Potential contributions of keystone species to intestinal ecosystem in patients with Crohn's disease.

AIMS: Ravelling the central but poorly understood issue that potential contributions of keystone species to intestinal ecosystem functioning of patients with certain life-altering diseases including Crohn's disease (CD). METHODS AND RESULTS: In this study, a combination of 16S rRNA gene amplicon sequencing and amplicon-oriented metagenomic profiling was applied to gain insights into the shifts in bacterial community composition at different stages of CD course, and explore the functional roles of identified keystone species in intestinal microecosystem. Our results showed significant alterations in structure and composition of gut microbiota between CD patients and healthy control (HC) (P < 0.05), but was no difference at active and remission stages. Whole-community-based comprehensive analyses were employed to identify the differential species such as Escherichia coli, Anaerostipes hadrus, and Eubacterium hallii in CD patients, with healthy populations as the control. Metagenome-wide functional analyses further revealed that the relative abundance of specialized metabolism-related genes such as cynS, frdB, serA, and gltB from these bacterial species in CD group was significantly different (P < 0.05) from that in HC, and highlighted the potential roles of the keystone species in regulating the accumulation of important metabolites such as succinate, formate, ammonia, L-glutamate, and L-serine, which might have an effect on homeostasis of intestinal ecosystem. CONCLUSIONS: The findings identify several potential keystone species that may influence the intestinal microecosystem functioning of CD patients and provide some reference for future CD treatment.

Genome-centric investigation of the potential succession pattern in gut microbiota and altered functions under high-protein diet.

Excessive intake of protein has been considered as a factor leading to intestinal microecological disorder, but why and how intestinal microbes change under the high-protein diet (HPD) have yet to be fully elucidated. Here, we performed 16S rRNA gene amplicon sequencing and metagenomic sequencing on contents of cecum, colon and feces from two groups of mice with standard diet (SD) and HPD. And then the microbial alteration of composition and function were deeply analyzed by using several statistical models and bioinformatic methods. Among the three niches, the microbes in the colon are observed to show the most significant change with lower alpha-diversity and higher beta-diversity after HPD. In addition, this alteration of microbial structure may be related to the replacement process and co-occurring community. Most species are also enriched or impoverished in the colon during this process. After analyzing the functional genes related to protein and carbohydrate hydrolysis in different niches, we found that the carbon source provided by poor carbohydrates compared with the rich protein may be the potential factor driving the enrichment of mucin degraders and desulphaters in the colon under HPD. Therefore, our study provided a new insight to understand the underlying mechanism of HPD affecting intestinal health from the perspective of microbial functional ecology.

Exploring the Plasticity of Diet on Gut Microbiota and Its Correlation with Gut Health.

Dietary habits have been proven to help alter the composition of gut microbiota, and exploring the impact of nutritional patterns on gut microbiota changes can help protect gut health. However, few studies have focused on the dietary impact on the gut microbiota over an experimental timeframe. In this study, 16S rRNA gene sequencing was employed to investigate the gut microbiota of mice under different dietary patterns, including AIN-93G diet (Control), high protein diet (HPD), high fiber diet (HFD), and switch diet (Switch). The alpha diversity of the HPD group significantly decreased, but HFD can restore this decline. During HPD, some genera were significantly upregulated (e.g., Feacalibaculum) and downregulated (e.g., Parabacteroides). However, after receiving HFD, other genera were upregulated (e.g., Akkermansia) and downregulated (e.g., Lactobacillus). In addition, the interaction between pathogenic bacteria was more pronounced during HPD, while the main effect was probiotics during HFD. In conclusion, the plasticity exhibited by the gut microbiota was subject to dietary influences, wherein disparate dietary regimens hold pivotal significance in upholding the well-being of the host. Therefore, our findings provide new ideas and references for the relationship between diets and gut microbiota.

Pro-inflammatory Cytokines Promote the Occurrence and Development of Colitis-associated Colorectal Cancer by Inhibiting miR-615-5p.

BACKGROUND: Patients with ulcerative colitis (UC) may be prone to colitis-associated colorectal cancer (CAC), but there is still a poor understanding of the underlying mechanism so far. This study intended to clarify the role of pro-inflammatory cytokines and miR-615-5p in this process. METHODS: This experiment first detected miR-615-5p expressions in paraffin-embedded sections of colonic tissues from patients with UC and CAC. Then, we investigated the mechanism through which pro-inflammatory cytokines affected miR-615-5p. Furthermore, in vivo and in vitro tests were performed to identify how miR-615-5p affected colorectal cancer (CRC). Dual-luciferase reporter assay was then employed to identify the targeting relationship between miR-615-5p and stanniocalcin-1 (STC1). RESULTS: The miR-615-5p was lowly expressed in both cancerous and noncancerous colonic tissues of patients with CAC. Pro-inflammatory cytokines downregulated miR-615-5p expression. Overexpression of miR-615-5p reduced the proliferation and migration of CRC cells and had a certain therapeutic effect on in human CRC xenograft mice. Stanniocalcin-1 was identified to be a target gene of miR-615-5p and was involved in the effect of miR-615-5p on CRC. CONCLUSIONS: During the progression from UC to CAC, pro-inflammatory cytokines downregulate miR-615-5p, which may induce the upregulation of STC1, and promote the occurrence and development of tumors. These findings offer new insights into the mechanism of CAC and may indicate novel tumor markers or therapeutic targets.

Improved comprehensive evaluation of Crohn's disease activity by intestinal computed tomography enterography combined with endoscopy and biochemical indicators.

BACKGROUND AND STUDY AIMS: The treatment approach for Crohn's disease (CD) is focused on mucosal healing and resolution of transmural inflammation. The aim of this study is to evaluate the correlation between computed tomography enterography (CTE) and other treatments, in particular, endoscopy and biochemical indicators, in newly diagnosed patients with CD. PATIENTS AND METHODS: One hundred twenty-three patients with CD who received CTE in Xiangya Hospital, Central South University, China, from April 2017 to April 2019 were included. The clinical case data and imaging results were retrospectively reviewed. The clinical activity of CD was determined by the Crohn's disease activity index (CDAI) score and biochemical indicators. The relationships between CTE and endoscopy, CDAI score, and inflammatory markers were evaluated. RESULTS: The diagnostic rate of CTE of the 123CD patients was 68.3% (84/123). Logistic regression analysis showed that the specific CTE manifestations related to CD activity were intestinal wall stratification, comb sign, and abdominal abscesses (P < 0.05). Spearman's rank correlation analysis showed that inflammatory markers positively correlated with different CTE imaging manifestations. CONCLUSION: Intestinal CTE combined with endoscopy and biochemical indicators is both comprehensive and effective in evaluating the condition of CD patients.

Comparing diagnostic performance of Cantonese-Chinese version of Rome IV criteria and a short Reference Standard for functional dyspepsia in China.

INTRODUCTION: Functional dyspepsia (FD) is diagnosed based on self-reported symptoms and negative upper gastrointestinal endoscopic findings. The Rome criteria were not adopted as a diagnostic instrument in clinical guidelines due to their complexity. Different guidelines used relatively simple symptom assessment schemes with contents that vary significantly. A previously evaluated short Reference Standard may serve as a more standardised tool for guidelines. We evaluated its diagnostic accuracy against the Rome IV criteria in a cross-sectional study in Hong Kong. METHODS: A total of 220 dyspeptic patients sampled consecutively from a tertiary hospital and the community completed the Rome IV diagnostic questionnaire, which was translated into Cantonese-Chinese, and the Reference Standard. Sensitivity, specificity, positive and negative likelihood ratios (LRs), and area under the receiver operating characteristics curve (AUC), with 95% confidence intervals (CIs), were calculated. RESULTS: Among the participants, 160 (72.7%) fulfilled the Reference Standard with negative upper gastrointestinal endoscopic results. The Reference Standard identified patients with Rome IV-defined FD with 91.1% (95% CI 82.6%-96.4%) sensitivity and 37.6% (95% CI 29.6%-46.1%) specificity. The positive and negative LRs were 1.46 (95% CI 1.26-1.69) and 0.24 (95% CI 0.11-0.49), respectively. The AUC value was 0.64 (95% CI 0.59-0.69). CONCLUSIONS: The Reference Standard can rule out patients without Rome IV-defined FD. It may be used as an initial screening tool for FD in settings where the use of the Rome IV criteria is impractical. It may also provide a uniform definition and diagnostic rule for future updates of clinical guidelines.

Quantification of prevalence, clinical characteristics, co-existence, and geographic variations of traditional Chinese medicine diagnostic patterns via latent tree analysis-based differentiation rules among functional dyspepsia patients.

BACKGROUND: Traditional Chinese Medicine (TCM) treatment strategies are guided by pattern differentiation, as documented in the eleventh edition of the International Classification of Diseases (ICD). However, no standards for pattern differentiation are proposed to ensure inter-rater agreement. Without standardisation, research on associations between TCM diagnostic patterns, clinical features, and geographical characteristics is also not feasible. This diagnostic cross-sectional study aimed to (i) establish the pattern differentiation rules of functional dyspepsia (FD) using latent tree analysis (LTA); (ii) compare the prevalence of diagnostic patterns in Hong Kong and Hunan; (iii) discover the co-existence of diagnostic patterns; and (iv) reveal the associations between diagnostic patterns and FD common comorbidities. METHODS: A total of 250 and 150 participants with FD consecutively sampled in Hong Kong and Hunan, respectively, completed a questionnaire on TCM clinical features. LTA was performed to reveal TCM diagnostic patterns of FD and derive relevant pattern differentiation rules. Multivariate regression analyses were performed to quantify correlations between different diagnostic patterns and between diagnostic patterns and clinical and geographical variables. RESULTS: At least one TCM diagnostic pattern was differentiated in 70.7%, 73.6%, and 64.0% of the participants in the overall (n = 400), Hong Kong (n = 250), and Hunan (n = 150) samples, respectively, using the eight pattern differentiation rules derived. 52.7% to 59.6% of the participants were diagnosed with two or more diagnostic patterns. Cold-heat complex (59.8%) and spleen-stomach dampness-heat (77.1%) were the most prevalent diagnostic patterns in Hong Kong and Hunan, respectively. Spleen-stomach deficiency cold was highly likely to co-exist with spleen-stomach qi deficiency (adjusted odds ratio (AOR): 53.23; 95% confidence interval (CI): 21.77 to 130.16). Participants with severe anxiety tended to have liver qi invading the stomach (AOR: 1.20; 95% CI: 1.08 to 1.33). CONCLUSIONS: Future updates of the ICD, textbooks, and guidelines should emphasise the importance of clinical and geographical variations in TCM diagnosis. Location-specific pattern differentiation rules should be derived from local data using LTA. In future, patients' pattern differentiation results, local prevalence of TCM diagnostic patterns, and corresponding TCM treatment choices should be accessible to practitioners on online clinical decision support systems to streamline service delivery.

Latent tree analysis for the identification and differentiation of evidence-based Traditional Chinese Medicine diagnostic patterns: A primer for clinicians.

BACKGROUND: A supplementary chapter on the diagnostic patterns of Traditional Medicine, including Traditional Chinese Medicine (TCM), was introduced into the latest edition of the International Classification of Diseases (ICD-11). However, evidence-based rules are yet to be developed for pattern differentiation in patients with specific conventional medicine diagnoses. Without such standardised rules, the level of diagnostic agreement amongst practitioners is unsatisfactory. This may reduce the reliability of practice and the generalisability of clinical research. PURPOSE: Using cross-sectional study data from patients with functional dyspepsia, we reviewed and illustrated a quantitative approach that combines TCM expertise and computer algorithmic capacity, namely latent tree analysis (LTA), to establish score-based pattern differentiation rules. REVIEW OF METHODS: LTA consists of six major steps: (i) the development of a TCM clinical feature questionnaire; (ii) statistical pattern discovery; (iii) statistical pattern interpretation; (iv) TCM diagnostic pattern identification; (v) TCM diagnostic pattern quantification; and (vi) TCM diagnostic pattern differentiation. Step (i) involves the development of a comprehensive questionnaire covering all essential TCM clinical features of the disease of interest via a systematic review. Step (ii) to (iv) required input from TCM experts, with the algorithmic capacity provided by Lantern, a dedicated software for TCM LTA. MOTIVATIONAL EXAMPLE TO ILLUSTRATE THE METHODS: LTA is used to quantify the diagnostic importance of various clinical features in each TCM diagnostic pattern in terms of mutual information and cumulative information coverage. LTA is also capable of deriving score-based differentiation rules for each TCM diagnostic pattern, with each clinical feature being provided with a numerical score for its presence. Subsequently, a summative threshold is generated to allow pattern differentiation. If the total score of a patient exceeded the threshold, the patient was diagnosed with that particular TCM diagnostic pattern. CONCLUSIONS: LTA is a quantitative approach to improving the inter-rater reliability of TCM diagnosis and addressing the current lack of objectivity in the ICD-11. Future research should focus on how diagnostic information should be coupled with effectiveness evidence derived from network meta-analysis. This will enable the development of an implementable diagnostics-to-treatment scheme for further evaluation. If successful, this scheme will transform TCM practice in an evidence-based manner, while preserving the validity of the model.

Objective Outcomes of an Extended Anti-reflux Mucosectomy in the Treatment of PPI-Dependent Gastroesophageal Reflux Disease (with Video).

BACKGROUND: Anti-reflux mucosectomy (ARMS) is a choice for proton pump inhibitor (PPI)-dependent patients with gastroesophageal reflux disease (GERD). We present an extended anti-reflux mucosectomy, named ligation-assisted anti-reflux mucosectomy (L-ARMS). The aim of this study was to assess the feasibility of the procedure and short-term outcomes on PPI use and symptom resolution. METHODS: Institutional review board approval was obtained for retrospective review of a prospectively collected database including patients who underwent L-ARMS. L-ARMS includes mucosa ligation and endoscopic mucosectomy without submucosal injection around the squamocolumnar junction. The GERD symptoms, endoscopy, 24-h pH monitoring results, and manometry were collected by chart review. Voluntary validated surveys assessed symptomatic improvement over time. RESULTS: There were 69 patients available for review. The procedure was technically completed in all cases with no severe complications, and the average operation time was 33 min. At 6 months after L-ARMS, treatment with PPIs had been halted in 55.1% of the patients, 30.4% of the enrolled patients used PPIs occasionally, and the lower esophageal sphincter (LES) pressure, DeMeester scores, and GERD-health-related quality of life questionnaire (GERD-HRQL) scores showed a significant improvement compared with the baseline measurements (P < 0.001). Forty-five patients complained of mild dysphagia and were relieved in 4 weeks with no specific treatment. Compared to patients without dysphagia, patients complained of dysphagia after surgery had better clinical benefits indicated by GERD-HRQL and DeMeester score. CONCLUSIONS: As a modified ARMS, L-ARMS is an effective procedure for controlling GERD symptoms, esophageal acid exposure, and LES pressure, which can be safely performed endoscopically in a time-saving and simple manner.

A Machine Learning-Based System for Real-Time Polyp Detection (DeFrame): A Retrospective Study.

Background and Aims: Recent studies have shown that artificial intelligence-based computer-aided detection systems possess great potential in reducing the heterogeneous performance of doctors during endoscopy. However, most existing studies are based on high-quality static images available in open-source databases with relatively small data volumes, and, hence, are not applicable for routine clinical practice. This research aims to integrate multiple deep learning algorithms and develop a system (DeFrame) that can be used to accurately detect intestinal polyps in real time during clinical endoscopy. Methods: A total of 681 colonoscopy videos were collected for retrospective analysis at Xiangya Hospital of Central South University from June 2019 to June 2020. To train the machine learning (ML)-based system, 6,833 images were extracted from 48 collected videos, and 1,544 images were collected from public datasets. The DeFrame system was further validated with two datasets, consisting of 24,486 images extracted from 176 collected videos and 12,283 images extracted from 259 collected videos. The remaining 198 collected full-length videos were used for the final test of the system. The measurement metrics were sensitivity and specificity in validation dataset 1, precision, recall and F1 score in validation dataset 2, and the overall performance when tested in the complete video perspective. Results: A sensitivity and specificity of 79.54 and 95.83%, respectively, was obtained for the DeFrame system for detecting intestinal polyps. The recall and precision of the system for polyp detection were determined to be 95.43 and 92.12%, respectively. When tested using full colonoscopy videos, the system achieved a recall of 100% and precision of 80.80%. Conclusion: We have developed a fast, accurate, and reliable DeFrame system for detecting polyps, which, to some extent, is feasible for use in routine clinical practice.

Automated Disease Detection in Gastroscopy Videos Using Convolutional Neural Networks.

A large percentage of the world's population is affected by gastric diseases ranging from erosion and ulcer to serious ailments such as gastric cancer, which is mainly caused by Helicobacter pylori(H.pylori) infection. While most erosions and ulcers are benign, severe cases of gastric diseases can still develop into cancer. Thus, early screening and treatment of all gastric diseases are of great importance. Upper gastroscopy is one such common screening procedure that visualizes the patient's upper digestive system by inserting a camera attached to a rubber tube down the patient's digestive tracts, but since the procedure requires manual inspection of the video feed, it is prone to human errors. To improve the sensitivity and specificity of gastroscopies, we applied deep learning methods to develop an automated gastric disease detection system that detects frames of the video feed showing signs of gastric diseases. To this end, we collected data from images in anonymous patient case reports and gastroscopy videos to train and evaluate a convolutional neural network (CNN), and we used sliding window to improve the stability of our model's video performance. Our CNN model achieved 84.92% sensitivity, 88.26% specificity, and 85.2% F1-score on the test set, as well as 97% true positive rate and 16.2% false positive rate on a separate video test set.

Exploration of the Potential Relationship Between Gut Microbiota Remodeling Under the Influence of High-Protein Diet and Crohn's Disease.

Diet and gut microbiota are both important factors in the pathogenesis of Crohn's disease, and changes in diet can lead to alteration in gut microbiome. However, there is still insufficient exploration on interaction within the gut microbiota under high-protein diet (HPD) intervention. We analyzed the gut microbial network and marker taxa from patients with Crohn's disease in public database (GMrepo, https://gmrepo.humangut.info) combined with investigation of the changes of composition and function of intestinal microbiome in mice fed on HPD by metagenomic sequencing. The results showed that there was an indirect negative correlation between Escherichia coli and Lachnospiraceae in patients with Crohn's disease, and Escherichia coli was a marker for both Crohn's disease and HPD intervention. Besides, enriched HH_1414 (one of the orthologs in eggNOG) related to tryptophan metabolism was from Helicobacter, whereas reduced orthologs (OGs) mainly contributed by Lachnospiraceae after HPD intervention. Our research indicates that some compositional changes in gut microbiota after HPD intervention are consistent with those in patients with Crohn's disease, providing insights into potential impact of altered gut microbes under HPD on Crohn's disease.

AFP-Mask: Anchor-Free Polyp Instance Segmentation in Colonoscopy.

Colorectal cancer (CRC) is a common and lethal disease. Globally, CRC is the third most commonly diagnosed cancer in males and the second in females. The most effective way to prevent CRC is through using colonoscopy to identify and remove precancerous growths at an early stage. The detection and removal of colorectal polyps have been found to be associated with a reduction in mortality from colorectal cancer. However, the false negative rate of polyp detection during colonoscopy is often high even for experienced physicians. With recent advances in deep learning based object detection techniques, automated polyp detection shows great potential in helping physicians reduce false positive rate during colonoscopy. In this paper, we propose a novel anchor-free instance segmentation framework that can localize polyps and produce the corresponding instance level masks without using predefined anchor boxes. Our framework consists of two branches: (a) an object detection branch that performs classification and localization, (b) a mask generation branch that produces instance level masks. Instead of predicting a two-dimensional mask directly, we encode it into a compact representation vector, which allows us to incorporate instance segmentation with one-stage bounding-box detectors in a simple yet effective way. Moreover, our proposed encoding method can be trained jointly with object detector. Our experiment results show that our framework achieves a precision of 99.36% and a recall of 96.44% on public datasets, outperforming existing anchor-free instance segmentation methods by at least 2.8% in mIoU on our private dataset.

Room-Temperature Assembled MXene-Based Aerogels for High Mass-Loading Sodium-Ion Storage.

Low-temperature assembly of MXene nanosheets into three-dimensional (3D) robust aerogels addresses the crucial stability concern of the nano-building blocks during the fabrication process, which is of key importance for transforming the fascinating properties at the nanoscale into the macroscopic scale for practical applications. Herein, suitable cross-linking agents (amino-propyltriethoxysilane, Mn2+, Fe2+, Zn2+, and Co2+) as interfacial mediators to engineer the interlayer interactions are reported to realize the graphene oxide (GO)-assisted assembly of Ti3C2Tx MXene aerogel at room temperature. This elaborate aerogel construction not only suppresses the oxidation degradation of Ti3C2Tx but also generates porous aerogels with a high Ti3C2Tx content (87 wt%) and robustness, thereby guaranteeing the functional accessibility of Ti3C2Tx nanosheets and operational reliability as integrated functional materials. In combination with a further sulfur modification, the Ti3C2Tx aerogel electrode shows promising electrochemical performances as the freestanding anode for sodium-ion storage. Even at an ultrahigh loading mass of 12.3 mg cm-2, a pronounced areal capacity of 1.26 mAh cm-2 at a current density of 0.1 A g-1 has been achieved, which is of practical significance. This work conceptually suggests a new way to exert the utmost surface functionalities of MXenes in 3D monolithic form and can be an inspiring scaffold to promote the application of MXenes in different areas.

Surface Chemistry and Mesopore Dual Regulation by Sulfur-Promised High Volumetric Capacity of Ti3 C2 Tx Films for Sodium-Ion Storage.

Electrochemical sodium-ion storage has come out as a promising technology for energy storage, where the development of electrode material that affords high volumetric capacity and long-term cycling stability remains highly desired yet a challenge. Herein, Ti3 C2 Tx (MXene)-based films are prepared by using sulfur (S) as the mediator to modulate the surface chemistry and microstructure, generating S-doped mesoporous Ti3 C2 Tx films with high flexibility. The mesoporous architecture offers desirable surface accessibility without significantly sacrificing the high density of Ti3 C2 Tx film. Meanwhile, the surface sulfur doping of Ti3 C2 Tx favors the diffusion of sodium ions. These merits are of critical importance to realize high volumetric capacity of the electrode material. As a consequence, as the freestanding electrode material for electrochemical sodium-ion storage, the S-doped mesoporous Ti3 C2 Tx film exhibits a high volumetric capacity of 625.6 mAh cm-3 at 0.1 A g-1 , which outperforms that of many reported electrodes. Moreover, outstanding rate capability and excellent long-term cycling stability extending 5000 cycles are achieved. The work opens the door for innovative design and rational fabrication of MXene-based films with ultrahigh volumetric capacity for sodium-ion storage.

Porous hard carbon spheres derived from biomass for high-performance sodium/potassium-ion batteries.

Hard carbon is the most attractive anode material for electrochemical sodium/potassium-ion storage. The preparation of hard carbon spheres directly from the broad sources of biomass is of great interest but barely reported. Herein, we developed a simple two-step hydrothermal method to construct porous carbon microspheres directly from the original waste biomass of camellia shells. The porous carbon microspheres have high specific capacities of 250 mAh g-1and 264.5 mAh g-1at a current density of 100 mA g-1for sodium-ion batteries and potassium-ion batteries, respectively. And it has excellent cycle stability for sodium ions and potassium ions outperforming most reported hard carbons, which is mainly attributed to the microporous structure and spherical morphology. The work paves a way to prepare porous hard carbon spheres directly from biomass for alkali metal-ion batteries.

Increased mucin-degrading bacteria by high protein diet leads to thinner mucus layer and aggravates experimental colitis.

BACKGROUND AND AIM: Westernized high-fat diet increases the risk for inflammatory bowel diseases (IBDs), yet with insufficient understanding of the role of high-protein diet. We aimed to identify the effect of high-protein diets from different dietary proteins (casein, whey protein, soy protein) on experimental colitis and its impact on microbiota, structure and function of colonic mucus layer. METHODS: Female BALB/c mice were fed by standard diet, high-casein diet (HCD), high whey protein diet or high soy protein diet for 4 weeks. The susceptibility of dextran sulfate sodium (DSS)-induced colitis in mice and thickness of colonic mucus layer were compared after different dietary interventions, associated with the identification of the reversal effect of broad-spectrum antibiotic intervention (0.5 g/L of vancomycin and 1 g/L of neomycin sulfate, metronidazole and ampicillin in drinking water). Further analysis was performed on the synthesis of mucin, microbiota and sialidase involved in degradation of mucus layer. RESULTS: High-protein diets aggravated acute DSS-induced colitis independent of protein composition, while broad-spectrum antibiotics reversed this effect. HCD significantly altered the composition of bacteria in the colonic mucus layer, especially Bacteroides thetaiotaomicron and total mucin-degrading bacteria; besides, it increased sialidase concentration and reduced the thickness of mucus layer. However, it exhibited no significant effect on the synthesis of Muc2. Broad-spectrum antibiotics decreased the abundance of mucin-degrading bacteria and sialidase concentration while increased the thickness of mucus layer. CONCLUSION: High-protein diet shifts microbial composition and thickness of colonic mucus layer, leading to the aggravation of acute DSS-induced colitis.

Schottky Junctions with Bi Cocatalyst for Taming Aqueous Phase N2 Reduction toward Enhanced Solar Ammonia Production.

Solar-powered N2 reduction in aqueous solution is becoming a research hotspot for ammonia production. Schottky junctions at the metal/semiconductor interface have been effective to build up a one-way channel for the delivery of photogenerated electrons toward photoredox reactions. However, their applications for enhancing the aqueous phase reduction of N2 to ammonia have been bottlenecked by the difficulty of N2 activation and the competing H2 evolution reaction (HER) at the metal surface. Herein, the application of Bi with low HER activity as a robust cocatalyst for constructing Schottky-junction photocatalysts toward N2 reduction to ammonia is reported. The introduction of Bi not only boosts the interfacial electron transfer from excited photocatalysts due to the built-in Schottky-junction effect at the Bi/semiconductor interface but also synchronously facilitates the on-site N2 adsorption and activation toward solar ammonia production. The unidirectional charge transfer to the active site of Bi significantly promotes the photocatalytic N2-to-ammonia conversion efficiency by 65 times for BiOBr. In addition, utilizing Bi to enhance the photocatalytic ammonia production can be extended to other semiconductor systems. This work is expected to unlock the promise of engineering Schottky junctions toward high-efficiency solar N2-to-ammonia conversion in aqueous phase.

Delayed Infliximab Treatment Affects the Outcomes of Patients With Crohn's Disease During the COVID-19 Epidemic in China: A Propensity Score-Matched Analysis.

Background: The coronavirus disease 2019 (COVID-19) has swept the world and led to delays in the treatment of Crohn's disease patients treated with biologics. This study aims to investigate the risk factors for delayed treatment during the epidemic and to observe the short- and long-term influences of such delays among them to provide some reference on treatments. Methods: This study retrospectively enrolled patients diagnosed with Crohn's disease who received infliximab treatment between January 23, 2020 and April 30, 2020. Univariate and multivariate logistic regression were used to analyze the risk factors for delayed treatment. Propensity score matching was utilized to compare the effects of delayed treatment on the short- and long-term outcomes. Result: Our cohort identified a total of 53 patients with a delay rate of 71.7%. Of these patients, 38 were in the delayed group, and 15 were in the non-delayed group. Logistic regression analysis showed that the baseline levels of C-reactive protein were an influence factor for delaying treatment (OR = 0.967, 95% CI = 0.935-1.000, p = 0.047). Regarding short-term effects, the delayed group had a lower decrease in the Crohn's Disease Activity Index than the non-delayed group [-43.3 (-92.7, -9.7) vs. -17.3 (-29.0, 79.9), p = 0.038] and significantly higher long-term readmission rates (33.3% vs. 0%, p = 0.014). Conclusion: Delayed infliximab treatment could affect the short- and long-term outcomes in patients with Crohn's disease. Our study suggested that the regulated course of treatment with biological agents should be performed effectively and that education should be enhanced to minimize delays in treatment.