BackgroundSeveral studies have revealed a positive correlation between a Helicobacter pylori (HP) infection and the risk of non-alcoholic fatty liver disease (NAFLD). This meta-analysis was conducted to explore further the relationship between HP infection and NAFLD in the Asian and non-Asian populations.MethodsRelevant studies published from inception to July 22, 2021, in the following databases: PubMed, EMBASE, the Cochrane library, and Web of Science were comprehensively searched. The odds ratio (OR) and hazard ratio (HR) with a 95% confidence interval (95%CI) were pooled by the random-effects model or fixed-effects model. Additionally, subgroup and sensitivity analyses were performed. The funnel plot and the Egger test were used to estimate publication bias.ResultsThis meta-analysis included 25 studies involving 107,306 participants. Positive associations between HP infection and NAFLD were found both for the Asian (OR = 1.30, 95% CI: 1.13–1.49, P < 0.01; I2 = 94.30%, P < 0.01) and non-Asian populations (OR = 1.42, 95% CI: 1.04–1.94, P = 0.03; I2 = 44.90%, P = 0.09). Moreover, similar results were observed in the Asian female group (OR = 1.31, 95% CI: 1.17–1.46, P < 0.01; I2 = 46.30%, P = 0.07) but not for the Asian male group. Subgroup analyses for the Asian population showed that there were differences in the association among NAFLD diagnosis methods (P < 0.01) and the study design (P < 0.01). However, subgroup and sensitivity analyses results showed that the association for the non-Asian population was not stable enough.ConclusionsThe data obtained in this systematic review and meta-analysis suggested that an HP infection was associated with an increased risk of NAFLD for Asian and non-Asian populations. However, the association was not found for Asian males. Further studies are required to establish the causal association, especially for the non-Asian population.Systematic review registrationIdentifier: CRD42021266871.

目的:分析法莫替丁联合消石利胆胶囊治疗老年胆源性消化不良的效果及对患者生活质量和症状改善的影响.方法:选取2019年1月—2020年1月我院收治的70例老年胆源性消化不良患者,按照随机数字表法分为对照组和联合组,每组35例.对照组给予法莫替丁治疗,联合组给予法莫替丁联合消石利胆胶囊治疗,比较两组症状积分、症状缓解时间、生活质量及用药安全性.结果:联合组嗳气、厌油腻、右上腹痛、食欲不振、口干口苦、胆囊区压痛、上腹部灼烧感、早饱或餐后饱胀等症状积分和消失时间均短于对照组(P<0.05);联合组用药不良反应发生率与对照组相比,差异无统计学意义(P>0.05);联合组生理状况、社会功能、自理行为、情感状况、精神状况、生命活力、总健康等维度评分高于对照组(P<0.05).结论:法莫替丁联合消石利胆胶囊治疗可有效减轻老年胆源性消化不良患者的临床症状,缩短患者各项症状的缓解时间,促进患者的康复进程,保证患者用药安全性的同时提高了患者的生活质量,治疗效果显著.

Purpose Proviral integration of Moloney murine leukemia virus (PIM) family kinases can promote the survival and movement of carcinoma cells and the metastatic growth of various types of carcinoma. However, there are few studies on PIM1 in colorectal carcinoma (CRC), so we decided to investigate this issue. Methods Data about PIM1 expression and clinical and mutation information were downloaded from The Carcinoma Genome Atlas (TCGA). Survival analysis was performed by Kaplan-Meier method and the cumulative incidence of survival events was calculated. The correlation of PIM1 mRNA expression and immune infiltration score with the mutation index (TMB; tumor mutational burden), MSI (microsatellite instability)) was tested by Spearman's method. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis of PIM1 enrichment and carcinoma-related pathways in CRC were performed. Results PIM1 was elevated in most carcinomas, especially CRC. In CRC, PIPM1 had a correlation with the overall survival (OS), disease-specific survival (DSS), disease-free interval (DFI), and progression-free interval (PFI). They indicated that PIPM1 acts in the progression of CRC. PIM1 was correlated with MSI, immune score and immune cell infiltration. Thereby it linked its expression with the evaluation of treatment response. Conclusions Bioinformatics analysis confirmed PIM1 as a good biomarker for the prognosis and treatment evaluation of CRC.

自然力来自生命,生命表现为机体内环境的稳定与不断变化外环境的协调,人体自然力与疾病过程及结局密切相关,长期的中西医学实践过程中充分反映了自然力在疾病治疗中的影响和作用.老年疾病发病率高、合并症多、临床表现复杂,体现了独特的生理变化和病理特点,衰老导致机体退行性改变,影响了自然力的作用.对老年病人医疗干预要注意维护与自然力的平衡关系,治疗要充分考虑这个群体的个体状况、治疗效果和利弊分析,判断对机体造成的影响程度和承受能力,人体自然力在老年疾病治疗中的作用应该予以充分重视.

Objective:To examine the effect of helicobacter pylori(H.pylori)eradication on blood glucose and insulin levels in elderly patients with type 2 diabetes mellitus(T2DM).Methods:This was a prospective case-control study.Ninety-three diabetic elderly patients(≥ 80 years)under glycemic control and with H. pylori infection were selected as the DM group and eighty-nine elderly patients(≥ 80 years)without T2DM and with H. pylori infection were selected as the control group.Among them, bismuth quadruple was given to eradicate H. pylori.Levels of fasting blood glucose, insulin, glycated hemoglobin(HbA1c), gastrin, insulin resistance index(HOMA-IR), and insulin secretion index(HOMA-β)were compared before treatment and at 4, 8, 12 and 16 weeks after treatment.Rates of H. pylori eradication and adverse reactions were evaluated.Results:The eradication rate of H. pylori was similar between the DM group and the control group [73.1%(68 cases) vs.84.3%(75 cases), P>0.05]. There were no significant differences in levels of fasting blood glucose, insulin, HbA1c, gastrin, HOMA-IR, and HOMA- β before treatment and at 4, 8, 12, 16 weeks after treatment between the two groups( P>0.05). However, the incidence of constipation was significantly higher in the DM group than in the control group [25.8%(24 cases) vs.12.4%(11 cases), P<0.05]. Conclusions:The eradication of H. pylori has no significant effect on fasting blood glucose, insulin and HbA1c in elderly patients with or without T2DM.

BACKGROUND:Meprin is a member of the astaxanthin family; it performs many functions through a wide range of proteolytic enzyme activities during health and disease, including tumors and inflammatory conditions. The purpose of this systematic review was to evaluate the predictive value of MEP1A in tumor prognosis.METHODS:A comprehensive search was conducted on PubMed, Cochrane library, and Web of Science Database using a developed search strategy. The Newcastle-Ottawa Scale (NOS) or the Cochrane Collaboration's tool for assessing risk of bias will be used to access the methodological quality of included studies, and GRADE will be applied to evaluate evidence quality of outcomes. All analyses were performed by Stata 15.0.RESULTS:The results will systematically summarize and display the currently collected evidence on the predictive value of MEP1A in different tumor prognosis.CONCLUSION:This study may play a certain role in predicting the prognosis of cancer patients in the future, and may prompt clinicians to make necessary treatment or prevention plans as soon as possible.ETHICS AND COMMUNICATION:It is not necessary because the present systematic review is based on published studies.INPLASY REGISTRATION NUMBER:INPLASY2020100005.

Differences in inflammatory factors IL-6 and miR-1271 expression levels between elderly and young gastric cancer patients were investigated. A retrospective analysis of 146 cases of gastric cancer tissue and normal fresh tissue specimens diagnosed in The First Hospital of Lanzhou University from January 2013 to January 2015, was performed. Patients aged ≥60 years were the elderly group (76 cases), and patients ≤40 years were the youth group (70 cases). RT-qPCR was used to detect the relative expression levels of IL-6 and miR-1271, and Kaplan-Meier for a postoperative 3-year survival analysis of young and elderly gastric cancer patients. The expression level of IL-6 and miR-1271 was significantly higher in young gastric cancer tissues than that in elderly gastric cancer tissues (P<0.001). The expression levels of IL-6 and miR-1271 were correlated with age, tumor size, lymph node metastasis, distant metastasis, clinical stage and differentiation degree of gastric cancer patients (P<0.05). The 3-year overall survival rate of patients with a low expression of IL-6 and miR-1271 was better than that of patients with a high expression in young and elderly gastric cancer (P<0.05). IL-6 was highly expressed but miR-1271 expression was low in gastric cancer tissues. The 3-year overall survival rate of patients with the low expression of IL-6 was better than that of patients with the high expression in young and elderly gastric cancer. The high expression of miR-1271 was better than that of patients with the low expression in young and elderly gastric cancer. Findings of the present study provide data support for the clinical evaluation of differences between young and elderly gastric cancer and their prognosis.

Chronic constipation is one of the common health problems in the elderly and occurs in the form of primary and secondary constipation. The former is functional and the latter is related to organic diseases and drugs. To understand its etiology,risk factors and complications,the relevant clinical assessment and alarming signs should be attended. The treatment of chronic constipation includes non-pharmacologic,pharmacologic and surgical approaches. It is necessary to practice a three-stage treatment process of chronic constipation in accordance with the situation in China.

目的 观察各年龄段健康人群的胃排空状态及血浆生长抑素的变化.方法 应用超声显像法测定青年、中年、老年三组健康受试者的胃排空状态,计算各时间点胃窦部面积及胃半排空时间.应用放射免疫法检测青年、中年、老年三组的健康受试者基础及餐后生长抑素的变化.结果 三组胃半排空时间比较差异无统计学意义(P>0.05).三组胃排空率比较,15 min时间点,老年组胃排空率较中年组明显减少,差异有统计学意义(P<0.05),其余各组及其他时间点各组之间比较差异均无统计学意义(P>0.05);餐后各组生长抑素水平均较空腹时对应组明显升高(P<0.05),但空腹及餐后各组间生长抑素水平比较差异无统计学意义(P>0.05).结论 健康人群胃排空率未表现出明显增龄性变化,血浆生长抑素浓度与增龄之间无明显相关性.

Collagenous colitis is one of the two main types of microscopic colitis, which predominantly affects middle-aged and elderly women. It is characterized by the presence of chronic watery diarrhea, negative colonoscopy and characteristic histopathol-ogy findings of a thickened layer of sub-epithelial collagen. Course of the disease lasts for several months to years, seriously affecting peopleˊs quality of life. In recent years, its incidence continues to increase. This paper will review the pathogenesis, diagnosis and treatment of collagenous colitis.

This study aimed to investigate the changes in blood glucose of elderly patients with gastric cancer combined with type 2 diabetes mellitus (T2DM) after radical operation. Forty-six patients in DM group and 30 patients in non-DM group underwent radical surgery between January, 2007 and January, 2017 in The First Hospital of Lanzhou University, and the clinical data were retrospectively analyzed. Statistical analysis was conducted to explore the effect of radical operation on blood glucose control of the two groups of patients. In 46 patients with gastric cancer combined with T2DM, 24 patients received postoperative insulin intervention, and the remaining 22 patients did not receive insulin intervention. This latter set of patients comprised the non-insulin treatment group. Blood glucose control conditions, inflammatory markers, tumor markers and their effects on the prognosis were compared between the two groups. Level of postoperative blood glucose of the DM group was significantly higher than that of the non-DM group (P<0.05), while the level of blood glucose in the insulin treatment group was significantly lower than that in the control group (P<0.05). Levels of related tumor markers and inflammatory factors of insulin treatment group were significantly higher than those of the control group (P<0.05). The 5-year survival rate of insulin treatment group was significantly higher than that of the control group (P<0.05). Our results showed that the level of blood glucose was significantly increased in elderly patients with gastric cancer combined with T2DM after radical operation, and levels of blood glucose, tumor markers and inflammatory factors in elderly gastric cancer patients with T2DM without insulin were significantly increased after radical operation, and long-term prognosis is poor.

Objective To develop a method of isolation and identification of exosomes of bone marrow mesenchymal stem cells.Methods The mesenchymal stem cells were cultured by whole bone marrow adherence method.A new reagent -exosomes extraction kit was used to isolate and collecte exosomes.The exosomes were identified by elec-tron microscopy,particle size detection,flow cytometry and Western blot.Results The expression of CD45 on the surface of the third generation bone marrow mesenchymal stem cells was negative,and CD73 and CD105 were posi-tive;exosomes derived from bone marrow mesenchymal stem cells were round or oval,the size is non-uniform,the diameter is 30~100 nm,have a complete membrane structure,and containing low-density substances;Particle size detection particle diameter of the main peak was 61.25 nm, in which the diameter of particles was about 20-200 nm accounted for 72.4%;exosome expressed CD63 and CD81;The expression of CD9 and CD63 from cell cul-ture supernatants was positive.Conclusions The exosomes can be collected in the medium of mesenchymal stem cells.The exosomes derived from bone marrow mesenchymal stem cells can be identified by electron microscopy, particle size detection,flow cytometry and Western blot.

The present study was designed to analyze variations in blood fat, blood glucose and insulin-resistance in elder patients following surgery for hepatic carcinoma. It also investigated the correlation of insulin with the level of serum leptin and blood fat. A total of 80 patients with primary hepatic cancer who were admitted to The First Hospital of Lanzhou University for treatment between October 2014 and June 2016 were enrolled in the study. At the 1-year follow-up, the patients were divided into two groups based on their recurrence of hepatic cancer after surgery. The levels of serum leptin were detected prior to, one month and one year after surgery; the changes in blood fat, body mass index (BMI), waistline and hipline were measured at one year after surgery; alterations in the fasting blood glucose and blood glucose were measured at 2 h after meal. The fasting insulin (FINS) level and homeostasis model assessment-insulin resistance (HOMA-IR) index were also measured. Correlations between serum leptin and total cholesterol, FINS and fasting blood glucose were analyzed. In the recurrence group, the levels of serum leptin and FINS level were significantly reduced, while waistline and hipline were increased, compared with the non-recurrence group (P<0.05). The BMI and fasting blood glucose in the recurrence group was significantly elevated in comparison with the non-recurrence group (P<0.05). The HOMA-IR index was significantly increased in the recurrence group compared with the non-recurrence group (P<0.05). These results indicated that following surgery for hepatic cancer, the level of serum leptin in patients with recurrence was decreased with an increase in susceptibility to abnormal metabolism of blood fat and glucose. In addition, the serum leptin was negatively correlated with the total cholesterol level and fasting blood glucose and positively correlated with the FINS level in patients. It was concluded that leptin levels decreased in patients with postoperative recurrence, as well as the accumulation of visceral adipose tissue and the development of abnormal blood glucose metabolism was observed.

Background Pain is one of the most serious debilitating clinical problems.Dexmedetomidine (Dex) has been widely used for pre-,intra-,and post-operative sedation and analgesia.Objective To review the advantages of Dex in perioperative analgesia.Content Dex is a selective agonist of αr2 adrenergic receptors,and has multiple pharmacological properties,such as,analgesia,sedation,hypnosis,anti-anxiety,anti-tachycardia,etc.Perioperative administration of Dex significantly mitigates stress reaction to operation,stabilizes hemodynamics,reduces the dosage of opioids for analgesia and anesthesia,but prolongs the effects of opioids.Additionally.strong sedative effect without respiratory suppression makes Dex especially suitable for obstetric and pediatric analgesia.Cautions should be taken for the possibility that Dex may cause bradycardia in particular types of patients.Trend Although Dex is safe for perioperative analgesia,further investigations are warranted to identify more indications and contraindications.

Adoptive immune cells can regulate and strengthen immune function of cancer patients,thus effectively inhibit tumor escaping.Cytokine induced killer cells (CIK),natural killer cells (NK),tumor infiltrating lymphocytes (TIL),dendritic cells (DC),T cell receptor-modified T cells (TCR-T) and chimeric antigen receptor-modified T cells (CAR-T) eliminate tumor by killing tumor cells directly or stimulating the immune response against tumor cells through different mechanisms.

文章以2006-2014年间中国大陆30个地区为研究样本,运用增量资本产出率来衡量资源配置效率,用扣除科教文卫的地方财政支出/地方GDP和地方土地出让金/地方GDP来衡量政府干预,构建了以增量资本产出率为被解释变量,以政府干预、外商直接投资和其他相关控制变量为解释变量的线性回归固定效应模型,实证检验政府干预、外商直接投资与资源配置效率之间的相关性.得出政府干预确实阻碍了资源配置效率,而外商直接投资额改善了效率.进一步研究发现,两者间存在抵消效应,政府推动下的外商直接投资的作用被扭曲,根据实证结果最后提出应该简政放权,消除不适当的直接干预,发挥市场的引导作用,放松对金融资源的控制,控制内外资之间的比例.

Dexmedetomidine (DEX) is a highly selective α2 adrenergic receptor agonist. In this study, we investigated the analgesic effect and the underlying mechanisms of DEX on inflammatory visceral pain in rats. Twenty-five male Sprague Dawley (SD) rats were randomly divided into 5 groups, including control, sham, low dose DEX, medium dose DEX and high dose DEX group. Pain was induced with 10% formalin and scored every 15min till 2 h-post the induction. Hematoxylin-eosin (HE) staining was used to evaluate the toxicity of DEX on spinal cord neurons. Acetycholine (Ach) and noradrenaline (NA) levels were determined by using ELISA method. The expressions of natural nitric oxide synthase (nNOS), protein kinase γ (PKCγ) and protease-activated receptor 2 (PAR2) were determined by using western blot. DEX treatment relieved formaldehyde-induced pain in rats in a dose-dependent manner. Furthermore, DEX showed little neuro-toxicity on the spinal cord neurons, even at the highest dosage used in our study. Ach level was significantly increased in Sham group compared with control group. DEX treatment decreased NA levels and increased Ach levels in the incubation medium of spinal cord sections. Western blot analysis showed that the expression of nNOS, PKCγ and PAR2 was significantly decreased in DEX group compared with Sham group, whereas these effects of DEX on nNOS, PKCγ and PAR2 were blocked by both yohimbine and idazoxan, indicating that the analgesic effect of DEX is mediated by both α2 adrenergic receptor and imidazoline receptor. Yohimbine and idazoxan treatment significantly enhanced pain scores compared to DEX group, and which antagonizes the effects DEX. In conclusion, our study demonstrated that DEX could inhibit formaldehyde-induced pain by inhibiting nNOS, PKCγ and PAR2 expression through α2 adrenergic receptor and imidazoline receptor.

目的 观察增龄对胃排空的影响及与血浆胃泌素和胃动素的关系.方法 应用胃肠超声显像法分别对青年、中年、老年健康受试者进行胃排空测定,计算不同时间点胃窦部面积、绘制胃排空曲线计算胃半排空时间.利用放射免疫法分别检测受试者空腹及餐后血浆胃泌素和胃动素浓度.结果 青年、中年、老年组胃半排空时间无统计学差异(P>0.05);在15 min时间点青年组胃排空率显著小于老年组(P<0.05),其他时间点各组间胃排空无统计学差异(P>0.05).青年、中年、老年组餐后30 min血浆胃泌素和胃动素浓度均显著高于相应空腹组(P<0.05),但各组间空腹及餐后30 min均无统计学差异(P>0.05).结论 胃排空并未随年龄增加而减慢,血浆胃泌素和胃动素浓度也并未随年龄增加而变化.

目的 观察年龄对胃排空、胃中间横带(MTB)和胃内食物分布的影响.方法 50例健康志愿者按年龄不同分为青年组、中年组和老年组,进食99mTc-DTPA标记的试餐后利用双探头SPECT采集图像,通过计算机产生的像素将胃的每帧影像划分为近端胃、MTB、远端胃,分别测定、计算半排空时间、90 min胃内残留率、不同时相胃各部分面积、计数/像素比等.结果 老年组近端胃半排空时间较青年组、中年组缩短(P<0.05),远端胃90 min胃内核素残留率较青年组、中年组增多(均P<0.05);老年组近端胃60、90 min时相面积较青年组、中年组明显减少(P<0.05).30、60、90 min时相老年组远端胃面积较青年组、中年组明显增加(均P<0.05);在30、60、90 min时相老年组远端胃计数/像素比较青年组、中年组增加(P<0.05).老年组0、30、60、90 min MTB面积较青年组、中年组增宽(P<0.05).结论 胃排空并不随着年龄的增加而改变,但老年人进食后存在胃内食物分布异常,可能与MTB增宽有关.