Medium-chain triglyceride-rich enteral nutrition is more effective than low-fat enteral nutrition in rat colitis, but is equal in enteritis

Background. Although enteral nutrition (EN) therapy for Crohn's disease has been confirmed to be as effective as steroid therapy, the precise mechanism responsible for the effects of EN remains unclear, although some of the therapeutic effects of EN are believed to be due to a low dietary fat content. In order to elucidate the influence of fat in EN, it is important to investigate not only the quantity of fat, but also the source of the fat. Methods. We compared two enteral nutritional formulae: Elental (Ajinomoto) (elemental diet; ED), which contains only 1.5% fat, provided as long-chain triglycerides (LCT), versus Twinline (Snow Brand Milk Products) (TL), which contains a high percentage of fat (20.4%), provided mainly as medium-chain triglycerides (MCT). These formulae were tested on rat enteritis and rat colitis induced by trinitrobenzene sulfonic acid (TNBS). Results. Both ED and TL reduced the manifestations of enteritis. TL had a stronger anti-inflammatory effect than ED for colitis. TL also had nutritional advantages as compared with ED, as shown by the total serum protein in the TL group being significantly higher than that in the ED group. Conclusion. The results indicate that intraluminal MCT is suitable as a fat energy source during intestinal inflammation in rats. We suggest that Twinline may be more useful to improve nutritional status and to re-duce the mucosal inflammation in rat colitis, but that Twinline is equal in effect to Elental for rat enteritis. Received: November 10, 2000 / Accepted: April 13, 2001     

人类轮状病毒感染新生小鼠肠道外组织的病理变化

目的了解人类轮状病毒(RV)全身扩散后对机体的影响,为临床的防治提供有价值参考。方法选用对人类RV敏感的健康新生昆明小鼠,经灌胃与腹腔注射两种途径接种RV,3d后处死小鼠,光镜下观察各脏器病理变化;电镜下观察肝脏的病理变化;各脏器原位杂交,原位PCR检测RV,并与健康小鼠比较。结果光镜下:RV口服组小肠绒毛、胃固有层、心肌细胞有改变;RV腹腔注射组除上述改变外,肝,肾也有改变;电镜下:肝细胞线粒体肿胀、凝集病变尤为明显,细胞核固缩-崩解,粗面内质网扩张,肝细胞中存在大量脂滴和空泡;毛细胆管明显扩张,微绒毛脱落。原位杂交:RV口服组小肠上皮细胞,RV腹腔注射组肠、肾近曲小管上皮细胞呈阳性;原位间接PCR:RV口服组小肠绒毛、肠腺细胞、肾近曲小管和集合管上皮细胞呈阳性,RV腹腔注射组肠、肾、肝、心脏、胰呈阳性。结论RV一旦向全身扩散,可侵犯除肠之外的多个器官组织,提示人类RV也可能具有一定的泛嗜性。     

90例非轮状病毒腹泻患儿粪便中诺瓦克样病毒的检测

目的了解90份婴幼儿腹泻病人轮状病毒分子生物学方法检测阴性的粪便标本中诺瓦克样病毒感染状况。方法应用酶联免疫吸附实验方法(ELISA)进行诺瓦克样病毒抗原检测。结果90份粪便标本中诺瓦克样病毒I型(G1)和Ⅱ型(G2)阳性分别检出6例和19例,阳性率分别为6.67%和21.11%,两者差异有显著性。结论诺瓦克样病毒感染可能是武汉地区婴幼儿腹泻的重要病因之一,其中基因Ⅱ型为主要流行株。     

婴儿轮状病毒肠炎的饮食与临床疗效关系探讨

目的：探讨婴儿轮状病毒肠炎的饮食弓临床疗效关系。方法：将93例轮状病毒肠炎的婴儿按不同的喂养方式随机分为A、B、C3组，在其他治疗方法相同时，A组予去乳糖奶粉喂养，B组继续母乳喂养，C组普通罂儿奶粉喂养，两两比较其临床疗效。结果：A组总有效率明显高于B、C组，止泻天数短于B、C组，而体重降低程度明显低于B、C组（P〈0．01）：结论：轮状病毒肠炎的婴儿以去乳精奶粉喂养为宜。     

黄虎汤保留灌肠治疗婴幼儿轮状病毒肠炎效果与护理

目的：观察黄虎汤保留灌肠治疗婴幼儿轮状病毒肠炎效果,并总结护理体会。方法选择169例轮状病毒肠炎患儿,随机分为观察组86例,对照组83例,在常规治疗基础上,观察组采.用黄虎汤保留灌肠,对照组采.用思密达保留灌肠,3d为1个疗程。比较1个疗程后两组患儿疗效。结果两组患儿疗效比较,P＜0.05,差异具有统计学意义,观察组疗效率明显优于对照组。结论黄虎汤保留灌肠治疗婴幼儿轮状病毒肠炎疗效优于思密达保留灌肠治疗,辅以综合护理有助于提高治疗依从性和疗效。     

轮状病毒肠炎患儿异型淋巴细胞和免疫球蛋白水平的变化分析

目的探讨轮状病毒（RV）肠炎患儿异型淋巴细胞数量及免疫球蛋白水平治疗前后变化的临床意义。方法分别检测50例RV肠炎患儿（肠炎患儿组）及30例健康小儿（健康对照组）治疗前后的血常规和异型淋巴细胞数量及血清免疫球蛋白水平。结果治疗前RV肠炎患儿组外周血异型淋巴细胞明显高于健康对照组（P〈0.01）,RV肠炎患儿血清免疫球蛋白IgA、IgM和IgG水平下降。治疗后RV肠炎患儿组外周血异型淋巴细胞低于治疗前（P〈0.05）,血清免疫球蛋白IgA、IgM和IgG水平上升甚至接近正常水平。结论 RV肠炎患儿治疗前后进行异型淋巴细胞数量及免疫球蛋白水平的检测有助于对病毒感染的判断及了解患儿的机体免疫功能状态和对疾病治疗的有效性,对RV肠炎患儿的治疗有指导意义。     

婴幼儿轮状病毒性肠炎患儿54例血清心肌酶分析

目的通过检测并分析婴幼儿轮状病毒性肠炎与非轮状病毒感染性肠炎患儿心肌酶的水平,探讨轮状病毒感染与心肌损伤的相关性。方法 54例婴幼儿轮状病毒性肠炎的患儿作为观察组,78例轮状病毒阴性的腹泻病患儿作为对照组。两组患儿入院后抽取取空腹血清检查心肌酶[磷酸肌酸激酶(CK)及其同工酶(CK-MB)、门冬氨酸氨基转移酶(AST)]进行比较分析。两组患儿经治疗,腹泻症状消失后,将心肌酶三项均增高患儿的血清心肌酶进行治疗前后的分析比较。结果观察组中血清心肌酶三项(AST、CK-MB、CK)的水平较对照组高,差异有显著性(P0.05)。且入院时,观察组心肌酶三项均异常者有30例,占55.6%;对照组心肌酶三项均异常者有13例,占16.7%。观察组心肌酶异常者比率显著高于对照组,差异有显著性(P0.05)。治疗前,观察组心肌酶三项均异常者心肌酶水平较对照组增高,差异有显著性(P0.05);治疗后,两组心肌酶三项均异常者心肌酶水平差异无统计学意义(P0.05)。结论婴幼儿轮状病毒性肠炎较非轮状病毒性腹泻更容易导致患儿心肌的损伤,经治疗后,心肌酶可以在短时间内恢复正常。因此,在治疗婴幼儿轮状病毒性肠炎时应进行心肌酶的检测,并注意排除病毒性心肌炎。     

2012年长春市儿童医院婴幼儿轮状病毒性腹泻监测分析

目的了解长春市儿童医院5岁以下儿童轮状病毒性腹泻的流行病学特征及临床症状。方法对轮状病毒感染的流行病学特征、实验室检测结果和临床症状进行分析。结果共采集标本387份,其中轮状病毒(HRV)阳性225份,阳性率为58.14%,其中HRV合并其他致腹泻性病毒感染29份;HRV血清型G分型以G9型为主,P分型以P8型为主;13~18月龄之间检出率较高,男女性别比为1.59∶1,HRV检出高峰在10-12月。结论HRV是引起长春市儿童医院婴幼儿病毒性腹泻的主要病原体,做好病毒性腹泻的监测工作有利于早期采取干预措施,制定防控措施和方法,降低5岁以下儿童病毒性腹泻的发生率。     

Adult eosinophilic gastroenteritis and hypereosinophilic syndromes

Eosinophilic gastroenteritis （EGE） in the adult is a distinctive pathologically-based disorder characterized by an eosinophil-predominant mucosal inflammatory process. Most often, the disorder is detected during endoscopic investigation for abdominal pain or diarrhea. Other causes of gastric and intestinal mucosal eosinophilia require exclusion, including parasitic infections and drug-induced causes. Occasionally, the muscle wall or serosal surface may be involved. EGE appears to be more readily recognized, in large part, due to an evolution in the imaging methods used to evaluate abdominal pain and diarrhea, in particular, endoscopic imaging and mucosal biopsies. Definition of EGE, however, may be difficult, as the normal ranges of eosinophil numbers in normal and abnormal gastric and intestinal mucosa are not well standardized. Also, the eosinophilic inflammatory process may be either patchy or diffuse and the detection of the eosinophilic infiltrates may vary depending on the method of biopsy fixation. Treatment has traditionally focused on resolution of symptoms, and, in some instances, eosinophil quantification in pre-treatment and posttreatment biopsies. Future evaluation and treatment of EGE may depend on precise serological biomarkers to aid in definition of the long-term natural history of the disorder and its response to pharmacological or biological forms of therapy.