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Esophageal cancer is a common and poorly prognostic cancer, and early screening and early diagnosis arc the keys to improve the prognosis of patients. In recent years, more and more studies have shown that changes in gastrointestinal flora are associated with the occurrence, progression, recurrence, metastasis and chemotherapy resistance of esophageal cancer. This article mainly reviewed the changes of gastrointestinal flora in esophageal cancer patients and the progress of research on gastrointestinal flora in the screening, diagnosis and prognosis of esophageal cancer.
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Objective To evaluate the clinical efficacy of transjugular intrahepatic portosystem shunt (TIPS) and gastric coronary vein embolization (GCVE) in the treatment of patients with cirrhosis,portal hypertension and upper gastrointestinal bleeding.Methods From Jan 2014 to May 2017 72 patients were enrolled and divided into the TIPS group (36 cases,receiving TIPS) and TIPS + E group (36 cases,byTIPS+GCVE).Results Portal vein diameter (1.21 ±0.08)cm vs.(1.26 ±0.09)cm,portal pressure (23.9 ± 2.1) cmH2O vs.(25.1 ± 2.2) cmH2O and congestion index (0.06 ± 0.03) cm/s vs.(0.08 ±0.03) after 1 month of treatment in TIPS + E group was significantly lower than the TIPS group,and the portal vein velocity was significantly higher than that of the TIPS group (42 ± 6) cm/s vs.(38 ± 7) cm/s,t =2.491,2.367,2.828,t =2.343,all P ＜ 0.05.The Child-Pugh score in the TIPS + E group was significantly lower than that in the TIPS group (7.9 ± 1.4) vs.8.6 ± 1.6,t =2.074,P =0.042).There was no statisticall different difference in postoperative hepatic encephalopathy in the two groups (17％ vs.11％,x2 =0.465,P =0.496).The one-year rebleeding rates in the TIPS group and the TIPS + E group were 14％ and 3％,respectively.The risk of rebleeding in the TIPS + E group was significantly lower than that in the TIPS group (HR =0.218,P =0.041).The one-year access obstruction rates in the TIPS group and the TIPS + E group were 17％ and 14％,respectively.(P =0.679).The all-cause mortality rates of the TIPS group and the TIPS + E group were 8％ and 3％,respectively,showing no statistically (P =0.299).Conclusions TIPS + GCVE therapy in the treatment of portal hypertensive upper gastrointestinal bleeding effectively reduces the risk of rebleeding.
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Objective To investigate the correlation between decoy receptor (DcR) 1,DcR2,osteoprotegerin (OPG) gene polymorphisms and susceptibility of Crohn's disease (CD) in Han population in Zhejiang province.Methods From April 2008 to July 2017,at the Department of Gastroenterology of The Second Affiliated Hospital of Wenzhou Medical University,The First Affiliated Hospital of Wenzhou Medical University,Central Hospital of Wenzhou and Renmin Hospital of Wenzhou,285 patients diagnosed as having CD were enrolled,and during the same period 572 healthy individuals who received health checkup at the Second Affiliated Hospital of Wenzhou Medical University were collected as healthy control.The single nucleotide polymorphism (SNP) of DcR1 (rs12549481),DcR2 (rs1133782) and OPG (rs3102735) were examined by SNaPshot technique.An unconditional logistic regression analysis was performed to analyze the differences in each SNP mutation alleles and genotype frequencies between CD group and control group.Furthermore,their correlation with clinicopathological features of CD and the efficacy of corticosteroid and infliximab was also evaluated.Results The frequencies of mutant allele A and genotype GA + AA of DcR2 (rs1133782) of CD group were 11.93％ (68/570) and 22.81％ (65/285),respectively,which were higher than those of healthy control group (8.22％,94/1 144;and 15.91％,91/572;odds ratio (OR) =1.513,95％ confidence interval (CI) 1.088 to 2.104,P =0.013;OR =1.562,95％ CI 1.094 to 2.230,P =0.014).However there was no statistically significant difference in the mutant allele and genotype frequencies of DcR1 (rs12549481) and OPG (rs3102735) between two groups (all P ＞ 0.05).The frequencies of mutant allele C and genotype TC + CC of DcR1 (rs12549481) in patients with stricturing CD were 13.89％ (25/180)and 27.78％ (25/90),respectively,which were lower than those of patients with non-stricturing,non-penetrating CD (27.68％,62/224 and 48.21％,54/112),and the differences were statistically significant (OR =0.421,95％ CI 0.252 to 0.705,P =0.001;OR =0.413,95％ CI 0.229 to 0.747,P =0.003).Besides,the frequencies of mutant allele A and genotypes GA + AA of DcR2 in patients with penetrating CD were 7.23％ (12/166) and 13.25％ (11/83),which were lower than those of patients with non-stricturing,non-penetrating CD (15.62％,35/224 and 30.36％,34/112),and the differences were statistically significant (OR =0.407,95％ CI 0.205 to 0.809,P =0.009;OR =0.350,95％ CI 0.165 to 0.743,P =0.005).In addition,there was no statistically significant difference in the frequencies of mutant allele and genotypes of OPG (rs3102735) among subtypes of CD with different features (all P ＞ 0.012 5).Moreover,the DcR1 (rs12549481),DcR2 (rs1133782) and OPG (rs3102735) polymorphisms were not correlated with the efficacy of corticosteroid and infliximab (all P ＞ 0.05).Conclusions DcR1 (rs12549481) mutation may be correlated with stricturing CD.DcR2 (rs1133782) mutation may be correlated with CD,especially with penetrating CD.However,the gene polymorphism of OPG (rs3102735) is not correlated with the risk of CD susceptibility.And the above gene SNP may be independent of the efficacy of corticosteroid and infliximab.
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Gastric cancer is one of the most common malignancies worldwide. Early diagnosis and intervention is the key to improve the prognosis of patients with gastric cancer. Expression of miR-20a is up-regulated in the circulating blood of gastric cancer patients,cancer tissues and cell lines,and has been demonstrated to be closely related to the clinicopathological characteristics and prognosis of gastric cancer. MiR-20a promotes the proliferation of gastric cancer cells,regulates the self-renewal of gastric cancer stem cells,and induces chemoresistance via a variety of mechanisms. Detection of serum/ plasma miR-20a alone or in combination with other miRNAs is helpful for the early diagnosis and prediction of progression,relapse and prognosis of gastric cancer. MiR-20a has the potential to be used as a novel and noninvasive biomarker for gastric cancer.
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Wuhan University built up a new modular integrated curriculum in clinical medicine oriented for post competence,by learning from the successful international experience and the course of vertical and horizontal integration.The curriculum focused on five modules (including humanities and vocational course,courses of integrated medicine,clinical practice and thinking,innovation awareness and ability,prevention and health promotion program) and the eight integrated curriculum (including human structure,organization and function,cell,molecule and gene,reaction,nerve injury science,pathogen biology,CPPT,clinical skills).During the curriculum implementation,Wuhan University vigorously promoted the group discussion teaching,cultivated high-quality core teaching team,and effectively carried out curriculum construction and teaching evaluation,which effectively improved the level and quality of medical personnel training.
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Objective To investigate the value of endoscopic ultrasonography (EUS) and abdominal CT (CT) in diagnosis of periampullary lesions and to make comparison between the two procedures. Methods The patients suspected of surrounding lesions of ampullary from 2009 to 2013 in our hospital were included in this study. All the patients received both EUS and abdominal CT. The accuracy rate of these two examination methods was compared. Results 151 patients were confirmed as surrounding lesions of ampullary, including choledocholithiasis, ampullary tumors, ampullary inflammation, tumors of the pancreatic head and pancreatic cysts. The accuracy rate of these diseases was 83.6%, 90.6%, 6.5%, 100.0%, and 100.0%for EUS;while was 52.2%, 56.3%, 43.5%, 91.3%, and 100.0%for abdominal CT. The tatal accuracy rate for diagnosing periampullary lesions by EUS was significantly higher than that by abdominal CT (84.1% vs. 59.6%). Conclusions Endoscopic ultrasonography has higher value in diagnosis of periampullary lesions, and its accurate rate was higher than that of abdominal CT.
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Background:Acute kidney injury(AKI)is one of the early serious complications of acute pancreatitis(AP). Early identification and intervention have important clinical significance. Aims:To investigate the early predictive value of clinical indicators found within 48 hours after admission for AKI in patients with AP. Methods:A retrospective analysis of 205 AP patients from January 2014 to December 2014 at Renmin Hospital of Wuhan University was performed. AP patients were divided into AKI group and non-AKI group according to the KDIGO standard,the demographic characteristics,history of chronic diseases and indicators defined within 48 hours after admission such as Ranson score,BISAP score and biochemical indices were compared. The early predictive value of clinical indicators for AKI was evaluted,and strength of association between clinical indicators and AKI was assessed. Results:Compared with non-AKI group,Ranson score, BISAP score,D-dimer,PCT,blood glucose,triacylglycerol were significantly increased in AKI group(P 7)(P < 0. 05). Conclusions:D-dimer,PCT and calcium are effective and economical clinical indicators for the early prediction of AKI in patients with AP.
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Background:As the incidence of acute pancreatitis( AP)is increasing and the mortality remains high,early identification and early intervention of patients at risk of severe acute pancreatitis(SAP)is of great clinical significance. Aims:To investigate the value of commonly used AP-related serum biochemical markers for early prediction of severity of AP. Methods:Retrospective analysis was performed in 205 AP patients in Renmin Hospital of Wuhan University from Jan. 2014 to Dec. 2014,and 92 healthy subjects were served as controls. Patients with AP were divided into mild(n = 92), moderately severe(n = 72)and severe AP(n = 41)groups. The demographic characteristics,history of chronic diseases, serum biochemical markers within 48 hours after admission,Ranson score,BISAP score and other related clinical data were collected and compared between the four groups. The diagnostic performance of these indices in predicting SAP was evaluated by ROC curve,and the correlation of these indices with SAP was assessed by Logistic regression analysis. Results:There were significant differences in Ranson score,BISAP score,D-dimer,blood calcium,procalcitonin(PCT), CRP,hypersensitive CRP(HS-CRP),triacylglycerol and blood glucose between the four groups(P < 0. 05). The area under curve(AUC)of blood calcium was 0. 838 for early prediction of SAP,which was second to that of Ranson score and BISAP score. The accuracies of PCT and D-dimer were acceptable but inferior to blood calcium,while the accuracies of other indices were considerably low. Logistic regression analysis revealed that the odds ratio of risk for SAP of Ranson score,PCT and HS-CRP were all greater than 1 000,while that of blood calcium and D-dimer were 0. 013 and 19. 479, respectively. Conclusions:Of the AP-related serum biochemical markers,blood calcium,D-dimer and PCT are the preferred early predictors for severity of AP.
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Objective Endoscopic ultrasound guided fine needle aspiration biopsy (EUS-FNA) was performed for diagnosis and treatment of the pelvic Lesions and safety of this method were evaluated.Methods EUS-FNA was performed in 52 patients with pelvic Lesions selected by EUS,CT or MRI between March 2009 and June 2012.Both 19 and 22 gauge needles were used for EUS-FNA.The tissue specimens were analyzed by cytologic or histologic examination.The pelvic cystic lesions were drained and in which purulent lesions were lavaged with Metronidazole repeatedly.Results All patients recieved fine needle biopsy of the pelvic lesions.Among the 52 lesions,there were 42 solid lesions,10 cystic lesions.In solid lesions,cytology and pathology demonstrated malignant tumors in 28 patients,3 cases of malignant stromal tumors,3 cases of Inflammatory mass cases,2 cases of lymphoma,1 case of dermoid cyst,5 cases of other.In cystic lesions,2 cases of serous cystadenoma,perirectal abscess in 8 cases.6 purulent lesions were lavaged with Metronidazole repeatedly.Diagnosis rates of samples for immunohistology remained similar between 22 gauge and 19 gauge needles (P ＞0.05).During the operation,8 cases of perirectal abscess patients have different degree of pain.There were no other complications after the procedures except one patient suffering from fever.Conclusion EUS-guided FNA is minimaly invasive,a safe and accurate method for diagnosis of pelvic lesions.
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Objective To explore the effects of psychological disorders on qualityoflife of elderly patients with non-erosive reflux disease (NERD) under maintenance treatment of proton pump inhibitors (PPIs). Methods A total of 76 elderly patients with NERD treated by proton pump inhibitors (maintenance treatment of Esomeprazole over half a year) were enrolled. They were classified into symptom group aged (66.5±8.2) years (n=35) and symptom group aged(68.2+6.9)years (n=41)according to reflux symptoms,with 20 healthy people aged(65.4 ±8.8)years as control.The subjects completed the questioniaires on psychological status including self-rating anxiety scale (SAS) and self-rating depression scale (SDS) and their quality of life was evaluated by gastroesophageal heath related quality-of-life instrument(GERD -HRQL) and medical outcomes study short form(SF-36). Results Scores of SAS and SDS were significantly higher in symptom group (54.9±6.2,57.9±8.6) than in symptomless(37.9±8.7,42.7±7.9) and health control group (38.9± 7.2,43.1 ± 8.9),all (P＜0.05),but there was no difference between symptomless and health control group.The rates of anxiety and depression in symptom group (51.4％,57.1％) were increased as compared with symptomless (12.2％,9.8％)and health control group(0.0％,5.0％).Scores of GERD HRQL in symptom group were higher than in symptomlcss group (21.4± 5.0 vs.4.5±2.2,t=19.76,P＜0.01)while the indexes such as body pain,vitality,social function,affection,mental and whole health in score of SF-36 besides physiology function were lower in symptom group than in symptomless and control groups (P＜0.05 or P＜0.01 ).Only the significant differences in mental and whole health of SF-36 were found between symptomless and control groups (P＜0.01).Correlation analysis revealed that SAS and SDS scores were positively correlated with scores of GERD-HRQL in symptom group(P＜0.01) and negatively with all dimensions of SF-36 but physical function (P＜ 0.05). Conclusions Most of elderly symptomatic patients with NERD treated by PPI are in psychological disorders which results in lower quality of life.
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ObjectiveTo investigate the genomic and non-genomic effects of 17β-estradiol on gallbladder smooth muscle strips of guinea pig and their possible mechanism. MethodsAfter ovariectomized operation (OVX) and subcutaneous injection of 17β-estradiol, the contents of serum estradiol and cholecystokinin-octopeptide (CCK-8) of the sham operation group (Sham) guinea pigs, the OVX group, the OVX and subcutaneous injection 17β-estradiol for 1 day (OVX+E2, 1 d), 3 days (OVX+E2, 3 d) and 7 days (OVX+E2, 7 d) were detected by EILSA respectively. The effects of CCK-8/Ach on constriction of gallbladder muscle strip were observed among various groups by using tension transducer, and the acute effects of 17β-estradiol on guinea pig gallbladder smooth muscle strips were observed to probe its possible mechanism. ResultsCompared with the Sham group, the serum contents of estradiol and CCK-8 decreased in OVX group (P＜ 0. 05) whereas the sensitivity of OVX guinea pigs gallbladder muscle strips to CCK-8/Ach increased (P＜0.05). With the extension of the subcutaneous injection 17β-estradiol time (for 1, 3, 7 days), both the serum estradiol and CCK level increased (P＜ 0.05) while the guinea pig gallbladder strips sensitivity to CCK-8/Ach decreased (P＜0.05).17β-estradiol at concentration ranging from 10 9 to 10-7 mol/L have no effect on the guinea pig gallbladder strips contraction (P＞0.05), but at concentration of 10-6 and 10 5 mol/L, it can inhibit the gallbladder contraction (P＜0.05). The blocking agents, such as nimodipine, atropine, devazepide, ICI 182,780 and Y-27632, can block the inhibited effects of 17β-estradiol. ConclusionThe 17β-estradiol can affect the gallbladder motility, both by genomic and non-genomic pathway.
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Objective To explore the effect of biliary obstruction caused acute acalculous cholecystitis (AAC) on ultrastructure of gallbladder interstitial cells of Cajal (ICCs),and the possible mechanism of impaired contraction of gallbladder smooth muscle. Methods Total 60 healthy adult guinea pigs were in this study. The guinea pigs AAC model was induced by common bile duct ligation (BDL). The guinea pigs were divided into five groups equally,including sham control group (Sham),BDL for 12 hours (BDL-12),24 hours (BDL-24),48 hours (BDL-48) and 72 hours (BDL-72)groups. The gallbladder specimens were collected by the end of study. Gallbladder pathological changes were observed with HE staining under light microscope. Three muscle strips were collected of each gallbladder,fixed in constant temperature water bath with different concentration of eight peptide cholecystokinin agonist (CCK-8,1010 mmol/L,10-9 mmol/L,10-8 mmol/L,10-7 mmol/L and 10-6mmol/L),acetylcholine (Ach,10-8 mmol/L,107 mmol/L,10-6 mmol/L,10-5 mmol/L,10-4 mmol/L)and potassium chloride (KC1) (60 mmol/L). The contraction activity of gallbladder muscle strips was recorded by tonotransducer. The ultrastracture changes of gallbladder ICC in sham,BDL-12 and BDL-72 groups was examined by transmission electron microscopy. Results There was no obvious inflammation in Sham and BDL-12 groups. Compared with sham group,there were significant differences of biology score of gallbladder in BDL-48 and BDL-72 groups (P＜0. 05). After adding CCK-8,Ach and KC1,the contraction amplitude of gallbladder muscle increased in each group,and in dose-dependent manner. Compared with sham group,the effect value of each other groups decreased significantly (P＜0. 05). Compared with sham group,the morphology of ICC changed in BDL-12group,and more obvious in BDL-72 group. Conclusion Biliary obstruction can induce AAC. At the earlier stage of ACC,the impaired contraction of gallbladder smooth muscle present even without gallbladder inflammation occurrence. ICC may play an important role in impaired contraction.
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AIM To study the effects of progesterone on contractile activity of smooth muscle stripes and the large conduction Ca 2+ activated K + currents (BK Ca ) of single colonic myocytes in female guinea pig proximal colons METHODS Stripes and single cells were separated acutely from guinea pig proximal colon Contractions of stripes were measured by isonic transducer, and Ca 2+ activated K + currents were recorded with an Axopatch 1D amplifier under conventional whole cell patterns RESULTS 64 8 ?mol?L -1 progesterone produced longitudinal stripes significantly re laxation(0 1792 g?0 0873 g, n =6, P
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Objective To investigate the effects of serotonin(5-HT) on the ionic channels currents and membrane potentials of single guinea pig proximate colon myocytes. Methods Cell images before and after contraction were captured and analyzed with an imag e analysis software. Channels currents, action potential (AP) and resting potent ial (RP) were recorded with an EPC-9 amplifier. Results The direct actions of 10 ?mol/L 5-HT to myocytes resulted in followin g effects: Firstly, the exogenous stimulated peak values of AP reduced to 60%?7 .3%(n=7,P
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Objective To investigate the status of fragile histidine triad (FHIT) gene in human esophageal, gastric and colorectal carcinomas. Methods Ninety six samples of digestive tract cancer (including 21 esophageal carcinomas, 43 gastric carcinomas and 32 colorectal carcinomas) tissues and their adjacent non carcinoma tissues and 18 samples of normal tissue were examined by nested RT PCR for FHIT gene alteration. Results Aberrant transcripts were observed in 33.3% esophageal cancers, 51.7% gastric cancers and 31.3% colorectal cancers. In the adjacent esophageal,gastric and colorectal non carcinoma tissues the rate of aberrant transcripts were 4.8%,20.9% and 9.4%, respectively ( P
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AIM: To explore the effects of sodium ferulate (SF) on function of macrophages in colonic tissue of the colitis rats in vivo. METHODS: The immunological colitis model of rats was produced. SF was used intracolonically for 21 days. The contents of malondialdehyde (MDA), nitric oxide (NO), prostaglandin E_2 (PGE_2) and the activity of superoxide dismutase (SOD), interleukin-1 (IL-1), TNF-?, myelopexoxidase (MPO), and the expression level of NF-?B p65 in colonic tissue of the rats were detected. RESULTS: SF (200,400,800 mg/kg) decreased the elevated contents of MDA, NO, PGE_2, the activity of IL-1, TNF-?, MPO, and the expression level of NF-?B p65, while increased the reduced activity of SOD in colonic tissue of the colitis rats in a dose-depended manner. CONCLUSION: SF restrained the activity of activated colonic macrophages and relieved the colonic inflammation reaction in vivo in colitis rats, which may be related to the suppression of NF-?B activation. [
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Purpose:To investigate the variant expression of human belomerase reverse transcriptase (hTERT) and NF ?B p65 protein and their relationships in gastric carcinogenesis.Methods:A total of 41 primary gastric cancers, 15 cases dysplasia, 23 cases intestinal metaplasia and 10 cases normal gastric mucosa were taken into this study. Expression of hTERTmRNT, hTERT protein and p65 protein were determined by in situ hybridization and immunohistochemistry. Results:①Among normal mucosa intestinal metaplasia dysplasia carcinoma,p65 expression were 0?34.18%(8/23)?53.33%(8/15)?60.98%(25/41),hTERTmRNA 10.00%(1/10)?39.13%(9.23)?66.67%(10/15)?85.37%(35/41) and hTERT protein 0?30.43%(7/23)?60.00%(9/15)?78 05%(32/41),respectively. All the three parameters were significantly increased in dysplasia and carcinoma, compared to normal mucosa, while the expression level were also significantly higher in carcinoma than in intestinal metaplasia ( P
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AIMTo investigate the effects of ovarian hormone on th e expression of 5-HT 3 receptors in the rats colon. METHODS24 adult female SD rats were randomly divided into three groups:sham operation(Sham ) group;ovariectomy(OVX) group and ovariectomy with estrogen and progesterone(OV X+E 2+P) group. The 1 hour fecal pellets and the time of glass pellets output w ere observed 4 weeks after operation;and the expression of 5-HT 3 receptors mR NA in the colon tissues was studied by RT-PCR. RESULTSIn contra st with the Sham group and OVX+E 2+P group,OVX group showed increase in the fec al pellets output and decrease in the time of glass pellets output(P
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Aim To investigate the effects of emodin on the contraction of gallbladder smooth muscle(GBSM)and the L-type calcium current in GBSM cells.Methods Gallbladder muscle strips were obtained from adult guinea pigs and the resting tension was recorded.Gallbladder smooth muscle cells were isolated by enzymatic digestion,and calcium current was recorded by the whole-cell patch clamp method.Results Emodin-induced contraction of GBSM was significantly attenuated by pretreatment with nifedipine.Emodin increased the L-type calcium current in a dose-dependent manner.When 10 ?mol?L-1 emodin was applied to GBSM cells,the amplitude of L-type calcium current at +10 mV was enhanced by(45.2?2.26)%.In the presence of PKC inhibitor,staurosporine,emodin did not significantly affect the calcium current.Conclusion Emodin enhances L-type calcium current via PKC-dependent pathway and promotes gallbladder contraction.
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AIM To clarify the mechanism of berberine on mobility diarrhea by investigating the effects of berberine on calcium-activated potassium current I K(Ca) and delayed-rectifier potassium channel current I K(V) of guinea pig colonic smooth muscle cells. METHODS Single guinea pig colonic smooth muscle cells was isolated by collagenase; The effects of berberine on I K(Ca) and I K(V) were detected by using patch clamp technique, under the conventional whole cell patch clamp mode. RESULTS 10, 50, 100 ?mol?L -1 berberine inhibited I K(Ca) of guinea pig colonic smooth muscle cells significantly (P