垂体腺苷酸环化酶激活肽对内皮细胞表面低密度脂蛋白受体分布的影响

为研究垂体腺苷酸环化酶激活肽对内皮细胞表面低密度脂蛋白受体分布的影响，以胶体金─低密度脂蛋白为示踪物，结合透射电镜技术观察垂体腺苷酸环化酶激活肽作用于体外培养的内皮细胞后，其表面低密度脂蛋白受体分布变化情况。结果表明，垂体腺苷酸环化酶激活肽作用于内皮细胞后，内皮细胞光镜及电镜下的形态与对照组无明显差异，但内皮细胞表面低密度脂蛋白受体分布发生了变化，胶体金─低密度脂蛋白颗粒单独出现率升高（P＜0．05），内皮细胞内吞胶体金─低密度脂蛋白减少。提示垂体腺苷酸环化酶激活肽可能通过影响内皮细胞表面低密度脂蛋白受体的分布状态而减少低密度脂蛋白入胞代谢，进而减少低密度脂蛋白通过内皮细胞进入内膜下的机会，从而在抗动脉粥样硬化方面发挥作用。     

垂体腺苷酸环化酶激活肽在正常及高脂条件下对内皮细胞的作用

垂体腺苷酸环化酶激活肽在正常及高脂条件下对内皮细胞的作用常青，邓漪平（中山医科大学组织胚胎学教研室，广州５１００８９）垂体腺苷酸环化酶激活肽（ＰｉｔｕｉｔａｒｙＡｄｅｎｙｌａｔｅＣｙｃｌａｓｅ－ＡｃｔｉｖｉｔｉｎｇＰｏｌｙｐｅｐｔｉｄｅ，ＰＡＣＡＰ）...     

垂体腺苷酸环化酶激活肽及其在消化道的作用

垂体腺苷酸环化酶激活肽是一种新发现的脑肠肽。本文着重介绍其分子结构、体内分布、受体分布及其对消化道的主要作用。     

垂体腺苷酸环化酶激活肽及消化道的作用

垂体腺苷酸环化酶激活肽是一种新发现的脑肠肽。本文着重介绍其分子结构、体内分布、受体分布及其对消化道的主要作用。     

垂体腺苷酸环化酶激活肽对家兔实验性动脉粥样硬化血管重塑的影响

为探讨垂体腺苷酸环化酶激活肽对家兔动脉粥样硬化血管重塑的影响，将60只新西兰雄性家兔随机等分为正常对照组、动脉粥样硬化组和垂体腺苷酸环化酶激活肽组，分别于实验的第4、8和第12周末随机处死每组家兔各5－8只并取胸主动脉。在上述动脉条的头、中、尾部各截取约0．5cm长的组织作石蜡切片，苏木素－伊红染色，光镜下观察并用图像分析系统测量相关形态学参数。余下的动脉条用苏丹Ⅳ染色，作大体形态观察。结果发现，随时间延长，动脉粥样硬化组斑块面积逐渐增大，斑块检出率逐渐增加（P＜0．05），且斑块多分布于头段，而中段、尾段依次减少。管腔面积在早期斑块形成时并无改变，晚期则明显缩小（P＜0．05）。垂体腺苷酸环化酶激活肽组斑块面积、斑块最大厚度均小于同期动脉粥样硬化组，而管腔面积则大于动脉粥样硬化组（P＜0．05）。提示垂体腺苷酸环化酶激活肽可通过抑制负性血管重塑及促进正性血管重塑的作用而延缓动脉粥样硬化病变的进展。     

垂体腺苷酸环化酶激活肽受体在心血管组织及细胞表面的分布

目的 :了解垂体腺苷酸环化酶激活肽 (PACAP)受体在心血管组织、细胞表面的表达水平及分布差异。方法 :取SD大鼠肺作阳性对照 ,采用放射性配基 受体结合分析法检测SD大鼠心脏、主动脉及培养的猪血管内皮细胞 (EC)和平滑肌细胞 (SMC)膜上PACAP受体的分布状态。结果 :PACAP受体在心室组织的容量为(88.70 7± 4 6 .182 )fmol/mg蛋白 ,在主动脉为 (15 7.347± 84 .4 4 0 )fmol/mg蛋白 ,在肺则为 (1777.96 7± 88.712 )fmol/mg蛋白 ;在EC上的密度为 (6 6 99± 85 3.132 )结合位点 /细胞 ,在SMC上为 (2 784± 792 .4 30 )结合位点 /细胞。结论 :心血管组织PACAP受体数量低 ,显著低于肺组织 ;EC上的受体数目明显多于SMC。PACAP对心血管系统的强大作用不仅只通过其受体途径实现 ,可能与受体后作用途径的直接激活也有关。     

垂体腺苷酸环化酶激活肽与2型糖尿病

垂体腺苷酸环化酶激活肽(PACAP)是一种广泛分布于包括胰岛细胞在内的全身各个组织的神经肽，作为副交感和感觉神经递质发挥作用。PACAP刺激胰岛素的分泌是一种葡萄糖依赖性的，这一作用主要通过增加cAMP的形成和刺激钙的摄取来完成。大量动物实验表明，PACAP在调节胰岛素对摄食的反应具有重要的生理作用，与2型糖尿病的发生密切相关，其受体选择性激动剂对2型糖尿病具有潜在的治疗作用。     

冠状动脉M-受体的研究进展

毒蕈碱受体存在于冠状动脉内皮细胞及平滑肌细胞表面，内皮细胞表面的毒蕈碱受体被胆碱能激动剂激活后介导内皮细胞释放内皮舒张因子，导致冠状动脉舒张。对于内皮细胞及平滑肌细胞表面存在何种M-受体亚型目前尚有争议。本文对冠状动脉毒蕈碱受体及其作用进行综述。     

氧化型低密度脂蛋白诱导血管内皮细胞基因表达谱的改变

通过对氧化型低密度脂蛋白诱导血管内皮细胞基因表达谱改变的研究，为阐明氧化型低密度脂蛋白致内皮细胞功能障碍及动脉粥样硬化形成的分子机制提供科学依据。采用含有4000条全长已知人类基因cDNA以及96条参照基因cDNA克隆制作的基因表达谱芯片，筛查氧化型低密度脂蛋白（100mg/L)作为24h对人脐静脉血管内皮细胞的基因表达谱改变的影响。结果显示，氧化型低密度脂蛋白可诱导1条基因表达下调（泛肽激活酶），3条基因表达上调（血清和糖皮质激素诱导的蛋白激酶、热休克蛋白70和KDRF）。结果发现，在氧化型低密度脂蛋白作用的早期阶段可诱导内皮细胞相关基因的表达改变；首次发现氧化型低密度脂蛋白可诱导内皮细胞KDRF、泛肽激活酶和血清和糖皮质激素诱导的蛋白激酶基因表达改变，为揭示氧化型低密度脂蛋白引起血管内皮细胞功能障碍的机制提供了研究成果。     

血凝素样氧化型低密度脂蛋白受体1与动脉粥样硬化

作为氧化型低密度脂蛋白主要受体，血凝素样氧化型低密度脂蛋白受体1首先在内皮细胞表面发现，后来发现在巨噬细胞以及SMC表面也有表达。这种受体被氧化型低密度脂蛋白活化后，可导致内皮功能改变，诱导粘附分子的表达及内皮细胞的凋亡。这种受体能被一些炎症因子、氧化应激、机械刺激以及高血压、高血脂和糖尿病等诱导表达；能识别结合多种与动脉粥样硬化形成有关的配体，参与动脉粥样硬化进程。     

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.     

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。     

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。     

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.