Gut microbiota dynamics and fecal SCFAs after colonoscopy: accelerating microbiome stabilization by Clostridium butyricum.

BACKGROUND: Colonoscopy is a classic diagnostic method with possible complications including abdominal pain and diarrhoea. In this study, gut microbiota dynamics and related metabolic products during and after colonoscopy were explored to accelerate gut microbiome balance through probiotics. METHODS: The gut microbiota and fecal short-chain fatty acids (SCFAs) were analyzed in four healthy subjects before and after colonoscopy, along with seven individuals supplemented with Clostridium butyricum. We employed 16S rRNA sequencing and GC-MS to investigate these changes. We also conducted bioinformatic analysis to explore the buk gene, encoding butyrate kinase, across C. butyricum strains from the human gut. RESULTS: The gut microbiota and fecal short-chain fatty acids (SCFAs) of four healthy subjects were recovered on the 7th day after colonoscopy. We found that Clostridium and other bacteria might have efficient butyric acid production through bioinformatic analysis of the buk and assessment of the transcriptional level of the buk. Supplementation of seven healthy subjects with Clostridium butyricum after colonoscopy resulted in a quicker recovery and stabilization of gut microbiota and fecal SCFAs on the third day. CONCLUSION: We suggest that supplementation of Clostridium butyricum after colonoscopy should be considered in future routine clinical practice.

Root microbiota: Connecting nitrogen metabolism and theanine synthesis in tea plants.

Tea varieties exhibit seasonal theanine accumulation, with the high-theanine tea variety Rougui having a diverse root microbiota rich in nitrogen-related microbes. A synthetic community derived from Rougui roots enhances tea growth and theanine synthesis under nitrogen deficiency, emphasizing the microbiota's pivotal role.

Root microbiota confers rice resistance to aluminium toxicity and phosphorus deficiency in acidic soils.

Aluminium (Al) toxicity impedes crop growth in acidic soils and is considered the second largest abiotic stress after drought for crops worldwide. Despite remarkable progress in understanding Al resistance in plants, it is still unknown whether and how the soil microbiota confers Al resistance to crops. Here we found that a synthetic community composed of highly Al-resistant bacterial strains isolated from the rice rhizosphere increased rice yield by 26.36% in acidic fields. The synthetic community harvested rhizodeposited carbon for successful proliferation and mitigated soil acidification and Al toxicity through extracellular protonation. The functional coordination between plants and microbes offers a promising way to increase the usage of legacy phosphorus in topsoil. These findings highlight the potential of microbial tools for advancing sustainable agriculture in acidic soils.

Prognostic value of initial routine laboratory blood tests in patients with aneurysmal subarachnoid hemorrhage requiring mechanical ventilation: a retrospective cohort study.

Background: Aneurysmal subarachnoid hemorrhage (aSAH) necessitating mechanical ventilation (MV) presents a serious challenge for intensivists. Laboratory blood tests reflect individual physiological and biochemical states, and provide a useful tool for identifying patients with critical condition and stratifying risk levels of death. This study aimed to determine the prognostic role of initial routine laboratory blood tests in these patients. Methods: This retrospective cohort study included 190 aSAH patients requiring MV in the neurosurgical intensive care unit from December 2019 to March 2022. Follow-up evaluation was performed in May 2022 via routine outpatient appointment or telephone interview. The primary outcomes were death occurring within 7 days after discharge (short-term mortality) or reported at time of follow-up (long-term mortality). Clinico-demographic and radiological characteristics, initial routine laboratory blood tests (e.g., metabolic panels and arterial blood gas analysis), and treatment were analyzed and compared in relation to mortality. Multivariable logistic and Cox regression analyses, with adjustment of other clinical predictors, were performed to determine independent laboratory test predictors for short- and long-term mortality, respectively. Results: The patients had a median age of 62 years, with a median World Federation of Neurosurgical Societies grade (WFNS) score of 5 and a median modified Fisher grade (mFisher) score of 4. The short- and long-term mortality of this cohort were 60.5% and 65.3%, respectively. Compared with survivors, non-survivors had more severe disease upon admission based on neurological status and imaging features and a shorter disease course, and were more likely to receive conservative treatment. Initial ionized calcium was found to be independently associate with both short-term [adjusted odds ratio (OR): 0.92; 95% confidence interval (CI): 0.86 to 0.99; P=0.020] and long-term mortality [adjusted hazard ratio (HR): 0.95; 95% CI: 0.92 to 0.99; P=0.010], after adjusting for potential confounders. Moreover, the admission glucose level was found to be associated only with short-term mortality (adjusted OR: 1.19; 95% CI: 1.06 to 1.34; P=0.004). Conclusions: Laboratory screening may provide a useful tool for the management of aSAH patients requiring MV in stratifying risk levels for mortality and for better clinical decision-making. Further study is needed to validate the effects of calcium supplementation and glucose-lowering therapy on the outcomes in this disease.

Anti-Hebbian plasticity in the motor cortex promotes defensive freezing.

Regional brain activity often decreases from baseline levels in response to external events, but how neurons develop such negative responses is unclear. To study this, we leveraged the negative response that develops in the primary motor cortex (M1) after classical fear learning. We trained mice with a fear conditioning paradigm while imaging their brains with standard two-photon microscopy. This enabled monitoring changes in neuronal responses to the tone with synaptic resolution through learning. We found that M1 layer 5 pyramidal neurons (L5 PNs) developed negative tone responses within an hour after conditioning, which depended on the weakening of their dendritic spines that were active during training. Blocking this form of anti-Hebbian plasticity using an optogenetic manipulation of CaMKII activity disrupted negative tone responses and freezing. Therefore, reducing the strength of spines active at the time of memory encoding leads to negative responses of L5 PNs. In turn, these negative responses curb M1's capacity for promoting movement, thereby aiding freezing. Collectively, this work provides a mechanistic understanding of how area-specific negative responses to behaviorally relevant cues can be achieved.

Real-time jellyfish classification and detection algorithm based on improved YOLOv4-tiny and improved underwater image enhancement algorithm.

The outbreak of jellyfish blooms poses a serious threat to human life and marine ecology. Therefore, jellyfish detection techniques have earned great interest. This paper investigates the jellyfish detection and classification algorithm based on optical images and deep learning theory. Firstly, we create a dataset comprising 11,926 images. A MSRCR underwater image enhancement algorithm with fusion is proposed. Finally, an improved YOLOv4-tiny algorithm is proposed by incorporating a CBMA module and optimizing the training method. The results demonstrate that the detection accuracy of the improved algorithm can reach 95.01%, the detection speed is 223FPS, both of which are better than the compared algorithms such as YOLOV4. In summary, our method can accurately and quickly detect jellyfish. The research in this paper lays the foundation for the development of an underwater jellyfish real-time monitoring system.

Vitamin D supplementation reduced blood inflammatory cytokines expression and improved graft function in kidney transplant recipients.

Background: Chronic allograft dysfunction(CAD) is the leading cause of graft loss in kidney transplant recipients (KTRs). Inflammatory process is believed to be one of the major contributors to CAD. The aim of this study is to explore the anti-inflammatory effect of vitamin D (VD) supplementation in KTRs and its role in the graft function improvement(protection). Methods: A retrospective cohort of 39 KTRs with chronic antibody mediated rejection(CAMR)or stable renal function and a prospective cohort of 42 KTRs treated or untreated with VD were enrolled. Serum levels of vitamin D metabolism and serum inflammatory cytokines, renal graft function, and routine blood biomarkers were tested and dynamically tracked within 12 months post-transplant. Results: Compared with the stable group, the CAMR group exhibited significantly elevated serum levels of inflammatory cytokines IL-1ß, IFN-γ, IL-2, IL-10, IP-10, and HMGB1 (P <0.05). The supplementation of vitamin D effectively increased the serum concentration of vitamin D in kidney transplant recipients (KTRs) in the treated group. During the course of treatment, the treated group exhibited a gradual increase in eGFR levels, which were significantly higher than those observed in the untreated group at 12 months post-transplant (p<0.05). Notably, as eGFR improved, there was a significant decrease in levels of IL-1ß, IFN-γ, IL-2, IL-10, IP-10 and HMGB1 in the treated group compared to the untreated group (P<0.05). Conclusion: This study confirmed that immune-inflammation is a crucial factor in the development of CAD in KTRs.VD deficiency impairs its anti-inflammatory activity. By assisting in the regulation of excessive immune inflammation and restoration of immune homeostasis, effective VD supplementation contributes to protection and maintenance of graft function in KTRs.

Zishen Yutai Pill improves sperm quality and reduces testicular inflammation in experimental varicocele rats.

Objective: Zishen Yutai Pill (ZYP), containing 15 Chinese traditional medicine, is a safe and well quality-controlled TCM preparation with promising effects in many fields of reproduction. The current study was designed to investigate the therapeutic effects of ZYP on sperm quality and testis in varicocele (VC) rats. Materials and methods: Male Wistar rats were randomly divided into four groups (n = 6), i.e., a sham group, a VC group, and VC groups treated with different dose of ZYP (1575 and 3150 mg/kg/d, respectively). The experimental VC model was established by partial ligation of left renal vein. Six weeks after model establishment, ZYP was orally administered once a day for the next 6 weeks. Parameters relating to testis and sperm quality were assessed. Hematoxylin-eosin staining was used to showed testicular tissue damage in experimental VC rats. Expressions of proteins relating to NLRP3 inflammasome pathways were determined using Western blot (WB). The mRNA expressions of relating genes were determined using quantitative real-time PCR (qRT-PCR) analysis. Results: ZYP could significantly improve sperm motility and decrease sperm DNA fragmentation index in VC rats (P < 0.05). Hematoxylin-eosin (HE) staining showed that ZYP could alleviate testicular tissue damage caused by experimental varicocele in rats. Compared to the VC model, expressions of NLRP3, ASC, and caspase-1 in rats treated with ZYP were significantly down-regulated, as validated by both qRT-PCR and WB analysis (P < 0.05). Conclusions: In brief, ZYP could improve sperm DNA integrity by inhibiting the NLRP3 inflammasome pathway and alleviating the chronic inflammation of testicular tissue induced by experimental varicocele in rats.

Conversion of Methanol to Para-Xylene over ZSM-5 Zeolites Modified by Zinc and Phosphorus.

In this work, the influence of different phosphorus sources and the modification of zinc and phosphorus on the performance of the conversion of methanol to aromatics (MTA) was investigated. The results showed that the phosphorus source had a significant impact on the selectivity of para-xylene (PX) in xylene and catalyst stability. The introduction of P resulted in the covering of the active acid sites and the narrowing of the pore of the ZSM-5 zeolite, which improved the shape-selectivity for PX in the methanol conversion reaction. Compared with the modifiers of H3PO4 and (NH4)3PO4, the ZSM-5 zeolite modified by (NH4)2HPO4 exhibited better catalyst stability and PX-selectivity due to its larger specific surface area, pore volume and suitable acidity. When the ZSM-5 zeolite was modified by Zn and P, the effect of Zn and P on the selectivity to aromatics and PX in xylene was almost opposite. With the increase in P-loading, the selectivity of PX in xylene gradually increased but at the cost of decreasing the aromatic-selectivity. On the other hand, the loading of Zn introduced Zn-Lewis acid sites to provide aromatization active centers and improved the aromatic-selectivity. However, excessive Zn reduced the selectivity of PX in xylene. The catalyst activity and aromatic-selectivity could be improved to some extent with an appropriate ratio of Zn and P, while maintaining or increasing the para-selectivity of xylene. Compared with 5% P/ZSM-5 catalyst modified with only (NH4)2HPO4, the PX selectivity in xylene over the Zn-P/ZSM-5 catalyst modified with 5% Zn and 1% P improved from 86.6% to 90.1%, and the PX yield increased by 59%.

The non-specific lipid transfer protein McLTPII.9 of Mentha canadensis is involved in peltate glandular trichome density and volatile compound metabolism.

Mentha canadensis L. is an important spice crop and medicinal herb with high economic value. The plant is covered with peltate glandular trichomes, which are responsible for the biosynthesis and secretion of volatile oils. Plant non-specific lipid transfer proteins (nsLTPs) belong to a complex multigenic family involved in various plant physiological processes. Here, we cloned and identified a non-specific lipid transfer protein gene (McLTPII.9) from M. canadensis, which may positively regulate peltate glandular trichome density and monoterpene metabolism. McLTPII.9 was expressed in most M. canadensis tissues. The GUS signal driven by the McLTPII.9 promoter in transgenic Nicotiana tabacum was observed in stems, leaves, and roots; it was also expressed in trichomes. McLTPII.9 was associated with the plasma membrane. Overexpression of McLTPII.9 in peppermint (Mentha piperita. L) significantly increased the peltate glandular trichome density and total volatile compound content compared with wild-type peppermint; it also altered the volatile oil composition. In McLTPII.9-overexpressing (OE) peppermint, the expression levels of several monoterpenoid synthase genes and glandular trichome development-related transcription factors-such as limonene synthase (LS), limonene-3-hydroxylase (L3OH), geranyl diphosphate synthase (GPPS), HD-ZIP3, and MIXTA-exhibited varying degrees of alteration. McLTPII.9 overexpression resulted in both a change in expression of genes for terpenoid biosynthetic pathways which corresponded with an altered terpenoid profile in OE plants. In addition, peltate glandular trichome density was altered in the OE plants as well as the expression of genes for transcription factors that were shown to be involved in trichome development in plants.

[Construction of a core outcome set in clinical research of acupuncture and moxibustion for treatment of adhesive capsulitis].

This study aims to construct the core outcome set for the clinical trials of adhesive capsulitis treated with acupuncture and moxibustion. Using systematic review, semi-structured interview, Delphi questionnaire survey, analytic hierarchy process and expert consensus meeting, the primary outcomes are obtained, i.e. local tenderness, pain degree during movement, range of motion, changes in range of motion, function score, and score of local symptoms of shoulder joint. The secondary outcomes are myofascial thickness, thickness of the inferior wall of the joint capsule, health status, activity of daily living, incidence of adverse events, laboratory indexes, vital signs, cost-effectiveness, total effective rate, and patient satisfaction. It is expected to provide a reference for the outcome selection in clinical trials and the generation of medical evidences in the treatment of adhesive capsulitis with acupuncture and moxibustion.

A Curcumin-Modified Coordination Polymers with ROS Scavenging and Macrophage Phenotype Regulating Properties for Efficient Ulcerative Colitis Treatment.

Overexpression of classically activated macrophages (M1) subtypes and assessed reactive oxygen species (ROS) levels are often observed in patients with ulcerative colitis. At present, the treatment system of these two problems has yet to be established. Here, the chemotherapy drug curcumin (CCM) is decorated with Prussian blue analogs in a straightforward and cost-saving manner. Modified CCM can be released in inflammatory tissue (acidic environment), eventually causing M1 macrophages to transform into M2 macrophages and inhibiting pro-inflammatory factors. Co(III) and Fe(II) have abundant valence variations, and the lower REDOX potential in CCM-CoFe PBA enables ROS clearance through multi-nanomase activity. In addition, CCM-CoFe PBA effectively alleviated the symptoms of UC mice induced by DSS and inhibited the progression of the disease. Therefore, the present material may be used as a new therapeutic agent for UC.

Development of an Online Mind-Body Physical Activity Intervention for Young Adults during COVID-19: A Pilot Study.

The purpose of this study was to examine the association between the implementation of an online mind-body physical activity (MBPA) intervention and physical activity (PA), stress, and well-being in young adults during COVID-19. The participants were a sample of college students (N = 21; 81% female). The MBPA intervention was organized in four online modules that were administered asynchronously for 8 weeks with three separate 10 min sessions per week. The intervention components consisted of traditional deep breathing, diaphragm mindful breathing, yoga poses, and walking meditation. Objective PA behaviors were assessed using wrist-worn ActiGraph accelerometers, and stress and well-being data were collected using validated self-report instruments. A 2 (sex) × 3 (time) doubly multivariate analysis of variance test with a univariate follow-up showed that the % of wear time in light (LPA) and moderate-to-vigorous physical activity (MVPA) was significantly higher at the end of the intervention compared to baseline (LPA mean difference = 11.3%, p = 0.003, d = 0.70; MVPA mean difference = 2.9%, p < 0.001, d = 0.56). No significant differences were observed for perceived stress and well-being, and there was no moderating effect of sex. The MBPA intervention showed promise, as it was associated with higher PA in young adults during COVID-19. No improvements were observed for stress and well-being. These results warrant further testing of the intervention's effectiveness using larger samples.

The efficacy and safety of Chinese herbal medicine Guizhi Fuling capsule combined with low dose mifepristone in the treatment of uterine fibroids: a systematic review and meta-analysis of 28 randomized controlled trials.

OBJECTIVE: Guizhi Fuling Capsule (GZFL), a classic traditional Chinese medicine prescription, is often recommended for the treatment of uterine fibroids (UFs). However, the efficacy and safety of GZFL in combination with low-dose mifepristone (MFP) remains controversial. MATERIALS AND METHODS: We searched eight literature databases and two clinical trial registries for randomized controlled trials (RCTs) of the efficacy and safety of GZFL combined with low-dose MFP in the treatment of UFs from database inception to April 24, 2022. Data analysis was performed using the Meta package in RStudio and RevMan 5.4. GRADE pro3.6.1 software was used for the assessment of evidence quality. RESULTS: Twenty-eight RCTs were included in this study, including a total of 2813 patients. The meta-analysis showed that compared with low-dose MFP alone, GZFL combined with low-dose MFP significantly reduced follicle stimulating hormone (p < 0.001), estradiol (p < 0.001), progesterone (p < 0.001), luteinizing hormone (p < 0.001), uterine fibroids volume (p < 0.001), uterine volume (p < 0.001), menstrual flow (p < 0.001) and increased clinical efficiency rate (p < 0.001). Meanwhile, GZFL combined with low-dose MFP did not significantly increase the incidence of adverse drug reactions compared with low-dose MFP alone (p = 0.16). The quality of the evidence for the outcomes ranged from "very low" to "moderate." CONCLUSION: This study suggests that GZFL combined with low-dose MFP is more effective and safe in the treatment of UFs, and it is a potential treatment for UFs. However, due to the poor quality of the included RCTs formulations, we recommend a rigorous, high-quality, large-sample trial to confirm our findings.

Improved export coefficient model for identification of watershed environmental risk areas.

As a complex system under the joint action of man and nature, land use/cover directly or indirectly affects the environmental quality of the freshwater ecosystem. Studying the response of water environment quality to land use/cover change was significant to accurately simulate lake water quality and effectively enhance the management level. As an empirical model, the classical export coefficient model has been widely used and developed in agricultural non-point source pollution research because of its simple structure and convenient application. However, it assumes that the export coefficient of a particular type of land use/cover was constant, ignoring the influence of surface runoff and interception on the output intensity of pollutants in pollutant migration. This study improved the classical export coefficient model by adding factors such as precipitation, surface cover, and topography, evaluated the contribution of land use/cover to total nitrogen load into the lake in Dianchi Lake Basin, and applied the pollution assessment results to the identification of watershed environmental risk areas. The results showed that the improved export coefficient model could better simulate the relationship between land use/cover and total nitrogen load into Dianchi Lake from the basin. At the same time, spatial characteristics of the total nitrogen load contribution of the terrestrial could be represented. The high-risk areas in the basin were mainly cultivated land and construction areas with low vegetation coverage around lakes or downstream. The contribution per unit area to the TN load into the lake from areas with a high risk was 14.28 t/km2, which was 3.47 times that of medium-high-risk areas and 52.28 times that of the medium-risk area. Land use control measures in high-risk areas in the basin should be further strengthened, especially in the lakeside zone.

"I Felt Grounded and Clear-Headed": Qualitative Exploration of a Mind-Body Physical Activity Intervention on Stress Among College Students During COVID-19.

The COVID-19 pandemic affected college students' overall health. The aims of this qualitative inquiry were to provide a more comprehensive understanding of the effectiveness of the mind-body physical activity (MBPA) intervention and to explore the MBPA intervention experiences through the use of journals and photographs (photovoice) of a purposeful sample of 21 college students during the COVID-19 pandemic. An inductive qualitative process was used to explore the data that emerged from photovoice images and journals. Students' experiences were encapsulated in 6 key themes: (1) holistic individual well-being; (2) physical activity as a matter of necessity; (3) mind-body physical activity intervention impacts; (4) broadening strategies for adapting and reacting; (5) systemic effect of stress management changes; and (6) perceiving causes of stress. Participants reflected collective intellectual, physical, and emotional fatigue as obstacles and perceived stress. The quality of COVID-19 related perspectives and stressful experiences are defined from traumatic and overwhelming to higher than normal. Findings from this study contribute to our understanding of the distinctive factors of the COVID-19 era among college students. Health educators should consider the implementation of multilevel and multicomponent MBPA interventions, and our findings highlight the utility of supporting higher education students in a meaningful way.

The analgesic effects of ß-elemene in rats with neuropathic pain by inhibition of spinal astrocytic ERK activation.

Neuropathic pain takes a heavy toll on individual well-being, while current therapy is far from desirable. Herein, we assessed the analgesic effect of ß-elemene, a chief component in the traditional Chinese medicine Curcuma wenyujin, and explored the underlying mechanisms at the level of spinal dorsal horn (SDH) under neuropathic pain. A spared nerve injury (SNI)-induced neuropathic pain model was established in rats. Intraperitoneal injection (i.p.) of ß-elemene was administered for 21 consecutive days. Mechanical allodynia was explored by von Frey filaments. The activation of the mitogen-activated protein kinase (MAPK) family (including ERK, p38, and JNK) in spinal neurons, astrocytes, and microglia was evaluated using immunostaining 29 days after SNI surgery. The expression of GFAP, Iba-1, p-ERK, p-JNK, and p-p38 within the SDH was measured using immunoblotting. The levels of proinflammatory cytokines (including TNF-α, IL-1ß, and IL-6) were measured with ELISA. The levels of oxidative stress indicators (including MDA, SOD, and GSH-PX) were detected using biochemical tests. Consecutive i.p. administration of ß-elemene relieved SNI-induced mechanical allodynia (with an EC50 of 16.40 mg/kg). SNI significantly increased the expression of p-ERK in spinal astrocytes but not microglia on day 29. ß-elemene reversed spinal astrocytic ERK activation and subsequent upregulation of proinflammatory cytokines in SNI rats, with no effect on the expression of p38 and JNK in spinal glia. ß-elemene also exerted antioxidative effects by increasing the levels of SOD and GSH-PX and decreasing the level of MDA. Our results suggest that SNI induces robust astrocytic ERK activation within the SDH in the late phase of neuropathic pain. ß-elemene exerts remarkable analgesic effects on neuropathic pain, possibly by inhibiting spinal astrocytic ERK activation and subsequent neuroinflammatory processes. Our findings suggest that ß-elemene might be a promising analgesic for the treatment of chronic pain.

The association between maternal tea consumption and the risk of pregnancy induced hypertension: A retrospective cohort study in Lanzhou, China.

BACKGROUND: Existing evidence on the relationship between maternal tea consumption and pregnancy induced hypertension (PIH) is inconclusive. This study aimed to evaluate the association between maternal tea consumption and the risk of PIH. METHODS: This study analysed the data of women without chronic hypertension who participated in a retrospective birth cohort study conducted from 2010 to 2012 at the Gansu Provincial Maternity and Child Care Hospital in Lanzhou, China. Multivariable logistic regression models were used to estimate the association between tea consumption and the risk of PIH and its clinical subtypes by different tea exposure time windows. RESULTS: Among the 10,452 women included in this study, tea consumption during pregnancy was significantly associated with an increased risk of PIH (odds ratio [OR] = 1.44, 95 % confidence interval [CI]: 1.01, 2.05), gestational hypertension (OR = 1.86, 95 % CI: 1.07, 3.21), and early-onset preeclampsia (OR = 2.93, 95 % CI: 1.21, 7.09). This was especially the case with black tea (OR = 3.57, 95 % CI: 1.67, 7.62). CONCLUSIONS: Tea consumption during pregnancy might be associated with an increased risk of PIH, gestational hypertension, and early-onset preeclampsia. These findings have important implications for public health in reducing the PIH.

The Effects of Fatty Acids on Inflammatory Bowel Disease: A Two-Sample Mendelian Randomization Study.

Inflammatory Bowel Disease (IBD) is a severe relapsing inflammation of the gastrointestinal tract. The association between fatty acids (FAs) and IBD is controversial and it remains unclear whether there is a causal relationship between them. Mendelian randomization (MR) analysis was province/state for affiliations from the same country performed to clarify the causality. Eligible single nucleotide polymorphisms were selected as instrumental variables from six Genome-wide association studies, involving 114,999 individuals in UK Biobank. The summary-level data on IBD, including Crohn's disease (CD) and ulcerative colitis (UC), were obtained from the International Inflammatory Bowel Disease Genetics Consortium with 20,883 and 27,432 individuals involved. The primary inverse variance weighted (IVW) method as well as other supplementary analysis ones were adopted to evaluate the causal relationship between diverse FAs and IBD. The tests for heterogeneity and pleiotropy, and Leave-one-out analysis were adopted to verify the stability of the results. Omega-3 FA was found to have a causal effect on UC instead of CD. For each Standard Deviation increase in Omega-3 FA genetic levels, the risk of ulcerative colitis was found to be reduced by 39.9% by the IVW method (p = 1.766 × 10-4), by 57.8% by the MR Egger (p = 1.11 × 10-2), by 51.5% by the Weighted median estimator (p = 7.706 × 10-4), by 39% by the Maximum likelihood estimation (p = 3.262 × 10-4), and by 54.5% by the penalized weighted median estimator (p = 1.628 × 10-4). No causal relationship was found between other FAs (including total FA, saturated FA, polyunsaturated FA, monounsaturated FA and omega-6 FA) and IBD. The pleiotropic test and Leave-one-out analysis both proved the validity and reliability of these MR analyses. Omega-3 FA was observed to have a protective effect against UC, providing a new perspective on the investigation of the associations between FAs and IBD.

Outcome of the efficacy of Chinese herbal medicine for functional constipation: A systematic review and meta-analysis.

BACKGROUND: Functional constipation (FC) is a common and chronic gastrointestinal disease and its treatment remains challenging. AIM: To evaluate the efficacy and safety of Chinese herbal medicine (CHM) on efficacy rate, global symptoms, bowel movements and the Bristol Stool Scale score in patients with FC by summarizing current available randomized controlled trials (RCTs). METHODS: RCTs with CHM to treat FC were identified by a systematic search of six databases from inception to October 20, 2020. Two independent reviewers assessed the quality of the included articles and extracted data. Meta-analyses were performed to odds ratio (OR), mean differences (MD) and 95% confidence interval (CI) using random-effects models. Subgroup analyses and sensitivity analyses were used to explore and interpret the sources of heterogeneity. The funnel plot, Begg's test and Egger's test were used to detect publication bias. RESULTS: Ninety-seven studies involving 8693 patients were included in this work. CHM was significantly associated with a higher efficacy rate (OR: 3.62, 95%CI: 3.19-4.11, P < 0.00001) less severe global symptoms (OR: 4.03, 95%CI: 3.49-4.65, P < 0.00001) compared with control treatment, with the low heterogeneity between studies (I 2 = 0%, P = 0.76). CHM was also associated with more frequent bowel movements (MD 0.83, 95%CI: 0.67-0.98, P < 0.00001), a lower score on the Bristol Stool Scale (OR: 1.63, 95%CI: 1.15-2.32, P < 0.006), and a not significant recurrence rate (OR: 0.47, 95%CI: 0.22-0.99, P = 0.05). No serious adverse effects of CHM were reported. CONCLUSION: In this meta-analysis, we found that CHM may have potential benefits in increasing the number of bowel movements, improving stool characteristics and alleviating global symptoms in FC patients. However, a firm conclusion could not be reached because of the poor quality of the included trials. Further trials with higher quality are required.