BACKGROUND:Periampullary diverticulum (PAD) is a common anatomical variant, but its association with post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) remains controversial. While PAD may alter ampullary anatomy, increasing technical difficulty during ERCP, existing studies report inconsistent findings on its role in PEP pathogenesis. We hypothesize that PAD presence, particularly type B, shows a significant association with PEP development and may interact with procedural factors like pancreatic duct guidewire insertion. AIM:To examine the association between PAD (including subtypes A/B) and PEP incidence after ERCP for choledocholithiasis. METHODS:We conducted a retrospective cohort study of 615 patients undergoing ERCP at two tertiary hospitals from 2023 to 2025. Participants were stratified into PAD (n = 183; subtype A = 125, subtype B = 58) and non-PAD (n = 432) groups. The primary outcome was PEP incidence. Multivariable logistic regression adjusted for age, sex, hypertension, diabetes, gallbladder surgery, and guidewire insertion. Statistical significance was set at P < 0.05 (two-tailed). RESULTS:PAD prevalence was 29.8% (183/615). PEP occurrence was more frequent in PAD patients [15.3% (28/183)] than in non-PAD patients [4.2% (18/432)], odds ratio (OR) = 3.86, 95% confidence interval: 2.03-7.35, P < 0.001. Type B PAD showed a stronger association with PEP than type A (OR = 14.16, 95% confidence interval: 5.84-34.34, P < 0.001). Guidewire pancreatic duct entry was linked to higher PEP odds in PAD patients (adjusted OR = 5.02, P < 0.05). Hypertension also demonstrated an association with PEP in the PAD subgroup (P = 0.012). CONCLUSION:PAD, particularly type B, is independently associated with PEP after ERCP. Patients with these features, especially those with hypertension or pancreatic duct instrumentation, may benefit from enhanced monitoring and prophylaxis.

Acute pancreatitis (AP) have been documented to have severe impact on pancreatic function. Frequent incidence of AP can result in chronic pancreatitis and thereby it can increase the probability of pancreatic cancers. This study intended to examine the effect of selenium nanoparticles (Se-NPs) synthesized from Coleus forskohlii leaf extract on pancreatic function and AP in rat. Primarily, Se-NPs was fabricated using the C. forskohlii leaf extract. The synthesized nanomaterial was characterized through UV-visible, XRD, and FTIR spectroscopies. Notably, the zeta potential of Se-NPs was found to be -32.8 mV with a polydispersity index (PDI) of 0.18. Morphological analysis on SEM unveiled the spherical shape of Se-NP with an average particle size of 12.69 nm. Strikingly, cytotoxicity analysis on pancreatic cancer and normal cells unveiled the concentration-dependent toxicity profile. However, IC50 value is lower in normal pancreatic cell lines in comparison to pancreatic cancer cells lines. Assessment of Se-NPs on AP rats revealed the positive impact of Se-NPs. It effectively decreased the amount of lipase, amylase, IL-1 beta, MDA, NO, and Bcl-2 while increased the glucose, insulin, HOMA-beta and antioxidant potential in AP rats. In addition, an evaluation of Se-NPs in the pancreatic functions revealed the non-harmful effect of Se-NPs.

Over the last few decades, gut microbiota research has been the focus of intense research and this field has become particularly important. This research aimed to provide a quantitative evaluation of the 100 most-cited articles on gut microbiota and IBS and highlight the most important advances in this field.The database Web of Science Core Collection was used to download the bibliometric information the top 100 most-cited papers. Microsoft Excel 2021, CiteSpace, VOSviewer, R software, and an online analytical platform ( https://bibliometric.com/ ) were was applied to perform bibliometric analysis of these papers.The total citation frequency in the top 100 article ranged from 274 to 2324, with an average citation of 556.57. A total of 24 countries/regions made contributions to the top 100 cited papers, and USA, Ireland, and China were the most top three productive countries. Cryan JF was the most frequently nominated author, and of the top 100 articles, 20 listed his name. Top-cited papers mainly came from the Gastroenterology (n = 13, citations = 6373) and Gut (n = 9, citations = 3903). There was a significant citation path, indicating publications in molecular/biology/immunology primarily cited journals in molecular/biology/genetics fields. Keywords analysis suggested that the main topics on gut microbiota and IBS were mechanisms of microbiome in brain-gut axis." Behavior" was the keyword with the strongest burst strength (2.36), followed by "anxiety like behavior" (2.24), "intestinal microbiota" (2.19), and "chain fatty acid" (1.99), and "maternal separation" (1.95).This study identified and provided the bibliometric information of the top 100 cited publications related to gut microbiota and IBS. The results provided a general overview of this topic and might help researchers to better understand the evolution, Influential findings and hotspots in researching gut microbiota and IBS, thus providing new perspectives and novel research ideas in this specific area.

目的:探索内镜下球囊扩张术联合胆道细胞刷检应用于胆管癌的诊断价值。方法:单中心前瞻性研究，本研究在华中科技大学同济医学院附属武汉市中心医院进行，总结2018年1月-2020年1月期间影像学(CT或MRI)提示胆管恶性狭窄可能或原因不明胆管狭窄并同意行内镜逆行胰胆管造影诊治的患者的临床资料及随访情况。所纳入研究患者均行内镜下胆管狭窄球囊扩张术，并于球囊扩张前后分别进行细胞刷检术，扩张前留取病理组织为对照组样本，扩张后留取病理组织为试验组样本。试验组、对照组样本经同一名病理专业副主任医师阅片后提出病理诊断意见。若有癌细胞或显著异型细胞发现提示刷检阳性。若未见癌细胞或异型细胞则提示刷检阴性。阴性患者中结合临床仍高度考虑胆管癌且同意手术，术后大体标本证实为恶性的考虑刷检假阴性；难以判断胆管癌患者经随访2个月有进展考虑刷检假阴性。2个月随访无进展，暂考虑胆管良性狭窄可能。应用优势性检验(McNemar检验)分析试验组与对照组之间是否存在差异。结果:共纳入符合条件的研究病例39例，男性26例，女性13例，年龄(68.0±5.2)岁。经细胞学检测、手术病理及临床随访最终明确诊断胆管癌35例。对照组刷检阳性17例，细胞刷检敏感率48.6%(17/35)，试验组刷检阳性26例，细胞刷检敏感率74.2%(26/35)。另外有2例患者对照组刷检阳性，试验组刷检阴性。合计对照组及试验组刷检阳性共28例，细胞刷检敏感率80.0%(28/35)，两组比较差异有统计学意义( P<0.05)。 结论:内镜下球囊扩张术联合细胞刷检可提高胆管癌的病理诊断灵敏度，球囊扩张前后分别进行细胞刷检可提高诊断灵敏度。

Tight junction dysregulation and epithelial damage contribute to intestinal barrier loss in patients with acute liver failure (ALF); however, the regulatory mechanisms of these processes remain poorly understood. The aim of the present study was to investigate the changes of intestinal tight junction and intestinal mucosa in mice with ALF and their mechanisms. In the present study, ALF was induced in mice through an intraperitoneal injection of D-galactosamine and lipopolysaccharide (D-GalN/LPS), and the morphological changes of the liver or small intestine were analyzed using hematoxylin and eosin staining, scanning electron microscopy (SEM) and transmission electron microscopy (TEM). The intestinal tissues and isolated serum were analyzed using western blotting, immunofluorescence staining and ELISA. D-GalN/LPS-induced mice exhibited signs of hepatocyte necrosis, alongside inflammatory cell infiltration into the liver tissue and partial microvilli detachment in the small intestinal mucosa. TEM demonstrated that the intestinal epithelial tight junctions were impaired, whereas SEM micrographs revealed the presence of abnormal microvilli in D-GalN/LPS-induced mice. In addition, the expression levels of phosphorylated (p)-myosin light chain (MLC), MLC kinase (MLCK) and Rho-associated kinase (ROCK) were significantly increased in the D-GalN/LPS-induced mice compared with those in the control mice, whereas the subsequent inhibition of MLCK or ROCK significantly reduced p-MLC expression levels. Conversely, the expression levels of occludin and zonula occludens-1 (ZO-1) were significantly decreased in the D-GalN/LPS-induced mice, and the inhibition of MLCK or ROCK significantly increased occludin and ZO-1 protein expression levels compared with those in the control group. Changes in the serum levels of tumor necrosis factor-alpha (TNF-alpha) and interleukin (IL)-6 were similar to the trend observed in p-MLC expression levels. In conclusion, the findings of the present study suggested that in a D-GalN/LPS-induced ALF model, TNF-alpha and IL-6 signaling may increase MLCK and ROCK expression levels, further mediate phosphorylation of MLC, which may result in tight junction dysregulation and intestinal barrier dysfunction.

Objective:To explore the clinical characteristics of Coronavirus Disease (COVID-19) patients with gastrointestinal symptoms.Methods:The clinical data of 164 COVID-19 patients with gastrointestinal symptoms were extracted and analysed retrospectively.Results:In total, 505 COVID-19 patients were divided into two groups: those with gastrointestinal symptoms (G group) and those without gastrointestinal symptoms (NG group). Common gastrointestinal symptoms included inappetence, diarrhoea, nausea, abdominal pain, and vomiting. Significantly higher proportions of patients with fever, dizziness, myalgia, and fatigue were noted in group G than in group NG. Compared with patients without fever, there was a significant difference between G group and NG group in moderate fever or above, while there was no significant difference between the two groups in low fever. The laboratory results showed that patients in the G group had significantly higher C-reactive protein, lactate dehydrogenase, and α-hydroxybutyrate dehydrogenase levels than those in the NG group. Moreover, the proportion of patients with severe pneumonia was significantly higher in the G group than in the NG group.Conclusion:In Wuhan, the proportion of COVID-19 patients who experience gastrointestinal symptoms is relatively high. Patients who experience gastrointestinal symptoms are more likely to suffer from severe pneumonia, which may help clinicians identify patients at high risk of COVID-19 and thus reduce the incidence of this condition.

Objective: This study aimed to investigate the correlation of Helicobacter pylori (Hp) infection with disease risk and severity of colorectal adenoma, also to explore the association of cytotoxin-associated gene A (CagA) positive (CagA + )- Hp infection with gastrin and ki-67 expressions in colorectal adenoma patients. Methods: There were 1000 colorectal adenoma patients and 1500 controls consecutively enrolled, then Hp infection status was determined by 14 C urea breath test and rapid urease test. Also, serum CagA expression and gastrin expression of colorectal adenoma patients were determined by enzyme-linked immunosorbent assay. Ki-67 expression in adenoma tissue of colorectal adenoma patients was assessed using immunohistochemistry. Results: Hp + rate in colorectal adenoma patients (623 (62.3%)) was more elevated than that in controls (814 (54.3%)). Multivariate logistic regression model analysis disclosed that Hp + was an independent risk factor for colorectal adenoma. Additionally, Hp + was positively associated with tumor size and high-grade intraepithelial neoplasia in colorectal adenoma patients. Also, serum gastrin expression and intratumoral ki-67 expression were higher in Hp + CagA + patients and Hp + CagA − patients compared to Hp − patients, and they were also higher in Hp + CagA + patients compared to Hp + CagA − patients. Conclusion: Hp infection positively associates with higher disease risk and worse disease conditions of colorectal adenoma, and CagA enhances the carcinogenicity of Hp in colorectal adenoma.

目的 探讨长链非编码RNA SNHG16 (SNHG16)在胰腺癌中的表达及其功能.方法 采用实时荧光定量PCR (qRT-PCR)法检测SN HG16在46例胰腺癌癌组织和癌旁组织中的表达.采用卡方检验分析其表达水平与临床病理参数的相关性.Kaplan-M eier生存分析比较SNHG16表达水平不同的患者生存率差异.qRT-PCR检测SNHG16在4种胰腺癌细胞系及正常胰腺导管上皮细胞系中的表达.在胰腺癌细胞系AsPC-1中敲低SNHG16表达,采用活细胞计数(CCK-8)和流式细胞术分别测定细胞增殖和凋亡水平,Transw ell实验测定细胞侵袭能力,TOP/FOP闪光荧光素酶报告系统检测Wnt/β-Catenin信号激活状态,蛋白印迹法检测c-myc、β-连环蛋白(β-catenin)和细胞周期蛋白D1 (cyclin D1)的表达.结果 胰腺癌癌组织和细胞系中SNHG16表达显著上调(均P＜0.01).SNHG16高表达与患者肿瘤分化差、晚期TNM分期和淋巴结转移显著相关(均P＜0.05).SNHG16高表达组患者总生存率显著低于SNHG16低表达患者(P=0.003).敲低SNHG16表达可显著抑制胰腺癌细胞增殖和侵袭能力,并促进细胞凋亡.敲低SNHG16表达可抑制Wnt/β-catenin信号通路的激活和c-myc、β-catenin和cyclin D1的表达.结论 胰腺癌组织中SNHG16的表达上调,其表达水平与胰腺癌预后相关,SNHG16可能通过Wnt/β-catenin通路而促进胰腺癌细胞增殖和侵袭,并抑制凋亡,是胰腺癌潜在分子标志物.

Background and Purpose: The role of the cartilage oligomeric matrix protein (COMP) in epithelial-mesenchymal transition (EMT) in tumor progression has been studied, but its exact regulatory mechanism remains unknown. Methods: The interaction between COMP and the actin-binding protein transgelin (TAGLN) was identified by interaction protein prediction and co-immunoprecipitation and verified through the stochastic optical reconstruction microscopy (STORM) and duolink experiments. Western blot and immunofluorescence analyses were conducted to detect the changes in EMT-related markers after COMP overexpression and knockdown. Molecular docking and Biacore of the interaction interface of COMP/TAGLN revealed that Chrysin directly targeted COMP. The promotion of COMP and the Chrysin inhibition of EMT were detected through the cell migration, invasion, apoptosis, and xenotransplantation of nude mice. Results: COMP interacts with TAGLN in EMT in colorectal cancer to regulate cytoskeletal remodeling and promote malignant progression. COMP is highly expressed in highly malignant colorectal cancer and positively correlated with TAGLN expression. COMP knockdown can inhibit colorectal cancer metastasis and invasion, whereas COMP overexpression promotes EMT in colorectal cancer. Through virtual screening of the protein interaction interface, Chrysin, a flavonoid compound extracted from Oroxylum indicum, was found to have the highest docking score to the COMP/TAGLN complex. Chrysin inhibited COMP, thereby preventing EMT and the malignant progression of colorectal cancer. Conclusions: This study illustrated the role of COMP in EMT and suggested that COMP/TAGLN may be a potential tumor therapeutic target. Chrysin exhibits obvious antitumor effects. This work provides a preliminary antitumor therapy to target COMP or its interaction protein to inhibit EMT.

See also: Gut feeling from Wuhan: advice for gastrointestinal endoscopy performed during the COVID-19 outbreakEndoscopy 2020; 52(07): E261-E262DOI: 10.1055/a-1158-9016

a potential therapeutic approach to restore CD39 and immune homeostasis in AIH, as in other chronic inflammatory conditions.

Objective: This study aimed to investigate the correlation of Helicobacter pylori (Hp) infection with disease risk and severity of colorectal adenoma, also to explore the association of cytotoxin-associated gene A (CagA) positive (CagA + )- Hp infection with gastrin and ki-67 expressions in colorectal adenoma patients. Methods: There were 1000 colorectal adenoma patients and 1500 controls consecutively enrolled, then Hp infection status was determined by 14 C urea breath test and rapid urease test. Also, serum CagA expression and gastrin expression of colorectal adenoma patients were determined by enzyme-linked immunosorbent assay. Ki-67 expression in adenoma tissue of colorectal adenoma patients was assessed using immunohistochemistry. Results: Hp + rate in colorectal adenoma patients (623 (62.3%)) was more elevated than that in controls (814 (54.3%)). Multivariate logistic regression model analysis disclosed that Hp + was an independent risk factor for colorectal adenoma. Additionally, Hp + was positively associated with tumor size and high-grade intraepithelial neoplasia in colorectal adenoma patients. Also, serum gastrin expression and intratumoral ki-67 expression were higher in Hp + CagA + patients and Hp + CagA − patients compared to Hp − patients, and they were also higher in Hp + CagA + patients compared to Hp + CagA − patients. Conclusion: Hp infection positively associates with higher disease risk and worse disease conditions of colorectal adenoma, and CagA enhances the carcinogenicity of Hp in colorectal adenoma. Keywords Colorectal adenoma , Helicobacter pylori , cytotoxin-associated gene A , gastrin , ki-67

BACKGROUND Coronavirus disease 2019 (COVID-19) has become a worldwide pandemic. We investigated the clinical characteristics and risk factors for liver injury in COVID-19 patients in Wuhan by retrospectively analyzing the epidemiological, clinical, and laboratory data for 218 COVID-19 patients and identifying the risk factors for liver injury by multivariate analysis. AIM To investigate the clinical characteristics and risk factors for liver injury in COVID-19 patients in Wuhan. METHODS The 218 patients included 94 males (43.1%), aged 22 to 94 (50.1 +/- 18.4) years. Elevated aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were present in 42 (53.2%) and 36 (45.6%) cases, respectively, and 79 (36.2%) patients had abnormally elevated transaminase levels at admission. Patients with liver injury were older than those with normal liver function by a median of 12 years, with a significantly higher frequency of males (68.4%vs28.8%,P< 0.001) and more coexisting illnesses (48.1%vs27.3%,P= 0.002). Significantly more patients had fever and shortness of breath (87.3%vs69.8% and 29.1%vs14.4%, respectively) in the liver injury group. Only 12 (15.2%) patients had elevated total bilirubin. ALT and AST levels were mildly elevated [1-3 x upper limit of normal (ULN)] in 86.1% and 92.9% of cases, respectively. Only two (2.5%) patients had an ALT or AST level > 5 x ULN. Elevated gamma-glutamyl transpeptidase was present in 45 (57.0%) patients, and 86.7% of these had a gamma-glutamyl-transpeptidase level < 135 U/L (3 x ULN). Serum alkaline phosphatase levels were almost normal in all patients. Patients with severe liver injury had a significantly higher frequency of abnormal transaminases than non-severe patients, but only one case had very high levels of aminotransferases. RESULTS Multivariate analysis revealed that male sex, high D-dimer level, and high neutrophil percentage were linked to a higher risk of liver injury. The early stage of COVID-19 may be associated with mildly elevated aminotransferase levels in patients in Wuhan. Male sex and high D-dimer level and neutrophil percentage may be important predictors of liver injury in patients with COVID-19. CONCLUSION Male sex and high D-dimer level and neutrophil percentage may be important predictors of liver injury in patients with COVID-19.

Effects of miR-135a-5p and miR-141 on the biological function of colorectal cancer SW620 cells were investigated. Fifty-four specimens of cancer tissues and 54 specimens of corresponding adjacent tissues in colon cancer patients who were treated in The Central Hospital of Wuhan from March 2014 to March 2015 were collected. RT-PCR was used to detect the expression levels of miR-135a-5p and miR-141 in cancer tissues and adjacent tissues. The miR-135a-5p inhibitor and miR-141 mimic carriers were established. The cell proliferation was detected by CCK8, the invasion ability of cellsin vitrowas evaluated by Transwell chamber, and cell apoptosis of each group was detected by flow cytometry. The results of RT-qPCR showed that expression levels of miR-135a-5p in colorectal cancer tissues were significantly higher than those in adjacent tissues, the expression levels of miR-141 in colorectal cancer tissues were significantly lower than those in adjacent tissues, and the difference was statistically significant (P<0.001). The cell survival rates of the miR-135a-5p inhibitor group and the miR-141 mimic group were significantly lower than those of the NC group and the blank group 48 and 72 h after transfection (P<0.001). The number of invasive cells in the miR-135a-5p inhibitor group and the miR-141 mimic group was significantly lower than that in the blank group and the NC group (P<0.001). Apoptosis rate was significantly higher than that of the NC group and the blank group (P<0.001). In conclusion, low expression levels of miR-135a-5p and miR-141 in colorectal adenomas suggested that miR-135a-5p and miR-141 could act as tumor suppressors in the development of colorectal adenomas; miR-135a-5p and miR-141 inhibited the proliferation and invasion of colon cancer SW620 cells and promoted apoptosis of colon cancer cells.

Objective: This study aimed to investigate the correlation of Helicobacter pylori (Hp) infection with disease risk and severity of colorectal adenoma, also to explore the association of cytotoxin-associated gene A (CagA) positive (CagA + )- Hp infection with gastrin and ki-67 expressions in colorectal adenoma patients. Methods: There were 1000 colorectal adenoma patients and 1500 controls consecutively enrolled, then Hp infection status was determined by 14 C urea breath test and rapid urease test. Also, serum CagA expression and gastrin expression of colorectal adenoma patients were determined by enzyme-linked immunosorbent assay. Ki-67 expression in adenoma tissue of colorectal adenoma patients was assessed using immunohistochemistry. Results: Hp + rate in colorectal adenoma patients (623 (62.3%)) was more elevated than that in controls (814 (54.3%)). Multivariate logistic regression model analysis disclosed that Hp + was an independent risk factor for colorectal adenoma. Additionally, Hp + was positively associated with tumor size and high-grade intraepithelial neoplasia in colorectal adenoma patients. Also, serum gastrin expression and intratumoral ki-67 expression were higher in Hp + CagA + patients and Hp + CagA − patients compared to Hp − patients, and they were also higher in Hp + CagA + patients compared to Hp + CagA − patients. Conclusion: Hp infection positively associates with higher disease risk and worse disease conditions of colorectal adenoma, and CagA enhances the carcinogenicity of Hp in colorectal adenoma.

目的 检测96序列相似的家庭成员A(FAM96A)在人肝癌组织中的表达及其与肝癌生物学特征的关系.方法 采用实时荧光定量聚合酶链反应(Real-time PCR)及Western blot法检测FAM96A蛋白在肝癌组织和癌旁组织、HepG2细胞和L02细胞中的mRNA及蛋白表达量,比较其差异,并分析FAM96A蛋白表达差异与肝癌临床病理特征之间的关系.结果 Real-time PCR检测结果显示,FAM96A在肝癌组织中的mRNA表达低于癌旁组织(t=21.773,P＜0.001),在HepG2细胞中的表达低于L02细胞(t=26.153,P ＜0.001).同时,Western blot检测结果证实:与癌旁组织相比,FAM96A在肝癌组织中的蛋白表达显著降低(t=15.582,P＜0.001),在HepG2细胞中的表达同样低于L02细胞(t=14.478,P＜0.001).且FAM96A蛋白表达差异与本研究中48例肝癌患者肿瘤大小、是否合并门静脉癌栓、是否发生肝外转移、Child分级、巴塞罗那肝癌分期之间存在相关性(P＜0.001),然而与患者的性别、年龄、肿瘤个数、是否合并乙肝、是否合并肝硬化、血清甲胎蛋白无明显相关(P＞0.05).结论 FAM96A在人肝癌组织中表达显著下降,其表达水平与肝癌的发生发展、侵袭转移密切相关.

Background: Gastrointestinal stromal tumor (GIST) is a rare tumor of the small bowel, which can he difficult to diagnose and has a varied clinical outcome. Purpose: This is a retrospective review of the diagnosis, management, and clinical outcome of 32 patients diagnosed with primary small bowel GIST from a single center and a comparison of the findings with previously published cases. Patients and methods: Retrospective review of data from patient clinical records, endoscopic and imaging findings, surgical procedures, tumor h istology and inununohistochemistry, and clinical outcome was conducted. Results: Data of 32 patients with a median age of 56 years including 50%, men and women were reviewed. The majority (29/32) were symptomatic at presentation, with the main symptom being gastrointestinal bleeding (15/32). Imaging detection rates included ultrasound (0%), magnetic resonance imaging (0%), computed tomography (54.8%), computed tomography angiography (71.4%), and double-balloon enteroscopy (88.9%) The mean tumor diameter was 5.3 cm; 4 tumors were located in the duodenum, 21 in the jejunum, and 7 in the ileum. Based on the tumor size and mitotic index, 5 (15.6%), 15 (46.9%), 0 (0%), and 12 (37.5%) patients were classified into very low-risk, low-risk, intennediate-risk, and high-risk groups. Immunohistochemistry showed positive expression for CD117 (100%), LD34 (81.2%), DOG1 (93.8%), smooth muscle actin (37.5%), S100 (9.4%), and desmin (6.2%). Twenty-five patients (78.1%) were treated with open surgical tumor resection; seven patients (21.9%) underwent laparoscopic surgery. Postoperative complications that occurred in seven patients (21.9%) were resolved with conservative management. Four patients were treated with postoperative imatinib. At median follow-up of 30 months, two patients were died. Conclusion: The findings from this case series, combined with the findings from previously published cases, provide an update on the current status of the diagnosis and the therapeutic approaches that might lead to improvement in prognosis for patients who present with primary small bowel GIST.

Objective To investigate the expression difference of chemokine receptor CCR7 in 62 cases of liver cancer and explore the correlation between CCR7 expression and clinical biological characteristics of liver cancer.Methods Real-time PCR, Western blotting and immunohistochemistry were used to examine the expression and distribution of CCR 7 in liver cancer tis-sues and their adjacent tissues,HepG2 cells and L02 cells.Furthermore,the correlation between the expression difference of CCR7 and clinicopathological characteristics of liver cancer was analyzed.Results Immunohistochemistry showed that CCR7 protein was located in cytoplasm.In addition,the positive expression rate of CCR7 in tumor-adjacent tissues and liver tissues was 24.2%(15/62)and 66.1%(41/62),the difference was statistically significant(χ2 =22.013,P<0.05).CCR7 mRNA levels were significantly lower in tumor-adjacent tissues than in liver tissues[(0.512 ± 0.109)vs.(1.591 ± 0.221),t= -34.403,P<0.01]and lower in L02 cells than in HepG2 cells[(0.485 ± 0.106)vs.(1.768 ± 0.281),t= -33.629,P<0.01].While CCR7 protein expression levels were lower in adjacent tissues than in liver tissues and lower in L 02 cells than in HepG2 cells(all P<0.05).Moreover,the expression difference was correlated with tumor size,portal vein tumor thrombosis,Child-Turcotte-Pugh, extrahepatic metastasis,Barcelona Clinic Liver Cancer(BCLC)classification(P<0.05),but not with gender,age,tumor number, hepatitis B virus,cirrhosis of the liver and serum AFP of patients(P>0.05).Conclusion The CCR7 protein expression is sig-nificantly increased in liver cancer tissues as compared with its adjacent normal tissues.Additionally,CCR7 may be a good mark-er to evaluate the development,invasion and metastasis of liver cancer.

Increasing age is a risk factor for the development of colorectal adenomas and advanced adenomas. However, few studies have been published on the features of colorectal polyps in the elderly. The present study aimed to investigate the clinical, enteroscopic and pathological characteristics of colorectal polyps in Chinese elderly patients in a single center (The Central Hospital of Wuhan, Hubei, China). The endoscopic and pathological reports of colonoscopies performed in our center were retrospectively analyzed. A total of 7,795 consecutive patients referred for colonoscopy were evaluated between January 2013 and December 2014. Of the 297 who met the inclusion criteria, 279 polyps were observed in men and 230 in women. Of all the polyps, 263 were non-adenomatous polyps, 104 were non-advanced adenomas and 142 were advanced adenomas. 336 polyps were left-sided and 173 were right-sided. Polyps ≥10 mm were more likely to exhibit an adenomatous component and advanced features, and these findings continued to hold true when the size cut-off was set at 5 mm. The data shown in the present study have revealed that a significant number of polyps lie proximal to the splenic flexure. Thus, evaluation of the whole bowel is particularly important in elderly patients who are undergoing colonoscopy. In addition, the polyp size was associated with the presence of adenoma, and advanced component, diminutive and small polyps should not be ignored in elderly patients.