甘遂致小鼠稀便与炎性分泌相关（英文）

目的：甘遂在我国有着几千年的应用历史,主要用于促进肠运动。通过实验观察甘遂通便促进肠推进同时是否伴有病理变化。方法：应用30%甘遂提取物给小鼠灌胃后排便及其大小肠的影响,进行组织学检查。同时观察大小肠IL-1β,TNFα和Caspase3的mRNA和蛋白表达的变化。结果：甘遂能够明显促进小鼠排稀便,抑制肠平滑肌收缩,肠粘膜出现明显炎性损伤,并伴有IL-1β和TNFα表达的上调。结论：甘遂促进排便与刺激肠粘膜分泌和炎性反应有关。     

磷酸钠盐溶液与复方聚乙二醇电解质散用于肠道准备的方法应用

目的探讨磷酸钠盐溶液与复方聚乙二醇(PEG)电解质散用于肠道准备的疗效观察。方法对本院符合要求的结直肠癌手术患者60例分为两组,分别用磷酸钠盐溶液与复方PEG电解质散进行术前肠道准备处理,用ELISA法检测术前及术后患者血清IL-6及TNF-α水平。结果两组观察对象在术前肠道准备后IL-6及TNF-α水平较术前均有升高,且复方PEG电解质散组的增高程度比磷酸钠盐溶液组高。结论复方PEG电解质散不影响肠道微生态平衡,磷酸钠盐溶液对肠道免疫屏障的影响较小,两者各有优势,合理的应用与区别,能更好地发挥应用价值。     

食道癌术后肠内营养的护理

目的：探讨食道癌术后实施肠内营养护理的方法及其产生的临床效果.方法：回顾性分析2008年2月～2010年2月我院住院治疗的352例食道癌患者的临床资料,并对所有患者食道癌术后提供肠内营养,实施细致认真的护理,包括注意控制营养液滴注速度、温度,保持管道通畅及预防并发症发生等.结果：本组352例患者,340例成功实施了肠内营养护理,术后恢复良好.10例出现严重呕吐、腹泻或腹胀,2例空肠造瘘管堵塞.结论：食道癌术后实施肠内营养及做好肠内营养护理,能促进患者肠功能的恢复,改善患者的营养状况,促进患者伤口愈合,减少并发症发生.     

外周血白细胞凋亡障碍与大鼠肠缺血-再灌注损伤的关系

目的： 探讨外周血白细胞和中性粒细胞凋亡障碍在肠缺血-再灌注（IR）损伤中的作用。方法：20只雄性SD大鼠随机分为肠IR组和假手术对照组,每组10只。肠IR组夹闭肠系膜上动脉（SMA）30 min后再灌注60 min;对照组只分离而不夹闭SMA。观察肠黏膜形态学变化;检测肠黏膜上皮细胞凋亡指数（TUNEL法）和caspase-3活性;Annexin-V/PI法检测外周血白细胞和中性粒细胞（PMN）凋亡比例;检测夹闭前、夹闭30 min、再灌注30 min、再灌注60 min外周血白细胞数量。结果：(1)光镜下,对照组未见肠黏膜损伤,而IR组肠黏膜损伤严重;（2）IR组肠黏膜上皮细胞凋亡指数和caspase-3活性比对照组明显增高（P<0.05）;（3）IR组外周血白细胞和PMN凋亡比例比对照组明显降低（P<0.05）;IR组外周血白细胞数量在缺血30min时明显增高,再灌注后进一步增高,与缺血前和对照组比都有显著差异（P<0.05）。(4)肠黏膜caspase-3活性与外周血白细胞凋亡比例有显著的负相关（r=-0.764, P<0.01）,与PMN凋亡比例也有显著的负相关（r=-0.845,P<0.01）;肠黏膜上皮细胞凋亡指数与PMN凋亡比例也有显著的负相关（r=-0.638, P<0.05）。结论：外周血白细胞数量增加及凋亡障碍与缺血-再灌注引起的肠黏膜细胞损伤密切相关。     

肠缺血再灌注后应用抗组胺药对大鼠生存率的影响

目的： 在肠缺血再灌注后静脉给予抗组胺药酮替芬,观察它对SD大鼠小肠功能结构以及存活率的影响。方法： 72只SD大鼠随机分为3组：S组（假手术组）、M组（模型组）、K组（缺血再灌注＋酮替芬1 mg/kg组）,每组又分术后3 d、7 d两亚组。复制小肠缺血/再灌注模型,K组在再灌注前5 min和再灌注后3 d静脉注射酮替芬。观察各组大鼠3 d（S3,M3,K3）、7 d（S7,M7,K7）的存活率、存活状态,检测小肠组织组胺浓度,观察肠黏膜病理结构变化和肠黏膜肥大细胞（intestinal mucosal mast cell,IMMC）超微结构及类胰蛋白酶表达比较。结果： M3组、K3组存活率低于S3组（P<0.05）; M7组存活率低于S7组（P<0.05）,K3组与M3组、K7组与S7组存活率差别无显著（P>0.05）。K7组存活率高于M7组（P<0.05）。M组、K组肠黏膜绒毛损伤轻微。电镜示M组微绒毛肿胀脱落,K组微绒毛不齐;S组IMMC超微结构正常,M组脱颗粒现象明显,K组次之。各组间肠黏膜Chiu’s评分、IMMC计数及类胰蛋白酶表达比较均无显著差异（P>0.05）。K7组肠组织组胺浓度低于S7组和M7组（P<0.05）。 结论： 肠缺血再灌注后应用抗组胺药酮替芬能改善大鼠小肠黏膜结构并增加大鼠生存率,IMMC活化脱颗粒组胺释放可能不利于肠缺血再灌注损伤大鼠的长期生存。     

Microcoil Embolization for Acute Lower Gastrointestinal Bleeding

Purpose To assess outcomes after microcoil embolization for active lower gastrointestinal (GI) bleeding. Methods We retrospectively studied all consecutive patients in whom microcoil embolization was attempted to treat acute lower GI bleeding over 88 months. Baseline, procedural, and outcome parameters were recorded following current Society of Interventional Radiology guidelines. Outcomes included technical success, clinical success (rebleeding within 30 days), delayed rebleeding (>30 days), and major and minor complication rates. Follow-up consisted of clinical, endoscopic, and pathologic data. Results Nineteen patients (13 men, 6 women; mean age ± 95% confidence interval = 70 ± 6 years) requiring blood transfusion (10 ± 3 units) had angiography-proven bleeding distal to the marginal artery. Main comorbidities were malignancy (42%), coagulopathy (28%), and renal failure (26%). Bleeding was located in the small bowel (n = 5), colon (n = 13) or rectum (n = 1). Technical success was obtained in 17 patients (89%); 2 patients could not be embolized due to vessel tortuosity and stenoses. Clinical follow-up length was 145 ± 75 days. Clinical success was complete in 13 (68%), partial in 3 (16%), and failed in 2 patients (11%). Delayed rebleeding (3 patients, 27%) was always due to a different lesion in another bowel segment (0 late rebleeding in embolized area). Two patients experienced colonic ischemia (11%) and underwent uneventful colectomy. Two minor complications were noted. Conclusion Microcoil embolization for active lower GI bleeding is safe and effective in most patients, with high technical and clinical success rates, no procedure-related mortality, and a low risk of bowel ischemia and late rebleeding. An erratum to this article is available at .     

四磨汤口服液对剖宫产术后使用镇痛泵的初产妇肠功能恢复的影响

目的探讨四磨汤口服液对剖宫产术后使用硬膜外镇痛泵的初产妇肠功能恢复的影响。方法将87例剖宫产术后使用镇痛泵的初产妇,随机分为2组。实验组45例,术后6 h予四磨汤口服液,每次20 mL,每日3次口服。对照组42例,术后予常规饮食、治疗和护理。观察2组肠蠕动开始时间、肛门排气时间及腹胀发生情况。结果实验组肠蠕动时间、肛门排气时间提前,与对照组比较差异均有统计学意义(P<0.01);实验组腹胀发生率降低,与对照组比较差异有统计学意义(P<0.05)。结论剖宫产术后口服四磨汤口服液能促进术后使用镇痛泵产妇肠功能恢复,产妇可早进食补充营养,有利于乳汁的分泌。     

Bowel disease: prospective comparison of CT and 1.5-T pre- and postcontrast MR imaging with T1-weighted fat-suppressed and breath-hold FLASH sequences.

The potential of new high-field-strength magnetic resonance (MR) imaging sequences to evaluate bowel disease was investigated and compared with computed tomographic (CT) studies. Thirty-two patients were studied, 14 with known or suspected gastrointestinal tumors and 18 with known or suspected bowel inflammatory conditions. T1-weighted fat-suppressed spin-echo and breath-hold FLASH (fast low-angle shot) images were obtained before and after intravenous injection of 0.1 mmol/kg gadopentetate dimeglumine. Pathologic confirmation was obtained by biopsy (n = 18), surgical excision (n = 8), or endoscopy (n = 6). CT and MR images were analyzed separately in a prospective fashion and reviewed by consensus. Information from CT and MR images was comparable in cases of confirmed bowel neoplasia. CT scans had better spatial resolution, while fat-suppressed gadolinium-enhanced MR images had better contrast resolution. In the 18 cases of bowel inflammation, CT scans showed concentric wall thickening in 16, while MR images showed concentric wall thickening in 14 and increased contrast enhancement in 17. Contrast enhancement was better appreciated on fat-suppressed images than on FLASH images. The results suggest that MR imaging may play a role in the evaluation of bowel disease.     

MR imaging of crohn disease: Use of perflubron as a gastrointestinal contrast agent

This study was undertaken to evaluate the use of perflubron (perfluorooctylbromide) as an oral contrast agent for magnetic resonance (MR) imaging of patients with Crohn disease. MR examinations were performed before and after perflubron administration in 12 patients with documented Crohn disease. Glucagon was administered intramuscularly before the post-perflubron examinations. Each patient also underwent abdominal computed tomography within 48 hours of MR imaging. The imaging studies were analyzed for effectiveness of bowel marking with oral contrast agent, clarity of bowel wall visualization, and presence of bowel wall thickening and extraluminal manifestations of Crohn disease such as abscess or fistula formation. Analysis of the imaging studies showed effective marking of the bowel with perflubron and improved bowel wall visualization on postcontrast MR images. Detection of bowel wall thickening and extraluminal complications of Crohn disease was not significantly improved on postcontrast MR images. The authors conclude that perflubron administration effectively marked the bowel and increased the clarity of bowel wall visualization but did not significantly increase the detection of abnormalities related to Crohn disease in the study population.     

Value of CT in localizing site of gastrointestinal hemorrhage following negative angiography

This case report of severe gastrointestinal (GI) bleeding demonstrates the utility of computed tomography (CT) in localizing such hemorrhages when all other diagnostic modalities have been exhausted. All previous studies in this case were nondiagnostic. However, abdominal CT performed without the benefit of oral contrast but immediately following negative angiography was useful in directing the surgeon to the region of hemorrhage by documenting the presence of focally dense intraluminal contrast within the small bowel loops.