正常人及慢传输型便秘患者结肠动力学与胃肠激素的关系

目的:探讨正常人及慢传输型便秘患者的结肠动力状况与胃肠激素水平的关系。方法:运用结肠运输试验观察90例正常人及21例慢传输型便秘(STC)患者结肠动力状况,采用放射免疫法测定上述人群餐前、后血胃动素(MTL)、P物质(SP)、神经降压素(NT)、胃泌素(GAS)、血管活性肠肽(VIP)及生长抑素(SS)等浓度。结果:⑴正常组结肠运输试验80%标记物排出时间(80%TT)小于72 h,青中年组结肠动力明显强于老年组(P<0.05);STC结肠运输试验80%TT大于72 h。⑵正常组空腹及餐后MTL、SP、NT、GAS、VIP及SS浓度分别为:(288.00±127.83)、(26.19±19.12)、(46.95±18.12)、(51.00±21.92)、(176.93±126.64)、(17.72±11.68)ng/L和(336.16±116.06)、(36.86±19.08)、(74.24±34.71)、(102.15±49.15)、(152.14±90.72)、(37.30±30.07)ng/L。餐后多数激素分泌增加,其中SS、GAS与餐前比较有显著性差异(P<0.05)。⑶老年组餐前、后MTL、VIP及SS浓度均显著高于中青年组(P<0.05)。⑷正常组随着结肠动力的增强,MTL、VIP、SS浓度递减,SP、NT浓度递增。⑸STC组MTL、SP、NT、GAS、VIP及SS餐前、后浓度分别为:(227.92±90.46)、(30.17±18.71)、(78.75±52.88)、(24.55±15.50)、(169.21±119.16)、(43.13±33.70)ng/L和(267.94±126.68)、(16.27±14.00)、(110.25±97.08)、(74.08±65.98)、(25.92±12.63)、(25.88±11.51)ng/L。其中MTL、GAS餐前、后和VIP、SP餐后低于正常组,SS餐前明显高于而餐后低于正常组,NT餐前后均明显高于正常组。结论:⑴正常结肠运输试验80%TT≤72 h,青中年结肠动力较强。⑵正常人胃肠激素血浓度差异较大,除VIP外,进食后浓度均增高。⑶正常人多种激素浓度变化与结肠动力关系密切,参与调节和影响结肠动力。⑷STC血中多种胃肠激素水平异常,与结肠动力障碍密切相关。     

中药养胃散对大鼠胃肠粘膜中前列腺素生长抑素胃动素 …

目的 :从生物分子学方面探讨养胃散的治疗机理 ,观察用药后胃肠粘膜中前列腺素 (PG)、生长抑素 (SS)、胃动素 (MTL)的变化规律。方法 :SD大白鼠为实验动物 ,消炎痛损伤胃粘膜后 ,再给予中药养胃散 10d ,用放射免疫法测定胃、肠粘膜中的PG、SS、MTL的变化规律。结果 :养胃散能明显增加消炎痛损伤后的胃肠粘膜中的PG( 2 4 9.4 2± 89.35ng·L- 1)、SS( 2 .0 2± 0 .83ng·L- 1)、MTL( 98.82± 2 9.31ng·L- 1)的含量 ,与消炎痛组相比有显著性差异 (P <0 .0 1)。结论 :中药养胃散能增加胃肠粘膜内PG、SS、MTL的分泌 ,是其增强胃粘膜屏障功能的机理之一     

中药养胃散对大鼠胃肠粘膜中前列腺素生长抑素胃动素含量的影响

目的:从生物分子学方面探讨养胃散的治疗机理,观察用药后胃肠粘膜中前列腺素(PG)、生长抑素(SS)、胃动素(MTL)的变化规律.方法:SD大白鼠为实验动物,消炎痛损伤胃粘膜后,再给予中药养胃散10d,用放射免疫法测定胃、肠粘膜中的PG、SS、MTL的变化规律.结果:养胃散能明显增加消炎痛损伤后的胃肠粘膜中的PG(249.42±89.35 ng·L-1)、SS(2.02±0.83 ng·L-1)、MTL(98.82±29.31 ng·L-1)的含量,与消炎痛组相比有显著性差异(P＜0.01).结论:中药养胃散能增加胃肠粘膜内PG、SS、MTL的分泌,是其增强胃粘膜屏障功能的机理之一.     

肠易激综合征患者乙状结肠动力及胃肠激素变化的研究

目的 :研究肠易激综合征 (IBS)患者乙状结肠动力及其血浆、乙状结肠黏膜中胃肠激素含量的变化及临床意义。方法 :符合 Rome II诊断标准的便秘型、腹泻型 IBS患者及对照组各 1 3例 ,分别采用液体灌注测压法记录空腹和进餐状态下乙状结肠的压力波形 ;采用放射免疫法测定血浆和乙状结肠黏膜胃动素 (MTL)、血管活性肠肽 (VIP)、生长抑素 (SS)、胆囊收缩素(CCK)含量。结果 :在空腹状态下 ,腹泻型 IBS组乙状结肠动力指数 (1 5 .9± 4 .9)显著高于便秘型 IBS组 (1 0 .9± 5 .6 )和对照组(9.4± 3.6 ) ,进食后 30 min内 ,对照组的乙状结肠动力指数 (2 1 8.7± 76 .5 )升高的幅度更为显著 ,腹泻组的动力指数 (86 .5±5 3.4 )改变幅度也显著高于便秘组 (4 2 .4± 2 9.6 )。试餐后第 6 0分钟 ,腹泻型 IBS组乙状结肠动力指数 (6 5 .4± 1 1 .7)升高的幅度显著高于便秘组 (1 9.8± 1 4 .5 )和对照组 (2 3.2± 1 1 .3)。腹泻型 IBS患者血浆及乙状结肠黏膜中 MTL 含量显著高于对照组及 IBS便秘型患者 (P <0 .0 1 ) ;便秘型 IBS患者乙状结肠黏膜 VIP的含量高于正常组及腹泻型 IBS(P <0 .0 5 ) ,而血浆中VIP各组间差异无统计学意义 (P >0 .0 5 ) ;血浆及乙状结肠黏膜 SS的含量在便秘型 IBS中显著高于对照组及腹泻型 (P <0     

结肠运动与血胃动素、血管活性肠肽和P物质的关系

目的 :探讨结肠运动与胃动素 (MTL)、血管活性肠肽 (VIP)、P物质 (SP)的关系。方法 :运用结肠运输实验观察正常人结肠运输情况 ,采用放射免疫测定餐前后血中MTL ,VIP及SP的浓度。结果 :(1)青、中、老年组结肠运动力由强减弱 ,青、中年组 4 8h内结肠运动力明显高于老年组 (P <0 0 5 )。男女组间结肠运输试验差异无显著性 (P >0 0 5 ) ;(2 )空腹MTL ,VIP ,SP的浓度 :(2 6 7 34± 10 9 5 8)ng/L ,(176 93± 12 6 6 4 )ng/L ,(2 6 19± 19 12 )ng/L。餐后血MTL ,VIP ,SP分别为 :(2 88 0 8± 12 7 83)ng/L ,(15 2 14± 90 72 )ng/L ,(36 86± 19 0 8)ng/L ;(3)餐后 1h各组血中MTL ,SP ,VIP浓度 :青年组分别为 :(2 4 9 14± 10 4 4 7)ng/L ,(12 5 0 5± 79 97)ng/L ,(36 6 7± 2 0 92 )ng/L。中年组分别为 :(2 6 5 6 4± 12 5 5 2 )ng/L ,(14 3 38± 92 84 )ng/L ,(38 5 2± 2 2 2 6 )ng/L。老年组分别为 :(377 84±12 3 6 9)ng/L ,(2 0 4 77± 83 76 )ng/L ,(34 73± 10 30 )ng/L。老年组MTL ,VIP与青中年组比较 ,差异有显著性 (P <0 0 5 )。SP各组间无显著性差异 (P >0 0 5 )。男女组间差异无显著性 (P >0 0 5 ) ;(4)空腹与餐后比较 :青、中、老年组餐后SP均明显高于餐前 (P <0 0 5 )     

2型糖尿病胃轻瘫中医证型与胰岛素抵抗及胃肠激素的相关性研究

目的：探讨初诊2型糖尿病胃轻瘫(GDP)患者不同中医证型胰岛素抵抗及血浆胃肠激素的变化及其临床意义。方法：选择符合诊断标准的GDP患者98例,按中医分型标准分为肝胃不和组34例,脾胃虚弱组32例,胃阴不足组32例,采用放免法测定患者空腹胰岛素(FINS)以及胃泌素(GAS)、胃动素(MOT)、胰高血糖素(GLU)、血管活性肠肽(VIP)的含量。结果：肝胃不和组胰岛素抵抗指数(6.18±1.07)明显高于脾胃不和组(4.85±0.93)和胃阴不足组(4.69±0.88),有显著性差异(P<0.01)。GLU 3组之间无显著性差异(P>0.05)。肝胃不和组GAS(145.2±30.7ng/L)明显高于脾胃虚弱组(100.8±28.9ng/L)和胃阴不足组(111.4±21.4ng/L),有显著性差异(P<0.05)。肝胃不和组VIP(114.46±36.21ng/L)和脾胃虚弱组VIP(109.26±43.63ng/L)含量明显高于胃阴不足组VIP(82.54±15.77ng/L),比较有显著性差异(P<0.05)。肝胃不和组MOT(340.3±162.7ng/L)和胃阴不足组MOT(346.7±153.6ng/L)明显高于脾胃虚弱组MOT(288.9±127.2ng/L),有显著性差异(P<0.05)。结论：不同中医证型GDP患者胰岛素抵抗、血浆胃肠激素有一定的变化。其中胰岛素抵抗和MTL、VIP的变化有不同程度的证型特异性,而GTL、GLU的变化无明显的证型特异性。     

肠易激综合征结肠动力与胃肠激素的相关性研究

目的　研究肠易激综合征患者乙状结肠动力及其血浆、乙状结肠黏膜中胃肠激素含量的变化及其关系。方法　便秘型、腹泻型IBS组及对照组各13名,分别采用液体灌注测压法记录空腹和进餐状态下乙状结肠的压力波形;采用放射免疫法测定血浆和乙状结肠黏膜胃动素(MTL)、血管活性肠肽(VIP)、生长抑素(SS)、胆囊收缩素(CCK)含量。结果　在空腹状态下,腹泻组乙状结肠动力指数(15.9±4.9)显著高于便秘组(10.9±5.6)和对照组(9 .4±3.6);进食后30 min内,对照组的乙状结肠动力指数(218. 7±76. 5)升高的幅度更为显著,腹泻组的动力指数(86. 5±53. 4)显著高于便秘组(42 4±29 6)。试餐后60 min,腹泻组乙状结肠动力指数(65. 4±11. 7),显著高于便秘组(19 8±14 .5)和对照组(23 .2±11 .3)。腹泻组血浆及乙状结肠黏膜中MTL含量显著高于对照组及便秘组患者(P<0 .01);便秘组乙状结肠粘膜VIP的含量高于正常组及腹泻组(P<0 .05),血浆中VIP各组间无明显差异(P>0 .05);血浆及乙状结肠黏膜SS的含量在便秘组中显著高于对照组及腹泻组(P<0 .01~0 05);血浆CCK在腹泻组也明显高于对照组及便秘组(P<0. 05),在乙状结肠黏膜中各组间差异无显著性(P>0. 05)。空腹状态,乙状结肠黏膜MTL、CCK的含量与腹泻组乙状结肠动力指数呈正相关关系(r=     

中药白术对肝硬化大鼠肠动力及胃肠激素的影响

目的:观察中药白术对肝硬化大鼠肠道动力及其胃肠激素分泌的影响,探讨其可能的作用机制.方法:24只Wistar大鼠随机分为肝硬化模型组、肝硬化中药治疗组和正常对照组,采用葡聚糖蓝-2000为胃肠内标记物,观察大鼠肠道传输的变化,同时测定大鼠血浆、肠道组织中胃动素(MTL)、胆囊收缩素(CCK)、血管活性肠肽(VIP)及生长抑素(SS)含量的变化.结果:与对照组比较,肝硬化模型组大鼠小肠动力显著减弱(P<0.01),血浆及空肠组织中MTL、VIP、SS的含量明显增加(P<0.01,P<0.05),CCK的含量则显著减少(P<0.01);肝硬化中药治疗组大鼠小肠动力与对照组比较无明显差异,血浆及空肠组织中MTL、VIP、SS的含量与对照组比较无明显变化,CCK的含量则与肝硬化模型组无显著差异.结论:中药白术对肝硬化大鼠小肠运动功能减退有明显改善作用,其机制可能与MTL、VIP、SS的变化有关.     

急性胰腺炎大鼠血中抗炎症细胞因子的变化和生长抑素的调节作用

目的探讨实验性急性胰腺炎大鼠血中抗炎症细胞因子IL-10和TGF-β1的变化及生长抑素对其的调节作用.方法实验用SD大鼠随机分为正常对照组6只;胰腺炎组10只,采用开腹胰管注射5%牛黄胆酸钠(1.0-ml*kg-1)诱导急性胰腺炎,不治疗;生长抑素治疗组10只,胰腺炎诱导成功后0.5-h静脉注射施他宁20-μg*kg-1.胰腺炎组和生长抑素治疗组动物在术后2-h(n=6)、6-h(n=6)和24-h(n=8)处死,抽血,用ELISA法检测血中IL-10和TGF-β1及血淀粉酶含量,称胰腺湿重.结果对照组动物血IL-10浓度为(32.05±14.87)ng*L-1,TGF-β1浓度为(66.4±13.20)ng*L-1.胰腺炎组24-h后血IL-10和TGF-β1含量均显著升高(P<0.05),分别为(68.13±19.90)ng*L-1和(103.77±28.95)ng*L-1.生长抑素治疗组24-h血IL-10和TGF-β1浓度分别为(42.20±14.55)ng*L-1和(45.98±18.10)ng*L-1,明显低于胰腺炎组(P<0.05).结论急性胰腺炎时血中抗炎症细胞因子升高,并可能和胰腺炎后期的免疫抑制效应有关.生长抑素对抗炎症细胞因子的升高有抑制作用.     

肝胃不和型胃脘痛与血浆相关胃肠激素水平的研究

目的:研究肝胃不和型胃脘痛患者空腹血浆胃泌素(GAS)、胃动素(MTL)、生长抑素(SS)、血管活性肠肽(VIP)水平变化。方法:采集临床肝胃不和型胃脘痛病例及健康对照组空腹血液标本,用放免法检测两组血浆中GAS、MTL、SS、VIP含量。结果:肝胃不和型胃脘痛空腹血浆GAS和MTL水平明显下降,而空腹血浆SS及VIP水平无明显变化。结论:推测肝胃不和型胃脘痛可能与空腹血浆GAS和MTL水平下降有相关性,而与SS及VIP无明显相关性。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…