复方聚乙二醇4000电解质散在老年患者结肠镜术前准备中的应用

目的探讨复方聚乙二醇4000电解质散(和爽)在老年人结肠镜术前检查中的清肠效果及安全性。方法将80例老年患者随机分为两组:一组为和爽组(A组),采用复方聚乙二醇4000电解质散作为结肠镜术前准备;一组为电解质组(B组),采用电解质液作为结肠镜术前准备,观察老年人对两种方法的清肠效果及不良反应。结果A组结肠整体准备的有效率为91.2%,B组为71.7%,两组差异有显著性(P0.05)。A组不良反应的发生率为1.2%,B组为8.5%,两组不良反应的发生率无显著差异。结论复方聚乙二醇4000电解质散用于老年患者结肠镜前的肠道准备较好。     

聚乙二醇修饰的聚精氨酸基因载体的构建及其体外评价

目的 利用聚乙二醇（PEG）修饰非病毒基因载体聚精氨酸（PLR）,考察PEG修饰对PLR的细胞毒性和PLR介导的RNA干扰效率的影响。 方法 利用1H-NMR鉴定合成的PLR-PEG的结构,确定PEG的修饰度,利用凝胶电泳表征载体对siRNA的包裹能力,在前列腺癌干细胞模型细胞（RC-92a/hTERT）上考察PLR-PEG的细胞毒性,考察PLR-PEG/siRNA复合物的细胞摄取及相关基因的干扰效率。 结果 通过结构鉴定确定PLR-PEG合成成功;细胞毒性实验表明PEG修饰可以降低PLR的毒性;PEG修饰会降低PLR/siRNA复合物的细胞摄取,高N/P时对细胞摄取的影响不大;PEG修饰也会降低PLR介导的RNA干扰效率,但PEG修饰度在一定范围内对干扰效率的影响比较小。 结论 PEG修饰的PLR作为基因载体在前列腺癌干细胞的基因治疗中有一定的应用前景。     

聚乙二醇电解质散剂用于术前肠道准备的安全性与有效性

目的观察聚乙二醇电解质散剂(舒泰清)在肝胆外科术前肠道准备中的有效性和安全性。方法对50例拟行肝胆外科常规手术的病人,术前一日下午予口服4盒聚乙二醇电解质散剂进行肠道准备,当日晚餐进普食,观察肠道准备的效果;服药后第一日晨及手术当日复查生化,观察其安全性。结果聚乙二醇电解质散剂可以达到满意的清肠效果,未见明显不良反应及电解质改变(P0.05)。结论聚乙二醇电解质散剂用于肝胆外科术前肠道准备安全有效,具有临床使用价值。     

Change in renal function after sodium phosphate preparation for screening colonoscopy

AIM:To investigate the changes in renal function at 12-24 mo in patients following sodium phosphate(NaP) preparation for screening colonoscopy.METHODS:We carried out a retrospective study on the results from patients who received health check-up services as part of an employer-provided wellness program performed between August 2006 and May 2008 and who were followed up for 12-24 mo.Prior to screening colonoscopy,224 patients underwent bowel cleansing with NaP(NaP group) and 113 patients with polyethylene gl...     

住院患者结肠镜诊治肠道准备质量的影响因素研究

背景　随着内镜诊疗技术的发展,结肠镜已成为结肠癌筛查的金标准,患者的肠道准备是否充分与结肠镜诊治是否成功密切相关。目前国内外对住院患者的肠道清洁现状、清洁水平及其影响因素等方面的研究较少,而相关研究表明住院患者相比门诊患者肠道准备质量差,因此如何提高住院患者肠道准备质量尚待研究,且受到国内外学者的广泛关注。目的　了解住院与门诊患者结肠镜诊治的肠道准备差异,并分析住院患者结肠镜诊治肠道准备的影响因素。方法　2018年1—4月采用便利抽样法选取河北医科大学第二医院消化内镜中心拟行结肠镜诊治的住院患者220例（住院组）与门诊患者227例（门诊组）为研究对象。采用基线资料调查表及日常生活活动能力（ADL）量表了解患者的一般情况,采用肠道准备影响因素反馈表了解患者肠道准备的影响因素,采用渥太华肠道准备评分量表（OBPS）对两组患者肠道准备质量进行评分,采用多元线性回归分析住院患者OBPS评分的影响因素。结果　门诊组肠道准备不充分率为23.3%（53/227）,住院组肠道准备不充分率为49.5%（109/220）,门诊组右半结肠、横结肠、左半结肠、全结肠液体量OBPS评分及OBPS总分低于住院组（P<0.05）。两组间诊治前2 d进食低纤维饮食时间、开始服用复方聚乙二醇电解质散（PEG）至排出水样便运动步数、服用PEG后排便总次数、服用PEG后首次排便时间、末次服用PEG至诊治时间间隔、服用PEG后出现残渣样便次数、诊治前一晚睡眠时间、服用PEG时水温、诊治前2 d运动量比较,差异均有统计学意义（P<0.05）。多元线性回归分析结果显示,开始服用PEG至排出水样便运动步数（β=0,P<0.001）、服用PEG后排便总次数〔β=-0.042,95%CI（-0.078,-0.007）,P=0.019〕、服用PEG后出现残渣样便次数〔β=0.136,95%CI（0.033,0.238）,P=0.010〕、诊治前2 d运动量〔β=0.302,95%CI（0.100,0.504）,P=0.004〕是住院患者右半结肠OBPS评分的影响因素;开始服用PEG至排出水样便运动步数〔β=0,P<0.001〕是住院患者横结肠、左半结肠OBPS评分的影响因素;开始服用PEG至排出水样便运动步数〔β=0,P<0.001〕、末次服用PEG至诊治时间间隔〔β=-0.050,95%CI（-0.090,-0.009）,P=0.017〕、服用PEG后出现残渣样便次数〔β=0.155,95%CI（0.045,0.264）,P=0.006〕是住院患者全结肠液体量OBPS评分的影响因素;开始服用PEG至排出水样便运动步数（β=0,P<0.001）、服用PEG后排便总次数〔β=-0.105,95%CI（-0.193,-0.017）,P=0.020〕、服用PEG后出现残渣样便次数〔β=0.481,95%CI（0.226,0.736）,P<0.001〕、诊治前2 d运动量〔β=0.681,95%CI（0.178,1.184）,P=0.008〕是住院患者OBPS总分的影响因素。结论　开始服用PEG至排出水样便运动步数、服用PEG后排便总次数、末次服用PEG至诊治时间间隔、服用PEG后出现残渣样便次数、诊治前2 d运动量是住院患者肠道准备质量的影响因素,医务工作者应根据其影响因素采取相应的措施,减少肠道准备不充分的影响,保证结肠镜诊治过程的顺利进行。     

Efficacy of 1.2L polyethylene glycol plus ascorbic acid for bowel preparations

BACKGROUND A low-volume polyethylene glycol(PEG) solution that combines ascorbic acid with PEG-based electrolyte solution(PEG-ASC) is gaining mainstream acceptance for bowel preparation due to reduced volume and improved taste.Although several reports showed that bowel preparation with PEG-ASC volume lower than 2.0 L with laxative agents could be an alternative to traditional preparation regimen, the cleansing protocols have not been fully investigated.AIM To evaluate the cleansing efficacy of 1.2 L PEG-ASC solution comparing with 2.0 L PEG electrolyte(PEG-ELS) for bowel preparations.METHODS A randomized, single-blinded, open-label, single-center, non-inferiority study was conducted. In total, 312 Japanese adult patients(aged > 18 years) who underwent colonoscopy were enrolled. Patients were randomly allocated to bowel lavage with either 1.2 L of PEG-ASC solution with at least 0.6 L of an additional clear fluid(1.2 L PEG-ASC group) or 2.0 L of PEG-ELS(PEG-ELS group). Then, 48 mg of sennoside was administered at bedtime on the day before colonoscopy, and the designated drug solution was administered at the hospital on the day of colonoscopy. Bowel cleansing was evaluated using the Boston Bowel Preparation Scale(BBPS). The volume of fluid intake and required time for bowel preparation were evaluated. Furthermore, compliance, patient tolerance,and overall acceptability were evaluated using a patient questionnaire, which was assessed using a visual analog scale.RESULTS In total, 291 patients(1.2 L PEG-ASC group, 148; PEG-ELS group, 143) completed the study. There was no significant difference in successful cleansing, defined as a BBPS score ≥ 2 in each segment, between the two groups(1.2 L PEG-ASC group, 91.9%; PEG-ELS group, 90.2%; 95%CI:-0.03-0.09). The required time for bowel preparation was significantly shorter(164.95 min ± 68.95 min vs 202.16 min± 68.69 min, P < 0.001) and the total fluid intake volume was significantly lower(2.23 L ± 0.55 L vs 2.47 L ± 0.56 L, P < 0.001) in the 1.2 L PEG-ASC group than in the PEG-ELS group. Palatability, acceptability of the volume of solution, and overall acceptability evaluated using a patient questionnaire, which was assessed by the visual analog scale, were significantly better in the 1.2 L PEG-ASC group than in the PEG-ELS group(7.70 cm ± 2.57 cm vs 5.80 cm ± 3.24 cm, P < 0.001). No severe adverse event was observed in each group.CONCLUSION The 1.2 L PEG-ASC solution was non-inferior to the 2.0 L PEG-ELS solution in terms of cleansing efficacy and had better acceptability among Japanese patients.     

Polyethylene glycols: An effective strategy for limiting liver ischemia reperfusion injury

Liver ischemia-reperfusion injury(IRI) is an inherent feature of liver surgery and liver transplantation in which damage to a hypoxic organ(ischemia) is exacerbated following the return of oxygen delivery(reperfusion). IRI is a major cause of primary nonfunction after transplantation and may lead to graft rejection, regardless of immunological considerations. The immediate response involves the disruption of cellular mitochondrial oxidative phosphorylation and the accumulation of metabolic intermediates during the ischemic period, and oxidative stress during blood flow restoration. Moreover, a complex cascade of inflammatory mediators is generated during reperfusion, contributing to the extension of the damage and finally to organ failure. A variety of pharmacological interventions(antioxidants, anticytokines, etc.) have been proposed to alleviate graft injury but their usefulness is limited by the local and specific action of the drugs and by their potential undesirable toxic effects. Polyethylene glycols(PEGs), which are non-toxic water-soluble compounds approved by the FDA, have been widely used as a vehicle or a base in food, cosmetics and pharmaceuticals, and also as adjuvants for ameliorating drug pharmacokinetics. Some PEGs are also currently used as additives in organ preservation solutions prior to transplantation in order to limit the damage associated with cold ischemia reperfusion. More recently, the administration of PEGs of different molecular weights by intravenous injection has emerged as a new therapeutic tool to protect liver grafts from IRI. In this review, we summarize the current knowledge concerning the use of PEGs as a useful target for limiting liver IRI.     

Optimizing Dendritic Cell Preparation for Fusion with Melanoma Cells

Background: Fusion of dendritic cells (DCs) with melanoma cells could reinforce the antigenicity of tumors as a strategy for the treatment of malignant melanoma. However, the insufficient quantity of DCs and the low fusion efficiency limits the development of such approach. Objective: To define the dosage of the stimulating factors as well as the induction condition for the optimal DCs preparation and cell fusion. Methods: DCs were generated from murine bone marrow cells, and cultured with four different concentrations of the granulocyte-macrophage colony-stimulating factor (GM-CSF) and interleukin-4 (IL-4). DCs were confirmed to be mature by detecting the expression of MHC-II, CD11c, CD80, and CD83 by flowcytometry. DCs-melanoma fusion cells were generated using polyethylene glycols (PEG) with different molecular weights and the fusion efficiency was detected by fluorescence-activated cell sorter (FACS). Results: The largest quantity of DCs was found when cells were cultured with 1000 U/ ml of GM-CSF and 500 U/ml of IL-4 (1.69 ± 0.04 ×10 6 ml-1, p<0.001 when compared with the other three groups). The expression levels of MHC-II and CD83 on day 7 after incubation were significantly lower than those on day 3 (MHC-II: p<0.001; CD83: p<0.001). The efficiency of cell fusion under induction of PEG-3000 was significantly higher than that of PEG-4000 (15.4 ± 0.56% vs. 11.1 ± 0.45%, p<0.001). Conclusions: The largest quantity for mature DCs was stimulated with 1000 U/ml of GM-CSF and 500 U/ml of IL-4 and the highest fusion efficiency was under induction of PEG-3000.     

运用聚乙二醇6000沉淀筛检巨催乳素血症患者

目的：运用聚乙二醇6000沉淀筛检血清催乳素（PRL）水平升高患者中巨催乳素血症并进行临床样本验证。方法：运用聚乙二醇6000沉淀去除PRL升高患者血清中的巨催乳素分子（MPRL）。采用Sephacryl S-100HR层析柱联合化学发光免疫分析法、十二烷基硫酸钠-聚丙烯酰胺凝胶电泳联合蛋白质印迹法检测聚乙二醇6000沉淀血清MPRL的效果。采用聚乙二醇6000沉淀及化学发光免疫分析法检测PRL升高患者血清样本中的MPRL并筛查巨催乳素血症。分析真性高催乳素血症、高催乳素血症+巨催乳素血症、真性巨催乳素血症患者不同临床表现。结果：聚乙二醇6000沉淀后,血清样本中MPRL峰或MPRL杂交信号明显降低,但对大分子催乳素（BPRL）和小分子催乳素（SPRL）无明显影响。1538例血清PRL升高患者中,16.1%（247/1538）为巨催乳素血症,其余83.9%（1291/1538）为真性高催乳素血症。247例巨催乳素血症样本中,93.5%（231/247）为真性巨催乳素血症,6.5%（16/247）为巨催乳素血症+高催乳素血症。508例真性高催乳素血症患者中86.2%（438/508）有月经不调、停经／闭经、不孕不育或垂体瘤疾病,85.7%（6/7）高催乳素血症+巨催乳素血症患者有上述临床表现,真性巨催乳素血症患者仅15.5%（11/71）有上述临床表现。结论：血清PRL升高患者中有一定比例的真性巨催乳素血症（假性高催乳素血症）,运用聚乙二醇6000沉淀检测能简便有效地区分真性或假性高催乳素血症患者。