运脾颗粒对脾虚型慢传输型便秘小鼠SP和VIP含量的影响

为观察运脾颗粒对脾虚型慢传输型便秘小鼠肠道传输功能及结肠组织中P物质（sP）和血管活性肠肽（VIP）含量的影响,探讨运脾颗粒治疗脾虚型慢传输型便秘的药效与机制,为该药治疗便秘提供科学依据。采用复合造模法建立小鼠脾虚型慢传输型便秘模型,将小鼠分为空白对照组（A组）、模型对照组（B组）、麻仁对照组（c组）、运脾颗粒大剂量组（D组）、运脾颗粒中剂量组（E组）、运脾颗粒小剂量组（F组）,分别灌服相应药物,末次灌胃后测量肠道墨汁推进率;按放射免疫试剂盒方法分别测出结肠组织匀浆中SP、VIP的含量。结果显示,运脾颗粒能明显提高小鼠肠道传输功能,D组效果优于C组（P〈0．05）。运脾颗粒可明显增加便秘模型小鼠结肠组织中SP及VIP的含量,D、E、F组均优于c组（P〈O．05）,D组最明显（P〈0．01）。结果表明,运脾颗粒能明显提高小鼠肠道传输功能,且各项指标均优于C组（P〈0．05）,其机制可能是通过升高慢传输型便秘小鼠结肠中SP及VIP的含量来提高肠道传输功能。     

结肠慢传输型便秘与突触素和 P物质及血管活性肠肽的临床研究

目的探讨突触素(synapses,SY)、P物质(substanceP,SP)和血管活性肠肽(vasoactiveintestinepolypeptide,VIP)在结肠慢传输型便秘(slowtransitconstipation,STC)中的变化及病理学意义。方法应用免疫组织化学技术和病理显微镜分析图像系统,在中倍光镜下计算22例STC患者(STC组)和12例非梗阻性结直肠癌患者(对照组)的阳性染色区域的面积并进行对比。结果STC组患者结肠内SY、VIP和SP镜下阳性面积均较对照组明显减少。STC组和对照组SY分别为[(1.53±0.92)×105]μm2和[(3.33±1.09)×105]μm2;两组比较,P<0.001。SP分别为[(1.41±0.85)×105]μm2和[(2.22±1.31)×105]μm2,两组比较,P<0.05。VIP分别为[(1.22±0.72)×105]μm2和[(2.14±1.35)×105]μm2,两组比较P<0.05。结论STC患者存在肠神经系统突触功能障碍,从而导致肠神经递质下降。     

Reporting colonic mucosal biopsies in inflammatory conditions: a new approach

There may be considerable difficulty in making a definitive diagnosis in colitis from histopathology alone. This study is based on a well-tried system which has been used for 15 years in the University Hospital of South Manchester for the reporting of colonic biopsies. The varieties of histopathological pattern seen in colitis are described and the study shows how they can be used to refine diagnosis when good communication is maintained between the clinician and the histopathologist. The histopathology report is based on describing histological patterns rather than diagnoses but includes a differential diagnosis. The pathology report will allow the clinician together with the known clinical information to make an appropriate management decision. Ideally the final diagnosis is reached at a clinico–pathological conference.     

急性胰腺炎导致家兔Oddi括约肌一氧化氮合成酶和血管活性肠肽阳性神经细胞的减少

目的探讨Oddi括约肌中神经细胞的变化与重症急性胰腺炎（SAP）之间的关系。方法通过牛磺胆酸钠灌注的方式制备兔急性胰腺炎模型。采用免疫组化方法检测一氧化氮合成酶（NOs）和血管活性肠肽（vIP）在Oddi括约肌神经细胞中的表达。结果对照组肌间神经丛神经细胞的（45．83±2．17）％为NOS阳性细胞,（52．46±2．47）％为VIP阳性细胞,（22．73±1．95）％的神经细胞NOS和VIP均呈阳性表达。SAP组肌间神经丛神经细胞的（11．26±0．93）％为NOS阳性细胞,（28．62±2．83）％为VIP阳性细胞。SAP组的NOS和VIP阳性神经细胞的比例均明显低于对照组伊〈0．01）。结论NOS和VIP阳性神经细胞大量存在于Oddi括约肌;SAP时NOS及VIP阳性神经细胞比例均降低,可能是SAP时Oddi括约肌活动能力降低的原因。     

大鼠盆神经节NOS和VIP阳性神经元对阴茎海绵体的支配

目的：研究大鼠盆神经节(MPG)中一氧化氮合酶(NOS)、血管活性肠肽(VIP)阳性神经元对阴茎海绵体的支配。方法：应用辣根过氧化物酶(HRP)逆行示踪技术结合免疫组织化学和酶组织化学双标技术,观察大鼠MPD中还原型辅酶Ⅱ(NADPFI,NOS标志物)阳性和VIP阳性神经元对阴茎海绵体的支配。结果：HRP阳性标记神经元主要分布于MPG内靠近阴茎神经的区域。HRP阳性标记神经元中72％(210／292)为VIP免疫阳性,83％(268／323)为NADPH组化反应阳性。结论：大鼠盆神经节中NOS、VIP阳性神经元对阴茎海绵体有直接支配,NO和VIP作为神经递质或调质参与了阴茎勃起。     

Segmental colonic transit studies: comparison of a radiological and a scintigraphic method

OBJECTIVE: Colonic transit studies are used to diagnose slow transit constipation (STC) and to evaluate segmental colonic transit before segmental or subtotal colectomy. The aim of the study was to compare a single X-ray radio-opaque marker method with a scintigraphic technique to assess total and segmental colonic transit in patients with STC. METHOD: Thirty-one female patients (median age 46 years) with severe constipation and a prolonged or borderline prolonged colonic transit time on radio-opaque marker study were included in the study. They were subsequently investigated with (111)Indium-DTPA colonic transit scintigraphy, with a median time between the investigations of 4(range 1-27) months. Normal values of healthy female controls were used for comparison. RESULTS: There was no difference between the two methods in terms of prolonged or normal total colonic transit time. Twenty-nine of 31 female patients had a prolonged transit time only in one or two segments on the marker study. On scintigraphy, the transit time was prolonged for patients in the left (P < 0.05 to P < 0.001), but not in the right colon. With respect to prolonged or normal segmental transit time, there was a significant difference between the two methods only in the descending colon (P = 0.02). However, the results varied considerably for individual patients. CONCLUSION: Segmental colonic delay was a common finding. The two methods gave similar results for groups of patients, except in the descending colon. The variation of the results for individuals suggests that a repeated transit test may improve the assessment of total and segmental transit.     

Laparoscopic Nissen fundoplication in children: a single surgeon's experience.

BACKGROUND AND OBJECTIVES: Adult laparoscopic Nissen fundoplication has been steadily growing since its introduction to the United States in the 1990s. Its advantage over the traditional open approach is manifold. Application of laparoscopic fundoplication to children is slowly but surely following this trend. This study evaluates our initial experience with pediatric laparoscopic Nissen fundoplications. PATIENTS AND METHODS: We reviewed the records of 25 consecutive laparoscopic Nissen fundoplications performed by a single surgeon (GS) at our institution in the past three years. The patient ages ranged from 7 months to 18 years (mean, 7 years). All patients had documented gastroesophageal reflux disease. Complications from the reflux included vomiting in 15 patients, failure to thrive in nine, esophagitis in nine, and pulmonary symptoms in six. RESULTS: All Nissen fundoplications were performed laparoscopically without need for conversion to open technique. Blood loss was less than 50 cc in all cases. A tube gastrostomy was concurrently performed in 17. Mean operative time in all cases was 221 minutes. Average postoperative day on which feedings were begun was day 2, with an average resumption of regular feedings on postoperative day 3.5. Average date of discharge was postoperative day 6.8. Complications included difficulty controlling glucose in an insulin-dependent diabetic, and a lost needle, which added an additional hour to the operative time. There were eight admissions to the pediatric intensive care unit, all for observation secondary to their underlying medical problems. There was one postoperative death due to an underlying medical condition. CONCLUSIONS: Laparoscopic Nissen fundoplication is a safe and effective treatment option for children suffering from significant reflux. Time to regular feeding, analgesia requirements and hospital stay are decreased when compared to traditional procedures. Laparoscopic Nissen fundoplication may well become the procedure of choice for pediatric gastroesophageal reflux disease.     

腹腔镜、结肠镜联合手术治疗结肠息肉25例报告

目的:探讨腹腔镜、结肠镜联合治疗结肠息肉的安全性和可行性。方法:为25例无法用结肠镜切除的结肠息肉患者联合应用腹腔镜、结肠镜治疗。结果:25例患者均顺利完成手术,无中转开腹。手术时间40~150min,平均(70±15.62)min;术中出血10~40ml,平均(30±2.34)ml;肠功能恢复时间20~30h,平均(28±2.66)h;住院5~8d,平均(7±0.95)d。术后无并发症发生。随访8~14个月未见复发。结论:应用腹腔镜联合结肠镜治疗结肠镜无法切除的结肠息肉,提高了手术的安全性和彻底性。