RESUMO
The human gastro-intestinal tract is not only the habitat of gut microbiota, but also the main place that the body gets available nutrients. Therefore, the gut microbiota of human can be inseparable associated with the human nutrition. The common technologies used among gut microbiota research included metageonomic, metatranscriptomics, metaproteomics, and metabolomics. The research of gut microbiota based on above omics methods confirmed that diets were the main factors influencing the composition and expression of gut microbiota. The proportion, quantity, stable state, and metabolic changes of gut microbiota were closely related to obesity, diabetes mellitus, cardiovascular disease, and other nutritional-related diseases. Reasonable dietary intervention can adjust the disorders of gut microbiota, which can achieve prevention and treatment of obesity, diabetes, cardiovascular diseases, and other nutritional-related diseases. Although the single omics methods can be used to study the problems of some aspects of gut microbiota, the combination of multi-omics is needed to achieve the above objectives.
RESUMO
Purpose: To describe the clinical manifestations of hepatic myelopathy (HM) after transjugular intrahepatic portosystemic stent shunts (TIPSS)in five patients. Materials and Methods: Four men and one woman, age ranging from 41 to 54 years, had history of hepatitis B and recurrent bleeding from gastroesophageal varices. Obvious liver atrophy was found in the five patients before TIPSS procedure and shunt patency was by color Doppler US after TIPSS. Spinal cord MRI was performed in 4, CT and myelography were performed in lcase. Lumbar puncture was done in 5 patients. Results: Spastic paralysis in the lower extremities occurred progressively during 4 weeks to 4 months after TIPSS in the five patients. Weakness of the upper extremities presented in one patient, and urinary incontinence was in another one. HE following TIPSS occurred more than once (1~6 times) in these patients. Physical ex- amination revealed that hyperreflexia of tendons and positive reaction of ankle clonus were seen in all patients. Superficial sensation was normal in 5, decreasing in deep sesation in 1. Muscular atrophy in the paralytic lower extremities was not obvious in all but one patient. No mass effect or other abnormalities were found in the suspected spinal cords on the imaging studies. Lumbar puncture and cerebrospinal fluid examination were normal. The abnormalities of laboratory tests included hyperammonemia and hypoal- buminemia. Conclusion: Spastic paralysis with intact of superficial sensation in the lower extremity fol- lowing TIPSS should be considered as HM. The potential risk factors of TIPSS related HM were obvious liver atrophy, refractory hyperammonemia and HE follwing TIPSS.