Effect of Weikangfu Granule (胃康复冲剂) on the Physiopathologic Figure of Precancerosis of Gastric Mucosain Patients of Chronic Gastritis with Pi-Deficiency Syndrome

To study the physiopathologic basis of Weikangfu Granule （胃康复冲剂, WKFG） in treating precancerosis of gastric mucosa in patients of chronic gastritis with Pi-deficiency syndrome （CGPDS）. Methods： One hundred and fifteen patients of CG-PDS who suffered from intestinal metaplasia （IM） and atypical hyperplasia （ATHP） of gastric mucosa, were divided into two groups. The treated group （n=61） was treated by WKFG with its ingredients modified according to the syndrome type of patients. The control group（n=54） was treated with Weishu granule （胃舒冲剂）. The histopathological and subcellular ultrastructural changes were detected by optical microscope, screening electronic microscope, transmission electronic microscope and histochemical staining; the nuclear and mitochondrial ultrastructure of gastric mucosa were analyzed with energy dispersion X-ray analyser and image analysis system. And the changes of cAMP, lipid peroxide （LPO）, superoxide dismutase （SOD） before and after treatment in the treated group were measured and compared with those of the health control group consisting of 15 volunteers. Results： The symptomatic and pathological therapeutic effect in the treated group were significantly superior to those in the control group （P〈0.05）. The contents of Zn, Cu, cAMP, SOD and 3H-TdR LCT in gastric mucosa of the treated group before treatment were all lower than those of the healthy control group, yet all these indexes markedly increased after treatment, while serum LPO level, which increased before treatment was lowered after treatment. All the changes showed statistical significance （P〈0.05 or P〈0.01）. Conclusion： WKFG can reverse IM and ATHP in patients of CG-PDS, and the effect may be realized by way of increasing the level of Zn, Cu, cAMP and SOD in gastric mucosa, promoting cell differentiation, enhancing cellular immunity and reducing oxygen free radicals and lipid peroxidation.

Esophageal lichen planus:Current knowledge,challenges and future perspectives

Lichen planus(LP)is a frequent,chronic inflammatory disease involving the skin,mucous membranes and/or skin appendages.Esophageal involvement in lichen planus(ELP)is a clinically important albeit underdiagnosed inflammatory condition.This narrative review aims to give an overview of the current knowledge on ELP,its prevalence,pathogenesis,clinical manifestation,diagnostic criteria,and therapeutic options in order to provide support in clinical management.Studies on ELP were collected using PubMed/Medline.Relevant clinical and therapeutical characteristics from published patient cohorts including our own cohort were extracted and summarized.ELP mainly affects middle-aged women.The principal symptom is dysphagia.However,asymptomatic cases despite progressed macroscopic esophageal lesions may occur.The pathogenesis is unknown,however an immune-mediated mechanism is probable.Endoscopically,ELP is characterized by mucosal denudation and tearing,trachealization,and hyperkeratosis.Scarring esophageal stenosis may occur in chronic courses.Histologic findings include mucosal detachment,T-lymphocytic infiltrations,epithelial apoptosis(Civatte bodies),dyskeratosis,and hyperkeratosis.Direct immuno-fluorescence shows fibrinogen deposits along the basement membrane zone.To date,there is no established therapy.However,treatment with topical steroids induces symptomatic and histologic improvement in two thirds of ELP patients in general.More severe cases may require therapy with immunosuppressors.In symptomatic esophageal stenosis,endoscopic dilation may be necessary.ELP may be regarded as a precancerous condition as transition to squamous cell carcinoma has been documented in literature.ELP is an underdiagnosed yet clinically important differential diagnosis for patients with unclear dysphagia or esophagitis.Timely diagnosis and therapy might prevent potential sequelae such as esophageal stenosis or development of invasive squamous cell carcinoma.Further studies are needed to gain more knowledge about the pathogenesis and treatment options.

THE EXAMINATION OF AN EBV-DNASE GENE FRAGMENT IN THE PARAFFIN-EMBEDDED NPCI PRECANCEROUS AND FROM HIGHRISK POPULATION NASOPHARYNGEAL TISSUES

Objective: To examine if the EB virus appears innasopharyngeal epithelial cells in the course oftumorigenesis in nasopharyngeal carcinoma (NPC).Methods: Based on the annual investigation of SihuiCounty, a cancer-prevention base of Sun Yat-senUniversity of Medical Sciences(SUMS) and armorHospital out-patient clinic, more than 450 paraffinembedded NPC tissue specimells, precancerous lesionsand precancerosis from a high--risk population werecollected for detection of an EBV-DNase gene fragmentby an optimized PCR method. Results: In 145 of the149 (97.3%) cases with invasive NPC, and 2 of 4 caseswith in situ NPC, only 2 of the 155 subjects withprecancerosis was DNase gene positive, and all 47 casesexamined in the out-patient department of the TumorHospital with precancerous lesions in the nasopharynxwere negative. Conclusion: The universal presence ofan EBV-DNase gene in NPC tissues and the paucity ofEBV-DNase gene in nonmalignant and precancerouslesions in the nasopharynx in a high-risk populationimply that carcinogenesis of NPC occurs before theappearance of EBV in the nasopharynx.