活血清胰汤灌肠辅助手术治疗对急性重症胰腺炎患者的疗效观察

目的：探讨活血清胰汤灌肠辅助手术治疗急性重症胰腺炎对患者AMS、UAMY、LPS水平及免疫功能的影响。方法：选取2019年3月至2020年3月陕西省宝鸡市中医医院收治的急性重症胰腺炎患者70例作为研究对象，按随机数字表法将其分为对照组和观察组，每组35例。2组均采用经内镜逆行性胰胆管造影术进行治疗，对照组术后给予常规治疗，观察组术后在对照组的基础上加用活血清胰汤灌肠治疗，2组均治疗1周。比较2组治疗1周后的临床疗效；比较2组治疗前、治疗1周后的胰腺炎标志物水平、细胞免疫指标及体液免疫指标水平。结果：治疗1周后，观察组总有效率为94.29%，高于对照组（77.14%，P<0.05）。与治疗前比较，治疗1周后，2组血清AMS、LPS、UAMY及CD8+水平均降低，且观察组低于对照组（P<0.05）；2组血清CD3+、CD4+、IgG、IgM、IgA水平及CD4+/CD8+比值均升高，且观察组高于对照组（P<0.05）。结论：活血清胰汤灌肠辅助手术治疗急性重症胰腺炎，可通过降低患者血清AMS、LPS及UAMY水平，缓解炎性反应，同时可改善免疫功能，进而有助于提高疗效。     

血清SAA/CRP、CD64对儿童甲型流感早期诊断的临床价值分析

目的探讨血清淀粉酶A蛋白(SAA)与C-反应蛋白(CRP)比值SAA/CRP、中性粒细胞表面抗原CD64对儿童甲型流感早期诊断的临床价值。方法选择2017年8月~2019年2月来医院儿科就诊的125例流感症状患儿作为研究对象,根据患儿临床诊断结果将其分为甲型流感组31例、非甲型流感组94例;再选择同期在天津海河教育园区达文路卫生服务中心健康体检健康儿童30例作为对照组。患儿入组后立即留取鼻咽吸取液,采用RT-PCR鉴定流感病毒型别;采集末梢血进行7项呼吸道病毒联合检测及血清SAA、CRP以及外周血中性粒细胞表面抗原CD64表达水平。结果甲型流感组与非甲型流感组患儿血清SAA、SAA/CRP以及CD64指数显著高于对照组,甲型流感组血清SAA、SAA/CRP以及CD64指数显著高于非甲型流感组,差异均有统计学意义(P<0.05),3组儿童血清CRP水平比较差异无统计学意义(P>0.05)。运用ROC曲线分析在疑似甲型流感125例患儿中血清SAA、CRP、SAA/CRP以及CD64对甲型流感诊断价值,结果显示各指标诊断曲线下面积分别为0.908、0.641、0.994、0.957。结论甲型流感患儿血清SAA、SAA/CRP以及中性粒细胞表面受体CD64表达显著升高,在甲型流感患儿的早期临床诊断中具有较高的辅助价值。     

比较三种丙泊酚制剂对高脂血症患者围术期血脂水平的影响

目的比较三种丙泊酚制剂对高脂血症患者围术期血脂水平的影响。方法选择择期手术高脂血症患者80例,随机均分为四组,每组20例。A组和B组分别使用不同厂家的丙泊酚中长链脂肪乳(规格20ml/200mg),C组使用另一厂家的丙泊酚长链脂肪乳(规格50ml/500mg),D组吸入七氟醚维持全麻。分别在麻醉诱导前(T0)、手术结束时(T1)、手术结束后1h(T2)和术后24h(T3)抽取静脉血,检测总胆固醇(TC)、甘油三脂(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、血清淀粉酶(AMY)含量。结果四组完成例数:A组19例,B组17例,C组18例,D组19例。与T0时比较,A、B、C组在T1时TC值明显下降(P0.05),且A、C组下降更明显(P0.01);与D组比较,C组在T1、T2时TC值明显降低(P0.05)。与T0时比较,A、B、C组在T3时TG值明显降低(P0.05),B、C组下降更明显(P0.01)。与T0时比较,C组在T3时HDL明显升高(P0.05)。与T0时比较,A、B、C组在T1时LDL值明显下降(P0.05),C组下降更明显(P0.01);与D组比较,C组在T1、T2时LDL值明显降低(P0.01)。与D组比较,A组在T3时ALT、AST值明显升高(P0.05)。与T0时比较,A、B、C组在T2、T3时AMY值明显升高(P0.05);与D组比较,A、B、C组在T3时AMY值明显升高(P0.05),C组升高更明显(P0.01)。结论丙泊酚长链脂肪乳对高脂血症患者血脂的影响较中长链脂肪乳小,更适合用于高脂血症患者全身麻醉。     

Effects of dietary consistency and water content on parotid amylase secretion and gastric starch digestion in rats

The aim was to estimate the significance of oral sensation and mastication in inducing amylase secretion from the parotid gland and subsequent starch digestion in the stomach. Rats were fed three diets of similar chemical composition but different physical presentations. Two were solid, either pellets or powder, and one was liquid. Oral sensory activity would be greatest with the pellets and least with the liquid. Only the pellets would require significant mastication. Three criteria were used to estimate amylase secretion, amylase activity in the stomach, the depletion of glandular amylase activity and plasma amylase concentrations. Gastric starch digestion was estimated by measuring the concentration of reducing-sugars in the stomach contents. Parotid amylase secretion and gastric starch digestion were similar whether rats were fed pelleted or powdered solid food but much lower in rats fed a liquid diet. These findings support the view that it is the contact of dry food with the oral mucosa rather than the jaw movements involved in mastication that stimulates parotid amylase secretion.     

Moderate acute exercise (70% VO2 peak) induces TGF‐β, α‐amylase and IgA in saliva during recovery

Strenuous exercise promotes changes in salivary IgA and can be associated with a high incidence of upper respiratory tract Infections. However, moderate exercise enhances immune function. The effect of exercise on salivary IgA has been well studied, but its effect on other immunological parameters is poorly studied. Thus, this study determined the effect of moderate acute exercise on immunological salivary parameters, such as the levels of cytokines (TGF‐β and IL‐5), IgA, α‐amylase and total protein, over 24 h. Ten male adult subjects exercised for 60 min at an intensity of 70% VO₂ peak. Saliva samples were collected before (‘basal’) and 0, 12 and 24 h after an exercise session. The total salivary protein was lower after 12 and 24 h than immediately after exercise, whereas α‐amylase increased at 12 and 24 h after exercise compared with basal levels. The IgA concentration was increased at 24 h after exercise relative to immediately after exercise, and there was no difference in the IL‐5 while TGF‐β concentration increased in recovery. In conclusion, 70% VO₂ peak exercise does not induce changes immediately after exercise, but after 24 h, it produces an increase in salivary TGF‐β without changing IL‐5.     

Predicting the Peritoneal Absorption of Icodextrin in Rats and Humans Including the Effect of α-Amylase Activity in Dialysate

♦ Background:

Contrary to ultrafiltration, the three-pore model predictions of icodextrin absorption from the peritoneal cavity have not yet been reported likely, in part, due to difficulties in estimating the degradation of glucose-polymer chains by α-amylase activity in dialysate. We incorporated this degradation process in a modified three-pore model of peritoneal transport to predict ultrafiltration and icodextrin absorption simultaneously in rats and humans.

♦ Methods:

Separate three-pore models were constructed for humans and rats. The model for humans was adapted from PD Adequest 2.0 including a clearance term out of the peritoneal cavity to account for the absorption of large molecules to the peritoneal tissues, and considering patients who routinely used icodextrin by establishing steady-state plasma concentrations. The model for rats employed a standard three-pore model in which human kinetic parameters were scaled for a rat based on differences in body weight. Both models described the icodextrin molecular weight (MW) distribution as five distinct MW fractions. First order kinetics was applied using degradation rate constants obtained from previous in-vitro measurements using gel permeation chromatography. Ultrafiltration and absorption were predicted during a 4-hour exchange in rats, and 9 and 14-hour exchanges in humans with slow to fast transport characteristics with and without the effect of amylase activity.

♦ Results:

In rats, the icodextrin MW profile shifted towards the low MW fractions due to complete disappearance of the MW fractions greater than 27.5 kDa. Including the effect of amylase activity (60 U/L) resulted in 21.1% increase in ultrafiltration (UF) (7.6 mL vs 6.0 mL) and 7.1% increase in icodextrin absorption (CHO) (62.5% with vs 58.1%). In humans, the shift in MW profile was less pronounced. The fast transport (H) patient absorbed more icodextrin than the slow transport (L) patient during both 14-hour (H: 47.9% vs L: 40.2%) and 9-hour (H: 37.4% vs L: 31.7%) exchanges. While the UF was higher during the longer exchange, it varied modestly among the patient types (14-hour range: 460 – 509 mL vs 9-hour range: 382 – 389 mL). When averaged over all patients, the increases in UF and CHO during the 14-hour exchange due to amylase activity (7 U/L) were 15% and 1.5%, respectively.

♦ Conclusion:

The icodextrin absorption values predicted by the model agreed with those measured in rats and humans to accurately show the increased absorption in rats. Also, the model confirmed the previous suggestions by predicting an increase in UF specific to amylase activity in dialysate, likely due to the added osmolality by the small molecules generated as a result of the degradation process. As expected, this increase was more pronounced in rats than in humans because of higher dialysate concentrations of amylase in rats.     

康复新液对头颈部肿瘤放疗后重度放射性口腔黏膜炎的治疗作用及对唾液腺的保护作用

目的探讨康复新液对头颈部肿瘤放疗后重度放射性口腔黏膜炎的治疗作用及对唾液腺的保护作用。方法选取2016年10月—2019年10月在鄂东医疗集团市中心医院完成根治性放疗且发生重度放射性口腔黏膜炎的116例头颈部肿瘤患者,按随机数字表法将所有患者分为治疗组和对照组,每组各58例。在常规治疗的基础上,治疗组给予康复新液含服,10 ml/次,3次/d;对照组给予复方氯己定含漱液10~20 ml含漱,2次/d。分别于治疗前、治疗后第7天、治疗后第14天测量两组患者唾液流率、口腔p H值,应用ELISA法检测唾液淀粉酶及表皮生长因子水平。比较两组患者治疗疗效、口腔黏膜愈合时间及口腔真菌感染发生率。结果治疗后两组患者的唾液流率及口腔p H值均呈升高趋势(P<0.01);且治疗后治疗组患者唾液流率及口腔p H值均显著高于对照组患者同期,两组比较差异均有统计学意义(P<0.01)。治疗后两组患者AMS和EGF水平均呈升高趋势(P<0.01);且治疗后治疗组患者AMS和EGF水平显著高于对照组患者同期水平(P<0.01)。治疗后治疗组口腔黏膜愈合时间优于对照组,两组比较差异有统计学意义(t=6.167,P<0.01)。治疗第7天,治疗组有7例发生口腔真菌感染,对照组有16例发生口腔真菌感染,治疗组口腔真菌感染发生率为12.07%,对照为27.59%,两组比较差异有统计学意义(χ²=4.393,P<0.05)。治疗后治疗组总有效率为89.66%(52/58),对照组总有效率为68.97%(40/58),两组比较差异有统计学意义(χ²=7.565,P=0.006)。结论康复新液能提高对重度放射性口腔黏膜炎的治疗疗效,促进损伤黏膜的愈合,降低口腔真菌感染的发生率,其机制可能与促进唾液淀粉酶及表皮生长因子的分泌,提高唾液流率及口腔p H值有关。     

Pupil and salivary indicators of autonomic dysfunction in autism spectrum disorder

Dysregulated tonic pupil size has been reported in autism spectrum disorder (ASD). Among the possible sources of this dysregulation are disruptions in the feedback loop between norepinephrine (NE) and hypothalamic systems. In the current study, we examined afternoon levels of salivary alpha‐amylase (sAA, a putative correlate of NE) and cortisol (used to assess stress‐based responses) in two independent samples of children with ASD. We found a larger pupil size and lower sAA levels in ASD, compared to typical and clinical age‐matched controls. This was substantiated at the individual level, as sAA levels were strongly correlated with tonic pupil size. Relatively little diurnal variation in sAA taken in the home environment in the ASD group was also observed, while typical controls showed a significant linear increase throughout the day. Results are discussed in terms of potential early biomarkers and the elucidation of underlying neural dysfunction in ASD. © 2012 Wiley Periodicals, Inc. Dev Psychobiol 55: 465–482, 2013     

Actinobacterial enzyme inhibitors – A review

Abstract

Actinobacteria have potential as important new sources of enzyme inhibitors. Enzyme inhibitors have great demand in medicine, agriculture and biotechnology. In medicine, enzyme inhibitors can be used as therapeutic agents for bacterial, fungal, viral and parasitic diseases as well as treating cancer, neurodegenerative, immunological and cardiovascular diseases. Enzyme inhibitors are also valuable for the control of carbohydrate-dependent diseases such as diabetes, obesity and hyperlipidemia and melanogenesis in skin. They can be also involved in crop protection against plant pathogens, herbivorous pests and abiotic stresses such as drought. In this review, we discuss about several actinobacterial enzyme inhibitors with various industrial uses and biotechnological applications.