A clinical study of endoscopic histoacryl injection for newly-developed esophagogastric varices in cirrhotic patients undergoing splenectomy combined with pericardial devascularization / 中华消化内镜杂志

Objective:To investigate the efficacy of endoscopic histoacryl injection in cirrhotic patients with newly-developed esophagogastric varices (EGV) who have previously undergone splenectomy combined with pericardial devascularization.Methods:From January 2015 to January 2020, 125 cirrhotic patients with EGV treated with endoscopic histoacryl injection at the Department of Gastroenterology, Jinling Hospital, Medical School of Nanjing University, were included in the retrospective analysis. There were 45 patients in the group of splenectomy combined with pericardial devascularization (splenectomy group for short) and 80 patients in the non-splenectomy group. The efficacy of endoscopic treatment, postoperative variceal improvement, rebleeding rate, and complications were analyzed between the two groups.Results:Endoscopic histoacryl injection was successfully completed in all 125 patients, and the median volume of histoacryl was 4.5 mL. The overall effective rate in splenectomy and non-splenectomy group was 80.0% (36/45) and 57.5% (46/80), respectively. The difference in the number of significantly effective, effective, and ineffective cases between the two groups was statistically significant (16, 20, 9 cases, and 20, 26, 34 cases, respectively, χ 2=6.469, P=0.039). Two and 14 patients developed rebleeding in the splenectomy group and non-splenectomy group, respectively; and the difference in the rebleeding rate between the two groups was statistically significant (4.4% VS 17.5%, Log-rank P=0.039). No patient died within 1 year in either group, and no serious complications such as ectopic embolism occurred. Conclusion:After splenectomy combined with pericardial devascularization in cirrhotic patients with EGV and hypersplenism, the application of histoacryl has better short-term efficacy and can significantly reduce the rebleeding rate compared with the non-splenectomy group.

Resolving the lineage relationship between malignant cells and vascular cells in glioblastomas

Glioblastoma multiforme (GBM), a highly malignant and heterogeneous brain tumor, contains various types of tumor and non-tumor cells. Whether GBM cells can trans-differentiate into non-neural cell types, including mural cells or endothelial cells (ECs), to support tumor growth and invasion remains controversial. Here we generated two genetic GBM models de novo in immunocompetent mouse brains, mimicking essential pathological and molecular features of human GBMs. Lineage-tracing and transplantation studies demonstrated that, although blood vessels in GBM brains underwent drastic remodeling, evidence of trans-differentiation of GBM cells into vascular cells was barely detected. Intriguingly, GBM cells could promiscuously express markers for mural cells during gliomagenesis. Furthermore, single-cell RNA sequencing showed that patterns of copy number variations (CNVs) of mural cells and ECs were distinct from those of GBM cells, indicating discrete origins of GBM cells and vascular components. Importantly, single-cell CNV analysis of human GBM specimens also suggested that GBM cells and vascular cells are likely separate lineages. Rather than expansion owing to trans-differentiation, vascular cell expanded by proliferation during tumorigenesis. Therefore, cross-lineage trans-differentiation of GBM cells is very unlikely to occur during gliomagenesis. Our findings advance understanding of cell lineage dynamics during gliomagenesis, and have implications for targeted treatment of GBMs.

Distribution of food specific antibodies in patients with inflammatory bowel disease / 中华消化杂志

Objective To investigate the incidence of food intolerance in patients with inflammatory bowel disease (IBD) and to analyze the differential diagnostic value of intolerant food in Crohn 's disease (CD) and ulcerative colitis (UC) and its effects on the diseases.Methods From January 2017 to June 2018, at Department of Gastroenterology and Hepatology , Jinling Hospital, Medical School of Nanjing University /General Hospital of Eastern Theater Command , PLA, a total of 252 IBD (154 CD and 98 UC) patients were enrolled. In the same period 46 non-IBD patients were recruited.Allergic diseases were excluded.The food-specific IgG antibodies were detected by enzyme linked immunosorbent assay (ELISA) in all enrolled patients.The chi-square test, Kruskal-Wallis test and Spearman correlation analysis were performed for statistical analysis . Regression analysis was used to screen the risk factors .Results The total positive rates of serum IgG antibody of corn, rice, soybean, tomato and wheat in CD patients were 60.4％ (93 /154), 57.8％ (89 /154), 42.9％(66 /154), 68.2％ (105 /154) and 19.5％ (30 /154),respectively, which were higher than those in patients with UC (7.1％, 7 /98; 5.1％, 5 /98; 5.1％,5 /98; 16.3％, 16 /98 and 3.1％, 3 /98, respectively) and those of non-IBD patients (2.2％,1 /46; 2.2％,1/46; 0,0 /46; 0,0 /46 and 0,0/46, respectively), and the differences were statistically significant (χ2 =70.940,71.092,42.185,64.517,14.187;48.190,44.270, 29.424,66.029,10.542; all P <0.01).The total number of positive food related IgG antibodies had strong ability to discriminate CD, UC from non-IBD, the value of area under the curve (AUC) was 0.815 (95％confidence interval (CI) 0.762 to 0.869, P <0.01)and 0.824(95％CI 0.767 to 0.880,P <0.01).There was no correlation between the total number of IgG positive food and age in CD patients (P >0.05) and there was a negative correlation between the total number of IgG positive food and age in UC patients (rs =-0.376, P <0.01).The median number of total IgG positive food of patients with lesions involving the terminal ileum (L1) and ileocolon (L3) was two and four, respectively, and the difference was statistically significant (the statistic was 11.717,P =0.002).The median number of total IgG positive food of UC patients with rectal lesions (E1) and extensive colon lesions (E3) was zero and one, respectively, and the difference was statistically significant (the statistic was 7.191,P =0.022).In addition, positive IgG shrimp and soybean were risk factors of CD patients combined with extra-intestinal manifestations and low body mass index (odd ratio (OR) =24.558, 95％CI 2.243 to 268.936; OR =2.253, 95％ CI 1.048 to 4.841; both P <0.05, respectively ). Conclusions CD patients are more susceptible to food intolerance .The number of intolerant foods have differential diagnostic value in CD, UC and non-IBD.The larger the lesion of IBD patients, the more common the food intolerance.IgG antibody positive food positive, may affect extra-intestinal manifestations and nutritional status of CD patients .

Inflammatory bowel disease with thrombosis: a single center retrospective study / 中华消化杂志

Objective To analyze the clinical features and clinical significance of patients with inflammatory bowel disease (IBD) complicated by thrombosis.Methods From March 14th,2001 to February sixth 2017,at Nanjing General Hospital of Nanjing Military Command,27 IBD patients with thrombosis diagnosed by clinical symptoms,endoscopy,imaging and pathology were enrolled.During the same period,81 gender and age matched IBD patients without thrombosis were included in the control group.The basic data,information of IBD diagnosis and treatment and thrombotic events of patients were collected and analyzed.T-test and Chi-square test were performed for statistical analysis.Binary logistics regression was used for risk factors analysis.Results The mean age of diagnosis of IBD patients with thrombosis was (44.8 ± 15.8) years,which was higher than that of the IBD patients of control group ((36.0 ± 14.4) years),and the difference was statistically significant (t =2.69,P =0.008).Among 27 IBD patients with thrombosis,arterial thrombosis was 51.9％ (14/27),deep venous thrombosis of the lower extremity veins was 29.6％ (8/27),portal venous system involved was 11.1％ (3/27),pulmonary embolism was 3.7％ (1/27) and disseminated intravascular coagulation accounted for 7.4％ (2/27).Nine patients (33.3％,9/27) underwent surgery six months before the diagnosis of thrombosis.The results of binary logistic regression indicated that the age of diagnosis and vascular catheterization were independent risk factors for thrombosis in IBD patients (odds ratio (OR) =1.04,95％ confidence interval (CI) 1.01 to 1.07,P=0.01;0R=5.64,95％ CI 1.39 to 22.96,P=0.02).After medicine treatment or surgery,81.5％ (22/27) of the patients improved,9.1％ (2/22) were worse and 13.6％ (3/22) died.Conclusion Screening and prevention of thrombosis should be paid attention in IBD patients with a history of vascular catheterization,at active phase and older age when diagnosed.

Analysis of Correlation Between Nonalcoholic Fatty Liver Disease and Colorectal Polyps / 胃肠病学

Background:Nonalcoholic fatty liver disease(NAFLD)is the liver manifestation of metabolic syndrome,and may be related with the incidence of colorectal polyps. However,studies on the correlation between NAFLD and colorectal polyps are rare. Aims:To investigate the correlation between NAFLD and colorectal polyps. Methods:Clinical data of 130 asymptomatic patients accepted physical examination were retrospectively analyzed. Detection rates of NAFLD and colorectal polyps were evaluated,and the correlations with body mass index(BMI),hs-CRP,triglyceride,low density lipoprotein,total cholesterol,alanine aminotransferase(ALT),glutamyltranspeptidase(GGT)were analyzed. Results:Compared with non-NAFLD patients,the detection rate of colorectal polyps in NAFLD patients was significantly increased (66.3% vs. 40.0%,P=0.003 9),BMI,triglyceride and ALT were significantly increased(P<0.05). However,no significant differences in hs-CRP,low density lipoprotein,total cholesterol and GGT were found between NAFLD and non-NAFLD patients. Compared with non-colorectal polyps patients,the average age of patients with colorectal polyps was higher(P =0.013),and detection rate of NAFLD was significantly increased(72.6% vs. 47.4%,P =0.003 9). However,no significant differences in BMI,hs-CRP,triglyceride,low density lipoprotein,total cholesterol,ALT,GGT were found between colorectal polyps group and non-colorectal polyps group(P>0.05). Conclusions:NAFLD may be closely correlated with the incidence of colorectal polyps.

Pellagra affecting a patient with Crohn's disease

Abstract: Pellagra is a nutritional disease caused by a deficiency of niacin. It may lead to death if not identified and treated timely. We review the literature and report a female patient presented with clinical features of pellagra as a complication of Crohn's disease.

Correlation between Simplified Endoscopic Score for Crohn's Disease (SES-CD) and Clinical and Laboratory Markers in Patients with Crohn's Disease / 胃肠病学

Endoscopic activity has been used as an endpoint in treatment of Crohn's disease (CD).Simplified Endoscopic Score for Crohn's Disease (SES-CD) is a simple and easy-to-use endoscopic scoring system for CD, however, studies evaluating the correlation between SES-CD and noninvasive inflammatory markers are scarce.Aims: To investigate the correlation between SES-CD and clinical and laboratory inflammatory markers for identifying a noninvasive surrogate marker for endoscopic activity of CD.Methods: Forty-two patients with CD were enrolled for detecting laboratory inflammatory markers including leukocyte and platelet count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), hemoglobin (Hb), albumin (Alb) and fecal calprotectin (FC);SES-CD and Crohn' disease activity index (CDAI) were assessed.Predictive performance of these markers for endoscopic activity of CD was analyzed by ROC curve, and the correlation of SES-CD with all these markers was evaluated.Results: The platelet count, CRP, ESR, FC and SES-CD were significantly higher in active CD than in inactive CD, while Hb and Alb were significantly lower in active CD (P all <0.05).In all the noninvasive markers, only CDAI and FC had an area under the curve (AUC) greater than 0.9 for predicting CD endoscopic activity.Taken 150 as the cut-off value of CDAI and 50 μg/g (the upper limit of normal, ULN) as the cut-off value of FC, the sensitivity of CDAI and FC were 58.8% and 100%, and the specificity were 100% and 60.0%, respectively.SES-CD had moderate correlation with CDAI, platelet count, CRP, ESR, Alb and FC, respectively (P all <0.05).Conclusions: SES-CD is correlated moderately with the clinical and laboratory inflammatory markers, however, when taken the ULN as cut-off value the conventional inflammatory markers such as CDAI, CRP and ESR are hard to predict sensitively and accurately the endoscopic activity of CD;while FC has fairly high accuracy and sensitivity and can be used as a noninvasive surrogate marker for evaluating endoscopic activity of CD.

Effect of alprostadil on early proinflammatory cytokines and its therapeutic effect in patients with severe acute pancreatitis / 解放军医学杂志

Objective To investigate the effects of alprostadil on expression of proinflammatory cytokines in patients with severe acute pancreatitis (SAP) and evaluate the clinical efficacy.Methods Seventy-three SAP patients were collected from January 2014 to May 2016,and then were randomly divided into control group (n=37) and experimental group (n=36).On the basis of routine treatment,the experimental group patient was given alprostadil at a dose of 15μg/d.The expression of C-reactive protein (CRP),white blood cell (WBC) count,amylase,alanine aminotransferase (ALT),aspartate aminotransferase (AST),creatinine,serum proinflammatory cytokine tumor necrosis factor alpha (TNF-α),interleukin-1 beta (IL-1[β),interleukin-6 (IL-6) were detected in serum on the 1st,3rd and 7th day.Results The biochemical indexes and expression ofproinflammatory cytokines were significantly increased in the two groups on the 1st day,and decreased gradually,with a significant difference between the time points (P＜0.05),but the between-group difference was not significant (P＞0.05).These indexes were decreased significantly with the passage of time and there were significant differences between the two groups at the 3rd and 7th day (P＜0.05).Conclusion Alprostadil can effectively reduce the severity of early inflammatory reaction in SAP patients,and has important significance for improving the prognosis.

Analysis of Mid-and-Long Term Efficacy of Peroral Endoscopic Myotomy for Esophageal Achalasia / 胃肠病学

Background:Peroral endoscopic myotomy(POEM)is a novel minimally invasive endoscopic technique for treatment of esophageal achalasia(EA). It has been demonstrated to be safe and effective in several short-term clinical studies, however,studies focusing on its mid- and long-term outcome are rare. Aims:To investigate the mid-and-long term efficacy of POEM in EA patients. Methods:A retrospective analysis was performed in 41 EA patients who underwent POEM in the Department of Gastroenterology and Hepatology of Nanjing General Hospital of Nanjing Military Region from Jul. 2012 to Dec. 2013. All these patients were followed up periodically for clinical symptoms(Eckardt score),maximum esophageal diameter and lower esophageal sphincter pressure(LESP),and the intra- and post-operative complications and recurrence were recorded. Results:POEM was successfully completed in all 41 EA patients,the mean operative time was(69. 5 ± 20. 6)min(range 35-125 min),and the mean length of hospital stay was 3. 5 days. Compared with the pre-operative data,the post-operative Eckardt score,maximum esophageal diameter and LESP during follow-up(mean 26. 3 months, range 19-36 months)were significantly decreased(P all < 0. 05). Procedure-related complications were seen in 6 patients (14. 6% );the clinical success rate was 95. 1%(39 / 41)and the recurrence rate was 2. 4%(1 / 41). Conclusions:POEM is safe and effective in mid-and-long term follow-up with low recurrence rate. It might become the first-line therapy for EA,and the long-term efficacy and complications need further follow-up study.

Clinical diagnostic value of fecal neopterin and calprotectin on the activity of inflammatory bowel disease / 医学研究生学报

Objective Fecal biomarkers have emerged as an important tool for assessing and monitoring disease activity in patients with inflammatory bowel disease ( IBD) .We aimed to investigate the diagnostic value of fecal neopterin and calprotectin in pa-tients with active inflammatory bowel disease and made comparison with that of serum C-reactive protein ( CRP) . Methods A total of 151 consecutive patients with IBD (84 CD and 67 UC) provided 2 gram fecal samples for the measurement of fecal neopterin( FNP) and calprotectin( FCP) concentrations and 2 milliliter blood samples for the serum C-reactive protein measurement before undergoing a colonoscopy.ELISA was applied in the measurement.Clinical disease activities were scored independently according to the Best Crohn′s Disease Activity Index(CDAI) in patients with CD, while the Modi-fied Mayo Scores in patients with UC.Comaprison was made in the relativity of each fecal marker and IBD activity score, the optimum value of diagnosing IBD acitivity as to each fecal marker, as well as sensitivity, specificity, moreover, receiver operating characteristic curve ( ROC) was drawn.50 healthy volunteers who received a normal colonoscopy were also enrolled as the control group and asked to give a 2 gram fresh stool sample. Results The FNP and FCP concentrations in patients with IBD were significantly higher than those in healthy control group(P<0.05).Both FNP and FCP concentrations differed significantly in clinically active IBD when compared with those in patients with inactive disease( P<0.001) .In CD patients, the correlation coefficients of FNP and FCP with CDAI were 0.55 and 0.59, respectively(P<0.001).In UC patients, the correlation coefficients of FNP and FCP with Mayo scores were 0.74 and 0.77, respectively( P<0.001) .The correlation coefficients of serum CRP in CD and UC patients with clinical scores were 0.49 and 0.60, respectively(P<0.001).The area under the ROC curve(AUC) of FNP and FCP for the diagnosis of clinical activity in pa-tients with CD were 0.75 and 0.80, respectively.The AUC of FNP and FCP in UC patients were 0.85 and 0.90, respectively.The AUC of serum CRP in patients with CD and UC were 0.65 and 0.74, respectively.When combined FNP with FCP, the AUC in pa-tients with CD and UC were 0.85 and 0.92, respectively. Conclusion FNP is a novel reliable and non-invasive biomarker to evalu-ate clinical disease activity in patients with IBD as accurate as FCP, It is advisable to combine FNP with FCP to evaluate disease activi-ty in patients with IBD.

Expression of FHL1 and the significance in pancreatic fibrosis of chronic pancreatitis / 中华胰腺病杂志

Objective To explore the expression of transcriptional regulation factor FHL 1 in pancreatic fibrosis of chronic pancreatitis (CP) and clinical significance.Methods Serum samples from 20 CP patients treated in the Department of Gastroenterology , Nanjing General Hospital and 20 healthy controls in the corresponding period were collected .The level of FHL1 in the serum was detected by ELISA .Twenty male Wistar rats were randomly divided into control group and CP group according to the body weight .The CP rat model was established by injecting dibutyltin dichloride ( DBTC) through tail vein .All the rats were killed at 28 days after injection and the pancreas was collected , which was observed using hematoxylin and eosin ( HE) staining to investigate pathological changes . The expression of FHL1 in pancreas was measured by immunohistochemistry (IHC) and Western blotting (WB).Results The average of serum FHL1 level in two groups were (0.86 ±0.22)g/L and (1.18 ±0.22)g/L, respectively.The level of FHL1 in serum of CP patients was significantly lower than that of healthy cases , and the difference was statistically significant (t=10.54, P=0.001).Damaged pancreatic lobular structure , acinar atrophy and the obvious fibrous hyperplasia were observed in CP rats .The pathological score of abnormal structure , acinar atrophy, fibrosis, and inflammatory cell infiltration in the pancreas of the CP group was (2.2 ±0.4),(2.0 ±0.7),(2.4 ±0.3) and (2.8 ±0.6), respectively, but was all 0 in control group.The difference between two group was statistically significant ( t value =17.24, 9.01, 25.22 and 14.75, respectively, all P<0.001).The expression of FHL1 in the pancreatic tissue of CP group were less than that of normal group , and the difference was statistically significant (IHC:15 798 ±3 247 vs 37 570 ±9 254, t=2.438,P=0.016;WB:0.44 ±0.11 vs 0.89 ±0.03, t=4.289, P=0.002).Conclusions The protein of FHL1 was in low expression in the pancreas of CPs , indicating that FHL1 may participate in the formation of pancreatic fibrosis .

Correlation of Sugar Molecular Probes with Inflammatory Factors and Claudin-8 in Intestinal Permeability in Colitis Rats / 胃肠病学

Background:Intestinal permeability plays an important role in the development of ulcerative colitis. Sugar molecular probes is a safe and non-invasive method to measure intestinal permeability,and its correlation with inflammatory factors and claudin-8 is not clear. Aims:To explore the correlation of sugar molecular probes with TNF-α,CRP and claudin-8 in intestinal permeability in colitis rats. Methods:Twenty-four rats were assigned randomly to model group and normal control group. Colitis model was induced by DSS solution. Expressions of TNF-α,CRP were determined by ELISA,and expression of claudin-8 was determined by immunohistochemistry. Sugar molecular probes were determined by high performance liquid chromatography. Correlations of inflammatory factors and claudin-8 with sugar molecular probes were analyzed. Results:Compared with normal control group,expressions of colonic tissue TNF-α and CRP were significantly increased while expression of claudin-8 was significantly decreased in model group(P < 0. 01);secretion of lactulose and sucrolose,ratio of lactulose/ mannitol( L/ M)were significantly increased( P < 0. 01)while mannitol secretion was significantly decreased(P < 0. 01). Secretion of lactulose and sucrolose were positively correlated with expressions of TNF-α and CRP(P < 0. 01),but negatively with expression of claudin-8(P < 0. 01). L/ M ratio and mannitol secretion were negatively correlated with expressions of TNF-α and CRP(P < 0. 01),but positively with expression of claudin-8(P <0. 01). Conclusions:Sugar molecular probes and expressions of TNF-α,CRP,claudin-8 have similar results in predicting intestinal permeability in rats. Sugar molecular probes can be used as a potential method to measure intestinal permeability.

Expression and Significance of MicroRNA-595 in Inflammatory Bowel Disease / 胃肠病学

Background:Dysregulation of microRNAs is associated with intestinal mucosal barrier injury,intestinal inflammation and intestinal dysfunction. Abnormal expression of microRNAs occurs in patients with inflammatory bowel disease(IBD). Aims:To investigate the expression and significance of microRNA-595( miR-595)in IBD. Methods:A total of 100 patients with IBD at Nanjing General Hospital of Nanjing Military Command of PLA from July 2012 to July 2014 were enrolled,in which 63 cases were ulcerative colitis(UC)and 37 cases were Crohn’s disease(CD). According to disease activity,patients were divided into active UC(aUC)group,remissive UC(rUC)group,active CD(aCD)group and remissive CD(rCD)group. A total of 42 healthy subjects were served as normal control(NC)group. Specimens of serum and intestinal tissue were collected. Expression of miR-595 in serum and intestinal tissue was determined by fluorescence quantitative PCR. Luciferase report gene plasmid containing the 3’UTR of neural cell adhesion molecule 1(NCAM1)or fibroblast growth factor receptor 2(FGFR2)and plasmid containing miR-595 were co-transfected into human colon cancer cell line HCT116 to detect the effect of miR-595 on transcriptional activities of NCAM1 and FGFR2. Results:Expression of miR-595 in serum and intestinal tissue in UC and CD groups was significantly higher than that in NC group(P < 0. 05), and that in aUC and aCD groups was significantly higher than that in rUC and rCD groups,respectively(P < 0. 05). MiR-595 could down-regulate the transcriptional activities of NCAM1 and FGFR2 through directly binding to the 3’UTR of NCAM1 and FGFR2. Conclusions:Expression of miR-595 in serum and intestinal tissue is increased in patients with IBD and correlates with disease activity. MiR-595 inhibits the expressions of tight junction protein NCAM1 and FGFR2,thereby inducing injury of intestinal mucosal barrier and promoting intestinal inflammation. MiR-595 can serve as a serum biomarker for diagnosis of IBD and disease activity evaluation.

A Retrospective Analysis of Capsule Endoscopy in 573 Cases / 胃肠病学

Background:Capsule endoscopy has been demonstrated to be an effective diagnostic tool for small bowel diseases in a series of small sample researches. However,the results need to be verified by large sample studies. Aims:To investigate the diagnostic performance and safety of capsule endoscopy for small bowel diseases. Methods:Consecutive patients undergoing capsule endoscopy for suspected small bowel diseases from May 2008 to Apr. 2013 in Nanjing General Hospital of Nanjing Military Command of PLA were collected and analyzed retrospectively. Results:A total of 573 patients were enrolled,the overall success rate of the examination was 99. 13%(568 / 573)and the overall completion rate was 88. 38%(502 / 568). The mean time of capsule passing the pylorus was 43. 45 min,and that of passing the small bowel was 287. 21 min. The overall detection rate of small bowel lesions was 53. 52%(304 / 568)and the overall diagnostic rate was 51. 06%(290 / 568). Both the detection rate and diagnostic rate in patients with obscure gastrointestinal bleeding(OGIB) were significantly higher than those in patients with obscure abdominal pain and chronic diarrhea(64. 26% and 62. 46%vs. 41. 72% and 39. 07% ,and 32. 14% and 27. 38% ,P all < 0. 05). Small bowel lesions detected by capsule endoscopy included angiopathy(21. 38% ),ulceration(20. 72% ),neoplasms(14. 47% ),erosion(11. 84% ),and Crohn’s disease(11. 18%),etc. Capsule retention occurred in 2. 29%(13/568)of the patients,and one acute intestinal obstruction and 2 perforations were observed. Conclusions:Capsule endoscopy is a safe and effective diagnostic modality for small bowel diseases. OGIB is the most common indication for capsule endoscopy,and capsule endoscopy is also helpful for evaluation of established or suspected Crohn’s disease.

Changes in the Expression and Distribution of Claudins, Increased Epithelial Apoptosis, and a Mannan-Binding Lectin-Associated Immune Response Lead to Barrier Dysfunction in Dextran Sodium Sulfate-Induced Rat Colitis

BACKGROUND/AIMS: This animal study aimed to define the underlying cellular mechanisms of intestinal barrier dysfunction. METHODS: Rats were fed 4% with dextran sodium sulfate (DSS) to induce experimental colitis. We analyzed the sugars in 24-hour urine output by high pressure liquid chromatography. The expression of claudins, mannan-binding lectin (MBL), and MBL-associated serine proteases 2 (MASP-2) were detected in the colonic mucosa by immunohistochemistry; and apoptotic cells in the colonic epithelium were detected by the terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling method assay. RESULTS: The lactulose and sucralose excretion levels in the urine of rats with DSS-induced colitis were significantly higher than those in the control rats. Mannitol excretion was lower and lactulose/mannitol ratios and sucralose/mannitol ratios were significantly increased compared with those in the control group (p<0.05). Compared with the controls, the expression of sealing claudins (claudin 3, claudin 5, and claudin 8) was significantly decreased, but that of claudin 1 was increased. The expression of pore-forming claudin 2 was upregulated and claudin 7 was downregulated in DSS-induced colitis. The epithelial apoptotic ratio was 2.8%+/-1.2% in controls and was significantly increased to 7.2%+/-1.2% in DSS-induced colitis. The expression of MBL and MASP-2 in the intestinal mucosa showed intense staining in controls, whereas there was weak staining in the rats with colitis. CONCLUSIONS: There was increased intestinal permeability in DSS-induced colitis. Changes in the expression and distribution of claudins, increased epithelial apoptosis, and the MASP-2-induced immune response impaired the intestinal epithelium and contributed to high intestinal permeability.

The application value of fecal calprotectin in inflammatory bowel disease / 医学研究生学报

The diagnosis and monitoring of inflammatory bowel disease mainly depend on clinical presentation , endoscopical , histopathological and imaging findings .It has been demonstrated that fecal inflammatory biomarkers can be potential markers to replace endoscopy diagnosed disease activity .Calprotectin is a binding protein of calcium and zinc , which is mainly derived from neutrophils and macrophages .Calprotectin is an accurate noninvasive biomarker in diagnosing and monitoring inflammatory bowel disease in clin -ics.This paper reviews the progress of fecal calprotectin in the diagnosis, disease activity evaluation, clinical monitoring and prognosis of inflammatory bowel disease .

Relationship between Peripheral Blood CD3 +,CD4 + and CD8 + T Cells and Inflammation Markers in Patients with Crohn’s Disease / 胃肠病学

Background:Abnormal immune response is involved in the pathogenesis of Crohn’s disease( CD),and T lymphocytes are the main players in the immune response. Aims:To investigate the relationship between peripheral blood CD3 + ,CD4 + and CD8 + T cells and inflammation-related markers in patients with CD. Methods:Proportions of peripheral blood CD3 + ,CD4 + and CD8 + T cells were measured by flow cytometry in 26 CD patients( including 14 patients in active stage and 12 in remission stage )and 8 healthy volunteers(control group),and their correlation with inflammation-related markers(including white blood cell count,platelet count,ESR,CRP,albumin and hemoglobin) were analyzed. Results:Proportions of CD3 + ,CD4 + and CD8 + T cells were significantly increased in patients with active CD than those with remission CD and controls( P ﹤ 0. 05),however,no significant differences were found between remission CD patients and controls(P ﹥ 0. 05). ESR and CRP in active CD patients were significantly higher than those in controls(P ﹤ 0. 05),while albumin and hemoglobin levels were significantly decreased(P ﹤ 0. 05);albumin in remission CD patients was significantly lower than that in controls(P ﹤ 0. 05). No significant differences in white blood cell count and platelet count were found between active,remission CD patients and controls(P ﹥ 0. 05). Proportions of CD3 + , CD4 + and CD8 + T cells were positively correlated with CRP,and negatively correlated with hemoglobin( P ﹤ 0. 05);CD3 + and CD4 + T cells were positively correlated with ESR(P ﹤ 0. 05). However,CD3 + ,CD4 + and CD8 + T cells were not correlated with white blood cell count,platelet count and albumin level( P ﹥ 0. 05). Conclusions:Proportions of peripheral blood CD3 + ,CD4 + and CD8 + T cells are increased with the increase of disease activity in CD,and are positively correlated with CRP,and negatively correlated with hemoglobin.

Aflatoxin M1 preparation and identification of artificial antigens / 中国免疫学杂志

Objective:AFM1-BSA and AFM1-OVA were synthesized and then identified in this experiment.Methods: Using oximation method ,AFM1 was transformed to oxime compounds while the reaction process was monitored via TLC method aiming to identify the compounds.Coupled with carrier protein BSA and OVA respectively , we obtained AFM1-BSA and AFM1-OVA, then identified synthetic antigen via UV spectrophotometry and SDS-PAGE.Antigens were injected into experimental animals , finally obtaining the murine multi-antiserum.Eventually , the multi-antiserums were detected via indirect inhibition ELISA method to judge whether the antigens were effectively or not.Results:After oximation reaction ,the migration distance of oxime compounds in the thin layer plate was shorter.The maximum absorption peak of AFM1-BSA occurred in 274 nm,and was inconsistent with both UV absorption peaks of BSA and AFM 1.The electrophoretic velocity of AFM 1-BSA was less than that of BSA.All the titers of three immunized mice were 1×10-4 approximately;the multi-antiserum from No.3 sample had the best sensitivity ,its IC50 was 359.9 ng/ml.Conclusion:In this study,we obtained AFM1 artificial antigen and murine multi-antiserum of high sensitivity.

Safety and efficacy of endoscopic multiband mucosectomy for early esophageal carcinoma and intraepithelial neoplasia / 中华消化内镜杂志

Objective To study the effectiveness of endoscopic multiband mucosectomy ( EMBM ) for early cancer and precancerous lesions of the esophagus. Methods From August 2007 to December 2011,EMBM was performed on 46 patients (25 males and 21 females) with the average age of 59.0 (35-82) yr.All lesions were margined under NBI,with 2 to 13 cm in diameter (median 4 cm),and occupying at most two-third of the circumference of the esophagus.Of 46 patients,41 (89.1％ ) accepted deep sedation by intravenous injection of propofol.All patients were followed up with endoscopy at 1,6,12 months after the operation.Results A total of 48 lesions were resected completely by EMBM with 1-11 processes.During the procedure,controllable bleeding occurred in 3 cases and micro-perforation occurred in 1,which was cured by metal clip.Histopathological diagnoses revealed 3 cases of intramucosal squamous carcinoma,19 high grade intraepithelial neoplasia,17 low grade intraepithelial neoplasia,and 7 inflammatory hyperplasia.No recurrence was found during the follow-up of 1 to 53 months.Conclusion EMBM is effective and safe for the treatment of early cancer and precancerous lesions of the esophagus.Appropriate indication and manipulation can decrease complication occurrence.

Effect of dexamethasone ointment on preventing phlebitis induced by vinorelbine / 中国实用护理杂志

Objective We observed the effect of dexamethasone ointment on preventing phlebitis induced by vinorelbine. Methods Patients with malignant tumor who received chemotherapy of vinorelbine through peripheral superficial vein injection were divided into the observation group (70 cases) and the control group (72 cases) according to the date of hospitalization. All patients received vinorelbine four times averagely. Patients in the observation group was given dexamethasone ointment along punctured superficial vein. Patients in the control group received routine nursing measure. The incidence rate, time and degree of phlebitis was compared between these groups. Results The incidence rate and degree of phlebitis was lower than those of the control group (P< 0.01, P< 0.05). The incidence time of phlebitis in the observation group was also later than that of the control group (P<0.05). Conclusion Local application of dexamethasone ointment could effectively reduce the incidence of superficial phlebitis caused by vinorelbine chemotherapy.