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STUDY ON PATHOGENESIS AND TREATMENT OF STRESS ULCER IN RATS

Objective To investigate the relationship among rats′ stress ulcer and gastric acid, prostaglandin (PGs) and adrenocorticotropin (ACTH) and to probe the pathogenesis, prophylaxis and therapy. Methods Rats′ stress ulcer model was made by cold water soaking and was properly treated with drugs such as hyoscine, dexamethasone, ranitidine and losec. The amount and pH of gastric juice, change of gastric mucosa and PGs and ACTH of blood were determined. Results After rats were fasted for 24 hours a little gastric juice was aspirated. After cold water soaking of rats gastric juice was increased with the pH decreased, there was gastric mucosal bleeding, blood PGs was decreased and ACTH was increased. These suggest that on stress gastric mucosa bleeding is related with decreased gastric juice pH, decreased PGs and increase ACTH.Conclusion To control stress ulcer, pH of gastric juice and amount of PGs should be increased. Losec can increase gastric juice pH, so losec is the first choice to control stress ulcer.

Role of Alpha Adrenoceptor on Modulating Water in Lung of Severe Acute Pancreatitis Rat Model

ObjectiveTo explore effect of α-adrenoceptor on modulating water of lung in severe acute pancrea-titis (SAP) rat. MethodsThe SD rats were randomly divided into sham operation group (n=5) and SAP group,the SAP group was divided into subgroups of SAP-4 h (n=5) and SAP-24 h (n=5).SAP model was made by injecting taurocholate into bilopancreatic duct.The wet-to-dry ratio,alveolar fluid clearance (AFC),and AFC affected by α1-adrenoceptor inhibitor-prazosin and α2-adrenoceptor inhibitor-yohimbine separately or together were measured in the lungs.The α1-adrenoceptor and α2-adrenoceptor mRNA expressions in the lungs tissues were measured by real-time PCR. Results① The wet-to-dry ratios in the SAP-4 h group and SAP-24 h group were obviously decreased as compared with the sham operation group (P<0.05),which in the SAP-24 h group was significantly lower than that in the SAP-4 h group (P<0.05).② The AFCs in the SAP-4 h group and SAP-24 h group were obviously increased as compared with the sham operation group (P<0.05).The AFCs in the SAP with α1-adrenoceptor inhibitor-prazosin or α2-adrenocpetor inhibitor-yohimbine or prazosin combined with yohimbine were all obviously decreased as compared with the SAP group (P<0.05).③ The α1 adrenoceptor and α2 adrenoceptor mRNAs in the SAP-4 h group and SAP-24 h group were obviously increased as compared with the sham operation group (P<0.05). ConclusionAFC might be modulated by α-adrenoceptor in SAP rat.

Lennox-Gastaut 综合征的肾上腺皮质激素治疗进展

Lennox-Gastaut综合征（Lennox-Gastaut syndrome，LGS）是难治性癫痫之一，预后差，几乎所有的患儿都有发育停止或倒退，甚至生活无法自理，严重影响生活质量。当抗癫痫发作药物（Anti-seizure medications，ASMs）无效时，可选用非药物治疗，如迷走神经刺激术、病灶切除术、生酮饮食等，但大多数LGS病例仍无法控制发作。肾上腺皮质激素在LGS的治疗作用并未得到应有的重视。已有临床研究显示激素治疗的疗效优于常规ASMs治疗，但也存在复发率高，在药物选择、最佳剂量和疗程等方面均未达成共识。本文重点综述激素治疗LGS的进展。

可疑肾上腺内异位甲状腺1例报道并文献复习

目的总结肾上腺内异位甲状腺的影像学表现、病理特征、临床诊断、鉴别诊断以及治疗方法和预后。方法回顾性分析2023年3月广东医科大学附属医院收治的1例可疑肾上腺内异位甲状腺的临床表现、病理特征、治疗及预后情况，并结合国内外相关文献报道的26例肾上腺内异位甲状腺的病例资料进行分析。结果本例66岁女性患者，术前检查提示左侧肾上腺占位（考虑嗜铬细胞瘤）并行手术完整切除，术后根据病理学检查和免疫组织化学检查最终考虑诊断为肾上腺内异位甲状腺并腺瘤样增生，术后随访6个月未见复发。复习国内外文献报道的26例肾上腺内异位甲状腺患者资料，亚洲中老年女性多见（22例），左侧多发（17例），大部分（19例）由体检发现，通常表现为无痛性囊性肿块，大体呈类圆形，镜下可见甲状腺样组织，并见甲状腺样滤泡，滤泡腔内见嗜酸性胶质样物，部分区域可见滤泡与肾上腺皮质混杂，通常无肾上腺髓质成分，囊壁被覆扁平上皮细胞或甲状腺滤泡样细胞、可见核重叠，偶见核沟和包涵体，类似甲状腺乳头状癌细胞核，但未见砂粒体。免疫组织化学表现为PCK、EMA、TTF-1、Tg、Vimentin阳性，提示甲状腺分化，BRAFV600E、KRAS基因突变阴性。治疗以完整切除肿瘤为主，预后良好。结论肾上腺内异位甲状腺罕见，确切发生机制有待研究，临床术前不易辨识，应与肾上腺肿瘤、转移性甲状腺滤泡癌、乳头状癌等鉴别，免疫组织化学染色及基因检测有助于明确诊断，治疗以完整切除肿瘤为主，预后良好。

Value of Ultrasonography in Diagnosis and Differentiation of Tumors of Adrenal Gland

【摘要】 目的 探讨超声显像对肾上腺肿瘤的定位、定性诊断与鉴别诊断价值。 方法 对 2003年1月-2009年1月125例疑为肾上腺肿瘤患者进行超声及CT检查，并经手术与病理证实。超声显像诊断后经手术与病理证实为嗜铬细胞瘤48例，肾上腺皮质腺瘤41例，皮质腺癌11例，肾上腺转移癌 9例，髓样脂肪瘤8例，结节样增生2例，肾上腺结核4例，胰尾部肿瘤1例，肝脏肿瘤1例，肾上极肿瘤1例。 结果 肾上腺肿瘤的病理类型不同，声像图表现亦各不相同。超声显像定位诊断符合率为96.0%（120/125），定性诊断符合率为91.2% （114/125）。 结论 超声显像对肾上腺肿瘤的定位与定性诊断价值较大，可作为临床诊断的首选检查方法。【Abstract】 Objective To assess the value of ultrasonography in the diagnosis and differential diagnosis of tumors of adrenal gland. Methods From January 2003 to January 2009, 125 patients who were suspected to suffering from adrenal tumors underwent ultrasonography and CT examination. The results were then confirmed by surgery and pathology. There were 48 cases of pheochromocytoma, 41 adenoma, 11 adenocarcinoma, 9 metastatic tumor, 8 adrenal medullary lipoma, 2 nubblar hyperplasia, 4 tuberculosis of adrenal gland, 1 tumor of cauda pancreatic, 1 tumor of liver and 1 tumor of upper pole of kidney. Results The ultrasonographic features varied with different pathological types. The accuracy diagnosis of localizition and qualitation were 96.0% (120/125) and 91.2% (114/125) respectively. Conclusion Ultrasonography is useful in diagnosing tumors of adrenal gland, which may be used as the first choice for the disease.

以双眼中心性浆液性脉络膜视网膜病变首诊的肾上腺皮质癌1例

Regulation Role ofβ2 Adrenoceptor on Alveolar Fluid Clearance of Severe Acute Pancreatitis in Rats Model

ObjectiveTo discuss the effect ofβ2 adrenoceptor on the alveolar fluid clearance (AFC) of the rats with severe acute pancreatitis (SAP). MethodsSD rats was made to SAP model by injecting taurocholate into biliary-pancreatic duct.These rats were randomly divided into sham operation group and SAP group, the SAP group was divided into subgroups of SAP-4 h and SAP-24 h according to the sampling time after making model.The wet-to-dry ratio, AFC, and AFC affected byβ2 adrenoceptor agonist-terbutaline or inhibitor-propranolol were measured in the bilateral lungs.β2 adrenoceptor mRNA expression in the lungs tissues was measured by real-time-PCR. ResultsCompared with the sham operation group, the wet-to-dry ratio was significantly decreased (P < 0.05) and the AFC was significantly increased in the subgroup of SAP-4 h or SAP-24 h (P < 0.05), β2 adrenoceptor agonist-terbutaline couldn't increase the AFC of the subgroup of SAP-4 h or SAP-24 h (P > 0.05), inhibitor-propranolol could decrease AFC of subgroup of SAP-4 h or SAP-24 h (P < 0.05).β2 adrenoceptor mRNA was decreased in the subgroup of SAP-4 h or SAP-24 h as compared with the sham operation group (P < 0.05). ConclusionsBilateral lung liquid volome induced by SAP is less than the normal lung, AFC is increased in the early period of SAP but decreased in the late period.when the lung injury happens, β2 adrenoceptor might modulate AFC in rats of SAP model.The mechanism of lung injury of SAP is so complex that we need more experiments to be done.

Clinical Analysis of 17 Cases of Adrenocortical Hypofunction after Abdominal Operation

目的 探讨腹部手术后患者发生肾上腺皮质功能减退的临床特点及诊治方法。方法 回顾性总结分析我院自2003年1月至2006年12月期间行腹部手术8 974例患者中17例术后确诊为并发肾上腺皮质功能减退者的临床资料。结果 本组腹部手术后肾上腺皮质功能减退的发生率为0.19%（17/8 974），女性患者多于男性患者，男女之比约为1∶2； 其中55~64岁者2例，65~75岁者12例，75岁以上者3例。临床表现以嗜睡及消化道症状为主。实验室检查尿皮质醇水平降低，促肾上腺皮质激素兴奋试验阳性。1例出现肾上腺危象死亡，其余病例经激素治疗后康复。结论 腹部手术后肾上腺皮质功能减退多数病因不明确。临床以嗜睡及消化道症状为主要表现。实验室检查是确诊和激素治疗的依据。多预后良好，但发生肾上腺危象时仍可危及生命。

The Impact of Norepinephrine on Pulmonary Vein in Treating Septic Shock

Effect of Serum of Pregnant patients with Intrahepatic Cholestasis on the Excretion of Corticotropin-Releasing Hormone in the Placental Tissue in Vitro

【摘要】 目的 观察妊娠肝内胆汁淤积症（intrahepatic cholestasis of pregnancy，ICP）患者血清对体外培养的胎盘组织促肾上腺皮质激素释放激素（corticotropin-releasing hormone，CRH）的分泌水平的影响。 方法 收集2005年3月-7月在四川大学华西第二医院产科住院分娩的正常妊娠妇女胎盘组织及其血清（对照组）与ICP患者血清（ICP组）各10例。通过胎盘组织培养及放射免疫法测定其培养液中CRH水平。 结果 ICP组胎盘组织CRH分泌水平低于对照组，ICP组24、48、72、96 h分别为（84.95±34.98）、（74.57±29.93）、（71.16±27.26）、（81.07±37.18） pg/mL；对照组分别为（103.74±30.85）、（108.27±23.77） 、（109.20±23.81）、（118.15±26.84） pg/mL。两组比较，48h后差异有统计学意义（Plt;0.05）。 结论 ICP患者血清对体外培养的胎盘组织CRH分泌有抑制作用。【Abstract】 Objective To observe the effect of serum of pregnant patients with intrahepatic cholestasis (ICP) on the excretion level of corticotrophin-releasing hormone in the placental tissue in vitro. Methods Serum from 10 patients with ICP (ICP group) and from the healthy placental tissue of 10 normal people (control group) were collected from March to July, 2005. Cell culture and radioimmunoassay methods were used to investigate the corticotropin-releasing hormone (CRH) levels in placental tissue. Results The level of CRH in human placental tissue treated with sera of ICP was lower than that in the control group. 24, 48, 72, and 96 hours after treated with the serum, the levels of CRH in the ICP group were (84.95±34.98), (74.57±29.93), (71.16±27.26), and (81.07±37.18) pg/mL, respetively;while in the control group were (103.74±30.85), (108.27±23.77), (109.20±23.81), and (118.15±26.84) pg/mL, respectively. There was significant difference in the levels of CRH between ICP group and control group 48 hours after the culture (Plt;0.05). Conclusion The serum from the patients with ICP may inhibit the excretion of CRH in the placental tissue.