丹参抗大鼠乙酸性十二指肠溃疡作用机制的探讨

目的　探讨丹参抗大鼠乙酸性十二指肠溃疡的作用及机制。方法　按Okabe方法复制大鼠乙酸十二指肠溃疡模型 ,按传统方法测定溃疡指数、溃疡抑制率 ;用放射免疫法测定十二指肠溃疡部位的前列腺环素 (PGI2 )含量。结果　丹参组的溃疡指数显著低于对照组 (P <0 .0 1) ,其溃疡抑制率高于对照组 ,PGI2 的含量亦显著高于对照组 (P <0 .0 1)。结论　丹参具有抗大鼠十二指肠溃疡的作用 ,其机制可能是丹参提高了十二指肠粘膜的防御能力     

挫伤性脉络膜破裂出血

应用荧光血管造影方法观察118例眼挫伤病人的眼底改变。其中46例(39.0％)有脉络膜破裂去血。46例中视盘附近脉络膜破裂出血26例(56.5％);黄斑部脉络膜破裂出血13例(28.3％),其余部位脉络膜破裂出血7例(15.2％),三者间差异非常显著(P<0.01)。视盘颞侧部位脉络膜破裂出血22例(47.8％),鼻侧部位18例(39.1％),其余6例为视盘的上、下或环周破裂出血。     

A Case of Postbulbar Duodenal Ulcer with Jaundice

Abstract: A 63-year-old man was hospitalized because of jaundice and anorexia. An upper gastrointestinal series and hypotonic duodenography revealed circumferential sclerosis and stenosis of the duodenal wall. Endoscopic examination disclosed an ulcer, the upper margin of which was located at the papilla of Vater. The papilla was situated in the base of the ulcer. Endoscopic retrograde cholangiopancreatography disclosed mild dilatation of the common bile, intrahepatic bile and pancreatic ducts, but with neither severe stenosis nor occlusion. Nevertheless, there was some degree of circumferential compression and mild stenosis of the terminal portions of the bile and pancreatic ducts, as potential causes of obstructive jaundice in this patient. Computed tomographic examination of the abdomen revealed a tumorous lesion at the duodenal bulb. Because malignancy in the duodenum could not be ruled out, a pancreatoduodenectomy was performed. Histopathological examination showed a postbulbar duodenal ulcer, associated with inflammation of the papillary orifice and fibrosis of the region near the papilla. There was no evidence of a tumorous lesion. In this case, a postbulbar duodenal ulcer may have caused obstructive jaundice.     

核素显像评价电刺激对健康青年人小肠运动功能影响的试验研究

目的利用放射性核素显像研究十二指肠电刺激对人小肠通过时间的影响。方法12例健康青年志愿者,男女各6例,年龄21～25岁,中位年龄23岁。在胃镜引导下留置导管至十二指肠水平部,并安置电极,将99mTc-DTPA(二乙撑三胺五乙酸)和乳果糖混合液注入导管,用单光子发射式计算机断层仪(SPECT)进行连续小肠显像。择日对受试者进行电刺激,刺激条件:频率13Hz、波宽300ms、刺激强度5mA的方波,采用上述方法进行显像。使用感兴趣区分析法,生成小肠时间-放射性曲线,计算出小肠半排时间(T50),比较刺激前后小肠半排时间的变化。结果电刺激前后小肠平均半排时间分别为(49.5±15.8)min和(29.6±10.9)min,刺激前后T50变化有统计学意义(P<0.01)。结论放射性核素显像能很好地反映小肠运动变化,十二指肠电刺激能明显加快小肠运动。     

Angioarchitectural study of esophageal varices

Summary Pathomorphological and angioarchitectural characteristics of esophageal varices, mainly of ruptured varices, were studied in autopsy cases. Contrast medium was injected into the esophageal vein in 25 among 75 cases with varices, and in 4 cases without varices as a control. Out of the 75 cases with varices, rupture was confirmed in 8 cases. Ruptured points were recognized at the oral end of the longitudinal veins (these veins were called sudare-like veins in this study) in the lamina propria at the lower end of the esophagus in all of the 8 cases. This ruptured area was called the critical area. By morphometric examination, dilatation of these sudare-like veins was the most obvious in severe varices, and these veins were observed to penetrate the muscularis mucosae to connect to the submucosal veins at the critical area. This area seemed to be of the greatest significance in the pathogenesis of spontaneous variceal rupture.     

3D MRI-Based Multicomponent FSI Models for Atherosclerotic Plaques

A three-dimensional (3D) MRI-based computational model with multicomponent plaque structure and fluid-structure interactions (FSI) is introduced to perform mechanical analysis for human atherosclerotic plaques and identify critical flow and stress/strain conditions which may be related to plaque rupture. Three-dimensional geometry of a human carotid plaque was reconstructed from 3D MR images and computational mesh was generated using Visualization Toolkit. Both the artery wall and the plaque components were assumed to be hyperelastic, isotropic, incompressible, and homogeneous. The flow was assumed to be laminar, Newtonian, viscous, and incompressible. The fully coupled fluid and structure models were solved by ADINA, a well-tested finite element package. Results from two-dimensional (2D) and 3D models, based on ex vivo MRI and histological images (HI), with different component sizes and plaque cap thickness, under different pressure and axial stretch conditions, were obtained and compared. Our results indicate that large lipid pools and thin plaque caps are associated with both extreme maximum (stretch) and minimum (compression when negative) stress/strain levels. Large cyclic stress/strain variations in the plaque under pulsating pressure were observed which may lead to artery fatigue and possible plaque rupture. Large-scale patient studies are needed to validate the computational findings for possible plaque vulnerability assessment and rupture predictions.     

HIS网络在门诊挂号、收费管理中的应用

随着医院现代化的高速发展,医院信息系统(HIS)显得越来越来至关重要。对其要求越来越趋于完善性、全面性、灵活性、快捷性。这样就要求有一套完整的HIS来满足现代化医院管理的需要,实现现代化医院"以人为本"的管理理念,"一切以病人为中心",用现代化的管理理念结合工作需求,构建工作中的"和蔼"关系。     

Trypsin activity in chyme and juxtamural layer of mucus in experimental blocking of the Brunner's glands region of the rat duodenum

Department of Histology and Department of Operative Surgery, I. M. Sechenov Moscow Medical Academy Laboratory of Electron Microscopy, Institute of Nutrition, Academy of Medical Sciences of the USSR, Moscow. (Presented by Academician of the Academy of Medical Sciences of the USSR I. V. Sudakov.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 112, No. 11, pp. 542–545, November, 1991.     

Association of interleukin 1 gene family polymorphisms with duodenal ulcer disease

Cytokine genes taking part in the immunological response to Helicobacter pylori infection are good candidates to study for genetic predisposition to duodenal ulcer disease (DU). Among cytokines, interleukin (IL)-1beta and its natural specific inhibitor, the interleukin-1 receptor antagonist, are cytokines that play a key role in regulating gastric acid secretion and modulating the immune response in the gastrointestinal mucosa. We aimed to investigate whether polymorphisms in the IL-1B and IL-1RN genes are involved in the susceptibility to duodenal ulcer. DNA from 131 unrelated Spanish Caucasian patients with DU and 105 ethnically matched healthy controls was typed for the IL-1B-511, IL-1B-31, and IL-1B + 3954 gene polymorphisms, and the VNTR polymorphism in intron 2 of the IL-1RN gene by polymerase chain reaction (PCR)-based methods and TaqMan assays. H. pylori status and non-steroidal anti-inflammatory drugs (NSAIDs) use was determined in all patients and controls. Logistic regression analysis identified H. pylori infection (OR: 9.74; 95%CI = 3.53-26.89) and NSAIDs use (OR: 8.82; 95%CI = 3.51-22.17) as independent risk factors for DU. In addition, the simultaneous carriage of IL-1RN*2, IL-1B-511*C, IL-1B-31*T and IL-1B + 3954*C alleles was a genetic risk factor for DU in patients with H. pylori infection (OR: 3.22; 95%CI = 1.09-9.47). No significant differences in IL-1RN and IL-1B genotypes were found when patients were categorized according to gender, age of onset, smoking habit, NSAIDs use, type of complication and positive family history. Our results provide further evidence that host genetic factors play a key role in the pathogenesis of duodenal ulcer.     

Duodenal wall cysts may be derived from a ductal component of ectopic pancreatic tissue

AIMS: To clarify the mechanism of origin of duodenal wall cysts in patients with chronic pancreatitis, developing into duodenal stenosis. METHODS AND RESULTS: Specimens from 12 pancreatoduodenectomized patients with chronic pancreatitis and 51 controls were studied histopathologically and immunohistochemically. Variously shaped cystic lesions, averaging about 15 mm in diameter, were found in the duodenum in six of the 12 patients with chronic pancreatitis, but were not observed in the controls. Each case had an average of two cysts, which were located mainly in the muscularis propria of the duodenum with or without submucosal or extraduodenal-peripancreatic extensions. The inner part of the cyst wall consisted of a moderate rim of granulation tissue, with both myofibroblasts and smooth muscle proliferation in the tissue surrounding the cyst and the submucosal layer of the duodenum, occasionally accompanied by an epithelial lining. A ductal structure in the muscularis propria of the duodenum, possibly a ductal component of ectopic pancreatic tissue, was found in five of the six cases. Some of these structures showed cystic changes. Three of the six patients had accompanying duodenal stenosis. CONCLUSIONS: Duodenal wall cysts occur mainly in the muscularis propria of the duodenum associated with both myofibroblasts and smooth muscle proliferation, and may result in duodenal stenosis. These cysts may be derived from a ductal component of ectopic pancreatic tissue.