Background:Gastric ischemia-reperfusion injury often leads to calcium overload,excessive free radical production, leukocyte infiltration and microcirculation disturbance.Post hypoxic treatment can effectively reduce the injury induced by hypoxia/reoxygenation (H/R).Galanin receptor 2 (GalR2)is distributed mainly in the digestive and nervous system, which can regulate many endocrine activity.However,the protective effect of GalR2 on human gastric epithelial cells injury induced by H/R is not clarified.Aims:To investigate the protective effect and its mechanism of GalR2 agonist post-conditioning on human gastric epithelial cells injury induced by H/R.Methods:H/R model was constructed on human gastric epithelial cells GES-1.Normal control group (N group),H/R group,M1145 (GalR2 agonist)treatment group (M group),SB203580 (p38MAPK inhibitor) +M1145 treatment group (S +Mgroup)and DMSO solvent control group (D group)were established.Survival rate of cells was measured by MTT assay.Apoptosis rate of cells was determined by flow cytometry,and cell apoptosis was examined by Hoechst staining.Level of lactate dehydrogenase (LDH)was measured by ELISA.Expressions of Bcl-2,Bax and p38MAPK were determined by real-time quantitative PCR.Results:Survival rate of cells was significantly lower in H/R group than that in N and M groups (P <0.05 ).Apoptosis rate of cells was significantly higher in H/R group than that in N,M and S +M groups (P <0.05 ),and apoptosis rate of cells was significantly lower in Mgroup than that in S +M group (P <0.05).Expression of LDH was significantly higher in H/R group than that in Mand S +Mgroups (P <0.05).Expression of Bcl-2 was significantly higher in N and M groups than that in H/R,S +Mand D groups (P <0.05);expression of Bax was significantly higher in H/R group than that in N,M and S +Mgroups (P <0.05);expression of p38MAPK was significantly lower in H/R and S +M groups than that in M group (P <0.05 ).Conclusions:GalR2 agonist M1145 plays an effective role in reducing the injury of GES-1 cells induced by H/R,the effect may be conducted through p38MAPK pathway.

Background:The diagnostic accuracy of APRI and FIB-4 for liver fibrosis in patients with chronic hepatitis B is nothigh,especially for significant liver fibrosis (F≥2). Noninvasive diagnosis for liver fibrosis has become a research hotspot;and the diagnostic value of APRI combined with FIB-4 is not clear. Aims:To investigate the diagnostic value ofAPRI combined with FIB-4 for significant liver fibrosis in patients with chronic hepatitis B. Methods:A total of 171patients with chronic hepatitis B from January 2011 to October 2016 at General Hospital of Xinjiang Military Region wereenrolled. Liver biochemical indices,routine blood test and liver biopsy pathology were performed. APRI and FIB-4 werecalculated,ROC curve was drawn,and cutoff value of APRI and FIB-4 for diagnosing significant liver fibrosis wasdetermined,and mode of APRI combined with FIB-4 for diagnosing significant liver fibrosis was established. Results:Withthe increase in degree of liver fibrosis,APRI and FIB-4 were gradually increased (P < 0. 05). Area under ROC curve(AUC)for APRI and FIB-4 were 0. 812 and 0. 770,respectively. The sensitivity of FIB-4 for diagnosing significant liverfibrosis was higher than that of APRI. Sensitivity,specificity,negative predictive value,positive predictive value,andaccuracy of APRI combined with FIB-4 for diagnosing significant liver fibrosis were superior to APRI or FIB-4 used alone;and the specificity,accuracy of mode 2 were superior to mode 1. Conclusions:APRI combined with FIB-4 can increasethe accuracy for diagnosing significant liver fibrosis.

Background:China is an area with high incidence of gastric cancer,studies have shown that serum pepsinogen (PG) and gastrin-17 (G-17)levels can be used for gastric cancer screening. Aims:To investigate the values of serum PG and G-17 levels in screening gastric precancerous lesion and gastric cancer. Methods:A total of 211 patients with gastroduodenal disease diagnosed by endoscopy and biopsy from March 2016 to October 2016 at the First Affiliated Hospital of Soochow University were enrolled,and 67 healthy subjects were served as controls. Serum levels of PGⅠ,PGⅡ,G-17 and Hp-IgG antibodies were determined by ELISA. Results:Compared with control group,PGⅠ level and PGR were significantly decreased in atrophic gastritis group (P < 0. 01);serum PGⅠ level and PGR were significantly decreased, and G-17 level was significantly increased in low grade intraepithelial neoplasia group,high grade intraepithelial neoplasia group and gastric cancer group (P < 0. 01). ROC curve showed that the best cutoff values of PGⅠ,PGR and G-17 for diagnosing gastric cancer and gastric precancerous lesion were 74. 74 ng/ mL (sensitivity 88. 3％,specificity 78. 0％), 6. 59 (sensitivity 87. 0％,specificity 73. 8％),13. 02 pmol/ L (sensitivity 54. 2％,specificity 84. 4％),respectively. PGR and G-17 were the independent predictors of gastric cancer and gastric precancerous lesion. The sensitivity and specificity of combined detection of PGⅠ,PGR and G-17 for diagnosing gastric precancerous lesion and gastric cancer were 89. 9％ and 84. 4％,respectively. Conclusions:Serum PGⅠ,PGR and G-17 may be used as indicators of gastric cancer and gastric precancerous lesion screening. PG combined with G-17 for diagnosing gastric cancer and gastric precancerous lesion is more sensitive and specific than using serum PG or G-17 alone.

Background:Small intestinal bleeding is difficult to diagnose and treat because of its complex etiology and limit to examination method. Aims:To analyze the etiology,diagnosis,treatment and prognosis of small intestinal bleeding. Methods:The clinical data of 118 consecutive patients with small intestinal bleeding admitted from Oct. 2006 to Oct. 2016 at Daping Hospital,the Third Military Medical University were retrospectively analyzed. Results:Melena was the most common manifestation of small intestinal bleeding (41. 5％),followed by dark bloody stool,positive fecal occult blood test,hematochezia,and anemia with unknown cause. The major causes of bleeding were benign or malignant tumors (43. 2％),vascular lesions (28. 0％)and inflammatory lesions (15. 3％). Diagnosis was made by means of capsule endoscopy,colonoscopy,digital subtraction angiography (DSA),barium meal examination,multi-slice CT (MSCT)and CT enterography (CTE). Forty-one patients were treated by surgical operation,7 by selective arterial embolization,2 by endoscopic therapy,56 by conservative therapy,and all these patients achieved hemostasis. One patient died of massive hemorrhage and 11 were discharged with giving up of treatment. Conclusions:The leading cause of small intestinal bleeding is tumor,followed by vascular and inflammatory lesions. Capsule endoscopy is able to make definite diagnosis with high accuracy,and MSCT is the most widely used diagnostic approach. In addition to conventional treatment,surgical operation,interventional and endoscopic therapies also play important roles in treating small intestinal bleeding.

Background:Gastric xanthelasma is a benign and uncommon lesion with unknown etiology. It has been noted thatatrophic gastritis is frequently seen in patients with gastric xanthelasma. Aims:To investigate the relationship betweengastric xanthelasma and atrophic gastritis and its clinical significance. Methods:A total of 10645 consecutive patients whohad undergone gastroscopy from Apr. 2015 to Mar. 2016 at the Shanxi Provincial People's Hospital were enrolled andanalyzed retrospectively with respect to their demographic,clinical,endoscopic and histological features. Results:Theprevalence of gastric xanthelasma in patients recruited in this study was 2. 9％ . The mean age and prevalence of atrophicgastritis (47. 9％ vs. 16. 6％ )were significantly higher and the gastric atrophy was more severe in patients with gastricxanthelasma than those without (P all < 0. 001). Multivariate Logistic regression analysis revealed that age ≥50 years(adjusted OR =1. 349,95％ CI:1. 042 ～ 1. 747,P = 0. 023)and atrophic gastritis (adjusted OR = 3. 892,95％ CI:3. 076 ～4. 924,P <0. 001)were independently related to the presence of gastric xanthelasma. Likewise,the prevalence ofgastric xanthelasma in patients with atrophic gastritis was significantly higher than those without (7. 9％ vs. 1. 8％ ,P <0. 001). Age- and sex-matched control analysis proved the correlation between gastric xanthelasma and atrophic gastritis(P <0. 001). In addition,multiple xanthelasma was more prevalent in gastric xanthelasma patients with atrophic gastritisthan those without (32. 0％ vs. 13. 8％ ,P <0. 001). Conclusions:Gastric xanthelasma is correlated with age and presenceand severity of atrophic gastritis. Atrophic gastritis might be one of the etiological factors of gastric xanthelasma,and gastricxanthelasma might be an atypical mucosal lesion caused by gastric atrophy.

Intestinal flora plays an important role in promoting digestion,maintaining intestinal physiological function and regulating immune system. In recent years,it is found that intestinal flora not only regulates intestinal activity,but also affects the brain function and behavior. Early studies have shown that changes in probiotics may lead to alteration in brain function and mood. Studying the influence of intestinal flora on brain function helps us to catch on the pathogenesis of mental disorders such as autism,and expand our comprehension on the mechanism of brain activity as well. This article reviewed the advances in study on affecting pathway of intestinal flora on brain.

Neuroendocrine neoplasm (NEN)is a group of heterogeneous tumor originated from the neuroendocrine system,and gastrointestinal neuroendocrine neoplasm (GI-NEN)is the mostly frequently seen. The incidence of GI-NEN is increasing year by year,but the efficacy of clinical treatment is unsatisfactory. In recent years,new progress has been achieved in medical therapy of GI-NEN,including somatostatin analogues,interferon,mTOR inhibitor,vascular endothelial growth factor inhibitor and chemotherapeutic drugs. Peptide receptor radionuclide therapy also provides an additional option for treatment of metastatic GI-NEN. This article reviewed the recent progress of drug treatment for GI-NEN.

Long non-coding RNA (lncRNA)is a non-coding RNA which lacks a complete open reading frame (ORF)and plays an important role in biological processes such as cell proliferation,differentiation and apoptosis. At present,expression of lncRNA has been found to be abnormal in inflammatory reaction and inflammatory diseases. It might be involved in the development and progression of inflammatory diseases via regulating the expression of multiple genes and activation of signaling pathways. This article reviewed the progress in study on relationship between lncRNA and inflammatory diseases.

Non-alcoholic fatty liver disease (NAFLD)is a clinical syndrome characterized by hepatic fat deposition, and not caused by chronic heavy drinking and other liver damage factors. The pathogenesis of NAFLD is associated with environmental,genetic,immune and other various factors. Early diagnosis is helpful not only for distinguishing between simple non-alcoholic fatty liver (NAFL)and non-alcoholic steatohepatitis (NASH),but also for grading the extent of NAFLD lesion and delaying its further development. This article reviewed the clinical research progress of non-invasive diagnosis and evaluation of NAFLD.

Gastric cancer is a leading cause of cancer death worldwide. It is well known that Japan is the world leader in endoscopic diagnosis and treatment of early gastric cancer (EGC),thus the current status and executive standard in this area in Japan is worthy of studying. This paper reviewed numerous researches,reviews and epidemiological data, summarized the basic principles,standardized protocols,and the diagnostic algorithm and criteria and progress on endoscopic screening and diagnosis of EGC in Japan. Finally,the differences in endoscopic strategies for EGC existed between Japan and China were compared.