胰腺局部组织肾素-血管紧张素-醛固酮系统与胰腺炎

组织局部肾素-血管紧张素-醛固酮系统（RAAs）与组织循环、纤维化等关系密切，胰腺存在局部RAAS，并可能在胰腺循环调控、外分泌调节中起重要作用。胰腺炎时胰腺局部RAS异常激活，可能主要通过对局部组织循环的影响参与AP的发病和重症化，并且通过其致纤维化作用参与cP的发病。ACEI和ARB对大鼠胰腺炎具有良好防治效果，已在胰腺炎治疗中显示出一定前景。     

经内镜黏膜下植入疗法治疗胃食管反流病

胃食管反流病（gastroesophageal reflux disease，GERD）是主要表现为胸骨后烧心感及胸痛，可引起严重的并发症如食管狭窄、Barrett食管和食管腺癌，严重影响病人生活质量的一种胃肠道疾病。随着人们生活水平的提高，该病的发病人数有逐渐增多的趋势，因此得到临床医生的广泛关注。目前我国的GERD发病率尚未见报道。     

镇静剂在无痛性胃肠镜检查中的应用

该文对国外有关清醒镇静在无痛性胃肠镜检查中的应用文献进行复习，提示镇静剂用于无痛性胃肠镜检查安全、有效。     

肠易激综合征中医证型与肛管直肠动力学的相关性研究

目的：观察肠易激综合征（IBS）不同中医证型肛管直肠动力学变化及临床意义。方法：选择符合罗马Ⅱ标准的IBS患者59例，按中医标准分为肝郁脾虚组25例，脾胃虚弱组20例，脾胃阴虚组14例；另选健康志愿者23例为正常对照组（正常组）。采用水灌注式测压系统，测定其肛管直肠动力学。结果：3型患者直肠静息压、肛管静息压及肛管缩窄压均与正常组差异无显著性意义；但肝郁脾虚组直肠最大耐受量较正常组降低，出现肛管直肠抑制反射（RAIR）所需最小空气量、直肠初始感觉阈值与正常组差异无显著性意义；脾胃虚弱组出现RAIR所需最小空气量、直肠初始感觉阈值、直肠最大耐受量均与正常组差异无显著性意义；脾胃阴虚组上述3项指标均较正常组明显增高。结论：肝郁脾虚组直肠耐受性降低；脾胃阴虚组排便反射不协调、直肠敏感性降低而耐受性增高。     

端粒酶与肿瘤的研究近况

真核细胞的线状染色体提供了生物遗传物质快速重组、分配成功地克隆了人端粒酶的关键性分子一催化亚单位ｈＴＥＲＴ（ｈｕｍａｎ）程度及临床分期无关 ,也有人认为端粒酶的表达是肿瘤的发生的端粒酶与肿瘤的研究近况@赵秋枫$浙江省立同德医院!10012 @王实$浙江中医学院!研究生~~     

补气养阴解毒法对慢性萎缩性胃炎模型大鼠生长抑素和生长激素的影响

目的:探讨补气养阴解毒法对慢性萎缩性胃炎模型大鼠生长抑素(SS)和生长激素(GH)的影响。方法:选择雌性SD大鼠,用60％酒精、20mmol/L去氧胆酸钠、0.1％氨水建立慢性萎缩性胃炎模型,连续26周,预防用药大鼠同时用补气养阴解毒法中药进行干预;治疗用药大鼠造模结束后再用药13周。结果:慢性萎缩性胃炎大鼠存在SS高表达及GH低表达,与正常组比较均有显著性差异(P均<0.01)。结论:补气养阴解毒法中药能降低慢性萎缩性胃炎大鼠SS的高表达,预防和逆转胃粘膜萎缩。     

急性胰腺炎262例临床相关因素分析

急性胰腺炎(AP)是临床常见病,近年其发病率有增高趋势,重症急性胰腺炎(SAP)系消化科危重症之一,病死率一直在15%～30%之间[1].     

Relationship between peptic ulcer patients’ compliance and doctors’ order in China

Objective To get the knowledge about between patients’ compliance and doctors’ order in China, and to observe the influence on the reactivity of peptic ulcers due to the variation between patients’ compliance and doctors’ orders. Methods This is a prospective, randomized, multicenter, controlled trial of the efficacy in various instructional programs upon patients’ compliance with doctors’ orders. Patients with active peptic ulcers diagnosed through gastroscopic and pathologic examinations and followed up at the selected 100 hospitals of ten districts in Zhejiang Province of China between January 1 to December 31, 1997 were eligib le for this study. All patients were given the same medications (proton pump inhibitor and amoxycillin) and were divided into four groups (A, B, C, D) by randomly selected envelopes as follows. Group A: simple patient education, namely simple instruction about the use and the course of the medications, and the follow-up time. Group B: stressed patient education, namely detailed instruction about the use, the course, the curative and side effects, the necessity of following up as well as making appointments of being checked. Group C: supervised education, meaning that the patients were managed as Group A while their family members/friends as Group B. The family members/friends were also asked to supervise the patients in taking the medications, in following-up and giving their phone numbers to doctors. Group D: stressed patient education plus supervised education, meaning that the patients and their family members/friends were treated as both Group B and C.Results The compliance rate was 47.1% in all 11 983 patients. From high to low the compliance rates in the four groups were D (52.8%), C (46.8%), B (46.3%) and A (46.2%), but statistically there were no significant differences between them. The most compliant age was under 20 years with 51.7% as the rate of compliance , and the occupation was of medical workers (57.0%), and persons graduated from secondary specialized schools also had the highest compliance (55.4%). On the contrary, the most noncompliants were young people (20-29 years old, 44.6%), illiterate persons (43.9%) and self-employed laborers (43.9%). Mountain areas were the lowest (40.8%) compliant areas. The main reasons for the failure of compliance included drug cost (34.9%), inconvenience to see doctor (31.8%), forgetfulness of patients (24.2%). The reactivity of each group was shown as D (91.1%), C (90.3%), B (89.4%) and A (89.2%), with also no significant difference in statistics. But a big difference and be found between compliant group with the noncompliant one because the reactivity in the compliant group was 97.4% while in the noncompliant group was only 58.8% (x=1449.2, P&lt;0.005). Conclusion Compliance with doctors’ orders exerts a significant influence on the reactivity. The main reasons of noncompliance (drug costs, inconvenience to see doctor) are corresponding to the economic and social conditions in China.     

功能性消化不良的中西医结合研究

本文从中,西医两方面,阐述了功能性消化不良的病因病机,国内外对该病的最新认识及西医治疗,并提出了目前在ＦＤ的中西医研究方面,亟待解决的问题。     

补肾益气化瘀解毒法对肝纤维化大鼠肝细胞凋亡及凋亡相关基因的影响

目的 观察补肾益气化瘀解毒作用的中药复方肝力克对肝纤维化大鼠肝细胞的凋亡及其相关基因的影响,探讨中药治疗肝纤维化的作用机制.方法 以四氯化碳诱导建立大鼠肝纤维化模型,以不同剂量的中药肝力克进行治疗;光镜观察肝组织的病理学变化,采用TUNEL法检测肝细胞的凋亡情况,免疫组化法检测凋亡相关蛋白的表达.结果 中药肝力克能显著改变肝纤维化的病理状态,能减轻肝细胞的凋亡情况,并能调节凋亡相关基因的表达.结论 肝力克抗纤维化作用的机制可能是通过调节肝纤维化大鼠肝细胞的凋亡水平;抑制肝纤维化大鼠肝细胞Fas/FasL、Bcl-2/Bax的表达来实现的.