Intestinal failure (IF) is defined as the critical reduction of functional intestines below the minimum needed to absorb nutrients and fluids, so that intravenous supplementation with parenteral nutrition (PN) is required to maintain health and/or growth. Although the benefits are evident, patients receiving PN can suffer from serious cholestasis due to lack of enteral feeding and small intestinal bacterial overgrowth (SIBO). One such complication that may arise is intestinal failure-associated liver disease (IFALD). Evidences from recent studies suggest that alterations in the intestinal microbiota, as well as intraluminal bile acid driven signaling, may play a critical role in both hepatic and intestinal injury. Since Marshall first proposed the concept of the gut-liver axis in 1998, the role of gut-liver axis disorders in the development of IFALD has received considerable attention. The conversation between gut and liver is the key to maintain liver metabolism and intestinal homeostasis, which influences each other and is reciprocal causation. However, as a "forgotten organ" , intestinal microbiota on the pathogenesis of IFALD has not been well reflected. As such, we propose, for the first time, the concept of gut-microbiota-liver axis to emphasize the importance of intestinal microbiota in the interaction of gut-liver axis. Analysis and research on gut-microbiota-liver axis will be of great significance for understanding the pathogenesis of IFALD and improving the prevention and treatment measures.
Bacterial Infections/physiopathology* ; Bile Acids and Salts/physiology* ; Cholestasis/physiopathology* ; Enteral Nutrition ; Gastrointestinal Microbiome/physiology* ; Humans ; Intestinal Diseases/physiopathology* ; Intestines/physiopathology* ; Liver/physiopathology* ; Liver Diseases/physiopathology* ; Parenteral Nutrition/adverse effects* ; Short Bowel Syndrome/physiopathology* ; Signal Transduction

Inflammatory bowel disease(IBD) is a non-specific and chronic recurrent autoimmune disease that involves the gastrointestinal tract. Clinical symptoms of intestinal bleeding, diarrhea, and weight loss threat to human health and induce colorectal cancer. The pathogenesis included living environment, genetic factors, immune cell infiltration and immune stress, weakened mucosal barrier defense and intestinal flora imbalance. At present, clinical treatment drugs mainly include aminosalicylic acid, corticosteroids, immunosuppressants, biological agents, etc., in view of the disadvantages of poor therapeutic effect and expensive price. The active ingredients of traditional Chinese medicine(TCM) in the treatment IBD have various biological activities and multiple targets such as anti-inflammatory, antibacterial, anti-tumor and immune regulation. This article summarized the application and the research progress in protecting intestinal epithelial barrier, maintaining intestinal microbial homeostasis, inhibiting causative factors, and regulating Th1/Th17/Treg balance about TCM in the treatment of IBD. The review provided new ideas for further development of the new drugs on the mechanism based on active ingredients of TCM in IBD treatment.
Humans ; Inflammatory Bowel Diseases ; therapy ; Intestinal Mucosa ; drug effects ; physiopathology ; Medicine, Chinese Traditional

The ideal treatment and recovery of osteoarticular injury remain to be resolved. Small intestinal submucosa (SIS), a naturally-occurring decellularized extracellular matrix, has been recognized as an ideal scaffold for tissue engineering and widely used in repairing various tissues and organs. Nowadays its application has also been gradually increased in the field of orthopedics. We reviewed laboratorial studies and clinical trails about the application of SIS in bone and joint repair, aiming to evaluate its effects on the repair of bone, cartilage, meniscus, ligament and tendon. SIS has showed promising results in repairing bone, meniscus, ligament or tendon. However, additional studies will be required to further evaluate its effects on articular cartilage and tendon-bone healing. How to optimize SIS material,is also a focused problem concerned with making SIS a potential therapeutic option with high value for orthopedic tissue repair.
Animals ; Cell- and Tissue-Based Therapy ; Humans ; Intestinal Mucosa ; cytology ; Intestine, Small ; cytology ; Joint Diseases ; physiopathology ; surgery ; therapy ; Tissue Engineering ; instrumentation ; methods ; Tissue Scaffolds ; chemistry

OBJECTIVETo compare the difference in the clinical efficacy on infantile food accumulation treated with centripetal tuina therapy at spleen meridian site of different location.

METHODSSixty cases of infantile food accumulation were randomized into a palmar thumb surface group and a radial margin group, 30 cases in each one. In the palmar thumb surface group, the spleen meridian was stimulated with the pushing technique centripetally on the palmar side of the thumb. In the radial margin group, the spleen meridian was stimulated with the pushing, technique centripetally along the radial margin of the thumb. The traditional tuina techniques, such as tuisanguan, yun neibagua were combined in the two groups. The treatment was given once a day, 6 times a week, 12 treatments as one session. After the 1 session of treatment, the main symptom scores before and after treatment were compared in the patients of the two groups, the improvements in the accompanied symptoms were observed, such as appetite, defecation and tongue coating; and the efficacy was evaluated in the two groups.

RESULTSThe total effective rates were 93.3% (28/30) and 90.0% (27/30) in the palmar thumb surface group and the radial margin group respectively and the difference was not significant statistically in comparison of the two groups (P > 0.05). After treatment, the main symptom score was improved significantly in the two groups, indicating the significant difference as compared with that before treatment (both P < 0.05). The improvement in foul breathing in the palmar thumb surface group was better than that in the radial margin group (P < 0.05).

CONCLUSIONBetween the two kinds of pushing techniques at spleen meridian site, pushing on the palmar surface of the thumb and pushing along the radial margin, there is no difference in the total efficacy on infantile food accumulation. Regarding the improvement in foul breathing, the effect in the palmar thumb surface group is better than that in the radial margin group.

Acupuncture Points ; Child ; Child, Preschool ; Defecation ; Female ; Humans ; Infant ; Intestinal Diseases ; physiopathology ; therapy ; Male ; Massage ; Meridians ; Spleen ; physiopathology ; Treatment Outcome

Child ; Humans ; Intestinal Diseases ; metabolism ; physiopathology ; Intestinal Mucosa ; metabolism ; physiopathology ; Intestines ; metabolism ; physiopathology ; Membrane Proteins ; metabolism ; Pediatrics ; Permeability ; Phosphatidylinositol 3-Kinases ; metabolism ; Respiratory Hypersensitivity ; metabolism ; physiopathology ; Tight Junctions ; metabolism ; physiology

The changing patterns of goblet cell hyperplasia, intestinal epithelial cell turnover, and intestinal motility were studied in ICR and C57BL/6 mice infected with Gymnophalloides seoi (Digenea: Gymnophallidae). Whereas ICR mice retained G. seoi worms until day 7 post-infection (PI), C57BL/6 mice showed a rapid worm expulsion within day 3 PI. Immunosuppression with Depo-Medrol significantly delayed the worm expulsion in C57BL/6 mice. Goblet cell counts were increased in both strains of mice, peaking at day 1 PI in C57BL/6 mice and slowly increasing until day 7 PI in ICR mice. In C57BL/6 mice infected with G. seoi, newly proliferating intestinal epithelial cells were remarkably increased in the crypt, and the increase was the highest at day 1 PI. However, in ICR mice, newly proliferating intestinal epithelial cells increased slowly from day 1 to day 7 PI. Intestinal motility was increased in G. seoi-infected mice, and its chronological pattern was highly correlated with the worm load in both strains of mice. Meanwhile, immunosuppression of C57BL/6 mice abrogated the goblet cell proliferation, reduced the epithelial cell proliferation, and suppressed the intestinal motility. Goblet cell hyperplasia, increased intestinal epithelial cell turnover, and increased intestinal motility should be important mucosal defense mechanisms in G. seoi-infected C57BL/6 mice.
Animals ; *Cell Proliferation ; Disease Models, Animal ; Epithelial Cells/*physiology ; *Gastrointestinal Motility ; Helminthiasis/*physiopathology ; Hyperplasia ; Intestinal Diseases, Parasitic/*physiopathology ; Intestinal Mucosa/*physiopathology ; Male ; Mice, Inbred C57BL ; Mice, Inbred ICR ; Trematode Infections/*physiopathology

The progress in the idea and technology of rectal cancer improve the rate of sphincter-preservation, while bowel dysfunction is the major problem puzzling patients after sphincter-preserving operation. Recent researches reveal bowel dysfunction is closely associated with the postoperative change of anatomy, nerve damage and sphincter functional injury based on the mechanism of defecation function change through the analysis of anatomy, physiology and dynamics. This paper summarizes the mechanism and epidemiology of bowel dysfunction after rectal cancer operation, and elucidate the role of such mechanism in treatment and prevention of above bowel dysfunction.
Anal Canal ; surgery ; Humans ; Intestinal Diseases ; etiology ; Intestine, Small ; physiopathology ; Organ Sparing Treatments ; Postoperative Complications ; Rectal Neoplasms ; surgery

OBJECTIVETo explore the effect of food allergy (FA) on the development of visceralgia sensibility and the substance P (SP) expression in colon of developing rats with FA.

METHODThree-week old female Sprague-Dawley (SD) rats were randomly divided into two groups (n = 10 in each). The rats in FA group were sensitized with ovalbumin (OVA) 40 µg and Al(OH)3 1 mg suspension solution (0.2 ml) intraperitoneal (i.p.) injection on day 0, only OVA 40 µg solution i.p. on day 2, 4, 7, 9, 11, respectively, and the rats were challenged by gavage with OVA solution 30 mg (2 ml) on day 20, 24, 28, 30. The rats in non-sensitized (NS) group were not challenged except handled in the same ways. The serum OVA-IgE were determined by enzyme-linked immuno sorbent assay (ELISA) on day 0, 30. Jejunum segments were used to observe morphological structure, the expression of eosinophils, and the density and the percentage of degranulation of mast cells (MC). The rats were appraised for the pain sensibility of intestinal tract under colorectal distension irritation by the electrophysiological method on external oblique in the 18-24 hr after the last challenge. Colons were used to analyze the expression of SP through immunohistochemical staining and computer image analyzing system.

RESULTThe serum OVA-IgE concentration and the eosinophils, mast cell, the percentage of mast cells degranulation in FA group were more than NS group (P < 0.01). The amplitudes of spike external oblique muscle of abdomen (EOMA, µV) of the FA group under the colorectal distension (CRD) pressures at 0, 15, 30, 45, 60, 75 mm Hg were (17.74 ± 0.72), (18.63 ± 1.72), (22.55 ± 1.70), (28.63 ± 7.00), (33.97 ± 7.34), (37.26 ± 8.40), and (17.43 ± 1.18), (17.27 ± 1.16), (17.73 ± 1.42), (19.55 ± 3.54), (23.29 ± 5.46), (25.20 ± 4.75) in NS group. With the CRD pressure increased, the amplitudes of spike EOMA increased significantly. There were significant differences between groups under the CRD pressures at 30, 45, 60, 75 mm Hg (F = 47.470, 13.367, 13.317, 15.390, P < 0.01). The expressions of colons SP in FA group and NS group are 247.12 ± 90.83 and 103.90 ± 58.94, respectively (t = 4.183, P < 0.01).

CONCLUSIONSensitization through i.p. pathway and challenge by gavage with OVA in early life could result in FA in young SD rats. FA in early life enabled the amplitudes of spike EOMA and the expression of colons SP increase significantly. It may be related to increase in amount and degranulation of MC and SP abnormal expression in colon, which could lead to the development of visceralgia sensibility.

Animals ; Colonic Diseases, Functional ; metabolism ; Disease Models, Animal ; Electrophysiology ; Female ; Food Hypersensitivity ; complications ; metabolism ; Hyperalgesia ; etiology ; metabolism ; physiopathology ; Intestinal Mucosa ; metabolism ; pathology ; Mast Cells ; metabolism ; Ovalbumin ; adverse effects ; Pain Threshold ; Rats ; Rats, Sprague-Dawley ; Stress, Psychological ; Substance P ; metabolism

OBJECTIVETo explore the mechanism of reinforcing function of moxibustion to spleen-stomach.

METHODSForty healthy Sprague Dawley rats were randomly divided into 4 groups: group A (blank group), group B (model group), group C (moxibustion group) and group D (herbs group). The rat model of spleen-deficiency was established by intragastric administration with 200% Dahuang (Rhubarb) infusion. The rats in group A and B, and D served as the blank control, model, and Sijunzi decoction group respectively, while those in group C received moxibustion at "Zusanli" (ST 36), "Zhongwan" (CV 12), "Guanyuan" (CV 4), "Pishu" (BL 20) and "Weishu" (BL 21), etc. The common symptoms and intestinal propulsive rate were observed. The content of I-xylose in serum was detected by phloroglucinol method. Colorimetry method was used to detected content of ATP in jejunum tissues.

RESULTSCompared with group A, the symptom score in group B was increased significantly (both P < 0.01), while the intestinal propulsive rates, the content of D-xylose in serum and ATP in jejunum tissues were decreased significantly (P < 0.05, P < 0.01). Compared with group B, the symptom score in group C and D was decreased significantly (both P < 0.01), while the intestinal propulsive rates, the content of D-xylose in serum and ATP in jejunum tissues were increased significantly (P < 0.05, P < 0.01). There were no significant difference between group C and D (P > 0.05).

CONCLUSIONMoxibustion at "Zusanli" (ST 36) etc. could relieve symptoms of spleen-deficiency, enhance motility and absorption functions of small intestine and improve metabolism of small intestine. The efficacy is equal to administration of Sijunzi decoction.

Adenosine Triphosphate ; metabolism ; Animals ; Female ; Humans ; Intestinal Absorption ; Intestine, Small ; metabolism ; physiopathology ; Male ; Moxibustion ; Rats ; Rats, Sprague-Dawley ; Spleen ; physiopathology ; Splenic Diseases ; metabolism ; physiopathology ; therapy

Although it is difficult to define the term "aging" consensually, in medical fields, usually it means the progressive accumulation of irreversible degenerative changes leading to loss of homeostasis. It is supposable that there is also modest decline in the structure and function of several digestive organs. However, data about this subject are not enough. Main problem in studying aging digestive organ is that discrimination of primary senile change of the organ with secondary one from other senile diseases is not easy. That is, the prevalence of many non-digestive disorders which can badly affect the digestive functions is increasing by aging; for example, diabetes, malignancy, etc. To prove that some phenomenon is as result of pure senile change, it is necessary to exclude secondary one, but, the process is very complicated and difficult. In spite of this limitation, here, I will discuss the senile change of several digestive organs by aging, especially at the view of the gastrointestinal functions, with review of literatures.
*Aging ; Digestive System Diseases/*physiopathology ; Esophageal Diseases/physiopathology ; Humans ; Intestinal Diseases/metabolism/physiopathology ; Stomach Diseases/metabolism/microbiology/physiopathology