Objective:To evaluate the efficacy of lamb′s tripe extract and vitamin B 12 capsule (LTEVB 12C) on chronic atrophic gastritis (CAG) at different locations (antrum lesser curvature, antrum greater curvature, gastric angle, corpus lesser curvature, and corpus greater curvature). Methods:From August 2011 to January 2013, 715 patients with CAG in a multicenter, randomized, double-blind, placebo-controlled trial were enrolled from 16 tertiary first-class hospitals across the country, including the First Affiliated Hospital of Air Force Medical University, Nanfang Hospital of Southern Medical University, the First Hospital of Jilin University, West China Hospital of Sichuan University, etc., there were 476 cases in the LTEVB 12C group and 239 cases in the placebo group. The patients of the LTEVB 12C group received LTEVB 12C, and the patients of placebo group received LTEVB 12C mimetic, all the medications were taken 3 capsules each time and 3 times a day after meals, and the treatment course of 2 groups were both 6 months. The efficacy evaluation criteria included the effective rate (a decrease of ≥1 in histopathological score compared with baseline after 6 months of treatment) and the reversal rate (a decrease of ≥ 2 in histopathological score compared with baseline after 6 months of treatment in the patients with moderate to severe CAG). The impact of lesion sites on the therapeutic effects of LTEVB 12C was analyzed by logistic regression analysis. The two-way unordered Cochran-Mantel-Haenszel chi-square test considering the center effect and Pearson chi-square test were used for statistical analysis. Results:The effective rates of chronic inflammation at the antrum greater curvature and corpus greater curvature (23.3%, 110/473 vs. 13.0%, 31/239; 20.3%, 96/472 vs. 12.6%, 30/239), the effective rates of atrophy at the antrum lesser curvature, antrum greater curvature, gastric angle, corpus lesser curvature, and the corpus greater curvature (27.0%, 118/437 vs. 15.7%, 34/216; 29.2%, 126/432 vs. 18.5%, 38/205; 27.8%, 121/435 vs. 16.7%, 36/216; 32.5%, 127/391 vs. 19.8%, 37/187; 33.0%, 119/361 vs. 21.8%, 39/179), and the effective rates of intestinal metaplasia at the antrum lesser curvature, antrum greater curvature, gastric angle, and the corpus lesser curvature (45.0%, 112/249 vs. 29.8%, 31/104; 53.8%, 86/160 vs. 33.9%, 21/62; 45.8%, 103/225 vs. 24.0%, 25/104; 51.9%, 83/160 vs. 28.3%, 17/60) of the LTEVB 12C group were all higher than those of the placebo group, and the differences were statistically significant ( χ2=10.76, 6.39, 9.69, 7.91, 11.05, 9.62, 8.57, 5.20, 7.11, 12.45, and 6.73; all P<0.05). The reversal rates of chronic inflammation at the corpus lesser curvature and corpus greater curvature (5.2%, 12/231 vs. 0, 0/123; 4.7%, 8/170 vs. 0, 0/88), the reversal rates of atrophy at the antrum lesser curvature, antrum greater curvature, corpus lesser curvature, and the corpus greater curvature (6.8%, 22/323 vs. 1.3%, 2/151; 9.2%, 29/315 vs. 1.4%, 2/144; 14.2%, 38/267 vs. 2.5%, 3/121; 20.8%, 35/168 vs. 5.8%, 4/69), and the reversal rates of intestinal metaplasia at the antrum lesser curvature, antrum greater curvature, gastric angle, and the corpus lesser curvature (29.8%, 39/131 vs. 9.1%, 4/44; 41.0%, 32/78 vs. 12.5%, 3/24; 33.3%, 44/132 vs. 4.8%, 3/63; 50.0%, 37/74 vs. 8.7%, 2/23) of the LTEVB 12C group were all higher than those of the placebo group, and the differences were statistically significant ( χ2=6.58, 5.12, 5.60, 8.61, 11.43, 6.59, 7.30, 4.95, 15.92, 7.62; all P<0.05). There were no statistically significant differences in the effective rates and reversal rates of active inflammation at different locations between the LTEVB 12C group and the placebo group (all P>0.05). The results of logistic regression analysis (taking the antrum lesser curvature as the reference) further confirmed that the reversal rates of chronic inflammation ( OR=0.22, 95% confidence interval (95% CI): 0.07 to 0.67; OR=0.24, 95% CI: 0.07 to 0.80), atrophy ( OR=0.28, 95% CI: 0.16 to 0.49; OR=0.28, 95% CI: 0.16 to 0.49), and intestinal metaplasia ( OR=0.42, 95% CI: 0.24 to 0.77; OR=0.20, 95% CI: 0.08 to 0.52) at the corpus lesser curvature and corpus greater curvature were all higher than those at the antrum lesser curvature, and the differences were statistically significant (all P<0.05). There were no statistically siginificant differences in the reversal rates of the aforementioned pathological features between the antrum greater curvature, gastric angle, and the antrum lesser curvature (all P>0.05). Conclusion:LTEVB 12C can achieve good efficacy in the treatment of CAG, and the chronic inflammation, atrophy, and intestinal metaplasia at multiple locations are improved, especially at the corpus lesser curvature and the corpus greater curvature.

Objective:To evaluate the efficacy of lamb′s tripe extract and vitamin B 12 capsule (LTEVB 12C) on chronic atrophic gastritis (CAG) at different locations (antrum lesser curvature, antrum greater curvature, gastric angle, corpus lesser curvature, and corpus greater curvature). Methods:From August 2011 to January 2013, 715 patients with CAG in a multicenter, randomized, double-blind, placebo-controlled trial were enrolled from 16 tertiary first-class hospitals across the country, including the First Affiliated Hospital of Air Force Medical University, Nanfang Hospital of Southern Medical University, the First Hospital of Jilin University, West China Hospital of Sichuan University, etc., there were 476 cases in the LTEVB 12C group and 239 cases in the placebo group. The patients of the LTEVB 12C group received LTEVB 12C, and the patients of placebo group received LTEVB 12C mimetic, all the medications were taken 3 capsules each time and 3 times a day after meals, and the treatment course of 2 groups were both 6 months. The efficacy evaluation criteria included the effective rate (a decrease of ≥1 in histopathological score compared with baseline after 6 months of treatment) and the reversal rate (a decrease of ≥ 2 in histopathological score compared with baseline after 6 months of treatment in the patients with moderate to severe CAG). The impact of lesion sites on the therapeutic effects of LTEVB 12C was analyzed by logistic regression analysis. The two-way unordered Cochran-Mantel-Haenszel chi-square test considering the center effect and Pearson chi-square test were used for statistical analysis. Results:The effective rates of chronic inflammation at the antrum greater curvature and corpus greater curvature (23.3%, 110/473 vs. 13.0%, 31/239; 20.3%, 96/472 vs. 12.6%, 30/239), the effective rates of atrophy at the antrum lesser curvature, antrum greater curvature, gastric angle, corpus lesser curvature, and the corpus greater curvature (27.0%, 118/437 vs. 15.7%, 34/216; 29.2%, 126/432 vs. 18.5%, 38/205; 27.8%, 121/435 vs. 16.7%, 36/216; 32.5%, 127/391 vs. 19.8%, 37/187; 33.0%, 119/361 vs. 21.8%, 39/179), and the effective rates of intestinal metaplasia at the antrum lesser curvature, antrum greater curvature, gastric angle, and the corpus lesser curvature (45.0%, 112/249 vs. 29.8%, 31/104; 53.8%, 86/160 vs. 33.9%, 21/62; 45.8%, 103/225 vs. 24.0%, 25/104; 51.9%, 83/160 vs. 28.3%, 17/60) of the LTEVB 12C group were all higher than those of the placebo group, and the differences were statistically significant ( χ2=10.76, 6.39, 9.69, 7.91, 11.05, 9.62, 8.57, 5.20, 7.11, 12.45, and 6.73; all P<0.05). The reversal rates of chronic inflammation at the corpus lesser curvature and corpus greater curvature (5.2%, 12/231 vs. 0, 0/123; 4.7%, 8/170 vs. 0, 0/88), the reversal rates of atrophy at the antrum lesser curvature, antrum greater curvature, corpus lesser curvature, and the corpus greater curvature (6.8%, 22/323 vs. 1.3%, 2/151; 9.2%, 29/315 vs. 1.4%, 2/144; 14.2%, 38/267 vs. 2.5%, 3/121; 20.8%, 35/168 vs. 5.8%, 4/69), and the reversal rates of intestinal metaplasia at the antrum lesser curvature, antrum greater curvature, gastric angle, and the corpus lesser curvature (29.8%, 39/131 vs. 9.1%, 4/44; 41.0%, 32/78 vs. 12.5%, 3/24; 33.3%, 44/132 vs. 4.8%, 3/63; 50.0%, 37/74 vs. 8.7%, 2/23) of the LTEVB 12C group were all higher than those of the placebo group, and the differences were statistically significant ( χ2=6.58, 5.12, 5.60, 8.61, 11.43, 6.59, 7.30, 4.95, 15.92, 7.62; all P<0.05). There were no statistically significant differences in the effective rates and reversal rates of active inflammation at different locations between the LTEVB 12C group and the placebo group (all P>0.05). The results of logistic regression analysis (taking the antrum lesser curvature as the reference) further confirmed that the reversal rates of chronic inflammation ( OR=0.22, 95% confidence interval (95% CI): 0.07 to 0.67; OR=0.24, 95% CI: 0.07 to 0.80), atrophy ( OR=0.28, 95% CI: 0.16 to 0.49; OR=0.28, 95% CI: 0.16 to 0.49), and intestinal metaplasia ( OR=0.42, 95% CI: 0.24 to 0.77; OR=0.20, 95% CI: 0.08 to 0.52) at the corpus lesser curvature and corpus greater curvature were all higher than those at the antrum lesser curvature, and the differences were statistically significant (all P<0.05). There were no statistically siginificant differences in the reversal rates of the aforementioned pathological features between the antrum greater curvature, gastric angle, and the antrum lesser curvature (all P>0.05). Conclusion:LTEVB 12C can achieve good efficacy in the treatment of CAG, and the chronic inflammation, atrophy, and intestinal metaplasia at multiple locations are improved, especially at the corpus lesser curvature and the corpus greater curvature.

Objective:To compare the knowledge of endoscopic screening of gastrointestinal cancers between digestive healthcare workers and new chatbots (chatGPT and new Bing).Methods:A test with twenty-three questions of endoscopic screening of gastrointestinal cancers was conducted, focusing on the appropriate age of screening, high-risk factors, the follow-up time, and the advantages and risks of digestive endoscopy. Digestive healthcare workers were invited to complete the test through electronic questionnaires. New Bing and chatGPT were used to answer each question for 10 rounds. The primary endpoint was the correct rate of all answers. The answer accuracy between digestive healthcare workers and new chatbots were compared using variance analysis, and the factors that affected the accuracy of the answers in digestive healthcare workers were explored using univariate and multivariable liner regression analysis.Results:The results of the test completed by 76 digestive healthcare workers (21 residents, 28 digestive nurses, and 27 digestive doctors) were analyzed. The accuracies were 36.4%±10.9%, 34.5%±10.2%, 52.2%± 12.6%, 46.3%±9.8% and 67.1%±9.3% in residents, digestive nurses, digestive doctors, chatGPT, and new Bing, respectively, with significant difference ( F=22.6, P<0.001). The accuracy was highest in new Bing ( P<0.001). The accuracy was comparable between chatGPT and digestive doctors (LSD- t=-1.398, P=0.166), and both higher than that of digestive nurses (LSD- t=2.956, P=0.004; LSD- t=5.955, P<0.001) and residents (LSD- t=2.402, P=0.018; LSD- t=4.951, P<0.001). Furthermore, the accuracy was comparable between digestive nurses and residents (LSD- t=-0.574, P=0.567). Compared with new Bing, digestive doctors had lower accuracy in answering questions related to adverse events of screening, follow-up recommendation of intestinal metaplasia, high risk factors and screening methods for colon cancer ( P<0.05), but higher accuracy in answering questions related to endoscopic adverse events and screening methods for esophageal cancer ( P<0.05). Multivariable liner regression analysis showed that being digestive doctors ( β=11.7, t=3.054, P=0.003) and questionnaire response time (≥7.6 min) ( β=7.8, t=2.894, P=0.005) were independent factors for the answer accuracy of digestive healthcare workers. Conclusion:Compared with digestive healthcare workers, New chatbots—new Bing has higher accuracy in answering gastrointestinal cancer screening-related questions, but performs poorly in answering questions such as adverse events of endoscopy and screening methods for esophageal cancer.

Objective:To investigate the psychology status and quality of life in patients with inflammatory bowel disease(IBD) in China, and to analyze the influencing factors.Methods:From September 2021 to May 2022, 42 hospitals in 22 provinces(autonomous regions and municipalities directly under the central government) in China, the clinical data of 2 478 IBD patients were collected, which included age, gender, weight, first visit or not, disease activity, disease course, main clinical manifestations(diarrhea, abdominal pain, hematochezia, extraintestinal manifestations), complications, treatment medication(5-aminosalicylic acid, glucocorticoids, immunosuppressive agents, and biological agents), and whether to have surgery. Anxiety, depression, sleep quality and quality of life of IBD patients were evaluated by generalized anxiety disorder-7 items, patient health questionnaire-9 items, Pittsburgh sleep quality index and inflammatory bowel disease questionnaire, and the related influencing factors were analyzed. Univariate analysis and multiple linear regression analysis were used for statistical analysis.Results:The average age of 2 478 IBD patients was 37.96 years old, and male counted for 62.43%(1 547/2 478). There were 61.82%(1 532/2 478) of the IBD patients in the active stage of disease, mostly mild or moderate(588 and 734 cases). There were 60.61%(1 502/2 478) of the IBD patients with different degrees of anxiety, 58.35%(1 446/2 478) of the IBD patients with different degrees of depression, and 48.87%(1 211/2 478) of the IBD patients had different degrees of sleep problems. The results of multiple linear regression analysis indicated that female, higher level of disease activity and longer disease course were independent risk factors of anxiety, depression and sleep quality in the IBD patients(unstandardized regression coefficient(95% confidence interval) 1.08(0.65 to 1.50), 0.45(0.23 to 0.68), 0.19(0.02 to 0.36), 0.83(0.33 to 1.32), 0.62(0.36 to 0.88), 0.28(0.08 to 0.47), 0.47(0.16 to 0.77), 0.39(0.23 to 0.55), 0.14(0.02 to 0.26); P<0.001, <0.001, =0.025 , =0.001, <0.001, =0.005, =0.003, <0.001, =0.027). The usage of biological agents was an independent protective factor of anxiety(unstandardized regression coefficient(95% confidence interval) -0.67(-1.17 to -0.17), P=0.008), and older age was an independent risk factor of sleep quality(unstandardized regression coefficient(95% confidence interval) 0.35(0.09 to 0.61), P=0.008). Higher level of disease activity, symptoms of diarrhea, abdominal pain, presence of extraintestinal manifestations, usage of 5-aminosalicylic acid and glucocorticoid, and with surgical treatment were independent risk factors of quality of life(unstandardized regression coefficient(95% confidence interval) -11.00(-12.24 to -9.76), -2.90(-5.26 to -0.55), -3.93(-6.25 to -1.61), -5.79(-9.87 to -1.71), -4.78(-7.79 to -1.76), -7.71(-11.07 to -4.35), -4.37(-8.00 to -0.73); P<0.001, =0.016, =0.001, =0.005 , =0.002, <0.001, =0.019), while the usage of biological agents was an independent protective factor of quality of life (unstandardized regression coefficient(95% confidence interval) 4.72(1.97 to 7.48), P=0.001). Conclusion:IBD patients generally have different degrees of anxiety, depression and sleep problems, which affect the quality of life of patients. Gender, disease activity and disease course are the influencing factors of mental disorders in IBD patients.

Tumor-associated macrophages (TAMs), one of the dominating constituents of tumor microenvironment, are important contributors to cancer progression and treatment resistance. Therefore, regulation of TAMs polarization from M2 phenotype towards M1 phenotype has emerged as a new strategy for tumor immunotherapy. Herein, we successfully initiated antitumor immunotherapy by inhibiting TAMs M2 polarization via autophagy intervention with polyethylene glycol-conjugated gold nanoparticles (PEG-AuNPs). PEG-AuNPs suppressed TAMs M2 polarization in both in vitro and in vivo models, elicited antitumor immunotherapy and inhibited subcutaneous tumor growth in mice. As demonstrated by the mRFP-GFP-LC3 assay and analyzing the autophagy-related proteins (LC3, beclin1 and P62), PEG-AuNPs induced autophagic flux inhibition in TAMs, which is attributed to the PEG-AuNPs induced lysosome alkalization and membrane permeabilization. Besides, TAMs were prone to polarize towards M2 phenotype following autophagy activation, whereas inhibition of autophagic flux could reduce the M2 polarization of TAMs. Our results revealed a mechanism underlying PEG-AuNPs induced antitumor immunotherapy, where PEG-AuNPs reduce TAMs M2 polarization via induction of lysosome dysfunction and autophagic flux inhibition. This study elucidated the biological effects of nanomaterials on TAMs polarization and provided insight into harnessing the intrinsic immunomodulation capacity of nanomaterials for effective cancer treatment.

Background: The efficacy of ustekinumab (UST) in the treatment of patients with inflammatory bowel disease (IBD) has been affirmed abroad, but its efficacy and safety have not been reported in China due to its short term of use. Aims: To analyze the clinical efficacy and safety of UST in the treatment of IBD. Methods: The clinical data of IBD patients treated with UST from November 2020 to June 2022 in the First Affiliated Hospital of Air Force Medical University were analyzed retrospectively. Results: A total of 46 patients with IBD treated with UST were enrolled, including 41 patients with Crohn’s disease (CD) and 5 patients with ulcerative colitis (UC). At the 8

Pathology plays an important role in diagnosis and differential diagnosis of inflammatory bowel disease (IBD) . However, histopathological features of IBD vary among different patients and at different stages in the same patient. There is a lack of definitive morphological diagnostic criteria for IBD. Meanwhile, diagnostic accuracy is affected by training level and diagnostic experience of pathologists. In order to improve the pathological diagnosis of IBD, and to provide advice on practical diagnostic issues of IBD in China, experts guideline of pathological assessment was discussed by an expert group of pathologists and gastroenterologists.

Objective:To explore the therapeutic effects of lamb′s tripe extract and vitamin B12 (hereinafter referred to as lamb′s tripe) capsule on precancerous lesions of gastric mucosa in rats.Methods:Thirty-two rats of the 42 Wistar rats (model group) were selected for modelling, and in model group six rats died due to gavage, 10 rats were sacrificed for observing the results of modeling, and the left 16 rats were divided into administration group (eight rats) and non-administration group (eight rats). After modeling, five of the 10 rats without modelling treatment were selected as the normal control of the model group, the other five (negative control group) rats were included in drug intervention experiment. The drug intervention program was as follows: in administration group, rats were gavaged with lamb′s tripe 0.2 g/kg once per day for three months; in non-administration group and negative control group, rats were gavaged with 0.9% sodium chloride solution 0.2 g/kg once per day for three months. One rat died in each for the administration group and non-administration group due to gavage. Body weight gain, pH value of gastric juice and pathological changes of gastric mucosa of the three groups were evaluated. The number of nodules on gastric mucosal surface and the incidence and scores of precancerous lesions (intraepithelial neoplasia) in gastric mucosal were analyzed. The therapeutic effects of lamb′s tripe capsule on gastric mucosal precancerous lesions in rats were evaluated. Independent sample t test , Mann Whitney U test and chi-square test were used for statistical analysis. Results:The body weight gain of rats at the 6th week in the administration group was higher than that of rats in the non-administration group ((508.26±33.96) g vs. (495.50±23.01) g), and the pH value of gastric juice of rats in the administration group was lower than that of rats in the non-administration group (3.07±0.55 vs. 4.45±0.72), and the differences were statistically significant (both P<0.05). The number of proliferative nodules on the gastric mucosal surface of the rats in the administration group was less than that of rats in the non-administration group (the ratio of gastric fundus: 6.00(3.00, 7.00) vs. 11.00(7.00, 13.00); the ratio of gastric antrum: 0.00(0.00, 1.00) vs. 3.00(2.00, 4.00); the ratio of whole stomach: 7.00(3.00, 10.00) vs. 15.00(13.00, 17.00)), and the differences were statistically significant ( U=43.50, 49.00, 49.00, all P<0.05). The score of gastric mucosal precancerous lesions in the administration group was lower than that in the non-administration group(1.00±0.00 vs.1.14±0.38), and the incidence of precancerous lesions in the administration group was lower than that in the non-administration group (1/7 vs. 5/7), and the differences were statistically significant ( t=2.45, χ2=4.67, both P=0.031). Conclusions:Lamb′s tripe capsule can significantly inhibit the progression of precancerous lesions of gastric mucosa in rats, so as to play a role in preventing the occurrence of gastric cancer.

Pathology plays an important role in diagnosis and differential diagnosis of inflammatory bowel disease (IBD) . However, histopathological features of IBD vary among different patients and at different stages in the same patient. There is a lack of definitive morphological diagnostic criteria for IBD. Meanwhile, diagnostic accuracy is affected by training level and diagnostic experience of pathologists. In order to improve the pathological diagnosis of IBD, and to provide advice on practical diagnostic issues of IBD in China, experts guideline of pathological assessment was discussed by an expert group of pathologists and gastroenterologists.

Triple negative breast cancer (TNBC) is associated with a high risk of recurrence and generally a poor prognosis. Median survival time of metastatic triple negative breast cancer (mTNBC) is about one year. Currently, the mainstay of treatment for mTNBC remains cytotoxic chemotherapy. In recent years, the drugs involved in the clinical researches of mTNBC include poly-ADP-ribose polymerase inhibitors, phosphoinositide 3-kinase pathway inhibitors, antibody targeting epidermal growth factor receptor, antibody targeting trophoblast surface antigen-2, antibody targeting death receptor 5, endocrine therapy drugs for androgen receptor, and immune checkpoint inhibitors and so on. New drugs have gradually improved the survival of patients with mTNBC.