High mobility group box 1 protein (HMGB1), a damage-associated molecular pattern, exists ubiquitously in the cells of mammals. It contributes to maintaining the structure of nucleosome and modulating transcription of gene in nuclei. Extracellular HMGB1 plays two-way roles in promoting inflammatory and tissue repair. Released actively as well as passively following cytokine stimulation during cell death, HMGB1 may act as a late inflammatory factor and an endogenous damage-associated molecular pattern recognized by its receptors. And it may mediate the occurrence, development and outcome of the inflammatory injury of digestive system diseases, such as gastric mucosal injury, inflammatory bowel-disease, liver injury, pancreatitis, and so on. This review mainly concerns the research progresses of HMGB1 in the inflammatory injury of digestive system diseases. At the same time, HMGB1 itself, or as a therapeutic target, can promote tissue repair.
Animals ; Digestive System Diseases ; pathology ; HMGB1 Protein ; metabolism ; Humans ; Inflammation ; pathology

The prevalence of hospital malnutrition is still high in patients with digestive diseases, especially for those suffering from cancer and bowel diseases which cause malabsorption. It is well known that malnutrition is associated with delayed wound healing, impaired immunity, infection, increased complication, and poor convalenscence. Recently, nutrition screening and assessment by nutrition support team has become essential for nutrition management, and gastroenterologists comprise a dominant member of the nutrition support team. In critically ill patients and older people with chronic disease, nutritional support with enteral feeding and early feeding contributes to recovery and rehabilitation of patients. Securing enteral feeding routes, such as feeding tube insertion and placement of percutaneous endoscopic gastrostomy/jejunostomy, is an essential part of nutrition care that should be accomplished by gastroenterologists without much difficulty. It will also be necessary to recommend nutrition care as one of the clinical routines in gastrointestinal clinical practices. Therefore, education on nutrition care is strongly required as a part of gastroenterologist's training.
Critical Illness ; Digestive System Diseases/*pathology ; Enteral Nutrition ; Humans ; Malnutrition/*prevention & control ; *Nutritional Support

OBJECTIVETo study the value of three-dimensional 64-slice helical computer tomography (64-MSCT) in diagnosis and surgical treatment on diseases of digestive system.

METHODSFrom November 2005 to August 2006, 64-MSCT was performed on 102 patients suspected of digestive diseases to display foci of infection, hepatic conduit, biliary-pancreatic duct and portal venous system, followed by three-dimensional reconstruction of those targets. The reconstructed images as well as the data obtained from the reconstruction were compared with the surgical results.

RESULTSTwenty-five of 27 patients with portal hypertension (PHT) showed blur-free imaging of main portal vein (MPV) while the other 2 cases showed congenital cavernous transformation or thrombogenesis of MPV. Compensatory circulation of portal venous system was displayed satisfactorily in 27 cases. The three-dimensionally reconstructed images of 34 cases of hepatocellular carcinoma (HCC) demonstrated no invasion of tumors into the tissues and blood vessels of 23 cases, visible invasion into portal vein and hepatic veins of 9 cases, tumor embolus in portal veins of 1 case, and arterio-venous fistula in only one case. The 3D imaging of biliary passages displayed total concretion, tumor and constrictive or dilated biliary-pancreatic duct and bile duct around amphi-obstruction, which complied with the operations research of calculus of bile duct in 25 cases, cholangiocarcinoma in 5 cases, and cancer of pancreas in 5 cases. Operations research in accordance with the 3D reconstructed imaging accorded with imaging diagnosis in respect of PHT, HCC and diseases of biliary-pancreatic system at the rates of 100%, 97% and 100%, respectively.

CONCLUSIONSThree-dimensional 64-MSCT displays foci of infection and constructions of biliary-pancreatic duct and hepatic conduit stereoscopically.

Adolescent ; Adult ; Aged ; Digestive System ; blood supply ; diagnostic imaging ; pathology ; Digestive System Diseases ; diagnosis ; Female ; Humans ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Sensitivity and Specificity ; Tomography, Spiral Computed ; methods

No abstract available.
Aged ; Biopsy ; Endoscopy, Digestive System ; Female ; Humans ; Hypertension, Portal/*complications ; Polyps/*etiology/pathology ; Stomach Diseases/*etiology/pathology

Systemic lupus erythematosus(SLE) is a systemic disease of unknown etiology. Its main pathology is vasculitis and serositis, due to deposition of the immune complex or antibodies. Most findings are nonspecific ; abdominal manifestations include enteritis, hepatomegaly, pancreatic enlargement, serositis, lymphadenopathy, splenomegaly,nephritis, interstitial cystitis, and thrombophlebitis. We described radiologic findings of various organinvolvement of SLE; digestive system, serosa, reticuloendothelial system, urinary system, and venous system.Diagnosis of SLE was done according to the criteria of American Rheumatism Association. Understanding of thevariable imaging findings in SLE may be helpful for the early detection of abdominal involvement andcomplications.
Antibodies ; Antigen-Antibody Complex ; Cystitis, Interstitial ; Digestive System ; Enteritis ; Hepatomegaly ; Lupus Erythematosus, Systemic* ; Lymphatic Diseases ; Mononuclear Phagocyte System ; Pathology ; Rheumatic Diseases ; Serositis ; Serous Membrane ; Thrombophlebitis ; Vasculitis

BACKGROUNDSpleen in Traditional Chinese Medicine (TCM) is not actually the spleen in the anatomic sense designated in western medicine because its functions basically belong to the physiological category of digestive system in modern medicine, and it represents a macroscopic concept of digestion, absorption and nutrition metabolism. Spleen deficiency syndrome refers to the clinical phenomena such as hypofunction of digestion, absorption and nutrition metabolism. By integrating TCM with modern medicine, this paper is intended to explore the pathological basis of classification of spleen deficiency in chronic gastritis.

METHODBy means of optical microscope, scanning electron microscope (SEM), transmission electron microscope (TEM) and histochemical staining, we conducted histopathological and subcellular ultrastructural (nuclei and mitochondrial) analysis of gastric mucosa of 188 patients of spleen deficiency, and that of 42 voluntary blood donors without clinical symptoms.

RESULTSThe gastric mucosa of patients with spleen Qi deficiency (SQD) and spleen yang deficiency (SyangD) could either be affected by organic lesion (type G-occurring on the basis of chronic superficial gastritis (CSG), chronic atrophic gastritis (CAG)) or unaffected (type F-chiefly belonging to functional indigestion); spleen yin deficiency (SyinD) and spleen deficiency with Qi stagnation (SDQS) both occurred on the basis of CSG and CAG; and the degree of mucosa inflammatory cells infiltration, the degree of decrease in glands propria, and the incidence of IMIIb in CSG and CAG were more serious than those of G-SQD and G-SyangD, P < 0.05 - 0.01.

CONCLUSIONSpleen deficiency syndrome is likely to occur on the basis of organic lesion of gastric mucosa (disease with symptoms of both CSG or CAG and spleen deficiency symptoms), as well as on the basis of inorganic lesion of gastric mucosa (nondisease with symptoms, which is, despite spleen deficiency symptoms, there is no CSG or CAG). Besides, the clinical phenomenon of disease without symptoms (despite CSG or CAG, there is no spleen deficiency symptoms) occurres because of such factors as genetic diathesis and compensation. The lesion degree of CSG or CAG and the incidence of IMIIb of SyinD and SDQS are more serious than those CSG and CAG of G-SQD and G-SyangD.

Adult ; Chronic Disease ; Digestive System Diseases ; classification ; Epithelial Cells ; ultrastructure ; Female ; Gastric Mucosa ; pathology ; ultrastructure ; Gastritis ; pathology ; Humans ; Male ; Medicine, Chinese Traditional ; Splenic Diseases ; classification

Behcet's disease (BD) has been recognized as multi-systemic chronic vasculitic disorder of recurrent inflammation, characterized by the involvement of multiple organs and resulting in orogenital ulcers, uveitis, and skin lesions. Involvement of the central nervous system, vessels, and intestines in BD often leads to a poor prognosis. Digestive manifestations in BD have been reported in up to 1-60% of cases, although the rate varies in different countries. The most frequent extra-oral sites of gastrointestinal involvement are the ileocecal region and the colon. Gastric or esophageal involvement is reported to be very rare. Moreover, there have been no reports on the simultaneous involvement of the esophagus, stomach, ileum, and colon. Here, we present a 55-year-old Korean man with intestinal BD and multiple ileal and colonic ulcerations complicated by perforation, gastric ulcer with bleeding followed by perforation, and esophageal ulcers with bleeding.
Behcet Syndrome/complications/*diagnosis/pathology ; Cecal Diseases/complications/pathology ; Diagnosis, Differential ; Endoscopy, Digestive System ; Gastrointestinal Diseases/complications/*diagnosis ; Gastrointestinal Hemorrhage ; Humans ; Intestinal Perforation/*diagnosis/etiology/pathology ; Male ; Middle Aged ; Peptic Ulcer Perforation/pathology ; Stomach Ulcer/complications/pathology

OBJECTIVE: To assess the safety and efficacy of gastrointestinal anastomosis with nickel titanium shape memory alloy compression anastomosis clip. METHODS: We randomized 51 patients to undergo gastrointestinal anastomosis with stapler (n=25) and nickel titanium compression anastomosis clip (n=26) respectively. The following parameters were recorded to evaluate the safety and efficacy: mean hospitalization time, anastomotic complication, first post-operation flatus and bowel movement, and extrusion of the clip. RESULTS: Anastomotic complications such as leakage, stenosis and obstruction were not observed in both groups. There were no significant differences in the first post-operation flatus time and bowel movement time between the 2 groups (P>0.05). The clip was expelled with stool within 9-15 d. CONCLUSION Compression anastomosis clip is safe and effective.
Anastomosis, Surgical ; instrumentation ; methods ; Anastomotic Leak ; prevention & control ; Digestive System Surgical Procedures ; methods ; Female ; Gastroenterostomy ; instrumentation ; methods ; Gastrointestinal Diseases ; pathology ; surgery ; Humans ; Male ; Nickel ; Surgical Staplers ; Titanium

We report a case of unusual bronchopulmonary foregut malformation composed of a mediastinal bronchogenic cyst with sequestrated lung tissue and communicating tubular esophageal duplication associated with complete pericardial defect. A 18-yrold man, who had suffered from dry cough and mild dyspnea, was admitted because of an incidentally detected chest mass. A computed tomography scan demonstrated a cystic mass with an air fluid level connected with esophagus in the middle mediastinum. The surgically resected mass was a pleural invested accessory lobe of the lung (8.0x7.0x4.5 cm) connected with the esophageal wall by a tubular structure (3.0 cm in length and 2.0 cm in diameter). A complete left pericardial defect was also identified. Histologically, the cystic wall was composed of fibrovascular connective tissue with a smooth muscle layer, mixed seromucous glands and cartilage, and the inner surface of the cyst was lined by ciliated pseudostratified columnar epithelium. The inner surface of the tubular structure was lined by non-keratinizing or keratinizing squamous epithelium, and the wall contained submucosal mucous glands, muscularis mucosa, and duplicated muscularis propria. This case is important in understanding the embryological pathogenesis of the variable spectrum of the bronchopulmonary foregut malformation.
Adolescent ; Bronchogenic Cyst/*complications/*diagnosis ; Digestive System/pathology ; Esophageal Cyst/diagnosis/pathology ; Esophageal Diseases/*complications/*diagnosis ; Esophagus/abnormalities/*pathology ; Humans ; Lung/abnormalities/pathology ; Male ; Pericardium/pathology ; Tomography, X-Ray Computed

No abstract available.
Endoscopy, Digestive System ; Female ; Humans ; Intestinal Perforation/*diagnosis/etiology/surgery ; Jejunal Diseases/*diagnosis/etiology/surgery ; Jejunal Neoplasms/complications/*diagnosis/pathology ; Lymphoma, B-Cell, Marginal Zone/complications/*diagnosis/pathology ; Middle Aged ; Tumor Markers, Biological/analysis