Objective To explore the effects of the regulation of JAK/STAT signaling pathway by the therapy of astringent ulcer and muscle inducing enema on colon injury and mucosal barrier in ulcerative colitis(UC)model rats.Methods A rat model of ulcerative colitis was established using 2,4,6-trinitrobenzenesulfonic acid/ethanol method.The model was randomly divided into a normal control group(without modeling),a model group,a positive drug group(mesalazine sustained-release granules 0.42 g·kg-1),a high dose of Lianchuang Shengji Formula(enema 10.5 g·kg-1),a medium dose(enema 5.25 g·kg-1),and a low dose group(enema 2.62 g·kg-1).Compare the fecal occult blood,degree of colonic mucosal damage,and pathological changes of rats in each group,and detect the expression of JAK2,STAT3 proteins,and their phosphorylated proteins in colon tissue using Western blot method.Results The results showed that the mesalazine group,the medium and high-dose groups of Lianchuang Shengji Formula could increase the body mass of rats,reduce fecal occult blood score,improve colon damage,and achieve pathological results;The mesalazine group and the low,medium,and high dose groups of Lianchuang Shengji can downregulate the expression of p-JAK2 and p-STAT3 proteins(compared with the model group,P＜0.05),with the high-dose group being the most significant(P＜0.01).The apoptosis rate of colon tissue significantly decreased(P＜0.05).Conclusion The enema therapy of astringent ulcer and promoting muscle growth can significantly improve the pathological scores of bloody stools and colon injury in rats with ulcerative colitis.The mechanism may be related to the inhibition of JAK2 and STAT3 phosphorylation protein expression,and further inhibition of the JAK/STAT signaling pathway.

Objective To explore the effects of the regulation of JAK/STAT signaling pathway by the therapy of astringent ulcer and muscle inducing enema on colon injury and mucosal barrier in ulcerative colitis(UC)model rats.Methods A rat model of ulcerative colitis was established using 2,4,6-trinitrobenzenesulfonic acid/ethanol method.The model was randomly divided into a normal control group(without modeling),a model group,a positive drug group(mesalazine sustained-release granules 0.42 g·kg-1),a high dose of Lianchuang Shengji Formula(enema 10.5 g·kg-1),a medium dose(enema 5.25 g·kg-1),and a low dose group(enema 2.62 g·kg-1).Compare the fecal occult blood,degree of colonic mucosal damage,and pathological changes of rats in each group,and detect the expression of JAK2,STAT3 proteins,and their phosphorylated proteins in colon tissue using Western blot method.Results The results showed that the mesalazine group,the medium and high-dose groups of Lianchuang Shengji Formula could increase the body mass of rats,reduce fecal occult blood score,improve colon damage,and achieve pathological results;The mesalazine group and the low,medium,and high dose groups of Lianchuang Shengji can downregulate the expression of p-JAK2 and p-STAT3 proteins(compared with the model group,P＜0.05),with the high-dose group being the most significant(P＜0.01).The apoptosis rate of colon tissue significantly decreased(P＜0.05).Conclusion The enema therapy of astringent ulcer and promoting muscle growth can significantly improve the pathological scores of bloody stools and colon injury in rats with ulcerative colitis.The mechanism may be related to the inhibition of JAK2 and STAT3 phosphorylation protein expression,and further inhibition of the JAK/STAT signaling pathway.

OBJECTIVE: To determine the prevalence, factors associated with and patterns of concomitant Chinese medicine (CM) with Western treatment use among patients with rheumatoid arthritis (RA) in a tertiary referral centre (Singapore General Hospital) in Singapore. METHODS: We conducted a cross-sectional interviewer-administered survey of a consecutive sample of patients with RA in Singapore General Hospital centre regarding their CM use including data on patient demographics, disease characteristics, concomitant use of CM and reasons, concerns and disclosure patterns from March to August 2015. Univariate and multivariate logistic regression analyses were performed to determine the associations of CM use. RESULTS: Prevalence of CM use among the 258 patients surveyed (male: female 42: 216; Chinese: Malay: Indian 191: 29: 34; mean age: 61 years; mean duration of RA: 10 years) was 46.1% (119/258). On multivariate analysis, Chinese ethnicity (OR, 95% CI: 4.11, 1.49-11.36), Chinese speakers (OR, 95% CI: 2.35, 1.03-5.54), middle-income group (OR, 95% CI: 2.53, 1.01-6.31) and greater learned helplessness (OR, 95% CI: 1.13, 1.04-1.22) were significantly associated with CM use. More CM users disclosed their CM use to CM physicians (87.3%, 96/110), sought advice from them on treatment interactions (59.4%, 57/96) and how best to combine treatments (49.0%, 47/96) than did so with rheumatologists (42.0%, 50/119; 40.0%, 20/50; and 42.0%, 21/50, respectively). Forty-two percentage (29/69) of patients who concealed CM use from rheumatologists because their rheumatologists did not specifically enquire about CM use. CONCLUSIONS Concomitant CM use among patients with RA treated in a tertiary referral centre in Singapore is high but voluntary disclosure is low. The associations identified can help doctors identify and enquire about CM use, minimizing potential adverse interactions.
Arthritis, Rheumatoid/epidemiology* ; Cross-Sectional Studies ; Ethnicity ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Prevalence

Objective In comparison with Xpert C.difficile/Epi through detection of Clostridium difficile toxin genes from clinical stool , the performance of a laboratory-developed ( LD) assay was evaluated in detail.Methods A total of 176 stool specimens collected from patients with diarrhea in the First People′s Hospital of Yuhang District and the People′s Hospital of Yingzhou , Ningbo from August 1 to December 30 were detected by the two assays in parallel , and meanwhile the C.difficile strains will be isolated and identified for C.difficile toxin genes by a conventional PCR assay .The Cross-tabs Analysis was used for the results by using SPSS20.0 software.Results In comparison with the results of Xpert C.difficile/Epi as the standard, the LD assay had a sensitivity of 91.7％(22/24), a specificity of 100％(152/152), a positive predictive value (PPV) of 100％(22/22), and negative predictive value (NPV) 98.7％(152/154).The results of two assays were statistically coherent (Kappa=0.950, P<0.001).In comparison with culture and detection of toxin genes results , the LD assay had a sensitivity of 90.0％ ( 18/20 ) , a specificity of 97.0％(152/156), a PPV of 81.8％ (18/22), and NPV of 98.7％ (152/154)(Kappa=0.838, P<0.001), and the Xpert C.difficile/Epi assay had a sensitivity of 90.0％ (18/20), a specificity of 96.0％(150/156), a PPV of 75.0％(18/24), and NPV of 98.7％ (150/152)(Kappa=0.792, P<0.001). Conclusions The performance of the LD assay was similar to that of the Xpert C .difficile/Epi kit in detection of toxigenic C.difficile.The LD assay could be directly applied to detection of toxigenic C.difficile from clinical stool samples .The clinical application of this LD assay will also provide a domestic and promising diagnostic assay for diagnosis of C.difficile infection in China.

We employed a multiplex polymerase chain reaction (PCR) coupled with capillary electrophoresis (mPCR-CE) targeting six Clostridium difficile genes, including tpi, tcdA, tcdB, cdtA, cdtB, and a deletion in tcdC for simultaneous detection and characterization of toxigenic C. difficile directly from fecal specimens. The mPCR-CE had a limit of detection of 10 colony-forming units per reaction with no cross-reactions with other related bacterial genes. Clinical validation was performed on 354 consecutively collected stool specimens from patients with suspected C. difficile infection and 45 isolates. The results were compared with a reference standard combined with BD MAX Cdiff, real-time cell analysis assay (RTCA), and mPCR-CE. The toxigenic C. difficile species were detected in 36 isolates and 45 stool specimens by the mPCR-CE, which provided a positive rate of 20.3% (81/399). The mPCR-CE had a specificity of 97.2% and a sensitivity of 96.0%, which was higher than RTCA (x = 5.67, P = 0.017) but lower than BD MAX Cdiff (P = 0.245). Among the 45 strains, 44 (97.8%) were determined as nonribotype 027 by the mPCR-CE, which was fully agreed with PCR ribotyping. Even though ribotypes 017 (n = 8, 17.8%), 001 (n = 6, 13.3%), and 012 (n = 7, 15.6%) were predominant in this region, ribotype 027 was an important genotype monitored routinely. The mPCR-CE provided an alternative diagnosis tool for the simultaneous detection of toxigenic C. difficile in stool and potentially differentiated between RT027 and non-RT027.
Clostridium Infections ; diagnosis ; Clostridium difficile ; genetics ; Electrophoresis, Capillary ; Feces ; microbiology ; Genes, Bacterial ; Humans ; Polymerase Chain Reaction ; Ribotyping ; Sensitivity and Specificity

Objective In comparison of the performances for the detection of Clostridium difficile toxin B genes from stool between BD MAX Cdiff assay and a laboratory-developed (LD) assay.The LD assay was evaluated in clinical application.Methods This study was a clinical application research.A total of 147 stool specimens from patients with diarrhea in Hangzhou First Hospital affiliated with Zhejiang Chinese Medical University were detected by the two assays from 1 July to 30 September 2014.DNA extraction and amplification of the tcdB gene were performed automatically on the BD MAX platform.Meanwhile, the tcdA and tcdB gene were detected by the LD real-time PCR assay after DNA extraction.Then, the results were analyzed by use of SPSS 10.0.Results A total of 147 stool samples were collected.There were 33 C.difficile positive cases and 114 negative cases detected by both of two assays.However, there were four stool samples had incongruent results.In comparison with BD MAX, the LD assay had a sensitivity of 93.94% (31/33), a specificity of 98.25% (112/114), a positive predictive value of 93.94% (31/33), and negative predictive value 98.25% (112/114).Furthermore, the results of the LD assay were statistically coherent with that of the BD assay (Kappa=0.922, P<0.01).Conclusions The LD assay was highly sensitive and accurate as BD MAX Cdiff assay in the detection of toxigenic Clostridium difficile.Furthermore, this LD assay could be also applied to detection of clinical stool samples directly with low cost.The assay will be more promising in diagnosis of toxigenic C.difficile in clinical application in China due to no additional instrument needed.