Effect of fecal microbiota transplantation on intestinal flora in mice with acute-on-chronic liver failure / 临床肝胆病杂志

ObjectiveTo investigate the protective effect of fecal microbiota transplantation (FMT) on mice with acute-on-chronic liver failure (ACLF) and its effect on intestinal flora. MethodsA total of 40 mice were randomly divided into control group (CON group), model group (MOD group), FMT group (feces of the mice in the CON group were used as fecal microbiota donor), and FMT model group (ANFMT group, with feces of the mice in the MOD group as fecal microbiota donor), with 10 mice in each group. All mice were observed in terms of body weight, death, liver histopathology, and changes in aspartate aminotransferase (AST), alanine aminotransferase (ALT), and intestinal flora. A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups, and the SNK-q test was used for further comparison between two groups. ResultsCompared with the CON group, the MOD group had a significant reduction in body weight and significant increases in AST and ALT (all P＜0.05), as well as large patchy necrosis of hepatocytes, significant increases in Verrucomicrobia, Akkermansia, and Erysipelatoclostridium, and significant reductions in Dubosiella and Duncaniella (all P＜0.05). Compared with the CON group, the ANFMT group had a significant increase in AST (P＜0.05), hepatocyte swelling and mild ballooning degeneration, significant increases in Unclassified and Faecalibaculum, and significant reductions in Patescibacteria, Deferribacteres, Muribaculum, Candidatus_Saccharimonas, Rikenella, Odoribacter, Mucispirillum, and Lachnospiraceae_unclassified (all P＜0.05). Compared with the MOD group, the FMT group had significant reductions in AST and ALT (both P＜0.05), mild hepatocellular necrosis and marked ballooning degeneration, significant increases in Paramuribaculum and Bilophila, and significant reductions in Firmicutes, Rikenella, and Absiella (all P＜0.05). ConclusionIntestinal flora disturbance is observed in ACLF mice, and dysbacteriosis may lead to liver injury. FMT can alleviate liver inflammation in ACLF mice and thus exert a protective effect.

Half-effective dosage of etomidate for combined remifentanil used in elderly patients in gastroscope / 临床麻醉学杂志

Objective To determine ED50 and ED9 5 of etomidate for combined remifentanil used in elderly patients in gastroscope.Methods Twenty-three patients were scheduled to receive gastros-copy aged 65-78 years old including males 13 and females 10,weighting 45-76 kg and ASA Ⅰ-Ⅲ. They were slowly injected remifentanil 0.3 μg/kg,and then etomidate 0.20 mg/kg,gastroscopy was performed after their eyelash reflex disappeared.The dosage of etomidate were determined by modified up-and-down methods,0.20 mg/kg was initial dosage.During the gastroscope,restlessness, frowning,swallowing,choking cough could be seen.The adjacent experimental interval dosage was 0.05 mg/kg,the trial was ended when there was the seventh cross-sectional,and determined the ED50 and ED9 5 of etomidate and (95%confidence interval)of them for gastroscope with probability a-nalysis methods.Results The ED50 of etomidate was 0.1 7 mg/kg and 95%CI 0.14-0.21 mg/kg,and the ED9 5 was 0.23 mg/kg,95%CI 0.20-0.42 mg/kg respectively.Conclusion The ED50 and ED9 5 of etomidate combined with remifentanil used for elderly patients for gastroscope respectively are 0.1 7 mg/kg and 0.23 mg/kg.

Effects of flurbiprofen on tourniquet-induced lower extremity ischemia-reperfusion injury / 中国现代医生

Objective To observe the effects of flurbiprofen on tourniquet-induced lower extremity ischemia-reperfu-sion (I/R) injury. Methods Ninety ASA I or II patients, aged 30-59 years, scheduled for elective orthopedic operation on CSEA,were randomly assigned into 3 groups (n=30 each):control group (group C),low dose flurbiprofen (group D1) and flurbiprofen (group D2). A tourniquet was applied after affected limb blood droved and inflated (80kPa) and dura-tion of less than 90 min. Patients in group D1 were infused flurbiprofen 1mg/kg slowly on 10 min before the tourniquet inflated and patients in group D2 infused flurbiprofen 2mg/kg. Patients in group C received normal saline 5mL.Blood samples were taken before operation (T0) and taken 30min(T1),2h(T2) after tourniquet release to determine the plasma concentrations of MDA, SOD, TNF-α,IL-6,IL-8.Results The plasma concentrations of MDA, SOD, TNF-α,IL-6,IL-8 in these three group was lower at T1 and T2 than it at T0(P<0.05). The plasma concentrations of MDA, SOD, TNF-α, IL-6,IL-8 in group D1and D2 was lower at T1 and T2 than it at T0(P <0.05). The plasma concentrations of MDA was lower at T2 than it at T1(P<0.05). Conclusion Flurbiprofen can reduce inflammation on tourniquet-induced lower ex-tremity ischemia-reperfusion injury.