ABSTRACT
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.
ABSTRACT
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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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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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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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 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.