Irritable bowel syndrome(IBS)is one of the most common functional gastrointestinal disorders,of which diarrhea-predominant IBS(IBS-D)accounts for the largest proportion.The pathogenesis of IBS-D is complicated and diverse,and there is currently a lack of clinically effective drugs.The establishment of animal models is an essential tool for further studies of the disease mechanisms,evaluation of clinical efficacy,and drug development,and the preparation and evaluation standards of models are important factors affecting the quality of the research.Based on the currently accepted pathogenesis of IBS-D and the previous modeling experience of our research group,this review systematically summarizes the evaluation method used in animal models of IBS-D in terms of diarrhea observation,visceral sensitivity tests,and intestinal motility tests,to provide a reference for future studies.

Although immune checkpoint inhibitors(ICIs)are widely used in cancer therapy,showing great advantages and development potential,it is accompanied by a series of immune-related adverse reactions,of which myositis is a potentially fatal adverse event,which has attracted great attention.Herein,we reported a case of advanced esophageal cancer with myositis after treatment with camrelizumab,which was characterized by myasthenia gravis(MG)with myasthenic crisis,and recovered after active rescue by multidisciplinary cooperation.

Objective:To evaluate the effectiveness and safety of phacoemulsification cataract extraction combined with intraocular lens implantation (PEI) plus goniosynechilysis (GSL) and goniotomy (GT) for advanced primary angle-closure glaucoma (PACG).Methods:An observational case series study was performed.Fifty eyes of 50 patients with advanced PACG were enrolled in Zhongshan Ophthalmic Center from August 2020 to June 2021.All the patients received PEI+ GSL+ GT and were followed up for over 6 months, with a mean follow-up of 7.5 (6, 10) months.Intraocular pressure (IOP) was measured with a Goldmann applanation tonometer.Best corrected visual acuity (BCVA) was examined with an ETDRS chart and converted to logarithm of the minimum angle of resolution (LogMAR) units for analysis.Types and number of anti-glaucoma medications applied before and after surgery, and the surgical complications were collected.Success rate of surgery was calculated.Complete surgical success was defined as an IOP of 5-18 mmHg (1 mmHg=0.133 kPa) with a reduction of 20% from baseline without anti-glaucoma medication, no vision-threatening complications, no loss of light perception, and no reoperation.Qualified success was defined as an IOP of 5-18 mmHg with a reduction of 20% from baseline with or without anti-glaucoma medication, no vision-threatening complications, no loss of light perception, and no reoperation.This study adhered to the Declaration of Helsinki.This research protocol was approved by an Ethics Committee of Zhongshan Ophthalmic Center (No.2021KYPJ177). Written informed consent was obtained from each subject before entering the cohort.Results:The mean preoperative IOP was (28.81±7.81)mmHg, and the IOP at the end of follow-up was (13.41±4.10)mmHg, showing a statistically significant decrease ( t=12.260, P<0.001). The postoperative IOP was decreased by 13.80 (9.10, 19.40)mmHg, with a percentage decrease of 51.1% (38.6%, 67.1%). The mean preoperative and postoperative BCVA was (0.92±0.11) LogMAR and (0.88±0.10) LogMAR, respectively, and no significant difference was found ( t=-0.560, P=0.580). The number of anti-glaucoma medications was reduced from 2 (1, 3) before operation to 0 (0, 0) after operation.The complete success rate of surgery was 80% (40/50), and the qualified success rate was 94% (47/50). Surgical complications mainly included hyphema in 7 eyes, IOP spike in 7 eyes, and corneal edema in 3 eyes.No vision-threatening complication occurred. Conclusions:PEI+ GSL+ GT is preliminarily effective and safe for advanced PACG by reducing IOP and application of anti-glaucoma medications with few complications.

Objective: To evaluate the effectiveness of health belief model-based health education intervention in improving blood pressure control of patients with hypertension in community settings. Methods: From September 2016 to September 2017, 400 newly diagnosed patients with hypertension were recruited from 6 community healthcare centers with comparable population size and health services in the Shunyi District of Beijing. All community healthcare centers were randomly assigned to the intervention group (206 patients) and the control group (194 patients). Patients in the intervention group received 3 lectures (20-30 min for each) of health belief model-based health education. Patients in the control group received usual care. The basic characteristics, health beliefs, and health literacy were collected, and blood pressure was measured before and after the intervention, respectively. The difference-in-difference model was used to analyze the change of blood pressure and the influencing factors between two groups before and after the intervention. Results: A total of 134 patients in the intervention group and 129 patients in the control group completed the study. After adjusting for the age, gender, family income, medical insurance, chronic diseases and family history, the score of perceived barriers was increased by 1.65 (P=0.016), and perceived seriousness was decreased by 0.73 (P=0.018). The systolic blood pressure of patients was decreased by 7.37 mmHg (1 mmHg=0.133 kPa, P=0.001) and diastolic blood pressure was decreased by 4.07 mmHg (P=0.014), respectively. The β (95%CI) values were -7.37 (-11.88,-2.86) and -4.07 (-7.30, -0.84). The perceived susceptibility and self-efficacy had a significant influence on the blood pressure of patients (P<0.05). Conclusion Health belief model-based health education intervention could significantly improve the blood pressure control of patients with hypertension in the community settings.

Objective To study the constituents of urinary stones in patients in Zhejiang,and analyze the composition difference between patients from northern Zhejiang province and southern Zhejiang province.Methods From October 2012 to October 2018,clinical data of 4 423 urinary stone patients treated in Sir Run Run Shaw Hospital,the Second Affiliated Hospital of Wenzhou Medical University,and Huzhou First People's Hospital was retrospectively analyzed.Infrared spectrum was used to analyze urinary calculi constituents.Among 4 423 patients,there were 3 041 males and 1 382 females,male to female ratio was 2.2∶ 1,and the mean age was (51.2 ±16.5) years.There were 2 974 northern Zhejiang patients and 1 449 southern Zhejiang patients.High incidence age group was 41-60 years [48.2％ (2 136/4 423)].The distribution characteristics of urinary calculi constituents in different groups of sex,age,and region were analyzed.Results Among the 4 423 cases,the mixed urinary stones were dominant in the urinary calculus [73.1％ (3 235/4 423)],in which,the most component was the calcium oxalate monohydrate + calcium oxalate dehydrate + carbonated apatite [36.2％ (1 604/4 423)];among the pure stones,the most component was the calcium oxalate monohydrate [16.3 ％ (719/4 423)].Carbonated apatite stones [70.1％ (970/1 382) vs.61.0％ (1 856/3 041),P ＜0.05] and magnesium ammonium phosphate stones [12.7％ (176/1 382) vs.4.9％ (150/3 041),P ＜ 0.05] were both more prevalent in females than males,but uric acid stones[10.6％ (325/3 041) vs.5.8％ (81/1 382),P ＜0.05] were more common in males than females.The proportions of calcium oxalate stones[90.6％ (961/1 060) vs.76.2％ (935/1 227),P ＜0.05],carbonated apatite stones [77.6％ (823/1 060) vs.50.7％ (623/1 227),P ＜ 0.05],and magnesium ammonium phosphate stones[9.1％ (97/1 060) vs.6.5％ (80/1 227),P ＜0.05] of 0-40 years group were all higher than ＞ 60 years group,however,uric acid stones were more frequent in ＞ 60 years group [3.5％ (38/1 060) vs.17.0％ (209/1 227),P ＜ 0.05].The proportion of calcium oxalate stones in southern Zhejiang was lower than northern Zhejiang [79.0％ (1 145/1 449) vs.89.4％ (2 661/ 2 974),P ＜ 0.05].However,carbonated apatite stones [71.5％ (1 037/1 449) vs.60.1％ (1 789/2 974),P ＜ 0.05],magnesium ammonium phosphate stones [15.1％ (220/1 449) vs.3.5％ (106/ 2 974),P ＜ 0.05],and uric acid stones [10.7％ (156/1 449) vs.8.4％ (250/2 974),P ＜ 0.05] were more prevalent in southern Zhejiang than northern Zhejiang.Conclusions The distribution of constituents of urinary stones in Zhejiang was different in genders,age,and regions.Carbonated apatite stones and magnesium ammonium phosphate stones were more prevalent in females and young people,and uric acid stones were more common in males and old people.Calcium oxalate stones were more common in youths.Moreover,calcium oxalate stones were more frequent in northern Zhejiang,and carbonated apatite stones,magnesium ammonium phosphate stones and uric acid stones were common in southern Zhejiang.

Objective To explore the scientific development direction in medical institutions under the new health care reform,and provide a reference for promotion of scientific innovation and development of medical institutions in Beijing.Methods Through analyzing the fund of Natural Science Foundation of China (NSFC) in 2016,scientific competitive power of medical institutions in Beijing was explored from the aspect of project type,subject classification and talent training.Results The NSFC by medical institutions in Beijing mainly focused on medical science department (92.68％),of which corresponding subjects were mainly oncology,neural and mental disease and traditional Chinese medicine.The project approved rates of tertiary hospitals subordinate to country and Beijing were 43.46％ and 29.22％,respectively.Only a few dispersing talent projects were obtained.Conclusions Funds and approved rate of NSFC increased.Medical institutions in Beijing had relatively strong scientific competitive power in the fundamental researches of major and difficult diseases,and traditional Chinese medicine.Fundamental researches,talent training,research team building and international cooperation should be improved in the further.

[Abstract] Objective: To investigate the expression and clinical significance of PD-1/PD-L1 in gastric cancer (GC) tissues. Methods: Paraffin embedded tumor tissues and clinical data of 82 GC patients who had undergone operation at the Fourth Hospital of Hebei Medical University from January 2007 to December 2007 were collected, and their survival status was followed. The protein expressions of PD-1 and PD-L1 in tumor tissues were detected by immunohistochemistry. Kaplan-Meier analysis and Log-Rank test were adopted to analyze the survival of GC patients, and the ROC curve was plotted. Results: The positive rate of PD-L1 protein expression was 42.68% while the positive rate of PD-1 expression was 13.41% in GC tissues. The positive rate of PD-1 and PD-L1 expression in GC tissues of patients without pre-operative distant metastasis was significantly lower than those patients with pre-operative metastasis (PD1： 3.28% vs 42.86%; PD-L1： 13.11% vs 90.48%; all P<0.01). The positive rate of PD-L1 expression in tumor stroma of patients without pre-operative distant metastasis was significantly lower than those with metastasis (PD-L1: 13.11% v s 47.62%, P<0.01). The resection range of stomach, PD-L1 over-expression and the presence of pre-operative distant metastasis were the adverse factors affecting the prognosis of patients with GC (P<0.05). Conclusion: PD-1 and PD-L1 expressions in GC tissues were closely related to the presence of pre-operative distant metastasis and the depth of tumor infiltration. The postoperative survival of patients who were PD-L1 positive was shorter than the negative ones.

Objective To investigate the therapeutic effect of L-carnitine combined with erythropoietin (EPO) and iron on renal anemia in rats. Methods The renal anemia rat model was established using adenine. All rats were randomly divided into three groups: control group (group A), EPO combined with iron group (group B), and L-carnitine combined with EPO and iron treatment group (group C). The levels of red blood cells (RBC), hemoglobin (Hgb), hematocrit (Hct), C-reactive protein (CRP), Fe in peripheral blood (Fe), serum ferritin (SF) and transferrin saturation (TS) were measured. Pathological changes in the kidney, liver and small intestine tissues were examined using HE staining. Results Compared with the group A, the levels of RBC, Hgb, Hct, Fe, SF, and TS were significantly increased, however, the level of CRP significantly decreased in the groups B and C (P＜ 0. 05). In the group C, the levels of RBC, Hgb, and CRP was higher than the group B (P＜ 0. 05). Furthermore, the pathological changes in the kidney, liver and small intestine tissues were improved in the groups B and C. Conclusions L-carnitine combined with EPO and iron has a therapeutic effect on renal anemia in rats, thus, it deserves further studies and application.

Objective: To investigate the relationship between the mutations in precore/core (preC/C) region of hepatitis B virus (HBV) gene and the postoperative survival in patients with hepatocellular carcinoma. Methods: A total of 81 cases in HBV associated hepatocellular carcinoma (HBV-HCC) patients with cancer tissue genomic DNA were extracted. The preC/C region of HBV was amplified and sequenced, and survival-associated HBV mutations were identified according to the NCBI database. The relationships between the mutations in the preC/C region and HCC survival was analyzed with the Kaplan-Meier method and the Cox proportional hazards model. Eleven mutational sites were identified as statistically significant independent predictors of HBV-HCC postoperative survival. Results: The portal vein thrombosis, tumor TNM classification and size were identified as statistically significant independent predictors of survival in HBV-HCC patients. In the research, we found that seven mutational sites in preC/C region of HBV were associated with independent risk factors for postoperative survival in patients of HBV-HCC. The following five mutational sites were identified as statistically significant independent predictors of HBV-HCC survival: 1915, 2134, 2176, 2221, 2260. The mutational site of 1979 and 2245 were identified for the association with survival at a borderline significance level. Conclusions The portal vein thrombosis, tumor TNM classification, size and seven mutational sites in the PreC/C region were identified as independent predictors of postoperative survival in HCC patients.

Objective To study the immunoregulatory effect of sodium butyrate(NaB)on T helper cell 17(Th17)and the effect on toll-like receptor 4(TLR4)signal pathway in autoimmune hepatitis (AIH).Methods Fifty male C57BL/6 mice(6 weeks of age)according to the random number table method divided into control group(n=10),AIH group(n=10),NaB group(n=10)and high roughage diet(HRD)group(n=10),and the other ten mice were used to extract hepatic sytosolic S-100.After the establishment of AIH model,mice in NaB group were given sodium butyrate 500 mg/(kg·d)by gavage and those in HRD group were fed with high-fiber stuff.After 3 weeks of treatment,all the mice were sacrificed.The pathological change was observed.The serum levels of alanine aminotransferase(ALT), aspartate transaminase(AST),IL-17A and TNF-α,the proportion of Th17 in spleen,the expression levels of TLR4 and myeloid differentiation factor 88(MyD88)in liver were observed in each group.The tests of normality and homogeneity of variance were used to compare the means of each group.One-way analysis of variance and multiple comparative analyses were used in the statistical analysis.Results HE staining showed that inflammatory cell infiltration and hepatocyte necrosis were significantly reduced in mice treated with NaB and HRD compared to AIH group.Serum ALT levels in control group,AIH group,NaB group and HRD group were(24.833 ± 2.229),(88.333 ± 9.543),(27.167 ± 3.189)and (29.833 ± 6.113)U/L,respectively,while AST levels in each group were(97.00 ± 14.953),(285.000 ± 35.434),(139.500 ± 38.976)and(127.167 ± 28.687)U/L,respectively.The differences among groups were all statistically significant(F=156.49 and 44.118,respectively,both P<0.01).The proportion of Th17 in spleen and the expressions of the transcription factors retinoid-related orphan receptor gamma t in the spleen of the NaB group and HRD group were significantly lower than those of AIH group.The differences were statistically significantly(F=21.780 and 68.283,respectively,both P<0.05).The expressions of TLR4 and MyD88 in liver of AIH group were significantly higher than control group,but those were inhibited in NaB group and HRD group.The differences were statistically significantly(F= 26.235 and 28.293,respectively,both P<0.01).The expressions of IL-17 and TNF-α in liver and serum decreased in NaB group and HRD group.Conclusion NaB exerts an immunoregulatory effect in AIH and improves inflammatory reaction in liver.