“肠梗”治疗粘连性肠梗阻425例

本文对采用自行研制的中草药浓缩剂“肠梗”治疗的粘连性肠梗阻４２５例进行临床分析。根据不同的病理及临床特征将其分为三种类型，其中广泛粘连型是“肠梗”治疗的最佳适应症，粘连扭转型是其禁忌证。并对中转手术的指征、时间等问题进行了讨论。认为该方法具有简单易行、安全可靠、成功率高的特点，是一种易于推广的治疗粘连性肠梗阻的有效方法，具有较高的临床实际应用价值     

原发性小肠恶性肿瘤的CT诊断

本文回顾性分析３４例经病理证实的原发性小肠恶性肿瘤的ＣＴ表现。病变包括腺癌１６例，平滑肌肉瘤１２例，淋巴瘤６例。ＣＴ扫描能明确肿瘤向腔内和腔外侵犯的程度，清晰显示肿瘤与邻近结构的关系，有无局部及远处转移等，为临床治疗提供帮助。鉴别诊断应包括小肠良性肿瘤、炎性病变和转移性肿瘤等。     

10Gyγ线照射后小鼠两相邻肠段运动变化

本文用同时记录两相邻空肠段的收缩活动来观察经10Gyγ线照射后小肠运动的变化,以了解照射后是否出现逆蠕动,以便进一步分析肠套叠形成的原因.结果表明,照射后两相邻肠段出现强度不一的收缩活动,并且可以产生逆蠕动;但是这种逆蠕动发生的机率是不大的.本实验未观察到逆蠕动发生的规律性.因此,逆蠕动的产生可能是照射后发生肠套叠的部分原因.     

Effects of enteral feedback inhibition on motility,luminal flow,and absorption of nutrients in proximal gut of minipigs

We wanted to clarify whether the postprandial intestinal feedback control activated by nutrients in the distal gut exerts different effects on motility, transit of digesta, and absorption of nutrients in the proximal gut. Additionally, interrelationships among motility, transit, and absorption were to be elucidated because these relationships have only been investigated in the fasted state. In five minipigs, a 150-cm segment of the proximal jejunum was isolated by two cannulas. Motility of the jejunal segment was recorded by multiple strain gauges and analyzed by computerized methods. Markers (Cr- and Cu-EDTA) were used for the measurement of the flow rate, transit time, and absorption of nutrients. After a meal, the test segment was perfused with 2 kcal/min of an elemental diet over a period of 90 min. A feedback inhibition was activated by infusion of nutrients into the midgut at rates of 1–4 kcal/min. Saline was infused as control. With increasing energy loads infused into the midgut, the motility index and the length of contraction waves decreased, whereas the incidence of stationary contractions increased, ie, the motility changed from a propulsive to a segmenting pattern. These modulations of motility were associated with a linear decrease in the flow rate and a linear increase in transit time. Flow and transit were linearly correlated with each other. Additionally, the reduction in flow rate and the delay in luminal transit were associated with a linear increase in the absorption of nutrients. However, the increase in absorption induced by the feedback mechanism was small (7.3–13.4%) compared to the marked inhibition of the motility parameters (54–64%), the flow rate (59%), and the delay of transit (5.8-fold). Feedback control primarily modulated motor patterns and luminal flow, whereas the small increase in absorption was only a side effect due to the longer contact time of the nutrients with the mucosa.The study was supported by the Deutsche Forschungsgemeinschaft, grant Eh 64/6-3.     

Absorption of Propranolol in Humans Following Oral,Jejunal, and Heal Administration

Pharmaceutical Research -     

Comparison of the Permeability Characteristics of a Human Colonic Epithelial (Caco-2) Cell Line to Colon of Rabbit,Monkey, and Dog Intestine and Human Drug Absorption

The in vitro permeabilities of Caco-2 monolayers and permeabilities in tissue sections from colon of monkey, rabbit, and dog were compared using a series of compounds. The selected compounds differed in their physicochemical properties, such as octanol/water partition coefficient, water solubility, and molecular weight. Their structure included steroids, carboxylic acids, xanthins, alcohols, and polyethylene glycols. A linear permeability relationship was established between Caco-2 and colon tissue from both rabbit and monkey. The results suggest that Caco-2 is twice as permeable as rabbit and five times as permeable as monkey colon. However, no clear relationship could be established between Caco-2 monolayers and dog colon permeability. A relationship between permeability in Caco-2 monolayers and human absorption was found. The results suggest that within certain limits, permeability of Caco-2 monolayers may be used as a predictive tool to estimate human drug absorption.     

Interactions between peripheral blood CD8 T lymphocytes and intestinal epithelial cells (iEC)

Intestinal intraepithelial lymphocytes (iIEL) are primarily CD8 cells and most of them have a CD28^? phenotype, the phenotype of effector cytotoxic T cells. We asked whether the predominance of CD8⁺ CD28^? T cells in the gut may result from peripheral blood T cells preferentially migrating to the iIEL compartment and adhering to iEC. Compared with CD4 cells, adhesion of resting CD8⁺ T cells to iEC cell lines was significantly higher. Adhesion could be blocked with a MoAb to gp180, a molecule expressed on iEC which is known to interact with CD8/lck. No significant difference in the level of adhesion was observed between CD8⁺ CD28⁺ and CD8⁺ CD28^? T cells. Thus CD8 cells may preferentially migrate to the iIEL compartment, but loss of CD28 expression could occur in situ after migration. Consistent with this hypothesis, the CD8⁺ CD28^? cells became enriched after co-culturing T cells with iEC cell lines and primary iEC. Induction of the CD8⁺ CD28^? phenotype in cord blood and adult T cells was observed in co-cultures with iEC and also with mitogens and superantigens. In the latter case, CD28 down-modulation was seen specifically in the Vβ subset targeted by the superantigen, indicating that loss of CD28 expression is a direct result of T cell receptor (TCR)-mediated stimulation. The combined results suggest that CD8⁺ CD28^? T cells are antigen experienced T cells, and that they may have a survival advantage in the presence of gut epithelial cells in vitro. This may contribute to the predominance of CD8⁺ CD28^? T cells in the iIEL compartment.     

小儿乙状结肠冗长症病理特点分析

目的 探讨小儿乙状结肠冗长症的病理特点，以提高对该症病理特点的认识。方法 分析我科1993～2002年间经手术治疗12例小儿乙状结肠冗长症的临床病理资料。结果 小儿乙状结肠冗长症病理特点与先天性巨结肠同源病相似。主要表现为乙状结肠肠壁肥厚，部分肌纤维变性。结肠黏膜萎缩，黏膜下充血水肿；肌间神经丛减少，均可见神经节细胞发育幼稚，且数量减少或体积变小，呈固缩或空泡变性。结论 小儿乙状结肠冗长症大多有肠神经元发育异常。     

实验小鼠肠道正常菌群

在动物肠道中栖息的细菌，构成了肠道正常菌群。实验动物的质量与肠道菌群的状态有着十分密切的联系，肠道菌群平衡状态在维持动物机体的生理状态、正常功能，以及抵抗外袭菌方面起着重要的作用。小鼠肠道中，每克肠内容物含有上亿个菌体，可分为10～15个属，上百个种。肠道正常菌群的主要菌属有双歧杆菌、拟杆菌(类杆菌)、肠球菌、乳杆菌、梭杆菌、真杆菌。不同品系的小鼠之间，各种菌的数量有所不同。本文简要介绍了近年来对小鼠肠道正常菌群的研究进展。     

褪黑素对结肠黏膜上皮细胞氧化应激的影响

目的 探讨褪黑素对大鼠结肠黏膜上皮细胞氧化应激的影响。方法 在分离培养正常大鼠结肠黏膜上皮细胞基础上，利用FeSO4 H2O2产生*OH攻击制备结肠黏膜细胞氧化损伤模型，同时预先加入褪黑素并观察损伤减轻程度。实验设正常对照组、模型对照组、5-氨基水杨酸给药组(0.1mmol／L)，褪黑素给药组(0．01、0．1、l.0mmol／L)。培养一定时间后，取上清测乳酸脱氢酶(LDH)、丙二醛(MDA)、谷胱甘肽过氧化物酶(GSHPx)、过氧化氢酶(CAT)、超氧化物歧化酶(SOD)、一氧化氮(NO)和黏液含量。结果 模型组大鼠结肠黏膜上皮细胞：MDA、LDH和NO水平增高，CAT、GSHPX、SOD和黏液含量减少。不同剂量褪黑素呈剂量依赖性的减少LDH释放，抑制MDA和NO的形成，恢复黏液、CAT、GSHPX及SOD水平。结论 褪黑素对大鼠结肠黏膜氧化损伤具有保护作用。