谈谈便秘与大便困难

在门诊常遇见不少病人述说大便困难,有便意或有下坠感但便不出来,也有人说大便于燥,数天一次,肛门坠胀不适,十分痛苦。类似现象不少,男女老少都有,症状轻重不一。在这里我想谈谈这到底是怎么回事。要说清楚还得了解一下排便的过程。肠道内容物在小肠的时间约占全肠道的10％,绝大部分时间是停留在大约1．5米长的大肠里。而大肠的右半部分主要是吸收水分等物质,左半主要是存放或推移、排出粪便。粪便主要储存于乙状结肠,正常状态下,直肠一般是空虚的,并有一定的田压力和大约每分钟5次的蚂动波,但远远小于肛门部括约肌的努息压,…     

脑缺血与神经细胞凋亡

近年研究发现脑缺血后迟发性神经元死亡（ＤＮＤ）受ＩＥＧｓ、ｂｃｌ－２、ＩＣＥ、ｐ５３等多种基因调控,蛋白合成抑制剂与谷氨酸受体拮抗均对脑缺血损伤有保护作用,提示神经兴奋毒性作用与凋亡机制共同参与了脑缺血后神经元的死亡,从而为人类脑缺血的治疗提供了新的途径。     

临证病案3则

1　胆胃同治除胆胀案梅某 ,男 ,5 3岁。 2 0 0 0年 12月 9日初诊。 3年前 ,因右胁部反复隐痛作胀伴微热 ,去省级某医院体检 :墨非氏征阳性 ,可触及胀大的胆囊 ,Ｂ超示 :胆囊壁毛糙略增厚 ,确诊为慢性胆囊炎。服用中、西药物虽能控制 ,终因劳累或饮食不慎每每发作。刻下 :体胖 ,证见每至下午身微热 ,右胁部胀满作痛牵引胃脘胀闷热感 ,纳呆口苦 ,大便时干 ,小便微黄 ,舌体瘦质红 ,舌边夹瘀点 ,舌苔薄黄 ,脉象弦缓 ,左尺弱。四诊合参 ,缘由肥人多湿 ,湿阻气机 ;湿热留恋 ,胆腑阴伤所致的胆胀病证。治以利胆和胃 ,清热养阴。药用 :柴胡、川楝子…     

Arsenic Trioxide Induced Differentiation and Apoptosis in Human Nasopharyngeal Carcinoma Xenografts in BALB／C Nude Mice

To study the effect of arsenic trioxide (As2O3) on human poorly differentiated nasopharyngeal cancer cell line, CSNE-1, in vivo and its possible mechanism of action. Methods: CSNE-1 cells were established as xenografts in BALB/C nude mice. The tumor-bearing mice were treated with As2O3 at the dose of 5 mg/kg every day. The tumor growth was observed by tumor-growth curve. Morphologic changes were studied under light microscopy and electron microscopy. TUNEL was used to detect apoptosis. The expression of PCNA, p53, Bcl-2 and Bax were determined by immunohistochemistry. Results: The cell growth and proliferate activity were significantly inhibited by As203 at the dose of 5 mg/kg every day. Morphologic changes such as the formation of keratinization of tumor cells, decreased ratio of nuclear/cytoplasm, increased organelle and plasmic fibril in cytoplasm were identified. Cytodesma, desmosomes and micro-process were seen under light microscopy and transmission electron microscopy, which revealed that the cancer cells underwent differentiation. In addition, remarkable cell apoptosis were observed by TUNEL assay. Over expression of p53 and Bax was detected in the As203 treatment group when compared with control group. Conclusion: As203 inhibited proliferation of human poorly differentiated nasopharyngeal cancer cell CSNE-1 by inducing differentiation and apoptosis, which may be related to the up-regulation of p53 and Bax expression.     

肛门直肠坠胀的症状鉴别诊断

在肛肠科就诊患者中,以肛门直肠坠胀为主诉的病人为数不少。产生这一症状的原因很多。笔者从事肛肠专科临床工作10多年来,经过不断地总结,从伴随症状方面归纳为如下病症,现将鉴别要点分述如下。1脱垂性混合痔本病多在发病数年,痔核反复充血,脱出后不易回纳时感觉坠胀。若痔核内有大量血栓,则疼痛较甚,或有刺痛,压痛敏感,在齿线附近的皮下可见血栓;若兼有灼热感,说明痔核表面有溃疡;而痔核内主要是曲张的静脉丛者,坠胀相对轻些。2绞窄性混合痔病程短,多数是第一次发病。起病前大便秘结,数日不解,临厕努挣,或负重远行,痔核脱出后嵌顿水肿。压…     

消胀合剂治疗妇产科手术后腹胀疗效观察及护理

目的：应用消胀合剂治疗妇产科手术后腹胀。方法：患者口服消胀合剂200ml／次，早晚分服。结果：显效82％，有效13％，无效5％，总有效率95％。结论：消胀合剂对妇产科手术后腹胀有较好疗效，无副作用，值得推广应用。     

健脾消胀制剂与枸橼酸莫沙必利对胃运动效应的比较

目的比较健脾消胀制剂与枸橼酸莫沙必利对大鼠胃运动效应的异同。方法采用胃饲树脂小球并计数的方法计算胃排空率及采用高灵敏度感应片传感器记录在用不同剂量的健脾消胀制剂以及枸橼酸莫沙必利灌胃前后的胃肠平滑肌运动改变。结果健脾消胀制剂与枸橼酸莫沙必利胃排空率均快于对照组（各组P值均小于0．05），且呈剂量依赖性。两种药物对应剂量组之间无显著差异。健脾消胀制剂30min内使胃运动幅度增强（P〈0．001，P〈0．001，P〈0．01），增强胃运动的效应早于枸橼酸莫沙必利。结论健脾消胀制剂与枸橼酸莫沙必利均能增强胃肠运动，健脾消胀制剂增强胃运动的效应早于枸橼酸莫沙必利。     

黄芪消胀汤合三甲化积胶囊治疗肝硬化腹水65例

笔者从1997年8月至2003年10月采用自拟黄芪消胀汤合三甲化积胶囊治疗肝硬化腹水65例．取得了满意的效果，报告如下：