Serological screening,endoscopic imaging,morphological visual verification of precancerous gastric diseases and changes in the gastric mucosa are the main stages of early detection,accurate diagnosis and preventive tr...Serological screening,endoscopic imaging,morphological visual verification of precancerous gastric diseases and changes in the gastric mucosa are the main stages of early detection,accurate diagnosis and preventive treatment of gastric precancer.Laboratory-serological,endoscopic and histological diagnostics are carried out by medical laboratory technicians,endoscopists,and histologists.Human factors have a very large share of subjectivity.Endoscopists and histologists are guided by the descriptive principle when formulating imaging conclusions.Diagnostic reports from doctors often result in contradictory and mutually exclusive conclusions.Erroneous results of diagnosticians and clinicians have fatal consequences,such as late diagnosis of gastric cancer and high mortality of patients.Effective population serological screening is only possible with the use of machine processing of laboratory test results.Currently,it is possible to replace subjective imprecise description of endoscopic and histological images by a diagnostician with objective,highly sensitive and highly specific visual recognition using convolutional neural networks with deep machine learning.There are many machine learning models to use.All machine learning models have predictive capabilities.Based on predictive models,it is necessary to identify the risk levels of gastric cancer in patients with a very high probability.展开更多
Chronic gastritis ( CG ) and peptic ulcer ( PU ) are frequently-occurring diseases. It is now well recognized that Helicobacter pylori (Hp) is a major factor that leads to CG and PU[1-8] In order to study the relation...Chronic gastritis ( CG ) and peptic ulcer ( PU ) are frequently-occurring diseases. It is now well recognized that Helicobacter pylori (Hp) is a major factor that leads to CG and PU[1-8] In order to study the relationship among T lymphocyte subsets, NO, Hexosamine and Hp infection in patients with chronic gastric diseases, the levelsof blood T lymphocyte subsets, plasma NO and hexosamine in gastric mucosa were measured respectively in 30 patients with CG and 32 patients of PU + CG.展开更多
Helicobacter pylori (H.pylori) infects approximately 50% of the world population.The multiple gastrointestinal and extra-gastrointestinal diseases caused by H.pylori infection pose a major healthcare threat to familie...Helicobacter pylori (H.pylori) infects approximately 50% of the world population.The multiple gastrointestinal and extra-gastrointestinal diseases caused by H.pylori infection pose a major healthcare threat to families and societies;it is also a heavy economic and healthcare burden for countries that having high infection rates.Eradication of H.pylori is recommended for all infected individuals.Traditionally,"test and treat"and"screen and treat"strategies are available for various infected populations.However,clinical practice has noticed that these strategies have some shortfalls and may need refinement,mostly due to the fact that they are not easily manageable,and are affected by patient compliance,selection of treatment population and cost-benefit estimations.Furthermore,it is difficult to control infections from the source,therefore,development of additional,compensative strategies are encouraged to solve the above problems and facilitate bacteria eradication.H.pylori infection is a family-based disease,but few studies have been performed in a whole family-based approach to curb its intra-familial transmission and the development of related diseases.In this work,a third,novel whole family-based H.pylori eradication strategy is introduced.This approach screens,identifies,treats and follows up on all H.pylori-infected individuals in entire families to control H.pylori infection among family members,and reduce its long-term complications.This strategy is high-risk population-oriented,and able to reduce H.pylori spread among family members.It also has good patient-family compliance and,importantly,is practical for both high and low H.pylori-infected communities.Future efforts in these areas will be critical to initiate and establish healthcare policies and management strategies to reduce H.pylori-induced disease burden for society.展开更多
AIM: To assess the impact of Helicobacter pylori(H. pylori) genotypes and patient age and sex on the development of gastric diseases.METHODS: H. pylori-infected patients(n = 233) referred to the endoscopy unit at Tehr...AIM: To assess the impact of Helicobacter pylori(H. pylori) genotypes and patient age and sex on the development of gastric diseases.METHODS: H. pylori-infected patients(n = 233) referred to the endoscopy unit at Tehran University of Medical Sciences(Tehran,Iran) were diagnosed with chronic gastritis(CG),gastric ulcer(GU),or duodenal ulcer(DU). Brucella blood agar was used for biopsy cultures and H. pylori isolation under microaerobic conditions. H. pylori isolates were confirmed with biochemical tests and through amplification of the 16 S r RNA gene. DNA was extracted from fresh cultures of the H. pylori isolates and used for amplification of vac A alleles and the cag A gene. Statistical analysis was performed to determine the association between H. pylori genotypes,age(< 40 years vs > 40 years) and sex of the patient,and gastric diseases.RESULTS: CG was the most prevalent gastric disease(113/233; 48.5%),compared to GU(64/233; 27.5%)and DU(56/233; 24%). More patients were male,and gastric diseases were more frequent in patients > 40 years(P < 0.05). The percentage of CG and GU patients that were male and female did not show a significant difference; however DU was more common in males(P < 0.05). Interestingly,a diagnosis of CG in patients > 40 years was more common in females(18.5%) than males(11.6%)(P = 0.05),whereas a diagnosis of GU or DU in patients > 40 years was more frequent in males(14.6% vs 10.7% and 12.4% vs 4.3%,respectively). Overall,genotyping of the H. pylori isolates revealed that the vac A s1(82%),vac A m2(70%),and cag A+(72.5%) alleles were more frequent than vac A s2(18%),vac A m1(29.2%),and cag A-(all P < 0.05). The vac A s1m2 cag A+ genotype was the most prevalent within the three disease groups. vac A s1m2 frequency was 56.2% with a similar occurrence in all diagnoses,while vac A s1m1 appeared more often in DU patients(33.9%). A genotype of vac A s2m2 occurred in 15% of isolates and was more common in CG patients(21.2%); vac A s2m1 was the least common genotype(3%). The vac A s1 allele was found to be a risk factor for DU,vac A s2 for CG,and vac A s1 and vac A s2 for GU(all P < 0.05). The vac A s2m2 genotype was associated with the development of CG and GU compared to DU(P < 0.05). No correlation was found between vac A m or cag A and gastric diseases.CONCLUSION: The outcome of H. pylori infection is the result of interaction between bacterial genotypes and the age and sex of infected individuals.展开更多
AIM: To explore the correlation between Helicobacter pylori(H. pylori)-associated gastric diseases and colorectal neoplasia.METHODS: Patients included in this study underwent a colonoscopy and esophago-gastro-duodenos...AIM: To explore the correlation between Helicobacter pylori(H. pylori)-associated gastric diseases and colorectal neoplasia.METHODS: Patients included in this study underwent a colonoscopy and esophago-gastro-duodenoscopy(EGD) along with histopathological measurement between March 2012 and March 2015 at Qi-Lu Hospital of Shandong University, who also had results of H. pylori detection. A total of 233 cases were selected. Demographic data, H. pylori infection status(including results of rapid urease tests and gastric mucosa pathological examinations) and histopathological examination results of gastric and colorectal mucosa were gathered and analyzed. The statistical analysis focused on the prevalence of colorectal neoplasms among patients with various histopathological categories of the stomach. ORs and their 95%CI were calculated to describe the strengths of the associations.RESULTS: The incidence rates of colorectal adenoma without high-grade intraepithelial neoplasia(HGIEN)(OR = 2.400, 95%CI: 0.969-5.941), adenoma with HGIEN(5.333, 1.025-27.758) and adenocarcinoma(1.455, 0.382-5.543) were all higher for patients with H. pylori-associated gastritis than for those in the control group. The incidence rate of colorectal adenoma with HGIEN(3.218, 0.767-13.509) was higher in patients with intestinal metaplasia than in the control group, while the incidence rates of adenoma without HGIEN(0.874, 0.414-1.845) and adenocarcinoma(0.376, 0.096-1.470) were lower in the intestinal metaplasia group than in the control group. The incidence rate of colorectal adenoma without HGIEN(3.111, 1.248-7.753) was significantly higher in the gastric intraepithelial neoplasia group than in the control group, while the rates of adenoma with HGIEN(1.481, 0.138-15.941) and adenocarcinoma(2.020, 0.561-7.272) were higher in the gastric intraepithelial neoplasia group. Incidence rates of colorectal adenoma without HGIEN(1.067, 0.264-4.314), adenoma with HGIEN(2.667, 0.231-30.800) and adenocarcinoma(2.182, 0.450-10.585) were all higher in the gastric adenocarcinoma group than in the control group.CONCLUSION: H. pylori infection as well as H. pylori-associated gastric diseases are risk factors for colorectal neoplasia.展开更多
Pepsinogen,secreted from the gastric mucosa,is the precursor of pepsin.It is categorized as pepsinogen 1 and pepsinogen 2 based on its immunogenicity.The pepsinogen content that can enter the blood circulation through...Pepsinogen,secreted from the gastric mucosa,is the precursor of pepsin.It is categorized as pepsinogen 1 and pepsinogen 2 based on its immunogenicity.The pepsinogen content that can enter the blood circulation through the capillaries of the gastric mucosa is approximately 1%and remains stable all the time.The pepsinogen content in serum will change with the pathological changes of gastric mucosa.Therefore,the level of pepsinogen in serum can play a role in serologic biopsy to reflect the function and morphology of different regions of gastric mucosa and serve as an indicator of gastric disease.This study conducts relevant research on serum pepsinogen 1,pepsinogen 2,and the ratio of pepsinogen 1 to pepsinogen 2,and reviews their important value in clinical diagnosis of Helicobacter pylori infection,gastric ulcer,and even gastric carcinoma,providing ideas for other researchers.展开更多
Altered micro RNA（mi RNA） associated with gastric cancer（GC） development and mi R-17 and mi R-106 b were differentially expressed in GC tissues. This study detected serum levels of mi R-17 and mi R-106 b expressio...Altered micro RNA（mi RNA） associated with gastric cancer（GC） development and mi R-17 and mi R-106 b were differentially expressed in GC tissues. This study detected serum levels of mi R-17 and mi R-106 b expression in GC, benign gastric disease（BGD） and healthy controls to assess them as tumor markers for GC. Serum samples from 40 GC, 32 BGD（10 gastric ulcer, 14 gastric polyps, and 8 gastric ulcer with polyps） and 36 healthy individuals were subjected to quantitative reverse transcription polymerase chain reaction（q RT-PCR） analysis of mi R-17 and mi R-106 b expression. The data showed that the serum levels of mi R-17 and mi R-106 b were significantly reduced in healthy individuals and BGD patients compared to GC patients. There was a significant association of mi R-17 and mi R-106 b expression with age, but not with other clinicopathological features, such as gender, tumor differentiation, stage and lymphatic metastasis. Further analysis showed that, in discriminating GC patients from healthy controls, mi R-17 could yield a receiver-operating characteristic（ROC） area under the curve（AUC） of 0.879 with 80.6% sensitivity and 87.5% specificity and mi R-106 b could yield an AUC of 0.856 with 75.0% sensitivity and 92.5% specificity. The combined AUC of mi R-17 and mi R-106 b was 0.913 with 83.3% sensitivity and 87.5% specificity. Collectively, these data suggest that detection of serum mi R-17 and mi R-106 b levels should be further evaluated as novel non-invasive biomarkers in early GC detection and surveillance of disease progression.展开更多
Helicobacter pylori infection represents a widespread chronic condition with varying prevalence influenced by race, ethnicity, and geography. The severity of H. pylori-associated diseases is determined by an array of ...Helicobacter pylori infection represents a widespread chronic condition with varying prevalence influenced by race, ethnicity, and geography. The severity of H. pylori-associated diseases is determined by an array of virulence factors. Although extensive studies have been conducted globally, data on the distribution of Helicobacter pylori virulence genes in Libya remain limited, constraining insights into the pathogenicity of local strains and hindering the development of targeted interventions. This study aimed to evaluate the prevalence of H. pylori infection, characterize essential virulence genes [vacA variants (s1/s2, m1/m2), cagA, and iceA1], and examine their association with gastroduodenal diseases among Libyan patients. Gastric biopsies from 144 participants were analyzed using polymerase chain reaction (PCR) assays, and risk factor data were collected via questionnaires. H. pylori was detected in 63.2% of samples by PCR. The vacA gene was present in 84.6% of cases, cagA in 58.2%, and iceA1 in 29.7%. Among vacA variants, s1 allele was most common (53.2%), followed by m1 (42.9%), m2 (37.7%), and s2 (13%) alleles. Significant associations were identified between specific virulence genes and the development of gastroduodenal diseases, highlighting their role in pathogenicity. This investigation is one of Libya’s first comprehensive assessments of H. pylori virulence factors, addressing a critical epidemiological gap. The high prevalence of virulence genes suggests their potential as disease biomarkers. These findings contribute to a deeper understanding of H. pylori pathogenicity within the Libyan population and establish a basis for future clinical interventions and public health strategies to manage and prevent H. pylori-associated diseases in Libya and comparable regions.展开更多
BACKGROUND Diabetic gastrointestinal autonomic neuropathy(DGAN)often affects the patients’quality of life.Thus,research on influencing factors of DGAN may promote DGAN prevention and decrease the incidence rate.This ...BACKGROUND Diabetic gastrointestinal autonomic neuropathy(DGAN)often affects the patients’quality of life.Thus,research on influencing factors of DGAN may promote DGAN prevention and decrease the incidence rate.This study used electrogastrogram(EGG)to assess the relationship between metabolic dysfunction-associated steatotic liver disease(MASLD)and DGAN.AIM To analyze the changes of EGG in patients with MASLD and type 2 diabetes mellitus(T2DM),and to elucidate whether ultrasound-diagnosed MASLD is an independent risk factor for diabetic gastric motility disorders(DGMD).METHODS A total of 272 patients with T2DM hospitalized at the Second Affiliated Hospital of Soochow University from December 2020 to December 2021 and the Affiliated Suqian Hospital of Xuzhou Medical University from November 2023 to June 2024 were included in the cross-sectional study.General information,clinical data,and medical history of all study subjects,including name,age,gender,body mass index,and duration of diabetes were collected.Laboratory tests included biochemical parameters,glycosylated hemoglobin(HbA1c),fasting C-peptide,2h postprandial C-peptide and 25-hydroxyvitamin D[25(OH)D].EGG,fundus examination and carotid artery ultrasonography were performed and results were recorded.According to the results of EGG,the subjects were divided into the DGMD group and non-DGMD group.RESULTS The duration of diabetes,fasting blood glucose(FBG),HbA1c,25(OH)D and the prevalence of MASLD were significantly higher in the DGMD group(P<0.05).Multiple logistic regression analysis showed that the duration,FBG,25(OH)D and the presence of MASLD were independent influencing factors.CONCLUSION MASLD is strongly associated with an increased incidence of DGMD.Timely treatment of MASLD is effective to prevent diabetic gastroparesis.展开更多
BACKGROUND Gastric cancer is a growing clinical challenge,particularly due to the increased risk of postoperative gastroesophageal reflux disease(GERD)following surgical treatment.traditional Chinese medicine(TCM),inc...BACKGROUND Gastric cancer is a growing clinical challenge,particularly due to the increased risk of postoperative gastroesophageal reflux disease(GERD)following surgical treatment.traditional Chinese medicine(TCM),including acupuncture and herbal medicine,has been proposed as an adjunctive therapy to promote gastrointestinal recovery and alleviate GERD symptoms.AIM To retrospectively study the clinical efficacy of modified Lou Bei Er Chen decoction combined with acupuncture in treating patients with GERD after radical gastrectomy due to gastric cancer.METHODS A retrospective study was conducted,including patients with gastric cancer or malignant tumors of the stomach from January 2019 to December 2023 in the Affiliated Taizhou People’s Hospital of Nanjing Medical University.Patients with a TCM diagnosis of qi depression and phlegm obstruction(n=128)were selected on the basis of prescription and treatment principles.They were then divided into a control group(n=61)and an observation group(n=67).The control group received treatment with Western medicine domperidone.The observation group were treated with Lou Bei Er Chen decoction orally,with acupuncture at specific RESULTS The observation group showed significantly shorter times for first flatus,defecation,bowel sound recovery,and initiation of nasogastric enteral nutrition than the control group(P<0.05).Upon treatment,the two groups demonstrated a significant reduction in gastrointestinal dysfunction scores,with a more significant reduction in the observation group(P<0.001).The GERD-Q scores significantly decreased after 8 weeks of treatment in the two groups(P<0.05),with a significant reduction in the observation group(P<0.05),compared with baseline.The TCM syndrome scores significantly decreased after 4 and 8 weeks of treatment in the two groups(P<0.05),with a significant reduction in the observation group(P<0.05).The effective rate of the observation group after 8 weeks of treatment was significantly higher than that after 4 weeks(χ2=13.648,P=0.003),and it was significantly higher than that of control group(χ2=13.879,P=0.003).CONCLUSION Lou Bei Er Chen decoction combined with acupuncture treatment can effectively alleviate clinical symptoms in patients GERD after gastric cancer surgery and improve their life quality.It is worthy of further promotion and application.展开更多
BACKGROUND Submucosal tumors arise from the subepithelial layer anywhere along the gastr-ointestinal tract,most commonly in the stomach.A wide range of lesions,from benign to malignant,may present as gastric submucosa...BACKGROUND Submucosal tumors arise from the subepithelial layer anywhere along the gastr-ointestinal tract,most commonly in the stomach.A wide range of lesions,from benign to malignant,may present as gastric submucosal tumors.However,the gastric involvement of Crohn’s disease(CD)is generally not considered in the differential diagnosis of such lesions.CASE SUMMARY A 23-year-old male patient presented with a gastric subepithelial tumor.The medical history included CD.Diagnostic workup revealed a 3-cm mucosal lesion with a central ulceration on the posterior wall of the distal antrum.The patient underwent laparoscopic wedge resection of stomach,and the postoperative course was uneventful.Histopathological analysis confirmed a diagnosis of gastric CD presenting as a subepithelial tumor.CONCLUSION Despite its rarity,upper gastrointestinal CD can present as a gastric subepithelial tumor,warranting consideration in young patients with CD.展开更多
Objective： To investigate the difference in susceptibilities to allitridi of Helicobacter pylori （H.pylori） strains in different gastric diseases and the associations with different genotypes. Methods： H.pylori st...Objective： To investigate the difference in susceptibilities to allitridi of Helicobacter pylori （H.pylori） strains in different gastric diseases and the associations with different genotypes. Methods： H.pylori strains were isolated from gastric antral biopsy specimens and identified. DNA was isolated from H.pylori strains. Different genotypes were determined by polymerase chain reaction（PCR）, and the allitridi MICs were determined by agar dilution methods. MIC50 was calculated. Results： The susceptibilities of H, pylori strains varied among different gastric diseases. H.pylori strains in superficial gastritis were significantly more susceptible to allitridi than those in atrophic gastritis （relative median potency was 0.49, 95% confidence interval was from 0.24 to 0.80）, strains in superficial gastritis were significantly more susceptible than those in gastric cancer （relative median potency was 0.32, 95% confidence interval was from 0.06 to 0.68） and strains in atrophic gastritis were significantly more susceptible than those in gastric cancer（relative median potency was 0.16, 95% confidence interval was from 0.02 to 0.40）. The susceptibilities of H.pylori strains with different genotypes varied among different gastric diseases. In atrophic gastritis, strains with vacAsl＋ were significantly more susceptible to allitridi than those with vacAsl（relative median potency was 0.21, 95% confidence interval was from 0.04 to 0.73）. In gastric cancer, strains with vacAmlb＋ were significantly more susceptible than those with vacAmlb-（relative median potency was 0.07, 95% confidence interval was from 0.03 to 0.49）. Conclusion： The vacA genotypes play an important role in the susceptibility to allitridi in different gastric diseases.展开更多
Objective: to explore the value of gastrointestinal contrast-enhanced ultrasound in the diagnosis of gastric space-occupying diseases. Methods: 100 patients with suspected gastric space-occupying lesions who were hosp...Objective: to explore the value of gastrointestinal contrast-enhanced ultrasound in the diagnosis of gastric space-occupying diseases. Methods: 100 patients with suspected gastric space-occupying lesions who were hospitalized in the Department of Gastroenterology of our hospital from August 2020 to August 2021 were selected for gastrointestinal contrast-enhanced ultrasound and gastroscopy respectively, and the examination results of the patients were recorded. Results: ① Pathological results showed that 80% of the patients were stomach occupying lesions;② Contrast-enhanced ultrasound showed that 78% of the patients were stomach occupying lesions;③ Gastroscopy showed that 73% of the patients were stomach occupying lesions;④ There was no significant difference between the two methods (P>0.05). Conclusion: gastrointestinal contrast-enhanced ultrasound has a high detection rate and is painless, non-invasive and non-radiation. It is worthy of wide clinical application.展开更多
Objective:China is one of the countries with the heaviest burden of gastric cancer(GC)in the world.Understanding the epidemiological trends and patterns of GC in China can contribute to formulating effective preventio...Objective:China is one of the countries with the heaviest burden of gastric cancer(GC)in the world.Understanding the epidemiological trends and patterns of GC in China can contribute to formulating effective prevention strategies.Methods:The data on incidence,mortality,and disability-adjusted life-years(DALYs)of GC in China from1990 to 2019 were obtained from the Global Burden of Disease Study(2019).The estimated annual percentage change(EAPC)was calculated to evaluate the temporal trends of disease burden of GC,and the package Nordpred in the R program was used to perform an age-period-cohort analysis to predict the numbers and rates of incidence and mortality in the next 25 years.Results:The number of incident cases of GC increased from 317.34 thousand in 1990 to 612.82 thousand in2019,while the age-standardized incidence rate(ASIR)of GC decreased from 37.56 per 100,000 in 1990 to 30.64 per 100,000 in 2019,with an EAPC of-0.41[95%confidence interval(95%CI):-0.77,-0.06].Pronounced temporal trends in mortality and DALYs of GC were observed.In the next 25 years,the numbers of new GC cases and deaths are expected to increase to 738.79 thousand and 454.80 thousand,respectively,while the rates of incidence and deaths should steadily decrease.The deaths and DALYs attributable to smoking were different for males and females.Conclusions:In China,despite the fact that the rates of GC have decreased during the past three decades,the numbers of new GC cases and deaths increased,and will continue to increase in the next 25 years.Additional strategies are needed to reduce the burden of GC,such as screening and early detection,novel treatments,and the prevention of risk factors.展开更多
AIM: To determine gastric emptying, blood pressure, mesenteric artery blood flow, and blood glucose responses to oral glucose in Parkinson’s disease.METHODS: Twenty-one subjects (13 M, 8 F; age 64.2 &#...AIM: To determine gastric emptying, blood pressure, mesenteric artery blood flow, and blood glucose responses to oral glucose in Parkinson’s disease.METHODS: Twenty-one subjects (13 M, 8 F; age 64.2 ± 1.6 years) with mild to moderate Parkinson’s disease (Hoehn and Yahr score 1.4 ± 0.1, duration of known disease 6.3 ± 0.9 years) consumed a 75 g glucose drink, labelled with 20 MBq <sup>99m</sup>Tc-calcium phytate. Gastric emptying was quantified with scintigraphy, blood pressure and heart rate with an automated device, superior mesenteric artery blood flow by Doppler ultrasonography and blood glucose by glucometer for 180 min. Autonomic nerve function was evaluated with cardiovascular reflex tests and upper gastrointestinal symptoms by questionnaire.RESULTS: The mean gastric half-emptying time was 106 ± 9.1 min, gastric emptying was abnormally delayed in 3 subjects (14%). Systolic and diastolic blood pressure fell (P < 0.001) and mesenteric blood flow and blood glucose (P < 0.001 for both) increased, following the drink. Three subjects (14%) had definite autonomic neuropathy and 8 (38%) had postprandial hypotension. There were no significant relationships between changes in blood pressure, heart rate or mesenteric artery blood flow with gastric emptying. Gastric emptying was related to the score for autonomic nerve function (R = 0.55, P < 0.01). There was an inverse relationship between the blood glucose at t = 30 min (R = -0.52, P < 0.05), while the blood glucose at t = 180 min was related directly (R = 0.49, P < 0.05), with gastric emptying.CONCLUSION: In mild to moderate Parkinson’s disease, gastric emptying is related to autonomic dysfunction and a determinant of the glycaemic response to oral glucose.展开更多
AIM: To investigate -765G > C COX-2 polymorphism and H pylori infection in patients with gastric adenocarcinoma, peptic ulcer disease (PUD) and non- ulcer dyspepsia (NUD). METHODS: We enrolled 348 adult patients (6...AIM: To investigate -765G > C COX-2 polymorphism and H pylori infection in patients with gastric adenocarcinoma, peptic ulcer disease (PUD) and non- ulcer dyspepsia (NUD). METHODS: We enrolled 348 adult patients (62 gastric adenocarcinoma, 45 PUD and 241 NUD) undergoing upper gastrointestinal endoscopy at two referral centers between September, 2002 and May, 2007. H pylori infection was diagnosed when any of the four tests (RUT, culture, histopathology and PCR) were positive. Genotyping for -765G > C polymorphism of COX-2 was performed by PCR-RFLP analysis. RESULTS: Frequency of C carrier had significantassociation with gastric adenocarcinoma as compared to NUD [77.4% vs 29%, P < 0.001, odds ratio (OR) 8.20; 95% confidence interval (95% CI), 4.08-16.47] and PUD (77.4% vs 31.1%, P < 0.001; OR 8.04; 95% CI, 3.25-19.90). Risk of gastric adenocarcinoma was significantly higher in patients having C carrier with (OR 7.83; 95% CI 3.09-19.85) and without H pylori infection (OR 7.06; 95% CI, 2.61-19.09). Patients with C carrier and H pylori infection had significant risk for the development of PUD (P < 0.001; OR 5.65; 95% CI, 2.07-15.34). CONCLUSION: -765G > C COX-2 polymorphism with or without H pylori could be a marker for genetic susceptibility to gastric adenocarcinoma. COX-2 polymorphism in presence of H pylori infection might be useful in predicting the risk of PUD.展开更多
Hericium erinaceus is an edible and medicinal mushroom commonly used in traditional Chinese medicine for centuries.Several studies have highlighted its therapeutic potential for gastrointestinal disorders such as gast...Hericium erinaceus is an edible and medicinal mushroom commonly used in traditional Chinese medicine for centuries.Several studies have highlighted its therapeutic potential for gastrointestinal disorders such as gastritis and inflammatory bowel diseases.In addition,some components of this mushroom appear to possess strong antineoplastic capabilities against gastric and colorectal cancer.This review aims to analyse all available evidence on the digestive therapeutic potential of this fungus as well as the possible underlying molecular mechanisms.展开更多
AIM: To check the utility of postcibal ultrasonography for the evaluation of reflux in relation to gastric emptying in infants with recurrent respiratory symptoms and to link imaging with clinical data.METHODS: Esopha...AIM: To check the utility of postcibal ultrasonography for the evaluation of reflux in relation to gastric emptying in infants with recurrent respiratory symptoms and to link imaging with clinical data.METHODS: Esophageal reflux (hyperechoic retrograde filling) and gastric emptying (antral areas) were quantified before and after ingestion of a standard formula in 35 untreated infants (13 with chronic cough,22 with recurrent bronchitis) and in 31 controls.RESULTS: The prevalence of abnormal (≥8 episodes)postcibal refluxes was 74% in patients and 3% in controls. Number, duration of the longest episode and extent of refluxes were significantly higher in patients compared to controls. Number of refluxes was higher in patients with symptomatic refluxes than in those without.Infants with recurrent bronchitis had more refluxes than those with chronic cough and controls. Extent and timing of gastric emptying were similar in patients and controls.CONCLUSION: Esophageal ultrasonography is a useful and physiological test in infants with recurrent respiratory diseases, which have a high prevalence of abnormal postcibal esophageal reflux and a gastric emptying similar to that of normal controls. Esophageal reflux is more severe in subjects with recurrent bronchitis than in those with chronic cough.展开更多
We report a case of an isolated hepatic neoplasia which originated in a site of the liver previously affected by radiation induced liver disease (RILD) in a patient resected for gastric cancer and referred to us for h...We report a case of an isolated hepatic neoplasia which originated in a site of the liver previously affected by radiation induced liver disease (RILD) in a patient resected for gastric cancer and referred to us for high serum alpha-fetoprotein (AFP) levels. This case challenged us in distiguishing, even histologically, between primary liver cancer and AFP producing gastric cancer metastasis. Only a panel of immunohis-tochemical markers allowed the definitive diagnosis of liver metastasis of endodermal stem cell-derived and AFP producing gastric cancer. We discuss the criteria for a differential diagnosis, as well as the possible link between RILD and emergence of liver neoplasia.展开更多
Ig G4-related disease is a recently recognized entity linked initially to autoimmune pancreatitis and has been subsequently described in nearly every organ system. Men over the age of 50 represent the most affected de...Ig G4-related disease is a recently recognized entity linked initially to autoimmune pancreatitis and has been subsequently described in nearly every organ system. Men over the age of 50 represent the most affected demographic group and a comprehensive set of diagnostic criteria has been developed to aid treating clinicians. Though elevated levels of Ig G4 in the serum are suggestive of the disease, definitive diagnosis is made on histopathology. Treatment is tailored to the clinical presentation with corticosteroid therapy known to have proven efficacy. Gastric manifestations of the Ig G4-related disease primarily come in two varieties, notably chronic ulceration or pseudotumor formation. Autoimmune pancreatitis conveys increased risk for Ig G4-related disease of the stomach, which is independent of Helicobacter pylori status. In this case report, we present an acute gastric-pericardial fistula secondary to Ig G4-related disease that required urgent operative management. To our knowledge, this is the first report in the medical literature describing this complication of Ig G4-related disease.展开更多
文摘Serological screening,endoscopic imaging,morphological visual verification of precancerous gastric diseases and changes in the gastric mucosa are the main stages of early detection,accurate diagnosis and preventive treatment of gastric precancer.Laboratory-serological,endoscopic and histological diagnostics are carried out by medical laboratory technicians,endoscopists,and histologists.Human factors have a very large share of subjectivity.Endoscopists and histologists are guided by the descriptive principle when formulating imaging conclusions.Diagnostic reports from doctors often result in contradictory and mutually exclusive conclusions.Erroneous results of diagnosticians and clinicians have fatal consequences,such as late diagnosis of gastric cancer and high mortality of patients.Effective population serological screening is only possible with the use of machine processing of laboratory test results.Currently,it is possible to replace subjective imprecise description of endoscopic and histological images by a diagnostician with objective,highly sensitive and highly specific visual recognition using convolutional neural networks with deep machine learning.There are many machine learning models to use.All machine learning models have predictive capabilities.Based on predictive models,it is necessary to identify the risk levels of gastric cancer in patients with a very high probability.
文摘Chronic gastritis ( CG ) and peptic ulcer ( PU ) are frequently-occurring diseases. It is now well recognized that Helicobacter pylori (Hp) is a major factor that leads to CG and PU[1-8] In order to study the relationship among T lymphocyte subsets, NO, Hexosamine and Hp infection in patients with chronic gastric diseases, the levelsof blood T lymphocyte subsets, plasma NO and hexosamine in gastric mucosa were measured respectively in 30 patients with CG and 32 patients of PU + CG.
基金Supported by grants to SZD from Henan Provincial GovernmentScience and Technology Bureau,No.142300410050Henan Provincial Government-Health and Family Planning Commission,No.20170123+1 种基金Henan Provincial Innovative Talents Projects of 2016and 2017National Natural Science Foundation of China,No.U1604174
文摘Helicobacter pylori (H.pylori) infects approximately 50% of the world population.The multiple gastrointestinal and extra-gastrointestinal diseases caused by H.pylori infection pose a major healthcare threat to families and societies;it is also a heavy economic and healthcare burden for countries that having high infection rates.Eradication of H.pylori is recommended for all infected individuals.Traditionally,"test and treat"and"screen and treat"strategies are available for various infected populations.However,clinical practice has noticed that these strategies have some shortfalls and may need refinement,mostly due to the fact that they are not easily manageable,and are affected by patient compliance,selection of treatment population and cost-benefit estimations.Furthermore,it is difficult to control infections from the source,therefore,development of additional,compensative strategies are encouraged to solve the above problems and facilitate bacteria eradication.H.pylori infection is a family-based disease,but few studies have been performed in a whole family-based approach to curb its intra-familial transmission and the development of related diseases.In this work,a third,novel whole family-based H.pylori eradication strategy is introduced.This approach screens,identifies,treats and follows up on all H.pylori-infected individuals in entire families to control H.pylori infection among family members,and reduce its long-term complications.This strategy is high-risk population-oriented,and able to reduce H.pylori spread among family members.It also has good patient-family compliance and,importantly,is practical for both high and low H.pylori-infected communities.Future efforts in these areas will be critical to initiate and establish healthcare policies and management strategies to reduce H.pylori-induced disease burden for society.
基金Supported by Research Council of the University of Tehran
文摘AIM: To assess the impact of Helicobacter pylori(H. pylori) genotypes and patient age and sex on the development of gastric diseases.METHODS: H. pylori-infected patients(n = 233) referred to the endoscopy unit at Tehran University of Medical Sciences(Tehran,Iran) were diagnosed with chronic gastritis(CG),gastric ulcer(GU),or duodenal ulcer(DU). Brucella blood agar was used for biopsy cultures and H. pylori isolation under microaerobic conditions. H. pylori isolates were confirmed with biochemical tests and through amplification of the 16 S r RNA gene. DNA was extracted from fresh cultures of the H. pylori isolates and used for amplification of vac A alleles and the cag A gene. Statistical analysis was performed to determine the association between H. pylori genotypes,age(< 40 years vs > 40 years) and sex of the patient,and gastric diseases.RESULTS: CG was the most prevalent gastric disease(113/233; 48.5%),compared to GU(64/233; 27.5%)and DU(56/233; 24%). More patients were male,and gastric diseases were more frequent in patients > 40 years(P < 0.05). The percentage of CG and GU patients that were male and female did not show a significant difference; however DU was more common in males(P < 0.05). Interestingly,a diagnosis of CG in patients > 40 years was more common in females(18.5%) than males(11.6%)(P = 0.05),whereas a diagnosis of GU or DU in patients > 40 years was more frequent in males(14.6% vs 10.7% and 12.4% vs 4.3%,respectively). Overall,genotyping of the H. pylori isolates revealed that the vac A s1(82%),vac A m2(70%),and cag A+(72.5%) alleles were more frequent than vac A s2(18%),vac A m1(29.2%),and cag A-(all P < 0.05). The vac A s1m2 cag A+ genotype was the most prevalent within the three disease groups. vac A s1m2 frequency was 56.2% with a similar occurrence in all diagnoses,while vac A s1m1 appeared more often in DU patients(33.9%). A genotype of vac A s2m2 occurred in 15% of isolates and was more common in CG patients(21.2%); vac A s2m1 was the least common genotype(3%). The vac A s1 allele was found to be a risk factor for DU,vac A s2 for CG,and vac A s1 and vac A s2 for GU(all P < 0.05). The vac A s2m2 genotype was associated with the development of CG and GU compared to DU(P < 0.05). No correlation was found between vac A m or cag A and gastric diseases.CONCLUSION: The outcome of H. pylori infection is the result of interaction between bacterial genotypes and the age and sex of infected individuals.
基金Supported by the National Natural Science Foundation of China,No.81372681Key Research Development Program of Shandong Province,No.2015GGH318014
文摘AIM: To explore the correlation between Helicobacter pylori(H. pylori)-associated gastric diseases and colorectal neoplasia.METHODS: Patients included in this study underwent a colonoscopy and esophago-gastro-duodenoscopy(EGD) along with histopathological measurement between March 2012 and March 2015 at Qi-Lu Hospital of Shandong University, who also had results of H. pylori detection. A total of 233 cases were selected. Demographic data, H. pylori infection status(including results of rapid urease tests and gastric mucosa pathological examinations) and histopathological examination results of gastric and colorectal mucosa were gathered and analyzed. The statistical analysis focused on the prevalence of colorectal neoplasms among patients with various histopathological categories of the stomach. ORs and their 95%CI were calculated to describe the strengths of the associations.RESULTS: The incidence rates of colorectal adenoma without high-grade intraepithelial neoplasia(HGIEN)(OR = 2.400, 95%CI: 0.969-5.941), adenoma with HGIEN(5.333, 1.025-27.758) and adenocarcinoma(1.455, 0.382-5.543) were all higher for patients with H. pylori-associated gastritis than for those in the control group. The incidence rate of colorectal adenoma with HGIEN(3.218, 0.767-13.509) was higher in patients with intestinal metaplasia than in the control group, while the incidence rates of adenoma without HGIEN(0.874, 0.414-1.845) and adenocarcinoma(0.376, 0.096-1.470) were lower in the intestinal metaplasia group than in the control group. The incidence rate of colorectal adenoma without HGIEN(3.111, 1.248-7.753) was significantly higher in the gastric intraepithelial neoplasia group than in the control group, while the rates of adenoma with HGIEN(1.481, 0.138-15.941) and adenocarcinoma(2.020, 0.561-7.272) were higher in the gastric intraepithelial neoplasia group. Incidence rates of colorectal adenoma without HGIEN(1.067, 0.264-4.314), adenoma with HGIEN(2.667, 0.231-30.800) and adenocarcinoma(2.182, 0.450-10.585) were all higher in the gastric adenocarcinoma group than in the control group.CONCLUSION: H. pylori infection as well as H. pylori-associated gastric diseases are risk factors for colorectal neoplasia.
基金Supported by the National Natural Science Foundation of China,No.82172336“Pioneer”and“Leading Goose”R&D Program of Zhejiang,No.2022C03118 and No.2023C03075+1 种基金Natural Science Foundation of Zhejiang Province,No.LQ23H050005Scientific Research Project of Zhejiang Provincial Education Department,No.Y202250731.
文摘Pepsinogen,secreted from the gastric mucosa,is the precursor of pepsin.It is categorized as pepsinogen 1 and pepsinogen 2 based on its immunogenicity.The pepsinogen content that can enter the blood circulation through the capillaries of the gastric mucosa is approximately 1%and remains stable all the time.The pepsinogen content in serum will change with the pathological changes of gastric mucosa.Therefore,the level of pepsinogen in serum can play a role in serologic biopsy to reflect the function and morphology of different regions of gastric mucosa and serve as an indicator of gastric disease.This study conducts relevant research on serum pepsinogen 1,pepsinogen 2,and the ratio of pepsinogen 1 to pepsinogen 2,and reviews their important value in clinical diagnosis of Helicobacter pylori infection,gastric ulcer,and even gastric carcinoma,providing ideas for other researchers.
基金supported by National Natural Science Foundation of China (Grant No. 81372140, 81301688, 81272192, 81171882, 81172298)Ph.D. Programs Foundation of Ministry of Education of China (No. 20130162110050 and 20130162120093)+6 种基金Post-doctoral Foundation of Central South University (No. 131425) China Postdoctoral Science Foundation (2014M552167)Key Program for International Cooperation Projects of Hunan Province (no. 2011WK2011)Natural Science Foundation of Hunan Province (Grant No. 12JJ4088)Technology Project of Hunan Province (2012SK3229)Research foundation of Health Department of Hunan Province (B2012-100)125 Talent Project of the Third Xiangya Hospital of Central South University
文摘Altered micro RNA（mi RNA） associated with gastric cancer（GC） development and mi R-17 and mi R-106 b were differentially expressed in GC tissues. This study detected serum levels of mi R-17 and mi R-106 b expression in GC, benign gastric disease（BGD） and healthy controls to assess them as tumor markers for GC. Serum samples from 40 GC, 32 BGD（10 gastric ulcer, 14 gastric polyps, and 8 gastric ulcer with polyps） and 36 healthy individuals were subjected to quantitative reverse transcription polymerase chain reaction（q RT-PCR） analysis of mi R-17 and mi R-106 b expression. The data showed that the serum levels of mi R-17 and mi R-106 b were significantly reduced in healthy individuals and BGD patients compared to GC patients. There was a significant association of mi R-17 and mi R-106 b expression with age, but not with other clinicopathological features, such as gender, tumor differentiation, stage and lymphatic metastasis. Further analysis showed that, in discriminating GC patients from healthy controls, mi R-17 could yield a receiver-operating characteristic（ROC） area under the curve（AUC） of 0.879 with 80.6% sensitivity and 87.5% specificity and mi R-106 b could yield an AUC of 0.856 with 75.0% sensitivity and 92.5% specificity. The combined AUC of mi R-17 and mi R-106 b was 0.913 with 83.3% sensitivity and 87.5% specificity. Collectively, these data suggest that detection of serum mi R-17 and mi R-106 b levels should be further evaluated as novel non-invasive biomarkers in early GC detection and surveillance of disease progression.
文摘Helicobacter pylori infection represents a widespread chronic condition with varying prevalence influenced by race, ethnicity, and geography. The severity of H. pylori-associated diseases is determined by an array of virulence factors. Although extensive studies have been conducted globally, data on the distribution of Helicobacter pylori virulence genes in Libya remain limited, constraining insights into the pathogenicity of local strains and hindering the development of targeted interventions. This study aimed to evaluate the prevalence of H. pylori infection, characterize essential virulence genes [vacA variants (s1/s2, m1/m2), cagA, and iceA1], and examine their association with gastroduodenal diseases among Libyan patients. Gastric biopsies from 144 participants were analyzed using polymerase chain reaction (PCR) assays, and risk factor data were collected via questionnaires. H. pylori was detected in 63.2% of samples by PCR. The vacA gene was present in 84.6% of cases, cagA in 58.2%, and iceA1 in 29.7%. Among vacA variants, s1 allele was most common (53.2%), followed by m1 (42.9%), m2 (37.7%), and s2 (13%) alleles. Significant associations were identified between specific virulence genes and the development of gastroduodenal diseases, highlighting their role in pathogenicity. This investigation is one of Libya’s first comprehensive assessments of H. pylori virulence factors, addressing a critical epidemiological gap. The high prevalence of virulence genes suggests their potential as disease biomarkers. These findings contribute to a deeper understanding of H. pylori pathogenicity within the Libyan population and establish a basis for future clinical interventions and public health strategies to manage and prevent H. pylori-associated diseases in Libya and comparable regions.
基金Supported by Noncommunicable Chronic Diseases-National Science and Technology Major Project,No.2023ZD0507200The Suqian Sci Tech Program,No.Z2023106+2 种基金National Natural Science Foundation of China,No.82071234,No.31400947 and No.82170836Gusu Talent Program,No.GSWS2022030The Clinical Research Center of Neurological Disease of The Second Affiliated Hospital of Soochow University,No.ND2024A02.
文摘BACKGROUND Diabetic gastrointestinal autonomic neuropathy(DGAN)often affects the patients’quality of life.Thus,research on influencing factors of DGAN may promote DGAN prevention and decrease the incidence rate.This study used electrogastrogram(EGG)to assess the relationship between metabolic dysfunction-associated steatotic liver disease(MASLD)and DGAN.AIM To analyze the changes of EGG in patients with MASLD and type 2 diabetes mellitus(T2DM),and to elucidate whether ultrasound-diagnosed MASLD is an independent risk factor for diabetic gastric motility disorders(DGMD).METHODS A total of 272 patients with T2DM hospitalized at the Second Affiliated Hospital of Soochow University from December 2020 to December 2021 and the Affiliated Suqian Hospital of Xuzhou Medical University from November 2023 to June 2024 were included in the cross-sectional study.General information,clinical data,and medical history of all study subjects,including name,age,gender,body mass index,and duration of diabetes were collected.Laboratory tests included biochemical parameters,glycosylated hemoglobin(HbA1c),fasting C-peptide,2h postprandial C-peptide and 25-hydroxyvitamin D[25(OH)D].EGG,fundus examination and carotid artery ultrasonography were performed and results were recorded.According to the results of EGG,the subjects were divided into the DGMD group and non-DGMD group.RESULTS The duration of diabetes,fasting blood glucose(FBG),HbA1c,25(OH)D and the prevalence of MASLD were significantly higher in the DGMD group(P<0.05).Multiple logistic regression analysis showed that the duration,FBG,25(OH)D and the presence of MASLD were independent influencing factors.CONCLUSION MASLD is strongly associated with an increased incidence of DGMD.Timely treatment of MASLD is effective to prevent diabetic gastroparesis.
文摘BACKGROUND Gastric cancer is a growing clinical challenge,particularly due to the increased risk of postoperative gastroesophageal reflux disease(GERD)following surgical treatment.traditional Chinese medicine(TCM),including acupuncture and herbal medicine,has been proposed as an adjunctive therapy to promote gastrointestinal recovery and alleviate GERD symptoms.AIM To retrospectively study the clinical efficacy of modified Lou Bei Er Chen decoction combined with acupuncture in treating patients with GERD after radical gastrectomy due to gastric cancer.METHODS A retrospective study was conducted,including patients with gastric cancer or malignant tumors of the stomach from January 2019 to December 2023 in the Affiliated Taizhou People’s Hospital of Nanjing Medical University.Patients with a TCM diagnosis of qi depression and phlegm obstruction(n=128)were selected on the basis of prescription and treatment principles.They were then divided into a control group(n=61)and an observation group(n=67).The control group received treatment with Western medicine domperidone.The observation group were treated with Lou Bei Er Chen decoction orally,with acupuncture at specific RESULTS The observation group showed significantly shorter times for first flatus,defecation,bowel sound recovery,and initiation of nasogastric enteral nutrition than the control group(P<0.05).Upon treatment,the two groups demonstrated a significant reduction in gastrointestinal dysfunction scores,with a more significant reduction in the observation group(P<0.001).The GERD-Q scores significantly decreased after 8 weeks of treatment in the two groups(P<0.05),with a significant reduction in the observation group(P<0.05),compared with baseline.The TCM syndrome scores significantly decreased after 4 and 8 weeks of treatment in the two groups(P<0.05),with a significant reduction in the observation group(P<0.05).The effective rate of the observation group after 8 weeks of treatment was significantly higher than that after 4 weeks(χ2=13.648,P=0.003),and it was significantly higher than that of control group(χ2=13.879,P=0.003).CONCLUSION Lou Bei Er Chen decoction combined with acupuncture treatment can effectively alleviate clinical symptoms in patients GERD after gastric cancer surgery and improve their life quality.It is worthy of further promotion and application.
文摘BACKGROUND Submucosal tumors arise from the subepithelial layer anywhere along the gastr-ointestinal tract,most commonly in the stomach.A wide range of lesions,from benign to malignant,may present as gastric submucosal tumors.However,the gastric involvement of Crohn’s disease(CD)is generally not considered in the differential diagnosis of such lesions.CASE SUMMARY A 23-year-old male patient presented with a gastric subepithelial tumor.The medical history included CD.Diagnostic workup revealed a 3-cm mucosal lesion with a central ulceration on the posterior wall of the distal antrum.The patient underwent laparoscopic wedge resection of stomach,and the postoperative course was uneventful.Histopathological analysis confirmed a diagnosis of gastric CD presenting as a subepithelial tumor.CONCLUSION Despite its rarity,upper gastrointestinal CD can present as a gastric subepithelial tumor,warranting consideration in young patients with CD.
基金supported by the National"Tenth-Five"Key Technologies R& D Program of China(2004BA703B04-02)the Technology Project of Liaoning Province(2007408001-1)
文摘Objective： To investigate the difference in susceptibilities to allitridi of Helicobacter pylori （H.pylori） strains in different gastric diseases and the associations with different genotypes. Methods： H.pylori strains were isolated from gastric antral biopsy specimens and identified. DNA was isolated from H.pylori strains. Different genotypes were determined by polymerase chain reaction（PCR）, and the allitridi MICs were determined by agar dilution methods. MIC50 was calculated. Results： The susceptibilities of H, pylori strains varied among different gastric diseases. H.pylori strains in superficial gastritis were significantly more susceptible to allitridi than those in atrophic gastritis （relative median potency was 0.49, 95% confidence interval was from 0.24 to 0.80）, strains in superficial gastritis were significantly more susceptible than those in gastric cancer （relative median potency was 0.32, 95% confidence interval was from 0.06 to 0.68） and strains in atrophic gastritis were significantly more susceptible than those in gastric cancer（relative median potency was 0.16, 95% confidence interval was from 0.02 to 0.40）. The susceptibilities of H.pylori strains with different genotypes varied among different gastric diseases. In atrophic gastritis, strains with vacAsl＋ were significantly more susceptible to allitridi than those with vacAsl（relative median potency was 0.21, 95% confidence interval was from 0.04 to 0.73）. In gastric cancer, strains with vacAmlb＋ were significantly more susceptible than those with vacAmlb-（relative median potency was 0.07, 95% confidence interval was from 0.03 to 0.49）. Conclusion： The vacA genotypes play an important role in the susceptibility to allitridi in different gastric diseases.
文摘Objective: to explore the value of gastrointestinal contrast-enhanced ultrasound in the diagnosis of gastric space-occupying diseases. Methods: 100 patients with suspected gastric space-occupying lesions who were hospitalized in the Department of Gastroenterology of our hospital from August 2020 to August 2021 were selected for gastrointestinal contrast-enhanced ultrasound and gastroscopy respectively, and the examination results of the patients were recorded. Results: ① Pathological results showed that 80% of the patients were stomach occupying lesions;② Contrast-enhanced ultrasound showed that 78% of the patients were stomach occupying lesions;③ Gastroscopy showed that 73% of the patients were stomach occupying lesions;④ There was no significant difference between the two methods (P>0.05). Conclusion: gastrointestinal contrast-enhanced ultrasound has a high detection rate and is painless, non-invasive and non-radiation. It is worthy of wide clinical application.
基金supported by the National Key Research and Development Program of China(No.2017YFC0907003)the National Natural Science Foundation of China(No.81973116 and 81573229)the Joint Research Funds for Shandong University and Karolinska Institute(No.SDU-KI-2020-03)。
文摘Objective:China is one of the countries with the heaviest burden of gastric cancer(GC)in the world.Understanding the epidemiological trends and patterns of GC in China can contribute to formulating effective prevention strategies.Methods:The data on incidence,mortality,and disability-adjusted life-years(DALYs)of GC in China from1990 to 2019 were obtained from the Global Burden of Disease Study(2019).The estimated annual percentage change(EAPC)was calculated to evaluate the temporal trends of disease burden of GC,and the package Nordpred in the R program was used to perform an age-period-cohort analysis to predict the numbers and rates of incidence and mortality in the next 25 years.Results:The number of incident cases of GC increased from 317.34 thousand in 1990 to 612.82 thousand in2019,while the age-standardized incidence rate(ASIR)of GC decreased from 37.56 per 100,000 in 1990 to 30.64 per 100,000 in 2019,with an EAPC of-0.41[95%confidence interval(95%CI):-0.77,-0.06].Pronounced temporal trends in mortality and DALYs of GC were observed.In the next 25 years,the numbers of new GC cases and deaths are expected to increase to 738.79 thousand and 454.80 thousand,respectively,while the rates of incidence and deaths should steadily decrease.The deaths and DALYs attributable to smoking were different for males and females.Conclusions:In China,despite the fact that the rates of GC have decreased during the past three decades,the numbers of new GC cases and deaths increased,and will continue to increase in the next 25 years.Additional strategies are needed to reduce the burden of GC,such as screening and early detection,novel treatments,and the prevention of risk factors.
基金Supported by the Royal Adelaide Hospital,No.13RAH1475Australian Postgraduate Award and a Dawes scholarship from the Royal Adelaide Hospital(to Trahair LG)NHMRC Senior Career Development Award(to Jones KL)
文摘AIM: To determine gastric emptying, blood pressure, mesenteric artery blood flow, and blood glucose responses to oral glucose in Parkinson’s disease.METHODS: Twenty-one subjects (13 M, 8 F; age 64.2 ± 1.6 years) with mild to moderate Parkinson’s disease (Hoehn and Yahr score 1.4 ± 0.1, duration of known disease 6.3 ± 0.9 years) consumed a 75 g glucose drink, labelled with 20 MBq <sup>99m</sup>Tc-calcium phytate. Gastric emptying was quantified with scintigraphy, blood pressure and heart rate with an automated device, superior mesenteric artery blood flow by Doppler ultrasonography and blood glucose by glucometer for 180 min. Autonomic nerve function was evaluated with cardiovascular reflex tests and upper gastrointestinal symptoms by questionnaire.RESULTS: The mean gastric half-emptying time was 106 ± 9.1 min, gastric emptying was abnormally delayed in 3 subjects (14%). Systolic and diastolic blood pressure fell (P < 0.001) and mesenteric blood flow and blood glucose (P < 0.001 for both) increased, following the drink. Three subjects (14%) had definite autonomic neuropathy and 8 (38%) had postprandial hypotension. There were no significant relationships between changes in blood pressure, heart rate or mesenteric artery blood flow with gastric emptying. Gastric emptying was related to the score for autonomic nerve function (R = 0.55, P < 0.01). There was an inverse relationship between the blood glucose at t = 30 min (R = -0.52, P < 0.05), while the blood glucose at t = 180 min was related directly (R = 0.49, P < 0.05), with gastric emptying.CONCLUSION: In mild to moderate Parkinson’s disease, gastric emptying is related to autonomic dysfunction and a determinant of the glycaemic response to oral glucose.
基金Council of Science and Technology, Governmentof Uttar Pradesh, India, No. CST/SERPD/D-3402The financialassistance from Indian Council of Medical Research (ICMR),New Delhi, No. 80/512/2004-ECD-I
文摘AIM: To investigate -765G > C COX-2 polymorphism and H pylori infection in patients with gastric adenocarcinoma, peptic ulcer disease (PUD) and non- ulcer dyspepsia (NUD). METHODS: We enrolled 348 adult patients (62 gastric adenocarcinoma, 45 PUD and 241 NUD) undergoing upper gastrointestinal endoscopy at two referral centers between September, 2002 and May, 2007. H pylori infection was diagnosed when any of the four tests (RUT, culture, histopathology and PCR) were positive. Genotyping for -765G > C polymorphism of COX-2 was performed by PCR-RFLP analysis. RESULTS: Frequency of C carrier had significantassociation with gastric adenocarcinoma as compared to NUD [77.4% vs 29%, P < 0.001, odds ratio (OR) 8.20; 95% confidence interval (95% CI), 4.08-16.47] and PUD (77.4% vs 31.1%, P < 0.001; OR 8.04; 95% CI, 3.25-19.90). Risk of gastric adenocarcinoma was significantly higher in patients having C carrier with (OR 7.83; 95% CI 3.09-19.85) and without H pylori infection (OR 7.06; 95% CI, 2.61-19.09). Patients with C carrier and H pylori infection had significant risk for the development of PUD (P < 0.001; OR 5.65; 95% CI, 2.07-15.34). CONCLUSION: -765G > C COX-2 polymorphism with or without H pylori could be a marker for genetic susceptibility to gastric adenocarcinoma. COX-2 polymorphism in presence of H pylori infection might be useful in predicting the risk of PUD.
文摘Hericium erinaceus is an edible and medicinal mushroom commonly used in traditional Chinese medicine for centuries.Several studies have highlighted its therapeutic potential for gastrointestinal disorders such as gastritis and inflammatory bowel diseases.In addition,some components of this mushroom appear to possess strong antineoplastic capabilities against gastric and colorectal cancer.This review aims to analyse all available evidence on the digestive therapeutic potential of this fungus as well as the possible underlying molecular mechanisms.
文摘AIM: To check the utility of postcibal ultrasonography for the evaluation of reflux in relation to gastric emptying in infants with recurrent respiratory symptoms and to link imaging with clinical data.METHODS: Esophageal reflux (hyperechoic retrograde filling) and gastric emptying (antral areas) were quantified before and after ingestion of a standard formula in 35 untreated infants (13 with chronic cough,22 with recurrent bronchitis) and in 31 controls.RESULTS: The prevalence of abnormal (≥8 episodes)postcibal refluxes was 74% in patients and 3% in controls. Number, duration of the longest episode and extent of refluxes were significantly higher in patients compared to controls. Number of refluxes was higher in patients with symptomatic refluxes than in those without.Infants with recurrent bronchitis had more refluxes than those with chronic cough and controls. Extent and timing of gastric emptying were similar in patients and controls.CONCLUSION: Esophageal ultrasonography is a useful and physiological test in infants with recurrent respiratory diseases, which have a high prevalence of abnormal postcibal esophageal reflux and a gastric emptying similar to that of normal controls. Esophageal reflux is more severe in subjects with recurrent bronchitis than in those with chronic cough.
文摘We report a case of an isolated hepatic neoplasia which originated in a site of the liver previously affected by radiation induced liver disease (RILD) in a patient resected for gastric cancer and referred to us for high serum alpha-fetoprotein (AFP) levels. This case challenged us in distiguishing, even histologically, between primary liver cancer and AFP producing gastric cancer metastasis. Only a panel of immunohis-tochemical markers allowed the definitive diagnosis of liver metastasis of endodermal stem cell-derived and AFP producing gastric cancer. We discuss the criteria for a differential diagnosis, as well as the possible link between RILD and emergence of liver neoplasia.
文摘Ig G4-related disease is a recently recognized entity linked initially to autoimmune pancreatitis and has been subsequently described in nearly every organ system. Men over the age of 50 represent the most affected demographic group and a comprehensive set of diagnostic criteria has been developed to aid treating clinicians. Though elevated levels of Ig G4 in the serum are suggestive of the disease, definitive diagnosis is made on histopathology. Treatment is tailored to the clinical presentation with corticosteroid therapy known to have proven efficacy. Gastric manifestations of the Ig G4-related disease primarily come in two varieties, notably chronic ulceration or pseudotumor formation. Autoimmune pancreatitis conveys increased risk for Ig G4-related disease of the stomach, which is independent of Helicobacter pylori status. In this case report, we present an acute gastric-pericardial fistula secondary to Ig G4-related disease that required urgent operative management. To our knowledge, this is the first report in the medical literature describing this complication of Ig G4-related disease.
