肛瘘术前高分辨力3．OT MRI检查的临床价值

目的探讨肛瘘术前高分辨力3．0TMRI检查的临床价值。方法18例经手术证实的肛瘘患者术前均行MRI检查。评估和比较MRI各序列显示的瘘管、内口、外口及肛瘘分型。结果MRI诊断2例高位肛瘘,16例低位肛瘘;复杂肛瘘3例,其中两例为高位,15例为简单肛瘘。根据Parks分型,MRI,显示括约肌间瘘12例,经括约肌瘘3例,括约肌上瘘1例,括约肌外瘘2例。与手术相比,MR诊断肛瘘（或脓肿）、内口、外口及分型的符合率分别为94．4％（17／18）、85．7％（18／21）、100％（18／18）、88．9％（16／18）。结论MRI术前检查能够为外科治疗提供较多信息,有较高的临床价值。     

结直肠癌患者肠道微生物多样性的研究进展

结直肠癌是最常见的消化道恶性肿瘤之一,其发病原因除了饮食、环境以及遗传因素外,越来越多的证据指向肠道菌群失调与结直肠癌发生发展有密切的关系。许多元基因组学的研究为揭示肠道微生物在结直肠癌发生发展中起到的作用提供了大量科学依据。在这篇综述中,我们会介绍结直肠癌患者肠道微生物多样性的研究进展,并总结结直肠癌发生发展相关的细菌及其研究现状。     

Role of transcutaneous perianal ultrasonography in evaluation of fistulas in ano.

OBJECTIVE: The purpose of this study was to evaluate the role of transcutaneous perianal ultrasonography in evaluation of fistulas in ano and to assess its possible role as a first-line investigation, for follow-up, and as a possible substitute for magnetic resonance imaging. METHODS: Transcutaneous perianal ultrasonography was performed in 30 patients with fistulas in ano with the use of a 3- to 6-MHz sector probe, a 7- to 11-MHz linear probe, and a 5- to 7-MHz endocavitary probe. Patients were followed clinically and at surgery to assess the accuracy of transcutaneous perianal ultrasonography. RESULTS: A total of 43 fistulas, sinus tracts, or both were found in 26 patients. They appeared as hypoechoic tracts. Eleven of 30 patients had the presence of a collection or abscess, which appeared as hypoechoic areas. Twenty-four of 29 patients with positive findings underwent surgery. In these, 35 of 39 tracts were surgically confirmed (positive predictive value, 90%). The positive predictive value for demonstration of an internal opening was 85% (22/26) when compared with direct visualization or probing. Sensitivity for detection of tracts was 100%, and that for demonstration of an internal opening was 96% (26/27). The negative predictive value for sinus/fistulous tracts was nearly 100%. Transcutaneous perianal ultrasonography could not adequately evaluate suprasphincteric-type fistulas. However, it is a good, inexpensive modality in the evaluation of patients with fistulas in ano and also helps in follow-up of these patients. It can also be used to select patients who need magnetic resonance imaging. CONCLUSIONS: Transcutaneous perianal ultrasonography has the potential to become the first investigation in patients with perianal fistulas and abscesses.     

Isolation and gut microbiota modulation of antibiotic-resistant probiotics from human feces

Antibiotic-resistant probiotics may be advantageous for antibiotic-induced gut microbiota imbalance. In this article, we aimed to isolate antibiotic-resistant bacteria as potential probiotics. Feces from 3 healthy adults and 2 infants were used to isolate the antibiotic-resistant bacteria. Then we established gut microbiota imbalance mice model by antibiotics treatment and used it to assess the effect of the probiotics. Finally, we identified 8 isolates, and 6 of them were used as probiotics cocktail. Number of anaerobe, lactobacilli, and Bifidobacterium in feces were higher in the probiotic group (9.47 ± 0.35 log₁₀CFU/g, 8.74 ± 0.18 log₁₀CFU/g, 7.24 ± 0.38 log₁₀CFU/g, respectively) compared with model group (P < 0.05). Richness and diversity index of probiotic group (19.79 ± 0.29 and 2.95 ± 0.06, respectively) were larger than model group (P < 0.05). Diarrhea and mucosal edema had been alleviated during probiotic treatment. Our results validated that bacteriotherapy was available to treat gut microbiota imbalance.     

超重肥胖和正常体重人群肠道菌群的差异分析

目的探讨超重肥胖和正常体重人群肠道菌群的差异,为临床防治超重和肥胖提供参考。方法选择2018年9月至2020年5月在吉林市人民医院营养科就诊的122例患者,根据体质量指数(BMI)分为超重肥胖组(n=57)和正常体重组(n=65)。检测两组患者肠道菌群含量和相关血生化指标。结果超重肥胖组空腹血糖(Glu)、血清三酰甘油(TG)、丙氨酸氨基转移酶(ALT)、谷氨酰转肽酶(GGT)、尿素(Ur)和尿酸(UA)水平均高于正常体重组(P<0.01,P<0.05),而高密度脂蛋白胆固醇(HDL-C)水平低于正常体重组(P<0.01)。超重肥胖组的拟杆菌门和普雷沃菌属高于正常体重组,而厚壁菌门、双歧杆菌属、乳杆菌属、肠球菌属和链球菌属低于正常体重组(P<0.01)。拟杆菌门和普雷沃菌属与BMI呈正相关(r=0.403,P<0.01;r=0.420,P<0.01);放线菌门和双歧杆菌属与BMI呈负相关(r=-0.251,P<0.01;r=-0.436,P<0.01)。Logistic回归分析显示,调整年龄、性别、Glu、TG、HDL-C、ALT、GGT...     

In vitro alterations of intestinal bacterial microbiota in fecal samples during storage

The human gastrointestinal tract harbors an extremely diverse and complex microbial ecosystem. Most of the existent data about the enteric microflora have been generated using stool samples, but the collection and storage of fecal samples are often problematic. The influence of the storage of stool samples on the bacterial diversity and the degradation of bacterial DNA was analysed in this study. Stool samples from 5 healthy volunteers were exposed to different storage temperatures and durations. The bacterial diversity and the amount of intact bacterial DNA were analysed by single-stranded conformation polymorphism analysis (SSCP) and real-time polymerase chain reaction (PCR), both using a 16S rDNA approach. Additionally, biopsy specimens were taken from 3 of the 5 individuals to compare fecal and mucosal flora. The bacterial diversity of the fecal flora and the total number of bacteria were significantly reduced after 8 and 24 hours at both room temperature and 4°C. The mucosa-associated bacterial microflora showed substantial differences compared with the fecal flora. The observed alterations of fecal flora during storage point to the difficulty of the molecular analysis of the bacterial diversity and the enumeration of bacterial cells in fecal samples.     

Gut microbiota and nutrient interactions with skin in psoriasis: A comprehensive review of animal and human studies

The intestinal tract(i.e.,the gut),is where the body’s nutrients are absorbed,and is simultaneously inhabited by numerous microbes.An increasing body of literature suggests a crucial role for the gut microbiome in modulating systemic inflammatory disease.Psoriasis is a chronic systemic inflammatory disease and its pathogenesis is related to the interaction between genetic susceptibility,immune response and environmental triggers.The omics era has allowed physicians to assess different aspects of psoriasis pathogenesis such as the microbiome,infectome,and autoinfectome.Furthermore,diet appears to play an important role in modulating disease activity,perhaps by influencing gut microbes.Given these observations,we aimed to summarize the current knowledge regarding skin-microbiome-gut-nutrients and psoriasis.     

粪菌移植治疗炎症性肠病的现状和问题

已有随机对照临床试验证实粪菌移植治疗肠道艰难梭菌感染具有很好的疗效。尽管目前尚缺乏高质量的证据支持,粪菌移植已逐渐应用于治疗其他肠道微生态失调的疾病,譬如炎症性肠病（IBD）。该文追溯粪菌移植的起源、阐述粪菌移植的研究现状、介绍粪菌移植的实施方案、讨论粪菌移植治疗IBD的有效性以及分析粪菌移植治疗IBD的可行性。目前粪菌移植广泛用于临床仍存在一些问题,但粪菌移植治疗IBD非常具有前景,值得重视该研究领域。