肠道T细胞淋巴瘤临床分析

本文总结报告了3例肠道T细胞淋巴瘤(intestinal T-cell lymphoma，ITCL)的诊治资料，并结合文献复习，发现IT—CL多见于中年男性，以腹痛、血便、发热、体质量下降为主要症状，治疗效果差，预后不良。病理改变以肠道溃疡形成为特点，溃疡形态呈多形性、多灶性、不规则，镜下瘤细胞明显异型、弥漫性浸润，中至大细胞多见。肿瘤细胞呈T细胞表型。ITCL临床少见，缺乏特异性临床表现，极易误诊。故临床医师应重视对ITCL临床病理特征、免疫表型和基因型的研究，注意识别，促其早期诊治。     

复合吸收促进剂对葛根素肠吸收及毒性的影响

目的 考察吸收促进剂配伍对葛根素肠吸收的影响,并进一步观察复合吸收促进剂对肠黏膜的毒性.方法 运用外翻肠囊法,采用L9(3)4正交设计试验考察各吸收促进剂的协同作用,确定较理想复合吸收促进剂;运用显微形态学观察复合吸收促进剂对肠黏膜的毒性.结果 复合吸收促进剂:1%壳聚糖、0.02%白芷挥发油、0.06%冰片配伍具有协同作用,可显著提高葛根素的肠吸收;复合吸收促进剂无肠黏膜毒性.结论 1%壳聚糖、0.02%白芷挥发油、0.06%冰片配伍可安全有效地促进葛根素的肠吸收.     

胆囊结石与胆囊收缩素受体(CCK-A)和血管活性肠肽(VIP)的关系研究

目的探讨胆囊动力学异常在胆囊结石形成中的作用.方法随意选择胆囊结石患者35例,胆囊息肉样病变患者25例,正常对照30例.B超测空腹胆囊容积.放射免疫法测定血浆中血管活性肠肽(VIP)的浓度,逆转录-聚合酶链反应(rt-PCR)法测胆囊黏膜中胆囊收缩素(CCK-A)受体表达数目.结果①胆囊结石组胆囊空腹体积明显大于其它两组(F=3.45,P=0.039);②胆囊结石组胆囊收缩率明显低于其它两组 (F=5.747,P=0.005);③三组之间餐后VIP升高量无明显差异 (F=0.768,P=0.47);④胆囊结石组胆囊收缩素(CCK-A)受体表达明显低于胆囊息肉样病变组(t′=4.390,P=0.022),差异具有显著性.结论①胆囊结石组空腹胆囊体积增大与其胆囊结石形成有关; ②胆囊结石组胆囊收缩功能下降导致结石形成;③胆囊收缩素(CCK-A)受体表达低,使胆囊收缩功能减弱,促进胆囊结石的形成;④血管活性肠肽(VIP)与胆囊结石的形成无明显关系.     

盐炙对补骨脂吸收特性的影响

 目的通过考察炮制前、后补骨脂中主要成分补骨脂素和异补骨脂素胃肠道吸收参数的变化,研究炮制对补骨脂吸收特性的影响。方法以SD大鼠为模型动物,进行大鼠在体肠灌注实验。并分别考察高、中、低3个浓度下的药动学参数,以确定浓度对吸收的影响。采用t检验法考察生品和盐炙品中补骨脂素和异补骨脂素的药动学参数之间的差异。结果生品中补骨脂素在高、中、低3个浓度下的吸收速率常数为0.203,0.165,0.203 h^-1,异补骨脂素的吸收速率常数则分别为0.178、0.168,0.204 h^-1;而盐炙品中补骨脂素在高、中、低3个浓度下的吸收速率常数为0.326,0.377,0.369 h^-1,异补骨脂素的吸收速率常数则分别为0.373,0.371,0.329 h^-1。盐炙品的吸收速率明显高于生品,而不同浓度下的吸收速率常数没有明显变化。结论补骨脂生品和盐炙品在小肠中的吸收机制是简单的被动扩散,吸收呈现一级动力学过程;炮制可以增加补骨脂的吸收。     

Nationwide investigations of intestinal obstruction in Japan

Two nationwide questionnaire surveys of intestinal obstruction in Japan were undertaken, covering two two-year periods, from January, 1975 to December, 1976 and from January, 1985 to December, 1986, respectively. The findings of a comparative review of these two surveys indicated that although the overall mortality of intestinal obstruction had not changed between 1975/76 and 1985/86, being 6.8 per cent and 6.5 per cent, respectively, simple adhesive obstruction had decreased from 3.2 per cent in 1975/76 to 2.0 per cent in 1985/86. The main cause of adhesion was laparotomy and in cases of both simple adhesive obstruction and strangulated adhesive obstruction, the rate of adhesion secondary to laparotomy of the upper gastrointestinal tract and colon and rectum had increased between 1975/76 and 1985/86. Obstructions caused by neoplasms had increased from 8.2 per cent in 1975/76 to 10.0 per cent in 1985/86, while those caused by adhesions had incresed further still, from 42.5 per cent in 1975/76 to 60.8 per cent in 1985/86. Among the latter group, nonoperatively treated cases had increased, which may be accounted for by the fact that facilities which adopt non-operative treatment using intestinal decompression as the first choice for simple adhesive obstruction cases have increased. In both surveys, the mortality of cases receiving nonoperative treatment was lower than that of operative cases.     

Analysis of factors that determine the compliance of rat jejunum to distension in vivo

Distension of the intestine is commonly used to elicit reflex responses at other sites in the gastrointestinal tract, and also to evaluate pain of intestinal origin. The sensory neurones, that initiate the reflexes or pain responses, react to the forces generated in the wall of the intestine. Thus, the responses of the intestine at the site of distension, particularly changes in contractile activity, influence the signals from the gut. In the present work we have analysed the relationship between distension and pressure changes in the jejunum of the rat, in vivo. Isovolumic distension for 5 min caused an initial pressure increase which declined quickly in the first 30 s, and then declined more slowly. Phasic pressure increases were superimposed on the baseline pressure change. Hexamethonium blocked the phasic pressure increases, whereas the initial rapid and subsequent slower pressure decline during distension persisted. Inhibition of nitric oxide synthase (NOS) increased intraluminal pressure and caused increased frequency and irregularity of phasic pressure increases. However, the decline in jejunal pressure during distension was not changed by inhibition of NOS. The pressure decline during isovolumic distension was similar whether saline or paraffin oil were used to distend the intestine, indicating that the decline was not due to increased hydrostatic pressure causing water and electrolyte to cross the mucosal epithelium from the lumen to the intestinal interstitium. Hyoscine had no significant effect on the pressure profile when the intestine was distended. However, when the systemic or the local circulation of the jejunum was infused with nicardipine, the pressure that was achieved during isovolumic distension was less, although the rate of change in pressure during the slow decline was similar. It is concluded that distension evokes phasic pressure increases in the jejunum, that are nerve-mediated, and increases the tension in the wall through a stretch-activated increase in contractile force generated by the circular muscle. The decline in pressure during maintained distension is primarily a consequence of visco-elastic properties of the wall of the intestine.     

四君子汤改善抗生素脱污染小鼠肠道菌群失调的研究

目的：研究中药四君子汤对肠道菌群失调小鼠的调节作用。方法：小鼠经盐酸林可霉素灌肠造成菌群失调模型。将小鼠分自然恢复组。丽珠肠乐组，四君子汤组，治疗后，进行组织病理学和肠道菌群检测。结果：四君子汤组中肠道菌群最大幅度增加，与自然恢复组相比差异显。肠道粘膜损伤修复比自然恢复组好。结论：四君子汤能够促进肠粘膜损伤修复。调节肠道菌群失调。是一种理想的微生态调节剂。     

大气细菌粒子浓度的时间分布特征及最佳采样时间的研究

用ＭＦ－４５型和ＨＴＫ－２０１型空气微生物采样器分别在北京、天津和沈阳三地观测了不同季节和一天中大气细菌粒子的浓度及其变化。结果表明：京、津二地春季大气细菌粒子浓度高，分别为２０５３个／ｍ３和２５５６个／ｍ３；夏季低，分别为９９５个／ｍ３和１０６４个／ｍ３。沈阳秋季大气细菌粒子浓度高，为１０１０８个／ｍ３；冬季低，为１２９４个／ｍ３。一天中，大气细菌粒子浓度呈双峰型变化，６：００～７：００和１８：００时大气细菌粒子浓度高，１１：００～１３：００和１：００～２：００时大气细菌粒子浓度低。根据大气细菌粒子浓度的季节变化和一天中大气细菌粒子浓度的时间分布特征，经过京、津、沈三地一天中分别１２次、８次、６次和４次不同采样时间组合的大气细菌粒子浓度的数理统计分析，大气细菌粒子浓度的监测拟集中在一年冬、春、夏、秋四季的中间月份，即１月、４月、７月、１０月进行；一天中采样８次的时间序列可为７：００、１０：００、１３：００、１６：００、１９：００、２２：００、１：００、４：００一天采样４次的时间序列可为５：００、１１：００、１７：００、２３：００。白天采样４次的时间序列可为春、秋季６：００、９：００、１２：００、１５：００?     

A Correlation Between the Permeability Characteristics of a Series of Peptides Using an in Vitro Cell Culture Model (Caco-2) and Those Using an in Situ Perfused Rat Ileum Model of the Intestinal Mucosa

In an attempt to establish an in vitro/in situ correlation of intestinal permeability data, the permeability coefficients (P _app) for a series of model peptides, which were determined using an in situ perfused rat ileum model, were compared to the permeability coefficients (P _mono) determined using an in vitro cell culture model (Caco-2). The model peptides, which were all blocked on the N-terminal (acetyl, Ac) and the C-terminal (amide, NH2) ends, consisted of D-phenylalanine (F) residues (e.g., AcFNH₂, AcFFNH₂, AcFFFNH₂). To alter the degree of hydrogen bonding potential, the nitrogens of the amide bonds were sequentially methylated [e.g., AcFF(Me)FNH₂, AcF(Me)F(Me)FNH₂, Ac(Me)F(Me)F(Me)FNH₂, Ac-(Me)F(Me)F(Me)FNH(Me)]. These peptides were shown not to be metabolized in the in situ perfused rat ileum system. The results of the transport experiments showed that there were poor correlations between the apparent permeability coefficients (P _app) determined in an in situ perfused rat ileum model and the octanol–water partition coefficients (r = 0.60) or the hydrogen bonding numbers (r = 0.63) of these peptides. However, good correlations were observed between the in situ P _app values for these peptides and their partition coefficients in heptane–ethylene glycol (r = 0.96) and the differences in their partition coefficients between octanol–water and isooctane–water (r = 0.86). These results suggest that lipophilicity may not be the major factor in determining the intestinal permeability of these peptides and that hydrogen bonding potential may be a major contributing factor. A good correlation (r = 0.94) was also observed between the P _app values determined for these peptides in the in situ perfused ileum model and those P _mono values determined in the in vitro cell culture model (Caco-2) (Conradi et al., Pharm. Res. 8:1453–1460, 1991). These results suggest that the permeability values determined in the Caco-2 cell culture model may be a good predictor of the intestinal permeability of peptides.     

Could Chronic Mesenteric Originated Hypoxia Insult Produce Opposite Pathologic Features： Hypoplasia and Hyperplasia of the Intestine

Chronic ischemia produces corresponding tissue hypoplasia. However, here we report a distinctive hypertrophy of the intestine due to chronic mesenteric insufficiency, which was confirmed by angiography in two patients with opposite characteristic pathologic presentation of intestine. During surgery of the first patient, an approximately 60cm long ileum with sausage consistency and cyanosis color was identified proximal to the caecum; wall-attached thromboembolism material and the hypertrophied segment of ileum were removed. In the other patient, the intestine wall was paper thin; after aorto-mesenteric bypass the intestine wall grew thicker. Post operative recovery of both patients was uneventful. The commonly observed situation after a long-standing hypoxic insult in a setting of chronic mesenteric ischemia is that the target tissue will at least develop a slight hypoplasia. However, the cases we present here had either pronounced hyperplasia or severe hypoplasia. We thus report it, expecting to identify a special mechanism to explain this paradox.