Objective To investigate the characteristics of intestinal microflora and its effect on fecal secretory immunoglobulin A (sIgA) in the elderly. Methods All 104 cases were assigned to two groups: the control group (healthy adults, age<60 years ,n=36) and the elderly group (healthy elderly persons, age ≥60 years, n=68). Feces samples of all cases were cultured under both aerobic and anaerobic conditions for the 6 bacteria (4 kinds of anaerobes and 2 kinds of aerobes) and the yeasts. The ratio of bifidobaeterium to Enterobacteria (the ratio of B/E) was calculated, which reflected personal colonization resistance. The fecal sIgA was also measured. Results Compared with control group, the number of fecal bifidobacterium and the ratio of B/E were significantly decreased in elderly group[(9.1±1.1)vs. (10.2±0.8)lgCFU/g,P<0. 01 ;(1. 02±0.14) vs. (1.24± 0. 18), P < 0. 01], and the number of enterobacteria and peptostreptococcus was significantly increased in elderly group [(9.2±1.3) vs. (8. 2±0.7) lgCFU/g, P < 0. 05 ; (8. 5 ±1.4) vs. (7.1 ± 1.6)lgCFU/g, P<0. 05]. The fecal slgA was much lower than that in control group [(652.9± 184.3) vs. (793. 5±150. 3)μg/ml, P<0. 05]. Moreover, the quantity change of bifidobacterium was correlated with the concentration of fecal sIgA(r=0. 562, P<0. 01). Conclusions The number of fecal bifidobacterium is significantly decreased, while the number of enterobacteria and peptostreptococcus is significantly increased in elderly persons. The colonization resistance is significantly decreased and the intestinal immuno-barrier function is injuried in elderly persons, which have influenced the intestinal microflora.

Based on the TCM theory of " Unity of Spirit and Body" and emotional changes causing diseases, rat models were made by bindking and wator -immersion methods to produce stress ulceration.' Counter -proved by treating such rats with compound - herbal recipe for regulating Qi descending adverse flowing and dissipating lumps, the Xinshen No. 1., it was proved that the nature of the functional disturbance in the models was the micro - circulatory disturbance of heural - hormonal system. Hence, the remedy yields therapeutic action spirit (emotional and psychic factors )and the body.

Objective To investigate the causes, clinical features, classifications and liver function change of drug-induced liver damage (DILD) in the elderly. Methods One hundred and sixty seven inpatients with acute drug-induced liver injury in our hospital in the past ten years (January 2000 to December 2009) were retrospectively investigated,and the diagnosis and classification methods of acute DILD were based on international consensus meeting (international criteria). Results Among 167 DILI cases, there were 53 cases (31.7%) in the older group and 114 cases (68.3%) in middle-youth age group. Fatigue and jaundice were the more common symptoms, accounting for 50.3% and 46.7%, respectively. In 167 cases, no obvious symptoms and signs were shown in 25 cases. There were no significance differences in clinical manifestation between two groups. Many drugs could induce liver injury. The most common drugs inducing DILD were Chinese traditional and herbal drugs, accounting for 47.9%. Drugs used in heart diseases and inducing liver injury were more common in the older group. In this study, 40 (75.5%), 5 (9.4%) and 8 (15.1%) cases were designated as hepatocellular, cholestetic and mixed DILD in the older group, and 91 (78.9%), 8 (7.4%) and 15 (13.7%) in middle-youth age group, respectively. There were no significance differences between two groups in classifications. Conclusions Many drugs could cause liver injury. The symptoms of acute DILD are nonspecific. Drugs used in heart diseases and inducing liver injury are more common in older patients.

ObjectiveTo investigate the change in the serum level of complement C5a after obstruction removal and its correlation with the serum levels of liver fibrosis markers in patients with obstructive jaundice. MethodsA total of 164 patients with obstructive jaundice who underwent endoscopic retrograde cholangiopancreatography and obstruction removal in our hospital from June 2012 to June 2014 were enrolled, and 20 healthy adults were enrolled as the control group. The serum levels of complement C5a and four liver fibrosis markers, type Ⅳ collagen (ⅣP), pre-type Ⅲ collagen (PⅢP), laminin (LN), and hyaluronic acid (HA), were measured. The t-test was applied for comparison between groups, and linear correlation analysis was applied for correlation analysis. ResultsCompared with the healthy controls, the patients with obstructive jaundice had a significantly higher serum level of complement C5a (89.7±30.2 vs 62.2±21.1 ng/L; t=2.213, P=0.016), and the serum level of complement C5a was closely related to the course of obstruction (r=0.954, P=0003). The serum level of complement C5a decreased significantly after obstruction removal (66.2±26.3 ng/L; t=1.998, P=0.021). Before obstruction removal, the serum level of complement C5a increased synchronously with those of ⅣP (r=0.976, P＜0.001), PⅢP (r=0972, P＜0.001), LN (r=0.915, P=0.039), and HA (r=0.962, P=0.002); after obstruction removal, the serum level of complement C5a decreased synchronously with those of ⅣP (r=0.965, P=0.001), PⅢP (r=0.912, P=0.003), and HA (r=0.875, P=0023). ConclusionComplement C5a may be involved in the development of liver fibrosis induced by obstructive jaundice.

肌肉硬度； 竖脊肌； 信度； 康复训练