Efficacy and safety of fecal microbiota transplantation for treatment of ulcerative colitis:A post-consensus systematic review and metaanalysis

BACKGROUND Numerous studies have assessed the efficacy and safety of fecal microbiota transplantation(FMT)as a therapy for ulcerative colitis(UC).However,the treatment processes and outcomes of these studies vary.AIM To evaluate the efficacy and safety of FMT for treating UC by conducting a systematic meta-analysis.METHODS The inclusion criteria involved reports of adult patients with UC treated with FMT,while studies that did not report clinical outcomes or that included patients with infection were excluded.Clinical remission(CR)and endoscopic remission(ER)were the primary and secondary outcomes,respectively.RESULTS We included nine studies retrieved from five electronic databases.The FMT group had better CR than the control group[relative risk(RR)=1.53;95%confidence interval(CI):1.19-1.94;P<0.0008].ER was statistically significantly different between the two groups(RR=2.80;95%CI:1.93-4.05;P<0.00001).Adverse events did not differ significantly between the two groups.CONCLUSION FMT demonstrates favorable performance and safety;however,well-designed randomized clinical trials are still needed before the widespread use of FMT can be recommended.Furthermore,standardizing the FMT process is urgently needed for improved safety and efficacy.

New cancer suppressor gene for colorectal adenocarcinoma:Filamin A

AIM:To determine the expression and significance of filamin A(FLNa)in colorectal adenocarcinoma tissue.METHODS:The expression of FLNa in 46 colorectal cancer tissues and normal tissues was detected by immunohistochemistry,reverse transcription polymerase chain reaction(RT-PCR)and Western blotting,and its relationship with clinical parameters and prognosis was analyzed.RESULTS:The positive expression of FLNa in cancer tissues was lower than that in normal mucosa,and the difference was statistically significant.The expression of FLNa correlated with liver metastasis,lymph node metastasis and rectal invasion depth,regardless of sex,age,tumor location,tumor size,gross shape and histological type of colorectal carcinoma.Multivariate analysis showed that FLNa was an independent risk factor for postoperative survival of patients with colorectal adenocarcinoma.Moreover,survival analysis showed that the expression level of FLNa was closely related with survival of patients with colorectal adenocarcinoma.The results of RT-PCR and Western blotting were consistent with those of immunohistochemistry.CONCLUSION:FLNa showed low expression in colorectal adenocarcinoma,high correlation with the incidence and development of colorectal cancer,and was considered an indicator of prognosis.

Low concentration of sodium hyaluronate temporarily elevates the tear film lipid layer thickness in dry eye patients with lipid deficiency

AIM： To investigate the effects of different concentrations of artificial tears on lipid layer thickness （LLT） and blink rate （BR） in dry eye patients. METHODS： This study included 106 eyes of 58 patients with dry eye. The lipid deficiency type was defined as the LLT baseline 〈75 nm. The LLT and BR were measured at baseline and 1, 5 and 15min after the instillation of 0.1% or 0.3% sodium hyaluronate （SH） eye drops by using the LipiView ocular surface interferometer. RESULTS： In the lipid deficiency group, the LLT increased from baseline at 1rain post instillation. The LLT after the instillation of 0.1% SH was significantly higher than that after the instillation of 0.3% SH （P〈0.001）. The LLT returned to baseline at 15min post instillation of 0.1% SH and at 5min post instillation of 0.3% SH. In the non-lipid deficiency group, the LLT decreased from baseline at lmin and returned to baseline at 5rain for both treatments. The BRs were not significantly different at different time points for both treatments. CONCLUSION： SH eye drops induce a short-term increase in LLT of patients with lipid deficiency. A low concentration of artificial tears have a stronger effect than a high concentration of artificial tears on the increase in LLT. in comparison, SH eye drops induce a transient and slight decrease in LLT of patients without lipid deficiency. A low concentration of artificial tears might be better for patients with lipid deficiency.

Lipid layer thickness and tear meniscus height measurements for the differential diagnosis of evaporative dry eye subtypes

AIM： To explore a new diagnostic index for differentiating the evaporative dry eye（EDE） subtypes by analysis of their respective clinical characteristics. METHODS： A cross-sectional study of 139 patients（139 eyes） with EDE who were enrolled and classified as obstructive meibomian gland dysfunction（MGD）（n=81） and non-obstructive MGD（n=58） EDE. All patients completed a Standard Patient Evaluation of Eye Dryness（SPEED） questionnaire and were evaluated for average lipid layer thickness（LLT）, tear meniscus height measurements（TMH）, tear break-up time（TBUT）, ocular surface staining score, Schirmer I test（SIT）, lid margin abnormalities, and meibomian gland function and morphology. RESULTS： Age, average LLT, TMH, scores of lid margin abnormalities, meibum quality, meibomian gland loss（MGL）（all P≤0.001）, and TBUT（P=0.03） were all significantly different between obstructive MGD EDE patients and nonobstructive MGD EDE patients. Average LLT in obstructive MGD EDE was correlated with meibomian expressibility（r=-0.541, P≤0.001）, lid margin abnormalities were marginally not significant（r=0.197, P=0.077）, and TMH was correlated with MGL（total MGL： r=0.552, P≤0.001; upper MGL： r=0.438, P≤0.001; lower MGL： r=0.407, P≤0.001）. Average LLT in non-obstructive MGD EDE, was correlated with meibomian expressibility and Oxford staining（r=-0.396, P=0.002; r=-0.461, P≤0.001）. The efficiency of combining average LLT and TMH was optimal, with a sensitivity of 80.2% and a specificity of 74.1%. Obstructive MGD EDE patients had an average LLT≥69 nm and TMH≥0.25 mm, while non-obstructive MGD EDE patients had an average LLT〈69 nm and TMH〈0.25 mm.CONCLUSION： Obstructive MGD EDE and nonobstructive MGD EDE have significantly different clinical characteristics. Combining average LLT and TMH measurements enhanced their reliability for differentiating these two subtypes and provided guidance for offering more precise treatments for EDE subtypes.

State-Dependent Topological Invariants and Anomalous Bulk-Boundary Correspondence in Non-Hermitian Topological Systems with Generalized Inversion Symmetry

Breakdown of bulk-boundary correspondence in non-Hermitian(NH)topological systems with generalized inversion symmetries is a controversial issue.The non-Bloch topological invariants determine the existence of edge states,but fail to describe the number and distribution of defective edge states in non-Hermitian topological systems.The state-dependent topological invariants,instead of a global topological invariant,are developed to accurately characterize the bulk-boundary correspondence of the NH systems,which is very different from their Hermitian counterparts.At the same time,we obtain the accurate phase diagram of the one-dimensional non-Hermitian Su–Schrieffer–Heeger model with a generalized inversion symmetry from the state-dependent topological invariants.Therefore,these results will be helpful for understanding the exotic topological properties of various non-Hermitian systems.