胃肠道手术患者术后感染病原菌及感染危险因素分析

目的 探究胃肠道手术患者术后感染病原菌及其感染高危因素,为该类患者的治疗提供参考。 方法 选择2017年1月至2019年10月于我院行胃肠道手术的106例患者为研究对象,检测感染患者病原菌分布,同时检测感染与非感染患者肠道菌群情况,分析患者术后感染的相关危险因素。 结果 106例胃肠道手术患者中感染18例(16.98%),共分离出病原菌23株,其中革兰阴性菌占52.17%(12/23),以大肠埃希菌(34.78%,8/23)为主;革兰阳性菌占43.48%(10/23),以金黄色葡萄球菌(26.09%,6/23)为主;真菌占4.35%(1/23)。感染患者肠道大肠埃希菌、肠杆菌数量均明显高于未感染患者,双歧杆菌数量明显低于未感染患者(均P60岁、急诊手术、普通手术室、参观手术人数>3人、手术时间>2 h、接台手术均为胃肠道手术患者术后感染的独立危险因素(均P结论 胃肠道手术患者术后感染风险较高,同时会出现肠道菌群失衡。重视患者高危因素对提高患者手术效果,调整肠道菌群失衡和改善患者预后意义重大。     

针灸联合逍遥散合半夏厚朴汤治疗肝郁脾虚型抑郁症患者伴胃肠功能紊乱的临床疗效

摘要 目的：探讨针灸联合逍遥散合半夏厚朴汤治疗肝郁脾虚型抑郁症患者伴胃肠功能紊乱的临床疗效。方法：选取我院2020年5月到2023年5月收治的80例抑郁症伴胃肠功能紊乱患者作为研究对象,中医证型均为肝郁脾虚型,分为观察组与对照组,40例。对照组患者采取逍遥散合半夏厚朴汤治疗,观察组在对照组基础上增加针灸治疗,对比两组患者临床疗效,分别在治疗前后应用汉密尔顿抑郁量表（HAMD）、负性认知加工偏向问卷（NCPBQ）评价抑郁症状和负性认知情况,并对比治疗前后肿瘤坏死因子-α（TNF-α）、C反应蛋白（CRP）、白细胞介素-6（IL-6）表达水平和胃动素（motilin,MTL）、生长抑素（SS）、胃泌素（GAS）相关血清肠胃激素表达水平,并采用世界卫生组织生活质量-100量表（WHOQOL-100）评估生活质量。结果：观察组治疗总有效率较对照组高（P＜0.05）;治疗前两组患者HAMD、NCPBQ评分对比无差异（P＞0.05）,治疗后两组患者均降低,且观察组较对照组低（P＜0.05）;治疗前两组患者TNF-α、CRP、IL-6相关炎症因子和MTL、SS、GAS相关胃肠激素水平对比无明显差异（P＞0.05）,治疗后两组患者TNF-α、CRP、IL-6、SS、GAS水平均降低,且观察组较对照组低,MTL水平升高,观察组较对照组高（P＜0.05）;两组患者治疗后生活质量相关评分均升高,且观察组较对照组高（P＜0.05）。结论：针灸联合逍遥散合半夏厚朴汤治疗肝郁脾虚型抑郁症伴胃肠功能紊乱疗效显著,可减轻患者抑郁情绪和负性认知,降低炎症反应,改善胃肠激素水平,提升患者生活质量。     

承气活血通腑汤联合穴位贴敷治疗粘连性肠梗阻的疗效及对胃肠功能和血清炎性因子的影响

目的:探讨承气活血通腑汤联合穴位贴敷治疗粘连性肠梗阻的疗效及对胃肠功能和血清炎性因子的影响.方法:选取2018年2月到2020年7月期间于我院接受诊治的粘连性肠梗阻患者60例.分组方法采用随机数字表法,将入选患者分为对照组(n=30,常规治疗)、研究组(n=30,对照组的基础上给予承气活血通腑汤联合穴位贴敷治疗),对比...     

TRIM31 interacts with p52 and inhibits Src-induced anchorage-independent growth

Tripartite motif-containing protein (TRIM) family proteins are involved in a broad range of biological processes and, consistently, their alterations result in diverse pathological conditions such as genetic diseases, viral infection and cancer development. In this study, we found that one of the TRIM family proteins, TRIM31, is highly expressed in the gastrointestinal tract and interacts with p52^Shc, one of the signal transducers. We also found by a binding assay that almost the whole region other than the RING domain is required for the binding to p52^Shc but found by pulse-chase analysis that overexpression of TRIM31 does not affect the stability of p52^Shc. Moreover, we found that overexpression of TRIM31 suppresses anchorage-independent cell growth induced by the active form of c-Src. These results suggest that TRIM31 attenuates c-Src signaling via p52^Shc under anchorage-independent growth conditions and is potentially associated with growth activity of cells in the gastrointestinal tract.     

腹腔镜对结直肠癌患者血清基质金属蛋白酶、胃肠激素及应激激素水平的影响

目的:探讨腹腔镜对结直肠癌患者血清基质金属蛋白酶、胃肠激素及应激激素水平的影响。方法:将110例结直肠癌患者纳入本研究,随机分为对照组和观察组,均55例,分别给予对照组和观察组患者开腹手术治疗和腹腔镜手术治疗,对比治疗前后患者的血清基质金属蛋白酶、胃肠激素及应激激素水平。结果:治疗前,两组血清基质金属蛋白酶(Matrix metalloproteinase,MMP)MMP-2、MMP-9、血清胃动素(Motilin,MTL)、胃泌素(Gastrin,GAS)、皮质醇(Cortisol,Cor)、去甲肾上腺素(Noradrenaline,NE)水平比较差异均无统计学意义(P0.05);与组内治疗前相比,两组治疗后血清MMP-2、MMP-9、MTL、GAS水平均显著降低,血清COR、NE水平均显著升高,差异有统计学意义(P0.05);观察组治疗后血清MMP-2、MMP-9、NE、COR水平均明显低于对照组,血清GAS、MTL水平均明显高于对照组,差异对比均有显著性(P0.05)。结论:腹腔镜治疗结直肠癌可有效降低患者血清基质金属蛋白酶水平,促进胃肠功能恢复,减轻机体应激损伤。     

董氏指压法治疗积滞患儿的临床疗效及对血清Ghrelin水平和胃肠动力的影响

目的:探讨董氏指压法治疗积滞患儿临床疗效及对血清Ghrelin水平和胃肠动力的影响。方法:选取2015年12月-2016年12月上海中医药大学附属岳阳中西医结合医院儿科收治的积滞乳食内积证患儿120例作为研究对象,按随机数字表法分为两组,其中治疗组60例予以董氏指压法,对照组60例予以针刺四缝,两组均治疗8周。比较两组治疗前后血清Ghrelin水平以及胃半排空时间、胃窦收缩频次,并对比两组的临床疗效。结果:治疗组总有效率为98.33%(59/60),与对照组的95.00%(57/60)比较无统计学差异(P0.05)。两组治疗4周后、8周后胃半排空时间均显著低于治疗前,而胃窦收缩频次以及血清Ghrelin水平均显著高于治疗前(均P0.05),且治疗组治疗4周后、8周后胃半排空时间显著低于对照组(均P0.05),治疗8周后治疗组胃窦收缩频次和血清Ghrelin水平显著高于对照组,差异均有统计学意义(均P0.05)。结论:董氏指压法治疗小儿积滞的疗效良好,可显著升高血清Ghrelin水平,增进食欲,改善胃肠蠕动,值得临床推广。     

黄芪当归汤联合莫沙比利治疗功能性便秘的疗效及对血清胃肠激素水平的影响

目的:研究黄芪当归汤联合莫沙比利治疗功能性便秘的临床疗效及对血清胃肠激素水平的影响。方法:选择2015年3月至2016年5月我院接受治疗的功能型便秘患者86例。按照随机数字表法分为观察组与对照组,各43例。对照组患者给予莫沙比利治疗,观察组同时加用黄芪当归汤治疗,对比两组临床疗效、不良反应;检测患者治疗前后血清胃动素(MTL)、P物质(SP)水平;采用SF-36生活质量量表对患者治疗后的生活质量进行评价。结果:观察组治疗总有效率为95.35%(41/43),显著高于对照组的81.40%(35/43),差异有统计学意义(P0.05)。两组腹痛、皮疹、稀便发生率对比,均无统计学意义(均P0.05)。治疗前两组血清胃肠激素水平对比无显著差异,治疗后两组MTL均降低,而SP均上升,且治疗后观察组MTL水平显著低于对照组,SP水平显著高于对照组(均P0.05)。治疗后观察组患者饮食、精神、睡眠以及心理四个维度的生活质量评分均显著高于对照组,差异均有统计学意义(均P0.05)。结论:黄芪当归汤联合莫沙比利治疗功能性便秘具有显著的临床疗效,能有效改善患者血清胃肠激素水平,提高患者生活质量,且安全可靠,值得推广应用。     

Morphological changes during ontogeny of the canine proximal colon

The development of the canine proximal colon from the completion of organogenesis through 43 days after birth was studied using light microscopy, immunofluorescence and electron microscopy. During this period the tunica muscularis increased in thickness from 42±6 m in animals midway through the gestation period to 317±29 m in animals 25–30 days old. This increase in thickness resulted from an increase in the number and size of smooth muscle cells in the circular and longitudinal muscle layers. The cross-sectional thickness of the circular muscle layer increased from 10±2 smooth muscle cells midway through the gestation period to 92±7 cells in animals 25–30 days old. The longitudinal layer increased in thickness from 1.5±1 cells in animals midway through the gestation period to 44±2 cells in animals 25–30 days old. Smooth muscle cells from both layers also increased in diameter and length. Ultrastructural and immunohistochemical studies suggested that many of the smooth muscle cells were undergoing development throughout the fetal period. Midway through the gestation period, the circular layer was positive for desmin-like immunoreactivity (D-LI), while both the circular and longitudinal layers were positive for vimentinlike immunoreactivity (V-LI). By birth, V-LI was suppressed in the circular and longitudinal layers, and both layers expressed D-LI. The enteric nervous system was already established midway through the gestation period, and submucosal and myenteric ganglia could be identified, although the chemical coding and mature morphology of neurons were incomplete. NADPH-diaphorase-positive neurons, indicating the expression of nitric oxide synthase, developed by the time of birth. Interstitial cells of Cajal (IC) could not clearly be identified midway through gestation, however, potential precursors to ICs were observed. Several classes of ICs were identifiable at birth.     

Effect of CCK-8 on myoelectrical activity of the gastrointestinal tract in the conscious miniature pig

In conscious miniature pigs, with implanted electrodes in the wall of the antrum pylori, duodenum, jejunum, and ileum, the influence of IV infusions of CCK-8 (17.5 and 175 pM/kg/min) on gastrointestinal myoelectrical activity was measured. Although both doses under study induced a decrease in antral spike activity, only the higher dose resulted in an overall decrease in integrated myoelectrical activity. In the ileum both doses augmented spiking activity during the infusion, but inhibited electrical activity after the end of the infusion. No response was observed in the duodenum and jejunum. The experiments demonstrate the overall inhibitory effect of CCK-8 on antral electrical activity and its stimulatory influence on ileal smooth muscle.