Correlation analysis of intestinal flora and pathological process of type 2 diabetes mellitus

ObjectiveTo observe the relationship between the different stages of type 2 diabetes mellitus (T2DM) and the intestinal flora and verify its underlying mechanism.MethodsT2DM rats were generated by high-fat diet (HFD) combined with intraperitoneal streptozotocin (STZ) injection. The rats were divided into four groups: the control group (fed with normal feed for 1 month), the HFD group (fed with HFD for 1 month), the T2DM group (HFD combined with STZ and blood glucose ≥11.1 mM), and the unformed T2DM model (Un-mod) group (HFD combined with STZ and blood glucose <11.1 mM). Feces were collected, and bacterial communities in the fecal samples were analyzed by 16S rRNA gene sequencing. The content of short-chain fatty acids (SCFAs) in feces was measured by gas chromatography. Western blot and quantitative real-time polymerase chain reaction were used to detect the expression of G protein-coupled receptor 41 (GPR41) and GPR43.ResultsAt different stages of T2DM, the intestinal flora and SCFAs content of rats were significantly decreased (all P < .05). Our results indicated that g__Prevotella had a significant negative correlation, and g__Ruminococcus_torques_group and g__lachnoclastic had a significant positive correlation with blood glucose. The content of SCFAs, in particular acetate and butyrate, in rat feces of different stages of T2DM were significantly reduced, as well as GPR41 and GPR43 expression. The results in the Un-mod group were similar to the T2DM group, and the expression of GPR41 and GPR43 proteins were significantly higher than those in the T2DM group (both P < .001).ConclusionThe intestinal flora–SCFAs–GPR41/GPR43 network may be important in the development of T2DM. Decreasing blood glucose levels by regulating the intestinal flora may become a new therapeutic strategy for T2DM, which has very important clinical and social values.     

基于肠道菌群稳态探析龟鹿二仙胶治疗少弱精子症思路＊

肠道菌群的稳态、与人体阴阳平衡、脾肾功能密切相关，且与正常精子的发生有着密切关联。本文从肠道菌群稳态角度对龟鹿二仙胶治疗少弱精子症进行方药探析，认为龟鹿二仙胶通过调节人体肠道菌群稳态平衡阴阳，从而达到改善少弱精子症作用，为进一步研究龟鹿二仙胶对肠道菌群的影响以及与精液质量的关系提供理论依据。     

Low-molecular-weight chitosan relieves enterotoxigenic Escherichia coli-induced growth retardation in weaned pigs

The objective of the present study was to evaluate the effects of low-molecular-weight chitosan (LMWC) on the growth performance, immune responses and intestinal health of weaned pigs challenged by enterotoxigenic Escherichia coli (ETEC). A total of 32 weaned pigs were randomly allocated to four treatments: non-challenged (fed with basal diet), ETEC-challenged (fed with basal diet) and ETEC-challenged plus 50 or 100 mg/kg LMWC supplementation, respectively. After 11 days feeding, the non-challenged pigs were infused with sterilised Luria–Bertani culture, while the remaining pigs were infused with 2.6 × 10¹¹ colony-forming units of ETEC. At 3 days post-challenge, all pigs were administered d-xylose at 0.1 g/kg body weight. One hour later, blood samples were obtained, and the pigs then euthanised to collect intestinal samples. Data showed that only 100 mg/kg LMWC supplementation attenuated (P < 0.05) the average daily gain reduction caused by ETEC. Furthermore, besides the decreased (P < 0.05) serum tumour necrosis factor-α and immunoglobulin (Ig) G concentrations detected in ETEC-challenged pigs supplemented with LMWC at 50 or 100 mg/kg, the higher dose (100 mg/kg) also decreased (P < 0.05) the serum IgM concentration and increased (P < 0.05) the villus height and villus height-to-crypt depth ratio in both the jejunum and ileum, and the sucrase activity in the ileal mucosa. Moreover, LMWC supplementation (50 or 100 mg/kg) in ETEC-challenged pigs elevated (P < 0.05) the mRNA levels of jejunal mucosal peptide transporter 1 and ileal mucosal peptide transporter 1, divalent metal transporter 1 and zinc transporter 1, and decreased (P < 0.05) the ileal and caecal E. coli abundances, while 100 mg/kg LMWC additionally elevated (P < 0.05) the ileal Bacillus abundance, and caecal and colonic Bifidobacterium abundances. These results suggest that LMWC helps alleviate ETEC-induced growth retardation in weaned pigs, which could be associated with the inhibition of the immune responses and improved intestinal health.     

Management of acute sigmoid volvulus: A Tunisian experience

Background/objectiveSigmoid volvulus is the most common type of volvulus. Its epidemiological features, as well as its management, differ between developed and developing countries. This work aims to analyze the epidemiological features thus allowing to compare them to the rest of the “volvulus belt’’ and assess the surgical management of sigmoid volvulus in Tunisia.MethodThis is a retrospective review of 64 patients with sigmoid volvulus treated in the General Surgery department of Jendouba Hospital. January 2005–December 2019.Results64 patients were treated for acute sigmoid volvulus. The sex ratio male to female ratio was 5.4/1 with male predominance. 5.4:1 (54 males to 10 females). The mean age was 62 years. The classic triad of intestinal occlusion was reported in 56 patients. The mean duration of symptoms was 4.2 days. An accurate preoperative diagnosis was made in 58 cases. Forty patients had a viable bowel obstruction, and all of them had a resection and primary anastomosis. Sixteen patients had a gangrenous bowel obstruction, of which 6 patients had resection-primary anastomosis, and 10 had Hartmann's procedure. Out of the total five deaths reported, there were only two among patients who had resection-primary anastomosis for gangrenous bowel obstruction. The most common postoperative complication was wound infections in 5 cases. The median length of hospital stay following surgery was 8 days. No recurrences of volvulus after a median follow-up of 11 months.ConclusionsAlthough Tunisia belongs to the volvulus belt, the epidemiologic features of sigmoid volvulus tend rather be similar to those of developed countries. The use of primary surgery, if no endoscopy is performed, is a good alternative. For patients who have contraindications for endoscopic treatment, surgical treatment is the only option.     

玉液汤对2型糖尿病肥胖患者肠道菌群及脂质代谢的影响

目的：探讨玉液汤对2型糖尿病肥胖患者肠道菌群及脂质代谢影响。方法：选取2017年2月至2019年2月广州市中医医院收治的2型糖尿病肥胖患者106例作为研究对象，按照就诊顺序分为对照组和观察组，每组53例。2组均给予基础治疗+药物治疗，观察组再加用玉液汤治疗。观察2组治疗前、完成治疗后肠道菌群、脂质代谢、中医症状积分、血糖相关指标、体质量、腰围、体质量指数(BMI)变化并比较。结果：2组治疗前各指标比较差异无统计学意义（P>0.05），完成治疗后观察组患者的中医症状积分、FINS、HOMA-IR、HbAlc、BMI、腰围、体质量、TC、TG、LDL-C、肠杆菌、酵母菌、肠球菌、畏寒肢冷、腰膝酸软、脘腹2组患者治疗后HDL-C、双岐杆菌、乳杆菌、拟杆菌均较治疗后明显上升，且观察组高于对照组（P<0.05）。结论：玉液汤能改善2型糖尿病肥胖患者脂质代谢和临床症状，降低血糖，能调节肠道菌群紊乱，从而提高疗效。     

胃癌手术患者肠内营养治疗及肠道微生态调节的研究进展

胃癌是全球范围内发病率第5位、死亡率第3位的恶性肿瘤；对于有手术机会的胃癌患者主要的治疗方案仍是手术切除，由于胃癌患者精神心理因素、肿瘤消耗、机械梗阻、分解代谢增加等因素会导致患者严重的营养代谢问题，继而影响手术的安全性以及术后康复。外科手术是胃癌最主要的治疗方式，但由手术带来的创伤、生理结构的改变，以及术后的化疗则进一步加重上述问题。肠道微生态是人体免疫功能等重要组成部分，而现有研究提示肿瘤代谢、外科手术、化疗等均可能造成肠道菌群的改变。随着加速康复外科理念的发展，胃癌的综合治疗越来越为外科医生所重视。如何改善患者胃癌术后身体营养状况、减轻肠道菌群紊乱，进而减少术后并发症、加快术后康复，已成为胃肠外科医生关注的重点。本文主要通过文献回顾对行胃癌患者围术期肠内营养治疗及肠道微生态调节的应用进行综述。     

应用专科护理质量指标管理提高结肠镜诊疗病人肠道准备的合格率

[目的]探讨专科护理质量指标管理在提高结肠镜诊疗病人肠道准备合格率的作用。[方法]选取2018年3月-2018年6月行结肠镜检查的341例病人为对照组,实施常规肠道准备,2018年7月-2018年10月行结肠镜检查的401例病人为观察组,运用专科护理质量指标进行管理,落实包括建立标准饮食单、规范的泻药服用及方法、分时段健康教育及图片式粪便观察等护理措施及相应质控查检表等相关内容,比较两组病人肠道准备合格率及耐受度。[结果]观察组较对照组病人的肠道准备合格率及耐受度均有明显提高,差异有统计学意义(P<0.01)。[结论]应用专科护理质量指标管理,显著提高了病人肠道准备的合格率及病人的耐受度,体现了标准化肠道准备过程中人性化关怀,同时提升了专科护理质量及护士的专科综合能力。     

益生菌联合肠内营养对急性胰腺炎患者肠道菌群及外周血miR-155的影响

目的 探讨益生菌联合肠内营养对急性胰腺炎患者肠道菌群及外周血miR-155的影响。 方法 选取2016年6月至2018年12月河北医科大学第二医院消化内科收治的92例急性胰腺炎患者作为研究对象，根据随机数字表法分为观察组（n=46）和对照组（n=46），对照组在常规治疗基础上给予肠内营养治疗，观察组在对照组基础上给予双歧杆菌乳杆菌三联活菌片，观察两组患者治疗前后肠道菌群、炎性介质及血清miR-155变化，比较两组患者治疗后胃肠道功能恢复情况。结果 治疗后，观察组双歧杆菌、乳酸杆菌增加数量，肠球菌、大肠埃希菌减少数量，血清CRP、IL-6、IL-17、TNF-α、miR-155降低水平均显著高于对照组（P<0.05）；观察组患者胃肠生活质量量表（GIQLI）评分高于对照组，腹胀消失时间、腹痛消失时间、肠鸣音恢复时间、血清淀粉酶恢复正常时间均少于对照组（P<0.05）。结论 益生菌联合肠内营养治疗急性胰腺炎可调节肠道菌群平衡，降低血清miR-155水平，缓解炎性反应，促进肠道功能恢复。