Lycium barbarum polysaccharide alleviates DSS-induced chronic ulcerative colitis by restoring intestinal barrier function and modulating gut microbiota

PURPOSE

This study examined the protective effects and mechanism of Lycium barbarum polysaccharides (LBP) in the context of intestinal barrier function and intestinal microbiota in mice with dextran sulfate sodium (DSS)-induced chronic ulcerative colitis (UC).

METHODS

C57BL/6J male mice were assigned to a standard normal diet without DSS (control group), a normal diet with DSS (DSS group, 2% DSS given discontinuously for 3 weeks) or a normal diet supplemented with LBP (1% dry feed weight, LBP group, 2% DSS given discontinuously for 3 weeks) for a total of 8 weeks, at which point colonic tissues and caecal contents were collected.

RESULTS

LBP exerted a significant effect against colitis by increasing body weight, colon length, DAI and histopathological scores. LBP inhibited proinflammatory cytokines (IL-1β, IL-6, iNOS and TNF-α) expression, improved anti-inflammatory cytokine (IL-10) expression, promoted the expression of tight junction proteins (Occludin and ZO-1) via nuclear factor erythroid 2-related factor 2 (Nrf2) activation and decreased Claudin-2 expression to maintain the intestinal mucosal barrier. In addition, the abundances of some probiotics (Ruminococcaceae, Lactobacillus, Butyricicoccus, and Akkermansia) were decreased with DSS treatment but increased obviously with LBP treatment. And LBP reduced the abundance of conditional pathogens associated with UC (Mucispirillum and Sutterella). Furthermore, LBP improved the production of short-chain fatty acids (SCFAs), including acetic acid, propionic acid, butyric acid and isobutyric acid.

CONCLUSION

LBP can alleviate DSS-induced UC by regulating inflammatory cytokines and tight junction proteins. Moreover, LBP promotes probiotics, suppresses conditional pathogens and increases SCFAs production, showing a strong prebiotic effect.

[Clinical effect of negative pressure wound therapy in emergency limb-salvage operation of destructive injury of limb]

Objective: To explore the clinical effect of negative pressure wound therapy (NPWT) in emergency limb-salvage operation of destructive injury of limb. Methods: From July 2014 to December 2017, 43 patients with destructive injury of limb in one side conformed to the inclusion criteria were admitted to our hospital. The patients were divided to NPWT group of 24 patients [ 21 males and 3 females, aged (38±10) years] and routine dressing change group of 19 patients [ 17 males and 2 females, aged (37±10) years] according to their treatment methods. After the emergency debridement, fracture external fixation, neurovascular exploration, and microsurgical repair were performed, NPWT were applied on wounds of patients in NPWT group and routine dressing change treatment on wounds of patients in routine dressing change group. On 7 to 10 days after the emergency operation, incidence of arterial embolism of patients in the two groups were calculated, and condition of wound infection of patients in the two groups were observed. Complete wound healing time and survival condition of limb were recorded. Data were processed with independent sample t test or chi-square test. Results: Incidence of arterial embolism of patients in NPWT group on 7 to 10 days after the emergency operation was 6.67% (3/45), which was close to 5.56% (2/36) of patients in routine dressing change group (χ(2)=0.043, P>0.05). There was 1 patient with wound infection in NPWT group on 7 to 10 days after the emergency operation, obviously less than 6 patients in routine dressing change group (χ(2)=5.847, P<0.05). Complete wound healing time of patients in NPWT group was (30±4) d, significantly shorter than (36±8) d of patients in routine dressing change group (t=2.813, P<0.01). Limbs of 24 patients in NPWT group survived, which was close to 18 patients in routine dressing change group (χ(2)=1.293, P>0.05). Conclusions: NPWT can significantly reduce tthe wound infection rate and shorten the time of wound healing of limb with destructive injury after emergency operation, which is worthy of popularization in clinic.

[A cohort study comparing the efficacy and safety of bortezomib plus dexamethasone versus bortezomib, epirubicin and dexamethasone in patients with multiple myeloma]

OBJECTIVE

Bortezomib plus dexamethasone (BD) and bortezomib, epirubicin plus dexamethasone (PAD) are both front-line regimens of multiple myeloma. This study aimed to assess the efficacy and safety of BD versus PAD regimens in multiple myeloma.

METHODS

All 208 patients with newly diagnosed multiple myeloma using either BD or PAD front-line regimens were enrolled between November 2006 and July 2014. Front-line chemotherapy regimens were 2-7 cycles. Response rates, overall survival, progression-free survival, and adverse effects were retrospectively analyzed.

RESULTS

(1) In PAD group, the overall response rate was 82.9% [complete response(CR) 28.6%, very good partial response(VGPR) 12.9%], which was similar as that in BD group [70.3% (CR 26.8%, VGPR 5.1%), P=0.049]. The estimated median progression-free survival was 34.0 months in PAD group versus 25.0 months in BD group (P=0.010). (2) The triplet regimen has a higher accumulated response rate along with chemotherapy cycles, but it didn't show any difference with the doublet regimen. (3) In elderly patients (>65 years old), the overall response rates in two groups had no significant difference (P=0.769), while in patients ≤65 years old, PAD regimen were more effective than BD regimen (P=0.037). (4) Grade 3 and 4 adverse events were recorded with a higher number of patients in the PAD group than those in the BD group.

CONCLUSIONS

Compared with BD regimen, PAD regimen improves the initial response rates, especially deep responses, as well as progression-free survival in patients with newly diagnosed multiple myeloma. However, more severe toxicities are accordingly higher. In elderly patients, overall response rate, estimated median progression-free survival, and median overall survival are all comparable in both regimens.