Progress in the relationship between intestinal fungal dysbiosis and digestive system tumors / 中华微生物学和免疫学杂志

Intestinal fungal dysbiosis is closely associated with the development and progression of many diseases including tumors. The disruption of fungal communities is involved in tumorigenesis and progression through inducing aberrant host immune responses and the production of certain metabolites as well as promoting the establishment of interactions with bacteria. Fungal dysbiosis is a potential marker for early detection of digestive tumors and a factor influencing the efficacy of tumor therapy. Studying the association between gut fungi and digestive tumors may facilitate the prevention, diagnosis and treatment of digestive tumors.

Guidelines for Diagnosis and Treatment of Chronic Gastritis in China (2022, Shanghai) / 胃肠病学

Chronic gastritis is a commonly seen disease; clinicians have always attached to the importance of understanding its etiology and clinical manifestations, standardizing its diagnosis and treatment, and preventing its progression to cancers. Based on the consensus opinions on the diagnosis and treatment of chronic gastritis in the past three editions, and referring to the international consensuses and guidelines on the management of precancerous lesions of gastric mucosa, it is of clinical value and feasibility to formulate the guidelines for the diagnosis and treatment of chronic gastritis in line with China′s national conditions. This guideline was initiated by Chinese Society of Gastroenterology, with major members of the Cancer Collaboration Group of Chinese Society of Gastroenterology serving as the convenors and authors. Based on the internationally accepted principles and methods of guideline development and the extensive collection of opinions from gastroenterologists and physicians, 53 evidence-based recommendations were given for nine major clinical problems related to chronic gastritis, aiming to improve the diagnosis, treatment and management of chronic gastritis.

Construction and application of inflammatory bowel disease cohort database / 胃肠病学

Under the organization of Renji Hospital, Shanghai Jiao Tong University School of Medicine, a specialized disease database of inflammatory bowel disease (IBD) cohort was deployed, and a brief introduction of the database was made in this article. The IBD data set was established by referring to domestic and foreign standards. Through data extraction, cleaning, normalization and other information processing technologies, data from multi‑source heterogeneous platform were arranged to form a specialized major disease database of IBD cohort and the efficiency and quality of data collection in clinical practice, teaching and scientific research were guaranteed. The display and personalized export capacities of the database can promote the researches on IBD and assist the clinical decision‑making. It provides not only efficient, comprehensive and reliable research‑level data support for scientific research, but also a precise guidance for diagnosis and treatment of the disease. Furthermore, it can excavate the potential clinical principles based on medical big data.

ZNF460 Mediates STAT3 Phosphorylation to Promote Progression of Hepatocellular Carcinoma by Activating ZDHHC7 Transcription / 胃肠病学

Background: ZNF460 is a member of the zinc finger protein family transcription factors, and is involved in the regulation of a variety of cellular functions. It has been demonstrated to be closely related to digestive system cancers. Aims: To analyze the expression level of ZNF460 in hepatocellular carcinoma (HCC), and explore the effect and potential mechanisms of ZNF460 on tumor cell proliferation. Methods: Immunohistochemical staining was used to determine the expression level of ZNF460 in tissue microarray of 76 HCC and paired adjacent tissues, and the correlation between ZNF460 expression and TNM staging was analyzed. The effect of ZNF460 on HCC cell proliferation was evaluated by CCK‑ 8 and colony formation assays. Genes positively related to ZNF460 expression in HCC were screened through LinkedOmics database, and the KEGG and GSEA pathway enrichment analyses were performed; the possible downstream molecules of ZNF460 were explored and verified by overexpression or knockdown of ZNF460 in HCC cells combined with luciferase reporter assay and other experiments. Results: ZNF460 was highly expressed in HCC and was positively correlated with TNM staging. ZNF460 promoted the proliferation of HCC cells, and the underlying mechanism might be associated with the transcriptional activation of ZDHHC7, the coding gene of palmitoyl transferase DHHC7 and the subsequent STAT3 palmitoylation and phosphorylation. Conclusions: ZNF460 is highly expressed in HCC and promotes cell proliferation and tumor progression via STAT3 activation. It might be a promising molecular marker and therapeutic target for HCC.

Berberine might block colorectal carcinogenesis by inhibiting the regulation of B-cell function by Veillonella parvula / 中华医学杂志(英文版)

BACKGROUND@#Colorectal carcinogenesis and progression are related to the gut microbiota and the tumor immune microenvironment. Our previous clinical trial demonstrated that berberine (BBR) hydrochloride might reduce the recurrence and canceration of colorectal adenoma (CRA). The present study aimed to further explore the mechanism of BBR in preventing colorectal cancer (CRC).@*METHODS@#We performed metagenomics sequencing on fecal specimens obtained from the BBR intervention trial, and the differential bacteria before and after medication were validated using quantitative polymerase chain reaction. We further performed ApcMin/+ animal intervention tests, RNA sequencing, flow cytometry, immunohistochemistry, and enzyme-linked immunosorbent assays.@*RESULTS@#The abundance of fecal Veillonella parvula ( V . parvula ) decreased significantly after BBR administration ( P = 0.0016) and increased through the development from CRA to CRC. Patients with CRC with a higher V. parvula abundance had worse tumor staging and a higher lymph node metastasis rate. The intestinal immune pathway of Immunoglobulin A production was activated, and the expression of TNFSF13B (Tumor necrosis factor superfamily 13b, encoding B lymphocyte stimulator [BLyS]), the representative gene of this pathway, and the genes encoding its receptors (interleukin-10 and transforming growth factor beta) were significantly upregulated. Animal experiments revealed that V. parvula promoted colorectal carcinogenesis and increased BLyS levels, while BBR reversed this effect.@*CONCLUSION@#BBR might inhibit V. parvula and further weaken the immunomodulatory effect of B cells induced by V. parvula , thereby blocking the development of colorectal tumors.@*TRIAL REGISTRAION@#ClinicalTrials.gov, No. NCT02226185.

Guidelines for Diagnosis and Treatment of Chronic Gastritis in China (2022, Shanghai) / 胃肠病学

Chronic gastritis is a commonly seen disease; clinicians have always attached to the importance of understanding its etiology and clinical manifestations, standardizing its diagnosis and treatment, and preventing its progression to cancers. Based on the consensus opinions on the diagnosis and treatment of chronic gastritis in the past three editions, and referring to the international consensuses and guidelines on the management of precancerous lesions of gastric mucosa, it is of clinical value and feasibility to formulate the guidelines for the diagnosis and treatment of chronic gastritis in line with China’s national conditions. This guideline was initiated by Chinese Society of Gastroenterology, with major members of the Cancer Collaboration Group of Chinese Society of Gastroenterology serving as the convenors and authors. Based on the internationally accepted principles and methods of guideline development and the extensive collection of opinions from gastroenterologists and physicians, 53 evidence⁃based recommendations were given for nine major clinical problems related to chronic gastritis, aiming to improve the diagnosis, treatment and management of chronic gastritis.

Advances in Research on Risk Factors for Early-onset Colorectal Cancer / 胃肠病学

The incidence and mortality of early-onset colorectal cancer (EOCRC) are increasing worldwide and have become a major issue in the field of public health. Dietary, environment and lifestyle factors are related to the incidence of EOCRC, and gut microbiota may play an important role in the development of EOCRC. This article reviewed the risk factors of EOCRC, the potential relationship between gut microbiota and EOCRC, and the prevention of EOCRC, which may provide new ideas for the prevention and treatment of EOCRC.

Progress in Research on Relationship Between Wnt Signaling Pathway and Occurrence, Development of Gastric Cancer / 胃肠病学

For global perspective, gastric cancer has a high incidence and mortality, and becomes one of the important issues affecting human health. Studies indicate that the activation and inhibition of Wnt signaling pathway are closely related to the occurrence and development of gastric cancer, and Wnt signaling pathway is affected by many factors. Study on the relationship between Wnt signaling pathway and the occurrence and development of gastric cancer is helpful to provide enlightenments for the study on prevention and treatment of gastric cancer. This article reviewed the progress in research on relationship between Wnt signaling pathway and occurrence, development of gastric cancer.

Clinical Application of Transparent Cap in Retrograde Single-balloon Enteroscopy / 胃肠病学

Background: Enteroscopy-based biopsy pathology has high diagnostic value for suspected small bowel diseases. Retrograde single-balloon enteroscopy (SBE) is difficult to operate due to the influence of colonic segment. Transparent cap has been widely used in the diagnostic and therapeutic endoscopic procedure, which is conducive for inserting the enteroscope and stabilizing the intestinal cavity. Aims: To explore the role of transparent cap in retrograde SBE. Methods: A total of 64 cases of patients who were hospitalized for retrograde SBE in Suzhou Wuzhong People's Hospital were recruited and allocated into 2 groups according to the random number table method, with 32 cases in each group. Patients in experimental group received cap-assisted SBE and those in control group received routine SBE. All procedures were performed by an experienced senior endoscopist. Outcomes measured included time to reach the ileocecus, terminal ileum intubation rate, depth of insertion, diagnostic yield, and the related complications. Results: The mean time to reach the ileocecus was shorter in experimental group than in control group [(11.8±2.0) min vs. (13.6±2.8) min, P0.05). No severe complications were observed in all the cases. Conclusions: Cap-assisted retrograde SBE is an efficient method for optimizing the intubation rate, insertion depth and procedure time, and is suitable for promotion in clinical practice.

Exploration and practice of integrated digestive system course for medical students / 中华医学教育探索杂志

Integrated medical curriculums are becoming more and more popular in medical colleges at home and abroad. In this article, the methods and teaching of integrated digestive system course at Shanghai Jiao Tong University School of Medicine was thoroughly introduced from the theoretical course, PBL course, trainee course, assessment method and effect evaluation. The successful experience of practice of the integrated digestive system curriculum was summarized as follow: strong guarantee from systems, adequate reserves of teaching faculty and good mechanism of feedback. Also, the problems in the practice of the curriculum were presented, which include the shortage of corresponding textbook and of deep running-in between teachers.

Effect of DHPS on Metastasis of Gastric Cancer and its Possible Mechanism / 胃肠病学

Background:Deoxyhypusine synthase(DHPS)is a key factor in post-translational modification of the precursor of eukaryotic initiation factor 5A(eIF-5A),and eIF-5A is closely related to the regulation of proliferation and invasion of tumor cells. Aims:To investigate the expression of DHPS in gastric cancer and its clinical significance,and to explore the possible mechanism of its effect on metastasis of gastric cancer. Methods:Tissue microarray containing 92 gastric cancer tissues and paired adjacent cancerous tissues was employed to detect the DHPS expression by using immunohistochemical staining,and the correlation of DHPS expression with the clinicopathological characteristics of gastric cancer was analyzed. DHPS-siRNA and GC7,an inhibitor of DHPS were used,respectively to intervene human gastric cancer cell line MGC803. The invasive ability of MGC803 cells was assessed by cell invasion assay,and the expressions of metastasis-related proteins including vascular endothelial growth factor(VEGF),matrix metalloproteinase 2(MMP2)and MMP9 were detected by ELISA. Results:In 62(67.4%)cases of gastric cancer,DHPS was highly expressed,and its expression was closely related to tumor diameter,TNM stage and depth of invasion(P <0.05),but not related to gender,age,lymph node metastasis and distant metastasis(P >0. 05). Both DHPS-siRNA and GC7 could down-regulate the invasiveness of MGC803 cells,while the former could also reduce the expressions of VEGF,MMP2 and MMP9 proteins(P <0.05). Conclusions:DHPS is highly expressed in gastric cancer and associated with tumor invasion and progression. DHPS is expected to be a new target for diagnosis and treatment of gastric cancer because of its regulatory effect on invasion and metastasis of tumor cells.

Attention Should be Paid to Studies on Prophylaxis of Colorectal Cancer via Intervention on Environmental ;Factors / 胃肠病学

Most colorectal cancers develop from adenomas. Environmental factors play an important role in the development and progression of adenoma. Recently,epidemiologic investigations on lifestyle change including diet and exercise and drug intervention studies have proved the relationship between environmental factors and colorectal cancer. Screening,polypectomy and surveillance via colonoscopy are the main measures of colorectal cancer prevention. However, the efficacy is unsatisfactory. Therefore,attention should be paid to studies on colorectal cancer prophylaxis via intervention on environmental factors. Emphasis should be put on various aspects of environmental intervention in clinical practice,and prophylaxis strategies should be generated individually in accordance with the local condition and situation.

Expression and Clinical Significance of TRIM55 in Colorectal Cancer / 胃肠病学

TRIM55 is a member of TRIM family.Most TRIM proteins, which can be defined as E3 ubiquitin ligase because of the RING-finger domain, are closely related with the initiation and progression of cancer.Aims: To study the expression and clinical significance of TRIM55 in colorectal cancer, and explore the potential mechanism of TRIM55 in colorectal cancer.Methods: Seventy colorectal cancer tissues and corresponding paracancerous tissues taken from colorectal cancer patients from October 2014 to December 2015 at Shanghai Ren Ji Hospital were enrolled.Real-time PCR was performed to examine the expression of TRIM55.Human colorectal cancer cell line HCT116 was transfected with TRIM55 small interfering RNA (siRNA), cell proliferation was measured by CCK-8 assay, Western blotting was implemented to determine the protein expressions of TRIM55 and SOCS1.Results: The expression of TRIM55 was significantly increased in 49 colorectal cancer tissues than in corresponding paracancerous tissues.Increased expression of TRIM55 was closely correlated with tumor differentiation (P=0.032), AJCC staging (P=0.001) and lymph node metastasis (P=0.001), but not related to gender, age, tumor size, invasion depth, distant metastasis and vascular invasion (P>0.05).After transfection with TRIM55 siRNA, mRNA and protein expressions of TRIM55 were significantly decreased (P<0.01), proliferation of HCT116 cells was significantly decreased (P<0.01), and protein expression of SOCS1 was significantly increased (P<0.01).Conclusions: E3 ubiquitin ligase TRIM55 may promote the proliferation of colorectal cancer cells via influencing the expression of SOCS1, thus promoting the progression of colorectal cancer.This indicates that detection of TRIM55 expression may provide a new approach for diagnosis and therapy of colorectal cancer.

Research on similarities and differences of colorectal cancer epigenetic modiifcations in the Eastern and Western population / 中国癌症杂志

Colorectal cancer remains a major threat to people’s health around the world. Researchers have paid more and more attention to colorectal cancer epigenetics. From two main aspects of colorectal cancer epigenetics: DNA methylation and histone modiifcation, this article analyzes the similarities and differences between patients with colorectal cancer in Eastern and Western countries. This review brielfy introduces epigenetic modiifcation of genes that were used to be biomarkers and therapeutic targets. Although there are some common features of colorectal cancer in the world, analysis has showed that some obvious epigenetic differences do exist in different races. For example, it had been conifrmed in the studies that there are differences in speciifc gene methylation, histone modiifcation sites and the degree of methylation and acetylation among countries, which provide the basis for speciifc diagnosis, treatment and prognosis of colorectal cancer in different ethnic groups. With improved research methods and increased sample size, more and more special molecular targets of colorectal cancer tissues will be found, and then personalized therapy for colorectal cancer can be achieved.

Relationship between genetic variants in the Toll-like receptor pathway genes and susceptibility of gastric cancer and esophageal squamous cell carcinoma / 中华消化杂志

Objective To investigate the relationship between genetic variants in the Toll-like receptor (TLR) pathway genes and susceptibility of gastric cancer (GC) and esophageal squamous cell carcinoma (ESCC).Methods The data of whole genome association studies of the high-risk population of GC and ESCC in China were analyzed by adaptive rank-truncated product (ARTP) method in pathway and gene level.The associations between single nucleotide polymorphism (SNP) and susceptibility of GC and ESCC were analyzed with additive model of unconditional Logistic regressions.PLINK 1.07 and SPSS 19.0 software were performed for statistical analyses,and ARTP package in R3.0.2 was used for pathway and gene level analysis.Results In gene-level analyses,eight genes were found to be associated with susceptibility of GC (P ＜0.05) and six genes were associated with susceptibility of ESCC (P ＜ 0.05).In single SNP-level analyses,21 SNPs were statistically correlated with susceptibility of GC (P ＜ 0.01),and 11 SNPs were statistically correlated with susceptibility of ESCC (P ＜0.01).Conclusions Some genetic variants in TLR pathway are associated with risk of GC and ESCC.The potential molecular mechanisms need further investigation.

Multicenter clinical study of compound azintamide enteric-coated tablets in the treatment of 240 patients with dyspepsia after gastrointestinal surgery / 中华消化杂志

Objective To explore the efficacy and safety of compound azintamide enteric‐coated tablets in the treatment of patients with dyspepsia after gastrointestinal surgery .Methods Multicenter , randomized ,double blind ,placebo‐controlled ,parallel controlled method w as applied .From January 2011 to January 2013 , of 240 patients with dyspepsia after gastrointestinal surgery from 12 hospitals in Shanghai were enrolled and divided into medicine treatment group (n= 120) and placebo control group (n= 120 ) ,received compound azintamide enteric‐coated tablets or placebo , respectively . Compound azintamide enteric‐coated tablet (100 mg) or placebo was oral taken each time ,three times per day for four weeks .Total and respective score of dyspeptic symptoms (abdominal distension ,loss of appetite ,early satiety ,belching ,nausea ,abdominal pain or abdominal discomfort) were evaluated prior to study and on the 1st , 2nd , 3rd and 4th week after treatment . On the 4th week after treatment ,the efficacy of the improvement of dyspeptic symptoms was compared between the two groups ,and the safety was also evaluated .The score of the quality‐of‐life was compared between the two groups prior to study and on the 4thweek after treatment .The t‐test was performed for comparison between measurement data ,Chi‐square test was used for count data ,and rank sum test was used for rank data .Results At one week after treatment ,the scores of abdominal distension (4 .61 ± 0 .98 ) ,early satiety (2 .87 ± 0 .64 ) ,belching (3 .03 ± 0 .58) ,abdominal pain or abdominal discomfort (3 .13 ± 0 .79) and total score (18 .32 ± 3 .44) of patients in medicine treatment group were significantly lower than those of placebo control group (8 .83 ± 1 .28、4 .28 ± 0 .61、4 .87 ± 1 .07、5 .46 ± 0 .87、29 .63 ± 5 .50) ,and the differences were statistically significant (t=28 .524、17 .400、16 .453、21 .619 and 18 .983 ,all P 0 .05) .At 2nd ,3rd and 4th week after treatment ,respective score of dyspeptic symptoms and total score of medicine treatment group (2nd week:2.57±1.28,1.87±1.17,1.55±1.27,1.55±1.08,1.09±0.82,1.98±1.02,10.53±4.54,3rdweek:1 .42 ± 0 .60 ,1 .11 ± 0 .45 ,0 .94 ± 0 .37 ,0 .94 ± 0 .41 ,0 .79 ± 0 .31 ,1 .42 ± 0 .55 ,6 .52 ± 2 .41 ,4th w eek:1.13±0.51,0.46±0.12,0.58±0.13,0.38±0.16,0.30±0.07,0.81±0.33,3.65±1.06)wereall significantly lower than those of placebo control group (2nd week:8 .50 ± 2 .61 ,3 .78 ± 2 .01 ,4 .08 ± 2 .14 , 4.73±2.64,2.27±2.13,4.91±2.24,28.25±8.86,3rdweek:7.92±2.51,3.68±1.76,4.08±1.86, 4.71±1.77,2.14±0.83,5.01±1.31,27.54±8.09,4th week:7.63±2.37,3.67±1.63,3.92±2.08, 4 .66 ± 2 .95 ,2 .14 ± 1 .65 ,4 .67 ± 2 .34 ,and 26 .68 ± 7 .45) ,and the differences were statistically significant (all t=0 .000 ,all P<0 .01) .At 4th week after treatment ,the total efficacy of total score improvement of dyspepsia symptoms in medicine treatment group was 86 .21% (100/116) ,which was significantly better than that of placebo control group (39 .16% (47/120)) ,and the difference was statistically significant (Z=9 .464 ,P<0 .01) .The total score of quality of life in medicine treatment group was significantly lower than that of placebo control group (12 .24 ± 4 .30 and 22 .13 ± 6 .18) ,and the difference was statistically significant (t=14 .225 , P< 0 .01 ) .No adverse events was observed in both groups during treatment period . Conclusion Compound azintamide enteric‐coated tablets may effectively improve dyspeptic symptoms and quality of life in patients with dyspepsia after gastrointestinal surgery ,and with good safety .

ZEB1-mediated EZH2 overexpression promotes induction of autophagy via PTEN in colorectal cancer / 重庆医学

Objective To investigate whether EZH2 participates in the process of authphagy and its regulatory mechanism in CRC (colorectal cancer) .Methods ZEB1 ,EZH2 and PTEN expression were measured by Western blot and immunohistochemistry respectively .ZEB1 ,EZH2 and PTEN mRNA level were measured by real-time PCR .Electron microscopy was introduced to validate the existence of autophagy .Results Knockdown of EZH2 induced the formation of autophagosome in colorectal cancer cell lines , which was evident on electron microscopy .Furthermore ,Western Blot and real-time PCR data showed that ZEB1 and EZH2 may regulate the expression of PTEN ,which played a vital role in autophagy .Moreover ,downregulation of ZEB1 significantly reduced the expression of EZH2 .An inverse correlation between the expression of EZH2 and ZEB1 ,and the expression of PTEN was also revealed in CRC tissues ,when compared with normal tissue in patients .Conclusion The impact of EZH2 on autophagy via PTEN during CRC carcinogenesis is revealed .At the same time ,EZH2 expression may be regulated by ZEB1 in colorectal cancer .

Efficacy and safety of compound azintamide enteric-coated tablet in the treatment of patients with post-cholecystectomy dyspepsia:a randomized, double-blinded, placebo controlled multicentre clinical trial / 中华消化杂志

Objective To evaluate the efficacy and safety of compound azintamide enteric-coated tablet in the treatment of patients with post-cholecystectomy dyspepsia.Methods A multicentre,randomized,double-blinded,placebo-controlled trail was conducted.A total of 120 patients with post-cholecystectomy dyspepsia were divided into azintamide group (n=60) and placebo group (n＝60),taking compound azintamide enteric-coated tablet or placebo 100 mg each time,three times per day for 28 days.The score of each dyspeptic symptom (abdominal distension,loss of appetite,early satiety,belching,nausea,abdominal pain or abdominal discomfort) and total score of dyspepsia were evaluated prior to study and on the 7th,14th,21st and 28th day after treatment.The efficacy of the improvement of dyspeptic symptoms was compared between the two groups on the 28th day after treatment and the safety was evaluated.The score of the quality-of-life was compared between the two groups prior to study and on the 28th day after treatment.The t-test or chi-square test was performed for statistical analysis.Results The scores of abdominal distension,belching,nausea,abdominal pain or abdominal discomfort and the total score of azintamide group on the 7th day after treatment (5.7±3.1,3.5±2.1,0.3±0.1,3.3±1.7 and 17.9±9.6) were significantly lower than those prior to study (8.9±5.3,5.3±2.5,0.9±0.4,4.5±3.7,24.3±14.5;t=3.758,3.976,10.494,2.125 and 2.654,allP＜0.05).On the14th,21st and28thday after treatment in azintamide group,the score of each dyspeptic symptom and the total score were lower than those prior to study.The symptom of abdominal distension significantly improved on the 7th,14th,21st and 28th day after treatment in placebo group,and the score of early satiety and total score of dyspepsia were significantly lower on the 28th day after treatment compared with those before treatment.In azintamide group,the total efficacy rate was 66.7％ (40/60),which was higher than that of placebo group (38.3％,23/60) and the difference was statistically significant (x2 =9.653,P ＜ 0.01).On the 28th day after treatment,SF-NDI of azintamide group was 4.4±3.4,which was significantly lower than that of placebo group (9.6±6.0) and the difference was statistically significant (t=5.450,P＜0.01).In azintamide group there was one patient with rash on the 7th day after treatment,and in placebo group there was one patient with headache on the 14th day after treatment.The symptoms disappeared seven days after medicine withdrawal.Conclusion Compound azintamide enteric-coated tablet effectively improves dyspeptic symptoms and quality of life in patients with post-cholecysteetomy dyspepsia and has good safety.

Activation and its clinical significance of the mammalian target of rapamycin pathway and its downstream proteins in gastric cancer / 中华消化杂志

Objective To investigate the activation and clinical significance of the mammalian target of rapamycin (mTOR) pathway related protein and eukaryotic translation factor 4E-binding protein 1 (4E-BP1) in gastric cancer.Methods The activation of mTOR and 4E-BP1 in gastric cancer tissues of 38 surgical patients were detected by immunohistochemical method.The differences of phosphorylated mTOR and 4E-BP1 expression among cancerous tissues,para-cancerous tissues and normal gastric mucosa tissues and dinicopathological variables were analyzed by Chi square test and Kruskal-Wallis test.Results The positive expression rate of phosphorylated mTOR in the gastric cancerous tissues was significantly higher than that of para-cancerous tissues and normal tissues [71.1％ (27/38),50.0 ％ (19/38) and 44.7 ％ (17/38),x2 =11.031,P =0.026].The positive expression rate of downstream protein 4E-BP1 in the gastric cancer tissues was also significantly higher than that of paracancerous tissues and normal tissues [68.4％(26/38),57.9％(22/38) and 28.9％ (11/38),x2 =13.943,P=0.007].There was no correlation between phosphorylated mTOR and 4E-BP1 expression and tumor Lauren's sub-type,infiltration,differentiation degree,lymph node metastasis and patient's age.There was statistical significant difference between activated 4E-BP1 expression and tumor size in gastric cancer (H=3.86,P＜0.05).Conclsions mTOR pathway was over activated in gastric cancer.There was difference between phosphorylation degree of its downstream protein 4E-BP1 and the tumor size.

How to be a qualified PBL tutor / 中华医学教育探索杂志

Problem-based learning has gradually become an important pedagogical tool in the medical curriculum.Behaviors of PBL tutor play an unique role in teaching.A good PBL tutor must consider the following issues:ample preparing before class,awareness of learning outside the tutorial room,social congruence,dealing with the difficult student and dysfunctional group,sharing the PBL experience and seeking support or advice from peers.