目的 探讨新生儿坏死性小肠结肠炎(NEC)炎症损伤与肠道微生态-LPS-TLR4通路之间的关系。方法 本研究收集2019年3月1日—2021年1月31日在中山市人民医院新生儿监护室确诊为NEC新生儿11例为实验组,随机选取30 例同期在新生儿科病房住院喂养顺利,排除NEC及败血症诊断的新生儿为对照组。采集2组新生儿的粪便标本,进行Real-time PCR表达谱分析2组粪便肠道菌群;取2组外周静脉血检测外周血单核细胞Toll样受体4(TLR4)和血清PCT、CRP、IL-6、SAA等指标,对比2组肠道菌群、外周血单核细胞TLR4和炎症指标水平,通过统计学分析组间差异。结果 本研究结果提示实验组变形菌门占82%(9/11),厚壁菌门占9%(1/11),放线菌门占9%(1/11),对照组变形菌门占20%(6/30),厚壁菌门占73%(22/30),放线菌门占7%(2/30),2组患儿的粪便肠道菌群分布有差异(χ²=11.521,P<0.05);实验组患儿外周血单核细胞TLR4水平高于对照组,组间差异有统计学意义(P<0.001);实验组患儿血清PCT、CRP、IL-6和SAA等炎症指标高于对照组,组间差异有统计学意义(P<0.001)。结论 NEC患儿的肠道菌群以变形菌门为主,伴外周血单核细胞TLR4和外周血炎症指标升高。可见,肠道微生态-LPS-TLR4通路可能与新生儿坏死性小肠结肠炎炎症损伤相关,具体的机制仍需进一步深入研究。

Objective To investigate the relationship between intestinal flora-LPS-TLR4 pathway and the inflammatory injury of neonatal necrotizing enterocolitis (NEC). Methods Eleven neonates with NEC from March, 2019 to January, 2021 were enrolled as the experimental group, and 30 neonates without NEC and septicemia who were admitted in the department of neonatology in the same period were included as the control group. Faecal flora from the two groups were collected and analyzed by Real-time PCR. Toll-like receptor 4 (TLR4) and serum PCT, CRP, IL-6, SAA in peripheral blood were measured. The intestinal flora, the expression of TLR4 in peripheral blood leukocytes and inflammatory markers were compared between two groups. Results It showed that the ratio of Proteobacteria was 82% (9/11), Firmicutes was 9% (1/11), Actinobacteria was 9% (1/11) in the experimental group. In the control group, the ratio of Proteobacteria was 20% (6/30), Firmicutes was 73% (22/30), Actinobacteria was 7% (2/30). There was a significant difference in the distribution of faecal flora between the two groups (χ² = 11.521, P<0.05), and the level of TLR4 in peripheral blood of the experimental group was significantly higher than that of the control group (P＜0.001). The levels of serum PCT, CRP, IL-6 and SAA in the experimental group were significantly higher than those in the control group (P＜0.001). Conclusions The main intestinal flora of neonates with NEC is Proteobacteria, with elevated TLR4 expression and inflammatory markers in peripheral blood. Therefore, the intestinal flora-LPS-TLR4 pathway may be associated with inflammatory injury in neonatal necrotizing enterocolitis.The specific mechanism still needs further study.

目的 分析闽西南地区在院炎症性肠病患者流行病学资料,从而加强对炎症性肠病的认识。方法 回顾性研究炎症性肠病患者临床特点及用药情况。结果 纳入317例炎症性肠病,克罗恩病占212例,男女之比 2.07:1,溃疡性结肠炎占105例,男女比例1.84:1。克罗恩病患者确诊平均年龄29岁,以患A2型为主,溃疡性结肠炎者确诊平均年龄44岁。女性B2型比例明显高于男性。溃疡性结肠炎患者的病变部位主要为E3型(44.8%)。结论 炎症性肠病患者临床表现多样。克罗恩病确诊年龄主要是A2型, L3型是主要病变部位分型,B2型是疾病行为主要分型。E3型是溃疡性结肠炎患者的主要病变部位。克罗恩病多以免疫抑制剂和生物制剂治疗,糖皮质激素和5-ASA类制剂是轻中度的UC患者主要治疗措施。生物制剂、糖皮质激素治疗多用于重度UC患者。

Objective To analyze the epidemiological data of inflammatory bowel disease (IBD)patients in southwest Fujian Province, so as to improve the understanding of IBD. Methods To retrospectively study the clinical characteristics and medication of inflammatory bowel disease patients. Results A total of 317 IBD patients were included.Crohn's disease accounted for 212 cases, with a male-to-female ratio of 2.07:1, and ulcerative colitis accounted for 105 cases, with a male-to-female ratio of 1.84:1.Patients with Crohn's disease were diagnosed at an average age of 29, mainly with type A2, while patients with ulcerative colitis were diagnosed at an average age of 44. The proportion of female with type B2 was significantly higher than that of male.The lesions of ulcerative colitis patients were mainly type E3 (44.8%).Conclusions Patients with IBD had diverse clinical manifestations.The age of diagnosis of Crohn's disease was mainly type A2, type L3 was the main lesion, type B2 was the main disease classification.Crohn's disease was mainly treated with immunosuppressive and biological therapy. Glucocorticoids and 5-ASA were the main treatment for patients with mild-to-moderate ulcerative colitis. Biological agents and glucocorticoid therapy were mostly used in severe patients.

目的 观察牙周基础治疗联合口腔正畸对牙周炎患者炎症细胞因子的疗效分析。方法 以2017年4月—2018年5月于我院医院进行治疗的82例牙周炎患者为研究对象,按随机数字表法分为研究组(41例,给予牙周基础治疗联合口腔正畸)和对照组(41例,口腔正畸)。观察两组患者治疗后临床疗效,对比治疗前后两组患者牙周指数情况、血清炎症因子及咀嚼功能。结果 治疗1周后,研究组有效率高于对照组(97.56% vs 82.93%),组间比较(P<0.05)。治疗前,两组SBI、PLI、GI比较(P＞0.05);治疗1周后,两组SBI、PLI、GI均低于治疗前,与对照组SBI、PLI、GI比较,研究组降低,组间比较(P<0.05)。治疗前,两组AL、PD比较(P＞0.05);治疗1周后,两组AL、PD均低于治疗前,与对照组AL、PD比较,研究组降低,组间比较(P<0.05)。治疗前,两组TNF-α、IL-8及IL-6水平比较(P＞0.05);治疗1周后,两组TNF-α、IL-8及IL-6水平均低于治疗前,与对照组TNF-α、IL-8及IL-6水平比较,研究组下降明显,组间比较(P<0.05)。治疗前,研究组及对照组的咀嚼功能分别为(51±2)分、(52±2)分,两组比较(P＞0.05);治疗后1周,研究组及对照组的咀嚼功能分别为(85±4)分、(73±3)分,研究组咀嚼功能明显高于对照组,组间比较(P<0.05)。结论 牙周基础治疗联合口腔正畸治疗牙周炎患者效果确切,可降低炎症反应,值得临床推广应用。

目的 分析慢性肾衰竭患者接受肾衰康方治疗对其血清微炎症状态的影响及肾功能的保护作用。方法 将2020年1月—2020年12月作为研究时间段,选取期间广东祈福医院接诊的50例慢性肾衰竭患者,另将随机数字表法作为分组依据,将全部病例分为对照组(行常规治疗,纳入25例)、观察组(加用肾衰康方治疗,纳入25例),对组间中医症状评分、血清微炎症状态、肾功能指标、氧化应激指标展开分析。结果 组间中医症状评分、血清微炎症状态、肾功能指标、氧化应激指标在治疗前无明显差异,P>0.05;观察组中医症状评分、血清微炎症状态、肾功能指标、氧化应激指标在治疗后优于对照组,P<0.05。结论 肾衰康方对改善慢性肾衰竭患者血清微炎症状态、氧化应激水平、临床症状均有较好效果,且能保护肾功能,值得推广。

Objective To analyze the effect of Shenshuaikang decoction on serum microinflammation and renal function in patients with chronic renal failure. Methods From January 2020 to December 2020, 50 patients with chronic renal failure treated by Clifford Hospital were selected, and the random number table method was used for grouping. All cases were divided into control group (n=25) and observation group (n=25). The TCM symptom score, serum microinflammatory state, renal function index and oxidative stress index were analyzed. Results There were no significant differences in TCM symptom score, serum microinflammatory state, renal function index and oxidative stress index between the two groups before treatment, P>0.05; the TCM symptom score, serum microinflammatory state, renal function index and oxidative stress index of the observation group were better than those of the control group after treatment, P<0.05. Conclusion Shenshuaikang decoction has good effect on improving serum microinflammation, oxidative stress level and clinical symptoms of patients with chronic renal failure, and also can protect renal function, which is worthy of promotion.

目的 比较压力控制通气(PCV)中不同吸气流速对单肺通气(OLV)患者呼吸功能及炎症因子的影响。方法 本研究为2018—2019年对75例单肺通气患者的前瞻性研究。患者在麻醉和单肺通气(OLV)后随机分为吸气流量30 L/min(A组)、50 L/min(B组)或70 L/min(C组)。比较OLV前(T₀)、OLV后30 min(T₁)、60 min(T₂)和120 min(T₃)的呼吸力学、呼吸功能、血流动力学和血气分析,中心静脉血检测分析IL- 6、IL-8、TNF-α和sICAM-1,观察术后3天肺部并发症和ARDS的发生情况。结果 三组一般情况、血流动力学指标差异均无统计学意义(P＞0.05);B组、C组PaCO₂较A组降低(P<0.05);与T₀时比较,T₁-T₃时三组PaO_2、SVO₂均降低(P<0.05);三组PH、SO₂和HB差异均无统计学意义(P>0.05)。与A组比较,B组、C组ΔVT增大(P<0.05);三组Ppeak差异无统计学意义;与A组比较,B组、C组PEEP均增大(P<0.05);与A组比较,T₁-T₃时B组、C组V_D/V_T减少(P>0.05);与T₀比较,T₁-T₃时三组Qs/Qt增加(P<0.05);与A组比较,T₁-T₃时B组、C组Cdyn增大(P<0.05);与T₀相比,T₁-T₃时三组PaO₂/FiO₂降低(P<0.05);与T₀相比,T₁-T₃时三组IL-6、IL-8、TNF-α和sICAM-1的浓度增多(P<0.05),但A组、B组低于C组(P<0.05)。三组患者发生术后肺部并发症和ARDS差异均无统计学意义。结论 在PCV模式下通过增加吸气流速能增加VT,减少死腔率,促进 CO₂的交换,并且改善肺动态顺应性,但并不能很好的改善氧合及肺内分流。吸气流速50 mL/L在较小炎症反应的情况下达到上述改善呼吸功能和呼吸力学,可推荐应用于进行OLV患者。

Objective The effects of different inspiratory velocity PCV on respiratory function and inflammatory factors in patients with one-lung ventilation OLV were compared. Methods This was a prospective study of 75 patients with one-lung ventilation in 2018-2019. The subjects were randomized to the inspiratory velocity 30(group A),50(group B)or 70(group C)L/min after anesthesia and one-lung ventilation OLV. Respiratory mechanics,respiratory function,hemodynamics and blood gas parameters were compared between the three groups pre-OLV(T₀)and after 30 (T₁), 60 (T₂), and 120 (T₃)minutes of OLV.Center venous blood was collected to measure interleukin (IL)-6, IL-8,tumor necrosis factor (TNF)-α,andsoluble intercellular adhesion molecule-1 levels.Observation of pulmonary complications and occurrence of ARDS 3 days after operation were made. Results Hemodynamic and general patient status were similar between the three groups (all P>0.05). PaCO₂was lower in the group B and group C compared with the group A (P<0.05). Compared with T₀, PaO₂ and SVO₂were lower at T₁-T₃of the three groups(P<0.05). PH, SO2 and HB were similar between the three groups (all P>0.05).ΔVT was higher in the group B and group C compared with the group A (P<0.05);Ppeak were similar between the three groups (all P>0.05). PEEP was higher in the group B and group C compared with the group A (P<0.05); V_D/V_T decreased in the group B and group C compared with the group A (P<0.05).Compared with T₀,Qs/Qt increased at T₁-T₃ of the three groups (all P<0.05). Cdyn increased at T₁-T₃ of the group B and group C(all P<0.05). PaO₂/FiO₂ decreased at T₁-T₃ of the three groups(all P<0.05).Compared with T₀, the concentrations of Il-6, Il-8, TNF-α and sICAM-1 increased at T₁-T₃of three groups (P<0.05), and in group A and group B were lower than those in group C (P<0.05).The number of patients who had postoperative pulmonary complications PPCS or acute respiratory distress syndrome(ARDS)were similar between the three groups (all P>0.05). Conclusion In PCV mode, it can increase VT by increasing the inspiratory velocity, reduce the V_D/V_T, promote the exchange of CO₂, and increase the Cdyn, but it cannot improve the oxygenation and Qs/Qt.Inspiratory velocity of 50 mL/L to achieve the above improvement in respiratory function and respiratory mechanics in the case of a smaller inflammatory response. It may be recommended for use in patients undergoing OLV.

目的 探讨哮喘患者的气道炎症表型分布及肺功能指标情况。方法 选择226 例哮喘患者为研究对象,其中50 例为重症哮喘,76 例为普通哮喘,对比哮喘患者的气道炎症表型分布情况及患者肺功能指标情况。结果 226 例哮喘患者中,嗜酸性粒细胞型最为常见,占36.73%,之后为中性粒细胞型（31.86%）、混合细胞型（22.12%）、寡细胞型（9.29%）;重度哮喘患者中,中性粒细胞型患者肺功能相关指标均低于其它类型的重症患者（P<0.05）。结论 在哮喘气道炎症表型中,最常见的表型为嗜酸性粒细胞型,其中中性粒细胞型的哮喘患者的肺功能最差。

Objective To explore the phenotype distribution and lung function indicators of airway inflammation in asthmatic patients. Methods 226 cases of asthma patients were chosen as the research objects,in which 50 cases of severe asthma,76 cases of asthma,to compare asthma airway inflammation phenotype distribution and lung function index. Results Among 226 asthma patients,eosinophilic granulocytes were the most common,accounting for 36.73%,followed by neutrophilic granulocytes （31.86%）,mixed cell types （22.12%） and oligocytes （9.29%）. Among patients with severe asthma, the lung function of neutrophil patients was lower than that of other severe patients（P < 0.05）. Conclusion Among asthmatic airway inflammatory phenotypes, the most common phenotype is eosinophilic granulocyte type, among which neutrophil asthmatic patients have the worst lung function.

目的 通过比较炎症性肠病(IBD)患者的血脂水平,探讨炎症性肠病疾病活动程度与血脂的相关性。方法 收集2013年1月—2018年5月在南方医科大学附属南海医院住院的159例IBD患者和159例健康对照为研究对象,检测分析两组的血浆TG、TC、LDL-C、HDL-C、脂蛋白a、白蛋白和超敏C反应蛋白(hCRP)水平差异,分析IBD患者疾病活动程度与血脂异常的关系。结果 与对照组比较,IBD患者的TG、TC、LDL-C、HDL-C和白蛋白均下降,但脂蛋白a升高(P＜0.05),且CD组的TC、LDL-C、HDL-C、白蛋白均较UC组更低(P＜0.05)。TC、LDL-C、HDL-C等胆固醇水平随IBD疾病活动程度加重而逐渐下降,且与hCPR呈负相关,脂蛋白a与hCRP呈正相关性,但未见TG水平与疾病活动相关。结论 IBD患者的胆固醇水平下降,脂蛋白a升高,CD患者更明显,胆固醇水平随IBD病情加重逐渐下降,且与hCRP呈负相关。

Objective To explore the correlations between disease activity of inflammatory bowel disease(IBD) and lipid profiles levels by compare the levels of plasma lipids in patients with IBD. Methods A total of 159 IBD patients admitted to Nanhai Hospital of Southern Medical University from January 2013 to May 2018 were included in the study and the clinical data were collected. There were 159 healthy people recruited in the control group. The differences of plasma levels of triglycerides(TG), total cholesterol(TC), low-density lipoprotein cholesterol(LDL-C), high-density lipoprotein cholesterol(HDL-C), lipoprotein(a), albumin and high-sensitivity C-reactive protein(hCRP) between these two groups were analyzed respectively. The relationships between lipids levels and the severity of IBD were analyzed. Results Plasma levels of TG,TC,LDL-C,HDL-C and albumin were lower in IBD group than those in control group,but lipoprotein(a) was higher than control group(P＜0.05). The levels of TC,LDL-C,HDL-C and albumin were lower in CD patients compared to those of UC(P＜0.05). Plasma levels of TC,LDL-C,HDL-C gradually decreased with the severity of IBD. TC,LDL-C,HDL-C values were negatively correlated with hCRP levels in IBD patients. And lipoprotein(a) values was positively correlated with hCRP levels in IBD patient. However, there was no association between TG levels and the severity of IBD. Conclusion TG、TC、LDL-C、HDL-C levels are decreased and lipoprotein(a) is increased in IBD patients, especially CD patients, compared with healthy controls. Moreover, the cholesterol levels are negatively associated with more severe disease activity.

目的 观察百草枯中毒后大鼠血液中炎症因子的变化,以及大承气汤结合氢化可的松在百草枯中毒治疗中的作用。方法 选用广东省实验动物所的160只SD大鼠,雌雄各半。其中随机抽取 120 只大鼠给予百草枯溶液按18 mg/kg的剂量一次性腹腔注射给药,制造百草枯中毒大鼠模型其余 40只大鼠不作处理,作为正常组。再将模型组分为大承气汤联合氢化可的松组、氢化可的松组及盐水对照组,观察大鼠中毒情况,观察并分析给药后1 d、3 d以及5 d大鼠的肺组织以及血清炎症因子TNF-α、IL-2、IL-6等的变化情况。结果 正常对照组在中毒后1 d、3 d未见大鼠死亡,在5 d有1只动物死亡;模型组大鼠TNF-α、IL-2、IL-6水平高于对照组,差异有统计学意义(P<0.05);正常对照组大鼠各因子水平,随着中毒时间的延长逐渐增加,均有差异(P<0.05);大承气汤联合氢化可的松组给药后各时间点TNF-α、IL-2、IL-6降低,与氢化可的松组、盐水对照组均有差异(P<0.05)。结论 大鼠百草枯中毒后,肺组织发生纤维化改变,且TNF-α、IL-2、IL-6因子的水平升高,随着时间的推移,呈现上升趋势;大承气汤对百草枯中毒大鼠肺组织具有保护作用,可能调控各炎症因子作用,减缓病情进展来实现。

目的 观察不同剂量卡介苗核酸(Bacille Calmette-guerin DNA , BCG-DNA)在不同干预时间对哮喘小鼠气道高反应性及气道炎症的干预作用。方法 1.将Balb/c雌鼠随机分为哮喘模型组、NS对照组、BCG- DNA干预组。干预组根据干预的时间和干预制剂剂量的不同分为-7DNA1 μg、-7DNA10 μg、-7DNA100 μg、10DNA1 μg、10DNA10 μg、10DNA100 μg、17DNA1 μg、17DNA10 μg、17DNA100 μg组。2.在末次激发48小时后,测定各浓度级乙酰甲胆碱激发下的增强的呼气间歇 (Enhanced Pause, Penh)值,将其与小鼠激发前吸入NS后的Penh的百分比(Penh%NS),作为其气道反应性评价指标;其次对肺泡灌洗液进行细胞学分析。结果 1.气道反应性:①-7DNA1 μg组从Mch为3.12～50 mg/mL之间的Penh%NS显著低于哮喘组(P<0.05);②-7DNA10 μg组和-7DNA 100 μg组从Mch为6.25～25 mg/mL之间的Penh%NS显著低于哮喘组(P<0.05);③10DNA10 μg组从Mch为12.5～25 mg/mL之间的Penh%NS显著低于哮喘组(P<0.05);④10DNA100 μg组从Mch为3.12、12.5～50 mg/mL之间的Penh%NS显著低于哮喘组(P<0.05);⑤17DNA1 μg组在Mch为3.12、12.5 mg/mL的Penh%NS显著低于哮喘组(P<0.05);⑥17DNA10 μg组在Mch为12.5 mg/mL之间的Penh%NS显著低于哮喘组(P<0.05) 2.气道炎症:10DNA1 μg、-7DNA10 μg、10DNA10 μg和17DNA10 μg组的BALF细胞分类Eos%分别为:35.34±3.81、27.30±6.91、38.20±6.56、42.17±5.17;显著低于哮喘组的Eos%(48.8±6.12)(P<0.05);10DNA1 μg组的Eos%显著低于-7DNA1 μg组的Eos%(P<0.05);-7DNA10 μg组的Eos%显著低于10DNA10 μg、17DNA10 μg、-7DNA1 μg和-7DNA100 μg组的Eos%(P<0.05)。结论 BCG-DNA能降低哮喘小鼠的气道高反应性,减轻哮喘小鼠的气道炎症,早期(－7 d)中小剂量的干预效果较佳。

Objective To investigate the effect of Bacille Calmette-Guerin BCG-DNA on airway hyperresponsiveness and airway inflammation in asthmatic mouse model. Methods 1.According to different intervention, mouse were divided into asthma groups, NS control group, BCG-DNA group. According to different time and dosage intervened with asthma model, the BCG-DNA group were subdivided into -7DNA1 μg、-7DNA10 μg、-7DNA100 μg、10DNA1 μg、10DNA10 μg、10DNA100 μg、17DNA1 μg、17DNA10 μg and 17DNA100 μg group. 2.48 hours after the final incitation, the mice were stimulated with increasing concentrations of methacholine, and the airway resistance was measured. Enhance pause (Penh) was taken for each group. Bronchoalveolar lavage cytology was performed to evaluate the airway inflammation. Results 1.Airway hyperresponsiveness: ① Penh%NS of-7DNA1 μg group was significantly lower than the asthma group when Mch was 3.12~50 mg/mL (P<0.05); ② Penh%NS of -7DNA10 μg group and -7DNA100 μg group were significantly lower than the asthma group when Mch was 6.25~50 mg/mL (P<0.05);③ Penh%NS of 10DNA10 μg group was significantly lower than the asthma group when Mch was 12.5~25 mg/mL (P<0.05); ④ Penh%NS of 10DNA100 μg group was significantly lower than the asthma group when Mch was 3.12,12.5~50 mg/mL (P<0.05); ⑤ Penh%NS of 17DNA1 μg group was significantly lower than the asthma group when Mch was 3.12 or 12.5 mg/mL (P<0.05);⑥Penh%NS of 17DNA10 μg group was significantly lower than the asthma group when Mch was 12.5 mg/mL(P<0.05). 2.Airway inflammation: The Eos% of 10DNA1 μg, -7DNA10 μg,10DNA10 μg and 17DNA10 μg group (35.34±3.81、27.30±6.91、38.20±6.56、42.17±5.17) were lower than the asthma group (P<0.05); The Eos% of 10DNA1 μg group was lower than the -7DNA1 μg group (P<0.05); The Eos% of -7DNA10 μg group was lower than the 10DNA10μg, 17DNA10 μg,-7DNA1 μg and -7DNA100 μg group (P<0.05). Conclusion BCG-DNA can inhibit the airway inflammation and hyperresponsiveness in asthmatic mouse model. Early interventions with middle dose bring better results.

目的 探讨吸烟对稳定期COPD患者炎症反应和肺功能的影响。方法 选取2013年8月—2016年9月我院门诊收治的稳定期COPD患者70例为研究对象,其中吸烟35例(X1组)、不吸烟35例(X2组),另选取同期入院的不吸烟健康志愿者35例纳入健康组,采用酶联免疫吸附试验(ELISA)测定血清白介素-6(IL-6)、白细胞介素-8(IL-8)及肿瘤坏死因子-α(TNF-α)水平,以肺功能检测仪测定三组一秒用力呼气容积(FEV1)、一秒用力呼气容积/用力肺活量比值(FEV1/FVC)、FEV1占预计值百分比(FEV1％),并采用自拟症状评分表及简明健康调查简表(SF-36)评价呼吸困难程度及生活质量。结果 X1组IL-6、IL-8及TNF-α依次为(135.27±1.24)pg/mL、(189.45±1.14)pg/mL、(39.39±1.14)pg/mL,明显高于X2组、健康组(P均<0.05);X1组FEV1(0.75±0.14)L、FEV1/FVC(3.65±1.87)％、FEV1％(3.45±0.12)％低于X2组、健康组(P均<0.05);X1组症状积分(10.17±1.02)分较X2组、健康对照组高(P<0.05),而其SF-36评分(54.27±1.46)分明显低于X2及健康组(P<0.05);X2组上述指标与健康组比较亦有统计学意义(P均<0.05)。结论 吸烟可明显增加稳定期COPD患者IL-6、IL-8、TNF-α等炎症因子水平,同时降低肺功能,临床应采取措施进行有效干预,防止患者病情恶化。