[Clinical effectiveness of fecal microbiota transplantation combined with nutritional support and psychological intervention in patients with "Tetralogy of Tongji"]

Objective: To summarize and analyze the clinical effect of fecal microbiota transplantation (FMT) combined with nutritional support and psychotherapy in patients with "Tetralogy of Tongji" (comprising chronic gastrointestinal dysfunction, mental and psychological disorders, malnutrition, and endocrine disorders). Methods: A longitudinal study was conducted. The inclusion criteria were as follows: (1) patients were under 70 years of age; (2) patients exhibited chronic gastrointestinal dysfunction (in accordance with the Rome IV diagnostic criteria for irritable bowel syndrome ie. chronic functional constipation, diarrhea, abdominal pain and abdominal distention) with onset occurring more than one year previously; (3) patients exhibited malnutrition (body mass index ≤ 18.5 kg/m²); (4) patients exhibited depression, anxiety, or state as diagnosed by a psychologist using the Hamilton anxiety rating scale (HAMA) and the Hamilton depression scale (HAMD); (5) patients were women of childbearing age with amenorrhea or menstrual disorder with a duration ≥6 months. Patients were excluded if they exhibited gastrointestinal bleeding, short bowel syndrome, radiation-induced intestinal injury, intestinal obstruction or inflammatory bowel disease, recurrent/metastatic tumors, systemic infectious diseases, life-threatening systemic comorbidities, intorlerate to nasojejunal, percutaneous gastrostomy / jejunostomy or FMT. The clinical data of 43 patients at Shanghai Tenth People's Hospital exhibiting the "Tetralogy of Tongji" and who received microflora transplantation combined with nutritional support and psychotherapy from June 2017 to June 2021 was prospectively collected. There were 12 males and 31 females with a mean age of 35.2±16.7 years. All 43 patients had chronic gastrointestinal dysfunction. Of these, 24 patients had depression and 19 had anxiety. There were 26 women of reproductive age, including 13 cases of menstrual disorder and 9 cases of amenorrhea. The treatment intervention was a combination of FMT (microflora solution or microflora capsule), nutritional support (enteral nutrition) and psychological intervention. The following were assessed before treatment and 1, 3, 6 months after treatment: (1) gastrointestinal function was assessed using the gastrointestinal symptoms rating scale (GSRS), where a higher score is indicative of more serious gastrointestinal symptoms, and the gastrointestinal quality of life index (GIQLI), where a higher score is indicative of higher quality of life; (2) psychological status was assessed using HAMA and HAMD scores, where a lower score is indicative of reduced severity of anxiety or depression symptoms, respectively; (3) nutritional status was assessed by measurements of total blood protein, albumin, fibrinogen and prealbumin, as well as measurements of body mass and body mass index (BMI); (4) neuroendocrine function was assessed by measurement of blood levels of cortisol, dopamine and noradrenaline, as well as menstruation in women of reproductive age. Results: The follow-up rates at 1, 3 and 6 months after treatment were 90.7% (39/43), 72.1% (31/43) and 55.8% (24/43), respectively. The total effective rate for chronic gastrointestinal dysfunction was 81.4% (35/43), of which the average GSRS score decreased from 29.35±3.56 before treatment to 18.25±2.56 in the sixth month (P<0.001). The average GIQLI score increased from 56.23±10.34 before treatment to 91.04±20.39 in the sixth month (P<0.001). All patients had malnutrition before treatment. After 6 months, their body weight had increased from 40.61±8.88 kg to 50.45±6.23 kg (P<0.001), and BMI had increased from 15.17±1.87 kg/m² to 19.58±1.42 kg/m² (P<0.001). The average total protein level was 60.99± 5.99 g/L before treatment. After 6 months, this had increased to 64.21±4.23 g/L (F=2.715, P=0.022). The average prealbumin level increased from 150.14±56.04 mg/L before treatment to 258.17±86.94 mg/L after 6 months (F=15.124, P<0.001). In this study, 24 patients with depression/depressed state were included. After treatment, the average HAMD score in these patients decreased from 22.79±6.63 before treatment to 9.92±7.24 after 6 months (P<0.001). There were 19 patients with anxiety disorder/anxiety state. After treatment, the average HAMA score in these patients decreased from 17.15±4.34 before treatment to 7.73±4.10 after 6 months (P<0.001). Observing the endocrine efficacy of 26 women of childbearing age, it was found that the effective rate of this treatment on endocrine regulation was 69.2% (18/26). Although there was no significant change in blood cortisol levels after 6 months, average blood dopamine levels decreased from 32.91±10.65 nmol/L before treatment to 13.02±5.58 nmol/L after 6 months (P<0.001). Average blood norepinephrine levels decreased from 49.75±15.23 ng/L before treatment to 19.21±9.58 ng/L after 6 months (P<0.001). Conclusion: The strategy of FMT combined with nutritional support and psychological intervention is effective in improving the symptoms of the "Tetralogy of Tongji".

[Clinical significance and intervention strategy of gastrointestinal psychiatry]

With the development of global economy and society,the number of patients who suffer from functional gastrointestinal disorders (FGID) and mental illness is growing. In recent years, a substantial amount of high-quality research evidence shows that these two kinds of diseases often coexist, and they are mutually causal, and their common pathophysiology is the abnormal interaction of "bacteria-gut-brain axis". In clinical practice, there are some problems, such as insufficient recognition and attention of both doctors and patients to its clinical manifestations, lack of understanding of pathophysiological mechanism, and lack of overall and integrated views of intervention methods, which may be the main factors of poor curative effect at present. Therefore, according to the global research progress and the author's clinical experience, we put forward a new viewpoint of "gastrointestinal psychiatry", it concluded that clinical intervention strategies needed to include dietary and lifestyle changes as well as multidisciplinary interventions such as probiotics, prebiotic, fecal microbiota transplantation and cognitive psychology. On the basis of gastrointestinal psychiatry, this paper systematically elaborated the diagnosis and treatment of this kind of diseases.

[Analysis of allergen spectrum and sensitization factors in children with allergic rhinitis]

Objective:The aim of this study is to analyze the distribution of common allergens in allergic rhinitis patients aged 2-15 in Zhangjiagang area,in order to provide a path to know the epidemic features of children with AR, and supports epidemiological materials to find better prevention, diagnosis and treatment for them.Method:From July.2015 to July.2018,1 320 children aged 2-15 who were suspected with allergic rhinitis by the doctors of ENT clinic in the Zhangjiagang Affiliated Hospital,were enrolled in this project.Using the serum specific IgE detection methods to detect common allergens in those patients,then analyze the relationship among allergens and gender,age and visiting time of every single patient.Result:The total positive rate of 1 320 children was 82.50%,and the total positive rate of 8 common inhaled allergens was 82.50%.The main allergens were dust mites and dogs. The total positive rate of Children aged in 7-12 was the highest,and the positive rate of dust mites of male was higher than female.The common food allergens total positive rate was 9.09%.And the top three food allergens were milk,shrimp,crab.The number of visitors in July and August was the most in a year.The dust mite had the highest positive rate among common inhaled allergen in a year,and the maximum value appeared in July.The rate of patients who were allergic to one inhalant allergen were lower than those who were allergic to two or more inhalant allergens.Conclusion:The dust mite is the major allergen above all.The total positive rate of Children aged in 7-12 was the highest,and the positive rate of dust mites of male was higher than female;the maximum value appeared in July and August.The rate of patients who were allergic to one inhalant allergen were lower than those who were allergic to two or more inhalant allergens.

[Analysis of Koch phenomenon of Mycobacterium tuberculosis-infected guinea pigs vaccinated with recombinant tuberculosis vaccine AEC/BC02]

OBJECTIVE

To observe the Koch phenomenon of Mycobacterium tuberculosis(MTB)-infected guinea pigs after vaccinated with killed H37Ra bacteria or tuberculosis vaccine candidate AEC/BC02.

METHODS

Eighteen guinea pigs were challenged subcutaneously with 5.0×10(3) CFU MTB and after 40 days were divided into 3 groups (6 per group): NS group, AEC/BC02 group and H37Ra group, which were injected intramuscularly 3 times at 1 day interval with normal saline, AEC/BC02 vaccine and killed H37Ra bacteria respectively. Three weeks after the first vaccination, all guinea pigs were sacrificed to evaluate gross pathological scores for liver, spleen and lung, bacterial loads in lung and spleen, and lung inflammation.

RESULTS

The gross pathological score in H37Ra group (48±26) was lower than that in NS group(62±15), but the difference was not significant (t=1.093, P=0.300). The AEC/BC02 group had a significantly lower gross pathological score (36±15) than NS group (t=2.980, P=0.014). No significant difference between H37Ra group and AEC/BC02 group was observed (t=1.009, P=0.337). The spleen bacterial load [(5.31±0.80) log10 CFU]in H37Ra group was slightly lower than that in NS group[(5.57±0.75) log10 CFU] but the difference was not significant (t=1.581, P=0.574). In AEC/BC02 group bacterial load in the spleen was (4.64±0.64) log10 CFU and significantly lower than NS group (t=2.306, P=0.044) and no significant difference between H37Ra group and AEC/BC02 group was observed (t=1.602, P=0.140). Meanwhile, the lung bacterial load in AEC/BC02 group was (3.71±1.01) log10 CFU and in H37Ra group was (3.82±1.25) log10 CFU. Compared to (4.15±0.69) log10 CFU in the NS group, no significant differences were found (t=0.881, P=0.399; t=0.566, P=0.584, respectively). For the lung inflammation, the inflamed areas in H37Ra group were significantly larger [(33.0±4.4%)] than those in both NS group [(14.8±8.4) %, t=4.719, P=0.001] and AEC/BC02 group [(14.8±8.4) %, t=3.616, P=0.005], and no significant differences were seen between AEC/BC02 group and NS group (t=1.041, P=0.322).

CONCLUSION

The lung inflammation indicated that killed H37Ra bacteria evoked an obvious Koch reaction in the MTB-infected guinea pigs, whereas AEC/BC02 vaccine showed a low risk of causing Koch phenomenon.

Structural properties and superconductivity of SrFe(2)As(2 - x)P(x) (0.0 ≤ x ≤ 1.0) and CaFe(2)As(2 - y)P(y) (0.0 ≤ y ≤ 0.3)

The SrFe(2)As(2 - x)P(x) (0.0 ≤ x ≤ 1.0) and CaFe(2)As(2 - y)P(y) (0.0 ≤ y ≤ 0.3) materials were prepared by a solid-state reaction method. X-ray diffraction measurements indicate that the single-phase samples can be successfully obtained for SrFe(2)As(2 - x)P(x) (0.0 ≤ x ≤ 0.8) and CaFe(2)As(2 - y)P(y) (0.0 ≤ y ≤ 0.3). Visible contraction of the lattice parameters is determined due to the relatively smaller radius of P ions in comparison with that of As. The spin-density-wave (SDW) instability associated with the tetragonal to orthorhombic phase transition is suppressed noticeably in both systems following the increase in P content. The highest superconducting transitions are observed at about 27 K in SrFe(2)As(1.3)P(0.7) and at about 13 K in CaFe(2)As(1.925)P(0.075), respectively. Structural analysis suggests that lattice contraction could notably affect the superconductivity in these materials.

[Quantitative analysis of cellular morphometry and DNA content measurement of experimental lung adenocarcinoma]

This article reported the image analysis of normal epithelia of bronchi (group 1), hyperplasia epithelia (group 2), atypical hyperplasia epithelia (group 3) and adenocarcinoma (group 4) of the lung in the hamsters induced by tin mine dust and chimney dust in Yunnan Tin Min CO. 16 parameters were observed and compared. Each value was tested by stepwise discriminational classification and an accuracy rate of 95% was reached. DNA ploidy was investigated, and no case of > 5C cell was found in normal and hyperplasia group. Severe atypia had a lower percentage, (4.00%) and lung adenocarcinoma was characterized by a high percentage of > 5C cell (10.75%), A significant difference was shown between the percentage of > 5C cell of severe atypia and that of adenocarcinoma. Significantly different (P < 0.01).

[Experimental study on effect of Brucea javanica oil emulsion on rabbit intracranial pressure]

Using the method of intubation into lateral cerebral ventricle, the effect of Brucea javanica oil emulsion (BJOE) venous emulsion and oral emulsion on rabbits with normal and intracranial hypertension respectively were observed, to study whether BJOE could reduce intracranial pressure or not. The results shown that venous emulsion of BJOE had strong action against the elevation of intracranial pressure produced by SNP (P < 0.01) while oral emulsion had mild action against it, which was similar to the clinical observation exhibiting improvement of clinical manifestations after application of BJOE on intracranial hypertension caused by brain metastasis from lung cancer.

Nutritional and haematological status of Chinese farmers: the influence of 13.5 months treatment with riboflavin, retinol and zinc

A retinol (15 mg), riboflavin (200 mg) and zinc (50 mg) supplement or a placebo (D-mannitol) was given to 610 Chinese farmers weekly for 13.5 months. Riboflavin, retinol, beta-carotene, tocopherol and zinc status were measured in all subjects at the start and end of the intervention and in a subsample at 2 months. Plasma vitamin C, haemoglobin and haematocrits were measured on other subsamples at the end of the supplementation period. At the start vitamin A, zinc and riboflavin status were poor. Plasma retinol and zinc concentrations were higher in men than women but the opposite was observed with respect to beta-carotene. There was no difference between the sexes for tocopherol and riboflavin. Tocopherol:cholesterol ratios suggested vitamin E status was good and vitamin C status also appeared adequate. The supplement increased plasma retinol throughout the whole period but riboflavin status improved only over the first 2 months and then remained constant. Plasma zinc increased in both treatment and placebo groups by approximately 15 to 20 per cent in men and women. Mean concentrations of retinol and tocopherol and beta-carotene (in women only) increased by approximately 20 per cent in the placebo group. It is argued that seasonal factors and/or the placebo may have been responsible for the increase in retinol and beta-carotene in the placebo group. The lack of an increase in beta-carotene in the men may have been due to their higher retinol requirements. Lastly, the increase in retinol may have been responsible for the increase in tocopherol and zinc in plasma since these nutrients increased in those whose plasma retinol increased, irrespective of treatment.

A prospective study of esophageal cytological atypia in Linxian county

Between 1975 and 1986, in Linxian county (LX), a prospective study of esophageal cytological hyperplasia and atypia was conducted on 3 groups of subjects: 294 with marked atypia, 328 with mild hyperplasia and 336 normal controls; all were diagnosed by cytology. Results showed that no significant difference in incidence of esophageal cancer (EC) appeared between subjects with mild hyperplasia and controls, while the incidence of EC in subjects with marked atypia was 1,178.92/100,000 which was 2.39 (after age-adjustment 2.90) times higher than that found in the control group and was of statistical significance (chi 2 = 8.92, p less than 0.01). In all groups, the relatively high risk of contracting EC was closely associated with drinking ground water, smoking and a low standard of living. These results suggest that early treatment should be given to subjects with marked atypia, accompanied by preventive measures against carcinoma of the esophagus, such as hygienic drinking water, abstention from smoking and better living conditions.

Blood, retinol and zinc riboflavin status in relation to precancerous lesions of the esophagus: findings from a vitamin intervention trial in the People's Republic of China

Data from a double-blind intervention trial in China are reanalyzed to explore auxiliary information. The trial had shown that in a high-risk area for esophageal cancer the dietary supplementation of apparently healthy individuals with a combination of retinol, riboflavin, and zinc did not lead to a different prevalence of precancerous lesions of the esophagus among those receiving the active treatment compared to a placebo group. However, improvement of blood retinol and zinc levels were also observed in the placebo group. The logistic regression analysis presented in this paper illustrates that those individuals who showed large increases in retinol, riboflavin, and zinc blood levels were more likely to have a histologically normal esophagus at the end of the trial. This effect is clearer for retinol than for riboflavin and zinc and it is independent of whether the change was caused by the active treatment or occurred otherwise.

Correlation between high salt intake and mortality rates for oesophageal and gastric cancers in Henan Province, China

This paper concerns the analysis of the rank correlation between salt quantity sold (SQS) to the Henan inhabitants from 1964-66, 1974-76 and their mortality rates for oesophageal cancer and gastric cancer in 1974-76. Both sets of data were in agreement with each other, and were consistent with the geographical distribution of these two diseases. Correlation coefficients derived from such analysis were as follows: oesophageal cancer in males--0.61 (p less than 0.01); and in females--0.47 (p less than 0.01); gastric cancer in males--0.63 (p less than 0.01), and in females--0.54 (p less than 0.01). SQS was positively correlated with mortality rates for oesophageal cancer and gastric cancer whereas it was not correlated with cancers of the liver, lung cancer and leukaemia in males and cervical cancer in females. There was no significant difference between the relevant parameters of the high incidence area and those of the low incidence area. These findings show that salt intake such as salty vegetables and cured meat might be one of the risk factors inducing oesophageal and gastric cancers.

Trends in morbidity and mortality for oesophageal cancer in Linxian County, 1959-1983

Data on morbidity and mortality from oesophageal cancer (EC) over the 25 years from 1959-1983 indicate that this malignancy has been the commonest cause of death in Linxian (LX) county during that period, accounting for 16% of deaths from all causes and 65% of deaths from cancer. Whereas incidence and mortality of EC were high but stable during this period, a decline in mortality has been noted recently in younger age groups, coinciding with an improvement in nutritional standards. Cohort analysis for the period 1879-1954 demonstrates mortality peaks among individuals born late in the last century and early in the present one. It also shows that a decline in mortality appears to have started among natives of the county born during the period 1935-1954.