The high incidence,mortality,and disability associated with ischemic stroke pose a significant threat to human health.The intestinal microbiota significantly influences the onset,progression,and prognosis of ischemic ...The high incidence,mortality,and disability associated with ischemic stroke pose a significant threat to human health.The intestinal microbiota significantly influences the onset,progression,and prognosis of ischemic stroke.Gut flora plays a pivotal role in brain-gut interactions.The reflection of changes in the gut and brain caused by gut microbes faciltates the investigation of early warning biomarkers and potential therapeutic targets for ischemic stroke.In this narrative review of the relationship between gut microbiota and ischemic stroke,we primarily discuss three topics,grounded in real-world human and animal studies.First,we examined the relationship between ischemic stroke and intestinal microbiota and its metabolites,delineate the overall characteristics of intestinal microbiota dysregulation in ischemic stroke,and assess the potential clinical value,prevailing research controversies,and unique phenomena of intestinal microbiota metabolites such as trimethylamine N-oxide and short-chain fatty acids in ischemic stroke.Second,we explored the potential communication pathways between intestinal flora and ischemic stroke based on the brain-gut axis,encompassing metabolic pathways,immune pathways,and neural pathways.Finally,we encapsulated the factors influencing the severity of ischemic stroke via intestinal flora,the pharmacological and nonpharmacological interventions that modulate intestinal flora in treating ischemic stroke,and the current research landscape of intestinal flora in the context of ischemic stroke sequelae.展开更多
Background:Spontaneous intracerebral hemorrhage(SICH)has high morbidity and mortality,with no clear standard of treatment available.Compared with the craniotomy approach,neuroendoscopy is a relatively minimally invasi...Background:Spontaneous intracerebral hemorrhage(SICH)has high morbidity and mortality,with no clear standard of treatment available.Compared with the craniotomy approach,neuroendoscopy is a relatively minimally invasive treatment method,and may be an efficient alternative.Therefore,this meta-analysis aimed to assess the clinical efficacy of neuroendoscopy and craniotomy in SICH patients.Methods:The electronic databases Web of Science,PubMed,EmBase,MEDLINE,and the Cochrane Library were systematically searched.According to the PRISMA template,we finally selected and analyzed 14 eligible studies that evaluated neuroendoscopy versus craniotomy.Primary outcomes included operation time,intraoperative blood loss volume,evacuation rate,residual hematoma,complications,hospital stay duration,clinical outcomes,and other parameters.Results:A total of 4 randomized controlled trials(RCTs)and 10 retrospective studies(non-RCTs)involving 1652 patients were included in the final analysis.In the neuroendoscopy(NE)group,operation time(p<0.00001),intraoperative blood loss volume(p<0.0001),hematoma evacuation rate(p=0.0002),complications(p<0.00001),hospitalization days(p=0.004),and mortality(p<0.0001)were significantly different from those of the craniotomy(C)group,with a higher rate of good recovery compared with the craniotomy group(P<0.00001).Conclusions:These findings suggest that patients with SICH and physicians may benefit more from neuroendoscopic surgery than craniotomy.展开更多
基金National Natural Science Foundationof China,Grant/Award Numbers:81901173,82060231,82360252National Natural Science Foundation Cultivation Projectof Affiliated Hospital of Guizhou Medical University,Grant/Award Number:2022-08+1 种基金Guizhou Province Department of Science and Technology,Grant/Award Number:Qian Ke He JiChu-ZK-[2023]-Key 039Doctoral Research Start-up Fund,Grant/Award Number:gytybsky-2021-6。
文摘The high incidence,mortality,and disability associated with ischemic stroke pose a significant threat to human health.The intestinal microbiota significantly influences the onset,progression,and prognosis of ischemic stroke.Gut flora plays a pivotal role in brain-gut interactions.The reflection of changes in the gut and brain caused by gut microbes faciltates the investigation of early warning biomarkers and potential therapeutic targets for ischemic stroke.In this narrative review of the relationship between gut microbiota and ischemic stroke,we primarily discuss three topics,grounded in real-world human and animal studies.First,we examined the relationship between ischemic stroke and intestinal microbiota and its metabolites,delineate the overall characteristics of intestinal microbiota dysregulation in ischemic stroke,and assess the potential clinical value,prevailing research controversies,and unique phenomena of intestinal microbiota metabolites such as trimethylamine N-oxide and short-chain fatty acids in ischemic stroke.Second,we explored the potential communication pathways between intestinal flora and ischemic stroke based on the brain-gut axis,encompassing metabolic pathways,immune pathways,and neural pathways.Finally,we encapsulated the factors influencing the severity of ischemic stroke via intestinal flora,the pharmacological and nonpharmacological interventions that modulate intestinal flora in treating ischemic stroke,and the current research landscape of intestinal flora in the context of ischemic stroke sequelae.
文摘Background:Spontaneous intracerebral hemorrhage(SICH)has high morbidity and mortality,with no clear standard of treatment available.Compared with the craniotomy approach,neuroendoscopy is a relatively minimally invasive treatment method,and may be an efficient alternative.Therefore,this meta-analysis aimed to assess the clinical efficacy of neuroendoscopy and craniotomy in SICH patients.Methods:The electronic databases Web of Science,PubMed,EmBase,MEDLINE,and the Cochrane Library were systematically searched.According to the PRISMA template,we finally selected and analyzed 14 eligible studies that evaluated neuroendoscopy versus craniotomy.Primary outcomes included operation time,intraoperative blood loss volume,evacuation rate,residual hematoma,complications,hospital stay duration,clinical outcomes,and other parameters.Results:A total of 4 randomized controlled trials(RCTs)and 10 retrospective studies(non-RCTs)involving 1652 patients were included in the final analysis.In the neuroendoscopy(NE)group,operation time(p<0.00001),intraoperative blood loss volume(p<0.0001),hematoma evacuation rate(p=0.0002),complications(p<0.00001),hospitalization days(p=0.004),and mortality(p<0.0001)were significantly different from those of the craniotomy(C)group,with a higher rate of good recovery compared with the craniotomy group(P<0.00001).Conclusions:These findings suggest that patients with SICH and physicians may benefit more from neuroendoscopic surgery than craniotomy.
