As an immune organ,the intestine plays the role of barrier to the bacterium and endotoxin.And the glutamine is necessary to maintain the function of intestine mucosa endothelium.It has the theoretical significance and clinical value for the growth and repair of intestine mucosa endothelium,the improvement of immune function, and the reduction of oxidant injury.The effect of glutamine on the intestine barrier and its mechanism are reviewed.

The roles of the probiotics improving the intestine flora disturbance, protecting the intestine defense and barrier functions, and modulating the microbial balance are taking more attention in present years with important theoretical significance and clinical application value. We review the effect of probiotics on the intestinal microecology and its possible mechanisms.

Lactobacillus can maintain the stability of microbiological environment in intestine and its surface layer protein controls the biological function of intestinal epithelia cells. The mechanism of adhering had been studied. In this article, we review the progress of surface layer protein in the study of the isolation, identification and the biological reaction with the intestinal epithelia cells .

Objective To investigate the effect of enteral and parenteral nutrition on gut microecology in rats with abdominal infection. Methods Fourteen Sprague-Dawley (SD) model rats of abdominal infection, which had survived for more than 6 days were divided into two groups: PN group ( n =7) and PN+EN group ( n =7) via jejunostomy and jugular vein respectively for another 5 days. The nutrition support in the two groups was isonitrogen and isocaloric. At sacrifice on the sixth day, occludin and IgA level in plasma cells of intestine epithelium of the gut were measured by immunohistochemistry. Vena cava blood and homogenated tissue of liver, lung and mesenteric lymph nodes were cultured to determine bacterial translocations, and portal vein blood was tested for endotoxin. Results The expression of occludin and IgA in the small and large intestine in PN+EN group were stronger than PN group ( P

Objective: To investigate the influences of enteral and parenteral nutrition suppled by gut on the gut microecology of the rats with abdominal infection. Methods: 14 Sprague-Dawley(SD)rats with abdominal infection models made with cecal ligation and perforation method were divided into two groups: parenteral nutrition (PN group, n=7) and PN+enteral nutrition (EN group, n=7) . The components of nutrition solutions in the two groups were isonitrogen and isocaloric. The rats were killed in the sixth day. The feces in cecum were cultured for anaerobic bacterial growth and analysed by bacterial group DNA fingerprint spectrum with random amplified polymorphic DNA . Results: ①The total death rate of the rats was 69.6%. Abdominal cavity abscess, liver abscess, and pulmonary infection commonly appeared in the model rats. ②The number of germs cultured in EN group was higher than in the PN group, but the quantity of Cl Perfrigens was higher , too. The gene stripe of probiotics group in EN group was similar to that in normal rats showed in the DNA fingerprint spectrum, but was significantly different in PN group with strange stripes. Conclusion: Application of early EN may correct the intestinal flora disturbance resulted from PN and increase the quantity of intestinal flora, but it can't control the species and may increase some conditional pathogenic bacteria .

Objective To evaluate early diagnosis and preemptive therapy of human cytomegalovirus infection in renal transplant recipients. Methods We selected 165 renal transplant recipients who underwent transplantation from January 2007 to January 2009 and adhered to follow-up as research subjects. The samples of blood and urine were collected before transplantation, every 1 week from 2 to 8 weeks and every 2 weeks from 9 to 24 weeks after transplantation. The viral load of blood and urine was detected by fluorescence quantitative polymerase chain reaction (FQ-PCR). Once HCMV DNA load was more than 103 copies/ml, preemptive therapy was done immediately by ganciclovir. Results All the samples of blood and urine were negative before operation. HCMV DNA load could be detected in the concentrated urine at the second week and the peak of HCMV DNA loadoccurred from the sixth to eighth week after operation. At the same detection time, the number ofpositive recipients in the concentrated urine was more than in blood. In 30 cases HCMV DNA load was detected in the blood and the positive rate was 18.18%. In 64 cases HCMV DNA load was detected in the concentrated urine and the positive rate was 38.79%. The positive rate of the concentrated urine was significantly higher than in blood (P＜0.05). In 30 cases positive for HCMV DNA in the blood and urine, ganciclovir was given and the viral load was decreased gradually. But 8 recipients developed into CMV pneumonia and were cured through the comprehensive treatment. The clearance time of HCMV DNA in the concentrated urine was 10.2 ± 3.4 days. Thirty-four cases that were only positive for HCMV DNA in the urine were also treated by ganciclovir and no case developed into CMV pneumonia. The clearance time of HCMV DNA was 5.5 ± 2.1 days, and the clearance time was shortened as compared with that in those positive for HCMV DNA in the blood and urine (P＜0.05). Conclusion FQ-PCR can detect HCMV DNA in the concentrated urine in advance and increase the positive rate. Once the sample of the concentrated urine is positive, preemptive therapy has a good effect.

Objective To observe the feasibility of 125I intra-operative implantation plus palliative resection of gastric carcinoma for treatment of advanced gastric cancer infiltrating pancreas. Methods 125 I was implanted intraoperatively into the residual pancreatic cancer tissues after gastric carcinoma was palliatively removed. Results From Feb. 2005 to Jun. 2009, 15 cases (9 male, 6 female) advanced gastric cancer patients were treated with 125 I intra-operative implantation. The patients' ages ranged from 41 to 78 years, with the median age of 64 years old. There were 10 cases of gastric cancer infiltrating the neck or body of pancreas and 5 cases infiltrating pancreatic head. No severe post-operative complications were recorded. The follow-up showed that there were 5 cases of CR (33.3%), 9 cases of PR (60%), 1 case of NC (6.7%) and no PD patients were found. Conclusion 125I intra-operative implantation plus palliative gastric resection is feasible and effective for patients of advanced gastric cancer infiltrating the pancreas.

In recent years, with the in-depth research on intestinal microecology, probiotics, probiotics, synbiotics, fecal bacteria transplantation and other microecological therapies have become new clinical treatment and intervention methods. The occurrence and development of some chronic diseases are closely related to the disorder of intestinal flora. Therefore, in clinical practice, the treatment and adjuvant treatment of chronic dis-eases related to intestinal flora disorder with the method of intestinal microecology will bring better treatment op-tions and clinical prognosis. How to better regulate intestinal flora to bring more benefits to such patients, as well as what kind of microecologics and treatment methods are the primary problems and challenges in the inter-vention of chronic diseases with microecologics. Based on the current trend of intestinal microecological inter-vention in chronic diseases, this article proposedthe microecological intervention strategy, in order to improve theunderstanding of this topic.

Objective To investigate the influence of infection factors on kidney transplantation after organ donation and possible countermeasures.Methods Thirty-seven cases of kidney transplantation in Organ Transplantation Center of Qianfoshan Hospital Affiliated to Shandong University from January 2014 to December 2016 were retrospectively analyzed.The patients were divided into two groups according to perioperative infection prevention programs:42 patients with postoperative routine use of cephalosporins or penicillin for 2 weeks,and 95 patients with postoperative application of carbapenems + micafungin.Postoperative infection rate,occurrence time,pathogen infection;donor age,perioperative pathogens of donor and receptor (organ preservation solution,drainage fluid,urine,sputum samples),acute rejection,delayed graft function (DGF),diabetes mellitus,and the use of immunosuppressive agents were recorded.Results The infection rate in carbapenem + micafungin group was 12.6％,and the infection rate in cephalosporin or penicillin group was 19.4％ (P＜0.05).Pathogen positive detection rate of the drainage fluid,urine and sputum was lower in carbapenems + micafungin group than that in cephalosporins or penicillin (P＜0.05).Within 2 weeks after operation,the detection rate of bacteria and fungi in the carbapenems +micafungin infection prevention group was lower than that in the control group (P＜0.05).There was no significant difference in the detection of viruses (P＞0.05).There were no significant differences in the detection of pathogens among the two weeks to six months after surgery (P＞ 0.05).Donor infection,acute rejection,DGF,and diabetes mellitus were the risk factors for postoperative infection (P＜0.05).Conclusion The application of carbapenems and micafungin can reduce the incidence of infection for the early stage of DCD kidney transplantation.Donor infection,acute rejection,DGF and diabetes mellitus are all risk factors for the postoperative infection.

Objective To observe the results and reality of transurethral resection of bladder tumor with preexcitation of electric cutting loop in the prevention of obturator nerve reflex.Methods The clinical data of 186 patients with bladder tumors admitted from January 2015 to August 2018 were retrospectively analyzed.There were 112 males and 74 females aged 35 to 83 years,average (59 ± 11)years.76 patients were admitted because of intermittent gross hematuria and 110 patients were admitted because of physical check-up.All patients underwent ultrasound,CT (plain scan/enhancement) and cystoscopy before operation.The pathological diagnosis of cystoscopy biopsy was bladder urothelial cell carcinoma.There were 105 cases clinical stage Ta stage,81 cases of T1 stage.There were 103 single cases and 39 multiple cases of non-muscular invasive bladder.According to the different surgical techniques,the patients were divided into two groups:the pre-excitation group and lateral incision group.There were 142 cases in pre-excitation group.In the pre-excitation group,the tumors were removed routinely by the resection ring.When the resection ring was far away from the tumors,the pedal switch was pressed to excite the resection ring.The resection ring was moved to the location of the tumors,and the tumors were cut to the muscular layer.The operation was completed after 2 cm electric cauterization around the wound and hemostasis.In the lateral incision group,the tumors were removed routinely by the electric resection ring.The operation time,incidence of obturator nerve reflex,incidence of bladder perforation,amount of bleeding,retention time of catheter,pathological grading,risk grading,hospitalization time and recurrence rate of tumors at 6 months after operation were compared between the two groups.Results The operation was successfully completed in both groups,and there was no transition to open operation.In the pre-excitation group,the operation time was 10 minutes to 56 minutes,with an average of (28 ± 12) minutes,and the intraoperative blood loss ranged from 5 ml to 70 ml,with an average of (35 ± 15) ml.In the lateral incision group,the operation time was 15 minutes to 65 minutes,with an average of (28 ± 11) minutes,and the blood loss was 10 ml to 80 ml,with an average of (40 ± 15) ml.There was no significant difference in operation time and blood loss between the two groups (P ＞ 0.05).There were only 3 cases of obturator nerve reflex in preexcitation group,the incidence was 2.1％.There were 13 cases of obturator nerve reflex in lateral resection group,the incidence was 29.5％.There was significant difference of nerve reflex incidence between the two groups (P ＜ 0.05).Conclusions In transurethral resection of bladder tumors,the method of pre-excitation of plasma resection ring can effectively decrease obturator nerve reflex and make the operation safer.