ObjectiveTo explore the composition of the intestinal microbiota in ulcerative colitis (UC) patients and to identify differences in the microbiota between patients with active disease and those in remission.MethodsBetween September 2020 and June 2021, we enrolled into our study, and collected stool samples from, patients with active UC or in remission and healthy control subjects. The diagnosis of UC was based on clinical, endoscopic, radiological, and histological findings. The composition of the intestinal microbiota was determined by sequencing of the 16S rRNA V3–V4 region and by bioinformatic methods. The functional composition of the intestinal microbiota was predicted using PICRUSt 2 (Phylogenetic Investigation of Communities by Reconstruction of Unobserved States) software.ResultsWe found that the intestinal flora was significantly less rich and diverse in UC patients than in healthy control subjects. Beta diversity analysis revealed notable differences in the intestinal flora compositions among the three groups, but there was no statistical difference in alpha diversity between UC patients with active disease and those in remission. At the phylum level, the relative abundances of Proteobacteria and Patescibacteria were significantly higher, and the relative abundances of Desulfobacterota and Verrucomicrobiota were lower, in UC patients with active disease than in the healthy control group. Higher levels of potential pathogens and lower levels of butyrate-producing bacteria were also detected in UC patients with active disease. Linear discriminant analysis Effect Size (LefSe) revealed that 71 bacterial taxa could serve as biomarkers, with 26 biomarkers at the genus level. In addition, network analysis showed that there was a positive correlation between Roseburia and Lachnospira. Functional predictions indicated that gene functions involving the metabolism of some substances, such as methane, lipopolysaccharide, geraniol, and ansamycins, were significantly different among the three groups.ConclusionThe richness and diversity of the intestinal microbiota differed significantly among the three groups. Richness describes the state of being rich in number of intestinal bacteria, whereas diversity is the number of different species of intestinal bacteria. Different bacterial taxa could be used as biomarkers, expanding our understanding of the relationship between the intestinal microbiota microenvironment and UC in the future.

Background: Proton pump inhibitors (PPIs) and potassium-competitive acid blocker (PCAB) are two different drugs that may be used after upper gastrointestinal endoscopic submucosal dissection (ESD). However, whether PCAB can reduce postoperative complications more than PPIs is a matter of controversy.Methods: We searched studies that reported the effectiveness of PCAB and PPIs in preventing delayed bleeding after gastric ESD by using PubMed, EMBASE, the Cochrane Library, Web of Science, etc. The Cochrane Risk of Bias Tool and Newcastle Ottawa Quality Assessment Scale were applied to evaluate the quality of the researches. All statistical analyses were carried out using Stata 15.1,including drawing the forest map, subgroup analysis, sensitivity analysis and detection of publication bias.Results: Seventeen studies with 51294 patients were included. There was a statistically difference in the overall delayed bleeding rate between the Vonoprazan group and the PPIs group. The overall mean relative risk (RR) for delayed bleeding following the administration of Vonoprazan was 0.72 (P<0.05) with a 95% confidence interval (CI) (0.67-0.77). However, there was no statistically difference in the incidence of blood transfusion events between the two groups[RR=0.76,95% CI (0.41-1.40)]. There was a statistical difference in the shrinkage ratio between the Vonoprazan group and the PPIs group. The weighted mean difference was 2.68(P<0.05) with a 95% CI (0.44-4.91). The sensitivity analysis showed all results were robust.Conclusions: Compared with PPIs, Vonoprazan showed a better efficacy in reducing the incidence of delayed bleeding and promoting the contraction of artificial ulcers. It might be an appropriate choice that postoperative management of gastric ESD in patients with stomach neoplasms.