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Objective To investigate the effect of KRAS gene mutation and clinical factors on postopera-tive prognosis of rectal cancer patients and to explore their value in prognosis. Methods A total of 130 cases of rectal cancer patients from January to December 2010 were collected in the study. The tumor tissues sample was used to detect the KRAS gene mutation and 5-year follow-up was conducted. The correlation between KRAS gene mutation and clinical pathological features was analyzed.The clinic pathological factors that may affect the progno-sis were analyzed by survival analysis. Results Forty-five patients had mutations in No.2 expressed region of KRAS,with a mutation rate of 34.6%.KRAS gene mutation and stronger positive expression of EGFR(P<0.05), and multiple metastasis of tumor(P<0.05)were strongly coupled.The average survival of patients with wild-type KRAS gene was 57.5 months and that of patients with KRAS gene mutation 58.9 months but no significant differ-ence was observed(P>0.05).The TNM by high staging,multiple metastasis,lung metastasis and liver metasta-sis of cancer cells was closely related with poor postoperative prognosis of patients(P<0.05).The average surviv-al of postoperative patients in stage Ⅳ was 49months. Conclusions KRAS gene mutation in patients with rectal cancer after surgery is related with stronger positive expression of EGFR and multiple metastasis of cancer.TNM by high staging and metastatic sites affects the prognosis. The survival of rectal cancer after surgery in patients with stage Ⅳ are prolonged but the relation between KRAS genovariation and patients′ postoperative prognosis can not be determined.
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Objective To analyze the difference of salivary microbiome between the patients with functional dyspepsia and healthy controls.Methods Saliva samples were collected from the patients with functional dyspepsia and healthy control.Genomic DNA of the samples was extracted,and the high-throughput sequencing technology was used to conduct DNA sequence of 16S rRNA-V4 region.Subsequently,all the data were performed by the bioinformatic analysis.Results The salivary microbiome in the functional dyspepsia group was dominated by Proteobacteria,while Bacteroidetes was the top microbiota in the heathy control group.In the functional dyspepsia group,the Chao1 index,ACE index,Shannon index and Simpson index were 1 295,1 351,4.93 and 0.90 respectively.In the healthy control group,the above indexes were 1 001,1 351,5.28 and 0.92 respectively.The PCoA ba sically separated the microbiome composition of the two groups.Sixteen kinds of microbiota were significantly different between two groups using linear discriminant analysis effect size tool,including Bacteroidetes,Prevotella,Prevotellaceae,Neisseria,Betaproteobacteria and Proteobacteria,etc.Conclusion Saliva in the patients with functional dyspesia has characteristic microbiome composition,which is dominated by Proteobacteria,but the richness and diversity between the two groups have no difference.Neisseria is one of the significantly different bacteria between the two groups.
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Objective To analyze the diversity of salivary bacteria in patients with nonalcoholic fatty liv-er disease(NAFLD group)and healthy control group(HC group). Methods Saliva samples were collected from 24 patients with nonalcoholic fatty liver disease and 22 healthy control.Genomic DNA of the samples was extracted and extended to 16S rRNA V4-V5 hypervariable region after PCR with Illumina high-throughput sequencing tech-nology.All the data,including operational taxonomic units,diversity indexes and species annotation,etc.was ana-lyzed. Results 39118 optimized sequences in the saliva of each group were obtained,including nonalcoholic fatty liver group clustering OTUs about 308 ± 48 and healthy control group clustering OTUs about 305 ± 53.The diversi-ty analysis of NAFLD group and HC group showed that there was little difference in diversity of the whole salivary bacteria.The data of the species analysis of the saliva bacteria in two group indicate that the composition was simi-lar and the relative abundance was different in phylum and genus.In NAFLD group,the ratio of the abundance of firmicutes(20.42%)increased and the proportion of bacteroides(36.75%)decreased in phylum. Genus of the NAFLD group,the ratio of fusobacterium,porphyromonas and veillonella increased significantly,and the ratio of prevotella and[Prevotella]decreased.Conclusion In the NAFLD group,the abundance of firmicutes increased, and the abundance of the bacteria decreased.It was speculated that the imbalance of the salivary bacteria is associ-ated with nonalcoholic fatty liver disease.
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Objective To explore the mediating effects of resilience between family function and geriatric depression. Methods By convenient sampling, 212 elderly people who were from the communities in Yuexiu, Guangxhou city were analyzed by using Geriatric Depression Scale (GDS-30) and Family Concern Index Questionnaire (APGAR) and Connor-Davidson Resilience Scale (CD-RISC) and the self-designed General Condition Questionnaire, and a mediating model was proposed and the impacts of resilience on family function and geriatric depression were tested. Results The incidence rate of depression among the community elderly was 23.6% (50/212), and the average score of APGAR was 7.87 ± 2.83, and the average score of CD-RISC was 83.66 ± 12.88. The scores of GDS-30 showed significantly negative correlation with the scores of APGAR (r=-0.582,P<0.01)and the scores of CD-RISC (r=-0.425, P<0.01), and there was positive correlation between the scores of APGAR and the scores of CD-RISC (r=0.335, P < 0.01). The mediating model had high degree of fitting, and level of path had statistical significance (P < 0.01). Resilience was the mediator between family function and geriatric depression. Family function had direct effects (0.50) on geriatric depression and indirect effects (0.11) through resilience, and the combined effects of family function and resilience determined 45%changing range of geriatric depression. Conclusions Family function was a direct predictor of geriatric depression, and resilience had mediating effects between family function and geriatric depression. Community mental health work should pay enough attention to the effects of family function on the life of the aged, and increased the care to the elderly with family dysfunction, while promote and develop family-centered mental health education, propaganda and psychological guidance, so that improves resilience of the aged and help the aged positively coping and maintain good mental health status.
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Objective To compare sedated water exchange and conventional colonoscopy in the recovery time,rates of reaching ileocecal valve and adenoma detection.Methods A total of 200 newly diagnosed patients undergoing colonoscopy with routine bowel preparation and propofol intravenous anesthesia were randomly divided into 2 groups:water exchange group (WE) and conventional group,100 patients in each group.The operations were performed by two experienced physicians.The recovery time,rates of reaching ileocecal valve and adenoma detection of each group were analyzed and compared after operation.Results The recovery times of patients in water exchange and conventional groups were 8.08±0.58 min and 12.34±0.72 min,respectively (F =2 147.33,P＜ 0.05).Rates of reaching ileocecal valve were 100.00％(100/100,WE group) and 96.00％ (96/100,conventional group),respectively(x2 =4.17,P＜0.05).Adenoma detection rates of whole colon were 43.00％ (43/100,WE group) and 29.00％ (29/100,conventional group) (x2=4.25,P＜0.05),of which small adenomas (＜ 1.0 cm) accounted for 83.96％ (89/106,WE group) and 70.59％ (48/68,conventional group) (x2 =4.43,P ＜ 0.05),respectively.Adenoma detection rates of proximal colon were 28.00％ (28/100,WE group) and 20.00％ (20/100,conventional group) (x2 =1.75,P＞ 0.05),of which small adenomas (＜ 1.0 cm) accounted for 90.41％ (66/73,WE group) and 74.47％ (35/47,conventional group) (x2 =5.45,P ＜ 0.05),respectively.Conclusion Water exchange colonoscopy can not only shorten the recovery time of patients,but also increase rates of reaching ileocecal valve and adenoma detection.
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BACKGROUND:Conditioned medium from mesenchymal stem cels (MSC-CM) that contains abundant MSCs paracrine substances may represent a promising alternative to MSCs transplantation. However, normal MSC-CM with insufficient paracrine ability is not effective for tissue damage repair. OBJECTIVE:To investigate the effects of MSC-CM with (MSC-CMHyp) and without hypoxic activation (MSC-CMNor) on the proliferation and apoptosis of radiation-induced injured intestinal epithelial cels (IEC-6) and to further discuss the paracrine mechanisms. METHODS: IEC-6 cels were exposed to 10 Gy irradiation and cultured in MSC-CMHyp, MSC-CMNor, and DMEM-F12 medium, respectively. RESULTS AND CONCLUSION: Findings from trypan blue staining, flow cytometry and western blot assay showed that, compared with the DMEM-F12 medium group, treatment with MSC-CMHyp significantly enhanced IEC-6 viability proliferation after radiation-induced injury, as wel as significantly decreased cel apoptosis and expression of Caspases-3/8 (P 0.05). On the other hand, the increased levels of vascular endothelial growth factor, basic fibroblast growth factor, insulin-like growth factor-1, and interleukin-10 were detected in the MSC-CMHyp group compared to the MSC-CMNor group (P < 0.05). These results suggest that the MSC-CMHyp improves the viability and proliferative capacity of IEC-6 cels after radiation-induced injuryvia up-regulating secretion of cytokines and down-regulating apoptotic signaling.
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BACKGROUND:Conditioned medium from mesenchymal stem cels (MSC-CM) may represent a promising alternative to MSCs transplantation. Previous studies have shown that inflammatory activation can strengthen the multiple biological potencies of MSCs; however, normal MSCs with insufficiency of immunocompetence and migration ability are not effective for tissue damage repair. OBJECTIVE:To investigate differential effects of MSC-CM with and without inflammatory activation on radiation-induced intestinal injury.METHODS:MSCs from the bone marrow of SD rats were separated, cultured and identified, and then co-cultured with non-irradiated IEC-6 or irradiated IEC-6 in a transwel system for 24 hours. Then, MSCs with inflammatory activation were cultured alone for another 48 hours. After that, the supernatant was colected as non-activated MSC-CM (MSC-CMNOR) and MSC-CM under radiation-induced inflammatory condition (MSC-CMIR). Rats were exposed to 14 Gy whole abdominal irradiation and randomly divided into four groups: control group, radiation injury group (DMEM/F12), MSC-CMNOR group and MSC-CMIR group. Continuous administration was givenvia tail vein and intraperitoneal implantation of Alzet microosmotic pumps. Intestinal samples were colected at 1, 3, 7 days after radiation for analysis of short circuit variation, at 3 days after radiation for analysis of intestinal epithelium ultrastructure, and at 1, 3, 5, 7, 14 days after radiation for histological observation of the intestinal epithelium using hematoxylin-eosin staining. Blood samples were colected at 1, 3, 7 days after radiation for analysis of serum xylose levels. In addition, the survival state and survival time of rats were observed and recorded. RESULTS AND CONCLUSION: The short circuit variation responding to electrical field stimulation was significantly reduced at al frequencies, but it was significantly improved in the MSC-CMIR group. Similarly, the intestinal absorption (serum xylose levels) was also significantly impaired by irradiation, but improved by delivery of MSC-CMIR (P < 0.05). At 3 days after MSC-CMIR infusion, the intestinal epithelium exhibited an increase in crypt size and vilous length (P < 0.05). Under the electron microscope, a reduction in intestinal microvili and open tight junctions in irradiated intestinal epithelium was found, and the intestine from rats treated with MSC-CMIR had more obvious tight junctions. In addition, treatment with MSC-CMIR dramaticaly improved the survival rate and mean survival time of irradiated rats as compared to those treated with DMEM/F12 or MSC-CMNOR (P < 0.05). Taken together, the present study demonstrated that MSC-CMIR , but not non-activated MSC-CM, improves the structural and functional restoration of the smal intestine after radiation-induced intestinal injury.
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Objective To study the etiology,relevant factors and endoscopic characteristics of acute lower gastrointestinal tract hemorrhage.Methods A total of 938 patients receiving emergency colonoscopy for acute lower gastrointestinal tract hemorrhage were collected to study the etiological profiles.Different causes between young group and elderly group were also recorded.Results The total detectable rate of acute lower gastrointestinal tract hemorrhage in respect of causes was 96.16％ (902/938).The five leading causes were colorectal malignancy (41.26％),erosive colorectal polypus (12.37％),inflammatory bowel disease (9.59％),erosive and ulcer colitis (10.34％) and hemorrhoids (8.64％).Compared with youth and middle age patients,the incidence of colorectal malignancy (x2 =68.116,df =2,P =0.000) and colorectal polyps (x2 =9.101,df =2,P =0.011) were significantly increased in elderly patients,while incidence of inflammatory bowel disease (x2 =62.150,df=2,P =0.000) and erosive and ulcer colitis (x2 =20.292,df =2,P =0.000) were significantly decreased in those patients.Conclusions Emergency colonoscopy for diagnosis of acute lower gastrointestinal tract hemorrhage is an important measure.The major manifestation is bleeding resulting from colorectal malignancy,erosive colorectal polypus,inflammatory bowel disease,erosive and ulcer colitis and anal hemorrhoid.Age is associated with the cause of lower gastrointestinal tract bleeding induced by different kinds of lesions at the colorectum.
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OBJECTIVE:To evaluate the short and long-term therapeutic effects of endoscopic variceal ligation(EVL) plus somatostatin on bleeding esophageal varices METHODS:64 patients with acute esophageal variceal bleeding due to portal hypertension underwent EVL,then the patients were divided into EVL group and EVL+somatostatin group RESULTS:The short-term hemostatic rates reached 93% in both groups There were significant differences in postoperative rebleeding rate and average interval of rebleeding between two groups(P
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Objective To investigate the endoscopic prevalence of erosive esophagitis (EE) among 13 hospitals in Guangdong province of China. Methods Retrospectively reviewed all the cases (63459 cases) that received oesophagogastrodeuodenoscopy in 13 main hospitals in Guangdong province of China in 2003. Los Angeles criteria for classification of erosive esophagitis were employed as the basis of analysis. Results One thousand two hundreds and sixty-three patients (age range 3-90yr, mean 50. 2 ?17. 1 ) were found to have EE. The overall prevalence of EE was 1. 99% (1263/63459). The prevalence of EE in A, B, C, and D grade were 0. 94% , 0. 69% , 0. 21% and 0. 14% respectively. Age correlated positively on endoscopic grading of EE (F=22. 932, P