Intestinal permeability to lactulose and mannitol in growing rats with iron-deficiency anemia

Iron deficiency can have nonhematological manifestations, some of which may affect the gastrointestinal tract. The aim of this study was to determine if iron-deficiency anemia in growing rats affected small-bowel permeability as assessed by the urinary ratio of lactulose and mannitol. Thirty-seven male Harlan Sprague-Dawley rats (21 d of age) were randomly divided into two groups and fed either an iron-deficient (n=19) or an iron-sufficient diet (n=18) that contained either 13.5 or 43.8 mg of iron/kg diet, respectively. Animals were evaluated between 25 and 38 d of dietary treatment. Intestinal permeability was assessed by measuring the lactulose/mannitol urinary ratio following administration of a solution that contained the two sugars. At the end of the study, the mean body weight of rats fed the low-iron diet was approx 95% that of the controls. The mean hemoglobin (g/dL) was significantly lower in the low-iron diet group (11.2±1.4) than in the control group (16.9±0.8) (p=0.001). The liver iron concentration (μg/g) of the anemic group (41.4±4.7) was also statistically (p=0.001) lower than in the control group (116.6±18.2). The lactulose/mannitol ratio was lower in the anemic rats (2.0±0.7) than in the control group (2.6±0.7) (p=0.008), a finding that is not suggestive of intestinal mucosal atrophy, previously described in anemic children.     

Total parenteral nutrition adversely affects gut barrier function in neonatal piglets

Sepsis is the most common morbidity in preterm infants, who often receive total parenteral nutrition (TPN). We hypothesized that gut barrier function is compromised in TPN-fed compared with enterally fed newborn piglets (ENT pigs). Colostrum-deprived newborn pigs were implanted with jugular venous and bladder catheters under general anesthesia. Pigs were either administered TPN (n = 15) or fed formula (ENT pigs, n = 15). After 6 days, pigs were gavaged a solution of mannitol, lactulose, and polyethylene glycol 4000 (PEG 4000) and urine was collected for 24 h. At 7 days, small bowel samples were assayed for myeloperoxidase activity, morphometry, and tight junction protein abundance. Intestinal contents and peripheral organ sites were cultured for bacteria. Urinary recovery (%dose) of mannitol (53 vs. 68) was lower, whereas that of lactulose (2.93 vs. 0.18) and PEG 4000 (12.78 vs. 0.96) were higher in TPN vs. ENT pigs, respectively (P < 0.05). Incidence of translocation was similar in TPN and ENT pigs. Myeloperoxidase activity was increased in TPN vs. ENT pigs in the jejunum (P < 0.001) and was weakly correlated with lactulose (R2 = 0.32) and PEG 4000 (R2 = 0.38) recovery. Goblet cell counts did not change, but intraepithelial lymphocyte numbers decreased with TPN. Only claudin-1 protein abundance was increased in the TPN group. We conclude that TPN is associated with impairment of neonatal gut barrier function as measured by permeability but not translocation.     

Studies on intestinal permeability of cirrhotic patients by analysis lactulose and mannitol in urine with HPLC/RID/MS

The method for separation and determination of lactulose (L) and mannitol (M) in urine was developed by HPLC with a refractive index detector (RID). The linearity ranged from 5 to 1000 microg/mL for L and M, respectively. Recoveries ranged from 93.1% to 97.1%. The intra- and inter-day relative standard deviations of peak area were between 0.8-1.4% (n=3) and 1.4-3.6% (n=3). The limits of detection were obtained with 1.40 microg/mL for L and 1.65 microg/mL for M. The ratios of L/M in the urine samples for the spontaneous ascitic fluid infection (SAI), sterile ascitic fluid (SA) patients, and healthy volunteers (HV) were determined. The results showed well the correlations among the L/M ratio, intestinal permeability (IP) and the illness status of patients, and also indicated lactulose could improve the IP of SAI patients. The peaks of L and M in chromatograms were identified by electrospray ionization/mass spectrometry (ESI/MS), which ensured the accurate measurement of the ratio L/M. This method presented a rapid, accurate, and practical technique for determining IP in clinical practice and investigating the pathology of hepatocirrhosis.     

Colonic fermentation from lactulose inhibits lipolysis in overweight subjects

One of the strategies to prevent insulin resistance is to reduce circulating free fatty acids (FFA). The aim of this study is to assess the effect of an oral lactulose load on fatty acid metabolism in overweight subjects. Eight overweight subjects received a primed constant intravenous infusion of [1-(13)C]acetate and of [1,1,2,3,3-(2)H(5)]glycerol for 9 h. After 3 h of tracer infusion, patients ingested 30 g lactulose, or saline solution. Arterialized blood samples were collected every 20 min. Basal plasma concentrations of acetate were similar before and between oral treatments as well as glycerol and FFA concentrations. Plasma acetate turnover was 11.4 +/- 2.4 vs. 10.7 +/- 1.4 micromol.kg(-1).min(-1) [not significant (NS)], and plasma glycerol turnover was 3.8 +/- 0.4 vs. 4.8 +/- 1.9 micromol.kg(-1).min(-1) (NS). After lactulose ingestion, acetate concentration increased twofold and then decreased to baseline. Acetate turnover rate increased to 15.5 +/- 2.2 micromol.kg(-1).min(-1) after lactulose treatment, whereas it was unchanged after saline treatment (10.3 +/- 2.2 micromol.kg(-1).min(-1), P < or = 0.0001). In contrast, FFA concentrations decreased significantly after lactulose ingestion and then increased slowly. Glycerol turnover decreased after lactulose ingestion compared with saline, 2.8 +/- 0.4 vs. 3.5 +/- 0.3 micromol.kg(-1).min(-1) (P < or = 0.05). A significant negative correlation was found between glycerol and acetate turnover after lactulose treatments (r = -0.78, P < or = 0.02). These results showed in overweight subjects a short-term decrease in FFA level and glycerol turnover after lactulose ingestion related to a decrease of lipolysis in close relationship with an increase of acetate production.     

Gas chromatographic method for detection of urinary sucralose: application to the assessment of intestinal permeability

We developed a capillary column gas chromatography (CCGC) method for the measurement of urinary sucralose (S) and three other sugar probes including, sucrose, lactulose (L) and mannitol (M) for use in in vivo studies of intestinal permeability. We compared the capillary method with a packed column gas chromatography (PCGC) method. We also investigated a possible role for sucralose as a probe for the measurement of whole gut permeability. Sample preparation was rapid and simple. The above four sugars were detected precisely, without interference. We measured intestinal permeability using 5- and 24-h urine collections in 14 healthy volunteers. The metabolism of sugars was evaluated by incubating the intestinal bacteria with an iso-osmolar mixture of mannitol, lactulose and sucralose at 37 degrees C for 19 h. Sugar concentrations and the pH of the mixture were monitored. The use of the CCGC method improved the detection of sucralose as compared to PCGC. The average coefficient of variation decreased from 15% to 4%. It also increased the sensitivity of detection by 200-2000-fold. The GC assay was linear between sucralose concentrations of 0.2 and 40 g/l (r=1.000). Intestinal bacteria metabolized lactulose and acidified the media but did not metabolize sucralose or mannitol. The new method for the measurement of urinary sucralose permits the simultaneous quantitation of sucrose, mannitol and lactulose, and is rapid, simple, sensitive, accurate and reproducible. Because neither S nor M is metabolized by intestinal bacteria, and because only a tiny fraction of either sugar is absorbed, this pair of sugar probes appears to be available for absorption throughout the GI tract. Thus, the 24-h urinary concentrations of S and M, or the urinary S/M ratio following an oral dose of a sugar mixture, might be good markers for whole gut permeability.     

高压液色谱用于肠通透性的测定

目的 建立一种测定肠通透性的可靠方法。方法 以甘露醇和乳果糖为探测剂,用带脉冲电化学检测器的高压液相色谱仪对２０例健康成人样品中的甘露醇和乳果糖进行检测。结果 ２０个样品中的甘露醇和乳果糖均被检测到,其最低质量浓度分别为０．２０２８ｍｇ／Ｌ和０．１９３０ｍｇ／Ｌ,回收率分别为９８．２％和１０４．３％。结论 用带脉冲电化学检测器的高压液相色谱仪测定尿中的甘露醇和乳果糖是一种灵敏度高,特异性强,操作简     

Resolution of common dietary sugars from probe sugars for test of intestinal permeability using capillary column gas chromatography

BACKGROUND: The most widely accepted method for the evaluation of intestinal barrier integrity is the measurement of the permeation of sugar probes following an oral test dose of sugars. The most-widely used sugar probes are sucrose, lactulose, mannitol and sucralose. Measuring these sugars using a sensitive gas chromatographic (GC) method, we noticed interference on the area of the lactulose and mannitol peaks. METHODS: We tested different sugars to detect the possible makeup of these interferences and finally detected that the lactose interferes with lactulose peak and fructose interferes with mannitol peak. On further developing of our method, we were able to reasonably separate these peaks using different columns and condition for our assay. Sample preparation was rapid and simple and included adding internal standard sugars, derivitization and silylation. We used two chromatographic methods. In the first method we used Megabore column and had a run time of 34 min. This resulted in partial separation of the peaks. In the second method we used thin capillary column and was able to reasonably separate the lactose and lactulose peaks and the mannitol and fructose peaks with run time of 22 min. RESULTS: The sugar probes including mannitol, sucrose, lactulose, sucralose, fructose and lactose were detected precisely, without interference. The assay was linear between lactulose concentrations of 0.5 and 40 g/L (r(2)=1.000, P<0.0001) and mannitol concentrations of 0.01 and 40 g/L (r(2)=1.000). The sensitivity of this method remained high using new column and assay condition. The minimum detectable concentration calculated for both methods was 0.5 mg/L for lactulose and 1 mg/L for mannitol. CONCLUSION: This is the first report of interference of commonly used sugars with test of intestinal permeability. These sugars are found in most of fruits and dairy products and could easily interfere with the result of permeability tests. Our new GC assay of urine sugar probes permits the simultaneous quantitation of sucralose, sucrose, mannitol and lactulose, without interference with lactose and fructose. This assay is a rapid, simple, sensitive and reproducible method to accurately measure intestinal permeability.     

Gas chromatography applied to the lactulose—mannitol intestinal permeability test

Intestinal permeability can be modified by various illnesses, trauma and sepsis. Alterations of the intestinal wall can facilitate the diffusion of potentially harmful substances such as endotoxins, as well as bacterial translocation. We describe the validation of a capillary gas chromatographic method for the determination of mannitol and lactulose, used as intestinal permeability probes. The method is linear up to 3 g/l for mannitol and 300 mg/l for lactulose; recovery from overload samples is between 92 to 110%. Intra-assay coefficients of variation (C.V.s) were 2.7 and 6.8% for mannitol and lactulose, respectively, and inter-assay C.V.s were 8.9 and 9.3%. Normal values for 25 healthy subjects (mean ± S.D.) were 14.5 ± 3.1% and 0.27 ± 0.15% for mannitol and lactulose, respectively. The GC method presented is rapid and precise.     

Assessment of the Effect of Intestinal Permeability Probes (Lactulose And Mannitol) and Other Liquids on Digesta Residence Times in Various Segments of the Gut Determined by Wireless Motility Capsule: A Randomised Controlled Trial

Background

Whilst the use of the mannitol/lactulose test for intestinal permeability has been long established it is not known whether the doses of these sugars modify transit time Similarly it is not known whether substances such as aspirin that are known to increase intestinal permeability to lactulose and mannitol and those such as ascorbic acid which are stated to be beneficial to gastrointestinal health also influence intestinal transit time.

Methods

Gastric and intestinal transit times were determined with a SmartPill following consumption of either a lactulose mannitol solution, a solution containing 600 mg aspirin, a solution containing 500 mg of ascorbic acid or an extract of blackcurrant, and compared by doubly repeated measures ANOVA with those following consumption of the same volume of a control in a cross-over study in six healthy female volunteers. The dominant frequencies of cyclic variations in gastric pressure recorded by the Smartpill were determined by fast Fourier transforms.

Results

The gastric transit times of lactulose mannitol solutions, of aspirin solutions and of blackcurrant juice did not differ from those of the control. The gastric transit times of the ascorbic acid solutions were significantly shorter than those of the other solutions. There were no significant differences between the various solutions either in the total small intestinal or colonic transit times. The intraluminal pHs during the initial quartiles of the small intestinal transit times were lower than those in the succeeding quartiles. This pattern did not vary with the solution that was consumed. The power of the frequencies of cyclic variation in intragastric pressure recorded by the Smartpill declined exponentially with increase in frequency and did not peak at the reported physiological frequencies of gastric contractile activity.

Conclusions

Whilst the segmental residence times were broadly similar to those using other methods, the high degree of variation between subjects generally precluded the identification of all but gross variation between treatments. The lack of any differences between treatments in either total small or large intestinal transit times indicates that the solutions administered in the lactulose mannitol test of permeability had no consistent influence on the temporal pattern of absorption. The negatively exponential profile and lack of any peaks in the frequency spectra of cyclic variation in gastric intraluminal pressure that were consistent with reported physiological frequencies of contractile activity profile suggests that the principal source of this variation is stochastic likely resulting from the effects of external events occasioned by normal daily activities on intra-abdominal pressure.

Trial Registration

Australian New Zealand Clinical Trials Registry ACTRN12615000596505     

Cellobiose and lactulose coupled with mannitol and determined using ion-exchange chromatography with pulsed amperometric detection,are reliable probes for investigation of intestinal permeability

Lactulose/mannitol and cellobiose/mannitol tests are currently used in the investigation of intestinal permeability (IP) in many gastrointestinal diseases. The aim of this study was to produce a good technique for the determination and comparison of the above-mentioned sugar probes to overcome the problem caused by the presence of significant glycosuria in patients affected by particular metabolic disorders such as diabetes mellitus. Tests were performed in 25 healthy volunteers, using either cellobiose (Ce) (5 g) and mannitol (Ma) (2 g), or lactulose (La) (5 g) and mannitol (2 g), given as oral isosmolar loads. Sugars were recovered in urine collected for 5 h. Analysis was carried out by using anion-exchange chromatography (AEC) with pulsed amperometric detection (PAD). Baseline separation of the above carbohydrates was achieved within 13 min by using a Carbopac PA-100 column and linear gradient elution. Carbohydrate quantification was performed by an internal standard method. The calibration curve for each sugar is linear to 40 mM. The limit of sugar detection is 0.01 mM. Recovery of sugar probes is between 98.2 and 100%.The %La, %Ce, %Ma in urine were evaluated and their ratios (Ce/Ma and La/Ma) were calculated. No significant difference in IP parameters were shown (La/Ma to Ce/Ma 0.018+/-0.014 vs. 0.012+/-0.007; the attendant probability of the null hypothesis being P=0.0714). Ce/Ma and/or La/Ma tests result similarly reliable in the clinical investigation of IP and the described new method is also helpful in urine even with high glucose concentration, without any interference.     

粪菌移植联合乳果糖对顽固性功能性便秘患者胃肠功能、生活质量及心理状态的影响*

目的:研究粪菌移植联合乳果糖对顽固性功能性便秘患者胃肠功能、生活质量及心理状态的影响。方法:选取2016年6月至2018年5月我院消化内科收治的顽固性功能性便秘患者100例为研究对象,按照随机数字表法将患者分为对照组(n=45)和研究组(n=55)。对照组给予乳果糖口服治疗,研究组则采用粪菌移植联合乳果糖治疗,两组均治疗6周。对比两组临床疗效、胃肠功能以及治疗前后生活质量和心理状态的变化,并观察两组治疗期间不良反应发生情况。结果:与对照组比较,研究组总有效率明显升高(P0.05)。研究组首次自主排便时间、肛门首次排气时间、肠鸣音恢复时间均短于对照组,胃肠减压引流量高于对照组(P0.05)。治疗6周后,两组患者生活质量自评量表(PAC-QOL)评分、Zung焦虑自评量表(SAS)评分和抑郁自评量(SDS)评分均较治疗前降低,且与对照组比较,研究组PAC-QOL评分、SAS评分、SDS评分均降低(P0.05)。两组不良反应发生率比较差异无统计学意义(P0.05)。结论:粪菌移植联合乳果糖对顽固性功能性便秘具有较好的疗效,可改善患者胃肠功能和心理状态,同时可提高患者生活质量,无严重不良反应发生。     

Intestinal permeability in children with Crohn's disease and coeliac disease.

Mannitol and lactulose were used as probe molecules to measure intestinal permeability in children with active small-bowel Crohn''s disease and with untreated coeliac disease. Mannitol and lactulose were administered by mouth in a moderately hypertonic solution (580 mmol (mosmol)/l), and results were expressed as the ratio of the molecules excreted in urine over five hours. Patients with Crohn''s disease had a sixfold increase in permeability (due to increased lactulose permeability) and those with coeliac disease a fivefold increase (due to decreased mannitol permeability). From these results the test offers potential as a noninvasive investigation in children with small-bowel disease.     

Neutrophil depletion prevents intestinal mucosal permeability alterations in burn-injured rats

Cutaneous thermal injury increases intestinal mucosal permeability. The mechanisms of this functional disturbance are not fully understood. We investigated whether accumulation of neutrophils in the intestine contributes to the increase in mucosal permeability. Labeled and unlabeled lactulose and mannitol were infused into a segment of rat ileum or jejunum. Blood concentrations of [(3)H]lactulose and [(14)C]mannitol were measured after 30, 60, and 90 min. On day 1 postburn, lactulose permeability increased fourfold in the ileum and twofold in the jejunum compared with sham-burned rats; mannitol permeability increased twofold in the ileum and 1. 5-fold in the jejunum. A greater increase in permeability occurred on day 3 postburn in the ileum, but not in the jejunum. The depletion of neutrophils in burned rats prevented the increase in permeability in both segments on day 1 postburn. Histological studies of intestines from burned, with or without neutrophil depletion, and sham-burned rats showed similar morphology. However, numerous neutrophils were found in the extravascular compartment in day 1 postburn, but not in neutrophil-depleted and sham-burned rats. These findings support the concept that the burn-induced increase in mucosal permeability is produced during the accumulation of neutrophils in the intestine and can be abrogated by the depletion of neutrophils.     

双歧杆菌四联活菌片联合乳果糖对乙肝肝硬化患者肠道菌群 和肠黏膜屏障功能及肝功能水平的影响

目的研究双歧杆菌四联活菌片联合乳果糖对乙肝肝硬化患者肠道菌群、肠黏膜屏障功能及肝功能水平的影响。方法选择2017年12月至2018年12月于我院感染科住院治疗的乙肝肝硬化患者80例,按照随机数字表法分为试验组和对照组各40例。两组患者常规予以抗病毒及保肝治疗。试验组患者加用双歧杆菌四联活菌片和乳果糖口服液。对照组患者仅给予乳果糖口服液。检测患者肠道肠杆菌、肠球菌、双歧杆菌、乳杆菌和白假丝酵母数量。测定患者血清内毒素和血清二胺氧化酶水平及尿乳果糖/甘露醇(L/M)比值。记录两组患者丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)和总胆红素(TBIL)水平。观察治疗过程中的药物不良反应发生情况。结果治疗4周后,试验组患者肠道肠球菌数量高于治疗1周后(18.41±2.92 vs 18.32±3.06),同时试验组患者肠道双歧杆菌数量与治疗前、治疗1周后以及对照组同时期相比差异也有统计学意义(均P0.05)。试验组患者治疗后肠道乳杆菌和白假丝酵母水平与治疗前相比差异均有统计学意义(均P0.05)。治疗4周后,对照组患者肠道肠杆菌水平高于治疗1周后(F=10.192,P=0.019);而白假丝酵母水平高于治疗前(F=8.567,P=0.024)。治疗前两组患者血清内毒素、血清二胺氧化酶和尿L/M以及AST、ALT、TBIL水平差异无统计学意义(均P0.05)。治疗1个月后,两组患者血清内毒素、血清二胺氧化酶和尿L/M以及AST、ALT、TBIL均较治疗前明显下降(均P0.05),且试验组的下降幅度较对照组更大(均P0.05)。两组患者均未发生不良反应。结论双歧杆菌四联活菌片联合乳果糖可以改善乙肝肝硬化患者肝功能状态,调节失衡的肠道菌群,降低肠黏膜通透性,值得临床推广。     

首荟通便胶囊联合乳果糖口服液对老年功能性便秘患者焦虑抑郁和血清胃肠激素的影响

摘要 目的：探讨首荟通便胶囊联合乳果糖口服液治疗老年功能性便秘的疗效及对患者焦虑抑郁情绪和血清胃肠激素的影响。方法：选取2017年12月~2019年12月期间来我院就诊的老年功能性便秘患者150例,根据随机数字表法分为A组（n=75,乳果糖口服液治疗）和B组（n=75,首荟通便胶囊联合乳果糖口服液治疗）,记录两组治疗2周后的疗效及治疗期间不良反应发生情况。比较治疗前、治疗2周后患者的血清胃动素（MTL）、P物质（SP）以及Zung焦虑自评量表（SAS）评分、Zung抑郁自评量表（SDS）评分、临床症状评分。结果：两组治疗2周后粪便性状、排便困难、排便不尽感、排便间隔等症状评分均下降,且B组低于A组（P<0.05）。B组治疗2周后的总有效率为85.33%（64/75）,A组治疗2周后的总有效率为69.33%（52/75）,B组总有效率高于A组（P<0.05）。两组治疗2周后SAS、SDS评分均下降,且B组低于A组（P<0.05）。两组治疗2周后血清MTL、SP升高,且B组高于A组（P<0.05）。两组不良反应发生率比较无差异（P>0.05）。结论：首荟通便胶囊联合乳果糖口服液治疗老年功能性便秘,可有效改善临床症状,调节焦虑抑郁情绪,改善患者血清胃肠激素水平,疗效较好。     

A comparison of intestinal permeability between humans and three common laboratory animals

Intestinal permeability of humans and three species of experimental animals was assessed by the oral administration of the three non-metabolizable sugars: lactulose, rhamnose and mannitol and collecting all the urine produced in a specified time. The total percentage recovery of the permeability markers was determined by high performance liquid chromatographic assays of urinary aliquots. The permeability of the human gut to mannitol was substantially greater than that of rats, guinea pigs, or hamsters (18-, 6- and 29-fold increases, respectively). The permeability to lactulose in humans was somewhat less than that found in guinea pigs (P less than 0.05), but three times greater than that found in rats or hamsters (P less than 0.001). Human rhamnose permeability was substantially greater than that of rats, guinea pigs or hamsters (6-, 2.5-, and 7-fold increases, respectively). The results suggest that the permeability of the human gut to probe molecules is considerably different from that of three common laboratory rodents, but is closest to that of guinea pigs. Possible species differences in the physiological factors which control permeability are discussed.     

Rapid increases in respiratory epithelial permeability occur after intratracheal instillation of PMA

We measured pulmonary epithelial permeability by quantifying the disappearance of two water-soluble compounds, [14C]mannitol and [3H]inulin, after their instillation, with and without phorbol myristate acetate (PMA), into gas-filled perfused (50 ml/min) rabbit lungs in situ. Both tracers disappeared in a monoexponential fashion over 30 min with calculated first-order rate constants (control; n = 11) of 0.0008 +/- 0.0002 and 0.0027 +/- 0.0008 min-1 for inulin and mannitol, respectively. The ratio of the rate constants (3.1 +/- 0.5) was not significantly different from the ratio of diffusivities of mannitol:inulin (3.7). Addition of PMA (250 micrograms) significantly (n = 9, P less than 0.05) increased the rate constants for both inulin and mannitol to 0.0024 +/- 0.0007 and 0.0087 +/- 0.0025 min-1, respectively, while not affecting their ratio (4.3 +/- 0.5). Addition of human leukocytes (4-8 X 10(8)/l) to the perfusate did not exacerbate the effect of 250 micrograms PMA (n = 3). The addition of catalase (n = 7) completely inhibited the effect of 250 micrograms PMA. PMA (250 micrograms) did not significantly affect perfusion pressure but increased wet-to-dry weight ratios. Light microscopic histology showed damage to epithelial and endothelial cells after 250 micrograms PMA which was not seen after coinstillation of catalase. Catalase sensitivity of functional and structural effects of PMA suggests that the effect was secondary to production of hydrogen peroxide. Since this effect was noted in lungs not perfused with neutrophils and addition of leukocytes did not exacerbate the increase in permeability, we hypothesize that an undetermined pulmonary cell type was the source of hydrogen peroxide. Finally, we found no evidence for restrictive pores with radii of 0.4-1.4 nm.     

人工发酵古尼虫草中甘露醇的测定

利用比色法简便、准确和快速地测定发酵生产的古尼虫草菌丝中甘露醇含量。结果表明 ,甘露醇的最大特征吸收峰在 41 2nm处 ,质量浓度在 1 0～ 5 0mg/L范围内线性较好 ,其回归方程 ρ=-0 842 +97 3 2 9A,r=0 9992 ;平均回收率 1 0 0 2 4% ,RSD =0 5 4% (n=5 )。样品中甘露醇采用水提取法 ,提取时间 2h。甘露醇显色后 2 0min内测定对结果影响不大 ,在测定时要注意排除果糖对测定结果的影响。用此法测得发酵古尼虫草菌丝体中甘露醇的含量为 7.4% ,RSD =0 .2 4% (n =6)。     

乳果糖口服液联合聚乙二醇电解质散剂在便秘患者行结肠镜检查前肠道准备中的应用研究

目的:探讨便秘患者行结肠镜检查前联合应用乳果糖口服液联合聚乙二醇电解质散剂的临床效果。方法:将90例接受结肠镜检查的便秘患者分为实验组和对照组,每组各45例,实验组肠镜检查前1天口服乳果糖口服液及聚乙二醇电解质散剂,对照组检查前1天口服聚乙二醇电解质散剂,比较两组患者的首次大便时间(开始服药至初次大便时间)、排便次数、大便清澈时间(初次大便至大便清澈时间)、肠道准备清洁度和不良反应情况。结果:实验组首次大便时间、大便清澈时间均短于对照组,差异有统计学意义(P0.05)。实验组完成肠道准备的排便次数较对照组次数增多,差异有统计学意义(P0.05)。实验组肠道准备清洁度优于对照组,差异有统计学意义(P0.05)。两组不良反应发生率无明显差异(P0.05)。结论:便秘患者结肠镜检查前肠道准备中联合应用乳果糖口服液联合聚乙二醇电解质散剂可提高肠道清洁度,增加排便次数,缩短大便清澈时间,达到理想的清肠效果,有助于发现微小病变,降低肠镜检查的漏诊率。     

Effects of pleural pressure and abdominal pressure on diaphragmatic blood flow

Alveolar transfer of prostaglandin E2 (PGE2) was characterized in isolated perfused guinea pig lungs (n = 19) by measuring radioactivity appearing in the venous effluent during 30 min after intratracheal instillation of [3H]PGE2, [14C]-mannitol, and [125I]iodoantipyrine. Recovery of lipid-soluble [125I]iodoantipyrine [91 +/- 3% (SE)] after 30 min was used to estimate total 3H and 14C delivered to the exchanging region of lung at time 0. In seven control lungs, 58 +/- 4% of [14C]mannitol and 16 +/- 4% of [3H]PGE2 was retained 10 min after instillation. Neither perfusion with diphloretin phosphate (10 micrograms/ml; n = 4) nor hypothermia (5 degrees C; n = 5) significantly affected the amount of [14C]mannitol retained; however, [3H]PGE2 remaining in these lungs increased significantly to 36 +/- 4 and 53 +/- 2%, respectively. Addition of unlabeled PGE2 (200 micrograms) to the instilled solution (n = 3) increased retention of both [14C]mannitol (80 +/- 3%) and [3H]PGE2 (65 +/- 4%). Alveolar transfer of [3H]PGE2 was calculated as the difference in percent retention of [14C]mannitol and [3H]PGE2 and normalized to that of [14C]mannitol. After 10 min, alveolar transfer of [3H]PGE2 was 71 +/- 8% in control lungs but was decreased to 26 +/- 7, 10 +/- 5, and 19 +/- 6% by diphloretin phosphate, hypothermia, or unlabeled PGE2, respectively. These data suggest that alveolar clearance of PGE2 involves a saturable drug- and temperature-sensitive process.