内镜下不同阑尾内口分型之间小肠细菌过度生长情况的比较

目的探讨内镜下不同形态阑尾内口的小肠细菌过度生长(SIBO)情况。方法从门诊健康体检人群中筛选出153例,进行葡萄糖氢呼气试验检查,记录SIBO情况,并进行结肠镜检查,记录阑尾内口形态,依据结肠镜下阑尾内口形态分为漏斗型、膜样型和裂隙型3组,将3组人群的SIBO情况进行对比分析。结果①体检人群中阑尾内口形态比例:漏斗型63.4%(97/153)膜样型22.2%(34/153)裂隙型14.4%(22/153);②漏斗型组人群SIBO阳性率明显高于膜样型组和裂隙型组,差异有统计学意义(P 0.01);③膜样型组人群SIBO阳性率明显高于裂隙型组,两者比较差异有统计学意义(P 0.01)。结论内镜下阑尾内口形态比例漏斗型远高于膜样型和裂隙型,临床上应高度重视阑尾内口漏斗型人群有易并发SIBO的可能。     

Vitamin B12 and health

OBJECTIVE

To review recent evidence that suggests vitamin B12 is associated with risk reduction for some chronic diseases and birth defects.

QUALITY OF EVIDENCE

A MEDLINE search from 1999 to 2007 was performed using the key word vitamin B12. The most relevant articles (129) dealt with cardiovascular disease, cancer, mental health, and birth outcomes; most studies presented level II evidence.

MAIN MESSAGE

Vitamin B12 might confer health benefits; however, such benefits are difficult to ascertain because of the complementary functions of vitamin B12 and folic acid. Vitamin B12 might lower high homocysteine levels below a threshold level achieved by folic acid alone. Furthermore, the interactions between the nutritional environment and genotype might have an important influence on vitamin B12, chronic disease risk, and risk of neural tube defects.

CONCLUSION

Vitamin B12 might help protect against chronic disease and neural tube defects, but more research, particularly in the area of nutritional genomics, is needed to determine how vitamin B12 might augment the benefits of folic acid. Some consideration should be given to the potential value of fortifying foods with vitamin B12 in addition to the current mandatory folic acid fortification of grains.     

Small intestine bacterial overgrowth does not correspond to intestinal inflammation in cystic fibrosis

Abstract

Introduction. Small intestine bacterial overgrowth (SIBO) has been reported in cystic fibrosis (CF) patients. However, the potential link to intestinal inflammation has not been studied so far. Therefore, we aimed to assess whether SIBO correlates with intestinal inflammation in CF patients. Material and methods. As a preliminary study, we assessed whether calprotectin is detectable in sputum expectorated by 10 CF patients. Since significant immunoreactivity was documented, in the major study we have included exclusively CF subjects not expectorating sputum for at least two weeks. Fecal calprotectin was measured in 25 CF patients and 30 healthy subjects (HS). All CF subjects were tested for the presence of SIBO using the hydrogen-methane breath test (BT). According to obtained results CF patients were divided into SIBO positive and negative subgroups. Subsequently, the intensity of intestinal inflammation in both subgroups was compared. Results. Fecal calprotectin concentrations in CF patients (range: 1.8–302.5; median 80.0 mg/L) were significantly higher (p < 0.00001) than in HS (not detectable – 15.5; 2.5 mg/L). Calprotectin levels were abnormal in 21 (84%) studied CF subjects and none of HS. Abnormal BT results were found in 10 (40.0%) of CF patients. Calprotectin concentrations in SIBO positive and negative patients did not differ. Conclusions. Gastrointestinal inflammation is a frequent finding in cystic fibrosis patients. However, small intestine bacterial overgrowth does not seem to be the major or at least not the only determinant of intestinal inflammation. Indirect measures of intestinal inflammation in CF patients may give false positive results.     

肝硬化失代偿期患者病因及分级与小肠细菌过度生长的关系研究

目的 研究肝硬化失代偿期患者肝硬化病因及肝硬化分级与小肠细菌过度生长的关系.方法 选取2018年1月至2019年1月洪湖市中医医院收治的178例肝硬化失代偿期患者(Child-Pugh分级B级98例,C级80例)作为观察组,120例肝纤维化患者作为肝纤维化组,另选择同期50例体检健康者作为对照组.将观察组分为小肠细菌过...     

Unconjugated serum bile acids as a marker of small intestinal bacterial overgrowth

Non-invasive methods to detect small intestinal bacterial overgrowth often lack specificity in patients who have undergone an ileal resection or have an accelerated intestinal transit. Since elevated serum unconjugated bile acid levels have been found in patients with clinical signs of bacterial overgrowth, we studied the clinical value of unconjugated serum bile acids as a marker of small intestinal bacterial overgrowth. Patients with culture-proven bacterial overgrowth had significantly elevated fasting unconjugated serum bile acid levels (median and range: 4.5; 1.4-21.5 mumol l-1) as compared to healthy subjects (0.9; 0.3-1.7 mumol l-1, P less than 0.005), to persons with an accelerated intestinal transit (1.0; 0.3-1.9 mumol l-1, P less than 0.005) and to persons who have undergone an ileal resection (2.1; 0.7-3.6 mumol l-1, P less than 0.005). The same was true 30 and 60 min after ingestion of a Lundh meal. Serum unconjugated bile acid levels above 4 mumol l-1 were found in eight of 10 patients with culture-proven small intestinal bacterial overgrowth whereas serum levels above 4 mumol l-1 were found in none of the patients from the three control groups. These results suggest that determination of unconjugated serum bile acids is of clinical value in the evaluation of patients suspected of small intestine bacterial overgrowth.     

Vitamin B12 assays compared by use of patients' sera with low vitamin B12 content

We compared four radioisotope dilution (RD) methods and a microbiological assay for measuring concentrations of vitamin B12 in a selected panel of serum samples from patients known to be deficient in the vitamin. Low (less than 100 ng/L) and borderline (100-180 ng/L) results were similar between methods, but use of the manufacturers' recommended ranges for borderline results would have changed the diagnostic classifications for 22 of 38 samples. Results of all the RD methods inter-correlated well, but less so with the microbiological assay. Borderline, nondiagnostic results were common to all methods, and no apparent advantage was gained from using the microbiological assay.     

The Role of the Pancreas in Vitamin B12 Absorption: Studies of Vitamin B12 Absorption in Partially Pancreatectomized Rats

The effect of partial pancreatectomy (80-90%) on vitamin B(12) absorption was studied in the rat. The absorption of 5 ng of (57)Co-labeled vitamin B(12) was significantly reduced from 70 +/-2.5% (mean +/-SE) in control and sham-operated rats to 32 +/-2.6% in partially pancreatectomized rats. Hog pancreatic extract (0.17 g/kg) improved vitamin B(12) absorption from 30.0 to 61.0% in partially pancreatectomized rats but did not alter vitamin B(12) absorption in control rats. Chloramphenicol did not enhance vitamin B(12) absorption in partially pancreatectomized rats with pancreatic extract-improved vitamin B(12) malabsorption. The partially pancreatectomized rats with pancreatic extract-improved vitamin B(12) malabsorption were sacrificed and the stomach and small bowel studied in vitro to further define the pathogenesis of the vitamin B(12) malabsorption. Rat gastric intrinsic factor stimulated vitamin B(12) uptake by intestinal sacs prepared from partially pancreatectomized rats 3.1-fold. Gastric intrinsic factor prepared from partially pancreatectomized rats was as effective in promoting vitamin B(12) uptake by rat intestinal sacs as intrinsic factor prepared from control rats. These data indicate that partially pancreatectomized rats develop an abnormality in the absorption of labeled vitamin B(12) which can be corrected by pancreatic extract. The vitamin B(12) malabsorption is due to neither an alteration in gastric intrinsic factor activity nor an impairment of the intrinsic factor-vitamin B(12) receptor in the intestine. It is suggested that in the partially pancreatectomized rats the intrinsic factor-vitamin B(12) complex exists in a form which is not available for absorption.     

云南白药与维生素B12液外敷治疗痛风性关节炎

痛风是核蛋白及嘌呤代谢失调 ,血尿酸增高引起组织损伤的一种异质性疾病。其特点是特征性急性关节炎反复发作 ,关节红、肿、热、痛 ,活动受限。痛风的急性期常在午夜突然发病 ,病人因疼痛而惊醒 ,给病人带来莫大的痛苦。为了减轻病人的痛苦 ,自 1999年 11月— 2 0 0 1年 5月 ,应用云南白药与维生素 B1 2 液外敷治疗痛风性关节炎 6 6例 ,疗效显著。1　资料与方法1.1　临床资料　 1999年 11月— 2 0 0 1年 5月收治住院痛风病人 132例 ,将其随机分为治疗组和对照组各 6 6例。治疗组 :男6 4例 ,女 2例 ,年龄 4 5岁～ 78岁 ;对照组 :男 6 3例 ,…     

Vitamin B12 deficiency: issues in nursing care.

Vitamin B12 deficiency is a relatively common occurrence with potentially devastating consequences. The wide range of etiologies and symptoms makes it imperative for the nurse to use a comprehensive approach to assessing and managing the patient with vitamin B12 deficiency.     

碘伏、维生素B12治疗艾滋病口腔溃疡病人的护理

艾滋病即获得性免疫缺陷综合征 ,由于感染人类免疫缺陷病毒 (ＨＩＶ) ,造成多系统损害 ,免疫功能低下 ,而继发真菌、细菌、病毒感染而发生口腔溃疡。此外 ,由于慢性复发性腮腺炎 ,腮腺功能的减退或丧失 ,更增加了艾滋病病人口腔感染的机会 ,无论感染的病原体种类如何 ,它都属于全身机会性感染的一部分 ,并反复发作 ,给病人带来持续性疼痛 ,导致咀嚼吞咽困难以及味觉的改变 ,影响食欲及进食 ,造成营养进一步缺乏 ,水电解质紊乱 ,低蛋白血症 ,甚至发生败血症而死亡。因而有效的口腔护理 ,预防和减轻病人口腔感染 ,延长艾滋病病人的生存期极为…