大黄素对肠黏膜屏障损伤的保护作用及机制研究

目的观察大黄素对大鼠肠缺血再灌注（IR）肠黏膜屏障功能的影响。方法 48只雄性SD大鼠,随机分为假手术（S）组、模型（IR）组、模型＋生理盐水（IRS）组和模型＋大黄素（IRE）组。IRE组给予40mg/（kg.d）大黄素灌胃,IRS组给予等量生理盐水灌胃,连续7 d,于第7天给药2 h后,制备肠缺血再灌注模型。光镜和透射电镜下分别观察各组小肠病理改变和紧密连接损伤,并进行Chiu’s评分。用TUNEL法检测肠黏膜细胞凋亡指数,Western Blot半定量法测定肠黏膜Claudin-1、Occludin蛋白含量。结果 IRE组与IR组、IRS组相比,小肠病理损伤和紧密连接结构破坏明显减轻,Chiu’s评分降低（P〈0.05）,细胞凋亡指数降低（P〈0.05）,两种连接蛋白Claudin-1、Occludin含量增加（P〈0.05）。结论大黄素可以缓解肠缺血再灌注造成的肠道损伤、减少肠黏膜细胞凋亡、保护肠上皮细胞间紧密连接,对肠黏膜屏障具有保护作用。     

口服药物在胃肠道内的相互作用

通过分类说明，介绍口服药物在胃肠道内可能发生的相互作用，系统回顾以往熟知的相互作用，如吸附、络合、沉淀作用等，通过改变胃肠道蠕动或胃肠道pH值，影响合并用药的吸收；同时介绍了近年来引起人们重视的新的药物相互作用，为临床合理用药提供参考。     

四君子汤对无水乙醇诱导的小鼠急性胃肠黏膜损伤的保护作用

目的 研究四君子汤对乙醇诱导的小鼠急性胃肠黏膜损伤的保护作用。方法 将60只小鼠随机分为6组：对照组、模型组、奥美拉唑（阳性药,4 mg·kg^-1）组和四君子汤低、中、高剂量（4、6、8 g·kg^-1）组,每组10只,连续ig给药14 d后,在造模前全部小鼠禁食禁水24 h,末次给药1 h后,除对照组外,其余各组小鼠每只ig无水乙醇10 mL·kg^-1诱发急性胃肠黏膜损伤。造模1 h后,脱颈椎处死小鼠后开腹,取出胃及十二指肠,观察胃黏膜的损伤情况并拍照,分析小鼠胃黏膜损伤分数、治疗指数;HE染色观察胃及十二指肠黏膜病理组织学变化;试剂盒法检测血清丙二醛（MDA）、总超氧化物歧化酶（SOD）水平; Westernblotting法检测胃肠组织白细胞介素-1β （IL-1β）、白细胞介素-10 （IL-10）和肿瘤坏死因子-α （TNF-α）蛋白表达水平。结果 胃黏膜损伤评价结果显示,与对照组比较,模型组小鼠胃黏膜有明显出血带;与模型组比较,各用药组小鼠胃黏膜损伤有不同程度的改善,损伤分数均显著降低（P＜0.05、0.001） ,四君子汤高剂量组治疗效果最好,治疗指数达到72.54%,与阳性药奥美拉唑治疗效果相当。HE染色结果显示,模型组小鼠胃及十二指肠腺体排列紊乱,黏膜上皮细胞大量坏死、脱落,四君子汤发挥明显改善作用。与模型组比较,四君子汤中、高剂量组以及奥美拉唑组小鼠血清中MDA水平显著下降（P＜0.001）、SOD活性显著升高（P＜0.05、0.001）,胃及十二指肠组织IL-1β、TNF-α蛋白表达显著下降（P＜0.05、0.01、0.001）,IL-10蛋白表达显著增加（P＜0.01）。结论 四君子汤可能通过抑制炎症和抗氧化应激反应对乙醇诱导的小鼠急性胃肠黏膜损伤发挥保护作用。     

Protective effects of prostaglandins against nonsteroidal anti-inflammatory drug-induced gastrointestinal mucosal injury

Nonsteroidal anti-inflammatory drugs (NSAIDs) are an integral part of the therapy of rheumatic diseases. All NSAIDs have the potential to cause damage to the gastrointestinal (GI) tract and have been implicated as a cause of peptic ulceration and massive life-threatening bleeding, often without warning symptoms. The basis of the damaging actions of NSAIDs on the GI tract is believed to be a consequence of two events: depletion of endogenous prostaglandins (PGs) and a direct damaging action on the mucosal integrity. Current evidence indicates that PGs play an important role in maintaining the integrity of the GI tract against ulcerogenic stimuli and are therefore ideally suited to counteract the NSAID-induced deleterious actions on the mucosa. With the exception of synthetic prostaglandins, the current therapeutic interventions used for the treatment of NSAID injury are not ideal. Misoprostol, a synthetic E-prostaglandin analogue, has been found to prevent and heal GI lesions induced by NSAIDs. The basis for the protective effect of prostaglandins is a consequence of their gastric antisecretory and mucosal protective properties. The mucosal protective effects of misoprostol are multifactorial and include, in part, the stimulation of mucus and bicarbonate secretion, an increased or sustained mucosal blood flow and the stabilization of the barrier function of the stomach. Misoprostol represents a major new advance in our therapeutic armamentarium for the treatment and prevention of NSAID-induced GI mucosal injury.     

Effects of erythromycin on the propulsive motility of upper gastrointestinal tract in rats

The differences between the postprandial mixing or propulsion and the interdigestive motility of the gastrointestinal (GI) tract are already known. Earlier studies showed dose-dependent differences in the effects of erythromycin on interdigestive motility. The various GI side-effects (vomiting, diarrhoea) also suggest that there are different effects of erythromycin on the GI motility. The aim of our study was to examine postprandially the propulsive effects of different doses of erythromycin on the movement of intraluminal contents in the upper GI tract of the rat. The animals were fasted for 24 h before the experiments but water was given freely. The rats received 1.5 ml 1.5% methylcellulose painted with 0.05% phenol-red intragastrically (test solution). Erythromycin(E. lactobionate) was given intravenously at doses of 0.05, 0.1, 0.25, 0.5, 1.0 and 5.0 mg/kg 15 min before the administration of a test solution. The animals were sacrificed 20,60 and 120 min after administration of methylcellulose, when the distance between the front of the painted intraluminal contents and the pylorus was measured and expressed as a percentage of the total length of small intestine. The phenol-red content in the stomach and small intestine was measured spectrophotometrically and the gastric emptying was calculated from the ratio of the measured total and intestinal phenol-red content. Our results showed that the small doses of erythromycin (0.1 and 0.25 mg/kg) accelerated gastric emptying after 20 min but did not change significantly the propulsive motility of upper small intestine; however, large doses of erythromycin (1.0 and 5.0 mg/kg) decreased gastric emptying and upper GI motility after 20 and 60 min. In summary, the prokinetic action of small doses of erythromycin was demonstrated, but its effecttime on GI motility is short and the ratio of the stimulating and inhibitory doses is 1:10. This paper was presented at the Section of IUPHAR GI Pharmacology Symposium on ’Biochemical pharmacology as an approach to gastrointestinal disorders (basic science to clinical perspectives)‘, October 12-14, 1995, Pécs, Hungary.     

大黄素对胃肠道黏膜损伤保护作用的机制研究进展

大黄素是一种蒽醌衍生物,具有抑菌、抗炎、抗纤维化、保护胃肠道黏膜屏障等功效。大黄素能通过多种作用机制对胃肠道黏膜产生保护作用,具体体现在其可减少缺血后再灌注损伤、抑制炎症的产生、清除或抑制氧自由基、调节胃肠道内分泌、促进损伤后修护、保护细胞间紧密连接等,研发以大黄素为主要成分的新型胃肠道黏膜保护剂,可为胃肠道黏膜损伤性疾病的治疗提供新的治疗手段。     

Sense of taste in the gastrointestinal tract

Recent advances in molecular biology have led to the investigation of the molecular mechanism by which chemicals such as odors and tastants are perceived by specific chemosensory organs. For example, G protein-coupled receptors expressed within the nasal epithelium and taste receptors in the oral cavity have been identified as odorant and taste receptors, respectively. However, there is much evidence to indicate that these chemosensory receptors are not restricted to primary chemosensory cells; they are also expressed and have function in other cells such as those in the airways and gastrointestinal (GI) tract. This short review describes the possible mechanisms by which taste signal transduction occurs in the oral cavity and tastants/nutrients are sensed in the GI tract by taste-like cells, mainly enteroendocrine and brush cells. Furthermore, it discusses the future perspectives of chemosensory studies.     

阿昔洛韦在大鼠胃肠道吸收的研究

目的：了解阿昔洛韦在大鼠胃肠道的吸收情况。方法：采用大鼠在体灌流技术，对阿昔洛韦在大鼠胃部及不同肠段的吸收进行了研究。结果：3h后胃中吸收平均值为9．46％，在小肠上部、中部、下部和结肠段的吸收百分率分别为20．22％，15．70％，9．15％和4．59％。结论：阿昔洛韦主要在胃肠道上部吸收，但吸收亦较差。     

小儿静脉滴注红霉素时胃肠道副反应的防治

目的:比较磷酸铝凝胶、蒙脱石散剂对小儿红霉素静滴时胃肠道副反应的防治效果.方法:249例支原体肺炎患儿,随机分为磷酸铝凝胶治疗组、蒙脱石散剂治疗组和对照组各83例,观察三组在红霉素静滴时胃肠道副反应(包括腹痛、腹泻、恶心、呕吐)的发生情况.结果:磷酸铝凝胶和蒙脱石散剂治疗组红霉素静滴后胃肠道副反应发生率明显低于对照组(P＜0.01),磷酸铝凝胶治疗组的发生率较蒙脱石散剂治疗组更低(P＜0.05).三组的治疗效果无明显差别(P＞0.05).结论:磷酸铝凝胶、蒙脱石散剂可明显减少红霉素静脉滴注时的胃肠道副反应而不影响其疗效,尤以磷酸铝凝胶的效果显著,可广泛用于临床实践.     

Rhythm of digestion: keeping time in the gastrointestinal tract

1. The best characterized mammalian circadian rhythms follow a light-entrained central master pacemaker in the suprachiasmatic nucleus and are associated with fluctuations in the activities of clock genes, including Clock , Bmal1 , Per and Cry , the products of which bind to sequences in the promoters of effector genes. This is the central clock.
2. In the present review, we discuss evidence for an independent, but interacting, gut-associated circadian clock, the peripheral clock, which is entrained by food.
3. Disruption of circadian rhythms is associated with a wide range of pathologies, most prominently metabolism linked, but the effects of disruption of circadian rhythms on the digestive system are less well studied, although also likely to lead to functional consequences. There are clues suggestive of links between gastrointestinal disorders related to inflammation, cancer and motility and disruption of peripheral rhythms. Research aimed at understanding these links is still in its infancy.
4. We also discuss practical aspects of the presence of circadian rhythms in gastrointestinal tissues for researchers related to experimental design, data interpretation and the choice of animal models.
5. There is currently sufficient evidence to suggest that circadian rhythms are important to gut function, metabolism and mucosal defence and that further investigation will uncover connections between disordered rhythms and gastrointestinal malfunction.     

急诊内镜下清除上消化道异物的治疗效果分析

目的探讨应用内镜清除急诊消化道异物患者的临床效果。方法选取本院2012年1月～2013年6月收治的94例上消化道异物患者作为研究对象,按患者的人院顺序分为观察组和对照组,每组47例,对照组采用常规模式下的内镜治疗方案,观察组采用急诊内镜下清除上消化道异物的治疗方案,比较两组的治疗效果、治疗时间和不良反应发生率。结果观察组的总有效率为100．0％,明显高于对照组的93．6％,差异有统计学意义（P〈0．05）。观察组的治疗时间为（9．08±1．82）h,短于对照组的（15．72±2．01）h,差异有统计学意义（P〈0．05）。观察组的不良反应发生率低于对照组,差异有统计学意义（P〈0．05）。结论急诊内镜下清除上消化道异物的治疗方案能有效提高治疗效果,缩短患者的治疗时间,降低不良反应发生率,值得临床推广应用。     

类胰升血糖素肽—1免疫细胞在大鼠和胎儿胃肠道的分布

为了研究类胰升血糖素肽－１免疫细胞在大鼠和胎儿胃肠道中的分布情况,应用免疫组织化学ＡＢＣ法,对大鼠和胎儿胃肠道中ＧＬＰ－１进行研究。结果表明,大鼠胃肠道中ＧＬＰ－１免疫细胞密度最大的是回肠,其次是结肠和直肠,月台 儿胃肠道中ＧＬＰ－１免疫细胞密度最大的是直肠,其次是结肠和回肠。     

Distribution of substance P in the rat gastrointestinal tract — Lack of effect of capsaicin pretreatment

A new method for extraction of immunoreactive substance P (I-SP) from rat intestine including pulverization of tissue frozen in liquid nitrogen and extraction with acid acetone is described. Using this method, amounts of I-SP in the rat intestine were found to be higher than previously reported. The highest concentrations of I-SP were found in the small intestine. Capsaicin pretreatment of newborn or adult rats had no effect on intestinal I-SP concentrations indicating that intrinsic SP neurones are capsaicin-insensitive.     

水飞蓟素磷脂酰胆碱复合物对实验性肝损伤的保护作用

目的:观察水飞蓟素磷脂酰胆碱复合物(SIL-PC)对3种肝损伤模型小鼠肝功能的影响,并与水飞蓟素(SIL)进行比较.方法:采用CCl4,D-Galn及免疫性肝损伤模型,以AST及ALT为指标,观察SIL-PC对肝损伤小鼠的保肝效应.结果:SIL-PC可剂量依赖性降低CCl4致肝损伤小鼠血清AST和ALT活性.对D-Galn致肝损伤小鼠,800mg·kg-1 SIL-PC分别使肝损伤小鼠血清AST和ALT活性下降约61%和43%,与模型组比较,P＜0.01.在免疫性肝损伤模型,SIL-PC 100～800mg·kg-1剂量依赖性降低血清AST,ALT活性,且相同剂量的SIL-PC作用明显强于SIL.结论:SIL-PC对小鼠肝损伤有明显的保护作用,且其保护作用明显强于SIL.     

水飞蓟素抗肿瘤作用及其机制研究进展

水飞蓟素是从植物水飞蓟种子中提取得到的一类生物活性成分,含65%～80%黄酮木脂素(或称水飞蓟素混合物)、少许黄酮、20%～35%脂肪酸和一些多酚。水飞蓟素除用于治疗肝炎和肝硬化等肝脏疾病外,对前列腺癌、皮肤癌、膀胱癌、肺癌和结肠癌等具有抑制作用。近年研究发现,水飞蓟素抗肿瘤的作用机制与其调节细胞周期、诱导细胞凋亡及抑制新生血管形成等作用有关。另外,水飞蓟素具有抗炎、抗肿瘤转移及抗氧化活性,与抗肿瘤药物具有协同增效作用。     

FOLFOX4方案治疗晚期胃肠道肿瘤临床观察

目的观察FOLFOX4化疗方案治疗晚期胃肠道肿瘤的疗效和毒性反应。方法36例晚期胃肠道肿瘤患者，其中胃癌16例，结直肠癌20例。给予奥沙利铂（L-OHP）85mg／m2静脉滴注2h，第1天；亚叶酸钙（CF）200mg／m^2。静脉滴注，2h，第1、2天；氟尿嘧啶（5-FU）400mg／m^2，静脉推注，第1、2天，5-FU600mg／m^2微泵持续静脉滴注，22h，第1、2天，2周重复，4周为1个周期。2个周期后以WHO评价标准评价疗效和毒性。结果总有效（CR＋PR）率为44．6％，其中胃癌总有效率为37．5％，结直肠癌总有效率50％，两组比较差异无统计学意义（P〉0．05），中位缓解时间7．4个月，中位生存期11．4个月，1年生存率为50％。主要毒副反应为急性造血系统，感觉神经毒性和胃肠道反应，对症治疗均能耐受。结论FOLFOX4方案治疗晚期胃肠道肿瘤有提高总生存率的趋势，但远期生存率和后期并发症尚需进一步观察。     

Surgical vagotomy enhances the Indomethacin–Induced gastrointestinal mucosal damage in rats

Karádi O, Bódis B, Király á, Abdel-Salam OME, Sütō G, Vincze á, Mózsik Gy. Surgical vagotomy enhances the indomethacin-induced gastrointestinal mucosal damage in rats. Inflammopharmacology. 1994;2:389-399. Indomethacin (IND)-induced gastrointestinal mucosal lesions and changes of vascular permeability were studied in rats with and without acute bilateral surgical vagotomy. The aims of study were (a) to compare IND-induced mucosal lesions in the stomach, small intestine and large bowel of rats with intact vagus and acute surgical vagotomy and (b) to evaluate the changes of vascular permeability following these treatments. The gastrointestinal (GI) mucosal damage was produced by IND (20 mg/kg s.c.) at 24 and 48 h after IND administration. Sham operation (laparotomy alone) or surgical vagotomy alone was carried out in control animals. The number and severity of GI mucosal damage was determined. The changes of mucosal vascular permeability were determined by Evans Blue assays in the GI mucosa and in the contents of stomach, small intestine and colon. Evans Blue was given into the tail vein at 15 min before the killing of animals. It was found that (a) no ulceration and change in mucosal vascular permeability was found in any parts of GI tract after sham operation or surgical vagotomy (without IND); (b) IND caused mucosal injury coincidental with vascular permeability in the stomach and small intestine, but not in the large bowel; (c) surgical vagotomy aggravated the IND-induced mucosal damage and increased vascular permeability in the stomach and small intestine, but not in the colon. In conclusion, the intact vagal nerve is required for the prevention of gastric and small intestinal mucosa to protect against IND injury.     

腹腔镜下生物胶治疗上消化道急性穿孔

目的 评价腹腔镜下生物胶治疗上消化道急性穿孔的有效性和安全性。方法 回顾性分析17例上消化道急性穿孔的病例资料。结果 本组病例无死亡、手术效果好。结论 腹腔镜下生物胶治疗上消化道急性穿孔具有创伤小、美观、术后恢复快，值得推广。