胃机械-电活动与胃肠激素水平老化改变初探

目的：比较分析不同月龄段大鼠胃机械-电活动变化及胃肠粘膜，脑组织中GAS，MTL，VIP水平。方法：用Maclab数据分析系统，描记不同月龄组大鼠胃内压力曲线及胃平滑肌可传导电刺激阈值，用放射免疫法测定胃肠粘膜及脑组织中GAS，MTL，VIP水平。结果：老龄组胃内张力及收缩波幅下降，电刺激阈值明显升高，胃肠粘膜中激素水平变化不大，脑组织中主要表现为下降趋势，结论：老化过程中胃运动功能及脑组织中胃肠激素水平均明显下降。     

胃肠肽在胃肠运动调节中的作用

胃肠运动（ｇａｓｔｒｏｉｎｔｅｓｔｉｎａｌｍｏｔｉｌｉｔｙ）主要受两方面因素的调节;一是肠神经系统,二是体液因素．胃肠肽具有上述两方面作用,它们不仅能在各种生理刺激下释放以内分泌方式影响胃肠运动,而且还作为肠道肽能神经纤维的神经递质对胃肠运动进行调节．此外,胃肠肽还在中枢水平调节胃肠运动,如一些脑－肠肽（ＣＣＫ,ＳＰ,ＳＳ等）在中枢注射可影响胃肠传输及胃肠运动方式［１］．整个胃肠道是一个巨大的内分泌器官．有些激素主要存在于胃肠道内分泌细胞,有的主要存在于胃肠神经系统,而有些则同时存在于两者之中．…     

急性阑尾炎32例胃肠电图分析

目的观察急性阑尾炎胃肠电图数据,了解其胃肠电活动情况。方法 32例急性阑尾炎患者术前行胃肠电图检查,观察胃肠电图波形平均幅值(P)、波形平均频率(f)、胃肠电节律紊乱百分比(RD)、波形反应面积(RA)、正常慢波百分比(PSW)。结果胃肠电图1、2、3、4导联P在(183.44±100.98)~(212.44±109.9)μV,f在(3.33±0.64)~(3.47±0.74)cpm,RD在(26.16±6.88)%~(27.8±7.23)%,RA在(67.84±35.55)~(73.00±40.51)μV.s;PSW在(50.84±8.59)%~(52.86±7.76)%。5、6、7、8导联P在(127.06±73.97)~(135.00±77.74)μV,f在(11.18±3.07)~(12.35±5.12)cpm,RD在(26.66±4.85)%~(28.06±5.23)%,RA在(46.16±27.21)~(50.16±29.75)μV.s,PSW在(45.05±7.35)%~(47.68±7.06)%。结论急性阑尾炎的胃肠电节律处于紊乱状态。     

Ghrelin与胃肠疾病关系的研究进展

Ghrelin是生长激素促分泌素受体的内源性配体,与受体结合后产生广泛的生物学效应,可刺激生长激素分泌、调节能量代谢等作用.而在消化系统中,Ghrelin具有保护胃肠黏膜、调节胃肠动力、促进胃酸分泌及控制肿瘤细胞增殖的作用,现将其与胃肠病疾病的研究进展综述如下.     

糖尿病病人胃肠运动功能障碍的胃肠动力学与胃肠激素研究

糖尿病病人胃肠运动功能障碍的胃肠动力学与胃肠激素研究李志芳，孙大裕，陆玮本研究试图通过对糖尿病病人进行胃肠测压，同时进行植物神经功能、血糖、血浆ＶＩＰ水平的测定，探讨糖尿病病人胃肠运动障碍的测压表现，血浆ＶＩＰ的改变。并初步了解血浆ＶＩＰ与糖尿病病人...     

胃肠起搏器治疗功能性便秘180例

[目的]探讨胃肠起搏器在功能性便秘治疗中的作用.[方法]应用WCH型胃肠起搏器对慢性功能性便秘患者进行体外胃肠起搏治疗,观察治疗前后腹胀、排便次数、粪便性状、排便完成时间及胃电图变化.[结果]治疗后患者腹胀、排便次数、粪便性状、排便完成时间均明显下降,症状的有效率为98.3%,腹胀总有效率为96.05%;治疗后胃电节律紊乱纠正率为77.9%.[结论]胃肠起搏对功能性便秘具有明显的治疗作用.     

肠清胶囊对实验动物胃肠动力的影响

目的 :研究肠清胶囊对实验动物胃肠动力的影响。方法 :将 2 4只大白兔随机分为 0 .9% Na Cl溶液对照组、甘露醇组、番泻叶组和肠清液组 ,测定给药前后的胃肠电活动。结果 :4组实验动物中 ,肠清液组的胃肠电振幅最强 ,与对照组比较 P <0 .0 5。结论 :肠清胶囊具有增强胃肠动力 ,促进排空肠腔内粪便的作用     

一九九八年中华医学会全国胃肠电及胃肠动力疾病学术会(包头)会议纪要

１９９８年７月３１日到８月２日在内蒙古包头市召开中华医学会全国胃肠电及胃肠动力疾病学术会。全国各地胃肠动力病专家共同主持了会议，与会代表２００余人，收到论文３００余篇，全国消化学会各位常委参加了会议。会议分功能性消化不良症（ＦＤ），胃食管反流病（ＧＥ...     

Ghrelin的胃肠动力学研究进展

Ghrelin是1999年被发现的生长激素促分泌激素受体的内源性配体,是胃动素相关类家族的调节肽。Ghrelin主要由胃基底部泌酸腺X/A样细胞分泌,并释放进入血液循环。它除了可以刺激生长激素、泌乳刺激素及促肾上腺皮质激素释放外,还可以促进食欲、增强胃肠动力、刺激胃酸分泌、影响睡眠节律、调节胰腺内分泌功能、调节糖代谢、能量代谢等。此文综述了Ghrelin在胃肠动力方面的研究进展。     

LPS+TNF-α致休克大鼠胃肠运动及屏障功能的改变

目的观察内毒素和肿瘤坏死因子(TNF)联合致休克模型大鼠胃肠运动功能改变及粘膜损伤的程度.方法采用Wistar ♂大鼠,用内毒素和人重组TNF-α联合致休克模型;将电极埋置在胃、十二指肠、空肠的浆膜面,记录大鼠的胃肠电活动,给大鼠灌胃碳末,测量碳末的推进速度,计数大鼠胃肠电快波频率(F)、振幅指数(AI)及碳末推进速度;取制膜后2h的肠系膜淋巴结、心、肝、脾、肺、肾和血进行细菌培养,观察肠道细菌的移位情况;制膜1h后给大鼠灌胃乳果糖/甘露醇混悬液,收集大鼠6h尿液,用高压液相技术测定尿中乳果糖和甘露醇含量,计算它们排出率之比,测定肠粘膜的通透性. 用χ2检验比较各组器官细菌感染率的不同,用t检验统计各组间其他各指标的差异,P＜0.05有显著性差异.结果①制模大鼠胃肠运动的改变:模型大鼠胃肠电活动明显抑制,快波的频率[Fre:胃电(1.32±0.30),十二指肠电(4.47±0.76),空肠电(4.07±1.25)次/min]及振幅指数[AI:胃电(13.70±3.23),十二指肠电(43.06±8.00),空肠电(30.79±7.49)μV/min]明显低于制模前[Fre:胃电(2.91±0.17) ,十二指肠电(17.52±2.43)空肠电(22.32±3.35)次/min;AI:胃电(26.18±3.45),十二指肠电(158.48±65.92),空肠电(149.12±27.52)μV/min],制模大鼠的肠推进速度明显低于正常大鼠(模型组vs 正常对照组:30.7%±3.6%vs 72.8%±3.9%,P＜0.05) ②制模大鼠肠粘膜通透性升高:乳果糖排泄率/甘露醇排泄率12.2±1.2明显高于正常对照组0.06±0.01, P＜0.05. 小肠组织蛋白中的二胺氧化酶活性降低[(0.04±0.04) vs (0.56±0.04)U/g]. 肠道细菌发生易位,易位率为100%,与正常对照组比较,P＜0.05.结论内毒素与TNF联合可制伴有明显胃肠功能障碍的休克模型.     

Electrical therapies for gastrointestinal motility disorders

Introduction: Gastrointestinal (GI) motility disorders are common in clinical settings, including esophageal motility disorders, gastroesophageal reflux disease, functional dyspepsia, gastroparesis, chronic intestinal pseudo-obstruction, post-operative ileus, irritable bowel syndrome, diarrhea and constipation. While a number of drugs have been developed for treating GI motility disorders, few are currently available. Emerging electrical stimulation methods may provide new treatment options for these GI motility disorders.

Areas covered: This review gives an overview of electrical therapies that have been, and are being developed for GI motility disorders, including gastroesophageal reflux, functional dyspepsia, gastroparesis, intestinal motility disorders and constipation. Various methods of gastrointestinal electrical stimulation are introduced. A few methods of nerve stimulation have also been described, including spinal cord stimulation and sacral nerve stimulation. Potentials of electrical therapies for obesity are also discussed. PubMed was searched using keywords and their combinations: electrical stimulation, spinal cord stimulation, sacral nerve stimulation, gastrointestinal motility and functional gastrointestinal diseases.

Expert commentary: Electrical stimulation is an area of great interest and has potential for treating GI motility disorders. However, further development in technologies (devices suitable for GI stimulation) and extensive clinical research are needed to advance the field and bring electrical therapies to bedside.     

Gastrointestinal electrical stimulation for treatment of gastrointestinal disorders: gastroparesis, obesity, fecal incontinence, and constipation

Electrical stimulation of the gastrointestinal (GI) tract is an attractive concept. Since these organs have their own natural pacemakers, the electrical signals they generate can be altered by externally delivering electric currents by intramuscular, serosal, or intraluminal electrodes to specific sites in the GI tract. This article reviews the advances in electrical stimulation of the GI tract by describing various methods of GI electrical stimulation and their peripheral and central effects and mechanisms; updating the status of GI electrical stimulation in the clinical settings of gastroparesis, obesity, fecal incontinence, and constipation; and predicting future directions and developments of GI electrical stimulation technology and their areas of possible clinical applications.     

Effect of explosive noise on gastrointestinal transit and plasma levels of polypeptide hormones

AIM: To investigate the effect of firing noise on gastrointestinal transit and probe its mechanism by measuring the levels of plasma polypeptide hormones. METHODS: A total of 64 SD rats were randomly divided into a control group and three stimulating groups. Firing noise of different intensity by sub-machine guns was used as inflicting factor. The effect of firing noise on liquid substance gastrointestinal transit and solid substance gastrointestinal transit was observed by measuring the ratio of carbon powder suspension transmitting and barium sticks transmitting respectively. Plasma levels of polypeptide hormones were measured by radio-immunoassay. RESULTS: The noise accelerated gastrointestinal transit of solid food by more than 80 db;and accelerated gastrointestinal transit of liquid food significantly by more than 120 db. Meantime, plasma levels of plasma motilin (MTL)(157.47±16.08; 151.90±17.08), somatostatin (SS)(513.97±88.77; 458.25±104.30), substance P (SP)(115.52±20.70; 110.28±19.96) and vasoactive intestinal peptide (VIP) (214.21±63.17; 251.76±97.24) remarkably changed also. CONCLUSION: Within a certain intensity range, the firing noise changes the levels of rat plasma gastrointestinal hormones, but the gastrointestinal transit is still normal. Beyond the range, the noise induces plasma hormone levels disturbance and gastrointestinal transit disorder.     

Connection between inflammation and carcinogenesis in gastrointestinal tract: Focus on TGF-β signaling

Inflammation is a primary defense process against various extracellular stimuli,such as viruses,pathogens,foods,and environmental pollutants.When cells respond to stimuli for short periods of time,it results in acute or physiological inflammation.However,if the stimulation is sustained for longer time or a pathological state occurs,it is known as chronic or pathological inflammation.Several studies have shown that tumorigenesis in the gastrointestinal (GI) tract is closely associated with chronic inflammati...     

Synchronous occurrence of gastrointestinal stromal tumors and other primary gastrointestinal neoplasms

INTRODUCTION Gastrointestinal stromal tumors (GISTs) are an un-common mesenchymal neoplasm affecting the GI tract. The synchronous occurrence of mesenchymal tumors and other primary gastrointestinal malignancies has been rarely reported in the literature[…     

急性逆行胃电刺激对肥胖患者胃容受性、胃排空和胃肠激素释放的影响

目的 观察急性逆行胃电刺激(RGES)对肥胖患者胃容受性、胃排空和胃肠激素释放的影响.方法 选取肥胖患者16例.第1天经胃镜放置胃黏膜电极,第2天进行液体餐负荷试验、标准固体餐胃排空试验,每次试验开始前30min及试验过程中给予RGES.标准固体餐胃排空试验前后检测血清瘦素、生长激素释放肽、抵抗素和肽YY.第3天给予假性刺激,通过自身对照比较急性RGES对相关指标的影响.结果 16例患者体重指数为(32.90±2.99)kg/m2.急性RGES明显减少患者达到饱感所进液体餐量[分别为(460±148)ml和(630±219)ml,t=-7.200,P＜0.01]和最大耐受程度进餐量[分别为(699±215)ml和(926±295)ml,t=-5.390,P＜0.01],对标准固体餐胃半排空时间、1h及2h标准固体餐存留率的影响分别为(109±26)min和(103±31)min,t=1.009,P=0.329;(63.37±9.75)%和(59.73±12.87)%,t=1.834,P=0.087;(42.22±13.97)%和(38.33±16.87)%,t=1.780,P=0.095.急性RGES后胃肠激素水平/刺激前水平和假性胃电刺激后水平/刺激前水平分别为瘦素(1.03±0.34和1.08±0.38,t=-0.386,P=0.705)、生长激素释放肽(0.99±0.11和0.98±0.12,t=0.413,P=0.685)、抵抗素(1.11±0.25和0.99±0.24,t=1.753,P=0.100)、肽YY(1.56±0.71和1.33±0.61,t=1.402,P=0.181).结论 急性RGES通过降低胃容受性显著减少肥胖患者的进食液体餐量,一定程度上减缓胃排空,但对相关胃肠激素释放无显著影响.

Abstract：

Objective To observe the effect of acute retrograde gastric electrical stimulation (RGES) on gastric accommodation,emptying and gastrointestinal hormones releasing in obese patients. Methods Sixteen obese patients were examined. On the first day,a pair of mucosal gastric electrodes was placed under endoscope. The liquid meal load test and the standard solid meal gastric emptying test were carried out on the second day. RGES was performed starting at 30 minutes before each test and through the whole testing process. The serum leptin,ghrelin,resistin and peptide YY were examined before and after the standard solid meal gastric emptying test. On the third day,sham stimulation was given. The effect of acute RGES on related index was compared by self-control.Results BMI of the 16 patients was (32. 90±2. 99) kg/m2. Acute RGES significantly reduced the liquid meal volume of fullness [(460±148) ml and (630±219) ml,t=-7. 200,P＜0. 01] and the maximal tolerable meal volume [(699±215) ml and (926±295) ml,t=- 5. 390,P＜0. 01]. The effects of RGES and sham RGES on half-emptying time of standard solid meal was (109±26) min and (103±31) min (t=1. 009,P= 0. 329);on the retention rate of standard solid meal at one hour and two hour was (63. 37±9. 75)% and (59. 73±12.87)% (t=1. 834,P= 0. 087),(42.22±13.97)%and (38. 33±16. 87)% (t= 1.780,P= 0. 095),respectively. The ratio of gastrointestinal hormones after and before the stimulation also of the sham stimulation,leptin was 1. 03±0. 34 and 1. 08±0. 38(t=-0.386,P=0. 705),ghrelin was 0. 99±0. 11 and 0. 98±0. 12 (t= 0. 413,P=0.685),resistin was 1. 11±0. 25 and 0. 99±0. 24 (t= 1. 753,P= 0. 100),and peptide YY was 1. 56±0. 71 and 1. 33±0. 61 (t=1. 402,P= 0. 181). Conclusions In obese patients,acute RGES significantly reduce the liquid meal volume by lower gastric accommodation,to certain extent which will delay gastric emptying. There is no significant influence on gastrointestinal hormones releasing.     

胃促生长素与消化道运动

胃促生长素(ghrelin)是新发现的内源性多肽,有促生长激素分泌和调节食欲、调节能量代谢的作用,它主要由胃底X/A样细胞分泌,广泛分布于胃和肠道组织,且与胃动素在结构上有高度相同性,故其与消化道运动的关系近来备受关注,现综合有关文献,对ghrelin与消化道运动的关系作一综述.     

Acupuncture treatment in gastrointestinal diseases： A systematic review

The purpose of this work was to assess the evidence for effectiveness of acupuncture （AC） treatment in gastrointestinal diseases. A systematic review of the Medline-cited literature for clinical trials was performed up to May 2006. Controlled trials assessing acupuncture point stimulation for patients with gastrointestinal diseases were considered for inclusion. The search identified 18 relevant trials meeting the inclusion criteria. Two irritable bowel syndrome （IBS） trials, 1 Crohn＇s disease and 1 colitis ulcerosa trial had a robust random controlled trial （RCT） design. In regard to other gastrointestinal disorders, study quality was poor. In all trials, quality of life （QoL） improved significantly independently from the kind of acupuncture, real or sham. Real AC was significantly superior to sham acupuncture with regard to disease activity scores in the Crohn and Colitis trials. Efficacy of acupuncture related to QoL in IBS may be explained by unspecific effects. This is the same for QoL in inflammatory bowel diseases （IBD）, whereas specific acupuncture effects may be found in clinical scores. Further trials for IBDs and in particular for all other gastrointestinal disorders would be necessary to evaluate the efficacy of acupuncture treatment. However, it must be discussed on what terms patients benefit when this harmless and obviously powerful therapy with regard to QoL is demystified by further placebo controlled trials.     

高血压脑出血与消化道出血的关系

目的 探讨高血压脑出血患者脑出血部位、出血量与消化道出血率及病死率的关系.方法 对540例脑出血患者,按脑出血部位、血肿量、有无脑室出血、中线结构移位,分别比较消化道出血率和病死率.结果 合并消化道出血132例（24.4%）,死亡112例（20.7%）.消化道出血发生率分别为脑叶出血组25.4%,小脑出血组17.6%,脑干出血组30.4%,蛛网膜下腔出血组36.7%,脑基底节区出血并脑室出血组37.0%和局限脑基底节区出血组11.5%;病死率脑叶出血组25.4%,小脑出血组11.8%,脑干出血组21.7%.蛛网膜下腔出血组30.0%,脑基底节区出血并脑室出血组35.2%、局限脑基底节区出血组6.9%.合并消化道出血组病死率48.5%,无消化道出血组病死率11.8%.结论 脑出血并消化道出血提示死亡率的增加.应毫不延误地积极治疗.     

Carbonic anhydrases in normal gastrointestinal tract and gastrointestinal tumours

Carbonic anhydrases (CAs) catalyse the hydration of C02 to bicarbonate at physiological pH. This chemical interconversion is crucial since HCO3- is the substrate for several biosynthetic reactions. This review is focused on the distribution and role of CA isoenzymes in both normal and pathological gastrointestinal (GI) tract tissues. It has been known for many years that CAs are widely present in the GI tract and play important roles in several physiological functions such as production of saliva, gastric acid, bile, and pancreatic juice as well as in absorption of salt and water in intestine. New information suggests that these enzymes participate in several processes that were not envisioned earlier. Especially, the recent reports on plasma membrane-bound isoenzymes IX and XII have raised considerable interest since they were reported to participate in cancer invasion and spread. They are induced by tumour hypoxia and may also play a role in von Hippel-Lindau (VHL)-mediated carcinogenesis.