Effect of wheat bran on weight of stool and gastrointestinal transit time: a meta analysis

Twenty original papers that reported on the effect of wheat bran on large bowel function were analysed. Bran increased the stool weight and decreased the transit time in each study in healthy controls and in patients with the irritable bowel syndrome, with diverticula, and with chronic constipation. Statistical evaluation of the data showed, however, that constipated patients had lower stool output and slower transit whether or not they had taken bran, and they responded less well to bran treatment than controls. From these data it is concluded that bran can be expected to be only partially effective in restoring normal stool weight and transit time in patients who are constipated.     

Unprocessed Bran in Treatment of Diverticular Disease of the Colon

Seventy patients with diverticular disease of the colon were treated with a high-residue, low-sugar diet including unprocessed bran. Follow-up for an average of 22 months showed marked relief of symptoms in 62 patients. Bowel habit was restored towards normal and abdominal discomfort relieved. Only seven patients were unable to give up the use of laxatives. Eight patients did not tolerate the bran diet, and one of these needed surgical treatment. None of the 62 patients who took the diet needed surgery.     

Effect of Methylcellulose on Rectal and Colonic Pressures in Treatment of Diverticular Disease

Six patients with diverticular disorder confirmed by barium-enema examination were given a six-month course of methylcellulose (Celevac) tablets; their rectal and rectosigmoid colonic pressures were measured before and afterwards. Open-tipped, fluid-filled, narrow-bore polyethylene tubes were used for pressure measurements and care was taken to site the tubes similarly in all patients before and after treatment. After methylcellulose treatment the mean rectosigmoid pressures had fallen to the same range as the mean rectal pressures, a highly significant reduction. Methylcellulose significantly reduces rectosigmoid pressures in diverticular disease.     

Sterculia bulk-forming agent with smooth-muscle relaxant versus bran in diverticular disease.

Sterculia with and without a smooth-muscle relaxant (alverine citrate) had similar beneficial effects on constipation and reduced the transit times in diverticular disease. Intracolonic pressure, however, varied with the preparation used. Though both preparations relieved the symptoms of diverticular disease, the one containing alverine citrate was more effective. Part of the mode of action of bran may be to relax the smooth muscle of the gut, since its actions were more comparable to those of sterculia plus alverine citrate than to those of sterculia alone.     

Action of Different Bran Preparations on Colonic Function

Two different types of commercially available bran were studied. One of these was composed of flake-like particles (coarse bran) whereas the other had smaller, finer particles with a floury component (fine bran). The effectiveness of the two preparations in lowering intraluminal pressure and decreasing transit time in patients with constipation and diverticular disease was assessed. Only coarse bran promoted changes at the dose used. The physical properties of the brans were examined in an effort to explain their differing effects. It is concluded that water-holding capacity, upon which the beneficial effect of bran may depend, is a function of particle size. The greater water-holding capacity of coarse bran makes it preferable for the treatment of colonic disorders.     

Oral administration of hydrolyzed rice bran prevents the common cold syndrome in the elderly based on its immunomodulatory action

The preventive effect of Hydrolyzed Rice Bran against the common cold syndrome was examined in elderly people. Arabinoxylan derivatives of Hydrolyzed Rice Bran (HRB) were prepared from water-soluble rice bran through partial processing using a carbohydrate complex. Using the water-soluble Rice Bran (RB) as a control, a cross over double-blind study was conducted on both substances over a 6-week administration period. Fifty elderly people aged from 70 to 95 years participated in the study and the comparative data from 36 participants were analyzed. There were no withdrawals from in the study due to the side effects of the experimental foods. Symptoms were observed and scored. The total symptom score for the RB treatment group was three times higher than that for the HRB treatment group. The average duration of symptoms was 2.6 days for RB whereas it was only 1.2 days for HRB. Furthermore, some immunomodulatory action was observed in laboratory tests. HRB was shown to be useful in reducing the physical stress associated with acute respiratory tract infection.     

妇科千金片联合抗生素治疗慢性盆腔炎的临床疗效观察

目的:评价妇科千金片联合抗生素治疗慢性盆腔炎的疗效。方法:对照组选用抗生素治疗,观察组在此基础上加用妇科千金片治疗。同时对两组患者治疗前后血液流变学、血清C-反应蛋白检测及局部体征进行评价。结果:对照组、治疗组总有效率分别为71.43%、92.86%;治疗组疗效优于对照组(P<0.05)。两组均可使异常升高的血液流变学、血清C-反应蛋白指标降低,但治疗组明显优于对照组,两组间比较有显著性差异(P<0.05)。结论:运用妇科千金片联合抗生素治疗慢性盆腔炎疗效显著,能改善全身及盆腔的血液循环,改善组织营养,提高机体的新陈代谢,有利于盆腔炎性分泌物的消散和吸收,从而达到治疗的目的。     

硝酸异山梨酯片联合美托洛尔治疗老年冠心病心绞痛的疗效及对IL-18及hs-CRP水平的影响．

目的：观察硝酸异山梨酯片联合美托洛尔治疗老年冠心病心绞痛的临床效果,观察联合用药对患者血浆白介素．18（Inter．1eukin,IL-18）、超敏C反应蛋白（HighsensitivityCreactiveprotein,hs—CRP）的影响。方法：选择本院收治的老年冠心病心绞痛患者84例,随机分为研究组和对照组,各42例,研究组给予硝酸异山梨酯片20mg,3次／d,口服,美托洛尔12．5mg,1次／d,口服;对照组仅给予硝酸异山梨酯片20mg,3次／d,口服,疗程均为28d。观察两组用药后心绞痛改善情况,并观察两组治疗前后血清IL-8、hs-CRP变化。结果：治疗后,研究组总有效率为90．5％;对照组总有效率为69．0％,研究组总有效率明显高于对照组（P〈0．01）。治疗后两组心率、心绞痛发作频率明显降低,持续时间明显缩短（P〈0．05）;研究组心率、心绞痛发作频率明显低于对照组,持续时间也较对照组短（P〈0．05）。治疗前两组血浆IL-18、hs-CRP水平比较无统计学差异（P〉0．05）;治疗后研究组IL．18、hs．CRP水平明显低于对照组（P〈O．05）。结论：硝酸异山梨酯片联合美托洛尔治疗老年冠心病心绞痛能够进一步减轻患者IL．18、hs．CRP水平,对心绞痛治疗效果较单独应用酸异山梨酯片更佳。     

凝结芽孢杆菌活菌片治疗母乳性黄疸的临床观察

目的探讨凝结芽孢杆菌活菌片（商品名：爽舒宝）治疗母乳性黄疸的临床疗效。方法将母乳性黄疸患儿69例随机分为观察组和对照组,观察组34例在常规治疗的同时给予口服凝结芽孢杆菌活菌片;对照组35例应用蓝光、菌栀黄颗粒等常规治疗。治疗中观察患儿黄疸消退时间并定期检测血清胆红素含量,血常规情况。结果治疗后观察组总有效率、日均胆红素下降值均明显高于对照组,治疗第5天血清胆红素值低于对照组,黄疸消退时间亦明显短于对照组,差异具有统计学意义（P〈0．05）。观察组和对照组的白细胞计数和红细胞计数均降为正常值,血红蛋白也有所降低,但仍高于正常值,差异无统计学意义（P〉0．05）。结论凝结芽孢杆菌活菌片治疗母乳性黄疸,可提高总有效率,迅速降低胆红素水平,缩短黄疸消退时间,且无不良反应发生。     

High Bulk Diet for Diverticular Disease of the Colon

In the past century diverticular disease of the colon has changed from being almost unknown to becoming the most common disease of the colon. Studies in Britain indicated that the pathological basis of the disease is a thickening of the colonic musculature, with diverticulosis and diverticulitis developing because of increased intracolonic pressures generated by the thickened colon wall. This pressure can be sharply reduced by increased colonic bulk. Geographical and anthropological data reveal that diverticular disease results from Western civilization''s food habits, specifically the reduced fiber content in food. There is evidence that increasing the dietary intake of fiber by the addition of bran can prevent formation of diverticula and relieve the symptoms of established disease. Large scale studies are recommended both as treatment and to further test the validity of this concept.     

Does super efficient starch absorption promote diverticular disease?

The amount of starch escaping absorption in the small intestine was measured in eight patients with symptomatic diverticular disease and eight controls. Unabsorbed starch was calculated from breath hydrogen measurements after a potato meal compared with the hydrogen response to lactulose. The proportion of unabsorbed starch was low in all the patients (mean 3.3%) and was only about a quarter of that in the controls (12.4%; p less than 0.01). These findings confirm that unabsorbed starch provides an important quantity of carbohydrate reaching the colon and suggest that super efficient starch absorption, by reducing this provision, may promote the development of diverticular disease.     

Natural history of coronary artery disease in relation to angiographic, hemodynamic and clinical factors

Studying the natural history of coronary artery disease could provide a frame of reference for prognosis and appraisal of treatment for patients having this disease. We studied a total of 465 consecutive patients with angiographically significant coronary artery disease, defined as greater than 50% stenosis in at least one principal artery, who were followed with medical treatment only from 1 to 7 years. Excluding patients with left main coronary disease, there were 73 deaths, of whom 63 were cardiac. The 5-year cumulative survival rates were 72% for the entire group, 87% for single vessel disease, 73% for double vessel disease and 51% for triple vessel disease. In single vessel disease, patients with left anterior descending artery involvement tended to have higher mortality. In double vessel disease, survival was worse with the combination of left anterior descending and right coronary artery involvements than the other 2 combinations. A history of myocardial infarction was not significantly different from angina in 5-year survival rate. Nevertheless, an abnormal Q-wave in ECG was associated with lower survival. History of hypertension and electrocardiographic left ventricular hypertrophy did not affect survival. While congestive heart failure, abnormal resting LVEDP and left ventricular asynergy were all associated with reduced survival. The left ventricular ejection fraction had highly prognostic value, only 42% of patients survived with ejection fraction less than 0.3 at the end of 5 years after angiography.     

Squamous cell carcinoma antigen for monitoring cervical cancer

The tumour-associated antigen was determined in the plasma of patients with squamous cell carcinoma (SCC) of the uterine cervix by radioimmunoassay. Setting a limit of 2 ng/ml, levels were abnormal in 13.4% of healthy controls, in 14% of patients with carcinoma in situ and in 62% of patients with invasive cervical SCC. The incidence of elevated SCC antigen levels and the absolute antigen plasma concentration were dependent upon the tumour load, increasing significantly with advanced stage disease. Abnormal SCC antigen values in operable cervical cancer declined to normal within one week after radical hysterectomy with pelvic lymphadenectomy. In cases of radiotherapy antigen values took 4-6 weeks after the start of treatment to return to normal. The success of both treatment modalities was announced by an early rise in the SCC antigen in the initial phase of therapy, followed by normalisation. After successful primary treatment and a complete remission during further follow-up SCC antigen in plasma was only increased in 3.8% of the cases. Retrospective evaluations in ten patients with progressive disease showed the reappearance of abnormal SCC titers and further increase preceeding the clinically detectable relapse or progression, with a median interval of 8 weeks. The present study indicates that SCC antigen determination is not useful for the early diagnosis of cervical cancer, but it is a potential means for monitoring the efficacy of individual anticancer therapy of SCC of the uterine cervix and for detecting recurrent disease.     

Colonic Response to Pentazocine

The effects of pentazocine on colonic motor activity were studied in five normal subjects, five patients with irritable bowel syndrome, and five patients with diverticular disease. The drug decreased intraluminal colonic pressures in all patients but one. Since morphine, which increases intraluminal colonic pressures, is contraindicated in patients with abdominal pain of colonic origin (diverticular disease, irritable bowel syndrome), we suggest that pentazocine may be a useful drug in such cases.     

Intravenous methylprednisolone in the treatment of Graves' ophthalmopathy.

Eleven euthyroid patients with severe Graves'' eye disease were treated with intravenous methylprednisolone and followed up for six months or more by ophthalmological assessment, orbital computed tomography (CT), photographs, and antibody measurements. Papilloedema resolved in the single patient in whom it was present; visual acuity was abnormal in seven eyes initially and in only one eye after treatment; the intraocular pressure differential, which reflects muscle dysfunction, was initially abnormal in 18 eyes but showed a progressive and distinct improvement; nine patients showed substantial improvement in inflammatory signs. Exophthalmos improved early after treatment, but this improvement was not maintained. Orbital CT showed a pronounced reduction in the bulk of eye muscles after treatment in eight of nine patients. Autoantibodies to the thyroid stimulating hormone receptor declined. Adverse effects were trivial. Thus eight patients showed a clear response to intravenous methylprednisolone as judged by ophthalmic assessment and CT scan. The two patients who showed little response and one who had none all had a long history (more than a year) of ophthalmopathy. Results were better than those with oral steroids and adverse effects less. Treatment of Graves'' eye disease is more likely to be effective if given early; patients should be referred promptly to specialist centres, where treatment with intravenous methylprednisolone should be considered.     

Hypercoagulability and hypofibrinolysis in sickle-cell disease.

Fifty-two patients with sickle-cell (SC) disease (48 with SC-beta-thalassaemia and 4 with homozygous SC-anaemia) were studied as regards blood coagulation and fibrinolysis. It was found that the thrombin and the reptilase times of the patients' plasma were significantly shorter than normal. The mean values of platelet count, fibrinogen level and factor VIII activity of patients with SC disease were higher than normal; however, in the group of patients transfused, with less than 50% haemoglobin S (HbS), the fibrinogen level and the factor VIII activity were significantly lower compared to the other patients. Antithrombin-III (At-III) activity was normal in all. The fibrinolytic activity was normal in patients with asymptomatic SC disease, but reduced in patients on painful crises. Plasminogen and fibrinogen/fibrin degradation product (FDP) levels were normal in all patients. Two patients on painful crises with complications had additional abnormal findings, namely prolonged prothrombin time, reduced At-III level and elevated FDP.     

Cardiac abnormalities and exercise tolerance in patients receiving renal replacement therapy.

The exercise tolerance of the survivors of a consecutive group of 100 patients in a renal dialysis and transplant programme was compared with the prevalence of cardiac abnormalities detected by exercise testing, echocardiography, and radionuclide angiography. Fifty four patients attended for investigation 27 (SD 7) months after starting renal replacement therapy. Forty three of them (80%) were receiving antihypertensive treatment. Their performance on a bicycle ergometer exercise test was compared with that of 62 normal subjects and the patients divided into five groups of decreasing ability. The exercise tolerance of the patients was very poor, only 17 performing within the normal range. Impairment in exercise capacity was not explained by the type or quality of renal replacement therapy. Fourteen patients developed ischaemic electrocardiographic changes on exercise. Left ventricular ejection fraction was assessed by gated blood pool scanning in 37 patients; all nine of the patients with an abnormally low radionuclide ejection fraction also had abnormal exercise tolerance. Satisfactory M mode echocardiograms were obtained from 45 of the patients, and only two were normal. Left ventricular hypertrophy was detected in 25 (56%) of the echocardiograms, and abnormalities indicating impaired left ventricular function were common and widespread. Grouping all the abnormal cardiac features together for the patients in each exercise group showed a striking linear trend of increasing proportion of cardiac abnormalities with worsening exercise tolerance among the five exercise groups (p less than 0.001). The proportion of patients becoming unemployed within one year of starting renal replacement therapy similarly increased, from nil to 60% from the best exercise group to the most incapacitated. Twenty nine of the original cohort of 100 patients subsequently died, cardiovascular disease accounting for 12 (41%) of these deaths. Diminished exercise tolerance in patients receiving renal replacement therapy is strongly associated with cardiac abnormalities and reduced employment prospects.     

妇科再造丸联合甲基睾丸素片治疗子宫肌瘤的疗效分析

目的：分析妇科再造丸联合甲基睾丸素片治疗子宫肌瘤的临床疗效和安全性。方法：62例子宫肌瘤患者随机分为治疗组和对照组,治疗组共32人,接受妇科再和联合甲基睾丸素片联合治疗,对照组共30人,单纯接受甲基睾丸素片治疗;免疫组织化学法检测治疗组和对照组患者子宫肌瘤PR表达水平;RT-PCR检测治疗组和对照组患者子宫肌瘤Caspase．3mRNA和PRmRNA表达;BC-5500血球分析仪检测HB、RBC、HCT,分析比较两组患者上述指标的差异。结果：治疗组临床疗效有效率为87．5％,对照组临床疗效有效率为53．3％,两组比较有统计学差异（P〈0．05）。两组在治疗后HB、RBC、HCT均较治疗前改善,且治疗组较对照组改善明显,差异有统计学意义（P〈O．01）。治疗组和对照组治疗后PRmRNA的表达程度与治疗前相比,明显下降,具有统计学意义（P〈0．05）;治疗组治疗后PRmRNA表达水平与对照组治疗后PRmRNA表达水平相比,有明显差异,具有统计学意义（P〈0．05）;治疗组治疗后Caspase-3mKNA的表达程度与治疗前相比,明显增强,具有统计学意义（P〈0．05）;治疗组治疗后Caspase-3mRNA表达水平与对照组治疗后Caspase-3mRNA表达水平相比,有明显差异（P〈0．05）;治疗组和对照组治疗后PR的阳性细胞数目与治疗前相比,显著下降（P〈0．001）;治疗组治疗后PR阳性细胞数目与对照组治疗后PR阳性细胞数目相比,有明显差异（P〈0．05）。结论：妇科再造丸联合甲基睾丸素片优于单独应用甲基睾丸素片治疗子宫肌瘤。     

The role of cytology in the diagnosis and follow-up of patients with cervical adenocarcinoma

A review was undertaken of the 121 patients with cervical adenocarcinoma, ranging in age from 10 to 91 years, who had cytology specimens examined in this laboratory. All but two had cervicovaginal smears. Fifty-eight patients had cervical smears taken prior to treatment; 91% of these contained malignant cells. The commonest histologic subtype was mucinous adenocarcinoma (61 patients; 52%), followed by endometrioid carcinoma (26 cases; 22%), adenosquamous carcinoma (16 cases; 14%) and clear-cell carcinoma (12 cases; 10%). The cytologic characteristics were evaluated and correlated with the histopathology. During the follow-up period after definitive treatment, 119 patients had gynecologic smears taken; 24% were positive, representing 64% of those cases with central recurrences. In two patients, the abnormal smear was the first indicator of recurrence. Nine patients had 11 nongynecologic specimens revealing metastatic disease. Notable in this study were the 18 asymptomatic women, of whom 15 also had either no visible cervical lesion or minimal changes associated with benign conditions; cytology was abnormal in all but two. Cytology was effective in detecting disease. Its usefulness continued during the follow-up period in identifying or confirming recurrent or metastatic disease.     

Beriberi heart disease in London

Haemodynamic measurements before and after treatment are described in two patients with beriberi heart disease. The first patient had severe disease with a cardiac output of 17·3 litres per minute, which had returned to normal a month later. The second patient had moderate disease with a cardiac output of 7·4 litres per minute; a fall in this and a rise in systemic vascular resistance was found one and two hours after the intravenous injection of aneurine hydrochloride. The plasma pyruvate concentration was raised in the first patient but only slightly so in the second, in whom the pyruvate metabolism test was abnormal. The haemodynamic studies in both cases were of considerable help in making the diagnosis. The diagnosis of beriberi should be considered in any patient with heart disease who has a history of alcoholism, especially as prompt vitamin treatment is curative.