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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.
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Objective To explore the effects of urokinase type plasminogen activator (uPA) gene-modified bone marrow-derived liver stem cells ( BDLSC) transplantation on hepatocyte regeneration in CCl4-induced liver fibrosis rats. Methods Ten male Fisher 344 rats were donor rats of BDLSC. The BDLSC of male rat was transfected with AduPA. Thirty-six female Fisher 344 rats were equally divided into normal group (injected subcutaneously with olive oil) , model group (CCl4 induced the model, injected through tail vein with 0. 9% sodium chloride), BDLSC group (CCl4 induced the model, injected through tail vein with BDLSC) and gene transfected group (CCl4 induced the model,injected through tail vein with gene transfected BDLSC). Liver function and area of collagen were observed. The expression of hepatic growth factor ( HGF) and its receptor c-met mRNA in rats' liver tissues were tested by semiquantitative RT-PCR. The expressions of proliferating cell nuclear antigen (PCNA) in rats' liver tissues were determined by immunohistochemistry staining. Results The areas of collagen in normal group, model group, BDLSC group and gene transfected group was 0. 12% ± 0.03%, 14. 49%±1.40%, 8. 25%±0. 82% and 5. 12%±0. 40% accordingly, there were significant differences between groups (P<0. 05). Compared with model group and BDLSC group, the liver function of gene transfected group significantly improved, the serum levels of hyaluronic acid (HA),procollagen Ⅲ (PCⅢ) and the content of hydroxyproline in liver tissues decreased dramatically. The expression of HGF and c-met at mRNA levels were up-regulated significantly, and the expression of PCNA protein in liver tissues increased obviously. Conclusion uPA gene-modified BDLSC transplantation may induce proliferation of hepatocytes, and then improve the liver functions of fibrotic rats induced by CCl4.
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The medical students, Shanghai Jiaotong University School of medical from 5- year,7-year, 8-year to general of academic, received evidence-based medicine (EBM) education. The students' background and attitudes about EBM were different. Teaching EBM should pay attention to the relationship of EBM and basic courses, especially for deferent students. Teaching EBM should transform from imparting basic knowledge to learning skills on their own initiative.
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Objective To investigate physicians' awareness of diagnostic criteria for irritable bowel syndrome (IBS). Methods Questionnaire was used to investigate awareness of diagnostic criteria for IBS among 782 physicians in 34 hospitals in Shanghai during August 2008. Results Overall, 82. 7 percent (647/782) of physicians surveyed thought they knew or partly knew diagnostic criteria for IBS. More than 70. 0 percent of physicians knew Rome criteria, but less than 25.0 percent knew other criteria. Awareness of current Rome criteria, whether mental symptoms included in it, and its time frame differed significantly among physicians in varied specialties (P ＜ 0. 01 ). Gastroenterologists had more knowledge about Rome criteria than other specialists, but most physicians, including gastroenterologists, did not fully understand its applicability. Conclusions Although gastroenterologists knew more about diagnostic criteria for IBS, their knowledge still needed to be perfected and updated. Awareness of diagnostic criteria for IBS was poor in nongastroenterological physicians and general practitioners knew it to certain extent.
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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.
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Objective To design a questionnaire on factors that affect diagnosis of irritable bowel syndrome for physicians, and determine the retest reliability. Methods The questionnaire was completed after literature review, and 9 experts were invited to revise the questionnaire. Thirty-four physicians filled the questionnaire for pre-test and did it again for re-test 4 weeks later. Kappa value of each question of the questionnaire was calculated. Results Content validity and face validity were assured by experts. Kappa values were over 0.61 in all items, which achieved substantial level. Conclusion The questionnaire designed has fairly good reliability and validity, and can be used in investigation of irritable bowel syndrome for physicians.
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In the past few years,it has been disclosed that identified epigenetic processes and epigenetic changes are involved in human diseases.Disorders of these processes may influence chromatin structure and gene expression,which may result in complicated syndroms,multiple-factor diseases and cancers. The researchprogress of epigenetic processes of several diseases is reviewed in this paper.
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Objective To explore the curative effectiveness of transplantation of bone marrow-derived liver stem cells (BDLSCs) transfected with rat interleukin-10 (IL-10) gene in the treatment of liver fibrosis in rats. Methods β2m-/Thy-1+BDLSCs isolated from Wistar rats were transfected with adenovirus-mediated rat IL-10 gene Wistar rats were subcutaneously injected with CCl4 to induce liver fibrosis, and randomly divided into three groups as follows: (1) the model group, infused with 1 ml normal saline (NS); (2) the BDLSC group, infused with NS containing untreated β2m-/Thy-1+BDLSCs (2×105 cells); (3) the IL-10 group, infused with NS containing β2m-/Thy-1+ BDLSCs transfected with IL-10 gene (2×105 cells). Infusion was done via the portal vein. Rats subcutaneously injected with olive oil served as control (the normal group). The BDLCs labeled with diamidine phenylindole dihydrochloride (DAPI) in the liver were localized. Pathological changes and collagen area in liver tissues were observed. Liver function and blood blotting function were tested. Results β2m-/Thy-1+ BDLSCs labeled with DAPI were observed in liver tissues of rats. Significant pathological changes of liver tissues were observed in the model group. Compared with the model group, pathological changes were alleviated to some extent in the BDLSC group. The morphology of liver tissue in the IL-10 group was mostly close to that in the normal group. Collagen deposition of liver tissues was increased obviously in the model group. However, transplantations of untreated and IL-10-transfected BDLSCs both reduced collagen area. Compared with the BDLSC group, collagen deposition was significantly suppressed in the IL-10 group. Transplantation of IL-10-transfected BDLSCs suppressed obviously the levels of ALT, AST, ALP, TBIL, PT and APTT as compared with the model group (P<0. 05). The levels of ALT, TBIL, PT and APTT in the IL-10 group were significantly reduced to the normal levels as compared with those in the BDLSC group (P<0. 05).Conclusions Transplantation of BDLSCs transfected with rat IL-10 gene was effective in treating liver fibrosis in rats. This combined strategy of IL-10 gene and BDLSCs may represent a feasible, effective and safe therapy form for liver fibrosis.
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Objective To analyze the clinical presentation of functional dyspepsia in Chinese ado lescents.Methods A stratified,randomized study by cluster sampling was employed,which recruited 51 956 students from high and primary schools in six provinces and two cities.All students were requested to fill in a questionnaire.Functional dyspepsia was diagnosed according to Rome Ⅱ criteria.Results Among 51 956 students,10 174 were diagnosed as functional dyspepsia(accounted for 19.58%).Heart burn,hiccup and air swallowing to terminate hiccup were major symptoms of functional dyspepsia.The upper abdominal distention,epigastric pain,anorexia and insomnia were common in boys than girls with no significance(P＞0.05).The belching,early satiety,fatigue and anxiety were significantly higher in girls than boys.Conclusions Functional dyspepsia is a common disorder among the adolescents.Educa-tion and psychotherapy are important in the treatment of students with functional dyspepsia.
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Objective To investigate the changes of connective tissue growth factor(CTGF)gene expression level and the association with pathological staging of liver fibrosis and changes of type Ⅰ,Ⅲ collagen gene expression levels in he- patic fibrogenesis.Methods Hepatic fibrosis rat models were created by subcutaneous injections of CCl_4,and the de- gree of hepatic fibrosis in model rats was determined by HE staining and Sirius red staining.The expressions of CTGF, type Ⅰ and Ⅲ collagen gene of the rat liver tissue specimens were analysed with the Western blot and/or Reverse tran- scription polymerase chain reaction(RT-PCR).Results Grade I fibrosis was observed in rat liver tissue of CCl_4 in- ductiun for 2 weeks,and grade Ⅲ fibrosis in that of CCl_4 induction for 6 weeks.The CTGF mRNA and protein and type Ⅰ and Ⅲ collagen mRNAs in hepatic tissue of grade Ⅰ fibrosis and grad Ⅲ fibrosis were increased by 0.64?0.078、 2.66?0.269、1.83?0.096、2.85?0.096 and 2.81?0.055、6.41?0.224、3.25?0.13、2.69?0.082 fold com- pared with normal control,respectively.Conclusion The changes of CTGF gene expression level significantly correla- ted with the degree of liver fibrosis and type Ⅰ collagen gene expression,but not with type Ⅲ collagen expression in liver fibrogenesis.These findings suggested that the upregulation of CTGF gene expression might play an important role in the process of liver fibrogenesis,and postulating the interference of CTGF expression might be a new strategy.
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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.
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<p><b>OBJECTIVE</b>To assess whether Angiotensin II (Ang II) and carbon tetrachloride (CCl(4)) used in combination could accelerate the process of fibrosis and whether Ang II play a role in exagerating hepatic fibrosis in rats.</p><p><b>METHODS</b>Ang II was injected into the abdominal cavity of Sprague-Dawley (SD) rats together with subcutaneous injection of CCl(4). Rats were killed after 14 and 28 d. Blood serum and liver specimen were collected. The extent of fibrosis in the stained liver tissue sections was determined with the KS 400 Image Analysis System.</p><p><b>RESULTS</b>Rats receiving Ang II and CCl(4) for 28 d showed extensive liver fibrosis. Along with the increase of hepatic fibrosis, the serum concentration of Ang II went up gradually.</p><p><b>CONCLUSIONS</b>A combination of Ang II and CCl(4) would accelerate the process of hepatic fibrosis. Ang II probably took part in the occurrence of heparic fibrosis.</p>
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Animales , Masculino , Ratas , Alanina Transaminasa , Sangre , Angiotensina II , Sangre , Toxicidad , Aspartato Aminotransferasas , Sangre , Tetracloruro de Carbono , Toxicidad , Cirrosis Hepática Experimental , Ratas Sprague-Dawley , Sistema Renina-Angiotensina , FisiologíaRESUMEN
<p><b>OBJECTIVE</b>To examine the expression changes of activin beta A, beta C, beta E and follistatin mRNA in the development of rat hepatic fibrosis induced by carbon tetrachloride (CCl(4)).</p><p><b>METHODS</b>Hepatic fibrosis was induced in rats by subcutaneous injections of 40% carbon tetrachloride oily solution for a period of 1 to 7 weeks. After carbon tetrachloride injection of 1, 2, 3, 4, 5, 6, and 7 weeks, the 6-12 rats were killed every time. The kinetics of activin beta A, beta C, beta E and follistatin mRNA expression were assessed by the semi-quantity RT-PCR.</p><p><b>RESULTS</b>Activin beta A, beta C, beta E and follistatin mRNA could be detected in normal rat livers. After CCl(4) injection for 2 or 3 weeks, beta A mRNA was transiently decreased and became undetectable, then increased gradually. After CCl injection for 6 and 7 weeks, beta A mRNA level was significantly higher than controls (P<0.01). beta C mRNA could be detected after CCl(4) injection for 1 to 4 weeks and was significantly increased after 5 weeks over controls (P<0.05). beta E mRNA could not be detected after CCl(4) injection for 1 to 5 weeks, but significantly increased after CCl(4) injection for 6 or 7 weeks compared with controls (P<0.01). Except for normal rat liver, no follistatin mRNA was detected in rats after CCl(4) injection.</p><p><b>CONCLUSIONS</b>Activins and follistatin have different expression changes in the development of hepatic fibrosis and the imbalance of activins and follistatin expression may involve in the formation of hepatic fibrosis.</p>
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Animales , Masculino , Ratas , Activinas , Genética , Tetracloruro de Carbono , Folistatina , Expresión Génica , Subunidades beta de Inhibinas , Genética , Cirrosis Hepática Experimental , Genética , Patología , ARN Mensajero , Genética , Metabolismo , Ratas Sprague-Dawley , Reacción en Cadena de la Polimerasa de Transcriptasa InversaRESUMEN
?-Est. Besides,?-Est could promote the expression of ER ? by HSC at the concentration of 10 -7 mol/L but not its metabolites. Conclusion The present results indicate that ?-Est may attenuate hepatic fibrosis and the possible mechanism is via the action of its metabolites.
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Objective The present study was to elucidate whether there was a local renin-angiotensin-aldosterone system (RAAS)in rat hepatic stellate cells(HSC)and the immortalized rat HSC line—HSC-T6. Methods HSC was isolated by perfusion of collagenase and pronase to liver. The renin activity, angiotensin Ⅱ(Ang Ⅱ) and aldosterone(ALD) concentration in the cells were assayed by radio-immunoassay. Angiotensin converting enzyme(ACE) activity was detected by ultra-violet spectrophotography. The expression of angiotensin Ⅱ type 1 receptor(AT1R) was determined by immunohistochemistry. RT-PCR method was used to assay the mRNA expression of renin, angiotensinogen, ACE, AT1R and CYPⅡB2(the critical enzyme of aldosterone synthesis). Results Ang Ⅱ, ALD, renin and ACE activity could be detected in HSC and HSC-T6. Immunohistochemistry showed that both of them could express AT1R. mRNAs of renin, ACE, AT1R and CYPⅡB2 were also detected in both of them. Conclusions Both rat HSC and the immortalized rat HSC line HSC-T6 possessa a local RAAS.
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Objective Recently, a series of studies demonstrated that activation of local renin angiotensin system (RAS) may be related to tissue fibrosis, but the role of RAS in hepatic fibrogenesis has not been evaluated. The present study was designed: (1) to assess the effect of angiotensin converting enzyme (ACE) inhibitor and angiotensin Ⅱ type 1 (AT1) receptor antagonist in preventing hepatic fibrosis induced by CCl 4 administration in rats; (2) to investigate whether or not there are expression of AT1 receptors on hepatic stellate cells. Methods Study was conducted in male Sprague Dawley rats. Except for control group, three treated groups, either enalapril (10 mg/kg), losartan (10 mg/kg) or a combination of enalapril and losartan were given to the fibrotic rats (daily gavage), and saline vehicle was given to the control rats. After 6 weeks, liver fibrosis was assessed directly by hepatic morphometric analysis, which have been considered the gold standard for the quantitative measurement of fibrosis. The expression of AT1 receptors and ? smooth muscle actin (? SMA) in liver tissue were detected by immunohistochemical techniques. Results Compared to the rats of control groups, either enalapril or losartan, or a combination of two drugs can limit the expansion of the interstitium ( P 0.05). Expression of AT1 receptors was found in abundance in hepatic fibrotic interstitium of fibrotic rats, whereas only limited in vasculature in rats of control group to a very slight degree. Conclusions The present results demonstrated that: (1) activation of RAS is related to hepatic fibrosis induced by CCl 4; (2) angiotensin converting enzyme inhibitor and AT1 blocker might slow the propression of hepatic fibrosis; (3) activated hepatic stellate cell expresses AT1 receptors.
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Objective To assess the diagnostic value of Manning's criteria, Rome Ⅰ criteria and Rome Ⅱ criteria in Chinese patients of irritable bowel syndrome. Methods 724 subjects were enrolled from the outpatient department of gastroenterology and the physical examination center of Xinhua hospital. Self designed questionnaire, routine physical examination and selective accessory diagnostic procedures were undergone in all subjects including 402 cases of irritable bowel syndrome,134 cases of non ulcer dyspepsia,90 cases of ulcerative colitis and 98 healthy controls. According to Manning criteria, Rome Ⅰcriteria and Rome Ⅱcriteria, the sensitivity, specificity, positive likelihood and negative predictive value(PV), positive likelihood and negative likelihood were calculated separately. Results The sensitivity and specificity of Manning's criteria, Rome Ⅰ criteria and Rome Ⅱcriteria were 96.02% (95%CI:95.06%-100.0%), 77.36% (75.31%-79.41%), 68.41% (66.14%-70.68%) and 47.51% (44.78%-50.23%), 73.29%(70.87%- 75.70 %) 83.23% (81.19%-85.27%),respectively. The positive PV and negative PV were 69.55%, 78.33% , 83.59% and 90.53%, 72.17%, 67.85%, respectively.The positive likelihood and negative likelihood were 1.83 , 2.90 , 4.07 and 0.08, 0.31, 0.38, respectively. Conclusion Irritable bowel syndrome could be positively diagnosed by taking an appropriate history and questionnaires,Rome Ⅱ criteria had higher validity in diagnosis of irritable bowel syndrome.
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Objective Activin A, a member of the transforming growth factor (TGF ?) superfamily, has been reported to overexpress in liver cirrhosis. The aim of this study was to examine the expression changes of activin A in the process of carbon tetrachloride induced rat hepatic fibrosis. Methods Hepatic fibrosis was induced in rats by subcutaneous injections of 40% carbon tetrachloride oily solution for a period of 1 to 7 weeks. 6～10 rats were killed at week 1,2,3,4,5,6 and 7 weeks. The kinetics of activin A messenger RNA expression and its protein localization were assayed by semi quantity reverse transcription polymerase chain reaction (RT PCR) and immunohistochemistry. Results RT PCR and immunohistochemistry showed normal rat liver could express activin A mRNA and protein, and its expression was transiently decreased and became undectable after carbon tetrachloride injections for 2 or 3 weeks, then increased grandually. After carbon tetrachloride injecting for 6 and 7 weeks, activin A mRNA and protein expression were significantly enhanced in rats liver ( P
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0.05). There was a higher prevalence of IBS in Heilongjiang province (14.02%) than that in Shanghai (11.72%, P
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Objective To investigate the effects of different doses of angiotensin Ⅱ(Ang Ⅱ) on hepa tic stellate cells(HSC) proliferation and collagen synthesis in rats. Methods The pronase E and collagen Ⅰ were used to isolate HSC, 3H TdR, 3H Leu and 3H Pro incorporation methods were used to evaluate the effects of different doses of AngⅡ on HSC DNA, protein and proline synthesis. Results It showed that 10 -9 ～10 -6 mol/L AngⅡ could significantly increase the 3H TdR incorporation rate of HSC ( P