Relationship between clinical features and intestinal microbiota in Chinese patients with ulcerative colitis

BACKGROUND Dysbacteriosis may be a crucial environmental factor for ulcerative colitis(UC).Further study is required on microbiota alterations in the gastrointestinal tract of patients with UC for better clinical management and treatment.AIM To analyze the relationship between different clinical features and the intestinal microbiota,including bacteria and fungi,in Chinese patients with UC.METHODS Eligible inpatients were enrolled from January 1,2018 to June 30,2019,and stool and mucosa samples were collected.UC was diagnosed by endoscopy,pathology,Mayo Score,and Montreal classification.Gene amplicon sequencing of 16S rRNA gene and fungal internal transcribed spacer gene was used to detect the intestinal microbiota composition.Alpha diversity,principal component analysis,similarity analysis,and Metastats analysis were employed to evaluate differences among groups.RESULTS A total of 89 patients with UC and 33 non-inflammatory bowel disease(IBD)controls were enrolled.For bacterial analysis,72 stool and 48 mucosa samples were obtained from patients with UC and 21 stool and 12 mucosa samples were obtained from the controls.For fungal analysis,stool samples were obtained from 43 patients with UC and 15 controls.A significant difference existed between the fecal and mucosal bacteria of patients with UC.Theα-diversity of intestinal bacteria and the relative abundance of some families,such as Lachnospiraceae and Ruminococcaceae,decreased with the increasing severity of bowel inflammation,while Escherichia-Shigella showed the opposite trend.More intermicrobial correlations in UC in remission than in active patients were observed.The bacteriafungi correlations became single and uneven in patients with UC.CONCLUSION The intestinal bacteria flora of patients with UC differs significantly in terms of various sample types and disease activities.The intermicrobial correlations change in patients with UC compared with non-IBD controls.

Percutaneous aspiration and sclerotherapy of a giant simple hepatic cyst causing obstructive jaundice:A case report and review of literature

BACKGROUND Giant simple hepatic cysts causing intrahepatic duct dilatation and obstructive jaundice are uncommon.A variety of measures with different clinical efficacies and invasiveness have been developed.Nonsurgical management,such as percutaneous aspiration and sclerotherapy,is often applied.CASE SUMMARY The case is a 39-year-old female with a 5-mo history of cutaneous and scleral icterus,loss of appetite,and dark urine.Lab tests showed jaundice and liver function abnormalities.Imaging revealed a giant simple hepatic cyst obstructing the intrahepatic bile ducts.A combination of percutaneous catheter aspiration and lauromacrogol sclerotherapy was successfully performed and the effects were satisfactory with the size of cyst decreasing from 13.7 cm×13.1 cm to 3.0 cm×3.0 cm.Further literature review presented the challenges of managing giant simple hepatic cysts that cause obstructive jaundice and compared the safety and efficacy of a combination of percutaneous aspiration and lauromacrogol sclerotherapy with other management strategies.CONCLUSION Giant simple hepatic cysts can cause obstructive jaundice,and a combination of percutaneous catheter aspiration and sclerotherapy with lauromacrogol are suggested to treat such cases.

Polyp recurrence after colonoscopic polypectomy

Colorectal cancer(CRC)is the third most commonly diagnosed malignant tumor in the world.The past few years have seen a remarkable increase in both incidence and mortality of CRC in developing countries like China,posing a serious threat to human health.It is currently believed that about 70%of colorectal cancers are derived from conventional adenomas and 30%are derived from serrated adenomas.[1]As reported,CRC incidence rates per 10,000 person-years were 20.0 for advanced adenoma and 9.1 for non-advanced adenoma.[2]Colonoscopy,as an important tool for CRC screening and follow-up,can prevent the development of CRC by detecting and removing precancerous lesions,thereby effectively reducing the incidence and mortality.Current guidelines for post-polypectomy surveillance mostly recommend a 3-to 10-year interval according to baseline risk stratification.[3]However,there is no such guideline in China yet and doctors tend to perform the next colonoscopy within 1 year,which is much shorter than current international recommendations.