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1.
The in vivo capacity of urea nitrogen synthesis (CUNS) during alanine stimulation was measured within the blood amino acid concentration interval 7.3-11.6 mmol/l, where urea synthesis is at maximum and independent of substrate concentration. Three groups of rats were fed for 14 days, either a low protein diet (8%), a normal diet (17%), or a high protein diet (53%). Diet protein modified both CUNS and plasma glucagon concentration. CUNS was 5.86 +/- 2.93, 7.43 +/- 2.16, and 19.31 +/- 4.32 mumol/(min.100 g BW) (mean +/- SD, N = 6), respectively. The corresponding plasma glucagon concentrations after alanine stimulation were 222 +/- 400, 633 +/- 229, and 1700 +/- 627 ng/l, respectively. The in vivo kinetics of urea production is regulated by dietary protein, possibly via glucagon. This implies that the liver plays an active part in adaptation of whole body nitrogen homeostasis to dietary changes.  相似文献   

2.
Heat stress (HS) jeopardizes livestock health and productivity and both may in part be mediated by reduced intestinal integrity. Dietary zinc improves a variety of bowel diseases, which are characterized by increased intestinal permeability. Study objectives were to evaluate the effects of supplemental zinc amino acid complex (ZnAA) on intestinal integrity in heat-stressed growing pigs. Crossbred gilts (43±6 kg BW) were ad libitum fed one of three diets: (1) control (ZnC; 120 ppm Zn as ZnSO4; n=13), (2) control+100 ppm Zn as ZnAA (Zn220; containing a total of 220 ppm Zn; n=14), and (3) control+200 ppm Zn as ZnAA (Zn320; containing a total of 320 ppm Zn; n=16). After 25 days on their respective diets, all pigs were exposed to constant HS conditions (36°C, ∼50% humidity) for either 1 or 7 days. At the end of the environmental exposure, pigs were euthanized and blood and intestinal tissues were harvested immediately after sacrifice. As expected, HS increased rectal temperature (P⩽0.01; 40.23°C v. 38.93°C) and respiratory rate (P⩽0.01; 113 v. 36 bpm). Pigs receiving ZnAA tended to have increased rectal temperature (P=0.07; +0.27°C) compared with ZnC-fed pigs. HS markedly reduced feed intake (FI; P⩽0.01; 59%) and caused BW loss (2.10 kg), but neither variable was affected by dietary treatment. Fresh intestinal segments were assessed ex vivo for intestinal integrity. As HS progressed from days 1 to 7, both ileal and colonic transepithelial electrical resistance (TER) decreased (P⩽0.05; 34% and 22%, respectively). This was mirrored by an increase in ileal and colonic permeability to the macromolecule dextran (P⩽0.01; 13- and 56-fold, respectively), and increased colonic lipopolysaccharide permeability (P⩽0.05; threefold) with time. There was a quadratic response (P⩽0.05) to increasing ZnAA on ileal TER, as it was improved (P⩽0.05; 56%) in Zn220-fed pigs compared with ZnC. This study demonstrates that HS progressively compromises the intestinal barrier and supplementing ZnAA at the appropriate dose can improve aspects of small intestinal integrity during severe HS.  相似文献   

3.
To elucidate the role of luminal nutrients and glucagon-like peptide-2 (GLP-2) in intestinal adaptation, rats were subjected to 70% midjejunoileal resection or ileal transection and were maintained with total parenteral nutrition (TPN) or oral feeding. TPN rats showed small bowel mucosal hyperplasia at 8 h through 7 days after resection, demonstrating that exogenous luminal nutrients are not essential for resection-induced adaptation when residual ileum and colon are present. Increased enterocyte proliferation was a stronger determinant of resection-induced mucosal growth in orally fed animals, whereas decreased apoptosis showed a greater effect in TPN animals. Resection induced significant transient increases in plasma bioactive GLP-2 during TPN, whereas resection induced sustained increases in plasma GLP-2 during oral feeding. Resection-induced adaptive growth in TPN and orally fed rats was associated with a significant positive correlation between increases in plasma bioactive GLP-2 and proglucagon mRNA expression in the colon of TPN rats and ileum of orally fed rats. These data support a significant role for endogenous GLP-2 in the adaptive response to mid-small bowel resection in both TPN and orally fed rats.  相似文献   

4.
目的观察和评价凝结芽孢杆菌活菌片(商品名:爽舒宝)对腹泻型肠易激综合征患者的临床疗效。方法将100例腹泻型肠易激综合征患者随机分为3组,其中爽舒宝治疗组32例,马来酸曲美布汀治疗组35例,联合治疗组33例。3组患者疗程均为60d,记录3组患者腹痛、腹泻、排便异常等症状的变化。结果在近期疗效方面,联合治疗组有效率(87.87%)高于爽舒宝治疗组(75.00%),而这两组的有效率均高于马来酸曲美布汀治疗组(51.43%)。在远期疗效方面,爽舒宝治疗组患者有效率(100.00%)和联合治疗组(100.00%)之间无显著差异,而这两组的有效率均高于马来酸曲美布汀治疗组(74.29%)。治疗结束后,3组患者大便次数、腹痛、大便性状等各项症状体征积分均较治疗前显著降低(P0.05),其中联合治疗组患者治疗后各项症状体征积分与爽舒宝治疗组比较差异无统计学意义(P0.05),但均低于马来酸曲美布汀治疗组(P0.05)。结论凝结芽孢杆菌活菌片治疗腹泻型肠易激综合征疗效显著,值得在临床治疗中推广应用。  相似文献   

5.
BackgroundR-spondins, including R-spondin 1 (RSPO1), are a family of Wnt ligands that help to activate the canonical Wnt/β-catenin pathway, which is critical for intestinal epithelial cell proliferation and maintenance of intestinal stem cells. This proliferation underpins the epithelial expansion, or intestinal adaptation (IA), that occurs following massive bowel resection and short bowel syndrome (SBS). The purpose of this study was to identify if recombinant human RSPO1 (rhRSPO1) could be serially administered to SBS zebrafish to enhance cellular proliferation and IA.MethodsAdult male zebrafish were assigned to four groups: sham + PBS, SBS + PBS, sham + rhRSPO1, and SBS + rhRSPO1. Sham fish had a laparotomy alone. SBS fish had a laparotomy with distal intestinal ligation and creation of a proximal stoma. Fish were weighed at initial surgery and then weekly. rhRSPO1 was administered post-operatively following either a one- or two-week dosing schedule with either 3 or 5 intraperitoneal injections, respectively. Fish were harvested at 7 or 14 days with intestinal segments collected for analysis.ResultsRepeated intraperitoneal injection of rhRSPO1 was feasible and well tolerated. At 7 days, intestinal epithelial proliferation was increased by rhRSPO1. At 14 days, SBS + rhRSPO1 fish lost significantly less weight than SBS + PBS fish. Measurements of intestinal surface area were not increased by rhRSPO1 administration but immunofluorescent staining for β-catenin and gene expression for cyclin D1 was increased.ConclusionsIntraperitoneal injection of rhRSPO1 decreased weight loss in SBS zebrafish with increased β-catenin + cells and cyclin D1 expression at 14 days, indicating improved weight maintenance might result from increased activation of the canonical Wnt pathway.  相似文献   

6.
We postulated that daily drenching of propylene glycol to cows in early lactation would increase plasma glucose and insulin concentrations and improve fertility in postpartum cows. Thirty-six Holstein cows were assigned to treatment or control groups. Each treatment cow was given 500 ml of propylene glycol by drenching daily from 7 to 42 days of lactation. Blood samples for glucose, insulin, nonesterified fatty acids (NEFA), and plasma urea N were collected at 0, 30, and 90 min postdrenching once weekly during 1-6 weeks. Blood samples were collected for progesterone analysis and cows were palpated three times per week until 11 weeks to assess ovarian status. Propylene glycol did not affect dry matter intake (DMI), milk yield or energy balance in treatment cows. After drenching, propylene glycol increased (P<0.01) plasma glucose and insulin and decreased (P<0.01) NEFA; plasma urea N of the treatment group tended (P=0.07) to be higher than that of the control group through 90 min. Days to first service, days open, and services per conception were not different between groups. Conception rates to first insemination were 33% in the control group and 57% in treated cows, but these were not significantly different. First ovulation of treatment cows occurred earlier than that of control cows (32.3 versus 44.5 days, P=0.06) and the length of the first luteal phase was longer in treated cows (13.1 versus 7.3 days, P<0.05). These data are consistent with the hypothesis that insulin is important for normal ovarian function. During negative energy balance, treatment with propylene glycol, which induced small increases in plasma concentrations of insulin, prevented the short luteal phase characteristic of the first estrous cycle in control cows.  相似文献   

7.
目的观察酪酸梭菌活菌胶囊(商品名:阿泰宁)对胆道结石患者术后肠功能紊乱的疗效及对术后消化吸收功能的改善作用。方法选取40例行胆总管切开探查术且术后出现腹泻、腹胀、消化不良等肠功能紊乱的胆总管结石患者。随机分为观察组和对照组,每组20例。两组患者均予以生理盐水补液、止泻药止泻和低脂饮食等常规治疗,观察组患者加服酪酸梭菌活菌胶囊,3粒/次,2次/d,连用28d。观察两组患者用药后的临床疗效及不良反应。结果观察组患者临床总有效率(100.0%)显著高于对照组(80.0%)(P0.05);腹泻和腹胀的时间显著短于对照组(P0.01);同时治疗后观察组患者总胆固醇、甘油三酯、球蛋白水平显著高于对照组(P0.05),电解质紊乱发生率低于对照组(P0.05)。治疗期间所有患者未见不良反应。结论酪酸梭菌活菌胶囊治疗胆道结石患者术后肠功能紊乱疗效显著,能够显著改善患者对脂质的消化吸收能力,对患者术后消化吸收功能的改善具有积极的作用,值得临床推广应用。  相似文献   

8.
In this open sequential study we evaluated the long-term effectiveness and tolerability of the i.m. administration of slow release lanreotide 30 mg (SRL) in 18 acromegalics (7 M/11 F, age 50.9+/-12.7 yr). Baseline mean GH and IGF-1 levels were 15.8+/-6.6 ng/ml and 702+/-74 ng/ml, respectively. Four hours, 1, 7, and 14 days after SRL, mean GH levels were 8.9+/-5.9 (p < 0.005), 11.4+/-6.9 (p < 0.05), 9.1+/-4.5 (p < 0.05), and 9.1+/-4.1 ng/ml (p < 0.05), respectively; and the IGF-1 values at 1, 7, and 14 days were 624+/-77 (p < 0.05), 555+/-83 (p < 0.001), and 467+/-58 ng/ml (p < 0.0001), respectively. Four hours after SRL administration GH was < 2.5 ng/ml in 11 patients and decreased 85% of the basal value, without normalizing, in another case. In the following 2 weeks, 7 and 2 patients maintained GH < 2.5 ng/ ml or < 50% of baseline; 3 and 2 of them attained IGF-1 values in the normal range or < 50% of basal levels. A patient developed acute pancreatitis after the injection of the drug and therefore stopped the treatment. Another patient did not continue SRL, and she was turned on octreotide, s.c. administered (OCT), because only the latter treatment ameliorated significantly the headache. In 16/18 patients the treatment was continued until the 24th month. SRL was administered every 14 days until the 24th month in 3 cases, whereas in 13 patients the dose schedule was increased every 10 days since the 7th month because they did not normalize serum GH and IGF-1 levels. In these 16 patients baseline GH and IGF-1 levels were 10.0+/-2.5 ng/ml and 671+/-75 ng/ml, respectively. At the 1st, 3rd, and 6th month of treatment mean GH levels fell to 5.4+/-1.4 (p < 0.05), 5.3+/-1.8 (p < 0.05), and 5.0+/-1.6 (p < 0.05) ng/ml, respectively; and IGF-1 declined to 511+/-87 (p < 0.005), 565+/-85 (p < 0.05), and 525+/-94 (p < 0.01) ng/ml, respectively. Throughout the first semester GH was < 2.5 ng/ml in 5 patients and decreased > 50% in another three. IGF-1 levels normalized in 3/5. Throughout the following 18 months of treatment, mean GH (3.4+/-1.0 ng/ml) and IGF-1 (413+/-75 ng/ml) values decreased significantly in comparison with both the baseline concentrations (GH p < 0.01, IGF-1 p < 0.001) and the levels measured during the 1st semester of treatment (GH p < 0.05, IGF-1 p < 0.001). GH remained < 2.5 ng/ml in 11 patients, and in 8/11 cases IGF-1 fell in the normal range. Serum GH and IGF-1 levels decreased by more than 50% of baseline levels in 2 other cases. At MRI, pituitary adenoma was no longer evident in one patient previously treated with OCT and significantly decreased in another patient previously treated with surgery plus radiotherapy, as well as in a patient previously untreated. During treatment the percentage of patients complaining of headache and fatigue decreased significantly (chi2, p < 0.05 and p < 0.0005, respectively). Overall, the headache (p < 0.005), arthralgia (p < 0.05), and paresthesia (p < 0.01) ameliorated significantly. Ultrasound scan showed gallbladder sludge or sand-like stones in 5/11 patients. This study, which is one of the longest surveys on a relatively large series of acromegalics treated with SRL, confirms the long-term effectiveness of this drug for the treatment of patients with active acromegaly. SRL decreases significantly GH and IGF-1 in most cases and induces the shrinkage of the pituitary tumor in some patients previously either untreated or both treated for acromegaly. SRL improves significantly clinical symptoms and it is well tolerated.  相似文献   

9.
The loss of functional small bowel surface area leads to a well-described adaptive response in the remnant intestine. To elucidate its molecular regulation, a cohort of cDNAs were cloned using a rat gut resection model and subtractive/differential hybridization cloning techniques. This study reports a novel cDNA termed "ileal remnant repressed" (IRR)-219, which shares 80% nucleotide identity with the 3'end of a human intestinal IgG Fc binding protein (IgGFcgammaBP) and is homologous to human and rat mucins. IRR-219 mRNA is expressed in intestine and colon only. At 48 h after 70% intestinal resection, mRNA levels decreased two- to fivefold in the adaptive small bowel but increased two- to threefold in the colon. Expression of IRR-219 was suppressed in adaptive small bowel as late as 1 wk after resection. IRR-219 expression is also regulated during gut ontogeny. In situ hybridization revealed IRR-219 expression in small intestinal and colonic goblet cells only. Its unique patterns of expression during ontogeny and after small bowel resection suggest distinctive roles in small bowel and colonic adaptation.  相似文献   

10.
The goal of this research was to study the effect of the substitution of wheat starch by potato starch (PS) on the performance, health and digestion of growing rabbits. Three experimental diets were formulated with 0%, 7% and 14% PS (PS0, PS7 and PS14, respectively) and similar starch contents (22% dry matter basis), proteins and fibre. The three diets were administered to three groups of 48 rabbits from weaning (28 days) to slaughter (70 days), and growth and health measurements were made. Another 10 rabbits per diet (30 rabbits at each age), reared under similar conditions, were slaughtered at 6 to 10 weeks of age, and the digesta were collected to analyse the caecal microbial activity (pH, volatile fatty acids (VFA) levels, fibrolytic activity) and the starch concentration in the ileal digesta. At the same ages, the whole tract digestibility coefficients were measured in 10 other rabbits for each treatment (30 rabbits). The feed intake between 28 and 42 days of age (days) increased by 11% (P < 0.05) in PS0 v. PS14. Over the whole growth period (28 to 70 days), weight gain was similar among diets (40.5 g/day), whereas the feed intake and feed conversion increased (8.5% and 5.2%, respectively; P < 0.05) with the PS14 diet. Mortality and morbidity were not affected by the diets. The starch concentration of the ileal contents increased (P < 0.01) with the addition of PS to the diet (0.39%, 0.77% and 1.08% for diets PS0, PS7 and PS14, respectively). Starch digestibility was 0.8 percentage units higher (99.8% v. 99.0%) with the PS0 diet than the PS14 diet (P = 0.04). The bacterial cellulolytic activity in the caecum tended to be higher with the PS14 diet (P = 0.07). The total VFA caecal concentration increased (P < 0.01) only in 6-week-old rabbits with PS7 compared with PS0 (54.7 v. 74.5 mmol/l). Protein digestibility and ileal starch concentration decreased (P < 0.05) with age (6 v. 10 weeks), and hemicelluloses digestibility increased (P < 0.05). At 10 weeks of age, rabbits showed a higher VFA pool (6.25 mol) and proportion of butyrate (15.9%) and a lower proportion of acetate (79.3%), ammonia level (7.5 mmol/l) and C3/C4 ratio (0.31) than at 6 weeks of age. The intake of potato starch had no effect on the performance, caecal microbial activity or digestive health of growing rabbits.  相似文献   

11.
Children with short bowel syndrome face life-threatening complications. Therefore, there is an urgent need for a new therapy to induce effective adaptation of the remnant intestine. Adaptation occurs only during feeding. We focused on preprandial acyl ghrelin and des-acyl ghrelin, and postprandial glucagon-like peptide-2 (GLP-2), which are known to have active orexigenic and trophic actions. This study aims to clarify the secretion trends of these hormones after massive small bowel resection and to obtain basic data for developing a new treatment. Sixty-three growing male rats were used: 3 were designated as controls receiving no operation and 60 were randomized into the 80% small bowel resection (80% SBR) group and the transection and re-anastomosis group. Changes in body weight, food intake, and remnant intestine morphology were also assessed for 15 days after the operation. Acyl ghrelin and des-acyl ghrelin levels increased immediately, equivalently in both operation groups (P = 0.09 and 0.70). Interestingly, in 80% SBR animals, des-acyl ghrelin peaked on day 1 and acyl ghrelin peaked on day 4 (P = 0.0007 and P = 0.049 vs controls). GLP-2 secretion was obvious in 80% SBR animals (P = 2.25 × 10−6), which increased immediately and peaked on day 4 (P = 0.009 vs. controls). Body weight and food intake in 80% SBR animals recovered to preoperative levels on day 4. Morphological adaptations were evident after day 4. Our results may suggest a management strategy to reinforce these physiological hormone secretion patterns in developing a new therapy for short bowel syndrome.  相似文献   

12.
A sequential medium was evaluated on the survival, activation and growth rates of caprine preantral follicles submitted to a long-term culture period, aiming to establish an ideal in vitro culture system. Ovarian fragments were cultured for 16 days in α-MEM(+) alone or supplemented with hormones (GH and/or FSH) added sequentially on different days of culture. Ovarian fragments were cultured in the first (days 0-8) and second (days 8-16) halves of the culture period, generating 10 treatments: α-MEM(+)/α-MEM(+), FSH/FSH, FSH/GH, FSH/FSH+GH, GH/GH, GH/FSH, GH/FSH+GH, FSH+GH/FSH+GH, FSH+GH/FSH and FSH+GH/GH. Follicle morphology, viability and ultrastructure were analyzed. After day 1 of culture, FSH treatments maintained the percentage of normal follicles similar to the fresh control. At day 16 of culture, the treatment FSH/GH showed the highest (P<0.05) percentage of normal follicles. The ultrastructure of follicles was preserved in the fresh control and FSH/GH treatment. Follicles cultured with FSH/GH had a higher (P<0.05) viability than α-MEM(+); however the viability was lower (P<0.05) when compared to the fresh control. The FSH/GH treatment showed the highest (P<0.05) percentage of follicular activation and secondary follicle formation and produced the largest (P<0.05) mean follicular diameter after 16 days of culture. In conclusion, a sequential medium supplemented with FSH followed by GH during a long-term culture maintains the survival, viability and ultrastructure of goat preantral follicles, and promotes activation and secondary follicles.  相似文献   

13.
目的观察肠易激综合征(IBS)模型WHBE兔神经内分泌激素和电解质水平的变化,探讨神经-体液-内分泌系统在IBS中的作用。方法以湿热环境应激加小剂量致泻剂诱导WHBE兔建立IBS模型,在造模9d和14d时取血分离血清,检测血清中5-羟色胺(5-HT)、多巴胺(DA)、促肾上腺皮质激素(ACTH)、皮质醇(COR)、β-内啡肽(β-EP)激素和K^+、Na^+、cl^-含量的变化,并以JW兔作对照。结果与正常对照组比,造模9d时WHBE兔的5-HT、DA、ACTH、β-EP、COR均显著升高(P〈0.05,P〈0.01),Na^+、K^+含量均显著降低(P〈0.01),而JW兔ACTH、β-EP、COR均显著升高(P〈0.05,P〈0.01),K^+含量显著降低(P〈0.05);造模14d时WHBE兔5-HT、ACTH、β-EP均显著升高(P〈0.05,P〈0.01),JW兔ACTH显著升高(P〈0.05);相关分析显示,IBS模型中血清中5-HT、COR与Na^+、K^+浓度呈显著负相关(P〈0.05,P〈0.01),血清中DA、β-EP水平与Na^+、K^+、Cl^-浓度呈显著负相关(P〈0.05,P〈0.01),ACTH水平则与K^+浓度呈显著负相关(P〈0.01)。结论IBS的发生不仅与HPA轴兴奋性升高有关,亦与体液因素有关,故神经-体液-内分泌系统参与了WHBE兔IBS的发生过程。  相似文献   

14.
Visceral hyperalgesia has been suggested to play a role in the development of symptoms presented by irritable bowel syndrome patients. Otilonium bromide was developed to block smooth muscle Ca release to control cramping pain of these patients. Aims: to determine whether otilonium bromide can influence sensory thresholds of patients suffering from irritable bowel syndrome. METHODS: 15 patients with Rome-II positive IBS were tested by Synectics Visceral Stimulator Barostat using rapid phasic distension (870 ml/min). The sensory threshold for first sensation, stool, pain and maximum tolerable volume and pressure were measured. All of the parameters were tested before and 1 week after the initiation of otilonium bromide (Spasmomen, Berlin Chemie, 3x40 mg) therapy. RESULTS: The perceptual thresholds for first sensation, stool, pain and maximum tolerable distention were, 8.8+/-1.7 Hgmm, 19.2+/-2.1 Hgmm, 26.3+/-2.8 Hgmm, 28.7+/-2.8 Hgmm for pressure, 90+/-21 ml, 145+/-28 ml, 208+/-25 ml, 213+/-28 ml for volume, before treatment, respectively. Otilonium bromide treatment did not influence the thresholds for first sensation and stool, 7.4+/-1.4 Hgmm, 20.7+/-4.6 Hgmm and 83+/-21 ml, 178+/-35.8 ml, respectively. The pressure threshold of pain was significantly higher 1 week after treatment (26.3+/-2.8 Hgmm vs. 29.1+/-5.5 Hgmm, P<0.05), but the volume threshold of this sensation remained unchanged (208+/-25 ml vs. 234+/-39 ml, not significant). The pressure (28.7+/-2.8 Hgmm vs. 38.1+/-3.4 Hgmm, P<0.05) and volume (213+/-28 ml vs. 278+/-27 ml, P<0.05) thresholds for maximum tolerable volume were increased by 7 days otilonium bromide treatment. CONCLUSION: These data suggest that otilonium bromide enhances sensory thresholds to recto-sigmoideal distention.  相似文献   

15.
Twenty pluriparous, spring-calving Brahman cows were used to determine luteal competency, as measured by serum progesterone concentrations, during the first and the second postpartum estrous cycles. Prior to and after calving, all cows were maintained in good body condition on Coastal bermudagrass pasture (IFN 1-00-703). The calves were allowed to suckle ad libitum, and sterile marker bulls were maintained with the cow herd as an aid in estrus detection throughout the trial. Cow weight and body condition score were recorded within 24 hours after calving and again at the first behavioral estrus observed. From day 1 through day 14 (day 0 = estrus) of both the first and the second postpartum estrous cycles, blood samples were collected from each cow, processed to yield serum and analyzed by radioimmunoassay for progesterone concentrations. There was a higher incidence of abnormal estrous cycles following the first postpartum estrus (35%) than following the second (5%) postpartum estrus (P<0.05). The abnormal first estrous cycles were characterized by either a short luteal phase (four cows) or by standing estrus behavior without luteal tissue formation (three cows). When serum progesterone concentrations were compared for all cows during the first estrous cycle with those during the second estrous cycle, there was less progesterone released during the cycle (P<0.05) and lower peak progesterone concentrations (P<0.10) during the first estrous cycle. However, if the abnormal cows were excluded from the analyses, there was no difference (P>0.10) in either progesterone concentrations through the 14 days measured or in peak progesterone concentrations between the first and the second postpartum estrous cycles. It can be concluded from this study that the higher incidence of abnormal luteal function following the first postpartum estrus may contribute to the decreased conception rates observed when cows are bred at their first postpartum estrus.  相似文献   

16.
目的通过美常安干预肠易激综合征(IBS)伴小肠细菌过度生长(SIBO)患者,探讨IBS与SIBO之间的关系。方法选取40例IBS患者为IBS组,40例健康志愿者为对照组,两组患者治疗前均进行乳果糖氢呼气试验(LHBT)明确SIBO情况。IBS组中SIBO阳性者予美常安干预,观察其治疗前后的症状变化,疗程结束后复查LHBT。结果 IBS组患者SIBO发病率为55.0%,对照组为10.0%,两组患者SIBO发病率比较差异有统计学意义(P0.05);IBS组中SIBO阳性患者治疗后显效1例,有效12例,无效6例,脱落3例,有效率为68.0%,SIBO转阴率为57.9%。IBS组中SIBO阳性患者治疗前后腹胀程度、排便频率异常时间、排便时腹痛率及总积分比较差异有统计学意义(P0.05)。结论 IBS患者SIBO发病率远高于健康者,美常安能改善IBS伴SIBO患者部分症状及SIBO发病率,IBS的发生与SIBO之间存在一定关系,但对于IBS患者单纯补充益生菌制剂疗效并不理想,仍需结合其他手段进行干预。  相似文献   

17.
Previous work in our group has demonstrated that mouse salivary gland has the highest concentration of salivary-derived VEGF protein compared with other organs and is essential for normal palatal mucosal wound healing. We hypothesize that salivary VEGF plays an important role in maintaining the integrity of the gastrointestinal mucosa following small bowel resection (SBR). Thirty-five 8- to 10-wk-old C57BL/6 female mice were divided into seven treatment groups: 1) sham (transaction and anastomosis, n = 5); 2) SBR (n = 8); 3) sialoadenectomy and small bowel resection (SAL+SBR, n = 8); 4) sialoadenectomy and small bowel resection with EGF supplementation (SAL+SBR+EGF, n = 9); 5) sialoadenectomy and small bowel resection with VEGF supplementation (SAL+SBR+VEGF, n = 9); 6) sialoadenectomy and small bowel resection supplemented with EGF and VEGF (SAL+ SBR+VEGF+EGF, n = 6); 7) selective inhibition of VEGF in the submandibular gland by Ad-VEGF-Trap following small bowel resection (Ad-VEGF-Trap+SBR, n = 7). Adaptation was after 3 days by ileal villus height and crypt depth. The microvascular response was evaluated by CD31 immunostaining and for villus-vessel area ratio by FITC-labeled von Willebrand factor immunostaining. The adaptive response after SBR was significantly attenuated in the SAL group in terms of villus height (250.4 +/- 8.816 vs. 310 +/- 19.35, P = 0.01) and crypt depth (100.021 +/- 4.025 vs. 120.541 +/- 2.82, P = 0.01). This response was partially corrected by orogastric VEGF or EGF alone. The adaptive response was completely restored when both were administered together, suggesting that salivary VEGF and EGF both contribute to intestinal adaptation. VEGF increases the vascular density (6.4 +/- 0.29 vs. 6.1 +/- 0.29 vs. 5.96 +/- 0.20) and villus-vessel area ratio (0.713 +/- 0.01 vs. 0.73 +/- 0.01) in the adapting bowel. Supplementation of both EGF and VEGF fully rescues adaptation, suggesting that the adaptive response may be dependent on VEGF-driven angiogenesis. These results support a previously unrecognized role for VEGF in the small bowel adaptive response.  相似文献   

18.
Widgerow AD  Jackson L 《Plastic and reconstructive surgery》2004,113(3):1050-4; discussion 1055-6
Irritable bowel syndrome is a chronic disease involving pain or discomfort relieved by defecation and associated with a change in frequency or consistency of the stools. The effect of abdominoplasty on patients with irritable bowel syndrome has not been elucidated, so advising patients with irritable bowel syndrome about the effects of surgery on their disease was difficult. One hundred female patients from a pool of 120 patients responded to a questionnaire relating to abdominoplasty surgery. Follow-up ranged from 6 months to 2 years. Patients completed questionnaires formulated on the basis of Rome II Diagnostic Criteria. Of the 100 patients, nine had true irritable bowel syndrome, nine had moderate symptoms and were receiving medication (not true irritable bowel syndrome), 16 had mild symptoms on occasional medication, and 66 had no symptoms of irritable bowel syndrome before surgery. Of the true irritable bowel syndrome patients, all had symptomatic improvement with decreased medication, eight of the nine patients with moderate symptoms improved markedly, and five of the 16 patients with mild symptoms improved significantly. No patient had any initiation or deterioration of symptoms. It is thus concluded that the symptoms of irritable bowel syndrome are certainly not worsened, in the short term, by surgery, and may be alleviated or improved in most significant cases.  相似文献   

19.
Intestinal adaptation is an important compensatory response to massive small bowel resection (SBR) and occurs because of a proliferative stimulus to crypt enterocytes by poorly understood mechanisms. Recent studies suggest the enteric nervous system (ENS) influences enterocyte proliferation. We, therefore, sought to determine whether ENS dysfunction alters resection-induced adaptation responses. Ret+/- mice with abnormal ENS function and wild-type (WT) littermates underwent sham surgery or 50% SBR. After 7 days, ileal morphology, enterocyte proliferation, apoptosis, and selected signaling proteins were characterized. Crypt depth and villus height were equivalent at baseline in WT and Ret+/- mice. In contrast after SBR, Ret+/- mice had longer villi (Ret+/- 426.7 ± 46.0 μm vs. WT 306.5 ± 7.7 μm, P < 0.001) and deeper crypts (Ret+/- 119 ± 3.4 μm vs. WT 82.4 ± 3.1 μm, P < 0.001) than WT. Crypt enterocyte proliferation was higher in Ret+/- (48.8 ± 1.3%) than WT (39.9 ± 2.1%; P < 0.001) after resection, but apoptosis rates were similar. Remnant bowel of Ret+/- mice also had higher levels of glucagon-like peptide 2 (6.2-fold, P = 0.005) and amphiregulin (4.6-fold, P < 0.001) mRNA after SBR, but serum glucagon-like peptide 2 protein levels were equal in WT and Ret+/- mice, and there was no evidence of increased c-Fos nuclear localization in submucosal neurons. Western blot confirmed higher crypt epidermal growth factor receptor (EGFR) protein levels (1.44-fold; P < 0.001) and more phosphorylated EGFR (2-fold; P = 0.003) in Ret+/- than WT mice after SBR. These data suggest that Ret heterozygosity enhances intestinal adaptation after massive SBR, likely via enhanced EGFR signaling. Reducing Ret activity or altering ENS function may provide a novel strategy to enhance adaptation attenuating morbidity in patients with short bowel syndrome.  相似文献   

20.
Glucagon-like peptide-2 (GLP-2) is an intestinal trophic enteroendocrine peptide that is associated with intestinal adaptation following resection. Herein, we investigate the effects of GLP-2 in a total parenteral nutrition (TPN)-supported model of experimental short bowel syndrome. Juvenile Sprague-Dawley rats underwent a 90% small intestinal resection and jugular catheter insertion. Rats were randomized to three groups: enteral diet and intravenous saline infusion, TPN only, or TPN + 10 microg.kg(-1).h(-1) GLP-2. Nutritional maintenance was isocaloric and isonitrogenous. After 7 days, intestinal permeability was assessed by quantifying the urinary recovery of gavaged carbohydrate probes. The following day, animals were euthanized, and intestinal tissue was processed for morphological and crypt cell proliferation (CCP) analysis, apoptosis (caspase-3), and expression of SGLT-1 and GLUT-5 transport proteins. TPN plus GLP-2 treatment resulted in increased bowel and body weight, villus height, intestinal mucosal surface area, CCP, and reduced intestinal permeability compared with the TPN alone animals (P < 0.05). GLP-2 treatment induced increases in serum GLP-2 levels and intestinal SGLT-1 expression (P < 0.01) compared with either TPN or enteral groups. No differences were seen in the villus apoptotic index between resection groups. Enterally fed resected animals had a significant decrease in crypt apoptotic indexes compared with nontreated animals. This study demonstrates that GLP-2 alone, without enteral feeding, stimulates indexes of intestinal adaptation. Secondly, villus hypertrophy associated with adaptation was predominantly due to an increase in CCP and not to changes in apoptotic rates. Further studies are warranted to establish the mechanisms of action and therapeutic potential of GLP-2.  相似文献   

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