双歧杆菌分泌型粘附素对肠上皮细胞应激反应的影响

目的 观察双歧杆菌分泌型粘附素对肠上皮细胞应激反应后核因子(NF)-κB DNA结合活性、细胞胞质核因子抑制蛋白κB(IκB)、细胞胞核NF-κB p65的表达和肿瘤坏死因子(TNF)-α、白细胞介素(IL)-1β、IL-8等细胞因子表达的影响.方法 经培养的肠上皮Lovo细胞分为5组,分别经LPS( 100 ng/ml)、H2O2( 200 μmol/L)直接刺激3h以及经双歧杆菌分泌型粘附素(30 μg/ml)预孵30 min后再予LPS( 100 ng/ml)、H2O2刺激(200 μmol/L)刺激3h,正常对照组未作任何处理.采用凝胶电泳迁移率试验(EMSA)方法检测NF-κB DNA结合活性;Western印迹法分别检测细胞胞质IκB和细胞胞核NF-κBp65的表达;RT- PCR方法检测TNF-α、IL-1β、IL-8等细胞因子mRNA的表达情况.结果LPS和H2O2刺激后,细胞表现出较高的NF-κB DNA结合活性[分别为正常对照组的(6.20±0.35)倍和(4.16±0.52)倍]和细胞胞核NF-κB p65的表达[分别为(0.64±0.05)和(0.67±0.06)],而细胞胞质IxB的表达则较弱[分别为(0.28±0.10)和(0.39±0.12)];以双歧杆菌分泌型粘附素预孵后,前二者活性明显降低,而后者的表达明显增强;LPS和H2O2处理后,TNF-α、IL-1β、IL-8等细胞因子mRNA的表达水平均明显增高[LPS处理组分别为(0.92±0.10)、(0.38±0.03)、(1.44±0.25),H2O2处理组分别为(0.89±0.13)、(0.36±0.06)、(1.42±0.18)],而粘附素预孵后则可显著降低它们的表达水平.NF-κB DNA结合活性与TNF-α、IL-1β、IL-8三种细胞因子的mRNA表达水平均呈显著正相关.结论 双歧杆菌分泌型粘附素对LPS和H2O2诱导的肠上皮细胞NF-κB DNA结合活性有显著抑制作用,NF-κB的活化可能与TNF-α、IL-1β和IL-8等炎性细胞因子的表达调控有关.     

胃肠镜室医护人员职业感染危险因素与对策

目的探讨胃肠镜室医护人员职业感染危险因素,制定防控对策。方法对胃肠镜室医护人员职业感染危险因素进行回顾分析,主要包括：胃肠镜操作中的传播、胃肠镜器械的传播、医护人员安全防护意识淡漠、管理制度的落实不力、患者的特殊反应、忽视胃肠镜前的准备工作、化学消毒剂的危害等。结果胃肠镜室医护人员因安全防护意识淡漠、个人防护措施欠落实、环境及病人检查前准备不充分、胃肠镜及相关附件、物品消毒不严等而面临着诸多潜在的职业感染危险因素。结论必须加强预防控制胃肠镜室医院感染,保障医护人员,病人的医疗安全,严格执行卫生部的《内镜清洗消毒技术操作规范》做好各项防护措施的落实。     

肝门阻断再灌注对脑兴奋性氨基酸及受体mRNA表达的影响

目的： 探讨无肝期后的再灌注对脑组织兴奋性氨基酸（EAAs）及其受体mRNA表达的影响。方法：分别采用血气分析、高效液相色谱荧光检测和半定量RT-PCR方法，研究大鼠肝门阻断和假手术组再灌注6 h、12 h和24 h后门静脉电解质和pH、脑组织Glu、Asp含量以及大脑皮层中NMDAR mRNA的相对含量表达的差异，观察无肝期后再灌注损伤对肝外远隔脏器脑EAAs及NMDA受体mRNA表达的的影响。结果：肝门阻断期间门静脉pH显著降低，［K⁺］升幅超过1倍，但开放后逐渐恢复；［Ca²⁺］于再灌注后持续下降至12 h；脑皮层中的Glu和Asp再灌注后分别在6 h、24 h出现2个高峰［Glu:(349±145) μg·g^-1wt,(456±203) μg·g^-1wt vs (238±24) μg·g^-1wt,(225±59) μg·g^-1wt;Asp: (134±50) μg·g^-1wt,(166±50) μg·g^-1wt vs (99±24) μg·g^-1wt,(71±20) μg·g^-1wt］；NMDAR亚单位NR1mRNA的表达在再灌注后显著升高后逐渐下降［(1.63±0.06) μg·g^-1wt vs (1.18±0.05) μg·g^-1wt;(1.73±0.06) μg·g^-1wt vs (1.17±0.03) μg·g^-1wt］,而NR2B mRNA在12 h升高(1.75±0.04 vs 1.18±0.05)，2者24 h时均恢复至对照组水平。结论：肝门阻断后肝和肠道再灌注过程可启动神经突触前Glu大量释放和重吸收抑制，引起脑皮层EAAs的堆积，同时刺激NMDARmRNA的表达，通过Glu - NMDAR途径可能引发脑损伤。     

茵陈丹蛇汤配合自血疗法治疗痤疮肠胃湿热证临床研究

目的:观察茵陈丹蛇汤配合自血疗法治疗痤疮肠胃湿热证的临床疗效。方法:将92例患者随机分为治疗组和对照组,治疗组48例采用茵陈丹蛇汤配合自血疗法治疗;对照组44例,口服治疗红霉素肠溶胶囊。两组患者均同时外用异维A酸红霉素凝胶外涂,治疗3个疗程后比较两组患者的临床疗效、血清细胞因子水平及临床症状积分情况。结果:治疗后治疗组有效率为91.7%,对照组有效率为72.7%,两组比较,差异有统计学意义(P0.05);治疗组血清中白细胞介素-1α、白细胞介素-6较治疗前明显降低(P0.05),与对照组治疗后比较,差异有统计学意义(P0.05);治疗组临床症状积分改善情况优于对照组,差异有统计学意义(P0.05);两组患者均未出现严重不良反应。结论:茵陈丹蛇汤配合自血疗法治疗痤疮肠胃湿热证疗效显著,安全性高,其作用机制可能与其抑制血液中炎症因子有关。     

Embolotherapy for expanding duodenal hematoma

Nonoperative management is currently the recommended initial treatment of duodenal hematomas resulting from blunt abdominal trauma, except in those patients who have persistent hemorrhage which leads to transfusion requirement or hemodynamic instability. This case report describes the use of transcatheter embolization to manage a patient with persistent hemorrhage. This procedure may expand the indications for conservative management.     

CT enteroclysis: technique and clinical applications

CT enteroclysis (CTE) has been gradually evolving with technical developments of spiral and multidetector row CT technology. It has nowadays become a well-defined imaging modality for the evaluation of various small bowel disorders. Volume challenge of 2L of enteral contrast agent administrated to the small bowel via a nasojejunal catheter ensures luminal distension, the prerequisite for the detection of mural abnormalities, also facilitating the accurate visualization of intraluminal lesions. CT acquisition is centered on small bowel loops, reconstructed in thin axial slices and completed by multiplanar views. Image analysis is essentially done in cine-mode on work-stations. CTE is of particular diagnostic value in intermediate or advanced stages of Cohn's disease, including the depiction of extraintestinal complications. It has become the imaging modality of choice for the localization and characterization of small bowel tumors. The cause and degree of low-grade small bowel obstruction is more readily analyzed with the technique of CTE than conventional CT. Limitations of CTE concern the assessment of pure intestinal motility disorders, superficial mucosal lesions and arteriovenous malformations of the small bowel, which are not consistently visualized. CTE should be selectively used to answer specific questions of the small bowel. It essentially contributes to the diagnostic quality of modern small bowel imaging, and therefore deserves an established, well-defined place among the other available techniques.     

重型颅脑损伤后肠动力障碍动物模型的建立

目的 采用改良的自由落体撞击法建立小鼠重型颅脑损伤后肠动力障碍(intestinal motility disorders,IMD)模型,为进一步研究损伤后IMD机制奠定基础.方法 采用自制圆柱套杆撞击器对小鼠致伤,于伤后1,6h、1,3,7d各时相点观察脑、肠组织的病理学改变,检测脑含水量、小肠推进率.结果 重型颅脑损伤后在脑组织出血水肿时期,肠道亦有急性炎症、充血等表现;脑含水量于6h增加,24 h达高峰;损伤后1h即出现小肠推进率的下降,6h达最低值.结论 小鼠重型颅脑损伤后存在IMD,本装置采用改良Feeney自由落体撞击法可成功建立重型颅脑损伤后IMD的小鼠模型.     

The zebrafish as a model to study intestinal inflammation

Starting out as a model for developmental biology, during the last decade, zebrafish have also gained the attention of the immunologists and oncologists. Due to its small size, high fecundity and full annotation of its genome, the zebrafish is an attractive model system. The fact that fish are transparent early in life combined with the growing list of immune cell reporter fish, enables in vivo tracking of immune responses in a complete organism. Since zebrafish develop ex utero from a fertilized egg, immune development can be monitored from the start of life. Given that several gut functions and immune genes are conserved between zebrafish and mammals, the zebrafish is an interesting model organism to investigate fundamental processes underlying intestinal inflammation and injury. This review will first provide some background on zebrafish intestinal development, bacterial colonization and immunity, showing the similarities and differences compared to mammals. This will be followed by an overview of the existing models for intestinal disease, and concluded by future perspectives in light of the newest technologies and insights.     

Specific probiotics alleviate allergic rhinitis during the birch pollen season

AIM： To investigate whether birch pollen allergy symptoms are linked with gut microbiota changes and whether probiotics have an effect on these.
METHODS： Forty seven children with confirmed birch pollen allergy were randomized to receive either a probiotic combination of Lactobacillus acidophilus （L. acidophilus） NCFM^TM （ATCC 700396） and Bifidobacterium lactis （B. lactis） BI-04 （ATCC SD5219） or placebo in a double-blind manner for 4 mo, starting prior to onset of the birch pollen season. Symptoms were recorded in a diary. Blood samples were taken for analysis of cytokines and eosinophils. Fecal samples were analysed for microbiota components, calprotectin and IgA. Nasal swabs were taken for analysis of eosinophils.
RESULTS： The pollen season induced a reduction in Bifldobacterium , Clostridium and Bacteroides which could not be prevented by the probiotic intervention. During the intervention, significantly higher numbers ofB. lactis 11.2 × 10^7 ± 4.2 ×10^7 vs 0.1 × 10^7 ± 0.1 × 10^7 bacteria/g feces （P 〈 0.0001） and L. acidophilus NCFMTM 3.5 × 10^6 ± 1.3 × 10^6 vs 0.2 × 10^6 ±0.1 × 10^6 bacteria/g feces （P 〈 0.0001） were observed in the probiotic group compared to the placebo group.During May, there was a tendency for fewer subjects, （76.2% vs 95.2%, P = 0.078） to report runny nose, while during June, fewer subjects, 11.1% vs 33.3%, reported nasal blocking in the probiotics group （P = 0.101）. Concomitantly, fewer subjects in the probiotic group had infiltration of eosinophils in the nasal mucosa compared to the placebo group, 57.1% vs 95% （P = 0.013）. Eye symptoms tended to be slightly more frequent in the probiotic group, 12.5 d [interquartile range （IQR） 6-18] vs 7.5 d （IQR 0-11.5） （P = 0.066） during May. Fecal IgA was increased in the placebo group during the pollen season; this increase was prevented by the probiotics （P = 0.028）.
CONCLUSION： Birch pollen allergy was shown to be associated with changes in fecal microbiota composition. The specific combination of probiotics used was shown to prevent the pollen-induced infiltration of eosinophils into the nasal mucosa, and indicated a trend for reduced nasal symptoms.