Early diagnosis is one of the difficulties in strangulated intestinal obstruction.Serological markers for the early diagnosis of intestinal obstruction has become a hot spot resently.Studies have shown that histidine decarboxylase had a high sensitivity and specificity in the diagnosis of gastric mucosal injury of intestinal obstruction,which would be expected to become an effective serological marker for the early diagnosis of strangulated intestinal obstruction.In this review,the author will describe the advance of serum histidine decarboxylase level for diagnosis of strangulated intestinal obstruction.

Objective To investigate the expression and significance of Histidine decarboxylase (HDC) in liver and intestinal tissue for early diagnosis of strangulated intestinal obstruction.Methods Ten male Wistar rats for the control group and 20 ones for the test group which was divided into A,B groups.Group A (n =10) was made by using ligating ileum for 1 h and group B (n =10) was for 3 h.When intestinal ob struction models were built,the changes of pathology in liver and intestine tissue were observed by light microscope.Real time quantitative PCR was used to detect the expression of HDC in liver and intestinal tissue.Results Under light microscopic level,the injury score of intestine in test group was increased in comparison with that in control group.At 3 h after strangulated intestinal obstruction,RT-PCR showed that brightness of HDC band in intestine tissue was significantly higher than the control.Real time quantitative PCR also showed that the expression of HDC in liver tissue in group A and group B increased 1.34 fold(P ＞0.05) and 2.21 fold (P ＜ 0.05) respectively,when compared with the control group.The expression of HDC in intestine tissue in group A and group B increased 1.81 fold(P ＞ 0.05) and 8.02 fold (P ＜ 0.01) respectively,when compared with the control group.Conclusion Expression of HDC can be used for early diagnosis of strangulated intestinal obstruction.

Author thinks that it is necessary to improve current clinical surgery teaching work by improving teachers'quality,advocating initiative teaching and professional education,guiding students how to deal with the relationship of doctors and patients,increasing the consciousness of law and self protection and making unified teaching content and target.

Objective To investigate the clinical values of the leukocyte count,D-dimer,histidine decarboxylase (HDC) and intestinal fatty acid binding protein (I-FABP) for diagnosing acute intestinal obstruction.Methods Sixty patients who treated in China-Japan Union Hospital of Jilin University from January 2017 to January 2018 were collected prospectively,and were divided into strangulated intestinal obstruction (STR-IO) group (n =20),simple intestinal obstruction (SIM-IO) group (n =20) and peritonitis group (n =20).Twenty healthy volunteers were collected as control group.Automatic blood cell analyzer was used to detecting the leukocyte count.The concentration of plasma D-dimer was detected by immune turbidimetry method.The concentration of serum HDC and I-FABP were measured by enzyme linked immunosorbent assay (ELISA) method.Compared the above indicators of four groups of samples.The measurement data are expressed as mean ± standard deviation (Mean ± SD).Tamhane's T2 and Dunnett's T3 methods were used to comparison between groups.Estimation of receiver operating characteristic curve(ROC) and area under curve (AUC) used logistic regressive model.Results The leukocyte count in control group,SIM-IO group,peritonitis group,and STR-IO group were (6.97 ± 1.68) × 109/L,(8.24 ± 2.78) × 109/L,(11.33 ±4.75) × 109/L,and(12.53 ± 5.96) × 109/L respectively.STR-IO group and peritonitis group were significantly higher than those of control group(F =12.74,P =0.01),but there was no significant difference between SIM-IO group and control group(P ＞ 0.05).The concentration of plasma D-dimer in control group,SIM-IO group,peritonitis group,and STR-IO group were (0.44± 0.30) μg/ml,(1.17 ± 0.67) μg/ml,(1.20 ± 0.72) μg/ml,and (1.67 ± 0.67) μg/ml respectively.The concentration of D-dimer in STR-IO group was significantly higher than those of control group (F =57.08,P =0.00),and there was no significant difference among other group (P ＞ 0.05).The concentration of serum HDC in control group,SIM-IO group,peritonitis group,and STR-IO group were (5.51 ±4.30) ng/ml,(14.33 ± 3.71) ng/ml,(11.53 ± 4.67) ng/ml,and (35.65 ± 21.15) ng/ml respectively.The concentration of HDC in STR-IO group was significantly higher than those of other three groups (F =39.03,P =0.00).The concentration of serum I-FABP in control group,SIM-IO group,peritonitis group,and STR-IO group were (0.20 ± 0.06) ng/m],(0.31 ± 0.17) ng/ml,(0.22 ±0.03)ng/ml,and (0.81 ±0.56) ng/ml respectively.The concentration of I-FABP in STR-IO group was significantly higher than those of other three groups (F =23.07,P =0.01).The AUC of HDC,I-FABP,D-dimer,and leukocyte count were 0.998,0.868,0.730,and 0.704 respactively.Conclusion Leukocyte count,D-dimer,and HDC or I-FABP combined detection may be a more effective index for diagnosing acute intestinal obstruction.

Epidemiological studies in recent years have found that the incidence of gastric signet ring cell carcinoma (SRCC) has increased significantly. In this paper, we first reviewed cell origin and biomarkers of SRCC, and the relationship between SRCC and various pathological types of gastric cancer. The early diagnosis rate of gastric SRCC is low, which may be due to the unclear mechanism of pathology and precancerous lesions. In clinical practice, SRCC has the characteristics of low differentiation and high degree of malignancy. Most of patients with gastric cancer Borrmann IV(diffuse infiltrative type) are gastric SRCC, and their prognosis is poor. The average age of gastric SRCC was 55 to 61 years old. Besides, in female, the incidence of SRCC was significantly higher than that of non-SRCC gastric cancer. It is found that the expressions of estrogen and progesterone receptors in SRCC tissues are high. The relationship between gastric SRCC and sex hormones may be the cause of gender differences in the pathogenesis of gastric SRCC. Due to the low risk of lymph node metastasis in early SRCC, endoscopic mucosal resection and endoscopic submucosal dissection can be performed for <3 cm, submucosal invasive, medium differentiated tumors, or <3 cm, highly differentiated, ulcerative and submucosal lesions. For non-metastatic advanced gastric SRCC, surgical resection and adequate lymph node dissection should be performed owing to the high risk of lymph node metastasis. Adjuvant chemotherapy is also considered to improve the long-term prognosis of patients. Taxane therapy may be more effective in gastric SRCC. Recent data show that gastric SRCC and diffuse gastric cancer are more sensitive to mitomycin C, doxorubicin and docetaxel than intestinal type gastric cancer, but are not sensitive to fluorouracil and cisplatin. These treatment perspectives still need to be confirmed in future studies.