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OBJECTIVE To explore the intestinal absorption characteristics of saikosaponins. METHODS Based on everted intestinal sac model， using accumulative absorption amount （Q） and absorption rate constant （Ka） as indexes， UHPLC-MS/MS technique as a method， the absorption of saikosaponin A， B2， C， D and F from total saponins of Bupleurum chinense （8 g/mL， by crude drug） in the duodenum， jejunum and ileum was detected. RESULTS The correlation coefficients （r） of the regression equations for the absorption of saikosaponins A， B2， C and F in the duodenum， jejunum and ileum were all higher than 0.95， while the r of saikosaponin D in the above intestinal segments was lower than 0.95； compared with the absorption of the same composition in the duodenum， the Q and Ka of saikosaponin A and C circulating in jejunum and ileum for 120 min， as well as the Q and Ka of saikosaponin F circulating in the ileum for 120 min were significantly decreased （P＜0.05）. CONCLUSIONS Saikosaponin A and the other 4 saikosaponins are all absorbed in the duodenum， jejunum and ileum； among them， saikosaponin A， B2， C and F are linearly absorbed， which conforms to the zero-order absorption characteristics， but saikosaponin D shows non- linear absorption.
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Objective:To explore the integration path of medical resources in regional medical consortium, find out the problems affecting the process of integration, and put forward relevant suggestions.Methods:Methods According to the purposive sampling and combined with grounded theoretical research methods, semi-structured interviews were conducted with 73 government officials, heads and backbones of medical institutions in different regions of a city from August to November 2019. The data obtained from semi-structured interviews were analyzed by using grounded theory, and the path framework of medical resource integration in regional medical consortium was constructed through open coding, spindle coding and selective coding.Results:Four key links of medical resource integration in the regional medical alliance were sorted out, namely, integration prerequisites, integration strategies, support conditions, and integration methods, which together constituted the main axis of the theoretical framework. In addition, integration methods were affected by integration prerequisites, integration strategies and support conditions. The four factors and integration willingness served as influencing factors to exert impact on the integration tendency.Conclusions:The integration of medical resources in the medical alliance is a systematic project, which emphasizes the organic and overall governance of each key link, and the interaction between various elements will affect the final effect of medical resource integration.
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The purpose of this study was to investigate the injury of aspirin and clopidogrel on small intestinal mucosa in rats and the protective effect of teprenone.The study found that aspirin and clopidogrel could cause intestinal mucosal injury in rats,which was even worse with dual drugs.The mechanism of mucosal injury included free radical injury induced by aspirin and decreased synthesis of vascular endothelial growth factor (VEGF) by clopidogrel.Teprenone may repair intestinal mucosa via boosting VEGF level.
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BACKGROUND: Our previous findings indicate that inflammation-activated bone marrow mesenchymal stem cell conditioned medium (MSC-CM) contribute to repairing the structure and function of the small intestine after radiation-induced acute intestinal injury. However, it is unclear whether the repair effect can be achieved by regulating small intestinal stem cells. OBJECTIVE: To investigate the effects of inflammation-activated bone marrow MSC-CM on the small intestinal epithelial stem cells after acute radiation-induced intestinal injury and to further discuss the repairing mechanism. METHODS: Bone marrow mesenchymal stem cells of Sprague-Dawley rats were separated, cultured and identified. Then, the bone marrow mesenchymal stem cells were co-cultured with normal or radiation-induced IEC-6 cell lines in the Transwell system for 24 hours. Inflammation-activated bone marrow mesenchymal stem cells were cultured alone for 48 hours. Non-activated MSC-CM (MSC-CMNOR) and MSC-CM under radiation-induced inflammatory condition (MSC-CMIR) were collected. Adult Sprague-Dawley rats (provided by the Experimental Center of Sun Yat-Sen University North Campus) were randomly divided into four groups with 20 rats in each group: control group, radiation group, radiation+MSC-CMNOR group and radiation+MSC-CMIR group. The rats in the latter three groups were exposed to one-off 14 Gy whole abdominal radiation to make a rat model of acute radiation-induced small intestinal injury. Three-day continuous administration beginning within 4 hours after successful modeling was given via the tail vein and intraperitoneal implantation of Alzet micro-osmotic pumps: EMEM-F12 (200 μL/d) for the radiation group, MSC-CMNOR for radiation+MSC-CMNOR group and MSC-CMIR for radiation+MSC-CMIR group. There was 2 mL of concentrated conditioned medium in the pump which was released at a constant rate of 10 μL/h into the abdominal cavity after implantation. Intestinal samples were collected at 1, 3, 5, 7 days after radiation for immunochemistry staining, western blot and qRT-PCR detection. RESULTS AND CONCLUSION: (1) On the 3rd day after radiation, Lgr5 positive cells, which were actively proliferating on the base of crypts, became significantly reduced compared with the normal control group, and there was nearly no existing Lgr5 positive cells. However, after infusion of MSC-CMIR, Lgr5 positive intestinal stem cells were significantly increased compared with the radiation group, while in the radiation+MSCNOR group, there was no significant increase in Lgr5 positive intestinal stem cells. (2) On the 3rd day after radiation injury, Bmi1 positive intestinal stem cells were almost invisible. After infusion of MSC-CMIR, Bmi1 positive intestinal stem cells increased significantly, and it was observed not only in the +4 cell position but also in the common position used to be Lgr5 stem cells, indicating that Bmi1 stem cells could differentiate into Lgr5 positive cells to act its repairing effect. (3) Western blot and qRT-PCR further confirmed that the radiation+MSC-CMIR group was significantly higher on the Lgr5 expression level than the radiation group and the radiation+MSC-CMNOR group, and it returned to the normal level on the 7th day after the continuous high expression level. The repair effect of radiation+MSC-CMNOR group was weaker, and only on the 7th day, the expression level of Lgr5 was statistically different from the radiation group. To conclude, inflammation-activated bone marrow MSC-CM exert a protective effect on the small intestinal epithelial stem cells after acute radiation-induced intestinal injury
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BACKGROUND: Our previous findings indicate that inflammation-activated bone marrow mesenchymal stem cell conditioned medium (MSC-CM) contribute to repairing the structure and function of the small intestine after radiation-induced acute intestinal injury. However, it is unclear whether the repair effect can be achieved by regulating small intestinal stem cells. OBJECTIVE: To investigate the effects of inflammation-activated bone marrow MSC-CM on the small intestinal epithelial stem cells after acute radiation-induced intestinal injury and to further discuss the repairing mechanism. METHODS: Bone marrow mesenchymal stem cells of Sprague-Dawley rats were separated, cultured and identified. Then, the bone marrow mesenchymal stem cells were co-cultured with normal or radiation-induced IEC-6 cell lines in the Transwell system for 24 hours. Inflammation-activated bone marrow mesenchymal stem cells were cultured alone for 48 hours. Non-activated MSC-CM (MSC-CMNOR) and MSC-CM under radiation-induced inflammatory condition (MSC-CMIR) were collected. Adult Sprague-Dawley rats (provided by the Experimental Center of Sun Yat-Sen University North Campus) were randomly divided into four groups with 20 rats in each group: control group, radiation group, radiation+MSC-CMNOR group and radiation+MSC-CMIR group. The rats in the latter three groups were exposed to one-off 14 Gy whole abdominal radiation to make a rat model of acute radiation-induced small intestinal injury. Three-day continuous administration beginning within 4 hours after successful modeling was given via the tail vein and intraperitoneal implantation of Alzet micro-osmotic pumps: EMEM-F12 (200 μL/d) for the radiation group, MSC-CMNOR for radiation+MSC-CMNOR group and MSC-CMIR for radiation+MSC-CMIR group. There was 2 mL of concentrated conditioned medium in the pump which was released at a constant rate of 10 μL/h into the abdominal cavity after implantation. Intestinal samples were collected at 1, 3, 5, 7 days after radiation for immunochemistry staining, western blot and qRT-PCR detection. RESULTS AND CONCLUSION: (1) On the 3rd day after radiation, Lgr5 positive cells, which were actively proliferating on the base of crypts, became significantly reduced compared with the normal control group, and there was nearly no existing Lgr5 positive cells. However, after infusion of MSC-CMIR, Lgr5 positive intestinal stem cells were significantly increased compared with the radiation group, while in the radiation+MSCNOR group, there was no significant increase in Lgr5 positive intestinal stem cells. (2) On the 3rd day after radiation injury, Bmi1 positive intestinal stem cells were almost invisible. After infusion of MSC-CMIR, Bmi1 positive intestinal stem cells increased significantly, and it was observed not only in the +4 cell position but also in the common position used to be Lgr5 stem cells, indicating that Bmi1 stem cells could differentiate into Lgr5 positive cells to act its repairing effect. (3) Western blot and qRT-PCR further confirmed that the radiation+MSC-CMIR group was significantly higher on the Lgr5 expression level than the radiation group and the radiation+MSC-CMNOR group, and it returned to the normal level on the 7th day after the continuous high expression level. The repair effect of radiation+MSC-CMNOR group was weaker, and only on the 7th day, the expression level of Lgr5 was statistically different from the radiation group. To conclude, inflammation-activated bone marrow MSC-CM exert a protective effect on the small intestinal epithelial stem cells after acute radiation-induced intestinal injury
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Objective To compare sedated water exchange and conventional colonoscopy in the recovery time,rates of reaching ileocecal valve and adenoma detection.Methods A total of 200 newly diagnosed patients undergoing colonoscopy with routine bowel preparation and propofol intravenous anesthesia were randomly divided into 2 groups:water exchange group (WE) and conventional group,100 patients in each group.The operations were performed by two experienced physicians.The recovery time,rates of reaching ileocecal valve and adenoma detection of each group were analyzed and compared after operation.Results The recovery times of patients in water exchange and conventional groups were 8.08±0.58 min and 12.34±0.72 min,respectively (F =2 147.33,P＜ 0.05).Rates of reaching ileocecal valve were 100.00％(100/100,WE group) and 96.00％ (96/100,conventional group),respectively(x2 =4.17,P＜0.05).Adenoma detection rates of whole colon were 43.00％ (43/100,WE group) and 29.00％ (29/100,conventional group) (x2=4.25,P＜0.05),of which small adenomas (＜ 1.0 cm) accounted for 83.96％ (89/106,WE group) and 70.59％ (48/68,conventional group) (x2 =4.43,P ＜ 0.05),respectively.Adenoma detection rates of proximal colon were 28.00％ (28/100,WE group) and 20.00％ (20/100,conventional group) (x2 =1.75,P＞ 0.05),of which small adenomas (＜ 1.0 cm) accounted for 90.41％ (66/73,WE group) and 74.47％ (35/47,conventional group) (x2 =5.45,P ＜ 0.05),respectively.Conclusion Water exchange colonoscopy can not only shorten the recovery time of patients,but also increase rates of reaching ileocecal valve and adenoma detection.
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Prevention and treatment of tumor metastasis are important for the therapy of colon cancer. The discovery of stem cell markers provides a new approach for radical treatment of cancer. So far,the colon cancer stem cell markers discovered included several membrane protein molecules,transcription factors and related signal pathway. Exploration of colon cancer stem cell markers could contribute to the treatment of colon cancer and improve the survival rate and life quality of patients. This article reviewed the advances in study on colon cancer stem cell markers.
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Objective To investigate the incidence,clinical characteristics and risk factors of upper gastrointestinal bleeding (UGIB) in patients with acute coronary syndrome (ACS) who were administrated with aspirin and clopidogrel dual antiplatelet therapy after percutaneous coronary intervention (PCI).Methods ACS patients who had undergone PCI in the cardiovascular institute of Guangdong General Hospital from September 2009 to August 2014 were retrospectively enrolled.The incidence of UGIB and clinical characteristics of ACS patients on dual antiplatelet therapy for 1 year after PCI were analyzed.Risk factors of UGIB were screened in the cohort of patients and sex and age matched controls with ratio 1:3.Results A total of 9 118 ACS patients had undergone PCI and UGIB occurred in 189 patients (2.07％,189/9 118) from September 2009 to August 2014.UGIB patients with history over one year,gastrointestinal tumors or varices or negative endoscopy were excluded.Thus the revised incidence of UGIB occurred was 0.61％ in 56 patients (0.61％,56/9 118) and appeared to decline year by year.Most patients (91.07％,51/56) had melena or stool occult blood positive (OB +),while others had bloody stool or haematemesis.Most UGIB were ulcer-related which was proved by endoscopy,accounting for 67.86％(38/56).There were 24 cases with duodenal ulcer,13 with gastric ulcer and 1 with complex ulcer,while others were gastric erosion,gastritis and duodenitis.The risk factors of UGIB were previous history of peptic ulcer (P ＜ 0.01) and renal impairment (P ＜ 0.01).On the other side,PPI intake was a protective factor (P ＜ 0.05).The incidence of new-onset ACS was 1.44％ (50/3 464) in PPI group,compared with 1.34％(76/5 654) in no PPI group (P ＞ 0.05).PPI use for the prevention of UGIB after PCI didn't increase the recurrence of ACS.Conclusions The incidence of UGIB is 0.61％ in ACS patients on dual antiplatelet therapy (aspirin and clopidogrel) for 1 year after PCI and falls year by year.Administration of PPI after PCI protects patients from UGIB,especially in those with precious history of peptic ulcer and renal impairment.
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BACKGROUND:Conditioned medium from mesenchymal stem cels (MSC-CM) that contains abundant MSCs paracrine substances may represent a promising alternative to MSCs transplantation. However, normal MSC-CM with insufficient paracrine ability is not effective for tissue damage repair. OBJECTIVE:To investigate the effects of MSC-CM with (MSC-CMHyp) and without hypoxic activation (MSC-CMNor) on the proliferation and apoptosis of radiation-induced injured intestinal epithelial cels (IEC-6) and to further discuss the paracrine mechanisms. METHODS: IEC-6 cels were exposed to 10 Gy irradiation and cultured in MSC-CMHyp, MSC-CMNor, and DMEM-F12 medium, respectively. RESULTS AND CONCLUSION: Findings from trypan blue staining, flow cytometry and western blot assay showed that, compared with the DMEM-F12 medium group, treatment with MSC-CMHyp significantly enhanced IEC-6 viability proliferation after radiation-induced injury, as wel as significantly decreased cel apoptosis and expression of Caspases-3/8 (P 0.05). On the other hand, the increased levels of vascular endothelial growth factor, basic fibroblast growth factor, insulin-like growth factor-1, and interleukin-10 were detected in the MSC-CMHyp group compared to the MSC-CMNor group (P < 0.05). These results suggest that the MSC-CMHyp improves the viability and proliferative capacity of IEC-6 cels after radiation-induced injuryvia up-regulating secretion of cytokines and down-regulating apoptotic signaling.
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BACKGROUND:Conditioned medium from mesenchymal stem cels (MSC-CM) may represent a promising alternative to MSCs transplantation. Previous studies have shown that inflammatory activation can strengthen the multiple biological potencies of MSCs; however, normal MSCs with insufficiency of immunocompetence and migration ability are not effective for tissue damage repair. OBJECTIVE:To investigate differential effects of MSC-CM with and without inflammatory activation on radiation-induced intestinal injury.METHODS:MSCs from the bone marrow of SD rats were separated, cultured and identified, and then co-cultured with non-irradiated IEC-6 or irradiated IEC-6 in a transwel system for 24 hours. Then, MSCs with inflammatory activation were cultured alone for another 48 hours. After that, the supernatant was colected as non-activated MSC-CM (MSC-CMNOR) and MSC-CM under radiation-induced inflammatory condition (MSC-CMIR). Rats were exposed to 14 Gy whole abdominal irradiation and randomly divided into four groups: control group, radiation injury group (DMEM/F12), MSC-CMNOR group and MSC-CMIR group. Continuous administration was givenvia tail vein and intraperitoneal implantation of Alzet microosmotic pumps. Intestinal samples were colected at 1, 3, 7 days after radiation for analysis of short circuit variation, at 3 days after radiation for analysis of intestinal epithelium ultrastructure, and at 1, 3, 5, 7, 14 days after radiation for histological observation of the intestinal epithelium using hematoxylin-eosin staining. Blood samples were colected at 1, 3, 7 days after radiation for analysis of serum xylose levels. In addition, the survival state and survival time of rats were observed and recorded. RESULTS AND CONCLUSION: The short circuit variation responding to electrical field stimulation was significantly reduced at al frequencies, but it was significantly improved in the MSC-CMIR group. Similarly, the intestinal absorption (serum xylose levels) was also significantly impaired by irradiation, but improved by delivery of MSC-CMIR (P < 0.05). At 3 days after MSC-CMIR infusion, the intestinal epithelium exhibited an increase in crypt size and vilous length (P < 0.05). Under the electron microscope, a reduction in intestinal microvili and open tight junctions in irradiated intestinal epithelium was found, and the intestine from rats treated with MSC-CMIR had more obvious tight junctions. In addition, treatment with MSC-CMIR dramaticaly improved the survival rate and mean survival time of irradiated rats as compared to those treated with DMEM/F12 or MSC-CMNOR (P < 0.05). Taken together, the present study demonstrated that MSC-CMIR , but not non-activated MSC-CM, improves the structural and functional restoration of the smal intestine after radiation-induced intestinal injury.
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Objective To study the etiology,relevant factors and endoscopic characteristics of acute lower gastrointestinal tract hemorrhage.Methods A total of 938 patients receiving emergency colonoscopy for acute lower gastrointestinal tract hemorrhage were collected to study the etiological profiles.Different causes between young group and elderly group were also recorded.Results The total detectable rate of acute lower gastrointestinal tract hemorrhage in respect of causes was 96.16％ (902/938).The five leading causes were colorectal malignancy (41.26％),erosive colorectal polypus (12.37％),inflammatory bowel disease (9.59％),erosive and ulcer colitis (10.34％) and hemorrhoids (8.64％).Compared with youth and middle age patients,the incidence of colorectal malignancy (x2 =68.116,df =2,P =0.000) and colorectal polyps (x2 =9.101,df =2,P =0.011) were significantly increased in elderly patients,while incidence of inflammatory bowel disease (x2 =62.150,df=2,P =0.000) and erosive and ulcer colitis (x2 =20.292,df =2,P =0.000) were significantly decreased in those patients.Conclusions Emergency colonoscopy for diagnosis of acute lower gastrointestinal tract hemorrhage is an important measure.The major manifestation is bleeding resulting from colorectal malignancy,erosive colorectal polypus,inflammatory bowel disease,erosive and ulcer colitis and anal hemorrhoid.Age is associated with the cause of lower gastrointestinal tract bleeding induced by different kinds of lesions at the colorectum.
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Objective To explore the changes of etiology and mortality of upper gastrointestinal bleeding (UGIB) in the last 20 years in Guangdong region. Methods A total of 3140 UGIB cases diagnosed in Guangdong General Hospital from January 1990 to October 2009 were analyzed with retrospective analysis. Groups were divided according to admission chronological order and age to analyze the causes of UGIB to get the trend of changes and influencing factors. Results UGIB occurred more in men than in women, the gender ratio was 2. 5∶1. There was no significant change in gender composition between the first and later 10 years. Peptic ulcer bleeding (PUB) was the main cause of UGIB in young and middle-age patients (age0. 05) and esophagogastric variceal bleeding (EVB) (11. 7% vs 12. 9%, P>0.05) remained stable. The occurrence of AGML bleeding significantly increased than before (32. 4% vs 18. 8%,P<0. 01), and became one of the most important causes of UGIB. Conclusions PUB is still the most important cause of UGIB in Guangdong region. AGML becomes another important cause of UGIB in elder patients, which may relate to the increasing use of non-steroidal anti-inflammatory drugs (NSAIDs), anti-platelet and antineoplastic medicine.
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f miRNAs had enhanced effects on the proliferation and apoptosis of pancreatic cancer cell than any single miRNA transfection.
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OBJECTIVE:To evaluate the short and long-term therapeutic effects of endoscopic variceal ligation(EVL) plus somatostatin on bleeding esophageal varices METHODS:64 patients with acute esophageal variceal bleeding due to portal hypertension underwent EVL,then the patients were divided into EVL group and EVL+somatostatin group RESULTS:The short-term hemostatic rates reached 93% in both groups There were significant differences in postoperative rebleeding rate and average interval of rebleeding between two groups(P