Background:Irritable bowel syndrome(IBS)is a commonly seen functional intestinal disorder. Dietary factors are important factors affecting the abdominal symptoms of IBS patients. Aims:To investigate the effect of dietary factors on abdominal symptoms of IBS and the application of dietary adjustment strategy in patients lived in Xian,Shaanxi Province and the surrounding areas. Methods:Fifty-four outpatients with abdominal complaints who met the Rome Ⅲ criteria of IBS from Feb. 2015 to Jul. 2015 at the Second Affiliated Hospital of Xian Jiaotong University were enrolled. Twenty healthy volunteers were served as controls. All subjects completed a questionnaire containing issues mainly on IBS symptoms, eating habits,dietary factors causing abdominal symptoms,and the patients’coping styles. Results:Compared with healthy controls,more rice and less spicy food,fatty food,raw/ cold food,acidic beverages and alcohol drinking were observed in diet of IBS patients(P all < 0. 05). Abdominal symptoms of IBS patients could be caused or exacerbated predominantly by cold food(55. 6% ),fatty food(55. 6% ),raw food(48. 1% ),meat(48. 1% )and spicy food (40. 7% ). More than half of the IBS patients(63. 0% ) adopted an elimination diet to minimize their abdominal symptoms. Spicy food(59. 3% ),raw food(48. 1% ),cold food(44. 4% ),fatty food(44. 4% )and meat(37. 0% ) were the most frequently eliminated classes of food. Conclusions:Dietary factors can affect the abdominal symptoms of IBS in patients lived in Xian,Shaanxi Province and the surrounding areas and elimination diet based on foods they perceive as problematic is widely used. The classes of food and eating habits causing abdominal symptoms are quite different between domestic and overseas IBS patients.

Objective To investigate the influence of heparin pretreatment on serum and lung tissue level of neutrophil extracellular traps (NETs) in septic mice model and its molecular mechanism.Methods Ninety male C57BL/6J mice were randomly divided into control group (n = 30), lipopolysaccharides (LPS) group (n = 30, 30 mg/kg LPS in 100μL normal saline was intraperitoneally injected) and LPS+heparin group (n = 30, 8 U of heparin in 20μL normal saline was subcutaneously injected 30 minutes before the injection of LPS). Six hours later of LPS injection, blood was collected and lung tissue was harvested. Enzyme linked immunosorbent assay (ELISA) was used to assess the concentration of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and histones 2AX (H2AX), neutrophil elastase (NE), which reflected NETs concentration. PicoGreen fluorescent dyes was used to detect serum circulating free DNA (cf-DNA/NETs) concentration. The protein expression levels of H2AX and NE in lung tissue were examined by Western Blot.Results The serum concentrations of TNF-α, IL-6, H2AX, NE, cf-DNA/NETs, and the protein expression levels of H2AX and NE in lung tissue of septic mice were significantly higher than those of control group [TNF-α (ng/L): 133.0±14.1 vs. 2.7±1.0, IL-6 (ng/L): 3911.2±189.2 vs. 298.9±52.5, H2AX (ng/L): 545.5±40.0 vs. 21.9±8.3, NE (μg/L): 6.48±0.12 vs. 0.47±0.15, cf-DNA/NETs (μg/L): 846.3±137.5 vs. 152.7±36.4, H2AX protein (gray value): 1.14±0.09 vs. 0.68±0.04, NE protein (gray value): 0.56±0.03 vs. 0.32±0.04, allP < 0.05]. After heparin pretreatment, levels of serum TNF-α, H2AX, NE, cf-DNA/NETs, and protein expression levels of H2AX and NE in lung tissue were significantly reduced [TNF-α (ng/L): 83.2±7.6 vs. 133.0±14.1, H2AX (ng/L): 435.0±39.0 vs. 545.5±40.0, NE (μg/L): 4.26±0.17 vs. 6.48±0.12, cf-DNA/NETs (μg/L): 606.5±73.9 vs. 846.3±137.5, H2AX protein (gray value): 0.91±0.03 vs. 1.14±0.09, NE protein (gray value): 0.42±0.03 vs. 0.56±0.03, allP < 0.05], but no significant change was found in IL-6 (ng/L: 3919.9±166.6 vs. 3911.2±189.2,P > 0.05).Conclusion Heparin pretreatment could significantly decrease the level of NETs in serum and lung tissue, and can be the potential mechanism of its organ protection in sepsis.

On the basis of analysis of the current status and future tendency of development of the health services industry in Shanghai,the authors identified key problems and bottlenecks.Thus they made clear the target positioning and principles of the industry,and proposed the basic ideas and pattern of the industry in the 13 th five-year plan period,focusing on such fields as private and high-end healthcare services,traditional Chinese medicine services,public health services,commercial health insurance,and other related industries.In the end,corresponding supporting polices were proposed.

To analyze the potential limitations of hospital-level research projects management by summarizing its performance status from 2008 to 2011,including but not limited to lack of time for conducting research,insufficient financial funds,inadequate funding application,inadequate supervision.Thus,since 2014,our hospital has adopted some new measurements for projects management,including full-time research,hierarchical management,full mobilization,the establishment of reward and punishment measures,which significantly improved the quality of hospital-level research projects,and the rate of longitudinal follow-up project,research enthusiasm of medical staff,and sustainable development of hospital science and technology.

Objective To study the nutritional risks in elderly patients with prostate cancer and explore its related factors.Methods 346 elderly patients with prostate cancer in Wuhan area from May 2013 to May 2014 were chosen as the objects in this study.Nutritional risk screening 2002 was used to evaluate nutritional risk.The sleep quality,anxiety,lower urinary tract symptoms,differentiation and other data of patients were collected.The influencing factors for nutritional risk in the patients were analyzed.Results The ratio of nutritional risk in elderly advanced prostate cancer patients was 35.3％ (122/346).The nutritional risk was increased with age (P＜0.05).The prostate cancer patients with nutritional risk had a higher international prostate symptom score (IPSS) (P＜ 0.05).Monovariate factor analysis showed that sleep quality,operation,pathology staging,radiotherapy,chemotherapy,lower urinary tract symptoms (LUTS) were the impact factors for nutritional status in elderly patients with prostate cancer (P＜0.05).Logistic regression analysis showed that age (OR=0.29),sleep quality (OR=0.25) were the protective factors for the nutritional status,while surgery (OR=12.67),pathological staging (OR=1.65),radiotherapy (OR=2.65),SPSS (OR=1.55),chemotherapy (OR=1.85) were the risk factors for nutritional status (P＜ 0.05).Conclusions The incidence of nutritional risk is high in elderly prostate cancer patients.Age,sleep quality are the protective factors,and operation,pathology staging,SPSS,chemotherapy,and radiotherapy are the risk factors for nutritional status.

Objective:To analyze the effect of traditional Chinese medicine (TCM) non-drug therapy on all-cause mortality and 12-month readmission in patients with chronic heart failure.Methods:A total 824 patients aged (80±10) years with chronic heart failure admitted to 4 hospitals in Shanghai Pudong New Area from January 2016 to December 2019 were retrospectively enrolled. Propensity score match (PSM) method was used and 602 patients (301 pairs) were successively matched into TCM non-drug group (study group) and control group. The basic information, comorbidities, medication, laboratory test results, imaging findings, 12-month readmission and all-cause mortality after discharge were compared between two groups. Cox regression was used to analyze the influencing factors of adverse events in patients with chronic heart failure.Results:After PSM there were no significant differences in baseline variables between study group and control group ( P>0.05). The one-year survival probability of the study group was higher than that of the control group ( P=0.013). The adverse event incidence rate [43.52% ( n=131) vs. 53.82% ( n=162)], all-cause mortality [15.61% ( n=47) vs. 23.59% ( n=71)], 3-month readmission [10.96% ( n=33) vs. 17.61% ( n=53)], 6-month readmission [16.90% ( n=51) vs. 24.25% ( n=73s)], cardiac function classification, hs-CRP and NT-proBNP levels in study group were significantly lower than those in control group (all P<0.05). The Cox proportional risk model showed that old age ( RR=1.018, P<0.01), decreased cardiac function ( RR=2.200, P<0.01), diabetes ( RR=1.340, P=0.04), NT-proBNP≥7 900 ng/L( RR=1.557, P=0.01) were risk factors, while TCM non-drug therapy ( RR=0.768, P=0.04) was protective factor for the occurrence of adverse events. Conclusion:TCM non-drug therapy has a protective role for the occurrence of adverse events in patients with chronic heart failure. The use of TCM non-drug therapy should be advocated to improve the prognosis of patients, particularly at grassroots level.

Objective:To observe the effect of herbal-partitioned moxibustion (HPM) on pain-related behavior and emotion in a rat model of chronic inflammatory visceral pain, and to investigate the mechanism.
Methods:Twenty-four male Sprague-Dawley (SD) rats were randomly divided into three groups:a normal group, a model group and an HPM group. Except for the normal group, rats in the other two groups were clystered with mixed liquor of Trinitrobenzene Sulfonic Acid (TNBS) and 50%ethanol to induce the chronic inflammatory visceral pain model. After the models were established successfully, rats in the HPM group were treated with HPM at bilateral Tianshu (ST 25) and Qihai (CV 6). Rats in the normal group and the model group were only fixed as those in the HPM group without treatment. Abdominal withdrawal reflex (AWR) score, mechanical withdrawal threshold (MWT) and thermal withdrawal latency (TWL) were adopted to detect the visceral and somatic pain;meanwhile, open field test (OFT) and elevated plus maze test (EPMT) were employed to evaluate pain emotions such as depression and anxiety.
Results:Compared with the normal group, AWR scores of the model group were significantly increased under different stimulus expansion pressure level (P<0.01), MWT and TWL were significantly decreased (P<0.05);in OFT, the values of horizontal activities and vertical activities were significantly decreased (P<0.01);in EPMT, the proportion of the number of entry into the open arms (OE%) and that of residence time in the open arms (OT%) significantly decreased (P<0.01), indicating that the model was successful. Compared with the model group, the AWR score of the HPM group was decreased significantly (P<0.05), MWT and TWL were significantly increased (P<0.05), the values of horizontal activities and vertical activities in the model group were significantly increased (P<0.01);in OFT and EPMT, OE%and OT%were significantly increased (P<0.01).
Conclusion:HPM has analgesic effect on chronic inflammatory visceral pain. It can reduce the visceral and somatic pain in rats and markedly improve the emotions such as anxiety and depression induced by chronic visceral pain.

Objective:To observe the effects of acupuncture and moxibustion on ubiquitin-like containing PHD and RING finger domains 1(UHRF1)and DNA methyltransferase 1(DNMT1)in ectopic endometrium of rats with endometriosis(EMS). Methods:Forty Sprague-Dawley rats were randomly divided into a sham operation group with 10 rats and a model-building group with 30 rats according to body mass.EMS rat models were established in the model-building group and then were divided into a model group,an acupuncture and moxibustion group,and a progesterone group,with 10 rats in each group.All rats were fixed by a fixator.The sham operation group and the model group were given normal saline by gavage.The acupuncture and moxibustion group received acupuncture at Xuehai(SP10)and Sanyinjiao(SP6),moxibustion at Guanyuan(CV4),and gavage of normal saline.The progesterone group was given the mixed liquid made of dydrogesterone and normal saline by gavage.After 28 d of treatments,the three diameters(length,width,and height)of EMS rats'ectopic cysts were measured,the cyst volumes were calculated,the volumes before intervention were subtracted,and the difference values were used to evaluate the growth of ectopic cysts.UHRF1 and DNMT1 mRNA and protein levels in normal endometrium,eutopic endometrium,and ectopic endometrium were detected by real-time polymerase chain reaction and immunohistochemistry. Results:There was no significant difference in the ectopic cyst volume difference between the acupuncture and moxibustion group and the progesterone group(P>0.05),but they were smaller than that of the model group(P<0.05).The levels of UHRF1 and DNMT1 mRNA and protein in the ectopic endometrium of the model group were lower than those in the normal endometrium(P<0.05).The levels of DNMT1 mRNA and UHRF1 protein in the eutopic endometrium of the model group were lower than those in the normal endometrium(P<0.05).The levels of UHRF1 mRNA and protein and the level of DNMT1 protein in the ectopic endometrium of the acupuncture and moxibustion group were higher than those in the model group(P<0.05),and the level of UHRF1 mRNA was higher than that in the progesterone group(P<0.05).The level of DNMT1 mRNA in the eutopic endometrium of the acupuncture and moxibustion group was higher than that in the model group(P<0.05).The levels of UHRF1 and DNMT1 mRNA and protein in the acupuncture and moxibustion group were insignificantly different from those in the normal endometrium(P>0.05). Conclusion:Acupuncture and moxibustion may up-regulate the levels of UHRF1 mRNA and UHRF1 and DNMT1 proteins in the ectopic endometrium to the normal level so as to reduce the volume of ectopic cysts and cure EMS in rats.

Objective:To investigate the central mechanism of moxibustion in treating chronic inflammatory visceral pain(CIVP)and its analgesic effect from the perspective of the p38 mitogen-activated protein kinase(MAPK)/Ets-like transcription factor 1(ELK1)signaling pathway in the spinal cord. Methods:Clean-grade male Sprague-Dawley rats were randomly divided into a normal group,a model group,a herb-partitioned moxibustion(HPM)group,a sham-HPM group,a p38 MAPK inhibitor group,and a dimethyl sulfoxide(DMSO)group.CIVP rat models were prepared using an enema mixture of 2,4,6-trinitrobenzene sulfonic acid solution and 50%ethanol.The HPM group was treated with HPM;the sham-HPM group was treated the same as the HPM group,but the moxa cones were not ignited;rats in the p38 MAPK inhibitor group received L5-L6 intrathecal injection of p38 MAPK inhibitor(SB203580);rats in the DMSO group received L5-L6 intrathecal injection of 2%DMSO.Abdominal withdrawal reflex(AWR),mechanical withdrawal threshold(MWT),and thermal withdrawal latency(TWL)were used to observe pain-related behaviors in each group.Hematoxylin-eosin staining was used to observe the morphological changes in rat colon tissue.Western blotting and real-time quantitative reverse-transcription polymerase chain reaction were used to detect the phosphorylated protein and mRNA expression of apoptosis signal-regulating kinase 1(ASK1),MAPK kinase(MKK)3/6,p38 MAPK,ELK1,and mitogen and stress-activated protein kinase 1(MSK1)in the spinal cord. Results:Compared with the normal group,CIVP rats had severe colonic inflammatory injuries,and the pathological injury scores increased significantly,along with increased AWR scores under different colorectal distension(CRD)stimulation pressures and decreased MWT and TWL;the mRNA and phosphorylated protein expression of p38 MAPK,ELK1,MSK1,ASK1,MKK3,and MKK6 all increased in the spinal cord(P<0.01).After HPM treatment,the colon injuries were repaired,and the pathological injury scores decreased;under different CRD stimulation pressures,the AWR scores decreased,and the MWT and TWL increased;the mRNA and phosphorylated protein expression of p38 MAPK,ELK1,ASK1,and MKK3 in the spinal cord also decreased,with statistically significant differences compared with the model group and the sham-HPM group(P<0.01).There were no significant differences in the above indicators between the HPM group and the p38 MAPK inhibitor group(P>0.05),and the same was true regarding the comparisons between the model group and the DMSO group. Conclusion:HPM exerted analgesic effects via downregulating the mRNA and phosphorylated protein expression of ASK1,MKK3,p38 MAPK,and ELK1 in the spinal cord of CIVP rats.The inhibition of spinal p38 MAPK/ELK1 signaling pathway activation may be one of the mechanisms by which HPM relieves pain in CIVP.

OBJECTIVETo investigate the correlation between tissue factor (TF) expression and hepatic metastasis and prognosis in rectal cancer.

METHODSTF expression was retrospectively studied by immunohistochemical method in specimens of 40 rectal cancer, 3 hepatic metastasis and 6 benign adenoma with relation to their clinicopathologic data.

RESULTS1. TF expression was detected in 20 (50%) of the 40 primary rectal cancer specimens and all the 3 hepatic metastatic specimens, but not in the 6 benign adenoma or normal mucosa of rectum, 2. Significant correlation was observed between TF expression and synchronic hepatic metastasis (P = 0.002) and heterochronic hepatic metastasis (P = 0.001) and 3. TF was a risk factor for the prognosis of primary rectal cancer (P = 0.024).

CONCLUSIONTissue factor expression may play a role in the process of developing hepatic metastasis. It may be considered as a new clinical indicator for monitor of hepatic metastasis and prognosis of primary rectal cancer.

Adenoma ; metabolism ; pathology ; Humans ; Immunohistochemistry ; methods ; Liver Neoplasms ; metabolism ; secondary ; Logistic Models ; Predictive Value of Tests ; Proportional Hazards Models ; Rectal Neoplasms ; metabolism ; pathology ; Rectum ; metabolism ; Retrospective Studies ; Staining and Labeling ; methods ; Thromboplastin ; biosynthesis