Characteristics of the composition of intestinal flora in cirrhotic patients with malnutrition / 临床肝胆病杂志

ObjectiveTo investigate the characteristics of the composition of intestinal flora and the serum level of endotoxin in cirrhotic patients with malnutrition， and to provide new diagnosis and treatment ideas for improving the nutritional status of patients with liver cirrhosis. MethodsA total of 58 patients with liver cirrhosis who were hospitalized in Department of Gastroenterology， People’s Hospital of Zhengzhou， from March 2021 to November 2022 were enrolled as experimental group （LC group）， and according to the Royal Free Hospital-Nutritional Prioritizing Tool， they were divided into low malnutrition risk group （LC-A group with 28 patients） and moderate/high malnutrition risk group （LC-B group with 30 patients）； 25 individuals who underwent physical examination during the same period of time were enrolled as control group （HC group）. Peripheral blood and feces samples were collected from all subjects. The limulus amebocyte lysate gel method was used to measure the concentration of endotoxin in peripheral blood， and high-throughput sequencing and bioinformatics analysis were used to investigate the characteristics of intestinal flora. The independent-samples t test was used for comparison of normally distributed continuous data between two groups； a one-way analysis of variance was used for comparison between multiple groups， and the least significant difference t-test were used for further comparison between two groups. The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups， and the Kruskal-Wallis H test was used for comparison between multiple groups. The chi-square test was used for comparison of categorical data between groups. The Spearman test was used for correlation analysis. ResultsThere were significant differences between the three groups in the levels of alanine aminotransferase （H=7.054， P<0.05）， gamma-glutamyl transpeptidase （H=9.644， P<0.05）， albumin （Alb） （F=32.768， P<0.05）， total bilirubin （TBil） （H=20.980， P<0.05）， and serum endotoxin （F=108.672， P<0.05）. There was a significant difference in Chao1 index between the three groups （F=5.110， P=0.008） and between the HC group and the LC-B group （P<0.05）. Compared with the HC group， the LC-A group and the LC-B group had significant reductions in Chao1 index and Shannon index， and there was a significant difference in Chao1 index between the HC group and the LC-B group （P<0.05）. At the phylum level， the intestinal flora in each group was mainly composed of Bacteroidota， Firmicutes， Proteobacteria， and Actinobacteriota， accounting for more than 95% of all phyla， and there was a significant difference in the relative abundance of Firmicutes between the HC group and the LC-B group （P<0.05）. Serum endotoxin was significantly negatively correlated with Ruminococcaceae （r=-0.420， P=0.007）， and spirochete was significantly positively correlated with TBil （r=0.419， P=0.007） and was significantly negatively correlated with Alb （r=-0.492， P=0.001）. ConclusionThere are unique changes in intestinal flora in cirrhotic patients with malnutrition， and differentially expressed flora are associated with endotoxemia. Improving intestinal microecology in liver cirrhosis may help to improve nutritional status.

Factors influencing HIV testing and counselling services among men who have sex with men in Western China: a cross-sectional study based on Andersen's Behavioral Model

BACKGROUND@#Men who have sex with men (MSM), as a marginal population, has been largely ignored by health service projects. We assessed the utilization of HIV testing and counselling services and its influencing factors based on Andersen's Behavioral Model, so as to provide a theoretical basis for future infectious disease prevention and control strategies and health services policy formulation for these population.@*METHOD@#This was a cross-sectional study. A sample survey was conducted in Western China, and an anonymous self-administered questionnaire survey was conducted among MSM. Based on Andersen's Behavioral Model, the questionnaire divided the influencing factors into predisposing factor, enabling factor and need factor. Multivariate logistic regression analysis was used to explore the factors influencing the utilization of HIV testing and counselling.@*RESULTS@#There were 3184 valid questionnaires. In the survey of HIV health services, 82.85% MSM had HIV testing and 64.98% MSM had HIV counselling, respectively. Among the predisposing factor, age 25 years old and over was a facilitator of HIV testing and counselling, and ethnicity was a factor associated with HIV testing. Among the enabling factor, MSM living in urban were more likely to have access to testing and counselling services, and income was also linked to HIV testing. Among the need factor, a high level of HIV knowledge could promote testing and counselling, and a history of sexually transmitted diseases (STD) was a facilitator of testing.@*CONCLUSIONS@#HIV testing is widespread in Western China and higher than counselling service. MSM with high-risk characteristics should be identified as a priority in the future public health services.

Research Progress on Assessment of Blood Supply of Spinal Tumors and Methods of Reducing Intraoperative Blood Loss / 肿瘤防治研究

In order to avoid the intra- and post-operative risks caused by massive blood loss, there are various clinical methods for evaluating the blood supply of the tumor and the distribution of blood vessels around the tumor before surgery, such as dynamic enhanced CT, dynamic enhanced magnetic resonance imaging, digital subtraction angiography, etc. And there are a variety of pre- and intra-operative methods to reduce tumor bleeding, such as transarterial vertebral tumor embolization, percutaneous or transpedicular injection of Onyx/NBCA, antifibrinolytic drugs, controlled deliberate hypotension, etc. This article reviews on spinal tumor blood supply assessment and the methods to reduce the amount of surgical bleeding.

Expression and function of miR-346 in colon cancer cells / 中国综合临床

Objective To detect the expression of miR-346 in colon cancer cells and the relationship with invasion and metastasis, so as to provide experimental basis for predicting and treating targets of colon cancer. Methods Quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect the expression of microRNA-346 in colon cancer cell lines ( HCT116, COLO205, SW620) and normal colon epithelial cells ( NCM460 ) . The expression of microRNA-346 was up-regulated or down-regulated by mimic or inhibitor and transfected into HCT116 cells. The transfection efficiency was detected by qRT-PCR. The metastasis and infiltration behavior of HCT116 cells were observed by Transwell. Results The relative expression of microRNA-346 in colon cancer cell lines HCT116, COLO205 and SW620 were (0. 372±0. 068),(1. 284±0. 253),(1. 105±0. 203),respectively. The relative expression of COLO-205 and SW620 in normal colon epithelial cells (NCM460) was (0. 126±0. 004). Compared with NCM460 group, COLO-205 group and SW620 group had significant difference (t＝9. 652,P＜0. 01; t＝7. 753,P＜0. 01). The invasion and metastasis ability of HCT116 cells increased after the up-regulation of the expression of microRNA-346 (t＝2. 458,P＜0. 05; t＝2. 194,P＜0. 05),and decreased after the down-regulation of the expression of microRNA-346 (t＝2. 247,P＜0. 05; t＝2. 065,P＜0. 05) . Conclusion Mir-346 is highly expressed in colon cancer cells and regulates invasion and metastasis of colon cancer cells.

Relationship of TLR2 and TLR4 expressions on the surface of peripheral blood mononuclear cells to small intestinal bacteria overgrowth in patients with hepatocellular carcinoma / 中华肝脏病杂志

Objective@#To investigate TLR2 and TLR4 expressional situation on the surface of peripheral blood mononuclear cells (PBMC) in patients with hepatocellular carcinoma (HCC) and their relationship with small intestinal bacterial overgrowth (SIBO).@*Methods@#Flow cytometry was used to detect TLR2 and TLR4 expressional situation on the surface of PBMC in 78 cases with HCC, 56 cases with cirrhosis and 33 healthy controls. Furthermore, lactose hydrogen breath test (LHBT) was used to detect small intestinal bacterial overgrowth.@*Results@#Of the 78 cases with HCC, 56 cases (71.8%) were SIBO-positive, 23 cases (41.1%) were SIBO- positive in 56 cases with cirrhosis, and 1 (3.0%) was SIBO-positive in 33 healthy controls. The incidence of SIBO in HCC patients was higher than cirrhosis patients (χ2 = 12.72, P < 0.05) and healthy controls (χ2 = 41.18, P < 0.05). The expression levels of TLR2 and TLR4 in HCC patients (100.55 ± 24.22, 42.76 ± 15.96) were significantly higher than cirrhosis (67.42 ± 18.36, 24.38 ± 8.68)and healthy control group (33.06 ± 11.72, 12.52 ± 4.46) (P < 0.05). Furthermore, the expression levels of TLR2 and TLR4 in SIBO-positive patients (108.75 ± 20.40, 48.1 ± 14.98) were higher than SIBO-negative patients (79.67 ± 20.60, 28.62 ± 7.36) (P < 0.05).@*Conclusion@#The expression of TLR2 and TLR4 and the incidence of SIBO in HCC patients are significantly higher than cirrhosis and healthy control group. Moreover, the high expressions of TLR2 and TLR4 in SIBO-positive HCC patients may promote the development of HCC.

Relationship between small intestinal bacterial overgrowth and severity of with hepatitis B cirrhosis / 临床肝胆病杂志

ObjectiveTo investigate the relationship between small intestinal bacterial overgrowth (SIBO) and the severity of hepatitis B cirrhosis. MethodsForty-seven patients with hepatitis B cirrhosis who visited Department of Gastroenterology, Zhengzhou People′s Hospital, from June 2014 to June 2015 were selected as cirrhosis group; these patients consisted of 11 Child-Pugh class A cases, 16 Child-Pugh class B cases, and 20 Child-Pugh class C cases. Fifteen healthy volunteers were selected as control group. The levels of procalcitonin, bilirubin, plasma albumin, and globulin were measured in all subjects. The lactulose hydrogen breath test (LHBT) was performed to measure small intestinal bacterial growth. Comparison of categorical data was made by chi-square test or Fisher's exact test. Comparison of normally distributed continuacs data between groups was performed by t test, The correlations of SIBO with procalcitonin, bilirubin, plasma albumin, and albumin/globulin ratio were investigated by Pearson correlation analysis. ResultsSIBO was found in 22 (46.8%) of the 47 patients with liver cirrhosis, consisting of 2 (18.1%) in the 11 Child-Pugh class A cases, 7 (43.7%) in the 16 Child-Pugh class B cases, and 13 (65.0%) in the 20 Child-Pugh class C cases. The prevalence of SIBO showed a significant difference between the controls and all patients with hepatitis B cirrhosis, Child-Pugh class B cases, or Child-Pugh class C cases (P=0.005, 0.037, or 0.001), but no significant difference between the controls and Child-Pugh class A cases (P=0556); there was a significant difference in the prevalence of SIBO between Child-Pugh class A cases and Child-Pugh class B/C cases (χ2=4727,P=0.030). The levels of procalcitonin, bilirubin, plasma albumin, and globulin were significantly correlated with LHBT set-value (r=0.895, 0.907, -0.810, and 0.755, respectively, all P＜0.001). ConclusionThe prevalence of SIBO increases with exacerbation of liver injury in patients with hepatitis B cirrhosis. The levels of procalcitonin, bilirubin, and globulin are positively correlated with SIBO, while plasma albumin level is negatively correlated with SIBO.

The Therapeutic Effects of the Cord Blood Stem Cell Transplantation in Patients with Severe Hepatitis / 天津医药

Objective To study the effect of the cord blood stem cell transplantation therapy in patients with severe hepatitis. Methods Forty patients with severe hepatitis were randomly divided into control groups (n=20) and observed group (n=20). The patients in two groups were treated with the conventional liver protective therapy respectively, such as compound glycyrrhizin and glutathione. The patients in observed groups were performed with the cord blood stem cell trans-plantation therapy. After isolation and purification, the cells were transplanted into the liver via hepatic artery and then were transplanted via peripheral veins. The biochemical indices of albumin (ALB), prothrombin activity (PTA),alpha-fetoprotein (AFP)and clinical symptoms were detected at different times after therapy. Results After 4-week therapy, the levels of PTA (%)and AFP(μg/L)were significantly increased in observed group compared with those of control group (53.56 ± 5.15 vs 48.26±5.53,92.16±9.09 vs 43.57±11.33,P＜0.01). After 8-week therapy, the levels of alanine aminotransferase (ALT), total bilirubin (TBIL) and AFP were significantly decreased in observed group than those of control group. The level of PTA was sig-nificantly higher in observed group than that of control group (62.61±4.35 vs 54.95±3.01,P＜0.05 or P＜0.01). There were no significant differences in levels of ALB and blood ammonia between two groups (P>0.05). There were no serious complications and adverse reactions in two groups of patients. There was no significant difference in mortality between two groups ( 20%vs 35%,χ2=0.818,P>0.05). Conclusion Cord blood stem cell therapy has a good effect on treating severe hepatitis, which is safe and no significant adverse reactions, and can be used as a new method for treating the severe hepatitis.

Clinical analysis of 58 cases of amyloidosis / 中华全科医师杂志

Fifty eight patients with amyloidosis diagnosed by biopsy were admitted to Beijing Friendship Hospital from January 1983 to September 2007 and their clinical data were analyzed retrospectively.Twenty of the 58 cases were systemic amyloidosis,and other 38 were local amyloidosis.In 20 cased of systemic amyloidosis,kidney was involved in 75% cases,liver was in 55%,nervous system Was in 55%and heart Was in 50%.The lesion of local amyloidosis was usually limited in one single organ.

Design and implementation of aphasia rehabilitation software based on speech recognition / 生物医学工程学杂志

A new software therapy instrument is proposed for the rehabilitation of aphasia caused by cerebral disorder, which is different from general drug therapy or physical therapy and is, based on modern speech and biofeedback principles. Aphasia rehabilitation software package on the therapy instrument were designed and implement. The features of the software and its future application were discussed.

Design of USB Bus power circuits for neuromuscular rehabilitator / 医疗卫生装备

This paper analyses the characteristics of USB bus power.Based on the power demand of the circuits for neuromuscular rehabilitator,power voltage transformation circuits are designed for the realization of USB bus power supply.

Clinical Application Value of Spiral CT Portography / 实用放射学杂志

Objective To evaluate clinical application of spiral CT portal vein (SCTP).Methods 110 patients with different hepatic diseases underwent SCT enhanced scan. The portal vain 3D images of different hepatic diseases were obtained with maximum intensity projection(MIP). Results SCTP could directly demonstrate the location and width of the portal and hepatic veins, detect the invasion and tumor thrombosis of portal vein.The degree of variation of portal vein was correlated to the grade of hepatic function. Conclusion SCTP has better clinical value. It can content requirement of clinic diagnosis.