Probiotic is a promising nutritional intervention for the prevention and alleviation of type 2 diabetes (T2DM).In this study,the remission potential of a multi-species probiotic (Lactobacillus acidophilus NCFM,Lactoba...Probiotic is a promising nutritional intervention for the prevention and alleviation of type 2 diabetes (T2DM).In this study,the remission potential of a multi-species probiotic (Lactobacillus acidophilus NCFM,Lactobacillus rhamnosus GG,Bifidobacterium lactis HN019 and Streptococcus thermophilus ST447) and its fermented yoghurt on the symptoms of high fat diet and streptozotocin induced T2DM mice were investigated,and the underlying mechanisms were elucidated.Multi-species probiotic and probiotic yoghurt elicited similar but varying efficacy in decreasing the body weight loss,improving organ weight,glucose tolerance and insulin resistance,regulating the levels of blood glucose,HbA1c,insulin and lipid as well as protecting the pancreatic islets.Their tangible antidiabetic effects may be ascribed to the mutual promotion between the repair of the intestinal barrier/permeability and the optimization of gut microbiota structure.Furthermore,the intestinal flora-short chain fatty acids-intestinal hormones/inflammatory pathway was activated and thereby conferring healthy benefits to the host.This proposed probiotic combination appears to provide a viable approach to alleviate T2DM.展开更多
Background Although bypass surgery is an effective treatment for moyamoya vasculopathy(MMV),the incidence of postoperative complications is still high.This study aims to introduce a novel evaluating system based on in...Background Although bypass surgery is an effective treatment for moyamoya vasculopathy(MMV),the incidence of postoperative complications is still high.This study aims to introduce a novel evaluating system based on individualised pathophysiology of MMV,and to assess its clinical significance.Methods This multicentre,prospective study enrolled adult patients with MMV from Huashan Hospital,Hehai University and National Center for Neurological Disorders,China between March 2021 and February 2022.Multimodal neuroimages containing structural and functional information were used to evaluate personalised disease severity and fused to localise the surgical field,avoid invalid regions and propose alternative recipient arteries.The recipient artery was further selected intraoperatively by assessing regional haemodynamic and electrophysiological information.The preanastomosis and postanastomosis data were compared with assist with the postoperative management.Patients who received such tailored revascularisations were included in the novel group and the others were included in the traditional group.The 30-day surgical outcomes and intermediate long-term follow-up were compared.Results Totally 375 patients(145 patients in the novel group and 230 patients in the traditional group)were included.The overall complication rate was significantly lower in the novel group(p˂0.001).In detail,both the rates of postoperative infarction(p=0.009)and hyperperfusion syndrome(p=0.010)were significantly lower.The functional outcomes trended to be more favourable in the novel group,though not significantly(p=0.260).Notably,the proportion of good functional status was higher in the novel group(p=0.009).Interestingly,the preoperative statuses of perfusion and metabolism around the bypass area were significantly correlated with the occurrence of postoperative complications(P˂0.0001).Conclusions This novel evaluating system helps to identify appropriate surgical field and recipient arteries during bypass surgery for MMV to achieve better haemodynamic remodelling and pathophysiological improvement,which results in more favourable clinical outcomes.展开更多
Background and purpose Light transmission aggregometry(LTA)and CYP2C19 genotype analysis are commonly used to evaluate the antiplatelet effects of clopidogrel during the interventional treatment of intracranial aneury...Background and purpose Light transmission aggregometry(LTA)and CYP2C19 genotype analysis are commonly used to evaluate the antiplatelet effects of clopidogrel during the interventional treatment of intracranial aneurysms.The aim of this study was to determine which test can predict ischaemic events during these treatments.Methods Patient demographic information,imaging data,laboratory data and ischaemic complications were recorded.LTA and CYP2C19 genotype results were compared,and multiple linear regression was performed to examine factors related to platelet reactivity.Multivariate regression analysis was performed to determine whether LTA and CYP2C19 could predict ischaemic complications and to identify other clinical risk factors.Receiver operating characteristic curve analysis was conducted to calculate the cut-off value for predicting ischaemic complications.A subgroup analysis was also performed for different CYP2C19 genotype metabolisers,as well as for patients with flow diverters and traditional stents.Results A total of 379 patients were included,of which 22 developed ischaemic events.Maximum platelet aggregation induced by ADP(ADP-MPA)could predict ischaemic events(p<0.001;area under the curve,0.752(95%CI 0.663 to 0.842)),and its cut-off value was 41.5%.ADP-MPA(p=0.001)and hypertension duration>10 years(p=0.022)were independent risk factors for ischaemic events,while the CYP2C19 genotype was not associated with ischaemic events.In the subgroup analysis,ADP-MPA could predict ischaemic events in fast metabolisers(p=0.004)and intermediate metabolisers(p=0.003).The cut-off value for ischaemic events was lower in patients with flow diverters(ADP-MPA=36.4%)than in patients with traditional stents(ADP-MPA=42.9%).Conclusions ADP-MPA can predict ischaemic complications during endovascular treatment of intracranial aneurysms.Patients with flow diverters require stronger antiplatelet medication than patients with traditional stents.展开更多
Acute basilar artery occlusion(BAO)may lead to severe disability or death in about 70%of patients.12 Previous studies have estab-lished endovascular treatment(EVT)as the standard treatment for patients with acute ante...Acute basilar artery occlusion(BAO)may lead to severe disability or death in about 70%of patients.12 Previous studies have estab-lished endovascular treatment(EVT)as the standard treatment for patients with acute anterior circulation occlusions.3-9 However,the ideal effective treatment for acute BAO remains controversial.展开更多
基金financially supported by the Key Special Projects of the Ministry of Science and Technology(SQ2020YFF0419518)China Scholarship Council(no.202006120438,Beijing).
文摘Probiotic is a promising nutritional intervention for the prevention and alleviation of type 2 diabetes (T2DM).In this study,the remission potential of a multi-species probiotic (Lactobacillus acidophilus NCFM,Lactobacillus rhamnosus GG,Bifidobacterium lactis HN019 and Streptococcus thermophilus ST447) and its fermented yoghurt on the symptoms of high fat diet and streptozotocin induced T2DM mice were investigated,and the underlying mechanisms were elucidated.Multi-species probiotic and probiotic yoghurt elicited similar but varying efficacy in decreasing the body weight loss,improving organ weight,glucose tolerance and insulin resistance,regulating the levels of blood glucose,HbA1c,insulin and lipid as well as protecting the pancreatic islets.Their tangible antidiabetic effects may be ascribed to the mutual promotion between the repair of the intestinal barrier/permeability and the optimization of gut microbiota structure.Furthermore,the intestinal flora-short chain fatty acids-intestinal hormones/inflammatory pathway was activated and thereby conferring healthy benefits to the host.This proposed probiotic combination appears to provide a viable approach to alleviate T2DM.
基金supported by the National Natural Science Foundation of China(grant number 82171313)Shanghai Hospital Development Center(grant number SHDC2022CRD032)Shanghai Municipal Science and Technology Commission Project(grant number 19DZ1930304),ZJLab,and Shanghai Zhou Liangfu Medical Development Foundation'Brain Science and Brain Diseases Youth Innovation Program'.
文摘Background Although bypass surgery is an effective treatment for moyamoya vasculopathy(MMV),the incidence of postoperative complications is still high.This study aims to introduce a novel evaluating system based on individualised pathophysiology of MMV,and to assess its clinical significance.Methods This multicentre,prospective study enrolled adult patients with MMV from Huashan Hospital,Hehai University and National Center for Neurological Disorders,China between March 2021 and February 2022.Multimodal neuroimages containing structural and functional information were used to evaluate personalised disease severity and fused to localise the surgical field,avoid invalid regions and propose alternative recipient arteries.The recipient artery was further selected intraoperatively by assessing regional haemodynamic and electrophysiological information.The preanastomosis and postanastomosis data were compared with assist with the postoperative management.Patients who received such tailored revascularisations were included in the novel group and the others were included in the traditional group.The 30-day surgical outcomes and intermediate long-term follow-up were compared.Results Totally 375 patients(145 patients in the novel group and 230 patients in the traditional group)were included.The overall complication rate was significantly lower in the novel group(p˂0.001).In detail,both the rates of postoperative infarction(p=0.009)and hyperperfusion syndrome(p=0.010)were significantly lower.The functional outcomes trended to be more favourable in the novel group,though not significantly(p=0.260).Notably,the proportion of good functional status was higher in the novel group(p=0.009).Interestingly,the preoperative statuses of perfusion and metabolism around the bypass area were significantly correlated with the occurrence of postoperative complications(P˂0.0001).Conclusions This novel evaluating system helps to identify appropriate surgical field and recipient arteries during bypass surgery for MMV to achieve better haemodynamic remodelling and pathophysiological improvement,which results in more favourable clinical outcomes.
基金funded by the National Natural Science Foundation of China(81671139 and 82072036)Capital's Funds for Health Improvement and Research(2022-1-2041)and Summit Talent Program(DFL20220503).
文摘Background and purpose Light transmission aggregometry(LTA)and CYP2C19 genotype analysis are commonly used to evaluate the antiplatelet effects of clopidogrel during the interventional treatment of intracranial aneurysms.The aim of this study was to determine which test can predict ischaemic events during these treatments.Methods Patient demographic information,imaging data,laboratory data and ischaemic complications were recorded.LTA and CYP2C19 genotype results were compared,and multiple linear regression was performed to examine factors related to platelet reactivity.Multivariate regression analysis was performed to determine whether LTA and CYP2C19 could predict ischaemic complications and to identify other clinical risk factors.Receiver operating characteristic curve analysis was conducted to calculate the cut-off value for predicting ischaemic complications.A subgroup analysis was also performed for different CYP2C19 genotype metabolisers,as well as for patients with flow diverters and traditional stents.Results A total of 379 patients were included,of which 22 developed ischaemic events.Maximum platelet aggregation induced by ADP(ADP-MPA)could predict ischaemic events(p<0.001;area under the curve,0.752(95%CI 0.663 to 0.842)),and its cut-off value was 41.5%.ADP-MPA(p=0.001)and hypertension duration>10 years(p=0.022)were independent risk factors for ischaemic events,while the CYP2C19 genotype was not associated with ischaemic events.In the subgroup analysis,ADP-MPA could predict ischaemic events in fast metabolisers(p=0.004)and intermediate metabolisers(p=0.003).The cut-off value for ischaemic events was lower in patients with flow diverters(ADP-MPA=36.4%)than in patients with traditional stents(ADP-MPA=42.9%).Conclusions ADP-MPA can predict ischaemic complications during endovascular treatment of intracranial aneurysms.Patients with flow diverters require stronger antiplatelet medication than patients with traditional stents.
文摘Acute basilar artery occlusion(BAO)may lead to severe disability or death in about 70%of patients.12 Previous studies have estab-lished endovascular treatment(EVT)as the standard treatment for patients with acute anterior circulation occlusions.3-9 However,the ideal effective treatment for acute BAO remains controversial.
