Background:Fanconi anemia( FA ),an autosomal or x-linked recessive inherited disease,is caused by gene mutation related to FA pathway of DNA damage and with the clinical features of congenital malformation,bone marrow failure and susceptibility to cancer. Aims:To investigate the expression of Fanconi anemia complementation group D2 (FANCD2)in colorectal cancer and its correlation with prognosis. Methods:Fifty-six surgical resected specimens of colorectal cancer tissue and para-cancer noncancerous tissue from May 2012 to September 2013 at Guangzhou First People’s Hospital were obtained. Ninety-three patients with colorectal cancer from January 2008 to April 2009 at Guangzhou First People ’s Hospital were enrolled and the specimens of colorectal cancer tissue were obtained. The expression of FANCD2 mRNA in 56 specimens of colorectal cancer tissue and para-cancer noncancerous tissue was determined by qPCR. The expression of FANCD2 protein in 49 of 56 specimens of colorectal cancer tissue and para-cancer noncancerous tissue and 93 specimens of colorectal cancer tissue was determined by immunohistochemistry. Follow up was conducted in 93 patients and the correlation between the expression of FANCD2 and prognosis was analyzed. Results:Expression of FANCD2 mRNA was significantly higher in colorectal cancer tissue than that in para-cancer noncancerous tissue [0.102(0.047,0. 163)vs. 0. 051(0. 025,0. 095)](P =0. 007). Expression of FANCD2 mRNA was significantly correlated with lymph node metastasis and Dukes stage( P <0. 05 ). Positivity rates of FANCD2 protein expression in colorectal cancer tissue and para-cancer noncancerous tissue were 77. 6%(38/49)and 22. 4%(11/49),respectively. Expression of FANCD2 protein was significantly correlated with lymph node metastasis and Dukes stage(P<0. 05). The overall 5-year survival rate was significantly lower in patients with positive expression of FANCD2 protein than that in patients with negative expression of FANCD2 protein(35. 5% vs. 71. 0%)(P<0. 01). Conclusions:FANCD2 is associated with malignant potential of colorectal cancer and could be a potential marker for prognosis.

Peutz-Jeghers syndrome ( PJS ) is a rare autosomal dominant inherited disease characterized by mucocutaneous pigmentation and multiple gastrointestinal polyposis. Recent studies suggested that mutation in STK11 gene on chromosome 19p13. 3 was considered as the major cause of PJS. In this paper,we summarized the clinical features, pathogenesis,diagnosis and treatment of PJS through literature review.

Background:Of the diagnostic modalities of gastroesophageal reflux disease( GERD),radioisotopic examination is more physiological and non-invasive as compared with upper gastrointestinal endoscopy,24-hour esophageal pH monitoring and esophageal manometry. Aims:To examine the diagnostic value of 99m Tc-labeled single-photon emission-computed tomography(SPECT)for GERD. Methods:Ten erosive esophagitis(EE),10 nonerosive reflux disease(NERD)and 10 noncardiac chest pain patients were enrolled in this study. All of them had a high reflux disease questionnaire( RDQ)score (>12)and were positive for proton pump inhibitor(PPI)test. Ten volunteers without reflux symptoms served as controls. After the taking of 99mTc-labeled acidic drinks,SPECT scan was performed in esophageal region for indentifying the radioactivity at gastroesophageal junction. Through region-of-interest,the stomach and esophagus were outlined and the GERindex was calculated. Results:Radioactivity was observed in lower esophagus in 8 patients of EE group,including 6 spontaneous reflux and 2 induced reflux;in NERD group and noncardiac chest pain group,the corresponding data were 5,3, 2 and 6,2,4,respectively. No reflux was observed in control group. Positivity rates of reflux identified by SPECT in EE, NERD and noncardiac chest pain groups were all significantly higher than that in control group(80. 0%,50. 0% and 60. 0%vs. 0%,P<0. 05). Conclusions:99m Tc-labeled SPECT has clinical value for diagnosis of GERD and is potential for being used as a method of GERD examination in clinical practice.

Background:In the treatment of many gastric diseases,eradication of Helicobacter pylori( Hp)is important. With the increasing in antibiotic resistance of Hp,the eradication efficacy of conventional triple and quadruple therapy for Hp is decreasing in recent years. Aims:To assess the efficacy and safety of quadruple therapy combined with astragalus membranaceus for Hp eradication. Methods:A total of 395 Hp-infected patients with chronic gastritis/dyspepsia and peptic ulcer diagnosed by gastroscopy were enrolled,of them 185 patients were of chronic gastritis/dyspepsia group and 210 patients were of peptic ulcer group. Patients in the two groups were subdivided into trial group and control group. Patients in trial group were given quadruple therapy combined with astragalus membranaceus for 14 days,and patients in control group were given quadruple therapy only for 14 days. Hp eradication was assessed by 13 C-urea breath test 4 weeks after treatment. Results:A total of 358 patients(90. 6%)completed the study. In chronic gastritis/dyspepsia group,the eradication rate was significantly higher in trial group than in control group by PP analysis(P<0. 05),but no significant difference was found by ITT analysis(P>0. 05). In peptic ulcer group,the eradication rates by PP and ITT analysis showed no significant differences between trial group and control group(P>0. 05). In control group,the eradication rates by PP and ITT analysis were significantly higher in peptic ulcer group than in chronic gastritis/dyspepsia group( P <0. 01). In trial group,the eradication rates by PP and ITT analysis were not significantly different between chronic gastritis/dyspepsia group and peptic ulcer group( P >0. 05 ). The incidence of adverse effects was not significantly different between chronic gastritis/dyspepsia group and peptic ulcer group as well as trial group and control group( P>0. 05). Conclusions:Quadruple therapy combined with astragalus membranaceus could increase the eradication rate of Hp in chronic gastritis/dyspepsia group safely.

Background:Prognosis of early colorectal carcinoma( ECC)is well because of low rate of lymph-node metastasis ( LNM). How to improve the detection rate and select appropriate therapy for ECC has been an eager task in clinical practice. Aims:To analyze the pathological features of ECC treated by endoscopic resection(ER)or surgery,and evaluate the therapeutic efficacy of ER. Methods:Pathological data of 503 ECC lesions treated by ER or surgery were retrospectively analyzed. Risk factors of infiltration depth,LNM of ECC were analyzed,and therapeutic efficacy of ER was evaluated. Results:The overall detection rate of ECC was 10. 7%. The incidence of LNM was 1. 2%(6/503);the LNM incidence of mucosal high-grade neoplasia was 0%( 0/247 ),while was 2. 3%( 6/256 ) in submucosal carcinoma. The LNM incidence of submucosal superficial carcinoma treated by ER was 0%( 0/31 ). Tumor location, size,histological type and LNM had significant impacts on infiltration depth(P<0. 05). The rates of en bloc,complete and curative resection by ER were 96. 0%,94. 2% and 82. 1%,respectively. Infiltration depth was the risk factor of piecemeal,incomplete and noncurative resection of ER(P<0. 05). Conclusions:The incidence of LNM in ECC is extremely low. Accurate evaluation of character and infiltration depth of lesion before operation is helpful for selecting appropriate therapy. It should be cautious to choose ER for lesions infiltrated into submucosa,thereby to improve the therapeutic efficacy of ER.

Background:Matrix metalloproteinase-9(MMP-9)is known to play a key role in tumor invasion and metastasis by mediating the degradation of extracellular matrix. It has been revealed that neutrophil gelatinase-associated lipocalin ( NGAL)is capable of protecting MMP-9 from degradation and thereby preserving its enzymatic activity. Aims:To explore the MMP-9 and NGAL levels in peripheral blood of gastric cancer patients and their clinical significance. Methods:Serum levels of MMP-9 and NGAL were determined by ELISA in 76 gastric cancer patients and 50 healthy controls. Correlations of serum MMP-9 and NGAL levels with clinicopathological features of gastric cancer were analyzed,and their diagnostic performance for screening gastric cancer was evaluated by ROC curve. Results:Serum levels of MMP-9 and NGAL in patients with gastric cancer were significantly higher than those in healthy controls(P<0. 01),and either of them was positively correlated with the TNM stage of gastric cancer. Furthermore,MMP-9 was correlated with lymph node metastasis and serosal invasion,while NGAL was correlated with distant metastasis. However,tumor differentiation was not correlated with either MMP-9 or NGAL. By ROC curve,608. 19 ng/mL and 14. 71 ng/mL were identified as the cutoff value of serum MMP-9 and NGAL,respectively,for screening gastric cancer. Sensitivity and specificity of MMP-9 were 64. 5% and 90. 0%,and those of NGAL were 85. 5% and 90. 0%,respectively. When parallel test was taken,the sensitivity would be increased to 94. 7% and specificity being 82. 0%. Conclusions:Serum levels of MMP-9 and NGAL are elevated and associated with tumor progression in patients with gastric cancer. Both of them might be used as potential markers for screening,disease assessment and prognosis prediction of gastric cancer.

Background:Primary biliary cirrhosis( PBC ) is an autoimmune liver disease,the cause of the disease remain incompletely understood. In addition to genetic and environmental factors,autoantibodies,multiple immunocytes and cytokines are considered to be involved in the development of PBC. Recent studies indicated that interleukin-9(IL-9)had pleiotropic functions in inflammatory regulation in allergic and autoimmune diseases. Aims:To investigate the expression and clinical significance of IL-9 in patients with PBC. Methods:A total of 30 specimens of peripheral blood and 20 specimens of liver tissue from PBC patients were collected. Ten specimens of peripheral blood from healthy subjects and 4 specimens of normal liver tissue were served as controls. Level of serum IL-9 was determined by ELISA,and expression of IL-9 in liver tissue was detected by immunohistochemistry. Correlations between IL-9 and serum biochemical indicators, immune indicators and histologic stage of liver tissue were analyzed. Results:Level of serum IL-9 was significantly increased in PBC patients than in normal control group(P<0. 05),and was positively correlated with level of serum IgG (r=0. 681,P<0. 01). Amount of IL-9 positive cells in liver tissue was significantly increased in PBC patients than in normal control group(P <0. 01),and was positively correlated with histologic stage of liver tissue(rs =0. 465,P <0. 05). Conclusions:Expression of IL-9 is significantly increased in peripheral blood and liver tissue in patients with PBC and is positively correlated with level of serum IgG and histologic stage of liver tissue,which suggests an important role of IL-9 in the pathogenesis of PBC.

Background:It is commonly recommended that patients should refrain from driving for 24 hours after sedation for endoscopy,however,this recommendation has been queried recently. Aims:To investigate the effect of sedation on early postoperative cognitive function in patients undergoing endoscopy. Methods:One hundred adult patients undergoing sedative esophagogastroduodenoscopy ( EGD ) were randomly recruited, and another 100 adult patients undergoing conventional EGD were served as controls. All patients had an education level more than 9 years. Cognitive function was assessed by number connection test-A( NCT-A),number cancellation test and digit symbol test( DST)before propofol sedation or the beginning of endoscopic procedure and was reassessed when the discharge criteria were met. If the results obtained were inferior to those before EGD,a third assessment was taken 30 minutes later until the results recovered or being superior to the baseline levels. Results:All patients completed the first and second assessment,and 124 patients had taken the third assessment. When the discharge criteria were met,result of number cancellation test was inferior to that before EGD in sedation group( P =0. 000 ). Furthermore,the results were analyzed by grouping with age,number cancellation test in young patients and NCT-A in elderly patients were inferior to that before EGD,respectively(P=0. 000 and P =0. 025 ). In control group,none of the results were inferior to those before EGD. The results of the third assessment recovered or being superior to the baseline levels. Conclusions:Early postoperative cognitive dysfunction at discharge is common in patients undergoing endoscopy using propofol sedation,but the impairment will recover by a prolonged staying calm before discharge. The optimal time for discharge and resuming driving remains to be further studied.

Background:Studies have shown that GEF-H1 can activate Rho protein, and is closely associated with tumorigenesis,tumor progression,infiltration,migration. Aims:To construct human pEGFP-GEF-H1 vector and stably transfect into colon cancer HCT116 cells,and determine the expression of GEF-H1. Methods:The gene sequence was designed according to the Online primers synthesis software for constructing recombinant plasmid pEGFP-GEF-H1. HCT116 cells were transfected with plasmid pEGFP-GEF-H1,empty plasmid,respectively,and HCT116 cells without transfection were served as blank control group. Expression of green fluorescence protein was observed under fluorescence microscope. mRNA and protein expressions of GEF-H1 were determined by RT-PCR and Western blotting,respectively. Results:Human pEGFP-GEF-H1 vector was successfully constructed and identified by sequence analysis. After transfection with pEGFP-GEF-H1,green fluorescence could be observed in HCT116 cells,and the mRNA and protein expressions of GEF-H1 were higher than those in empty plasmid group and blank control group. Conclusions:Recombinant plasmid pEGFP-GEF-H1 is successfully constructed in vitro,and transfection into HCT116 cells leads to high expression of GEF-H1, thereby can provide experimental materials needed for further study on correlation between colon cancer and GEF-H1.

Mucin as an important member in gastrointestinal mucus layer has become the focus of research. Many studies suggested that MUC1 mucin is involved in the mechanism of Helicobacter pylori( Hp)infection. It is important to understand the relationship between MUC1 mucin and Hp for preventing Hp infection and gastric cancer. This article reviewed the relationship between MUC1 mucin and Hp.