AIM:To study the therapeutic efficacy of a new transnasal ileus tube advanced endoscopically for adhesive small bowel obstruction.METHODS:A total of 186 patients with adhesive small bowel obstruction treated from Sept...AIM:To study the therapeutic efficacy of a new transnasal ileus tube advanced endoscopically for adhesive small bowel obstruction.METHODS:A total of 186 patients with adhesive small bowel obstruction treated from September 2007 to February 2011 were enrolled into this prospective randomized controlled study.The endoscopically advanced new ileus tube was used for gastrointestinal decompression in 96 patients and ordinary nasogastric tube(NGT) was used in 90 patients.The therapeutic efficacy was compared between the two groups.RESULTS:Compared with the NGT group,the ileus tube group experienced significantly shorter time for relief of clinical symptoms and improvement in the findings of abdominal radiograph(4.1 ± 2.3 d vs 8.5 ± 5.0 d) and laboratory tests(P < 0.01).The overall effectiveness rate was up to 89.6% in the ileus tube group and 46.7% in the NGT group(P < 0.01).And 10.4% of the patients in the ileus tube group and 53.3% of the NGT group underwent surgery.For recurrent adhesive bowel obstruction,ileus tube was also significantly more effective than NGT(95.8% vs 31.6%).In the ileus tube group,the drainage output on the first day and the length of hospital stay were significantly different depending on the treatment success or failure(P < 0.05).The abdominal radiographic improvement was correlated with whether or not the patient underwent surgery.CONCLUSION:Ileus tube can be used for adhesive small bowel obstruction.Endoscopic placement of the ileus tube is convenient and worthy to be promoted despite the potential risks.展开更多
Background： In vitro experiments have revealed that toll-like receptor 4 （TLR4） pathway is involved in the progression ofimmunoglobulin A nephropathy （IgAN） by induction of proinflammatory cytokines. Evidence sho...Background： In vitro experiments have revealed that toll-like receptor 4 （TLR4） pathway is involved in the progression ofimmunoglobulin A nephropathy （IgAN） by induction of proinflammatory cytokines. Evidence showed that, in other disease models, peroxisome proliferator-activated receptor-7 （PPAR-7） agonists have been shown to exert anti-inflammatory effects through suppression of the expression and activity of TLR4. However, the interaction between PPAR-7 and TLR4 in IgAN has not been fully studied both in vitro and in vivo. In this study, we explored whether TLR4 pathway attributed to the progression of IgAN in experimental rats. Methods： Bovine gamma globulin was used to establish IgAN model. Fifty-four Lewis rats were randomly divided into six groups： ControliaK242, IgANTAK242, toll-like receptor 4 inhibitor （TAK242） groups （rats were administrated with TLR4 inhibitor, TAK242） and Controlpo, IgANpo, Pio groups （rats were administrated with PPAR-y agonist, pioglitazone）. Urinary albumin-to-creatinine ratio （ACR）, serum creatinine, and blood urea nitrogen were detected by automatic biochemical analyzer. Renal histopathological changes were observed after hematoxylin-eosin staining, and the IgA deposition in glomeruli was measured by immunofluorescence staining. Real-time polymerase chain reaction and Western blotting were used to detect TLR4 and interleukin- 1 beta （IL- 1β） message ribonucleic acid （mRNA） and protein expression in renal tissues. Results were presented as mean -4- standard deviation. Differences between groups were analyzed by one-way analysis of variance. Results： Compared to normal rats, experimental rats showed higher ACR （4.45 ± 1.33 mg/mmol vs. 2.89 ± 0.96 mg/mmol, P 〈 0.05）, obvious IgA deposition with mesangial hypercellularity, hyperplasia of mesangial matrix accompanied by increased serum IL-Iβ （48.28 ± 13.49 μg/ml vs. 35.56 ± 7.41μg/ml, P 〈 0.05）, and renal expression of IL-Iβ and TLR4. The biochemical parameters and rena展开更多
文摘AIM:To study the therapeutic efficacy of a new transnasal ileus tube advanced endoscopically for adhesive small bowel obstruction.METHODS:A total of 186 patients with adhesive small bowel obstruction treated from September 2007 to February 2011 were enrolled into this prospective randomized controlled study.The endoscopically advanced new ileus tube was used for gastrointestinal decompression in 96 patients and ordinary nasogastric tube(NGT) was used in 90 patients.The therapeutic efficacy was compared between the two groups.RESULTS:Compared with the NGT group,the ileus tube group experienced significantly shorter time for relief of clinical symptoms and improvement in the findings of abdominal radiograph(4.1 ± 2.3 d vs 8.5 ± 5.0 d) and laboratory tests(P < 0.01).The overall effectiveness rate was up to 89.6% in the ileus tube group and 46.7% in the NGT group(P < 0.01).And 10.4% of the patients in the ileus tube group and 53.3% of the NGT group underwent surgery.For recurrent adhesive bowel obstruction,ileus tube was also significantly more effective than NGT(95.8% vs 31.6%).In the ileus tube group,the drainage output on the first day and the length of hospital stay were significantly different depending on the treatment success or failure(P < 0.05).The abdominal radiographic improvement was correlated with whether or not the patient underwent surgery.CONCLUSION:Ileus tube can be used for adhesive small bowel obstruction.Endoscopic placement of the ileus tube is convenient and worthy to be promoted despite the potential risks.
文摘Background： In vitro experiments have revealed that toll-like receptor 4 （TLR4） pathway is involved in the progression ofimmunoglobulin A nephropathy （IgAN） by induction of proinflammatory cytokines. Evidence showed that, in other disease models, peroxisome proliferator-activated receptor-7 （PPAR-7） agonists have been shown to exert anti-inflammatory effects through suppression of the expression and activity of TLR4. However, the interaction between PPAR-7 and TLR4 in IgAN has not been fully studied both in vitro and in vivo. In this study, we explored whether TLR4 pathway attributed to the progression of IgAN in experimental rats. Methods： Bovine gamma globulin was used to establish IgAN model. Fifty-four Lewis rats were randomly divided into six groups： ControliaK242, IgANTAK242, toll-like receptor 4 inhibitor （TAK242） groups （rats were administrated with TLR4 inhibitor, TAK242） and Controlpo, IgANpo, Pio groups （rats were administrated with PPAR-y agonist, pioglitazone）. Urinary albumin-to-creatinine ratio （ACR）, serum creatinine, and blood urea nitrogen were detected by automatic biochemical analyzer. Renal histopathological changes were observed after hematoxylin-eosin staining, and the IgA deposition in glomeruli was measured by immunofluorescence staining. Real-time polymerase chain reaction and Western blotting were used to detect TLR4 and interleukin- 1 beta （IL- 1β） message ribonucleic acid （mRNA） and protein expression in renal tissues. Results were presented as mean -4- standard deviation. Differences between groups were analyzed by one-way analysis of variance. Results： Compared to normal rats, experimental rats showed higher ACR （4.45 ± 1.33 mg/mmol vs. 2.89 ± 0.96 mg/mmol, P 〈 0.05）, obvious IgA deposition with mesangial hypercellularity, hyperplasia of mesangial matrix accompanied by increased serum IL-Iβ （48.28 ± 13.49 μg/ml vs. 35.56 ± 7.41μg/ml, P 〈 0.05）, and renal expression of IL-Iβ and TLR4. The biochemical parameters and rena
