[ ABSTRACT] Trillions of microbes inhabit the human intestine, forming a complex microecological community.It has been found that the gut microbiotas contribute nutrients and energy to the host, and they are also involved in the occur-rence and development of human diseases.With the continuous development of related research, there is increasing evi-dence suggesting a close relationship between gut microbiota and human diseases.The discovery of this relationship affects the development of modern health care individually.In this review, we focus on the influence factors to the diversity of gut microbiota, which has influences on colorectal cancer, aging, obesity, immunity, drug effects and malnutrition.

Objective:To analyze the role of preoperative circulating tumor cell(CTC) and circulating tumor vascular endothelial cells (CTEC) in the diagnosis of gastric cancer and its correlation with the clinicopathological characteristics of gastric cancer.Methods:Sixty-two gastric cancer patients and 11 patients of benign gastric diseases were enrolled. Subtraction enrichment (SE) and immunofluorescence staining-chromosome fluorescence in situ hybridization (i·FISH) were used to integrate the unique SE-i ·FISH technology platform detecting patients′ CTC and CTEC.Results:The number of CTC in the gastric cancer group was significantly higher than that in the control group ( t=2.693, P=0.009); the number of CTEC in the gastric cancer group was higher than the control group ( t=2.015, P=0.048). With the cut-off value being set at 9 cells/6 ml in blood, the sensitivity of CTC in the diagnosis of gastric cancer is 84%, and the specificity is 82% (AUC=0.876, 95% CI, 0.792-0.963, P<0.01); When set at 6 cells/6 ml, the sensitivity of CTEC in the diagnosis of gastric cancer is 50%, and the specificity is 100%(AUC=0.727, 95% CI, 0.603-0.851, P=0.02). CTC positive is closely related to tumor location(χ 2=4.292, P=0.038 ) and TNM stage(CTC≥10, χ 2=4.848, P=0.028; CTC≥11, χ 2=6.234, P=0.013). CTEC positive is closely related to serum CA19-9(χ 2=4.858, P=0.028) and serum CA724 (χ 2=4.108, P=0.043 ) . Conclusion:SE-i·FISH technology has high sensitivity and specificity in the detection of CTC and CTEC of gastric cancer.

OBJECTIVETo explore the role of CD4(+)CD25(+) regulatory T cells (Treg) in the occurrence of spontaneous subarachnoid hemorrhage (SAH).

METHODSFifteen patients with spontaneous SAH, 15 with traumatic SAH, and 15 with headache without organic pathologies as confirmed by lumbar puncture (control group) were examined with flow cytometry for Treg in the peripheral blood and cerebrospinal fluid and intracellular cytokine interleukin-10 (IL-10) and transforming growth factor beta1 (TGF-β1) levels. The Glasgow score (GCS), neurological deficit score (NIHSS), headache, visual analog scale (VAS) and hospitalization time were compared between the two SAH groups.

RESULTSSpontaneous SAH patients showed significantly lowered peripheral blood Treg, IL-10, and TGF-β1 in the cerebrospinal fluid compared with the patients with traumatic SAH and the control group (P<0.05), and the 3 measurements were comparable between the latter two groups (P>0.05). After administration of treatment, of Treg content in spontaneous SAH patients increased progressively and became comparable with those in the other two groups at the third and fourth lumbar punctures. Spontaneous SAH patients showed significantly lower GCS, NIHSS, and VAS with shorter hospital stay than the traumatic SAH patients. Correlation analysis showed that Treg, IL-10 and TGF-β1 were all inversely correlated with NIHSS, VAS, and duration of hospitalization but positively correlated with GCS (the absolute r values were all greater than 0.6, P<0.05).

CONCLUSIONTreg deficiency can be an important mechanism for the occurrence of spontaneous SAH, and a higher level of Treg indicates a better outcome of the patients.

Adult ; CD4 Lymphocyte Count ; Case-Control Studies ; Female ; Flow Cytometry ; Humans ; Interleukin-10 ; cerebrospinal fluid ; Interleukin-2 Receptor alpha Subunit ; Male ; Middle Aged ; Subarachnoid Hemorrhage ; cerebrospinal fluid ; metabolism ; T-Lymphocytes, Regulatory ; metabolism ; Transforming Growth Factor beta1 ; cerebrospinal fluid

This paper introduces the significance, the present development situation and some suggestions of the medical measurements.
Diagnostic Equipment ; standards ; Equipment and Supplies ; standards ; Magnetic Resonance Imaging ; instrumentation ; standards ; Medical Staff ; education ; Research Design ; standards ; Tomography, X-Ray Computed ; standards

OBJECTIVETo observe restoration of the wrist function and complications of Colles fracture treated with different kinds of external fixation.

METHODSTwo hundreds and seventy-five patients with Colles fracture during March 1998 to Oct 2006 which were fixed with three kinds of external fixation were analyzed retrospectively. Group A: there were 95 patients, 61 male, 34 female, with an average age of (26.2 +/- 0.4) years, fixed by the small moulding plywood on the wrist in mild dorso-extend or neutral position; Group B:90 patients, 61 male, 29 female, with an average age of (24.0 +/- 1.5) years, fixed by the small moulding plywood on the wrist in mild palmar flexion; Group C: 90 patients, 65 male, 25 female, with an average age of (25.0 +/- 2.1) years, fixed by plaster on the wrist in mild dorso-extend or neutral position. According to the Frykaman typing,number of type I to VIII in group A was 25, 31, 20, 11, 3, 2 ,2, 1 in turn,type I to VIII in group B was 22, 30, 17, 9, 4, 4, 2, 2 in turn; type I to VIII in group C was 24, 30, 18, 9, 4, 3, 1, 1 in turn. Comparing the age, sex and the type of fracture, there were no statistical significant differences among three groups. After 6 to 18 months following-up survey, the restoration of the wrist and complication incidence were statistically analyzed.

RESULTSTo compare the restoration of the wrist joint and complication incidence after various fixation, there were significant differences between group A and B and C (P < 0.05) in statistics.

CONCLUSIONThe treatment of the Colles fracture by the small moulding plywood fixation on the wrist in mild dorso-extend or neutral position is benefit to restore the wrist joint function and has fewer complications..

Adult ; Colles' Fracture ; surgery ; External Fixators ; Female ; Fracture Fixation ; methods ; Humans ; Male ; Retrospective Studies

OBJECTIVETo explore the influence of Free-skin-grafted penoscrotal avulsion injuries on spermatogenesis.

METHODSForty-two male New Zealand albino rabbits during child-bearing period were divided into the experimental group (n = 24) and the control group (n = 18) using random digits table, and 24 female rabbits with reproductive history were used for mating experiment. The experimental group animal's scrotum skin were excised, and the split skin from abdominal region was used to repair the skin defect of scrotum. The control group did not any processing. Six rabbits were randomly chosen respectively in control group and on the 3rd and 8th weekend after the model was successfully established in experimental group. The testicular surface temperature was measured in the eighteen rabbits using the method of burying thermometer, then the testicular biopsy were performed for hematoxylin-eosin (HE) staining. On the 8(th) weekend after the model was successfully established in experimental group, matched-pair feed was performed in the other 12 rabbits respectively in experimental group and in control group. Observation of corresponding mother rabbit fertility. Three patients of penoscrotal avulsion injuries were treated using split skin grafts, and the information of sex life and the quality of sperm were obtained by follow up.

RESULTSThe testicular surface temperature was similar on the 3rd and 8th weekend after the model was successfully established in experimental group [(36.15 ± 0.24)°C, (36.77 ± 0.42)°C] with that of the control group. Testis tissue (HE) staining showed the tier of spermatogenic cells was rule arrangement and lot of mature sperms were found in the convoluted seminiferous tubules in control group. The tier of spermatogenic cells was diminished and disposed derangement, the spermatozoa were not seen on the 3(th) weekend of the experiment group. The tier of spermatogenic cells was increased and some spermatozoa were seen on the 8th weekend of the experiment group. Male and female matched-pair feed showed the experimental group conception rate 8/12, and 4.1 ± 3.2 rabbit babies were born averagely, while that of was 12/12 and 6.0 ± 1.3 in control group (P > 0.05). The skin grafts there were some contracture in early stage (1 - 2 months) when the skin grafts applied to repair the avulsing scrotum in three patients. But the skin grafts became loose with downward sagging and there were the good cosmetic result in one year, and without any contracture. The sperm quality was normal after the skin grafts applied to repair the avulsing scrotum in the late stage.

CONCLUSIONSThe skin grafting is little arrest the testicle spermatogenesis in the three methods (skin flap reconstruction scrotum, testicle buried, split skin grafting) that have usually been used to repair scrotum skin lose. For a young male, the best treatment for penoscrotal avulsion injuries is free skin grafting, while skin flaps are not recommended for reconstructing the scrotum.

Adult ; Animals ; Female ; Follow-Up Studies ; Humans ; Male ; Rabbits ; Scrotum ; injuries ; surgery ; Skin Transplantation ; methods ; Spermatogenesis ; Surgical Flaps

OBJECTIVETo study the association of polymorphisms of FokI rs2228570 in the vitamin D receptor (VDR) gene and TMPRSS6 rs855791 with cow's milk protein allergy (CMPA) in children.

METHODSQuantitative real-time PCR was used to analyze the single nucleotide polymorphisms of FokI rs2228570 in the VDR gene and TMPRSS6 rs855791 in 100 children with CMPA and 100 healthy children (control group). The multivariate logistic regression model was used to identify the risk factors for CMPA.

RESULTSThere were significant differences in the frequencies of CC, CT, and TT genotypes of TMPRSS6 rs855791 between the CMPA and control groups (P=0.008), and the CMPA group had a significantly higher frequency of TT genotype. The multivariate logistic regression analysis showed that the children with TT genotype of rs855791 had an increased risk of CMPA (OR=3.473, P=0.011). However, there was no significant difference in the genotype distribution of FokI rs2228570 in the VDR gene between the two groups (P=0.686).

CONCLUSIONSTMPRSS6 rs855791 polymorphism is associated with CMPA in children, and TT genotype may be the susceptible genotype of CMPA. FokI rs2228570 polymorphism is not associated with CMPA.

Objective To discuss the microsurgical resection of intracranial cystic tumors.Methods From August 2003 to August 2010, 47 patients who had been diagnosed by imaging with intracranial cystic tumor received microsurgical resection. The tumors were confirmed by pathological examination postoperation.There were 22 cases of cystic glioma,8 cases of cystic meningioma,3 cases of malignant cystic meningioma,4 cases of cystic ependymoma,4 cases of angioreticuloma and 6 cases of cystic metastatic tumor.When the skull was minimally opened according to the location of the tumor,the hydatid fluid was absorbed before separation and resection of the tumor with its capsule under endoscopy. Results Total resection was performed in 31 cases (65.96％) and sub-total resection in 16cases (34.04％).No operative death occurred.Neural dysfunction was observed not long postoperation in 6 cases (12.77％),including one case of trigeminal nerve injury,one case of abducent nerve injury,one case of facial nerve dysfunction,one case of glossopharyngeal nerve injury,2 cases of paralysis and 2cases of hydrocephalus.Forty-one patients were followed up for 0.5 to 6 years.Eight patients (17.02％)had recurrence and 2 died. Conclusion Microneurosurgery can improve the total resection rate of intracranial cystic tumors with minimal invasion to neural functions.

OBJECTIVETo investigate the manifestation and diagnostic value of multislice spiral CT (MSCT) and MRI imaging in detection of tumor recurrence after liver transplantation for hepatocellular carcinoma (HCC).

METHODSThe clinical data of 161 consecutive HCC patients who underwent orthotopic liver transplantation were retrospectively reviewed. Twenty-nine HCC patients were classified by pTNM according to the "Pittsburgh criteria". MSCT and MRI findings of tumor recurrence after liver transplantation were evaluated retrospectively in 29 stage II-IVb HCC patients. The recurrence site and relapse interval between liver transplantation and recurrence were analyzed.

RESULTSLung tumor recurrence were found in 21 cases, presented as cotton-like lesions in a diameter of 2 - 3 cm, with a clear margin and homogeneous density. Pleural tumor recurrence was detected in 4 cases. Liver tumor recurrence were found in 9 cases, which can be divided into four subtypes: multinodular in 4 cases, diffuse lesion in 2 cases, huge mass in 2 cases, and uninodular in 1 case. Two cases showed tumor thrombus in the inferior vena cava and portal vein. Lymph node tumor recurrence was found in 9 cases, presented as multiple nodules at hepatic hilum, lesser peritoneal sac, posterior mediastinum, retroperitoneum, or around pancreatic head, and accompanied with merging and necrosis in one case. Bone tumor recurrence were found as osteolytic destruction in 4 cases, and accompanied with adjacent soft-tissue mass in 2 cases. The recurrence sites of the 29 cases were as following: lung (21 cases, 72.4%), liver (9 cases, 31.0%), lymph nodes (9 cases, 31.0%), bone (4 cases, 13.8%) and other sites (3 cases, 10.3%). Lung tumor recurrence was found in all the 10 stage IVb patients with tumor recurrence after liver transplantation, significantly more frequent than that in stage IVa patients (P = 0.023). After liver transplantation, all 25 patients with stage III approximately IVb HCC developed recurrence within one year, but in the 4 cases with stage II HCC at one year later (P = 0.009).

CONCLUSIONThe results of our study show that in hepatocellular carcinoma patients after liver transplantation, the lung and pleura are the most frequent site of recurrence, followed by liver, lymph node and bone as the second and third sites. The Stage IVb hepatocellular carcinoma should be regarded as a contradiction for liver transplantation due to rapid recurrence. Tumor recurrence occurs later in stage II HCC than in stage III approximately IVb patients. MSCT and MRI are of significant importance in diagnosis and formulating operation plan in HCC patients with recurrence after liver transplantation.

Adult ; Carcinoma, Hepatocellular ; diagnosis ; diagnostic imaging ; secondary ; surgery ; Female ; Follow-Up Studies ; Humans ; Liver Neoplasms ; diagnosis ; diagnostic imaging ; pathology ; surgery ; Liver Transplantation ; Lung Neoplasms ; diagnosis ; diagnostic imaging ; secondary ; Lymphatic Metastasis ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; diagnosis ; diagnostic imaging ; Neoplastic Cells, Circulating ; Pleural Neoplasms ; diagnosis ; diagnostic imaging ; secondary ; Retrospective Studies ; Tomography, Spiral Computed ; methods

OBJECTIVETo observe the dynamic changes of Th17/Treg balance in patients following surgical intervention for intracranial aneurysm rupture.

METHODSThe percentage of Th cells and the intracellular IL-17 level, Treg cell percentage and transforming growth factor -β1 (TGF-β1) levels were examined in 73 patients with rupture of aneurysms before and at 24 h, 72 h and 1 week after operation, with 62 patients with unruptured aneurysms and 65 healthy volunteers as the control. The correlations among the immune cells, cytokines and clinical characteristics of the patients (NIHSS, ADL and hospitalization stay) were analyzed.

RESULTSTh17 percentage and intracellular IL-17 levels were significantly higher in the patients with ruptured and unruptured aneurysms than in the healthy volunteers, and were significantly higher in patients with ruptured aneurysms than in those with unruptured aneurysms. Treg cell percentage and TGF-β1 level were significantly lower in patients with aneurysms than in the healthy volunteers, and were lower in patients with ruptured aneurysms than in those with uruptured aneurysms (P<0.05). Patients with intracranial aneurysm rupture showed significantly increased Th17 cell percentage and IL-17 level but significantly lowered Treg cell percentage and TGF-β1 at 24 h following the surgery (P<0.05); these changes were reversed significantly at 72 h and 1 week after the surgery. Th17 cell percentage and IL-17 level were positively correlated with NIHSS and the length of postoperative hospital stay but inversely correlated with ADL; Treg cell percentage and TGF-β1 were inversely correlated with NIHSS and hospital stay but positively with ADL (P<0.05).

CONCLUSIONIn patients with intracranial aneurysms, the systemic immune inflammatory response is highlighted by excessive Th17 cells and insufficient Treg cells, which are closely related with the outcomes of the patients following surgical intervention. Evaluation of Th17/Treg balance and the cytokine levels can help to assess the prognosis of patients with aneurysm rupture.

Aneurysm, Ruptured ; immunology ; Flow Cytometry ; Humans ; Interleukin-17 ; blood ; Intracranial Aneurysm ; immunology ; Postoperative Period ; Prognosis ; T-Lymphocytes, Regulatory ; cytology ; Th17 Cells ; cytology ; Transforming Growth Factor beta1 ; blood