Objective:To evaluate the nutritional risk and its risk factors in patients with chronic pancreatitis (CP).Methods:Using nutritional risk screening 2012,a retrospective study was performed to analyze nutritional risk in 156 CP patients.Conditional logistic regression model was applied to identify the risk factors from fourteen clinical features that potentially influen cenutritional risk.Results:Proportion of patients with nutritional risk was significantly higher than malnutrition patients (44.9％ vs 25.6％,x2 =12.64,P =0.000 4).Univariate analysis indicated the following seven factors,gender,concomitant diabetes mellitus,intervention by endoscope or surgery,pancreatic enzyme replacement therapy,anxiety depression,insufficient eating and nutritional support for less than 3 months were associated with higher nutritional risk in CP patients (P ＜ 0.01).The result of multivariate analysis showed that anxiety depression,insufficient eating and nutritional support for less than 3 months werethe risk factors for malnutrition CP patients.Conclusion:There are higher nutritional risks in CP patients and early psychotherapy,sufficient eating and timely parenteral or enteral nutrition support should be undertaken for patients with chronic pancreatitis.

Value-based medicine is a new medical model which develops on the basis of evidence-based medicine and perfectly combines the skills and experiences of doctors with patients and hospitals’ value. According to the definition and connotation of the value-based medicine,this paper introduced its preliminary application at different stages(theoretical teaching,internship and practice) of digestive disease courses by teaching theory courses and letting students involved in the management of different individuals of the same disease. Meanwhile,this paper discussed on its effects.

ObjectiveTo investigate the preventive effects of rosiglitazone on nonalcoholic steatohepatitis (NASH) rats and to explore the potential mechanisms in modulating peroxisome proliferator-activated receptor gamma (PPARγ),nuclear factor kappa B (NF-κB),and cyclooxygenase-2 (COX-2) expression.Methods Thirty male SD rats were assigned into the normal group ( n =10),the model group ( n =10),rosiglitazone prevention group [ n =10,simultaneously 4mg/( kg · d) gavage daily at beginning].Liver appearance,liver index,and histological changes were assessed.Serum tumor necrosis factor-o (TNF-c) and prostaglandin E2 (PGE2) were determined using enzyme-linked immunosorbent assay.The expressions of PPARγ,NF-κB,and COX-2 in liver were determined using immunohistochemical methods.The mRNA and protein expressions of COX-2 were disclosed by real-time polymerase chain reaction and Western blot analysis.ResultsCompared with the normal group,the liver index significantly increased in model group (3.92 ±0.72 vs.5.71 ± 1.05,P =0.004).HE and Masson staining showed significantly increased steatosis,inflammation,and fibrosis.The serum levels of TNF-α,PGE2 in high-fat-diet-fed rats were significantly increased ( 11.72 ± 2.47 vs.29.39 ± 5.32,P =0.002 ; 236.60 ± 24.90vs.288.24 ± 17.17,P =0.004).Immunohistochemistry showed NF-κB and COX-2 in livers were significantly elevated,but PPARγ wasdecreased in nonalcoholic steatohepatitis rats.Real-time polymerase chain reaction and Western blot found mRNA and protein expressions of COX-2 were increased in the model group (0.57 ± 0.08 vs.2.83 ± 0.24,P =0.0007 ; 0.38 ± 0.03 vs.1.00 ± 0.03,P =0.004).Compared with the model group,the expressions of PPARγsignificantly increased and the expressions of NF-κB and COX-2 significantly decreased ( mRNA:2.83 ± 0.24 vs.0.46 ± 0.11,P =0.002 ; protein: 1.00 ± 0.03 vs.0.62 ± 0.02,P =0.006 ) in the rosiglitazone prevention group.ConclusionBy inhibiting NF-κB and COX-2 expressions,rosiglitazone can reduce insulin resistance and then prevent the occurrence and deve lopment of nonalcoholic steatohepatitis.

Objective:To determine the expression level of bone morphogenetic proteins-4 (BMP-4) and the relationship between the expression of BMP-4 and the clinical/pathological parameters in patients with gastric cancer. Methods:Using im-munohistochemical staining technique ,expressions of BMP-4 were investigated in different tissues from 90 gastric cancer specimens and 30 specimens from normal gastric mucosa as control. ResultS:The positive rate of BMP-4 was 23. 3% (21/90) in gastric cancer and 3. 3% (1/30) in normal gastric mucosa. The expression of BMP-4 in gastric cancer was closely related with locus, serosa infiltration,cell differentiation and lymph node metastasis (P

Objective To evaluate the impact of rosiglitazone (Ros) on liver expression of peroxisome proliferator-activated receptor γ (PPARγ),nuclear factor (NF-κB) and cyclooxygenase-2(COX-2) in treatment of nonalcoholic steatohepatitis (NASH) rats.Methods Thirty Sprague-Dawley rats were divided into normal group,model group and Ros treated group with 10 each.Except the normal group,the other two groups were given high fat diet for 12 weeks for NASH model.The rats in Ros treated group were gavaged 4 mg/kg of Ros daily at the 12th week for 8 weeks.All rats were sacrificed at the 20th week for blood sample and liver tissue.Biochemical parameters of liver function,lipid metabolism,glycometabolism and antioxidant enzyme activities were measured.The histological change of the liver were assessed with HE and Masson staining.The level of tumor necrosis factor (TNF)-α and prostaglandin E2 (PGE2) was measured using ELISA.The expression of PPARγ,NF-κB and COX-2 was detected with immunohistochemistry.The mRNA and protein expressions of COX-2 were tested by real-time PCR and Western blotting,respectively.Results In comparison with model group,Ros treated group showed significant improvement in hepatic steatosis,inflammation and fibrosis(all P value<0.05).In model group,the serum levels of fasting blood glucose,insulin and HOMA-insulin resistance index (HOMA-IRI),total cholesterol (TC),total triglyeride (TG),lowdensity lipoprotein cholesterol (LDL-C) and free fatty acids were increased,but HDL-C level was decreased.All above parameters markedly improved after Ros treatment.The levels of ALT and AST,total anti-oxidation competence,superoxide dismutase,catalase,glutathione peroxidase and malondialdehyde in Ros treated group were significantly ameliorated when compared with those in model group.Immunohistochemistry showed that the expression of NF-κB and COX-2 was significantly elevated,but PPARγ was decreased in model group.Real-time PCR and Western blot revealed that the mRNA and protein expressions of COX-2 were higher in the model group than those in normal group (0.57±0.08 vs 0.38±0.03;2.83±0.24 vs 1.00±0.03,P=0.000 and P=0.004,respectively),but significantly lower in Ros treated group (0.55±0.06 and 1.84±0.13,P<0.01).Conclusions Ros can reduce oxidative stress and insulin resistance in NASH rats by activing PPARγ expression and inhibiting expression of NF-κB and cyclooxygenases.

Portal vein embolization involves different pathophysiological processes such as primary or secondary portal vein thrombosis and extrahepatic portal vein occlusion. After clarifying the connotation of portal vein embolization, this article briefly introduces the etiology and grading system of portal vein embolization, as well as its pathogenesis and multidisciplinary collaborative diagnosis and treatment methods, and emphasizes the importance of multidisciplinary collaboration.