RBBP7, regulated by SP1, enhances the Warburg effect to facilitate the proliferation of hepatocellular carcinoma cells via PI3K/AKT signaling

BACKGROUND

Hepatocellular carcinoma (HCC) is characterized by aggressive progression and elevated mortality rates. This study aimed to investigate the regulatory effects of RBBP7 on HCC pathogenesis and the underlying mechanisms.

METHODS

The expression and clinical feature of RBBP7 were evaluated using bioinformatics analysis and the assessment of clinical HCC samples. CCK8 and colony formation were employed to estimate cell proliferation function of RBBP7. Aerobic glycolysis levels of RBBP7 were evaluated by measuring ATP levels, lactic acid production, glucose uptake capacity, and the expression of relevant enzymes (PFKM, PKM2, and LDHA). The phosphorylation levels in PI3K/AKT signaling were measured by western blotting. The regulatory effect of transcription factors of specificity protein 1 (SP1) on RBBP7 mRNA expression was confirmed in dual-luciferase reporter assays and chromatin immunoprecipitation experiments. The proliferation- and glycolysis-associated proteins were assessed using immunofluorescence staining in vivo.

RESULTS

We found that RBBP7 is expressed at high levels in HCC and predicts poor survival. Functional assays showed that RBBP7 promoted HCC proliferation and glycolysis. Mechanistically, it was demonstrated that RBBP7 activates the PI3K/AKT pathway, a crucial pathway in glycolysis, contributing to the progression of HCC. The outcomes of the dual-luciferase assay further confirmed that SP1 is capable of activating the promoter of RBBP7.

CONCLUSIONS

RBBP7, which is up-regulated by SP1, promotes HCC cell proliferation and glycolysis through the PI3K/AKT pathway. The findings of this study suggest that RBBP7 is a potential biomarker for HCC.

ScRNA-seq revealed disruption in CD8+ NKG2A+ natural killer T cells in patients after liver transplantation and immunosuppressive therapy

BACKGROUND

Liver transplantation (LT) offers a good survival chance for both the patient in short or long term, but still faces many challenges in the treatment of LT, such as the side effects associated with long-term immunosuppression, which is one of the side effects that occurs in most patients. However, the dynamics of the cellular immune system composition over time during immune tolerance to LT after immunosuppressive therapy are not known.

METHODS

Using single-cell transcriptome sequencing, we analyzed five peripheral blood samples (one normal individual and four patients who underwent LT and received immunosuppressive therapy for 2 months, 1 year, 3 years, and 7 years, respectively) for immune cell composition and gene expression.

RESULTS

A total of 17,462 peripheral blood mononuclear cells were acquired from a normal individual without LT and patients who underwent LT and received immunosuppressive therapy for 2 months, 1 year, 3 years, and 7 years, respectively. A total of 24 cell clusters were obtained and categorized into four different cell types based on gene expression characteristics as follows: eight clusters of T cells, two clusters of B cells, two clusters of neutrophils, two clusters of monocytes, natural killer cells, and natural killer T (NKT) cells (n = 4), and six other cell clusters. Cell subset analysis, pseudotime analysis, and intercellular communication analysis revealed that the CD8+ NKT cells specifically expressed NKG2A (KLRC1, CD159A), which may be an important cell group for CD8+ NKG2A+ NKT cells in LT, thereby highlighting the heterogeneity and functional diversity in patients who undergo LT.

CONCLUSIONS

We comprehensively analyzed single-cell RNA sequencing data from a normal individual and patients who underwent LT and elucidated the mechanism underlying the development of immune tolerance in LT. CD8+ NKT cells specifically expressing KLRC1 play a crucial role in LT, and dynamic monitoring of these cells may provide novel avenues for the diagnosis and treatment of LT-related immune rejection.

Integrative analyses of genes related to liver ischemia reperfusion injury

Background

Liver ischemia reperfusion injury (LIRI) is not only a common injury during liver transplantation and major hepatic surgery, but also one of the primary factors that affect the outcome of postoperative diseases. However, there are still no reliable ways to tackle the problem. Our study aimed to find some characteristic genes associated with immune infiltration that affect LIRI, which can provide some insights for future research in the future. Therefore, it is essential for the treatment of LIRI, the elucidation of the mechanisms of LIRI, and exploring the potential biomarkers. Efficient microarray and bioinformatics analyses can promote the understanding of the molecular mechanisms of disease occurrence and development.

Method

Data from GSE151648 were downloaded from GEO data sets, and we performed a comprehensive analysis of the differential expression, biological functions and interactions of LIRI-associated genes. Then we performed Gene ontology (GO) analysis and Kyotoencydlopedia of genes and genomes (KEGG) enrichment analysis of DEGs. At last, we performed a protein-protein interaction network to screen out hub genes.

Results

A total of 161 differentially expressed genes (DEGs) were identified. GO analysis results revealed that the changes in the modules were mostly enriched in the neutrophil degranulation, neutrophil activation involved in immune response, and neutrophil mediated immunity. KEGG enrichment analysis of DEGs demonstrated that LIRI mainly involved the cytokine-cytokine receptor interaction. Our data indicated that macrophages and neutrophils are closely related to LIRI. 9 hub genes were screened out in the protein-protein interaction network.

Conclusions

In summary, our data indicated that neutrophil degranulation, neutrophil activation involved in immune response, neutrophil mediated immunity and cytokine-cytokine receptor interaction may play a key role in LIRI, HRH1, LRP2, P2RY6, PKD1L1, SLC8A3 and TNFRSF8, which were identified as potential biomarkers in the occurrence and development of LIRI. However, further studies are needed to validate these findings and explore the molecular mechanism of these biomarkers in LIRI.

Thalidomide combined with endoscopy in the treatment of Cronkhite-Canada syndrome: A case report

BACKGROUND

Cronkhite-Canada syndrome (CCS) is a rare non-hereditary disease with a poor prognosis and a mortality rate of up to 55%. Currently, there is no standard treatment for CCS. The department of gastroenterology of our hospital admitted a patient with CCS whose symptoms improved significantly after treatment with thalidomide combined with endoscopy, and there was no obvious adverse reaction during the 2-year follow-up.

CASE SUMMARY

A 47-year-old Chinese man presented with diarrhea for more than 4 mo, accompanied by loss of taste, fatigue, and weight loss. Physical examination demonstrated that the patient’s skin and hands were hyperpigmented, the front edges of the nails of both hands were notably thickened and yellow, and the nails were partially atrophied. Gastrointestinal endoscopy identified a diffuse polypoid bulge, and the patient bore an albumin level of 27.3 g/L. The level of the calcium correction amount was (2.164 mM) which allowed for a comprehensive diagnosis of Cronkhite-Canada syndrome, combined with hypoalbuminemia and hypocalcemia. Thalidomide of 150 mg per day was administered to regulate immunity, and the symptoms were relieved after 1 wk. During the follow-up period, polyps were still found that had not been resolved by thalidomide treatment, and endoscopic therapy was performed. This resulted in further improvement of his condition and no particular discomfort during the 2 years of follow-up.

CONCLUSION

The patient’s symptoms were significantly relieved by thalidomide 2 years after treatment, proposing it as a potential treatment for CCS.

Rare primary rectal mucosa-associated lymphoid tissue lymphoma with curative resection by endoscopic submucosal dissection: A case report and review of literature

BACKGROUND

Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) occurs in approximately 9% of non-Hodgkin B-cell lymphomas. The gastrointestinal tract is the most commonly affected site of the extranodal forms of primary non-Hodgkin’s lymphomas. However, it rarely occurs within the rectum, and at present, there is no consensus on its diagnosis and treatment at this site.

CASE SUMMARY

We report a rare laterally spreading tumour-like rectal MALT lymphoma case in which the diagnosis and the depth of infiltration were determined by magnifying endoscopy and ultrasonic endoscopy. Then, the lesion was en bloc resected by endoscopic submucosal dissection (ESD) alone. The lesion was confirmed as MALT lymphoma by haematoxylin and eosin staining, immunohistochemical staining and gene arrangement analysis. Surveillance exams have indicated a 2-year disease-free survival for this patient.

CONCLUSION

We report a rare primary rectal MALT lymphoma that was curable with resection by ESD. ESD is a safe and effective therapeutic option for rectal MALT lymphoma.

Chinese Consensus Report on Family-Based Helicobacter pylori Infection Control and Management (2021 Edition)

OBJECTIVE

Helicobacter pylori infection is mostly a family-based infectious disease. To facilitate its prevention and management, a national consensus meeting was held to review current evidence and propose strategies for population-wide and family-based H. pylori infection control and management to reduce the related disease burden.

METHODS

Fifty-seven experts from 41 major universities and institutions in 20 provinces/regions of mainland China were invited to review evidence and modify statements using Delphi process and grading of recommendations assessment, development and evaluation system. The consensus level was defined as ≥80% for agreement on the proposed statements.

RESULTS

Experts discussed and modified the original 23 statements on family-based H. pylori infection transmission, control and management, and reached consensus on 16 statements. The final report consists of three parts: (1) H. pylori infection and transmission among family members, (2) prevention and management of H. pylori infection in children and elderly people within households, and (3) strategies for prevention and management of H. pylori infection for family members. In addition to the 'test-and-treat' and 'screen-and-treat' strategies, this consensus also introduced a novel third 'family-based H. pylori infection control and management' strategy to prevent its intrafamilial transmission and development of related diseases.

CONCLUSION

H. pylori is transmissible from person to person, and among family members. A family-based H. pylori prevention and eradication strategy would be a suitable approach to prevent its intra-familial transmission and related diseases. The notion and practice would be beneficial not only for Chinese residents but also valuable as a reference for other highly infected areas.

[A case of high-temperature steel bar penetration injury from scrotum to buttocks]

On November 17, 2013, the Second Affiliated Hospital of Kunming Medical University admitted a 23-year-old male patient with a high-temperature steel bar penetration injury from scrotum to buttocks who was transferred from another hospital. Expanded debridement, suture, and drainage of the perineum, right thigh, and right hip were performed as soon as possible after admission. A sputum suction tube was used as the guide mark for expanded debridement during the operation to ensure the accuracy of the direction and scope of expanded debridement. The incision was treated with vacuum sealing drainage (VSD) and full drainage. On the 20th day after the operation (the 25th day after admission), the unhealed wound was transplanted with split-thickness skin graft from the right thigh, and the drainage of the operation area and dressing change were strengthened. On the 53rd day after injury, the patient was discharged after complete wound healing. This case suggests that VSD after early debridement is an effective means to treat high-temperature steel bar penetration injuries.

[Research advances on autologous hair transplantation in the treatment of secondary cicatricail alopecia]

Secondary cicatricial alopecia (hereinafter referred to as cicatricial alopecia) after burn and trauma affects the aesthetic appearance and even the physical and mental health of patients, and reduces their quality of life and happiness. Autologous hair transplantation provides an idea for the treatment of cicatricial alopecia, which makes the transplanted hair show a natural growth state. This paper introduces the cicatricial alopecia and autologous hair transplantation and reviews the application and limitations of autologous hair transplantation in treating cicatricial alopecia.

Establishment and validation of a computer-assisted colonic polyp localization system based on deep learning

BACKGROUND

Artificial intelligence in colonoscopy is an emerging field, and its application may help colonoscopists improve inspection quality and reduce the rate of missed polyps and adenomas. Several deep learning-based computer-assisted detection (CADe) techniques were established from small single-center datasets, and unrepresentative learning materials might confine their application and generalization in wide practice. Although CADes have been reported to identify polyps in colonoscopic images and videos in real time, their diagnostic performance deserves to be further validated in clinical practice.

AIM

To train and test a CADe based on multicenter high-quality images of polyps and preliminarily validate it in clinical colonoscopies.

METHODS

With high-quality screening and labeling from 55 qualified colonoscopists, a dataset consisting of over 71000 images from 20 centers was used to train and test a deep learning-based CADe. In addition, the real-time diagnostic performance of CADe was tested frame by frame in 47 unaltered full-ranged videos that contained 86 histologically confirmed polyps. Finally, we conducted a self-controlled observational study to validate the diagnostic performance of CADe in real-world colonoscopy with the main outcome measure of polyps per colonoscopy in Changhai Hospital.

RESULTS

The CADe was able to identify polyps in the test dataset with 95.0% sensitivity and 99.1% specificity. For colonoscopy videos, all 86 polyps were detected with 92.2% sensitivity and 93.6% specificity in frame-by-frame analysis. In the prospective validation, the sensitivity of CAD in identifying polyps was 98.4% (185/188). Folds, reflections of light and fecal fluid were the main causes of false positives in both the test dataset and clinical colonoscopies. Colonoscopists can detect more polyps (0.90 vs 0.82, P < 0.001) and adenomas (0.32 vs 0.30, P = 0.045) with the aid of CADe, particularly polyps < 5 mm and flat polyps (0.65 vs 0.57, P < 0.001; 0.74 vs 0.67, P = 0.001, respectively). However, high efficacy is not realized in colonoscopies with inadequate bowel preparation and withdrawal time (P = 0.32; P = 0.16, respectively).

CONCLUSION

CADe is feasible in the clinical setting and might help endoscopists detect more polyps and adenomas, and further confirmation is warranted.

Individualized selection of biological agents in treatment of inflammatory bowel disease

Inflammatory bowel disease (IBD) is a chronic non-specific inflammatory disease that can affect the ileum, colon, rectum, and even the entire digestive tract. In recent 10 years, with the in-depth understanding of its pathological mechanisms, the development of new drugs has been accelerated, and more and more biological agents have begun to be widely used in the treatment of IBD. The emergence of biological agents has significance for the treatment of IBD. This article will discuss how to individualize the selection of biologics from three aspects: The mechanism of action and clinical application of different biological agents, risk weighing, and rescue treatment for failure of anti-TNF therapy.

Awareness and attitude of fecal microbiota transplantation through transendoscopic enteral tubing among inflammatory bowel disease patients

BACKGROUND

Transendoscopic enteral tubing (TET) has been used in China as a novel delivery route for fecal microbiota transplantation (FMT) into the whole colon with a high degree of patient satisfaction among adults.

AIM

To explore the recognition and attitudes of FMT through TET in patients with inflammatory bowel disease (IBD).

METHODS

An anonymous questionnaire, evaluating their awareness and attitudes toward FMT and TET was distributed among IBD patients in two provinces of Eastern and Southwestern China. Question formats included single-choice questions, multiple-choice questions and sorting questions. Patients who had not undergone FMT were mainly investigated for their cognition and acceptance of FMT and TET. Patients who had experience of FMT, the way they underwent FMT and acceptance of TET were the main interest. Then all the patients were asked whether they would recommend FMT and TET. This study also analyzed the preference of FMT delivery in IBD patients and the patient-related factors associated with it.

RESULTS

A total of 620 eligible questionnaires were included in the analysis. The survey showed that 44.6% (228/511) of patients did not know that FMT is a therapeutic option in IBD, and 80.6% (412/511) of them did not know the concept of TET. More than half (63.2%, 323/511) of the participants stated that they would agree to undergo FMT through TET. Of the patients who underwent FMT via TET [62.4% (68/109)], the majority [95.6% (65/68)] of them were satisfied with TET. Patients who had undergone FMT and TET were more likely to recommend FMT than patients who had not (94.5% vs 86.3%, P = 0.018 and 98.5% vs 87.8%, P = 0.017). Patients’ choice for the delivery way of FMT would be affected by the type of disease and whether the patient had the experience of FMT. When compared to patients without experience of FMT, Crohn’s disease and ulcerative colitis patients who had experience of FMT preferred mid-gut TET (P < 0.001) and colonic TET (P < 0.001), respectively.

CONCLUSION

Patients’ experience of FMT through TET lead them to maintain a positive attitude towards FMT. The present findings highlighted the significance of patient education on FMT and TET.

Anaplastic lymphoma kinase-negative anaplastic large cell lymphoma masquerading as Behcet's disease: A case report and review of literature

BACKGROUND

Anaplastic large cell lymphoma (ALCL) is a CD30-positive T cell lymphoma, a rare type of non-Hodgkin lymphoma. The current World Health Organization classification system divides ALCLs into anaplastic lymphoma kinase (ALK)-positive and ALK-negative groups. ALCL rarely presents in the gastrointestinal tract.

CASE SUMMARY

A 54-year-old male was admitted to the department of gastroenterology for abdominal pain. He presented with lower abdominal pain, diarrhea and recurrent oral and penile ulcers. He was misdiagnosed with Behcet's disease and treated with prednisone. But after one month, he was hospitalized in another hospital for reexamination. This time, the lesion on the penis was biopsied for histological examination. The final pathological diagnosis was ALCL, ALK-negative. The patient was treated with cyclophosphamide, doxorubicin, vincristine, prednisolone chemotherapy. However, he died within one month.

CONCLUSION

Gastrointestinal ALCL needs to be considered in the differential diagnosis to avoid delaying treatment. Repeated biopsy is the most important for early diagnosis and treatment.

MicroRNA-30b regulates insulin sensitivity by targeting SERCA2b in non-alcoholic fatty liver disease

BACKGROUND & AIMS

Insulin resistance is strongly associated with non-alcoholic fatty liver disease, a chronic, obesity-related liver disease. Increased endoplasmic reticulum (ER) stress plays an important role in the development of insulin resistance. In this study, we investigated the roles of miRNAs in regulating ER stress in the liver of rats with obesity.

METHODS

We used miRNA microarray to determine the miRNA expression profiles in the liver of rats fed with a high fat diet (HFD). We used prediction algorithms and luciferase reporter assay to identify the target gene of miRNAs. To overexpress the miRNA miR-30b or inhibit miR-30b rats were injected with lentivirus particles containing PGLV3-miR-30b or PGLV3-miR-30b antimiR through tail vein. Hepatic steatosis was measured using transient elastography in human subjects.

RESULTS

Our data showed that miR-30b was markedly up-regulated in the liver of HFD-treated rats. Bioinformatic and in vitro and in vivo studies led us to identify sarco(endo)plasmic reticulum Ca²⁺ -ATPase 2b (SERCA2b), as a novel target of miR-30b. Overexpression of miR-30b induced ER stress and insulin resistance in rats fed with normal diet, whereas inhibition of miR-30b by miR-30b antimiR suppressed ER stress and insulin resistance in HFD-treated rats. Finally, our data demonstrated that there was a positive correlation between serum miR-30b levels and hepatic steatosis or homoeostasis model assessment of insulin resistance (HOMA-IR) in human subjects.

CONCLUSIONS

Our findings suggest that miR-30b represents not only a potential target for the treatment of insulin resistance, but also a non-invasive disease biomarker of NAFLD.

Risk factors for colorectal neoplasia in patients with underlying inflammatory bowel disease: a multicenter study

BACKGROUND

This study sought to evaluate the risk factors for the development of colitis-associated neoplasia (CAN) in Chinese patients with inflammatory bowel disease (IBD).

METHODS

IBD patients who developed CAN between 1999 and 2016 were identified from eight medical centers. In addition to initial pathology evaluation, a CAN diagnosis was confirmed by two expert pathologists. Patients with CAN (n = 29) were compared with non-CAN controls (n = 87). Matching was performed for gender and IBD type with a ratio of three controls to one subject.

RESULTS

Of the 29 patients with CAN, 8 (27.6%) had colorectal cancer (CRC), 20 (69.0%) had a final diagnosis of low-grade dysplasia and 1 (3.4%) had high-grade dysplasia. Multivariate analysis revealed that an older age at the time of IBD diagnosis and a longer IBD duration were independent risk factors for the development of CAN, with odds ratios of 1.09 [95% confidence interval (CI): 1.04-1.14, P < 0.001] and 1.14 (95% CI: 1.03-1.27, P = 0.013), respectively. Comparison between IBD patients with CRC and those with dysplasia indicated that the former were older at the time of IBD diagnosis (P = 0.012) and had longer IBD durations (P = 0.019).

CONCLUSIONS

Older age at the time of IBD diagnosis and longer IBD duration were found to be associated with the development of CAN in IBD patients.

Strategies for remission induction of inflammatory bowel disease

Inflammatory bowel diseases (IBD) is an abnormal immune-mediated, chronic, recurrent gastrointestinal inflammatory disorder, which is caused by a variety of factors, including ulcerative colitis (UC) and Crohn's disease (CD). IBD is characterized by alternating periods of relapse and remission. During the active period of IBD, clinicians usually formulate an appropriate medical management plan based on the disease activity, location, extent, and the medication history. In this way, remission can be induced as soon as possible. This paper summarizes the strategies for remission induction of IBD.

Thalidomide and thalidomide analogues in treatment of patients with inflammatory bowel disease: Meta-analysis

AIM

To examine the efficacy and safety of thalidomide and thalidomide analogues in induction and maintenance of remission in patients with inflammatory bowel disease (IBD).

METHODS

A literature search was performed in the following databases: PubMed, EMBASE, Web of Science, Ovid and the Cochrane Library, and Chinese databases such as the China National Knowledge Infrastructure, China Science and Technology Journal Database (VIP), Wanfang Data. The randomized controlled analysis was performed to assess the effects of thalidomide therapy on inflammatory bowel disease for patients who did show good response with other therapies.

RESULTS

Three studies (n = 212) met the inclusion criteria were used in this Meta-analysis. No difference was found between thalidomide/thalidomide analogues and placebo in the induction of remission (RR = 1.36, 95%CI: 0.83-2.22, P = 0.22), the induction of clinical response (RR = 1.14, 95%CI: 0.75-1.72, P = 0.54) and the induction of adverse events (RR = 1.41, 95%CI: 0.99-2.02, P = 0.06).

CONCLUSION

Currently, there is not enough evidence to support use of thalidomide or its analogue for the treatment in patients of any age with IBD. However, it warrants a reanalysis when more data become available.

Improved protocol for extracting genomic DNA from frozen formalin-fixed tissue resulting in high-quality whole mtDNA

Formalin fixation and paraffin embedding is widely used for convenient and long-term storage of tumor tissue and precious sources to perform genetic studies. However, DNA fragmentation is one of the major flaws of genomic DNA isolation from formalin fixation tissues, which limits its further usage. Here, we present an improved method for isolating high-quality genomic DNA from formalin fixation tissue. We obtained high-quality genomic DNA of more than 20 kb from samples frozen for more than 2 years. Furthermore, to verify DNA quality, the whole mitochondrial DNA (mtDNA) genomes from the normal and tumor tissue of the same patient were successfully amplified with two overlapping PCR fragments comprising more than 8379 bp in length for each fragment. In addition, the whole genomes were sequenced with a 48-well based primer panel in order to avoid potential sequencing errors from artificial recombination, which was further confirmed with an mtDNA phylogenetic strategy. Our improved DNA extraction method from formalin fixation tissue and sequencing strategy for entire mtDNA genomes will generate unambiguous sequence analysis results for clinical samples.

Factors affecting adherence to treatment in inflammatory bowel disease

Inflammatory bowel disease (IBD) is a group of chronic inflammatory diseases of the intestine, which includes Crohn's disease (CD) and ulcerative colitis (UC). IBD is a kind of refractory disease. Currently, drugs including 5-ASA, corticosteroids, and immunosuppressant drugs as well as biological agents are the basic treatment. The vast majority of patients need these drugs to induce and maintain remission. The choice of treatment and patients' adherence are equally important, because the disease prognosis is related to the medication adherence. Although current treatments have been greatly optimized, little attention has been paid to many factors associated with non-adherence to IBD medications in China. This article reviews the domestic and foreign research on the factors influencing IBD medication adherence, with an aim to help medical personnel identify factors that influence treatment adherence and effectively manage this refractory disease.

Ischemic bowel disease associated with granulomatosis with polyangiitis: A case report

Granulomatosis with polyangiitis (GPA) is a chronic multisystemic disorder of unknown etiology that leads to necrotising granulomatous vasculitis, commonly involving the respiratory system and the kidneys. Gastrointestinal involvement is a rare manifestation of this disease. Although uncommon, GPA may involve the small bowel or colon and exhibit symptoms of intestinal ischemia and secondary peritonitis, including abdominal pain, fever, diarrhea and gastrointestinal bleeding which are nonspecific. Here we report a case of ischemic bowel disease associated with granulomatosis with polyangiitis to improve the awareness by clinicians.

Effect of HSF2 silencing on NLRP3 inflammasome in THP-1 cells

AIM: To study the effect of heat shock transcription factor 2 (HSF2) silencing on NLR family, pyrin domain containing 3 (NLRP3) inflammasome in THP-1 cells.

METHODS: THP-1 cells were transfected with a lentivirial vector (LV-HSF2-RNAi) to induce HSF2 silencing. PMA was used to induce THP-1 cells to differentiate into macrophages. Then different groups of cells were stimulated with lipopolysaccharides (LPS). The mRNA and protein expression levels of NLRP3, ASC, Caspase1 and IL-1β were measured by RT-PCR and Western Blot, respectively. The level of IL-1β was measured by ELISA.

RESULTS: The protein level of HSF2 in the HSF2-siRNA group was significantly lower than those in the control group and negative siRNA group (P < 0.05). The mRNA and protein expression levels of NLRP3, ASC, Caspase1 and IL-1β in the HSF2-siRNA group were significantly higher than those in the control group and negative siRNA group (P < 0.05). IL-1β levels in cell supernants in the HSF2-siRNA group were significantly higher than those in the control group and negative siRNA group (control group: 257.010 pg/mL±26.148 pg/mL; siRNA group: 538.800 pg/mL±52.250 pg/mL; negative siRNA group: 238.231 pg/mL±29.245 pg/mL) (P < 0.05).

CONCLUSION: HSF2 silencing significantly raises the mRNA and protein expression of NLRP3 inflammasome and IL-1β in THP-1 cells.

Effect of knockdown or overexpression of heat shock transcription factor 2 on apoptosis and migration of human colonic epithelial cells

AIM: To explore the role of heat shock transcription factor 2 (HSF2) in cell apoptosis and migration in human colonic epithelial cell line HT-29 by means of interference and overexpression.

METHODS: Apoptosis of HT-29 cells was induced by incubation with sodium butyrate (SB) for different durations. Cytotoxicity was estimated by MTT assay, and the cell cycle and apoptosis were observed by flow cytometry to choose the optimal time and concentration of SB. HT-29 cells were then transfected with HSF2 siRNA or a lentiviral vector (Ubi-MCS-3FLAG-SV40-EGFP). The overexpression or knockdown of HSF2 was detected by Leica DMIRB and Western blot. After transfection, cell migration ability was measured by wound healing assay and Transwell assay. Apoptosis of HT-29 cells was induced with SB after transfection, cell proliferation was studied by MTT assay, and cell cycle and apoptosis were observed by flow cytometry.

RESULTS: Compared with the negative control (NC) group, SB at 2.5, 5.0, or 10 mmol/L could significantly cause growth inhibition after 48 h of incubation (P < 0.01), and the effect was time- and dose-dependent. The apoptosis rate was significantly higher in the SB treated groups (1.25, 2.5, 5.0, or 10 mmol/L for 48 h) than in the NC group (51.588% ± 5.110%, 77.732% ± 2.746%, 90.115% ± 1.438%, 94.247% ± 1.243% vs 0.548% ± 0.113%, P < 0.01). When the SB concentration was>2.5 mmol/L, the apoptosis rate increased significantly (P < 0.01). When treated with 1.25 mmol/L SB for 48 h, the percentage of cells in G₀/G₁ phase cell did not show a significant difference compared with the NC group; when the concentration was > 2.5 mmol/L (5.0 or 10.0 mmol/L), SB could induce G₁/G₀ arrest (P < 0.01). After lentiviral transfection, a large number of HT-29 cells with green fluorescence was observed by Leica DMIRB (transfection efficiency>80%). Lentiviral transfection of siRNA could effectively inhibit expression of HSF2, while lentiviral transfection of Ubi-MCS-3FLAG-SV40-EGFP induced overexpression of HSF2. HSF2 overexpression significantly increased cell proliferation and migration compared with the empty vector treated group (P < 0.05), while HSF2 knockdown significantly inhibited the proliferation and migration of HT-29 cells compared with the negative siRNA group (P < 0.05). HSF2 overexpression or knockdown had no significant impact on cell cycle distribution. HSF2 overexpression significantly decreased cell apoptosis rate (P < 0.05), while HSF2 knockdown significantly increased cell apoptosis rate (P < 0.05).

CONCLUSION: HSF2 might be a protective factor for epithelial cell apoptosis. HSF2 achieves the effects of cell protection possibly through the cell cycle regulation.

Non-drug treatment of inflammatory bowel disease

Inflammatory bowel disease (IBD) is an idiopathic, chronic, nonspecific inflammatory disease. IBD is comprised of two major types, ulcerative colitis (UC) and Crohn's disease (CD), and is hard to be cured. Currently, aminosalicylic acid preparations, corticosteroids and immunosuppressant drugs are the main treatments for the disease, but there exists poor drug efficacy in some cases, and patients are prone to side effects. Biological agents greatly improve the efficacy, but for a small number of refractory patients, comprehensive intervention containing non-drug treatments is needed. Non-drug treatments like fecal microbiota transplantation (FMT), stem cell transplantation, and granulocyte and monocyte apheresis (GMA) have shown enormous potential for the treatment of IBD, and have become a hot spot of IBD treatment research in recent years. In this paper, we review the non-drug treatments for IBD, in order to broaden the horizons of clinicians in the treatment of IBD.

The whole mitochondrial genome of the Lesser Kestrel (Falco naumanni)

Falconiformes include most of the predatory birds, they play crucial role in maintaining the balance of ecology system. To further illustrate the phylogenetic status for the species of Falconiformes, the entire mitochondrial DNA (mtDNA) genome of Falco naumanni was amplified and sequenced, further phylogenetic analysis was performed by incorporating with other 8 entire mtDNA genomes representing 8 species of predatory birds by taking the Apus apus and Haematopus ater as out-groups. Our results indicated that the mtDNA genome of F. naumanni includes 17,370 base pairs in length, which has the similar organization and gene order with other mtDNA genomes of the species belonging to Falconiformes. Further phylogenetic analyses supported that the F. naumanni clustered with other species of Falconidae, which formed the sister group of Accipitridae, Cathartes aura located at the basal position with Haematopus ater. In addition, Pandion haliaetus was clustered with other species of Accipitridae, which was conflict with the traditional classification system by taking P. haliaetus as an independent Familia of Falconidae.

Relationship between brain-gut axis and inflammatory bowel disease

Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn's disease (CD), is a chronic relapsing inflammatory disease affecting the gastrointestinal tract. The incidence of IBD has increased dramatically year by year in China. Currently, the IBD research is focused on genetically predisposed factors, immune response, environmental triggers and infections. However, the etiology of IBD is still unclear. Recently, more attention has been paid to the research of neural regulation affecting the progression of IBD. Previous research has revealed that psycho-neuro-endocrine-immune modulation through the brain-gut axis plays a crucial role in the pathogenesis of IBD. It is important to explore other psychotherapies applied to adjutant therapy in IBD. This review reviews the recent advances in understanding the relationship between the brain-gut axis and inflammatory bowel disease.

Impaired growth and puberty in pediatric patients with inflammatory bowel disease: Etiology and treatment

Growth failure associated with delayed puberty is a unique feature in pediatric patients with inflammatory bowel disease (IBD), especially those with Crohn's disease, which has a negative effect on quality of life, emotional functioning, social functioning, and body image. Although the underlying mechanisms are not fully clear, the condition may be induced by the effects of malnutrition, inflammatory process and glucocorticoid on the growth hormone/insulin-like growth factor-1 axis or on the growth plate. Nutrition, biologic agents, intestinal resection and glucocorticoids are main treatments. Standards for monitoring and treatment of impaired growth and development in pediatric IBD patients need to be formulated. To achieve optimal growth, the efforts of hospitals, families and society are necessary.

Mitochondrial DNA Haplogroup A may confer a genetic susceptibility to AIDS group from Southwest China

The acquired immunodeficiency syndrome (AIDS) in humans was one of the chronic infections caused by human immunodeficiency virus (HIV), and the interactions between viral infection and mitochondrial energetic implicated that mitochondrial DNA (mtDNA) variation(s) may effect genetic susceptibility to AIDS. Thus, to illustrate the maternal genetic structure and further identify whether mtDNA variation(s) can effect HIV infection among southwest Chinese AIDS group, the whole mtDNA control region sequences of 70 AIDS patients and 480 health individuals from southwest China were analyzed here. Our results indicated the plausible recent genetic admixture results of AIDS group; comparison of matrilineal components between AIDS and matched Han groups showed that mtDNA haplogroup A (p = 0.048, OR = 3.006, 95% CI = 1.109-8.145) has a significant higher difference between the two groups; further comparison illustrated that mtDNA mutations 16,209 (p = 0.046, OR = 2.607, 95% CI = 0.988-6.876) and 16,319 (p = 0.009, OR = 2.965, 95% CI = 1.278-6.876) have significant differences between AIDS and matched control groups, and both of which were the defining variations of mtDNA haplogroup A, they further confirmed that mtDNA haplogroup A may confer genetic susceptibility to AIDS. Our results suggested that haplogroup A may confer a genetic susceptibility to AIDS group from Southwest China.

Expression of heat shock factor 2 and proinflammatory cytokines in ulcerative colitis

AIM: To examine the mRNA and protein expression of heat shock factor 2 (HSF2) as well as the levels of proinflammatory cytokines like tumor necrosis factor α (TNF-α), interleukin 1β (IL-1β) and IL-8 in the colonic mucosa and serum of patients with ulcerative colitis (UC).

METHODS: Colonic mucosa and blood specimens were obtained from patients with UC who were admitted at the First Affiliated Hospital of Kunming Medical University from February 2013 to February 2014. Patients with abdominal pain or discomfort who were eventually diagnosed with irritable bowel syndrome according to Roman Ⅲ criteria and had no lesions under colonoscopy were used as controls. UC disease activity evaluation was performed using UC-DAI. The mRNA expression levels of HSF2, TNF-α, IL-1β and IL-8 in the mucosa were detected by real-time fluorescence quantitative PCR. Serum concentrations of HSF2, TNF-α, IL-1β and IL-8 were detected using ELISA. The correlations of HSF2 expression with disease activity, TNF-α, IL-1β and IL-8 in UC were also explored.

RESULTS: Twenty UC and five control mucosa specimens were collected, and 60 UC and 20 control blood specimens were obtained. Patients with mild to severe UC had significantly higher mRNA expression of HSF2 (mild: 1.30 ± 0.11 vs 1.00 ± 0.00, P < 0.05; moderate: 1.50 ± 0.14 vs 1.00 ± 0.00, P < 0.01; severe: 2.02 ± 0.19 vs 1.00 ± 0.00, P < 0.01), TNF-α (mild: 6.28 ± 1.79 vs 1.00 ± 0.00, P < 0.05; moderate: 10.21 ± 1.68 vs 1.00, P < 0.01; severe: 19.23 ± 4.38 vs 1.00 ± 0.00, P < 0.01), IL-1β (mild: 48.91 ± 13.72 vs 1.00 ± 0.00, P < 0.05; moderate: 99.12 ± 17.28 vs 1.00 ± 0.00, P < 0.01; severe: 212.89 ± 29.69 vs 1.00 ± 0.00, P < 0.01) and IL-8 (mild: 27.49 ± 4.55 vs 1.00 ± 0.00, P < 0.05; moderate: 54.73 ± 12.00 vs 1.00 ± 0.00, P < 0.01; severe: 124.73 ± 26.08 vs 1.00 ± 0.00, P < 0.01) in the colon mucosa than controls. HSF2 expression had a positive expression correlation with the levels of these pro-inflammatory cytokines (r = 0.89, 0.89, 0.80, P < 0.001). Serum concentrations of HSF2 (mild: 0.91 ng/mL ± 0.33 ng/mL vs 0.42 ng/mL ± 0.29 ng/mL, P < 0.05; moderate: 1.26 ng/mL ± 0.28 ng/mL vs 0.42 ng/mL ± 0.29 ng/mL, P < 0.01; severe: 2.15 ng/mL ± 0.42 ng/mL vs 0.42 ng/mL ± 0.29 ng/mL, P < 0.01), TNF-α (mild: 17.29 pg/mL ± 1.71 pg/mL vs 13.45 pg/mL ± 3.63 pg/mL, P < 0.05; moderate: 17.42 pg/mL ± 1.85 pg/mL vs 13.45 pg/mL ± 3.63 pg/mL, P < 0.01; severe: 21.16 pg/mL ± 2.15 pg/mL vs 13.45 pg/mL ± 3.63 pg/mL, P < 0.01), IL-1β (mild: 11.86 pg/mL ± 5.18 pg/mL vs 4.93 pg/mL ± 2.92 pg/mL, P < 0.05; moderate: 15.05 pg/mL ± 2.90 pg/mL vs 4.93 pg/mL ± 2.92 pg/mL, P < 0.01; severe: 22.77 pg/mL ± 7.19 pg/mL vs 4.93 pg/mL ± 2.92 pg/mL, P < 0.01) and IL-8 (mild: 19.49 pg/mL ± 4.38 pg/mL vs 8.25 pg/mL ± 2.23 pg/mL, P < 0.01; moderate: 32.18 pg/mL ± 6.81 pg/mL vs 8.25 pg/mL ± 2.23 pg/mL, P < 0.01; severe: 60.19 pg/mL ± 9.71 pg/mL vs 8.25 pg/mL ± 2.23 pg/mL, P < 0.01) in UC patients were significantly higher than those in controls, and HSF2 concentration was also positively correlated with serum levels of these proinflammatory cytokines (r = 0.77, 0.73, 0.85, P < 0.001).

CONCLUSION: Colonic mRNA expression levels and serum concentrations of HSF2, TNF-α, IL-1β and IL-8 increase in UC patients. The expression level of HSF2 is positively correlated with TNF-α, IL-1β and IL-8, suggesting that HSF2 might be used as a new marker for evaluating inflammation activity level in UC.

Reasonable selection and application of antibiotics in the treatment of Crohn's disease

Crohn's disease (CD) is one of the two major forms of inflammatory bowel disease (IBD). Although the etiology of CD is unclear, many experimental and clinical observations support the potential role for intestinal microflora in the pathogenesis of CD. Manipulation of the luminal content using antibiotics may therefore represent a potentially effective therapeutic option. Some randomized controlled trials have demonstrated the efficacy of these drugs in treating the perianal disease, inducing and maintaining of CD remission and decreasing CD recurrence rates in operated patients. But, the use of antibacterial therapy for CD is also controversial, even this approach is frequently and successfully adopted in clinical practice. Fairly narrow indications for antibiotics are suggested by current management guidelines. Large studies are required to better define the role of antibacterial agents and combination regimens in CD. Broad-spectrum antibiotics, such as metronidazole, fluoroquinolones and rifaximin, are widely used to treat CD, and their effects have been recognized. Because of the lack of adequate theoretical support and adverse drug reactions, the reasonable application of antibiotics to treat CD is still a clinical problem.

Microbial ecological agents and inflammatory bowel disease

Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn's disease (CD), is a chronic non-specific inflammatory condition of the gastrointestinal tract with unknown etiology. During the exploration of the etiology, treatment and other aspects of IBD, it has been gradually realized that microbial ecological agents (MEAs) are helpful in the treatment of IBD. This article reviews the relationship between MEAs and IBD with regard to the intestinal environment in IBD, the therapeutic effect of MEA in IBD and the possible mechanisms involved.

Pathological characteristics of IBD: An analysis of 430 cases

AIM: To summarize the pathological characteristics of inflammatory bowel disease (IBD) in hospitalized patients in Kunming by retrospectively analyzing data over the past 10 years.

METHODS: The detailed data for 430 patients with IBD, including 379 with ulcerative colitis (UC) and 51 with Crohn's disease (CD), were obtained from seven large general hospital of Kunming from January 1998 to March 2007. IBD was diagnosed based on the diagnostic and treatment criteria established in the digestion disease institute branch conference of China in 2007. The pathological characteristics of IBD were then analyzed.

RESULTS: The pathology diagnosis coincidence rate in UC and CD was 24.4% and 27.5%, respectively. Approximately 56.2% of 379 UC patients underwent pathological examination, of which 180 cases had described microscopic features. The microscopic manifestations included erosion or ulcer in 25% of cases, cryptitis and crypt abscess in 29%, cryptae twisting and branching in 1.8%, cryptae atrophy in 1.7%, fluffiness surfaces in 0.56%, goblet cells reduction in 11.1%, fundus phlogocytosis in 5.6%, gland hyperplasia in 8.9%, and atypical hyperplasia in 3.9%. Approximately 78.4% of 51 patients with CD underwent pathological examination, of which 30 cases had described microscopic features. The microscopic manifestations included active chronic inflammation in 100% of cases, non-caseating granuloma in 23.3%, and fissuring ulcer in 23.3%.

CONCLUSION: The number of cases undergoing pathological examination was not very high, and the coincidence rate was low. Pathological characteristics of UC were mainly erosion or ulcer, cryptitis and crypt abscess, while those of CD were mainly non-caseating granuloma and fissuring ulcer, both of which were in active chronic inflammation period.

Gene expression profiles in peripheral blood mononuclear cells of ulcerative colitis patients

AIM: To identify peripheral blood mononuclear cell (PBMC) gene expression profiles of ulcerative colitis (UC) patients, using oligonucleotide microarrays, to gain insights into UC molecular mechanisms.

METHODS: The Human OneArray microarrays were used for a complete genome-wide transcript profiling of PBMCs from 12 UC patients and 6 controls. Differential analysis per gene was performed with a random variance model; t test and P values were adjusted to control the false discovery rate (5%). Gene ontology (GO) was deployed to analyze differentially expressed genes at significant levels between patients and controls to identify the biological processes involved in UC.

RESULTS: Comparative analysis revealed that 4438 probes (4188 genes) were differentially expressed between the two groups, of which 3689 probes (3590 genes) were down-regulated whereas 749 probes (598 genes) were up-regulated. Many disregulated genes in our data have been reported by previous microarray studies carried out on intestinal mucosa samples, such as S100A8, CEACAM1 and S100A9. GO enrichment analysis revealed 67 high enrichment up-regulated categories and one significant down-regulated category. The up-regulated genes were mainly involved in immune and inflammatory response, cell cycle and proliferation, DNA metabolism and repair.

CONCLUSION: Gene expression profiling of PBMCs from patients with UC has highlighted several novel gene categories that could contribute to the pathogenesis of UC.

Correlation between psychological factors and irritable bowel syndrome

AIM: To investigate the incidence of anxiety and depression and factors associated with the occurrence of anxiety and depression in patients with irritable bowel syndrome (IBS) to provide a theoretical basis for the use of anti-anxiety/depression and psychological treatments in IBS patients with psychological abnormalities.

METHODS: Sixty patients with IBS treated from December 2010 to December 2011 in Department of Gastroenterology of the First Affiliated Hospital of Kunming Medical University and 60 healthy controls were included in this study. The patients were assessed using the ZUNG self-rating anxiety scale, ZUNG self-rating depression scale, life event scale and social support rating scale. All scores were compared using statistical methods.

RESULTS: The incidences of anxiety and depression were significantly higher in IBS patients than in healthy controls (P < 0.05, P < 0.01). The self-rating anxiety scale and self-rating depression scale scores differed significantly between IBS patients and healthy controls (both P < 0.01). Although there was no significant difference in positive event scores and social support total scores between IBS patients and healthy controls (both P > 0.05), a statistical significance was noted in negative event score between the two groups (P < 0.01).

CONCLUSION: The incidences of anxiety and depression are significantly higher in IBS patients than in normal controls. Negative life events have an important mental impact on IBS patients. Life events and social support are closely related to psychological changes in IBS patients. IBS patients' psychological state should be monitored in clinical practice, and appropriate interventions should be given if anxiety and depression develop in these patients.

Multicenter case-control study of the risk factors for ulcerative colitis in China

AIM: To evaluate potential risk factors in the development of ulcerative colitis (UC) in China.

METHODS: A total of 1308 patients with UC and 1308 age-matched and sex-matched controls were prospectively studied in China. The UC cases were collected from 17 hospitals in China from April 2007 to April 2010. Uniform questionnaires were designed to investigate risk factors including smoking, appendectomy, stress, socio-economic conditions, nonsteroidal anti-inflammatory drugs (NSAIDs), oral contraceptives, diet, breastfeeding, infections and family sanitary conditions. Group comparisons by each factor were done using simple logistic regression analysis. Conditional logistic regression was used for multivariate analysis.

RESULTS: By univariate analysis, the variables predictive of UC included feeling stress, light and heavy alcoholic drinking, spicy food, sugar consumption and infectious diarrhea, while heavy tea intake and tap water consumption were protective against UC. On multivariate analysis, the protective factor for UC was tap water consumption [odds ratios (OR) = 0.424, 95%CI: 0.302-0.594, P < 0.001]; while the potential risk factors for UC were heavy sugar consumption (OR = 1.632, 95%CI: 1.156-2.305, P < 0.001), spicy food (light intake: OR = 3.329, 95%CI: 2.282-4.857, P < 0.001; heavy intake: OR = 3.979, 95%CI: 2.700-5.863, P < 0.001), and often feeling stress (OR = 1.981, 95%CI: 1.447-2.711, P < 0.001). Other factors, such as smoking habit, appendectomy, breastfeeding, a history of measles, rural or urban residence, education, oral contraceptives, and NSAID use have not been found to have a significant association with the development of UC in the present study.

CONCLUSION: Our study showed tap water consumption was a protective factor for UC, while spicy food, heavy sugar consumption and often feeling stress were risk factors for UC in this Chinese population.

Construction of a eukaryotic expression plasmid encoding the human HSF2 gene and its expression in Caco-2 cells

AIM: To construct a eukaryotic expression plasmid encoding the human heat shock factor 2 (HSF2) gene and to examine its expression and localization in Caco-2 cells, a human colon adenocarcinoma cell line using FLAG tag as a reporter.

METHODS: The coding sequence of the HSF2 gene was amplified by PCR using human HSF2 cDNA as the template and subcloned into pCMV-Myc vector after digestion with EcoR I and Knp I. After the identity of recombinant plasmid was verified by direct sequencing, the plasmid was transfected into Caco-2 cells using Lipofectamine. Total RNA was extracted, reverse transcribed into cDNA, and tested by PCR. The expression of HSF2 and the recombinant fusion protein in Caco-2 cells was detected by Western blot. The expression and localization of HSF2 and the recombinant fusion protein in Caco-2 cells were observed by laser scanning confocal microscopy.

RESULTS: The coding sequence of the HSF2 gene was successfully inserted into the pCMV-Myc vector. Restriction enzyme digestion analysis showed that the length of the insert was 1557 bp, matching the expected size. The mRNA level of HSF2 in cells transfected with the recombinant plasmid was higher than those in non-transfected cells and cells transfected with empty vector. The expression of recombinant HSF2-FLAG fusion protein, which had a molecular weight of 70 kDa, was detected by Western blot. The expression of HSF2 in cells transfected with the recombinant plasmid increased dramatically in comparison with matched groups. The HSF2 and recombinant HSF2-FLAG protein were localized predominantly to the cytoplasm but partially aggregated around the nuclear envelope in Caco-2 cells.

CONCLUSION: The recombinant plasmid pCMV-HSF2-FLAG has been successfully constructed, which provides the basis for further study of possible roles of HSF2 in ulcerative colitis.

Heterotopic gastric mucosa in the upper and middle esophagus: 126 cases of gastroscope and clinical characteristics

BACKGROUND/AIMS

In this retrospective study, we aimed to investigate the prevalence of heterotopic gastric mucosa (HGM) in the upper and middle esophagus, to identify its macroscopic characteristics and evaluate clinical features.

METHODOLOGY

One hundred and twenty-six patients (82 males, 44 females; mean age 43.08 ± 12.84 years, range 15-81) with HGM in the upper and middle esophagus diagnosed by gastroscopy and biopsies were admitted to this retrospective study. Disease histories of all patients were carefully inquired, especially the associated complaints including discomfort of throat, heartburn or dysphagia, etc.

RESULTS

The prevalence was 0.21%. Patch size ranged between 5-20mm, mean diameter was 7.5 ± 3.7mm; 80 cases appeared as a single patch; 96.83% had the patch in the upper esophagus. Male gender was predominant (male:female ratio, 1.86), but age was not significant. The mean distance from the incisors to the patch was 18.83 ± 2.23cm and 17.20 ± 2.48cm in the male and the female respectively, with a significant difference (t=3.749, p<0.001). In 39 of 126 patients (26 male, 13 female), the esophageal and laryngopharyngeal symptoms were remarkable. Twelve were associated with other diseases of the esophagus. There were no correlations to esophageal symptom, gender, age, location, quantity or diameter. Among the 126 cases, 29 patients were associated with other esophageal diseases.

CONCLUSIONS

HGM patches in the esophagus should not be overlooked during endoscopy because they may lead to esophageal symptoms and even important complications in relation to their acid secretions.

Progress in research of biological activity markers for inflammatory bowel disease

The incidence of inflammatory bowel disease (IBD) has been increasing in recent years. The clinical manifestations of IBD are complicated, and both intestinal and extraintestinal symptoms may develop. Due to the lack of specific index, IBD is easy to be misdiagnosed, and evaluating disease activity is more difficult. Radiology, endoscopic and histological biopsy for diagnosis are expensive. Currently, there is an urgent need of a simple, noninvasive, sensitive, economic, and highly specific method for diagnosis of IBD. Biological activity markers may meet this demand. In this paper, the clinical applicability of biological activity markers, which come from both ulcerative colitis (UC) and Crohn's disease (CD), in identifying the presence or extent of inflammatory response, is reviewed.

Endoscopic diagnosis and treatment of ulcerative colitis

Ulcerative colitis (UC), one of non-specific chronic inflammatory conditions of the gastrointestinal tract with unknown complex etiology, is a chronic inflammatory bowel disorder characterized by diffuse mucosal inflammation of the colorectum with exacerbations and remissions. Nowadays, the diagnosis of UC is based mainly on symptoms, endoscopic findings, and histopathologic grading of biopsy specimens. However, there is a lack of a gold standard for the diagnosis of UC. Endoscopy is the cornerstone for diagnosis and evaluation of UC and plays a significant role in diagnosis, evaluating disease activity, malignancy surveillance and treatment. Over recent decades, the emergence of new imaging techniques, including endoscopic ultraonography, chromoendoscopy, magnification endoscopy, narrow-band endoscopic imaging, and laser scanning confocal microendoscopy, has provided a great boost to endoscopic diagnosis and treatment of UC. In this article, we will review the recent advances in endoscopic diagnosis and treatment of UC.

Stem cell transplantation for the treatment of inflammatory bowel disease

Inflammatory bowel disease (IBD) is comprised of ulcerative colitis and Crohn's disease and characterized by chronic inflammation of the intestinal tract. The etiology of IBD is still unknown. Traditional treatment mainly controls active inflammation and regulates immunologic derangements. Commonly used drugs include 5-aminosalicylic acid, glucocorticoid and immunosuppressant. Some cases of IBD require surgical treatment eventually. Due to multipe etiologies, IBD should be managed comprehensively. The appearance of biological agents, genetically modified methods, anticoagulant therapies, and stem cell transplantation therapies has made it more likely to cure IBD. Stem cell transplantation represents a new type of treatment for IBD. In this article, we review the role of stem cell transplantation in the treatment of IBD.

Significance of CEACAM6, Syndecan-1, PDGFA and HLA-DRB5 expression in patients with ulcerative colitis

AIM: To analyze the significance of the expression of carcinoembryonic antigen-related cell adhesion molecule 6 (CEACAM6), Syndecan-1, platelet-derived growth factor alpha (PDGFA) and HLA-DRB5 genes in the development and progression of ulcerative colitis.

METHODS: The mRNA expression of CEACAM6, Syndecan-1, PDGFA and HLA-DRB5 was detected by semiquantitative RT-PCR in peripheral blood mononuclear cells (PBMC) and colon specimens from 21 patients with ulcerative colitis.

RESULTS: The mRNA expression levels of CEACAM6, Syndecan-1 and PDGFA in patients with ulcerative colitis were significantly higher than those in normal controls (0.77 ± 0.23 vs 0.58 ± 0.14, 1.16 ± 0.39 vs 0.85 ± 0.16, 0.90 ± 0.18 vs 0.78 ± 0.13, all P < 0.01). The expression of HLA-DRB5 mRNA was also up-regulated in patients with ulcerative colitis compared with normal controls (0.58 ± 0.19 vs 0.42 ± 0.19, P < 0.01).

CONCLUSION: CEACAM6, Syndecan-1, PDGFA and HLA-DRB5 are highly expressed in ulcerative colitis and may therefore play an important role in the pathogenesis of ulcerative colitis.

Application of proteomics to the study of inflammatory bowel disease

Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn's disease (CD), is a chronic inflammatory disorder of the gastrointestinal tract. The initiation and development of IBD involve environmental and genetic factors, such as microorganisms. Complicated pathogenesis, diverse risk factors and atypical clinical features lead to a difficult diagnosis of IBD. The emergence of proteomics has given new impetus to IBD research. In this article, we will review the application of proteomics to the diagnosis of IBD and prediction of IBD-associated tumors.

Role of the Janus kinase/signal transducer and activator of transcription pathway in the pathogenesis of trinitrobenzenesulfonic acid-induced experimental colitis in rats

AIM: To investigate the role of the Janus kinase/signal transducer and activator of transcription (STAT) signaling pathway in the pathogenesis of trinitrobenzenesulfonic acid (TNBS)-induced experimental colitis in rats.

METHODS: TNBS was used to induce experimental colitis in rats. The rats were then intraperitoneally injected with rapamycin (RPM) and AG490 (a specific inhibitor of Janus kinase). Colonic inflammation was evaluated by histology. Western blot was used to detect the expression of matrix metalloproteinase (MMP)-1, MMP-2, MMP-3 and ITMP-1 proteins in the colon. Gelatin zymography was used to examine the activity of MMP-2 in colitis.

RESULTS: The pathological inflammation scores in the AG490 treatment group and RPM treatment group were significantly lower than that in the control group (5.50 ± 2.16 and 5.17 ± 1.80 vs 8.53 ± 2.18, respectively; P = 0.012 and P < 0.05). The expression levels of MMP-1 and MMP-2 proteins in the AG490 treatment group and RPM treatment group were significantly lower than those in the control group (all P < 0.05). In contrast, there were no significant changes in the expression levels of MMP-3 and TIMP-1 proteins between the control group and the two treatment groups (both P > 0.05). Compared with the control group, the activity of MMP-2 was obviously reduced in the two treatment groups (both P < 0.05).

CONCLUSION: Inhibition of the JAK/STAT signaling pathway by AG490 or RPM reduces disease activity in TNBS-induced experimental colitis through downregulation of MMP-1 and MMP-2 mRNA expression in colonic tissue.

Advances in the clinical applications of esomeprazole

Esomeprazole is the first proton pump inhibitor (PPI) to be developed as a single optical isomer. Ever since its first clinical application seven years ago, esomeprazole has attracted more and more attention due to relatively unique metabolism (compared to other PPIs), efficient and durable acid control, better safety and lower incidence of adverse reactions. In this article, we will review the clinical applications of esomeprazole in the treatment of gastroesophageal reflux disease (GERD), Helicobacter pylori infection, peptic ulcers, NSAID-related gastrointestinal disorders and upper gastrointestinal bleeding.

Research progress in susceptibility genes of inflammatory bowel disease

Inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis, is a group of non-specific chronic inflammatory conditions of the gastrointestinal tract with unknown complex etiology. Epidemiologic data indicate genetic contribution to IBD pathogenesis, which include familial aggregation, twin studies, racial and ethnic differences in disease prevalence. The most widely adopted approaches to identifying susceptibility genes in IBD include linkage studies, genome-wide association (GWA) studies and microarray. The first two technologies have confirmed NOD2, IL23R and other genes implicated in IBD pathogenesis and advances in microarray technology makes it possible to diagnose IBD at gene expression level. This article reviewed IBD related genes and introduced application of microarray to IBD research.

Multiscale active contour model for vessel segmentation

This paper presents a novel multiscale active contour model for vessel segmentation. The model is based on accurate analysis of the vessel structure in the image. According to different scale response of the eigenvalues of local second order derivative (Hessian matrix), a new vessel region information function, which shows a valid estimation of the vesselness measure, is defined. We introduce the posteriori probability estimation into the active contours framework and design a new objective function. The defined objective function is minimized using the variational method, and a new region-based external force is obtained, which is more accurate to the vessel structure and not sensitive to the initial condition. This active contour model combines the obtained region-based and conventional boundary-based force, which aims at finding more accurate vessel edges even when the vessel branches are low contrast or blurry. Furthermore, the proposed model is implemented by an implicit method of level set framework, the solution of which is steady and suitable for various topology changes. Moreover, two new speed functions for vessel segmentation in the level set method are presented, one for fast marching and the other for a narrow-band algorithm. The vessel segmentation experiments compared with previous geometric active contour models are shown on several medical images. The experimental results demonstrate the performance of our approach.

Therapeutic effect of phenanthroline on trinitrobenzene sulfonic acid-induced colitis in rats

AIM: To evaluate the effect of a matrix metalloproteinase (MMP) inhibitor, phenan-throline, on colonic inflammation in experi-mental colitis induced by trinitrobenzene sulfonic acid (TNBS) in rats.

METHODS: A rat model of experimental colitis was induced by administration of TNBS. Animals were divided into 3 groups, treated with 1, 10-phenanthroline (20 mg/kg per day), sulphasalazine, and double distilled water (1 mL, control group), respectively. All the animals were killed after 7 days. Myeloperoxidase (MPO) activity was assessed; the mRNA expression of MMP-1, MMP-2, MMP-3 and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) in colon tissues were detected by semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR). Meanwhile, MMP-3 and TIMP-1 proteins expression were analyzed by immunohistochemistry.

RESULTS: The absorbency value of MPO in the SASP group or phenanthroline group was significantly lower than that in the control group (0.25 ± 0.15, 0.16 ± 0.09 vs 0.48 ± 0.34, P = 0.025, 0.004). The expression levels of MMP-1, MMP-2 and MMP-3 mRNA had no markedly difference between the SASP group (0.19 ± 0.11, 0.35 ± 0.21, 0.25 ± 0.16) and phenanthroline group (0.33 ± 0.19, 0.29 ± 0.16, 0.22 ± 0.17); however, they were lower than those in the control group (0.45 ± 0.23, 0.53 ± 0.17, 0.62 ± 0.15; P = 0.002, 0.020, 0.000). There was no significant difference in TIMP-1 mRNA and protein among the three groups. However, the expression of MMP-3 protein in the SASP group or phenanthroline group was lower than that in the control group (2971.3 ± 1036.5, 2507.7 ± 1101.0 vs 7812.8 ± 4761.6, P = 0.000).

CONCLUSION: Phenanthroline may treat TNBS-induced colitis in rats by down-regulating MPO activity and MMP-1, MMP-2 and MMP-3 expression, but it has no effect on TIMP-1 expression.

Value of combined detection of CA19-9 and CA125 in differential diagnosis between benign and malignant ascites

AIM: To investigate the significance of cancer antigen-125 (CA-125) and CA19-9 combined detection in the differential diagnosis of benign and malignant ascites.

METHODS: A total of 59 patients were included in the study and divided into two groups based on the benignancy and malignancy. The levels of CA-125 and CA19-9 were detected in serum and ascitic fluid by protein chip technique.

RESULTS: The levels of CA125 and CA19-9 in ascitic fluid were 602.03 ± 405.72 and 370.65 ± 490.01 in malignant group, which were significantly higher than those in benign group (P <0.05). The level of serum CA125 was not markedly different between malignant and benign group, while CA19-9 level in malignant group (65.80 ± 117.45) was significantly higher than that in benign group (P < 0.05). The specificity, sensitivity and accuracy of ascitic CA19-9 in the diagnosis of malignant diseases were 66.7%, 46.2%, 57.7%, and those of ascitic CA125 were 57.6%, 61.5% and 59.3%, respectively. The specificity, sensitivity and accuracy of combined detection of CA19-9 and CA125 were 57.6%, 84.6% and 69.5%, respectively, and the sensitivity was significantly higher than that of CA19-9 (P < 0.01) or CA125 (P < 0.05) alone.

CONCLUSION: It is helpful to detect ascitic CA19-9 combined with CA125 in the differential diagnosis of malignant diseases.