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.

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.

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．

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

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.

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.

Environmental Monitoring ; methods ; Noise, Occupational ; statistics & numerical data

Objective To compare the effect of hepatic oval cells and bone marrow mesenchymal stem cells to treat liver fibrosis in mice. Methods The C57BL/6 mice were fed with 3,5-diethoxycarbonyl-1, 4-dihydro-collidine (DDC) in a standard food at a concentra-tion of 0.1% to activate the oval cells proliferation, then the nonparenchymal cells were separated by in situ perfusion and density gradient centrifugation, and finally Sca-1 antibody was used in conjunction with magnetic activated cell sorting (MACS) to separate the Sca-1 +cells. Other mice were injected subcutaneously with CCl4 to establish experimental liver fibrosis model. Finally, the fibrosis mice were trans-planted with HOC or MSC or saline by spleen injection according to the group they belonged to. Four weeks later, the liver function index, the hydroxyproline and the histopathological change among the groups were used to evaluate the effect of the treatment. Result The liver function index was improved after transplantation. HOC and MSE treatment could reduce both the hydroxyproline level and alleviate the fibro-sis, but HOC seems more effective in the group with continuing CCl4 injection(P < 0.05). When stopping injecting CCl4, the change of fi-brosis was not visible(P >0.05). Conclusion Both hepatic oval cells and bone marrow mesenchymal stem cells can improve the liver function, and alleviate the fibrosis level by transpleen transplantation, but hepatic oval cells were more effective.

Objective To evaluate the efficacy and safety of sunitinib versus sorafenib in the first-line treatment of advanced renal cell carcinoma.Methods Forty-two patients with advanced renal cell carcinoma were divided into two groups according to the therapeutic method.Twenty patients were treated with sunitinib (50 mg, oral administration, once a day, for 4 weeks, drug withdrawal of 2 weeks, 6 weeks was a cycle) and 22 patients were treated with sorafenib (400 mg, oral administration, twice a day, until the disease progression, 6 weeks was a cycle).The efficacy and toxicity were evaluated every 2-cycle treatment.Results All 42 patients could be evaluated.The disease remission rate (RR), disease control rate (DCR) of sunitinib group and sorafenib group were 30.0％ (6/20), 22.7％ (5/22), 90.0％ (18/20), 77.3％ (17/22) respectively,the median progression free survival (PFS) were 10.8, 6.2 months, the median overall survival (OS) were 25.6, 18.6 months respectively.There were no statistical differences in the RR (x2 =0.287, P =0.592) and DCR (x2 =1.222, P =0.269) between the two groups.There were statistical difference in the PFS (x2 =6.041, P =0.014) and OS (x2 =11.245, P =0.001) between the two groups.The most common toxicities of the sunitinib group were diarrhea, fatigue, oral mucositis, nausea, vomiting, all these toxicities were mainly Ⅰ-Ⅱ degree, and could be well tolerated.The hand-foot syndrome rate of the sorafenib group obviously exceeded the sunitinib group (59.1％ vs.25.0％ , x2 =4.972, P =0.026).Conclusion Sunitinib has good efficacy in the first-line treatment of advanced renal cell carcinoma with less toxicity than sorafenib, so it is worthy of popularization.