Objective To investigate the gastrointestinal symptoms in patients with chronic obstructive pulmonary disease (COPD) and explore its possible reasons.Methods Thirty-six patients with stable COPD were divided into mild group [21 cases,forced expiratory volume in first second (FEV1) measured values/predictive values ≥50％] and severe group (15 cases,FEV1 measured values/predictive values ＜ 50％) according to the pulmonary function.Replacement of 19 healthy volunteers as control group.The patients and volunteers completed the Gastrointestinal Symptom Rating Scales (GSRS) scores and received electrogastrography,the plasma vasoactive intestinal peptide (VIP) and intestinal fatty acid binding protein (Ⅰ-FABP) were detected.Results The GSRS scores in severe group and mild group was higher than that in control group[(17.73 ± 4.64),(14.29 ± 5.44) scores vs.(8.00 ± 2.29) scores],and severe group was higher than that in mild group,there was significant difference (P ＜ 0.05).The percentage of normal slow waves of fasting and postprandial,the percentage of bradygastria in severe group and mild group were lower than those in control group,there were significant differences(P ＜ 0.05).The level of VIP in severe group was lower than that in mild group and control group [(36.07 ± 9.22) μ g/L vs.(44.16 ± 7.88),(46.53 ± 4.54) μ g/L],the level of I-FABP was higher than that in mild group and control group [(35.80 ± 11.69) μ g/L vs.(27.40 ±9.53),(23.58 ±8.18) μg/L],there was significant difference (P ＜0.05),but there was no significant difference between mild group and control group (P ＞ 0.05).Conclusion The patients with COPD are accompanied with serious gastrointestinal symptoms and gastric dysrhythmia,severe COPD can be associated with VIP decrease and Ⅰ-FABP rise in peripheral blood.

Objective To evaluate the impact of endoscopic sphincterotomy (EST) and bile duct exploration with open surgery on immune function and inflammatory response.Methods Fifty-one patients with choledocholithiasis were divided into endoscopy group ( EG,n =24) and laparotomy group ( LG,n =27 ) according to the patients' will from June 2010 to February 2012.Procalcitonin( PCT),C-reactive protein (CRP),immunoglobulins (IgA 、lgG 、IgM ) and T lymphocyte (CD4、CD8 ) of peripheral blood were examined preoperatively and on the 1st,3rd and 5th day postoperatively.Results Compared with preoperative levels,postoperative levels of serum PCT and CRP were higher in both groups (P ＜0.01 ),but on the 3rd day after the operation,the changes of PCT and CRP levels in the two groups were not significantly different ( P ＞ 0.05 ).Postoperative levels of serum immunoglobulins of two groups were lower than preoperative levels (P ＜ 0.01 ),but the IgA and IgM levels in EG were significantly higher than those in the LG (P ＜ 0.05),and IgG levels in the two groups were not significantly different after surgery ( P ＞ 0.05 ).Compared with preoperative levels,postoperative levels of CD4,CD8 and CD4/CD8 ratio in EG were only slightly decreased (P ＞ 0.05 ),and returned to the preoperative levels on the 5th day postoperatively,but postoperative levels of these variables in LG were decreased significantly ( P ＜ 0.05).Postoperative levels of CD4,CD8 and CD4/CD8 ration of the two groups were significantly different (P ＜ 0.05).Conclusion Both EST and bile duct exploration with open surgery can inhibit immune function and induce inflammation,but the procedure of EST,which may mainly affect humoral immune function,has impact on immune function less intensely.

Medical genetics is the mutual penetrative and combined discipline of genetics and medicine.Medical genetics teaching should be improved to adapt to the discipline development.Teaching reform and practice of medical genetics was developed in basic medical college of Nanjing university of traditional Chinese medicine.Constructive exploration was made in teaching content,teaching techniques,teaching methods,scientific research and performance appraisal standards in order to improve the quality of medical genetics teaching and to train high-quality medical talents.

Background:Gastrointestinal dysmotility is frequently seen in patients with chronic obstructive pulmonary disease ( COPD). Simo Decoction is used for promoting gastrointestinal motility in clinical practice. Aims:To study the effect of Simo Decoction on gastrointestinal symptoms and motility in patients with COPD. Methods:Thirty-six patients with stable COPD in Shiyan Renmin Hospital from Sep. 2012 to Jun. 2013 were enrolled and received a 28-day course treatment of Simo Decoction oral solution,19 healthy volunteers were served as controls. All subjects were assessed with gastrointestinal symptom rating scale(GSRS). Electrogastrography was performed and levels of vasoactive intestinal peptide(VIP)and intestinal fatty acid-binding protein( I-FABP)in peripheral blood were measured. Patients with COPD were re-examined for the above-mentioned parameters after treated with Simo Decoction. Results:The baseline GSRS score and serum I-FABP level in COPD patients were significantly increased as compared with controls(P<0. 05),while the baseline serum VIP level,as well as the fasting and postprandial normal gastric slow wave percentage in COPD patients were significantly decreased(P <0. 05). After 28-day course of Simo Decoction treatment,all these parameters in COPD patients were improved as compared with those before treatment(P<0. 05),serum levels of VIP,I-FABP and normal gastric slow wave percentage were similar to those of controls. Conclusions:Simo Decoction can ameliorate the gastrointestinal symptoms and dysmotility in patients with COPD. The regulatory effect of Simo Decoction on gastrointestinal motility might be bidirectional.

Aim To study effects of loganin and morro-niside on aging astrocytes induced by D-galactose. Methods Cortex astrocytes of newly born rats were cultured in vivo and indentified by immunofluorescence method.Firstly,appropriate D-galactose concentration was selected and effects of loganin and morroniside on proliferation activity of aging astrocytes induced by D-galactose were determined by MTT test.Then SOD, MDA were taken as indicators to study the effects of loganin and morroniside on aging astrocytes induced by D-galactose.Thirdly,growth factors like gliar cell line-derived neurotrophic factor (GDNF),basic fibro-blast growth factor (bFGF)tested by ELISA method and expression of Bax,caspase-3,phospho-extracellu-lar signal-regulated kinese (p-ERK1 /2),phospho-mi-togen-actived protein kinase /extracellular signal-regu-lated kinase kinase (p-MEK1 /2)were taken as indi-cators to discuss the potential protection mechanism. Results Loganin and morroniside exerted certain effects on proliferation of aging astrocytes induced by D-galactose,improving SOD,GDNF,bFGF release and lowering MDA release significantly (P <0.05 ). The expressions of Bax and caspase-3 proteins had no difference between model group and loganin group, morroniside group.While the expressions of p-ERK1 /2,p-MEK1 /2 of loganin group,morroniside group were improved significantly compared with model group.Conclusion Loganin and morroniside have protective effects on aging astrocytes induced by D-ga-lactose,and increase the proliferation ability.Protec-ting their antioxidant systems and improving the expres-sion of p-ERK1 /2,p-MEK1 /2 proteins are possible mechanisms.

Objective To evaluate the therapeutic effect of esophageal intraluminal stents with 125I seeds based on survival time and quality of life (QOL) of patients with advanced esophageal cancer.Methods A total of 37 patients with advanced esophageal cancer who underwent placement of esophageal 125I irradiation stent were followed up.The QOL was evaluated by QLQ-C30 and QLQ-OES18 questionnaires before the procedure, and 1 week and 3 months after.Results The mean survival time of 37 patients was 28 weeks, with 3-month and 6-month survival rates at 94.6% (35/37) and 51.4% (19/37), respectively.Compared with the baseline, the scores of emotional functioning(EF), cognitive functioning(CF),global quality of life(QL), fatigue(FA), pain(PA), financial difficulties(FI) and pain of QLQ-OES18(OESPA) assessed 1 week after stent placement increased (P<0.05) significantly and dysphapia of QLQ-OES18(OESDYS), eating of QLQ-OES18(OESEAT), trouble swallowing saliva of QLQ-OES18(OESSV) and choked when swallowing of QLQ-OES18(OESCH) decreased significantly (P<0.05).At 3 months after stent placement, the scores of FI increased significantly (P<0.05), and those of nausea or vomiting (NV), OESDYS,OESEAT, OESSV and OESCH decreased significantly (P<0.05).The scores of FI,OESDYS, OESCH, role functioning(RF), EF,CF,FA and OESPA at 3 months were significantly different from those at 1 week after the procedure (P<0.05).Other variables at 1 week and 3 months after the procedure were not different from those before (P>0.05).Conclusion Implantation of 125I seeds combined with esophageal intraluminal stents may prolong survival time and improve QOL of patients with advanced esophageal cancer.

Objective To compare the recurrence rate and long-term follow-up angiographic findings between stent-assisted coil embolization and simple coil embolization in treating large and giant intracranial aneurysms.Methods The clinical data and imaging materials of a total of 90 patients with large and giant intracranial aneurysms (＞10 mm,91 aneurysms in total),who were admitted to authors' hospital during the period from January 2004 to January 2016 to receive interventional embolization therapy,were retrospectively analyzed.Of the 90 patients,52 patients (52 lesions in total) received simple coil embolization (SCE group)and 38 patients (39 lesions in total) received stent-assisted coil embolization (SACE group).Postoperative recurrence rates of aneurysm were compared between the two groups,and recurrence risk factors were analyzed.Results The whole postoperative recurrence rate of aneurysm and re-treatment rate were 38.5％(35/91) and 20.9％(19/91) respectively;the recurrence rate and re-treatment rate of SACE group were 35.9％ (14/39) and 17.9％ (7/39) respectively,while those of SCE group were 40.4％ (21/52) and 23.1％ (12/52) respectively;the differences between the two groups were not statistically significant (P＞0.05).Multivariate logistic regression indicated that the recurrence risk factors of large or giant intracranial aneurysms included rupture of aneurysm (OR=0.284,95％CI=0.083-0.978,P=0.046),simple coil embolization (OR=5.03,95％ CI=1.04-24.44,P=0.045),concurrent hypertension (OR =0.13,95％ CI=0.036-0.51,P=0.003)and long time after operation (OR=1.002,95％CI=1.001-1.003,P=0.002).Conclusion Compared with simple coil embolization,stent-assisted coil embolization can reduce the recurrence rate of aneurysm.Rupture of aneurysm,simple coil embolization,long time after operation and concurrent hypertension are independent risk factors for recurrence of aneurysm after transcatheter arterial embolization.

Objective: To explore the role of toll-like receptor 4 (TLR4)/NF-κB signaling pathway in acute necrotizing pancreatitis (ANP)-associated lung injury and the intervention of lipoxin A4 (LXA4) analogue. Methods: Forty-five Sprague-Dawley rats were randomly(random number)divided into the sham operation group, experimental group, and intervention group, each group containing 15 rats. ANP animal models were prepared by injecting sodium taurocholate into biliopancreatic tube in the experimental group. No sodium taurocholate was injected into biliopancreatic duct in the sham operation group. After the preparation of ANP animal models in the intervention group, LXA4 was injected through the tail vein. Rats in each group were randomly divided into 3 subgroups (n=5 each subgroup). The serum amylase, TNF- α, IL-1β, IL-6 and endotoxin levels were detected 6, 12 and 24 h after the operation. The lung injury scores were assessed and the lung wet/dry weight ratio was calculated. The expressions of TLR4 and NF-κB p65 in lung tissues were detected by Western blot. Results: Serum levels of amylase, TNF-α, IL-1β, IL-6 and endotoxin in the experimental and intervention groups were significantly higher than those in the sham operation group, while the levels of the above indicators in the intervention group was significantly lower than those in the experimental group, and the differences were statistically significant (P<0.05). Postoperative lung injury scores and lung wet/dry weight ratio in the experimental group were significantly higher than those in the sham operation group, and the differences were statistically significant (P<0.05). Lung injury scores in the intervention group 6 h after operation had no significant difference compared with those in the sham operation group (P>0.05), while lung wet/dry weight ratio in the intervention group 6 h after operation, and lung injury scores and lung wet/dry weight ratio in the intervention group 12 h or 24 h respectively after operation were significantly higher than those in the sham operation group, with statistically significant differences (P<0.05). Postoperative lung injury scores and lung wet/dry weight ratio in the intervention group were significantly lower than those in the experimental group, and the differences were statistically significant (P<0.05). The expressions of TLR4 and p65 in the lung tissues of the experimental and intervention groups were significantly higher than those of the sham operation group, and the expressions of TLR4 and p65 in the lung tissues of the intervention group were significantly lower than those of the experimental group, with statistically significant differences (P<0.05). Conclusions LXA4 can reduce the severity of acute necrotizing pancreatitis-associated lung injury, and its mechanism is related to reducing the stimulation of endotoxin, thus inhibiting TLR4 signaling pathway and the activation of p65 to down-regulate the level of pro-inflammatory cytokines.

Objective:To explore the mechanism of pioglitazone in reducing lung injury induced by acute pancreatitis.Methods:Thirty healthy male SD rats were randomly(random number) divided into the sham operation group, model group and pioglitazone group, with 10 rats in each group. After anesthesia, the rats in the sham operation group were injected with normal saline retrogradely through the pancreaticobiliary duct. In the model group, after anesthesia, the rats were retrogradely injected with sodium taurocholate into the pancreaticobiliary duct to construct the lung injury model of severe acute pancreatitis. In the pioglitazone group, the model was established after intraperitoneal injection of pioglitazone. Six rats in each group were randomly selected and killed 12 h after operation, and then lung tissue and venous blood were collected. The levels of serum amylase and TNF-α and NO in lung tissue homogenate were detected and compared among the three groups; the expression of TLR2 mRNA and TLR4 mRNA in lung tissue was detected by RT-PCR and compared among the three groups; the lung tissue pathological injury score and lung leakage index were calculated and compared among the three groups. The correlation of TLR2 and TLR4’s mRNA expression with lung tissue pathological injury score and lung leakage index was analyzed.Results:The levels of serum amylase and the levels of TNF-α and NO in lung tissue homogenate in the model group were significantly higher than those in the sham operation group, and the above indexes in the pioglitazone group were significantly lower than those in the model group ( P<0.05). The expression levels of TLR2 mRNA and TLR4 mRNA in lung tissue, the lung tissue pathological injury score and lung leakage index in the model group were significantly higher than those in the sham operation group, and the above indexes in the pioglitazone group were significantly lower than those in the model group ( P<0.05). Spearman correlation analysis showed that the expression levels of TLR2 mRNA and TLR4 mRNA in lung tissue were significantly positively correlated with the lung tissue pathological injury score ( rs=0.959, P<0.001; rs=0.924, P<0.001). Pearson correlation analysis showed that the expression levels of TLR2 mRNA and TLR4 mRNA in lung tissue were significantly positively correlated with the lung leakage index ( r=0.957, P<0.001; r=0.958, P<0.001). Conclusions:Pioglitazone may reduce the severity of severe acute pancreatitis induced lung injury by inhibiting the expression of TLR2 mRNA and TLR4 mRNA in lung tissue.

Objective:To explore the mechanism of miR-494 negatively regulating ROCK1 and PTEN in inhibiting apoptosis of pancreatic cells and participating in the occurrence and development of acute pancreatitis.Methods:Pancreatic acinar cells AR42J from rats were treated by caerulein, and then the levels of amylase, tumor necrosis factor alpha (TNF-α), interleukin 1 (IL-1) and IL-6 in the supernatant of cell culture were detected by ELISA to verify the cell model of acute pancreatitis. RT-PCR was used to detect the expression of miR-494 in normal AR42J cells (control group) and acute pancreatitis cell model (model group). Flow cytometry was used to detect the apoptosis of the control group, negative control miRNA transfected acute pancreatitis cell model (negative control group) and miR-494 transfected acute pancreatitis cell model (miR-494 transfection group). Western blot was used to detect the expression of ROCK1 and PTEN in the control group, negative control group and miR-494 transfection group.Results:The levels of amylase, TNF-α, IL-1 and IL-6 in the supernatant of AR42J cells treated with caerulein for 8 h and 12 h were significantly higher than those at 0 h and the control group ( P<0.05), indicating that the model was successfully constructed. The expression levels of miR-494 at 8 h, 12 h and 24 h after the establishment of acute pancreatitis cell model were significantly higher than those at 4 h and the control group ( P < 0.05). The apoptosis rate of the model group was significantly higher than that of the control group ( P<0.05), and the apoptosis rate of the miR-494 transfection group was significantly lower than that of the model group ( P<0.05). The expression levels of ROCK1 and PTEN in the miR-494 transfection group were significantly lower than those in the model group and negative control group ( P<0.05). Conclusions:When acute pancreatitis occurs, overexpression of miR-494 can inhibit the expression of pro-apoptotic protein, thus inhibiting the apoptosis of pancreatic acinar cells and promoting the development of acute pancreatitis.