BACKGROUND:Many studies have shown that interstitial Cajal-like cell (ICLC) abnormalities are closely related to a variety of dynamic gastrointestinal disorders. ICLCs are pacemaker cells for gastrointestinal movement and are involved in the transmission of nerve impulses.AIM:To elucidate the expression profile and significance of cholecystokinin-A (CCK-A) receptors in ICLCs in the common bile duct (CBD), as well as the role of CCK in regulating CBD motility through CCK-A receptors on CBD ICLCs.METHODS:The levels of tyrosine kinase receptor (c-kit) and CCK-A receptors in CBD tissues and isolated CBD cells were quantified using the double immunofluorescence labeling technique. The CCK-mediated enhancement of the movement of CBD muscle strips through CBD ICLCs was observed by a muscle strip contraction test.RESULTS:Immunofluorescence showed co-expression of c-kit and CCK-A receptors in the CBD muscularis layer. Observations of isolated CBD cells showed that c-kit was expressed on the surface of ICLCs, the cell body and synapse were colored and polygonal, and some cells presented protrusions and formed networks adjacent to the CBD while others formed filaments at the synaptic terminals of local cells. CCK-A receptors were also expressed on CBD ICLCs. At concentrations ranging from 10-6 mol/L to 10-10 mol/L, CCK promoted CBD smooth muscle contractility in a dose-dependent manner. In contrast, after ICLC removal, the contractility mediated by CCK in CBD smooth muscle decreased.CONCLUSION:CCK-A receptors are highly expressed on CBD ICLCs, and CCK may regulate CBD motility through the CCK-A receptors on ICLCs.

目的:探讨苦参碱联合胃复春片治疗慢性萎缩性胃炎疗效及对患者血清胃蛋白酶原亚群的影响.方法:将200例慢性萎缩性胃炎患者随机分作观察组与对照组,观察组采用苦参碱联合胃复春片治疗,对照组仅采用胃复春片治疗.比较两组患者的治疗效率、症状积分、胃镜下观察情况并检测血清胃蛋白酶原亚群含量.结果:观察组患者的总有效率98.0％,高于对照组的87.0％,组间差异有统计学意义(P<0.05).观察组患者胃酸烧心、胃脘疼痛、食欲不振等症状积分低于对照组(均P<0.05),但两组患者呃逆嗳气症状积分比较,差异无统计学意义(P>0.05).治疗后观察组胆汁反流、糜烂、溃疡等发生率低于对照组,组间差异有统计学意义(均P<0.05);而两组患者的出血斑发生率比较,差异无统计学意义(P>0.05).治疗后观察组胃蛋白酶原Ⅰ(90.57±14.36)μg/L、胃蛋白酶原I/胃蛋白酶原Ⅱ(9.23±0.99),高于对照组的(63.45±12.85)μg/L、(7.56±0.82),观察组胃蛋白酶原Ⅱ(7.87±4.35)μg/L低于对照组的(9.75±4.87)μg/L,组间比较差异有统计学意义(均P<0.05).结论:苦参碱联合胃复春片可有效缓解慢性萎缩性胃炎临床症状,改善患者血清胃蛋白酶原亚群含量.

背景合理控制血压并不能有效降低妊娠期高血压(PIH)患者子痫前期发生风险,而控制PIH患者血压的同时最大限度地增加脐动脉血流直接关系到母婴结局,因此探讨PIH患者精准控压策略具有重要现实意义.目的 对比拉贝洛尔片与硝苯地平缓释片对PIH患者血压、血浆同型半胱氨酸(Hcy)水平、脐动脉血流动力学的影响,以初步探索基于无创血流动力学监测的PIH精准控压策略.方法 选取湖北省妇女儿童医院内科及武汉市中心医院新洲区分院内科门诊2015年6月—2019年3月收治的PIH患者120例,采用SPSS 16.0统计学软件完全随机化设计分组法分为A组和B组,每组60例;另选取同期在湖北省妇女儿童医院进行产检及分娩的健康孕妇60例作为对照组.本研究启动降压治疗的血压阈值为≥150/100 mm Hg(1 mm Hg=0.133 kPa),以治疗后血压控制在130～140/80～90 mm Hg为达标.A组患者口服拉贝洛尔片,B组患者口服硝苯地平缓释片;两组患者均连续治疗4周.比较三组受试者入组次日及A组与B组患者治疗后收缩压(SBP)、舒张压(DBP)、血浆Hcy水平及脐动脉收缩末期血流速度/舒张末期血流速度比值(S/D)、时间平均流速(VM)、搏动指数(PI)、阻力指数(RI),并比较A组与B组患者治疗2、3、4周血压达标率,母婴结局,治疗期间药物不良反应发生情况;入组次日血浆Hcy水平与PIH患者脐动脉血流动力学指标的相关性分析采用Pearson相关分析.结果 B组2例患者因药物不良反应不能耐受而未按规定完成4周治疗.A组、B组患者入组次日SBP、DBP、血浆Hcy水平及脐动脉S/D、PI、RI高于对照组,脐动脉VM慢于对照组(P<0.01),而A组与B组患者入组次日SBP、DBP、血浆Hcy水平及脐动脉S/D、VM、PI、RI比较,差异无统计学意义(P>0.05);B组患者治疗后SBP、DBP、血浆Hcy水平及脐动脉S/D、PI、RI高于A组,脐动脉VM慢于A组(P<0.05).Pearson相关分析结果显示,入组次日血浆Hcy水平与PIH患者脐动脉PI、RI、S/D呈正相关(r值分别为0.55、0.46、0.42,P<0.01),与脐动脉VM呈负相关(r=-0.38,P<0.01).A组与B组患者治疗2、3、4周血压达标率比较,差异无统计学意义(P>0.05).两组患者轻度子痫前期、胎盘早剥发生率比较,差异无统计学意义(P>0.05);B组患者中行剖宫产者所占比例高于A组,胎龄、新生儿出生体质量及Apgar评分低于A组(P<0.05).B组患者治疗期间药物不良反应发生率高于A组(P<0.05).结论 PIH患者血浆Hcy水平明显升高,脐动脉血流动力学指标异常;与硝苯地平片缓释片相比,拉贝洛尔片可更有效地降低PIH患者血压、血浆Hcy水平并改善脐动脉血流动力学指标、母婴结局,且安全性较高,应重视PIH患者降压药物的选择;血浆Hcy水平与PIH患者脐动脉血流动力学指标有关,PIH患者可适当补充外源性叶酸;PIH患者降压阈值定为≥150/100 mm Hg、降压目标值定为130～140/80～90 mm Hg可行,而基于无创血流动力学监测的PIH精准控压策略有助于最大限度地改善PIH患者母婴结局.

目的 观察音乐电刺激治疗功能性消化不良的临床疗效.方法 选取符合罗马Ⅲ诊断标准的功能性消化不良患者81例,按随机数字表法分为治疗组(41例)和对照组(40例).对照组给予口服泮托拉唑肠溶胶囊及枸橼酸莫沙必利片;治疗组在口服药物基础上给予音乐电刺激治疗;治疗4周后观察疗效.两组患者治疗前后均评价主要症状积分、抑郁自评量表(SDS)、焦虑自评量表(SAS)得分以及记录餐前后体表胃电图(EGG).结果 在症状、疗效评价上,治疗组总有效率达85.36％,优于对照组的67.50％ (P＜0.05);与治疗前相比,治疗组的SDS、SAS评分明显降低(P＜0.05),对照组SDA、SAS评分无明显改变;治疗组治疗后EGG主频率、餐后/餐前主功率较治疗前明显改善(P＜0.01),对照组则改善不明显.结论 音乐电刺激治疗可以改善消化不良症状、焦虑抑郁状态,调节胃电节律紊乱和增强胃电功率.

目的:探讨基于运动手环计算术后活动量对胰十二指肠切除术患者的影响.方法:将74例行胰十二指肠切除术患者按住院期间日活动距离分为高活动量组34例、中等活动量组22例、低活动量组18例,比较三组患者营养状况、住院时间、住院费用、术后并发症发生率以及下床活动时疼痛视觉模拟评分法(VAS)评分.结果:高活动量组和中等活动量组营养状况总体好于低活动量组(P<0.05),但中等活动量组的白蛋白含量和低活动量组比较差异无统计学意义(P>0.05).高活动量组和中等活动量组的住院时间、住院费用以及VAS评分均低于低活动量组(P<0.05);相比其他两组,低活动量组的胃排空延迟发生率升高(61％)(P<0.05).结论:胰十二指肠切除术后患者每日活动量>400 m,有助于患者康复,可以缩短住院时间,降低住院费用,医务人员应合理使用镇静药物进行疼痛控制,以减轻患者痛苦.

[目的]探讨结直肠癌患者血清脂联素(ADP)与细胞周期蛋白D1(Cyclin D1)和核因子-κB(NF-κB)的相关性及临床意义.[方法]检测47例健康人和63例结直肠癌患者血清ADP、NF-κB、Cyclin D1以及炎症因子的含量.[结果]血清ADP水平比较发现,癌症患者较健康人低,TNM分期Ⅲ+Ⅳ期患者较Ⅰ+Ⅱ期患者低(均P＜0.05);血清NF-κB、Cyclin D1及炎症因子含量比较发现,癌症患者较健康人高,Ⅲ+Ⅳ期患者较Ⅰ+Ⅱ期患者高.血清ADP与NF-κb、Cyclin d1和炎症因子均呈负相关性.以结直肠癌为因变量进行回归分析,ADP、NF-κB以及Cyclin D1的回归系数为-0.202、0.585和6.549.[结论]ADP是结直肠癌的保护因素,与NF-κB和Cyclin D1具有负相关性,可作为临床上结直肠癌患者病情进展评估的一项生物指标.

目的 观察长链非编码RNA(lncRNA)BANCR在胃癌细胞中的表达变化,及其对细胞增殖、迁移能力的影响,并探讨其机制.方法 采用RT-PCR法检测胃癌细胞AGS、BSG823、MGC-803、Hs746T和正常胃上皮细胞GES-1中的lncRNA BANCR.将AGS细胞分成LV-BANCR shRNA组、LV-NC组及BLANK组,采用Lipo-fectamine2000分别转染pcDNA3.1-LV-BANCR shRNA、pcDNA3.1-LV-NC及PBS;分别于培养0、1、2、3、4 d后采用MTT试验检测细胞增殖能力,采用细胞划痕试验检测细胞迁移能力,采用Western blotting法检测细胞中的核转录因子NF-κB1p50、NF-κB1p105及磷酸化细胞外信号调节激酶(p-ERK).结果 AGS、BSG823、MGC-803、Hs746T细胞中lncRNA BANCR相对表达量高于GES-1细胞(P均<0.05).培养3、4 d后,LV-BANCR shRNA组OD值小于LV-NC组和BLANK组(P均<0.05).LV-BANCR shRNA组划痕愈合率低于LV-NC组(P<0.05).LV-BANCR shRNA组NF-κB1p50、NF-κB1p105、p-ERK相对表达量均低于LV-NC组(P均<0.05).结论 lncRNABANCR在胃癌细胞中高表达.沉默lncRNA BANCR表达可抑制胃癌细胞的增殖、迁移能力,其机制可能与NF-κB1 p50、NF-κB1 p105及p-ERK表达下调有关.

目的:探讨柔性护理在老年手术患者护理中的应用效果.方法:选取本院2017年1月至2018年5月综合科收治的160例老年患者为研究对象,利用Excel软件将患者分为对照组与观察组,每组患者各80例,所有患者均实施手术治疗,对照组患者采取常规护理干预,观察组患者采取柔性护理,比较两组患者护理干预前后焦虑、抑郁评分变化及对护理的满意度.结果:两组患者干预前焦虑、抑郁评分比较无统计学意义(>0.05),干预后观察组患者焦虑、抑郁评分低于对照组,观察组患者满意度为92.50％,对照组患者满意度为78.75％,差异有统计学意义(<0.05).结论:对老年手术患者实施柔性护理干预可有效改善患者心理状态,提升患者对护理工作的满意度,应在临床上广泛推广.

观察在基于气机论治运用四君子汤加减对脾胃虚弱型非糜烂性胃食管反流病及抗Hp的疗效.方法:选取2015年7月至2017年2月武汉市中西医结合医院消化科门诊和住院部诊治的脾胃虚弱型非糜烂性胃食管反流病(Non-erosive Reflux Disease,NERD)Hp阳性患者90例,按随机数字表法将患者分为观察组与对照组,每组45例.对照组采用抗Hp三联疗法加胃动力药治疗,观察组在此基础上加以中药四君子汤加减口服,分别在治疗前及6周后对2组的症状积分改善程度,临床疗效及Hp转阴率进行统计分析,同时观察电镜下食管黏膜细胞的变化.结果:在6周后,观察组总有效率(95.55％)优于对照组(84.44％)(P<0.05);2组的临床症状积分Sc值均明显降低(P<0.05),且观察组明显优于对照组(P<0.05).观察组转阴41例(91.11％,对照组37例(82.22％),观察组的转阴率明显优于对照组(P<0.05),2组细胞间隙宽度变小,细胞间隙内单位面积桥粒数目增多(P<0.05),且观察组明显优于对照组(P<0.05).结论:在脾胃虚弱型非糜烂性胃食管反流病抗Hp治疗时,结合使用中药四君子汤加减可明显提高疗效,提高Hp转阴率.

目的 探讨参苓白术散联合氟哌噻吨美利曲辛治疗功能性消化不良的疗效.方法 选择2013年1月至2016年1月武汉市中西医结合医院消化内科收治的功能性不良患者96例,应用随机数表法分为对照组和观察组,每组48例.对照组给予吗丁啉治疗,观察组给予参苓白术散和氟哌噻吨美利曲辛治疗,疗程均为28 d.比较两组患者主要临床症状改善情况,采用中医证候积分进行总体疗效评价,采用酶联免疫法检验患者胃动素含量,采用超声法检测患者胃排空时间.结果 观察组患者的治疗总有效率为87.50%,明显高于对照组的70.83%,差异有统计学意义(P<0.05);在中医症状积分改善方面,观察组和对照组患者治疗后的嗳气[(0.53±0.12)分vs(0.71±0.15)分]、恶心[(0.77±0.20)分vs(1.26±0.39)分]、腹胀[(1.41±0.32)分vs(1.75±0.41)分]和腹痛[(1.01±0.41)分vs(1.83±0.62)分]评分比较,观察组均明显低于对照组,差异均有统计学意义(P<0.05);治疗后,观察组患者的血清胃动素含量为(421.19±69.25)pg/mL,明显高于对照组的(382.58±82.97)pg/mL,差异有统计学意义(P<0.05);观察组患者治疗后的胃排空时间为(26.97±6.50)min,明显短于对照组的(33.31±5.98)min,差异有统计学意义(P<0.05).结论 参苓白术散联合氟哌噻吨美利曲辛治疗功能性消化不良疗效显著,其能够改善患者嗳气、恶心、腹胀和腹痛等证候,其作用可能与调节患者胃动素从而改善胃排空功能相关.

目的:观察方药补中益气汤在治疗便秘型肠易激综合征的临床疗效,并分析其对患者相关指标的影响.方法:选取2016年1月至2016年12月武汉市中西医结合医院消化内科门诊及住院的便秘型肠易激综合征患者90例,通过随机数字法随机分为观察组和对照组,每组45例.在基础治疗的同时,对照组予以双歧杆菌三联活菌胶囊口服,观察组加补中益气汤口服,2组均治疗8周.治疗前后抽取血液测定血清内P物质(Substance P)、血浆生长抑素(Somatostatin,SS),神经肽Y(Neuropeptide Y,NPY).通过肠镜下取结肠黏膜组织,运用荧光定量PCR测定其蛋白酶激活受体-2水平,同时进行肠敏感度的评定及临床疗效分析.结果:治疗后观察组总有效率(88.89％)优于对照组(77.78％)(P<0.05).2组肠道敏感度均较治疗前明显改善(P<0.05),且观察组腹痛、腹胀、腹泻评分改善程度明显优于对照组(P<0.05).同时治疗后2组患者的血清SP、SS水平及肠黏膜PAR-2表达均降低,而血清NPY水平升高,且观察组改善程度优于对照组(P<0.05)结论:脾胃虚弱证便秘型肠易激综合征患者口服补中益气汤可以有效的改善其临床症状.

AIM To evaluate the safety and efficacy of modified Shenling Baizhu powder combined with electroacupuncture (EA) in the treatment of diarrhea-predominant irritable bowel syndrome (D-IBS) with regard to the improvement of clinical symptoms and psychological state.METHODS Seventy D-IBS patients were randomly divided into an observation group and a control group (n =35 each).The observation group was treated with modified Shenling Baizhu powder combined with EA at Tianshu (ST25),Shangjuxu (ST37),Zusanli (ST36),Sanyinjia (SP6),Taichong (LR3),Baihui (GV20),30 min for each treatment,5 times a week,for 4 wk.The control group were treated with maleic acid trimebutine,0.1 g each time,three times a day,for 4 wk.The irritable bowel syndrome symptom severity score (IBS-SSS),irritable bowel syndrome quality of life (IBS-QOL),and symptom check list-90 (SCL-90) were sued to evaluate the clinical symptoms,quality of life,and psychological symptoms in the two groups before treatment,after 4 wk of treatment,and at 4 wk after treatment,respectively.Drug adverse reactions were also recorded.RESULTS The clinical curative effect was 97.1％ in the observation group and 91.4％ in the control group.After 4 wk of treatment,the degree and frequency of abdominal pain and overall IBS-SSS score was significantly better (P ＜ 0.05),and anxiety was more significantly improved in the observation group than in the control group.At 4 wk after treatment,the scores of anxiety,somatic mind,physical role,and health concerns were improved more significantly in the observation group than in the control group (P ＜ 0.05),with anxiety and health concerns improved most prominently (P ＜ 0.01).SCL-90 symptoms showed no statistically significant difference between the two groups before treatment (P ＞ 0.05);however,at 4 wk after treatment,there was a significant difference between the two groups with regard to somatization score (P ＜ 0.05).CONCLUSION Modified Shenling Baizhu powder combined with EA can significantly improve the clinical symptoms and psychological status of D-IBS patients,without obvious adverse reactions.

Objective To investigate the effects of miRNA-219-5p on the proliferation,apoptosis,and invasion of pancreatic carcinoma cells and its mechanism. Methods Real-time fluorescence quantitative PCR (qPCR)was carried out to determine miR-219-5p expression in the pancreatic carcinoma cell lines Panc-1,AsPC-1,and Bxpc-3 and normal pancreatic ductal epithelial cell line HPDE6-C7. Further,Panc-1 cells were chosen and were divided into two groups:the normal control group (NC group)(transfection with miR-219-5p scramble)and miR-219-5p group (transfection with miR-219-5p mimics). The cell proliferation and apoptosis were detected by MTT assay and flow cytometry. The invasion ability was checked by transwell assay. The expression of epidermal growth factor receptor (EGFR)and Cleaved Caspase-3 pro-teins was examined by Western blotting. Results MiR-219-5p expression was lower in pancreatic carcinoma cell lines Panc-1,AsPC-1,and Bxpc-3,as compared with that in the pancreatic ductal epithelial cell line HPDE6-C7 (all P <0. 01). The OD490nm of the miR-219-5p group was significantly lower than that of the NC group at 72,96,and 120 h (all P < 0. 01);the apoptosis rate was higher (all P < 0. 01). The invasive cells were (75. 3 ± 6. 9)/ Hp in the miR-219-5p group,which was significantly lower than that [(172. 5 ± 10. 5)/ Hp]in the NC group (P < 0. 01). The expressive level of EGFR in the miR-219-5p group was significantly lower than NC group (0. 31 ± 0. 09 vs. 1. 0,P < 0. 01). The expres-sion of Cleaved Caspase-3 was up-regulated in the miR-219-5p group as compared with that of NC group (2. 7 ± 0. 15 vs.1. 0,P < 0. 01). Conclusions The miR-219-5p is lowly expressed in pancreatic carcinoma cell lines. The over-expression of miR-219-5p can inhibit the proliferation and invasion of pancreatic carcinoma cells,and induce the apoptosis,possibly though the down-regulated protein expression of EGFR and up-regulated protein expression of Cleaved Caspase-3.

Objective To investigate levels of epidermal growth factor (EGF) and prostaglandin E2 (PGE2) in Han Chinese patients with Helicobacter pylori-positive gastric low-grade intraepithelial neoplasia (LGIN).Methods In this prospective, observational study, gastric specimens from patients with LGIN were collected by gastroscopy with consecutive biopsy. EGF and PGE2 concentrations in serum and gastric juice from patients with LGIN were measured by enzyme-linked immunosorbent assay. Presence of H. pylori infection was assessed in patients with LGIN and healthy controls.Results Out of 5638 patients and 548 controls, H. pylori infection in patients with chronic gastritis was associated with disease type (endoscopic classification) and disease severity. Patients with H. pylori-positive LGIN had significantly higher concentrations of serum EGF and lower concentrations of serum PGE2 versus patients with H. pylori-negative LGIN. Serum EGF and PGE2 levels in patients with LGIN were not significantly associated with disease type, but were significantly associated with disease severity.ConclusionsH. pylori infection was associated with chronic gastritis type (endoscopic classification) and disease severity. Abnormal EGF and PGE2 levels may be associated with H. pylori-positive LGIN in Han Chinese patients in central China.

目的 探讨Wnt3a对结肠癌SW480细胞增殖的调控效应及其作用机制.方法 将培养好的结肠癌细胞SW480随机分为对照组和Wnt3a组,对照组仅给予DMEM培养基处理,Wnt3a组给予100 ng/mL Wnt3a培养.用MTT法检测细胞增殖情况,计算相对活细胞百分比;用平板克隆形成实验检测细胞克隆形成率(PE);用流式细胞术检测细胞周期分布;用Western blotting法检测细胞内醛脱氢酶1B1(ALDH1 B1)蛋白表达,RT-PCR技术检测ALDH1 B1 mRNA表达.结果 Wnt3a诱导24、48、72 h,Wnda组相对活细胞百分比高于对照组(P均＜0.05).Wnt3a诱导7d,Wnt3a组PE高于对照组(P＜0.05).Wnt3a诱导24h,Wnt3a组G1期细胞百分比低于对照组,G2期细胞百分比高于对照组(P均＜0.05).Wnt3a诱导48 h,Wnt3a组ALDH1B1蛋白、mRNA相对表达量高于对照组(P均＜0.05).结论 Wnt3a可能通过诱导ALDH1B1高表达促进结肠癌SW480细胞增殖.

目的：探讨幽门螺杆菌（helicobacter pylori，HP）感染与胃镜下不同胃炎类型及病理之间的关系。方法：2010年1月至2012年12月在我院行胃镜检查诊断的5638例患者连续性行胃镜下黏膜活检，对其内镜和病理表现进行分型分级，并检测患者的HP感染情况，分析HP感染与胃镜下不同胃炎类型及病理之间的关系。结果：所有5638例患者中浅表性胃炎、糜烂性胃炎及萎缩性胃炎的HP阳性率分别为51．00％、72．89％及77．22％；糜烂性胃炎及萎缩性胃炎患者与浅表性胃炎患者比较均有显著差异（P＜0．01）。在病理检查中度炎症反应程度的患者HP感染率明显高于轻度炎症反应患者（P＜0．01）；重度炎症反应程度的患者HP感染率明显高于中度炎症反应患者（P＜0．01）。在病理检查有活动性炎症的患者HP感染阳性率为86．79％，而无活动性炎症的患者HP感染率为53．18％，有显著统计学差异（P＜0．01）。在病理检查有肠上皮化生患者及有上皮类瘤变患者中HP感染阳性率分别为84．86％及89．80％，而无肠上皮化生及无上皮类瘤变患者的HP感染率为分别为48．08％及56．92％，比较均有显著差异（P＜0．01）。结论：HP感染可加重胃黏膜的炎症反应，同时促进慢性胃炎向萎缩性胃炎、肠上皮化生、上皮内瘤变发展。

目的探讨瘦素、瘦素受体、磷脂酰肌醇3-激酶（PI3-K）（p85α）以及蛋白激酶B（PKB）在非酒精性脂肪性肝病（NAFLD）中的表达及临床意义。方法选取2007年5—9月武汉市中心医院肝胆外科收治的术前B超诊断为脂肪肝,术中肝穿刺活组织检查证实为NAFLD的患者30例为NAFLD组;另选择同时期因胆囊结石（静止期）及胆囊息肉住院的肝功能正常者30例为对照组,检测两组患者血清瘦素水平,并采用免疫组织化学法检测两组患者肝细胞中瘦素、瘦素受体、PI3-K（p85α）及PKB的表达,分析其相关性。结果 NAFLD组患者血清瘦素水平为（10.90±3.39）μg/L,较对照组的（5.55±1.96）μg/L升高（t=-7.841,P＜0.05）。NAFLD组较对照组肝细胞瘦素、瘦素受体水平及PI3-K（p85α）光密度值增高,PKB光密度值降低（P＜0.05）。NAFLD组患者血清瘦素水平与肝组织中瘦素光密度值,肝细胞中瘦素光密度值与PI3-K（p85α）光密度值均呈正相关（r值分别为0.413和0.365,P＜0.05）;肝细胞中PI3-K（p85α）光密度值与PKB光密度值,血清瘦素水平与肝细胞中PKB光密度值均呈负相关（r值分别为-0.854和-0.923,P＜0.05）。对照组患者血清瘦素水平与肝细胞中瘦素光密度值,肝细胞中瘦素光密度值与PI3-K（p85α）光密度值,PI3-K（p85α）光密度值与PKB光密度值,血清瘦素水平与PKB光密度值均呈正相关（r值分别为0.593、0.795、0.840和0.686,P＜0.05）。结论 NAFLD患者中瘦素及瘦素受体表达增高,PKB表达降低,瘦素的过度表达不能活化PKB,存在瘦素抵抗。瘦素/PI3-K激活PKB的缺陷可能是NAFLD瘦素抵抗的一种新的机制。

目的:研究胃肠起搏及黛力新辅助抑酸药物治疗老年胃食管反流病的疗效。方法:将研究对象随机分为3组,A组给予雷贝拉唑钠肠溶胶囊及多潘立酮片口服,B组给予雷贝拉唑钠肠溶胶囊溶片并辅助胃肠起搏器治疗,C组给予雷贝拉唑钠肠溶胶囊及黛力新口服并辅助胃肠起搏器治疗,治疗时间均为4周,比较3组的疗效。结果:A、B、C组有效率分别为80%、80%、92%,C组疗效优于A组及B组(A组与C组及B组与C组P均<0.05)。HAMA评分的变化,C组治疗前后比较差异有显著性(P<0.01);治疗后C组与A组及B组比较差异有显著性(P<0.01)。结论:胃肠起搏辅助雷贝拉唑及黛力新治疗胃食管反流病比抑酸药物联合胃肠促动力药更显著地改善胃食管反流病患者的症状,且能有效改善患者的焦虑症状。

Aim To evaluate the plasma epoxyeicosatrienoic acids(EET) levels in patients with coronary heart disease,in order to investigate the relationship between EET and high sensitivity C-reactive protein(hs-CRP) and blood lipoprotein.Methods Plasma samples of peripheral venous blood of 30 patients and 30 controls were drawn.Enzyme-linked immunosorbent assay(ELISA) was used to measure the plasma EET levels.hs-CRP,total cholesterol(TC),triglyceride(TG),high density lipoprotein-cholesterol(HDLC),and low density lipoprotein-cholesterol(LDLC) levels were measured with a Hirachi 7170A analyzer.Results The levels of EET(60.01±35.06 μg/L) were significantly lower in patients with coronary heart disease compared with those in control group(88.07±33.60 μg/L,P0.05),and the EET levels were inversely correlated with hs-CRP(r=-0.286,P=0.027).Conclusions The levels of EET were significantly lower in patients with coronary heart disease,and the levels of EET were inversely correlated with hs-CRP.It is suggested that the decrease of plasma EET might be involved in the atherosclerosis inflammatory process.

Objective To explore the role of adiponectin in the development and progression of nonalcoholic fatty liver disease(NAFLD) through detecting changes of serum adiponectin level and the expression of adiponectin in NAFLD.Methods 30 NAFLD patients and 30 patients with other diseases were included in the study.Body mass index(BMI),fasting blood glucose(FBG),fasting insulin(FINS),total cholesterol(TC),triglyceride(TG),alanine aminotransferase(ALT),aspartate aminotransferase(AST),gamma glutamyl transpeptidase(GGT),adiponectin and HOMA-IR(homeostasis model assessment insulin resistance) were measured.The expression of adiponectin in NAFLD was examined in the two groups using immunohistochemistry.Results The levels of BMI,ALT,GGT,TG,FINS and HOMA-IR were significantly higher in NAFLD group than in control group(all P<0.05).The levels of adiponectin were significantly lower in NAFLD group than in control group(all P<0.05).No statistically significant differences were found in the levels of AST,FBG and TC between NAFLD group and control group(all P>0.05).The average optical in adiponectin of the biopsy specimen in NAFLD group was significantly lower than that in control group(P<0.05).Conclusion Adiponectin plays a key role in the occurrence and development of NAFLD.