Objective To compare the efficacy of rabeprazole and hydrotalcite in treatment of patients with bile-reflux gastritis after cholecystectomy.MethodsPatients,who underwent cholecystectomy and were confirmed with bile reflux gastritis by 24 h gastric bilirubin monitoring,were enrolled in the study.Patients were randomly assigned into control group (n=30),rabeprazole group (n= 30,20 mg daily),hydrotalcite group (n= 29,1.0 g three times daily) and rabeprazole combined with hydrotalcite group (combination group,n= 31) and treated for 8 weeks.Dyspeptic symptoms of abdominal pain,bloating,heartburn and bitter taste were observed.The endoscopic and histological examination were performed 2 weeks after treatment to evaluate the improvement of inflammation and histological activity.The 24 h bilirubin monitoring was used to assess the total per cent of bilirubin absorption (value of 0.14 units or greater) time,the number of reflux episodes and the number of reflux episodes lasting longer than 5 min.Results The dyspeptic symptoms were relieved in three groups after treatment.However,the endoscopic oedema (2.11 ±0.77 vs 1.50 ±0.67,P<0.05) and the histological activity (2.87±0.72 vs 1.97±0.78,P<0.05) as well as the number of reflux episodes> 5 min (18.26+ 1.80 vs 9.70± 1.20) were improved most significantly in combination group after treatment.There was no statistical difference in rabeprazole and hydrotalcite groups before and after treatment.Whereas the total percent time of bilirubin absorption value >0.14 decreased in three treatment groups after treatment (P<0.05).Conclusion Rabeprazole combined with hydrotalcite is effective in the treatment of patients with bile reflux gastritis after cholecystectomy.

Objective To investigate the association of sleep quality with prevalence of irritable bowel syndrome (IBS) in communities of Shanghai.Methods A survey on prevalence of IBS in communities of Jiangqiao County,Jiading District of Shanghai was conducted using a stratified,randomized cluster-sampling method.A total of 11 569 questionnaires was collected.The IBS was diagnosed according to Rome Ⅲ criteria,and Athens Insomnia Scale (ALS) was used for selfassessment.The relationship between sleep quality and IBS was analyzed.Results The prevalence of insomnia was 21.00% in community groups,33.02% in IBS patients and 18.74% in non-IBS patients.The incidence of insomnia was significant higher in IBS group than non-IBS group (P =0.004,OR = 2.14,95 % CI:1.92- 2.39).Among IBS patients,the incidence of insomnia was higher in females than in males (37.24% vs 28.41%,P = 0.000).A logistic analysis for psychological contributing factors in IBS revealed that insomnia might be one of the risk factors for IBS (OR= 2.11,95% CI:1.89-2.36).Conclusion IBS patients have poor sleep quality,especially in females.

Objective To investigate the distribution of biliary bacteriology and their sensitivity to antibiotics in patients with biliary tract infection in Jinshan area in recent 3 years.Methods Bile specimens collected from 367 patients with cholelithiasis between June 2006 and June 2009 were cultured and tested for drug sensitivity to aerobic bacteria.The results were statistically analyzed.Results One hundred and fifty-six bacterial strains were found in 142 (38.7%) bile specimens including gram negative strains (97,62.2%),gram positive strains (51,32.7% ),and fungal strains (8,5.1%).Enterococcus (17.9%) was major pathogen and follwed by Escherichia coli (12.8%),staphylococcus (11.5%),Klebsiella pneumoniae (8.3%),Pseudomonas aeruginosa (7.7%).Whereas the mixed infection was found in 26 (18.3%) specimens.The positive rate of bacterial infection was 53.1% in patients over 60 years of age (X2=8.36,P<0.01 ) and 47.1% in patients with acute biliary infection(X2=4.68,P<0.05).The drug susceptibility revealed that gram negative strains had low resistance to Meropenem (7.5 %),and followed by Imipenem (8.8 %),Cefoperazone +Sulbactam (19.7%),Amikacin (21.9%) and Tazobactam+Piperacillin (TZP,25.3%),but they were highly resistant to Ampicillin,Quinolones and some third generation of Cephalosporins (>50% ).In gram positive strains,none was resistant to Vancomycin,11.3% to fosfomycin and 11.6% to chloromycetin.They were highly resistant to Penicillins,Ampicillin and Cefazollin (>40%).ConclusionsEnterococcus,Escherichia coli,Sstaphylococcus and Klebsiella pneumoniae are commonly seen pathogens in biliary tract infection in Jinshan area.Use of Sulperazone or TZP plus Amikacin and metronidazole is recommended.Imipenem and Vancomycins may be second choice in treatment of severe biliary infection and refractory infection.

Objective To elucidate the association of interleukin (IL)-17F A7488G (p.His161Arg) polymorphism with gastric cancer susceptibility,clinicopathological features and survival.Methods DNA from 927 unrelated patients with gastric cancer and 777 age and gendermatched healthy controls was typed for IL-17F A7488G polymorphism by polymerase chain reactionrestriction fragment length polymorphism.Logistic regression analyses and Cox proportional hazards analyses were used to evaluate the associations between polymorphisms and gastric cancer susceptibility,clinicopathological features and survival.Results There was significant difference between healthy controls and patients with gastric cancer with respect to frequencies of IL-17FA7488G genotypes (X2= 16.55,P<0.01).After adjusted for age and gender,IL-17F A7488G GA and GG genotypes were associated with an increased risk of gastric cancer compared with the AA genotype (OR=1.51;95% CI:1.22-1.87 for GA;OR=1.61,95% CI:1.03-2.51 for GG).In comparison with AA genotype carriers,the risk of gastric cancer increased in those with GA or GG genotypes (OR= 1.53,95 % CI:1.25- 1.87,P<0.01 ).Further stratification analyses indicated that the effect of IL-17F A7488G GA genotype was especially noteworthy in gastric cancer patients of noncardia,intestinal type,poorly and moderately differentiated,and lymph node metastasis.Whereas there was no significant difference in survival among subjects with different polymorphisms of IL-17F A7488G gene (P= 0.534).Conclusions Genetic polymorphism of IL-17F A7488G involves in susceptibility to gastric cancer,which also influences certain subtypes of gastric cancer according to clinicopathological features,however,it is not the independent risk factor for prognosis of gastric cancer patients.

Objective To investigate the effect of nociceptin/orphanin FQ (N/OFQ) on crossorgan sensitization and bladder function disorders in rat model with visceral hypersensitivity. Methods The model of cross-organ sensitization was induced by basic OVA-sensitization combined with colon mustard oil instillation in 44 female SD rats. All rats were then divided into control group (n= 14,infusion with 0.9% NaCl solution), model group (n= 14) and N/OFQ group (n= 16, infusion with N/OFQ). The anti-nociceptive effect of N/OFQ were evaluated by using the visceromotor response (VMR) to grade bladder distention (0. 5～2.0 ml, 20 s). Bladder function was evaluated with the cystometry by measuring voiding pressure and micturition frequency. Results The rats in model group had a significant increase of VMR response at 1.0 ml, 1.5 ml and 2.0 ml of pressure when compared to those in control group (P=0. 006,0. 015 and 0. 0331, respectively). However, N/OFQ treatment was able to reverse the increased VMR response in N/OFQ group at 1.5 ml and 2.0 ml of pressure (P=0. 016 and 0. 031, respectively). It was showed that mustard oil significantly reduced bladdervoiding pressure (P＜0. 01) and significantly increased micturition frequency (P＜0.01)in model group when compared to control group. The N/OFQ reversed the decrease of voiding pressure (P=0. 0038) and the increase of micturition frequency in N/OFQ group( P = 0. 001). Conclusions These findings indicate that the rat model of cross-organ sensitization was able to be established successfully by the basic OVA-sensitization combined with colon mustard oil instillation. N/OFQ has an antinociceptive effect on cross-organ hypersensitivity and attenuates changes in bladder urodynamic function.

Objective To investigate the efficacy and side effects of Fufangbanmao capsules combined with FOLFOX-4 (Oxaliplatin + 5-fluorouracil /Calcium folinate) regimen in the treatment of metastatic colorectal cancer (MCC). Methods A total of 107 patients with previously untreated MCC, who were admitted to the hospital between April 2006 and October 2008, were randomly divided into combination group (n = 54) and chemotherapy group (n = 53). In combination group, patients received Fufangbanmao capsules (750 mg twice daily) and FOLFOX4 regimen (oxaliplatin 85 mg/m2 day 1, infusion of CF 200 mg/m2 for 2 hours followed by bolus 5-FU 400 mg/m2 and a 22-hour infusion of 5-FU 600 mg/m2 ). Whereas the patients in chemotherapy group were treated with FOLFOX4 regimen. Results The effective rate was 44. 4% in combination group and 37. 7% in chemotherapy group with no significant difference (P = 0. 481). The median time to progression (TTP) was 11. 6 and 7. 9 months in combination group and chemotherapy group, respectively, with significant difference (P=0. 020). The difference was found in improvement of quality of life (QOL) between combination group and chemotherapy group (57. 4% vs 32. 1 % , P=0. 008). The side effects in two groups included gastrointestinal toxicities, neuropathy, alopecia and bone marrow suppression. However, Ⅲ/Ⅳ neutropenia was significantly less in combination group(37. 0%) when compared with chemotherapy group (58. 5%, P = 0. 043). Conclusions In first-line treatment of MCC, Fufangbanmao capsules combined with FOLFOX4 regimen showed synergic and enhanced effect for improving TTP and QOL, and also reduced the incidence of neutropenia.

Objective To evaluate the value of evoked potentials (EP) in diagnoses of minimal hepatic encephalopathy (MHE) for liver cirrhotic patients without overt hepatic encephalopathy (OHE). Methods A blind and self control study was conducted in 114 liver cirrhotic patients without OHE. All patients were tested for MHE by the number connection test-A(NCT-A), digit symbol test (DST), visual evoked potentials (VEP), brain-stem auditoru evoked potentials (BAEP), short latency somatosensory evoked potentials (SSEP), P300 auditory event-related potentials (P300ERP). MHE was identified when the NCT-A or/and DST was abnormal. The positive rate was compared among VEP, BAEP, SSEP and P300ERP for their reliability and validity in diagnosis of MHE. Results Of 114 patients, 60 patients were found with MHE (52. 6%), which was positively correlated with Child-Pugh classifications (r=0. 278, P = 0. 003). The positive rate was found 17.5% in VEP, 29.8% in BAEP, 38. 6% in SSEP and 57. 0% in P300ERP. There was no significant difference in diagnosis of MHE between P300ERP and NCT-A+DST (X2 =0. 432,P = 0. 511). The sensitivity of VEP, BAEP, SSEP or P300ERP for diagnosis of MHE was 13. 3%, 41. 7%, 46. 7% or 73. 3%, respectively, whereas the specificity was 77. 8%, 83. 3%, 70. 4% or 61. 1 %, respectively. The receiver operating characteristic curve revealed that the best sensitivity and specificity for the diagnosis of MHE was P300EERP (area under the curve was 0. 672, 95%CI 0. 572 * 0. 773). The agreement of NCT-A+DST with VEP, BAEP, SSEP or P300ERP was 43. 9%, 61. 4%, 57. 9% or 67. 5%. Conclusions P300ERP is a sensitive and specific method for the diagnosis of MHE. which can serve as a supplement but not instead of NCT-A+DST.

Objective To investigate the potential mechanism for symptoms related to epigastric discomfort in patients without Helicobacter pylori (H.pylori) infection.Methods Patients who underwent gastric endoscopy and conformed H.pylori negative by histologic examination were enrolled.Among them,232 adult patients were collected between August 2006 and November 2006 and 31 children were collected between September 2005 and August 2009.All patients showed no apparent abnormality by endoscopic examination.The endoscopic biopsy was examined with HE or Warthin-Starry staining.Results In adult group,arteriole obstruction was found in 16 (8.8%) cases and focal haemorrhage in 82 (45.6%) cases.Both were existed in 82 (45.6%) cases.The histopathologic findings showed that arteriole obstruction in transition zone (65.2 %,P = 0.159) was common,whereas the focal haemorrhage in gastric fundus and corpus (65.6%,P=0.001) was in predominance.The symptom of heartburn was less in patients with arteriole obstruction and/or focal haemorrhage in comparison with those without these changes (x2 =8.564,P=0.003).In adolescent group,arteriole obstruction and/or focal haemorrhage accounted for 96.8% (30/31).Conclusion Gastric mucosa ischemic resulted from arteriole obstruction are commonly seen in both adult and adolescent patients,which is an important reason for epigastric discomfort in H.pylori negative patients.

Objective To assess the predictive value of thiopurine methyltransferase genotyping and enzyme activity in relation to side effects in patients with inflammatory bowel disease (IBD) who were treated with azathioprine (AZA). Methods One hundred and eleven IBD patients (26 with ulcerative colitis and 86 with Cronh's disease) with indication of AZA administration between April 2004 and Dec. 2009 were enrolled. All patients received 2 mg/kg of AZA daily. Polymerase chain reaction and high performance liquid chromatography were used to genotype the TPMT * 2, * 3A, * 3B, * 3C and to detect TPMT activity, respectively. The association of TPMT genotype and activity with side effects was analyzed in patients treated with AZA for 24 weeks or more, or in those discontinued AZA because of adverse effects. Results Adverse effects were reported in 38(33. 9%) patients, the most frequent being myelosuppression (20. 5%). The frequency of TPMT * 3C heterozygous mutation was 0. 9% (1/112). The TPMT activity was (12. 9±4. 8) U/ml RBC with unimodal distribution. One patient with TPMT * 3C heterozygous mutation developed myelosuppression at the 4th week after AZA treatment. The TPMP genotype myelosuppression patients. Conclusions TPMT genotype mutation and low enzyme activity can be used to predict myelosuppression with high specifically and low sensitivity. In patients treated with AZA, co-administration of 5-ASA results in a high frequency of myelosuppression with no effect on TPMT activity.

Objective To assess the prevalence of gastroesophageal reflux disease(GERD) in the population of Fujian province, and to analyze the risk factors in relation to the disease. Methods A survey on GERD symptoms and its related factors was carried out in the population of Fuzhou city in Fujian province using a stratified random sampling method. According to reflux disease questionnaire (RDQ) score, the subjects were divided to GERD group with Sc≥ 12 and control group with Sc＜ 12.The risk factors related to GERD were compared between two groups. Results A total of 1347residents were investigated. The prevalence of GERD was 8.76 %, and male to female ratio wasincreased in population above 40 years of age (P＜0.05). The incidence of GERD in subjects with different occupations was as follows: the businessmen [17.91%(12/67)], retirees [13.48%(12/89)]and soldiers [2.94%(2/68)]. Symptoms including abdominal distension, belching, nausea, vomiting,dyspepsia were common in GERD group compared to control group (P ＜ 0.01). Besides, the laryngitis, pharyngitis and mouth ulcer were common in GERD group compared to control group ( P＜0.05). The risk factors of GERD were eating greasy (OR= 1.589) and sweetmeat (OR= 2.413),overeating (OR = 2.053), constipation (OR = 1.650), acridity food (OR = 1.366 ), coffee (OR =1.295), strong tea (OR= 1.362). Conclusions The prevalence of GERD is high in the population of Fujian province, and many factors are closely related to reflux.