Increasing evidences have shown that intestinal microbiota may contribute to the etiology of colorectal cancer(CRC). Studies have shown some microbial species which can increase the risk of CRC. Intestinal bacteria can promote carcinogenesis by affecting DNA integrity,regulating immune reaction,inducing inflammation,increasing cell proliferation and altering stem cell dynamics. Modulation of intestinal microbiota may become an approach to prevent or treat CRC. This article reviewed the effect and mechanism of intestinal bacteria flora on CRC.

Patients who have functional gastrointestinal disorders(FGIDs)often together with psychological disorders and damaged quality of live. Management of FGIDs patients failed to conventional drug therapy,so-called the refractory FGIDs,is a challenge for gastroenterologists. Till now,FGIDs are still not fully recognized and clarified and having only limited therapeutic approaches. In this article,we reviewed the clinical characteristics of refractory FGIDs accompanying with psychological disorders and the progress in research on their diagnosis and treatment for improving the understanding and formularizing the management of this disease.

Colorectal cancer is a common malignant tumor,and invasion and metastasis are the major causes of death. Epithelial-mesenchymal transition(EMT)occurs along with transition from epithelial phenotype to mesenchymal phenotype. EMT is involved in the genesis,development,invasion and metastasis of various tumors including colorectal cancer. EMT is closely associated with chemotherapy resistance of tumors. Various signaling pathways are involved in the pathogenesis of EMT and its mechanism is not fully clear. This article reviewed the molecular mechanism and role of EMT in colorectal cancer.

Inflammatory bowel disease(IBD)is a kind of chronic and non-specific inflammatory disease comprising Crohn’s disease(CD)and ulcerative colitis(UC),the etiology has not yet been clarified. Endothelin-1(ET-1)is an active polypeptide composed of 21 amino acid residues,which can constrict blood vessels by activating voltage-dependent Ca2 + channels in vascular smooth muscle cells. Studies have shown that ET-1 plays an important role in the pathogenesis of IBD. This article reviewed the progress in study on ET-1 in the pathogenesis of IBD.

Prevention and treatment of tumor metastasis are important for the therapy of colon cancer. The discovery of stem cell markers provides a new approach for radical treatment of cancer. So far,the colon cancer stem cell markers discovered included several membrane protein molecules,transcription factors and related signal pathway. Exploration of colon cancer stem cell markers could contribute to the treatment of colon cancer and improve the survival rate and life quality of patients. This article reviewed the advances in study on colon cancer stem cell markers.

significant for the precaution of gastric cancer risk population. Aims:To explore gastric cancer susceptibility gene profiling in an area in Shanghai,and to assess the risk of gastric cancer susceptibility. Methods:A total of 152 patients with primary gastric cancer at Shanghai Pudong Hospital were enrolled,and 152 demographic characteristics matched patients with non-gastrointestinal diseases,non-tumor were served as controls. Gene polymorphism was determined by allele specific polymerase chain reaction. Susceptibility gene of gastric cancer was screened. Multiple genes interactions were analyzed and multiple genes risk was evaluated by DEMCHUK model. Results:Univariate analysis showed that CYP2E1,NAT2M1,NAT2M2,NAT2,XRCC1194,MTHFRA1298C,VDR TaqⅠ were susceptibility genes of gastric cancer. Multivariate analysis showed that CYP2E1(C1/ C1),NAT2M1(T/ T),NAT2M2(A/ A),XRCC1194( T/ T)and MTHFRA1298C(A/ C)were susceptibility genotypes. Synergistic effect was found between genes except MTHFRA1298C (A/ C)with NAT2M1(T/ T)and NAT2M2(A/ A)(P ﹤0. 05). Multiple genes risk analysis showed that combination OR of multiple genes was highly correlated with gene frequency,and the risk of gastric cancer was increased with the increasing number of susceptibility genes. Conclusions:CYP2E1(C1/ C1),NAT2M1(T/ T),NAT2M2( A/ A),XRCC1194( T/ T) and MTHFRA1298C( A/ C) are susceptibility genotypes of gastric cancer. Carrying multiple susceptibility genes can significantly increase the risk of gastric cancer.

Background:Gankyrin is an ankyrin repeat oncoprotein overexpressed and involved in the tumorigenesis and progression of various cancers. Aims:To investigate the effect and underlying mechanism of down-regulation of gankyrin expression on proliferation of gastric cancer cells. Methods:Lentivirus vector carrying gankyrin-targeted siRNA was transfected into human gastric cancer cell line MKN28. Cell proliferation,cell cycle distribution and β-catenin/ cyclin D1 signaling pathway was analyzed by MTT assay,flow cytometry and Western blotting,respectively,in gankyrin-silenced MKN28 cells and control cells. Results:The transfection efficiency of lentivirus vector was more than 90% ,and the protein expression of gankyrin in gankyrin siRNA transfected MKN28 cells was significantly repressed( P ﹤ 0. 01). Compared with cells transfected with control lentivirus and cells without transfection,MKN28 cells transfected with gankyrin siRNA showed markedly repressed cell growth after 3-day-culture;the proportion of cells in cell cycle G1 phase was significantly increased,and that in S phase was significantly decreased;down-regulated expression of β-catenin and cyclin D1 was observed(P all ﹤ 0. 01). Conclusions:Down-regulation of gankyrin expression in gastric cancer cells may induce cell cycle G1 phase arrest and inhibit cell proliferation by suppressing β-catenin/ cyclin D1 signaling pathway. Gankyrin might be a promising novel target for targeted therapy of gastric cancer.

Background:The overlap of autoimmune liver disease with extrahepatic autoimmune disease adds the difficulty of diagnosis. It is essential to understand their clinical features. Aims:To analyze the clinical characteristics of primary biliary cirrhosis-autoimmune hepatitis( PBC-AIH ) overlap syndrome, and to investigate the effect of extrahepatic autoimmune disease on PBC-AIH. Methods:The clinical data including general information,clinical manifestations, biochemical parameters,immunological parameters,liver histopathological features,imaging findings and incidence of extrahepatic autoimmune disease of 81 patients with PBC-AIH were retrospectively analyzed. According to whether overlapping with extrahepatic autoimmune disease,PBC-AIH patients were divided into combination group and non-combination group. The clinical characteristics of the two groups were analyzed. Results:The ratio of male to female of 81 patients with PBC-AIH was 1 ∶ 9. 1,and the average age was(58. 1 ± 9. 9)years old. Of the patients 53. 1% had symptoms,the percentage of jaundice and pruritus was 18. 5% . Serum levels of ALT,AST,ALP,GGT,TBil and Glo were increased in all patients and IgG and IgM levels were increased in most of the patients. The positive rates of ANA, AMA and/ or AMA-M2,SMA and gp210 and/ or sp100 were 100% ,90. 1% ,1. 2% and 11. 1% ,respectively. Portal lymphoplasmacyte infiltration and interface hepatitis were the major liver histopathological features;50. 6% of the patients had both histological features of PBC and AIH. Cirrhosis was diagnosed in 28 patients(34. 6% )by imaging,and abdominal lymph nodes enlargement was found in 76 patients(93. 8% ). Twenty-three patients(28. 4% )overlapped with extrahepatic autoimmune disease;Sjogren’s syndrome and autoimmune thyroid disease were the most frequently overlapped extrahepatic autoimmune diseases. The level of GGT was significantly lower in combination group than in non-combination group(P = 0. 001). No statistically significant differences in other clinical characteristics were found between the two groups. Conclusions:It is crucial to understand the clinical characteristics of PBC-AIH and to screen the overlapped extrahepatic autoimmune disease,especially Sjogren’s syndrome and autoimmune thyroid disease.

Background:The abnormal expression of costimulatory molecules is closely related to immune escape of tumor cells. Programmed death-1(PD-1)is an important negative costimulatory molecule,and can induce and maintain the immune tolerance of tumor cells by binding with related ligands,thus promotes the development and progress of tumor. Aims:To investigate the expression of peripheral blood PD-1 and its clinical significance in patients with colorectal cancer. Methods:Eighty-eight patients with colorectal cancer from March 2015 to September 2015 at the First Affiliated Hospital of Soochow University were enrolled,and 16 healthy volunteers were served as controls. Level of soluble PD-1(sPD-1)was determined by ELISA. The expression of PD-l on CD3 + T cells in peripheral blood was measured by flow cytometry. Results:Level of sPD-1 and expression of PD-l on CD3 + T cells in peripheral blood in colorectal cancer patients were significantly higher than those in controls(P ﹤ 0. 05). Level of sPD-1 in colorectal cancer patients was closely related to tumor differentiation,lymph node metastasis and Dukes’stage( P ﹤ 0. 05),but not related to gender,age and tumor location(P ﹥ 0. 05). Conclusions:Peripheral blood PD-1 is highly expressed in patients with colorectal cancer,and is positively correlated with tumor stage and metastasis. The detection of PD-1 is helpful to estimate the progress of colorectal cancer,and it may become a new tumor marker or a target for anti-tumor targeted therapy.

Background:For patients with liver cirrhosis and acute decompensation(AD),it is of great clinical importance to predict short-term mortality at admission. It has been reported that CLIF-C OF,MELD and MELD-Na score can accurately predict the short-term mortality,but all these scoring systems are complicated and have limits in their application. Aims:To define a simple and objective scoring system -- simplified MELD score for short-term mortality prediction in HBV-related cirrhotic patients with AD. Methods:A total of 890 consecutive HBV-related cirrhotic patients with AD hospitalized during Jan. 2005 to Dec. 2010 at Shanghai Ren Ji Hospital were enrolled retrospectively. Clinical data and patients’outcome were collected,and simplified MELD score was calculated by using total bilirubin,international normalized ratio and creatinine values at admission. Patients were classified into different prognostic groups according to their 28-day mortalities and simplified MELD score. Kaplan-Meier survival curve was used to analyze the 1-year accumulate survival rate,and ROC curve was used to evaluate the performance of different scoring systems in predicting 28-day mortality. Results:Simplified MELD score at admission could classify HBV-related cirrhotic patients with AD into low,moderate and high 28-day mortality groups and different long-term prognostic groups;the score of low,moderate and high 28-day mortality group was 0-2,3 and 4-6,respectively,and the corresponding mortality was 5. 5% ,19. 8% and 48. 6% ,respectively. Simplified MELD score had the same good performance as compared with the CLIF-C OF,MELD and MELD-Na scores in predicting 28-day mortality,the area under ROC curve was 0. 828,0. 831,0. 828 and 0. 830,respectively. Conclusions:Simplified MELD score can accurately classify HBV-related cirrhotic patients with AD into low,moderate and high 28-day mortality groups at admission. It is convenient for using in clinical practice.