枯草杆菌BF-7658α-淀粉酶生产菌株所产蛋白酶热稳定性研究

我国α—淀粉酶(EC3.2.1.1)生产是用枯草杆菌BF—7658菌株,它产生的酶是个复杂酶系。其中混杂的蛋白酶未见酸性蛋白酶。发酵液经热处理后,测蛋白酶活力。结果,碱性蛋白酶耐热性比中性蛋白酶强。发酵液经55℃,30分钟热处理后,碱性蛋白蛋残存活力与室温(20～25℃)下碱性蛋白酶活力相差不显著(P>0.05),而中性蛋白酶则相差显著(P<0.05)。用电泳法观察发酵液蛋白酶电泳谱型,显示两条蛋白酶区带。     

Ultrastructural,immunohistochemical and biochemical studies on amylase and ACTH producing lung cancer

Summary Tumour tissue from a lung cancer patient who showed elevated serum amylase and adrenocorticotropin (ACTH) was studied ultrastructurally, immunohistochemically and biochemically. Histologically the tumour was a small cell carcinoma. On electron microscopic examination the tumour cells contained large zymogen-like granules within the cytoplasm. Furthermore, cells which possessed many small dense core granules of the endocrine type were also observed. It was of interest that the large zymogen-like granule-containing tumour cells had microvilli at the apical border, connected by desmosomes and forming lumina showing adenocarcinomatous differentiation. Electrophoretic analysis of the serum revealed that the major elevated amylase was of the salivary type with minor components. Immunostaining clearly demonstrated that most of the tumour cells possessed immunoreactive ACTH, whereas salivary amylase was only found in occasional clusters of the tumour cells. The results seem to indicate that the tumour showed both endocrine and exocrine characteristics - an amphicrine carcinoma, expressing amylase and ACTH simultaneously.     

尿胰蛋白酶原—2测定对急性胰腺炎的早期诊断价值

目的 探讨尿胰蛋白酶原－2测定在急腹症中筛选急性胰腺炎的价值。方法 对346例连续就诊的急腹症病人同时测定尿胰蛋白酶原－2及血、尿淀粉酶。结果 41例急性胰腺炎中有38例尿胰蛋白酶原－2阳性,敏感性为92．7％,305例非胰腺炎的急腹症病人有15例假阳性,特异性为95．1％。5例重症急性胰腺炎中尿胰蛋白酶原－2全部阳性。结论 尿胰蛋白酶原－2是急腹症病人筛选急性胰腺炎快而简便的方法,具有较高的特异性和敏感性。     

单一稳定液体试剂直接测定α-淀粉酶

目的 :建立以α- 2 -氯 - 4-硝基苯 -半乳糖吡喃麦芽糖苷 ( Gal- G2 - CNP)作底物的α-淀粉酶 (α-amylase)的直接测定方法。方法 :利用国外最新合成的 Gal- G2 - CNP( alpha- 2 - chloro- 4- nitrophenyl-galactopyranosylmaltoside)作底物 ,用速率法测定α-淀粉酶活力。结果 :线性范围可达 30 0 0 U/L ( r=0 .9998) ,变异系数为 0 .30 %～ 0 .53%。与宝灵曼公司的 ET- G7- PNP法 〔1〕的相比 :r=0 .9998,Y=0 .76X 0 .2 0 ( n=2 0 0 ) ,与 G3 - CNP的相比 r=0 .9999,Y=1 .0 1 X 1 1 .7( n=2 0 0 )。结论 :简便、直接、灵敏、经济、试剂单一稳定、反应转化率高、线性范围宽、基质本身自然水解极微 ,各项指标符合国际临床化学学会( IFCC)提出的“理想的淀粉酶检测方法”的要求〔2〕。适于各种类型的自动分析     

Immunoreactive trypsin in the adult respiratory distress syndrome

With the purpose of studying the role of proteinases in the development of ARDS, plasma levels of immunoreactive trypsin (IRT) and amylase were measured in 43 intensive care patients at risk of developing ARDS (22 polytrauma, seven abdominal surgery, four burns, two DIC and eight pancreatitis). Twenty four of these 43 patients developed ARDS and 31 presented abnormal IRT values (above 70 g/L). Twenty-one of these 31 patients had ARDS; a significant correlation thus appeared between ARDS and abnormal IRT values. In nine patients, IRT values were higher than 800 g/L and remained high for 3 to 4 days. A statistically significant correlation also appeared between abnormal IRT and septic phenomena: 20 patients with high IRT values presented septic problems. When IRT values were high, amylase values were often also abnormal: 12 of 23 patients with high IRT had abnormal amylase levels (the eight patients with documented pancreatitis were excluded); no other clinical signs or symptoms of pancreatitis were present in these patients. IRT could be one of the mediators of ARDS in septic patients. It is not clear that the pancreas is the origin of IRT in all cases.     

Ionophore A23187 can mimick the changes in membrane permeability that occur during acetylcholine-stimulation of pancreatic acinar secretion

Acetylcholine (ACh) released from vagal terminals increases the permeability of the pancreatic acinar membrane to Na⁺ and Ca²⁺ ions. In this report, we compare the induced changes in intracellular Na⁺ and Ca²⁺ electrode potentials (E_Na and E_Ca) due to ACh-stimulation of acini with those observed during stimulation with the calcium ionophore, A23187, which mimicks the action of ACh on pancreatic secretion. Stimulation with ACh concentrations varying from 10^–8 to 10^–5 M and with A23187 concentrations of 10^–6 and 10^–5 M caused parallel increases in cytosolic Ca²⁺ and Na⁺ ([Ca]_i, [Na]_i). The magnitude of the increases in [Ca]_i and [Na]_i due to A23187-stimulation further indicate that when presented with a calcium challenge the acinar cells continue to regulate [Ca]_i close to physiological levels and suggest that the observed increases in ionized calcium could reflect much larger increases in complexed Ca²⁺. ACh-stimulation following removal of either extracellular Na⁺ or Ca²⁺ ions, eliminated the intracellular increases found when the removed ions is present, but did not affect the increases usually found with the other ion. The independence of the permeability changes to either the presence of Ca²⁺ or Na⁺ indicates the ACh-induced currents carried by Na⁺ and Ca²⁺ are also independent. The selective translocation of Na⁺ and Ca²⁺ during acetylcholine-stimulation in a manner analogous to the changes observed when ionophore A23187 was used as stimulus, indicates the ability of the activated acinar membrane to function as an ionophore.     

通腑解毒方联合六合丹辅助西医治疗急性胰腺炎临床研究

目的:观察通腑解毒方联合六合丹辅助西医治疗急性胰腺炎的临床疗效及对患者肠功能屏障、肝功能、炎症反应的影响。方法:将157例急性胰腺炎患者采用简单随机法分为西医组(n=78)和辨证组(n=79)。西医组给予西医治疗,辨证组在西医组治疗基础上给予通腑解毒方灌肠联合六合丹外敷治疗。比较两组临床相关指标、中医症候积分、疗效、28 d病死率、血清学指标。结果:辨证组总有效率高于西医组,腹痛、腹胀缓解时间及首次排便时间、进食时间均短于西医组(均P<0.05)。治疗后,两组各项中医症候积分较治疗前下降,且辨证组低于西医组(均P<0.05)。治疗后,两组血、尿淀粉酶及二胺氧化酶(DAO)、D-乳酸、谷草转氨酶(AST)、C反应蛋白(CRP)、单核细胞趋化因子-1(MCP-1)、谷丙转氨酶(ALT)水平均较治疗前下降,且辨证组低于西医组(均P<0.05)。两组28 d病死率比较,差异无统计学意义(P>0.05)。结论:通腑解毒方联合六合丹辅助西医治疗急性胰腺炎可促进腹痛、腹胀的缓解,保护肠功能屏障,抑制炎症反应,提高疗效。     

Acute pancreatitis and amiodarone： A case report

Amiodarone, a class Ⅲ antiarrhythmic drug, is one of the most effective drugs used in the treatment of ventricular and paroxysmal supraventricular tachyarrhythmia. Adverse effects of amiodarone including pulmonary toxicity, hepatotoxicity, aggravation of arrhythmia, and thyroid diseases are well understood. A 66-year old woman with acute pancreatitis was admitted to our hospital with the complaint of epigastralgia radiating to both flanks for two months. Her symptoms and elevation of pancreatic enzymes did not respond to conventional medical treatment of pancreatitis for 18 d. No known causal factors for pancreatitis such as biliary tract stone, hypertriglyceridemia and alcohol consumption could be identified. Under the suspicion of amiodarone-induced acute pancreatitis, amiodarone was substituted by propafenone. Her symptoms soon alleviated and serum lipase level declined. Three months after hospital discharge, the abdominal pain did not recur. Amiodarone was approved to treat recurrent ventricular fibrillation or sustained ventricular tachyarrhythmia that has been resistant to other medications since 1986. Pancreatitis is a very rare adverse effect associated with the use of amiodarone, and only four cases of amiodarone-induced pancreatitis have been reported in literature. We report a patient who developed acute pancreatitis during amiodarone therapy.     

Prevalence and prognosis of increased pancreatic enzymes in patients with COVID-19: A systematic review and meta-analysis

IntroductionThe prevalence of increased pancreatic enzymes (elevated serum amylase and/or lipase) and its relationship to clinical outcomes in patients with coronavirus disease 2019 (COVID-19) infection is not known.MethodsA systematic review and meta-analysis of relevant studies reporting prevalence and impact of increased pancreatic enzymes (defined as an elevation in amylase and/or lipase levels above the upper limit of normal [ULN] value) in COVID-19 was undertaken.ResultsA total of 36,496 patients from 21 studies were included for this meta-analysis. The overall prevalence and mortality for increased pancreatic enzymes (>ULN) in COVID-19 were 25.4% (95% CI, 15.8%–36.2%) and 34.6% (95% CI, 25.5%–44.4%), respectively. The overall prevalence and mortality for increased pancreatic enzymes (>3 × ULN) were 6.1% (95% CI, 3.6%–9.2%) and 39.2% (95% CI, 18.7%–61.6%), respectively. Patients with increased pancreatic enzymes, including elevated serum lipase or amylase of either type, had worse clinical outcomes, including need for ICU admission, mechanical ventilation and mortality.DiscussionIncreased pancreatic enzymes is frequent and may exacerbate the consequences of COVID-19 infection.