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Fecal microbiota in pouchitis and ulcerative colitis

World Journal of Gastroenterology 2016年第40期22卷 8929-8939页

作者： Kai-Yu Li Jian-Lin Wang Jiang-Peng Wei Sen-Yang Gao Ying-Ying Zhang Li-Tian Wang Gang Liu Department of General Surgery Tianjin Medical University General Hospital Department of General Surgery Tianjin NanKai Hospital

AIM To investigate the changes in microbiota in feces of patients with ulcerative colitis(UC) and pouchitis using genomic *** Fecal samples were obtained from UC patients with or without an ileal pouch-anal anastomosis(IPAA) procedure, as well as healthy controls. The touchdown polymerase chain reaction technique was used to amplify the whole V3 region of the 16 S r RNA gene, which was transcribed from DNA extracted from fecal samples. Denaturing gradient gel electrophoresis was used to separate the amplicons. The band profiles and similarity indices were analyzed digitally. The predominant microbiota in different groups was confirmed by sequencing the 16 S rR NA gene. RESULTS Microbial biodiversity in the healthy controls was significantly higher compared with the UC groups(P < 0.001) and IPAA groups(P < 0.001). Compared with healthy controls, the UC patients in remission and those in the mildly active stage, the predominant species in patients with moderately and severely active UC changed obviously. In addition, the proportion of the dominant microbiota, which was negatively correlated with the disease activity of UC(r =-6.591, P < 0.01),was decreased in pouchitis patients. The numbers of two types of bacteria, Faecalibacterium prausnitzii and Eubacterium rectale, were reduced in UC. Patients with pouchitis had an altered microbiota composition compared with UC patients. The microbiota from pouchitis patients was less diverse than that from severely active UC patients. Sequencing results showed that similar microbiota, such as Clostridium perfringens, were shared in both UC and *** Less diverse fecal microbiota was present in patients with UC and pouchitis. Increased C. perfringens in feces suggest its role in the exacerbation of UC and pouchitis.

关键词： Pouchitis Intestinal flora Ulcerative colitis Disease activity index Ileal pouch-anal anastomosis

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Enteral nutrition combined with glutamine promotes recovery after ileal pouch-anal anastomosis in rats

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World Journal of Gastroenterology 2018年第5期24卷 583-592页

作者： Yan-Yan Xu An-Qi He Gang Liu Kai-Yu Li Jian Liu Tong Liu Department of General Surgery Tianjin Medical University General Hospital

AIM To assess the effect of enteral nutrition(EN) supplemented with glutamine on recovery after ileal pouch-anal anastomosis(IPAA) in rats, to provide an experimental basis for nutritional support in patients with ulcerative colitis(UC) after IPAA. METHODS Male Sprague-Dawley(SD) rats were randomly divided into three groups(n = 8) after IPAA operation using a microsurgical technique. From the third postoperative day, rats in the control group, EN group, and immune nutrition(IN) group were fed standard rat chow, short peptide EN, and short peptide EN combined with glutamine ad libitum, respectively. The rats' general condition was observed throughout the study. Serum levels of total protein(TP), albumin(ALB), prealbumin(PA), and transferrin(TF) were detected on the 30 th postoperative day, using an automatic biochemical analyzer. The ileal pouch mucosa was stained with hematoxylin and eosin(HE), and occludin protein levels were detected by *** The body weight of rats in the EN group(359.20 ± 10.06 g) was significantly higher than that in the control group(344.00 ± 9.66 g)(P 0.05 for all). CONCLUSION EN combined with glutamine may effectively improve nutritional status after IPAA. Our results suggest a benefit of glutamine supplementation in EN for UC patients undergoing IPAA, although human st

关键词： Enteral nutrition Glutamine Ileal pouchanal anastomosis Nutritional status Recovery

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Lactobacillus acidophilus alleviates pouchitis after ileal pouch-anal anastomosis in rats

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World Journal of Gastroenterology 2017年第26期23卷 4735-4743页

作者： Yan-Yan Xu Ying-Ying Zhang An-Qi He Kai-Yu Li Sen-Yang Gao Gang Liu Department of General Surgery Tianjin Medical University General Hospital

AIM To assess the therapeutic potential of Lactobacillus acidophilus(LA) for the treatment of pouchitis in a rat *** Sprague Dawley rats underwent proctocolectomy and ileal pouch-anal anastomosis followed by administration of dextran sulfate sodium(DSS) to induce pouchitis. Rats with pouchitis were randomly divided into three groups: no intervention(NI), normal saline(NS, 3 m L/d normal saline for 7 d), and LA(3 m L/d LA at 1× 1010 colony-forming units for 7 d). General body condition was recorded and pouch specimens were obtained for histological examination. m RNA expression levels of interleukin(IL)-1β, IL-6, IL-10, and tumor necrosis factor-α were determined by RT-PCR. Zonula occludens protein 1(ZO-1) levels were measured by immunohistochemistry. RESULTS LA reduced weight loss associated with pouchitis(P < 0.05) and improved the symptoms of pouchitis in rats. Compared with the NI and NS groups, rats in the LAgroup showed earlier disappearance of hematochezia(6.17 ± 0.75, 6.50 ± 0.55, 3.17 ± 0.75, P < 0.05) and higher fecal scores(2.67 ± 0.48, 2.50 ± 0.51, 4.42 ± 0.50, respectively, P < 0.05). Histological scores were also lower in the LA group compared with the other two groups(7.17 ± 0.98, 8.00 ± 0.89, 4.00 ± 0.89, respectively, P < 0.05). m RNA expression levels of IL-1β, IL-6, and tumor necrosis factor-α were significantly reduced, while IL-10 m RNA levels were significantly increased in the LA group(P < 0.05, respectively). ZO-1 protein levels were also significantly increased after administration of LA(P < 0.05). CONCLUSION LA alleviates pouchitis induced by DSS after ileal pouchanal anastomosis by decreasing pro-inflammatory factors and increasing anti-inflammatory factors, and restoring ZO-1 expression in the mucosa.

关键词： Lactobacillus acidophilus Pouchitis Ileal pouch-anal anastomosis Dextran sulfate sodium Rats

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赋能干预对溃疡性结肠炎术后疗效影响研究

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中国实用外科杂志 2016年第11期36卷 1220-1223页

作者：高森阳张迎迎李凯钰胡芳刘刚天津医科大学总医院普外科天津300052

目的探讨赋能干预对溃疡性结肠炎(UC)病人全结直肠切除回肠贮袋肛管吻合术(IPAA)后肛门功能及生活质量影响。方法选取2010年1月至2014年9月天津医科大学总医院普外科收治的行IPAA的UC病人60例,采用随机数字表法将病人分为干预组(30例)... 详细信息

目的探讨赋能干预对溃疡性结肠炎(UC)病人全结直肠切除回肠贮袋肛管吻合术(IPAA)后肛门功能及生活质量影响。方法选取2010年1月至2014年9月天津医科大学总医院普外科收治的行IPAA的UC病人60例,采用随机数字表法将病人分为干预组(30例)和对照组(30例),分别接受赋能干预和传统健康指导。干预6个月后,以24 h和夜间便次及Kirwan分级评价术后肛门自制功能,Bristol粪便分类法评定粪便性状;于干预前及干预6个月后,采用血浆中血清总蛋白(TP)、前白蛋白(PA)、白蛋白(ALB)及转铁蛋白(TRF)的水平评估病人的营养状况,采用IBDQ问卷评估生活质量。结果赋能6个月后,干预组病人24 h和夜间便次均优于对照组,差异有统计学意义[24 h:(4.3±1.5)次vs.(5.9±2.4)次;夜间:(1.6±0.7)次vs.(2.3±1.3)次,均P0.05)。干预组病人Bristol大便分类4类20例、5类6例、6类4例,对照组4类11例、5类17例、6类2例,差异有统计学意义(χ2=8.540,P<0.05)。营养状况方面,干预组病人ALB水平高于对照组[(47.4±5.8)g/L vs.(43.3±6.5)g/L,P<0.05)];IBDQ问卷得分方面,干预组在肠道症状、全身症状等维度均高于对照组,差异有统计学意义(均P<0.05)。结论赋能干预可以改善UC病人IPAA后肛门功能及粪便性状,提高其生活质量。

关键词：溃疡性结肠炎全结直肠切除回肠贮袋肛管吻合术赋能生活质量肛门功能

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miRNA在炎症性肠病中的研究进展

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中华结直肠疾病电子杂志 2017年第3期6卷 230-233页

作者：王力田杨立胜刘刚天津医科大学总医院普通外科 300052

炎症性肠病(IBD)为一类反复发作的肠道慢性非特异性炎性疾病,主要包括溃疡性结肠炎(UC)和克罗恩病(CD)。其病因及发病机制目前尚不明确,可能与多种因素有关。近年研究发现microRNA(miRNA)在IBD患者中表达异常,可能参与IBD的发生、发展... 详细信息

炎症性肠病(IBD)为一类反复发作的肠道慢性非特异性炎性疾病,主要包括溃疡性结肠炎(UC)和克罗恩病(CD)。其病因及发病机制目前尚不明确,可能与多种因素有关。近年研究发现microRNA(miRNA)在IBD患者中表达异常,可能参与IBD的发生、发展。本文就IBD患者特异性miRNA表达异常的研究进展作一综述,旨在探讨miRNA在IBD发病机制、诊断和预后判断中的价值,为其临床应用提供依据。

关键词：消化系统结肠炎,溃疡性 Crohn病 microRNA

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益生菌治疗贮袋炎的研究进展

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中华结直肠疾病电子杂志 2017年第1期6卷 60-63页

作者：高森阳刘刚天津医科大学总医院普外科 300052

贮袋炎是中重度溃疡性结肠炎患者全结直肠切除回肠贮袋肛管吻合术后的常见并发症,临床表现为便次增多、便血、腹痛、发热等,目前其病因及发病机制尚未明确,但大多数学者认为贮袋菌群的改变(失调)导致了免疫激活和炎症的发生。因此,针对... 详细信息

贮袋炎是中重度溃疡性结肠炎患者全结直肠切除回肠贮袋肛管吻合术后的常见并发症,临床表现为便次增多、便血、腹痛、发热等,目前其病因及发病机制尚未明确,但大多数学者认为贮袋菌群的改变(失调)导致了免疫激活和炎症的发生。因此,针对其菌群改变应用益生菌治疗贮袋炎成为国内外学者日益关注的课题,本文就贮袋炎的发病机制及益生菌治疗贮袋炎的现状做如下综述。

关键词：消化系统治疗贮袋炎全结直肠切除回肠贮袋肛管吻合术益生菌

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