参七消痞颗粒对慢性萎缩性胃炎大鼠COX-2、Bcl-2的调节作用研究

[目的]观察参七消痞颗粒对慢性萎缩性胃炎(CAG)大鼠COX-2、Bcl-2蛋白表达的影响。[方法]通过N-甲基-N-硝基-N-亚硝基胍(MNNG)负荷其他因素建立CAG大鼠模型(14周),之后再随机分为模型组、摩罗丹组(阳性对照组1)、叶酸组(阳性对照组2)、参七消痞颗粒高、中、低剂量组,另从实验开始造模时就设立正常对照组(空白组)。各组大鼠给予相应药物灌胃治疗8周。治疗结束后,苏木精-伊红染色观察胃黏膜病理改变,ELISA法大鼠血清中PGI、PGII水平,并计算PGI/PGII;使用放射免疫法检测大鼠血清中GAS水平,免疫组织化学法检测大鼠胃组织COX-2、Bcl-2蛋白表达。[结果]与模型组比较,参七消痞颗粒中、低剂量组与模型组比较血清GAS水平显著降低(P0.01、P0.05),与空白组比较,模型组大鼠胃组织COX-2、Bcl-2蛋白表达均明显升高(P0.01),而参七消痞颗粒各剂量组及阳性对照组均较模型组降低(P0.01、P0.05)。[结论]参七消痞颗粒能明显改善CAG大鼠的胃黏膜病变,其治疗机制可能与下调COX-2、Bcl-2蛋白的表达有关。     

复方隔山消颗粒对大鼠慢性萎缩性胃炎的治疗作用

[目的]探讨复方隔山消颗粒对大鼠实验性慢性萎缩性胃炎（CAG）的治疗作用。[方法]将110只大鼠随机分为5组：正常对照（正常）组，模型对照（模型）组，复方隔山消颗粒高、中、低剂量组，每组22只。除正常组外，均采用55℃15%氯化钠灌胃方法制作CAG动物模型，用不同剂量的复方隔山消颗粒进行治疗后，取胃黏膜组织，切片，观察胃黏膜萎缩、肠上皮化生（IM）、异型增生（Dys）及损伤情况。[结果]模型组大鼠胃黏膜腺体萎缩，可见IM，黏膜肌层和固有层问有较多增生的纤维结缔组织。经不同剂量的复方隔山消颗粒治疗后，各剂量组大鼠胃黏膜损伤指数与模型组比较均明显降低（P〈0.01，〈0.05），黏膜萎缩、IM、Dys鼠数与模型组比较均明显减少（均P〈0.01）。[结论]复方隔山消颗粒对大鼠实验性CAG胃黏膜病变有较好的防治作用。     

胃痞颗粒治疗胃癌前病变的实验研究

[目的]观察胃痞颗粒对胃黏膜上皮异型增生大鼠胃黏膜上皮细胞凋亡及调控基因蛋白表达的影响。探讨胃痞颗粒治疗胃癌前病变的作用机制。[方法]采用N-甲基-N-硝基-N-亚硝基胍（MNNG）诱导造模。设空白组、模型组、胃痞颗粒Ⅰ组及Ⅱ组，进行常规病理检测、TUNEL细胞凋亡检测、Bcl-2、Fas、P53（突变型）蛋白表达检测。[结果]胃黏膜组织病理学变化，中、重度异型增生率胃痞颗粒Ⅰ、Ⅱ组与模型组相比明显降低（均P〈0．05）；P53（突变型）、Bcl-2基因蛋白表达，胃痞颗粒Ⅰ、Ⅱ组明显低于模型组（均P〈0．05）；Fas蛋白表达，胃痞颗粒Ⅰ、Ⅱ组均高于模型组，但前者差异无统计学意义（P〉0．05），后者差异有统计学意义（P〈0．05）。[结论]胃痞颗粒对大鼠实验性胃黏膜癌前病变有逆转治疗作用。     

胃炎Ⅰ号对慢性萎缩性胃炎PCNA、Bcl-2和Bax表达的影响

目的:以增殖细胞核抗原(proliferating cell nuclear antigen,PCNA)和B细胞淋巴瘤基因-2(B cell lymphoma 2,Bcl-2)、Bcl-2相关X蛋白(Bcl-2 associated X protein,Bax)两种蛋白为切入点,研究胃炎Ⅰ号对大鼠慢性萎缩性胃炎(chronic atrophic gastritis,CAG)癌前病变治疗的作用机制.方法:制备大鼠治疗CAG模型,分别用免疫组织化学LSAB法(labeled streptavidinbiotin method)染色和链酶亲和素一过氧化物酶复合物(streptavidin peroxidase conjugate,SP c o n j u g a t e)免疫组织化学法染色检测大鼠PCNA和Bcl-2、Bax两种蛋白的表达.结果:所有大鼠胃黏膜的PCNA显色反应均为阳性,但正常组呈阳性的细胞很少,规律分布,且显色弱,主要分布在增殖带;而模型组显阳性的细胞则明显增多,密度与正常组相比,差异有统计学意义;胃炎Ⅰ号组呈阳性的细胞面密度(阳性细胞面积与统计场总面积的比值)与自然恢复组相比显著减少,与正常组相比差异无统计学意义;阳性对照组与自然恢复组相比差异无统计学意义.而阳性细胞周密度,即阳性细胞周长与统计场总面积的比值统计结果为:模型组减小不明显,较正常组显著增高;胃炎Ⅰ号组和阳性对照组与正常组差异无统计学意义.胃炎Ⅰ号组PCNA阳性细胞的面密度较自然恢复组显著降低,但阳性对照组与自然恢复组相比则差异无统计学意义;治疗组PCNA表达明显减弱,大鼠胃黏膜Bax阳性表达明显增强,Bcl-2表达则明显减弱.结论:抑制胃黏膜PCNA和Bcl-2的表达,促进Bax的表达是胃炎Ⅰ号治疗CAG癌前病变的机制之一.     

胃痞消对实验性大鼠慢性萎缩性胃炎的作用

[目的]探讨健脾化瘀解毒复方胃痞消对慢性萎缩性胃炎(CAG)模型大鼠胃黏膜上皮细胞病理改变的影响.[方法]采用致癌化学物N-甲基-N'-硝基-N亚硝基胍配合饥饱失常、耗气泻下法建立CAG脾虚模型.采用免疫组化法检测胃黏膜萎缩、肠上皮化生等病理变化.[结果]模型对照组胃黏膜萎缩、肠化生均较正常组明显增加(P＜0.01);胃痞消预防组、高、中、低剂量组较模型对照组明显降低(均P＜0.01).[结论]胃痞消防治CAG的作用机制与其通过降低胃黏膜萎缩、肠化生及两者并见出现率,逆转已发生的萎缩,从而阻止其发生癌变.     

凋亡相关蛋白Bcl-2、Bax在消炎痛所致胃黏膜细胞凋亡中的作用

目的研究在体情况下消炎痛（Indomethacin,IND）所致胃黏膜细胞凋亡过程中Bcl-2、Bax蛋白表达的变化,以探讨其黏膜损伤机制。方法 SD大鼠胃内灌注不同剂量IND,灌胃后3h处死,采用TUNEL标记技术检测黏膜细胞凋亡;应用免疫组化方法检测Bcl-2、Bax蛋白表达的变化。结果①TUNEL标记显示对照组大鼠胃黏膜仅见少量凋亡细胞,IND使凋亡细胞数明显增加,计算机图像分析显示单位面积内阳性细胞平均像素点30mg/kg组为对照组的6.3倍（P〈0.01）,60～120mg/kg组分别为对照组的8.0、12.6和17.1倍,明显高于对照组（P〈0.01）;②免疫组化染色显示对照组大鼠Bcl-2在胃腺体部呈中等至强阳性表达,平均灰度值为113.8±9.6;而Bax蛋白仅在胃腺体及基底部呈弱阳性表达,平均灰度值为128.5±6.1。30mg/kgIND使Bcl-2表达明显减弱（P〈0.05vs对照组）,灰度值为124.8±6.3,60～90mg/kg组呈中等至弱阳性表达,灰度值分别为153.1±10.1、174.1±8.6,120mg/kg组仅见散在弱阳性细胞分布于胃腺体部,灰度值为222.3±14.6,表达均明显低于对照组（P〈0.01）,表达水平变化同细胞凋亡显著负相关（r=-0.9771,P〈0.01）;Bax表达在30～90mg/kg组呈中等阳性,明显高于对照组（P〈0.05）,灰度值分别为107.4±4.2、90.1±5.6、72.8±6.3,120mg/kg组在胃腺体及基底部见大量强阳性染色细胞分布,灰度值为69.8±6.2,表达明显高于对照组（P〈0.01）,其变化与细胞凋亡明显正相关（r=0.9725,P〈0.01）。结论 IND使凋亡抑制蛋白Bcl-2表达减弱和促凋亡蛋白Bax表达增强,从而降低了Bcl-2/Bax,导致胃黏膜细胞凋亡。     

萎胃颗粒对大鼠萎缩性胃炎模型COX-2和p53表达的影响

[目的]探讨萎胃颗粒对慢性萎缩性胃炎(CAG)大鼠模型COX-2和p53表达的影响。[方法]选取90只SD雄性大鼠随机分为6组(空白对照组、病理组、维酶素组、萎胃颗粒大剂量组、萎胃颗粒中剂量组、萎胃颗粒小剂量组),每组15只。对于病理组和4个治疗组进行CAG模型的复制,造模成功后,病理组、维酶素组、萎胃颗粒各剂量组分别给予相应的药物灌胃。治疗12周后,光镜下观察各组大鼠胃组织的病理损伤情况;并用免疫组化、ELISA等方法检测各组胃黏膜及血液中COX-2、p53表达情况。[结果]镜下可见CAG大鼠模型复制成功,且萎胃颗粒有治疗作用。免疫组化及ELISA试验显示空白组COX-2和p53呈弱表达;病理组COX-2和p53呈强阳性表达,显著高于空白组(P0.001);而萎胃颗粒3个不同剂量治疗组的COX-2和p53阳性表达均不同程度减弱,明显低于病理组(P0.001),且以大剂量组最为显著。[结论]萎胃颗粒能够调节CAG大鼠模型COX-2和p53表达,增强黏膜屏障的防御和修复能力,从而发挥对CAG的治疗作用。     

复方参七消痞汤对慢性萎缩性胃炎大鼠胃组织病理形态及血清生长激素皮表皮生长因子的影响

[目的]观察参七消痞方(SQ)对慢性萎缩性胃炎(CAG)大鼠组织病理形态及血清生长激素(GH)、表皮生长因子(EGF)的影响.[方法]通过N-甲基-N’-硝基-N-亚硝基胍(MNNG)综合其他因素建立CAG大鼠模型(14周),之后再随机分为模型组、摩罗丹组、叶酸组、参七消痞组.模型组给予0.9％氯化钠1 ml/0.1 kg灌胃,摩罗丹组摩罗丹3.6 g/kg灌胃,叶酸组叶酸2 mg/kg灌胃,参七消痞组参七消痞汤9 g/kg灌胃,共计8周.另从实验开始造模时设立空白对照组.每周监测大鼠体重,第22周取材,观察大鼠胃病理组织学改变,测量胃窦区褶皱处胃黏膜腺体厚度(L1)/黏膜肌层厚度(L2)的比值;腹主动脉取血分离血清,放免法检测血清GH、EGF水平.[结果]参七消痞组与模型组相比,肉眼及镜下观察均大鼠胃黏膜组织病理形态有不同程度的改善,L1/ L2比值提高(P＜0.01);血清GH水平有升高趋势(P＜0.05),血清EGF水平显著升高[(0.84±0.17)、(0.72±0.17)μg/L,P＜0.01].[结论]复方参七消痞汤能明显改善CAG大鼠的胃黏膜病变,其治疗机制可能与升高血清EGF水平有关.     

参芪饮对脾胃虚弱型慢性萎缩性胃炎伴肠化生的病理及Caspase-3表达的干预研究

[目的]观察自拟参芪饮对脾胃虚弱型慢性萎缩性胃炎（CAG）伴肠化生（IM）患者胃黏膜萎缩I、M程度及Caspase-3表达的影响,探讨参芪饮对CAG伴IM的逆转作用。[方法]经电子胃镜检查病理确诊,以脾胃虚弱证为主症,≥45岁的CAG伴IM患者186例,随机分为3组各62例,治疗1年,治疗前后苏木精-伊红染色病理判定胃黏膜萎缩程度I、M程度;S-P法检测Caspase-3抗体。[结果]治疗前186例患者胃黏膜萎缩、IM、Caspase-3蛋白表达平均积分分别为：2.46±0.68、2.47±0.44、4.38±0.70。治疗后3组萎缩程度积分I、M积分、Caspase-3蛋白表达积分比较差异均有统计学意义（P〈0.01、〈0.05、〈0.01）。治疗前后萎缩程度积分：参芪饮组与叶酸组、对症组比较P〉0.05、〈0.01;IM程度积分和Caspase-3表达积分：参芪饮组与叶酸组、对症组比较P〈0.05、〈0.01。[结论]参芪饮能够减轻脾胃虚弱证为主症的CAG伴IM胃黏膜萎缩和IM程度,能够上调胃黏膜组织Caspase-3蛋白的表达,且优于叶酸。     

萎胃康对萎缩性胃炎大鼠TFF3和Bcl-2表达的影响

目的以肠三叶因子(TFF3)和B细胞淋巴瘤基因-2(Bcl-2)两种蛋白为切入点,探讨萎胃康治疗慢性萎缩性胃炎(CAG)的可能机制。方法 SD大鼠84只随机分为造模组70只,正常对照组14只。采用复合造模法制备CAG大鼠模型,经6 w造模成功后,将造模组剩余的60只大鼠随机分为模型对照组及萎胃康高、中、低剂量组和阳性药物组(12只/组)。各组给予相应的药物,每天灌胃1次,连续治疗30 d后,分别用Realtime PCR法和Western印迹法检测各组大鼠胃黏膜TFF3和Bcl-2两种蛋白的表达。结果与正常组比较,模型组大鼠胃黏膜TFF3 mRNA表达和Bcl-2蛋白表达均显著升高(P<0.05);与模型组比较,各治疗组大鼠胃黏膜TFF3 mRNA表达和Bcl-2蛋白表达均显著降低(P<0.05);其中以萎胃康高剂量组降低最明显,较萎胃康中、低剂量组有显著差异(P<0.05)。结论抑制胃黏膜TFF3和Bcl-2表达是萎胃康颗粒治疗CAG的机制之一。     

MNA-SF在老年高血压患者营养评价中的应用研究

目的探讨简易营养评价精法在老年高血压患者中运用的可行性。方法利用MNA-SF量表对老年高血压患者的营养状况做调查。结果 MNA-SF量表结果显示,营养不良者占11%,营养正常者占89%。结论 老年高血压患者仍存在营养不良的现象,应加强护理和健康教育。MNA-SF在老年高血压患者的营养评价中有一定的实用价值。     

Complications associated with the treatment of haemophiliacs with inhibitors

To examine the safety profile of products used to treat inhibitor patients unresponsive to factor VIII, a review of published clinical experience was performed. The products evaluated were activated prothrombin complex concentrates (aPCCs), such as AUTOPLEX® T, porcine factor VIII and recombinant activated factor VII (rVIIa). Safety characteristics included potential for transmission of infectious agents, anamnesis, thrombogenicity, thrombocytopenia and allergic reactions. While viral transmission has been virtually eliminated, the risk is theoretically higher with plasma-derived products such as aPCC and porcine factor VIII than with rVIIa, although contamination of cultured cells is a concern. Anamnesis occurs with aPCCs and porcine factor VIII, and may induce resistance to further therapy with porcine factor VIII. Thrombosis and disseminated intravascular coagulation are very infrequently reported in patients exposed to aPCCs and rVIIa, and never with porcine factor VIII. The latter is occasionally associated with thrombocytopenia, but this uncommonly limits treatment with this agent. Lastly, allergic reactions occur with about equal frequency with all products, but anaphylaxis is mainly a concern after administration of porcine factor VIII. In conclusion, products currently available are reasonably safe. Considerations such as efficacy, availability, ease of administration and cost must also be considered in making treatment choices.     

Complications associated with the treatment of haemophiliacs with inhibitors

To examine the safety profile of products used to treat inhibitor patients unresponsive to factor VIII, a review of published clinical experience was performed. The products evaluated were activated prothrombin complex concentrates (aPCCs), such as AUTOPLEX® T, porcine factor VIII and recombinant activated factor VII (rVIIa). Safety characteristics included potential for transmission of infectious agents, anamnesis, thrombogenicity, thrombocytopenia and allergic reactions. While viral transmission has been virtually eliminated, the risk is theoretically higher with plasma-derived products such as aPCC and porcine factor VIII than with rVIIa, although contamination of cultured cells is a concern. Anamnesis occurs with aPCCs and porcine factor VIII, and may induce resistance to further therapy with porcine factor VIII. Thrombosis and disseminated intravascular coagulation are very infrequently reported in patients exposed to aPCCs and rVIIa, and never with porcine factor VIII. The latter is occasionally associated with thrombocytopenia, but this uncommonly limits treatment with this agent. Lastly, allergic reactions occur with about equal frequency with all products, but anaphylaxis is mainly a concern after administration of porcine factor VIII. In conclusion, products currently available are reasonably safe. Considerations such as efficacy, availability, ease of administration and cost must also be considered in making treatment choices.     

Clinical experience with duodenum-preserving total resection of the head of the pancreas with pancreaticocholedochoduodenostomy

The results of duodenum-preserving total resection of the head of the pancreas (DpTRHP) in 20 patients were compared with the results of pylorus-preserving pancreatico-duodenostomy (PpPD), a procedure in conventional use for the treatment of benign diseases, in 19 patients. The mean operative time for DpTRHP was 4.5±0.9 h, this being not significantly different from that for PpPD, whereas the mean intraoperative blood loss with DpTRHP (825±508ml) was significantly less than that with PpPD (1382±798 ml) (P<0.05). The morbidity and mortality rates of patients treated with DpTRHP were 25% and 0%, respectively, and there were no significant differences between the two surgical treatment groups for these values. The outcome of treatment with DpTRHP was excellent, as was that of PpPD, in terms of the frequency of early gastric stasis, the duration of hospital stay, the patient's capacity for taking food, gaining weight, and working, and the performance status 6 months postoperatively. Thus, DpTRHP, which entails the least extent of resection of the head of the pancreas compared to other currently employed procedures and enables the operator to accomplish reconstruction of the pancreatic and biliary systems without resecting or interrupting the continuity of the digestive tract, was not attended by any serious complications, while, digestive tract function was well preserved, and satisfactory results were produced.     

Experience with the treatment of patients with hypertrophic cardiomyopathy with obsidan and isoptin

Forty-five patients with hypertrophic cardiomyopathy were examined clinically and echocardiographically. The results of their treatment with obsidan and isoptin in relation to various types of central hemodynamic disorders are presented. The data have been obtained making it possible to treat patients differentially with regard to the form of the disease. The treatment of this category of patients requires the echocardiographic monitoring of the parameters of the central hemodynamics and myocardial contractility.