三联疗法根除幽门螺杆菌治疗对肠道微生态的影响

目的 探讨抗幽门螺杆菌(Hp)治疗对患者肠道菌群状态(肠道微生态)及耐药性的影响。方法 分别称取60例患者治疗前后新鲜粪便0．5g，选择肠道菌群中具代表性的4种需氧菌和6种厌氧菌分别进行需氧和厌氧培养，从培养出的菌落中挑选相同的菌株进行治疗前后药敏试验。结果 (1)治疗后肠道菌群中肠杆菌、葡萄球菌、拟杆菌、双歧杆菌、消化球菌、梭菌、乳杆菌、真杆菌均较治疗前明显降低(P＜0．05)；(2)治疗后肠道菌群中大肠埃希氏菌、消化链球菌、赛氏葡萄球菌、普氏梭杆菌、肺炎致病性链球菌群、产气真杆菌等对庆大霉素、红霉素、环丙沙星、特美丁、头孢噻肟钠等药耐药率明显增加，且存在多重耐药(P＜0．05)；(3)治疗后超广谱β—内酰氨酶阳性的消化链球菌、表皮葡萄球菌、普氏梭杆菌、肺炎致病性链球菌群、赛氏葡萄球菌等较治疗前分别增加26．2％、33．3％、28．6％、35．3％、28．6％。结论 三联抗Hp治疗后肠道菌群失调、耐药菌株的增加、传播与扩散对广大人群存在潜在危险。     

Complications of intestinal augmentation and substitution cystoplasty

Summary The content of these papers has been heavily weighted towards reconstructions performed utilizing segments of stomach. This was not done to place a value judgment on this type of reconstruction, rather it helps establish an awareness of: (1) potentially serious metabolic and gastrointestinal complications not previously reported in children and (2) particularly frequent symptomatic disturbances collectively included in the hematuria-dysuria syndrome. Recognition of problems specifically associated with a certain type of intestinal segment, as well as complications generally accompanying any form of intestinal reconstruction, will hopefully provide pediatric urologists and nephrologists with a better understanding of the issues that must be addressed in using these newer surgical techniques and focus attention on the specific indications and contraindications for incorporating intestinal segments into the urinary tract. Although long-term follow-up information still remains sparse, it appears that regular surveillance programs are required and both pediatric nephrologists and urologists need to be part of these programs.     

结肠造口关闭术78例临床分析

目的探讨结肠造口关闭术的手术时机及技巧。方法对1983年~2006年间78例行结肠造口关闭术病例的临床资料进行回顾性分析。结果手术时间1~8.5h,平均2.4h。并发症发生率为10.25%。结论造口关闭术手术时机应个体化,术前准备充分,合理的手术方式是降低并发症发生率的关键。     

直肠癌Miles术后并发内疝性肠梗阻的防治(附5例报告)

目的:探讨直肠癌Miles术后内疝性肠梗阻的原因、预防和诊治.方法:对1998年1月至2006年10月间收治的直肠癌Miles术后并发内疝性肠梗阻5例进行回顾性分析.结果:Miles术后并发内疝性肠梗阻的发生率为6%(5/82),表现术后不同程度的腹胀,阵发性腹痛,呕吐,胃管引流液每天超过500 mL者,结肠造瘘口无排气排便;腹部轻压痛,肠鸣音活跃或亢进.腹部立、卧位X线片检查,均发现肠腔扩张、多个液平或孤立性肠袢扩张.5例均行剖腹探查而证实,疝内容物为回肠,其中行单纯粘连松解复位2例,部分回肠切除、端端吻合术3例.再次手术后均痊愈出院.结论:Miles术后内疝性肠梗阻常缺乏典型的临床表现,早期诊断和及时剖腹探查是处理的关键,其重点在于预防.     

拮氟锐对大鼠肠道氟吸收及微量元素的影响

拮氟锐是由硼、微量元素和中药制成的抗氟药物。本文应用肠道原位灌流技术。观察了拮氟锐对大鼠肠道氟吸收的干预作用及微量元素的影响。结果透明：拮氟锐可促进肠道ＢＦ４的形成，使氟吸收量减少，血氟降低。同时，拮氟锐可拮抗氟所致的微量元素的降低。与硼锌组比较，拮氟锐的抗氟作用效果更明显。     

肠道革兰氏阴性杆菌及孤菌快速鉴定的研究

目的：为寻求肠道G杆菌及弧菌快速鉴定的方法。方法：菌种经增菌及分离培养后，取菌落接种于综合生化培养基，并在综合生化培养基管口悬挂硫化氢和靛基质试纸条。同时以克氏双糖铁培养基作对照，置37℃培养18-24h。取综合生化管培养基，外加测试氧化酶，共获取11项生化指标。结果：对689株不同菌种与综合生化管培养基和常规双糖铁培养的测试结果，符合率为99．97％，(7577/7579)和99．79％(7563/7579)。结论：综合生化管是适合医疗卫生单位微生物实验室的一种快速检验方法。     

三种粪便隐血试验的比较研究

粪便隐血试验是检测消化道微量出血的重要手段。本文用三种隐血试验:血红蛋白定量试验(HQT)、反向间接血球凝集试验(RPHA)和联苯胺试验(BT)对不同消化道疾病患者的粪便进行检测。结果表明隐血的检出用HQT和RPHA较BT更为特异和敏感。     

Absorption and presystemic glucuronidation of 1-naphthol in the vascularly fluorocarbon emulsion perfused rat small intestine

Summary Using the isolated vascularly fluorocarbon emulsion perfused rat small intestine some factors which determine the extent of the intestinal glucuronidation of 1-naphthol to 1-naphthol--d-glucuronide were studied. Increasing the luminal 1-naphthol concentration resulted in a concomitant increase in the 1-naphthol appearance in the vascular perfusate. In contrast, the total appearance of 1-naphthol--d-glucuronide increased less than proportional to the increase in the luminal 1-naphthol concentration. About 88% of the total amount of 1-naphthol--d-glucuronide excreted was released into the vascular perfusate. The capacity-limited intestinal glucuronide efflux is most likely due to saturation of the excretory mechanism for 1-naphthol--d-glucuronide. Decreasing the vascular flow rate influenced both the appearance of 1-naphthol and 1-naphtol--d-glucuronide in the vascular perfusate, whereas the appearance of 1-naphthol--d-glucuronide in the luminal perfusate was essentially flow-independent. A noradrenaline-induced change in the haemodynamic state of the vascular bed (with the total flow kept constant) resulted in a marked decrease in the 1-naphthol vascular concentration. The vascular 1-naphthol--d-glucuronide concentration was only slightly affected. These results indicate that changes in blood flow and blood flow distribution within the intestinal wall can affect the extent of presystemic intestinal metabolism by interfering with the absorption of the parent compound and the efflux of formed conjugates. These parameters can be of paramount importance for causing variable intestinal first-pass effects of drugs in vivo. Send offprint requests to M. H. de Vries at the above address     

Ciliated Cells in the Human Gastric Mucosa Evidence of Metaplastic Change

In the gastric mucosa of Japanese patients, ciliated cells were found in association with intestinal metaplasia. The cells occurred frequently in the pyloric mucosa of nearly half of the cases examined but rarely in the cardiac mucosa of total 12 cases, but never adjacent to the chief cells of gastric glands. The ciliated cells were always found in the basal part of cardiac and pyloric glands, but never in the surface or in the foveolar epithelium. Furthermore, ciliated cells containing a few small mucus granules and simultaneously possessing numerous cilia and basal bodies were noted. Ciliated cells in the gastric mucosa have been found mainly in elderly Japanese patients, but were also observed exceptionally in one Chinese, two Swedes and one American. These ciliated cells are not present in the normal human gastric and intestinal mucosa, and therefore a new term, "ciliated metaplasia", is proposed for their occurrence. Acta Pathol Jpn 40: 98–106, 1990.     

Loss of differentiation in intestinal metaplasia in cancerous stomachs. A comparative morphologic study.

229 stomachs resected for duodenal and gastric ulcer and carcinoma were examined with special regard to the morphological and histochemical pattern of intestinal metaplasia (IM). The results of qualitative and semiquantitative studies were analysed statistically. Whereas duodenal and gastric ulcer cases are best discriminated by the presence or absence of IM, the strongest discriminating factor between carcinoma and gastric ulcer is the content of goblet cells in metaplastic crypts. Metaplastic crypts lined exclusively with goblet cells producing sulfated acid glycoproteins could be identified in more than one third of the cancer cases. The increase in goblet cells coincides with a loss of the more differentiated cells in the metaplastic glands, such as enterocytes, APUD cells, or Paneth cells. This "enterocoli metaplasia" seems to be specific for cancer bearing mucosa and occurs more often in cancer of intestinal type; it may represent a form of a derepressive dedifferentiation. The significance of enterocoli metaplasia as a premalignant lesion remains to be elucidated.