目的 总结胆管结核的临床特点，以提高胆管结核的认识和诊断水平。方法 分析1例胆管结核患者的临床资料、诊断过程并复习文献。结果 根据患者病程中有盗汗、胸片中有陈旧性结核、术前结核感染T细胞斑点试验（T-SPOT. TB）（＋＋＋）等信息，结合术中快速病理，明确诊断为胆管结核，行胆肠吻合术后，抗结核治疗6个月后患者痊愈。结论 胆管结核是一种罕见疾病，对于年轻患者患有占位性病变导致梗阻性黄疸、影像学中肿瘤特征不典型、患者来自结核高发区、有陈旧性结核病史、病程中有低热盗汗等任一症状者，应该注意结核的鉴别诊断，首选T-SPOT. TB检测或内镜引导下穿刺活检，术中冰冻活检是避免胆管结核患者过度医疗的最后一道防线。
ObjectiveTo summarize the progress and challenges in the research of gallbladder cancer organoid, and explore the possible solution strategies. MethodThe literature relevant to the researches of gallbladder cancer organoid at home and abroad in recent years was reviewed. ResultsThe research of gallbladder cancer organoid was in its infancy. The gallbladder cancer organoid was mainly constructed from surgically resected gallbladder cancer tissues. Now the research of gallbladder cancer organoid had made some progress, such as on the pathogenesis and drug screening of gallbladder cancer. ConclusionsThe study on gallbladder cancer organoid can further understand the gallbladder cancer and help to speed up the update of diagnosis and treatment plan. However, the model of gallbladder cancer organoid is facing the challenges such as low construction success rate. The experience gained from organoids research in other diseases is worthy of reference.
ObjectiveTo explore the variation of the structure of the intestinal flora between healthy people and patients with obstructive jaundice perioperatively. MethodsFrom February 2013 to August 2014, 20 patients with obstructive jaundice and 10 healthy persons (normal control group) in our hospitol were selected as the research object. The first stool specimens of the research object after admission were obtained and the total fecal bacteria DNA were extracted. After polymerase chain reaction amplification, the changes in the structure of bacterial flora were dynamic observed by using denaturing gradient gel electrophoresis (DGGE), and the gel bands were analyzed by using Quantity One software. The similarity and diversity of flora structure, and principal component analysis (PCA) were analyzed. ResultsSignificant differences of colonic microflora were found between patients with obstructive jaundice and healthy people; advantage intestinal flora in obstructive jaundice patients was significant lower than the normal control group. With the extension of time and degree of obstruction aggravated, a descending trend was found in number, abundance, and diversity of the intestinal microflora (P < 0.05). ConclusionThere is significant differences in the structure of colon bacteria in patients with obstructive jaundice and healthy persons.
【摘要】 目的 探讨NF-κB在重症急性胰腺炎小鼠肠黏膜屏障功能损伤中的调控机制。 方法 36只BALB/C小鼠随机分为对照组、模型组、NF-κB干预组，每组12只。18 h后处死小鼠，比较各组的腹腔内大体改变、肠黏膜病理改变，肠道通透性的变化及血清细胞因子水平，肠上皮紧密连接蛋白occludin的表达。 结果 模型组小鼠腹腔内呈明显炎症反应，肠管水肿，肠黏膜水肿，肠道通透性显著增高，NF-κB特异性阻断剂能降低肠道损伤，改善肠黏膜水肿，上调肠上皮紧密连接蛋白occludin的表达，显著降低肠道通透性，降低细胞因子水平。 结论 NF-κB阻断剂能够通过选择性的抑制NF-κB活性，改善受损的肠屏障功能。这一作用通过上调肠上皮紧密连接蛋白occludin的水平而实现。【Abstract】 Objective To investigate the roles of NF-κB in the intestinal mucosal barrier injury in mice with severe acute pancreatitis(SAP). Methods Thirty-six BALB/C mice were randomly assigned to normal control group, SAP model group and intervention group. Eighteen hours later, pathological intestinal villus changes, intestinal permeability, serum cytokines were evaluated in all three groups. Results In SAP model group, intestinal mucosa was found to be oedematous and intestinal permeability was markedly increased. NF-κB could ameliorate intestinal injury and mucosa edema, and improve intestinal permeability by upregulating occluding expression. Conclusion NF-κB could protect the function of intestinal mucosal barrier by inhibiting NF-κB activity, which suggests that NF-κB may play an intermediating role in SAP-induced intestinal failure through upregulating occluding expression.
ObjectiveTo explore the influence of miRNA-155/PU.1 signaling pathway blockade on bone marrow-derived dendritic cells (DCs) maturation and immune function of rat small intestinal transplantation. MethodsThe DCs were induced by adherent culture.The critical transcription factor gene PU.1 was designed and PU.1 siRNA was synthe-sized.The DCs were transfected by liposome transfection and a pair of PU.1 siRNA was screened according to the high silencing efficiency.The expressions of DCs surface markers CD80, CD86, and MHC-Ⅱamong three groups (PU.1 silent group, negative control group, and control group) were analyzed by flow cytometry.The IL-10 and IL-12p70 secretion levels in the supernatant were tested by ELISA method.The allogeneic T lymphocyte proliferation was tested by mixed lymphocyte reaction.The transfected cells were intravenously injected into the recipient rat on day 7 before intestinal transplantation.The survival conditions as well as pathological changes were observed in each group recipients. Results①The surface molecules CD80, CD86, and MHC-Ⅱin the PU.1 silent group were (27.0±5.6)%, (23.6±4.8)%, and (36.8±6.8)%, respectively; versus (74.0±9.4)%, (76.5±8.7)%, and (87.8±11.3)% in the negative control group, respectively, which were significantly lower in former and showing an in creased trend (P < 0.05).②Compared with the negative control group, IL-10 secretion level was significantly increased (P < 0.05), IL-12p70 secretion level significantly decreased (P < 0.05) in the PU.1 silent group.③The proliferation of T lymphocytes in the PU.1 silent group was significantly lower than that in the negative control group (P < 0.05).④When the transfected DCs were injected into the intestinal transplantation rats on day 7 before operation, the survival time was (14.3±3.3) d, (7.8±1.5) d, and (8.0±2.5) d in the PU.1 silent group, negative control group, and control group, respectively, which in the PU.1 silent group were significantly longer than that in the other two groups (P < 0.05), and the graft pathology showed that there were mild intestinal tissue damage, lymphocyte infiltration or villus edema in the PU.1 silent group. ConclusionmiRNA-155/PU.1 signaling pathway blockade could reduce DCs maturation and induce receptor-specific immune tolerance, which are proved both in vivo and in vitro.