Fecal microbiota changes with fermented kimchi intake regulated either formation or advancement of colon adenoma

Gut bacteria might contribute in early stage of colorectal cancer through the development and advancement of colon adenoma, by which exploring either beneficial bacteria, which are decreased in formation or advancement of colon adenoma and harmful bacteria, which are increased in advancement of colon adenoma may result in implementation of dietary interventions or probiotic therapies to functional means for prevention. Korean fermented kimchi is one of representative probiotic food providing beneficiary microbiota and exerting significant inhibitory outcomes in both APC/^Min+ polyposis model and colitis-associated cancer. Based on these backgrounds, we performed clinical trial to document the changes of fecal microbiota in 32 volunteers with normal colon, simple adenoma, and advanced colon adenoma with 10 weeks of fermented kimchi intake. Each amplicon is sequenced on MiSeq of Illumina and the sequence reads were clustered into Operational Taxonomic Units using VSEARCH and the Chao Indices, an estimator of richness of taxa per individual, were estimated to measure the diversity of each sample. Though significant difference in α or β diversity was not seen between three groups, kimchi intake significantly led to significant diversity of fecal microbiome. After genus analysis, Acinobacteria, Cyanobacteria, Clostridium sensu, Turicibacter, Gastronaeophillales, H. pittma were proven to be increased in patients with advanced colon adenoma, whereas Enterococcua Roseburia, Coryobacteriaceau, Bifidobacterium spp., and Akkermansia were proven to be significantly decreased in feces from patients with advanced colon adenoma after kimchi intake. Conclusively, fermented kimchi plentiful of beneficiary microbiota can afford significant inhibition of either formation or advancement of colon adenoma.     

目标管理方案降低导尿管相关性尿路感染发生率的临床实践

目的 实施目标管理方案降低导尿管相关性尿路感染发生率,通过制订目标、实施目标、完成目标,推进质量改善。方法 对某三级甲等综合医院2020年4月—9月留置导尿管的住院患者,应用目标管理方案,依次制订质量改善目标、质量改善计划,实施计划并对过程进行质量评价,通过评估结果的反馈改进行动,实现质量改善。设定1个月为1个质量周期,首个周期的质量为基线,之后各周期质量与之比较,同时与前1周期质量比较。结果 12个过程指标与基线质量比较,6个指标在第2个周期得以改善（P<0.05）,此后凡优于第2周期和基线质量的指标,较基线质量比较,差异均具有统计学意义（均P<0.001）。5个过程指标基线完成率已达到较高水平,与后续测量数据持平。结果指标导尿管相关性尿路感染发生率项目末期较基线显著降低（P<0.05）。过程指标10项措施执行完成率≥95%,2项措施执行率≥91%,达成目标。结论 应用目标管理方案进行质量改善,实现目标导向指标具体化管理,对护理质量进行客观测量,科学比较,切实降低了留置导尿管住院患者的导尿管相关性尿路感染发生率,促进护理质量提升。     

Increased blood–brain barrier vulnerability to systemic inflammation in an Alzheimer disease mouse model

Behavioral and psychological problems are often observed in patients with dementia such as that associated with Alzheimer disease, and these noncognitive symptoms place an extremely heavy burden on the family and caregivers. Although it is well know that these symptoms often are triggered by infection of peripheral organs, the underlying mechanisms for these pathological conditions are still unclear. In this study, using an Alzheimer amyloid precursor protein (APP)-transgenic mouse, we analyzed behavioral changes and brain inflammatory response induced by peripheral administration of lipopolysaccharide. Application of a unique in vivo microdialysis system revealed that the increase in brain inflammatory cytokine (interleukin-6) level was significantly higher in APP-Tg than in wild-type mice after peripheral lipopolysaccharide injection, which was associated with more severe sickness behaviors. The blood–brain barrier became more permeable in APP-Tg mice during peripherally evoked inflammation, suggesting the increased vulnerability of the blood–brain barrier to inflammation in this animal model of Alzheimer's disease. These findings might provide insight into the pathogenesis of noncognitive symptoms in dementia and a basis to develop new therapeutic treatments for them.     

Adaptive reconfiguration of the human NK‐cell compartment in response to cytomegalovirus: A different perspective of the host‐pathogen interaction

As discussed in this review, human cytomegalovirus (HCMV) infection in healthy individuals is associated with a variable and persistent increase of NK cells expressing the CD94/NKG2C activating receptor. The expansion of NKG2C⁺ NK cells reported in other infectious diseases is systematically associated with HCMV co‐infection. The functionally mature NKG2C^bright NK‐cell subset expanding in HCMV⁺ individuals displays inhibitory Ig‐like receptors (KIR and LILRB1) specific for self HLA class I, and low levels of NKp46 and NKp30 activating receptors. Such reconfiguration of the NK‐cell compartment appears particularly marked in immunocompromised patients and in children with symptomatic congenital infection, thus suggesting that its magnitude may be inversely related with the efficiency of the T‐cell‐mediated response. This effect of HCMV infection is reminiscent of the pattern of response of murine Ly49H⁺ NK cells against murine CMV (MCMV), and it has been hypothesized that a cognate interaction of the CD94/NKG2C receptor with HCMV‐infected cells may drive the expansion of the corresponding NK‐cell subset. Yet, the precise role of NKG2C⁺ cells in the control of HCMV infection, the molecular mechanisms underlying the NK‐cell compartment redistribution, as well as its putative influence in the response to other pathogens and tumors remain open issues.     

Infection resistance of degradable versus non-degradable biomaterials: An assessment of the potential mechanisms

Extended life expectancy and medical development has led to an increased reliance on biomaterial implants and devices to support or restore human anatomy and function. However, the presence of an implanted biomaterial results in an increased susceptibility to infection. Due to the severity of the potential outcomes of biomaterial-associated infection, different strategies have been employed to reduce the infection risk. Interestingly, degradable biological materials demonstrate increased resistance to bacterial infection compared to non-degradable synthetic biomaterials. Current knowledge about the specific mechanisms of how degradable biological materials are afforded increased resistance to infection is limited. Therefore, in this paper a number of hypotheses to explain the decreased infection risk associated with the use of degradable versus non-degradable biomaterials are evaluated and discussed with reference to the present state of knowledge.     

Outbreak of Mycoplasma pneumoniae at a military academy

In 2019,an outbreak of Mycoplasma pneumoniae (M.pneumoniae) occurred at a military academy in China.The attack rate (10.08％,60/595) was significantly different among the units.High-intensity training and crowded environments to which cadets are exposed are the high risk factors for the outbreak of M.pneumoniae.In-time prevention and control measures effectively controlled the spread of the epidemic.     

Interventions for preventing falls in people post-stroke: A meta-analysis of randomized controlled trials

BackgroundFalls are a serious challenge facing individuals post-stroke. In the past decades, various fall prevention interventions have been developed. It remains unknown if any of these interventions are effective in reducing falls in this population. Such a knowledge gap could impede the effort of preventing falls in people post-stroke.Research questions1) Are there effective interventions to prevent falls among people in the post-acute and chronic stages of stroke? and 2) How do fall prevention interventions change three key fall risk factors in this population: balance, mobility, and lower limb strength?MethodsEleven databases were searched for randomized controlled trials which included falls in people post-stroke as an outcome measure. Information on the participants, training protocol, and outcome measures were collected for each study. The primary outcome is the number of fallers and the explanatory variables included mean difference and standard deviation for fall risk factors. Studies were quality appraised using the Physiotherapy Evidence Database scale and the funnel plot.ResultsThirteen studies enrolling 1352 participants were identified. Effect size quantified by the odds ratio (OR) for falls and standardized mean difference (SMD) for fall risk factors were calculated. Overall no intervention appears to be significantly more effective in preventing falls than placebo training (OR = 0.88 with a range of [0.23 3.66]; 95 % confidence interval = [0.64 1.21], p = 0.44). All interventions showed little effect in improving the fall risk factors (SMD = −0.01 to 0.06 and p-value = 0.38–0.86), except one (the combined treadmill and overground walking) which significantly improved mobility.SignificanceCurrently no program is effective in reducing falls in people post-stroke. Future studies should measure falls as a primary outcome based on a consistent definition of falls and reliable approaches to collect falls data.     

湿润烧伤膏治疗剖宫产及会阴侧切术后切口愈合不良疗效观察

【摘要】 目的 观察湿润烧伤膏治疗剖宫产及会阴侧切术后切口愈合不良的临床疗效? 方法 选取 2017 年 6 月至 2019 年 12 月廊坊市第四人民医院收治的60例剖宫产及会阴侧切术后切口愈合不良产妇作为研究对象, 并按照随机数表法将其随机分为观察组与对照组, 每组 30 例, 观察组患者局部切口采用湿润烧伤膏换药治疗, 对照组患者局部切口采用常规碘伏消毒?生理盐水纱布或 1% 依沙吖啶纱布引流治疗, 对比两组患者切口愈合时间及切口疼痛程度? 结果 观察组患者切口愈合时间≤10 d 者 25 例? 10 ~ 20 d 之间者 5 例, 对照组患者切口愈合时间≤10 d 者 16 例? 10 ~ 20 d之间者10例? > 20 d 者4例, 观察组患者切口愈合时间明显短于对照组(Z = 2.628, P = 0.009)? 观察组患者中无明显疼痛不适 21例? 轻度疼痛8例?中度疼痛1例, 对照组患者中无明显疼痛不适5例?轻度疼痛 18 例? 中度疼痛5例?重度疼痛2例, 观察组患者切口疼痛程度明显低于对照组(Z =-4.203, P < 0.001)? 结论 湿润烧伤膏可有效减轻剖宫产及会阴侧切术后愈合不良切口的疼痛程度, 缩短切口愈合时间, 值得临床推广应用?