N-乙酰半胱氨酸对葡聚糖硫酸钠诱导的小鼠溃疡性结肠炎的保护作用

目的观察N-乙酰半胱氨酸(NAC)灌肠对小鼠急性溃疡性结肠炎的作用。方法5%葡聚糖硫酸钠(DSS)自由饮用7 d诱导小鼠急性溃疡性结肠炎,同时予以生理盐水(NS)、5-氨基水杨酸(5-ASA)、NAC保留灌肠,观察小鼠体重、粪便性状、隐血便血,计算疾病活动度(DAI)积分,检测结肠长度、结肠过氧化物酶(MPO)活性、血清过氧化物歧化酶(SOD)活力和丙二醛(MDA)含量及肠黏膜病理改变。结果NAC组小鼠隐血、便血、体重下降、DAI积分、病理改变等均好于模型组、NS组(P<0.05),与5-ASA组疗效相似。NAC组SOD活力高于模型组,MPO活性、MDA含量则低于模型组(P<0.05)。结论NAC对DSS诱导的小鼠急性溃疡性结肠炎黏膜损伤有保护作用,其机制可能与抗氧化应激有关。     

益生菌对小鼠溃疡性结肠炎的影响

目的 探讨环氧合酶2(COX-2)在溃疡性结肠炎(UC)小鼠中的发病作用及益生菌治疗UC的可能作用机制.方法 采用右旋葡聚糖硫酸钠(DSS)诱导的小鼠UC模型,将60只BALB/c小鼠分为6组:空白时照组、DSS模型组、生理盐水(NS)组、柳氮磺胺吡啶(SASP)组、乳酸杆菌组和双歧杆菌组,10只/组,造模第8天处死小鼠,计算小鼠组织学损伤评分、评价组织病理学改变及结肠黏膜COX-2免疫组化情况.结果 乳酸杆菌组、双歧杆菌组及SASP组小鼠一般情况好,组织学损伤评分低,小鼠结肠黏膜COX-2的表达较DSS模型组明显减少.结论 乳酸杆菌和双歧杆菌可能通过抑制结肠黏膜COX-2的表达而减轻小鼠结肠黏膜的损伤,达到治疗UC的目的 .其疗效与SASP相当.     

胃三联与胃二联疗法治疗幽门螺旋杆菌的临床研究

自从Ｗａｒｒｅｎ和Ｍａｓｈａｌｌ１９８３年发现幽门螺旋杆菌（ＨＰ）与胃、十二指肠疾病的关系以来，探讨安全有效根除ＨＰ的药物和治疗方法是当今ＨＰ研究的重要课题［１］。本文报导采用胃三联和胃二联药物治疗，观察了其ＨＰ的根除率，消化性溃疡愈合的有效率及其二者的关系．１对象和方法１．１病例选择本组病例共１６４例，包括同期门诊和住院的人，采用随机分组的方法将病人分为两组，胃三联组（Ａ组），胃二联组（Ｂ组），Ａ组７９例，Ｂ组８５例，Ａ、Ｂ两组所含慢性胃炎、胃溃疡、十二指肠溃疡的病例数见表１：Ａ组平均年龄为４…     

青春双歧杆菌和嗜酸乳酸杆菌对急性期和恢复期结肠炎小鼠Th1/Th2亚群的影响

Objective To observe and analyze the effect of B. Adolescentis and L. Acidophilus on the proportion of Th cell Th1/Th2 in peripheral blood of UC-mice in acute stage and recovery stage. Method 40 BABL/c mice were induced by 3% DSS water for 7 clays free drinking and then with distilled water for 10 days. They were randomly allocated in 4 groups: NS group, SASP group, BF0624 group and LT0637 group, also the fifth group-10 normal animals. The blood of mice were collected by removing their eyes at day 8 and day 18, and then the mononuclear cells were iso]atecl. The proportion of Th1/Th2 was analyze through flow eytometry,hy labeling the specific antibody ot Th cellular membrane with the CD4 antibody, and the cytoplastie antigen of Thl or Th2 with IIA antibody or IF'N-γ antibody. Result The proportion of Th1/Th2 in normal mouse was 0. 84 -0. 94,and it raised up in DSS-mice at both acute stage and recovery stage. It decreased unequally after 7 or 17 days'B, adoleseentis, L. Acidophilus and SASP treatment, but that of all three groups were lower than NS group (2.21±0. 83). Even the proportion got close to the normal animals after 17 days'L. Acidophilus -treated. Conclusion The proportion of Thl/Th2 increased at the acute stage and recovery stage of DSS-mice. Both B. Adoleseentis and L. Acidophilus had more effective than SASP on decreasing the proportion of Th1/Th2 at two stages,ospecially L. Acidophilus.     

嗜酸乳杆菌对实验性结肠炎小鼠肠黏膜趋化因子RANTES和MCP-1表达的影响

目的观察嗜酸乳杆菌对小鼠溃疡性结肠炎(UC)肠黏膜趋化因子RANTES和单核细胞趋化蛋白(MCP-1)表达的影响,了解其治疗UC的效果及其可能的作用机制。方法采用2.5%的葡聚糖硫酸钠(DSS)建立小鼠结肠炎模型。70只BALB/c小鼠随机分为正常组,阴性对照(生理盐水,NS)组,阳性对照(美沙拉嗪)组,模型对照组,嗜酸乳杆菌低剂量(106CFU/ml)、中剂量(107CFU/ml)组、高剂量(108CFU/ml)组。用疾病活动指数(DAI)评分和病理组织学积分检测各干预组的疗效;免疫组织化学法检测结肠组织中趋化因子RANTES和MCP-1蛋白的表达;反转录-聚合酶链反应(RT-PCR)检测结肠组织中RANTES、MCP-1和STAT1基因的表达。结果嗜酸乳杆菌可改善实验性结肠炎小鼠一般情况,降低DAI积分;与模型、阴性对照组相比,RANTES和MCP-1蛋白、基因的表达均下降(P<0.05);转录因子STAT1基因表达也下降(P<0.05)。其效果与美沙拉嗪相当,其中以嗜酸乳杆菌高剂量组效果最佳。结论嗜酸乳杆菌对急性期实验性结肠炎小鼠有治疗作用,疗效与剂量呈正相关;其部分机制可能与通过抑制转录因子STAT1的激活,进而减少结肠黏膜趋化因子RANTES和MCP-1的表达有关。     

青春双歧杆菌和嗜酸乳酸杆菌对急性期和恢复期结肠炎小鼠Th1/Th2亚群的影响

Objective To observe and analyze the effect of B. Adolescentis and L. Acidophilus on the proportion of Th cell Th1/Th2 in peripheral blood of UC-mice in acute stage and recovery stage. Method 40 BABL/c mice were induced by 3% DSS water for 7 clays free drinking and then with distilled water for 10 days. They were randomly allocated in 4 groups: NS group, SASP group, BF0624 group and LT0637 group, also the fifth group-10 normal animals. The blood of mice were collected by removing their eyes at day 8 and day 18, and then the mononuclear cells were iso]atecl. The proportion of Th1/Th2 was analyze through flow eytometry,hy labeling the specific antibody ot Th cellular membrane with the CD4 antibody, and the cytoplastie antigen of Thl or Th2 with IIA antibody or IF'N-γ antibody. Result The proportion of Th1/Th2 in normal mouse was 0. 84 -0. 94,and it raised up in DSS-mice at both acute stage and recovery stage. It decreased unequally after 7 or 17 days'B, adoleseentis, L. Acidophilus and SASP treatment, but that of all three groups were lower than NS group (2.21±0. 83). Even the proportion got close to the normal animals after 17 days'L. Acidophilus -treated. Conclusion The proportion of Thl/Th2 increased at the acute stage and recovery stage of DSS-mice. Both B. Adoleseentis and L. Acidophilus had more effective than SASP on decreasing the proportion of Th1/Th2 at two stages,ospecially L. Acidophilus.     

鼻胆管引流预防ERCP术后并发症分析

目的 探讨内镜下鼻胆管引流术在预防逆行性胰胆管造影(ERCP)术后急性胰腺炎,高淀粉酶血症及胆道感染的效果.方法 将32例具有胰腺炎高危因素的患者(A组)完成ERCP术后行鼻胆管引流,观察术后血清淀粉酶及急性胰腺炎,高淀粉酶血症和胆道感染的发生情况,并与同期ERCP术后未行鼻胆管引流患者32例(B组)作对比研究.结果 A组患者ERCP术后血清淀粉酶为(220.5±53.8)u/L,明显低于B组相同时间血清淀粉酶[(405.8±52.9)u/L,P＜0.05)],A组无患者发生急性胰腺炎及胆道感染,亦明显低于B组.结论 内镜下鼻胆管引流能够有效预防ERCP术后急性胰腺炎,高淀粉酶血症及胆道感染.     

43例克罗恩病手术患者蒙特利尔分型特征分析

目的探讨克罗恩病手术患者蒙特利尔分型的临床特点。方法回顾分析43例克罗恩病手术患者（手术组）的临床资料,按蒙特利尔分型标准进行临床分型,对比非手术的克罗恩病患者（非手术组）125例各亚型的临床特征。结果手术组17～40岁（A2）28例（65．1％）,大于40岁（A3）者14例（32．6％）。16岁以下（A1）者只有1例;与非手术组比较,差异无统计学意义（P〉0．05）。手术组病变累及回肠末端（E1）18例（41．9％）,结肠（TJ2）11例（25．6％）,回结肠（L3）13例（30．2％）,上消化道（IA）1例（2．3％）;与非手术组比较,差异也无统计学意义（P〉0．05）。疾病行为：手术组无狭窄无穿透（B1）1例（2．3％）,狭窄（B2）26例（60．5％）,穿透（B3）16例（37．2％）;与非手术组的B1亚型79例（63．2％）、B2亚型44例（35．2％）和B3亚型2例（1．6％）相比,差异有统计学意义（P=0．000、P=0．004和P=0．000）。结论克罗恩病手术患者的年龄和病变部位的亚型与非手术患者相同,但其疾病行为主要为狭窄和穿透亚型．是手术治疗的主要原因。     

全覆膜支架在医源性食管穿孔治疗中的应用

目的探讨全覆膜支架在医源性食管穿孔治疗中的应用价值。方法 5例医源性食管穿孔患者,先以胃镜确定穿孔位置,再在胃镜下采用国产全覆膜支架常规置入,封堵瘘口,常规禁食,抗感染,留置胃管,有气胸者行闭式引流。结果所有5例患者中2例在3周后拔除支架,3例在3个月后拔除支架,瘘口均完全愈合。结论全覆膜支架治疗医源性食管穿孔,疗效肯定,值得推广使用。     

皮圈结扎与金属夹子治疗上消化道Dieulafoy病变出血的临床对比研究

目的:比较内镜下皮圈结扎（EBL)与金属夹子（EHP)治疗Dieulafoy病变出血的疗效及安全性。方法:2004年2月至2006年10月共有34例上消化道Dieulafoy病变出血患者入选本研究,其中22例病灶位于胃部,10例位于胃肠吻合口,2例位于十二指肠球部。将患者随机分成EBL组（n=16)和EHP组（n=18),分别采用EBL或EHP治疗,并对两组治疗结果进行比较。结果:EBL组与EHP组达到止血平均所需的皮圈戓金属夹子个数相似;两组早期止血率、再出血率、转外科手术率、并发症发生率、平均输血量及平均住院时间差异均无统计学意义(均P>0.05)。结论:本组小样本的临床研究提示,EBL与EHP治疗上消化道Dieulafoy病变出血在临床疗效与安全性方面无明显差异。