INTESTINES

  • 文章类型: Journal Article
    就人体表面积而言,肠是最大的器官。它不仅负责吸收营养,而且还负责对外部世界的保护。肠道微生物群对于维持正常运作的肠道屏障至关重要。主要通过生产其代谢产物:短链脂肪酸,胆汁酸,和色氨酸衍生物。过量消费乙醇对肠道健康构成重大威胁。它不仅损害肠上皮,但是,也许主要是,它改变了肠道微生物组。那些乙醇驱动的变化改变了它的代谢组,剥夺宿主生理肠道微生物群的保护作用。这篇文献综述讨论了乙醇消费对肠道的影响,肠道微生物群,和它的代谢组,全面概述乙醇破坏肠道稳态的机制,并讨论新的治疗干预的潜在途径。
    The intestine is the largest organ in terms of surface area in the human body. It is responsible not only for absorbing nutrients but also for protection against the external world. The gut microbiota is essential in maintaining a properly functioning intestinal barrier, primarily through producing its metabolites: short-chain fatty acids, bile acids, and tryptophan derivatives. Ethanol overconsumption poses a significant threat to intestinal health. Not only does it damage the intestinal epithelium, but, maybe foremostly, it changes the gut microbiome. Those ethanol-driven changes shift its metabolome, depriving the host of the protective effect the physiological gut microbiota has. This literature review discusses the impact of ethanol consumption on the gut, the gut microbiota, and its metabolome, providing a comprehensive overview of the mechanisms through which ethanol disrupts intestinal homeostasis and discussing potential avenues for new therapeutic intervention.
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  • 文章类型: Journal Article
    胃肠外科的进步将注意力转向优化康复,包括通过使用减少术后住院时间延长的喂养方法,并发症,和死亡率,在其他不良后果中。本研究的主要目标是确定当前同行评审的文献报告择期肠手术的术后结果,并评估择期肠手术后患者对口服喂养的耐受性的临床证据。
    通过PubMed和Scopus进行了详尽的文献检索。搜索结果筛选了潜在的文章,和文章根据预设的资格标准进行资格评估.数据被合成,并对结果进行了专题报道和讨论。
    数据库搜索产生了1,667篇文章,从中选择了18项随机对照试验纳入本研究.这项研究包括874名早期口服喂养(EOF)患者,865名传统经口喂养患者,和91例患者的术后护理未指定。完成了数据合成,并进行了荟萃分析。结果表明,EOF患者需要明显更短的时间来耐受固体饮食,并且住院时间更短。此外,EOF组肠功能恢复较早.
    结果显示对EOF具有良好的耐受性,住院时间较短,和更快的肠道功能恢复,提示择期肠道手术后EOF相对安全。然而,应进行类似基线条件的进一步研究以验证这些结果.
    Advancements in gastrointestinal surgery have directed attention toward optimizing recovery, including through the use of feeding methods that reduce prolonged postoperative hospital stays, complications, and mortality, among other undesirable outcomes. This study\'s primary goals were to identify current peer-reviewed literature reporting the postoperative outcomes of elective bowel surgery and to evaluate the clinical evidence of patients\' tolerance to oral feeding following elective bowel surgery.
    An exhaustive literature search was conducted via PubMed and Scopus. The search results were screened for potential articles, and articles were assessed for eligibility based on prespecified eligibility criteria. The data were synthesized, and the results were reported and discussed thematically.
    The database search yielded 1,667 articles, from which 18 randomized controlled trials were chosen for inclusion in this study. This study included 874 early oral feeding (EOF) patients, 865 traditional oral feeding patients, and 91 patients whose postoperative care was unspecified. Data synthesis was done, and meta-analyses were conducted. The results showed that EOF patients required a significantly shorter time to tolerate a solid diet and had shorter hospital stays. In addition, bowel function was restored earlier in EOF groups.
    The results show good tolerance to EOF, shorter hospitalizations, and faster restoration of bowel function, suggesting that EOF after elective bowel surgery is relatively safe. However, further studies with similar baseline conditions should be conducted to verify these results.
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  • 文章类型: Journal Article
    方法:母乳中的微生物对于早期建立婴儿肠道菌群至关重要,对婴儿健康具有重要意义。母乳微生物主要来自母体肠道微生物群的迁移。该综述表明,母亲饮食对肠道菌群的调节可能是改善婴儿健康的有效策略。
    结果:本文综述了母乳微生物群对婴儿发育和肠道健康的影响。讨论了通过肠-乳房途径在母体肠道和乳房中的微生物群之间的密切关系。基于饮食对肠道菌群的影响,提出改变母体膳食结构是调节母乳菌群和婴儿肠道菌群的新策略,这将对婴儿健康产生积极影响。
    结论:母乳微生物对婴儿发育和免疫系统的调节具有有益作用。母亲的肠道和乳房可以通过肠-乳腺途径进行一定的细菌迁移。研究表明,在母乳喂养期间干预母亲的饮食可以影响母亲的肠道微生物群的组成,从而调节母乳和婴儿肠道的微生物群,与婴儿健康密切相关。
    METHODS: The microbes in breast milk are critical for the early establishment of infant gut microbiota and have important implications for infant health. Breast milk microbes primarily derive from the migration of maternal intestinal microbiota. This review suggests that the regulation of maternal diet on gut microbiota may be an effective strategy to improve infant health.
    RESULTS: This article reviews the impact of breast milk microbiota on infant development and intestinal health. The close relationship between the microbiota in the maternal gut and breast through the entero-mammary pathway is discussed. Based on the effect of diet on gut microbiota, it is proposed that changing the maternal dietary structure is a new strategy for regulating breast milk microbiota and infant intestinal microbiota, which would have a positive impact on infant health.
    CONCLUSIONS: Breast milk microbes have beneficial effects on infant development and regulation of the immune system. The mother\'s gut and breast can undergo certain bacterial migration through the entero-mammary pathway. Research has shown that intervening in a mother\'s diet during breastfeeding can affect the composition of the mother\'s gut microbiota, thereby regulating the microbiota of breast milk and infant intestines, and is closely related to infant health.
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  • 文章类型: Journal Article
    T淋巴细胞性肠道平滑肌炎是小儿肠道假性阻塞的罕见原因。诊断可能很困难,需要在剖腹手术或腹腔镜检查期间进行全层肠活检,并可能进行肠造口。目前,免疫抑制疗法是唯一可用的治疗方法。由于正在进行的纤维化改变,诊断和治疗的延迟可能会对预后产生负面影响;因此,早期诊断和后续治疗至关重要。这篇综述总结了关于新闻学的现有信息,诊断步骤,和治疗方式。这里,我们报告了过去20年中报道的最年轻的肠平滑肌炎病例,并回顾了以前的病例,分析了其治疗方法。
    T-lymphocytic intestinal leiomyositis is a rare cause of \"pediatric intestinal pseudo-obstructions.\" Diagnosis may be difficult and requires full-thickness bowel biopsies during laparotomy or laparoscopy with possible enterostomy. Currently, immunosuppressive therapy is the only available treatment. A delay in diagnosis and therapy may negatively affect the prognosis because of ongoing fibrotic alterations; therefore, early diagnosis and consequent treatment are crucial. This review summarizes the available information on the nosology, diagnostic steps, and treatment modalities. Here, we report the youngest case of enteric leiomyositis reported in the last two decades and analyze its management by reviewing previous cases.
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  • 文章类型: Journal Article
    肠功能障碍与神经和内分泌问题越来越相关,引起人们对其对世界健康影响的担忧。随着检测和治疗肠道疾病的几项突破性技术的引入,前几年取得了重大进展。另一方面,传统的侵入式诊断技术既昂贵又耗时。此外,常规药物(非胶囊)的功效降低,因为它们在达到目标之前更有可能降解。在这种情况下,基于不同类型的生物大分子的微胶囊已被用于封装活性药物和传感器,以追踪肠道疾病并解决这些问题。几种生物大分子/生物材料(天然蛋白质,海藻酸盐,壳聚糖,纤维素和RNA等.)被广泛用于制造肠道疾病的微胶囊,能显著提高治疗效果,减少不良反应。本文系统总结了基于生物大分子材料的微囊化用于肠道健康控制和功效增强。并探讨了微胶囊化生物大分子药物在减轻肠道炎症中的应用及机理研究,除了涵盖用于肠道健康的微胶囊药物递送系统的制备技术。微胶囊递送系统在肠道疾病诊断中的限制和潜在应用,治疗,并强调了监视。
    Intestinal dysfunction is becoming increasingly associated with neurological and endocrine issues, raising concerns about its impact on world health. With the introduction of several breakthrough technologies for detecting and treating intestinal illnesses, significant progress has been made in the previous few years. On the other hand, traditional intrusive diagnostic techniques are expensive and time-consuming. Furthermore, the efficacy of conventional drugs (not capsules) is reduced since they are more likely to degrade before reaching their target. In this context, microcapsules based on different types of biological macromolecules have been used to encapsulate active drugs and sensors to track intestinal ailments and address these issues. Several biomacromolecules/biomaterials (natural protein, alginate, chitosan, cellulose and RNA etc.) are widely used for make microcapsules for intestinal diseases, and can significantly improve the therapeutic effect and reduce adverse reactions. This article systematically summarizes microencapsulated based on biomacromolecules material for intestinal health control and efficacy enhancement. It also discusses the application and mechanism research of microencapsulated biomacromolecules drugs in reducing intestinal inflammation, in addition to covering the preparation techniques of microencapsulated drug delivery systems used for intestinal health. Microcapsule delivery systems\' limits and potential applications for intestinal disease diagnosis, treatment, and surveillance were highlighted.
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  • 文章类型: Systematic Review
    饮食因素可以改变肠道屏障的功能,导致渗透率变化。这项系统评价分析了饮食或饮食干预与健康个体肠道屏障通透性(IBP)变化之间联系的证据。使用虚拟数据库EMBASE对主要研究进行了系统的搜索,PubMed,WebofScience,CINAHL,还有Scopus.这项审查遵循了PRISMA2020指南,使用纽卡斯尔-渥太华量表进行观察性研究,使用ROB2.0进行随机临床试验,评估方法学质量。在恢复的3725项研究中,12人符合审查条件。菊苣菊粉和益生菌可降低中等程度证据的成人IBP。用果糖获得相反的结果,这增加了成人的IBP,证据等级很低.只有不同膳食成分的干预研究被发现,很少有研究评估特定饮食对IBP的影响。因此,没有强有力的证据表明饮食或饮食干预会增加或减少健康个体的IBP.对这一主题的研究是必要的,偏见风险低,证据质量好,因为对健康人群的了解仍然很少。
    Dietary factors can modify the function of the intestinal barrier, causing permeability changes. This systematic review analyzed evidence on the link between diet or dietary interventions and changes in intestinal barrier permeability (IBP) in healthy individuals. A systematic search for primary studies was conducted using the virtual databases EMBASE, PubMed, Web of Science, CINAHL, and Scopus. This review adhered to PRISMA 2020 guidelines, assessing the methodological quality using the Newcastle-Ottawa scale for observational studies and ROB 2.0 for randomized clinical trials. Out of 3725 studies recovered, 12 were eligible for review. Chicory inulin and probiotics reduced IBP in adults with a moderate GRADE level of evidence. The opposite result was obtained with fructose, which increased IBP in adults, with a very low GRADE level of evidence. Only intervention studies with different dietary components were found, and few studies evaluated the effect of specific diets on the IBP. Thus, there was no strong evidence that diet or dietary interventions increase or decrease IBP in healthy individuals. Studies on this topic are necessary, with a low risk of bias and good quality of evidence generated, as there is still little knowledge on healthy populations.
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  • 文章类型: Journal Article
    在过去的十年里,肠道类器官技术为体外复制肠道生理过程中的组织或器官形态发生以及研究各种肠道疾病的发病机理铺平了道路。肠道类器官在药物筛选中受到青睐,因为它们具有高通量体外培养的能力,并且与患者的遗传特征更相似。此外,作为疾病模型,肠道类器官在筛选诊断标志物方面有广泛的应用,确定治疗目标,探索疾病的表观遗传机制。此外,作为一个可移植的细胞系统,在溃疡性结肠炎和短肠综合征等疾病中,类器官在受损上皮的重建中发挥了重要作用,以及肠道物质交换和代谢功能恢复。跨学科方法的兴起,包括类器官芯片技术,基因组编辑技术,和微流体,大大加速了类器官的发展。在这次审查中,首先使用VOSviewer软件可视化肠道类器官的热合被引期刊和关键词趋势。随后,我们总结了目前肠道类器官技术在疾病建模中的应用,药物筛选,和再生医学。这将加深我们对肠道类器官的理解,并进一步探索肠道的生理机制和肠道疾病的药物开发。
    In the past decade, intestinal organoid technology has paved the way for reproducing tissue or organ morphogenesis during intestinal physiological processes in vitro and studying the pathogenesis of various intestinal diseases. Intestinal organoids are favored in drug screening due to their ability for high-throughput in vitro cultivation and their closer resemblance to patient genetic characteristics. Furthermore, as disease models, intestinal organoids find wide applications in screening diagnostic markers, identifying therapeutic targets, and exploring epigenetic mechanisms of diseases. Additionally, as a transplantable cellular system, organoids have played a significant role in the reconstruction of damaged epithelium in conditions such as ulcerative colitis and short bowel syndrome, as well as in intestinal material exchange and metabolic function restoration. The rise of interdisciplinary approaches, including organoid-on-chip technology, genome editing techniques, and microfluidics, has greatly accelerated the development of organoids. In this review, VOSviewer software is used to visualize hot co-cited journal and keywords trends of intestinal organoid firstly. Subsequently, we have summarized the current applications of intestinal organoid technology in disease modeling, drug screening, and regenerative medicine. This will deepen our understanding of intestinal organoids and further explore the physiological mechanisms of the intestine and drug development for intestinal diseases.
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  • 文章类型: Journal Article
    肠移植是一项复杂的技术程序,为患有终末期肠衰竭的患者提供了享受改善生活质量的机会,营养和生存。与其他类型的器官移植相比,这是器官移植领域相对较新的进步。然而,在过去的几十年里取得了巨大的进步,包括使用缺血预处理,基因治疗,并在保存溶液中添加药物补充剂。然而,尽管取得了这些进展,由于几个因素,肠道移植仍然是一项具有挑战性的工作。其中值得注意的是缺血再灌注损伤(IRI),这导致细胞完整性和粘膜屏障功能的丧失。此外,IRI导致移植失败,延迟的移植物功能,移植物和受体存活率下降。这需要寻找新的治疗途径和改进的移植方案以预防或减弱肠IRI。在许多正在研究的对抗IRI及其相关并发症的候选药物中,一氧化氮(NO)。NO是一种内源性产生的气态信号分子,具有几种治疗特性。这篇小型综述的目的是讨论肠移植中的IRI及其相关并发症,和NO作为一种新兴的药理学工具来对抗这种具有挑战性的病理状况。I.
    Intestinal transplantation is a complex technical procedure that provides patients suffering from end-stage intestinal failure an opportunity to enjoy improved quality of life, nutrition and survival. Compared to other types of organ transplants, it is a relatively new advancement in the field of organ transplantation. Nevertheless, great advances have been made over the past few decades to the present era, including the use of ischemic preconditioning, gene therapy, and addition of pharmacological supplements to preservation solutions. However, despite these strides, intestinal transplantation is still a challenging endeavor due to several factors. Notable among them is ischemia-reperfusion injury (IRI), which results in loss of cellular integrity and mucosal barrier function. In addition, IRI causes graft failure, delayed graft function, and decreased graft and recipient survival. This has necessitated the search for novel therapeutic avenues and improved transplantation protocols to prevent or attenuate intestinal IRI. Among the many candidate agents that are being investigated to combat IRI and its associated complications, nitric oxide (NO). NO is an endogenously produced gaseous signaling molecule with several therapeutic properties. The purpose of this mini-review is to discuss IRI and its related complications in intestinal transplantation, and NO as an emerging pharmacological tool against this challenging pathological condition. i.
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  • 文章类型: Journal Article
    背景:吲哚菁(ICG)的荧光成像已被广泛用于评估肿瘤外科手术中的肠灌注。在紧急情况下,存在许多需要肠灌注评估的情况。大型前瞻性研究或RCT评估可行性,ICG在紧急情况下缺乏安全性和实用性。主要目的是评估ICG在紧急情况下评估肠灌注的有用性。
    方法:该手稿是根据系统审查和荟萃分析声明(PRISMA)的首选报告项目的建议起草的。通过Pubmed进行了系统的文献检索,Scopus,和ISI科学网。使用非随机研究的方法学指数(MINORS)对纳入研究进行评估。根据Cochrane协作和流行病学指南中观察性研究的荟萃分析的建议进行荟萃分析,并采用Mantel-Haenszel随机效应模型计算效应大小。
    结果:确定了10,093篇论文。全文回顾了84次,78例排除在外:64例病例报告;10例无原始数据的综述;2例致编辑的信件;2例包含无法提取的数据.最后,6项研究22-27可用于质量评估和定量合成.使用ICG荧光血管造影术的再次手术概率与传统的RD肠灌注评估相似,为-0.04(95%CI:-0.147至0.060)。结果具有统计学意义P=0.029,尽管异质性不可忽略,I2指数为59.9%。没有发现小的研究效果或发表偏倚。
    结论:关于使用IGC荧光治疗缺血性肠病的首次分析显示,这种方法在评估紧急情况下肠灌注时是一种安全可行的工具。本课题应在高质量的研究中进一步研究。
    BACKGROUND: Fluorescence imaging with indocyanine green (ICG) has been extensively utilized to assess bowel perfusion in oncologic surgery. In the emergency setting, there are many situations in which bowel perfusion assessment is required. Large prospective studies or RCTs evaluating feasibility, safety and utility of ICG in the emergency setting are lacking. The primary aim is to assess the usefulness of ICG for evaluation of bowel perfusion in the emergency setting.
    METHODS: The manuscript was drafted following the recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA). A systematic literature search was carried out through Pubmed, Scopus, and the ISI Web of Science. Assessment of included study using the methodological index for nonrandomized studies (MINORS) was calculated. The meta-analysis was carried out in line with recommendations from the Cochrane Collaboration and Meta-analysis of Observational Studies in Epidemiology guidelines, and the Mantel-Haenszel random effects model was used to calculate effect sizes.
    RESULTS: 10 093 papers were identified. Eighty-four were reviewed in full-text, and 78 were excluded: 64 were case reports; 10 were reviews without original data; 2 were letters to the editor; and 2 contained unextractable data. Finally, six studies 22-27 were available for quality assessment and quantitative synthesis. The probability of reoperation using ICG fluorescence angiography resulted similar to the traditional assessment of bowel perfusion with a RD was -0.04 (95% CI: -0.147 to 0.060). The results were statistically significant P =0.029, although the heterogeneity was not negligible with a 59.9% of the I2 index. No small study effect or publication bias were found.
    CONCLUSIONS: This first metanalysis on the use of IGC fluorescence for ischemic bowel disease showed that this methodology is a safe and feasible tool in the assessment of bowel perfusion in the emergency setting. This topic should be further investigated in high-quality studies.
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  • 文章类型: Journal Article
    肠或多内脏移植(Tx)后无法闭合腹部仍然是经常发生的问题。两种有吸引力的重建方法,尤其是在大的腹壁缺损中,全层腹壁血管化复合同种异体移植物(AW-VCA)和非血管化直肌筋膜(NVRF)Tx。这篇综述比较了手术技术,免疫学,一体化,临床经验,以及这两种技术的迹象。在AW-VCATx中,血管吻合是必需的,移植物在Tx后经历肥大。此外,它具有免疫益处和良好的临床结果。NVRFTx是一种简单的技术,无需血管吻合。此外,快速整合和新生血管形成,临床结局良好.
    Failure to close the abdomen after intestinal or multivisceral transplantation (Tx) remains a frequently occurring problem. Two attractive reconstruction methods, especially in large abdominal wall defects, are full-thickness abdominal wall vascularized composite allograft (AW-VCA) and nonvascularized rectus fascia (NVRF) Tx. This review compares surgical technique, immunology, integration, clinical experience, and indications of both techniques. In AW-VCA Tx, vascular anastomosis is required and the graft undergoes hypotrophy post-Tx. Furthermore, it has immunologic benefits and good clinical outcome. NVRF Tx is an easy technique without the need for vascular anastomosis. Moreover, a rapid integration and neovascularization occurs with excellent clinical outcome.
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