OBJECTIVETo investigate the correlation between the pathogeneses of diarrhea-pre- dominant irritable bowel syndrome (D-IBS) complicated functional dyspepsia (FD) patients of Gan-stagnation Pi-deficiency Syndrome (GSPDS) and symptoms, psychological states, and gastrointestinal hormones.

METHODSA total of 111 patients with confirmed D-IBS complicated FD of GSPDS were recruited as the treated group by using Rome III standard and Chinese medical syndrome standard. And 30 healthy volunteers were recruited as the control group. The general condition, scoring for digestive symptoms, and the distribution of GSPDS subtype of all subjects were recorded by a questionnaire, and assessed by Symptom Checklist (SCL-90; a software for psychological test developed by Beijing Huicheng Adult Cor- poration). Meanwhile, plasma levels of 5-hydroxytryptamine (5-HT), somatostatin (SS), vasoactive intestinal peptide (VIP), endothelin (ET), interleukin 10 (IL-10), and interleukin 12 (IL-12) were measured in all subjects.

RESULTS(1) The subtype of D-IBS complicated FD of GSPDS was dominant in Pi-qi deficiency type (51/111,45.9%),Pi yang deficiency type (34/111,30.6%), and GSPDS. There was no statistical difference in the scoring of digestive symptoms among the 3 subtypes (P >0.05). (2) Compared with the control group, the anxiety factor score and the total score significantly increased in all three subtypes of D-IBS complicated FD of GSPDS, and the depression score of Pi yang deficiency type and Gan-depression type also significantly increased (P <0.05, P <0.01); the depression score of Gan-depression type was significantly higher than that of the Pi-qi deficiency type (P <0.01). Plasma 5-HT levels were obviously lower in D-IBS complicated FD patients of GSPDS accompanied with anxiety or depression than in those with no obvious psychological abnormalities, and VIP and IL-10 levels were significantly lower than those in the control group (P <0.05). Plasma VIP levels were also obviously lower in D-IBS complicated FD patients of GSPDS accompanied with anxiety or depression than in those with no obvious psychological abnormalities (P <0.01), and SS levels were significantly lower than those in the control group (P <0.05). There was no statistical difference in plasma ET or IL-12 levels in each patient group, when compared with the control group (P >0.05). (3) Compared with the.control group, plasma 5-HT levels significantly increased, plasma VIP and IL-10 levels significantly decreased in ach subtype of D-IBS complicated FD patients of GSPDS (P <0.05, P <0.01), and no significant change of SS, ET, or IL-12 occurred (P >0.05). Besides, plasma 5-HT levels were significantly higher in Gan-depression type than in Pi yang deficiency type, VIP levels were lower in Gan-depression type than in Pi-qi deficiency type (all P <0.05).

CONCLUSIONSGan stagnation and Pi deficiency were dominant in D-IBS complicated FD patients of GSPDS. Psychological abnormalities, increased plasma 5-HT levels, and decreased plasma VIP levels were closely correlated with Gan stagnation subtype, which provided some reference for looking for objective indicators of Chinese medical syndromes in treating D-IBS complicated FD patients of GSPDS.

Adult ; Case-Control Studies ; Diarrhea ; etiology ; Dyspepsia ; blood ; complications ; psychology ; Gastrointestinal Hormones ; blood ; Humans ; Irritable Bowel Syndrome ; blood ; complications ; psychology ; Psychological Tests ; Qi ; Serotonin ; Surveys and Questionnaires ; Yang Deficiency

Objective To evaluate the prevalence of extraosseous findings on integrated CT images of routine SPECT/CT bone imaging and its clinical incremental values. Methods A total of 843 patients (470 males, 373 females, age range: 26-92 years) who underwent SPECT/CT bone imaging during May 2013 to December 2015 were enrolled in this retrospective study. A modified C-RADS was used to classify the extraosseous findings to E1, E2, E3 and E4. χ2 test was used for data analysis. Results The CT images in 78.6%(663/843) of patients were normal or with no additional clinical significance (E1 and E2), and those in 21.4%(180/843) of patients might need further assessment (E3 and E4). The rate of E4 extraosseous findings in patients with malignancy was higher than that in patients without malignancy: 9.5%(59/622) vs 5.0%(11/221); χ2=4.352, P<0.05. There was no significant difference of the rate between genders: 8.5%(40/470) in males vs 8.0%(30/373) in females; χ2=0.510, P>0.05. With age increasing, the prevalence of E4 finding increased and the rate was the highest in the patients over 80 years old (125%, 16/128). Seventy patients had E4 findings and chest masses and nodules were the most common, followed by the abdominal or pelvis lymph node enlargements. Conclusions Potentially important extraosseous findings are common on SPECT/CT. Systematic reviewing CT images and communicating the important unexpected findings to clinical physicians could enhance its clinical incremental values.

Objective To investigate forte and technique in radical correction of gastric eardia carcinoma (esophagojejunostomy and gastric stump esophago anastomosis). Methods 753 Patients with gastric cardia carcinoma admitted to our hospital from 1998 to 2007 treated with radical correction by jejuno-osophagus an-astomosis and esophagogastric anastomosis to digestive tract reconstruction, circular staplers were used in all cases. Results There was no death (no leakage、bleeding and stricture of anastornotic entrance stenosis)in these cases by thoracoabdominal approach 6 cases, anastomotic leakage 0 case, pero-eutting 2 cases, steno-sis 4 cases, infection of abdominal cavity 1 case, diaphragmatic hernia 1 case, pathologic diagnosis of exam-ple after operation , the upper cut positive 1 case, the lower cut negative in all cases. Conclusions in rad-ical correction gastric cardia carcinoma, the application of circular stapler makes this procedure simple, reli-ability, safety and time saving, descends the ratio of radical correction of gastric cardia carcinoma by thora-coabdominal approach, decreases surgical trauma, decurtate the period of recovery following an illness, pre-vent the complications of post-operation such as the leakage and stricture of anastomotic entrance. But the applieation of circular stapler is not absolutely trustworthy, there are also any ratio of leakage ,haemorrhage and stricture of anastomotic entrance, the technique worth summarizing and investgating in the future.

Aim To construct p27kip1 eukaryotic expression plasmid to investigate its influence on mononuclear cell proliferation and cell cycle for further researching the role of p27kip1 in disease prevention and treatment.Methods p27kip1 gene was cloned into pcDNA3.0 eukaryotic expression,then pcDNA3.0/p27kip1 mediated by liposome was transfected into mononuclear cell.MTT assay and flow cytometry were used to analyze cell proliferation and cell cycle.Results The mouse pcDNA3.0/p27kip1 eukaryotic expression plasmid were successfully constructed.The cells transfected with pcDNA3.0/p27kip1 expressed more p27 protein,and their proliferation was inhibited obviously.The percentage of the cells in G0/G1 phase increased,and that in S phase decreased significantly.Conclusions Mouse pcDNA3.0/p27kip1 eukaryotic expression plasmid could be expressed in mononuclear cells,and overexpression of p27 protein could inhibit mononuclear cell proliferation by restricting the cell cycle,making cell cycle arrest in G0/G1 phase.

Objective To investigate the diagnostic values of serum free fatty acids (FFA) and urine podocalyxin (PCX) in the patients with type 2 diabetic nephropathy(DN).Methods A total of 120 patients with type 2 diabetes mellitus (DM) were enrolled,and they were divided into three groups,normal albumin group(NA),microalbuminuria group(MA) and heavy albuminuria group(HA),based on the urinary albumin-creatinine ratio(UACR).In addition,40 healthy persons participated in medical examination were selected as the control group.Serum FFA levels were detected by a biochemical analyzer and urine PCX levels by ELISA.The correlation between them was analyzed by Pearson correlation,and their diagnostic values in type 2 DN were evaluated by the receiver operating characteristic curve (ROC).Results Serum FFA levels in the NA,MA,HA and control groups were (0.61 ± 0.14),(0.81 ± 0.13),(0.95 ± 0.18) and (0.49 ± 0.11) mmol/L,respectively,and urine PCX levels were (1.86 ± 0.45),(4.47 ± 1.48),(6.72 ± 1.40)and(1.38 ±0.24) ng/mL,respectively.The levels of serum FFA and urine PCX in type 2 DM patients were significantly higher than those in the control group(P ＜ 0.05),and increased with the progression of type 2 DM.Pearson correlation analysis showed that serum FFA levels were positively correlated with urine PCX levels(r =0.73,P ＜ 0.05).The sensitivity of serum FFA,urine PCX and combined detection in the diagnosis of type 2 DN were 74.1％,80.6％ and 89.5％,respectively,and the latter significantly higher than the former two (P ＜ 0.05).Conclusion Serum FFA and urine PCX levels increase significantly in diabetic patients with renal injury,and both of them have important clinical values in the diagnosis of type 2 DN.

Objective To investigate the cerebral regularity of dynamic charge and the correlation with intracranial pressure(ICP),clinical seriousness and prognosis on acute stage of intracerebral hemorrhage(ICH) patients by transcranial Doppler(TCD).Methods 54 patients with first acute supratentorial ICH 24h after onset were studied.All patients were dynamic evaluated by beside TCD on 1st,7th,21st day.The correlation of TCD with ICP,MESSS were studied.Results On the 1st day the TCD abnormity of the acute phase of the ICH occurred mainly in the anterior circulation of cerebrum,in which the cardinal manifestation was high-resistance,low-flow velocity blood waveforms,especially on the bleeding side.Continuous TCD monitoring revealed the low velocity of the cerebral blood flow increased;meanwhile the high value of PI decreased gradually and the TCD monitoring was within the normal range three weeks after the attack.The ICP had negative correlation with the VmMCA,positive correlation with the PI value.MESSS scale had negative correlation with the VmMCA,positive correlation with the PI value.Conclusions The TCD examination can be used to monitor the cerebral hemodynamics of the patients suffering from intracerebral hemorrhage.The combination of fVEP and TCD facilitate the evaluation of the dynamic changes of ICP so as to instruct lowering the ICP.

Objective To explore the aging mechanisms of human adult adipose-derived stem cells (hADSCs) in vitro.Methods The hADSCs came from the production of normal patients with liposuction.The hADSCs were cultured in the 37℃ incubator and passed until the cells were senescent.The senescence-associated β-gal staining (SA-β-gal) and histone protein γH2AX staining were carried out in both young and old hADSCs.The quantitative real-time PCR (qRT-PCR) was conducted to check the difference of the transcription function of the young and old hADSCs.Results The cultured hADSCs would be the senescent cells when the PD number was more than 35.The aging cells became big and had large flat nuclei and much more lososomes in the cytoplasm.The SA-β-gal staining and γH2AX staining were mostly positive in the aging hADSCs (PD>35) compared with the self-renewing hADSCs (PD<20).The qRT-PCR results showed that the transcription levels of Nanog and Oct4 gene were very low in aging hADSCs compared with the self-renewing ones.Conclusions The hADSCs will be senescent (SEN) when cultured and passed in vitro for long time and the aging process is similar to that of stem cells in vivo.The aging model of hADSCs can be established by this method and will be very useful in the anti-aging drug, regeneration medicine, tissue engineering and stem cell therapy.

Objective To investigate the clinical value of human soluble endothelial protein C receptor (sEPCR) after heart valve replacement.Methods 78 cases of patients with heart valve replacement in the Second Affiliated Hospital of Nantong University from January 2005 to June 2016 were selected as the research objects,who were divided into embolic group and control group,38 cases in embolic group and 40 cases in control group,the index of two groups 1 d preoperative,while dynamic monitoring international standardization ratio (INR) and embolism,were detected,of which INR and sEPCR were examined.The INR and sEPCR oftwo groups was compared with t test.Results The INR and sEPCR of two groups 1 d preoperative had no significant difference (1.24±0.32 vs 1.23±0.19,34.91±9.14 μg/L vs 35.56±10.22 μg/L;t=0.17,P =0.868;t=0.30,P=0.768,respectively).The average value of dynamic monitoring INR in control group had no significant difference when compared with the results of embolism (1.86±0.95 vs 1.93±0.97,t=0.32,P=0.748).But the sEPCR had significant difference (101.33±27.15 μg/L vs 41.67±11.82 μg/L,t=12.69,P=0.000).Conclusion The important indexes of sEPCR could effectively guide the anticoagulant treatment,especially those who with the sEPCR value too high,the embolic threatening should be paid attention to.

Humans ; Hypersensitivity ; drug therapy ; Probiotics ; therapeutic use

Objective To investigate and analyze the status quo of professional identity of nursing students with different educational backgrounds.Methods With stratified-cluster random sampling,635 students were surveyed using the nursing students' professional identity questionnaire.Results The total score of professional identity of junior college nursing students was significantly higher than that of undergraduate students.Junior college nursing students had a higher score in professional knowledge dimension than undergraduate and graduate students,while the score of nursing undergraduate students was higher than that of graduate students.Junior college nursing students had a higher score in professional will dimension than undergraduate and graduate students.Nursing graduate students had a higher score in professional expectation dimension than junior college and undergraduate students,while the score of undergraduate students was higher than that of junior college students.Whatever the educational background,professional skill and professional expectation were the top two dimensions,while professional knowledge and professional emotion were the last two dimensions.The difference was statistically significant between the answers of nursing students with different educational backgrounds to the following questions,such as which is the most probable factor affecting your learning enthusiasm,who has the greatest impact on your professional thought about nursing and which nursing field are you most willing to go in for.There was significant difference in professional identity score between different grades of junior college and undergraduate nursing students,while there is no significant grade difference in graduate students.Conclusions There were some differences of professional identity of nursing students with different educational backgrounds.Nursing educators should carry out the professional education according to the student's educational backgrounds.