肝硬化患者肠道微生态的变化

目的:观察肝硬化(hepatic cirrhosis,HC)患者粪便中类杆菌、双歧杆菌、肠球菌、大肠杆菌、直肠真杆菌-球形梭菌和梭状芽胞杆菌,比较肝硬化患者与健康对照组之间肠道微生态的差异,以了解肝硬化患者肠道菌群的变化.方法:收集2010-03/2010-12遵义市第一人民医院消化科所收治的肝硬化患者29例,并以13例同期健康在校大学生作对照,收集粪便标本.经固定、玻片上涂片,荧光原位杂交(fluorescent in situ hybridization,FISH),激光共聚焦扫描显微镜(laser scanning confocal microscopy,LSCM)对细菌进行计数观察.应用秩相关检测法进行分析.结果:肝硬化患者与健康对照组比较粪便中双歧杆菌、类杆菌、真杆菌-直肠梭菌、肠球菌、大肠杆菌和梭状芽胞杆菌均较健康对照组显著减少(Z=-4.006、-4.34、-4.399、-4.174、-3.558、-3.95,均P<0.01),6种细菌的比例发生改变,表现为双歧杆菌及类杆菌专性厌氧菌的数量减少,大肠杆菌、直肠真杆菌-球形梭菌、肠球菌和芽胞杆菌的数量增多(P<0.05).细菌数量及比例之间的这种改变与肝硬化病因及肝硬化严重程度(Child-Pugh)分级无明显相关性(P>0.05).结论:肝硬化患者肠道中6种细菌数量及构成比发生改变,肠道微生态的这种变化与肝硬化不同病因及疾病严重程度之间无明显相关性.     

加味胃苓汤对肝硬化腹水患者肠道菌群的影响

目的:观察加味胃苓汤对肝硬化腹水患者肠道菌群的影响。方法:70例肝硬化腹水患者随机分为治疗组与对照组,每组35例,另取35例健康医护人员作为健康组。对照组患者给予常规西药综合治疗,治疗组患者在常规西药综合治疗基础上,加服中药加味胃苓汤,疗程均为4周。观察两组患者治疗前后粪便细菌培养中常见细菌(肠杆菌、肠球菌、葡萄球菌、酵母菌、拟杆菌、双歧杆菌、梭菌、乳酸杆菌)的变化。结果:(1)与健康人比,肝硬化腹水患者肠道菌群肠杆菌、肠球菌、葡萄球菌、酵母菌数量显著增加(P 0. 01),拟杆菌、双歧杆菌、梭菌、乳酸杆菌数量显著下降(P 0.05)。(2)治疗组患者经加味胃苓汤治疗后肠道菌群肠杆菌、肠球菌、葡萄球菌数量显著下降(P 0. 05),拟杆菌、乳酸杆菌数量显著增加(P 0.05);4周治疗后,两组患者比较,治疗组肠道肠杆菌、肠球菌、葡萄球菌数量较对照组低,拟杆菌、乳酸杆菌数量较对照组高(P 0.05)。结论:肝硬化腹水患者存在肠道菌群失衡,表现为肠道肠杆菌、肠球菌、葡萄球菌、酵母菌数量增加,拟杆菌、双歧杆菌、梭菌、乳酸杆菌数量下降。加味胃苓汤可有效改善肝硬化腹水患者的肠道菌群失调情况。     

扬州市初诊为溃疡性结肠炎患者的肠道菌群变化及意义

目的探讨扬州地区初诊为溃疡性结肠炎(UC)患者的肠道菌群组成、分布及改变在UC发病中的作用及意义。方法选取2014年1月至2016年1月期间在扬州市区2家大型综合性医院初诊为UC的124例患者以及100名同期健康体检者,采集受试者的新鲜粪便进行菌群分析,比较双歧杆菌属、乳酸杆菌属、拟杆菌属、梭菌属、肠球菌属及大肠杆菌属这6种菌群定量结果及双歧杆菌/大肠杆菌(B/E)值。结果与健康对照组相比,UC患者肠内双歧杆菌属(5.6±0.3比8.7±0.4)CFU/g、乳酸杆菌属(3.4±0.6比9.5±0.5)CFU/g、拟杆菌属(4.9±0.2比7.9±0.5)CFU/g、梭菌属(5.0±0.3比7.8±0.6)CFU/g,数量明显减少,而大肠杆菌属(8.4±0.4比3.6±0.5)CFU/g、肠球菌属(7.6±0.6比4.4±0.2)CFU/g,数量增加,差异均有统计学意义(P均0.05);细菌培养结果的阳性检出率与菌群数量变化结果基本相符。UC患者B/E1,较健康对照组低且差异有统计学意义(P0.05)。结论与健康对照组相比,UC患者肠道菌群呈失衡状态。在扬州地区UC患者肠道内乳酸杆菌属、双歧杆菌属减少,且乳酸杆菌属减少更明显,提示在益生菌治疗上可能应倾向于应用乳酸杆菌属。     

对鸡只不同日龄不同肠段正常肠菌群的研究

定量测定了雏鸡,中鸡和成鸡的11个正常肠道菌群,结果①随日龄增长双歧杆菌和大肠杆菌显著增加,肠球菌显著减少;②不同肠段作T测验比较,除需氧芽胞杆菌无显著差异外其余均有显著差异(P<0.01);③在空肠和直肠占优势的菌群为双歧杆菌、乳酸杆菌及拟杆菌。     

细菌16SrDNA荧光定量PCR法分析溃疡性结肠炎患者肠道菌群变化

目的 应用实时荧光定量PCR技术对溃疡性结肠炎(ulcerative colitis,UC)患者的粪便菌群进行定量分析.方法 研究对象包括30名UC活动期、30名UC缓解期患者及22名正常对照,收集其粪便标本.根据细菌的16S rDNA序列设计双歧杆菌属、乳酸杆菌属、肠球菌属和大肠杆菌的特异性引物.待测粪便标本提取细菌基因组DNA,进行实时荧光定量PCR反应测定16S rDNA拷贝数,分析不同细菌的数量.结果 UC活动期患者与正常对照相比,粪便中双歧杆菌(8.45±0.92 vs 9.10±0.78)、乳酸杆菌(8.11±0.94 vs 8.69±0.55)数量明显减少(P＜0.05),大肠杆菌(9.88±1.34 vs 9.71±0.92)和肠球菌(7.74±0.63 vs 7.61±0.49)无明显变化(P＞0.05);而UC缓解期患者粪便中4种细菌数量(双歧杆菌9.15±0.81,乳酸杆菌8.51±0.80,大肠杆菌9.54±1.64,肠球菌7.90±0.46)均与正常对照无明显差异(P＞0.05).结论 UC活动期患者粪便双歧杆菌、乳酸杆菌数量较正常对照明显减少,而UC缓解期患者粪便菌群与正常对照无明显差异.提示肠道菌群失调可能是具有UC遗传易感性个体发病的触发因素.     

结直肠癌患者膳食纤维摄入情况对肠道菌群的影响

目的探讨结直肠癌患者膳食纤维的摄入对肠道菌群的影响。方法 280例结直肠癌患者为研究对象,并选取参与体检的290例健康人群作为对照组;采用自行设计的调查问卷调查受试者基本情况及膳食纤维摄入情况。收集两组研究对象粪便,提取粪便DNA,采用荧光定量PCR方法测定受试者肠道菌群水平,分析肠道菌群与大肠癌发病的相关性。结果除谷类与海鲜,结直肠癌组蔬菜、水果、豆类的摄入均明显低于对照组(均P<0.05),肉类的摄入明显高于对照组(P<0.05),总膳食纤维的摄入明显低于对照组研究对象(P<0.05)。结直肠癌患者乳酸杆菌、双歧杆菌明显减少(P<0.05),大肠杆菌、粪肠球菌、屎肠球菌、拟杆菌属、脆弱拟杆菌、单形拟杆菌、多形拟杆菌、吉氏拟杆菌、普通拟杆菌、梭杆菌属、梭菌属、肉毒梭菌、艰难梭菌明显增多(均P<0.05)。在结直肠癌组中,除脆弱拟杆菌、单形拟杆菌外,在对照组中,除吉氏拟杆菌外高膳食纤维亚组与低膳食纤维亚组的各菌群水平均有差异(均P<0.05);在高膳食纤维亚组,结直肠癌患者与对照组研究对象各菌群水平均有差异(均P<0.05)。结直肠癌组与对照组乳酸杆菌、双歧杆菌与膳食纤维水平呈正相关(均P<0.05),粪肠球菌、屎肠球菌、普通拟杆菌、梭杆菌属、梭菌属、肉毒梭菌、艰难梭菌与膳食纤维水平呈负相关(均P<0.05)。结论结直肠癌患者膳食纤维的摄入情况影响肠道菌群水平。     

老年冠心病患者血尿酸、血脂水平与肠道菌群分布的关系研究

目的探讨老年冠心病患者血尿酸、血脂水平与其肠道菌群分布情况的关系。方法选取2018年3月至2019年8月我院收治的老年冠心病患者120例为研究组,选取同期在我院进行体检的健康志愿者120名为对照组。检测比较两组研究对象的血尿酸水平、血脂水平、肠道菌群分布情况;对老年冠心病患者的血尿酸、血脂水平与其肠道菌群数量的关系进行Pearson相关分析。结果研究组患者的血尿酸(BUA)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)水平明显高于对照组健康者,高密度脂蛋白胆固醇(HDL-C)水平明显低于对照组健康者,差异有统计学意义(P0.05)。研究组患者粪便中的双歧杆菌、乳酸杆菌、拟杆菌数量明显少于对照组健康者,大肠杆菌、梭菌、链球菌数量明显多于对照组健康者,差异有统计学意义(P0.05)。Pearson相关分析结果显示,研究组患者的BUA水平与其粪便中的双歧杆菌、乳酸杆菌数量呈负相关,与其粪便中的大肠杆菌数量呈正相关;TG水平与其粪便中的大肠杆菌、梭菌数量呈正相关,与其粪便中的双歧杆菌、乳酸杆菌、拟杆菌数量呈负相关;HDL-C水平与其粪便中的梭菌、链球菌数量呈正相关;LDL-C水平与其粪便中的双歧杆菌、梭菌、链球菌数量呈负相关;TC水平与其粪便中的大肠杆菌数量呈正相关,与其粪便中的双歧杆菌、乳酸杆菌数量呈负相关。结论老年冠心病患者的血脂、血尿酸水平增高与其肠道菌群分布异常有关,肠道菌群可能对患者的血脂水平有重要的影响。     

肠道菌群状态与特应性皮炎病变程度的相关性分析

目的探讨成年特应性皮炎患者粪便中肠道菌群状况与病情严重程度的相关性。方法收集68例成年特应性皮炎患者（观察组）及20例健康查体者（对照组）的粪便标本,采用PCR荧光定量法对粪便中双歧杆菌、乳酸杆菌、大肠杆菌、粪肠球菌和屎肠球菌的数量进行检测;同时用SCORAD标准对患者进行病情评价,分析病情严重程度与肠道菌群变化的相关性。结果观察组粪便中双歧杆菌及乳酸杆菌的数量明显少于对照组（P〈0．01）,病情为轻、中、重度者双歧杆菌及乳酸杆菌数量有组间差异;大肠杆菌、粪肠球菌和屎肠球菌的数量则无明显统计学差异。结论成年特应性皮炎患者肠道菌群数量与病情严重程度有关。     

不同年龄健康人群肠道微生态差异比较

目的 分析不同年龄健康人群肠道微生态的差异,探讨年龄与肠道菌群组成变化的相关性.方法 收集少年组、成年组和老年组健康人群的粪样,对其主要菌群进行细菌培养和计数,采用荧光定量PCR技术分析其主要菌群在属水平上的定性和定量变化,计算其反映肠道定植抗力的指标B/E值(双歧杆菌与肠杆菌数值比).结果 粪便细菌培养结果显示,成年组和老年组的双歧杆菌数量较少年组明显减少(均P＜0.01),乳酸菌数量也明显减少(分别为P＜0.01、P＜0.05);老年组类杆菌和肠杆菌数量较少年组和成年组均显著增加(均P＜0.01);成年组和老年组肠球菌数量较少年组明显增加(分别为P＜0.05、P＜0.01),老年组与成年组比较也明显增加(P＜0.05);老年组的B/E值(0.88±0.13),较少年组(1.15±0.15)和成年组(1.01±0.20)显著减少(均P＜0.05).用荧光定量PCR检测双歧杆菌、类杆菌、肠杆菌数量及B/E值结果差异同细菌培养结果相符;荧光定量PCR检测少年组与老年组的乳酸菌数量差异、少年组与成年组的肠球菌数量差异较培养结果更为显著(定量PCR结果P＜0.01;培养结果P＜0.05).结论 随着年龄的增长,肠道双歧杆菌和乳酸菌数量明显减少,类杆菌、肠杆菌、肠球菌数量显著增加,肠道定植抗力也不断下降.     

肝移植患者肠道双歧杆菌的生态结构

目的探讨肝移植患者肠道双歧杆菌属细菌种群分子生态结构变化特点。方法采用荧光定量PCR技术分析健康人27例、肝硬化患者51例及肝移植后患者113例粪便双歧杆菌在属及种水平上的定性和定量变化。结果与健康人比较,肝移植及肝硬化患者肠道双歧杆菌总量、肠道假小链双歧杆菌或小链双歧杆菌组细菌及青春型双歧杆菌显著减少均P<0.01;肝移植患者肠道长双歧杆菌显著增多(P<0.01)。肝移植患者肠道假小链双歧杆菌或小链双歧杆菌、青春型双歧杆菌、短型双歧杆菌检出率显著低于健康人群均P<0.01。肝移植组患者肠道双歧杆菌多样性显著低于健康人群(X~2=20.1,P<0.01)。结论肝移植及肝硬化患者肠道双歧杆菌种群生态结构均存在显著异常,尤以假小链双歧杆菌或小链双歧杆菌组及青春型双歧杆菌的数量及检出率降低最为显著,肝移植组患者肠道双歧杆菌多样性显著低于健康人群。     

Control of intraabdominal hemorrhage and shock: a comparison of fluid resuscitation, MAST, and balloon occlusion

Our study examined the efficacy of four treatment modalities in controlling hemorrhage and achieving hemodynamic stabilization in hemorrhagic shock: intravenous fluid replacement (IV); military antishock trousers used concomitantly with fluids (MAST); balloon occlusion at the level of the diaphragm with concomitant fluid replacement (balloon); and a combination of MAST inflation, balloon occlusion, and fluid resuscitation (MAST and balloon). Twenty-eight mongrel dogs were anesthetized, and the spleen was exposed and completely crushed. The abdomen was closed, and treatment was initiated and continued for four hours or until the dog died. For all conditions the hematocrit dropped during the course of the experiment; balloon occlusion was effective at slowing this drop (P less than .0001), but MAST had no statistically significant effect. Animals with balloons bled more slowly into the abdominal cavity than did animals in the other two groups (P less than .0001). MAST also were effective at slowing the bleeding (P less than .05). Of the balloon and the MAST and balloon dogs, all except one survived the entire four hours; this difference between balloon and nonballoon dogs is significant (P = .002). MAST did not have a statistically significant effect on survival. Perfusion pressure (PP) declined during the course of the experiment, and the balloon was effective at slowing this decline (P less than .0001); none of the other comparisons was statistically significant.     

A Call to Action to Enhance Filovirus Disease Outbreak Preparedness and Response

The frequency and magnitude of recognized and declared filovirus-disease outbreaks have increased in recent years, while pathogenic filoviruses are potentially ubiquitous throughout sub-Saharan Africa. Meanwhile, the efficiency and effectiveness of filovirus-disease outbreak preparedness and response efforts are currently limited by inherent challenges and persistent shortcomings. This paper delineates some of these challenges and shortcomings and provides a proposal for enhancing future filovirus-disease outbreak preparedness and response. The proposal serves as a call for prompt action by the organizations that comprise filovirus-disease outbreak response teams, namely, Ministries of Health of outbreak-prone countries, the World Health Organization, Médecins Sans Frontières, the Centers for Disease Control and Prevention—Atlanta, and others.     

Interplay between interferon-mediated innate immunity and porcine reproductive and respiratory syndrome virus

Innate immunity is the first line of defense against viral infection, and in turn, viruses have evolved to evade host immune surveillance. As a result, viruses may persist in host and develop chronic infections. Type I interferons (IFN-α/β) are among the most potent antiviral cytokines triggered by viral infections. Porcine reproductive and respiratory syndrome (PRRS) is a disease of pigs that is characterized by negligible induction of type I IFNs and viral persistence for an extended period. For IFN production, RIG-I/MDA5 and JAK-STAT pathways are two major signaling pathways, and recent studies indicate that PRRS virus is armed to modulate type I IFN responses during infection. This review describes the viral strategies for modulation of type I IFN responses. At least three non-structural proteins (Nsp1, Nsp2, and Nsp11) and a structural protein (N nucleocapsid protein) have been identified and characterized to play roles in the IFN suppression and NF-κB pathways. Nsp's are early proteins while N is a late protein, suggesting that additional signaling pathways may be involved in addition to the IFN pathway. The understanding of molecular bases for virus-mediated modulation of host innate immune signaling will help us design new generation vaccines and control PRRS.     

Disease Pandemics and Major Epidemics Arising From New Encounters between Indigenous Viruses and Introduced Crops

Virus disease pandemics and epidemics that occur in the world’s staple food crops pose a major threat to global food security, especially in developing countries with tropical or subtropical climates. Moreover, this threat is escalating rapidly due to increasing difficulties in controlling virus diseases as climate change accelerates and the need to feed the burgeoning global population escalates. One of the main causes of these pandemics and epidemics is the introduction to a new continent of food crops domesticated elsewhere, and their subsequent invasion by damaging virus diseases they never encountered before. This review focusses on providing historical and up-to-date information about pandemics and major epidemics initiated by spillover of indigenous viruses from infected alternative hosts into introduced crops. This spillover requires new encounters at the managed and natural vegetation interface. The principal virus disease pandemic examples described are two (cassava mosaic, cassava brown streak) that threaten food security in sub-Saharan Africa (SSA), and one (tomato yellow leaf curl) doing so globally. A further example describes a virus disease pandemic threatening a major plantation crop producing a vital food export for West Africa (cacao swollen shoot). Also described are two examples of major virus disease epidemics that threaten SSA’s food security (rice yellow mottle, groundnut rosette). In addition, brief accounts are provided of two major maize virus disease epidemics (maize streak in SSA, maize rough dwarf in Mediterranean and Middle Eastern regions), a major rice disease epidemic (rice hoja blanca in the Americas), and damaging tomato tospovirus and begomovirus disease epidemics of tomato that impair food security in different world regions. For each pandemic or major epidemic, the factors involved in driving its initial emergence, and its subsequent increase in importance and geographical distribution, are explained. Finally, clarification is provided over what needs to be done globally to achieve effective management of severe virus disease pandemics and epidemics initiated by spillover events.     

Barrett's Esophagus: Where Do We Stand?

Barrett''s esophagus (BE) is a precursor for esophageal adenocarcinoma, which has an increased incidence rate over the last few decades. Its importance stems from the poor five-year survival of esophageal adenocarcinoma and current data that suggest a survival benefit when surveillance programs are implemented. In this review, we will cover the pathophysiology and natural history of BE and the different endoscopic findings. The prevalence of BE in different geographic areas and the incidence of high-grade dysplasia and adenocarcinoma in this patient population is reviewed. Recent recommendation for screening and surveillance of BE has been covered in this review as well as the efficacy of nonconventional imaging modalities and endoscopic ablation therapies.     

The Technology Transfer from Europe to China in the 17th–18th Centuries: Non-Invasive On-Site XRF and Raman Analyses of Chinese Qing Dynasty Enameled Masterpieces Made Using European Ingredients/Recipes

Two masterpieces of the Qing Dynasty (1644–1912 CE), one in gilded brass (incense burner) decorated with cloisonné enamels stylistically attributed to the end of the Kangxi Emperor’s reign, the other in gold (ewer offered by Napoleon III to the Empress as a birthday present), decorated with both cloisonné and painted enamels bearing the mark of the Qianlong Emperor, were non-invasively studied by optical microscopy, Raman microspectroscopy and X-ray microfluorescence spectroscopy (point measurements and mapping) implemented on-site with mobile instruments. The elemental compositions of the metal substrates and enamels are compared. XRF point measurements and mappings support the identification of the coloring phases and elements obtained by Raman microspectroscopy. Attention was paid to the white (opacifier), blue, yellow, green, and red areas. The demonstration of arsenic-based phases (e.g., lead arsenate apatite) in the blue areas of the ewer, free of manganese, proves the use of cobalt imported from Europe. The high level of potassium confirms the use of smalt as the cobalt source. On the other hand, the significant manganese level indicates the use of Asian cobalt ores for the enamels of the incense burner. The very limited use of the lead pyrochlore pigment (European Naples yellow recipes) in the yellow and soft green cloisonné enamels of the Kangxi incense burner, as well as the use of traditional Chinese recipes for other colors (white, turquoise, dark green, red), reinforces the pioneering character of this object in technical terms at the 17th–18th century turn. The low level of lead in the cloisonné enamels of the incense burner may also be related to the use of European recipes. On the contrary, the Qianlong ewer displays all the enameling techniques imported from Europe to obtain a painted decoration of exceptional quality with the use of complex lead pyrochlore pigments, with or without addition of zinc, as well as cassiterite opacifier.