犬Oddi括约肌狭窄模型的建立及其胆道动力学的变化

目的建立犬Oddi括约肌（sphincter of Oddi,SO）狭窄模型,探讨其胆道动力学的变化。方法禁食16～18h成年杂种犬麻醉后,超声测量胆总管管径。实验组行经腹切开十二指肠,机械性损伤SO致其狭窄;对照组仅行经腹切开十二指肠,术毕饲养。定期检查肝功能,4周后再次麻醉下行超声测量胆总管管径及开腹行SO测压。最后切取SO及周围组织行病理检查。结果实验组术后4周肝功能TBIL、DBIL、GGT、ALP明显高于术前,超声测量胆总管管径大于术前,病理检查发现括约肌组织纤维化,而对照组均无明显变化。与对照组相比,实验组胆总管及SO基础压明显升高,SO收缩幅度降低,收缩频率升高,收缩时间缩短。结论SO狭窄模型成功建立;Oddi括约肌狭窄后其胆道动力学发生明显改变。     

低位直肠癌保肛术与Miles术的远期疗效比较

目的 :比较低位直肠癌保肛术与 Miles术远期疗效。方法 :对 1994～ 1995年 71例距肛缘 5～ 7cm的低位直肠癌进行回顾性分析。其中保肛手术组 34例 ,Miles术组 37例。结果 :保肛组 2年局部复发 3例 (3/34) ,2、 5年生存率分别为 82 .4%及 6 1.8% ,Miles组局部复发 4例 (4/37) ,2、 5年生存率分别为 81.1%及 5 6 .8% ,两组比较差异均无显著性 (P >0 .0 5 )。结论 :对距肛缘 5～ 7cm低位直肠癌可行保肛手术 ,提高生存质量。     

犬双侧迷走神经干切断术对Oddi括约肌肌电的影响

目的研究双侧迷走神经干切断术对Oddi括约肌(SO)肌电的影响。方法禁食16~18h(可自由饮水),成年杂种犬麻醉后,实验组行膈肌水平双侧迷走神经干切断术加幽门成形术,对照组仅行幽门成形术。手术后8周行SO肌电记录(SOE)。结果实验组慢波幅度明显升高,快波未观察到显著性变化。结论双侧迷走神经干切断术对SO肌电产生明显影响。     

直肠癌保肛手术的规范化实施

当前,保肛手术已成为直肠癌的首选术式。究竟有多少是应该选作保肛手术？又有多少不适宜施行保肛手术？笔者旨在阐述在临床上应该如何正确对患者选择实施保肛手术：首先．应在术前作全面评估：然后,根据检查结果严格按照美国国立癌症综合网络（NCCN）直肠癌实践指南规定来决定手术指征：同时．必须按照根治与保功能这两方面的要求来选用手术方式。总之．对直肠癌选作保肛手术必须达到根治性切除和功能良好双满意的目的。这是推行直肠癌保肛手术规范化实施的原因。     

105a. Der Sphincter als Schrittmacher analer Erkrankungen

Zusammenfassung Das Kontinenzorgan entblößt seine Hauptangriffsfläche zwischen Linea ano rectalis und Hiltonscher Linie. Auf eine Irritation unterschiedlicher Intensität reagiert vor allem der M. sphincter ani internus empfindlich. Seine konsekutive und reaktive Überfunktion und die ihm eigene anatomische Grundstruktur wirken unter den dargelegten Voraussetzungen krankheitsverschlimmernd, beispielhaft dargestellt an der Fissur-, Hämorrhoidal-, Prolaps-und Fistelerkrankung.     

Influence of indomethacin on effects of endothelin-1 on guinea pig isolated rings of common bile duct and sphincter of Oddi.

The effects of endothelin-1 on motility of guinea pig extra-hepatic biliary tract portions were studied. Endothelin-1 (< or =100 nM) failed to contract rings of hepatic, cystic, proximal or distal common bile ducts, or choledochal or papillary halves of sphincter of Oddi. At 100 nM, endothelin-1 or sarafotoxin S6c (selective endothelin ET(B) receptor agonist) inhibited contractions of choledochal (but not papillary) sphincter of Oddi to carbachol (1 microM) by 63+/-5 and 45+/-9%, respectively. In distal common bile duct, indomethacin (5.6 microM) unmasked potent contractile effects of endothelin-1 [EC(50) 7.8 (5.5-11.1) nM; E(MAX) 80+/-6% of response to 80 mM KCl] and enhanced the contractile potency of carbachol (585-fold at EC(50) level), but not cholecystokinin C-terminal octapeptide. Inhibition of cholinergic responsiveness of the choledochal sphincter of Oddi by endothelin-1 was reduced by BQ-123 (1 microM; endothelin ET(A) receptor antagonist; cyclo[DTrp-DAsp-Pro-DVal-Leu]) and abolished by either BQ-123 plus BQ-788 (1 microM; endothelin ET(B) receptor antagonist; N-cis-2,6-dimethylpiperidinocarbonyl-L-gamma-methylleucyl-D-1-methoxycarboyl-D-norleucine) or indomethacin. Thus, eicosanoids of the cyclo-oxygenase pathway (i.e. prostanoids) suppress endothelin-1-induced contractions of distal common bile duct and mediate endothelin ET(A) and ET(B) receptor-dependent inhibition of cholinergic responsiveness of the choledochal portion of the sphincter of Oddi.     

莨菪碱类药物对食管下括约肌α型肾上腺受体的阻滞作用

本文研究了莨菪碱类药物对家兔食管下括约肌(LES)紧张压力的影响,家兔用乌拉坦麻醉后,制作小胃、记录食管下括约肌压力(LESP)和血压变化,切断双侧颈迷走神经,排除迷走神经对LES控制,LESP平均升高39.58±2.76%(P<0.01)n=52,而莨菪碱类药物、酚妥拉明、哌唑嗪均能抑制切断迷走神经后的LES使其LESP降低,抑制强度顺序:哌唑嗪,酚妥拉明、阿托品、山莨菪碱、东莨菪碱、樟柳碱。苯肾上腺素可引起LESP明显高,用莨菪碱类药物,酚妥拉明,哌唑嗪后,再次注射苯肾上腺素其LESP升高作用受到抑制、抑制强度顺序与前述一致,初步证明莨菪碱类药物对LESα型肾上腺素受体具有阻滞作用、     

Pressure integrating transducer for oesophageal manometry

A transducer has been designed that gives an integrated measure of the radial pressure profile at a specific level in the oesophagus. The oesophageal pressure is picked up by a semicylinder elastically connected to a transducer housing by means of a slotted semicylinder. The displacement of the semicylinder is sensed by a semiconductor transducer element. The transducer has a linear relation between static pressure and output voltage, flat frequency characteristic and low temperature drift.