[Imbalance of CD4(+) T cell subgroups in ulcerative colitis].

OBJECTIVE: To investigate the relationship of the imbalance of CD4(+) T cell subgroups and the pathogenesis of ulcerative colitis (UC). METHODS: Peripheral blood samples were collected from 24 UC patients and 17 healthy donors. Then the phenotype of CD4(+) T cells and the major transcription factor expression of each subset were analyzed by flow cytometry and real-time PCR (polymerase chain reaction) respectively. The serum concentrations of major cytokines of each subgroup were measured by cytometric bead array (CBA) and ELISA (enzyme-linked immunosorbent assay). RESULTS: (1) The proportion of Treg cells in the UC group was lower than the control group (6.7% ± 1.7% vs 7.9% ± 1.4%, P = 0.016), especially in active stage (6.4% ± 1.7%, P = 0.005). As compared with the control group, the expression of FOXP3 mRNA was lower in the UC Group (P = 0.020). And so was the serum concentration of TGF-ß1 [(21 ± 8) µg/L vs (28 ± 7) µg/L, P = 0.026]. (2) There were no significant differences in Th1-related transcription factors and cytokines between two groups. (3) Th2 cells were higher in the UC group (2.7% ± 1.1% vs 1.6% ± 0.4%, P = 0.002), especially in active stage (2.8% ± 1.0%, P = 0.001). The expression of GATA-3 mRNA was 4.4 folds higher than that of the controls (P = 0.045). (4) Th17 cells were higher in the UC group (3.4% ± 1.8% vs 1.8% ± 0.7%, P = 0.005). And the RORγt mRNA expression was 13 folds higher in UC group (P = 0.001); the serum concentrations of IL-6 and IL-17 were higher in the UC group (both P < 0.05). (5) The ratios of Treg/Th2 and Treg/Th17 were significantly lower in the UC group and associated with disease activity (both P < 0.05). CONCLUSION: The imbalances of Th2, Treg and Th17 subgroups may play pivotal roles in the pathogenesis of UC.

[Procyanidins enhance the chemotherapeutic sensitivity of laryngeal carcinoma cells to cisplatin through autophagy pathway].

OBJECTIVES: To investigate the effect of Procyanidins (OPCs) on the autophagy of laryngeal cancer cell line TU686 and to explore the effect of OPCs on the chemosensitivity of laryngeal cancer cells to DDP in terms of autophagy and apoptosis. METHODS: CCK-8 was used to detected the effect of different concentrations of OPC and DDP on TU686 cell viability. Experimental grouping: Both kinds of cells were divided into CON group, DDP group, OPC group and MIX group. Annexin-V-FITC/PI double staining of flow cytometry was used to detect the effect of each experimental group on the apoptosis. Cell immunofluorescence staining was used to detect the formation of autophagy. Western blot was used to detect the expression of autophagy-related and apoptosis-related proteins. Autophagy inhibitors (3-MA) were used to study the effect of autophagy on apoptosis. RESULTS: The results of CCK-8 showed that TU686 cells were inhibited by OPC and DDP in a concentration-dependent manner for 24 hours. LC3-Ⅱ protein staining showed that compared with CON group, DDP group and OPC group, MIX group significantly induced autophagy formation in TU686 cells (P<0.05). Flow cytometry showed that compared with CON group, apoptosis of TU686 cells was induced in DDP group, OPC group and MIX group. And the effect of MIX on apoptosis was significantly higher than that of OPC and DDP groups (P<0.05). After pretreatment with 3-MA, the apoptotic effect of OPC group and MIX group on TU686 cells was significantly decreased (P<0.05). Western blot results showed that the expression of LC3-Ⅱ and Caspase-3 in DDP, OPC and MIX groups was significantly higher than that in CON group (P<0.05). In MIX group, the expression of LC3-Ⅱ and Caspase-3 also had significant difference (P<0.05) compared with single drug group. After using 3-MA to inhibit autophagy, the expression of LC3-Ⅱ was significantly decreased (P<0.05), and the expression of Caspase-3 was decreased along with LC3-Ⅱ, but the decrease of Caspase-3 expression was only significant in OPC and MIX group (P<0.05). CONCLUSIONS: OPC can induce autophagy in laryngeal carcinoma TU686 cells and promote its apoptosis, which in turn enhances sensitivity of laryngeal cancer cells to cisplatin chemotherapy.

The spectra, symptom profiles and overlap of Rome III functional gastrointestinal disorders in a tertiary center in South China.

OBJECTIVE: Most previous studies exploring the overlap of functional gastrointestinal disorders (FGID) focus on the overlap between functional dyspepsia (FD) and irritable bowel syndrome (IBS). In this study, we aimed to explore the spectra, symptom profiles and overlap of all FGID using the validated Chinese version of the Rome III questionnaire. METHODS: Consecutive newly diagnosed FGID patients who were admitted to the Outpatient Gastroenterology Clinic from 10 May to 10 September 2012 were recruited in the study. All the patients complained of gastrointestinal (GI) symptoms for at least 3 months with a symptom onset of at least 6 months before diagnosis after excluded organic diseases. Patients who met the inclusion criteria were asked to complete the scoring algorithm for the Rome III integrated questionnaire. RESULTS: Among 350 eligible patients, 302 (86.3%) returned completed questionnaires. A total of six major domains including 17 disorders were diagnosed. The four most prevalent FGID were FD (54.6%), IBS (40.7%), unspecified functional bowel disorder (13.9%) and functional constipation (12.6%). The three most prevalent symptoms in FGID were abdominal pain (66.2%), loose stool (58.3%) and abdominal bloating/distension (56.3%). Of the 302 patients, 152 (50.3%) had one to five overlapping FGID. Only functional bloating had no overlap. Six patients had five overlapping FGID simultaneously. In all, 63 patients had overlapping FD and IBS. CONCLUSIONS: This study provided the detailed spectra and symptom profiles for all FGID. Overlapping FGID are common in China.

Primary Care Management of Chronic Constipation in Asia: The ANMA Chronic Constipation Tool.

Chronic constipation (CC) may impact on quality of life. There is substantial patient dissatisfaction; possible reasons are failure to recognize underlying constipation, inappropriate dietary advice and inadequate treatment. The aim of these practical guidelines intended for primary care physicians, and which are based on Asian perspectives, is to provide an approach to CC that is relevant to the existing health-care infrastructure. Physicians should not rely on infrequent bowel movements to diagnose CC as many patients have one or more bowel movement a day. More commonly, patients present with hard stool, straining, incomplete feeling, bloating and other dyspeptic symptoms. Physicians should consider CC in these situations and when patients are found to use laxative containing supplements. In the absence of alarm features physicians may start with a 2-4 week therapeutic trial of available pharmacological agents including osmotic, stimulant and enterokinetic agents. Where safe to do so, physicians should consider regular (as opposed to on demand dosing), combination treatment and continuous treatment for at least 4 weeks. If patients do not achieve satisfactory response, they should be referred to tertiary centers for physiological evaluation of colonic transit and pelvic floor function. Surgical referral is a last resort, which should be considered only after a thorough physiological and psychological evaluation.