Gut microbiota is one of the complicated eco-systems in human body.A large amount of bacteria colonize in the healthy human intestine, which not only play a variety of biological functions, but also are associated with various diseases.By adding microecological agents (probiotics, prebiotics, and synbiotics), we are able to improve the gut microbiota structure and reduce the related carcinogenic metabolites, and also to improve the clinical manifestations of certain diseases.Therefore, it is meaningful to apply microecological agents (probiotics, prebiotics, and synbiotics) both in healthy population and patients.We reviewed the researches on microecological aspect of gut microbiota-related diseases, aiming to shed some light on fully understanding and popularizing of the application of microecological agents among different populations.

Objective To investigate the effect and mechanism of exogenous leptin on liver injury in severe acute pancreatitis rat .Methods Thirty male SD rats were randomly divided into the sham operation group ,SAP group and leptin intervention group . The SAP rat models was established by retrograde injection of 3 .5% sodium taurocholate into the biliopancreatic duct .The leptin intervention group was intraperitoneally injected with leptin 20 μg/kg .The rats in each group were sacrificed at 12 h after model‐ing .The pancreas and liver tissues were taken for HE staining and detecting the nuclear factor kappa B (NF‐κB) .The cell apoptosis in situ labeling method was adopted for detecting the liver tissue cell apoptosis index .ALT ,AST and AMY were detected . Results Compared with the sham operation group ,the liver tissue pathology score in SAP group and leptin intervention group were significantly increased(P<0 .05) .The liver tissue pathology scores in the leptin intervention group were lower than those in the SAP group(P<0 .05) .The NF‐κB expression of liver tissue in the SAP group and leptin intervention group was obviously increased compared with the sham operation group ,the expression in the leptin intervention group was decreased compared with the SAP group (P<0 .05) .The liver cell apoptosis index in the leptin intervention group and SAP group was significantly higher than that in the sham operation group (P<0 .05) ,and which leptin intervention group was decreased compared with the SAP group (P<0 .05) . The results of ALT ,AST and AMY in the SAP group and leptin intervention group were increased significantly compared with the sham operation group(P<0 .05) ,while which in the leptin intervention group was decreased compared with the SAP group (P<0 .05) .Conclusion The exogenous leptin may play the protective effect on SAP complicating liver damage by lowering the liver tis‐sue NF‐κB expression and reducing the liver cell apoptosis index .

Objective To observe the expression of high mobility group A 1(HMGA1)protein in pituitary adenoma(PA)and explore its relationship with the aggressiveness and recurrence of PA .Methods The labeling index(LI)of HMGA1, detected by immunohistochemistry staining , was compared between aggressive and non-ag-gressive PA, recurrent and non-recurrent PA.Results The expression of HMGA1 were observed in all 52 cases of PA and homogenously distributed in nuclear of tumor cells .The LI of HMGA1 showed no significant difference between functioning and nonfunctioning PA (P=0.79), as well as among different immunophenotypical variants of PA(P=0.28).The expression of HMGA1 was significantly higher in the aggressive PA than in the nonaggres-sive PA(0.50 ±0.20 vs 0.24 ±0.17, P=0.000).Patients with a recurrent PA had a higher value of HMGA 1 than patients with a non-recurrent PA(0.60 ±0.20 vs 0.24 ±0.18, P=0.000).The expression of HMGA1 in-creased stepwise with the tumor size, as the highest was present in macro-sized PA(0.52 ±0.20)and the lowest was in micro-sized PA(0.18 ±0.17).A similar trend was found in Hardy's grade I(0.18 ±0.17),II(0.30 ± 0.20)and III-IV(0.50 ±0.20)(P=0.003).The area under the ROC curve was 0.918(>0.90).When the LI reached 49.2%, the predicting specificity was 90.5%and the sensitivity was 71.4%.Conclusions The LI of HMGA1 has a positive correlation with the tumor size , aggressiveness and recurrence of PA and also has a valua-ble predicting efficacy for PA recurrence .The characteristics of HMGA 1 in PA can help pathologists make repro-ducible evaluation on prognosis of PA .

Objeetive To analyze the clinicopathologic features of proliferative sclerosing IgA nephropathy and the efficacy of prednisone therapy.Methods A retrospective analysis was conducted,enrolling 50 patients with biopsy-proven primary proliferative sclerosing IgA nephropathy who were admitted in the Hospital from January 2005 to June 2015-26 males and 24 females,mean age (36.8 ± 10.4) years.Clinicopathologic features and prednisone therapeutic effect were analyzed.Results The clinical manifestations of 50 cases were nephritis syndrome with varying degrees of renal insufficiency,including 32 cases (64.0％) with hypertension,15 cases (30.0％) with microscopic hematuria.Renal biopsy showed the incidence of glomerular global sclerosis was 17.0％-47.2％,tubular atrophy/ interstitial fibrosis outstanding (T0 50％,T1 32％,T2 18％).After prednisone treatment,compared with sustained remission group and relapse group,invalid patients had higher incidence of hypertension (P ＜ 0.05),relatively lower Hb (P ＜ 0.01) and serum albumin,more significant renal dysfunction (P ＜ 0.01),more severe glomerular global sclerosis,segmental sclerosis,tubular atrophy/ interstitial fibrosis,while the lower interstitial inflammatory cell infiltration.During the follow-up,which lasted from 6 to 132 months (median 27.3 months),the effective rate of treatment was 74.0％ after sufficient prednisone or half dose prednisone therapy.Repeated recurrence rate was 32.0％.At the end of the follow-up period,13(26.0％) patients entered the stage of uremia.Conclusions Application of glucocorticoids in the treatment of proliferative sclerosing IgA nephropathy can protect renal function and delay the progression of renal impairment.The efficacy of glucocorticoids therapy is significantly associated with the presence or absence of hypertension,the degree of renal function impairment,and the severity of the onset of renal pathology.

Objective To evaluate the curative effect and security of mechanical thrombectomy with SolitaireAB stent system in acute superior mesenteric artery embolism(SMAE).Methods The clinical data of 5 cases who had undergone mechanical thrombectomy with SolitaireAB stent system under digital subtraction angiography (DSA) were analyzed retrospectively.Results A successful thrombus removal of superior mesenteric arterial by SolitaireAB stent system was observed in the whole 5 patients.The patients had recovered well after operation and no complications such as arterial dissection,perforation and hemorrhage or intestinal ischemia occurred.Conclusion The arterial mechanical thrombectomy with SolitaireAB stent system are characterized with high rate of recanalization,fine security,minimal invasion and less complications in patients with acute superior mesenteric arterial embolism.

Objective To investigate the relationship between serum vitamin B12 level and arsenic methylation and the risk of arsenic poisoning in the arsenic exposed population.Methods Three villages in Midu County,Dali City,Yunnan Province were investigated.Cross-sectional study was used to select 103 subjects.The population was divided into three groups according to drinking water arsenic exposure situation and whether arsenic poisoning patients:28 cases of control group (not exposed to high arsenic),30 cases of arsenic patient group and 45 cases of non patient group.Instant peripheral blood samples and urine samples were collected.The content of arsenic in urine was determined by hydride generation cold trap and atomic absorption spectrophotometry.The levels of vitamin B12 in serum were determined by chemiluminescence immunoassay.The urine arsenic and serum vitamin B12 contents in different groups were compared,the arsenic poisoning prevalence rate in people with different levels of serum vitamin B12 was investigated,and the correlation between serum vitamin B12 level and the metabolism of arsenic methylation was analyzed.Results The level of urinary inorganic arsenic (iAs),monomethylated arsenic (MMA) and dimethylated arsenic (DMA),total arsenic (tAs) were significantly different between groups (F =13.032,20.778,21.978,22.155,all P ＜ 0.05).The levels of urine arsenic in patients with arsenic exposure [(94.56 ± 107.62),(75.76 ± 54.31),(270.19 ± 185.10),(444.02 ± 323.28) μg/g Cr] and non patient with arsenic exposure [(40.05 ± 47.47),(45.11 ± 46.06),(183.91± 151.45),(270.84 ± 231.45) μg/g Cr] were significantly higher than those in control group [(7.58 ± 4.82),(4.27 ± 2.01),(26.89 ± 11.45),(38.91 ± 13.34) μg/g Cr,all P ＜ 0.05].The serum levels of vitamin B12 were significantly different between groups (F =6.650,P ＜ 0.05),patients exposed to arsenic [(366.05 ± 120.03) ng/L] was significantly lower than the control group [(533.70 ± 180.12) ng/L,P ＜ 0.05].There were significant differences in the detection rate of arsenic poisoning among different levels of serum vitamin B12 (x2=8.13,P ＜ 0.05),the lower dose of vitamin B12,the more serious the incidence of arsenic poisoning.The content of vitamin B12 was negatively correlated with MMA％ (r =-0.21,P ＜ 0.05),and positively correlated with SMR (r =0.21,P ＜ 0.05).Conclusion Low levels of vitamin B12 in serum may increase the risk of arsenic poisoning.

Objective:To investigate the effects of TGF-β1 on T lymphocytes of BALB/c mice infected with Echinococcus granulosus( E.granulosus ) in vitro.Methods: The inhibitor group:the spleen cells of BALB/c mouse were co-cultured with E.granulosus and SB525334.The control group:the spleen cells of BALB/c mouse were co-cultured with E.granulosus and PBS.The blank group:the spleen cells of BALB/c mouse were co-cultured with RPMI-1640 medium and SB525334.The lymphocytes were collected at 48 h post-infection.The T lymphocyte subsets, the number of CD4+CD25+T cells, the number of NK cells, and the expression of NKG2D receptor were detected by flow cytometry.The NK cell activity was determined with the lactate dehydrogenase leakage assay(LDH).Results:The inhibition the TGF-β1 receptors resulted in the increase of in the number of CD4+T cells,the decrease in the number of CD8+T cells,the increase of in the ratio CD4+/CD8+T cells,the decrease of in the number of CD4+CD25+T cells,the increase in the expression of the NKG2D receptors,the increase in the lysis rate of Yac-1 cells by NK cells,and a positive cor-relation between the expression of activity receptor NKG2D and killing activity of NK, which were mediated by E.granulosus.Conclusion: The inhibition of TGF-β1 receptors can enhance the immune response of T lymphocytes against E.granulosus infection in vitro.

Objective To investigate the significance of the objective audit system of mammography diagnostic report in evaluating the diagnostic mammography practice in Peking University First Hospital.Methods According to the regulations issued by the US Food and Drug Administration (FDA 1992) and the mammographic practice parameters recommended by the American College of Radiology (ACR 2013),we retrospectively analyzed the diagnostic mammographic reports in Peking University First Hospital from November 14,2015 to November 14,2016.We calculated the diagnostic sensitivity,specificity,positive predictive value (PPV2),and the third positive predictive value (PPV3).The pathological and follow-up results(the negative patient)were used as the golden standard.All data were compared with the reference data of United States mammography diagnostic report system.Results A total of 1 779 mammography diagnostic reports were analyzed,including 137 malignant cases and 1 642 benign cases.The sensitivity of diagnosis of malignant breast lesions was 93.4％ (128/137),the specificity was 95.2％ (1 563/1 642),PPV2 was 61.8％ (128/207) and PPV3 was 83.1％(128/154).Compared with the recommended target value (sensitivity＞85.0％,specificity＞90.0％,PPV2:25.0％～40.0％),most statistical data were within the recommended range except PPV2 and PPV3,which werehigher.Conclusions The quality of the mammographic report in Peking University First Hospital reached the recommended level in the United States.However,the low proportion of recommendation of biopsy suggested a possibility of missed diagnosis.

Objective To explore the effects of preoperative video interview on postoperative anxiety, heart rate, blood pressure and delirium in ICU patients.Methods A total of 188 patients in ICU were divided into experimental group (n=90, preoperative video interview of ICU) and control group (n=98, routine preoperative interview) with the method of random number table between January 2015 to March 2016. The anxiety, heart rate, blood pressure and incidence rate of delirium of patients were compared between groups before interview and after operation when patients' consciousness recovered.Results There were 14 patients with moderate or severe anxiety in experimental group and 26 in control group with a significant difference (Z=2.079,P<0.05) after consciousness recovered. Moreover, heart rate, heart pressure and the incidence rate of delirium in experimental group[(71.18±5.65) times/minute, (124.44±10.76)mmHg, 6.67%] were all lower than those in control group with significant differences (t/χ2=10.8915, 6.4448,4.610;P<0.05). Conclusions Preoperative video interview of ICU can effectively relieve anxiety, improve heart pressure and heart rate, reduce the incidence rate of delirium of patients. It is worthy of being generalized and applied.

Objective:To evaluate the feasibility of a predictire model composed of non-specific test indexes in early diagnosis of gastric cancer.Methods:From the database of electronic medical record system of Shanghai Changhai Hospital, a total of 24 615 case records were included from January 1, 2010 to April 30, 2019, including 10 497 cases of gastric cancer, 5 198 cases of precancerous diseases, and 8 920 cases of health examination. Through stratified random sampling, the study population was divided into validation set, training set and test set. After data processing and quality control for all laboratory variables, the optimal machine learning algorithm and diagnostic efficiency grouping were selected through four machine learning algorithms, induding the gradient boosting decision tree, random forest, support vector machine, and artificial neural network, and the data were trained by backward stepwise regression method to build the best feature model.Result:In this study, a diagnostic model V22 consisting of 22 routine testing parameters was established. V22 could distinguish early gastric cancer from control group composed of healthy group and precancerous disease, AUC was 0.808, the sensitivity was 85.7%, and the specificity was 91.9%. For CEA negative gastric cancer, V22 also showed high diagnostic accuracy, AUC was 0.801.Conclusion:V22 was a valuable model for the diagnosis of gastric cancer. V22 was an auxiliary diagnostic model of gastric cancer with clinical application value, which could well distinguish early gastric cancer from the control group composed of healthy group and precancerous disease, and the detection rate of early gastric cancer was better than the traditional tumor marker CEA.