Objective To analyze the clinical characteristics of gastric polyps in different histopathological types. Methods Based on histopathological difference, gastric polyps were categorized into fundic gland polyps, hyperplastic polyps, inflammatory polyps, adenomatous polyps, etc; Different types of polyps in the aspects of distribution, Helicobacter pylori (H. pylori) infection, the relationship between the proton pump inhibitors (PPI) and the occurrence of gastric polyps to provide guidance on treatment Results 365 cases of gastric polyps were diagnosed in 10 197 patients who underwent gastroscopy. The prevalence was 3. 6%. The histopathological type of the polyps were fundic gland polyps (61. 1%), hyperplastic polyps (23. 3%) , inflammatory polyps (12. 3%) , adenomatous polyps (2. 2%). 289 cases showed single polyps, which was the majoriry across all types of gastric polyps. Majority of the gastric polyps were located in gastric body and fundus, followed by gastric antrum and cardia Most of the fundic gland polyps were located in gastric body and fundus; Majority of the hyperplastic polyps and adenomatous polyps were located in gastric antrum; The main locations of inflammatory polyps were cardia and gastric body and fundus. A higher percent (51. 6%) of fundic gland polyps patients used PPI. The difference was statistically significant compared with the hyperplastic polyps(8. 2%)and inflammatory polyps group(8.9%) (x2 = 48. 31,27. 63 ,P <0. 01). The H. pylori infection rate of hyperplastic polyps and inflammatory polyps were 72.4% and 74.4% ,respectively, both of which were higher than that of fundic gland polyps(20. 2%)(x2 =46. 50,35. 04, P < 0. 01) . One year after the H. pylori eradication, the recurrence cases of hyperplastic polyps and inflammatory polyps were 1/41 and 0/19,respectively. Conclusions The main histopathological type of gastric polyps is fundic gland polyps followed by hyperplastic polyps. The main location of the gastric polyps is gastric body and fundus, followed by gastric antrum and cardia. The distribution of different types of gastric polyps has some characteristics. Long-time usage of PPI may increase the risk of fundic gland polyps. The occurrence of hyperplastic polyps and inflammatory polyps may be related to H. pylori infection. The H. pylori eradication helps preventing the recurrence of hyperplastic and inflammatory gastric polyps.

Objective To summarize the clinical and pathological data of gastric polyps under gastroscope,and to investigate the clinical characteristics of gastric polyps in elderly patients.Methods The 692 cases of gastric polyps diagnosed by gastroscopy and pathology were retrospectively analyzed.The elder group was defined as aged 60 years and over.The young group was defined as aged less than 60 years.The data were analyzed by SPSS software.Results The detected ratios of gastric polyps were 3.9% in the elder group and 2.9% in the young group (χ2 =15.792,P<0.01).The rates of gastric polyps found in fundus,gastric body and gastric antrum were 32.0%,41.3% and 19.8% respectively in the elder group.And the corresponding rates in the young group were 37.5%,45.8% and 11.1% respectively (χ2 = 2.277,1.404,10.289,P = 0.131,0.236,0.001).The pathological types of the gastric polyps were in the order of fundic gland (60.0%),hyperplastic (26.2%),inflammatory (11.3%),adenomatous (1.7%) and others (0.8%).The diagnostic rates of hyperplastic polyps in the elder group and the young group were 31.7% and 21.9% respectively;the corresponding rates of adenomatous polyps were 3.0% and 0.8% respectively (χ2 = 8.525,4.834,P=0.004,0.028).Conclusions The detected ratio of gastric polyps is higher in the elder group than in the young group.In both groups,the polyps in the fundus and the body are more prevalent,followed by those in the antrum.The diagnostic rate of polyps in the antrum is significantly higher in the elder group than in the young group.Although the main pathological type of the gastric polyps is fundic gland in both groups,the diagnostic rates of hyperplastic polyps and adenomatous polyps are both higher in the elder group,the risk of cancer is higher as well.Therefore,in the elderly,the gastric polyps are recommended to be cut off as soon as possible and followed up closely.

Objective To assess the reliability of a newly developed enzyme immunoassay for Helicobacter pylori-specific antigen detection in the old patients' stools. Methods The 199 old patients referred to our department for upper gastrointestinal endoscopy were included. Among which, 48 patients suffered from subtotal gastrectomy previously, and 151 patients never had any gastric surgery. All patients underwent gastroscopy with biopsies for rapid urease test (RUT) and histology (Warthin-Starry stain). Used RUT and Warthin-Starry stain as gold standard, Helicobacter pylori (H. pylori) status was defined positive (or negative) if both RUT and Warthin-Starry stain were positive (or negative). A stool specimen was collected for each patient and tested by using a novel enzyme immunoassay for H. pylori detection (HpSA). Every patient was also detected by 13 C-urease breath test ( 13C-UBT). Sensitivity and specificity of these two tests were calculated respectively. Results H. pylori ststus was positive in 81 patients and negative in 70 patients of 151 patients. The sensitivity and specificity of HpSA were 96.3% and 90.0%, and 13 C-UBT were 92.6% and 92.9% respectively; H. pylori infection was confirmed in 23 of 48 patients with gastric surgery, the sensitivity of HpSA test for the diagnosis of H. pylori infection was 91.3% and its specificity 88.0%, and 13 C-UBT were 65.2% and 92.0% respectively, the sensitivity of 13 C-UBT was lower than HpSA in the patients with a history of gastric surgery (P

Objective To study the effect of compound hypertonic saline solution (HSD) on sepsis.Methods 133 male Wistar rats were divided into four groups,sham operation group (n =15),cecal ligation and puncture (CLP)group (n =45),CLP plus normal saline (NS) group (n =45),and CLP plus HSD group (n =28).A rat model of sepsis was reproduced by CLP,and the rats in sham operation group received celiotomy without ligation and puncture.All rats in four groups received subcutaneous injection of 30 mL/kg 0.9％ sodium chloride after laparotomy.The rats in CLP plus NS group and CLP plus HSD group received infusion of 5 mL/kg 0.9％ sodium chloride or 7.5％ sodium chloride/6％ dextran post CLP via jugular vein for 3 hours,with the infusion rate of 0.4 mL·kg-1·min-1.The survival rate of each group was observed 9 hours and 18 hours after laparotomy.Mean arterial pressure (MAP) at 0,9,18 hours were monitored.Blood specimens were collected from all rats 0,9 and 18 hours after laparotomy,respectively,for measurement of the plasma levels of tumor necrosis factor-α (TNF-α),interleukin-1β (IL-1β),and procalcitonin (PCT).The rats were all sacrificed,and their lung tissues were harvested for the neutrophil count in bronchoalveolar lavage fluid (BALF),myeloperoxidase (MPO) activity in lung tissue,wet/dry weight ratio (W/D) of lung,and pathological changes in lung tissue.Results There was no death in the sham operation group.The survival rates at 9 hours and 18 hours were 62.2％ and 31.1％ in the CLP group,57.8％ and 35.6％ in the CLP plus NS group,85.7％ and 64.3％ in the CLP plus HSD group,and they were all significantly higher compared with those of the CLP group and the CLP plus NS group (P ＜ 0.05 or P ＜ 0.01).MAP levels in the CLP group and the CLP plus NS group were significantly lower than those in sham operation group,and the plasma levels of TNF-α,IL-1β and PCT were significantly higher compared with those of sham operation group,while there was no difference between CLP group and the CLP plus NS group.MAP and the plasma levels of TNF-α,IL-1β and PCT in the CLP plus HSD group were significantly improved compared with those of the CLP plus NS group at 9 hours and 18 hours [MAP (mmHg,1 mmHg =0.133 kPa) at 9 hours:102±5 vs.94±6,18 hours:90±2 vs.72±3; TNF-α (ng/L) at 9 hours:284.19±57.18 vs.329.67±45.79,18 hours:263.46±42.58 vs.349.68±52.40; IL-1β (ng/L) at 9 hours:219.28±39.21 vs.263.47±32.36,18 hours:195.98±39.06 vs.250.10±41.57; PCT (μg/L) at 9 hours:2.32±0.37 vs.4.52±0.75,18 hours:2.89±0.62 vs.5.02±0.84; P ＜ 0.05 or P ＜ 0.01].The ratio of neutrophils in BALF,MPO activity and lung W/D at 18 hours in the CLP group and the CLP plus NS group were significantly higher than those of the sham operation group,while they were all significantly lower in the CLP plus HSD group than those of the CLP group and the CLP plus NS group [ratio of neutrophils in BALF:0.094±0.019 vs.0.148±0.062,0.151 ±0.055; MPO (U/g):1.19±0.45 vs.2.31 ±0.79,2.64±0.69; lung W/D ratio:4.02 ± 0.63 vs.5.14 ± 0.59,5.12 ± 0.83,all P ＜ 0.05].Under light microscope,no pathobiological changes were found in sham operation group.The lung tissues in the CLP group and the CLP plus NS group showed congestion,edema,infiltrating inflammatory changes,while the inflammatory changes in the lung tissue in the CLP plus HSD group were significantly alleviated.Conclusion HSD can obviously ameliorate the circulatory failure in septic rats,alleviate immune disturbance and acute lung injury,and improve the survival rate of rats with sepsis.

Objective To evaluate the expression of metastasis-associated lung adenocarcinoma transcript 1 (MALAT-1) in ovarian cancer cell lines, and to investigate the biological effects of down-regulated MALAT-1 on OVCAR3 cells.Methods qRT-PCR analysis was used to examine the expression level of MALAT-1 gene in ovarian cancer cells, including ES-2, A2780, SKOV3 and OVCAR3 cell lines.For functional research, four shRNA oligos specially targeting MALAT-1 and a empty vector were designed and constructed into pGPU6/GFP/Neo, then transfected into OVCAR3 cells.qRT-PCR was used to confirm the effective suppression of MALAT-1.Changes of proliferation and adhesion of cells were analyzed by CCK-8 and adhesion assays.Wound-healing, transwell migration and invasion assays were used to examine migration and invasion of MALAT-l-silencing cells in vitro.Results The expression of MALAT-1 gene in OVCAR3 cells was high, and qRT-PCR results confirmed successfully the knockdown of MALAT-1 after transient transfection.After successful suppression of MALAT-1, the proliferation, wound-healing and adhesion ability in vitro were inhibited to some degree.In transwell migration assay, the number of migration cells in MALAT-1-silencing group was 52.17±4.48, which is much less than that in the negative and control groups (286.50± 12.23 and 295.67±6.96, respectively).In invasion assay, the number of invasion cells passing the transwell membrane in MALAT-1-silencing group (37.33±2.40) was also decreased significantly, compared to that in the negative and control groups (239.00±15.72 and 222.67±20.85, P ＜ 0.05).Conclusions shRNA-mediated silence of MALAT-1 can effectively inhibit the proliferation, adhesion, migration and invasion abilities of ovarian cancer cell line OVCAR3 in vitro, indicating MALAT-1 is expected to be a target gene for the treatment of ovarian cancer.

Objective To summarize the clinical phenotype profiles and mitochondrial DNA mutation in maternally inherited diabetes and deafness ( MIDD ) , and to improve the diagnosis and treatment of this disease in clinical practice. Methods Sixteen patients with MIDD in six families from Peking Union Medical College from 2007 to Dec 2014 were confirmed as carrying the mitochondrial ( mt) DNA 3243 A to G mutation. Sanger sequencing was used to detect the mt DNA 3243 A to G mutation. The peak height G/A ratio was used to determine mutation heteroplasmy levels. Results The patients with early onset of diabetes (35. 0 ± 14. 6 years), deafness, normal or lower body mass index ( BMI) , and maternal hereditary tendency suggested the diagnosis of MIDD. The peak height G/A ratio was significantly different according to the onset age of MIDD [≤25 years (61. 6 ± 20. 17)%;25-45 years (16.59±8.64)%;>45 years(6.37±0.59)%;P<0.01]. The peak height G/A ratio was negatively correlated with the onset age of MIDD(r=-0. 785,P=0. 001). Conclusion Early onset of diabetes with deafness, normal/lower BMI, and maternal hereditary tendency strongly suggests the diagnosis of MIDD. The peak height G/A ratio might provide a simple prediction regarding the onset age and severity of MIDD.

Objective:To evaluate the changes in CD4 + CD25 + regulatory T cells (Treg)/helper cell type 17 (Th17) during intestinal damage in septic rats. Methods:Forty-eight clean-grade Sprague-Dawley rats, aged 3 months, weighing 200-300 g, were divided into control group (group C)and sepsis group(group Sep), with 24 rats in each group.The modified cecal ligation and puncture method was used to establish the model of sepsis in anesthetized rats.Resuscitation was performed with normal saline after operation, and the right jugular vein catheterization was used for treatment of enteral nutrition in two groups.Six rats were sacrificed at 12, 24, 48 and 72 h after surgery (T 1-4), and mesenteric lymph nodes and colon were obtained.The percentage of Treg cells and Thl7 cells in mesenteric lymph nodes was detected by flow cytometry.The contents of interleukin-17 (IL-17), IL-23, transforming growth factor beta (TGF-β) and IL-10 in colon tissues were determined by enzyme-linked immunosorbent assay. Results:Compared with group C, the percentage of Treg cells was significantly decreased at T 1, the percentage of Treg cells at T 3, 4 and Th17 cells at T 2-4 were increased, the contents of IL-17 and IL-23 at T 1-4, TGF-β at T 3-4 and IL-10 at T 2-4 were increased, and TGF-β contents were decreased at T 2 in group Sep ( P<0.05). Conclusion:The mechanism of intestinal damage is related to Treg and Th17 cell imbalance in septic rats.

Objective To evaluate the effect of thymosin α1 (Tα1) on sepsis in rats.Methods A total of 120 pathogen-free healthy male Sprague-Dawley rats,weighing 250-300 g,aged 7 weeks,were divided into 3 groups using a random number table method:sham operation group (group S,n =24),sepsis group (group CLP,n=48) and Tα1 group (group T,n=48).Sepsis was induced by modified cecal ligation and puncture in anesthetized rats,and vena cava cannula was placed through the right jugular vein to connect the micropump infusion device.In group S,the cecum was only turned without ligation and perforation,and total venous nutrient solution 60 ml was intravenously infused daily for 3 days.After successful establishment of the model,total venous nutrient solution 60 ml was intravenously infused daily for 3 days in group CLP.After successful establishment of the model in group T,Tα1 0.18 mg/kg was subcutaneously injected daily at a fixed time,and total venous nutrient solution 60 ml was intravenously infused daily for 3 days.Twenty-four rats in group CLP and group T were selected,and the survival rate were observed within 3 days after establishing the model.At 12,24,36 and 72 h after establishing the model,6 rats were selected from each group,and blood samples were collected from the jugular vein for determination of the levels of regulatory T cells (Tregs) and T helper cell 17 (Th17) (using flow cytometry) and serum interleukin-10 (IL-10),IL-17 and tumor necrosis factor-alpha (TNF-α) concentrations (by enzymelinked immunosorbent assay),and the IL-10/TNF-cα ratio was calculated.Results Compared with group S,the level of Tregs in peripheral blood was significantly decreased at 24 h after establishing the model and was increased at 36 and 72 h after establishing the model,and the level of Th17 in peripheral blood and serum IL-10,IL-17 and TNF-α concentrations were increased at each time point after establishing the model,and the IL-10/TNF-α ratio was increased at 36 and 72 h after establishing the model in group CLP,and the levels of Tregs and Th17 in peripheral blood were significantly increased at 72 h after establishing the model,the concentrations of serum IL-10 and IL-17 were increased at each time point after establishing the model,serum TNF-α concentrations were increased at 12 and 24 h after establishing the model,and the IL-10/TNF-α ratio was increased at 36 and 72 h after establishing the model in group T (P＜0.05).Compared with group CLP,the levels of Tregs and Th17 in peripheral blood were significantly decreased,the serum IL-10 and IL-17 concentrations and IL-10/TNF-α ratio were decreased at 36 and 72 h after establishing the model,serum TNF-α concentrations were decreased at 72 h after establishing the model,and the survival rate was increased within 3 days after establishing the model in group T (P＜0.05).Conclusion Tα1 can reduce sepsis through improving the cellular immune function in rats.

Objective We have summarized the clinical characteristics of inappropriate antidiuresis(SIAD).Methods We adopted retrospective analysis to analyze the clinical and lab data of 40 cases.Results The most common causes of SIAD were malignant tumor,lung disease,and central nervous system disease.The five major abnormal lab data were:hypochloraemia,hypouricemia,hyponitremia,hypocalcemia,and low hematocrit.Conclusion It is important to diagnose SIAD as soon as possible,and patient presented hyponatremia combined with hypouricemia must be suspected to have SIAD.

Objective:To investigate the effect of autophagy on the Treg/Th17 cell imbalance in mice with acute lung injury (ALI).Methods:Twenty-four male SD mice were randomly divided into the sham operation group (S group), sepsis group (Sep group) and autophagy inhibitor 3-methyladenine group (Sep +3-MA group). ALI model was prepared by LPS tracheal dripping method. The mouse pathological injury score mice were evaluated under light microscopy and the W/D ratio was calculated. The counts of Th17 cells and Treg cells in tracheoalveolar lavage fluid (BALF) of mice and the levels of related cytokines were detected by flow cytometry. The expressions of LC3-Ⅱ, Beclin-1 and p62 in Th17 cells and Treg cells in BALF were determined by Western blot.Results:CCompared with the S group, the lung histopathological score and W/D ratio of the Sep group and Sep+3-MA group increased ( P<0.05). Compared with the Sep group, the count of Th17 cells in BALF of the Sep +3-MA group decreased, while the count of Treg cells increased significantly with the progression of sepsis( P<0.05), and the levels of IL-17, IL-10 and TNF-α were significantly decreased ( P<0.05). TGF-β1 levels increased in the early stages of sepsis, but decreased significantly with the progression of sepsis( P<0.05). Compared with the Sep group, LC3-Ⅱ expression in BALF Th17 cells and Treg cells of the Sep+3-MA group showed a downward trend, but there was no statistical difference, while Beclin-1 expression significantly decreased ( P<0.05), and the expression of p62 significantly increased ( P<0.05). Conclusions:Abnormal activation of autophagy in Th17 cells and Treg cells is involved in the immune imbalance of Th17/Treg cells in ALI with sepsis. Inhibition of autophagy can restore the functions of Th17 cells and Treg cells, and improve the imbalance of Th17/Treg by inhibiting autophagy may become a new idea to control the pathogenesis and progression of immune disorders with sepsis.