Search

An 83-year-old female, suffering from abdominal pain, nausea, and vomiting, was admitted to our hospital. Gas-liquid level and tumor was not seen on the abdominal computed tomography scan. Instead, two high density balloon which were 2.7cm(distal) and 3.3cm(proximal) in diameter separately were shown (Figure A) in small intestine. The balloons proved to be part of ileus tube and iohexol which was incorrectly injected into the balloons caused a blockage in the tube. During colonoscopy, we were surprised to find that the distal balloon had passed through the ileocecal valve and we punctured it easily (Figure B). However, affected by the broken distal balloon, we could not reach another one. Finally, we cut off the connector fixed to the face and instructed the patient to take some oral paraffin oil and exercise appropriately. The next day, the balloons were discharged with the symptoms alleviated. It is rare for iatrogenic foreign body to cause ileal obstruction).

Background and Aim Acute liver failure (ALF) poses a serious public health issue. The menstrual blood‐derived mesenchymal stem cells (MenSCs) have been applied to cure various liver‐related diseases. However, the efficacy and mechanism are far from clear. This study aims to explore the efficacy and potential mechanism of MenSCs to cure ALF. Methods We investigate the potential mechanism of MenSCs on the ALF in vitro and in vivo. A2A adenosine receptor (A2AR) activation was investigated as the potential reinforcer for MenSCs treatment. Lipid polysaccharide/d‐galactosamine (d‐GalN) was employed to induce ALF. Diverse techniques were used to measure the inflammatory cytokines and key signaling molecules. Hematoxylin–eosin stain and aminotransaminases were applied to evaluate the liver injury. Flow cytometry was employed to assess the T cells. Results The MenSCs can decrease the lipid polysaccharide‐induced inflammatory cytokine elevation and related signaling molecules in ALF, including TLR4, phosphorylated‐NF‐kBp65 (p‐NF‐kBp65), PI3K, and p‐AKT, p‐mTOR and p‐IKK in vitro. Moreover, MenSCs also can significantly reverse the liver injury, inflammatory cytokines elevation and related signaling molecules increase, and Treg/Th17 ratio decrease in vivo. In addition, MenSCs plus A2AR agonist can enhance the above changes. Conclusions The MenSCs can attenuate the ALF‐induced liver injury via inhibition of TLR4‐mediated PI3K/Akt/mTOR/IKK signaling. Then, this inhibits the p‐NF‐κBp65 translocate into nuclear, which causes a decrease of inflammatory cytokines release. Moreover, A2AR agonist can play a synergic role with MenSCs and enhance the above‐mentioned effects.

Intestinal mucosal inflammation and epithelial barrier dysfunction have been implicated as pathological factors in inflammatory bowel disease (IBD). An emerging area of IBD research focuses on probiotics. The probiotic

Zhu Zhang, Huahong Wang Department of Gastroenterology, Peking University First Hospital, Beijing 100034, People’s Republic of ChinaCorrespondence: Huahong WangDepartment of Gastroenterology, Peking University First Hospital, Beijing 100034, People’s Republic of ChinaTel +86-10-83572301Email Wanghhbjdx08@126.comIntroduction: The long-non-coding RNA HCP5 (HLA complex P5) has been extensively linked to the ability of cancer cells to resist chemotherapeutic interventions. Here, we investigated the role of HCP5 in gastric cancer (GC) which to-date has been poorly characterized. Our results indicated that HCP5 expression was up-regulated in GC cells.Methods: HCP5, miR-519d, and high mobility group A1 (HMGA1) expression levels in GC cells were measured using quantitative real-time PCR (qRT-PCR) and Western blot analysis. Drug sensitivity and apoptosis of tumor cells were assessed using cell counting kit-8, flow cytometry, and caspase activity assay. Bioinformatics and luciferase reporter assays were employed for analyzing the interactions between HCP5, miR-519d, and HMGA1.Results: HCP5 knockdown suppressed proliferation and weakened the resistance to cisplatin (DDP) of GC cells. miR-519d was down-regulated in GC cells and sponged by HCP5. HMGA1 was directly inhibited by miR-519d and its expression was up-regulated in GC cells. HCP5 exacerbated the resistance to cisplatin of GC cells in vitro by enhancing HMGA1 expression via sponging miR-519d.Conclusion: In summary, HCP5 promoted proliferation and contributed to DDP resistance in GC cells through miR-519d/HMGA1 axis.Keywords: lncRNA HCP5, gastric cancer, cisplatin, miR-519d, HMGA1

To explore the influence of long non-coding ribonucleic acid (lncRNA) small nucleolar RNA host gene 1 (SNHG1) on the proliferation and apoptosis of gastric cancer cells.SNHG1 was knocked down using small-interfering RNAs (siRNAs) in gastric cancer cell line MGC-803 and then the changes in the expression levels of SNHG1 and Notch1 in each group of cells were evaluated via quantitative reverse transcription polymerase chain reaction (qRT-PCR).After intervention of SNHG1 by siRNAs, compared with NC-siRNA group, SNHG1-siRNA group exhibited notably lowered RNA and messenger RNA (mRNA) levels of SNHG1 and Notch1 (p0.05), a substantially lowered proliferation rate (p0.05), a remarkably raised apoptosis rate (p0.05) and markedly decreased protein expression levels of Notch1 and Bax (p0.05). Additionally, the cells treated with Notch1 inhibitor had the proliferation substantially inhibited (p0.05), while there was no notable change in the RNA expression of SNHG1 in the cells.LncRNA SNHG1 can depend on the Notch1 pathway to suppress the proliferation of gastric cancer cells and promote their apoptosis.

Background and aim The treatment of patients with functional dyspepsia (FD) remains unsatisfactory. We assessed the efficacy of Zhizhu Kuanzhong (ZZKZ) capsule, a traditional Chinese medicine formula, in patients with postprandial distress syndrome (PDS) of FD. Methods The study was designed as a multicenter, randomized, double-blinded, controlled clinical trial. Three-hundred ninety-two patients with PDS defined by Rome III criteria from 16 centers in China were randomly assigned to receive either ZZKZ or placebo. The proportion of the responders at 4 weeks after randomization was considered primary endpoint. Secondary endpoint was the symptom score reduction of each dyspeptic symptom relative to the baseline at 4 weeks after randomization in all subjects. Results In terms of the primary endpoint, the proportion of the responders concerning the composite PDS symptom score was 38.8% and 54.7% in placebo group and ZZKZ group, respectively (P = 0.003), in per protocol analysis at 4 weeks after randomization. Concerning the individual evaluated upper gastrointestinal symptoms, only postprandial fullness and early satiety showed significant difference in symptom score reduction at 4 weeks after randomization between placebo and ZZKZ groups. Conclusions Zhizhu Kuanzhong is superior to placebo in the treatment of PDS with FD. The exact mechanisms by which ZZKZ improves symptoms remain to be established (http://www.chictr.org.cn/ChinCTR-TRC-14004714).

A young patient had serious hematochezia for nearly 2 months without obvious cause. Abdominal CT images showed rare features such as serious hemorrhage and multiple miliary nodules in the small bowel. The colonoscopy showed multiple lymphoid follicles in the terminal ileum. The laparotomy showed adverse adhesion in the abdominal cavity and multiple miliary noduli in the surfaces of small bowel wall. The pathology suggested tuberculosis. This patient received anti-TB therapy and the condition improved gradually. There are many variants of GI tuberculosis demonstrating uncommon and rare imaging features. It turned to be difficult in diagnosis when it showed the rare appearance, such as the great amount of intestinal bleeding and multiple noduli in our case. The reason why gastrointestinal bleeding might be attributed to the invasiveness of submucosal vessels by the tuberculosis bacteria. And the multiple noduli on the bowel wall might be the granuloma formation. Therefore, from the experience of our case, gastrointestinal tract might also be the first and only involved site, and it may cause great amount of bleeding to a life danger, even in young people.

Objectives To assess the efficacy and safety of omeprazole given with the new single capsule of bismuth, metronidazole and tetracycline (OBMT) compared with quadruple treatment consisting of omeprazole, bismuth, amoxicillin and clarithromycin (OBAC) for Helicobacter pylori eradication in duodenal ulcer patients. Methods This single-blind, randomized multicentre trial was conducted in 10 tertiary hospitals in China between January 2013 and April 2014. Patients were randomized to receive 10 days of OBMT therapy or 10 days of OBAC therapy. Our primary outcome was the H. pylori eradication rate, confirmed by negative [13C]urea breath tests 20-25 days after the end of omeprazole maintenance. Antibiotic resistance was determined by Etest. This study is registered with ClinicalTrials.gov, number ChiCTR-TRC-13003143. Results One hundred and ninety-two patients received OBMT therapy and 192 received OBAC therapy. There was no significant difference between the eradication rates achieved by OBMT and OBAC in either the ITT analysis (86.46% versus 87.50%, P = 0.762) or the PP analysis (94.58% versus 93.06%, P = 0.563). The efficacies of OBMT and OBAC were not affected by metronidazole or clarithromycin resistance. Treatment-emergent adverse events (TEAEs) for both treatments were similar; gastrointestinal and CNS symptoms were the most commonly reported. Conclusions The new single-capsule OBMT quadruple therapy is as effective and well tolerated as the widely used OBAC therapy for treatment of H. pylori in clinical practice in China. In addition, this OBMT therapy largely overcomes H. pylori metronidazole and clarithromycin resistance.

Background/Aims There is a need for a simple and practical tool adapted for the diagnosis of chronic constipation (CC) in the Asian population. This study compared the Asian Neurogastroenterology and Motility Association (ANMA) CC tool and Rome III criteria for the diagnosis of CC in Asian subjects. Methods This multicenter, cross-sectional study included subjects presenting at outpatient gastrointestinal clinics across Asia. Subjects with CC alert symptoms completed a combination Diagnosis Questionnaire to obtain a diagnosis based on 4 different diagnostic methods: self-defined, investigator`s judgment, ANMA CC tool, and Rome III criteria. The primary endpoint was the level of agreement/ disagreement between the ANMA CC diagnostic tool and Rome III criteria for the diagnosis of CC. Results The primary analysis comprised of 449 subjects, 414 of whom had a positive diagnosis according to the ANMA CC tool. Rome III positive/ANMA positive and Rome III negative/ANMA negative diagnoses were reported in 76.8% and 7.8% of subjects, respectively, resulting in an overall percentage agreement of 84.6% between the 2 diagnostic methods. The overall percentage disagreement between these 2 diagnostic methods was 15.4%. A higher level of agreement was seen between the ANMA CC tool and self-defined (374 subjects [90.3%]) or investigator`s judgment criteria (388 subjects [93.7%]) compared with the Rome III criteria. Conclusion This study demonstrates that the ANMA CC tool can be a useful for Asian patients with CC. (J Neurogastroenterol Motil 2017;23:262-272)

Background This study aimed to understand the disease characteristics and treatment outcomes of Crohn’s disease (CD) in a real-world setting in China. Methods In this prospective, non-interventional, multicenter disease registry, adults (≥18 years) with existing and newly diagnosed CD were recruited from 14 medical centers across China from January 2015 to January 2017. The study consisted of the enrollment and follow-up periods, of 12 months each. Demographic, clinical characteristics, diagnostic duration and management of CD at enrollment were evaluated. Logistic regression analysis and stepwise multivariate logistic regression analysis used to assess the relationship between the risk factors and CD. Results Of 504 enrolled patients, 499 (99.0%) were eligible for analysis. The mean (SD) age at study enrollment was 32.3 (11.43) years and the majority (69.7%) of participants were male. In the past 15 years, a sustained decrease of the period of time in the diagnosis of CD was observed, at about 39.4 (24.11) months in 2010, which decreased to 3.1 (2.13) months in 2015. The most common presenting symptoms of CD included abdominal pain (78.0%), diarrhea (58.1%), weight loss (52.9%) and fever (30.1%). Oral ulcer (19.4%) and arthritis (9.8%) were the most common extra-intestinal manifestations. Non-stricturing non-penetrating (B1) (49.9%) behavior and ileocolonic involvement (L3) (56.2%) location were more frequent. Perianal disease was observed in 29.1% of the patients. Around 23.8% (119/499) patients had CD-related surgery other than perianal disease surgery. Older age at enrollment, longer disease course, complicated disease behavior and absence of perianal disease were all surgery risk factors (p

Table S1. List of participating centers; Full analysis set. Table S2. Subject dispositions; Screened analysis set. Table S3. Logistic model for each correlation factor to Crohn’s disease behavior (B1 vs. B2 + B3); Full analysis set. Table S4. Logistic model for each correlation factors to Crohn’s disease localization (L1 vs. L2 vs. L3 vs. L4); Full analysis set. (DOC 111 kb)

The treatment of patients with functional dyspepsia (FD) remains unsatisfactory. We assessed the efficacy of Zhizhu Kuanzhong (ZZKZ) capsule, a traditional Chinese medicine formula, in patients with postprandial distress syndrome (PDS) of FD.The study was designed as a multicenter, randomized, double-blinded, controlled clinical trial. Three-hundred ninety-two patients with PDS defined by Rome III criteria from 16 centers in China were randomly assigned to receive either ZZKZ or placebo. The proportion of the responders at 4 weeks after randomization was considered primary endpoint. Secondary endpoint was the symptom score reduction of each dyspeptic symptom relative to the baseline at 4 weeks after randomization in all subjects.In terms of the primary endpoint, the proportion of the responders concerning the composite PDS symptom score was 38.8% and 54.7% in placebo group and ZZKZ group, respectively (P = 0.003), in per protocol analysis at 4 weeks after randomization. Concerning the individual evaluated upper gastrointestinal symptoms, only postprandial fullness and early satiety showed significant difference in symptom score reduction at 4 weeks after randomization between placebo and ZZKZ groups.Zhizhu Kuanzhong is superior to placebo in the treatment of PDS with FD. The exact mechanisms by which ZZKZ improves symptoms remain to be established (http://www.chictr.org.cn/ChinCTR-TRC-14004714).

To observe the effects and safety of quadruple regimens including domestically manufactured rabeprazole used as first line/initial therapy for Helicobacter pylori(H.pylori) eradication in gastritis and duodenal ulcer patients, and to investigate the effects of extended use of bismuth after the quadruple therapy on eradication of H. pylori.From January to August 2013, 430 patients with chronic gastritis or duodenal ulcer who were confirmed as H. pylori positive in gastroscopy for upper gastrointestinal symptoms were enrolled from 12 centers in China for initial treatment using quadruple regimens for H. pylori eradication. The study was a prospective, multicenter, randomized double-blinded double-dummy parallel-controlled clinical trial. The 310 chronic gastritis patients were divided into 2 groups: group A1 was given quadruple regime (rabeprazole+ amoxicillin+ clarithromycin+ bismuth potassium citrate) for 10 days followed by bismuth-placebo for 21 days; group A2 was given the quadruple regimen for 10 days and then bismuth potassium citrate for 21 days. The duodenal ulcer patients were given the quadruple for 10 days, then rabeprazole for 14 days. All the patients took (13)C urea breath test to detect H. pylori 28 days after medicine withdrawal.Altogether 428 cases were enrolled and 404 completed the trial. The total eradication rate in the chronic gastritis patients was 85.1% (262/308, intention-to-treat (ITT)analysis), which was 81.7% (125/153, ITT) in the A1 group and 88.4% (137/155, ITT) in the A2 group; the eradication rate in the duodenal ulcer patients was 85.8% (103/120, ITT). No severe adverse effects were reported. The symptoms (pain, burning sensation, reflux, belching, nausea, and vomiting) improvement status was similar among A1 and A2 groups.The quadruple regimen using rabeprazole manufactured in China and administered for 10 days as first line/initial therapy in chronic gastritis and duodenal ulcer patients could achieve good H. pylori eradication rate. The extended use of bismuth after 10-day quadruple regimen might further improve the eradication rate. The regimens containing proton-pump inhibitor and bismuth may be well tolerated and safe in clinical application.

Artemisin is a sesquiterpene lactone with an endoperoxide bridge first isolated from the aerial parts of Artemisia annua L. (Compositae). It is an important antimalarial component, but as of present remains quite expensive due to its low content in the plant, the only commercial source of the compound. In this study, we found a 49% increase of the artemisinin content in A. annua SP18 on day 8 after treatment with methyl jasmonate (MeJA), together with an 80% increase in artemisinic acid and 28% in dihydroartemisinic acid, the two potential precursors of artemisinin. In addition, the effects of exogenous MeJA on other secondary metabolites were evaluated by metabolite profiling using orthogonal signal correction partial least square discriminant analysis (OSC-PLS). Six sesquiterpenoids and three triterpenoids were selected as marker compounds in OSC-PLS. Their content also changed significantly after MeJA treatment, including a 50% increase in methyl artemisinic acid, a 67% increase in squalene and a 60% increase in peak 51 (an unidentified sesquiterpenoid). These compounds are promising targets for further studies on artemisinin biosynthesis and metabolic engineering.

Artemisinin from Artemisia annua has become one of the most important drugs for malaria therapy. Its biosynthesis proceeds via amorpha-4,11-diene, but it is still unknown whether the isoprenoid precursors units are obtained by the mevalonate pathway or the more recently discovered non-mevalonate pathway. In order to address that question, a plant of A. annua was grown in an atmosphere containing 700 ppm of 13CO2 for 100 min. Following a chase period of 10 days, artemisinin was isolated and analyzed by 13C NMR spectroscopy. The isotopologue pattern shows that artemisinin was predominantly biosynthesized from (E,E)-farnesyl diphosphate (FPP) whose central isoprenoid unit had been obtained via the non-mevalonate pathway. The isotopologue data confirm the previously proposed mechanisms for the cyclization of (E,E)-FPP to amorphadiene and its oxidative conversion to artemisinin. They also support deprotonation of a terminal allyl cation intermediate as the final step in the enzymatic conversion of FPP to amorphadiene and show that either of the two methyl groups can undergo deprotonation.

Amorpha-4,11-diene synthase (ADS) of Artemisia annua catalyzes the conversion of farnesyl diphosphate into amorpha-4,11-diene, the first committed step in the biosynthesis of the antimalarial drug artemisinin. The promoters of ADS contain two reverse-oriented TTGACC W-box cis-acting elements, which are the proposed binding sites of WRKY transcription factors. A full-length cDNA (AaWRKY1) was isolated from a cDNA library of the glandular secretory trichomes (GSTs) in which artemisinin is synthesized and sequestered. AaWRKY1 encodes a 311 amino acid protein containing a single WRKY domain. AaWRKY1 and ADS genes were highly expressed in GSTs and both were strongly induced by methyl jasmonate and chitosan. Transient expression analysis of the AaWRKY1-GFP (green fluorescent protein) reporter revealed that AaWRKY1 was targeted to nuclei. Biochemical analysis demonstrated that the AaWRKY1 protein was capable of binding to the W-box cis-acting elements of the ADS promoters, and it demonstrated transactivation activity in yeast. Co-expression of the effector construct 35S::AaWRKY1 with a reporter construct ADSpro1::GUS greatly activated expression of the GUS (beta-glucuronidase) gene in stably transformed tobacco. Furthermore, transient expression experiments in agroinfiltrated Nicotiana benthamiana and A. annua leaves showed that AaWRKY1 protein transactivated the ADSpro2 promoter activity by binding to the W-box of the promoter; disruption of the W-box abolished the activation. Transient expression of AaWRKY1 cDNA in A. annua leaves clearly activated the expression of the majority of artemisinin biosynthetic genes. These results strongly suggest the involvement of the AaWRKY1 transcription factor in the regulation of artemisinin biosynthesis, and indicate that ADS is a target gene of AaWRKY1 in A. annua.

Amorpha-4,11-diene synthase (ADS) is a very important enzyme which catalyzes the committed step of artemisinin biosynthesis. In this work, two lines of transgenic Artemisia annua L. which ADS was over-expressed (line A9) and suppressed (line Amsi), respectively, were utilized. And the transgenic line GUS with β-Glucuronidase gene was regarded as the control. Their terpenoid metabolic profiling was investigated by using GC × GC–TOFMS. The metabolic profiling method established included simple extraction, two-dimension separation and multivariate analysis. Partial least squares discriminant analysis (PLS-DA) was used to classify two transgenic lines and the control line. Eleven important compounds in classification were identified. Most of them were sesquiterpenoids including monoterpenoid, diterpenoid and four bioprecursors of artemsisnin. Compared with the control, artemisinin and bioprecursors in the line A9 increased as a result of over-expressing ADS. Borneol and phytol also increased in the line A9, but (E)-β-farnesene and germacrene D were reversely altered. The result indicated that over-expression of the ADS affected not only artemisinin biosynthesis, but also the whole metabolic network of terpenoid. Compared with the line A9, no opposite change of artemisinin and related derivatives was observed in the line Amsi, the ADS inhibition had no significant effect on artemisinin biosynthesis in the line Amsi.

A type III polyketide synthase cDNA and the corresponding gene (PcPKS2) were cloned from Polygonum cuspidatum Sieb. et Zucc. Sequencing results showed that the ORF of PcPKS2 was interrupted by three introns, which was an unexpected finding because all type III PKS genes studied so far contained only one intron at a conserved site in flowering plants, except for an Antirrhinum majus chalcone synthase gene. Besides the unusual gene structure, PcPKS2 showed some interesting characteristics: (1) the CHS "gatekeepers" Phe215 and Phe265 are uniquely replaced by Leu and Cys, respectively; (2) recombinant PcPKS2 overexpressed in Escherichia coli efficiently afforded 4-coumaroyltriacetic acid lactone (CTAL) as a major product along with bis-noryangonin (BNY) and p-hydroxybenzalacetone at low pH; however, it effectively yielded p-hydroxybenzalacetone as a dominant product along with CTAL and BNY at high pH. Beside p-hydroxybenzalacetone, CTAL and BNY, a trace amount of naringenin chalcone could be detected in assays at different pH. Furthermore, 4-coumaroyl-CoA and feruloyl-CoA were the only cinnamoyl-CoA derivatives accepted as starter substrates. PcPKS2 did not accept isobutyryl-CoA, isovaleryl-CoA or acetyl-CoA as substrate. DNA gel blot analysis indicated that there are two to four PcPKS2 copies in the P. cuspidatum genome. RNA gel blot analysis revealed that PcPKS2 is highly expressed in the rhizomes and in young leaves, but not in the roots of the plant. PcPKS2 transcripts in leaves were induced by pathogen infection, but not by wounding.

A rapid and convenient method to separate and quantify ursolic acid (UA) and oleanolic acid (OA) of cornus ( Macrocarpium officinale (Sieb. et Zucc.) Nakai), a traditional Chinese medicine and food materials, was established by reversed-phase high performance liquid chromatographic (RP-HPLC). The Linear ranges were 1.01–6.06 μg/μl for UA and 0.51–2.55 μg/μl for OA with good correlation. The average recovery rates were 103.0% of UA and 97.9% of OA, respectively. The precision and the repeatability of the analytical method were satisfied. Samples of cornus at different developmental stages were detected, and the UA contents varied from a high of over 0.520% to less than 0.107%, while OA contents varied from 0.221% to 0.050% during the fruit growth. This study showed that the contents of UA and OA varied considerably with fruit development, especially with the development of exocarp, and the results indicated that the appropriate picking time was in later September. The distinct contents of UA and OA in different parts of cornus (exocarp, sarcocarp, and core) suggested the two compounds mainly located in exocarp of the fruit.

Artemisia annua L. is an annual herb native of Asia and this plant has been famous for the discovery of the anti-malarial drug artemisinin since 1971. In this work, to investigate variety of whole metabolites, metabolic fingerprinting analysis of A. annua L. was carried out by GC and GC-MS coupled with trimethylsilyl derivatisation. Principal component analysis and partial least squares discriminant analysis were employed to classify GC data of A. annua L. samples at five developmental stages. The results indicated that there was no distinct difference of metabolites between control (001) and transgenic strain (F4) from the tender seedling stage to adult seedling stage, but clear differences were detected at pre-flower budding stage, flower budding stage and full flowering stage. Three precursors of artemisinin biosynthesis were studied at five developmental stages and found that a possible bottleneck exists in the conversion from artemisinic acid or dihydroartemisinic acid to artemisinin.

Artemisia annua L. is an annual herb native of Asia, it has been used for many centuries for the treatment of fever and malaria. In this paper, analysis of the volatile oil of Artemisia annua L. was performed by comprehensive two-dimensional gas chromatography time-of-flight mass spectrometry (GC x GC-TOF MS). Three hundred and three components were tentatively identified and terpene compounds are the main components of Artemisia annua L. volatile oil. Artemisinic acid is tentatively qualified.

The purpose of the study is to evaluate a new immunochemical fecal occult blood test method (Hemosure IFOBT), and compare it to the Guaiac-based chemical method (CFOBT) for colorectal cancer detection. A hypothetical sequential method (SFOBT), in which IFOBT was used only as a confirmatory test for CFOBT, was also evaluated. A total of 324 patients were recruited from 5 major hospitals in Beijing, China. For each patient, 3 consecutive stool samples were collected for simultaneous CFOBT and IFOBT tests, followed by colonoscopic examination. We compared the sensitivity and specificity of the 3 methods (CFOBT, IFOBT and SFOBT) in two settings, with the first 2 consecutive samples versus all 3 samples. Although the sensitivity for the detection of cancer and large (20 mm) or multiple adenoma was similar for all 3 methods in the three-sample setting, in the two-sample setting IFOBT had higher sensitivity than SFOBT for detecting cancer (87.8% vs. 75.5%, respectively, p0.05) and large (20 mm) or multiple adenomas (65.4% vs. 42.3%, respectively, p0.05). The IFOBT also had a higher specificity than the CFOBT (89.2% vs. 75.5%, respectively, p0.01) in "normal" individuals defined by colonoscopy in the three-sample setting. Comparing two-sample setting to the three-sample setting, both CFOBT and SFOBT showed significant loss of sensitivity for the detection of cancer as well as adenoma, whereas the sensitivity for IFOBT did not change significantly. Overall, IFOBT with two-sample testing showed compatible sensitivity and specificity to the three-sample testing, and had a lower relative cost per cancer detected than the three-sample testing. In conclusion, the new Hemosure IFOBT with two consecutive stool samples appears to be the most cost-effective approach for colon cancer screening.

Artemisia annua L. is a traditional Chinese medicinal plant. In the 1970s, Chinese scientists first isolated colorless needle-like crystals with antimalarial activity from A. annua and named artemisinin. The chemical structure of artemisinin was confirmed as a sesquiterpene lactone with an endoperoxide bridge, of melting point 156–157 °C and molecular formula C15H22O5.

Here, we report the full genome sequence of an H1N2 avian influenza virus (AIV) isolated from wild waterfowl in Dongting Lake. Phylogenetic analysis showed that it was a novel recombinant AIV between domestic ducks and wild waterfowl. Investigation of this virus is helpful for our understanding of the ecology of AIV in this region.

Background Probiotics are widely used for the induction and maintenance of remission in inflammatory bowel disease (IBD) and pouchitis. There are a large number of meta-analyses (MAs)/ systematic reviews (SRs) on this subject, the methodological quality of which has not been evaluated. Objectives This study aimed to evaluate the methodological quality of and summarize the evidence obtained from MAs/SRs of probiotic treatments for IBD and pouchitis patients. Methods The PubMed, EMBASE, Cochrane Library and China National Knowledge Infrastructure (CNKI) databases were searched to identify Chinese and English language MAs/SRs of the use of probiotics for IBD and pouchitis. The Assessment of Multiple Systematic Reviews (AMSTAR) scale was used to assess the methodological quality of the studies. Results A total of 36 MAs/SRs were evaluated. The AMSTAR scores of the included studies ranged from 1 to 10, and the average score was 5.81. According to the Canadian Agency for Drugs and Technologies in Health, 4 articles were classified as high quality, 24 articles were classified as moderate quality, and 8 articles were classified as low quality. Most of the MAs/SRs suggested that probiotics had potential benefits for patients with ulcerative colitis (UC), but failed to show effectiveness in the induction and maintenance of remission in Crohn’s disease (CD). The probiotic preparation VSL#3 may play a beneficial role in pouchitis. Conclusion The overall methodological quality of the current MAs/SRs in the field of probiotics for IBD and pouchitis was found to be low to moderate. More MAs/SRs of high quality are required to support using probiotics to treat IBD and pouchitis.

Artemisinin, a sesquiterpene lactone endoperoxide, is a valuable and powerful antimalarial drug obtained from the aerial parts of a Chinese herb, Artemisia annua (Liu et al., 1979). Artemisinin and its derivatives show few or no side effects with the existing antimalarial drugs, it has consequently been regarded as the next generation of antimalarial drugs (Looaresuwan, 1994). Currently, commercial production of artemisinin mainly based on its extraction and purification from plant material, however, the endogenous production of artemisinin is very low (0.01%-0.8% dry weight) (Wallaart et al., 1999). In view of the limited availability of artemisinin and the increased demand, the synthetic preparation of artemisinin becomes an attractive proposition. However due to its complex structure, the complete chemical synthesis is very difficult (Schmid & Hofheinz, 1983). Artemisia annua as the only valid source, many research groups have directed their investigations toward the enhancement of artemisinin production in A. annua cell cultures or whole plants by biotechnological approaches. However these approaches were still proved to be not successful (Ghingra et al., 2000). Recently, several genes in artemisinin biosynthesis have been cloned, and important advances in artemisinin biosynthesis have been achieved, which makes it possible to regulate artemisinin biosynthesis in a direct way, for example, by metabolic engineering (Abdin et al., 2003).

Artemisinin has been proven to be an effective antimalarial compound, especially for chloroquine-resistant and cerebral malaria. However, its biosynthesis pathway is still not completely clear. In order to get new clues about artemisinin biosynthesis, metabolic profiling by gas chromatography (GC) and gas chromatography-mass spectrometry (GC-MS) was applied to compare the secondary metabolites of two Artemisia annua L., genotype SP18 and 001, for some phenotypic and agricultural trait differences, including artemisinin content, existed between the two genotypes. Samples at 7 time points of three growth stages were studied. The data of profiles were subjected to multivariate analysis with partial least squares discriminant analysis (PLS-DA). The results indicated that there were clear differences in terpenoids and artemisinin metabolism between different growth stages and genotypes. Twenty-one compounds, including artemisinin and its related precursors, were selected as the marker compounds of the PLS-DA between the two genotypes. Among them, artemisinic acid, arteannuin B, borneol, beta-farnesene and an unidentified sesquiterpenoid (peak 48) were abundant in 001, while camphor, methyl artemisinic acid and lanceol accumulated mainly in SP18. The relationship between these differences and artemisinin biosynthesis in the two genotypes of A. annua were discussed.

To investigate the clinical manifestations, diagnosis and treatment of gastric stromal tumors.31 patients with gastric stromal tumors treated from 1993, 1 - 2001, 9 were analyzed retrospectively. All cases were diagnosed by pathological and immunohistochemistry examinations. According to Levin's standard combining with Hurliman's and Goldbum's methods, the patients were classified.There are no significant difference between male and female patients. 50 - 60 years old patients have high incidence. The distribution of gastric tromal tumors is fundusbodyantrum. Diagnosis of this condition is sometimes difficult and treatment is often delayed because patients usually present with nonspecific abdominal symptoms. The main manifestations of gastric stromal tumors are upper gastrointestinal hemorrhage 61.3% (19/31), 7 patients with acute hemorrhage and 12 with chronic hemorrhage. Most of them were malignant. Abdominal malaises and/or distention 32.3% (10/31) and abdominal pain 22.6% (7/31). Gastroscopy, ultrasound gastroscopy, computed tomography, B type ultrasound and upper gastrointestinal X-ray series are helpful to diagnosis. But the final diagnosis is decided by pathological and immunohistochemistry examinations. Gastric stromal tumors exhibit consistent immunohistochemical expressions of CD(117) and/or CD(34). The operative treatment is thought of the first choice. Effect of the chemotherapy isn't satisfied. There is no standard chemotherapy for gastric stromal tumors.Gastric stromal tumor is a kind of separated submucosal tumor which is different from leiomyoma, leiomyosarcoma and neurogenic tumors. Pathological and immunohistochemistry inspectations are very important to make clear diagnosis. Early diagnosis and rational treatment are the keys to improve the prognosis.