Background:Ideal bowel preparation is the prerequisite for the successful diagnostic and therapeutic colonoscopy.The retention of intestinal bubbles can seriously affect the clarity of the intestinal mucosa and subsequently decrease the detection rate of colonoscopy.Aims:To investigate the application value of dyclonine hydrochloride mucilage in bowel preparation for colonoscopy.Methods:This study was a randomized double-blinded placebo-controlled trial.Patients who underwent colonoscopy from October 2020 to October 2023 at Hainan West Central Hospital were enrolled and randomly allocated into the dyclonine hydrochloride mucilage group and the control group.3 L polyethylene glycol(PEG)+dyclonine hydrochloride mucilage and 3 L PEG+placebo were given for bowel preparation,respectively.The quality of bowel preparation was evaluated by Boston bowel preparation scale(BBPS)score and bubble score.Furthermore,a questionnaire was conducted.The cecal intubation time,withdrawal time,adenoma detection rate and adverse reaction were compared between the two groups.Results:A total of 482 patients who underwent colonoscopy were included.No significant differences in clinical characteristics such as gender,age,body mass index(BMI)and main reasons for colonoscopy were found between the dyclonine hydrochloride mucilage group and the control group(all P>0.05).Compared with the control group,no significant differences existed in total BBPS score and segment scores for right,transverse,and left colon in the dyclonine hydrochloride mucilage group(all P>0.05),but the total bubble score and segment scores for right,transverse,and left colon were significantly decreased(all P<0.001).The withdrawal time in the dyclonine hydrochloride mucilage group was significantly decreased compared to the control group(P<0.001),and the adenoma detection rate was significantly increased(P=0.001).However,no significant differences in cecal intubation time and incidence of adverse reaction were found between the two groups(all P>0.05).Conclusions:Administration of dyclonine hydrochloride mucilage during bowel preparation for colonoscopy can reduce the formation of intestinal bubbles,shorten the withdrawal time and increase the adenoma detection rate.

Objective:To investigate the effect of glucagon like peptide-2(GLP-2)on 2,4,6-trinitrobenzenesulfonic acid(TNBS)induced intestinal mucosal tissue damage and the effects of helper T cell 1/helper T cell 2(Th1/Th2)balance in rats with Crohn's disease(CD).Methods:Forty rats were randomly divided into control group,CD group,treatment(CD+GLP-2)group and positive control[CD+sulfasalazine(SASP)]group,with 10 rats in each group.TNBS induced CD model was established and the rats in the other 3 groups were given corresponding treatment.After completion,colon macroscopic damage index(CMDI)was evaluated,HE staining was used to observe the histopathological changes of intestinal mucosa,TUNEL staining was used to detect apoptosis of co-lonic tissue cells,ELISA was used to determine serum IFN-γ,TNF-α,IL-12,IL-4 and IL-10,immunohistochemical staining was used to detect the expressions of IFN-γ and IL-4 in colon tissues,flow cytometry was used to determine the proportion of Th1/Th2 in spleen.Results:Compared with CD group,CMDI in CD+GLP-2 group and CD+SASP group were significantly decreased(P all<0.001),intes-tinal mucosal damage was improved,the positive rate of TUNEL in colon tissue was significantly decreased(P all<0.001),the con-tents of IFN-γ,TNF-α and IL-12 in serum were significantly decreased(P all<0.001),the contents of IL-4 and IL-10 in serum were significantly increased(P all<0.001),the expression of IFN-γ in colon tissue was significantly decreased and the expression of IL-4 was significantly increased(P all<0.001),the proportion of Th1 cells was significantly decreased while the proportion of Th2 cells was significantly increased(P all<0.001),Th1/Th2 also decreased significantly(P all<0.001).Conclusion:GLP-2 can effectively im-prove the intestinal mucosal injury of CD rats induced by TNBS,and the mechanism may be related to regulating the immune balance of Th1/Th2 cells,inhibiting inflammatory response and reducing cell apoptosis.

Background:Ideal bowel preparation is the prerequisite for the successful diagnostic and therapeutic colonoscopy.The retention of intestinal bubbles can seriously affect the clarity of the intestinal mucosa and subsequently decrease the detection rate of colonoscopy.Aims:To investigate the application value of dyclonine hydrochloride mucilage in bowel preparation for colonoscopy.Methods:This study was a randomized double-blinded placebo-controlled trial.Patients who underwent colonoscopy from October 2020 to October 2023 at Hainan West Central Hospital were enrolled and randomly allocated into the dyclonine hydrochloride mucilage group and the control group.3 L polyethylene glycol(PEG)+dyclonine hydrochloride mucilage and 3 L PEG+placebo were given for bowel preparation,respectively.The quality of bowel preparation was evaluated by Boston bowel preparation scale(BBPS)score and bubble score.Furthermore,a questionnaire was conducted.The cecal intubation time,withdrawal time,adenoma detection rate and adverse reaction were compared between the two groups.Results:A total of 482 patients who underwent colonoscopy were included.No significant differences in clinical characteristics such as gender,age,body mass index(BMI)and main reasons for colonoscopy were found between the dyclonine hydrochloride mucilage group and the control group(all P>0.05).Compared with the control group,no significant differences existed in total BBPS score and segment scores for right,transverse,and left colon in the dyclonine hydrochloride mucilage group(all P>0.05),but the total bubble score and segment scores for right,transverse,and left colon were significantly decreased(all P<0.001).The withdrawal time in the dyclonine hydrochloride mucilage group was significantly decreased compared to the control group(P<0.001),and the adenoma detection rate was significantly increased(P=0.001).However,no significant differences in cecal intubation time and incidence of adverse reaction were found between the two groups(all P>0.05).Conclusions:Administration of dyclonine hydrochloride mucilage during bowel preparation for colonoscopy can reduce the formation of intestinal bubbles,shorten the withdrawal time and increase the adenoma detection rate.

Objective:To investigate the effect of glucagon like peptide-2(GLP-2)on 2,4,6-trinitrobenzenesulfonic acid(TNBS)induced intestinal mucosal tissue damage and the effects of helper T cell 1/helper T cell 2(Th1/Th2)balance in rats with Crohn's disease(CD).Methods:Forty rats were randomly divided into control group,CD group,treatment(CD+GLP-2)group and positive control[CD+sulfasalazine(SASP)]group,with 10 rats in each group.TNBS induced CD model was established and the rats in the other 3 groups were given corresponding treatment.After completion,colon macroscopic damage index(CMDI)was evaluated,HE staining was used to observe the histopathological changes of intestinal mucosa,TUNEL staining was used to detect apoptosis of co-lonic tissue cells,ELISA was used to determine serum IFN-γ,TNF-α,IL-12,IL-4 and IL-10,immunohistochemical staining was used to detect the expressions of IFN-γ and IL-4 in colon tissues,flow cytometry was used to determine the proportion of Th1/Th2 in spleen.Results:Compared with CD group,CMDI in CD+GLP-2 group and CD+SASP group were significantly decreased(P all<0.001),intes-tinal mucosal damage was improved,the positive rate of TUNEL in colon tissue was significantly decreased(P all<0.001),the con-tents of IFN-γ,TNF-α and IL-12 in serum were significantly decreased(P all<0.001),the contents of IL-4 and IL-10 in serum were significantly increased(P all<0.001),the expression of IFN-γ in colon tissue was significantly decreased and the expression of IL-4 was significantly increased(P all<0.001),the proportion of Th1 cells was significantly decreased while the proportion of Th2 cells was significantly increased(P all<0.001),Th1/Th2 also decreased significantly(P all<0.001).Conclusion:GLP-2 can effectively im-prove the intestinal mucosal injury of CD rats induced by TNBS,and the mechanism may be related to regulating the immune balance of Th1/Th2 cells,inhibiting inflammatory response and reducing cell apoptosis.

OBJECTIVE: To detect potential mutations of the PKHD1 gene in two pedigrees affected with infantile polycystic kidney disease. METHODS: Clinical data and peripheral venous blood samples were collected from the probands and their parents as well as fetal amniotic fluid cells. Genome DNA was extracted from the peripheral blood samples and amniotic fluid cells. Exons 32 and 61 of the PKHD1 gene were amplified with PCR and subjected to direct sequencing. RESULTS: The proband of pedigree 1 was found to carry c.4274T>G (p.Leu1425Arg) mutation in exon 32 and c.10445G>C (p.Arg3482Pro) mutation in exon 61 of the PKHD1 gene, which were inherited from her father and mother, respectively. The fetus has carried the c.4274T>G (p.Leu1425Arg) mutation. In pedigree 2, the wife and her husband had respectively carried a heterozygous c.5979_5981delTGG mutation and a c.9455delA mutation of the PKHD1 gene. No chromosomal aberration was found in the umbilical blood sample, but the genetic testing of their fetus was failed. Based on software prediction, all of the 4 mutations were predicted to be pathogenic. CONCLUSION PKHD1 c.4274T>G (p.Leu1425Arg), c.10445G>C (p.Arg3482Pro), c.5979_5981delTGG and c.9455delA were likely to be pathogenic mutations. The results have facilitated genetic counseling and prenatal diagnosis for the two pedigrees.
DNA Mutational Analysis ; Female ; Genetic Counseling ; Humans ; Mutation ; Pedigree ; Polycystic Kidney Diseases ; diagnosis ; genetics ; Pregnancy ; Prenatal Diagnosis ; Receptors, Cell Surface ; drug effects

Objective To investigate the effect of the peroxide proliferator-activated receptorgamma (PPAR-γ) agonist rosiglitazone on the motor function recovery of hind limbs in rats with spinal cord injury.Methods Sixty-eight female SD rats were used to establish spinal cord injury model by modified Allen method.(1) Eight rats were randomly divided into negative control group and rosiglitazone group with four rats in each group.The expression of aspartate proteolytic enzyme-1 (caspase-1) in spinal cord of rats 7 days after injury was detected by immunohistochemical staining.(2) Forty-eight rats were randomly divided into negative control group,rosiglitazone group,rosiglitazone + Clostridium chitosans group [nuclear factor kappa B (NF-kappa B) activator],rosiglitazone + monosodium urate group [oligomerization domain-like receptor protein 3 (NLRP3) antagonist],with 12 rats in each group.BBB scores of hindlimb motor function were assessed at 1,3,14,21 and 28 days after injury in each group.The expression of interleukin-1 β (IL-1 β) and tumor necrosis factor-α (TNF-α) in each group was detected by ELISA at 28 days after injury.Microglia were isolated from the spinal cord of 12 rats and cultured for 7 days.They were randomly divided into the following five groups:(1) negative control group:no drug treatment;(2) rosiglitazone group:1 micromol/L rosiglitazone treatment;(3) rosiglitazone + Clostridium chitin group:1 micromol/L rosiglitazone + 20 micromol/L Clostridium chitosporin treatment;(4) Clostridium chitosan treatment Mycoplasma group:20 μ mol/L shell Clostridium treatment;(5) Clostridium chitosanin + MCC950 group [(NLRP3) antagonist]:20 μmol/L Clostridium chitosanin + 100 nmol/L MCC950;Western blot was used to detect the expressions of caspase-1,NF-kappa B and NLRP3 in microglia cells;ELISA was used to detect the expressions of IL-1β and TNF-α in the supernatant of microglia culture.Results Compared with negative control group,caspase-1 expression was decreased in rosiglitazone group in spinal cord injury area [gray matter area:5.1 ± 0.8∶6.9 ± 1.1;white matter area:5.6 ± 0.9 ∶ 7.5 ± 1.1] (P ＜ 0.05).At 28 days after operation,the rosiglitazone group had the highest BBB score [(14.7 ± 1.6) points],and the BBB score of rosiglitazone + Clostridium chitosans group (10.5 ± 2.1) points was superior to that of rosiglitazone + monosodium urate group [(7.2 ± 1.3)points,P ＜ 0.05].The expressions of IL-1β and TNF-α in rosiglitazone + monosodium uric acid group were lower than those in other groups at 28 days after injury (P ＜ 0.05).In vitro,the expressions of caspase-1,NF-kappa B,IL-1β and TNF-α in rosiglitazone group were lower than those in negative control group (P ＜ O.05).The expressions of caspase-1,NLRP3,IL-1β and TNF-α in rosiglitazone + Clostridium chitosani group were higher than those in rosiglitazone group,(P ＜ 0.05).The expressions of caspase-1 and IL-1β were higher than those in Clostridium chitosani + MCC950 group (P ＜0.05),but there was no significant difference in the expression of TNF-α between the two groups (P ＞0.05).Conclusion Rosiglitazone can promote the recovery of hind limb motor function in rats with spinal cord injury by inhibiting the expression of NF-kappa B,thereby reducing the activation of NLRP3 inflammatory bodies in microglia and ultimately inhibiting the occurrence of inflammation.