2016年 · 第36卷第12期

There are more than 1 000 species of bacteria inhabiting the human intestine, and their total number is close to 1×10¹³～1×10¹⁴CFU. Most of the bacteria in the intestinal tract colonize the human colon, and the bacteria content per gram of intestinal content is as high as 1×10¹²CFU. The intestinal micro-ecosystem is the largest and most important micro-ecosystem in the body, which plays an important role in the health and nutrition of the host, and is the key factor in activating and maintaining the intestinal physiological function^[1]。 Under normal circumstances, the human body selectively colonizes certain microorganisms in the intestine and provides them with suitable habitat and nutrition. These microorganisms and their metabolites play a biological barrier function in the human body, participate in the maturation of the immune system and the regulation of immune response, and play an important role in various physiological metabolisms in the body. Some studies have even pointed out that the kinds and quantities of beneficial bacteria in human intestines can reflect the health state of human body to a certain extent^[2]。

Most patients with advanced esophageal cancer suffer greatly because they can't eat, and their treatment aims mainly at improving their quality of life. At present, the commonly used treatment methods include local surgical resection and palliative treatment. Local surgical resection is injurious and often intolerable by patients. Commonly used palliative treatment methods include endoscopic dilatation, esophageal stent placement, endoscopic chemotherapy sustained-release seed implantation and nasogastric nutrition tube placement. Intracavitary radiofrequency ablation is the latest achievement of radiofrequency ablation technology, which is mainly used for the treatment of cavity organ tumors, such as biliary tract tumors and low colorectal cancer. At present, there are few reports of using endovascular radiofrequency ablation technology to treat esophageal cancer in China. This study retrospectively compared the efficacy of radiofrequency ablation with endoluminal catheter and esophageal stent in the treatment of patients with malignant obstruction of esophageal cancer within 6 months.

China is a high incidence area of esophageal cancer, most of which are esophageal squamous cell carcinoma (esophageal squamous cell carcinoma, ESCC)^[1,2,3]Its incidence distribution varies greatly, especially in Henan, Hebei, Shanxi and other provinces, which belong to high-incidence areas. Although a large number of studies have tried to explore the pathogenesis of ESCC in recent years, attention has been paid to its early diagnosis and treatment modalities. However, so far, the etiology, the mechanism of occurrence and development of ESCC are still not very clear, and there is no breakthrough in early diagnosis and treatment. It is still one of the important malignant tumors that seriously threaten people's life. The 5-year survival rate of patients in middle and advanced stage is 10% ~15%^[4]。 In-depth research on the mechanism of ESCC occurrence and development is the key to early diagnosis and treatment of esophageal cancer and improve the survival of patients.

Rectal cancer is a common malignant tumor of the digestive tract, accounting for 60% to 75% of colorectal cancer. In recent years, its incidence has been increasing year by year^[1]。 At present, surgery is still the first choice for the treatment of rectal cancer. The judgment of benign and malignant rectal tumors and their staging before surgery is crucial for the choice of treatment options and prognostic evaluation. Transrectal ultrasound imaging has the advantages of simple operation, rapid safety, low price and so on, and it has irreplaceable advantages in preoperative assessment of the depth of tumor invasion and the presence of lymph node metastasis^[2]。

non-alcoholic fatty liver disease (NAFLD) refers to a clinical syndrome characterized by diffuse hepatocellular bullous steatosis, excluding ethanol and other definite liver injury factors. In recent years, with the improvement of economic level and the change of lifestyle, the incidence of NAFLD has shown an obvious upward trend. The prevalence of NAFLD in the general population is as high as 20% ~60%, which has become a global disease and seriously threatens people's health^[1]。H.pyloriIt is a Gram-negative bacillus, mainly colonized in human gastric mucosal epithelium. Epidemiological investigation shows that its infection rate in Chinese natural population has exceeded 50%^[2]。 It is currently believed that,H.pyloriIt is the main causative factor of gastric inflammatory reaction, peptic ulcer, gastric lymphoma and gastric cancer^[3]。 The study also found that,H.pyloriThere is a close association with liver tumors and parenteral diseases involving abnormal lipid metabolism^[4]。 Where NAFLD is associated withH.pyloriThe relationship between^[5]However, the sample size of related studies is small and the results are not the same. Therefore, in order to further explore the relationship between NAFLD and middle-aged and elderly peopleH.pyloriIn 2013, this study conducted a cross-sectional survey on all middle-aged and elderly employees of a petrochemical enterprise in Zhenhai District, Ningbo. The results are reported as follows.

hepatic angiomyolipoma (HAML) is a rare benign tumor of the liver, which is mainly composed of blood vessels, smooth muscle and fat^[1]。 HAML can occur in different genders, but the majority of patients are women. Most patients with HAML are asymptomatic when diagnosed, and a few complain of abdominal discomfort, abdominal distension and other non-specific symptoms, which are often misdiagnosed as liver cancer. It has been reported that the preoperative diagnostic accuracy of HAML is only 25% ~52%, or even lower^[1,2]。 The benign biological behavior of HAML has been recognized, but more and more cases have been reported that it will have malignant changes such as enlargement, metastasis, invasive growth, and postoperative recurrence^[3,4,5,6]。 Although some scholars have given recommendations on the diagnosis and treatment of HAML, there are no ideal diagnosis and treatment guidelines^[7,8]。 In order to accumulate more experience on the diagnosis and treatment of HAML, this study retrospectively analyzed the clinical manifestations, imaging examinations, pathological features, treatment methods and prognosis of 6 patients with HAML.

Microwave ablation is an important treatment for hepatocellular carcinoma, but the recurrence rate is still relatively high after treatment^[1]。 It has been reported in some literature that thermal ablation combined with molecular targeted drugs can help to expand their respective curative effects and improve the therapeutic effect of hepatocellular carcinoma^[2,3]。 targeted contrast-enhanced ultrasound (targeted-CEUS) has been recognized as an effective imaging technique to accurately and quantitatively evaluate tumor angiogenesis at the molecular level^[4,5]。 Through the combination of ligands on microbubbles and specific targets, local acoustic signals can be amplified, so as to achieve the purpose of specific imaging, and then non-invasively evaluate tumor growth and response to molecular targeted therapy at the molecular level. In this study, we constructed a therapeutic model of incomplete thermal ablation of subcutaneous implanted tumors in nude mice combined with bevacian monoclonal antibody (hereinafter referred to as monoclonal antibody), and used targeted ultrasound contrast agent carrying vascular endothelial growth factor receptor 2 (VEGFR2) to show intratumoral microcirculation perfusion, aiming to explore the efficacy and application value of incomplete thermal ablation combined with molecular targeted drugs.

Isolated adrenocorticotropic hormone (ACTH) deficiency refers to secondary adrenocortical dysfunction that is not accompanied by pituitary hormone deficiency except ACTH deficiency. The disease has low incidence, no specific clinical manifestations, and is easy to be misdiagnosed^[1]。 Some patients only presented with non-specific gastrointestinal symptoms and were admitted to the gastroenterology department. The clinical data of 4 adult patients with isolated ACTH deficiency with gastrointestinal symptoms as the first episode were retrospectively analyzed to improve the understanding of gastroenterologists on this disease.

The 5th Beijing Forum on Integrated Medicine of Traditional Chinese and Western Medicine for Gastrointestinal Function and Motility Diseases, sponsored by Digestive Integrated Medicine Branch of China Association for the Promotion of Traditional Chinese Medicine, Chinese Society of Traditional Chinese Medicine, Peking Union Medical College Hospital, General Hospital of Chinese People's Liberation Army, Wangjing Hospital of Chinese Academy of Chinese Medical Sciences, Beijing Jishuitan Hospital, Peking University First Hospital, Peking University Third Hospital and Journal of Traditional Chinese Medicine (English version), was held in the lecture hall of Beijing European and American Alumni Association on July 3, 2016.

IBS is a common functional intestinal disease in clinic. Its pathogenesis has not been fully elucidated so far, and there is a lack of ideal therapeutic drugs. Based on the basic and clinical research of IBS in recent years and the progress of diagnosis and treatment in the recently published 2016 Rome IV standard^[1]Now, the current situation of drug treatment for IBS is analyzed.

IBD is a chronic nonspecific intestinal inflammatory reactive disease of unknown etiology, including UC and CD. At present, the diagnosis of IBD is mainly combined with clinical manifestations, endoscopic manifestations and histopathology, and the diagnosis is made on the basis of excluding other intestinal diseases^[1]。 In recent years, some imaging diagnostic methods such as endoscopic ultrasonography, computed tomography enterography (CTE) and magnetic resonance enterography (MRE) have played an important role in the diagnosis of IBD. Endoscopic ultrasound combines endoscopy and ultrasound to obtain histological features of the gastrointestinal tract hierarchy and ultrasound images of the surrounding adjacent organs^[2]； CTE and MRE refer to the images obtained by using oral contrast agent to uniformly expand all small intestines, and then intravenously injecting contrast agent to enhance the CT or MRI continuous scan, which can clearly show mucosal enhancement, intestinal wall thickening, intestinal wall blood supply and extraintestinal lesions, etc^[3]。 The application of endoscopic ultrasound, CTE and MRE in the diagnosis of IBD is reviewed.

fecal microbiota transplantation is to isolate functional bacterial flora from healthy human feces, and then transplant it into the digestive tract of patients, so as to achieve the treatment of diseases by reconstructing the intestinal flora of patients^[1]。 Although the mechanism is unknown, more and more clinical trials have been conducted worldwide to reveal its potential therapeutic prospects for a variety of gastrointestinal and external diseases. However, in addition to the lack of relevant clinical data and the lack of uniform norms, the development of fecal bacteria transplantation technology has also impacted traditional culture, ethical values, religious concepts and management norms, and triggered rethinking of concepts such as "health" and "disease", "risk" and "ownership".

In recent years, the incidence of primary liver cancer has gradually increased, becoming the sixth most common cancer and accounting for the second cause of cancer death. Hepatocellular carcinoma includes hepatocellular carcinoma, cholangiocellular carcinoma and mixed carcinoma, with hepatocellular carcinoma accounting for 70% to 85%^[1]。 The most common causes of hepatocellular carcinoma are viral hepatitis and alcoholic hepatitis, but 15% ~50% of hepatocellular carcinomas are not related to chronic liver disease caused by viral infection and alcohol consumption. At present, it is believed that about half of them may be related to non-alcoholic fatty liver disease (NAFLD)^[1]。 NAFLD includes non-alcoholic fatty liver disease (NAFL), non-alcoholic steatohepatitis (NASH) and NASH-associated cirrhosis, and can also progress to end-stage changes such as liver cancer. The increase in the prevalence of hepatocellular carcinoma is inseparable from the increase in the prevalence of NAFLD. The latest research progress in epidemiology, risk factors, pathogenesis and treatment of non-alcoholic fatty liver disease-hepatocellular carcinoma (NAFLD-HCC) is reviewed.