自发性夜间胃碱化形成机制探讨

目的　探讨自发性夜间胃碱化的形成是否与十二指肠胃反流 (DGR)及迷走神经功能有关。方法　 2 0例功能性消化不良 (FD)患者采用胃内 pH和胆红素同步监测法 ,比较夜间自发性碱化与胆汁反流的关系 ;另外 2 0例无心血管疾病的FD患者采用胃内 pH和心电Holter同步监测 ,进行心率变异性 (HRV)时域分析 ,以SDNN、rMSSD、PNN5 0为指标 ,观察夜间自发性碱化与迷走神经功能的关系。结果　 2 0例FD患者中出现夜间自发性碱化者 1 2例 ,其中 8例 (占66.7% )同时有胆红素吸光值升高 ;2 0例无心血管疾病的FD患者中 1 3例有夜间自发性碱化 ,7例无自发性碱化 ,二者比较SDNN、rMSSD均在正常范围 ,差异无显著性 (P >0 .0 5 ) ;2 4h胃 pH与PNN5 0对照观察表明 ,夜间时段与白天相比PNN5 0明显升高 ,有自发性碱波组与无自发性碱化组二者相比 ,PNN5 0无显著差别。结论　自发性夜间胃碱化的形成与DGR有关 ,并不是迷走神经张力降低导致胃酸分泌减少所致。     

THE ROLE OF MAGNESIUM METABOLISM IN ESSENTIALHYPERTENSION WITH INSULIN RESISTANCE

Magnesiumisanimportantpositiveioninthebodyinvolvedinmanymetabolismsinthetissues,andalsoisanimportantcofactorforg1ucoseoxi-dizingmetabolism.Insulinisanimportantfactorinregulatingmagnesiuminbloodandce11s,itenab1esmagnesiumtogointothecellfromoutsidethecell,andregulatestheMg' levelthrougheffectsonglucoseoxidizingmetabolismt1i.Somescholarsassumethat"abnormalmagnesiumandcalciummetabolisminsidethecellmightbealinkingfactorinhypertensionandinsulinresistance[2)."Themechanismofmagnesiummetabolisminessent…     

自主神经功能检测对早期糖尿病自主神经功能损害的诊断价值

目的评价自主神经功能检测对早期糖尿病自主神经功能损害的诊断价值。方法50例2型糖尿病患者进行自主神经功能检查,即交感皮肤反应和心血管自主神经功能检测,并与30名健康人进行对比分析。结果糖尿病患者自主神经功能检测中交感皮肤反应,瓦氏比值和深呼吸时心率变异与对照组比较均有显著性差异(P<0.05),三者的异常率分别为70%,46%和50%;以交感皮肤反应的异常率最高,尤其以双下肢明显。立卧位血压差和冰水试验与对照组比较无显著性差异(P>0.05),其异常率分别为12%和16%。结论检测外周器官自主神经功能状态的方法中以交感皮肤反应的阳性率最高,可以作为检测早期糖尿病自主神经功能的常规筛选检查。     

Serum renalase inversely related to heart rate variability in dialysis patients

Heart rate variability （HRV） is a noninvasive technique for autonomic nerve activity assessment and an indirect index of adrenergic cardiovascular drive. Renalase is the only known enzyme degrading circulatory catecholamines, participating in regulations of the cardiovascular and sympathetic nervous systems. This study aims at the relation between serum renalase and HRV indexes in dialysis patients. There were 14 hemodialysis （HD） cases, 16 continuous ambulatory peritoneal dialysis （PD） cases, and 16 healthy volunteers enrolled in this study. All the subjects underwent 24 h Holter testing by using a dynamic electocardiogram monitor system to determine HRV parameters, and serum renalase levels were measured. The standard deviation of normal to normal R-R intervals （SDNN, a measure of beat-to-beat variability）, root mean square successive difference （RMSSD）, and the proportion derived by dividing NN50 （the number of interval differences of successive normal to normal intervals greater than 50 ms） by the total number of NN intervals （pNN50） were determined to assess HRV. Both HD and PD patients presented increased maximum heart rate （Max-HR）, minimum heart rate （Min-HR） and average heart rate （Ave-HR）, and presented decreased SDNN, RMSSD and pNN50 relative to healthy controls. Serum levels of renalase were highly negatively correlated with Ave-HR （correlation coefficient r = -0.68, probability P 〈 0.01）, while positively correlated with SDNN （r = 0.64, P 〈 0.01） in both the HD and PD groups. Serum level of renalase was positively correlated with 24 h urine volume （r = 0.73, P 〈 0.01） in PD patients. Renalase might be reciprocally related to HRV and inversely related to Ave-HR in dialysis patients, which will help to probe into renalase＇s physiology and may pave the way to explore renalase replacement therapy in patients with end stage renal disease （ESRD）.     

胆汁反流对胃内pH值的影响

目的　观察胆汁反流对胃内 pH值的影响。方法　对不同浓度胆汁和胃液的混合液及内镜下抽取的黄染和无黄染胃液 ,测定pH和胆红素吸光值 ;2 0例功能性消化不良患者同步监测2 4h胃内pH和胆红素吸光值。结果　胆汁浓度为 2 0 %时吸光值已达 0 90 0 ,而pH仍在 1 0左右 ;浓度为 60 %时pH始上升达 4以上。黄染组pH <4的病例占 80 % ,吸光值为 0 .348±0 .1 31 ,无黄染组pH <4的病例占 81 % ,吸光值为 0 .0 0 8± 0 .0 0 3,pH和吸光值之间无明显相关性。 1 2例有夜间自发性碱波者 8例同步有胆红素吸光值升高 ,8例无夜间自发性碱波者 4例有胆红素吸光值升高。结论　在一定浓度下 ,胆汁反流对胃内 pH值影响较小。     

24h胃内pH的节律研究

为探讨２４ ｈ 胃内ｐＨ的节律变化,对４２ 例受试者（正常组１０ 例、功能性消化不良组２５ 例、其它组７ 例）用便携式ｐＨ 记录仪作２４ ｈ 胃内ｐＨ监测,所有受试者空腹胃液ｐＨ≤２。结果显示２４ ｈ 胃内ｐＨ值随进餐后上升＞ ４,持续２～３ｈ;夜间可出现与进餐无关的无酸波（ｐＨ＞ ４）,出现率为７９％ （３３／４２）,以后半夜多见。功能性消化不良组无酸波持续时间较正常组明显长,可能与病理性十二指肠胃反流有关     

NINE-YEAR EFFICACY OF HEPATITIS B VACCINATION WITHLOW-DOSE IN THE THIRD INJECTION

Nowthescheduleofvaccinationagainsthep-atitis BisusuallythreedosesoflOUg(or2oUg)',,.Itisusedasgoldstandard,asitislargelyappliedandrecommendedbyvaccinemanufactqrers.Inor-dertousethevaccinemorerationallyandtoobtainsafeimmunizationwithreducedcosts,manystud-iescompareddifferentscheduleswithvariantdosages.Buttheconclusionsdidn'tmatchwitheachother-Andfornolong-termfollowingup,theresultscan'tbeputintopractice.Inadouble-blindandrandomizedtrial,start-edinl986,weprovidedvaccineofvariantdosagesinthethir…     

功能性消化不良与十二指肠胃反流关系的研究

目的研究功能性消化不良(FD)与十二指肠胃反流(DGR)的关系。方法对20例健康对照者和22例FD患者进行胃内pH和Bilitec 2000同步监测,并对FD患者DGR症状进行评分,研究DGR症状与胃内pH≥4及胆红素吸光值(Abs)≥0.14总时间百分比的关系。结果FD组餐后期pH≥4时间(%)和Abs≥0.14时间(%)明显高于正常组,分别为45.78±22.54和23.69±17.26,45.12±25.31和23.97±18.54,有显著性差异,P均<0.05。两组夜间胃内pH≥4和Abs≥0.14出现例数(%)、总持续时间(min)、反流次数、反流>5 min次数及最长反流时间无显著性差异。上腹痛症状评分(SS)与胃内pH≥4总时间%存在相关关系,r=0.678,P<0.01;呕吐胆汁SS与胃内Abs≥0.14总时间%存在相关关系,r=0.495,P<0.05。结论DGR在FD发生中起一定作用。     

CYP2C19基因多态性对埃索美拉唑抑酸效应的影响

目的　研究CYP2C19基因多态性与埃索美拉唑抑酸效应的关系。方法　开放、对照研究。 36名健康志愿者参加本研究。根据PCR -RFLP方法确定的CYP2C19基因型 ,将志愿者分为两组 :CYP2C19强代谢型组 (n =2 4 )及弱代谢型组 (n =12 ) ,男女比例分别为 18∶6及 8∶4 ;年龄平均 (2 4± 1.0 )岁及 (2 0± 1.87)岁 ;体质量平均 (6 1± 6 .75 )kg及(5 9± 4 .0 6 )kg ;身高分别为 (172± 5 .32 )cm及 (16 9± 5 .19)cm。分别给予埃索美拉唑片 2 0mg单剂量口服 ,动态监测2 4h胃内pH。结果　强代谢型组与弱代谢型组间抑酸起效时间、胃内pH >4的总时间及时间百分比 (% )、胃内 pH中位数、pH均值以及夜间酸突破的胃内 pH和持续时间差异均无显著性 (P均 >0 .0 5 )。结论　未观察到CYP2C19基因多态性对埃索美拉唑的抑酸效应的影响。     

沙利度胺对老年特发性肺纤维化患者BALF中IL-6、TNF-α、TGF-β1表达的影响

目的观察沙利度胺对老年特发性肺纤维化(IPF)患者支气管肺泡灌洗液(BALF)中IL-6、TNF-α、TGF-β1表达的影响,结合临床指标的变化探讨其治疗IPF的机制。方法用酶联免疫吸附法检测25例沙利度胺联合强的松治疗前、治疗后12周和24周的老年IPF患者BALF中IL-6、TNF-α、TGF-β1的表达情况,同时检测治疗前、治疗后24周肺功能和胸部高分辨CT的变化情况,并与20例单独应用强的松的老年IPF患者进行对照。结果沙利度胺组患者BALF中IL-6、TNF-α、TGF-β1的表达在治疗后12周、24周较本组治疗前及对照组明显下降(P<0.05)、肺功能较本组治疗前及对照组明显改善(P<0.05);对照组患者BALF中IL-6、TNF-α、TGF-β1的表达在治疗后12周、24周较治疗前无明显下降(P>0.05)、肺功能较治疗前无明显改善(P>0.05)。沙利度胺组治疗总有效率68%、胸部HRCT总吸收率84%;对照组治疗总有效率30%、胸部HRCT总吸收率35%,两组差异有统计学意义(P<0.05)。结论沙利度胺可能是通过降低老年IPF患者BALF中IL-6、TNF-α、TGF-β1的表达,改善患者肺功能及临床症状,延缓了病程进展。     

肿瘤坏死因子α、白介素1β和舒马曲坦对大鼠三叉神经节离体培养后降钙素基因相关肽mRNA表达水平的影响

目的探讨肿瘤坏死因子α(TNF-α)、白介素1β(IL-1β)和抗偏头痛药物舒马曲坦(Sumatriptan)对大鼠三叉神经节(TG)离体培养后降钙素基因相关肽(CGRP)mRNA表达水平的影响及其细胞内信号转导机制。方法将不同浓度的TNF-α、IL-1β、IL-2和Sumatriptan分别加入DMEM培养液中,与SD大鼠TG离体孵育24h;进一步将细胞内丝裂原激活的蛋白激酶(MAPK)信号转导系统ERK1/2、JNK、P38三条信号通路关键激酶特异性阻断剂PD98059、SP600125、SB239063加入DMEM培养液中,30min后分别加入有效浓度的炎性因子TNF-α和IL-1β后,与大鼠TG共同孵育24h,实时定量PCR(RT-PCR)法检测TG内CGRP-mRNA表达水平变化。结果 50μg/L的TNF-α、25μg/L的IL-1β可明显上调离体TG内CGRP-mRNA表达水平(P<0.05),0.1g/L和0.5g/L Sumatriptan能显著下调TG内CGRP-mRNA表达水平,而20～80μg/L的IL-2对CGRP-mRNA表达无影响。特异性阻滞剂SP600125、SB239063分别与50μg/L TNF-α、25μg/L IL-1β孵育24h后,CGRP-mRNA表达量较对照组显著降低(P<0.05)。结论 TG离体培养时,炎性因子TNF-α、IL-1β可显著上调CGRP-mRNA表达水平;一定浓度的舒马曲坦能下调CGRP-mRNA表达;JNK和P38信号转导通路参与了TNF-α、IL-1β诱导的TG内CGRP-mRNA上调过程。     

THE CYTOTOXIC EFFECTS OF CRUDE BILE ON HUMAN PANCREATIC CANCER CELL LINES

Thebileacidswereconfirmedasnonspecificcytotoxicsubstanceswhichplayveryimportantro1einpathophysiologyofextrahepaticcholesta-sis[la.Invitrostudieshadprovedthatthebileacidscouldcausechronicandacuteinjuryofpancreaticductalepitheliumactingasaninitiatorofpancre-atitist2i.Thepancreaticcancerisamajorworld-widepublichealthproblernandremainsasignifi-cantclinica1challenge.Atthetimeofdiagnosis,about7o%ofpancreaticcancerpatientsmanifestobstructivejaundicewhichcanresultinprogressiveliverdysfunctionandculmin…     

THE OVEREXPRESSION OF APOPTOSIS -RELATED GENES OF P53 AND BCL-2 IN CERVICAL CARCINOMA

It is reported that the 1oss of wtp53 function isbelieved to play an important role in the pathogen-esis of carcinomas of the uterine cervix. It has beenshown that the Ps3 gene product may be inactivatedin three principal ways: Ofollowing somatic pointmutation F @following loss of heterozygosity J and@ following human papillomavirus (HPV) infec-tion,as the viral oncoprotein E6 is known to bind,stabilise and ultimately degrade wild type P,,['J.The bcl--2 proto--onocgene is involved in the t…     

大骨节病病区儿童的硒负荷试验结果分析

对处于不同地区的大骨节病病区儿童,非病区儿童和1组服硒病区的儿童(7岁～13岁),一次性口服0.1%亚硒酸钠0.5ml(相当于150μg硒),进行了硒负荷试验。结果表明:硒负荷试验能够简便、敏感准确地反映机体硒状态;病区儿童存在着硒缺乏,表现在硒负荷后尿硒排泄少,排泄高峰后延;服硒盐病区儿童硒负荷结果和非病区儿童一致。本文还对硒负荷试验的特点、意义以及和血、尿硒的关系进行了讨论。     

大白鼠同神经与不同神经输入对脊髓背角神经元的会聚

实验用大白鼠。分级刺激腓肠神经和腓肠肌神经,对被激活的背角神经元进行观察,进而对皮肤、肌肉神经传入会聚神经元进行了分类,发现同一神经刺激被激活的背角神经元可分为A、A—C和C 3个类型,其中A—C型占多数(皮神经激活68%,肌神经激活50.4%)。实验中记录到125个皮,肌会聚神经元(CMCN),按对皮、肌A类和C类传入纤维的反应,分为A—A、A—AC、AC—A,AC—AC、C—C 5型,其中AC—AC和A—A型占多数(分别为46.27%和26.12%).结果提示,上述多种会聚形式,可能是皮、肌粗、细初级传入在脊髓水平对感觉传入(特别是痛觉)进行调制的基础,因此将在镇痛、痛过敏中起作用。     

THE EXPRESSION OF BCL-2 AND BAX PROTEINS IN GASTRIC CARCINOMA AND PRECANCEROUS LESIONS

Gastric carcinoma is one of the most commonmalignant tumors in China,and great attention hasbeen paid to its carcinogenesis research. In recentyears, it has been found that oncogenes played agreat role in the occurrence and development ofgastric carcinoma. The expression of apoptosis--as-sociated oncogenes, bcl-2 and bax, in early-stagegastric carcinoma and precancerous lesions was ex-amined by us with immunohistochemical method toevaluate their role in the genesis of gastric carcino-ma.MATE…     

The effect of bile reflux on the intragastric pH

Oblective To observe the effect of bile reflux on the intragastric pH. Methods We used ambulatory intragastric pH monitoring along with simultaneous Bilitec 2000 to measure the pH and absorbance of the mixed gastric juice diluted with bile with increasing bilirubin concentration in vitro and the yellow and clear gastric juice aspirated under endoscopy. In vivo,we studied 20 functional dispepsia patients for 24 h with simultaneous intragastric pH and bilirubin monitoring. Results In vitro dilutions,the absorbance value reached to 0. 900 while the concentration was only 20% ,but when the pH of the solution was more than 4,it′s concentration was already up to 60％. The mean absorbance of the yellow gastric juice(0. 348± 0. 131) was significantly higher than that of the clear juice (0. 008 ± 0. 003)(P＜0.05). The pH of 80％ yellow gastric juice was less than 4, the percentage was not significantly different from the clear samples (81％) (P＞0. 05). The pH showed no correlation with the absorbance in the yellow and clear groungs. Eight of the 12 patients with the spontaneous nocturnal episcodes of alkalinization had simultaneous increase of absorbance,4 of the 8 subjects with no aikalinization had increase of absorbance. Gonclusion In some concentration,bile reflux affect little on the intragastric pH.     

萘丁美酮对十二指肠胃返流所致胃黏膜损伤保护作用的实验研究

目的探讨非甾体类消炎药萘丁美酮对十二指肠返流导致返流性胃炎的治疗作用。方法用SD大鼠建立十二指肠胃返流模型,40只模型大鼠等分为萘丁美酮组和西沙比利组、铝碳酸镁组、空白手术组;另取10只SD大鼠作为假手术组。干预时间12周。对模型大鼠的胃标本进行病理学检查,采用免疫组化方法对胃黏膜的COX2和TNFα进行染色。结果萘丁美酮组的病理改变明显轻于空白手术组(P<0.01)而又重于假手术组(P<0.05),与铝碳酸镁组和西沙比利组相比则差异不显著(P>0.05)。TNFα的免疫组化染色显示,萘丁美酮组与其他各组间均无显著性差异(P>0.05)。COX2的免疫组化染色显示,萘丁美酮组与空白手术组相比COX2表达明显降低(P<0.01),与铝碳酸镁组、西沙比利组和假手术组相比则无显著性差异(P>0.05)。结论在十二指肠返流导致的返流性胃炎中,萘丁美酮有明显的治疗效果。萘丁美酮可明显降低胃黏膜组织中COX2水平。     

慢性盐缺乏、盐负荷对血清内源性哇巴因水平的影响

目的观察慢性盐缺乏和盐负荷对内源性哇巴因(EO)分泌的影响,探讨在慢性盐缺乏或盐负荷状态下EO对SD大鼠钠代谢和血压的调节作用。方法以含0.02%(低盐)、0.5%(普食)及8%(高盐)的普通加碘盐饲料喂养SD大鼠8周,原子吸收分光光度法检测尿液中钠离子、钾离子浓度,酶联免疫吸附法(ELISA)检测EO水平。结果高盐组SD大鼠血压较同期普食组和低盐组显著性升高(P<0.01)。高盐组24 h尿钠排泄量较普食组和低盐组显著增加(P<0.01)。高盐组24 h尿钾排泄量显著低于对照组和低盐组(P<0.01)。高盐组与普食组比较血清EO水平无统计学差异,低盐组于第4周开始血清EO水平高于普食组和高盐组,有统计学差异(P<0.01)。结论慢性盐缺乏时SD大鼠EO水平升高,提示其为慢性盐缺乏状态下维持血压的调节因子;而慢性盐负荷时血压明显升高,但未发现EO显著升高。     

家犬腰椎牵拉损伤引起马尾神经功能改变的实验研究

设计了椎间松解及椎体外固定器固定的动物模型 ,通过调整外固定器长度 ,造成椎管内马尾神经牵拉损伤。当外固定器长度增大 2 cm时 ,马尾诱发电位( CESEP)的 N2 波幅度降低。动物清醒后出现 :1后肢运动与感觉障碍 ,神经功能评分明显降低。随牵拉强度增加 ,N2 波幅度逐渐降低并伴 CESEP图形畸变 ,直至最终消失。 2双后肢运动及痛觉丧失。神经功能评分减至 0分。故通过调整外固定器长度 ,可动态改变脊柱牵拉损伤程度 ,损伤程度与 CESEP及动物神经功能评分一致。该模型还有可排除 SEP假阴性或假阳性之突出优点。