Gastric intestinal metaplasia (IM), a common clinical pathological diagnosis, is a premalignant condition of intestinal type gastric cancer. The pathogenesis is still unclear, which links with helicobacter pylori (Hp) infection, bile reflux, nitrite intake, vitamin deficiency and so on. In recent studies, the relevant genes involved with transdifferentiation of gastric epithelium to intestinal epithelium are CDX2, SOX2, PDX1, OCT1, SHH, Runx3, Tff, and so on. Overall, the phenotype shift of gastric intestinal metaplasia is a complex and long process, current treatments targeted to the cause of IM such as Hp infection, bile reflux only can prevent its development, but fail to reverse the clinical process, so further clarification to the pathogenesis is still needed to guide the clinical treatment.

Nonalcoholic fatty liver disease (NAFLD) is a clinicopathological syndrome caused by liver damage factors except alcohol and has the major feature of diffuse macrovesicular hepatocyte steatosis.Thetwo-hit hypothesis can partly explain the pathogenesis of NAFLD.Recent studies have found that ceramide is a key molecular messenger involved in the development and progression of NAFLD,and as a sphingolipid,it is closely associated with the two-hit hypothesis.This article reviews the role of ceramide in NAFLD.

OBJECTIVE:To provide reference for drug use labeling for pregnant and lactating women. METHODS:The drug package inserts were collected from Linxi Hospital of Kailuan General Hospital during Jul. 2013-Dec. 2015. The information about drug use labeling for pregnant and lactating women was analyzed statistically. RESULTS:Among 762 drug package inserts,pack-age inserts which were not labeled with or labeled with indefinite drug use information for pregnant and lactating women accounted for 31.89% and 52.76% respectively. Among package inserts of 361 domestic chemical drugs and biological products,339 Chinese patent medicine and 62 imported drug,package inserts which were not labeled or labeled with indefinite drug use information for pregnant and lactating women accounted for 22.99% and 25.21%,44.54% and 88.50%,14.52% and 17.74%,respectively. CON-CLUSIONS:Except for poor drug use labeling for pregnant and lactating women in package inserts package,there still are other problems,such as items listed dispersedly,presentation content not consistent. Compared with imported drugs,the missing informa-tion for pregnant and lactating women are obvious in drug package inserts of domestic chemical drugs and biological products,and severe in those of Chinese patent medicine. It is recommended that drug manufacturers should strengthen drug tracing and monitor-ing after listed,and update and revise related content of package inserts timely;drug administration department should strengthen drug package inserts supervision,and unify and standardize labeled content management of drug use.

Objective:To explore the clinical appearance,diagnosis method and curative efficacy of one patient with esophageal teratoma complicated with rupture of esophagus in order to raise the awareness of the clinicians for the disease. Methods:The patient with chest pain after eating was admitted to hospital,and upper gastrointestinal radiography,chest CT and endoscopy were taken,which showed rupture of esophagus.Then an emergency thoracic exploration was performed.A too long cleft and much necrosis were identified,so the repair of esophagus was changed into excision and anastomosis. Results: The operation was successful,and the pathological findings showed the rupture of esophageal teratoma.Follow-up showed no complication till now.Conclusion:Esophageal teratoma complicated with esophageal rupture is rare.Clinicians should improve the understanding and reduce the misdiagnosis rate.

Objective To study the relationship of insulin-like growth factor-Ⅰ receptor(IGF-ⅠR)and carcinogenesis of gastric cancer.Methods The expression of IGF-ⅠR was detected in 40 cases of resected gastric cancer tissues and adjacent normal gastric mucosa by immunohistochemistry.The expression of IGF-ⅠR in gastric cancer cell lines(MGC803 and SGC7901)was detected by Western Blot.siRNAs targeted to IGF-ⅠR were designed,synthesized and transfected into MGC803 cells,the changes of IGF-IR protein level were detected by Western Blot at 48 h after transfection,the cell proliferation was examined by MTT,and then the growth curve was obtained.Results The positive rate of IGF-IR expression in gastric cancer tissues was 75.5%,significantly higher than that of adjacent normal tissues (25%,P＜0.01).The expression level of IGF-IR was related with TNM stage,lymphnode metastasis (P＜0.05),but not related with sex,age,histological differentiation,invasion depth of gastric cancer (P＞0.05).Intense expression of IGF-ⅠR was showed in gastric cancer cell lines.The inhibition ratio of IGF-ⅠR expression in sigNAl group were 89.80%±4.10%,the cell proliferation decreased to mininlunl level at the fifth day aftertransfection(by 29.0%±4.0%of mock-treated group),the cell number decreased by 21.15%±1.10%of mock treated group at the same time.Conclusions IGF-ⅠR is over-expressed in gastric cancer cells and can be effectively silenced by RNA interferes,therefore the growth of tmnor cell Was inhibited.Thus,it indicates that IGF-ⅠR may be a promising target for gene therapy of gastric cancer.

Objective:To analyze the hepatic hemodynamics changes after partial splenic embolization in patients with cirrhosis and hypersplenism.Methods:A total of 26 patients with cirrhosis and hypersplenism who underwent partial splenic embolization in the General Hospital of Ningxia Medical University from April 2018 to June 2019 were included in this study. The clinical data was retrospectively studied. The study objects consisted of 19 males and 7 females with an average of 55 years. Whole-liver perfusion enhanced CT imaging scan was performed for all patients. Changes in laboratory indexes and the blood perfusion of the liver sections including hepatic arterial perfusion, portal venous perfusion, total liver perfusion and hepatic arterial perfusion indexes before PSE and postoperative 1 month were compared.Results:The postoperative leukocyte and platelet counts increased, and the prothrombin time decreased in the 26 patient, and the differences were significant ( P<0.05). The hepatic arterial perfusion of the left lateral section, left medial section, right anterior section and right posterior section increased in postoperative 1 month, from 10.0 (7.0, 13.5) ml·min -1·(100 ml) -1, 9.3 (5.4, 12.8) ml·min -1·(100 ml) -1, 8.0 (6.0, 11.2) ml·min -1·(100 ml) -1, 10.7 (7.1, 13.8) ml·min -1·(100 ml) -1 to 7.7 (4.2, 11.0) ml·min -1·(100 ml) -1, 6.9 (2.6, 10.2) ml·min -1·(100 ml) -1, 7.1 (4.1, 8.7) ml·min -1·(100 ml) -1, 5.9 (4.4, 8.5) ml·min -1·(100 ml) -1, respectively. The differences were all significantly different ( P<0.05). There were no significant difference in portal venous perfusion and total liver perfusion before and after operation ( P>0.05). The hepatic arterial perfusion index of left lateral section, right anterior section and right posterior section increased after operation ( P<0.05). Conclusion:For patients with cirrhosis and hypersplenism who underwent partial splenic embolization, the state of hypersplenism was relieved, the hepatic arterial blood flow increased, and the liver function improved.

Objective:To investigate the effect of Shentai Tea Polyphenols on memory and its underlying mechanism in healthy elderly adults.Methods:According to the randomized, double blind and placebo-controlled prospective experimental design, 240 healthy middle-aged or elderly subjects with normal objective cognition were recruited in our hospital from April to December 2019 through advertising, and they were randomly divided into an experimental group ( n=120) and a control group ( n=120). Oral administration of Shentai Tea Polyphenols or placebo capsules (lasting for 90 d, 2 times/d, 2 capsules/time) was given to subjects in the two groups. The neuropsychological scale scores and near-infrared brain imaging data of all subjects were collected before and after intervention, and the mean time from baseline data collection before intervention to follow-up data collection after medication was controlled within 6 months. Results:In patients from the experimental group, as compared with those before intervention, scores of delayed recall and recognition memory in the auditory verbal learning test (Huashan version) and Boston naming test, scores of Montreal cognitive assessment scale (basis version) were significantly higher, and scores of Hamilton anxiety scale, shape trails test A and rapid-eye-movement sleep behavior disorder screening questionnaire were significantly lower after intervention ( P<0.05); however, only scores of delayed recall in the auditory verbal learning test (Huashan version) were significantly increased in the control group ( P<0.05). A total of 23 pairs of differences of brain function connection before and after intervention in the experimental group were significantly higher than those in the control group ( P<0.05), mainly involving the function connection of forehead peak network (FPN), and function connection of FPN-default network, function connection of FPN-somatosensory movement network, function connection of FPN-dorsal attention network and function connection of FPN-visual network, as well as the function connection of default network and somatosensory movement network. Conclusion:Shentai Tea Polyphenols can improve cognitive performances including memory, language and executive function, anxiety mood and sleep quality in healthy middle aged or elderly subjects by affecting the functional connections of the networks in the brain.