手术联合自拟益气健脾润肠通便方治疗女性直肠前突所致出口梗阻型便秘的效果观察

目的探讨手术联合自拟益气健脾润肠通便方治疗女性直肠前突所致出口梗阻型便秘的疗效及安全性。方法选取2017年6月—2020年5月在石家庄市中医院行手术治疗的80例女性直肠前突致出口梗阻型便秘患者为研究对象。采用随机数字表法将其分为对照组和观察组,每组40例。两组均行经阴道修补术、痔上黏膜环形错位套扎吻合术(EPH),观察组在此基础上于术后2 d开始口服自拟益气健脾润肠通便中药方,14 d为1个疗程,连续服用2个疗程后评估疗效,记录不良反应发生情况,比较远期疗效。结果观察组治疗前后排便频率、排便困难程度、粪便性状、排便时间、排便不尽感、头昏、乏力、口干口渴评分的差值大于对照组(P<0.05)。观察组患者临床有效率高于对照组(95.00%VS 80.00%,P<0.05)。两组患者的腹胀/腹泻、恶心/呕吐、出血、疼痛、尿潴留发生率及不良反应总发生率比较,差异无统计学意义(P>0.05),且上述不良反应均为轻度,无重度不良反应。观察组治疗前后出口梗阻型便秘评分(ODS)的差值大于对照组(P<0.05),复发率低于对照组(P<0.05)。结论经阴道修补术、EPH术后口服自拟益气健脾润肠通便中药方,可有效改善女性直肠前突所致出口梗阻型便秘临床症状,提高近、远期疗效,降低复发率,且不增加不良反应发生风险。

Clinical study on nutrition support in patients with severe acute pancreatitis

AIM: To investigate the effect of nutritional support therapy on severe acute pancreatitis (SAP).METHODS: A total of 96 patients with severe acute pancreatitis were divided randomly into control and treatment groups.The former group received total parenteral nutrition (TPN)via central venous infusion, while parenteral nutrition (PN)and enteral nutrition (EN) therapies were applied in different phases for the latter group. The nutrition status, acute phase responses, pancreas lesions, enteric mucosa penetrability and immune functions were monitored.RESULTS: Body weight and prealbumin concentration were increased in treatment group, compared to those in the control group, but albumin concentration did not change significantly.Acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ)scores decreased after 7 d of treatment, whereas the scores of the control group decreased on the 11th day. Concentrations of tumor necrosis factor-α (TNF-α), interleukine-6 (IL-6) and serum C reactive protein (CRP) dropped earlier in the treatment group (on the 4th day) than that in the control group (on the 7th day). No difference was observed in pancreatic lesions between the control and treatment groups.Concentration of endotoxin and lactulose/manicol (L:M) ratio of urine did not change in treatment group, but those in the control group were elevated markedly. Compared with the treatment group, CD4:CD8 T cells ratio and immunoglobulin G (IgG) concentration in the control group decreased significantly.CONCLUSION: Compared to TPN, the combined therapy of EN and PN could improve the nutrition status and moderate the acute phase response obviously. Moreover, the integrity of enteric mucosa and immune function were protected more effectively in treatment group than in the control one. On the other hand, EN did not simulate the excretion of pancreas and avoid exaggerating the inflammation of pancreas. Thus,appropriate application of PN and EN appears to be more effective for patients with SAP.

Correlation of N-myc downstream-regulated gene 1 overexpression with progressive growth of colorectal neoplasm

AIM:To study the function of N-myc downstream-regulated gene 1 (NDRG1) in colorectal carcinogenesis and its correlation with tumor lymph node metastasis,METHODS:NDRG1 was detected at its protein level by immunohistochemistry (IHC) and image analysis (IA), and NDRG1 mRNA was detected by in situ hybridization (ISH) in formalin-fixed and paraffin-embedded sections with a total of 190 specimens including 38 normal colorectal mucosae, 31 colorectal adenomas, 45 non-metastatic colorectal carcinomas (CRCs), 38 metastatic primary CRC and subsequently regional lymph nodes respectively. At the same time, the correlations of NDRG1 with sex, age of patients and histological types of colorectal carcinomas were observed.RESULTS: NDRG1 proteins were gradually increased in colorectal carcinogenesis (P<0.05 or P<0.01). There was a significant difference in the expression of NDRG1 between non-metastatic and metastatic CRCs (P<0.05), and the correlation was positive (P<0.01, rs=0.329). However, there was no obvious difference in the expression of NDRG1 between the primary sites of CRCs and that in the metastatic sites of corresponding regional lymph nodes, nor was there an apparent difference in sex, age, and histological types.The expression of NDRG1 mRNA was generally in concordance with that of NDRG1 protein.CONCLUSION: NDRG1 gene may play an important role in colorectal carcinogenesis.In addition, NDRG1 may be a putative tumor metastasis promoter gene and is regarded as one of the molecular biological markers that can forecast early metastasis of CRCs. NDRG1 gene in the metastatic sites of regional lymph nodes may preserve its expression characteristics in the primary sites of CRCs to some extent.The expression of NDRG1 is not affected by sex, age and histological types. The role of NDRG1 in tumor metastatic process can be demonstrated by in vivo and in vitro.

Inhibitory effects of berberine on ion channels of rat hepatocytes

AIM: To examine the effects of berberine, an isoquinoline alkaloid with a long history used as a tonic remedy for liver and heart, on ion channels of isolated rat hepatocytes.METHODS: Tight-seal whole-cell patch-clamp techniques were performed to investigate the effects of berberine on the delayed outward potassium currents (Ik), inward rectifier potassium currents (Ik1) and Ca^2+ release-activated Ca^+ currents (ICRAC) in enzymatically isolated rat hepatocytes.RESULTS: Berbenne 1-300 μmol/L reduced/K in a concentration-dependent manner with EC50 of 38.86=1=5.37 μmol/L and nH of 0.82±0.05 (n = 8). When the bath solution was changed to tetraethylammonium (TEA) 8 retool/L,IK was inhibited.Berberine 30 μmol/L reduced/K at all examined membranepote ntials, especially at potentials positive to +60 mV (n = 8,P<0.05 or P<0.01 vs control). Berberine had mild inhibitory effects on IK1 in rat hepatocytes. Berberine 1-300 μmol/L also inhibited ICRAC in a concentration-dependent fashion. The fitting parameters were EC50 = 47.20±10.86 μmol/L,nH= 0.71±0.09 (n = 8). The peak value of/CRAC in the I-Vrelationship was decreased by berberine 30 μmol/L at potentialnegative to -80 mV (n = 8, P<0.05 vscontrol). But the reverse potential of/CRAC occurred at voltage 0 mV in all cells.CONCLUSION: Berberine has inhibitory effects on potassium and calcium currents in isolated rat hepatocytes, which may be involved in hepatoprotection.

Effects of palmatine on potassium and calcium currents in isolated rat hepatocytes

AIM: To study the effects of palmatine, a known inhibitoron delayed rectifier potassium current and L-type calciumcurrent (ICa,L) in guinea pig ventricular myocytes, on thepotassium and calcium currents in isolated rat hepatocytes.METHODS: Tight-seal wh ole-cell patch-clamp techniqueswere performed to investigate the effects of palmatine onthe delayed outward potassium currents (IK), inward rectifierpotassium current (IK1) and Ca2+ release-activated Ca2+current (ICRAC) in enzymatically isolated rat hepatocytes.RESULTS: Palmatine 0.3-100 μM reduced IK in a concentationdependent manner with EC50of 41.62±10.11 μM and nH,0.48±0.07 (n=8). The effect of the drug was poorly reversibleafter washout. When the bath solution was changed totetraethylammonium (TEA) 8 mM, IK was inhibited.Palmatine 10 μM and 100 μM shifted the I-V curves of IKdownward, and the block of IK was voltage-independent.Palmatine 0.3-100 μM also inhibited ICRAC in a concentration-dependent manner. The fitting parameters were as follows:ECs0=51.19±15.18 μM, and nH=0.46+0.07 (n=8). The peakvalue of ICRAC in the I-V relationship was decreased bypalmatine 10 μM and 100 μM. But the reverse potential ofIcRAcoCcurred at Voltage=0 mV in all cells. Palmatine 0.3-100 μM failed to have any significant effect on either inwardor outward components of IK1 at any membrane potentialexamined.CONCLUSION: The inhibitory effects on IK and ICRAC couldbe one of the mechanisms that palmatine exerts protectiveeffect on hepatocytes.

Logistic回归模型在不典型浸润性导管癌诊断中的应用

目的筛选不典型浸润性导管癌诊断的超声征象,建立Logistic回归预测模型。方法回顾性分析42例经超声诊断为BI-RADS 4a类肿块且病理证实为浸润性导管癌患者的术前超声图像。建立Logistic回归模型,绘制ROC曲线,评价该模型的预测价值。结果多因素Logistic回归分析结果显示:肿块边缘不光整[■=23.371(95%CI:2.207,247.442)]、微钙化[■=5.120(95%CI:1.481,17.697)]及RI>0.7[■=12.912(95%CI:2.579,46.165)]对不典型浸润性导管癌具有癌诊断意义;利用这3个指标建立不典型浸润性导管癌的诊断模型:Logistics(P)=-1.674+3.152×(微钙化赋值)+1.633×(不光整赋值)+2.390×(RI>0.7赋值)。模型诊断不典型浸润性导管癌的截断值为>0.380,ROC曲线下面积为0.804(95%CI:0.711,0.897),敏感性为85.7%(95%CI:0.715,0.956),特异性为59.1%(95%CI:0.432,0.733),约登指数、准确率分别为0.448、72.1%。结论利用超声征象建立的模型敏感性较高,临床实用性较好。

Action of progesterone on contractile activity of isolated gastric strips in rats

AIM: To study the effect of progesterone on contractile activity of isolated gastric strips in rats.METHODS: Wistar rats were sacrificed to remove whole stomach. Then, the stomach was opened and the mucosal layer was removed. Parellel to either the circular or the longitudial fibers, muscle strips were cut from fundus, body,antrum and pylorus. Each muscle strip was suspended in a tissue chamber containing 5 mL Krebs solution. Then the motility of gastric strips in tissue chambers was simultaneously recorded. The preparations were subjected to 1 g load tension and washed with 5 ml Krebs solution every 20 min. After 1 h equilibration, progesterone or antagonists were added in the tissue chamber separately. The antagonists were added 3 min before using progesterone (50 μmol. L-1).RESULTS: Progesterone decreased the resting tension of fundus and body longitudinal muscle (LM) (P＜0.05). It inhibited the mean contractile amplitude of body and antrum LM and circular muscle (CM), and the motility index of pyloric CM (P＜0.05). The inhibition of progesterone on the mean contractile amplitude could be partially blocked by phentolamine in LM of the stomach body (the mean contractile amplitude of body LM decreased from -7.5±5.5to -5.2±4.5 P＜0.01), and by phentolamine or indomethacin in CM of body (The inhibition of progesterone on the mean contractile amplitude of body CM decreased from -5.6±3.0to -3.6±2.7 by phentolamine and from -5.6±3.0 to -3.5±2.5by indomethacin, P＜0.01). Hexamethonium, propranolol and L-NNA (inhibitor of NO synthetase) didn′t affect the action of progesterone (P＞0.05).CONCLUSION: The study suggested that progesterone can inhibit the contractile activity of isolated gastric strips in rats and the mechanism seems to be a direct one except that the action on gastric body is mediated through prostaglandin and adrenergic α receptor partly.

Electrophysiological effects of anthopleurin-Q on rat hepatocytes

AIM: To study the effects of AP-Q on CCl4-induced acute liver injury, delayed outward potassium current (Iκ), inward rectifier potassium current (Iκ1) and calcium release-activated calcium current (ICRAC) in isolated rat hepatocytes. METHODS: A single dose of CCl4 (10 μg/mL, ip) was injected to induce acute liver injury in rats. Serum aminotransferase activities were determined. Whole cell patch-clamp techniques were used to investigate the effects of AP-Q on delayed outward potassium current (Iκ), inward rectifier potassium current (IKI) and calcium release-activated calcium current (ICRAC). RESULTS: AP-Q (3.5 and 7 μg/kg) pretreatment significantly reduced ALT and AST activities. AP-Q 0.1-100 nM produced a concentration-dependent increase of Iκ with EC50 value of 5.55±1.8 nM (n=6). AP-Q 30 nM shifted the I-V curve of Iκ leftward and upward. CCl4 4 mM decreased Iκ current 28.6±0.5% at 140 mV. After exposure to CCl4 for 5 rain, AP-Q 30 nM attenuated the decrease of Iκ induced by CCl4 close to normal amplitude. AP-Q 0.01-100 nM had no significant effect on either inward or outward components of Iκ1 at any membrane potential examined. AP-Q 0.1-100 nM had no significant influence on the peak amplitude of ICRAC, either,and did not affect the shape of its current voltage curve. CONCLUSION: AP-Q has a protective effect on CCl4-induced liver injury, probably through selectively increased Iκ in hepatocytes.

Expression changes in tau and microtubule-associated proteins in rat testicular interstitium

Objective: To examine the expression of the tau protein and mi-crotubule-associated proteins (MAP) in the testicular interstitium of aged and young rats. Methods: Sprague-Dawley male rats were divided into a young group (6 months) and an aged group (28 months) of 10 animals each. The two-step immunohistochemistry method with the antibody against tau protein and MAPa was performed with the testis tissues. Results: The immunoreactive cells of the testicular interstilial tau protein were significantly increased (P<0.01) and those of the MAP significantly decreased (P<0.01) in the aged than in the young rats. Conclusion: The changes in the expression of the tau protein and MAP may be related to the aging process of the testis.

Allergenicity studies of Naoluotai injection and H3 injection before and after ultrafiltration

OBJECTIVE To explore the influence of ultrafiltration on the allergenicity of Naoluotai injection and H3 injectable powder in guinea pig.METHODS The ultra filtrated and non-ultra filtrated Naoluotai injection was utilized to do the sensitization test of guinea pig.The guinea pig was sensitized three times by subcutaneous injection of test solution every other day.After 16 dof the first sensitization.All guinea pigs were challenged.The serotonin level in guinea pig plasma before and after the challenge was recognized as the evaluation criteria of allergenicity.RESULTS The increasing rate of serotonin in guinea pigs sensitized by ultra filtrated Naoluotai injection was 5.80% while by non-ultra filtrated Naoluotai injection was 37.03%.The increasing rate in ultra filtrated and non-ultra filtrated H3 injection was 23.59% and 61.94%,respectively.CONCLUSION The animal protein in tradition Chinese medicine injection was thought to be allergized.The ultrafiltration technology could reduce the allergenicity of tradition Chinese medicine injection and improve its safety.

Almost Sure Central Limit Theorems for Heavily Trimmed Sums

We obtain an ahnost sure central limit theorem(ASCLT)for heavily trimmed sums.We also prove a function-typed ASCLT under the same conditions that assure measurable functions to satisfy the ASCLT for the partial sums of i.i.d,random variables with EX_1=0,EX_1~2=1.