ObjectiveTo summarize the clinical features and experience of Methicillin-resistant Staphylococcus aureus (MRSA)-associated enteritis. MethodsClinical data of 21 patients with MRSA-associated enteritis who were treated in our hospital from Jan. 2003 to May. 2015 were analyzed retrospectively. ResultsAfter diagnosed or suspected of MRSA-associated enteritis, the 21 patients received a drug therapy with vancomycin instead of other antibiotic, 3 patients (14.3%) who failed to get satisfactory symptom relief received a plus therapy with biapenem; 13 patients (61.9%) received treatment which plus drugs such as Bacillus licheniformis capsules or combining Bifidobacterium to regulate intestinal microflora. Severe complications, such as intestinal fistula (8 patients, 38.1%）, toxic shock (16 patients, 76.2%）, organ system failure (14 patients, 66.7%) occurred in 17 patients (80.9%) of the 21 patients when 2-7 days (mean of 4.7 days) after diarrhea. Among 21 patients received therapy, 7 patients (33.3%) were cured and 2 patients (9.5%) were improved, whereas 11 patients died, with a total mortality of 52.4%, another 1 patient was lost to follow up (4.8%). There were 8 patients who were followed-up for 1-12 months (the median time was 3.1-month). During the followed-up period, 2 of them died and others stayed alive without occurrence. ConclusionAlthough uncommon, MRSA-associated enteritis progressed rapidly, with many complications and high mortality rate. Early diagnosis and timely targeted treatment restoring the balance of gastrointestinal microecology are the key to decrease its mortality.
Objective To explore the value of fecal calprotectin （FCP） in the activity evaluation for ulcerative colitis （UC）. Methods Sixty three patients with UC （UC group） and 30 patients with gastrointestinal symptoms but without abnormal results of colonoscopy （control group）， who were treated in The Forth Affiliated Hospital of China Medical University between Sep. 2007 to Dec. 2009 were enrolled to examine the FCP， C-creative protein （CRP）， and erythrocyte sedimentation rate （ESR）. Then comparison between UC group and control group was performed. Results Levels of FCP and CRP in active gradeⅠ，Ⅱ， and Ⅲ group were all significantly higher than those of control group and inactive UC group （P＜0.05）， with the increase of active grade of UC， the level of FCP gradually increased （P＜0.05）. The levels of CRP in active grade Ⅱ and Ⅲ group were all significantly higher than those of gradeⅠgroup （P＜0.05）， but didn’t differed between active grade Ⅱ and Ⅲ group （P＞0.05）. There were no significant difference among 5 groups on ESR （P＞0.05）. Levels of FCP （rs=0.807， P＜0.01）， CRP（rs=0.651， P＜0.01）， and ESR （rs=0.371， P＜0.05） in active grade group were significantly related to histological grade under colonoscopy. Conclusion FCP examination is simple， inexpensive， repeatable， and noninvasive， and FCP can be used as an marker of activity evaluation in UC.
ObjectiveTo investigate the level of serum long non-coding RNA antisense non-coding RNA INK4 locus (LncRNA ANRIL) in patients with ulcerative colitis (UC), and to analyze the diagnostic value of serum LncRNA ANRIL level in UC. MethodsA total of 143 UC patients admitted to the First Affiliated Hospital of Henan University of Science and Technology from February 2015 to November 2019 were retrospectively analyzed, and 145 healthy people with normal physical examination in the First Affiliated Hospital of Henan University of Science and Technology were selected as the control group. The relationship between serum LncRNA ANRIL level and PCT/IL-17 level was analyzed, the serum levels of LncRNA ANRIL, PCT, and IL-17 were compared between the two groups, and their diagnostic value for UC was explored.ResultsThe disease degree of 143 UC patients: 41 cases were mild, 59 cases were moderate, and 43 cases were severe; endoscopic grade: 38 cases were grade Ⅰ, 65 cases were grade Ⅱ, and 40 cases were grade Ⅲ. Compared with the control group, the serum levels of LncRNA ANRIL, PCT, and IL-17 were increased in the UC group (P<0.05); the levels of serum LncRNA ANRIL, PCT, and IL-17 in the UC group increased gradually with the increase of disease severity and endoscopic grade (P<0.05). The serum levels of LncRNA ANRIL were positively correlated with the levels of PCT and IL-17 in the UC patients (r=0.596, P<0.001; r=0.492, P<0.001). The area under the curve (AUC) of serum LncRNA ANRIL level in the diagnosis of UC was 0.851, the cut-off value was 1.29, the sensitivity and specificity were 75.5% and 83.4%, respectively. The AUC of serum LncRNA ANRIL combined with PCT in the diagnosis of UC was 0.898, the corresponding sensitivity and specificity were 81.8% and 87.6%, respectively. The sensitivity and diagnostic value of combination of LncRNA ANRIL and PCT were higher than that of serum LncRNA ANRIL alone (Z=2.102, P=0.036). ConclusionsThe serum level of LncRNA ANRIL in UC patients is increased, which has a certain diagnostic value, and it combines with PCT can better predict UC.
目的 简化全大肠切除回肠贮袋肛管吻合术，避免全大肠切除术时腹壁回肠造瘘。方法 采用全大肠切除直肠肌鞘内回肠肛管吻合改进术式治疗25例家族性腺瘤性息肉病及1例溃疡性结肠炎患者，并进行了定期随访。结果 术后1年患者的肛门功能恢复正常，大便1～4次/天，可正常参加工作； 除2例发生术后早期不完全性小肠梗阻和1例癌变患者术后发生性功能障碍外无其它并发症。结论 该术式具有技术简单、病变切除彻底、无回肠造袋、不需要回肠造瘘、直视下剥离粘膜完全、止血操作容易、并发症少、术后肛门功能满意等优点。
Objective To explore the mechanism of action of Xiao chengqitang in the treatment of ulcerative colitis (UC) by network pharmacology. Methods From January 17th to January 20th, 2022, the active components and action targets of Xiao chengqitang (Radix Rhei Et Rhizome, Magnolia Officinalis Rehd Et Wils and Aurantii Fructus Immaturus) were obtained from Traditional Chinese Medicine System Pharmacology Database and Analysis Platform. “Ulcerative Colitis” was used as a search term to retrieve related targets of UC from GeneCards database, to obtain the targets for the treatment of UC using Xiao chengqitang. Then, Cytoscape 3.7.2 software was used for further topological analysis and the Chinese medicine compound-target network of genes was constructed. At the same time, protein-protein interaction network of Xiao chengqitang for the treatment of UC was constructed by STRING database. In addition, targets of Xiao chengqitang for the treatment of UC were applied for gene ontology (GO) analysis, as well as Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis. Results A total of 26 major active ingredients of Xiao chengqitang were obtained after screening, corresponding to 122 drug targets, 4837 disease targets for UC and 86 drug-disease common targets. According to protein-protein interaction network topology analysis parameters, 10 key therapeutic targets were screened, namely RAC-alpha serine/threonine-protein kinase, cellular tumor antigen p53, tumor necrosis factor-α, interleukin-6, caspase-3, prostaglandin-endoperoxidesynthases 2, transcription factor AP-1, vascular endothelial growth factor A, myc proto-oncogene protein and interleukin-1β. The results of GO and KEGG analysis indicated that the therapeutic targets of Xiao chengqitang for UC were mainly enriched in phosphatidylinositol 3-kinase-protein kinase B signaling pathway, inflammatory bowel disease, nuclear factor κB signaling pathway, calcium signaling pathway and peroxisome proliferators-activated receptor signaling pathway. Conclusions The potential mechanism of Xiao chengqitang in the treatment of UC may be that Xiao chengqitang acts on key therapeutic targets such as RAC-alpha serine/threonine-protein kinase, cellular tumor antigen p53, tumor necrosis factor-α, interleukin-6, prostaglandin-endoperoxidesynthases 2, vascular endothelial growth factor A and interleukin-1β, and participates in the regulation of phosphatidylinositol 3-kinase-protein kinase B signaling pathway, nuclear factor κB signaling pathway and calcium signaling pathway.