Bile acids play critical roles in the solubilization and absorption of lipids. The ileal apical sodium-dependent bile acid transporter( ASBT)located at the enterocyte brush border is responsible for the reuptake of bile acids and the maintenance of bile acid homeostasis. Recently,great success has been made in understanding the relationship between ASBT and intestinal inflammation,tumorigenesis,secretion,motility,sensation,gut microbiota,and gut-liver axis in addition to its expression regulation,which implicates ASBT as a contributor of some gastrointestinal diseases and a promising new therapeutic target for these diseases. In this review article,the advances in study on above-mentioned issues were summarized.

Gastrointestinal motility disorder is one of the key pathophysiological mechanisms of functional gastrointestinal disorders (FGIDs). The prokinetics, dopamine D

Objective Atrophic gastritis, as a pre-cancerous condition of gastric cancer, is developed from non-atrophic gastritis.The aims of this study was to compare the gene expression profiles between atrophic gastritis and non-atrophic gastritis using cDNA microarray and to explore the molecular mechanisms in the development of atrophic gastritis. Methods Endoscopy and biopsy were performed consecutively in 227 patients (143 male, 84 female, age range between 16-72 years, with average age 48.6 years). Diagnosis of non-atrophic gastritis and atrophic gastritis was made according to histological examination, and 120 patients were in non-atrophic group and 107 in atrophic group. The total RNA was extracted from the biopsy specimens of two groups with Trizol reagent. cDNA microarray consisting 8 464 human genes (HGEC-80s kit) was used, and labeled cDNA with fluorescence probes were hybridized to microarray, and then the comparison of gene expression profiles was made between atrophic and non-atrophic gastritis. Results It was identified that in gene expression profiles of atrophic gastritis there were 165 genes showing a greater than 2-fold increase and 460 genes showing a greater than 50% decrease as compared to non-atrophic gastritis. RT-PCR analysis revealed similar results as in DNA microarray. Conclusions There is different expression in many genes between the gastric mucosal cells of non-atrophic and atrophic gastritis mucosa. Many genes expression profiles are involved in atrophic gastritis that would be of help in further understanding the development of atrophic gastritis.

Objective To explore the invading mechanism of amebae in lamina porpria and observe the interaction between the cysteine proteinase (CP) of Entamoeba histolytica and laminin. Methods CP was identified by laminin-sepharose affinity chromatography, followed by isolation, purification and inhibitor experiment. The hydrolytic activity was measured by gelatin electrophoresis. Results Purified CP of E.histolytica showed a strong affinity with laminin. The molecular weight of CP is 27 kDa. It can be inhibited by EC-64 and exhibited a protein hydrolytic activity. Conclusion The specific affinity and hydrolytic activity of CP might play an important role in its invasion to the basement membrane of intestinal mucosa.

Serum pepsinogen(PG)is an effective marker for evaluating gastric mucosa function and can be used as a supplement for screening and early diagnosis of gastric cancer. Recently,serum PG has become a hot spot of study in portal hypertensive gastropathy and functional dyspepsia. Serum PG detection is a noninvasive,simple and low cost investigation method with marked clinical value. This article reviewed the value of serum PG detection in warning gastric cancer and evaluating gastric mucosa function.

Objective To evaluate the efficacy difference between flupentixol and melitracen combined with conventional medicine and conventional drug alone in the treatment of irritable bowel syndrome (IBS).Methods Studies on flupentixol and melitracen combined with conventional medicine (pinaverium bromide and trimebutine maleate) and conventional medicine alone in the treatment of IBS were collected and reviewed through searching the Chinese Academic Journals Full-text Database,Chinese VIP Full-text Database and PubMed database.After that,the test for homogeneity and the combined effect test were estimated. Results A total of 12 clinical studies on flupentixol and melitracen combined with conventional medicine for four to twelve weeks in the treatment of IBS were collected six studies indicated the homogeneity test of flupentixol and melitracen combined with pinaverium bromide (x2 =1.90,df=5,P=0.86,I2 =0).For the fixed-effect model,the odds ratio was 7.92 and 95％ CI was between 4.85 and 12.95,which suggested the combined therapy was better.The other six studies indicated the homogeneity test of flupentixol and melitracen combined with trimebutine maleate (x2 =5.60,df=5,P =0.35,I2 =10.6 ％).For the fixed-effect model,the odds ratio was 5.91 and 95％ CI was between 4.06 and 8.61,which suggested the combined therapy was better.After merging the 12 studies it indicated the homogeneity test of flupentixol and melitracen combined with conventional medicine (x2 =8.40,df =11,P =0.68,I2 =0).For the fixed effect model,the odds ratio was 6.63 and 95％ CI was between 4.92 and 8.93.Conclusion The efficacy of flupentixol and melitracen combined with conventional medicine in the treatment of IBS was better than that of conventional medicine alone,however,still more high quality trials are needed for further confirmation.

Objective To evaluate the efficacy and safety of mosapride in the treatment of gastroesophageal reflux disease (GERD). Methods Papers of PubMed,EMBASE,OVID,VIP Database and WANGFANG Data were searched and reviewed according to international Cochrane Collaboration.Results A total of 21 trials (1666 patients) were included.The treatment group was with mosapride and PPI,the control group was with single PPI or PPI and placebo.The Results of Meta analysis showed:for non-erosive negative reflux disease,there was no significant difference in efficacy between two groups.As for erosive esophagitis treated with mosapride (5mg):There was no significant difference in the 4-week healing rates between treatment group and control group (P =0.06).The 4-week symptom relief rate of treatment group was better than that of control group (P＜0.01).The 6-week healing rate of treatment group was better than that of control group (P＜0.01).The 6-week symptom relief rate of treatment group was better than that of control group (P＜0.01).There was no significant difference in the 8-week healing rate of esophagitis between treatment group and control group (P =0.05).The 8-week symptom relief rate of treatment group was better than that of control group (P＜0.01).For erosive esophagitis treated with mosapride 10mg,.The 8-week symptom relief rate of treatment group was better than that of control group (P=0.02).Conclusion According to the meta-analysis of these 21 trails,mosapride was safe and effective in the treatment of GERD.However due to the quality of the literatures,the above findings should be treated with caution.

Objective:To analyze the consistency between the histopathological results of routine endoscopy and biopsy in observing the gastric mucosa of patients with non-malignant gastroduodenal diseases,and to evaluate the necessity of biopsy following gastric endoscopy.Methods: From Jan.2005 to Dec.2005,320 patients who received upper gastrointestinal endoscopy and biopsy because of upper abdominal symptoms were included in this study.The patients were selected consecutively according to their disorders diagnosed by macroscopic endoscopy and were divided into 64 groups.The 5 patients in each group had reflux esophagitis,non-atrophic gastritis,atrophic gastritis,gastric ulcer and duodenal ulcer,respectively.Patients in the same group were matched with each other in gender,age and their history of diseases.The results of endoscopy,including the exudation,congestion,erosion,roughness,bile reflux,etc.,were read by 2 experienced endoscopists.The biopsy was performed by an experienced pathologist and pathological variables included active inflammation,chronic inflammation,atrophy,intestinal metaplasia and atypical hyperplasia.The status of Helicobacter pylori(H.pylori) infection was evaluated by rapid urea test,silver staining and histological methods;the result was deemed positive when the results of either 2 tests were positive.Results: Erosion,exudation,roughness,and H.pylori infection were related with active inflammation;erosion and H.pylori infection were related with chronic inflammation;roughness of mucosa was related with atrophy;roughness and H.pylori infection were related with intestinal metaplasia;and obsolete hemorrhage,H.pylori infection,roughness mucosa,and bile reflux were related with atypical hyperplasia.Macroscopic diagnosis rate of atrophic gastritis was 71.9%(46/64) with a false positive rate of 28.2%(18/64) and a false negative rate of 34.38%(22/64).Conclusion: Macroscopic diagnosis is indicative to pathological changes of gastric mucosa,but the predictive value is relatively poor,making biopsy and pathological examination necessary in the diagnosis of gastric mucosa disorders during routine endoscopic examination.

Background: Esophageal variceal bleeding is a clinical emergency and the major cause of death in patients with liver cirrhosis.Aims: To assess the value of platelet count (PC)/spleen diameter (SD) ratio in predicting the presence of esophageal varices (EV) in patients with HBV-related cirrhosis in China.Methods: A total of 91 consecutive HBV-related cirrhosis patients with EV from Aug.2013 to Dec.2015 at Renji Hospital (South Campus),School of Medicine,Shanghai Jiao Tong University were enrolled.Thirty-two HBV-related cirrhosis patients without EV were enrolled as controls.Upper gastrointestinal endoscopy,routine laboratory examinations and abdominal ultrasonography were performed and the related parameters were collected.Binary Logistic regression analysis was carried out to identify independent risk factors associated with EV.ROC curve was used to evaluate the predictive performance of PC/SD ratio for the presence of EV.Results: The PC/SD ratio was significantly lower in EV group than in non-EV group (538.2±327.0 vs.1 105.9±426.6,P=0.001).Binary Logistic regression analysis showed that the PC/SD ratio was independently associated with the presence of EV (OR=57.29,95％ CI: 15～214,P=0.000).In ROC curve analysis,the area under the curve (AUC) of PC/SD ratio in predicting the presence of EV was 0.853;the optimal cutoff value was 842,and the sensitivity,specificity,positive predictive value and negative predictive value were 85.7％,75.0％,90.7％,and 64.9％,respectively.Conclusions: PC/SD ratio can be used as a non-invasive tool for prediction of the presence of EV in patients with HBV-related cirrhosis.It may reduce the number of unnecessary endoscopy.

Background:More and more evidences suggest that microRNA plays an important role in the development of gastric cancer (GC).Expression of miR-129 in GC tissues is found abnormal, however, the mechanism of miR-129 in cell proliferation and invasion is still undefined.Aims:To investigate the expression of miR-129 in GC tissue and GC cell lines and the mechanism of miR-129 in proliferation and invasion of SGC-7901 cells.Methods:Eighty-two GC tissues and corresponding paracancerous tissues were collected, human gastric epithelial cell line and different GC cell lines were cultured, qPCR was conducted to assess miR-129 expression.SGC-7901 cells were transfected with miR-129 mimic or miR-NC, and then were transfected with overexpressed HMGA2 plasmid.Colony formation assay was used to detect cell proliferation ability, and Transwell chamber was used to assess cell invasion ability.Pearson correlation analysis was used to analyze the correlation between miR-129 and HMGA2 mRNA expression.Luciferase assay was performed to determine the activity of luciferase.mRNA and protein expressions of miR-129, HMGA2 were determined by qPCR and Western blotting, respectively.Results:Compared with paracancerous tissues, expression of miR-129 was significantly decreased in GC tissues (P<0.05);when compared with human gastric epithelial cells, expression of miR-129 was significantly decreased in GC cell lines (P<0.05).Compared with miR-NC group, proliferation and invasion abilities of SGC-7901 cells were inhibited in miR-129 mimic group (P<0.05).HMGA2 mRNA expression in GC tissues was significantly upregulated (P<0.05), and was negatively correlated with miR-129 expression (r=-0.543 9, P<0.01).Luciferase activity in wild-type miR-129 mimic group was significantly lower than that in miR-NC group (P<0.05);mRNA and protein expressions of HMGA2 were decreased after transfection with miR-129 mimic (P<0.05).Compared with miR-129+vector group, proliferation and invasion of SGC-7901 cells were significantly increased in miR-129 mimic+HMGA2 group (P<0.05).Conclusions:The expression of miR-129 is decreased in GC tissue and cells;miR-129 inhibits SGC-7901 cells proliferation and invasion by negatively regulating HMGA2.