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Identifying high-risk individuals for gastric cancer surveillance from western and eastern perspectives: Lessons to learn and possibility to develop an integrated approach for daily practice 预览
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作者 Duc Trong Quach Toru Hiyama Takuji Gotoda 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第27期3546-3562,共17页
Current evidence shows that individuals with gastric dysplasia, severe and extensive gastric atrophy, extensive gastric intestinal metaplasia and the incomplete subtype of intestinal metaplasia are at high risk for ga... Current evidence shows that individuals with gastric dysplasia, severe and extensive gastric atrophy, extensive gastric intestinal metaplasia and the incomplete subtype of intestinal metaplasia are at high risk for gastric cancer(GC) development. There are several approaches to identifying these subjects,including noninvasive methods, esophagogastroduodenoscopy and histology.The main approach in Western countries is histology-based while that in Eastern countries with a high prevalence of GC is endoscopy-based. Regarding asymptomatic individuals, the key issues in selecting applicable approaches are the ability to reduce GC mortality and the cost-effectiveness of the approach. At present, population-based screening programs have only been applied in a few Asian countries with a high risk of GC. Pre-endoscopic risk assessment based on demographic and clinical features, such as ethnicity, age, gender, smoking and Helicobacter pylori status, is helpful for identifying subjects with high pre-test probability for a possibly cost-effective approach, especially in intermediate-and low-risk countries. Regarding symptomatic patients with indications for esophagogastroduodenoscopy, the importance of opportunistic screening should be emphasized. The combination of endoscopic and histological approaches should always be considered as endoscopy provides a real-time assessment of the patient’s risk level. In addition, imaging enhanced endoscopy(IEE) has been shown to facilitate targeted biopsies resulting in better correlation between endoscopic and histological findings. Currently, the use of IEE is recommended for endoscopic examinations, and the Operative Link for Gastric Intestinal Metaplasia or Operative Link on Gastritis Assessment grading systems are recommended for histological examinations whenever available. However,resource limitations are an important barrier in many regions worldwide. Thus,for an approach to be applicable in real-life practice, it should be not only evidence-based but also resource-sensitive. In 展开更多
关键词 GASTRIC cancer PRECANCEROUS GASTRIC lesions Dysplasia GASTRIC ATROPHY Chronic ATROPHIC gastritis Intestinal METAPLASIA SURVEILLANCE Screening Costeffective
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The role of endoscopy in the management of hereditary diffuse gastric cancer syndrome 预览
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作者 Shria Kumar Jessica M Long +1 位作者 Gregory G Ginsberg Bryson W Katona 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第23期2878-2886,共9页
Hereditary diffuse gastric cancer(HDGC) syndrome is an inherited cancer risk syndrome associated with path-ogenic germline CDH1 variants. Given the high risk for developing diffuse gastric cancer, CDH1 carriers are re... Hereditary diffuse gastric cancer(HDGC) syndrome is an inherited cancer risk syndrome associated with path-ogenic germline CDH1 variants. Given the high risk for developing diffuse gastric cancer, CDH1 carriers are recommended to undergo prophylactic total gastrectomy for cancer risk reduction. Current guidelines recommend upper endoscopy in CDH1 carriers prior to surgery and then annually for individuals deferring prophylactic total gastrectomy.Management of individuals from HDGC families without CDH1 pathogenic variants remains less clear, and management of families with CDH1 pathogenic variants in the absence of a family history of gastric cancer is particularly problematic at present. Despite adherence to surveillance protocols, endoscopic detection of cancer foci in HDGC is suboptimal and imperfect for facilitating decision-making. Alternative endoscopic modalities, such as chromoendoscopy,endoscopic ultrasound, and other non-white light methods have been utilized,but are of limited utility to further improve cancer detection and risk stratification in HDGC. Herein, we review what is known and what remains unclear about endoscopic surveillance for HDGC, among individuals with and without germline CDH1 pathogenic variants. Ultimately, the use of endoscopy in the management of HDGC remains a challenging arena, but one in which further research to improve surveillance is crucial. 展开更多
关键词 CDH1 gene HEREDITARY DIFFUSE GASTRIC CANCER GASTRIC CANCER Endoscopic screening ENDOSCOPY
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Personalized medicine in functional gastrointestinal disorders:Understanding pathogenesis to increase diagnostic and treatment efficacy 预览
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作者 Xiao Jing Wang Michael Camilleri 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第10期1185-1196,共12页
There is overwhelming evidence that functional gastrointestinal disorders(FGIDs) are associated with specific mechanisms that constitute important targets for personalized treatment. There are specific mechanisms in p... There is overwhelming evidence that functional gastrointestinal disorders(FGIDs) are associated with specific mechanisms that constitute important targets for personalized treatment. There are specific mechanisms in patients presenting with functional upper gastrointestinal symptoms(UGI Sx). Among patients with UGI Sx, approximately equal proportions(25%) of patients have delayed gastric emptying(GE), reduced gastric accommodation(GA), both impaired GE and GA,or neither, presumably due to increased gastric or duodenal sensitivity.Treatments targeted to the underlying pathophysiology utilize prokinetics,gastric relaxants, or central neuromodulators. Similarly, specific mechanisms in patients presenting with functional lower gastrointestinal symptoms, especially with diarrhea or constipation, are recognized, including at least 30% of patients with functional constipation pelvic floor dyssynergia and 5% has colonic inertia(with neural or interstitial cells of Cajal loss in myenteric plexus);25% of patients with diarrhea-predominant irritable bowel syndrome(IBSD) has evidence of bile acid diarrhea;and, depending on ethnicity, a varying proportion of patients has disaccharidase deficiency, and less often sucrose-isomaltase deficiency. Among patients with predominant pain or bloating, the role of fermentable oligosaccharides, disaccharides, monosaccharides and polyols should be considered. Personalization is applied through pharmacogenomics related to drug pharmacokinetics, specifically the role of CYP2 D6, 2 C19 and 3 A4 in the use of drugs for treatment of patients with FGIDs. Single mutations or multiple genetic variants are relatively rare, with limited impact to date on the understanding or treatment of FGIDs. The role of mucosal gene expression in FGIDs, particularly in IBS-D, is the subject of ongoing research. In summary, the time for personalization of FGIDs, based on deep phenotyping, is here;pharmacogenomics is relevant in the use of central neuromodulators. There is still unclear impact of the role of genet 展开更多
关键词 Gastrointestinal symptoms GASTRIC emptying GASTRIC accommodation DIARRHEA CONSTIPATION Irritable bowel syndrome Bile acid DIARRHEA Phenotypes PHARMACOGENOMICS PROKINETICS NEUROMODULATORS
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Gastro-duodenal disease in Africa:Literature review and clinical data from Accra,Ghana 预览
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作者 Timothy N Archampong Richard H Asmah +6 位作者 Cathy J Richards Vicki J Martin Christopher D Bayliss Edília Botao Leonor David Sandra Beleza Carla Carrilho 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第26期3344-3358,共15页
Gastroduodenal disease(GDD)was initially thought to be uncommon in Africa.Amongst others,lack of access to optimal health infrastructure and suspicion of conventional medicine resulted in the reported prevalence of GD... Gastroduodenal disease(GDD)was initially thought to be uncommon in Africa.Amongst others,lack of access to optimal health infrastructure and suspicion of conventional medicine resulted in the reported prevalence of GDD being significantly lower than that in other areas of the world.Following the increasing availability of flexible upper gastro-intestinal endoscopy,it has now become apparent that GDD,especially peptic ulcer disease(PUD),is prevalent across the continent of Africa.Recognised risk factors for gastric cancer(GCA)include Helicobater pylori(H.pylori),diet,Epstein-Barr virus infection and industrial chemical exposure,while those for PUD are H.pylori,non-steroidal antiinflammatory drug(NSAID)-use,smoking and alcohol consumption.Of these,H.pylori is generally accepted to be causally related to the development of atrophic gastritis(AG),intestinal metaplasia(IM),PUD and distal GCA.Here,we perform a systematic review of the patterns of GDD across Africa obtained with endoscopy,and complement the analysis with new data obtained on premalignant gastric his-topathological lesions in Accra,Ghana which was compared with previous data from Maputo,Mozambique.As there is a general lack of structured cohort studies in Africa,we also considered endoscopy-based hospital or tertiary centre studies of symptomatic individuals.In Africa,there is considerable heterogeneity in the prevalence of PUD with no clear geographical patterns.Furthermore,there are differences in PUD within-country despite universally endemic H.pylori infection.PUD is not uncommon in Africa.Most of the African tertiary-centre studies had higher prevalence of PUD when compared with similar studies in western countries.An additional intriguing observation is a recent,ongoing decline in PUD in some African countries where H.pylori infection is still high.One possible reason for the high,sustained prevalence of PUD may be the significant use of NSAIDs in local or over-the-counter preparations.The prevalence of AG and IM,were similar or modestly higher ove 展开更多
关键词 GASTRODUODENAL PEPTIC ULCER GASTRIC cancer AFRICA Pre-malignant Atrophy Intestinal metaplasia DUODENAL ULCER GASTRIC ULCER
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Issues and controversies in esophageal inlet patch 预览
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作者 Adriana Ciocalteu Petrica Popa +1 位作者 Mircea Ionescu Dan Ionut Gheonea 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第30期4061-4073,共13页
The proximal esophagus is rarely examined,and its inspection is often inadequate.Optical chromoendoscopy techniques such as narrow band imaging improve the detection rate of inlet patches in the proximal esophagus,a r... The proximal esophagus is rarely examined,and its inspection is often inadequate.Optical chromoendoscopy techniques such as narrow band imaging improve the detection rate of inlet patches in the proximal esophagus,a region in which their prevalence is likely underestimated.Various studies have reported correlations between these esophageal marks with different issues such as Barrett’s esophagus,but these findings remain controversial.Conflicting reports complicate the process of interpreting the clinical features of esophageal inlet patches and underestimate their importance.Unfortunately,the limited clinical data and statistical analyses make reaching any conclusions difficult.It is hypothesized that inlet patches are correlated with various esophageal and extraesophageal symptoms,diagnoses and the personalized therapeutic management of patients with inlet patches as well as the differential diagnosis for premalignant lesions or early cancers.Due to its potential underdiagnosis,there are no consensus guidelines for the management and follow up of inlet patches.This review focuses on questions that were raised from published literature on esophageal inlet patches in adults. 展开更多
关键词 INLET PATCH Ectopic GASTRIC MUCOSA Heterotopic GASTRIC MUCOSA ESOPHAGEAL cancer Narrow band imaging Optical chromoendoscopy Cervical ESOPHAGUS Functional dyspepsia Barrett’s ESOPHAGUS Helicobacter pylori
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Gastric per-oral endoscopic myotomy: Current status and future directions 预览
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作者 Alexander Podboy Joo Ha Hwang +5 位作者 Linda A Nguyen Patricia Garcia Thomas A Zikos Afrin Kamal George Triadafilopoulos John O Clarke 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第21期2581-2590,共10页
Gastroparesis, or symptomatic delayed gastric emptying in the absence of mechanical obstruction, is a challenging and increasingly identified syndrome. Medical options are limited and the only medication approved by t... Gastroparesis, or symptomatic delayed gastric emptying in the absence of mechanical obstruction, is a challenging and increasingly identified syndrome. Medical options are limited and the only medication approved by the Food and Drug Administration for treatment of gastroparesis is metoclopramide, although other agents are frequently used off label. With this caveat, first-line treatments for gastroparesis include dietary modifications, antiemetics and promotility agents, although these therapies are limited by suboptimal efficacy and significant medication side effects. Treatment of patients that fail first-line treatments represents a significant therapeutic challenge. Recent advances in endoscopic techniques have led to the development of a promising novel endoscopic therapy for gastroparesis via endoscopic pyloromyotomy, also referred to as gastric per-oral endoscopic myotomy or per-oral endoscopic pyloromyotomy. The aim of this article is to review the technical aspects of the per-oral endoscopic myotomy procedure for the treatment of gastroparesis, provide an overview of the currently published literature, and outline potential next directions for the field. 展开更多
关键词 Gastroparesis GASTRIC per-oral ENDOSCOPIC MYOTOMY Per-oral ENDOSCOPIC PYLOROMYOTOMY MYOTOMY ENDOSCOPIC MYOTOMY Peroral ENDOSCOPIC MYOTOMY GASTRIC emptying
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胃炎性纤维性息肉的临床和内镜特点分析 预览
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作者 张馨梅 关月 +2 位作者 吴寒 张予蜀 张振玉 《胃肠病学和肝病学杂志》 CAS 2019年第7期779-781,共3页
目的探讨胃炎性纤维性息肉(inflammatory fibroid polyp,IFP)的临床和内镜特点。方法对27例病理确诊为胃IFP患者的临床表现、内镜、超声内镜特征,治疗及预后情况进行回顾性分析。结果27例胃IFP患者年龄(60.5±9.9)岁(27~77岁),女性... 目的探讨胃炎性纤维性息肉(inflammatory fibroid polyp,IFP)的临床和内镜特点。方法对27例病理确诊为胃IFP患者的临床表现、内镜、超声内镜特征,治疗及预后情况进行回顾性分析。结果27例胃IFP患者年龄(60.5±9.9)岁(27~77岁),女性多于男性。临床症状可见腹痛、腹胀、黑便或无明显症状。胃窦部、单发病灶为主(96.3%),偶见多发。病灶形态多样,以山田Ⅱ型为多见(60.7%),部分病灶表面糜烂或溃疡形成(25.9%)。病灶直径(1.2±0.5)cm(0.6~2.5cm)。超声内镜见起源于黏膜肌层,或起源于黏膜下层、向黏膜肌层延伸的低回声团块。所有患者经内镜下切除病灶,随访未见复发。结论胃IFP缺乏特异性症状,病灶形态多样,内镜下切除预后好,超声内镜表现有助于鉴别诊断,指导治疗。 展开更多
关键词 炎性纤维性息肉 内镜 超声内镜 治疗
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Artificial intelligence for endoscopy 预览
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作者 Hiroyuki Imaeda Yoshikazu Tsuzuki +3 位作者 Kazuya Miyaguchi Keigo Ashitani Hideki Ohgo Hidetomo Nakamoto 《世界荟萃分析杂志》 2019年第7期343-345,共3页
In recent times,there has been progressive development in artificial intelligence(AI)following the introduction of deep learning in the medical field including gastroenterology and endoscopy.Most of the reported studi... In recent times,there has been progressive development in artificial intelligence(AI)following the introduction of deep learning in the medical field including gastroenterology and endoscopy.Most of the reported studies were based on retrospective data.Several prospective studies of real-time diagnosis of moving images using the AI system are expected to match the real clinical situation and to aid the endoscopists in the detection and diagnosis of neoplasms without missing any lesion.AI can read a large number of endoscopic images in a few minutes and make a diagnosis;therefore,it is expected to cover the lack of support for the screening esophagogastroduodenoscopy in the health check-up and a large number of capsule images,thereby freeing the endoscopists from this burden.AI can help make the diagnosis during the endoscopic procedure and thereby prevent an unnecessary biopsy for patients taking antithrombotic drugs.AI can also be useful for education and training in endoscopy.Trainees can learn to perform endoscopy and the detection and diagnosis of lesions by the support of AI.In the near future,real-time endoscopic diagnosis using AI is expected to lessen the burden of endoscopists,to enhance the quality level of endoscopists,to overcome the miss of lesions and to make optimal diagnosis. 展开更多
关键词 Artificial INTELLIGENCE ENDOSCOPY GASTRIC CANCER COLONIC NEOPLASM
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Effect of Jianpi Yiqi Prescription serum on the gastric cancer cell growth and angiogenesis
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作者 Xing-Long Wang 《海南医科大学学报(英文版)》 2019年第10期28-31,共4页
Objective: To study the effect of Jianpi Yiqi Prescription serum on the gastric cancer cell growth and angiogenesis. Methods: SD rats were selected and given intragastric administration of Jianpi Yiqi solution and nor... Objective: To study the effect of Jianpi Yiqi Prescription serum on the gastric cancer cell growth and angiogenesis. Methods: SD rats were selected and given intragastric administration of Jianpi Yiqi solution and normal saline respectively to collect aorta blood and prepare the Jianpi Yiqi Prescription serum and blank serum;gastric cancer SGC-7901 cells were cultured and divided into 10% drug serum group, 10% blank serum group and 10% fetal bovine serum group, and the cell proliferation activity, apoptosis index as well as proliferation gene, apoptosis gene and angiogenesis gene expression were measured after 24 h of treatment. Results: Cell proliferation activity as well as EZH2, UHRF1, CyclinA, CyclinB1, CDK1, c-IAP1, XIAP, VEGF, VEGFR2, HIF-1α and COX2 mRNA expression in cells of 10% drug serum group was significantly lower than those of 10% blank serum group and 10% fetal bovine serum group while apoptosis index as well as Caspase-3 and PDCD5 mRNA expression in cells was significantly higher than those of 10% blank serum group and 10% fetal bovine serum group. Conclusion: Jianpi Yiqi Prescription serum can inhibit the gastric cancer cell growth and angiogenesis. 展开更多
关键词 GASTRIC cancer Jianpi Yiqi PRESCRIPTION PROLIFERATION Apoptosis ANGIOGENESIS
Compound Kushen injection combined with chemotherapy in the treatment of gastric cancer: a meta-analysis of randomized controlled trials 预览
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作者 Su-Tong Liu Kai-Qi Su Wen-Xia Zhao 《TMR肿瘤》 2019年第1期118-126,共9页
Objective: This study aims to systematically evaluate the efficacy and safety of compound kushen injection (CKI) in combination with chemotherapy in patients with gastric cancer (GC). Methods: A comprehensive electron... Objective: This study aims to systematically evaluate the efficacy and safety of compound kushen injection (CKI) in combination with chemotherapy in patients with gastric cancer (GC). Methods: A comprehensive electronic search was conducted by searching PubMed, EMBASE, Cochrane Library, Chinese Biological Medical disc, China National Knowledge Infrastructure and Wanfang databases (the last update January 20, 2018). All randomized controlled trials (RCTs) of CKI plus chemotherapy versus chemotherapy alone in GC patients were identified. The quality of each study was evaluated using the Jadad’s scale, and the meta-analysis was performed using Review Manager 5.3 and STATA 14 software. Results: A total of nine studies on 688 cases were included in this study. The results showed that CKI combined with chemotherapy had a better effect on improving patients’ overall response rate (ORR) and life quality. The consequences of Egger’s and Begg’s tests showed there was no significant publication bias. Conclusion: The current evidence showed that CKI may enhance the clinical efficacy of chemotherapy, improve the quality of life and increase the safety in patients with gastric cancer. 展开更多
关键词 Compound kushen INJECTION CHEMOTHERAPY GASTRIC cancer RANDOMIZED controlled trials
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A left-side channel design improving insertion of gastric tube via the supraglottic airway device
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作者 Jing-Dong Ke Hai-Jun Hou +1 位作者 Min Wang Fu-Shan Xue 《中华医学杂志:英文版》 SCIE CAS CSCD 2019年第11期1365-1367,共3页
To the Editor:The supraglottic airway device (SAD) with an additional gastric drainage channel may be beneficial for patients needing gastric decompression during surgery, such as laparoscopic cholecystectomy and cesa... To the Editor:The supraglottic airway device (SAD) with an additional gastric drainage channel may be beneficial for patients needing gastric decompression during surgery, such as laparoscopic cholecystectomy and cesarean delivery. Furthermore, addition of gastric drainage channel is a typical feature of second-generation SAD. However, all of second-generation SADs have a gastric tube channel opening at the center of the distal tip. Such a design may cause some difficulty for insertion of the gastric tube if there is an inadequate position of the device tip in the upper esophageal aperture. In normal anatomy, the upper esophageal aperture is actually inclined to the left side of the trachea. Thus, we inferred that it should be much easier to insert a gastric tube into the esophagus, if the gastric drainage channel is placed at the left side of the SAD tip. 展开更多
关键词 SUPRAGLOTTIC AIRWAY DEVICE (SAD) drainage channel GASTRIC drainage pathway
NIMA related kinase 2 promotes gastric cancer cell proliferation via ERK/MAPK signaling 预览
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作者 Wei-Dong Fan Tao Chen Peng-Jun Liu 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第23期2898-2910,共13页
BACKGROUND NIMA related kinase 2(NEK2) is closely related to mitosis, and it is currently considered to be over-expressed frequently in many poorly prognostic cancers.However, the effect of the up-regulated NEK2 on ce... BACKGROUND NIMA related kinase 2(NEK2) is closely related to mitosis, and it is currently considered to be over-expressed frequently in many poorly prognostic cancers.However, the effect of the up-regulated NEK2 on cellular signaling in tumors,such as gastric cancer(GC), is con-fusing.AIM To determine the role of the up-regulation of NEK2 in GC.METHODS To investigate the pathological significance of NEK2 in GC, the expression pattern of NEK2 in GC was investigated based on the 'Oncomain' database and compared between 30 pairs of cancer samples and adjacent tissues. The coexpression of NEK2 and ERK in GC was analyzed using The Cancer Genome Atlas(TCGA) database and confirmed in clinical samples by quantitative realtime PCR(qRT-PCR), and the survival curve was also plotted. Western blot or qRT-PCR was used to analyze the effect of NEK2 on the phosphorylation levels of ERK and c-JUN in two GC cell lines(BGC823 and SGC7901) with NEK2 overexpression, and the expression of the downstream effector cyclin D1.Furthermore, CCK8, EdU incorporation assay, and flow cytometry were used to detect the proliferative ability of BGC823 and SGC7901 cells with stably silenced ERK.RESULTS NEK2 was significantly up-regulated in human GC tissues. ERK was significantly associated with NEK2 expression in human clinical specimens, and combined overexpression of NEK2 and ERK potentially forecasted a poor prognosis andsurvival in GC patients. NEK2 knockdown in GC cells inhibited ERK and c-JUN phosphory-lation and reduced the transcription of cyclin D1. More interestingly,NEK2 can rescue the inhibition of cellular viability, proliferation, and cell cycle progression due to ERK knockdown.CONCLUSION Our results indicate that NEK2 plays a carcinogenic role in the malignant proliferation of GC cells via the ERK/MAPK signaling, which may be important for treatment and improving patient survival. 展开更多
关键词 NIMA RELATED KINASE 2 ERK/MAPK SIGNALING Cyclin D1 Cell proliferation Gastric cancer
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Proteomics of the mediodorsal thalamic nucleus of rats with stress-induced gastric ulcer 预览
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作者 Sheng-Nan Gong Jian-Ping Zhu +1 位作者 Ying-Jie Ma Dong-Qin Zhao 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第23期2911-2923,共13页
BACKGROUND Stress-induced gastric ulcer(SGU) is one of the most common visceral complications after trauma. Restraint water-immersion stress(RWIS) can cause serious gastrointestinal dysfunction and has been widely use... BACKGROUND Stress-induced gastric ulcer(SGU) is one of the most common visceral complications after trauma. Restraint water-immersion stress(RWIS) can cause serious gastrointestinal dysfunction and has been widely used to study the pathogenesis of SGU to identify medications that can cure the disease. The mediodorsal thalamic nucleus(MD) is the centre integrating visceral and physical activity and contributes to SGU induced by RWIS. Hence, the role of the MD during RWIS needs to be studied.AIM To screen for differentially expressed proteins in the MD of the RWIS rats to further elucidate molecular mechanisms of SGU.METHODS Male Wistar rats were selected randomly and divided into two groups, namely, a control group and an RWIS group. Gastric mucosal lesions of the sacrificed rats were measured using the erosion index and the proteomic profiles of the MD were generated through isobaric tags for relative and absolute quantitation(iTRAQ) coupled with two-dimensional liquid chromatography and tandem mass spectrometry. Additionally, iTRAQ results were verified by Western blot analysis.RESULTS A total of 2853 proteins were identified, and these included 65 dysregulated(31 upregulated and 34 downregulated) proteins(fold change ratio ≥ 1.2). Gene Ontology(GO) analysis showed that most of the upregulated proteins are primarily related to cell division, whereas most of the downregulated proteins are related to neuron morphogenesis and neurotransmitter regulation. Ingenuity Pathway Analysis revealed that the dysregulated proteins are mainly involved in the neurological disease signalling pathways. Furthermore, our results indicated that glycogen synthase kinase-3 beta might be related to the central mechanismthrough which RWIS gives rise to SGU.CONCLUSION Quantitative proteomic analysis elucidated the molecular targets associated with the production of SGU and provides insights into the role of the MD. The underlying molecular mechanisms need to be further dissected. 展开更多
关键词 Mediodorsal THALAMIC nucleus Proteome Restraint water-immersion STRESS Stress-induced gastric ulcer GLYCOGEN SYNTHASE kinase-3 beta
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A case of locally advanced gastric cancer treated with nivolumab, trastuzumab, plus chemotherapy in a neoadjuvant setting
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作者 Shi-Yu Jiang Yan Qin Yuan-Kai Shi 《中华医学杂志:英文版》 SCIE CAS CSCD 2019年第11期1370-1371,共2页
To the Editor:Recently,the advantages of peri-operative chemotherapy in downstaging tumor and improving patient survival have been reported. Herein, we report a case of gastric cancer patient receiving neoadjuvant che... To the Editor:Recently,the advantages of peri-operative chemotherapy in downstaging tumor and improving patient survival have been reported. Herein, we report a case of gastric cancer patient receiving neoadjuvant chemotherapy along with trastuzumab and nivolumab. 展开更多
关键词 CHEMOTHERAPY GASTRIC cancer patients TUMOR
Clinical observation of laparoscopic radical gastrectomy for advanced gastric cancer 预览
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作者 Xiao-Xiao Yan Yong-Hong Dong +2 位作者 Jing Wang Ji-Guang Xie Jun-Jun Su 《TMR肿瘤》 2019年第1期151-156,共6页
Objective: To explore the clinical efficacy of laparoscopic radical gastrectomy and traditional open radical gastrectomy for advanced gastric cancer. Methods: 116 patients with advanced gastric cancer in our hospital ... Objective: To explore the clinical efficacy of laparoscopic radical gastrectomy and traditional open radical gastrectomy for advanced gastric cancer. Methods: 116 patients with advanced gastric cancer in our hospital were randomly selected, including 55 cases in the experimental group and 61 cases in the control group. The clinical effects, CEA, CA-199, AFP and postoperative complications of the two groups were compared. Results: The indexes of operation and post-operation (average operation time, incision length, exhaust time, intraoperative bleeding volume, hospital stay, enteral nutrition time), and the total number of lymph nodes dissected in the experimental group was less than that in the control group (P < 0.05). There was no difference in CEA, CA-199 and AFP before operation and 1 month after operation. The incidence of complications in laparoscopic group was 9.1% lower than that in control group (27.9%). Conclusion: Laparoscopic radical gastrectomy has many advantages in the treatment of gastric cancer, which can effectively reduce complications and is worth promoting. 展开更多
关键词 LAPAROSCOPIC RADICAL GASTRECTOMY Open RADICAL GASTRECTOMY ADVANCED GASTRIC cancer
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Gastroesophageal reflux disease,obesity and laparoscopic sleeve gastrectomy:The burning questions 预览
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作者 Halim Bou Daher Ala I Sharara 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第33期4805-4813,共9页
Obesity is a global health epidemic with considerable economic burden.Surgical solutions have become increasingly popular following technical advances leading to sustained efficacy and reduced risk.Sleeve gastrectomy ... Obesity is a global health epidemic with considerable economic burden.Surgical solutions have become increasingly popular following technical advances leading to sustained efficacy and reduced risk.Sleeve gastrectomy accounts for almost half of all bariatric surgeries worldwide but concerns regarding its relationship with gastroesophageal reflux disease(GERD)has been a topic of debate.GERD,including erosive esophagitis,is highly prevalent in the obese population.The role of pre-operative endoscopy in bariatric surgery has been controversial.Two schools of thought exist on the matter,one that believes routine upper endoscopy before bariatric surgery is not warranted in the absence of symptoms and another that believes that symptoms are poor predictors of underlying esophageal pathology.This debate is particularly important considering the evidence for the association of laparoscopic sleeve gastrectomy(LSG)with de novo and/or worsening GERD compared to the less popular Roux-en-Y gastric bypass procedure.In this paper,we try to address 3 burning questions regarding the inter-relationship of obesity,GERD,and LSG:(1)What is the prevalence of GERD and erosive esophagitis in obese patients considered for bariatric surgery?(2)Is it necessary to perform an upper endoscopy in obese patients considered for bariatric surgery?And(3)What are the long-term effects of sleeve gastrectomy on GERD and should LSG be done in patients with pre-existing GERD? 展开更多
关键词 REFLUX EROSIVE Acid BARIATRIC OBESITY Gastric BYPASS ENDOSCOPY
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Gastric volvulus presenting as an acute coronary syndrome with long-lasting electrocardiographic changes 预览
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作者 Shi-Lin FANG Ming DENG +4 位作者 Ya-Nan PENG Chang GAO Qiu ZHAO Jing LIU Xue-Dong GAN 《老年心脏病学杂志:英文版》 SCIE CAS CSCD 2019年第3期309-312,共4页
A sixty-one-year-old male,with a medical history of coronary heart disease and myocardial bridge (not confirmed by cardiac catheterization) in the past three years and a 1-h history of sudden onset nausea,retching,dia... A sixty-one-year-old male,with a medical history of coronary heart disease and myocardial bridge (not confirmed by cardiac catheterization) in the past three years and a 1-h history of sudden onset nausea,retching,diaphoresis,epigastric discomfort without any chest pain.The electrocardiogram revealed ST elevation myocardial infarction (STEMI) changes (Figure 1A).Urgent cardiac catheterization revealed mild myocardial bridge in the middle of the left anterior descending (LAD)(10% systolic compression) and normal left ventricular function without regional wall motion abnormalities.Three high-sensitivity cardiac troponin I (HSTNT) titers done at 4,8 and 20 h from the onset of symptoms were HSTNT =10.5 pg/mL,10.9 pg/mL,25.4 pg/mL (less than 26.2) with CK-MB = 3 pg/mL,18 pg/mL,13 pg/mL (< 25) and the myoglobin levels were = 34.8 pg/mL,39.6 pg/mL,44.5 pg/mL (< 140.1),respectively. 展开更多
关键词 Acute CORONARY SYNDROME ECG GASTRIC VOLVULUS
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Early Pattern of Epstein-Barr Virus Infection in Gastric Epithelial Cells by"Cell-in-cell"
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作者 Wenxing Yue Meijuan Zhu +9 位作者 Lielian Zuo Shuyu Xin Jing Zhang Lingzhi Liu Shen Li Wei Dang Siwei Zhang Yan Xie Fanxiu Zhu Jianhong Lu 《中国病毒学:英文版》 CAS CSCD 2019年第3期253-261,共9页
Epstein-Barr virus(EBV)is an important human dsDNA virus,which has been shown to be associated with several malignancies including about 10%of gastric carcinomas.How EBV enters an epithelial cell has been an interesti... Epstein-Barr virus(EBV)is an important human dsDNA virus,which has been shown to be associated with several malignancies including about 10%of gastric carcinomas.How EBV enters an epithelial cell has been an interesting project for investigation."Cell-in-cell"infection was recently reported an efficient way for the entry of EBV into nasopharynx epithelial cells.The present approach was to explore the feasibility of this mode for EBV infection in gastric epithelial cells and the dynamic change of host inflammatory reaction.The EBV-positive lymphoblastic cells of Akata containing a GFP tag in the viral genome were co-cultured with the gastric epithelial cells(GES-1).The infection situation was observed under fluorescence and electron microscopies.Real-time quantitative PCR and Western-blotting assay were employed to detect the expression of a few specific cytokines and inflammatory factors.The results demonstrated that EBV could get into gastric epithelial cells by"cell-in-cell"infection but not fully successful due to the host fighting.IL-1β,IL-6 and IL-8 played prominent roles in the cellular response to the infection.The activation of NF-κB and HSP70 was also required for the host antiviral response.The results imply that the gastric epithelial cells could powerfully resist the virus invader via cell-in-cell at the early stage through inflammatory and innate immune responses. 展开更多
关键词 EPSTEIN-BARR virus(EBV) Cell-in-cell INFECTION GASTRIC EPITHELIAL cells INFLAMMATORY response
内镜全层切除术治疗胃黏膜下肿瘤的临床效果分析 预览
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作者 赵飞 王帮平 +6 位作者 牛洪流 赵克昌 彭传林 肖爱荣 年碧 易静 张辉 《中国内镜杂志》 2019年第7期77-81,共5页
目的研究内镜下全层切除术(EFTR)在治疗胃黏膜下肿瘤(SMT)中的临床价值.方法回顾性分析2015年12月-2017年6月宿州市第一人民医院应用EFTR治疗的52例胃SMT的临床资料,统计手术成功率、SMT完整切除率,记录手术时间;观察患者术后有无出血... 目的研究内镜下全层切除术(EFTR)在治疗胃黏膜下肿瘤(SMT)中的临床价值.方法回顾性分析2015年12月-2017年6月宿州市第一人民医院应用EFTR治疗的52例胃SMT的临床资料,统计手术成功率、SMT完整切除率,记录手术时间;观察患者术后有无出血、穿孔等并发症;术后内镜随访,评估患者术后创面愈合及病变残留、复发情况.结果运用EFTR成功剥离52例患者合计53枚SMT,手术时间35.0~78.0 min,平均45.2 min,手术成功率100.0%,肿瘤完整切除率100.0%,肿瘤直径大小为1.0~3.2 cm,平均1.5 cm.病灶位于贲门下23枚(43.4%),胃底17枚(32.1%),胃体10枚(18.8%),胃窦2枚(3.8%),胃角1枚(1.9%);术中2例患者发生动脉性出血(3.8%),应用热活检钳止血成功.术后随访3~6个月,所有病例创面愈合良好.术后石蜡病理诊断结果为间质瘤36枚(67.9%),平滑肌瘤15枚(28.3%),异位胰腺2枚(3.8%).术后无迟发性出血及迟发穿孔发生.52例患者术后3~6个月复查胃镜,病灶均完全消失,术后创面愈合良好,治疗有效率为100.0%(52/52).结论 EFTR治疗胃SMT是一种安全、有效的临床技术. 展开更多
关键词 黏膜下肿瘤 内镜全层切除术
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Electroacupuncture at ST36 modulates gastric motility via vagovagal and sympathetic reflexes in rats 预览
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作者 Meng-Jiang Lu Zhi Yu +2 位作者 Yan He Yin Yin Bin Xu 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第19期2315-2326,共12页
BACKGROUND Electroacupuncture (EA) at ST36 can significantly improve gastrointestinal symptoms, especially in promoting gastrointestinal motility. The automatic nervous system plays a main role in EA, but few studies ... BACKGROUND Electroacupuncture (EA) at ST36 can significantly improve gastrointestinal symptoms, especially in promoting gastrointestinal motility. The automatic nervous system plays a main role in EA, but few studies exist on how vagovagal and sympathetic reflexes affect EA to regulate gastrointestinal motility. AIM To study the role of vagovagal and sympathetic reflexes in EA at ST36, as well as the associated receptor subtypes that are involved. METHODS Gastric motility was measured with a manometric balloon placed in the gastric antrum area in anesthetized animals. The peripheral nervous discharge was measured using a platinum electrode hooking the vagus or greater splanchnic nerve, and the central nervous discharge was measured with a glass microelectrode in the dorsal motor nucleus of the vagus (DMV). The effects and mechanisms of EA at ST36 were explored in male Sprague-Dawley rats which were divided in to a control group, vagotomy group, sympathectomy group, and microinjection group [including an artificial cerebrospinal fluid group, glutamate (L-Glu) group, and γ-aminobutyric acid (GABA) group] and in genetically modified male mice [β1β2 receptor-knockout (β1β2-/-) mice, M2M3 receptorknockout (M2M3-/-) mice, and wild-type control mice].RESULTS EA at ST36 promoted gastric motility during 30-120 s. During EA, both vagus and sympathetic nerve discharges increased, with a much higher frequency of vagus nerve discharge than sympathetic discharge. The gastric motility mediated by EA at ST36 was interdicted by vagotomy. However, gastric motility mediated by EA at ST36 was increased during 0-120 s by sympathectomy, which eliminated the delay effect of EA during 0-30 s, but it was lower than the control group during 30-120 s. Using gene knockout mice and their wild-type controls to explore the receptor mechanisms, we found that EA at ST36 decreased gastric motility in M2/3-/- mice, and promoted gastric motility in β1/2-/- mice. Extracellular recordings showed that EA at ST36 increased spikes of the DMV. Micr 展开更多
关键词 Gastric MOTILITY ELECTROACUPUNCTURE Vagovagal REFLEX SYMPATHETIC nerve RATS
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