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 observe the time-effect relationship between acupuncture treatment and the absorption of cerebral hematoma and edema in the acute stage of cerebral hemorrhage to determine the optimal time for acupuncture intervention in cerebral hemorrhage.Methods Three hundred patients with cerebral hemorrhage in the acute stage were randomly allocated to treatment groups 1, 2, 3 and 4, and control group, 60 cases each. The control group received symptomatic treatment for regulating blood pressure, reducing intracranial pressure by dehydration, maintaining electrolyte balance, nourishing nerves and preventing and treating complications. The treatment groups were given acupuncture in addition. Treatment group 1 received acupuncture at 24 hrs after the attack; treatment group 2, at 72 hrs; treatment group 3, at one week; treatment group 4, at two weeks. Pre-/post-treatment hematoma size parameter difference value and cerebral peripheral edema grade parameters were observed in every group.Results There were statistically significant pre-/post-treatment differences in hematoma size and cerebral edema grade in every group (P<0.01,P<0.05). There were statistically significant post-treatment differences in hematoma size and cerebral edema grade between every treatment group and the control group (P<0.05). There were statistically significant post-treatment differences in hematoma size and cerebral edema grade between treatment group 1, 2 or 3 and treatment group 4 (P<0.05), between treatment group 1 or 2 and treatment group 3 (P<0.05) and between treatment groups 1 and 2 (P<0.05).Conclusions Acupuncture has a positive therapeutic effect in patients with cerebral hemorrhage in the acute stage. The earlier acupuncture intervention in the acute stage of cerebral hemorrhage, the more remarkable the effect.

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 efficacy of three different methods of digestive tract reconstruction after total gastrectomy.Methods:A total of 106 cases underwent the uncutted Roux-en-Y esophagojejunostomy with a jejunal pouch(group A,n=38) ,Roux-en-Y esophagojejunostomy with the J-type jejunal pouch(group B,n=31) ,and Roux-en-Y esophagojejunostomy with the Orr-type jejunal pouch(group C,n=37) respectively.The clinical data were retrospectively studied.The digestive tract reconstruction time,the post-operative complication incidence rate,postprandial symptoms,food-intake quantity,weight,serum nutritional parameters and emptying time of the gastricsubstitute were compared respectively.Results:The reconstruction time was the shortest in group A,which was significantly shorter than that in group B(P0.05) ,Group A was significantly lower than group B and C in the incidence of roux stasis syndrome.The Visick score of group A were superior to those of group B and C in 6 and 12 months after operation.The food intake gain of group A and B were superior to that of group C 6 and 12 months after operation.There were no significant differences among 3 groups in the term of weight,Hb and ALB loss and prognosis nutritional index(PNI) 6 months postoperatively.Weight and ALB loss in group A and B were lower than those in group C 12 months postoperatively,but PNI was higher in group A and B than those in group C.Emptying time of the gastric substitute was prolonged both in group A and B 12 months postoperatively.Conclusion:The uncutted Roux-en-Y esophagojejunostomy may act as an adoptable method of digestive tract reconstruction after total gastrectomy for gastric cancer.

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.

Objective This study is aimed to assess the accuracy of clinical measurement of remission and investigate the association between clinical remission and the ultrasound imaging assessment of synovitis and infla'mation and to explore the value of ultrasound imaging in the evaluation of disease activity in the tight control of rheumatoid arthritis (RA).Methods RA patients with a disease activity score in 28 joints (DAS28-ESR) ≤2.6 for at least 3 months were stratified-using a standard and more stringent DAS28 and simplified disease activity index (SDAI) remission thresholds and the corresponding clinical and ultrasound imaging measures of synovitis were recorded.In addition,a retrospective analysis of disease activity in patients was carried out.Mann-Whitney U test,x2 test and multi-factor analysis of variance of repeated measurements were used for statistical analysis.Results A total of 48 cases were recruited.Thirty-seven cases (77％) met the ACR remission criteria,29 cases (60％) fulfilled the SDAI remission criteria,and 32 (67％) cases reached 2010 ACR/EULAR Boolean-based definition of remission criteria.There was no significant differences on imaging disease activity between SDAI remission patients and those who were not in remission (GS score,P=0.38; PD score,P=0.32).Seventy-nine percent patients in SDAI remission had GS and/or PD activity,but the difference was not statistically different when compared with patients who did not reach SDAI remission (P=0.29).Sustainable remission obtained in patients who also had achieved image remission could have longer remission time (P＜0.01) Conclusion Using more stringent clinical remission criteria could help in reducing residual inflammatory activity of,but ultrasound PD activities may not be significantly reduced.Integrated clinical indicators such as physical examination and imaging tools such as ultrasound can provide more accurate assessment of disease activity and could be used to guide treatment to achieve trueremission.

This critical review was summarized more systematically about the JAK2V617F mutation of related research progress in myeloproliferative disorders (MPD) research fields and the identification of JAK2V617F mutation represents an important advance in our understanding of MPD was agreed. The authors focused on several sensitive problems of post the JAK2 mutation era, and expressed their opinions. The Guideline of the MPD diagnostic criteria recommended by WHO in 2008 was accepted. The authors recommend the MPD, rather than myeloproliferative neoplasm (MPN). The treatment for the MPD (not including the CML) is recommended. Before the effective targeting of JAK2V617F specific inhibitors for the treatment of the MPD, short-term of use hydroxyurea (HU) was suggested to suppress excessive proliferation of bone marrow of MPD and a long course of treatment application of inteferon-α(IFN-α), and low-dose of aspirin in a timely manner were recommended to prevent thrombosis and other complications.

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.

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.