Intestinal mucosal barrier has the function to isolate intestinal contents and internal environment,prevent foreign antigens and pathogens invading to lamina propria mueosae and can maintain organic homeostasis and normal activities.Impairment of the intestinal barrier is a key event in various gastrointestinal diseases.Probiotics are live microorganisms which ingested and reach the intestines in sufficient numbers to confer benefit to the host.It can improve or prevent many gastrointestinal diseases.The main reason is probiotics can maintain intestinal barrier function in various paths.This paper reviews its mechanisms of action.

Inflammatory bowel disease(IBD) is a recurrent chronic nonspecific intestinal inflammatory disease which can be seen at any age.Its pathogenesis is not clear and the incidence is increasing.Intestinal mucosal barrier has the function to isolate intestinal contents and internal environment which can prevent pathogens invade to lamina propria mucosae and maintain organic homeostasis and normal activities.Impairment of intestinal barrier is a key event in various gastrointestinal diseases,such as IBD.The dysfunction of intestinal mucosal mechanic barrier,immunologic barrier and biologic barrier or their interactions all can induce gastrointestinal diseases.Identifying the specific mechanism of intestinal mucosal barrier impairment in pathogenesis of IBD,maintaining and restoring intestinal barrier function is becoming a new strategy in the treatment of IBD.

Objective To study the influence of microinflammation factors on the pregnancy outcome in gestational diabetes mellitus (GDM) patients.Methods Forty-eight GDM women with abnormal hsCRP and IL-6 concentration were selected as study group another 36 GDM women with normal concentration as control group.The difference of the two groups in common data and outcomes of pregnancy were retrospectively analyzed.Results There were significant difference in hypertensive disorders,prom,premature delivery,intra-uterine asphyxia,mega fetus,uterine-incision delivery and fetus hypoglycemia hypocalcemia between two groups (P ＜0.05).Conclusions Microinflammation factors have promote influence on the development and outcomes of GDM.Early diagnosis and impose intervention may have positive effect.

Objective To investigate the correlation between occurrence time and condition severity in patients of bronchial asthma complicated with allergic rhinitis. Methods The 583 outpatients with asthma in an asthma clinic during 1996-2002 were divided into simple asthma group (Group Ⅰ with 292 cases) and asthma complicated with allergic rhinitis group (Group Ⅱ with 291 cases), and their data were compared and statistically analyzed. Results The proportion of those complicated with other diseases, e.g. , nasal polyp, sinusitis, atopic dermatitis, and with a history of allergy, e.g. , food allergy, drug allergy and positive skin allergic test, was significantly higher in the Group Ⅱ than that in the Group Ⅰ ( P

Individual susceptibility to cancer induced by environmental agents may be influenced by polymorphic metabolic genes responsible for the activation or detoxification of carcinogens．The association between genetic polymorphisms in cytochrome P4501A1 (CYP1A1) and lung cancer susceptibility has been extensively studied．The various CYP1A1 alleles exhibit population frequencies that depend on race and ethnicity．An increased risk of lung cancer in Asians was found to be associated with genetic polymorphisms in CYP1A1．However，reports from Caucasians are not consistant，probably suggesting the ethnic-sepecific effect of the polymorphisms in the locus on the cancer．Evidence also exists for the association between levels of carcinogen-DNA adducts or frequency of oncogene and tumor suppressor gene mutations and CYP1A1 polymorphisms．These findings provide a better understanding of the relationship between CYP1A1 and lung cancer susceptibility．

ObjectiveTo investigate the effect of age and gender on the position of termination of the conus medullaris (CMT).MethodsOne thousand three hundred and thirty-nine patients aged 4-89 yr scheduled for lumbar magnetic resonance imaging examination were selected.The position of CMT was determined using Visart 1.5 T or Magnetom Trio 3.0 T magnetic resonance imaging instrument.Results Five hundred and ninety-four male patients and 745 female patients were enrolled in the study.There was no significant difference in the percentage of CMT located at the L2,3 intervertebral disc level between female (1.2％) and male (0.5％) patients (P＞0.05),and female patients had a lower mean CMT than male patients (P＜0.01).There was no correlation between age and mean CMT in patients aged ≤19 yr (P＞ 0.05).There was a positive correlation between age and mean CMT in female patients aged≤20 yr (r =0.076,P＜0.05),but there was no correlation between age and mean CMT in male patients aged ≤ 20 yr (P＞0.05 ).ConclusionFemale patients have a lower mean CMT than male patients,and there is still a risk when performing spinal anesthesia,although the probability that CMT located at the L2,3 intervertebral disc level is low in female and male patients.The position of CMT is lower with increased age in adult female patients,but it is not related to age in adult male patients.

Educational narrative is the application of narratology in the field of education.This paper introduced the definition of educational narrative and its characteristics of life,situationality and reflexivity,and then discussed the applicableness of the application of educational narrative in the medical ethics education.Based on this,it proposed the effectiveness means,namely that to improve theory quality and enhance the ability of narration,clarify the narrative theme and select material carefully,take care of medical students' growth and listen to their voice.

Objective To identify the clinical characteristic of familial Creutzfeldt-Jakob disease(fCJD) in one pedigree with four cases in two-generation and to investigate its pathogenetic mechanism.Methods The pedigree was investigated in the fCJD kindred,protein capture assay was used to do quantitative analysis of 14-3-3 protein in the cerebrospinal fluid.Types of PrP gene mutation were studied by polymerase chain reaction(PCR) and DNA sequence analysis.Results(1) The onset age during four cases in two-generation was lower than the sporadic CJD and it tended to go down by generations.(2) The 14-3-3 protein level in the index case's cerebrospinal fluid was 125 ng/ml,which was higher than intersection point by 13.9 times.(3) In the index case,inserting mutation in site 231 of PRNP was induced by an adenine insertion between base 788 and 789.(4) No PrP gene mutation was found in the index case's younger brother and daughter.Conclusions The fCJD is identified in the index case,which is caused by inserting mutation in the site 231 of PRNP.There is no significant difference in the clinical manifestations between fCJD and sporadic CJD.However,the onset age of fCJD is lower than the sporadic CJD and patients from the same pedigree die at familiar ages.

Objective To investigate the clinical effect of caffeine citrate combined with continuous positive airway pressure( CPAP) in the treatment of primary apnea of prematurity.Methods 80 premature infants with primary apnea who received therapy from January 2014 to August 2015 were selected as research subjects.According to ran-dom number table,the infants were divided into two groups equally.Besides conventional treatments,the control group received treatment of caffeine citrate,while the observation group received CPAP and caffeine citrate.Then,the cura-tive efficacy,situation of apnea and adverse reactions were compared.Results The total effective rate between the observation group and the control group had statically significant difference(95.0%vs.77.5%,P<0.05) .Compared with the control group,the observation group had statistically less seizure frequency,shorter duration of seizure and disappearance time of symptoms(all P<0.05).During the treatment,incidence rates of tachycardia,dysphoria and electrolyte disturbance in the observation group were statistically lower than those in the control group (all P<0.05), while the incidence of feeding intolerance in the two groups had no statistically significant difference ( P >0 .0 5 ) . Conclusion Caffeine citrate in combination with CPAP is effective for primary apnea of prematurity,which can sig-nificantly increase curative efficacy,lessen seizure frequency of apnea,shorten duration of seizure and disappearance time of symptoms with less adverse reactions.

Objective To evaluate endoscopic ultrasonography (EUS) in preoperative staging of gastric carcinoma,and to study the molecular biologic basis of its ultrasonic manifestation.Methods Sev-enty-four patients with gastric carcinoma were referred to EUS and staged preoperatively.The staging esults of EUS were compared with the histopathological staging and the expression of PTEN.Results The verall accuracy rate of EUS for determination of T staging was 82.4%(61/74),for T1,T2,T3 and T4 were 100.0%,72.7％,85.O％ and 78.9％,respectively.For N staging,EUS had the overall accuracy rate of 74.3%(55/74),with sensitivity and specificity of 80.8％ and 59.1％,respectively.The preoperative EUS for T and N staging of gastric carcinoma was of inverse correlation with the expression of PTEN.Conclusions EUS is an accurate staging modality in determining carcinoma invasive depth and lymph node involved,with a few exceptions of overstaging and understaging.However,EUS criteria to differentiate benign from malignant nodes still need to be further defined by future studies.The preoperative EUS for T and N staging could well display the molecular pathologic basis of gastric carcinoma.