Role of gut microbiota and bacterial metabolites in mucins of colorectal cancer.

Colorectal cancer (CRC) is a major health burden, accounting for approximately 10% of all new cancer cases worldwide. Accumulating evidence suggests that the crosstalk between the host mucins and gut microbiota is associated with the occurrence and development of CRC. Mucins secreted by goblet cells not only protect the intestinal epithelium from microorganisms and invading pathogens but also provide a habitat for commensal bacteria. Conversely, gut dysbiosis results in the dysfunction of mucins, allowing other commensals and their metabolites to pass through the intestinal epithelium, potentially triggering host responses and the subsequent progression of CRC. In this review, we summarize how gut microbiota and bacterial metabolites regulate the function and expression of mucin in CRC and novel treatment strategies for CRC.

The effects of early enteral nutrition on the nutritional statuses, gastrointestinal functions, and inflammatory responses of gastrointestinal tumor patients.

OBJECTIVE: This paper was designed to investigate the effects of early enteral nutrition (EEN) on the nutritional statuses, gastrointestinal functions, and inflammatory responses of gastrointestinal tumor patients. METHODS: A total of 194 gastrointestinal tumor patients treated in our hospital from May 2017 to February 2019 were recruited as the study cohort. Among them, 101 patients were administered enteral nutrition (the study group), and 93 patients were administered parenteral nutrition (the control group). The two groups were compared in terms of their nutritional statuses, gastrointestinal functions, inflammatory responses, and other indicators. RESULTS: On the third day after the operation (postoperative 3 d), the serum albumin (ALB) and prealbumin (PA) levels were significantly reduced in both groups (P>0.05). On the seventh day after the operation (postoperative 7 d), the two nutritional indices increased significantly in both groups (P<0.05), and were significantly higher in the study group (P<0.05). Compared with the control group, the patients in the study group experienced shorter lengths of stay (LOS), earlier first anal exhaust times, and faster intestinal peristalsis recovery times (P<0.05). On the third day after the operations, the high-sensitive C-reactive protein (hs-CRP) and prostaglandin E (PGE) levels were significantly reduced in both groups (P<0.05), and the decrease was significantly greater in the study group (P<0.05). In addition, the CD3+, CD4+, CD8+ and CD4+/CD8+ levels were significantly reduced in both groups on the third day after the operation (P>0.05). On the seventh day after the operation, the first three immune indices increased significantly in both groups (P<0.05), and they were significantly higher in the study group (P<0.05). The incidences of vomiting, diarrhea, and abdominal distension in the study group were significantly lower than they were in the control group (P<0.05). After the treatment, the patients' quality of life (QOL) was significantly higher in the study group (P<0.05). CONCLUSION: For gastrointestinal tumor patients, EEN can improve their gastrointestinal functions, enhance their immune functions, and reduce their expressions of inflammatory cytokines while improving their nutritional statuses and QOL.

Effects of Dexmedetomidine and ACE Genotype on Cardiovascular Response During the Decannulation Period of General Anesthesia in Patients With Essential Hypertension.

PURPOSE: This study investigated the effects of dexmedetomidine on cardiovascular response during the decannulation period of general anesthesia in patients with different genotypes of angiotensin-converting enzyme (ACE) and essential hypertension. METHODS: The present study enrolled patients with essential hypertension and American Society of Anesthesiologists class II or III who were scheduled to undergo abdominal surgery under general anesthesia. Patients were assigned to 1 of 6 groups according to ACE genotype, as detected by polymerase chain reaction-restriction fragment length polymorphism, as follows: DD; ID; II; and DD, ID, and II each with dexmedetomidine (Dex). Dexmedetomidine was intravenously infused at 0.5 µg/kg/h for 30 min before the end of surgery in groups DD (Dex), ID (Dex), and II(Dex). Anesthesia was induced and maintained by the same anesthetics in all patients. Systolic and diastolic blood pressure, heart rate (HR), ECG, and rate-pressure product were recorded before anesthesia induction; at 30 min before the end of surgery; at the end of surgery; and at 0, 1.5, 5, and 10 min after extubation. FINDINGS: A total of 210 patients were enrolled (n = 35 per genotype). After extubation, systolic and diastolic blood pressure, HR, and RPP were increased markedly from baseline in groups DD, ID, and II; the increases were greater in groups DD and ID than in group II. No significant changes in blood pressure, HR, or RPP were found, and proper sedative was achieved in groups DD (Dex), ID (Dex), and II(Dex). The prevalences of cardiac arrhythmia were higher in groups DD and ID than in groups II, DD (Dex), ID (Dex), and II(Dex). IMPLICATIONS: Patients essential hypertension and the ACE D allele had a strong hemodynamic response to tracheal extubation, on which dexmedetomidine was found to have both a prevention and treatment effect.