玛咖保肝通便及调节肠道菌群的作用研究

目的：评价玛咖保肝通便以及对肠道菌群的调节作用,进一步挖掘玛咖的药用价值,为玛咖应用提供参考。方法：采用酒精性肝损伤（ALD）小鼠模型,测定肝功能、炎症介质及脂质过氧化指标,评价玛咖水提液的保肝作用;采用小鼠小肠蠕动抑制模型,测定墨汁推进率、小鼠血清中胃动素（MTL）和环磷酸鸟苷（cGMP）的水平,评价玛咖水提液的通便作用;通过16S rDNA技术测定盲肠内容物的肠道菌群,对所得到数据进行生物信息学分析,评价玛咖水提液对肠道菌群的调节作用。结果：ALD小鼠模型中,与模型组比较,中剂量组小鼠血清中谷丙转氨酶（GPT）、谷草转氨酶（GOT）的活力明显下降（P<0.05）,低剂量组小鼠血清中碱性磷酸酶（ALP）的活力明显下降（P<0.05）,高剂量、低剂量能明显降低小鼠肝组织中炎症介质单核细胞趋化蛋白-1（MCP-1)的含量（P<0.05或P<0.01）,高剂量、中剂量能明显抑制小鼠血清中炎症介质肿瘤坏死因子-α(TNF-α)的含量（P<0.05或P<0.01）,高剂量、中剂量、低剂量能明显升高小鼠肝脏组织中谷胱甘肽(GSH)的含量（P<0.05或P<0.01）;小鼠小肠蠕动抑制模型中,与模型组比较,玛咖水提液高剂量能明显增加小鼠小肠推进率（P<0.01或P<0.05）,中剂量组能明显增加小鼠血清中MTL的含量（P<0.05）,高剂量、中剂量组能降低cGMP水平。玛咖调节肠道菌群的研究显示,与空白组比较,在门水平上,玛咖水提液高剂量、中剂量、低剂量可减少厚壁菌门（Firmicutes）的丰度;高剂量、低剂量可增加拟杆菌门（Bacteroidetes）的丰度。在属水平上,玛咖水提液中剂量增加了乳杆菌属（Lactobacillus）的丰度;中、低剂量增加了拟普雷沃菌属（Alloprevotella）的丰度,且高剂量、中剂量、低剂量剂量肠道微生物群落有显著性差异。代谢功能预测结果显示,与空白组比较,玛咖水提液高剂量、低剂量组RNA加工和修饰、细胞运动、细胞外结构、细胞骨架项降低,其他代谢功能升高;玛咖水提液中剂量组细胞运动、细胞骨架项降低,其他代谢功能升高。结论：玛咖水提液具有保肝、通便、调节肠道菌群的作用。     

草血竭提取物对胃肠功能的影响

目的:观察草血竭提取物对胃肠功能的影响。方法:采用排便反射、胃排空、肠推进、兔离体肠管法。结果:草血竭提取物能抑制小鼠排便反射,延缓胃排空,抑制肠内容物推进,并有镇痛作用,但不影响兔离休肠管自发性和乙酰胆碱诱发的收缩。结论:草血竭提取物能影响胃肠道功能。     

不同子宫切除术式对排粪功能的影响

目的:探讨不同子宫切除术式对排粪功能的影响。方法:子宫切除患者66例,按术式不同分为全子宫切除术36例(A组),次全子宫切除术30例(B组)进行排粪造影检查。结果:A组阴道后疝(11例,30.56%)、会阴下降(10例,27.78%)的检出率高于对照组,有显著差异。B组阴道后疝(4例,13.33%)、会阴下降(2例,6.67%)的检出率与对照组相比,无显著差异。结论:全子宫切除术后导致的排粪功能障碍主要与形成阴道后疝、会阴下降有关;次全子宫切除术对排粪功能的影响明显小于全子宫切除术,次全子宫切除术是一种可选择的较好的手术方式。     

Neuroleptic-induced emotional defecation: effects of scopolamine and haloperidol

Most investigators have found adecrease in emotional defecation in rats given neuroleptics in novel environments, supporting their action as a major tranquilizer. We have found, however, that in rats a profoundincrease in emotional defecation can result from neuroleptic administration in well habituated environments, such as the homecage. Anticholinergics are known to be effective in treating the side effects associated with neuroleptic administration in humans. Therefore the present study determined the effects of anticholinergic treatment in this animal model. In male rats, defecation was measured for a 1-h test period in their homecage following various doses of the central and peripheral anticholinergics, scopolamine, andn-methylscopolamine, respectively. A decrease in fecal excretions and an attenuation of haloperidol-induced defecation was found following administration of scopolamine.n-Methylscopolamine reduced defecation at all doses. Whenn-methylscopolamine was combined with haloperidol, both fecal mass and number decreased significantly. Since both anticholinergic agents reduced haloperidol-induced defecation it is suggested that their effectiveness is mediated through peripheral mechanisms.     

2种常用辅助促排便措施对急性心肌梗死早期患者心脏功能的影响

目的对开塞露肛注和蓖麻油口服2种促排便措施对急性心肌梗死(AMI)早期患者排便时心脏功能状态的影响进行比较,为临床护理提供依据。方法将需采取促排便措施的AMI早期患者随机分为开塞露组和蓖麻油组,开塞露组给予开塞露20~40ml肛注,蓖麻油组给予蓖麻油10~30ml口服。观察比较患者在平静、促排便前、促排便后、便中前期、便中后期、便后整理、便后5min、便后30min8个时段中心率、血压、心肌耗氧量等指标的变化。结果开塞露组与蓖麻油组在促排便后开塞露组的心率和心肌耗氧量显著高于蓖麻油组,且有显著性差异(P<0.05),其他时段无显著性差异。结论开塞露肛注者与蓖麻油口服者在排便过程中各时段心脏自律性和心肌缺血情况的变化基本相同。但在开塞露肛注后等待排便期间,患者的心肌耗氧量较蓖麻油口服者增加明显,不宜过多延长开塞露肛注后等待排便的时间。     

The colon J-pouch as a cause of evacuation disorders after rectal resection: myth or fact?

Background  Colon J-pouch (JCP) reconstructions result in a better functional outcome than straight coloanal anastomosis (SCA) in terms of continence and frequency of defecation after rectal resection but might be associated with more evacuation difficulties. In order to evaluate this hypothesis, we systematically reviewed the literature to collect data on evacuation disorders after rectal resection in randomized or otherwise comparative trials. Materials and methods  Randomized controlled trials and comparative trials evaluating CJP versus SCA, latero-terminal anastomosis (LTA), and transverse coloplasty pouch (TCP) were ascertained by methodical search using Medline, Embase, and PubMed. Pooled estimates of outcomes were calculated for early-, intermediate-, and long-term follow-up. Primary meta-analysis outcomes were sensation of incomplete evacuation, prolonged evacuation, use of laxatives, use of enemas and suppositories, and stool fragmentation. Results  When compared to SCA, CJP was associated with significantly less “prolongation of evacuation” but more “use of laxatives” in the intermediate-term follow-up, while both less “sensation of incomplete evacuation” and less “fragmentation” was found after CJP in the long-term. When compared to TCP, CJP was associated with significantly less fragmentation in the intermediate-term follow-up. Conclusions  Evacuation disorders are a unique problem of low anterior resection and are not specifically related to the colon J-pouch. An erratum to this article can be found at     

直肠癌低位前切除术后肠功能改变的研究

直肠癌低位前切除术后,患者往往出现大便次数增多,大便失禁等排便功能障碍.研究表明,其功能障碍与新建直肠顺应性改变、肛门内括约肌功能损伤、内括约肌神经反射通路损伤、排便感觉变化等病理生理机制有关.     

高中生排便状况及相关因素调查分析

为了解高中学生排便状况,探讨诱发便秘的相关因素,采取整群分层随机抽样方法,于2009年3～6月对6048名在校高中生进行问卷调查,调查内容包括排便状况及相关因素共86项问题。结果显示,参照罗马Ⅲ便秘的诊断标准,便秘三联症的检出率为46．5％,女性、饮水较少、性格内向、偏食肉类及辛辣食物、生活及排便习惯不规律、常强忍便意、有排便不良习惯者更易出现便秘三联症。结果表明,高中生便秘三联症主要与不良饮食习惯、排便习惯,以及学习紧张等多种因素有关。