康泰胶囊对肠易激综合征内脏高敏感性大鼠背根神经元兴奋性的影响

【目的】观察康泰胶囊对肠易激综合征(IBS)内脏高敏感性大鼠结肠背根神经元(DRG)兴奋性的作用,探讨康泰胶囊治疗IBS的作用机制。【方法】选用SD大鼠,随机分为正常组、模型组、康泰胶囊组(剂量为6.06 g/kg)、匹维溴铵组(剂量为50 mg/kg),除正常组外,其他组大鼠均采用慢性不可预计条件应激法复制内脏高敏感性IBS模型,根据腹部回缩反射(AWR)结果评估模型内脏敏感程度,分离模型大鼠背根神经元,应用膜片钳全细胞记录技术测定背根神经元的基电流强度和2倍基电流刺激下神经元反应,观察康泰胶囊对内脏高敏感IBS大鼠结肠背根神经元电生理特性的影响。【结果】康泰胶囊可以显著降低模型大鼠AWR评分(P<0.05或P<0.01),显著升高结肠DRG的基强度(P<0.01),显著减少2倍基强度刺激产生的动作电位数(P<0.01)。【结论】抑制应激引起的内脏高敏感IBS大鼠结肠背根神经元兴奋性增高可能是康泰胶囊治疗IBS的作用机制之一。     

白芍总苷粉针剂的免疫药理作用

【目的】探讨白芍总苷(ＴＧＰ)粉针剂的免疫药理作用。【方法】观察ＴＧＰ粉针剂对小鼠迟发型超敏反应(ｄｅｌａｙｅｄｈｙ－ｐｅｒｓｅｎｓｉｔｉｖｉｔｙ,ＤＨ)、碳廓清、溶血素生成反应、免疫器官重量和脾淋巴细胞增殖的影响。【结果】腹腔内注射(ｉ．ｐ．)ＴＧＰ粉针剂２００~３００ｍｇ·ｋｇ－１·ｄ－１,连用７ｄ,可显著降低小鼠ＤＨ和碳廓清指数;１００~３００ｍｇ·ｋｇ－１·ｄ－１ｉ．ｐ×７ｄ对小鼠溶血素生成反应、小鼠脾脏和胸腺重量均无明显影响;在６４~２５６μｇ·ｍＬ－１浓度范围内可抑制刀豆素蛋白 Ａ(ＣｏｎＡ)诱导的体外小鼠脾淋巴细胞增殖反应。【结论】ＴＧＰ粉针剂在适当剂量下可抑制特异性细胞免疫反应和单核/巨噬细胞、Ｔ淋巴细胞功能,并对免疫器官重量无明显影响。     

Gastric Hypersensitivity in Nonulcer Dyspepsia An Inconsistent Finding

Visceral hypersensitivity is claimed to beinvolved in the pathogenesis of nonulcer dyspepsia(NUD). We evaluated whether gastric hypersensitivity isa consistent finding in an unselected group of NUDpatients. In 11 patients and 20 healthy controls, astandardized gastric distension was performed using agastric barostat. Perception was scored by aquestionnaire and compared between the two groups. Therewas a linear pressure/volume relationship duringgastric distension in both groups. The pain threshold inNUD patients was significantly lower compared tocontrols [5.5 ± 4.0 mm Hg above minimaldistending pressure (mdp) and 10.2 ± 2.2 mm Hg above mdp,respectively, P < 0.004], irrespective of the H.pylori status. However, more than 50% of the NUDperception scores were in the control range at mostdistension levels. Gastric hypersensitivity could be confirmed inNUD patients as a group. However, there is aconsiderable overlap concerning perception in responseto distension between unselected NUD patients andcontrols.     

祛风清肺口服液抗Ⅰ型变态反应的实验研究

为探讨中药祛风清肺口服液治疗“风热喉痒咳嗽”的免疫学机理,用天花粉致敏大白鼠,分别观察各组致敏大鼠抗血清对正常大鼠皮肤被动过敏反应（ＰＣＡ）的影响、模型组大鼠抗血清对各组大鼠（包括给药组与对照组）皮肤ＰＣＡ的影响以及祛风清肺口服液对大鼠腹腔肥大细胞间接释放组织胺的影响。结果显示：皮内注射祛风清肺口服液低、高剂量组大鼠抗血清的大鼠皮肤皮片浸液的吸光度值比模型组降低（Ｐ＜０．０１或Ｐ＜０．００１）;注射模型组大鼠抗血清后,祛风清肺口服液低、高剂量组大鼠背部皮肤注射点皮片浸液光密度值比正常组降低（Ｐ＜０．０５）;祛风清肺口服液能抑制致敏大鼠腹腔肥大细胞释放组胺,与正常对照组相比,差异有显著性（Ｐ＜０．０１）。结果表明祛风清肺口服液有抗Ⅰ型变态反应作用,为其治疗“风热喉痒咳嗽”提供了一定的免疫药理学基础。     

Case Report: Gastrointestinal Amyloidosis Secondary to Hypersensitivity Vasculitis Presenting with Intestinal Pseudoobstruction

Hypersensitivity vasculitis is characterized byinflammation and necrosis of small blood vesselssecondary to allergic or hypersensitivity mechanisms (1,2). Gastrointestinal involvement with edema and bleeding also has been reported (3-5).Long-standing inflammation, such as rheumatic disease,infectious disease, inflammatory bowel disease, familialMediterranean fever, and malignancy, may lead tosystemic amyloidosis (6). Gastrointestinal involvementmay induce anorexia, nausea and vomiting, diarrhea,constipation, bleeding, malabsorption, andpseudoobstruction (6, 10-12). In this report we discussa patient with hypersensitivity vasculitis with severeintestinal bleeding who developed systemic amyloidosiswith intestinal pseudoobstruction 29 months after onset.Secondary amyloidosis due to hypersensitivity vasculitis has not been previously reported,and the causal relationship is discussed in thisreport.     

Mast Cell Degranulation Induces Delayed Rectal Allodynia in Rats: Role of Histamine and 5-HT

Visceral hypersensitivity is a common feature offunctional bowel disorders, where an increased number ofmast cells have often been described. Thus, weinvestigated the effect of an experimental mast cell degranulation induced by BrX-537A on somatic(tail heating) and visceral (rectal distension)sensitivity in rats and the involvement of histamineand/or serotonin on this last response. After BrX-537Aadministration, the latency of tail withdrawal reflex wasshortened within the 2- to 8-hr period. Moreover,BrX-537A reduced the distension volume threshold from0.8 ml to 0.4 ml inducing allodynia, from 6 to 12 hrafter its administration. This effect was suppressedby doxantrazole (mast cell stabilizing agent) and WAY100635 (5-HT_1A receptor antagonist), andreproduced by 5-HTP (5-HT precursor) and 8-OH-DPAT(5-HT_1A receptor agonist). However, neither granisetron(5-HT3 receptor antagonist) nor H1, H2, or H3 histaminereceptor antagonists modified the BrX-537A-inducedallodynia. Consequently, mast cell degranulation initiates a delayed somatic and visceralallodynia, with the participation of serotonin, through5-HT_1A receptor activation, on the visceralresponse.     

Dental Complications Following Gastric Restrictive Bariatric Surgery

Background: Morbid obesity is a scourge of the 21st century. The effective therapeutic measure is bariatric surgery. The medical literature has inadequately reported the potential deleterious effects of such surgery on dental health. Acidic levels in the oral cavity, which are known to be one of the postoperative side-effects of bariatric surgery, directly result in dental caries and tooth erosion. We investigated the self-assessment of postoperative bariatric patients with regard to their dental health and associated variables. Methods: 113 patients (25% compliance), who had been operated on in three Jerusalem hospitals, responded to a mailed questionnaire. Results: Patients' average age was 40±10 years; bariatric surgery had been performed 5±4 years previously. Of the patients, 37% reported eating more sweet foods after surgery, only 20% reported improved oral hygiene, only 34% reported increased frequency of visits to the dentist, and 37% reported greater dental hypersensitivity after surgery. Significant associations were found between reported dental hypersensitivity and vomiting (P=0.013), and also dental hypersensitivity and indigestion (P=0.021). Patients from the three hospitals reported different patterns of visits to the dentist. The most common variable (80% of the subjects) associated with visits to the dentist after surgery was dental hypersensitivity. Conclusion: Medical teams need to consider potential dental problems after bariatric surgery, and to supply their patients with the appropriate information and instructions regarding oral hygiene maintenance, healthy dietary patterns and regular dental health monitoring by a dentist or dental hygienist.     

Submandibular Gland Peptide-T (SGP-T) Inhibits Intestinal Anaphylaxis

A novel peptide, submandibular gland peptide-T(SGP-T), which reduces allergen-induced hypotension, wasexamined for effects on intestinal anaphylaxis.Hooded-Lister rats were sensitized to egg albumin and prepared for the measurement of in vivomyoelectric activity of the jejunum. The disruption ofmigrating myoelectric complexes (MMCs) that occurs uponintraluminal, duodenal challenge with antigen of sensitized rats was inhibited by 75% uponintravenous treatment with 100 g/kg of SGP-T. Inaddition, SGP-T reduced the number of rats experiencinganaphylactic diarrhea and disrupted MMCs, but thepeptide did not alter antigen-provoked release of ratmast cell protease II. The mechanism of action of SGP-Tremains to be determined, but it apparently does not actdirectly on mast cells to exert its antianaphylactic action. These results emphasize that modulationof immediate hypersensitivity reactions is only one ofseveral gastrointestinal activities that are affected bygrowth factors and peptides released from salivary glands.     

Adrenergic Denervation Hypersensitivity in Ileal Circular Smooth Muscle After Small Bowel Transplantation in Rats

Effects of small bowel transplantation (SBT) onileal motility are unknown. The aim of the present studywas to investigate changes in spontaneous contractileactivity and sensitivity to cholinergic and adrenergic agents in the ileal circular muscleafter SBT in rats. Orthotopic SBT was performed insyngeneic rats to avoid immune phenomena. Distal ilealcircular muscle strips from rats one week (N = 10) and eight weeks (N = 10) after SBT werestretched to optimal length (L_o), and basalspontaneous activity at Lo was measured. Dose-responseexperiments to the cholinergic agonist bethanechol (Be,10^-8-10^-4 M) were performed in the presence oftetrodotoxin (TTX, 10^-6 M) and to theadrenergic agonist norepinephrine (NE,10^-8-10^-4 M) with or without TTX.ED50 (negative log of drug-concentration that induced 50% effect) was calculated. We also studiedrats with selective jejunoileal ischemia/reperfusion,intestinal transection/reanastomosis, naive controls,and sham operated controls (N 8/group). Spontaneous basal activity did not differ among groups.Sensitivity to Be was not different in rats after SBT orin other groups compared to control tissue. After SBT,hypersensitivity to NE was shown by a significant increase of ED at one and eight weeks after SBT(5.1 ± 0.3 vs 6.2 ± 0.4 and 6.2 ±0.2, respectively; P < 0.05) regardless of thepresence of TTX. No hypersensitivity was observed afterischemia-reperfusion, intestinal transection-reanastomosis, or shamoperation. It is concluded that ileal hypersensitivityto NE was related to the extrinsic denervation obligatedby the transplantation procedure, possibly mediated through an increase in number of receptors onsmooth muscle, not on the enteric nerves.     

Central hypersensitivity in whiplash: implications for physiotherapy assessment and management

Abstract

It is emerging that whiplash-associated disorder (WAD) is a complex condition characterised by a variety of physical and psychological features. Generalised sensory hypersensitivity is one of these features and its presence reflects augmented central pain processing mechanisms. Whilst most studies have investigated these processes in chronic WAD, it is becoming clear that in some of the whiplash injured, sensory disturbances are present from soon after injury, and are associated with both poor recovery and recalcitrance to multimodal physiotherapy interventions. Evidence for sensory hypersensitivity in WAD and possible underlying mechanisms of these phenomena are reviewed. Physiotherapists play an important role in the evaluation and management of whiplash injury. It is important that sensory disturbances be identified early in the clinical assessment of the whiplash injured patient and that ensuing management strategies address these changes, if the aim of treatment is to prevent the transition to chronicity.