樟柳碱、东莨菪碱、山莨菪碱对急性肾衰大鼠肾微血管损伤的保护作用

目的 :研究急性肾衰时肾微血管的损伤及樟柳碱、东莨菪碱、山菪莨碱对这些损伤的影响。方法 :采用左肾动脉注射油酸的方法建立大鼠急性肾衰模型 ,采用电镜、光镜及TTC显色观察大鼠急性肾衰不同时期肾微血管超微结构、肾组织结构及TTC显色的改变。结果 :左肾动脉注射油酸后 1 0min ,肾小球毛细血管内皮细胞坏死 ;肾小球毛细血管不同程度充血肿胀 ,在皮质与髓质交界区 ,可见小血管内充满大量红细胞 ;TTC显色呈鲜红色。注射油酸后 6h和 2 4h上述损伤加重 ,TTC显然出现典型的不显色苍白区。三种莨菪药物不同程度减轻了急性肾衰时肾微血管损伤 ,改善了肾组织缺血 ,减少了肾小管上皮细胞坏死数。结论 :急性肾衰时很早即出现肾微血管的损伤 ,三种莨菪药对急性肾衰时肾微血管和组织结构的损伤均有保护作用。

Effect of morphine and M-cholinoceptor blocking drugs on human sphincter of Oddi during choledochofiberscopy manometry

OBJECTIVE: To evaluate the effects of morphine on the human sphincter of Oddi pressure and the antagonism of anticholinergic agents against morphine. METHODS: The action of these drugs on the sphincter of Oddi (SO) was evaluated by means of choledochofiberscopy manometry in 40 operated patients with T-tube. The patients were divided randomly into 4 groups: anisodamine, atropine, buscopan, and control. The following data were recorded: duodenal pressure (DP), basal pressure of the sphincter of Oddi (BPSO), contractive amplitude of the sphincter of Oddi (CASO), contractive frequency of the sphincter of Oddi (CFSO), contractive duration of the sphincter of Oddi (CDSO), and pressure of the common bile duct (PCBD). Both morphine and anticholinergic agents were given intramuscularly. RESULTS: After injection of 10 mg morphine, BPSO, CASO, CFSO, and PCBD increased significantly. After injection of 15 mg anisodamine or 0.75 mg atropine, CASO, BPSO declined obviously, and after injection of 20 mg buscopan, CASO, BPSO, CFSO declined obviously, but in anisodamine, atropine and buscopan groups, they differed insignificantly. CONCLUSIONS: The results illustrate that SO manometry via choledochofiberscopy is a new method for SO dynamic study. Morphine can increase DP, BPSO, CASO, PCBD, but anisodamine atropine and buscopan can antagonize the effect of morphine.

急性肾衰大鼠肾阻抗容积脉波的改变及三种莨菪药的治疗作用

用自己建立的阻抗法描记大鼠肾容积脉波，研究油酸致急性肾衰时肾阻抗容积脉波的改变及樟柳碱、东莨菪碱、山莨菪碱对这些改变的影响。结果表明：左肾动脉注射油酸后１０ｍｉｎ、１ｈ、６ｈ出现低平及平顶波，波高及流入容积速度明显低于注射前及生理盐水对照组。三种莨菪药治疗后，低平及平顶波明显减少或消失，波高及流入容积速度明显提高。结果说明：急性肾衰早期肾内脉动血管弹性降低，紧张度增高，周围阻力增加，肾组织血液灌流量降低；三种莨菪药均可改善肾内脉动血管的功能。

Prostate magnetic resonance imaging at 3 Tesla:Is administration of hyoscine-N-butyl-bromide mandatory?

AIM: To evaluate the value of administration of hyoscine-N-butyl-bromide (HBB) for image quality magnetic resonance imaging (MRI) of the prostate. METHODS: Seventy patients were retrospectively included in the study. Thirty-five patients were examined with administration of 40 milligrams of HBB (Buscopan ; Boehringer, Ingelheim, Germany); 35 patients were examined without HBB. A multiparametric MRI protocol was performed on a 3.0 Tesla scanner without using an endorectal coil. The following criteria were evaluated independently by two experienced radiologists on a five-point Likert scale: anatomical details (delineation between peripheral and transitional zone of the prostate, visualisation of the capsule, depiction of the neurovascular bundles); visualisation of lymph nodes; motion related artefacts; and overall image quality.RESULTS: Comparison of anatomical details between the two cohorts showed no statistically significant difference (3.9 ± 0.7 vs 4.0 ± 0.9, P = 0.54, and 3.8 ± 0.7 vs 4.2 ± 0.6, P = 0.07) for both readers. There was no significant advantage regarding depiction of local and iliac lymph nodes (3.9 ± 0.6 vs 4.2 ± 0.6, P = 0.07, and 3.8 ± 0.9 vs 4.1 ± 0.8, P = 0.19). Motion arte- facts were rated as 'none' to 'few' in both groups and showed no statistical difference (2.3 ± 1.0 vs 1.9 ± 0.9, P = 0.19, and 2.3 ± 1.1 vs 1.9 ± 0.7, P = 0.22). Overall image quality was rated 'good' in average for both cohorts without significant difference (4.0 ± 0.6 vs 4.0 ± 0.9, P = 0.78, and 3.8 ± 0.8 vs 4.2 ± 0.6, P = 0.09). CONCLUSION: The results demonstrated no significant effect of HBB administration on image quality. The study suggests that use of HBB is not mandatory for MRI of the prostate at 3.0 Tesla.

急性肾衰大鼠肾组织水含量变化及三种莨菪药的治疗作用

采用比重梯度法定量研究了油酸致急性肾衰大鼠肾组织水含量的改变及樟柳碱、东莨菪碱、山莨菪碱对这些改变的影响。结果表明，左肾动脉注射油酸后１０ｍｉｎ，左肾皮质比重轻度降低，６ｈ及２４ｈ后左肾皮质及髓质比重均降低；低剂量油酸首先引起皮质比重降低，继而髓质的比重也降低；樟柳碱和山莨菪碱可提高左肾组织比重。上述结果说明，急性肾衰初期仅肾皮质水含量增加，维持期肾髓质水含量也增加，肾组织水含量随油酸剂量的加大而增加，樟柳碱和山莨菪碱可减轻急性肾衰大鼠肾组织水肿。

三种莨菪药对急性肾衰大鼠血栓素及前列环素代谢的影响

本文研究了急性肾衰时血栓素及前列环素代谢的改变，观察了樟柳碱，东莨菪碱及山莨菪碱对这些改变的影响。结果表明，肾衰后24小时，左肾皮质及髓质血栓素B2（TXB2）及6－酮－前列腺素F1α（6KF）均明显增高，6KF与TXB2比值无明显改变；肾衰后48小时，左肾皮质及髓质TXB2明显增高，6KF增高不明显，6KF与TXB2比值明显降低。三种药物对肾组织TXB2及6KF无明显影响．但均可提高血液中6KF含量，使6KF与TXB2比例增加。其作用以东莨菪碱最明显，其次是樟柳碱及山莨菪碱。结果说明，肾组织TXB2和6KF比例的变化可能是急性肾衰维持期肾组织血流量持续降低，肾功能恶化的重要因素。东莨菪碱及樟柳碱可提高血液中前列环素含量，这可能有助于肾组织血流量的恢复。

三种莨菪药对急性肾衰大鼠血变性改变的影响

本文研究了油酸致大鼠急民生肾衰时血液流变性的改变。观察了樟柳碱，东莨菪 及山莨菪碱对这些改变的影响。

间苯三酚或百舒平联合奥尔芬治疗急性胆绞痛的临床研究

目的:观察间苯三酚或百舒平联合奥尔芬治疗急性胆绞痛的临床疗效。方法:将我院2012年1月至2012年10月急诊就诊的急性胆绞痛98例随机分为观察组45例和对照组53例,对照组应用间苯三酚和奥尔芬治疗,观察组应用百舒平和奥尔芬治疗,比较两组的临床疗效和不良反应。结果:两组胆绞痛缓解的总有效率分别为97.8%(44/45)和96.2%(51/53),疗效和不良反应均无明显差异(P>0.05)。结论:间苯三酚或百舒平联合奥尔芬治疗急性胆绞痛缓解疼痛快,有效率高,副作用少。

樟柳碱、东莨菪碱、山莨菪碱对急性肾功能衰竭大鼠的治疗作用

本文采用直接从左肾动脉注射油酸的方法制备大鼠急性肾功能衰竭(ARF)模型,从改善微循环的角度寻求ARF的防治措施。结果表明,樟柳碱、东莨菪碱、山莨菪碱均可不同程度减轻肾内微血管损伤及肾组织水肿,改善肾内脉动血管的功能,提高肾组织血液灌流量,提高血液中前列环素(PGI_2)的浓度,减轻肾组织缺血及肾小管损伤。樟柳碱的效果优于东莨菪碱及山莨菪碱。这些结果证明,莨菪类药对油酸致大鼠ARF有治疗作用。