[Evaluation and Early Diagnosis of Gastrointestinal Failure in Acute Pancreatitis].

Objective To investigate the application of Acute Gastrointestinal Injury(AGI) grading in evaluating gastrointestinal failure in patients with acute pancreatitis(AP). Methods In this retrospective observational study,patients presented with moderate severe AP and severe AP in our hospital from October 2013 to October 2016 were consecutively enrolled.Logistic regression analysis and receiver operating characteristic curve were used to explore and evaluate potential predictors of gastrointestinal failure. Results A total of 202 patients were included in this study,with 90 cases(44.6%) identified as gastrointestinal failure.Survival curve showed significantly increased risk of death in patients with gastrointestinal failure(P < 0.05).Logistic regression analysis showed age(OR=1.06,95%CI:1.03-1.09,P<0.001),complaint of stopping flatus and defecation(OR=7.02,95%CI:2.08-23.66,P=0.002),increased counts of white blood cells in peripheral blood(OR=1.09,95%CI:1.02-1.17,P=0.015),decreased level of serum albumin(OR=0.93,95%CI:0.86-1.00,P=0.048),and increased level of serum creatinine at admission(OR=1.02,95%CI:1.01-1.04,P=0.001) were the independent risk factors of gastrointestinal failure.The area under curves of Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) and Beside Index for Severity in Acute Pancreatitis (BISAP) scores in diagnosing gastrointestinal failure were 0.999 and 0.782,respectively. Conclusions Gastrointestinal failure can remarkably increase the risk of death in patients with AP.Both APACHE Ⅱ and BISAP scores at admission are useful in diagnosing gastrointestinal failure in patients with AP.

[Effects of Vitamin D Receptor on Mucosal Barrier Proteins in Colon Cells under Hypoxic Environment].

To investigate the expressions of mucosal barrier proteins in colon cell line DLD-1 under hypoxic environment in vitro and its mechanism. Methods After DLD-1 cells were treated separately with hypoxia(l% O2),vitamin D(100 nmol/L),or vitamin D plus hypoxia for 48 hours,the expressions of vitamin D receptor(VDR),tight junction proteins zonula occludens-1(ZO-1),occludin,Claudin-1,and adherent junction protein(E-cadherin)were determined by Western blot.Stable VDR knock-down(Sh-VDR)DLD-1 cell line and control DLD-1 cell line were established by lentivirus package technology and the protein expressions after hypoxia treatment were detected. Results Compared with control group,the expressions of occludin,Claudin-1,and VDR increased significantly after hypoxia treatment(all P<0.001).In addition to the protein expressions of occludin,Claudin-1 and VDR,the expressions of ZO-1 and E-cadherin were also obviously higher in vitamin D plus hypoxia group than in single vitamin D treatment group(all P<0.001).After hypoxia treatment,Sh-VDR cell line showed significantly decreased expressions of ZO-1(P<0.001),occludin(P<0.05),Claudin-1(P<0.01)and E-cadherin(P<0.001)when compared with untreated Sh-VDR cell line. Conclusion VDR acts as a regulator for the expressions of intestinal mucosal barrier proteins under hypoxia environment in DLD-1 colon cell line,indicating that VDR pathway may be another important protective mechanism for gut barrier in low-oxygen environment.

Autoimmune pancreatitis associated with inflammatory bowel diseases: A retrospectively bidirectional case-control study in China.

OBJECTIVES: Autoimmune pancreatitis (AIP) is a rare and enigmatic immune-mediated inflammatory disease. We aimed to investigate the prevalence, characteristics, and associated factors of AIP-inflammatory bowel disease (IBD) in China. METHODS: A retrospective bidirectional case-control study was performed. The diagnoses of IBD and AIP were made based on the European Crohn's and Colitis Organization guidelines and the International Consensus Diagnostic Criteria. IBD controls were matched by age, sex, and IBD type at a ratio of 1:4, while AIP controls were matched by AIP types. RESULTS: The age-standardized prevalence of AIP-IBD patients in the IBD and AIP population were 292.0 and 8151.93 per 100 000 population, respectively. IBD patients had a higher risk of AIP compared to non-IBD patients (odds ratio 8.4, 95% confidence interval 4.7-14.9, P < 0.0001), and AIP patients had a higher risk of developing IBD compared to the general population in China. The mean age at diagnosis of IBD and AIP was 34.83 years and 40.42 years. IBD was diagnosed before AIP in seven cases. The median total IBD and AIP duration was 43.5 months and 13.5 months. Use of mesalamine and tuberculosis were associated with AIP in IBD patients (P = 0.031). And fecal occult blood test was associated with IBD in AIP patients (P = 0.008). CONCLUSIONS: Most AIP-IBD patients had ulcerative colitis and type 2 AIP. IBD patients are more likely to develop AIP compared to the general population, and vice versa. Use of mesalamine and tuberculosis infection were associated with AIP, and fecal occult blood test was associated with IBD.

Historical variation of structural novelty in a natural product library.

To evaluate the potential of natural products as novel structure suppliers, a historical analysis was performed on the structural novelty of a natural product library, viz., the Chapman & Hall/CRC Dictionary of Natural Products. The results show that although the unexplored natural product universe is still ample, it is more and more difficult to find novel agents from nature, with the discovery probability of novel structures and scaffolds being lower than 50% in the near future, which mainly results from the intrinsic redundancy of natural products and, thus, is unlikely to be reversed merely through technical progresses.

[Diffusion of Microorganism and Main Pathogenic Bacteria During Municipal Treated Wastewater Discharged into Sea].

Numerous microorganisms, especially pathogens, exist in treated wastewater, which leads to possible risk to population health and marine ecological security when treated wastewater is discharged into the sea. This study selects Maidao municipal sewage treatment plant as the location. The microbial community and the dynamic distribution and seasonal variation of pathogens are analyzed by high-throughput sequencing technology. The results showed that the microbes in the discharge were distributed into 20 to 27 phyla, and the dominant phyla were Proteobacteria, Firmicutes, and Bacteroidetes, which were mainly distributed in 44 to 65 classes. The predominant pathogens are mainly composed of Gammaproteobacteria, Betaproteobacteria, and Epsilonproteobacteria in the Proteobacteria category. The proportion of most dominant phyla and classes in the sample decreased with an increase in diffusion distance. There were mainly 55 species pathogenic bacteria in the water discharging into the sea. The pathogenic genes in the discharge were mainly related to cancer, cardiovascular disease, immune system diseases, infectious diseases, metabolic diseases, and neurodegenerative diseases. When compared with the blank samples, it was found that the biomass of pathogenic bacteria decreased sharply with the diffusion by the seawater, and most of the pathogens were not detected 1000 m away from the seashore. Arcobacter spp. caused human and animal diarrhea and bacteremia, Acinetobacter spp. caused nosocomial infections, and Shewanella hafniensis posed a threat to seafood farming and fishing. The three species of pathogenic bacteria mentioned above occupied a fairly large proportion of the discharge into the sea.

[Influence of Different Patterns of Discharge on Microbial Diffusion in Municipal Treated Wastewater].

Numerous pathogens exist in treated wastewater, leading to possible population health and ecological security risks when treated waste water is reused or discharged. To investigate the influence of different patterns of discharge on microbial diffusion in the municipal treated waste water, high-throughput sequencing technology was used to analyze the bacterial community structure, dominant flora, and typical pathogens. It was found that those bacteria were distributed in 58 classes. There were 32 species with a relative abundance of more than 1%. While there were only 41 classes in the water sample taken as a direct discharge to the sea, and there were 28 species with relative abundances of more than 1%. The water sample collected as a discharge to the sea through a river displayed higher bacterial diversity than the sample collected as a direct discharge to the sea, indicating that the microorganisms in the treated waste water was more likely to diffuse in when directly discharged to the sea. The relative abundance of dominant bacteria decreased with an increase in the diffusion distance, while the relative abundance of Cyanobacteria increased as the diffusion distance increased. The relative abundance in the water sample collected as a discharge to the sea through a river was higher. The dominant bacteria in the two systems are to Proteobacteria, Bacteroidetes, and Firmicutes. However, the dominant bacteria at the class and species levels quite dissimilar in the two systems. The bacterial diversities near the outfall were much higher than that in the seawater (blank sample), and the abundance was higher, which related to sewage treatment. In addition, there was a certain amount of pathogens and potential pathogens, including Pseudoalteromonas haloplanktis and Pseudomonas anguilliseptica, which were highly pathogenic. Their relative abundances were still higher after dilution. Arcobacter spp. was related to human and animal diarrhea and bacterial and other diseases. Therefore, the detection of these types of bacteria when the treated waste water is discharged is very important.