槟榔对功能性消化不良模型大鼠胃运动的影响

目的：观察槟榔对功能性消化不良（FD）模型大鼠胃平滑肌运动的影响。方法：夹尾刺激复制FD模型，采用应变片传感器整体记录方法，测定FD模型大鼠胃运动并与正常对照鼠比较，以鉴定模型的合理性；测定高浓度槟榔煎液（100％）和低浓度槟榔煎液（25％）对FD模型大鼠胃运动振幅和频率的影响。结果：模型组大鼠空腹和灌注0．85％氯化钠溶液后与对照组比较，胃运动频率明显下降（P＜0．01），振幅减弱（P＜0．05），两种浓度槟榔煎液均可显著增强FD大鼠胃收缩振幅指数，而对FD大鼠胃运动频率无明显影响（P＞0．05）。结论：造模符合FD病理生理特点，槟榔有显著的促FD大鼠胃平滑肌收缩的作用，主要增强收缩振幅。     

功能性消化不良肝郁模型大鼠、胃排空障碍与胃平滑肌超微结构的关系

[目的]探讨功能性消化不良（FD）大鼠胃排空障碍与胃平滑肌细胞及Cajal间质细胞（ICC）超微结构的关系。[方法]运用夹尾刺激法制备FD肝郁动物模型,采用定量方法观察模型大鼠胃排空情况,用透射电镜观察其胃平滑肌超微结构的变化。[结果]模型组日饮水量、进食量[（50．56±5．04）m1,（19．86±2．14）朗比正常组[（55．79±2．67）ml,（23．14±1．05）胡明显减少,而胃内色素残留率（30．15±3．12）％比正常组（2．30±1．88）％明显增加（P〈0．05）。胃平滑肌细胞之间及平滑肌细胞与ICC之间的缝隙连接松弛,ICC数目减少。[结论]FD肝郁模型大鼠胃平滑肌超微结构的变化,可能是导致FD胃动力减慢的重要原因。     

平胃消导胶囊对功能性消化不良模型大鼠胃电活动和胃肠激素的影响

[目的]观察平胃消导胶囊对情志刺激引起的功能性消化不良（FD）模型大鼠胃电活动和胃肠激素水平的影响,探讨其可能的作用机制。[方法]将实验大鼠随机分为6组：空白对照组,模型组,多潘立酮药物对照组,平胃消导胶囊大、中、小剂量组。除空白对照组外,其余各组用夹尾激怒法复制FD大鼠模型,观察和对比各组大鼠胃窦消化间期综合肌电（IMC）活动,检测血浆胃动素（MOT）和血管活性肠肽（VIP）水平,并以此评价药物疗效。[结果]与模型组相比,平胃消导胶囊治疗组IMC周期缩短（P〈0．05,〈0．01）、Ⅲ相时程延长（P〈0．01）、Ⅲ相发生率增高（P〈0．05,〈0．01）,血浆MOT水平升高（P〈0．05,〈0．01）,VIP水平降低（P〈0．01）。[结论]平胃消导胶囊可增强FD模型大鼠胃电活动,恢复性调节MOT、VIP）水平,表现出良好的整体调节和促进胃排空作用。加大剂量治疗效果更好,是治疗FD疗效确切的中药制剂。     

调中颗粒对胃肌间Cajal间质细胞功能及数量的影响

[目的]观察功能性消化不良（FD）大鼠胃肌间Cajal间质细胞（ICC）超微形态结构、分布特点和密度变化,探讨调中颗粒治疗FD的机制。[方法]将40只大鼠随机分为5组,各8只,除正常组外,其余采用夹尾法制备FD模型,胃电图的方法检测造模是否成功,电镜观察胃肌间ICC的超微结构。酪氨酸激酶受体c-kit免疫组化法观察不同药物治疗后胃肌间阳性ICC的分布和水平变化。[结果]模型组大鼠胃电参数低于正常组（P〈0．05）;ICC的超微结构证实ICC与胃平滑肌运动具有密切相关性;调中颗粒能明显升高胃窦ICC水平（P〈0．05）,优于多潘立酮（P〈0．05）。[结论]调中颗粒能通过调节ICC的分布和数量,升高胃窦ICC的表达,促进胃蠕动,改善FD大鼠胃电节律。调中颗粒疗效优于半夏泻心汤和多潘立酮,具有整体调节作用。     

肥大细胞在胃感觉过敏患者胃黏膜中的改变

目的：了解国人功能性消化不良（FD）患者是否存在胃机械感觉过敏，对胃感觉过敏患者胃黏膜肥大细胞数量及脱颗粒情况进行研究，探讨肥大细胞在胃感觉过敏中的作用。方法：运用电子恒压器测定40例FD患者和15例正常人的胃感觉阈值。根据感知阈值将23例FD患者分为两组：感觉正常组（FD－N）和感觉过敏组（FD－H）。免疫组化方法染色肥大细胞，计数肥大细胞数；图像分析了解肥大细胞在扩张刺激前后平均吸光度值（A）的变化；电镜观察大细胞超微结构改变。结果：FD患者对胃机械扩张刺激的感知阈值，不适阀值，疼痛阈值均较正常人显著下降（P＜0．01，P＜0．01，P＜0．05），感觉过敏感患者近端胃黏膜肥大细胞数量明显多于FD－N组和对照组（P＜0．05）。刺激前后感觉过敏患者肥大细胞平均A值减少百分数较FD－N组和对照组明显增多（P＜0．05），电镜观察到肥大细胞与神经末梢关系密切，肥大细胞释放的颗粒有向神经末梢靠扰趋势。结论：部分FD患者存在胃机械感觉过敏；胃感觉过敏与胃黏膜肥大细胞数量增多，脱颗粒增加有关。     

小陷胸汤治疗功能性消化不良的实验研究

[目的]探讨小陷胸汤对功能性消化不良（FD）模型大鼠的作用机制。[方法]采用不规则喂养配合夹尾刺激法建立FD大鼠模型，予以小陷胸汤水煎液灌胃治疗。观测大鼠胃固体排空率，检测胃组织内一氧化氮（NO）及血浆胃动素（MOT）水平，并与空白对照组、模型对照组和多潘力酮组进行比较。[结果]小陷胸汤能明显升高胃排空率（P〈0．05），与多潘力酮等效（P〉0．05）；能显著降低胃组织NO水平，且优于多潘力酮（P〈0．01）；能明显升高血浆MOT水平（P〈0．05），与多潘力酮等效（P〉0．05）。[结论]小陷胸汤能提高FD大鼠胃固体排空率；减轻NO对胃排空的抑制；增强MOT水平，促进胃排空。在降低胃组织NO方面明显优于多潘力酮。     

胃祺Ⅱ号方治疗功能性消化不良疗效观察及对大鼠胃排空的影响

目的：观察胃祺Ⅱ号方治疗功能性消化不良（FD）的临床疗效和对大鼠胃排空的影响。方法：收集FD患68例，随机分为治疗组（37例）和西沙比利对照组（31例），观察其临床疗效；同时观察该方对大鼠酚红胃排空的影响。结果：胃祺Ⅱ号方和西沙必利的总有效率分别为89．19％和83．87％，无统计学差异（P＜0．05）；本方能改善FD各主要临床症状，且无不良反应；随访中药组无一例复发，显优于西药组（复发率33．33％）（P＜0．05）。该方能促进大鼠胃酚红排空，较对照组有显差异（P＜0．05）。结论：胃祺Ⅱ号方能有效改善FD各主要症状，近期疗效显，远期疗效可靠。该方能显促进胃排空，改善胃运动功能。     

肝胃不和型功能性消化不良大鼠胃动素和P物质的表达及中药情志舒的干预作用

目的：观察肝胃不和型功能消化不良（FD）大鼠胃和十二指肠运动功能、血浆胃动素（MOT）含量和胃肠壁P物质（SP）的表达，探讨肝胃不和型FD的发病机制及中药情志舒治疗肝胃不和型FD的可能机制。方法：将64只大鼠随机分为对照组，模型组，多潘立酮组及情志舒组；应力传感器记录大鼠胃和十二指肠移行性复合运动（MMC）；放免法测定大鼠血浆MOT含量；PAP免疫组化法观察SP在胃窦壁和十二指肠壁的表达情况。结果：与模型组比较，情志舒组MMC周期缩短，Ⅲ相延长，频率加快，幅度高，MMCⅢ相发生率增加，胃和十二指肠协调收缩率显著增加，MMCⅢ相时血浆MOT含量显著增加；胃肠壁SP免疫阳性产物表达也明显增强（P＜0．01，＜0．05）。结论：胃肠MMCⅢ相异常，胃肠协调运动障碍可能是肝胃不和型FD的发病机制之一，肝胃不和型FD大鼠血浆MOT含量的降低和胃肠壁SP表达的降低可能是肝胃不和型FD发病的神经生学基础，情志舒可能增加MMCⅢ相血浆MOT的释放和胃肠壁SP的表达，从而改善胃肠运动功能来治疗肝胃不和型FD。     

慢性束缚及夹尾刺激致大鼠肠易激综合征模型的建立及其内脏敏感性评价

[目的]探讨建立肠易激综合征（IBS）动物模型的方法，并评价其内脏敏感性变化。[方法]采用慢性束缚、夹尾刺激作为应激原诱导IBS大鼠模型，检测其肠道运动（结肠排便时间、排便颗粒）和感觉（腹壁收缩反射、腹壁肌电活动），并以逍遥散及匹维溴胺进行药物反证。[结果]与正常对照（对照）组比较，慢性束缚、夹尾刺激诱导IBS大鼠结肠转运效应明显增高（P〈0．01），在1．0、1．5、2．0ml不同扩张容量下腹壁收缩反射评分及腹壁肌电活动明显增高（P〈0．05，〈0．01）。而经药物治疗后，可明显降低大鼠结肠转运功能及内脏高敏感性（P〈0．05，〈0．01）。[结论]慢性束缚、夹尾刺激可以引起大鼠肠道运动增强，内脏敏感性增高，而肠黏膜未见异常病理改变，符合IBS的基本特征，可用于实验研究。     

槟榔对功能性消化不良模型大鼠胃运动的影响

目的观察槟榔对功能性消化不良(FD)模型大鼠胃平滑肌运动的影响.方法夹尾刺激复制FD模型,采用应变片传感器整体记录方法,测定FD模型大鼠胃运动并与正常对照鼠比较,以鉴定模型的合理性;测定高浓度槟榔煎液(100%)和低浓度槟榔煎液(25%)对FD模型大鼠胃运动振幅和频率的影响.结果模型组大鼠空腹和灌注0.85%氯化钠溶液后与对照组比较,胃运动频率明显下降(P<0.01),振幅减弱(P<0.05).两种浓度槟榔煎液均可显著增强FD大鼠胃收缩振幅指数,而对FD大鼠胃运动频率无明显影响(P>0.05).结论造模符合FD病理生理特点;槟榔有显著的促FD大鼠胃平滑肌收缩的作用,主要增强收缩振幅.     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.