Altered oral microbiota in chronic hepatitis B patients with different tongue coatings

AIM To elucidate tongue coating microbiota and metabolic differences in chronic hepatitis B(CHB) patients with yellow or white tongue coatings.METHODS Tongue coating samples were collected from 53 CHBpatients(28 CHB yellow tongue coating patients and 25 CHB white tongue coating patients) and 22 healthy controls.Microbial DNA was extracted from the tongue samples,and the bacterial 16 S ribosomal RNA gene V3 region was amplified from all samples and sequenced with the Ion Torrent PGM^(TM)sequencing platform according to the standard protocols.The metabolites in the tongue coatings were evaluated using a liquid chromatographymass spectrometry(LC-MS) platform.Statistical analyses were then performed.RESULTS The relative compositions of the tongue coating microbiotas and metabolites in the CHB patients were significantly different from those of the healthy controls,but the tongue coating microbiota abundances and diversity levels were not significantly different.Compared with the CHB white tongue coating patients,the CHB yellow tongue coating patients had higher hepatitis B viral DNA(HBV-DNA) titers(median 21210 vs 500,respectively,P = 0.03) and a significantly lower level of Bacteroidetes(20.14% vs 27.93%,respectively,P = 0.013) and higher level of Proteobacteria(25.99% vs 18.17%,respectively,P = 0.045) in the microbial compositions at the phylum level.The inferred metagenomic pathways enriched in the CHB yellow tongue coating patients were mainly those involved in amino acid metabolism,which was consistent with the metabolic disorder.The abundances of bacteria from Bacteroidales at the order level were higher in the CHB white tongue coating patients(19.2% vs 27.22%,respectively,P = 0.011),whereas Neisseriales were enriched in the yellow tongue coating patients(21.85% vs 13.83%,respectively,P = 0.029).At the family level,the abundance of Neisseriaceae in the yellow tongue patients was positively correlated with the HBV-DNA level but negatively correlated with the S-adenosyl-L-methionine level.CONCLUSION This research illustrates specific clinical features and bacterial structures in CHB patients with different tongue coatings,which facilitates understanding of the traditional tongue diagnosis.

Study on Tongue Coating Microbiota in Patients with Atrophic Gastritis

Aims: To explore the tongue coating microbiota composition in patients with atrophic gastritis by using the 16S rRNA gene sequencing technology. Methods: The study included 29 atrophic gastritis patients and 29 age and gender-matched non-atrophic gastritis controls. By sequencing the V3-V4 region of the 16S rRNA, we investigated the microbial community structure and diversity on the tongue coating. Results: There was no significant difference in the microbial diversity on the tongue coating between the two groups. However, compared with the control, the atrophic gastritis group had a smaller number of operational taxonomic units (OTUs). At the class level, patients with atrophic gastritis had lower relative abundances of Betaproteobacteria and Spirochaetia than the control group. At the gene level, the abundance of Neisseria and Aggregatibacter in atrophic gastritis group had significantly decreased compared with control ones. Furthermore, functional prediction revealed that 24 metabolic pathways significantly differed between the two groups. Conclusions: Our findings provide novel evidence that tongue coating microbiota may be a biomarker for characterizing patient with atrophic gastritis, but its mechanism needs to be further elaborated.

Arnold Tongues for Discrete Hill’s Equation

In this work we study two types of Discrete Hill’s equation. The first comes from the discretization process of a Continuous-time Hill’s equation, we called Discretized Hill’s equation. The Second is a naturally obtained in Discrete-Time and will be called Discrete-time Hill’s equation. The objective of discretization is preserving the continuous-time behavior and we show this property. On the contrary a completely different dynamic property was found for the Discrete-Time Hill’s equation. At the end of the paper is shown that both types share the nonoscillatory behavior of solutions in the 0-th Arnold Tongue.

内镜电凝加PPI治疗岛型及舌型SSBE疗效观察

目的观察内镜下高频电凝加PPI治疗岛型及舌型SSBE的近中期疗效及安全性。方法经内镜及病理检查确诊的岛型及舌型SSBE病例39例,随机及自愿结合分组。23例治疗组患者在内镜下对岛型及舌型SSBE病灶施行高频电凝治疗,同时口服雷贝拉唑,20mg,bid,疗程4周。16例对照组患者则单纯予雷贝拉唑口服,20mg,bid,持续抑酸治疗。分别于治疗后第3个月、6个月、12个月、18个月及24个月行胃镜随访,对照原内镜图片,观察各组岛型及舌型SSBE病灶的变化,并在原病灶处取活组织检查其病理改变。对治疗组中复查内镜未达显效者,再次行镜下电凝治疗并予雷贝拉唑口服,20mg,bid,疗程4周。结果治疗组随访病例平均显效率87.6%,总有效率100%;未出现出血、穿孔及食管狭窄等并发症。对照组平均显效率6.6%,平均总有效率26.5%,平均无效率73.5%。结论经内镜下高频电凝加PPI治疗岛型及舌型SSBE安全,近期疗效明显。

舌鳞癌DNA倍体性和S期细胞比率与其预后关系

对７２例舌鳞癌根治术后病者作随访复查和用流式细胞仪对其石蜡包埋标本作ＤＮＡ含量测量。结果５年生存率为５６．９％，５年内死亡者和５年存活者异倍体率分别为６４．５％和４１．５％（Ｐ＞０．０５），而高Ｓ期细胞比率（ＳＰＦ）分别为９０．３％和４１．５％（Ｐ＜０．０１）。有颈淋巴转移者五年生存率（２８．６％）低于无颈淋巴转移者（６８．６％）（Ｐ＜０．０５）。两者异倍体率和高ＳＰＦ分别有显著差异和非常显著差异。高ＳＰＦ在临床期之间、Ｃ１和Ｇ２之间均有明显差异。提示ＤＮＡ倍体性与舌鳞癌５年生存率无关，而高ＳＰＦ则有密切关系。认为ＳＰＦ作为估测舌鳞癌的预后有较高的价值。

舌鳞状细胞癌组织中Cks1、Skp2和p27^(kip1)蛋白的表达及其临床意义

目的:检测舌鳞状细胞癌(舌癌)组织中Cks1、Skp2和p27kip1蛋白的表达,分析其与患者临床病理特征的关系,探讨其在舌癌的发生发展及预后中的作用。方法:采用免疫组织化学法检测45例舌癌组织、30例癌旁组织和10例正常舌黏膜组织中Cks1、Skp2和p27kip1蛋白的表达情况;比较不同类型舌组织中各蛋白表达阳性率的差异;分析Cks1、Skp2和p27kip1蛋白表达与舌癌临床病理学参数的关系。结果:在舌癌组织中,Cks1和Skp2蛋白呈强表达,阳性表达率为73.3%和62.2%,在癌旁组织和正常舌黏膜组织中其阳性表达率依次降低,阳性表达率分别为23.3%、10.0%和36.7%、10.0%;在舌癌组织中,p27kip1蛋白表达明显减少或缺失,阳性表达率为24.4%,在癌旁组织中和正常舌黏膜组织中其阳性表达水平依次升高,阳性表达率分别为30.0%和70.0%;在舌癌组织中Cks1和Skp2蛋白阳性表达率高于正常舌黏膜组织和癌旁组织(P<0.05),而p27kip1蛋白阳性表达率低于正常舌黏膜组织和癌旁组织(P<0.05)。舌癌组织中Cks1、Skp2和p27kip1蛋白阳性表达率与舌癌患者的年龄和性别无关联(P>0.05);与癌组织淋巴结转移、TNM分期、分化程度和临床分期有关联(P<0.05)。结论:舌癌组织中Cks1和Skp2蛋白阳性表达率升高、p27kip1蛋白阳性表达率降低,Cks1、Skp2和p27kip1蛋白阳性表达率的检测有助于判断舌癌的恶性程度和预后。

Microbial community structure of different tongue fur types in patients with chronic gastritis

OBJECTIVE:To explore the correlation between tongue and oral microbiota,we studied the microbial community structure of different tongue coating types in patients with chronic gastritis.METHODS:16S rDNA gene sequencing and bioinformatics analysis were used to study the dynamic changes and correlation of microbial flora in patients with chronic gastritis,healthy people,and patients with different tongue fur.In addition,it was also discussed between the severity of gastritis and the microflora of tongue fur.RESULTS:The microbial diversity of tongue fur in patients with chronic gastritis was significantly different from healthy controls.There were significant changes in bacterial communities’diversity and relative abundance between extra tongue fur in patients but not in healthy people.Oral bacteria with relative abundance>1%and P<0.05 among different tongue fur flora were dominant bacteria,including 12 phyla such as Bacteroidetes,Proteobacteria and Firmicutes,and 256 genera such as Neisseria,Prevotella_7 and Haemophilus.CONCLUSIONS:The changes in oral flora in patients with chronic gastritis were related to tongue fur.Therefore,the significant microbiota might enlighten further study on the correlation between tongue inspection and oral microbiota in patients with chronic gastritis.

Primary intestinal lymphangiectasia in an adult patient:A case report and review of literature

BACKGROUND Primary intestinal lymphangiectasia(PIL),first described in 1961,is a rare disorder of unknown etiology resulting in protein-losing enteropathy.The disease is characterized by dilatation and leakage of intestinal lymph vessels leading to hypoalbuminemia,hypogammaglobulinemia,and lymphopenia.Since the severity and location of lymph vessels being affected can vary considerably,the range of associated symptoms is wide from mild lower-limb edema to generalized edema,abdominal and/or pleural effusion,and recurrent diarrhea,among others.Although usually developing in early childhood,we present the case of a 34-yearold woman with PIL.Moreover,we performed a literature review systematically assessing clinical presentation,and provide a practical approach to facilitate diagnosis and therapy of PIL in adults.CASE SUMMARY Our patient presented with unspecific symptoms of abdominal discomfort,fatigue,nausea,and recurrent edema of the lower limbs.Interestingly,a striking collinearity of clinical symptoms with female hormone status was evident.Additionally,polyglobulia,hypoalbuminemia,hypogammaglobulinemia,and transient lymphocytopenia were evident.Due to suspicion of a bone marrow disease,an extensive diagnostic investigation was carried out excluding secondary causes of polyglobulinemia and hypoalbuminemia.The diagnosis of primary intestinal lymphangiectasia was established after 22 wk by histological analysis of biopsy samples obtained via enteroscopy.Consecutively,the patient was put on a high-protein and low-fat diet with medium-chain triglycerides supplementation leading to significant improvement of clinical symptoms until 2 years of follow-up.CONCLUSION PIL can be the reason for cryptogenic hypoalbuminemia,hypogammaglobulinemia,and lymphopenia in adulthood.Due to difficulty in correct diagnosis,treatment initiation is often delayed despite being effective and welltolerated.This leads to a significant disease burden in affected patients.PIL is increasingly been recognized in adults since the majority of case reports were published within the last 10 years,pointing towards an underestimation of the true prevalence.The association with female hormone status warrants further investigation.

Correction Method of Light Hydrocarbons Losing and Heavy Hydrocarbon Handling for Residual Hydrocarbon (S_1) from Shale

In China, hot researches on shale oil were raised by the important breakthrough of shale oil in America. Obviously, the first important issue is the actual shale oil resource potential of China, and the selection of the key appraisement parameter is vital to the shale oil resource amount. Among the appraisement parameters, the oil content parameter（S1） is the key one, but the evaluation result is generally lower because of light hydrocarbon losing and heavy hydrocarbon handling. And the more important thing is that the light hydrocarbon with small molecular weight is more recoverable, and therefore its amount is important to the total shale oil yields. Based on pyrolysis experiments and the kinetic model of hydrocarbon generation, correction factors and a model of light hydrocarbon losing and heavy hydrocarbon handling were established. The results show that the correction factor of heavy hydrocarbon handling is 3.2, and that of light hydrocarbon losing is controlled by kerogen type, maturity and hydrocarbon generation environment（closed or open）.

A Brief Analysis of Negative Transfer of Chinese on the English Writings

Based on the researches of language transfer,contrastive analysis and error analysis,this paper tries to investigate the negative transfer of Chinese on Chinese students'English writings from the perspective of syntax.During one and a half months'teaching practice in Shannxi Hanzhong No.1 Middle School,the author lived through the real teaching process and found that there were lots of problems in students'English writings.The author makes a contrastive study of the different characteristics existing in Chinese and English languag es at the level of syntax,and analyses the typical syntactic errors appearing in the 60 students'English compositions collected from one or dinary class.These syntactic errors are caused by the negative transfer of Chinese.The purpose of the investigation is to study in what pat tern students have been influenced by Chinese in their English writings.Based on the findings and analysis of the mother tongue transfer on English writings,some implications are also provided in order to help minimize or eliminate the interference of negative transfer of the Chinese in students'English writings and improve the teaching and learning of English.

An unusual presentation of fistulating Crohn's disease:Ascites

Whilst ascites is a common presenting complaint in patients with decompensated chronic liver disease and disseminated malignancy,in Crohn's disease however,it is exceptionally rare.We describe a patient with no prior history of inflammatory bowel or liver disease,presenting with rapid onset gross ascites and scrotal swelling.Further investigations revealed severe hypoalbuminemia and transudative ascitic fluid with normal other liver function tests and a negative liver screen.Computed tomography revealed widespread ascites and pleural effusions with no features of malignancy or portal hypertension,and a small bowel barium series showed features of fistulating small bowel Crohn's disease.An ileo-colonoscopy confirmed the presence of terminal ileal inflammatory stricture.The patient's clinical condition and serum albumin improved with a combination of diuretics,elemental diet,antibiotics and oral 5-aminosalicylic acid therapy.

Case for flaccid tongue treated by Guan’s tongue acupuncture

In this article,one proved case of flaccid tongue treated by Guan’s tongue acupuncture was introduced by the three-step method of"puncture,prick,and swallowing".This case was an elderly female patient with Parkinson disease,which had the main clinical symptoms of flaccid and weak tongue,and speech and swallowing disorder,and was diagnosed as flaccid tongue(deficiency of the both qi and blood,and deficiency syndrome of liver and kidney).The patient received diagnosis and treatment based on an overall analysis of its dialectical characteristics,using the five acupoints of Heart,Jīnjīn(金津EX-HN12),Yùyè(玉液EX-HN13),Tongue root acupoint 1,and Tongue root acupoint 2 in total.First,the four acupoints of EX-HN12,EX-HN13,Tongue root acupoint 1,and Tongue root acupoint 2 were punctured successively,and then using the reinforcing method,the Heart on the tongue surface was pricked.Finally,the patient was advised to make a slow swallowing action.Through tongue acupuncture therapy for 6 times,the patient’s speech and swallowing function was improved,which achieved a satisfactory therapeutic effects.

鲁艳芳运用五苓散治疗儿童脾虚湿困型地图舌经验探析

地图舌是儿童常见病理性舌象之一,发病机制尚不明确,目前在临床中以外用激素及口服补锌治疗为主,疗效欠佳且容易反复,中医治疗本病不仅能有效防止复发及加重,也能改善患儿偏颇体质,故临床广为应用。文章总结了鲁艳芳教授治疗儿童地图舌的临证经验,认为小儿地图舌的发生与脾失健运,津液代谢失常有关,强调健运脾胃,利水渗湿,采用以五苓散为主方进行加减治疗儿童地图舌,在临床上取得显著疗效。

肿瘤耐药蛋白在舌鳞癌中的表达及意义

目的 检测P_糖蛋白 (Pgp) ,多药耐药相关蛋白 (MRP) ,肺耐药相关蛋白 (LRP) ,谷胱苷肽_S转移酶 (GST_π)及DNA拓扑异构酶Ⅱα(TopoⅡα)在舌鳞癌组织中的表达水平及与化疗疗效的关系。方法 采用卡铂、平阳霉素和氨甲喋呤化疗方案对 4 0例舌鳞癌患者进行化疗 ,分别于化疗前和化疗后用免疫组织化学LsAB法检测Pgp ,MRP ,LRP ,GST_π ,TopoⅡα在 80例舌鳞癌组织中的表达 ,其中 4 0例为化疗前 ,4 0例为化疗后。结果 在检测的舌癌组织中 ,化疗前Pgp ,MRP ,LRP ,GST_π ,TopoⅡα的阳性表达率分别为 4 7 5 % ,5 0 % ,35 % ,4 5 % ,82 5 % ,它们的表达与临床病理无关 (P >0 0 5 ) ;Pgp ,MRP化疗前后水平上升 (P <0 0 5 ) ;Pgp,MRP与化疗耐药效果有关 (P <0 0 5 ) ;共表达现象普遍 ,Pgp ,MRP ,GST_π及MRP ,GST_π联合表达率在化疗无效者中为 4 0 %和 5 0 % ,而在化疗有效者中为 0。结论 Pgp ,MRP 。

城市化进程中失地农民合理利益保障研究

改革开放以来,随着我国城市化和工业化步伐的加快,大量征用了农民的土地,并产生了为数众多的失地农民。失地农民失地失业,未来生活缺乏保障。在征地过程中,如何保障失地农民的合理利益?如何确定对失地农民的合理补偿?本文针对这样一个问题,分析了土地换保障的理论基础,以及失地农民的合理利益结构和保障成本,并进一步分析了上海市"小城镇保险模式"的积极意义及完善对策。

强直性脊柱炎患者检测骨代谢指标潜在的临床价值

目的:探讨骨代谢指标和人类白细胞抗原B27(HLA-B27)在检测强直性脊柱炎(AS)患者的临床意义,并分析其诊断价值。方法:研究对象为94例AS患者、239例其他病种对照和80例健康对照组,并对其结果进行回顾性分析。结果:AS组β-胶原特殊序列(β-CTX)高于对照组,而骨钙素(OC)、25羟基维生素D[25-(OH)D]和甲状旁腺素(PTH)低于对照组(P<0.05);AS组C反应蛋白(CRP)和β-CTX呈明显的正相关(P<0.01),25-(OH)D呈负相关(P<0.05),其他骨代谢指标和CRP无相关性;AS组HLA-B27阳性率明显高于其他组(P<0.05),且HLA-B27在诊断AS时具有很高的敏感性和特异性;AS组25-(OH)D检测的敏感性高于β-CTX,但特异性低于β-CTX。结论:骨代谢指标对AS早期筛查,临床诊断有着重要价值,尤其是β-CTX和25-(OH)D的诊断价值更为明显。

失语症及舌三针治疗机理浅析

[目的]概述现代医学和祖国医学对失语症的认识,分析舌三针治疗失语症的机理。[方法]从中西医病因、病理、治法等方面对失语症进行总体论述,进而从穴位分布、经络循行、局部解剖以及实验研究等多角度分析舌三针治疗失语症的机理。[结果]现代医学对失语症分类、机理、评定研究深入,祖国医学侧重治疗,干预手段较多。舌三针穴位,位于咽喉部,与心、脾、肾等多条经络相关,针刺能够改善局部循环,增强神经肌肉兴奋性,对多种生物因子表达有积极的作用,能促进语言功能恢复。[结论]失语症的机制复杂,治疗难度较大,舌三针具有坚实的理论基础和临床疗效,值得传承推广。

134例桥本甲状腺炎合并甲状腺结节患者的中医证候分布规律

目的:总结桥本甲状腺炎合并甲状腺结节患者常见中医证候分布及辨证分型规律,从而为桥本甲状腺炎合并甲状腺结节的中医防治提供依据。方法:选取2017年6月至2018年5月上海中医药大学附属曙光医院收治的桥本甲状腺炎合并甲状腺结节患者134例作为研究对象。采集临床症状、体征等中医四诊资料。建立相应所需的数据库,将信息转化成计数资料。应用频数分析和聚类分析方法对收集的资料进行整理,总结出中医常见证候及辨证分型。结果:134例患者中女117例、男17例,平均年龄(40.19±12.61)岁,平均病程(28.48±40.42)个月。51项四诊信息中,临床症状出现频次最高的5项证候为:颈前肿大、神疲乏力、健忘、经期乳胀、咽干口燥;主要脉象为:细脉、细滑脉、滑脉;主要舌象为:舌胖大、有齿痕、舌暗红、苔薄或者苔薄白。通过聚类分析得出3个证型:气阴两虚证;肝郁肾虚、气滞痰凝证;脾虚肝郁、气滞血瘀证。结论:本病主要病变部位为肝、脾、肾。病机本虚标实,虚实夹杂。本虚为气阴两虚、脾肾亏虚为主,标实表现为肝郁、气滞、痰凝、血瘀。整体临床表现以虚证为主,实证为次。

13例舌血管瘤的电化学治疗

目的 :探讨电化学疗法对舌血管瘤的疗效。方法 :采用电化学治疗舌血管瘤 13例。治疗电压 5～ 8V ,电流 5 0～ 80mA ,参考治疗电量 5 0～ 80C/cm3 瘤体。治疗中观察瘤体变化 ,瘤体固缩变硬时治疗结束。结果 :13例患者术后均随访 0 .5a以上。 13例中完全治愈 6例、部分治愈 6例 ,有效率 92 .3%。结论 :电化学治疗舌血管瘤是目前一项新的治疗方法 ,其安全、有效、创伤小、恢复快、操作方便 ,易于为患者接受 ,是治疗舌血管瘤行之有效的方法。