Objective To detect the expression of human telomerase reverse transcriptase (hTERT ) and telomerase in hu‐man fetal gastric fibroblasts .Methods Human fetal gastric fibroblasts were isolated and cultured ,epithelial cells were exduded by CK‐18 immune staining .hTERT protein was determined by indirect immunofluorescence .Telomerase activity was analyzed using telomeric repeat amplification protocol assay (TRAP)while the same analysis in adult gastric fibroblast ,which as to be positive con‐trol .Results Cultured fibroblasts were CK‐18 negative .The positive hTERT immunostaining was detected in both cellular cyto‐plasm and nuclear compartments .Amplified telomeric repeats (about 170 bp) in human fetal gastric fibroblasts were longer than those (160 bp) in adult gastric fibroblasts .Conclusion hTERT and telomerase were expressed in human fetal gastric fibroblasts .

Objective Colorectal polyp is a precancerous lesion of colorectal cancer .Aim of the study was to explore the risk fac-tors of colorectal polyp malignant transformation .Methods The related information of 75 084 colonoscopies performed from 2003 to 2012 in Southwest Hospital in Chongqing were collected and the relationship between polyp malignant transformation and the pa-tient age ,sex ,polyp location ,size or histological types was analyzed .Results From 2003 to 2012 ,polyps were diagnosed in 14 806 cases of the total 75 084 patients with a 19 .72% detection rate .There were significant difference of the left-side and right-side pol-yp detection rate in different age groups ,and the frequency of polyps distributed in the whole colorectum increased with the increase of age .The rates of epithelial neoplasia and malignant transformation increased with age .At the same time ,malignant transforma-tion rate was significant higher in polyps located in left-side than that in right-side (P<0 .0167) ,in adenoma than that in inflamma-tory hyperplastic polyp (P<0 .01) .The larger diameter and the more villus ,the higher rate of malignant transformation .Conclusion Patient age ,polyp size ,location and histological type could be considered as the significant predictors of colorectal polyp malignant transformation .It may be useful to treat the polyp with endoscopy in patient with age more than 45 and adenoma whose diameter was not less than 1 cm ,located in left-side for prevention of colorectal cancer .

Advanced studying doctors play important roles in the clinical services, and how to train them to improve training quality is worth investigating. We classified them into three types such as the clinical skills-improved, the special skills-trained and clinical knowledge eextensively-spread, then employed the individual teaching methods and emphasized the medical ethics during the training, which is not only beneficial to us, but also of great importance and necessity to advanced studying doctors themselves.

Objective To investigate the relationship between single-nucleotide polymorphisms of IVS13-98G/T of human protection of telomeres 1 (hPOT1) genes and gastric cancer. Methods A total of 168 patients with gastric cancer (gastric cancer group) who had been admitted to Wuwei Cancer Hospital, Wuwei People's Hospital and Liangzhou District Hospital from December 2005 to July 2006 and 156 healthy people (control group) were genotyped by polymerase chain reaction (PCR) and PCR-restriction fragment length polymorphism (PCR-RFLP) method, and the relationship between the distribution of genotypes and the risk faetors of gastric cancer was analyzed. The distribution of genotypes and allele frequency between the 2 groups were compared by chi-square test. Hardy-weinberg equilibrium test was adopted to determine whether the distribution of genotypes and allele frequency were representative. Relative risk and 95% confidence interval were calculated by non-conditional Logistic regression model. Results The frequencies of genotypes GG, GT and TT of hPOT1IVS13-98 G/T were 21.4%, 41.7% and 36.9% in gastric cancer group, and 24.4%, 51.9% and 23.7% in control group. The allele frequencies of G- and T-allele were 42.3%, 57.7% in gastric cancer group, and 49.7%, 50.3% in control group. There was no significant difference in allele frequencies of G- and T-allele between the 2 groups (X~2=3.58, P>0.05). Compared with genotype TT, the relative risks for GT and GG were 0.439 (95% CI: 0.251-0.767, P < 0.05) and 0.514 (95 % CI: 0.264-0.999, P=0.05). There was no influence of different genotypes of hPOT1IVS13-98 G/T, sex, smoking history, family history of cancer on gastric cancer. Conclusion Single-nucleotide polymorphisms of IVS13-98G/T of hPOT1 may be a protective factor of gastric cancer.

Objective To evaluate the differences, including clinical symptoms, endoscopic and histopathologic findings, status of Helicobacter pylori (Hp) infection and cytokeratin (CK) expressions, be-tween Barrett esophagus (BE) and heterotopic gastric mucosa (HGM) in upper esophagus. Methods Clinical data of 152 patients with BE and 52 patients with HGM in upper esophagus diagnosed from February 2004 to September 2005 were retrospectively studied. The parameters being compared include-ed clinical manifestations, conventional and magnifying endoscopic findings, histopathological findings, Hp infection determined by rapid urease test and Warthin-Starry staining and expression of CK phenotypes detec-ted by immunohistochemistry. Results Gastro-esophngeal reflux was observed in 64. 5% of patients with BE (98/152), higher than that in patients with HGM ( 13.5%, 7/52, χ2 = 40. 36, P < 0. 01 ). Endoscopic faveolus of BE mucosa included 46 cases of spot pattern, 65 striations and 41 villiform patterns, while those of HGM were all striation patterns. The histologic classification in BE included 56 cases of fundic type, 39 junction type and 57 specialized intestinal metaplasia, while in HGM mucesa, 31 cases of fundic type, 16 junction type and 5 antrum type were diagnosed, and no goblet cells were found. Moderate and severe infil-tration of inflammatory cells in BE mucosa was 63.2% (96/152), which was significantly higher than that in HGM mucosa (15/52, 28. 8%, P<0. 01). However, no difference was found in gastric antrum inflam-mation between the two groups (44.7%, 68/152, vs. 51.9%, 27/52, P>0.05). No difference was ob-served in prevalence of Hp infection between BE and HGM groups (P >0. 05 ), either in involved mucosa or in antrum. CK7 was not expressed in HGM or normal squamons mucosa, but was expressed in BE. CK20 and CK19 were expressed in both HGM and BE, and CK13 expression was found in some BE nmcosa including gas-tric metaplesia (55/95) and intestinal metaplasia (29/57) but not in HGM mucosa. Conclusion There are differences between HGM and BE, in regarding of reflux symptoms, magnifying endoscopic findings, histo-logical types and CKs expressions, which may be indicators to make differential diagnosis.

Objective To detect the differential expression genes(DEGs)between Barrettg esophagus(BE)and normal esophagus with oligomicroarray,and to explore the target genes related to the development of BE.Methods The total RNAs of matched BE and normal esophagus mucosa from saIne patient were isolated with one step Trizol method.Matched RNAs were qualified with 10g/L agarose gel electrophoresis.After tRNA purification,cRNAs were synthesized and labeled with fluorescence.which were tIlen hybridized with Agilent oligomicroarray containing 30,968 probes.The fluorescence intensity features were detected by Agilent scanner and quantified by software Feature Extraction.Results On average,2 biopsies by disposable jumbo biopsy forceps provided approximately 5μg RNA required for microarray.The total RNA,reverse transcription product and fluorescence labeled cRNA were all of high quality.Among 2-fold DEGs,there were 142 up-regulated genes and 284 down-regulated genes including 15 bel-2 related genes such as bel-2,MCL1,BAX,BIK and BCLAF1 Conclusion Microarray-based studies are feasible in endoscopically obtained tissues.The development of BE is a complicated process involving multi-genes,in which abnormal expression of bel-2 family related genes might be involved,but the exact mechanism needs further research.

Objective To investigate the effects of antisense recombinant euraryotic expression vector of HCCR-2 on the proliferation and apoptosis of HepG2. Methods The antisense recombinant eukaryotic expression vector of HCCR-2 was constructed. The vector was stably transfected to the HepG2 cells, and positive clones were selected by G418 (antiseuse vector group), pIRES2-EGFP vector was transfected into the HepG2 cells in the same way (pIRES2-EGFP group). The conditions of the nontransfected HepG2 cells were used as control (HepG2 group). Changes in cell growth curve, cell cycle, cell apoptosis and morphology of HepG2 cells after the transfec-tion were detected by MTT method, flow cytometry and transmission electron microscopy, respectively. All the data were analyzed by one-way ANOVA and chi-square test. Results The expression level of HCCR-2 mRNA was down-regulated to 0.39±0.04 in antisense vector group, and the expression level of HCCR-2 mRNA in pIRES2-EGFP group and HepG2 group were 0.62±0.06 and 0.72±0.03, respectively, with significant difference among the 3 groups (F=43.701, P<0.05). The apoptotic rate of HepG2 cells in antisense vector group, pIRES2-EGFP grop and HepG2 group were 13.30%, 2.51% and 2.07%, respectively, with significant difference among the 3 group (χ2=6.793, 8.721, P<0.05). The growth of HepG2 cells in antisense vector group was retarded, and was blocked in G0/G1 stage. Conclusions The HCCR-2 antisense recombinant eukaryotic expression vector can inhibit the mRNA expression of HCCR-2 and promote the apoptosis of cells. HCCR-2 may be involved in cell regulation and the proliferation of hepatocellular carcinoma cells.

Objective To investigate the endoscopic and ultrasonic endoscopic features of colorectal carcinoid and the indications of endoscopic treatment. Methods The clinical data of 22 patients with colorectal carcinoid who had been admitted to our hospital from 2002 to 2007 were collected. The endoscopic and ultrasonic endoscopic features and the relationship between the features and invasion depth of colorectal carcinoid were analyzed. Results Under the endoscope, early carcinoid presented submucosa tumor with 1.5cm in diameter, and yellow or white smooth surface; advanced carcinoid presented submucosa tumor with 0.8-3.0cm in diameter, and yellow or white little nodus or ulcerative surface. The ultrasonic endoscopic feature of the colorectal carcinoid was orbicular-ovate low level echo tumor with punctiform slightly high-level echo and an unsharpness edge. Sixteen mucosal layer-cancers and submucosal layer-cancers were removed by endoscopic mucosal resection, and 10 of them were additional treated by argon plasma coagulation. After a follow-up period of 4-36 months, no recurrence was observed. Conclusions Endoscopy and endoscopic ultrasonography are effective methods to diagnose colorectal carcinoid and its invasion depth. Endoscopic treatment is a simple, safe and effective means to treat the early colorectal carcinoid tumors.

Objective To develop a novel endoscopic classification system to determine the invasion depth of early esophageal cancer.Methods The esophageal lesion was endoscopicaUy stained with Lugol's iodine first,then methylene blue.According to the growth pattern,height and cup depth under endoscope,the lesions were classified into 5 types,including surface diffusion growth,intra-lumen growth,intra-wall growth,bi-direction growth and mix growth types.The lesions were then removed by endoscopic mucosa reection or surgery,the precise invasion depth of the lesion was determined pathologically and the results were compared with the endoscopy classification.Results The data of 44 cases of esophageal mucosal cancer and 34 cases of esophageal sub-mueosal cancer were included.With the criteria of mucosal cancer as surface diffusion growth,intra-lumen growth <5mm,bi-direetion growth <2mm and intra-wall growth <0.5 mm,the diagnostic specificity was 89.1%(41/46) and sensitivity was 93.2%(41/44).With the criteria of submucosal cancer as intra-lumen growth≥5 mm,hi-direction growth≥2mm,intra-wall growth≥0.5 mm and mix growth type,the diagnostic specificity was 90.6%(29/32) and sensitivity was 85.3%(29/34).The overall diagnostic accuracy in differentiating esophageal mucosal cancer from esophageal submueosal cancer by endoscopic classification was 89.7%(70/78).Conclusion This endoscopic classification system is effective in differentiating esophageal mucosal cancer from submucosal ones.

Objective To investigate the effect of rebamipide on chronic non-atrophic gastritis (NAG) with erosion and its protection of gastric mucosa from Helicobacter priori(Hp) associated lesions.Methods Patients(n=452)with endoscopically confirmed NAG with erosion from 11 hospitals in China were enrolled and randomly assigned at a ratio of 3:1 to receive either rebamipide(100 mg t.i.d.)or sucralfate(1.0 t.i.d.)for 8 weeks.Hp infected patients received eradication treatment before randomization.Symptoms,endoscopic scores and histological changes were recorded before and after therapy.Concentrations of serum prostaglandin E(PGE:)and oxygen free radical(MDA)were measured in patients from 2 centers.Results Per-protocol analysis(n=415)showed that the dyspeptic symptom score in rebamipide group decreased significantly after eight weeks of treatment. The endoscopic inflammation score in rebamipide group also decreased from 2.65 ±0.09 to 0.60±0.10(P<0.001),which was,significantly better than that of sucralfate group(P<0.001).Histological findings were consistent with the endoscopic findings.There Was a significant elevation(P=0.002)in PGE2 concentration in mucesa from rebamipide-treated subjects [(225.4±18.3) pg/g vs.(266.7±14.7)Pg/g] compared with that in sucralfate group.The concentration of MDA significantly decreased from(325.9±65.6)mmoL/g to(216.5±61.5)mmol/g,which is markedly different from that of sucralfate group(P=0.046).No statistical difference was found between Hp eradication group,Hp infection group and Hp negative group,regarding the effect of Rebamipide.Conclusion Compared to sucralfate,Rebamipide demonstrates a superior effect on improvement of dyspepsia symptom and endoscopic findings in erosive NAG,which is not influenced by Hp infection.