炎症性肠病患者肠道菌群变化及其与炎性因子的相关性

目的探讨炎症性肠病(IBD)患者肠道菌群的变化,并分析其与炎性因子的相关性。方法选择IBD患者178例,其中活动期112例(活动组)、缓解期66例(缓解组),另选择82例健康查体者作为对照组。采集各组新鲜粪便,使用梯度稀释法定量培养分析肠道菌群;采集静脉血应用ELISA法检测血清IL-6、IL-17、IL-22、IL-33水平。结果与对照组、缓解组比较,活动组粪便中大肠杆菌、肠球菌数量升高,双歧杆菌、乳酸杆菌数量降低,血清IL-6、IL-17、IL-22和IL-33水平升高(P均<0.05)。对照组、缓解组各观察指标比较均无统计学差异。大肠杆菌、肠球菌数量与IL-6、IL-17、IL-22和IL-33水平呈正相关,双歧杆菌、乳酸杆菌数量与IL-6、IL-17、IL-22、IL-33水平均呈负相关(P均<0.05)。结论 IBD活动期患者存在肠道菌群失衡,后者与炎症的发生密切相关。     

急性胰腺炎后患者血清再生相关细胞因子与胰腺功能的相关性研究

目的 探讨血清肝细胞生长因子(HGF)、表皮生长因子(EGF)、碱性成纤维生长因子(bFGF)、再生蛋白(Reg)-1、Reg-4的水平变化对急性胰腺炎(AP)恢复期胰腺内、外分泌功能的影响及机制.方法 根据2007年中国AP诊治指南草案对25例轻症AP恢复期和34例重症AP恢复期患者进行随访研究.同时选取20名健康志愿者作对照.应用酶联免疫吸附法检测血清HGF、EGF、bFGF、Reg-1、Reg-4表达水平,同时检测空腹血糖、胰岛素、C肽及粪弹力蛋白酶(FE)1水平,评估胰腺内、外分泌功能.统计分析胰腺功能与发病时临床指标的相关性以及这些再生相关因子与胰腺功能的相关性.结果 患者组FE1水平[(205.9±18.3)μg/g]较正常对照组[(333.9±19.7)μg/g]显著下降(P<0.01),空腹血糖、胰岛素及C肽水平则显著升高(P<0.01).轻、重症胰腺炎组恢复期胰腺内、外分泌功能差异无统计学意义(P值均>0.05).轻症与重症胰腺炎组HGF、EGF、bFGF、Reg-1、Reg-4表达水平差异无统计学意义(P值均>0.05).AP恢复期重度和轻、中度外分泌功能受损者血清HGF表达水平[分别为(983.76±372.65)和(946.80±254.47)pg/ml]高于外分泌功能正常者[(263.44±110.35)pg/ml,P值均<0.05].AP恢复期糖尿病患者EGF表达水平[(704.41±190.37)pg/ml]高于血糖正常者[(360.03±48.39)pg/ml,P<0.05].血清HGF水平与FE1水平负相关(r=-0.331,P<0.01).AP恢复期是否发生糖耐量异常或糖尿病与急性发病时的CT分级相关(P<0.05).结论 患者在AP恢复期存在明显胰腺内、外分泌功能不全.血清EGF、HGF表达水平可能分别与AP恢复期内、外分泌功能修复有关.     

内镜逆行胰胆管造影后胰腺炎患者炎性因子和氧化应激与胰腺代谢能力的相关性研究

目的 探究内镜逆行胰胆管造影的代谢反应与胰腺功能改变的相关性。方法 择取2020年6月至2021年11月在武安市第一人民医院收治的100例实施内镜逆行胰胆管造影术患者为研究对象,患者年龄28～76岁,平均年龄57.35±8.62岁,其中男性患者67例,女性患者33岁。将其中术后74例未出现急性胰腺炎(AP)患者设为轻症急性胰腺炎组,术后26例出现急性AP患者设为重症急性胰腺炎组。使用核磁共振(NMR)光谱对血清葡萄糖、血清β-羟基丁酸和血清乙酰乙酸进行分析。通过酶联免疫吸附试验检测患者血清淀粉酶和脂肪酶浓度。通过酶联免疫吸附试验检测患者血清细胞因子浓度。通过分光荧光法测定患者血清氧化应激水平。结果 重症急性胰腺炎患者血清葡萄糖、血清β-羟基丁酸和血清乙酰乙酸较轻症急性胰腺炎组升高(P<0.05)。重症急性胰腺炎患者尿液β-羟基丁酸和乙酰乙酸水平较轻症急性胰腺炎组升高(P<0.05)。重症急性胰腺炎患者血清淀粉酶和脂肪酶浓度较轻症急性胰腺炎患者升高(P<0.05)。重症急性胰腺炎患者血清IL-6和CRP浓度较轻症急性胰腺炎组升高(P<0.05)。重症急性胰腺炎患者...     

胰腺外分泌功能试验诊断慢性胰腺炎的进展

用人工合成猪胰泌素行内镜胰腺功能试验、缩胆囊素刺激后脂肪酶峰值测定及^11C蛋氨酸正电子发射体层成像是较有前途地评价胰腺功能的新方法;粪弹性蛋白酶检测因灵敏度和特异度高、相对价廉且无侵入性,可作为筛选慢性胰腺炎高风险人群的首选。     

慢性胰腺炎和胰腺癌发生及发展中肠道微生态的研究进展

肠道微生态对于维持机体健康至关重要.越来越多的研究表明,肠道微生态失衡与胰腺疾病相关,肠道菌群失调在慢性胰腺疾病,如慢性胰腺炎、自身免疫性胰腺炎、慢性酒精性胰腺炎和胰腺癌的发生、发展中发挥着重要作用.重建肠道微生态对胰腺疾病有一定疗效,粪菌移植可能是胰腺疾病的新型治疗策略.     

稳定期慢性阻塞性肺疾病与血清炎性因子的相关性临床治疗分析

目的：分析稳定期 COPD 与血清炎性因子的相关性。方法搜集2012年12月至2014年11月我院稳定期 COPD 43例作为研究组,对照组选取同期健康吸烟者43例。分别采集研究组与对照组外周静脉血,取标本上清液,采用酶联免疫法进行检测,观察研究组与对照组的单核细胞趋化蛋白1(MCP-1)、C 反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)、脑钠肽(BNP)水平,并对两组人员的检测结果进行对比。分析研究组不同圣乔治呼吸问卷(SGRQ)评分、BODE 指数分级患者检测水平,对检测指标与疾病相关性进行研究。结果研究组与对照组血清炎性因子对比,研究组各项指标较高,差异有统计学意义(P <0.05)。检测结果显示疾病与 MCP-1、CRP、TNF-α、BNP 密切相关。结论稳定期 COPD 患者 MCP-1、CRP、TNF-α、BNP 等血清炎性因子明显升高,与疾病有一定相关性。因此,对于此种疾病的治疗,应当充分考虑血清炎性因子的影响,并明确影响程度,确保疾病诊断的准确性,为后续治疗奠定基础。     

急性胰腺炎后胰腺功能和形态变化的研究现状

急性胰腺炎作为临床上常见的疾病，关于其治愈或好转后胰腺功能和形态改变的研究较少。目前认为急性胰腺炎发病后只要去除诱发病因以及相关并发症，胰腺功能和形态就可恢复，但这一观点仍存争议。本文就急性胰腺炎后胰腺功能和形态的变化作一综述。     

细胞因子与胰腺星状细胞在慢性胰腺炎胰腺纤维化中的作用

胰腺星状细胞是产生胰腺纤维化的关键细胞,并最终导致慢性胰腺炎的形成。在此过程中有多种细胞因子参与,而各种因子的产生途径、相互作用机制不尽相同。本就目前所了解的一些细胞因子如：TGFβ1、PDGF、EGF以及NFκB的生物学特征、信号传导机制作一简要综述。     

急性胰腺炎与肠道微生态

急性胰腺炎是常见的急腹症之一,特别是重症急性胰腺炎,发病急,病情重,并发症多,病死率高。分析重症急性胰腺炎的临床经过,其病程呈双峰型变化。在早期,临床表现为全身炎症反应综合征和多器官系统功能不全;而病程中后期以胰腺、胰周脓肿和败血症等感染合并症为主。我科经过20余年的临床实践,率先提出“益活清下法”为主的中西结合治疗,并取得了显著疗效,使急性胰腺炎的病死率控制在10．77％左右,居国内领先水平。     

胰腺外分泌功能检查对慢性胰腺炎的诊断价值

从理论上讲，胰腺外分泌功能检查是诊断慢性胰腺炎(CP)最可靠的方法之一，然而迄今可供临床应用的胰腺外分泌功能检查敏感性和特异性均较差，在胰外分泌功能严重不足时才呈异常表现，临床诊断价值有限。但根据患者临床表现及影像学检查结果，结合胰外分泌功能检查仍有助于了解患者的     

B cell function in patients with chronic pancreatitis and its relation to exocrine pancreatic function

Summary Exocrine pancreatic function was evaluated by a Lundh meal test and a secretin-cholecystokinin test in 16 patients with chronic pancreatitis. B cell function was assessed by measuring the concentration of C-peptide after stimulation with oral glucose and intravenous glucagon. The C-peptide response to intravenous glucagon and oral glucose was closely correlated (r = 0.88,p < 0.01). Plasma C-peptide after glucagon was significantly correlated to the post-prandial concentration of lipase (r = 0.72,p < 0.001), amylase (r=0.64,p < 0.05) and to amylase output (r = 0.64,p < 0.05). Eight out of nine patients treated with insulin had residual B cell function, but it diminished significantly with increasing duration of diabetes. We conclude that B cell function is correlated to pancreatic enzyme secretion and that patients with insulin-treated diabetes secondary to chronic pancreatitis have a residual insulin secretion similar to that of patients with Type 1 (insulin-dependent) diabetes.     

Insulin secretion and pancreatic exocrine function in patients with chronic pancreatitis

Summary The relationship between insulin responses to oral glucose and pancreatic exocrine function were examined in 15 patients with chronic pancreatitis. Good correlations were found between the insulin responses and exocrine pancreatic function measured as the concentrations of pancreatic enzymes in duodenal juice after intravenous cholecystokinin-pancreazymin (CCK-PZ). There appears to be a roughly parallel loss of endocrine and exocrine function in the course of chronic pancreatitis.     

Correlation between pancreatic endocrine and exocrine function and characteristics of pancreatic endocrine function in patients with diabetes mellitus owing to chronic pancreatitis

Summary Conclusion Pancreatic endocrine capacities are remarkably disturbed in patients with pancreatic diabetes owing to calcific pancreatitis as opposed to those owing to noncalcific pancreatitis. Insulin secretion in calcific pancreatitis resembled, that in insulin-dependent diabetes mellitus (IDDM), whereas insulin secretion in noncalcific pancreatitis resembled that in non-IDDM (NIDDM). The involvements of acinar cell and ductal cell function closely correlate with endocrine function (insulin and glucagon secretions) in chronic pancreatitis (pancreatic diabetes). Background We sought to clarify the differences of pancreatic endocrine function between pancreatic diabetes and primary diabetes, and to verify the correlations between pancreatic exocrine and endocrine dysfunction in patients with chronic pancreatitis. Methods Urinary C-peptide (CPR) excretion and fasting plasma glucagon levels in patients with pancreatic diabetes owing to calcific pancreatitis (19 cases) and owing to noncalcific pancreatitis (14 cases) were studied in comparison with those in patients with insulin-dependent diabetes mellitus (IDDM, 23 cases), noninsulin-dependent diabetes (NIDDM, 18 cases), and in healthy controls (11 cases). In addition, pancreatic exocrine function was investigated in patients with chronic pancreatitis (calcific and noncalcific) and in healthy controls. The correlation between pancreatic exocrine and endocrine function was studied. Results The urinary CPR excetion in controls was 94.9±20.5 μg/d. The urinary CPR excretion in calcific pancreatitis was 12.8±7.4 μg/d and it resembled that in IDDM (9.4±5.8 μg/d). The urinary CPR excretion in noncalcific pancreatitis was 41.5±30.1 μg/d, being similar to that in NIDDM (49.3±21.0 μg/d). The plasma glucagon level in calcific pancreatitis was 64.1±15.9 ρg/mL, which was significantly lower than the values in IDDM (111.2±50.2 ρg/mL) and NIDDM (96.7±21.9 ρg/mL). The plasma glucagon level in calcific and noncalcific pancreratitis (88.4±29.6 ρg/mL) were significantly lower than that in controls (12.9±21.6 ρg/mL). The residual capacities of acinar cells and ductal cells were strongly correlated with urinary CPR excretion and plasma glucagon concentration.     

Risk factors of post-ERCP pancreatitis in high-risk patients despite prevention with prophylactic pancreatic stents

Abstract

Objectives: To analyze risk factors of post-ERCP pancreatitis (PEP) in high risk patients in whom prophylactic pancreatic stents (PPSs) were intended to use to prevent endoscopic retrograde cholangiography (ERCP)-related complications.

Patients and methods: Three hundred and seventeen high-risk patients for developing PEP were considered for preventive pancreatic stent placement in our endoscopy unit over 5 years. 5 Fr, 3–5?cm long PPSs were used. All data were collected in a predefined database. Development of PEP despite PPS placement was analyzed.

Results: PEP occurred in 29 of 288 successfully stented patients (10.07%; 24 mild, four moderate, one severe). PPS was protective against all risks factors except for sphincter of Oddi dysfunction (SOD). PPS related complication rate was 2.78% (n?=?8). Unsuccessful stenting occurred in 29 patients (9.15%), PEP developed in 41.38% (n?=?12; seven mild, four moderate, one severe). Those patients who had more patient related risk factors were more likely to develop PEP despite preventive measures with PPS. On the contrary, PPS placement was less successful in patients who had more procedure related risk factors.

Conclusions: PPS is protective against all risks factors of PEP except for SOD in high-risk patients. More vulnerable patients who have more patient-related risk factors are more likely to develop PEP despite PPS is used, while more complex procedures predispose to unsuccessful PPS placement in patients with more procedure-related risk factors. PPS insertion in high-risk patients is effective and safe preventive method and the procedure related complication rate is reasonably low.     

Pancreatic stenting for the preservation of pancreatic function in chronic pancreatitis with stricture

Background: Although many reports have documented pain relief achieved by pancreatic stenting, the effect of stenting on pancreatic function is less clear. In addition, the effects of stent caliber and patency have not been considered in most previous studies. Pain and pancreatic function after stenting of the main pancreatic duct (MPD) were examined. Methods: Records of 24 patients with chronic pancreatitis who had an MPD stricture treated with a 10‐Fr stent from June 1996 to June 2002 were reviewed. The average age was 57.0 ± 1 years, and the male : female ratio was 7 : 1. Eleven patients had diabetes mellitus. Stent patency, pancreatic pain and pancreatic endocrine and exocrine function were examined before stenting and 6 months after stenting. Stenting was continued for 1 year or more, with repeated stent exchange every 3 months. Results: The stent became occluded in 29% of cases, migration occurred in 15% of cases, and the 50% patency time was 125 days. Pancreatic pain was relieved by stenting in all cases. The diameter of the MPD, the Bentiromide test value, weight and body mass index were improved. Conclusion: Stenting relieves blockage of the main pancreatic duct and provides both pain relief and preservation of residual pancreatic function.     

支气管哮喘患者血清炎症因子与肺功能相关性研究简

目的 探讨IL-2、IL-6、IL-8和TNF-α在支气管哮喘发病机制中的作用以及与肺功能的相关性.方法 以98例支气管哮喘患者为研究对象.以55例健康查体者作为对照组.结果 ①IL-6、IL-8、TNF-α水平在发病组明显高于稳定组,IL-2明显低于稳定组;稳定组IL-8和TNF-α均低于对照组.②随着严重度分期的升高,IL-6、IL-8、TNF-α水平呈进行性上升,IL-2水平呈进行性下降.③在发病组,IL-2与FEV1%pre呈正相关;IL-6、IL-8、TNF-α分别与FEV1%pre均呈负相关.在稳定组,IL-8、TNF-α与FEV1%pre仍呈负相关.结论细胞因子在一定程度可反应气道炎症的严重程度,其与肺功能之间均存在相关性.     

Relationship between enteral nutrition and serum levels of inflammatory factors and cardiac function in elderly patients with heart failure: A protocol for systematic review and meta-analysis

Background: Published studies investigating enteral nutrition''s effect on serum inflammatory factors and the cardiac function of malnourished elderly patients with heart failure (HF) are of poor quality, with small sample sizes, and involve a homogeneous population. Therefore, in order to provide new medical evidence for clinical treatment, we undertook a systematic review and meta-analysis to assess the relationship between enteral nutrition and serum levels of inflammatory factors and cardiac function in elderly patients with HF.Methods: The protocol was written following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement guidelines. Electronic databases including Web of Science, Embase, PubMed, Wanfang, Data, Scopus, Science Direct, Cochrane Library will be searched in April 2021 by 2 independent reviewers. The primary outcome is body mass index, triceps skin fold thickness, upper arm muscle circumference, serum total protein, albumin, and hemoglobin''s change in index; secondary outcomes include left ventricular ejection fraction, B-type natriuretic peptide, interleukin-6, C-reactive protein, and tumor necrosis factor-α. The risk of bias assessment of the included studies was performed by 2 authors independently using the tool recommended in the Cochrane Handbook for Systematic Reviews of Interventions (version 5.1.0). We will perform meta-analysis using Review Manager Software.Results: The review will add to the existing literature by showing compelling evidence and improved guidance in clinic settings.Conclusion: Its findings will provide helpful evidence for the application of enteral nutrition in elderly patients with HF.OSF registration number:10.17605/OSF.IO/RTYBP.     

肝癌患者肠道微生态结构变化的特点分析

目的探讨原发性肝癌患者肠道菌群结构的变化。方法选择2017年9月至2018年12月广东省第二人民医院诊疗的原发性肝癌患者87例,另取健康体检者80名作为健康对照。制备微生物基因组DNA后Illumina平台进行高通量测序。结果原发性肝癌组和健康对照组间α多样性差异无统计学意义(P>0.05)。肝癌组拟杆菌门和变形菌门所占百分比为(56.41±4.63)%和(9.26±1.82)%,显著高于健康对照组的(53.32±4.22)%和(7.42±1.16)%(均P<0.05)。肝癌组厚壁菌门和放线菌门所占百分比为(32.62±3.75)%和(0.34±0.05)%,显著低于健康对照组的(37.25±4.13)%和(0.62±0.11)%(均P<0.05)。肝癌组拟杆菌属和大肠杆菌螺旋杆菌属所占百分比为(50.83±4.15)%和(11.35±1.87)%,显著高于健康对照组的(42.45±3.84)%和(8.52±1.71)%(均P<0.01)。肝癌组双歧杆菌属和梭菌属所占百分比为(21.13±3.64)%和(10.44±1.25)%,显著低于健康对照组的(28.54±4.13)%和(14.28±1.52)%(均P<0.01)。结论肝癌患者肠道微生态系统中拟杆菌以及其隶属的拟杆菌门,大肠杆菌螺旋杆菌属属以及其隶属的变形菌门所占比例明显著高于对照组,双歧杆菌属以及其隶属的放线菌门和梭菌属以及其隶属的厚壁菌门所占比例明显著低于对照组。     

支原体肺炎患儿血清IgM、IgG、IgA、T细胞亚群及炎症因子水平观察

目的 观察支原体肺炎患儿血清IgM、IgG、IgA、T细胞亚群、炎症因子水平,并分析其临床意义。方法 选取2015年2月—2019年2月在我院接受治疗的支原体肺炎患儿为观察对象,同时选取同期在我院体检的健康儿童作为对照,观察2组研究对象以及不同病情程度的支原体肺炎患儿血清IgM、IgG、IgA、T细胞亚群、炎症因子水平的差异。结果 支原体肺炎患儿IgA、CD3+T细胞水平均低于对照组(P均<0.05),CD4+T细胞、CD8+T细胞、IL-6、超敏C-反应蛋白(hypersensitiveC-reactiveprotein,hs-CRP)水平均高于对照组(P均<0.05),2组的IgM、IgG水平差异均无统计学意义(P均>0.05)。重症组患儿IgA、CD3+T细胞水平低于轻症组,CD4+T细胞、CD8+T细胞、IL-6、hs-CRP水平均高于轻症组(P均<0.05),2组的IgM、IgG水平差异均无统计学意义(P均>0.05)。结论 支原体肺炎患儿IgA、CD3+T细胞水平较低,CD4+T细胞、CD8+T细胞、IL-6、hs-CRP水平较高,且与患儿的病情严重程度有关。