背景:骨质疏松性骨折是骨质疏松症最严重的并发症,既往的研究已经证实了肠道菌群对骨骼组织具有调节作用,肠道菌群与骨质疏松性骨折有着重要关系,但是二者之间的因果关系尚不清楚。目的:使用孟德尔随机化(MR)方法探索肠道菌群与骨质疏...背景:骨质疏松性骨折是骨质疏松症最严重的并发症,既往的研究已经证实了肠道菌群对骨骼组织具有调节作用,肠道菌群与骨质疏松性骨折有着重要关系,但是二者之间的因果关系尚不清楚。目的:使用孟德尔随机化(MR)方法探索肠道菌群与骨质疏松性骨折之间的因果关系。方法:从IEU Open GWAS数据库和芬兰数据库R9中分别获得了肠道菌群和骨质疏松性骨折的GWAS数据集,以肠道菌群作为暴露因素,骨质疏松性骨折作为结局变量,采用随机效应逆方差加权法、MR-Egger回归、加权中位数法、简单模型法以及加权模型法进行孟德尔随机化分析来评估肠道菌群与骨质疏松性骨折之间是否存在因果关系,通过敏感性分析来检验结果的可靠性和稳健性,并进行反向孟德尔随机化分析来进一步验证正向孟德尔随机化分析中确定的因果关系。结果与结论:①此孟德尔随机化分析结果表明,肠道菌群与骨质疏松性骨折之间存在因果关系。放线菌目(OR=1.562,95%CI:1.027-2.375,P=0.037)、放线菌科(OR=1.561,95%CI:1.027-2.374,P=0.037)、放线菌属(OR=1.544,95%CI:1.130-2.110,P=0.006)、丁酸球菌属(OR=1.781,95%CI:1.194-2.657,P=0.005)、粪球菌属-2(OR=1.550,95%CI:1.068-2.251,P=0.021)、Family ⅩⅢ UCG-001属(OR=1.473,95%CI:1.001-2.168,P=0.049)、产甲烷短杆菌属(OR=1.274,95%CI:1.001-1.621,P=0.049)、罗氏菌属(OR=1.429,95%CI:1.015-2.013,P=0.041)的丰度升高,会增加患者骨质疏松性骨折的风险;②拟杆菌纲(OR=0.660,95%CI:0.455-0.959,P=0.029)、拟杆菌目(OR=0.660,95%CI:0.455-0.959,P=0.029)、克里斯滕森氏菌科(OR=0.725,95%CI:0.529-0.995,P=0.047)、瘤胃球菌科(OR=0.643,95%CI:0.443-0.933,P=0.020)、肠杆菌属(OR=0.558,95%CI:0.395-0.788,P=0.001)、直肠真杆菌属(OR=0.631,95%CI:0.435-0.916,P=0.016)、毛螺菌科-UCG008(OR=0.738,95%CI:0.546-0.998,P=0.048)、瘤胃梭菌属-9(OR=0.492,95%CI:0.324-0.746,P=0.001)的丰度升高,会降低患者骨质疏松性骨折的风险。③文章通过孟德尔随机化方法发现了16种与骨质疏松性骨折相关的肠道菌群,即以肠道菌群为暴露因素,骨质疏松性骨折为结局变量,8种肠道菌群与骨质疏松性骨折呈正向因果关联,另外8种肠道菌群与骨质疏松性骨折呈负向因果关联。④此研究结果不仅为临床上骨质疏松性骨折的早期预测及潜在治疗靶点确定了新的生物标志物,还为骨组织工程中研究通过肠道菌群改善骨质疏松性骨折的发生与预后提供了实验基础和理论依据。展开更多
反流性食管炎(RE)是消化系统常见疾病,中医药治疗颇具特色。严光俊教授从医三十余载,治疗脾胃病临证经验丰富,认为RE的病机关键为肝郁,脾虚为病变根本原因,以疏肝健脾,和胃降逆为基本治疗原则,亦重视化瘀通络,身心同治等,临床用药灵活,...反流性食管炎(RE)是消化系统常见疾病,中医药治疗颇具特色。严光俊教授从医三十余载,治疗脾胃病临证经验丰富,认为RE的病机关键为肝郁,脾虚为病变根本原因,以疏肝健脾,和胃降逆为基本治疗原则,亦重视化瘀通络,身心同治等,临床用药灵活,疗效显著。Reflux esophagitis (RE) is a common disease of the digestive system, and Chinese medicine treatment has its own characteristics. Prof. Yan Guangjun has been practicing medicine for more than 30 years and has rich experience in treating spleen and gastric diseases. He believes that the key to the pathogenesis of RE is depression of the liver and deficiency of the spleen as the root cause of the disease, and that the basic treatment principle is to dredge the liver and strengthen the spleen, harmonize with the stomach and reduce the rebelliousness of the stomach, and he also attaches importance to the elimination of blood stasis and opening up of the channels, and treating the body and mind together, and his clinical medicine is flexible and effective.展开更多
文摘背景:骨质疏松性骨折是骨质疏松症最严重的并发症,既往的研究已经证实了肠道菌群对骨骼组织具有调节作用,肠道菌群与骨质疏松性骨折有着重要关系,但是二者之间的因果关系尚不清楚。目的:使用孟德尔随机化(MR)方法探索肠道菌群与骨质疏松性骨折之间的因果关系。方法:从IEU Open GWAS数据库和芬兰数据库R9中分别获得了肠道菌群和骨质疏松性骨折的GWAS数据集,以肠道菌群作为暴露因素,骨质疏松性骨折作为结局变量,采用随机效应逆方差加权法、MR-Egger回归、加权中位数法、简单模型法以及加权模型法进行孟德尔随机化分析来评估肠道菌群与骨质疏松性骨折之间是否存在因果关系,通过敏感性分析来检验结果的可靠性和稳健性,并进行反向孟德尔随机化分析来进一步验证正向孟德尔随机化分析中确定的因果关系。结果与结论:①此孟德尔随机化分析结果表明,肠道菌群与骨质疏松性骨折之间存在因果关系。放线菌目(OR=1.562,95%CI:1.027-2.375,P=0.037)、放线菌科(OR=1.561,95%CI:1.027-2.374,P=0.037)、放线菌属(OR=1.544,95%CI:1.130-2.110,P=0.006)、丁酸球菌属(OR=1.781,95%CI:1.194-2.657,P=0.005)、粪球菌属-2(OR=1.550,95%CI:1.068-2.251,P=0.021)、Family ⅩⅢ UCG-001属(OR=1.473,95%CI:1.001-2.168,P=0.049)、产甲烷短杆菌属(OR=1.274,95%CI:1.001-1.621,P=0.049)、罗氏菌属(OR=1.429,95%CI:1.015-2.013,P=0.041)的丰度升高,会增加患者骨质疏松性骨折的风险;②拟杆菌纲(OR=0.660,95%CI:0.455-0.959,P=0.029)、拟杆菌目(OR=0.660,95%CI:0.455-0.959,P=0.029)、克里斯滕森氏菌科(OR=0.725,95%CI:0.529-0.995,P=0.047)、瘤胃球菌科(OR=0.643,95%CI:0.443-0.933,P=0.020)、肠杆菌属(OR=0.558,95%CI:0.395-0.788,P=0.001)、直肠真杆菌属(OR=0.631,95%CI:0.435-0.916,P=0.016)、毛螺菌科-UCG008(OR=0.738,95%CI:0.546-0.998,P=0.048)、瘤胃梭菌属-9(OR=0.492,95%CI:0.324-0.746,P=0.001)的丰度升高,会降低患者骨质疏松性骨折的风险。③文章通过孟德尔随机化方法发现了16种与骨质疏松性骨折相关的肠道菌群,即以肠道菌群为暴露因素,骨质疏松性骨折为结局变量,8种肠道菌群与骨质疏松性骨折呈正向因果关联,另外8种肠道菌群与骨质疏松性骨折呈负向因果关联。④此研究结果不仅为临床上骨质疏松性骨折的早期预测及潜在治疗靶点确定了新的生物标志物,还为骨组织工程中研究通过肠道菌群改善骨质疏松性骨折的发生与预后提供了实验基础和理论依据。
文摘反流性食管炎(RE)是消化系统常见疾病,中医药治疗颇具特色。严光俊教授从医三十余载,治疗脾胃病临证经验丰富,认为RE的病机关键为肝郁,脾虚为病变根本原因,以疏肝健脾,和胃降逆为基本治疗原则,亦重视化瘀通络,身心同治等,临床用药灵活,疗效显著。Reflux esophagitis (RE) is a common disease of the digestive system, and Chinese medicine treatment has its own characteristics. Prof. Yan Guangjun has been practicing medicine for more than 30 years and has rich experience in treating spleen and gastric diseases. He believes that the key to the pathogenesis of RE is depression of the liver and deficiency of the spleen as the root cause of the disease, and that the basic treatment principle is to dredge the liver and strengthen the spleen, harmonize with the stomach and reduce the rebelliousness of the stomach, and he also attaches importance to the elimination of blood stasis and opening up of the channels, and treating the body and mind together, and his clinical medicine is flexible and effective.
