胃扩张时胃内分泌变化的神经机制：在体及离体大鼠胃的研究

本实验用麻醉大鼠及带血管灌流的离体大鼠胃，对胃扩张引起胃内分泌的变化及其机制进行了研究。结果显示：①在体实验部分：用10mlNS扩张胃，血浆胃泌素水平明显升高，生长抑素无明显变化；切断双侧颈迷走神经，则血浆胃泌素水平降低，而生长抑素水平升高。②离体实验部分：扩张胃引起胃泌素分泌减少，生长抑素分泌增加；血管灌注阿托品或河豚毒，使扩张引起的效应各受阻30％或50％左右，而VIP拮抗剂对其无明显作用。结论：整体情况下，胃扩张引起胃泌素分泌增加和生长抑素分泌抑制是通过迷走依赖的途径实现的，这一作用掩盖了胃内存在的抑制胃泌素、刺激生长抑素分泌的调节系统的效应；胆碱能及非胆碱能机制均涉及该调节中，但后者确切的本质尚有待进一步的研究。     

生长抑素对胰源性溃疡血清与胃液胃泌素影响

研究了空腹麻醉的犬，经主胰管匀速连续灌注１０ｍｍｏｌ／Ｌ去氧胆酸钠，建立胰源性溃疡的实验模型。经胃灌注生长抑素，用放免法测定血清和胃液胃泌素含量，结果显示，脾生长抑制组疗效最为理想，各项胃泌素指标趋地正常平稳。生长抑素治疗组较重症胰腺组间的差别具有显著性差异。     

生长抑素对胰源性溃疡血清与胃液胃泌素

研究了空腹麻醉犬，经主胰管匀速连续灌注１０ｍｍｏｌ／Ｌ去氧胆酸钠，建立胰源性溃疡的实验模型。经胃灌注生长抑素，用放免法测定血清和胃液胃泌素含量。结果显示，用生长抑素组疗效最为理想，各项胃泌素指标趋于正常或平稳。     

幽门螺杆菌感染与老年消化性溃疡发病关系的调查

目的 探讨幽门螺杆菌(HP)阳性和阴性老年消化性溃疡病人胃窦部生长抑素、胃泌素及D、C细胞密度的关系.方法 2000年2月～2004年9月在本院内科住院病人80例,均经胃镜距幽门5cm处胃窦部取黏膜组织8块.3块进行快速尿素酶试验(UT试验),Worenin-starry银染色及HE组织病理学检查,2块活检胃组织用待测生长抑素及胃泌素,余3块组织用缓冲液及D.Boriv液固定待进行胃窦黏膜D、C细胞免疫组化染色.结果 HP阳性组较HP阴性组生长抑素含量明显减少(P<0.01),胃泌素/生长抑素比值明显增加(P<0.05):D、C细胞密度明显降低( P<0.01),C/D比值明显升高(P<0.05).结论 HP感染在老年消化性溃疡发病中起重要作用.     

幽门螺杆菌感染与老年消化性溃疡发病关系的研究

目的 :探讨幽门螺杆菌 (HP)阳性和阴性老年消化性溃疡病人胃窦部生长抑素、胃泌素及 D、G细胞密度的关系。方法 :快速尿素酶试验 ,胃泌素及生长抑素的放免测定 ,胃窦粘膜 D、G细胞免疫组化染色。结果 :HP阳性组较 HP阴性组生长抑素含量明显减少 (P<0 .0 1) ,胃泌素 /生长抑素比值明显增加 (P<0 .0 5) ;D、G细胞密度明显降低 (P<0 .0 1) ,G/ D比值明显升高 (P<0 .0 5)。结论 :HP感染在老年消化性溃疡发病中起重要作用。     

胃泌素、生长抑素的表达与胃癌生物学行为相关性研究

目的 研究胃癌组织中胃泌素(gastrin)、生长抑素(somatostasis，SS)的表达及其与胃癌生物学行为的关系。方法 应用免疫组化SP法，对42例胃癌组织中胃泌素、生长抑素蛋白表达进行检测。结果 胃泌素表达水平在胃癌Ⅰ、Ⅱ期与Ⅲ、Ⅳ期比较，有显著性差异，随着胃癌的进展，胃泌素的蛋白表达呈递增趋势。胃癌分化程度降低，生长抑素蛋白表达减弱，即高分化胃癌生长抑素蛋白表达水平显著高于低分化胃癌。结论 胃泌素促进胃癌的生长、浸润和转移，而生长抑素则抑制胃癌细胞增殖，胃泌素、生长抑素表达与胃癌的生物学行为有一定关系。     

柴胡疏肝散对胃溃疡大鼠血浆、胃、蓝斑中胃泌素及生长抑素的影响

目的研究柴胡疏肝散对急性应激胃溃疡大鼠血浆、胃、蓝斑中胃泌素及生长抑素含量的干预作用。方法将32只大鼠随机分为正常对照组、胃溃疡模型组、柴胡疏肝散组、雷尼替丁组,采用不可预知性刺激造成大鼠急性胃溃疡模型,观察各组大鼠血浆、胃、蓝斑中胃泌素及生长抑素含量的变化。结果与模型组相比,柴胡疏肝散不仅能明显降低血浆、胃中胃泌素含量,而且能降低胃组织中的生长抑素含量,差异均有统计学意义(P<0.05),血浆中生长抑素未见明显降低(P>0.05),蓝斑中两者差异均无统计学意义(P>0.05),但雷尼替丁能显著降低蓝斑中胃泌素含量、血浆中生长抑素含量,差异均有统计学意义(均P<0.05),而对蓝斑中生长抑素含量则无影响。结论柴胡疏肝散改善外周或中枢胃泌素及生长抑素含量可能是治疗应激性胃溃疡的作用机制之一。     

ERCP术前与术后不同时机应用生长抑素对老年消化道出血患者的影响

目的分析内镜逆行单管造影术(ERCP)术前与术后不同时机应用生长抑素对老年消化道出血患者的影响。方法回顾性分析2017年3月至2019年6月绵阳市中心医院收治的400例消化道出血患者的临床资料,在ERCP术前6 h给予生长抑素治疗的110例患者纳入A组,术后12 h内给予生长抑素治疗的150例患者纳入B组,术前6 h至术后12 h内全程连续给予生长抑素治疗的140例患者纳入C组。对比三组老年患者输血量、止血时间、血清淀粉酶水平,给药前后胃肠激素指标(胃泌素、血清胃动素、胰高血糖素)及不良反应发生情况。结果C组输血量少于A组、B组[(256.8±10.2) m L比(408.6±14.1) mL、(410.1±14.6) mL],C组止血时间短于A组、B组[(18.4±2.4) h比(30.4±7.0) h、(30.1±6.4) h],C组血清淀粉酶低于A组、B组[(116.2±18.1) U/L比(190.4±34.4) U/L、(195.2±38.4) U/L](均P <0.01)。胃泌素、胃动素、胰高血糖素的组间和时点间存在交互作用(P <0.01),给药12 h、给药1 d,三组胃泌素、胃动素、胰高血糖素均呈下降趋势,C组胃泌素、胃动素、胰高血糖素均低于A组和B组。A组、B、组C组总不良反应发生率分别为9.09%(10/110)、6.67%(10/150)、12.86%(18/140),比较差异无统计学意义(P> 0.05)。结论老年消化道出血患者行ERCP,全程给予生长抑素,能够显著改善消化道出血相关症状,纠正胃肠激素紊乱,虽然一定程度上增加了不良反应,但均在患者耐受范围内。     

埃索美拉唑治疗应激性溃疡出血疗效观察

目的 比较埃索美拉唑与泮托拉唑治疗应激性溃疡合并出血的疗效.方法 将63例应激性溃疡合并出血患者随机分为治疗组（32例）和对照组（31例）.在常规治疗的基础上,治疗组给予埃索美拉唑注射液,对照组选用泮托拉唑注射液;治疗1周,观察两组患者临床疗效及胃酸、胃泌素及生长抑素的改变情况.结果 治疗组临床有效率达87.0％,对照组为66.6％,差异有统计学意义（P＜0.0 5）.治疗前,两组胃酸（pH值）、胃泌素分泌及生长抑素差异均无统计学意义（P＞ 0.05）;治疗后,两种药物均能降低胃酸（pH值）、减少胃泌素分泌及促进生长抑素分泌（均P＜ 0.05）,且治疗组程度更加明显（均P＜0.05）.结论 埃索美拉唑较泮托拉唑更能改善应激性溃疡合并出血患者的临床症状及抑制应激性溃疡合并出血患者的胃酸、胃泌素的过度分泌和提高生长抑素分泌,具有一定的临床推广价值.     

乙酰胆碱、胃泌素、生长抑素对大鼠胃酸分泌调节的实验形态学研究

目的 探讨神经-内分泌改变对胃酸分泌的影响及致胃粘膜损伤的机制。方法 Wistar大鼠15只,正常对照组、应激组、胆碱酯酶抑制剂处理组各5只。应激组采用寒冷捆缚刺激,实验前后分别测定血压及胃酸变化。用药组静脉注射胆碱酯酶抑制剂,最后切断胃迷走神经,测胃酸三次;分别处死动物后在胃底、胃小弯侧胃体、胃幽门及十二指肠取材固定,应用组织化学方法显示胆碱酯酶阳性神经成分,应用免疫组化PAP法检测胃泌素细胞(G细胞)和生长抑素细胞(D细胞),切片在光镜下对比观察。结果 用药组胆碱酯酶AchE活性降低,乙酰胆碱降解减少,胃泌素释放增多使胃酸及生长抑素相应释放增多,G、D细胞消耗性减少。迷走神经干切断后,胃神经节细胞及神经干数量减少,胃泌素释放减少,胃酸、生长抑素释放亦相应降低。应激组胃神经节细胞及神经干呈强阳性染色,胃酸、胃泌素(Gas)、生长抑素(SS)释放增多,G、D细胞消耗性减少。结论 迷走神经兴奋与胃泌素、生长抑素浓度增加呈正相关,副交感神经刺激胃酸分泌;心理应激致植物神经功能紊乱在胃粘膜损伤中有很重要的作用,胃酸是应激性胃粘膜损伤发展的重要原因之一。     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.