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BACKGROUND:Gut microbiota is closely related to host energy balance and metabolism.The metabolites of intestinal flora can regulate the occurrence and development of obesity and can be a new target for the prevention and treatment of obesity. OBJECTIVE:To summarize the interaction between the intestinal flora and obesity,as well as the specific mechanism underlying regulation of obesity by metabolites of intestinal flora,thereby providing a new reference and basis for the prevention and treatment of obesity. METHODS:"Intestinal microbiota,intestinal bacteria,intestinal microbiota metabolites,short-chain fatty acids,bile acids,ipopolysaccharide,trimethylamine N-oxide,medium-chain fatty acids,tryptophan derivatives,obesity"were used as search terms in Chinese and English.Literature related to obesity from 1990 to 2022 was retrieved in PubMed and CNKI databases.According to inclusion and exclusion criteria,88 articles were finally selected. RESULTS AND CONCLUSION:Intestinal flora is closely related to the occurrence and development of obesity.For example,changes in the Firmicutes to Bacteroidetes ratio can be used as a biomarker for the diagnosis of obesity,and the occurrence of obesity can be delayed by the colonization of probiotics such as Bifidobacterium breve,Lactobacillus and Akkermansia.Intestinal flora is mainly mediated by the metabolites of intestinal flora to participate in the regulation of obesity.For example,short-chain fatty acid can regulate adipogenesis by regulating signaling pathways such as G protein-coupled receptors 41,43 and peroxisome proliferator-activated receptor γ,thus delaying the occurrence and development of obesity.Bile acids can increase insulin sensitivity and body energy expenditure by promoting the activation of G protein-coupled receptor 5 and farnesol X receptor.In addition,lipopolysaccharide,trimethylamine oxide,medium-chain fatty acids and tryptophan derivatives are also widely involved in the occurrence and development of obesity through various signaling pathways.Further studies have found that metabolites of the same bacterial community exert heterogeneous effects in the specific process of regulating obesity via different signaling pathways.For example,under the influence of high-fat diet,acetic acids can activate the parasympathetic nervous system,leading to hyperphagia and liver insulin resistance and thus accelerating the physiological course of obesity.
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BACKGROUND:Intestinal flora and its metabolites can participate in the pathological process of osteoporosis and play an important role in the diagnosis and treatment of osteoporosis.In addition,exercise can regulate the intestinal flora and thus affect the occurrence and development of osteoporosis. OBJECTIVE:To summarize the effects and mechanism of intestinal flora on osteoblasts,osteoclasts,and bone marrow mesenchymal stem cells,and the potential role of exercise-mediated intestinal flora in regulating osteoporosis. METHODS:"Intestinal flora,intestinal bacteria,metabolites of intestinal flora,bone metabolism,osteoporosis,exercise"were selected as keywords.Literatures from 1990 to 2023 were retrieved from PubMed and CNKI databases. RESULTS AND CONCLUSION:Changes in the abundance and diversity of intestinal flora and changes in the levels of intestinal flora metabolites such as trimethylamine oxide and bile acid can be used as biomarkers for the diagnosis of osteoporosis.The imbalance of intestinal flora can lead to intestinal barrier dysfunction and excessive production of lipopolysaccharides and trimethylamine oxide,induce the secretion of tumor necrosis factor-α and other inflammatory cytokines,activate the nuclear factor κB signaling pathway and aggravate oxidative stress,thus promoting osteoclast differentiation,inducing osteoblast apoptosis and affecting bone marrow mesenchymal cell migration.Remodeling intestinal flora homeostasis can inhibit inflammatory response,downregulate oxidative stress,inhibit osteoclast differentiation,promote osteoblast differentiation,and regulate the osteogenic migration of bone marrow mesenchymal cells to prevent and treat osteoporosis.Exercise can regulate intestinal flora homeostasis,improve intestinal barrier function,promote the secretion of short-chain fatty acids and bile acids,down-regulate serum lipopolysaccharide level,reduce oxidative stress,and then inhibit osteocyte apoptosis,inhibit osteoclast differentiation,promote osteoblast differentiation,and regulate osteocyte nutrient metabolism to exert the potential of preventing and treating osteoporosis.
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The visual impairment and blindness caused by myopia have become a global burden, and the World Health Organization has included the prevention and control of myopia in the global program for preventing blindness. In China, the development of myopia is showing a trend with higher incidence, younger age, and higher refractive errors. Moving forward the port of prevention and control myopia has become an important strategy to address the current predicament. Premyopia refers to the stage in children where the refractive power is ≤+0.75 D and >-0.50 D, and there are multiple risk factors during this stage that can potentially lead to myopia. Currently, the incidence of premyopia and its transformation into myopia is high, and the key prevention and control measures include building a predictive model for the transformation of premyopia into myopia, emphasizing the reduction of exposure to risk factors, using low-concentration atropine eye drops, red light therapy, and optical defocus intervention. This article provides a comprehensive review of the current situation regarding the incidence of premyopia and its transformation into myopia, as well as the research progress on existing prevention and control measures, with the aim of providing relevant references for the prevention and control of myopia during the premyopia stage.
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The early diagnosis of primary hepatocellular carcinoma combined with portal vein tumor thrombus is very difficult,and when the patients are diagnosed,they are usually at an advanced stage,and the optimal treatment time has missed. In recent years, more and more scholars believe that the diagnosis and treatment of hepatocellular carcinoma with portal vein tumor thrombus need multi?disciplinary diagnosis and treatment,it also has a certain effect in the clinic, it is expected to make the early diagnosis and the early treatment for patients with hepatocellular carcinoma combined with portal vein tumor thrombus in the future,and form a standardized treatment process.
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Objective To evaluate the role of microglia in paraventricular nucleus (PVN) in sus-ceptibility to depression in rats with chronic visceral pain. Methods Ninety-six pathogen-free healthy male Sprague-Dawley rats, aged 8 days, were divided into 6 groups (n= 16 each) using a random number table: sham operation group (S group), chronic visceral pain group (CHVP group), sham operation plus colorectal distension group (S+C group), chronic visceral pain plus colorectal distension group (CHVP+C group), chronic visceral pain plus phosphate buffer solution plus colorectal distension group (CHVP+P+C group) and chronic visceral pain plus minocycline plus colorectal distension group (CHVP+M+C group). Colorectal distension was not performed in S group. In CHVP group, chronic visceral pain was induced by performing colorectal distension twice daily on postnatal days 8, 10, and 12. Phosphate buffer solution 0. 5μl was injected into PVN by stereotaxic method at 8th week after birth in CHVP+P+C group, and 2％ mi-nocycline 0. 5 μl was injected into PVN at 8th week after birth in CHVP+M+C group. Eight rats in each group were selected 2 h later for measurement of visceral pain threshold. In S+C, CHVP+C, CHVP+P+C and CHVP+M+C groups, colorectal distension was performed for 2 times, open field test and sucrose preference test were then performed, the rats were sacrificed and PVN was removed for determination of micro-glial activation by immunofluorescence. Results The pain threshold was significantly decreased in CHVP, CHVP+C, CHVP+P+C and CHVP+M+C groups as compared with S and S+C groups (P<0. 05). The pain threshold was significantly increased in CHVP+M+C group when compared with CHVP +P +C group (P<0. 05). Compared with S, CHVP and S+C groups, the total locomotor distance, the number of rea-ring and sucrose consumption were significantly reduced, and the proportion of activated microglia in PVN was increased in CHVP+C, CHVP+P+C and CHVP+M+C groups (P<0. 05). Compared with CHVP+P+C group, the total locomotor distance, the number of rearing and sucrose consumption were significantly in-creased, and the proportion of activated microglia in PVN was decreased in CHVP+M+C group (P<0. 05). Conclusion Microglia in PVN is involved in regulation of susceptibility to depression in rats with chronic visceral pain.
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Objective Liver is a common site of metastasis of gastric cancer and hitherto there has been no uniform treatment for liver metastasis of gastric cancer. This study was to investigate the clinical characteristics and prognostic factors of liver metastasis of gastric cancer in order to provide some evidence for the improvement of the diagnosis and treatment of the disease. Methods We ret-rospectively analyzed the clinical characteristics and survival data of 143 patients with liver metastasis of gastric cancer treated in our hospital between March 2007 and September 2012. We investigated the independent risk factors affecting the prognosis of the disease u-sing the Cox Regression Model. Results Seventy-five ( 52. 4%) of the 143 patients survived for 12 months, 41 ( 28. 7%) for 24 months, and 18 (12.6%) for 36 months, with a median survival time of 14 months. Univariate analysis revealed statistically significant differences in the survival time among the patients with different histological grades of primary gastric cancer, time of liver metastasis, types of metastatic liver cancer, extra-liver metastasis, and treatment methods ( P<0.05) . Multivariate Cox regression analysis showed the histological grade of gastric cancer to be low-or non-differentiation ( HR=2.67, 95% CI:1.51-4.72) and the type of liver meta-static cancer to be H2 ( HR=1.89, 95% CI:1.08-3.29) or H3 ( HR=2.13, 95% CI:1.32-3.44) , which were independent risk fac-tors affecting the prognosis of liver metastasis of gastric cancer, while palliative chemotherapy ( HR=0.55, 95% CI:0.32-0.95) was an independent protective factor of its prognosis. Conclusion Patients with liver metastasis from gastric cancer usually have a poor prognosis, especially those with histologically low-grade gastric cancer or type-H2 or -H3 liver metastatic cancer. The prognosis of thepatients undergoing palliative chemotherapy may have a better prognosis than those receiving best supportive care. A comprehensive therapy should be recommended to patients with liver metastasis from gastric cancer.
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Objective To compare the clinical value of different endoscopic methods for infiltration depth of early esophageal cancer. Methods Patients with suspected esophageal cancer, examined in Sichuan Provincial People′s Hospital from August 2013 to February 2016 were enrolled to this study. The patients underwent narrow band imaging( NBI) with magnifying endoscopy( including IPCL?type and B?type methods) and endoscopic ultrasonography(EUS) to estimate infiltration depth and then underwent iodine staining and biopsy. All lesions, which included the identified moderate?severe hyperplasia, high?grade intraepithelial neoplasia and early esophageal cancer and those which were diagnosed as possible cancer by white light and NBI with the negative pathological results, were given endoscopic or surgical procedure depending on patients′ choices. A total of 54 cases were diagnosed as early esophageal cancer, with pathological results as the gold standard. The diagnostic accuracy of invasion depth of these patients was compared by the statistic kappa values. Results Type B of NBI was highly consistent with the final pathological results(Kappa=0?802). White light endoscopy and IPCL type had poorer results(Kappa=0?596, Kappa = 0?601 ) compared with the final pathological results. However, EUS had the lowest consistency with the final pathological results( Kappa=0?132) . For the mucosal layer( M1?M2) infiltration of the esophageal cancer, type B showed the highest accuracy ( 86?7%, 26/30 ) , followed by white light endoscopy(76?7%, 23/30) and IPCL type(73?3%, 22/30). And EUS showed the lowest diagnostic accuracy(30?0%, 9/30) and the highest over?diagnostic rate(70?0%,21/30). For the cancer infiltration depth( M3?SM1 ) , type B also showed slightly higher accuracy rate ( 89?5%, 17/19 ) than IPCL type (78?9%, 15/19) and white light endoscopy (73?7%, 14/19). And EUS still showed the lowest accuracy rate( 42?1%, 8/19 ) and the highest over?diagnostic rate ( 52?6%, 10/19 ) . Conclusion White light endoscopy is still valuable for the invation depth of early esophageal cancer. But B type and IPCL?type of NBI are superior to white light endoscopy. B type presents higher accuracy rate than others, and it seems much easier to operate than IPCL?type for beginners. Accuracy rate of EUS is unsatisfactory, and the over?diagnostic rate is much higher than others. Diagnosis with EUS alone is not recommended.
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Objective To observe the effects of dexmedetomidine on the perioperative stress in patients undergoing uvulopalatopharyngoplasty (UPPP).Methods Sixty patients scheduled for uvulopalatopharyngoplasty (UPPP), all males, aged 18-65 years, of ASA physical status Ⅰ or Ⅱ, were selected randomly.Then the patients were divided into dexmedetomidine group (group D) and control group (group C), 30 patients in each group.The patients of group D were administered 1.0 μg/kg bolus dose of dexmedetomidine over 10 min before tracheal intubation, followed by 0.5 μg·kg-1·h-1 infusion for 12 hours in ICU after surgery.And the patients in group C were given normal saline instead as in group D.The levels of MAP, HR, PaO2, PaCO2, norepinephrine (NE), epinephrine (E), cortisol (Cor), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were recorded at time points of entering operating room (T0), tracheal intubation (T1), 30 min after operation (T2), upon entering ICU (T3), and extubation (T4).Results HR of group D was significantly slower than that of group C during T1-T4 (P<0.05).MAP of group D was lower than that of group C during T1-T4 (P<0.05).The levels of NE, E, Cor, IL-6, TNF-α of group D were significantly lower than that of group C during T1-T4(P<0.05).Compared with group C , the incidence of cough reflex during extubation was lower in group D significantly (P<0.05).Conclusion Intravenous infusion of dexmedetomidine can suppress perioperative stress effectively and stabilize hemodynamics for the patients undergoing UPPP without prolonging the recovering time, extubation time and the duration in ICU.
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Objective To evaluate the safety and efficacy of multi-band mucosectomy (MBM) for early esophageal cancer and precancerous lesions.Methods Data of 28 patients with early esophageal cancer or precancerous lesions undergoing MBM were reviewed in regarding of procedure complications and follow-up results.Results A total of 32 lesions were resected successfully by MBM in one session,with mean procedure time of 28.3 minutes.The mean diameter of specimens was 12mm.No residual neoplasm was found at the base of any resected specimens.The post-MBM pathological findings consisted of 2 cases of intramucosal cancer,1 case of submucosal cancer,and 25 cases of moderate-severe dysplasia.No perforation,delayed hemorrhage or subcutaneous emphysema occurred.Intraoperative bleeding occurred in 23 cases,including 3 cases of pulsatile bleeding,which were controlled with metal clip,and 20 cases of minor bleeding which were managed with APC or halted automatically at the end of procedure.Chest pain after the procedure occurred in 5 cases and were relieved soon.The patient with submucosal cancer underwent subsequent surgical resection,with no residual cancer in surgical specimen or lymph node metastasis.Twenty seven other cases were followed up endoscopically for 2-12 months.Esophageal stricture occurred in 2 cases,and were successfully relieved by dilatation with stent or bougienage.No recurrent lesion or metastasis were revealed.Conclusion MBM is a relatively safe and effective endoscopic technique for treatment of early esophageal intramucosal cancer and precancerous lesions,but further studies are needed to evaluate the long-term results.