Helicobacter pylori(H.pylori)infection remains a pivotal driver of chronic gastritis,peptic ulcer,gastric mucosa-associated lymphoid tissue lymphoma and gastric cancer,yet its eradication is increasingly frustrated by...Helicobacter pylori(H.pylori)infection remains a pivotal driver of chronic gastritis,peptic ulcer,gastric mucosa-associated lymphoid tissue lymphoma and gastric cancer,yet its eradication is increasingly frustrated by climbing antibiotic resistance and intolerable side-effects of standard triple or quadruple therapies.In recent years,fecal microbiota transplantation(FMT),a strategy that reconstructs the gut ecosystem by introducing a healthy donor microbiome,has emerged as a novel adjunct or alternative.By competitively excluding H.pylori,reinforcing mucosal barrier integrity,modulating host immunity and secreting bacteriocins,FMT can raise eradication rates,relieve dyspeptic symptoms and lower recurrence.This review synthesizes up-to-date pre-clinical,pilot and controlled clinical data,dissects underlying mechanisms,compares delivery routes,donor screening protocols and safety profiles,and discusses regulatory,ethical and standardization hurdles that must be overcome before large-scale clinical application.展开更多
Fecal incontinence is a common condition that can significantly impact patients’quality of life.Obstetric anal sphincter injury and anorectal surgeries are common etiologies.Endoanal ultrasound and anorectal manometr...Fecal incontinence is a common condition that can significantly impact patients’quality of life.Obstetric anal sphincter injury and anorectal surgeries are common etiologies.Endoanal ultrasound and anorectal manometry are important diagnostic tools for evaluating patients.There are various treatment options,including diet,lifestyle modifications,drugs,biofeedback therapy,tibial and sacral nerve neuromodulation therapy,and surgery.In this editorial,we will discuss current controversies and novel approaches to fecal incontinence.Screening for asymptomatic anal sphincter defects after obstetric anal sphincter injury and in patients with inflammatory bowel disease is not generally recommended,but may be helpful in selected patients.The Garg incontinence score is a new score that includes the assessment of solid,liquid,flatus,mucous,stress and urge fecal incontinence.Novel tests such as translumbosacral anorectal magnetic stimulation and novel therapies such as translumbosacral neuromodulation therapy are promising diagnostic and treatment options,for both fecal incontinence and neuropathy.Home biofeedback therapy can overcome some limitations of the office-based therapy.Skeletal muscle-derived cell implantation of the external anal sphincter has been further studied as a possible treatment option.Sacral neuromodulation may be useful in scleroderma,congenital fecal incontinence and inflammatory bowel disease but merits further study.展开更多
Inflammatory bowel disease,particularly Crohn's disease(CD),has been linked to modifications in mesenteric adipose tissue(MAT)and the phenomenon known as"creeping fat"(CrF).The presence of CrF is believe...Inflammatory bowel disease,particularly Crohn's disease(CD),has been linked to modifications in mesenteric adipose tissue(MAT)and the phenomenon known as"creeping fat"(CrF).The presence of CrF is believed to serve as a predictor for early clinical recurrence following surgical intervention in patients with CD.Notably,the incorporation of the mesentery during ileocolic resection for CD has been correlated with a decrease in surgical recurrence,indicating the significant role of MAT in the pathogenesis of CD.While numerous studies have indicated that dysbiosis of the gut microbiota is a critical factor in the development of CD,the functional implications of translocated microbiota within the MAT of CD patients remain ambiguous.This manuscript commentary discusses a recent basic research conducted by Wu et al.In their study,intestinal bacteria from individuals were transplanted into CD model mice,revealing that fecal microbiota trans-plantation(FMT)from healthy donors alleviated CD symptoms,whereas FMT from CD patients exacerbated these symptoms.Importantly,FMT was found to affect intestinal permeability,barrier function,and the levels of proinflammatory factors and adipokines.Collectively,these findings suggest that targeting MAT and CrF may hold therapeutic potential for patients with CD.However,the study did not evaluate the composition of the intestinal microbiota of the donors or the subsequent alterations in the gut microbiota.Overall,the gut microbiota plays a crucial role in the histopathology of CD,and thus,targeting MAT and CrF may represent a promising avenue for treatment in this patient population.展开更多
Through investigating ten recreational marine beaches in China, we aimed to detect the occurrence of human enteric viruses in coastal bathing beaches and find a correlationship, if any, between the presence of enteric...Through investigating ten recreational marine beaches in China, we aimed to detect the occurrence of human enteric viruses in coastal bathing beaches and find a correlationship, if any, between the presence of enteric viruses in surface seawater and the concentrations of fecal coliforms, the conventional indicator of fecal pollution. In this study, twenty seawater samples were assayed for fecal coliforms and human pathogenic enteric viruses （hepatitis A viruses, rotaviruses, polioviruses） analysis. Enteric viruses were detected by RT-PCR, in 20 sample sites, 5%, 40%, 40% were positive for the presence of human hepatitis A viruses, rotaviruses, polioviruses, respectively. Seven of 20 sites are suffering from severe fecal contamination, based on traditional plate counts of fecal coliform outnumbering the established thresholds for recreation. Additionally, statistical analysis presented that no correlation was found between bacterial indicators and viruses in surface seawaters. The data confirmed that indicator bacteria in water are not reflective of the presence of enteric viruses in marine waters. Thus, current recreational water quality standards of both bacterial and viral indices should be reevaluated.展开更多
This study highlights the potential of diatomaceous earth to eliminate pathogenic microorganisms from canal sediments used in agricultural irrigation.The findings demonstrate both technical feasibility and economic be...This study highlights the potential of diatomaceous earth to eliminate pathogenic microorganisms from canal sediments used in agricultural irrigation.The findings demonstrate both technical feasibility and economic benefits for agriculture,particularly in regions where such irrigation practices are common.The research incorporates three distinct projects.The first involved monitoring water and sediment quality in the Xochimilco canal zone in Mexico City.The other two were experimental studies aimed at assessing the efficacy of diatomaceous earth in reducing fecal coliforms in sediments.The first project evaluated the water and sediment quality.Subsequently,an experiment was conducted in the San Gregorio Atlapulco chinampa,where diatomaceous earth was applied to a coriander crop to measure its effectiveness in reducing fecal coliforms.A laboratory experiment at the Institute of Engineering,UNAM,tested the impact of diatomaceous earth on sediments from a Xochimilco canal,focusing on fecal coliform reduction.In all experiments,diatomaceous earth was utilized in its commercial form.The results of the first project identified wastewater discharges as the primary source of pathogenic contamination in the canals.The second demonstrated a significant reduction—over 70%—in fecal coliforms within a crop after the application of diatomaceous earth.Similarly,the third project achieved an average fecal coliform reduction of 70%in sediments during laboratory testing.The study underscores the affordability and accessibility of diatomaceous earth for local agricultural producers.Moreover,its application does not adversely affect soil quality or crop productivity,further supporting its viability as a sustainable solution for improving irrigation water quality.展开更多
Background L-Glutamate and L-aspartate are functional amino acids that play pivotal roles in the cellular metabolic pathways of swine enterocytes.Therefore,this study aimed to investigate the effects of dietary L-glut...Background L-Glutamate and L-aspartate are functional amino acids that play pivotal roles in the cellular metabolic pathways of swine enterocytes.Therefore,this study aimed to investigate the effects of dietary L-glutamate and L-aspartate on growth performance,diarrhea severity,intestinal barrier integrity,and fecal microbiota of weaned piglets challenged with F18 enterotoxigenic Escherichia coli(ETEC).Weaned piglets were randomly assigned to seven dietary treatments,including unchallenged and ETEC-challenged controls,amino acid-supplemented groups,and an antibiotic control,to assess their responses to ETEC challenge.Results Supplementation with 1%L-glutamate or 2%L-aspartate enhanced growth performance,with significantly greater(P<0.05)average daily weight gain and gain-to-feed ratio compared with the positive control group from d 0 to d 5 post-inoculation.Pigs fed with 1%or 2%L-aspartate had reduced(P<0.05)diarrhea severity in ETEC-challenged pigs compared with the positive control group.The 1%L-aspartate supplementation also supported intestinal structure by increasing(P<0.05)duodenal villi height and ileal villi width compared with carbadox supplementation.Additionally,1%L-glutamate supplementation significantly improved(P<0.05)resilience in ETEC-challenged pigs by reducing fecal shedding ofβ-hemolysin-producing bacteria compared with the positive control group on d 14 post-inoculation.Moreover,1%L-aspartate supplementation promoted intestinal barrier integrity by significantly up-regulated(P<0.05)the expression of ileal OCDN and ileal ZO-1 compared with the positive control group on d 14 post-inoculation.Interestingly,2%L-aspartate supplementation altered the intestinal mucosa by down-regulating(P<0.05)the expression of jejunal CLDN-1,while up-regulating(P<0.05)the expression of ileal CLDN-1 compared with the negative control group on d 14 post-inoculation.Furthermore,L-glutamate supplementation significantly changed proportions of Firmicutes and Bacteroidota and showed the trend for enrichment in beneficial bacterial genera such as Bifidobacterium and Megasphaera in ETEC-infected pigs by d 14 post-inoculation.Conclusion Supplementation with L-glutamate or L-aspartate promoted growth performance,supported gut health,and enhanced disease resistance in weaned pigs challenged with F18 ETEC.During the weaning period,L-glutamate or L-aspartate could potentially be considered conditionally essential amino acids,helping to alleviate weaning complications and reduce the need for antibiotic use in swine farming.展开更多
Crohn’s disease(CD)is an idiopathic,chronic,and recurrent inflammatory condition of the gastrointestinal tract.Recent studies suggest a potential role of gut microbiota in CD,particularly dysbiosis—an imbalance in g...Crohn’s disease(CD)is an idiopathic,chronic,and recurrent inflammatory condition of the gastrointestinal tract.Recent studies suggest a potential role of gut microbiota in CD,particularly dysbiosis—an imbalance in gut bacteria.While dysbiosis is consistently observed in CD,it remains uncertain whether it is a cause or a consequence of the disease.Given its association with CD,the therapeutic potential of fecal microbiota transplantation(FMT)has been explored.This review examines the role of gut microbiota in CD,evaluates the therapeutic potential of probiotics and FMT,and highlights current research findings and limitations.Key studies on the relationship between gut dysbiosis,probiotics,and FMT in CD were analyzed,with a focus on randomized trials,meta-analyses,and clinical observations.Dysbiosis is a consistent feature of CD,but its causative role remains unclear.Probiotics,prebiotics,and synbiotics have shown no efficacy in inducing or maintaining remission in CD.FMT shows potential as a therapeutic option for CD,but its efficacy remains inconsistent and inconclusive.The variability in outcomes,including diminished effects over time despite repeated FMT,underscores the need for larger,well-controlled trials.Only one randomized controlled trial(RCT)has compared FMT with sham transplantation,but the sample size was very small.Other studies are limited by factors such as small sample sizes,lack of control groups,short follow-up periods,and inconsistent methodologies,making it challenging to draw definitive conclusions.While gut dysbiosis likely plays a role in CD pathogenesis,its causative role remains uncertain.Current evidence does not support FMT as a reliable treatment for inducing or maintaining remission in CD,though it appears generally safe.Larger,standardized,RCTs are necessary to clarify the therapeutic role of FMT in CD management.展开更多
Fecal incontinence(FI),which can arise from various pathogenic mechanisms,has attracted considerable attention worldwide.Despite its importance,the reproduction of the defecatory system to study the mechanisms of FI r...Fecal incontinence(FI),which can arise from various pathogenic mechanisms,has attracted considerable attention worldwide.Despite its importance,the reproduction of the defecatory system to study the mechanisms of FI remains limited,largely because of social stigma and being considered inappropriate.Inspired by the rectum’s functionalities,we developed a soft robotic system that includes a power supply,pressure sensors,data acquisition systems,a flushing mechanism,stages,and a rectal module.Specifically,the innovative soft rectal module includes actuators inspired by sphincter muscles,both soft and rigid covers,and a soft rectum mold.The rectal mold,which was fabricated from materials that mimic human rectal tissue,was produced using a mold replication fabrication method.Both the soft and rigid components of the mold were created using three-dimensional(3D)printing technology.In addition,the sphincter muscle-inspired actuators featured double-layer pouch structures that were modeled and optimized based on multilayer perceptron methods to obtain a high contraction ratio(100%),generate high pressure(9.8 kPa),and have a short recovery time(3 s).Upon assembly,this defecation robot could smoothly expel liquid feces,perform controlled solid fecal cutting,and defecate extremely solid long feces,thus closely replicating the functions of the human rectum and anal canal.This defecation robot has the potential to facilitate human understanding of the complex defecation system and contribute to the development of improved quality-of-life devices related to defecation.展开更多
BACKGROUND Simultaneous assessment of gut microbiota in stool and tissue samples is crucial for a better understanding of their role in Crohn’s disease(CD),yet most reports have focused on fecal microbiota alone.Addi...BACKGROUND Simultaneous assessment of gut microbiota in stool and tissue samples is crucial for a better understanding of their role in Crohn’s disease(CD),yet most reports have focused on fecal microbiota alone.Additionally,gut microbiota may serve as a clinically useful diagnostic biomarker of CD although data on this is limited.AIM To evaluate gut microbiota in tissue and stool samples in patients with active CD to understand the structure and function compared to healthy controls(HC).We also assessed their utility as a diagnostic biomarker of CD.METHODS Adult patients with active CD and HC were prospectively recruited for this study.The clinical and investigation details were recorded.Rectal mucosal biopsy and stool samples were obtained to assess the bacterial population.DNA was extracted,the V3-V4 region of the 16S rRNA gene was amplified,and library preparation was done and sequenced on the Illumina MiSeq platform.The bacterial diversity,composition,dysbiosis,predicted function,and predictors of disease state were estimated using the QIIME 2 pipeline and R packages.RESULTS We recruited 66 patients with CD(age 39.7±11.1 years,65.2%males)and 69 HC.Comparison of tissue with fecal microbiota in active CD showed significant differences in composition and predicted function.Both tissue and fecal microbiota from active CD showed reduced microbial diversity and compositional differences compared to HC,and disease state was a key determinant of bacterial population.Differences(CD vs HC)were noted in the abundance of several predicted synthetic and degradation pathways in both tissue and stool bacteria.Tissue microbiota was a superior predictor of active CD than stool(area under receiver operating characteristic curve 0.8 vs 0.62).CONCLUSION Gut microbial characteristics revealed significant structural and functional differences between CD and HC in both tissue and stool.Tissue bacteria performed well as a microbial biomarker for clinical diagnosis of CD.展开更多
Background and Objective Inflammation plays a pivotal role in the progression of coronary artery disease(CAD).High-sensitivity C-reactive protein(hsCRP)serves as a well-established biomarker for assessing cardiovascul...Background and Objective Inflammation plays a pivotal role in the progression of coronary artery disease(CAD).High-sensitivity C-reactive protein(hsCRP)serves as a well-established biomarker for assessing cardiovascular inflammation risk.However,the specific intestinal microbiota alteration contributing to increased inflammation remains unclear.Therefore,the present study investigated the correlation between the intestinal microbiota and inflammation in patients with unstable angina(UA).Methods A cohort of 92 patients with UA was recruited for this study.The plasma hsCRP level was measured via a CardioPhase hsCRP assay,fecal samples were collected after admission,and 16S rRNA sequencing was conducted to identify the fecal microbial profile.The participants were classified into two groups according to the median hsCRP level(1.11 mg/L).The composition of the fecal microbiota was compared between patients with hsCRP≥1.11 mg/L and those with hsCRP<1.11 mg/L.Additionally,the correlations between the fecal microbiota and clinical characteristics were analyzed.Results A notable reduction in the relative abundance of Akkermansia was observed in patients with hsCRP≥1.11 mg/L,whereas the diversity of the fecal microbiota was not significantly different between patients with hsCRP≥1.11 mg/L and those with hsCRP<1.11 mg/L.Furthermore,the abundance of Akkermansia was negatively correlated with hsCRP levels.Conclusion This study suggested a significant association between decreased levels of Akkermansia and inflammatory risk in patients with UA.These findings underscore the potential role of the intestinal microbiota in contributing to inflammation in UA patients.Further work is needed on the mechanism by which the microbiota contributes to inflammatory risk.展开更多
Blueberry anthocyanins(VA)and blackberry anthocyanins(RA)showed benefits on metabolic syndrome(MS)induced by high-fat diet(HFD)in mice.In this study,we investigated whether the therapeutic effects of VA and RA were ac...Blueberry anthocyanins(VA)and blackberry anthocyanins(RA)showed benefits on metabolic syndrome(MS)induced by high-fat diet(HFD)in mice.In this study,we investigated whether the therapeutic effects of VA and RA were achieved by the gut microbiota regulation and whether these effects could be replicated through fecal microbiota transplantation(FMT)using the HFD caused MS model in pseudo-germ-free mice.The results demonstrated that the beneficial effects of VA and RA on MS,including reducing body weight gain and fat accumulation,improving glucose and lipid metabolism,and mitigating intestinal barrier damage,were attributed to the gut microbiota and could be replicated by FMT.16S r RNA sequencing analysis suggested that FMT from donor mice supplemented with VA and RA could regulate the gut microbiota composition.Particularly,FMT from RA supplemented mice displayed the potential to restore the diversity of gut microbiota and the ratio of Firmicutes to Bacteroidetes.Meanwhile,FMT from VA supplemented mice appeared to exert its effects by selectively influencing specific gut microbiota,such as the genus Akkermansia.Furthermore,our analysis identified 10 common differential amplicon sequence variants(ASVs)among groups compared to HFD-HFD group.Notably,ASV_36450 was negatively associated with metabolic parameters,suggesting that Lactobacillus might be the potential bacteria in regulating MS.Overall,our study demonstrated that FMT from VA and RA supplemented mice could ameliorate MS induced by HFD in mice through regulating specific gut microbiota.展开更多
Fecal incontinence,a debilitating condition that significantly impairs quality of life,affects 2%-21%of adults worldwide.For patients whose structural defects are unresponsive to conservative therapies,sphincter recon...Fecal incontinence,a debilitating condition that significantly impairs quality of life,affects 2%-21%of adults worldwide.For patients whose structural defects are unresponsive to conservative therapies,sphincter reconstruction remains the primary treatment approach.Although traditional surgical techniques effectively restore anatomy in the short term,their long-term efficacy is constrained by progressive muscle atrophy and fibrotic scarring.In complex cases,alternative interventions,including dynamic gracilis or gluteus maximus transposition and artificial sphincter implantation,offer therapeutic options yet are associated with increased surgical risks and high complication rates.Emerging therapies such as regenerative medicine and neuromodulatory approaches have potential,although further rigorous clinical validation is needed to establish standardized protocols.Optimizing fecal incontinence management necessitates precise patient stratification,multidisciplinary collaboration,and the development of individualized treatment algorithms.Advancements in this field depend on large-scale clinical trials and comprehensive long-term outcome assessments to improve therapeutic efficacy and patient-centered care.展开更多
BACKGROUND Hepatocellular carcinoma(HCC),the predominant form of primary liver cancer,is a key contributor to cancer-related deaths globally.However,HCC diagnosis solely based on blood biochemical markers lacks both s...BACKGROUND Hepatocellular carcinoma(HCC),the predominant form of primary liver cancer,is a key contributor to cancer-related deaths globally.However,HCC diagnosis solely based on blood biochemical markers lacks both sensitivity and specificity.AIM To investigate alterations of the fecal metabolome and intestinal bacteria and reveal the correlations among differential metabolites,distinct bacteria,and serum indicators.METHODS To uncover potentially effective therapeutic targets for HCC,we utilized nontargeted liquid chromatography-mass spectrometry and high-throughput DNA sequencing targeting the 16S rRNA gene.This comprehensive approach allowed us to investigate the metabolome and microbial community structure of feces samples obtained from patients with HCC.Furthermore,we conducted an analysis to assess the interplay between the fecal metabolome and intestinal bacterial population.RESULTS In comparison to healthy controls,a notable overlap of 161 differential metabolites and 3 enriched Kyoto Encyclopedia of Genes and Genomes pathways was observed in the HCC12(comprising patients with stage I and II HCC)and HCC34 groups(comprising patients with stage III and IV HCC).Lachnospira,Streptococcus,and Veillonella had significant differences in abundance in patients with HCC.Notably,Streptococcus and Veillonella exhibited significant correlations with serum indicators such as alpha-fetoprotein(AFP).Meanwhile,several differential metabolites[e.g.,4-keto-2-undecylpyrroline,dihydrojasmonic acid,1,8-heptadecadiene-4,6-diyne-3,10-diol,9(S)-HOTrE]also exhibited significant correlations with serum indicators such asγ-glutamyl transferase,total bilirubin,AFP,aspartate aminotransferase,and albumin.Additionally,these two genera also had significant associations with differential metabolites such as 1,2-Dipentadecanoyl-rac-glycerol(15:0/20:0/0:0),arachidoyl ethanolamide,and 4-keto-2-undecylpyrroline.CONCLUSION Our results suggest that the metabolome of fecal samples and the composition of intestinal bacteria hold promise as potential biomarkers for HCC diagnosis.展开更多
Background:More efficacious,noninvasive screening methods are needed for advanced colorectal neoplasia.miR-92a is a reliable and reproducible biomarker for early colorectal cancer detection in stool samples.We compare...Background:More efficacious,noninvasive screening methods are needed for advanced colorectal neoplasia.miR-92a is a reliable and reproducible biomarker for early colorectal cancer detection in stool samples.We compared the diagnostic efficacies of miR-92a,immunochemical fecal occult blood testing(FIT),and their combination(FIT+miR-92a)in a prospective multicenter screening trial.Methods:Overall,16,240 participants aged 30-75 years were enrolled between April 1,2021,and December 31,2023.A total of 15,586 participants returned samples available for both FIT and miR-92a tests.All those with positive,and a random selection of those with negative screening tests were recommended to undergo colonoscopy.Follow-ups were performed until participants completed the colonoscopic examination.A total of 1401 screen-positive and 2079 randomly selected screen-negative individuals completed colonoscopies.Primary outcomes included sensitivity,number needed to screen(NNS),Youden index and receiver operating characteristic area under the curve(AUC)for advanced adenomas and colorectal cancer[advanced neoplasia(AN)]for each screening modality in the diagnostic performance analysis.Results:Colonoscopy was performed in 3480 individuals.The colonoscopy compliance rate was 47.8%for screen-positive individuals.The sensitivity of miR-92a vs.FIT for AN was 70.9%vs.54.3%(P<0.001),NNS was 24.7 vs.32.2(P=0.001),Youden index was 47.9%vs.35.0%(P<0.001),AUC was 0.74 vs.0.67(P=0.010).FIT+miR-92a had a sensitivity of 85.4%,an NNS of 20.5,a Youden index of 47.9%and an AUC of 0.74 for AN.Conclusions:For AN screening,miR-92a demonstrated better sensitivity,NNS,Youden index and AUC as compared with FIT.Compared with FIT,using miR-92a appears to be more efficient for population-based screening programs.Screening sensitivity for AN can be further enhanced if conditionally used in combination with FIT.Trial registration Chinese Clinical Trial Registration Number:ChiCTR2200065415.展开更多
OBJECTIVE:To analyze the mechanism of Tongqiao Yizhi decoction(TQYZD,通窍益智颗粒)in treating vascular dementia(VaD)rats using brain tissue untargeted metabonomics and fecal 16S rRNA gene sequencing.METHODS:The chemic...OBJECTIVE:To analyze the mechanism of Tongqiao Yizhi decoction(TQYZD,通窍益智颗粒)in treating vascular dementia(VaD)rats using brain tissue untargeted metabonomics and fecal 16S rRNA gene sequencing.METHODS:The chemical composition of TQYZD was analyzed by ultra-high performance liquid chromatography-high resolution mass spectrometry.The effects of TQYZD on VaD rats were evaluated by water maze test,hematoxylin-eosin staining,enzyme-linked immunosorbent assay and Western blot.Untargeted metabolomics and 16S rRNA sequencing were utilized to explore the relationship between metabolic profiles and the structure and function of intestinal flora.Fecal microbiota transplantation(FMT)was used to validate the role of gut microbiota in VaD.Spearman correlation analysis of differential metabolites and gut microbiota was performed.RESULTS:The results showed that TQYZD improved cognitive function and neuronal damage in VaD rats,and reduced inflammatory response and repaired the intestinal barrier.In addition,TQYZD had the effect of modulating gut microbes in VaD rats,and FMT further confirmed that gut flora plays an important role in TQYZD treatment of VaD.Untargeted metabolomics revealed that VaD could lead to metabolic disorders in brain tissues,and TQYZD significantly altered the metabolites of brain tissues in Middle Cerebral Artery Occlusion rats.The results of spearman correlation analysis showed that there was a significant correlation between intestinal flora and the metabolites of brain tissues.CONCLUSION:In this study,we demonstrated that TQYZD can improve metabolic disorders in vascular dementia rats by acting on intestinal flora.展开更多
Chronic liver disease has become a global health crisis,with increasing incidence and mortality rates placing a substantial burden on healthcare systems worldwide.A key factor in the progression of chronic liver disea...Chronic liver disease has become a global health crisis,with increasing incidence and mortality rates placing a substantial burden on healthcare systems worldwide.A key factor in the progression of chronic liver disease is intestinal microbiota dysbiosis,which influences liver function via the intricate liver-gut axis.This axis plays a central role in various physiological processes,and disruptions in microbial composition can exacerbate liver pathology.Fecal microbiota transplantation(FMT)has emerged as a promising therapeutic strategy,with the potential to restore the composition and metabolic functions of the intestinal microbiota.Supported by encouraging findings from clinical trials and animal studies,FMT has demonstrated therapeutic benefits,including improvements in clinical symptoms,objective indicators,and long-term prognosis.These benefits encompass reductions in hepatic lipid deposition and inflammation,mitigation of complications in advanced liver disease,promotion of hepatitis B e antigen seroconversion,and enhancement of cognitive function.Although clinical evidence remains preliminary,current data underscore the transformative potential of FMT in managing chronic liver diseases.Nonetheless,challenges persist,including the need for standardized procedures,variability among donors,potential risks,and concerns regarding long-term safety.This review provides a comprehensive evaluation of the current literature on the efficacy and safety of FMT,while exploring future research directions to expand its application in liver disease management.展开更多
Objective:To analyze the preventive and management effects of the 4R crisis management theory on incontinence-associated dermatitis(IAD)in ICU patients with fecal incontinence.Methods:A hundred patients with fecal inc...Objective:To analyze the preventive and management effects of the 4R crisis management theory on incontinence-associated dermatitis(IAD)in ICU patients with fecal incontinence.Methods:A hundred patients with fecal incontinence who were admitted to the ICU for treatment between January 2024 and December 2024 were selected and randomly divided into two groups using a random number table.The observation group received 4R crisis management theory,while the control group received routine management.The IAD risk score,incidence of IAD,severity of IAD,and formation and healing time of IAD were compared between the two groups.Results:After management,the IAD risk score of the observation group was lower than that of the control group(P<0.05).The incidence of IAD in the observation group was lower than that in the control group,the proportion of mild IAD was higher than that in the control group,the formation time of IAD was later than that in the control group,and the healing time was shorter than that in the control group(P<0.05).Conclusion:Adopting the 4R crisis management theory for ICU patients with fecal incontinence can reduce the risk of IAD occurrence,effectively prevent IAD,reduce its severity,delay its formation time,and promote good healing.展开更多
BACKGROUND Certain subgroups are at an increased risk of false fecal immunochemical test(FIT)results;however,related studies are limited,and the available evidence is conflicting.AIM To evaluate factors associated wit...BACKGROUND Certain subgroups are at an increased risk of false fecal immunochemical test(FIT)results;however,related studies are limited,and the available evidence is conflicting.AIM To evaluate factors associated with false-positive and false-negative FIT results.METHODS This retrospective study was based on the database of the Tianjin Colorectal Cancer Screening Program from 2012 to 2020.A total of 4129947 residents aged 40-74 years completed at least one FIT.Of these,24890 asymptomatic participants who underwent colonoscopy examinations and completed lifestyle questionnaires were included in the analysis.Multivariable logistic regression was performed to identify the factors associated with false FIT results.RESULTS Among the overall screening population,88687(2.15%)participants tested positive for FIT.The sensitivity,specificity,positive predictive value,and negative predictive value of FIT for advanced neoplasms were 58.2%,44.8%,9.7%,and 91.3%,respectively.Older age,female sex,smoking,alcohol consumption,higher body mass index,and hemorrhoids were significantly associated with increased odds of false-positive and lower odds of falsenegative FIT results.Moreover,features of high-grade dysplasia or villous for advanced adenoma and the presence of cancer were also associated with lower odds of false-negative results,while irregular exercise and diverticulum were associated with higher odds of false-positive results.CONCLUSION FIT results may be inaccurate in certain subgroups.Our results provide important evidence for further individualization of screening strategies.展开更多
Objective To investigate the therapeutic efficacy and potential mechanisms of fecal microbiota transplantation(FMT)in patients with type 2 diabetes mellitus(T2DM),and to preliminarily identify the traditional Chinese ...Objective To investigate the therapeutic efficacy and potential mechanisms of fecal microbiota transplantation(FMT)in patients with type 2 diabetes mellitus(T2DM),and to preliminarily identify the traditional Chinese medicine(TCM)syndrome element characteristics of FMT in the treatment of T2DM.Methods Between March 25,2023 and September 30,2024,T2DM patients who met the inclusion and exclusion criteria were enrolled at the Department of Rheumatology and Endocrinology of the Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine.Participants received oral microbiota capsules as an adjunct to metformin therapy.Information obtained by four diagnostic methods of TCM,along with clinical and laboratory parameters,was collected before and after the intervention.Metagenomic sequencing was employed to analyze the gut microbiota,and Spearman correlation analysis was used to explore the relationship between laboratory indicators and differential bacterial genera.According to the post-treatment reduction in glycosylated hemoglobin(HbA1c),patients were categorized into a response(R)group and a non-response(NR)group.Treatment outcomes,safety indicators,gut microbiota changes,and TCM syndrome element features were compared between the two groups.Results A total of 53 T2DM patients were included in the final analysis,and 30 patients were assigned to R group and 23 to NR group.After treatment,the R group exhibited significant reductions in HbA1c,fasting plasma glucose(FPG),and 2-hour postprandial glucose(2hPG)(P<0.05 or P<0.01).The NR group also showed significant decreases in HbA1c and FPG levels P<0.01 or P<0.05.Compared with the NR group,after treatment,FPG level in the R group demonstrated significant reductions(P<0.01).As compared with before treatment,pancreatic islet function demonstrated enhancement in the R group,a significant increase in the 2-hour pastprandial C-peptide(2hC-P)levels in R group(P<0.05),whereas no marked change was observed in the NR group.Regarding body composition indicators,the R group showed significantly lower waist-hip ratio(WHR),visceral fat(VF),and subcutaneous fat(SF)levels compared with the NR group(P<0.01).After treatment,the NR group exhibited a significant elevation in aspartate aminotransferase(AST)levels(P<0.05).Other safety-related indicators fluctuated within normal reference ranges,and no other adverse events,such as diarrhea,fever,or nausea,were reported.Metagenomic sequencing showed that FMT improved the diversity and richness of the gut microbiota,remodeling its overall structure.At the phylum level,the abundance of p_Firmicutes decreased significantly(P<0.01),while the abundances of p_Bacteroidota and p_Proteobacteria increased significantly(P<0.01).At the family level,among the 125 identified taxa,the abundances of f_Bacteroidaceae,f_Lactobacillaceae,and f_Sutterellaceae were significantly elevated,whereas six families,including f_Lachnospiraceae,f_Ruminococcaceae,and f_Coriobacteriaceae,were significantly decreased(all P<0.05).Among the 367 taxa at the genus level,the top 10 differential genera showed significantly increased abundances of g_Bacteroides and g_Sutterella,and significantly decreased abundances in eight genera,including g_Faecalibacterium,g_Ruminococcus,g_Blautia,and g_Collinsella(all P<0.05).Correlation analysis suggested that the phylum p_Bacillota was positively correlated with improvements in T2DM laboratory parameters,g_norank_f_Prevotellaceae was significantly positively correlated with fasting C-peptide(FC-P)and 2hC-P(P<0.05).HbA1c demonstrated a significantly positive correlation with g_Blautia and g_Gemmiger(P<0.05)and a significantly negative correlation with g_Bacteroides and g_Collinsella(P>0.05).Analysis of syndrome element characteristics revealed that the R group was primarily characterized by pathological patterns of dampness,phlegm,and Yang deficiency.Before treatment,statistically significant reductions in syndrome element scores were observed for dampness,Yang deficiency,spleen,phlegm,Qi deficiency,Qi stagnation,and Yin deficiency(P<0.01),as well as for heat and liver(P<0.05).The NR group was mainly featured with Qi deficiency and Yin deficiency.Statistically significant changes in their syndrome element scores after treatment were noted for Qi deficiency(P<0.01),and for spleen,Qi stagnation,liver,and blood deficiency(P<0.05).In this group,the score changes for Yang deficiency,Yin deficiency,heat,and dampness were not statistically significant(P>0.05).Conclusion The principles of syndrome element differentiation can be effectively applied to predict treatment efficacy and facilitate patient selection for FMT in the treatment of T2DM.Patients with T2DM presented with specific TCM syndrome element characteristics,notably dampness,phlegm,and Yang deficiency,represent a highly responsive population to FMT therapy.展开更多
The pathogens and opinion for antibiotic treatment in adult patients with 1-14 fecal white blood cells per high power field （WBC/HPF） of acute non-bloody diarrhea remain obscure. The study attempts to clarify it. St...The pathogens and opinion for antibiotic treatment in adult patients with 1-14 fecal white blood cells per high power field （WBC/HPF） of acute non-bloody diarrhea remain obscure. The study attempts to clarify it. Stool specimens of adult patients with acute non-bloody diarrhea and stool examination showing 1-14 fecal WBC/HPF were collected for bacterial culture and viral detection. Patients included in this study were 196 cases with mean age of （37.9±17.4） years and 42.3% was women. The bacterial and viral detection rates were 63 （32.1%） and 21 （10.7%）, respectively. Of the isolated pathogens, campylobacteria was present in 14 （22.0%） samples and was the most common bacteria and calicivirus was found in 10 （47.6%） samples and was the most common virus. Based on single pathogens, 46 cases were caused by invasive pathogens, 26 cases were caused by non-invasive pathogens. The body temperature was significantly higher in feverish patients caused by invasive pathogens than those caused by non-invasive pathogens （（38.44-0.7） ℃ vs （37.74-0.4） ℃, P = 0.002）. The probability of diarrhea caused by invasive pathogens was higher in patients with T〉38.4℃ than those with T_〈38.4℃ （RR = 1.5）. When T〉38.4℃ is used as the threshold for antibiotic treatment, the misuse rate of antibiotics would decrease from 26.9% to 3.8% （P = 0.021）. So T〉38.4 ℃ may be used as a possible reference value for antibiotic treatment in adult patients with 1-14 fecal WBC/HPF of acute non-bloody diarrhea.展开更多
基金the 2026 Health Commission Fund of Guizhou Province,China.the freestatistics suite for its technical support.
文摘Helicobacter pylori(H.pylori)infection remains a pivotal driver of chronic gastritis,peptic ulcer,gastric mucosa-associated lymphoid tissue lymphoma and gastric cancer,yet its eradication is increasingly frustrated by climbing antibiotic resistance and intolerable side-effects of standard triple or quadruple therapies.In recent years,fecal microbiota transplantation(FMT),a strategy that reconstructs the gut ecosystem by introducing a healthy donor microbiome,has emerged as a novel adjunct or alternative.By competitively excluding H.pylori,reinforcing mucosal barrier integrity,modulating host immunity and secreting bacteriocins,FMT can raise eradication rates,relieve dyspeptic symptoms and lower recurrence.This review synthesizes up-to-date pre-clinical,pilot and controlled clinical data,dissects underlying mechanisms,compares delivery routes,donor screening protocols and safety profiles,and discusses regulatory,ethical and standardization hurdles that must be overcome before large-scale clinical application.
文摘Fecal incontinence is a common condition that can significantly impact patients’quality of life.Obstetric anal sphincter injury and anorectal surgeries are common etiologies.Endoanal ultrasound and anorectal manometry are important diagnostic tools for evaluating patients.There are various treatment options,including diet,lifestyle modifications,drugs,biofeedback therapy,tibial and sacral nerve neuromodulation therapy,and surgery.In this editorial,we will discuss current controversies and novel approaches to fecal incontinence.Screening for asymptomatic anal sphincter defects after obstetric anal sphincter injury and in patients with inflammatory bowel disease is not generally recommended,but may be helpful in selected patients.The Garg incontinence score is a new score that includes the assessment of solid,liquid,flatus,mucous,stress and urge fecal incontinence.Novel tests such as translumbosacral anorectal magnetic stimulation and novel therapies such as translumbosacral neuromodulation therapy are promising diagnostic and treatment options,for both fecal incontinence and neuropathy.Home biofeedback therapy can overcome some limitations of the office-based therapy.Skeletal muscle-derived cell implantation of the external anal sphincter has been further studied as a possible treatment option.Sacral neuromodulation may be useful in scleroderma,congenital fecal incontinence and inflammatory bowel disease but merits further study.
文摘Inflammatory bowel disease,particularly Crohn's disease(CD),has been linked to modifications in mesenteric adipose tissue(MAT)and the phenomenon known as"creeping fat"(CrF).The presence of CrF is believed to serve as a predictor for early clinical recurrence following surgical intervention in patients with CD.Notably,the incorporation of the mesentery during ileocolic resection for CD has been correlated with a decrease in surgical recurrence,indicating the significant role of MAT in the pathogenesis of CD.While numerous studies have indicated that dysbiosis of the gut microbiota is a critical factor in the development of CD,the functional implications of translocated microbiota within the MAT of CD patients remain ambiguous.This manuscript commentary discusses a recent basic research conducted by Wu et al.In their study,intestinal bacteria from individuals were transplanted into CD model mice,revealing that fecal microbiota trans-plantation(FMT)from healthy donors alleviated CD symptoms,whereas FMT from CD patients exacerbated these symptoms.Importantly,FMT was found to affect intestinal permeability,barrier function,and the levels of proinflammatory factors and adipokines.Collectively,these findings suggest that targeting MAT and CrF may hold therapeutic potential for patients with CD.However,the study did not evaluate the composition of the intestinal microbiota of the donors or the subsequent alterations in the gut microbiota.Overall,the gut microbiota plays a crucial role in the histopathology of CD,and thus,targeting MAT and CrF may represent a promising avenue for treatment in this patient population.
基金provided by the National High Technology Research and Development Program("863"Program)of China,grant no.2006AA09Z162the National Key Scientific and Technological Project,grant no.908-01-ZH3
文摘Through investigating ten recreational marine beaches in China, we aimed to detect the occurrence of human enteric viruses in coastal bathing beaches and find a correlationship, if any, between the presence of enteric viruses in surface seawater and the concentrations of fecal coliforms, the conventional indicator of fecal pollution. In this study, twenty seawater samples were assayed for fecal coliforms and human pathogenic enteric viruses （hepatitis A viruses, rotaviruses, polioviruses） analysis. Enteric viruses were detected by RT-PCR, in 20 sample sites, 5%, 40%, 40% were positive for the presence of human hepatitis A viruses, rotaviruses, polioviruses, respectively. Seven of 20 sites are suffering from severe fecal contamination, based on traditional plate counts of fecal coliform outnumbering the established thresholds for recreation. Additionally, statistical analysis presented that no correlation was found between bacterial indicators and viruses in surface seawaters. The data confirmed that indicator bacteria in water are not reflective of the presence of enteric viruses in marine waters. Thus, current recreational water quality standards of both bacterial and viral indices should be reevaluated.
文摘This study highlights the potential of diatomaceous earth to eliminate pathogenic microorganisms from canal sediments used in agricultural irrigation.The findings demonstrate both technical feasibility and economic benefits for agriculture,particularly in regions where such irrigation practices are common.The research incorporates three distinct projects.The first involved monitoring water and sediment quality in the Xochimilco canal zone in Mexico City.The other two were experimental studies aimed at assessing the efficacy of diatomaceous earth in reducing fecal coliforms in sediments.The first project evaluated the water and sediment quality.Subsequently,an experiment was conducted in the San Gregorio Atlapulco chinampa,where diatomaceous earth was applied to a coriander crop to measure its effectiveness in reducing fecal coliforms.A laboratory experiment at the Institute of Engineering,UNAM,tested the impact of diatomaceous earth on sediments from a Xochimilco canal,focusing on fecal coliform reduction.In all experiments,diatomaceous earth was utilized in its commercial form.The results of the first project identified wastewater discharges as the primary source of pathogenic contamination in the canals.The second demonstrated a significant reduction—over 70%—in fecal coliforms within a crop after the application of diatomaceous earth.Similarly,the third project achieved an average fecal coliform reduction of 70%in sediments during laboratory testing.The study underscores the affordability and accessibility of diatomaceous earth for local agricultural producers.Moreover,its application does not adversely affect soil quality or crop productivity,further supporting its viability as a sustainable solution for improving irrigation water quality.
基金Funding support was from the Novo Nordisk Foundation with the project's grant number NNFSA210073688.
文摘Background L-Glutamate and L-aspartate are functional amino acids that play pivotal roles in the cellular metabolic pathways of swine enterocytes.Therefore,this study aimed to investigate the effects of dietary L-glutamate and L-aspartate on growth performance,diarrhea severity,intestinal barrier integrity,and fecal microbiota of weaned piglets challenged with F18 enterotoxigenic Escherichia coli(ETEC).Weaned piglets were randomly assigned to seven dietary treatments,including unchallenged and ETEC-challenged controls,amino acid-supplemented groups,and an antibiotic control,to assess their responses to ETEC challenge.Results Supplementation with 1%L-glutamate or 2%L-aspartate enhanced growth performance,with significantly greater(P<0.05)average daily weight gain and gain-to-feed ratio compared with the positive control group from d 0 to d 5 post-inoculation.Pigs fed with 1%or 2%L-aspartate had reduced(P<0.05)diarrhea severity in ETEC-challenged pigs compared with the positive control group.The 1%L-aspartate supplementation also supported intestinal structure by increasing(P<0.05)duodenal villi height and ileal villi width compared with carbadox supplementation.Additionally,1%L-glutamate supplementation significantly improved(P<0.05)resilience in ETEC-challenged pigs by reducing fecal shedding ofβ-hemolysin-producing bacteria compared with the positive control group on d 14 post-inoculation.Moreover,1%L-aspartate supplementation promoted intestinal barrier integrity by significantly up-regulated(P<0.05)the expression of ileal OCDN and ileal ZO-1 compared with the positive control group on d 14 post-inoculation.Interestingly,2%L-aspartate supplementation altered the intestinal mucosa by down-regulating(P<0.05)the expression of jejunal CLDN-1,while up-regulating(P<0.05)the expression of ileal CLDN-1 compared with the negative control group on d 14 post-inoculation.Furthermore,L-glutamate supplementation significantly changed proportions of Firmicutes and Bacteroidota and showed the trend for enrichment in beneficial bacterial genera such as Bifidobacterium and Megasphaera in ETEC-infected pigs by d 14 post-inoculation.Conclusion Supplementation with L-glutamate or L-aspartate promoted growth performance,supported gut health,and enhanced disease resistance in weaned pigs challenged with F18 ETEC.During the weaning period,L-glutamate or L-aspartate could potentially be considered conditionally essential amino acids,helping to alleviate weaning complications and reduce the need for antibiotic use in swine farming.
文摘Crohn’s disease(CD)is an idiopathic,chronic,and recurrent inflammatory condition of the gastrointestinal tract.Recent studies suggest a potential role of gut microbiota in CD,particularly dysbiosis—an imbalance in gut bacteria.While dysbiosis is consistently observed in CD,it remains uncertain whether it is a cause or a consequence of the disease.Given its association with CD,the therapeutic potential of fecal microbiota transplantation(FMT)has been explored.This review examines the role of gut microbiota in CD,evaluates the therapeutic potential of probiotics and FMT,and highlights current research findings and limitations.Key studies on the relationship between gut dysbiosis,probiotics,and FMT in CD were analyzed,with a focus on randomized trials,meta-analyses,and clinical observations.Dysbiosis is a consistent feature of CD,but its causative role remains unclear.Probiotics,prebiotics,and synbiotics have shown no efficacy in inducing or maintaining remission in CD.FMT shows potential as a therapeutic option for CD,but its efficacy remains inconsistent and inconclusive.The variability in outcomes,including diminished effects over time despite repeated FMT,underscores the need for larger,well-controlled trials.Only one randomized controlled trial(RCT)has compared FMT with sham transplantation,but the sample size was very small.Other studies are limited by factors such as small sample sizes,lack of control groups,short follow-up periods,and inconsistent methodologies,making it challenging to draw definitive conclusions.While gut dysbiosis likely plays a role in CD pathogenesis,its causative role remains uncertain.Current evidence does not support FMT as a reliable treatment for inducing or maintaining remission in CD,though it appears generally safe.Larger,standardized,RCTs are necessary to clarify the therapeutic role of FMT in CD management.
基金supported by Grant-in-Aid for Scientific Research on Innovative Areas from the Japan Society for the Promotion of Science(Nos.18H05473 and 23K13290).
文摘Fecal incontinence(FI),which can arise from various pathogenic mechanisms,has attracted considerable attention worldwide.Despite its importance,the reproduction of the defecatory system to study the mechanisms of FI remains limited,largely because of social stigma and being considered inappropriate.Inspired by the rectum’s functionalities,we developed a soft robotic system that includes a power supply,pressure sensors,data acquisition systems,a flushing mechanism,stages,and a rectal module.Specifically,the innovative soft rectal module includes actuators inspired by sphincter muscles,both soft and rigid covers,and a soft rectum mold.The rectal mold,which was fabricated from materials that mimic human rectal tissue,was produced using a mold replication fabrication method.Both the soft and rigid components of the mold were created using three-dimensional(3D)printing technology.In addition,the sphincter muscle-inspired actuators featured double-layer pouch structures that were modeled and optimized based on multilayer perceptron methods to obtain a high contraction ratio(100%),generate high pressure(9.8 kPa),and have a short recovery time(3 s).Upon assembly,this defecation robot could smoothly expel liquid feces,perform controlled solid fecal cutting,and defecate extremely solid long feces,thus closely replicating the functions of the human rectum and anal canal.This defecation robot has the potential to facilitate human understanding of the complex defecation system and contribute to the development of improved quality-of-life devices related to defecation.
基金Supported by the Science and Engineering Research Board,No.EMR/2016/007033.
文摘BACKGROUND Simultaneous assessment of gut microbiota in stool and tissue samples is crucial for a better understanding of their role in Crohn’s disease(CD),yet most reports have focused on fecal microbiota alone.Additionally,gut microbiota may serve as a clinically useful diagnostic biomarker of CD although data on this is limited.AIM To evaluate gut microbiota in tissue and stool samples in patients with active CD to understand the structure and function compared to healthy controls(HC).We also assessed their utility as a diagnostic biomarker of CD.METHODS Adult patients with active CD and HC were prospectively recruited for this study.The clinical and investigation details were recorded.Rectal mucosal biopsy and stool samples were obtained to assess the bacterial population.DNA was extracted,the V3-V4 region of the 16S rRNA gene was amplified,and library preparation was done and sequenced on the Illumina MiSeq platform.The bacterial diversity,composition,dysbiosis,predicted function,and predictors of disease state were estimated using the QIIME 2 pipeline and R packages.RESULTS We recruited 66 patients with CD(age 39.7±11.1 years,65.2%males)and 69 HC.Comparison of tissue with fecal microbiota in active CD showed significant differences in composition and predicted function.Both tissue and fecal microbiota from active CD showed reduced microbial diversity and compositional differences compared to HC,and disease state was a key determinant of bacterial population.Differences(CD vs HC)were noted in the abundance of several predicted synthetic and degradation pathways in both tissue and stool bacteria.Tissue microbiota was a superior predictor of active CD than stool(area under receiver operating characteristic curve 0.8 vs 0.62).CONCLUSION Gut microbial characteristics revealed significant structural and functional differences between CD and HC in both tissue and stool.Tissue bacteria performed well as a microbial biomarker for clinical diagnosis of CD.
基金supported by the National Natural Science Foundation of China(No.82030016,No 82230011 and No.82200533).
文摘Background and Objective Inflammation plays a pivotal role in the progression of coronary artery disease(CAD).High-sensitivity C-reactive protein(hsCRP)serves as a well-established biomarker for assessing cardiovascular inflammation risk.However,the specific intestinal microbiota alteration contributing to increased inflammation remains unclear.Therefore,the present study investigated the correlation between the intestinal microbiota and inflammation in patients with unstable angina(UA).Methods A cohort of 92 patients with UA was recruited for this study.The plasma hsCRP level was measured via a CardioPhase hsCRP assay,fecal samples were collected after admission,and 16S rRNA sequencing was conducted to identify the fecal microbial profile.The participants were classified into two groups according to the median hsCRP level(1.11 mg/L).The composition of the fecal microbiota was compared between patients with hsCRP≥1.11 mg/L and those with hsCRP<1.11 mg/L.Additionally,the correlations between the fecal microbiota and clinical characteristics were analyzed.Results A notable reduction in the relative abundance of Akkermansia was observed in patients with hsCRP≥1.11 mg/L,whereas the diversity of the fecal microbiota was not significantly different between patients with hsCRP≥1.11 mg/L and those with hsCRP<1.11 mg/L.Furthermore,the abundance of Akkermansia was negatively correlated with hsCRP levels.Conclusion This study suggested a significant association between decreased levels of Akkermansia and inflammatory risk in patients with UA.These findings underscore the potential role of the intestinal microbiota in contributing to inflammation in UA patients.Further work is needed on the mechanism by which the microbiota contributes to inflammatory risk.
基金financially supported by grants from the National Natural Science Foundation of China(32170377,81973463)the Primary Research&Development Plan of Jiangsu Province(BE2020344,BE2022371)。
文摘Blueberry anthocyanins(VA)and blackberry anthocyanins(RA)showed benefits on metabolic syndrome(MS)induced by high-fat diet(HFD)in mice.In this study,we investigated whether the therapeutic effects of VA and RA were achieved by the gut microbiota regulation and whether these effects could be replicated through fecal microbiota transplantation(FMT)using the HFD caused MS model in pseudo-germ-free mice.The results demonstrated that the beneficial effects of VA and RA on MS,including reducing body weight gain and fat accumulation,improving glucose and lipid metabolism,and mitigating intestinal barrier damage,were attributed to the gut microbiota and could be replicated by FMT.16S r RNA sequencing analysis suggested that FMT from donor mice supplemented with VA and RA could regulate the gut microbiota composition.Particularly,FMT from RA supplemented mice displayed the potential to restore the diversity of gut microbiota and the ratio of Firmicutes to Bacteroidetes.Meanwhile,FMT from VA supplemented mice appeared to exert its effects by selectively influencing specific gut microbiota,such as the genus Akkermansia.Furthermore,our analysis identified 10 common differential amplicon sequence variants(ASVs)among groups compared to HFD-HFD group.Notably,ASV_36450 was negatively associated with metabolic parameters,suggesting that Lactobacillus might be the potential bacteria in regulating MS.Overall,our study demonstrated that FMT from VA and RA supplemented mice could ameliorate MS induced by HFD in mice through regulating specific gut microbiota.
基金Supported by Science and Technology Projects in Guangzhou,No.SL2022A03J00756.
文摘Fecal incontinence,a debilitating condition that significantly impairs quality of life,affects 2%-21%of adults worldwide.For patients whose structural defects are unresponsive to conservative therapies,sphincter reconstruction remains the primary treatment approach.Although traditional surgical techniques effectively restore anatomy in the short term,their long-term efficacy is constrained by progressive muscle atrophy and fibrotic scarring.In complex cases,alternative interventions,including dynamic gracilis or gluteus maximus transposition and artificial sphincter implantation,offer therapeutic options yet are associated with increased surgical risks and high complication rates.Emerging therapies such as regenerative medicine and neuromodulatory approaches have potential,although further rigorous clinical validation is needed to establish standardized protocols.Optimizing fecal incontinence management necessitates precise patient stratification,multidisciplinary collaboration,and the development of individualized treatment algorithms.Advancements in this field depend on large-scale clinical trials and comprehensive long-term outcome assessments to improve therapeutic efficacy and patient-centered care.
基金Supported by the Department of Science and Technology of Shanxi Province,No.20210302124369the Health Commission of Shanxi Province,No.2021116Shanxi Administration of Traditional Chinese Medicine,No.2024ZYY2C054.
文摘BACKGROUND Hepatocellular carcinoma(HCC),the predominant form of primary liver cancer,is a key contributor to cancer-related deaths globally.However,HCC diagnosis solely based on blood biochemical markers lacks both sensitivity and specificity.AIM To investigate alterations of the fecal metabolome and intestinal bacteria and reveal the correlations among differential metabolites,distinct bacteria,and serum indicators.METHODS To uncover potentially effective therapeutic targets for HCC,we utilized nontargeted liquid chromatography-mass spectrometry and high-throughput DNA sequencing targeting the 16S rRNA gene.This comprehensive approach allowed us to investigate the metabolome and microbial community structure of feces samples obtained from patients with HCC.Furthermore,we conducted an analysis to assess the interplay between the fecal metabolome and intestinal bacterial population.RESULTS In comparison to healthy controls,a notable overlap of 161 differential metabolites and 3 enriched Kyoto Encyclopedia of Genes and Genomes pathways was observed in the HCC12(comprising patients with stage I and II HCC)and HCC34 groups(comprising patients with stage III and IV HCC).Lachnospira,Streptococcus,and Veillonella had significant differences in abundance in patients with HCC.Notably,Streptococcus and Veillonella exhibited significant correlations with serum indicators such as alpha-fetoprotein(AFP).Meanwhile,several differential metabolites[e.g.,4-keto-2-undecylpyrroline,dihydrojasmonic acid,1,8-heptadecadiene-4,6-diyne-3,10-diol,9(S)-HOTrE]also exhibited significant correlations with serum indicators such asγ-glutamyl transferase,total bilirubin,AFP,aspartate aminotransferase,and albumin.Additionally,these two genera also had significant associations with differential metabolites such as 1,2-Dipentadecanoyl-rac-glycerol(15:0/20:0/0:0),arachidoyl ethanolamide,and 4-keto-2-undecylpyrroline.CONCLUSION Our results suggest that the metabolome of fecal samples and the composition of intestinal bacteria hold promise as potential biomarkers for HCC diagnosis.
基金supported by the Capital’s Funds for Health Improvement and Research(2024-1G-4023)the National Natural Science Foundation of China(82273721).
文摘Background:More efficacious,noninvasive screening methods are needed for advanced colorectal neoplasia.miR-92a is a reliable and reproducible biomarker for early colorectal cancer detection in stool samples.We compared the diagnostic efficacies of miR-92a,immunochemical fecal occult blood testing(FIT),and their combination(FIT+miR-92a)in a prospective multicenter screening trial.Methods:Overall,16,240 participants aged 30-75 years were enrolled between April 1,2021,and December 31,2023.A total of 15,586 participants returned samples available for both FIT and miR-92a tests.All those with positive,and a random selection of those with negative screening tests were recommended to undergo colonoscopy.Follow-ups were performed until participants completed the colonoscopic examination.A total of 1401 screen-positive and 2079 randomly selected screen-negative individuals completed colonoscopies.Primary outcomes included sensitivity,number needed to screen(NNS),Youden index and receiver operating characteristic area under the curve(AUC)for advanced adenomas and colorectal cancer[advanced neoplasia(AN)]for each screening modality in the diagnostic performance analysis.Results:Colonoscopy was performed in 3480 individuals.The colonoscopy compliance rate was 47.8%for screen-positive individuals.The sensitivity of miR-92a vs.FIT for AN was 70.9%vs.54.3%(P<0.001),NNS was 24.7 vs.32.2(P=0.001),Youden index was 47.9%vs.35.0%(P<0.001),AUC was 0.74 vs.0.67(P=0.010).FIT+miR-92a had a sensitivity of 85.4%,an NNS of 20.5,a Youden index of 47.9%and an AUC of 0.74 for AN.Conclusions:For AN screening,miR-92a demonstrated better sensitivity,NNS,Youden index and AUC as compared with FIT.Compared with FIT,using miR-92a appears to be more efficient for population-based screening programs.Screening sensitivity for AN can be further enhanced if conditionally used in combination with FIT.Trial registration Chinese Clinical Trial Registration Number:ChiCTR2200065415.
基金Supported by the Southwest Medical University Project:Exploring the Neuroprotective Mechanism of Tongqiao Yizhi Decoction on Vascular Dementia Rats Based on the Brain Gut Axis(southwest Medical University[2021]No.1)。
文摘OBJECTIVE:To analyze the mechanism of Tongqiao Yizhi decoction(TQYZD,通窍益智颗粒)in treating vascular dementia(VaD)rats using brain tissue untargeted metabonomics and fecal 16S rRNA gene sequencing.METHODS:The chemical composition of TQYZD was analyzed by ultra-high performance liquid chromatography-high resolution mass spectrometry.The effects of TQYZD on VaD rats were evaluated by water maze test,hematoxylin-eosin staining,enzyme-linked immunosorbent assay and Western blot.Untargeted metabolomics and 16S rRNA sequencing were utilized to explore the relationship between metabolic profiles and the structure and function of intestinal flora.Fecal microbiota transplantation(FMT)was used to validate the role of gut microbiota in VaD.Spearman correlation analysis of differential metabolites and gut microbiota was performed.RESULTS:The results showed that TQYZD improved cognitive function and neuronal damage in VaD rats,and reduced inflammatory response and repaired the intestinal barrier.In addition,TQYZD had the effect of modulating gut microbes in VaD rats,and FMT further confirmed that gut flora plays an important role in TQYZD treatment of VaD.Untargeted metabolomics revealed that VaD could lead to metabolic disorders in brain tissues,and TQYZD significantly altered the metabolites of brain tissues in Middle Cerebral Artery Occlusion rats.The results of spearman correlation analysis showed that there was a significant correlation between intestinal flora and the metabolites of brain tissues.CONCLUSION:In this study,we demonstrated that TQYZD can improve metabolic disorders in vascular dementia rats by acting on intestinal flora.
基金Supported by National Key R&D Program of China,No.2022YFC2304505 and No.2021YFC2301801the Beijing Municipal of Science and Technology Major Project,No.Z221100007422002+1 种基金the Capital Funds for Health Improvement and Research,No.CFH-2024-1-2181Beijing Igandan Foundation,No.iGandanF-1082023-GSH011.
文摘Chronic liver disease has become a global health crisis,with increasing incidence and mortality rates placing a substantial burden on healthcare systems worldwide.A key factor in the progression of chronic liver disease is intestinal microbiota dysbiosis,which influences liver function via the intricate liver-gut axis.This axis plays a central role in various physiological processes,and disruptions in microbial composition can exacerbate liver pathology.Fecal microbiota transplantation(FMT)has emerged as a promising therapeutic strategy,with the potential to restore the composition and metabolic functions of the intestinal microbiota.Supported by encouraging findings from clinical trials and animal studies,FMT has demonstrated therapeutic benefits,including improvements in clinical symptoms,objective indicators,and long-term prognosis.These benefits encompass reductions in hepatic lipid deposition and inflammation,mitigation of complications in advanced liver disease,promotion of hepatitis B e antigen seroconversion,and enhancement of cognitive function.Although clinical evidence remains preliminary,current data underscore the transformative potential of FMT in managing chronic liver diseases.Nonetheless,challenges persist,including the need for standardized procedures,variability among donors,potential risks,and concerns regarding long-term safety.This review provides a comprehensive evaluation of the current literature on the efficacy and safety of FMT,while exploring future research directions to expand its application in liver disease management.
基金Exploration of the Preventive Effect of Skin Management Program Based on 4R Crisis Management Theory on Incontinence-Associated Dermatitis in ICU Patients with Fecal Incontinence(Project No.:YK202335)。
文摘Objective:To analyze the preventive and management effects of the 4R crisis management theory on incontinence-associated dermatitis(IAD)in ICU patients with fecal incontinence.Methods:A hundred patients with fecal incontinence who were admitted to the ICU for treatment between January 2024 and December 2024 were selected and randomly divided into two groups using a random number table.The observation group received 4R crisis management theory,while the control group received routine management.The IAD risk score,incidence of IAD,severity of IAD,and formation and healing time of IAD were compared between the two groups.Results:After management,the IAD risk score of the observation group was lower than that of the control group(P<0.05).The incidence of IAD in the observation group was lower than that in the control group,the proportion of mild IAD was higher than that in the control group,the formation time of IAD was later than that in the control group,and the healing time was shorter than that in the control group(P<0.05).Conclusion:Adopting the 4R crisis management theory for ICU patients with fecal incontinence can reduce the risk of IAD occurrence,effectively prevent IAD,reduce its severity,delay its formation time,and promote good healing.
基金Supported by Natural Science Foundation of Tianjin,No.21JCZDJC00060 and No.21JCYBJC00180Tianjin Health and Medical Science and Technology Project,No.TJWJ2023QN040National Key Research and Development Program,No.2017YFC1700606 and No.2017YFC1700604.
文摘BACKGROUND Certain subgroups are at an increased risk of false fecal immunochemical test(FIT)results;however,related studies are limited,and the available evidence is conflicting.AIM To evaluate factors associated with false-positive and false-negative FIT results.METHODS This retrospective study was based on the database of the Tianjin Colorectal Cancer Screening Program from 2012 to 2020.A total of 4129947 residents aged 40-74 years completed at least one FIT.Of these,24890 asymptomatic participants who underwent colonoscopy examinations and completed lifestyle questionnaires were included in the analysis.Multivariable logistic regression was performed to identify the factors associated with false FIT results.RESULTS Among the overall screening population,88687(2.15%)participants tested positive for FIT.The sensitivity,specificity,positive predictive value,and negative predictive value of FIT for advanced neoplasms were 58.2%,44.8%,9.7%,and 91.3%,respectively.Older age,female sex,smoking,alcohol consumption,higher body mass index,and hemorrhoids were significantly associated with increased odds of false-positive and lower odds of falsenegative FIT results.Moreover,features of high-grade dysplasia or villous for advanced adenoma and the presence of cancer were also associated with lower odds of false-negative results,while irregular exercise and diverticulum were associated with higher odds of false-positive results.CONCLUSION FIT results may be inaccurate in certain subgroups.Our results provide important evidence for further individualization of screening strategies.
基金National Natural Science Foundation of Joint Fund in China (U22A20376)。
文摘Objective To investigate the therapeutic efficacy and potential mechanisms of fecal microbiota transplantation(FMT)in patients with type 2 diabetes mellitus(T2DM),and to preliminarily identify the traditional Chinese medicine(TCM)syndrome element characteristics of FMT in the treatment of T2DM.Methods Between March 25,2023 and September 30,2024,T2DM patients who met the inclusion and exclusion criteria were enrolled at the Department of Rheumatology and Endocrinology of the Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine.Participants received oral microbiota capsules as an adjunct to metformin therapy.Information obtained by four diagnostic methods of TCM,along with clinical and laboratory parameters,was collected before and after the intervention.Metagenomic sequencing was employed to analyze the gut microbiota,and Spearman correlation analysis was used to explore the relationship between laboratory indicators and differential bacterial genera.According to the post-treatment reduction in glycosylated hemoglobin(HbA1c),patients were categorized into a response(R)group and a non-response(NR)group.Treatment outcomes,safety indicators,gut microbiota changes,and TCM syndrome element features were compared between the two groups.Results A total of 53 T2DM patients were included in the final analysis,and 30 patients were assigned to R group and 23 to NR group.After treatment,the R group exhibited significant reductions in HbA1c,fasting plasma glucose(FPG),and 2-hour postprandial glucose(2hPG)(P<0.05 or P<0.01).The NR group also showed significant decreases in HbA1c and FPG levels P<0.01 or P<0.05.Compared with the NR group,after treatment,FPG level in the R group demonstrated significant reductions(P<0.01).As compared with before treatment,pancreatic islet function demonstrated enhancement in the R group,a significant increase in the 2-hour pastprandial C-peptide(2hC-P)levels in R group(P<0.05),whereas no marked change was observed in the NR group.Regarding body composition indicators,the R group showed significantly lower waist-hip ratio(WHR),visceral fat(VF),and subcutaneous fat(SF)levels compared with the NR group(P<0.01).After treatment,the NR group exhibited a significant elevation in aspartate aminotransferase(AST)levels(P<0.05).Other safety-related indicators fluctuated within normal reference ranges,and no other adverse events,such as diarrhea,fever,or nausea,were reported.Metagenomic sequencing showed that FMT improved the diversity and richness of the gut microbiota,remodeling its overall structure.At the phylum level,the abundance of p_Firmicutes decreased significantly(P<0.01),while the abundances of p_Bacteroidota and p_Proteobacteria increased significantly(P<0.01).At the family level,among the 125 identified taxa,the abundances of f_Bacteroidaceae,f_Lactobacillaceae,and f_Sutterellaceae were significantly elevated,whereas six families,including f_Lachnospiraceae,f_Ruminococcaceae,and f_Coriobacteriaceae,were significantly decreased(all P<0.05).Among the 367 taxa at the genus level,the top 10 differential genera showed significantly increased abundances of g_Bacteroides and g_Sutterella,and significantly decreased abundances in eight genera,including g_Faecalibacterium,g_Ruminococcus,g_Blautia,and g_Collinsella(all P<0.05).Correlation analysis suggested that the phylum p_Bacillota was positively correlated with improvements in T2DM laboratory parameters,g_norank_f_Prevotellaceae was significantly positively correlated with fasting C-peptide(FC-P)and 2hC-P(P<0.05).HbA1c demonstrated a significantly positive correlation with g_Blautia and g_Gemmiger(P<0.05)and a significantly negative correlation with g_Bacteroides and g_Collinsella(P>0.05).Analysis of syndrome element characteristics revealed that the R group was primarily characterized by pathological patterns of dampness,phlegm,and Yang deficiency.Before treatment,statistically significant reductions in syndrome element scores were observed for dampness,Yang deficiency,spleen,phlegm,Qi deficiency,Qi stagnation,and Yin deficiency(P<0.01),as well as for heat and liver(P<0.05).The NR group was mainly featured with Qi deficiency and Yin deficiency.Statistically significant changes in their syndrome element scores after treatment were noted for Qi deficiency(P<0.01),and for spleen,Qi stagnation,liver,and blood deficiency(P<0.05).In this group,the score changes for Yang deficiency,Yin deficiency,heat,and dampness were not statistically significant(P>0.05).Conclusion The principles of syndrome element differentiation can be effectively applied to predict treatment efficacy and facilitate patient selection for FMT in the treatment of T2DM.Patients with T2DM presented with specific TCM syndrome element characteristics,notably dampness,phlegm,and Yang deficiency,represent a highly responsive population to FMT therapy.
基金Major National Science and Technology Projects(Grant No.2013ZX10004605,2013ZX10004605001004)
文摘The pathogens and opinion for antibiotic treatment in adult patients with 1-14 fecal white blood cells per high power field （WBC/HPF） of acute non-bloody diarrhea remain obscure. The study attempts to clarify it. Stool specimens of adult patients with acute non-bloody diarrhea and stool examination showing 1-14 fecal WBC/HPF were collected for bacterial culture and viral detection. Patients included in this study were 196 cases with mean age of （37.9±17.4） years and 42.3% was women. The bacterial and viral detection rates were 63 （32.1%） and 21 （10.7%）, respectively. Of the isolated pathogens, campylobacteria was present in 14 （22.0%） samples and was the most common bacteria and calicivirus was found in 10 （47.6%） samples and was the most common virus. Based on single pathogens, 46 cases were caused by invasive pathogens, 26 cases were caused by non-invasive pathogens. The body temperature was significantly higher in feverish patients caused by invasive pathogens than those caused by non-invasive pathogens （（38.44-0.7） ℃ vs （37.74-0.4） ℃, P = 0.002）. The probability of diarrhea caused by invasive pathogens was higher in patients with T〉38.4℃ than those with T_〈38.4℃ （RR = 1.5）. When T〉38.4℃ is used as the threshold for antibiotic treatment, the misuse rate of antibiotics would decrease from 26.9% to 3.8% （P = 0.021）. So T〉38.4 ℃ may be used as a possible reference value for antibiotic treatment in adult patients with 1-14 fecal WBC/HPF of acute non-bloody diarrhea.
