Restorative proctocolectomy with ileal pouch-anal anastomosis(IPAA)has become the surgical treatment of choice for many patients with medically refractory ulcerative colitis(UC)and familial adenomatous polyposis(FAP)....Restorative proctocolectomy with ileal pouch-anal anastomosis(IPAA)has become the surgical treatment of choice for many patients with medically refractory ulcerative colitis(UC)and familial adenomatous polyposis(FAP).UC patients with IPAA(UC-IPAA)are,nevertheless,susceptible to inflammatory and noninflammatory sequelae such as pouchitis,which is only rarely noted in FAP patients with IPAA.Pouchitis is the most frequent long-term complication of UC-IPAA patients,with a cumulative prevalence of up to 50%.Although the aetiology of pouchitis remains unclear,accumulating evidence suggests that a dysbiosis of the pouch microbiota and an abnormal mucosal immune response are implicated in its pathogenesis.Studies using culture and molecular techniques have detected a dysbiosis of the pouch microbiota in patients with pouchitis.Risk factors,genetic associations,and serological markers suggest that interactions between the host immune response and the pouch microbiota underlie the aetiology of this idiopathic inflammatory condition.This systematic review focuses on the dysbiosis of the microbiota that inhabit the pouch in UC and FAP patients and its interaction with the mucosal immune system.A metaanalysis was not attempted due to the highly heterogeneous microbiota composition and the different detection methods used by the various studies.Although no specific bacterial species,genus,or family has as yet been identified as pathogenic,there is evidence that a dysbiosis characterized by decreased gut microbiota diversity in UC-IPAA patients may,in genetically predisposed subjects,lead to aberrant mucosal immune regulation triggering an inflammatory process.展开更多
Fecal microbiota transplantation(FMT) has garnered significant attention in recent years in the face of a reemerging Clostridium difficile(C.difficile) epidemic.Positive results from the first randomized control trial...Fecal microbiota transplantation(FMT) has garnered significant attention in recent years in the face of a reemerging Clostridium difficile(C.difficile) epidemic.Positive results from the first randomized control trial evaluating FMT have encouraged the medical community to explore the process further and expand its application beyond C.difficile infections and even the gastrointestinal domain.However promising and numerous the prospects of FMT appear,the method remains limited in scope today due to several important barriers,most notably a poorly defined federal regulatory policy.The Food and Drug Administrationhas found it difficult to standardize and regulate the administration of inherently variable,metabolically active,and ubiquitously available fecal material.The current cumbersome policy,which classifies human feces as a drug,has prevented physicians from providing FMT and deserving patients from accessing FMT in a timely fashion,and subsequent modifications seem only to be temporary.The argument for reclassifying fecal material as human tissue is well supported.Essentially,this would allow for a regulatory framework that is sufficiently flexible to expand access to care and facilitate research,but also appropriately restrictive and centralized to ensure patient safety.Such an approach can facilitate the advancement of FMT to a more refined,controlled,and aesthetic process,perhaps in the form of a customized and wellcharacterized stool substitute therapy.展开更多
通过分析比较我国国家卫生健康委员会、美国疾病预防控制中心(centers for disease control and prevention,CDC)、欧洲感染病协作网(European network of infections disease,EUNID)发布的高等级隔离病房(high-level isolation unit,HL...通过分析比较我国国家卫生健康委员会、美国疾病预防控制中心(centers for disease control and prevention,CDC)、欧洲感染病协作网(European network of infections disease,EUNID)发布的高等级隔离病房(high-level isolation unit,HLIU)的疾病收治范围、规模、日常运营和硬件设施等国内外规范差异,为我国HLIU技术规范建设提供参考。展开更多
The Mazhuang gas reservoir is located in the eastern part of the Junggar Basin. Itsgas-producing pool is averagely 2000 m deep. It is a mid-shallow reservoir. The natural gasrich 2--7% of C_2-C_4 gaseous hydrocarbons ...The Mazhuang gas reservoir is located in the eastern part of the Junggar Basin. Itsgas-producing pool is averagely 2000 m deep. It is a mid-shallow reservoir. The natural gasrich 2--7% of C_2-C_4 gaseous hydrocarbons is mainly composed of methane. δ^(13)C_(CH_4). valuesare--47----45‰, heavier than microbiogenic gas, and lighter than coal--type gas as well asoil--associated gas. The maternal materials of gas source rocks are primarily from the type-Ⅲ organic matter at the low--mature stage (0.5%<R_0≤0.8%). The discovery of the reservoiris of great significance not only to the further exploration of natural gas but also to theenrichment of the gas--forming theory and the perfection of the classification of natural gastypes.展开更多
文摘Restorative proctocolectomy with ileal pouch-anal anastomosis(IPAA)has become the surgical treatment of choice for many patients with medically refractory ulcerative colitis(UC)and familial adenomatous polyposis(FAP).UC patients with IPAA(UC-IPAA)are,nevertheless,susceptible to inflammatory and noninflammatory sequelae such as pouchitis,which is only rarely noted in FAP patients with IPAA.Pouchitis is the most frequent long-term complication of UC-IPAA patients,with a cumulative prevalence of up to 50%.Although the aetiology of pouchitis remains unclear,accumulating evidence suggests that a dysbiosis of the pouch microbiota and an abnormal mucosal immune response are implicated in its pathogenesis.Studies using culture and molecular techniques have detected a dysbiosis of the pouch microbiota in patients with pouchitis.Risk factors,genetic associations,and serological markers suggest that interactions between the host immune response and the pouch microbiota underlie the aetiology of this idiopathic inflammatory condition.This systematic review focuses on the dysbiosis of the microbiota that inhabit the pouch in UC and FAP patients and its interaction with the mucosal immune system.A metaanalysis was not attempted due to the highly heterogeneous microbiota composition and the different detection methods used by the various studies.Although no specific bacterial species,genus,or family has as yet been identified as pathogenic,there is evidence that a dysbiosis characterized by decreased gut microbiota diversity in UC-IPAA patients may,in genetically predisposed subjects,lead to aberrant mucosal immune regulation triggering an inflammatory process.
文摘Fecal microbiota transplantation(FMT) has garnered significant attention in recent years in the face of a reemerging Clostridium difficile(C.difficile) epidemic.Positive results from the first randomized control trial evaluating FMT have encouraged the medical community to explore the process further and expand its application beyond C.difficile infections and even the gastrointestinal domain.However promising and numerous the prospects of FMT appear,the method remains limited in scope today due to several important barriers,most notably a poorly defined federal regulatory policy.The Food and Drug Administrationhas found it difficult to standardize and regulate the administration of inherently variable,metabolically active,and ubiquitously available fecal material.The current cumbersome policy,which classifies human feces as a drug,has prevented physicians from providing FMT and deserving patients from accessing FMT in a timely fashion,and subsequent modifications seem only to be temporary.The argument for reclassifying fecal material as human tissue is well supported.Essentially,this would allow for a regulatory framework that is sufficiently flexible to expand access to care and facilitate research,but also appropriately restrictive and centralized to ensure patient safety.Such an approach can facilitate the advancement of FMT to a more refined,controlled,and aesthetic process,perhaps in the form of a customized and wellcharacterized stool substitute therapy.
文摘通过分析比较我国国家卫生健康委员会、美国疾病预防控制中心(centers for disease control and prevention,CDC)、欧洲感染病协作网(European network of infections disease,EUNID)发布的高等级隔离病房(high-level isolation unit,HLIU)的疾病收治范围、规模、日常运营和硬件设施等国内外规范差异,为我国HLIU技术规范建设提供参考。
基金Project supported by the National Natural Science Foundation of China.
文摘The Mazhuang gas reservoir is located in the eastern part of the Junggar Basin. Itsgas-producing pool is averagely 2000 m deep. It is a mid-shallow reservoir. The natural gasrich 2--7% of C_2-C_4 gaseous hydrocarbons is mainly composed of methane. δ^(13)C_(CH_4). valuesare--47----45‰, heavier than microbiogenic gas, and lighter than coal--type gas as well asoil--associated gas. The maternal materials of gas source rocks are primarily from the type-Ⅲ organic matter at the low--mature stage (0.5%<R_0≤0.8%). The discovery of the reservoiris of great significance not only to the further exploration of natural gas but also to theenrichment of the gas--forming theory and the perfection of the classification of natural gastypes.
