Diarrheal Diseases: A Review on Gastroenteritis Bacteria Global Burden and Alternative Control of Multidrug-Resistant Strains

Diarrheal diseases represent a significant and pervasive health challenge for humanity. The aetiology of diarrheal diseases is typically associated with the presence of enteropathogens, including viruses, bacteria and parasites. The implementation of preventive measures, including the maintenance of good food hygiene, effective water sanitation, and the development of rotavirus vaccines, has resulted in a notable reduction in the prevalence of the disease. However, the emergence of bacterial multidrug resistance due to the past or present inappropriate use of antibiotics has rendered bacterial infections a significant challenge. The objective of this review is threefold: firstly, to provide an overview of diarrheal diseases associated with bacteria;secondly, to offer a concise analysis of bacterial multidrug resistance on a global scale;and thirdly, to present the potential of filamentous fungi as an alternative solution to the challenge posed by multidrug-resistant strains. Campylobacter spp. is the most dangerous bacteria, followed by Shigella spp. and Vibrio cholerae in all age groups combined. However, Shigella spp. was the deadliest in children under five years of age and, together with E. coli, are the most antibiotic-resistant bacteria. With their highly developed secondary metabolism, fungi are a reservoir of natural bioactive compounds.

Based on network pharmacology,molecular docking and experimental validation to reveal the potential molecular mechanism of quercetin for the treatment of diarrheal irritable bowel syndrome

Objective:To explore the potential mechanism of action of quercetin in the treatment of diarrhea irritable bowel syndrome(IBS-D).Methods:The potential targets of quercetin were obtained from the TCMSP,SwissTar-getPrediction,and BATMAN-TCM databases.The targets of IBS-D were obtained by searching the GeneCards database with"diarrhea irritable bowel syndrome"as the keyword,and the targets of quercetin and IBS-D were intersected.The PPI network was constructed by Cytoscape 3.7.1 software.The intersected targets were imported into the DAVID database for GO functional analysis and KEGG pathway enrichment analysis.The binding ability of quercetin to the core targets was observed using molecular docking.Based on this,we established an IBS-D rat model,administered quercetin for intervention,and experimentally validated the network pharmacology prediction results by HE staining and ELISA assay.Results:Network pharmacology analysis showed that TP53,TNF-α,AKT1,VEGF-A,IL-6 factors and MAPK,PI3K-Akt signaling pathway as the core targets and pathways of quercetin for the treatment of IBS-D.The results of animal experiments revealed that quercetin could inhibit the secretion of TP53,TNF-α,AKT1,VEGF-A,IL-1βand IL-6,reduce the inflammatory response and improve IBS-D.Conclusion:Quercetin could protect colon tissue by regulating the expression of TP53,TNF-α,AKT1,VEGF-A,IL-1βand IL-6,thereby treating IBS-D.

Genetic and Antibiotic Resistance Characteristics ofCampylobacterjejuni Isolated from Diarrheal Patients,Poultry and Cattle in Shenzhen

Objective To investigate genetic and antibiotic resistance characteristics of Campylobacter jejuni(C. jejuni) isolated from Shenzhen. Methods Multilocs sequence typing and agar dilution methods were used to define the genotype and antibiotic resistance of C. jejuni, respectively. Results In total, 126 C. jejuni strains were isolated. The prevalence of C. jejuni was 5.3% in diarrheal patients. The prevalence in poultry meat(36.5%) was higher than that in cattle meat(1.1%). However, the prevalence in poultry cloacal swabs(27.0%) was lower than that in cattle stool(57.3%). Sixty-two sequence types were obtained, among which 27 of the STs and 10 alleles were previously unreported. The most frequently observed clonal complexes were ST-21(11.9%), ST-22(10.3%), and ST-403(7.1%). ST-21, ST-45, ST-354, ST-403, and ST-443 complexes overlapped between isolates from patients and cattle, whereas ST-45 and ST-574 complexes overlapped between isolates from patients and poultry. All C. jejuni were resistant to at least one antibiotic. The highest resistance rate was toward ciprofloxacin(89.7%), followed by tetracycline(74.6%), and nalidixic acid(69.0%). Conclusion This is the first report of the genotypes and antibiotic resistance of C. jejuni in Shenzhen. Overlapping clonal complexes were found between isolates from patients and cattle, and between patients and poultry.

Analgesic,anti-inflammatory and anti-diarrheal activities of ethanolic leaf extract of Typhonium trilobatum L.Schott

Objective:To explore the efficacy of ethanolic leaf extract of Typhonium trilobatum L.Schott in treating diarrhea,pain and inflammation using experimental models.Methods:In the present study,acetic acid-induced writhing,xylene-induced ear edema and castor oil-imluced diarrlieal model were used to evaluate the analgesic,anti-inflammatory and anti-diarrheal activities,respectively.Acute toxicity test was carried out to fix the safe doses of the plant extract.Results:The plant extract demonstrated a significant inhibition of writhing(P<0.01)compared with the control group in acetic acid-induced writhing test in mice.The extract also significantly inhibited the xylene induced ear edema formation(P<0.05).In anti-diarrheal test,the extract significantly decreased the frequency of defecation and increased the mean latent period(P<0.0l)in castor oil-induced diarrheal model mice at the doses of 250 and 500 mg/kg body weight.Conclusions:These results suggest that the extract possesses significant analgesic,anti-inflammatory and anti-diarrheal activities that support to the ethnopharmacologicl uses of this plant.

Isolation and Identification of Two Antibacterial Agents from <i>Chromolaena odorata</i>L. Active against Four Diarrheal Strains

Chromolaena odorata L (Asteraceae) is a bad invasive plant, found in the humid tropics and sub-tropics worldwide. It is used against dysentery, diarrhea, malaria, wound healing, headache and toothache in traditional medicine. In the present study, we investigated the antibacterial activities of different leaves extracts of Chromolaena odorata L. (cyclohexane, dichloromethane, ethyl acetate and butanol) against four clinical diarrheal strains (Klebsiella oxytoca, Salmonella enterica, Shigella sonnei and Vibrio cholera). We demonstrated that C. odorata leaves extracts show an antibacterial activity between 0.156 and 1.25 mg/mL. Bioassay-guided chromatography by bioautography with iodonitrotetrazolium-based colorimetric assay allowed the isolation and identification of two active compounds. After the combination of RP-HPLC, mass spectrometry analysis, 1D and 2D-NMR spectroscopy, we isolated and characterized two active molecules corresponding to 3’,4’,5,6,7-Pentamethoxyflavone (Sinensetin) and4’,5,6,7-Tetramethoxyflavone (Scutellareintetramethyl ether).

The effect of zinc supplementation on diarrheal diseases in children in the Niger Delta Sub-Region of Nigeria

This study evaluated the trend of diarrheal diseases managed with zinc supplementation by comparing it with diarrheal diseases managed without zinc supplementation at the University of Port Harcourt Teaching hospital (UPTH), Nigeria. The study was a descriptive retrospective study done at the Diarrhea Training Unit (DTU) of UPTH to determine the effect of zinc supplementation in the management of diarrhea in children under 5 years. Out of the 134 case records studied, of children aged 0 to 59 months who presented with diarrhea at the DTU, 57 children did not receive zinc supplementation between October and December, 2007 and 77 children received zinc supplementation between October and December 2009. The results showed that (74) 96.1% of patients who received zinc supplementation, and (48) 84.2% of those who did not, had no repeat diarrheal episodes when seen at the follow up clinic. On the other hand, 1.3% of those who received zinc supplementation and 1.8% of those who did not, had increased episodes of diarrhea when seen at the follow up clinic. Of those who received, and those who did not receive zinc supplementation, 2.6% and 14% respectively, had reduced episodes of diarrhea. These findings clearly demonstrate the effectiveness of zinc supplementation in halting the course of diarrheal diseases in children aged 0 to 59 months. We therefore advocate for the use of zinc supplementation in the management of diarrhea in

Anti-diarrheal and spasmolytic activities study of 3,4-Dihydro-2-(4-Morpholinylmethy)-1(2H)-Naphthalenone(CY)

Objective To investigate the spasmolytic and anti-diarrheal activities of 3,4-dihydro-2-(4-morpholinylmethy)-1(2H)-naphthalenone(CY),which was first synthesized by Welch,Willard M et al.in 1977.Methods The spasmolytic effects of CY were tested on isolated rabbit small intestine at the concentration of 0.01 to 3 mM;the diarrheal-index was evaluated on diarrhea mice to study the anti-diarrheal activities of CY.Results CY(0.1-1 mM)inhibited spontaneous motility of rabbit small intestine and at the concentration of 0.01 to 3 mM CY inhibited the contractile response of rabbit small intestine and colon induced by acetylcholine(10-2 mg·mL-1),high K+(60 mM)and BaCl2(1 mg·mL-1).When tested against calcium channel blocked in rabbit small intestine and colon,CY caused a rightward shift in the Ca2+ dose-response curves,similar to that produced by verapamil,a well-known calcium antagonist.CY could inhibit the diarrhea induced by castor oil,MgSO4 and liquid paraffin and LD50 of CY is 277.2 mg·kg-1.Conclusions CY may produce its spasmolytic and anti-diarrheal effects as a calcium antagonist.

Accessibility to Safe Drinking Water and Diarrheal Diseases: A Quasi-Experiment on a Case of Water Well Drilling in the Village of Kassouala, Municipality of Tchaourou, Benin, January 2018-July 2019

Background: In 2017, 900 million people in the world did not have sustainable access to safe drinking water (SDW). In addition, between 2016 and 2020, the global population with safely managed drinking water at home increased from 70 percent to 74 percent. Drinking water insecurity is the daily situation of people in developing countries. The lack of SDW supply is at the root of many diseases, including diarrheal diseases. Kassouala is a village in the municipality of Tchaourou without access to SDW, but having benefited from the drilling of a well in September 2018. The objective of this study was to study the effect of access to safe drinking water on the frequency of diarrheal diseases in Kassouala between January 2018 and July 2019. Methods: We conducted a quasi-experimental study in Kassouala using the natural experiments of the village of Bérétou as a control group for estimating the effect of a causal nature. There were double temporal (January 2018-July 2019) and geographical (Kassouala-Bérétou) comparisons based on data collected from health care registers. A population-based comparability survey of the two villages was conducted among 170 households in each village (experimental village, control village). A two-stage cluster sampling procedure was used to select the survey participants. Data were collected from heads of household by semi-structured questionnaire. We used Pearson or Mantel-Haenszel chi-square tests, as appropriate, and the “difference-in-difference” method to assess the effect. Results: In Kassouala, the proportion of households with access to safe drinking water had increased to 78.88%, whereas it was nil in 2018 before the well drilling, and the frequency of diarrheal diseases decreased significantly from January 2018 before drilling to July 2019 after drilling (57.11% to 44.64%;p Conclusion: Access to safe drinking water in Kassouala has a causal effect on the reduction of diarrheal diseases. However, for the supply of drinking water to be integrated into the community development plan of Tchaourou, it is necessary to support the scaling up of this intervention, which would be considered as a pilot, of a community participation program.

调神健脾针刺法联合电针治疗腹泻型肠易激综合征的疗效观察及对肥大细胞活化的影响

目的观察调神健脾针刺法联合电针治疗对腹泻型肠易激综合征(irritable bowel syndromediarrheal,IBS-D)的临床疗效及其对患者肠黏膜肥大细胞活化的影响。方法将60例IBS-D患者按随机数字表法分为药物组和观察组,每组30例。药物组予口服马来酸曲美布汀分散片治疗,观察组予调神健脾针刺法联合电针治疗。观察两组治疗前后肠易激综合征症状严重程度量表(irritable bowel syndrome-symptom severity scale,IBS-SSS)评分、肠易激综合征生活质量量表(irritable bowel syndrome-quality of Life,IBS-QOL)评分和医院焦虑抑郁量表(hospital anxiety and depression scale,HADS)评分及肠黏膜肥大细胞(mast cells,MCs)活化程度的变化。比较两组临床疗效。结果观察组总有效率优于药物组(P<0.05)。治疗后,两组IBS-SSS和HADS评分均降低(P<0.05),且观察组均优于药物组(P<0.05)。治疗后,两组IBS-QOL评分均升高(P<0.05),且观察组高于药物组(P<0.05)。治疗后,两组MCs数量与脱颗粒比例均降低(P<0.05),且观察组优于药物组(P<0.05)。结论“调神健脾”针刺法联合电针治疗IBS-D的临床疗效优于单一口服药物治疗,可缓解腹痛等临床症状,提高生活质量,改善抑郁状态,降低MCs活化程度。

Epidemiological Surveillance: Genetic Diversity of Rotavirus Group A in the Pearl River Delta, Guangdong, China in 2019

Objective This study aimed to understand the epidemic status and phylogenetic relationships of rotavirus group A(RVA)in the Pearl River Delta region of Guangdong Province,China.Methods This study included individuals aged 28 days–85 years.A total of 706 stool samples from patients with acute gastroenteritis collected between January 2019 and January 2020 were analyzed for 17 causative pathogens,including RVA,using a Gastrointestinal Pathogen Panel,followed by genotyping,virus isolation,and complete sequencing to assess the genetic diversity of RVA.Results The overall RVA infection rate was 14.59%(103/706),with an irregular epidemiological pattern.The proportion of co-infection with RVA and other pathogens was 39.81%(41/103).Acute gastroenteritis is highly prevalent in young children aged 0–1 year,and RVA is the key pathogen circulating in patients 6–10 months of age with diarrhea.G9P[8](58.25%,60/103)was found to be the predominant genotype in the RVA strains,and the 41 RVA-positive strains that were successfully sequenced belonged to three different RVA genotypes in the phylogenetic analysis.Recombination analysis showed that gene reassortment events,selection pressure,codon usage bias,gene polymorphism,and post-translational modifications(PTMs)occurred in the G9P[8]and G3P[8]strains.Conclusion This study provides molecular evidence of RVA prevalence in the Pearl River Delta region of China,further enriching the existing information on its genetics and evolutionary characteristics and suggesting the emergence of genetic diversity.Strengthening the surveillance of genotypic changes and gene reassortment in RVA strains is essential for further research and a better understanding of strain variations for further vaccine development.

Postnatal Total Serum Protein Concentration Influences the Health and Growth Parameters of Preweaned Female Holstein Friesian Calves

This study focuses on the effect of the total serum protein(TSP)concentrations at 3 days after birth on the health and growth parameters of preweaned female Holstein Friesian calves.A total of 165 female calves were enrolled and evaluated for morbidity which included diarrhea(D),respiratory disease(Rd)and omphalitis(O).Also,calves with more than one disorder in the same time were recorded as multi-morbid.Body weight(BW)was determined at birth,30 and 60 days of age.Blood samples were taken at 3 days after birth and TSP was determined using a digital Brix refractometer.For statistical analysis all female calves based on TSP concentration were grouped into 3 categories:1-TSP≥6.2 g/dL,2-TSP 5.8-6.1 g/dL,and 3-TSP<5.8 g/dL.Overall,the average of TSP concentration was 6.38 g/dL.The prevalence of diarrhea,respiratory disease(Rd)and omphalitis(O)was 16.96%,7.88%and 4.85%respectively,in calves with one disorder and 6.06%in calves with D+Rd,3.64%in calves with Rd+O,3.03%in calves with O+D,and 3.64%in calves with D+Rd+O.As the TSP concentration in calves decreased from≥6.2 g/dL to<5.8 g/dL the calf hood disorders increased in female calves with one disorder and with more than one disorder.The female calves with fair to poor immunity(category 3-TSP<5.8 g/dL)were significantly more likely(OR 6.28,95%CI 2.91-13.5,p value<0.001)to be affected by diseases compared with female calves with excellent immunity(category 1-TSP≥6.2 g/dL).Also BW and average daily gain(ADG)at 30 and 62 days of life decreased as TSP concentrations decreased.The female calves with TSP≥6.2 g/dL at 3 days of life had the greatest BW at 30 and 62 days of age(51.8 kg and 77.1 kg respectively)compared with female calves with TSP<5.8 g/dL at 3 days of life(46.6 and 70.6 kg respectively).Moreover,starter feed intake during the first 30 days of life,31 to 62 days of life and 1 to 62 days of life was greater in female calves with excellent immunity(TSP≥6.2 g/dL)than female calves with good immunity(TSP 5.8-6.1 g/dL)or with fair to poor immunity(<5.8 g/dL TSP).Measuring the TSP at 3 days of calf’s This study focuses on the effect of the total serum protein(TSP)concentrations at 3 days after birth on the health and growth parameters of preweaned female Holstein Friesian calves.A total of 165 female calves were enrolled and evaluated for morbidity which included diarrhea(D),respiratory disease(Rd)and omphalitis(O).Also,calves with more than one disorder in the same time were recorded as multi-morbid.Body weight(BW)was determined at birth,30 and 60 days of age.Blood samples were taken at 3 days after birth and TSP was determined using a digital Brix refractometer.For statistical analysis all female calves based on TSP concentration were grouped into 3 categories:1-TSP≥6.2 g/dL,2-TSP 5.8-6.1 g/dL,and 3-TSP<5.8 g/dL.Overall,the average of TSP concentration was 6.38 g/dL.The prevalence of diarrhea,respiratory disease(Rd)and omphalitis(O)was 16.96%,7.88%and 4.85%respectively,in calves with one disorder and 6.06%in calves with D+Rd,3.64%in calves with Rd+O,3.03%in calves with O+D,and 3.64%in calves with D+Rd+O.As the TSP concentration in calves decreased from≥6.2 g/dL to<5.8 g/dL the calf hood disorders increased in female calves with one disorder and with more than one disorder.The female calves with fair to poor immunity(category 3-TSP<5.8 g/dL)were significantly more likely(OR 6.28,95%CI 2.91-13.5,p value<0.001)to be affected by diseases compared with female calves with excellent immunity(category 1-TSP≥6.2 g/dL).Also BW and average daily gain(ADG)at 30 and 62 days of life decreased as TSP concentrations decreased.The female calves with TSP≥6.2 g/dL at 3 days of life had the greatest BW at 30 and 62 days of age(51.8 kg and 77.1 kg respectively)compared with female calves with TSP<5.8 g/dL at 3 days of life(46.6 and 70.6 kg respectively).Moreover,starter feed intake during the first 30 days of life,31 to 62 days of life and 1 to 62 days of life was greater in female calves with excellent immunity(TSP≥6.2 g/dL)than female calves with good immunity(TSP 5.8-6.1 g/dL)or with fair to poor immunity(<5.8 g/dL TSP).Measuring the TSP at 3 days of calf’s life,offers information directly correlated to an individual calf’s immunity status,their likeliness of morbidity,mortality and body development and overall the effectiveness of the colostrum management program in the dairy farm.life,offers information directly correlated to an individual calf’s immunity status,their likeliness of morbidity,mortality and body development and overall the effectiveness of the colostrum management program in the dairy farm.

基于网络药理学、分子对接与实验验证揭示槲皮素治疗腹泻型肠易激综合征的潜在分子机制

目的:探索槲皮素治疗腹泻型肠易激综合征(Diarrhoeal irritable bowel syndrome,IBS-D)的潜在作用机制。方法:从TCMSP、SwissTar-getPrediction、BATMAN-TCM数据库获得槲皮素的潜在靶点,以“diarrhea irritable bowel syndrome”作为关键词检索GeneCards数据库,得到IBS-D的相关靶点,将槲皮素与IBS-D的靶点取交集。通过Cytoscape 3.7.1软件构建PPI网络。交集靶点导入DAVID数据库进行GO功能分析和KEGG途径富集分析。利用分子对接观察槲皮素与核心靶点的结合能力;在此基础上,建立IBS-D大鼠模型,给予槲皮素进行干预,通过HE染色、ELISA检测对网络药理学预测结果进行实验验证。结果:网络药理学分析显示,TP53,TNF-α,AKT1,VEGF-A,IL-6因子和MAPK、PI3K-Akt信号通路作为槲皮素治疗IBS-D的核心靶点和通路;动物实验结果发现,槲皮素能抑制TP53,TNF-α,AKT1,VEGF-A,IL-1β和IL-6的分泌,减轻炎症反应,改善IBS-D。结论:槲皮素可能下调TP53,TNF-α,AKT1,VEGF-A,IL-1β和IL-6的表达保护结肠组织,从而治疗IBS-D。

理肠丸治疗腹泻型肠易激综合征的疗效观察和对免疫球蛋白及肠道菌群调节的影响

目的目的探讨IBS-D的治疗方法。方法将100例IBS-D患者随机分为治疗组和对照组,各50例,对照组口服匹维溴铵片,治疗组口服理肠丸。观察治疗前后两组中医证候评分与疗效、IBS-SSS评分与疗效、免疫球蛋白及肠道菌群。结果治疗后,治疗组中医证候评分与疗效、IBS-SSS评分与疗效、IgA、IgG、肠杆菌、肠球菌、双歧杆菌、乳酸杆菌改善程度均优于对照组(P<0.01)。结论理肠丸治疗IBS-D效果显著。

中医经方治疗腹泻型肠易激综合征的研究进展

腹泻型肠易激综合征(IBS-D)是最常见的功能障碍型肠病之一,发病率高,治愈难度大,目前对其研究主要围绕临床和实验两方面。中医经方在IBS-D的治疗中疗效显著,本文整理并总结其疗效及机制的最新进展,为中医药防治IBS-D的临床及基础研究提供思路与借鉴。

参苓白术散加减对腹泻型肠易激综合征脾虚湿盛证患者血清胃肠激素水平的影响

目的探讨腹泻型肠易激综合征(IBS-D)脾虚湿盛证患者应用参苓白术散加减治疗的效果。方法选取2020年10月至2022年10月该院收治的78例IBS-D脾虚湿盛证患者为研究对象,按照随机数字表法分为观察组与对照组,各39例。对照组采用匹维溴铵治疗,观察组联合参苓白术散加减治疗,均连续治疗4周。比较两组总有效率、降钙素基因相关肽(CGRP)、血管活性肠肽(VIP)、5-羟色胺(5-HT)、胆囊收缩素(CCK)水平,以及中医证候总积分、生活质量、不良反应。结果治疗前,观察组与对照组CGRP、VIP、5-HT、CCK水平,中医证候总积分,IBS生活质量量表(IBS-QOL)评分比较,差异无统计学意义(P>0.05)。治疗后,观察组总有效率(94.87%)高于对照组(79.92%),CGRP、VIP、5-HT、CCK水平及中医证候总积分均低于对照组,IBS-QOL评分高于观察组,差异均有统计学意义(P<0.05)。两组均未见明显不良反应。结论匹维溴铵治疗基础上联合参苓白术散加减治疗IBS-D脾虚湿盛证患者效果确切,且具有良好的安全性,值得临床推广应用。

安肠止泻方剂联合针刺治疗腹泻型肠易激综合征模型大鼠对炎症因子的效果

目的:分析安肠止泻方剂联合针刺治疗腹泻型肠易激综合征(IBS-D)模型大鼠对炎症因子的效果。方法:50只SPF级SD大鼠(2周龄)分为健康组(未造模,日常灌胃生理盐水)、模型组(造模成功后不予其他干预,日常灌胃生理盐水)、方剂组(造模成功后予以安肠止泻方剂)、针刺组(造模成功后予足三里、关元、内关穴针刺干预)和联合组(联合使用方剂组、针刺组干预方式),干预周期均为14 d。比较各组造模前和造模后(造模14 d)、干预前和干预后(干预14 d)白介素1(IL-1)、白介素6(IL-6)、肿瘤坏死因子α(TNF-α)含量的统计学差异。结果:造模后,模型组IBS-D大鼠IL-1、IL-6、TNF-α含量均高于健康组,差异均有统计学意义(P<0.05)。组内比较发现,方剂组、针刺组、联合组IBS-D大鼠干预后的IL-1、IL-6、TNF-α含量均低于干预前,差异均有统计学意义(P<0.05)。干预后组间比较,除联合组针刺组TNF-α含量、针刺组和方剂组IL-6和TNF-α含量的差异无统计学意义(P>0.05),其余各组IL-1、IL-6、TNF-α含量差异均有统计学意义(P<0.05)。结论:安肠止泻方剂联合针刺干预IBS-D效果优于单种干预措施,能明显控制体内炎症状态。

食源性产超广谱β-内酰胺酶的致泻性大肠埃希菌的毒力基因分型及耐药分析

目的分析食源性产超广谱β-内酰胺酶(ultraspectrumβ-lactamase,ESBLs)的致泻性大肠埃希菌(diarrheagenic Escherichia coli,DEC)的毒力基因分型特征及耐药情况。方法以苏州市食源性疾病监测中通过聚合酶链式反应(polymerase chain reaction,PCR)进行毒力基因检测并分型的285株DEC为研究对象,采用微量肉汤法对29种抗菌药进行药敏试验,其中头孢噻肟/克拉维酸(CTX/C)及头孢他啶/克拉维酸(CAZ/C)用于检测其是否产ESBLs,其余27种抗生素根据其最低抑菌浓度(minimal inhibitory concentration,MIC)判定敏感(S)、中介(I)及耐药(R)。采用χ^(2)检验或Fisher精确概率法比较产ESBLs的DEC与非产ESBLs的DEC间的耐药差异。结果苏州市检出的285株DEC中,产ESBLs的DEC为47株,占比16.49%(47/285),毒力基因型以肠道聚集性大肠埃希菌(enteroaggregative Escherichia coli,EAEC)为主(38.30%,18/47)。总耐药率为97.87%(46/47),对23种抗生素产生耐药,对氨苄西林(ampicillin,AMP)、头孢唑啉(cefazolin,CFZ)、头孢呋辛(cefuroxime,CXM)、头孢噻肟(cefotaxime,CTX)、头孢噻呋(ceftiofur,CEF)、四环素(tetracycline,TET)、萘啶酸(nalidixic acid,NAL)、甲氧苄氨嘧啶/磺胺甲噁唑(trimethoprim/sulfamethoxazole,SXT)的耐药率较高,对头孢他啶/阿维巴坦(CZA)、碳青霉烯类药物(IPM、MEM、ETP)及替加环素(tigacycline,TIG)不耐药;在与非产ESBLs的DEC比较中发现对AMP、氨苄西林/舒巴坦(ampicillin/sulbactam,AMS)、头孢唑啉(cefazoline,CFZ)等13种抗菌药的耐药率存在统计学差异(P<0.05)。产ESBLs的DEC多重耐药率为89.36%(42/47),远高于非产ESBLs的DEC的48.74%(116/238)。产ESBLs的DEC最多见是耐6种抗生素(MDR6),最常见的多重耐药谱为AMP-CFZ-CXM-CTX-CEF-NAL。结论食源性产ESBLs的DEC耐药情况及多重耐药形势均较严峻,应引起公共卫生监测的重视。

自拟中药方(健脾温阳止泻汤)治疗腹泻型肠易激综合征的临床疗效分析

目的探讨自拟中药方(健脾温阳止泻汤)治疗腹泻型肠易激综合征的临床效果。方法选取2022年1月—2023年1月寿光市人民医院收治的80例腹泻型肠易激综合征患者为研究对象,经随机数表法分为对照组和治疗组,每组40例。对照组给予口服复方谷氨酰胺肠溶胶囊的方法进行治疗;治疗组给予自拟健脾温阳止泻汤,比较两组的症状积分及疗效。结果治疗后,治疗组患者的总有效率为95%,对照组患者的治疗总有效率为75%,治疗组的总有效率高于对照组,差异有统计学意义(χ^(2)=6.405,P<0.05);治疗组症状积分低于对照组,差异有统计学意义(P<0.05)。结论健脾温阳止泻汤治疗腹泻型肠易激综合症的效果较为明显,可以改善患者腹胀、腹痛、排便症状。

基于数据挖掘分析曹志群教授治疗腹泻型肠易激综合征的用药规律

目的探讨曹志群教授治疗腹泻型肠易激综合征(IBS-D)的用药规律。方法选取2020年10月—2021年10月期间曹志群教授于山东中医药大学附属医院门诊诊治的IBS-D患者128例,选取其首诊处方作为研究对象,使用Microsoft Office Excel 2019软件对中药频率、功效、性味归经等进行频数统计,提取使用频率>30%的高频药物,将数据录入古今医案云平台进行药物关联分析和聚类分析,并使用IBM SPSS Modeler18.0软件对高频药物绘制药物关联网络图。结果128首中药处方中共包含107味中药。其中高频药物有白术、党参、木香、黄连、菟丝子、茯苓、乌梅、莲子、白扁豆等;药性以平性、温性为主,药味以甘、苦、辛为主,归经以脾、胃经为主;系统聚类分析得到新处方4首。结论曹志群教授在治疗IBS-D时围绕着“脾虚湿盛”的基本病机,从肝、脾、肾三脏入手,以疏肝、建中、温下、行气为基本治法,重视健脾化湿,同时注意调节气机升降。

基于网络药理学和分子对接技术的理中汤治疗腹泻型肠易激综合征的作用机制

目的通过网络药理学和分子对接技术探讨理中汤治疗腹泻型肠易激综合征(IBS-D)的潜在分子机制。方法通过TCMSP数据库获取理中汤主要化学成分及其作用靶标,从GeneCards数据库获取IBS-D疾病靶标,采用R软件处理疾病症与理中汤有效成分靶标,绘制韦恩图。通过Cytoscape 3.7.1软件联合STRING数据库构建蛋白互作(PPI)网络,对交集靶标进行GO和KEGG富集分析,使用Vina软件对核心靶标及有效成分进用分子对接验证。结果筛选得出药物疾病共同靶点155个,通过PPI网络的拓扑分析出度值前五的靶蛋白c-Jun氨基末端激酶(JUN)、信号传导及转录激活蛋白3(STAT3)、雌激素受体1(ESR1)、蛋白激酶1(AKT1)和白细胞介素(IL)-1β;GO和KEGG通路富集分析表明,理中汤可能作用于IL-17、癌症相关、糖尿病并发症中AGE-RAGE、动脉粥样硬化、TNF等相关信号通路,可通过减少病理损伤、炎症和氧化应激反应,从而减轻IBS-D。分子对接显示,活性化合物与筛选出的靶标之间具有良好的结合能力。结论理中汤通过多成分、多靶点、多途径的相互作用,以及调节炎症反应、氧化应激等主要病理环节治疗IBS-D。