Analysis of biliary microbiota in experimental pigs before and after enteral extended biliary stents implantation / 中华消化内镜杂志

Objective:To compare the changes of biliary microbiota after enteral extended biliary stents (EEBS) implantation with that of conventional plastic stents in animal experiment, and to preliminarily investigate its possible mechanism in preventing stents occlusion.Methods:A total of 12 healthy Bama minipigs were randomly assigned to the conventional plastic stent group ( n=6) and the EEBS group ( n=6) using simple random method. The bile samples of all pigs were collected before stents implantation and 4 weeks after stents placement. The biliary microbiota composition and diversity before and after different stents implantation were analyzed by 16S rRNA gene sequencing and compared. Results:No complications including acute cholangitis, perforation, bleeding, or death occurred in 12 pigs. Eight days after stents implantation, stents were out of bile duct in all pigs under endoscopy, while the bile samples were collected again for analysis. The main composition of biliary microbiota at the phylum level were Proteobacteria, Firmicutes and Bacteroidota. Alpha-diversities revealed the Shannon ( P=0.004) and Simpson index ( P=0.008) significantly decreased in the conventional stent group after stents placement, and Bata diversity analysis also showed a significant difference in microbial composition (Anosim: R=0.514 8, P=0.011). There was no significant difference in Observed species index ( P=0.095), Chao1 index ( P=0.136), Shannon index ( P=0.353), Simpson index ( P=0.227) or Bata diversity (Anosim: R=0.059 3, P=0.187) in the EEBS group before and after stents placement. LEfSe algorithm indicated Bacteroides_ fragilis and Proteobacteria- Gammaproteobacteria- Enterobacterales- Enterobacteriaceae- scherichia_ Shigella- Escherichia_ coli significantly increased in the conventional stent group, and Desulfobacterota- Desulfovibrionia- Desulfovibrionales- Desulfovibrionaceae- Bilophila significantly increased in the EEBS group after stents placement. Conclusion:The biliary microbiota change slightly after EEBS implantation in the short-term, and EEBS may prevent duodenobiliary reflux by prolonging the reflux path.

Value of endoscopic retrograde cholangiopancreatography in pancreaticobiliary maljunction / 中华消化内镜杂志

Objective:To explore the clinical characteristics of pancreaticobiliary maljunction (PBM) and its disease spectrum, and to evaluate therapeutic endoscopic retrograde cholangiopancreatography (ERCP).Methods:Data of 52 PBM patients who received therapeutic ERCP procedures for abdominal pain, jaundice and fever in Department of Gastroenterology of Peking University Third Hospital from June 2006 to March 2021 were collected. The clinical characteristics, typing, the change of disease spectrum and ERCP procedures were analyzed.Results:Among 52 PBM patients, female was more common. Abdominal pain and jaundice were the most common clinical manifestations, among which 20 were type Ⅰ, 25 type Ⅱ and 7 type Ⅲ. Half patients had the choledochal cyst. The mean timespan from the first onset to the final diagnosis was 12.2 years. Twenty-four cases (46.2%) had changes in PBM disease spectrum. Among 69 ERCP procedures, 5 (7.2%) failed. Difficult cannulation rate was 34.6% (18/52), and 11 patients underwent advanced cannulation techniques, while it was 15.4% (657/4 275) in the conterpart non-PBM patients in the same period, with significant difference between them ( χ2=14.455, P<0.05). Multiple therapeutic ERCP techniques including endoscopic sphincterotomy, pancreatic stent placement, removal of stones from the duct were applied with the successful rate of 92.8% (64/69). The incidence of post-ERCP pancreatitis was 15.4% (8/52). Conclusion:The chief clinical problem may be changed over time in PBM patients. Although ERCP plays an important role in PBM and its disease spectrum, there may be a higher rate of difficult cannulation and postoperative complications.

Historical Evolution and Modern Clinical Application of Qingxin Lianzi Yin / 中国实验方剂学杂志

Qingxin Lianzi Yin （QXLZY）， as an ancient classical formula for clearing the heart and nourishing the Yin， was composed of nine herbs （Scutellariae Radix， Ophiopogonis Radix， Lycii Cortex， Plantaginis Semen， Glycyrrhizae Radix et Rhizoma Praeparata Cum Melle， Nelumbinis Semen， Poria， Astragali Radix and Ginseng Radix et Rhizoma）， coming from Prescriptions of the Bureau of Taiping People's Welfare Pharmacy. It could clear away the heart-fire， promote the interaction of the heart and kidney， replenish Qi and Yin， and stop strangury-turbidity. It was used to treat gonorrhea of urination， seminal emission， restlessness， wasting-thirst and so on. At present， the usage and dosage of QXLZY and its addition and subtraction are different in clinical practice. Most of the studies just focus on its clinical efficacy， and there is few review literature reflecting its historical evolution. Based on this， this paper systematically clarified the historical evolution， composition， preparation， interpretation， function， and modern clinical application of QXLZY. This work has been explained the historical evolution of QXLZY， and found that it was wildly used in modern clinical， especially suitable for the treatment of chronic urinary system diseases. At the same time， QXLZY also had significant therapeutic effects on neurasthenia， stomatitis， diabetic nephropathy and other aspects. Through the comprehensive analysis of ancient and modern literature， this work explores the true connotation of QXLZY from the perspective of traditional Chinese medicine theory， which can point out the direction of the clinical application and positioning of this famous classical formula after it comes into the market， and also can provide reference basis for its subsequent in-depth research and development.

Characteristics of benign and malignant lesions of ampullary polyps and the accuracy of forceps biopsy / 北京大学学报(医学版)

OBJECTIVE@#To distinguish the endoscopic and clinical features of ampullary polyps, to investigate the endoscopic cancer risk factors of ampullary polyps based on the compared differences of benign lesions and adenocarcinoma, and to assess the accuracy of forceps biopsy.@*METHODS@#Authors retrospectively analyzed the data extracted from patients treated with endoscopic papillectomy (EP) from January 2009 to May 2019 in the Department of Gastroenterology, Peking University Third Hospital. Endoscopic pictures and pathology reports were reevaluated and analyzed. Differences between benign and cancer groups were conducted.@*RESULTS@#In the study, 42 cases were involved, 35 to 83 years old, containing 83.3% older than 50 years old patients. The histological types were as follows, 2 for inflammatory polyps (4.8%), 1 for neuroendocrine tumor (2.4%), 1 for hyperplastic polyp (2.4%), 5 for grade Ⅰ adenoma (11.9%), 10 for grade Ⅱ adenoma (23.8%), 4 for grade Ⅲ adenoma (9.5%) and 19 for adenocarcinoma (45.2%), and 90.5% were adenoma or adenocarcinoma. The average age of benign group (inflammatory polyps and adenomas) was (56.7±9.2), which was significantly younger than that of adenocarcinoma group [(66.0±9.8), P=0.004]. Tumor diameter in adenocarcinoma group[(2.3±0.8) cm] was significantly larger than that in benign group[(1.6±0.6) cm, P=0.002]. Benign lesions only showed Yamada type Ⅰ(57.1%)and type Ⅱ(42.9%). The percentage of Yamada type Ⅰ (36.8%)and type Ⅱ(31.6%) in adenocarcinoma group was lower than that in benign group. Moreover, Yamada type Ⅲ (31.5%) was only found in the adenocarcinoma group. Significant differences were observed between the two groups in Yamada types (P=0.046). Most of the benign lesions had clear boundary(18/21, 85.7%). The percentage of clear boundary in adenocarcinoma group (2/19, 10.5%) was significantly lower than that in the benign group (P < 0.001). No significant differences were investigated in color (P=0.353) and surface (P=0.324) between benign and adenocarcinoma lesions. Pooling age, lesion diameter, Yamada type and clear boundary into Logistic regression analysis, only age (OR=1.186, 95%CI 1.025-1.373, P=0.022) and clear boundary (OR=66.218, 95%CI 3.421-1 281.840, P=0.006) were the independent cancer risk factors. Only 2 (10.5%) in the 19 cancer patients had positive biopsy results before EP. As compared with post-EP, 55.3% (21/38) biopsies were under-estimated, including 17 (17/19, 89.5%) adenocarcinomas and 4 (4/10, 40%) grade Ⅱ adenomas.@*CONCLUSION@#adenoma and adenocarcinoma were the major histological type of ampullary po-lyps. Age and unclear boundary were the independent risk factors of ampullary adenocarcinoma. Forceps biopsy was not enough for ampullary polyp differentiation.

Evaluation of the effect of coronary artery lesions on left ventricular myocardial movement in early systolic stage with two-dimensional speckle tracking imaging echocardiography / 中国医学影像技术

Objective: To explore the feasibility of two-dimensional speckle tracking imaging echocardiography (2D-STE) in evaluation of the impact of coronary artery lesions on left ventricular myocardial movement in early systolic stage. Methods: A total of 179 patients with suspected coronary heart disease who underwent coronary angiography were collected, and left ventricular heart sarcomeres of all patients were divided into control group (no stenosis), mild group (stenosis ≤ 50%), moderate group (50%

The expression and clinical significance of Sox 11 in cervical carcinogenesis / 西安交通大学学报(医学版)

Objective To explore the expression level of Sox11 gene in cervical cancer cell lines and cervical pathology tissue .Methods The expression of Sox11 protein was detected in cervical cancer cell lines HeLa , CaSki ,SiHa and C-33A as well as NC ,LSIL ,HSIL and CC using immunohistochemistry and Western blot .We analyzed the relationship between Sox11 expression in cervical cancer and clinicopathologic parameters .Results The expression of Sox11 protein in normal cervical tissue ,low-grade cervical squamous intraepithelial neoplasia was significantly higher than that in the high-grade cervical squamous intraepithelial neoplasia and invasive cervical cancer tissue , and the expression was reduced with the progression of cervical lesions .The expression of Sox11 protein in the invasive cervical cancer was reduced with increased malignant degree .The expression of Sox11 protein in the invasive cervical cancer was significantly correlated with HPV infection ,but not associated with the age , clinical stage ,lymph node metastasis or muscular infiltration depth .Conclusion Sox11 expression is negatively correlated with cervical cancer development ,suggesting that as a tumor suppressor gene ,Sox11 may play a role in cervical cancer development and its absence or low expression is associated with the development of cervical cancer and is an early event of cervical carcinogenesis and may be a sign of malignant change of cervical tissue .

Clinical efficacy of suspended overlength biliary stents reformed from nasobiliary tubes for prevention of duodenobiliary reflux( with video) / 中华消化内镜杂志

Objective To evaluate the efficacy of the suspended overlength biliary stents modified from nasobiliary tube for prevention of duodenobiliary reflux. Methods Suspended overlength biliary stents were placed in the intrahepatic bile duct of 18 patients with extrahepatic bile duct stricture who underwent biliary stents implantation once or more via ERCP from February 2014 to May 2016.Data of these patients were followed up to June 30, 2017 with self-control method. The patency time of suspended overlength biliary stents was compared with the ordinary biliary stents which were implanted in the last ERCP. Incidence of complications was recorded.Results Eighteen patients were enrolled in the study, but one patient lost follow-up. Finally 17 patients were enrolled in the analysis. Nine patients were malignant and 8 benign biliary stricture. The median patency time of suspended overlength biliary stents was 210 days, which was much longer than that of ordinary stents with median patency time of 139 days(P＝0. 015). The median patency time of overlength biliary stents and metal stents in 3 patients with malignant stricture were 278 days and 205 days (P＝1. 000). The median patency time of overlength biliary stents and traditional plastic stents in 6 patients with malignant stricture were 156 days and 65 days, respectively(P＝0. 049). The median patency time of this innovative stents was prolonged in benign biliary stricture patients (254 days VS 143 days, P＝0. 025). Only one patient developed mild pancreatitis after ERCP. Conclusion Suspended overlength biliary stents can prolong the patency time without increasing postoperative complications, which is worth popularization.

MicroRNAs and autophagy after cerebral ischemia / 国际脑血管病杂志

MicroRNA is a class of short-chain non-coding RNA that regulates gene expression at post-transcriptional level.It can participate in the pathophysiology processes of tumor regulation,neurodegenerative disease,and cardiovascular disease.Recent studies have shown that microRNA can play a reguhtory role in ischemic brain damage through autophagy.This article reviews the effect of microRNA on autophagy after cerebral ischamia and its possible mechanisms.

Progresses of echocardiography in evaluating coronary slow flow phenomenon / 中国医学影像技术

Coronary slow flow phenomenon (CSFP) is an angiographic diagnosis characterized by delayed peripheral coronary perfusion in the absence of significant epicardial coronary lesions.Cardiac structure and systolic function of most patients had no abnormality,but there might be recurrent chest pain with impairment in quality of life.Therefore,it is very important to diagnose and assess CSFP using noninvasive,easy and safe technique.With the development of echocardiography in recent years,CSPF can be quantitatively and qualitatively analyzed with conventional echocardiography,two-dimensional and three-dimensional speckle tracking echocardiography and myocardial contrast echocardiography.Progresses of echocardiography in evaluating CSFP were reviewed in this article.

Correlation study of DWI types and degree of neurologic impairment in acute ischemic stroke patients with atrial fibrillation / 实用放射学杂志

Objective To explore the correlations of diffusion-weighted imaging (DWI) types and the degree of neurologic impairment in acute ischemic stroke patients with atrial fibrillation.Methods DWI images and National Institutes of Health Stroke Scale(NIHSS) of 186 patients with acute ischemic stroke patients with atrial fibrillation were collected retrospectively.The correlation of DWI features and NIHSS was analyzed.Results On DWI,all acute ischemic stroke patients with atrial fibrillation presented high signal intensity.Single cortex-subcortical infarction mostly appeared in the anterior circulation(94,50.5%);Multi-infarction commonly occurred in the posterior circulation(18,13.0%);The neurological deficit scores of subcortical-cortex infarction in the left anterior circulation(16.75±7.10) were higher than that in the right side(13.50±5.70)(P<0.05).The neurological deficit scores of cortex-subcortical infarction in the posterior circulation (6.38±2.03) were significantly lower than that in the multi-infarction (16.77±8.90) (P<0.05).Conclusion DWI types are valuable for etiological diagnosis in ischemic stroke.Combination with NIHSS score could provide a basis for clinical individual treatment programs selection and prognostic evaluation.

Effect of Helicobacter pylori eradication on reflux esophagitis therapy: a multi-center randomized control study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Helicobacter pylori (H. pylori) frequently colonizes the stomach. Gastroesophageal reflux disease (GERD) is a common and costly disease. But the relationship of H. pylori and GERD is still unclear. This study aimed to explore the effect of H. pylori and its eradication on reflux esophagitis therapy.</p><p><b>METHODS</b>Patients diagnosed with reflux esophagitis by endoscopy were enrolled; based on rapid urease test and Warth-Starry stain, they were divided into H. pylori positive and negative groups. H. pylori positive patients were randomly given H. pylori eradication treatment for 10 days, then esomeprazole 20 mg bid for 46 days. The other patients received esomeprazole 20 mg bid therapy for 8 weeks. After treatment, three patient groups were obtained: H. pylori positive eradicated, H. pylori positive uneradicated, and H. pylori negative. Before and after therapy, reflux symptoms were scored and compared. Healing rates were compared among groups. The χ2 test and t-test were used, respectively, for enumeration and measurement data.</p><p><b>RESULTS</b>There were 176 H. pylori positive (with 92 eradication cases) and 180 negative cases. Healing rates in the H. pylori positive eradicated and H. pylori positive uneradicated groups reached 80.4% and 79.8% (P = 0.911), with reflux symptom scores of 0.22 and 0.14 (P = 0.588). Healing rates of esophagitis in the H. pylori positive uneradicated and H. pylori negative groups were, respectively, 79.8% and 82.2% (P = 0.848); reflux symptom scores were 0.14 and 0.21 (P = 0.546).</p><p><b>CONCLUSIONS</b>Based on esomeprazole therapy, H. pylori infection and eradication have no significant effect on reflux esophagitis therapy.</p>

Relationship of Helicobacter pylori eradication with gastric cancer and gastric mucosal histological changes: a 10-year follow-up study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Helicobacter pylori (Hp) is a common and potentially curable cause of gastric mucosa lesion. This study investigated the relationship of Hp infection with histological changes in gastric mucosa and gastric cancer in Hp-positive patients compared with Hp-eradication patients followed up for ten years.</p><p><b>METHODS</b>From an initial group of 1 006 adults, 552 Hp-positive subjects were randomly assigned to a treatment group (T; n = 276) or a placebo group (P; n = 276). In the randomized, double-blind, placebo-controlled, parallel trial, T group subjects received oral doses of omeprazole, amoxicillin and clarithromycin for 1 week; those in the P group received a placebo. One month after treatment ended, a 13C urea breath test was performed, and Hp was undetectable in 88.89% of the T group. All subjects were followed at 1, 5, 8, and 10 years after treatment, with endoscopy and biopsies for histological examination.</p><p><b>RESULTS</b>Gastric mucosa inflammation was significantly milder in the T group than that in the P group one year after Hp eradication and this persisted for 10 years. Glandular atrophy and intestinal metaplasia (IM) had deteriorated in both groups during ten years. However, the increased score of glandular atrophy at both the gastric antrum and corpus, and IM only at the gastric antrum, in the P group was more obvious than that in the T group. During the 10 years, 9 patients were diagnosed with gastric cancer (2 in the T group; 7 in the P group; P = 0.176). When mucosal atrophy was absent at the gastric antrum and corpus when entering the study, the incidence of gastric cancer in the P group (n = 6) was much higher than that in the T group (n = 0, P = 0.013).</p><p><b>CONCLUSIONS</b>Hp eradication may significantly diminish and help halt progression of gastric mucosal inflammation and delay the development of IM and atrophy gastritis. Hp eradication is helpful for reducing the risk for gastric cancer, especially in the early stage of Hp infection.</p>

Analysis of the expressions of alphaB-crystallin in the brain tissues of agent 263K-infected hamsters at terminal stage / 病毒学报

alphaB-crystallin is a member of the sHSP (Small heat shock protein) family, which plays an impor tant role in multiple neurodegeneration diseases. To give insight into the possible alternation and the role of aB-crystallin in prion disease, the alphaB-crystallin levels in the brain tissues of agent 263K-infected hamsters were evaluated. Western blots and IHC revealed that at the terminal stages of the diseases, the levels of alphaB-crystallin were increased up to 3-fold in the brain tissues of scrapie infected 263K hamsters compared with normal controls. Immunofluorescent assays revealed that the up-regulated alphaB-crystallin was mainly observed in astrocytes, but not in neurons. The co-localization between alphaB-crystallin and abnormal deposition of PrPsc in the brain tissues of the scrapie infected hamsters was not observed. The study may provide a foundation for further revealing the potential role of alphaB-crystallin in prion disease.

Study on the correlation between membrane protein Flotillin-1 and PrPc endocytosis / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To explore whether the membrane-associated protein Flotillin-1 has relationship with endocytosis of PrPc.</p><p><b>METHODS</b>The expression of Flotillin-1 in different cell lines was detected with the method of Western Blot; the interaction between Flotillin-1 and PrPc in Cells which were treated with copper ions was observed using immunoprecipitation method.</p><p><b>RESULTS</b>(1) Flotillin-1 was widely expressed in many cell lines without significant difference in the amounts of expression level; (2) Only in the appearance of copper ions, the protein complexes of PrPc and Flotillin-1 can be detected with the method of IP, which were related to copper ions concentration and processing time.</p><p><b>CONCLUSION</b>The membrane-associated protein Flotillin-1 has the relationship with the endocytosis of PrPc.</p>

Response surface optimization of microwave-assisted extraction for HPLC-fluorescence determination of puerarin and daidzein in Radix Puerariae thomsonii / 药物分析学报

Microwave-assisted extraction was optimized with response surface methodology for HPLC-fluorescence determination of puerarin and daidzein in Radix Puerariae thomsonii.The optimized extraction procedure was achieved by soaking the sample with 70% methanol（1∶15,v/v）for 30 min,and then microwave irradiation for 11 min at a power of 600 W.Coupling the extraction process with HPLC-fluorescence presented good recovery,satisfactory precision,and good linear relation.Compared with a method from the Chinese Pharmacopoeia,the proposed method enables higher extraction efficiency and more accurate analytical results.It can be of potential value in quality assessment of Radix Puerariae thomsonii medicinal materials.

Recent changes in the prevalence of Helicobacter pylori infection among children and adults in high- or low-incidence regions of gastric cancer in China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The prevalence of Helicobacter pylori (H. pylori) infection varies by geographic locations. Studies indicate that the infection rate of H. pylori was previously high in China but that rates had been declining worldwide over recent decades.</p><p><b>THE AIMS OF OUR STUDY WERE</b>(1) to determine the current prevalence of H. pylori infection among children and adults residing in areas with high (Muping County, Shandong) and low (Yanqing County, Beijing) incidences of gastric cancer in China, and (2) to compare the prevalence for 2006 with the prevalence for the early 1990s.</p><p><b>METHODS</b>Using Warthin-Starry silver staining of gastric mucosal biopsy specimens and H. pylori stool antigen tests (HpSA), we tested a total of 2065 asymptomatic children aged 8 - 15 years and adults aged 40 - 79 years in the above two regions from May to July 2006. We evaluated 520 children and 526 adults from Muping, and 516 children and 503 adults from Yanqing. Subjects were selected randomly and H. pylori status was determined by HpSA in children and either HpSA or histology of gastric biopsies in adults. Data obtained in the early 1990s in the same two areas of China were also collected and studied.</p><p><b>RESULTS</b>For children, the prevalence of H. pylori infection was significantly higher in Muping (37.69%) than it was in Yanqing (25.58%, P < 0.001). In both regions, the prevalence of H. pylori increased with age but was not related to gender. A significant difference was observed between 8 - 9-years old and 10 - 11-years old (P < 0.05), but not between other adjoining age groups (P > 0.05). From 1991 to 2006 H. pylori prevalence among 8 - 10-year-old children decreased in Muping (60.00% vs 32.07%, P < 0.001), but not Yanqing (24.06% vs 19.10%, P > 0.05). In the adult group, H. pylori prevalence was 50.95% in Muping, which was significantly higher than the 41.35% positive rate in Yanqing (P < 0.01). But there were no statistically significant differences between different age groups of 40 - 49, 50 - 59, and 60 - 79 years, or between males and females. A significant decrease in H. pylori prevalence in both regions was observed when the results of 2006 were compared with the data obtained in 1990 in Muping (50.95% vs 73.78%, P < 0.001) and in 1992 in Yanqing (41.35% vs 55.35%, P < 0.01).</p><p><b>CONCLUSIONS</b>After fifteen years, the prevalence of H. pylori infection among both children and adults remained significantly higher in areas with a high incidence of gastric cancer in China compared with that in areas with a low incidence of gastric cancer. H. pylori infection rates have decreased in the general Chinese population during recent years.</p>

Molecular chaperones and neurodegenerative diseases / 神经科学通报·英文版

Neurodegenerative diseases are characterized by the accumulation of intracellular or extracellular protein aggregates that result from conformational changes in proteins. These diseases may result from an imbalance between the production of misfolded proteins and normal chaperone capacity. Molecular chaperones provide a first line of defence against misfolded, aggregation-prone proteins and are, therefore, promising therapeutic targets for neurodegenerative diseases.

Progress of integrative Chinese and Western medicine in treating polycystic ovarian syndrome caused infertility / 中国结合医学杂志

Polycystic ovarian syndrome (PCOS) is one of the most popular diseases that cause menstrual dysfunction and infertility in women. The present paper is a brief retrospection on the progress in treatment of PCOS caused infertility with integrative Chinese and Western medicine (ICWM). It can be seen from these materials that using traditional Chinese medicine (TCM) recipes formulated by Shen-replenishing herbs or acupuncture to reinforce Gan-Shen, regulate Chong-Ren Channels in treating PCOS, stable clinical efficacy could be obtained, with less adverse reaction, though the effect initiated somewhat late. Whereas, when Shen-replenishing recipe and acupuncture are combined with hormone or ovulation promoting drugs of Western medicine, the above-mentioned shortcomings would be overcome. So, this combined therapy is frequently used in clinical practice.

The value of p16 and death-associated protein kinase methylation and autofluroscene spectrum analysis of gastric juice in diagnosing gastric carcinoma / 中华消化杂志

Objective To explore the feasibility of detecting death-associated protein(DAP) kinase promoter hypermethylation in the tumor tissues and plasma of patients with gastric adenocarcino- ma,and to evaluate the effect of DNA hypermethylation and autofluroscene spectrums of gastric juice on diagnosing gastric carcinoma.Methods Primary tumor tissues and plasma and gastric juice of 50 patients with gastric adenocarcinoma were collected.Gastric mucosa tissue,plasma and gastric juice of 20 patients with chronic superficial gastritis and 20 patients with benign gastric ulcer and 30 patients with chronic atrophic gastritis were collected as controls.After sodium-bisulfite treatment,extracted DNA was amplified for DAP kinase promoter hypermethylation by methylation-specific polymerase chain reac- tion.At the same time the gastric juice autofluroscene spectrums(the excitation wavelength was 288 nm,whereas the range of emission wavelength was 300-800 nm)were detected.Results Among the samples from 50 patients,p16 and DAP kinase hypermethylation were detected in 74.4% and 68.1% of tumor tissues,52.0% and 58.0% of plasma,58.6% and 76.0% of gastric juice.No hypermethylation was detected in samples of chronic superficial gastritis and serum of patients with gastric ulcer.Among the patients with gastric ulcer,p16 and DAP kinase hypermethylation were detected in 10.0% and 20.0% of tissues,5.0% and 15.0% of gastric juice.Among the samples from 30 patients with chronic atrophic gastritis,p16 and DAP kinase were detected in 10.0% and 23.3% of tissues,3.3% and 3.3% of sera,3.3% and 20.0% of gastric juice.The intensity of gastric juice autofluroscence spectrums of patients with gastric carcinoma was much higher than those in controls.The sensitivity of p16 and DAP kinase hypermethylation and autofluorescence spectrums together were 95.6% and 97.8% respectively.Con- clusions Promoter hypermethylation of the p16 and DAP kinase gene detected in plasma and gastric juice consists with that in primary tumor tissues of patients with gastric adenocarcinoma.The combination of DNA hypermethylation and autofluorescence spectrum has a good future in diagnosing gastric carcinoma.