基于网络药理学和实验验证研究柴胡疏肝散治疗慢性萎缩性胃炎的作用机制＊

目的 通过网络药理学的方法进行预测，再深一步进行动物实验验证来研究柴胡疏肝散治疗CAG的作用机制。方法 首先在TCMSP数据库中检索柴胡疏肝散的所有活性成分与药物靶点；通过收集PharmGkb、OMIM、GeneCards和DrugBank数据库中收录的慢性萎缩性胃炎的相关靶点。将药物靶点与疾病靶点进行映射筛选出交集靶点，将得到的交集靶点构建PPI网络与活性成分-共同靶点网络，并对其进行GO和KEGG富集分析。最后利用Vina软件进行分子对接实验验证，并通过免疫印迹法验证柴胡疏肝散对两种受体蛋白EGFR和STAT1的影响。结果 最终筛选得到柴胡疏肝散活性成分104个，潜在靶点238个，与慢性萎缩性胃炎的交集靶点52个；GO与KEGG富集分析分别得到2166条目和148条目，主要涉及到JAK-STAT信号通路、TNF信号通路、HIF-1信号通路等；分子对接结果显示EGFR、STAT1两个靶点能够与核心活性成分能够自发结合成较为稳定的构像；免疫印迹法实验证明柴胡疏肝散能够降低大鼠胃黏膜组织EGFR和STAT1蛋白表达。结论 通过网络药理学和实验验证，发现柴胡疏肝散可能通过调节EGFR和STAT1蛋白表达来共同调控胃黏膜细胞增殖与凋亡，进而发挥着治疗慢性萎缩性胃炎的效果，为深入进行柴胡疏肝散治疗慢性萎缩性胃炎的作用机制研究提供新思路和新方法。     

超脉冲CO2点阵激光联合PRP治疗面部痤疮凹陷性瘢痕疗效分析

目的:探究超脉冲CO2点阵激光联合富血小板血浆(PRP)治疗面部痤疮凹陷性瘢痕的疗效。方法:72例面部痤疮凹陷性瘢痕患者,随机分为观察组(36例)和对照组(36例)。对照组采用超脉冲CO2点阵激光治疗,观察组采用超脉冲CO2点阵激光联合PRP治疗。比较两组患者的灰度差异、时间指标、瘢痕程度、疼痛、不良反应及视觉评估。结果:观察组的并发症发生率为11.11%,低于对照组的36.11%,差异具有统计学意义(P<0.05)。治疗后,两组患者的灰度差异率均减小,且观察组患者的灰度差异率显著低于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组的炎性渗出时间、红肿时间、愈合时间、停工时间及瘢痕程度评分均低于对照组,差异均具有统计学意义(P<0.05);但疼痛度评分组间比较,差异无统计学意义(P>0.05)。结论:超脉冲CO2点阵激光联合PRP治疗面部痤疮凹陷性瘢痕效果较好,可有效降低瘢痕程度,减少治疗时间及并发症的发生,帮助患者迅速回归正常工作与生活,值得临床推广使用。     

胃幽门弯曲菌感染对胃癌发生影响的探讨

应用Warthin-starry镀银技术检查胃幽门弯曲菌,对中国胃癌高发区及美国胃癌高发区新奥尔良检查了300例具有胃症状的胃粘膜标本。结果发现幽门弯曲菌阳性率为60～62%,并且看到这种细菌的感染与慢性胃炎病变的程度有明显的关系。本文探讨了幽门弯曲菌的感染与胃癌癌前病变的关系。     

新疆维吾尔族慢性胃炎患者HLA-DRB1等位基因与幽门螺杆菌感染的关系

目的研究新疆维吾尔族慢性胃炎患者HLA-DRB1等位基因与幽门螺杆菌（Hp）感染的关系。方法采用幽门螺杆菌分离培养技术检测33例维吾尔族慢性胃炎患者幽门螺杆菌感染情况,采用PCR-SSP检测HLA-DRB1＊0405、HLA-DRB1＊08、HLA-DRB1＊12等位基因,并与36例汉族慢性胃炎患者进行比较。结果1）新疆维吾尔族慢性胃炎患者Hp阳性率（78.8%）显著高于汉族慢性胃炎患者（58.3%）（P〈0.05）;2）维吾尔族、汉族慢性胃炎患者Hp感染与HLA-DRB1＊0405、HLA-DRB1＊08、HLA-DRB1＊12等位基因无相关性（P〉0.05）。结论1）维吾尔族慢性胃炎患者Hp感染率高于汉族慢性胃炎患者;2）维吾尔族、汉族慢性胃炎患者Hp感染与HLA-DRB1＊0405、HLA-DRB1＊08、HLA-DRB1＊12等位基因无关。     

Atrophic dermatofibroma accompanied by aneurysmatic characteristics

A 40-year-old man presented a painful haemorrhagic plaque on his chest in the same location where a nodular lesion had been presented for many years. After 2 months, the plaque was replaced by a depressed lesion. The lesion diagnosed as an anetoderma was excised and the biopsy showed an atrophic dermatofibroma accompanied by aneurysmatic characteristics.     

Duodenogastric reflux after choledochoduodenostomy

Duodenogastric reflux (DGR) has been implicated in several disease processes. The present study was carried out to document the incidence and evaluate the clinical significance of DGR after choledochoduodenostomy (CDD). A total of 13 patients who had undergone cholecystectomy with a standard side-to-side CDD for choledocholithiasis or chronic pancreatitis were studied by symptom evaluation, scintigraphy, endoscopy, and gastric mucosal histology at least 6 months after surgery. The scintigraphic findings were then compared with those of 10 patients who had undergone cholecystectomy alone. Only two patients (15%) had mild dyspeptic symptoms. The incidence of DGR after CDD was 69% compared to 20% in the cholecystectomy alone group (P < 0.05). In the majority of patients the DGR was only mild to moderate and the severity correlated well with the degree of endoscopic gastritis, but not with the clinical symptoms or histological findings. These results indicate that while CDD is associated with a high incidence of DGR, its occurrence does not produce significant clinical symptoms.     

糜烂性胃炎462例分析

目的探讨糜烂性胃炎(EG)在内镜下的形态、分布及预后.方法对1997年1月～2003年12月经内镜确诊的462例糜烂性胃炎进行分析.结果462例中,男性336例,女性126例,男女之比2.67:1.隆起糜烂型185例,占40.04%;平坦糜烂型277例,占59.96%.胃窦部363例,占总数的78.57%;其中隆起糜烂型173例,占47.66%;平坦糜烂型190例,占52.34%,两型之间差异无显著性(P＞0.05).胃高位99例,占总数的21.43%;其中隆起糜烂型12例,占12.12%;平坦糜烂型87例,占87.88%;胃窦部隆起糜烂型占47.66%(173/363),胃高位隆起糜烂型占12.12%(12/99);隆起糜烂型和平坦糜烂型HP感染率分别为83.78%和27.08%,差异有非常显著性(χ2=142.68,P＜0.01).结论胃窦部与胃高位糜烂性胃炎的发病率均以男性为主,其中隆起糜烂型好发于胃窦部,而胃高位以平坦糜烂型为主.     

莫沙必利联合铝碳酸镁治疗胆汁反流性胃炎疗效观察

目的　探讨铝碳酸镁及莫沙必利对胆汁反流性胃炎的疗效。方法　将 45例经胃镜证实胃液内有胆汁贮留及胃窦明显炎症的胆汁反流性胃炎随机分为A、B、C组。A组 ( 15例 )服用莫沙必利 5mg/次 ,3次 /d ;B组 ( 16例 )服用铝碳酸镁 1.0g/次 ,3次/d ;C组 ( 14例 )同时服用西沙必利和铝碳酸镁 ,剂量同A、B组。治疗 4周后观察上腹痛、腹胀、恶心、呕吐症状变化。结果　治疗后三组患者症状均明显减轻 ( P <0 .0 5或 <0 .0 1) ,C组症状改善更明显 ( P <0 .0 5或 <0 .0 1)。结论　莫沙必利、铝碳酸镁联合应用治疗肝胆汁反流性胃炎的疗效优于单一用药     

Helicobacter pylori infection and gastric emptying of solids in humans

Helicobacter pylori has been implicated in a number of upper gastrointestinal illnesses. In a controlled study, we have investigated the relationship between H. pylori infection and gastric emptying of solids in two groups of patients with chronic symptoms of dyspepsia. In the first group, 19 patients with non-ulcer dyspepsia and H. pylori infection underwent a standard test of gastric emptying after ingestion of 500 μCi of Tc-labelled chicken liver. The results were compared to a control group of 16 uninfected volunteers. We also studied a second group of 20 patients with previously diagnosed idiopathic gastroparesis for the prevalence of H. pylori infection and its relationship to symptom severity and rates of gastric emptying. In the first group of patients, the half-time of gastric emptying was significantly less among the infected patients compared to the uninfected volunteers (108 ± 9 vs. 142 ± 14 min, P < 0.05). In the second group of patients with gastroparesis, the prevalence of H. pylori was not significantly different among these patients than among 21 age and sex matched controls (20% vs. 38%, P = 0.32). Gastric emptying was markedly slow in all 20 patients in the second group but less so among the four with H. pylori infection. Symptom scores were no different between infected and uninfected patients. We conclude that H. pylori infection is not associated with abnormally slow gastric emptying. On the contrary, gastric H. pylori infection appears to be associated with mildly accelerated emptying of solids compared to normal controls. Idiopathic gastroparesis and dyspepsia related H. pylori infection are separate but sometimes overlapping disorders.     

氟中毒和氟砷中毒对胃粘膜的影响

作者通过内窥镜对新疆奎屯地区氟中毒患者３５名，氟砷中毒患者３２名，对照组２５名的胃粘膜进行观察，旨在了解氟元素和砷元素对胃粘膜的影响，在３个组中慢性胃炎的炎症程度与炎症活动性有显著性差异。２个中毒组间无显著性差异。结果表明在高氟区和高氟砷区患者的胃粘膜层病理改变主要是任性氟中毒引起，单纯性砷中毒并无协同作用。