腹盆腔巨大多发黏液乳头型室管膜瘤合并肠梗阻一例

黏液乳头型室管膜瘤(myxopapillary ependymomas,MPEs)是一类常见于脊髓圆锥、马尾、终丝的中枢神经系统疾病,其在1932年被首次提出,约占所有室管膜瘤的13%,可发生于任何年龄段^([1-2])。多年来有报道其可起源于骶骨及骶尾部皮下等椎管外部位的病例,但肿瘤广泛浸润腹盆腔则十分罕见,其与椎管内MPEs的发病机制及临床特征均存在差异^([3-4])。因此本文总结报道2021年7月同济大学附属第十人民医院腹部外科疑难诊治中心收治的1例腹盆腔巨大多发黏液乳头型室管膜瘤合并不完全性肠梗阻的病例,旨在为腹盆腔疑难肿瘤以及椎管外MPEs的诊治提供参考。

Dysbiosis of gut microbiota was closely associated with psoriasis

Psoriasis is an autoimmune disease and gut microbiota participate in the establishment of intestinal immunity. This study was performed to identify the fecal microbial composition of psoriasis patients, and investigated the influence of subgroup(type and severity) on the fecal microbial composition, and to define the key microbiota in the pathogenesis of psoriasis. Fecal samples from 35 psoriasis patients and 27 healthy controls were sequenced by 16 S rRNA and then analyzed by informatics methods. We found that the microbiota of the psoriasis group differed from that of the heathy group. The relative abundances of Firmicutes and Bacteroidetes were inverted at the phylum level, and 16 kinds of phylotype at the genus level were found with significant difference. No microbial diversity and composition alteration were observed among the four types of psoriasis. The microbiota of psoriasis patients in the severe state differs from those of psoriasis patients with more mild conditions and also the healthy controls. The veillonella in fecal microbiota showed a positive relationship with h-CRP in blood. This research proved that psoriasis patients have a significant disturbed microbiota profiles. Further study of psoriasis based on microbiota may provide novel insights into the pathogenesis of psoriasis and more evidence for the prevention and treatment of psoriasis.

Alterations in intestinal microbiota of colorectal cancer patients receiving radical surgery combined with adjuvant CapeOx therapy

An intricate relationship exists and interactions occur between gut microbiota and colorectal cancer(CRC).Radical surgery combined with adjuvant chemotherapy(AC) serves as the mainstream therapeutic scheme for most CRC patients.The current research was conducted to assess the effect of surgery or chemotherapy on gut microbiota.Forty-three CRC patients who received radical surgery and AC were enrolled.Fecal samples were collected preoperatively,postoperatively,and after the first to fifth cycles of postoperative chemotherapy.The microbial community of each sample was analyzed using high throughput 16S rRNA amplicon sequencing.Compared with preoperative samples,fecal samples collected postoperatively exhibited a significant decrease of obligate anaerobes,tumor-related bacteria,and butyric acid-producing bacteria.However,a significant increase of some conditional pathogens was observed.In addition,the AC regimen(CapeOx) was found to alter intestinal microbiota dramatically.In particular,several changes were observed after chemotherapy including an increase of pathogenic bacteria,the "rebound effect" of chemotherapy-adapted bacteria,the shift of lactate-utilizing microbiota from Veillonella to Butyricimonas and Butyricicoccus,as well as the decrease of probiotics.Both radical surgery and CapeOx chemotherapy exert a non-negligible effect on the gut microbiota of CRC patients.Microbiota-based intervention may be beneficial for patients during postoperative clinical management.

Ketogenic diet alleviates colitis by reduction of colonic group 3 innate lymphoid cells through altering gut microbiome

Accumulating evidence suggests that ketogenic diets(KDs)mediate the rise of circulating ketone bodies and exert a potential antiinflammatory effect;however,the consequences of this unique diet on colitis remain unknown.We performed a series of systematic studies using a dextran sulfate sodium(DSS)animal model of inflammatory colitis.Animals were fed with a KD,low-carbohydrate diet(LCD),or normal diet(ND).Germ-free mice were utilized in validation experiments.Colon tissues were analyzed by transcriptome sequencing,RT2 profiler PCR array,histopathology,and immunofluorescence.Serum samples were analyzed by metabolic assay kit.Fecal samples were analyzed by 16S rRNA gene sequencing,liquid chromatography-mass spectrometry and gas chromatography-mass spectrometry.We observed that KD alleviated colitis by altering the gut microbiota and metabolites in a manner distinct from LCD.Quantitative diet experiments confirmed the unique impact of KD relative to LCD with a reproducible increase in Akkermansia,whereas the opposite was observed for Escherichia/Shigella.After colitis induction,the KD protected intestinal barrier function,and reduced the production of R0Ryt+CD3_group 3 innate lymphoid cells(ILC3s)and related inflammatory cytokines(IL-17a,IL-18,IL-22,Ccl4).Finally,fecal microbiota transplantation into germ-free mice revealed that the KD-mediated colitis inhibition and ILC3 regulation were dependent on the modification of gut microbiota.Taken together,our study presents a global view of microbiome-metabolomics changes that occur during KD colitis treatment,and identifies the regulation of gut microbiome and ILC3s as novel targets involving in IBD dietary therapy.

Fluid balance in major abdominal surgery deserves more exploration

Professor Myles and his team have published their latest study entitled"Restrictive versus Liberal Fluid Therapy for Major Abdominal Surgery"in the New England Journal of Medicine(1).This international study enrolled 2,983 patients undergoing major abdominal surgery in seven countries.