Objective To detect the expression of matrix Gla protein(MGP),signal transduction and activator of transcription 3(STAT3),β-catenin and matrix metalloproteinase 2(MMP2)in gastric adenocarcinoma and atrophic gastritis,and investigate the cor-relation of them.Methods The relative expression levels of MGP,STAT3,β-catenin and MMP2 proteins were detected by Western blot experiment and immunohistochemical experiment,and the correlation between the four proteins and gastric adenocarcinoma and a-trophic gastritis was investigated.Results The results of Western blot showed that the relative expression levels of MGP,STAT3,β-catenin and MMP2 proteins in atrophic gastritis group were higher than those in non-atrophic gastritis group,and the differences were statistically significant(P＜0.05).The relative expression levels of MGP,STAT3,β-catenin and MMP2 proteins in gastric adenocarci-noma group were higher than those in non-atrophic gastritis group and atrophic gastritis group,and the differences were statistically sig-nificant(P＜0.05).The results of immunohistochemical experiment showed that the positive rates of MGP,STAT3,β-catenin and MMP2 in atrophic gastritis group were higher than those in non-atrophic gastritis group.The positive rates of MGP,STAT3,β-catenin and MMP2 in gastric adenocarcinoma group were higher than those in non-atrophic gastritis group and atrophic gastritis group;except that STAT3 was not statistically significant in non-atrophic gastritis group and atrophic gastritis group,and the differences among other groups were statistically significant(P＜0.0125).In atrophic gastritis and gastric adenocarcinoma,the expressions of MGP,STAT3,β-catenin and MMP2 were positively correlated(P＜0.05).Conclusion MGP may activate downstream MMP2 through JAK2/STAT3 signaling pathway and Wnt/β-catenin signaling pathway to promote the occurrence and development of gastric adenocarcinoma and a-trophic gastritis.

Objective:To investigate the efficacy and safety of endoscopic submucosal dissection (ESD) for the treatment of upper gastrointestinal lesions .Methods:IT knife and HOOK knife were applied in ESD for the treatment of 30 cases of upper gastrointestinal mucosal or submucosal lesions revealed by gastroscopy .The ESD procedure was conducted as follows .Firstly , 0 .9% sodium chloride solution was injected into the submucosa so as to elevate the mucosa on lesion .Secondly ,the mucosa around the lesion was pre‐cut .Thirdly ,the lesion was dissected completely from the surrounding connective tissue .Results:The diameters of the lesions ranged from 0 .8 to 4 .5 cm with mean of (2 .6 ± 1 .3) cm .As postoperative pathology confirmed , there was tumor residual on wound surface of 2 cases after ESD ,and they received extended resection .And the lesions of the other 28 cases were successfully resected by ESD .The success rate of complete dissection was 93 .3% (28/30) .The ESD procedure time (from fluid injection to complete dissection) ranged from 29 to 110 min ,with a mean of (48 ± 11 .2) min .The average amount of bleeding during operation was 45 mL and the bleeding was successfully stopped by electro‐coagulation ,argon plasma coagulation . One patient (aspirin was stopped 5 days before operation) suffered hemorrhage per‐diapedesin and recovered after conservative treatment .The bleeding rate of ESD was 3 .33% (1/30) .Perforation occurred in 3 cases during the ESD procedure ,and was closed with metallic endoclip .And no case was transferred to laparotomy .The perforation rate of ESD was 10 .0% (3/30) .After the operation ,16 cases were followed up .And the follow‐up period ranged from 3 to 6 months ,with a mean of (4 .5 ± 1 .2) months .The wound surfaces of 16 cases were healed ,and there was no residue or recurrence .Conclusions:The curative effect of ESD for the treatment of upper gastrointestinal lesions is reliable ,as it can not only wholly remove the large lesion ,but also provide with pathological proof .With ESD ,less pain ,faster rehabilitation ,and lower recurrent rate can be achieved for patients .

Background; Biological agents have become an important treatment for moderate-to-severe ulcerative colitis (UC). Studies have shown that vedolizumab (VDZ) has good efficacy. Ainis; To systematically evaluate the efficacy and safety of VDZ in the treatment of moderate-to-severe UC. Methods; Studies on VDZ, anti-tumor necrosis factor (TNF)-α in treatment of moderate-to-severe UC were retrieved from PubMed, Web of Science, EBSCO, The Cochrane Library, CNKI, SinoMed from the date of database establishment to August 2021. According to inclusion and exclusion criteria, literatures were screened and extracted. RevMan 5. 4 software was used to conducted meta-analysis. Results; Eleven studies involving 3 921 patients were included. Meta-analysis showed that the clinical response rate ( OR = 2. 14, 95% CI; 1. 73-2. 64, P<0.00001), the clinical remission rate (OR = 1.67, 95% CI; 1.42-1.96, P<0.00001), the endoscopic response rate (OR = 1.62, 95% CI; 1.29-2.03, P<0.000 1), and the histological response rate (OR = 1. 98, 95% CI; 1.61-2.44, P<0.000 01) in VDZ group were significantly higher than those in anti-TNF-α group. However, no significant difference in incidence of adverse reactions was found between the two groups (OR = 0.51, 95% CI; 0.26-1. 01, P = 0.05). Conclusions; Compared with anti-TNF-α, VDZ is more effective in the treatment of moderate-to-severe UC, and there is no significant difference in incidence of adverse reactions.