Kodi glucagon ndi chiyani?

Kodi glucagon ndi chiyani ndipo amachititsa? Izi zimapangidwa ndi maselo a pancreatic ndipo zimagwira ntchito yofunika kwambiri pakuwonetsetsa kuti ntchito yanthawi zonse ya munthu ikugwira ntchito. Pamodzi ndi mahomoni ena omwe amatulutsidwa ndi timadzi ta m'magazi a endocrine, amawongolera magwiridwe antchito a ziwalo zambiri ndi machitidwe.

Matenda a pancreatic

Nkhope ndi gawo lofunikira mthupi la munthu, popanda lomwe limatha kugwira ntchito moyenera. Zimapanga mahomoni angapo omwe amakhudza mwachindunji njira za metabolic. Amatenga nawo gawo pakusintha kwa zinthu zomwe zimabwera ndi chakudya, kuzisintha kukhala zophatikizika zomwe zimatha kulowetsedwa ndi maselo.

Ma mahomoni akuluakulu omwe amatha kupangidwa ndi kapamba ndi:

• insulin Zoyenera kuchita ndi kusintha magazi m'thupi,
• glucagon. Imakhala ndi zotsutsana ndi insulin,
• somatostatin. Ntchito yayikulu ndikupewa kupangira zinthu zingapo zomwe zimagwira ntchito molimbitsa thupi (mwachitsanzo, mahomoni okula, thyrotropin, ndi ena),
• pancreatic polypeptide. Amayang'anira dongosolo logaya chakudya.

Kufotokozera kwa mahormone

Glucagon imatchedwa mahomoni am'maselo a alpha omwe amakhala kuzilumba za Langenhans. Itha kupangidwanso pogwiritsa ntchito mbali zina za m'mimba. Malinga ndi kapangidwe kazinthuzi, glucagon ali ndi chilengedwe cha peptide. Izi zimapangidwa kuchokera ku preproglucagon. Kupanga kwa timadzi timeneti kumatengera kuchuluka kwa glucose yemwe amabwera ndi chakudya.

Komanso, ndende yake imayendetsedwa ndi insulin, ma amino acid ena ndi mafuta acids. Ngati munthu achulukitsa kuchuluka kwa chakudya chama protein muzakudya zake, izi zimatsogolera kuchuluka kwa alanine ndi arginine. Ma amino acids amathandizira kuchuluka kwa mahomoni awa m'magazi a anthu. Kenako, womalizirayo amakhala ngati chothandizira. Zimatembenuza amino acid kukhala glucose, zomwe zimatsogolera kuperekanso minyewa yonse yamthupi ndi mahomoni ofunikira.

Komanso, katulutsidwe wa glucagon umachuluka kuchokera kuchita masewera olimbitsa thupi kwambiri. Ngati munthu atayika thupi kukayezetsa kambiri (pamlingo woyesayesa), kukhazikika kwa mahomoni kumatha kuwonjezeka kuposa nthawi 5.

Chizindikiro cha chinthu ichi ndichakuti chimawonongedwa mu ziwalo zina - chiwindi, impso. Komanso, timadzi timeneti timagwera m'madzi am'magazi, m'magulu amtovu. Kutulutsa kwamphamvu kwambiri kwa timadzi ta glucagon m'magazi ndi 27-120 pg / ml.

Cholinga cha ntchito

Ntchito za glucagon ndi:

• imakhudza kuwonongeka kwa chiwindi ndi minofu yambiri ya glycogen, pomwe imasungidwa ngati nkhokwe yamphamvu. Zotsatira zake, glucose wamasulidwa,
• Njira yakusweka kwa lipid imayambitsa. Izi ndichifukwa choti kuchuluka kwa lipase m'maselo amthupi kumawonjezeka. Zotsatira zake, zinthu zophulika za lipid, zomwe zimachokera mphamvu, zimalowa m'magazi
• njira yopanga shuga kuchokera ku zinthu zosagwirizana ndi gulu la chakudya
• kuchuluka kwa magazi kwa impso,

• glucagon kumawonjezera kuthamanga kwa magazi, pafupipafupi komanso kuchuluka kwa minofu yamtima,
• pakukhudzana kwambiri, mahomoni amatulutsa antispasmodic. Izi zimapangitsa kuchepetsedwa kwa minyewa yosalala komwe mafupa a matumbo amapangidwa,
• kuchuluka kwa sodium excretion kuchokera m'thupi kumawonjezeka. Zotsatira zake, chiŵerengero cha ma electrolytic mthupi chimakhala chofanana. Izi zimakhudza bwino magwiridwe antchito a mtima,
• kuchira kwa maselo a chiwindi kumawonedwa,
• pamakhala zovuta pamaselo, chifukwa chomwe kutuluka kwa insulin kumachokera,
• kuchuluka intracellular calcium ndende.

Udindo wa mahomoni m'thupi la munthu

Limagwirira ntchito ya glucagon amawonedwa kuwonjezera kupezeka kwa mphamvu zolimbitsa thupi kwa chigoba minofu. Zinthu zotere zomwe zimakhudzidwa mwachindunji ndi mahomoni zimaphatikizapo glucose, mafuta aulere acids, keto acid. Komanso, muzochitika zina (zomwe zimasowetsa nkhawa kwambiri), kupatsidwa magazi kwa minofu yamatumbo kumachuluka chifukwa cha kukondoweza mtima. Hormone iyi imathandizira pazomwe zimakhala zamatekisimba. Izi zimapangitsa chidwi chapadera cha thupi pamavuto monga "kugunda kapena kuthamanga".

Udindo wa glucagon, womwe ntchito yake ndikupanga kuchuluka kwa shuga m'thupi, ndiwothandiza kwambiri kwa moyo wabwinobwino wamunthu. Dongosolo lamanjenje lapakati silitha kugwira ntchito popanda zinthu izi. Pomwe imagwira ntchito m'magazi a anthu imayenera kukhala pafupifupi 4 g la shuga pa ola limodzi. Komanso, chifukwa cha kusweka kwa lipids, kuchuluka kwa cholesterol m'thupi kumachepetsedwa kwambiri. Koma zochuluka kwambiri za timadzi timeneti zimabweretsa zotsatirapo zoyipa. Mwachitsanzo, pamkhalidwewu, zotupa zoyipa zimapezeka nthawi zambiri.

Kugwiritsa ntchito mankhwala osokoneza bongo

Mankhwala okhala ndi glucagon (malangizowo amatsimikizira izi) ali ndi zinthu zotengedwa kuchokera ku zikondamoyo zochokera kuzinyama (nkhumba, bovine).

Ndi ofanana ndi zinthu zomwe zimapangidwa ndi thupi la munthu. Mphamvu ya Glucagon ya mankhwala pokhudzana ndi zinthu monga shuga ndi glycogen zimakupatsani mwayi wogwiritsa ntchito njira zochizira milandu:

• woopsa chifukwa cha hypoglycemia. Nthawi zambiri zimawonedwa mwa odwala matenda a shuga. Amagwiritsidwa ntchito makamaka ngati sizotheka kupereka shuga m'magazi,
• pakuwunika ma radiation ngati njira yothinikizira maumbidwe am'mimba,
• ndi mankhwalawa odabwitsa odwala omwe ali ndi vuto lamaganizidwe,
• Pamaso pa pachimake diverticulitis monga njira yochotsera spasms,
• pamaso pa pathologies a biliary thirakiti,
• kumasula minofu yosalala yamatumbo.

Njira yogwiritsira ntchito

Malangizo a glucagon amawonetsa kuti mankhwalawa amagwiritsidwa ntchito kwa hypoglycemia mu 1 ml kudzera mu intravenly kapena intramuscularly. Miyezi yambiri ya shuga amawonekera pakatha mphindi 10 pambuyo pakupereka mankhwala. Nthawi zambiri izi zimakhala zokwanira kupewa kuwonongeka kwa mtima wamanjenje.

Malangizo ogwiritsira ntchito mankhwalawa akuwonetsa kuti angagwiritsidwe ntchito kuchuluka kwa 0,5-1 ml kwa ana odwala omwe thupi lawo limaposa 20 kg. Ngati mwana akulemera zochepa, ndiye kuti mulingo wovomerezeka sioposa 0.5 ml, womwe ndi 20-30 μg / kg. Ngati woyamba wa mahomoni kufunika kwake sikunachitike, tikulimbikitsidwa kubweretsanso jakisoni pakatha mphindi 12.

Contraindication

Zinthu zotsatirazi zimawerengedwa kuti ndi cholakwika pakugwiritsa ntchito mankhwala a horoni:

• Hypersensitivity pamagawo a othandizira,
• hyperglycemia
• insulinoma
• pheochromocytoma.

Mankhwalawa akuwonetsedwa pochiza mavuto ena mwa amayi apakati. Sichidutsa chotchinga ndipo sichikhudza mwana wosabadwayo mwanjira iliyonse. Munthawi ya kuyamwitsa, ma horoni amaikidwa mosamala.

Kodi glucagon ndi chiyani?

Chiyambireni kupezeka kwa insulin, zidapezeka kuti pambuyo pakuyang'aniridwa mwa njira yake, yodziwika ndi mtundu wa hypoglycemic, chizindikirochi chimayang'aniridwa ndi hyperglycemia yayifupi, koma yotsimikizika.

Pambuyo pakuwona zodabwitsazi, Abel ndi omwe adagwira nawo ntchito adakwanitsa kupeza insulin yomwe ilibe malo oyambitsa hyperglycemia. Nthawi yomweyo, zidapezeka kuti hyperglycemia yochepa yomwe idawonedwa koyambirira kwa kayendetsedwe ka insulin idayambitsidwa osati ndi insulin yokha, koma chifukwa chodetsa mkati mwake.

Akuti chodetsa ichi cha insulin ndichinthu cha thupi cha kapamba, chomwe chimatchedwa "glucagon". Kulekanitsidwa kwa glucagon ku insulin ndikovuta kwambiri, koma posachedwa adayesedwa mu mawonekedwe a crystalline ndi Staub.

Glucagon ndi zinthu zomanga thupi zomwe sizimayenda ndipo zimakhala ndi ma amino acid onse omwe amapezeka mu insulin, kupatula proline, isoleucine ndi cystine, ndi ma amino acid awiri, methionine ndi tryptophan, omwe samapezeka mu insulin. Glucagon ndiwofatsa kuposa insulin kwa alkalis. Kulemera kwake kwa mamolekyulu kuyambira 6000 mpaka 8000.

Udindo wa glucagon m'thupi la munthu

Glucagon, malinga ndi ofufuza onse, ndi gawo lachiwiri la kapamba lomwe limakhudzidwa ndi kayendedwe ka kagayidwe kazachilengedwe ndikuthandizira kutulutsidwa kwa thupi kwa glucose m'magazi kuchokera ku chiwindi cha glycogen ndi hypoglycemia.

Chofunikira: Kuyendetsa glucagon m'mitsempha kumayambitsa kuwoneka kwa glycemia kwakanthawi. Ubale pakati pa hyperglycemic zochita za glucagon ndi glycogen zomwe zimachitika m'chiwindi zinaonedwa ndikuwona zomwe zinaonetsa kuti atapereka glucagon ku nyama zathanzi, kuwonjezeka kwa shuga kwa magazi kumawonetsedwa, pomwe kugwiritsa ntchito kwake nyama zomwe zili ndi matenda a shuga a m'magazi, pomwe zosunga mu chiwindi sizinathe, kusangalatsidwa.

Glucagon imapezeka osati pakukonzekera malonda a insulin ambiri, komanso m'matumba a pancreatic. Amanenanso kuti maselo a alpha ndi malo omwe amapanga glucagon ndipo maselo a beta ndi malo a insulin.

Mawuwa adanenedwa pamaziko akuti nyama zoyesera zomwe zili ndi matenda osokoneza bongo a alloxan, momwe maselo a beta amawonongedwa mwanjira ina, kutulutsa kwa pancreatic gland kumapitilizabe kukhala ndi glucagon.

Chifukwa cha zowonera zomwe zinawonetsa kuti cobalt chloride mosamala imawononga maselo a alpha, maphunziro adachitika pazomwe glucagon amapezeka atatha kugwiritsa ntchito mankhwalawa, pomwe kuchepa kwa kuchuluka kwake ndi 60% kudadziwika. Komabe, olemba ena amakana kuti glucagon amapangidwa ndi maselo a alpha, ndipo akukhulupirira kuti malo ake opangidwabe sanadziwikebe bwinobwino.

Yolembedwa ndi olemba angapo, kuchuluka kwakukulu kwa glucagon kunapezeka mu 2/3 ya mucosa ya m'mimba ndipo pang'ono pang'ono mu duodenum. Zochepa kwambiri zomwe zilipo m'chigawo cha pyloric cha m'mimba ndipo sizikupezeka mucosa la m'matumbo akuluakulu komanso chikhodzodzo.

Zinthu zokhala ndi zinthu zofanana ndi glucagon zimapezekanso mkodzo wowonekera ndi mkodzo wa odwala omwe ali ndi matenda ashuga, mkodzo wa nyama yokhala ndi matenda osokoneza bongo a alloxan. Muzochitika izi, titha kulankhula za mahomoni pawokha kapena zinthu zomwe zasokonekera.

Glucagon imayambitsa hyperglycemia, glycogenolysis pakalibe ma adrenal gland chifukwa cha chiwindi cha glycogen. Hyperglycemia samakula ndi kuperekera kwa glucagon mu nyama yokhala ndi chiwindi chochotsedwa. Glucagon ndi insulin ndizotsutsana ndipo limodzi amathandizira kuti azikhala ndi glycemic bwino, pomwe kubisala kwawo kumakhudzidwa ndi kusinthasintha kwa shuga m'magazi.

Ngakhale isanayambike insulini, magulu osiyanasiyana a maselo anapezeka m'malo ocheperako pancreatic. Glucagon yokha idapezeka ndi Merlin ndi Kimball mu 1923, pasanathe zaka ziwiri insulin. Komabe, ngati kupezeka kwa insulin kuyambitsa chisokonezo, ndiye kuti ndi anthu ochepa omwe adayamba chidwi ndi glucagon.

Pazaka zopitilira 40 tsopano pakhala kuwonekeratu kuti ndi gawo liti lofunikira la thupi lomwe timadzi timene timapanga mu glucose ndi metabolone metabolism, koma ntchito yake ngati mankhwala idakalipobe masiku ano. Glucagon imagwiritsidwa ntchito pokhapokha pakuchotsa mpumulo ya hypoglycemia, komanso kuwunika ma radiation ngati mankhwala omwe amachepetsa matumbo a m'matumbo.

Mphamvu zamankhwala

Glucagon ndi polypeptide imodzi yokhala ndi zotsalira za 29 amino acid. Pali kufotokozera kwapakati pakati pa glucagon ndi mahomoni ena a polypeptide, kuphatikizapo secretin, VIP, ndi gastroinhibitory peptide. Mitundu ya amino acid ya glucagon mwa zolengedwa zomwe zimasungidwa kwambiri, ndizofanana mwa anthu, ng'ombe, nkhumba ndi makoswe.

Glucagon imapangidwa kuchokera ku prroglucagon, peptide yoyambirira ya amino acid ndi magawo asanu omwe amapanga magawo osiyanasiyana (Bell et al., 1983). N-terminal sign peptide mu molekyu ya prroglucagon imatsatiridwa ndi glycine-pancreatic peptide, motsatiridwa ndi amino acid mndandanda wa glucagon ndi glucagon-ngati peptides amitundu 1 ndi 2.

Chenjezo: Kukonzekera kwa prroglucagon kumachitika m'njira zingapo ndipo zimatengera minofu yomwe zimachitikira. Zotsatira zake, ma peptides osiyanasiyana amapangidwa kuchokera ku prrohormone yemweyo mu ma-cell a pancreatic islets ndi matumbo a neuroendocrine cell (L-cell) (Mojsov et al., 1986).

Glicentin, chinthu chofunikira kwambiri chapakatikati pokonzekera, chimakhala ndi N-terminal glycine-pancreatic peptide ndi C-terminal glucagon, yolekanitsidwa ndi zotsalira ziwiri za arginine. Oxyntomodulin imakhala ndi glucagon ndi C-terminal hexapeptide, yolekanitsidwa ndi zotsalira ziwiri za arginine.

Ntchito yakuthupi ya glucagon precursors siyodziwikiratu, koma njira yovuta yogwiritsira ntchito preproglucagon ikuwonetsa kuti onsewa ayenera kukhala ndi ntchito zapadera. M'magulu obisika a-cell a pancreatic islets, chapakati pa glucagon ndi mzere wotumphukira kuchokera ku glycine ndiosiyanika.

M'matumbo a L-cell, ma granules a chinsinsi amakhala ndi glycine yokha, mwachiwonekere, maselo amenewa alibe ma enzyme omwe amasintha glycine kukhala glucagon. Oxyntomodulin imamangiriza ku glucagon receptors pa hepatocytes ndikuwonjezera adenylate cyclase, ntchito ya peptide iyi ndi 10-20% ya ntchito ya glucagon.

Mtundu woyamba wa glucagon ngati peptide ndiwowonjezera mphamvu ya insulin katulutsidwe, koma ilibe mphamvu pa hepatocytes. Glycine, oxyntomodulin ndi glucagon ngati ma peptides amapezeka makamaka m'matumbo. Zobisika zawo zimapitilira pambuyo pancreatectomy.

Malamulo apadera

Glucagon secretion imayendetsedwa ndi glucose kuchokera ku chakudya, insulin, amino acid ndi mafuta acids. Glucose ndi cholepheretsa champhamvu chobisika cha glucagon. Ikamamwa pakamwa, imakhala ndi mphamvu kwambiri pakubisika kwa glucagon kuposa kutsata kwa iv (monga, mwadzidzidzi, pazobisalira za insulin). Mwinanso, mphamvu ya glucose imayendetsedwa ndi mahomoni ena am'mimba.

Upangiri! Umatayika mu mellitus wosadukiza kapena wowonongeka, ndipo sapezeka pachikhalidwe chaosayenera. Zotsatira zake, kuchuluka kwa shuga pamaselo a-cell, osachepera gawo, kumadalira kukondoweza kwa insulin katulutsidwe. Somatostatin, mafuta achilengedwe aulere komanso matupi a ketone amalepheretsanso kubisalira kwa glucagon.

Ma amino acid ambiri amathandizira kubisalira kwa glucagon komanso insulin yonse. Izi zikufotokozera chifukwa chake, mutatha kudya mapuloteni oyera, insulin-mediated hypoglycemia simapezeka mwa anthu. Monga glucose, ma amino acid amakhala othandiza kwambiri ngati atengedwa pakamwa kuposa momwe amaperekedwa kudzera m'mitsempha. Chifukwa chake, mphamvu zawo zitha kugwiritsidwanso ntchito ndi mahomoni azigawo.

Kuphatikiza apo, katulutsidwe ka glucagon kamayendetsedwa ndi dongosolo la mantha aumwini. Kuyipitsa kwa ulusi wamanjenje wachifundo womwe umalowa m'mphepete mwa kapamba, komanso kuyambitsa kwa adrenostimulants ndi sympathomimetics kumawonjezera chinsinsi cha timadzi timeneti.

Acetylcholine imachitanso chimodzimodzi. Glucagon wa matenda ashuga. Odwala omwe ali ndi matenda osokoneza bongo a mellitus, kuchuluka kwa glucagon mu plasma kumakulitsidwa.Chifukwa cha kuthekera kwake kopititsa patsogolo shuga ndi glycogenolysis, glucagon imachulukitsa hyperglycemia. Komabe, kubisala kwa glucagon secretion mu shuga mellitus kumawoneka ngati kwachiwiri m'chilengedwe ndipo kumatha ngati misempha ya m'magazi itasintha (Unger, 1985).

Udindo wa hyperglucagonemia mu shuga mellitus wafotokozedwa momveka bwino poyesera somatostatin (Gerich et al., 1975). Somatostatin, ngakhale sikhala ndi matenda a glucose, amachepetsa kwambiri kukula kwa hyperglycemia ndi ketonemia mwa odwala omwe ali ndi matenda a shuga a insulin atangotuluka mwadzidzidzi.

Mwa anthu athanzi, poyankha hypoglycemia, glucagon secretion imawonjezeka, ndipo ndi insulin yodalira matenda a shuga mellitus njira yotetezera yofunika iyi imatayika kumayambiriro kwa matendawa.

Njira yamachitidwe

Glucagon imamangiriza ku receptor pamitsempha yama cell ofunikira, cholandiracho ndi glycoprotein wolemera maselo 60,000 (Sheetz ndi Tager, 1988). Kapangidwe ka receptor sichinadziwike kotheratu, koma ndikudziwika kuti adalumikizidwa ndi puloteni ya Gj yomwe imayambitsa adenylate cyclase.

Chofunikira: Mphamvu yayikulu ya glucagon pa hepatocytes imasungidwa ndi cAMP. Kusintha kwa gawo la N-terminal la molekyu ya glucagon imasinthira kukhala agonist pang'ono: mgwirizano wa receptor umasungidwa pamlingo wina kapena wina, ndipo kuthekera kwoyambitsa adenylate cyclase kumakhala kutayika kwambiri (Unson et al., 1989). Makamaka, Phen'-glucagon ndi des-His'-Glu9-glucagonamide amachita makamaka.

Kudzera mu phosphorylation yochokera kwa cAMP, glucagon imayendetsa phosphorylase, enzyme yomwe imathandizira kuchepa kwa glycogenolysis. Nthawi yomweyo, glycogen synthetase phosphorylation imachitika, ndipo ntchito yake imachepa.

Zotsatira zake, glycogenolysis imatheka, ndipo glycogeneis imalepheretsa. cAMP imathandizanso kulembedwa kwa mtundu wa phosphoenolpyruvate carboxykinase, ma enzyme omwe amathandizira kuchepetsa gluconeogenesis reaction (Granner et al., 1986). Nthawi zambiri, insulin imayambitsa mavuto ena, ndipo kuchuluka kwa mahomoni onsewo ndikokwanira, zochita za insulin zimapambana.

CAMP imayimira phosphorylation ya enzyme ina yofunafuna, 6-phosphofructo-2-kinase / fructose-2,6-diphosphatase (Pilkis et al., 1981, Foster, 1984). Kuphatikizika kwa chidwi cha fructose-2,6-diphosphate, komwe, kumayendetsa gluconeogeneis ndi glycogenolysis, zimatengera enzyme iyi.

Momwe kuchuluka kwa glucagon kumakhala kwakukulu komanso insulin yotsika, 6-phosphofructo-2-kinase / fructose-2,6-diphosphatase phosphorylates ndipo amagwira ntchito ngati phosphate -ase, akumachepetsa mawonekedwe a fructose-2,6-diphosphate m'chiwindi.

Momwe kuchuluka kwa insulin kumakhala kokwanira komanso glucagon kutsika, enzyme imatsika ndikuchita ngati kinase, ikuwonjezera zomwe zili fructose-2,6-diphosphate. Fructose-2,6-diphosphate ndi activator wa phosphofrodokinase, enzyme yomwe imathandizira kuchepa kwa glycolysis.

Chifukwa chake, kuchuluka kwa glucagon ndikokwanira, glycolysis imalephereka, ndipo gluconeogenesis imatheka. Izi zimabweretsa kuwonjezeka kwa milonyl-CoA, kuthamangitsidwa kwa makutidwe ndi okosijeni a mafuta acids ndi ketogeneis. Mosiyana ndi izi, insulin ikakhala yayikulu, glycolysis imatheka, ndipo gluconeogeneis ndi ketogeneis amakakamizidwa (Foster, 1984).

Chenjezo: Glucagon, makamaka yozama kwambiri, samangokhala pachiwindi, komanso pamankhwala ena. Mu adipose minofu, imayendetsa adenylate cyclase ndikuwonjezera lipolysis, mu myocardium imawonjezera mphamvu ya mtima. Glucagon imatsitsimutsa minofu yosalala ya m'mimba, ma analogu a mahomoni omwe samayambitsa adenylate cyclase nawonso amakhala ndi vuto lofananalo.

M'minyewa ina (kuphatikizapo chiwindi), pali mtundu wina wa glucagon receptor, kumangiriza kwa mahomoni kwa iwo kumabweretsa kupangidwe kwa IF3, DAG komanso kuwonjezeka kwa intracellular calcium calcium (Murphy et al., 1987). Udindo wa glucagon receptor mu kayendetsedwe ka kagayidwe kamadziwika.

Zotsatira za pharmacological

Glucagon ndi wokonda kuteteza thupi.

Glucagon, yomwe ntchito zake zimasiyana mosiyanasiyana ndi ntchito ya insulin, imachulukitsa kuchuluka kwa glucose m'ziwalo zina chifukwa cha zotsatira zake ziwiri: kusokonekera kwa glycogen (chakudya chachikulu cha chiwindi ndi chiwopsezo cha gluconeogeneis (kapangidwe ka glucose kochokera kuzinthu zina). Mwa kuyambitsa glycogenolysis (kusokonekera kwa glycogen to glucose) m'chiwindi, glucagon imakulitsa kuchuluka kwa shuga m'magazi kwa mphindi zingapo.

Glucagon, yemwe ntchito zake sizimangokhala pazotsatira za hyperglycemic, amatha kupatsirana ma spasms komanso amakhala ndi inotropic (kusintha kwa kugunda kwa mtima) komanso chronotropic (kusintha kwa kuchuluka kwa mtima) kumapangitsa mtima chifukwa chakuwonjezeka kwa mapangidwe a cAMP (mkhalapakati pakufalitsa kwa ma signenti a mahomoni ena).

Mlingo waukulu wa Glucagon umapangitsa mpumulo wamatumbo kwambiri, womwe suyendetsedwa ndi adenylate cyclase.

Zisonyezero zogwiritsa ntchito glucagon

Glucagon timadzi totengera:

• mpumulo wa kwambiri hypoglycemic zinthu,
• shuga wamagazi ochepa (hypoglycemia) mwa odwala matenda a shuga;
• mankhwala othandizira odwala matenda amisala,
• kufufuza kwazigawo zosiyanasiyana zamatumbo am'mimba ngati chothandiza.

Mphamvu ya mankhwala achilengedwe

Kuphatikiza kwachilengedwe komwe kumapangidwanso ndikofunikira kwambiri kuti timvetsetse kufunika kwake. Amayamba chifukwa cha zochita za maselo a alpha a zilumba za Langenhans. Amapangidwanso ndi ziwalo zina zam'mimba.

Glucagon ndi mtundu umodzi wa polypeptide. Muli 29 amino acid. Kapangidwe kake kamafanana ndi insulin, koma mumakhala ma amino acid omwe sapezeka mu insulin (tryptophan, methionine). Koma cystine, isoleucine ndi proline, omwe ndi gawo la insulin, sapezeka mu glucagon.

Hormone iyi imapangidwa kuchokera pre-glucagon. Momwe amapangira zimadalira kuchuluka kwa glucose omwe amalowa mthupi ndi chakudya. Kukondoweza kwa kupanga kwake ndi kwa arginine ndi alanine - ndi kuchuluka kwawo mthupi, glucagon imapangidwa kwambiri.

Ndi masewera olimbitsa thupi mopitilira muyeso, kuchuluka kwake kumatha kuchuluka kwambiri. Komanso, zomwe zimapezeka m'magazi zimatengera insulin.

Nchiyani chimatsogolera pakuwonjezera komanso kusowa kwa mahomoni m'thupi?

Zotsatira zoyambirira kwambiri za mahormoni ndikuwonjezereka kwa kuchuluka kwa glucose ndi mafuta acids. Kuti ikhale yabwinoko kapena yoyipa, zimatengera kuchuluka kwa glucagon wopangidwa.

Pamaso pa zopatuka, zimayamba kupangidwa zochuluka - kotero kuti ndizowopsa pakupanga zovuta. Koma zomwe zimakhala zochepa kwambiri, zomwe zimayambitsidwa ndi zolakwika m'thupi, zimabweretsa zotsatirapo zoyipa.

Kuchulukitsa kwa panganoli kumabweretsa kuchuluka kwa thupi ndi mafuta acid ndi shuga. Kupanda kutero, izi zimatchedwa hyperglycemia. Mlandu umodzi womwe umachitika osati wowopsa, koma mwatsatanetsatane wa hyperglycemia umabweretsa chitukuko. Itha kutsagana ndi tachycardia komanso kuwonjezeka kwa kuthamanga kwa magazi, komwe kumayambitsa matenda oopsa komanso mtima.

Kuyenda kwambiri kwa magazi kudzera m'matumbo kumapangitsa kuti mavalidwe awo asanakwane, zomwe zingayambitse matenda amitsempha.

Ndi kuchuluka kocheperako kwa timadzi timeneti, thupi la munthu limakumana ndi vuto la shuga, lomwe limayambitsa hypoglycemia. Mkhalidwewu ulinso pakati pa owopsa komanso a m'magazi, chifukwa ungayambitse zambiri zosasangalatsa.

Izi zikuphatikiza:

• nseru
• chizungulire
• kunjenjemera
• ochepa ogwira ntchito
• kufooka
• kudziwa zolakwika
• kukokana.

Wovulala kwambiri atamwalira.

Zambiri paz kanema wa glucagon pa kulemera kwa munthu:

Kutengera izi, titha kunena kuti, ngakhale pali zinthu zambiri zothandiza, zomwe zili mu glucagon mthupi siziyenera kupitilira zinthu wamba.

Kodi glucagon wamtundu wanji?

Glucagon ndi timadzi tating'onoting'ono tokhala ndi polypeptide timene timasungidwa ndi ma cell omwe anthu amawatengera kuti azangokhala. M'munsi mwa matumbo ang'onoang'ono muli maselo ofanana, omwe amatchedwa "L-cell", omwe amatseka gulu la glucagon-peptides (enteroglucagon) lomwe limasowa zochita za glucagon.

Amakhulupirira kuti amagwira ntchito inayake yoyendetsera m'mimba. Njira za radioimmunological zokhudzana ndi mphamvu ya plasma glucagon yokhudzana ndi ma glucagon enieni a antibodies samawona enteroglucagon, koma akuwonetsa mitundu inanso iwiri yomwe ilipo mu plasma (immunoreactive glucagon-9000 IRG9000 and plasma glucagon BHP), mulingo womwe sazindikira kusinthasintha kwachangu.

Zotsatira za glucagon pakuwonekera kwa ma plasma ndizochepa kwa chiwindi, pomwe timadzi timene timalimbana ndi insulin. Imakulitsa modabwitsa hepatic glycogenolysis ndi kutulutsa shuga m'magazi am'magazi, imathandizira gluconeogeneis, ndikuthandizanso kayendedwe kazinthu zamagetsi zamafuta amtundu wautali wamafuta mumochondria, komwe ma asidi awa amapanga oxidation ndi komwe matupi a ketone amapangidwira.

Glucagon Wowonjezera

Secretion ya Glucagon imatheka chifukwa cha kuchepa kwa glucose, kukhudzika kwachisoni kwa kapamba, kulowetsedwa kwamkati mwa amino acid (mwachitsanzo arginine), komanso kumayendetsedwa ndi mahomoni am'matumbo am'mimba, mafuta amayamba kulowa m'matumbo mulingo wa glucagon, koma izi sizimachitika pomwe zinthuzi zili m'gulu la chakudya chopatsa mphamvu, pomwe nthawi ya shuga m'magazi amachepetsa).

Ma glucagonomas ndi zotupa za glucagon zomwe sizimadziwika mwachangu kuchokera ku ma pancreatic islets (onani khansa ya pancreatic).

Kodi glucagon ndi chiyani, ntchito ndi mtundu wa mahomoni

Chiwalo chofunikira mthupi lathu ndi kapamba. Amapanga mahomoni angapo omwe amakhudza kagayidwe ka thupi. Izi zimaphatikizapo glucagon, chinthu chomwe chimatulutsa shuga m'maselo. Kuphatikiza apo, kapamba amapanga insulin, somatostatin ndi pancreatic polypeptide.

Somatostatin ali ndi udindo woletsa ntchito yopanga mahomoni okula komanso ma catecholamines (adrenaline, norepinephrine). Peptide imayang'anira magawo a kugaya ntchito. Insulin ndi glucagon amawongolera zomwe zili gwero lalikulu lamphamvu - glucose, ndipo mahomoni awiriwa akutsutsana mwachindunji. Kodi glucagon ndi ntchito zina ziti zomwe tili nazo, tidzayankha m'nkhaniyi.

Kupanga kwa glucagon ndi ntchito

Glucagon ndi chinthu cha peptide chomwe chimapangidwa ndi zisumbu za Langerhans ndi maselo ena apachifinya. Kholo la Hormone uyu ndi prroglucagon. Zokhudzana ndi kapangidwe ka glucagon amakhala ndi shuga wopezeka ndi thupi kuchokera ku chakudya. Komanso kapangidwe ka timadzi timeneti timapangidwa ndi zinthu zomwe zimapangidwa ndi munthu yemwe ali ndi chakudya. Amakhala ndi arginine ndi alanine, zomwe zimachulukitsa kuchuluka kwa zomwe zafotokozedwa m'thupi.

Kuphatikizika kwa glucagon kumakhudzidwa ndi ntchito zolimbitsa thupi ndi masewera olimbitsa thupi. Mukamakulitsa katundu, mphamvuyo imakhala yotchuka kwambiri. Zimayambanso kupanga bwino kwambiri pakusala kudya. Monga woteteza, chinthucho chimapangidwa nthawi ya nkhawa. Kuchita kwake kumakhudzidwa ndikuwonjezeka kwa kuchuluka kwa adrenaline ndi norepinephrine.

Glucagon amagwiritsidwa ntchito kupanga glucose kuchokera ku mapuloteni amino acid. Chifukwa chake, limapereka ziwalo zonse za thupi ndi mphamvu yofunikira kugwira ntchito. Ntchito za glucagon zimaphatikizapo:

• Kuwonongeka kwa glycogen m'chiwindi ndi minofu, chifukwa chomwe glucose omwe amasungidwa pamenepo amatulutsidwa m'magazi ndikuthandizira kagayidwe kamphamvu.
• kuwonongeka kwa lipids (mafuta), komwe kumathandizanso kuti thupi likhale ndi mphamvu,
• kupanga shuga kwa zakudya zopanda mafuta
• Kuwapatsa magazi impso,
• kukweza magazi
• kuchuluka kwa mtima
• antispasmodic zotsatira,
• kuchuluka kwa zamatekisiti,
• kukopa kwa chiwindi
• kuthamanga kwa njira ya kuchotsa masodium ndi phosphorous m'thupi,
• kusintha kwa magnesium,
• kuchuluka kwa calcium m'maselo,
• kuchoka kwa maselo a insulin.

Tiyenera kudziwa kuti glucagon simalimbikitsa kupanga kwa glucose mu minofu, chifukwa alibe ma receptor ofunikira omwe amayankha mahomoni. Koma mndandanda umawonetsa kuti gawo la zinthu mthupi lathu ndilokulirapo.

Chenjezo: Glucagon ndi insulin ndi mahomoni awiri omenya nkhondo. Insulin imagwiritsidwa ntchito kupangira shuga m'maselo. Amapangidwa ndi shuga wambiri, kuisunga mosungira. Mphamvu ya zochita za glucagon ndikuti imatulutsa shuga m'maselo ndikuyitsogolera ku ziwalo za thupi kuti ikhale ndi mphamvu.

Tiyeneranso kukumbukiranso kuti ziwalo zina za thupi zimatenga shuga, ngakhale magwiridwe antchito a insulin. Izi zimaphatikizapo ubongo wamutu, matumbo (mbali zina zake), chiwindi, komanso impso zonse. Pofuna kuwongolera kusinthana kwa shuga mthupi, mahomoni ena amafunikanso - iyi ndi cortisol, mahomoni amantha, adrenaline, omwe amakhudza kukula kwa mafupa ndi minofu, somatotropin.

Chikhalidwe cha mahomoni ndi kupatuka pamenepo

Mlingo wa mahomoni a glucagon umatengera zaka za munthu. Akuluakulu, foloko pakati pamtengo wotsika komanso wapamwamba ndi yaying'ono. Gome ndi ili:

Kupatuka kuchokera ku voliyumu yabwinoko ya mahomoni kungasonyeze matenda. Kuphatikiza, posankha kuchuluka kwa chinthu, izi ndizotheka:

• kwambiri cystic fibrosis wa endocrine tiziwalo timene timayambitsa kupuma,
• kutupa kosatha kwa kapamba,
• kutsika kwa glucagon kumachitika pambuyo pancreatic kuchotsa ntchito.

Ntchito za glucagon ndikuchotsa zina mwazomwe zili pamwambapa. Zambiri ikuwonetsa chimodzi mwazinthuzi:

• kuchuluka kwa shuga chifukwa cha mtundu 1 wa shuga,
• chotupa cham'mimba,
• kutupa kwapakhungu,
• matenda a chiwindi (kusinthika kwa maselo mu minofu yotupa),
• kuchuluka kwa glucocorticoids molingana ndi m'badwo wam'mimba yawo yam'mimba,
• kulephera kwa impso
• kuchita masewera olimbitsa thupi mopitirira malire
• kupsinjika kwa malingaliro.

Vuto la kuchuluka kapena kuchepa kwa mahomoni, dokotalayo amapereka mankhwala ena kuti adziwe matenda olondola. Kuti muwone mulingo wa glucagon, biochemistry yamwazi imachitika.

Othandizira okhala ndi glucagon

Kuphatikizika kwa Glucagon kumachitika kuchokera ku mahomoni a nyama, pogwiritsira ntchito mwayi wokhala ndi thunthu lofanana. Mankhwalawa amamasulidwa mwanjira yamadzimadzi a jakisoni komanso mwanjira ya mapiritsi a pakamwa. Zilonda zimaperekedwa kudzera m'mitsempha kapena intramuscularly. Mankhwala ndi mankhwala otsatirawa:

• shuga wochepa shuga
• mankhwala owonjezera a kukhumudwa,
• kufunika kothetsera matumbo,
• Kutonthoza ndi kuwongola minofu yosalala,
• Ndi matenda am'mimba,
• ndikuwunika kwam'mimba.

Malangizowo akufotokozera kuti jakisoni wa jakisoni yemwe amaperekedwa kudzera m'mitsempha kapena ngati sichingatheke kubayitsa mtsempha, kudzera m'mitsempha, ndi 1 ml. Pambuyo pa jakisoni, kuchuluka kwa mahomoni, limodzi ndi kuchuluka kwa shuga, kumawonedwa pambuyo pa mphindi 10.

Mankhwalawa amatha kugwiritsidwa ntchito pochiza ana. Ngati kulemera kwa khanda kumakhala kochepera 20 kg, mlingo sayenera kupitirira 0,5 ml. Kwa ana olemera, mlingo umachokera ku 0,5 mpaka 1 ml. Ngati mphamvu ya kayendetsedwe ka mankhwala sikokwanira, jakisoni amabwerezedwa pambuyo pa mphindi 12. Ndikofunikira kumayamwa kwina.

Kuthandiza ana ndi amayi apakati kungachitike mu chipatala moyang'aniridwa ndi katswiri. Pokonzekera matenda a radiation, 0,25 mg mpaka 2 mg wa mankhwalawa amaphatikizidwa. Mlingo, kutengera mkhalidwe wa wodwala ndi kulemera kwake, amawerengedwa ndi dokotala. Ndi zoletsedwa kumwa mankhwalawa mwanjira iliyonse popanda mankhwala a dokotala.

Ngati mankhwalawa amagwiritsidwa ntchito posamalira mwadzidzidzi, mukatha kumwa, muyenera kudya zinthu zamapuloteni, kumwa kapu ya tiyi wotsekemera wokoma ndikupita kukagona kwa maola awiri.

Contraindication ku Glucagon chithandizo

Glucagon ndi yoletsedwa kugwiritsidwa ntchito pazotsatirazi:

• matenda a kapamba chifukwa cha kupanga kwa insulin ndi ma cell a chotupa,
• shuga wambiri
• Ndi chotupa kapena chotupa chotupa (pheochromocytoma), ma cell omwe amapanga katekisimu,
• ndi tsankho la munthu kwa othandizira.

Kuti muzindikira koyambirira kwa contraindication ku chithandizo cha mahomoni, njira zowonjezera zakufunika zimafunikira. Zotsatira zoyipa za kutenga Glucagon zimatha kukhala nseru komanso kufuna kusanza. Ngati kugwiritsa ntchito mankhwalawa sikunapereke zotsatira zomwe zikuyembekezeredwa, njira yothandizira shuga iyenera kuperekedwa kwa wodwala.

Mankhwalawa amatha kugwiritsidwa ntchito pochiritsa amayi oyembekezera. Imachedwetsedwa ndi placenta ndipo sifika kwa mwana wosabadwayo. Pakudya, kugwiritsa ntchito mankhwalawa kumatheka pokhapokha kuyang'aniridwa ndi katswiri.

Ngati glucose ali pansipa, ndiyenera kuchita chiyani?

Dokotala asanafike, mutha kuwonjezera shuga wanu pakudya zakudya zina. Ndi bwino kudya uchi 50 g, womwe umakhala ndi fructose, shuga komanso sucrose. Kupatula apo, fructose yokhayo yomwe ndi yoyipa. Ndipo ngati glucagon ndi glucose sizipangidwa zochuluka kutipatsa shuga, shuga amayenera kutengedwa ngati chakudya.

Thandizani kubwezeretsa tiyi wamphamvu ndi kupanikizana. Pambuyo pa kuchuluka kwambiri kapena kupanikizika kwamanjenje, ndikofunika kudya kwambiri ndi zakudya zopatsa mphamvu kwambiri. Mndandanda wawo umaphatikizapo zakudya zam'nyanja, mtedza, maapulo, tchizi, nthanga za maungu, mafuta a masamba. Phindu limabweretsa mpumulo m'chipinda chotsegulira phokoso komanso kugona tulo tofa nato.

Kodi glucagon ndi gawo lanji mthupi lake

Glucagon wa "njala" sadziwika pang'ono kuyerekeza ndi insulin, ngakhale zinthu ziwiri izi zimagwira ntchito m gulu lolimba ndikuchita gawo lofunikira mthupi lathu. Glucagon ndi amodzi mwa mahomoni akuluakulu a kapamba, omwe, limodzi ndi insulin, omwe ali ndi udindo wokhazikitsa shuga m'magazi. Kukonzekera kwa mahomoni potengera apo kumagwiritsidwa ntchito mwachangu mankhwala kuti achire matenda a shuga komanso kukonzekera matenda am'mimba.

Kapangidwe ndi kaphatikizidwe ka glucagon

Glucagon amatchedwa mosiyana, koma nthawi zambiri amatchulidwa ngati mahomoni - wotsutsana ndi insulin. Asayansi a H. Kimball ndi J. Murlin adatulukira chinthu chatsopano mu kapamba mu 1923, patatha zaka ziwiri atapeza insulini. Komano, ndi anthu ochepa omwe amadziwa za gawo la glucagon m'thupi lomwe silingabwezedwe.

Langizo! Masiku ano, m'mankhwala, ntchito zazikuluzikulu ziwiri za "mahomoni a njala" zimagwiritsidwa ntchito - hyperglycemic and diagnostic, ngakhale kwenikweni mankhwalawo amagwira ntchito zingapo zofunika mthupi nthawi imodzi. Glucagon ndi mapuloteni, makamaka, mahomoni a peptide mu kapangidwe kake kama mankhwala. Mwa kapangidwe kake, ndi polypeptide imodzi yolumikizira ya 29 amino acid. Amapangidwa kuchokera ku preproglucagon, polypeptide yamphamvu kwambiri yomwe imaphatikizira 180 amino acid.

Ndi kufunikira kwa glucagon m'thupi, kapangidwe kake ka amino acid ndikosavuta, ndipo ngati tigwiritsa ntchito chilankhulo cha sayansi, "ndizosasintha". Chifukwa chake, mwa anthu, ng'ombe, nkhumba ndi makoswe, kapangidwe ka timadzi timeneti ndi chimodzimodzi. Chifukwa chake, kukonzekera kwa glucagon nthawi zambiri kumapezeka kuchokera ku zikondamoyo za ng'ombe kapena nkhumba.

Ntchito ndi zotsatira za glucagon m'thupi

Katulutsidwe wa glucagon amapezeka gawo la kumapeto kwa kapamba pansi pa dzina lochititsa chidwi "zisumbu za Langerhans." Gawo lachisanu mwa mabanjawa ndi maselo apadera a alpha omwe amapanga mahomoni.

Zinthu zitatu zomwe zimakhudza kupanga kwa glucagon:

• Kuchuluka kwa shuga m'magazi (kutsika kwamisempha yovuta kwambiri kumapangitsa chidwi cha kuchuluka kwa "mahomoni a njala" mu plasma).
• Kuwonjezeka kwa kuchuluka kwa amino acid m'magazi, makamaka alanine ndi arginine.
• Kuchita masewera olimbitsa thupi (Kuchita zolimbitsa thupi mopitirira malire a mphamvu za anthu kumawonjezera kuchuluka kwa mahomoni nthawi 4-5).

Kamodzi m'magazi, "mahomoni amanjala" amathamangira kumalo olowera maselo a chiwindi, kumangirira kwa iwo ndikuthandizira kutulutsa kwa glucose m'magazi, kuisunga mosasunthika. Komanso, glucagon wamafuta wa kapamba amachita izi: ntchito mthupi:

• imayambitsa kuphwanya kwa lipid ndikutsitsa cholesterol yamagazi
• timapitiriza kuyenda kwa magazi mu impso
• amalimbikitsa kukhathamira kwa sodium kuchokera m'thupi (ndipo izi zimathandiza kugwira ntchito kwa mtima)
• nawo kukonzanso maselo a chiwindi
• imalimbikitsa kutulutsa kwa insulin m'maselo

Komanso, glucagon ndiwothandizika kwambiri pamanja mwa adrenaline popereka kulimbana kwa thupi kapena kuyankha kwa ndege. Adrenaline akatulutsidwa m'magazi, glucagon imakulitsa kuchuluka kwa glucose pafupifupi nthawi yomweyo kuti ipitsetse minofu yamatumbo, komanso imathandizira kupatsidwa minofu ya oxygen.

Chikhalidwe cha glucagon m'magazi ndi zovuta zake

Mlingo wa glucagon m'magazi umasiyanasiyana kwa ana ndi akulu. Mwa ana a zaka 4 mpaka 14, msambo wa "mahomoni a njala" amatha kusiyanasiyana pakati pa 0-148 pg / ml, kwa akulu kuthamanga kwa 20-100 pg / ml ndikuloledwa. Koma ngati chizindikiro cha glucagon chikugwa kapena chikukwera m'munsi pazoyenera, izi zimatha kuwonetsa mavuto osiyanasiyana mthupi.

Kutsika kwa glucagon m'magazi nthawi zambiri kumawonetsa cystic fibrosis, pancreatitis yosatha, ndipo amadziwika pambuyo pancreatectomy (kuchotsedwa kwa kapamba).

Kukula kwa mahomoni ndi chizindikiro cha zotsatirazi:

• mtundu 1 shuga
• glucagonoma (chotupa cha maselo a alpha m'mapapo)
• pachimake kapamba
• matenda ammbuyo
• Cushing's syndrome
• aakulu aimpso kulephera
• pachimake hypoglycemia
• kupsinjika kali konse (kuvulala, kuwotcha, kugwira ntchito, ndi zina).

Contraindication akusonyeza malangizo a glucagon

Glucagon, yemwe ntchito zake zimakhala zowopsa m'matenda ena, zimaphatikizidwa mu milandu yotsatirayi:

• glucagonoma (chotupa chopanga glucagon chochuluka),
• insuloma (chotupa chomwe chimapanga insulin kwambiri),
• pheochromocytoma (chotupa chotulutsa katekisimu owonjezera),
• Hypersensitivity kuti glucagon.

Mosamala, mankhwalawa amalembera azimayi oyembekezera komanso oyamwa.

Zowonjezera

Glucagon iyenera kusungidwa pamtunda wofanana ndi 15-30 0 C.

Zambiri zokhudzana ndi mankhwalawa ndizofanana, zimaperekedwa pazidziwitso ndipo sizilowa m'malo mwa malangizo ovomerezeka. Kudzipatsa nokha mankhwala kuopsa!

Ngakhale mtima wa munthu sugunda, akhoza kukhalabe ndi moyo nthawi yayitali, monga asodzi aku Norweji a Jan Revsdal. "Galimoto" yake idayima kwa maola 4 asodzi atasowa ndikugona mu chisanu.

Amayi ambiri amatha kusangalala mwakuganizira za thupi lawo lokongola pakalilore kuposa kugonana. Chifukwa chake, akazi, yesetsani kuyanjana.

Mankhwala ambiri poyamba anali ogulitsidwa ngati mankhwala osokoneza bongo. Mwachitsanzo, a heroin adagulitsidwa ngati mankhwala a chifuwa. Ndipo cocaine adalimbikitsidwa ndi madokotala ngati opaleshoni komanso ngati njira yowonjezerera kupirira.

Ku UK, kuli lamulo malinga ndi momwe dokotala wothandizira amatha kukanachita opaleshoni ngati atasuta kapena wonenepa kwambiri. Munthu ayenera kusiya zizolowezi zoipa, kenako, mwina, sangafunikire opareshoni.

Poyesera kuti wodwalayo atuluke, madokotala nthawi zambiri amapita kutali kwambiri. Ndiye, mwachitsanzo, Charles Jensen wina mzaka kuyambira 1954 mpaka 1994. adapulumuka ntchito zopitilira 900 neoplasm.

Magawo anayi a chokoleti chakuda ali ndi zopatsa mphamvu pafupifupi mazana awiri. Chifukwa chake ngati simukufuna kukhala bwino, ndibwino kuti musadye zopitilira awiri patsiku.

Ntchito yomwe munthu samakonda imakhala yovulaza psyche yake kuposa kusowa kwa ntchito konse.

Ngati mungagwere kuchokera pabulu, mukulola khosi lanu kusiyana ndi kugwa kuchokera pa kavalo. Ingoyesani kutsutsa mawu awa.

Ngati mumamwetulira kawiri kokha patsiku, mutha kuchepetsa kuthamanga kwa magazi ndikuchepetsa chiopsezo cha matenda a mtima ndi stroko.

Munthu amene amamwa mankhwala opondeleza nthawi zambiri amakhalanso ndi nkhawa. Ngati munthu athana ndi kukhumudwa paokha, ali ndi mwayi wonse wakuyiwalako zamtunduwu mpaka kalekale.

Madokotala a mano adapezeka posachedwa. Kalelo m'zaka za zana la 19, inali ntchito ya tsitsi wamba kuti akatulutse mano odwala.

Munthu wophunzira sakhala wokonzeka kutenga matenda aubongo. Ntchito zaluso zimathandizira kuti pakhale ziwalo zina zowonjezera kulipirira odwala.

Vibrator woyamba adapangidwa m'zaka za zana la 19. Adagwira ntchito pa injini yankhonya ndipo adapangira kuti azitsatira khungu la akazi.

Poyamba zinkakhala kuti kumatheka kumapangitsa thupi kukhala ndi mpweya wabwino. Komabe, izi zidatsutsidwa. Asayansi atsimikizira kuti pogalamuka, munthu amazizira ubongo ndikusintha magwiridwe ake.

Impso zathu zimatha kuyeretsa malita atatu a magazi mphindi imodzi.

Chiwerengero cha ogwira ntchito muofesi chakwera kwambiri. Izi zikuchitika makamaka m'mizinda yayikulu. Ntchito yamaofesi imakopa amuna ndi akazi.