Pregabalin modulation of spinal and brainstem visceral nociceptive processing

Brainstem and spinal mechanisms mediating visceral nociception are investigated here using electrophysiology and immunohistochemistry techniques in a model of acute visceral pain. Colorectal distension (CRD) produced graded visceromotor responses (VMR) in normal rats, and these were facilitated by intracolonic mustard oil (MO) that generated acute visceral hyperalgesia. The neuropathic pain drug pregabalin (PGB) is thought to have state-dependent effects in attenuating neuropathic, but not acute somatic pain, likely by impairing calcium-channel trafficking. We found that systemic PGB produced antinociceptive effects on CRD-evoked VMRs in naïve rats lacking pathophysiology and in MO-pretreated rats. Systemic PGB also significantly reduced Fos labelling in lumbosacral spinal cords of rats given noxious repetitive CRD; however, PGB did not alter this measure of neural activity in the brainstem. Differential brainstem processing of noxious somatic and visceral stimuli may underlie the unique lack of state-dependent actions of PGB in this visceral pain model. Single-unit recordings in the rostral ventromedial medulla (RVM) verify that brainstem processing of somatic and visceral stimuli differs. The effects of CRD on RVM cells classed as ON, OFF, or NEUTRAL were independent of their somatic responses, with surprising changes in RVM cell activity to innocuous visceral stimulation. PGB also markedly reduced the visceral responses of RVM ON-cells to noxious CRD. These results illustrate clear differences in the central processing of visceral and somatic stimuli, yet a common role for descending modulation by brainstem activity in mediating evoked pain measures.     

Cystic lymphangioma of the spleen: MR findings with pathologic correlation

A case of histologically confirmed cystic lymphangioma of the spleen was presented. On MR imaging, the mass was shown as multiloculated hyperintensity areas on T2-weighted images, corresponding to dilated lymphatic spaces. The septa were demonstrated as hypointensity bands, corresponding to abundant fibrous connective tissues. MR findings correlated well with histologic findings. MRI was a useful noninvasive modality for the diagnosis.     

Spontaneous splenic infarction associated with sumatriptan use

Triptans are specific agonists of the serotonergic 5-HT_1B/1D receptors that have increasingly been used in the treatment of migraine and cluster headaches. Though they are generally considered safe, there have been a few reports of myocardial infarction and stroke associated with triptan use. We report a patient who developed spontaneous splenic infarction after the use of sumatriptan for the treatment of migraine headache.     

二级脾蒂离断法在腹腔镜脾切除术中的临床应用

目的：探讨腹腔镜下二级脾蒂离断法脾切除术的可行性、有效性和安全性。方法对我院2008年7月至2012年12月施行32例腹腔镜下二级脾蒂离断法脾切除术的患者临床资料进行回顾分析。结果32例患者均顺利完成手术。手术时间平均170 min,术中平均出血量220 ml,术后切口感染和术后4 d 部分腹腔渗血各1例,无其它严重并发症。结论腹腔镜下二级脾蒂离断法脾切除术安全有效,并可降低手术费用,值得临床推广。     

保留脾脏及供应血管胰体尾切除治疗胰腺断裂伤18例报道

目的 探讨保留脾脏胰体尾切除治疗胰腺体尾部断裂伤的临床可行性和效果.方法 对扬州大学临床医学院2008年3月-2012年11月实施保留脾脏胰体尾切除治疗胰腺断裂伤18例患者的临床资料进行回顾性分析评价.结果 18例患者均能顺利施行保留脾脏胰体尾切除.手术时间152 ～188 min,平均172 min;术中出血量155 ～356 mL,平均191 mL;住院时间为13～19 d,平均15 d.无术后大出血、胰漏、腹腔感染等严重术后并发症.结论 保留脾脏胰体尾切除治疗胰腺体尾部断裂伤减少了“无辜性脾切除”,是一种保全脏器功能效果较好、安全可行的手术方式.     

穴位贴敷在重症监护室无创通气患者护理中的应用

目的:观察穴位贴敷在重症监护室(ICU)无创通气患者护理中的效果。方法:将60例行无创通气治疗的患者采用随机数字表法分为2组各30例。对照组行普通常规护理,观察组在对照组护理方案的基础上行穴位贴敷等对症护理,2组均护理7 d。观察2组护理期间谵妄及腹胀发生率。结果:护理后,观察组谵妄、腹胀发生率均低于对照组(P<0.05)。结论:采用穴位贴敷对ICU无创通气患者进行护理,能降低谵妄、腹胀发生率。     

外伤性脾破裂216例临床诊治分析

【摘要】〓目的〓报告外伤性脾破裂的诊断及治疗体会。方法〓回顾性分析10年来我院收治的216例脾外伤患者的临床资料,并将前5年病例为对照组,后5年病例为治疗组,对比分析其诊断、治疗方法、并发症发生率。结果〓216例患者中,81例非手术治疗成功,135例行手术治疗,其中5例为延迟性破裂行脾切除;两组对照,近5年病人非手术病例治疗比例显著提高(P<0.05),而并发症发生率、输血量、住院时间无明显差异(P>0.05)。结论〓非手术治疗脾外伤在临床中的比例逐渐提高,切脾、保脾应兼顾脾损伤的程度和病人的血流动力学情况行个体化治疗。     

针灸结合六君子汤治疗脾虚气滞型功能性消化不良的疗效

〔摘 要〕 目的：观察针灸联合六君子汤加减治疗脾虚气滞型功能性消化不良患者的临床效果。方法：选择 2016 年 7 月 至 2017 年 9 月奉节县人民医院收治的脾虚气滞型功能性消化不良的患者 86 例为研究对象,随机分为对照组和观察组,每 组 43 例。对照组应用六君子汤加减治疗,观察组基于对照组治疗的基础上联合针灸治疗,疗程为 1 个月,比较两组患者的 治疗效果以及临床症状改善时间。结果：治疗后,观察组患者的临床治疗总有效率为 97.67 %,高于对照组的 88.37 %,差 异具有统计学意义（P ＜ 0.05）;观察组患者的临床症状改善时间短于对照组,差异具有统计学意义（P ＜ 0.05）。结论： 针灸联合六君子汤加减治疗脾虚气滞型功能性消化不良,效果显著。     

脾虚湿阻型单纯性肥胖小鼠模型的构建及评价

目的:为进一步开展中医治疗肥胖的研究,建立脾虚湿阻型单纯性肥胖小鼠模型并进行评价。方法:100只4周龄的C57BL/6N小鼠随机分为正常组20只和模型组80只,以高脂饮食加水湿垫料因素造模10周后,在肥胖模型的基础上按照脾虚湿阻证表征进一步筛选出脾虚湿阻单纯性肥胖小鼠。通过观察实验组与对照组小鼠的脂肪分布与体积,并结合小鼠的脂肪组织湿重及系数来评价小鼠的体脂含量;通过对小鼠进行葡萄糖耐量及胰岛素抵抗实验,再进一步测定小鼠血糖血脂的水平,从而对模型进行进一步的评价。结果:单纯性肥胖小鼠获得率88.75%,脾虚湿阻型单纯性肥胖小鼠造模成功率81.25%。脾虚湿阻型单纯性肥胖小鼠的体质量、Lee’s指数、粪便含水量、脂肪体积等均大于对照组小鼠,饮食量、饮水量、疲劳乏力等均小于对照组小鼠,血糖血脂水平均高于对照组小鼠,并且出现了葡萄糖耐量异常及胰岛素抵抗现象。结论:以高脂饮食加水湿垫料诱导的方式可以科学地建立脾虚湿阻型单纯性肥胖小鼠模型,为中医药治疗肥胖奠定基础。     

基于高通量测序技术的脾虚腹泻型肠易激综合征小鼠与健康小鼠肠道菌群的差异研究

目的:研究探讨基于16S rDNA基因测序技术的脾虚腹泻型肠易激综合征(Diarrhea-predominant irritable bowel syndrome,IBS-D)小鼠肠道菌群的变化情况。方法:选择20只清洁级幼龄ICR小鼠随机分为空白组(CK)与模型组(IBS-D)并建立脾虚型IBS-D小鼠模型,对2组小鼠粪便进行16S rDNA基因测序。结果:与健康小鼠比较,脾虚型IBS-D小鼠肠道菌群的丰富度与多样性均降低,在门、纲、目、科、属、种6个分类水平上,2组小鼠的菌群构成及构成比皆存在差异,其中在门水平上健康小鼠拟杆菌门与厚壁菌门共占94.14%,而脾虚型IBS-D小鼠拟杆菌门与厚壁菌门共占79.63%;与健康小鼠比较,脾虚型IBS-D小鼠拟杆菌门、Saccharibacteria、蓝藻门减少,变形菌门、疣微菌门增多;在属水平上,健康小鼠以拟杆菌属、另枝菌属、乳酸菌属等为优势菌群,而脾虚型IBS-D小鼠以拟杆菌属、阿克曼菌属、Parasutterella等为优势菌群;与健康小鼠比较,脾虚型IBS-D小鼠另枝菌属、乳酸菌属、理研菌属、Candidatus Saccharimonas、分节丝状菌属、瘤胃球菌属、脱硫弧菌属、Gelria减少,拟杆菌属、阿克曼菌属、Parasutterella、Lachnoclostridium、厌氧棍状菌属、Blautia、埃希氏菌属、Erysipelatoclostridium、Parabacteroides、克雷伯氏菌属、厌氧原体属、Flavonifractor、Candidatus Stoquefichus、Anaerostipes、Epulopiscium、沙雷氏菌属增多。结论:2组小鼠的菌群构成及构成比皆存在差异,脾虚型IBS-D小鼠表现为大量有益菌的下降与有害菌的增加。