Background:Patients with functional gastrointestinal disorders(FGIDs)often experience stigma related to symptom attribution and psychological interventions.Treatment as usual,including the use of neuromodulators,has shown limited effectiveness.Therefore,there is an urgent need for a comprehensive and individualized psychosomatic approach to effectively manage FGIDs in clinical practice.Aims:To evaluate whether the psychosomatic model of gastroenterology provide superior outcomes in FGIDs management compared with treatment as usual.Methods:A total of 165 FGIDs patients who attended the Department of Gastroenterology at the Third Affiliated Hospital of Soochow University from May 2024 to July 2024 were enrolled and randomly assigned to the treatment as usual group and the psychosomatic gastroenterology treatment group.Patients in treatment as usual group received lifestyle modifications and pharmacotherapy,including neuromodulators,while those in psychosomatic gastroenterology group received the symptom-oriented stepped reattribution model in addition to treatment as usual.After a 4-week intervention,treatment efficacy was assessed based on patient-reported outcomes.Neuromodulators adherence and overall clinical efficacy were compared between the two groups.Results:After 4 weeks of intervention,the effectiveness rates were 51.2％in the treatment as usual group and 85.0％in the psychosomatic gastroenterology group(P＜0.001).Neuromodulators adherence rates were 38.5％in the treatment as usual group and 85.4％in the psychosomatic gastroenterology group(P＜0.001).Patients in the psychosomatic gastroenterology group showed significantly lower scores on the GAD-7,PHQ-9,PHQ-15,and GCBI scales and higher scores on the GIQLI scale compared to the treatment as usual group(all P＜0.05).Conclusions:The psychosomatic model of gastroenterology significantly improves the neuromodulators adherence and the overall clinical efficacy in FGIDs patients compared with treatment as usual.

Background:Patients with functional gastrointestinal disorders(FGIDs)often experience stigma related to symptom attribution and psychological interventions.Treatment as usual,including the use of neuromodulators,has shown limited effectiveness.Therefore,there is an urgent need for a comprehensive and individualized psychosomatic approach to effectively manage FGIDs in clinical practice.Aims:To evaluate whether the psychosomatic model of gastroenterology provide superior outcomes in FGIDs management compared with treatment as usual.Methods:A total of 165 FGIDs patients who attended the Department of Gastroenterology at the Third Affiliated Hospital of Soochow University from May 2024 to July 2024 were enrolled and randomly assigned to the treatment as usual group and the psychosomatic gastroenterology treatment group.Patients in treatment as usual group received lifestyle modifications and pharmacotherapy,including neuromodulators,while those in psychosomatic gastroenterology group received the symptom-oriented stepped reattribution model in addition to treatment as usual.After a 4-week intervention,treatment efficacy was assessed based on patient-reported outcomes.Neuromodulators adherence and overall clinical efficacy were compared between the two groups.Results:After 4 weeks of intervention,the effectiveness rates were 51.2％in the treatment as usual group and 85.0％in the psychosomatic gastroenterology group(P＜0.001).Neuromodulators adherence rates were 38.5％in the treatment as usual group and 85.4％in the psychosomatic gastroenterology group(P＜0.001).Patients in the psychosomatic gastroenterology group showed significantly lower scores on the GAD-7,PHQ-9,PHQ-15,and GCBI scales and higher scores on the GIQLI scale compared to the treatment as usual group(all P＜0.05).Conclusions:The psychosomatic model of gastroenterology significantly improves the neuromodulators adherence and the overall clinical efficacy in FGIDs patients compared with treatment as usual.

Objective To investigate the expression of vascular endothelial growth factor (VEGF) and Bax in non‐small cell lung cancer (NSCLC) and clinical value .Methods Paraffin specimens were collected from 80 cases of NSCLC tissues(NSCLC group) and 20 cases of normal lung tissue adjacent to benign lesions(control group) .Western blot and immunohistochemistry were used to dectect the expression of VEGF and Bax .The relationship of the expression of VEGF and Bax with histological classifica‐tion ,stage ,lymph mode metastasis were analyzed .Results The expression of VEGF in NSCLC group was higher than that in con‐trol group ,the differences were statistically significant (P<0 .05) .The higher expression of VEGF in the group of stage Ⅲ‐Ⅳ was obtained than that in the group of stage Ⅰ‐Ⅱ (P<0 .05) .The higher expression of VEGF in the group with lymph mode metasta‐sis was obtained than that in the group without lymph mode metastasis (P<0 .05) .The expression of VEGF was not found to be related with histological classification (P>0 .05) .The expression of Bax in NSCLC tissue was lower than that in normal tissue ,the differences was statistically significant (P<0 .05) .The lower expression of Bax in the group of stage Ⅲ‐Ⅳ was obtained than that in the group of stage Ⅰ‐Ⅱ (P<0 .05) .The lower expression of Bax in the group with lymph mode metastasis was obtained than that in the group without lymph mode metastasis (P<0 .05) .The expression of Bax was not found to be related with histological classification (P>0 .05) .The expression of VEGF was negatively correlated with Bax in NSCLC (P<0 .05) .Conclusion The ex‐pression of VEGF played a promoting effect in the NSCLC ,and was negatively correlated with the expression of Bax protein ,and the expression of the two could provide a basis for the diagnosis and prognosis of NSCLC .

Objective To investigate the effect of ambient temperature on body mass, thermogenic activity and un-coupling protein-1 ( UCP1) content of brown adipose tissue ( BAT) in tree shrews ( Tupaia belangeri) , and to provide the-oretical basis for establishing tree shrews model of obesity.Methods Forty healthy adult tree shrews with similar body mass were uesd in our experiment.The tree shrews were divided into five groups (n=8):control group (0 d), the ani-mals were maintained under 25 ±1℃ and 12L:12D ( light : dark, lights on 08:00) photoperiod; and the animals were maintained under 5 ±1℃and 12L:12D photoperiod for 7 d, 14 d, 21 d and 28 d groups, respectively.At the end of ex-periment, the changes of body mass, nonshivering thermogenesis (NST), BAT mass and uncoupling protein 1 (UCP1) con-tent were determined.Results Compared with the control group (0 d), the body mass, NST, BAT mass and UCP1 con-tent of the cold acclimation groups were improved significantly, the BAT color also obviously deepened, and after cold accli-mation for 28 d, the body mass, NST, BAT mass and UCP1 content were increased by 26.32%, 20.65, 53.85%and 43%, respectively.Apparently, the UCP1 content was significantly positively correlated with BAT mass and NST.Conclusions BAT proliferation may be induced and UCP1 expression upregulated by cold acclimation in Tupaia belangeri, therefore, en-hancing the thermogenic activity of brown adipose tissue to increase energy expenditure.We would speculate that BAT might be used as a target organ for treatment of obesity by energetic approach in the future.

BACKGROUNDAllogeneic peripheral blood stem cell transplantation from unrelated donors (UR-PBSCT) is an alternative treatment for many hematologic diseases due to lack of human leukocyte antigen (HLA)-identical sibling donors. This study aimed to evaluate the impact of the degree of the HLA match on the clinical efficacy of UR-PBSCT.

METHODSPatients who underwent UR-PBSCT from September 2003 to September 2012 were retrospectively investigated. They were divided into three groups according to high-resolution molecular typing. SPSS version 17.0 was used to analysis and compare the statistics of engraftment, incidence of GVHD, other complications and survival among the groups.

RESULTSOne hundred and eleven patients received UR-PBSCT, 60 of them with an HLA matched donor (10/10), 36 of them with a one locus mismatched donor (9/10), and 15 of them with a two loci mismatched donor (8/10). Similar basic characteristics were found in the three groups. No differences were found in engraftment of myeloid cells or platelets in the three groups (P > 0.05). Two-year cumulative incidence of relapse, overall survival (OS) and disease-free survival (DFS) among those three groups were similar (P > 0.05). The cumulative incidence of 100-day III-IV aGVHD in the HLA matched group and the one HLA locus mismatched group were significantly lower than that in the two HLA loci mismatched group (3.3%, 8.6%, and 26.7%, P = 0.009). The occurrence rate of new pulmonary infections in the HLA matched group was lower than in the two HLA mismatched groups (26.67%, 52.78%, and 41.18%, P = 0.035). The cumulative incidence of 100-day and 2-year transplantation related mortality (TRM) in two HLA loci mismatched group was higher than in the HLA matched group and in the one HLA locus mismatched group, (8.4%, 11.8% and 33.3%, P = 0.016) and (12.3%, 18.7% and 47.5%, P = 0.002).

CONCLUSIONSHLA mismatch will not significantly impact the engraftment or 2-year survival after UR-PBSCT, but two mismatched HLA loci may increase the cumulative incidence of severe aGVHD and TRM.

Adolescent ; Adult ; Child ; Female ; HLA Antigens ; immunology ; Humans ; Male ; Middle Aged ; Peripheral Blood Stem Cell Transplantation ; standards ; Unrelated Donors ; Young Adult