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.

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 investigate the epidemiological characteristics and antibiotic sensitivity of Salmonella infection in children with diarrhea in Zhongshan City for rational use of antibiotics.Methods A total of 6 920 stool specimens were collected from children with diarrhea including outpatients and inpatients in Zhongshan Boai Hospital from September 2009 to April 2013.Salmonella strains (n = 344)were isolated and identified by enrichment culture.The overall infection rate was 5.0%(344/6 920).Antimicrobial susceptibility was tested by VITEK-2 Compact automicroscan.Results Of the 344 strains of Sal-monella,185 (53.8%)strains were Salmonella typhimurium ,43 (12.5%)were Salmonella stanley ,29 (8.4%)were Sal-monella enteritidis .The male-to-female ratio was 1.8∶1 for the children with diarrhea.The infection rate was 68.9% (237/344)in children under 1-year old.Susceptibility testing results indicated that majority (88.9%-98.0%)of these Salmonella strains were susceptible to levofloxacin,piperacillin-tazobactam,cefepime,ceftazidime,and ceftriaxone,but to ampicillin, 39.2% of the strains were susceptible.Conclusions Most Salmonella infections in Zhongshan City were caused by Salmonella typhimurium,followed by Salmonella stanley and Salmonella enteritidis .Such infections usually peak in summer and autumn seasons.The chidren under 1-year old were more susceptible to Salmonella infections.Higher incidence of infection is associat-ed with boys.Antibiotics should be chosen reasonably and prudently based on antimicrobial sensitivity testing.

Objectives To investigate the treatment and curative effect on paranasal sinuses and bronchitis in children. Methods Treatment of 62 cases of paranasal sinuses and bronchiolitis was retrospectively analyzed. Antibiotics was used in conventional treatment group (n=23). On top of conventional treatment, conventional plus topical treatment group (n=39) was additionally treated with nasal inhaled corticosteroids, sinus puncture, adenoid or tonsil surgery, etc. Results In conventional treatment group and conventional plus topical treatment group, the total effective rate of treatment for more than 8 weeks was 86.96%and 100.00%respectively, the effective rate for those treated for 4-8 weeks was 39.13%and 61.54%respectively. There was signiifcant difference in the effective rate of treatment for more than 8 weeks and for 4-8 weeks (both P<0.05) between two groups. Signiifcant difference also existed between the effective rate of treatment for more than 8 weeks and for 4-8 weeks (P<0.05) in each group. Conclusions Childhood sino-bronchitis should be treated not only with conventional treatment, but also with cor-rect topical treatment for local pathological changes in nasal sinus and nasopharynx. Longer treatment is needed for children with recurrent chronic sino-bronchitis.

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.