There are a large number of people suffering from gastric cancer (GC) worldwide, so the study of biomarkers for GC is urgently needed. This study aimed to investigate the role of esophageal ...cancer-related gene 4 (ECRG4) in the growth, metastasis, and prognosis of GC and the possible underlying mechanism.
The expression of ECRG4 was detected in GC tissues by quantitative polymerase chain reaction (PCR), Western blot, and immunohistochemistry. The relationships between ECRG4 expression and clinicopathological parameters of patients with GC were statistically analyzed, and Kaplan-Meier prognosis and survival curves of the patients were plotted. ECRG4 was overexpressed in the human gastric adenocarcinoma cell line (AGS) and human GC cell line 27 (HGC27), and the
effects of ECRG4 overexpression on the growth, invasion, and metastasis of GC were analyzed and verified in nude mice. To identify the downstream transcription factors potentially regulated by ECRG4, ribonucleic acid (RNA) sequencing and differential gene expression analysis were performed on ECRG4-overexpressing cells. Quantitative PCR, Western blot, and immunohistochemistry were used to detect the expression of the downstream transcription factors targeted by ECRG4 in GC.
The ECRG4 mRNA and protein expression levels were low in GC tissues and were associated with a poor prognosis. Least absolute shrinkage and selection operator (LASSO) Cox regression and Kaplan-Meier survival analyses showed that patients with low ECRG4 expression had worse prognosis and survival. Overexpression of ECRG4 inhibited the proliferation, metastasis, and invasion of GC cells. RNA sequencing analysis showed that overexpression of ECRG4 induced the upregulation of Krüppel-like factor 2.
Our findings show that ECRG4 promotes GC progression via Krüppel-like factor 2 signaling and highlight ECRG4 as a potential GC biomarker and therapeutic target.
Background
Geographic differences exist in the antibiotic resistance patterns of Helicobacter pylori. Personalized treatment regimens based on local or individual resistance data are essential. We ...evaluated the current status of H. pylori resistance in Ningxia, analyzed resistance‐related factors, and assessed the concordance of phenotypic and genotypic resistance.
Methods
Strains were isolated from the gastric mucosa of patients infected with H. pylori in Ningxia and relevant clinical information was collected. Phenotypic antibiotic susceptibility assays (Kirby–Bauer disk diffusion) and antibiotic resistance gene detection (Sanger sequencing) were performed.
Results
We isolated 1955 H. pylori strains. The resistance rates of H. pylori to amoxicillin, levofloxacin, clarithromycin, and metronidazole were 0.9%, 42.4%, 40.4%, and 94.2%, respectively. Only five tetracycline‐resistant and one furazolidone‐resistant strain were identified. Overall, 3.3% of the strains were sensitive to all six antibiotics. Multidrug‐resistant strains accounted for 22.9%, of which less than 20% were from Wuzhong. Strains isolated from women and patients with nonulcerative disease had higher rates of resistance to levofloxacin and clarithromycin. Higher rates of resistance to metronidazole, levofloxacin, and clarithromycin were observed in the older age group than in the younger age group. The kappa coefficients of phenotypic resistance and genotypic resistance for levofloxacin and clarithromycin were 0.830 and 0.809, respectively, whereas the remaining antibiotics showed poor agreement.
Conclusion
H. pylori antibiotic resistance is severe in Ningxia. Therefore, furazolidone, amoxicillin, and tetracycline are better choices for the empirical therapy of H. pylori infection in this region. Host sex, age, and the presence of ulcerative diseases may affect antibiotic resistance of the bacteria. Personalized therapy based on genetic testing for levofloxacin and clarithromycin resistance may be a future direction for the eradication therapy of H. pylori infection in Ningxia.
Gastric cancer (GC) has been become the second leading cause for cancer-associated death. This study aimed to investigate Orexin A levels and associated receptors in tumor tissues of GC patients.
...Forty-six consecutive gastric cancer patients (GC, n=46) and 13 chronic atrophic gastritis patients (CAG, n=13) were recruited. Meanwhile, 18 health individuals visiting Medical Examination Department were involved as control (N group, n=18). ELISA was used to examine Orexin A concentration. Immunohistochemistry assay was used to examine OX1R and OX2R. HE staining was applied to evaluate inflammation. qRT-PCR was employed to detect OX1R, OX2R, prepro-Orexin mRNAs. Serum Helicobacter pylori (H. pylori) infection was measured.
Orexin A expression in GC patients was significantly up-regulated compared to N group and CAG group (p<0.05). Orexin A expression was increased in CAG group compared to N group (p<0.05). Gastric cancer tissues exhibited significantly obvious inflammation compared to N group and CAG group (p<0.05). OX1R and OX2R expressions were significantly down-regulated in GC group compared to N group and CAG group (p<0.05). OX1R and OX2R were lower significantly in GC group compared to CAG group (p<0.05). Prepro-Orexin was significantly depleted in tumor tissues of GC group compared to N group and CAG group (p<0.05). Orexin A expression was un-associated with gender, age and differential grades (p>0.05). CAG and GC patients demonstrated higher H. pylori infection rates.
Orexin A was associated with inflammation by interacting with OX1R/OX2R receptor and activating prepro-Orexin in tumor tissues of gastric cancer patients.
Aim
To determine the tolerance and acceptance of hepatic venous pressure gradient (HVPG) measurements in patients with liver cirrhosis.
Methods
This prospective international multicenter study ...included 271 patients with cirrhosis who were scheduled to undergo HVPG measurement between October 2019 and June 2020. Data related to the tolerance and acceptance of HVPG measurements were collected using descriptive questionnaires.
Results
HVPG measurements were technically successful in all 271 patients, with 141 (52.0%) undergoing HVPG measurement alone. The complication rate was 0.4%. Postoperative pain was significantly lower than preoperative expected pain (p < 0.001) and intraoperative pain (p < 0.001), and intraoperative pain was also significantly lower than preoperative expected pain (p = 0.036). No, mild, moderate, severe, and intolerable discomfort scores were reported by 36.9%, 44.6%, 11.1%, 6.3%, and 0.4% of these patients, respectively, during HVPG measurement and by 54.6% 32.5%, 11.4%, 1.5%, and 0%, respectively, after HVPG measurement. Of these patients, 39.5% had little understanding and 10% had no understanding of the value of HVPG measurement, with 35.1% and 4.1% regarding HVPG measurements as being of little or no help, respectively. Most patients reported that they would definitely (15.5%), probably (46.9%), or possibly (29.9%) choose to undergo additional HVPG measurements again, and 62.7% regarded the cost of the procedure as acceptable.
Conclusion
HVPG measurement was safe and well‐tolerated in patients with cirrhosis, but patient education and communication are warranted to improve the acceptance of this procedure.
Key points
Significant findings of the study: This prospective multicenter study showed that HVPG measurement was well‐tolerated in patients with cirrhosis, but the acceptance of HVPG measurement was not as high as expected.
What this study adds: Although HVPG measurement was safe and well‐tolerated in patients with cirrhosis, more in‐depth patient education and communication are warranted to improve the acceptance of the procedure.
HVPG measurement was safe and well‐tolerated in cirrhosis, however, patient‐education and communication were warranted to improve the acceptance of the procedure.
OBJECTIVESHelicobacter pylori (H. pylori) infection causes a variety of intragastric and extragastric diseases. Despite its decreasing global prevalence, it remains a major public health problem in ...many developing countries. This study aimed to understand the prevalence of H. pylori infection and its risk factors in five cities of the Ningxia Hui Autonomous Region, an area with high incidence of gastric cancer. METHODSCross-sectional studies were conducted in Ningxia from 2017 and 2022, to detect the prevalence of H. pylori using the 14C urea breath test. All participants completed a questionnaire that included demographics, personal habits, household economic characteristics, and previous health status. Multiple logistic regression analyses were used to identify independent factors for H. pylori infection. RESULTSOur findings demonstrated that the prevalence of H. pylori infection in Ningxia decreased significantly from 60.3% in 2017 to 43.6% in 2022, with an increase in public awareness rate from 35.9% in 2017 to 68.5% in 2022. The lowest infection rate was found in Zhongwei and highest in Guyuan. The prevalence of H. pylori infection was higher among Hui ethnicity, farmers, individuals living in rural areas, individuals with lower income, low education, and those who consumed less fruit. Gallbladder, respiratory, cardiovascular and autoimmune diseases were not associated with H. pylori infection. CONCLUSIONSThe prevalence of H. pylori in Ningxia decreased in the past five years. Ethnicity, location, occupation, income, education, and consumption of fruits were independent risk factors for H. pylori infection in Ningxia. It was not associated with extra-gastric disease.
Gastric cancer (GC) has been become the second leading cause for cancer-associated death. This study aimed to investigate Orexin A levels and associated receptors in tumor tissues of GC patients.
...Forty-six consecutive gastric cancer patients (GC, n=46) and 13 chronic atrophic gastritis patients (CAG, n=13) were recruited. Meanwhile, 18 health individuals visiting Medical Examination Department were involved as control (N group, n=18). ELISA was used to examine Orexin A concentration. Immunohistochemistry assay was used to examine OX1R and OX2R. HE staining was applied to evaluate inflammation. qRT-PCR was employed to detect OX1R, OX2R, prepro-Orexin mRNAs. Serum Helicobacter pylori (H. pylori) infection was measured.
Orexin A expression in GC patients was significantly up-regulated compared to N group and CAG group (p<0.05). Orexin A expression was increased in CAG group compared to N group (p<0.05). Gastric cancer tissues exhibited significantly obvious inflammation compared to N group and CAG group (p<0.05). OX1R and OX2R expressions were significantly down-regulated in GC group compared to N group and CAG group (p<0.05). OX1R and OX2R were lower significantly in GC group compared to CAG group (p<0.05). Prepro-Orexin was significantly depleted in tumor tissues of GC group compared to N group and CAG group (p<0.05). Orexin A expression was un-associated with gender, age and differential grades (p>0.05). CAG and GC patients demonstrated higher H. pylori infection rates.
Orexin A was associated with inflammation by interacting with OX1R/OX2R receptor and activating prepro-Orexin in tumor tissues of gastric cancer patients.
El cáncer gástrico (CG) se ha convertido en la segunda causa principal de muerte asociada al cáncer. El objetivo de este estudio fue investigar la concentración de orexina-A y de los receptores asociados en tejidos tumorales de pacientes con CG.
Se seleccionó a 46 pacientes consecutivos con CG (n=46) y a 13 pacientes con gastritis atrófica crónica (GAC) (n=13). Al mismo tiempo, se utilizó como control a 18 individuos sanos que visitaron la unidad de reconocimiento médico (grupo N, n=18). Se empleó un ELISA para analizar la concentración de orexina-A. Se usó un ensayo inmunohistoquímico para el análisis de OX1R y OX2R. Se aplicó tinción hematoxilina-eosina para evaluar la inflamación. Se utilizó PCR cuantitativa en tiempo real para detectar el ARNm de OX1R, OX2R y prepo-orexina. Se evaluó la infección por Helicobacter pylori (H. pylori) en suero.
La expresión de orexina-A en pacientes con CG era considerablemente mayor en comparación con el grupo N y el grupo de GAC (p<0,05). La expresión de orexina-A fue mayor en el grupo de GAC en comparación con el grupo N (p<0,05). Los tejidos con cáncer gástrico presentaron una inflamación significativamente visible en comparación con el grupo N y el grupo de GAC (p<0,05). La expresión de OX1R y OX2R fue notablemente menor en el grupo de CG en comparación con el grupo N y el grupo de GAC (p<0,05). OX1R y OX2R fueron significativamente menores en el grupo de CG en comparación con el grupo de GAC (p<0,05). La prepo-orexina se encontraba especialmente disminuida en tejidos tumorales del grupo de CG en comparación con el grupo N y el grupo de GAC (p<0,05). La expresión de la orexina-A no se asoció al sexo, la edad o los grados diferenciales (p>0,05). Los pacientes con GAC y CG registraron tasas de infección por H. pylori más elevadas.
La orexina-A se asoció con la inflamación al interactuar con los receptores OX1R/OX2R y activar la prepo-orexina en tejidos neoplásicos de pacientes con cáncer gástrico.
Endoscopy plays an important role in the management of acute variceal bleeding (AVB) in patients with cirrhosis. This study aimed at determining the optimal endoscopy timing for cirrhotic AVB.
...Patients with cirrhosis with AVB across 34 university hospitals in 30 cities from February 2013 to May 2020 who underwent endoscopy within 24 hours were included in this study. Patients were divided into an urgent endoscopy group (endoscopy <6 h after admission) and an early endoscopy group (endoscopy 6-24 h after admission). Multivariable analysis was performed to identify risk factors for treatment failure. Primary outcome was the incidence of 5-day treatment failure. Secondary outcomes included in-hospital mortality, need for intensive care unit, and length of hospital stay. A propensity score matching analysis was performed. In addition, we performed an analysis, in which we compared the 5-day treatment failure incidence and the in-hospital mortality among patients with endoscopy performed at <12 hours and 12-24 hours.
A total of 3319 patients were enrolled: 2383 in the urgent endoscopy group and 936 in the early endoscopy group. After propensity score matching, on multivariable analysis, Child-Pugh class was identified as an independent risk factor for 5-day treatment failure (HR, 1.61; 95% CI: 1.09-2.37). The incidence of 5-day treatment failure was 3.0% in the urgent endoscopy group and 2.9% in the early group ( p = 0.90). The in-hospital mortality was 1.9% in the urgent endoscopy group and 1.2% in the early endoscopy group ( p = 0.26). The incidence of need for intensive care unit was 18.2% in the urgent endoscopy group and 21.4% in the early endoscopy group ( p = 0.11). The mean length of hospital stay was 17.9 days in the urgent endoscopy group and 12.9 days in the early endoscopy group ( p < 0.05). The incidence of 5-day treatment failure in the <12-hour group was 2.3% and 2.2% in the 12-24 hours group ( p = 0.85). The in-hospital mortality was 2.2% in the <12-hour group and 0.5% in the 12-24 hours group ( p < 0.05).
The data suggest that performance of endoscopy within 6-12 or within 24 hours of presentation among patients with cirrhosis with AVB led to similar treatment failure outcomes.
The roles of angiopoietins in gastric cancer progression are still not fully understood. In this study the expressions of angiopoietin-1 (Ang-1), -2 (Ang-2) were compared by immunohistochemistry in ...53 gastric cancer and 23 normal gastric mucosa samples. Results revealed that Ang-2 expression was significantly increased in gastric cancer tissues (74%) and was correlated with higher TNM stage, lymph node metastasis as well as distance metastasis. The expression of Ang-1 was also elevated in cancerous tissues (66%) and significantly associated with differentiation degree. In addition, Ang-2 as well as its receptor Tie2 expressions were higher in 12 pairs of gastric cancer tissue samples than those in corresponding adjacent samples by Western blot, while Ang-1 expression showed great heterogeneity. Furthermore, the expressions of Ang-1 and Ang-2 were almost positive in eight gastric cancer cell lines. Among them, AGS expressed both Ang-2 and a relatively moderate amount of Ang-2
443, a novel splice form of Ang-2, while others showed only Ang-2 mRNA expression.
Objectives: Colonic diverticular disease has become a common condition among the Japanese elderly. Diverticular bleeding also turns it into an acute and life-threatening problem. In some cases, it is ...difficult to manage the bleeding. This study reviews the diagnosis and therapeutic methods in 37 patients with diverticular bleeding at Matsue City Hospital, with the hope our experiences may inspire others. Patients: 180 patients with colonic iverticulosis (mean age 53.6± 57 yrs, males / females = 123/57) hospitalized in Matsue City Hospital were enrolled in this study from August 2005 to June 2012. 37 of these patients suffered from diverticular bleeding (mean age 71.5 ± 11.2 yrs, males / females = 26/11). The therapeutic methods and outcomes of these 37 patients are here reviewed. Results: These 37 patients had a mean initial hemoglobin level of 11.7 g/dl (ranging from 5.3 to 15.9 g/dl) on admission, and their mean lowest hemoglobin level during initial hospitalization was 9.0 g/dl (ranging from 5.3 to 13.7 g/dl). 14 patients (37.8%) needed blood transfusions. At the time of admission, 12 patients (32 5%) were on anticoagulant and/or antiplatelet therapy. Prior to colonoscopy, an urgent dynamic CT scan was performed on all patients for the diagnostic purposes. Emergency or planned colonoscopy was performed on 34 cases (91.9%). Colonoscopy permitted definite identification of bleeding sites in 12 cases (35.3%) (4 cases in the ascending, 2 in the transverse, 1 in the descending and 5 in the sigmoid colon). In 8 of these cases, the bleeding was successfully stopped by endoscopic hemostatic procedure alone. In the 4 other cases, successful hemostasis was ultimately achieved with the aid of interventional radiology (IR). Altogether, a total of 15 patients received IR, whereby bleeding was successfully stopped in 8 cases. Eventually, bleeding stopped spontaneously in 21(56.8%) patients. There were no surgical cases or therapy-related deaths during the period. Conclusion: Identification of bleeding sites is essential for the treatment of colonic diverticular bleeding but often difficult because diverticula are usually multiple. Colonoscopy is widely used as it allows direct visual diagnosis and immediate therapy. But when endoscopic hemostasis fails or in severe cases, the timely choice of IR is an important alternative.
Organ-specific metastasis is an important character of cancer cells. Cancer cells that can metastasize to a special organ were thought to have different proteins in cell membrane, which might have ...potential utility as diagnostic markers and therapeutic targets. In the present work, based on high liver-metastatic gastric cancer cells, XGC9811-L, a screening approach with phage displayed peptide library, was successfully used to isolate 8-mer peptide ligands binding to the target cells. The phage20 had the highest binding efficiency to XGC9811-L cells, which also displayed remarkable cell specificity. Peptide20 that was displayed on phage20 could suppress the motility and invasion of XGC9811-L significantly. The adhesive ability of XGC9811-L to collagen IV was also inhibited by peptide20. Furthermore, phage20 could significantly reduce the incidence of liver metastasis of gastric cancer transplanted into nude mice and was also beneficial for the reduction the number of metastatic nodles in the liver. In conclusion, the phage display is an effective method to screen for the new molecules associated with organ-specific metastasis. The selected peptide20 can reverse the liver metastasis behavior of the gastric cancer cells.
