Objective To investigate the influencing factors for early acute gastrointestinal injury in critically ill patients in the intensive care unit.Methods Among the patients admitted from January 2021 to July 2023,there were 80 critically ill patients with an APACHE Ⅱ score of ≥15 points.Based on whether gastrointestinal injury occurred within one week of admission,they were divided into an acute gastrointestinal injury group(observation group,40 cases)and a control group of 40 cases randomly selected from cases without gastrointestinal injury.Univariate analysis was conducted on various clinical data of the two groups of patients,and the meaningful indicators of univariate analysis were included as independent variables in logistic regression analysis to further screen for risk factors causing gastrointestinal injury in early severe patients.Receiver operating characteristic(ROC)curve was drawn to further evaluate the predictive value of risk factors.Results The results of univariate analysis showed that the observation group had neutrophil/lymphocyte ratio(NLR),lactate,albumin,and application time of vasoactive drugs(h)of 14.05±4.52,(6.94±1.66)mmol/L,(24.49±2.73)g/L,and 63(0,93.5)h,respectively,while the control group had neutrophil/lymphocyte ratio(NLR),lactate,albumin,and vasoactive drug application time(h)of 8.78±3.74,(4.06±1.30)mmol/L,(26.89±2.90)g/L,and 0(0,43)h,respectively.The differences between the two groups were statistically significant(P＜0.05).The results of logistic regression analysis showed that NLR(OR=1.36,95％CI 1.18-1.57,P＜0.001),lactate(OR=18.54,95％CI 3.28-104.73,P=0.001),and application time of vasoactive drugs(h)(OR=1.03,95％CI 1.01-1.04,P＜0.001)all had statistical significance and were risk factors for early acute gastrointestinal injury in critically ill patients;The variable albumin is a protective factor for early acute gastrointestinal injury in critically ill patients,but it has statistical significance(OR=0.74,95％CI 0.63-0.88,P=0.001).ROC curve analysis showed that NLR,lactate,and application time of vasoactive drugs(h)AUC(95％CI)were 0.800(0.707-0.894),0.969(0.940-0.999),and 0.716(0.600-0.831),respectively;The sensitivities were 65％,85％,and 55％,respectively;and the specificities were 80％,95％,and 88％,respectively;the differences were statistically significant(P＜0.05).Conclusion NLR,lactate,and application time of vasoactive drugs(h)are the risk factors for early acute gastrointestinal injury in critically ill patients in the intensive care unit,and have high predictive value.

OBJECTIVE: To investigate the regulatory effects of two traditional mineral medicines (TMMs), Gypsum Fibrosum (Shigao, GF) and Terra Flava Usta (Zaoxintu, TFU), on gut-beneficial bacteria in mice, and preliminarily explore their mechanisms of action. METHODS: Mice were randomly divided into 3 groups (n=10 per group): the control group (standard diet), the GF group (diet supplemented with 2% GF), and the TFU group (diet supplemented with 2% TFU). After 4-week intervention, 16S rRNA gene sequencing was used to analyze the changes in the gut microbiota (GM). Scanning electron microscopy, in combination with coumarin A tetramethyl rhodamine conjugate and Hoechst stainings, was used to observe the bacteria and biofilm formation. RESULTS: Principal coordinate analysis revealed that GF and TFU significantly altered the GM composition in mice. Further analysis revealed that GF and TFU affected different types of gut bacteria, suggesting that different TMMs may selectively modulate specific bacterial populations. For certain bacteria, such as Faecalibaculum and Ileibacterium, both GF and TFU exhibited growth-promoting effects, implying that they may be sensitive to TMMs and that different TMMs can increase their abundance through their respective mechanisms. Notably, Lactobacillus reuteri, a widely recognized and used probiotic, was significantly enriched in the GF group. Random forest analysis identified Ileibacterium valens as a potential indicator bacterium for TMMs' impact on GM. Further mechanistic studies showed that gut bacteria formed biofilm structures on the TFU surface. CONCLUSIONS This study provides new insights into the interaction between TMMs and GM. As safe and effective natural clays, GF and TFU hold promise as potential candidates for prebiotic development.
Animals ; Gastrointestinal Microbiome/drug effects* ; Bacteria/growth & development* ; Mice ; Biofilms/drug effects* ; Male ; RNA, Ribosomal, 16S/genetics*

Objective To investigate the influencing factors for early acute gastrointestinal injury in critically ill patients in the intensive care unit.Methods Among the patients admitted from January 2021 to July 2023,there were 80 critically ill patients with an APACHE Ⅱ score of ≥15 points.Based on whether gastrointestinal injury occurred within one week of admission,they were divided into an acute gastrointestinal injury group(observation group,40 cases)and a control group of 40 cases randomly selected from cases without gastrointestinal injury.Univariate analysis was conducted on various clinical data of the two groups of patients,and the meaningful indicators of univariate analysis were included as independent variables in logistic regression analysis to further screen for risk factors causing gastrointestinal injury in early severe patients.Receiver operating characteristic(ROC)curve was drawn to further evaluate the predictive value of risk factors.Results The results of univariate analysis showed that the observation group had neutrophil/lymphocyte ratio(NLR),lactate,albumin,and application time of vasoactive drugs(h)of 14.05±4.52,(6.94±1.66)mmol/L,(24.49±2.73)g/L,and 63(0,93.5)h,respectively,while the control group had neutrophil/lymphocyte ratio(NLR),lactate,albumin,and vasoactive drug application time(h)of 8.78±3.74,(4.06±1.30)mmol/L,(26.89±2.90)g/L,and 0(0,43)h,respectively.The differences between the two groups were statistically significant(P＜0.05).The results of logistic regression analysis showed that NLR(OR=1.36,95％CI 1.18-1.57,P＜0.001),lactate(OR=18.54,95％CI 3.28-104.73,P=0.001),and application time of vasoactive drugs(h)(OR=1.03,95％CI 1.01-1.04,P＜0.001)all had statistical significance and were risk factors for early acute gastrointestinal injury in critically ill patients;The variable albumin is a protective factor for early acute gastrointestinal injury in critically ill patients,but it has statistical significance(OR=0.74,95％CI 0.63-0.88,P=0.001).ROC curve analysis showed that NLR,lactate,and application time of vasoactive drugs(h)AUC(95％CI)were 0.800(0.707-0.894),0.969(0.940-0.999),and 0.716(0.600-0.831),respectively;The sensitivities were 65％,85％,and 55％,respectively;and the specificities were 80％,95％,and 88％,respectively;the differences were statistically significant(P＜0.05).Conclusion NLR,lactate,and application time of vasoactive drugs(h)are the risk factors for early acute gastrointestinal injury in critically ill patients in the intensive care unit,and have high predictive value.