目的 探讨胃肠激素与生理性十二指肠胃反流（DGR）及胃肠消化问期移行性复合运动（MMC）的关系。方法 选择健康志愿者2O例，进行24h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（N0）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（98.23士12.14）μmol•L-1和（71.24士1O.21） μmol•L-1（P<0.01）；（87.32士11.46） μmol•L-1和（69.45±10.56） μmol•L-1（P<0.05）；血浆中MTL、SP、SS的浓度无显著性差异。血浆MTL浓度在胃窦MMCHI相时为（329.56士47.28）ng•L-1，比MMCI相（237.43士41.54）ng•L-1和MMCII相（256.56士44.32）ng•L-1显著增高（P均<O.05）。SP、SS、和N0在MMC各相无显著差异。结论 DGR的发生与N0浓度改变有关；MTL与MMCHI相的发生有关。

目的 探讨非甾体类消炎药萘丁美酮对十二指肠返流导致返流性胃炎的治疗作用。方法 用SD大鼠建立十二指肠胃返流模型，4O只模型大鼠等分为萘丁美酮组和西沙比利组、铝碳酸镁组、空白手术组；另取l0只SD大鼠作为假手术组。干预时间l2周。对模型大鼠的胃标本进行病理学检查，采用免疫组化方法对胃黏膜的COX-2和TNF-a进行染色。结果 萘丁美酮组的病理改变明显轻于空白手术组（P<0.01）而又重于假手术组（P<0.05），与铝碳酸镁组和西沙比利组相比则差异不显著（P>0.05）。TNF-a的免疫组化染色显示，萘丁美酮组与其他各组间均无显著性差异（P>0.05）。COX一2的免疫组化染色显示，萘丁美酮组与空白手术组相比COX一2表达明显降低（P<0.01），与铝碳酸镁组、西沙比利组和假手术组相比则无显著性差异（P>0.05）。结论 在十二指肠返流导致的返流性胃炎中，萘丁美酮有明显的治疗效果。萘丁美酮可明显降低胃黏膜组织中COX-2水平。

AIM: To explore the effect of six bile salts, including glycocholate (GC), glycochenodeoxycholate (GCDC), glycodeoxycholate (GDC), taurocholate (TC), taurochenodeoxycholate (TCDC), taurodeoxycholate (TDC), and two bile acids including cholic acid (CA) and deoxycholic acid (DCA) on esophageal cancer Eca109 cell line. METHODS: Eca109 cells were exposed to six bile salts, two bile acids and the mixed bile salts at different concentrations for 24-72h. 3-[4, 5-Dimethylthiazol-2-yl]-2, 5-diphenyltetrazolium bromide (MTT) assay was used to detect the cell proliferation. Apoptotic morphology was observed by phase-contrast video microscopy and deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay. Sub-G1 DNA fragmentations and early apoptosis cells were assayed by flow cytometry (FCM) with propidium iodide (PI) staining and annexin V-FITC conjugated with PI staining. Apoptosis DNA ladders on agarose were observed. Activation of caspase-3 was assayed by FCM with FITC-conjugated monoclonal rabbit anti-active caspase-3 antibody and expressions of Bcl-2 and Bax proteins were examined immunocytochemically in 500μmol/L-TCinduced apoptosis cells. RESULTS: Five bile salts except for GC, and two bile acids and the mixed bile salts could initiate growth inhibition of Eca109 cells in a dose-and time-dependent manner. TUNEL, FCM, and DNA ladder assays all demonstrated apoptosis induced by bile salts and bile acids at 500μmol/L, except for GC. Early apoptosis cell percentages in Eca109 cells treated with GCDC, GDC, TC, TCDC, TDC, CA at 500μmol/L for 12h, DCA at 500μmol/L for 6 h, and mixed bile salts at 1000μmol/L for 12h were 7.5%, 8.7%, 14.8%, 8.9%, 7.8%, 9.3%, 22.6% and 12.5%, respectively, all were significantly higher than that in control (1.9%). About 22% of the cell population treated with TC at 500μmol/L for 24h had detectable active caspase-3, and were higher than that in the control (1%). Immunocytochemical assay suggested that TC down-regulated Bcl-2 protein level and up-regulated Bax protein level. CONCLUSION: GCDC, GDC, TC, TCDC, TDC, CA and DCA, except for GC, can inhibit growth and induce apoptosis of esophageal cancer Eca109 cells. Activation of caspase-3, decreased Bcl-2 protein and increased Bax protein are involved in TC-induced apoptosis of Eca109 cells.

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；20例功能性消化不良患者同步监测24h胃内pH和胆红素吸光值。储果胆汁浓度为20%时吸光值已选0.900，而pH仍在1.0左右：浓度为60%时pH始上升选4以上。黄染组pH<4的病例占80%，吸光值为0.348±0.131，无黄染组pH<4的病例占81%，吸光值为0.008±0.003，pH和吸光值之间无明显相关性。12例有夜间自发性碱波者8例同步有胆红素吸光值升高，8倒无夜间自发性碱波者4侧有胆红素吸光值升高。结论 在一定浓度下，胆汁反漉对胃内pH值影响较小。