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【Objective】 To study the incidence and risk factors of bone loss in ulcerative colitis （UC） patients and understand the characteristics of fecal microbiota so as to provide new ideas for the mechanism and new treatment of bone loss in UC patients. 【Methods】 We chose adult UC patients from Department of Gastroenterology in The First Affiliated Hospital of Xi’an Jiaotong University as research subjects. We collected the patients’ related data and divided them into two groups. Then we analyzed the data to understand the incidence of and risk factors for bone loss in the UC patients. Furthermore， we collected the feces of the patients. Based on high-throughput sequencing technology， we analyzed the fecal microbiota’s diversity， species composition and metabolic pathways to understand the differences between the two groups. 【Results】 In the 24 UC patients， the incidence of bone loss was 62.5%. The incidence of bone loss was significantly higher in chronic relapsing UC patients than in initial patients， and the incidence of bone loss increased with the severity of UC. Serum calcium and 25-hydroxyvitamin D concentrations in the normal group were significantly higher than those in the bone loss group. β diversity significantly differed and the species composition of fecal microbiota significantly differed at the levels of phylum， class， order， family and genus between the two groups. Compared with the normal group， the expression abundance of Shigellosis， Geraniol degradation， Steroid hormone biosynthesis pathways was significantly increased in the bone loss group. 【Conclusion】 There is a high incidence of bone loss in UC patients. The clinical type， disease severity， serum calcium and 25-hydroxyvitamin D concentrations are related to bone loss in these patients. In the bone loss group， the diversity of fecal microbiota， especially the proportion of probiotics， is reduced， and the abundance of many disease-related metabolic pathways is significantly upregulated.
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Inflammatory bowel disease (IBD) has been considered gradually as a systemic disease that could affect many extra-intestinal organs or tissues and cause a variety of extra-intestinal manifestations or complications. Bone loss is one of the common extra-intestinal complications of IBD. IBD patients have an increased risk of osteopenia, osteoporosis and fracture than healthy people. The mechanisms of bone loss in IBD patients include deficiency of calcium and vitamin D, immune, inflammation, dysbiosis of gut microbiota, endocrine hormone, and drug effects. In addition to life style adjustment, nutritional therapy and anti-osteoporosis drugs, immunosuppressant, biological agents, probiotics and fecal microbiota transplantation might be expected to become effective treatments for bone loss in IBD patients. This article reviewed the mechanism and treatment prospect of bone loss in patients with IBD.
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Objective To explore the effects and regulation mechanism of miR-489 on the stem cell phenotype and epithelial-mesenchymal transition of colon cancer cells in vitro.Methods The miR-489 expression of colon cancer cell lines ( HT29, SW480 and SW620, HCT116) and normal intestinal epithelial cells HIEC were detec-ted by RT-qPCR, the miR-489 expression in colon cancer cells was raised by gene transfection technology, the colon cancer stem cell markers CD133, CD44, EpCAM, ALDH1 and epithelial marker E-cadherin, mesenchy-mal cells markers vimentin and N-cadherin were detected by Western blot.The expression of TWIST1 mRNA and protein were detected by RT-qPCR and Western blot.Results The miR-489 relative expression in four kinds of colon cancer cells ( HT29, SW480 and SW620, HCT116) were significantly lower than that of normal HIEC in-testinal epithelial cells, the difference was statistically significant ( P<0.05) .Up-regulation of miR-489 expres-sion in HT29 and HCT116 cells leaded to lower expression of colon cancer stem cell marker CD133, CD44, EpCAM ALDH1 and mesenchymal cells markers Vimentin , N-cadherin, higher expression of epithelial markers ;E-cadherin (P<0.05).Also, up-regulation of miR-489 expression in HT29 and HCT116 cells leaded to lower ex-pression of TWIST 1 mRNA and protein ( P<0.05 ) .Conclusions miR-489 is down-regulated in colon cancer cells and up-regulation of miR-489 expression inhibits stem cell phenotype and epithelial-mesenchymal transition through targeting TWIST1 in colon cancer .
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Objective To study the skills and effects of endoscopic retrograde appendicitis therapy (ERAT) in treating patients with uncomplicated acute appendicitis .Methods We enrolled 21 patients with suspected acute appendicitis who then underwent emergent ERAT between October 2014 and January 2015 .The data of treatment were collected and the operative skills and effects of ERAT were analyzed . Results ERAT was completed successfully in all the patients ,resulting in a success rate of 100% .Mean operation time of ERAT was (49 .7 ± 18 .2) min and mean hospital stay was (3 .3 ± 1 .6)d .Cannulation of the appendix lumen was the most critical step of ERAT ,and cannulation time [(5 .7 ± 4 .9)min , P< 0 .05] was shortened significantly by the use of LoopTip guidewire . Fourteen patients with intraluminal appendicoliths (7 of massive appendicoliths , 4 of sand‐like appendicoliths and 3 of sand‐like appendicoliths with luminal stenosis ) underwent endoscopic lithotomy successfully with balloon or basket ,with the success rate of 100% .One patient who presented perforation after appendicolith removal by basket was cured with conservative treatment .Appendix stent was inserted ,then pulled out after 1 week in 9 patients ,while no complaint or complication of the stent was observed .Operation time of ERAT shortened with the increase of case number .Conclusion ERAT is an effective and safe therapy for treating patients with uncomplicated acute appendicitis .The high success rate and safety of ERAT will be achieved by selecting suitable instruments for cannulation and appendicolith removal ,deciding suitable indications for stenting ,and accumulating of operative cases .
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Objective To study the effect and safety of endoscopic retrograde appendicitis therapy (ERAT) in treating patients with uncomplicated acute appendicitis. Methods Patients with uncomplicated acute appendicitis were enrolled and divided into ERAT group and LA group received laparoscopic appendectomy. Then compare treat-ment condition, complications and follow-up of the two groups. Results ERAT were completed successfully in all the patients in ERAT group, while one patient underwent a reversion to open appendectomy for technical difficulties in LA group. Mean operative time was (49.7 ± 18.2) min for ERAT group and (68.9 ± 25.9) min for LA group (P <0.05). Fever relief time (1.3 ± 0.5) d, WBC normalization time (2.0 ± 0.9) d, mean bed time (0.1 ± 0.2) d and mean hospital stay (3.3 ± 1.6) d for ERAT group were significantly lower than LA group (P <0.05). 14 patients with intra-luminal appendicoliths (7 of massive appendicoliths, 4 of broken appendicoliths and 3 of broken appendicoliths with luminal stenosis) underwent endoscopic lithotomy successfully in ERAT group, resulting in a success rate of 100.00%. One patient presented perforation after ERAT was cured with conservative treatment. During the follow-up of at least 1/2 year, the rate of recurrence was 10.00% in ERAT group. 1 patient (5.00%) underwent LA at the 5th month after ERAT during the follow-up. Conclusion ERAT is an effective and safe therapy in treating patients with uncomplicated acute appendicitis with advantages of minimal invasiveness and quick recovery. Uncomplicated acute appendicitis with appendicoliths and/or luminal stenosis are the most suitable indications for ERAT.