Objective To study the characteristics of intestinal flora between diarrhea-predominant irritable bowel syndrome(IBS-D)and healthy population,and to provide a clinical basis for the basic research of IBS-D.Methods A total of 32 IBS-D patients admitted to Wenzhou People's Hospital,the Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University from January 2023 to June 2024 were selected as IBS-D group,and 33 healthy during the same period as control group.Cluster diversity was determined by 16S rDNA of clusters in feces and quantification of DNA.Results The diversity of IBS-D group decreased significantly than control group,and the relative abundance of proteobacteria increased in the IBS-D group,and the relative abundance of E.coli-Shigella and Klebsiella increased in the IBS-D group.Conclusion Intestinal microbiota diversity in IBS-D patients reduced and proteobacteria is the potential pathogen of IBS-D.

Objective To study the characteristics of intestinal flora between diarrhea-predominant irritable bowel syndrome(IBS-D)and healthy population,and to provide a clinical basis for the basic research of IBS-D.Methods A total of 32 IBS-D patients admitted to Wenzhou People's Hospital,the Wenzhou Third Clinical Institute Affiliated to Wenzhou Medical University from January 2023 to June 2024 were selected as IBS-D group,and 33 healthy during the same period as control group.Cluster diversity was determined by 16S rDNA of clusters in feces and quantification of DNA.Results The diversity of IBS-D group decreased significantly than control group,and the relative abundance of proteobacteria increased in the IBS-D group,and the relative abundance of E.coli-Shigella and Klebsiella increased in the IBS-D group.Conclusion Intestinal microbiota diversity in IBS-D patients reduced and proteobacteria is the potential pathogen of IBS-D.

Objective To investigate the changes of serum bile acid profiles in early non-alcoholic fatty liver disease(NAFLD)and explore their clinical significance at the same time combined with liver enzyme-related indicators.Methods A total of 58 patients with early NAFLD who were treated in Department of Gastroenterology,Wenzhou People's Hospital from January 2021 to December 2022 were selected as early NAFLD group,along with 66 healthy individuals as control group.Basic information and blood samples were collected and ultra performance liquid chromatography-mass spectrometry/mass spectrometry was used to determine 15 types of serum bile acid profile.Statistical analysis was performed in correlation with liver enzyme indicators.Results Compared with control group,serum concentration of taurocholic acid(TCA)and taurochenodeoxycholic acid(TCDCA)increased in early NAFLD group,which were highly correlated with the disease(VIP>1,p(corr)>0.6 according to SIMCA software analysis).Binary Logistic regression analysis showed that body mass index,total cholesterol,triglyceride,and TCA were independent risk factors in the early-stage of NAFLD,with OR(95%CI)values of 2.367(1.511-3.709),6.481(2.003-20.963),4.950(1.675-14.631)and 2.643(1.335-5.234)(TCA values were log2 transformed),with all P<0.05.Receiver operating characteristic curve analysis showed that TCA and TCDCA had a certain predictive capability in diagnosis of the early NAFLD,and the diagnostic evaluation ability was higher,and area under the curve of them were more than 0.7.Conclusion The bile acid profile of patients with early NAFLD are changed,mainly TCA and TCDCA,which have a positive correlation with the early NAFLD and expected to become a serological marker of early NAFLD.

Objective To investigate the changes of serum bile acid profiles in early non-alcoholic fatty liver disease(NAFLD)and explore their clinical significance at the same time combined with liver enzyme-related indicators.Methods A total of 58 patients with early NAFLD who were treated in Department of Gastroenterology,Wenzhou People's Hospital from January 2021 to December 2022 were selected as early NAFLD group,along with 66 healthy individuals as control group.Basic information and blood samples were collected and ultra performance liquid chromatography-mass spectrometry/mass spectrometry was used to determine 15 types of serum bile acid profile.Statistical analysis was performed in correlation with liver enzyme indicators.Results Compared with control group,serum concentration of taurocholic acid(TCA)and taurochenodeoxycholic acid(TCDCA)increased in early NAFLD group,which were highly correlated with the disease(VIP>1,p(corr)>0.6 according to SIMCA software analysis).Binary Logistic regression analysis showed that body mass index,total cholesterol,triglyceride,and TCA were independent risk factors in the early-stage of NAFLD,with OR(95%CI)values of 2.367(1.511-3.709),6.481(2.003-20.963),4.950(1.675-14.631)and 2.643(1.335-5.234)(TCA values were log2 transformed),with all P<0.05.Receiver operating characteristic curve analysis showed that TCA and TCDCA had a certain predictive capability in diagnosis of the early NAFLD,and the diagnostic evaluation ability was higher,and area under the curve of them were more than 0.7.Conclusion The bile acid profile of patients with early NAFLD are changed,mainly TCA and TCDCA,which have a positive correlation with the early NAFLD and expected to become a serological marker of early NAFLD.

Objective To compare of clinical and pathological features between gastric polyps and colorectal polyps.Methods The clinical characteristics and pathological features of 2 125 patients with gastric polyps and 4 924 patients with colorectal polyps admitted in Wenzhou People's Hospital from 2004 to 2013 were compared.The detection rates,the indication of endoscopy,distribution,number,size and pathological type of gastric polyps and colorectal polyps were analyzed.Results The detection rate of gastric polyps was 3.1％ (2 125/69 575) and that of colorectal polyps was 24.5％ (4 924/20 124) (χ2 =9 886.401,P ＜0.01).The detection rates of gastric polyps in age groups ＜ 20,20-39,40-59 and ≥60 were 1.8％ (23/1 302),1.8％ (399/22 600),3.4％ (1 137/33 087) and 4.5％ (566/12 586),respectively (χ2 =238.867,P ＜ 0.01);and those for colorectal polyps were 6.6％ (14/211),11.6％ (623/5 385),26.0％ (2 622/10 070) and 37.3％ (1 665/4 458),respectively (χ2 =934.724,P ＜ 0.01).The detection rates of gastric polyps in age groups 20-39,40-59 and ≥60 were lower than those in colorectal polyps(all P ＜ 0.01).The detection rate of gastric polyps in males was lower than that in females(2.3％,848/36 447 vs.3.9％,1 277/33 128,χ2 =273.807,P ＜0.01),while the detection rate of colorectal polyps in males was higher than that in females (28.8％,3 239/11 230 vs.18.9％,1 685/8 894,χ2 =262.518,P ＜ 0.01).Diarrhea and gastrointestinal bleeding in patients with colorectal polyps was more common than those in patients with gastric polyps (23.5％,1 156/4 924 vs.2.5％,54/2 125,χ2 =558.080,P＜0.01;12.1％,597/4 924 vs.2.4％,51/2 125,χ2 =168.150,P ＜0.01).Single polyps were more common in gastric polyps than colorectal polyps(80.7％,1 714/2 125 vs.67.6％,3 331/ 4 924,χ2 =186.337,P ＜0.01).Polyps with size ≥ 1.0 cm were more common in colorectal polyps than those in gastric polyps (24.3％,1 197/4 924 vs.13.6％,289/2 125,χ2 =102.333,P ＜ 0.01).The proportion of inflammatory and hyperplastic types in gastric polyps was higher than that in colorectal polyps (67.1％,1 378/2 125 vs.27.5％,1 273/4 924,χ2 =934.394,P ＜0.01;26.9％,552/2 125 vs.9.9％,459/4 924,χ2 =319.588,P ＜0.01);while the proportion of adenoma and canceration in gastric polyps was lower than that in colorectal polyps (1.7％,34/2 125 vs.62.4％,2 893/4 924,χ2 =2 135.743,P ＜0.01;0.4％,9/2 125 vs.4.8％,221/4924,χ2 =80.362,P＜0.01).Conclusions In comparison with gastric polyps,the detection rate of colorectal polyps is higher.The detection rate of gastric polyps is higher in females,w hile that of colorectal polyps is higher in males.The detection rates of gastric polyps andcolorectal polyps increase with the age.The main pathological type of gastric polyps is inflammatory,while that of colorectal polyps is adenoma.The canceration of colorectal polyps is more common than that of gastric polyps.

Objective To investigate the clinical characterisitics of chronic panereatitis(CP) with mass.Methods The clinical features,radiologieal and pathologic records of 39 cases of chronic pancreatitis with mass confirmed pathologically between January 2005 to December 2007 were retrospectively reviewed,and compared with 17 surgical pathologically confirmed patients with pancreatic cancer.Results The jaundice was found in 14 of 39 patients with pancreatits and 1 of 17 patients with pancreatic cancer,with significant difference between two groups(χ2=0.111,P=0.045).Elevated serum CEA and CA19-9 were found in 0 and 12 patients with pancreatitis.respectively,and 3 and 11 patients with pancreatic cancer,respectively(P=0.025 and=0.018,respectively).CT examination showed that the atrophy pancreas and the infiltration of surrounding and blood vessels were found in 0 and 5 patients with pancreatitis or 3 and 8 patients with pancreatic cancer,respectively(all P values＜0.05).The magnetic resonance cholangiopanereatography (MRCP) examination revealed that dilation of bile and pancreatic ducts,and calculus in pancreas duct were found in 14,2 and 15 patients with pancreatitis,or 11,6 and 2 patients with pancreatic cancer,respectively(all P values ＜0.05).Pancreatic cancer was confiremed by endoscopic ultrasonography guided fine needle aspiration(EUS-FNA)in 10 of 14 patients with pancreatic cancer,but none in 18 patients with pancreatitis.Conclusions It is difficult to diagnose CP with mass,but it will helpful ifassists diagnosis with clinical features,tumor markers and image examinations,especially with biopsyexamination.