The intestine is a complex symbiotic system, and the gut microbiota is closely related to host health. Studies have indicated that the gut microbiota influences physiological functions of the host by producing a variety of metabolites, which act as signaling molecules and substrates for metabolic reactions in the host. Dysbiosis of the gut microbiota affects the abundance of gut microbiota-derived metabolites, thereby influencing host health by disrupting signal transduction in multiple organs. Additionally, dietary compounds can shape the gut microbiota, affecting gut microbiota-derived metabolite levels and regulating host metabolism. This article introduces the methods for mining gut microbiota-derived metabolites, reviews the roles of these metabolites in metabolic diseases and related dietary interventions. Which provides a perspective on the prevention and treatment of metabolic diseases by targeting these metabolites, enriching the knowledge on the role of gut microbiota in the regulation of host metabolism.
Gastrointestinal Microbiome/physiology* ; Humans ; Dysbiosis/microbiology* ; Metabolic Diseases/metabolism* ; Diet

With the increasing prevalence of chronic kidney disease (CKD) and the progress of renal replacement therapy, there were more and more patients with long-term hemodialysis (hemodialysis). Cardiovascular diseases were the leading cause of death among hemodialysis patients, and a lot of these patients needed to be treated with percutaneous coronary intervention (PCI). However, hemodialysis patients had higher risks of both bleeding and thrombotic events, which made it difficulty to select drugs and their dosages for post-PCI dual antiplatelet therapy in clinical practice, and the impacts of hemodialysis on dual antiplatelet therapy were still unclear. We reported a 65-year-old male patient with CKD, who was on long-term hemodialysis treatment and underwent PCI for acute non-ST segment elevation myocardial infarction. The patient was given dual antiplatelet therapy with aspirin and clopidogrel after the procedure, and on the fourth day after PCI (14 hours after restarting hemodialysis), he developed subacute stent thrombosis due to clopidogrel resistance, which was resolved after revascularization. Based on the treatment experience in this patient and review of relevant literature, we proposed recommendations on management of dual antiplatelet therapy in long-term hemodialysis patients from 3 aspects: drug selection, clopidogrel dose adjustment, and hemodialysis management after PCI.

With the increasing prevalence of chronic kidney disease (CKD) and the progress of renal replacement therapy, there were more and more patients with long-term hemodialysis (hemodialysis). Cardiovascular diseases were the leading cause of death among hemodialysis patients, and a lot of these patients needed to be treated with percutaneous coronary intervention (PCI). However, hemodialysis patients had higher risks of both bleeding and thrombotic events, which made it difficulty to select drugs and their dosages for post-PCI dual antiplatelet therapy in clinical practice, and the impacts of hemodialysis on dual antiplatelet therapy were still unclear. We reported a 65-year-old male patient with CKD, who was on long-term hemodialysis treatment and underwent PCI for acute non-ST segment elevation myocardial infarction. The patient was given dual antiplatelet therapy with aspirin and clopidogrel after the procedure, and on the fourth day after PCI (14 hours after restarting hemodialysis), he developed subacute stent thrombosis due to clopidogrel resistance, which was resolved after revascularization. Based on the treatment experience in this patient and review of relevant literature, we proposed recommendations on management of dual antiplatelet therapy in long-term hemodialysis patients from 3 aspects: drug selection, clopidogrel dose adjustment, and hemodialysis management after PCI.

Objective:To evaluate the effects of pulmonary embolism response team (PERT) on the quality of care and clinical outcomes in patients with acute pulmonary embolism.Methods:This was a single-center retrospective cohort study. Patients with acute pulmonary embolism treated in Beijing Anzhen Hospital Affiliated to Capital Medical University from July 5, 2016 to July 4, 2018 were enrolled. Patients with acute pulmonary embolism who had traditional care from July 5, 2016 to July 4, 2017 (before the implementation of PERT) were classified as PERT pre-intervention group. Patients with acute pulmonary embolism who started PERT care from July 5, 2017 to July 4, 2018 were divided into the PERT intervention group. The diagnosis and treatment information of patients was collected through the electronic medical record system, and the quality of care (time from visit to hospitalization, time from hospitalization to anticoagulation initiation, time from visit to definitive diagnosis, total hospital stay, time in intensive care unit (ICU), hospitalization cost) and clinical outcomes (in-hospital mortality and incidence of bleeding) were compared between the two groups.Results:A total of 210 patients with acute pulmonary embolism, aged (63.3±13.7) years old, with 102 (48.6%) female patients were included. There were 108 cases in PERT pre-intervention group and 102 cases in PERT intervention group. (1) Quality of diagnosis and treatment: there was a statistical significance between the two groups in the distribution of time from diagnosis to definitive diagnosis ( P=0.002). Among them, the rate of completion of diagnosis within 24 hours after PERT intervention was higher than that before PERT intervention (80.4% (45/56) vs. 50.0% (34/68), P<0.001). The time from treatment to hospitalization was shorter than that before PERT intervention (180.0 (60.0, 645.0) min vs. 900.0 (298.0, 1 806.5) min, P<0.001). The total length of hospital stay was less than that before PERT intervention (12 (10, 14) d vs. 14 (11, 16) d, P=0.001). There was no statistical significance in the time from hospitalization to anticoagulant therapy, the length of ICU stay and hospitalization cost between the two groups (all P>0.05). (2) Clinical outcomes during hospitalization: There was no statistical significance in the incidence of hemorrhage and mortality between the two groups during hospitalization (both P>0.05). Conclusion:PERT has improved the efficiency of diagnosis and treatment of patients with acute pulmonary embolism and significantly shortened the total hospital stay, but its impact on clinical outcomes still needs further study.

Objective:To detect the expression of angiogenic factor (AGGF1) with G-patch and FHA domain 1 in hepatocellular carcinoma (HCC), and to investigate its relationship with HCC angiogenesis, invasion and metastasis and its clinical significance.Methods:A total of 90 primary HCC patients were selected from the Huangshi Central Hospital and Hubei Province Cancer Hospital from January 2019 to September 2020. Clinicopathological data of all patients were collected. The expression of AGGF1 and CD34 in cancer tissues of 90 HCC patients was detected by immunohistochemistry, and microvascular density (MVD) was calculated. The patients were followed up for three years. The relationship between AGGF1 and serum angiopoietin-2 (Ang-2) content, MVD, clinicopathological parameters and postoperative prognosis was analyzed.Results:The positive rate, relative expression level and MVD value of AGGF1 in HCC tissues were significantly higher than those in adjacent tissues (all P<0.05). The relative expression of AGGF1 in cancer tissues was positively correlated with the MVD value ( r=0.716). Serum Ang-2 content and MVD in AGGF1-positive patients were significantly higher than those in AgGF1-negative patients (all P<0.01). AGGF1 expression in HCC tissues was significantly correlated with tumor differentiation, tumor size, (China Liver Cancer (CNLC) staging, lymph node metastasis, vascular invasion, and postoperative recurrence and metastasis (all P<0.01). Kaplan-Meier analysis showed that the 2- and 3-year survival rates of patients with high AGGF1 expression were significantly lower than those of patients with low AGGF1 expression (all P<0.01). Multivariate analysis showed that CNLC stage, lymph node metastasis, vascular invasion, AGGF1 expression, postoperative recurrence and metastasis were the influencing factors for postoperative survival of HCC patients (all P<0.05). Conclusions:The high expression of AGGF1 can promote the angiogenesis of HCC, and is significantly correlated with invasion and metastasis and poor prognosis, which can be a potential evaluation indicator of HCC clinical prognosis.

Objective:To observe the clinical characteristics of female patients with ST-segment elevation myocardial infarction (STEMI) complicated with multivessel disease (MVD) undergoing direct percutaneous coronary intervention (PCI), and to explore the factors affecting the prognosis of female patients.Methods:In this retrospective cohort study. 1 033 patients (196 women) with STEMI combined with MVD who were admitted to our hospital from 2005 to 2015 and successful completed direct PCI within 24 h onset of symptom were enrolled. Patients’ baseline data, PCI data and follow-up results were recorded. Kaplan-Meier method was used to plot the survival curve. Cox regression model was used to screen the prognostic factors of STEMI patients with multivessel disease.Results:Compared with male patients, the age of female patients was significantly older, while the proportion of smoking history, family history of coronary heart disease, and stent implantation history was significantly lower, the time from onset to PCI was significantly longer, and the proportion of intraoperative slow blood flow/no-reflow was significantly higher among female patients. The mean follow-up time was 4 years, and the incidence of major adverse cardiovascular events (MACE) was higher in women than in men. The main factor affecting the prognosis of female patients was Killip cardiac function grade Ⅱ~Ⅳ ( HR=1.804, 95% CI: 1.060~3.071, P<0.05). The number of lesions with >50% occlusion ( HR=1.808, 95% CI 1.123-2.912, P < 0.01) was a common risk factor for both men and women. Conclusions:Compared with male patients, there is more treatment delay among female patients with STEMI and MVD, the incidence of MACE is higher, and cardiac insufficiency is the main factor affecting the prognosis of female patients.

Objective:To analyze the effect of elevated pulmonary artery pressure measured by echocardiography on clinical characteristics and adverse events in patients with acute pulmonary embolism.Methods:Retrospective analysis hospitalized patients with acute pulmonary embolism diagnosed in Beijing Anzhen Hospital Affiliated to Capital Medical University from January 1, 2018 to December 31, 2020 were divided into elevated pulmonary artery pressure group and control group according to pulmonary artery pressure measured by echocardiography. The differences between the two groups in admission baseline data, admission basic situation, admission hematology examination, admission imaging examination, in-hospital medication and in-hospital adverse events were compared.Results:A total of 568 patients with acute pulmonary embolism were included, including 178 in the elevated pulmonary artery pressure group and 390 in the control group. The data analysis of the two groups showed that the proportion of height, weight, body mass index, smoking history, coronary heart disease history, stroke history, diabetes history, chronic heart failure history, chronic obstructive pulmonary disease history and chronic renal insufficiency history in the group with elevated pulmonary artery pressure was significantly higher than that in the control group. The proportion of fracture in the group with elevated pulmonary artery pressure was significantly lower than that in the control group, and the proportion of tumor and heart rate were significantly higher than those in the control group. The hemoglobin, international standardized ratio, D-dimer, PaO 2, SaO 2, etc. of patients with elevated pulmonary artery pressure were significantly lower than those of the control group, and TnI, B-type natriuretic peptide, etc. were significantly higher than those of the control group. The left ventricular ejection fraction of patients with elevated pulmonary artery pressure was significantly lower than those of the control group, and the left ventricular end diastolic diameter, the proportion of mitral regurgitation, the proportion of tricuspid regurgitation, and the proportion of pulmonary artery embolism were significantly higher than those of the control group. The use proportion of rivaroxaban in patients with elevated pulmonary artery pressure was significantly lower than that in the control group, and the use proportion of aspirin and warfarin was significantly higher than that in the control group. The incidence of all-cause death, acute heart failure and in-hospital hemorrhage in the group with elevated pulmonary artery pressure was significantly higher than that in the control group. There was no significant difference in other indexes between the two groups. Conclusions:There are some differences in clinical characteristics and prognosis between patients with acute pulmonary embolism complicated with elevated pulmonary artery pressure and patients with normal pulmonary artery pressure. The increase of pulmonary artery pressure may increase the risk of all-cause death, acute heart failure and nosocomial bleeding to a certain extent.

Objective::This study aimed to estimate the proportion of non-obstructive coronary artery disease (CAD) patients in large percutaneous coronary intervention (PCI) centers in China.Methods::The study was conducted at 6 large PCI centers in China from January 1, 2013 to December 31, 2015. Demographic and clinical data were collected from medical records, prescription records, and laboratory reports of patients with symptoms of angina who underwent coronary angiography (CAG).Results::A total of 1713 patients were consecutively screened, 1600 of whom were included in the study. CAG showed that 300 patients had non-obstructive CAD while 1300 had obstructive CAD. Among the 300 patients with non-obstructive CAD, 203 displayed mild coronary stenosis (20%-49%) and 91 had normal coronary status (ie, <20% stenosis). Of the 1300 patients with obstructive CAD, 61.6% (801/1300) had typical symptoms of angina, compared with 49.3% (148/300) for patients with non-obstructive CAD. In addition, there were more women than men in the non-obstructive CAD group, whereas the reverse was observed among obstructive CAD patients.Conclusion::The prevalence of non-obstructive CAD in the Chinese population with coronary heart disease was estimated to be approximately 20%. Additionally, typical angina symptoms were correlated with obstructive CAD, whereas female gender was identified as a risk factor for non-obstructive CAD.

Objective::This study aimed to estimate the proportion of non-obstructive coronary artery disease (CAD) patients in large percutaneous coronary intervention (PCI) centers in China.Methods::The study was conducted at 6 large PCI centers in China from January 1, 2013 to December 31, 2015. Demographic and clinical data were collected from medical records, prescription records, and laboratory reports of patients with symptoms of angina who underwent coronary angiography (CAG).Results::A total of 1713 patients were consecutively screened, 1600 of whom were included in the study. CAG showed that 300 patients had non-obstructive CAD while 1300 had obstructive CAD. Among the 300 patients with non-obstructive CAD, 203 displayed mild coronary stenosis (20%-49%) and 91 had normal coronary status (ie, <20% stenosis). Of the 1300 patients with obstructive CAD, 61.6% (801/1300) had typical symptoms of angina, compared with 49.3% (148/300) for patients with non-obstructive CAD. In addition, there were more women than men in the non-obstructive CAD group, whereas the reverse was observed among obstructive CAD patients.Conclusion::The prevalence of non-obstructive CAD in the Chinese population with coronary heart disease was estimated to be approximately 20%. Additionally, typical angina symptoms were correlated with obstructive CAD, whereas female gender was identified as a risk factor for non-obstructive CAD.

Objective: To analyle prevalence and trend of substance abuse behaviors among adolescents in Guangdong province and to provide theoretical evidence for effective interventions. Methods: Data regarding smoking, drinking, drugs abuse from Adolescents Health Risk Behavior Survey in 2007, 2010, 2013 and 2016 were collected and comparatively analyzed. Results: The incidences of tried smoking(27.37%), current smoking(8.32%), passive smoking(45.52%), current drinking(27.97%) and drug using(0.75%) in 2016 were lower than that in 2007(32.40%, 10.81%, 52.69%, 31.97%, 1.35%), and the average annual decrease rate were 1.89%, 2.95%, 1.64%, 1.50%, 6.75%, respectively(χ2=152.73, 92.50, 313.92, 46.48, 46.64, P<0.01). During the past decate, the incidences of current smoking in rural adolescents(12.02%, 10.64%, 9.99%, 10.10%) were significantly higher than that in urban adolescents(8.88%, 8.52%, 8.17%, 6.56%)(χ2=54.46, 26.62, 25.23, 100.43, P<0.01); the incidences of current drinking in urban adolescents(33.57%, 30.37%, 35.76%, 30.46%) were significantly higher than that in rural adolescents(30.97%, 28.48%, 28.47%, 25.32%)(χ2=16.71, 10.13, 153.47, 81.76, P<0.01); the incidence of current drinking was the highest among college students in each monitoring year(47.71%, 41.76%, 42.36%, 37.77%)(χ2=583.37, 681.25, 610.04, 729.02, P<0.01); the incidence of current smoking was the highest among vocational school students in each monitoring year(16.36%, 17.00%, 14.90%, 16.71%)(χ2=256.45, 515.61, 339.63, 742.52, P<0.01); In addition to the incidence of drug abuse was the highest among college students in 2010(2.02%), vocational school students were the highest in other years(χ2=66.92, 34.38, 23.08, 20.55, P<0.01). Conclusion Smoking and drug abuse among adolescents in Guangdong showed a declining trend by years, as well as the prevalence of drinking behavior. Strengthened intervention should be targeted on smoking behavior among rural students, drinking behavior among urban students, and smoking behavior and drug abuse among vocational school students.