见明显的凋亡细胞;4周及8周DM组凋亡数呈进行性增多（P〈0．01）。IHC显示,NC组肾组织TNF-α、NF-κBp65有轻微阳性表达;4周、8周DM组NF-KBp65、TNF-α表达有逐渐上升的趋势,均显著高于正常对照组（P〈0．01）。NF-κBp65、TNF-α阳性表达呈正相关（P〈0．01）;肾组织NF-a和NF-κBp65表达与肾组织细胞凋亡之间均呈正相关（P〈0．01）;与DM组比较,DMR组4周、8周组肾组织TNF-α和NF-κBp65的过度表达均被显著抑制（P〈0．01）,肾组织细胞凋亡数显著减少（P〈0．01）。结论NF-κB及其诱导的TNF-α在糖尿病肾病损伤中发挥重要作用,雷帕霉素可能通过抑制NF-κB和TNF-α的表达减少减轻肾组织细胞凋亡。     

虫草菌丝对非酒精性脂肪肝病大鼠肝细胞凋亡的作用及其相关机制

目的（1）证实肝细胞凋亡的异常增多存在于非酒精性脂肪性肝病中。（2）观察虫草菌丝对肝细胞凋亡异常增多的影响，并探讨可能的分子机制。方法通过高脂饮食建立大鼠非酒精性脂肪性肝病（NAFLD）的模型，同时设立正常饮食对照组，病理对照组（NASH组），虫草菌丝干预组（CS组）。肝组织切片HE染色观察肝脏病理改变；检测肝组织超氧化物歧化酶（SOD）活性；TUNEL检测肝组织肝细胞凋亡情况；免疫组织化学染色观察肝组织Bax、Bcl-2、Caspase-3、NF-κB P65蛋白表达情况。结果（1）与正常对照组相比，病理对照组大鼠肝组织广泛弥漫肝细胞脂肪变性，炎性细胞浸润、坏死、局部有纤维组织增生；肝脏SOD活性显著降低（P〈0．01）；TUNEL法检测肝细胞凋亡显著增多（P〈0．01）；免疫组化染色显示Bax、Caspase-3蛋白表达增加（P〈0．01），而Bcl-2无显著变化（P〉0．05）；（2）与病理对照组相比，虫草菌丝组大鼠肝组织有广泛肝细胞脂肪变性，炎性细胞浸润，可见灶性及点状坏死，未见纤维组织增生；肝组织SOD活性高于病理对照组（P〈0．05）；TUNEL法检测凋亡的肝细胞显著减少（P〈0．01）；免疫组化染色显示Bax、Caspase-3蛋白表达也明显降低（分别为P〈0．05、P〈0．01），而Bcl-2、NF-κB P65蛋白表达增加（P〈0．01）。结论（1）NASH时肝细胞凋亡异常增多。（2）虫草菌丝可以通过增加超氧化物歧化酶（SOD）活性来减少活性氧含量，降低Bax表达，增加Bcl-2表达和活化NF-κB P65减轻NAFLD中肝细胞凋亡从而在一定程度上具有保护肝脏功能的作用，对延缓或阻止脂肪肝病变的进展起到一定的作用。     

铜绿假单胞菌肺炎大鼠核因子-κB表达及二硫代氨基甲酸吡咯烷对其的影响

目的探讨NF-κB及其诱导TNFα在大鼠铜绿假单胞菌（PA）肺炎中的表达及二硫代氨基甲酸吡咯烷（PDTC）对其的影响。方法72只SD大鼠分为健康对照组、PA组、PDTC干预组。每组24只。PA组大鼠制作PA模型,PDTC干预组制作PA模型前腹腔注射PDTC200mg／kg体重。PA组、PDTC干预组接种铜绿假单胞菌悬液0．2ml（6×10^8CFU／m1）。观察大鼠肺组织形态学改变,免疫组化及Western blot检测肺组织NF-κB表达,RT-PCR检测肺组织TNFαmRNA表达。结果PA组大鼠肺组织明显充血、水肿,大量炎性细胞浸润;PDTC干预组大鼠肺组织充血、水肿等炎性表现较PA组明显减轻。PA组大鼠肺组织NF-κB表达阳性细胞明显增多,PDTC干预组NF—κB表达阳性细胞明显减少。Western blot显示,各时间点NF-κB表达不同,3h达高峰。RT—PCR显示,PA组TNFαmRNA高表达,以6h最为明显;PDTC干预组TNFαmRNA表达明显下调,与PA组相比,差异有统计学意义（P〈0．01）。结论NF-κB及其诱导的TNFα在PA肺炎中发挥重要作用,PDTC可能通过抑制NF-κB的活性减轻PA引起的肺损伤。     

重组腺病毒IκBaM预处理诱导大鼠脑缺血耐受的实验研究

目的：通过观察重组腺病毒IκBaM（recombination adenovirus expression of IκBaM，AdIκBaM）预处理对核转录因子κB（nuclear factor kappaB，NF—κB）表达的影响，探讨其在脑缺血耐受中的作用。方法：预先皮质注射AdIκBaM，特异地抑制NF—κB的激活，分为皮质注射重组AdIκBaM组（A组）、单纯局部缺血组（B组）、假手术组（C组）。采用大鼠大脑中动脉线栓法制备局部脑缺血模型。应用红四氯氮唑（TTC）染色测定各组脑梗塞体积，免疫组化法观测NF—κB的表达情况。结果：（1）A组脑皮质梗塞体积百分比明显小于B组，差异非常显著（P〈0．01）。（2）C组细胞核中NF—κB p65的表达率明显小于A组、B组（P〈0．01），A组脑皮质的p65阳性细胞率明显小于B组（P〈0．01）。结论：局灶脑缺血能使NF—κB p65活化并参与脑缺血损伤。AdIκBaM能特异抑制NF—κB表达，缩小脑组织梗塞体积，对缺血脑组织具有保护作用。NF-κB表达下调可能是局灶性脑缺血耐受产生的分子机制之一。     

核因子κB和Th1/Th2细胞因子在哮喘小鼠发病中的变化及胸腺素、地塞米松干预作用的研究

目的探讨核因子κB（NF-κB）和Th1／Th2细胞因子在哮喘发病过程中的作用以及胸腺素α、地塞米松的干预作用及其临床应用分子生物学依据。方法建立哮喘模型，给予胸腺素及地塞米松。用ELISA法测BALF上清液中嗜酸粒细胞、淋巴细胞IL-4、IL-5和IFN-γ的水平，用免疫组化方法测支气管肺组织中NF-κB的活性。结果哮喘组BALF中的嗜酸粒细胞、淋巴细胞、IL-4、IL-5及肺组织NF-κB的P65、P50与正常组水平相比升高，差异有显著统计学意义（P〈0．05）。胸腺素干预组的嗜酸粒细胞、IL-4、IL-5、IFN-γ、NF-κB的P65、P50与哮喘组水平相比降低，差异有显著统计学意义（P〈0．05）。地塞米松组的嗜酸粒细胞、淋巴细胞、IL-4、IL-5、IFN-γ、NF-κB的P65、P50与哮喘组水平相比下降，差异有显著统计学意义（P〈0．05）。胸腺素组与地塞米松组间IL-4／IFN-γ相比，差异无显著统计学意义（P〉0．05）。IL-4、IL-5的水平与NF-κB阳性率有显著相关（r=0．96171、0．97393，P〈0．01）。结论Th2优势反应及NF-κB的激活在哮喘的发病机制中起重要作用。胸腺素α可抑制NF-κB的活性，明显提高IFN-γ的水平。地塞米松可以抑制NF-κB的活性，明显降低IL-4、IL-5细胞因子的水平。     

辛伐他汀对胰岛素抵抗大鼠肝脏NF-κB p65表达的影响

目的探讨辛伐他汀（SV）对胰岛素抵抗（IR）大鼠肝脏NF-κB p65表达的影响。方法采用高脂饲料喂养建立IR大鼠模型，并用正常血糖-高血浆胰岛素钳夹技术评估，IR大鼠给予SV治疗。应用Western blot方法检测大鼠肝脏中NF-κB p65蛋白的表达。结果（1）高脂饲料组的葡萄糖输注率明显低于基础饲料组（P〈0．01）。（2）SV治疗组肝脏NF-κB p65蛋白的表达明显低于高脂未治疗组（P〈0．05），但与基础饲料组无明显差别。（3）与基础饲料组相比，SV治疗组和高脂未治疗组的胰岛素敏感性指数（ISI）明显降低（P〈0．05）；SV治疗组与高脂未治疗组的ISI无明显差别。结论SV能使高脂诱导的IR大鼠肝脏升高的NF-κB p65蛋白表达水平恢复正常，但不能明显改善全身胰岛素抵抗。     

抗氧化剂对大鼠重症急性胰腺炎胰腺腺泡细胞凋亡的影响

目的探讨四氢化吡咯二硫代氨基甲酸酯（PDTC）对重症急性胰腺炎（SAP）胰腺腺泡细胞凋亡的影响。方法SD大鼠72只，随机分为：假手术组（sham operation，SO）、SAP组和PDTC组。SAP模型采用5％牛磺胆酸钠1ml/kg胰胆管逆行穿刺注射建立，PDTC组在造模前1h给予腹腔注射PDTC（1130mg/kg），术后分4个时段（1、3、6、12h）分批进行腹主动脉采血后处死，取胰腺组织作病理切片与液氮冻存。胰腺腺泡细胞的凋亡检测应用TUNEL法、电镜以及免疫组化法检测胰腺组织Caspase-3的表达；核因子（NF）-κB活化的检测应用免疫组化法。同时观察各组血清淀粉酶、脂肪酶水平及胰腺组织病理学评分。结果SAP组各时间点血清淀粉酶及脂肪酶水平及胰腺组织病理组织学评分较SO组显著增高（P〈0．05）。PDTC治疗组血清淀粉酶、脂肪酶水平较SAP组明显降低；胰腺组织病理组织学评分明显改善。PDTC治疗后3、6、12h胰腺组织Caspase-3的表达显著高于SAP组（P〈0．01），而在1h无统计学差异；各时间点胰腺腺泡细胞凋广指数显著高于SAP组（P〈0．01）；NF—κB的活化显著低于SAP组（P〈0．01）。结论SAP时，PDTC可能通过抑制NF—κB的活化，从而抑制NF—κB介导胰腺细胞的抗凋亡效应，减少胰腺腺泡细胞坏死。     

NF—κB、TGF-β1在肝纤维化中的改变及护肝片的影响

目的探讨中、晚期纤维化大鼠肝组织核转录因子-κB（NF-κB）、转化生长因子β1（TGF-β1）的变化及护肝片对其影响。方法采用12．5％CCl4诱导的大鼠肝纤维化模型，自造模之目起，大鼠分组灌胃给药（护肝片921mg·kg^-1）或溶媒，每日1次，直至8或13周末，分别处死动物，取左叶肝组织石蜡包埋，制作组织芯片，免疫组化S．P法检测大鼠肝组织NF-κB p65、TGF-β1蛋白的表达，并用MetaMorph图像分析系统对NF-κBp65、TGF-β1蛋白表达量进行定量分析。结果（1）模型复制8和13周，模型组的肝损伤及其纤维化分级均明显高于正常组（P〈0．01），护肝片组的肝损伤及其纤维化分级均轻于模型组。（2）模型复制8和13周，模型组NF-κB p65、TGF-β1蛋白的表达较正常组明显增强（P〈0．01）；NF-κBp65蛋白和TGF-β1蛋白的表达之间呈显著的正相关（P〈0．01）；（3）护肝片显著抑制8、13周纤维化肝组织NF-κBp65、TGF-β1蛋白的表达（P〈0．01）。结论护肝片可减轻肝组织的损伤及其纤维化程度，抑制NF-κB、TGF-β1的表达可能是其抗肝纤维化作用的靶点之一。     

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.