结肠回肠反流与末端回肠黏膜结肠化的相关性研究

目的探讨末端回肠黏膜结肠化与结肠回肠反流之间的关系。方法选择2014年3月至2016年1月期间我院收治的行回盲部手术回肠结肠吻合患者33例(手术组)和慢性末端回肠炎患者31例(肠炎组)为研究对象,再选择同期来我院体检的健康者37例为对照组,分别行病理学和内镜检查,比较分析各组检查结果。结果手术组和肠炎组的回盲瓣舒缩功能异常率明显高于对照组(P0.05);肠炎组和手术组的杯状细胞增多、微绒毛异常以及绒毛萎缩比例均高于对照组(P0.05);同时,三组的结肠黏膜T淋巴细胞亚群水平比较差异有统计学意义(P0.05),并且随访1年,回肠末端黏膜结肠化与时间呈正比关系。结论结肠回肠反流与末端回肠黏膜结肠化密切相关,也是慢性末端回肠炎的一个重要病理基础。     

回肠Na^＋／胆汁酸转运体与高脂血症关系的研究

目的：探讨回肠Na^＋／胆汁酸性转运体（IBAT）基因表达与高脂血症形成的相关性。方法：取Wistar雄性大鼠60只随机分为2组：普通饮食组（对照组）、高脂饮食组（实验组）。喂养13周后分别提取对照组和实验组wistar大鼠的空肠末端、回肠末端、盲肠、结肠近端组织，应用RT—PCR和免疫SP法分别检测2组模型Wistar大鼠的空肠末端、回肠末端、盲肠、结肠近端组织的IBAT基因表达强度；对所得结果进行统计分析。结果：IBAT基因表达：结肠近端在对照组和实验组均无表达，空肠末端、回肠末端、盲肠表达实验组强于对照组（P〈0．05）。结论：实验组的IBAT表达升高，引起体内胆酸池增大和肝内胆固醇含量升高，从而引起血清胆固醇增加，加速高脂血症的形成。     

回肠末端炎的杯状细胞超微结构变化及其意义探讨

本文报告了8例慢性回肠末端炎与4例正常对照者回肠末端粘膜电镜下杯状细胞数目及超微结构变化。材料与方法:在纤维结肠镜病理学确诊后进行取材,取材部位相同;病例组8例,男5例,女3例,平均年龄35岁,对照组4例,男2例,女2例,平均年龄34.5岁。按潘氏方法进行汁数、分类。结果:①杯状细胞/吸收细胞比值对比,P<0.01,有显著性差异,提示病例组杯状细胞数目增多。②杯状细胞分为二类,对照组为中等量Ⅰ型杯状细胞,但无Ⅱ型粘液分泌细胞;病例组Ⅰ、Ⅱ型杯状细胞均增多,但Ⅰ型多有细胞器退变;Ⅱ型粘液分泌细胞内有丰富的粗面内质网及游离核蛋白体,而高尔基复合体少见,分泌颗粒互不融合,单个释放。讨论:本文分析了杯状细胞增多以及形态学变化可能在慢性回肠末端炎发病中的作用。     

大剂量氨甲喋呤对大鼠肠黏膜损伤及叶酸解救的对照观察

[目的]观察大剂量氨甲喋呤(HDMTX)及叶酸解救时大鼠肠黏膜的损伤情况,并建立相关的动物模型.[方法]6周龄大鼠分两组,单纯HDMTX组(HDM)每鼠一次注射MTX10mg后逐日杀鼠取肠作黏膜形态学检查及ALP测定.叶酸解救组(CFR)注射MTX后24h开始解救共7次(0.15mg/次)至第72h,第3、5、7、10天杀鼠.[结果]用MTX后第3天开始出现腹泻,第4天最严重,CFR组腹泻轻.用MTX后小肠绒毛变短,绒毛及腺窝上皮细胞变矮至扁平,第2、3天最严重;CFR组小肠黏膜形态改变较HDM组轻,第5天恢复,后短暂高于用药前又再回复;回肠黏膜改变早于空肠,细胞高度的变化早于绒毛.小肠黏膜ALP活性早期与形态学改变一致,但恢复后期仍低于用药前.结肠上皮细胞第1、2天变矮,绒毛长度则无显著变化.[结论]HDMTX致大鼠小肠黏膜严重损伤,表现为绒毛萎缩和上皮细胞变矮,恢复期绒毛有暂时性过度增长现象,但功能上可能仍有缺陷;结肠黏膜影响不大.叶酸解救减轻但未能完全阻止肠黏膜损伤.     

回肠结肠淋巴瘤:16例系列报道

背景:原发性回肠结肠黏膜相关的淋巴样组织淋巴瘤(M ALT)和被套细胞淋巴瘤(M CL)结肠镜下和临床表现的差别还不明确。方法:分别回顾了8例原发性M ALT和8例回肠末端和(或)结肠直肠M CL患者的结肠镜下和临床表现的特征。对所有病例检测了CD5和(或)细胞周期蛋白D1的表达。结果:M ALT内镜下特征以覆盖正常黏膜的突起为特点,有或没有溃疡。M A LT的肉眼表现分类为:孤立性(4例)、多发性(3例)和多发性淋巴瘤样息肉(M LP)(1例)。内镜所见M CL形态可分为多处突起(2例)和M LP(6例)。M CL患者比M A LT患者的临床分期恶性度更高。结论:…     

环状回肠造口术后回肠黏膜的形态学和缩氨酸YY的适应性时段改变

目的:缩氨酸YY的分泌机制涉及全身性因素诸如体液和神经刺激,以及局部因素如肠蠕动和肠腔内营养物。本研究用来阐明在全身不同刺激环境下局部刺激对缩氨酸YY分泌的影响。方法:回肠造口术后3个月内休复为短期组(14例患者)而术后6个月修复的为长期组(14例患者)。术后修复时比较近端的有功能回肠环和末端的无功能回肠环黏膜分泌缩氨酸Y Y浓度及细胞形态学的改变如绒毛高度、腺管深度、黏膜厚度及绒毛指数。对照组为右侧部分结肠切除术患者(21例),其回肠末端黏膜中缩氨酸YY浓度正常。结果:末端回肠中缩氨酸YY的峰浓度为307.4±21pm ol/g,但…     

对疑有结肠结核患者外观正常的末端回肠和盲肠进行内镜活检

背景和研究目的:结肠结核通常通过结肠镜和病变部位活检来确诊。但是,结肠活检的诊断效率不是很高。据我们所知,还没有研究探讨对内镜下表现正常的盲肠和末端回肠进行活检以诊断结肠或(和)回肠结核的意义。患者和方法:将临床疑为结肠结核、在结肠镜或回肠镜下无异常表现的患者纳入本次研究。在患者回肠和盲肠获取多个活检标本。结果:对50例患者进行研究,其中43例(86%)可进行末端回肠插管。对来自盲肠和末端回肠的活检标本进行组织学检查发现2例患者有非干酪样肉芽肿。这两份标本均来自末端回肠。在另外2例患者的标本中发现了疏松排列的上皮…     

大剂量氨甲喋呤对大鼠肠黏膜损伤及叶酸解救的对照观察

【目的】观察大剂量氨甲喋呤(HDMTX)及叶酸解救时大鼠肠黏膜的损伤情况，并建立相关的动物模型。【方法】6周龄大鼠分两组，单纯HDMTX组(HDM)每鼠一次注射MTX 10mg后逐日杀鼠取肠作黏膜形态学检查及ALP测定。叶酸解救组(CFR)注射MTX后24h开始解救共7次(0．15mg／次)至第72h，第3、5、7、10天杀鼠。【结果】用MTX后第3天开始出现腹泻，第4天最严重，CFR组腹泻轻。用MTX后小肠绒毛变短，绒毛及腺窝上皮细胞变矮至扁平，第2．3天最严重；CFR组小肠黏膜形态改变较HDM组轻，第5天恢复，后短暂高于用药前又再回复；回肠黏膜改变早于空肠，细胞高度的变化早于绒毛。小肠黏膜ALP活性早期与形态学改变一致，但恢复后期仍低于用药前。结肠上皮细胞第1、2天变矮，绒毛长度则无显变化。【结论】HDMTX致大鼠小肠黏膜严重损伤，表现为绒毛萎缩和上皮细胞变矮，恢复期绒毛有暂时性过度增长现象，但功能上可能仍有缺陷；结肠黏膜影响不大。叶酸解救减轻但未能完全阻止肠黏膜损伤。     

失血性休克及肠系膜上静脉阻断对兔小肠黏膜结构和屏障功能的影响

目的本实验观察失血性休克、静脉阻断及开放后缺血一再灌注多重损伤对小肠黏膜结构和屏障功能的影响。方法日本大白兔20只随机分为实验组和对照组,在各个时间段取肠系膜静脉血检测血浆内毒素及丙二醛水平,取末端回肠检测小肠黏膜厚度和绒毛高度。结果实验组在休克1h后和再灌注1h后血浆内毒素及丙二醛水平均明显升高（P〈0．01）;实验组小肠黏膜厚度和绒毛高度明显下降（P〈0.01）。结论在经历失血性休克、肠系膜上静脉阻断及再灌注损伤多重打击下,小肠黏膜结构和屏障功能遭受了严重破坏,进而引起细菌移位和内毒素血症,对机体造成不利影响。     

调肠消炎片及拆方对溃疡性结肠炎大鼠结肠黏膜超微结构及Occludin蛋白表达的影响

目的 观察调肠消炎片及拆方对溃疡性结肠炎(UC)大鼠模型结肠黏膜超微结构及Occludin蛋白表达的影响.方法 采用葡聚糖硫酸钠制备SD大鼠UC模型,模型建立后,分组分别给予不同的药物治疗,疗程结束后,处死大鼠,透射电镜观察结肠黏膜超微结构改变,免疫组织化学法测定大鼠肠黏膜Occludin蛋白的表达.结果 蒸馏水治疗组及调肠消炎片拆方组大鼠一般状况较差,电镜下结肠黏膜上皮表面的微绒毛变短、扭曲,甚至脱落,细胞器减少,细胞质液化溶解,腺上皮细胞间连接稍松散,杯状细胞,胞内颗粒呈排空状态.调肠消炎片原方组、双歧杆菌组及柳氮磺吡啶组一般状况有所改善,结肠黏膜上皮表面的微绒毛基本完整,腺上皮间相互连接紧密,肠腺杯状细胞,胞浆内黏液颗粒较丰富.各组大鼠肠黏膜Occludin蛋白的表达:调肠消炎片原方组>补气药组>蒸馏水治疗组>双歧杆菌治疗组>清热利湿药组>行气药组,差异有统计学意义(P<0.05).结论 调肠消炎片对UC大鼠模型结肠黏膜超微结构有改善作用,调肠消炎片及其拆方对UC大鼠模型结肠黏膜Occludin蛋白的表达有着不同的影响.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.