Objective To investigate clinical effect of reattribution-cognitive-pharmacy model (RCPM) in the treatment for irritable bowel syndrome(IBS). Methods 125 subjects with diarrhea predominant irritable bowel syndrome (IBS-D) were divided into two groups randomly. 62 patients in group A were treated with 10 ～ 20 mg of paroxetine without any other medication or psychological interview and 63 patients in group B received RCPM with interviewing once a week for 6 sessions and took 10 ～ 20 mg of paroxetine in the same way as group A after a week. The effect was evaluated at the end of 4 weeks and 12 weeks by a questionnaire. Results At the end of 4 weeks,29 patients in group A reported a reduction in abdominal pain,and 28 reported a reduction in stool frequency ,and 12 patients stopped taking paroxetine because of worrying about those side effect . In group B 48 reported a reduction in abdominal pain ,and 42 reported a reduction in stool frequency ,and 3 patients stopped taking paroxetine. At the end of 12 weeks,36 patients in group A reported a reduction in abdominal pain ,and 30 reported a reduction in stool frequency,and 14 patients stopped taking paroxetine because of worry about those side effect. In group B,54 cases reported a reduction in abdominal pain,and 45 reported a reduction in stool frequency,and 5 patients stopped taking paroxetine because of no obvious improvement. Conclusion RCPM can alleviate the abdominal pain and bowl movement frequency of IBS-D,and it seems better than paroxetine treatment alone. RCPM can improve compliance of paroxetine in patients with IBS-D.

OBJECTIVE:To investigate the clinical efficacy of alprostadil combined with edaravone in the treatment of unsta-ble angina pectoris(UAP),and their effects on serum oxidative stress indexes,the levels of MMP-2 and MMP-9. METHODS:Be-sides conventional treatment,control group was treated with Alprostadil injection 2 ml added into 0.9% Sodium chloride injection (NS)100 ml,ivgtt,qd;while observation group was additionally treated with Edaravone injection 15 ml added into NS 100 ml, ivgtt,qd. Treatment courses of 2 groups lasted for 2 weeks. The frequency and duration of UAP attack,serum levels of MDA, SOD,TAC,MMP-2 and MMP-9 levels were observed 2 groups;the occurrence of ADR was also observed. RESULTS:There was no statistical significance in frequency of angina pectoris attack,duration,MDA,SOD,TAC,MMP-2 and MMP-9 between 2 groups before treatment (P>0.05). After treatment,the total effective rate of observation group (94.3%) was significantly higher than that of control group(81.4%). The frequency of angina pectoris attack and the level of MDA,were significantly reduced,and the duration of angina pectoris was significantly shortened SOD and TAC increased significantly;the change of observation group was more significant than that of control group with statistical significance(P<0.05). ADR was mild in 2 groups;there was no statisti-cal significance in the incidence of ADR(P>0.05). CONCLUSIONS:Alprostadil combined with edaravone is significantly effec-tive for UAP,reduces the frequency of angina,shortens the duration of angina pectoris,alleviates oxidative stress and reduces se-rum levels of MMP-2 and MMP-9 with good safety.

To study the coumarins of Anemone raddeana Regel, the compounds were separated by silica gel column chromatography and HPLC. Their structures were identified by their physicochemical property and spectral analysis. Two new compounds were isolated and identified as 4, 7-dimethoxyl-5-methyl-6-hydroxy coumarin (1) and 4, 7-dimethoxyl-5-formyl-6-hydroxycoumarin (2). The bioassays indicated that compounds 1 and 2 could significantly inhibit the proliferation of cancer cell, and showed the agonist effect on the transactivity of retinoic acid receptor-alpha (RARalpha). In addition, the two compounds had inhibitory effect against human leukocyte elastase (HLE).

Objective To observe the effects of live combined bifidobacterium,lactobacillus and enterococcus powder on immunoglobulin E (IgE) and interleukin-17 (IL-17) in atopic children with bronchiolitis.Methods Sixty cases of atopic children with bronchiolitis were randomly divided into the therapy group (30 cases) and the control group (30 cases).Twenty-five healthy children were enrolled as the healthy control group.Both the therapy group and the control group were given traditional therapy.The therapy group received live combined bifidobacterium,lactobacillus and enterococcus powder for 2 months.The change of IgE and IL-17 levels were observed during the acutestage,remission stage and after receiving live combined bifidobacterium,lactobacillus and enterococcus powder for 2months.Results (1) The levels of IgE and IL-17 of therapy group[(132.36 ±9.50) μg/L and (77.76 ±7.95)μg/L] during acute stage were markedly higher than those in the healthy control group [(52.80 ±4.92) μg/L and (46.92 ±4.79) μg/L] (all P ＜0.001).The levels of IgE and IL-17 of control group [(128.83 ± 8.06) μg/L and (76.61 ±6.18) μg/L] during remission stage were markedly higher than those in the healthy control group [(52.80 ±4.92) μg/L and (46.92 ± 4.79) μg/L] (all P ＜ 0.001).(2) The levels of IgE of therapy group (56.67 ± 9.20)μg/L after receiving live combined bifidobacterium,lactobacillus and enterococcus powder for 2 months were markedly lower than those in the control group (70.50 ± 11.38) μg/L (P ＜ 0.001).The levels of IL-17 of therapy group [(49.63 ± 6.35) μg/L] at the time after receiving live combined bifidobacterium,lactobacillus and enterococcus powder for 2 months were markedly lower than these in the control group (54.77 ± 6.33) μg/L (P =0.003).Conclusion Receiving live combined bifidobacterium,lactobacillus and enterococcus powder for two months can decrease the IgE and IL-17 levels in atopic children with bronchiolitis.

Objective To investigate the efficacy of combination of reattribution cognitive psychotherapy and low-dose antidepressants in the treatment of ulcerative colitis (UC) complicated with functional symptoms , and to explore the psychosomatic digestive disease pattern that incorporated psychosocial variables into clinical thinking and practice .Methods From March 2016 to April 2017 ,sixty patients with UC who met the admission criteria were randomly divided into control group and observation group with 30 patients in each group .Both groups were treated with oral mesalazine ,and the observation group was further treated with reattribution cognitive psychotherapy and antidepressants . Clinical symptoms ,self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were applied to assess the efficacy at the time of enrollment and four weeks after treatment in both groups .Chi square test or t test was performed for statistical analysis .Results Among the 60 patients ,47 (78 .3％ ) met four syndromes of diagnostic criteria for phychosomatic research , and there was no statistically significant difference in the case number of each syndrome between the two groups (P> 0 .05) .After four weeks treatment ,the total effective rates of observation group and control group was 93 .3％ (28/30 ) and 53 .3％ (16/30) ,respectively ,and the difference was statistically significant (χ2 = 22 .667 ,P< 0 .05) . Before and four weeks after treatment , the SAS scores of observation group were 54 .50 ± 6 .70 and 41 .07 ± 3 .72 ,respectively ,and the difference was statistically significant (t=9 .595 ,P= 0 .005) .The SAS scores of control group were 54 .30 ± 6 .06 and 51 .90 ± 7 .92 ,respectively ,and the difference was not statistically significant (P=0 .195) .Before and four weeks after treatment ,the SDS scores of observation group were 50 .63 ± 6 .29 and 34 .40 ± 4 .58 ,respectively ,and the difference was statistically significant (t=11 .426 ,P=0 .025) .The SDS scores of control group were 50 .03 ± 6 .02 and 43 .47 ± 6 .81 ,respectively , and the difference was not statistically significant ( P= 0 .307 ) . Conclusions Psychosomatic model can significantly improve the functional symptoms complicated with UC .It is meaningful to incorporate psychosocial variables into clinical thinking and practice in psychosomatic digestive disease pattern .

OBJECTIVETo investigate the genetic cause and prognosis of a fetus with a rare karyotype.

METHODSFluorescence in situ hybridization (FISH) was used for verifying a structural chromosomal abnormality detected by conventional karyotyping analysis. Whole genome DNA microarray was used to analyze copy number variations carried by the fetus.

RESULTSThe fetus was found to have a 46,XX,dup(21)(?q21q22) karyotype, which was verified by FISH analysis as repetition of chromosome 21 region, namely nuc ish 21q22×3. Whole genome DNA microarray confirmed that there was a 17.87 Mb duplication in the 21q21.3q22.3 region, which involved GATA1, JAK2 and ALL genes and spanned the Down syndrome region. The genes are implicated in craniofacial abnormalities, cardiac abnormalities, mental retardation, growth retardation, limb abnormalities. In addition, there was also an 8.43 Mb deletion in the 4p16.1p16.3 region, which involved FGFR3, LETM1, WHSC1 and WHSC2 and other 64 OMIM genes and spanned the Wolf-Hirschhorn syndrome region. The genes are implicated in growth retardation, craniofacial abnormalities, cardiac abnormalities, mental retardation, and hypotonia. After consultation, the family chose to terminate the pregnancy at 25th week of gestation.

CONCLUSIONFISH can help to verify structural chromosome abnormalities suspected by conventional karyotyping analysis. Combined with whole genome microarray, these can determine copy number variation and its region containing the disease genes, and facilitate clinical analysis of the fetus.

Abortion, Eugenic ; Adult ; Chromosome Banding ; Chromosome Deletion ; Chromosome Disorders ; diagnosis ; genetics ; Chromosome Duplication ; Chromosomes, Human, Pair 21 ; genetics ; Chromosomes, Human, Pair 4 ; genetics ; DNA Copy Number Variations ; Female ; Fetal Diseases ; diagnosis ; genetics ; Genetic Counseling ; Humans ; In Situ Hybridization, Fluorescence ; Karyotyping ; Pregnancy ; Prenatal Diagnosis ; methods

OBJECTIVETo perform prenatal diagnosis for a fetus with multiple malformations.

METHODSThe fetus was subjected to routine karyotyping and whole genome microarray analysis. The parents were subjected to high-resolution chromosome analysis.

RESULTSFetal ultrasound at 28+4 weeks has indicated intrauterine growth restriction, left kidney agenesis, right kidney dysplasia, ventricular septal defect, and polyhydramnios. Chromosomal analysis showed that the fetus has a karyotype of 46,XY,der(2),der(20), t(2;20)(q37.3;p12.2), t(5;15) (q12.2;q25) pat. SNP array analysis confirmed that the fetus has a 5.283 Mb deletion at 2q37.3 and a 11.641 Mb duplication at 20p13p12.2. High-resolution chromosome analysis suggested that the father has a karyotype of 46,XY,t(2;20)(q37.3;p12.2),t(5;15)(q12.2;q25), while the mother has a normal karyotype.

CONCLUSIONThe abnormal phenotype of the fetus may be attributed to a 2q37.3 microdeletion and a 20p13p12.2 microduplication. The father has carried a complex translocation involving four chromosomes. To increase the chance for successful pregnancy, genetic diagnosis and/or assisted reproductive technology are warranted.

Abnormalities, Multiple ; genetics ; Adult ; Chromosome Deletion ; Chromosomes ; genetics ; Female ; Fetus ; abnormalities ; Gene Duplication ; genetics ; Humans ; Karyotyping ; methods ; Male ; Pregnancy ; Prenatal Diagnosis ; methods

OBJECTIVETo conduct genetic testing and prenatal diagnosis for a pregnant women with growth retardation, severe mental retardation, and a history of adverse pregnancies.

METHODSG-banded chromosome analysis, fluorescence in situ hybridization (FISH), and whole genome DNA microarray were used to analyze the patient and her fetus.

RESULTSThe women was found to be a chimera containing two cell lines with 47 and 46 chromosomes, respectively. Both have involved deletion of 18q21.2q23. FISH analysis suggested that the cell line containing 47 chromosomes has harbored a chromosome marker derived from chromosome 15. The marker has contained chromosome 15p involving the SNRPN locus and part of 15q, which gave rise to a karyotype of 47,XX,del18q21.3,+ish mar D15Z1+ SNRPN+[82]/46,XX,del18q21.3[18]. Whole genome DNA microarray confirmed that a 3.044 Mb fragment from 15q11.2q12 was duplicated, which involved NIPA1, SNRPN and other 17 OMIM genes. Duplication of this region has been characterized by low mental retardation, autism, developmental delay. Meanwhile, there was a 17.992 Mb deletion at 18q21.33q23, which contained 39 OMIM genes including TNFRSF11A and PHLPP1. This fragment was characterized by mental retardation, developmental delay, short stature, and cleft palate. Whole genome microarray analysis confirmed that there was a 17.9 Mb deletion at 18q21.33q23, which has been implemented with mental retardation, general growth retardation, short stature, and cleft palate. After genetic counseling, the family decided to terminate the pregnancy at 21st week.

CONCLUSIONCombined chromosome karyotyping, FISH, and whole genome DNA microarray can determine the origin of marker chromosomes and facilitate delineation of its correlation with the clinical phenotype.

Abortion, Eugenic ; Adult ; Chromosome Aberrations ; Chromosome Banding ; Chromosomes, Human, Pair 15 ; genetics ; Chromosomes, Human, Pair 18 ; genetics ; Fatal Outcome ; Female ; Fetus ; abnormalities ; metabolism ; Growth Disorders ; embryology ; genetics ; Humans ; In Situ Hybridization, Fluorescence ; Intellectual Disability ; embryology ; genetics ; Karyotype ; Karyotyping ; Prenatal Diagnosis ; methods

Objective To investigate the prevalence of thyroid nodules(TN)among centenarians in Hainan province and explore the association between thyroid nodules and major chronic diseases.Methods A mixed cross-sectional study of questionnaire survey,medical examination including ultrasonography and laboratory examination were conducted in elderly who resided in Hainan province and aged 100 and over,the subjects who have signed consent and complete data in both basic information and medical examination were included in this study.Eight hundred and four centenarians were finally enrolled and data of them was analyzed to investigate the prevalence of thyroid nodules and to explore its association with common chronic diseases by comparing the prevalence of chronic conditions between groups with and without thyroid nodules.Results The overall prevalence of TN was 73.5%(591、804)and the prevalence of TN was significantly higher in female when comparing with male[75.1%(505、672)vs 65.2%(86、132)](P <0.001).No significant correlation was found between the prevalence of TN and major chronic diseases (P>0.05),however,the factors associated with dyslipidemia and anemia such as TC[(4.6±1.2)mmol、L vs(4.3±1.5)mmol、L],LDL-C[(2.8±0.8)mmol、L vs(2.7±0.8)mmol、L],and Hb[(110.6±22.5)g、L vs(105.5±31.7)g、L]were significant higher in TN group than those in Non-TN group(P <0.05). Conclusions The thyroid nodule is common in centenarian population and its prevalence was higher in female than male.The associations between TN and biomarkers of dyslipidemia and anemia are found in the present study.

Objective: To study the correlation of lifestyle characteristics with thyroid nodules in a population-based sample of centenarians in Hainan. Methods: The study was based on China Hainan Centenarian Cohort Study (CHCCS) conducted in 18 cities and counties in Hainan province from 2014 to 2016. A group of multidisciplinary team interviewed and examined local centenarians with structured questionnaires and ultrasonography procedures. A total of 918 centenarians were analyzed after excluding those who refused ultrasonographic examinations or had relevant missing data. Thyroids of centenarians were examined by 3-year experienced sonographer, details on lifestyle characteristics and dietary habits were collected by standard procedure. Results: Of the 918 centenarians, 683 (74.4%) had thyroid nodules under the ultrasonography procedures. The prevalence of thyroid nodules in different group of areca nut consumption varied significantly (P<0.05). In multivariate logistic regression model, the results showed female and areca nut intake were independently associated with thyroid nodules in centenarians (P<0.05). Conclusions The modifiable variables including areca nut intake as well as non-modifiable such as gender are independent determinants of thyroid nodules in centenarians. Further studies are warranted to explore and verify these associations in populations with different ranges of age.