前列腺癌根治性切除术后会阴部红外线照射提高患者控尿的 前瞻性的研究

目的:探讨对于前列腺癌根治术的患者,术后采用红外线会阴部照射,提高患者拔管后控尿的效果。方法:对76例前列腺癌根治术后患者,随机分为两组,实验组术后第一天起采用会阴部红外线照射治疗,连续10天,空白对照组不做任何处理,然后评估患者拔除尿管后控尿情况。结果:随访一年后发现,实验组中,37(97%)例的患者能够控制排尿,而对照组31(82%)例患者能够控制排尿(P=0.01)。实验组中可以控制排尿的患者,在拔除尿管以后,平均25±39天后可以控制排尿;而对照组中的患者则需要75±103天才能控制排尿(P<0.001)。接受红外线照射的患者尿控情况明显好于未接受治疗患者。结论:盆底红外线照射是前列腺癌根治术后提高患者尿控能力的有效的治疗方式。     

兔迷走复合区内微量注射TRH对奥迪氏括约肌肌电的影响及传出途径分析

目的和方法：本工作旨在研究免迷走复合区（ＤＶＣ）内ＴＲＨ对奥迪氏括约肌（ＳＯ）肌电的调节作用及外周途径。结果：（１）ＤＶＣ内注射ＴＲＨ（０．８ｎｍｏｌ,１μｌ）后,慢波电位（ＳＷ）频率不变,但锋电位频率（ＦＳＰＳＯ）及幅度（ＡＳＰＳＯ）、锋电位发生率（ＩＳＰ）明显增加．（２）ＤＶＣ内分别注射不同剂量ＴＲＨ（０．１３,０．２５,０．５０,０．８０,１．３０ｎｍｏｌ,１μｌ）后,各剂量ＴＲＨ均能引起ＦＳＰＳＯ增加。随注射剂量的增加,ＳＯ反应强度和持续时间均增加,呈现明显的剂量反应关系。（３）ＤＶＣ内注射ＴＲＨ兴奋ＦＳＰＳＯ的效应可被静脉注射阿托品（０．２ｍｇ／ｋｇ）或迷走神经切断完全阻断,但不能被静脉注射酚妥拉明（１．５ｍｇ／ｋｇ）、心得安（１．５ｍｇ／ｋｇ）或脊髓切断术所阻断。结论：ＤＶＣ内ＴＲＨ可能对ＳＯ肌电有重要的调节作用,这种作用是通过迷走神经及外周Ｍ受体介导。     

Effect of regulatory polypeptides on the substance P stimulated lower esophageal sphincter pressure in pigs

The effect of graded doses of vasoactive intestinal polypeptide (VIP), enkephalin, neuropeptide Y (NPY), gastrin-17, pentagastrin, cholecystokinin (CCK)-4, CCK-8, neurotensin, somatostatin, and thyrotropin-releasing hormone (TRH) on the substance P (SP)-stimulated lower esophageal sphincter pressure (LESP) in anaesthetized pigs was studied by direct infusion of the peptides into the arterial supply of the lower esophageal sphincter (LES). Infusion of SP in a dose of 20 pmol/kg per min for 3 min significantly increased the LESP (P less than 0.01). Simultaneous VIP infusion at 5--40 pmol/kg per min showed a dose-dependent inhibition of the effect of SP on the LESP. None of the other peptides had any effect on the LESP during simultaneous infusion of SP. Pharmacological blockade by atropine (250 mu/kg) or guanethidine (1 mg/kg) had no effect on the SP-stimulated LESP. In conclusion, the SP-induced stimulation of the LESP is abolished by VIP, and both peptides seem to play a role in the complex regulation of the LESP.     

Ultrastructure of Esophageal Gland Secretory Granules in Juveniles of Heterodera glycines

Ultrastructural observations of the feeding sites of soybean cyst nematode juveniles 3 days after inoculation of soybean roots revealed the presence of feeding tubes in the host cell syncytium. Feeding tubes, which were extruded from the stylet tips, were formed by products of secretory granules that originated in the dorsal esophageal gland and accumulated in the ampulla of the gland extension. Granules traversing the space between the gland cell and the ampulla were regulated in their movement by two sets of sphincter-like muscles located anterior and posterior to the metacorpus pump chamber. Sections through the sphincter muscles revealed obliquely arranged fibers, which in a contracted mode caused microtubules in the gland extension to be tightly packed and devoid of granules.     

Rat model of anal sphincter injury and two approaches for stem cell administration

AIM To establish a rat model of anal sphincter injury and test different systems to provide stem cells to injured area.METHODS Adipose-derived stem cells(ASCs) were isolated from BDIX rats and were transfected with green fluorescent protein(GFP) for cell tracking. Biosutures(sutures covered with ASCs) were prepared with 1.5 × 10~6 GFPASCs, and solutions of 10~6 GFP-ASCs in normal saline were prepared for injection. Anorectal normal anatomy was studied on Wistar and BDIX female rats. Then, we designed an anal sphincter injury model consisting of a 1-cm extra-mucosal miotomy beginning at the anal verge in the anterior middle line. The sphincter lesion was confirmed with conventional histology(hematoxylin and eosin) and immunofluorescence with 4', 6-diamidino-2-phenylindole(commonly known as DAPI), GFP and α-actin. Functional effect was assessed with basal anal manometry, prior to and after injury. After sphincter damage, 36 BDIX rats were randomized to three groups for:(1) Cell injection without repair;(2) biosuture repair; and(3) conventional suture repair and cell injection. Functional and safety studies were conducted on all the animals. Rats were sacrificed after 1, 4 or 7 d. Then, histological and immunofluorescence studies were performed on the surgical area.RESULTS With the described protocol, biosutures had been covered with at least 820000-860000 ASCs, with 100% viability. Our studies demonstrated that some ASCs remained adhered after suture passage through the muscle. Morphological assessment showed that the rat anal anatomy is comparable with human anatomy; two sphincters are present, but the external sphincter is poorly developed. Anal sphincter pressure data showed spontaneous, consistent, rhythmic anal contractions, taking the form of "plateaus" with multiple twitches(peaks) in each pressure wave. These basal contractions were very heterogeneous; their frequency was 0.91-4.17 per min(mean 1.6980, SD 0.57698), their mean duration was 26.67 s and mean number of peaks was 12.53. Our morphological assessment revealed that with the aforementioned surgical procedure, both sphincters were completely sectioned. In manometry, the described activity disappeared and was replaced by a gentle oscillation of basal line, without a recognizable pattern. Surprisingly, these findings appeared irrespective of injury repair or not. ASCs survived in this potentially septic area for 7 d, at least. We were able to identify them in 84% of animals, mainly in the muscular section area or in the tissue between the muscular endings. ASCs formed a kind of "conglomerate" in rats treated with injections, while in the biosuture group, they wrapped the suture. ASCs were also able to migrate to the damaged zone. No relevant adverse events or mortality could be related to the stem cells in our study. We also did not find unexpected tissue growths. CONCLUSION The proposed procedure produces a consistent sphincter lesion. Biosutures and injections are suitable for cell delivery. ASCs survive and are completely safe in this clinical setting.     

NO对家兔Oddi括约肌肌电活动和血压的影响

应用３２只家兔观察一氧氮对Ｏｄｄｉ括约肌肌电和血压的影响。静脉注射ＮＯ合酶抑制剂Ｎ＾Ｇ－硝基－Ｌ－精氨酸,可见ＳＯ肌电振幅增大和血压升高,Ｌ－ＮＮＡ所致的肌电活动增强可Ｌ－精氨酸反转。     

Automatic detection of motor unit innervation zones of the external anal sphincter by multichannel surface EMG

A method to detect automatically the location of innervation zones (IZs) from 16-channel surface EMG (sEMG) recordings from the external anal sphincter (EAS) muscle is presented in order to guide episiotomy during child delivery. The new algorithm (2DCorr) is applied to individual motor unit action potential (MUAP) templates and is based on bidimensional cross correlation between the interpolated image of each MUAP template and two images obtained by flipping upside-down (around a horizontal axis) and left–right (around a vertical axis) the original one. The method was tested on 640 simulated MUAP templates of the sphincter muscle and compared with previously developed algorithms (Radon Transform, RT; Template Match, TM). Experimental signals were detected from the EAS of 150 subjects using an intra-anal probe with 16 equally spaced circumferential electrodes. The results of the three algorithms were compared with the actual IZ location (simulated signal) and with IZ location provided by visual analysis (VA) (experimental signals). For simulated signals, the inter quartile error range (IQR) between the estimated and the actual locations of the IZ was 0.20, 0.23, 0.42, and 2.32 interelectrode distances (IED) for the VA, 2DCorr, RT and TM methods respectively.     

双吻合器在全直肠系膜切除低位直肠癌保肛手术中应用的探讨

目的探讨双吻合器在全直肠系膜切除低位直肠癌保肛手术中的应用方法、并发症及临床效果。方法回顾性分析在全直肠系膜切除的基础上,应用双器械吻合技术,对48例中低位直肠癌行低位或超低位吻合的保肛手术方法,观察其术后并发症,以及术后排便功能,局部复发率。结果随访1～4年,低位吻合44例,超低位吻合4例。15例6个月内大便次数每天多于5次,6个月后大便次数均在每天3次以下,无大便失禁。吻合口漏1例,吻合口狭窄1例,吻合口出血3例,吻合口复发1例,全组无手术死亡。结论双吻合器能简化手术操作,维持正常排便功能,提高了生活质量。     

Down Regulated Expression of the β1 Subunit of the Big-conductance Ca^2＋ Sensitive K＋ Channel in Sphincter of Oddi Cells from Rabbits Fed with a High Cholesterol Diet

Hypercholesterolemia,which is closely related to gallbladder bile stasis,can cause sphincter ofOddi dysfunction (SOD) by increasing the tension of sphincter of Oddi (SO).Intracellular calcium ionconcentration ([Ca~(2 )]_i) could influence the tension of SO.The β1 subunit of the big-conductance Ca~(2 )sensitive K~ channel (BK_(Ca) can enhance the sensitivity of the BK_(Ca) channel to [Ca~(2 )]_i.Absence and decline ofthe BK_(Ca) channel subunit β1 could lead to many diseases.However,the relationship betweenhypercholesterolemia and the expression of β1 subunit is not well understood.In this study,we successfullyexpressed and purified the rabbit BK_(Ca) β1 subunit protein and prepared its polyclonal antibody.The specificityof the prepared antibody was determined by western blotting.A SOD rabbit model induced by a high cholesteroldiet was established and the expression of the β1 subunit of SO was determined by immunohistochemicalstaining and western blotting.Compared with the controls,our results demonstrated that hypercholesterolemiacould decrease the expression of the β1 subunit in the SO cells from rabbits.This indicates that lowerexpression of BK_(Ca) channel β1 subunit might induce SOD.