Background Gut dysbiosis is associated with aging and several human diseases. Studies about bacteriophage have suggested its influence on bacteria and immunity. However, the role of gut microbiota, especially phages, in the progression of arterial stiffness remains largely unknown. Methods This was a cross-sectional study based on baseline data from our cardiovascular disease cohort. Cardiovascular disease-free participants (n=157) were divided into two groups, using brachial-ankle pulse wave velocity (baPWV) 1400 cm/s as the arterial stiffness cut-off point. The microbial composition between the two groups was compared with the integration of electronic medical records and fecal metagenomics. Results The microbial β-diversity based on the Bray-Curtis dissimilarity of the two groups was different (P = 0.039). Diverse bacteria and bacteriophages with altered abundance and specific functional pathways were found in the elevated arterial stiffness group. The abundance of species such as Agathobaculum butyriciproducens, Alistipes indistinctus, and Megamonas funiformis decreased in patients. Enriched opportunistic pathogens were found in individuals with elevated arterial stiffness, including Aggregatibacter aphrophilus, Clostridium aldenense, Morganella morganii, and Gemella haemolysans. A large number of phages differed between the two groups and a random forest model of arterial stiffness was constructed. In the case of using only 20 bacteriophage features, the area under the receiver operating curve (AUC) of the model reached 0.826 (95% CI, 0.760-0.892). Among these, we found a Caudovirales bacteriophage infecting Faecalibacterium prausnitzii and an unknown bacteriophage infecting Bacteroides, which was closely related to B. vulgatus (rho = 0.400, adjusted P < 0.001). Conclusions Our study identifies lots of novel associations between gut microbiota and arterial function. We speculated that the elimination of pathogenic bacteria and phage therapy may sustain vascular health.
Background There are many studies that have examined the association between Helicobacter pylori (H. pylori) infection and diabetic complications, but the results remained equivocal. The aim of this study was to evaluate the association between H. pylori infection and diabetic complications. Methods This retrospective study consisted of 2310 type-2 diabetes (T2D) patients between January 2016 and December 2021. H. pylori infection status was diagnosed by the rapid urease test or the 13C-urea breath test. Logistic regression analyses were carried out to evaluate the association of H. pylori infection with diabetic complications. Results We included a total of 960 T2D patients, and 481 patients (50.1%) were H pylori-positive. The H. pylori-positive patients had a higher proportion of diabetic nephropathy than patients without H. pylori infection (P = 0.042). Furthermore, we found that H. pylori infection was statistically associated with diabetic nephropathy (odds ratio [OR], = 1.462, 95% confidence interval [CI], 1.006–2.126, P = 0.046) after adjustment for potential confounders. In addition, we demonstrated that the H. pylori-positive and hypertension (OR = 4.451, 95% CI, 2.351-8.427, P < 0.001), H. pylori-positive and glycated hemoglobin A1c (HbA1c) ≥7% (OR = 3.364, 95% CI, 1.300-8.702, P = 0.012), H. pylori-positive and the known diabetes duration≥ 10 years (OR = 3.322, 95% CI,1.845-5.982, P <0.001) might have a synergistic effect on the development of diabetic nephropathy. H. pylori infection appeared not to be associated with the other complications of T2D (retinopathy, neuropathy and peripheral vascular disease). Conclusions Our results indicated that T2D patients with H. pylori infection had a higher risk of nephropathy development, which may be further aggravated under the combination of H. pylori infection and other risk factors.
Background PD-1 monoclonal antibody combined with chemotherapy has become the standard first-line treatment for advanced gastric cancer. This study retrospectively analyzed the clinical efficacy and adverse reactions of PD-1 monoclonal antibody combined with chemotherapy compared with chemotherapy alone, and analyzed the factors that may affect the efficacy. Methods From January 2019 to October 2022, 62 patients with advanced gastric cancer were treated in Baotou Cancer Hospital, 32 in the PD-1 antibody combined chemotherapy group and 30 in the simple chemotherapy group; The two sets of baseline characteristic analysis are comparable. PD-1 antibodies include: Sintilimab, Tislelizumab, Nivolumab and Camrelizumab. Treatment protocol: PD-1 antibody 200mg, 21 days per cycle, chemotherapy protocol: oxaliplatin 130mg/m2+capecitabine 1000mg/m2, oral twice a day. The clinical efficacy, adverse reactions and duration of remission were recorded. SPSS20.0 was used for analysis, P Results In the combined group, the clinical effective rate was 58.38%(19/32), and the disease control rate was 78.13%(25/32); Chemotherapy group: the clinical effective rate was 53.33%(16/30), and in the disease control rate was 63.33%(19/30); The difference between the two groups was statistically significant (P<0.05); Among the adverse reactions, the incidence of more than three degrees of adverse reactions in the two groups was 15.63%(5/32) and 13.33%(4/30) respectively, with no statistically significant difference (P>0.05); The incidence of adverse reactions related to immunotherapy for more than three degrees was 12.50%(4/32); The median remission time of the two groups was 11.5 months and 7.5 months respectively, with a statistically significant difference(P<0.05). Among the influencing factors, the patients with HP+, good nutritional status and younger age benefited more from the combined treatment group. Conclusions In the real world, first-line PD-1 antibody combined chemotherapy has higher clinical efficacy than simple chemotherapy, has longer remission depth, and the adverse reactions are controllable, which is superior to chemotherapy. Immunotherapy is affected by many factors and needs individualized treatment.
Few prospective studies have investigated the joint effect of lifestyle factors and genetic susceptibility on the risk of irritable bowel syndrome (IBS). This study aims to evaluate the associations of lifestyle and genetic factors with incident IBS in the UK Biobank. We analyzed data from 481,057 participants (54% female) without prevalent IBS at enrollment in the UK Biobank. An overall healthy lifestyle was defined using six modifiable lifestyle factors, including smoking, body mass index (BMI), sleep duration, diet, physical activity, and alcohol consumption, and hence categorized into ‘favorable’, ‘intermediate’, and ‘unfavorable’ lifestyles. A Cox proportional hazard model was used to investigate the association between a healthy lifestyle and incident IBS. Furthermore, we constructed a polygenic risk score (PRS) for IBS and assessed whether lifestyle modified the effect of genetics on the development of IBS. During a median follow-up of 12.1 years, 8,645 incident IBS were ascertained. Specifically, among the six modifiable lifestyle factors, adequate sleep demonstrates the greatest protective effect (hazard ratio [HR]: 0.72, 95% CI: 0.69,0.75) against IBS.Compared with a favorable lifestyle, an unfavorable lifestyle was associated with a 56% (95% CI: 46%-67%) increased risk of IBS (P = 8.99×10-40). The risk of incident IBS was 12% (95% CI: 4%-21%) higher among those at high genetic risk compared with those at low genetic risk (P = 0.005). When considering the joint effect of lifestyle and genetic susceptibility, the HR nearly doubled among individuals with high genetic risk and unfavorable lifestyle (HR: 1.80; 95% CI:1.51-2.15; P = 3.50×10-11) compared to those with low genetic risk and favorable lifestyle. No multiplicative or addictive interaction was observed between lifestyle and genetics. The findings from this study indicated that lifestyle and genetic factors were independently associated with the risk of incident IBS. All these results implicated a possible clinical strategy of lowering the incidence of IBS by advocating a healthy lifestyle.
Background Magnetically controlled capsule endoscopy (MCE) is a novel technique for which there is no agreed gastric preparation. We aimed to investigate whether no talking from 1 hour prior to the MCE procedure could improve the quality of gastric preparation. Methods 48 patients referred for MCE were randomly assigned to gastric preparation with either routine regimen (A), or no talking from 1 hour prior to the procedure with routine regimen (B). Image quality was assessed using cleanliness and visualization scores, with higher scores equating to better image quality. Results The total cleanliness scores were (mean±SD) 15.28±1.81 (A) and 21.39±1.28 (B). The total visualization scores (mean±SD) were 10.65±2.54 (A) and 15.23±1.12 (B). While the image quality of the whole stomach in group B was significantly better than group A (P<0.01). Group B could significantly shorten operating time than group A (P<0.05). MCE detected positive findings in 21 (52.5%), 27 (67.5%) patients in groups A and B, respectively, with no significant difference between groups (P>0.5). Conclusions No talking prior to MCE shortened operating time and produced better gastric mucosal image quality. It helps improve the efficiency of MCE.
