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Plants delicately regulate endogenous auxin levels through the coordination of transport, biosynthesis, and inactivation, which is crucial for growth and development. While it is well-established that the actin cytoskeleton can regulate auxin levels by affecting polar transport, its potential role in auxin biosynthesis has remained largely unexplored. Using LC-MS/MS-based methods combined with fluorescent auxin marker detection, we observed a significant increase in root auxin levels upon deletion of the actin bundling proteins AtFIM4 and AtFIM5. Fluorescent observation, immunoblotting analysis, and biochemical approaches revealed that AtFIM4 and AtFIM5 affect the protein abundance of the key auxin synthesis enzyme YUC8 in roots. AtFIM4 and AtFIM5 regulate the auxin synthesis enzyme YUC8 at the protein level, with its degradation mediated by the 26S proteasome. This regulation modulates auxin synthesis and endogenous auxin levels in roots, consequently impacting root development. Based on these findings, we propose a molecular pathway centered on the 'actin cytoskeleton-26S proteasome-YUC8-auxin' axis that controls auxin levels. Our findings shed light on a new pathway through which plants regulate auxin synthesis. Moreover, this study illuminates a newfound role of the actin cytoskeleton in regulating plant growth and development, particularly through its involvement in maintaining protein homeostasis via the 26S proteasome., (© 2024 The Author(s). New Phytologist © 2024 New Phytologist Foundation.)

Objective: To compare the short-term and long-term outcomes between robotic gastrectomy (RG) and laparoscopic gastrectomy (LG) for gastric cancer., Background: The clinical outcomes of RG over LG have not yet been effectively demonstrated., Methods: This retrospective cohort study included 3599 patients with gastric cancer who underwent radical gastrectomy at eight high-volume hospitals in China from January 2015 to June 2019. Propensity score matching was performed between patients who received RG and LG. The primary end point was 3-year disease-free survival (DFS)., Results: After 1:1 propensity score matching, 1034 pairs of patients were enrolled in a balanced cohort for further analysis. The 3-year DFS in the RG and LG was 83.7% and 83.1% ( P =0.745), respectively, and the 3-year overall survival was 85.2% and 84.4%, respectively ( P =0.647). During 3 years of follow-up, 154 patients in the RG and LG groups relapsed (cumulative incidence of recurrence: 15.0% vs 15.0%, P =0.988). There was no significant difference in the recurrence sites between the 2 groups (all P >0.05). Sensitivity analysis showed that RG had comparable 3-year DFS (77.4% vs 76.7%, P =0.745) and overall survival (79.7% vs 78.4%, P =0.577) to LG in patients with advanced (pathologic T2-4a) disease, and the recurrence pattern within 3 years was also similar between the 2 groups (all P >0.05). RG had less intraoperative blood loss, lower conversion rate, and shorter hospital stays than LG (all P >0.05)., Conclusions: For resectable gastric cancer, including advanced cases, RG is a safe approach with comparable 3-year oncological outcomes to LG when performed by experienced surgeons., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Colorectal cancer (CRC) is one of the most common types of malignant tumor. Many genetic factors have been proved to show high association with the occurrence and development of CRC and many mutations are detected in CRC. PTPN4/PTP-MEG1 is a widely expressed non-receptor protein tyrosine phosphatase. Over the past three decades, PTPN4 has been demonstrated in the literature to participate in many biological processes. In this study, we identified a nonsense mutation of PTPN4 with a mutation ratio of 90.90% from 1 case of rectal cancer, leading to loss of function in PTPN4 gene. Several somatic mutations occurred in 5/137 rectal cancer samples from The Cancer Genome Atlas Rectum Adenocarcinoma (TCGA READ) database. Interestingly, we found that PTPN4 negative cytoplasm staining was more prone to lymphatic metastasis (N = 50, P = 0.0153) and low expression of PTPN4 in rectal cancer was highly associated with poor prognosis. Overexpression of PTPN4 suppressed the cell growth, and moreover, the loss of PTPN4 accelerated cell growth and boosted clonogenicity of CRC cells. Furthermore, we revealed that the deletion of PTPN4 promoted the tumor formation of NCM460 cells in vivo. In terms of the molecular mechanism, we demonstrated that PTPN4 dephosphorylates pSTAT3 at the Tyr705 residue with a direct interaction and suppresses the transcriptional activity of STAT3. In summary, our study revealed a novel mechanism that the tumorigenesis of colorectal cancer might be caused by the loss of PTPN4 through activating STAT3, which will broaden the therapy strategy for anti-rectal cancer in the future., (© 2019 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.)

Under the positive human land use regulation (e.g. afforestation), understanding the impacts of landscape pattern changes on urban and rural thermal fields can provide reference data for future construction and optimization of urban afforestation projects and bring new insights for future landscape patterns and thermal fields environment related research. Under the context of "One Million Mu Plain Afforestation Project" in Beijing plain area, we applied remote sensing technology and geographic information system and used transfer-matrix method and coupling analysis to evaluate the impacts of plain afforestation on thermal field environment and to explore the correlation between changes in landscape patterns resulted from urban afforestation projects and urban land surface temperature. Our results showed that the percentage of landscape (PLAND) of forests and parks increased by 7.6% and 0.5% after the afforestation project in Beijing plain area, respectively. The heat island intensity decreased by 19.2% of entire plain area, and by 23.3% of suburban area, however, it increased by 23.5% of city area. Spanning urban to urban-rural interface, the PLAND of forests and parks, the mean patch size (MPS) of forests and wetlands were significantly negatively correlated with the changes in landscape surface temperature (LST). In city area, the area-weighted mean shape index (AWMSI) of forests was significantly positively correlated with the changes of LST. In suburban area, the MPS and AWMSI of forests showed significantly negative correlation with changes of LST, which was contrary to parks. After the implementation of afforestation project in Beijing plain area, the increased urban forests and urban parks had mitigated thermal fields to some extent. The scale of mitigation was limited and most areas with decreased heat island intensity were concentrated in newly planted sites in suburban area. The more connected the forests and wetlands, the better the relief of the thermal fields in the plain area. Impacted by the grain size, time, topography, human activities and other factors, the change in landscape patterns caused by the control of land use structure showed non-linear correlation with the change of LST.

Aim: To investigate expression of cell cycle-related and expression-elevated protein in tumor (CREPT) in colorectal cancer (CRC) and determine its prognostic value in response to 5-fluorouracil (5-FU)., Methods: The relative expression of CREPT in CRC tumor samples was determined using immunohistochemistry. The protein content in cell lines was analyzed by immunoblotting. Cell viability was measured with the CCK-8 assay. Cell cycle and apoptosis analyses were performed with flow cytometry., Results: CREPT was overexpressed in CRC tissues and correlated with histological grade. Clinicopathological analysis indicated that CREPT was positively related to tumor progression. Exogenous expression of CREPT stimulated cell proliferation and accelerated the cell cycle. More importantly, high expression of CREPT sensitized CRC cells to 5-FU treatment. Furthermore, we demonstrated that 5-FU elicited significant apoptosis in CREPT-positive cells., Conclusion: Aberrant overexpression of CREPT contributes to tumorigenesis of CRC by promoting cell proliferation and accelerating the cell cycle, and confers sensitivity to 5-FU. CREPT is a potential prognostic biomarker for 5-FU in CRC., Competing Interests: Conflict-of-interest statement: We declare that we have no financial and personal relationships with other people or organizations that can inappropriately influence our work, there is no professional or other personal interest of any nature or kind in any product, service and/or company that could be construed as influencing the position presented in, or the review of, the manuscript titled “Overexpression of CREPT confers colorectal cancer sensitivity to fluorouracil”.

Objective: The downregulation of Long non-coding RNA MEG3 (MEG3) has been observed in breast cancer (BC). However, there is no previous study of the relationship between MEG3 and patient prognosis in BC. Accordingly, this study investigated the prognostic values of MEG3 in BC patients., Materials and Methods: we performed RT-qPCR to detect the expression of MEG3 in 207 paired BC tissues and adjacent noncancerous tissues. The association of MEG3 expression with clinicopathological factors or prognosis was statistically analyzed., Results: Our findings revealed that the MEG3 expression was significantly decreased in clinical BC tissues compared to adjacent normal tissues (p < 0.01). MEG3 level was significantly associated with differentiation grade (p  = 0.004), TNM stage (p  = 0.011) and lymph nodes metastasis (p  = 0.000). Using Kaplan-Meier analysis, we found that patients with low MEG3 expression had significantly poor overall survival (OS) rate (p  < 0.001) and progression-free survival (PFS)  rate (p  < 0.001). Moreover, multivariate Cox analysis revealed MEG3 expression was an independent poor prognostic factor for both 5-year OS (p  = 0.003) and 5-year PFS (p  = 0.002) in BC patients., Conclusions: Our results indicated that MEG3 expression was an independent prognostic factor for patients with BC, which may serve as a novel biomarker in BC patients.

Objective: We aimed to investigate the association between gastric cancer and microsatellite instability (MSI) in the present study., Method: Phenol-chloroform method was employed for DNA extraction from the cancer tissues of 65gastric cancer patients and the dysplasia tissues and normal control tissues of 32 non-gastric cancer patients. The microsatellite loci Bat25, Bat26, D2S123, D5S346 and D17S250 were detected by using PCR-SSCP silver staining technique, and the MSI of the gastric cancer tissues and the precancerous tissues was analyzed., Results: Of 65 gastric cancer cases, MSI was detected in 43 cases, with the detection rate of 66.2%. There were 13 cases showing MSI-H and 30 cases showing MSI-L, accounting for 30.2% and 69.8%, respectively. Among 32 cases of dysplasia tissues, MSI was detected in 10 cases, with the detection rate of 31.3%. Two cases of dysplasia tissues showed MSI-H and 8 cases showed MSI-L, accounting for 20.0% and 80.0%, respectively., Conclusion: Gastric cancer patients had a high detection rate of MSI. It is speculated that MSI is another molecular mechanism of carcinogenesis and may serve as a sensitive diagnostic indicator of gastric cancer.

Objective: To investigate whether microsatellite instability (MSI) of gastric cancer and precancerous lesions were existed and its effect., Methods: Laser microdissection was used. Gastric, intestinal metaplasia, dysplasia and normal mucosa were collected respectively. Five microsatellite loci were selected and MSI was detected by denaturing high-performance liquid chromatography., Results: In the five microsatellite loci REF-positive phenotype, intestinal metaplasia MSI was 20.7%. Dysplasia MSI was 22.4%. Gastric MSI was 47.9%, and there was no MSI in normal gastric mucosa., Conclusion: MSI gradually increased from precancerous lesions to gastric cancer. The early detection of MSI may be a potential early warning indicator for early diagnosis of gastric cancer.

The impact of early enteral nutrition (EEN) on clinical outcomes of gastric cancer patients was investigated. Three hundred pa-tients undergoing gastric cancer surgery from July 2010 to May 2014 were randomly divided into experimental and control groups (n = 150/group). Experimental group patients received enteral nutrition in water during the early postoperative period. Control group patients received conventional perioperative treatment. Patients' clinical outcomes, post-operative immune function, and nutritional statuses were compared, which revealed that the postoperative fever duration (80.2 ± 6.0 vs 88.1 ± 8.1 h, P < 0.05), anal exhaust time (78.8 ± 9.3 vs 85.3 ± 8.4 h, P < 0.05), and length of hospitalization (7.73 ± 2.13 vs 9.77 ± 1.76 days, P < 0.01) differed significantly. Treatment costs in thousands of dol-lars were 31.24 ± 3.21 for the experimental group and 35.61 ± 2.32 for the control group; this difference was statistically significant (P < 0.01). The incidence of postoperative complications did not significantly differ between the experimental and control groups [14.0% (21/150) vs 17.3% (26/150), P > 0.05]. At postoperative days 3 and 7, the CD3(+), CD4(+), natural killer cell, albumin, and prealbumin levels and CD4(+)/CD8(+) ra-tio were significantly higher in the experimental group than the control group (all P < 0.05). CD8(+) cell counts were significantly lower in the experimental group than the control group (P < 0.05). Postsurgical oral EEN can improve nutritional status and immune function and promote early recovery of intestinal function in patients with gastric cancer.

We investigated the impact of early enteral nutrition (EEN) and parenteral nutrition (PN) on prealbumin (PA) and high-sensitivity C-reactive protein (hs-CRP) in patients after gastric cancer surgery. Sixty-eight selected patients undergoing gastric cancer surgery were randomly divided into the EEN (N = 34) and PN (N = 34) groups. Body weight (BW), serum albumin (ALB), transferrin (TF), PA, hs-CRP, length of hospital stay, cost of postoperative nutritional support, and incidence of complications were compared between groups. On postoperative day 7, the BW, TF, ALB, and PA for both groups were significantly decreased compared with the values obtained on preoperative day 1 (P < 0.01). A significant decrease was observed in TF and PA in the PN group compared with the EEN group (P < 0.01). There was no significant difference in BW and ALB between the two groups (P > 0.05). The hs-CRP level of both groups was significantly higher than on preoperative day 1. There was a significant increase in hs-CRP in the PN group compared with the EEN group (P < 0.01). The anal exhaust time, length of hospital stay, and nutritional support cost were significantly shorter or lower in the EEN group than in the PN group (P < 0.01). There was no significant difference in the incidence of complications between the two groups (P > 0.05). EEN helps regulate the postoperative response of patients after gastric cancer surgery, promotes rehabilitation, and accelerates the recovery of gastrointestinal function. Furthermore, EEN has the advantage of being inexpensive.

Purpose: This study investigated the impact of early enteral nutrition (EEN) on the clinical outcomes of gastric cancer patients after radical gastrectomy., Methods: Four hundred gastric cancer patients undergoing radical gastrectomy of any extend with D2 nodal dissection were randomly divided into an experimental and a control group with 200 cases in each group. Patients in the control group received postoperative parenteral nutrition (PN), while patients in the experimental group received postoperative EEN. After treatment, the clinical outcomes, postoperative immune function, and nutritional status of the two groups were evaluated., Results: The postoperative fever time, intestinal function recovery time, anal exhaust time, and the length of hospital stay for patients in the experimental group were significantly shorter than those of the control group. We did not find significant differences in anastomotic leak, postoperative ileus and regurgitation between the two groups. The activities of multiple immune cell types, including CD3⁺, CD4⁺, CD4⁺/CD8⁺, and natural killer (NK) cells, were significantly lower in both groups on postoperative day 1 when compared with the preoperative levels (p<0.05). The level of CD8⁺ was not significantly different between the two groups (p>0.05). After treatment, levels of CD3⁺, CD4⁺, CD4⁺/CD8⁺, and NK cells in the experimental group patients were 35.6 ± 4.2, 42.2 ± 3.0, 1.7 ± 0.3, and 27.3 ± 5.3%, respectively, on postoperative day 7, which were similar to the preoperative levels. The immune cell levels from the control group patients remained significantly lower when compared with preoperative values; in addition, these values were also significantly lower when compared with the EEN patients (p<0.05) CONCLUSION: For gastric cancer patients undergoing radical gastrectomy, the clinical outcome, immune function and nutritional status after EEN were significantly improved. These data suggest the widespread use of EEN in clinical practice.

Low expression of myeloid/lymphoid or mixed-lineage leukemia 3 (MLL3) is reportedly associated with gastric cancer and tumor progression. The purpose of this study was to examine the expression of MLL3 in tissue samples of patients with gastric cancer and to analyze the relationship between MLL3 protein expression and clinical records. Using immunohistochemical staining and Kaplan-Meier analysis for MLL3 in gastric cancer patients, we found that low expression of MLL3 had a significant relationship with a low survival rate compared to positive MLL3 expression in the patients analyzed (P<0.05). Our data suggest that MLL3 expression plays a vital role in gastric cancer development, and that this protein is an important marker for the prognosis of gastric cancer.

Purpose: Several studies indicated that the expression level of MLL3 gene in gastric cancer tissue was associated with prognosis, and previous studies also suggested that genetic polymorphisms of MLL3 were related to the risk for gastric cancer. The present study aimed to investigate the association of a missense mutation (S3660L) in the MLL3 gene with gastric cancer risk in a Chinese population., Methods: In the present study, we identified a novel missense mutation in MLL3 gene (S3660L) by directly sequencing method in 48 gastric cancer patients. To further explore the relation between gastric cancer and this mutation, we selected 354 gastric cancer patients and 377 healthy control subjects and designed a case-control study., Results: We found that the AG genotype (14.9 vs 6.40%, odds ratio/OR=2.58, 95% CI: 1.33-4.54, p<0.001) and A allele (7.5 vs 3.2%, OR=2.46, 95% CI: 1.55~5.34, p<0.001) were common in the gastric cancer patients than in the control subjects., Conclusion: We concluded that this novel missense (S3660L) mutation in MLL3 gene is likely to increase the gastric cancer risk.

It is reported that the expression level of MLL3 in gastric cancer tissue highly correlates with tumor progression. However, whether MLL3 genetic variants are associated with the risk of gastric cancer remains unclear. In this study, we conducted a genotyping analysis for MLL3 in 314 cases of gastric cancer and 322 controls from the Chinese Han population. 4 SNPs (rs6943984, rs4725443, rs3800836, rs6464211) were selected for the present analysis. We found 2 SNPs (rs6943984, rs4725443) of MLL3 gene were significantly associated with the risk of gastric cancer : the rs6943984 with the minor allele A and rs4725443 with the minor allele C revealed strong associations with increased gastric cancer risk [P <0.001, OR=1.97, 95% CI=1.48~2.64 and P <0.001, OR = 2.23, 95% CI = 1.54~3.24]. Haplotype analysis of the four SNPs showed that haplotype A-T-A-C, G-T-G-C, and G-C-A-C increased the risk of gastric cancer (P <0.001, P=0.18, and P<0.001, respectively), while haplotype G-T-A-C significantly reduced the risk of gastric cancer (P <0.001). We concluded that MLL3 variants are significantly associated with gastric cancer risk. Our results for the first time provided new insight into susceptibility factors of MLL3 gene variants in carcinogenesis of gastric cancer of the Chinese Han population.

Objective: To study the feasibility and early results of radical resection of esophageal carcinoma using single-port thoracoscopy combined with laparoscopy., Methods: From March 2010 to December 2010, 6 patients with esophageal carcinoma underwent radical resection by single-port thoracoscopy combined with laparoscopy in the General Hospital of People's Liberation Army. With the patients at a supine position, laparoscopy was performed to complete stomach mobilization and abdominal lymph node dissection. Thoracoscopy was then carried out with the patients lying on the left to mobilize the esophagus and dissect thoracic lymph nodes. Finally, the stomach was pulled into the thoracic cavity via the hiatus of the diaphragm to construct a tube-like stomach, which was then anastomosed to the esophagus using the OrVil system., Results: No patient was converted to open surgery during the operation. The total operative time ranged from 200 to 320 min. The mean laparoscopic time was 75(range, 45-90) min, and the mean thoracoscopic time 160(120-240) min. The mean intraoperative blood loss was 220(160-300) ml. The mean lymph node retrieval was 12(9-18). No anastomotic fistula, chylothorax, lung infection were found postoperatively., Conclusion: After esophageal resection using single-port thoracoscopic and laparoscopy, reconstruction using OrVil system is safe and feasible.

Objective: To investigate the variation of cell proliferation and growth in different pathological lesions of gastric mucosa and to assess the possible roles of expression of epidermal growth factor receptor (EGFR), transforming growth factor beta receptor type I and type II (TGF(beta)RI, TGF(beta)RII)., Methods: The proliferating cell nuclear antigen (PCNA), EGFR, TGF(beta)RIand TGF(beta)RII were studied in chronic superficial gastritis (CSG, n = 30), chronic atrophic gastritis (CAG, n = 26), intestinal metaplasia (IM,n = 40), Dysplasia (DYS, n = 22), early gastric cancer (EGC, n = 22), advanced gastric cancer (AGC, n = 26) by immunohistochemical methods and their relations with carcinogenesis were analyzed., Results: (1) In different gastric mucosa lesions (CSG, CAG, IM, DYS, EGC, AGC), there were significantly different expression of PCNA (chi2 = 91.06, P < 0.0001), EGFR (chi2 = 52.82, P < 0.0001), TGF(beta)RI (chi2 = 15.93, P = 0.007) and TGF(beta)RII (chi2 = 40.48, P < 0.0001), PCNA and EGFR were increased, TGF(beta)RI and TGF(beta)RII were decreased. (2) In DYS stage, PCNALI (40.00 +/- 16.34) was higher than in CSG (16.63 +/- 10.52), CAG (16.92 +/- 8.50) and IM (23.25 +/- 18.64), but lower than EGC (53.09 +/- 13.51) and AGC (57.54 +/- 16.88) (P < 0.0001); (3) EGFR expression in IM (55.0%) and DYS (72.7%) were higher than in CSG (10.0%) and CAG (3.8%) (P < 0.0001), but no different with EGC (59.1%) and AGC (73.1%). (4) TGF(beta)RI expression in EGC (50.0%) and AGC (30.8%) were lower than in CSG (73.3%) (P = 0.007). (5) TGF(beta)RII expression in AGC (26.9%) was lower than in CSG (83.3%), CAG (82.8%), IM (65.0%), DYS (54.5%) and EGC (45.5%) significantly (P < 0.0001). (6) The expression of EGFR had positive correlation with PCNA, TGF(beta)RI and TGF(beta)RII had negative correlation with PCNA respectively, TGF(beta)RI and TGF(beta)RII had positive correlation., Conclusions: DYS is the key link in the change of cell proliferation during gastric carcinogenesis; The increase of EGFR and the decrease of TGF(beta)R may play important roles in promoting gastric carcinogenesis by affecting gastric cell proliferation.

Objective: To study the effect of helicobacter pylori on gastric mucosal cell proliferation in gastritis., Methods: Fifty-six gastritis patients with or without Helicobacter pylori infection (Hp+ 27; Hp- 29) were selected. The expression of proliferation cell nuclear antigen (PCNA), epidermal growth factor receptor (EGFR), transforming growth factor beta receptor type I and type II(TGFbetaRI, TGFbetaRII) in gastric mucosa were examined by immunohistochemical method., Results: The PCNA and EGFR were significantly higher in Hp positive chronic gastritis patients than in Hp negative ones(P<0.05); The TGFbetaRI(P=0.16) and TGFbetaRII(P=0.97) were lower., Conclusion: Hp infection promotes over proliferation of gastric mucosal cells.

To define the clinical and pathological characteristics of Helicobacter pylori-associated gastritis, 173 patients with chronic gastritis, including 99 Hp-positive and 74 Hp-negative patients were studied. We found that there were no significant differences between Hp-positive and Hp-negative patients with regard to clinical symptoms, gastric acid secretion and serum basal gastrin level, whereas the grades of chronic gastritis and active gastritis were markedly higher in Hp-positive patients. 91.2% of patients with active gastritis had evidence of Hp infection. With the increase in Hp density, the proportion of high grades (II and III) gastritis tended to increase, especially the severe active gastritis. In addition, glandular atrophy and intestinal metaplasia in antral mucosa were significantly commoner in Hp-positive patients. There were no significant differences between the two groups in duodenogastric reflux rate, but the reflux rate over moderate degree in Hp-positive patients (19.59%) was somewhat lower that in Hp-negative patients (36.36%) (P = 0.09).

A sensitive and specific serological diagnostic test for Helicobacter pylori infection has been developed and validated in 120 patients with dyspeptic symptoms undergoing endoscopy. This test is to use urease, a protein unique to H. pylori, as the basis for the enzyme linked immunosorbent assay (ELISA) that detects serum H. pylori urease antibodies. The ELISA mean optical density (OD) in H. pylori-positive group is higher than that in H. pylori-negative group (0.57 +/- 0.23 vs 0.24 +/- 0.15, P < 0.001), a cut-off 0.3 OD yields a sensitivity of 95% and a specificity of 93%. Serum absorption test showed that Escherichia coli, Klebsiella pneumonia, Proteus mirabilis, Yersinia enterocolotica, Pseudomonas aeruginosa cell lysate do not influence serum H. pylori urease antibody level, though they all have urease except E. coli. The result implied that H. pylori urease can be a good antigen to detect serum H. pylori antibody and it would be useful for epidemiological survey and routine diagnostic approach. Nearly half of the blood donors showed positive result with H. pylori urease antibody. It is suggested that H. pylori infection is quite common in the asymptomatic population.

Basal and pentagastrin-stimulated gastric acid secretion and basal serum gastrin level were investigated in 55 active duodenal ulcer patients with antral colonization with Helicobacter pylori (HP) and 17 patients without. Our study shows that basal (BAO) and pentagastrin-stimulated gastric acid secretion (MAO and PAO) were significantly higher in HP positive than in HP negative patients with duodenal ulcer disease. There were also a tendency to increase in basal serum gastrin concentration in HP positive patients. We suggest that antral HP increases antral gastrin release and gastric secretion. Increased acid secretion then causes duodenal ulcers by producing a low intraduodenal pH.

Antibody activities to campylobacter pylori in serum were estimated by an enzyme-linked immunosorbent assay (ELISA) to crude antigens, prepared by sonication of whole organisms obtained from bacterial culture in 100 patients with chronic gastritis. Significantly raised serum IgG antibody activities to C. pylori was found in colonised patients with gastritis, especially in patients with active gastritis. High activities were also found beyond the age of 30. In 6 patients cleared of C. pylori with furazolidone and/or colloidal bismuth subcitrate (De-NoL), serial testing has shown a fall in activity to normal level by 1/2 year in 4 patients. The specificity and sensitivity of the sero-diagnostic assay was 85.3% and 97% respectively. The positive and negative predictive values were 92.8% and 93.5% respectively. The results indicate that such a serodiagnostic assay could be used to screen patients with C. pylori colonisation in epidemiological surveys.

Eighty patients with Campylobacter pylori-associated duodenal ulcer disease were randomly allocated to receive colloidal bismuth subcitrate (CBS)tablet 120 mg four times a day or ranitidine 150 mg twice daily in a trial comparing the effects of these drugs in short-term healing and post-healing relapse rates of duodenal ulceration. At 8 weeks 88.1% (37/42) of those on CBS and 92.1% (35/38) of those on ranitidine had ulcers healed. The difference is not significant. After ulcer healing, the cumulative rates of relapse, as determined endoscopically, for symptomatic and asymptomatic ulcers were 19.4% (6/31) for CBS and 46.7% (14/30) for ranitidine at 6 months (P less than 0.05) and 41.9% (13/31) for CBS and 73.3% (22/30) for ranitidine at 12 months (P less than 0.05). As campylobacter pylori was cleared in 35 of the 42 patients (83.3%) in the CBS group, while only one of the 38 patients (2.63%) in the ranitidine group (P less than 0.005), it is possible that the clearance of Campylobacter pylori by CBS is instrumental to the reduction of the rate of reulceration.

Five patients with duodenal ulcer received cimetidine and after an interval of four days cimetidine with antacid. Cimetidine in serum was analysed with high performance liquid chromatography. There was no significant difference in the values of the pharmacokinetic parameters of cimetidine (Cmax, tmax and AUC) when taking cimetidine alone and cimetidine plus antacid. 53 outpatients with endoscopically proven duodenal ulcer were evaluated in a randomized study, so as to compare the therapeutic effect of cimetidine and aluminum hydroxide gel plus cimetidine. 18 of 26 patient taking cimetidine alone (69.2%) and 19 of 27 patients taking cimetidine plus antacid (70.4%) had their ulcer completely healed after 4 weeks. The overall healing rates after 8 weeks for the groups taking cimetidine alone and cimetidine plus antacid were 80.0% and 92.6% respectively with no significant difference. This study indicates: (1) Simultaneous administration of aluminum hydroxide gel does not alter the bioavailability of cimetidine. (2) Combined administration of aluminum hydroxide gel and cimetidine does not alter the therapeutic effect of cimetidine in patients with duodenal ulcer.

Obesity can be reversed in ob/ob mice by parabiosis to lean littermates, by islet transplantation, and by injection of pancreatic polypeptide. These observations suggest that obese mice have functioning satiety centers but lack a circulating satiety factor of pancreatic origin which could be pancreatic polypeptide. This hypothesis has been difficult to test because antisera currently available do not cross-react with rodent pancreatic polypeptide. We have raised an antiserum against the biologically active carboxyl-terminal hexapeptide that measures mouse pancreatic polypeptide specifically. This antiserum has been used to compare circulating and tissue concentrations of pancreatic polypeptide in obese and lean mice. Although pancreatic contents were significantly (p less than 0.01) increased in obese mice (237 +/- 34 pmol/g) compared with lean littermates (107 +/- 20 pmol/g), no postprandial increase in circulating concentrations was observed in obese mice. The hypothesis that obese mice lack a satiety factor of pancreatic origin could be explained by the failure of release of pancreatic polypeptide.

Thirty patients with bile reflux gastritis, proven by gastroscopy and Milk 99mTc-EHIDA Test, were studied and their clinical features were compared with those of patients with non-bile reflux gastritis. The symptoms were similar in both groups of patients, whereas histologically in bile reflux gastritis there were more hyperemia of mucosa, more obvious edema in lamina propria and more polymorphonuclear infiltration. Furthermore, in bile reflux gastritis the histological changes were more severe in the antrum and decreased in severity toward the cardia. Acid secretion was significantly lower in patients with bile reflux gastritis than in patients with non-bile reflux gastritis while the serum gastrin level was significantly higher in the former than in the latter group. The authors suggest that there may be a vicious cycle among duodenogastric reflux, low level of gastric acidity and high level of serum gastrin. When duodenogastric reflux occurs, not only the bile salts damage the gastric mucosa and subsequently cause the back diffusion of hydrogen ion but also the alkaline duodenal juice neutralizes the gastric acid, resulting in decrease of gastric acidity. The bile salts and low acidity can stimulate the release of serum gastrin which antagonizes the effects of cholecystokinin and secretin on pyloric tone and aggravates the duodenogastric reflux.

Duodenogastric reflux was estimated in 101 patients with chronic gastritis by means of endoscopy and milk 99mTc-EHIDA test. 61 patients (60.4%) were deemed to be duodenogastric reflux positive by endoscopy, as compared to 40 patients (39.6%) by milk 99mTc-EHIDA test. These differences are statistically significant (P less than 0.005). The discrepancy arises largely from the error in endoscopic estimation of duodenogastric reflux. In a group of 58 patients who were mild to moderate reflux positive by endoscopy, the assessment made by the milk 99mTc-EHIDA test was reflux positive in only 33 (57%). In other words more than 40% of the endoscopically reflux positive patients did not show reflux with 99mTc activity in the stomach. Measurement of the ratio of 99mTc activity in gastric aspirates to the total 99mTc activity injected intravenously was carried out in 13 patients. A perfect correlation was found between the ratio and the grading of duodenogastric reflux estimated by the milk 99mTc-EHIDA test. This finding suggests that by using the milk 99mTc-EHIDA test, duodenogastric reflux may be monitored semiquantitatively without recourse to a nasogastric tube. Furthermore, 10 patients were evaluated twice by the milk 99mTc-EHIDA test at intervals ranging from 3-14 days. In 8 patients the results were identical. This indicates the good reproducibility of the test. This study demonstrates that milk 99mTc-EHIDA test is a more physiological and more accurate method of studying duodenal contents in the stomach, than endoscopy.