Aquaporins,known as a family of water channel proteins,are crucial factors involved in colonic transmembrane water transport and play important roles in maintaining the homeostasis of internal and external environment of intestinal cells and modulating enteric nerve functions. Diarrhea-predominant irritable bowel syndrome( IBS-D)is a commonly seen gastrointestinal functional disorder in clinical practice. Recently,there are more and more researches focusing on the roles of aquaporins in IBS-D,however,mechanisms of its protective or damaging effects on IBS-D are still not clear. In this review article,the progress of research on the modulatory effect of aquaporins in IBS-D was summarized.

Numerous studies showed that changes in serum pepsinogen( PG)and gastrin-17( G-17)levels can reflect histological condition of gastric mucosa,that can be served as serological biopsy of gastric fundic glandular mucosa. The decrease of serum PGⅠ level and PGⅠ/ PGⅡ ratio(PGR)as well as increase of G-17 denotes a high risk of gastric cancer. Helicobacter pylori(Hp)infection can cause chronic active gastritis,and the progress of inflammation can lead to atrophy and intestinal metaplasia of mucosa. This article reviewed the diagnostic value of serum PG,G-17 and Hp antibody for atrophic gastritis and gastric cancer.

Noninfectious diarrhea is a kind of digestive disease caused by many factors and the main clinical features are increased frequency of defecation and change of character of stool,most of the patients have intestinal microecological imbalance. Improving the intestinal microecological balance is very important in the treatment of noninfectious diarrhea. Microbial ecological agent(MEA)has definite efficacy for the treatment of noninfectious diarrhea,and gradually becomes the commonly used drug for noninfectious diarrhea in clinical practice. This article reviewed the use of MEA in the treatment of noninfectious diarrhea.

Background:Resistance of Helicobacter pylori(Hp)to antibiotics is the primary reason for failure of Hp eradication therapies. It has been reported that there are regional differences in the resistance rate of Hp to commonly used antibiotics. Monitoring the regional Hp resistance status is helpful for improving the eradication rate in local area. Aims:To investigate the resistant spectrum of clinical Hp strains to commonly used antibiotics in Jiaxing Area,Zhejiang Province. Methods:A total of 17 402 patients who underwent gastroscopy from Jan. 2009 to Dec. 2013 at Jiaxing First Hospital were recruited for Hp culturing by using gastric antral biopsies. Then a drug sensitive test was performed for the Hp strains obtained from the culturing. Sensitivity of these Hp strains to metronidazole,amoxicillin,gentamicin,furazolidone,clarithromycin and levofloxacin was determined. Results:Among the 17 402 cases of gastric antral biopsies,5 898(33. 9% )were positive for Hp culturing. Drug sensitive test revealed that the resistance rate of metronidazole was extremely high in all year and age groups;the resistance rates of clarithromycin and levofloxacin were increasing by years;and the resistance rates of furazolidone,amoxicillin and gentamicin were considerably low in all year and age groups. When two antibiotics were combined,amoxicillin and gentamicin accounted for the lowest resistance rate,and the next were amoxicillin and furazolidone,and gentamicin and furazolidone,respectively. Conclusions:The clinical Hp strains isolated from all age groups in Jiaxing Area,Zhejiang Province are highly resistant to metronidazole,therefore it is not recommended to be used in first line eradication regimen. Amoxicillin combined with gentamicin/ furazolidone is an ideal antibiotic combination for patients with Hp infection in all age groups;and combination of gentamicin and furazolidone is recommended to patients who are allergic to penicillin.

Background:Serum levels of pepsinogen( PG),gastrin-17( G-17)and Helicobacter pylori( Hp)infection are closely associated with gastric cancer. Studies on relationship of serum levels of PG and G-17 with Hp infection in Uygur and Han population with gastric cancer in Xinjiang area are rare. Aims:To investigate serum levels of PG and G-17 and their relationships with Hp infection in Uygur and Han population with gastric cancer in Xinjiang area. Methods:A total of 198 Uygur and 50 Han gastric cancer patients were enrolled,and healthy people with the same race were served as normal controls. Serum levels of PGⅠ,PGⅡ,G-17 were determined by ELISA,PGⅠ/ PGⅡ ratio(PGR)was calculated. Urea breath test and stool Hp antigen test were used to detect Hp infection. Results:Serum PGⅠ level and PGR in Uygur and Han patients with gastric cancer were significantly decreased than those in corresponding control groups(P < 0. 05),and serum levels of PGⅡ and G-17 were significantly increased(P < 0. 05). Serum PGⅠ level and PGR in Uygur gastric cancer patients were significantly decreased than those in Han gastric cancer patients(P < 0. 05),and serum G-17 level was significantly increased(P < 0. 05). Hp infection rate in Uygur and Han patients with gastric cancer were significantly increased than those in corresponding control groups( P < 0. 05). Serum level of PG Ⅰ and PGR were significantly decreased in Han gastric cancer patients with Hp-positive than in Hp-negative patients,and serum levels of PGⅡ and G-17 were significantly increased(P < 0. 05). Serum levels of PGⅠ,PGⅡ and G-17 were significantly increased in Uygur gastric cancer patients with Hp-positive than in Hp-negative patients,PGR was significantly decreased(P < 0. 05). Serum levels of PGⅠ,PGⅡ and PGR were significantly increased in Uygur gastric antral cancer patients than in gastric corpus cancer and proximal gastric cancer patients(P < 0. 05). Conclusions:Decreased serum PGⅠ level,PGR and increased serum level of G-17 can be used as biomarkers to screen gastric cancer in Uygur and Han population in Xinjiang area. Hp infection in Uygur and Han patients with gastric cancer is related to the changes of serum level of PGⅠ,PGR and G-17.

Background:In recent years,the incidence and mortality of colorectal carcinoma have been increasing rapidly. Diagnosing and treating cancer at gene level have become a new effective approach. Aims:To investigate the expression of S-phase kinase-associated protein 2(Skp2)and its relationship with vascular endothelial growth factor(VEGF)and tumor microvessel density(MVD)in colorectal carcinoma. Methods:Thirty-five colorectal carcinoma patients from March 2014 to March 2015 at People’s Hospital of Hubei University of Medicine were enrolled. Fifteen para-cancerous tissue samples were served as controls. The expressions of Skp2,VEGF and MVD value were determined by immunohistochemical SP, and their relationships with clinicopathological characteristics were analyzed. Results:The expression of Skp2 in colorectal carcinoma was significantly higher than that in para-cancerous tissue( P = 0. 000),and was correlated with tumor differentiation and lymph node metastasis(P < 0. 05),but not with gender,age and TNM stage(P > 0. 05). Expression of VEGF and MVD value were significantly higher than those in para-cancerous tissue(P = 0. 019,P = 0. 002),and were correlated with lymph node metastasis and TNM stage(P < 0. 05). Expression of Skp2 was positively correlated with the expression of VEGF and MVD value in colorectal carcinoma( r = 0. 569,P = 0. 000;r = 0. 481,P = 0. 017 ). Conclusions:The abnormal high expression of Skp2 is involved in the angiogenesis of colorectal carcinoma. Skp2,VEGF expressions and MVD value may be served as important markers for malignancy degree of colorectal carcinoma.

Background:Peroral endoscopic myotomy(POEM)is a novel minimally invasive endoscopic technique for treatment of esophageal achalasia(EA). It has been demonstrated to be safe and effective in several short-term clinical studies, however,studies focusing on its mid- and long-term outcome are rare. Aims:To investigate the mid-and-long term efficacy of POEM in EA patients. Methods:A retrospective analysis was performed in 41 EA patients who underwent POEM in the Department of Gastroenterology and Hepatology of Nanjing General Hospital of Nanjing Military Region from Jul. 2012 to Dec. 2013. All these patients were followed up periodically for clinical symptoms(Eckardt score),maximum esophageal diameter and lower esophageal sphincter pressure(LESP),and the intra- and post-operative complications and recurrence were recorded. Results:POEM was successfully completed in all 41 EA patients,the mean operative time was(69. 5 ± 20. 6)min(range 35-125 min),and the mean length of hospital stay was 3. 5 days. Compared with the pre-operative data,the post-operative Eckardt score,maximum esophageal diameter and LESP during follow-up(mean 26. 3 months, range 19-36 months)were significantly decreased(P all < 0. 05). Procedure-related complications were seen in 6 patients (14. 6% );the clinical success rate was 95. 1%(39 / 41)and the recurrence rate was 2. 4%(1 / 41). Conclusions:POEM is safe and effective in mid-and-long term follow-up with low recurrence rate. It might become the first-line therapy for EA,and the long-term efficacy and complications need further follow-up study.

Background:Acute-on-chronic liver failure( ACLF)is a commonly seen liver failure in China,and lacking an animal model that can effectively simulate the dynamic change of immune status of ACLF. Aims:To establish an animal model that can simulate dynamic change of immune status of ACLF by repeated administration of concanavalin A(ConA). Methods:Mice were randomly divided into normal control group and ConA repeated administration group. Mice in ConA repeated administration group were injected with ConA 15 mg/ kg through retrobulbar angular vein every 48 hours for 5 times,and mice in control group were injected with same volume of 0. 9% NaCl solution. Serum levels of IL-6,IL-10,IL- 12,TNF-α,IFN-γ,MCP-1 in peripheral blood were assessed by CBA assay,and the ratio of IL-10/ TNF-α was calculated. The expression of HLA-DR,number and proportion of CD4+ T cells and the expression of PD-1 of monocytes in peripheral blood were detected by flow cytometry. Results:Peripheral blood cytokines changed from predominated proinflammatory cytokines into predominated anti-inflammatory cytokines with the increasing in time of administration in ConA repeated administration group. Compared with control group,HLA-DR expression of monocytes in peripheral blood was significantly decreased(P <0. 05),number and proportion of CD4+ T cells were significantly decreased(P <0. 05), and PD-1 expression was significantly increased( P < 0. 05)in ConA repeated administration group. Conclusions:An animal model of ACLF immune status from systemic inflammatory response syndrome( SIRS) to compensatory antiinflammatory response syndrome(CARS)induced by repeated ConA stimulation is successfully established.

Colorectal cancer is one of the most commonly seen malignant tumors,and the metastatic colorectal cancer is of poor prognosis. The median overall survival for chemotherapy is only 1-1. 5 years. Recently,molecular targeted therapy targeting at vascular endothelial growth factor and epidermal growth factor receptor was used widely for metastatic colorectal cancer and becoming a hot spot of related researches. This article focused on the strategy and hypothesis of molecular targeted therapy for treatment of metastatic colorectal cancer.

Chronic hepatitis B(CHB)is one of the most commom cause of liver fibrosis. Accurate assessment of liver fibrosis is essential for the strategy of treatment and judgement of prognosis . Liver biopsy is the gold standard for staging fibrosis,but it is invasive with high cost,low reproducibility and poor acceptance by patients. Therefore,it is urgent to explore a noninvasive modality for the assessment of liver fibrosis. Recent evidence highlights that elastographic techniques, biochemical markers and the diagnostic model consisted of several serum markers have the potential for the diagnosis of liver fibrosis. This article reviewed the progress in noninvasive assessment of liver fibrosis in patients with CHB.