The value of serum related cytokines in predicting intestinal mucosal injury in severe acute pancreatitis patients / 中国医师杂志

Objective:To analyze the value of serum related cytokines in predicting intestinal mucosal injury in patients with severe acute pancreatitis (SAP) and its correlation with intestinal mucosal injury.Methods:A total of 92 patients with SAP admitted to the First Hospital of Qinhuangdao from January 2020 to December 2021 were included in the study. According to the presence or absence of intestinal mucosal barrier dysfunction, the patients were divided into intestinal mucosal barrier dysfunction group (33 cases) and non-intestinal mucosal barrier dysfunction group (59 cases). Another 100 healthy subjects were selected as the control group. Clinical data of the subjects were collected. Serum levels of procalcitonin (PCT), D-lactic acid (D-L), endotoxin, diamine oxidase (DAO), citrulline and intestinal fatty acid binding protein (I-FABP) of the three groups were compared, and the correlation between the above indexes was analyzed by Pearson correlation analysis. Receiver operating characteristic (ROC) curve was used to analyze the value of each indicator in predicting intestinal mucosal barrier dysfunction in SAP patients.Results:The levels of serum PCT, D-L, endotoxin, DAO and I-FABP in intestinal mucosal barrier dysfunction group, non-intestinal mucosal barrier dysfunction group and control group showed a downward trend, while the level of serum citrulline showed an upward trend, with statistically significant difference (all P<0.05). Pearson correlation analysis showed that serum citrulline was negatively correlated with serum PCT, D-L, and endotoxin levels ( r=-0.740, -0.629, -0.310, all P<0.05); There was a positive correlation between serum DAO and serum PCT, D-L and endotoxin levels ( r=0.482, 0.779, 0.338, all P<0.05); There was a positive correlation between serum I-FABP and serum PCT, D-L and endotoxin levels ( r=0.613, 0.421, 0.341, all P<0.05). The ROC curve results showed that the area under the curve (AUC) of serum PCT, D-L, endotoxin, DAO, citrulline, and I-FABP predicting intestinal mucosal injury in SAP patients were 0.816, 0.789, 0.732, 0.801, 0.812, and 0.857, respectively. The AUC of the combination of the above indicators predicting intestinal mucosal barrier dysfunction in SAP patients was 0.909, significantly higher than that predicted by each index alone (all P<0.05). Conclusions:The occurrence of intestinal mucosal barrier dysfunction in SAP patients may be related to the increase of serum PCT, D-L, endotoxin, DAO, I-FABP levels and the decrease of citrulline levels. It may be considered to predict the risk of intestinal mucosal injury by detecting the levels of various indicators in patients′ serum.

Yinlai Decoction Protects Microstructure of Colon and Regulates Serum Level of D-Lactic Acid in Pneumonia Mice Fed with High-Calorie and High-Protein Diet / 中国结合医学杂志

OBJECTIVE@#To investigate the effect of Yinlai Decoction (YD) on the microstructure of colon, and activity of D-lactic acid (DLA) and diamine oxidase (DAO) in serum of pneumonia mice model fed with high-calorie and high-protein diet (HCD).@*METHODS@#Sixty male Kunming mice were randomly divided into 6 groups by the random number table method: normal control, pneumonia, HCD, HCD with pneumonia (HCD-P), YD (229.2 mg/mL), and dexamethasone (15.63 mg/mL) groups, with 10 in each group. HCD mice were fed with 52% milk solution by gavage. Pneumonia mice was modeled with lipopolysaccharide inhalation and was fed by gavage with either the corresponding therapeutic drugs or saline water, twice daily, for 3 days. After hematoxylin-eosin staining, the changes in the colon structure were observed under light microscopy and transmission electron microscope, respectively. Enzyme-linked immunosorbent assay was used to detect the protein levels of DLA and DAO in the serum of mice.@*RESULTS@#The colonic mucosal structure and ultrastructure of mice in the normal control group were clear and intact. The colonic mucosal goblet cells in the pneumonia group tended to increase, and the size of the microvilli varied. In the HCD-P group, the mucosal goblet cells showed a marked increase in size with increased secretory activity. Loose mucosal epithelial connections were also observed, as shown by widened intercellular gaps with short sparse microvilli. These pathological changes of intestinal mucosa were significantly reduced in mouse models with YD treatment, while there was no significant improvement after dexamethasone treatment. The serum DLA level was significantly higher in the pneumonia, HCD, and HCD-P groups as compared with the normal control group (P<0.05). Serum DLA was significantly lower in the YD group than HCD-P group (P<0.05). Moreover, serum DLA level significantly increased in the dexamethasone group as compared with the YD group (P<0.01). There was no statistical significance in the serum level of DAO among groups (P>0.05).@*CONCLUSIONS@#YD can protect function of intestinal mucosa by improving the tissue morphology of intestinal mucosa and maintaining integrity of cell connections and microvilli structure, thereby reducing permeability of intestinal mucosa to regulate the serum levels of DLA in mice.

Relationship between intestinal flora and intestinal barrier dysfunction in patients with sepsis / 中华急诊医学杂志

Objective:To explore the relationship between intestinal flora disorder and intestinal barrier dysfunction in patients with sepsis.Methods:A prospective observational study was conducted to include 10 patients with sepsis (sepsis group) admitted to the ICU of General Hospital of Ningxia Medical University from February 2017 to June 2017, 10 normal postoperative patients (non-sepsis group) admitted to the ICU of General Hospital of Ningxia Medical University in the same period, and 10 healthy persons (control group) were served as controls. General information was recorded. Fecal samples of the three groups of experimental subjects were detected and analyzed by using 16S rRNA gene sequencing technology. The venous blood of the sepsis and non-sepsis groups were collected and the levels of D-lactic acid and bacterial endotoxin in were measured by enzymatic method at the corresponding time points. The correlation between the levels of D-lactic acid and bacterial endotoxin and intestinal flora of patients with sepsis was analyzed.Results:The change consistency of pathogenic bacteria between clinical infection and intestinal pathogenic bacteria in patients with sepsis was observed and analyzed. Sputum culture of patients with sepsis was Acinetobacter baumannii (corresponding patient number: S5, S6, S8), Stenotrophomonas maltophilia (corresponding patient number: S6, S7), and Enterococcus (corresponding patient number: S7). In the intestinal flora of corresponding patients, the OUT abundance were increased. Patients with sepsis (corresponding patient number S7) showed E. coli in blood culture, and in his intestinal flora the OUT abundance was increased. Correlation analysis showed that the serum D-lactic acid level was negatively correlated with the proportion of Firmicutes in intestinal flora in the non-sepsis and sepsis groups, while was positively correlated with the proportion of Firmicutes (r value: -0.532, 0.468, respectively, P<0.05). Conclusions:The gut microbiota dysbiosis is correlated with intestinal barrier function in sepsis patients with sepsis. The spread of pathogenic bacteria between clinical infection and intestinal bacteria in sepsis patients has potential consistency.

Clinical significance on serum intestinal fatty acid binding protein and D-lactic acid levels in early intestinal injury of patients with sepsis / 中华危重病急救医学

Objective To investigate the changes and clinical significances of intestinal fatty acid binding protein (I-FABP) and D-lactic acid levels in early intestinal injury of patients with sepsis and septic shock. Methods A prospective observational study was conducted. Thirty septic patients (septic group) and 30 septic shock patients (septic shock group) were admitted to the intensive care unit (ICU) of General Hospital of Ningxia Medical University from August 2018 to December 2018, and 20 healthy adults were served as healthy control group. Serum samples were collected within 24 hours after ICU admission in septic shock and septic groups, and in healthy control group during physical examination. The serum I-FABP, D-lactic acid, endotoxin, hypersensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and lactic acid (Lac) were determined. Gender and age of all subjects, and basic diseases, the main area of infection and acute physiology and chronic health evaluationⅡ(APACHEⅡ) scores within 24 hours after ICU admission of all patients were recorded. At the same time, the survival of the patients was followed up for 28 days. Spearman correlation analysis was used to analyze the correlation between serum I-FABP, D-lactic acid and other parameters. Risk factors of death in patients with sepsis and septic shock were screened by multivariate Logistic regression analysis of bicategorized variables. Results There was no significant difference in gender or age among the groups, as well as in the proportion of basic diseases, celiac infection or non-celiac infection between the sepsis group and the septic shock group, indicating that the general clinical baseline data among the groups were comparable. Serum levels of I-FABP and D-lactic acid in the sepsis group and the septic shock group were significantly higher than those in the healthy control group [I-FABP (μg/L): 27.46 (22.52, 34.39), 36.95 (29.82, 44.24) vs. 17.93 (14.65, 22.11), D-lactic acid (mg/L): 15.32 (9.84, 38.62), 27.95 (10.01, 47.69) vs. 9.38 (8.81, 14.48), all P < 0.01]. The serum level of I-FABP in the septic shock group was significantly higher than that in the sepsis group (P < 0.05), but the difference in serum D-lactic acid level between the two groups was not statistically significant (P > 0.05). Serum I-FABP level in the celiac infection group (n = 40) was significantly higher than that in the non-celiac infection group [n = 20; μg/L: 34.76 (27.46, 43.90) vs. 25.71 (20.55, 37.77), P < 0.01], but the difference in serum D-lactic acid level was not statistically significant [mg/L: 25.13 (9.83, 40.55) vs. 30.36 (10.17, 50.00), P > 0.05]. There was no significant difference in serum I-FABP or D-lactic acid levels between the survival group (n = 34) and the death group [n = 26; I-FABP (μg/L): 33.39 (25.20, 39.50) vs. 29.26 (22.50, 43.81), D-lactic acid (mg/L): 14.83 (9.71, 38.45) vs. 33.90 (11.93, 45.34), both P > 0.05]. Correlation analysis between serum I-FABP, D-lactic acid level and endotoxin, inflammatory factors, Lac and APACHEⅡ score in septic and septic shock patients showed that only D-lactic acid was significantly positively correlated with TNF-α and Lac (r values were 0.455 and 0.406, respectively, both P < 0.01), while I-FABP was not correlated with endotoxin, inflammatory factors, Lac or APACHEⅡscore. Multivariable Logistic regression analysis showed the APACHEⅡ score was an independent risk factor to affect the prognosis (death for 28 days) of septic and septic shock patients [odds ratio (OR) = 1.248, 95% confidence interval (95%CI) = 1.091-1.427, P = 0.001], while I-FABP, D-lactic acid, endotoxin, hs-CRP, TNF-α, IL-6, and Lac had no impact on 28-day prognosis of patients. Conclusion Serum I-FABP and D-lactic acid levels can evaluate early intestinal injury in patients with sepsis and septic shock, but neither of them is related to the prognosis of patients.

Effects of Endotoxin Affinity Adsorbent SPV on Intestinal Permeability and Bacterial Translocation in Hemorrhagic Shock Model Rats / 中国药房

OBJECTIVE： To observe the effects of endotoxin affinity adsorbent SPV on intestinal permeability and bacterial translocation in hemorrhagic shock model rats.  METHODS： Totally 85 male SD rats were randomly divided into normal group （5 rats）， shock group （each 5 rats at each time point， 20 rats in total）， SPV low-dose， medium-dose and high-dose groups （Montmorillonite powder 0.3 g， Polymyxin B sulfate 0.5 mg， Vitamin B6 5 mg dissolved in normal saline to obtain SPV solution 5 mL， as low dose； medium and high dose were 2 or 3 times as high as low dose. Each 5 rats of each group at each time point， 60 rats in total）. Administration groups were given SPV solution intragastrically 5， 10， 15 mL once， respectively； normal group and shock group were given normal saline 5 mL intragastrically once. Thirty minutes after last medication， other groups received femoral artery catheterization and bleeding to induce hemorrhagic shock model， except for normal group. The activities or contents of diamine oxidase （DAO）， endotoxin and D-lactic acid， positive rates of intestinal bacterial translocation were detected in each group at 1， 4， 8， 16 h after recovery. RESULTS： Compared with normal group， the activities of DAO of rats in shock group were enhanced significantly， and the serum contents of endotoxin and D-lactic acid were increased significantly （P＜0.05）. Compared with shock group， the activities of DAO were decreased significantly in SPV groups （at each time point during 1-16 h）； the serum contents of endotoxin and D-lactic acid （at each time point during 1-16 h）， positive rates of intestinal bacterial translocation （SPV low-dose group at each time point during 4-16 h， SPV medium-dose and high-dose groups at each time point during 1-16 h） were decreased significantly （P＜0.05）. Above indexes in SPV medium-dose and high-dose groups （at each time point during 1-16 h） were significantly lower than those of SPV low-dose group （P＜0.05）. There was no statistical significance in above indexes between SPV medium-dose group and high-dose group （P＞0.05）. CONCLUSIONS： The endotoxin affinity adsorbent SPV can improve the permeability of the intestinal wall and inhibit bacterial translocation in hemorrhagic shock model rats in dose-dependent manner. The effects of which may be associated with reducing the activities or contents of serum DAO， endotoxin， D-lactic acid， and down-regulating the positive rate of bacterial translocation.

Clinical investigation of intestinal barrier dysfunction in septic patients / 中华急诊医学杂志

Objective To investigate the intestinal barrier dysfunction in sepsis and septic shock patients,and to analyze the relationship between infection site and the severity of the disease.Methods A prospective observational research was carried out in 42 sepsis patients,47 septic shock patients and 36 postoperative patients without sepsis as control admitted to Department of Critical Care Medicine of General Hospital of Ningxia Medical University from November 2015 to June 2017.Blood samples were collected from patients on the first day and the third day after admission to the intensive care unit (ICU) to measure D-lactic acid and endotoxin levels of sepsis and septic shock patients by enzymatic method,while the blood sample of control group was just tested on the first day.Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score,Sequential Organ Failure Assessment (SOFA) score of patients were recorded on the first day after admission.Sepsis and septic shock patients were divided into intra-abdominal infection group(n=54) and extra-abdominal infection group(n=35).Results (1) Compared with control group,D-lactic acid and endotoxin levels in sepsis patients and septic shock patiems were significantly higher on the first day and third day (all P＜0.01).There were no significant differences in D-lactic acid and endotoxin between sepsis group and septic shock group on the first day (both P＞0.05),but endotoxin level of septic shock group was higher than that in sepsis group(P＜0.05) and there was no significant differences in D-lactic acid level between these two groups (P＞0.05) on the third day.(2) In the intra-abdomen infection group,there were no significant differences in D-lactic acid and entotoxin between sepsis patients and septic shock patients on the first day and the third day after admission (all P＞0.05).(3)There were no significant differences in D-lactic acid and endotoxin between intra-abdominal infection group and extra-abdominal infection group on the first day and the third day after admission(all P＞0.05).Conclusions Sepsis and septic shock patients often have intestinal barrier dysfunction.The dysfunction is correlated with the severity of disease,but there is no relationship with the infective site.Endotoxin is superior to blood D-lactic acid in reflecting the severity of sepsis.

Clinical Trial of Electroacupuncture Treatment for Relieving Stress Responses in Patients Undergoing Gastrointestinal Surgery / 针刺研究

OBJECTIVE: To observe the therapeutic effect of electroacupuncture (EA) at Zusanli (ST 36) and Neiguan (PC 6) on stress responses of patients undergoing gastrointestinal surgery. METHODS: A total of 40 patients undergoing gastrointestinal surgery were randomized into conventional treatment group (control) and EA group (n＝20 in each group). Patients of the EA group received conventional treatment (pre- and post-surgical fasting, measures for gastrointestinal decompression, parenteral nutrition support, and patient controlled analgesia pump, etc.) and EA stimulation (2 Hz, 30 min) of bilateral ST 36 and PC 6 (twice after surgery, at an interval of 6 h), and patients of the control group received conventional treatment only. The visual analogue scale (VAS) score was used to assess the patients' pain severity and the blood glucose levels were detected once every 4－6 h within 24 h after operation. Serum cortisol (Cort) and adrenocorticotropic hormone (ACTH) levels were detected by chemiluminescence method, and serum D-lactic acid level (for assessing gastrointestinal mucosal injury) was assayed by ELISA. RESULTS: After the treatment, the levels of serum Cort, ACTH, D-lactate acid and the highest blood glucose were significantly lower in the EA group than those in the control group (P0.05). CONCLUSION: EA at ST 36 and PC 6 can alleviate stress responses and reduce intestinal mucosal damage in patients undergoing gastrointestinal surgery.

Study on the level of D-lactic acid and the intestinal barrier function of children with hand, foot and mouth disease of different intestinal virus infection / 中国医师进修杂志

Objective To explore the variation of serum D-lactic acid levels and the correlation between different intestinal viral and intestinal barrier function in children with hand, foot and mouth disease (HFMD). Methods The stools of 129 children with HFMD were collected and were detected by reverse transcription polymerase chain reaction. The children were divided into four groups according the fecal pathogens detection:enterovirus 71 (EV71) positive group, Coxsackie virus A16 (CoxA16) positive group, other intestinal virus positive group (EA positive group), and no intestinal virus group (EA negative group). Two ml venous blood and separation serum was collected in each group of children, and the level of serum D-lactic acid was detected further. Results There were 20 cases of other Coxsackie virus, and they were not grouped. Fifty-seven patients were in EV71 positive group, 26 patients were in CoxA16 positive group, 10 patients were in EA positive group, and 16 patients were in EA negative group. The level of D- lactic acid in four groups was 26.28 (17.02- 58.01), 14.43 (8.93- 20.66), 10.66 (6.64- 18.51) and 14.07 (11.83- 27.46) mg/L. The results of rank test showed the level of D-lactic in EV71 positive group was significantly higher than that in EA positive group (Z=-2.432, P=0.015) and EA negative group (Z=-3.092, P=0.002). Conclusions D-lactic acid level increases significantly in EV71 infection children and suggests that the illness is more serious and the intestinal barrier is damaged. Doctors should pay more attention to monitor and protect gastrointestinal function of children with HFMD.

Protective effect of Allicin on intestinal mucosal barrier of septic rats / 中华急诊医学杂志

Objective To investigate the protective effect of allicin on intestinal mucosal barrier of septic rats so as to explore the possible mechanism.Methods Twenty-four male SD rats were randomly (random number) divided into sham,septic model and allicin treatment group.Septic model was established by cecal ligation and puncture (CLP) in rats.Rats in the treatment group were administered with allicin (30 mg/kg,ip)at 6 h and 12 h after modeling,while those in the model and sham groups were treated with equal amount of saline instead.Rats were sacrificed at 24 h and the serum D-lactic acid,diamine oxidase (DAO) and fluorescence isothiocyanate-dextran (FITC-Dextran,FD-40) were determined to evaluate the intestinal mucosal barrier function.The levels of tumor necrosis factor-α (TNF-α),interleukin-6 (IL-6),malondialdehyde (MDA),and the activity of superoxide dismutase (SOD) in intestinal tissue were measured.Histopathological changes of intestinal mucosa injury were assessed by Hematoxylin-eosin staining.Results Compared with the sham group,levels of serum D-lactic acid,DAO and FD-40 increased significantly in the CLP group (D-lactic acid:599.4±101.1 vs.149.2±20.63 nmoL/mL,t=11.84,P＜0.01;DAO:302.1 ±64.5 vs.76.57±14.76 ng/mL,t=9.433,P＜0.01;FD-40:6664.0±1437.0vs.1446.0±205.0 ng/mL,t =9.704,P ＜0.01);intestinal morphology damage occurred in the CLP group;intestinal levels of TNF-α,IL-6 and MDA increased greatly (TNF-αt:186.35 ±20.43 vs.58.76 ±8.94 pg/mL,t=17.23,P＜0.01;IL-6:763.25±85.23vs.125.36±14.37 pg/mL,t=22.54,P＜0.01;MDA:29.36±3.27vs.7.24±0.85 nmol/mg prot,t=16.61,P＜0.01),while SOD activity reduced (35.75±6.53 vs.73.26 ±8.35 U/rmg prot,t =10.57,P ＜0.01) in the CLP group.Allicin treatment greatly inhibited the increase of D-lactic acid,DAO and FD-40 levels in rat plasma caused by CLP (D-lactic acid:330.1 ±81.77 vs.599.4±101.1 nmol/mL,t=7.086,P＜0.01;DAO:171.8±49.70vs.302.1±64.56ng/mL,t=5.45,P＜0.01;FD-40:3349.0±1167.0 vs.6664.0±1437.0 ng/mL,t=6.165,P＜0.01);intestinal morphology damage was improved in the allicin treatment group;allicin treatment greatly inhibited the intestinal levels of TNF-o,IL-6 and MDA and preserved the intestinal SOD activity compared with the CLP group (TNF-α:95.37 ±12.68 vs.186.35 ±20.43 pg/mL,t =12.29,P＜0.01;IL-6:354.27±46.27vs.763.25±85.23pg/mL,t=14.45,P＜0.01;MDA:16.27±3.14vs.29.36±3.27 nmol/mgprot,t=9.831,P＜0.01;SOD:55.35 ±6.23vs.35.75±6.53 U/mgprot,t=5.522,P ＜0.01).Conclusions Allicin could inhibit local inflammation and oxidative stress in the intestine and exerts protective effect on intestinal mucosal barrier of septic rats.

Effect of goal-directed fluid therapy on the intestinal blocking of the elderly patients with colon cancer surgery / 实用医学杂志

Objective To evaluate the effects of two fluid therapy methods guided by SVV and CVP re-spectively on intestinal barrier of colon cancer surgery with elderly patients. Methods 50 elderly patients with ASA Ⅱ~Ⅲ level were randomly divided into Group S (fluid therapy guided by SVV) and Group C (convention-al fluid therapy). Each group has 25 cases. Patients in group S were treated under goal-directed fluid infusion strategy with target of 10%≤SVV≤12%. Group C received conventional infusion characterized by monitoring central venous pressure (CVP) and mean arterial pressure (MAP). Fluid volume, surgery time, urine volume, blood loss, exhausting time, post-operative hospitalization days in Group S and Group C were recorded. MAP, HR, CVP, SVV, HCO3- of patients were recorded at the same time before anesthesia (T0), beginning of surgery (T1), one hour after surgery (T2) and ending of surgery (T3) respectively. Venous blood samples were collected at the time points of T0, T1, T2 and T3 to detect DAO and D-lactic acid levels. Results MAP and CVP at time points of T2 and T3 in Group S were obviously lower than that in Group C; total intraoperative fluid volume in Group S was obviously less than that in Group C (P < 0. 05); postoperative exhausting time and hospitalization days in Group S decreased significantly (P < 0.05) and the content of DAO and D-lactic acid in Group S were lower than that in Group C (P < 0.05). Conclusion For elderly patients with colon cancer surgery, fluid thera-py guided by SVV is better than conventional fluid therapy guided by CVP in protecting intestinal barrier.

Curative Effect of Bifid Triple Viable Capsules in Patients after Laparoscopic Cholecystectomy / 中国药师

Objective:To discuss the curative effect of bifid triple viable capsules in the patients after laparoscopic cholecystecto-my ( LC) . Methods:Totally 100 cases of patients with LC were selected and divided into the observation group and the control group at random. The patients in the two groups underwent LC under the general anesthesia, and were given routine medical treatment after the operation. The patients in the observation group were additionally given bifid triple viable capsules, 630mg per time, twice a day for 1 week as the treatment course. The changes in the occurrence of diarrhea, alteration of intestinal flora and plasma D-lactic acid of the patients and drug adverse reactions in the two groups were observed and compared after the medical treatment. Results:One week after the operation, the occurrence of diarrhea and alteration of intestinal flora of the patients in the observation group were lower than those in the control group (P0. 05). Conclusion: The application of bifid triple viable capsules in the pa-tients after LC can effectively reduce the plasma D-lactic acid levels, occurrence of diarrhea and alteration of intestinal flora with prom-ising security, which is good for the postoperative recovery of the patients.

Protective effect of the combined application of carlbachol and compound dietary fiber on intestinal barrier function of burn rats / 中国综合临床

Objective To investigate the protective effect of the combined application of carlbachol and compound dietary fiber on the intestinal barrier function in burn rats.Methods The 30％ total body surface area (TBSA) Ⅲ scald Wistar rats were randomly divided into four groups.Rats in group A were fed with physiological saline,in group B were fed with compound dietary fiber,in group C were fed with carlbachol and in group D were fed with carlbachol and compound dietary fiber.The rats were sacrificed at 6,12 and 24 hours after treatment,and selected normal rats for control group.Blood samples were taken for detecting plasma endotoxin,D-lactic acid,D-lactic acid content.Tissue samples were harvested from the small intestine for pathological study under light microscopy.Results (1) The damage of the structure of small intestine mucosa was different among 4 groups,and the most obvious was at 24 h after treatment.(2)The level plasma of endotoxin in Group D was (0.517±0.034) EU/L,significant lower than that in group A ((0.659±0.074) EU/L),Group B ((0.589 ±0.027) EU/L) and Group C((0.587±0.026) EU/L),and the difference was significant(P＜0.05).(3) Dlactic acid level in Group D was (102.996±10.102) μg/L,significant lower than that in group A((133.538 ±8.621) μg/L),Group B ((121.223± 10.519) μg/L) and Group C ((122.700± 11.146) μg/L),and the difference was significant(P＜0.05).Conclusion In early stage of burn shock,the therapy of combined with carlbachol and compound dietary fiber has obvious protective effect on rat intestinal barrier.Meanwhile,it is better than the treatment effect of single carlbachol or compound dietary fiber to some extent.

Effect of Bifid Triple Viable Capsules on Plasma D-Lactic Acid and Stool S-IgA in Patients with Colorectal Cancer after Operation / 中国药师

Objective:To discuss the effect of bifid triple viable capsules on plasma D-lactic acid and stool S-IgA in the patients with colorectal cancer after the operation. Methods:Totally 68 cases of patients with colorectal cancer after the operation were selected and divided into the observation group and the control group at random. The patients in the two groups were given enteral nutrition and postoperative routine medical treatment with the treatment course of one week from the third day after the operation. The patients in the observation group were additionally given 620 mg bifid triple viable capsules, twice a day. The occurrence rates of diarrhea and flora imbalance, D-lactic acid in plasma, S-IgA in stool and adverse drug reaction ( ADR) in the two groups were observed and compared after the medical treatment. Results:After the one-week medical treatment, the occurrence rates of diarrhea and flora imbalance in the observation group were much lower than those in the control group (P<0. 05). After the treatment, D-lactic acid in plasma in the two groups was declined, while S-IgA in stool was decreased than that before the treatment, and the changes in the observation group were more notable than those in the control group (P<0. 05 or P<0. 01). No obvious ADR appeared in the two groups during the medical treatment. Conclusion:The application of bifid triple viable capsules in the patients with colorectal cancer after the operation can re-duce D-lactic acid in plasma and ralse S-IgA in stool, which can effectively recover intestinal mucosal barrier function and local immu-nity, and reduce alteration of intestinal flora and occurrence of diarrhea with high security.

The protective effect of sodium pyruvate solution to intestinal barrier in hemorrhagic shock rats by intraperitoneal resuscitation / 中华急诊医学杂志

Objective To study the protective effect of sodium pyruvate solution to intestinal barrier in Hemorrhagic shock rats by intraperitoneal resuscitation.Methods A total of 40 Male SD ratswere healthy and clean,were randomly (random number) divided into four groups:sham operation group (group Ⅰ),hemorrhagic shock model group (group Ⅱ),the recovery of the compound sodium chloride intravenous + intraperitoneal recovery of the PD-2 liquid group (group iiⅢ),the recovery of the compound sodium chloride intravenous + sodium pyruvate abdominal recovery group (group Ⅳ) (n =10).In addition to the group Ⅰ,the other three groups are used the HS model by The Wiggers improvement prepared,group Ⅲ,Ⅳ were used the same amount of intravenous recovery,At the same time to the abdominal cavity were respectively injected 20 mL 2.5％ PD-2 liquid and 20 m 2.5％ sodium pymvate solution.After 2 h,each group were taken arterial blood measured arterial blood gases (pH,PaCO2,PaO2) and D-lactic acid,small intestine specimens under the light microscope to observe the morphological changes of the rat small intestinal mucosa.Results Blood gas analysis:group Ⅲ and Ⅳ was significantly increased compared with group Ⅱ in pH levels and PaO2 content (P ＜ 0.01),and comoared to group Ⅲ,pH levels and PO2 levels of group Ⅳ increased more significantly (P ＜ 0.05) ; D-LA content:Group Ⅲ,Ⅳgroup is significantly lower than group Ⅱ (P ＜ 0.01) ; compared with group Ⅲ and group Ⅳ,D-LA significantly decreased (P ＜ 0.05).Light microscope,the group Ⅱ,the rat small intestine layer of a high degree of villous edema,submucosal vascular collapse within the lamina propria glands focal area of necrosis,and large areas of mucosal villi necrosis,defects; group Ⅲ and group Ⅳof small intestinal damage compared to group Ⅱ significantly reduced; Ⅳgroup of the rat small intestine villi edema,lodging and the degree of necrosis in group Ⅲ.Intestinal epithelial damage index score:the Ⅳ group than in group Ⅱ and Ⅲ group (P ＜ 0.01 or P ＜ 0.05).Conclusions The venous recovery and intraperitoneal resuscitation can significantly reduce the plasma D-LA content of hemorrhagic shock in rats,correct acidosis,increase the oxygen partial pressure ; and intestinal mucosal barrier function,the protective of sodium pyruvate solution is better than the PD-2 liquid.

Effects of intensive insulin therapy on the intestinal permeability in sepsis patients / 肠外与肠内营养

Objective: To discuss the effect of intensive insulin therapy on D-lactic acid and diamine oxidase level in patients with sepsis.Methods: 48 patients was divided into control group and conventional group randomly.Content of D-lactic acid and diamine oxidase in serum was detected with absorption spectrometry before and after therapy.Result: D-lactic acid and diamine oxidase in patients decreased significantly in control group compared to that of conventional group.Conclusion: Insulin can depress interstinal permeability and ameliorate sepsis symptom resulted from bacterial translocation from intestine.

Effects of dietary fiber complex on intestinal mucosal barrier in rats with experimental ulcerative colitis / 中华消化杂志

Objective To evaluate the effect of enteral nutrision (EN) containing dietary fiber complex (DFC) on intestinal mucosal barrier in rats with experimental colitis. Methods Ninety six SD rats were induced into ulcerative colitis by acetic acid enema.than were divided into 3 groups. The rats in group C received non-DFC nutrison, while the rats in group Tl or group T2 received soluble dietary fiber (SDF) and insoluble dietary fiber (IDF) of the EN with different proportion (1:2 or 1:3, respectively). At the first-, third-,fifth- and seventh-day after the EN, the concentration of D-lactate and diamine oxidase (DAO) activity in plasma were detected and intestinal samples were obtained to observe the changes of intestinal mucosa. Results At the third-,fifth- and seventh-day,the D-lactate concentration and the DAO activity in plasma significantly reduced in group Tl and T2 when compared with group C (P<0. 05) , but there was no statistical difference between group Tl and group T2. The scores of histological damages of colon in the group Tl and group T2 decreased in comparison with group C at all time points (P < 0. 05). However, the scores of histological damages of colon significantly decreased in group T2 when compared with group Tl at day 5 and day 7 (P <0. 05). Conclusion EN containing DFC may reduce the intestinal permeability of colitis in rats, which has a protective effect on intestinal mucosal barrier. While different proportions of the SDF or IDF ratio result in different effects on the mucosal protection. This protective effect will be enhanced by increasing the ratio of IDF in a certain scale.

The protective effects of intra-peritoneal fluid resuscitation on small intestinal mucosa in rats with hemorrhagic shock / 中华急诊医学杂志

Objective To investigate the protective effects of intra-peritoneal fluid resuscitation on small intestinal mucosa in rats with hemorrhagic shock. Method Fifty Sprague-Dawley (SD) rats were randomly (random number) divided into five groups, namely sham operation group (group I ), hemorrhagic shock group (group Ⅱ ), intra-venous fluid resuscitation group (group Ⅲ ) . intravenous fluid resuscitation plus intra-peritoneal saline resuscitation (group Ⅳ ) and intravenous fluid resuscitation plus intra-peritoneal PD-2 solution resuscitation group (group Ⅴ ). The rats of 5 groups were processed with cannulations of right common carotid artery, right femoral vein and left femoral artery with systemic heparinization. The rat models of hemorrhagic shock were established with modified Wigger' s method by which the blood exsanguinated from left femoral artery. The rats of group Ⅲ were resuscitated with shed blood plus twice equal volume of Ringer's solution after modeling of hemorrhagic shock.The rats of group Ⅳ and group Ⅴ were administered intra-peritoneally with 30 mL saline and 30 mL of 2.5% PD-2 solution, respectively as adjuncts to those used in the group Ⅲ . The specimens of blood and small intestine of rats of all groups were collected 60-120 minutes after modeling and resuscitation. The activity of plasma diamine oxidase (DAO) was determined with chromatometry, the level of plasma D-lactic acid (D-LA) with spectorophotometry and the level of plasma lipopolysaccharide (LPS) with nephelometry. The histopathological and ultrastructure changes of small intestine tissue of rats were observed under light microscope and electronic microscope. Results There were remarkable differences in activity of DAO, and the levels of D-LA and IPS in rats between those ingroup Ⅱ and group I (P <0.01), and between those in group V and groups Ⅱ , Ⅲ or Ⅳ (P <0.05 or P < 0.01) The pathomorphology and ultra-structure of small intestine tissues were severely damaged in group Ⅱ compared with those in group Ⅰ , and those markedly lessened in group V compared with groups Ⅱ , Ⅲ and Ⅳ . Conclusions Intraperitoneal fluid resuscitation with PD-2 solution can significantly protect the integrity of intestinal mucosa and the normal permeability of intestinal wall, and blunts the histopathological changes, and restrains bacterial translocation from gut and reduces the level of plasma endotoxin.

Therapeutical effect of somatostatin on the bowel barrier damage of hypoxic encephalopathy / 国际儿科学杂志

Objective To explore the therapeutical effect of somatostatin(SST) on the damaged bowel barrier of 7-day-old SD rats with hypoxic-ischemic encephalopathy(HIE). Methods Total 7-day-old SD rats were randomly divided into untreated control group(n=6), sham-operated group(n = 6), HIE model group(n = 8) and SST-treated group(n = 8). After 6 hours of operation, abdominal aorta blood of the rats was collected to measure the level of D-lactic acid, the ileum was taken for pathological analysis and immunohistochemistry staining of SP. Results The level of D-lactic acid in HIE model group was obviously increased[(10.30 ± 1.70)mg/L], and there were significant differences compared to untreated control group, sham-operated group as well as SST-treated group respectively(P < 0.05, respectively). The cillia of ileum became widen and shorten, and the number of it decreased. At the same time, in the stratum mucosa and the neurofibrillary tangle, the expression of SP was increased (average optical density: 12.67 ± 5.46), and there were significant differences compared to untreated control group, sham-operated group as well as SST-treated group raspectively (P < 0.05,respectively).Compared with HIE model group,the level of D-lactic aeid decreased obviously[(7.35 ± 1.55) mg/L] in SST-treated group,and there were no differences compared to untreated control group and sham-operated group respectively. The intestinal villi became thinner and higher in the SST-treated group, even the number increased. Besides that, the expression of SP decreased(average optical density: 0.73 ± 0.09), and there were no differences compared to untreated control group and sham-operated group respectively. Conclusion The therapeutical effect of SST on the bowel barrier damage of 7-day-old SD rats with HIE is clear.

Effect of Ruhuang preparation on endotoxin and intestinal defence function of cirrhotic rats / 中华中医药杂志

Objective: To study the influence of Ruhuang(Rhubarb and Lactohacillin) preparation to endotoxin and intestinal defence function of cirrhotic rats.Methods:88 male Wister rats were randomly divided into normal group,model group,prevention group,prevention of control group,model treatment group and model treatment of control group.Liver cirrhosis model was induced by CCl4 combined with other factors,Ruhuang preparation was used for the prevention and treatment,lactulose was used as positive control drug.The level of plasma endotoxin,intestinal mucosal S-IgA and serum D-lactic acid were detected.Results : The blood plasma endotoxin level of Ruhuang prevention group and model treatment group is lower than that of model group obviously(P

Experimental Study of Influence of CO_2 Pneumoperitoneum on Intestinal Mucosa Permeability in Rats with Liver Cirrhosis / 中国普外基础与临床杂志

Objective To investigate the influence of CO_2 pneumoperitoneum on intestinal mucosa permeability in rats with liver cirrhosis.Methods Fifty rats were randomly divided into following groups: control group(n=5),cirrhosis group(n=5) and pneumoperitoneum group(n=40);the pneumoperitoneum group was further divided into 8 mm Hg group(n=20) and 13 mm Hg group(n=20).Four time points were chosen,including 0.5,2,6,and 12 hours after the end of pneumoperitoneum.After rat models with cirrhosis were established successfully,the abdominal cavity was insufflated with CO_2 and maintained under the pressures of 8 mm Hg and 13 mm Hg respectively for two hours.The portal venous blood was collected and the levels of D-lactic acid and endotoxin were measured.Results The levels of endotoxin and D-lactic acid in cirrhosis group were much higher than those of control group(P0.05).Conclusion The intestinal mucosa permeability is increased in rats with liver cirrhosis.It can be further increased under CO_2 pneumoperitoneum with certain pressure and time and in a pressure-dependent manner.The permeability can decrease after removal of pneumoperitoneum.