ABSTRACT
Irritable bowel syndrome is a common functional gastrointestinal disorder, among which diarrhea-type irritable bowel syndrome (IBS-D) is the main type in China, which is seriously affecting the quality of life for patients. The pathogenesis of IBS-D is still unclear. It has been found that Intestinal flora disorder is an important pathogenesis of IBS-D. There is a close relationship between intestinal flora and IBS-D TCM syndrome types, and there are differences in intestinal flora of different TCM syndrome types of IBS-D. However, TCM syndrome types are a complex and multi-factor combination. Therefore, based on the TCM theory of nature and location of disease, this article proposed the following conclusions through analyzing previous studies on intestinal flora of different TCM syndromes of IBS-D, including that the intestinal flora of different TCM syndromes have different characteristics and there are differences in the functions of flora, deficiency and excess of disease are associated with the diversity and abundance of intestinal flora, cold and heat of disease are related to the proportion of beneficial bacteria and opportunistic pathogens, and the characteristics of intestinal flora are the microcosmic manifestation of the disease position of TCM. In addition, this article also proposed the application of fecal bacteria transplantation based on the theory of nature and location of disease. Based on this theory, the study on intestinal flora of IBS-D can provide help for objectification of TCM syndrome types, and also provide TCM research ideas for revealing the pathogenesis of IBS-D.
ABSTRACT
Objective: To investigate the correlation between the expression of p53, p63 or PIM1 protein and the survival of patients with nodal or extranodal diffuse large B-cell lymphoma (DLBCL). Methods: Immunohistochemical staining was applied to examine the expressions of p53, p63 and PIM1 proteins in nodal or extranodal DLBCL. The differences in the expressions of p53, p63 and PIM1 proteins between nodal and extranodal DLBCL were analyzed by χ2 test. Kaplan-Meier survival curve and COX proportional hazard model were used to analyze the relationship between the clinicopathological factors (including p53, p63 and PIM1 expressions) and the prognosis of patients with nodal or extranodal DLBCL. Results: Among 212 DLBCL cases, there were 101 nodal cases and 111 extranodal cases (including 55 cases of gastrointestinal DLBCL and 56 cases of non-gastrointestinal DLBCL). The expression rates of p53, p63 and PIM1 proteins in all cases were 19.0%, 25.2% and 54.7%, respectively. Among them, p53 was expressed more frequently in extranodal gastrointestinal cases (P 0.05). Much more p53-positive cases were observed with international prognostic index (IPI) ≥ 3 (P 0.05). Survival analysis showed that the expression of p53 or p63 protein was a significant inferior prognostic factor for overall survival (OS) and progression-free survival (PFS) in nodal patients or extranodal non-gastrointestinal DLBCL patients, respectively (both P < 0.05), while PIM1 expression was an inferior prognostic factor for PFS in extranodal gastrointestinal cases (P < 0.05). Conclusion: The molecular mechanisms of DLBCL pathogenesis may be different between different locations of DLBCL, which is worth further exploration.