The main reason for the death of the patient with acute hemorrhage necrosis pancreatitis (AHNP) is pancreatic infection and multi-organ failure caused by endotoxemia and intestinal bacterial translocation[1-7]. Howeve...The main reason for the death of the patient with acute hemorrhage necrosis pancreatitis (AHNP) is pancreatic infection and multi-organ failure caused by endotoxemia and intestinal bacterial translocation[1-7]. However, the pathogenesis of endotoxemia and intestinal bacterial translocation remains a question[8-10]; moreover, no effective method of prevention and cure for it has been found till now[11 -15] In the present study, we infused low dose dopamine and low molecular weight dextran through the catheters to abdominal aorta and portal vein, and observed its influence on the endotoxin concentration in plasma and the rate of translocation of intestinal bacteria in AHNP rats.展开更多
Dear Sir,Dai et al.[1] must be commended on their useful investigation of the clinical significance of endotoxins in the expressed prostatic secretions （EPS） of chronic prostatitis （CP） patients. However, we take ...Dear Sir,Dai et al.[1] must be commended on their useful investigation of the clinical significance of endotoxins in the expressed prostatic secretions （EPS） of chronic prostatitis （CP） patients. However, we take issue with their conclusion. The conclusion that EPS endotoxin determination is helpful in diagnostic confirmation is plausible,展开更多
AIM To clarify whether endotoxin is of pathogenic importance for hepatocarcinogenesis, or the increased cancer risk results solely from the cirrhotic process. METHODS The rat model of hepatoma was treated by the in...AIM To clarify whether endotoxin is of pathogenic importance for hepatocarcinogenesis, or the increased cancer risk results solely from the cirrhotic process. METHODS The rat model of hepatoma was treated by the intake of 0 03% thioacetamide in drinking water for six months. During induction of hepatoma, rats were additionally treated with splenectomy and/or lipopolysaccharide administration. The liver nuclear DNA index and proliferation index were quantitatively analyzed by flow cytometry. Hepatic histology was examined with light and electron microscopes. Plasmic endotoxin concentration and γ glutamyl transpeptidase activity were measured, and hepatoma incidence was recorded. RESULTS Thioacetamide induced cirrhosis and hepatoma in Wistar rats with histology or regenerative nodule, fibrosis and neoplastic foci were quite similar to the pathogenic process of human cirrhosis leading to hepatoma. In comparison with TAA controls (DNA index: 1 15±0 21), exo endotoxin increased the DNA index by 7 8% (1 24±0 25, P <0 02) and hepatoma rate by 16 7. Splenectomy induced enteric endotoxemia increased the DNA index by 25% (1 44±0 15, P <0 01) and hepatoma rate by 33%. A summation of the effects of these two factors increased the DNA index by 36% ( P <0 01)and hepatoma incidence by 50%, moreover, the level of endotoxemia showed a close relation with DNA index ( r =0 96, P <0 01), as well as with the occurrence rate of hepatoma ( r =0 00, P <0 01). Histological findings further verified such alterations. CONCLUSION Lipopolysaccharide administration and/or splenectomy induced enterogenic endotoxemia may enhance rat hepatocarcinogenesis induced by oral intake of thioacetamide.展开更多
In the recent decade, interest in treatment and prevention of many critical, severe and acute diseases caused by bacterial endotoxins has been aroused along with the advance of the knowledge on the nature of the endot...In the recent decade, interest in treatment and prevention of many critical, severe and acute diseases caused by bacterial endotoxins has been aroused along with the advance of the knowledge on the nature of the endotoxin and the conditions involved. In abroad, attention has been mainly payed to raising antisera and monocolonal antibodies against the endotoxin and the induced mediators. However, the allergic reactions and the cost are still the problems. Till now, there is no drug that can antagonize endotoxin with high effectiveness and low toxicity. Clinical treatments are still confined in inhibiting or killing the pathogen, and correcting the internal environmental disturbance. Being less toxic and rich in resources with low cost and less side-effects, screening of effective Chinese drugs for antagonizing endotoxin is of important and practical significance. Endotoxin belongs to the category of toxic evils, or more precisely, the heat toxin in TCM. Therefore the application of heat-clearing and detoxifying Chinese drugs to antagonizing endotoxins is consistent with the theory of TCM. Some achievements in this field are reported as follows.展开更多
Aim: To evaluate the clinical significance of the quantitative determinations of endotoxins in the expressed prostatic secretions (EPS) of chronic prostatitis (CP) patients. Methods: The EPS of 45 patients with CP and...Aim: To evaluate the clinical significance of the quantitative determinations of endotoxins in the expressed prostatic secretions (EPS) of chronic prostatitis (CP) patients. Methods: The EPS of 45 patients with CP and 15 normal volunteers were obtained for microscopic examination, bacterial culture and endotoxin determination. The level of endotoxins was determined by the Limulus-amebocyte-lysate test with chromogenic substrate. Results: Patients with CP had higher mean levels of endotoxins in EPS than normal volunteers [52.06 ± 32.83 EU.L^(-1) vs. 4.77 ± 4.14 EU'L^(-1) (P < 0.05)]. The levels of endotoxins in CP type Ⅱ, type Ⅲa and type Ⅲb were 68.62 ± 34.78 EU.L^(-1), 45.30± 23.33 EU.L^(-1) and 15.83 ± 5.31 EU·L^(-1), respectively [type Ⅱ vs. type Ⅲa (P > 0.05), type Ⅲb vs. normal controls (P > 0.05), type Ⅱ/type Ⅲa vs. normal controls P < 0.05)]. Conclusion: CP patients have elevated levels of endotoxins in the EPS, which suggests that inflammation is a feature of this disease. EPS endotoxin determination is not only helpful in diagnostic confirmation, but also in evaluating the response to treatment in CP patients.展开更多
Background The bacterial endotoxins test （BET） is a method used to detect or quantify endotoxins （lipo-polysaccharide,LPS） and is widely used in the quality control of parenteral medicines/vaccines and clinical di...Background The bacterial endotoxins test （BET） is a method used to detect or quantify endotoxins （lipo-polysaccharide,LPS） and is widely used in the quality control of parenteral medicines/vaccines and clinical dialysis fluid.It is also used in the diagnosis of endotoxemia and in detection of environment air quality control.Although BET has been adopted by most pharmacopoeias,result judgment algorithms （RJAs） of the test for interfering factors in the BET still differ between certain pharmacopoeias.We have evaluated RJAs of the test for interfering factors for the revision of BET described in the Chinese Pharmacopoeia 2010 （CHP2010）.Methods Original data from 1 748 samples were judged by RJAs of the Chinese Pharmacopoeia 2010,the Japanese Pharmacopoeia 2011 （JP2011）,the European Pharmacopoeia 7.0 （EP7.0）,the United States Pharmacopoeia 36 （USP36）,and the Indian Pharmacopoeia 2010 （IP2010）,respectively.A SAS software package was used in the statistical analysis.Results The results using CHP2010 and USP36,JP2011,EP7.0,and IP2010 had no significant difference （P=-0.7740）.The results using CHP2010 of 1 748 samples showed that 132 samples （7.6%） required an additional step; nevertheless there was no such requirement when using the other pharmacopeias.The kappa value of two RJAs （CHP2010 and EP7.0） was 0.6900 （0.6297-0.7504） indicating that the CHP2010 and other pharmacopoeias have good consistency.Conclusions The results using CHP2010 and USP36,JP2011,EP7.0,and IP2010 have different characteristics.CHP2010 method shows a good performance in Specificity,mistake diagnostic rate,agreement rate,predictive value for suspicious rate,and predictive value for passed rate.The CHP2010 method only had disadvantages in sensitivity compared with other pharmacopeias.We suggest that the Chinese pharmacopoeia interference test be revised in accordance with the USP36,JP2011,EP7.0,and IP2010 judgment model.展开更多
Endotoxins have been credited for over 50% of sepsis cases, with significantly greater mortality.1 A literature indicates wide-spread agreement that early detection of endotoxemia, endotoxin in the bloodstream, is th...Endotoxins have been credited for over 50% of sepsis cases, with significantly greater mortality.1 A literature indicates wide-spread agreement that early detection of endotoxemia, endotoxin in the bloodstream, is the major key for patient survival from sepsis.2 Today the most popular endotoxin detection system is bacterial endotoxins test （BET）, adopted by most pharmacopoeias. Interference test is a part of the bacterial endotoxin inspection method, used to judge whether the sample can be applied in BET. However, Limuloid resources are exhausted in China, which is an important source for LAL. Here, we reported 5 simple models for interfering factors test in the BET, and compared new models with the United States Pharmacopoeia 36 （USP36）.展开更多
BACKGROUND Acute appendicitis,a common condition with a higher prevalence among men,has shown an increasing incidence in recent years owing to lifestyle changes.It is characterized by right lower quadrant abdominal pa...BACKGROUND Acute appendicitis,a common condition with a higher prevalence among men,has shown an increasing incidence in recent years owing to lifestyle changes.It is characterized by right lower quadrant abdominal pain,rebound tenderness,and rapid onset.Its pathogenesis is complex and potentially linked to infection,environment,and genetics.Timely intervention is crucial to prevent complications.While surgery is the primary treatment,it carries risks,including postoperative infections that may necessitate re-operation.Gram-negative bacteria release endotoxin(ETX),which induces inflammation and is recognized by toll-like receptor 4(TLR4).This study evaluated ETX and TLR4 levels in patients with acute appendicitis to assess the risk of postoperative incision infections,aiding in prevention and treatment.AIM To explore ETX and TLR4 expression in the blood of patients with acute appendicitis and its association with in postoperative incision infection.METHODS A total of 153 patients with acute appendicitis treated at our hospital between April 2022 and March 2024(n=153)were included in the study.Patients were categorized into infected(n=36)and uninfected(n=117)groups according to the development of postoperative incision infections.General characteristics and blood levels of ETX and TLR4 were compared,and the factors influencing postoperative infection were identified using multivariate logistic regression.ETX and TLR4 predictive values were analyzed using receiver operating characteristic curves.RESULTS No statistically significant differences were observed between the two groups in terms of sex,age,or other general characteristics(P>0.05).Compared to the uninfected group,the infected group had a higher proportion of patients with suppurative or gangrenous appendicitis,longer surgical times,longer incision lengths,and elevated ETX and TLR4 levels(P<0.05).Multivariate logistic regression analysis identified pathological type,surgical method,surgical time,and incision length as factors influencing postoperative incision infection in acute appendicitis.Receiver operating characteristic curve analysis revealed that both ETX and TLR4 levels were predictive factors for postoperative incision infection,with higher prediction efficiency when combined.CONCLUSION Pathological type,surgical method,surgical time,and incision length significantly influence postoperative incision infection risk in patients with acute appendicitis.Elevated ETX and TLR4 levels serve as valuable predictors of post-appendectomy infections.展开更多
Rationale: Endotoxin contamination in conventionally purified water poses serious risks to hemodialysis patients, leading to complications such as inflammation and sepsis. Addressing these risks is essential for enhan...Rationale: Endotoxin contamination in conventionally purified water poses serious risks to hemodialysis patients, leading to complications such as inflammation and sepsis. Addressing these risks is essential for enhancing patient safety and meeting global dialysis water quality standards. Advanced filtration technologies, such as titanium dioxide (TiO₂)-based nanoparticle filters, offer a promising approach to improve water purification processes in renal care. Objectives: This study aimed to develop and evaluate the effectiveness of a TiO₂-based nanoparticle microporous filtration system for hemodialysis water purification. The objectives included analyzing the system’s performance in reducing chemical contaminants (calcium, magnesium, aluminum, and lead) and microbiological contaminants (total viable count [TVC] and endotoxin units [EU]) across multiple renal centers. Methods: Water samples from three renal centers (RC1, RC2, and RC3) were analyzed pre- and post-filtration. TiO₂ nanoparticles were synthesized using the sol-gel method and characterized via Fourier Transform Infrared (FTIR) spectroscopy and Scanning Electron Microscopy with Energy Dispersive X-ray analysis (SEM/EDX). The microporous filter, fabricated with TiO₂ nanoparticles, silicon dioxide, and polyethylene glycol (PEG), was tested for its ability to remove contaminants. Analytical techniques included spectroscopy for chemical analysis and microbiological assays for contaminant quantification. Results: Post-treatment analysis revealed significant reductions in chemical contaminants, with removal efficiencies averaging 78% for calcium, 80% for magnesium, 81% for aluminum, and 76.6% for lead across all centers. Microbiological contamination was also substantially reduced, with 78–80% removal of TVC and 76–84.6% reduction in EU levels. FTIR analysis confirmed the presence of hydroxyl groups critical for adsorption, while SEM/EDX characterization revealed a crystalline structure with a particle size of 1.45 nm, pore size of 4.11 μm, filter height of 2.56 mm, and bulk density of 0.58 g/cm³. Conclusion: The TiO₂-based nanoparticle filtration system demonstrated high efficacy in removing chemical and microbiological contaminants, significantly improving water quality for hemodialysis. These results highlight its potential as a practical solution for renal centers, especially in resource-constrained settings. Further studies are needed to evaluate its long-term performance and feasibility for widespread adoption. Recommendation: Renal centers should consider adopting TiO2-based nanoparticle filters to address persistent water quality challenges. Pilot implementations across diverse settings can provide insights into operational feasibility. Additional research should explore scalability, maintenance requirements, and cost-effectiveness to optimize integration into healthcare systems. Significance Statement: This study introduces a practical and innovative solution to improve hemodialysis water purification. By effectively reducing both chemical and microbiological contaminants, the TiO2-based filtration system has the potential to enhance patient safety and outcomes, particularly in settings where maintaining high water quality standards remains challenging.展开更多
This communication demonstrates the feasibility of the gel-clot method for the analysis of bacterial endotoxins in water extracts of perfluorocarbon which is a water insoluble liquid medical device. Perfluorocarbon （...This communication demonstrates the feasibility of the gel-clot method for the analysis of bacterial endotoxins in water extracts of perfluorocarbon which is a water insoluble liquid medical device. Perfluorocarbon （10 mL） was shaken with 10 mL water for 15 min at 2000 r/min and the endotoxin present was extracted to the aqueous phase without interference inhibition/enhancement of the product and the recovery of endotoxin added to perfluorocarbon was determined, A validation study confirmed that endotoxins presented in perfluorocarbon pass over into the aqueous phase at concentrations of 20, 10 and 5EU/mL with recoveries from 86.8% to 96.8%. Therefore, the gel-clot test is suitable for detecting bacterial endotoxins in perfluorocarbon which is a water insoluble medical device.展开更多
During the periparturient period, dairy cows exhibit negative energy balance due to limited appetite and increased energy requirements for lactogenesis. The delicate equilibrium between energy availability and expendi...During the periparturient period, dairy cows exhibit negative energy balance due to limited appetite and increased energy requirements for lactogenesis. The delicate equilibrium between energy availability and expenditure puts cows in a state of metabolic stress characterized by excessive lipolysis in white adipose tissues(AT), increased production of reactive oxygen species, and immune cell dysfunction. Metabolic stress, especially in AT, increases the risk for metabolic and inflammatory diseases. Around parturition, cows are also susceptible to endotoxemia. Bacterial-derived toxins cause endotoxemia by promoting inflammatory processes and immune cell infiltration in different organs and systems while impacting metabolic function by altering lipolysis, mitochondrial activity, and insulin sensitivity. In dairy cows, endotoxins enter the bloodstream after overcoming the defense mechanisms of the epithelial barriers, particularly during common periparturient conditions such as mastitis, metritis, and pneumonia, or after abrupt changes in the gut microbiome. In the bovine AT, endotoxins induce a pro-inflammatory response and stimulate lipolysis in AT, leading to the release of free fatty acids into the bloodstream. When excessive and protracted, endotoxin-induced lipolysis can impair adipocyte's insulin signaling pathways and lipid synthesis. Endotoxin exposure can also induce oxidative stress in AT through the production of reactive oxygen species by inflammatory cells and other cellular components. This review provides insights into endotoxins' impact on AT function, highlighting the gaps in our knowledge of the mechanisms underlying AT dysfunction, its connection with periparturient cows' disease risk, and the need to develop effective interventions to prevent and treat endotoxemia-related inflammatory conditions in dairy cattle.展开更多
Inhalation of reclaimed water is known to cause lung infammation,and free endotoxins have been shown to be a major risk factor for acute exposure.Subchronic exposure has also been shown to induce infammatory responses...Inhalation of reclaimed water is known to cause lung infammation,and free endotoxins have been shown to be a major risk factor for acute exposure.Subchronic exposure has also been shown to induce infammatory responses with visible tissue damage.However,subchronic risk factors have yet to be identified,and a threshold for the protection of occupational populations during urban reuse is necessary.In this study,potential risk factors in reclaimed water were examined by subchronic exposure with fractionated reclaimed water,and the health risk threshold was tested with a series of diluted reclaimed water.Accordingly,following a 12-week exposure,macromolecules and microorganisms were found to be two major risk factors in reclaimed water that could cause pulmonary infammation,including increased proportion of polymorphonuclear leukocytes in bronchoalveolar fuid,formation of inducible bronchus-associated lymphoid tissue,and elevation of Immunoglobulin A levels.Moreover,infammation persisted after a 4-week recovery period.The calculated threshold of reclaimed water exposure for mice was 31.8 Endotoxin Unit(EU)/(kg·day)under when exposed to 50%additional relative humidity from reclaimed water at 25℃ for 2 hr/day.Meanwhile,the subchronic threshold estimate for humans under the same exposure conditions was found to be 12.2 EU/(kg·day),corresponding to endotoxin levels of 61.7 EU/mL in reclaimed water.The threshold level of endotoxin was lower than that in most non-potable reclaimed water.The findings of this study suggest that occupational exposure of reclaimed water can serve as a potential risk to workers.展开更多
Bacterial endotoxin(a type of lipopolysaccharide,LPS)that acts as the strongest immune stimulant exhibits high toxicity to human health.The golden standard detection methods rely heavily on the use of a large amount o...Bacterial endotoxin(a type of lipopolysaccharide,LPS)that acts as the strongest immune stimulant exhibits high toxicity to human health.The golden standard detection methods rely heavily on the use of a large amount of tachypleus amebocyte lysate(TAL)reagents,extracted from the unique blue blood of legally protected horseshoe crabs.Herein,a cost-effective distance-based lateral flow(D-LAF)sensor is demonstrated for the first time based on the coagulation cascade process of TAL induced by endotoxin,which causes the generation of gel-state TAL.The gelation process can increase the amount of trapped water molecules and shorten the lateral flow distance of the remaining free water on the pH paper.The water flow distance is directly correlated to the concentration of endotoxin.Noteworthy,the D-LAF sensor allows the detection of endotoxin with the reduced dosage of TAL reagents than the golden standard detection methods.The detection limit of endotoxin is calculated to be 0.0742 EU/mL.This method can be applied to the detection of endotoxin in real samples such as household water and clinical injection solution with excellent performance comparable to the commercial ELISA kit.展开更多
The association between PM_(2.5)(particulate matter≤2.5μm)short-term exposure and its health effect is non-linear from the epidemiological studies.And this nonlinearity is suggested to be related with the PM_(2.5)he...The association between PM_(2.5)(particulate matter≤2.5μm)short-term exposure and its health effect is non-linear from the epidemiological studies.And this nonlinearity is suggested to be related with the PM_(2.5)heterogeneity,however,the underlying biological mechanism is still unclear.Here,a total of 38 PM_(2.5)filters were collected continuously for three weeks in winter Beijing,with the ambient PM_(2.5)varying between 10 and 270μg/m^(3).Human monocytes-derived macrophages(THP-1)were treated with PM_(2.5)water-soluble elutes at10μg/mL to investigate the PM_(2.5)short-term exposure effect from a proinflammatory perspective.The proinflammatory cytokine tumor necrosis factor(TNF)induced by the PM_(2.5)elutes at equal concentrations were unequal,showing the heterogeneity of PM_(2.5)proinflammatory potentials.Of the various chemical and biological components,lipopolysaccharide(LPS)showed a strong positive association with the TNF heterogeneity.However,some outliers were observed among the TNF-LPS association.Specifically,for PM_(2.5)from relatively clean air episodes,the higher LPS amount corresponded to relatively low TNF levels.And this phenomenon was also observed in the promotion tests by treating macrophages with PM_(2.5)elutes dosed with additional trace LPS.Gene expression analysis indicated the involvement of oxidative-stress related genes in the LPS signaling pathway.Therefore,a potential oxidative-stress-mediated suppression on the PM_(2.5)-borne LPS proinflammatory effect was proposed to be accounted for the outliers.Overall,the results showed the differential role of LPS in the heterogeneity of PM_(2.5)proinflammatory effects from a component-based perspective.Future experimental studies are needed to elucidate the signaling pathway of LPS attached on PM_(2.5)from different air quality episodes.展开更多
Background:The aim of this study was to investigate the effects of different minimally invasive surgical procedures on intestinal muco-sal barrier function.Methods:In this study,76 patients who underwent minimally inv...Background:The aim of this study was to investigate the effects of different minimally invasive surgical procedures on intestinal muco-sal barrier function.Methods:In this study,76 patients who underwent minimally invasive gastric cancer surgery were selected,and peripheral blood was collected to test the levels of serum plasma D-lactic acid,diamine oxidase,and bacterial endotoxin before and 1 and 3 days after sur-gery.These markers were compared at different time points before and after surgery to understand the recovery of the intestinal muco-sal barrier function in patients after surgery.Results:On the first postoperative day,the change in serum D-lactic acid relative to the preoperative levels was significantly(P<0.05)lower in the laparoscopic surgery group(4.05[-0.195,6.917 mmol/L])than in the robot-assisted surgery group(7.56[5.190,12.145 mmol/L]).Both the serum D-lactic acid and bacterial endotoxin levels were significantly higher on the first postoperative day compared with preoperative levels,and although they showed a gradual decrease by the third day,they remained significantly higher than the pre-operative levels(P<0.05).The Student-Newman-Keuls method for pairwise comparison of the measurements at each time point dem-onstrated that the differences in D-lactic acid and bacterial endotoxin levels between the preoperative sample and the sample collected on the third postoperative day were statistically significant(P<0.05).Conclusions:Compared with the laparoscopic surgery group,the robotic surgery group showed larger changes in the postoperative serum D-lactic acid level,suggesting that the robotic surgery resulted in greater damage to the barrier function of the intestinal mucosa.The serum D-lactic acid and bacterial endotoxin levels were significantly higher in postoperative patients and showed a trend to gradually decrease,suggesting that the intestinal mucosal barrier function of patients after minimally invasive gastric cancer surgery is damaged and then gradually recovers.展开更多
In the present study, we aimed to establish the 8th National Standard of Endotoxin using three batches of proposed National Standard of Endotoxin. We co-calibrated the potency of the proposed preparations against the ...In the present study, we aimed to establish the 8th National Standard of Endotoxin using three batches of proposed National Standard of Endotoxin. We co-calibrated the potency of the proposed preparations against the 3rd International Standard （10/178） using the gel-clot method, kinetic-turbidimetric test and kinetic-chromogenic test. A total of 14 laboratories participated in this collaborative study. By comparing precision of three approved candidates＇ calibration results and analyzing the differences among the three results from different methods, we ultimately selected one of candidates as 8th National Standard of Endotoxin, and its potency is 9000 EU/ampoule and lot is 150801-201601.展开更多
AIM To study the effect of hepatocyteapoptosis and necrosis induced by TNF-α on thepathogenesis of acute severe hepatitis(ASH).METHODS The model of ASH was prepared inD-galactosamine(GAIN)sensitized BALB/c miceby inj...AIM To study the effect of hepatocyteapoptosis and necrosis induced by TNF-α on thepathogenesis of acute severe hepatitis(ASH).METHODS The model of ASH was prepared inD-galactosamine(GAIN)sensitized BALB/c miceby injection of either endotoxin(ET)or tumornecrosis factor-α(TNF-α).Morphologicalchanges of apoptotic hepatocytes were studiedby both light and electron microscope and in siteend labeling method(ISEL).Molecular biologicalchanges of DNA ladder were observed byelectrophoresis of extract from liver tissues.Biochemical changes were measured by alanineaminotransferase(ALT),asparticaminotransferase(AST)and TNF-α.The relationbetween apoptosis and necrosis was evaluatedsimultaneously.RESULTS The sequence of hepatocyteapoptosis,necrosis,and final death from ASHwas observed both in GAIN/ET and GAIN/TNF-agroup.Apoptosis was prominent at 3.5 h and 5 hafter injection of inducer,while necrosis becamedominant at 9 h after challenge.The appearanceof apoptosis was earlier in GAIN/TNF-α groupthan that in GAIN/ ET group.Pretreatment ofmice with antiTNF IgG1 may completely preventthe liver injury induced by GalN/ET.CONCLUSION TNF-α can cause liver damageby inducing hepatic apoptosis and necrosis inmice with endotoxemia.展开更多
OBJECTIVE： To investigate the effect of the periplaneta americana extract on the intestinal mucosal barrier and prognostic implications in patients with sepsis. METHODS： Sixty and six patients with sepsis were assig...OBJECTIVE： To investigate the effect of the periplaneta americana extract on the intestinal mucosal barrier and prognostic implications in patients with sepsis. METHODS： Sixty and six patients with sepsis were assigned randomly to treatment group （32 cases） and control group （32 cases）. The extractfrom periplaneta americana plus conventional medication for sepsis was administered to the treatment group, while the control group only received conventional treatment. The gastrointestinal function scores and acute physiology and chronic health evaluation II （APACHE 11 ） scores of all subjects were documented at baseline, at days 1, 3 and 7 after treatment respectively and their blood endotoxin was tested at the same time points as well. The incidence of death was recorded for both groups throughout the trial. RESULTS： At days 3 and 7 after treatment, gastrointestinal function score, APACHE II, and endotoxin level in treatment group wasbetter than that in con- trol group and the difference between them was significant （both P〈0~05）. Although the incidence of death in treatment group was less than that in control group, the difference between the two groups was not significant （P〉 0.05）. CONCLUSION： The extract of periplaneta ameri- cana had protective effect on intestinal mucosal barrier and could improve the condition and prog- nosis in patients with sepsis.展开更多
基金the China Postdoctoral Sciences Foundation No C.P.S.F 1996.2~#
文摘The main reason for the death of the patient with acute hemorrhage necrosis pancreatitis (AHNP) is pancreatic infection and multi-organ failure caused by endotoxemia and intestinal bacterial translocation[1-7]. However, the pathogenesis of endotoxemia and intestinal bacterial translocation remains a question[8-10]; moreover, no effective method of prevention and cure for it has been found till now[11 -15] In the present study, we infused low dose dopamine and low molecular weight dextran through the catheters to abdominal aorta and portal vein, and observed its influence on the endotoxin concentration in plasma and the rate of translocation of intestinal bacteria in AHNP rats.
文摘Dear Sir,Dai et al.[1] must be commended on their useful investigation of the clinical significance of endotoxins in the expressed prostatic secretions （EPS） of chronic prostatitis （CP） patients. However, we take issue with their conclusion. The conclusion that EPS endotoxin determination is helpful in diagnostic confirmation is plausible,
文摘AIM To clarify whether endotoxin is of pathogenic importance for hepatocarcinogenesis, or the increased cancer risk results solely from the cirrhotic process. METHODS The rat model of hepatoma was treated by the intake of 0 03% thioacetamide in drinking water for six months. During induction of hepatoma, rats were additionally treated with splenectomy and/or lipopolysaccharide administration. The liver nuclear DNA index and proliferation index were quantitatively analyzed by flow cytometry. Hepatic histology was examined with light and electron microscopes. Plasmic endotoxin concentration and γ glutamyl transpeptidase activity were measured, and hepatoma incidence was recorded. RESULTS Thioacetamide induced cirrhosis and hepatoma in Wistar rats with histology or regenerative nodule, fibrosis and neoplastic foci were quite similar to the pathogenic process of human cirrhosis leading to hepatoma. In comparison with TAA controls (DNA index: 1 15±0 21), exo endotoxin increased the DNA index by 7 8% (1 24±0 25, P <0 02) and hepatoma rate by 16 7. Splenectomy induced enteric endotoxemia increased the DNA index by 25% (1 44±0 15, P <0 01) and hepatoma rate by 33%. A summation of the effects of these two factors increased the DNA index by 36% ( P <0 01)and hepatoma incidence by 50%, moreover, the level of endotoxemia showed a close relation with DNA index ( r =0 96, P <0 01), as well as with the occurrence rate of hepatoma ( r =0 00, P <0 01). Histological findings further verified such alterations. CONCLUSION Lipopolysaccharide administration and/or splenectomy induced enterogenic endotoxemia may enhance rat hepatocarcinogenesis induced by oral intake of thioacetamide.
文摘In the recent decade, interest in treatment and prevention of many critical, severe and acute diseases caused by bacterial endotoxins has been aroused along with the advance of the knowledge on the nature of the endotoxin and the conditions involved. In abroad, attention has been mainly payed to raising antisera and monocolonal antibodies against the endotoxin and the induced mediators. However, the allergic reactions and the cost are still the problems. Till now, there is no drug that can antagonize endotoxin with high effectiveness and low toxicity. Clinical treatments are still confined in inhibiting or killing the pathogen, and correcting the internal environmental disturbance. Being less toxic and rich in resources with low cost and less side-effects, screening of effective Chinese drugs for antagonizing endotoxin is of important and practical significance. Endotoxin belongs to the category of toxic evils, or more precisely, the heat toxin in TCM. Therefore the application of heat-clearing and detoxifying Chinese drugs to antagonizing endotoxins is consistent with the theory of TCM. Some achievements in this field are reported as follows.
文摘Aim: To evaluate the clinical significance of the quantitative determinations of endotoxins in the expressed prostatic secretions (EPS) of chronic prostatitis (CP) patients. Methods: The EPS of 45 patients with CP and 15 normal volunteers were obtained for microscopic examination, bacterial culture and endotoxin determination. The level of endotoxins was determined by the Limulus-amebocyte-lysate test with chromogenic substrate. Results: Patients with CP had higher mean levels of endotoxins in EPS than normal volunteers [52.06 ± 32.83 EU.L^(-1) vs. 4.77 ± 4.14 EU'L^(-1) (P < 0.05)]. The levels of endotoxins in CP type Ⅱ, type Ⅲa and type Ⅲb were 68.62 ± 34.78 EU.L^(-1), 45.30± 23.33 EU.L^(-1) and 15.83 ± 5.31 EU·L^(-1), respectively [type Ⅱ vs. type Ⅲa (P > 0.05), type Ⅲb vs. normal controls (P > 0.05), type Ⅱ/type Ⅲa vs. normal controls P < 0.05)]. Conclusion: CP patients have elevated levels of endotoxins in the EPS, which suggests that inflammation is a feature of this disease. EPS endotoxin determination is not only helpful in diagnostic confirmation, but also in evaluating the response to treatment in CP patients.
文摘Background The bacterial endotoxins test （BET） is a method used to detect or quantify endotoxins （lipo-polysaccharide,LPS） and is widely used in the quality control of parenteral medicines/vaccines and clinical dialysis fluid.It is also used in the diagnosis of endotoxemia and in detection of environment air quality control.Although BET has been adopted by most pharmacopoeias,result judgment algorithms （RJAs） of the test for interfering factors in the BET still differ between certain pharmacopoeias.We have evaluated RJAs of the test for interfering factors for the revision of BET described in the Chinese Pharmacopoeia 2010 （CHP2010）.Methods Original data from 1 748 samples were judged by RJAs of the Chinese Pharmacopoeia 2010,the Japanese Pharmacopoeia 2011 （JP2011）,the European Pharmacopoeia 7.0 （EP7.0）,the United States Pharmacopoeia 36 （USP36）,and the Indian Pharmacopoeia 2010 （IP2010）,respectively.A SAS software package was used in the statistical analysis.Results The results using CHP2010 and USP36,JP2011,EP7.0,and IP2010 had no significant difference （P=-0.7740）.The results using CHP2010 of 1 748 samples showed that 132 samples （7.6%） required an additional step; nevertheless there was no such requirement when using the other pharmacopeias.The kappa value of two RJAs （CHP2010 and EP7.0） was 0.6900 （0.6297-0.7504） indicating that the CHP2010 and other pharmacopoeias have good consistency.Conclusions The results using CHP2010 and USP36,JP2011,EP7.0,and IP2010 have different characteristics.CHP2010 method shows a good performance in Specificity,mistake diagnostic rate,agreement rate,predictive value for suspicious rate,and predictive value for passed rate.The CHP2010 method only had disadvantages in sensitivity compared with other pharmacopeias.We suggest that the Chinese pharmacopoeia interference test be revised in accordance with the USP36,JP2011,EP7.0,and IP2010 judgment model.
文摘Endotoxins have been credited for over 50% of sepsis cases, with significantly greater mortality.1 A literature indicates wide-spread agreement that early detection of endotoxemia, endotoxin in the bloodstream, is the major key for patient survival from sepsis.2 Today the most popular endotoxin detection system is bacterial endotoxins test （BET）, adopted by most pharmacopoeias. Interference test is a part of the bacterial endotoxin inspection method, used to judge whether the sample can be applied in BET. However, Limuloid resources are exhausted in China, which is an important source for LAL. Here, we reported 5 simple models for interfering factors test in the BET, and compared new models with the United States Pharmacopoeia 36 （USP36）.
文摘BACKGROUND Acute appendicitis,a common condition with a higher prevalence among men,has shown an increasing incidence in recent years owing to lifestyle changes.It is characterized by right lower quadrant abdominal pain,rebound tenderness,and rapid onset.Its pathogenesis is complex and potentially linked to infection,environment,and genetics.Timely intervention is crucial to prevent complications.While surgery is the primary treatment,it carries risks,including postoperative infections that may necessitate re-operation.Gram-negative bacteria release endotoxin(ETX),which induces inflammation and is recognized by toll-like receptor 4(TLR4).This study evaluated ETX and TLR4 levels in patients with acute appendicitis to assess the risk of postoperative incision infections,aiding in prevention and treatment.AIM To explore ETX and TLR4 expression in the blood of patients with acute appendicitis and its association with in postoperative incision infection.METHODS A total of 153 patients with acute appendicitis treated at our hospital between April 2022 and March 2024(n=153)were included in the study.Patients were categorized into infected(n=36)and uninfected(n=117)groups according to the development of postoperative incision infections.General characteristics and blood levels of ETX and TLR4 were compared,and the factors influencing postoperative infection were identified using multivariate logistic regression.ETX and TLR4 predictive values were analyzed using receiver operating characteristic curves.RESULTS No statistically significant differences were observed between the two groups in terms of sex,age,or other general characteristics(P>0.05).Compared to the uninfected group,the infected group had a higher proportion of patients with suppurative or gangrenous appendicitis,longer surgical times,longer incision lengths,and elevated ETX and TLR4 levels(P<0.05).Multivariate logistic regression analysis identified pathological type,surgical method,surgical time,and incision length as factors influencing postoperative incision infection in acute appendicitis.Receiver operating characteristic curve analysis revealed that both ETX and TLR4 levels were predictive factors for postoperative incision infection,with higher prediction efficiency when combined.CONCLUSION Pathological type,surgical method,surgical time,and incision length significantly influence postoperative incision infection risk in patients with acute appendicitis.Elevated ETX and TLR4 levels serve as valuable predictors of post-appendectomy infections.
文摘Rationale: Endotoxin contamination in conventionally purified water poses serious risks to hemodialysis patients, leading to complications such as inflammation and sepsis. Addressing these risks is essential for enhancing patient safety and meeting global dialysis water quality standards. Advanced filtration technologies, such as titanium dioxide (TiO₂)-based nanoparticle filters, offer a promising approach to improve water purification processes in renal care. Objectives: This study aimed to develop and evaluate the effectiveness of a TiO₂-based nanoparticle microporous filtration system for hemodialysis water purification. The objectives included analyzing the system’s performance in reducing chemical contaminants (calcium, magnesium, aluminum, and lead) and microbiological contaminants (total viable count [TVC] and endotoxin units [EU]) across multiple renal centers. Methods: Water samples from three renal centers (RC1, RC2, and RC3) were analyzed pre- and post-filtration. TiO₂ nanoparticles were synthesized using the sol-gel method and characterized via Fourier Transform Infrared (FTIR) spectroscopy and Scanning Electron Microscopy with Energy Dispersive X-ray analysis (SEM/EDX). The microporous filter, fabricated with TiO₂ nanoparticles, silicon dioxide, and polyethylene glycol (PEG), was tested for its ability to remove contaminants. Analytical techniques included spectroscopy for chemical analysis and microbiological assays for contaminant quantification. Results: Post-treatment analysis revealed significant reductions in chemical contaminants, with removal efficiencies averaging 78% for calcium, 80% for magnesium, 81% for aluminum, and 76.6% for lead across all centers. Microbiological contamination was also substantially reduced, with 78–80% removal of TVC and 76–84.6% reduction in EU levels. FTIR analysis confirmed the presence of hydroxyl groups critical for adsorption, while SEM/EDX characterization revealed a crystalline structure with a particle size of 1.45 nm, pore size of 4.11 μm, filter height of 2.56 mm, and bulk density of 0.58 g/cm³. Conclusion: The TiO₂-based nanoparticle filtration system demonstrated high efficacy in removing chemical and microbiological contaminants, significantly improving water quality for hemodialysis. These results highlight its potential as a practical solution for renal centers, especially in resource-constrained settings. Further studies are needed to evaluate its long-term performance and feasibility for widespread adoption. Recommendation: Renal centers should consider adopting TiO2-based nanoparticle filters to address persistent water quality challenges. Pilot implementations across diverse settings can provide insights into operational feasibility. Additional research should explore scalability, maintenance requirements, and cost-effectiveness to optimize integration into healthcare systems. Significance Statement: This study introduces a practical and innovative solution to improve hemodialysis water purification. By effectively reducing both chemical and microbiological contaminants, the TiO2-based filtration system has the potential to enhance patient safety and outcomes, particularly in settings where maintaining high water quality standards remains challenging.
文摘This communication demonstrates the feasibility of the gel-clot method for the analysis of bacterial endotoxins in water extracts of perfluorocarbon which is a water insoluble liquid medical device. Perfluorocarbon （10 mL） was shaken with 10 mL water for 15 min at 2000 r/min and the endotoxin present was extracted to the aqueous phase without interference inhibition/enhancement of the product and the recovery of endotoxin added to perfluorocarbon was determined, A validation study confirmed that endotoxins presented in perfluorocarbon pass over into the aqueous phase at concentrations of 20, 10 and 5EU/mL with recoveries from 86.8% to 96.8%. Therefore, the gel-clot test is suitable for detecting bacterial endotoxins in perfluorocarbon which is a water insoluble medical device.
基金supported by USDA-National Institute of Food and Agriculture (Washington, DC) competitive grants 2019-67015-29443 and 202167015-34563Department of Large Animal Clinical Sciences (East Lansing, MI), Office of the Associate Dean for Research and Graduate Studies of the College of Veterinary Medicine (East Lansing, MI)+2 种基金Michigan State University College of Veterinary Medicine Endowed Research Funds 2020 (East Lansing, MIRobert and Janet Hafner Fund for Animal Health)the Michigan Alliance for Animal Agriculture (East Lansing, awards AA-21-154, AA-22-055)。
文摘During the periparturient period, dairy cows exhibit negative energy balance due to limited appetite and increased energy requirements for lactogenesis. The delicate equilibrium between energy availability and expenditure puts cows in a state of metabolic stress characterized by excessive lipolysis in white adipose tissues(AT), increased production of reactive oxygen species, and immune cell dysfunction. Metabolic stress, especially in AT, increases the risk for metabolic and inflammatory diseases. Around parturition, cows are also susceptible to endotoxemia. Bacterial-derived toxins cause endotoxemia by promoting inflammatory processes and immune cell infiltration in different organs and systems while impacting metabolic function by altering lipolysis, mitochondrial activity, and insulin sensitivity. In dairy cows, endotoxins enter the bloodstream after overcoming the defense mechanisms of the epithelial barriers, particularly during common periparturient conditions such as mastitis, metritis, and pneumonia, or after abrupt changes in the gut microbiome. In the bovine AT, endotoxins induce a pro-inflammatory response and stimulate lipolysis in AT, leading to the release of free fatty acids into the bloodstream. When excessive and protracted, endotoxin-induced lipolysis can impair adipocyte's insulin signaling pathways and lipid synthesis. Endotoxin exposure can also induce oxidative stress in AT through the production of reactive oxygen species by inflammatory cells and other cellular components. This review provides insights into endotoxins' impact on AT function, highlighting the gaps in our knowledge of the mechanisms underlying AT dysfunction, its connection with periparturient cows' disease risk, and the need to develop effective interventions to prevent and treat endotoxemia-related inflammatory conditions in dairy cattle.
基金supported by the National Natural Science Foundation of China (Nos.51738005 and 21777084)。
文摘Inhalation of reclaimed water is known to cause lung infammation,and free endotoxins have been shown to be a major risk factor for acute exposure.Subchronic exposure has also been shown to induce infammatory responses with visible tissue damage.However,subchronic risk factors have yet to be identified,and a threshold for the protection of occupational populations during urban reuse is necessary.In this study,potential risk factors in reclaimed water were examined by subchronic exposure with fractionated reclaimed water,and the health risk threshold was tested with a series of diluted reclaimed water.Accordingly,following a 12-week exposure,macromolecules and microorganisms were found to be two major risk factors in reclaimed water that could cause pulmonary infammation,including increased proportion of polymorphonuclear leukocytes in bronchoalveolar fuid,formation of inducible bronchus-associated lymphoid tissue,and elevation of Immunoglobulin A levels.Moreover,infammation persisted after a 4-week recovery period.The calculated threshold of reclaimed water exposure for mice was 31.8 Endotoxin Unit(EU)/(kg·day)under when exposed to 50%additional relative humidity from reclaimed water at 25℃ for 2 hr/day.Meanwhile,the subchronic threshold estimate for humans under the same exposure conditions was found to be 12.2 EU/(kg·day),corresponding to endotoxin levels of 61.7 EU/mL in reclaimed water.The threshold level of endotoxin was lower than that in most non-potable reclaimed water.The findings of this study suggest that occupational exposure of reclaimed water can serve as a potential risk to workers.
基金supported by the National Natural Science Foundation of China(No.T2250410382)Natural Science Foundation of Shandong Province(Nos.ZR2020QB153 and ZR2022YQ12)+3 种基金Taishan Scholars Program(Nos.tsqn201812088 and ts20190948)Shandong Scientific and Technical Small and Medium-sized Enterprises Innovation Capacity Improvement Project(No.2022TSGC2533)The Science,Education and Industry Integration of Basic Research Project of Qilu University of Technology(No.2023PY058)Qilu University of Technology Talent Research Project(No.2023RCKY087)。
文摘Bacterial endotoxin(a type of lipopolysaccharide,LPS)that acts as the strongest immune stimulant exhibits high toxicity to human health.The golden standard detection methods rely heavily on the use of a large amount of tachypleus amebocyte lysate(TAL)reagents,extracted from the unique blue blood of legally protected horseshoe crabs.Herein,a cost-effective distance-based lateral flow(D-LAF)sensor is demonstrated for the first time based on the coagulation cascade process of TAL induced by endotoxin,which causes the generation of gel-state TAL.The gelation process can increase the amount of trapped water molecules and shorten the lateral flow distance of the remaining free water on the pH paper.The water flow distance is directly correlated to the concentration of endotoxin.Noteworthy,the D-LAF sensor allows the detection of endotoxin with the reduced dosage of TAL reagents than the golden standard detection methods.The detection limit of endotoxin is calculated to be 0.0742 EU/mL.This method can be applied to the detection of endotoxin in real samples such as household water and clinical injection solution with excellent performance comparable to the commercial ELISA kit.
基金supported by the National Natural Science Foundation of China (Nos.42075117 and 41807306)。
文摘The association between PM_(2.5)(particulate matter≤2.5μm)short-term exposure and its health effect is non-linear from the epidemiological studies.And this nonlinearity is suggested to be related with the PM_(2.5)heterogeneity,however,the underlying biological mechanism is still unclear.Here,a total of 38 PM_(2.5)filters were collected continuously for three weeks in winter Beijing,with the ambient PM_(2.5)varying between 10 and 270μg/m^(3).Human monocytes-derived macrophages(THP-1)were treated with PM_(2.5)water-soluble elutes at10μg/mL to investigate the PM_(2.5)short-term exposure effect from a proinflammatory perspective.The proinflammatory cytokine tumor necrosis factor(TNF)induced by the PM_(2.5)elutes at equal concentrations were unequal,showing the heterogeneity of PM_(2.5)proinflammatory potentials.Of the various chemical and biological components,lipopolysaccharide(LPS)showed a strong positive association with the TNF heterogeneity.However,some outliers were observed among the TNF-LPS association.Specifically,for PM_(2.5)from relatively clean air episodes,the higher LPS amount corresponded to relatively low TNF levels.And this phenomenon was also observed in the promotion tests by treating macrophages with PM_(2.5)elutes dosed with additional trace LPS.Gene expression analysis indicated the involvement of oxidative-stress related genes in the LPS signaling pathway.Therefore,a potential oxidative-stress-mediated suppression on the PM_(2.5)-borne LPS proinflammatory effect was proposed to be accounted for the outliers.Overall,the results showed the differential role of LPS in the heterogeneity of PM_(2.5)proinflammatory effects from a component-based perspective.Future experimental studies are needed to elucidate the signaling pathway of LPS attached on PM_(2.5)from different air quality episodes.
基金funded by the Medical and Health Suitable Technology Development and Extension Project of Guangxi(No.S2021096)the Guangxi Key Laboratory of Enhanced Recovery After Surgery for Gastrointestinal Cancer.
文摘Background:The aim of this study was to investigate the effects of different minimally invasive surgical procedures on intestinal muco-sal barrier function.Methods:In this study,76 patients who underwent minimally invasive gastric cancer surgery were selected,and peripheral blood was collected to test the levels of serum plasma D-lactic acid,diamine oxidase,and bacterial endotoxin before and 1 and 3 days after sur-gery.These markers were compared at different time points before and after surgery to understand the recovery of the intestinal muco-sal barrier function in patients after surgery.Results:On the first postoperative day,the change in serum D-lactic acid relative to the preoperative levels was significantly(P<0.05)lower in the laparoscopic surgery group(4.05[-0.195,6.917 mmol/L])than in the robot-assisted surgery group(7.56[5.190,12.145 mmol/L]).Both the serum D-lactic acid and bacterial endotoxin levels were significantly higher on the first postoperative day compared with preoperative levels,and although they showed a gradual decrease by the third day,they remained significantly higher than the pre-operative levels(P<0.05).The Student-Newman-Keuls method for pairwise comparison of the measurements at each time point dem-onstrated that the differences in D-lactic acid and bacterial endotoxin levels between the preoperative sample and the sample collected on the third postoperative day were statistically significant(P<0.05).Conclusions:Compared with the laparoscopic surgery group,the robotic surgery group showed larger changes in the postoperative serum D-lactic acid level,suggesting that the robotic surgery resulted in greater damage to the barrier function of the intestinal mucosa.The serum D-lactic acid and bacterial endotoxin levels were significantly higher in postoperative patients and showed a trend to gradually decrease,suggesting that the intestinal mucosal barrier function of patients after minimally invasive gastric cancer surgery is damaged and then gradually recovers.
文摘In the present study, we aimed to establish the 8th National Standard of Endotoxin using three batches of proposed National Standard of Endotoxin. We co-calibrated the potency of the proposed preparations against the 3rd International Standard （10/178） using the gel-clot method, kinetic-turbidimetric test and kinetic-chromogenic test. A total of 14 laboratories participated in this collaborative study. By comparing precision of three approved candidates＇ calibration results and analyzing the differences among the three results from different methods, we ultimately selected one of candidates as 8th National Standard of Endotoxin, and its potency is 9000 EU/ampoule and lot is 150801-201601.
文摘AIM To study the effect of hepatocyteapoptosis and necrosis induced by TNF-α on thepathogenesis of acute severe hepatitis(ASH).METHODS The model of ASH was prepared inD-galactosamine(GAIN)sensitized BALB/c miceby injection of either endotoxin(ET)or tumornecrosis factor-α(TNF-α).Morphologicalchanges of apoptotic hepatocytes were studiedby both light and electron microscope and in siteend labeling method(ISEL).Molecular biologicalchanges of DNA ladder were observed byelectrophoresis of extract from liver tissues.Biochemical changes were measured by alanineaminotransferase(ALT),asparticaminotransferase(AST)and TNF-α.The relationbetween apoptosis and necrosis was evaluatedsimultaneously.RESULTS The sequence of hepatocyteapoptosis,necrosis,and final death from ASHwas observed both in GAIN/ET and GAIN/TNF-agroup.Apoptosis was prominent at 3.5 h and 5 hafter injection of inducer,while necrosis becamedominant at 9 h after challenge.The appearanceof apoptosis was earlier in GAIN/TNF-α groupthan that in GAIN/ ET group.Pretreatment ofmice with antiTNF IgG1 may completely preventthe liver injury induced by GalN/ET.CONCLUSION TNF-α can cause liver damageby inducing hepatic apoptosis and necrosis inmice with endotoxemia.
文摘OBJECTIVE： To investigate the effect of the periplaneta americana extract on the intestinal mucosal barrier and prognostic implications in patients with sepsis. METHODS： Sixty and six patients with sepsis were assigned randomly to treatment group （32 cases） and control group （32 cases）. The extractfrom periplaneta americana plus conventional medication for sepsis was administered to the treatment group, while the control group only received conventional treatment. The gastrointestinal function scores and acute physiology and chronic health evaluation II （APACHE 11 ） scores of all subjects were documented at baseline, at days 1, 3 and 7 after treatment respectively and their blood endotoxin was tested at the same time points as well. The incidence of death was recorded for both groups throughout the trial. RESULTS： At days 3 and 7 after treatment, gastrointestinal function score, APACHE II, and endotoxin level in treatment group wasbetter than that in con- trol group and the difference between them was significant （both P〈0~05）. Although the incidence of death in treatment group was less than that in control group, the difference between the two groups was not significant （P〉 0.05）. CONCLUSION： The extract of periplaneta ameri- cana had protective effect on intestinal mucosal barrier and could improve the condition and prog- nosis in patients with sepsis.
