Objective To investigate the etiology, clinical features, diagnosis and treatment of regional portal hypertension (RPH).Methods The clinical data of 26 patients with RPH treated in Beijing Chaoyang Hospital Affiliated to Capital Medical University between January 2005 and June 2010 were analyzed with retrospective analysis.The first symptom, routine analysis of blood, liver function test, hepatitis B and C markers, tumor markers, abdominal ultrasound, abdominal enhanced CT, endoscopy findings of 26 patients and the results of abdominal CT angiography (CTA) of 16cases were analyzed.Results Pancreatic disease (18 cases) was the leading cause of RPH.The main clinical manifestations of splenomegaly in 26 cases, irregularly abdominal pain in 14 cases, and upper gastrointestinal bleeding in 10 cases.Isolated gastric varices were revealed by endoscopy in 25 cases,complicated with lower esophageal varices in 1 case.4 cases with endoscopic tissue glue injection in gastric variceal bleeding, splenectomy in 4 cases, 2 cases with splenectomy and pericardialdevascularization, 2 cases with splenectomy, pancreatic tail resection and spleno-renal shunt, 3 cases with splenic embolization treatment.Conclusions RPH often accompanied by pancreatic disease,manifested as splenomegaly, hypersplenism, but normal liver function, absence of liver cirrhosis.Isolated gastric varices is the characteristic features of RPH.RPH caused by benign diseases is curable.Splenectomy is more effective than simple endoscopic hemostasis in RPH associated with gastrointestinal bleeding.

Objective To investigate the clinical significance and biological role of G-protein coupled receptor 49(GPR49) expression in pancreatic carcinoma.Methods GPR49 expression in tumor and adjacent normal tissues of 77 patients with pancreatic cancer was compared by tissue microarray and immunohistochemistry.And then, the GPR49 expression levels in the tumor tissues of patients with different pathological grades and clinical stages were analyzed.GPR49 positive pancreatic cancer cell line CFPAC-1 was taken as cellular model.CFPAC-1 cells were stimulated with roof plate-specific spondin(RSPO)1, the ligand of GPR49, in vitro.The effect of RSPO1 on CFPAC-1 cells proliferation was evaluated with cell counting.The effect of RSPO1 on the expression of membrane molecular CD44 in CFPAC-1 cells was detected by flow cytometry.CFPAC-1 cells incubated with RSPO1 were subcutaneously implanted into nude mice.And then, the time of tumor formation and tumor size were observed.T test and single factor analysis of variance were performed for statistical analysis.Results GPR49 was widely expressed in all 77 pancreatic cancer tissues.By immunohistochemistry, the score of GPR49 expression in pancreatic cancer tissues was 9.0±2.4, which was higher than that of adjacent normal tissues (5.7±2.4), and the difference was statistically significant (t=8.995, P<0.01).There was no correlation between GPR49 expression and tumor sizes, pathological grades, lymph node metastasis, and clinical stages (all P>0.05).The results of experiments in vitro indicated that RSPO1 could promote CFPAC-1 cells proliferation and up-regulate CD44 expression in CFPAC-1 cells.Experiments in vivo demonstrated that after 30 days the tumor volume of mice implanted with RSPO1-pretreated CFPAC-1 cells was (606.0±188.0) mm3, which was larger than that of PBS-pretreated group ((364.2±83.7) mm3), and the difference was statistically significant (t=2.616, P=0.031).Conclusion GPR49 is widely expressed in pancreatic cancer cells and RSPO1/GPR49 pathway has play a role in promoting the proliferation of pancreatic cancer cells, which might be a potential target for interfering pancreatic cancer.

Objective To investigate the effects and mechanism of microRNA150 (miRNA150) on proliferation, invasion and metastasis of gastric cancer.Methods From January 2015 to June 2016, 45 surgical specimens were collected.The expression of miRNA150 and Ras-interacting protein 1(RASIP1) at miRNA level in gastric cancer tissues and paracancerous tissues were quantified by quantitative real-time fluorescent reverse transcriptase-polymerase chain reaction (qRT-PCR).The correlation between miRNA150 and the biological features of gastric cancer as well as RASIP1 expression was analyzed.Gastric cancer cell line SGC-7901 was cultured and transfected with pcDNA3.1-miRNA150 expression plasmids.The effect of miRNA150 over-expression on the proliferation of SGC-7901 cells was determined by 3-(4,5-dimethyl-2-thiazolyl)-2,5-dipheayl 2-H-tetrazolium bromide (MTT) assay.And the effect of miRNA150 over-expression on the invasion and metastasis of SGC-7901 cells was detected by Transwell assay.The potential target gene of miRNA150 was analyzed by bioinformatics software and dual-luciferase reporter assay system.The effect of miRNA150 over-expression on RASIP1 expression in SGC-7901 cells was tested by qRT-PCR and Western blotting.Analysis of variance and t test were used to compare normal distribution data.And the Mann-Whitney rank sum test was used to compare skewed distribution data.Spearman assay was used for correlation analysis.Results The median level of miRNA150 in gastric cancer tissue was higher than that of paracancerous tissues (3.85, 0.26 to 7.92 vs 1.98, 0.19 to 5.66), and the difference was statistically significant (U=466.22,P<0.05).The median level of RASIP1 mRNA in gastric cancer tissue (1.65, 0.13 to 3.59) was lower than that of paracancerous tissues (2.96, 0.59 to 6.08), and the difference was statistically significant (U=522.31,P<0.05).The results of correlation analysis indicated that RASIP1 expression level was negatively correlated with miRNA150 expression (r=-0.589, P=0.008).The RASIP1 expression at mRNA level was negatively correlated with miRNA150 expression (r=-0.614, P=0.004).The dual-luciferase reporter assay showed RASIP1 was the target gene of miRNA150.The miRNA150 expression level was related with tumor size, TNM staging and lymph node metastasis(χ2=5.81, 6.00 and 10.04,all P<0.05).The results of MTT assay showed that after SGC-7901 cells cultured for 24 hours, the A value of pcDNA3.1-miRNA150 plasmid transfected cells was higher than that of the untransfected SGC-7901 cells (0.51±0.04 vs 0.79±0.03), and the difference was statistically significant (t=4.745, P<0.05).The results of Transwell assay indicated that there were more invasive and metastatic cells in pcDNA3.1-miRNA150 plasmid transfected cells.The results of qRT-PCR showed that the relative levels of RASIP1 mRNA in control group, pcDNA3.1-miRNA150 plasmid transfected cells and pcDNA3.1 empty plasmid transfected cells were 1.00±0.02, 0.51±0.03 and 1.08±0.03, respectively.The RASIP1 mRNA level in pcDNA3.1-miRNA150 plasmid transfected cells was lower than untransfected and pcDNA3.1 empty plasmid transfected cells, and the differences were statistically significant (t=3.940, 4.120, both P<0.05).miRNA150 could negtively regulate the RASIP1 protein expression and promote the proliferation and invasion of gastric cacer cells.Conclusions Over-expression of miRNA150 induced invasion and metastasis of gastric cancer by down-regulating RASIP1 expression.miRNA150 may be a novel biomarker for the diagnosis and treatment of tumor metastasis.

Objective To study the expression of long non-coding RNA (LncRNA) stomach cancer-associated transcript 16 (STCAT16) in gastric cancer tissues and its effects on the proliferation, migration and invasion of gastric cancer cells.Methods The different expression of STCAT16 in 32 cases of gastric carcinoma and corresponding adjacent tissues was detected by real-time fluorescence quantitative polymerase chain reaction (PCR).The STCAT16 overexpression plasmid and empty vector was separately transfected gastric cancer cell line AGS with low expression of STCAT16.The cell proliferation of empty vector group, non-transfection group and STCAT16 analogue transfection group was evaluated by cell counting kit-8 (CCK-8) assay at 0, 24, 48, 72 and 96 hours after transfection.The colony forming ability was tested by colony formation assay.The cell invasion ability was measured by Transwell chamber assay and migration ability was tested by scratch-wound assay.The effects of STCAT16 on tumorigenicity in vivo were verified by tumorigenicity experiments in nude mice.T-test and one-way analysis of variance were performed for data analysis.Repeated measures analysis of variance was used to compare the repeated measured data among groups.Chi square test and Fisher exact probability method were used for comparison of counting data.Results The expression of STCAT16 in gastric cancer tissues was low (0.87±0.19), while it was high in corresponding adjacent tissues (2.32±0.37), and the difference was statistically significant (t=-20.859, P<0.05).The expression of STCAT16 of STCAT16 analogue transfection group was higher than that of empty vector group (3.43±0.25 vs 1.00±0.06), and the difference was statistically significant (t=-16.795,P<0.05).Compared to empty vector group and non-transfection group, the cell proliferation decreased in STCAT16 analogue transfection group at 72 and 96 hours after transfection (1.41±0.07, 1.42±0.08, 1.03±0.09, and 1.72±0.11, 1.78±0.14, 1.24±0.08, respectively), and the differences were statistically significant (t=15.043,5.358, 12.193 and 8.109, all P<0.05).The results of colony formation assay indicated that the colony forming ability of gastric cells in STCAT16 analogue transfection group was lower than that in empty vector group (97.3±9.1 vs 185.0±20.1) and non-transfection group (97.3±9.1 vs 138.0±11.1), and the differences were statistically significant (t=11.634 and 4.417,both P<0.05).The results of Transwell assay showed that the number of AGS cells passing through the membrane of STCAT16 analogue transfection group was significantly less than those of empty vector group and non-transfection group (151.0±28.1 vs 228.0±38.2 and 151.0±28.1 vs 199.3±17.9), and the differences were statistically significant (t=4.823 and 4.747,both P<0.05).After transfection for 48 hours and 72 hours, the scratch-wound repair rate of STCAT16 analogue transfection group decreased, compared with those of empty vector group and non-transfection group ((52.67±6.11)%, (53.33±5.51)%, (42.67±4.72)%, and (90.67±2.51)%, (90.60±5.41)%, (69.67±1.52)%, respectively), and the differences were statistically significant (t=5.773, 5.955, 21.000 and 5.881, all P<0.05).The results of tumorigenicity in nude mice showed that compared with those of empty vector group, the tumor size of STCAT16 analogue transfection group was smaller at one-, two-, three-and four-week ((0.42±0.10) cm3 vs (0.16±0.05) cm3, (0.66±0.13) cm3 vs (0.34±0.05) cm3, (1.25±0.22) cm3 vs (0.54±0.13) cm3, (2.54±0.46) cm3 vs (0.78±0.41) cm3)), and the differences were statistically significant (t=3.175, 4.190, 7.996 and 9.705, all P<0.05).Conclusions STCAT16 is lowly expressed in gastric cancer tissues.The proliferation, migration, invasion ability and tumorigenicity in nude mice of gastric cancer cell is inhibited after upregulating the expression of STCAT16.

Objective To investigate the computed tomography (CT) features of autoimmune pancreatitis (AIP).Methods The CT imaging data of 33 patients with AIP confirmed by pathology and/or steroid therapy were retrospectively analyzed.Image analysis including the shape of pancreas, density of lesion, contrast enhancement, the changes of pancreatic duct and biliary duct, peripancreatic appearances and adjacent organ involvement.T test was performed for statistical analysis.Results Among 33 patients with AIP, 23 cases (70%) with pancreatic parenchyma diffuse enlargement, eight cases (24%) with partial enlargement and two cases (6%) with normal pancreas.The lesions appeared hypoattenuating or isoattenuating on plain CT scan.After contrast-enhanced scan, the average CT values of lesions were (75.7±17.0) Hu at arterial phase, which was lower than that of venous phase (90.7±12.0) Hu, and the difference was statistically significant (t=3.378,P=0.002).The lesions demonstrated as progressive enhancement at venous phase.Among 33 patients, the main pancreatic duct was visible in six patients (18%).Sixteen patients (48%) presented with intrahepatic and extrahepatic biliary tract dilatation caused by intrapancreatic common bile duct stenosis.Thickened envelope-like structure around the lesions, presenting as capsule sign was seen in 14 patients (42%).Extra-pancreatic organ involvement was found in seven patients including three cases of kidney involvement.After treated with steroid, seven patients repeated CT which showed different degrees of improvement.Conclusion The main CT findings of AIP are diffuse and partial enlargement of pancreas with progressive enhancement at venous phase, envelope-like structure around pancreas, and stenosis of intrapancreatic common bile duct, which are important in the diagnosis and differential diagnosis of AIP.

Objective To assess the value of computed tomography (CT) and magnetic resonance imaging (MRI) in the diagnosis of pancreatic neuroendocrine neoplasms (PNEN) and to analyze the factors influencing thepreoperative imaging diagnosis of PNEN.Methods From January 2016 to November 2016, patients with PNEN diagnosed by surgery and biopsy were collected. CT and MRI data of them were analyzed. The CT values or signal intensity of the lesions and the pancreatic parenchyma were measured and the contrast-to-noise ratio (CNR) of the lesion was calculated. Detecting sensitivity and diagnosis accuracy of CT and MRI were compared. Detecting sensitivity of different MRI sequences was also analyzed. Diagnosis accuracy of non-functional PNEN and functional PNEN was compared and analyzed. Lesion CNR was compared between arterial phase and portal venous phase of the contrast enhanced CT. The sensitivity, accuracy and constituent ratio were compared by nonparametric analysis. Independent sample t test and one-way analysis of variancewere performed for the quantitative parameters comparison. Results A total of 54 patients with 56 lesions of PNEN were included for two of whom had two lesions each. CT and MRI were both performed in 44 patients (46 lesions).Detecting sensitivity and diagnosis accuracy of CT were 97.8% (45/46) and87.0% (40/46), respectively. Detecting sensitivity of MRI were 97.8% (45/46) and89.1% (41/46), respectively. There was no significant difference in detecting sensitivity and diagnosis accuracy between CT and MRI (both P>0.05). The CNR of lesion in arterial phase was higher than that of portal venous phase(4.7±3.8 vs 3.4±2.5), and the difference was statistically significant (t=2.949, P<0.05). Detecting rates of T1 weighted imaging with fat suppression (T1WI-FS) image, T2 weighted imaging with fat suppression (T2WI-FS) image, diffusion weighted imagingand dynamic contrast enhanced T1WI-FS image were 90.0% (45/50), 88.0%(44/50), 86.0%(43/50), and 91.7% (44/48), respectively. There was no significant difference in detecting rate among these images sequences (Q=2.526, P=0.510). Tumor diameter in non-functional PNEN was significantly larger than that in functional PNEN ((2.9±1.6) cm vs (1.7±0.7) cm)(t=3.479,P<0.05). The overall diagnosis rate of non-functional PNEN with CT and MRI before operation was 70.8% (17/24), which was significantly lower than that of functional PNEN (100.0%, 31/31) (χ2=10.360，P=0.002).Conclusions CT and MRI are both sensitive in detectingPNEN, and they were two complementary modalities. CT image in arterial phase delineated the lesion better than that in portal venous phase. MRI images with different sequences can becomplementary and there is no significant difference in detecting sensitivity for PNEN among different sequences. CT and MRI play an equal rolein the diagnosis of PNEN before operation. Because of atypical CT and MRI findings, the diagnosis of non-functional PNEN is more difficult thanfunctional PNEN.

Objective To investigate the diagnostic value of computer image analysis assisted aroundness measurement of gastric gland lumens in well-differentiated gastric adenocarcinoma.Methods From January 2016 to July 2016,10 hematoxylin-eosin (H-E) stained slides of pathologically diagnosed well-differentiated gastric adenocarcinoma were collected.At the same period,H-E stained slides of gastric epithelial hyperplasia and normal gastric mucosa,six slides of each,were collected as controls.All of them were scanned into high resolution.Digital data roundness,long diameter and short diameter were measured and compared.Kruskal-Wallis rank sum test was used for statistical analysis.Results The median values of lumen roundness of normal gastric mucosa,gastric epithelial hyperplasia and welldifferentiated gastric adenocarcinoma were 79.7°(10.6°),73.0°(12.3°) and 58.6°(15.2°),respectively,and the difference among three groups was statistically significant (H=494.827,P＜0.01).The values of gland roundness of normal gastric mucosa were higher than those of gastric mucosal hyperplasia and welldifferentiated gastric adenocarcinoma,and the differences were statistically significant (T=156.007 and -508.579,both P＜0.01).The value of gland roundness of gastric mucosal hyperplasia was higher than that of well-differentiated gastric adenocarcinoma,and the difference was statistically significant (T=-352.572,P＜0.01).The values of long diameter of gland lumens in normal gastric mucosa,gastric mucosal hyperplasia and well-differentiated gastric adenocarcinoma were 24.1 μm(11.8 μm),43.1 μm (28.8 μm),and 96.0 μm(79.3 μm),respectively,and the difference among three groups was statistically significant (H=744.987,P＜0.01).The values of short diameter of gland lumens in normal gastric mucosa,gastric mucosal hyperplasia and well-differentiated gastric adenocarcinoma were 16.0 μm (8.7 μm),22.7 μm (13.1 μm) and 33.5 μm (38.0 μm),respectively,and the difference among three groups was statistically significant(H=248.170,P＜0.01).Conclusion The roundness of gastric gland lumens can be used as an effective parameter for the differential diagnosis of normal gastric mucosa,gastric mucosal hyperplasia and well-differentiated gastric adenocarcinoma.

Objective To compare the difference in the effects on liver function between transjugular intrahepatic portosystemic shunt (TIPS) alone and the combination of TIPS and left gastric vein embolization (LGVE) in patients with liver cirrhosis.Methods This research was a retrospective study.From September 2014 to September 2015,31 patients with liver cirrhosis underwent TIPS (TIPS group) and 29 patients with liver cirrhosis underwent TIPS combined with LGVE (TIPS+LGVE group) were enrolled.The data of the liver function of patients before and after operation were collected and the Child-Pugh score and model for end-stage liver disease (MELD) were also calculated.Student's t test and chi-squared test were performed for statistical analysis.Results The preoperative portal vein pressures of TIPS group and TIPS+LGVE group were (28.48±2.77) mmHg (1 mmHg=0.133 kPa) and (28.38± 2.92) mmHg,respectively.And after operation,the portal vein pressures decreased to (17.81 ± 1.47) mmHg and (17.97 ± 2.04) mmHg,respectively,and the differences were both statistically significant (t=18.908 and 11.648,both P＜0.01).At 12 months after operation,Child-Pugh score of TIPS+ LGVE group was 5.69 ± 1.19,which was significantly lower than that before operation (7.03±1.76),and the difference was statistically significant (t=3.398,P=0.001),which was also lower than that of TIPS group at the same time point (6.52 ± 1.54),and the difference was statistically significant (t =2.303,P=0.025).At 12 months after operation,the component ratio of patients with Child-Pugh grade A of TIPS±LGVE group was 89.7％ (26/29),which was higher than that before operation (44.8％,13/29),and the difference was statistically significant (x2=13.228,P＜0.01).The component ratio of patients with Child-Pugh grade B was 6.9 ％ (2/29),which was lower than that before operation (41.4 ％,12/29),and the difference was statistically significant (x2 =9.416,P＜ 0.01).Conclusions TIPS significantly reduces portal vein pressure in patients with liver cirrhosis and it does not deteriorate liver function of patients in the long term.The combination of TIPS and LGVE is better than TIPS alone in improving liver function in patients with liver cirrhosis,especially in improvig long-term liver function in patients of Child-Pugh A and B grade.

Objective To investigate the effects of intestinal microbiota of patients with chronic constipation on the expression of serotonin transporter (SERT) and the bowel movement in mice.Methods Fecal samples of patients with slow transit constipation met Rome Ⅲ criteria and healthy normal controls were collected and made into fecal microbiota solution.Twenty specfic pathogen free (SPF) mice were divided into experiment group and control group.The mice of two groups were both pre-treated with streptomycin to establish the germ-free mice model.The mice of control group were gavaged with mixed fecal microbiota solution of healthy normal controls and the mice of experiment group were gavaged with mixed fecal microbiota solution of patients with chronic constipation.Mice were sacrificed after fed for 15 days.Defecation parameters and ink discharge time of mice were detected.The expressions of SERT mRNA and SERT protein in mice intestinal tissues were detected with real time-polymerase chain reaction and Western blotting.The 5-hydroxytryptamine (5-HT) levels of mice intestinal tissues were evaluated by enzyme-linked immunosorbent assay (ELISA) and double immunofluorescent staining.The methods of t test and Chi-square test were performed for statistical analysis.Results On the 15th day,the total number of the feces within 2 h of the experiment group and control group was 8.55±1.83 and 12.14±2.90,respectively,and the difference was statistically significant (t=3.33,P＜0.05).The weight of feces were (151.90 ± 32.42) mg and (246.72 ± 64.01) mg,respectively,and the difference was statistically significant (t=4.18,P＜0.01).The dry weight of feces were (65.52±11.76) mg and (92.93±23.07) mg,respectively,and the difference was statistically significant (t=3.37,P＜0.05).The water content of feces were (56.63 ± 3.01) ％ and (61.95 ± 3.70) ％,respectively,and the difference was statistically significant (t=3.57,P＜0.05).The defecating time of first black feces of the experiment group and control group were (83.24±11.31) min and (69.06±2.72) min,respectively,and the difference was statistically significant (t=-2.74,P＜0.05).The expressions of SERT mRNA and SERT protein levels in mice intestine tissues of the experiment group were significantly higher than those of the control group (t =2.61,-6.89;both P＜0.05).5-HT level of mice intestinal tissues of the experimental group and control group were (151.69± 10.18) ng/mL and (198.77 ± 25.99) ng/mL,respectively,and the difference was statistically significant (t=-4.13,P＜0.01).Conclusion Intestinal microbiota of patients with chronic constipation may influence the expression of SERT in the mice intestinal tissues,and then decrease the level of 5-HT,slowing the bowel movement in mice.

Objective To explore the expression and its clinical significance of immunoglobulin G4 (IgG4) in inflammatory bowel disease (IBD) by detecting the expression of IgG4 in the serum and intestinal mucosa of patients with IBD.Methods From March 2015 to August 2016,68 patients with ulcerative colitis (UC),132 patients with Crohn's disease (CD) and 52 healthy controls were collected.The serum levels of IgG4 were detected by immunonephelometry.The expression of IgG4 in intestinal mucosa was analyzed by immunohistochemistry.Five high power fields (HPF) were randomly selected in each specimen.C-reaction protein (CRP) and erythrocyte sedimentation rate (ESR) of patients with UC,patients with CD and healthy controls were detected.The extent of disease,clinical type,disease activity scores (UC scored by Mayo score system,CD scored by Crohn's disease activity index (CDAI)) and current treatment were collected.The correlation between IgG4 expression and CRP,ESR,Mayo score and CDAI were analyzed.Independent sample t test,Chi square test and Pearson's correlation were performed for statistical analysis.Results The results of immunonephelometry indicated that the serum levels of IgG4 of patients with UC,CD and healthy controls were (0.79±-0.61),(0.69±0.59) and (0.41±0.32) g/L,respectively;all were lower than standard level 1.35 g/L.The results of immunohistochemistry revealed that the number of IgG4 positive cells in the colonic mucosa of active UC and CD patients were higher than that of healthy controls ((15.42±12.47)/HPF,(18.65±12.46)/HPF and (4.71±4.14)/HPF),and the differences were statistically significant (t=5.392 and 8.450,both P＜0.05).There was no statistically significant difference in mucosal IgG4 expression between UC,CD patients at remission phase and healthy controls ((4.72±4.23)/HPF,(5.30±4.87)/HPF and (4.71±4.14)/HPF,both P＞0.05).There was no statistically significant difference in mucosal IgG4 expression between UC and CD patients at active phase and remission phase (both P＞0.05).The case number of active patients,CRP,ESR and Mayo scores of IgG4 positive UC patients were all higher than those of IgG4 negative group(x2 =5.499,t=2.811,3.471 and 4.676;all P＜0.05).The number of active patients,CRP,ESR and CDAI of IgG4 positive CD patients were all higher than those of IgG4 negative group(x2 =4.341,t=3.842,3.892 and 2.935,all P＜ 0.05).In UC patients,the number of IgG4 positive cells was positively correlated with CRP,ESR and Mayo scores (r=0.382,0.381 and 0.470;P=0.001,0.003 and P＜0.01).The number of IgG4 positive cells was positively correlated with CRP,ESR and CDAI in CD patients (r=0.199,0.209 and 0.201;P=0.022,0.016 and 0.021).Conclusions The expression level of IgG4 significantly increased in the intestinal mucosa of IBD patients correlated with the activity of disease.The expression level of [gG4 may be one of the parameters to evaluate the activity of IBD.