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Functional constipation (FC) is common, yet the etiology is not clear. Accumulating evidence suggests an association between FC and abnormal gut microbiota. The relationship between the gut microbiota and the gut transit is likely bidirectional. This review summarizes the current evidence regarding the impact of gut microbiota on the pathogenesis of FC. By modulating the colonic motility, secretion, and absorption, gut microbiota may contribute to the development of FC through microbial metabolic activities involving bile acids, short-chain fatty acids, 5-hydroxytryptamine, and methane. In support of the key roles of the gut microbiota in FC, treatment with probiotics, prebiotics, synbiotics, and traditional Chinese medicine often result in compositional and functional changes in the gut microbiota. Further studies on the pathogenesis of FC and the therapeutic mechanism of microecological agents will provide a knowledge base for better management of FC.

Objectives The aim of this study was to determine the difference and correlation in pulmonary artery (PA) size when measured from the electrocardiogram (ECG)-gated computed tomography (CT) and non-ECG-gated CT. Methods In the retrospective study, 279 patients who underwent both ECG-gated CT and non-ECG-gated CT were enrolled. Maximum and minimum diameters of main pulmonary artery (MPA), right pulmonary artery (RPA), and ascending aorta (AAO) were measured, whereas mean diameters of MPA and RPA were obtained. The same PA size parameters were also measured on non-ECG-gated CT. Results There was a significant difference in maximum and minimum PA diameters between ECG-gated CT and non-ECG-gated CT, whereas mean PA diameters showed no statistically difference. The PA parameters showed a strong positive correlation between these 2 examinations. Conclusions The PA size was different between ECG-gated CT and non-ECG-gated CT, whereas the PA size parameters on non-ECG-gated CT could be used to predict those with ECG-gated CT, which allow for confident prediction of pulmonary hypertension and guide further surgical intervention.

Prostate-specific membrane antigen (PSMA) positron emission tomography (PSMA-PET) is an ideal tool for staging and restaging of prostate cancer (PCa). This study was designed to investigate the prognostic role of preoperative 68Ga-PSMA-11 PET/CT in predicting pathological upgrading from multiparametric magnetic resonance imaging–targeted biopsy (mpMRI-TB) to final radical prostatectomy (RP) specimens in patients with localized PCa. A total of 67 biopsy-confirmed localized PCa patients with mpMRI and 68Ga-PSMA-11 PET/CT prior to RP were included. Clinical and imaging characteristics derived from mpMRI and PET/CT were compared in patients with or without pathological upgrading. Predictors for pathological upgrading were evaluated by using univariate and multivariable analyses. A prediction model was developed based on the identified parameters and validated using internal validation. Pathological upgrading from mpMRI-TB to final RP specimens occurred in 38.8% (26/67) of the patients. Multivariable logistic regression analysis showed SUVmax (OR: 1.223, 95% CI 1.068–1.399, p = 0.003); highest tumor grade at mpMRI-TB, ISUP grade group (ISUP GG) 1 vs. 4 (OR: 0.11, 95% CI 0.000–0.452, p = 0.018) and ISUP GG 2 vs. 4 (OR: 0.16, 95% CI 0.001–0.252, p = 0.003); and multifocality on PET/CT (OR: 9.821, 95% CI 1.438–67.085, p = 0.02) were independent risk factors for pathological upgrading. Our developed prediction model based on the identified parameter showed good calibration at internal validation (mean absolute error = 0.033). 68Ga-PSMA-11 PET/CT was found to be an ideal biomarker for the prediction of pathological upgrading from mpMRI-TB to RP, especially for patients with lower tumor grade at mpMRI-TB.

Nanofiltration, one of the effective water-purification technologies, can have a certain adsorption effect on two typical antibiotics sulfamethoxazole and azithromycin. In this paper, the effects o...

The aim of the present study was to develop a novel nomogram that incorporated clinical factors, imaging parameters and biopsy pathological factors (including cribriform morphology) to predict adverse pathology in prostate cancer (PCa). A total of 223 patients with PCa, who had undergone preoperative multi-parametric magnetic resonance imaging and had a biopsy of Gleason pattern (GP) 4, absence of GP 5 and pure Grade Group (GG) 3 [Gleason score (GS) 3+4, GS 4+3, GS 4+4], were retrospectively enrolled onto the study. The contribution of GG to the biopsy and Prostate Imaging Reporting and Data System (PI-RADS) score for PCa harboring adverse pathology were analyzed. Univariate and multivariate logistic regression analyses were performed to determine significant pathology predictors of adverse pathology for nomogram development. The nomogram was internally validated using bootstrapping with 1,000 iterations. The diagnostic performance of the nomogram was analyzed by receiver operating characteristics (ROC) analysis and decision curve analysis (DCA). A higher biopsy GG and PI-RADS score were associated with an increased likelihood of adverse pathology. Prostate specific antigen density (PSAD), biopsy GG, cribriform morphology on biopsy and PI-RADS score were significant predictors and were included in the nomogram. The ROC area under the curve of the nomogram was 0.88 (95% confidence interval, 0.84-0.91), with a high specificity (0.91) and moderate sensitivity (0.72). The novel nomogram was shown to have a higher net benefit for the prediction of adverse pathology in PCa, compared with any individual factors determined by DCA. Overall, a novel nomogram incorporating PSAD, PI-RADS score, biopsy GG and cribriform morphology on biopsy was shown to perform well in the prediction of PCa harboring adverse pathology at the time of radical prostatectomy.

OBJECTIVE To investigate the influence of tumour location zone on positive surgical margin (PSM) status after Retzius-sparing robot-assisted radical prostatectomy (RS-RARP). MATERIALS AND METHODS A total of 203 consecutive patients with prostate cancer (PCa) who underwent RS-RARP at our centre were divided into three cohorts according to the tumour zonal origin described on preoperative magnetic resonance imaging (MRI). Clinical and pathological characteristics were compared among the three groups. The associations of clinicopathological variables with PSM status after RS-RARP were also evaluated. RESULTS The rates of PSM in patients with transition zone (TZ) and mixed origin tumours were significantly higher than in patients with peripheral zone tumours (P < 0.01). Of the PSMs in patients with TZ and mixed origin cancers, 42.0% and 40.9%, respectively, were located at the anterior part of the gland. On multivariate analysis, presence of a TZ tumour was significantly associated with a higher PSM rate after RS-RARP (P < 0.01). Sub-analysis showed that high-risk patients with TZ tumours had a higher risk of PSM after RS-RARP (P < 0.01). CONCLUSION Presence of a TZ tumour is an independent risk factor for PSMs after RS-RARP. Preoperative identification of TZ tumours might aid surgical planning for the Retzius-sparing technique, especially in high-risk patients.

PIRADS v2 stipulates that dynamic contrast-enhanced (DCE) imaging be used to categorize diffusion-weighted-imaging (DWI) score 3 (DWI 3) peripheral zone (PZ) lesions as PIRADS score 3 (PIRADS 3; DCE −) or PIRADS 4 (DCE +). It’s controversial for the value of DCE in improving clinically significant prostate cancer (csPCa) detection. We aimed to figure out whether DCE improves csPCa detection and explore new available measures to improve csPCa detection. We retrospectively enrolled 375 patients who underwent mp MRI before MRI/ultrasound (US) fusion-targeted biopsy (TB) with transperineal systematic biopsy (SB). All lesions were classified as DWI 3/DCE −, DWI 3/DCE +, DWI 4/PIRADS 4 lesions. Detection rates of csPCa for each lesion group were analyzed. The diagnostic performance of each approach was analyzed by receiver operating characteristics (ROC) analysis and decision curve analysis. Totally, 109 DWI 3 or DWI 4 single lesions in PZ were analyzed (n = 109). The rates of csPCa detection for Group A, Group B, Group C is 10.3%, 13.9%, 55.9%, respectively (A vs. B, p = 0.625; B vs. C, p

Our purpose was to explore the value of 68Ga-prostate-specific membrane antigen (PSMA) PET/CT for detection of phosphatase and tensin homolog (PTEN)–loss prostate cancer. Methods: We retrospectively enrolled 75 patients who underwent multiparametric MRI and 68Ga-PSMA PET/CT before radical prostatectomy. Lesions were outlined on pathologic images, and regions of interest were drawn on matched multiparametric MRI and PET/CT images. Imaging parameters, including average apparent diffusion coefficient and SUVmax, were derived. Immunohistochemical staining was performed to evaluate the PTEN status. The diagnostic performance of imaging parameters was analyzed by receiver-operating-characteristic analysis. Univariate logistic regression analyses were used to evaluate the association between clinical and imaging variables and PTEN status. Results: In total, 103 lesions from 75 patients were analyzed. Of these lesions, 38 of 103 (36.9%) showed PTEN-loss status. Our study showed a strong association between SUVmax and PTEN-loss tumors both in the per-patient analysis (P 0.05) and score on the Prostate Imaging Reporting and Data System, version 2 (P > 0.05). Surprisingly, SUVmax was a significant predictor for detection of PTEN-loss tumors (odds ratio of 7.56 and 95% confidence interval of 2.18–26.24 on per-patient analysis; odds ratio of 13.66 and 95% confidence interval of 4.32–43.24 on per-lesion analysis). Conclusion:68Ga-PSMA PET/CT could effectively detect aggressive PTEN-loss tumors.

Background To achieve imaging report standardization and improve the quality and efficiency of the intra-interdisciplinary clinical workflow, we proposed an intelligent imaging layout system (IILS) for a clinical decision support system-based ubiquitous healthcare service, which is a lung nodule management system using medical images. Methods We created a lung IILS based on deep learning for imaging report standardization and workflow optimization for the identification of nodules. Our IILS utilized a deep learning plus adaptive auto layout tool, which trained and tested a neural network with imaging data from all the main CT manufacturers from 11,205 patients. Model performance was evaluated by the receiver operating characteristic curve (ROC) and calculating the corresponding area under the curve (AUC). The clinical application value for our IILS was assessed by a comprehensive comparison of multiple aspects. Findings Our IILS is clinically applicable due to the consistency with nodules detected by IILS, with its highest consistency of 0·94 and an AUC of 90·6% for malignant pulmonary nodules versus benign nodules with a sensitivity of 76·5% and specificity of 89·1%. Applying this IILS to a dataset of chest CT images, we demonstrate performance comparable to that of human experts in providing a better layout and aiding in diagnosis in 100% valid images and nodule display. The IILS was superior to the traditional manual system in performance, such as reducing the number of clicks from 14·45 ± 0·38 to 2, time consumed from 16·87 ± 0·38 s to 6·92 ± 0·10 s, number of invalid images from 7·06 ± 0·24 to 0, and missing lung nodules from 46·8% to 0%. Interpretation This IILS might achieve imaging report standardization, and improve the clinical workflow therefore opening a new window for clinical application of artificial intelligence. Fund The National Natural Science Foundation of China.

To explore the diagnostic performance of 68Ga-PSMA PET/CT for identification of pathological cribriform morphology in prostate cancer (PCa). The study retrospectively enrolled 49 PCa patients who had undergone preoperative multiparametric MRI (mpMRI) and 68Ga-PSMA PET/CT, and who had Gleason pattern (GP) 4 and absence of GP 5 on radical prostatectomy specimens. Lesions with GP 4 were outlined and stratified according to their cribriform status. Volumes of interest were drawn on matched mpMRI and PET images, and parameters including average apparent diffusion coefficient (ADCmean), tenth percentile ADC (ADC10%) and maximum standardized uptake value (SUVmax) were derived. The Mann-Whitney U test was used for continuous variables and the chi-squared test for categorical variables. Receiver operating characteristic analysis was used to compare imaging parameters in identifying cribriform morphology. The associations between cribriform-positive PCa and imaging variables were evaluated in a univariate analysis using a logistic regression model. A total of 62 lesions were identified in 49 patients with GP 4. Of these lesions, 37 (59.7%) in 34 patients (69.4%) showed cribriform morphology. ADCmean and ADC10% were similar between cribriform-positive and non-cribriform groups (P > 0.05), while SUVmax was significantly different (median SUVmax 18.3 vs. 9.4 per patient, P = 0.003, 18.2 vs. 7.2 per lesion, P

Prostate-specific membrane antigen (PSMA) positron emission tomography (PSMA-PET) is an ideal tool for staging and restaging of prostate cancer (PCa). This study was designed to investigate the prognostic role of preoperativeA total of 67 biopsy-confirmed localized PCa patients with mpMRI andPathological upgrading from mpMRI-TB to final RP specimens occurred in 38.8% (26/67) of the patients. Multivariable logistic regression analysis showed SUV

Cyclooxygenase-2 (COX-2) is an inducible enzyme stimulated by various inflammatory factors (IFs). Chronic gastritis is a classic model of “inflammation-cancer transformation” and Helicobacter pylori-related gastric diseases (HPGD) are specific ones of this model. Traditional Chinese Medicine (TCM) syndromes could play a predictive role in gastric histopathological evolution. To search for early warning evidence about “inflammation-cancer transformation,” this study is about to explore interaction of COX-2 with Helicobacter pylori (Hp) in HPGD with different TCM syndromes. All included subjects underwent endoscopy and biopsy. Hp infection was detected by rapid urease test and methylene blue staining. Histopathological characteristics and COX-2 expression in gastric mucosa (GM) were, respectively, observed by hematoxylin-eosin and Elivision™ plus. SPSS 18.0 and Stata 11.0 statistical software packages were used for statistical analysis. Results of immunohistochemical staining in this study showed COX-2 expression in Hp-positive patients was stronger than that in Hp-negative ones. Spearman’ analysis indicated that degrees of both Hp infection and COX-2 expression were positively correlated with those of gastric inflammation and inflammatory activity. Compared with the relative normal group, both severe dysplasia group and gastric carcinoma group had more severe Hp infection and COX-2 expression. Compared with the nonsyndrome, syndrome of internal block of static blood (IBSB) had higher scores in semiquantitative analysis of COX-2 protein expression among TCM groups. Moreover, multivariate logistics regression analysis suggested that patients with Hp infection could increase the risk of IBSB. These results indicated that COX-2 interacting with Hp could play an important role in transforming gastric chronic nonresolving inflammation into carcinoma in subjects with HPGD, as well as inducing the formation of IBSB. HPGD together with IBSB could be an early warning evidence for GM with histopathological evolution from benign to malignant.

SUMMARY PIWI proteins are known as mediators of transposon silencing in animal germlines but are also found in adult pluripotent stem cells of highly regenerative animals, where they are essential for regeneration. Study of the nuclear PIWI protein SMEDWI-2 in the planarian somatic stem cell system reveals an intricate interplay between transposons and cell differentiation in which a subset of transposons is inevitably activated during cell differentiation, and the PIWI protein is required to regain control. Absence of SMEDWI-2 leads to tissue-specific transposon derepression related to cell-type-specific chromatin remodeling events and in addition causes reduced accessibility of lineage-specific genes and defective cell differentiation, resulting in fatal tissue dysfunction. Finally, we show that additional PIWI proteins provide a stem-cell-specific second layer of protection in planarian neoblasts. These findings reveal a far-reaching role of PIWI proteins and PIWI-interacting RNAs (piRNAs) in stem cell biology and cell differentiation., Graphical Abstract, In brief Chromatin reorganization is an essential part of cell differentiation but risks reactivation of silenced repetitive elements. Li et al. show that planarians use continuous surveillance by a nuclear PIWI protein to chaperone the chromatin transition from pluripotent to differentiated cell, which is crucial for the planarian’s impressive regeneration and homeostasis.

A new type of membrane ecosystem (MES) was constructed by combining the artificial floating ecosystem (AFES) with microfiltration (MF) and nanofiltration (NF) membranes to investigate the removal of 4 antibiotics and 7 antibiotic-resistance genes (ARGs) during 15 days in urban rivers. Two groups of experiments were set, namely no algae/plant group and algae/plant group in which Microcystis aeruginosa and Acorus calamus were planted in the ecological floating island. In no algae/plant group, the removal rate of antibiotics at the outlet of the AFES was 50–78%. However, the abundance of ARGs decreased by less than one order of magnitude. After the combination with algae and plants, the removal of each antibiotic increased by 10–20%, and the ARGs decreased by one order of magnitude or two. MF reached an overall removal rate of 70–95% for antibiotics, while NF was able to achieve over 96%. The log removal rate of each ARGs was 1–4.5, and sul1 decreased most. Quinolones ARGs (qnrD and qnrS) were below the detection limit after MF. In the AFES, sul1, sul2 and qnrS were mainly removed. ermB was always lowest level of all ARGs. After MF and NF, the relative abundance of ARGs changed irregularly, and ermB, qnrS, sul1, sul2 and tetX remained in the NF permeation solution. Conventional indicators (COD, TP, TN, NH4+-N), antibiotics and ARGs except ermB and tetM were correlated with each other. In brief, the MES could control conventional pollution and effectively remove antibiotics and ARGs from river water.

Background To evaluate the role of free-hand transperineal targeted prostate biopsy using multiparametric magnetic resonance imaging-transrectal ultrasound (mpMRI-TRUS) fusion in Chinese men with repeated biopsy. Methods A total of 101 consecutive patients suspicious of prostate cancer (PCa) at the mpMRI scan and with prior negative biopsy and elevated PSA values were prospectively recruited at two urological centers. Suspicious areas on mpMRI were defined and graded using PI-RADS score. Targeted biopsies (TB) were performed for each suspicious lesion and followed a 12-core systematic biopsy (SB). Results of biopsy pathology and whole-gland pathology at prostatectomy were analyzed and compared between TB and SB. The risk for biopsy positivity was assessed by univariate and multivariate logistic regression analysis. Results Fusion biopsy revealed PCa in 41 of 101 men (40.6%) and 25 (24.8%) were clinically significant. There was exact agreement between TB and SB in 74 (73.3%) men. TB diagnosed 36% more significant cancer than SB (22 vs 13 cases, P = 0.012). When TB were combined with SB, an additional 14 cases (34.1%) of mostly significant PCa (71.4%) were diagnosed (P = 0.036). TB had greater sensitivity and accuracy for significant cancer than SB in 26 men with whole-gland pathology after prostatectomy. PI-RADS score on mpMRI was the most powerful predictor of PCa and significant cancer. Conclusions Free-hand transperineal TB guided with MRI-TRUS fusion imaging improves detection of clinical significant PCa in Chinese men with previously negative biopsy. PI-RADS score is a reliable predictor of PCa and significant cancer. Electronic supplementary material The online version of this article (doi:10.1186/s12894-017-0241-3) contains supplementary material, which is available to authorized users.

Our purpose was to explore the value of (68)Ga-prostate-specific membrane antigen (PSMA) PET/CT for detection of phosphatase and tensin homolog (PTEN)–loss prostate cancer. Methods: We retrospectively enrolled 75 patients who underwent multiparametric MRI and (68)Ga-PSMA PET/CT before radical prostatectomy. Lesions were outlined on pathologic images, and regions of interest were drawn on matched multiparametric MRI and PET/CT images. Imaging parameters, including average apparent diffusion coefficient and SUV(max), were derived. Immunohistochemical staining was performed to evaluate the PTEN status. The diagnostic performance of imaging parameters was analyzed by receiver-operating-characteristic analysis. Univariate logistic regression analyses were used to evaluate the association between clinical and imaging variables and PTEN status. Results: In total, 103 lesions from 75 patients were analyzed. Of these lesions, 38 of 103 (36.9%) showed PTEN-loss status. Our study showed a strong association between SUV(max) and PTEN-loss tumors both in the per-patient analysis (P < 0.01) and in the per-lesion analysis (P < 0.01), yielding sensitivity and specificity of 0.80 and 0.77, respectively, in the per-patient analysis and 0.83 and 0.74, respectively, in the per-lesion analysis. Meanwhile, higher pathologic PSMA expression was found in the PTEN-deficiency tumors. However, there was no significant difference between PTEN-loss tumors and PTEN-intact tumors using parameters such as average apparent diffusion coefficient (P > 0.05) and score on the Prostate Imaging Reporting and Data System, version 2 (P > 0.05). Surprisingly, SUV(max) was a significant predictor for detection of PTEN-loss tumors (odds ratio of 7.56 and 95% confidence interval of 2.18–26.24 on per-patient analysis; odds ratio of 13.66 and 95% confidence interval of 4.32–43.24 on per-lesion analysis). Conclusion: (68)Ga-PSMA PET/CT could effectively detect aggressive PTEN-loss tumors.

To develop a risk model with combined clinical characteristics and multiparametric MRI parameters for prediction of cribriform morphology in intermediate-risk prostate cancer (CaP) patients.We retrospectively included 215 CaP patients received multiparametric MRIexamination, targeted biopsy (TB) combined with systematic biopsy (SB), radical prostatectomy and final Gleason group 2 or 3. Cribriform status was confirmed on both biopsy slices and whole-mount sections. Characteristics were stratified by cribriform status. Mann Whitney U test was performed for continuous variables and the χCribriform morphology was identified in 51.2% (110/215) patients. Cribriform-positive CaP demonstrated significantly higher prostate-specific antigen level, higher prostate-specific antigen density , larger lesion dimension on MRI, higher Prostate Imaging Reporting and Data System score, larger tumor dimension, higher Gleason score, higher pT stage, higher pN stage and more positive surgical margin (all P0.01). Sensitivities of TB, SB, TB + SB for detecting cribriform morphology were 28.2% (31/110), 22.7% (25/110), and 36.4% (40/110), respectively. Further, prostate-specific antigen density (P = 0.003), Prostate Imaging Reporting and Data System score (P0.001), and maximal biopsy Gleason score (P = 0.004) were independent predictors for positive cribriform morphology. Cribriform-risk nomogram was constructed with the 3 parameters and demonstrated considerable discrimination (area under the curve = 0.887, sensitivity 79.2%, specificity 84.0%) and calibration (mean absolute error 0.021), harboring net benefits with threshold probabilities range from 0 to 0.88.A cribriform-risk nomogram was developed and well predicted aggressive cribriform morphology in intermediate-risk CaP patients.

To explore the diagnostic performance ofThe study retrospectively enrolled 49 PCa patients who had undergone preoperative multiparametric MRI (mpMRI) andA total of 62 lesions were identified in 49 patients with GP 4. Of these lesions, 37 (59.7%) in 34 patients (69.4%) showed cribriform morphology. ADC

Background: Helicobacter pylori (H. pylori)-related gastric diseases are a series of gastric mucosal disorders associated with H. pylori infection. Gastric cancer (GC) is widely believed to evolve from gastritis and gastric ulcer. As an important adhesion molecule of epithelial cells, E-cadherin plays a key role in the development of gastric diseases. In this review, we aim to seek the characteristic of E-cadherin expression at different stages of gastric diseases. Methods: We searched plenty of databases for research literature about E-cadherin expression in H. pylori-related gastric diseases, and reviewed the relationship of E-cadherin and H. pylori, and the role of E-cadherin at different stages of gastric diseases. Results: H. pylori was shown to decrease E-cadherin expression by various ways in vitro, while most of clinical studies have not found the relationship between H. pylori and E-cadherin expression. It is defined that poor outcome of GC is related to loss expression of E-cadherin, but it is still unclear when qualitative change of E-cadherin expression in gastric mucosa emerges. Conclusion: Expression level of E-cadherin in gastric cells may be a consequence of injury factors and body’s selfrepairing ability. More studies on E-cadherin expression in gastric mucosa with precancerous lesions need to be performed, which may be potential and useful for early detection, prevention and treatment of GC.

Objective To systematically evaluate the efficacy and safety of Modified Tongxie Yaofang (M-TXYF) for the treatment of diarrhea-predominant irritable bowel syndrome (IBS-D). Method Electronic databases including PubMed, Springer Link, EMBASE, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature (CBM), Wanfang, and Chinese Scientific Journals Database (VIP) were conducted from their inception through May 11, 2017 without language restrictions. Primary and secondary outcomes were estimated by 95% confidence intervals (CI). RevMan 5.3 and the Cochrane Collaboration’s risk of bias tool were analyzed for this meta-analysis. Results Twenty-three literatures with a total of 1972 patients were included for the meta-analysis. The overall risk of bias evaluation was low. The pooled odds ratio showed that M-TXYF was significantly superior to routine pharmacotherapies (RP) in clinical therapeutic efficacy (OR 4.04, 95% CI 3.09, 5.27, P < 0.00001, therapeutic gain = 17.6%, number needed to treat (NNT) = 5.7). Moreover, compared with RP, M-TXYF showed that it can significantly reduce the scores of abdominal pain (standardized mean difference (SMD) -1.27; 95% CI -1.99, -0.56; P = 0.0005), abdominal distention (SMD -0.37; 95% CI -0.73, -0.01; P = 0.09), diarrhea (SMD -1.10; 95% CI -1.95, -0.25; P = 0.01), and frequency of defecation (SMD -1.42; 95% CI -2.19, -0.65; P = 0.0003). The differences of the adverse events between experiment and control groups had no statistical significance. Conclusion This meta-analysis indicated that M-TXYF could be a promising Chinese herbal formula in treating IBS-D. However, considering the lack of higher quality of randomized controlled trials (RCTs), highly believable evidences should be required.

Aim This meta-analysis analyzed the efficacy and safety of traditional Chinese medicine (TCM) for the treatment of irritable bowel syndrome with constipation (IBS-C). Methods We searched seven electronic databases for randomized controlled trials investigating the efficacy of TCM in the treatment of IBS-C. The search period was from inception to June 1, 2017. Eligible RCTs compared TCM with cisapride and mosapride. Article quality was evaluated with the Cochrane Risk Bias Tool in the Cochrane Handbook by two independent reviewers. Begg’s test was performed to evaluate publication bias. Review Manager 5.3 and Stata 12.0 were used for analyses. Results Eleven eligible studies comprising a total of 906 participants were identified. In the primary outcome, TCM showed significant improvement in overall clinical efficacy compared with cisapride and mosapride (odds ratio [OR] = 4.00; 95% confidence interval [CI]: 2.74,5.84; P < 0.00001). In terms of secondary outcomes, TCM significantly alleviated abdominal pain (OR = 5.69; 95% CI: 2.35, 13.78; P = 0.0001), defecation frequency (OR = 4.38; 95% CI: 1.93, 9.93. P = 0.0004), and stool form (OR = 4.96; 95% CI: 2.11, 11.65; P = 0.0002) in the treatment group as compared to the control group. A lower recurrence rate was associated with TCM as compared to cisapride and mosapride (OR = 0.15; 95% CI: 0.08, 0.27; P < 0.00001). No adverse effects were observed during TCM treatment. Conclusions TCM showed greater improvement in terms of clinical efficacy in the treatment of IBS-C than cisapride and mosapride, although it was not possible to draw a definitive conclusion due to the small sample size, high risk, and low quality of the studies. Large multi-center and long-term high-quality randomized control trials are needed.

Pathology results from systematic biopsy and targeted biopsy for prostate cancer. (DOCX 16Â kb)

Proportion of all cancers and clinically significant cancers stratified by PI-RADS score according to mpMRI scan. PCa, prostate cancer. (DOCX 138 kb)

Modified Banxia Xiexin decoction (MBXD) is a classical Chinese herbal formula in treating gastroesophageal reflux disease (GERD) for long time, but the efficacy of it is still controversial. This study is to evaluate the efficacy and safety of MBXD for the treatment of GERD in adults. The search strategy was carried out for publications in seven electronic databases. RevMan software version 5.3 and the Cochrane Collaboration’s risk of bias tool were performed for this review. Twelve RCTs were included for the analysis. The results of overall clinical efficacy and efficacy under gastroscope demonstrated that MBXD was superior to conventional western medicine. Meanwhile, the results of subgroup analysis showed clinical heterogeneity between the two groups. However, there was no statistically significant difference in acid regurgitation between the two groups. But in the improvement of heartburn and sternalgia, the results showed statistically significant differences for the comparison between two groups. In addition, the adverse reactions of the experiment groups were not different from those of the control groups. This systematic review indicates that MBXD may have potential effects on the treatment of patients with GERD. But because the evidence of methodological quality and sample sizes is weak, further standardized researches are required.

Seed limitation of desired indigenous species has constrained the succession of established plantations from an early successional stage, to more natural forests in South China. Because of its low cost and time-saving advantages, direct seeding has been considered a useful method in forest regeneration. To improve our understanding of whether and how direct seeding can lead to the establishment of indigenous tree species, we carried out an experiment in four typical plantations (eucalyptus, mixed-native, mixed-legume, mixed-conifer) and a shrubland in South China. We also tested the effect of understory vegetation and litter removal on seedling establishment and growth. Seeds of three indigenous tree species (Castanopsis chinensis, Cryptocarya chinensis, and Psychotria rubra) were sown with understory vegetation and litter either retained or removed. Seedling emergence, survival, and growth were recorded for 21 months. We found that conditions that favored seedling emergence often differed from those that favored seedling survival. While the removal of understory vegetation and litter did not influence the final seedling establishments for all the three introduced species, growth of Psychotria rubra was influenced at several sites. Seed mass was positively correlated with seedling emergence and subsequent growth. The large-seeded Castanopsis chinensis showed higher emergence and growth than the intermediate-seeded Cryptocarya chinensis or the small-seeded Psychotria rubra. Seedlings of Castanopsis chinensis grew better in plant communities with high understory light penetration and high soil exchangeable potassium. Growth of P. rubra seedlings decreased significantly with soil hydrolyzed nitrogen. In conclusion, direct seeding can be useful for the establishment of indigenous tree species into plantations and shrubland. Optimizing early seedling establishment and growth will require the selection of suitable native species for improving seedling establishment in different plantations. Additionally, understory vegetation and litter and fertilizer should be properly managed to enhance the establishment of certain indigenous tree species.

Assessing the characteristics of seed supply will be vital to better understand the dynamics of forest regeneration. In this study, we surveyed the aboveground vegetation, the seed rain, the seed bank, and natural seedling emergence in four typical 24-year-old plantations (eucalyptus, mixed-native, mixed-legume, and mixed-conifer) and a naturally successioned shrubland in southern China. The dominant species in the understory were similar among the five plant communities. The seed rain and the seed bank were dominated by shrubs and herbs but indigenous tree species were rare. Species that were common to all five-plant communities represented a great proportion of the seeds in the seed rain and seed bank. The seed rain consisted mostly of seeds derived from the local plant community. Seed abundance was greater in the seed bank than in the seed rain, and species richness was greater in the seed bank and in the corresponding plant community than in the seed rain. Species composition similarity between the seed rain, the seed bank, and the aboveground vegetation was low, because the seed rain contained much fewer species, and the seed bank and aboveground vegetation contained many different species, respectively. These findings indicate that both the seed rain and the seed bank play important roles in providing seeds for plant recruitment in the understory, but the seed bank contributes more than the current seed rain to the diversity of recruited plants. The current plant community has little impact on the qualitative composition of the seed rain and seed bank. Based on these data, it appears that succession to the desired zonal, mature forest community is unlikely to result from seeds in the seed rain or seed bank. Lack of seed availability of desired zonal mature forest species is the main bottleneck currently limiting succession in the plantations. Reintroduction of late-successional species could facilitate the desired succession.

To better understand the potentials of the soil seed banks in facilitating succession towards a more natural forest of native tree species, we quantified the size and composition of the soil seed banks in established plantations in South China. The seed banks were from four typical 22-year-old plantations, i.e., legume, mixed-conifer, mixed-native, and Eucalyptus overstory species. Species diversity in the seed banks was low, and the vegetation species differed from those found in the seed bank in each plantation. A total of 1211 seedlings belonging to eight species emerged in a seedling germination assay, among which Cyrtococcum patens was most abundant. All species detected were shrubs and herbs, and no viable indigenous tree seeds were found in soil samples. Size and species composition of the seed banks might be related to the overstory species compositions of the established plantations. The seed bank density in soils was highest in the mixed-conifer plantation followed by Eucalyptus, mixed-native, and legume plantations. Species richness among the seed banks of plantations was ranked as follows: Eucalyptus > mixed-conifer > mixed-native = legume. The results indicated that the soil seed banks of the current plantations are ineffective in regenerating the former communities after human disturbances. Particularly, the absence of indigenous tree species seeds in the seed banks would limit regeneration and probably contribute to arrested succession at the pioneer community stage. It would appear from these data that the soil seed banks under the current plantations should not be considered as a useful tool leading the succession to more natural stages. Introduction of target indigenous species by artificial seeding or seedling planting should be considered to accelerate forest regeneration.