双歧杆菌三联活菌治疗新生儿黄疸对患儿肠道菌群、胆红素水平的影响

摘要 目的：探讨双歧杆菌三联活菌治疗新生儿黄疸对患儿肠道菌群、胆红素水平的影响。方法：选取2021年5月-2023年5月于南京市江宁医院收治的300例黄疸患儿,采用随机数表法将患儿分为益生菌组和参照组,均纳入150例。参照组患儿采用常规治疗,益生菌组在参照组基础上加用双歧杆菌三联活菌散治疗,两组均持续治疗1周。比较两组患儿治疗效果,治疗前后肠道菌群、胆红素水平、炎症指标变化,以及两组患儿治疗期间的不良反应发生情况。结果：益生菌组治疗的有效率为90.67%,参照组为82.00%,差异有统计学意义（P＜0.05）。治疗后,且益生菌组双歧杆菌、嗜酸乳杆菌水平高于参照组,益生菌组大肠杆菌水平低于参照组,差异有统计学意义（P＜0.05）;益生菌组总胆红素（TBIL）、直接胆红素（DBIL）和间接胆红素（IBIL）水平参照组低,差异均有统计学意义（P＜0.05）;益生菌组炎症水平较参照组低,差异有统计学意义（P＜0.05）;益生菌组γ-谷氨酰转移酶（GGT）和碱性磷酸酶（ALP）较参照组低,差异均有统计学意义（P＜0.05）。益生菌组不良反应发生率为10.00%,参照组为12.00%,差异无统计学意义（P＞0.05）。结论：双歧杆菌三联活菌治疗新生儿黄疸可以改善患儿肠道菌群和炎症水平,减轻患儿肝脏负担,降低胆红素水平。     

Effect of Bilirubin on the Membrane Potential of Rat Brain Synaptosomes

The effect of the neurotoxic pigment bilirubin on the membrane potential of rat brain synaptosomes was studied by using the tetraphenylphosphonium ion (TTP+) technique. Bilirubin induces a rapid depolarization of synaptosomes, as reflected by an efflux of previously accumulated [3H]TTP+. This phenomenon persisted when the membrane potential across either the plasma membrane of the synaptosome or the inner membrane of the entrapped mitochondria was selectively depressed, thus indicating that both components of the synaptosomal membrane potential were affected by bilirubin. Bovine serum albumin, used at a albumin/bilirubin molar ratio of 1:1, had the capacity to completely prevent and reverse the effect of bilirubin. This fact demonstrates that the bilirubin-induced TPP+ release from synaptosomes is a reversible process that requires the presence of bilirubin interacting with the synaptosomal membranes. These results, together with the inhibition by bilirubin of [3H]TPP+ and [2-14C]acetate uptake by synaptosomal plasma membrane vesicles isolated from rat brain, suggest that bilirubin depresses the membrane potential across the synaptosomal plasma membrane by a mechanism involving alterations in ion permeability. This effect could be of relevance in the pathogenesis of bilirubin encephalopathy.     

血清胆红素的光敏氧化

竹红菌乙素是一种芘醌类的光敏剂.实验结果表明在可见光的照射下.它能加速血清胆红素的光氧化,氧化速率提高5倍以上.比较在不同溶剂中各种活性氧淬灭剂对胆红素光氧化的抑制作用,指出血清胆红素光敏氧化反应包括自由基氧化反应(Ⅰ型反应)和单态氧氧化反应(Ⅱ型反应)等多重机制.     

微量血胆红素测定仪的临床应用

目的 :了解微量血胆红素测定仪测定血胆红素的正确性。方法 :黄疸婴儿 5 0例 ,男 2 9例 ,女 2 1例 ,年龄平均为 2 1 6天。采用玻璃毛细管在患儿足跟采集少量血在微量血胆红素测定仪上测定 ,并与静脉采血测得的血胆红素值进行比较。结果 :二种方法测得的血红素值无显著差别 (P >0 0 5 ) ,二者之间有非常显著的相关 ,相关系数r=0 96 996 ,P <0 0 1。结论 :微量法测定血胆红素简便 ,迅速 ,减少对婴儿的损伤 ,为黄疸婴儿血胆红素的测定提供了较大方便 ,应予推广应用     

Photo-isomerization and oxidation of bilirubin in mammals is dependent on albumin binding

The bilirubin (BR) photo-conversion in the human body is a protein-dependent process; an effective photo-isomerization of the potentially neurotoxic Z,Z-BR as well as its oxidation to biliverdin in the antioxidant redox cycle is possible only when BR is bound on serum albumin. We present a novel analytical concept in the study of linear tetrapyrroles metabolic processes based on an in-depth mapping of binding sites in the structure of human serum albumin (HSA). A combination of fluorescence spectroscopy, circular dichroism (CD) spectroscopy, and molecular modeling methods was used for recognition of the binding site for BR, its derivatives (mesobilirubin and bilirubin ditaurate), and the products of the photo-isomerization and oxidation (lumirubin, biliverdin, and xanthobilirubic acid) on HSA. The CD spectra and fluorescent quenching of the Trp–HSA were used to calculate the binding constants. The results of the CD displacement experiments performed with hemin were interpreted together with the findings of molecular docking performed on the pigment–HSA complexes. We estimated that Z,Z-BR and its metabolic products bind on two independent binding sites. Our findings support the existence of a reversible antioxidant redox cycle for BR and explain an additional pathway of the photo-isomerization process (increase of HSA binding capacity; the excess free [unbound] BR can be converted and also bound to HSA).     

Liquid chromatographic method for the determination of lidocaine and monoethylglycine xylidide in human serum containing various concentrations of bilirubin for the assessment of liver function

A high-performance liquid chromatographic method is described for determination of lidocaine (2-(dietyloamino)-N-(2,6-dimetylofenylo) acetamid) and its metabolite, monoethylglycine xylidide (MEGX), in human serum containing various concentration of bilirubin. Lidocaine and its metabolite were extracted from human serum using dichloromethane. After separation of the layers and freezing at -32 degrees C, the organic layer was decanted and evaporated under a stream of nitrogen. The sample was dissolved in the mobile phase (12% acetonitrile in 15mM potassium dihydrogen orthophosphate, pH 3.0), and after separation on a Supelcosil LC-8-DB column, the analytes were measured by ultraviolet detection at 205nm. Trimethoprim (TMP) was used as the internal standard. The recovery of the examined analytes ranged from 95.7 to 97.9% for lidocaine and from 98.0 to 99.9% for MEGX. The lower limit of quantification (LLOQ) was established at 200microg/l for lidocaine and at 10microg/l for MEGX. The choice of suitable conditions for chromatographic separation of lidocaine and its metabolite MEGX allowed the elimination of the influence of endogenous bilirubin on the result of analysis.     

不同剂量阿托伐他汀钙短期应用对冠状动脉粥样硬化性心脏病患者血清胆红素水平的影响

目的:探讨不同剂量阿托伐他汀钙短期应用对冠状动脉粥样硬化性心脏病患者血清胆红素水平的影响。方法:按照详细的纳入及排除标准的筛选共计264例冠状动脉粥样硬化性心脏病患者入选,分为20 mg和40 mg治疗剂量组,观察患者用药前后胆红素水平的变化水平的改变。结果:与服药前的相比,服用阿托伐他汀钙40 mg和20 mg的患者血清总胆红素、直接胆红素水平均呈显著性上升(P0.05),而间接胆红素水平差异无显著性。服药1个月后,40 mg组患者血清总胆红素、直接胆红素水平升高较20 mg组更显著(P0.05),但两组间接胆红素水平差异没有显著性。总胆红素变化率与患者胆固醇水平呈显著相关性,其20mg组为0.419,40 mg组为0.634(P0.001)。结论:阿托伐他汀钙治疗冠状动脉粥样硬化性心脏病患者可导致其血清总胆红素和直接胆红素水平升高,且高剂量较低剂量对总胆红素和直接胆红素的影响更明显。     

Bilirubin exhibits a novel anti-cancer effect on human adenocarcinoma

Anti-oxidants are essential for intracellular free radical scavenging, as free radicals are one of the causes for tumorigenesis. Our objective was to use bilirubin and investigate its action on human carcinoma cell lines. Bilirubin manifested as a prooxidant showing its cytopathic effect on TMK-1, showing growth inhibition close to 50%. Cell cycle analysis showed an arrest at G0/G1. Flow cytometry investigations with Red CC-1 showed an increase by more than 2 times suggesting a prooxidative role of bilirubin. To check the effect of radicals on DNA, a Comet Assay displayed a typical comet's tail with bilirubin treated slides, only. Further, staining with DAPI showed apoptotic action of bilirubin. Decreased mitochondrial function by bilirubin was observed with Mitotracker Green FM staining. These unexpected data have led us to conclude that bilirubin has anti-cancer activity as a prooxidant and may have a more vital role in the human body than realized.     

牛脾胆绿素还原酶的性质

纯牛脾胆绿素还原酶是单一蛋白质,分子量约34 000,等电点约6.2。该酶对胆绿素具有专一性,在还原胆绿素为胆红素中,以还原胆绿素Ⅸ_α最快,Ⅸ_β、Ⅸ_γ和Ⅸ_δ皆很慢。于还原反应中,此酸可以NADH为电子和氢供体,NADPH亦然。然而,NADH依赖性酸与NADPH依赖性酶动力学性质不同:与NADH反应的最适pH7.0,而与HADPH反应时为8.5;两者活性均为过量的胆绿素所抑制,不过,NADPH依赖性酶更敏感。     

Bilirubin removal from human plasma by Cibacron Blue F3GA using immobilized microporous affinity membranous capillary method

A novel affinity sorbent system for direct bilirubin removal from human plasma was developed. These new adsorbents comprise Cibacron Blue F3GA as the specific ligand, and microporous membranous poly(tetrafluoroethylene) capillary (modified by coating with a hydrophilic layer of poly(vinyl alcohol) after activation) as the carrier matrix. The affinity adsorbents carrying 126.5 micromol Cibacron Blue F3GA/g polymer was then used to remove bilirubin in a flow-injection system. Non-specific adsorption on the poly(vinyl alcohol) coated capillary remains low, and higher affinity adsorption capacity, of up to 76.2 mg/g polymer was obtained after dye immobilization. The bilirubin adsorption capacity of the affinity capillary decreased with increase in the recirculation rate of plasma. The adsorption capacity increased with increase the temperature while decreased with increase the ionic strength. The maximum adsorption was only observed in neutral solution (pH 6-7). The adsorption isotherm fitted the Langmuir model well. These new adsorbents have higher velocity of mass transfer, better adsorption capacity, less fouling, longer service life and good reusability. The results of blood tests suggested the dye affinity capillary has good blood compatibility.     

产胆红素氧化酶菌种筛选

选出一株产胆红素氧化酶的菌种露湿漆斑菌—Myrotheciumr oriclum,简称MTR89—403。此菌产酶最适培养基:40—80％的马铃薯浸出液100ml、葡萄糖1g,pH6.0。培养条件:500ml三角瓶装100ml培养基,在27℃、200rpm旋转摇床培养84h,得到的最高酶活为1300u/L,比活为12.3u/mg蛋白。     

疣孢漆斑菌(Myrothecium Verrucaria)J-1胆红素氧化酶的纯化及性质初步研究

从中国土样中筛选到一株能产生胆红素氧化酶的微生物(Myrothecium Verrucaria)J-1,培养后,分离纯化,最后经QAE—Sephadex A50柱层析,得到胆红素氧化酶比活为207.65 U/A 280nm,总产率为22.3％。纯酶紫外吸收峰为278 nm,凝胶电泳为单一色带。分子量估计为52000。它能迅速、特异地氧化胆红素为胆绿素,并进一步氧化成目前还不清楚的紫色化合物。最佳作用pH为7.0,最佳作用温度为40℃。     

Effects of bilirubin on potassium (86Rb+) influx and ionic content in Ehrlich ascites cells

Potassium influx, intracellular potassium and sodium content and cellular volume were determined in vitro in Ehrlich ascites cells in the presence of up to 0.8 mM bilirubin in the incubation medium. Bilirubin uptake into cells as a function of bilirubin concentration in the incubation medium increased linearly with a molar bilirubin/albumin ratio of 20 : 1. Potassium influx and intracellular content decreased while cellular volume increased after 180 min of incubation of cells in bilirubin at a molar bilirubin/albumin ratio of 20 : 1. At a bilirubin/albumin ratio 2 : 1, potassium influx decreased, cellular volume remained unchanged, and bilirubin uptake into cells became saturated at bilirubin concentrations greater than 0.3 mM. It is suggested that bilirubin-induced alterations in potassium gradients across cell membranes may play a role in toxic effects of bilirubin on cells.     

\"妈咪爱\"对新生儿胆红素代谢影响的临床观察

目的研究复方乳酸杆菌健肠剂-妈咪爱对新生儿胆红素代谢的影响.方法对重庆市妇幼保健院产科2003年12月～2004年1月生产的足月单胎正常新生儿60例,随机分为观察组与对照组.观察组生后12 h即给予妈咪爱0.5 g bid,口服1月.用TCB(经皮测黄疸仪JH20-1B)于生后1～30 d连续测试观察黄疸变化.结果观察组与对照组婴儿黄疸于生后3 d,黄疸达到高峰的时间,黄疸的高峰值,黄疸消退至正常的时间差异,均有显著性.结论复方乳酸杆菌健肠剂-妈咪爱可以延缓新生儿黄疸达到高峰的时间,降低黄疸高峰值,缩短新生儿黄疸高峰期,促进黄疸消退,对预防新生儿高胆红素血症发生有一定作用.     

活性氧自由基诱发的胆红素聚合、聚集及稳定自由基的形成

 为了深入了解胆红色素类结石形成的触发机制,我们研究了活性氧自由基与胆红素的作用。结果表明:·O_2和·OH均可诱发胆红素聚合和聚集,井使胆红素转变成稳定的自由基,从而引起脂质过氧化和透明质酸分子降解。经自由基处理的胆红素溶解度减小,粒度分布趋向颗粒变大.根据以上事实,重点讨论了自由基触发的胆色素类结石的致病过程。     

Effect of cucurbitacins on bilirubin-albumin binding in human plasma

The aim of this study is to investigate the effect of three cucurbitacins (Cuc) E, D and I on the bilirubin-albumin binding, both in human serum albumin (HSA) and in plasma. Bilirubin-HSA solution and plasma free of cucurbitacins were prepared as well as others containing serial concentrations of cucurbitacins. The concentration of unbound bilirubin was determined in bilirubin-HSA solution and the direct and total bilirubin concentrations were measured in plasma (with normal or elevated bilirubinemia) by Jendrassik and Grof method. In the conditions we adopted Cuc E and D (to a lesser extent), decreased the levels of unbound bilirubin in bilirubin-HSA solution and decreased direct bilirubin concentration and total bilirubin concentration in plasma in a dose-dependent manner while Cuc I had no effect. The effect of Cuc is related to the presence of native HSA. Thus, when albumin was absent or has been denatured by heating or by urea, Cuc E did not modify bilirubin levels, suggesting that the native structure of albumin is essential for such activity. The interaction of HSA with Cuc E was investigated by fluorescence spectroscopy. Cuc E increased the intrinsic fluorescence of the protein and the magnitude of fluorescence intensity of bilirubin-albumin complex. We concluded that Cuc E and D produced a rearrangement in the structure of albumin, particularly in the domain-II, resulting in an increase in the binding of bilirubin to albumin regardless to whether it's conjugated to glucuronic acid or unconjugated.     

Psychological stress increases bilirubin metabolites in human urine

Some authors have suggested that psychological stress induces the production of reactive oxygen species (ROS). Some studies have supported that bilirubin exerts anti-oxidative effects in vivo. However, it is not known whether ROS induced by psychological stress provoke bilirubin oxidation in vivo. We investigated if the concentration of bilirubin oxidative metabolite (BOM), a bilirubin oxidative metabolite, increased in urine from subjects exposed to psychological stress. Sixty healthy male volunteers working in a pharmaceutical company were divided into a Group I which did not attend a conference, a Group II which attended a conference but did not deliver a speech, and a Group III which attended a conference and delivered speeches in the presence of the company executives. Subjective stress was scored (self-rating score) after subjects in Group III delivered their speeches at the conference. Urine was collected on the next day. The BOM concentrations, as measured by enzyme-linked immunosorbent assay, were normalized to the urinary concentration of creatinine. The concentration of BOM in Group III was significantly higher compared to that in Groups I and II (p<0.01 and p<0.05, respectively). Furthermore, in Group III, the concentration of BOM correlated with the self-rating stress score (r=0.53, p<0.01). These findings suggest that emotional stimuli are associated with an increase in the oxidative metabolites of bilirubin in human urine, and that BOMs could be useful markers of psychological stress.