目的:调查国内多器官功能障碍综合征(multiple organ dysfunction syndrome,MODS)患者胃肠功能损伤的流行病学情况。方法:采用多中心、前瞻性调查方法,分析2002年3月—2005年1月全国11省市的37家三级医院1087例MODS患者的病历资料。结果...目的:调查国内多器官功能障碍综合征(multiple organ dysfunction syndrome,MODS)患者胃肠功能损伤的流行病学情况。方法:采用多中心、前瞻性调查方法,分析2002年3月—2005年1月全国11省市的37家三级医院1087例MODS患者的病历资料。结果:1087例患者中,胃肠功能损伤的发生率、病死率分别为78.8%、61.7%。其中入住重症监护室(ICU)患者其28d病死率为58.9%。MODS患者胃肠功能损伤发生及死亡的高危因素分别为存在腹水、未应用或未适当应用肠内营养,用用肾上腺素等。结论:MODS患者胃肠功能损伤发生率高,其发生高危因素及死亡高危因素与腹水、肠内营养的应用等相关。患有胃肠功能损伤的MODS患者其入住ICU28d病死率较非胃肠功能损伤患者显著升高。展开更多
目的：观察宣肺通腑汤治疗中老年重症肺炎合并胃肠功能障碍的疗效及对胃肠功能的保护作用及对炎症因子的影响。方法：将104例符合要求的患者随机分为对照组和观察组各52例。对照组给予抗感染治疗、抗炎治疗、对症治疗及支持治疗,给予枸...目的：观察宣肺通腑汤治疗中老年重症肺炎合并胃肠功能障碍的疗效及对胃肠功能的保护作用及对炎症因子的影响。方法：将104例符合要求的患者随机分为对照组和观察组各52例。对照组给予抗感染治疗、抗炎治疗、对症治疗及支持治疗,给予枸橼酸莫沙必利口服溶液,10 m L/次,3次/d,口服;双歧杆菌三联活菌散,2 g/次,3次/d,口服。观察组在对照组治疗的基础上给予宣肺通腑汤,1剂/d。两组疗程均连续治疗14 d。记录治疗前后CURB65,SMART-COP,临床肺部感染评分（CPIS）,中医证候评分、胃肠功能障碍（GIDF）,急性病生理和长期健康Ⅱ评分（APACHEⅡ）和多器官功能障碍综合征（MODS）评分,检测治疗前后血清胃动素（MTL）,胃泌素（GAS）,D-乳酸,二胺氧化酶（DAO）,降钙素原（PCT）,白细胞介素-6（IL-6）,IL-8,肿瘤坏死因子-α（TNF-α）水平;记录ICU病死率（2周内）,ICU住院日、机械通气时间。结果：观察组患者临床疗效愈显率为59.62%,高于对照组愈显率38.46%（χ^2=4.6564,P〈0.05）;观察组机械通气时间和ICU住院日均短于对照组（P〈0.01）,观察组ICU病死率11.54%,低于对照组病死率15.38%,组间比较差异无统计学意义;观察组患者CURB65,SMART-COP,CPIS,中医证候,GIDF,APACHEⅡ和MODS评分均低于对照组（P〈0.01）;观察组血清GAS,D-乳酸和DAO水平均低于对照组,MTL水平高于对照组（P〈0.01）;观察组患者血清PCT,TNF-α,IL-6和IL-8水平均低于对照组（P〈0.01）。结论：在西医常规治疗的基础上,宣肺通腑汤辅助治疗重症肺炎合并GIDF患者,可控制临床症状,调节胃肠激素,促进肠黏膜屏障修复和胃肠功能恢复,抑制炎症反应,减轻病情程度,缩短了疾病的愈合时间。展开更多
The aim of this study was to compare the structure of gut microbiota in Parkinson's disease(PD) patients and healthy controls;and to explore correlations between gut microbiota and PD clinical features. We analyze...The aim of this study was to compare the structure of gut microbiota in Parkinson's disease(PD) patients and healthy controls;and to explore correlations between gut microbiota and PD clinical features. We analyzed fecal bacterial composition of 24 PD patients and 14 healthy volunteers by using 16 S rRNA sequencing. There were significant differences between PD and healthy controls, as well as among different PD stages. The putative cellulose degrading bacteria from the genera Blautia(P=0.018),Faecalibacterium(P=0.048) and Ruminococcus(P=0.019) were significantly decreased in PD compared to healthy controls.The putative pathobionts from the genera Escherichia-Shigella(P=0.038), Streptococcus(P=0.01), Proteus(P=0.022), and Enterococcus(P=0.006) were significantly increased in PD subjects. Correlation analysis indicated that disease severity and PD duration negatively correlated with the putative cellulose degraders, and positively correlated with the putative pathobionts. The results suggest that structural changes of gut microbiota in PD are characterized by the decreases of putative cellulose degraders and the increases of putative pathobionts, which may potentially reduce the production of short chain fatty acids, and produce more endotoxins and neurotoxins; and these changes is potentially associated with the development of PD pathology.展开更多
目的:分析大承气汤治疗胃肠功能障碍患者的作用及临床疗效。方法:计算机检索Pub Med、CBMdisc、重庆维普、中国知网和万方数据库,查找有关应用大承气汤治疗胃肠功能障碍的文献,根据文献纳入标准进行筛选,Rev Man 5.2软件对纳入文献进行M...目的:分析大承气汤治疗胃肠功能障碍患者的作用及临床疗效。方法:计算机检索Pub Med、CBMdisc、重庆维普、中国知网和万方数据库,查找有关应用大承气汤治疗胃肠功能障碍的文献,根据文献纳入标准进行筛选,Rev Man 5.2软件对纳入文献进行Meta分析。结果:最终纳入13个研究,共1308名病例。Meta分析结果显示,大承气汤能有效改善胃肠功能障碍患者的临床症状,提高临床疗效,缩短住院时间,其差异有统计学意义。结论:大承气汤对胃肠功能障碍的疗效优于单独常规的西医治疗,在临床上具有良好的应用前景。展开更多
Background In 2012,the working group on abdominal problems of the European Society of Intensive Care Medicine （ESICM） proposed a definition and also guidelines for the grading system and treatment of acute gastroint...Background In 2012,the working group on abdominal problems of the European Society of Intensive Care Medicine （ESICM） proposed a definition and also guidelines for the grading system and treatment of acute gastrointestinal injury （AGI）.Until now,clinical reports on this topic have not been available,and the practicality of using the AGI grading system requires further validation in the clinic.Therefore,we conducted this study to evaluate the feasibility of utilizing the current AGI grading system in a clinical environment,and to provide evidence for its usefulness in assessing the severity and prognosis of critically ill patients with gastrointestinal dysfunction.Methods A total of 133 patients were examined for the presence or absence of AGI,their scores on the Acute Physiology and Chronic Health Evaluation （APACHE） Ⅱ and Lausanne Intestinal Failure Estimation （LIFE） test,and 28 days mortality.The presence and severity of AGI was based on guidelines provided by the ESICM.The patients were assigned to a NOAGI group （n=50） or an AGI group （n=83）.The AGI group was then further divided into three subgroups,consisting ofAGI Ⅰ （risk group,n=38）,AGI Ⅱ （gastrointestinal dysfunction group,n=33） and AGI Ⅲ＋AGI Ⅳ （gastrointestinal failure group,n=12）.These subgroups were then compared for differences in AGI indicators.Results There were no statistically significant differences between the AGI group and the NO-AGI group in terms of age,gender,APACHE Ⅱ score or LIFE score （P ＞ 0.05）; however,the two groups showed a significant difference in their respective rates of 28 days mortality （32.5％ in the AGI group vs.8.0％ in the NO-AGI group （P ＜ 0.05））.Patients in the three AGI subgroups showed significant differences in their 28 d mortality rates,APACHE Ⅱ,and LIFE scores.AGI grading system showed strong positive correlations with APACHE Ⅱ and LIFE scores （P ＜ 0.05）.Conclusions The currentAGI grading system can be used to identify and evaluate gastroint展开更多
文摘目的:调查国内多器官功能障碍综合征(multiple organ dysfunction syndrome,MODS)患者胃肠功能损伤的流行病学情况。方法:采用多中心、前瞻性调查方法,分析2002年3月—2005年1月全国11省市的37家三级医院1087例MODS患者的病历资料。结果:1087例患者中,胃肠功能损伤的发生率、病死率分别为78.8%、61.7%。其中入住重症监护室(ICU)患者其28d病死率为58.9%。MODS患者胃肠功能损伤发生及死亡的高危因素分别为存在腹水、未应用或未适当应用肠内营养,用用肾上腺素等。结论:MODS患者胃肠功能损伤发生率高,其发生高危因素及死亡高危因素与腹水、肠内营养的应用等相关。患有胃肠功能损伤的MODS患者其入住ICU28d病死率较非胃肠功能损伤患者显著升高。
文摘目的：观察宣肺通腑汤治疗中老年重症肺炎合并胃肠功能障碍的疗效及对胃肠功能的保护作用及对炎症因子的影响。方法：将104例符合要求的患者随机分为对照组和观察组各52例。对照组给予抗感染治疗、抗炎治疗、对症治疗及支持治疗,给予枸橼酸莫沙必利口服溶液,10 m L/次,3次/d,口服;双歧杆菌三联活菌散,2 g/次,3次/d,口服。观察组在对照组治疗的基础上给予宣肺通腑汤,1剂/d。两组疗程均连续治疗14 d。记录治疗前后CURB65,SMART-COP,临床肺部感染评分（CPIS）,中医证候评分、胃肠功能障碍（GIDF）,急性病生理和长期健康Ⅱ评分（APACHEⅡ）和多器官功能障碍综合征（MODS）评分,检测治疗前后血清胃动素（MTL）,胃泌素（GAS）,D-乳酸,二胺氧化酶（DAO）,降钙素原（PCT）,白细胞介素-6（IL-6）,IL-8,肿瘤坏死因子-α（TNF-α）水平;记录ICU病死率（2周内）,ICU住院日、机械通气时间。结果：观察组患者临床疗效愈显率为59.62%,高于对照组愈显率38.46%（χ^2=4.6564,P〈0.05）;观察组机械通气时间和ICU住院日均短于对照组（P〈0.01）,观察组ICU病死率11.54%,低于对照组病死率15.38%,组间比较差异无统计学意义;观察组患者CURB65,SMART-COP,CPIS,中医证候,GIDF,APACHEⅡ和MODS评分均低于对照组（P〈0.01）;观察组血清GAS,D-乳酸和DAO水平均低于对照组,MTL水平高于对照组（P〈0.01）;观察组患者血清PCT,TNF-α,IL-6和IL-8水平均低于对照组（P〈0.01）。结论：在西医常规治疗的基础上,宣肺通腑汤辅助治疗重症肺炎合并GIDF患者,可控制临床症状,调节胃肠激素,促进肠黏膜屏障修复和胃肠功能恢复,抑制炎症反应,减轻病情程度,缩短了疾病的愈合时间。
基金supported by Future Life Sciences International Ltd.(NSBJ01032014,http://ffsi.jpl)
文摘The aim of this study was to compare the structure of gut microbiota in Parkinson's disease(PD) patients and healthy controls;and to explore correlations between gut microbiota and PD clinical features. We analyzed fecal bacterial composition of 24 PD patients and 14 healthy volunteers by using 16 S rRNA sequencing. There were significant differences between PD and healthy controls, as well as among different PD stages. The putative cellulose degrading bacteria from the genera Blautia(P=0.018),Faecalibacterium(P=0.048) and Ruminococcus(P=0.019) were significantly decreased in PD compared to healthy controls.The putative pathobionts from the genera Escherichia-Shigella(P=0.038), Streptococcus(P=0.01), Proteus(P=0.022), and Enterococcus(P=0.006) were significantly increased in PD subjects. Correlation analysis indicated that disease severity and PD duration negatively correlated with the putative cellulose degraders, and positively correlated with the putative pathobionts. The results suggest that structural changes of gut microbiota in PD are characterized by the decreases of putative cellulose degraders and the increases of putative pathobionts, which may potentially reduce the production of short chain fatty acids, and produce more endotoxins and neurotoxins; and these changes is potentially associated with the development of PD pathology.
文摘目的:分析大承气汤治疗胃肠功能障碍患者的作用及临床疗效。方法:计算机检索Pub Med、CBMdisc、重庆维普、中国知网和万方数据库,查找有关应用大承气汤治疗胃肠功能障碍的文献,根据文献纳入标准进行筛选,Rev Man 5.2软件对纳入文献进行Meta分析。结果:最终纳入13个研究,共1308名病例。Meta分析结果显示,大承气汤能有效改善胃肠功能障碍患者的临床症状,提高临床疗效,缩短住院时间,其差异有统计学意义。结论:大承气汤对胃肠功能障碍的疗效优于单独常规的西医治疗,在临床上具有良好的应用前景。
文摘Background In 2012,the working group on abdominal problems of the European Society of Intensive Care Medicine （ESICM） proposed a definition and also guidelines for the grading system and treatment of acute gastrointestinal injury （AGI）.Until now,clinical reports on this topic have not been available,and the practicality of using the AGI grading system requires further validation in the clinic.Therefore,we conducted this study to evaluate the feasibility of utilizing the current AGI grading system in a clinical environment,and to provide evidence for its usefulness in assessing the severity and prognosis of critically ill patients with gastrointestinal dysfunction.Methods A total of 133 patients were examined for the presence or absence of AGI,their scores on the Acute Physiology and Chronic Health Evaluation （APACHE） Ⅱ and Lausanne Intestinal Failure Estimation （LIFE） test,and 28 days mortality.The presence and severity of AGI was based on guidelines provided by the ESICM.The patients were assigned to a NOAGI group （n=50） or an AGI group （n=83）.The AGI group was then further divided into three subgroups,consisting ofAGI Ⅰ （risk group,n=38）,AGI Ⅱ （gastrointestinal dysfunction group,n=33） and AGI Ⅲ＋AGI Ⅳ （gastrointestinal failure group,n=12）.These subgroups were then compared for differences in AGI indicators.Results There were no statistically significant differences between the AGI group and the NO-AGI group in terms of age,gender,APACHE Ⅱ score or LIFE score （P ＞ 0.05）; however,the two groups showed a significant difference in their respective rates of 28 days mortality （32.5％ in the AGI group vs.8.0％ in the NO-AGI group （P ＜ 0.05））.Patients in the three AGI subgroups showed significant differences in their 28 d mortality rates,APACHE Ⅱ,and LIFE scores.AGI grading system showed strong positive correlations with APACHE Ⅱ and LIFE scores （P ＜ 0.05）.Conclusions The currentAGI grading system can be used to identify and evaluate gastroint
