Gastrointestinal tract

胃肠道
  • 文章类型: Journal Article
    最近的研究引起了人们对新一代益生菌的潜在健康益处的极大兴趣。尽管益生菌补充剂丰富,它们的粘附,从而在宿主的肠道中定植,益生菌功效的决定因素,仍然值得怀疑。的确,胃肠道,一个多组分和复杂的系统,模糊了对益生菌黏附机制的全面理解。本研究旨在使用两种体外方法研究益生菌的粘附能力,这些方法是专门开发的,以研究细菌-粘液团聚和对肠粘液的有效粘附。五种益生菌菌株,包括大肠杆菌,植物乳杆菌,Duncaniae,长双歧杆菌,和长双歧杆菌。选择婴儿进行调查。在这种情况下,大肠杆菌证明了对粘液的粘附性较高,植物乳杆菌,还有B.婴儿,强调菌株特有的差异。虽然总聚集能力在8%到82%之间,对粘液的实际可行粘附率仍然相当低(0.6%-2.9%)。SEM图像显示,形态特征,链和/或簇形成能力,以及表面胞外多糖的存在,可能对细菌粘附有影响。这项研究有助于了解益生菌粘附以及简单有效的离体方法来研究细菌对肠粘液的粘附,这是在宿主肠道中进一步定殖的先决条件。
    Recent research has promoted considerable interest in the potential health benefits of the new generation of probiotics. Despite the abundance of probiotic supplements, their adhesion and thereby colonization in the intestinal tract of the host, a determining factor of probiotic efficacy, remains questionable. Indeed, the gastrointestinal tract, a multi-component and complex system, obscures the comprehensive understanding of the probiotic adhesion mechanism. This study aimed to investigate the adhesion capacity of probiotic bacteria using two ex-vivo approaches that were specifically developed to investigate the bacteria-mucus agglomeration and the viable adhesion to intestinal mucus. Five probiotic bacterial strains including Escherichia coli, Lactiplantibacillus plantarum, Faecalibacterium duncaniae, Bifidobacterium longum, and Bifidobacterium longum str. infantis were selected for the investigation. In that context, higher adhesion to mucus was demonstrated by E. coli, L. plantarum, and B. infantis, emphasizing strain-specific differences. While total agglomeration capacity ranged from 8 % to 82 %, actual viable adhesion to mucus remained rather low (0.6 %-2.9 %). SEM images revealed that morphological characteristics, chain and/or cluster forming ability, as well as the presence of surface exopolysaccharides, might have an impact on bacterial adhesion. This study contributes knowledge on probiotic adhesion as well as simple and effective ex-vivo approaches to investigate the bacterial adhesion to the intestinal mucus, which is prerequisite for further colonization in the gut of the host.
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  • 文章类型: Journal Article
    背景:放射治疗(RT)对宫颈癌有效,但对附近器官会引起晚期副作用(SE)。这些晚期SE在RT后超过3个月发生,并且通过临床发现来评级以确定它们的严重程度。虽然影像学研究描述了晚期胃肠道(GI)SE,没有人证明研究结果与毒性分级之间存在相关性.在这项研究中,我们证明了晚期胃肠道毒性的患病率,CT检查结果,以及它们的相关性。
    方法:我们回顾性研究了2015年至2018年接受RT治疗的子宫颈癌患者。患者特征和治疗来自医院的数据库。随访期间获得晚期RTOG/EORTCGISE和CT图像。使用预定义的标准从CT图像审查RT后的GI变化。计算CT检查结果的风险比(RR),和多变量对数二项回归确定调整后的RR。
    结果:这项研究包括153名患者,年龄中位数为57岁(IQR49-65)。≥2级RTOG/EORTC晚期GISE的患病率为33(27.5%)。CT表现为91例(59.48%)肠壁增强(BW)增厚,3例(1.96%)肠梗阻,7例(4.58%)肠穿孔,6例(3.92%)有瘘管,0(0%)与肠缺血,消化道出血0(0%)。调整后的RR显示BW增厚增加(RR9.77,95%CI2.64-36.07,p=0.001),肠梗阻(RR5.05,95%CI2.30-11.09,p<0.001),和肠穿孔(RR3.82,95%CI1.96-7.44,p<0.001)与较高的晚期胃肠道毒性等级相关。
    结论:我们的研究显示CT表现与2-4级晚期胃肠道毒性相关。未来的研究应该通过不同的成像和毒性分级系统来验证和完善这些发现,以评估其潜在的预测价值。
    BACKGROUND: Radiotherapy (RT) is effective for cervical cancer but causes late side effects (SE) to nearby organs. These late SE occur more than 3 months after RT and are rated by clinical findings to determine their severity. While imaging studies describe late gastrointestinal (GI) SE, none demonstrate the correlation between the findings and the toxicity grading. In this study, we demonstrated the late GI toxicity prevalence, CT findings, and their correlation.
    METHODS: We retrospectively studied uterine cervical cancer patients treated with RT between 2015 and 2018. Patient characteristics and treatment(s) were obtained from the hospital\'s databases. Late RTOG/EORTC GI SE and CT images were obtained during the follow-up. Post-RT GI changes were reviewed from CT images using pre-defined criteria. Risk ratios (RR) were calculated for CT findings, and multivariable log binomial regression determined adjusted RRs.
    RESULTS: This study included 153 patients, with a median age of 57 years (IQR 49-65). The prevalence of ≥ grade 2 RTOG/EORTC late GI SE was 33 (27.5%). CT findings showed 91 patients (59.48%) with enhanced bowel wall (BW) thickening, 3 (1.96%) with bowel obstruction, 7 (4.58%) with bowel perforation, 6 (3.92%) with fistula, 0 (0%) with bowel ischemia, and 0 (0%) with GI bleeding. Adjusted RRs showed that enhanced BW thickening (RR 9.77, 95% CI 2.64-36.07, p = 0.001), bowel obstruction (RR 5.05, 95% CI 2.30-11.09, p < 0.001), and bowel perforation (RR 3.82, 95% CI 1.96-7.44, p < 0.001) associated with higher late GI toxicity grades.
    CONCLUSIONS: Our study shows CT findings correlate with grade 2-4 late GI toxicity. Future research should validate and refine these findings with different imaging and toxicity grading systems to assess their potential predictive value.
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  • 文章类型: Journal Article
    运动显著改变了人体的生理功能,比如增加心输出量和肌肉血流量,降低肾小球滤过率(GFR)和肝血流量,因此,改变吸收,分布,药物的代谢和排泄。在这项研究中,我们旨在建立运动过程中人体生理参数的数据库,并为每个生理参数的变化与运动强度之间的关系构建方程,包括心输出量,器官血流量(例如肌肉血流量和肾脏血流量),氧气吸收,血浆pH和GFR,等。多项式方程用于说明生理参数(P)和心率(HR)之间的关系,作为运动强度的指标。咪达唑仑的药代动力学,奎尼丁,运动过程中的地高辛和利多卡因是通过基于全身生理的药代动力学(WB-PBPK)模型和对100名虚拟受试者给药后开发的生理参数数据库来预测的。WB-PBPK模型模拟结果表明,大多数观察到的血浆药物浓度落在模拟的第5-95百分位数范围内,估计的药物峰浓度和曲线下面积也在0.5-2.0倍的观察范围内。敏感性分析显示,运动强度,锻炼持续时间,用药时间和生理参数的变化显着影响药物的药代动力学,以及取决于药物特性和运动条件的净效应。总之,使用开发的WB-PBPK模型和生理参数数据库可以定量预测运动过程中药物的药代动力学。意义陈述本研究在WB-PBPK模型中模拟了运动过程中人体生理参数的实时变化,并全面研究了口服和静脉内给药后运动过程中的药代动力学变化。此外,还揭示了运动过程中影响药代动力学的因素。
    Exercise significantly alters human physiological functions, such as increasing cardiac output and muscle blood flow, decreasing glomerular filtration rate (GFR) and liver blood flow, thereby, altering absorption, distribution, metabolism and excretion of drugs. In this study, we aimed to establish a database of human physiological parameters during exercise and to construct equations for the relationship between changes in each physiological parameter and exercise intensity, including cardiac output, organ blood flow (e.g. muscle blood flow and kidney blood flow), oxygen uptake, plasma pH and GFR, etc. The polynomial equation was used for illustrating the relationship between the physiological parameters (P) and heart rate (HR), which served as an index of exercise intensity. Pharmacokinetics of midazolam, quinidine, digoxin and lidocaine during exercise were predicted by a whole body physiologically based pharmacokinetic (WB-PBPK) model and the developed database of physiological parameters following administration to 100 virtual subjects. The WB-PBPK model simulation results showed that most of the observed plasma drug concentrations fell within 5th-95th percentiles of the simulations, and the estimated peak concentrations and area under the curve of drugs were also within 0.5-2.0 folds of observations. Sensitivity analysis showed that exercise intensity, exercise duration, medication time and alterations in physiological parameters significantly affected drug pharmacokinetics, and the net effect depending on drug characteristics and exercise conditions. In conclusion, pharmacokinetics of drugs during exercise could be quantitatively predicted using the developed WB-PBPK model and database of physiological parameters. Significance Statement This study simulated real-time changes of human physiological parameters during exercise in the WB-PBPK model and comprehensively investigated pharmacokinetic changes during exercise following oral and intravenous administration. Furthermore, the factors affecting pharmacokinetics during exercise were also revealed.
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  • 文章类型: Journal Article
    益生菌,特别是酵母属酵母,对它们的健康益处和作为抗生素替代品的潜力很有价值。为了有效,这些微生物必须承受恶劣的环境条件,需要先进的保护技术,如封装,以保持益生菌在加工过程中的活力,storage,通过消化系统。这篇综述和荟萃分析旨在描述和比较用于封装酵母属的方法和试剂。,检查操作条件,酵母起源,和物种。它提供了有关营养酵母消费的健康益处的文献的概述。根据系统评价和荟萃分析(PRISMA)指南的首选报告项目进行了书目调查。荟萃分析比较了封装方法在封装和暴露于胃肠道后的活力。在应用纳入/排除标准后选择了19项研究。冷冻干燥被认为是最有效的细胞存活,而离子凝胶化对于维持暴露于胃肠道后的生存力是最好的。因此,冷冻干燥和离子凝胶的组合被证明在封装过程中最有效地保持高细胞活力,storage,和消费。对用于人类食品和动物饲料的益生菌的研究表明,将冷冻干燥和离子凝胶化相结合可以有效地保护酵母属。;然而,必须考虑工业可扩展性。关于使用农业工业残留物作为包封剂的酵母包封的报告为保存潜在的益生菌酵母提供了有希望的策略,有助于工业过程的环境可持续性。
    Probiotics, particularly yeasts from the genus Saccharomyces, are valuable for their health benefits and potential as antibiotic alternatives. To be effective, these microorganisms must withstand harsh environmental conditions, necessitating advanced protective technologies such as encapsulation to maintain probiotic viability during processing, storage, and passage through the digestive system. This review and meta-analysis aims to describe and compare methods and agents used for encapsulating Saccharomyces spp., examining operating conditions, yeast origins, and species. It provides an overview of the literature on the health benefits of nutritional yeast consumption. A bibliographic survey was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. The meta-analysis compared encapsulation methods regarding their viability after encapsulation and exposure to the gastrointestinal tract. Nineteen studies were selected after applying inclusion/exclusion criteria. Freeze drying was found to be the most efficient for cell survival, while ionic gelation was best for maintaining viability after exposure to the gastrointestinal tract. Consequently, the combination of freeze drying and ionic gelation proved most effective in maintaining high cell viability during encapsulation, storage, and consumption. Research on probiotics for human food and animal feed indicates that combining freeze drying and ionic gelation effectively protects Saccharomyces spp.; however, industrial scalability must be considered. Reports on yeast encapsulation using agro-industrial residues as encapsulants offer promising strategies for preserving potential probiotic yeasts, contributing to the environmental sustainability of industrial processes.
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  • 文章类型: Journal Article
    为了研究参芪补气散(SQBQP)对平均日增重的影响,血液指标,胃肠道微生物,和小牛的血清代谢产物.
    将总共105头小牛随机分为三组(每组n=35):对照组(C,用基础饮食喂养21天)和两个治疗组(SQBQP-L和SQBQP-H,饲喂基础日粮,补充15和30g/kg的SQBQP),分别为21天。使用LC-MS/MS鉴定SQBQP的活性成分。用ELISA试剂盒和生化试剂盒测定血清消化酶和抗氧化指标,分别。通过液相色谱-质谱/质谱(LC-MS/MS)分析血清差异代谢物,通过16SrDNA测序分析瘤胃液和粪便中的菌群。进一步对SQBQP-H组和C组的胃肠道菌群和血清代谢产物进行Spearman相关性分析。
    SQBQP的主要活性成分主要包括多糖,黄酮类化合物,有机酸。与对照组(C)相比,SQBQP-H(高剂量)和SQBQP-L(低剂量)组的小牛血清淀粉酶(AMS)水平显着增加(P<0.001),脂肪酶含量显著降低(P<0.05)。此外,平均每日收益,T-AOC,SQBQP-H组奶牛纤维素酶含量显著升高(P<0.05)。SQBQP-H组瘤胃菌群中的变形杆菌和丁氏弧菌明显低于C组(P<0.05)。变形杆菌的相对丰度,放线菌,念珠菌_杆菌属,异常球菌_Thermus,蓝细菌,SQBQP-H组明显升高(P<0.05),Tenericte和Oscillibacter的相对丰度显着降低(P<0.05)。血清代谢组学分析显示20种差异代谢物,主要富含氨基酸的生物合成,β-丙氨酸代谢,酪氨酸,和色氨酸生物合成代谢途径(P<0.05)。相关性分析结果表明,瘤胃菌群中的Butyrivibrio和肠道菌群中的镰刀菌属与平均日增重呈极显著正相关,血清生化指标,差异代谢产物(-)-表没食子儿茶素(R>0.58,P<0.05)。
    SQBQP可以通过调节胃肠道菌群和体内代谢过程来促进小牛体重增加并增进健康。
    UNASSIGNED: To investigate the effects of Shen Qi Bu Qi Powder (SQBQP) on the average daily gain, blood indexes, gastrointestinal microflora, and serum metabolites of calves.
    UNASSIGNED: A total of 105 calves were randomly assigned to three groups (n = 35 per group): the control group (C, fed with a basal diet for 21 days) and two treatment groups (SQBQP-L and SQBQP-H, fed with the basal diet supplemented with 15 and 30 g/kg of SQBQP), respectively for 21 days. The active components of SQBQP were identified using LC-MS/MS. Serum digestive enzymes and antioxidant indices were determined by ELISA kits and biochemical kits, respectively. Serum differential metabolites were analyzed by liquid chromatography-mass spectrometry/mass spectrometry (LC-MS/MS), while flora in rumen fluid and fecal were analyzed by 16S rDNA sequencing. Further correlation analysis of gastrointestinal flora and serum metabolites of SQBQP-H and C groups were performed with Spearman\'s correlation.
    UNASSIGNED: The principal active components of SQBQP mainly includes polysaccharides, flavonoids, and organic acids. Compared to the control group (C), calves in the SQBQP-H (high dose) and SQBQP-L (low dose) groups showed a significant increase in serum amylase (AMS) levels (P<0.001), while lipase content significantly decreased (P<0.05). Additionally, the average daily gain, T-AOC, and cellulase content of calves in the SQBQP-H group significantly increased (P<0.05). Proteobacteria and Succinivibrio in the rumen flora of the SQBQP-H group was significantly lower than that of the C group (P<0.05). The relative abundance of Proteobacteria, Actinobacteria, Candidatus_Saccharibacteria, Deinococcus_Thermus, Cyanobacteria, and Succinivibrio in the SQBQP-H group was significantly increased (P<0.05), while the relative abundance of Tenericutes and Oscillibacter was significantly decreased (P<0.05). Serum metabolomics analysis revealed 20 differential metabolites, mainly enriched in amino acid biosynthesis, β-alanine metabolism, tyrosine, and tryptophan biosynthesis metabolic pathways (P<0.05). Correlation analysis results showed that Butyrivibrio in rumen flora and Oscillibacter_valericigenes in intestinal flora were significantly positively correlated with average daily gain, serum biochemical indexes, and differential metabolite (-)-Epigallocatechin (R>0.58, P<0.05).
    UNASSIGNED: SQBQP can promote calves weight gain and enhance health by modulating gastrointestinal flora and metabolic processes in the body.
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  • 文章类型: Journal Article
    背景:克氏锥虫通过属于Triatominae亚家族的嗜血虫子传播给人类。它的矢量内循环是复杂的,并且仅发生在昆虫的中肠中。解剖消化道内寄生虫与其载体之间的串扰所涉及的元素应该提供新的靶标,以中断寄生虫的生命周期并影响矢量能力。这些相互作用是由寄生虫用来感染和利用其宿主的策略形成的,和宿主的反应,旨在检测和消除寄生虫。当前研究的目的是表征T.cruzi在其矢量中的建立对中肠动力学的影响。
    方法:在本研究中,我们使用高通量定量蛋白质组学方法评估了克氏毛虫感染对感染后6小时和24小时模型昆虫Rhodniusprolixus中肠前肠内蛋白表达的影响.
    结果:摄入后不久,寄生虫通过上调218种蛋白质来调节消化上皮的蛋白质组,并对涉及广泛细胞功能的11种蛋白质的表达产生负面影响,由于它们在细胞代谢和体内平衡中的重要作用,其中许多是关键的。这种快速反应强调了寄生虫对媒介细胞机器的复杂操纵。此外,对寄生虫立即诱导的蛋白质的更深入的分析揭示了线粒体蛋白质的明显优势,从而改变了该细胞器的亚蛋白质组景观。这包括参与ATP生成的呼吸链的各种复合物。除了线粒体代谢失调,大量的解毒蛋白质,如抗氧化酶和P450细胞色素,立即被寄生虫诱导,强调应激反应。
    结论:这项研究首次说明了与T.cruzi接触后消化上皮的反应,以及寄生虫对线粒体亚蛋白质组的改变。这种对载体生理学的操纵可归因于寄生虫对信号通路的级联激活。理解这一回应的要素,以及它的触发器,可能是控制美国锥虫病传播的创新策略的基础,例如开发旨在破坏寄生虫增殖和在Triatomine载体内传播的有针对性的干预措施。
    BACKGROUND: Trypanosoma cruzi is transmitted to humans by hematophagous bugs belonging to the Triatominae subfamily. Its intra-vectorial cycle is complex and occurs exclusively in the insect\'s midgut. Dissecting the elements involved in the cross-talk between the parasite and its vector within the digestive tract should provide novel targets for interrupting the parasitic life cycle and affecting vectorial competence. These interactions are shaped by the strategies that parasites use to infect and exploit their hosts, and the host\'s responses that are designed to detect and eliminate parasites. The objective of the current study is to characterize the impact of T. cruzi establishment within its vector on the dynamics of its midgut.
    METHODS: In this study, we evaluated the impact of T. cruzi infection on protein expression within the anterior midgut of the model insect Rhodnius prolixus at 6 and 24 h post-infection (hpi) using high-throughput quantitative proteomics.
    RESULTS: Shortly after its ingestion, the parasite modulates the proteome of the digestive epithelium by upregulating 218 proteins and negatively affecting the expression of 11 proteins involved in a wide array of cellular functions, many of which are pivotal due to their instrumental roles in cellular metabolism and homeostasis. This swift response underscores the intricate manipulation of the vector\'s cellular machinery by the parasite. Moreover, a more in-depth analysis of proteins immediately induced by the parasite reveals a pronounced predominance of mitochondrial proteins, thereby altering the sub-proteomic landscape of this organelle. This includes various complexes of the respiratory chain involved in ATP generation. In addition to mitochondrial metabolic dysregulation, a significant number of detoxifying proteins, such as antioxidant enzymes and P450 cytochromes, were immediately induced by the parasite, highlighting a stress response.
    CONCLUSIONS: This study is the first to illustrate the response of the digestive epithelium upon contact with T. cruzi, as well as the alteration of mitochondrial sub-proteome by the parasite. This manipulation of the vector\'s physiology is attributable to the cascade activation of a signaling pathway by the parasite. Understanding the elements of this response, as well as its triggers, could be the foundation for innovative strategies to control the transmission of American trypanosomiasis, such as the development of targeted interventions aimed at disrupting parasite proliferation and transmission within the triatomine vector.
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  • 文章类型: Journal Article
    本研究旨在阐明果冻制剂的口服药物吸收过程。含有具有不同膜通透性的药物的琼脂和果胶基果冻(高:安替比林[ANT],介质:美托洛尔[MET],low:阿替洛尔[ATE])被制备并测试了大鼠的体外药物释放和体内药物吸收。所有药物在两种胶冻制剂的体外释放曲线相似,除了在中性pH下更快地从果胶果冻中释放。相比之下,果冻制剂中ATE而不是ANT的体内吸收明显低于溶液。口服后,琼脂胶冻对ATE和MET的吸收较低,而额外的水摄入量显着增加了吸收。通过由果冻组成的隔室模型描述了药物吸收的过程,肠液,和血液隔室。果冻中的药物扩散到肠液中,然后渗透到肠膜中。通过考虑限速过程,确定了琼脂果冻的膜通透性依赖性药物吸收和水摄入量的影响。总之,果冻制剂可能会减少和延迟药物口服吸收,尤其是渗透性差的药物。肠液量是控制药物吸收的重要因素之一。
    This study aims to clarify the process of oral drug absorption from jelly formulations. Agar and pectin-based jellies containing drugs with different membrane permeability (high: antipyrine [ANT], medium: metoprolol [MET], low: atenolol [ATE]) were prepared and tested for in vitro drug release and in vivo drug absorption in rats. All drugs showed similar release profiles in vitro from both jelly formulations, except for the faster release from pectin jelly at neutral pH. In contrast, in vivo absorption of ATE but not of ANT from jelly formulations was significantly lower than from solution. Absorption of ATE and MET was low from agar jelly after oral administration, whereas additional water intake significantly increased the absorption. The process of drug absorption was described by the compartmental model consisting of jelly, intestinal fluid, and blood compartments. Drugs in the jelly diffuse into the intestinal fluid and then permeate the intestinal membrane. By considering the rate-limiting process, membrane permeability-dependent drug absorption from agar jelly and the effects of water intake were identified. In conclusion, jelly formulations may potentially decrease and delay drug oral absorption, especially of poorly permeable drugs. Intestinal fluid volume is one of the important factors to control the drug absorption.
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  • 文章类型: Editorial
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  • 文章类型: Journal Article
    背景:许多研究表明肠道微生物群与关节疾病之间存在关联。“肠关节轴”在基孔肯雅病毒(CHIKV)感染中也具有潜在作用。CHIKV感染后的促炎性关节炎可能会破坏宿主的稳态并导致菌群失调。这项研究调查了粪便和肠道菌群的特征,肠代谢产物,以及CHIKV感染后肠组织基因调控的变化,利用多组学分析探讨肠道菌群参与CHIKV感染的发病机制。
    结果:CHIKV感染增加了感染动物的GI系统中炎症的全身负担。此外,感染诱导的GI微生物群和代谢物的改变可能间接参与CHIKV感染后GI和骨炎症的调节,包括炎性小体和白介素-17炎性细胞因子水平的调节。
    结论:我们的结果表明,胃肠道及其微生物参与了CHIKV感染的调节,这可以作为CHIKV感染的辅助治疗指标。视频摘要。
    BACKGROUND: Many studies have demonstrated the association between intestinal microbiota and joint diseases. The \"gut-joint axis\" also has potential roles in chikungunya virus (CHIKV) infection. Pro-inflammatory arthritis after CHIKV infection might disrupt host homeostasis and lead to dysbacteriosis. This study investigated the characteristics of fecal and gut microbiota, intestinal metabolites, and the changes in gene regulation of intestinal tissues after CHIKV infection using multi-omics analysis to explore the involvement of gut microbiota in the pathogenesis of CHIKV infection.
    RESULTS: CHIKV infection increases the systemic burden of inflammation in the GI system of infected animals. Moreover, infection-induced alterations in GI microbiota and metabolites may be indirectly involved in the modulation of GI and bone inflammation after CHIKV infection, including the modulation of inflammasomes and interleukin-17 inflammatory cytokine levels.
    CONCLUSIONS: Our results suggest that the GI tract and its microbes are involved in the modulation of CHIKV infection, which could serve as an indicator for the adjuvant treatment of CHIKV infection. Video Abstract.
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  • 文章类型: Journal Article
    这项研究旨在表征临床结果,安全,腔内金属支架(LAMS)治疗良性胃肠狭窄的疗效。
    对2017年6月至2023年7月因良性狭窄而接受LAMS放置的所有患者进行单中心回顾性审查。主要结果是技术上的成功,早期临床成功,晚期临床成功(LCS),和持续的后LAMS临床成功(SPLCS)。次要结果包括支架停留时间,狭窄改变,不良事件,再干预率,和症状学评估。
    35例患者接受了42例LAMS的放置(74%为女性,平均年龄:54.2±11.7岁)。吻合口狭窄占病例的64%(N=27,胃空肠吻合术占45%)。性病中位数为91.0天(四分位距[IQR]:55.0-132.0)。在所有情况下都获得了技术成功。80%的病例获得了早期临床成功和LCS。在45%(n=15)的病例中实现了SPLCS。总体再干预率为63%,再次干预的中位时间为50.5天(IQR:24-105)。不良事件总体发生率为28%(n=12),具有24%的迁移率(n=10)。83%的病例完成了随访,中位持续时间为629天(范围:192.0-1297.0)。在留置LAMS期间,症状总体改善为79%(n=27),而在取出后30天和60天时为58%和56%,分别。
    良性胃肠狭窄的LAMS与较高的技术和早期临床成功率/LCS率相关,积极的生活质量指标,和可耐受的不良事件发生率。总的来说,LAMS摘除后症状复发和高再干预率增加了治疗良性胃肠道狭窄的难度,但在部分病例中也主张LAMS是一种确定的治疗方法.
    UNASSIGNED: This study aimed to characterize the clinical outcomes, safety, and efficacy of lumen-apposing metal stents (LAMS) in treating benign gastrointestinal strictures.
    UNASSIGNED: A single-center retrospective review of all patients who underwent LAMS placement for benign strictures from June 2017 to July 2023. Primary outcomes were technical success, early clinical success, late clinical success (LCS), and sustained post-LAMS clinical success (SPLCS). Secondary outcomes included stent dwell time, stenosis changes, adverse events, reintervention rates, and symptomatology evaluation.
    UNASSIGNED: Thirty-five patients underwent placement of 42 LAMS (74% female, mean age: 54.2 ± 11.7 years). Anastomotic strictures accounted for 64% of cases (N = 27, 45% at the gastrojejunal anastomosis). The median STD was 91.0 days (interquartile range [IQR]: 55.0-132.0). Technical success was obtained in all cases. Early clinical successand LCS were achieved in 80% of cases overall. SPLCS was achieved in 45% (n = 15) of cases. The overall reintervention rate was 63%, with a median time to reintervention being 50.5 days (IQR: 24-105). adverse events occurred in 28% (n = 12) overall, with a 24% migration rate (n = 10). Follow-up was completed in 83% of cases with a median duration of 629 days (range: 192.0-1297.0). Overall symptom improvement occurred in 79% (n = 27) during indwelling LAMS versus 58% and 56% at 30- and 60-days post-removal, respectively.
    UNASSIGNED: LAMS for benign gastrointestinal strictures are associated with high technical and early clinical success/LCS rates, positive quality-of-life metrics, and a tolerable adverse event rate. Overall, recurrence of symptoms and high reintervention rates post-LAMS removal reinforce the difficulty in managing benign gastrointestinal strictures but also argue for LAMS as a definitive therapy in select cases.
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