2.85 功能性消化不良对餐后胃排空功能影响的临床研究

目的探讨功能性消化不良(FD)返流样亚型(RL),餐后胃内食物的分布和对胃排空功能的影响.方法采用胃实时超声显像技术应用轨迹法对62例功能性消化不良(FD)中24 例和健康志愿者18例进行胃排空功能的临床研究,通过餐后不同时段内胃体、胃窦截面积, 排空速率(%/min)、胃体、胃窦内食物残留率、胃窦收缩频率、十二指肠-胃返流等多项观察指标进行餐后胃排空功能的评估.结果显示62例FD中24例为RL,除胃体截面积与正常组相接近外,其余观察指标胃窦排空速率减慢(0.37%/min),餐后90min胃窦残留率(92.42%),与正常组(0.57%/ min、41.78%)相比较胃排空时间明显延长(P＜0.05).结论采用胃实时超声显像技术对具有FD症状的患者进行胃排空功能的测定、评估、判断FD的临床亚型和量化,具有重要的临床实用价值.     

红霉素对豚鼠离体回肠的收缩作用

红霉素对豚鼠离体回肠的收缩作用余贤恩，罗绮凝右江民族医学院生理学教研室微生物学教研室红霉素（ＥＭ）在低于抗感染剂量时即可增强人、狗的胃肠运动及胃排空，也可加强胆囊排空，并刺激兔离体小肠及大肠收缩。国外研究发现红毒素对豚鼠离体肌肉无影响或抑制小肠运动。...     

无创检测与评价胃动力功能(综述)——生物电阻抗方法

胃动力,包括胃的运动和排空,是一个复杂的电活动——机械收缩和传导的过程,它由胃平滑肌的肌电活动开始,引发胃体、胃窦收缩并向远端的幽门传播。胃蠕动的节律与胃电活动相一致,约3次／min,是胃动力信号的特征频率。胃动力的检测包括胃的收缩、蠕动规律及胃排空时间的测量。     

2.65 大承气冲剂和针刺治疗胃肠运动功能障碍疾病的研究

目的本研究利用人体为对象,观察大承气冲剂和针刺足阳明胃经穴足三里、内庭对某些消化道运动功能障碍性疾病的治疗作用,阐明其作用机理.方法选择腹部手术后、糖尿病和习惯性便秘等胃肠运动障碍性疾病患者为观察对象,应用先进的胃窦、十二指肠和空肠灌注测压技术、体表胃电图描记技术、胃动素的放免测定、口-盲传输时间测定、99锝同位素描记测定胃排空等手段,直接观察中药下法常用方剂大承气汤的新剂型-大承气冲剂和针刺足阳明胃经的足三里、内庭穴对消化道运动功能障碍性疾病的治疗作用和对消化道运动功能的影响.结果大承气冲剂使腹部手术后患者胃电的低频波和高频波的比例明显减少 ,正常波的比例明显增高,可显著改善术后胃电节律的紊乱;大承气冲剂可提高腹部手术后患者胃窦、十二指肠和空肠MMC Ⅲ期的幅度和时间,显著减少胃肠逆蠕动波的数量,增加正蠕动波的比例;大承气冲剂可显著增加腹部手术后患者血中胃动素水平,促进胃肠运动功能的恢复;大承气冲剂可减少口-盲传输时间,改善糖尿病和习惯性便秘患者的胃肠运动功能 .针刺足三里和内庭穴通过增加胃电正常波的比例和减少低频波和高频波的数量,来改善腹部手术后消化不良患者的胃节律,增加胃电幅度;针刺足三里和内庭穴后胃的ROI区明显缩小,提示针刺足三里和内庭穴可促进腹部手术后消化不良患者的胃排空.结论大承气冲剂是显效的胃肠动力药,不仅可用于促进腹部外科患者的胃肠运动功能的恢复,提高手术的成功率,降低手术后并发症,还能改善糖尿病和习惯性便秘患者的胃肠运动功能状况,促进胃肠蠕动.针刺足三里和内庭穴可有效的促进腹部手术后消化不良患者胃肠运动功能的恢复,且无副作用,方法简便,可用于消化道运动障碍疾病的治疗.     

丹参对大鼠胃泌素所致胃液分泌,胃体,十二指肠粘膜血流和胃…

本文采用幽门结扎法，氢气清除和应力感受器技术分别测量了丹参注射前后胃液分泌量，胃体十二指肠粘膜血流量和胃窦运动的改变，以进一步探讨丹参的抗消化性溃疡作用机理。结果表明，丹参灌注后４０分钟左右，胃泌素所致的胃液分泌亢进和胃酸排出增多受到明显抑制；丹参注入后２０究钟，胃体和十二指肠粘膜的血流量分别增加了２５．３％和２８．３％（Ｐ＜０．０１）；丹参对胃窦运动的收缩频率无影响，但却抑制其收缩振幅，注入丹参     

血浆胃功素(MTL)测定在糖尿病的临床应用

血浆胃动素(MTL)是由22个氨基酸组成的直链多肽,分子量为2700,由胃肠粘膜MD细胞所分泌,主要见于小肠上段绒毛基底部,也见于小肠其它部位,十二指肠和回肠上段也有相当的含量。 其主要生理作用是通过引发胃和小肠近端IMMC的第Ⅲ期,诱发胃和小肠的强烈收缩活动并向远端传播;从而对胃肠内容物的排空起到重要作用。 糖尿病性胃肠病变是糖尿病慢性并发症之一。目前没有简便易行的检查手段来确诊。为此我们对DM患者的血浆MTL进行了探讨,现报告如下。     

丹参对大鼠胃泌素所致胃液分泌、胃体、十二指肠粘膜血流和胃窦运动的影响

本文采用幽门结扎法，氢气清除和应力感受器技术分别测量了丹参注射前后胃液分泌量，胃体十二指肠粘膜血流量和胃窦运动的改变，以进一步探讨丹参的抗消化性溃疡作用机理。结果表明，丹参灌注后４０分钟左右，胃泌素所致的胃液分泌亢进和胃酸排出增多受到明显抑制；丹参注入后２０分钟，胃体和十二指肠粘腹的血流量分别增加了２５．３％和２８．３％（Ｐ＜０．０１）；丹参对胃窦运动的收缩频率无影响，但却抑制其收缩振幅，注入丹参后１０、３０和６０分钟，胃窦运动指数分别下降了１４．９６％、１６．２６％和１４．９０％（Ｐ＜０．０５）。上述结果提示，改善粘膜血流供应，降低胃窦运动是丹参抗消化性溃疡的主要作用机制。     

功能性消化不良患者消化间期移行性复合运动及胃动素水平研究

为探讨FD患者胃肠运动及胃动素变化的规律对20例胃肠动力障碍型功能性消化不良（FD）患者及20例健康志愿者用连续灌注导管测压系统进行胃十二指肠压力测定,并测定空腹血浆胃动素水平。结果显示FD患者血浆胃动素水平明显低于对照组,同时存在胃及十二指肠动力异常,表现为胃窦Ⅲ期缺乏或持续时间缩短及十二指肠运动减弱。提示：FD的发生与胃肠动力低下及低胃动素水平有关。     

2.96 单纯性肥胖症与营养不良患儿液体胃排空对比研究

目的探讨单纯性肥胖症与营养不良患儿胃动力学状态.方法以牛奶作为胃液体试验餐,采用实时超声测定液体胃排空.结果单纯性肥胖症、营养不良患儿及健康儿液体试验餐120min后胃内残留率分别为7±±4(x±S)、23±5及14±10;其100%胃排空所需时间分别为146±28(x± S,min)、17617及169±46;试餐后60min各组胃体蠕动频率和胃窦收缩频率分别为42±0. 6(次/min)和4.6±0.6;2.5±0.3和2.7±0.4及3.8±0.6和3.7±0.9.结论单纯性肥胖儿胃液体排空明显加快;营养不良患儿明液排空延迟.     

鼠消化道功功的昼昼夜律

鼠为夜间活动动物,它不同于人类,它的昼夜活动节律尚未见有系统研究。为了进一步探讨昼夜节律的机理及以应用,我们从消化道功能开始着手,研究了胃的排空功能、胃的泌酸功能、肠的推进运动功能以及胰的外分泌功能等几个方面的鼠的昼夜节律变化。按Borella法测定胃、肠运动功能。在120只小鼠上观察了胃排空运动的昼夜节律。     

Transitional cell carcinoma arising in the gastric remnant following gastrocystoplasty: a case report and review of the literature

Urinary bladder augmentation with segments of the stomach (gastrocystoplasty), small bowel, or large intestine (enterocystoplasty) improves capacity and compliance in patients with bladder dysfunction. Although malignant complications of enterocystoplasty have been reported, the risk of malignancy in the setting of gastrocystoplasty is not known. We describe the case of a 73-year-old woman who developed a transitional cell carcinoma associated with transitional cell metaplasia and dysplasia of the gastric epithelium 14 years following gastrocystoplasty. To our knowledge, this is the first reported case of a malignant complication of this surgical procedure. We conclude that patients who have undergone gastrocystoplasty are at an increased risk for the development of malignancy in the neobladder and require close long-term follow-up, similar to patients who have undergone enterocystoplasty.     

Effect of AS-4370 on gastric motility in patients with diabetic autonomic neuropathy]

Delayed gastric emptying in diabetic patients occurs with progress of automatic neuropathy as one late complication. Delayed emptying is deeply correlated with poor glycemic control, due to imbalance between nutrients absorption and effect of exogenous insulin. AS-4370 is a newly developed prokinetic agent which has been reported to selectively activate motility of the upper gastrointestinal tract through enhancing acetylcholine release from nerve terminals within the enteric mural plexus. In this study, we evaluated the effect of AS-4370 on gastric motility in diabetic patients with autonomic neuropathy. Eight diabetic patients with autonomic neuropathy (3 males and 5 females) with mean age of 56 years old (range 29-66) participated to this study after giving written informed consent. Gastric motility was evaluated by gastric emptying and electrogastrography. Gastric emptying study was done using 99mTc-Tin colloid labeled omelet meal served with 2 slices of toast and 200 ml of milk. Electrogastrography was recorded from epigastric skin surface, for 30 minutes before and after meal each. AS-4370, 7.5 mg tid, was given for four weeks after basal recording of gastric motility studies. Following the 4-week treatment with AS-4370, gastric motility studies were repeated. For the motility studies after medication, drug was given 30 minutes before test meal. Gastric retention rate at 150 minutes in all patients were over 45% of upper limit of normal range in basal study with mean value of 69 +/- 5%, which decreased significantly to 52 +/- 5%, with AS-4370 treatment (p < 0.01). Gastric emptying speed, another parameter for gastric emptying also improved with medication.(ABSTRACT TRUNCATED AT 250 WORDS)     

Involvement of cholecystokinin receptor in the inhibition of gastric emptying by oxytocin in male rats

The effects of oxytocin (OT) on gastric emptying and plasma levels of cholecystokinin (CCK) were studied in male rats. Gastrointestinal motility was assessed in rats 15 min after intragastric instillation of a test meal containing charcoal and Na2(51)CrO4. Gastric emptying was determined by measuring the amount of radiolabeled chromium contained in the small intestine as a percentage of the initial amount received. Blood samples were collected for OT and CCK radioimmunoassay. After administration of OT (0.2-0.8 mg x kg(-1)), gastric emptying was inhibited, whereas plasma concentrations of OT and CCK were increased in a dose-dependent manner. Atosiban, an oxytocin receptor antagonist, effectively attenuated the OT-induced inhibition of gastric emptying. However, administration of atosiban alone had no effect on gastric emptying. Devazepide (3 mg x kg(-1)), a selective CCKA receptor antagonist, effectively attenuated the OT-induced inhibition of gastric emptying. L-365, 260, a selective CCKB receptor antagonist, did not alter the OT-induced inhibition of gastric emptying. These results suggest that OT inhibits gastric emptying in male rats via a mechanism involving CCK stimulation and CCKA receptor activation.     

复方陈香胃片对胃肠功能影响的实验研究

目的:研究复方陈香胃片对胃肠功能的主要药理作用,探讨其治疗消化性溃疡的作用机理。方法:昆明种小鼠72只随机分为正常对照组、复方陈香胃片组和吗丁啉组,以相应药物灌胃,7d后分别检测各组小鼠胃内色素相对残留率及小肠推进比,观察小鼠胃排空和小肠推进情况;另取8只SD大鼠胃条置于恒温平滑肌槽中,分别给予吗丁啉和复方陈香胃片不同浓度的刺激,观察大鼠离体胃条运动的情况并记录曲线。结果:复方陈香胃片及吗丁啉均能减少胃内色素残留率,提高小肠色素推进率;增加离体胃条张力,且成量效关系(p<0.05)。结论:复方陈香胃片能够较好的改善胃肠功能,且作用优于吗丁啉,改善胃肠功能可能是其治疗消化性溃疡的作用机制之一。     

A radiological study of gastric (abomasal) emptying in calves before and after vagotomy.

1. Gastric emptying has been studied in the conscious, standing calf by lateral radiography and fluoroscopy of radiopaque meals instilled into the abomasum before and after vagotomy. 2. Bilateral cervical vagotomy proved to be the only certain way of achieving total vagal transection. By instillation of milk into the abomasum through a cannula calves were maintained in normal, healthy condition for up to 36 days after vagotomy. 3. Motility of the antrum was not impaired by vagotomy so that some movement of gastric chyme to the duodenum occurred within minutes of instillation into the abomasum. Complete transference of the test meal was, however, delayed after vagotomy. 4. The greatest effect of vagotomy appeared to be on the abomasal body so that inadequate amounts of chyme were transferred to the antrum for pumping to the duodenum. 5. Delay in passage of contrast material through the intestine was related to delay in gastric emptying although vagotomy may have affected the intestine directly. 6. Following vagotomy the abomasum showed a resumption of normal motility and emptying after 7-29 days. This effect of vagotomy is similar to that seen in the simple stomach and is probably due to the establishment of intrinsic gastric control.     

The effects of general anaesthesia on antroduodenal motility, gastric pH and gastric emptying in man

This survey was based on five recently published papers. The aims of the studies were to to investigate the effect of general anaesthesia on antroduodenal motility, gastric pH and gastric emptying. Antroduodenal motility was measured by manometry, gastric pH by a stomach microelectrode and gastric emptying rate using paracetamol absorption as an index. Two studies deal with antroduodenal motility during basal conditions and after administration of paracetamol and diazepam in 11 healthy volunteers. Three studies deal with the effects of 4 different methods of general anaesthesia on antroduodenal motility, gastric pH and gastric emptying rate in 43 patients undergoing orthopedic or plastic surgery not involving the abdomen having four different methods of general anaesthesia. In the healthy volunteers a close connection between antral activity and gastric emptying rate was found. Paracetamol had no effects on gastric pH. The changes in motility (a shortening of phase III and a decline in the incidence of antral phase III activity) were minor and ascribed to diurnal variations and by a possible stimulation of antral activity by the positioning of the manometric tube. It was found that no paracetamol was absorbed in the quiescent phase I, irrespective of its duration, and that the absorption rate of paracetamol correlated with the duration of phase II and the occurrence of antral activity during phases II and III. The effects of premedication with diazepam on antroduodenal motility, gastric pH and gastric emptying rate was investigated in the same healthy volunteers prior to the patient studies. Also in this study a correlation between antral activity and gastric emptying rate was found. Furthermore, it was observed that some volunteers had fast gastric emptying rate, indicated by fast absorption of paracetamol, the first study day and slow the second. It seemed that any intra- or interindividual variation in gastric emptying rate arises from individual variations in antroduodenal motility. Diazepam tended to increase gastric emptying rate by enhancing the amplitudes of antral contractions and the motility index during phase II and pH of the gastric juice increased. Gastroduodenal motility was found to be normal in patients awaiting elective orthopedic or plastic surgery when premedicated with diazepam. pH of the gastric contents was not different from the findings in volunteers after administration of diazepam. All methods of general anaesthesia reduced the duration of the interdigestive motility complex, mainly by a reduction of phase II. General anaesthesia with halothane and enflurane depressed antral motility.(ABSTRACT TRUNCATED AT 400 WORDS)     

Central oxytocin attenuates augmented gastric postprandial motility induced by restraint stress in rats

Restraint stress delays gastric emptying via uncoordinated motility pattern in rats. Central oxytocin has anxiolytic effects and attenuates the hypothalamic-pituitary-adrenal (HPA) axis in response to stress and facilitates stress-induced delayed gastric emptying. However, the role of central oxytocin in regulating gastric motility remains unknown. Postprandial gastric motility was recorded via a strain-gauge transducer, implanted on the antrum in Sprague–Dawley (SD) rats. To investigate whether central and peripheral oxytocin are involved in gastric motility, oxytocin (10 μg) was administered intracerebroventricularly (icv) and intraperitoneally (ip). Central and peripheral oxytocin administration did not affect the postprandial gastric motility under non-stressed conditions. Restraint stress augmented gastric contractions. Central administration of oxytocin, but not peripheral administration, abolished the augmented postprandial gastric contractions induced by restraint stress. Oxytocin facilitates stress-induced delayed gastric emptying via alleviating uncoordinated gastric motility. Oxytocin might be a candidate for the treatment of stress-induced GI motility disorders.     

Use of short-term bio-impedance for gastric motility assessment

Gastric motility (GM) has been assessed using bio-impedance (BI) techniques in the time domain using short term recordings and analyzing mainly the median of the area under the fast Fourier transform (FFT) spectra. The BI technique has been applied to the gastric system mainly for gastric emptying (GE) studies. However, gastric motility evaluation using BI has not been fully implemented. In this study, we propose the use of the BI technique for the evaluation of gastric motility considering global features of the fast FFT spectra. The study was performed in eleven healthy subjects who were evaluated in fasting and postprandial conditions. The results indicate that the use of the median of the area under the FFT spectra is equivalent to the use of the main peak of the spectra to determine the changes in gastric motility from the fasting to the postprandial state. This demonstrates that BI is a valid technique for gastric motility evaluation in short time recordings.     

Magnetic resonace appearance of gall bladder ascariasis

Ascariasis is a common disease in many developing countries and is a common cause of biliary and pancreatic diseases in endemic areas. Numerous studies have been published on biliary tract ascariasis. All these have documented ultrasonography as the primary imaging modality for biliary tract ascariasis. Magnetic Resonance Cholangiopancreatography (MRCP) has been the latest entrant for the study of bilary tract. MRCP findings of biliary tract ascariasis have been scarcely documented. MRCP is a unique non-invasive investigation for demonstrating ascariasis in gall bladder and bilary tract clearly. We present MR appearances of gall bladder and biliary tract in a proven case of biliary ascariasis.