血清5'-核苷酸酶与肝功能生化酶的联合检测在胆道良恶性疾病中的诊断价值

目的 探讨5'-核苷酸酶(5'NT)与肝功能生化酶的联合检测在胆道良恶性病变中的诊断价值.方法 采用速率法检测经手术及病理证实的胆道恶性肿瘤74例,慢性胆囊炎70例,胆结石+慢性胆囊炎68例及正常健康人70例血清中5'-核苷酸酶水平,同时检测肝功能相关的血清总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL)、γ-谷氨酰氨转肽酶(GGT)、碱性磷酸酶(ALP).结果 胆囊癌+胆管癌的血清5'NT水平明显高于慢性胆囊炎、胆结石+慢性胆囊炎组及正常健康人群(P＜0.05),而胆囊癌+胆管癌(伴梗阻)组与胆囊癌+胆管癌(未梗阻)组差异无统计学意义(P＞0.05),胆道良性疾病与健康人群之间差异也无统计学意义(P＞0.05).胆道恶性疾病中5'NT与ALP、GGT呈高度正相关(r=0.665,r=0.519;F=57.16,F=26.588,P＜0.05).血清5'NT、ALP、GGT联合检测的特异性、敏感度分别为95.65%和94.59%.结论 5'NT与肝功能生化酶类指标联合应用,可作为诊断胆道良恶性疾病的较为敏感、有效的生化指标,有助于胆道良恶性疾病的鉴别.     

Do synbiotics really enhance beneficial synbiotics effect on defecation symptoms in healthy adults?: Randomized,double-blind,placebo-controlled trial

Goals:We examined whether synbiotics enhance improvement by probiotics.Background:Probiotics, which are beneficial microbacteria, are a nutritional intervention for treatment of functional constipation or its tendency. Prebiotics, meanwhile, can promote the proliferation of probiotics in the gastrointestinal tract and enhance their beneficial effects. Synbiotics, a combination of probiotics and prebiotics, may be superior to probiotics in the treatment of defecation-related symptoms, but this requires elucidation.Study:This randomized, double-blind, placebo-controlled study enrolled 69 healthy adults with constipation tendency. Participants were allocated to either control, probiotics, or synbiotics groups and they recorded details of their defecations and their condition. The first 2 weeks were the observation period and the latter 2 weeks were the intervention period, in which participants took test foods. Probiotic foods included Bifidobacterium longum NT strain (10¹⁰ CFU/day), synbiotic foods included the NT strain (10¹⁰ CFU/day) and galactooligosaccharide (1 g/day). Placebo foods contained the vehicle only. Participants answered questionnaires (Patient Assessment on Constipation Symptoms [PAC-SYM], and one on dietary history) on the last day of each period.Results:Nine participants withdrew consent, and 2 of the remaining 60 had missing data. Age, body mass index, and sex were not significantly different between the 3 groups. Frequency of bowel movements in the fourth week, the primary endpoint, was not increased in the probiotics or synbiotics groups compared with the control group, and the frequency of bowel movements and days with defecation were not changed by probiotics or synbiotics during the intervention period. Probiotics and synbiotics did not improve stool conditions, although incomplete defecation was improved by probiotics but not by synbiotics compared with placebo. PAC-SYM indicated that stool condition and total scores were improved by probiotics but not by synbiotics during the intervention compared with placebo.Conclusion:The probiotic strain Bifidobacterium longum NT can improve constipation symptoms, especially stool condition, but it does not increase bowel movement frequency in healthy adults with constipation tendency. Synbiotics treatment seemed to diminish this improvement of constipation induced by probiotics. This study indicates the possibility of attenuation of beneficial effects from probiotics by the use of synbiotics, contrary to synbiotics theory.     

Platelet-rich plasma with keratinocytes and fibroblasts enhance healing of full-thickness wounds

Advances in tissue engineering led to the development of various tissue-engineered skin substitutes (TESS) for the treatment of skin injuries. The majority of the autologous TESS required lengthy and costly cell expansion process to fabricate. In this study, we determine the possibility of using a low density of human skin cells suspended in platelet-rich plasma (PRP)-enriched medium to promote the healing of full-thickness skin wounds. To achieve this, full-thickness wounds of size 1.767 cm² were created at the dorsum part of nude mice and treated with keratinocytes (2 × 10⁴ cells/cm²) and fibroblasts (3 × 10⁴ cells/cm²) suspended in 10% PRP-enriched medium. Wound examination was conducted weekly and the animals were euthanized after 2 weeks. Gross examination showed that re-epithelialization was fastest in the PRP+cells group at both day 7 and 14, followed by the PRP group and NT group receiving no treatment. Only the PRP+cells group achieved complete wound closure by 2 weeks. Epidermal layer was presence in the central region of the wound of the PRP+cells and PRP groups but absence in the NT group. Comparison between the PRP+cells and PRP groups showed that the PRP+cells-treated wound was more mature as indicated by the presence of thinner epidermis with single cell layer thick basal keratinocytes and less cellular dermis. In summary, the combination of low cell density and diluted PRP creates a synergistic effect which expedites the healing of full-thickness wounds. This combination has the potential to be developed as a rapid wound therapy via the direct application of freshly harvested skin cells in diluted PRP.