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Multiple short-term and long-term complications might occur after liver transplantation. In the early stage after liver transplantation, the incidence of multidrug-resistant bacteria is likely to cause different types of infection, one of which is intestinal flora imbalance. In the recent decade, a series of studies have demonstrated that intestinal flora plays an important role in maintaining intestinal homeostasis. Intestinal flora may interact with other organs via multiple patterns. Among which, gut-liver axis is one of the most critical channels for regulating microenvironment of the host. Changes in the quantity and composition of intestinal flora could lead to intestinal flora imbalance. In both local and systemic systems, extensive interaction exists between intestinal flora and immune system. In this article, the risk factors of intestinal flora imbalance after liver transplantation, influence of intestinal flora imbalance on liver transplant recipients and relevant treatment strategies were reviewed.
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The impact of intestinal flora on human and animal health and diseases has attracted much attention both at home and abroad in recent years. The intestinal flora constitutes the intestinal microecosystem and plays an important role in physiological activities such as nutrition, metabolism, growth and development, barrier protection, and immunity. In this article, the relationship between intestinal dysbiosis and psychiatric diseases has been reviewed from two aspects:metagenomic characterization of intestinal microflora diversity in neurological diseases and validation of the relationship between intestinal flora and psychiatric diseases by fecal bacteria transplantation in germ-free mice. In addition, the microbial-gut-brain axis theory has been proposed in recent years, which links the nerve-endocrine-immune system to form a two-way signaling pathway. Intestinal flora plays an important role in regulating the central nervous system by promoting neurotransmitter release, endocrine, and immunity. The system plays an important role. Changes in intestinal flora mainly affect the host's nervous system through vagus nerve pathways, endocrine pathways, immune pathways, etc, thereby triggering or aggravating depression, autism, Alzheimer's disease, schizophrenia, Parkinson's disease, etc. This article reviews the relationships between host-related neurological abnormalities, intestinal flora imbalance and mental diseases, and discusses the research methods, research progress, and mechanism of the correlation between intestinal flora imbalance and mental diseases to research progress on microbe-gut-brain axis.
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Diabetes is a kind of disease which poses a great threat to human health. Its occurrence and development are often related to many factors such as heredity and environment. According to the eighth edition of Diabetes Federation's diabetes map in 2017， there are about 425 million diabetics in the world. It is estimated that by 2045， the number of diabetics will increase to 700 million， becoming a health problem that has attracted increasing attention all over the world， among which the number of type 2 diabetics （T2DM）accounts for more than 90% of the total. Therefore， it is of great significance to study the pathological mechanism for the effective prevention and treatment of diabetes. Intestinal microflora coexists with human beings and forms an important micro ecosystem， which is involved in the metabolism of substance and energy. In recent years， with the development of high-throughput sequencing technology， a large number of studies have shown that in addition to obesity， genetic and insulin dysfunction， intestinal flora disorder may also lead to diabetes. The unbalanced diet structure of T2DM patients destroys the balance of intestinal flora. It is generally believed that the occurrence and development of T2DM may be one of the results of the intestinal microbial disorder caused by over nutrition. However， there is no clear mechanism of how intestinal flora participates in the development of T2DM. At present， it is generally believed that the intestinal flora may affect the metabolism of the body through the participation in bile acid metabolism， short chain fatty acid metabolism， low-level inflammatory response and other ways. At present， the prevention and treatment of T2DM is mainly based on drug control. Through surgical operation， increasing the number of probiotics， fecal transplantation and other methods to intervene the intestinal microflora to adjust the intestinal microflora， it provides a new means for the prevention and treatment of T2DM. This paper discusses the interaction between T2DM and intestinal microflora in recent years and the possible treatment measures in the future.
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OBJECTIVE: To analyze the risk factors and relationship between intestinal flora imbalance and anastomotic leakage after laparoscopic rectal cancer lower anterior resection(LAR)in patients with middle-low rectal cancer.METHODS: Clinical data of 155 patients with mid to low rectal cancer who underwent laparoscopic lower anterior resection at Peking Union Medical College Hospital from November 2016 to April 2019 were retrospectively analyzed.Postoperative intestinal flora imbalance and anastomotic leakage were evaluated,and statistical results were gained.RESULTS: Of the 155 patients,34(21.9%)patients had postoperative intestinal flora imbalance. Twenty patients of anastomotic leakage after operation(12.9%)were discovered,and 18 patients(11.6%)had both anastomotic leakage and intestinal flora imbalance. Univariate and multivariate logic regression analysis showed that intestinal flora imbalance(χ~2=25.674,OR=90.398,P0.05).CONCLUSION: The early diagnosis of postoperative intestinal floraimbalance in rectal cancer patients depends more on clinical experience. Intestinal floraimbalance,the enlargement of tumor diameterare risk factors for anastomotic leakage,and protective enterostomy would reduce the incidence of anastomotic leakage.
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@#In recent years, the etiology of periodontitis has tended to be based on the theory of flora imbalance. That is, periodontitis is not caused by specific bacteria but by the breakdown of the oral flora balance, which leads to an immune imbalance. Imbalanced bacterial flora cooperate with each other to produce virulent factors that destroy organism tissues and induce immune cells to produce abnormal levels of cytokines, causing greater damage. This article reviews the initiation of a flora imbalance, the interaction between bacteria, the immune damage of the host and the prevention and treatment of the flora imbalance. The literature review shows that peroxidase released by inflammatory reactions, host immune responses to pathogenic microorganisms and some systemic factors, such as diabetes, can trigger flora imbalance. As a result, ion transport, substance synthesis and metabolism of bacteria change; virulence factors increase; and the oral flora balance is disrupted. Red complex bacteria enter gingival epithelial cells, produce adhesin, and selectively inhibit the expression of specific chemokines, which is beneficial for other pathogenic bacteria to enter gingival epithelial cells. Toxicity factors increase throughout the body, directly destroying body tissues and inducing innate and adaptive immune responses, thus causing related immune damage. The dysbacteriosis model of periodontitis provides a new idea for the prevention and treatment of periodontitis, such as using biological factors, bacteriophages, probiotics and other methods to reduce the number of periodontal pathogens to restore the steady state of periodontal flora.
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Endometriosis is a multiple disease that afflicts the health of women at childbearing age,and its incidence rate has been increasing year by year,furthermore,there has been a trend to be younger.At present,the pathogenesis of endometriosis has been not expounded completely,its cure rate is not high with high recurrence rate.In recent years,studies have shown that the human is a commensal body composed of a large number of microorganisms,and especially the microorganisms in the intestinal are closely related to the health of the body.Based on the previous studies on endometriosis,this paper proposes that its pathogenesis may be related to intestinal microbiological disorder,and aims to provide new ideas for the treatment of endometriosis.
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AIM:To investigate the change of intestinal flora distribution and its relationship with interleukin -23(IL-23)/IL-17 axis in ulcerative colitis(UC)patients.METHODS:The fresh fecal samples from 20 patients with ac-tive UC and 20 healthy controls were collected.The distribution of the flora was analyzed by direct smear and traditional bacterial culture.The changes of bacteria were detected by real-time PCR.The hemoglobin,albumin,erythrocyte sedimen-tation,and C-reactive protein levels were tested routinely.Both normal and damaged mucosal tissues of UC patients were examined and obtained by colonoscopy,and further assessed by Mayo scoring,Baron grading and HE staining.The expres-sion of IL-17 and IL-23 was observed by immunohistochemistry and Western blot.RESULTS:(1)The degree of flora im-balance in active UC patients was higher than that in the healthy controls(P<0.05).(2)The results of aerobic culture showed that the number of Escherichia coli in the UC patients was significantly lower than that in the normal controls(P<0.01),while Enterococcus was increased obviously(P<0.01).The results of anaerobic culture revealed that the numbers of Bacteroidetes,Bifidobacterium bifidum and Lactobacilli in the UC patients were significantly decreased(P<0.01).(3) Quantitative analysis of target bacteria showed that the relative quantification of Escherichia coli,Bacteroidetes,Bifidobacte-rium bifidum and Lactobacilli in the UC patients was significantly lower than that in the normal subjects,and the number of Enterococcus was significantly increased(P<0.01).(4)Compared with control group,no significant change of hemoglo-bin in the UC patients was ovserved,albumin was significantly decreased(P<0.05), but erythrocyte sedimentation and C-reactive protein levels were elevated obviously(P<0.01).(5)The Mayo score, Baron grade, and histopathological score were all increased(P<0.01).(6)High IL-17 and IL-23 expression levels were detected in the UC patients(P<0.01).(7)Correlation analysis showed that the average absorbance values of IL -17 and IL-23 expression were positively correlated with Baron grade(r=0.717,P=0.02;r=0.849,P=0.016)and pathological score(r=0.660, P=0.03;r=0.675,P=0.032).Meanwhile, the average absorbance value of IL-23 expression was negatively correlated with the number of Escherichia coli(r =-0.699, P =0.025), and positively correlated with Enterococcus(r =0.872, P =0.010).Furthermore,the average absorbance value of IL-17 expression was positively correlated with Enterococcus(r=0.764,P=0.046),and both of them were not correlated with other bacteria.CONCLUSION: Obvious flora imbalance exists in active UC patients,changed intestinal microflora is closely related with the degree of inflammation.IL-23/IL-17 axis,as a key factor in the development of UC,may be related to the changes of intestinal microflora.The interaction be-tween intestinal microflora and IL-23/IL-17 axis plays an important role in the pathogenesis of UC.
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Objective To study the effects of intestinal flora imbalance after ig administration on pharmacokinetic parameters of baicalin or baicalein in rats. Methods The SD rats were divided into four groups including baicalin group, antibiotic + baicalin group, baicalein group, and antibiotic + baicalein group. Traditional antibiotic medicine lincomyci were used to induce rats gut micro dysbiosis for 5 d. The pharmacokinetics of related technologies and methods were used, and the rats were administered with Moore dose (370 μmol/kg) of baicalin and baicalein. The plasma samples were collected at different time points within 20 h, and the concentration of baicalin was determined with LC-MS/MS, and the curve was drawn. The data were analyzed by DAS.2.2 software, comparison of baicalin and baicalein in animal behavior changes of rats in normal rats and antibiotics. Results The results showed that the baicalein was metabolized entirely and the metabolite baicalin was detected mainly in rat plasma after oral administration of baicalein. These results showed that the Cmax [ (7.80 ± 5.52) mg/L] of baicalin in rats in antibiotic + baicalin group was decreased compared with that with baicalin alone [Cmax (16.35 ± 9.48) mg/L]. Meanwhile, the AUC0~t of baicalin in antibiotic + baicalin group was 32.60 ± 18.88 mg∙h/L which was significantly lower than that in rats with baicalin alone [ (75.16 ± 48.40) mg∙h/L]. These results showed that the Cmax [ (10.28 ± 5.57) mg/L] of baicalin in rats of antibiotic + baicalein group was decreased compared with that with baicalein alone [Cmax (60.39 ± 56.32) mg/L]. Meanwhile, the AUC0~t of baicalin in antibiotic + baicalein group was (71.67 ± 54.49) mg∙h/L which was significantly lower than that in rats with baicalein alone [ (212.51 ± 101.25) mg∙h/L]. Conclusion Baicalin and baicalein showed bad pharmacokinetic behavior in rats when the rat intestinal flora is imbalance.
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Objective To observe clinical efficacy of probiotics agents in the prevention and treatment of severe pulmonary infection in elderly patients with antibiotic-associated diarrhea (AAD).Methods 60 cases of elderly patients with severe pulmonary infection (more than or equal to 60 years old) were randomly divided into the treatment group ( 31 cases ) and control group ( 29 cases ) , the control group received broad-spectrum antibiotics or using two linked above anti-infection treatment, the treatment group were added with probiotic agent ( lactobacillus complex capsules).The diarrhea, the use of antibiotics and the stool routine, bacteria before and after 5, 10, 15 days of group were observed.Results After 15 days treatment, the number of Escherichia coli in treatment group was lower than that in control group (P<0.05), the number of Bacterium lacticum and Bifidobacterium bifidum in treatment group were higher than those in control group ( P<0.05 ) .The AAD rate in treatment goup was 12.90%, which was lower than 41.38% in control group (P<0.05).There were significant differences in beginning time and duration of diarrhea between two groups (P<0.05). Conclusion The intestinal probiotics reduced induced by antibiotics in elderly patients with severe pulmonary infection , the probiotics agents could redress intestinal flora imbalance, keep the steady state of intestinal flora, and prevent and cure the antibiotic-associated diarrhea.
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Objective To investigate the relationship among the activity of diseases , the alteration of intestinal flora and the serum immuoglobulin (Ig) in patients with ulcerative colitis (UC) and to further evaluate the clinical value of fecal cue ratio in assessing humoral immune abnormalities. Methods Clinical data of 401 UC patients admitted in Peking University First Hospital from January 2013 to May 2015 were analyzed. According to Mayo index , patients were divided into inactive and active groups , and the active group was further divided into the mild, moderate and severe group. Serum immunoglobulin (IgG, IgM, IgA, C3 and C4) and fresh fecal bacteria cue proportion were measured. Statistical analysis was made to find the relevance among the above indexes. Results With the increase of disease activity , the intestinal flora imbalance aggravated (Spearmann correlation coefficient equals 0.295, P < 0.05) and serum IgM decreased significantly. However, serum C3 increased obviously. Serum C4 increased in mild to moderate group but decreased significantly in severe group. With the aggravation of intestinal flora imbalance , serum IgM and IgA decreased but C3 increased (P < 0.05). Conclusions The measurement of intestinal flora cue proportion, Ig, C3 and C4 may contribute to better determining the severity of diseases and provide beneficial information for therapy.
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Objective To study the clinical significance of fecal smear examination on diagnosing intestinal flora imbalance in infantile diarrhea.Methods A sterile cotton swab was used to spread a layer of fresh feces quantum satis from a sterile container on a clean slide;the smear was fixed and stained with Gram′s methods after it was air-dried,then the specimen was observed with a microscopy(field lens 100 ? eye lens 10) and recorded.Results In the acute diarrhea group(40 cases),the distribution feature of 3 floras on the fecal smears:≥50% Gram-negative bacilli in 6 cases(15%),≥50% Gram-positive cocci in 30 cases(75%) and ≥68% Gram-positive bacilli in 4 cases(10%).In the delayed and chronic diarrhea group(62 cases),the distribution feature of 3 floras on the fecal smears:≥50% Gram-negative bacilli in 7 cases(11.29%),≥50% Gram-positive cocci in 44 cases(70.97%) and ≥68% Gram-positive bacilli in 6 cases(9.68%).In the normal control group(32 cases),the distribution feature of 3 floras on the fecal smears:≥50% Gram-negative bacilli in 1 case(3.13%),≥50% Gram-positive cocci in 1 case(3.13%),and ≥68% Gram-positive bacilli in 17 cases(53.13%).For the distribution of 3 floras in the 3 groups,chi-squared test was performed,and the results showed that the difference was significant in Gram-positive cocci(?~2=47.76 P0.05).Conclusions Acute,delayed or chronic diarrhea can lead to flora imbalance.In order to timely and rapidly know the flora imbalance in children with diarrhea,clinically the simple,easily operated and practical smear staining method shall be widely applied.