Background The m6A modified demethylase FTO affects the progression of gastric cancer (GC), and the role mechanism of FTO in GC is still unclear. We, here, explored the role of FTO and unrevealed the mechanisms of its function in GC. Methods The expression and clinical prognosis of FTO in GC were examined via UALCAN and GEPIA online databases. Effect of FTO shRNA on GC cellular malignant phenotype were proved by CCK-8, Transwell, Wound healing assay and Flow cytometric assay. RNA-sequencing data of FTO depleted AGS cells were downloaded to analyze differentially expressed genes of FTO downstream. The GO and KEGG pathway enrichment were performed for the DEGs by DAVID. RT-qPCR and RIP-qPCR assay were applied to verify the MOXD1 mRNA and methylated mRNA in FTO shRNA group. The expression and clinical prognosis of MOXD1 in GC were explored via UALCAN, GEPIA and Kaplan-Meier plotter. The role and mechanism and of MOXD1 in GC cell lines were detected and analyzed. Results The expression of FTO was found to be elevated in GC tissues compared with normal tissues, and worse survival were strongly related to high expression of FTO in GC. FTO silencing suppressed the proliferation, migration and promoted apoptosis of GC cells. A total of 5856 DEGs were obtained in between NC and FTO depleted AGS cell groups, and involved in the cancer related pathways. Here, FTO targets MOXD1 mRNA and promotes its expression via m6A methylation. MOXD1 upregulation was associated to poor prognosis of GC. MOXD1 silencing suppressed the malignant phenotype of GC cells. MOXD1 activated cancer -related signaling pathway (MAPK, TGF-β, NOTCH and JAK/STAT). Conclusions Our study demonstrated that FTO silencing decreased MOXD1 expression to inhibit the progression of GC via m6A methylation modification. FTO/MOXD1 may be potential targets for the treatment and prognosis of GC.

Byakangelicin mostly obtained from the root of Angelica dahurica and has protective effect on liver injury and fibrosis. In addition, Byakangelicin, as a traditional medicine, is also used to treat colds, headache and toothache. Recent studies have shown that Byakangelicin exhibits anti-tumor function; however, the role of Byakangelicin in breast tumor progression and related mechanism has not yet been elucidated. Our study aims to investigate the role of Byakangelicin in breast tumor progression and the underlying mechanism. To measure the effect of Byakangelicin on JAK2/STAT3 signaling, a dual luciferase reporter assay and a Western blot assay were performed. CCK8, colony formation, apoptosis and cell invasion assays were used to examine the inhibitory potential of Byakangelicin on breast cancer cells. Additionally, SHP-1 was silenced by specific siRNA duplex and the function of SHP-1 on Byakangelicin-mediated inhibition of JAK2/STAT3 signaling was evaluated. Byakangelicin treatment significantly inhibited STAT3 transcriptional activity. In addition, Byakangelicin treatment blocked JAK2/STAT3 signaling in a dose-dependent manner. Byakangelicin-treated tumor cells showed a dramatically reduced proliferation, colony formation and invasion ability. Moreover, Byakangelicin remarkedly induced breast cancer cell apoptosis. Furthermore, Byakangelicin regulated the expression of SHP1.In conclusion, our current study indicated that Byakangelicin, a natural compound, inhibits SHP-1/JAK2/STAT3 signaling and thus blocks tumor growth and motility.

OBJECTIVE:To explore the role of long non-coding RNA ABHD11-AS1 in regulation of glycolysis in gastric cancer cells and its molecular mechanism.METHODS:The null plasmid pcDNA-Vector and the overexpression plasmid pcDNA-ABHD11-AS1 were transfected into human gastric cancer cell lines MKN45 and MGC803 with low ABHD11-AS1 expression, and the changes in cell proliferation, colony formation, migration and invasion were examined using CCK-8 assay, colony formation assay and Transwell assay. Glucose uptake and lactate production of the cells were detected to assess the changes in glycolytic activity. The LncMAP database was used to identify potential transcription factors regulated by ABHD11-AS1, and the candidate transcription factor was determined by literature review, and the result was verified using Western blotting.RESULTS:Transfection with pcDNA-ABHD11-AS1 significantly increased ABHD11-AS1 expression in MGC803 and MKN45 cells, which exhibited obviously accelerated cell proliferation (P<0.05), increased colony formation rate and enhanced cell migration and invasion abilities (P<0.01). ABHD11-AS1 overexpression obviously promoted glycolysis in MGC803 and MKN45 cells (P<0.05). Analysis of the database suggested that ABHD11-AS1 may regulate the classical glycolysis-related gene c-Myc in gastric cancer cells. Western blotting demonstrated that the expression of c-Myc increased significantly after upregulating ABHD11-AS1 in gastric cancer cells.CONCLUSION:ABHD11-AS1 promotes glycolysis in gastric cancer cells by upregulating c-Myc to accelerate gastric cancer progression.

Objective:To compare the role and efficacy of serum Helicobacter pylori ( HP) antibody combined with pepsinogen (PG) (ABC method), serum PG combined with gastrin-17 (G-17) (new ABC method) and a new gastric cancer screening scoring system for early gastric cancer screening in healthy people. Methods:Serological examinations were performed on healthy people who underwent physical examination and gastroscopy at the Physical Examination Center of Shanghai Songjiang District Central Hospital from January 2019 to December 2021. The population were divided into low-risk population, medium-risk population and high-risk population based on the above three primary screening methods for gastric cancer. Using gastroscopy and biopsy pathology as the gold standard, the ratio of each risk stratification and the detection rate of gastric cancer of the three screening methods were calculated. Advantages and disadvantages of the three methods were evaluated.Results:A total of 3 199 people who completed physical examination and gastroscopy were included in the study. Ten cases (0.31%) of esophageal cancer were detected by endoscopy, all of whom were early esophageal cancer. Thirty-seven cases (1.16%) of gastric cancer were detected,and the detection rate of early gastric cancer was 86.49%(32/37). The three gastric cancer screening methods were used to evaluate the risk of gastric cancer. According to ABC method, there were 1 853 cases (7.92%) in the low-risk group, 1 339 cases (41.86%) in the medium-risk group, and 7 cases (0.22%) in the high-risk group. The detection rates of gastric cancer were 0.97% (18/1 853), 1.42% (19/1 339), and 0.00%, respectively. According to the new ABC method, there were 2 362 cases (73.84%) in the low-risk group, 804 cases (25.13%) in the medium-risk group, and 33 cases (1.03%) in the high-risk group. The detection rates of gastric cancer were 1.14% (27/2 362), 1.24% (10/804), and 0.00%, respectively. According to the new gastric cancer screening scoring system, there were 1 448 cases (45.26%) in the low-risk group, 1 213 cases (37.92%) in the medium-risk group and 538 cases (16.82%) in the high-risk group. The detection rates of gastric cancer were 0.28% (4/1 448), 1.32% (16/1 213) and 3.16% (17/538), respectively. The detection rate of gastric cancer in the medium- and high-risk groups in total was significantly higher than that in the low-risk group with significant difference ( χ 2=17.935, P<0.001). The ROC curve showed that the AUC of the ABC method, the new ABC method and the new gastric cancer screening scoring system were 0.546, 0.503 and 0.760, respectively. The AUC of the new gastric cancer screening scoring system was significantly higher than those of the ABC method and the new ABC method, and the differences were statistically significant ( P<0.001). Conclusion:The detection rate of gastric cancer in the medium- and high-risk groups of the new gastric cancer screening scoring system is higher than that of the low-risk group, and the missed diagnosis rate of the new gastric cancer screening scoring system is lower than those of the ABC method and the new ABC method. The screening score is of high value for early gastric cancer screening in the healthy population.

BACKGROUND A large percentage of patients with ectopic pancreas are asymptomatic. When present, the symptoms are typically non-specific. These lesions are predominantly located in the stomach and benign in nature. Synchronous multiple early gastric cancer（SMEGC）（two or more simultaneous malignant lesions with early gastric cancer） is relatively rare and particularly easy to overlook during endoscopic examination. The prognosis of SMEGC is generally poor. We report a rare case of ectopic pancreas with concomitant SMEGC.CASE SUMMARY A 74-year-old woman presented with paroxysmal upper abdominal pain. On initial investigations, she tested positive for Helicobacter pylori（H. pylori）. She underwent esophagogastroduodenoscopy which revealed a 1.5 cm × 2 cm major lesion at the greater curvature and a 1 cm minor lesion at the lesser curvature of the stomach. On endoscopic ultrasound, the major lesion showed hypoechoic changes, uneven internal echoes and unclear boundaries between some areas and the muscularis propria. Endoscopic submucosal dissection was performed to excise the minor lesion. A laparoscopic resection was chosen for the major lesion. On histopathological examination, the major lesion contained high grade intraepithelial neoplasia with a small focus of cancer. A separate underlying ectopic pancreas was found under this lesion. The minor lesion contained high grade intraepithelial neoplasia. In this case, the patient was diagnosed with SMEGC with concomitant ectopic pancreas in the stomach.CONCLUSION Patients with atrophy, H. pylori, and other risk factors should be carefully investigated to avoid missing other lesions including SMEGC and ectopic pancreas.

Immunoglobulin G4-related disease (IgG4-RD) is a fibrous inflammatory process related to immunomodulation. The involvement of the pancreato-biliary tract, retroperitoneum/aorta, head and neck, and salivary glands are the most frequently observed disease phenotypes, differing in their epidemiological features, serological findings, and prognostic outcomes. IgG4-RD was combined with oesophageal ulcers, and the patients were infected with cytomegalovirus at the time of the examination. This constituted a huge challenge in the diagnosis and treatment of oesophageal ulcers. We report the case of a 53-year-old male who experienced nausea, vomiting, and anaemia recurrently for many years. According to his medical records, an upper gastrointestinal endoscopy revealed an oesophageal ulcer, and he had had numerous hospital visits for anaemia but with no definitive diagnosis, and he had responded poorly to therapy. However, with persistent symptoms, he came to our hospital and, according to the results of the upper gastrointestinal endoscopy, a serum IgG4 test, and histopathological and immunohistochemical staining, he was finally diagnosed with IgG4-related oesophageal disease combined with a cytomegalovirus infection. We hope that through this case, we can learn more about IgG4-RD and, at the same time, give clinicians a better understanding of IgG4-RD combined with oesophageal ulceration, a new understanding of cytomegalovirus infections, and improved clinical knowledge.

OBJECTIVE:This study aimed to evaluate the resistance of Helicobacter pylori (H. pylori) to common antibiotics in Shanghai. METHODS:A total of 1171 eligible subjects participated in the study. Antibiotic susceptibility to six common antibiotics was examined with the disk diffusion method. Mutations in resistant-related genes were identified via Sanger sequencing analysis. RESULTS:Overall, the resistance rates of strains to amoxicillin, clarithromycin, levofloxacin, metronidazole, tetracycline, and furazolidone were 0.1%, 27.8%, 31.1%, 79.9%, 0.1%, and 0.5%, respectively. Compared with untreated patients, resistance rates of clarithromycin (P < 0.01), levofloxacin (P < 0.01), and metronidazole were significantly higher in re-treated patients (P < 0.05). The total multiple resistance rate was 40.5%. Age (levofloxacin), gender (clarithromycin, levofloxacin, and metronidazole) and endoscopic findings (clarithromycin and levofloxacin) were independent factors influencing antibiotic resistance. High correlation was observed between the drug susceptibility test and molecular test for the resistance to clarithromycin and levofloxacin. CONCLUSIONS:The resistance rates of H. pylori to amoxicillin, tetracycline, and furazolidone were low, whereas the resistance rates of H. pylori to clarithromycin, levofloxacin, and metronidazole were high, especially in re-treated patients. Our results indicate that the clinical resistance patterns of clarithromycin and levofloxacin could be guided by relevant gene mutations.

背景:"牵手型"胃癌是一种罕见的胃癌亚型,目前对该型胃癌的认知仍欠缺.目的:探讨"牵手型"早期胃癌的临床、内镜和病理特征.方法:连续收集2016年1月—2021年12月在上海交通大学医学院附属松江医院诊断为"牵手型"早期胃癌的病例,采集病史资料进行回顾性分析.同时对病理标本行免疫组化染色,并电话随访预后情况.结果:共14例符合筛选条件的"牵手型"早期胃癌患者纳入研究,其中男性9例,女性5例,平均年龄65.9岁.患者均无胃癌家族史,临床症状无特异性,幽门螺杆菌(Hp)感染均阳性.病灶主要位于胃中、下1/3,内镜下病灶背景黏膜均有萎缩,多为中重度萎缩.病灶大体形态浅表凹陷型(0-Ⅱc)11例,浅表平坦型(0-Ⅱb+Ⅱc)3例,色泽均发红,10例病灶边界不清晰.10例患者行内镜黏膜下剥离术,4例行外科手术治疗,均实现完全切除.病理结果黏膜下癌3例,黏膜内癌11例.免疫组化染色显示多数患者为混合型免疫表型,同时存在胃型标志物MUC5AC、MUC6和肠型标志物MUC2、CD10、CDX-2阳性,Ki-67指数多在30％～70％之间.术后平均随访38个月,所有患者均存活,2例在内镜随访中发现异时性早期胃癌.结论:对于Hp阳性、内镜下萎缩性胃炎背景的浅表凹陷型或浅表平坦型发红病灶,应考虑"牵手型"早期胃癌可能.对于此类患者,术前应充分评估病变范围和浸润深度,以指导手术方案的选择,术后应重视内镜随访.

INTRODUCTION: Although the 9-minute mean withdrawal time (m-WT) is often reported to be associated with the optimal adenoma detection rate (ADR), no randomized trials of screening colonoscopy have confirmed the impact of a 9-minute m-WT on adenoma miss rate (AMR) and ADR. METHODS: A multicenter tandem trial was conducted in 11 centers. Seven hundred thirty-three asymptomatic participants were randomized to receive segmental tandem screening colonoscopy with a 9-minute withdrawal, followed by a 6-minute withdrawal (9-minute-first group, 9MF, n = 366) or vice versa (6-minute-first group, 6MF, n = 367). The primary outcome was the lesion-level AMR. RESULTS: The intention-to-treat analysis revealed that 9MF significantly reduced the lesion-level (14.5% vs 36.6%, P < 0.001) and participant-level AMR (10.9% vs 25.9%, P < 0.001), advanced adenoma miss rate (AAMR, 5.3% vs 46.9%, P = 0.002), multiple adenomas miss rate (20.7% vs 56.5%, P = 0.01), and high-risk adenomas miss rate (14.6% vs 39.5%, P = 0.01) of 6MF without compromising detection efficiency (P = 0.79). In addition, a lower false-negative rate for adenomas (P = 0.002) and high-risk adenomas (P < 0.05), and a lower rate of shortening surveillance schedule (P < 0.001) were also found in 9MF, accompanying with an improved ADR in the 9-minute vs 6-minute m-WT (42.3% vs 33.5%, P = 0.02). The independent inverse association between m-WT and AMR remained significant even after adjusting ADR, and meanwhile, 9-minute m-WT was identified as an independent protector for AMR and AAMR. DISCUSSION: In addition to increasing ADR, 9-minute m-WT also significantly reduces the AMR and AAMR of screening colonoscopy without compromising detection efficiency.

目的 对上海市松江区14264例大肠癌筛查阳性并完成全结肠镜检查患者进行回顾性分析,为进一步完善大肠癌筛查流程及提高筛查效率提供依据.方法 2015年1月-2018年12月大肠癌筛查阳性并在松江区中心医院内镜中心完成全结肠镜检查的14264例患者纳入研究,统计受检者的年龄、性别、病变检出情况、病变部位,并分析结直肠肿瘤检出率与年龄、性别的关系,根据初筛结果比较不同筛查方法结直肠肿瘤检出率的情况.结果14264例受检者中,男性7315例,女性6949例,共检出结直肠息肉6303例(43.9％),其中腺瘤性息

Background The current consensus regarding gastric cancer screening in China recommends Li’s Scoring System to assess the risk of gastric cancer. Objectives To compare the predictive capacity of three prediction rules: the ABC method, the Scoring System from the Japan Public Health Center (JPHC), and Li’s Scoring System in Chinese health examination populations. Methods We retrospectively evaluated 1,436 patients undergoing gastroscopy. The patients were classified into three groups (low, medium and high risk) according to each rule. The predictive capacity of three rules to assess the risk of gastric cancer was compared. Results A total of 28 (1.95%) cases with gastric cancer were detected. The Scoring System from JPHC and Li’s Scoring System performed similarly, and the areas under the receiver-operating characteristic (ROC) curves (AUC) were 0.745 (95%CI: 0.722–0.767), and 0.739 (95%CI: 0.715–0.761), respectively. And the AUC for the ABC method was 0.642 (95%CI: 0.617–0.667), significantly lower than that for the Scoring System from JPHC ( p < 0.05).Li’s Scoring System had the highest sensitivity, significantly higher than that of the Scoring System from JPHC (85.71% vs 53.57%, p <0.05). Larger proportions of low-risk patients were diagnosed as gastric cancer by the Scoring System from JPHC (1.99%) and ABC method (0.99%) than by Li’s Scoring System (0.55%). Conclusions The Scoring System from JPHC and Li’s Scoring System have a similar performance in assessing the risk of gastric cancer, but Li’s Scoring System is more effective in Chinese health examination populations because of the lowest probability of missed diagnosis.

目的 总结分析结直肠息肉癌变的临床、内镜及组织学特点.方法 2017年1月—2019年12月共3934例患者在上海市松江区中心医院经内镜诊断为结直肠息肉并行内镜下切除治疗,其中117例术后病理证实存在息肉癌变,对其临床资料进行回顾性分析.结果 117例结直肠息肉癌变患者中男性71例,女性46例;年龄29～86岁,平均(62.7±10.9)岁;行内镜下黏膜剥离术(ESD)16例,内镜下黏膜切除术(EMR)101例;术后大体病理类型为高级别上皮内瘤变89例,腺癌28例;所有病灶均顺利切除,无大出血、感染及穿孔等严重并发症;术后追加手术13例,随访时间为3～43个月,平均(23.9±10.5)个月,术后出现膀胱癌1例,肺癌1例,并已行手术治疗,目前患者全部存活.单因素分析结果显示:术前病理类型、息肉部位、大小、大体形态均与结直肠息肉癌变相关(P<0.05);而性别,年龄与息肉癌变无明显相关(P>0.05).结论 结直肠息肉癌变与息肉部位、大小、大体形态和病理类型相关,其临床和病理特点有迹可循,及早干预癌变结直肠息肉有利于改善患者预后.

Objective:To explore the efficiency of a new scoring system of gastric cancer screening for early gastric cancer in health examination population.Methods:The risk score of gastric cancer was assessed based on the new scoring system in health examination population. A notice for further gastroscopy was sent to the medium-risk and high-risk people. Gastroscopy was performed on those who agreed to undergo the examination.Results:From January to April 2019, a total of 5 357 people in health system visited the Physical Examination Center of Shanghai Songjiang Clinical Medical College of Nanjing Medical University for health examination. Seven hundred and forty people were classified as medium- and high-risk groups by the new screening system, 576 in medium-risk group, and 164 in high-risk group. Among them, 131 cases (17.70%) came for further gastroscopy, of whom 91 (69.47%) were in the medium-risk group and 40 (30.53%) in the high-risk group. After gastroscopy, 4 cases of gastric cancer and 1 case of esophageal cancer were detected, and both were early cancer. In the medium-risk group, 2 cases (2/91, 2.20%) of early gastric cancer and 1 case (1/91, 1.10%) of early esophageal cancer were found. In the high-risk group, 2 cases (2/40, 5.00%)of early gastric cancer were found. The tumor detection rate of high-risk group (5.00%) was higher than that of medium-risk group (3.30%), but there was no significant difference ( P>0.05). Conclusion:Risk stratification with the new scoring system of gastric cancer screening can improve the detection rate of early gastric cancer.

Helicobacter pylori antibiotic resistance is a serious concern in China, where it severely influences treatment for H. pylori infection. To overcome this, it is essential to apply personalized therapies based on local or individual data on antibiotic-resistant phenotypes or genotypes. We conducted a large-scale multi-center study with a retrospective cross-sectional observational design to investigate the antibiotic-resistant phenotypes and genotypes of H. pylori in China. Strains were isolated from the gastric biopsy samples of H. pylori-infected patients from five different regions in China. The strains were tested for antibiotic-resistant phenotypes and genotypes, and the agreement between the two was assessed. In total, 4242 H. pylori strains were isolated and cultured, with an 84.43% success rate. The primary and secondary antibiotic resistance rates of H. pylori were 37.00% and 76.93% for clarithromycin, 34.21% and 61.58% for levofloxacin, 2.20% and 6.12% for amoxicillin, 1.61% and 3.11% for furazolidone, 1.18% and 3.31% for tetracycline, and 87.87% and 93.48% for metronidazole, respectively. The dual-resistance patterns for metronidazole/clarithromycin, metronidazole/levofloxacin, and clarithromycin/levofloxacin were 43.6%, 38.4%, and 26.1%, respectively. Clarithromycin- and levofloxacin-resistant H. pylori phenotypes and genotypes showed satisfactory agreement. Based on these findings, clarithromycin- and levofloxacin-resistant genotype testing could partially replace traditional antibiotic susceptibility testing in China. Continuous monitoring and personalized treatments based on individual and local H. pylori antibiotic-resistance data remain necessary.

Objective:To investigate the clinical, endoscopic and pathological characteristics of synchronous multiple early gastric cancer (SMEGC), and to reduce the rate of missed diagnosis.Methods:Clinical data of 227 early gastric cancer patients treated by endoscopic submucosal dissection (ESD) and/or surgery in Songjiang Hospital, Shanghai Jiaotong University School of Medicine from January 2017 to December 2019 were retrospectively analyzed. The differences of clinical, endoscopic and pathological characteristics between solitary early gastric cancer (SEGC) group (200 cases) and SMEGC group (27 cases) were compared. The relevance of endoscopic and pathological features of major and minor lesions of SMEGC was also analyzed.Results:Among the 227 early gastric cancer patients, 27 (11.9%) were SMEGC (58 lesions), of which 25 cases were detected preoperatively, and 2 cases were reexamined within 6 months after surgery with another lesion found at a different site from the previous lesion. In the SMEGC group, the percentages of male and atrophy and intestinal metaplasia in surrounding mucosa were significantly higher than those of the SEGC group [85.2% (23/27) VS 61.5% (123/200), χ2=5.815, P=0.016; 96.3% (26/27) VS 81.0% (162/200), χ2=3.912, P=0.048]. The mean age of the SMEGC group was significantly higher than that of the SEGC group (68.7±6.7 years VS 63.8±9.8 years, t=-2.561, P=0.011). The correlation analysis showed a significant correlation between the major and minor lesions of SMEGC in the size of lesion ( r=0.640, P<0.001), vertical location ( r=0.518, P=0.006), macroscopic type ( r=0.904, P<0.001) and depth of invasion ( r=0.470, P=0.013). Conclusion:SMEGC is prevalent in elderly males with atrophic gastritis and intestinal metaplasia. It is necessary to be alert to the possibility of multiple cancer lesions, if an early cancer lesion is found under endoscopy, especially those that may have the same or similar shape and invasion depth in the same vertical distribution range.

背景:胃癌预后较差与确诊时多处于中晚期相关,因此早期筛查对于降低胃癌死亡率至关重要.目的:比较日本胃癌筛查评分和新型胃癌筛查评分对早期胃癌及其癌前病变的筛查作用.方法:纳入2016年1月—2018年12月上海某社区居民.入选者接受胃镜检查、行日本胃癌筛查评分和新型胃癌筛查评分,采用ROC曲线评估两种评分方法对胃癌及其癌前病变的筛查价值.结果:共纳入292例受试者,检出胃癌2例(0.7％),癌前病变9例(3.1％).根据日本胃癌筛查评分,低危、中危、高危组分别为263例(90.1％)、27例(9.2％)、2例(0.7％);根据新型胃癌筛查评分,低危、中危、高危组分别为214例(73.3％)、75例(25.7％)、3例(1.0％).两种评分的高危、中危组胃癌及其癌前病变检出率均明显高于低危组(17.2％ 对2.3％,P=0.000;10.3％ 对1.4％,P=0.000).两种评分方法具有中度一致性(κ=0.561,P=0.011).日本胃癌筛查评分筛查胃癌及其癌前病变的敏感性和特异性分别为0.455和0.915,新型胃癌筛查评分分别为0.727和0.751.结论:两种胃癌筛查评分方法具有中度一致性.新型胃癌筛查评分对胃癌及其癌前病变的筛查价值较高,高危组胃癌及其癌前病变的检出率明显高于低危组.

Emerging evidence has revealed that dysregulation of lncRNA is associated with the initiation and progression of cancer. However, the function of these lncRNAs in cancer remains largely unexplored. Here, we reported that AFDN‐DT, an lncRNA that is repressed in gastric cancers (GC), functions as a tumour suppressor by inhibiting cell growth and metastasis through transcriptional repression of genes involved in metastasis. Using in vitro and in vivo models, we demonstrated that overexpression of AFDN‐DT inhibited the proliferation and metastasis of GC. We found that AFDN‐DT was located at the nucleus and interacted with the chromatin in gastric cells. Further, ChIRP‐seq experiments and RNA‐seq analysis revealed that AFDN‐DT directly bound to the promoter regions and regulated the expression of genes essential for malignant transformation. Moreover, we demonstrated that DNA hypermethylation could repress AFDN‐DT expression and treatment with DNA methylation inhibitors restored its expression. Collectively, the results of our study demonstrated the tumour suppressive role of AFDN‐DT in GC and elucidated the transcription regulatory role of tumour suppressive lncRNAs, which can serve as potential prognostic markers for GC.

目的 研究胃镜检查前通过宣教等措施阻止患者吞咽唾沫对上消化道黏膜可见度的影响.方法 采用前瞻性、随机、单盲、对照临床研究方法 ,对研究组和对照组共400例患者进行普通胃镜检查,比较研究组和对照组上消化道黏膜可见度评分.结果 研究组黏膜可见度总评分明显高于对照组(P<0.01);研究组在上消化道各部位黏膜可见度评分均大于对照组(P<0.05);研究组在消化道各部位黏膜可见度评分≥3分的患者所占比率明显高于对照组(P<0.05).结论 胃镜检查前宣教和干预阻止患者吞咽唾沫能提高上消化道黏膜可见度.

Previous studies revealed that caspase recruitment domain protein 9 (CARD9) was involved in severe acute pancreatitis (SAP) inflammation and that interfering with its expression in vivo could inhibit inflammation. However, the specific mechanism is unknown. This study aimed to discover the related signal pathways of CARD9 in macrophages. SiRNA interference technology was used in vivo and in vitro to detect CARD9‐related signal pathways in peritoneal macrophages. Furthermore, Toll‐like receptor 4 (TLR4) and membrane‐associated C‐type lectin‐1 (Dectin‐1) pathways in macrophages were activated specially to looking for the upstream signal path of CARD9. Results showed up‐regulation of CARD9 expression in peritoneal macrophages of SAP rats (P < .05). CARD9 siRNA alleviated inflammatory cytokines, and inhibited the phosphorylation of NF‐κB and p38MAPK in peritoneal macrophages in vivo or in vitro. Meanwhile, CARD9 siRNA reduced the concentration of CARD9 and Bcl10 in peritoneal macrophages, and TLR4 and Dectin‐1 took part in CARD9 signal pathways in macrophages. In conclusion, there is an inflammation signal pathway comprised of TLR4/Dectin‐1‐CARD9‐NF‐κB/p38MAPK activated in macrophages in SAP. Blockade of CARD9 expression in macrophages can effectively alleviate SAP inflammation.

目的 分析近5年我院早期胃癌检出率,总结提高早期胃癌检出率的措施.方法 回顾性分析2014年1月至2018年9月我院胃癌患者资料,统计经手术或内镜黏膜下剥离术(endoscopic submucosal dissection,ESD)后病理证实的早期胃癌例数,对胃镜活检病理为上皮内肿瘤的患者召回行胃镜检查,分析此举措能否提高早期胃癌检出率.结果 我院2014年1月至2018年9月共完成胃镜检查77 658例次,共发现胃癌738例,胃癌发现率为0.95％;其中355例胃癌患者在我院行外科手术或ESD,病理证实为早期胃癌者148例,早期胃癌占我院治疗胃癌数量的41.69％.已随访外院治疗胃癌172例,其中病理证实为早期胃癌者22例;早期胃癌总例数为170例,总的早期胃癌检出率为23.04％.2017年至2018年异常病理患者570例,电话随访后,257例召回完成胃镜精查,精查率为45.09％,精查后发现早期胃癌67例;总早期胃癌的检出率为31.48％;2014年至2016年异常病理患者412例,86例召回完成胃镜精查,精查率为20.87％,精查后发现早期胃癌33例,总早期胃癌检出率为16.43％.2017年至2018年的早期胃癌检出率明显高于2014年至2016年(x2=23.24,P=0.001).不确定的上皮内肿瘤患者中有97例完成胃镜精查,发现早期胃癌7例,占7.22％;低级别上皮内肿瘤患者中,有211例完成胃镜精查,发现早期胃癌61例,占28.91％;高级别上皮内肿瘤患者中35例完成胃镜精查,确诊早期胃癌32例,占91.43％.结论 对活检病理检查为不确定的上皮内肿瘤及上皮内肿瘤者由专人负责电话随访召回,进行胃镜精查能明显提高早期胃癌的检出率,减少漏诊,是提高早期胃癌检出率的有效措施.