加味痛泻要方对家兔体外结肠平滑肌的作用

[目的]观察加味痛泻要方对家兔体外结肠平滑肌的作用。[方法]用生理记录仪记录正常及药物致痉孪肠管蠕动曲线,分别加入加味痛泻要方40、80、160 mg/ml,记录用药后兔结肠的蠕动曲线。分别计算给药前、后的抑制率和拮抗率。[结果]加味痛泻要方不仅对正常家兔结肠蠕动呈明显抑制作用,而且对平滑肌兴奋药,包括乙酰胆碱及氯化钡引起的平滑肌痉挛均有明显的对抗作用,具有剂量依赖性。[结论]加味痛泻要方可以很好地改善肠痉挛,对家兔体外结肠平滑肌的非规律性收缩有明显的缓解作用,推测该方可能是通过拮抗乙酰胆碱M受体起作用。     

A 14-Day Elemental Diet Is Highly Effective in Normalizing the Lactulose Breath Test

Treatment of small intestinal bacterial overgrowth is frustrated by the low efficacy of antibiotics. Elemental diets have been shown to reduce enteric flora. In this study, we evaluate the ability of an elemental diet to normalize the lactulose breath test (LBT) in IBS subjects with abnormal breath test findings. Consecutive subjects with IBS and abnormal LBT suggesting the presence of bacterial overgrowth underwent a 2-week exclusive elemental diet. The diet consisted of Vivonex Plus (Novartis Nutrition Corp., Minneapolis, MN) in a quantity based on individual caloric requirement. On day 15 (prior to solid food), subjects returned for a follow-up breath test and those with an abnormal LBT were continued on the diet for an additional 7 days. The ability of an elemental diet to normalize the LBT was determined for days 15 and 21. A chart review was then conducted to evaluate any clinical benefit 1 month later. Of the 93 subjects available for analysis, 74 (80%) had a normal LBT on day 15 of the elemental diet. When those who continued to day 21 were included, five additional patients normalized the breath test (85%). On chart review, subjects who successfully normalized their breath test had a 66.4 +/- 36.1% improvement in bowel symptoms, compared to 11.9 +/- 22.0% in those who failed to normalize (P < 0.001). An elemental diet is highly effective in normalizing an abnormal LBT in IBS subjects, with a concomitant improvement in clinical symptoms.     

Visceral hyperalgesia and intestinal dysmotility in a mouse model of postinfective gut dysfunction

BACKGROUND & AIMS: We established the concept that transient enteric infection may lead to persistent gut dysfunction, evident in vitro, in nematode-infected mice. The present study determined whether gut dysfunction in this model involves motor and sensory changes reminiscent of changes found in patients with postinfective irritable bowel syndrome (PI-IBS) and investigated underlying mechanisms. METHODS: Mice infected up to 70 days previously with Trichinella spiralis (Tsp) underwent videofluoroscopy with image analysis to assess upper gastrointestinal motility. Pseudoaffective responses to colorectal distention (CRD) were assessed using a barostat and validated by single fiber recordings from spinal nerves during CRD. Tissues were examined at different time points for histology, immunohistochemistry, and cytokine analysis. Some mice received dexamethasone intraperitoneally on days 23-25 PI or Tsp antigen orally on days 29, 43, and 57 PI. RESULTS: From day 28 PI, no discernible inflammation was present in the gut. Frequency and propagation velocity of intestinal contractions decreased, and retroperistalsis increased at days 28 to 42 PI. CRD induced an allodynic and hyperalgesic response in PI mice, which was accompanied by increased single unit discharge. Gavage of Tsp antigen induced T-cell responses and sustained gut dysfunction for 70 days PI. Administration of dexamethasone postinfection normalized dysmotility and visceral hyperalgesia. CONCLUSIONS: Long-lasting gut dysmotility and hyperalgesia develop in mice after transient intestinal inflammation. These changes are maintained by luminal exposure to antigen and reversed by corticosteroid treatment. The findings prompt consideration of this as a model of PI-IBS.     

Influence of blood glucose levels on rat liquid gastric emptying

The glycemic influence on liquid gastric emptying in rats was studied. Diabetic hyperglycemia was induced by streptozotocin intravenous injection seven days before the motility experiment. Some streptozotocin-treated rats further received a daily insulin injection (2.5 or 10 IU/kg). Immediate hyperglycemia was induced in a separate group of rats by continuous intravenous glucose infusion (44 or 88 mg/kg/min) 10 min before the experiment. Rats were killed 15 min after radiochromium feeding; then the radioactivity of stomach and small intestine were counted to obtain the gastric emptying value. Emptying in diabetic rats was delayed compared with controls (mean±se: 40.9±2.6% vs. 54.2±2.8%,P<0.01). Low-dose insulin treatment reversed the impairment, while high-dose treatment even enhanced emptying. Immediate hyperglycemia induced with two glucose infusions also inhibited gastric emptying. Present results indicate that hyperglycemia elicited with any hyperglycemic model is at least one of the important mechanisms to delay liquid gastric emptying.This study was supported by the National Science Council, Republic of China, grant NSC 84-2331-B-075-68.     

Effect of Acarbose on Vascular Disease in Patients with Abnormal Glucose Tolerance

INTRODUCTION: Excessive postprandial (pp) glucose excursion in people with IGT and type 2 diabetes is associated with a cascade of proatherogenic events. Acarbose, a potent competitive inhibitor of alpha-glucosidases of the small intestine specifically reduces pp hyperglycemia with an average reduction of HbA1c by 0.8% in Cochrane metaanalysis. This is associated with pleiotropic effects on a broad spectrum of cardiovascular (CV) risk factors: reduction of overweight, lowering of blood pressure, triglycerides, hsCRP, fibrinogen and other biomarkers of low grade inflammation. RESULTS AND DISCUSSION: Flow mediated vasodilation was improved and progression of intima media thickness was reduced by acarbose. In the STOP-NIDDM trial in people with IGT acarbose decreased the incidence of diabetes by 36%. The STOP-NIDDM trial with CV events as secondary objective is the only intervention trial in people with IGT so far with a significant benefit for CV disease inclusive hypertension. In a metaanalysis of controlled studies (MeRIA) in patients with type 2 diabetes, treatment with acarbose was associated with a 64% lower rate of myocardial infarction and 35% less CV events. CONCLUSION: Thus results so far available prove that acarbose is an effective and safe drug to treat abnormal glucose tolerance. They suggest that acarbose can help to control a broad spectrum of CV risk factors and may prevent CV disease.     

急性脑血管病患者应激性高血糖、血清钾、钠、氯的变化及其与中风类型、病情轻重、预后关系

目的探讨急性脑血管病患者应激性高血糖、血清钾、钠、氯的变化及其与中风类型、病情轻重、预后关系。方法本文对我院神经内科2004年6月～2005年6月住院急性脑血管病患者248例进行研究，其中出血性中风89例，缺血性中风159例，于入院次日晨检测空腹血糖、血清钾、钠、氯，观察血糖、血钠、血氯、血钾值的变化及其与脑卒中类型、病情轻重、预后关系。结果（1）急性脑血管病患者易出现应激性高血糖、低钠血症、低氯血症、低钾血症；（2）出血性中风血糖明显高于缺血性中风；高血糖组死亡率明显高于非高血糖组；死亡组的血糖均值亦显著高于存活组；统计学上差异有显著性。（3）出血性中风低血钠、低血氯的发生率明显高于缺血性中风，统计学上差异有显著性；低血钠、低血氯组中的中、重度患者显著多于正常血钠、血氯组；与正常血钠、血氯组相比，高血钠、高血氯组患者在中风类型、病情轻重及预后方面差异均无显著性，但血钠、血氯显著升高时，死亡率明显增加。与正常血钾组相比，低血钾组中患者在中风类型、病情及预后方面差异无显著性，但血钾明显降低时，病死率增加。高血钾组患者在中风类型、病情轻重和正常血钾组相比差异无显著性，但病死率则明显高于正常血钾组。结论急性脑血管病患者存在应激反应，急性脑血管病患者应激性高血糖、低钠血症、低氯血症可以作为判断急性脑血管病病情、预后评估的指标之一。高钠血症、高氯血症、高钾血症、低钾血症与中风类型、病情及预后方面差异无显著性，但当出现严重的高钠血症、高氯血症、高钾血症、低钾血症时，病死率明显增加。     

Application of low dose of FK506 in pancreas transplantation model in Wistar-SD rats

Objective: To probe into application of low dose of FK506(Tacrolimus) in pancreas transplantation.

Methods: Effects of low-dose FK506 (Tacrolimus) in pancreas transplantation with examination of ELISA Electron microscopy and TUNEL by method of random control were studied.

Results: Blood glucose concentration in control group is higher than that in treated group A (FK506) and treated group B (CsA) 7 days after transplantation (p?<?0.05). Serum C-peptide and insulin concentrations in control group are less than that in treated group A (FK506) and treated group B (CsA) 7 days after transplantation (p?<?0.05). Blood glucose, serum C-peptide and insulin concentrations are same as that in control group, group A (FK506) and group B (CsA) (p?>?0.05).There are more apoptotic nuclei in control group than that in treated group A (FK506) and treated group B (CsA) (p?<?0.05). There is no significant difference between group A (FK506) and treated group B (CsA) in sum of apoptotic nuclei (p?>?0.05). There is no significant difference among treated group A (FK506) and treated group B (CsA) in electron microscopy fields.

Conclusion: Low-dose FK506 applied in pancreas transplantation could not only be effective for immunosuppressive, but also be safe for islet cells of pancreas.