加味四逆散对肝硬化患者血清胃肠激素变化的临床观察

[目的]观察加味四逆散对肝硬化患者胃肠激素血浆浓度的影响，并探讨其临床意义。[方法]150例肝硬化并胃动力障碍患者随机分为2组，对照组采用基础治疗，给予能量合剂、还原型谷胱甘肽、甘草酸制剂等保肝药物外，并给予口服西沙比利片5mg／次，3次／d；治疗组在基础治疗上加用加味四逆散，疗程均为15d。用放射免疫法测定2组患者治疗前后血清胃动素（MOT）、促胃液素（GAS）、血管活性肠肽（VIP）和生长抑素（SS）的水平。[结果]2组患者治疗后血清MOT、VIP、GAS、SS水平较治疗前均有明显变化（P〈0．05，〈0．01），2组间比较差异有统计学意义（P〈0．05）。[结论]加味四逆散能明显改善肝硬化患者胃动力障碍症状，改善血清胃肠激素水平。     

小陷胸汤治疗功能性消化不良的实验研究

[目的]探讨小陷胸汤对功能性消化不良（FD）模型大鼠的作用机制。[方法]采用不规则喂养配合夹尾刺激法建立FD大鼠模型，予以小陷胸汤水煎液灌胃治疗。观测大鼠胃固体排空率，检测胃组织内一氧化氮（NO）及血浆胃动素（MOT）水平，并与空白对照组、模型对照组和多潘力酮组进行比较。[结果]小陷胸汤能明显升高胃排空率（P〈0．05），与多潘力酮等效（P〉0．05）；能显著降低胃组织NO水平，且优于多潘力酮（P〈0．01）；能明显升高血浆MOT水平（P〈0．05），与多潘力酮等效（P〉0．05）。[结论]小陷胸汤能提高FD大鼠胃固体排空率；减轻NO对胃排空的抑制；增强MOT水平，促进胃排空。在降低胃组织NO方面明显优于多潘力酮。     

平胃消导胶囊对功能性消化不良模型大鼠胃电活动和胃肠激素的影响

[目的]观察平胃消导胶囊对情志刺激引起的功能性消化不良（FD）模型大鼠胃电活动和胃肠激素水平的影响,探讨其可能的作用机制。[方法]将实验大鼠随机分为6组：空白对照组,模型组,多潘立酮药物对照组,平胃消导胶囊大、中、小剂量组。除空白对照组外,其余各组用夹尾激怒法复制FD大鼠模型,观察和对比各组大鼠胃窦消化间期综合肌电（IMC）活动,检测血浆胃动素（MOT）和血管活性肠肽（VIP）水平,并以此评价药物疗效。[结果]与模型组相比,平胃消导胶囊治疗组IMC周期缩短（P〈0．05,〈0．01）、Ⅲ相时程延长（P〈0．01）、Ⅲ相发生率增高（P〈0．05,〈0．01）,血浆MOT水平升高（P〈0．05,〈0．01）,VIP水平降低（P〈0．01）。[结论]平胃消导胶囊可增强FD模型大鼠胃电活动,恢复性调节MOT、VIP）水平,表现出良好的整体调节和促进胃排空作用。加大剂量治疗效果更好,是治疗FD疗效确切的中药制剂。     

调中颗粒对胃肌间Cajal间质细胞功能及数量的影响

[目的]观察功能性消化不良（FD）大鼠胃肌间Cajal间质细胞（ICC）超微形态结构、分布特点和密度变化,探讨调中颗粒治疗FD的机制。[方法]将40只大鼠随机分为5组,各8只,除正常组外,其余采用夹尾法制备FD模型,胃电图的方法检测造模是否成功,电镜观察胃肌间ICC的超微结构。酪氨酸激酶受体c-kit免疫组化法观察不同药物治疗后胃肌间阳性ICC的分布和水平变化。[结果]模型组大鼠胃电参数低于正常组（P〈0．05）;ICC的超微结构证实ICC与胃平滑肌运动具有密切相关性;调中颗粒能明显升高胃窦ICC水平（P〈0．05）,优于多潘立酮（P〈0．05）。[结论]调中颗粒能通过调节ICC的分布和数量,升高胃窦ICC的表达,促进胃蠕动,改善FD大鼠胃电节律。调中颗粒疗效优于半夏泻心汤和多潘立酮,具有整体调节作用。     

胃祺Ⅱ号方治疗功能性消化不良疗效观察及对大鼠胃排空的影响

目的：观察胃祺Ⅱ号方治疗功能性消化不良（FD）的临床疗效和对大鼠胃排空的影响。方法：收集FD患68例，随机分为治疗组（37例）和西沙比利对照组（31例），观察其临床疗效；同时观察该方对大鼠酚红胃排空的影响。结果：胃祺Ⅱ号方和西沙必利的总有效率分别为89．19％和83．87％，无统计学差异（P＜0．05）；本方能改善FD各主要临床症状，且无不良反应；随访中药组无一例复发，显优于西药组（复发率33．33％）（P＜0．05）。该方能促进大鼠胃酚红排空，较对照组有显差异（P＜0．05）。结论：胃祺Ⅱ号方能有效改善FD各主要症状，近期疗效显，远期疗效可靠。该方能显促进胃排空，改善胃运动功能。     

白萝卜提取物对大鼠小肠动力作用的影响

[目的]研究白萝卜提取物(Raphanus sativus L extract,Ecr)和西沙比利对大鼠小肠动力作用的影响,并进行对比观察,为开发Ecr促胃肠动力作用的药用价值提供理论依据。[方法]采用旋转蒸发的方法制备Ecr后,以1 ml/kg(每1 ml折合生药约57 g)的剂量灌胃给药,同时设立西沙比利对照组和0.85%氯化钠对照组。应用小肠肌电测定和胃肠内标记物葡聚糖蓝2000进行标记的方法,测定给药前后大鼠小肠消化间期移行性复合肌电活动(Interdigestive myoelectrical complex,IMC)的变化和小肠推进比。[结果]Ecr对小肠推进有明显促进作用,IMC周期显著缩短,活动期单位时间内快波数明显增加,且与西沙比利组没有显著性差异,但与0.85%氯化钠对照组相比差异有统计学意义。[结论]Ecr对大鼠小肠动力具有显著的促进作用,其作用效果与西沙比利相近。     

小柴胡汤对正常大鼠胃肠激素影响的研究

[目的]观察小柴胡汤对大鼠血及胃组织胃动素（MOT）、促胃液素（Gas）和血管活性肠肽（VIP）的影响，探讨该方促胃肠动力作用的可能机制。[方法]健康SD大鼠30只随机分为小柴胡汤、莫沙比利和0．85％氯化钠3组，每组10只。用药后采用放射免疫方法检测大鼠血和胃组织中的MOT、Gas及VIP水平。[结果]小柴胡汤组可升高血和胃组织中MOT，与0．85％氯化钠组比较差异有统计学意义（P〈0．05），与莫沙比利组比较差异无统计学意义（P〉0．05）；小柴胡汤对血和胃组织中的Gas和VIP与0．85％氯化钠组比较P〉0．05。[结论]小柴胡汤的促胃肠动力作用可能与MOT密切相关。     

健脾理肠汤治疗便秘型肠易激综合征96例

[目的]观察健脾理肠汤治疗便秘型肠易激综合征（IBS）的疗效。[方法]用自拟健脾理肠汤（治疗组）治疗96例，并与西药（对照组）治疗90例对照，治疗4周结束时记录症状变化；随访6个月，记录随访期的病情变化，进行统计分析。[结果]治疗4周后，治疗组总有效率96．87％，优于对照组82．22％（P〈0．05），治疗组缓解腹痛和便秘症状亦优于对照组（P〈0．05或〈0．01）。6个月后随访，治疗组总有效率（87．50％）优于对照组（74．44％），2组比较差异有统计学意义（P〈0．05）。[结论]健脾理肠汤是治疗便秘型IBS的有效中药复方。     

槟榔对大鼠胃运动及神经递质的影响

[目的]探讨槟榔对大鼠胃排空运动的影响及其机制,为临床应用槟榔提供理论依据。[方法]48只Wistar大鼠随机分为低浓度（25％）槟榔（A）组、高浓度（100％）槟榔（B）组、对照（c）组。分别给大鼠灌服低、高浓度槟榔液、蒸馏水1、6h后,以葡聚糖蓝-2000为胃内标记物,观察大鼠胃肠动力变化;同时用免疫组化染色观察胃窦肌间神经丛P物质（SP）、血管活性肠肽（VIP）的变化;放射免疫分析法测定胃窦、空肠组织匀浆及血浆胃动素（MOT）、SP、VIP水平。[结果]灌服低、高浓度槟榔液1、6h后大鼠胃排空运动明显增强,胃窦肌间神经丛SP明显增加,VIP明显减少（均P〈0．01或〈0．05）;胃窦及空肠组织匀浆MOT、SP明显增加,VIP明显减少（均P〈0．01或〈0．05）;血浆MOT、SP明显增加,VIP明显减少（均P〈0．01或〈0．05）。[结论]槟榔对大鼠胃运动有明显促进作用,其机制可能与胃窦肌间神经丛、胃窦及空肠组织、血浆SP;胃窦及空肠组织、血浆MOT增加及胃窦肌间神经丛、胃窦及空肠组织、血浆VIP减少有关。     

疏肝健脾法对功能性消化不良血浆胃动素和生长抑素的影响

[目的]观察中医疏肝健脾法治疗肝郁脾虚型功能性消化不良（FD）的临床疗效及对血浆胃动素（MOT）和生长抑素（SS）水平的影响。[方法]选择确诊为FD患者120例，按2：1比例随机分为2组，治疗组（疏肝健脾方治疗）80例，对照组（莫沙必利治疗）40例，并设正常组40例。采用放射免疫法测定2组患者治疗前、后空腹血浆MOT和SS水平，并与正常组测得值对比。[结果]治疗组临床症状总有效率为92．5％，对照组为90．0％，差异无统计学意义，但前者显效率为85．0%，明显高于对照组的60．0%（P〈0．05）。治疗组MOT及SS治疗前后比较差异均有统计学意义（均P〈0．01）。[结论]中医疏肝健脾法治疗FD患者疗效显著，能升高血浆MOT及降低SS水平，推动胃肠蠕动，促进胃肠道排空，达到改善患者临床症状的目的。     

Three layer functional model and energy exchange concept of aging process

Relying on a certain degree of abstraction, we can propose that no particular distinction exists between animate or living matter and inanimate matter. While focusing attention on some specifics, the dividing line between the two can be drawn. The most apparent distinction is in the level of structural and functional organization with the dissimilar streams of ‘energy flow’ between the observed entity and the surrounding environment. In essence, living matter is created from inanimate matter which is organized to contain internal intense energy processes and maintain lower intensity energy exchange processes with the environment. Taking internal and external energy processes into account, we contend in this paper that living matter can be referred to as matter of dissipative structure, with this structure assumed to be a common quality of all living creatures and living matter in general. Interruption of internal energy conversion processes and terminating the controlled energy exchange with the environment leads to degeneration of dissipative structure and reduction of the same to inanimate matter, (gas, liquid and/or solid inanimate substances), and ultimately what can be called ‘death.’ This concept of what we call dissipative nature can be extended from living organisms to social groups of animals, to mankind. An analogy based on the organization of matter provides a basis for a functional model of living entities. The models relies on the parallels among the three central structures of any cell (nucleus, cytoplasm and outer membrane) and the human body (central organs, body fluids along with the connective tissues, and external skin integument). This three-part structural organization may be observed almost universally in nature. It can be observed from the atomic structure to the planetary and intergalactic organizations. This similarity is corroborated by the membrane theory applied to living organisms. According to the energy nature of living matter and the proposed functional model, the decreased integrity of a human body's external envelope membrane is a first cause of the structural degradation and aging of the entire organism. The aging process than progresses externally to internally, as in single cell organisms, suggesting that much of the efforts towards the restoration and maintenance of the mechanisms responsible for structural development should be focused accordingly, on the membrane, i.e., the skin. Numerous reports indicate that all parts of the human body, like: bones, blood with blood vessels, muscles, skin, and so on, have some ability for restoration. Therefore, actual revival of not only aging tissue of the human body's membrane, but the entire human body enclosed within, with all internal organs, might be expected. We assess several aging theories within the context of our model and provide suggestions on how to activate the body's own anti-aging mechanisms and increase longevity. This paper presents some analogies and some distinctions that exist between the living dissipative structure matter and inanimate matter, discusses the aging process and proposes certain aging reversal solutions.     

Unusual responses of nocturnal pineal melatonin synthesis and secretion to swimming: Attempts to define mechanisms

Abstract: The effect of swimming at night on rat pineal melatonin synthesis was compared with that of light exposure at night. Rats were forced to swim at 0030 hr (lights out at 2000 hr) and sacrificed by decapitation 15 and 30 min later, immediately after swimming. Other groups of animals were exposed to white light (650μW/cm²) for 15 and 30 min at same time. Swimming caused a rapid and highly significant drop in the melatonin content in the pineal gland; however, the activity of N-acetyltransferase (NAT), the supposed rate limiting enzyme in the melatonin production, was not changed. Despite the drop in pineal melatonin levels, serum concentrations of the indole remained elevated in the rats that swam. In contrast, melatonin levels in the pineal and serum of light exposed rats fell precipitously, accompanied by a significant suppression of NAT activity. Since we anticipated that the strenuous exercise associated with swimming may induce release of artrial natriuretic peptide (ANP) from the heart, which in turn could cause the release of pineal melatonin, in a second study we injected physiological saline intravenously to stretch the cardiac muscle and release ANP. Three milliliters of normal saline was injected during the day into the jugular vein of anesthetized rats that were pretreated with isoproterenol to stimulate pineal melatonin production. Animals were killed 15 min after the saline injection, and pineal NAT activity and pineal melatonin levels were measured. The saline injections caused no alteration in the elevated levels of either NAT or melatonin. These data suggest that the disparity in pineal NAT activity (which was high) and pineal melatonin (which was low), in animals swum at night, may not be caused by ANP which is released during strenuous exercise such as swimming.     

Melatonin and photoperiodic time measurement: Seasonal breeding in the sheep

Abstract: Well-established circadian physiology supports the view that photoperiodic time measurement utilizes the coincidence between the presence of light and a photosensitive phase of a 'biological clock' to alter reproductive status—the so-called external coincidence model of seasonal breeding. In this review, we examine the mechanism whereby photoperiod interacts with presumed suprachiasmatic nuclei activity to allow endogenous melatonin to normally synchronize reproductive activity to the optimal time of year. The Romney Marsh sheep is particularly explored as an experimental model. It is suggested that the on/off activity of seasonal reproduction may be a robust mechanism able to be predictably manipulated by the judicious use of the light/dark cycle and exogenous melatonin, but firmly based on circadian principles.     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Serological survey of HIV and syphilis in pregnant women in Madagascar

Objectives Peripartal transmission of human immunodeficiency virus (HIV) and Treponema pallidum, the causative agent of syphilis, leads to severe consequences for newborns. Preventive measures require awareness of the maternal infection. Although HIV and syphilis testing in Madagascar could be theoretically carried out within the framework of the national pregnancy follow‐up scheme, the required test kits are rarely available at peripheral health centres. In this study, we screened blood samples of pregnant Madagascan women for HIV and syphilis seroprevalence to estimate the demand for systemic screening in pregnancy. Methods Retrospective anonymous serological analysis for HIV and syphilis was performed in plasma samples from 1232 pregnant women that were taken between May and July 2010 in Ambositra, Ifanadiana, Manakara, Mananjary, Moramanga and Tsiroanomandidy (Madagascar) during pregnancy follow‐up. Screening was based on Treponema pallidum haemagglutination tests for syphilis and rapid tests for HIV, with confirmation of positive screening results on line assays. Results Out of 1232 pregnant women, none were seropositive for HIV and 37 (3%) were seropositive for Treponema pallidum. Conclusions Our findings are in line with previous studies that describe considerable syphilis prevalence in the rural Madagascan population. The results suggest a need for screening to prevent peripartal Treponema pallidum transmission, while HIV is still rare. If they are known, Treponema pallidum infections can be easily, safely and inexpensively treated even in pregnancy to reduce the risk of transmission.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.