Serum pepsinogen(PG)is an effective marker for evaluating gastric mucosa function and can be used as a supplement for screening and early diagnosis of gastric cancer. Recently,serum PG has become a hot spot of study in portal hypertensive gastropathy and functional dyspepsia. Serum PG detection is a noninvasive,simple and low cost investigation method with marked clinical value. This article reviewed the value of serum PG detection in warning gastric cancer and evaluating gastric mucosa function.

[Objective]To summarize the thought process behind Chief QIU Shengliang's decision to dispel dampness in order to fortify the spleen and tonify the spleen Yang in clinical treatment of distention and fullness.[Methods]The clinical applications of the aforementioned dampness dispelling technique were compiled for future reference through experience gained via apprenticeship,gathered medical cases,Chief QIU's verbal account on the matter and relevant references.Proven clinical cases were also attached at the end of the report for verification.[Results]Living environment,fast-paced jobs and irregular diet nowadays are making people more prone to spleen-stomach dysfunction and inhibition of Qi movement throughout the middle-Jiao,which in turn leads to distention and fullness.Chief QIU often clinically treats distention and fullness using the aforementioned dampness dispelling technique,for which remarkable efficacy has been achieved.In the medical case reported in this study,the patient was admitted due to recurrent abdominal distension and frequent loose stool.the patient was diagnosed with abdominal distension featuring spleen deficiency and dampness excess by Chief QIU.After treated by strengthening the spleen,dispelling dampness,warming the spleen Yang,promoting digestion and tranquilizing the mind,the patient showed significantly improved condition.[Conclusion]Chief QIU treats distention and fullness by dispelling dampness with the view to fortify the spleen and tonifying the spleen Yang,whose therapeutic efficacy is worth extensive share and popularization.

Background: Epidemiological evidence revealed that stress is the causative factor of dyspeptic symptoms. It has been documented that duodenal inflammation is one of the key mechanisms of dyspepsia, and macrophage is crucial for inflammation. Aims: To determine whether patients with functional dyspepsia (FD) comorbid psychological stress have duodenal inflammation. Furthermore, to identify whether macrophage is involved in the mechanisms of stress-related duodenal inflammation by using water avoidance stress (WAS)animal model. Methods: Duodenal inflammation was observed and compared between FD patients with psychological factors and asymptomatic healthy controls. WAS mouse model with 1 h stress daily for 10 days was used to evaluate the duodenal inflammation at different time points to describe its dynamic changes. The role of macrophage in the development of duodenal inflammation was determined in an interventional study, in which the resident macrophages were depleted by clodronate liposomes. In both clinical and animal studies, the severity of duodenal inflammation was assessed by HE staining and immunocyte counts, the macrophage infiltration was detected by immunohistochemistry, and the expression of inflammatory cytokines was detected by real-time PCR. Results: FD patients with psychological factors developed severe duodenal inflammation in comparison with the healthy controls (immunocytes/HPF: 138.91±7.13 vs. 81.44±23.60, P<0.000 1). At the same time, the expressions of proinflammatory cytokines (IL-1β, TNF-α, and IL-17A) were increased, while the expressions of anti-inflammatory cytokines (IL-10 and TGF-β) were decreased (all P<0.05). In WAS mouse model, a dynamic change in duodenal inflammation which peaked on day 5 was observed, and the changes of macrophage infiltrating in the duodenal tissue were consistent with the duodenal inflammation. Clodronate liposomes pretreatment could effectively deplete macrophages, protected the WAS mouse model against duodenal inflammation (immunocytes/HPF: 75.10±4.08 vs. 202.43±5.18, P<0.001), with a marked reduction of the expressions of proinflammatory cytokines (IL-1β, TNF-α, and IL-8), and a marked elevation of the expression of anti-inflammatory cytokine IL-10 (all P<0.05). Conclusions: Psychological stress may lead to dyspeptic symptoms via macrophage-mediated duodenal inflammation.