Use of breath hydrogen to quantify carbohydrate malabsorption: Lack of effect of soluble fibre (guar)

Breath H2 has been used for several years to quantify carbohydrate malabsorption. Dietary fibre, particularly fermentable fibres such as guar, may influence breath hydrogen and reduce the validity of this test. Therefore we studied, in healthy subjects over 12 hour periods, the effect on breath hydrogen of taking 15g guar either alone, with food, or with lactulose. Guar alone did not significantly increase breath H2 levels compared to fasting, nor did it increase breath H2 responses when added to test meals of white bread or lactulose. However, guar delayed mouth to caecum transit time from 2.25±0.37 hrs for lactulose alone to 4.0±0.53 hrs for guar plus lactulose (p<0.05). After 15g lactulose was consumed in divided doses over 5 hrs to mimic the delayed transit caused by guar, the peak breath H2 level was reduced by 32% (p<0.02), but total breath H2 was no different from 15g guar added to 15g lactulose. We conclude that guar is not likely to have a significant impact on carbohydrate malabsorption calculations based on the breath H2 technique.     

Surgical management of obstructive right-sided colon cancer at a national level results of a multicenter study of the French Surgical Association in 776 patients

Aim

To report the results of surgery for obstructive right colon cancer (ORCC) and to identify risk factors associated with worse outcomes that may help surgeons to choose the best surgical option.

16S rRNA序列测定结肠腺瘤性息肉与肠道菌群的相关性分析

目的探讨作为结肠癌癌前病变的结肠腺瘤性息肉(CAP)中肠道菌群的改变特征。方法随机收集2017年11月至2018年4月在昆明医科大学第一附属医院进行结肠镜检查的结肠腺瘤性息肉患者(CAP组)30例和无腺瘤息肉的健康个体(HC组)30名。通过内镜下电凝电切治疗,收集CAP患者的腺瘤组织和健康志愿者(HC)的肠黏膜组织,提取基因组DNA,对细菌16S rRNA基因V3~V4区进行扩增,通过Illumina MiSeq平台进行序列测定,实验结果使用秩和检验(Wilcoxon检验)进行比较法分析。结果CAP患者的腺瘤组织中肠道菌群α多样性高于健康肠黏膜组织(Chao指数、Ace指数P<0.01)。门水平分析中,CAP组中拟杆菌门(FC=0.38)的丰度显著降低(P<0.01);属水平分析中,拟杆菌属(FC=0.32)、埃希菌属(FC=0.57)、瘤胃球菌属(FC=0.42)、Blautia(FC=0.27)、Dorea(FC=0.57)在CAP组中丰度降低(P<0.05);假单胞菌属(FC=2.43)、乳球菌(FC=2.84)、土芽孢杆菌属(FC=2.07)和不动杆菌属(FC=2.36)丰度升高(P<0.05)。结论与HC肠黏膜组织相比,CAP患者腺瘤组织中菌群的丰度和多样性存在显著的差异,表明腺瘤性息肉患者黏膜中菌群存在失衡现象。这种肠道微环境的失衡,对研究结肠腺瘤性息肉的发生和发展具有重要意义。     

老年结肠癌并急性肠梗阻的术后并发症的危险因素分析

目的 探讨老年结肠癌伴发急性肠梗阻术后并发症及其危险闪素.方法 回顾性分析2009年6月-2011年6月治疗的70例老年患者的临床资料.结果 患者术后有19例(27.1%)出现并发症,围手术期死亡8例(11.4%).单因素分析显示,美国麻醉医师协会(ASA)分级3～4级、APACHE-Ⅲ评分者＞14分、闭袢性结肠梗阻及合并肠穿孔或肠浆膜撕裂术后并发症发生率较高.结论 结肠癌致急性肠梗阻术后并发症发生率及围手术期死亡率较高;对于有高危因素的患者应谨慎选择恰当术式及术后加强监护.     

结肠代食管术治疗食管良性狭窄

目的：探讨结肠代食管术治疗食管良性狭窄的临床治疗效果。方法整群选取该院2008年12月—2013年1月进行结肠代食管术的52例食管良性狭窄患者作为研究对象,观察患者进行手术的时间、手术后并发症的发生率、手术后的死亡率情况以及随访的情况。结果所有患者手术均顺利完成,没有出现死亡的病例。患者进行手术的时间平均为（190.76±19.87）min;患者手术后并发症的发生率为17.31%（9例）,手术后的死亡率为9.62%（5例）;对患者随访1~2年,依据Pompeo的生存质量分级进行评估,其中1级者有23例,2级者有18例,3级者有6例,没有4级的病例。结论结肠代食管术后在对患者随访的过程中,多数患者满意手术后的生活质量,患食管良性狭窄的患者,肠代食管术是保证其手术后生活质量的比较好的选择。     

Effect of Cassia nomame on Small Intestine Movement, Diuresis, and Anti-inflammation in Rats

Objective To investigate the preliminary pharmacological screening of Cassia nomame.Methods The effect of aqueous extract from C.nomame on gastrointestinal motor function was investigated by assessing the intestinal transit rate(ITR)of charcoal modeled into gastrointestinal motility dysfunction(GMD)by the administration of dopamine,atropine,or noradrenaline to the rats,respectively.Diuresis was studied in vivo by estimating the urine output.The anti-inflammatory activity was expressed as the percentage of swelling reduction by comparison on the mean thickness of ear swelling in mice.Results The ITR in these GMD animals was significantly retarded compared to that in normal animals.The retardation,however,was significantly inhibited by the ig administration of C.nomame(2 g/kg)for all GMD animals.The results suggested that C.nomame had the potential for development into a prokinetic agent that could prevent or alleviate GMD in patients.C.nomame increased urine output and suppressed significantly ear swelling induced by dirnethyl benzene in mice.Conclusion C.nomame could increase the gastrointestinal contractile activity of rats and has the effects of diuresis and anti-inflammation.     

Effects of Dietary Arabinogalactan on Gastrointestinal and Blood Parameters in Healthy Human Subjects

Objectives: Arabinogalactan (AG) is a non-digestible soluble dietary fiber that resists hydrolytic enzyme action and enters the large bowel intact where it is fermented by resident microflora. To determine whether AG has similar physiological properties to other soluble dietary fibers, we examined the effect of 15 and 30 g per day of a commercially available AG from Western Larch on several gastrointestinal and blood parameters.

Methods: Gastrointestinal parameters included fecal microflora, fecal enzyme activity, fecal short-chain fatty acids, fecal pH, fecal weight, transit time and bowel frequency. Blood parameters included total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, Apo-A1, Apo-B, glucose and insulin. The study consisted of two three-week diet treatments with no washout period. Participants (n=20, 11 males, 9 females) consumed their usual diet in addition to 15 or 30 g AG in a beverage sweetened with aspartame as compared to their usual diet with the control beverage.

Results: Significant increases in total fecal anaerobes were observed with 15 g (p=0.01) and 30 g AG (p=0.001). A significant increase (p=0.02) in Lactobacillus spp. was observed when subjects consumed AG for a total of six weeks regardless of dose. There were no significant changes in other microflora, fecal enzyme activity, transit time, frequency, fecal weight, fecal pH and short-chain fatty acids. Fecal ammonia levels decreased with 15 g (p=0.001) and 30 g (p=0.002) AG. No significant changes in blood lipids or blood insulin were observed.

Conclusions: These data suggest that dietary AG is easily incorporated into the diet, well tolerated in subjects and has some positive effects on fecal chemistry.