Objective:To observe and analyze the influence of deoxycholic acid (DCA) on intestinal microbiota and bile acid metabolism during the process of enteritis induced by DCA in mice.Methods:Twenty C57BL/6J mice were randomly and equally divided into DCA group and control group. The mice in DCA group were developed by feeding the feed with 0.2% DCA and the mice in control group were developed with routine feed for 24 weeks. The degree of intestinal tissue inflammation was evaluated by HE staining and scored, the change of intestinal microbiota was analyzed by pyrosequencing, bile acid levels of all grades in faeces were detected by high performance liquid chromatography-tandem mass spectrometry (HPLC-MS) , the expressions of bile acid-related genes were detected by quantitive real-time PCR.Results:The intestinal histology scores in DCA group was significantly higher than that of the control group (both P<0.05) . The diversity of fecal microbiota in the DCA group was significantly reduced, the percentage of Firmicutes at the phylum level and the percentage of Clostridium XIVa at the genus level were significantly decreased (both P<0.05) . The total bile acid, secondary bile acid, unconjugated bile acid and tauro-α-muricholic acid (T-α-MCA) of mice faeces in DCA group were significant higher than those in control group (all P<0.05) . The expression of biliary acid transporter gene organic solute transporter β ( Ost- β) , farnesoid X receptor ( FXR) and fibroblast growth factor 15 ( FGF15) in DCA group decreased significantly (all P<0.05) , while the expressions of liver bile synthesis rate-limiting enzymes Cyp7a1, Cyp7b1 and Cyp27a1 increased obviously (all P<0.05) . Conclusions:DCA can induce the progress of enteritis, which may be related to its destruction of intestinal microbiota in mice and the promotion of liver bile acid synthesis through FXR-FGF15 signaling pathway.

Objective:To observe and analyze the influence of deoxycholic acid (DCA) on intestinal microbiota and bile acid metabolism during the process of enteritis induced by DCA in mice.Methods:Twenty C57BL/6J mice were randomly and equally divided into DCA group and control group. The mice in DCA group were developed by feeding the feed with 0.2% DCA and the mice in control group were developed with routine feed for 24 weeks. The degree of intestinal tissue inflammation was evaluated by HE staining and scored, the change of intestinal microbiota was analyzed by pyrosequencing, bile acid levels of all grades in faeces were detected by high performance liquid chromatography-tandem mass spectrometry (HPLC-MS) , the expressions of bile acid-related genes were detected by quantitive real-time PCR.Results:The intestinal histology scores in DCA group was significantly higher than that of the control group (both P<0.05) . The diversity of fecal microbiota in the DCA group was significantly reduced, the percentage of Firmicutes at the phylum level and the percentage of Clostridium XIVa at the genus level were significantly decreased (both P<0.05) . The total bile acid, secondary bile acid, unconjugated bile acid and tauro-α-muricholic acid (T-α-MCA) of mice faeces in DCA group were significant higher than those in control group (all P<0.05) . The expression of biliary acid transporter gene organic solute transporter β ( Ost- β) , farnesoid X receptor ( FXR) and fibroblast growth factor 15 ( FGF15) in DCA group decreased significantly (all P<0.05) , while the expressions of liver bile synthesis rate-limiting enzymes Cyp7a1, Cyp7b1 and Cyp27a1 increased obviously (all P<0.05) . Conclusions:DCA can induce the progress of enteritis, which may be related to its destruction of intestinal microbiota in mice and the promotion of liver bile acid synthesis through FXR-FGF15 signaling pathway.

This paper summarized the experience of caring a patient with pancreatic cancer-related depression treated with pancreaticoduodenectomy and postoperative delayed gastric emptying.The nursing included several key points.On the base of collaboration of muhi-disciplinary teams,to strengthen supportive psychological intervention and safety management after admission;to use multimodal analgesia combined with cognitive behavioral therapy to reduce postoperative pain.After the patient was complicated with gastric emptying obstacles,solution-focus mode,sham feeding and nutritional support programs were implemented.Long-term follow-up with physician-nurse collaboration mode was implemented to enhance quality of life of the patient.

Objective To compare the degree of atherosclerosis in middle-aged versus elderly patients with chronic kidney disease (CKD),and to explore the relationship between inflammatory molecules in venous blood and atherosclerosis.Methods Totally 87 elderly patients and 64 middleaged patients with CKD were selected.The vein fasting blood samples were taken in the morning.Serum levels of interleukin (IL)-18,IL-6,tumor necrosis factor (TNF-α),high-sensitivity C-reactive protein (hs-CRP) were measured by enzyme-linked immunosorbent assay (ELISA) and ankle-brachial pulse wave conduction velocity (baPWV) was detected.Results Inflammatory molecules such as IL-18,IL-6,TNF-α and hs-CRP levels in venous blood were increased with the severity of CKD in both two groups,and the levels of inflammatory molecules were higher in elderly group than in middle-aged group.There was a signifiant difference in the detection rate of patients with baPWV＞1400 cm/s between elderly group and middle-aged group [30 cases (34.5％) vs.11 cases (17.2％),x2 =5.58,P＜0.05].The prevalence of PWV＞1400 cm/s was higher in patients with hyperlipidemia and hypertension than in patients with diabetes or heart disease (elderly group:100％,100％ vs.45.5％,40％; middle-aged group:80％,100％ vs.28.6％,33.3％,respectively; P＜0.05).The inflammatory protein (IL-18,IL-6,TNF-α and hs-CRP) levels were significantly higher in patients with baPWV＞ 1400 cm/s than those with baPWV ＜ 1400 cm/s (P＜0.05).Conclusions The degree of atherosclerosis is more severe in elderly CKD patients than in middle-aged CKD patients,which needs to be taken seriously enough.

ObjectiveTo evaluate the effect of transabdominal gastric fundusectomy plus distal esophagectomy in patients suffering from portal hypertension. MethodsEighteen portal hypertension patients with a history of bleeding esophageal varix were treated by this procedure on elective basis.ResultsAll cases were followed up for an average of 46 months. There was no recurrent hemorrhage and no mortality during the follow-up.ConclusionsThis procedure is well tolerated by the patients with definite immediate effect and low recurrent bleeding rate.