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With the rapid growth of metabolic dysfunction (MD) worldwide, there is also a gradual increase in the number of patients with chronic hepatitis B virus (HBV) infection and MD. Comorbidity with metabolic disorders such as hyperglycemia, hypertension, and dyslipidemia may increase the risk of adverse liver outcomes and cardiovascular events in patients with chronic HBV infection and affect the response to anti-HBV therapy. The standardized management of patients with chronic HBV infection and MD has become a challenge at present, and further in-depth research on the interaction between MD and HBV and targeted management strategies will help to optimize the clinical management of patients with chronic HBV infection.
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ObjectiveTo investigate the mechanism of Magnolia officinalis cortex for constipation-type irritable bowel syndrome(IBS-C) rats before and after sweating. MethodIBS-C rat model was established by gavage of ice water, and rats were randomly divided into the blank group, model group, mosapride group(1 mg·kg-1), M. officinalis cortex group(10 g·kg-1) and sweated M. officinalis cortex group(10 g·kg-1). The changes of body weight, fecal number and fecal water content of rats were observed, 16S rRNA sequencing was used to detect the structural changes of fecal intestinal flora in rats, the levels of 5-hydroxytryptamine(5-HT) and substance P(SP) in colonic tissues of rats were determined by enzyme-linked immunosorbent assay(ELISA). ResultCompared with the model group, the fecal water content and fecal number of mosapride group, M. officinalis cortex group and sweated M. officinalis cortex group were significantly increased(P<0.05). At the phylum level, the top four species of flora abundance were Firmicutes, Bacteroidetes, Spirochaetes and Proteobacteria. Compared with the blank group, the proportion of Firmicutes in the model group was significantly reduced(P<0.05), while the proportion of Spirochaetes was significantly increased(P<0.05). Compared with the model group, the proportion of Firmicutes and Spirochaetes in M. officinalis cortex group and sweated M. officinalis cortex group tended to be similar to that in the blank group, and the proportion of Spirochaetes in sweated M. officinalis cortex group was lower than that of M. officinalis cortex group. At the family level, the top four species of flora abundance were Lactobacillaceae, S24_7, Ruminococcaceae, Bacteroidaceae, compared with the blank group, the proportion of Lactobacillaceae in the model group decreased significantly(P<0.05), and its proportion in the M. officinalis cortex group and sweated M. officinalis cortex group increased significantly after administration(P<0.05), and the flora structure of the two groups tended to be similar to that of the blank group. At the genus level, the top four species of flora abundance were Lactobacillus, Unspecified_S24_7, Bacteroides and Treponema. Compared with the blank group, the proportion of Lactobacillus in the model group decreased significantly(P<0.05), while the proportion of Treponema increased significantly(P<0.05). Compared with the model group, ratio of bacterial structure of Lactobacillus and Treponema in the M. officinalis cortex group and sweated M. officinalis cortex group tended to be similar to those in the blank group, indicating that M. officinalis cortex could restore the intestinal microbial structure of IBS-C rats before and after sweating. Compared with the model group, the 5-HT content in mosapride group was significantly reduced(P<0.05), the contents of 5-HT and SP in the M. officinalis cortex group and sweated M. officinalis cortex group were significantly increased(P<0.01), and the sweated M. officinalis cortex group was higher than the M. officinalis cortex group. ConclusionM. officinalis cortex can play a therapeutic role on IBS-C rats by regulating 5-HT pathway and intestinal flora structure before and after sweating.
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The intestinal mucus layer is a barrier that separates intestinal contents and epithelial cells, as well as acts as the "mucus layer-soil" for intestinal flora adhesion and colonization. Its structural and functional integrity is crucial to human health. Intestinal mucus is regulated by factors such as diet, living habits, hormones, neurotransmitters, cytokines, and intestinal flora. The mucus layer's thickness, viscosity, porosity, growth rate, and glycosylation status affect the structure of the gut flora colonized on it. The interaction between "mucus layer-soil" and "gut bacteria-seed" is an important factor leading to the pathogenesis of non-alcoholic fatty liver disease (NAFLD). Probiotics, prebiotics, fecal microbiota transplantation (FMT), and wash microbial transplantation are efficient methods for managing NAFLD, but their long-term efficacy is poor. FMT is focused on achieving the goal of treating diseases by enhancing the "gut bacteria-seed". However, a lack of effective repair and management of the "mucus layer-soil" may be a reason why "seeds" cannot be well colonized and grow in the host gut, as the thinning and destruction of the "mucus layer-soil" is an early symptom of NAFLD. This review summarizes the existing correlation between intestinal mucus and gut microbiota, as well as the pathogenesis of NAFLD, and proposes a new perspective that "mucus layer-soil" restoration combined with "gut bacteria-seed" FMT may be one of the most effective future strategies for enhancing the long-term efficacy of NAFLD treatment.
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Humanos , Hepatopatia Gordurosa não Alcoólica/terapia , Microbioma Gastrointestinal , Probióticos , Prebióticos , Transplante de Microbiota Fecal , Bactérias , Fígado/patologiaRESUMO
With the continuous improvement of treatment ability in intensive care unit (ICU), many critically ill and complex patients have survived due to the development of technology. However, most of them suffer from the psychological and physiological problems of post-intensive care syndrome (PICS). Therefore, the early identification and prevention of PICS is particularly critical. We should understand the pathophysiological mechanism of PICS, strictly implement ABCDEFG bundle management measures [including airway management (A), breath (B), reasonable analgesia and sedation treatment (C), prevention of delirium (D), early rehabilitation (E), family engagement (F), good communication (G)] during ICU hospitalization, and pay attention to reasonable nutritional support, optimizing blood glucose management, providing positive psychological intervention and support to patients through family members' encouragement and accompanying, ICU diary and other forms, following up the health status of patients transferred out/discharged from ICU, providing multi-disciplinary and professional continuing medical services, finding the entry point and timing of traditional Chinese medicine intervention, and giving full play to the advantages of integrated traditional Chinese and Western medicine treatment, which can improve the quality of life of patients. This article reviews the pathophysiological mechanism, risk factors, prevention and management measures, traditional Chinese medicine syndrome differentiation and treatment of PICS, in order to improve the early identification, diagnosis and treatment of critical patients with PICS, and improve the prognosis of patients.
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Objective To meta-analyze the effect of mirror therapy on the lower limb motor function and ac-tivities of daily living of stroke survivors so as to evaluate its clinical efficacy. Methods Medline, PubMed, OT seeker, the Cochrane library, the Wanfang database, the VIP database and the CNKI were searched for reports of randomized and controlled trials (RCTs) of the effect of mirror therapy on the lower limb motor function and activities of daily living of stroke survivors published between December 2008 and December 2018. Strict inclusion and exclu-sion criteria were applied, and the quality of the documents was comprehensively assessed according to version 5.1.0 of the Cochrane manual. The results were analyzed using version 5.2 of the RevMan software suite. Results Four-teen trials were included. Meta-analysis showed that mirror therapy had been shown to improve the patients'scores of Fugl-Meyer assessment ( FMA ), functional ambulance category ( FAC ) and modified Barthel index ( MBI ). Conclusion Mirror therapy can improve the motor function of the affected lower extremities of stroke survivors and their ability in the activities of daily living.
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@#Spasticity is one of common manifestations of upper motor neuron injury, and often evaluated with semi-quantitative scales. Ultrasound elastography (UE) can provide elastic information for muscle tissue, and can be used for the evaluation of muscle tension after cerebral palsy and stroke, as well as the efficacy of treatment. It correlates well with clinical spasm rating scales. However, UE may also be used for assessment of spasticity after spinal cord injury and multiple sclerosis, etc.
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Objective To study the changes of immune function and liver function in patients with primary biliary cirrhosis.Methods From March 2013 to March 2016 in our hospital patients with primary biliary cirrhosis 30 cases as the observation group.There were 17 patients with mild liver injury and 13 with severe hepatic dysfunction.And at the same time for the admission of 30 patients with other liver diseases in patients with liver disease as a group,30 cases underwent physical examination as healthy group were detected by flow cytometry in three groups of subjects of immunity comparison of three groups of cells,dendritic cell subsets in peripheral blood and liver function index.Results The CD4+ cells and CD8+ cells in the observation group were significantly higher than those in the healthy group(P<0.05),while the CD11c+ cells,CD123+ cells and NK cells were significantly lower than those in the healthy group(P<0.05).In the observation group,CD4+ cells,CD8+ cells,CD11c+ cells and CD123+ cells were significantly higher than those of other liver diseases but the NK cells were significantly lower than those of the other groups (P<0.05).In healthy group,CD4+ cells,CD8+ cells,CD11c+ cells,CD123+ cells and NK cells were significantly higher than those of other liver disease group(P<0.05) The CD4+,CD8+ and CD123+ cells in the liver injury group were significantly higher than those in the liver function damage group,while the CD11c+ and NK cells were significantly lower than those in the liver function group,and the difference was statistically significant(P<0.05).The CD4+ and CD8+ cells in the AMA-M2 negative group were significantly lower than that in the AMA-M2 positive group,while those in CD123+,CD1 1c+ and NK cells were significantly higher than those in the AMA-M2 positive group,and the difference was statistically significant (P< 0.05).Conclusion The immune function of patients with primary biliary cirrhosis and liver function injury are associated with production of serum AMA-M2 antibodies,including CD11c+ and CD123+ or as the main factors influence the development of the disease and the AMA-M2 antibody.
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Objective To study the distribution of bacterium extended spectrum beta lactamases (ESBLs) in sputum samples from patients with lower respiratory tract infection in Panzhihua Hospital of Integrated Traditional Chinese and Western Medicine . Methods A total of 512 strains of gram negative bacterium were isolated from sputum samples of patients with lower respiratory tract infection from January 2014to January 2016 ,standard disk diffusion method was used to detected ESBLs ,drug sensitivity was performed by K-B disk diffusion method .Distribution and drug resistant status of ESBLs bacterium were analyzed .Results Detec-tion rate of ESBLs bacteriumin cadre ward and ICU were higher than that in department of respiration ,and the difference was sta-tistical significant(P< 0 .01) .Among ESBLs bacterium isolated from department of respiration ,Escherichia coli accounted for 37 .5% ,Enterobacter cloacae accounted for 25 .8% .Among ESBLs bacterium isolated from cadre ward ,Escherichia coli accounted for 58 .2% ,Enterobacter cloacae accounted for 45 .5% .The resistant rate of gram negative bacterium producing ESBLs to trime-thoprim was lowest .Conclusion It′s important to understand the distribution and drug resistant status of gram negative bacterium , so as to provide the basis for rational use of antibiotics .
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Objective To study the changes of immune function and liver function in patients with primary biliary cirrhosis.Methods From March 2013 to March 2016 in our hospital patients with primary biliary cirrhosis 30 cases as the observation group.There were 17 patients with mild liver injury and 13 with severe hepatic dysfunction.And at the same time for the admission of 30 patients with other liver diseases in patients with liver disease as a group,30 cases underwent physical examination as healthy group were detected by flow cytometry in three groups of subjects of immunity comparison of three groups of cells,dendritic cell subsets in peripheral blood and liver function index.Results The CD4+ cells and CD8+ cells in the observation group were significantly higher than those in the healthy group(P<0.05),while the CD11c+ cells,CD123+ cells and NK cells were significantly lower than those in the healthy group(P<0.05).In the observation group,CD4+ cells,CD8+ cells,CD11c+ cells and CD123+ cells were significantly higher than those of other liver diseases but the NK cells were significantly lower than those of the other groups (P<0.05).In healthy group,CD4+ cells,CD8+ cells,CD11c+ cells,CD123+ cells and NK cells were significantly higher than those of other liver disease group(P<0.05) The CD4+,CD8+ and CD123+ cells in the liver injury group were significantly higher than those in the liver function damage group,while the CD11c+ and NK cells were significantly lower than those in the liver function group,and the difference was statistically significant(P<0.05).The CD4+ and CD8+ cells in the AMA-M2 negative group were significantly lower than that in the AMA-M2 positive group,while those in CD123+,CD1 1c+ and NK cells were significantly higher than those in the AMA-M2 positive group,and the difference was statistically significant (P< 0.05).Conclusion The immune function of patients with primary biliary cirrhosis and liver function injury are associated with production of serum AMA-M2 antibodies,including CD11c+ and CD123+ or as the main factors influence the development of the disease and the AMA-M2 antibody.
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Objective To study the distribution of bacterium extended spectrum beta lactamases (ESBLs) in sputum samples from patients with lower respiratory tract infection in Panzhihua Hospital of Integrated Traditional Chinese and Western Medicine . Methods A total of 512 strains of gram negative bacterium were isolated from sputum samples of patients with lower respiratory tract infection from January 2014to January 2016 ,standard disk diffusion method was used to detected ESBLs ,drug sensitivity was performed by K-B disk diffusion method .Distribution and drug resistant status of ESBLs bacterium were analyzed .Results Detec-tion rate of ESBLs bacteriumin cadre ward and ICU were higher than that in department of respiration ,and the difference was sta-tistical significant(P< 0 .01) .Among ESBLs bacterium isolated from department of respiration ,Escherichia coli accounted for 37 .5% ,Enterobacter cloacae accounted for 25 .8% .Among ESBLs bacterium isolated from cadre ward ,Escherichia coli accounted for 58 .2% ,Enterobacter cloacae accounted for 45 .5% .The resistant rate of gram negative bacterium producing ESBLs to trime-thoprim was lowest .Conclusion It′s important to understand the distribution and drug resistant status of gram negative bacterium , so as to provide the basis for rational use of antibiotics .
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OBJECTIVE: The study aims to investigate the correlation between total input for a period of 24 h and the daily physiological requirements to develop practical guidelines for postoperative infusion management of cleft patients. METHODS: Sixty-three cleft lip and palate patients under three years old who underwent surgery were included in the study. The amount of liquid taken orally as well as intravenous input were recorded for a period of 24 h and compared with the daily physiological requirements. Based on the comparison results, the amount of intravenous infusion was adjusted to match the physiological requirements. Eighty-one patients under one year old were also included to evaluate the effectiveness of the adjustment. The amount of liquid taken orally and intravenous inputs were also recorded and the correlation between total input and urine output analyzed. RESULTS: The total input of the first group of patients significantly exceeded the physiological requirements. After adjustment, the liquid intake remained at the same level, but the total intake moved closer to the physiological requirements. Statistically significant correlations were observed between liquid taken orally and intravenous intakes, and between total intake and urine formation. CONCLUSIONS: More precise management of postoperative infusion is necessary for cleft patients. For patients less than six months old, the amount of intravenous infusion should be around 60% of the physiological requirements, whereas that for patients between six months and one year should be around 75%.
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Fenda Labial , Humanos , Infusões Intravenosas , Período Pós-OperatórioRESUMO
Objective To develop a new method for the determination of inorganic sulfide in source water by ion chromatography combined with pulsed amperometric detector.Methods The source water samples were injected into ion chromatography system after being filtrated with 0.22 ?m nylon membrane.100 mmol/L of NaOH-250 mmol/L of the NaOAc-0.5% (V/V) ethylenediamine was used as the eluent,special polarizable anions separation column IonPac 3AS7 was selected and sulfide was separated from other anions by isocratic eluent following by three-waveform pulsed amperometric detection.Results The liner range of determination for sulfide was 5-1 000 ?g/L,the equation of linear regression was y=0.325 4x-1.305 3.The detection limit was 0.5 ?g/L,the recovery rates were in the range of 90.8%-96.7%,and the relative standard deviation was 1.32%.Conclusion The method is simple with good selectivity,high sensitivity and good reproducibility and is applicable to the determination of inorganic sulfide in source water.