目的:明确黄连提取物及其化学成分对豚鼠胃平滑肌收缩运动的影响,探讨与黄连"健胃"和"败胃"作用相关的药效物质基础。方法:采用张力测定法,观察黄连水提物、黄连总生物碱(0.3～1 000μg/mL)及其化学成分小檗碱、巴...目的:明确黄连提取物及其化学成分对豚鼠胃平滑肌收缩运动的影响,探讨与黄连"健胃"和"败胃"作用相关的药效物质基础。方法:采用张力测定法,观察黄连水提物、黄连总生物碱(0.3～1 000μg/mL)及其化学成分小檗碱、巴马丁碱和药根碱(0.3～1000μmol/L)对豚鼠离体胃窦环行肌自发收缩和电场刺激(electrical field stimulation,EFS)诱发收缩的影响。结果:小剂量黄连水提物和黄连总生物碱均能促进胃窦环行肌的自发收缩,而大剂量则抑制。小檗碱、巴马丁碱和药根碱具有相似效应,其中在发挥促收缩作用时药根碱作用最强,在发挥抑制作用时小檗碱作用最强。另外,黄连水提物、黄连总生物碱、小檗碱、巴马丁碱和药根碱均能增加EFS诱发的平滑肌收缩幅度,其中药根碱的作用最强。结论:小剂量黄连"健胃"与大剂量"败胃"作用可能与其影响胃平滑肌收缩有关。小檗碱、巴马丁碱和药根碱都是黄连影响胃平滑肌收缩的有效成分,药根碱促平滑肌收缩的作用最强,而小檗碱抑制平滑肌收缩的作用最强。展开更多
AIM To assess the accuracy of serum procalcitionin(PCT)as a diagnostic marker in verifying upper and lower gastrointestinal perforation(GIP).METHODS This retrospective study included 46 patients from the surgical inte...AIM To assess the accuracy of serum procalcitionin(PCT)as a diagnostic marker in verifying upper and lower gastrointestinal perforation(GIP).METHODS This retrospective study included 46 patients from the surgical intensive care unit(ICU)of the Second Affiliated Hospital of Harbin Medical University who were confirmed to have GIP between June 2013 and December 2016.Demographic and clinical patient data were recorded on admission to ICU.Patients were divided into upper(n=19)and lower(n=27)GIP groups according to the perforation site(above or below Treitz ligament).PCT and WBC count was obtained before laparotomy and then compared between groups.Meanwhile,the diagnostic accuracy of PCT was analyzed.RESULTS Patients with lower GIP exhibited significantly higher APACHE II score,SOFA score and serum PCT level than patients with upper GIP(P=0.017,0.004,and0.001,respectively).There was a significant positive correlation between serum PCT level and APACHE II score or SOFA score(r=0.715 and r=0.611,respectively),while there was a significant negative correlation between serum PCT level and prognosis(r=-0.414).WBC count was not significantly different between the two groups,and WBC count showed no significant correlation with serum PCT level,APACHE II score,SOFA score or prognosis.The area under the receiver operating characteristic curve of PCT level to distinguish upper or lower GIP was 0.778.Patients with a serum PCT level above 17.94 ng/d L had a high likelihood of lower GIP,with a sensitivity of 100%and a specificity of 42.1%.CONCLUSION Serum PCT level is a reliable and accurate diagnostic marker in identifying upper or lower GIP before laparotomy.展开更多
AIMTo investigate the efficacy of thrombomodulin (TM)-α for treatment of disseminated intravascular coagulopathy (DIC) in the field of gastrointestinal surgery.METHODSThirty-six peri-operative DIC patients...AIMTo investigate the efficacy of thrombomodulin (TM)-α for treatment of disseminated intravascular coagulopathy (DIC) in the field of gastrointestinal surgery.METHODSThirty-six peri-operative DIC patients in the field of gastrointestinal surgery who were treated with TM-α were retrospectively investigated. The relationships between patient demographics and the efficacy of TM-α were examined. Analysis of survival at 28 d was also performed on some parameters by means of the Kaplan-Meier method. Relationships between the initiation of TM-α and patient demographics were also evaluated.RESULTSAbscess formation or bacteremia was the most frequent cause of DIC (33%), followed by digestive tract perforation (31%). Twenty-six patients developed DIC after surgery, frequently within 1 wk (81%). TM-α was most often administered within 1 d of the DIC diagnosis (72%) and was continued for more than 3 d (64%). Although bleeding tendency was observed in 7 patients (19%), a hemostatic procedure was not needed. DIC scores, systemic inflammatory response syndrome (SIRS) scores, quick-sequential organ failure assessment (qSOFA) scores, platelet counts, and prothrombin time ratios significantly improved after 1 wk (P < 0.05, for all). The overall survival rate at 28 d was 71%. The duration of TM-α administration (≥ 4 , ≤ 6) and improvements in DIC-associated scores (DIC, SIRS and qSOFA) at 1 wk were significantly better prognostic factors for 28-d survival (P < 0.05, for all). TM-α was administered significantly earlier to patients with severe clinical symptoms, such as high qSOFA scores, sepsis, shock or high lactate values (P < 0.05, for all).CONCLUSIONEarly administration of TM-α and improvements in each parameter were essential for treatment of DIC. The diagnosis of patients with mild symptoms requires further study.展开更多
文摘目的:明确黄连提取物及其化学成分对豚鼠胃平滑肌收缩运动的影响,探讨与黄连"健胃"和"败胃"作用相关的药效物质基础。方法:采用张力测定法,观察黄连水提物、黄连总生物碱(0.3～1 000μg/mL)及其化学成分小檗碱、巴马丁碱和药根碱(0.3～1000μmol/L)对豚鼠离体胃窦环行肌自发收缩和电场刺激(electrical field stimulation,EFS)诱发收缩的影响。结果:小剂量黄连水提物和黄连总生物碱均能促进胃窦环行肌的自发收缩,而大剂量则抑制。小檗碱、巴马丁碱和药根碱具有相似效应,其中在发挥促收缩作用时药根碱作用最强,在发挥抑制作用时小檗碱作用最强。另外,黄连水提物、黄连总生物碱、小檗碱、巴马丁碱和药根碱均能增加EFS诱发的平滑肌收缩幅度,其中药根碱的作用最强。结论:小剂量黄连"健胃"与大剂量"败胃"作用可能与其影响胃平滑肌收缩有关。小檗碱、巴马丁碱和药根碱都是黄连影响胃平滑肌收缩的有效成分,药根碱促平滑肌收缩的作用最强,而小檗碱抑制平滑肌收缩的作用最强。
基金Supported by National Natural Science Foundation of China,No.81571871
文摘AIM To assess the accuracy of serum procalcitionin(PCT)as a diagnostic marker in verifying upper and lower gastrointestinal perforation(GIP).METHODS This retrospective study included 46 patients from the surgical intensive care unit(ICU)of the Second Affiliated Hospital of Harbin Medical University who were confirmed to have GIP between June 2013 and December 2016.Demographic and clinical patient data were recorded on admission to ICU.Patients were divided into upper(n=19)and lower(n=27)GIP groups according to the perforation site(above or below Treitz ligament).PCT and WBC count was obtained before laparotomy and then compared between groups.Meanwhile,the diagnostic accuracy of PCT was analyzed.RESULTS Patients with lower GIP exhibited significantly higher APACHE II score,SOFA score and serum PCT level than patients with upper GIP(P=0.017,0.004,and0.001,respectively).There was a significant positive correlation between serum PCT level and APACHE II score or SOFA score(r=0.715 and r=0.611,respectively),while there was a significant negative correlation between serum PCT level and prognosis(r=-0.414).WBC count was not significantly different between the two groups,and WBC count showed no significant correlation with serum PCT level,APACHE II score,SOFA score or prognosis.The area under the receiver operating characteristic curve of PCT level to distinguish upper or lower GIP was 0.778.Patients with a serum PCT level above 17.94 ng/d L had a high likelihood of lower GIP,with a sensitivity of 100%and a specificity of 42.1%.CONCLUSION Serum PCT level is a reliable and accurate diagnostic marker in identifying upper or lower GIP before laparotomy.
文摘AIMTo investigate the efficacy of thrombomodulin (TM)-α for treatment of disseminated intravascular coagulopathy (DIC) in the field of gastrointestinal surgery.METHODSThirty-six peri-operative DIC patients in the field of gastrointestinal surgery who were treated with TM-α were retrospectively investigated. The relationships between patient demographics and the efficacy of TM-α were examined. Analysis of survival at 28 d was also performed on some parameters by means of the Kaplan-Meier method. Relationships between the initiation of TM-α and patient demographics were also evaluated.RESULTSAbscess formation or bacteremia was the most frequent cause of DIC (33%), followed by digestive tract perforation (31%). Twenty-six patients developed DIC after surgery, frequently within 1 wk (81%). TM-α was most often administered within 1 d of the DIC diagnosis (72%) and was continued for more than 3 d (64%). Although bleeding tendency was observed in 7 patients (19%), a hemostatic procedure was not needed. DIC scores, systemic inflammatory response syndrome (SIRS) scores, quick-sequential organ failure assessment (qSOFA) scores, platelet counts, and prothrombin time ratios significantly improved after 1 wk (P < 0.05, for all). The overall survival rate at 28 d was 71%. The duration of TM-α administration (≥ 4 , ≤ 6) and improvements in DIC-associated scores (DIC, SIRS and qSOFA) at 1 wk were significantly better prognostic factors for 28-d survival (P < 0.05, for all). TM-α was administered significantly earlier to patients with severe clinical symptoms, such as high qSOFA scores, sepsis, shock or high lactate values (P < 0.05, for all).CONCLUSIONEarly administration of TM-α and improvements in each parameter were essential for treatment of DIC. The diagnosis of patients with mild symptoms requires further study.
