大鼠实验性胃炎中PGP9．5、C—kit及胃泌素、生长抑素表达的观察研究

目的通过观察胃炎大鼠组织PGP9．5及c—kit与胃泌素（GAS）、生长抑素（SS）表达变化，探讨胃cajal间质细胞（ICC）、肠神经及胃肠激素在胃炎发病中的作用。方法45只大鼠分胃炎A组、胃炎B组、对照组3组，分别灌喂幽门螺杆菌（Hp）SS1菌株、2％阿司匹林和0．6N盐酸1：1混合液、生理盐水，处死后取胃窦及胃体组织PGP9．5染色及检测胃体黏膜C-kit及胃窦黏膜GAS、SS表达，测量胃壁神经元胞体、c—kit阳性表达的ICC最长直径（Dmax，μm）、平均面积（μm^2）及光密度（nm）以及GAS、SS表达的积分光密度，并进行比较。结果（1）胃炎A组、B组胃壁神经元表达PGP9．5细胞平均面积、光密度均低于对照组（P〈0．01），胃炎A组与B组比较差异无统计学意义（P〉0．05）；（2）胃炎A组GAS表达明显高于对照组，而SS表达则低于对照组（P〈0．05）。胃炎B组与对照组比较两项表达结果差异均无统计学意义（P〉0．05）。直线相关分析显示SS与GAS呈负相关（r=-0．333，P〈0．01）；（3）胃炎A组、B组C-kit表达细胞分布面积和直径均明显小于对照组（P〈0．05），胃炎A组与B组比较差异无统计学意义（P〉0．05），三组c—kit表达细胞的积分光密度比较差异无统计学意义（P〉0．05）。结论Hp感染和NSAID可能改变胃壁神经元及ICC的形态结构。Hp感染可明显抑制胃窦SS分泌，而增加GAS分泌；NSAID诱导的胃炎对GAS与SS的影响不显著。     

Neuropeptides in epilepsy

Neuropeptides play an important role in modulating seizures and epilepsy. Unlike neurotransmitters which operate on a millisecond time-scale, neuropeptides have longer half lives; this leads to modulation of neuronal and network activity over prolonged periods, so contributing to setting the seizure threshold. Most neuropeptides are stored in large dense vesicles and co-localize with inhibitory interneurons. They are released upon high frequency stimulation making them attractive targets for modulation of seizures, during which high frequency discharges occur. Numerous neuropeptides have been implicated in epilepsy; one, ACTH, is already used in clinical practice to suppress seizures. Here, we concentrate on neuropeptides that have a direct effect on seizures, and for which therapeutic interventions are being developed. We have thus reviewed the abundant reports that support a role for neuropeptide Y (NPY), galanin, ghrelin, somatostatin and dynorphin in suppressing seizures and epileptogenesis, and for tachykinins having pro-epileptic effects. Most in vitro and in vivo studies are performed in hippocampal tissue in which receptor expression is usually high, making translation to other brain areas less clear. We highlight recent therapeutic strategies to treat epilepsy with neuropeptides, which are based on viral vector technology, and outline how such interventions need to be refined in order to address human disease.     

生长激素治疗重症急性胰腺炎的研究进展

重症急性胰腺炎（SAP）是由多种原因引起的胰酶激活和胰腺组织的自身消化为主要特征的伴或不伴其他器官功能改变的急腹症.由于该病的发病机制尚未完全阐明,治疗方法有待进一步探索.近年来研究发现,生长激素（GH）联合生长抑素（SS）治疗SAP取得良好效果.该文回顾性分析国内外相关文献,对GH治疗SAP可能的作用机制及GH联合SS治疗SAP的研究进展予以综述.     

生长抑素联合垂体后叶素治疗肝硬化并发上消化道大出血的疗效分析

目的：观察生长抑素联合垂体后叶素治疗肝硬化并发上消化道大出血的疗效。方法：随机将64例患者分为治疗组32例和对照组32例，两组均禁食、安置胃管，同时运用泮托拉唑40mg静滴。治疗组用生长抑素首推250μg，后以250Iμg／h持续微量泵人，垂体后叶素50u加人生理盐水维持静滴0．1u／min，对照组用生长抑素首推250μg，后以250μg／h持续微量泵人，观察疗效。结果：治疗组总有效率93．75％，对照组为84．4％，两组比较差异具有统计学意义（P〈0．05）。结论：生长抑素联合垂体后叶素治疗肝硬化上消化道大出血具有较好疗效。     

Pharmacological approach to acute pancreatitis

The aim of the present review is to summarize the current knowledge regarding pharmacological prevention and treatment of acute pancreatitis （AP） based on experimental animal models and clinical trials. Somatostatin （SS） and octreotide inhibit the exocrine production of pancreatic enzymes and may be useful as prophylaxis against Post Endoscopic retrograde cholangiopancreatography Pancreatitis （PEP）. The protease inhibitor Gabexate mesilate （GM） is used routinely as treatment to AP in some countries, but randomized clinical trials and a meta-analysis do not support this practice. Nitroglycerin （NGL） is a nitrogen oxide （NO） donor, which relaxes the sphincter of Oddi. Studies show conflicting results when applied prior to ERCP and a large multicenter randomized study is warranted. Steroids administered as prophylaxis against PEP has been validated without effect in several randomized trials. The non-steroidal anti-inflammatory drugs （NSAID） indomethacin and diclofenac have in randomized studies showed potential as prophylaxis against PEP. Interleukin 10 （IL-10） is a cytokine with anti-inflammatory properties but two trials testing IL-10 as prophylaxis to PEP have returned conflicting results. Antibodies against tumor necrosis factor-alpha （TNF-α） have a potential as rescue therapy but no clinical trials are currently being conducted. The antibiotics beta- lactams and quinolones reduce mortality when necrosis is present in pancreas and may also reduce incidence of infected necrosis. Evidence based pharmacological treatment of AP is limited and studies on the effect of potent anti-inflammatory drugs are warranted.     

肠易激综合征血浆及乙状结肠粘膜中生长抑素的变化

应用放射免疫分析法检测正常组２４例及肠易激综合征组２６例受检者血浆及乙状结肠粘膜中生长抑素的含量，旨在探讨ＩＢＳ患者历浆及乙状结肠粘膜中ＳＳ的含量有无变化，以及它在ＩＢＳ疾病过程中的可能作用和临床意义。结果；ＩＢＳ组血浆中ＳＳ的浓度明显高于正常组；乙状结肠粘膜中的ＳＳ的含量痛秘型ＩＢＳ显著高于痛泻型，痛泻型ＩＢＳ显著高于正常组。     

Effect of somatostatin on postoperative gastrointestinal function and stress level in children with acute abdomen: a prospective randomized controlled study北大核心CSCD

目的 探讨生长抑素对急腹症患儿术后胃肠功能及应激水平的影响。 方法 选取2019年8月至2021年6月徐州市儿童医院收治的行手术治疗的102例急腹症患儿为研究对象。将患儿随机分为观察组和对照组,每组各51例。对照组患儿术后给予止血、抗感染等常规治疗,观察组在常规治疗的基础上加用生长抑素。术前、术后第1天及术后第5天采集两组患儿外周血,比较两组患儿血清血管内皮素-1（endothelin-1,ET-1）、促肾上腺皮质激素（adrenocorticotropic hormone,ACTH）、皮质醇（cortisol,Cor）及胃泌素、胃动素水平,以及两组患儿术后恢复情况及并发症发生率。 结果 术前两组患儿血清ET-1、ACTH、Cor、胃动素及胃泌素水平差异无统计学意义（P>0.05）。术后第1天、第5天,观察组患儿血清ET-1、ACTH、Cor水平均显著低于对照组（P<0.05）;术后第5天,观察组患儿胃动素与胃泌素水平均高于对照组（P<0.05）。术后观察组患儿首次肛门排气时间、肠鸣音恢复时间、首次排便时间、住院时间均较对照组缩短（P<0.05）。观察组并发症发生率（6%）显著低于对照组（24%,P<0.05）。 结论 生长抑素可显著降低急腹症患儿术后应激反应,改善胃肠功能,降低并发症发生率,有益于疾病预后。     

Mechanisms of Action and Resistance of Somatostatin Analogues for the Treatment of Hepatocellular Carcinoma: A Message Not Well Taken

Somatostatin (SST) acts as an inhibitory peptide of various secretory and proliferative processes. Apart from neuroendocrine tumors, where SST analogues have an established role, they have been tested in other tumors such as hepatocellular carcinoma (HCC) in the view of the fact that chemotherapy is not working. Several positive reports have been published. Approximately 40% of patients respond with improved survival and an impressive quality of life. A usual misunderstanding in trial designs is that, although SST is not a rescue drug, selection of patients is inappropriate, with mostly moribund patients being recruited. SST analogues do not seem to work in 60% of HCCs and this has been linked to the presence of SST receptors (SSTR) in the tumor, while several resistance mechanisms might be involved. Future management should engage more specific SST analogues targeted to a tumor with a known SSTR map. The use of somatostatin analogues as an adjunct therapy in combination with other treatment modalities should also be investigated.