Objective To explore the relation between IL-10 promoter region gene polymorphism and irritable bowel syndrome (IBS).Methods By polymerase chain reaction combined with restrition fragment length polymophism (PCR-RFLP),gene type of IL-10 promoter -1082 and -819 sites in 313 IBS patients and 281 controls was analyzed.Results The distribution of IL-10-1082 and-819 allele frequencies in IBS group,control group and total was in accordance with Hardy-Weinberg equilibrium law.The frequency of IL-10-819 T allele in diarrhea subtype (79.8％) and mixed IBS subgroup (77.1％) was significantly higher than that in control group (65.7％).There were no significant differences in IL-10-1082 A/G allele frequency between each subtypes and control group (P＞0.05),however there was statistically difference between diarrhea subtype and mixed IBS subgroup (P＜0.05).The frequency of-819 T/T genotype in IBS group (51.1 ％ )was significantly higher than that of control group (40.2％),the frequency of C/T genotype was significantly lower than that of control group,and the difference was statistically significant (all P＜0.05).The IL-10-819 T/T allele frequency of all IBS subtypes was significantly higher than that of control group; however C/T allele genotype frequency of all IBS subtypes was significantly lower than that of control group,and the difference was statistically significant (all P ＜ 0.05). There was no significant difference of C/C allele genotype between subtypes (P＜0.05).There was no significant difference of -1082 allele genotype between IBS group and control group (P＞0.05).The frequency of -1082 A/A genotype in diarrhea subtype of IBS patients (93.3％) was significantly higher than that of mixed IBS subtype (82.4％),while the frequency of A/G genotype was lower than that of mixed IBS subtype,and the difference was statistically significant (all P ＜ 0.05 ); there was no significant difference between other IBS subtypes and control group (P＞0.05).Conclusion IL-10-819 promoter T/Tgenotype may be related to IBS pathogenesis.

0.05). However in OAC group, there were significant differences between EM and IM(P0.05). Conclusions RAC and OAC triple therapy could eradicate H. pylori effectively. The efficacy of rabeprazole-based triple therapy was less affected by the CYP2C19 genotype. The eradication rates of H. pylori in PM and IM were higher than that in EM.

Objective To investigate the risk factors of upper gastrointestinal injury induced by non-steroidal anti-inflammatory drugs (NSAIDs).Methods A total of 1032 patients which used NSAIDs was selected.Patients were divided into two groups based on the condition of dyspepsia,peptic ulcer or upper gastrointestinal bleeding:the adverse drug reaction group (331 cases) and the control group (701 cases).Data of two groups on clinical presentation,laboratory test,medication and treatment were analyzed.Risk factors for the adverse drug reaction were identified by multivariable Logistic regression.Results The two groups had significant difference in age ＞ 65 years old,Helicobacter pylori (Hp) infection,ulcer history,drug overdose,combination with glucocorticoid,addicted to tobacco and alcohol history,non-specific inhibitor of cyclooxygenase(COX)-2,combination with anticoagulant,concomitant chronic cardiopulmonary disease (P ＜ 0.05).Logistic regression analysis by backward elimination method revealed that following variables retained,such as combination with glucocorticoid (OR =3.104,95％ CI 1.936-4.695),Hp infection (OR =2.768,95％ CI 2.047-3.742),drug overdose (OR =2.411,95％ CI 1.683-3.453),ulcer history (OR =1.781,95％ CI 1.278-2.480),age ＞ 65 years old (OR =1.659,95％ CI 1.237-2.225),non-specific inhibitor of COX-2 (OR =1.470,95％ CI 1.103-2.133),addicted to tobacco and alcohol history (OR =1.459,95％ CI 1.032-2.064),concomitant chronic cardiopulmonary disease (OR =1.357,95％ CI 1.008-2.143),P＜0.05.Conclusion Combination with glucocorticoid,Hp infection,drug overdose,ulcer history,age ＞ 65 years old,non-specific inhibitor of COX-2,addicted to tobacco and alcohol history,concomitant chronic cardiopulmonary disease are risk factors of upper gastrointestinal injury induced bv NSAIDs.

Objective:To determine the effect of apatinib combined with Xiaoyan decoction for the treatment of non-squamous non-small cell lung cancer. Methods:Thirty-eight patients with non-squamous non-small cell lung cancer were randomly categorized into apatinib group (group A, 18 cases) and apatinib combined with Xiaoyan decoction group (group B, 20 cases). All patients did not under-go surgical treatment, radiotherapy, or chemotherapy during the study. Results:The median progression free survival (mPFS) of ad-vanced non-squamous non-small cell lung cancer patients reached up to 3 months. The mPFS, objective response rate, and disease control rate of the apatinib combined with Xiaoyan decoction group showed no significant difference and statistical significance (P>0.05). The apatinib combined with Xiaoyan decoction group was superior to the apatinib group with regard to alleviating clinical symp-toms and adverse reactions (P<0.05). Conclusion:Xiaoyan decoction combined with apatinib can improve the clinical symptoms of pa-tients and reduce the incidence of adverse reactions in the treatment of advanced non-squamous non-small cell lung cancer.

In spite of much progress on its mechanism, diagnosis and treatment, diabetes mellitus remains a public health challenge. The harm of diabetes is not significantly reduced, instead shows an increasing tendency year by year. To achieve an in?depth and comprehensive understanding of the underlying mechanism, and to develop efficacious, stable and hypoglycemia?risk free drugs, it is crucial to gain more knowledge about diabetes from animal models. In this review, the types of diabetes animal models, modeling methods, the advantages and disadvantages, their applicable scope are discussed aiming to provide a reference for researchers to choose appropriate animal models.

Objective To investigate the expression of sphingosine kinase 1(SphK1)and NF-κB in colon carcinoma tissues and their correlation with clinicopathologic features.Methods Sixty-six paraffinembedded colon carcinoma samples and 66 fresh colon carcinoma samples were tested using immunohistochemistry,RT-PCR and Western blot,respectively.Results In 66 fresh colon carcinoma samples,the positive rate of SphK1 and NF-κB mRNA expression were 84.85％(56/66)and 74.24％(49/66),while the positive rate of SphK1 and NF-κB protein detected by Western blot were 78.79％(52/66)and 69.70％(46/66).The positive rates were higher than those in the adjacent tissues[mRNA:63.64％(42/66),48.49％(32/66);protein:57.58％(38/66),45.45％(30/66)]and the normal mucosa [mRNA:42.42％(28/66),25.76％(17/66); protein:36.36％(24/66),24.24％(16/66)],with statistical significances(all P values ＜ 0.05).The mean expressive levels of SphK1 and NF-kB mRNA and protein in colon carcinoma were both significantly higher than those in the adjacent tissues and the normal mucosa(mRNA:0.55±0.06 vs0.35 ±0.05 vs0.25±0.05,0.75 ±0.06 vs0.43±0.05 vs0.30±0.04 ; protein:0.77 ± 0.05 vs 0.38 ± 0.06 vs 0.12 ± 0.03,0.45 ± 0.08 vs 0.23 ± 0.05 vs 0.13 ± 0.03 ;all P values ＜ 0.05).There was a close correlation between SphK1 and NF-kB expression levels (r =0.459,P =0.036).The results of immunohistochemistry were similar to those of RT-PCR and Western blot.Overexpression of SphK1 and NF-κB in colon carcinoma was related with depth of invasion,distant and lymph node metastasis and Dukes'stages(all P values ＜0.05).The expression of SphK1 was also related with differentiation(P ＜ 0.05).Conclusions Overexpression of SphK1 and NF-κB may be involved in the pathogenesis and progression of colon carcinoma.Moreover,SphK1 and NF-κB may be correlated with the invasion and metastasis of colon carcinoma.

Objective To determine the persistence time of genotype 4 hepatitis E (HE) viremia after the onset of clinical symptoms in HE patients and provide essential data for study on HE epidemiologieal transmission, so that to evaluate potential contagiousness of HE patients after clinical stage. Methods The first serum samples from 162 HE patients after hospitalized in Eastern China were collected and tested for hepatitis E virus (HEV) RNA by nested reversed transcription- polymerase chain reaction (RT-PCR). The persistence time of HEV viremia after the onset of clinical symptoms was estimated with Kaplan-Meier survival analysis. Results HEV RNA was detectable in 101 out of 162 serum samples with positive rate of 62.35%, which was all grouped to genotype 4 by homology analysis. Furthermore, HEV RNA was detectable in 74 (64.91%) out of 114 male and 27 (56.25%) out of 48 female, which was not significantly different (χ2 = 1.08, P=0. 30). Kaplan-Meier survival analysis showed that the median persistence time of HEV genotype 4 viremia was 24 days after the onset of clinical symptoms (95% CI: 18-30 days), which meant that the viremia of 50% HE patients remaining detectable up to 24 days after the onset. The 75% and 25% percentiles were 14 days and 31 days, respectively. There was no significant difference of viremia persistence time between male and female (Breslow test: P=0.98, Tarone-Ware test: P=0.91). Conclusions The viremia of 75% patients with HEV genotype 4 infection could persistent until 2 weeks after the onset of clinical symptoms and that of some patients could persistent over 1 month. It is indicated that the viremia is still persistent and HE patient could be a reservoir even after the clinical symptoms disappeared and biochemical marks normalized.

ObjectiveTo summarize the results of stereotactic radiation therapy (SRT) with or without whole-brain radiotherapy (WBRT) in the treatment of multiple brain metastasis.MethodsFrom May 1995 to April 2010,totally 98 newly diagnosed multiple (2 - 13 lesions) brain metastases patients were treated in our centre.Forty-four patients were treated with SRT alone and 54 with SRT + WBRT.Dose fractionation schemes were 15 -26 Gy in 1 fraction or 24.0 -52.5 Gy in 2 - 15 fractions with 3.5 - 12.0 Gy per fraction,depending on the tumor volume,location,and history of prior irradiation.Kaplan-Meier and Cox proportional hazards regression analyses were used for survival analysis.The median age of the whole group was 55 years.The survival time was calculated from the date of radiation treatment to the day of death by any cause.ResultsThe median follow-up time for the whole group was 12 months,and the follow-up rate was 100％.The median overall survival time was 13.5 months for the whole group,there was no difference between SRT alone group and SRT + WBRT group ( 13.0 months vs.13.5 months,χ2 =0.31,P =0.578 ).The Karnofsky Performance Score ( KPS) at the time of treatment ( χ2 =6.25,P =0.012 ),the interval between the diagnosis of the primary tumor and brain metastases ( χ2 =7.34,P =0.025 ) and the status of extracranial metastases ( χ2 =4.20,P =0.040) were independent prognosis factors for survival in multivariate analyses.ConclusionsStereotactic radiation therapy is an effective and alternative treatment choice for multiple brain metastases.

Objective To explore the prognostic factors of brain metastases from primary breast cancer treated with stereotactic radiotherapy (SRT).Methods Retrospectively analyze 37 brain metastatic patients from primary breast cancer.Among these patients nineteen were treated with stereotactic radiotherapy alone,eight patients were treated with whole brain radiotherapy (WBRT) plus SRT,the other ten patients were intracranial recurrence after WBRT and treated with SRT for salvage.Kaplan-Meier analyses were used to calculate survival time.Logrank and Cox proportional hazards regression analyses were performed for univariate and multivariate analyses.Results The median follow-up time were 11 months and 15 months for the whole group and the alive.The median overall survival time was 11 months (95％ CI =6-16.month) for the whole group.The median overall survival time was 13.5 months for the whole group.In univariate analysis,the triple negative breast cancer (x2 =5.95,P =0.004),lower Karnofsky performance score (KPS,x2 =13.85,P =0.000),the interval between the diagnosis of the primary tumor and brain metastases ≤ 30 months (x2 =6.62,P =0.010),high RPA grade (x2 =15.35,P =0.000) and intracranial recurrence after whole brain radiotherapy (x2 =4.43,P =0.035) were negative prognostic factors for brain metastasis of breast cancer treated with stereotactic radiotherapy.In multivariate analyses,the triple negative breast cancer (x2 =9.58,P =0.008),lower KPS (x2 =6.65,P =0.010),and intracranial recurrence after whole brain radiotherapy (x2 =3.95,P =0.047) were negative prognostic factor.Conclusion The triple negative breast cancer,lower KPS,and intracranial recurrence after WBRT were negative prognostic factor for brain metastasis from primary breast cancer treated with SRT.

Objective:The aim of this study was to investigate the prognostic value of vitamin B12 as the non-invasive biomarker to predict long-term rebleeding rate in cirrhotic patients with esophagogastric varices.Methods:From Dec 1, 2016 to Dec 31, 2017, cirrhotic patients with esophagogastric varices who had been admitted to Zhongshan Hospital affiliated to Fudan University were enrolled. All these patients received endoscopic treatment to prevent variceal rebleeding. The serum vitamin B12 and folic acid levels were measured in all of them. The receiver operating characteristic (ROC) analysis, Kaplan-Meier analysis, univariate and multivariate cox regression analysis were conducted to explore the value of vitamin B12 in predicting 3-year variceal rebleeding in cirrhotic patients with esophagogastric varices after endoscopic treatment.Results:115 patients were included. The ROC curve analysis indicated that the optimal cutoff value of vitamin B12 for 3-year variceal rebleeding was 567.25 pg/ml. According to the cut-off value, the patients were divided into high-level vitamin B12 group ( n=49) and low-level vitamin B12 group ( n=66). Compared with the low vitamin B12 group, the high vitamin B12 group had lower albumin level, less male (63.3% vs 80.3%), and higher 3-year rebleeding rate ( P<0.05). Cox analysis showed that vitamin B12 and platelet were independent prognostic factors for 3-year rebleeding in patients with variceal bleeding. Conclusions:Elevated peripheral blood vitamin B12 predicts a higher risk of long-term rebleeding in patients with liver cirrhosis and esophagogastric varices.