慢性胃炎中医证侯与胃窦十二指肠运动及胃炎程度的相 …

研究慢性胃炎中医辩证分型与幽门螺杆菌（Ｈｐ）感染、胃粘膜炎症程度以及胃窦十二指肠消化间期移行性运动复合波之间的关系。将慢性胃炎１１７例,按中医辩证分为实证和虚证,实施包括脾胃湿热型３７例和肝胃不和型３４例,虚证包括脾胃虚型２６例和胃阴不足型２０例。均进行内镜、Ｈｐ及病理检查,分型统计并进行显著性检验。其中３８例用腔内测压法分别测定其消化间期移行性运动复合波（ＭＭＣ）。实证组Ｈｐ阳性率高于虚证组,依     

The CINOD, AZD3582, exhibits an improved gastrointestinal safety profile compared with naproxen in healthy volunteers

COX-inhibiting nitric oxide donators (CINODs) are a new class of drugs in development for the treatment of acute and chronic pain. They comprise a COX-inhibiting moiety linked to a nitric-oxide-donating component and are designed to provide an innovative mechanism of action of balanced COX inhibition and controlled nitric oxide donation. Through these pathways, CINODs should provide analgesic and anti-inflammatory efficacy, while offering gastrointestinal safety through the tissue-protective effects of nitric oxide donation. AZD3582 [4-(nitrooxy)butyl-(2S)-2-(6-methoxy-2-naphthyl)propanoate] is the first agent in the CINOD class to enter extensive clinical development. Pre-clinical studies demonstrate that AZD3582 has a superior gastrointestinal safety profile to naproxen, while demonstrating analgesic and anti-inflammatory efficacy. In healthy human volunteers, AZD3582 caused little gastrointestinal damage compared with equimolar doses of naproxen. Studies to evaluate the longer-term gastrointestinal safety of AZD3582, alongside its efficacy in alleviating chronic and acute pain, are ongoing.     

Change in Colonic Motility After Extrinsic Autonomic Denervation in Dogs

Changes in colonic motility were compared indogs undergoing autonomic denervation of the paraaorticand presacral (group A), paraaortic (group B), ormesocolonic region (group C), and sham operation (group D). Five bipolar recording electrodes wereplaced into the seromuscular layer of the colon andrectum. The numbers of continuous electrical responseactivity and contractile electrical complex after an intragastric olive oil injection were smallerin group A than in the other groups (P < 0.05) fromthree weeks through six months after denervation. Thisdifference was significant even in the proximal colon. These data suggest that the pelvic plexus mayplay an important role in colonic motility including theproximal colon. The damage to the plexus did not recoverfor at least six months after denevation. Pelvic plexus injury may thus be one ofpossible explanations for the prolonged change in bowelhabit after anterior resection of the rectum.     

芍药甘草汤对肠道运动的作用观察

【目的】研究芍药甘草汤对肠道平滑肌运动的影响及其作用机制。【方法】通过小鼠小肠墨汁推进实验观察芍药甘草汤对正常、亢进及抑制状态下胃肠运动的影响,并采用兔离体肠管实验研究其作用机制。【结果】芍药甘草汤能显著性抑制正常和亢进状态的小鼠小肠运动,显著性抑制正常离体肠管的活动,并呈现一定的量效关系;对乙酰胆碱(Ach)、组胺、新斯的明(Neo)、氯化钡(BaCl2)等不同离体兔肠模型均具有显著性抑制作用(P<0.05或P<0.01或P<0.001)。【结论】芍药甘草汤抑制胃肠运动的机理可能与抗胆碱样、钙拮抗、抗组胺有关,也可能与α受体有关。     

The Decrease in Plasma Ghrelin Concentrations following Bariatric Surgery Depends on the Functional Integrity of the Fundus

Background: Gastric bypass surgery, which involves the production of a reduced stomach pouch,has been shown to markedly suppress circulating ghrelin concentrations. Since bypassing the ghrelin-producing cell population may be relevant to the disruption of fundic-derived factors participating in food intake signaling, the effect of weight loss induced by either adjustable gastric banding (AGB), Roux-en-Y gastric bypass (RYGBP) or biliopancreatic diversion (BPD) was studied. Methods: 16 matched obese patients [35.0 + 2.4 years; initial body weight 124.8 ± 5.7 kg; body mass index (BMI) 47.1 ± 2.2 kg/m²] in whom similar weight loss had been achieved by either AGB (n=7), RYGBP (n=6) or BPD (n=3) were studied. Blood was obtained for biochemical and hormonal analyses. Body composition was assessed by air-displacement-plethysmography. Results: Comparable weight loss (AGB: 26.1 ± 5.1 kg; RYGBP: 32.1 ± 5.0; BPD: 31.7 ± 6.1; P=NS) and decrease in percentage body fat (AGB: 10.0 ± 1.5%; RYGBP: 14.2 ± 2.8; BPD: 10.3 ± 1.0; P=NS) induced by bariatric surgery exerted significantly different (P=0.004) effects on plasma ghrelin concentrations, depending on the surgical procedure applied (AGB: 480 ± 78 pg/ml; RYGBP: 117 ± 34; BPD: 406 ± 86). Without significant differences in BMI, body fat, glucose, triglycerides, cholesterol, insulin and leptin levels, patients who had undergone the RYGBP exhibited statistically significant diminished circulating fasting plasma ghrelin concentrations compared with the other two bariatric techniques which conserve direct contact of the fundus with ingested food (P=0.003 vs AGB and P=0.020 vs BPD). Conclusion: Fasting circulating ghrelin concentrations in patients undergoing diverse bariatric operations depend on the degree of dysfunctionality of the fundus.     

Early Experience With Computer-Mediated Flexible Circular Stapling Technique For Upper Gastrointestinal Anastomosis

Background: Creating the proximal anastomosis in laparoscopic biliopancreatic diversion with duodenal switch (LBPD-DS) and Roux-en-Y gastric bypass (LRYGBP) is a critical step in ensuring the success of the procedures. The aim of this study was to assess the safety and efficiency of performing this anastomosis using a flexible, computerized, circular stapling device. Method: We prospectively monitored the use of a newly FDA-approved stapling device (SurgASSIST, Power Medical Intervention) for the construction of the proximal anastomosis by a variety of approaches and reviewed the charts of 10 patients. Results: We successfully constructed 9 out of 10 proximal anastomoses: 2 gastro-jejunostomies and 7 duodeno-ileostomies, without any signs of leakage. In 2 patients, the stapling technique involved a transpyloric instrumental passage; both were complicated by the difficulty to pass either the flexible scope or the anvil through the narrow pyloric lumen. In 5 patients, the anvil was placed directly through a duodenotomy and no technical problems were encountered. The median time for performing the proximal anastomosis was 19 minutes (range 9-55).There were no postoperative complications in any patients. Conclusions: Stapling using the SurgASSIST was feasible and safe for performing laparoscopic anastomoses in bariatric bypass procedures. A duodenotomy for direct placement of the anvil into the postpyloric region seems to be most feasible for duodenoileostomies, while transoral passage of the anvil can be recommended for gastro-jejunostomies. In its current form, we do not recommend transoral placement of the flexible shaft of the SurgASSIST device. Further clinical trials need to be performed for comparison with existing devices.     

Review of gastrointestinal tolerability and safety of Meloxicam

Selective COX-2 inhibition relative to COX-1 has consistently been demonstrated for meloxicam in various in vitro test systems. In human platelets ex vivo COX-1-dependent thromboxane formation is partially and dose dependently inhibited, however no significant inhibition of platelet aggregation has been observed with the recommended doses of 7.5 mg and 15 mg meloxicam daily. With once daily dosing, meloxicam has demonstrated efficacy in osteoarthritis, rheumatoid arthritis and ankylosing spondylitis. Meloxicam was granted its first marketing authorization in 1995 and is now available in more than 100 countries. Meloxicam has been studied in clinical trials involving more than 30 000 patients and is estimated to have been prescribed for more than 30 million patients worldwide to date. Clinically, meloxicam offers similar efficacy to recommended doses of well-established nonsteroid anti-inflammatory drugs (NSAIDs), including diclofenac, piroxicam and naproxen. Meloxicam distinguishes itself from established NSAIDs with a reduced risk of certain gastrointestinal adverse events. This has consistently been demonstrated in randomized clinical trials, large scale clinical outcome studies, pooled analyses and meta-analyses. Post-marketing experience is consistent with the safety profile established in these studies and analyses.