Aged ; China ; Humans ; Ileum ; surgery ; Male ; Middle Aged ; Treatment Outcome ; Urinary Bladder Neoplasms ; surgery ; Urinary Diversion ; adverse effects ; Urinary Incontinence ; diagnosis ; drug therapy ; surgery ; therapy ; Urinary Reservoirs, Continent

Urinary tract infection (UTI) is one of the most common complications after radical cystectomy and orthotopic neobladder reconstruction. This study investigated the incidence and implicated pathogen of febrile UTI after ileal neobladder reconstruction and identify clinical and urodynamic parameters associated with febrile UTI. From January 2001 to May 2015, 236 patients who underwent radical cystectomy and ileal neobladder were included in this study. Fifty-five episodes of febrile UTI were identified in 46 patients (19.4%). The probability of febrile UTI was 17.6% and 19.8% at 6 months and 24 months after surgery, respectively. While, Escherichia coli was the most common implicated pathogen (22/55, 40.0%), Enterococcus spp. were the most common pathogen during the first month after surgery (18/33, 54.5%). In multivariate logistic regression analysis, ureteral stricture was an independent risk factor associated with febrile UTI (OR 5.93, P = 0.023). However, ureteral stricture accounted for only 6 episodes (10.9%, 6/55) of febrile UTI. Most episodes of febrile UTI occurred within 6 months after surgery. Thus, to identify risk factors associated with febrile UTI in the initial postoperative period, we assessed videourodynamics within 6 months after surgery in 38 patients. On videourodyamic examination, vesicoureteral reflux (VUR) was identified in 16 patients (42.1%). The rate of VUR presence in patients who had febrile UTI was not significantly different from those in patients without febrile UTI (50% vs. 39.3%, P = 0.556). Patients with febrile UTI had significantly larger residual urine volume (212.0 ± 193.7 vs. 90.5 ± 148.2, P = 0.048) than those without. E. coli and Enterococcus spp. are common pathogens and ureteral stricture and residual urine are risk factors for UTI after ileal neobladder reconstruction.
Aged ; Anti-Bacterial Agents/therapeutic use ; Cystectomy/adverse effects ; Enterococcus/isolation & purification ; Escherichia coli/isolation & purification ; Female ; Humans ; Ileum/*surgery ; Incidence ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Postoperative Complications ; Reconstructive Surgical Procedures ; Retrospective Studies ; Risk Factors ; Urinary Bladder Neoplasms/*surgery ; Urinary Tract Infections/drug therapy/*epidemiology/etiology/microbiology ; Urodynamics

OBJECTIVETo explore the effect of Shengjiang Xiexin Decoction (SXD) on the intestinal mucosal and functional cells of rats after irinotecan (CPT-11) chemotherapy.

METHODSTotally 24 healthy Sprague-Dawley (SD) male rats were divided into three groups, the normal control group, the CPT-11 group, the SXD combined CPT-11 group according to random digit table, 8 in each group. CPT-11 was injected at the daily dose of 150 mg/kg to rats in the CPT-11 group and the SXD combined CPT-11 group from the caudal vein on the 4th day, once daily for 2 successive days to duplicate delayed diarrhea model. Equal volume of normal saline was injected to rats in the normal control group from the caudal vein. SXD at 2 g/mL (10 g/kg body weight) was administered to rats in the SXD combined CPT-11 group by gastrogavage for 9 successive days. Deionized water was administered to rats in the CPT-11 group and the normal control group. Diarrhea was observed at 48, 60, 72, 84, 96, and 108 h to calculate the incidence rate of diarrhea. Meanwhile, scoring for diarrhea was performed by referring methods of Akinobu Kurita. Rats were killed on day 10, ileum, cecum, and colon tissues were collected and fixed in 10% formalin solution. HE staining was performed. Intestinal mucosa injuries were graded under light microscope according to the criterion of Chiu's score. The expressions of goblet cells and Paneth cells were observed by PAS stain. Enteroendocrine cells were observed by immunohistochemical CgA staining. Positive cells were counted and cumulative optical density (IOD) analyzed by Image-Pro-Plus 6.0.

RESULTSNo diarrhea occurred in rats of the normal control group at each time point. The incidence rate of diarrhea was 75.0% (6/8) at 48 h, 100.0% (8/8) at 60 h, 100.0% (8/8) at 72 h, 87.5% (7/8) at 84 h, 75.0% (6/8) at 96 h, and 75.0% (6/8) at 108 h in the CPT-11 group. The incidence rate of diarrhea was 25.0% (2/8) at 48 h, 50.0% (4/8) at 60 h, 12.5% (1/8) at 72 h, 0.0% (0/8) at 84 h in the SXD combined CPT-11 group. Compared with the same group at 60 h, scores for diarrhea at 48, 84, 96, and 108 h obviously decreased in the CPT-11 group, and scores for diarrhea at 48, 72, 84, 96, and 108 h obviously decreased in the SXD combined CPT-11 group (P < 0.05, P < 0.01). Compared with the same group at 72 h, scores for diarrhea at 84, 96, and 108 h obviously decreased in the CPT-11 group (P < 0.05, P < 0.01). Compared with the normal control group, scores for diarrhea increased in the CPT-11 group at each time point (P < 0.01); grading of ileum, cecum, and colon mucosal tissues increased (P < 0.05, P < 0.01); expressions of ileum and cecum mucosal epithelial goblet cells obviously decreased (P < 0.05); the number and expressions of ileum and cecum mucosal epithelial Paneth cells increased (P < 0.01). Expressions of ilium endocrine cells increased, while those of cecum and colon endocrine cells decreased in the CPT-11 group (P < 0.01). Compared with the CPT-11 group, scores for diarrhea were obviously lowered (P < 0.05, P < 0.01), grading of ileum, and cecum mucosal tissues decreased (P < 0.05, P < 0.01); expressions of ileum, cecum, and colon mucosal epithelial goblet cells obviously increased (P < 0.05, P < 0.01); the number and expressions of ileum cecum mucosal epithelial Paneth cells increased (P < 0.05); expressions of cecum and colon endocrine cells increased (P < 0.05, P < 0.01) in the SXD combined CPT-11 group.

CONCLUSIONSXD played roles in preventing and treating CPT-11 induced delayed diarrhea by improving CPT-11 chemotherapy induced apoptosis and necrosis of intestinal mucosal and functional cells.

Animals ; Apoptosis ; Camptothecin ; adverse effects ; analogs & derivatives ; Colon ; Diarrhea ; Drug Therapy ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Ileum ; Intestinal Mucosa ; drug effects ; Male ; Rats ; Rats, Sprague-Dawley ; Wound Healing ; drug effects

Crohn's disease is characterized by chronic transmural inflammation of the bowel and is associated with serious complications, such as bowel strictures, abscesses, fistula formation, and perforation. As neither medical nor surgical therapy provides a cure for Crohn's disease, the primary goals of therapy are to induce and maintain remission and prevent complications. As a biologic agent, infliximab, a monoclonal antibody to tumor necrosis factor, is indicated for refractory luminal and fistulizing Crohn's disease that does not respond to other medical therapies or surgery. Infliximab has proven to be very effective for inducing and maintaining remission in Crohn's disease; however, infliximab treatment has several potential complications. Here, we report a case of free perforation following a therapeutic response after an initial dose of infliximab for Crohn's disease. This is the first case report describing a free perforation in a Crohn's disease patient after an initial dose of infliximab.
Adolescent ; Anti-Inflammatory Agents, Non-Steroidal/adverse effects/*therapeutic use ; Antibodies, Monoclonal/*adverse effects/*therapeutic use ; Colonoscopy ; Crohn Disease/*drug therapy ; Dietary Fiber ; Female ; Fibrosis/pathology ; Humans ; Ileum/surgery ; Intestinal Perforation/*chemically induced/surgery ; Tomography, X-Ray Computed

OBJECTIVETo investigate the protective effect of baicalin on the intestinal mucosal injury caused by endotoxin-lipopolysaccharide (LPS) and the anti-oxidative injury in colonic and ileal mucosa of rats with septicopyemia.

METHODFifty healthy male BALB/c mice were randomly divided into 5 groups: the normal control group, the model group, and baicalin high-dose, medium-dose and low-dose groups. They were orally administered with double distilled water, 100 mg x kg(-1) of baicalin, 50 mg x kg(-1) of baicalin, and 25 mg x kg(-1) of baicalin respectively for three days, once a day. 1 h after the oral administration on 3 d, they were intraperitoneally injected with normal saline or LPS (17 mg x kg(-1)). At 20 h after the injection of LPS, all of the mice were sacrificed, and their colonic and ileal tissues were collected. The mental status, life state and death rate of mice in each group were observed, and the lengths of colonic were measured. Chiu's scoring method was used to assess the intestinal mucosal injury. Histopathological changes of intestinal tissues were tested by HE staining. The ultraviolet spectrophotometry was used to detect total antioxidant capacity (T-AOC), superoxide dismutase (T-SOD), and glutathione peroxidase (GSH-PX) of intestinal homogenate. The immunohistochemical method was used to analyze the expression of PCNA in intestinal tissues of each group.

RESULTThe death of mice was observed after the intraperitoneal injection of LPS. The death rates of baicalin groups were remarkably lower than the death rate of the model group. The colons in the medium-dose baicalin group were much longer than that in the model group (P < 0.05), with a much lower intestinal mucosa injury degree than the model group. Colonic and ileal injuries in the high-dose baicalin group significantly (P < 0.05). Colonic and ileal injuries in the medium-dose baicalin group and the low-dose baicalin group significantly reduced compare with the model group (P < 0.000 1). The medium-dose baicalin group showed no significant increase in homogenate's T-AOC, T-SOD and GSH-PX compare with the model group (P < 0.05). There was no significant difference between baicalin groups and the model group in PCNA.

CONCLUSIONBaicalin can protect intestinal epithelial cells suffering from injury from oxygen radicals, and relieve the intestinal injury caused by LPS by improving the intestinal mucosa structure and functions.

Animals ; Antioxidants ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; Flavonoids ; pharmacology ; Glutathione Peroxidase ; metabolism ; Humans ; Ileum ; drug effects ; enzymology ; injuries ; Intestinal Mucosa ; drug effects ; enzymology ; injuries ; Lipopolysaccharides ; adverse effects ; Male ; Mice ; Mice, Inbred BALB C ; Protective Agents ; pharmacology ; Sepsis ; drug therapy ; prevention & control ; Superoxide Dismutase ; metabolism

OBJECTIVETo identify the ileum tissue proteins differentially expressed in Pi-qi deficiency syndrome rats using proteomic approach.

METHODSThirty-seven rats were randomly divided into 3 groups, i. e., the normal control group (Group 1), the Pi-qi deficiency syndrome model group (Group 2), and the reserpine group (Group 3). The Pi-qi deficiency syndrome model was established using excessive exerting combined with irregular diet, and peritoneally injecting Reserpine Injection (1 mg/mL) respectively. The ileum tissues were separated after identified fuzzy method. The differentially expressed proteins were separated with two dimensional electrophoresis (2-DE), analyzed by Mass Spectrometry, and identified by MASCOT Software.

RESULTSThree proteins were differentially expressed in Group 2 and nine proteins were differentially expressed in Group 3 (P < 0.05).

CONCLUSIONPi-qi deficiency syndrome was closely related with decreased expression of albumin as well as increased expressions of trypsin and glucose-regulated protein 78.

Albumins ; metabolism ; Animals ; Drugs, Chinese Herbal ; pharmacology ; Female ; Heat-Shock Proteins ; metabolism ; Ileum ; drug effects ; metabolism ; Male ; Medicine, Chinese Traditional ; Proteome ; analysis ; Proteomics ; Qi ; Rats ; Rats, Sprague-Dawley ; Syndrome ; Trypsin ; metabolism

OBJECTIVETo study contractility of guinea pig ileum in vitro,and analyze the mechanism of anti-emetic effects of Lianqiao.

METHODUsing emesis-relating agonists as drugs, the inhibitory effects of Lianqiao on guinea pig ileum contractility in vitro were observed in organ bath.

RESULTLianqiao could inhibit guinea pig ileum spontaneous contractions, reducing the tone of contractions dose-dependently. Acetylcholine (Ach), histamine (His), 5-hydroxytryptamine (5-HT) stimulated contractions of the guinea pig ileum, enhanced the tone and amplitude. All the three doses (10, 5, 2 g x L(-1)) of Lianqiao could suppress the contractility, significantly reduced the tone and amplitude of ileum contractions stimulated by drugs but not the frequency. Dopamine could inhibit the spontaneous contraction tone and amplitude of ileum; Both the large doses (10, 5 g x L(-1)) of Lianqiao could antagonise the inhibitory effect of DA, enhance the tone and amplitude. Small dose(2 g x L(-1)) had additive effects on tone of ileum contractions with DA,but enhanced the amplitude not the frequency.

CONCLUSIONLianqiao have an inhibitory effect on guinea pig ileum contractions,the mechanism might be blocking M receptor, H1 receptor, 5-HT receptor and D2 receptor or directly suppressed ileum smooth muscle. The mechanisms of anti-emetic effect of Lianqiao needs further study.

Animals ; Antiemetics ; pharmacology ; Dopamine ; pharmacology ; Forsythia ; Guinea Pigs ; Ileum ; drug effects ; physiology ; Male ; Muscle Contraction ; drug effects ; Phytotherapy

OBJECTIVETo establish a method for quick investigating the absorption ingredients of Plantaginis semen and guiding the index selection for its quality control.

METHODThe absorption of three concentrations of Plantaginis semem was investigated with the in vitro everted intestinal sac (VEIS) model The intestinal sac contents of jejunum and ileum were collected at different time and geniposidic acid was detected by HPLC and LC-MS(n) as the representative marker.

RESULTSix ingredients could be detected. At different concentrations of Plantaginis semen, geniposidic acid tested by VEIS showed that there was a good linear correlation between the drug absorption from the medium across the intestinal epithelium into the sac contents in various intestines section. The absorption of the gut sacs from 0 to 90 min manifested a significant time-dependent manner. The Ka of geniposidic acid in the jejunum and ileum increased along with the raised dosage of the Plantaginis Semen (P < 0.05), which indicated a passive absorption manner.

CONCLUSIONThis method can be used as a tool to investigate the absorption ingredients of Plantaginis Semen. Comparing with the jejunum, the ileum can provide more absorption information faster. The optimal incubation time in intestinal sac was 90 min.

Animals ; Body Fluids ; chemistry ; metabolism ; Drugs, Chinese Herbal ; pharmacokinetics ; Ileum ; chemistry ; drug effects ; metabolism ; Intestinal Absorption ; Jejunum ; chemistry ; drug effects ; metabolism ; Male ; Models, Biological ; Plantago ; chemistry ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo establish a method for quick finding the absorption ingredients of Wuzhuyu decoction in order to select the index to control its quality.

METHODThe absorption of three concentration of Wuzhuyu decotion was investigated with the in vitro-everted intestinal sac model. The intestinal bag fluid of jejunum and ileum were collected in different time and the eight ingredients, which were evodiamine (Ev), rutaecarpine (Ru), limonin (Li), ginsenoside-Rb1, -Rg1, -Re (Rb1, Rg1, Re), isorhamnetin-3-O-beta-D-glucosyl(6''-->1'")-alpha-L-rhamnoside (Irs)and 6-gingerol (6-Gi), were detected by HPLC as the represent constituents in samples.

RESULTEight ingredients except Ru in samples could be detected, but Ev could not be detected in high concentration samples. The ratios between absorption ingredients were different from in Wuzhuyu decotion.

CONCLUSIONThe in vitro-everted intestinal sac canc absorb the ingredients of Wuzhuyu decotion selectivity. Compare with the ileum, the jejunum can provide the more absorption information and faster, the best test time is 60-90 min.

Animals ; Drug Evaluation, Preclinical ; methods ; Drugs, Chinese Herbal ; analysis ; pharmacokinetics ; Extracellular Fluid ; chemistry ; drug effects ; Ileum ; chemistry ; drug effects ; Intestinal Absorption ; Jejunum ; chemistry ; drug effects ; Male ; Rats ; Rats, Wistar

OBJECTIVETo prepare berberine microemulsion, and to investigate its properities and the absorption character in rat intestine in situ.

METHODThe optimum formulation of the blank microemulsion selected by pseudo tertiary phase diagrams and the berberine microemulsion was prepared based on the blank microemulsion. The viscosity, conductance, refraction rate and particle size of berberine microemulsion were surveyed. An in situ rat perfusion method was used to investigate the intestinal absorption of berberine microemulsion. A UV method for determination of berberine in the intestinal flux was established.

RESULTThe viscosity, conductance, refraction rate and particle size of berberine microemulsion were 2.11 cPas, 125.5 microomega, 1.363 and 24.0 nm, respectively. The absorption rate of berberine at the ileum was the best. The absorption of berberine microemulsion at the ileum was significantly higher than that of raw medicine (P < 0.01).

CONCLUSIONThe microemulsion system might improve the absorption of berberine in the intestinal tract.

Absorption ; Administration, Cutaneous ; Animals ; Berberine ; administration & dosage ; pharmacokinetics ; Drug Delivery Systems ; Drug Stability ; Female ; Ileum ; metabolism ; Intestinal Absorption ; drug effects ; Intestines ; metabolism ; Male ; Particle Size ; Rats ; Rats, Wistar ; Skin ; metabolism ; Skin Absorption ; drug effects ; physiology ; Solubility ; Technology, Pharmaceutical ; methods