大豆甙元对家兔回肠张力影响的分析

实验采用成都泰盟BL-生物机能实验系统,记录了家兔离体回肠张力。首先滴加大豆甙元进行观察,并分别用M型受体桔抗剂、α、β受体拮抗剂以及阿片受体阻断剂对家兔离体回肠张力活动中的相互作用进行观察,结果表明:大豆甙元对家兔离休回肠张力的频率、峰峰值均有抑制作用,分别滴加M型受体拮抗剂、α、β受体拮抗剂,以及阿片受体阻断剂均不影响大豆甙元的作用。

白芍作为低张力胃肠造影药物的实验研究

目的:探讨白芍作为低张力胃肠造影药物的可行性。方法:实验分为空白组、阳性对照组、白芍低中高剂量组;采用小鼠碳末排出实验、小肠推进实验和豚鼠离体回肠运动实验观察白芍水提液对肠运动的影响。结果:白芍中高剂量均能够延迟小鼠碳末排出时间,降低小肠推进率,增加豚鼠离体回肠平滑肌振幅变化。结论:白芍具有减慢肠蠕动、松弛肠平滑肌作用,具有作为低张力胃肠造影剂的可行性。

白芍作为低张力胃肠造影药物的临床应用

白芍为毛茛科植物白芍Paeonia lactiflora Pall.的去皮干燥根,药材主产于浙江、安徽、四川等地,性微寒,味苦、酸,归肝、脾经,具平肝止痛、养血调经、敛阴止汗之功效。其化学成分主要为挥发油类、单萜类、三萜类及黄酮类化合物等。实验研究证明白芍水提液具有降低胃肠张力,延迟胃肠排空的作用。本文将白芍提取液作为低张力造影药物,用于胃十二指肠钡餐造影,观察低张效果,现将结果报告如下。

旋覆代赭汤不同煎煮工艺对胃肠道影响的比较研究

目的 通过考察旋覆代赭汤对小鼠胃排空、小肠推进和离体肠段张力的影响,比较不同煎煮工艺在作用上的一致性和差异性。方法 分别采用正常小鼠和阿托品造模小鼠,用营养性半固体糊加活性炭法观察旋覆代赭汤传统煎（CJ）、机器常压煎（JCJ）、机器高压煎（JGJ）3种煎煮方法对小鼠胃内容物残留率和小肠推进率的影响;分别采用正常大鼠和阿托品所致大鼠肠段张力实验,考察CJ、JCJ、JGJ 3种煎煮方法对大鼠十二指肠段张力的作用。结果 旋覆代赭汤3种煎煮方法对正常小鼠胃内残留率作用不明显,而CJ小剂量、JCJ及JGJ 2个剂量组均能显著增强正常小肠推进率（P〈0.05～0.01）,尤以JCJ大剂量组更为明显;但在阿托品抑制作用的基础上,CJ小剂量、JCJ和JGJ大剂量组能显著减少胃内残留率（P〈0.05～0.01）,CJ、JCJ和JGJ各剂量组显著增强小肠推进率（P〈0.05～0.01）,尤以CJ各剂量组和JGJ大剂量组更为明显;3种煎煮方法均能提高大鼠肠段张力增强率,在正常情况下以JGJ组更为显著（P〈0.01）,在受阿托品抑制作用下,JCJ和JGJ组与更为显著（P〈0.05～0.01）,但3种煎煮方法比较未见显著差异（P〉0.05）。结论 旋覆代赭汤具有协调胃肠功能的作用,JCJ和JGJ的作用相近或略优于CJ法,为目前临床代煎采用的JCJ法和JGJ法提供实验依据。

水果籽最好别咽,当心引发肠梗阻

夏季正是吃杨梅的季节,杨梅酸甜可口,很受大家的喜爱,但不正确的食用方式却让张先生遭了罪!原来,最近杨梅大量上市,张先生经常买着吃,他觉得杨梅核小,就懒得吐,一块咽了下去。前两天他开始感觉腹部胀气和疼痛,吃了促消化药物后病情也无好转,胀痛范围和程度还较之前扩大、加剧,并出现恶心、呕吐等症状,就到医院就诊。接诊医生让张先生做了腹部立位平片,结果显示:腹部多发气液平面,诊断为急性肠梗阻。如果梗阻不解除,将导致胃肠张力越来越大、缺血坏死。

生姜可以止呕吗?

问:生姜有什么功效?答:生姜可以止呕,效果还不错。唐代药王孙思邈冠之以“呕家圣药”的美名。生姜,味辛、性温。辛可散、温可通,故能温胃散寒、和中降逆、止呕。现代药理研究表明,生姜的主要成分是挥发油和姜辣素以及多种氨基酸,能促进消化液的分泌,保护胃黏膜,增进食欲;促使胃肠张力、节律及蠕动增加;有止吐的作用。

调理脾胃“姜做主”

生姜不仅可以在日常用来调味品,它也有很好的药用价值。生姜味辛、性微温,入脾、胃、肺经,具有发汗解表、温中止呕、温肺止咳、解毒的功效。主治风寒感冒、胃寒胃痛、呕吐腹泻、风寒感冒咳嗽、鱼蟹中毒等病症。还有醒胃健脾、增进食欲的作用。生姜中含有辛辣和芳香的成分,含有姜油酮、姜辣素、淀粉和纤维,用于风寒感冒,可通过发汗,使寒邪从表而解。姜辣素对口腔和胃黏膜有刺激作用,能促进消化液分泌,增进食欲,可使肠张力、节律和蠕动增强。

椎管内阻滞并发骶尾神经损伤(马尾综合征)1例

马尾是神经系统的组成部分,其位于脊髓圆锥节段以下的椎管内,受伤可能并发马尾综合征(cauda equina syndrome,CES),指各种原因导致腰椎管内的马尾神经被压迫后出现的多条神经根的损伤的表现,是一种少见且严重的病症。临床上一般可出现腰痛、坐骨神经痛、鞍区和会阴部感觉异常(减退或缺失)、直肠张力下降、性功能障碍和踝、膝或海绵体反射缺失,以及直肠和膀胱功能障碍。

低张力Roux-y肠代膀胱术13例报告

目的总结低张力抗返流Roux-y肠代膀胱术的疗效. 方法采用改良输尿管-结肠、结肠-直肠吻合术对12例膀胱癌和1例膀胱阴道瘘患者行低张力Roux-y肠代膀胱术.于Roux-y吻合口上方1.5 cm作抗返流瓣,输尿管与结肠行Leadbetter法吻合,去肠管化做乙状结肠储尿囊.术后观察电解质、酸碱平衡和排尿情况. 结果随访0.5～5.0年,除2例偶有发热外,患者无肾积水,电解质和酸碱平衡正常,无尿失禁. 结论低张力抗尿粪返流Roux-y肠代膀胱术是一种创伤较小、并发症较少的肠代膀胱术.

中西医结合治疗急性小儿铅中毒36例疗效观察

我院1986～1990年,共收治36例小儿急性铅中毒,现报告如下。一、临床资料 36例均有多次饮用铅壶炖酒史,并经临床确诊为急性铅中毒的住院患儿。36例中,男25例,女11例;年龄7～13岁。临床表现为脐周阵发性疼痛、便秘头晕、头痛、齿龈铅线等。实验性检查:尿铅阳性35例,点彩红细胞36例阳性。二、治疗方法 36例患儿随机分为两组,中西医结合治疗组(甲组)20例,西药治疗组(乙组)16例。甲组用依地酸二钠钙盐30mg·kg/日加入10％葡萄糖中静滴,维生素C50mg·kg/日加入10％葡萄糖静滴,1次/天。并配合中药大承气汤治疗(大黄6g,川厚朴7g,枳实6g,芒硝4g),每日1剂。

军队离退休干部的营养保障问题

军队离退休干部的老年性生理变化可以直接影响其对营养素的需要和对食物的选择,主要是胃肠各部分分泌能力减弱引起的胃酸缺乏或过少,消化液中各种消化酶活力的下降;胃肠道功能衰退引起的胃肠张力减弱和蠕动减慢;行动迟缓,活动量减少与睡眠不良引起的食欲不佳;牙齿松动脱落引起咀嚼消化能力的降低,以及内分泌失调引起的体重超重或肥胖等。为适应这些生理变化,离退休干部必须针对自身的营养特点安排好自己的一日三餐,以延缓衰老过程,减少疾病,维护健康,保持良好体力与充沛精力,安度晚年。

Morphological properties and residual strain along the small intestine in rats

AIM: Residual stress and strain are important for gastrointestinal function and relate to the geometric configuration, the loading conditions and the zero-stress state of the gastrointestinal tract. The purpose of this project is to provide morphometric data and residual strains for the rat small intestine ( n =11). METHODS: To approach the no-load state, the intestine was surgically excised, transferred to an organ bath and cut transversely into short ring-shaped segments. Each ring was cut radially for obtaining the zero-stress state. The residual stress can be characterised by an opening angle. The strain difference between the zero-stress state and the no-load state is called residual strain. RESULTS: Large morphometric variations were found along the small intestine. The wall thickness was highest in the proximal duodenum and decreased in distal direction along the axis of the small intestine (P【0.001). The circumferential length of the inner and outer surfaces decreased rapidly along the length of duodenum by 30-50% (P【0.001). The wall area and lumen area showed a similar pattern (P【0.001). In zero-stress state the rings always opened up after making the cut. The experiments resulted in larger inner circumferential length and smaller outer circumferential length when compared to the no-load state. The wall thickness and wall area did not differ between the no-load and zero-stress state. The opening angle and tangent rotation angle increased along the length of the duodenum and had its highest value 30% down the intestine. Further down the intestine it decreased again (P【0.001). The serosal residual strain was tensile with the highest value close to the ligament of Treitz (P【0.001). The mucosal residual strain was compressive in all segments of the small intestine with average values between -0.25 and -0.4 and with the lowest values close to the ligament of Treitz (P【0.001). CONCLUSION: Axial variation in morphometric properties and residual strains were found in the small intestine. Existence of large residual strains indicates that the zero-stress state must be considered in future biomechanical studies in the gastrointestinal tract.

Ileocecal valve dysfunction in small intestinal bacterial overgrowth: A pilot study

AIM: To explore whether patients with a defective ileocecal valve (ICV)/cecal distension reflex have small intestinal bacterial overgrowth. METHODS: Using a colonoscope, under conscious sedation, the ICV was intubated and the colonoscope was placed within the terminal ileum (TI). A manometry catheter with 4 pressure channels, spaced 1 cm apart, was passed through the biopsy channel of the colonoscope into the TI. The colonoscope was slowly withdrawn from the TI while the manometry catheter was advanced. The catheter was placed across the ICV so that at least one pressure port was within the TI, ICV and the cecum respectively. Pressures were continuously measured during air insufflation into the cecum, under direct endoscopic visualization, in 19 volunteers. Air was insufflated to a maximum of 40 mmHg to prevent barotrauma. All subjects underwent lactulose breath testing one month after the colonoscopy. The results of the breath tests were compared with the results of the pressures within the ICV during air insufflation. RESULTS: Nineteen subjects underwent colonoscopy with measurements of the ICV pressures after intubation of the ICV with a colonoscope. Initial baseline readings showed no statistical difference in the pressures of the TI and ICV, between subjects with positive lactulose breath tests and normal lactulose breath tests. The average peak ICV pressure during air insufflation into the cecum in subjects with normal lactu-lose breath tests was significantly higher than cecal pressures during air insufflation (49.33 ± 7.99 mmHg vs 16.40 ± 2.14 mmHg, P = 0.0011). The average percentage difference of the area under the pressure curve of the ICV from the cecum during air insufflations in subjects with normal lactulose breath tests was significantly higher (280.72% ± 43.29% vs 100% ± 0%, P = 0.0006). The average peak ICV pressure during air insufflation into the cecum in subjects with positive lactulose breath tests was not significantly different than cecal pressures during air insufflation 21.23 ± 3.52 mmHg vs 16.10 ± 3.39 mmHg. The average percentage difference of the area under the pressure curve of the ICV from the cecum during air insufflation was not significantly different 101.08% ± 7.96% vs 100% ± 0%. The total symptom score for subjects with normal lactulose breath tests and subjects with positive lactu-lose breath tests was not statistically different (13.30 ± 4.09 vs 24.14 ± 6.58). The ICV peak pressures during air insufflations were significantly higher in subjects with normal lactulose breath tests than in subjects with positive lactulose breath tests (P = 0.005). The average percent difference of the area under the pressure curve in the ICV from cecum was significantly higher in subjects with normal lactulose breath tests than in subjects with positive lactulose breath tests (P = 0.0012). Individuals with positive lactulose breath tests demonstrated symptom scores which were significantly higher for the following symptoms: not able to finish normal sized meal, feeling excessively full after meals, loss of appetite and bloating. CONCLUSION: Compared to normal, subjects with a positive lactulose breath test have a defective ICV cecal distension reflex. These subjects also more commonly have higher symptom scores.

Diagnosis and management of splanchnic ischemia

Splanchnic or gastrointestinal ischemia is rare and randomized studies are absent. This review focuses on new developments in clinical presentation, diagnostic approaches, and treatments. Splanchnic ischemia can be caused by occlusions of arteries or veins and by physiological vasoconstriction during low-flow states. The prevalence of significant splanchnic arterial stenoses is high, but it remains mostly asymptomatic due to abundant collateral circulation. This is known as chronic splanchnic disease (CSD). Chronic splanchnic syndrome (CSS) occurs when ischemic symptoms develop. Ischemic symptoms are characterized by postprandial pain, fear of eating and weight loss. CSS is diagnosed by a test for actual ischemia. Recently, gastro-intestinal tonometry has been validated as a diagnostic test to detect splanchnic ischemia and to guide treatment. In single- vessel CSD, the complication rate is very low, but some patients have ischemic complaints, and can be treated successfully. In multi-vessel stenoses, the complication rate is considerable, while most have CSS and treatment should be strongly considered. CT and MR-based angiographic reconstruction techniques have emerged as alternatives for digital subtraction angiography for imaging of splanchnic vessels. Duplex ultrasound is still the first choice for screening purposes. The strengths and weaknesses of each modality will be discussed. CSS may be treated by minimally invasive endoscopic treatment of the celiac axis compression syndrome, endovascular antegrade stenting, or laparotomy-assisted retrograde endovascular recanalization and stenting.The treatment plan is highly individualized and is mainly based on precise vessel anatomy, body weight, co- morbidity and severity of ischemia.

No association between phosphatase and tensin homolog genetic polymorphisms and colon cancer

AIM: To investigate the association between single nucleotide polymorphisms (SNPs) in the phosphatase and tensin homolog (PTEN) tumor suppressor gene and risk of colon cancer. METHODS: We utilized a population-based casecontrol study of incident colon cancer individuals (n= 421) and controls (n = 483) aged ≥ 30 years to conduct a comprehensive tagSNP association analysis of the PTEN gene. RESULTS: None of the PTEN SNPs were statistically significantly associated with colon cancer when controlled for age, gender, and race, or when additionally adjusted for other known risk factors (P > 0.05). Haplotype analyses similarly showed no association between the PTEN gene and colon cancer. CONCLUSION: Our study does not support PTEN as a colon cancer susceptibility gene.

Three-dimensional surface model analysis in the gastrointestinal tract

The biomechanical changes during functional loading and unloading of the human gastrointestinal （GI） tract are not fully understood. GI function is usually studled by introducing probes in the GI lumen. Computer modeling offers a promising alternative approach in this regard, with the additional ability to predict regional stresses and strains in inaccessible locations. The tension and stress distributions in the GI tract are related to distensibility （tension-strain relationship） and smooth muscle tone. lore knowledge on the tension and stress on the GI tract are needed to improve diagnosis of patients with gastrointestinal disorders. A modeling framework that can be used to integrate the physiological, anatomical and medical knowledge of the GI system has recently been developed. The 3-D anatomical model was constructed from digital images using ultrasonography, computer tomography （CT） or magnetic resonance imaging （IRI）. Different mathematical algorithms were developed for surface analysis based on thin-walled structure and the finite element method was applied for the mucosa-folded three layered esophageal model analysis. The tools may be useful for studying the geometry and biomechanical properties of these organs in health and disease. These studies will serve to test the structurefunction hypothesis of geometrically complex organs.

Prolonged intestinal mucosal acidosis is associated with multiple organ failure in human acute pancreatitis: Gastric tonometry revisited

AIM： To evaluate whether multiple determinations of intramucosal pH （pHi） in acute pancreatitis （AP） patients could provide additional information of the disease severity during early hospitalization. METHODS： Twenty-one patients suffering from acute pancreatitis were monitored by gastric tonometry in the first 72 h after hospital admission. RESULTS： In the survivor group （n = 15） the initially low phi values returned to normal level （pHi ≥ 7.32） within 48 h （median pHi： d 1： 7.21; d 2： 7.32; d 3： 7.33）. In contrast, pHi values in the non-survivor group n = 6） were persistently either below or in the low normal range （median pHi 7.12; 7.12; 7.07 respectively）, but pHi differences between the two groups reached significance only after 24 h （P 〈 0.01）. Mucosal acidosis detected at any time during the monitored period was associated with the emergence of single or multiple organ dysfunction （P 〈 0.01）. CONCLUSION： Prolonged gastric mucosal acidosis was associated with remote organ dysfunction and failure in Acute Pancreatitis, however, correlation with the fatal outcome became significant only 24 h after admission. Due to its non-invasive nature gastric tonometry may supplement the pro-inflammatory markers to achieve a multi-faceted monitoring of the disease.

Dual regulatory role for phosphatase and tensin homolog in specification of intestinal endocrine cell subtypes

AIM:To investigate the impact of phosphatase and tensin homolog(Pten) in the specification of intestinal enteroendocrine subpopulations.METHODS:Using the Cre/loxP system,a mouse with conditional intestinal epithelial Pten deficiency was generated.Pten mutant mice and controls were sacrificed and small intestines collected for immunofluorescence and quantitative real-time polymerase chain reaction.Blood was collected on 16 h fasted mice by cardiac puncture.Enzyme-linked immunosorbent assay was used to measure blood circulating ghrelin,somatostatin(SST) and glucose-dependent insulinotropic peptide(GIP) levels.RESULTS:Results show an unexpected dual regulatory role for epithelial Pten signalling in the specification/differentiation of enteroendocrine cell subpopulations in the small intestine.Our data indicate that Pten positively regulates chromogranin A(CgA) expressing subpopulations,including cells expressing secretin,ghrelin,gastrin and cholecystokinin(CCK).In contrast,Pten negatively regulates the enteroendocrine subtype specification of non-expressing CgA cells such as GIP and SST expressing cells.CONCLUSION:The present results demonstrate that Pten signalling favours the enteroendocrine progenitor to specify into cells expressing CgA including those producing CCK,gastrin and ghrelin.

Phosphatase and tensin homolog expression related to cetuximab effects in colorectal cancer patients: A meta-analysis

AIM: To investigate the correlation between expression of phosphatase and tensin homolog (PTEN) and cetuximab effects in colorectal cancer. METHODS: We searched PubMed, EMBASE and ASCO to identify eligible studies. Finally, 8 randomized control studies were included in the meta-analysis. STATA 10.0 Software was used to investigate heterogeneity among individual studies and to summarize all the studies. Risk ratios (RRs) and hazard ratios (HRs) with 95% confidence intervals (CIs) were used to assess the strength of the association. RESULTS: Compared with 20 of 266 patients with loss of PTEN, 206 of 496 patients with intact PTEN protein expression had a better objective response rate to cetuximab-based therapy (RR, 4.75; 95% CI, 2.59-8.72; P < 0.001). PTEN positivity was associated with better progression-free survival (PFS) (HR, 0.675; 95% CI, 0.473-0.964; P = 0.031) but not with better overall survival (OS) (HR, 0.608; 95% CI, 0.411-0.899; P = 0.013). In patients with KRAS wild-type status, PTEN positivity did not predict a longer PFS or OS (PFS: HR, 0.707; 95% CI, 0.440-1.138; P = 0.154; OS: HR, 0.943; 95% CI, 0.646-1.377; P = 0.761). CONCLUSION: Expression of PTEN is related to the effect of cetuximab in colorectal cancer patients and should be considered in treatment with cetuximab.

Effects of Electroacupuncture at Different Points on Colorectal Distention-induced Changes in Blood Pressure, Electrogastrogram, Gastric Tension and Gastric Blood Flow

Objective: To investigate the specificity of the effects of electroacupuncture (EA) at different acupoints on gastric functional activity and gastric blood flow after colorectal distension (CRD) in the rat. Methods: Fifty Wistar rats were randomly divided into 5 groups: a control group, a Zusanli group, a non-point group, a Taichong group and a Neiguan group. Rats were anesthetized after 18 h of fasting, and a rat model of nociceptive blood pressure elevation and abnormal electrogastrogram (EGG) and gastric tension (GT) was prepared by gasbag-induced CRD. EA was given bilaterally, and its effects on gastric blood flow (GBF) of the arcus vasculosi of the greater omentum, blood pressure, EGG fast wave properties, and gastric smooth muscle tension (GT) were quantified. Results: CRD induced an increase in blood pressure that was significantly inhibited by EA at all points (all P<0.05), and the inhibitory effects were greater in the Zusanli and Neiguan groups compared to the non-point group (both P<0.05). CRD also caused reductions in GT and GBF, and in the amplitude, frequency and duration of EGG waves (all P<0.05). These effects were also reversed by EA. The effects of EA on EGG wave amplitude, GT, and GBF were superior in the Zusanli group compared to the Taichong group, Neiguan group, and the non-point group. Conclusion: EA significantly counteracted CRD-induced changes in blood pressure, GBF, EGG, and GT. The effects of stimulation at Zusanli (ST 36) were significantly greater compared to other points, indicating relative specificity of this acupoint.