胃肠激素与十二指肠胃反流及消化间期胃肠移行性复合运动的关系

目的　探讨胃肠激素与生理性十二指肠胃反流 (DGR)及胃肠消化间期移行性复合运动 (MMC)的关系。方法　选择健康志愿者 2 0例 ,进行 2 4h胃内 pH和胃内胆汁监测 ;采用灌注式测压法进行长时夜间胃窦十二指肠压力测定 ;分别于碱反流、胆汁反流发生前后及胃窦十二指肠MMC各时相抽血 ,检测胃动素 (MTL)、P物质 (SP)、生长抑素(SS)、一氧化氮 (NO)的水平。结果　碱反流和胆汁反流发生时与未发生时比较 ,血中NO的浓度明显增高 ,分别为(98.2 3± 12 .14 ) μmol·L-1和 (71.2 4± 10 .2 1) μmol·L-1(P <0 .0 1) ;(87.32± 11.4 6 ) μmol·L-1和 (6 9.4 5± 10 .5 6 ) μmol·L-1(P <0 .0 5 ) ;血浆中MTL、SP、SS的浓度无显著性差异。血浆MTL浓度在胃窦MMCⅢ相时为 (32 9.5 6± 4 7.2 8)ng·L-1,比MMCⅠ相 (2 37.4 3± 4 1.5 4 )ng·L-1和MMCⅡ相 (2 5 6 .5 6± 4 4 .32 )ng·L-1显著增高 (P均 <0 .0 5 )。SP、SS、和NO在MMC各相无显著差异。结论　DGR的发生与NO浓度改变有关 ;MTL与MMCⅢ相的发生有关。     

功能性消化不良与十二指肠胃反流关系的研究

目的研究功能性消化不良(FD)与十二指肠胃反流(DGR)的关系。方法对20例健康对照者和22例FD患者进行胃内pH和Bilitec 2000同步监测,并对FD患者DGR症状进行评分,研究DGR症状与胃内pH≥4及胆红素吸光值(Abs)≥0.14总时间百分比的关系。结果FD组餐后期pH≥4时间(%)和Abs≥0.14时间(%)明显高于正常组,分别为45.78±22.54和23.69±17.26,45.12±25.31和23.97±18.54,有显著性差异,P均<0.05。两组夜间胃内pH≥4和Abs≥0.14出现例数(%)、总持续时间(min)、反流次数、反流>5 min次数及最长反流时间无显著性差异。上腹痛症状评分(SS)与胃内pH≥4总时间%存在相关关系,r=0.678,P<0.01;呕吐胆汁SS与胃内Abs≥0.14总时间%存在相关关系,r=0.495,P<0.05。结论DGR在FD发生中起一定作用。     

胆汁反流对胃内pH值的影响

目的　观察胆汁反流对胃内 pH值的影响。方法　对不同浓度胆汁和胃液的混合液及内镜下抽取的黄染和无黄染胃液 ,测定pH和胆红素吸光值 ;2 0例功能性消化不良患者同步监测2 4h胃内pH和胆红素吸光值。结果　胆汁浓度为 2 0 %时吸光值已达 0 90 0 ,而pH仍在 1 0左右 ;浓度为 60 %时pH始上升达 4以上。黄染组pH <4的病例占 80 % ,吸光值为 0 .348±0 .1 31 ,无黄染组pH <4的病例占 81 % ,吸光值为 0 .0 0 8± 0 .0 0 3,pH和吸光值之间无明显相关性。 1 2例有夜间自发性碱波者 8例同步有胆红素吸光值升高 ,8例无夜间自发性碱波者 4例有胆红素吸光值升高。结论　在一定浓度下 ,胆汁反流对胃内 pH值影响较小。     

酵母菌活性物质及多糖对红细胞免疫粘附能力的影响

用 CD35单抗阻断实验研究酵母菌活性物质 (yeast competence products,YCP)和酵母多糖(zymosan A,ZA)增强红细胞免疫粘附能力并探讨其作用机理。结果显示 :YCP和 ZA组在 CD35单抗阻断前 RBC· C3 b RR率分别为 2 4 .73± 2 .72 ,2 2 .82± 3.6 6 ,与对照组 (12 .33± 1.0 7)比较有非常显著性差异 (P <0 .0 0 1)。CD35单抗阻断后 RBC· C3 b RR率分别为 6 .4 5± 1.86、6 .4 5± 1.2 9,与阻断前比较有非常显著性差异 (P <0 .0 0 1)。提示 YCP和 ZA能增强红细胞免疫粘附能力 ,其机理可能与红细胞膜上 CR1表达增强有关。     

慢性肾小球疾病患者尿液Ⅳ型胶原的检测及意义

目的　探讨慢性肾小球疾病患者尿液Ⅳ型胶原 (Ⅳ C)的变化及其临床意义。方法　应用ELISA法测定了 5 6例慢性肾小球疾病 (CGD)患者及 1 2例正常对照 (NC)、1 0例肝硬化(NGD)患者的尿液Ⅳ C。结果　①肾功正常的PGD患者尿液Ⅳ C高于NC ,但无统计学意义[(7.3± 6 .7) μg/Lvs(5 .7± 2 .3) μg/L ,P >0 0 5 ] ;②非肾病 (肝硬化 )患者尿液中未检出Ⅳ C ;③慢性肾功能衰竭患者尿液Ⅳ C显著高于正常对照及CGD肾功能正常患者 [(4 1 .6± 32 .9) μg/Lvs(5 .7± 2 .3) μg/L ,(1 5 .7± 1 0 .2 ) μg/L ,P <0 0 0 1 ]。 结论　①尿液Ⅳ C为慢性肾小球疾病的较为特异的标志物 ;②尿液Ⅳ C的变化更能反映慢性肾小球疾病的发展预后。     

2型糖尿病肾病患者血栓调节蛋白的变化

目的　探讨血浆内血栓调节蛋白 (TM)含量变化与 2型糖尿病肾病的关系及其在 2型糖尿病肾病发病中的意义 ,为早期诊断和治疗提供依据。方法　采用ELISA法 ,同时测定 6 9例 2型糖尿病患者和 12例正常人 (NC组 )血浆TM ;并根据 2 4h尿白蛋白排泄率 (UAER)将 2型糖尿病患者分为正常白蛋白尿组 (SDM组 ) ,微量白蛋白尿组 (即早期糖尿病肾病组 ,EDN组 ) ,大量白蛋白尿组 (即临床期糖尿病肾病组 ,CDN组 )。结果　①与NC组 (1.4 6 11± 0 .392 6 ) μg·L-1比较 ,血浆TM水平在SDM组 (2 .0 2 81± 0 .5 813) μg·L-1、EDN组 (2 .6 6 32± 1.0 0 3) μg·L-1、CDN组 (4 .5 86 1±2 .5 2 91) μg·L-1,均显著升高 (P <0 .0 0 5 ,P <0 .0 0 5 ,P <0 .0 0 1) ;与SDM组比较 ,EDN组和CDN组血浆TM显著升高 (P<0 .0 5 ,P <0 .0 0 1) ,CDN组血浆TM水平显著高于EDN组 (P <0 .0 0 1)。②血浆TM与UAER呈显著正相关 (r值为 0 .5 74 ,P <0 .0 0 1)。③血浆TM分别与病程、FPG、GHbAc、BUN、Cr、TC、LDL、SBP、DBP呈显著正相关 (r值分别为 0 .4 33、0 .2 2 7、0 .315、0 .2 2 8、0 .2 2 6、0 .2 0 7、0 .2 96、0 .4 77、0 .372 ,P均小于 0 .0 5 )。结论　血浆TM水平的测定有助于 2型糖尿病肾病的早期诊断     

豚鼠左心室中层肌细胞电生理特征的实验研究

目的　观察 2 5 0～ 80 0g豚鼠左心室游离壁内、外膜层及中层肌细胞的复极不均一性及室壁中层是否具有Mcell的特性。方法　应用标准玻璃微电极技术 ,记录不同基础周长时豚鼠左心室游离壁内、外膜层及中层肌细胞跨膜动作电位各种参数变化。结果　在所有刺激周期(BCL)测试中 ,中层肌细胞的复极至动作电位 90 %的时程 (APD90 )较心内、外膜层肌细胞长 ,在BCL =3 0 0ms时 ,内、外膜层及中层肌细胞的APD90 分别为 (2 0 7± 1 5 )ms,(2 1 4± 2 1 )ms,(2 1 5±2 7)ms( x±s;n =9;体质量 2 5 0～ 3 5 0 g)及 (2 0 6± 3 4 )ms,(1 99± 2 8)ms,(2 4 7± 2 5 )ms( x±s;n=1 0 ;体质量 3 5 0～ 80 0 g)。在BCL =3 0 0 0ms时 ,内、外膜层及中层肌细胞的APD90 分别为 (2 94± 3 4 )ms,(2 90± 49)ms,(3 1 3± 5 0 )ms( x±s;n =1 0 ;体质量 2 5 0～ 3 5 0 g)及 (2 96± 42 )ms,(2 5 9± 5 8)ms,(3 2 8± 3 6 )ms( x±s;n =1 0 ;体质量 3 5 0～ 80 0 g)。中层肌细胞APD 频率依赖性较心内、外膜层肌细胞更明显。结论　豚鼠左心室游离壁存在复极不均一性 ,中层肌细胞有更长的APDs,更明显的APD 频率依赖性。豚鼠左心室游离壁中层细胞具有Mcell的电生理特性。     

马洛替酯缓释片人体药代动力学及生物利用度

目的　研究马洛替酯缓释片单次给药和多次给药的人体药代动力学和生物利用度。方法　 2 0名健康男性志愿受试者随机交叉分别单次及多次口服马洛替酯缓释片与普通片 ,采用高效液相色谱法 (HPLC)测定血浆中马洛替酯的浓度 ,用 3P97程序进行数据处理。结果　单次口服马洛替酯缓释片与普通片 (6 0 0mg)后 ,AUC0～ 2 4分别为 (130 .77± 39.81)和 (135 .4 7± 4 6 .39) μg·h·L-1;AUC0～∞ 分别为 (16 4 .4 9± 5 1.6 9)和 (173.0 3± 6 5 .6 9) μg·h·L-1;Tmax分别为(4.15± 1.73)和 (2 .2 5± 0 .72 )h ;Cmax分别为 (2 4 .2 3± 11.2 3)和 (35 .0 5± 16 .0 2 ) μg·L-1;t1/ 2 分别为 (11.11± 2 .92 )和(10 .5 1± 1.98)h。多次口服马洛替酯缓释片 (每次 30 0mg,每日 2次 )与普通片 (每次 2 0 0mg ,每日 3次 )达稳态后 ,AUCss0～τ分别为 (112 .5 7± 34.37)和 (76 .97± 18.0 9) μg·h·L-1;Tmax分别为 (3.35± 1.2 2 )和 (2 .0 0± 0 .6 5 )h ;Cmax分别为 (2 1.4 6± 7.82 )和 (2 5 .2 8± 7.78) μg·L-1;Cmin分别为 (5 .4 5± 1.2 4 )和 (5 .0 6± 0 .81) μg·L-1;Cav分别为 (9.38± 2 .86 )和 (9.6 2± 2 .2 6 ) μg·L-1;波动度 (DF)分别为 (1.6 9± 0 .4 0 ) %和 (2 .0 8± 0 .6 2 ) %。马?     

COX-2、VEGF的表达和胃癌血管生成的关系

目的　探讨环氧化酶 2 (COX 2 )、血管内皮生长因子 (VEGF)与胃癌血管生成的关系。方法　用免疫组化SP法检测 4 5例胃癌、癌旁组织COX 2、VEGF和MVD的表达。结果　胃癌组织COX 2、VEGF和MVD的表达明显高于癌旁组织。COX 2 (+)或VEGF(+)组MVD(6 1.2 9± 14 .31;6 0 .0 7± 15 .86 )均显著高于COX 2 (- )或VEGF(- )组 (45 .38± 12 .4 2 ;4 3.0 6± 18.91,P <0 .0 5 ) ,COX 2、VEGF均为阳性组MVD(6 2 .4 6± 14 .34)明显高于两者均阴性组 (41.2 4± 13.6 5 ,P<0 .0 5 )或仅一项阳性组 (P <0 .0 5 )。COX 2、VEGF均与MVD显著正相关 (P <0 .0 1) ,COX 2与VEGF显著正相关 (P<0 .0 1)。结论　COX 2可能参与胃癌血管生成 ,VEGF可能是COX 2诱导肿瘤血管生成的重要介质     

低剂量米索前列醇用于足月妊娠引产的临床观察

目的　观察比较低剂量米索前列醇及蓖麻油餐用于足月妊娠引产的临床效果。方法　选择有引产指征、无引产及米索前列醇使用禁忌症的单胎、头位、胎膜完整的足月妊娠妇女 63例 ,随机分为A组 (2 0例 ,米索前列醇 2 5μg) ,B组 (2 0例 ,米索前列醇 50 μg)和C组 (2 3例 ,蓖麻油餐 )。2 4h阴道后穹窿置药一次。结果　A、B、C三组引产成功率分别为 85 0 %、80 0 %、86 95% ,用药后临产的时间分别为 (2 96± 1 46)min、(30 8± 2 31 )min、(2 0 6± 1 0 1 )min。分娩方式、新生儿体重、宫颈评分 ,三组比较差异均无显著性 (P >0 0 5)。B组第一产程和总产程较C组缩短 (P <0 .0 5) ,A组产时出血量较C组少 (P <0 0 5) ;宫缩过强羊水污染的发生率A组及C组较B组低。结论　低剂量米索前列醇用于足月妊娠引产是有效的。     

Relationship between the acid-suppression efficacy of proton pump inhibitors and CYP2C19 genetic polymorphism in patients with peptic ulcer

Obiective To investigate acid-suppression efficacy of proton pump inhibitors(PPls) in relation to CYP2C19 genetic polymorphism on patients with peptic ulcer. Methods By an open, randomized and control trial, fifty nine patients with active peptic ulcer were randomly assigned to receive one of three PPIs on a single dose (20 mg of each drug): omeprazole group (n=19), rabeprazole group (n=20) and esomeprazole group (n=20). lntragastric pH was recorded 1 hour before and 24 hours after administration. CYP2C19 genotype was tested in all patients. Resuits The EMs/PMs ratio of each group was 16/3,17/3 and 17/3, respectively. The total time that intragastric pH＞4, time percent pH＞4 and median pH in PMs patients were significantly higher than those in EMs patients of omeprazole group (P＜0.05). But all these differences were not found in rabeprazole group and esomeprazole group. The pH of nocturnal acid breakthrough (NAB) in both rabeprazole group and esomeprazole group was higher than that of omeprazole group, while there was no significant difference between rabeprazole group and esomeprazole group. Gonclusion The acid-suppression efficacy of omeprazole is highly dependent on CYP2C19 genetic polymorphism, while CYP2C19 genetic polymorphism may have a little influence on the acid-suppression efficacy of rabeprazole and esomeprazole. The acid-suppression action of rabeprazole and esomeprazole is superior to omeprazole, especially on night acid secretion.     

Genetic polymorphism of T6235C mutation in 3' non-coding region of CYP1A1 and GSTM1 genes and lung cancer susceptibility in the Mongolian population

Objective To estimate the relative risk for lung cancer associated with genetic polymorphism of T6235C mutation in 3' non-coding region (Msp Ⅰ) of cytochrome P450 1A1 (CYP1A1) and glntathione S-transferase M1 (GSTM1) in the Mongolian population in Inner Mongolian Region of China. Methods Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and multiplex PCR methods were used to analyze blood samples obtained from 263 case subjects and 263 control subjects to determine their genotypes for CYP1A1 and GSTM1.Control subjects were matched with case subjects by ethnic background, age and gender. Results The frequencies of the variant CYP1A1 genotypes (CYP1A1C) and GSTM1-null in lung cancer groups were higher than those in control groups (38.4% vs. 28. 5% and 57.8% vs. 48.0%). The individuals who corried with CYP1A1C genotype had a significantly higher risk of lung cancer (OR=1.56, 95% CI=1.08 to 2.25, P=0.016) than those who carried with non-variation CYP1A1 genotype. The ones who carried with GSTM1-null genotype also had a significantly higher risk of lung cancer (OR=1.49, 95% CI=1.06 to 2.10, P=0.023) than these who carried with GSTM1-present genotype.When combination of polymorphisms of CYP1A1 and GSTM1 genotypes was analyzed, the risk of lung cancer for combination of CYP1A1C and GSTM1-null genotypes was increased significantly (OR=2.084, 95e CI=1.27 to 3.42, P=0.003). Susceptibility to lung cancer was related to smoking (OR=2.10, 95% CI=1.48 to 2.98, P=0.000). Considering smoking status, the risk of lung cancer for combination of smoking and CYP1A1C genotype was remarkably increased (OR=2.76, 950/0 CI=1.74 to 4. 37, P=0.000). It was the same case with combination of smoking and GSTM1-null genotype (OR=4. 38, 95% CI=2.35 to 8.15, P=0.000). Conclusion The polymorphisms of CYP1A1C genotype and GSTM1-null are the risk factors of lung cancer in the Mongolian population in Inner Mongolia Region of China. Smoking is also related to susceptibility to lung cancer. There may be a synergetic interaction between CYP1A1C and GSTM1-null in the elevated susceptibility of lung cancer. Smoking may have a synergetic interaction with CYP1A1C and GSTM1-null in the elevated susceptibility of lung cancer.     

24h胃内pH的节律研究

为探讨２４ ｈ 胃内ｐＨ的节律变化,对４２ 例受试者（正常组１０ 例、功能性消化不良组２５ 例、其它组７ 例）用便携式ｐＨ 记录仪作２４ ｈ 胃内ｐＨ监测,所有受试者空腹胃液ｐＨ≤２。结果显示２４ ｈ 胃内ｐＨ值随进餐后上升＞ ４,持续２～３ｈ;夜间可出现与进餐无关的无酸波（ｐＨ＞ ４）,出现率为７９％ （３３／４２）,以后半夜多见。功能性消化不良组无酸波持续时间较正常组明显长,可能与病理性十二指肠胃反流有关     

The effect of bile reflux on the intragastric pH

Oblective To observe the effect of bile reflux on the intragastric pH. Methods We used ambulatory intragastric pH monitoring along with simultaneous Bilitec 2000 to measure the pH and absorbance of the mixed gastric juice diluted with bile with increasing bilirubin concentration in vitro and the yellow and clear gastric juice aspirated under endoscopy. In vivo,we studied 20 functional dispepsia patients for 24 h with simultaneous intragastric pH and bilirubin monitoring. Results In vitro dilutions,the absorbance value reached to 0. 900 while the concentration was only 20% ,but when the pH of the solution was more than 4,it′s concentration was already up to 60％. The mean absorbance of the yellow gastric juice(0. 348± 0. 131) was significantly higher than that of the clear juice (0. 008 ± 0. 003)(P＜0.05). The pH of 80％ yellow gastric juice was less than 4, the percentage was not significantly different from the clear samples (81％) (P＞0. 05). The pH showed no correlation with the absorbance in the yellow and clear groungs. Eight of the 12 patients with the spontaneous nocturnal episcodes of alkalinization had simultaneous increase of absorbance,4 of the 8 subjects with no aikalinization had increase of absorbance. Gonclusion In some concentration,bile reflux affect little on the intragastric pH.     

THE RELATIONSHIP BETWEEN THE SPONTANEOUS NOCTURNALEPISODES OF ALKALINIZATION AND AUTONOMIC NERVOUSFUNCTION ON FD PATIENTS

Spontaneousnocturnalepisodesofalkaliniza-tionduringtheearlymorningareseenin7o%~8o%ofnormalsubjectsandfunctionaldispepsia(FD)patientswhoundergoprolongedambulatoryintragastricpHmonitoring"."-Thedurationsofalkalineshiftsarefromhalfanhourtoseveralhours,thepHelevatesto7andeven8.However,controversyexistsovertheiretiology.Someinves-tigatorshavepostulatedbutnotprovedthatthereasonisadecreaseofvagaIactivitywithasubse-quentdecreaseinacidsecretiontl'3].Heartratevariability(HRV)representsanoninvasivean…     

味觉刺激和内脏刺激对大鼠臂旁核c-Fos表达的影响

目的　研究甜味觉刺激与不适内脏刺激对大鼠臂旁核c Fos样免疫反应性物质 (c Fos likeimmunoreactivity ,c FLI)表达的影响 ,探讨两种刺激信息在臂旁核的相互作用。方法　应用免疫组织化学方法 ,给予大鼠四种不同形式的刺激 ,分别为处理组T1:胃内灌注LiCl+口内灌注糖精 (I/GLiCl+I/OSac) ;T2 :胃内灌注LiCl+口内灌注蒸馏水 (I/GLiCl+I/Owater) ;T3 :胃内灌注蒸馏水 +口内灌注糖精 (I/Gwater +I/OSac) ;对照组C4:胃内灌注蒸馏水 +口内灌注蒸馏水 (I/Gwater+I/Owater)。比较联合刺激 (T1)与单独的不适内脏刺激 (T2 )和单独的甜味觉刺激 (T3 )对臂旁核不同部位c FLI表达的影响。结果　T1、T2组比T3、C4组在臂旁核外部外侧亚核的c FLI表达增加 (P <0 .0 1) ,T1组比T2、T3和C4组在外部内侧亚核的c FLI表达增加 (分别为P <0 .0 1,P <0 .0 5 ,P <0 .0 1)。各组之间在臂旁核腰区和背外侧亚核的c FLI表达没有显著性差异 (P >0 .0 5 )。结论　外部外侧亚核是一个处理内脏信息的亚核 ,外部内侧亚核参与了味觉信息和内脏信息相互作用的处理过程     

自发性夜间胃碱化形成机制探讨

目的　探讨自发性夜间胃碱化的形成是否与十二指肠胃反流 (DGR)及迷走神经功能有关。方法　 2 0例功能性消化不良 (FD)患者采用胃内 pH和胆红素同步监测法 ,比较夜间自发性碱化与胆汁反流的关系 ;另外 2 0例无心血管疾病的FD患者采用胃内 pH和心电Holter同步监测 ,进行心率变异性 (HRV)时域分析 ,以SDNN、rMSSD、PNN5 0为指标 ,观察夜间自发性碱化与迷走神经功能的关系。结果　 2 0例FD患者中出现夜间自发性碱化者 1 2例 ,其中 8例 (占66.7% )同时有胆红素吸光值升高 ;2 0例无心血管疾病的FD患者中 1 3例有夜间自发性碱化 ,7例无自发性碱化 ,二者比较SDNN、rMSSD均在正常范围 ,差异无显著性 (P >0 .0 5 ) ;2 4h胃 pH与PNN5 0对照观察表明 ,夜间时段与白天相比PNN5 0明显升高 ,有自发性碱波组与无自发性碱化组二者相比 ,PNN5 0无显著差别。结论　自发性夜间胃碱化的形成与DGR有关 ,并不是迷走神经张力降低导致胃酸分泌减少所致。     

夫妻配对MTHFR基因型分布与不明原因反复流产的关系

目的　探讨亚甲基四氢叶酸还原酶 (MTHFR)基因多态性在夫妻间的不同存在形式与不明原因反复流产之间的关系。方法　采用聚合酶链反应 限制性片段长度多态性 (PCR RFPL)的方法 ,对 32对有两次及两次以上不明原因流产史的夫妇和 39对健康夫妇进行MTHFR6 77C→T突变相关性研究。结果　病例组与正常对照组流产发生的危险性比较 ,夫妻双方都是纯合或杂合突变型 ,其基因型分布与流产发生的危险性增高高度相关 ,OR =2 94 1,95 %CI[1.0 6 2～ 8.133];夫妻双方有一人是纯合或杂合突变型 ,而另一人为野生型的 ,其基因型分布与流产发生的危险性无关联 ,OR =0 .819,95 %CI[0 .32 0～ 2 .0 94 ];夫妻双方都是野生型 ,其基因型分布与发生流产的危险性降低高度相关 ,OR =0 188,95 %CI[0 .0 4 6～ 0 .76 0 ]。结论　子代携带MTHFR纯合或杂合突变可能是胚胎早期发育异常的原因之一 ,从而导致流产的发生。