Oral microbiota in human systematic diseases / 国际口腔科学杂志·英文版

Oral bacteria directly affect the disease status of dental caries and periodontal diseases. The dynamic oral microbiota cooperates with the host to reflect the information and status of immunity and metabolism through two-way communication along the oral cavity and the systemic organs. The oral cavity is one of the most important interaction windows between the human body and the environment. The microenvironment at different sites in the oral cavity has different microbial compositions and is regulated by complex signaling, hosts, and external environmental factors. These processes may affect or reflect human health because certain health states seem to be related to the composition of oral bacteria, and the destruction of the microbial community is related to systemic diseases. In this review, we discussed emerging and exciting evidence of complex and important connections between the oral microbes and multiple human systemic diseases, and the possible contribution of the oral microorganisms to systemic diseases. This review aims to enhance the interest to oral microbes on the whole human body, and also improve clinician's understanding of the role of oral microbes in systemic diseases. Microbial research in dentistry potentially enhances our knowledge of the pathogenic mechanisms of oral diseases, and at the same time, continuous advances in this frontier field may lead to a tangible impact on human health.

Portal hypertension: Chronic multiple organ failure involving various critical severe diseases / 临床肝胆病杂志

Globally, the population living with liver cirrhosis is growing. There is the largest number of cirrhosis patients in China throughout the world. Acute-on-chronic liver failure (ACLF) is a clinical syndrome of sudden hepatic decompensations such as variceal bleeding, spontaneous bacterial peritonitis, hepatic encephalopathy and hepatorenal syndrome seen in patients with liver cirrhosis. ACLF leads to poor quality of life and high mortality. Portal hypertension is not only a consequence of the development of cirrhosis, but also a secondary or even superimposed attack to the development of cirrhosis. It is necessary to early reduce intrahepatic resistance by transjugular intrahepatic portosystemic shunt and drugs to improve the prognosis.

Development and clinical evaluation of an equipment with artificial intelligence real-time assistance in detection of gastrointestinal protruding lesions under endoscopy / 中华消化杂志

Objective:To develop an diagnostic equipment with artificial intelligence (AI) real-time assistance under endoscopy (endoscopic AI equipment) for the detection of gastrointestinal protruding lesions, and to evaluate its performance and safety.Methods:From January to December 2017, at Endoscopy Center of West China Hospital, Sichuan University, the endoscopic images of individuals who underwent routine gastroscopy and colonoscopy were collected. The model was established based on convolutional neural network and the endoscopic AI equipment was developed. From June to December 2019, a prospective, single center, blinded and parallel controlled study was conducted to compare the differences in evaluation of protruding lesions of the same patient under gastroscopy or colonoscopy between endoscopist and the endoscopic AI equipment and to evaluated the impact of lesion size (lesions <5 mm and ≥5 mm) on the detection of endoscopic AI equipment. The main outcome measure was the detection time difference in reporting the protruding lesion between endoscopic AI equipment and endoscopist; and the secondary indicator was the accuracy of endoscopic AI equipment in detecting the protruding lesion. Wilcoxon rank sum test and chi-square test were used for statistical analysis.Results:A total of 71 582 white light endoscopy images were used for endoscopic AI equipment training, which included 41 376 images of protruding lesions. The endoscopic AI equipment was successfully developed and obtained the registration certificate of medical devices of the People′s Republic of China (Sichuan Instrument Standard, 20202060049). The accuracy, sensitivity, and specificity of endoscopic AI equipment in detecting protruding lesions were 96.4%, 95.1% and 92.8%, respectively. The detection time of each protruding lesions under gastroscopy of endoscopic AI equipment was 1.524 seconds faster than that of endoscopist; but the detection time of each protruding lesions under colonoscopy was 0.070 seconds slower than that of endoscopist, and the differences were statistically significant ( Z=-5.505 and -4.394, both P<0.01). The detection time of each protruding lesions under gastroscopy or colonoscopy of endoscopic AI equipment was not inferior to that of endoscopist. The detection rate of protruding lesions under colonoscopy by endoscopic AI equipment was 89.9% (249/277) and the sensitivity was 89.9%; the detection rate of protruding lesions under colonoscopy was 87.0% (450/517) and the sensitivity was 86.9%. There were no statistically significant differences in the detection time difference, sensitivity and missed diagnostic rate between the lesions <5 mm and ≥5 mm detected by endoscopic AI equipment under gastroscopy (all P>0.05). The sensitivity of endoscopic AI equipment in detecting the lesions ≥5 mm under colonoscopy was higher than that of lesions <5 mm (96.8% vs. 84.9%), and the missed diagnostic rate was lower than that of lesions <5 mm (3.2%, 3/94 vs. 15.1%, 61/405), and the differences were statistically significant ( χ2=9.615 and 9.612, both P=0.002). No adverse events on patients and medical staffs occurred, and there were no cases of equipment electricity leakage, and abnormal work reported during the use of endoscopic AI equipment. Conclusions:The endoscopic AI equipment can report the protruding lesions simultaneously with endoscopists, and the accuracy is close to 90%, which is expected to be a practical assistant for endoscopists to avoid missed detection of protruding lesions.

Expert consensus for diagnosis and treatment of thrombocytopenia in China / 中华内科杂志

Thrombocytopenia is the main clinical manifestation or common complication of multiple diseases, but there is still a lack of systematic understanding of pathogenesis, underlying diseases and treatment strategies of thrombocytopenia. Based on evidence-based medicine, this consensus summarizes seven aspects related to thrombocytopenia, including definition, epidemiology, pathogenesis, clinical manifestations, laboratory examination, diagnosis and treatment. This consensus provides an important reference for the diagnosis and treatment of thrombocytopenia.

Effects of transjugular intrahepatic portosystemic shunt combined with left gastric vein embolization on the liver function of patients with liver cirrhosis / 中华消化杂志

Objective To compare the difference in the effects on liver function between transjugular intrahepatic portosystemic shunt (TIPS) alone and the combination of TIPS and left gastric vein embolization (LGVE) in patients with liver cirrhosis.Methods This research was a retrospective study.From September 2014 to September 2015,31 patients with liver cirrhosis underwent TIPS (TIPS group) and 29 patients with liver cirrhosis underwent TIPS combined with LGVE (TIPS+LGVE group) were enrolled.The data of the liver function of patients before and after operation were collected and the Child-Pugh score and model for end-stage liver disease (MELD) were also calculated.Student's t test and chi-squared test were performed for statistical analysis.Results The preoperative portal vein pressures of TIPS group and TIPS+LGVE group were (28.48±2.77) mmHg (1 mmHg=0.133 kPa) and (28.38± 2.92) mmHg,respectively.And after operation,the portal vein pressures decreased to (17.81 ± 1.47) mmHg and (17.97 ± 2.04) mmHg,respectively,and the differences were both statistically significant (t=18.908 and 11.648,both P＜0.01).At 12 months after operation,Child-Pugh score of TIPS+ LGVE group was 5.69 ± 1.19,which was significantly lower than that before operation (7.03±1.76),and the difference was statistically significant (t=3.398,P=0.001),which was also lower than that of TIPS group at the same time point (6.52 ± 1.54),and the difference was statistically significant (t =2.303,P=0.025).At 12 months after operation,the component ratio of patients with Child-Pugh grade A of TIPS±LGVE group was 89.7％ (26/29),which was higher than that before operation (44.8％,13/29),and the difference was statistically significant (x2=13.228,P＜0.01).The component ratio of patients with Child-Pugh grade B was 6.9 ％ (2/29),which was lower than that before operation (41.4 ％,12/29),and the difference was statistically significant (x2 =9.416,P＜ 0.01).Conclusions TIPS significantly reduces portal vein pressure in patients with liver cirrhosis and it does not deteriorate liver function of patients in the long term.The combination of TIPS and LGVE is better than TIPS alone in improving liver function in patients with liver cirrhosis,especially in improvig long-term liver function in patients of Child-Pugh A and B grade.

Work-up for diagnosis and treatment of liver cirrhosis: convention and development / 临床肝胆病杂志

Liver cirrhosis is one of the most important public health issues in China. The etiological treatment for patients with decompensated liver cirrhosis to delay progression has always been the practical and effective classical strategy. High-quality or creative methods for diagnosis and treatment come from ordinary and careful work. Portal hypertension is in nature a vascular disease, and relief of pressure in the portal system in time is the key to prevention of disease progression and various severe complications. The therapeutic decision should be made on the basis of a comprehensive understanding of portal hypertension, and minimally invasive techniques are important methods for such strategies.

Analysis of the role of endoscopic retrograde cholangiopancreatography in children with pancreaticobiliary diseases / 中华儿科杂志

<p><b>OBJECTIVE</b>To evaluate the safety and efficacy of endoscopic retrograde cholangiopancreatography (ERCP) in children with pancreaticobiliary diseases and the characteristics of pancreaticobiliary disorders in children.</p><p><b>METHOD</b>Retrospective review was conducted on the data of patients younger than 18 years who underwent ERCP between 2005 and 2012 at West China Hospital. The indications,ERCP findings, ERCP procedures, complications, and clinical outcomes were evaluated.ERCP procedures were performed using standard duodenoscopes under general anaesthesia or sedation, which included all endoscopic treatments, such as endoscopic sphincteropapillotomy, stone extraction, stent treatment and so on.</p><p><b>RESULT</b>One hundred and two ERCPs were performed on 68 patients, and all the procedures were successfully completed in 100% cases. There were 39 girls (57%), and median age at time of procedure was 14.6 years (range, 5-17 years).General anesthesia and sedation were performed in 81% and 19% of procedures, respectively. The ERCP findings were classified as follows:bile duct stone(s) (n = 37, 54%), pancreatic duct stone(s) (n = 8, 12%), bile duct benign stricture (n = 7, 10%) and other nonmalignant pancreaticobiliary diseases (n = 16, 24%).Four cases (4/102, prevalence 4%) were complicated with post-ERCP pancreatitis.Symptoms such as abdominal pain and jaundice were cured obviously after the procedures of ERCP were performed.</p><p><b>CONCLUSION</b>The main characteristics of pancreaticobiliary disorders in children were nonmalignant pancreaticobiliary diseases, such as bile duct stone, pancreatic duct stone, and bile/pancreatic duct benign stricture.When performed by well-trained endoscopists, ERCP is safe and effective in children.</p>

Parallel Shunt for the Treatment of Transjugular Intrahepatic Portosystemic Shunt Dysfunction

OBJECTIVE: To investigate the safety, efficacy and long-term patency of parallel shunts (PS) in the management of the transjugular intrahepatic portosystemic shunt (TIPS) dysfunction. MATERIALS AND METHODS: Between March 2007 and October 2010, 18 patients (13 men and 5 women) who underwent TIPS revision with the creation of PS were evaluated retrospectively. In the first 10 patients, a 10-mm-diameter Wallgraft endoprosthesis was deployed; in the latter 8 patients, an 8-mm-diameter Fluency endoprosthesis was deployed. RESULTS: The creation of PS was technically successful in all patients. The mean +/- standard deviation portosystemic pressure gradient before and after the procedure was 25.5 +/- 7.3 mm Hg (range, 16-37 mm Hg) and 10.9 +/- 2.3 mm Hg (range, 7-16 mm Hg), respectively. The duration of follow-up was 16.7 +/- 10.8 months (range, 6-42 months). The primary shunt patency rates at 12 months after the creation of PS was 70% with Wallgraft endoprostheses and 87.5% with Fluency endoprostheses. CONCLUSION: TIPS revision with the creation of PS is a safe, effective and durable method for treating shunt dysfunction.

Analysis of signs of digital subtraction angiography of small intestinal stromal tumor / 中华消化外科杂志

Objective To summarize the features of signs of digital subtraction angiography (DSA) of small intestinal stromal tumor (SIST) with different invasion risk degrees.Methods The clinical data of 15 patients with SIST who were admitted to the West China Hospital of Sichuan University from September 2008 to June 2010 were retrospectively analyzed.The signs of DSA of SIST with different invasion risk degrees were analyzed.Results The result of DSA showed that 1 patient with low-invasive SIST presented draining veins and clear edge with homogeneously stained tumor in arterial phase.Enlarged tumors vessels,sharp edges and uniform tumor staining were observed in 4 patients with low-invasive risks.Enlarged and disordered tumor vessels and irregular shape were observed in 4 patients with moderate-invasive risks,and 3 of them showed heterogeneity stained tumor.Obvious enlarged and disordered tumor vessels,unclear edge and uniform tumor staining were showed in 6 patients with high-invasive risks.Conclusions The higher invasive risks correlates with more irregular and disorder tumor vessels.The tumors with lower-invasive risks have more regular and trim blood vessels.

Diagnostic value of left-sided portal hypertension in chronic pancreatitis / 中华消化杂志

Objective To investigate the incidence of left-sided portal hypertension (LSPH) in chronic pancreatitis (CP) and other accompany conditions of CP and explore the diagnostic value of LSPH in chronic pancreatitis.Methods The clinical,pathological and imaging data of 125 CP patients received at least two imaging examination were retrospectively analyzed.The rates of abnormal pathologic findings,abnormal imaging findings and accompanying LSPH in CP were analyzed.The data were analyzed by chi-square test.Results Among 125 CP patients,29.6％ (37/125) received three or more than three kinds of imaging examinations.The pathological detection rates of pancreatic calcification or lithiasis,pancreatic ductal lesion,abnormal pancreatic morphology,pancreatic lesion and LSPH were 58.4％ (73/125),60.8％ (76/125),35.2％ (44/125),48.8％ (61/125) and 24.8％ (31/125),respectively.The sensitivities of imaging examination in those lesions were 68.5 ％(50/73),96.1％ (73/76),95.5％ (42/44),95.1％ (58/61) and 90.3％ (28/31),respectively.The detection rates of pancreatic calcification or lithiasis and pancreatic ductal lesion in pathological examination were significantly higher than those of the others,and differences were statistically significant (x2=33.764 and 37.932,both P＜0.01).The sensitivity of imaging examination in pancreatic calcification or lithiasis was lower than those of the others and the differences were statistically significant (x2 =36.526,P＜0.01).Among 125 CP patients with 223 pancreatic lesions detected by imaging examination,the rates of patients with 0,1,2,3,4 lesions accounted for pancreatic were 5.6％ (7/125),40.0％ (50/125),28.8％ (36/125),21.6％ (27/125) and 4.0％ (5/125),respectively.Of patients with pancreatic calcification or lithiasis,pancreatic ductal lesions,abnormal pancreatic morphology and pancreatic lesions detected by pathological examination,there were 23.7 ％(17/73),20.0％ (15/76),22.6％ (10/44) and 27.9％ (17/61) cases accompanied with LSPH,there was no difference between these groups (x2 =1.262,P=0.738).Conclusion LSPH may be a reference for CP diagnosis by imaging examination.

The role of a workflow in diagnosing biliary causes for acute pancreatitis / 中华内科杂志

ObjectiveTo establish a practical and effective clinical pathway (CP) for the etiological diagnosis of acute biliary pancreatitis.MethodsA total of 2216 patients enrolled were randomly divided into control group (n =1120) and CP group (n =1096) according to different etiological diagnosis methods including following doctor's established experiences and habits and the designed CP in our study.ResultsThere was no significant difference in baseline data between the two groups.The etiology of acute pancreatitis was determined in 91.1％ (999/1096) of cases in the CP group which was significantly higher than the control group (65.5 ％,734/1120),P ＜ 0.05.The enhanced etiological determination of CP group was mainly consisted of the increased detection of biliary stones,duodenal diseases as well as pancreas divisum,P ＜ 0.05.The positive etiological determination of magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography in the CP group were 59.1％ (273/462) and 86.0％ (98/114),respectively.ConclusionsThe CP established in this study significantly enhances the biliary etiological determination of acute pancreatitis. It is easy to be conducted and may be of importance to improve the quality of etiological diagnosis of acute pancreatitis.

The incidence and clinical characteristics of gastroenteropancreatic neuroendocrine neoplasm in Chengdu City in 2010 / 中华消化杂志

Objective To investigate the incidence of gastroenteropancreatic neuroendocrine neoplasm (GEP-NEN) in Chengdu City in 2010 and summarize clinical characteristics of GEP-NEN.Methods The incidence of GEP-NEN was estimated with the data in 2010 from the databases of West China Hospital and Chengdu Health Information Centre.Results A total of 77 cases of GEP-NEN were diagnosed in West China Hospital in 2010.Ten cases from other hospitals or non-Chengdu citizenship were excluded,so a total of 67 cases were included in this study.In 2010,the incidence of GEP-NEN was 1.86/105 in Chengdu City.Among 67 GEP-NEN cases,most lesions were located in pancreas and rectum (38 cases,56.7％),followed by stomach (10 cases),esophagus (seven cases) and duodenum (four cases).Among 57 GEP-NEN cases which had pathotogial grading,26 cases (45.6 ％) had neuroendocrine carcinomas or mixed adenoneuroendocrine carcinomas when diagnosed.Conclusions In 2010,the incidence of GEP-NEN in Chengdu City is similar to the reports from other countries.Pancreas,rectum and upper gastrointestinal tract are predilection sites of GEP-NEN.The diagnosis rate of early GEP NEN needs to be raised.

Incidence of severe acute pancreatitis in obese patients: a prospective multicenter controlled study / 中华胰腺病杂志

Objective To observe the incidence of severe acute pancreatitis (SAP) in obese acute pancreatitis (AP) patients with medical treatment, and evaluate the impact of obesity in AP progression.Methods A multicenter prospective controlled study was conducted. APACHE Ⅱ scoring system was used to evaluate the severity of AP. Results 161 patients with mild AP(MAP) were enrolled, according to the cut-off point of 25 kg/m2, these patient were divided into obese group (79 patients) and non-obese group (82patients). The levels of CRP, hypertriacylglycerolemia, complication rate, incidence of SAP and mortality were observed under the circumstance of identical medical treatment. The levels of CRP in obese group and non-obese group were (117±109 ) mg/L and (35±36 ) mg/L(P<0.01). The number of obese patients with hypertriacylglycerolemia was two times as many as that in non-obese patients, but there was no significantly difference. There was no local complication in both groups, but the incidence of systematic complication in obese patients (20.3%) was significantly higher than that in non-obese group (6.1%, P<0.01). 16patients (20.3%) in obese group progressed into SAP, which was significantly higher than that in non-obese group (5 patients, 6.1%, P<0.01). One patient(1.3%) died in obese group, but no one died in non-obese group. In MAP patients with APACHE Ⅱ 4～7 points, the incidence of SAP (43.3%) in obese group was significantly higher than that in non-obese group (18.5%, P<0.05). Conclusions Obese MAP patients with APACHE Ⅱ 4～7 points were prone to develop into SAP. More aggressive interventions are needed.

Effects of cholinergic receptor antagonists, adrenergic drugs and pethidine on the function of sphincter of Oddi isolated from rabbits / 中华消化杂志

Objective To investigate the contractive effect of atropine, noradrenaline,adrenaline and pethidine on sphincter of Oddi (SO) isolated from rabbits. Methods The rings of SO isolated from 60 rabbits were treated with Krebs solution and then were exposed to gradient atropine,anisodamin, noradrenalin, adrenaline or pethidine with 10 each. The rest 10 rings of SO treated with Krebs solution only were served as controls. The amplitude and frequency of contraction of SO were recorded. Results Compared with control group, all of the 5 medicines were able to significantly decrease the contractive amplitude, but not frequency, of SO at the concentrations ranged from 10-6 mol/L to 10-2 mol/L (P＜0.05). The inhibition order was as follows: noradrenaline ＞ adrenaline ＞atropine ＞ anisodamin ≈ pethidine. Conclusions Beside atropine and anisodamin, noradrenaline,adrenaline and pethidine also showed the direct relaxation of SO by decreasing contractive amplitude of SO. Adrenaline or noradrenaline displayed stronger effect in decreasing contractive amplitude of SO when compared with atropine or anisodamin.

Narrow-Band Imaging in diagnosis of colorectal neoplasm / 中华消化内镜杂志

Objective To evaluate the efficacy of narrow-band imaging (NBI) in diagnosis of color-ectal neoplasm. Methods A total of 96 colorectal neoplasm from 78 patients were observed under NBI, and the findings were compared with those from magnifying chromo-endoscopy and pathologic examinations. Re-suits The sensitivity of conventional colonoscopy in diagnosis of polyps was 78. 7%, which was increased to 99% (P < 0. 05) under NBI, with the clear identification of the shape and boundary of the lesions. Magnif-ying NBI colonoscopy provided images of pit patterns similar to those from chromo-endoscopy in diagnosis of type Ⅱ , ⅢL, Ⅳ and ⅤN, which showed better recognition than conventional colonoscopy, but less sensitiv-ity than chromo-endoscopy. Superficial vascular morphologic features could be better classified with NBI, with sensitivity of 100% and specificity at 87. 8%, which was superior to conventional colonoscopy but infe-rior to chromo-endoscopy. Conclusion Both chromo-endoscopy and NBI colonoscopy have better sensitivity and specificity in detection of colon polyps, while chromo-endoscopy reveals clear superficial structure of le-sion and pit pattern, and NBI demenstrates capillary morphology, which can distinguish neoplasm from non-neoplasm colorectal lesions. NBI, easy and convenient to switch, is an effective technique to make early di-agnosis of colorectal neoplasm.

Effects of vasoactive intestinal peptide or somatostatin on the expression of MADCAM-1 in the intestinal mucosa of rats with multiple organ dysfunction synarome / 中华急诊医学杂志

Objective To investigate the effects of somatostatin(SST)or vasoaetive intestinal peptide (VIP)on the expression of MAdCAM-1 in the intestinal muecosa of rats with multiple organ dysfunction syndrome (MODS)and its significance of prevention and treatment of MODS.Method Thirty six Wistar male rats were randomly divided into 6 groups(6 rats in each group),including control group,VIP group 1 and SST group1 (rats treated with VIP and SST respectively),MODS group(rats with MODS),VIP group 2 and SST group 2(NODS rats treated with VIP and SST respectively).The rat model of MODS(system inflammatory response syndrome,＞2 or-gans dysfunction)was established by occlusion of superior mesenteric arteries.0.2 ρmol·g-1 h -11 VIP or SST by intravenous injection combined with 0.25 ρmol/g VIP or SST by intraperitoneal injection were injected into rats.In each group,intestinal lymphocytes from rats labeled with 51 Cr were infused into rat veins and were quantified with γcounter in GALT.The expression of MAdCAM-1 in the intestinal mucosa was measured by western blot.Inflam-mation in the intestinal mucosa was evaluated with histological sections.Student's t test was used to assess differ-ence between the experiment group and the control group.Results In VIP group l and SST group 1,the peak values of MAdCAM-1 expression in diffusive lymphatic tissue of small intestinal were 157.67±2.52 and 154.33±3.22.and those in Peyer patches were 136.00±1.00 and 137.00±1.00.There were no significant difference when compared with control group(165.33±1.53,152.67±2.31,P＞0.05).The percentage of 51 Cr-lympho-cytes in diffusive lymphatic tissue of small intestine(1.04%±0.59%,1.01%±0.83%)showed no significant difference from control group(1.07%±0.61%,P＞0.05),and those in Peyer patches(1.83%±0.90%,1.56%±0.64%)were significantly less than control group(3.85%±2.02%,P＜0.05).In VIP group 2 and SST group 2,the peak values of MAdCAM-1 expression in diffusive lymphatic tissue of small intestinal(158.00±2.65,154.33±1.53)and Peyer patches(156.33±1.53.151.33±2.31)were significantly less than MODS group(175.33±2.52,173.00±2.65,P＜0.05).The percentage of 51 Cr-lymphocytes in diffusive lymphafic tissue of small intestine(1.58%±0.42%,1.45%±0.26%)and Peyer patches(2.14%±1.49%,0.81%±0.35%)were significantly less than MODS group(3.23%±1.69%,5.04%±1.23%,P＜0.05)and the se-vere histopathological danlage in intestine was relieved.Conclusions VIP or SST reduced intestinal lymphoeytes homing to GALT in rats with MODS through suppressing the expression of MAdCAM-1,and attenuated the inflam-matory injure in the intestinal mucosa.

Investigation on the relationship between chronic atrophic antral gastritis and the decrease of somatostatin levels in blood and pyloric glands / 中华消化杂志

Objective To investigate the relationship between chronic atrophic antral gastritis and the decrease of somatostatin levels in blood and pyloric glands and adaptable protection ability of gastric mucosa.Methods Gastric mucosa biopsy specimen and blood samples were collected to determine the levels of somatostatin(SST)using radioimmunoassay.Histological changes between pre-and post-treatment were observed under light microscope as well as the changes of uhramicrostrucuture under transmission electron microscope.Distribution of SST in gastric mucosa was studied by immunohistochemical staining and then quantified.Results The quantities of gastric antral D cells of chronic atrophic antral gastritis decrease obviously.SST was mainly distributed in D cells of mucosa pyloric gland crypt.The nucleus of mucus epithelial cells in atrophic gastric antral crypt had SST negative staining.Mitochodria swellen,crista broken,rough endoplasmic reticulum distension,mucus secretory granules decreasing,the nuclear membranes disappearing as well as ehromatin integrating could have been seen in the intracytoplasm of mucus epitheliun cells of chronic atrophic gastric antral gastritis.The average level of SST in blood,epithelium and crypt were obviously reduced comparing to that of in the control group.By immunochemistry staining,the SST level in crypt of atrophic gastric antral gastritis Was significantly reduced comparing to that of in control group.With the level of SST in blood＜10 pg/100μl,the probability ratio of emerging atrophy Was 67.7%.Conclusions In case of no systemic inflammatory reaction state,the decreased ability of human pyloric gland D cell in producing SST not only rehtes obviously with human chronic atrophic antral gastritis but also with the weakened adaptable protection ability of gastric mucosa.

The value of esomeprazole test in diagnosing gastroesophageal reflux disease:A randomized multi-center controlled trial / 中华消化杂志

Objective To evaluate the diagnostic value of esomeprazole test in patients with gastroesophageal reflux disease.Methods Consecutive patients with heartburn and/or acid regurgitation in three medical centers were enrolled in a prospective,randomized,double-blind study with a placebo-control design.After upper endoscopy examination,patients were divided into non-erosive reflux diseases and erosive esophagitis.All patients underwent 24-hour ambulatory esophageal pH monitoring.Those who were diagnosed as gastroesophageal reflux diseases had either esophagitis under endoscopy or abnormal esophageal acid exposure in 24-hour ambulatory esophageal pH monitoring.The patients were randomly divided into treatment group and control group.The patients in treatment group were received 40 mg of esomeprazole daily while the patients in control group were given placebo once daily for 14 days.The severity and frequency of heartburn were recorded both by doctors and patients before and during treatment.Results Two hundred and seventeen patients were completed the study(105 patients in treatment group and 112 patients in control group).If the symptom of heartburn which disappeared in the sixth and seventh day of the first week,it was defined as positive for esomeprazole test,the sensitivity and specificity in treatment group were 87.7% and 42.5%,respectively If the symptom of heartburn disap peared in the second week,it was defined as positive for esomeprazole test.The corresponding sensitivity and specificity in treatment group were 84.6% and 45%,respectively.The Youden index was 0.362 and 0.296 for criteria of one and two weeks,respectively.If the heartburn score improved by more than 50%,75% or 100% from the baseline score after treatment,it was defined as positive for esomeprazole test,the sensitivity and specificity were 95.4% and 32.5%,87.7% and 32.5%,84.6% and 45%,respectively.Conclusions The esomeprazole test has high value in diagnosis of GERD with sensitivity of 87.7% and specificity of 42.5%.Positive definition of heartburn disappeared in the sixth and seventh day is superior in cost-effective.

Induction of NAG-1 gene expression in colon cancer cells by non-steroidal anti-inflammatory drugs / 生物医学工程学杂志

This study was conducted to evaluate the growth and NAG-1 gene expression effected by Non-steroidal anti-inflammatory drug (NSAID) on colon cancer cell lines in vitro. The proliferation of colon cancer cells were determined by MTT assay and COX-2 protein expression were detected by Western blot. Total RNA was isolated from three kinds of colon cancer cell lines; the expressions of NAG-1 mRNA in the cells treated with or without NSAIDs were assessed by semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR) assay. Celecoxib, meloxicam and aspirin were able to inhibit the growth of HT-29, SW480 and LS174-T cells in dose-dependent manner. COX-2 protein expressed in HT-29 and LS174-T, but not in SW480 cells. All of colon cancer cells expressed NAG-1 gene and the level of LS174-T was lower than that of the other two cell lines. NAG-1 expression was increased by treatment with some NSAIDs in all three kinds of colon cancer cells. NSAIDs were able to potentially inhibit the growth of colon cell lines. Induction of NAG-1 gene expression by NSAID was not consistent with COX-2 expression.

Effects of combined octreotide and aspirin on the growth of gastric cancer / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the effects of the combination of octreotide and aspirin on the growth of gastric cancer.</p><p><b>METHODS</b>Proliferation of gastric cancer cell lines treated with octreotide or aspirin was determined by (3)H-thymidine incorporation. After xenografts of human gastric cancer were implanted orthotopically in the stomach of nude mice, they were administered octreotide plus aspirin for 8 weeks. The mRNA of somatostatin receptor in the tissues of gastric carcinoma was detected by reverse transcription polymerase chain reaction (RT-PCR). Cyclooxygenase-2 in gastric cancer tissues was measured by immunohistochemistry.</p><p><b>RESULTS</b>Both octreotide and aspirin significantly reduced the (3)H-thymidine incorporation of gastric cancer cells. Xenografts in situ were found in all stomachs of nude mice except for two in the combination group. Either size or weight of tumors treated by octreotide, aspirin or in combination was significantly reduced as compared with that of controls. The inhibition rate for tumor was 60.6% (octreotide), 39.3% (aspirin), and 85.6% (in combination) respectively. No severe side effects were observed in any treated groups. Somatostatin receptor-2 and -3 were expressed in the transplanted gastric adenocarcinomas. Aspirin could down-regulate the strong expression of cyclooxygenase-2 in the tissue of gastric adenocarcinomas of nude mice.</p><p><b>CONCLUSION</b>A combination of octreotide and aspirin significantly inhibited proliferation of gastric cancer through mediation of somatostatin receptors and suppression of cyclooxygenase-2.</p>