Pancreatic abscess(PA)is the most serious complication of severe acute pancreatitis(SAP),which can lead to systemic and/ or local complications,and even death. PA cannot be resolved automatically after the formation. Once diagnosed,early drainage,anti-infection and nutrition support should be undertaken,the most important is early drainage. In the past,the treatment of PA was mainly based on surgical treatment. With the development of minimally invasive techniques,endoscopic ultrasound(EUS)guided drainage and percutaneous catheter drainage(PCD)offer a new way for the treatment of PA. Preventing and early diagnosis of PA become a challenge in the treatment of SAP. This article reviewed the progress in diagnosis and treatment of SAP complicated with PA.

Bile reflux is not only related to diseases such as gastritis,esophagitis,pharyngitis,chorditis,bronchitis and pneumonia,but also related to residual gastric ulcer,residual gastric cancer,intestinal metaplasia,dysplasia and carcinogenesis. Risk factors related to bile reflux include various operation modes, various anastomosis methods, gallbladder stone, cholecystectomy and various non-operative factors such as age, gender, allergy, mental and psychological factors,congenital factors. This article reviewed the advances in study on risk factors related to bile reflux.

Hepatic stellate cells(HSCs),the pluripotent cells,exist between liver sinusoidal endothelial cells and hepatic epithelial cells. Activated HSCs transform to myofibroblast-like cells,start to proliferate,and de novo express some proinflammatory and profibrogenic genes,which promote hepatic fibrogenesis. Previous studies mainly focused on the relationship between HSCs and liver fibrosis,however,recent studies indicate that HSCs are essential for proliferation, differentiation and maturation of various liver cells in the process of liver development and regeneration. This review systematically summarized the source,developmental regulation and function of HSCs,and focused on progress of recent studies on the role of HSCs in liver development and regeneration. The novel knowledge of HSCs may provide clues for treatment of liver diseases.

Background:Recent studies have shown that long non-coding RNAs(lncRNAs)play important roles in carcinogenesis and cancer biology and the related context has attracted more and more attentions. PVT1,which encodes a lncRNA,is reported to be up-regulated and exhibit pro-oncogenic activity in a wide variety of human cancers. Aims:To investigate the expression of PVT1 in human pancreatic cancer cells and its effect on proliferation and apoptosis of HPAF-Ⅱ cells. Methods:One target siRNA against PVT1 was synthesized and transfected into HPAF-Ⅱ cells by using lipofactamine technique. PVT1 mRNA expression was detected by real-time PCR;capability of cell proliferation was examined by MTS and colony formation assays;cell cycle progression and apoptosis were measured by flow cytometry;and Western blotting was performed to determine the expressions of apoptosis-related proteins and proto-oncogene protein c-Myc. Results:The mRNA expression of PVT1 in several human pancreatic cancer cell lines,especially HPAF-Ⅱ cells was significantly higher than that in H6c7,a human immortalization normal pancreatic ductal epithelial cell line. Compared with HPAF-Ⅱ cells transfected with negative control siRNA or without transfection,silencing of PVT1 by siRNA-PVT1 resulted in remarkable reduction in cell proliferation,cell cycle G1 phase arrest,and notable apoptosis;meanwhile,the expressions of apoptosis-related proteins(cleaved-caspase-3 and cleaved-PARP)were up-regulated,the ratio for Bcl-2 / Bax was decreased,and the expression of c-Myc protein was down-regulated. Conclusions:LncRNA-PVT1 is highly expressed in human pancreatic cancer cell line HPAF-Ⅱ. It may affect the proliferation and apoptosis of HPAF-Ⅱ cells partially through regulating c-Myc expression.

The Japanese Society of Gastroenterology revised the evidence-based clinical practice guidelines for peptic ulcer disease in 2015. The revised guidelines consist of the following items:bleeding gastric and duodenal ulcers, Helicobacter pylori(Hp)eradication therapy and non-eradication therapy,drug-induced ulcer,non-Hp/ non-nonsteroidal anti-inflammatory drug( NSAID)-induced ulcer,and surgical treatment. This guideline describes the abovementioned content in detail and is a good reference for clinical practice. A full interpretation of this guideline was performed in this paper.

Background:Gastroesophageal reflux disease(GERD)is a common disease,its incidence is related to geographic environment and race. Studies reported on epidemiology of GERD in minority groups are rare. Aims:To investigate the prevalence and related risk factors of GERD in She population in Ningde. Methods:Three natural villages of She population in Ningde were selected for undergoing the cluster random sampling method. GERD was diagnosed by gastroesophageal reflux disease questionnaire(GerdQ)with score ≥8,and questionnaire was used to detect the prevalence and risk factors of GERD. Results:A total of 936 residents completed the questionnaire,and 89 were diagnosed as GERD, the prevalence was 9. 50% . Univariate analysis showed that the risk of GERD was significantly increased in She population with body mass index(BMI)≥24 kg/ m2 ,intake of strong tea or oily diet(P all < 0. 01). Multivariate analysis showed that BMI ≥24 kg/ m2(OR = 3. 022,95% CI:1. 917-4. 765),intake of strong tea(OR = 2. 145,95% CI:1. 338-3. 438) and oily diet(OR = 2. 016,95% CI:1. 208-3. 318)were the risk factors of GERD. Conclusions:The prevalence of GERD is high in She population in Fujian Province,and the etiology may be related to overweight and diet habit.

Background:Colorectal polyps are common gastrointestinal diseases,which are closely related to the development of colorectal cancer. Aims:To investigate the clinical features of high-risk people with intestinal polyps in colorectal cancer screening. Methods:People in Hongkou District,Shanghai,who were positive in fecal occult blood test or of the high risk category in colorectal cancer questionnaire from April 2013 to December 2014 were enrolled,and colonoscopy was performed at Branch of Shanghai First People’s Hospital. The overall detection rate,gender,age,location of lesion, morphology,and pathology were analyzed. Results:A total of 985 patients with colorectal polyps were recruited in this study. The overall detection rate of polyps was 48. 7% . The prevalence of colorectal polyps was significantly higher in males than in females(58. 7% vs. 38. 9% ;χ2 = 79. 788,P < 0. 01). The detection rates of colorectal polyps in different age groups were statistically significant(χ2 = 23. 820,P < 0. 01). Detection rate of polyps was significantly higher in left colon than in right colon(62. 4% vs. 37. 6% ;χ2 =190. 643,P <0. 01). The overall detection rate of protruding lesion 0-Ⅰwas 94. 5% ,and slightly elevated lesion 0-Ⅱa was 48. 3% . Detection rate of adenomatous pylops was significantly higher than non-adenomatous pylops(59. 3% vs. 47. 1% ;χ2 = 27. 326,P < 0. 01). The histological results were differed between two examination in 119 patients. Only 17. 8% of the patients operated were followed up by colonoscopy,and polyps recurred in 62. 3% of them. Conclusions:A higher incidence of colorectal polyps is found in people with high risk of colorectal cancer screening. High quality colonoscopy examination and effective operation in time can reduce the incidence of colorectal cancer.

Background:The efficacy of standard triple therapy for eradication of Helicobacter pylori(Hp)is decreasing in recent years,and bismuth-containing quadruple regimen becomes the first-line therapy for Hp infection. However,the application of bismuth has some limitations. Aims:To investigate the efficacy of proton pump inhibitor(PPI)-based standard triple therapy combined with teprenone for Hp eradication. Methods:A total of 155 Hp-infected chronic gastritis patients were enrolled from Jan. 2013 to Dec. 2014 at Aerospace Center Hospital,and were randomly assigned into standard triple therapy group,bismuth-containing quadruple therapy group and teprenone-containing quadruple therapy group. Patients in standard triple therapy group were given rabeprazole sodium 20 mg + amoxicillin and clavulanate potassium 914 mg +clarithromycin 500 mg bid for 10 days. Patients in bismuth-containing quadruple therapy group were given standard triple therapy combined with bismuth potassium citrate 0. 6 g bid for 10 days. Patients in teprenone-containing quadruple therapy group were given standard triple therapy combined with teprenone 50 mg bid for 10 days. Symptoms of patients were evaluated before and after eradication therapy. Four weeks after the end of therapy,13 C-urea breath test( UBT)was reexamined to assess the status of Hp infection. Results:One hundred and fifty-two patients completed the treatment course. By ITT analysis,the eradication rates of standard triple therapy group,bismuth-containing quadruple therapy group and teprenone-containing quadruple therapy group were 69. 8%(37 / 53),86. 5% (45 / 52)and 88. 0% (44 / 50), respectively;by PP analysis,the eradication rates of the three groups were 71. 2%(37 / 52),88. 2% (45 / 51)and 89. 8%(44 / 49),respectively. Eradication rates analyzed by ITT and PP in bismuth-containing quadruple therapy group and teprenone-containing quadruple therapy group were significantly higher than those in standard triple therapy group(P <0. 05),but no statistically significant difference was found between these two groups( P > 0. 05). Relieving rates of abdominal pain,abdominal distention and belching in bismuth-containing quadruple therapy group and teprenone-containing quadruple therapy group were higher than those in standard triple therapy group,but statistically significant difference was only found in relieving of abdominal pain between teprenone-containing quadruple therapy group and standard triple therapy group(88. 9% vs. 70. 3% ,P < 0. 05). Adverse effects included transient and mild nausea,diarrhea and black stool, etc. Conclusions:Teprenone-containing quadruple regimen are effective for Hp eradication and symptoms relieving with no severe adverse effects,the efficacy is comparable with bismuth-containing quadruple regimen.

Background:Hydrotalcite has been used in the treatment of gastric ulcer,but its mechanism is not clear. Aims:To investigate the efficacy and mechanism of hydrotalcite on experimental gastric ulcer in rats. Methods:Experimental acetic acid-induced gastric ulcer model was established in rats. Model rats were randomly assigned into control group,low and high dose hydrotalcite groups,and 0. 9% NaCl solution,880 mg·kg - 1 ·d - 1 ,1 230 mg·kg - 1 ·d - 1 hydrotalcite were intragastrically administrated,respectively. After 14 days,macroscopic examination was performed;and HE staining, CD31 staining and VG staining were used to evaluate the histological maturity,AB-PAS staining,level of hexosamine, immunohistochemical staining,serum levels of epidermal growth factor( EGF),prostaglandin E2( PGE2 )were used to evaluate the functional maturity. Results:Compared with control group,ulcer index(UI)was significantly decreased in high dose hydrotalcite group(P < 0. 05). Thickness of restored mucosa was significantly increased(P < 0. 05),number of cystically dilated gland was significantly decreased(P < 0. 01),microvessel density(MVD),collagen fiber,secretion of mucus,level of hexosamine,expressions of EGF,EGR receptor(EGFR)and PGE2 ,serum levels of EGF and PGE2 were significantly increased in low and high hydrotalcite groups( P < 0. 05,P < 0. 01). Conclusions:Hydrotalcite could obviously improve the histological and functional maturity of regenerative mucosa,as well as the quality of ulcer healing. The mechanism might be related to the neutralization of gastric acid,enhancement of mucus-HCO3 - barrier and up-regulation of expressions of EGF and PGE2 .

Background:Helicobacter pylori(Hp)is an important pathogen for peptic ulcer and gastric cancer,and is reportedly associated with a variety of extragastrointestinal diseases. However,there is no body fluid detection technique for Hp infection in clinical practice. Aims:To identify Hp infection-associated differentially expressed proteins in urine with relative molecular mass more than 10 kDa and provide potential biomarkers for diagnosis of Hp infection through body fluid detection. Methods:Midstream urine was collected from volunteers in the morning,and 13 C-urea breath test was performed to determine Hp infection. Each of 15 Hp-negative and 15 Hp-positive urine samples were mixed respectively for protein extraction. Spectra data were acquired by high performance liquid chromatogram-mass spectrometry,and label-free technology was used for relative quantitative analysis. The other 26 urine samples(15 Hp-negative and 11 Hp-positive) were used for validation by full scan. IPA software was employed for bioinformatics analysis. Results:A total of 475 urinary proteins were detected by label-free quantitative analysis and 42 differentially expressed proteins were identified. Finally,11 significantly up-regulated differentially expressed proteins were confirmed by external scanning validation. Bioinformatics analysis revealed the molecular functions,biological pathways,and related diseases of these differentially expressed proteins. Conclusions:These 11 differentially expressed proteins more than 10 kDa identified in urine might be potential biomarkers for diagnosis of Hp infection and provide molecular evidence for the correlation of Hp infection with extragastrointestinal diseases.