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Objective To investigate the association of lipid accumulation product (LAP) and visceral fat index (VAI) with nonalcoholic fatty liver disease (NAFLD) and the value of LAP and VAI in predicting the risk of NAFLD. Methods A total of 708 subjects who underwent physical examination in China-Japan Friendship Hospital from September 2018 to May 2019 were enrolled and divided into NAFLD group ( n =426) and non-NAFLD group ( n =282), and the two groups were compared in terms of LAP, VAI, and related biochemical parameters. The independent samples t -test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups.The chi-square test was used for comparison of categorical data between groups. The Spearman test was used for correlation analysis. The subjects were divided into L1-L4 groups based on LAP and V1-V4 groups based on VAI, and the distribution of NAFLD was compared between groups; a logistic regression analysis was used to calculate the risk of NAFLD at different levels of LAP and VAI, and the receiver operating characteristic (ROC) curves were plotted for LAP, VAI, waist circumference (WC), and body mass index (BMI) in predicting NAFLD in different sex and body weight subgroups, so as to evaluate the value of each index in the prediction and diagnosis of NAFLD. Results Compared with the non-NAFLD group, the NAFLD group had significantly higher age, proportion of male subjects, proportion of subjects with a smoking history, and levels of LAP, VAI, WC, BMI, systolic blood pressure, diastolic blood pressure, alanine aminotransferase, aspartate aminotransferase, total cholesterol, triglyceride, low-density lipoprotein cholesterol, fasting blood glucose, and serum uric acid, as well as a significantly lower level of high-density lipoprotein cholesterol (all P 0.7 in predicting the onset of NAFLD in different sex and body weight subgroups; the AUCs of LAP and VAI in the female subgroup were significantly higher than those in the male subgroup (LAP: 0.886 vs 0.785, P < 0.05; VAI: 0.824 vs 0.748, P < 0.05), and the corresponding sensitivities and specificities of LAP and VAI in the female subgroup were also higher than those in the male subgroup (sensitivity: LAP: 79.8% vs 63.7%; VAI: 77.9% vs 77.0%; specificity: LAP: 85.0% vs 81.1%; VAI: 77.6% vs 62.3%). Conclusion The risk of NAFLD increases with the increase in the levels of LAP and VAI. Both LAP and VAI have a good value in predicting NAFLD in different sex and body weight subgroups, especially in predicting NAFLD in the female population.
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Objective:To investigate the relationship between the E2 and E4 alleles of apolipoprotein E (apoE) gene and myocardial infarction (MI) in type 2 diabetes Mellitus (T2DM) patients, and to explore the relationship between apoE polymorphism and blood lipid metabolism.Methods:This case control study was conducted from August 2016 to March 2020 in China-Japan Friendship Hospital, 3 459 inpatients with T2DM were included including 3 044 patients without MI (T2DM group) and 415 patients with MI (T2DM+MI group). Real time fluorescent quantitative PCR was used to detect apoE polymorphism. Automatic biochemical analyzer was used to detect lipid levels. Logistic regression analyses were performed to determine the association of apoE with risk of MI in patients with T2DM.Results:(1) The frequency of E4 allele in T2DM+MI group (12.29%, 102/830) was significantly higher than in T2DM group (9.13%,556/6 088), while the frequency of E2 allele in T2DM+MI group (7.35%,61/830) was significantly lower than that in T2DM group (8.21%,500/6 088), P=0.012. Logistic regression analyses showed that E4 allele carrier (E3/E4+E4/E4) faced a higher risk for MI in T2DM patients ( OR=1.48, 95% CI 1.14-1.92, P=0.003), while E2 allele carrier(E2/E3+E2/E2)did not face a higher risk of MI in T2DM patients ( OR=0.88, P=0.642). (2) The levels of apoE polymorphism and blood lipid: The levels of TC, LDL-C and apoB increased in the order of E4 allele, wild type and E2 allele ( P<0.05). The levels of HDL-C, apoA1 and apoE decreased in the order of E4 allele, Wild type and E2 allele ( P<0.05). Conclusion:The E4 allele is a risk factor for MI in T2DM patients, and apoE polymorphism can affect blood lipid level in this patent cohort.
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Objective:To understand the status quo and impact of Beijing Standardized Residency Training program following three years of the medical education synergy policy from the perspective of residents.Methods:Online questionnaire was used from April to May 2018 to investigate two types of residents who had completed the program in Beijing in 2018, and a comparison was made with the 2014 training program, activities, evaluation, and support conditions. Statistical descriptions and Wilcoxon signed-rank test were used for analysis.Results:A total of 3 293 residents completed the Beijing Standardized Residency Training, of which 54.75% were resident physicians, and 45.25% were graduate students in clinical medicine. Compared with 2014, the completion rate of the disease types and quantity, clinical operation types and quantity required by the training plan has been significantly improved, with the proportions being 93.77% and 92.80%, respectively. The implementation rate of examinations in 7 departments including Internal Medicine was greater than 90%, which is significantly higher than that in 2014; The conditions for training support had improved significantly.Conclusions:The impact of Beijing Standardized Residency Training Program was already emerging since the medical education synergy policy in place. It was recommended that various measures be taken to steadily improve the quality of the " dual-track system" .
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Objective:To evaluate visceral sensitivity,gut barrier function and autonomic nerve function (ANF) in patients with diarrhea-predominant irritable bowel syndrome (IBS-D),and to explore their roles in IBS-D pathophysiology.Methods:A total of 46 IBS-D patients (IBS-D group) were selected from the Department of Gastroenterology of China-Japan Friendship Hospital from October 2015 to March 2016,and 20 healthy volunteer were served as a control group (HC group).Clinical and psychological symptoms were evaluated by questionnaire,and visceral sensitivity to rectal balloon distention,gut barrier function and autonomic nerve function (ANF) were examined.The difference in the abovementioned indexes were compared between the 2 groups,and the correlations in the parameters were analyzed in the IBS-D group.Results:The scores of IBS symptom severity scale (IBS-SSS),Hamilton anxiety scale (HAMA),Hamilton depression scale (HAMD) and visceral sensitivity index (VSI) were significantly higher in the IBS-D group than those in the HC group (P＜0.01).In the visceral sensitivity test,maximum tolerable threshold in the IBS-D group was significantly decreased compared to that in the HC group (P＜0.01);there was no significant difference in first sensation threshold and defecating sensation threshold between the two groups (P＞0.05).As gut barrier function markers,the serum diamine oxidase (DAO) and d-lactate were significantly increased in the IBS-D group (P＜0.05).In ANF test,the total score and parasympathetic score as well as the proportion of abnormal scores in the IBS-D group were significantly higher than those in the HC group (P＜0.05).In IBS-D group,the HAMA,VSI and serum DAO were positively correlated with IBS-SSS (r=0.528,0.575,0.507;P＜0.01),while the 3 visceral sensitivity thresholds were negatively correlated with IBS-SSS (r=-0.636,-0.476,-0.697;P＜0.01);in addition to the IBS-SSS,the HAMA,HAMD,VSI and serum DAO were also significant negatively correlated with the visceral sensitivity thresholds (all P＜0.05);no significant correlations were found between the ANF and the other parameters.Conclusion:IBS-D patients show psychological symptoms,visceral hypersensitivity,impaired gut barrier function and abnormal ANF characterized by parasympathetic dysfunction;the former 3 factors are all associated with disease severity,and thus may play vital roles in IBS-D pathophysiology.
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ObjectiveTo investigate the antioxidant effect of matrine and its clinical effect in the treatment of rats with nonalcoholic steatohepatitis (NASH). MethodsA total of 30 rats were randomly divided into three groups: control group, NASH group, and matrine group, with 10 in each. A high-fat diet was used to establish the rat model of NASH, and matrine was given by gavage for treatment at a dose of 36 mg·kg-１·d-1. The changes in body weight and liver weight were observed in all rats. HE staining was used to observe the histopathological changes of the liver. The serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) and the content of reduced glutathione (GSH), superoxide dismutase (SOD), and malondialdehyde (MDA) in liver tissue were measured. A one-way analysis of variance was used for the comparison between multiple groups, and the SNK-q test was used for further comparison between any two groups. ResultsCompared with the NASH group, the matrine group had significant reductions in the serum levels of ALT and AST (ALT: 52.0±3.0 U/L vs 41.8±3.7 U/L, P＜0.001; AST: 233.6±9.4 U/L vs 170.1±1.8 U/L, P＜0.001). The matrine group showed marked improvement in the histopathological changes of the liver compared with the NASH group. Compared with the NASH group, the matrine group had significantly increased content of SOD and GSH in liver tissue (SOD: 17.7±2.0 μg/mg vs 27.0±3.6 μg/mg, P＜0.001; GSH: 16.5±1.6 U/mg vs 28.5±2.1 U/mg, P＜0.001) and significantly reduced content of MDA (22.9±1.9 nmol/mg vs 17.8±1.8 nmol/mg, P＜0.001). ConclusionMatrine has an antioxidant effect and a marked clinical effect in the treatment of rats with NASH.
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Objective To investigate the correlation between dynamic changes in esophageal impedance and dilated intercellular space (DIS) of patients with acid-induced non erosive reflux disease (NERD).Methods From September 2013 to July 2014,a total of 35 patients with NERD and 20 healthy controls were selected and underwent 24 h multichannel intraluminal impedance and pH monitoring (MII-pH monitoring),acid perfusion test and gastroendoscopy examination.One piece of mucosa tissue was taken under gastroendoscope from the anterior and posterior walls at 2 cm above the dentate line of the esophagus.Intercellular space (ICS) of the esophageal epithelia cells was measured by software after hematoxylin and eosin staining.t test and variance analysis were performed for statistical analysis.Pearson correlation analysis was used for correlation analysis.Results Impedance baseline of distal esophagus and impedance recovery rate of patients with NERD were lower than those of healthy control group,which were (2 998±701) Ω vs (3 880±1 054) Ω and (30.1±14.0) Ω/min vs (53.0±14.5) Ω/min,and the differences were statistically significant (t=3.65,5.41;both P＜0.01).Compared with healthy control group,ICS of the esophageal epithelial cells was obviously wider (1.03 ± 0.20) μm vs (0.66±0.14) μm,and the difference was statistically significant (t=-6.57,P＜0.01).Impedance baseline of esophagus and impedance recovery rate of patients with positive acid perfusion test were lower than those of patients with negative acid perfusion test,which were (2 755±680) Ωvs (3 411±536) Ω and (25.4±13.0) Ω minvs (33.4±9.8) Ω /min,and the differences were statistically significant (t =2.99,2.03;both P＜0.05).The correlation between impedance recovery rate and ICS was negative (r=-0.70,P＜0.01).Conclusions Recurrent reflux induced injury and delayed mucosal headline may be the factors of impaired mucosal integrity in patients with NERD.The changes esophageal of impedance baseline to a certain extent reflected the degree of esophageal mucosal integrity impairment.
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Objective To evaluate the possibility of slow and rapid liquid nutrient loading test (LNLT) in the proximal gastric function assessment according to the results of gastric barostat testing.Methods From April to August in 2013,20 healthy volunteer were selected.The sensitivity of gastric,basic abdominal pressure,gastric sensing threshold,gastric discomfort and pain thresholds were examined by barostat.The average gastric volume after fasting was tested by barostat,which reflected gastric accommodation.And then 200 mL liquild meal was taken in five minutes by the volunteers.The difference value between the maximum gastric volume in 60 minutes after taking the meal minus the average gastric volume after fasting was used to evaluate the proximal gastric adapted diastolic function.In LNLT,volunteers drank 100 mL/min and 15 mL/min (rapid and slow) liquid meal.The threshold value of drinking volume,satiety drinking volume and maximum drinking volume were determined.Pearson correlation analyses were performed in the results of fast and slow LNLT,correlation between LNLT and sensitivity of gastric,gastric adapted diastolic function tested by barostat.Results The basic abdominal pressure,gastric sensing threshold,gastric discomfort and pain thresholds,gastric volume after fasting,maximum gastric volume and adapted diastolic volume was (6.8±1.2) mmHg (1 mmHg=0.133 kPa),(2.7±1.9) mmHg,(5.2±2.0) mmHg,(7.3-±-2.1) mmHg,(188.7-±-80.0) mL,(505.2±133.7) mL and (316.5±87.7) mL,respectively.The maximum gastric volume after the meal was at (9.8±3.3) min after meal.In rapid LNLT,the threshold value of drinking volume,satiety drinking volume and maximum drinking volume of volunteers was (209-±-96),(501±148) and (674±199) mL,respectively,and that in slow LNLT was (107 ± 43),(340 ± 134) and (524 ± 213) mL,respectively,there was correlation between rapid and slow LNLT (r=0.768,0.825 and 0.856,all P＜0.01).The maximum drinking volume of rapid and slow LNLT was at (8.6± 1.2) and (34.9±6.4) minutes after meal.Threshold value of drinking volume in the slow drinking test was positively correlated with the gastric sensing threshold (r=0.714,P＜0.01).Satiety drinking volume in the slow drinking test was correlated with gastric sensing threshold,gastric discomfort and pain thresholds (r=0.599,0.650 and 0.622,all P＜0.01).The proximal gastric adapted diastolic volume was related with slow satiety drinking volume,rapid satiety drinking volume,slow maximum drinking volume and rapid drinking volume (r＝0.543,0.636,0.527 and 0.493,all P＜0.05).Conclusions Threshold value of drinking volume and satiety drinking volume in the slow LNLT is more suitable for evaluating the sensitivity of stomach.Satiety drinking volume in the rapid LNLT is more suitable for the evaluating of gastric adapted diastolic function.
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Objective To analyze the correlation of gamma-glutamyl transpeptidase (GGT)level with alpha-fetoprotein (AFP)level and to re-evaluate the diagnostic value of GGT for hepatocellular carcinoma (HCC).Methods Four hundred and seventy-two patients with HCC or liver cirrhosis,who were hospitalized in China-Japan Friendship Hospital from January 2003 to June 2009,were included in the study.The correlation between GGT and AFP was analyzed by Spearman nonparametric test.The cut-off values for the two parameters were determined based on their receiver operating characteristics (ROC)curves,areas under the ROC curve (AUCs),sensitivity,and specifici-ty,and the diagnostic values were presented using their sensitivity,specificity,and correct index.Statistical analysis was performed using SPSS 17.0.Normally distributed continuous data were analyzed by independent-samples t test,while non-normally distributed continuous data were analyzed by Mann -Whitney U test.Categorical data were analyzed by Pearson chi -square test,continuity-corrected chi -square test,or Fisher’s exact test.Results Among 472 patients,224 were diagnosed with HCC,and 248 with liver cirrhosis.Compared with cirrhotic patients,HCC patients had a significantly higher GGT level (113 (58-254)U/L vs 38 (22-72)U/L,Z=-11.037,P<0.001)and a significantly higher AFP level (429.5 (15.7-1210.0)ng/ml vs 5.7 (3.4-18.2)ng/ml,Z=-10.157,P<0.001).A significant correlation was found between GGT and AFP (r=0.449,P<0.001).The AUC was 0.784 for GGT and 0.788 for AFP.The cut-off value was 60 U/L for GGT and 20 ng/ml for AFP.The sensitivity was 74.1%for GGT,71.8%for AFP,and 90.7%for a combina-tion of the two parameters,the specificity was 70.2%,77.6%,and 58.7%,respectively,and the correct index was 0.443,0.494,and 0.494,respectively.Conclusion GGT may be regarded as one biomarker for HCC,and its level is significantly correlated with AFP level. The diagnostic value of AFP may not be improved when used in combination with GGT.
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Objective To evaluate proximal gastric function in patients with functional dyspepsia (FD) met Rome Ⅲ criteria and its subtypes.Methods Thirty FD patients were enrolled,including 15 patients with postprandial distress syndrome (PDS) and 15 patients with epigastric pain syndrome (EPS).A total of 30 healthy volunteers were recruited as control.All the subjects received barostat examination.Minimal distending pressure (MDP),pressure and volume of thresholds for first sensation and maximal tolerance for gastric sensitivity were recorded.When the pressure level was MDP+2 mmHg (1 mmHg=0.133 kPa),average volume at 30 minutes before meal,averaged volume at 60 minutes after meal and maximum accommodation volume after meal were recorded,and receptive diastolic volume was calculated.The gastric hypersensitivity and impaired accommodation were observed.Student's t test or x2 test was performed for statistical analysis.Results MDP,pressure of first-sensation,maximum sensation pressure,volume of first sensation and maximal sensation volume of FD group were (6.17 ±1.95) mmHg,(8.44±2.01) mmHg,(14.62±3.72) mmHg,(123.59±53.26) mL and (451.26±140.44) mL,respectively; which were lower than those of healthy control group ((9.27±1.99) mmHg,(12.04±2.66) mmHg,(19.74±4.18) mmHg,(168.41±73.06) mL and (556.89±124.07) mL),and the differences were statistically significant (t=-6.080,-5.900,-5.011,-2.723 and-2.995,all P＜0.01).The averaged volume at 30 minutes before meal and 60 minutes after meal was (212.19±120.82) mL and (333.97±121.86) mL while those of healthy control group was (191.69±66.19) mL and (385.58±83.05) mL,and there were no significant differences between the two groups (both P＞0.05).The maximum postprandial accommodation volume and receptive diastolic volume of FD group were (405.10±111.29) mL and (190.16±97.22) mL,which were lower than those of healthy control group ((461.10±87.60) mL and (262.83±78.39) mL),and the differences were statistically significant (t=-2.599 and-3.187,both P＜0.05).The maximum postprandial accommodation volume of FD patients was at 15 to 20 minutes after meal and in healthy control it was at five to ten minutes after meal.Among the 30 FD patients,12 patients (40 ％) had gastric hypersensitivity,including eight PDS patients and four EPS patients,and there was no significant difference in the ratio between two groups (P＞0.05) ;nine patients (30 ％) had impaired accommodation,including five PDS patients and four EPS patients,and there was no significant difference in the ratio between two groups (P＞ 0.05).Conclusions Gastric hypersensitivity and impaired accommodation often appear in FD patients,and there is no significant difference between PDS and EPS subtypes.FD patients with different pathophysiologic mechanisms cannot be efficiently distinguished according to Rome Ⅲ criteria.
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Objective To evaluate the clinic application effects of laparoscopy in the diagnosis and treatment of abdominal difficult and complicated diseases.Methods The clinical data of 64 cases of agnogenic abdominal diseases underwent laparoscopic exploration and biopsies were retrospectively analyzed.All the patients were difficult cases to diagnose,who have one or more clinical situations,such as abdominal pain,ascites of unknown origin,abdominal mass and intestinal obstruction,and obscure hemorrhage of small intestine.Results Definite diagnosis was made in 62 patients after laparoscopy (96.9％).In patients with ascites,abdominal mass,intestinal obstruction and hemorrhage of small intestine,the definite diagnostic rate were 93.3％,100.0％,100.0％ and 6/6,respectively.The complication rate of laparoscopic exploration was 1.6％ (1/64).Underwent laparoscopic exploration,14 of 64 cases (22％) were treated by operation.Among them,8 cases (8/14) were treated by therapeutic laparoscopy,and other 6 cases (6/14) were treated by abdominal surgery without any comliactions.Conclusion Laparoscopic exploration is safe and effective in diagnosis and treatment of abdominal difficult and complicated diseases.
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Objective To explore the corrective role of lived combined Bacillus subtilis and Enterococcus faecium enteric-coated capsules on the bacteria overgrowth in small intestinal (SIBO)and assess the efficacy and possible mechanism of it in the treatment of diarrhea predominant irritable bowel syndrome (IBS-D).Methods From May to August 2013,IBS-D patients were collected.Screened by lactulose hydrogen breath test (LHBT),and a total of 60 SIBO positive patients were enrolled in the study and divided into experimental group and control group.Live combined Bacillus subtilis and Enterococcus faecium enteric were given to the experimental group and starch given to the control group,both were capsules,each 250 mg,three times per day,two capsules each time,and the treatment course was four weeks.Before and after administration a questionnaire was conducted in the study objects,including basic information (age,gender,disease type,family history and accompanied diseases) and the severe degree of the symptoms (abdominal pain,bloating,abdominal discomfort,increased frequency of defecation,defecation urgency,defecation endless,defecation hard,bowel and exhaust).Fasting peripheral venous blood was taken from the study individuals before and after administration.The level of interleukin (IL)-1β,IL-6,IL-10,IL-12 and tumor necrosis fator-α(TNF-α) in serum were detected by enzyme linked immunosorbent assay(ELISA).t-test was performed for measurement data comparison between two groups,and chi-square test was for count data comparison.Results Among 60 SIBO positive IBS-D patients,30 patients were in experimental group and 30 in control group.The SIBO negative conversion rate of experimental group and control group was 63.3 ％(19/30) and 30.0％ (9/30),the difference was statistically significant (x2 =6.696,P＜0.05).Before and after administration,in control group there were no significant differences in severe degree scoring of abdominal pain,bloating,abdominal discomfort,increased frequency of defecation,defecation urgency,defecation endless,defecation hard,bowel and exhaust or the level of TNF-α,IL-1β,IL-6,IL-10 and IL-12 (all P＞0.05).In experimental group,before and after administration there were statistically significant differences in severe degree scoring of abdominal floating (2.97 ± 1.45 vs 2.61±1.28),level of IL 1β ((1390.81±103.95) ng/L vs (1209.76±113.26) ng/L)and IL-10/IL-12 (4.94±0.74 vs 5.30±0.43),the differences were statistically significant (t=2.052,5.279 and 2.282,all P＜0.05).There were no signinficant differences in other items (all P＞0.05).Conclusions Lived combined Bacillus subtilis and Enterococcus faecium enteric coated capsules could alleviate the symptoms of abdominal floating.The possible mechanism may related with correcting SIBO,inhibiting low degree of inflammation reaction and regulating the inflammatory cytokines.
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A new type of gastric electrical stimulator (GES) was introduced. After the stimulator was implanted in beagle dogs, its stimulating effects and the pathological changes at the implant site were observed to study the safety and efficacy of stimulator as well as the tissue compatibility of the materials used. The results showed that, this type of stimulator was safe and capable of inhibiting food intake of the dogs, and that the materials used had good tissue compatibility.
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Animals , Dogs , Female , Electric Stimulation , Methods , Electrodes, Implanted , Histocompatibility , Stomach , PhysiologyABSTRACT
Objective To observe the effect of acute retrograde gastric electrical stimulation (RGES) on gastric accommodation,emptying and gastrointestinal hormones releasing in obese patients. Methods Sixteen obese patients were examined. On the first day,a pair of mucosal gastric electrodes was placed under endoscope. The liquid meal load test and the standard solid meal gastric emptying test were carried out on the second day. RGES was performed starting at 30 minutes before each test and through the whole testing process. The serum leptin,ghrelin,resistin and peptide YY were examined before and after the standard solid meal gastric emptying test. On the third day,sham stimulation was given. The effect of acute RGES on related index was compared by self-control.Results BMI of the 16 patients was (32. 90±2. 99) kg/m2. Acute RGES significantly reduced the liquid meal volume of fullness [(460±148) ml and (630±219) ml,t=-7. 200,P＜0. 01] and the maximal tolerable meal volume [(699±215) ml and (926±295) ml,t=- 5. 390,P＜0. 01]. The effects of RGES and sham RGES on half-emptying time of standard solid meal was (109±26) min and (103±31) min (t=1. 009,P= 0. 329);on the retention rate of standard solid meal at one hour and two hour was (63. 37±9. 75)% and (59. 73±12.87)% (t=1. 834,P= 0. 087),(42.22±13.97)%and (38. 33±16. 87)% (t= 1.780,P= 0. 095),respectively. The ratio of gastrointestinal hormones after and before the stimulation also of the sham stimulation,leptin was 1. 03±0. 34 and 1. 08±0. 38(t=-0.386,P=0. 705),ghrelin was 0. 99±0. 11 and 0. 98±0. 12 (t= 0. 413,P=0.685),resistin was 1. 11±0. 25 and 0. 99±0. 24 (t= 1. 753,P= 0. 100),and peptide YY was 1. 56±0. 71 and 1. 33±0. 61 (t=1. 402,P= 0. 181). Conclusions In obese patients,acute RGES significantly reduce the liquid meal volume by lower gastric accommodation,to certain extent which will delay gastric emptying. There is no significant influence on gastrointestinal hormones releasing.
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Objective To study the effects of matrine on proliferation, cell cycle and apoptosis of human hepatocarcinoma cell line HepG2 and probe into the mechanisms of its anti-hepatocarcinoma effects.Methods The HepG2 cells were treated with different concentration of matrine (0.0125, 0.02, 0.05, 0.1, 0.2,0.4, 0.8, 1.6 g/L) for different time (24, 48, 72 h), then investigate the effects of matrine on cell proliferation by MTT, and the effects on cell cycle and apoptosis by flow cytometry. Results Matrine can inhibit the HepG2 cells proliferation at the concentration of 0.1 g/L and above in a concentration-dependent and timedependent manner(P ＜0.01). The result of FCM showed that the cell cycle of HepG2 was retarded at G1 phase treated with matrine for 48 h at the concentration of 0.8 g/L [(75.3±6.5)% vs (64.1±6.3)%, P ＜0.05], whereas was retarded at G2 phase treated with matrine for 48 h at the concentration of 1.6 g/L [(29.1 ±9.1)% vs (11.6±2.1)%, P ＜0.01]. The apoptosis of HepG2 cells can be induced by matrine for 12, 24 h or 48 h at the concentration of 0.4, 0.8, 1.6 g/L. Conclusion Matrine can inhibit cell proliferation, interfere cell cycle and inducing apoptosis of hepatocarcinoma cells, which may be involved in the mechanisms of matrine's antihepatocarcinoma effects.
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Based on the theory of organizational performance appraisal and the needs of developing China's hospital performance assessment system, the paper proposed the concept and emphasized the significance of establishing a comparative hospital performance assessment system in China. By sharing identical experiences from overseas, the paper also advocates that as China is building its comparative hospital performance assessment framework, it is imperative to verify the comparability of hospital performance assessment indicators, build a quality-centered comparative model for hospital performance assessment, and a three-tier comparative model to cover hospitals, departments and posts. These efforts will further improve China's performance assessment system.
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Objective To study the diagnostic value of porphobilin staining of gastric mucus for primary pathologic duodenogastric reflux (DGR). Methods A total of 58 DGR patients diagnosed from January, 2007 to April, 2008 were recruited to the study as DGR group, and 21 healthy volunteers as control.All subjects underwent 24-hour intragastric bilirubin monitor and gastroscopy. Bilirubin absorption value of 0. 25 and median reflux time of 23.60% were taken as thresholds to differentiate low reflux group ( reflux time ＜ 23.60% ) and high reflux group (reflux time ≥23.60% ). Porphobilin staining of gastric mucosa was quantitatively analyzed. Results Deposition of porphobilin in mucosa of gastric antrum, gastric angle and gastric body in primary pathologi DGR group was significantly higher than those in healthy group (P ＜0. 05 ). The occurrence of atrophic and intestinal metaplasia of gastric antrum in high reflux group was significantly higher than that of low reflux group (P ＜ 0. 05). Deposition of porphobilin in mucosa of gastric antrum, gastric angle and gastric body in high reflux group was significantly higher than that of low reflux group (P ＜ 0. 05 ). The New Sydney system pathological scores of gastric antrum and angle of high reflux group was higher than that of low reflux group ( P ＜ 0. 05 ). The deposition of porphobilin in mucosa of gastric antrum and gastric angle was positively correlated with New Sydney system pathological scores in primary pathological DGR group (r=0.59, P=0.041 andr=0.73, P=0.038). Conclusion Porphobilin staining of mucosa in gastric antrum can reflect the severity of bile reflux, and is positively correlated with the extent of gastric mucosal lesion, which may be helpful in diagnosis of primary pathological DGR.
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Objective The aim of this study is to evaluate the accuracy of EUS in rectal cancer restaging after neoadjuvant therapy. Methods EUS staging was performed after neoadjuvant therapy in 61 patients who were diagnosed as having local advanced rectal cancer. All patients underwent subsequent surgi-cal resection and complete pathologic staging. Results Compared with pathological staging, the total accura-cy of post-therapy EUS T-staging was 59.0% (36/61). The T-overstaging rate was 36.1% (22/61) and un-derstaging rate was 4.9% (3/61). Accuracy of EUS N-staging was 68.9% (42/61), N-overstaging and un-derstaging rates were 14.7% (9/61) and 16.4% (10/61), respectively. Conclusion The accuracy of EUS restaging for rectal cancer after neoadjuvant therapy is relatively low.
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Objective To investigate the effects of cell proliferation and apoptasis on the develop-ment of gastric mucosal lesion in patients with primary pathological duodena-gastric reflux (DGR). Methods Gastroscopy, histologie examination of gastric mucosal biopsy and 24-hour intra-gastric bilirubin monitoring with Bilitec 2000 were performed in 58 patients with primary pathological DGR. Immunohisto-chemical staining was used to detect the expressions of Ki-67 and Bcl-2 proteins. Cell apoptosis in gastric mucesa was determined by TUNEL technique. Results The proliferating index (PI) and apoptosis index (AI) in patients with primary pathological DGR were significantly higher than those in control group (P< 0.05). The differences of PI and AI between high reflux group and low reflux group were significant (P< 0.05). The incidence difference of chronic superficial gastritis (CSG) and chronic atrophic gastritis (CAG) in gastric antrum between the two groups was significant (P<0.05). With lesion progressing from normal gastric mucosa, CSG, CAG to intestinal metaplasia (IM), PI and AI increased gradually and consistently. PI was still on the rise after dysplasia (Dys), but AI decreased. The positive expression rate of Ki-67 in Dys were significantly higher than that of other groups (P<0.05), so was that of Bcl-2 (P<0.05). Conclusion Cell proliferation and apoptesis may be one aspect of the main pathogenesis of gastric mucesa lesion and cell dysplasia in patients with primary pathological DGR. Over-expreasion of Ki-67 and Bcl-2 proteins in CAG, IM and Dys may play a key role in the development of gastric cancer.
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Objective To study the expression of tyrosine protein kinase in hepatocellular carcinoma(HCC)and observe the correlation between tyrosine protein kinase and clinical features.Methods A total of 30 cases with HCC were enrolled in this study.ERK,P38,C-jun,JAK2,STAT3 and STAT5 were detected by immunohistochemical method using tissue chip technology.Results The expression of ERK(0.220±0.033),P38(0.174±0.024),C-jun(0.183±0.064),JAK2(0.192±0.044),STAT3(0.197±0.078)and sTAT5(0.181±0.066)in HCC was significantly higher than that(0.065±0.028,0.058±0.028,0.042±0.016,0.070±0.030,0.052±0.024,0.052±0.023)in cirrhosis 1iver tissues(P＜0.01).There was significantly positive correlation of the expression between ERK,C-jun,JAK2,STAT3 and STAT5(P＜0.01 or P＜0.05).But the expression of P38 was negatively correlated with ERK in the HCC tissues(r=-0.404,P＜0.05).JAK2 had significant correlation with tumor differentiation.The expression of J AKz in stage Ⅲ was significantly higher than that in stage Ⅰ and Ⅱ cancer tissues.Conclusion There is important significance of the excessive activation of MAPK and JAK-STAT signaI transduction in hepatocellular carcinoma process.The unbalance of signal transduction might be one of the pathogenesis of tumor progress.
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Objective To study the association among gastric mucosal lesions caused by primary pathological duodenogastric reflux(DGR),H.pylori infection,and bile reflux.Methods Twenty-four hour intragastric bilirubin monitoring were performed on 58 patients with primary pathological DGR.The patients were divided into high reflux group(n=29)and lOW reflux group(n=29)based on the severity of bile reflux(＜23.60%).The association among gastric mucosal lesions,H.pylori infection,and bile reflux were analyzed.Results The positive rate of H.pylori infection was 20.7% (6/29)in high reflux group and 48.3%(14/29)in low reflux group(P＜0.05).The frequency of intestinal metaplasia in gastric antrum and angularis in high reflux group was higher than that in low reflux group(P＜0.05).The pathological scores of gastric antrum and angularis in H.pylori positive group and high reflux group were higher than those in H.pylori negative group and low reflux group (P＜0.05).The time percentage of bilirubin absorbance≥0.25 in H.pylori positive group was lower than that in negative group(P＜0.05),while the difference in short reflux frequency,long reflux frequency,longest reflux time,maximum,mean and median value of absorbance between H.pylori positive and negative groups showed no significant difference(P＞0.05).The time percentage of bilirubin absorbance≥0.25 was positively correlated with pathological scores of gastric antrum and angularis in both H.pylori positive and negative groups(P＜0.05),but was not correlated with that of gastric body(P＞0.05).Conclusions In patients with primary pathological DGR,excessive bile reflux is related to chronic lesion of gastric mucosa.regardless of H.pylori infection.Bile reflux may inhibit H.pylori to locate in gastric mucosa.H.pylori infection and bile reflux may co-contribute to gastric mucosal lesions.