Objective To evaluate the barium meal radiography and CT scans in diagnosing malignant gastrointestinal stromal tumors (GIST) of small intestine. Methods The clinical and imaging data of 16 patients with GISTs of small intestine which were diagnosed surgically and pathologically were analyzed and summarized. In this group CT scan and gastrointestinal barium exam(GI) was performed. Results The tumors included 6 low-malignant GISTs of small intestine and 10 high-malignants. The diameter varied from 3.2 cm to 7.2 cm, the average size was 5.6 cm. The main signs of barium meal of malignant GIST of small intestine included flattened or destroyed mucosa runae, partial lumen stenosis, and barium fleck and fistula in the tumor. On CT scans, the main manifestation was an extraluminal mass with multiple necrosis areas of low density. Conclusion Barium examination and helical CT scan are the major imaging techniques in the determination of the location of GIST of small intestine. The appearance of imperfect lumen and the irregular tumor with multiulcerations or low density regions and inhomoneneous enhancement may lead to the correct diagnosis of malignant GIST.

Objective To explore the protective effect of Sijunzi decoction and Danggui Buxue decoction on the immunological function in tumor-bearing mice treated by cyclophosphamide.Methods Transplantable carcinomas animal model were constructed by inoculating tumor cell to mice for 24 hours,and randomly divided into five groups.Tumor-bearing control group were reveived normal saline 0.2 mL per mice one day by intraperitoneal injection,and normal saline 0.4 mL per mice each day by intragastric administration.Cyclophosphamide group were reveived CTX 20 mg per kg weight each day,and normal saline 0.4 mL per mice each day.Sijunzi decoction and Danggui Buxue Decoction low dose group were reveived CTX 20 mg per kg weight each day and traditional Chinese medicine 0.1 g per mice each day.Sijunzi decoction and Danggui Buxue Decoction mediate dose group were reveived CTX 20 mg per kg weight each day and traditional Chinese medicine 0.2 g per mice each day.Sijunzi decoction and Danggui Buxue Decoction high dose group were reveived CTX 20 mg per kg weight each day and traditional Chinese medicine 0.4 g per mice each day.The weight indices of thymus gland and spleen,NK-cell activity and the proliferation of T-lymphocyte in five groups were measured after ten 10 days treatment.Results The weight indices of thymus gland and spleen,NK-cell activity and the proliferation of T- lymphocyte were increased in all three Sijunzi decoction and Danggui Buxue decoction groups,especially in Sijunzi decoction and Danggui Buxue decoction mediate and high dose group,the differences between them and CTX group were statistically significan(P<0.05,P<0.01).Conclusion Sijunzi decoction and Danggui Buxue decoction can antagonize the decrease of immunological function in tumor-bearing mice treated by chemotherapy.

AIM: To explore the effects of sterigmatocystin (ST) on IL-4 expression and secretion of murine spleen cells in vitro. METHODS: The secretion and expression of IL-4 in murine spleen cells were studied with ELISA and semi-quantitative RT-PCR method after ST pretreatment at five different dosages (0.125 mg/L, 0.25 mg/L, 0.5 mg/L, 1 mg/L, 2 mg/L) for 2 h and 12 h, respectively. RESULTS: Semi-quantitative RT-PCR analysis showed that the expression of IL-4 mRNA in ST 0.125, 0.25 and 0.5 mg/L treated groups were higher than that in control group, especially in ST 0.5 mg/L group ( P

ObjectiveTo explore the effect of Yinaotongluo capsule on preventing the microcirculation dysfunction in rats.Methods40 SD rats were randomly divided into the thrombosis model group, three Yinaotongluo capsule groups (low, moderate and high dosages) and control group with 8 rats in each group. Photosensitizer was injected through vessel. Endothelium damage, cell adhesion and thrombosis were induced by photochemistry. The change of microcirculation was recorded and analyzed by microphotography technique.ResultsYinaotongluo capsule groups could prolong the time to thrombosis induced by photochemistry compared with control group (P<0.05). However, the area of thrombus to vessel significantly decreased in all Yinaotongluo capsule groups compared with control group (P<0.01). The effect of moderate dosage group of Yinaotongluo capsule was superior to Buchangnaoxintong group.ConclusionYinaotongluo capsule can improve the microcirculation of mesentery of rats, in part it can improve the systematic microcirculation of rats.

Objective: To analyze the clinical features and risk factors of ulcerative colitis (UC)complicated with Epstein-Barr(EB)-viremia and the effect of antiviral therapy on the remission of the symptoms. Methods: From April 2014 to January 2018, data of 239 UC patients hospitalized at the Department of Gastroenterology of Second Hospital of Hebei Medical University were collected. The patients were divided into EB-viremia group (trial group, n=43) and non-EB-viremia group (control group, n=196) according to EB virus-DNA detection. The general condition, clinical characteristics and therapeutic efficacy of the two groups were compared. The risk factors and the effect of antiviral therapy on the remission of symptoms of UC complicated with EB-viremia were analyzed. Chi-square test and logistic analysis were used for statistical analysis. Results: There were no significant differences in gender, age, clinical type, lesion range, the proportion of patients treated with 5-aminosalicylic acid or corticosteroids, the percentage of patients with diarrhea and bloody stool, the proportion of patients with spontaneous bleeding, platy ulcer and longitudinal ulcer under colonoscopy, the course of disease or Mayo score between the trial group and control group (all P>0.05). The proportions of patients with smoking history and severe disease, treatment with azathioprine and 6-mertocapurine (6-MP), treatrnent with infliximab, symptoms of fever or abdominal pain and deep and large ulcer under colonoscopy in the trial group were all higher than those in the control group, and the differences were all statistically significant (χ²=5.304, 6.608, 6.718, 6.939, 8.783, 4.493 and 5.425, all P<0.05). The results of multivariate logistic regression analysis showed that smoking history and treatment with azathioprine and 6-MP were risk factors of UC complicated with EB-viremia (OR=2.801 and 9.343, 95%CI 1.170 to 6.703 and 1.749 to 49.922, P=0.021 and 0.009). The improvement rates of the trial group and control group were 79.1%(34/43) and 95.4%(187/196), respectively. There was a significant difference in the improvement rate between the two groups (χ²=10.551, P=0.001). In the trial group, 12 patients (27.9%) received ganciclovir treatment, fonr patients (9.3%) had foscarnet sodium treatment, 21 patients (48.8%) were treated with the combination of these two medications and six cases (14.0%) did not received any antiviral treatment. After three weeks, the improvement cases of the above regimens were 8, 4, 16 and 6, respectively. There were no statistically significant differences in the improvement rate of patients with and without antiviral treatment, further more, no difference was found in the improvement rate of patients with different antiviral treatments (all P>0.05). Conclusions Smoking history and purine treatment are risk factors of UC complicated with EB-viremia.

Objective: To explore the effects of macrophages with high expression of TL1A on the activation and proliferation of HSCs in vitro. Methods: The Bone marrow-derived macrophages (BMMs) and peritoneal macrophages (PMs) from wild type (WT) and myeloid-overexpressed TL1A transgenic mice were isolated, differentiated and activated. HSCs were harvested from activated macrophages culture supernatant (CM). HSCs were detected by immunofluorescence and real-time Q-PCR. And the proliferation was detected by CCK-8 and BrdU assay kit. The levels of IL-1β and PDGF-BB in macrophage culture supernatants were determined by enzyme-linked immunosorbent assay (ELISA). Results: BMMs-derived CM-intervention HSCs were used to detect the expression of α-smooth muscle actin (α-SMA) on the 2nd, 4th and 6th day respectively by immunofluorescence method. There was no significant difference between the two groups on the 2 nd and the 6th day, P > 0.05; On day 4, the CM/Tg group was significantly higher than that of CM/WT group, P < 0.01; the results of CMs derived from PMs were consistent with the above trend. The expression of α-SMA mRNA on the 2nd, 4th and 6th day was detected by real-time Q-PCR method using BM-derived CMs. No significant difference was found between the groups on the 2nd day (P > 0.05).α-SMA mRNA increased further on the 4th and 6th day, and the level of CM/Tg in CM/Tg group was significantly higher than that in CM/WT group (P < 0.05). The detection results of CMs derived from PMs were consistent with the above trend. The results of CCK-8 assay and BrdU assay showed that the proliferation rate of HSCs in CM Tg group was significantly higher than that in CM/WT group (P < 0.01). The CMs derived from PMs were used to interfere with HSCs. And the results were consistent with the above trend. For BMMs, the levels of IL-1β and PDGF-BB in the lipopolysaccharide (LPS) + IFNγ/Tg culture supernatant were significantly higher than those in the LPS+IFNγ/WT group (P < 0.01). For the culture supernatants of PMs Liquid test results consistent with the above trend. Conclusion Macrophages with high expression of TL1A could enhance the activation and proliferation of HSCs by increasing the secretion of IL-1β and PDGF-BB.

Objective To investigate the effects of tumor necrosis factor-related ligand-1A(TL1A)on activation of T helper 9(Th9)cells of colonic tissues in chronic experimental colitis mice.Methods The chronic experimental colitis mice model was established with drinking dextran sulfate sodium salt(DSS).A total of 32 lymphocytes TL1A highly expressed mice and wild type(WT)mice were divided into WT control group, transgene control group,WT modeling group and transgene modeling group.The mice of control groups were administrated with distilled water. The mice of modeling groups received 3% DSS in drinking water discontinuously.The mice were sacrificed on 29 days after modeling.Body mass was measured,length of colon was recorded,scores of gross colon and the disease activity index(DAI)were calculated.The colonic morphological changes were observed by hematoxylin-eosin(H-E)staining.The lamina propria mononuclear cells(LPMC)were isolated and the number of Th9 cells was tested by flow cytometry.The levels of interleukin-9(IL-9)in serum and LPMC were detected by enzyme-linked immunosorbent assay(ELISA).The expressions of IL-9 protein and mRNA of the colonic tissues were measured by Western blotting and real-time polymerase chain reaction(PCR),respectively.T test and single factor analysis of variance were performed for statistical analysis.Results The percentage of body mass loss of WT modeling group was lower than that of transgene modeling group(16.2% ± 1.0% vs 18.9% ± 1.2%),and the difference was statistically significant(t=4.90, P<0.05).The scores of gross colon,DAI and pathology of transgene modeling group were all higher than those of WT modeling group(2.80 ± 0.64 vs 1.60 ± 0.31,2.55 ± 0.20 vs 1.58 ± 0.17,and 11.85 ± 0.86 vs 9.50 ± 0.79),and the differences were statistically significant(t=4.77,10.45 and 5.69,all P<0.05).The number of LPMC in transgene modeling group was higher than that of WT modeling group(3.70×106± 0.28×106vs 2.65×106± 0.32 × 106)and the difference was statistically significant(t= 6.98,P< 0.05).The percentage of Th9 in total CD4+T cells of LPMC in colonic tissues of transgene modeling group was higher than that of WT modeling group(0.54% ± 0.04% vs 0.23% ± 0.03%),and the difference was statistically significant(t= 17.54,P< 0.05).The serum IL-9 level of transgene modeling group was higher than that of WT modeling group((170.23 ± 5.69)pg/mL vs(150.62 ± 6.45)pg/mL),and the difference was statistically significant(t= 6.50,P< 0.05).The level of IL-9 secreted by LMPC of transgene modeling group was higher than that of WT modeling group((265.21 ± 8.76)pg/mL vs (237.58 ± 10.24)pg/mL),and the difference was statistically significant(t= 5.80,P< 0.05).The expressions of IL-9 protein and mRNA of transgene modeling group were higher than those of WT modeling group(1.31 ± 0.09 vs 1.18 ± 0.03,and 8.26 ± 1.13 vs 2.25 ± 0.29,respectively),and the differences were statistically significant(t=3.88 and 14.57,both P< 0.05).Conclusion TL1A high expression in lymphocytes can promote Th9 cells differentiation and IL-9 secretion which involved in the genesis of chronic experimental colitis.

Objective:To explore the risk factors, clinical features, endoscopic characteristics and the efficacy of antiviral therapy in ulcerative colitis (UC) patients complicated with cytomegaloviremia (CMV) and Epstein-Barr (EB) viremia.Methods:From April 1, 2014 to January 31, 2019, at The Second Hospital of Hebei Medical University, a total of 320 UC patients hospitalized at the Department of Gastroenterology were enrolled. According to the pathogens, the patients were divided into four groups: complicated with CMV and EB viremia group ( n=35), only complicated with CMV viremia group ( n=33), only complicated with EB viremia group ( n=52) and without CMV and EB viremia group ( n=200). Clinical features and the efficacy of antiviral therapy of the patients were retrospectively analyzed. Multivariate logistic regression was used to analyze the risk factors of UC complicated with CMV and EB viremia. Kruskal-Wallis H test, Chi-square test and Fisher exact test were used for statistical analysis. Results:The proportion of patients of age>60 years old (42.86%, 15/35), the rate of glucocorticoid use (51.43%, 18/35) within three months before onset and the inefficacy rate of glucocorticoid treatment (22.86%, 8/35) of UC complicated with CMV and EB viremia group were all higher than those of UC without CMV and EB viremia group (14.00%, 28/200; 24.50%, 49/200; 1.00%, 2/200), and the differences were statistically significant ( χ2=17.062, 10.598 and 29.769; all P<0.01). However, there were no statistically significant differences between UC complicated with CMV and EB viremia group and UC without CMV and EB viremia group in gender, and treatment of 5-aminosalicylic acid (5-ASA), azathioprine and infliximab within three months before onset (all P>0.05). The proportion of patients with fever (54.29%, 19/35), abdominal pain (91.43%, 32/35), hematochezia (94.29%, 33/35), weight loss (28.57%, 10/35), severe disease activity (94.29%, 33/35), total colon involvement (91.43%, 32/35), serum albumin less than 30 g/L (71.43%, 25/35) and hemoglobin less than 100 g/L (48.57%, 17/35) of UC complicated with CMV and EB viremia group were all higher than those of UC without CMV and EB viremia group (13.50%, 27/200; 43.00%, 86/200; 44.00%, 88/200; 13.50%, 27/200; 38.00%, 76/200; 65.00%, 130/200; 18.00%, 36/200 and 18.50%, 37/200), and the differences were statistically significant ( χ2=31.475, 27.945, 32.930, 5.100 and 40.194, Fisher exact test, χ2=44.242 and 15.220, all P<0.01). However, there were no statistically significantl differences in clinical classification and disease course (all P>0.05). The incidence rates of deep ulcer (45.71%, 16/35), irregular ulcer (42.86%, 15/35) and longitudinal ulcer (8.53%, 3/35) under endoscopy of UC complicated with CMV and EB viremia group were significantly higher than those of UC without CMV and EB viremia group (1.50%, 3/200; 3.50%, 7/200 and 1.00%, 2/200), and the differences were statistically significant ( χ2=72.521 and 49.837, Fisher exact test, all P<0.01). The incidence rates of deep ulcer and irregular ulcer under endoscopy of UC complicated with CMV and EB viremia group were higher than those of UC only complicated with EB viremia group (15.38%, 8/52 and 11.54%, 6/52), and the differences were statistically significant ( χ2=9.663 and 11.206, P=0.002 and 0.001). The results of Multivariate Logistic regression analysis showed that severe disease activity, serum albumin level less than 30 g/L, and deep ulcer and irregular ulcer under endoscopy were risk factors of UC patients complicated with CMV and EB viremia (odds ratio=48.519, 44.352, 53.432 and 39.989, 95% confidence interval 9.057 to 587.669, 4.499 to 437.245, 3.302 to 864.670 and 3.418 to 467.910, all P<0.05). The improvement rate of antiviral therapy in UC complicated with CMV and EB viremia group (73.53%, 25/34) was significantly lower than those of UC only complicated with CMV group (96.88%, 31/32) and UC only complicated EB viremia group (95.65%, 44/46), and the differences were statistically significant ( χ2=6.989 and 6.310, P=0.008 and 0.012). Conclusions:UC patients with severe disease activity, serum albumin level less than 30 g/L, and deep ulcer and irregular ulcer under endoscopy are more likely to develop CMV and EB viremia. The more severe the disease, the worse the treatment response, so it is necessary to strengthen the screening to CMV and EB virus infection in UC patients.

Objective:To summarize the clinical features of intestinal Beh?et′s disease, so as to provide reference for the diagnosis of the disease.Methods:From April 1 2014 to January 31 2019, the clinical data of 47 patients diagnosed as intestinal Beh?et′s disease at the Second Hospital of Hebei Medical University were retrospectively analyzed, which included initial symptoms, gastrointestinal symptoms, complications, erythrocyte sedimentation rate (ESR), the levels of C reactive protein (CRP), hemoglobin, serum albumin, results of acupuncture test, gastrointestinal involved site and ulcer shape. At the same time, gender differences of clinical manifestations were compared. Chi-square test was used for statistical analysis.Results:Among 47 patients with intestinal Beh?et′s disease, the initial symptoms of 26 (55.3%) cases were gastrointestinal symptoms. Abdominal pain was the most common symptom, the others were diarrhea, anorexia, abdominal distension and perianal abscess, and the incidence rate was 80.9%(38/47), 46.8% (22/47), 42.6% (20/47), 36.2% (17/47) and 2.1% (1/47), respectively. The main complications were gastrointestinal bleeding, perforation and obstruction, and the incidence rates was 40.4% (19/47), 4.3% (2/47) and 4.3% (2/47), respectively. Thirty-seven (78.7%) patients had different degrees of hypoalbuminemia (serum albumin<35 g/L). The CRP level of 36(76.6%) patients increased. The ESR of 36 (76.6%) patients increased. Twenty-two (46.8%) patients had mild anemia (hemoglobin<90 g/L). The acupuncture test was positive in 25 (53.2%) patients. The involved sites of gastrointestinal tract were terminal ileum and ileocecal junction, colon, esophagus, duodenum and jejunum, stomach, and rectum, the proportion was 57.4% (27/47), 27.2% (13/47), 23.4% (11/47), 23.4% (11/47), 17.0% (8/47) and 8.5% (4/47), respectively. All 47 (100.0%) patients had oral ulcers. 62.1%(18/29) patients presented with multiple ulcers under endoscope. The shape of ulcer was round ulcer, irregular ulcer, and longitudinal ulcer, the proportion was 48.3% (14/29), 34.5% (10/29) and 17.2 (5/29), respectively. The incidence rate of genital ulcer of female patients with intestinal Beh?et′s disease was higher than that of male patients with intestinal Beh?et′s disease (85.7%, 18/21 vs. 30.8%, 8/26), and the difference was statistically significant ( χ2=14.189, P<0.01). There were no significant differences between the female group and the male group in the incidence rate of oral ulcer, abdominal pain, diarrhea, and positive rate of acupuncture test (100.0%, 21/21 vs. 100.0%, 26/26; 85.7%, 18/21 vs. 76.9%, 20/26; 42.9%, 9/21 vs. 50.0%, 13/26; 52.4%, 11/21 vs. 58.3%, 14/26, all P>0.05). Conclusions:The common clinical symptoms of intestinal Beh?et′s disease are oral ulcers, abdominal pain, diarrhea and genital ulcer. Female patients with intestinal Beh?et′s disease are more likely to develop genital ulcer than male patients with intestinal Beh?et′s disease. Multiple ulcers are more common under endoscopy, which are round ulcer, irregular ulcer and longitudinal ulcer. The most common sites are the terminal ileum and ileocecal junction, followed by colon, esophagus and other parts.

Background:Ulcerative colitis(UC)patients are the high risk population of cytomegalovirus(CMV)infection. CMV infection may aggravate the disease progression of UC,and the prognosis of UC patients with CMV infection may be improved by antiviral therapy. Aims:To systematically evaluate the effects of CMV infection and antiviral therapy on prognosis of UC patients. Methods:PubMed,Cochrane Library,Embase,CNKI,Wanfang,SinoMed and VIP database were retrieved to collect the case-control studies studying the effects of CMV infection and antiviral therapy on prognosis of UC patients. Meta-analysis was conducted by RevMan 5.3 software. Results:Twenty case-control studies were enrolled. Meta-analysis showed that UC patients in CMV infection group were more serious(OR=1.62,95% CI:1.13-2.33),and had larger intestinal lesions(OR=0.63,95% CI:0.43-0.92),higher risks of steroid dependence/resistance(OR=6.13, 95% CI:1.98-19.00)and colectomy(OR=1.64,95% CI:1.14-2.36). Antiviral therapy for UC patients with CMV infection significantly improved the early clinical remission rate(OR =2.08,95% CI:1.03-4.17),decreased risk of colectomy(OR=2.12,95% CI:1.06-4.22). Conclusions:CMV infection can aggravate the progress of UC,enlarge the extent of intestinal lesion,increase the risks of steriod dependence/resistance and colectomy. Antiviral therapy significantly improves the early clinical remission rate,and decreases the risk of colectomy.