Field stimulation-induced responses of circular smooth muscle from guinea-pig stomach

Summary Field stimulation of circular smooth muscle of guinea-pig stomach from the regions of the cardia and fundus caused contraction responses at low stimulation frequencies (0.25–1 Hz) with relaxation at higher frequencies (1–10 Hz), whilst tissues of the body and antrum responded with contraction throughout the frequency range. Atropine (10^–9–10^–8 M) antagonised the contraction responses of all tissues, with relaxation developing at higher concentrations (except for antral tissue). In contrast, metoclopramide (10^–8–10^–6 M) caused modest (cardia, fundus) or marked (body, antrum) enhancement of contractions to field stimulation, whilst domperidone (10^–8–10^–7 M), haloperidol (10^–8–10^–6 M), prazosin, propranolol and methysergide (10^–8–10^–6 M) failed to modify the contraction responses. However, whilst yohimbine and guanethidine failed to modify the contractions of the cardia, fundus and body tissues, those of the antral preparations were antagonised by nanomolar concentrations of yohimbine and by guanethidine (10^–6–5×10^–5 M). To optimise the relaxation responses for study, atropine was included in the physiological solution. Relaxation to field stimulation of preparations from the body and cardia, but not the fundus, was antagonised by reserpine pretreatment (5 mg/kg i.p., 24h), addition of guanethidine (10^–5–10^–4 M), phentolamine, prazosin or propranolol (10^–7–10^–6 M) (the effects of prazosin and propranolol being additive). Higher concentrations of haloperidol and domperidone antagonised the relaxation responses of the body preparations only. Metoclopramide, yohimbine and methysergide (10^–8–10^–6 M) were ineffective. Thus, it is concluded that the contractile effects of the 4 stomach areas to field stimulation reflects a major cholinergic involvement, with an additional ₂-adrenoceptor contractile component in antral tissue. Relaxation responses of cardia and body tissue involve ₂- and -adrenoceptors plus a further, unidentified, non-adrenergic component; the latter represents the total relaxation response of the fundic preparation.     

论吴鞠通治疳学术思想

吴鞠通《温病条辨·解儿难》对疳疾的论治文短义深,所提治疳九妙法蕴藏着深奥的学术思想。本文从脾胃学说、升降出入学说、营卫学说等方面进行了阐发,以期能发掘其学术渊薮,指导学术研究及临床实践。     

Apomorphine contracts and relaxes circular smooth muscle of guinea-pig stomach via action on adrenoceptor mechanisms

Summary Nanomolar concentrations of apomorphine caused contractions of the circular smooth muscle from the body region of the guinea-pig stomach, the response showing rapid tachyphylaxis. These contractions were antagonised by yohimbine but not by prazosin, haloperidol, propranolol or methysergide. Higher concentrations of apomorphine caused concentration-related relaxations of the stomach body which were not subject to tachyphylaxis. These were antagonised by propranolol but not by prazosin, yohimbine or haloperidol. Dopamine-induced contractions of the circular smooth muscle from the stomach body were antagonised by apomorphine in nanomolar concentration; acetylcholine-induced contractions and isoprenaline-, dopamine- and phenylephrine-induced relaxations were unaffected by apomorphine. Thus, it is concluded that the contraction of circular smooth muscle from the stomach body to apomorphine is mediated via an adrenoceptor with characteristics of the ₂-type, and that a partial agonist-antagonists action prevents subsequent contractile responses to apomorphine and dopamine. Relaxation caused only at higher concentrations of apomorphine is mediated via an adrenoceptor with characteristics of the -type.     

Benzamide action at α2-adrenoceptors modifies catecholamine-induced contraction and relaxation of circular smooth muscle from guinea-pig stomach

Summary Dopamine was shown to act on the circular smooth muscle of the stomach body to cause contraction at a yohimbine-sensitive site (₂) and a relaxation at a prazosin-sensitive site (₁). Metoclopramide and tiapride failed to modify either response, failed to antagonise a relaxation to phenylephrine at 1(₁ sites in the same tissue, and failed to modify the contractions caused by dopamine and phenylephrine at an ₂-adrenoceptor site in the pyloric sphincter. However, (+)- and (–)-sultopride and (+)-sulpiride antagonised the dopamine-induced contractions of the stomach body indicating an ₂-antagonist action. An ability to attenuate the relaxation of this tissue may reflect a displacement of the contraction curve to the right rather than an ₂-antagonist action since the response to phenylephrine was not antagonised either in this tissue or in the pyloric sphincter. Within the central nervous system the (–)-enantiomers of sultopride and sulpiride have a highly selective dopamine receptor blocking action. This cotrasts with the present findings in the stomach musculature of a non-stereospecific antagonism at ₂-type adrenoceptors.     

慢性严重误吸的手术治疗

目的：探讨不同病因所致慢性严重误吸患者的最佳手术治疗方式。方法：对8例慢性严重误吸患者分别采用3种手术方式治疗；①气管切开术(5例)、颈气管永久性造瘘术(1例)，气管套管佩带气囊，进食时气囊充气以阻止误吸；②会厌瓣缝合术(即喉口闭锁术，1例)；③胃永久性造瘘术(1例)。结果：8例患者均能经口进食，食物的性状种类不受限制，且未发现吸入性肺炎。其中5例带气囊者仅在进食后放气时，略有轻微刺激性咳嗽，1例喉癌行Arslan术式者，仍有较轻误吸现象，以上6例患者堵管时均能发声，可日常交谈；1例采用会厌瓣缝合术患者，术后经口进食已完全杜绝误吸现象；1例行胃永久性造瘘术者，能较好解决进食误吸，无胃反流现象。结论：会厌瓣缝合术(喉口闭锁术)、气管切开术(或颈气管永久性造瘘术)和胃永久性造瘘术3种术式，均是解决慢性误吸的外科治疗方法，可依不同的病因及患者的具体情况选择最佳术式。     

运脾法的理论与实践

根据文献资料和临床实践体会，介绍运脾法的理论意义及其在临床上的应用，分述为运脾化湿法、运脾和胃法、温运脾阳法、养胃助运法、理气助运法、益气助运法，以期探讨运脾法的实质。     

Lanzoprazole promotes gastric carcinogenesis in rats with duodenogastric reflux

Background Duodenogastric reflux is known to cause an increased frequency of cancer in the glandular portion of the stomach in rats. Furthermore, it is debated whether inhibition of gastric acid secretion may promote gastric carcinogenesis. In the present study we examined the combined effect of gastroduodenal reflux and acid inhibition with respect to the development of gastric carcinoma in the rat.Methods Following the construction of a gastrojejunostomy in male Wistar rats, half of them were given the proton pump inhibitor lanzoprazole for 1 year. The rats were then killed and the pH in the stomach and gastrin in blood were measured. The stomach was examined macroscopically as well as histologically.Results Gastrin levels at autopsy were significantly increased in treated rats compared to the control group, confirming an effect of lanzoprazole on gastric acid secretion. Body weight was significantly reduced in the treated rats. Thirty of 79 rats developed gastric cancer, and they were all adenocarcinomas of the Lauren intestinal type. Gastric cancers occurred significantly more often in lanzoprazole-treated rats (50%) compared with controls (27%).Conclusion Lanzoprazole given orally enhances the carcinogenic effect of duodenogastric reflux in rats.     

Marimastat对裸鼠原位种植人胃癌生长和转移抑制的实验研究

目的 探讨基质金属蛋白酶抑制剂Marimastat对胃癌生长和转移的抑制作用。方法 采用人胃腺癌细胞株SGC—7901完整组织块棵鼠原位种植，建立胃癌转移模型。移植7天后开始腹腔内注射Marimastat，隔天1次，剂量为0mg/kg(对照组)、10mg/kg、30mg/kg、60mg/kg(治疗组)，共用8周，第9周处死动物，测量原位肿瘤大小、抑瘤率、肿瘤微血管密度(MVD)、MMP—9的高表达率、观察肿瘤转移情况。结果 治疗组原位肿瘤瘤重明显较对照组轻，肿瘤肝脏转移、腹膜转移、肿瘤组织微血管密度和肿瘤组织MMP—9高表达率与对照组比较，均有显著性差异(P＜0．05)，且与Marimastat剂量呈正相关。结论 Marimastat对体内胃癌的生长及转移均有抑制作用。     

胃癌患者术后NDV-ATV治疗对机体免疫功能的影响

目的 探讨新城鸡瘟病毒修饰的自体肿瘤疫苗(NDV—ATV)治疗胃病术后患者机体免疫功能的影响。方法 采用流式细胞术分析36例胃病术后(术后2、3、4、5周)NDV—ATV治疗患者外周静脉血T淋巴细胞亚群及NK细胞的变化情况，并以15例术后未接受NDV—ATV治疗的胃癌患者作对照。结果 对照组术后CD3^ 、CD4^ 、NK细胞所占百分比和CD4^ /CD8^ 逐渐升高，以术后3周内升高最为明显。NDV—ATV治疗组，术后CD3^ 、CD4^ 、NK细胞所占百分比和CD4^ /CD8^ 上升速度更快，持续时间更长。治疗结束后与治疗前比较，有非常显著性差异(P＜0．01)；且明显高于未接受NDV—ATV治疗的对照组患者(P＜0．05)。第1次治疗后和治疗结束后相比较有显著性差异(P＜0．05)。结论 NDV—ATV可同时视为1种免疫调节剂，能明显改善胃癌患者术后机体的免疫功能，提高机体抗肿瘤能力。     

PN0胃癌淋巴结微转移的检测及其预后意义

目的　评估细胞角蛋白免疫组化染色诊断PN0 胃癌区域淋巴结微转移的临床病理意义。方法　采用免疫组织化学方法 ,用细胞角蛋白 19单抗检测了 3 9例经传统HE染色诊断为无转移 (PN0 )胃癌患者的 3 74个淋巴结。结果　淋巴结微转移率为 3 3 .3 % ( 13 /3 9) ,微转移度为 4.5 % ( 17/3 74) ,微转移与其它临床病理特点无显著相关性 (P >0 .0 5 )。微转移阳性者与阴性者总生存率显著不一致 (P =0 .0 2 73 )。多变量分析表明淋巴结微转移是独立的预后因素。结论　细胞角蛋白 19单抗免疫组化染色方法较常规组织学检查方法敏感性更高 ,提高了淋巴结微转移的检出率和临床分期的准确性。淋巴结微转移对胃癌预后有重要作用