9^th Euro-Global Gastroenterology Conference October 24-25, 2016 Valencia, Spain

Zekuan Xu has completed his PhD at the age of 38 years from Nanjing Medical University. Now, he is the director of General Surgery, the First Affiliated Hospital of Nanjing Medical University. He has published more than 40 papers in reputed journals and has been serving as reviewers of Oncotarget, Tumor Biology and so on.

Objective The aim of this study was to investigate the safety and feasibility of laparoscopic uncut Roux-en-Y anastomosis in the distant gastrectomy for gastric cancer. Methods The clinical data of 92 patients performed laparoscopic uncut Roux-en-Y anastomosis in the Department of Gastric Surgery, the First Affiliated Hospital of Nanjing Medical University from June 2014 to June 2016 were analyzed retrospectively. Results The operations were performed successfully for all patients. The mean operation duration, anastomosis time, blood loss and the number of lymph nodes dissection during the surgery were (178.67±29.12) min, (30.84±7.41) min, (48.78±35.64) ml and 34.43±9.84 respectively. The time spent before gastrointestinal motility, liquid-diet intake, out-of-bed ambulation and the average hospitalization days after operation were (76.40±21.47) hours, (5.30±1.25) days, (48.14±20.25) hours and (9.19±3.09) days respectively. Postoperatively, 6 patients experienced complications, including gastrointestinal bleeding (2 patients), duodenal stump fistula (1 patient), Chylorrhea (1 patient)，Roux-Y stasis syndrome after gastrectomy (2 patients)，all of the complications were cured conservatively. None of the other complications occurred, such as anastomotic fistula, anastomotic stenosis, infection of incision, etc. Conclusion The laparoscopic uncut Roux-en-Y anastomosis is safe and feasible in the distant gastrectomy with D2 dissection for gastric cancer, with advantages of less trauma, faster recovery and so on.

Sylvia S. Sedhom was graduated from the faculty of Pharmacy, Ain shams University, has completed her Master’s degree at the age of 28 years from Ain Shams University. She works as a clinical pharmacist in the Pharmacology department in the National Research Centre, Cairo, Egypt. She has an interest in Research and has various presentations about different topics in clinical pharmacology.

Background: Non Alcoholic Fatty Liver Disease (NAFLD) is the most common cause of chronic liver injury. Elevated Uric acid (UA) is an important factor in the development of NAFLD. Both combined result in Apoptosis which is an important mechanism in pathogenesis of NAFLD, where it leads to activation of caspase family of intracellular proteases which then cleave different intracellular proteins including cytokeratin 18 (CK18) which can be used as a key marker in NAFLD. Objective: Evaluating the effect of treating hyperuricemia by allopurinol on NAFLD patients by blood markers as CK18, liver enzymes (GOT, GPT), Cholesterol (Chol) and Triglyceride (TG).Methods:31 hyperuricemic patients with NAFLD diagnosed by ultrasound were enrolled in the study and divided into two groups; Group A (14 patients): Placebo group who received starch based tablets for 3 months and Group B (17 patients): Treatment group who received allopurinol (300 mg) for 3 months. UA, CK 18, GPT, GOT, Chol and TG were measured before and after treatment.Results: The study showed a significant decline in CK18 levels after treatment (P=0.006), improvement in GPT and GOT levels after treatment (P<0.001 and P=0.013 respectively), also there was an improvement in Chol and TG levels after treatment (P= 0.01 and 0.038 respectively). Conclusion: Allopurinol may play a role in improvement of patients with NAFLD associated with hyperuricemia and CK18 may be used as a good marker in assessing patients’ improvement

Inna is an experienced doctor (Pediatrician), Researcher with more than 23 years practical experience in treatment, diagnosis and prevention of various diseases of children and adolescents. In 2006, Inna received academic degree of PhD in Medical Sciences (main specialty Pediatrics). Until April 2014, she worked as a Researcher at the Institute of Children and Adolescents Health Care of National Academy of Medical Sciences of Ukraine. She has more than 60 scientific publications in various journals, eight Innovations and three Methodological recommendations for practical public health. Living in Luxemburg she works in an Economic Advisory Company as a Business Development Manager and as a Researcher of new methods of diagnosis and treatment in the field of medicine.

The aim of the present study is improving prophylaxis and treatment of chronic gastroduodenal pathology in adolescents on the basis of determining clinical, endoscopic, and morphological peculiarities of said pathology. A total of 155 adolescents 11 to 18 years of age with inflammatory-destructive diseases of the upper gastrointestinal tract and Connective Tissue Disorders (CTD) were studied. The traits of the CTD, including the Marfan syndrom, were determined relying on the Ghent criteria. Morphological peculiarities are represented by high frequency of reflux-gastritis (77%) and a reduction in the level of interstitial collagens type 3 and type 1 in the lamina propria of gastric and duodenal mucosa. The form of mucosal lesions is a chronic non-atrophic (surface) gastritis with simultaneous inflammation in the antral and fundal parts. Duodenal ulcer was detected in 12% only and it was accompanied by detection of Helicobacter pylori. The connective tissue matrix of the mucosa is characterized by structural transformation of collagen fibrils (wrong orientation, focal sclerosis, immaturity). It is accompanied by decrease in a mucosa functional ability with development of the valve-sphincter failure. The role of CTD in the development of gastroduodenal pathology in puberty has been established. A genetically dependent insufficiency of interstitial collagens is a major cause of development bile reflux, which is a leading factor of gastroduodenal pathology formation in adolescents with CTD. The work provides grounds for employing in adolescents with CTD rehabilitation measures, connected with a prevention of reflux-gastritis progression and stimulation of the collagen synthesis.

HYUN MIN KOH has completed her MD at the age of 31 years from Jeju National University and PhD studies from Jeju National University School of Medicine. She is the fourth year in pathology residency, Jeju National University Hospital. She is a associate member of the Korean Society of pathologists

Background: Aurora kinase A is a member of the serine/threonine kinase family and plays important roles in mitosis and chromosome stability. This study evaluated the clinical significance of Aurora kinase A expression in colorectal cancer patients in Korea. Methods: Aurora kinase A protein expression was evaluated by immunohistochemistry in 151 patients with colorectal adenocarcinoma using tissue microarray blocks. We then analyzed the relationship between clinicopathological characteristics and Aurora kinase A expression. In addition, we assessed the prognostic significance of various clinicopathological data for progression-free survival. Results: Aurora kinase A expression was detected in 45% (68/151) of the cases. Positive staining for Aurora kinase A was observed more often in male patients (P=0.035) and distally located tumors (P=0.021). progression-free survival was shorter in patients with Aurora kinase A expression compared to those with low-level Aurora kinase A expression (P<0.001). Univariate analysis revealed that Aurora kinase A expression (P=0.001), age (P=0.034), lymphatic invasion (P=0.001), perineural invasion (P=0.002), and TNM stage (P=0.013) significantly affected progression-free survival. In a multivariate analysis of progression-free survival, a Cox proportional hazard model confirmed that Aurora kinase A expression was an independent and significant prognostic factor in colorectal adenocarcinoma (hazard ratio, 3.944; P<0.001). Conclusions: Thus, Aurora kinase A could serve as an independent factor to predict a poor prognosis in Korean colorectal cancer patients.

Paweł Kozieł has graduated from Silesian Medical University in 2011 and he works in Department of Internal Medicine in Bytom as junior assistant. Currently Paweł is also a PhD student in the Medical Doctor programs at Silesian Medical University in Katowice. His works was recently published in 4 international journals and 2 local journal, in the areas of gastroenterology, oncology and endoscopic techniques in particular

ADAM proteins belongs to the family of matrix metalloproteinase. In humans identified ca. 20 members of this group. The main role of these proteins are involved in the processes of migration, adhesion and cell proliferation, hence their importance in the process of carcinogenesis. In the present study we examined the relationship between serum levels of ADAM 12 ADAM 17 in patients with colorectal cancer depending on the staging and grading. The study included 70 patients (41 men, 39 women), age: 32-88 years (mean age 69.01). Protein concentrations in serum were determined by ELISA and the results are compiled in the Statistica 12. ADAM 12 protein concentrations ranged 0, 6- 26,72ng / ml (mean: 5,00ng / ml). Protein concentrations of ADAM 17: 0, 44-9, 83 ng / ml (mean: 2.09 ng / ml). In the study group, 31 patients were classified as early stage of the disease (TNM I-IIC). In the study group dominated second degree of histological malignancy (G2- 48 patients) and the most common type of cancer was Adenocarcinoma. Based on the analysis, there was no significant relationship between the degree of clinical stage and histological grade of colorectal cancer and serum concentrations of ADAM 12 and 17. Moreover positive relationship between serum concentration of ADAM 12 and ADAM 17 was found. In our view, research on the role of ADAM proteins in colorectal cancer need to be continued, and presented results can be a starting point for further projects.

Hongsoon Jung has completed his MD at the age of 25 years from Catholic University of Korea and postdoctoral studies from Catholic University Korea, College of Medicine. He is now attched in division of gastroenterology of Seoul St. Mary’s Hospital and fellowship training

Flumazenil is a benzodiazepine antagonist that blocks the central effects of benzodiazepines. Previous studies suggest that routine use of flumazenil after midazolam sedation for endoscopy shorten the recovery time, but there is no data on timing of flumazenil administration. In this study we assessed the timing of flumazenil in outpatients receiving intravenous sedation with midazolam. From 2012 August to 2015 July, 74 participants undergoing sedative diagnostic endoscopy with midazolam were prospectively included. They were randomized in a double-blind to receive either flumazenil immediately (immediately group) or 30 minutes later after the procedure (delayed group). Four hours after the sedative endoscopy each patient was interviewed by telephone to assess the primary end point, sleepiness and dizziness. 74 participants were analyzed, 37 with immediate administration of flumazenil and 37 with delayed administration. There were no significant differences between the two groups in age, sex, blood pressure, pulse rate, the average dose of midazolam, procedure duration, recovery time, previous history of endoscopy and satisfaction score from the patients. Also, there was no significant difference in sleepiness and dizziness between immediately group and delayed group. Sleepiness (Immediately injected group = 56.8%, delayed injected group = 45.9%) and dizziness (Immediately injected group = 24.3%, delayed injected group = 40.5%) was observed in almost half of the participants, in particular within two hours. In this prospective, randomized, double-blinded clinical trial showed that there is no significant difference in safety between two groups. Patient who received flumazenil should be monitored for 2 hours after its administration because of the potential for re-sedation.

Paweł Kozieł has graduated from Silesian Medical University in 2011 and he works in Department of Internal Medicine in Bytom as junior assistant. Currently Paweł is also a PhD student in the Medical Doctor programs at Silesian Medical University in Katowice. His works was recently published in 4 international journals and 2 local journal, in the areas of gastroenterology, oncology and endoscopic techniques in particular

The antiproliferative and immunomodulatory effects of melatonin (MLT) have been demonstrated in a variety of neoplasms including colorectal cancer (CRC). In humans and other mammals, MLT acts on target tissues through membrane and retinoid nuclear receptors. The aim of the study was to evaluate transcription activity of melatonin receptors and genes associated with regulation of their activity in colorectal adenocarcinoma tissues in relation to clinical stage of cancer. A total of 24 pairs of surgically removed tumoral and healthy (marginal) tissues samples from colorectal cancer patients at clinical stages I-II and III-IV were collected. As the additional control, twenty normal samples were taken from people whose the large intestine tissues were reported as non-tumoral after colonoscopy. Expression of mRNA genes was studied by microarray HG-U133A analysis. The analysis of genes expression profile was performed using commercially available oligonucleotide microarrays of HG-U133A (Affymetrix, Santa Clara, CA). We found a high increase of MT1 mRNA expression levels in all cancerous samples vs. non-cancerous tissues. The MT2 mRNA expression levels increased slightly in marginal and malignant samples. The melatonin receptors gene expression was dependent on tumour grade. Among the genes participating in the cascade of signal transfer in cell activated by MLT via MLT1 and MLT2, the following ones: GNA11, OXTR, and TPH1 encoding genes respectively as differentiating stage III and IV of CRC. Monitoring the expression levels of genes that are related to melatonin receptors may offer a strategy to anticipate tumour development and estimate the molecular changes that occur during carcinogenesis. The mechanism behind this association needs further elucidation

vijaya kumar is a professor and head of dept. Of pediatric surgery, kasturba medical college, manipal university, manipal, karnataka state, india.

Chronic Pancreatitis is a chronic inflammatory disease characterized by fibrosis and destruction of exocrine pancreatic tissue. It is prevalent in many parts of the world with varying epidemiological profiles in different areas. There is a relatively high prevalence of such disorders in southern India. In most series, the etiologies are trauma, biliary tract distension or unknown . In majority of CP in children, medical therapy alone suffices and surgical intervention is reserved for complications. This study was conducted to establish the clinical profile of pancreatic disorders in paediatric patients ranging in age from 1 to 19 years in a tertiary care hospital in southern India. Materials and Methods: The records of the patients up to 19 years of age diagnosed to have pancreatitis at our institution for the last 12 years were reviewed with a proforma to record the following parameters: age, gender, presenting complaints, examination findings, investigations, management with medical treatment, surgical intervention or both and complications. There were 50 patients ranging from age group 3 to 19 years, out of which 30 were males and 20 were females. 41 patients were between the ages of 11-19 years old, 5 were between the ages of 6-10 years, and 4 were between the ages of 1-5 years old. 28 patients presented with acute on chronic pancreatitis and 22 patients had calcific chronic pancreatitis. The etiology of CP in 42 patients was idiopathic, in 4 was biliary tract disease, 2 were alcoholic, and 2 were congenital (pancreatic divisum). Complications like pseudo cyst was seen in 19 patients, ascites in 4, diabetes in 3, pleural effusion in 3, splenic thrombosis in one, acute necrotizing pancreatitis in one, retroperitoneal abscess in one and acute renal failure in one patient. Apart from medical line of management, 12 patients underwent stenting of pancreatic duct and 10 underwent surgical treatment for complications. Among the complications, acute relapses of chronic pancreatitis were the most common. 38% of the patients had pseudocysts. 44% had calcific pancreatitis. 6% developed diabetes. 8% had ascites. 6% had pleural effusion. And there were 3 deaths due to sepsis.

Magdalena Potempa Student Research Cycle Department of Pathophysiology and Endocrinology School of Medicine with the Division of Dentistry in Zabrze Medical University of Silesia

Proper rules of dietary habits should be present in most of households and known by every adult people, particulary among parents raising their children and educating them how to eat healthy. Regular nutritional habits are an elementary factor to achieve good growth and human health. Our main assumption of this research was to determinate through anonymous questionnaire the level of knowledge of proper nutritional habits among parents of children attending some primary Schools in Poland (Silesian and Opole Voivodeship). This research is a follow-up of our previous study, which were focused on the assessment of dietary habits among children going to Primary Schools (in the age od 6-13 years old). Our last study consisted of nearly 1000 respondents living in rural and urban areas. The results were alarming – approximately 20% of all studied children have overweight and the same percent revealed obesity.Proper body mass was shown only among 40% of populated study group. These findings persuaded us to go ahead and broaden this results. We want to know, which factors determine this disturbances most. Thnaks to our present resarch we would have a possibility of a wider analysis of the thema connected with diet. We could analyse the results looking at the nutritional principles having at family home – the most important factor in creating children dietary habits. Our results of present study are still in progress. We alread have about 1000 questionnaires sent to the parents and now we are preparing the results. We trurly hope that the esearch will be interesting and could improve the knowledge about society orientation about nutrition. Key words: proper dietary habits, knowledge, awareness, parents of children

Objectives: Invasive aspergillosis (IA) after liver transplant surgery has resulted in high morbidity and mortality in recipients. This study was undertaken to determine the incidence rate of this infection liver transplant recipients (LTRs) using molecular method in unique center for liver transplant in, Shiraz university of Medical Sciences, Iran. Methods: Four hundred fifty six recipients who underwent liver transplant were followed for Aspergillus infections by nested PCR. Blood samples were collected from patients suspected to IA according to clinically signs and symptoms. Clinical samples from recipients were collected and evaluated by rotin microscopic and culture methods. Recipients received fluconazole after surgery as prophylaxis and also received corticosteroid drug, and tacrolimus. Results: The female-to-male ratio was 173:283 (mean age, 30.1 years). Sensitivity and specificity of the nested polymerase chain reaction was 90.5% and 92%, respectively. Aspergillosis was detected in 20 recipients (4.4%) by routine and molecular method of whom 13 recipients died (63.2%) The etiologic agents were Aspergillus flavus and Aspergillus fumigatus. During the study period, 12 infected recipients died (60%). Conclusions: In this study the incidence rate of invasive aspergillosis was high associated with poor outcomes. Liver recipient susceptible to IA due to use of systemic immunosuppression. Infections occurring during the 1-6 first month post-transplantation. Early diagnosis and treatment provide the best outcome for these patients

MS. Seyedeh Azra Shamsdin is currently a PhD student of Immunology doing her course at clinical Microbiology Research Center of Shiraz University of Medical Sciences and has published more papers in reputed journals.

Introduction: Studies of gastric metaplasia and neoplasia in mouse models have informed us about the pathway to gastric carcinogenesis. VEGF and ERp57 were identified as markers for gastric metaplasia. Aim: To investigate the expression of VEGF and ERp57 in gastric metaplasia and adenocarcinoma in humans. Methods: 224 paraffin-embedded tissues from 112 patients with gastric cancer were stained for ERp57and VEGF by horseradish peroxidase immunohistochemical technique, in which VEGF or ERp57 quantification score is obtained. Results: The level of VEGF expression was significantly higher in metaplasia and adenocarcinoma than that in normal gastric mucosa (p≤0.01).VEGF score revealed significant differences in differentiation degree, and histological type of the gastric carcinoma and depth of invasion (p≤0.05).ERp57 staining significantly increased in normal gastric mucosa, compared with that in cancer and metastases (p≤0.05).ERp57 expression correlated with greater depth of tumor and advanced stages (p≤0.01). Conclusion High VEGF expression and low ERp57 expression are correlated with the progression of gastric cancer. Therefore, VEGF and ERp57 are prognostic markers for such patients.

MS. Seyedeh Azra Shamsdin is currently a PhD student of Immunology doing her course at clinical Microbiology Research Center of Shiraz University of Medical Sciences and has published more papers in reputed journals.

Introduction: Helicobacter pylori (H. pylori) is causally associated with peptic ulcer and gastritis. This microorganism induces cellular immune response. Among different lymphocytes, Th17 and Tc17 can contribute pathological immune response in defense against microbes. H. pylori may the cause of gastritis is because of increased activation of Th17,Tc17 and changes of cytokines such as IL-17A, IL- 6, IL-21, IL-23 and TGF-β. Aim: To find the relationship between Th17, Tc17 and the cytokines IL-17A, IL- 6, IL-21, IL-23 and TGF-β in the patients suffering from H. pylori infection with signs of gastritis. Materials and Methods: Seventy-six samples of patients with gastrointestinal problems were collected. The percentage of Th17, Tc17 was measured by Flow cytometry. The levels of IL-17A, IL- 6, IL-21, IL-23 and TGF-β cytokines were measured by ELISA Conclusion: We can conclude that Th22 and Tc17 and corresponding cytokines can play a critical role in gastritis in the individuals infected with H. pylori. Key word: Th17, Tc17, IL-17A, IL- 6, IL-21, IL-23, TGF-β, Gastritis, H. pylori