双歧杆菌四联活菌片对乙肝相关慢加急性肝衰竭合并感染患者肠道菌群及免疫功能的影响

目的分析双歧杆菌四联活菌片对乙肝相关慢加急性肝衰竭(HBV-ACLF)合并感染患者肠道菌群及免疫功能的影响,为该病的治疗提供参考。方法选择2017年12月至2018年12月我院收治的106例HBV-ACLF合并感染患者,采用随机数字表法将其分为对照组(n=53)与研究组(n=53)。对照组患者采用常规治疗,研究组患者在对照组基础上口服双歧杆菌四联活菌片,两组患者均治疗1个月。比较两组患者治疗总有效率及肠道菌群(双歧杆菌、肠球菌、乳杆菌、肠杆菌)、免疫功能(CD4~+细胞、CD8~+细胞、CD4~+/CD8~+)、肝功能[丙氨酸氨基转移酶(ALT)、天冬氨酸转氨酶(AST)]情况。结果研究组患者治疗总有效率显著高于对照组(90.57%vs 73.58%,χ~2=5.194,P=0.023)。治疗前,两组患者肠道双歧杆菌、肠球菌、乳杆菌、肠杆菌数量及CD4~+细胞、CD8~+细胞、CD4~+/CD8~+、AST、ALT水平差异无统计学意义(均P0.05)。治疗后,对照组患者肠道双歧杆菌、肠球菌、乳杆菌、肠杆菌数量较治疗前差异无统计学意义(均P0.05),而研究组患者肠道乳杆菌、双歧杆菌数量较治疗前显著升高,肠杆菌、肠球菌数量较治疗前显著下降(均P0.05)。治疗后两组患者CD4~+细胞、CD4~+/CD8~+水平较治疗前显著升高,CD8~+细胞、AST、ALT水平较治疗前显著下降(均P0.05)。治疗后研究组患者CD4~+细胞、CD4~+/CD8~+水平较对照组显著升高,CD8~+细胞、AST、ALT水平较对照组显著下降(均P0.05)。结论双歧杆菌四联活菌片治疗HBV-ACLF合并感染患者的临床疗效较好,能够调节患者肠道菌群,改善患者免疫功能及肝功能,值得临床推广。     

双歧杆菌四联活菌片 对重症脑卒中患者肠道功能的影响

目的探讨双歧杆菌四联活菌片对重症脑卒中患者肠道菌群及肠黏膜屏障功能的影响。方法选择重庆市人民医院2017年1月至2017年11月收治的100例重症脑卒中患者,随机将入选患者分为治疗组和对照组各50例。治疗组在常规肠内营养(EN)治疗基础上联用双歧杆菌四联活菌片治疗,对照组给予常规EN治疗。比较两组患者治疗前后营养状况、肠道菌群数量和肠黏膜屏障功能。比较两组患者治疗后消化道并发症发生率。结果治疗前,两组患者营养状况、肠道菌群数量和肠黏膜屏障功能差异无统计学意义(P0.05)。治疗后,两组患者营养状况指标白蛋白(ALB)、血红蛋白(Hb)和三头肌肌围(MAMC)水平,肠道有益菌(双歧杆菌、乳杆菌和拟杆菌)数量均有所上升,肠黏膜屏障功能指标二胺氧化酶(DAO)、D-乳酸水平及肠道有害菌数量(小梭菌和肠球菌)均降低。与对照组相比,治疗组患者ALB、Hb和MAMC水平,肠道双歧杆菌、乳杆菌和拟杆菌数量均显著升高,DAO、D-乳酸水平和小梭菌、肠球菌数量均显著降低,差异有统计学意义(P0.05)。治疗组患者消化道并发症发生率均低于对照组(P0.05)。结论双歧杆菌四联活菌片能够显著改善脑卒中患者的营养状况,有效调节菌群失衡,改善肠黏膜屏障功能,降低并发症发生。     

肠内外营养联合支持对老年消化道肿瘤患者术后营养免疫状况的影响

目的:观察对比老年消化道肿瘤患者术后给予肠内营养(EN)、肠外营养(PN)联合应用(EN+PN)和单独采用PN对患者营养和免疫状况的影响。方法:选择我院2010年6月~2014年10月收治的老年消化道肿瘤患者60例,采用随机数字表法将所有患者分为PN组27例和PN+EN组33例。检测并比较两组患者血红蛋白(Hb)、血清白蛋白(Alb)、前白蛋白(Pre Alb)、转铁蛋白(TFN)、T淋巴细胞亚群及体重(BW)指标及术后并发症。结果:术后第8天较术前第七天两组患者血清Alb、Pre Alb、TFN均出现明显上升(P0.05),但两组间比较差异无统计学意义(P0.05),两组患者Hb和BW均略有下降,差异不存在统计学意义(P0.05);术后第8天EN+PN组患者的CD3+、CD4+/CD8+基本恢复到第七天水平,而PN组患者CD3+、CD4+/CD8+均低于第七天水平,差异存在统计学意义(P0.05);术后En+PN组较PN组,肛门排气时间较早、住院时间较短,差异均存在统计学意义(P0.05);两组均未发现严重并发症。结论:PN+EN和PN营养支持均可以改善老年消化道肿瘤患者术后的营养状况,但PN+EN更有利于提高患者免疫力,缩短住院时间。因此,PN+EN具有营养丰富、安全可靠的优点,值得临床推广应用。     

双歧杆菌三联活菌对胃癌部分切除患者术后 炎症因子、免疫和营养状态的影响

目的 探究胃癌部分切除术后补充双歧杆菌三联活菌对患者营养状态、炎症和免疫因子的影响,为肿瘤术后患者营养治疗支持提供建议。方法 选取2017年1月至2018年12月在我院行部分胃癌切除术的早期胃癌患者114例,采用随机数表法分为对照组(57例)与观察组(57例),两组患者于术后3～5 d开始进食,观察组在此基础上使用双歧杆菌三联活菌片,3粒/次,3次/日,口服,疗程14 d。对比两组治疗前后炎症因子水平(ELISA法测定外周血IL-2、IL-6及TNF-α水平)、免疫细胞水平(流式细胞仪测定外周血CD4~+、CD8~+、CD4~+/CD8~+水平)、营养状态(蛋白质测定仪测定外周血白蛋白和总蛋白水平)及治疗不良反应。结果 治疗前两组IL-2、IL-6及TNF-α水平无明显差异(t=1.861,0.744,1.489;P=0.064,0.457,0.138),治疗后两组上述指标均较治疗前显著下降,其中观察组治疗后上述指标水平显著低于对照组(t=5.784,6.153,8.457;均P0.05);治疗前两组CD4~+、CD8~+、CD4~+/CD8~+水平无明显差异(t=1.301,1.084,0.542;P=0.198,0.283,0.590),治疗后两组CD4~+、CD4~+/CD8~+均较治疗前显著提高,CD8~+显著下降,其中观察组治疗后CD4~+、CD4~+/CD8~+水平显著高于对照组(t=5.205,3.904;均P0.05),CD8~+显著低于对照组(t=6.507;P0.05);治疗前两组白蛋白及总蛋白水平无明显差异(t=1.301,0.651;P=0.198,0.518),治疗后两组上述水平均较治疗前显著提高,其中观察组治疗后白蛋白及总蛋白水平显著高于对照组(t=13.664,8.590;均P0.05);两组不良反应发生率无明显差异(5.26%vs 10.53%;χ~2=1.086,P=0.297)。结论 胃癌部分切除术后补充益生菌可有效调节患者的炎症和免疫状态,显著改善营养状况。     

胸腺肽α-1联合小剂量醋酸泼尼松对高龄重症患者呼吸机肺炎临床疗效及免疫功能的影响

目的:探讨胸腺肽α-1联合小剂量醋酸泼尼松对高龄重症患者呼吸机肺炎临床疗效及免疫功能影响。方法:收集我院就诊的64例呼吸机肺炎患者,随机分为实验组和对照组,每组32例。两组患者入院后均给予相应的基础治疗,对照组患者给予醋酸泼尼松片治疗,实验组患者在对照组的基础上给予胸腺肽治疗。观察并比较两组患者治疗前后血清CD4~+、CD8~+、CD4~+/CD8~+水平,机械通气时间、ICU停留时间、临床疗效以及不良反应的发生情况。结果:与治疗前相比,两组患者治疗后的CD4~+、CD4~+/CD8~+水平均升高,CD8~+水平均下降,差异具有统计学意义(P0.05);与对照组相比,实验组患者CD4~+、CD4~+/CD8~+水平较高,CD8~+水平较低,差异具有统计学意义(P0.05)。与对照组相比,实验组患者的机械通气时间以及ICU停留时间较短,临床治疗有效率较高,差异具有统计学意义(P0.05);两组患者不良反应发生率比较差异无统计学意义(P0.05)。结论:胸腺肽α-1联合小剂量激素能够提高高龄重症患者呼吸机肺炎患者的临床疗效和免疫功能。     

双歧杆菌乳杆菌三联活菌片联合血必净注射液对急性胰腺炎患者炎性介质、细胞免疫指标及肠黏膜屏障功能的影响

目的:探讨血必净注射液联合双歧杆菌乳杆菌三联活菌片治疗急性胰腺炎(SAP)患者的临床疗效。方法:选取2016年9月～2019年4月期间我院收治的SAP患者119例,根据随机数字表法将患者随机分为对照组(n=59)和研究组(n=60),对照组给予血必净注射液治疗,研究组在对照组的基础上联合双歧杆菌乳杆菌三联活菌片治疗,比较两组临床疗效,炎性介质、细胞免疫指标水平、肠黏膜屏障功能及不良反应发生情况。结果:研究组治疗7d后总有效率高于对照组(P0.05)。两组治疗期间未见药品不良反应发生。两组血清内毒素、二胺氧化酶(DAO)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)以及C反应蛋白(CRP)、CD8~+水平均降低,且研究组低于对照组(P0.05),CD4~+/CD8~+、CD4~+、NK细胞水平升高,且研究组高于对照组(P0.05)。结论:SAP患者在血必净的基础上联合双歧杆菌乳杆菌三联活菌片治疗,可提高机体细胞免疫功能,改善炎性因子水平和肠黏膜屏障功能,且用药安全性较好,临床应用价值较高。     

益生菌对肠易激综合征患者肠道微环境及免疫功能的影响

目的:探讨益生菌对肠易激综合征患者肠道微环境及免疫功能的影响,为临床相关研究提供参考。方法:选择2013年6月-2015年6月在我院接受治疗的肠易激综合征患者79例作为研究对象,根据治疗方案不同分为研究组(47例)和对照组(42例)。研究组患者采用双歧三联活菌联合美沙拉嗪治疗,对照组患者给予美沙拉嗪治疗。观察并比较两组患者治疗前后肠道内肠杆菌、双歧杆菌、乳酸杆菌、粪肠球菌及类杆菌的变化情况,以及血清CD4~+,CD8~+及CD4~+/CD8~+水平,并评价两组的临床疗效。结果:治疗前,两组患者肠道菌群数量比较,差异无统计学意义(P0.05);治疗后,两组患者肠道内大肠杆菌及粪肠球菌数量均减少,且研究组少于对照组,差异具有统计学意义(P0.05);治疗后,两组患者肠道内乳酸杆菌、双歧杆菌和类杆菌数量均增加,且研究组高于对照组,差异具有统计学意义(P0.05)。治疗前,两组患者免疫功能指标比较,差异无统计学意义(P0.05);治疗后,两组患者CD4~+T细胞以及CD4~+/CD8~+均显著高于治疗前,而CD8~+T细胞显著降低,差异具有统计学意义(P0.05);治疗后,研究组患者CD4~+T细胞及CD4~+/CD8~+均高于对照组,而CD8+T细胞低于对照组,差异具有统计学意义(P0.05)。研究组患者的临床疗效(91.67%)高于对照组(76.67%),但两组比较,差异无统计学意义(P0.05)。结论:益生菌制剂治疗不仅能够调节肠易激综合征患者肠道内的菌群平衡,而且能够改善患者的免疫功能,值得临床推广应用。     

百令胶囊联合左卡尼汀对维持性血液透析患者氧化应激、T淋巴细胞亚群及营养状态的影响*

目的:探讨百令胶囊联合左卡尼汀对维持性血液透析(MHD)患者氧化应激、T淋巴细胞亚群及营养状态的影响。方法:选取我院于2015年6月至2017年4月期间接受MHD治疗的慢性肾衰竭患者72例为研究对象。按照数表法将患者随机分为对照组(n=36)和实验组(n=36)。两组患者均行MHD治疗,实验组患者在此基础上给予百令胶囊联合左卡尼汀治疗,疗程均为6个月。比较两组治疗前、治疗6个月后的氧化应激指标:血浆丙二醛(MDA)、血浆谷胱甘肽过氧化物酶(GSHPx)、血浆总高半胱氨酸(tHcy)水平,免疫功能指标:CD3~+、CD4~+、CD8~+、CD4~+/CD8~+,营养状态指标:血红蛋白(Hb)、白蛋白(Alb)、前白蛋白(PA)、总胆固醇(TCh)、三酰甘油(TG)、脂蛋白(a)[Lp(a)]。结果:两组患者治疗6个月后MDA、t Hcy水平下降,且实验组低于对照组(P0.05);治疗6个月后实验组患者GSHPx水平高于治疗前与对照组(P0.05),而对照组GSHPx水平与治疗前相比差异无统计学意义(P0.05)。治疗6个月后,实验组患者CD3~+、CD4~+、CD4~+/CD8~+水平高于治疗前及对照组,而CD8~+低于治疗前及对照组(P0.05)。实验组治疗6个月后Hb、Alb、PA水平高于治疗前及对照组,而Lp(a)低于治疗前及对照组(P0.05),实验组患者TCh、TG水平与治疗前比较差异无统计学意义(P0.05);对照组治疗6个月后Hb、Alb、PA、TCh、TG、Lp(a)水平与治疗前比较差异均无统计学意义(P0.05)。结论:百令胶囊联合左卡尼汀可减轻MHD患者氧化应激反应,调节T淋巴细胞亚群,同时改善患者营养状况,值得临床推广应用。     

双歧杆菌三联活菌片对溃疡性结肠炎患者免疫功能及Fas/FasL表达的影响

目的:研究双歧杆菌三联活菌片对溃疡性结肠炎患者免疫功能及Fas/FasL表达的影响。方法:选取2014年7月至2015年6月本院收治的84例溃疡性结肠炎患者,根据患者入院顺序分为观察组(42例)和对照组(42例)两组。对照组采取美沙拉秦肠溶片进行治疗,观察组在此基础上结合双歧杆菌三联活菌片进行治疗。分析两组患者治疗前和治疗2个月后炎症因子水平、T细胞亚群以及Fas/FasL表达情况,并比较两组患者的临床疗效。结果:观察组总的有效率显著高于对照组(P0.05)。治疗后,观察组的血清白介素-1(IL-1)、白介素-6(IL-6)、白介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)水平显著低于对照组(P0.05),CD4+、CD4+/CD8+T细胞亚群显著高于对照组,CD8+、Fas/FasL表达显著低于对照组,差异均有统计学意义(P0.05)。结论:使用双歧杆菌三联活菌片治疗溃疡性结肠炎患者能改善患者的免疫功能及Fas/Fasl表达,减轻炎症反应,临床效果良好。     

糖尿病肾病患者微炎症状态与营养状况及免疫功能的相关性分析

目的:探讨糖尿病肾病(DN)患者微炎症状态与营养状况及免疫功能的关系。方法:选取2015年6月～2018年6月期间我院收治的DN患者90例作为观察组,依据尿微量白蛋白排泄率(UAER)水平将其分为A组(正常白蛋白尿,UAER20μg/min,n=28)、B组(微量白蛋白尿,UAER20～200μg/min,n=29)、C组(蛋白尿,UAER200μg/min,n=33),另选取同期来我院行健康体检的志愿者40例作为对照组,检测所有研究对象微炎症、营养状况、免疫功能等相关指标并比较,采用Pearson相关性分析微炎症状态指标与营养状况指标及免疫功能指标的相关性。结果:观察组C反应蛋白(CRP)、白介素-6(IL-6)、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)均高于对照组(P0.05),观察组白蛋白(Alb)、血红蛋白(Hb)、CD3~+、CD4~+、CD4~+/CD8~+、免疫球蛋白G(IgG)均低于对照组(P0.05)。B组、C组CRP、IL-6、IgA、IgM均高于A组,且C组高于B组(P0.05),B组、C组Alb、Hb、CD3~+、CD4~+、CD4~+/CD8~+均低于A组,且C组低于B组(P0.05),三组IgG比较差异无统计学意义(P0.05)。经Pearson相关性分析显示,CRP、IL-6与Alb、Hb、CD3~+、CD4~+、CD4~+/CD8~+呈负相关(P0.05),与IgA、IgM呈正相关(P0.05),与IgG不相关(P0.05)。结论:DN患者存在不同程度的微炎症、免疫功能下降以及营养不良状况,通过控制或消除促炎因子,提高机体免疫功能,改善机体营养状况,可能对延缓DN的病情发展具有一定的临床意义。     

A Unique Protease Cleavage Site Predicted in the Spike Protein of the Novel Pneumonia Coronavirus (2019-nCoV) Potentially Related to Viral Transmissibility

正Dear Editor,In December 2019, a novel human coronavirus caused an epidemic of severe pneumonia(Coronavirus Disease 2019,COVID-19) in Wuhan, Hubei, China(Wu et al. 2020; Zhu et al. 2020). So far, this virus has spread to all areas of China and even to other countries. The epidemic has caused 67,102 confirmed infections with 1526 fatal cases     

Curcuminoids as inhibitors of thioredoxin reductase: A receptor based pharmacophore study with distance mapping of the active site

Curcumin is the yellow pigment of turmeric that interacts irreversibly forming an adduct with thioredoxin reductase (TrxR), an enzyme responsible for redox control of cell and defence against oxidative stress. Docking at both the active sites of TrxR was performed to compare the potency of three naturally occurring curcuminoids, namely curcumin, demethoxy curcumin and bis-demethoxy curcumin. Results show that active sites of TrxR occur at the junction of E and F chains. Volume and area of both cavities is predicted. It has been concluded by distance mapping of the most active conformations that Se atom of catalytic residue SeCYS498, is at a distance of 3.56 from C13 of demethoxy curcumin at the E chain active site, whereas C13 carbon atom forms adduct with Se atom of SeCys 498. We report that at least one methoxy group in curcuminoids is necessary for interation with catalytic residues of thioredoxin. Pharmacophore of both active sites of the TrxR receptor for curcumin and demethoxy curcumin molecules has been drawn and proposed for design and synthesis of most probable potent antiproliferative synthetic drugs.     

Comparative morphology of the carpel in the Liliaceae: Hewardieae, Petrosavieae, and Tricyrteae

The young pistils in the melanthioid tribes, Hewardieae, Petrosavieae and Tricyrteae, are uniformly tricarpellate and syncarpous. They lack raphide idioblasts. All are multiovulate, with bitegmic ovules. The Petrosavieae are marked by the presence of septal glands and incomplete syncarpy. Tepals and stamens adhere to the ovary in the Hewardieae and the Petrosavieae but not in the Tricyrteae. Two vascular bundles occur in the stamens of the Hewartlieae and Tricyrtis latifolia. Ventral bundles in the upper part of the ovary of the Hewardieae are continuous with compound septal bundles and placental bundles in the lower part. Putative ventral bundles occur in the alternate position in the Tricyrteae and putative placental bundles in the opposite. position in the Petrosavieae. The dichtomously branched stigma in each carpel of the Tricyrteae is supplied by a bifurcated dorsal bundle.     

Enterovirus 71 3C proteolytically processes the histone H3 N-terminal tail during infection

Highlights
1. The N-terminal tail of histone H3 is specifically cleaved during EV71 infection.
2. Viral protease 3C is identified as a protease responsible for proteolytically processing the N-terminal H3 tail.
3. Our finding reveals a new epigenetic regulatory mechanism for Enterovirus 71 in virus-host interactions.     

Detection of EBV and HHV6 in the Brain Tissue of Patients with Rasmussen’s Encephalitis

Rasmussen’s encephalitis (RE) is a rare pediatric neurological disorder, and the exact etiology is not clear. Viral infection may be involved in the pathogenesis of RE, but conflicting results have reported. In this study, we evaluated the expression of both Epstein-Barr virus (EBV) and human herpes virus (HHV) 6 antigens in brain sections from 30 patients with RE and 16 control individuals by immunohistochemistry. In the RE group, EBV and HHV6 antigens were detected in 56.7% (17/30) and 50% (15/30) of individuals, respectively. In contrast, no detectable EBV and HHV6 antigen expression was found in brain tissues of the control group. The co-expression of EBV and HHV6 was detected in 20.0% (6/30) of individuals. In particular, a 4-year-old boy had a typical clinical course, including a medical history of viral encephalitis, intractable epilepsy, and hemispheric atrophy. The co-expression of EBV and HHV6 was detected in neurons and astrocytes in the brain tissue, accompanied by a high frequency of CD8⁺ T cells. Our results suggest that EBV and HHV6 infection and the activation of CD8⁺ T cells are involved in the pathogenesis of RE.     

Perinatal Vertical Transmission of Chikungunya Virus in Ruili,a Town on the Border between China and Myanmar

正Dear Editor,Chikungunya virus (CHIKV), an arbovirus in the family of Togaviridae, genus Alphavirus, is transmitted by the A.aegyptii or A. albopictus mosquito, and causes disease in humans characterized by fever, rash, and arthralgia (Silva and Dermody 2017; Suhrbier 2019). It was first reported in 1953 in Tanzania, and caused only a few outbreaks and sporadic cases in Africa and Asia in last century. However, in the epidemic in 2004, CHIKV acquired mutations that conferred enhanced transmission by the A. albopictus mosquito(Schuffenecker et al. 2006). Since then, it has successively caused outbreaks in Africa, the Indian Ocean, South East Asia, the South America, and Europe (Zeller et al. 2016).     

Development of a Novel Reverse Transcription Loop-Mediated Isothermal Amplification Method for Rapid Detection of SARS-CoV-2

In conclusion, the novel visual RT-LAMP assay is a simple, rapid, and sensitive approach for detection of SARS-CoV-2, and it is ready for application in primary care and community hospitals or health care centers, and even patients' own houses in response to the current SARS-CoV-2 epidemic because the assay does not require sophisticated equipment and skilled personnel. Furthermore, it is also ready to be used in fields for screening samples from wild animals and environments to facilitate the identification of potential intermediate hosts that mediate the cross-species transmission of SARS-CoV-2 from bats to humans.