丽珠胃三联根除幽门螺杆菌的临床观察

目的：观察丽珠胃三联治疗幽门螺杆菌（HP）的效果。方法：采用同类对象，不同方法分组对照试验，观察HP根除情况，溃疡愈合情况及不良反应，结果：HP根除率两组分别为86．7％、85．0％，差异无显著性（P＞0．05），十二指肠溃疡的总有效率分别为88．9％、92．5％，差异无显著性（P＞0．05），结论：丽珠胃三联具有药物剂量小，疗程短，疗效高，价格低，便于携带等特点，是较为理想的根除Hp的方案。     

碱性成纤维细胞生长因子复合制剂局部治疗复发性阿弗他溃疡的临床研究

目的：观察bFGF复合制剂局部治疗复发性阿弗他溃疡的近期疗效。方法：bFGF组60例应用bFGF与适量替硝唑、地卡因配伍成复合制剂喷涂于溃疡面；常规治疗组40例应用锡类散、思密达交替涂敷于溃疡面，均每日3次，疗程5d。结果：bFGF组溃疡大小、疼痛及充血3项指标改善值均明显优于对照组（P＜0．001），临床疗效较常规治疗组显（P＜0．05）。无明显不良反应。结论：该复合制剂局部治疗复发性阿弗他溃疡安全、有效。     

Successful topical hemotherapy with a new occlusive dressing for an intractable ulcer on the toe

Topical hemotherapy is a method of applying heparinized venous blood directly onto the surface of an ulcer, which is covered with an occlusive hydrocolloidal dressing. It is often effective on chronic ulcers with thick necrosis, because some proteinases and growth factors in plasma are probably involved in the digestion of necrotic tissues and the acceleration of granulation and epithelization. We treated a patient with an intractable ulcer on the toe caused by a peripheral circulatory disturbance due to her systemic sclerosis. As conventional topical hemotherapy cannot be applied to ulcers on the round tip of a toe, we made a device for occlusive dressing of topical hemotherapy which could successfully improve the previously refractory ulcer.     

抑酸与不同抗菌药治疗幽门螺杆菌相关性消化性溃疡的对照研究

目的:评价洛赛克、羟氨苄青霉素二联疗法对幽门螺杆菌(HP)相关性消化性溃疡的疗效。方法:将83例HP阳性的胃和十二脂肠溃疡患者按就诊顺序分为A、B两组。A组43例,每次口服洛赛克20mg,1天1次,21天,羟氨苄青霉素500mg,1天3次,14天。B组40例,在A组服药的基础上再给甲硝唑400mg,1天3次,14天。结果:两组溃疡愈合率分别为93.0%、95.0%,HP消除率分别为81.4%、85.0%。结论:两组溃疡治愈率和HP消除率差异无显著性(P>0.05),B组副作用明显高于A组(P<0.05)。     

胃癌旁与溃疡旁粘膜组织的胃镜病理分析

胃镜观察并钳取胃癌旁与溃疡旁粘膜组织各60例。胃癌旁组的中、重度萎缩、肠化及不典型增生的检出率较溃疡旁组高,尤其是重度的肠化及不典型增生两组间差异有显著意义(P<0.05)。肠化者经AB_(?)~(2·5)—PAS染色后,两组中79.5％病例AB与PAS均阴性,而AB—PAS均阴性者仅发生在溃疡旁组。     

THE VAGUS AND NEUROTENSIN RELEASE IN DUODENAL ULCER—CLINICAL AND EXPERIMENTAL STUDIES

Although meal-stimulated neurotensin release from the small intestine is inhibited by cholinergic blockade, it is uncertain whether this cholinergic mechanism involves the vagus. This study examines me role of the vagus in neurotensin release by first determining the effect of vagotomy on meal-stimulated plasma neurotensin in man and second, the effect on plasma neurotensin of electrical stimulation of the vagus in sheep. Six volunteers were studied 6–8 weeks after truncal vagotomy and pyloroplasty. Basal plasma neurotensin at 32(15–67) pmol/l (median, range) was greater than in normal controls at 17 (9–52) pmol/1 (p < 0.05). Following a standard meal, plasma neurotensin rose significantly (p < 0.05), but similarly in both post-vagotomy and control groups to maxima of 74 (43–76) pmol/l and 52 (35–65) pmol/l, respectively. Basal plasma neurotensin in the six sheep was below the detection limit of the assay and remained undetectable during electrical stimulation of the vagus. Significant rises in plasma pancreatic polypeptide and gastrin confirmed the efficacy of the electrical stimulation. It is concluded that although the vagus might have a tonic inhibitory effect on basal plasma neurotensin, meal-stimulated neurotensin release is vagally independent. The inhibitory cholinergic influence on meal-stimulated release is most likely therefore to be mediated by cholinergic nerves of the enteric nervous system.     

Antral G-cell hyperplasia (Pseudo-Zollinger-Ellison syndrome) and chronic duodenal ulceration in a child

A 13-year-old boy with hypergastrinaemia and chronic duodenal ulcer disease is reported. Antral G-cell hyperplasia (AGCH) appeared to be the cause of his underlying hypergastrinaemia. Differentiation between AGCH (pseudo-Zollinger-Ellison syndrome) and an extragastric gastrin-secreting tumour (true Zollinger-Ellison syndrome) was made on the basis of the gastrin responses to stimulation with intravenous secretin as compared to an oral protein test meal. The localisation of the source of hypergastrinaemia determined the appropriate operative procedure for this patient. Vagotomy and gastric antrectomy is recommended for AGCH. The possible familial nature of this disease and the pathway to diagnosis and management are emphasised. Offprint requests to: J. M. Ham     

胃和十二指肠线状溃疡的X线诊断

本文报告19例胃和十二指肠线状溃疡，并就其X线表现进行了分析讨论。本组男17例，女2例，11例胃线状溃疡，8例十二指肠球部溃疡，均为横向线状溃疡。线状溃疡可呈线状或棒状，长度＞8mm，宽度＜2.5mm，胃或十二指肠的轮廓变形，绒毛状线状龛影和皱襞集中到线状龛影是诊断线状溃疡的重要线索。     

静脉溃疡病人愈合后皮肤结构变化的超声随访观察

目的观察静脉溃疡愈合后皮肤的超声结构,以探讨创面的愈合质量。方法应用皮肤超声仪检测静脉溃疡病人愈合后形成的瘢痕表皮及真皮的厚度,并分析真皮中的低回声区像素(LEPs)。结果与正常皮肤比较,静脉溃疡愈合后的瘢痕的平均表皮厚度显著增加(P<0.01),平均真皮厚度则显著降低(P<0.01),而真皮中LEPs的数量及分布均无明显变化。皮肤的回声参数与创面愈合时间、创面大小、创面存在时间及病人年龄均无显著的相关性。结论静脉溃疡创面愈合后,真皮中液体的数量及分布无显著改变,表明愈合后水肿得到了控制。     

复方654—2膜剂治疗顽固性小腿慢性溃疡

我们研制的654-2膜剂是以654—2、氯霉素为主药,通过其扩张微血管,改善微循环、抑菌、消炎,促进肉芽上皮生长等作用,外敷治疗顽固性小腿慢性溃疡,取得明显的疗效。溃疡愈合时间短,平均三周,无需口服、肌注抗生素,且操作简单方便,付作用轻微,本文就治疗方面有关问题进行讨论。