高压氧综合治疗糖尿病性胃轻瘫患者的疗效观察

目的观察高压氧（HBO）联合吗丁啉综合治疗对糖尿病性胃轻瘫患者胃动素及胃排空时间的影响。方法采用随机数字表法将2000年10月至2004年10月间连续人院的糖尿病性胃轻瘫患者112例随机分为高压氧组和对照组各46例，HBO组在给予吗丁啉（每次10mg，每天3次，连用4周）的基础上加用HBO治疗，HBO采用多人氧舱，在舱内停留120min，压力为0．25MPa（2．5ATA），戴面罩吸人纯氧60min（30min各2次，中间休息10min吸人舱内空气），10次为1个疗程，共3个疗程，每疗程间隔3～5d（排除HBO治疗禁忌证）。对照组为单纯吗丁啉，每次10mg，每天3次，连用4周。45d分别对两组患者治疗前后胃动素、空腹血糖、胃排空时间及症状的改善各项指标进行研究对比。结果HBO组和对照组总有效率分别为92．9％和76．8％，症状的改善、胃动素及胃排空时间治疗组均优于对照组，差异有显著性（P〈0．05）。结论糖尿病性胃轻瘫患者在服用吗丁啉的基础上应用HBO可降低胃动素、加速胃排空时间，对临床症状的改善具有积极作用。     

大肠癌病人血清胃泌素水平变化及其意义

采用放射免疫方法测定了３１例大肠癌、１３例非肿瘤者血清标本和２０例大肠癌组织、邻近肿瘤（〈３ｃｍ）及远离肿瘤（５ｃｍ）之结肠粘膜组织匀浆标本中的胃泌素浓度。发现：Ｄｕｋｅｓ Ｃ．Ｄ期大肠癌病人血清胃泌素显著高于非肿瘤者（Ｐ〈０．０５）；血清胃泌素浓度与病程进展呈显著正相关（Ｐ〈０．０５）；直肠癌病人血清胃泌素显著高于非肿瘤（Ｐ〈０．０５）；血清胃泌素水平与肿瘤分化程度无关；肿瘤切除后血清胃泌素显著     

Serum gastrin and pepsinogen in shift workers

Summary Gastrointestinal complaints, including peptic ulcer, are believed to be associated and enhanced by shift work (SW). However, there are no clear reports in the literature about this acquired pathology. Serum gastrin (G) and group I pepsinogen (PG1) are thought to play a role in the pathogenesis of peptic ulcer and may be considered a useful test of the gastric function. Five adult male foundry shift workers, without any demonstrated gastrointestinal pathology, were studied over a month's span during the following weekly rotating shift schedule: 07.45–16.45, 06.00–14.00, 14.00–22.00, 22.00–06.00. Six adult, day-working males acted as controls. Blood samples drawn at the beginning and at the end of each weekly shift were assayed for G and PG1 utilizing RIA kits. Our data showed that SW causes a prominent change in the gastrin/acidopepsin secretion system.     

功能性消化不良患者胃排空障碍与胃肠激素的关系

目的 探讨功能性消化不良(FD)患者胃排空障碍与胃肠激素间的关系。方法 对54例四患者进行胃排空检查，根据结果将其分为胃排空延缓的FD组(FDD组)和胃排空正常的四组(FDN组)，另以17名正常人作为对照组。用放免法测定受试者血浆(空脂和餐后)、胃窦十二指肠粘膜组织的神经降压素(NT)和胃动宗(MTL)含量。结果 FDD组空脂和餐后血浆、胃窦和十二指肠粘膜组织的NT含量均明显高于对照组及FDN组。各组试餐前后血浆NT增幅差异无显著性。FDD组空脂和餐后血浆、胃窦和十二指肠粘膜组织的MIL含量均明显低于对照组及FDN组。各组十二指肠粘膜组织MTL含量均明显高于胃窦粘膜。结论 FD患者胃排空障碍与NT、MIL密切相关。NT、MIL在FD的发病机制中可能具有一定作用。     

采用组织芯片技术分析胃癌组织中胃泌素和胃泌素释放肽的表达

目的研究胃癌组织中胃泌素(GAS)、胃泌素释放肽(GRP)的表达及其临床意义。方法采用组织芯片技术制作60例胃癌组织芯片,同时用生物素-链霉菌卵白素检测系统(SP)免疫组织化学方法检测胃癌组织芯片中GAS、GRP的表达。结果60例胃癌中GAS阳性率为30.0%;GRP阳性率为11.7%。中、低分化胃癌GAS、GRP阳性率高于高分化胃癌(P<0.05);印戒细胞癌GAS、GRP阳性率显著高于其他组织学类型胃癌(P<0.05);胃癌GAS、GRP阳性表达与淋巴结转移相关(P<0.05)。结论应用组织芯片大规模高效检测临床组织样本是可行的,具有快速、方便、经济、准确的特点。     

小肠广泛切除术后高胃泌素血症与结肠代偿性变化的关系

观察大鼠小肠广泛切除术后血清胃泌素和结肠粘膜代偿性改变的动态变化规律,发现术后14天内血清胃泌素稍低于正常组,从第14天开始血清胃泌素升高加快,至21天时差异有显著性意义(P<0.05),第28天时差异有非常显著性意义(P<0.01).血清胃泌素变化与术后结肠粘膜DNA、RNA变化呈正相关关系(P<0.001),提示高胃泌素血症可能是引起小肠广泛切除术后结肠粘膜代偿性变化的主要因素之一.     

The effects of cysteamine on the upper gastrointestinal tract of children with cystinosis

The purpose of this study was to evaluate the effects of cysteamine on gastric acid output and serum gastrin levels in children with nephropathic cystinosis. We studied four children with nephropathic cystinosis receiving a dose of free base cysteamine of 14.35 mg/kg four times a day (range 12.30 – 18.80 mg/kg). Gastric acid was measured for the hour before and after administration of the medication. Serum gastrin levels were obtained at 0, 30, 60, and 90 min following the medication. Gastrointestinal anatomy was evaluated by endoscopy and biopsy. Following administration of the medication, all subjects showed an increase in gastric acid output. Mean acid output increased from 0.79 to 2.22 mEq/h. Mean gastric acid output adjusted for body weight increased from 0.03 to 0.09 mEq/kg per hour. Following administration of the medication, all subjects showed an increase in serum gastrin. The mean increase above the base value was 38.3 pg/dl. Two of the four subjects demonstrated visual and histological evidence of inflammation. Cysteamine has a marked effect on gastric acid production and serum gastrin, even at the dose used in children with nephropathic cystinosis. The clinical effect of this acid production is unknown but may be significant. Received February 13, 1996; received in revised form February 25, 1997; accepted February 27, 1997     

The role of intracellular calcium stores in motilin induced contractions of the longitudinal muscle of the rabbit duodenum

Summary The contraction of longitudinal muscle strips of the rabbit duodenum in response to motilin and acetylcholine was investigated in normal and high K⁺-solutions in the presence and absence of external calcium, in order to demonstrate the existence of pharmaco-mechanical coupling for motilin and to examine whether the peptide mobilizes calcium from an intracellular store. In depolarized smooth muscle (140 mM K⁺), motilin (3.2×10⁹ –1×10^–7 M) and acetylcholine (1×10^–5 M) were still capable of causing a considerable, transient, concentration-dependent contraction in the presence of Ca²⁺. The extra-contraction to motilin was not blocked by tetrodotoxin (1 g/ml) nor by atropine (10^–7 M), but acetylcholine (10^–5 M) was blocked by atropine. Verapamil (10^–7 M) could selectively block the K⁺ contraction without affecting the extra agonist contraction. Nitroprusside was ineffective up to 10^–4 M in high K⁺-solutions, but in normal Hepes-buffer it caused a concentration-dependent rightward shift of the concentration-response curve of motilin and acetylcholine contractions. In a calcium-depleted medium, high K⁺-depolarized muscle strips were still responsive to motilin and acetylcholine, but higher concentrations (10^–6 M) were needed than in the presence of calcium and the contractions reached only 57 +- 11% and 74 +- 9% respectively of the maximal contraction in 1.2 mM Ca²⁺ containing solutions. The response to motilin (10^–6 M) was not only smaller than that to acetylcholine (10^–5 M), it also faded more rapidly with time. The response to one agonist could not be repeated except by using a higher concentration of the same or the other agonist, and the magnitude of this second response depended upon the dose used in the first one. We conclude that pharmaco-mechanical coupling exists for motilin and that this peptide is able to elicit contractions by mobilization of calcium from an intracellular store. This store overlaps with the one used by acetylcholine. Our experiments also reinforce the hypothesis that in the rabbit motilin exerts a direct action upon smooth muscle cells.     

Prolyl-leucyl-glycinamide shares some effects with oxytocin but decreases oxytocin levels

Oxytocin treatment in rats induces long-lasting antistress and growth promoting effects. This study investigated whether prolyl-leucyl-glycinamide (PLG) (the c-terminal tripeptide of oxytocin) or tocinoic acid (the ring structure of oxytocin) could induce some of these effects in male rats. For this purpose, PLG (2 or 10 mg/kg, s.c.) or tocinoic acid (1 mg/kg, s.c.) was administered to rats once a day for 3 or 5 days. Blood pressure, heart rate, spontaneous motor activity, nociceptive thresholds, and the survival of ischaemic musculocutaneous flaps were measured. In addition, endogenous oxytocin levels and plasma levels of some hormones known to be influenced by oxytocin were determined. PLG (2 mg/kg, s.c., but not 10 mg/kg, s.c.) decreased diastolic blood pressure (p<0.05) and locomotor activity (p<0.05). PLG (10 mg/kg, s.c.) decreased gastrin (p<0.05) and endogenous oxytocin levels in plasma (p<0.01). Tocinoic acid decreased locomotor activity (p<0.05), but did not affect any of the other parameters measured. In conclusion, this study showed that both PLG and tocinoic acid decrease locomotor activity. In addition, PLG also induced some other effects similar to those induced by oxytocin treatment but when administered in high doses it decreased oxytocin levels.     

幽门螺旋杆菌对慢性胃炎患者胃窦黏膜内G、D细胞的影响

目的　了解幽门螺旋杆菌 (HP)对慢性胃炎胃窦黏膜内G、D细胞的影响。　方法　用免疫组织化学双重染色法 ,观察正常人、HP- 组和HP+ 组慢性胃炎患者胃窦黏膜内G、D细胞的数量 ,G D细胞的比值以及G、D细胞接触的百分率。　结果　G细胞数量在 3组中无明显差异 (P >0 0 5 ) ,HP+ 胃炎组D细胞显著减少 ,与其他 2组相比有显著性差异 (P <0 0 1) ;而G D细胞比值增高 ,G、D细胞接触的百分率下降。　结论　HP可抑制胃窦D细胞生长抑素的合成和D细胞的增殖 ,从而可能减少D细胞对G细胞胃泌素分泌的抑制。