Adaptation of a multicomponent treatment for irritable bowel syndrome to a small-group format

We evaluated a multicomponent treatment program for IBS that had been adapted to a small-group format. Patient acceptance was satisfactory with 14 of 17 potential patients completing treatment. No reductions of GI symptoms were noted in a 12-week symptom-monitoring baseline phase; diarrhea became significantly worse. Treatment led to significant (p less than .05) reductions in abdominal pain and diarrhea. Nine of 14 (64.3%) patients were clinically improved.     

Behavioral treatment of irritable bowel syndrome: a 1-year follow-up study

Sixteen clients afflicted with irritable bowel syndrome (IBS) were reassessed 1 year following completion of a multicomponent treatment package incorporating progressive muscle relaxation, thermal biofeedback, cognitive therapy, and IBS education. For the 14 patients who kept a 2-week symptom diary, significant reductions in ratings of abdominal pain and tenderness, diarrhea, and flatulence were obtained comparing pretreatment and follow-up symptom-diary ratings. Eleven of 14 clients were improved over pretreatment levels, 57% met the criteria for clinical improvement of at least a 50% reduction in major symptom scores, and all but 1 of 16 rated themselves as subjectively improved.     

Efficacy and safety of Saccharomyces boulardii in the 14-day triple anti-Helicobacter pylori therapy: a prospective randomized placebo-controlled double-blind study

Background: Recent studies indicate a potential role of Saccharomyces boulardii in the prevention of Helicobacter pylori treatment‐related side‐effects and also in improvement of eradication rate. Our aim is to investigate the efficacy and safety of S. boulardii in the prevention of side‐effects related to H. pylori eradication. The secondary aim of the study was to define the effect of S. boulardii on the eradication success of anti‐H. pylori therapy. Materials and methods: One hundred and twenty‐four patients with H. pylori infection (male/female: 44/80, mean age: 48 ± 14.25 year) receiving 14 days of triple therapy (clarithromycin 500 mg b.i.d., amoxicillin 1000 mg b.i.d., and lansoprazole 30 mg b.i.d.) were randomly assigned to S. boulardii or placebo. Dyspeptic symptoms were recorded by using modified Glasgow Dyspepsia Questionnaire (GDQ). Side‐effect profile and tolerability were assessed using a symptom‐based questionnaire. H. pylori status was rechecked after 6 weeks after completion of eradication therapy. Results: H. pylori eradication rate, although higher in the treatment group, was statistically similar in treatment and control groups: 71% (44/62) versus 59.7% (37/62), respectively (p > .05). Nine (14.5%) patients in the treatment group and 19 (30.6%) patients in the placebo group experienced diarrhea (p < .05). Epigastric discomfort was more frequent in the control group [9 (14.5%) versus 27 (43.5%), respectively (p < .01)]. Diffuse abdominal pain, abdominal gas, taste disturbance, urticaria, nausea symptoms were similar in both groups. GDQ scores after treatment were significantly better for treatment group (mean ± SD, range: 1.38 ± 1.25 (0–5) vs. 2.22 ± 1.44 (0–6), respectively; p < .01). Conclusion: S. boulardii improved anti‐H. pylori antibiotherapy‐associated diarrhea, epigastric discomfort, and treatment tolerability. In addition, S. boulardii supplement decreased post‐treatment dyspepsia symptoms independent of H. pylori status. However, S. boulardii had no significant affect on the rate of H. pylori eradication.     

Weight Loss Expectations in Patients with Binge‐Eating Disorder

Objective: To study weight loss expectations in patients with binge‐eating disorder and to examine whether expectations differed by sex and motivation for treatment. Research Methods and Procedures: One hundred and thirty patients (104 women and 26 men), aged 23 to 61 (mean age, 43.0 years), with BED completed a measure of desired weights that included their dream weight, happy weight, acceptable weight, and disappointed weight. In a structured interview, participants were asked their primary motivation for seeking treatment (appearance or health) and their lowest adult weight (LAW). Results: The BED participants reported weight loss expectations that far exceeded expert and governmental guidelines. In this sample, desired dream body mass index (BMI), happy BMI, and acceptable BMI averaged reductions in current weight of 36%, 29%, and 23%, respectively. Even the “disappointed” BMI was an average 14% reduction in current weight, and was 1.5 to 3 times greater than the expert recommendation (5% to 10%). Comparisons of desired weights were significantly different for women and men, whereas percent reductions from current weight were not. Although weight goal expectations were significantly lower for those motivated by appearance, compared with those motivated by health, percent reductions for current weight were not. Desired dream weight correlated with reported LAW, and the mean difference between these weights was not significant. Discussion: These findings suggest that patients with BED have weight loss expectations that far exceed expert and governmental guidelines and that these expectations do not differ by sex or motivation for seeking treatment. One possible explanation for these unrealistic desired weights may be the patients’ recollections of their LAWs.     

Epidemiological Study on Infectious Diarrheal Diseases in Children in a Coastal Rural Area of Kenya

Diarrheal diseases are major causes of morbidity and mortality among children in developing countries. We have analyzed the causative agents of diarrhea in children under five years of age who resided in rural environments but attended a hospital in Malindi, a coastal town in Kenya. Bacterial diarrhea was found in 239 (27.7%) of 862 patients with diarrhea. Diarrheagenic Escherichia coli, including enteropathogenic, enterotoxigenic, and enterohaemorrhagic strains, was isolated from 119 (13.8%) patients, followed by Salmonella spp. (63 cases, 7.3%) and Shigella spp. (56 cases, 6.5%). Intestinal parasites were found in 109 (12.6%) of the patients. Entamoeba histolytica and Giardia lamblia were found in 67 (7.8%) and 42 (4.9%) of the cases, respectively. Rotavirus was found in 69 (16.1%) of 428 cases, a part of the 862 cases. Significant differences in age distribution were seen in diarrheal cases due to Campylobacter spp., G. lamblia, and rotavirus. No significant seasonal incidence of specific pathogens was found, but the number of diarrheal patients was significantly correlated to rainfall. Drinking water was contaminated with bacteria at concentrations ranging from 10³ to 10⁶ CFU/ml in 98% of the households and by coliform bacteria at concentrations of 10² to 10⁵ CFU/ml in 72% of the households. These results suggest that the main routes of infection may be contaminated drinking water and fecal-oral transmission of enteric pathogens. Consequently, we propose that the enhancement of hygienic practice through health education is a feasible control measure of diarrhea in the study area.     

Behavioral treatment of irritable bowel syndrome: A 1-year follow-up study

Sixteen clients afflicted with irritable bowel syndrome (IBS) were reassessed 1 year following completion of a multicomponent treatment package incorporating progressive muscle relaxation, thermal biofeedback, cognitive therapy, and IBS education. For the 14 patients who kept a 2-week symptom diary, significant reductions in ratings of abdominal pain and tenderness, diarrhea, and flatulence were obtained comparing pretreatment and follow-up symptom-diary ratings. Eleven of 14 clients were improved over pretreatment levels, 57% met the criteria for clinical improvement of at least a 50% reduction in major symptom scores, and all but 1 of 16 rated themselves as subjectively improved.     

Simple chronic colitis model using hypopigmented mice with a Hermansky–Pudlak syndrome 5 gene mutation

Pigmentation in mammals is important for protection of skin and eyes from ultraviolet radiation. Dysregulation of pigmentation is often associated with other conditions that are not directly linked to pigmentation. Here, we isolated spontaneously occurring hypopigmented mice that occasionally experienced severe diarrhea during lactation. Treatment of these mice with dextran sulfate sodium salt, a conventional method to induce acute colitis, caused chronic diarrhea with granulomatous colitis. Gene mapping and sequencing revealed that the mice had a nonsense mutation in the Hermansky–Pudlak syndrome (Hps)5 gene. As some HPS patients can develop granulomatous colitis, the simple induction of chronic colitis in spontaneously mutated Hps5‐deficient mice may become an invaluable model for exploring treatment options in patients with HPS as well as other patients with inflammatory bowel disease.     

百里酚和香芹酚改变肠道微生物组成抑制羔羊腹泻的作用研究

【目的】本试验研究百里酚和香芹酚对滩羊羔羊腹泻、肠道短链脂肪酸和微生物组成的影响,旨在为利用植物提取物手段治疗羔羊腹泻提供可用的添加剂和理论基础。【方法】本研究选择腹泻发病时间为2-3 d的10只腹泻羔羊,随机分为2组,分为腹泻羔羊组(CON组)和百里酚和香芹酚处理组(SCAT组),试验期间SCAT组羔羊补充200 mg/只/d的百里酚和香芹酚1:1混合品,处理时间为7 d。【结果】百里酚和香芹酚处理能够显著提高腹泻羔羊日增重,降低羔羊腹泻指数和腹泻率(P<0.05),降低血清促炎因子表达水平(P<0.05),提高肠道短链脂肪酸(short-chain fatty acids,SCFA)丁酸浓度(P<0.05);同时百里酚和香芹酚能够改变腹泻羔羊肠道微生物组成,提高肠道中双歧杆菌(Bifidobacteriaceae)和阿克曼氏菌(Akkermansiaceae)的相对丰度,降低肠杆菌科(Enterobacteriaceae)相关菌的相对丰度。【结论】百里酚和香芹酚能够提高肠道有益菌相对丰度和有益代谢物丁酸的浓度,降低致病菌相对丰度,从而有效抑制羔羊腹泻,可作为新型替...     

Zinc treatment of hydroponically grown barley plants causes a reduction in root and cell hydraulic conductivity and isoform‐dependent decrease in aquaporin gene expression

The cellular and molecular basis of a reduction in root water uptake in plants exposed to heavy metals such as zinc (Zn) is poorly studied. The aim of the present study on hydroponically grown barley (Hordeum vulgare) was to test whether any reduction in root hydraulic conductivity (Lp) in response to Zn treatment is accompanied by a reduction in cell Lp and gene expression level of aquaporin (AQP) isoforms. Plants were grown in the presence of 0.25 μM, (control), 0.1 and 1 mM Zn in the root medium and analysed when they were 16–18 days old. Root and cell Lp was determined through exudation and cell pressure probe analyses, respectively, and gene expression of five candidate AQPs was analysed [real time quantitative polymerase chain reaction (PCR)]. Zinc treatments caused significant reductions (25–83%) in transpiration rate, root and shoot fresh weight, surface area and stomatal conductance. Zinc concentrations in tissues increased more than 100‐fold. Root Lp decreased by 24% (0.1 mM Zn) and 58% (1 mM Zn), while cell Lp decreased by 45 and 71%, respectively. Gene expression of AQPs decreased by 14–80%; decreases were statistically significant for HvPIP1;3, HvPIP2;4 and HvPIP2;5. Turgor in root cortex cells was not reduced by Zn treatments. It is concluded that reductions in plant water flow in response to Zn treatment are facilitated through decreases in root (Lp) and shoot (stomata) hydraulics. The decrease in root Lp is facilitated through reductions in cell Lp and AQP gene expression and may also reflect increased suberization in the endodermis.     

口服双歧杆菌活菌散剂治疗急慢性腹泻的随机对照双盲双模拟多中心临床研究

目的 评价口服双歧杆菌活菌散剂治疗肠道菌群失调所致的急慢性腹泻的疗效和安全性.方法 采用阳性药物平行对照、分层区组随机、双盲双模拟、多中心临床试验设计方法.其中急性腹泻136例,慢性腹泻125例;每次口服双歧杆菌活菌散剂1包(1.0 g,含双歧杆菌活菌1.0亿个)或丽珠肠乐胶囊2粒,每日2次;急性腹泻疗程3 d,慢性腹泻疗程14 d,观察治疗后临床症状和大便常规的恢复情况,慢性腹泻中39例进行肠道菌群分析.结果 疗程结束时急性腹泻总有效率:口服双歧杆菌活菌散剂组为89.6%,丽珠肠乐胶囊组为91.2%,2组疗效相似,差异无显著性(P＞0.05);慢性腹泻总有效率:口服双歧杆菌活菌散剂组为88.1%,丽珠肠乐胶囊组为79.0%,2组疗效相似,差异无显著性(P＞0.05);慢性腹泻组中39例治疗前后进行的肠道菌群分析表明,2组双歧杆菌、拟杆菌和真杆菌治疗后比治疗前均有显著增加(P=0.00～0.02),但治疗前后增加值2组间比较差异无显著性(P＞0.05).安全性研究未发现不良反应.结论 口服双歧杆菌活菌散剂能有效治疗急慢性腹泻,疗效和安全性与丽珠肠乐胶囊相当.     

Intensive hemodialysis and hemoperfusion treatment of Amanita mushroom poisoning

Over a period of fifteen years, 41 patients including 23 males and 18 females with Amanita mushroom poisoning were treated at the University Hospital of Lund, Sweden. The intensity of poisoning was graded according to serum transaminase elevations and prothrombin time reductions. Severity was mild in 16 patients (Group A), moderate in 14 (Group B) and severe in 11 (Group C). Members of Group C reported shorter latency periods before the onset of symptoms, (10±1 hours,p<0.05) and longer delays in treatment, (34±4 hours), than did the other patients. Intensive treatment was begun before the results of urine amatoxin assays were reported. Treatment consisted of: fluid and electrolyte replacement, oral activated charcoal and lactulose, IV penicillin, combined hemodialysis and hemoperfusion in two 8 hour sessions, some received IV thioctic acid, others IV silibinin, all received a special diet. This combination of treatment modalities was used to accelerate the elimination of amatoxin from the patients' bodies. The longest period of hospitalization, 13±2 days, was required by the patients of Group C (p<0.01). All patients improved and were discharged from the hospital asymptomatic. No sequelae were later reported for the majority of those moderately and severely poisoned. We have concluded that intensive combined treatment applied in these cases is effective in relieving patients with both moderate and severe amanitin poisoning.     

A single-centre experience with octreotide in the treatment of different hypersecretory syndromes in patients with functional gastroenteropancreatic neuroendocrine tumors

The aim of this research was to assess the clinical and biochemical efficacy of the octreotide in the treatment of patients with various functional gastroenteropancreatic neuroendocrine tumors (GEP-NETs). The study included 14 patients treated with octreotide for 6 months. They were diagnosed with VIPoma, glucagonoma, gastrinoma, medullary thyroid carcinoma (solitary and as a part of MEN-II syndrome), pancreatic carcinoids (solitary and as a part of multiple endocrine neoplasia type-1 syndrome-MEN-1 syndrome) and midgut carcinoids. The patients presented with Verner-Morrison, glucagonoma, Zollinger Ellison and carcinoid syndrome respectively. All had a metastatic disease at the time of diagnosis and a positive octreoscan finding. Initially elevated chromogranin A (CgA) levels were detected in 11 (78.6%) and elevated 5-hydroxyindolacetic acid (5-HIAA) levels in 8 (57.1%) patients. Symptomatic efficacy assessments were made by diarrhea reductions during treatment course, and laboratory efficacy was assessed through changes in 5-HIAA and CgA levels. Assessments were made initially and following 6 months of therapy. Median urinary 5-HIAA and the number of stools decreased significantly (p = 0.016 and p = 0.009 respectively, p < 0.05) while CgA levels had the decreasing tendency but not statistically significant (p = 0.14). There was a positive correlation between the 5-HIAA reduction and the decrease in stool number at baseline and during treatment course (p < 0.05). No correlation was observed between 5-HIAA and CgA levels and also there was no correlation between CgA reduction and symptomatic improvement. The results prove octreotide to be effective in reducing symptoms and biochemical markers associated with hypersecretory syndromes of GEP-NETs.     

Role of temporary intestinal brush border dysfunction inCampylobacter jejuni diarrhea

The pathophysiologic effects ofCampylobacterjejuni on weanling ferrets were investigated by assessing jejunal disaccharidase activities, glucose and theophylline stimulation of jejunal mucosal ion transport, fecal levels of reducing sugars, and histologic appearance of the gut. Compared with uninoculated controls, ferrets at the peak ofCampylobacter-induced watery diarrhea exhibited two- to threefold reductions in sucrase, maltase, and lactase activity, a sixfold lower short-circuit current response to glucose stimulation, and a twofold higher response to theophylline stimulation, plus a striking increase in fecal levels of reducing sugars. These physiologic alterations rapidly returned to normal as diarrhea subsided. Jejunal epithelial cells of all diarrheic animals appeared morphologically normal by light microscopy. Passively immunized kits, heavily colonized but not diarrheic, were indistinguishable from controls in every assessment. These observations suggest that (i)Campylobacterjejuni exerts its pathophysiologic effect primarily by inducing a transient depression of intestinal brush border function and (ii) such effects can be prevented by humoral antibodies.     

Molecular Characterization of Fecal Microbiota in Patients with Viral Diarrhea

The study provides molecular analyses of fecal microbiota of diarrhea patients infected with four different types of viruses. Fecal specimens from 52 patients with viral diarrhea (13 each of adenovirus, norovirus, rotavirus, and astrovirus) and six healthy individuals were collected and etiological viral agent was confirmed by enzyme immunoassay and specific PCR. To assess the changes in microbial diversity in patients with viral diarrhea, DNA from stool were extracted and characterized by PCR-denaturing gradient gel electrophoresis (DGGE) with universal primers specific for the V3 region of 16S rRNA gene. The strongest bands of the DGGE profiling were excised and sequenced to identify the dominant groups. Bacteroides vulgatus, Bifidobacterium, and Lactobacillus genera were also enumerated by real time PCR. The results revealed that bacterial diversity and similarity in feces from viral diarrhea groups were significantly lower (mean H′/ H _max^￠ H_{ \max }^{\prime } 0.89–0.94, 29–43, respectively) as compared with those of healthy individuals (mean H′/ H _max^￠ H_{ \max }^{\prime } 1.36, 59, respectively). Sequencing of dominant bands affirmed that diarrhea groups were mainly comprised of phylum Firmicutes, such as genera Enterococcus, Peptostreptococcaceae incertae sedi, Streptococcus, Weissella, and Clostridium, and opportunistically pathogenic genus Shigella, while dominant group in healthy individuals was phylum Bacteroidetes. Copy number of Bacteroides vulgatus, Bifidobacterium, and Lactobacillus genera was also reduced significantly in viral diarrhea groups as compared to healthy group. It is concluded that opportunistic pathogens increases, while other species of commensal microbiota decrease significantly in the viral diarrhea patients and dysbacteriosis is dependent on type of virus infection.     

Caregiver recognition of childhood diarrhea, care seeking behaviors and home treatment practices in rural Burkina Faso: a cross-sectional survey

Introduction

To design effective national diarrhea control programs, including oral rehydration solution (ORS) and therapeutic zinc supplementation, information is needed on local perceptions of illness, external care seeking behaviors, and home treatment practices.

Methods

A cross-sectional, community-based household survey was conducted in the Orodara Health District, Burkina Faso. Caregivers of 10,490 children <27 months were interviewed to assess child diarrhea prevalence and related care practices. Characteristics of households, caregivers, children, and reported illnesses were compared for those caregivers who did or did not recognize the presence of diarrhea, as defined according to clinical criteria (≥3 liquid or semi-liquid stools/day). Multiple logistic regression models were used to examine factors associated with illness recognition and treatment.

Results

Clinically defined diarrhea was present in 7.6% (95% CI: 7.1–8.1%) of children during the 24 hours preceding the survey but recognized by only 55% of caregivers. Over half (55%) of the caregivers of 1,067 children with a clinically defined diarrhea episode in the past 14 days sought care outside the home; 78% of those seeking care attended a public sector clinic. Care was sought and treatment provided more frequently for children with fever, vomiting, anorexia, longer illness duration, and those living closer to the health center; and care was sought more frequently for male children. 80% of children with recent diarrhea received some form of treatment; only 24% received ORS, whereas 14% received antibiotics. Zinc was not yet available in the study area.

Conclusions

Caregivers frequently fail to recognize children''s diarrhea, especially among younger infants and when illness signs are less severe. Treatment practices do not correspond with international recommendations in most cases, even when caregivers consult with formal health services. Child caregivers need additional assistance to recognize diarrhea correctly, and both caregivers and health care providers need updated training on current diarrhea treatment recommendations.     

Second-line Helicobacter pylori eradication: a randomized comparison of 1-week or 2-week bismuth-containing quadruple therapy

Objectives: The increasing levels of bacterial antibiotic resistance have increased the need to evaluate the second‐line treatments for Helicobacter pylori. Bismuth‐based quadruple therapy is recommended as a second‐line treatment, but the optimal duration of this treatment is still debatable. We prospectively analyzed the eradication rate of H. pylori according to the duration of the second‐line bismuth‐based quadruple therapy. Methods: One hundred and ninety‐nine patients who failed at H. pylori eradication were prospectively randomized to receive pantoprazole 40 mg twice daily, metronidazole 500 mg thrice daily, and bismuth subcitrate 300 mg and tetracycline 500 mg four times daily for 7 days (PBMT7) or for 14 days (PBMT14). The post‐treatment H. pylori status was determined by the ¹³C‐urea breath test. The eradication rates, drug compliance, and side effects of each group were evaluated. Results: The intention‐to‐treat (ITT) eradication rates were 81.6% (95% CI 73.9–89.3%, 80/98) in the PBMT7 arm and 85.1% (95% CI 78.2–92.0%, 86/101) in the PBMT14 arm (p = .028, noninferiority test), while the per‐protocol (PP) eradication rates were 89.6% (95% CI 83.2–96.0%, 78/87) and 96.2% (95% CI 92.0–100.0% 77/80) (p = .015, noninferiority test), respectively. The compliance was 88.8% (87/98) and 79.2% (80/101) in the PBMT7 and PBMT14 groups, respectively. (p = .066) The number of patients having severe side effects was 15.3% (15/98) and 21.8% (22/101) in the PBMT7 and PBMT14 groups, respectively, which was similar between both groups. (p = .243). Conclusions: Although PBMT7 was not inferior to PBMT14 statistically, PBMT could not demonstrate enough ITT/PP eradication rate. Therefore, it could be better to extend the duration of treatment for 2 weeks for the second‐line treatment of H. pylori in Korea.     

Twice-a-day bismuth-containing quadruple therapy for Helicobacter pylori eradication: a randomized trial of 10 and 14 days

Background: Bismuth‐containing quadruple therapy given twice a day for 14 days has been shown to be an excellent first‐line H. pylori eradication therapy. Aim: To compare the efficacy and tolerability of twice‐a‐day bismuth‐containing quadruple H. pylori eradication therapy for 10 versus 14 days in a noninferiority trial. Methods: Dyspeptic patients with H. pylori infection and naïve to H. pylori treatment were randomly assigned to: pantoprazole 20 mg, tetracycline 500 mg, metronidazole 500 mg, and bismuth subcitrate caplets 240 mg given b.i.d. (with the midday and evening meals) for 10 or 14 days. Eradication was defined by negative UBT and/or histology 4–6 weeks posttherapy. Efficacy and side effects were determined. Results: A total of 417 patients were randomized (153 men, 264 women; median age 52). Per protocol (PP) treatment success with 14 and 10 days was essentially identical [i.e., 96% (95% CI: 92–98) vs 95% (95% CI: 91–98) for 14 days versus 10 days, respectively. Results with intention‐to‐treat (ITT) analysis were also similar (92% (95% CI, 87–95) vs 92% (95% CI, 88–96)) for 14 and 10 days, respectively. Compliance was excellent in both groups. Side effects were generally mild and similar between groups. Fatigue, discomfort, and vomiting were more common in those in the 14‐day group. The 10‐day regimen costs € 17.65 (ie, approximately 25%) less than the 14‐day regimen. Conclusions: Bismuth‐containing quadruple therapy remained highly effective (i.e., ≥95% PP and >90% ITT) despite reducing the duration from 14 to 10 days.     

Adjunctive subantimicrobial dose doxycycline in the management of institutionalised geriatric patients with chronic periodontitis

Objective: To assess the efficacy of subantimicrobial dose doxycycline (SDD; 20 mg doxycycline twice daily) as an adjunct to scaling and root planing (SRP) in the treatment of moderate‐severe chronic periodontitis (CP) in institutionalised elderly patients aged 65 years or older. Background: Previous studies have shown that SDD is of clinical benefit in the treatment of CP. However, the benefits of SDD in geriatric populations (65+ years) have not been determined. Material and methods: A 9‐month, double‐blind, randomised, placebo‐controlled pilot study was conducted. 24 institutionalised geriatric patients (65 years or older) with evidence of CP manifested by baseline clinical attachment levels (CAL) 5–9 mm, probing depths (PD) 4–9 mm and bleeding on probing (BOP) were recruited. At baseline, patients were treated by a standardised episode of SRP, and randomised to receive either adjunctive SDD or placebo. Full mouth PD and CAL were measured using the manual UNC‐15 periodontal probe at 3, 6, and 9 months post‐baseline to assess the response to treatment. Periodontal sites were stratified by baseline PD value: sites with PD 4–5 mm were considered moderately diseased and sites with PD ≥6 mm severely diseased. Results: The SRP + placebo resulted in PD reductions similar to those reported previously in the literature. At all time‐points and in both moderate and deep sites, SRP + SDD resulted in significantly greater PD reductions relative to baseline than SRP + placebo. At month 9, in moderate sites, mean PD reductions of 1.57 ± 0.11 mm were reported in the adjunctive SDD group, compared with 0.63 ± 0.11 mm in the adjunctive placebo group (p < 0.001). In deep sites at month 9, mean PD reductions of 3.22 ± 0.29 mm were reported in the adjunctive SDD group, compared with 0.98 ± 0.31 mm in the adjunctive placebo group (p < 0.05). Similar improvements were observed for CAL in the SDD group compared with the placebo group. Significantly lower BOP scores were also recorded at month 9 in the SDD group (7.5%) compared with the placebo group (71.2%) (p < 0.01). Conclusion: SDD used as an adjunct to SRP provides significant benefit for elderly patients with CP compared with SRP alone.     

Effect of swine leukocyte antigen‐DQA gene variation on diarrhea in Large White,Landrace, and Duroc piglets

Piglet diarrhea is one of the most common factors that affects the benefits of the swine industry. Although recent studies have shown that exon 2 of SLA‐DQA is associated with piglet resistance to diarrhea, contributions of genetic variation in the additional exon coding regions of this gene remain unclear. Here, we investigated variation in exons 1, 3 and 4 of the SLA‐DQA gene and evaluated their effects on diarrheal infection in 425 suckling piglets. No variation was identified in exon 1. In exon 3, there were eight alleles detected, generated by 14 single nucleotide polymorphisms (SNPs) and three nucleotide deletions, eight SNPs being newly identified. Four allele sequences and three SNPs were identified in exon 4, only one SNP being newly identified. Statistical analysis showed that the genotypes of exon 3 are significantly associated with piglet diarrhea; indeed, genotypes DQA*wb01/wb02 and wb04/wb05 are clearly associated with resistance to piglet diarrhea, as they have the lowest probabilities of infection (P < 0.05). However, no significant association was found between the genotypes of exon 4 and diarrhea (P > 0.05). These results provide important new information concerning the level of genetic diversity at the SLA‐DQA locus and suggest that further genetic association studies of piglet diarrhea resistance should include analyses of both exons 2 and 3 of this locus.     

消化道肿瘤术后肠道菌群失调的诊治

目的 :探讨消化道肿瘤术后肠道菌群失调的诊断与治疗。方法 :收集 10 4例消化道肿瘤患者 ,并分别给以常规补液、肠内营养及肠外营养。结果 :17例患者术后发生腹泻 ,肠内营养组无术后肠道菌群失调(P<0 .0 5 ) ,常规补液组及肠外营养组肠道菌群失调症患者 14例 ,给以双歧杆菌制剂等治疗菌群失调 ,症状得以改善。结论 :肠内营养有防治肠道菌群失调的作用 ,双歧杆菌等微生态制剂可用于治疗消化道肿瘤术后肠道菌群失调。