Inhibition of gastrointestinal motility by MPTP via adrenergic and dopaminergic mechanisms

The neurotoxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) was injected intraperitoneally in mice and caused an acute inhibition (of over 60%) of gastrointestinal motility, which was measured by the transit of charcoal. This inhibition was not related to conversion of MPTP to MPP⁺. Administration of the -adrenergic blocker propranolol significantly reduced, but did not completely block, the effect of MPTP. The dopaminergic blocker haloperidol also partly reversed the effects of MPTP. When these blockers were administered together, the action of MPTP was fully blocked. The results indicate that the toxin acted by releasing catecholamines (presumably norepinephrine and dopamine), thereby inhibiting motility.Supported by a grant from the Joint Research Fund of the Hebrew University and Hadassah.     

Minimal changes with long-term administration of anxiolytics on septal driving of hippocampal rhythmical slow activity

In free-moving male rats, the function relating frequency to the threshold current required to drive hippocampal rhythmical slow activity (RSA; theta) with septal stimulation has a minimum at 7.7 Hz. Classical anxiolytics all increase thresholds in the region of 7.7 Hz, and so does the novel anxiolytic buspirone. However, unlike classical anxiolytics, 2 or 3 weeks are normally required for the onset of the clinical effects of buspirone. This study tested the effects of long-term administration of chlordiazepoxide and buspirone on septal driving of RSA. Separate groups of naive rats received three IP injections per day of chlordiazepoxide (0.4 mg/kg), buspirone (0.1 mg/kg) or saline for 50 days. Both chlordiazepoxide and buspirone increased thresholds at 7.7 Hz, as expected. These acute effects were not significantly changed with chronic administration. Buspirone and chlordiazepoxide produced similar, statistically significant, but small cumulative reductions in thresholds at 6.9 Hz. The present experiments suggest that if the effects of anxiolytic drugs on septally driven RSA provide any basis for their clinical action, then classical anxiolytics may have two actions: an immediate effect on euphoria and tension and a delayed effect on anxiety proper — with buspirone sharing only the latter effect.     

用MTTp和F-V曲线形状对吸烟者肺通气功能的对比研究

为评价部分平均通过时间（ＭＴＴｐ）和Ｆ－Ｖ曲线形状对检查吸烟者小气道功能的临床意义,作者对１１６例被动和轻、重度主动吸烟者进行了常规肺通气功能、ＭＴＴｐ和Ｆ－Ｖ曲线形状的探讨。常规肺通气功能和Ｆ－Ｖ曲线形状用常规法测定。ＭＴＴｐ用“简易计算法”公式计算。结果显示凸型Ｆ－Ｖ曲线的分布随吸烟程度而上升。·Ｖ５０、·Ｖ２５下降及ＭＴＴ４５％～５５％、ＭＴＴ７０％～８０％延长在凸型与重度吸烟组一致。ＭＴＴ４５％～５５％与ＭＴＴ７０％～８０％延长的范围在两者都是预计值的１１０％～１２０％,表明小气道功能已有轻度障碍。因而凸型Ｆ－Ｖ曲线、ＭＴＴ４５％～５５％及ＭＴＴ７０％～８０％延长、·Ｖ５０、·Ｖ２５下降都是检查小气道功能的敏感指标。用“简易计算法”计算ＭＴＴｐ简便准确,宜于临床推广应用     

24-hour anti-ischaemic action with once daily nifedipine

Summary The ability of a fatty-alcohol matrix, slow-release tablet of nifedipine 60 mg to maintain a 24-hour antiischaemic action in the fixed dose of 60 mg once daily has been investigated in a randomised, placebo-controlled, double-blind trial.12 normotensive patients with angiographically proven coronary artery disease (stenosis of at least one major vessel 70%) were studied. The anti-ischaemic response was assessed over a period of 4 days as changes in the exercise-induced ST-segment depression 6 h and 24 h postdose, and ST segment changes in 24-h ambulatory ECGs.A measurable anti-ischaemic response was observed in 8 of the 12 patients. Exercise-induced ST-segment depression 6 h after the administration of nifedipine was reduced by 30% compared to placebo, and there was still a measurable anti-ischaemic response 24-h post-dosing. Both responses were independent of changes in exercise blood pressure. In 7 patients with ischaemic episodes in the 24-h ECGs, nifedipine treatment had only a minor effect on the intensity and duration of ischaemia.It is concluded that a significant anti-ischaemic effect lasting 24 h could be demonstrated using effort-induced ST-segment changes in patients with angiographically proven coronary heart disease, who were treated once daily with nifedipine 60 mg as a fatty-alcohol slow release tablet.     

The clinical utility of provocative radionuclide oesophageal transit in the evaluation of non-cardiac chest pain

We combined edrophonium provocative testing with the technique of radionuclide oesophageal transit (RET) in 30 consecutive patients with non-cardiac chest pain (NCCP) and 12 controls. The oesophageal transit time of aqueous technetium-99m sulfur colloid was determined before and after intravenous infusion of 80 g/kg edrophonium chloride (ED). Patient symptoms during provocative RET (P-RET) were recorded. Thirteen (43%) of the patients had abnormal study results, whereas all control subjects had normal results. Three groups considered abnormal were observed: (a) in two patients (6%), the pain was reproduced and transit pre- and post-ED administration was prolonged (>15 s); (b) in six patients (20%), the pain was reproduced, but transit was normal pre- and post-ED; (c) in five patients (17%), transit pre- and post-ED was prolonged, but no pain was reproduced. In five patients (17%), ED prolonged the transit time > 15 s without pain, but the baseline transit was normal. Transit time was measurable in 23 patients. Mean pre-ED transit time was 10.2 ± 7.4 s (mean ± SD) and post-ED, 12.4 ± 8.0 s (P=0.3). We conclude that ED has no significant effect on transit time, and the pain induced by ED rarely correlates with an abnormal transit; P-RET provides additional information to baseline RET, increasing sensitivity, and may be a useful screening method in the evaluation of patients with NCCP.     

便秘及肠道疾病与慢性前列腺炎综合征的相关性研究

目的　探讨大黄在慢性前列腺炎综合征 (CPS)治疗中的应用。方法　从理论上分析便秘或其他肠道疾病与CPS的相关性 ;在临床上将 42例CPS患者随机分为综合治疗加大黄组 (甲组 ) 2 3例与综合治疗不加大黄组 19例 (乙组 )进行比较。结果　根据美国国立卫生研究院慢性前列腺炎症状评分标准 (NIH -CPSI)评分 ,甲组的症状改善优于乙组。结论　便秘或其他肠道疾病与CPS存在相关性 ,在CPS的综合治疗中应用大黄可以改善症状     

便秘及其它肛肠疾病与慢性前列腺炎相关性机理探讨

许多CP患者有或曾经有过便秘病史 ,或者有其它肛肠疾患 ,推断CP可能与便秘及肠道慢性炎症存在一定的相关性。初步探讨便秘及其它肛肠疾患与CP相关性的解剖生理病理基础和机理 ;可能对CP的防治有一定的实际意义。     

针药结合治疗盆底失弛缓综合征引起便秘76例疗效观察

目的：观察针药结合治疗盆底失弛缓综合征引起便秘的临床疗效。方法：对76例患者采用针药结合方法治疗。电针主穴：天枢、上巨虚、支沟；口服中药熟地白术汤(熟地黄、白术、肉苁蓉)。结果：痊愈61例，有效13例，无效2例：痊愈率为80．26％，总有效率为97．37％。结论：针药结合治疗盆底失弛缓综合征引起便秘疗效肯定，尤适用于脾肾虚弱者。     

太溪穴临床应用举隅

太溪穴为足少阴肾经的输穴、原穴。介绍太溪穴的针灸操作方法、适应症及其治疗鼻衄、便秘、牙痛验案三则。     

The intestinal ecosystem in chronic functional constipation

Chronic functional constipation is common in infants, and the bacterial composition of stools in this condition is not known. The study aims were to: (i) investigate the composition of the intestinal ecosystem in chronic functional constipation; (ii) establish whether the addition of the water-holding agent calcium polycarbophil to the diet induces an improvement in constipation; and (iii) determine the composition of the intestinal ecosystem after the use of this agent. In total, 42 children (20F, 22M; mean age: 8.6±2.9y) were studied. Twenty-eight children with functional chronic constipation without anatomical disorders were treated double-blind in random sequence for 1 month with an oral preparation of calcium polycarbophil (0.62g /twice daily) or placebo. Intestinal flora composition was evaluated by standard microbiological methods and biochemical assays on faecal samples collected before and after treatment. Fourteen healthy children were studied as controls. The results show that (i) the constipated children presented a significant increase in clostridia and bifidobacteria in faeces compared to healthy subjects-different species of clostridia and enterobacteriaceae were frequently isolated; no generalized overgrowth was observed; Clostridia outnumbered bacteroides and E. coli mean counts by 2-3log, while bacteroides and E. coli counts were similar (5-6 log10/g fresh faeces); these intestinal disturbances could be defined as a dysbiosis, i.e. a quantitative alteration in the relative proportions of certain intestinal bacterial species. (ii) Clinical resolution of constipation was achieved only in 43% of treated children and an improvement in 21% (one bowel movement every 2 d). (iii) Calcium polycarbophil treatment induced no significant changes in the composition of the intestinal ecosystem, nor in blood chemistry parameters.