Objective To investigate the clinical and pathological characteristics of gastric polyps in Chongqing region.Methods Endoscopic reports and clinical data of 10 137 consecutive patients with gastric polyps diagnosed in our center from January 2007 to December 2016 were collected and retrospectively analyzed.Results During the period of 10 years,the spectrum of gastric polyps was altered with the frequency of hyperplastic polyp (HPP) decreasing from 66.39％ to 43.05％ (P ＜ 0.001),while that of fundic gland polyp (FGP) increasing from 25.04％ to 48.47％ (P ＜ 0.001).The prevalence of H.Pylori infection,dysplasia and high-grade intraepithelial neoplasia (HIN) was declined from 57.78％ to 37.42％ (P ＜0.05),3.79％ to 0.90％ (P ＜0.001),and 1.81％ to 0.56％ (P ＜0.01),respectively.The ratio of the HPPs patients was reduced with the age increasing,and the ratio was decreased from 73.62％ in the ≤30 years old group to 48.69％ in ＞ 70 years old group(P ＜ 0.001).However,the ratio of adenomatous polyp was increased from 0.34％ in the group aged 31 to 40 years old to 6.28％ in those ＞ 70 years old (P ＜0.001).The prevalence of dysplasia and HIN was increased by 3.89 and 4.75 times,respectively (P ＜0.001),in the group aged ＞60 years than those ≤60 years old.The incidence of reflux esophagitis in the FGPs patients was higher than those without (6.86％ vs 3.54％) (P ＜ 0.001),whereas,it showed inversely about the infection rate of H.pylori (28.48％ vs 45.30％) (P ＜ 0.001).The incidence of dysplasia were 60.47％,0.53％ and 0.20％ respectively in adenomatous polyp,HPP and FGP,as well as 47.67％,0.07％ and 0.03％ for HIN in adenomatous polyp,HPP and FGP.There were significant difference in the number and location of gastric polyps in different time periods,age groups and pathological types.Conclusion The prevalence of gastric hyperplastic polyps is obviously decreased in the past 10 years,and FGPs with hardly malignant potential are the most common type.Therefore,whether it is necessary to resect all polyps when encountered under endoscope,physicians should take into consideration pathological patterns,clinical characteristics and decision of patients and make the different management strategies finally.

Objective To assess the efficacy and safety of bismuth quadruple therapy for 10 or 14 days in eradicating Helicobacter pylori (H.pylori) infections in Chinese patients.Methods The databases including PubMed,Embase,the Cochrane Central Register of Controlled Trials,China National Knowledge Infrastructure Database,Chinese Biomedical Database and VIP database were searched for randomized controlled trials (RCTs) published from the year 2005 to 2016 describing bismuth-based quadruple therapy for 10 or 14 days in Chinese patients.The trails retrieved were examined for clinical features of patients,quality of study,eradication rate of H.pylori and incidence of adverse events.A meta-analysis of the included trials was performed using Revman 5.3 software,and the pooled relative risk (RR) and 95％ confidence intervals (CIs) were calculated;the publication bias was assessed with funnel plot.Results Forty-three trials involving a total of 7 686 patients were eligible for inclusion in the analysis.Intention-to-treat analysis showed that the eradication rate of H.pylori was 88.96％ (95％ CI:87.73％ ～90.19％) with bismuth quadruple therapy for 10 or 14 d and 74.11％ (95％ CI:72.53％ ～75.69％) with triple therapy,showing a significant difference in the efficacy between the 2 therapies (RR =1.20,95％ CI:1.16％ ～1.25％).Analysis of 9 trials comparing bismuth quadruple therapy for 10 or 14 d and for 7 d showed that a treatment duration for 10 or 14 d resulted in an significantly higher eradication rate than a treatment duration of 7 days [87.34％(95％ CI:84.87％ ～89.80％)vs 81.65％ (95％ CI:78.76％ ～84.54％),RR=1.07,95％ CI:1.02％ ～1.12％].The eradication rate produced by bismuth quadruple therapy for 10 or 14 d did not differ significantly from that by sequential therapy (RR =1.02,95％ CI:0.97％ ～1.07％) or concomitant therapy (RR =1.01,95％ CI:0.95％ ～ 1.07％).Conclusion Bismuth-based quadruple therapy for 10 or 14 d has a comparable efficacy in eradicating H.pylori with sequential therapy and concomitant therapy.Triple therapy and bismuth quadruple therapy for 7 d are not recommended as the primary options for treatment of H.pylori infection.

Objective To investigate the factors associated with the occurrence of gastric polyps to provide evidence for devising strategies for its prevention.Methods We retrospectively analyzed 504 cases of gastric polyps diagnosed by gastric endoscopy and subsequent pathological examination from different departments of the Southwest Hospital between October 2016 and March 2017.We also enrolled 504 subjects without gastric polyps during the same period to serve as the control group and paired them with the case group at a 1:1 ratio.The relevant data were collected from all the participants using a self-designed questionnaire.The factors associated with the occurrence of gastric polyps were analyzed with Chi-square test followed by multivariate logistic regression analysis.Results Univariate analysis showed that a history of using protonpump inhibitors (PPIs),a history of H.pylori infection,a family history of gastric polyps,smoking,drinking alcohol,drinking tea,physical exercise,eating speed,fruit intake,emotional status,psychological trauma and pressure from work and daily life were all potential factors related to the occurrence of gastric polyps.Multivariate logistic regression analysis identified a history of using PPIs,a history of H.pylori infection,a family history of gastric polyps,long-term alcohol drinking,eating fast and psychological trauma as the risk factors and physical exercise (not less than once a week) and eating fruits (not less than twice a week) as the protective factors against the occurrence of gastric polyps.Conclusion Multiple factors contribute to the occurrence of gastric polyps.Avoiding long-term use of PPIs and drinking alcohol,eradication of H.pylori infection,active exercise,sufficient fruit intake,a positive attitude and a good eating habit may effectively reduce the risk of gastric polyps.

目的研究口腔癌过表达蛋白1（oral cancer overexpressed protein 1,ORAOV1）在人结肠癌组织中的表达变化并探讨其对结肠癌细胞增殖能力、细胞周期及早期凋亡的影响。方法收集人结肠癌及癌旁组织标本,分别以qRT-PCR及Western blot检测ORAOV1在mRNA及蛋白水平的表达变化情况;采用RNAi技术获得ORAOV1低表达的Lo Vo及SW480细胞株,并使用Western blot对干扰结果进行鉴定;采用CCK-8检测干扰ORAOV1表达后两种结肠癌细胞增殖能力的变化;并采用流式细胞术检测干扰ORAOV1表达对结肠癌细胞周期及早期凋亡的影响。结果 qRT-PCR及Western blot结果分别显示结肠癌组织中的ORAOV1 mRNA及蛋白水平高于癌旁组织（P＜0.05）;Western blot检测证实Lo Vo及SW480细胞中ORAOV1干扰成功;在这两种结肠癌细胞株中,CCK-8检测结果显示,干扰ORAOV1可抑制细胞增殖能力;流式细胞术结果显示,干扰ORAOV1可使处于S期比例增加（P＜0.05）、早期凋亡比例增加（P＜0.05）。结论结肠癌组织中的ORAOV1表达增加,干扰ORAOV1可降低结肠癌细胞的增殖能力,可能与S期阻滞及细胞早期凋亡增加有关。

Objective To clarify the expression change and significance of phosphofurin acidic cluster sorting protein-2(PACS-2) in non-alcoholic fatty liver disease(NAFLD).Methods An in vitro NAFLD model was established by inducing the steatosis of HepG2 cells using palmitic acid.The cells were collected at the time points of 0,4,8,12,and 24 h after induction.The steatosis levels were measured by oil red staining.Rat NAFLD model was established in SD rats by feeding high fat diet,while the rats fed with normal food were set as control group.These rats were killed at 4,8,12,16 and 20 weeks after feeding.The expression of PACS-2,endoplasmic reticulum stress marker-glucose regulating protein 78(GRP78),Bax and Caspase-3 in the cell model and liver tissue samples were detected by q-PCR and Western blotting.Results The steatosis of HepG2 cells was induced by fatty acid successfully.The rat NAFLD model was established in SD rats successfully.The relative expression of PACS-2 at mRNA level was significantly decreased in the early stages(4 and 8 h),but increased in the late stages(12 and 24 h after treatment).That of GRP78 was up-regulated in 8 h,and then reached the highest level in 24 h after induction(P<0.01).That of Bax and Caspase-3 was also significantly increased in 12 and 24 h(P<0.01).The expression of these proteins showed similar trends as those at mRNA level(P<0.01).In the rat NAFLD model,the expression of PACS-2 protein was significantly decreased in the early stages(4 and 8 weeks),but then up-regulated in the late stages(16 and 20 weeks,P<0.01).The expression of GRP78 was up-regulated in 4 weeks,and reached the summit in 20 weeks(P<0.01).The expression of Bax and Caspase-3 were significantly up-regulated as compared the control in the late stage of NAFLD(P<0.01).Conclusion Mild expression of PACS-2 in the early stage of NAFLD might be involved in endoplasmic reticulum stress during the NAFLD process,and its up-regulation in the late stage may be associated with the apoptosis induced hepatocyte injury.

Objective: To observe the effect of Qiwei Tiexie Capsule on non-alcoholic fatty liver disease(NAFLD)in rats,and preliminary discuss on its influence of the ERS regulated factors.Methods: Wistar rats 60,were randomly divided into normal group,model group,Qiwei Tiexie Capsule treatment group,and Polyene phosphatidylcholine Capsule positive control group.After the treatment of drugs for 12 weeks respectively,we observed the pathological and histological character,the levels of serum AST,ALT,TG,FFA and the protein expression levels of liver tissue GRP78,SREBP-1c,Caspase-3,and TNF-α.Results: Compared with model group,the pathological features of liver in Qiwei Tiexie Capsule treatment group and Polyenephosphatidylcholine capsule positive control group were significantly alleviated,and the degree of inflammation,levels of serum AST,ALT,TG,FFA and the expression of liver tissue GRP78,SREBP-1c,Caspase-3,TNF-α were significantly reduced(P0.01);Qiwei Tiexie Capsule treatment group and Polyenephosphatidylcholine Capsule group had no statistical difference.Conclusion: Qiwei Tiexie Capsule has the exact effect on non-alcoholic fatty liver disease in simplex high fat diet rats,through reducing the expression of GRP78 protein in rat liver tissue,restoring the steady-state of endoplasmic reticulum,reducing the accumulation of lipid in the liver and inhibiting inflammatory,to moderate hepatic steatosis and inflammation degree.

OBJECTIVE To explore the therapeutic effect of bone marrow mesenchymal stem cells (BM-MSCs) on injured hepatocytes mediated by paracrine mechanisms and to investigate the potential molecular mechanism of this action. METHODS A contact-independent model of aberrant hepatic microenvironment was established by co-culturing BM-MSCs with D-galactosamine (D-GalN)-injured human L02 hepatic cells using a transwell assay platform. Secreted levels of insulin-like growth factor-1 (IGF-1) were measured by enzyme-linked immunosorbent assay of the co-culture supernatant. Expression of the IGF-1 receptor (IGF-1R) was assessed by Western blot. The effect of exogenous IGF-1 on proliferation of D-GalN-injured L02 cells was examined by MTT assay. RESULTS Upon co-culture, BM-MSCs promoted proliferation of D-GalN-injured L02 cells in a contact-independent manner (absorbance values of at 24 h: 0.36+/-0.08, 48 h: 0.52+/-0.06, and 96 h: 0.68+/-0.06; vs. uninjured cells t = 2.493, 3.116, and 2.285, respectively; all P less than 0.05). Robust expression of IGF-1 was identified in the supernatants of co-cultures and was demonstrated to have been secreted mainly from BM-MSCs under the influence of D-GalN-injured L02 cells. Constitutive expression of IGF-1R was found in the D-GalN-injured L02 cells and blocking of IGF-1R by a neutralizing antibody significantly inhibited the paracrine pro-proliferative effect of co-cultured BM-MSCs at 24 h, 48 h, and 72 h (t = 2.909, 2.328, and 2.560, respectively; all P less than 0.05). CONCLUSION BM-MSC-derived IGF-1 plays an important role in the paracrine pro-proliferative effect on D-GalN-injured L02 hepatocytes by engaging with the constitutively expressed IGF-1R on L02 cells.

Objective To investigate the differences among the curative effects of three different transplantation approaches of mesenchymal stem cells(MSCs) on rat model of cirrhosis.Methods The rat model of cirrhosis was constructed from female SD rats by subcutaneous injection of a mixture of carbon tetrachloride and olive oil combined with ethanol feeding.The rats of cirrhosis were randomly divided in a non-transplantation group(n=8),a portal vein transplantation group(n=8),a hepatic artery transplantation group(n=8),and a caudal vein transplantation group(n=8).MSCs were derived from the bone marrow of healthy SD rats through primary adherent culture,labeled with CM-DiI,and then transplanted into the rats of cirrhosis with the above three transplantation approaches.The levels of serum albumin,transaminases(ALT and AST),bilirubin,and type Ⅳ collagen were detected four weeks after transplantation.The MSC distribution and number in the liver were observed using a laser scanning confocal microscope.The degree of cirrhosis was determined by HE and Masson staining.Results The liver function of the rats of cirrhosis in the three transplantation groups was improved significantly four weeks after transplantation.As compared with the non-transplantation group,the three transplantation groups significantly exhibited increased serum albumin levels(P<0.05),decreased levels of transaminases,bilirubin and type Ⅳ collagen(P<0.05),and alleviated degree of cirrhosis(P<0.05).The curative effects of the three different transplantation approaches on the rats of cirrhosis,however,did not show statistical differences(P>0.05).Conclusion With similar curative effects,transplantation of MSCs into rat model of cirrhosis via portal vein,hepatic artery,and caudal vein can improve liver function and alleviate cirrhosis degree four weeks after transplantation.

<正>近年来,干细胞已经从实验室研究逐渐过渡到临床。目前用于临床的移植干细胞类型包括胚胎干细胞(embryonic stemcells,ESCs)、造血干细胞(hemopoietic stem cells,HSC)、骨髓间充质干细胞(bone marrow mesenchymal stem cells,BM-SCs)、脂肪源性间充质干细胞(adipose derived stemcells,AD-SCs)及内皮祖细胞(endothelial progenitor cells,EPCs)等。由于BMSCs分离简便,不需要体外培养和扩增,获取细胞数目