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ABSTRACT Gut dysbiosis is closely related to dysregulated microRNAs (miRNAs) in the intestinal epithelial cells, which plays an important role in the pathogenesis of Crohn’s disease (CD). We investigated the relationship between fecal gut microbiome (GM) and intestinal tissue miRNAs in different stages of pediatric CD. Metagenomic analysis and miRNA sequencing were conducted to examine the GM and intestinal miRNA profiles of CD patients before and after clinical induction therapy and the controls. Twenty-seven newly diagnosed, therapy-naïve pediatric patients with active CD and 11 non-inflammatory bowel disease (IBD) controls were recruited in this study. Among CD patients, 11 patients completed induction treatment and reached clinical remission. Both GM and miRNA profiles were significantly changed between CD patients and controls. Seven key bacteria were identified at species level including Defluviitalea raffinosedens, Thermotalea metallivorans, Roseburia intestinalis, Dorea sp. AGR2135, Escherichia coli, Shigella sonnei, and Salmonella enterica, the exact proportions of which were further validated by real-time quantitative PCR analysis. Eight key miRNAs were also identified including hsa-miR-215-5p, hsa-miR-194-5p, hsa-miR-12135, hsa-miR-509-3-5p, hsa-miR-212-5p, hsa-miR-4448, hsa-miR-501-3p, and hsa-miR-503-5p. The functional enrichment analysis of differential miRNAs indicated the significantly altered cyclin protein, cyclin-dependent protein, and cell cycle pathway. The close interactions between seven key bacteria and eight key miRNAs were further investigated by miRNA target prediction. The association between specific miRNA expressions and key gut bacteria at different stages of CD supported their important roles as potential molecular biomarkers. Understanding the relationship between them will help us to explore the molecular mechanisms of CD.IMPORTANCESince previous studies have focused on the change of the fecal gut microbiome and intestinal tissue miRNA in pediatric Crohn’s disease (CD), the relationship between them in different stages is still not clear. This is the first study to explore the gut microbiota and miRNA and their correlations with the Pediatric Crohn’s Disease Activity Index (PCDAI). Crohn’s Disease Endoscopic Index of Severity (CDEIS), and calprotectin, by applying two omics approach in three different groups (active CD, CD in remission with exclusive enteral nutrition or infliximab induction therapy, and the healthy controls). Both gut microbiome structure and the miRNA profiles were significantly changed in the different stage of CD. Seven key gut microbiome at species and eight key miRNAs were found, and their close interactions were further fully investigated by miRNA target prediction.

With the diversity of modern dietary lifestyles, digestive system disorders (DSD) have become a frequently occurring disease in recent years. Astragalus polysaccharide (APS) is a homogeneous polysaccharide extracted from Astragalus, which might ameliorate the digestive and absorptive functions. However, the treatment mechanisms remain unclear. In this study, rats with DSD were fed a high-fat⁻low-protein diet and subjected to weight-bearing swimming until exhaustion. When body weight and autonomous activities of the rats decreased, they were administered APS. After two weeks, serum metabolomics analysis based on LC-MS was performed to validate the therapeutic effect of APS and explore its mechanism. APS pharmacodynamics was determined in this study, and serum metabolomics analysis discovered and identified 16 significant, differentially produced metabolites involved in energy, amino acid, and lipid metabolism, including citric acid, lactic acid, alanine, phosphatidylcholine, phenylalanine. After treatment with APS, the levels of the above small-molecule metabolites were reversed. Our results show the efficacy of APS in DSD treatment through the regulation of perturbed metabolic pathways related to energy, amino acid, and lipid metabolism.

Context: Although gonadotropin-releasing hormone stimulation test (GnRHST) is the gold standard in diagnosing central precocious puberty (CPP), it is invasive, expensive, and time-consuming, requiring multiple blood samples to measure gonadotropin levels.Objective: We evaluated whether urinary hormones could be potential biomarkers for prepuberty or postpuberty, aiming to simplify the current diagnosis and prognosis procedure.Methods: We performed a cross-sectional study of a total of 355 girls with CPP in National Clinical Research Center for Child Health in China, including 258 girls with positive and 97 girls with negative results from GnRHST. Twenty patients received GnRH analogue (GnRHa) treatment and completed a 6-month follow up. We measured luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol, prolactin, progesterone, testosterone, and human chorionic gonadotropin in the first morning voided urine samples.Results: Their urinary LH levels and the ratios of LH to FSH increased significantly with the advancement in Tanner stages. uLH levels were positively associated with basal and peak LH levels in the serum after GnRH stimulation. A cutoff value of 1.74 IU/L for uLH reached a sensitivity of 69.4% and a specificity of 75.3% in predicting a positive GnRHST result. For the combined threshold (uLH ≥ 1.74 + uLH-to-uFSH ratio > 0.4), the specificity reached 86.6%. After 3 months of GnRHa therapy, the uLH and uFSH levels decreased accordingly.Conclusion: uLH could be a reliable biomarker for initial CPP diagnosis and screening; uLH could also be an effective marker for evaluating the efficacy of clinical treatment. [ABSTRACT FROM AUTHOR]

Introducción: La enfermedad coronaria de tres vasos es un diagnóstico frecuente en pacientes con cardiopatía isquémica. El intervencionismo coronario percutáneo es un método de revascularización usado en esta afección. Objetivo: Determinar la evolución de los pacientes con enfermedad coronaria de tres vasos tratados por intervencionismo percutáneo. Método: Se desarrolló un estudio longitudinal, prospectivo y descriptivo, en 130 pacientes de ambos sexos con enfermedad coronaria de tres vasos revascularizados por intervencionismo percutáneo, con un período de seguimiento de dos años. Resultados: La edad promedio en los pacientes estudiados fue de 72,8 ± 7,2 años, con predominio del sexo masculino (62, 9%). Los factores de riesgo cardiovascular de mayor prevalencia fueron la hipertensión arterial (65,0%) y la dislipidemia (53,2%). Se obtuvo un 91,5% de éxito en los procedimientos terapéuticos con revascularización de todos los territorios isquémicos en el 63,3%. La mortalidad global fue de 6,2%. La incidencia de infarto no fatal y trombosis de stent fue 4,6% y 5,4% respectivamente. La puntuación SYNTAX ≥ 33 se asoció a menor supervivencia libre de eventos cardiovasculares adversos. Conclusiones: Los pacientes con enfermedad coronaria de tres vasos tratados por intervencionismo percutáneo, mostraron una evolución favorable con baja incidencia de eventos adversos durante el seguimiento.

Introducción: Las lesiones en el tronco de la coronaria izquierda, son las que presentan peor pronóstico, debido a la gran extensión de miocardio que comprometen. Objetivo: Caracterizar los pacientes con diagnóstico de enfermedad arterial del tronco coronario no protegido tratados por intervencionismo coronario percutáneo en el CIMEQ entre 2014 y 2016. Método: Estudio observacional longitudinal y prospectivo, en pacientes con lesión ≥ 50 % en TCI, diagnosticados por angiografía coronaria. Se estudió a todo el universo expresado según criterios de inclusión y exclusión correspondiendo a 20 pacientes. Se usó estadística descriptiva básica. Resultados: La edad promedio en los pacientes estudiados fue de 68,5 ± 7,4 años, con predominio del sexo masculino (64, 7%). Los factores de riesgo cardiovascular de mayor prevalencia fueron la hipertensión arterial (60%) y la diabetes mellitus (40%). La dislipidemia y el hábito de fumar representaron el 35 %. En el 65% de los casos se usó la vía de acceso radial. El 70% de los pacientes presentaron puntuación SYNTAX bajo. Se presentaron complicaciones peri proceder en el 15% de los pacientes y la mortalidad a los dos años fue del 5%. Conclusiones: La mayoría de los pacientes tratados correspondieron al sexo masculino y en edades superiores al sexo femenino. La vía de acceso radial fue la más usada. La complejidad anatómica predominante expresada por la puntuación SYNTAX correspondió al primer tertil. Un tercio de los pacientes no sufrieron complicaciones peri proceder y la mortalidad en seguimiento a los dos años fue considerada baja.

Introducción: a pesar de los avances terapéuticos en nuestro país persisten tasas elevadas de insuficiencia cardíaca, que constituye la vía final de las enfermedades cardiovasculares. Objetivo: evaluar la eficacia de un programa de rehabilitación cardiovascular en pacientes con insuficiencia cardíaca crónica de etiología isquémica. Métodos: se realizó un estudio observacional prospectivo analítico en el Hospital CIMEQ. Se incluyeron 60 pacientes con tratamiento médico convencional. En 30 pacientes se aplicó un programa de rehabilitación que incluyó ejercicios físicos aeróbicos y charlas educativas (grupo activo), los restantes conformaron el grupo control. Resultados: a los 6 meses el grupo activo alcanzó disminución en la frecuencia cardíaca basal de 10 lpm y de 10 mm/hg y 5 mm/hg en cifras de presión arterial sistólica y diastólica, respectivamente. El grupo activo mejoró la capacidad de esfuerzo medida en equivalentes metabólicos (7,6 ± 2 frente a 5,8 ± 2; p < 0,01) y la clase funcional en el 100 % frente al 33 %; p < 0,05, sin mostrar diferencias significativas en el tiempo de ejercicio. En los pacientes rehabilitados la fracción de eyección del ventrículo izquierdo se incrementó en el 5 %. Conclusiones: los pacientes con insuficiencia cardíaca vinculados con programas de ejercicios físicos, muestran mejoría de la función cardíaca, la tolerancia al esfuerzo y la clase funcional. Alcanzan mayor reducción en las cifras de presión arterial y frecuencia cardíaca basal, por lo que se hace necesaria la potenciación y empleo de programas de rehabilitación cardiovascular, en el manejo de estos pacientes.Introduction: despite the therapeutic progress achieved in our country, heart failure rates are still high, which is the final pathway toward cardiovascular disease. Objective: evaluate the efficacy of a cardiovascular rehabilitation program in patients with chronic heart failure of ischemic etiology. Methods: an observational analytical prospective study was conducted with 60 patients receiving conventional medical treatment at CIMEQ Hospital. Thirty of the patients underwent a rehabilitation program which included aerobic physical exercise and educational talks (active group). The remaining patients constituted the control group. Results: after six months the active group had achieved a decrease in basal heart rate of 10 lpm and of 10mm/hg and 5mm/hg in systolic and diastolic blood pressure values, respectively. The active group improved their exercise capacity measured as metabolic equivalents (7.6 ± 2 vs. 5.8 ± 2; p < 0.01) and their functional class in 100% versus 33 %; p < 0.05 without any significant differences in exercise time. Rehabilitated patients exhibited a 5 % left ventricular ejection fraction increase. Conclusions: patients with heart failure receiving physical exercise programs improve their cardiac function, their exercise tolerance and their functional class. They also achieve a greater reduction in blood pressure and basal heart rate. It is therefore necessary to strengthen cardiovascular rehabilitation programs and use them with these patients.