BACKGROUND Portal vein thrombosis(PVT)is a condition caused by hemodynamic disorders.It may be noted in the portal vein system when there is an inflammatory stimulus in the abdominal cavity.However,PVT is rarely repor...BACKGROUND Portal vein thrombosis(PVT)is a condition caused by hemodynamic disorders.It may be noted in the portal vein system when there is an inflammatory stimulus in the abdominal cavity.However,PVT is rarely reported after hepatectomy.At present,related guidelines and major expert opinions tend to consider vitamin K antagonists or low-molecular weight heparin(LMWH)as the standard treatment.But based on research,direct oral anticoagulants may be more effective and safe for noncirrhotic PVT and are also beneficial by reducing the recurrence rate of PVT.CASE SUMMARY A 51-year-old woman without any history of disease felt discomfort in her right upper abdomen for 20 d,with worsening for 7 d.Contrast-enhanced computed tomography(CECT)of the upper abdomen showed right liver intrahepatic cholangiocarcinoma with multiple intrahepatic metastases but not to the left liver.Therefore,she underwent right hepatic and caudate lobectomy.One week after surgery,the patient underwent a CECT scan,due to nausea,vomiting,and abdominal distension.Thrombosis in the left branch and main trunk of the portal vein and near the confluence of the splenic vein was found.After using LMWH for 22 d,CECT showed no filling defect in the portal vein system.CONCLUSION Although PVT after hepatectomy is rare,it needs to be prevented during the perioperative period.展开更多
Morinda officinalis oligosaccharides(MOO) are an oral drug approved in China for the treatment of depression in China. However, MOO is hardly absorbed so that their anti-depressant mechanism has not been elucidated. H...Morinda officinalis oligosaccharides(MOO) are an oral drug approved in China for the treatment of depression in China. However, MOO is hardly absorbed so that their anti-depressant mechanism has not been elucidated. Here, we show that oral MOO acted on tryptophan → 5-hydroxytryptophan(5-HTP) → serotonin(5-HT) metabolic pathway in the gut microbiota. MOO could increase tryptophan hydroxylase levels in the gut microbiota which accelerated 5-HTP production from tryptophan;meanwhile, MOO inhibited 5-hydroxytryptophan decarboxylase activity, thus reduced 5-HT generation,and accumulated 5-HTP. The raised 5-HTP from the gut microbiota was absorbed to the blood, and then passed across the blood-brain barrier to improve 5-HT levels in the brain. Additionally, pentasaccharide,as one of the main components in MOO, exerted the significant anti-depressant effect through a mechanism identical to that of MOO. This study reveals for the first time that MOO can alleviate depression via increasing 5-HTP in the gut microbiota.展开更多
文摘BACKGROUND Portal vein thrombosis(PVT)is a condition caused by hemodynamic disorders.It may be noted in the portal vein system when there is an inflammatory stimulus in the abdominal cavity.However,PVT is rarely reported after hepatectomy.At present,related guidelines and major expert opinions tend to consider vitamin K antagonists or low-molecular weight heparin(LMWH)as the standard treatment.But based on research,direct oral anticoagulants may be more effective and safe for noncirrhotic PVT and are also beneficial by reducing the recurrence rate of PVT.CASE SUMMARY A 51-year-old woman without any history of disease felt discomfort in her right upper abdomen for 20 d,with worsening for 7 d.Contrast-enhanced computed tomography(CECT)of the upper abdomen showed right liver intrahepatic cholangiocarcinoma with multiple intrahepatic metastases but not to the left liver.Therefore,she underwent right hepatic and caudate lobectomy.One week after surgery,the patient underwent a CECT scan,due to nausea,vomiting,and abdominal distension.Thrombosis in the left branch and main trunk of the portal vein and near the confluence of the splenic vein was found.After using LMWH for 22 d,CECT showed no filling defect in the portal vein system.CONCLUSION Although PVT after hepatectomy is rare,it needs to be prevented during the perioperative period.
基金supported by Key Project of Beijing Natural Science Foundation (No.7181007,China)the CAMS Innovation Fund for Medical Sciences (CIFMS+2 种基金Nos.2016-I2M-3-011,20211-I2M-007,2021-I2M-1-027,and 2021-I2M-1-028,China)National Natural Science Foundation of China (Nos.81973290 and 82173888)Beijing Key Laboratory of Non-Clinical Drug Metabolism and PK/PD study (Z141102004414062,China)。
文摘Morinda officinalis oligosaccharides(MOO) are an oral drug approved in China for the treatment of depression in China. However, MOO is hardly absorbed so that their anti-depressant mechanism has not been elucidated. Here, we show that oral MOO acted on tryptophan → 5-hydroxytryptophan(5-HTP) → serotonin(5-HT) metabolic pathway in the gut microbiota. MOO could increase tryptophan hydroxylase levels in the gut microbiota which accelerated 5-HTP production from tryptophan;meanwhile, MOO inhibited 5-hydroxytryptophan decarboxylase activity, thus reduced 5-HT generation,and accumulated 5-HTP. The raised 5-HTP from the gut microbiota was absorbed to the blood, and then passed across the blood-brain barrier to improve 5-HT levels in the brain. Additionally, pentasaccharide,as one of the main components in MOO, exerted the significant anti-depressant effect through a mechanism identical to that of MOO. This study reveals for the first time that MOO can alleviate depression via increasing 5-HTP in the gut microbiota.
