Bile reflux is not only related to diseases such as gastritis,esophagitis,pharyngitis,chorditis,bronchitis and pneumonia,but also related to residual gastric ulcer,residual gastric cancer,intestinal metaplasia,dysplasia and carcinogenesis. Risk factors related to bile reflux include various operation modes, various anastomosis methods, gallbladder stone, cholecystectomy and various non-operative factors such as age, gender, allergy, mental and psychological factors,congenital factors. This article reviewed the advances in study on risk factors related to bile reflux.

[Summary] Gastric cancer is seriously dangerous to human health with constantly high incidence .Human gastric mucosa can express gastrokines that can inhibit cancer cell growth .Gastrokines is expressed abundantly in normal tissues while downregulated or absent in gastric cancer and precancerous lesion .It plays an important role in the suppression of gastric cancer proliferation combining with the other factors such as helicobacter pylori infection or trefoil factors .In this paper we made a review about the suppression of gastrokines on gastric cancer cell proliferation .

CMTM3 and CMTM7 are two newly discovered anti-oncogenes,which exist in various kinds of organs and tissues and having multiple biological functions including cell proliferation,differentiation,migration,and apoptosis. Recently,it has been shown that these two anti-oncogenes have closely relationship with gastrointestinal tract tumor,which can inhibit the growth of esophageal,gastric,and colorectal cancer. In this review article,the advances in study of the relationship between these two anti-oncogenes and tumors of gastrointestinal tract were summarized.

Bile reflux gastritis (BRG)has been recognized as a chemical gastropathy due to excessive duodenogastric reflux (DGR).Abnormalities in pyloric anatomic structure,as well as antropyloric and duodenal dysmotility are considered to be implicated in the occurrence of pathologic DGR.Bile acid may induce apoptosis of gastric mucosal cells,and high concentration of bile acid plays a crucial role in the induction of intestinal metaplasia in stomach.In this review article, advances in study on BRG,including the mechanisms of DGR,the pathogenic effect of bile acid on gastric mucosa,and the diagnosis and treatment of BRG were summarized.

2 cm, 8 were operated and 2 were untreated. All the lesions were located outside the rectum. There were 3 cases of death and 5 cases of distant or lymph node metastasis. Out of the 44 cases, distant or lymph node metastasis occurred in 6 cases, the metastasis rate being 13.6%. Conclusions[WTBZ] Endoscopy is the first choice to diagnose digestive tract carcinoids, which, if ≤ 1 cm in diameter, can be treated with EMR.

Neuroendocrine neoplasm (NEN)is a group of heterogeneous tumor originated from the neuroendocrine system,and gastrointestinal neuroendocrine neoplasm (GI-NEN)is the mostly frequently seen. The incidence of GI-NEN is increasing year by year,but the efficacy of clinical treatment is unsatisfactory. In recent years,new progress has been achieved in medical therapy of GI-NEN,including somatostatin analogues,interferon,mTOR inhibitor,vascular endothelial growth factor inhibitor and chemotherapeutic drugs. Peptide receptor radionuclide therapy also provides an additional option for treatment of metastatic GI-NEN. This article reviewed the recent progress of drug treatment for GI-NEN.

Objective To investigate the prevalence of gastric cancer and the relationship between H.pylori infection and the histopathologic changes of gastric mucosa in patients who had their H.pylori eradicated for 8 years in the high incidence region of gastric cancer. Methods One thousand and six adults(age from 35 to 75 years old)were randomly selected in Yantai area, Shandong province in 1996. Five hundreds and fifty two individuals with H.pylori positive were randomly divided into treatment group (n=276) and placebo group(n=276). Treatment group received triple therapy (omeprazol, amoxycillin and clarithromycin) for one week. The placebo group was served as control. One month after completion of treatment, H.pylori status was reassessed by 13C-UBT. Eradication rate of H.pylori in the treatment group was 89%.Follow-up study was carried out with endoscopy in the 2nd, 5th and 8th year, respectively. The endoscopic appearance and histology of the biopsies from the same site obtained at the first and final endoscopy were compared. Results ①At the 8th year′s follow up, 7 patients deve-loped gastric cancer, 1 in the H.pylori negative group(n=246)and 6 in the H.pylori positive group(n=306). The prevalence was 1/1968 person years in the treatment group and 6/2448 person years in placebo group(P0.05). ③ Eight years after eradication of H.pylori , the proportion of gastric atrophy in the body in the H.pylori eradication group was much lower than that in the non-eradication group(P0.05). Conclusions H.pylori infection increased the risk of gastric cancer occurrence, H.pylori eradication is able to reduce such risk. H.pylori eradication results in reduction in the pre-valence of gastric atrophy in the body, while continued H.pylori infection leads to progressive aggrava-tion of gastric atrophy and intestinal metaplasia.

Objective To investigate the gastroscopic manifestations and pathological diagnosis of large gastric folds.MethodsClinical data of 161 cases with large gastric folds,who were diagnosed by gastroscopy from January 2002 to April 2008,were analyzed.Endoscopic mucosal resection or strip-off biopsy by ultrasonic endoscopy was performed if diagnosis could not be identified using routine biopsy by the gastroscopy.ResultsOf the 161 cases,79 patients had chronic inflammation(49.1%),67 had gastric cancer(41.6%),11 showed malignant lymphoma(6.8%),2 suffered from Menetrier's disease(1.2%),1 had acute inflammation(0.6%),and 1 showed no obvious lesion(0.6%);the rate of Helicobacter pylori infection was 42.2%(68/161),and the positive rate for Helicobacter pylori in patients with gastric cancer was 34.3%(23/67).Endoscopic mucosal resection biopsy was performed on 15(9.3%) of the cases,5 of them had chronic inflammation,5 showed gastric cancer,4 were confirmed with malignant lymphoma,and 1 was diagnosed as having Menetrier disease.The lesion of large gastric folds involved the whole stomach in 10 patients,the gastric fundus in 10,gastric corpus in 86,gastric antrum in 5,both the gastric fundus and corpus in 31,and both the gastric corpus and antrum in 19.All of the 10 cases,who had the whole stomach being invaded,were diagnosed as having gastric cancer.Though both gastric cancer and chronic inflammation showed similar manifestations under gastroscope,the levels of the characteristics were significantly different(Dilatancy poor: ?2=10.093,P=0.001;peristalsis poor: ?2=19.116,P=0.000;gastric cavity narrowing: ?2=18.159,P=0.000;texture stiffness: ?2=54.302,P=0.000;texture brittle: ?2=6.132,P=0.013;erosion: ?2=5.619,P=0.018;and ulcer: ?2=22.743,P=0.000).ConclusionsMost of the patients with large gastric folds are diagnosed as having chronic inflammation,gastric cancer,or malignant lymphoma,while Menetrier disease and acute inflammation seldom occur.The lesion usually involves the gastric corpus.For those who have the whole stomach being invaded,gastric cancer can be revealed.Most of the malignant cases show ulcers,dilatancy poor,and peristalsis poor under a gastroscope.Endoscopic mucosal resection biopsy is effective for identifying the diagnosis of malignant lesions.

Objective To estimate the expressions of cyclin D1 and Ki67 in esophageal squamous cell carcinomas and their clinical significance. Methods The expressions of cyclin D1 and Ki67 were detected by immunohistochemistry in 28 specimens esophageal squamous cell carcinoma (ESCC) and 33 samples esophagitis tissue. Results The positive expression rate of cyclin D1 in ESCC and esophagitis tissues was 60.7% (17/28) and 33.3% (11/33) respectively (?2=4.573,P=0.032),while the mean Ki67 label index (Ki67 LI) was (49.21?25.15)% and (11.62?9.87)% respectively (t=7.908,P=0.000). The positive expression rate of cyclin D1 in TNM stage I tissues was 14.3% (1/7),which was significantly lower than that in stages Ⅲ and Ⅳ tissues[85.7% (6/7) and 100% (5/5),P=0.029 and 0.015,respectively]. In cases with lymph node metastasis,the positive rate of cyclin D1 expression was 90.9% (10/11) that was significantly higher than that in those without lymph node metastasis (P=0.016). The 28 patients with ESCC were followed up for 6 to 34 months [mean,(25.0?4.2) months],during which 19 patients survived,4 patients died of deterioration of the primary diseases (3 cases) or cerebrovascular affair (1 case),and the other 5 patients was lost to follow-up. Conclusions The expression of cyclin D1 is correlated with advanced tumor and lymph node metastasis. The Ki67 is highly expressed in ESCC tissues; no relationship exists between the level of the expression and the pathological differentiation type and TNM stage of ESCC.

Objective To investigate the relationship between the pathology of gastric polyp tissues and the precancerous and malignant transformations of its background mucosa by endoscopic biopsy. Methods From 2003 to 2008,1825 patients were diagnosed with gastric polyps in our hospital by gastroscopy and pathological examination. We classified the lesions and then analyzed the relationship between pathological changes of gastric polyp tissues and the precancerous and malignant transformations of its background mucosa by endoscopic biopsy. Results In this study,the detection rate of gastric polyps was 4.3% (1825/42 003). The lesions included fundic gland polyps (FGP,62.5%,1141/1825),hyperplasia polyps (HPP,32.2%,587/1825),adenoma (0.8%,14/1825),inflammatory polyps (IP,1.7%,31/1825),and coincident polyps (two types of polyps were found in one case,2.8%,52/1825). The rates of intestinal metaplasia (IM,5.3%,31/587) and dysplasia (6.8%,40/587) in HPP tissue were higher than those in FGP tissues (0.2%,2/1141 and 0.4%,4/1141,P