Stress Causes Dyspepsia via Macrophage-mediated Duodenal Inflammation / 胃肠病学

Background: Epidemiological evidence revealed that stress is the causative factor of dyspeptic symptoms. It has been documented that duodenal inflammation is one of the key mechanisms of dyspepsia, and macrophage is crucial for inflammation. Aims: To determine whether patients with functional dyspepsia (FD) comorbid psychological stress have duodenal inflammation. Furthermore, to identify whether macrophage is involved in the mechanisms of stress-related duodenal inflammation by using water avoidance stress (WAS)animal model. Methods: Duodenal inflammation was observed and compared between FD patients with psychological factors and asymptomatic healthy controls. WAS mouse model with 1 h stress daily for 10 days was used to evaluate the duodenal inflammation at different time points to describe its dynamic changes. The role of macrophage in the development of duodenal inflammation was determined in an interventional study, in which the resident macrophages were depleted by clodronate liposomes. In both clinical and animal studies, the severity of duodenal inflammation was assessed by HE staining and immunocyte counts, the macrophage infiltration was detected by immunohistochemistry, and the expression of inflammatory cytokines was detected by real-time PCR. Results: FD patients with psychological factors developed severe duodenal inflammation in comparison with the healthy controls (immunocytes/HPF: 138.91±7.13 vs. 81.44±23.60, P<0.000 1). At the same time, the expressions of proinflammatory cytokines (IL-1β, TNF-α, and IL-17A) were increased, while the expressions of anti-inflammatory cytokines (IL-10 and TGF-β) were decreased (all P<0.05). In WAS mouse model, a dynamic change in duodenal inflammation which peaked on day 5 was observed, and the changes of macrophage infiltrating in the duodenal tissue were consistent with the duodenal inflammation. Clodronate liposomes pretreatment could effectively deplete macrophages, protected the WAS mouse model against duodenal inflammation (immunocytes/HPF: 75.10±4.08 vs. 202.43±5.18, P<0.001), with a marked reduction of the expressions of proinflammatory cytokines (IL-1β, TNF-α, and IL-8), and a marked elevation of the expression of anti-inflammatory cytokine IL-10 (all P<0.05). Conclusions: Psychological stress may lead to dyspeptic symptoms via macrophage-mediated duodenal inflammation.

Vagal Transient Receptor Potential Ankyrin 1 Mediates Stress-exacerbated Visceral Mechanonociception After Antral Cold Exposure

BACKGROUND/AIMS: Abdominal pain can be evoked or exacerbated after gastrointestinal cold stimulation in some patients with diarrhea-predominant irritable bowel syndrome (IBS-D), indicating a low temperature-induced sensitization of visceral perception. We investigated the role of vagal transient receptor potential ankyrin 1 (TRPA1, a cold-sensing ion channel) in cold-aggravated visceral mechanonociception in a stress-induced IBS animal model. METHODS: TRPA1 expression was examined in antral biopsies of healthy controls and IBS-D patients. Abdominal symptoms were assessed before and after warm or cold water intake. The visceromotor response (VMR) to colorectal distention (CRD) following intra-antral infusion of cold saline was measured in animals undergoing sham or chronic water avoidance stress. TRPA1 expression, extracellular signal-regulated protein kinase 1/2 (ERK1/2) phosphorylation, and neuronal calcium influx in vagal afferents were assessed. RESULTS: Compared to healthy controls, IBS-D patients displayed elevated antral TRPA1 expression, which was associated with symptom scores after cold (4°C) water intake. Intra-antral infusion of cold saline increased VMR to CRD in naive rats, an effect dependent on vagal afferents. In stressed rats, this effect was greatly enhanced. Functional blockade and gene deletion of TRPA1 abolished the cold effect on visceral nociception. TRPA1 expression in vagal (but not spinal) afferents increased after stress. Moreover, the cold-induced, TRPA1-dependent ERK1/2 activation and calcium influx in nodose neurons were more robust in stressed rats. CONCLUSIONS: Stress-exaggerated visceral mechanonociception after antral cold exposure may involve up-regulation of TRPA1 expression and function on vagal afferents. Our findings reveal a novel mechanism for abnormal gastrointestinal cold sensing in IBS.

Platelet Count/Spleen Diameter Ratio for Prediction of Esophageal Varices in Patients with HBV-related Cirrhosis: A Clinical Study / 胃肠病学

Background: Esophageal variceal bleeding is a clinical emergency and the major cause of death in patients with liver cirrhosis.Aims: To assess the value of platelet count (PC)/spleen diameter (SD) ratio in predicting the presence of esophageal varices (EV) in patients with HBV-related cirrhosis in China.Methods: A total of 91 consecutive HBV-related cirrhosis patients with EV from Aug.2013 to Dec.2015 at Renji Hospital (South Campus),School of Medicine,Shanghai Jiao Tong University were enrolled.Thirty-two HBV-related cirrhosis patients without EV were enrolled as controls.Upper gastrointestinal endoscopy,routine laboratory examinations and abdominal ultrasonography were performed and the related parameters were collected.Binary Logistic regression analysis was carried out to identify independent risk factors associated with EV.ROC curve was used to evaluate the predictive performance of PC/SD ratio for the presence of EV.Results: The PC/SD ratio was significantly lower in EV group than in non-EV group (538.2±327.0 vs.1 105.9±426.6,P=0.001).Binary Logistic regression analysis showed that the PC/SD ratio was independently associated with the presence of EV (OR=57.29,95％ CI: 15～214,P=0.000).In ROC curve analysis,the area under the curve (AUC) of PC/SD ratio in predicting the presence of EV was 0.853;the optimal cutoff value was 842,and the sensitivity,specificity,positive predictive value and negative predictive value were 85.7％,75.0％,90.7％,and 64.9％,respectively.Conclusions: PC/SD ratio can be used as a non-invasive tool for prediction of the presence of EV in patients with HBV-related cirrhosis.It may reduce the number of unnecessary endoscopy.

MicroRNA-129 Inhibits Gastric Cancer Cells Proliferation and Invasion by Targeting HMGA2 / 胃肠病学

Background:More and more evidences suggest that microRNA plays an important role in the development of gastric cancer (GC).Expression of miR-129 in GC tissues is found abnormal, however, the mechanism of miR-129 in cell proliferation and invasion is still undefined.Aims:To investigate the expression of miR-129 in GC tissue and GC cell lines and the mechanism of miR-129 in proliferation and invasion of SGC-7901 cells.Methods:Eighty-two GC tissues and corresponding paracancerous tissues were collected, human gastric epithelial cell line and different GC cell lines were cultured, qPCR was conducted to assess miR-129 expression.SGC-7901 cells were transfected with miR-129 mimic or miR-NC, and then were transfected with overexpressed HMGA2 plasmid.Colony formation assay was used to detect cell proliferation ability, and Transwell chamber was used to assess cell invasion ability.Pearson correlation analysis was used to analyze the correlation between miR-129 and HMGA2 mRNA expression.Luciferase assay was performed to determine the activity of luciferase.mRNA and protein expressions of miR-129, HMGA2 were determined by qPCR and Western blotting, respectively.Results:Compared with paracancerous tissues, expression of miR-129 was significantly decreased in GC tissues (P<0.05);when compared with human gastric epithelial cells, expression of miR-129 was significantly decreased in GC cell lines (P<0.05).Compared with miR-NC group, proliferation and invasion abilities of SGC-7901 cells were inhibited in miR-129 mimic group (P<0.05).HMGA2 mRNA expression in GC tissues was significantly upregulated (P<0.05), and was negatively correlated with miR-129 expression (r=-0.543 9, P<0.01).Luciferase activity in wild-type miR-129 mimic group was significantly lower than that in miR-NC group (P<0.05);mRNA and protein expressions of HMGA2 were decreased after transfection with miR-129 mimic (P<0.05).Compared with miR-129+vector group, proliferation and invasion of SGC-7901 cells were significantly increased in miR-129 mimic+HMGA2 group (P<0.05).Conclusions:The expression of miR-129 is decreased in GC tissue and cells;miR-129 inhibits SGC-7901 cells proliferation and invasion by negatively regulating HMGA2.

Practice and Experience of Clinical Pharmacists Participating in One Case of Cancer Patients with Infection Induced by Peripherally Inserted Central Catheter Complicated with Deep Venous Thrombosis / 中国药师

Objective:To explore the methods for drug therapy regimen formulation and pharmaceutical service of clinical pharma-cists for the infection induced by peripherally inserted central catheter ( PICC) complicated with deep venous thrombosis in cancer pa-tients. Methods:Referring to the related guide, clinical pharmacists put forward concrete opinions on how to choose anti-infective drugs and anti-thrombotic drugs for a cancer patient with PICC infection complicated with deep venous thrombosis. Clinical pharmacists sug-gested that vancomycin be used for the infection and low molecular weight heparin sodium for prophylactic anticoagulation. Meanwhile, pharmaceutical care for blood clotting function should be strengthened. Results:The proposals of clinical pharmacist were partly adopt-ed by clinicians. After the therapy, the temperature of the patient returned to normal, and the deep venous thrombosis was well con-trolled. The patient was out of hospital smoothly. Conclusion:Through the participation in clinical practice, clinical pharmacists can assist physicians in optimizing treatment plan and summarize the pharmaceutical care mode for the PICC infection and deep venous thrombosis in cancer patients, which can provide instructions for pharmaceutical care in the future.

Value of Serum Pepsinogen Detection in Warning Gastric Cancer and Evaluating Gastric Mucosa Function / 胃肠病学

Serum pepsinogen(PG)is an effective marker for evaluating gastric mucosa function and can be used as a supplement for screening and early diagnosis of gastric cancer. Recently,serum PG has become a hot spot of study in portal hypertensive gastropathy and functional dyspepsia. Serum PG detection is a noninvasive,simple and low cost investigation method with marked clinical value. This article reviewed the value of serum PG detection in warning gastric cancer and evaluating gastric mucosa function.

Analysis and treatment of abnormal results of Sysmex CA-1500 automated coagulation analyzer / 国际检验医学杂志

Objective To analyze the parametric errors during the use of Sysmex CA-1500 automated coagulation analyzer and their treatment measures .Methods Blood samples with test results showing “*”and without figure results were collected .Sysmex CA-1500 automated coagulation analyzer was employed to retest prothrombin time (PT ) ,activated partial thromboplastin time (APTT) and fibrinogen(FIB) .Results FIB ,PT and APTT were found abnormal in 226 cases(95 .77% ) ,5 cases(2 .12% ) and 5 cases(2 .12% ) ,respectively ,with FIB the mainly .ERR008 ,ERR004 ,ERR016 ,ERR002 ,ERR032 and ERR100 were found abnormal in 227 cases(76 .95% ) ,64 cases(21 .69% ) ,one case(0 .34% ) ,one case(0 .34% ) ,one case(0 .34% ) and one case(0 .34% ) ,respec-tively ,with ERR008 the mainly .Difference of no-error results between the initial and repeat test of PT and APTT showed no statis-tical significance(P>0 .05) ,while those of FIB demonstrated statistical significance (P<0 .01) .Conclusion Samples with paramet-ric errors during the use of Sysmex CA-1500 automated coagulation analyzer should be retested to promote the quality of blood co-agulation detection .

Six major problems and possible strategies of syndromes-genome study / 中华中医药杂志

Syndromes-genome research performed eight years ago, has made a series of achievements. At the same time,there are still many problems which have to be solved. Based on the research experience, six major problems were summed up, such as difficult to refine into a sample, difficult to sample, difficult to analysis mass data, difficult to combine TCM with western medicine disease, difficult to dock and function between TCM theory and genes, difficult to apply the result of Syndrome- genomics. In this paper, the author also put forward possible new strategies, such as establishing the characteristics of the gene database, combining with the known gene functions likely to explain the evidence of the mechanism for the realization of the modernization of TCM theory, speeding up the unknown gene research, occupying gene annotation territories.