Objective To study the expression of basic fibroblast growth factor(bFGF),fibroblast growth factor receptor-2(FGFR-2)and heparanase(Hpa)in the tissues of gastric cancer and precancerous lesions,and to explore its significance in the carcinogenesis and malignant progression of stomach.Methods The expression of bFGF,FGFR-2 and Hpa were detected by immunohistochemistry in 145 cases of paraffin-embedded specimens from different gastric mucosa,including 30 cases of chronic superficial gastritis(CSG),29 of intestinal metaplasia(IM),31 of dysplasia(Dys)and 55 of gastric carcinoma(GC).Results The expression of bFGF and FGFR-2 in CSG group was significantly lower than that of the other three groups(P

Objective To investigate the diagnostic value of contrast-enhanced ultrasound endoscopy(CE-EUS) for the upper gastrointestinal tract and adjacent lesions.Methods One hundred and eighty samples of upper gastrointestinal tract and adjacent lesions in the First Affiliated Hospital of Guangxi Medical University from June 2014 to March 2015 were collected and performed CE-EUS.The preliminary diagnosis was taken by observing the features of various kinds of solid mass,which was conducted the contrastive analysis with the results of fine needle aspiration cytology(EUS-FNA) and (or) histopathology, biliary brush cytology smear results,operative pathologic findings,and CT,MRI scans and follow-up results.Results In 180 cases of gastrointestinal tract and adjacent placeholder,169 cases of CE-EUS were in line with the final results,while 11 cases were not consistent,and the diagnostic consistency rate was 93.9%.Conclusion CE-EUS can guide EUS-FNA puncture for increasing its positive rate..

The deficiency in teaching resource is becoming severer as enrolled students increased and the awareness of respecting patients’rights is enhanced.It is urgent to develop new strategy to improve our diagnostic teaching in this situation.For this purpose,the scheme of developing half-dynamic interactive web for diagnostic education is proposed,and the advantage of the web are also discussed here.The advantages include enhancing students’interest and participation in study,bettering communication between the teachers and students,utilizing the collective intelligence,and integrating education resource.Excellent half-dynamic interactive web is helpful to transform the teachers’role from implanting into guiding,supervising,and examining.

Objective To evaluate the clinical value of magnetic resonance cholangiopancreatogra-phy ( MRCP) and endoscopic retrograde cholangiopancreatography ( ERCP) in the diagnosis of obstructive jaundice. Methods MRCP and ERCP were performed in 32 patients with obstructive jaundice, all patients were diagnosed surgically or histopathologically. Results The level of obstruction was diagnosied by MRCP and ERCP with accuracy of 90.6% (29/32) and 82. 8% (24/29) respectively(P =0. 5960) ,whereas the accuracy of combination of MRCP and ERCP reached 96. 9% (31/32) . For the etiologic diagnosis, the accuracy reached 75.0% (24/32) and 72. 4% (21/29) in MRCP and ERCP respectively ( P = 0. 9503) , whereas the accuracy MRCP and ERCP of imcombination reached 93. 8% (30/32) , significantly higher than that of MRCP( P = 0.0387) or ERCP alone(P = 0. 0245). Conclusions MRCP and ERCP are reliable and safe methods for the diagnosis of obstructive jaundice; furthermore, combination of the two procedures could improve the efficacy of diagnosis.

BACKGROUND:The hepatic stellate cells(HSCs)plays a key role in the development of liver fibrosis.Studies have shown that bone marrow-derived mesenchymal stem cell(BMSCs)transplantation can be used to treat liver fibrosis,but the mechanism for reversal of liver fibrosis remains unknown.OBJECTIVE:To explore the mechanism of bone marrow mesenchymal stem cells to regulate the proliferation of HSCs under co-culture in vitro.METHODS:Rat BMSCs and HSCs in the experimental group were cultured in the plastic culture plate(6 holes)to establish the upper and lower double-cell co-culture system.Rat normal fibroblast cell lines were seeded as control group;HSCs were cultured alone as blank group.Cell proliferation was determined by WST8 and cell cycle was determined by flow cytometry.The Cyclin D1 and P27 mRNA expression in HSC was determined by reverse transcription-polymerase chain reaction(RT-PCR)and the level of Cyclin D1 and P27 protein by Western blot.RESULTS AND CONCLUSION:HSCs co-cultured with BMSCs significantly inhibited HSC proliferation compared with the blank and control groups at 24,48,and 72 hours(P ＜ 0.01);Flow cytometry showed that the percentage of G_0/G_1 phase cells of co-culture group was increased but the S phase cells reduced(P ＜ 0.01)compared with the other groups at 72 hours,and BMSCs blocked HSC to convert from G_0/G_1 period to S phase.After HSCs co-cultured with BMSCs for 24 hours,the expression of Cyclin D1 mRNA and protein was reduced,and significantly less than the blank and control groups at 72 hours(P ＜ 0.01);no differences were detected in P27 mRNA expression in each group during the co-culture(P ＞ 0.05).After co-culture of 24 hours,the p27 protein expression was significantly increased compared with the blank and control groups(P ＜ 0.01).BMSCs inhibited the proliferation of HSCs,possibly through inhibiting CydinDI expression,increasing the p27 protein expression to cause cell cyde arresting in G_0/G_1 phase.

Objective To evaluate the diagnostic value of the cell block (CB) with immunostaining method by endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) biopsy for pancreatic lesions.Methods A total of 72 patients with pancreatic lesions underwent EUS-FNA at the First Affiliated Hospital of Guangxi Medical University from March 2012 to June 2013.The EUS-FNA samples of all patients were processed by conventional smear cytology,liquid-based cytology (LBC) and the cell block with immunostaining.Results There were 61 pancreatic patients who were finally diagnosed as having pancreatic tumors,including 55 cases of pancreatic cancer,2 pancreatic solid pseudopapillary tumor,4 pancreatic endocrine tumors (PETs),and 11 benign lesions:4 chronic pancreatitis,2 pancreatic tuberculosis,4 pancreatitis and 1 pancreatic mucinous cystadenoma.The diagnostic sensitivity of conventional smear cytology,liquid-based cytology and cell block with immuno-staining method were 68.9％ (42/61),75.4％ (46/61) and 90.2％ (55/61),respectively.The diagnostic specificity of three methods were all 100.0％.The diagnostic accuracy rates were 73.6％ (53/72),79.2％ (57/72) and 91.7％ (66/72),respectively.The diagnostic accuracy rate of the cell block with immunostaining was higher than those of conventional smear cytology (P ＜ 0.05) and the liquid-based cytology (P ＜ 0.05).Conclusion Endoscopic ultrasound-guided fine-needle aspiration is a safe and effective method with high sensitivity and specificity in the diagnosis of pancreatic lesions.Cell block method combining immunohistochemistry helps to increase the diagnosis and histological diagnosis of pancreatic lesions.The cell block has a greater clinical value in the diagnosis of pancreatic lesions.

Objective To evaluate measurement of the submucosal thickness with endoscopic ultrasonography (EUS) for activity of Crohn disease (CD).Methods Ten patients with active stage of CD and 10 healthy controls (HC) underwent EUS.Simple endoscopic score for Crohn disease(SES-CD)and submucosal thickness at the most severe lesions were measured and recorded.Submucosal thickness of the same region in CD patients were measured at remissive stage.In order to analyze the relationship between submucosal thickness and the stage of CD, submucosal thickness were compared among patients at active stage of CD, remissive stage of CD and HC.And the cut-off value of submucosal thickness was calculated to diagnose the stage of CD.Results The mean submucosal thicknesses of active stage and remissive stage of CD were 6.48±1.95 mm and 2.47±1.08 mm,respectively (P<0.01).The correlation analysis showed that submucosal thickness had a positive correlation with Crohn disease activity index(CDAI)(r=0.708,P<0.01) and SES-CD(r=0.807,P<0.01).Receiver operating characteristic curve analysis was used for 10 cases of CD patients and the area under the curve was 0.985(P<0.01).The cut-off value of submucosal thickness to diagnose active stage of CD was 3.85 mm, and the sensitivity and specificity reached 100% and 90% respectively.The Youden index was 0.9.Conclusion Measurement of gastrointestinal submucosal thickness by EUS could contribute to evaluate the stage of CD and to guide clinical treatment.

Objective To evaluate the therapeutic effect of endoscopic management of plastic stents of post-liver transplantation anastomotic biliary stricture. Methods From January 2010 to October 2015, clinical data of patients with post-liver transplantation anastomotic biliary stricture and received endoscopic retrograde cholangiopancreatog﹣raphy and plastic stents management was collected. The technical success rate, ERCP-related complications, clinical remission rate and long-term complications were main outcome measurements to compare the efficacy and safety of different number of stents in managing post-liver transplantation anastomotic biliary stricture. Results Among the 18 patients (0.5 ~ 60.0 months) with post-liver transplantation ABSs, seven patients received less plastic stents treat﹣ment (< 3 stents), nine patients with persistent anastomotic or recurrent stricture received multiple plastic stents treatment (≥ 3 stents), two patients received multiple plastic stents treatment once suffered with post-liver trans﹣plantation ABSs. The endoscopic technical success rate was seventy-six over eighty (95.0 %). Among the seven pa﹣tients received less plastic stents treatment, one loss to follow-up, two were still under treatment, one died of acute hepatic failure, one died of septic stock, one combined with biliary fistula resulted in treatment failure, one achieved clinical remission, the clinical remission rate was one third (33.3 %). Among the eleven patients received multiple plastic stents treatment, two loss to follow-up, one was still under treatment, two received surgery because of failed treatment, six achieved clinical remission, the clinical remission rate was 75.0 % (6/8). The average diameters and stent durations of management of 1 stent, 2 stents, 3 stents, 4 stents, 5 stents, 7 stents were 8.5 F, 17.0 F, 24.0 F, 28.0 F, 36.0 F, 50.0 F. Among the six early postoperative complications, five cases occurred in less stent manage﹣ment and one occurred in MPSs management, the early postoperative complication rate was 7.5 %(6/80). No severe ERCP-related complications and procedure-related deaths. Conclusions Endoscopic management of plastic stents is safe and effective for post-liver transplantation ABSs. Providing larger biliary support, the multiple plastic stents treatment was superior to less plastic stents treatment in view of clinical remission rate, especially for refractory one. Multiple plastic stents did not increase the incidence of complications, it could be used as the first-line treatment of post-liver transplantation duct-to-duct biliary anastomosis for its safety and effectivity.

Objective To study the diagnostic value of endoscopic retrograde cholangiopancreatography (ERCP) combined with intraductal ultrasonography (IDUS) for bile duct stricture diseases.Methods The results of endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography,intraductal uhrasonography,bile duct brushing cytology,the liquid-based cytology and the histopathological examination were analyzed retrospectively.The final diagnosis was made based on clinical data,histopathology and follow-up results(≥4 months).Results Twenty-one patients were diagnosed as having malignant biliary diseases,including 9 biliary tract carcinoma,4 duodenal papilla carcinoma,4 pancreatic cancer infiltrated common bile duct,4 cancer of the liver infiltrated common bile duct ; 15 were diagnosed as having benign biliary diseases,including 9 bile duct stones,4 liver fluke disease,lbile duct inflammatory stenosis,1 bile duct stricture caused by external compression.The accuracy rate of the EUS,ERCP,IDUS and ERCP + IDUS in the differential diagnosis of the bile duct stricture disease were 77.8％,88.9％,91.7％ and 94.4％,respectively.The accuracy rates of IDUS,ERCP,ERCP combined with IDUS were significantly higher than that of EUS (P ＜ 0.05).The sensitivity,specificity,positive predictive value and negative predictive value of ERCP combined with IDUS were 95.2％,93.3％,95.2％ and 93.3％ respectively which were higher than those of EUS,ERCP and IDUS.After the bile duct brushing cytology and the liquid-based cytology or histopathological examination,19 patients were diagnosed as having malignant biliary diseases,17 were benign biliary diseases.The sensitivity,specificity and accuracy of the procedures for malignant bile duct stricture disease were 90.5％,100.0％,94.4％ respectively.Conclusion ERCP combined with IDUS can improve the diagnostic accuracy.The diagnostic positive rate will be higher with the help of ERCP,IDUS and targeted brush.

Objective To investigate the expression of sphingosine kinase 1(SphK1)and NF-κB in colon carcinoma tissues and their correlation with clinicopathologic features.Methods Sixty-six paraffinembedded colon carcinoma samples and 66 fresh colon carcinoma samples were tested using immunohistochemistry,RT-PCR and Western blot,respectively.Results In 66 fresh colon carcinoma samples,the positive rate of SphK1 and NF-κB mRNA expression were 84.85％(56/66)and 74.24％(49/66),while the positive rate of SphK1 and NF-κB protein detected by Western blot were 78.79％(52/66)and 69.70％(46/66).The positive rates were higher than those in the adjacent tissues[mRNA:63.64％(42/66),48.49％(32/66);protein:57.58％(38/66),45.45％(30/66)]and the normal mucosa [mRNA:42.42％(28/66),25.76％(17/66); protein:36.36％(24/66),24.24％(16/66)],with statistical significances(all P values ＜ 0.05).The mean expressive levels of SphK1 and NF-kB mRNA and protein in colon carcinoma were both significantly higher than those in the adjacent tissues and the normal mucosa(mRNA:0.55±0.06 vs0.35 ±0.05 vs0.25±0.05,0.75 ±0.06 vs0.43±0.05 vs0.30±0.04 ; protein:0.77 ± 0.05 vs 0.38 ± 0.06 vs 0.12 ± 0.03,0.45 ± 0.08 vs 0.23 ± 0.05 vs 0.13 ± 0.03 ;all P values ＜ 0.05).There was a close correlation between SphK1 and NF-kB expression levels (r =0.459,P =0.036).The results of immunohistochemistry were similar to those of RT-PCR and Western blot.Overexpression of SphK1 and NF-κB in colon carcinoma was related with depth of invasion,distant and lymph node metastasis and Dukes'stages(all P values ＜0.05).The expression of SphK1 was also related with differentiation(P ＜ 0.05).Conclusions Overexpression of SphK1 and NF-κB may be involved in the pathogenesis and progression of colon carcinoma.Moreover,SphK1 and NF-κB may be correlated with the invasion and metastasis of colon carcinoma.