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1.
Hemorrhagic enterocolitis caused by Escherichia coli O157:H7 and its complication of hemolytic-uremic syndrome (HUS) are well known from large outbreaks caused by contaminated meats and vegetables. However most cases may be endemic, not related to an outbreak. We identified cases of HUS in Oklahoma, 2002-2005, from the Inpatient Hospital Discharge Database of the Oklahoma State Department of Health (OSDH) and also the cases of HUS and E. coli O157:H7 reported to the OSDH. 110 cases of HUS were identified from the hospital discharge database; only 14 (12.7%) were reported to the OSDH; 122 cases of E. coli O157:H7 infections were reported to the OSDH. Of the 110 cases of HUS, only six (5.5%) patients in two separate clusters may have had a common source of infection. Although interpretation is limited by the few reports to OSDH, our data suggest that E. coli O157:H7 infections and HUS, presumably related to contaminated food, are endemic throughout Oklahoma.  相似文献   

2.
目的  分析非典型溶血尿毒症综合征(aHUS) 患者的病因、临床特点,探讨改善预后的方法。方法  回顾性分析我院2003年1月至2009年12月26例aHUS患者病因、临床特点、治疗和预后。结果  26例aHUS患者中,家族性HUS 1例,特发性HUS 18例,继发性7例(妊娠相关HUS 4例,系统性红斑狼疮1例,恶性高血压1例,外伤后HUS 1例)。aHUS前驱症状包括恶心/呕吐(73%)、肉眼血尿(65%)、发热(50%)、皮肤粘膜出血(46%)、上呼吸道感染(35%)、少尿或无尿(31%)、腹痛(31%)等。15例aHUS行血浆置换(PE)治疗,其中6例PE+血液透析(HD),1例行PE+持续性静脉血液滤过(CVVH)+HD;4例单纯HD,1例行HD+CVVH;8例aHUS患者给予血浆输注。aHUS 18例纳入预后分析,完全有效14例,部分有效4例;肾脏预后肾功能正常16例,ESRD 2例,其中1例肾移植。结论  本组aHUS以特发性为主,继发原因有妊娠、系统性红斑狼疮,恶性高血压和外伤,临床表现多样且危重,PE和血浆输注为主要治疗,预后较差。  相似文献   

3.
Objective Verotoxin-producing Escherichia coli (VTEC) strains of serotype O157∶H7 have been implicated in a wide spectrum of diseases, including blood diarrhea, hemorrhagic colitis and hemolytic uremic syndrome (HUS).To further explore the pathological role of verotoxin (VT) in HUS and other VTEC-associated diseases, we investigated the effects of recombinant verotoxin 2 (rVT2) on the biological activity of neutrophils.Methods The technique of flow cytometry, a fluorescent probe 2,7-bis-(2-carboxyethyl)-5-(and-6)-carboxyfluorescein acetoxymethyl ester (BCECF/AM), and the assay of reduced cytochrome c to detect superoxide production were used in this study.Results rVT2 significantly inhibited spontaneous apoptosis in neutrophils.Neutrophils with prolonged survival due to rVT2 maintained various biological functions, such as the expression of adhesion molecules (shading CD62L and raising CD11b/CD18), adherence to human umbilical vein endothelial cells (HUVECs), and generation of superoxide (O2-).Conclusion Prolongation of the functional life-span of neutrophils by rVT2 may accelerate inflammatory responses at sites of inflammation. This may play a crucial role in neutrophil-mediated tissue injury in HUS and other VTEC-associated diseases.  相似文献   

4.
目的:揭示V毒素在溶血性尿毒症(HUS)和其他与多源性大肠杆菌(VTEC)相关疾病中的病理性损伤作用。方法:运用流式细胞技术,荧光标记探针-BCECF/AM和细胞色素C还原法测定超氧离子(O2^-)技术。结果:重组V2毒素(rVT2)对中性粒细胞自发性凋亡有着显著性的抑制作用。被rVT2延迟了凋亡的中性粒细胞仍然保留多种生物学活性,如:细胞表面粘附分子的表达(CD62L减少和CD11b/CD18增加),粘附人脐带静脉血管内皮细胞(HUVEC)以及产生超氧离子(O2^-)。结论:V2毒素延长中性粒细胞的功能性生命期限,会加重炎症局部的炎症反应,这可能是HUS和VTEC相关疾病的发生过程中,中性粒细胞介导的组织损伤的一个重要因素。  相似文献   

5.
Clinical reports have suggested that therapy with fresh frozen plasma is a useful adjunct in the management of the hemolytic-uremic syndrome (HUS). We reviewed the charts of 36 children with severe HUS who were treated at the Izaac Walton Killam Hospital for Children, Halifax, over 10 years to assess the effectiveness of plasma therapy. All children who required specific supportive therapy for renal dysfunction, hemolysis or serious extrarenal complications were included. We compared the outcome of 18 children who received plasma therapy from 1982 to 1987 with that of 18 children who did not. The two groups were similar with regard to the severity of HUS, the length of hospital stay, the duration of renal dysfunction and the incidence of disease-related complications, such as seizures, enterocolitis and cardiomyopathy. At discharge the prevalence of hypertension was higher in the plasma therapy group than in the control group. Plasma therapy did not demonstrate any benefit that would outweigh the risk of fluid overload, hyperproteinemia and transmission of viral infection.  相似文献   

6.
目的:研究旋毛虫对三硝基苯磺酸(TNBS)诱导的实验性小鼠肠炎模型Th1/Th2类细胞因子基因表达的影响。方法:雌性BALB/c小鼠随机分为50%乙醇对照组、旋毛虫(T. spiralis)应用组、 TNBS诱导肠炎模型组、预先感染T. spiralis后诱导TNBS模型组,(每组小鼠取材时保证6只以上)。采用RT-PCR方法观察感染旋毛虫和未感染旋毛虫小鼠于TNBS诱导肠炎后3 d和7 d时不同基因的表达变化,包括小鼠脾脏中IFN-γ、IL-4、IL-10 mRNA和结肠中IL-10 mRNA的表达量。结果:预先感染T. spiralis后诱导TNBS模型组小鼠在造模后3 d脾脏中IFN-γ mRNA的表达量与模型组比较差异无显著性(P>0.05),在造模后7 d脾脏中IFN-γ mRNA的表达量低于模型组(P<0.05), IL-4 mRNA的表达量于3 d和7 d时均高于模型组(P<0.05)。预先感染T. spiralis后诱导TNBS模型组小鼠在造模后3 d和7 d脾脏和结肠中IL-10 mRNA的表达量均高于模型组(P<0.05)。结论:旋毛虫对TNBS诱导的实验性小鼠肠炎外周免疫作用机制可能通过下调炎症性肠病过度的Th1型免疫反应、上调Th2型免疫反应而实现;IL-10既作为Th2类细胞因子又作为Tr1型细胞因子对实验性小鼠的肠道局部和外周免疫均产生重要调节作用。  相似文献   

7.
目的 研究2,4,6-三硝基苯磺酸(TNBS)致肠炎大鼠的背根神经节(DRG)神经元电生理特性,为更全面地了解炎症性肠病(IBD)提供借鉴。方法 SD大鼠(雄性,体质量160~200 g)随机分为实验组和对照组,实验组(n=5)给予30% TNBS溶液(剂量 40 mg/kg)灌肠,对照组(n=5)给予等效体积的生理盐水灌肠。在灌肠的第8天(炎症急性期)处死大鼠,对其结肠进行H-E染色,以确定造模是否成功;取其DRG神经元用全细胞膜片钳技术分析其电生理特性。结果 实验组大鼠体质量降低(P<0.001),H-E染色示肠黏膜腺体结构严重破坏,炎性细胞浸润明显,表明造模成功。TNBS致肠炎后大鼠DRG神经元动作电位的阈电流降低(P<0.05)。结论 TNBS致肠炎后大鼠DRG神经元兴奋性增高。  相似文献   

8.
Rabdosia serra (R. serra), an important component of Chinese herbal tea, has traditionally been used to treat hepatitis, jaundice, cholecystitis, and colitis. However, the chemical composition of R. serra and its effect against colitis remain unclear. In this study, the chemical composition of the water extract of R. serra was analyzed using ultra performance liquid chromatography coupled with a hybrid linear ion trap quadrupole-orbitrap mass spectrometer (UPLC-LTQ-Orbitrap-MS). A total of 46 compounds, comprising ent-kaurane diterpenoids, flavonoids, phenolic acids, and steroids, were identified in the water extract of R. serra, and the extract could significantly alleviate dextran sulfate sodium salt-induced colitis by improving colon length, upregulating anti-inflammatory factors, downregulating proinflammatory factors, and restoring the balance of T helper 17/T regulatory cells. R. serra also preserved intestinal barrier function by increasing the level of tight junction proteins (zonula occludens 1 and occludin) in mouse colonic tissue. In addition, R. serra modulated the gut microbiota composition by increasing bacterial richness and diversity, increasing the abundance of beneficial bacteria (Muribaculaceae, Bacteroides, Lactobacillus, and Prevotellaceae_UCG-001), and decreasing the abundance of pathogenic bacteria (Turicibacter, Eubacterium_fissicatena_group, and Eubacterium_xylanophilum_group). Gut microbiota depletion by antibiotics further confirmed that R. serra alleviated colitis in a microbiota-dependent manner. Overall, our findings provide chemical and biological evidence for the potential application of R. serra in the management of colitis.  相似文献   

9.
Coincidence of salmonellosis and ulcerative colitis is a rare clinical problem. Salmonella infection was reported to complicate the ulcerative colitis, as either facilitating its occurrence or activation. In this article, we present a case with salmonellosis whose clinicopathological findings also suggested ulcerative colitis. The patient improved rapidly after taking additional mesalazine to norfloxacin treatment. We conclude that salmonella infection might have either been coincidentally present or might have triggered an early ulcerative colitis in this patient who did not have history of inflammatory bowel diseases. In case of persistent severe diarrhea despite appropriate treatment, the possibility of a coincident inflammatory bowel disease such as ulcerative colitis should always be considered, especially in endemic regions for salmonellosis.  相似文献   

10.
Safdar N  Said A  Gangnon RE  Maki DG 《JAMA》2002,288(8):996-1001
Context  The use of antibiotics for treatment of Escherichia coli O157:H7 infection has become controversial since a recent small study found that it may increase the risk of hemolytic uremic syndrome (HUS). However, other larger studies have reported a protective effect or no association. Objective  To determine whether antibiotic therapy for E coli O157:H7 enteritis increases the risk of HUS. Data Sources  PubMed and MEDLINE computer searches were performed for studies published from January 1983 to February 2001 using the key words hemolytic uremic syndrome, risk factor, antibiotics, and Escherichia coli O157:H7. Reference lists of relevant publications were reviewed, and 12 experts in the field were contacted to identify additional reports. No language restrictions were applied to the search. Study Selection  Studies were included if they reported a series of patients with documented E coli O157:H7 enteritis, some of whom developed HUS; had clear definitions of HUS; and had adequate data delineating the relationship between antibiotic therapy and the occurrence of HUS. Nine of the 26 identified studies fulfilled these criteria. Data Extraction  Two authors (N.S. and A.S.) independently reviewed each report identified by the searches and recorded predetermined information relevant to the inclusion criteria. A pooled odds ratio was calculated using a fixed-effects model, with assessment of heterogeneity among the studies. Data Synthesis  The pooled odds ratio was 1.15 (95% confidence interval, 0.79-1.68), indicating that there does not appear to be an increased risk of HUS with antibiotic treatment of E coli O157:H7 enteritis. Incomplete reporting of data in individual studies precluded adjustment for severity of illness. Conclusion  Our meta-analysis did not show a higher risk of HUS associated with antibiotic administration. A randomized trial of adequate power, with multiple distinct strains of E coli O157:H7 represented, is needed to conclusively determine whether antibiotic treatment of E coli O157:H7 enteritis increases the risk of HUS.   相似文献   

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