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To review the clinical data of 13 patients with benign stenosis in deep small intestine treated by balloon-assisted enteroscopy from September 2017 to December 2019, and to evaluate the stenosis characteristics, endoscopic treatment effects and its safety in different lesions. The results showed that there were 6 cases of Crohn disease (CD), 4 cases of cryptogenic multifocal ulcerative stenosing enteritis (CMUSE) and 3 cases of small bowel stenosis with unknown etiology. A total of 38 stenoses were found after 17 enteroscopic treatments, including 35 web-like stenoses and 3 columnar stenoses. Thirteen stenoses were found in 6 patients with CD, including 4 single stenosis, 1 case of 3 stenoses and 1 case of 6 stenoses. Twenty-one stenoses were found in 4 patients with CMUSE and they were all web-like stenosis. A total of 18 times of balloon dilatation and 10 times of IT knife incision were performed. The technical success rate was 88.2% (15/17), and the clinical effective rate was 76.9% (10/13). The follow-up time was 3-28 months, and one patient underwent surgical treatment. There was 1 case of delayed hemorrhage and 3 cases of delayed perforation after operation. They were all improved by medical treatment. These results indicated that treatment of benign stenosis in deep small intestine by enteroscopy is technically feasible and can improve the symptoms of patients in a short time.
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Inflammatory bowel disease(IBD)is a non-specific,chronic intestinal inflammatory disease,and the pathogenesis of IBD is not completely clear. Mesenchymal stem cell(MSC)is a kind of pluripotent stem cell,which has the function of homing,tissue repair and immunomodulation. The therapeutic effects of MSC in systemic lupus erythematosus,graft-versus-host disease,myocardial infarction and some other diseases have been confirmed. Recent studies have shown that MSC has a unique advantage in the treatment of IBD. This article reviewed the advances in study on MSC in the treatment of IBD.
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It has been widely accepted that Faecalibacterium prausnitzii (Fp) induces the differentiation of Treg cells.Lymphocyte function-associated antigen-1 (LFA-1) is also involved in the differentiation of Treg cells.Aims: To investigate the effect of Fp on Treg cells and cytokines in colitis mice with LFA-1 knockout (LFA-1-/-).Methods: Twenty wild type mice and twenty LFA-1-/-mice with same genetic background were randomly divided into wild type control group, wild type treatment group, LFA-1-/-control group and LFA-1-/-treatment group.Colitis model was induced by drinking DSS solution.Mice in the two treatment groups were intragastrically administrated with Fp.General status and histopathological score were assessed.Percentages of Treg cells in spleen and mesenteric lymph nodes were measured by flow cytometry.Serum levels of IL-10 and TGF-β1 were measured by ELISA.mRNA expressions of IL-10 and TGF-β1 in colonic tissue were detected by real time PCR.Results: Compared with corresponding control groups, histopathological score was significantly decreased in wild type treatment group (P<0.05);percentages of Treg cells in spleen and mesenteric lymph nodes were significantly increased (P<0.05), serum levels of IL-10 and TGF-β1 were significantly increased (P<0.01), expression of TGF-β1 mRNA was significantly increased in wild type treatment group and LFA-1-/-treatment group (P<0.05);expression of IL-10 mRNA was significantly decreased in LFA-1-/-treatment group (P<0.01).Compared with wild type treatment group, serum level of TGF-β1 was significantly decreased (P<0.05), and mRNA expressions of IL-10 and TGF-β1 were significantly decreased in LFA-1-/-treatment group (P<0.05).Conclusions: Fp can up-regulate the percentages of Treg cells and enhance the secretion of anti-inflammatory cytokines IL-10 and TGF-β1 in LFA-1-/-mice.The therapeutic efficacy for colitis in wild type mice is superior to that in LFA-1-/-mice, which may be related to the inhibition of function of Treg cells and secretion of cytokines due to LFA-1 knockout.
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Background:The abundance of Faecalibacterium prausnitzii (Fp) is reduced in patients with inflammatory bowel disease (IBD).Previous studies demonstrated that the supernatant of Fp exerts an obvious anti-inflammatory effect in experimental colitis.Aims:To investigate the effect of Fp supernatant on monocytes/macrophages and colonic inflammation in dextran sulfate sodium (DSS)-induced colitis in mice.Methods:Thirty male C57BL/6J mice were randomly divided into control group,colitis group and Fp treatment group.Acute colitis was induced by drinking 4.5％ DSS in distilled water for seven days in colitis and Fp treatment groups.Mice in Fp treatment group were also given gastric infusion of Fp supernatant during the process of colitis induction.Weight loss,defecation and histopathological damage of colon tissue were observed.The percentages of monocytes and macrophages of different phenotypes in spleen and colonic lamina propria,as well as the serum levels of a series of inflammatory cytokines were detected by flow cytometry.Results:Compared with colitis group,Fp treatment showed an ameliorating effect on weight loss,shortening of colon length and histopathological damage (P ＜ 0.05).The percentages of total amount of monocytes and proinflammatory monocytes in spleen and colonic lamina propria,and the percentage of M1 macrophages in colonic lamina propria in Fp treatment group were significantly lower than those in colitis group;the percentage of M2 macrophages in colonic lamina propria in Fp treatment group was significantly higher than that in colitis group (P all ＜ 0.05).The serum levels of interleukin (IL)-10 and IL-4 in Fp treatment group were significantly higher than those in colitis group,and the levels of IL-6,interferon (IFN)-γ and chemokine CCL2 were significantly lower than those in colitis group (P all ＜ 0.05).Conclusions:Fp supernatant may exert anti-inflammatory effect in experimental colitis in mice via reducing proinflammatory monocytes,inducing M2 polarization of macrophages in inflamed colon,promoting secretion of anti-inflammatory cytokines,and inhibiting secretion of proinflammatory cytokines and chemokines.
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Objective To study effect of triple viable bacterium of bacillus (small peifeikang) on the intestinal microflora and inflammation factors in patients with infectious diarrhea.Methods From October 2010 to October 2014, 120 patients with infectious diarrhea were chosen as study objects, 30 cases of health examination were selected as healthy control group, All patients were divided into 2 groups:60 patients in small peifeikang group and 60 patients in control group.The therapeutic effect and the change of intestinal microflora and inflammation factors were compared between two groups.Results The effective rate of small peifeikang groupwas 100.00%, while that of control group was 96.67%,the difference had statistical significance (χ2 =5.52,P<0.05).The symptom disappearance time of diarrhea, vomiting and fever had statistical difference between two groups (P<0.05), that of dehydration had no statistical significance.After treatment, in small peifeikang group and control group, the number of bifidobacterium, lactobacillus, and B/E value had decreased significantly (P<0.05), and the number of intestinal bacteriahad increased significantly(P<0.05).The distribution of intestinal flora in small peifeikang group was better than that of control group, and the difference had statistical significance(P<0.05).After treatment, in small peifeikang group and control group, the level of endotoxin, IL -6, TNF-αand CRP had decreased significantly( P <0.05).The extent of decreasing in small peifeikang group was more significant than that of control group, and the difference had statistical significance ( P <0.05 ) . Conclusion The triple viable bacterium of bacillus can promote the recurrence of patients with infectious diarrhea by adjusting the distribution of intestinal microflora, and by its immune regulation function.
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Objective To compare the efficacy of stents 7 F and 10 F in drainage of pancreatic pseudocyst via EUS-FNA.Methods A retrospective analysis of patients with pancreatic pseudocyst who received endoscopic ultrasonography guided puncture drainage by using 7 F and 10 F double pigtail plastic stent respectively in Drum Tower Hospital of Nanjing University Medical School from 2010 to 2014 was conducted.Patients' hospitalization period, the time for 50％ cyst reduction, removal time, infection rate, and recurrence rate were compared.Results Twenty three patients with pancreatic pseudocyst were included, among whom 14 were male and 9 were female.The age ranged from 13 to 70 with an average of 45.1 years.Eleven patients were treated with 7 F pigtail plastic stents whereas 12 patients with 10 F pigtail plastic stents.All patients were treated with additional 8.5 F joint nose cyst drainage.Four cases in 7 F group got fever, 3 of whom were successful in anti-infection and 1 failed, having to change the stent.One case (9.1％) relapsed without symptoms after 52 months during the follow-up and received no intervention.Five cases in 10 F group got fever, 4 of whom were successful in anti-infection and 1 failed, having to change the stent.One case (8.3％) was identified as mild hemorrhage, and replantation needed to be performed in 1 case (8.3％) because stent was found to slip after 12 days.Two cases (16.7％) relapsed without symptoms after 11 and 24 months respectively and no intervention was received.There was no significant difference in patients' age, cyst size, removal time, infection rate and recurrence rate between the two groups.However, patients in group 10 F had a markedly shorter hospitalization period and time for cyst reduction by at least 50％ than those in group 7 F (P ＜ 0.05).Conclusion 10 F double pigtail plastic stents can drain the cyst faster, shorten the hospital stay, but there is no significant difference in infection or recurrence rate of cyst compared with 7 F stents.
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Background:Faecalibacterium prausnitzii( Fp) is one of the most abundant bacterium in human intestinal microbiota,and is closely correlated with the process of colitis-associated colorectal cancer(CAC). Aims:To observe the effect of Fp on CAC,and investigate the possible mechanism. Methods:The model of CAC was induced by azoxymethane (AOM)and dextran sodium sulfate( DSS). Fifty-two C57BL/ 6J mice were randomly divided into 4 groups:group A (AOM + DSS),group B(AOM + DSS + Fp),group C(AOM + DSS + Fp supernatant)and group D(control group). All the mice were sacrificed on day 92. DAI was assessed,serum levels of TNF-α and IL-10 were determined by ELISA. HE staining was used to examine the grade of tumor. Expressions of VEGF,COX-2,NF-κB in tumor tissue were measured by immunohistochemistry. Results:The tumorigenesis rates of group A,B,C were 100% ,100% and 77. 8% ,respectively;mainly were high-grade intraepithelial neoplasia. The tumor load in group A was significantly higher than that in group B (P < 0. 01),and the spleen index in group B was significantly higher than that in group C(P < 0. 01). Serum level of TNF-α was significantly lower(P < 0. 05)and IL-10 was significantly higher(P < 0. 05)in group A than that in group B. No significant differences in expressions of VEGF,COX-2,NF-κB were found among group A,B and C. Conclusions:Fp had no obvious effect on the occurrence rate of CAC,and Fp supernatant could decrease the incidence of CAC in mice. Fp and its supernatant could reduce the tumor load via regulating the expressions of TNF-α,IL-10.
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Background:Faecalibacterium prausnitzii(Fp)is a commensal intestinal bacterium that exhibits anti-inflammatory and immunomodulatory capacity in vivo and in vitro. It has been reported that Fp in intestinal lumen was reduced in patients with colorectal cancer,which might be a factor associated with cancer development. Aims:To investigate the effect and immunological mechanism of Fp and its genomic DNA(fDNA)on the killing activity of peripheral blood mononuclear cells (PBMCs)against human colon cancer LoVo cells. Methods:PBMCs derived from healthy adults were co-cultured in vitro with Fp,fDNA,or the digested fDNA(d-fDNA),respectively. Killing activity of PBMCs against LoVo cells was measured by MTT assay;concentrations of interferon-gamma(INF-γ),a Th1-type cytokine and interleukin-4(IL-4),a Th2-type cytokine in culture supernatant of PBMCs were determined by ELISA;and expressions of T-bet and GATA3,the transcription factors specific for Th1 and Th2 cells,were measured by real-time PCR. Results:Compared with the PBMCs not treated,fDNA could significantly enhance the killing activity of PBMCs against LoVo cells(P < 0. 05);meanwhile,it promoted IFN-γ secretion,up-regulated T-bet mRNA expression and inhibited IL-4 secretion and GATA3 mRNA expression in PBMCs(P < 0. 05). Similar effects were not observed in PBMCs treated with Fp and d-fDNA. Conclusions:fDNA enhances the killing activity of PBMCs against human colon cancer cells by up-regulating Th1 immune response.
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Objective To analyze the clinical features of patients with IgG4-associated biliary and pancreatic diseases,and to improve the understanding of these diseases.Methods Nine cases of patients with IgG4-associated pancreatitis and cholangitis were analyzed retrospectively,which included clinical manifestations,serological examination,imaging test,pathology,treatment and prognosis.Results Of the 9 patients,8 were male,1 was female,the average age was 61 years old.Four cases were presented with jaundice,2 cases with jaundice and abdominal pain,2 cases with abdominal pain,and 1 case with diabetes.Serum IgG4 levels were 3.46-21.3 g/L (mean 9.743 g/L) in 6 cases,and which were higher than normal value,3 patients did not undergo blood test of IgG4.Nineteen auto-antibodies (including ANCA) were all negative in 9 cases.CA19-9 was increased in 4 cases.CT manifestations showed 5 cases with low density pancreas mass (2 cases with biliary tract dilatation);1 case had pancreas swelling with dilatation of bile duct,and 2 cases with bile duct dilatation only,and CT findings in 1 case were negative.Four patients underwent EUS-FNA,and EUS features included hypoechoic lesions without peripancreatic lymph nodes.FNA results indicated 2 cases with IgG4 related chronic inflammation,2 cases with chronic inflammation with negative IgG4.Seven cases were confirmed to have IgG4 related pancreatitis,and 2 cases with IgG4 related cholangitis.Six patients received glucocorticoid treatment,and the dose ranged from 8-40 mg;3 patients underwent surgery and the surgical pathology indicated IgG4 positive plasma cell.Follow-up showed the serum IgG4 returned to normal,clinical symptoms improved remarkably,and pancreatic mass decreased.Conclusions IgG4 positive plasma cell infiltration is the main feature of IgG4-associated cholangitis and pancreatitis.The diagnosis should combine image,serology with pathology.Glucocorticoid is an effective treatment.
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Background:NLRP3 inflammasome attracts widespread attention in study of inflammatory bowel disease. Faecalibacterium prausnitzii(Fp)is an anti-inflammatory commensal bacterium that has preventive and therapeutic effects on rat colitis. Aims:To explore the underlying mechanism of Fp in treating experimental colitis in rats. Methods:Fifty rats were randomly divided into two groups,10 in control group and 40 in model group. Rats in model group were administered intrarectally with 5% TNBS and dehydrated alcohol to induce experimental colitis. Twenty-four hours afterwards,the model rats were further divided into four groups and administered intragastrically with PBS,culture medium,live Fp and Fp supernatant 1 mL per day,respectively,for 7 days. On day 8,all the rats were sacrificed for evaluation of colonic inflammation. Expressions of the constituents of NLRP3 inflammasome(NLRP3,ASC,and caspase-1)were assessed by Western blotting and real-time PCR;levels of IL-1β and IL-18,the downstream effectors of NLRP3 inflammasome,in colon and plasma were measured by real-time PCR and ELISA,respectively. Results:Weight loss, reduced colon length and colonic inflammatory injury were observed in model rats. These manifestations were ameliorated in live Fp and Fp supernatant groups than those in PBS and culture medium groups. In PBS and culture medium groups, expressions of NLRP3,ASC,and caspase-1 protein and mRNA in colonic tissue were significantly higher than those in control group(P < 0. 05),the colonic and plasma levels of IL-1β were increased(P < 0. 05),and IL-18 levels were decreased(P < 0. 05). In live Fp and Fp supernatant groups,IL-18 level showed a further reduction as compared with PBS and culture medium groups( P < 0. 05),but the increasing trend for other parameters was reduced( P < 0. 05). Conclusions:NLRP3 inflammasome participates in the development of TNBS-induced colitis in rats. Fp might alleviate colonic inflammation by inhibiting NLRP3 inflammasome and its downstream effectors.
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BacKground:Lymphocyte function-associated antigen-1( LFA-1 ) pIays a cruciaI roIe in the pathogenesis of infIammatory boweI disease by reguIating the activation and function of T ceIIs. Aims:To investigate the effect of LFA-1 deficiency( LFA-1-/-)on differentiation of mice na?ve T ceIIs into Th17 ceIIs in vitro. Methods:LFA-1-/- mice were breeded and the progeny genome DNA was extracted from the taiIs for genotyping by PCR. CD4+CD62L+ na?ve T ceIIs were separated from spIenic mononucIear ceIIs of LFA-1-/- progeny mice and wiId type ( WT ) C57BL/6J mice, respectiveIy,by magnetic-activated ceII sorting( MACS),and then the purity of separated ceIIs was determined. Na?ve T ceIIs obtained were cuItured in different inducing systems[ transforming growth factor-β( TGF-β),TGF-β + interIeukin-6 (IL-6),and TGF-β + IL-6 + IL-23]in vitro for Th17 ceII differentiation;ceIIs in each inducing system were coIIected for anaIyzing the ratio of Th17 ceIIs by fIow cytometry,and the expressions of Th17-specific transcription factor ROR-γt and Th17-specific marker IL-17A were measured by qRT-PCR and ELISA methods. Results:AII fifteen progeny mice were identified as LFA-1-/- genotype. Purity of CD4+CD62L+ na?ve T ceIIs separated by MACS was above 95%. Th17 ceIIs couId be induced by Iow-dose TGF-βcombined with IL-6,and the differentiation ratio was increased obviousIy when IL-23 was added. In inducing system containing TGF-β,IL-6 and IL-23,na?ve T ceIIs from LFA-1-/- mice produced more Th17 ceIIs than those from WT mice(17. 2% ± 1. 4% vs. 5. 7% ± 0. 2%,P<0. 001),expressions of ROR-γt mRNA and IL-17A mRNA were up-reguIated(P<0. 001),and IL-17A concentration in ceII cuIture supernatant was increased(P<0. 01). Conclusions:Deficiency of LFA-1 promotes the differentiation of mice na?ve T ceIIs into Th17 ceIIs in vitro.
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Background:Suppression of tumor suppressor genes plays a key role in the pathogenesis and progress of tumors. Some microRNAs may contribute to tumorigenesis by regulating tumor suppressor genes. Aims:To investigate the targeted regulatory effect of miR-483-3p on deleted in liver cancer 1(DLC1)gene in colorectal cancer. Methods:Sixteen patients with colorectal cancer admitted from October 2012 to April 2013 at Nanjing Drum Tower Hospital were enrolled. Expression of DLC1 in cancerous and adjacent noncancerous tissues was determined by Western blotting,and expression of miR-483-3p was determined by qRT-PCR. Dual luciferase reporter gene plasmid containing the 3’untranslated region(3’UTR)of DLC1 was constructed to validate the regulation of DLC1 by miR-483-3p in human colon cancer cell line HCT116. MiR-483-3p mimic was transfected into HEK293T cells and expression of DLC1 was determined by Western blotting;MiR-483-3p mimic was transfected into HCT116 cells and cell proliferation was measured by CCK-8 assay. Results:Expression of DLC1 was significantly lower in cancerous tissue than in noncancerous tissue,while expression of miR-483-3p was significantly higher in cancerous tissue than in noncancerous tissue(P<0. 05). MiR-483-3p mimic reduced the expression of DLC1 through directly binding to the 3’UTR of DLC1. Transfection of miR-483-3p mimic enhanced the proliferation of HCT116 cells significantly(P<0. 05). Conclusions:DLC1 is a target gene of miR-483-3p. MiR-483-3p might promote the development of colorectal cancer by down-regulating DLC1 expression at post-transcriptional level.
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ObjectiveTo investigate the diagnostic value of single balloon enteroscopy (SBE) for obscure gastrointestinal bleeding.MethodsA total of 78 SBE procedures was conducted on 72 patients with obscure gastrointestinal bleeding,with 40 via oral route and 38 via anal route.The procedure time,insertion depth and rate of positive finding were recorded.ResultsFor 40 SBE procedures performed via oral route,the mean procedure time was 60 minutes ( 15-110 minutes),and the mean insertion depth was 195 cm at the distal end of Trentz ligament (30-240 cm).For 38 SBE procedures performed via anus,the mean procedure time was 75 minuets (30-120 minutes),and the mean insertion depth was 160 cm at the proximal end of ileocecal valve (50-200 cm ).The whole diagnostic yield of obscure gastrointestinal bleeding was 62.5％.ConclusionSBE is a safe and useful tool for the diagnosis of obscure gastrointestinal bleeding.
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Objective To investigate the protective effects and mechanism of Faecalibacterium prausnitzii (Fp) and its products in 2,4,6-trinitrobenzene sulfonic acid (TNBS) induced colitis rats.Methods A total of 40 Sprague-Dawley rats were divided into healthy control group,colitis model group,Fp supernatant group,Fp bacteria group and Bifidobacterium longum (B.longum) group.The rats of the later four groups were enemaed with TNBS to establish the model.At five days before and one day after modeling,the rats were gavaged with phosphate buffer saline (PBS),the supernatant of Fp,live Fp bacteria and live B.longum respectively.Rats were executed at 48 hour after modeling.The colon tissues were taken for pathology examination.The content of short-chain fatty acids (SCFA) in fecal was tested by gas chromatography.The plasma level of interleukin-10 (IL- 10),interleukin-12 ( IL-12),interleukin-17 (IL-17) and interleukin-23 (IL-23) were detected by enzyme-linked immunosorbnent assay (ELISA) and the expression of IL-17 in intestinal mucosal tissues was measured by immunohistochemistry.The data were analyzed by one way ANOVA.Results Compared with the healthy control group,the rats of colitis group suffered serious weight loss and their intestinal pathology score increased [(193.57±14) g vs (170.25±19.18) g,(1.00±0.99) vs (3.34±0.38),t=2.83 and 7.55,all P value＜0.05].The Fp supernatant group showed protective effects in terms of weight and intestinal pathology score [(187.00± 14.67) g,(2.50±0.44),t=2.1 and 2.9,all P＜0.05].Compared with healthy control group,the plasma and colon tissue IL-17 concentration of colitis model group increased (16.61 pg/ml±2.45 pg/ml vs 20.47 pg/ml± 1.45 pg/ml,0.83±0.98 vs 5.14±0.90) (all P＜0.05).Compared with the colitis model group,the plasma and colon tissue IL-17 concentration of Fp supernatant group decreased ( 17.54 pg/ml± 1.51 pg/ml and 2.86±0.69).Conclusion Fp can regulate immune response and suppress rat colonic inflammation,which may be related with the expression of IL-17.
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Objective To explore the therapeutic effects and the mechanisms of Faecalibacterium prausnitzii (Fp) on trinitro-benzene-sulfonic acid-induced colitis.Methods Sixty Sprague-Dawley rats were divided into healthy control group, colitis model control group, Fp pretreated group,Fp supernatant pretreated group,Fp treated group and Fp supernatant treated group.Disease activity index (DAI),histological injury of colonic tissue,the content of butyrate in feces,forkhead box protein 3 (Foxp3) regulatory T cells (Treg) in peripheral blood and spleen and the level of interlenkin (IL)-17 and IL-6 in serum were evaluated.All the data were statistical analyzed by single factor analysis of variance. Results Compared with colitis model control group, DAI significantly lowered and histological injury obviously improved in Fp pretreated group, Fp supernatant pretreated group,Fp treated group and Fp supernatant treated group.The effects of Fp pretreated group were better than those of Fp treated group and Fp supernatant pretreated group were better than Fp supernatant treated group.The concentration of butyrate in Fp pretreated group,Fp supernatant pretreated group,Fp treated group and Fp supernatant treated group was (3091.08 ±485.50) × 106 mol/L,(1714.64 ± 351.25) × 10(-8) mol/L,(2064.75 ± 295.04) × 10-6 mol/L and (1089.13±321.23) × 10-6 mol/L respectively,there was significant difference between Fp pretreated group and other groups (F=49.796,P＜0.01).The peripheral blood level of Foxp3+ Treg in Fp supernatant pretreated group was highest.The spleen level of Foxp3+ Treg in Fp pretreated group and Fp supernatant pretreated group were significantly higher than that of other groups.The serum level of IL-17 and IL-6 in Fp pretreated group,Fp supernatant pretreated group,Fp treated group and Fp supernatant treated group was significantly lower than that of colitis model group.Conclustons Fp plays a role in promoting the repair of intestinal inflammatory reaction in colitis model rats.The mechanism may be related with butyrate producing,the peripheral blood and spleen level of Foxp3+ Treg up-regulating,suppressing the secretion of proinflammatory cytokine IL-17 and IL-6.Rebuilding the balance of Treg/Th17 to reduce local intestinal inflammation.
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Objective To explore endoscopic findings and histopathological characteristics of duodenal protuberant lesions in order to improve diagnosis of duodenal protuberant lesions.Methods A total of 869 cases of duodenal protuberant lesions were detected and collected in endoscopy center of Drum Tower Hospital from 2005 to 2010,of which endoscopy findings and pathological characteristics were studied retrospectively.Results Of the 869 case with duodenal protuberance,50 cases were misdiagnosed as real protuberant lesions.Of the 819 real protuberant lesions,781 cases (95.4％)were benign lesions and 38 cases (4.6％) were malignant lesions.Pathological results indicated that most were chronic inflammation benign lesions (338 cases),accounted for 41.3％.Secondary were Brunner gland hyperplasia (155 cases),accounted for 18.9％.Of malignant lesions,most were adenocarcinoma (25 cases,accounting for 3％ ),others were six cases of carcinoid tumor,six cases of malignant lymphoma and one case of embryonal rhabdomyosarcoma.Endoscopic findings of duodenal protuberant lesions were diverse,such as round,hemispheric,finger-like,lobulated,streak and so on.The diameter of duodenal protuberant lesions varied,the largest was 5 centimeter and most were sessile lesions (726 cases,88.6％).Endoscopic ultrasonic findings indicated that internal echo of benign lesions were even and each layer of structure was clear,while malignant lesions presented uneven internal echo,unclear layer structure and adjacent tissue or lymphoma nodes invasion.Conclusions Duodenal protuberant lesions cannot be confirmed by conventional endoscopic findings.Endoscopic ultrasonography may help to improve the diagnosis.Diagnosis should be confirmed by pathology.
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Objective To evaluate endoscopic ultrasonography (EUS) for diagnosis of large gastric folds. Methods EUS was performed in 66 patients with possible large gastric folds which could not be diagnosed by conventional gastroscopy. The characteristics of EUS findings were analyzed, and the EUS results were compared with pathological findings to evaluate the sensitivity, specificity and accuracy of EUS. Results The diagnostic sensitivity, specificity and accuracy of EUS for diffused infiltrated gastric cancer were 92.3%(24/26), 95.1% (39/41) and 95.5% (63/66), respectively, and those for gastric lymphoma were 92. 3% ( 12/13), 96. 1% (49/51) and 92. 4% (61/66), respectively. The accuracy in differential diagnosis of benign and malignant disease was 93.9% (62/66). There were statistical differences between benign and malignant large gastric folds in characteristics of EUS findings, including width of gastric wall, enlargement of muscularis propria and preservation of gastric layer ( P ＜ 0. 05 ). Conclusion EUS is of high accuracy for diagnosis of large gastric folds, especially for diffused infiltrated gastric cancer and gastric lymphoma. Such features as width of gastric wall, the enlargement of muscularis propria and the preservation of gastric layer are important features for differential diagnosis of benign and malignant lesions.
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Objective To investigate the value of a diagnostic criterion of capsule endoscopy (CE)for small bowel Crohn's disease (CD). Methods The clinical data of 50 patients with suspected CD who underwent CE from March 2003 to October 2008 were analyzed retrospectively. Diagnoses were made based on a criterion proposed by De Bona et al. Patients were grouped and followed up for 1 to 5 years. Results A total of 50 patients were enrolled and divided into 3 groups according to the results of CE. Group A included 25 patients as having small intestine CD on CE, in which 3 received surgery and was confirmed by pathology, and the other 22 got improved after treatments for CD. Group B was comprised of 15 patients who were clinically diagnosed as small intestinal CD and received experimental treatments, in which 13 patients improved and 2 others received surgery and were confirmed to be small intestine diverticula. Patients in group C ( n = 10) were diagnosed as non-specific enteritis and received medication of Bifico and metronidazole for at least 3 months. All patients were followed up for 1 to 5 years and no recurrence was observed. Conclusion This diagnostic criterion of CE for small bowel CD enables early diagnosis of the disease.
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Aim To investigate the effects of gastrin-17 on NF-κB signaling pathway in human colon cancer cells-Colo320WT.Methods All subjects were divided into four groups: control, gastrin-17,gastrin-17+L365,260 (gastrin-17 receptor blocker) and L365,260 group.Concerning gastrin-17 group,Colo320WT cells were treated by gastrin-17 for 12 h.Concerning gastrin-17+L360,265 group, Colo320WT cells were pretreated by L365,260 for 30 min and then were treated by gastrin-17 for 12 h.Concerning L365,260 group,Colo320WT cells were pretreated by L365,260 for 30 min.NF-κB DNA binding activity was determined by electrophoretic mobility shift assay (EMSA). Expressions of uPA protein and mRNA were assayed by Western blot and RT-PCR, respectively.Results NF-κB DNA binding activity increased more greatly in the Colo320WT cells stimulated by gastrin than that of the control group. And the expressions of uPA protein and mRNA were up-regulated more markedly than those of the control group. The above responses resulting from gastrin-17 were partly blocked by gastrin-17 receptor blocker, L365,260.Conclusion Gastrin-17 may activate NF-κB signaling pathway in human colonic cancer cells Colo320WT.
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Objective To investigate the expression of poly (ADP-ribose) polymerase-1 (PARP-1 ), cytokeratins (CK) 7/20, and p53 in patients with Barrett's esophagus and esophageal adenocareinoma,and to evaluate their significance. Methods Expression of PARP-1, CK7/20 and p53 were determined by immunohistochemistry in 108 patients (including 40 Barrett's esophagus, 28 esophageal adenocarcinoma and 40 cardiac mucosa). Results The expression of PARP-1 was found in Barrett's esophagus, esophageal ade-nocarcinoma and cardiac epithelium with a significantly higher level in esophageal adenocarcinoma than the other two groups (P <0. 01 ). CK7/20 was expressed in much of intestinal metaplasia, part of cardiac epi-thelium and adenocarcinoma cells. The positive expression of p53 was observed in all three groups, and it was significantly higher in adenocarcinoma group than in other two groups (P < 0. 05 ). PARP-1 expression is highly correlated with that of p53 in Barrett's esophagus ( r= 0.49, P < 0.01 ). Conclusion CK7/20 is a sensitive but less specific indicator for intestinal metaplasia. Both PARP-1 and p53 are involved in the patho-genesis of esophageal adenocarcinoma and might help to determine the risk of Barrett's esophagus developing into esophageal adenocarcinoma.
