In vitro models of human colon carcinoma cell line(Caco-2 cell monolayer) and human intestinal bacteria were used to investigate the intestinal transport and biotransformation of resibufogenin and cinobufagin in Chan ...In vitro models of human colon carcinoma cell line(Caco-2 cell monolayer) and human intestinal bacteria were used to investigate the intestinal transport and biotransformation of resibufogenin and cinobufagin in Chan Su by HPLC/APCI-MSn. The experimental results of Caco-2 cell monolayer demonstrate that the apparent permeability coefficients(Papp) of resibufogenin and cinobufagin are higher than 10–6 cm/s, which indicates that both resibufogenin and cinobufagin have a good absorption in the small intestine. And the biotransformation result of human intestinal bacteria shows that resibufogenin has been transformed to 3-epiresibufogenin and cinobufagin has been transformed to 3-epicinobufagin, deacetylcinobufagin and 3-epideacetycinobufagin, respectively.展开更多
BACKGROUND Esophageal replacement(ER)with gastric pull-up(GPU)or jejunal interposition(JI)used to be the standard treatment for long-gap esophageal atresia(LGEA).Changes of the ER grafts on a macro-and microscopic lev...BACKGROUND Esophageal replacement(ER)with gastric pull-up(GPU)or jejunal interposition(JI)used to be the standard treatment for long-gap esophageal atresia(LGEA).Changes of the ER grafts on a macro-and microscopic level however,are unknown.AIM To evaluate long-term clinical symptoms and anatomical and mucosal changes in adolescents and adults after ER for LGEA.METHODS A cohort study was conducted including all LGEA patients≥16 years who had undergone GPU or JI between 1985-2003 at two tertiary referral centers in the Netherlands.Patients underwent clinical assessment,contrast study and endoscopy with biopsy.Data was collected prospectively.Group differences between JI and GPU patients,and associations between different outcome measures were assessed using the Fisher’s exact test for bivariate variables and the Mann-Whitney U-test for continuous variables.Differences with a P-value<0.05 were considered statistically significant.RESULTS Nine GPU patients and eleven JI patients were included.Median age at follow-up was 21.5 years and 24.4 years,respectively.Reflux was reported in six GPU patients(67%)vs four JI patients(36%)(P=0.37).Dysphagia symptoms were reported in 64%of JI patients,compared to 22%of GPU patients(P=0.09).Contrast studies showed dilatation of the jejunal graft in six patients(55%)and graft lengthening in four of these six patients.Endoscopy revealed columnar-lined esophagus in three GPU patients(33%)and intestinal metaplasia was histologically confirmed in two patients(22%).No association was found between reflux symptoms and macroscopic anomalies or intestinal metaplasia.Three GPU patients(33%)experienced severe feeding problems vs none in the JI group.The median body mass index of JI patients was 20.9 kg/m^(2) vs 19.5 kg/m^(2) in GPU patients(P=0.08).CONCLUSION The majority of GPU patients had reflux and intestinal metaplasia in 22%.The majority of JI patients had dysphagia and a dilated graft.Follow-up after ER for LGEA is essential.展开更多
Objective To analyze the 40 years' experience of intestinal atresia and to introduce a new design of longoblique anastomosis for disproportional loop s of the intestine Methods A total of 449 cases of congenital...Objective To analyze the 40 years' experience of intestinal atresia and to introduce a new design of longoblique anastomosis for disproportional loop s of the intestine Methods A total of 449 cases of congenital atresia of the small intesti ne were classified into three groups according to the embryopathology: high grou p (145 cases), including duodenal and high jejunal atresia; middle group (288), including ileojejunal atresia; and low group (16), including terminal ileal at resia To analyze the survival rate and mode of treatment, we assigned the cases into 3 gr oups according to the year of admission: 1) 1956-1969 (173 cases), under the gen eral pediatric surgical care; 2) 1970-1985 (147), under the specialty neonatal s urgical care; and 3) 1986-1996 (129), with additional use of total parenteral nu trition Results The ileojejunal atresia group (middle group) had the highest m ortality rate (476%) The overall mortality rate decreased as the time went b y, dropping from 647% in the early years down to 186% in the recent years, a nd no hospital death occurred in the recent couple of years Conclusion Besides the improvement of neonatal surgical techniques, sel ecting a proper surgical procedure according to the embryopathology is essential to the r eduction of mortality The longoblique anastomosis is particularly acceptable in China at present for marked disproportional loops展开更多
基金Supported by the National Natural Science Foundation of China(Nos.30772721 and 30873360)
文摘In vitro models of human colon carcinoma cell line(Caco-2 cell monolayer) and human intestinal bacteria were used to investigate the intestinal transport and biotransformation of resibufogenin and cinobufagin in Chan Su by HPLC/APCI-MSn. The experimental results of Caco-2 cell monolayer demonstrate that the apparent permeability coefficients(Papp) of resibufogenin and cinobufagin are higher than 10–6 cm/s, which indicates that both resibufogenin and cinobufagin have a good absorption in the small intestine. And the biotransformation result of human intestinal bacteria shows that resibufogenin has been transformed to 3-epiresibufogenin and cinobufagin has been transformed to 3-epicinobufagin, deacetylcinobufagin and 3-epideacetycinobufagin, respectively.
文摘BACKGROUND Esophageal replacement(ER)with gastric pull-up(GPU)or jejunal interposition(JI)used to be the standard treatment for long-gap esophageal atresia(LGEA).Changes of the ER grafts on a macro-and microscopic level however,are unknown.AIM To evaluate long-term clinical symptoms and anatomical and mucosal changes in adolescents and adults after ER for LGEA.METHODS A cohort study was conducted including all LGEA patients≥16 years who had undergone GPU or JI between 1985-2003 at two tertiary referral centers in the Netherlands.Patients underwent clinical assessment,contrast study and endoscopy with biopsy.Data was collected prospectively.Group differences between JI and GPU patients,and associations between different outcome measures were assessed using the Fisher’s exact test for bivariate variables and the Mann-Whitney U-test for continuous variables.Differences with a P-value<0.05 were considered statistically significant.RESULTS Nine GPU patients and eleven JI patients were included.Median age at follow-up was 21.5 years and 24.4 years,respectively.Reflux was reported in six GPU patients(67%)vs four JI patients(36%)(P=0.37).Dysphagia symptoms were reported in 64%of JI patients,compared to 22%of GPU patients(P=0.09).Contrast studies showed dilatation of the jejunal graft in six patients(55%)and graft lengthening in four of these six patients.Endoscopy revealed columnar-lined esophagus in three GPU patients(33%)and intestinal metaplasia was histologically confirmed in two patients(22%).No association was found between reflux symptoms and macroscopic anomalies or intestinal metaplasia.Three GPU patients(33%)experienced severe feeding problems vs none in the JI group.The median body mass index of JI patients was 20.9 kg/m^(2) vs 19.5 kg/m^(2) in GPU patients(P=0.08).CONCLUSION The majority of GPU patients had reflux and intestinal metaplasia in 22%.The majority of JI patients had dysphagia and a dilated graft.Follow-up after ER for LGEA is essential.
文摘目的观察Ⅰ型小肠闭锁肠腔隔膜组织黏膜β干扰素TIR结构域衔接蛋白(TIR-domain-containing adapter-inducing interferon-β,TRIF)、肿瘤坏死因子受体相关因子蛋白3(tumor receptor associated factor,TRAF3)、干扰素-β(interferon-beta,IFN-β)和干扰素-λ1(interferon-λ1,IFN-λ1)分子的表达特征,探索胚胎期Toll样受体4(toll like receptor 4,TLR4)-TRIF非依赖性信号通路与肠管再通过程的相关性。方法采用免疫组化技术观察和比较新生儿正常肠壁和Ⅰ型肠闭锁隔膜组织黏膜层内TRIF通路内重要分子的表达特征。收集16例患儿组织标本(解放军总医院儿科医学部1例,首都儿科研究所1例,河北医科大学第二医院6例,哈尔滨市儿童医院5例,长春市儿童医院3例),均为术中证实的Ⅰ型肠闭锁隔膜组织,为隔膜组;以同一患儿术中行肠切除、肠吻合过程中钳取收集的正常肠壁组织为对照组。患儿手术年龄为出生后1~3 d,其中空肠闭锁13例(男5例,女8例),回肠闭锁3例(男1例,女2例)。将组织标本转入快速组织处理系统进行组织标本连续切片。采用常规HE染色进行定位,隔膜组和对照组各16例,每个病例染色后随机取4个视野(非肌肉区域),应用图像分析软件Image pro plus 6.0测量积分光密度(integral-optical density,IOD)和面积(Area),并计算出平均吸光度(A)(OD)。OD=IOD/Area。采用t检验和双盲法分析免疫组化平均光密度。结果新生儿正常肠壁组织黏膜层的TRIF、TRAF3、IFN-β和IFN-λ1的分子表达不明显或低表达,在隔膜组织黏膜层表达显著。半定量分析结果显示,TLR4、MyD88、TRAF6和IRAK4分子在隔膜组织黏膜层表达比新生儿正常肠壁黏膜层多,二者差异有统计学意义(隔膜组织分别为0.6316±0.0268,0.5066±0.0378,0.6091±0.0270,0.3841±0.0610,正常肠壁分别为0.4333±0.0409,0.3758±0.0365,0.4108±0.0263,0.2108±0.0573,P值分别为0.0042,0.0360,0.0057,0.0137)。结论TLR4/MyD88信号通路参与了Ⅰ型肠闭锁隔膜组织的形成或发展。
文摘Objective To analyze the 40 years' experience of intestinal atresia and to introduce a new design of longoblique anastomosis for disproportional loop s of the intestine Methods A total of 449 cases of congenital atresia of the small intesti ne were classified into three groups according to the embryopathology: high grou p (145 cases), including duodenal and high jejunal atresia; middle group (288), including ileojejunal atresia; and low group (16), including terminal ileal at resia To analyze the survival rate and mode of treatment, we assigned the cases into 3 gr oups according to the year of admission: 1) 1956-1969 (173 cases), under the gen eral pediatric surgical care; 2) 1970-1985 (147), under the specialty neonatal s urgical care; and 3) 1986-1996 (129), with additional use of total parenteral nu trition Results The ileojejunal atresia group (middle group) had the highest m ortality rate (476%) The overall mortality rate decreased as the time went b y, dropping from 647% in the early years down to 186% in the recent years, a nd no hospital death occurred in the recent couple of years Conclusion Besides the improvement of neonatal surgical techniques, sel ecting a proper surgical procedure according to the embryopathology is essential to the r eduction of mortality The longoblique anastomosis is particularly acceptable in China at present for marked disproportional loops
