Value of serum pepsinogen Ⅰ, Ⅱ and gastrin-17 in screening precancerous lesions of gastric cancer in physical examination population / 中国医师进修杂志

Objective:To evaluate the value of serum pepsinogen Ⅰ and Ⅱ combined with gastrin-17 in screening precancerous lesions of gastric cancer in physical examination population.Methods:Serum pepsinogen, gastrin-17 and Helicobacter pylori (Hp) antibody were detected in 18 354 physical examination people from July to December 2017 in Wenrong Hospital, Hengdian, Dongyang. The patients were divided into youth group (18 to 39 years old), middle-aged group (40 to 59 years old) and elderly group (≥60 years old) according to their ages. The correlation between the serological level of the above indexes and age was analyzed; according to the new ABC method, the test results were divided into groups A, B, C and D. The patients in group C and D were examined by gastroscopy. The differences of gastric mucosal atrophy or intestinal metaplasia and other precancerous lesions detected by gastroscopy in different age groups were compared.Results:Finally, 18 354 cases were enrolled, including 9 614 males and 8 740 females. With the increase of age, the proportion of group C and D increased gradually. In group C, 181 cases underwent gastroscopy, including 39 cases of atrophic gastritis, 29 cases of intestinal metaplasia and 3 cases of dysplasia/intraepithelial neoplasia, the detection rate of precancerous lesions was 39.23%; in group D, 94 cases underwent gastroscopy, including 22 cases of atrophic gastritis and 13 cases of intestinal metaplasia, the detection rate of precancerous lesions was 37.23%. The proportion of gastric precancerous lesions in group C and D was 29.63% in the young group, 69.70% in the middle-aged group and 71.58% in the old group, respectively. There was significant difference compared with the young group ( P<0.01); atypical hyperplasia occurred in 2.02% and 9.47% of the middle-aged group and the elderly group. Conclusions:The combined detection of serum pepsinogen Ⅰ and Ⅱ and gastrin-17 levels is of great value in the screening of precancerous lesions of gastric cancer; when this method used for early gastric cancer screening in healthy population, it is necessary to consider the influence of age for the risk stratification of gastric cancer.

A clinical study of cold snare resection for large colorectal polyps / 中华消化内镜杂志

Objective:To investigate the efficacy and safety of cold snare polypectomy (CSP) and hot snare polypectomy (HSP) for the removal of colorectal polyps of 10-15 mm.Methods:A total of 173 polyps of 154 patients with at least one polyp of 10-15 mm were resected under colonoscopy from December 2019 to December 2020. Based on Paris classification, the polyps were divided into Ⅰsp, Ⅰs and Ⅱa. According to random number table, the polyps were randomly divided into CSP group ( n=85) and HSP group ( n=88). The polyp size, location, morphology, histological classification, complete resection rate, incidence of complications, resection time and the number of prophylactic clips were compared between the two groups. Results:There were no significant differences in age, sex, indication of colonoscopy or the success rate of intubation at the end of ileum between the two groups. The polyps of the two groups were comparable in size, position, morphology and histological classification. There were no significant differences in the complete resection rate of polyps, rates of intraoperative bleeding and postoperative bleeding or perforation between the CSP group and the HSP group. The operation time in CSP group was significantly shorter than that in HSP group (63.5 ±23.6 s VS 184.3 ±62.4 s, P<0.05). The number of prophylactic clips used in CSP group was significantly less than that in HSP group (0.8±0.5 VS 1.4±0.7, P<0.05). Conclusion:CSP shows similar complete resection rate and complication incidence, and requires shorter operation time and fewer prophylactic clips, compared with HSP, in the resection of colorectal sessile polyps of 10-15 mm.

Comparison of different serological methods in screening early gastric cancer / 中华内科杂志

Objective To compare the consistency and detection rate of early gastric cancer (EGC) of three different methods including anti-Helicobacter pylori (Hp) antibody combined with pepsinogen (PG) (ABC method),serum PG combined with gastrin-17 (G-17) (new ABC method) and the new scoring system.Methods Serological tests were performed in Zhejiang population,which divided the subjects into low risk,intermediate risk and high risk groups.High risk subjects were examined by endoscopic and pathological examination.SPSS19.0 were used to evaluate the consistency of three methods.According to the receiver operating characteristic (ROC) curve,the ratio of G-17 to PG (PGR) was calculated for the optimal diagnostic cut-off value of EGC.Results A total of 30 126 subjects were recruited.Based on the data of ABC method,the proportions of low risk,intermediate risk and high risk group were 15 368 (51.01％),13 246 (43.97％),and 1 512 (5.02％),respectively.These proportions by the new ABC method were 20 584 (68.32％),8 990 (29.84％),552 cases (1.83％),respectively.By new scoring system,these were 20 810 (69.08％),8 059 (26.75％),and 1 257 (4.17％),respectively.Among them,1 263 subjects underwent endoscopy and 22 cases (1.74％) were finally diagnosed as gastric cancer including 19 EGC (86.4％).There were 1 case (0.35％),14 cases (1.84％),and 7 cases (3.21％) with gastric cancer in low risk,intermediate risk,and high risk groups by ABC methods,respectively.Gastric cancer patients were 7 (1.68％),10 (1.38％),and 5 (4.10％) in three groups respectively by new ABC methods.Via new scoring system,gastric cancer were detected in 5 (0.66％),9 (2.22％),and 8 (7.84％) patients of three risk groups respectively.The consistency of three screening methods was poor.The detection rate of gastric cancer in high risk group was higher than that in the other two (P＜0.05).The area under the curve (AUC) for diagnosis of gastric cancer by G-17 and PGR was 0.588 and 0.729,respectively.According to the PGR cut-off value determined by the fitted model,the incidence of gastric cancer in the low,intermediate and high risk groups was 0.94％,1.97％,and 6.31％,respectively.When the cut-off value is PGR＜4.135,the sensitivity is 0.855 and the specificity is 0.545.Conclusion The new scoring system has a better predictive value in EGC screening.The detection rate of EGC in high risk group is higher than that in low and intermediate risk groups.

Abdominal Obesity and Mortality in Continuous Ambulatory Peritoneal Dialysis Patients

BACKGROUND: The relationship between abdominal obesity (AO) and mortality in peritoneal dialysis (PD) patients is controversial. METHODS: The prevalence of AO in 84 PD patients was assessed in a cross-section manner and followed up for 9 years at a single center. AO was defined as a waist circumference (WC) of more than 90 cm in males or more than 80 cm in females. The patients were classified as either with AO(AO group) or without AO(nAO group). RESULTS: The AO group was older, contained more diabetics, more females, and had higher Charlson comorbidity index (aCCI) scores, BMI, and triglyceride and lower serum creatinine than the non-AO subjects. The follow-up duration was 53.2+/-34.4 months. At the end of the follow-up, eighteen patients (21.4%) were dead; 9 died of cardiovascular causes. The five year survival rate was 40.8%. Kaplan-Meier analysis revealed that both all-cause and cardiovascular-cause mortalities were similar in the AO and nAO groups. Multivariate analysis revealed the presence of AO not to be an independent risk factor of all-cause and cardiovascular-cause mortality. CONCLUSION: AO itself might not be a risk factor for mortality in PD patients. Nevertheless, further prospective studies with a large number of patients will be needed to prove this.

Effect of Dialysate Sodium Concentration on Sodium Gradient and Hemodialysis Parameters

This retrospective study was performed to determine the ranges of the sodium gradient (SG) between the dialysate sodium concentration (DNa) and serum sodium concentration (SNa) in hemodialysis (HD) patients and to examine the relationships between HD parameters over a 1 year period. Fifty-five clinically stable HD patients, who had been on HD >2 years were enrolled. Monthly HD [ultrafiltration (UF) amount, systolic blood pressure (SBP), frequency of intradialytic hypotension (IDH)] and laboratory data were collected and 12-month means were subjected to analysis. The SG was calculated by subtracting SNa from prescribed DNa. Mean SG values were 1.5+/-3.3 (range -5.6~9.1). SG was positively related to DNa and the frequency of IDH. A higher SG was associated with larger UF amounts and SBP reduction during HD. The percentages of patients with a SG > or =3mEq/L increased as DNa increased. On the other hand, SG was not found to be associated with SNa or pre-HD SBP. DNa appears to cause a significant increase in SG, and this seems to be related to HD parameters, such as, UF amount and IDH.

Excessive endoplasmic reticulum stress induces apoptotic cell death in chronic cyclosporine A nephrotoxicity / 中国病理生理杂志

AIM:To investigate the impact of excessive endoplasmic reticulum stress on apoptotic cell death in a rat model of chronic cyclosporine A ( CsA ) nephrotoxicity .METHODS: Male Sprague-Dawley rats on a low-salt diet were subcutaneously injected with vehicle (olive oil, 1 mL· kg-1· d-1) or CsA (15 mg/kg) daily for 1 or 4 weeks.Tu-bulointerstitial fibrosis and apoptotic cell death were estimated by trichrome staining and TUNEL staining .In addition , im-munohistochemistry and immunoblotting were used to evaluate the expression of immunoglobulin -binding protein ( BiP) , eu-karyotic initiation factor 2α(eIF2α), growth arrest and DNA damage-inducible protein 153 (GADD153), caspase-12 and caspase-3.RESULTS:The rats treated with CsA for 1 week did not develop tubulointerstitial fibrosis and TUNEL-positive cells, whereas 4-week treatment with CsA induced typical tubulointerstitial fibrosis and increased TUNEL-positive cells. CsA induced a significant increase in BiP and caspase-12 expression peaked at 1 week, and then returned to normal levels at 4 weeks.In contrast, the expression of eIF2α, GADD153 and caspase-3 in CsA-treated rat kidneys were significantly in-creased in a time-dependent manner .CONCLUSION:Excessive endoplasmic reticulum stress causes apoptotic cell death by depleting molecular chaperones and stimulating the proapoptotic pathway in chronic CsA nephrotoxicity .

Efficacy and safety of oxaliplatin chemotherapy programs as adjuvant treatment in colorectal cancer after surgery / 中华消化杂志

Objective To compare the efficacy and safety of 5-fluorouracil and calcium folinatc combined with oxaliplatin (FOLFOX) program with capecitabine regimen combined oxaliplatin (XELOX) program as adjuvant chemotherapy in advanced colorectal cancer after surgery.Methods The postoperative clinical data of 286 advanced colorectal cancer patients were retrospectively analyzed.Of which,204 patients received FOLFOX4/6 adjuvant chemotherapy and 82 patients received XELOX adjuvant chemotherapy.The three-years disease-free survival (DFS) time,three-years overall survival (OS) time and adverse reactions of the two groups were compared.Count data of the two groups' were compared by chi-square test,and measurement data were analyzed by t-test.Results In the FOLFOX4/6 group,153 patients (75 ％) completed 12 cycles of chemotherapy,and in the XELOX group,66 patients (80 ％) finished eight cycles of chemotherapy.There was no statistical difference in three-year DFS incidence (FOLFOX4/6 stage Ⅱ 87％,Ⅲ 82％; XELOX stage Ⅱ 83％,Ⅲ 80％) and three-year OS incidence (FOLFOX4/6 stage Ⅱ 92％,Ⅲ 88％; XELOX stage Ⅱ 89％,Ⅲ 86％) between two groups (all P＞0.05).There was no statistical difference in the incidence of common adverse reactions between FOLFOX4/6 and XELOX group (all P＞0.05).Adverse reactions of degree Ⅰ and Ⅱ were more common,while degree Ⅲ and Ⅳ were seldom.Of the adverse reactions of degree Ⅲ and Ⅳ,the incidence of neutropenia in patients of FOLFOX group was a little higher than in those of XELOX group,and the incidence of hand-foot syndrome was a litter higher in XELOX group than in FOLFOX group.However,there was no significant difference (x2 =0.060,0.928,both P＞0.05).Conclusion There was no statistical significance between FOLFOX4/6 and XELOX as postoperative auxiliary chemical therapy for advanced colorectal cancer,and both therapies possess good tolerance and safety.

Effects of the serum in shock rats and shenfu injection on the endothelial cell protein C receptor / 中华急诊医学杂志

Objective To investigate the effects of the serum from rats with hemorrhagic shock and Shenfu injection, on the expression of endothelial cell protein C receptor (EPCR) in human umbilical vein endothelial cells (HUVECs) cultured with rat serum. Method The soluble endothelial protein C receptor (sEPCR) in supernatant, the expression of EPCR mRNA and protein level of EPCR in HUVECs were detected by using enzyme linked immunosorbent assay ( ELISA), reverse transcription polymerase chain reaction (RT-PCR), and western bloting (WB) in normal control group, hemorrhagic shock serum (3 h, 12 h, 24h, 72 h) group, and Shenfu-treated (3 h, 12 h, 24 h, 72 h) group, respectively. Results The mean levels of sEPCR and the expression of EPCR mRNA were significantly higher in hemorrhagic shock serum (12 h, 24 h) group, and Shenfu -treated(24 h)group than those in normal control group (all P ＜0.01 ),the mean levels of sEPCR and the expressions of EPCR mRNA were significantly higher in Shenfu-treated ( 12 h) group than those in normal control group ( all P ＜0. 05 ), while the levels of protein were lower in hemorrhagic shock serum ( 12 h, 24 h) group and in Shenfu-treated(24 h)group than those in normal control group ( both P ＜0.01 ), and the level of EPCR protein was lower in Shenfu-treated( 12 h) group than that in normal control group ( P ＜ 0. 05) . The mean levels of sEPCR and the expressions of EPCR mRNA were significantly lower in Shenfu-treated ( 12 h, 24 h) group than those in hemorrhagic shock serum ( 12 h,24 h) group (all P ＜0.05), while the levels of EPCR protein were higher in Shenfu-treated ( 12 h, 24 h)group than those in hemorrhagic shock serum ( 12 h, 24 h) group ( P ＜ 0.05 ). Conclusions These data suggest that Shenfu injectio could affect the expression of EPCR mRNA and the level of EPCR protein, thereby it might be effective in prevention of development of hemorrhagic shock.

The application value of T-cell spot of tuberculosis test in differential diagnosis of Crohn's disease and intestinal tuberculosis / 中华消化杂志

Objective To evaluate the value of T-cell spot of tuberculosis test (T-spot.TB) in differential diagnosis of Crohn's disease and intestinal tuberculosis.Methods From May 2010 to October 2010,in Xijing hospital,Fourth Military Medical University,the peripheral blood samples of 126 patients were collected and peripheral blood mononuclear cells were isolated with density gradient centrifugation.T-spot.TB was conducted according to the kit instructions.The clinical diagnosis of Crohn's disease and intestinal tuberculosis was according to clinical manifestations, imaging,endoscopy,pathology,laboratory tests and on empirical anti-TB treatment response.The sensitivity and specificity of T-spot.TB in diagnosis of Crohn's disease and intestinal tuberculosis was analyzed.Results Fifteen patients were diagnosed as Crohn's disease (11.9％,15/126),14 patients were intestinal tuberculosis (11.1％,14/126) and 40 patients were extraintestinal tuberculosis (31.7％,40/126).The positive rate of T- spot.TB in Crohn's disease,intestinal tuberculosis,extra-intestinal tuberculosis and other diseases was 1/15,12/14,70％ (28/40) and 0％ (0/57),respectively.Thedifference between the groups was statistically significant (P =0.00).There was statistically significant difference of T-spot.TB positive rate between Crohn's disease and intestinal tuberculosis (x2 =70.58,P=0.00).The sensitivity and specificity of T- spot.TB in Crohn's disease detection was 93.3％(14/15) and 87.5％(14/16),in intestinal tuberculosis was 85.7％(12/14) and 93.3％ (14/15).The negatively predictive value of Crohn's disease was higher [87.5％ (14/16)] than that of intestinal tuberculosis [12.5％ (2/16)].Conclusion T-spot.TB is helpful for differential diagnosis of Crohn's disease and intestinal tuberculosis.

Triptolide downregulates Rac1 and the JAK/STAT3 pathway and inhibits colitis-related colon cancer progression

Triptolide, a diterpenoid triepoxide from the traditional Chinese medicinal herb Tripterygium wilfordii Hook. f., is a potential treatment for autoimmune diseases as well a possible anti-tumor agent. It inhibits proliferation of coloretal cancer cells in vitro and in vivo. In this study, its ability to block progress of colitis to colon cancer, and its molecular mechanism of action are investigated. A mouse model for colitis-induced colorectal cancer was used to test the effect of triptolide on cancer progression. Treatment of mice with triptolide decreased the incidence of colon cancer formation, and increased survival rate. Moreover, triptolide decreased the incidence of tumors in nude mice inoculated with cultured colon cancer cells dose-dependently. In vitro, triptolide inhibited the proliferation, migration and colony formation of colon cancer cells. Secretion of IL6 and levels of JAK1, IL6R and phosphorylated STAT3 were all reduced by triptolide treatment. Triptolide prohibited Rac1 activity and blocked cyclin D1 and CDK4 expression, leading to G1 arrest. Triptolide interrupted the IL6R-JAK/STAT pathway that is crucial for cell proliferation, survival, and inflammation. This suggests that triptolide might be a candidate for prevention of colitis induced colon cancer because it reduces inflammation and prevents tumor formation and development.

Effect of diterpenoid C from Radix Curcumae on proliferation of human gastric cancer cells SGC-7901 / 中华中医药杂志

Objective:To study the biological effects of new monomer 3 from Radix Curcumae on proliferation of human gastric cancer cells SGC-7901.Methods:Uing fluorescence microscope to observe the impact on SGC-7901 cells with different concentrations of the new monomer 3 at different times,using MTT assay to observe the growth inhibition rate of SGC-7901 cells,using flow cytometry to observe the apoptosis rate and cell cycle distribution of SGC-7901 cell.Results:Pronounced apoptosis had been found by fluorescence microscopy,apoptosis had a certain amount of time-dependent and concentration-dependent;Early apoptotic cells near normal morphology,normal nuclear morphology;late apoptotic cells'size shrink or round in shape,nuclear pyknosis or fragmentation.MTT method showed that the new monomer 3 had significantly inhibition on SGC-7901 cells,the half inhibition rate(IC50) was 30.14?g/mL.Flow cytometry(FCM) showed that:the new monomer 3 can increase the SGC-7901 cells in the S phase and G0/G1 and reduce it in G2/M.The change had time and concentration dependence;The apoptotic rates of dosing unit(24h,48h) compared with the control group had significant differences.The maximum apoptosis rate was 60.07%.Conclusion:The new monomer 3 inhibited human gastric cancer SGC-7901 cells significantly and had the impact on cell cycle distribution of the SGC-7901 cells and induction of apoptosis.