Objective To evaluate the efficacy of probiotics to treat irritable bowel syndrome (IBS).Methods Publications from database including PubMed,the Cochrane Library,Embase,CNKI,CBM and WanFang Data were searched up to August 31,2014.The randomized controlled trials (RCTs) on probiotics to treat IBS were eligible.The related articles were extracted and cross-checked independently by two reviewers.Methodological quality of trials was evaluated according to Cochrane Handbook 5.1.0 criteria.Meta-analysis was conducted using RevMan 5.2 software.Results A total of 17 RCTs involving 1 700 patients were included.Results of meta-analyses showed that compared with the placebo,probiotics was statistically better in improving the overall symptoms integral (SMD =-0.20,95％ CI-0.33--0.07,P =0.002),alleviating abdominal pain/discomfort (SMD =-0.19,95％ CI-0.29--0.09,P ＜ 0.001),relieving abdominal distention (SMD =-0.16,95％ CI-0.28--0.03,P =0.020),and defecation discomfort (SMD =-0.22,95％ CI-0.42--0.02,P =0.030).There was no statistical significance in the overall quality of life (SMD =-0.08,95％ CI-0.07-0.23,P =0.290) and adverse effect ratio (RR =1.08,95％CI0.79-1.49,P=0.630).Conclusion Probiotics have beneficial effects on IBS,which can improve the patients' symptoms and with less adverse reaction.Due to the bias,further large-scale,multicenter and high-quality RCTs are required to unify outcome indicators,further define sensitive strain,and standardize its usage,dosage and course of treatment.

Objective To further understand factors that influence health-related quality of life (HRQOL) in patients with ulcerative colitis (UC),especially the role of perceived stress and coping modes in Chinese patients with UC.Methods This study was a cross-sectional study.Patients with UC were recruited from July 2013 to September 2014 in Peking Union Medical College Hospital.HRQOL was measured using the inflammatory bowel disease questionnaire (IBDQ).Perceived stress was measured by Perceived Stress Scale (PSS).Coping strategy was evaluated using Medical Coping Modes Questionnaire (MCMQ).Demographic data,course of the disease,clinical disease activity,and disease phenotype according to Montreal classification were also collected.Univariate analyses were conducted to determine which variables were associated with HRQOL,and those were statistically significant were entered into a multivariate regression model.Results We recruited 214 patients (response rate 92.2％),whose median age was 37.5 (29.0,49.3) years old and median course of UC was 4 (2,9) years.Through univariate analyses,better HRQOL was significantly associated with regular medical visits,lower number of previous relapses and hospitalizations,no steroid use,Montreal E1,lower Mayo scores,clinical remission,less perceived stress and less acceptance strategy use.However,multivariate analyses revealed that perceived stress (OR =1.112,95％ CI 1.058-1.169),acceptance (OR =0.310,95％ CI 0.141-0.685),number of hospitalizations (OR =2.924,95 ％ CI 1.328-6.437) and clinical activity (OR =5.058,95 ％ CI 2.312-11.066) were most strongly related to HRQOL.Conclusions HRQOL of UC patients are not only associated with clinical activity of the disease,but also associated with coping strategy and perceivedstress.Further research needs to focus on whether or not relieving stress and guiding patients to cope with ulcerative colitis would improve HRQOL.

Recent epidemiologic data indicate that metfomin has an anti-tumor effect.However,the underlying anti-tumor mechanisms remain unclear.MicroRNAs (miRNAs)can exhibit pro-oncogenic or anti-oncogenic effects by regulating the differentiation and proliferation of cells.In vitro studies show that metformin can regulate the expressions of multiple miRNAs which are closely associated with tumor development,a process possibly relating to the anti-cancer roles of metformin.

Objective To evaluate the strength of tobacco control at or below county-level governments of Zhejiang Province,to explore the strategies and measures on tobacco control,and promote a smoke-free government.Methods By multistage stratified random sampling method,12 government ageucies were selected in 4 counties.The information of tobacco control strength and smoke-free environment creation was collected by interview and field observation,and the scores were calculated by using the percentage assignment method.An intercept suuvey was carried out in four counties and there were 405 civil servants under investigation.The data were analyzed by frequency statistic and correlation analysis.Results The smoking rate of civil servants was 17.8％,and the secondhand smoking rate was 61.9％;84.7％ of civil servants adnmitted the harm of smoking and 96.8％ admitted the harm of secondhand smoking.Support for forbidding the cigarette advertisements was highest and increasing the cigarette price was the weakest.The scores of smoke-free environment creation of project counties showed that the average score was 50.60,Zhuji and Luqiao got a maximum score of 57.14,Haiyan got a minimum score of 42.86.The scores of tobacco control strength showed that the average score was 82.35,Zhuji got a maximum score of 92.16,followed by Luqiao,Jiande and Haiyan counties,82.35,80.39 and 74.51 respectively.The scores of tobacco control strength,include policy,political will,capacity,and tobacco control efforts were the highest in Zhuji county.The results of correlation analysis showed that the total score of tobacco control strength had significant association with the score of smoke-free environment creation,smoking rate of civil servants,and approval rate of anti smoking in public places (P＜0.05).Conclusion The overall situation of tobacco control strength at or below county-level governments of Zhejiang province is good,but there is a relative shortage of smoke-free environment creation.Civil servants master the knowledge related to tobacco and support tobacco control policy.We should further promote the construction of smoke-free government.More effective smoking control measures should be conducted in order to raise the strength of tobacco control and finally implement the tobacco control legislation.

Objective To understand the prevalence of tobacco use among college students in different populations by sex,age and major,and to provide evidence for smoking control and health decision.Methods A total of 4 638 college students selected in 21 colleges through stratified multi-stage cluster sampling from Zhejiang Province were surveyed by using questionnaire analysis.Indicators such as tried smoking,current smoking,and secondhand smoke exposure,etc.,were calculated by weight on age proportions from the numbers of college students in Zhejiang.Results The prevalence of tried smoking and currcut smoking among college students were 29.72％ and 10.57％,respectively.The prevalence of tried smoking was 46.52％ for men,18.25％ for women;28.57％ for undergraduate,31.53％ for junior college;the prevalence of current smoking was 18.86％ for men,3.86％ for women;8.88％ for undergraduate,13.23％ for junior college students.The snoking rate in college students increased with age,the group of ≥21 Years was the highest (37.87％,16.09％).The lowest level of smoking was medical student (21.76％,2.19％).The prevalence of secondhand smoke exposure in outdoor and indoor places,and dormitory among students were 65.49％,60.33％,and 23.66％,respectively.In the past 30 days,college students have seen tobacco advertisement (47.38％),smoking scenes (60.20％),and got tobacco related gifts (10.40％),free tobacco products (8.93％);college students have seen information about tobacco control (60.50％),cigarette pack warning labels (58.45％),and learned the tobacco knowledge in class in the past 12 months (14.03％).Conclusion Current prevalence of smoking in college students in Zhejiang province remained at a high level,the rate of secondhand smoke exposure is high and in college students there was lack of tobacco control education in class.The results indicated that the policy about tobacco control in school was not enough and the task of health promotion should be taken more arduously.

OBJECTIVETo investigate the result of hip arthroplasty for failed internal fixation of femoral neck fractures.

METHODSFrom June 2007 to January 2014, 29 cases who underwent hip arthroplasty for failed of internal fixation of femoral neck fractures were reviewed. There were 12 males and 17 females. The mean age was 60.3 years (ranged 43 to 83 years) at the time of the fracture. Left hip was in 16 cases, right hip was in 13 cases. The average interval from fracture to arthroplasty was 23.3 months (ranged, 3 to 48 months).

RESULTSAll of 29 cases were performed total hip arthroplasty. There were 20 cases of cementless cup,7 cases of cementless cup with bone graft, 2 cases of cemented cup with bone graft; 13 cases of cementless stem, 16 cases of cemented stem. There were no complications occurred such as intraoperative fracture of the greater trochanter. The average operative time was (115 ± 38) minutes,the mean intraoperative blood loss was (420 ± 175) ml, the average postoperative drainage volume (240 ± 119) ml, intraoperative blood transfusion was (200 ± 220) ml, intraoperative fluid volume was (2,200 ± 400) ml, the average postoperative blood transfusion was (300 ± 200) ml. There was 1 case get postoperative dislocation. All patients were followed up for 14.7 months in average (ranged, 5 to 24 months). There was no revision for mechanical failure. Harris Hip Score significantly was improved from 51.1 ± 7.5 before the conversion to 88.5 ± 6.4 points at the final follow-up.

CONCLUSIONThe effect of the hip replacement for patients with failed internal fixation of femoral neck fractures was confirmed. This method can shorten the time on the bed and reduce the complications. It benefits the patients earlier functional recovery, but it must control operation indication. The long term efficacy is necessary to further observation.

Adult ; Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; methods ; Female ; Femoral Neck Fractures ; surgery ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Treatment Failure

Objective:To explore the influence of rosuvastatin in the lipid levels, atherosclerosis plaque and apoptosis in the plaque of atherosclerotic apolipoprotein E (ApoE)-knockout mouse models, and to clarify the mechanism of rosuvastatin in inhibiting atheromatous plaque and apoptosis in the plaque.Methods:Thirty healthy six-week old male mice were randomly divided into high fat diet group (n=10),rosuvastatin group (n=10)and general diet control group (n=10).The mice in first two groups were fed with high fat diet,and the mice in general diet control group were fed with general diet;4 weeks later the mice in three groups were respectively given 0.9% NaCl solution,rosuvastatin (10 mg·kg·d-1 )and 0.9% NaCl solution by gavage for 8 weeks.And then ELISA was used to detect the serum lipid levels,the area of atherosclerotic plaque was measured by HE staining, and the apoptosis in plaques was detected by TUNEL method;the expression of apoptosis-assoicated gene Bax protein was measured by immunohistochemical staining.Results:Compared with high fat diet group,the levels of total cholesterol (TC)and low density lipoprotein cholesterol (LDL-C)of the mice in rosuvastatin group were significantly decreased (P<0.05 or P<0.01),and the 1evel of high density lipoprotein cholesterol (HDL-C)was significantly increased (P<0.01).The aortic atherosclerotic plaque of the mice in high fat diet group was massive with a great quantity of foam cells, cholesterol crystal, necrotic cells and inflammatory cells in the plaque;the aortic atherosclerotic plaque of the mice in rosuvastatin group was smaller with less foam cells,necrotic cells and inflammatory cells;the aortic atherosclerotic plaque area of the mice in rosuvastatin group was significantly smaller than that in high fat diet group (P<0.01);the apoptotic index in the aortic atherosclerotic plaque of the mice in rosuvastatin group was significantly lower than that in high fat diet group (P<0.01).Compared with high fat diet group,the expression of Bax protein in rosuvastatin group was significantly decreased.Conclusion:Rosuvastatin may inhibit the progression of atherosclerotic plaque and the apoptosis in plaques through mitochondrial pathway.

Objective To investigate the expression of corticotropin-releasing factor (CRF) and its receptors including CRFR1 and CRFR2 on mouse mesenteric lymph nodes dendritic cells (MLNDC), and to analyze their effects on the biological phenotypes of intestinal dendritic cells .Methods The MLNDCs were isolated from C57BL/6 mice by using magnetic bead sorting .The purity of CD11c+DCs was identified by flow cytometry .The double-labeling immunofluorescence and the reverse transcriptase-polymerase chain reaction (RT-PCR) were performed to detect the expression of CRF , CRFR1 and CRFR2 on MLNDCs.The MLNDCs were exposed to CRF with or without the interference of CRFR 1 and CRFR2 antagonists .Flow cy-tometry was used to measure the changes of surface molecules ( MHCⅠ and MHCⅡ) and co-stimulatory molecules (CD80 and CD86).Results The CD11c+DCs accounted for (80.12±6.34)% of the isolate cells with a high cell viability of more than 90%.The expression of CRF , CRFR1 and CRFR2 at mRNA lev-el were detected in MLNDCs by RT-PCR.Results of the immunofluorescent staining assay indicated that both CRFR1 and CRFR2 were expressed on the surface of MLNDCs .The expression of CD86 on MLNDCs was inhibited by the treatment of MLNDCs with CRFR 1 antagonist , but enhanced by the treatment with CRFR2 antagonist .Conclusion Both CRF and CRFRs were detected in the MLNDCs isolated from the C57BL/6 mice.The CRF could alter the biological phenotypes of MLNDCs through binding to different CRFRs (CRFR1 and CRFR2), which affected the phenotypes of MLNDCs in opposite ways .

Objective To investigate the predictors of deep remission in patients with Crohn′s disease (CD)treated with infliximab.Methods From February 2008 to February 2015 ,the clinical, laboratory and follow up data of 44 CD patients who received infliximab treatment and maintained clinical remission over six months were retrospectively analyzed.Mucosal healing was defined as no ulcer under endoscopy.Deep remission was defined as clinical remission with mucosal healing.According to results of endoscopy examination,the enrolled patients were divided into deep remission group and non-deep remission group.T test or Wilcoxon rank sum test was used for comparison of measurement data between groups,and chi square test was performed for the rate comparison.Multivariate analysis was made with Logistic regression.Results Median age of 44 patients was 19.5 yeares,39 males (88.6%),five females (11 .4%),and the median disease duration was 35 .0 months (18.5 to 73.5 months).Deep remission was achieved in 20 CD patients with long-time follow-up (median follow-up time 19 months,12 to 29 months). The mean duration of achieving deep remission was (28.9 ± 14.3 )weeks.There was no statistically significant difference between 20 patients with deep remission and 24 patients without deep remission in age of onset,disease duration,smoking status,Montreal phenotype,concurrent medications (mesalazine, steroids and azathioprine ), as well as body mass index (BMI ) and laboratory tests (erythrocyte sedimentation rate (ESR),high-sensitivity C-reactive protein (hsCRP),hemoglobin (Hb)and platelet (PLT)count)before administrating.The results of Logistic regression demonstrated that extraintestinal manifestations (arthralgia)(odds ratio (OR)=29.9,95 % confidence interval (CI )1 .26 -714.20,P =0.036),normalization of hs CRP at 14 th week after induced remission (OR=0.88,95 %CI 0.78-0.99, P =0.045)and thrombocytopenia (OR = 0.98,95 %CI 0.96 - 0.99,P = 0.016 )were independent predictive factors of deep remission.Conclusions Infliximab could effectively maintain long term deep remission in treatment of CD.Arthralgia,normalization of hsCRP and PLT counts at 14 th week after induced remission are predictive factor of deep remission.

Objective To explore the determinants of willingness to quit smoking among pre-pregnancy male smokers, and to provide evidence for smoking cessation strategies. Methods An intercept survey was carried out in four cities in Zhejiang, and there were 552 pre-pregnancy male smokers from 1401 newly wedded couples under investigation. Result The pre-pregnancy male smoking rate was 39.82%, and only 6.88%of pre-pregnancy male smokers were categorized as highly nicotine-dependent. The rate of recent willingness to quit smoking was 50.54%, and reasons for quitting were as follows:a planned pregnancy (62.50%), an example for children (47.70%), and objections from family members (45.22%). The tobacco knowledge among pre-pregnancy male smokers is relatively poor, only 49.64% of smokers were aware 8 points in 11 questions; 88.75% of smoker's wives supported their husband to quit smoking. The associated factors of smoking cessation include: tobacco knowledge (OR=0.38), health self-assessment well (OR=1.90), wife's willing for husband to quit smoking (OR=2.87). Conclusion Compared to ordinary people, the proportion of intention to quit smoking was higher in pre-pregnancy male smokers. To strengthen health education and make wife initiating in husband's quitting programs would be more effective.