Development of job characteristics questionnaire for railway employees and test on its reliability and validity / 四川精神卫生

BackgroundThe mental health of employees in railway enterprises is related to the safety and stability of railway transportation. As an important factor affecting occupational mental health， job characteristics have attracted the attention of researchers. However， there exists a lack of job characteristic scales with occupational specificity in current researches relevant to the railway industry. ObjectiveTo develop a job characteristics questionnaire oriented to railway employees that takes both Job Demands-Resources Model （JD-R） and Chinese actual conditions into essential consideration， so as provide guidance for the research on the mental health of railway employees. MethodsPurposive and theoretical samplings were used to select 77 employees across 9 railway units as research objects， and interview method was used to conduct qualitative research in order to determine the structural dimensions and items of the questionnaire. The 612 subjects randomly selected from the railway maintenance system went through the preliminary test， then exploratory factor analysis and confirmatory factor analysis were employed to test the questionnaire. After forming a formal questionnaire on the job characteristics of railway employees， it is extended to the other four main industry systems of railway enterprises， responsible for locomotive maintenance， vehicle depot， signal and communication maintenance， and power supply respectively， to verify the stability and effectiveness. Results①Exploratory factor analysis showed that the questionnaire included two factors， job demands and job resources， with a total of 14 items. The factor loading of each item ranged from 0.761 to 0.916， and the two factors accounted for 71.02% of the total variance. The results of confirmatory factor analysis indicated good fitting of the two-factor model （χ2/df=3.310， RMSEA=0.087， GFI=0.892， CFI=0.932， NFI=0.905， IFI=0.932）. ② Confirmatory factor analysis was carried out in four extended samples of locomotive maintenance， vehicle depot， signal and communication maintenance， and power supply， and each result indicated a satisfactory model fit（χ2/df=2.678， 4.741， 4.868， 3.502， RMSEA=0.109， 0.096， 0.093， 0.084，GFI=0.832， 0.878， 0.894， 0.904，NFI=0.874， 0.935， 0.902， 0.928，IFI=0.917， 0.948， 0.920， 0.947）. ③Job demands in five sub-samples can positively predict job burnout and turnover intention （β=0.564~0.686， 0.425~0.554， P<0.01）. Job resources in five sub-samples can positively predict job performance and job satisfaction （β=0.594~0.752， 0.731~0.807， P<0.01）， and it can also negatively predict job burnout and turnover intention （β=-0.247~-0.186， -0.357~-0.175，P<0.05 or 0.01）.In sub-samples of locomotive maintenance and power supply， job demands can positively predict job performance （β=0.242，0.261， P<0.01）.In sub-samples of railway maintenance and signal and communication maintenance， job demands can negatively predict job satisfaction （β=-0.065， -0.091， P<0.01）. ConclusionThe questionnaire has good reliability and validity， and is applicable for the study of occupational mental health research on railway employees. ［Funded by Major Projects of the National Social Science Foundation of China （number， 19ZDA3580）， Scientific Research and Development Program of China Railway Chengdu Group Co.， Ltd （number， CX21099）］

Central precocious puberty with primary pigmented nodular adrenocortical disease: One case report / 中华内分泌代谢杂志

To report the clinical, imaging, and pathological feature of a rare case of central precocious puberty with primary pigmented nodular adrenocortical disease(PPNAD), and to conduct a retrospective analysis of PPNAD with relevant literatures. The pubic hair was found in the child for more than one year. Physical examination showed Cushing′s syndrome. ACTH in blood decreased, cortisol rhythm was disordered, 24-hour urine free cortisol increased and the paradoxical increase of urine free cortisol after high dose dexamethasone suppression test. Adrenal enhancement computed tomography(CT)showed multiple small nodular shadows in bilateral adrenal glands. Gonadotropin releasing hormone(GnRH)stimulation test supported central precocious puberty and GnRH analogue was used to control the sexual development. PPNAD was supported by pathology result. The symptoms of Cushing′s syndrome were relieved partially after left adrenalectomy.

Congenital lipoid adrenal hyperplasia with 46, XY karyotype and male external genitalia: Two cases and literature review / 中华内分泌代谢杂志

Congenital lipoid adrenal hyperplasia (CLAH) is a rare autosomal recessive disorder, which is characterized by adrenal insufficiency and 46, XY sex reversal. Two cases of CLAH with 46, XY karyotype exhibited male external genitalia were reported to explore the clinical and genetic features. A retrospective analysis of CLAH with relevant literatures was performed.

Comparison on value of energy spectrum CT and ultrasound in monitoring bone transport / 中国医学影像技术

Objective To compare monitoring value of energy spectrum CT and ultrasound in bone transport process. Methods Eighteen patients who underwent bone transport were examined with energy spectrum CT and ultrasonography at the 2nd, 4th, 6th week and 8th week after surgery, and the construction of lateral callus, the formation of callus in the intramedullary cavity, the range of organized hematoma and the nature of the vesicular area were observed, the length of bone extension area and organized hematoma were measured. The radiation dose of energy spectrum CT scan was also calculated. Results Primary callus structures were observed on CT and ultrasound at the 2nd to 8th week after surgery, and the callus and cortical bone could not be distinguished by ultrasound at the 8th weeks. At the 2nd to 8th week after surgery, both CT and ultrasound could observe the range of organized hematoma and the increased quantity of callus in the intramedullary cavity. There was no statistically significant difference of the length of systemic hematoma nor bone extension area measured with CT and ultrasound at the 2nd and 4th week after surgery (all P>0.05), while significant difference was detected in the length of systemic hematoma and bone extension area measured at the 6th weeks after surgery (both P0.05), while CT energy spectrum curve could identify the nature of fluid vesicles. The effective radiation dose of energy spectrum CT was (0.71±0.71)mSv. Conclusion Energy spectrum CT and ultrasound both have advantages in monitoring the formation of regenerated tissue during bone transport. Energy spectrum technology can be used as a new monitoring method.

Effects of autologous blood transfusion on coagulation function,inflammatory factors and immune function in patients with traumatic brain injury / 国际检验医学杂志

Objective To explore the effects of autologous blood transfusion on coagulation function,in-flammatory factors and immune function in patients with traumatic brain injury.Methods 85 patients taken autologous blood transfusion were selected as the observation group,30 cases with allogeneic blood transfusion were taken as control group.The blood transfusion volume,perioperative hematocrit,prothrombin time and postoperative complications were observed and compared between the two groups.Results In the observation group,the total amount of autologous blood transfusion in the observation group was 36 338mL,averaged (427.5 ± 28.3)mL,the total amount of allogeneic blood transfusion was 8 747 mL,averaged (102.9 ± 12.7) mL,and the autologous blood accounted for 80.6% of the total transfusion.61 patients only transfused autolo-gous blood,accounting for 71.8%.In the control group,the total allogeneic blood transfusion volume was 15 918 mL,averaged (530.6 ± 22.8)mL,the consumption of banked blood in the observation group was signifi-cantly less than that in the control group (P< 0.05).The levels of platelet (PLT) and plasma fibrinogen (FIB)in the control group increased significantly at 3 d after operation compared with those before operation (P<0.05);while activated partial thromboplastin time (APTT) began to decrease significantly at 3 d after operation (P<0.05);the prothrombin time (PT) and thrombin time (TT)decreased significantly at 7 d after operation(P<0.05),and the level of PLT and FIB in the observation group began to increase significantly at 1 d after operation (P<0.05).PT,APTT and TT were significantly reduced 1 d after operation.Compared with the control group,the level of PLT and FIB in each phase of the observation group was significantly high-er than that of the control group (P<0.05),and the PT,APTT and TT were significantly lower than those in the control group (P<0.05).After operation,the level of pro-inflammatory factors in the observation group was significantly lower than that of the control group.The level of anti inflammatory factors and immune function were significantly higher than that of the control group (P<0.05),and the incidence of complications in the observation group was 2.4%(2/85),which was significantly lower than 16.7%(5/30)of the control group,and the difference was statistically significant (P<0.05).Conclusion Autologous blood transfusion has the advantages of rapidness,timeliness and safety in the operation for patients with brain trauma.It is helpful to save blood,reduce the effect of trauma and blood transfusion on blood coagulation function and im-mune function,and reduce the risk of blood transfusion complications and postoperative infection,which is worth of clinical application.

Effectiveness of integrated early childhood development intervention on nurturing care for children aged 0-35 months in rural China / 中华儿科杂志

Objective@#To explore whether Integrated Early Childhood Development (IECD) program has effectively improved the nurturing care for children aged 0-35 months in rural China.@*Methods@#IECD has been implemented by the government of China with support from the United Nations Children's Fund (UNICEF) in four poverty-stricken rural counties since 2014. The interventions targeting the five key components of nurturing care (i.e. child and caregiver health, child nutrition, early learning support, child protection and social security) were delivered through the IECD program to children aged 0 to 35 months and their caregivers. A population-based intervention trial was designed to evaluate intervention effectiveness with data collected in 2013 (baseline) and 2016 (mid-term). The changes of nurturing care in the intervention and control group were analyzed by using a difference-in-differences (DID) model. This approach provided adjustment for sociodemographic and other confounding factors.@*Results@#The baseline and mid-term survey enrolled 1 468 and 1 384 children in the intervention group, and 1 485 and 1 361 in the control group. After two years of implementation, the prevalence of caregiver's depression in the intervention group showed a decrease of 9.1% (mid-term 34.8% (479/1 377) vs. baseline 43.9% (621/1 414)), whereas that in control group showed a decrease of 1.6% (mid-term 34.3% (464/1 353) vs. baseline 35.9% (509/1 419)). With the confounding adjusted in the difference-in-differences model, the decrease of the caregiver's depression prevalence in the intervention group was 7.0% greater than that in the control group (P=0.008). The qualified rate of minimum meal frequency in the intervention group showed an increase of 10.4% (mid-term 69.0% (532/771) vs. baseline 58.6% (481/821)), whereas the qualified rate in the intervention group showed an increase of 2.9% (mid-term 66.4% (469/706) vs. baseline 63.5% (508/800)). With the confounding adjusted in the difference-in-differences model, the increase of the qualified rate in the intervention group was 8.2% greater than that in the control group (P=0.021). The proportion of violent discipline by caregivers in the intervention group showed a decrease of 6.2% (mid-term 49.1% (478/973) vs. baseline 55.3% (554/1 001)), whereas the proportion in control group showed an increase of 4.5% (mid-term 58.4% (560/959) vs. baseline 53.9% (558/1 036)), and with the confounding adjusted in the difference-in-differences model, the difference in increase rate between two groups was 11.0% (P=0.001). The proportion of families with three or more children's books in the intervention group showed an increase of 12.7% (mid-term 42.7% (588/1 378) vs. baseline 30.0% (432/1 440)), whereas the proportion of the control group showed an increase of 4.2% (mid-term 25.7% (349/1 357) vs. baseline 21.5% (298/1 388)), and with the confounding adjusted in the difference-in-differences model, the difference in increase rate between two groups was 6.1% (P=0.007).@*Conclusions@#The IECD intervention strategy implemented in rural China effectively improved the mental health of caregivers, optimizes families' child feeding and early stimulation behaviors, while reducing violent discipline and other risk factors. IECD provides better nurturing care for the early development of children aged 0-35 months in rural China.

Paiteling treatment of cervical cervical high-risk HPV infection outcome / 中国生化药物杂志

Objective To explore the treatment effect on cervical Paiteling cervical high-risk human papiloma virus(HPV) infection outcome.MethodsRandomly selected from our hospital during January 2014 to January 2016 in 120 cases of cervical high-risk HPV infection patients as the research object, of which 40 cases were treated with Paiteling treatment (Paiteling group), 40 patients were treated with foscarnet sodium (foscarnet sodium group).Another 40 patients without intervention (control group).The outcome of HPV infection in three groups was compared.ResultsPatients with negative rate of special spirit (87.50%) and foscarnet sodium group (55.00%) and control group (50.00%) was statistically significant(P<0.05), and the special spirit Group continued the positive rate (2.50%) was significantly lower than the control group (42.50%) and foscarnet sodium group (37.50%).However, there was no significant difference between the groups in the rate of improvement and the incidence of new infections.There was no significant difference between the control group and the positive rate (50.00%) in the control group (42.50%) compared with that in the control group.ConclusionPaiteling treatment of clinical effect of cervical high-risk HPV infection, can effectively improve the symptoms of HPV infection, which can shorten the HPV clearance time, has positive clinical significance.

A novel homozygous mutation in PLA2G6 gene causes infantile neuroaxonal dystrophy in a case / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the clinical symptoms and potential mutations in the PLA2G6 gene for a child with infantile neuroaxonal dystrophy.</p><p><b>METHODS</b>Clinical data of the patient was collected. The coding regions of PLA2G6 gene was subjected to Sanger sequencing using blood DNA from the patient and her parents.</p><p><b>RESULTS</b>The patient has presented with psychomotor regression and hypotonia, followed by development of tetraparesis. A novel homozygous mutation G68A in the PLA2G6 gene was found by DNA sequencing, while her parents were both heterozygous carriers.</p><p><b>CONCLUSION</b>The psychomotor regression and tetraparesis of the patient was caused by infantile neuroaxonal dystrophy due to a novel homozygous mutation in the PLA2G6 gene, which was inherited from her parents.</p>

Effects of ω-3 polyunsaturated fatty acids intervention on Toll-like receptor 4 and high mobility group box 1 with intestinal ischemia/reperfusion injury / 中华临床营养杂志

Objective To investigate the expressions of Toll-like receptor 4 (TLR4) and high mobility group box 1 (HMGB1) expression on distant tissue during the intestinal ischemia/reperfusion and the effects of ω-3 polyunsaturated fatty acids (ω-3 PUFAs) intervention in rats.Methods Forty-eight Sprague-Dawley male rats,weighing (281.50 ± 22.68) g,were randomly divided into three groups (n =16) after gastrostomy:normal diet (N) group,enteral nutrition (EN) group and EN plus ω-3 PUFAs (PUFA) group.Each group was further divided into lymph drainage (I/R + D) and non-drainage (I/R) sub-groups (n =8 each) according to whether treated with intestinal lymph drainage.All the rats were subjected to 60 min ischemia by clamping the superior mesenteric artery,followed by 120 min reperfusion,while the rats in the I/R + D subgroups were treated with intestinal lymph drainage for 180 min at the same time.Results The interleukin-6 level in lymph in N (I/R + D) group was significantly higher than in the EN (I/R + D) and PUFA (I/R + D) groups (PUFA vs EN vs N:(154.57 ±69.30) ng/L vs (97.58 ±40.34) ng/L vs (85.35 ±23.93) ng/L,P =0.021).Besides,the serum level of HMGB1 in PUFA (I/R + D) group was significantly lower compared to the other 5 groups [PUFA (I/R) vs EN (I/R) vs N (I/R) vs PUFA (I/R + D) vs EN (I/R + D) vs N (I/R + D):(2.95 ± 1.17) μg/L vs (3.86 ±0.99) μg/L vs (4.45 ± 1.73) μg/L vs (1.71 ±1.41) μg/Lvs (2.11±0.56) μg/Lvs (3.13 ±0.79) μg/L,P=0.000],and it also decreased in the PUFA (I/R) and EN (I/R) groups than the N (I/R) group (respectively,P ＜ 0.05).Furthermore,the serum endotoxin level in PUFA (I/R) group was significantly lower compared to the N (I/R) and EN (I/ R) groups[PUFA(I/R) vsPUFA (I/R+D) vsEN (I/R) vs N (I/R):(0.020±0.004) EU/mlvs (0.028 ±0.006) EU/ml vs (0.028 ±0.005) EU/ml vs (0.018 ±0.006) EU/ml,P=0.014].Together the serum tumor necrosis factor-α level in both PUFA (I/R) and PUFA (I/R + D) groups were significantly lower than theEN (I/R),N (I/R) and N (I/R+D) groups [PUFA (I/R+D) vs PUFA (I/R) vs EN (I/R) vsN (I/R) vs N (I/R+D):(12.03 ±6.57) ng/L vs (14.32 ±6.11) ng/Lvs (23.27 ±15.60)ng/L vs (27.42 ± 10.37) ng/L vs (26.87 ± 5.30) ng/L,P =0.013].The jejunum and ileum mucosa in all the I/R groups showed swelling and atrophy and appeared fragile,while the PUFA groups showed less yellow staining and injury than the other two groups (P ＜ 0.05,respectively).In addition,the expressions of TLR4 mRNA in jejunum,ileum,and liver in all the drainage groups were respectively lower than the corresponding non-drainage groups [jejunum:PUFA (I/R) vs EN (I/R) vs N (I/R) vs PUFA (I/R+D) vs EN (I/R+D) vsN (I/R+D):2.32±0.62vs3.08±1.29vs3.50±2.44vs 1.62±0.79vs 1.67±1.11 vs 1.94±0.81,P=0.025; ileum:PUFA (1/R) vsEN (1/R) vsN (1/R) vs PUFA (1/R+D) vsEN (1/R+D) vs N (1/R+D):2.67±1.08 vs 5.22 ± 3.96 vs 6.95 ±4.92 vs 1.70±0.68 vs 1.80±0.29 vs3.68±1.47,P=0.012; liver:PUFA (1/R)vsEN (1/R)vsN (1/R)vs PUFA (1/R+D)vsEN (1/R+D)vsN (1/R+D):5.67 ±1.94 vs 7.50 ±3.89 vs 7.18 ±4.55 vs 1.70 ±0.86 vs 3.90 ± 1.95 vs 4.12 ±2.11,P =0.001],which was consistent with the reduction of HMGB1 and the decrease of nuclear factor-κB activity in intestine,liver,and lung (P =0.000).Conclusions Lymph drainage and ω-3 PUFAs intervention can reduce the production of HMGB1 and inflammation factors,inhibit the expression of HMGB1 and TLR4 mRNA,and thus alleviate distant tissue injury caused by intestinal L/R.

Comparison of clinical application of two definitions of metabolic syndrome in children and adolescents / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To compare and evaluate clinical applications of two definitions of metabolic syndrome in children and adolescents, which was developed by Pediatric Academy of Chinese Medical Association in 2012 (Chinese definition) and by International Diabetes Federation in 2007 (IDF definition), respectively.</p><p><b>METHODS</b>593 obese children and adolescents aged 10 ≊16 y from July 2006 to December 2012 were enrolled in the study. The diagnostic concordance of two definitions for metabolic syndrome and individual components was estimated, and their sensitivity and specificity for detecting insulin resistance and early macrovascular complications were compared.</p><p><b>RESULTS</b>The concordance between two definitions for diagnosing metabolic syndrome was good (kappa=0.626); as for detecting the individual components, the Kappa concordance index were 1.000, 0.803, 0.780, 0.734 and 0.594 for hypertriglyceridemia, hyperglycemia, cholesterol abnormality and hypertension, respectively. The incidence of insulin resistance and early macrovascular complications, detected by the two definitions, were both increased with increasing number of abnormal components. The sensitivity and specificity for detecting insulin resistance in children with metabolic syndrome were 54.5% and 65.7% by Chinese definition, and 36.1% and 83.1% by IDF definition; while the sensitivity and specificity for detecting early macrovascular complications were 58.3% and 55.8% by Chinese definition, and 37.3% and 70.8% by IDF definition. After adjusting for age and sex, compared to the obese children and adolescents without metabolic syndrome, the odds ratios of insulin resistance and early macrovascular complications were 2.166 (P<0.001) and 1.771(P=0.008) for children with metabolic syndrome diagnosed by Chinese definition, and the odds ratio of insulin resistance and early macrovascular complications were 2.618 (P<0.001) and 1.357 (P=0.190) by IDF definition.</p><p><b>CONCLUSION</b>The concordance between Chinese and IDF definitions for diagnosing metabolic syndrome in Chinese obese children and adolescents is good. Compared to IDF definition, Chinese definition is more sensitive for hypertension, hyperglycemia and hypercholesterolemia, thus it can more effectively detect insulin resistance and early macrovascular complication.</p>

Early identification of impaired renal function in obese children with non-alcoholic fatty liver disease / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To early assess the impaired renal function in the obese children with non-alcoholic fatty liver disease (NAFLD) and to identify the relationship between NAFLD and impairment of renal function.</p><p><b>METHODS</b>Three hundred and eighty-six obese children were enrolled and divided into NAFLD group and simple obesity group (control) according to the diagnostic criteria. Clinical biochemical parameters and early impaired renal functions were evaluated and compared. Among all patients 234 obese children aged over 10 y were subdivided into 3 groups: NAFLD combined with metabolic syndrome (NAFLD+MS) group, NAFLD group and simple obesity group (control), and the above indexes were compared among 3 groups.</p><p><b>RESULTS</b>The urinary microalbumin levels in NAFLD, NAFLD+MS (>10y) and NAFLD groups (>10y) were significantly higher than those in controls. Additionally, the positive correlations of urinary microalbumin with systolic pressure, triglyceride and 2h-postprandial blood glucose were found.</p><p><b>CONCLUSION</b>There is early renal dysfunction in children with NAFLD and those accompanied with MS, which may be associated with hypertension and glucose-lipid metabolic disorder. The results indicate that NAFLD is not only an early sign of early impaired renal function but also an early stage of chronic kidney disease (CKD) in obese children.</p>

The effect of murine intestine ischemia-reperfusion on endogenous ligand of TLR4 expression in distant organs / 中华普通外科杂志

Objective To investigate the expression of high mobility group box 1 (HMGBI) of TLR4 endogenous ligand and distant organ tissue injury after intestine ischemia/reperfusion and drainage of lymph fluid in rats. Methods Twenty-four Sprague-Dawley (SD) male rats (SPF grade) were evenly divided into 3 groups:Sham surgery group,intestine ischemia-reperfusion (I/R) group,and intestine ischemia-reperfusion with drainage of intestine lymph fluid (IR + drainage) group.The injury of distant organs such as lungs,liver,kidney was evaluated;The expression of high mobility group box 1 (HMGBI) of TLR4 endogenous ligand in intestine,lung and liver after the ischemia-reperfusion injury was measured by immunohistochemistry.Result HE stained sections,as well as HMGB1 immunohistochemistry results showed that the injury of ischemia/reperfusion (I/R) group and ischemia/reperfusion (I/R) + drainage group were more severe than that in the sham group.A large number of cells stained in I/R group,indicating that HMGB1 expression increased.The injury in I/R + drainage group was significantly less severe than I/R group.Western blot tests showed that the expression of HMGB1 in jejunum,ileum,liver,lung increased significantly in I/R group after L/R injury.Gray-scale values of HMGB1/β-actin were 0.3145 ± 0.0549、 1.7352 ± 0.3280、1.4443 ± 0.0926、3.1382 ± 0.4202.Lymph drainage significantly alleviated the damage,the expression of HMGB1 were significantly lower (P ＜0.05).Gray-scale values of HMGB1/β-actin were 0.1745 ± 0.0327、 1.1083 ± 0.2098、 1.1862 ± 0.1221、2.1095 ± 0.1993. Conclusion Increased expression of HMGB1 of TLR4 endogenous ligand is associated with intestinal and distant tissue injury during intestinal ischemia-reperfusion injury.Drainage of lymph fluid can block the gutlymph pathway and thus reduce the source of HMGB1 from the intestinal as well as the injury of distant tissue.

Effect of ω-3 polyunsaturated fatty acids on intestinal ischemiareperfusion injury and lymphatic duct ligation / 中华临床营养杂志

Objective To investigate the effect of intestinal lymphatic duct ligation and ω-3 polyun saturated fatty acids on intestinal and distant organ in intestinal ischemia-reperfusion injury. Methods Totally 40Sprague-Dawley (SD) male rats (SPF grade)after gastrostomy were equally randomized into sham group (Sham), enteral nutrition (EN) group, enteral nutrition and lymphatic duct ligation (EN + L) group, ω-3 polyunsaturated fatty acids (ω-3PUFA) group, and ω-3PUFA and lymphatic duct ligation (ω-3PUFA + L) group. After 7 days of nutritional intervention, rats were subjected to 60 minutes of intestinal ischemia, ischemia plus mesenteric lymph duct ligation, or sham procedures. After 3 days of continuous nutrition intervention using the original nutrient, lymph nodes, lung, intestine, liver, and blood specimens were harvested. Intestinal permeability and morphology, results of bacterial cultures, and serum cytokines were observed or detected. Result After 3 days of intestinal ischemia-reperfusion (I/R), the body weights of rats in EN group significantly decreased when com pared with the pre-I/R levels (P ＜ 0.05), while the body weights of rats in EN + L group were significantly lower than those in ω-PUFA group and ω-PUFA + L group (P ＜ 0. 05). After one day of intestinal ischemia-reperfusion (I/R), the L/M significantly increased in each group (P ＜0.05 or P ＜0. 01). After 3 days of intestinal ischemiareperfusion (I/R) , the L/M were significantly lower than the level one day after ischemia- reperfusion in EN + L group, ω-PUFA group, and ω-PUFA + L group (P ＜ 0.05). The L/M in EN group and EN + L group were significantly higher than that in ω-PUFA + L group (P ＜ 0. 05). The mucosa thickness and villus height of jejunum in ω-PUFA group and ω-PUFA + L group were significantly higher than those in Sham group, EN group, and EN + L group (P ＜ 0. 01 or P ＜ 0. 05). The mucosa thickness and villus height of ileum in ω-PUFA group and ω-PUFA +L group were also significantly higher than those in EN group (P ＜ 0.05). In ω-PUFA + L group, the serum endotoxin level and tumor necrosis factor-α level were significantly lower than those in EN group (P ＜ 0.05), interleukin (IL) -6 level was significantly lower than that in the ω-PUFA group (P ＜ 0.05), and IL-1 β level was significantly lower than those in other groups (P ＜ 0. 05). In EN group, the lung cell apoptosis index was significantly higher than those in other groups (P ＜ 0.05)and the levels of inducible nitric oxide synthase (iNOS)and myeloperoxidase (MPO) were significantly higher than those in ω-PUFA + L group (P ＜ 0. 05). The level of iNOS was also significantly higher in EN + L group than that in ω-PUFA + L group (P ＜ 0.05). Conclusions Sixty minutes of intestinal ischemia can cause intestinal injury, intestinal barrier dysfunction, and increased permeability of intestine. After 72 h of reperfusion, the intestinal injury can be partially recovered and the permeability can be lower than the post-ischemia level; however, bacterial endotoxin translocation and lung apoptotic cells still exist. Intestinal lymphatic ligation can alleviate the lung damage, promote repair of intestinal mucosa, reduce endotoxin translocation, and attenuate the systemic inflammatory response. EN added with ω-3PUFA is remarkably superior to conventional EN.

Change of high mobility group box 1 and effect of drainage of intestine lymph fluid on rat gut barrier during intestine ischemia-reperfusion / 中华临床营养杂志

Objective To investigate the change of high mobility group box 1 ( HMGBI ) after intestine ischemia reperfusion (I/R) in rats, compare the effect of drainage of intestine lymph fluid on gut barrier, and ex- plore the possible mechanism of iachemia-reporfusion injury. Methods Thirty-two Sprague-Dawley (SD) rats (SPF grade) were randomly divided into4 groups with 8 rats in each group: blank group, sham group, intestine is-chemia-reperfusion (I/R) group, and intestine ischemia-reperfusion with drainage of intestine lymph fluid (I/R +drainage) group. Indicators of gut barrier function damage, translocation of endotoxin, and change of HMGB1 and cytokines were detected after intestine ischemia-reperfusion injury. Results The gut barrier function damage and levels of endotoxin, HMGBI, tumour necrosis factor-alpha ( TNF-α), interleukin-6 ( IL-6 ), interleukin-1 beta (IL-1β), and soluble intercellular adhesion molecule-1 (sICAM-1) were significantly lower in blank group and sham group than in I/R group and I/R + drainage group ( P < 0. 05 ). Compared with the intestine I/R + drainage group, the levels of endotoxin and cytokines were significantly higher in the intestine I/R group. The level of HMGB1 was slightly higher than that in the intestine I/R + drainage group, but such difference was not statistically significant ( P > 0. 05 ). lmmunohistochemical staining also revealed that the expression of HMGB1 was significant- ly higher in I/R group than in I/R + drainage group. Conclusions Intestine iachemia-reperfusion injury can lead to the injury of intestine mucosal barrier and increase HMGB1 level HMGB1 may deteriorate gut barrier function and increase the leveh of systemic cytokines. Drainage of lymph fluid can block the gut-lymph pathway and thus decrease the levels of endotoxin and cytokines in systemic circulation and attenuate intestine ischemia-reperfusion injury.

Effect of Toll like receptor 4 and its endogenous ligands in ischemia-reperfusion injury / 基础医学与临床

TLR4 mediates I/R injury involving endogenous ligands.Interaction of TLR4 with endogenous ligands provides a critical link between tissue damage and activation of the innate immune response.In the early phase of liver,kidney,heart,or lung I/R injury,endogenous ligands are secreted from several kinds of cells,they are recognized by TLR4.Interaction of TLR4 with endogenous ligands,such as HMGB1,seems to be the most important trigger of inflammation and initiates signaling cascades leading to inflammatory and immune responses.Blocking the interaction of TLR4 with endogenous ligands may be useful in clinical management of inflammation and cellular necrosis caused by ischemic insults.