Exploring the links between gut microbiome changes and irritable bowel syndrome in Han populations in the Tibetan Plateau / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

The gut microbiome shows changes under a plateau environment, while the disbalance of intestinal microbiota plays an important role in the pathogenesis of irritable bowel syndrome (IBS); however, the relationship between the two remains unexplored. In this work, we followed up a healthy cohort for up to a year before and after living in a plateau environment and performed 16S ribosomal RNA (rRNA) sequencing analysis of their fecal samples. Through evaluating the participants' clinical symptoms, combined with an IBS questionnaire, we screened the IBS sub-population in our cohort. The sequencing results showed that a high-altitude environment could lead to changes in the diversity and composition of gut flora. In addition, we found that the longer the time volunteers spent in the plateau environment, the more similar their gut microbiota composition and abundance became compared to those before entering the plateau, and IBS symptoms were significantly alleviated. Therefore, we speculated that the plateau may be a special environment that induces IBS. The taxonomic units g_Alistipes, g_Oscillospira, and s_Ruminococcus_torques, which had been proved to play important roles in IBS pathogenesis, were also abundant in the IBS cohort at high altitudes. Overall, the disbalance of gut microbiota induced by the plateau environment contributed to the high frequency of IBS and the psychosocial abnormalities associated with IBS. Our results prompt further research to elucidate the relevant mechanism.

Construction of evaluation system for clinical effectiveness of Drug Selection Guideline for Medical Institutions / 中国药房

OBJECTIVE To establish an evaluation syste m of clinical effec tiveness of Drug Selection Guideline for Medical Institutions，and to provide reference for drug selection in medical institution. METHODS Retrieved from relevant Chinese government websites ，PubMed，Embase，CBM and CNKI ，etc.，from the inception to Sept. 14th 2021，related contents of clinical effectiveness related to three secondary indicators ，such as “recommended level and strength of guideline ”“clinical pathway ”and “evidence and level of efficacy ”were extracted respectively ；evaluation system was construction for the clinical effectiveness. RESULTS A total of 5，4 and 17 policy documents or literatures were included according to “recommended level and strength of guideline”“clinical pathway ”and“evidence and level of efficacy ”，respectively.“The recommended level and strength of drug guideline”could reflect the clinical effectiveness of drugs ，and the evaluation content referred to the recommended level and strength of the selected drugs in the guidelines for corresponding indications. “Clinical pathway ”was the embodiment of drug effectiveness, and the evaluation content referred to the clinical path of whether the selected drugs were included in the corresponding indications. The evaluation contents of “evidence and level of efficacy ”were different between chemical medicine/ biological agent and Chinese patent medicine ；evidence and quality level of efficacy research for chemical medicine/biological agent referred to GRADE system ，while those for Chinese patent medicine referred to classic works or clinical experience inheritance. Therefore，the evaluation contents of this index system were the evidence and quality level of the efficacy research related to selected drugs. CONCLUSIONS The evaluation system of clinical effectiveness of drugs constructed from the perspective of drug selection in medical institutions can lay the foundation of evaluation system for the construction of Drug Selection Guideline for Medical Institutions ，and also provide reference for drug selection in medical institutions.

Effect of dietary intervention on blood glucose in colonoscopy patients during intestinal preparation: a meta-analysis / 中华消化内镜杂志

Objective:To systematically evaluate the effect of dietary intervention on blood glucose during intestinal preparation for colonoscopy.Methods:Randomized controlled trials (RCTs) on the effects of different interventions on blood glucose during bowel preparation in colonoscopy patients were retrieved on PubMed, CNKI, and WanFang, and RevMan 5.3 software was applied for meta-analysis based on the intervention groups.Results:A total of 10 RCTs in 8 papers, including 3 345 patients, 1 603 patients in the control group and 1 742 patients in the intervention group, were reviewed. Meta-analysis results showed that 10 studies reported incidence of hypoglycemia and interventions during intestinal preparation, and heterogeneity among researches was statistical ( P<0.000 01, I2=80%). Under random effects model combined with effect quantity, compared with the control group, dietary intervention could significantly reduce the incidence of hypoglycemia during bowel preparation, the difference was significant ( OR=0.19, 95% CI: 0.09-0.40, P<0.05). Conclusion:Dietary intervention during intestinal preparation for colonoscopy can prevent the occurrence of hypoglycemia and avoid relative adverse reactions and parasympathetic nerve activity. However, due to the limited number and quality of included researches, the above conclusion need to be verified by more high-quality RCTs.

Incidence of hypoglycemia during colonoscopy and the prevention of hypoglycemia by enteric nutrients / 中华消化内镜杂志

To compare the incidence of hypoglycemia between day-before bowel preparation and split-dose bowel preparation in colonoscopy patients. The effects of enterald ietary nutrients on the prevention of hypoglycemia and the preparation quality of the intestine during colonoscopy were compared. The patients who underwent colonoscopy were divided into the day-before bowel preparation group, the split-dose bowel preparation group, and the split-dose bowel preparation + enteral nutrient diet group. All patients had their finger blood sugar tested before colonoscopy. The peripheral blood glucose level was measured before operation. After the endoscopic examination, the intestinal cleanliness of the patients was evaluated through the Boston intestinal preparation scale by endoscopists. The incidence of day-before bowel preparation group and split-dose bowel preparation group and enteral nutrient intervention group were 14.38%(23/160), 17.50% (28/160)and 6.45% (4/62), respectively. The proportions of high quality intestinal cleaning were 31.25% (50/160), 35.00% (56/160) and 82.26% (51/62) in the three groups respectively. The incidence of hypoglycemia was higher in split-dose bowel preparation group than that in day-before bowel preparation group. Enteral nutrient intervention can effectively reduce the incidence of hypoglycemia and improve the quality of intestinal preparation, which is a recommended intestinal preparation method.

Mutation analysis of the ABCA12 gene in two families with autosomal recessive congenital ichthyosis / 中华皮肤科杂志

Objective To detect mutations of the ABCA12 gene in 2 Chinese families with autosomal recessive congenital ichthyosis (ARCI).Methods According to the typical clinical manifestations,two probands were diagnosed with ARCI.DNA was extracted from the peripheral blood samples collected from the patients and their parents.High-throughput sequencing was conducted by using multi-gene array for genetic skin disorders to determine mutation sites in the probands,and then DNA isolated from the probands and their parents were bidirectionally verified by Sanger sequencing.Results Two compound heterozygous mutations (c.2759A＞G and c.7004A＞G) in the ABCA12 gene were found in the proband 1,and another two compound heterozygous mutations (c.6163_6164insT and c.7406G＞A) were identified in the proband 2.The parents of the two probands were heterozygous carriers of one of the two mutations in the ABCA12 gene.Function prediction for the 4 mutations showed that all of the 3 missense mutations (c.2759A＞G,c.7004A＞G and c.7406G＞A) may exert pathogenic effect,and fragnin encoded by the frameshift mutation c.6163_6164insT may also affect protein function,c.2759A＞G and c.6163_6164insT were newly identified mutation sites.Conclusion The compound heterozygous mutations in the ABCA 12 gene are the causative mutations responsible for ARCI in the two probands of the two pedigrees.