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Objective:To compare the efficacy and safety between WangShiBaoChiWan and mosapride in the treatment of functional dyspepsia (FD).Methods:From September 2019 to September 2020, patients with postprandial fullness and early satiation who met the Rome Ⅳ criteria for FD diagnosis were enrolled from 15 hospitals, including the First Affiliated Hospital of Naval Medical University (Shanghai Changhai Hospital), Beijing Traditional Chinese Medicine Hospital Affiliated to Capital Medical College. The subjects were randomly divided into WangShiBaoChiWan (experimental) group and mosapride (control) group in the ratio of 1∶1. The treatment regimens were WangShiBaoChiWan+ mosapride simulator, WangShiBaoChiWan simulator+ mosapride, respectively with a treatment period of 2 weeks. The primary efficacy outcome was the improvement rates of main symptoms before and after treatment, the secondary efficacy primary efficacy outcome was the total clinical effective rate and the change of the single symptom score. And the safety indicator included adverse events. Independent sample t-test, paired t-test and chi-square test were used for statistical analysis. Results:A total of 251 FD patients were enrolled in the full analysis set, including 124 in the experimental group and 127 in the control group; 241 FD patients were in the per-protocol analysis set, including 117 in the experimental group and 124 in the control group. The analysis of per-protocol analysis set showed that the improvement rates of the main symptoms of the experimental group and the control group were (66±29)% and (60±30)%, respectively, and the difference was not statistically significant ( P>0.05). The improvement rate of the main symptoms of the experimental group reached 117% of that of the control group, which exceeded the expected non-inferiority standard of 80%. The total clinical effective rates of the experimental group and the control group were 76.07% (89/117) and 75.81% (94/124), respectively, and the difference was not statistically significant ( P>0.05). The results of full analysis set showed that the incidence of adverse events of the experimental group and the control group was 1.62% (2/124) and 1.57% (2/127), respectively, and the difference was not statistically significant ( P>0.05). There were no serious adverse events in the two groups. Conclusion:The improvement rate of the main symptoms of WangShiBaoChiWan is not inferior to that of mosapride in the treatment of FD, and it has good safety.
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Background:There is no specific therapy for inflammatory bowel disease(IBD),and the pathogenesis of IBD is not fully clear. Aims:To explore the expression and clinical significance of IL-17BR in colon mucosa and peripheral blood mononuclear cell(PBMC)of patients with IBD. Methods:Colon mucosal biopsy specimens of 40 Crohn's disease(CD) patients,32 ulcerative colitis(UC)patients and 25 healthy controls and PBMC of 30 CD patients,27 UC patients and 25 healthy controls were collected. The expressions of IL-17BR in colon mucosa and PBMC were determined by immunohistochemistry and flow cytometry,respectively,and correlations between IL-17BR expression and levels of CRP, ESR,CDAI score and Mayo score were analyzed. Serum levels of TNF-α before and after infliximab(IFX)treatment were determined by ELISA,and correlations with IL-17BR were analyzed. Results:Compared with healthy controls,IL-17BR expressions in colon mucosa of CD and UC patients were significantly increased(P<0.05). IL-17BR expressions were significantly higher in active CD and UC patients than in remission CD and UC patients(P <0.05). No significant differences in IL-17BR expression in PBMC were found among CD,UC patients and healthy controls(P>0.05). The expression of IL-17BR in colon mucosa was positively correlated with CRP,ESR,CDAI score or Mayo score in CD,UC patients(P <0.05). After treatment with IFX,expression of IL-17BR in colon mucosa and serum TNF-α level were significantly decreased in CD patients(P<0.01). Expression of IL-17BR was positively correlated with serum TNF-α level in CD patients(P<0.05). Conclusions:The increasing of IL-17BR expression in IBD patients is closely correlated with activity of inflammation and TNF-α level. IL-17BR may play a vital role in immune response of intestinal mucosa,and can be used as a new marker for reflecting the activity of IBD.
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Objective To make a meta-analysis of the effectiveness of hyperthermic perfusion chemotherapy (HPC) combined with bevacizumab for malignant ascites or malignant pleural effusion,and to provide the references for further practice and studies.Methods VIP,Wanfang data,PubMed and CNKI were searched from inception to January 2018.HPC combined with bevacizumab or HPC alone for malignant ascites or pleural effusion were collected for controlled clinical trial (CCT).According to inclusion and exclusion criteria,two reviewers checked studies,extracted data and assessed quality of the included studies.RevMan 5.3 software was used to make a meta-analysis.Results A total of 4 CCT involved 226 patients.Meta-analysis showed that compared with the HPC alone,HPC combined with bevacizumab had a higher rate in clinical efficiency (OR =4.82,95 % CI 2.45-9.49,P < 0.000 01),malignant ascites or pleural effusion control rate (OR =4.06,95 % CI 1.09-15.11,P < 0.05),quality of life improvement rate (OR =6.79,95 % CI 3.53-13.08,P < 0.000 01),and the difference was statistically significant.Conclusion HPC combined with bevacizumab can improve the clinical effective rate,effusion control rate and quality of life improvement rate of the patients with malignant ascites or pleural effusion.
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Objective To detect the expression of tumor necrosis factor-α-induced protein-8 like-3 (TIPE3) in colonic mucosa of patients with colon cancer,and to analyze the correlation between its abnormal expression and clinicopathological features of patients with colon cancer.Methods The expression of TIPE3 mRNA in 58 cases of colon cancer and tumor adjacent tissues was detected by realtime polymerase chain reaction (RT-PCR).The expression of TIPE3 at protein level in 83 cases of colon cancer and tumor-adjacent tissues was determined by SP immunohistochemistry.Nonparametric rank-sum test and chi-square test were performed for statistical analysis.Results The relative expression of TIPE3 mRNA in the colon cancer tissues was 0.719 (0.104 to 0.887),which was lower than that of tumor-adjacent tissues (4.770,1.732 to 6.800),and the difference was statistically significant (Z=-6.345,P<0.05).There was no statistically significant difference in the expression of TIPE3 mRNA in colon cancer tissues between different gender,age and TNM stage (all P>0.05).The expression of TIPE3 mRNA in group of patients with lymph node metastasis (0.113,0.061 to 0.375) was lower than group of patients without lymph node metastasis (0.489,0.327 to 0.956;Z=3.815,P<0.01).The expression of TIPE3 mRNA of patients survived less than five years after operation (0.104,0.049 to 0.220) was lower than that of patients survived over five years (0.482,0.266 to 0.908;Z=-3.653,P<0.01).The expression of TIPE3 mRNA of patients with recurrence after operation (0.188,0.091 to 0.493) was lower than that of patients without recurrence (0.409,0.233 to 1.010;Z=-2.431,P=0.015).The recurrence rate of TIPE3 mRNA high expression group in five years after operation was lower than that of TIPE3 mRNA low expression group (23.1%,6/26 vs 56.2%,18/32);and the difference was statistically significant (x2 =6.508,P<0.05).The expression of TIPE3 at protein level of colon cancer tissues (44.6 %,37/83) was lower than that of tumor-adjacent tissues (68.7 %,57/83;x2 =8.004,P<0.05).The expression of TIPE3 at protein level was not correlated with age and gender (both P>0.05).The positive expression rate of patients at stage Ⅱ was higher than that of patients at stage Ⅲ (60.5%,23/38 vs 29.7%,1/37);and the difference was statistically significant (x2 =7.174,P< 0.05).The positive expression rate of TIPE3 in group of patients with lymph node metastasis was lower than that of groups of patients without lymph node metastasis (28.2%,11/39 vs 59.1%,26/44),and the difference was statistically significant (x2=7.983,P =0.005).Conclusions The expression of TIPE3 in colon cancer tissues is lower than that in tumor-adjacent tissues.Furthermore,it is correlated with lymph node metastasis,recurrence rate and survival rate.TIPE3 may be involved in the genesis,development,invasion and metastasis of colon cancer.
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Objective To analyze the experience of scientific research management in a Traditional Chinese medicine (TCM) hospitals.Methods We systematically summarized the experience of existing practices and established a TCM scientific research delicacy management model including project process management,funds management,personnel evaluation,institutional construction and output transfer.Results The scientific research management model was suitable for the hospital development,in accordance with daily medical and teaching practice.Conclusions Scientific research ability had gradually become an important indicator of TCM hospital evaluation.This management model could provide reference for related issues.
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Objective To explore the problems in traditional Chinese medicine (TCM) scientific research project management and provide possible countermeasures.Methods Through cluster sampling,all the scientific research administrators and staff in a hospital were selected.A questionnaire about TCM hospital scientific research management was designed and used in our study.Results The majority of participants were basically satisfied with current scientific research management in TCM.Problems were analyzed including complex project application,singular evaluating standard,inflexible fund management,and backward professional concept.Conclusions The management of scientific research projects in TCM should combine professional characteristics,innovatively and comprehensively improve management concept,system,team and method.
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Intestinal microecology is an important and complex biological system necessary for human health.Its disorder is involved in the development of various diseases of human body.The technology of intestinal microbiota transplantation can effectively regulate the intestinal flora,repair the imbalance of the intestinal microecology,and bring a new breakthrough for the treatment of many diseases of gastrointestinal tract and outside gastrointestinal tract.However,there is still no systematic and complete management standard for intestinal microbiota transplantation technology.This paper discussed related content involved in standardized management of intestinal microbiota transplantation technology and reflected the ethical problems involved in standardized management from the perspective of medical ethics,in order to promote the clinical application of intestinal microbiota transplantation technology.
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Objective To evaluate the efficacy and safety of Houpu Paiqi mixture in treatment of functional dyspepsia (FD)with abdominal distension symptom.Methods From July 2014 to June 2015 , in nine centers,a total of 162 FD patients with abdominal distension symptom and met Rome Ⅲpostprandial distress syndrome (PDS)diagnostic criteria were enrolled.All patients were randomly divided into trial group and control group,81 patients in either group.The patients of trial group and control group took Houpu Paiqi mixture or placebo,respectively,25 mL per time,twice daily,and both the courses of treatment were two weeks.Before and after the treatment,the improvement of main symptoms,total clinical efficacy rate and efficacy of traditional medicine between two groups were compared.Chi square test,Fisher exact probability method and Wilcoxon test were performed for statistical analysis.Results According to the results of per-protocol (PP)analysis,the total efficacy rate of trial group and control group was 69.4% (50/72)and 59.2% (42/71),respectively,and there was no statistically significant difference in total efficacy rate between the two groups (χ2 =1 .650,P =0.199 ). And there was no statistically significant difference in the improvement of PDS main symptoms(postprandial fullnessand early satiety)between the two groups (56.3% ±27.9% vs 54.4% ±32.1%,t =0.606,P =0.727 ).For those with baseline symptom score over 14,median early satiety score of trial group after the treatment was 0,which was lower than that of control group,and the difference was statistically significant (Z =-2.370,P =0.018).The total efficacy rate of traditional medicine of trial group was 80.8% (59/73 )and that of control group was 72.0% (54/75 ),and the difference was not statistically significant (χ2 = 0.676,P =0.411 ).Conclusion Houpu Paiqi mixture has certain efficacy in FD with abdominal distension,and could be used for the treatment of PDS-predominant FD.
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Background and purpose: Multidrug resistance (MDR) is the dominating obstacle to the chemotherapy. There is strong evidence that the phosphoinositide 3-kinases (PI3Ks) signaling pathway is involved in MDR phenotype, however, the mechanism of MDR occurrence is still unknown. This study tended to investigate the regulating effect of PI3K/Akt signaling pathway and its downstream target genes in P-glycoprotein (P-gp) (ABCB1 gene encoding)-mediated MDR in human colon carcinoma HCT-116/L-OHP cells. Methods:Pretreatment with PI3K selective inhibitor LY294002 (20μmol/L) for 2 h, the sensitivity of L-OHP was evaluated by the CCK-8 (cell counting kit-8) assay in HCT-116/L-OHP cells, and the expressions of P-gp, LRP, MRP-2, Akt, p-Akt, IκB and p-IκB were evaluated by Western blot. The activity of ABCB1 promoter was evaluated by chromatin immunoprecipitation analysis (CHIP). Results: After inhibiting the activity of PI3K/Akt signaling pathway, the IC50 value of L-OHP decreased from(157.48±16.73)μg/mL to (53.68±3.18)μg/mL in HCT-116/L-OHP cells, and the reversal index was 2.93 (P<0.01). The expressions of P-gp, p-Akt and p-IκB were down-regulation compared with the concrol group (P<0.01), but the expressions of LRP, MRP-2, Akt and IκB didn't change signiifcantly. CHIP result has conifrmed that NF-κB protein could bind to the region of ABCB1 gene promoter in HCT116/L-OHP cells. Conclusion:Blocking of PI3K/Akt/NF-kB signal pathway could increase the drug sensitivity to MDR cells, inhibit the phosphorylation of p-Akt and p-IκB, and reversing ABCB1/P-glycoprotein-mediated multidrug resistance in colon carcinoma cells.
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Shanghai district and county health system performance evaluation conceptual frameworkwas proposed based on health services system performance assessment frameworks raised by some countries and international organizations,and combined with Shanghai district and county health system characteristics.This framework contains two first grade indices and seven second grade indices:In the long term goals,'health','satisfaction' and 'disease risk protection' are the county's longterm effects of health system performance assessment dimensions; in the medium-term goals,the'accessibility','cost',' efficiency' and 'quality' are the county' s medium-term effects of health system performance assessment dimensions.This study aimed to evaluate Shanghai county health system's overall performance.Further study is needed in constructing its third grade indices.
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ObjectiveTo explore the relationship of trefoil factor family 3 (TFF3),vascular endothelial growth factor (VEGF) and hypoxia-inducible factor (HIF)-1α in gastric cancer SGC-7901 cells under hypoxic condition and try to investigate the mechanism of TFF3 in the genesis and development of gastric cancer. Methods The hypoxic model of gastric cancer SGC-7901 cell was induced by CoCl2 Gastric cancer cell line SGC-7901 cells were transfccted with pU6-siTFF3 plasmid which carrying RNAi targeted to human TFF3 and pU6-mock.Puromycin was selected as screening medicine.The stable and specific TFF3 inhibited gastric cancer cell line was established. Gastric cancer cell line SGC-7901 and TFF3 RNAi targeted gastric cancer cell line SGC 7901 were cultured under hypoxic condition and normoxic condition. The expression of TFF3,VEGF and HIF-1a at protein and mRNA level were detected by RT-PCR,Western blot and ELISA assay.The distribution and expression of TFF3 and HIF-1α in gastric cancer cell line SGC-7901 cells uuder normoxia and hypoxic condition were determined with immunofluorescence staining.Results The expressions of HIF-1a,TFF3 and VEGF in gastric cancer SGC-7901 cell increased under CoCl2 induced hypoxic condition (33.4 =1.8,14.8 ± 1.1 and 15.1 ± 1.2,respectively). Under hypoxie condition,the expression of VEGF and HIF-1α protein reduced in stable TFF3 RNAi SGC-7901cells.Conclusion TFF3 mediated the regulation of VEGF and HIF-1α expression under hypoxic condition.TFF3might be a potential anti-angiogenic target in gastric cancer treatment.
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Objective To investigate the effects of β-arrestin1 on proliferation,migration,invasion and apoptosis of human gastric cancer BGC-823 cell line.Methods The expression of β-arrestin1 in human gastric epithelial cell line GES,human gastric cancer cell line BGC-823,MKN-28 and SGC-7901 was detected by realtime-polymerase chain reaction (PCR) and Western blot.The stable β- arrestin1 and negative control interfered BGC-823 cell line were established by RNA interference technology.The cell proliferation,migration,invasion and cell apoptosis of β-arrestin1 stable interfered BGC-823 cell line was examined by cell counting,scratch test,Transwell chamber test and flow cytometry assays.The data were analyzed by t test.Results The expression of β-arrestin1 in cell line GES,MKN-28,SGC-7901 and BGC-823 was 0.001 ± 0.001,0.002 ± 0.000,0.003± 0.002 and 0.005 ± 0.000 respectively.The inhibition ratio of proliferation in β-arrestin1 interfered BGC-823 cells and negative control cells were -30.2 % and 100.0 %.The invasion ability was also inhibited,the number of migratory cells was 126.25±3.24 and 213.50±6.27 (t=0.000,P<0.01),and the apoptosis rate was (41.350±1.053)% and (11.497±0.589) % (t=0.015,P<0.05).Conclusions β-arrestin1 is highly expressed in gastric carcinoma,and the expression increased along with the malignancy degree.The cell proliferation,migration and invasion is inhibited by interference of β-arrestin1 in BGC-823 cells,while the cell apoptosis is promoted.
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The idea of establishing Shanghai Academy of Medical Sciences was brought forward in the background of great external changes.It was to meet the demand for resolving all kinds of conflicts about researches arised from the long time operation of Medical Institutes in Shanghai.This article mainly discusses about the necessity and plans for establishing Shanghai Academy of Medical Sciences.
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To investigate whether saikosaponin-d (SSd) had estrogen-like effects in mice.
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Objective To investigate mutation patterns in core promoter(CP)region of hepatitis B virus(HBV).Methods HBV DNA was extracted from sera of patients with chronic HBV infection.The CP sequence was amplified by polymerase chain reaction(PCR)and cloned into pMD19 T vector.The positive clones were then sequenced.The sequences were compared with known HBV genome in GenBank to identify the mutation sites and patterns of patients with chronic HBV infection.Results There were 74 clones from 21 patients with chronic HBV infection which were sequenced.The sequence comparisons showed that there was a 234-nucleotide deletion in CP region of HBV genome in 54 clones and a 245-nucleotide deletion in one clone.These deletion regions included CP,HBeAg initiation codon and direct repeat sequence(DR)Ⅰ regions,which named CP deletion(CPD).A1585T replacement mutation was also found in HBV strain with CPD,which indicated that there was linkage between these two mutations.Conclusions A novel mechanism of HBeAg negative chronic hepatitis B is observed,which includes deletions of CP and HBeAg initiation codon.Meanwhile,a simple and useful PCR method is developed to detect CPD.
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Objective To investigate the effect of rebamipide on chronic non-atrophic gastritis (NAG) with erosion and its protection of gastric mucosa from Helicobacter priori(Hp) associated lesions.Methods Patients(n=452)with endoscopically confirmed NAG with erosion from 11 hospitals in China were enrolled and randomly assigned at a ratio of 3:1 to receive either rebamipide(100 mg t.i.d.)or sucralfate(1.0 t.i.d.)for 8 weeks.Hp infected patients received eradication treatment before randomization.Symptoms,endoscopic scores and histological changes were recorded before and after therapy.Concentrations of serum prostaglandin E(PGE:)and oxygen free radical(MDA)were measured in patients from 2 centers.Results Per-protocol analysis(n=415)showed that the dyspeptic symptom score in rebamipide group decreased significantly after eight weeks of treatment. The endoscopic inflammation score in rebamipide group also decreased from 2.65 ±0.09 to 0.60±0.10(P<0.001),which was,significantly better than that of sucralfate group(P<0.001).Histological findings were consistent with the endoscopic findings.There Was a significant elevation(P=0.002)in PGE2 concentration in mucesa from rebamipide-treated subjects [(225.4±18.3) pg/g vs.(266.7±14.7)Pg/g] compared with that in sucralfate group.The concentration of MDA significantly decreased from(325.9±65.6)mmoL/g to(216.5±61.5)mmol/g,which is markedly different from that of sucralfate group(P=0.046).No statistical difference was found between Hp eradication group,Hp infection group and Hp negative group,regarding the effect of Rebamipide.Conclusion Compared to sucralfate,Rebamipide demonstrates a superior effect on improvement of dyspepsia symptom and endoscopic findings in erosive NAG,which is not influenced by Hp infection.
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Objective To determine whether trefoil factor 1(TFF1) could be associated with healing of gastric mucosa and differentiation of gastric carcinoma. Methods TFF1 in normal and various pathologic gastric mucosa was assessed by immunohistochemical method and analyzed with Motic Images Advanced 3.0 software. Results Compared with normal mucosa, increased TFF1 was detected in gastritis, gastric ulcer and duodenal ulcer. TFF1 was in increased expression in multiple and compound ulcer than simple ulcer. There was no significant difference among gastric ulcer, duodenal ulcer, gastritis and simple ulcer. Increased TFF1 was detected in peripheral mucosa of the gastric adenocarcinoma as compared with normal mucosa. The expression of TFF1 in gastric adenocarcinoma was related to the differentiation of adenocarcinoma, that is, the more poorly differentiated, the lower expression of TFF1. Conclusion TFF1 may play a significant role in gastric mucosa protection and epithelial restitution. TFF1 may also contribute to the differentiation of gastric adenocarcinoma.