ABSTRACT
Objective:To explore the efficiency of a new scoring system of gastric cancer screening for early gastric cancer in health examination population.Methods:The risk score of gastric cancer was assessed based on the new scoring system in health examination population. A notice for further gastroscopy was sent to the medium-risk and high-risk people. Gastroscopy was performed on those who agreed to undergo the examination.Results:From January to April 2019, a total of 5 357 people in health system visited the Physical Examination Center of Shanghai Songjiang Clinical Medical College of Nanjing Medical University for health examination. Seven hundred and forty people were classified as medium- and high-risk groups by the new screening system, 576 in medium-risk group, and 164 in high-risk group. Among them, 131 cases (17.70%) came for further gastroscopy, of whom 91 (69.47%) were in the medium-risk group and 40 (30.53%) in the high-risk group. After gastroscopy, 4 cases of gastric cancer and 1 case of esophageal cancer were detected, and both were early cancer. In the medium-risk group, 2 cases (2/91, 2.20%) of early gastric cancer and 1 case (1/91, 1.10%) of early esophageal cancer were found. In the high-risk group, 2 cases (2/40, 5.00%)of early gastric cancer were found. The tumor detection rate of high-risk group (5.00%) was higher than that of medium-risk group (3.30%), but there was no significant difference ( P>0.05). Conclusion:Risk stratification with the new scoring system of gastric cancer screening can improve the detection rate of early gastric cancer.
ABSTRACT
Objective To explore the correlation between food allergies and duodenal mast cells in pathogenesis with functional dyspepsia (FD).Methods The symptoms of FD were scored in 48 patients with FD,which included 23 patients with postprandial distress syndrome (PDS) and 25 patients with epigastric pain syndrome (EPS).The specimens of duodenal and descending part of duodenum mucosa were obtained under gastroscopy in 48 FD patients and 21 healthy volunteers,and 3 mL venous blood was taken at same time.The percentages of mast cells and degranulated mast cells were calculated after the specimens were stained by toluidine blue.The serum specific IgG antibodies of 14 food allergies were detected by enzyme-linked immunosorbent assay.Two-sample comparison was performed by t test,LSD-t-test for groups' comparison,chi-square or Fisher’s exact test for rates comparison and Pearson linear correlation for correlation analysis.Results The number of mast cells in duodenal and descending part of duodenum of FD group,PDS group and EPS group was significantly higher than that of control group and the differences were statistically significant (duodenal:t =3.387,3.536 and 3.510; descending part of duodenum:t=5.810,4.400 and 3.813; all P＜0.01).In duodenal and descending part of duodenum,the percentages of degranulated mast cells in all mast cells of FD [(60.23± 5.10)％ and (66.97±5.30)％],PDS [(59.84±4.50)％ and (66.63±5.37) ％] and EPS [(60.58±5.66) ％ and (67.28±5.32) ％] were all higher than those of control group [(25.38 ± 2.32％) and (30.66 ±2.89)％],and the differences were statistically significant (duodenal:t=33.639,25.496 and 26.563; descending part of duodenum:t=32.513,30.521 and 31.612; all P＜0.05).There was no correlation between the number of mast cells,percentage of degranulated mast cells in duodenal or descending part of duodenum and the scores of symptoms (all P＞0.05).In PDS group,the rates of positive specific IgG antibodies of beef,crab,shrimp,wheat and chicken were significantly higher than those of control group,and the differences were statistically significant (beef x2=12.108,crab x2=17.771,shrimp x2=6.832 and wheat x2=4.375,chicken (Fisher’s exact test); all P＜0.05).In EPS group,the rates of positive specific IgG antibodies of beef,soy and chicken were significantly higher than those of control group,and the differences were statistically significant (beef x2 =8.915,soy x2 =18.600,chicken (Fisher' s exact test) ; all P ＜0.01).The scores of positive specific IgG antibodies of food allergies and types of FD,PDS and EPS were significantly higher than those of control group,and the differences were statistically significant (the score of positive IgG:t=14.988,4.062 and 3.693; the positive type of IgG:t=8.805,4.177 and 3.388; all P＜0.01).The scores of positive specific IgG antibodies of food allergies and types were positively correlated with the number of mast cells and the percentage of degranulated mast cells in duodenal part of duodenum (the score of positive IgG:r=0.247 and 0.307,the positive type of IgG:r=0.243 and 0.326; all P＜0.05).Conclusion The specific IgG antibody of food allergies might play a role in the pathogenesis of FD through inducing an increase in the number of mast cells and the percentage of degranulated mast cells in duodenal mucosa.
ABSTRACT
Objective To observe the effects of different anesthesia methods on immune function of patients with biliary tract surgery in patients.Methods 64 patients with ASA Ⅰ～Ⅱ grade elective biliary tract surgery were randomly divided into general anesthesia group (n= 32) and epidural anesthesia group(n = 32) respectively.The changes of T cell subsets and natural killer(NK) cells were observed.Results The levels of CD3+ 、CD4+、 CD4+、CD8+ and NK cells after anesthesia 2h,postoperation 1d and 3d were significantly lower than those before anesthesia in two groups(P<0.05) .general anesthesia group after surgery 5d were significantly lower than those before anesthesia(P<0.05) ;After surgery 1d,3d and 5d,general anesthesia group was significantly lower than epidural anesthesia group (P<0.05) ;The levels of CD3+、CD4+ in general anesthesia group was significantly lower than epidural anesthesia group(P<0.05) ,after surgery 1 d,the levels of CD4+、 CD8+ and NK cells in epidural anesthesia group were significantly lower than those in general anesthesia group(P<0.05).Conclusion Anesthesia had an inhibition of transient varying degrees for the immune function of patients uaderwent biliary tract surgery,which general anesthesia was more evident than epidural anesthesia.