益生菌对婴儿期特应性皮炎预防作用的系统评价

目的系统评价益生菌对婴儿期特应性皮炎的预防作用。方法计算机检索中英文数据库,检索时限从建库到2017年12月,收集益生菌对婴儿期特应性皮炎预防的临床随机对照试验的文献,由2名研究员筛选文献及质量评价,采用RevMan 5.3软件进行Meta分析。结果最终纳入质量较高的20个研究,共3 701例患儿。结果显示:益生菌组特应性皮炎发生率低于对照组,两组差异具有统计学意义(RR=0.74,95%CI:0.64~0.86,P0.01)。进一步亚组分析后发现仅产前母亲或产后婴儿口服益生菌对婴儿期特应性皮炎无预防作用(RR=0.91,95%CI:0.62~1.33,P=0.62;RR=0.91,95%CI:0.71~1.16,P=0.43),而在两者均服用益生菌的比较中发现单独服用乳酸菌类或与其他益生菌混合服用同安慰剂组比较均具有预防作用(RR=0.70,95%CI:0.52~0.94,P0.05;RR=0.65,95%CI:0.50~0.86,P0.01)。结论孕母及产后婴儿均补充益生菌对婴儿期特应性皮炎具有预防作用,单独服用临床常用的乳酸菌类或与其他益生菌混合服用同样具有保护作用,但由于国内外菌株、种群差异等诸多因素,其对婴儿期特应性皮炎的保护机制在国内尚需进一步研究。     

过敏原检测在幼儿喘息性疾病中的临床意义

目的:探讨过敏原检测在幼儿喘息性疾病中的临床应用价值。方法:选择我院儿科收治的的1～5岁下呼吸道感染的特应性体质患儿217例,按照有无喘息症状分为喘息组与非喘息组。采集并比较两组患儿年龄、性别、过敏史(食物过敏,药物过敏,鼻炎,湿疹)、体外过敏原检测结果:TIgE(总IIgE)及sIgE(特异性IgE),(视sIgE≥2级为阳性)、一二级亲属过敏性疾病史。结果:(1)喘息组反复呼吸道感染及鼻炎人数均高于非喘息组(P0.05)。两组在湿疹、喜揉眼、食物过敏、药物过敏、一级亲属过敏史、二级亲属过敏史方面比较差异不具有统计学意义(P0.05)。(2)两组体外过敏原检测结果比较:喘息组户尘螨阳性人数多于非喘息组;(3)喘息患儿组根据是否伴有鼻炎及湿疹分为:A组,喘息,不伴有鼻炎及湿疹;B组,喘息伴有鼻炎或者湿疹;C组,喘息,伴有鼻炎及湿疹。ABC三组TIgE、年龄、吸入过敏原个数、吸入过敏原阳性人数、户尘螨阳性率逐渐增多,差异具有统计学意义(P0.05),其他吸入过敏原及食入过敏原比较差异无统计学意义。结论:反复呼吸道感染、鼻炎和喘息密切相关。尘螨是幼儿喘息、变应性鼻炎和特应性皮炎主要过敏原之一,是特应性体质患儿是否发生喘息的关键过敏原。     

益生菌预防成人艰难梭菌相关性腹泻的 Meta分析

目的系统评价益生菌预防成人艰难梭菌相关性腹泻(Clostridium difficile associated diarrhea,CDAD)的临床疗效。方法计算机检索PubMed、EMBASE、Cochrane、Web of Science、CBM、万方数据库、维普资讯网和中国知网全文数据库,纳入益生菌预防成人CDAD的随机对照试验(RCT),采用随机效应模型进行Meta分析。结果共有13项符合纳入标准的随机对照试验,包括5 179名患者,其中干预组2 730例,对照组2 449例。Meta分析结果显示,预防性使用益生菌可降低CDAD的风险(RR=0.49,95%CI0.33-0.75,I2=16.4%)。亚组分析发现益生菌高剂量(RR=0.41,95%CI0.22-0.77,P=0.043)、混合菌种(RR=0.43,95%CI0.24-0.75,P=0.037)与对照组相比,差异均有统计学意义。结论辅助性益生菌的应用能够有效预防成人艰难梭菌相关性腹泻的发生。但受纳入研究数量较少与研究质量的参差不齐的影响,本结论尚需要开展更多高质量、大样本的研究予以证实。     

口服益生菌对结直肠癌患者术后感染影响的Meta分析

目的系统评价口服益生菌对结直肠癌患者术后感染的影响。方法计算机检索PubMed、The Cochrane Library、EMbase、CNKI、WanFang Data和VIP数据库,搜集有关益生菌干预结直肠癌患者术后感染的随机对照试验(randomized controlled trials,RCTs),检索时限均为建库至2020年3月。由2名研究者独立筛选文献、提取资料并进行质量评价,采用RevMan 5.3软件与Stata 14.0软件进行Meta分析。结果共纳入13个RCTs(1122例患者),Meta分析结果显示:益生菌干预的试验组术后感染的总发生率低于对照组(OR=0.32,95%CI:0.24~0.44)。同时,试验组手术部位感染(OR=0.42,95%CI:0.27~0.66)、尿路感染(OR=0.30,95%CI:0.16~0.59)和肺部感染(OR=0.38,95%CI:0.23~0.66)的发生率也低于对照组,但腹腔脓肿(OR=0.55,95%CI:0.20~1.51)差异无统计学意义(P>0.05)。2组研究对象在吻合口瘘(OR=0.41,95%CI:0.19~0.87)和住院时间(WMD=-1.44,95%CI:-2.18~-0.71)差异也具有统计学意义。亚组分析结果提示2种及2种以上益生菌的联合效果可能高于单一益生菌干预的效果。结论结直肠癌患者口服益生菌可降低术后感染的发生率,改善患者预后。     

益生菌四联疗法对比铋剂四联疗法根除幽门螺杆菌感染的Meta分析

目的系统评价益生菌四联疗法对比铋剂四联疗法根除幽门螺杆菌(H.pylori)感染的疗效和不良反应。方法计算机检索中英文数据库,收集上述2种方案根除H.pylori感染的随机对照试验(RCT),检索时间均从建库至2016年10月。由2名评价员独立筛选文献、提取资料、评价纳入研究的偏倚风险,采取RevMan 5.3软件进行Meta分析。结果最终纳入12个RCT(共1 687例患者)。Meta分析结果显示:益生菌四联组患者对比铋剂四联组的H.pylori根除率按ITT分析为:80.6%vs81.2%;按PP分析为:81.2%vs 83.7%,差异无统计学意义(ITT分析:RR=0.99,95%CI:0.95~1.04,P=0.76;PP分析:RR=0.97,95%CI:0.93~1.01,P=0.17);益生菌四联组的总不良反应的发生率明显低于对照组(16.0%vs 34.9%),且差异有统计学意义(RR=0.46,95%CI:0.37~0.57,P0.01)。结论现有证据显示,益生菌四联疗法与铋剂四联疗法的H.pylori根除率相当,但益生菌四联疗法的不良反应低于铋剂四联疗法。由于纳入研究数量有限,质量不高,上述结论有待高质量的研究予以验证。     

益生菌对非酒精性脂肪肝治疗疗效的Meta分析

目的系统评价益生菌对非酒精性脂肪肝(non-alcoholic fatty liver disease,NAFLD)的治疗疗效。方法通过计算机检索PubMed、Cochrane、中国知网(CNKI)、万方、维普数据库(VIP)检索2008年5月-2018年5月益生菌治疗非酒精性脂肪肝相关文献,纳入11篇病例对照研究,采用NOS量表(Newcastle-Ottawa Scale)进行文献质量评价,提取身体质量指数(body mass index,BMI)、血清学指标、炎性指标及影像学分级等参数,应用RevMan 5.3软件进行Meta分析、亚组分析,Stata 12.0软件进行敏感性分析及发表偏倚检测。结果纳入的11篇病例对照研究符合标准,病例总数为650,Meta分析结果显示:益生菌组较对照组,可明显降低血清学指标ALT (WMD=-12.49,95%CI:-16.67～-8.31,P0.00001)、AST (WMD=-11.39,95%CI:-16.51～-6.26,P0.0001)、TC (WMD=-0.34,95%CI:-0.54～-0.13,P=0.001)水平,增加脂肪肝消退数(RR=4.20,95%CI:2.02～8.72,P=0.001),对于身体质量指数(WMD=-0.81,95%CI:-2.22～0.60,P=0.26)、胰岛素抵抗指数(WMD=-0.06,95%CI:-0.82～0.70,P=0.88)、炎症指标TNF (SMD=-1.00,95%CI:-2.11～0.11,P=0.08)差异则无统计学意义。对身体质量指数进行亚组分析显示,三种以上复合益生菌可明显降低身体质量指数水平(WMD=-2.30,95%CI:-2.43～-2.17,P0.00001)。结论益生菌制剂可改善非酒精性脂肪肝的肝功能及影像学表现,降低血脂水平,但并未明显降低身体质量指数、胰岛素抵抗及炎性指标TNF水平。发现三种以上复合益生菌对于降低BMI有一定作用。     

芽胞杆菌治疗幽门螺杆菌感染疗效的Meta分析

目的评价芽胞杆菌(Bacillus)联合根除标准疗法治疗幽门螺杆菌(H.pylori)感染的有效性。方法收集关于芽胞杆菌联合治疗H.pylori感染的随机对照试验(RCT),检索时限为建库至2020年5月;对符合纳入标准的研究进行偏倚风险评价及Meta分析。结果最终纳入14个RCT。Meta分析结果显示芽胞杆菌联合治疗能提高H.pylori根除率(ITT分析:RR=1.13,95%CI:1.08~1.18,P0.001;PP分析:RR=1.13,95%CI:1.09~1.17,P0.001),降低不良反应发生率(RR=0.42,95%CI:0.35~0.50,P0.001)。根据亚组分析结果,芽胞杆菌联合H.pylori两种常规治疗方案[三联疗法(RR=1.22,95%CI:1.10~1.36,P=0.003),铋剂四联疗法(RR=1.11,95%CI:1.07~1.15,P0.001)]以及芽胞杆菌联合H.pylori常规治疗的两种疗程[10 d(RR=1.14,95%CI:1.04~1.24,P=0.006),14 d(RR=1.14,95%CI:1.07~1.21,P0.001)]均提高H.pylori根除率;而亚组分析芽胞杆菌种类中,地衣芽胞杆菌差异有统计学意义(RR=1.14,95%CI:1.10~1.19,P0.001),凝结芽胞杆菌与蜡样芽胞杆菌需扩大样本量进一步统计分析。结论芽胞杆菌联合疗法能有利于提高H.pylori根除率,并降低总不良反应的发生,相对于标准疗法有一定的意义。     

国内静脉注射伏立康唑和氟康唑预防真菌感染临床疗效和安全性比较的Meta分析

目的 通过Meta分析探讨静脉注射伏立康唑和静脉注射氟康唑预防真菌感染的临床疗效和安全性。方法 以伏立康唑为实验组,氟康唑为对照组。通过计算机检索中国期刊全文数据库(CNKI)、万方数据库、维普数据库,并进一步对纳入文献的参考文献进行扩大检索。对符合纳入标准的随机对照研究(RCT)按Cochrane系统评价的方法,独立进行资料提取、质量评价并交叉核对后,采用Stata14.0软件进行Meta分析。结果 共纳入19篇研究,共计1492例患者。伏立康唑有着更高的有效率和有更低的不良反应,两者差异有统计学意义(RR=1.20,95%CI=1.14~1.26,P<0.001)和RR=0.76,95%CI=0.65~0.90,P=0.001)。同时在控制感染发热和真菌清除方面,伏立康唑有着更好的效果,两者差异有统计学意义,分别为(RR=1.63,95%CI=1.40~1.90,P<0.001和RR=1.27,95%CI=1.13~1.44,P<0.001)。结论 Meta分析结果表明伏立康唑比氟康唑预防真菌感染有更好的疗效和预后及更低的不良反应。     

呼吸道过敏性疾病与社会心理因素双向关系的Meta分析

目的:系统评价呼吸道过敏性疾病和社会心理因素的关系。方法:计算机检索Cochrance图书馆、Medline、EMbase、Pubmed、CBM、CNKI等数据库,查找包括心理社会因素对呼吸道过敏性疾病的影响或者呼吸道过敏性疾病对精神健康影响的临床研究,根据纳入和排除标准选择文献,对符合纳入标准的文献进行Meta分析,计算其合并OR值及95%CI。结果:共纳入20个病例研究(13篇文献),其中13个研究评估心理社会因素对呼吸道过敏性疾病的影响,7个研究评估效果呼吸道过敏性疾病对心理健康的影响。在这些研究中呼吸道过敏性疾病是评估哮喘和过敏性鼻炎。Meta分析结果显示社会心理因素和呼吸道疾病的发生发展有关[OR=1.77,95%CI(1.42,2.22)],呼吸道过敏性疾病与未来不健康的心理发生发展有关[OR=1.73,95%CI(1.47,2.03)]。结论:当前的研究发现呼吸道过敏性疾病和社会心理因素有很大的关系。这支持在呼吸道过敏性疾病治疗除了传统的生理和药理干预外,心理干预呼吸道对过敏性疾病的预防和管理也发挥作用。     

益生菌对肝移植术后患者感染的影响及相关因素Meta分析

目的应用益生菌对肝移植术后患者的感染情况及相关因素进行Meta分析,以得出新的结论。方法利用PUBMED、EMBASE、CNKI电子期刊数据库、万方数据库和维普数据库,检索益生菌对肝移植术后患者影响的对照研究的文献进行系统评价,应用Review Manager 5.3分析软件进行Meta分析。结果通过数据库检索21篇文章,根据纳入标准最终选择5篇,包括301名受试者(152名为试验组,149名为对照组)纳入分析,Meta分析显示与对照组相比,使用益生菌对肝移植的患者进行肠道准备,可以降低患者术后的感染率(OR=0.21,95%CI:0.11~0.41),差异有统计学意义(P0.05);能够减少住院时间(MD=-1.41,95%CI:-1.97~-0.86)和抗生素的应用时间(MD=-4.32,95%CI:-5.50~-3.13),差异有统计学意义(P0.05);降低胃肠道的不良反应(OR=0.51,95%CI:0.28~0.92),差异有统计学意义(P0.05)。结论在肝移植之前或当天给予益生菌能够减少肝移植术后患者的感染率、抗生素使用疗程及患者的住院时间。     

Scurvy in capybaras bred in captivity in Argentine

In order to determine if the absence of vitamin C in the diet of capybaras (Hydrochoerus hydrochaeris) causes scurvy, a group of seven young individuals were fed food pellets without ascorbic acid, while another group of eight individuals received the same food with 1 g of ascorbic acid per animal per day. Animals in the first group developed signs of scurvy-like gingivitis, breaking of the incisors and death of one animal. Clinical signs appeared between 25 and 104 days from the beginning of the trial in all individuals. Growth rates of individuals deprived of vitamin C was considerably less than those observed in the control group. Deficiency of ascorbic acid had a severe effect on reproduction of another population of captive capybaras. We found that the decrease in ascorbic acid content in the diet affected pregnancy, especially during the first stages. The results obtained suggest that it is necessary to supply a suitable quantity of vitamin C in the diet of this species in captivity.     

Changes in lactate dehydrogenase activity in chicken tissues in hyperthyreosis in ontogenesis

The lactate dehydrogenase activity in reactions of lactate oxidation and synthesis was studied in subfractions of the chicken brain, heart and liver at the embryonal, early postembryonal and adult stages of development after thyroxine administration. It has been shown that during embryogenesis thyroxine predominantly enhanced the rate of lactate oxidation in the mitochondrial tissues. A marked increase in the lactate synthesis was found in cytoplasm of the adult chicken tissues. Specificity of enzyme activity alterations was detected in the chicken brain during ontogenesis after thyroxine administration.     

Role for dopamine in malonate-induced damage in vivo in striatum and in vitro in mesencephalic cultures

Defects in mitochondrial energy metabolism have been implicated in the pathology of several neurodegenerative disorders. In addition, the reactive metabolites generated from the metabolism and oxidation of the neurotransmitter dopamine (DA) are thought to contribute to the damage to neurons of the basal ganglia. We have previously demonstrated that infusions of the metabolic inhibitor malonate into the striata of mice or rats produce degeneration of DA nerve terminals. In the present studies, we demonstrate that an intrastriatal infusion of malonate induces a substantial increase in DA efflux in awake, behaving mice as measured by in vivo microdialysis. Furthermore, pretreatment of mice with tetrabenazine (TBZ) or the TBZ analogue Ro 4-1284 (Ro-4), compounds that reversibly inhibit the vesicular storage of DA, attenuates the malonate-induced DA efflux as well as the damage to DA nerve terminals. Consistent with these findings, the damage to both DA and GABA neurons in mesencephalic cultures by malonate exposure was attenuated by pretreatment with TBZ or Ro-4. Treatment with these compounds did not affect the formation of free radicals or the inhibition of oxidative phosphorylation resulting from malonate exposure alone. Our data suggest that DA plays an important role in the neurotoxicity produced by malonate. These findings provide direct evidence that inhibition of succinate dehydrogenase causes an increase in extracellular DA levels and indicate that bioenergetic defects may contribute to the pathogenesis of chronic neurodegenerative diseases through a mechanism involving DA.     

SSTR5 ablation in islet results in alterations in glucose homeostasis in mice

Somatostatin (SST) peptide is a potent inhibitor of insulin secretion and its effect is mediated via somatostatin receptor 5 (SSTR5) in the endocrine pancreas. To investigate the consequences of gene ablation of SSTR5 in the mouse pancreas, we have generated a mouse model in which the SSTR5 gene was specifically knocked down in the pancreatic beta cells (betaSSTR5Kd) using the Cre-lox system. Immunohistochemistry analysis showed that SSTR5 gene expression was absent in beta cells at three months of age. At the time of gene ablation, betaSSTR5Kd mice demonstrated glucose intolerance with lack of insulin response and significantly reduced serum insulin levels. Insulin tolerance test demonstrated a significant increase of insulin clearance in vivo at the same age. In vitro studies demonstrated an absence of response to SST-28 stimulation in the betaSSTR5Kd mouse islet, which was associated with a significantly reduced SST expression level in betaSSTR5Kd mice pancreata. In addition, betaSSTR5Kd mice had significantly reduced serum glucose levels and increased serum insulin levels at 12 months of age. Glucose tolerance test at an older age also indicated a persistently higher insulin level in betaSSTR5Kd mice. Further studies of betaSSTR5Kd mice had revealed elevated serum C-peptide levels at both 3 and 12 months of age, suggesting that these mice are capable of producing and releasing insulin to the periphery. These results support the hypothesis that SSTR5 plays a pivotal role in the regulation of insulin secretion in the mouse pancreas.     

我国葫芦科植物离体培养研究进展

葫芦科植物包括多种瓜类蔬菜,对其进行离体培养研究具有重要的理论和实践意义。综述了国内在葫芦科植物器官培养、体细胞胚胎发生、花药培养、原生质体培养和体细胞杂交及离体遗传转化等方面取得的研究进展,并对葫芦科植物离体培养、遗传转化与育种的前景作了展望。