Objective To explore the prevalence,subtype,distribution characteristics and risk factors of IBS met ROME Ⅲ criteria in local adult residents of Shanghai Songjiang area.Methods With multi-stage,stratified cluster random sampling method,from April to May in 2010,residents of45 shanghai Songjiang communities were interviewed by questionnaire survey.IBS diagnosis was based on Rome Ⅲ criteria,and the subtypes were according to Bristol stool scale.Self-rating anxiety scale (SAS),self-rating depression scale (SDS) and Athens insomnia scale (AIS) were also simultaneously finished. Results There were 7648 individuals who completed the survey with qualified questionnaires; the efficient rate was 90％. The sample size accounted about 1.62％ of total population in Shanghai Songjiang area.Total 970 patients were detected,who met the Rome Ⅲ criteria,of those 492 males and 478 females.The adjusted prevalence of IBS was 13.1％,13.8％ in males and 12.7％ in females.The ratio of male to female was 1 ∶ 0.92.There was no significant difference in detection rate between males and females (P＞0.05).The prevalence was highest in the 18 to 29 years age group (18.2％,P=0.000).IBS unsubtyped (IBS-U) was the most common type in patients who met the Rome Ⅲ criteria (45.3 ％),IBS with diarrhea (IBS-D) type was more common in male (27.0％) and IBS with constipation (IBS-C) was more common in female (19.5％).The IBS prevalence of obesity group (x2 =4.046,P=0.044),higher education group (x2=31.210,P=0.000),mental group (x2 =8.409,P =0.015),unmarried group(x2 =26.933,P =0.000) and no abdominal surgery history group(x2 =5.894,P=0.015) was higher than that of control group.The risk of IBS prevalence in those who had the history of gastrointestinal infection,abdominal surgery,taking antibiotics or analgesics increased by 5.105,3.388,2.949 and 2.811 times respectively(P=0.000).Multivariate analysis indicated that the risk of IBS prevalence was increased by 1.69 times if took more spicy food,however high-protein diet was a protective factor (OR=0.900,P=0.000).Anxiety (OR=2.452,P=0.000) and insomnia (OR=1.923,P=0.000) were also risk factors of IBS.Conclusion IBS is a common and frequently occurring disease in Shanghai Songjiang community.The history of gastrointestinal infection,abdominal surgery,taking antibiotics or analgesics,intake of more spicy food,anxiety and insomnia may be risk factors of IBS.

Objective To investigate the association of sleep quality with prevalence of irritable bowel syndrome (IBS) in communities of Shanghai.Methods A survey on prevalence of IBS in communities of Jiangqiao County,Jiading District of Shanghai was conducted using a stratified,randomized cluster-sampling method.A total of 11 569 questionnaires was collected.The IBS was diagnosed according to Rome Ⅲ criteria,and Athens Insomnia Scale (ALS) was used for selfassessment.The relationship between sleep quality and IBS was analyzed.Results The prevalence of insomnia was 21.00% in community groups,33.02% in IBS patients and 18.74% in non-IBS patients.The incidence of insomnia was significant higher in IBS group than non-IBS group (P =0.004,OR = 2.14,95 % CI:1.92- 2.39).Among IBS patients,the incidence of insomnia was higher in females than in males (37.24% vs 28.41%,P = 0.000).A logistic analysis for psychological contributing factors in IBS revealed that insomnia might be one of the risk factors for IBS (OR= 2.11,95% CI:1.89-2.36).Conclusion IBS patients have poor sleep quality,especially in females.

ObjectiveTo investigate the incidence of skeletal and/or articular malformations in central core disease (CCD) patients, and their risk of malignant hyperthermia (MH) in orthopedics. Methods28 unrelated patients with central core disease collected in the past 23 years were analyzed retrospectively. Results22 patients showed limb muscle weakness, while 6 patients didn't show any clinical symptom. Skeletal and/or articular malformations appeared in 21 patients, including joint contracture in 11, joint dislocation in 9, scoliosis in 12, lordosis in 5 and thoracic deformity in 1. 6 of the 10 patients could not endure orthopedic operation because of MH attack or dubitable MH attack. Calcium-induced calcium release (CICR) test performed on other 8 patients with MH family history or MH attack showed all those patients were MH susceptibilities. ConclusionSkeletal and/or articular malformations are common in CCD, as well as MH attack in orthopedics.

OBJECTIVETo study the effect of Shexiang Baoxin pill (SBP) on the vascular endothelial function in patients with diabetes mellitus type 2 (DM2) complicated with angina pectoris.

METHODSTwo weeks after runin, according to the randomizing table, 111 patients were divided into two groups, the XBP group (56 patients) and the control group (55 patients, treated with delayed-released isosorbide mononitrate, DRIM), they were treated for 6 months. In the treatment period, the episodes of angina attack and condition of rescue medication were recorded in the daily card, and brachial arterial changes of endothelium-dependent relaxing function before and after treatment were measured by B-ultrasonography.

RESULTSComparison between the two groups in episodes of angina attack and rescue medication were insignificantly different. In the control group, the basal value of brachial arterial inner diameter before and after treatment was 3.68 +/- 0.56 mm and 3.70 +/- 0.58 mm respectively, those before and after responsive congestion was 5.44 +/- 0.81% vs 5.68 +/- 0.83%, and those before and after taking nitroglycerin was 19.8 +/- 4.9% vs 20. +/- 5.2%, all showed insignificant difference (P > 0.05). In the SBP group, the corresponding basal value was 3.73 +/- 0.62 mm vs 3.71 +/- 0.59 mm, and those after taking nitroglycerin 18.8 +/- 4.5 % vs 19.2 +/- 5.8%, also showed insignificant difference, but those before and after responsive congestion (5.69 +/- 0.79 % vs 9.56 +/- 3.82 %) did show significant difference (P < 0.01).

CONCLUSIONXBP could improve the vascular endothelial function in patients with DM2 complicated with angina pectoris.

Aged ; Angina Pectoris ; complications ; drug therapy ; Angioplasty, Balloon, Coronary ; Diabetes Mellitus, Type 2 ; complications ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Endothelium, Vascular ; drug effects ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy

Proton pump inhibitor (PPI) is considered as the standard treatment for acid-related disorders. However, its long-term use, especially in patients with gastroesophageal reflux disease, would cause potential risks, such as hypergastrinemia along with reduced gastric acidity, hyperplasia of enterochromaffin cells (ECL), gastric neoplasms, rebound gastric acid hypersecretion when PPI treatment is stopped, increased oxyntic gastritis in patients with H. pylori infection, and the possible stimulation of growth of non-gastric tumours due to hypergastrinaemia. Each of these trends has led to numerous studies and evaluations on the potential risk-benefit ratio of the long-term use of PPIs, and countermeasures are being proposed for these problems.

Objective To investigate the clinical and electrophysiological characteristics of cubital tunnel syndrome (CTS). Methods The clinical and electrophysiological data of 150 cases of CTS involving 173 upper limbs (UL) were collected. And the electrophysiological data of 76 healthy subjects were also collected. The data of EMG between the two groups were compared and analyzed statistically. Results Fibrillation potentials were detected in 114 and 91 UL, respectively, in abductor digiti minimi, and positive sharp waves in 50 and 48 UL, respectively, in the first dorsal interosseous muscle. The average conduction velocity of the ulnar nerve was decreased, with motor conduction velocity(MCV) from above to below elbow 34.6?9.75 m/s and sensory conduction velocity (SCV) 45.99?9.65m/s; the motor latency was prolonged and amplitude of motor action potential decreased. There was statistical difference between the patients and the healthy control groups ( P

Objective 　To study the clinical and electrophysiological features in Charcot-Marie-Tooth disease type 1A with gene duplication.Methods　Clinical symptoms and signs were summarized in 22 patients from 21 unrelated families. Electromyography (EMG) as well as motor conduction velocities (MCV) and sensory conduction velocities (SCV) examinations were performed in all patients. Results　Evidence of CMT was initially detected within the second decade in 18 patients. Nearly half of patients were sporadic cases. The typical clinical manifestations of CMT1A were weakness and atrophy in the distal limbs, weakness or absence of the tendon reflexes, talipes equinovarus and postural tremor the upper limb. Additionally, some special symptoms and signs were also observed occasionally, including brisk tendon reflexes, extensor plantar responses, scoliosis, foot ulcers and nystagmus. EMG revealed that 77.3% of the patients had fibrillation and positive sharp potentials. 81.8% of them had prolonged motor unit potential limit. Median MCV showed there was no significant difference between CMT1A patients and CMT1 patients without duplication (t=1.63, P＞0.05). Values of SCV and MCV for the lower limbs were not obtained in 20 patients and more than 2/3 of the patients respectively. Conclusions　The clinical features of CMT1A included high frequent of sporadic cases, early onset in the second decade and various manifestations. The electrophysiological features were that the damages of nerves for the lower limbs were more severer than those in the upper limbs and the damages of the sensory nerves were more severer than those of the motor nerves. The phenotype was variable although the genotype was the same in CMT1A patients with PMP22 duplication.

Objective To study the changes of neuronal nitric oxide synthase in skeletal muscles of Duchenne/Becker muscular dystrophies as to investigaing the pathogenesis of the disease. Methods NADPH diaphorase enzyme histochemistry and nNOS immunohistochemistry were used to analyze the muscle specimens from 36 patients with various muscular dystrophies and 10 normal controls. Results A positive staining was found in sarcolemma of both slow and fast-twitch muscle fibers, in 10 normal controls and 18 patients with non-muscular dystrophy as well as 12 LGMD and 2 FSHD; but a negative staining was found in 10 DMD, and a negative or faint staining in 9 BMD. The loss of nNOS in sarcolemma was associated with the loss of dystrophin, and exon 45～47 in dystrophin gene might be an important region for targeting nNOS to the sarcolemma. The deficiency of nNOS was associated with the severity of DMD/BMD, but no direct evidence for absence of nNOS in sarcolemma leading to the onset of muscle necrosis in DMD/BMD was detected.Conclusions nNOS is expressed at a high level in sarcolemma of normal muscle, and also expressed normally in muscles of those non-muscular dystrophy, LGMD and FSHD patients; but there appear absence or reduction expression in the sarcolemma of DMD and BMD. nNOS is involved in regulating of physiological functions of skeletal muscles and may be an important role in pathogenesis of DMD/BMD.

Objective To develop and compare the methods for determining the carrier status in the 18 deleted families of Duchenne and Becker muscular dystrophy. Methods Deletion analysis of the probands was performed by multiplex polymerase chain reaction (PCR) to amplify 9 dystrophin exons described by Chamberlain. Polymorphism linkage analysis was made on DNA with PCR amplification using primers of intragenic short tandem repeat sequences (STR44, STR45, STR49 and STR50), primers of 5′ end (5′DYS II) and primers of 3′end (MZ18, MZ19) in the members of the families. Gene dosage analysis was performed and DQ value was calculated. Results Both of deletions of exons and STR allelic fragments adjacent to the deleted exons were determined in the probands. STR allelic fragments of 6 pairs of heterozygotes, 2 pairs of homozygotes and 11 hemizygotes were detected at those loci in all of the female relatives. 13 female relatives in deleted families were assayed with gene dosage analysis. In 9 /13 female relatives DQ value was in the range of single copy and carrier status was ascertained.Conclusion Repeat sequence polymorphism as well as gene dosage analysis can potentially be used in carrier detection in the deleted families of Duchenne and Becker muscular dystrophy.

Objective To study the clinical manifestations and pathological features of distal myopathies, we investigated 71 distal myopathy patients collected in the past 16 years.Methods Clinical manifestations and pathological features of biopsied muscle specimens were summarized and analysed retrospectively. Results Twenty-six of the 71 patients were of Nonaka type, 38 of Miyoshi type, 2 of tibial muscular dystrophy (TMD) type, 4 of Welander type, and 1 of oculophayngodistal myopathy (OPDM) type. Nonaka type is a sporadic or autosomal recessively inherited disorder with preferential involvement of the anterior tibial muscles. In the 26 patients with Nonaka myopathy, the onset age ranged from 8 to 39 years, averaging 24 years, and the disease was rather rapidly progressive. Sternocleidomastoid, biceps brachii muscle, pectoralis major muscle and quadriceps femoris were also involved as the disease advanced. The serum CK was slightly elevated or normal. Muscle biopsies showed rimmed vacuoles markedly without obvious dystrophic features. 15-20-nm cytoplasmic and nuclear filaments were usually seen on electron microscope. The patients with Miyoshi type were characterized clinically by sporadic or autosomal recessive inheritance, preferential gastrocnemius muscle involvement, and dystrophic muscle pathology. Rimmed vacuoles were occasionally seen. Average age of onset was 23 years (range of 8-41 years). As the disease advanced, patients with Miyoshi myopathy occasionally showed apparent proximal muscle involvement. Serum CK was markedly elevated, ranging from 3-180 times than the normal. Welander type was found in four cases. Onset age was from 30 to 46 years. Weakness always began in the finger and wrist extensors. As the disease progressed, symptoms were spreading to the distal lower extremities slowly. The serum CK level was normal or only slightly elevated. Muscle biopsies showed dystrophic features, with rimmed vacuoles occasionally. The oneset ages of two patients with TMD were from 41 to 42 years. Weakness was confined mainly to the anterior tibial muscle. Muscle biopsies revealed fibre necrosis and regeneration. Rimmed vacuoles were present significantly. OPDM was found in a 38-year-old-onset patient with autosomal dominant inheritance and characterized by the weakness of distal lower extremity and development of extraocular muscles, vocal cord and pharyngeal muscle weakness. Muscle biopsies showed rimmed vacuoles without fibre necrosis.Conclusion Five types of distal myopathies were present in China, and Miyoshi and Nonaka myopathies were more common. The clinical and pathological findings of Chinese distal myopthies should be basically similar to those reported by other countries.