Probiotics Administration in Cystic Fibrosis: What Is the Evidence?

In the last 20 years, gut microbiota in patients with cystic fibrosis (CF) has become an object of interest. It was shown that these patients had gut dysbiosis and this could explain not only the intestinal manifestations of the disease but also part of those involving the respiratory tract. The acquisition of previously unknown information about the importance of some bacteria, i.e., those partially or totally disappeared in the gut of CF patients, in the regulation of the activity and function of the gut and the lung was the base to suggest the use of probiotics in CF patients. The main aim of this paper is to discuss the biological basis for probiotic administration to CF patients and which results could be expected. Literature analysis showed that CF intestinal dysbiosis depends on the same genetic mutations that condition the clinical picture of the diseases and is aggravated by a series of therapeutic interventions, such as dietary modifications, the use of antibiotics, and the administration of antacids. All this translates into a significant worsening of the structure and function of organs, including the lung and intestine, already deeply penalized by the genetic alterations of CF. Probiotics can intervene on dysbiosis, reducing the negative effects derived from it. However, the available data cannot be considered sufficient to indicate that these bacteria are essential elements of CF therapy. Further studies that take into account the still unsolved aspects on how to use probiotics are absolutely necessary.     

表面皮质激素吸入治疗儿童哮喘剂量的探讨

目的探讨我国哮喘儿童吸入皮质激素的疗效及安全性。方法研究５０例间歇发作型及轻度持续发作型哮喘儿童吸入不同剂量（２００～１２００μｇ／ｄ）皮质激素（二丙酸倍氯松,ＢＤＰ）的肺功能、气道高反应性及下丘脑－垂体－肾上腺轴（ＨＰＡＡ）功能的变化。将５０例哮喘患儿随机分为５组（每组１０例）,分别吸入安慰剂及ＢＤＰ２００,４００,８００,１２００μｇ／ｄ。结果经过３个月的治疗,各治疗组的第１秒用力呼气容积（ＦＥＶ１）,最高呼气流速（ＰＥＦ）及ＰＤ２０－ＦＥＶ１均显著升高,而对照组则无明显变化。治疗前后各组患儿的血浆ＡＣＴＨ及血清皮质醇基础值均无明显变化,血浆皮质醇对ＡＣＴＨ刺激的反应值在对照组及ＢＤＰ２００μｇ组无明显变化,而在ＢＤＰ≥４００μｇ／ｄ时则明显下降。结论２００μｇ／ｄ的ＢＤＰ能有效地改善哮喘儿童的肺功能,降低气道高反应性,但当剂量≥４００μｇ／ｄ时,则可能引起血皮质醇对ＡＣＴＨ刺激的反应性抑制。临床上使用ＢＤＰ吸入疗法治疗间歇发作型及轻度持续发作型儿童哮喘时,尽可能将剂量控制在每日４００μｇ以下     

胰岛素样生长因子-1受体基因变异与矮身材的研究进展

胰岛素样生长因子-1受体(IGF-1 R)是下丘脑-垂体-生长激素轴IGF信号通路的受体级联效应分子.近年来,国外IGF-1R基因突变矮身材报道逐年增多,现将IGF-1R基因缺陷与矮身材的研究进展总结如下,以期引起临床医师的重视.     

Intestinal and pharyngeal microbiota in early neonates: an analysis based on high-throughput sequencing北大核心CSCD

目的 初步探讨早期新生儿肠道和咽部微生物群的分布特点及相关性。 方法 选取上海市浦东新区妇幼保健院2021年9月—2022年1月出生的混合喂养的足月健康新生儿为研究对象。采用16S rRNA基因测序技术分析新生儿出生当天及出生后5~7 d的粪便和咽拭子样本,分析比较早期新生儿肠道和咽部微生物群的组成及功能差异。 结果 多样性分析表明,早期新生儿咽部微生物群的多样性高于肠道,但差异无统计学意义（P>0.05）。门水平上,出生当天肠道变形菌门相对丰度高于咽部（P<0.05）;出生后5~7 d肠道放线菌门和变形菌门相对丰度高于咽部、厚壁菌门相对丰度低于咽部（P<0.05）。属水平上,出生当天肠道和咽部的优势菌属组成差异无统计学意义（P>0.05）;出生后5~7 d肠道和咽部的链球菌属、葡萄球菌属、罗氏菌属、双歧杆菌属及埃希菌-志贺菌属等共生菌差异有统计学意义（P<0.05）。直系同源序列聚类数据库分析显示,咽部菌群更多地集中在染色质结构和动力学及细胞骨架上,而肠道菌群在RNA加工修饰、能量生成和转换、氨基酸转运代谢、碳水化合物转运代谢、辅酶转运和代谢等方面表现丰富（P<0.05）。京都基因和基因组百科全书分析显示,与咽部菌群相比,肠道菌群对细胞运动、细胞进程和信号转导、内分泌系统、排泄系统、免疫系统、代谢性疾病、神经系统和转录功能参数的预测程度更高（P<0.05）。 结论 新生儿出生时肠道和咽部的微生物群组成及多样性无显著差异,随着出生时间的推移,两个生态位的微生物群组成开始出现分化,并逐渐显现出各自不同的功能。     

肝郁脾虚证模型大鼠HPA轴中枢相关受体的表达及疏肝健脾方药的干预作用

目的观察肝郁脾虚证模型大鼠下丘脑-垂体-肾上腺皮质激素（HPA）轴中枢相关受体的变化及疏肝健脾方药的干预作用。方法将SD大鼠随机分为正常对照组、肝郁脾虚模型组、疏肝组（柴胡疏肝散组）、健脾组（四君子汤组）、疏肝健脾组（柴疏四君子汤组）,后4组大鼠采用慢性束缚＋饮食失节＋游泳疲劳的方法,连续造模4周,正常组不予处理。于造模第15天,中药各组分别给予柴胡疏肝散4．2g／kg、四君子汤4．53g／kg、柴疏四君汤4．27g／kg灌胃,连续14d。检测大鼠下丘脑促肾上腺皮质激素受体（ACTHR）、糖皮质激素受体（GR）和垂体下丘脑促皮质素释放激素受体（CRHR）、GRmRNA表达水平。结果与正常组相比,模型组大鼠下丘脑ACTHR、GRmRNA及垂体CRHR、GRmRNA表达水平明显降低（P〈0．05,P〈0．01）;与模型组比较,柴疏四君汤组下丘脑ACTHR、GRmRNA及垂体CRHR、GRmRNA表达水平均呈显著性增加（P〈0．05,P〈0．01）,柴胡疏肝散组大鼠下丘脑GR和垂体CRHR、GRmRNA的表达水平均见显著性增加（P〈0．05）,四君子汤组大鼠垂体CRHR、GRmRNA的表达水平显著性增加（P〈0．05）。与四君子汤和柴胡疏肝散比较,柴疏四君汤组大鼠下丘脑ACTHR、GRmRNA的表达水平显著性增加（P〈0．05）,其中柴胡疏肝散组较四君子汤比垂体GRmRNA的表达水平增加更显著（P〈0．05）。结论肝郁脾虚证模型大鼠HPA轴中的中枢相关受体表达呈全面下调,中药三方对模型大鼠下丘脑ACTHR、GRmRNA及垂体CRHR、GRmRNA的表达均有不同程度或选择l生上调作用,其中柴疏四君汤的作用最优,其次是柴胡疏肝散,四君子汤则作用较差。     

针刺对女性生殖内分泌影响的实验研究

目的 :观察针刺对外周血中FSH、LH、E2 、T、P的影响。方法 :选健康育龄女性 2 8名 ,以耳穴与体穴、手法和电针相结合的方法进行治疗 ,采用自身对照 ,检测治疗前后各项指标。结果 :针刺前后FSH、LH的变化无明显差异 (P >0 .0 5) ,而E2 、T、P的变化具有显著性差异 (P <0 .0 5)。结论 :针刺对垂体促性腺激素的分泌无明显影响 ,对卵巢性激素的分泌具有明显的抑制性效应。     

基于肠肾轴理论谈通腑泄浊法治疗慢性肾脏病

肠-肾轴学说认为肠道菌群的紊乱能够引起肠道屏障功能受损及全身微炎症反应,进而加重慢性肾脏病进程,这一理论的提出为慢性肾脏病的治疗提供了新的方向。通腑泄浊法是通过加强肠腑传化功能,使蓄积于肠道的湿浊毒邪从大便排出,进而调节脏腑气机,祛邪以扶正,与肠肾轴理论不谋而合。本文基于肠-肾轴理论,讨论通腑泄浊法治疗慢性肾脏病的应用,为慢性肾脏病的治疗提供新的思路和方法。     

甘松抗帕金森病作用及对大鼠肠道菌群的影响

该文旨在研究中医"脾胃"学说和现代理论"微生物-肠-脑轴"指导下甘松对帕金森病(Parkinson′s disease, PD)大鼠的治疗作用及对大鼠肠道菌群的影响。将40只大鼠随机分为空白对照组、模型对照组、左旋多巴组和甘松醇提物组,采用鱼藤酮颈背部皮下注射法制备PD大鼠模型。分别灌胃给药14 d后,通过旷场实验、斜板实验和爬杆实验,分析甘松对PD大鼠行为学的影响。行为学检测结束后,收集各组大鼠纹状体、结肠和结肠内容物。蛋白免疫印迹实验检测大鼠纹状体中酪氨酸羟化酶(tyrosine hydroxylase, TH)、α-突触核蛋白(α-synuclein,α-syn)和结肠组织中α-syn的表达;酶联免疫吸附测定实验检测大鼠纹状体和结肠组织中肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-1β(interleukin-1β,IL-1β)和核转录因子-κB(nuclear factor-kappa B,NF-κB)的含量;利用16S rRNA高通量测序技术对各组大鼠肠道菌群的多样性、差异菌门与优势菌属进行综合分析与评价。结果显示,甘松能够明显...     

Developmental origins theory from prematurity to adult disease

Developmental Origins Theory has received little coverage in the nursing literature, even though it has received much attention in other sciences. The theory proposes that prenatal stress provokes adaptive changes in endocrine and metabolic processes that become permanently programmed and impact later adult health. This paper reviews the theory and describes the primary neuroendocrine mechanism of hypothalamic-pituitary-adrenal axis function. Supporting research evidence in preterm infant and adult samples is presented. Through knowledge of the theory and the long-term sequelae for preterm infants, nurses will have a different theoretical perspective and growing evidence to consider in their care for pregnant women and infants.     

Transvaginal sonographic fetal axis determination in early second trimester

Objective  Correct prenatal determination of the fetal right/left axis is essential for the diagnosis of fetal malformations, in particular congenital heart anomalies. A reliable method of transabdominal echocardiographic assessment of the fetal situs in the late second trimester was established. We aimed to determine the validity of the transvaginal approach to assess fetal axis. Method  The study group consisted of 108 consecutive women in the second trimester of a singleton pregnancy, undergoing elective transvaginal anatomy scans. All had undergone previous transabdominal echocardiography to establish fetal axis. The same technique was used to assess the fetal axis during the transvaginal study, and the findings were compared. Results  There was total agreement in fetal axis determination between transabdominal and transvaginal scans in all cases. The accuracy of the transvaginal study was not affected by maternal obesity, fetal position or the presence of cardiac malformation (in one case). Conclusion  Transvaginal ultrasonography is the reliable and accurate means of determining the fetal axis. Both affiliations are affiliated with Sackler Faculty of Medicine, Tel Aviv University.