实验性大鼠内囊出血后H反射的改变及意义

目的　观察大鼠内囊出血后H反射的改变及意义。方法　将大鼠动脉血定向注入内囊以建立脑出血模型 ;检测左右侧腓肠肌H反射的变化 ;同时观察大鼠运动功能缺损和皮层血流量的改变情况。结果　大鼠右侧内囊出血后 ,左侧腓肠肌H反射波幅显著升高且明显高于右侧 (P <0 .0 1) ;左侧H反射的潜伏时明显缩短且明显低于右侧 (P <0 .0 5 ) ;相反 ,右侧H反射的波幅及潜伏时与出血前差异无显著性 (P >0 .0 5 )。大鼠左侧肢体出现了明显偏瘫体征。代表肢体的皮层局部血流量在出血后 7d右侧低于左侧。结论大鼠内囊出血可以引起支配对侧肢体的大鼠脊髓运动神经元兴奋性升高、脊髓单突触牵张反射增强。     

磁共振准连续动脉自旋标记技术在不随意运动型脑瘫患者中的初步研究

目的应用磁共振准连续动脉自旋标记(pseudo-continuous arterial spin labeling,pCASL)技术观察不随意运动型脑瘫患者脑部运动区(内囊后肢皮质脊髓束)的血流特点,通过血流变化来研究脑瘫患儿运动区的功能病理基础,为临床治疗效果及早期诊断提供影像支持。材料与方法回顾性分析经临床诊断为不随意运动型脑瘫患者与志愿者各20例,观察不随意运动型脑瘫患者双侧内囊后肢皮质脊髓束运动区脑血流量的变化,通过t检验分析志愿者、患儿及志愿者与患儿双侧脑血流的的情况。结果志愿者、不随意运动型脑瘫患者左、右两侧内囊后肢的皮质脊髓束运动区局部脑血流量差异有统计学意义(P0.05),左侧脑血流量高于右侧。志愿者与脑瘫患者左、右两侧局部脑血流量比较差异有统计学意义(P0.05),志愿者局部脑血流量高于不随意运动型脑瘫患者。结论双侧内囊后肢功能运动区脑血流减低是导致不随意运动型脑瘫运动区的功能病理基础之一,可以通过磁共振pCASL技术对不随意运动型脑瘫运动区的血流量进行定量分析。     

复方谷氨酰胺肠溶胶囊治疗肠易激综合征的疗效及对胃肠激素的影响

目的分析复方谷氨酰胺肠溶胶囊治疗肠易激综合征的疗效及对患者胃肠激素的影响。方法 72例肠易激综合征患者随机分为观察组和对照组。对照组患者给予肠易激综合征常规治疗,观察组患者在常规治疗基础上使用复方谷氨酰胺肠溶胶囊治疗。结果观察组患者治疗总有效率为94.45%,显著高于对照组的77.78%(P0.05)。观察组患者排便异常、腹胀、腹痛、胃肠不适、焦虑、抑郁及头痛改善率显著高于对照组(P0.05)。观察组患者VIP及SS水平显著低于对照组患者(P0.01)。结论复方谷氨酰胺肠溶胶囊能有效改善肠易激综合征患者症状,增强胃肠免疫力,调节胃肠激素分泌。     

Wireless Capsule Endoscopy Indication as a Predictor of Study Quality

PURPOSE: The aim of the study was to assess whether specific indications are associated with poor visualization during wireless capsule endoscopy (WCE) studies . Four hundred consecutive WCE studies performed at our institute were analyzed retrospectively. RESULTS: Data was available on cases involving 176 males and 224 females. About 23 capsules failed to exit the stomach (excluded from the study). Poor visualization was reported in 66 (17%) WCE studies. The most common indications were gastrointestinal (GI) blood loss (271 cases; 72%), abdominal pain and/or diarrhea (73 cases; 19%), and suspected inflammatory bowel disease (46 cases; 12%). Of the 271 patients suffering GI bleeding, visualization was reported to be poor in 53 (19%) patients; among those showing other indications, visualization was poor in 13 (11%) patients (P = 0.02). After controlling for secondary indications and age, GI bleeding was associated with a higher rate of poor visualization compared to all other indications (odds ratio 2.6; 95% confidence interval 1.4-6.8). CONCLUSIONS: Gastrointestinal bleeding as study indication for WCE is associated with a higher rate of poor visualization.     

Capsule endoscopy: current indications and future prospects

Capsule endoscopy represents a significant advance in the investigation of small bowel diseases and the beginning of wireless endoscopic imaging. Capsule endoscopy involves swallowing a video capsule endoscope, which is painless and relatively safe. Its use has been established for suspected small bowel bleeding, and the role of capsule endoscopy in the investigation of inflammatory bowel disease, iatrogenic disease, polyposis syndromes and coeliac disease is evolving. It is likely that in many instances it will become the next test after standard endoscopic evaluation. Early data suggest that capsule endoscopy improves outcome in patients with suspected small bowel bleeding, but more data are required on outcomes for the other indications.     

Danshao Huaxian capsule in treatment of decompensated cirrhosis resulting from chronic hepatitis B

BACKGROUND: The prognosis of decompensated cirrhosis resulting from chronic hepatitis B is poor, and the benefits of treatment with interferon are ourweight serious sideeffects and the risk of fatal exacerbation of disease. Danshao Huaxian capsule rapidly reduces hepatitis B virus(HBV)-DNA in serum to undetectable levels. METHODS: A total of 35 patients with chronic hepatitis B and decompensated cirrhosis were treated with Danshao Huaxian 1.2g. po. tid daily. Before the treatment, HBVDNA in serum was positive in all patients. Ten patients had Child-Pugh class B and 25, class C hepatitis B. Seven patients underwent liver transplantation within 6 months of initial treatment. Of the 10 patients of class B, 5 died within 6 months, and the other 5 did not complete the treatment for some reasons; the 25 patients of class C were treated for at least 6 months (mean =19 months). RESULTS: In most of the 25 patients, liver function was improved slowly but markedly after 9 months of treatment, showing a decreased level of serum bilirubin from 67±13 to 30±4μmol/L (P<0.05, baseline vs.6 months), an increased level of serum albumin from 27±1 to 34±1 g/L(P<0.05) and a decreased level of Child-Pugh score from 10.3±0.4 to 7.5+0.5 (P<0.05). Three patients developed resistance to Danshao Huaxian because of a mutation in the YMDD motif, but liver function was not deteriorated. Inhibition of viral replication with Danshao Huaxian resulted in a significant improvement of liver function in patients with decompensated HBV cirrhosis, but the long-term results remain uncertain. CONCLUSION: Danshao Huaxian capsule is effective in inhibiting viral DNA replication in patients with decompensated cirrhosis and making clinical improvement.     

经尿道前列腺增生腺瘤切除术与经膀胱前列腺增生腺瘤切除术的手术层面观察比较

目的：了解在BPH手术治疗中,经尿道前列腺增生腺瘤切除术（TUEB）与经膀胱前列腺增生腺瘤切除术（SPP）是否在同一手术层面即外科包膜层面进行。方法：TUEB组532例,SPP组8例。先行SPP切除腺瘤后插入电切镜观察切除后的创面并与TUEB术创面录像进行比较。结果：SPP组8例SPP手术创面观察与TUEB具有相同特征。统计学处理SPP观察项目均值为（34．19±0．37）,与TUEB组比较,两样本t检验结果：t=6．177,P〈0．001。结论：在本研究中,TUEB术与SPP术在同一手术层面即外科包膜内侧面进行。     

Usefulness of polyethylene glycol solution with dimethylpolysiloxanes for bowel preparation before capsule endoscopy

Background and Aim:  Capsule endoscopy (CE) is widely used for diagnosing small intestinal diseases. In some cases, however, observation of target sites is very poor during CE because of residues etc. Herein we report the usefulness of a preparation comprised of polyethylene glycol solution (PEG) for CE.
Methods:  This was a prospective, randomized, and single-blind study. Forty subjects, fasted for 12 h before CE, were randomized into two groups: 20 subjects in Group A were fasted only, whereas 20 in Group B received 1 liter (L) PEG with 200 mg dimethylpolysiloxane 3 h before CE. For evaluation, the observation period of the small intestine was divided into first and second halves. Subsequently, four investigators, blinded as to which group received the preparation, assessed the condition of the intestine using four rating scales in terms of 'residue' and 'intraluminal gas bubbles'. The effects of the preparation were statistically compared.
Results:  CE images were better in Group B than in Group A with respect to 'intraluminal gas bubbles' ( P  = 0.0038) in the first half of the observation period, as well as residue ( P  = 0.0087) and intraluminal gas bubbles ( P  = 0.0011) in the second half.
Conclusion:  Bowel preparation using 1 L PEG with dimethylpolysiloxane 3 h before CE significantly reduced residue and intraluminal gas bubbles, and was considered to be a useful method for CE.