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| 1 | Tube feeding,the microbiota,and Clostridium diff icile infection显示文摘Clostridium difficile (C. difficile) is now the leading cause of nosocomial diarrhea in the USA, accounting for 30% of patients with antibiotic-associated diarrhea, 70% of those with antibiotic-associated colitis, and most cases of pseudomembranous colitis. The organism has evolved over the last 8 years to become more virulent and resistant to antimicrobials (NAP1/027 strain) causing a more severe form of the disease that has increased mortality and healthcare costs. While it is generally accepted that the problem results from the overuse of antibiotics, and in particular second and third generation cephalosporins, fluoroquinolones and macrolides, recent studies suggest that acid suppres-sion with proton pump inhibitors (PPIs) may be equally culpable. A further common, but less recognized, etiological factor is the prolonged use of elemental diets. Such diets are totally absorbed within the small intestine and therefore deprive the colonic microbiota of their source of nutrition, namely dietary fiber, fructose oligosaccharides, and resistant starch. The resultant suppression of colonic fermentation leads to suppression of the 'good' bacteria, such as butyrate-producers (butyrate being essential for colonic mucosal health), and bifidobacteria and the creation of a 'permissive' environment for C. difficile colonization and subsequent infection. Based on this analysis, the best chance of suppressing the emerging C. difficile epidemic is to adopt a 3-pronged attack consisting of (1) avoidance of the use of prophylactic antibiotics, (2) the avoidance of prophylactic PPIs, and (3) the conversion of elemental diet feeding to a diet containing adequate indigestible carbohydrate after the first week of critical illness. In this review, we highlight the rising worldwide incidence of C. difficile associated diarrhea and the role played by non-residue diets in destabilizing the colonic microbiota. | Stephen JD O'Keefe | 2010 | World Journal of Gastroenterology2010，16，2： | 4 |
| 2 | Effect of fiber supplementation on the microbiota in critically ill patients显示文摘AIM:To determine tolerance to fiber supplementation of semi-elemental tube feeds in critically ill patients and measure its effect on colonic microbiota and fermentation.METHODS:Thirteen intensive care unit patients receiving jejunal feeding with a semi-elemental diet for predominantly necrotizing pancreatitis were studied.The study was divided into 2 parts:first,short-term (3-9 d)clinical tolerance and colonic fermentation as assessed by fecal short chain fatty acid(SCFA)concentrations and breath hydrogen and methane was measured in response to progressive fiber supplementation increasing from 4 g tid up to normal requirement levels of 8 g tid;second,4 patients with diarrhea were studied for 2-5 wk with maximal supplementation to additionally assess its influence on fecal microbiota quantitated by quantitative polymerase chain reaction (qPCR)of microbial 16S rRNA genes and Human Intestinal Tract Chip(HITChip)microarray analysis.Nearly all patients were receiving antibiotics(10/13)and acid suppressants(11/13)at some stage during the studies.RESULTS:In group 1,tolerance to progressive fiber supplementation was good with breath hydrogen and methane evidence(P=0.008 and P<0.0001,respectively)of increased fermentation with no exacerbation of abdominal symptoms and resolution of diarrhea in 2 of 4 patients.In group 2 before supplementation,fecal microbiota mass and their metabolites,SCFA,were dramatically lower in patients compared to healthy volunteers.From qPCR and HITChip analyses we calculated that there was a 97%reduction in the predominant potential butyrate producers and starch degraders.Following 2-5 wk of fiber supplementation there was a significant increase in fecal SCFA(acetate 28.4±4.1μmol/g to 42.5±3.1μmol/g dry weight,P=0.01;propionate 1.6±0.5 vs 6.22±1.1,P=0.006 and butyrate 2.5±0.6 vs 5.9±1.1,P=0.04)and microbial counts of specific butyrate producers,with resolution of diarrhea in 3 of 4 patients.CONCLUSION:Conventional management of critically ill patients,which includes the use of elemental diets and broad-spectrum antibiotics,was associated with gross suppression of the colonic microbiota and their production of essential colonic fuels,i.e.,SCFA.Our investigations show that fiber supplementation of the feeds has the potential to improve microbiota mass and function,thereby reducing the risks of diarrhea due to dysbiosis. | Stephen JD O'Keefe Junhai Ou James P DeLany Scott Curry Erwin Zoetendal H Rex Gaskins Scott Gunn | 2011 | World Journal of Gastrointestinal Pathophysiology2011，2，6： | 3 |
| 3 | The hereditary pancreatitis gene maps to long arm of chromosome 7 显示文摘 | Le Bodic L Bignon JD Raguenes O | 1996 | Hum Mol Genet1996，5，： | 1 |
| 4 | Isoflavone phytoestrogens consumed in soy decrease F( 2 )-isoprostane concentrations and increase resistance of low-density lipoprotein to oxidation in humans显示文摘 | Wiseman H O Reilly JD Adlercreutz H | 2000 | Am J Clin Nutr2000，72，2： | 1 |
| 5 | Demineralization and remineralization around orthodontic appliances: an in vivo study 显示文摘 | O'Reilly MM Featherstone JD | 1987 | Am J Orthod Dentofacial Orthop1987，92，1： | 1 |
| 6 | Acupuncture mobilizes the brain' s default mode and its anti correlated network in healthy subjects显示文摘 | Hui KK Marina O Claunch JD | 2009 | Brain Res2009，1287，84： | 1 |
| 7 | Atrial fibrillation ablation using a robotic catheter remote control system:initial human experience and long-term follow-up results显示文摘 | Saliba W Reddy VY Wazni O Cummings JE Burkhardt JD Haissaguerre M | | 0，，25： | 1 |
| 8 | Oxidant-antioxidant balance in acute lung injury显示文摘 | Lang JD McArdle PJ O'Reilly PJ | 2002 | Chest2002，122，6： | 1 |
| 9 | 一般人群中发生心力衰竭的10年风险方程显示文摘目前急需能减轻心力衰竭负担的一级预防策略,但未见实用有效的风险预测工具。该研究旨在得出一个计算心力衰竭事件发生的10年风险方程。研究者根据7个社区队列,至少12年随访的个体水平数据,推导并验证了心力衰竭的种族和性别特异性10年风险方程。1985-2000年间招募年龄30~79岁在基线时无心血管病的研究对象,创建一个集合队列并随机分组以进行方程推导和内部验证。在另两个队列中也评估了该模型的性能。 | Khan SS Ning H Shah SJ Yancy CW Carnethon M Berry JD Mentz RJ O’Brien E Correa A Suthahar N de Boer RA Wilkins JT Lloyd-Jones DM 刘青 叶鹏 | 2019 | 中华高血压杂志2019，27，6： | 1 |
| 10 | A Rat Middle Cerebral Artery Occlusion Model and Intravenous Cellular Delivery显示文摘 | Sasaki M Honmou O Kocsis JD | 2009 | Methods Mol Biol(S1064 - 3745)2009，5490，： | 1 |
| 11 | Gender differences in mortality after mitral valve operation : evidence for higher mortality in perimenopausal women 显示文摘 | Song HK Grab JD O'Brien SM | 2008 | Ann Thorac Surg2008，85，： | 1 |
| 12 | Theincidence and prognostic significance of elevated (ardiactroponins in patients with submassive pulmonary embolism 显示文摘 | Douketis JD Leeuwenkamp O Grobara P | 2005 | J Thromb Haemost2005，3，3： | 1 |
| 13 | Closed-loop, multiobjective optimization of two-dimensional gas chromatography/mass spectrometry for serum metabolomics 显示文摘 | O'Hagan S Dunn WB Knowles JD | 2007 | Anal Chem2007，79，： | 1 |
| 14 | The incidence and prognostic significance of elevated cardiac troponins in patients with submassive pulmonary embolism显示文摘 | Douketis JD Leeuwenkamp O Grobara P | 2005 | J Thromb Haemost2005，3，3： | 1 |
| 15 | Tackling antibiotic resistance显示文摘 | Bush K Courvalin P Dantas G Davies J Eisenstein B Huovinen P Jacoby GA Kishony R Kreiswirth BN Kutter E Lerner SA Levy S Lewis K Lomovskaya O Miller JH Mobashery S Piddock LJ Projan S Thomas CM Tomasz A Tulkens PM Walsh TR Watson JD Witkowski J Witte W Wr | | 0，，： | 1 |
| 16 | Receptor activator of nuclear factor kappaB ligand (RANKL) protein expression by B lymphocytes contributes to ovariectomy-induced bone loss显示文摘 | Onal M Xiong J Chen X Thostenson JD Almeida M Manolagas SC O'Brien CA | | 0，，： | 1 |
| 17 | Diabetes,other risk factors,and 12-yr cardiovascular mortality for men screened in the Multiple Risk Factor Intervention Trial显示文摘 | Stamler J Vaccaro O Neaton JD | 1993 | Diab Care1993，16，2： | 1 |
| 18 | Candidemia in a tertiary care hospital:epidmiology and factors influencing mortality 显示文摘 | Alonso-Valle H Acha O Garcia-Palomo JD | 2003 | Eur J Clin Microbiol Infect Dis2003，22，4： | 1 |
| 19 | Fungal cell gigantism during mammalian infection 显示文摘 | Zaragoza O Garcia-Rodas R Nosanchuk JD Cuenca- Estrella M Rodriguez-Tudela JL Casadevall A | 2010 | PLoS Pathog2010，6，10： | 1 |
| 20 | Accuracy of true frameless stereotaxy:in vivo measurenent and laboratory phantom studies显示文摘 | Dorpard NL Alberti O Palmer JD e al | 1999 | J Neurosurg1999，90，2： | 1 |
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