Inflammatory bowel disease (IBD) is an idiopathic intestinal inflammatory condition with chronic and relapsing manifestations and is characterized by a disturbance in the interplay between the intestinal microbiota, the gut, and the brain. The microbiota-gut-brain axis involves interactions among the nervous system, the neuroendocrine system, the gut microbiota, and the host immune system. Increasing published data indicate that psychological stress exacerbates the severity of IBD due to its negative effects on the microbiota-gut-brain axis, including alterations in the stress response of the hypothalamic-pituitary-adrenal (HPA) axis, the balance between the sympathetic nervous system and vagus nerves, the homeostasis of the intestinal flora and metabolites, and normal intestinal immunity and permeability. Although the current evidence is insufficient, psychotropic agents, psychotherapies, and interventions targeting the microbiota-gut-brain axis show the potential to improve symptoms and quality of life in IBD patients. Therefore, further studies that translate recent findings into therapeutic approaches that improve both physical and psychological well-being are needed.
Humans ; Inflammatory Bowel Diseases/metabolism* ; Stress, Psychological/microbiology* ; Gastrointestinal Microbiome/physiology* ; Brain/metabolism* ; Hypothalamo-Hypophyseal System ; Pituitary-Adrenal System ; Animals

Objective:To investigate the seasonal changes of glycated hemoglobin (HbA1c) in patients with acute ischemic stroke in Tianjin.Methods:Acute ischemic stroke patients with available HbA1c data admitted to the Department of Neurology, the Second Hospital of Tianjin Medical University from January 1, 2011 to December 31, 2020 were enrolled retrospectively. The demographic data, vascular risk factors, baseline clinical data and routine blood test findings were collected. The seasonal changes of various indexes were investigated. Multiple linear stepwise regression analysis was used to determine the influencing factors of HbA1c.Results:A total of 2 721 acute ischemic stroke patients with available HbA1c data were included, of whom 1 779 (65.4%) also had diabetes mellitus, 942 patients (34.6%) did not have diabetes mellitus. The baseline National Institutes of Health Stroke Scale score, body mass index, systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol and uric acid in the winter group were significantly higher than those in the summer group (all P<0.05). HbA1c had seasonal difference in acute ischemic stroke patients without diabetes mellitus ( P<0.05). For acute ischemic stroke patients with diabetes mellitus, HbA1c showed seasonal fluctuations only at HbA1c >7% ( P<0.05). Multiple linear stepwise regression analysis showed that combined with diabetes mellitus, using insulin and/or oral hypoglycemic drugs, fasting blood glucose, uric acid, creatinine and season were the independent infuencing factors of HbA1c. Conclusions:HbA1c in patients with acute ischemic stroke in Tianjin is characterized by seasonal fluctuations, which is high in winter and spring and low in summer and autumn. This difference is related to the level of HbA1c.

Objective:To investigate the seasonal changes of fasting plasma glucose (FPG) levels in patients with acute ischemic stroke.Methods:Patients with acute ischemic stroke who were hospitalized in the Department of Neurology, the Second Hospital of Tianjin Medical University and had fasting blood glucose data from January 1, 2016 to December 31, 2020 were enrolled retrospectively. The general data and FPG results of all patients were collected, and the seasonal changes of various indexes were analyzed. Multiple linear regression analysis was used to determine the influencing factors of FPG.Results:A total of 1 323 patients with acute ischemic stroke who had FPG data were enrolled, of whom 519 patients (39.2%) had diabetes mellitus and 804 (60.8%) had no diabetes mellitus. The baseline National Institutes of Health Stroke Scale score, body mass index, systolic blood pressure, diastolic blood pressure and FPG in the winter group were significantly higher than those in the summer group (all P<0.05). Further subgroup analysis of gender and age showed that the FPG level of elderly patients aged 65-80 years had significant seasonal changes ( P<0.05). Multiple linear regression analysis showed that age, season, body mass index, whether complicated with diabetes mellitus, whether using insulin and/or oral hypoglycemic drugs were the independent influencing factors of FPG levels. Conclusion:The FPG levels in patients with acute ischemic stroke have the characteristics of seasonal fluctuation, which is more obvious in elderly patients aged 65-80 years.

Objective To investigate the distribution and changes of pathogens in intensive care unit of our hospital from 2010 to 2015,and provide treatment suggestions for infection.Methods The data of pathogens and multi-drug resistant organisms(MDROs)in ICU from 2010 to 2015 were analyzed retrospectively by WHONET5.6,Microsoft Office Excel2007 and SPSS19.0.Results The numbers of pathogens in ICU were increasing year by year while the top six were Acinetobacter baumanni,Pseudomonas aeruginosa,Klebsiella pneumoniae,Escherichia coli,Staphylococcus aureus and Candida albicans.The dominant MDROs were multi-drug resistant Acinetobacter baumanni,multi-drug resistant Pseudomonas aeruginosa,extended spectrum β lactamase producing Escherichia coli and Klebsiella pneumonia,methicillin-resistant coagulase negative Staph-ylococcus and methicillin-resistant Staphylococcus aureus,etc.There were statistically dramatic significant differences of most MDROs during the six years(P<0.01).Conclusion The pathogens of ICU were mainly bacteria related to the healthcare associated infection,and the multi-drug resistance was obviously in dynamic change as well as most pathogens.As a suggestion,antibiotic agents should be used rationally according to the antimicrobial susceptibility results for treating the MDROs.

Objective The value of pro-gastrin releasing peptide ( PGRP) which is the tumor marker of small cell lung canc-er has become a hot topic in recent years .The research was to build a new enzyme-linked immune sorbent assay ( ELISA) method ai-ming at detecting the concentration of PGRP in patients′serum. Methods We utilized synthetic PGRP epitopes for the screening of the monoclonal antibodies , labeled the screened monoclonal antibodies with horseradish peroxidase by modified sodium iodide method , and then established double antibody sandwich ELISA which could be used to detect the serum concentrations of PGRP in cancer pa -tients. Results We successfully screened E 12 mAb which could be served as the coating antibody and ED 1 mAb as the labeled anti-body.The standard antibody density range of new ELISA was 33 pg/mL~1.7 ×104 pg/mL.The comparison experiments between our method and the commercially available ELISA kit showed no significant difference ( P>0.05).The specificity of our method was 50%, and the sensitivity was 100%, while IBL kit was 92.2% and 100% respectively. Conclusion New ELISA can be used to detect the serum PGRP concentration in patients with small cell lung cancer .

Objective To explore the application of the transtheoretical model and stages of change in maintenance hemodialysis patients .Methods One hundred and thirty-eight maintenance hemodialysis patients were chosen and received the three stages of interventions according to the transtheoretical model and stages of change.The changes of clinical biochemical indicator were compared before and after the intervention . Results The levels of the serum albumin and hemoglobin were respectively (39.3 ±9.1) g/L, (108.8 ± 11.7)g/L after the intervention, and were significantly higher than (37.2 ±8.3) g/L, (105.6 ±10.4) g/L before the intervention, and the differences were statistically significant (t=-2.002 9, -2.401 4, respectively;P<0.05).The systolic blood pressure, the concentrations of K +and Na +were respectively (148.6 ±20.5) mmHg, (5.5 ±1.4)mmol/L, (146.1 ±16.5)mmol/L before the intervention, and were significantly higher than (141.2 ±22.3)mmHg, (4.9 ±1.3)mmol/L, (139.2 ±20.3)mmol/L after the intervention, and the differences were statistically significant (t=2.869 9, 3.689 3, 3.098 5, respectively; P<0.05).The body weight, blood pressure and the compliance rate of no obvious edema were significantly increased after the intervention (P<0.05).The cases of well nourished patients evaluated by the SGA were 40 cases (44.9%) before the intervention, and were 70 cases (78.7%) after the intervention, and the difference was statistically significant (χ2 =16.49, P<0.05).Conclusions Transtheoretical model and stages of change is beneficial to control blood pressure , improve the prognosis , and increase the life quality of maintenance hemodialysis patients .

Objective To summarize our experience and treatment results of nasopharyngeal carcinoma treated in a single institution. Methods From Jan. 2000 to Dec.2003,1837 patients with histologically proven nasopharyngeal carcinoma(NPC) were retrospectively analyzed. The disease was staged according to the Fuzhou stage classification. 885 patients received cisplatin (DDP) based chemotherapy. All patients received radiotherapy to the nasopharynx and neck. The dose was 30.6-74.0 Gy, 1.8-2.0 Gy per fraction over 3.5-8.0 weeks to the primary site with 60Co γ rays or 6 MV X-rays. The dose to lymph nodes was 60-68 Gy. The residual disease was boosted by 192Ir afterloading brachytherapy,small external beam fields, conformal radiotherapy,or X-knife. Results The median follow-up time was 54(3-90) months. The 5-year overall survival(OS), disease-free survival (DFS), relapse-free survival (RFS) and distant metastasis free survival(DMSF) rates were 67.42% ,63.25% ,86.47% and 80.31% ,respectively. Clinical stage was the most significant prognostic factor,and OS was 88% ,74.8% ,65.9% ,52.4% and 20% for stage Ⅰ ,stage Ⅱ,stage Ⅲ,stage ⅣA and stage ⅣB,respectively. Gender,T,N and TNM stage were the significant prognostic factors of OS in multivariate analysis. Conclusions For NPC patients,the 5-year OS of 67.4% is achieved by conventional radiotherapy technique in our institution. Both univariate and multivariate analysis shows that gender and clinical stage are the significant prognostic factors of OS.

OBJECTIVE:To discuss the role and responsibility of clinical pharmacists in drug counseling for outpatients of our hospital.METHODS:The outpatient drug counseling records in our hospital from 2006 to 2007 were collected and analyzed by citing typical cases as example.RESULTS:The questions presented by patients were related to different aspects of pharmacy and most of which had been solved efficiently.CONCLUSION:In guiding patients' rational drug use,pharmacists should have extensive pharmaceutical knowledge meanwhile bear great responsibility.