Predictors of healthcare-seeking behavior among Chinese patients with irritable bowel syndrome

AIM To analyze predictors of healthcare-seeking behavior among Chinese patients with irritable bowel syndrome(IBS) and their satisfaction with medical care.METHODS Participating patients met IBS Rome Ⅲ criteria(excluding those with organic diseases) and were enrolled in an IBS database in a tertiary university hospital. Participants completed IBS questionnaires in face-to-face interviews. The questionnaires covered intestinal and extra-intestinal symptoms, medical consultations, colonoscopy,medications, and self-reported response to medications during the whole disease course and in the past year. Univariate associations and multivariate logistic regression were used to identify predictors for frequent healthcareseeking behavior(≥ 3 times/year), frequent colonoscopies(≥ 2 times/year), long-term medications, and poor satisfaction with medical care.RESULTS In total, 516 patients(293 males, 223 females) were included. Participants' average age was 43.2 ± 11.8 years. Before study enrollment, 55.2% had received medical consultations for IBS symptoms. Ordinary abdominal pain/discomfort(non-defecation) was an independent predictor for healthcare-seeking behavior(OR = 2.07, 95%CI: 1.31-3.27). Frequent colonoscopies were reported by 14.7% of patients(3.1 ± 1.4 times per year). Sensation of incomplete evacuation was an independent predictor for frequent colonoscopies(OR = 2.76, 95%CI: 1.35-5.67). During the whole disease course, 89% of patients took medications for IBS symptoms, and 14.7% reported they were satisfied with medical care. Patients with anxiety were more likely to report dissatisfaction with medical care(OR = 2.08, 95%CI: 1.20-3.59). In the past year, patients with severe(OR = 1.74, 95%CI: 1.06-2.82) and persistent(OR = 1.66, 95%CI: 1.01-2.72) IBS symptoms sought medical care more frequently.CONCLUSION Chinese patients with IBS present high rates of frequent healthcare-seeking behavior, colonoscopies, and medications, and low satisfaction with medical care. Intestinal symptoms are major predictors for healthcare-seeking behavior.

Postoperative chemotherapy with S-1 plus oxaliplatin versus S-1alone in locally advanced gastric cancer(RESCUE-GC study): a protocol for a phase Ⅲ randomized controlled trial

Background： The ACTS-GC study had shown postoperative adiuvant therapy with S-1 improved survival of patients with locally advanced gastric cancer. Addition of oxaliplatin to S-1 is considered to be acceptable as one of the treatment options for gastric cancer patients after radical gastrectomy with D2 lymph node excision. Methods： We have commenced a randomized phase III trial in December 2016 to evaluate S-I plus oxaliplatin compared with S-1 alone in the adjuvant setting for locally advanced gastric cancer. A total of 564 patients will be accrued from 13 Chinese institutions in two years. The primary endpoint is 3-year relapse-free survival. The secondary endpoints are 5-year overall survival, proportion of patients who complete the postoperative chemotherapy and incidence of adverse events. Ethic and dissemination： The trial has been approved by the institutional review board of each participating institution and it was activated on December, 2016. The enrollment will be finished in December, 2018. Patient＇s follow-up will be ended until December, 2023. Trial registration： ClinicalTrials.gov, identifier： NCT02867839. Registered on August 4, 2016.

Genome-wide identification and cold stress-induced expression analysis of the CBF gene family in Liriodendron chinense

Cold-resistance pathways that operate in model plants such as Arabidopsis thaliana and Oryza sativa have been studied extensively.It has been found that CBF genes play an important role in plant cold resistance.Liriodendron chinense,a tree known for its graceful tree shape and widely spread in south China,has weak cold tolerance.However,little is known about its response to cold.To further study the function of L.chinense CBF gene family,we started by characterizing all members of this gene family in the L.chinense genome and their expression profiling.Phylogenetic analysis found that 14 CBF genes in L.chinense are more closely related to their homologues in woody plants and A.thaliana than those in O.sativa.Cis-acting elements and GO analysis showed that some LcCBF genes participated in the biological process of cold stress response.The transcriptomic and RT-qPCR data showed that most of LcCBF genes displayed an initially increasing and subsequently decreasing trend during cold stress course and the expression profile of each member was different.Some LcCBF genes exhibited a different abundance in callus,root,stem and leaf tissues.The structure and expression characteristics of LcCBF genes imply that they may have similar and different functions in response to cold stress conditions.The identification and analysis of LcCBF gene family have laid the foundation for future studies into L.chinense cold stress mechanisms and for the cultivation of cold-resistance cultivars.

The role of γ-aminobutyric acid in aluminum stress tolerance in a woody plant, Liriodendron chinense×tulipifera

The aluminum(Al)cation Al^(3+)in acidic soil shows severe rhizotoxicity that inhibits plant growth and development.Most woody plants adapted to acidic soils have evolved specific strategies against Al^(3+)toxicity,but the underlying mechanism remains elusive.The four-carbon amino acid gamma-aminobutyric acid(GABA)has been well studied in mammals as an inhibitory neurotransmitter;GABA also controls many physiological responses during environmental or biotic stress.The woody plant hybrid Liriodendron(L.chinense×tulipifera)is widely cultivated in China as a horticultural tree and provides high-quality timber;studying its adaptation to high Al stress is important for harnessing its ecological and economic potential.Here,we performed quantitative iTRAQ(isobaric tags for relative and absolute quantification)to study how protein expression is altered in hybrid Liriodendron leaves subjected to Al stress.Hybrid Liriodendron shows differential accumulation of several proteins related to cell wall biosynthesis,sugar and proline metabolism,antioxidant activity,cell autophagy,protein ubiquitination degradation,and anion transport in response to Al damage.We observed that Al stress upregulated glutamate decarboxylase(GAD)and its activity,leading to increased GABA biosynthesis.Additional GABA synergistically increased Al-induced antioxidant enzyme activity to efficiently scavenge ROS,enhanced proline biosynthesis,and upregulated the expression of MATE1/2,which subsequently promoted the efflux of citrate for chelation of Al^(3+).We also showed similar effects of GABA on enhanced Al^(3+)tolerance in Arabidopsis.Thus,our findings suggest a function of GABA signaling in enhancing hybrid Liriodendron tolerance to Al stress through promoting organic acid transport and sustaining the cellular redox and osmotic balance.

The Chloroplast Genome of Cerasus Campanulata Diverges from Other Prunoideae Genomes

Cerasus Campanulata is one of several species belonging to the Prunoideae focke,a subfamily of the flowering plant Rosaceae.We investigated the details of its chloroplast genome which may reveal its genus independent of morphological determination.Here,we determined the complete chloroplast(cp)genome sequence of C.campanulata and performed sequence analysis to reveal the presence of 18 forward repeats,20 palindrome repeats,2 complement repeats,4 reverse repeats and 93 simple sequence repeats(SSRs).We additionally performed a comparative study of C.campanulata and seven other Prunoideae focke species.Then,maximum parsimony(MP)and maximum likelihood(ML)phylogenetic analyses were carried out in the little part of Rosaceae,respectively.The results strongly support a position of C.campanulata as a member of the Cerasus in the Rosaceae family.Moreover,the complete cp genome can be used for plant phylogenetic and evolutionary studies that will provide insight into the degree of gene conservation.

基于数据挖掘技术探讨针灸治疗荨麻疹的选穴规律及理论依据

目的:探讨针灸治疗荨麻疹的选穴规律、核心穴组及理论依据。方法:检索中国期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、维普期刊全文数据库(VIP)、万方数据知识服务平台(WF)上的电子文献,按照筛选标准收集针灸治疗荨麻疹的处方,利用Access 2010、Clementine 18.0、Stata软件对其进行描述性分析、关联规则分析和聚类分析。结果:共收集到8类各有侧重的针灸治疗方法,均选用膀胱经、督脉、任脉调和营卫祛风以治其表,大肠经、脾经、胃经健脾祛湿和血以治其里。用穴趋势集中,频率最高的前5位腧穴为曲池、血海、足三里、三阴交、膈俞,注重合穴、背俞穴、原穴等经气丰盛的特定穴的应用。腧穴配伍存在固定搭配,经穴置信度最高关联群是曲池-血海-大椎、耳穴则为肺-神门-风溪-肾上腺,通过聚类分析可得到三阴交-合谷-曲池-血海-足三里等12个聚类群。结论:通过数据挖掘技术可发现针灸治疗荨麻疹的规律,深化对针灸治疗荨麻疹的认识,为临床应用提供坚实的理论依据。

Variations of energy metabolism and adenosine Triphosphatase activity in gastric mucosa in chronic atrophic gastritis rats with Qi deficiency and blood stasis syndrome and effect of Zhiweifangbian capsule

OBJECTIVE: To study the effects of Zhiweifangbian (ZWFB) capsule on lactic dehydrogenase (LDH), succinic dehydrogenase (SDH) and ATPase activities in gastric mucosa of chronic atrophic gastritis (CAG) rats with Qi deficiency and blood stasis syndrome. METHODS: Totally 90 rats were randomly divided into 2 groups: normal group (n=10) and modelgroup (n=80). The CAG rat model of Qi deficiency and blood stasis type was induced by synthetic methods. After modeling for 12 weeks and the successful CAG model was determined, the CAG model rats were divided by random number table into model group (MG), ZWFB high-dose group (ZWFBH), ZWFB middle-dose group (ZWFBM), ZWFB low-dose group (ZWFBL) and Weimeisu group (WM), 9 rats in each group. The rats in the normal and model groups were intragastrically administrated with distilled water, 10 mL/kg every day; the ZWFB high-dose group with ZWFB, 0.6 g/ kg -1 · d -1 ; the ZWFB middle-dose group with ZWFB, 0.3 g/kg -1 · d -1 ; the ZWFB low-dose group with ZWFB, 0.15 g/kg -1 · d -1 , and the WM group with suspension of WM , 0.25 g/kg -1 · d -1 . The treatment was given for 90 consecutive days. Then general survival states were observed and the activities of LDH, SDH, Na + -K + -ATPase and Ca 2+ -Mg 2+ -ATPase in gastric mucosa tissue were detected. RESULTS: Compared with the normal group, activity of LDH in the gastric mucosa (P<0.05) and activities of SDH, Na + -K + -ATPase and Ca 2+ -Mg 2+ -ATPase significantly decreased in the normal group (P<0.05). Compared with the model group the activity of LDH decreased and activities of SDH, Na + -K + -ATPase and Ca 2+ -Mg 2+ -ATPase significantly increased in the high dose ZWFB group (P<0.05). CONCLUSION: ZWFB capsule can promote energy metabolism and ATPase activity in the gastric mucosa cell, so as to protect the function of the gastric mucosa cell.

Integrating a Market-Based Model in Trust-Based Service Systems

The reputation-based trust mechanism is a way to assess the trustworthiness of offered services, based on the feedback obtained from their users. In the absence of appropriate safeguards, service users can still manipulate this feedback. Auction mechanisms have already addressed the problem of manipulation by market- trading participants. When auction mechanisms are applied to trust systems, their interaction with the trust systems and associated overhead need to be quantitatively evaluated. This paper proposes two distributed architectures based on centralized and hybrid computing for integrating an auction mechanism with the trust systems. The empirical evaluation demonstrates how the architectures help to discourage users from giving untruthful feedback and reduce the overhead costs of the auction mechanisms.