[An epidemiologic study on functional constipation among adult communities in Shanghai].

OBJECTIVE: To determine the prevalence and risk factors of functional constipation (FC) by using Rome III criteria in the local adult communities. METHODS: A stratified randomized and community-based study by multi-stage cluster sampling was employed. A household survey was conducted from April to May 2010. All of the participants were interviewed face-to-face by filling out the self-administered questionnaires which based on Rome III criteria for the diagnosis of FC. Self-rating anxiety scale (SAS), self-rating depression scale (SDS) and Athens insomnia scale (AIS) were carried out to evaluate the psychological characteristics and qualities of sleep. RESULTS: A total of 7648 subjects fulfilled the questionnaires, with the response rate as 90.0%. 211 patients met the Rome III criteria, including 90 males and 121 females. The adjusted prevalence rates of FC were 2.5% in males, 3.3% in females and with an overall rate as 2.9%. The ratio of men to women was 1:1.32, with significant difference between males and females (P=0.043). The most common group was in the 18-29 year-olds (χ2=37.359, P=0.000). FC patients were more likely to be detected in the group with normal BMI (χ2=16.087, P=0.002), having received high education (χ2=27.604, P=0.000), being intelectuals (χ2=6.922, P=0.031) and divorced (χ2=22.000, P=0.000) than in other groups. Multivariate analysis showed that excessive intake of high-fat food was significantly associated with the presence of FC (odds ratio as 1.253, P=0.000), whereas foods with high-fiber (odds ratio as 0.854, P=0.029) might serve as protective factors. Significant differences between FC groups and control groups were found in the incidence of anxiety (with odds ratio as 2.583, P=0.000) and insomnia (odds ratio as 2.443, P=0.000). CONCLUSION: The prevalence of FC in adult communities in Shanghai Songjiang district was not higher than that in other parts of the communities. Excessive intake of high-fat food, anxiety and insomnia might be risk factors for FC and foods with high-fiber contents might serve as protective factors.

The efficacy of Combizym in the treatment of Chinese patients with dyspepsia: a multicenter, randomized, placebo-controlled and cross-over study: Shanghai Combizym Clinical Cooperative Group.

OBJECTIVE: To evaluate the efficacy and safety of Combizym treatment in Chinese patients with dyspepsia. METHODS: In this multicenter, randomized, placebo-controlled cross-over study, a total of 151 patients (76 men and 75 women, mean age: 44.67 +/- 6.46 years, range: 22-67 years) with dyspepsia whose symptoms were not relieved by placebos were recruited. They were randomly divided into group A (79 patients, 2 weeks of Combizym treatment, two tablets post-meal, t.i.d.; then 1 week of wash-out, followed by 2 weeks of placebo treatment, two tablets post-meal, t.i.d.) or group B (72 patients, 2 weeks of placebo treatment, two tablets post-meal, t.i.d. then one week of wash-out, followed by 2 weeks of Combizym treatment, 2 tablets post-meal, t.i.d.). The index of severity of the dyspepsia symptoms was evaluated before and after each treatment phase with Combizym or the placebo. RESULTS: Compared with the placebo, 2 weeks of Combizym treatment decreased the severity index of dyspepsia symptoms significantly (27.64 +/- 1.77 to 9.72 +/- 1.33 vs 23.99 +/- 1.28 to 22.03 +/- 1.40, P < 0.01). The efficacy rates of Combizym and the placebo on dyspepsia were 89.63% and 21.68%, respectively (P < 0.01). According to the improvement of symptoms index, individual dyspepsia symptoms that could be attenuated by Combizym therapy were anepithymia, abdominal distension, belching, diarrhea, abdominal pain, epigastric burning. None of patients reported adverse events during the study. CONCLUSION: Combizym treatment effectively ameliorates dyspepsia symptoms in Chinese patients, with satisfactory safety and compliance.

[Risk factors of irritable bowel syndrome in adolescents in China].

OBJECTIVE: To explore the risk factors for irritable bowel syndrome (IBS) among school adolescents in China. METHOD: A stratified, randomized study by cluster sampling was conducted, which recruited 51,956 students from high and primary schools in Chinese cities. All students were requested to fill in a questionnaire. RESULT: (1) Factors including class (odds ratio 1.12), excessive intake of pepper (odds ratio 1.17), fried (odds ratio 1.08) and starch-based foods (odds ratio 1.06), gastrointestinal tract infection (odds ratio 2.66), abuse of analgesic (odds ratio 1.49), inheritance (odds ratio 1.83), fatigue (odds ratio 1.32) and repression (odds ratio 1.45) were significantly associated with the presence of IBS (P < 0.05). High protein food (odds ratio 0.90) was a protective factor. CONCLUSION: Different food intake, gastrointestinal tract infection, abuse of analgesic, inheritance and psychological factors might be related to development of IBS in the students of the cities involved in this study.

[Effects of silencing connective tissue growth factor on rat transforming growth factor beta/Smads signal].

OBJECTIVE: To investigate the effects of small interfering RNA targeting connective tissue growth factor (CTGF) on rat transforming growth factor beta (TGF beta)/Smads signal pathway. METHODS: Chemically synthetic siRNA targeting CTGF was transfected into HSC T6 and then they were injected into rat livers through their intraportal veins. At the same time these rats also received CCl4 subcutaneously every three days for 6 consecutive weeks. Untreated HSC T6 or/and rats with random siRNA treatment served as controls. Total RNA or/and protein in HSC T6 and rat hepatic tissues were extracted. The expressions of CTGF and TGF beta 1, Smad2, 3 and 7 genes were detected by reverse transcription-polymerase chain reaction (RT-PCR) and/or Western blot. RESULTS: CTGF siRNA significantly reduced the expression of CTGF protein in HSC T6. At 48 h after CTGF siRNA treatment, the down-regulation of CTGF protein was the most significant, up to 94%+/-4% (t=46.196, P less than 0.01), but the expressions of TGF beta 1, Smad2, 3 and 7 mRNA showed no differences in HSC T6 compared with the blank controls. Six weeks after CCl4 injections, prominent up-regulations were observed in the gene expressions of CTGF and TGF beta 1 in saline control or siRNA-treated rat livers. Administering CTGF siRNA for six weeks markedly attenuated the induction of CTGF and TGF beta 1 genes; the expressions of CTGF and TGF beta 1 protein decreased by 95%+/-2% (F=21.234, P less than 0.01) and 74%+/-8% (F=13.464, P less than 0.05), respectively, whereas Smad2, 7 protein expressions were not affected. CONCLUSION: Silencing the CTGF gene can suppress the TGF beta /Smads signal pathway in rat livers.

[An epidemiologic study of irritable bowel syndrome among adolescents in China].

OBJECTIVE: To explore the prevalence of irritable bowel syndrome (IBS) and its distribution characteristics among adolescents in China. METHODS: A stratified and randomized study by cluster sampling was employed, the study recruited 51 956 students from high and primary schools in different Chinese cities. All students were requested to fill in a questionnaire. RESULTS: The prevalence of IBS in China was 53.5% according to the Manning criterion and 20.2% according to the Rome II criterion. The prevalence in male and female students showed no significant difference (P>0.05), but there was higher prevalence of IBS in high school students. The prevalence of IBS was 53.3% according to the Manning criterion and 19.6% according to the Rome II criterion in south China. The prevalence of IBS was 51.2% according to the Manning criterion and 18.9% according to the Rome II criterion in North China. The prevalence of IBS was 58.0% according to the Manning criterion and 23.4% according to the Rome II criterion in west China. CONCLUSION: IBS is a common disorder among the adolescents and the prevalence of IBS is increasing with increase of age in adolescents.

Suppressive effects of 17beta-estradiol on hepatic fibrosis in CCl4-induced rat model.

AIM: To investigate the pathway via which 17beta-estradiol (beta-Est) exerts suppressive effects on rat hepatic fibrosis. METHODS: In vivo study was done in CCl4-induced female hepatofibrotic rats. Fibrosis-suppressive effect of beta-Est (20 microg/kg/d) was evaluated in intact and ovariectomized rat models. Six weeks after the treatment, all the rats were sacrificed and specimens of serum or liver tissue were collected for the studies. Serum liver enzymes, fibrosis markers and estradiol levels were determined by standard enzymatic methods, ELISA and RIA, respectively. Degrees of fibrosis and areas of hepatic stellate cells (HSCs) positive for alpha-smooth muscle actin (alpha-SMA) in the liver were determined by van Gieson (VG) stain and immunohistochemistry. In vitro studies, HSCs were isolated by a combination of pronase-collagenase perfusion and density gradient centrifugation. First-passage HSCs were randomly divided into 10 groups, and different concentrations of beta-Est, 2-hydroxyestradiol (2OHE) or 2-methoxyestradiol (2MeOE) were separately added to the cell groups. After incubation for 72 h, the degree of cell proliferation, collagen production, alpha-SMA or estrogen receptor (ER) expression was determined by MTT assay, ELISA and immunohistochemistry, respectively. RESULTS: Beta-Est treatment reduced aspartate aminotransferase (AST), alanine aminotransferase (ALT), hyaluronic acid (HA) and type IV collagen (C IV) in sera, suppressed hepatic collagen content, decreased the areas of HSCs positive for alpha-SMA significantly in both intact and ovariectomized female hepatofibrotic rats. There was a negative correlation between the percentage of fibrotic area of liver tissue and the serum estradiol level; the calculated correlation coefficient was -0.57 (P<0.01). Beta-Est and its metabolites concentration-dependently (10(-9) mol/L-10(-7) mol/L) inhibited HSC proliferation and collagen synthesis. At the concentration of 10(-7) mol/L, they could inhibit alpha-SMA expression. The order of potency was 2MeOE>2OHE>beta-Est. CONCLUSION: Beta-Est may suppress hepatic fibrosis probably via its biologically active metabolites.