健脾渗湿汤对晚期大肠癌患者肠道微生态的影响

目的：研究中药健脾渗湿汤对晚期大肠癌化疗患者肠道微生态的影响及临床泄泻治疗作用。方法：60例晚期大肠癌患者,随机分为治疗组和对照组,治疗组30例,采用健脾渗湿汤联合化疗,化疗方案采用FOLFOX4方案;对照组30例,单纯化疗,方案同治疗组。4周期后,观察临床泄泻疗效;治疗前后粪便茵培养,对比肠道常驻茵（肠杆菌、肠球菌、双歧杆菌、乳酸杆菌）指标的变化。并分别观察两组患者治疗前后kamofsky（KPS）评分,食欲及体重方面的变化。结果：治疗组与对照组总有效率分别为86．7％和63．3％（P〈0．05）。与对照组比较,治疗组双歧杆菌及乳杆茵明显增多（P〈0．01）。两组患者在karnofsky评分,食欲及体重方面比较差异有统计学意义（P〈0．05）。结论：健脾渗湿汤具有调整肠道菌群的作用,联合化疗治疗大肠癌脾虚湿盛泄泻疗效显著,可提高患者生活质量。     

合生元长期治疗肝硬化的肠道微生态变化

目的观察肝硬化患者粪便中菌群的情况,为了解肝硬化患者肠道菌群的变化比较肝硬化患者与健康对照组之间的肠道微生态的差异进行综合分析比较。给予合生元(乳果糖和双歧三联活菌片)治疗后观察对比治疗组与肝硬化对照组肠道微生态的变化。方法收集2012年3月至2014年12月烟台市莱阳中心医院感染科所收治的肝硬化患者78例,随机分为肝硬化对照组和合生元组,合生元组在常规保肝抗病毒的基础上给予双歧三联活菌片(1.5 g,1天3次)及乳果糖(10 mL,1天3次),疗程为96周,肝硬化对照组,仅给予保肝、抗病毒、白蛋白等常规治疗。并以15例同期健康在校大学生作为健康对照组。测定治疗前后肠道菌群菌落计数,并用秩相关检测法进行分析。结果肝硬化组患者与正常对照组相比存在不同程度的肠道菌群失调,临床表现主要为:双歧杆菌减少(10.10±0.95比8.10±1.23,P<0.05)。给予合生元治疗后,合生元组双歧杆菌较对照组明显增多(9.98±0.85比8.40±1.05),差异有显著性(P值均<0.05)。结论根据研究发现肝硬化患者临床中存在肠道菌群失调的现象。益生菌制剂能有效改善临床肝硬化患者肠道菌群失调的表现症状。     

食物蛋白过敏与肠道微生态的国内外研究进展

目的随着目前全球食物蛋白过敏的患病率逐渐增加,其发病机制受到重视,研究发现食物蛋白过敏和肠道微生态系统密切相关。肠道微生态系统指正常微生物群以其宿主肠道组织和细胞及其代谢产物为环境,在长期进化过程中形成的能独立进行物质、能量及信息相互交流的统一的系统,其功能和结构的改变可导致食物蛋白过敏发生。维持肠道菌群的多样性及其与宿主之间的微生态平衡有利于维持正常的免疫应答。通过研究肠道菌群与食物蛋白过敏的联系,可以了解以肠道菌群为靶点预防及治疗食物蛋白过敏的潜在作用。     

微生态调节剂对烧伤大鼠肠道菌群失调的调节作用

采用含有肠粘膜原籍菌群 (双歧杆菌、乳酸杆菌 )的益生菌制剂和其生长促进剂 (低聚果糖 )的合生素制剂喂服烧伤大鼠 ,定量检测了肠道主要菌群。结果显示大鼠肠道主要生理性厌氧菌群基本稳定 ,肠道条件致病菌群无异常增高。提示微生态调节剂能够快速补充因烧伤而缺少的生理性菌群 ,避免肠道菌群失调症的发生     

微生态类药物的研究进展与临床应用评价

目的:评价微生态类药物制剂分类、临床应用情况和应用原则,以供临床用药参考。方法:通过查阅近期国内外文献进行总结、分析。结果与结论:微生态制剂作为新兴的一种生物制品,已经越来越多地引起医药界的重视,并为多种疾病的治疗提供了相应的辅助甚至替代的方法,但是由于其上市时间不长,因此关于其作用的各种参数报道较少,仍有待循证医学的进一步证实。     

肠道菌群与微生态制剂

肠道菌群与人体有着非常密切的联系,越来越多的研究显示,正常菌群在消化、免疫和抗病方面有着不可替代的作用,而菌群失调更是与许多疾病的发生、发展及转归密切相关。本文就肠道菌群的组成、数量、与疾病的关系及微生态制剂的应用做一综述。1胃肠道菌群的概况肠道微生态系统是人体最复杂的微生态系统。成人胃肠道中定植着1 000~1 150种菌种,微生物数量多达1 013~1 014个,约为人体细胞总数的10倍以上[1],     

肠道微生态与慢性疾病研究进展

肠道微生态是人体最主要最复杂的微生态系统,近年来其对人体健康与疾病的影响受到了广泛学者的关注。慢性疾病的发生与多种因素相关,肠道微生物可通过多种途径和机制参与慢性病的发生与发展。随着技术的飞跃发展,有关肠道微生态的研究取得了巨大的进展。本文对近年来肠道微生态与慢性病关系的研究进展进行综述,旨在为未来临床慢性病的诊治提供新的思路。     

微生态制剂在消化系统疾病中的应用

目的:评价微生态制剂在消化系统疾病中的临床疗效。方法:查阅近几年国内外相关文献,就微生态制剂应用中的相关问题,如临床治疗范围、与抗生素合用、如何正确使用等进行了探讨。结果及结论:微生态制剂在预防治疗急慢性感染性腹泻、抗生素相关性腹泻、肠易激综合征、根除幽门螺旋杆菌辅助治疗等疗效肯定,在临床中得到广泛应用。关于动力障碍性疾病,微生态制剂是否可作为动力障碍性疾病治疗的一种选择还需进一步证实。     

微生态制剂临床应用进展

<正> 微生态学(Microecoloy)于1977年由德国学者Volker Rush提出,是一门在细胞或分子水平上研究微生物层次生态规律的学科,在医学保健、疾病预防等方面具有重要的价值。近年来,由于人们生活方式的改变,广谱高效抗生素的应用,放疗、化疗的广泛使用,使人体正常菌群发生改变和失调,     

Regorafenib in the treatment of colorectal cancer

Introduction: Colorectal cancer (CRC) is among the most frequently diagnosed malignancies, and is commonly associated with metastatic disease at presentation. While chemotherapy represents a mainstay of management, options at the time of disease progression are limited. Regorafenib is a novel multikinase inhibitor which has been evaluated for patients with chemo-refractory metastatic CRC (mCRC) and is currently approved for use in a last-line-of-treatment setting.

Areas covered: Articles searchable on MEDLINE/PubMed were reviewed to provide context for use of regorafenib in the management of mCRC. Specific drug properties are discussed, including chemistry, pharmacodynamics, pharmacokinetics, and metabolism. Additionally, clinical efficacy is reported with consideration of Phases I–III data.

Expert opinion: Phase III evaluation has confirmed the efficacy of regorafenib for patients with chemo-refractory mCRC. Importantly, the rapid accrual of the CORRECT trial revealed the degree of unmet need for this patient population, and proved that it was feasible to compare novel agents to placebo when multiple lines of standard therapy have failed. In the coming years, the role of regorafenib in the management of mCRC should be further clarified, especially through identification of the patient population with greatest anticipated benefit and exploration of its use as an adjuvant or maintenance agent.     

Epirubicin in colorectal cancer

Summary Epirubicin, a stereoisomer of doxorubicin with suggested lower potential for cardiotoxicity in experimental animal tumor systems, was studied in a disease-oriented phase II trial in patients with advanced colorectal cancer. The drug was given as a direct iv injection of 90 mg/m² q 3 weeks. No objective response was observed in 52 evaluable patients with colon (n = 34) and rectal (n = 18) carcinoma. Fourteen patients (27%) had stable disease for a median of four treatment courses. Leukopenia (88%), nausea and vomiting (71%) and alopecia (54%) were the most common toxic effects.We conclude that epirubicin at the present dose and schedule is an ineffective agent in patients with metastatic colorectal cancer.     

Exposure to bisphosphonates and risk of colorectal cancer

Animal and in vitro studies suggest that the use of bisphosphonates (BPs) may be associated with reduced risk for colorectal cancer (CRC). However, results from these studies have been inconsistent. The aim of our study was to review and summarize the evidence provided by longitudinal studies on the association between BP use and CRC risk A comprehensive literature search for articles published up to October 2012 was performed. Prior to performing a meta-analysis, the studies were evaluated for publication bias and heterogeneity. Relative risks (RRs) or odds ratios were calculated. Six reports (four case–control studies and two cohort studies) published between 2010 and 2012 were identified. There was evidence of an association between any use of BPs and CRC risk using a fixed-effects model (RR = 0.80, 95% confidence interval = 0.74, 0.85) and a random-effects model (RR = 0.80, 95% confidence interval = 0.71, 0.90). However, we did not observe any evidence of a trend with increasing duration of use. Our findings indicate that there is evidence of an association between any use of BP and reduced CRC risk. However, this subject deserves further investigation.     

阿司匹林在结直肠癌防治中的研究进展

结直肠癌是我国常见的恶性肿瘤。尽管结直肠的致残率和致死率已有下降,且近十年对于结直肠癌的系统治疗有显著进展,但对其有效的预防措施与辅助疗法仍有待进一步研究。阿司匹林是解热镇痛类的经典药物,在风湿免疫疾病及心脑血管疾病有广泛的应用。近年来研究发现阿司匹林可降低结直肠腺瘤及结直肠癌的发病率。本文拟就阿司匹林对结直肠癌预防与治疗中的研究进展进行综述。     

Modulating Gut Microbiota: An Emerging Approach in the Prevention and Treatment of Multiple Sclerosis

Multiple sclerosis (MS) is a progressive neuromuscular disorder characterized by demyelination of neurons of the central nervous system (CNS). The pathogenesis of the disorder is described as an autoimmune attack targeting the myelin sheath of nerve cell axons in the CNS. Available treatments only reduce the risk of relapse, prolonging the remissions of neurological symptoms and halt the progression of the disorder. Among the new ways of targeting neurological disorders, including MS, there is modulation of gut microbiota since the link between gut microbiota has been rethought within the term gut-brain axis. Gut microbiota is known to help the body with essential functions such as vitamin production and positive regulation of immune, inflammatory, and metabolic pathways. High consumption of saturated fatty acids, gluten, salt, alcohol, artificial sweeteners, or antibiotics is the responsible factor for causing gut dysbiosis. The latter can lead to dysregulation of immune and inflammatory pathways, which eventually results in leaky gut syndrome, systemic inflammation, autoimmune reactions, and increased susceptibility to infections. In modern medicine, scientists have mostly focused on the modulation of gut microbiota in the development of novel and effective therapeutic strategies for numerous disorders, with probiotics and prebiotics being the most widely studied in this regard. Several pieces of evidence from preclinical and clinical studies have supported the positive impact of probiotic and/or prebiotic intake on gut microbiota and MS. This review aims to link gut dysbiosis with the development/progression of MS, and the potential of modulation of gut microbiota in the therapeutics of the disease.     

Putative mechanisms of action for indole-3-carbinol in the prevention of colorectal cancer

Background: Multiple factors are known to contribute to the development of cancer and numerous agents have been shown to confer some protection. Diets high in vegetables, especially cruciferous vegetables (broccoli, Brussels sprouts, cabbage etc.) provide such protection. Objective: To define the phytonutrients within this group of vegetables and how their chemoprotective properties might be conferred. Methods: Cruciferous vegetables provide the only human dietary source of a class of phytonutrients, the glucosinolates. The glucosinolate breakdown products, which include indole-3-carbinol and sulforaphane, have demonstrated various anticancer actions in laboratory studies. We give a brief overview of current understanding of the chemopreventive pathways for indole-3-carbinol in various human cancers and how this may relate, in particular, to colorectal cancer; the supporting evidence; and our opinion of its anticancer properties. The review is limited by the lack of bioavailability data in humans. Results: Indole-3-carbinol interacts with a multitude of intracellular processes, which may halt tumourgenesis and induce apoptosis.     

大肠癌组织癌细胞中 P-选择素的表达及其临床病理意义

摘要： 目的 探讨 P-选择素蛋白在大肠癌组织癌细胞中的表达及其临床病理意义。方法 运用免疫组织化学 法, 采用 P-选择素抗体检测 116 例大肠癌组织和 57 例癌旁正常组织 P-选择素的表达情况, 比较和分析 P-选择素 在大肠癌组织癌细胞和正常肠黏膜组织中的表达差异及其临床病理意义。结果 P-选择素在大肠癌组织中的癌细 胞、 血管内皮细胞均有表达。肿瘤细胞 P-选择素阳性表达率（77.6%, 90/116）明显高于癌旁正常肠黏膜组织中腺上 皮细胞 P-选择素的阳性表达率（17.5%, 10/57）, 差异有统计学意义（χ2=56.49, P＜0.05）。然而, 肿瘤细胞 P-选择素 阳性表达率在不同肿瘤直径、 分化程度、 浸润深度和有无淋巴结转移患者间比较差异无统计学意义（80.6% vs. 74.1%、 79.0% vs. 74.3%、 78.4% vs. 76.9%、 82.7% vs. 73.4%, 均 P＞0.05）。结论 大肠癌肿瘤组织中癌细胞表达 P-选 择素是该肿瘤的重要特征     

结直肠癌肝转移的诊治

结直肠癌是常见恶性肿瘤,其中肝转移是影响结直肠癌的生存率的重要因素。重视肝转移的早期诊断和适当的治疗,是社区医生必须掌握和了解的知识和技能。