BACKGROUND: Liver transplantation is one of the most effective therapeutic options for patients with end-stage liver diseases, and gut microbiota is actively involved in potential infections in pretransplant and postt...BACKGROUND: Liver transplantation is one of the most effective therapeutic options for patients with end-stage liver diseases, and gut microbiota is actively involved in potential infections in pretransplant and posttransplant patients. However, the diversity of gut microbiota and its relationship with the immune parameter of liver transplantation recipients are not well understood. METHODS: We collected fresh feces and blood samples from 190 participants in China from November 2004 to May 2008, including 28 healthy volunteers, 51 cirrhotic patients and 111 liver-transplanted patients. Six interesting gut bacteria, plasma endotoxin, serum cytokines (i.e., tumor necrosis factor alpha and interleukin-6) and fecal secretory IgA (SIgA) were investigated by real-time quantitative PCR, chromogenic limulus amoebocyte assay, sandwich-type enzyme-linked immunosorbent assay and radioimmunoassay, respectively. RESULTS: All Eubacteria, Bifidobacterium spp., Faecalibacterium prausnitzii and Lactobacillus spp. were significantly lower in the liver transplantation recipients while Enterobacteriaceae and Enterococcus spp. were significantly higher (P<0.05). Except for Enterococcus spp., other bacteria showed a tendency to restore to normal level along with the time after liver transplantation. Plasma endotoxin, interleukin-6 and fecal SIgA in cirrhotic patients increased significantly, but not in liver transplantation recipients. Plasma endotoxin and interleukin-6 were negatively correlated with all Eubacteria and the Bacteroides-Prevotella group, while tumor necrosis factor alpha was not significantly correlated with these six gut bacteria in cirrhotic patients.CONCLUSIONS: Our study demonstrates that abundant gut bacteria were altered significantly in both cirrhotic and liver transplantation patients, while plasma endotoxin and interleukin-6 increased remarkably in cirrhotic patients, showing significant correlations with gut microbiota. Interestingly, our data show a tendency for these gut bacteria to restore to normal levels展开更多
目的观察匹多莫德联合氨溴特罗口服液治疗小儿急性支气管炎的临床疗效。方法选取2015年1月—2016年1月三门峡市中心医院收治的急性支气管炎患儿82例,随机分为对照组和治疗组,每组各41例。对照组口服氨溴特罗口服液,未满8个月,2.5 m L/...目的观察匹多莫德联合氨溴特罗口服液治疗小儿急性支气管炎的临床疗效。方法选取2015年1月—2016年1月三门峡市中心医院收治的急性支气管炎患儿82例,随机分为对照组和治疗组,每组各41例。对照组口服氨溴特罗口服液,未满8个月,2.5 m L/次;8个月~1岁,5 m L/次;2~3岁,7.5 m L/次;4~5岁,10 m L/次;6~12岁,15 m L/次,均为2次/d;治疗组在对照组的基础上口服匹多莫德分散片,0.4 g/次,2次/d。两组患儿均连续治疗7 d。比较两组患者临床疗效、临床症状体征消失时间,对比两组治疗前后Ig G、Ig A、Ig M指标水平。结果治疗后,对照组和治疗组的总有效率分别为92.68%和97.56%,两组总有效率比较差异具有统计学意义(P<0.05)。与对照组相比,治疗后治疗组患儿咳嗽及肺部啰音消失的更快,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患儿Ig G、Ig M水平明显升高,治疗组患儿Ig A水平比治疗前明显升高,同组治疗前后差异具有统计学意义(P<0.05);且治疗后治疗组患儿Ig G、Ig A、Ig M水平明显优于对照组,两组比较差异具有统计学意义(P<0.05)。结论匹多莫德联合氨溴特罗口服液治疗小儿急性支气管炎具有良好的临床疗效,症状体征改善明显,具有一定的临床推广应用价值。展开更多
IgA 肾病（IgAN）是我国最常见的原发性肾小球肾炎，患病人群数量大、分布广、异质性强［1］。由于其发病机制认识的局限性及大规模随机试验的缺乏，IgA 肾病的诊疗缺乏统一标准。2009年，由国际 IgA 肾病协作组和肾脏病理协会共同发表...IgA 肾病（IgAN）是我国最常见的原发性肾小球肾炎，患病人群数量大、分布广、异质性强［1］。由于其发病机制认识的局限性及大规模随机试验的缺乏，IgA 肾病的诊疗缺乏统一标准。2009年，由国际 IgA 肾病协作组和肾脏病理协会共同发表了“IgA 肾病牛津分类法”，被认为具有很好的临床实用性，可用于评估预后。2010年，在第七届中华医学会肾脏病学分会组织下，编写出版了《临床诊疗指南·肾脏病学分册》［2］（以下简称中华医学会肾脏病临床诊疗指南），该指南很大程度上规范了我国 IgA 肾病的临床诊治。2012年改善全球肾脏疾病预后组织（KDIGO）公布了广泛被接受的 IgA 肾病治疗指南［3］，进一步规范了 IgA 肾病临床诊治。2014年，中国成人肾病综合征免疫抑制治疗专家组发表了专家共识，其中制定了 IgA 肾病免疫抑制治疗原则。我们对以上指南中的几个重要问题进行分析和解读，以供参考。展开更多
基金supported by the grants from the National Basic Research Program of China (973 program) (2007CB513003)Zhejiang Provincial Science and Technology Bureau Project(2006C23017)
文摘BACKGROUND: Liver transplantation is one of the most effective therapeutic options for patients with end-stage liver diseases, and gut microbiota is actively involved in potential infections in pretransplant and posttransplant patients. However, the diversity of gut microbiota and its relationship with the immune parameter of liver transplantation recipients are not well understood. METHODS: We collected fresh feces and blood samples from 190 participants in China from November 2004 to May 2008, including 28 healthy volunteers, 51 cirrhotic patients and 111 liver-transplanted patients. Six interesting gut bacteria, plasma endotoxin, serum cytokines (i.e., tumor necrosis factor alpha and interleukin-6) and fecal secretory IgA (SIgA) were investigated by real-time quantitative PCR, chromogenic limulus amoebocyte assay, sandwich-type enzyme-linked immunosorbent assay and radioimmunoassay, respectively. RESULTS: All Eubacteria, Bifidobacterium spp., Faecalibacterium prausnitzii and Lactobacillus spp. were significantly lower in the liver transplantation recipients while Enterobacteriaceae and Enterococcus spp. were significantly higher (P<0.05). Except for Enterococcus spp., other bacteria showed a tendency to restore to normal level along with the time after liver transplantation. Plasma endotoxin, interleukin-6 and fecal SIgA in cirrhotic patients increased significantly, but not in liver transplantation recipients. Plasma endotoxin and interleukin-6 were negatively correlated with all Eubacteria and the Bacteroides-Prevotella group, while tumor necrosis factor alpha was not significantly correlated with these six gut bacteria in cirrhotic patients.CONCLUSIONS: Our study demonstrates that abundant gut bacteria were altered significantly in both cirrhotic and liver transplantation patients, while plasma endotoxin and interleukin-6 increased remarkably in cirrhotic patients, showing significant correlations with gut microbiota. Interestingly, our data show a tendency for these gut bacteria to restore to normal levels
文摘目的观察匹多莫德联合氨溴特罗口服液治疗小儿急性支气管炎的临床疗效。方法选取2015年1月—2016年1月三门峡市中心医院收治的急性支气管炎患儿82例,随机分为对照组和治疗组,每组各41例。对照组口服氨溴特罗口服液,未满8个月,2.5 m L/次;8个月~1岁,5 m L/次;2~3岁,7.5 m L/次;4~5岁,10 m L/次;6~12岁,15 m L/次,均为2次/d;治疗组在对照组的基础上口服匹多莫德分散片,0.4 g/次,2次/d。两组患儿均连续治疗7 d。比较两组患者临床疗效、临床症状体征消失时间,对比两组治疗前后Ig G、Ig A、Ig M指标水平。结果治疗后,对照组和治疗组的总有效率分别为92.68%和97.56%,两组总有效率比较差异具有统计学意义(P<0.05)。与对照组相比,治疗后治疗组患儿咳嗽及肺部啰音消失的更快,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患儿Ig G、Ig M水平明显升高,治疗组患儿Ig A水平比治疗前明显升高,同组治疗前后差异具有统计学意义(P<0.05);且治疗后治疗组患儿Ig G、Ig A、Ig M水平明显优于对照组,两组比较差异具有统计学意义(P<0.05)。结论匹多莫德联合氨溴特罗口服液治疗小儿急性支气管炎具有良好的临床疗效,症状体征改善明显,具有一定的临床推广应用价值。
文摘IgA 肾病（IgAN）是我国最常见的原发性肾小球肾炎，患病人群数量大、分布广、异质性强［1］。由于其发病机制认识的局限性及大规模随机试验的缺乏，IgA 肾病的诊疗缺乏统一标准。2009年，由国际 IgA 肾病协作组和肾脏病理协会共同发表了“IgA 肾病牛津分类法”，被认为具有很好的临床实用性，可用于评估预后。2010年，在第七届中华医学会肾脏病学分会组织下，编写出版了《临床诊疗指南·肾脏病学分册》［2］（以下简称中华医学会肾脏病临床诊疗指南），该指南很大程度上规范了我国 IgA 肾病的临床诊治。2012年改善全球肾脏疾病预后组织（KDIGO）公布了广泛被接受的 IgA 肾病治疗指南［3］，进一步规范了 IgA 肾病临床诊治。2014年，中国成人肾病综合征免疫抑制治疗专家组发表了专家共识，其中制定了 IgA 肾病免疫抑制治疗原则。我们对以上指南中的几个重要问题进行分析和解读，以供参考。
