胃食管反流病与功能磁共振技术

随着对胃食管反流病研究的深入,大脑和食管感觉及胃排空的相互作用越来越受到重视,功能磁共振成像技术,有助于进一步了解胃食管反流病的发病机制。     

论《内经》中的“守神”“守机”“守气”

在针刺过程中,医者不能只拘守手部形式,针刺关键在于"治神"。治神是医者手法的核心,贯穿于整个施治过程中。以神"侯气"、"调气",进而"调神"、"调形体"。其理论在《内经》中已有叙述,具体包括:守神、守机和守气。这三者是对针灸医生针刺手法的要求,也是衡量针灸医生水平高低的标准之一。然而针道易陈而难入,针灸医生须认真钻研针刺手法和心法。针刺治神在于医者必须"心领神会",方能感悟。     

家兔阴茎皮肤感觉脊神经来源的电生理研究

目的:探讨家兔阴茎感觉神经来源。方法:健康成年雄性新西兰白兔12只,随机均分为两组:每组6只,A组在左侧脊神经上记录,B组在右侧脊神经上记录。对家兔阴茎施加不同大小的机械刺激,用神经单纤维记录技术,在同侧S1~S4脊神经上记录单纤维放电。结果:通过对家兔阴茎施加各种不同机械刺激,在同侧S2~S3脊神经上能记录到放电,S1、S4脊神经上未能记录到放电。左侧脊神经放电纤维数量分别为:S2:39.67±3.14,S3:21.00±2.19;右侧脊神经放电纤维数量分别为:S2:40.00±3.16,S3:19.67±2.58,左右侧差异无显著性(P>0.05)。结论:家兔阴茎皮肤感觉来源于S2~S3脊神经。     

Three-dimensional biomechanical properties of the human rectum evaluated with magnetic resonance imaging

A method to evaluate the three-dimensional (3-D) geometry of the human gastrointestinal wall may be valuable for understanding tissue biomechanics, mechano-sensation and function. In this paper we present a magnetic resonance imaging (MRI) based method to determine rectal geometry and validation of data obtained in three volunteers. A specially designed rectal bag was filled in a stepwise manner while MRI and bag pressure were recorded. 3-D models of curvatures, radii of curvature, tension and stress were generated and the circumferential and longitudinal strains were calculated. The computed bag volumes corresponded to the infused volumes. A pronounced bag elongation and decrease in wall thickness was observed during the bag filling. The spatial distributions of the biomechanical parameters were distinctly different between individuals and non-homogeneous throughout the rectal wall due to its complex geometry. The average tension and stress increased as a function of infused volume and circumferential strain. The present study provides a method for characterizing the complex in vivo 3-D geometry of the human rectum. The non-homogenous spatial curvature distribution suggests that simple estimates of tension based on pressure and volume do not reflect the true 3-D biomechanical properties of the rectum.     

健康人加压素释放和渴感的渗透压阈值

报道１２名受试者在静滴５％ＮａＣｌ２ｈ（每分钟０．０６ｍｌ／ｋｇ）的过程中血钠、血渗、血浆精氨酸加压素（ＡＶＰ）浓度和渴感等级的变化。结果显示，血浆ＡＶＰ浓度及渴感等级分别与血渗呈线性相关，回归方程分别为：血浆ＡＶＰ浓度（ｐＡＶＰ）－０．２４［血浆渗透压（ｐＯｓｍ）－２７４］（ｒ＝０．７２，Ｐ＜０．００１）；渴感等级（Ｔｈ）＝０．２３（ｐＯｓｍ－２７９）（ｒ＝０．６２，Ｐ＜０．００１）．两者灵敏度及阈值均较国外文献报道的结果低，认为加压素释放及渴感的渗透压阈值可能与遗传因素及生活习俗有关，ＡＶＰ分泌及渴感的渗透压调节可能存在种族差异。     

Clinical and manometric evaluation of anorectal function following low anterior resection with low anastomotic line using an EEA™ stapler for rectal cancer

Anorectal function was evaluated in eight patients who had low anterior resection of the rectum with a low anastomotic line, using an EEA^™ stapler, with determination of function based on periodic manometric studies and clinical symptoms. Immediately following surgery all patients suffered from frequent bowel actions and soiling. These symptoms improved with time and most patients could enjoy almost normal daily life by the sixth postoperative month. One month after surgery, anal canal resting pressure and maximum squeeze pressure were significantly reduced and rectoanal inhibitory reflex was absent; neither showed a distinct tendency to improve thereafter. Rectal sensation and reservoir capacity, which also were seriously impaired, recovered satisfactorily by the time of the six-month examination. This suggests that an improvement of clinical symptoms following this operation is dependent upon the recovery of reservoir capacity and sensation of the neorectum, and that this operative procedure is a functionally acceptable option for low rectal cancer.     

腹泻型与便秘型肠易激综合征直肠肛管动力和感觉功能的不同特点

目的 研究腹泻型与便秘型肠易激综合征（IBS）病人直肠肛管动力和直肠感觉功能的不同特点。方法 选择IBS病人85例，分成两组。其中腹泻组52例，便秘组33例，20例健康志愿者为对照组，采用PC Polygraf ID高分辨率多道胃肠功能测定仪，分别测定直肠肛管压力、直肠感知阈值、排便阈值、最大耐受量和直肠肛门抑制反射最低充气量。结果IBS病人的直肠静息压、肛管静息压和直肠肛门抑制反射最低充气量与健康对照组比较无显著性差异。腹泻组的最大缩窄压和排便阈值显著低于健康对照组。便秘组的松弛压、直肠感知阈值、排便阈值和最大耐受量显著高于健康对照组。结论腹泻型IBS病人的症状与最大缩窄压和排便闽值降低有关；而便秘型则与松弛压、直肠感知阈值、排便阈值和最大耐受量显著增高有关。