ABSTRACT
As the first line of defense between the intestinal environment and the outside world， the intestinal mucosal barrier is essential for maintaining the intestinal homeostasis. The intestinal mucosal barrier injury will change the intestinal permeability and allow bacterial translocation and the entry of endotoxins into blood， thus triggering a series of inflammatory responses， followed by the injury of related tissues and the aggravation of primary diseases. The spleen， the acquired foundation， is responsible for maintaining the internal and external balance of the body and resisting external evils. Its physiological function is similar to that of the intestinal mucosal barrier. Spleen deficiency easily leads to intestinal mucosal barrier dysfunction. Therefore， replenishing Qi， invigorating spleen， and restoring the efficacy of spleen and stomach qi in defensing and governing transportation and transformation are the keys to prevent and treat intestinal mucosal barrier injury. In recent years， studies have shown that the spleen-invigorating Chinese medicinals repair the intestinal mucosal injury by promoting the expression of intestinal epithelial tight junction proteins， regulating the intestinal immune function， microbial flora， and metabolites， and supplementing the intestinal nutrition， enabling them to gradually become a research hotspot. After reviewing the relevant articles published in China and abroad， this paper expounded the common syndrome types of traditional Chinese medicine （TCM）， the changes in intestinal mucosal barrier induced by spleen deficiency， the repairing effects of spleen-invigorating Chinese medicinals on intestinal mucosal barrier injury， in order to provide some clues for the research on the treatment of intestinal mucosal barrier dysfunction-related diseases with spleen-invigorating Chinese medicinals.
ABSTRACT
Butyrate-producing bacteria are specific intestinal bacteria with butyrate as the main metabolite, and most of them are Firmicutes.Butyrate-producing bacteria can synthesize butyrate with non-digestible carbohydrates in the diet, and then regulate intestinal microecology and microenvironment, thereby supplying energy to intestinal epithelial cells, affecting intestinal mucosal barrier, adjusting intestinal flora structure and regulating host immunity, so as to alleviate obesity, hypertension and other diseases.Therefore, the targeted regulation of butyrate-producing bacteria and butyrate has become a potential vital method for the prevention and treatment of many diseases.After oral administration, Chinese herbal medicine (CHM) enters the body, and first contacts gastrointestinal tract, so the interaction between CHM and microbiota existing in the intestine is an inevitable important process.It has been confirmed that CHM could regulate intestinal flora; and due to its complex composition and numerous components, CHM can exert interventional effects at multiple levels, in multiple pathways and on multiple targets.Its effect on the butyrate-producing bacteria is as follows.In the intestinal tract, CHM can play a " prebiotic" role, and enrich the beneficial butyrate-producing bacteria, and polysaccharides in CHM can be used as a fermentation substrate to promote the synthesis of butyrate, so as to achieve the effective regulation of butyrate-producing bacteria and butyrate.Based on that, this paper explored the relationship among butyrate-producing bacteria, butyrate and intestinal microecology, and reviewed relevant researches about the intervention of CHM on butyrate-producing bacteria to regulate intestinal microecology in recent years, in order to provide new research ideas for the application of CHM to prevent and treat diseases, as well as drug development.
ABSTRACT
Objective: To explore the predictive value of neutrophil/lymphocyte ratio (NLR) on myocardial injury in severe COVID-19 patients. Methods: In this single-center retrospective cohort study, we collected and analyzed data form 133 severe COVID-19 patients admitted to Renmin Hospital of Wuhan University (Eastern District) from January 30 to February 18, 2020. Patients were divided into myocardial injury group (n=29) and non-myocardial injury group (n=104) according the presence or absence of myocardial injury. The general information of patients was collected by electronic medical record database system. All patients were followed up for 30 days, the organ injury and/or dysfunction were monitored, the in-hospital death was compared between the two groups, and the disease progression was reevaluated and classified at 14 days after initial hospitalization. Logistic regression analysis was performed to identify risk factors of myocardial injury in severe COVID-19 patients. The ROC of NLR was calculated, and the AUC was determined to estimate the optimal cut-off value of NLR for predicting myocardial injury in severe cases of COVID-19. Results: There was statistical significance in age, respiratory frequency, systolic blood pressure, symptoms of dyspnea, previous chronic obstructive pulmonary disease, coronary heart disease history, white blood cells, neutrophils, lymphocytes, platelets, C-reactive protein, platelet counting, aspartate transaminase, albumin, total bilirubin, direct bilirubin, urea, estimated glomerular filtration rate, total cholesterol, low-density lipoprotein cholesterol, D-dimer, CD3+, CD4+, partial pressure of oxygen, partial pressure of CO2, blood oxygen saturation, other organ injury, clinical outcome and prognosis between patients with myocardial injury and without myocardial injury (all P<0.05). Multivariate logistic regression analysis showed that NLR was a risk factor for myocardial injury (OR=1.066，95%CI 1.021-1.111，P=0.033). ROC curve showed that NLR predicting AUC of myocardial injury in severe COVID-19 patients was 0.774 (95%CI 0.694-0.842), the optimal cut-off value of NLR was 5.768, with a sensitivity of 82.8%, and specificity of 69.5%. Conclusion: NLR may be used to predict myocardial injury in severe COVID-19 patients.
Subject(s)
Humans , Betacoronavirus , COVID-19 , Coronavirus Infections/pathology , Heart Diseases/virology , Lymphocytes/cytology , Myocardium/pathology , Neutrophils/cytology , Pandemics , Pneumonia, Viral/pathology , Prognosis , ROC Curve , Retrospective Studies , SARS-CoV-2ABSTRACT
<p><b>OBJECTIVE</b>To study the distribution of collagen IX gene in the disc and to determine its role in the pathogeny of idiopathic scoliosis (IS).</p><p><b>METHODS</b>The data included apical disc and intermediate disc from 14 cases of adolescent IS, 26 discs from 13 cases of scoliosis of confirmed pathogeny (CPS), which included 10 cases of congenital scoliosis and neurofibromatosis scoliosis. Six discs were obtained from 3 cases of normal young man served as controls. The distribution of collagen IX was studied in the apical disc of IS by immunohistochemistry and in situ hybridization (ISH) with RNA probe. The figure of collagen IX hybridization in the endplate cartilage was input to the figure analysis system. The mRNA content of collagen IX was compared between each group by SPSS software.</p><p><b>RESULTS</b>Collagen IX was mainly distributed in the inner fibrous annulus, nucleus and endplate cartilage. Collagen IX was secreted by the little round chondrocyte-like cells, which was not expressed in the hypertrophic cells. There was significant difference of collagen IX mRNA content between the concave side of apical disc in the IS and the normal disc(P < 0.05), and also between intermediate vertebrae of CS group and normal.</p><p><b>CONCLUSIONS</b>There is no obvious abnormal distribution of collagen IX in the disc of idiopathic scoliosis. Collagen IX may be related to the pathogensis of IS. More investigation such as quantity analysis and protein function determination is needed to confirm its role in the pathogenicity of IS.</p>