Geoepidemiologic variation in outcomes of primary sclerosing cholangitis

Primary sclerosing cholangitis (PSC) is a chronic, progressive, hepatobiliary disease characterized by inflammation and fibrosis of the intra- and extra-hepatic bile ducts. Its natural history is one that generally progresses towards cirrhosis, liver failure, cholangiocarcinoma, and ultimately disease-related death, with a median liver transplantation-free survival time of approximately 15-20 years. However, despite its lethal nature, PSC remains a heterogenous disease with significant variability in outcomes amongst different regions of the world. There are also many regions where the outcomes of PSC have not been studied, limiting the overall understanding of this disease worldwide. In this review, we present the geoepidemiologic variations in outcomes of PSC, with a focus on survival pre- and post-liver transplantation as well as the concurrence of inflammatory bowel disease and hepatobiliary neoplasia.     

益生菌联合肠内营养对急性胰腺炎患者肠道菌群及外周血miR-155的影响

目的 探讨益生菌联合肠内营养对急性胰腺炎患者肠道菌群及外周血miR-155的影响。 方法 选取2016年6月至2018年12月河北医科大学第二医院消化内科收治的92例急性胰腺炎患者作为研究对象，根据随机数字表法分为观察组（n=46）和对照组（n=46），对照组在常规治疗基础上给予肠内营养治疗，观察组在对照组基础上给予双歧杆菌乳杆菌三联活菌片，观察两组患者治疗前后肠道菌群、炎性介质及血清miR-155变化，比较两组患者治疗后胃肠道功能恢复情况。结果 治疗后，观察组双歧杆菌、乳酸杆菌增加数量，肠球菌、大肠埃希菌减少数量，血清CRP、IL-6、IL-17、TNF-α、miR-155降低水平均显著高于对照组（P<0.05）；观察组患者胃肠生活质量量表（GIQLI）评分高于对照组，腹胀消失时间、腹痛消失时间、肠鸣音恢复时间、血清淀粉酶恢复正常时间均少于对照组（P<0.05）。结论 益生菌联合肠内营养治疗急性胰腺炎可调节肠道菌群平衡，降低血清miR-155水平，缓解炎性反应，促进肠道功能恢复。     

Emodin attenuates acute lung injury in Cecal-ligation and puncture rats

Acute lung injury (ALI) is a major cause of sepsis-induced acute respiratory failure. Emodin has been considered to play a protective role for acute lung edema in cecal ligation and puncture (CLP)-induced sepsis model. In this study we aimed to investigate whether emodin could improve CLP-induced lung sepsis via regulating aquaporin (AQP) and tight junction (TJ), inflammatory factors, and pulmonary apoptosis. The results showed that sepsis-induced pulmonary pathological changes were significantly improved after emodin treatment. Emodin was found to upregulate AQP and TJ expression in the CLP model. Meanwhile, inflammatory cytokine release and pulmonary apoptosis was remarkably reduced after emodin treatment in lung sepsis. Our data demonstrated that emodin could suppresse inflammation, restore pulmonary epithelial barrier and reduce mortality in CLP-induced ALI, suggesting the potential therapeutic application of emodin in sepsis.     

易黄止带汤联合苦参凝胶治疗霉菌性阴道炎临床研究

目的:观察易黄止带汤联合苦参凝胶治疗霉菌性阴道炎(MV)的临床疗效。方法:选取MV患者120例,按随机数字表法分为对照组和观察组各60例。对照组给予酮康唑口服联合克霉唑栓治疗,观察组给予易黄止带汤口服及苦参凝胶阴道给药。比较2组治疗后临床症状消失时间、主要症状总积分、中医疗效、免疫球蛋白A(SIgA)、白细胞介素-2(IL-2)、IL-6、IL-8及降钙素原(PCT)表达情况。结果:观察组临床总有效率为90.00%,显著高于对照组77.70%(P<0.05)。观察组外阴瘙痒消失时间、白带恢复正常以及阴道黏膜充血消失时间均低于对照组(P<0.05)。治疗前,2组外阴瘙痒、尿急尿痛及白带量积分比较,差异无统计学意义(P>0.05)。治疗后,2组外阴瘙痒、尿急尿痛及白带量积分较治疗前降低(P<0.05),且观察组各症状积分均低于对照组(P<0.05)。治疗前,2组阴道分泌物中SIgA水平比较,差异无统计学意义(P>0.05)。治疗后,2组阴道分泌物中SIgA水平较治疗前升高,且观察组阴道分泌物中SIgA水平高于对照组(P<0.05)。治疗前,2组血清IL-2、IL-6、IL-8、PCT水平比较,差异无统计学意义(P>0.05)。治疗后,2组血清IL-2水平较治疗前升高,IL-6、IL-8、PCT水平较治疗前降低;且观察组血清IL-2水平高于对照组,IL-6、IL-8、PCT水平低于对照组;差异均有统计学意义(P<0.05)。结论:易黄止带汤联合苦参凝胶能缩短MV患者康复时间,提高免疫因子IL-2、SIgA表达,降低炎性反应,提高临床疗效,具有一定临床价值。     

细辛碎补汤联合米诺环素对慢性牙周炎患者牙周指标及 龈沟液炎症因子的影响

目的 探讨细辛碎补汤联合米诺环素对慢性牙周炎患者牙周指标及龈沟液炎症因子的影响。方法 选取 2019 年 1 月~2021 年 8 月杭州市萧山区中医院接诊的 96 例慢性牙周炎患者作为研究对象。以双色球法将患者 分为对照组和试验组，每组各 48 例。对照组患者在常规治疗基础上加用米诺环素，试验组患者在对照组治疗 基础上加用细辛碎补汤。比较两组患者的临床疗效、牙周指标、龈沟液炎症因子及不良反应发生情况。结果 试 验组患者总有效率显著高于对照组（P<0.05）。治疗后两组患者的探诊深度、菌斑指数、探诊出血指数、龈沟 液 C–反应蛋白、肿瘤坏死因子–α 及白介素–6 水平均显著低于本组治疗前（均 P<0.05），且试验组以上指标均 显著低于对照组（均 P<0.05）。两组患者不良反应发生率比较差异无统计学意义（χ2 =0.154，P=0.695）。结论 细 辛碎补汤联合米诺环素可有效提高慢性牙周炎患者疗效，改善牙周指标，其作用机制可能与降低龈沟液炎症 因子有关。     

百草枯诱导小鼠脑小胶质细胞的炎症反应

目的观察百草枯(PQ)诱导小鼠脑小胶质(BV2)细胞株的炎症反应。方法取处于对数生长期的BV_2细胞,分别暴露于终浓度为0(阴性对照)、20、40、80μmol/L的PQ溶液继续培养6、12、24、48 h。检测细胞活性和炎症因子[肿瘤坏死因子α(TNF-α)、白细胞介素-6(interleukin 6,IL-6)、IL-1β及活性氧(ROS)]水平。结果与阴性对照组比较,各剂量PQ染毒组BV_2细胞TNF-α、IL-1β、IL-6和ROS的水平及细胞抑制率均较高,差异均有统计学意义(P0.05);与染毒6 h比较,染毒12、24、48 h时BV_2细胞TNF-α、IL-1β、IL-6和ROS的水平及细胞抑制率均较高,差异均有统计学意义(P0.05)。且随着PQ染毒剂量的升高和染毒时间的延长,BV_2细胞的抑制率及TNF-α、IL-1β、IL-6和ROS水平均呈上升趋势。结论PQ能活化小鼠小胶质细胞,使其分泌炎症因子,同时诱导氧化损伤,加重细胞毒性作用。     

Transperineal ultrasonography in perianal Crohn disease: A valuable imaging modality

Aims of treatment for Crohn disease have moved beyond the resolution of clinical symptoms to objective end points including endoscopic and radiological normality. Regular re-evaluation of disease status to safely, readily and reliably detect the presence of inflammation and complications is paramount. Improvements in sonographic technology over recent years have facilitated a growing enthusiasm among radiologists and gastroenterologists in the use of ultrasound for the assessment of inflammatory bowel disease. Transabdominal intestinal ultrasound is accurate, affordable and safe for the assessment of lumi-nal inflammation and complications in Crohn disease, and can be performed with or without the use of intravenous contrast enhancement. Perianal fistulizing disease is a common, complex and often treatment-refractory complication of Crohn disease, which requires regular radiological monitoring. Endoanal ultrasound is invasive, uncomfortable and yields limited assessment of the perineal region. Although magnetic resonance imaging of the pelvis is established, timely access may be a problem. Transperineal ultrasound has been described in small studies, and is an accurate, painless and cost-effective method for documenting perianal fluid collections, fistulas and sinus tracts. In the present article, the authors review the literature regarding perineal ultrasound for the assessment of perianal Crohn disease and use case examples to illustrate its clinical utility.