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Guo LP, Wang WR, Liu JP, Wang BM, Zhou L. [Clinical features and lymphocyte subtypes in patients with IgG 4-related diseases]. Zhonghua Nei Ke Za Zhi 2024; 63:394-400. [PMID: 38561285 DOI: 10.3760/cma.j.cn112138-20231103-00291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Objective: To deepen understanding of IgG4-related diseases (RDs), we analyzed the associated lymphocyte subtypes, and explored the pathogenesis and potential immunotherapeutic targets. Methods: Eighty-six patients with IgG4-RDs were enrolled, and their clinical characteristics, peripheral lymphocyte subtypes, and disease course were analyzed. Results: The mean age of the participants was 36-87(62±11) years; 51 were male (59.3%) and 35 were women (40.7%); and 34.9% had a history of allergy. Follow-up lasted 4.8 (0.4, 14.1) months. The most common symptoms were abdominal pain, and submandibular gland and lacrimal gland swelling (each 20.9%). Sixty-five (75.6%) participants had multiple organ involvement, and the most frequently affected organs were the pancreas (52.3%), submandibular gland (51.2%), and lacrimal gland (34.9%). A high eosinophil count; high IgE, IgG, IgG1, and IgG4 concentrations; and low complement C3 and C4 concentrations were present in 18.8% (16/85), 30.0% (24/80), 72.9% (62/85), 58.3% (28/48), 89.5% (77/86), 61.2% (52/85), and 50.0% (42/84), respectively, of the participants. In addition, 64.7% (55/85) were positive for autoantibodies, and the most frequent was anti-nuclear antibody (63.5%). The proportion of CD4+T lymphocytes increased in 25.7% (9/35) of the participants, which was accompanied by an increase in the ratio of CD4+/CD8+T lymphocytes (22.9%, 8/35). Importantly, most participants (90.0%, 18/20) had a high proportion of regulatory T (Treg) cells. High interleukin (IL)-2, IL-6, and IL-10 concentrations were present in 50.0% (11/22), 33.3% (10/30), and 16.7% (5/30), respectively, of the participants. Substantial lymphoplasmacytic infiltration, fibrosis, IgG4-positive plasma cell infiltration, and lymphoid follicle hyperplasia or ectopic formation were present in 79.2% (42/53), 67.9%(36/53), 35.8%(19/53) and 30.2% (16/53), respectively, of the participants. Fifty-three participants with detailed pathologic data were also further evaluated, of whom 24.5% (13/53), 3.8% (2/53), and 67.9% (36/53) had definite, probable, and possible diagnoses; and 3.8% (2/53) could not be diagnosed. Compared with baseline, the percentage of eosinophils and the IgE, IgG, and IgG4 concentrations decreased significantly; and the complement C3 and C4 concentrations had increased significantly after 6 months of treatment (all P<0.05). The IgG4 concentration after 6 months of treatment negatively correlated with that of C4, and positively correlated with the baseline concentration of IgE and the IgG4/IgG ratio. Conclusion: IgG4-RDs are a group of diseases characterized by male predisposition; multiple organ involvement; a high eosinophil count; high IgE, IgG, IgG1, and IgG4 concentrations; and a low C3 concentration. Peripheral CD4+T cells and Treg cells are also more abundant. The diseases can be controlled with glucocorticoids and immunosuppressive drugs in the majority of instances. The IgG4 concentration after 6 months of treatment negatively correlates with the baseline complement C4 concentration and positively correlates with the IgE concentration and IgG4/IgG ratio, which suggests that IgG4/IgG, IgE, and complement should be closely monitored to evaluate disease activity and the efficacy of treatment in such patients.
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Affiliation(s)
- L P Guo
- Department of Gastroenterology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - W R Wang
- Department of Gastroenterology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - J P Liu
- Department of Gastroenterology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - B M Wang
- Department of Gastroenterology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - L Zhou
- Department of Gastroenterology, Tianjin Medical University General Hospital, Tianjin 300052, China
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Wu JY, Liu X, Wang SN, Jiang EL, Wang BM, Cao HL. [Advances of biological agents in the treatment of gastrointestinal acute graft-versus-host disease]. Zhonghua Nei Ke Za Zhi 2024; 63:107-112. [PMID: 38186127 DOI: 10.3760/cma.j.cn112138-20231004-00179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Affiliation(s)
- J Y Wu
- Department of Gastroenterology and Hepatology, General Hospital, Tianjin Medical University, Tianjin 300052, China
| | - X Liu
- Department of Gastroenterology and Hepatology, General Hospital, Tianjin Medical University, Tianjin 300052, China
| | - S N Wang
- Department of Gastroenterology and Hepatology, General Hospital, Tianjin Medical University, Tianjin 300052, China
| | - E L Jiang
- Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - B M Wang
- Department of Gastroenterology and Hepatology, General Hospital, Tianjin Medical University, Tianjin 300052, China
| | - H L Cao
- Department of Gastroenterology and Hepatology, General Hospital, Tianjin Medical University, Tianjin 300052, China
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He C, Li Y, Jiang X, Jiang MN, Zhao XX, Ma SR, Bao D, Qiu MH, Deng J, Wang JH, Qu P, Jiang CM, Jia SB, Yang SQ, Ru LS, Feng J, Gao W, Huang YH, Tao L, Han Y, Yang K, Wang XY, Zhang WJ, Wang BM, Li Y, Yang YL, Li JX, Sheng JQ, Ma YT, Cui M, Ma SC, Wang XZ, Li ZS, Liao Z, Han YL, Stone GW. Progression of Gastrointestinal Injury During Antiplatelet Therapy After Percutaneous Coronary Intervention: A Secondary Analysis of the OPT-PEACE Randomized Clinical Trial. JAMA Netw Open 2023; 6:e2343219. [PMID: 37976067 PMCID: PMC10656648 DOI: 10.1001/jamanetworkopen.2023.43219] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 10/04/2023] [Indexed: 11/19/2023] Open
Abstract
Importance Gastrointestinal injury progression induced by antiplatelet therapy in patients after percutaneous coronary intervention (PCI) has not been well studied. Objective To assess the association of aspirin, clopidogrel, and their combination with gastrointestinal injury progression among patients without high bleeding risk after PCI. Design, Setting, and Participants This secondary analysis assessed data from the Optimal Antiplatelet Therapy for Prevention of Gastrointestinal Injury Evaluated by ANKON Magnetically Controlled Capsule Endoscopy (OPT-PEACE) double-masked, placebo-controlled, multicenter randomized clinical trial. The OPT-PEACE trial was conducted at 28 centers in China, and recruitment took place from July 13, 2017, to July 13, 2019. The trial included patients with stable coronary artery disease or acute coronary syndromes without ST-segment elevation after PCI. Statistical analysis was conducted from September 13, 2022, to January 23, 2023. Interventions Patients underwent magnetically controlled capsule endoscopy (MCE) at baseline and after 6 months of dual antiplatelet therapy (DAPT) with aspirin (100 mg/d) plus clopidogrel (75 mg/d). Those with no evidence of gastrointestinal ulcers or bleeding (ie, the intention-to-treat [ITT] cohort) were randomized (1:1:1) to aspirin (100 mg/d) plus matching placebo (aspirin alone), clopidogrel (75 mg/d) plus matching placebo (clopidogrel alone), or DAPT for an additional 6 months. A third MCE was performed 12 months after PCI. Main Outcomes and Measures The primary outcome was the rate of gastric injury progression as assessed with the results of the 3 MCEs (at baseline, 6 months, and 12 months) in the modified intention-to-treat (mITT) population. The key secondary outcome was the rate of small-intestinal injury progression. Gastric or small-intestinal injury progression was defined as a quantitative increase in erosions or ulcers between the second and third MCEs (at 6 and 12 months, respectively). Results This study included the 394 patients in the mITT cohort. Their mean (SD) age was 56.9 (8.7) years, and most were men (296 [75.1%]). A total of 132 patients were randomized to aspirin alone, 132 to clopidogrel alone, and 130 to DAPT. Gastric injury progression occurred in 49 aspirin users (37.1%), 64 clopidogrel users (48.5%), and 69 DAPT users (53.1%) (P = .02), reflecting a lower rate of gastric injury progression among aspirin users vs DAPT users (risk ratio [RR], 0.70 [95% CI, 0.49-0.99]; P = .009). No significant difference was observed between clopidogrel alone and DAPT (48.5% vs 53.1%; P = .46) or between aspirin alone and clopidogrel alone (37.1% vs 48.5%; P = .06). A total of 51 aspirin users (38.6%), 65 clopidogrel users (49.2%), and 71 DAPT users (54.6%) (P = .03) developed progressive small-intestinal injury, reflecting a lower rate of small-intestinal injury among aspirin users vs DAPT users (RR, 0.71 [95% CI, 0.50-0.99]; P = .01). No difference was observed between patients treated with clopidogrel vs DAPT (49.2% vs 54.6%; P = .38) or with aspirin vs clopidogrel (38.6% vs 49.2%; P = .08). Conclusions and Relevance In this secondary analysis of a randomized clinical trial, ongoing use of aspirin, clopidogrel, or their combination between 6 and 12 months after PCI was associated with progressive gastric and small-intestinal injury in a substantial proportion of patients, more so with DAPT than with monotherapy. Clopidogrel was at least as likely as aspirin to induce gastrointestinal injury progression. Future research is warranted to determine what impact the findings from MCEs would have on decision-making of antiplatelet therapy. Trial Registration ClinicalTrials.gov Identifier: NCT03198741.
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Affiliation(s)
- Chen He
- Changhai Hospital, Naval Medical University, Shanghai, China
| | - Yi Li
- General Hospital of Northern Theater Command, Shenyang, China
| | - Xi Jiang
- Changhai Hospital, Naval Medical University, Shanghai, China
| | - Meng-Ni Jiang
- Changhai Hospital, Naval Medical University, Shanghai, China
| | - Xian-Xian Zhao
- Changhai Hospital, Naval Medical University, Shanghai, China
| | - Shu-Ren Ma
- General Hospital of Northern Theater Command, Shenyang, China
| | - Dan Bao
- General Hospital of Northern Theater Command, Shenyang, China
| | - Miao-Han Qiu
- General Hospital of Northern Theater Command, Shenyang, China
| | - Jie Deng
- Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Jin-Hai Wang
- Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Peng Qu
- Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Chun-Meng Jiang
- Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Shao-Bin Jia
- General Hospital of Ningxia Medical University, Yinchuan, China
| | - Shao-Qi Yang
- General Hospital of Ningxia Medical University, Yinchuan, China
| | - Lei-Sheng Ru
- No. 980 Hospital of Joint Logistical Support Force, Shijiazhuang, China
| | - Jia Feng
- No. 980 Hospital of Joint Logistical Support Force, Shijiazhuang, China
| | - Wei Gao
- Peking University Third Hospital, Beijing, China
| | | | - Ling Tao
- Xijing Hospital of Air Force Medical University, Xi’an, China
| | - Ying Han
- Xijing Hospital of Air Force Medical University, Xi’an, China
| | - Kan Yang
- Third Xiangya Hospital of Central South University, Changsha, China
| | - Xiao-Yan Wang
- Third Xiangya Hospital of Central South University, Changsha, China
| | - Wen-Juan Zhang
- General Hospital of Tianjin Medical University, Tianjin, China
| | - Bang-Mao Wang
- General Hospital of Tianjin Medical University, Tianjin, China
| | - Yue Li
- First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - You-Lin Yang
- First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jun-Xia Li
- Seventh Medical Center of the General Hospital of the People’s Liberation Army, Beijing, China
| | - Jian-Qiu Sheng
- Seventh Medical Center of the General Hospital of the People’s Liberation Army, Beijing, China
| | - Yi-Tong Ma
- The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Min Cui
- The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Si-Cong Ma
- General Hospital of Northern Theater Command, Shenyang, China
| | - Xiao-Zeng Wang
- General Hospital of Northern Theater Command, Shenyang, China
| | - Zhao-Shen Li
- Changhai Hospital, Naval Medical University, Shanghai, China
| | - Zhuan Liao
- Changhai Hospital, Naval Medical University, Shanghai, China
| | - Ya-Lin Han
- General Hospital of Northern Theater Command, Shenyang, China
| | - Gregg W. Stone
- Mount Sinai Heart and the Cardiovascular Research Foundation, Icahn School of Medicine at Mount Sinai, New York, New York
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Huang H, Li HZ, Wang YR, Song Y, Wang BM, Cao HL, Jiang K. [Single hydrogen-methane breath test for the diagnosis of small intestinal bacterial growth]. Zhonghua Nei Ke Za Zhi 2023; 62:1335-1340. [PMID: 37935501 DOI: 10.3760/cma.j.cn112138-20221111-00843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
Objective: To investigate the diagnostic value of a single hydrogen-methane breath test (SHMBT) for small intestinal bacterial overgrowth (SIBO). Method: The current investigation was a cross-sectional study. Questionnaires and SHMBTs were administered to 162 patients with gastrointestinal symptoms (case group) and 69 healthy volunteers (control group). Differences in SHMBT results between the two groups were assessed,and cut-off values of CH4 (methane) and H2 (hydrogen) were analyzed via receiver operating characteristic (ROC) curves. Lastly,archived SHMBT data from 2 655 patients with gastrointestinal symptoms (validation set) were used to evaluate the diagnostic value of the SHMBT with respect to SIBO. The Chi-square test,the Mann-Whitney U test,Spearman's Rank correlation analysis,and the Z test were used for statistical analysis. Results: Based on the international recommended diagnostic criteria for SIBO,which are fasting CH4 ≥10 ppm (parts per million) or H2 ≥20 ppm,the SHMBT-positive rate in the case group was significantly higher than that of control group (35.2% vs. 21.7%, χ2=4.08, P=0.043). Levels of CH4 and H2 were higher in the case group than in the control group [CH4: 3(2,7) vs. 3(1,3) ppm, H2: 11(4,22) vs. 10(5,15) ppm],and the difference in CH4 levels was statistically significant (Z=6.22,P=0.001). ROC curves were generated based on whether the subjects had gastrointestinal symptoms. The areas under the ROC curves were 0.633 for CH4 alone,0.531 for H2 alone, and 0.620 for CH4 combined with H2. The cut-off values were fasting CH4≥4 ppm,fasting H2≥13 ppm,and fasting CH4 ≥5 ppm (or CH4≥4 ppm and H2≥24 ppm),respectively. Measuring CH4 alone and CH4 combined with H2 was effective for determining the presence of gastrointestinal symptoms (P<0.05). When CH4 alone or CH4 combined with H2 were used as diagnostic indicators of SIBO, the respective SHMBT-positive rates in the validation set were 34.2% and 30.4%. These rates did not significantly differ from the SIBO-positive rate of 32.0% obtained via the international recommended diagnostic criteria (P>0.05). The specificity of CH4 alone was 79.9%,and the accuracy of CH4 alone was 68.8%. The specificity of CH4 combined with H2 was 85.0%,and the accuracy of CH4 combined with H2 was 71.7%. Conclusion: Rapid one-time determination of CH4 and H2 in exhaled breath may a viable diagnostic method for SIBO, and using CH4 combined with H2 (i.e.,fasting CH4≥5 ppm, or CH4 ≥4 ppm and H2 ≥24 ppm) as cutoff values may be feasible.
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Affiliation(s)
- H Huang
- Department of Gastroenterology,General Hospital,Tianjin Medical University,Tianjin 300052,China
| | - H Z Li
- Department of Gastroenterology,Second Teaching Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300150,China
| | - Y R Wang
- Department of Gastroenterology,Tianjin Fourth Central Hospital,Tianjin 300142, China
| | - Y Song
- Department of Gastroenterology,General Hospital,Tianjin Medical University,Tianjin 300052,China
| | - B M Wang
- Department of Gastroenterology,General Hospital,Tianjin Medical University,Tianjin 300052,China
| | - H L Cao
- Department of Gastroenterology,General Hospital,Tianjin Medical University,Tianjin 300052,China
| | - K Jiang
- Department of Gastroenterology,General Hospital,Tianjin Medical University,Tianjin 300052,China
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Wang LW, Ruan H, Wang BM, Qin Y, Zhong WL. Microbiota regulation in constipation and colorectal cancer. World J Gastrointest Oncol 2023; 15:776-786. [PMID: 37275451 PMCID: PMC10237018 DOI: 10.4251/wjgo.v15.i5.776] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/23/2023] [Accepted: 04/21/2023] [Indexed: 05/12/2023] Open
Abstract
The relevance of constipation to the development and progression of colorectal cancer (CRC) is currently a controversial issue. Studies have shown that changes in the composition of the gut microbiota, a condition known as ecological imbalance, are correlated with an increasing number of common human diseases, including CRC and constipation. CRC is the second leading cause of cancer-related deaths worldwide, and constipation has been receiving widespread attention as a risk factor for CRC. Early colonoscopy screening of constipated patients, with regular follow-ups and timely intervention, can help detect early intestinal lesions and reduce the risks of developing colorectal polyps and CRC. As an important regulator of the intestinal microenvironment, the gut microbiota plays a critical role in the onset and progression of CRC. An increasing amount of evidence supports the thought that gut microbial composition and function are key determinants of CRC development and progression, with alterations inducing changes in the expression of host genes, metabolic regulation, and local and systemic immunological responses. Furthermore, constipation greatly affects the composition of the gut microbiota, which in turn influences the susceptibility to intestinal diseases such as CRC. However, the crosstalk between the gut microbiota, constipation, and CRC is still unclear.
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Affiliation(s)
- Li-Wei Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Hao Ruan
- China Resources Biopharmaceutical Company Limited, Beijing 100029, China
| | - Bang-Mao Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Yuan Qin
- College of Life Sciences and Medicine, Zhejiang Sci-Tech University, Hangzhou 310018, Zhejiang Province, China
| | - Wei-Long Zhong
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
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Liu M, Zhang HX, Zhang L, Zhao JW, Zhou L, Wang BM. [Inhibition of receptor-interacting protein 3 improves experimental autoimmune hepatitis]. Zhonghua Gan Zang Bing Za Zhi 2022; 30:1231-1236. [PMID: 36891703 DOI: 10.3760/cma.j.cn501113-20200819-00466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
Objective: To evaluate the potential of receptor-interacting protein 3 (RIP3) as a therapeutic target for autoimmune hepatitis (AIH). Methods: Immunofluorescence assay was used to observe the activated expression levels of RIP3 and its downstream signal mixed lineage protein kinase domain-like protein (MLKL) in the liver tissues of patients with AIH and hepatic cyst. Concanavalin A (ConA) was injected into the tail vein to induce acute immune-mediated hepatitis in mice. Intervention was performed by intraperitoneal injection of RIP3 inhibitor GSK872 or solvent carrier. Peripheral blood and liver tissues were collected. Serum transaminases level, qPCR and flow cytometry were analyzed. The intergroup comparison was performed with an independent sample t-test. Results: The expression level of p-RIP3 (the activated forms of RIP3) and phosphorylated p-MLKL (MLKL after phosphorylation) downstream signal were significantly higher in the liver tissue of AIH patients than those of controls. Compared with the control group, the expression levels of RIP3 and MLKL mRNA were significantly increased in the liver tissue of AIH patients (relative expression levels 3.28±0.29 vs. 0.98±0.09, 4.55±0.51 vs. 1.06±0.11), and the differences were statistically significant (t=6.71 and 6.77, respectively, and P<0.01). The expression levels of RIP3 and MLKL mRNA were significantly higher in the mice liver tissue of ConA-induced immune hepatitis than those in the control group (relative expression levels 2.35±0.09 vs. 0.89±0.11,2.77±0.22 vs. 0.73±0.16,t=10.4,6.33, P<0.01). RIP3 inhibitor GSK872 had significantly attenuated ConA-induced immune liver injury and inhibited the expression of tumor necrosis factor-α, interleukin-6, interleukin-1β and NLRP3 in liver. Compared with the control group, the proportions of CD45+F4/80+ macrophages, CD4+ IL-17+ Th17 cells, CD4+ CD25+ regulatory T (Treg) cells and CD11b+ Gr-1+ myeloid derived suppressor cells (MDSCs) were significantly increased in the liver of ConA + Vehicle group. Compared with ConA + Vehicle group, the proportion of CD45+F4/80+ macrophages and CD4+ IL-17+ Th17 cells were significantly decreased, while the proportion of CD4+ CD25+Treg cells and CD11b+ Gr-1+ MDSCs with immunomodulatory functions were significantly increased in mice liver of ConA+GSK872 group. Conclusion: AIH patients and ConA-induced immune hepatitis mice have activated RIP3 signal in liver tissues. Inhibition of RIP3 reduces the expression and proportion of proinflammatory factors and cells, and promotes the accumulation of CD4+ CD25+ Treg cells and CD11b+ Gr-1+ MDSCs with immunomodulatory functions in the liver of mice with immune hepatitis, thereby alleviating liver inflammation and injury. Therefore, the inhibition of RIP3 is expected to be a new approach for the treatment of AIH.
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Affiliation(s)
- M Liu
- Department of Gastroenterology and Hepatology, General Hospital of Tianjin Medical University, Tianjin 300052, China
| | - H X Zhang
- Department of Gastroenterology and Hepatology, General Hospital of Tianjin Medical University, Tianjin 300052, China
| | - L Zhang
- Department of Gastroenterology and Hepatology, General Hospital of Tianjin Medical University, Tianjin 300052, China
| | - J W Zhao
- Department of Gastroenterology and Hepatology, General Hospital of Tianjin Medical University, Tianjin 300052, China
| | - L Zhou
- Department of Gastroenterology and Hepatology, General Hospital of Tianjin Medical University, Tianjin 300052, China
| | - B M Wang
- Department of Gastroenterology and Hepatology, General Hospital of Tianjin Medical University, Tianjin 300052, China
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Zhai JH, Li SX, Jin G, Zhang YY, Zhong WL, Chai YF, Wang BM. Blue rubber bleb nevus syndrome complicated with disseminated intravascular coagulation and intestinal obstruction: A case report. World J Clin Cases 2022; 10:11929-11935. [PMID: 36405278 PMCID: PMC9669868 DOI: 10.12998/wjcc.v10.i32.11929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 09/16/2022] [Accepted: 09/23/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Blue rubber bleb nevus syndrome is a rare vascular malformation syndrome with unclear etiopathogenesis and noncurative treatments. It is characterized by multiple vascular malformations of the skin, gastrointestinal tract, and other visceral organs. The most common symptoms are intermittent gastrointestinal bleeding and secondary iron deficiency anemia, thus requiring repeated blood transfusions and hospitalizations. It is easily missed and misdiagnosed, and there is no specific treatment.
CASE SUMMARY We report a case of blue rubber bleb nevus syndrome combined with disseminated intravascular coagulation and efficacy of treatment with argon plasma coagulation under enteroscopy and sirolimus. A 56-year-old female patient was admitted to the hospital with 3-year history of fatigue and dizziness that had aggravated over the past 10 d with melena. The patient had a history of repeated melena and multiple venous hemangiomas from childhood. After treatment with argon plasma coagulation combined with sirolimus for nearly 8 wk, the patient’s serum hemoglobin increased to 100 g/L. At the 12-mo follow-up, the patient was well with stable hemoglobin (102 g/L) and no recurrent intestinal bleeding.
CONCLUSION Argon plasma coagulation and sirolimus may be an efficacious and safe treatment for blue rubber bleb nevus syndrome, which currently has no recommended treatments.
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Affiliation(s)
- Jian-Hua Zhai
- Department of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin 300052, China
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Shi-Xin Li
- Department of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Ge Jin
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Yuan-Yuan Zhang
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Wei-Long Zhong
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Yan-Fen Chai
- Department of Emergency Medicine, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Bang-Mao Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
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Tan ND, Liu XW, Liu CX, Li SB, Chen HH, Li X, Wu H, Liao AJ, Zhen YB, Shen PZ, Huo LJ, Liu HL, Shi RH, Zhang BQ, Zhang ZY, Wang JN, Zhan Q, Deng H, Shu X, Tuo BG, Wang QZ, Du SY, Qi LZ, Zhang GX, Peng Q, Wang BM, Ye B, Chen MH, Xiao YL. Efficacy of keverprazan for duodenal ulcer: A phase II randomized, double-blind, parallel-controlled trial. J Gastroenterol Hepatol 2022; 37:2060-2066. [PMID: 36068945 DOI: 10.1111/jgh.16000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 08/28/2022] [Accepted: 09/03/2022] [Indexed: 12/09/2022]
Abstract
BACKGROUND AND AIM Considering the limitation of varying acid suppression of proton pump inhibitors, this study was aimed to assess the efficacy, safety, and dose-effect relationship of keverprazan, a novel potassium-competitive acid blocker, in the treatment of duodenal ulcer (DU) compared with lansoprazole. METHODS A randomized, double-blind, double-dummy, multicenter, low-dose, high-dose, and positive-drug parallel-controlled study was conducted to verify the non-inferiority of keverprazan (20 or 30 mg) to lansoprazole of 30 mg once daily for 4 to 6 weeks and dose-effect relationship of keverprazan in the treatment of patients with active DU confirmed by endoscopy. RESULTS Of the 180 subjects randomized, including 55 cases in the keverprazan_20 mg group, 61 cases in the keverprazan_30 mg group, and 64 cases in the lansoprazole_30 mg group, 168 subjects (93.33%) completed the study. The proportions of healed DU subjects in the keverprazan_20 mg, keverprazan_30 mg, and lansoprazole_30 mg groups were respectively 87.27%, 90.16%, and 79.69% at week 4 (P = 0.4595) and were respectively 96.36%, 98.36%, and 92.19% at week 6 (P = 0.2577). The incidence of adverse events in the keverprazan_20 mg group was lower than that in the lansoprazole_30 mg (P = 0.0285) and keverprazan_30 mg groups (P = 0.0398). CONCLUSIONS Keverprazan was effective and non-inferior to lansoprazole in healing DU. Based on the comparable efficacy and safety data, keverprazan of 20 mg once daily is recommended for the follow-up study of acid-related disorders. (Trial registration number: ChiCTR2100043455.).
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Affiliation(s)
- Nian-di Tan
- Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Xiao-Wei Liu
- Department of Gastroenterology, Xiangya Hospital Central South University, Changsha, Hunan Province, China
| | - Cheng-Xia Liu
- Department of Gastroenterology, Binzhou Medical University Hospital, Binzhou, Shandong Province, China
| | - Sheng-Bao Li
- Department of Gastroenterology, Taihe Hospital, Shiyan, Hubei Province, China
| | - Hong-Hui Chen
- Department of Gastroenterology, The Second Hospital, University of South China, Hengyang, Hunan Province, China
| | - Xing Li
- Department of Gastroenterology, Jiangxi Pingxiang People's Hospital, Pingxiang, Jiangxi Province, China
| | - Hao Wu
- Department of Gastroenterology, The Second Affiliated Hospital, WenZhou Medical University, Wenzhou, Zhejiang Province, China
| | - Ai-Jun Liao
- Department of Gastroenterology, The First Affiliated Hospital of University of South China, Hengyang, Hunan Province, China
| | - Yan-Bo Zhen
- Department of Gastroenterology, Jinan Central Hospital, Jinan, Shandong Province, China
| | - Peng-Zhen Shen
- Department of Gastroenterology, Zigong Fourth People's Hospital, Zigong, Sichuan Province, China
| | - Li-Juan Huo
- Department of Gastroenterology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China
| | - Hong-Ling Liu
- Department of Gastroenterology, Luo Yang First People's Hospital, Luoyang, Henan Province, China
| | - Rui-Hua Shi
- Department of Gastroenterology, Zhongda Hospital Southeast University, Nanjing, Jiangsu Province, China
| | - Bing-Qiang Zhang
- Department of Gastroenterology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhen-Yu Zhang
- Department of Gastroenterology, Nanjing First Hospital, Nanjing, Jiangsu Province, China
| | - Jian-Ning Wang
- Department of Gastroenterology, Nanjing Jiangning Hospital, Nanjing, Jiangsu Province, China
| | - Qiang Zhan
- Department of Gastroenterology, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu Province, China
| | - Hong Deng
- Department of Gastroenterology, People's Hospital of Deyang City, Deyang, Sichuan Province, China
| | - Xu Shu
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China
| | - Bi-Guang Tuo
- Department of Gastroenterology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou Province, China
| | - Qi-Zhi Wang
- Department of Gastroenterology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui Province, China
| | - Shi-Yu Du
- Department of Gastroenterology, China-Japan Friendship Hospital, Beijing, China
| | - Ling-Zhi Qi
- Department of Gastroenterology, Jilin Province People's Hospital, Changchun, Jilin Province, China
| | - Guo-Xin Zhang
- Department of Gastroenterology, Jiangsu Province Hospital, Nanjing, Jiangsu Province, China
| | - Qiong Peng
- Department of Gastroenterology, The Third Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Bang-Mao Wang
- Department of Gastroenterology, General Hospital, Tianjin Medical University, Tianjin, China
| | - Bin Ye
- Department of Gastroenterology, Lishui Municipal Central Hospital, Lishui, Zhejiang Province, China
| | - Min-Hu Chen
- Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Ying-Lian Xiao
- Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province, China
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Du XH, Wang BM, Zhang BY, Liu X, Tian ZC, Yao WT. [Role of CT and MRI image fusion and computer assisted simulation technique in guiding type Ⅲ and Ⅳ primary pelvic sarcoma surgeries]. Zhonghua Wai Ke Za Zhi 2022; 60:567-572. [PMID: 35658344 DOI: 10.3760/cma.j.cn112139-20220127-00040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To explore the possible clinical benefits of CT/MRI image fusion and computer-assisted simulation techniques in guiding type Ⅲ and Ⅳ primary pelvic bone tumor surgeries. Methods: The clinic data of primary bone sarcomas patients treated at Department of Bone and Soft Tissue,Zhenghzhou University Affiliated Cancer Hospital from January 2019 to December 2021 were retrospectively analyzed. Based on whether the CT and MRI image fusion technique was utilized for tumor evaluation and surgical planning,the patients were divided into image fusion group (n=21) or control group (n=27). There were 7 male and 14 female patients included in the image fusion group, with the age of (37.0±10.4) years(range: 18 to 67 years). In the control group, there were 10 males and 17 females with the age of (39.7±15.2) years (range: 16 to 65 years). Both groups included osteosarcoma,chondrosarcoma and undifferentiated polymorphic sarcoma as the pathological diagnosis. Clinical information such as gender,age,pathological diagnosis,location of disease,and metastasis at diagnosis were collected. Surgical related information such as duration of surgery,blood loss,surgical margin,and wound complications were also obtained. Periodical follow-ups every 3 months were performed for all patients to monitor the status of local recurrence,distant metastasis,and survival information. Independent t test and χ² test were used for data comparison between groups. Results: Significant reduced duration of surgery was observed in the image fusion group in comparison with control group both in type Ⅲ and Ⅳ surgeries ((144.0±31.6)min vs. (248.2±56) min,t=-8.084, P<0.01); (173.0±42.0)min vs. (306.1±62.0)min, t=-4.518, P<0.01). Blood loss was significantly reduced in the image fusion group compared with the control group ((484.8±226.3)ml vs. (836.1±359.8)ml,t=-4.130, P<0.01). In addition, significant lower ratio of R1 margin and recurrence rates of type Ⅲ and Ⅳ surgeries were found in the image fusion group comparing with the control group (4.8%(1/21) vs. 22.2%(6/27), χ²=4.214, P=0.040; 4.8%(1/21) vs. 22.2%(6/27), χ²=4.214, P=0.040).In the image fusion group, there were 3 cases of incision infection, 1 of which underwent secondary debridement.And in thecontrol group there were 7 cases of incision infection, 3 of which underwent secondary debridement. There was no significant difference in the incidence of complications between the two groups (14.2%(3/21)vs. 25.9%(7/27), χ²=0.645, P=0.422). Up to the last follow-up, 1 patient died in the image fusion group and 2 patients died in the control group, the difference was not statistically significant (χ²=1.885, P=0.220). Conclusion: Compared with the traditional operation,the image fusion technique can significantly reduce the duration of surgery,blood loss and lower the recurrence rate by achieving better surgical margins.
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Affiliation(s)
- X H Du
- Department of Bone and Soft Tissue,Zhenghzhou University Affiliated Cancer Hospital,Henan Cancer Hospital,Key Laboratory for Digital Assessment of Spinal-pelvic Tumor and Surgical Aid Tools Design (Zhengzhou),Key Laboratory for Perioperative Digital Assessment of Bone Tumors (Henan),Zhengzhou 450003, China
| | - B M Wang
- Department of Bone and Soft Tissue,Zhenghzhou University Affiliated Cancer Hospital,Henan Cancer Hospital,Key Laboratory for Digital Assessment of Spinal-pelvic Tumor and Surgical Aid Tools Design (Zhengzhou),Key Laboratory for Perioperative Digital Assessment of Bone Tumors (Henan),Zhengzhou 450003, China
| | - B Y Zhang
- Department of Bone and Soft Tissue,Zhenghzhou University Affiliated Cancer Hospital,Henan Cancer Hospital,Key Laboratory for Digital Assessment of Spinal-pelvic Tumor and Surgical Aid Tools Design (Zhengzhou),Key Laboratory for Perioperative Digital Assessment of Bone Tumors (Henan),Zhengzhou 450003, China
| | - X Liu
- Department of Bone and Soft Tissue,Zhenghzhou University Affiliated Cancer Hospital,Henan Cancer Hospital,Key Laboratory for Digital Assessment of Spinal-pelvic Tumor and Surgical Aid Tools Design (Zhengzhou),Key Laboratory for Perioperative Digital Assessment of Bone Tumors (Henan),Zhengzhou 450003, China
| | - Z C Tian
- Department of Bone and Soft Tissue,Zhenghzhou University Affiliated Cancer Hospital,Henan Cancer Hospital,Key Laboratory for Digital Assessment of Spinal-pelvic Tumor and Surgical Aid Tools Design (Zhengzhou),Key Laboratory for Perioperative Digital Assessment of Bone Tumors (Henan),Zhengzhou 450003, China
| | - W T Yao
- Department of Bone and Soft Tissue,Zhenghzhou University Affiliated Cancer Hospital,Henan Cancer Hospital,Key Laboratory for Digital Assessment of Spinal-pelvic Tumor and Surgical Aid Tools Design (Zhengzhou),Key Laboratory for Perioperative Digital Assessment of Bone Tumors (Henan),Zhengzhou 450003, China
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10
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Zhou CB, Pan SY, Jin P, Deng JW, Xue JH, Ma XY, Xie YH, Cao H, Liu Q, Xie WF, Zou XP, Sheng JQ, Wang BM, Wang H, Ren JL, Liu SD, Sun YW, Meng XJ, Zhao G, Chen JX, Cui Y, Wang PQ, Guo HM, Yang L, Chen X, Ding J, Yang XN, Wang XK, Qian AH, Hou LD, Wang Z, Chen YX, Fang JY. Fecal Signatures of Streptococcus anginosus and Streptococcus constellatus for Noninvasive Screening and Early Warning of Gastric Cancer. Gastroenterology 2022; 162:1933-1947.e18. [PMID: 35167866 DOI: 10.1053/j.gastro.2022.02.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 01/25/2022] [Accepted: 02/06/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND & AIMS Most patients with gastric cancer (GCa) are diagnosed at an advanced stage. We aimed to investigate novel fecal signatures for clinical application in early diagnosis of GCa. METHODS This was an observational study that included 1043 patients from 10 hospitals in China. In the discovery cohort, 16S ribosomal RNA gene analysis was performed in paired samples (tissues and feces) from patients with GCa and chronic gastritis (ChG) to determine differential abundant microbes. Their relative abundances were detected using quantitative real-time polymerase chain reaction to test them as bacterial candidates in the training cohort. Their diagnostic efficacy was validated in the validation cohort. RESULTS Significant enrichments of Streptococcus anginosus (Sa) and Streptococcus constellatus (Sc) in GCa tumor tissues (P < .05) and feces (P < .0001) were observed in patients with intraepithelial neoplasia, early and advanced GCa. Either the signature parallel test Sa∪Sc or single signature Sa/Sc demonstrated superior sensitivity (Sa: 75.6% vs 72.1%, P < .05; Sc: 84.4% vs 64.0%, P < .001; and Sa∪Sc: 91.1% vs 81.4%, P < .01) in detecting early GCa compared with advanced GCa (specificity: Sa: 84.0% vs 83.9%, Sc: 70.4% vs 82.3%, and Sa∪Sc: 64.0% vs 73.4%). Fecal signature Sa∪Sc outperformed Sa∪CEA/Sc∪CEA in the discrimination of advanced GCa (sensitivity: 81.4% vs 74.2% and 81.4% vs 72.3%, P < .01; specificity: 73.4% vs 81.0 % and 73.4% vs 81.0%). The performance of Sa∪Sc in the diagnosis of both early and advanced GCa was verified in the validation cohort. CONCLUSION Fecal Sa and Sc are noninvasive, accurate, and sensitive signatures for early warning in GCa. (ClinicalTrials.gov, Number: NCT04638959).
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Affiliation(s)
- Cheng-Bei Zhou
- Division of Gastroenterology and Hepatology; Shanghai Institute of Digestive Disease; NHC Key Laboratory of Digestive Diseases; State Key Laboratory for Oncogenes and Related Genes, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Si-Yuan Pan
- Division of Gastroenterology and Hepatology; Shanghai Institute of Digestive Disease; NHC Key Laboratory of Digestive Diseases; State Key Laboratory for Oncogenes and Related Genes, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Peng Jin
- Department of Gastroenterology, The First Medical Center of Chinese People's Liberation Army General Hospital, The Seventh Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Jia-Wen Deng
- Division of Gastroenterology and Hepatology; Shanghai Institute of Digestive Disease; NHC Key Laboratory of Digestive Diseases; State Key Laboratory for Oncogenes and Related Genes, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jin-Hui Xue
- Department of Clinical Research, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Xin-Yue Ma
- Division of Gastroenterology and Hepatology; Shanghai Institute of Digestive Disease; NHC Key Laboratory of Digestive Diseases; State Key Laboratory for Oncogenes and Related Genes, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yuan-Hong Xie
- Division of Gastroenterology and Hepatology; Shanghai Institute of Digestive Disease; NHC Key Laboratory of Digestive Diseases; State Key Laboratory for Oncogenes and Related Genes, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Hui Cao
- Department of Gastrointestinal Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Qiang Liu
- Department of Pathology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Wei-Fen Xie
- Department of Gastroenterology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Xiao-Ping Zou
- Department of Gastroenterology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Jian-Qiu Sheng
- Department of Gastroenterology, The First Medical Center of Chinese People's Liberation Army General Hospital, The Seventh Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Bang-Mao Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin Institute of Digestive Diseases, Tianjin Key Laboratory of Digestive Diseases, Tianjin, China
| | - Hong Wang
- Department of Gastroenterology, Shanghai Jing'an District Central Hospital, Fudan University, Shanghai, China
| | - Jian-Lin Ren
- Department of Gastroenterology, Zhongshan Hospital, Xiamen University, Xiamen, China
| | - Si-De Liu
- Guangdong Provincial Key Laboratory of Gastroenterology, Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yun-Wei Sun
- Department of Gastroenterology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiang-Jun Meng
- Department of Gastroenterology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Gang Zhao
- Department of Gastrointestinal Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jin-Xian Chen
- Department of Gastrointestinal Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yun Cui
- Division of Gastroenterology and Hepatology; Shanghai Institute of Digestive Disease; NHC Key Laboratory of Digestive Diseases; State Key Laboratory for Oncogenes and Related Genes, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Pei-Qin Wang
- Department of Gastroenterology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Hui-Min Guo
- Department of Gastroenterology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Lang Yang
- Department of Gastroenterology, The First Medical Center of Chinese People's Liberation Army General Hospital, The Seventh Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Xin Chen
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin Institute of Digestive Diseases, Tianjin Key Laboratory of Digestive Diseases, Tianjin, China
| | - Jia Ding
- Department of Gastroenterology, Shanghai Jing'an District Central Hospital, Fudan University, Shanghai, China
| | - Xiao-Ning Yang
- Department of Gastroenterology, Zhongshan Hospital, Xiamen University, Xiamen, China
| | - Xin-Ke Wang
- Guangdong Provincial Key Laboratory of Gastroenterology, Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Ai-Hua Qian
- Department of Gastroenterology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Li-Dan Hou
- Department of Gastroenterology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zheng Wang
- Department of Gastrointestinal Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
| | - Ying-Xuan Chen
- Division of Gastroenterology and Hepatology; Shanghai Institute of Digestive Disease; NHC Key Laboratory of Digestive Diseases; State Key Laboratory for Oncogenes and Related Genes, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
| | - Jing-Yuan Fang
- Division of Gastroenterology and Hepatology; Shanghai Institute of Digestive Disease; NHC Key Laboratory of Digestive Diseases; State Key Laboratory for Oncogenes and Related Genes, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
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Cheng J, Zhong WL, Zhao JW, Zhai JH, Chen C, Chao AJ, Ren Z, Zhou L, Wang BM. Alterations in the composition of the gut microbiota affect absorption of cholecalciferol in severe osteoporosis. J Bone Miner Metab 2022; 40:478-486. [PMID: 35103840 DOI: 10.1007/s00774-021-01303-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 12/10/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION To evaluate the relationship between the gut microbial composition and intestinal cholecalciferol absorption in patients with severe osteoporosis (SOP). MATERIALS AND METHODS Eighteen patients with primary osteoporosis (OP) and 18 with SOP were included. Their clinical data were collected and their circulating concentrations of cholecalciferol and 25(OH)D3 were measured. Fecal samples were collected and their microbial contents were analyzed using 16S rDNA sequencing. RESULTS The age, sex, body mass index, and body mass of the participants did not differ between the groups. The prevalence of gastrointestinal symptoms in the participants with SOP was significantly higher than that in the participants with OP. There were significant differences in the 25(OH)D3 and cholecalciferol concentrations between participants with SOP or OP and there was a significant positive correlation between the concentrations of these substance. The diversity of the gut microbiota in participants with SOP was significantly higher than that in participants with OP. Firmicutes was more abundant in the SOP group and the ratio of Firmicutes/Bacteroidetes in participants with SOP was higher. Conversely, Bifidobacterium was significantly less abundant, as were the order and family it belongs to. At the species level, Bifidobacterium was the most significant difference between the two groups. CONCLUSION Differences in the intestinal microecology, especially Bifidobacterium, are associated with differences in the absorption of cholecalciferol and in the circulating 25(OH)D3 concentration, which may influence the progression of OP to SOP.
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Affiliation(s)
- Jing Cheng
- Gastroenterology Department, Tianjin Medical University General Hospital, Tianjin, China
- Department of Orthointernal, Tianjin Hospital, Tianjin, China
| | - Wei-Long Zhong
- Gastroenterology Department, Tianjin Medical University General Hospital, Tianjin, China
| | - Jing-Wen Zhao
- Gastroenterology Department, Tianjin Medical University General Hospital, Tianjin, China
| | - Jian-Hua Zhai
- Gastroenterology Department, Tianjin Medical University General Hospital, Tianjin, China
| | - Chen Chen
- Gastroenterology Department, Tianjin Medical University General Hospital, Tianjin, China
| | - Ai-Jun Chao
- Department of Orthointernal, Tianjin Hospital, Tianjin, China
| | - Zhe Ren
- Department of Orthointernal, Tianjin Hospital, Tianjin, China
| | - Lu Zhou
- Gastroenterology Department, Tianjin Medical University General Hospital, Tianjin, China.
| | - Bang-Mao Wang
- Gastroenterology Department, Tianjin Medical University General Hospital, Tianjin, China.
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Zhu JH, Qian YY, Pan J, He C, Lan Y, Chen WN, Wang BM, Zhao W, Li JN, Li XQ, Lv B, Fan YH, Zuo XL, Li Z, Zou DW, Li ZS, Liao Z. Efficacy and safety of vibrating capsule for functional constipation (VICONS): A randomised, double-blind, placebo-controlled, multicenter trial. EClinicalMedicine 2022; 47:101407. [PMID: 35518121 PMCID: PMC9062239 DOI: 10.1016/j.eclinm.2022.101407] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 03/30/2022] [Accepted: 04/04/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Functional constipation (FC) is an intractable disease that carries large financial burden as well as emotional and physical stress. We aimed to assess the efficacy and safety of the newly developed smartphone-controlled vibrating capsule (VC) in patients with FC. METHODS From December 2018 to February 2020, we did a multicenter, blinded, placebo-controlled randomised trial in six top general hospitals in China focusing on patients aged 18 to 80 with FC. Patients were randomly assigned in a 1:1 ratio to receive VCs or placebo treatment for six weeks (two capsules per week) after a two-week baseline period. The primary outcome was the responder rate, defined as the proportion of patients with an increase of at least one complete spontaneous bowel movement (CSBM) per week during treatment compared to baseline in the full analysis set. This trial is registered with ClinicalTrials.gov, number NCT04671264, and is completed. FINDINGS 107 patients aged from 18 to 74 were randomly assigned to receive VC (n = 53) or placebo treatment (n = 54). The responder rate in the VC group was significantly higher than that in the placebo group (64·2% vs. 35·8%; difference, 27·7% [95% CI, 10·4-45·1]; P = 0·005). More patients in the VC group reported weekly CSBMs ≥ 1 for at least four weeks during treatment (difference, 22·7% [95% CI, 8-46]; P = 0·022) and follow-up period (difference, 17.3% [95% CI, 0-35]; P = 0·048). The mean Patient Assessment of Constipation-Symptoms score and Patient Assessment of Constipation-Quality of Life score differed significantly from the baseline in both groups (all P < 0·0001). The most common adverse event associated with VC was abdominal discomfort (3·7%). INTERPRETATION VCs can promote defecation, as well as ameliorating symptoms and improving the quality of life in patients with FC with sustained efficacy. VC appears to be a potential alternative physical treatment for FC with the exact mechanism and parameters warranting further investigation. FUNDING The study was supported by "One hundred leading scientists for 21st century" of Health Department of Shanghai Municipal Government (to ZL, No.2017BR005).
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Affiliation(s)
- Jia-Hui Zhu
- Department of Gastroenterology, Digestive Endoscopy Center, Changhai Hospital, 168 Changhai Road, Shanghai 200433, China
- National Clinical Research Center for Digestive Diseases, Shanghai, China
| | - Yang-Yang Qian
- Department of Gastroenterology, Digestive Endoscopy Center, Changhai Hospital, 168 Changhai Road, Shanghai 200433, China
- National Clinical Research Center for Digestive Diseases, Shanghai, China
| | - Jun Pan
- Department of Gastroenterology, Digestive Endoscopy Center, Changhai Hospital, 168 Changhai Road, Shanghai 200433, China
- National Clinical Research Center for Digestive Diseases, Shanghai, China
| | - Chen He
- Department of Gastroenterology, Digestive Endoscopy Center, Changhai Hospital, 168 Changhai Road, Shanghai 200433, China
- National Clinical Research Center for Digestive Diseases, Shanghai, China
| | - Yu Lan
- Department of Gastroenterology, Beijing Jishuitan Hospital, Beijing, China
| | - Wei-Na Chen
- Department of Gastroenterology, Beijing Jishuitan Hospital, Beijing, China
| | - Bang-Mao Wang
- Department of Gastroenterology, Tianjin Medical University General Hospital, Tianjin, China
| | - Wei Zhao
- Department of Gastroenterology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jing-Nan Li
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiao-Qing Li
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bin Lv
- Department of Gastroenterology, Zhejiang Provincial Hospital of TCM, Hangzhou, China
| | - Yi-Hong Fan
- Department of Gastroenterology, Zhejiang Provincial Hospital of TCM, Hangzhou, China
| | - Xiu-Li Zuo
- Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, China
| | - Zhen Li
- Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, China
| | - Duo-Wu Zou
- Department of Gastroenterology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhao-Shen Li
- Department of Gastroenterology, Digestive Endoscopy Center, Changhai Hospital, 168 Changhai Road, Shanghai 200433, China
- National Clinical Research Center for Digestive Diseases, Shanghai, China
| | - Zhuan Liao
- Department of Gastroenterology, Digestive Endoscopy Center, Changhai Hospital, 168 Changhai Road, Shanghai 200433, China
- National Clinical Research Center for Digestive Diseases, Shanghai, China
- Corresponding author at: Department of Gastroenterology, Digestive Endoscopy Center, Changhai Hospital, 168 Changhai Road, Shanghai 200433, China.
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Wang BM, Hu G, Hu LH, Chen D, An Y, Li C, Jia G, Hu GP. [Research progress of micronucleus visualization analysis and artificial intelligence detection strategy]. Zhonghua Yu Fang Yi Xue Za Zhi 2022; 56:391-396. [PMID: 35381665 DOI: 10.3760/cma.j.cn112150-20210408-00340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The micronucleomics test can comprehensively display a variety of harmful endpoints, such as DNA damage and repair, chromosome breakage or loss and cell growth inhibition, with fast, simple and economical feature. Micronucleomics is not only widely used in the comprehensive assessment of the types and modes of genetic action of exogenous chemicals (such as drugs, food additives, cosmetics, environmental pollutants, etc.), but also plays an important role in the screening and risk assessment of cancer population at high risk. However, the traditional micronucleomics image counting method has the characteristics of time-consuming, low accuracy, and high cost, which cannot meet the current analysis requirements of large-scale, multi-index, rapidity, high precision and visualization. In recent years, with the rapid development of the era of precision medicine based on big data, visualized analysis of new micronucleomics based on machine learning and detection strategies based on deep learning have shown a good application prospect. This review, based on the application value of micronucleomics, systematically compares the traditional and new artificial intelligence counting of micronucleus images, and discusses the future direction of micronucleus image detection.
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Affiliation(s)
- B M Wang
- School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, China School of Medical Science and Engineering, Beihang University, Beijing 100191, China
| | - G Hu
- School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, China School of Medical Science and Engineering, Beihang University, Beijing 100191, China
| | - L H Hu
- Peking University First Hospital, Beijing 100034, China
| | - D Chen
- School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, China School of Medical Science and Engineering, Beihang University, Beijing 100191, China
| | - Y An
- High-tech Innovation Center of Big Data Precision Medicine, Beihang University, Beijing 100191, China
| | - C Li
- School of Medical Science and Engineering, Beihang University, Beijing 100191, China High-tech Innovation Center of Big Data Precision Medicine, Beihang University, Beijing 100191, China
| | - G Jia
- School of Public Health, Peking University, Beijing 100191, China
| | - G P Hu
- School of Medical Science and Engineering, Beihang University, Beijing 100191, China High-tech Innovation Center of Big Data Precision Medicine, Beihang University, Beijing 100191, China
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Chen YM, Li Y, Wang X, Wang ZL, Hou JJ, Su S, Zhong WL, Xu X, Zhang J, Wang BM, Wang YM. Effect of Bacillus subtilis, Enterococcus faecium, and Enterococcus faecalis supernatants on serotonin transporter expression in cells and tissues. World J Gastroenterol 2022; 28:532-546. [PMID: 35316963 PMCID: PMC8905020 DOI: 10.3748/wjg.v28.i5.532] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 10/16/2021] [Accepted: 01/06/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Bacillus subtilis (B. subtilis), Enterococcus faecium (E. faecium), and Enterococcus faecalis (E. faecalis) are probiotics that are widely used in the clinical treatment of irritable bowel syndrome (IBS). Whether the supernatants of these three probiotics can improve gastrointestinal sensation and movement by regulating the serotonin transporter (SERT) expression needs to be clarified.
AIM To investigate whether B. subtilis, E. faecium, and E. faecalis supernatants can upregulate SERT expression in vitro and in vivo.
METHODS Caco-2 and HT-29 cells were stimulated with probiotic culture supernatants for 12 and 24 h, respectively. A male Sprague-Dawley rat model of post-infectious irritable bowel syndrome (PI-IBS) was established and the rats were treated with phosphate-buffered saline (group A) and three probiotics culture supernatants (groups B, C, and D) for 4 wk. The levels of SERT were detected by quantitative PCR and western blotting.
RESULTS The levels of SERT at post-treatment 12 and 24 h were significantly elevated in Caco-2 cells treated with B. subtilis supernatant compared with those in the control group (aP < 0.05). Those levels were markedly upregulated in Caco-2 cells stimulated with E. faecium and E. faecalis supernatants at 24 h (aP < 0.05). In addition, SERT expression in groups B, C, and D was significantly higher than that in group A in the 2nd wk (aP < 0.05). Increased SERT expression was only found in group D in the 3rd wk (aP < 0.05). However, there was no significant difference in SERT expression between the groups in the last week (P > 0.05).
CONCLUSION The supernatants of B. subtilis, E. faecium, and E. faecalis can upregulate SERT expression in intestinal epithelial cells and the intestinal tissues in the rat model of PI-IBS.
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Affiliation(s)
- Yi-Ming Chen
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Ying Li
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Xin Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Ze-Lan Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Jun-Jie Hou
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Shuai Su
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Wei-Long Zhong
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Xin Xu
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Jie Zhang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Bang-Mao Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Yu-Ming Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
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15
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Liu XT, Zhao W, Chen X, Wang BM. [Diagnosis and treatment of achalasia of cardia]. Zhonghua Nei Ke Za Zhi 2022; 61:214-218. [PMID: 35090259 DOI: 10.3760/cma.j.cn112138-20211214-00884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- X T Liu
- Department of Gastroenterology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - W Zhao
- Department of Gastroenterology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - X Chen
- Department of Gastroenterology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - B M Wang
- Department of Gastroenterology, Tianjin Medical University General Hospital, Tianjin 300052, China
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16
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Hou JJ, Wang X, Wang YM, Wang BM. Interplay between gut microbiota and bile acids in diarrhoea-predominant irritable bowel syndrome: a review. Crit Rev Microbiol 2021; 48:696-713. [PMID: 34936854 DOI: 10.1080/1040841x.2021.2018401] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Irritable bowel syndrome (IBS) is a common functional gastrointestinal disease that disturbs the physiology and psychology of patients and increases the burden on families, the healthcare system, society, and economic development, affecting more and more people around the world. Despite the multiple factors that account for IBS remaining incompletely studied, emerging evidence demonstrated the abnormal changes in gut microbiota and bile acids (BAs) metabolism closely associated with IBS. Moreover, microbiota drives significant modifications for BAs, consisting of deconjugation, 7α-dehydroxylation, oxidation, epimerization, desulfation, esterification, and so on, while BAs, in turn, affect the microbiota directly or indirectly. In light of the complex connection among gut microbiota, BAs, and IBS, it is urgent to review the latest research progress in this field. In this review, we described the disorders of intestinal microecology and BAs profiles in IBS-D and also highlighted the cross-talk between gut microbiota and BAs in the context of IBS-D. Integrating these, we suggest that new therapeutic strategies targeting the microbiota-BAs axis for IBS-D, even for other related diseases caused by bacteria-bile acid dysbiosis should be expected.
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Affiliation(s)
- Jun-Jie Hou
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China.,Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Tianjin, China.,Tianjin Key Laboratory of Digestive Disease, Tianjin Medical University General Hospital, Tianjin, China
| | - Xin Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China.,Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Tianjin, China.,Tianjin Key Laboratory of Digestive Disease, Tianjin Medical University General Hospital, Tianjin, China
| | - Yu-Ming Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China.,Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Tianjin, China.,Tianjin Key Laboratory of Digestive Disease, Tianjin Medical University General Hospital, Tianjin, China
| | - Bang-Mao Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China.,Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Tianjin, China.,Tianjin Key Laboratory of Digestive Disease, Tianjin Medical University General Hospital, Tianjin, China
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17
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Gao J, Cao HL, Chen C, Wang BM, Zhang Q. [Research progress of obstructive sleep apnea syndrome on colorectal cancer]. Zhonghua Jie He He Hu Xi Za Zhi 2021; 44:1004-1008. [PMID: 34758527 DOI: 10.3760/cma.j.cn112147-20210305-00148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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18
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Zhao W, Zhang LY, Wang BM. [The role and mechanism of interstitial cells of Cajal in the pathogenesis of achalasia]. Zhonghua Nei Ke Za Zhi 2021; 60:1010-1012. [PMID: 34689526 DOI: 10.3760/cma.j.cn112138-20210205-00102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- W Zhao
- Department of Gastroenterology, General Hospital of Tianjin Medical University, Tianjin 300052, China
| | - L Y Zhang
- Department of Gastroenterology, General Hospital of Tianjin Medical University, Tianjin 300052, China
| | - B M Wang
- Department of Gastroenterology, General Hospital of Tianjin Medical University, Tianjin 300052, China
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19
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Luo Y, Zhu LP, Lei Y, Zhao JW, Wang BM, Chen X. Research progress of non-steroidal anti-inflammatory drug-induced small intestinal injury. Shijie Huaren Xiaohua Zazhi 2021; 29:1191-1200. [DOI: 10.11569/wcjd.v29.i20.1191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Non-steroidal anti-inflammatory drugs (NSAIDs) are used widely around the world because of their anti-inflammatory, analgesic, and antiplatelet activity. However, long-term application of NSAIDs can lead to complications. Previously, the clinical attention was dedicated to the NSAID-induced upper gastrointestinal complications. Recently, the detection rate of small intestinal damage related to NSAIDs has increased due to the wide use of endoscopes such as capsule endoscopy and double-balloon colonoscopy. Although the majority of patients have no significant symptoms, there are still a small percentage of patients who develop obvious symptoms or complicated ulcers that require therapeutic intervention. Despite significant advances in our understanding of NSAIDs, the treatment modality and regimen for NSAID-induced small intestinal damage have remained relatively unclear. This article will provide a comprehensive overview of NSAID-induced small intestinal damage with regard to the epidemiology, clinical manifestations, diagnosis, risk factors, pathogenesis, and treatment, in order to provide informative evidence for clinical practice.
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Affiliation(s)
- Yang Luo
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Lan-Ping Zhu
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Yue Lei
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Jing-Wen Zhao
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Bang-Mao Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Xin Chen
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
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20
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Khan S, Guo X, Liu T, Iqbal M, Jiang K, Zhu L, Chen X, Wang BM. An Update on Eosinophilic Esophagitis: Etiological Factors, Coexisting Diseases, and Complications. Digestion 2021; 102:342-356. [PMID: 32570246 DOI: 10.1159/000508191] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 04/26/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND Eosinophilic esophagitis (EoE) is an immune-mediated clinicopathological condition characterized by esophageal infiltration with eosinophils resulting in chronic inflammation and stricture. SUMMARY The recent increase in the incidence of EoE and the characteristic presentation of symptoms with difficulty swallowing and food bolus impaction has raised key concerns of clinicians as well as researchers. EoE often presents with dysphagia, food impaction, nausea, regurgitation or vomiting, and decreased appetite. It is more common in males, affecting both adults and children. The causative manner of this condition is complex and multifactorial. Throughout recent years, researchers have made a significant contribution to understanding the pathogenesis of EoE, genetic background, natural history, work on allergy, and standardization in the evaluation of disease activity. There is relatively high prevalence of EoE among the population, emphasizing the importance of this disease. Key messages: Esophageal involvement with eosinophils may be manifested as isolated or with coexisting conditions and should be taken into consideration in the differential diagnosis. This study aimed to provide gastroenterologists with novel insights into the evaluation of esophageal involvement with eosinophils and to pay special attention to the etiological factors, coexisting clinical diseases, and complications.
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Affiliation(s)
- Samiullah Khan
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xiaopei Guo
- Department of Gastroenterology and Hepatology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Tianyu Liu
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
| | - Muhammad Iqbal
- Department of Otorhinolaryngology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Kui Jiang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
| | - Lanping Zhu
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xin Chen
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
| | - Bang-Mao Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China,
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21
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Khan S, Zhu LP, Jiang K, Liu W, Chen X, Wang BM. Immunoglobulin G4-Related Disease Manifesting as Isolated, Typical, and Nontypical Gastroesophageal Lesion: A Research of Literature Review. Digestion 2021; 101:506-521. [PMID: 31291621 DOI: 10.1159/000501513] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 06/14/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND Immunoglobulin G4-related disease (IgG4-RD) is an autoimmune inflammatory and fibrotic condition. The disease is characterized by tissue infiltration with dense lymphoplasmacytes and IgG4-positive plasma cells. SUMMARY The aim of this study was to provide gastroenterologists with novel insights into evaluating the gastroesophageal involvement with IgG4-RD or mimickers of this condition and to give special attention to clinicopathological features. A literature review was performed using the PubMed database. A total of 39 studies presenting cases in the form of isolated, typical, and nontypical gastroesophageal involvement with IgG4-RD published between 2010 and 2018 were included. These studies were thoroughly reviewed for symptoms, lesion location, lesion type, lesion size, immune-histopathology, associated diseases, treatment, and follow-up. Of the 39 studies reviewed, 9 were esophageal IgG4-RD lesions, isolated esophageal IgG4-RD 66.66% (6/9), a typical form of esophageal IgG4-RD 11.11% (1/9), and nontypical form esophageal IgG4-RD 22.22% (2/9). The 30 gastric IgG4-RD that include isolated gastric IgG4-RD 46.66% (14/30), typical gastric IgG4-RD 40% (12/30), and nontypical gastric IgG4-RD 13.33% (4/30). The majority of lesions were inflammatory tumors, ulceration, nodular lesions, chronic gastritis, and malignant lesions. Key Messages: IgG4-RD may be manifested by isolated, typical and nontypical forms of gastroesophageal lesions and should be taken into consideration in the differential diagnosis. Corticosteroids may be the sole diagnostic treatment for this condition.
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Affiliation(s)
- Samiullah Khan
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
| | - Lan-Ping Zhu
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
| | - Kui Jiang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
| | - Wentian Liu
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xin Chen
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
| | - Bang-Mao Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China,
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22
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Hou JJ, Wang X, Li Y, Su S, Wang YM, Wang BM. The relationship between gut microbiota and proteolytic activity in irritable bowel syndrome. Microb Pathog 2021; 157:104995. [PMID: 34048892 DOI: 10.1016/j.micpath.2021.104995] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 05/05/2021] [Accepted: 05/05/2021] [Indexed: 02/08/2023]
Abstract
Irritable bowel syndrome (IBS) is a common functional gastrointestinal disease that affects 3.8-9.2% of the world population. It affects the physiology and psychology of patients and increases the burden on families, the healthcare system, society, and economic development. Presently, a large number of studies have shown that compared to healthy individuals, the composition and diversity of gut microbiota in IBS patients have changed, and the proteolytic activity (PA) in fecal supernatant and colonic mucosa of IBS patients has also increased. These findings indicate that the imbalance of intestinal microecology and intestinal protein hydrolysis is closely related to IBS. Furthermore, the intestinal flora is a key substance that regulates the PA and is associated with IBS. The current review described the intestinal microecology and intestinal proteolytic activity of patients with IBS and also discussed the effect of intestinal flora on PA. In summary, this study proposed a pivotal role of gut microbiota and PA in IBS, respectively, and provided an in-depth insight into the diagnosis and treatment targets of IBS as well as the formulation of new treatment strategies for other digestive diseases and protease-related diseases.
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Affiliation(s)
- Jun-Jie Hou
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, PR China.
| | - Xin Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, PR China.
| | - Ying Li
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, PR China.
| | - Shuai Su
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, PR China.
| | - Yu-Ming Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, PR China.
| | - Bang-Mao Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, PR China.
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23
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Zhu LP, Khan S, Hui YY, Yang B, Wang SY, Sun KD, Yu ZH, Zhao JW, Wang BM, Chen X. IgG4-Related Disease with Ascites: Report of a Case Simulating Primary Peritoneal Papillary Serous Carcinoma. Dig Dis Sci 2021; 66:1751-1756. [PMID: 32556817 DOI: 10.1007/s10620-020-06376-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Accepted: 05/30/2020] [Indexed: 12/27/2022]
Affiliation(s)
- Lan-Ping Zhu
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052, China
| | - Samiullah Khan
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052, China
| | - Yang-Yang Hui
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052, China
| | - Bo Yang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052, China
| | - Sai-Yu Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052, China
| | - Kai-di Sun
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052, China
| | - Zi-Han Yu
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052, China
| | - Jing-Wen Zhao
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052, China
| | - Bang-Mao Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052, China
| | - Xin Chen
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, 300052, China.
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24
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Su S, Zhang ZF, Wang X, Wang YM, Wang BM. Mechanism of Lactobacillus rhamnosus in treatment of irritable bowel syndrome. Shijie Huaren Xiaohua Zazhi 2021; 29:366-371. [DOI: 10.11569/wcjd.v29.i7.366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Irritable bowel syndrome (IBS) is a clinically common functional gastrointestinal disease, which affects the quality of life of patients. Therefore, it is of great significance to explore effective treatment methods for IBS. Probiotics can improve the symptoms of IBS patients and their quality of life. Lactobacillus rhamnosus is one of the most studied probiotics and has attracted much attention. . Lactobacillus rhamnosus has been used to treat IBS, and much progress has been made in recent years. Lactobacillus rhamnosus can improve the symptoms of IBS by regulating the imbalance of the intestinal flora, protecting the intestinal barrier function, exerting anti-inflammatory activity, regulating the intestinal immunity, improving visceral hypersensitivity, and inhibiting bacteria. This review aims to elucidate the possible mechanism of Lactobacillus rhamnosus in the treatment of IBS.
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Affiliation(s)
- Shuai Su
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Zhi-Fang Zhang
- Department of Neurology, Tianjin Xiqing Hospital, Tianjin 300380, China
| | - Xin Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Yu-Ming Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Bang-Mao Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
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25
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Liu YL, Zhang QZ, Wang YR, Fu LN, Han JS, Zhang J, Wang BM. Astragaloside IV Improves High-Fat Diet-Induced Hepatic Steatosis in Nonalcoholic Fatty Liver Disease Rats by Regulating Inflammatory Factors Level via TLR4/NF-κB Signaling Pathway. Front Pharmacol 2021; 11:605064. [PMID: 33708118 PMCID: PMC7941269 DOI: 10.3389/fphar.2020.605064] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 12/22/2020] [Indexed: 01/18/2023] Open
Abstract
Objective: Astragaloside IV (AS-IV) is the primary bioactive component purified from Astragalus membranaceus which is one of the traditional Chinese medicines. Research studies found that AS-IV has significant pharmacological effects on focal cerebral ischemia/reperfusion, cardiovascular disease, pulmonary disease, liver cirrhosis, and diabetic nephropathy, but little is known about the effects of AS-IV on nonalcoholic fatty liver disease (NAFLD). In this study, we investigated whether AS-IV has beneficial effects on NAFLD in rats and its potential mechanisms. Methods: Male SD rats were fed with high-fat diet (HFD) for 12 weeks to establish NAFLD rat model, and then, the rats were divided into five groups. The control group rats were fed with normal diet for 12 weeks and then were given normal saline (1.0 ml kg−1 day−1) by intragastric administration for 4 weeks. The model group rats were fed with HFD for 12 weeks and then were given normal saline (1.0 ml kg−1 day−1) by intragastric administration for 4 weeks. The AS-IV-L, AS-IV-M, and AS-IV-H groups were treated with 20, 40, and 80 mg kg−1 day−1 of AS-IV by intragastric administration for 4 weeks and given HFD diet. Then, we detected serum transaminase (ALT, AST), blood lipid (TG, TC), inflammatory cytokines (IL-6, IL-8 and TNF-α), liver histology(NAFLD activity score), TLR4/MyD88 signaling pathway in liver tissue. Results: We found AS-IV significantly reduced serum levels of AST, ALT, TG, TNF-α, IL-6, and IL-8 in NAFLD rats and downregulate the expression of TLR4 mRNA, MyD88 mRNA, NF-κB mRNA, and proteins in liver tissue. Moreover, AS-IV could significantly reduce the NAFLD activity score of NAFLD rat liver. Conclusion: In this study, we demonstrated that AS-IV have a protective effect on NAFLD by inhibiting TNF-α, IL-6 and IL-8 levels and down-regulating TLR4, MyD88 and NF-κB expression in rat liver tissues.
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Affiliation(s)
- Ying-Li Liu
- Gastroenterology, the Fourth Central Clinical College, Tianjin Medical University, Tianjin, China.,Gastroenterology, Tianjin Fourth Central Hospital, Tianjin, China
| | - Qiu-Zan Zhang
- Gastroenterology, the Fourth Central Clinical College, Tianjin Medical University, Tianjin, China.,Gastroenterology, Tianjin Fourth Central Hospital, Tianjin, China
| | - Yan-Rong Wang
- Gastroenterology, the Fourth Central Clinical College, Tianjin Medical University, Tianjin, China.,Gastroenterology, Tianjin Fourth Central Hospital, Tianjin, China
| | - Li-Na Fu
- Gastroenterology, the Fourth Central Clinical College, Tianjin Medical University, Tianjin, China.,Gastroenterology, Tianjin Fourth Central Hospital, Tianjin, China
| | - Jing-Shu Han
- Gastroenterology, the Fourth Central Clinical College, Tianjin Medical University, Tianjin, China.,Gastroenterology, Tianjin Fourth Central Hospital, Tianjin, China
| | - Jing Zhang
- Gastroenterology, the Fourth Central Clinical College, Tianjin Medical University, Tianjin, China.,Gastroenterology, Tianjin Fourth Central Hospital, Tianjin, China
| | - Bang-Mao Wang
- Gastroenterology, Tianjin Medical University General Hospital, Tianjin, China
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26
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Jin H, Wang B, Zheng ZQ, Zhang LL, Chen QY, Zhao CS, Wang BM, Zhao W. Peroral endoscopic myotomy for the treatment of achalasia after failed pneumatic dilation. Surg Endosc 2021; 35:6960-6968. [PMID: 33398574 DOI: 10.1007/s00464-020-08207-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 12/02/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS POEM is a rescue endoscopic therapy for patients who had previously failed surgical or endoscopic treatment. However, data regarding its effectiveness after failed pneumatic dilation (PD) and its long-term effects are limited. We aimed to retrospectively investigate the long-term outcomes in patients who had undergone POEM after failed PD. METHODS Data from 66 achalasia patients with a 2-year follow-up period were analyzed. Intraprocedural events were compared between the first POEM group (patients without prior-endoscopic intervention) and prior PD group (patients who had pre-POEM PD). Symptom evaluation, HRM and 24 h-pH DeMeester scores between the two groups were performed at 2 years after the POEM procedure. Muscularis externa samples were obtained from the lower esophagus using POEM to assess the muscle fibrosis with Azan-Mallory staining. RESULTS POEM was successfully performed for all achalasia patients. During the 2-year follow-up period, the success rate of POEM was 96.15% (25/26) for patients with prior PD and 95% (38/40) with primary POEM. For patients with type II achalasia and who underwent prior PD, the post-procedure DeMeester score was higher compared to patients who underwent POEM only (P < 0.05). A larger number of patients who underwent primary POEM (27.50%, 11/40) complained of mild heartburn compared to patients who underwent POEM after PD (7.69%, 2/26) (P < 0.05). With regards to fibrosis, the majority of patients who underwent POEM only were classified as F-1 (45.00%, 18/40), while the majority of patients who underwent prior PD were classified as F-2 (42.3%, 11/26). The degree of fibrosis was significantly different between the two groups (P < 0.05). Both surgical time and prior PD were correlated with the degree of fibrosis (P < 0.05). CONCLUSIONS Despite the technical challenges, pre-POEM endoscopic treatment does not impact the safety and efficacy of POEM in achalasia patients. Longer follow-up studies using larger cohorts are needed to determine long-term outcomes and complications of POEM.
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Affiliation(s)
- Hong Jin
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, 300070, China
| | - Bin Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, 300070, China
| | - Zhong-Qing Zheng
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, 300070, China
| | - Li-Li Zhang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, 300070, China
| | - Qiu-Yu Chen
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, 300070, China
| | - Chun Shan Zhao
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, 300070, China
| | - Bang-Mao Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, 300070, China
| | - Wei Zhao
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, 300070, China.
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27
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Song Y, Jiang K, Wang BM, Liu WT, Lin R. miR‑31 promotes tumorigenesis in ulcerative colitis‑associated neoplasia via downregulation of SATB2. Mol Med Rep 2020; 22:4801-4809. [PMID: 33173968 PMCID: PMC7646903 DOI: 10.3892/mmr.2020.11573] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 08/18/2020] [Indexed: 12/20/2022] Open
Abstract
Ulcerative colitis (UC) features chronic, non-infectious inflammation of the colon. The risk of ulcerative colitis‑associated neoplasia (UCAN) increases in direct association with the duration of this disease. Whether miRNAs exert a regulatory effect on the pathogenesis of UCAN has remained to be elucidated. In the present study, differentially expressed genes (DEGs) and microRNAs (miRNAs/miRs) were identified using bioinformatics analysis of Gene Expression Omnibus datasets. Enrichment analyses were performed to determine the function of the DEGs. The target genes of key miRNAs were predicted using miRWalk. Validation of DEGs and miRNAs in patients with UC, UC with low‑grade dysplasia and UC with high‑grade dysplasia (UC‑HGD) was performed using reverse transcription‑quantitative PCR analysis. A total of 38 differentially expressed miRNAs and 307 mRNAs were identified from the profiles and miR‑31 was validated as being overexpressed in UCAN tissues, particularly in the UC‑HGD samples. Furthermore, special AT‑rich DNA‑binding protein 2 (SATB2) was validated as a target gene of miR‑31 and SATB2 expression was negatively correlated with miR‑31 expression. Therefore, miR‑31 is upregulated in UCAN and it may promote tumorigenesis through downregulation of SATB2.
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Affiliation(s)
- Yan Song
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| | - Kui Jiang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| | - Bang-Mao Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| | - Wen-Tian Liu
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| | - Rui Lin
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
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28
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Hui YY, Zhu LP, Yang B, Zhang ZY, Zhang YJ, Chen X, Wang BM. Gastrointestinal bleeding caused by jejunal angiosarcoma: A case report. World J Clin Cases 2020; 8:4565-4571. [PMID: 33083419 PMCID: PMC7559686 DOI: 10.12998/wjcc.v8.i19.4565] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 05/24/2020] [Accepted: 08/25/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Angiosarcoma is a rare disease with a poor prognosis. Its occurrence in the small intestine is low, and gastrointestinal bleeding caused by small intestinal angiosarcoma is unusual.
CASE SUMMARY Here, we report the case of a 57-year-old man who presented with hematochezia for 1 mo. The patient had a medical history of chronic viral hepatitis B for 15 years. The causes of gastrointestinal bleeding were initially diagnosed as esophagogastric variceal bleeding or portal hypertensive gastropathy before endoscopy. However, after a complicated diagnostic and therapeutic process, including gastroendoscopy, colonoscopy, contrast-enhanced computed tomographic (CT), positron emission computed tomography/CT, capsule endoscopy, and pathological and immunohistochemical examinations, small intestinal angiosarcoma was diagnosed. Arrest of bleeding was achieved after surgical treatment. Furthermore, the patient had lung cancer with bone and adrenal metastases. At the follow-up 10 mo after the operation, the patient was alive.
CONCLUSION Gastroenterologists should maintain strong vigilance to small intestinal angiosarcoma, which is necessary for the early identification of this infrequent but fatal disease.
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Affiliation(s)
- Yang-Yang Hui
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Lan-Ping Zhu
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Bo Yang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Zi-Yue Zhang
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin 300072, China
| | - Yu-Jie Zhang
- Department of Pathology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Xin Chen
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Bang-Mao Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
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29
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Wang F, Liu TS, Yuan XL, Luo HY, Gu KS, Yuan Y, Deng YH, Xu JM, Bai YX, Wang Y, Liao WJ, Zhang HL, Bi F, Wang BM, Zhuang ZX, Jiang TJ, Xu RH. Trastuzumab plus docetaxel and capecitabine as a first-line treatment for HER2-positive advanced gastric or gastroesophageal junction cancer: a phase II, multicenter, open-label, single-arm study. Am J Cancer Res 2020; 10:3037-3046. [PMID: 33042632 PMCID: PMC7539783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 05/14/2020] [Indexed: 06/11/2023] Open
Abstract
Gastric cancer (GC) is the second most common cancer in China. The ToGA study showed that trastuzumab in combination with fluoropyrimidine plus cisplatin prolonged overall survival (OS) in patients with human epidermal growth factor receptor 2 (HER2)-positive advanced GC (AGC). However, some patients may not be able to receive this regimen. We conducted a clinical study to evaluate the efficacy and safety of trastuzumab in combination with docetaxel+capecitabine (DX) in patients with HER2-positive AGC. This phase II, multi-center, open-label, single arm study enrolled patients with HER2-positive AGC who had not received prior treatment for metastatic disease. Patients were treated with a regimen of trastuzumab (8 mg/kg loading dose followed by 6 mg/kg, day 1), capecitabine (1000 mg/m2 twice daily, days 1-14) and docetaxel (60 mg/m2, day 1 for 6 cycles) every 3 weeks. The primary endpoint was progression-free survival (PFS) and the secondary endpoints were objective response rate (ORR), OS and safety profiles. Sixty-seven patients with AGC were enrolled from 14 centers. 64 were included in the full analysis set (FAS). The median PFS was 8.1 months (95% confidence interval [CI]: 5.6-12.8) and the median OS was 20.9 months (95% CI: 15.1-33.0). Response was evaluated in 59 patients. The ORR was 67.8%. The most common adverse events of Grade ≥3 were neutropenia, leukopenia, hand-foot syndrome, febrile neutropenia and anemia. We concluded that combination treatment with trastuzumab and DX was well-tolerated and highly effective in patients with HER2-positive AGC, and may offer an alternative to current treatments.
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Affiliation(s)
- Feng Wang
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer MedicineGuangzhou, China
| | - Tian-Shu Liu
- Zhongshan Hospital, Fudan UniversityShanghai, China
| | - Xiang-Lin Yuan
- Tongji Hospital, Huazhong University of Science and TechnologyWuhan, China
| | - Hui-Yan Luo
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer MedicineGuangzhou, China
| | - Kang-Sheng Gu
- The First Affiliated Hospital of Medical University of AnhuiHefei, China
| | - Ying Yuan
- The Second Affiliated Hospital of Medical College of Zhejiang UniversityHangzhou, China
| | - Yan-Hong Deng
- The 6th Affiliated Hospital, Sun Yat-sen UniversityGuangzhou, China
| | | | | | - Ying Wang
- Shengjing Hospital, China Medical UniversityShenyang, China
| | - Wang-Jun Liao
- Nanfang Hospital, Southern Medical UniversityGuangzhou, China
| | - He-Long Zhang
- Tangdu Hospital, Fourth Military Medical UniversityXian, China
| | - Feng Bi
- West China HospitalChengdu, China
| | - Bang-Mao Wang
- Tianjin Medical University General HospitalTianjin, China
| | - Zhi-Xiang Zhuang
- The Second Hospital Affiliated to Suzhou UniversitySuzhou, China
| | - Teng-Jia Jiang
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer MedicineGuangzhou, China
| | - Rui-Hua Xu
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer MedicineGuangzhou, China
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30
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Zhang H, Maimaitiaili M, Liu Y, Wang XH, Wang BM, Cao HL. [New insight into the pathogenesis and treatment of juvenile polyposis syndrome]. Zhonghua Er Ke Za Zhi 2020; 58:432-435. [PMID: 32392966 DOI: 10.3760/cma.j.cn112140-20190827-00544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- H Zhang
- Department of Emergency, Tianjin Children's Hospital,Tianjin 300074, China
| | - Maimaitiabudu Maimaitiaili
- Department of Gastroenterology and Hepatology, Hotan District People's Hospital, Xinjiang Uygur Autonomous Region, Hotan 848000, China
| | - Y Liu
- Department of Gastroenterology and Hepatology, Tianjin Third Central Hospital, Tianjin 300170, China
| | - X H Wang
- Department of Gastroenterology and Hepatology, Hotan District People's Hospital, Xinjiang Uygur Autonomous Region, Hotan 848000, China
| | - B M Wang
- Department of Gastroenterology, General Hospital, Tianjin Medical University, Tianjin 300052, China
| | - H L Cao
- Department of Gastroenterology, General Hospital, Tianjin Medical University, Tianjin 300052, China
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31
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Zhao TM, Wang Y, Deng Y, Fan XF, Cao XC, Hou LJ, Mao LH, Lin L, Zhao W, Wang BM, Jiang K, Zhao JW, Sun C. Bicyclol Attenuates Acute Liver Injury by Activating Autophagy, Anti-Oxidative and Anti-Inflammatory Capabilities in Mice. Front Pharmacol 2020; 11:463. [PMID: 32362825 PMCID: PMC7181473 DOI: 10.3389/fphar.2020.00463] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 03/25/2020] [Indexed: 12/25/2022] Open
Abstract
Bicyclol, a novel synthetic antihepatitis drug, has been shown to protect against liver injury via various pharmacological activities. The purpose of the current study was to further investigate the protective effect of bicyclol against carbon tetrachloride (CCl4)-induced acute liver injury (ALI) and its underlying molecular mechanism, particularly autophagic machinery, anti-oxidative, and anti-inflammatory potentials. Our results found that treatment with bicyclol significantly reduced CCl4-induced hepatotoxicity by alleviating histopathological liver changes, decreasing the alanine transaminase levels, promoting autophagic flux, attenuating the expression of inflammatory cytokines, and modulating oxidative markers. Furthermore, bicyclol efficiently induced the conversion of LC3 and enhanced the liver expressions of ATG7 and Beclin-1. Meanwhile, bicyclol induced the activation of nuclear factor erythroid 2-related factor 2 (Nrf2) and p62. These protective effects may be mediated by activation of AMP-activated protein kinase and inhibition of mTOR or MAPK signaling pathways. Taken together, our study firstly suggests that bicyclol has protective potential against CCl4-induced hepatotoxicity, which might be closely associated with induction of autophagy, concomitant anti-oxidative stress, and anti-inflammatory response.
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Affiliation(s)
- Tian-Ming Zhao
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China.,Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Tianjin, China
| | - Ya Wang
- Department of Gastroenterology, Shanxi Academy of Medical Sciences Shanxi Bethune Hospital, Taiyuan, China
| | - You Deng
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China.,Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Tianjin, China
| | - Xiao-Fei Fan
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China.,Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Tianjin, China
| | - Xiao-Cang Cao
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China.,Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Tianjin, China
| | - Li-Jun Hou
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China.,Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Tianjin, China
| | - Li-Hong Mao
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China.,Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Tianjin, China
| | - Lin Lin
- Department of Gastroenterology, Tianjin Medical University General Hospital Airport Hospital, Tianjin, China
| | - Wei Zhao
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China.,Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Tianjin, China
| | - Bang-Mao Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China.,Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Tianjin, China
| | - Kui Jiang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China.,Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Tianjin, China
| | - Jing-Wen Zhao
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China.,Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Tianjin, China
| | - Chao Sun
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China.,Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Tianjin, China.,Department of Gastroenterology, Tianjin Medical University General Hospital Airport Hospital, Tianjin, China
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32
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Chen YX, Gao QY, Zou TH, Wang BM, Liu SD, Sheng JQ, Ren JL, Zou XP, Liu ZJ, Song YY, Xiao B, Sun XM, Dou XT, Cao HL, Yang XN, Li N, Kang Q, Zhu W, Xu HZ, Chen HM, Cao XC, Fang JY. Berberine versus placebo for the prevention of recurrence of colorectal adenoma: a multicentre, double-blinded, randomised controlled study. Lancet Gastroenterol Hepatol 2020; 5:267-275. [PMID: 31926918 DOI: 10.1016/s2468-1253(19)30409-1] [Citation(s) in RCA: 89] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 11/21/2019] [Accepted: 11/22/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Chemoprevention of colorectal adenoma and colorectal cancer remains an important public health goal. The present study aimed to investigate the clinical potential and safety of berberine for prevention of colorectal adenoma recurrence. METHODS This double-blind, randomised, placebo-controlled trial was done in seven hospital centres across six provinces in China. Individuals aged 18-75 years who had at least one but no more than six histologically confirmed colorectal adenomas that had undergone complete polypectomy within the 6 months before recruitment were recruited and randomly assigned (1:1) to receive berberine (0·3 g twice daily) or placebo tablets via block randomisation (block size of six). Participants were to undergo a first follow-up colonoscopy 1 year after enrolment, and if no colorectal adenomas were detected, a second follow-up colonoscopy at 2 years was planned. The study continued until the last enrolled participant reached the 2-year follow-up point. All participants, investigators, endoscopists, and pathologists were blinded to treatment assignment. The primary efficacy endpoint was the recurrence of adenomas at any follow-up colonoscopy. Analysis was based on modified intention-to-treat, with the full analysis set including all randomised participants who received at least one dose of study medication and who had available efficacy data. The study is registered with ClinicalTrials.gov, number NCT02226185; the trial has ended and this report represents the final analysis. FINDINGS Between Nov 14, 2014, and Dec 30, 2016, 553 participants were randomly assigned to the berberine group and 555 to the placebo group. The full analysis set consisted of 429 participants in the berberine group and 462 in the placebo group. 155 (36%) participants in the berberine group and 216 (47%) in the placebo group were found to have recurrent adenoma during follow-up (unadjusted relative risk ratio for recurrence 0·77, 95% CI 0·66-0·91; p=0·001). No colorectal cancers were detected during follow-up. The most common adverse event was constipation (six [1%] of 446 patients in the berberine group vs one [<0·5%] of 478 in the placebo group). No serious adverse events were reported. INTERPRETATION Berberine 0·3 g twice daily was safe and effective in reducing the risk of recurrence of colorectal adenoma and could be an option for chemoprevention after polypectomy. FUNDING National Natural Science Foundation of China.
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Affiliation(s)
- Ying-Xuan Chen
- Division of Gastroenterology and Hepatology, Shanghai Institute of Digestive Disease, State Key Laboratory for Oncogenes and Related Genes, Key Laboratory of Gastroenterology & Hepatology, Ministry of Health, Renji Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Qin-Yan Gao
- Division of Gastroenterology and Hepatology, Shanghai Institute of Digestive Disease, State Key Laboratory for Oncogenes and Related Genes, Key Laboratory of Gastroenterology & Hepatology, Ministry of Health, Renji Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Tian-Hui Zou
- Division of Gastroenterology and Hepatology, Shanghai Institute of Digestive Disease, State Key Laboratory for Oncogenes and Related Genes, Key Laboratory of Gastroenterology & Hepatology, Ministry of Health, Renji Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Bang-Mao Wang
- Department of Gastroenterology and Hepatology, General Hospital, Tianjin Medical University, Tianjin, China
| | - Si-De Liu
- Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jian-Qiu Sheng
- Department of Gastroenterology, the Seventh Medical Center of PLA General Hospital, Beijing, China
| | - Jian-Lin Ren
- Department of Gastroenterology, Zhongshan Hospital, Xiamen University, Xiamen, China
| | - Xiao-Ping Zou
- Division of Gastroenterology and Hepatology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Zhan-Ju Liu
- Department of Gastroenterology, the Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
| | - Yan-Yan Song
- Department of Biostatistics, Clinical Research Institute, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Bing Xiao
- Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xiao-Min Sun
- Department of Gastroenterology, the Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
| | - Xiao-Tan Dou
- Division of Gastroenterology and Hepatology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Hai-Long Cao
- Department of Gastroenterology and Hepatology, General Hospital, Tianjin Medical University, Tianjin, China
| | - Xiao-Ning Yang
- Department of Gastroenterology, Zhongshan Hospital, Xiamen University, Xiamen, China
| | - Na Li
- Department of Gastroenterology, the Seventh Medical Center of PLA General Hospital, Beijing, China
| | - Qian Kang
- Department of Gastroenterology, the Seventh Medical Center of PLA General Hospital, Beijing, China
| | - Wei Zhu
- Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Hong-Zhi Xu
- Department of Gastroenterology, Zhongshan Hospital, Xiamen University, Xiamen, China
| | - Hui-Min Chen
- Division of Gastroenterology and Hepatology, Shanghai Institute of Digestive Disease, State Key Laboratory for Oncogenes and Related Genes, Key Laboratory of Gastroenterology & Hepatology, Ministry of Health, Renji Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Xiao-Chuang Cao
- Department of Gastroenterology and Hepatology, General Hospital, Tianjin Medical University, Tianjin, China
| | - Jing-Yuan Fang
- Division of Gastroenterology and Hepatology, Shanghai Institute of Digestive Disease, State Key Laboratory for Oncogenes and Related Genes, Key Laboratory of Gastroenterology & Hepatology, Ministry of Health, Renji Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
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33
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Chen X, Li BX, Zhu LP, Ma S, Zhao JW, Zhong WL, Wang BM. Cronkhite-Canada syndrome: A rare polyposis. Shijie Huaren Xiaohua Zazhi 2019; 27:977-983. [DOI: 10.11569/wcjd.v27.i16.977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Cronkhite-Canada syndrome (CCS) is a rare non-genetic disease whose clinical manifestations are diffuse polyps of the gastrointestinal tract, finger-nail malnutrition, alopecia, skin pigmentation, diarrhea, weight loss, and taste disorders. The majority of CCS cases have a poor prognosis and often have life-threatening complications. The etiology of and appropriate treatments for CCS are still in the exploratory stage. This paper aims to improve the understanding of CCS and explore its best treatments by summarizing the common causes, clinical manifestations, endoscopic features, and treatment options of CCS.
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Affiliation(s)
- Xin Chen
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Bian-Xia Li
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Lan-Ping Zhu
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Shuang Ma
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Jing-Wen Zhao
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Wei-Long Zhong
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Bang-Mao Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
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34
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Song Y, Yang H, Lin R, Jiang K, Wang BM. The role of ferroptosis in digestive system cancer. Oncol Lett 2019; 18:2159-2164. [PMID: 31402933 DOI: 10.3892/ol.2019.10568] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 06/11/2019] [Indexed: 12/21/2022] Open
Abstract
Ferroptosis is a type of regulated cell death dependent on iron and reactive oxygen species. Ferroptosis is distinct from other cell death modalities, including apoptosis, autophagy and necrosis. Dysregulated ferroptosis has been implicated in a number of diseases, including neuropathy, ischemia reperfusion injury, acute kidney failure and cancer. The digestive system consists of several organs. The morbidity and mortality rates of digestive system cancer are high. The current review summarizes the role of ferroptosis in digestive system cancer. A large number of molecules, including tumor protein p53, retinoblastoma protein, nuclear factor E2-related factor 2, KH RNA binding domain containing signal transduction associated 1, cysteine dioxygenase type 1, metallothionein-1G, nuclear receptor coactivator 4, CDGSH iron sulfur domain 1, heat shock protein family A (Hsp70) member 5 and acyl-CoA synthetase long chain family member 4, regulate ferroptosis in digestive system cancer. Drugs such as cisplatin, baicalein, haloperidol, artesunate, piperlongumine, saponin and bromelain may cause cancer cell death by inducing ferroptosis. An improved understanding of ferroptosis in digestive system cancer may give rise to novel diagnostic and making therapeutic strategies.
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Affiliation(s)
- Yan Song
- Department of Gastroenterology, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| | - Hu Yang
- Department of Nephrology, Second Hospital of Tianjin Medical University, Tianjin 300211, P.R. China
| | - Rui Lin
- Department of Gastroenterology, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| | - Kui Jiang
- Department of Gastroenterology, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| | - Bang-Mao Wang
- Department of Gastroenterology, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
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Ma S, Wang SY, Zhu LP, Chen X, Wang BM. Esophageal microbiota and esophageal diseases. Shijie Huaren Xiaohua Zazhi 2019; 27:767-772. [DOI: 10.11569/wcjd.v27.i12.767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The microbiota of the esophagus has been the least systematically studied among the organs of the gastrointestinal tract. Esophageal microbiota has been proved to be complex with a high diversity until recently. Alterations of its composition are associated with the development and progression of esophageal diseases. Immunoinflammatory responses caused by dysbiosis may play a role in the pathogenesis of esophageal disorders. This review addresses the characteristics of esophageal microbiota in physiological and pathological conditions, aiming to provide new insights into esophageal microecology-based intervention strategies for esophageal diseases.
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Affiliation(s)
- Shuang Ma
- Department of Gastroenterology and Hepatology, General Hospital of Tianjin Medical University, Tianjin 300052, China
| | - Sai-Yu Wang
- Department of Gastroenterology and Hepatology, General Hospital of Tianjin Medical University, Tianjin 300052, China
| | - Lan-Ping Zhu
- Department of Gastroenterology and Hepatology, General Hospital of Tianjin Medical University, Tianjin 300052, China
| | - Xin Chen
- Department of Gastroenterology and Hepatology, General Hospital of Tianjin Medical University, Tianjin 300052, China
| | - Bang-Mao Wang
- Department of Gastroenterology and Hepatology, General Hospital of Tianjin Medical University, Tianjin 300052, China
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Li YN, Zhou L, Zhang J, Wang Y, Wang XY, Guo LP, Li SQ, Wang BM. [Characteristics of initial diagnosis in autoimmune liver disease: an 18-year, retrospective single-center study]. Zhonghua Nei Ke Za Zhi 2019; 58:366-371. [PMID: 31060145 DOI: 10.3760/cma.j.issn.0578-1426.2019.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Objective: To analyze the chorological changes of diagnosis in patients with autoimmune liver disease (AILD) and related factors for early diagnosis. Methods: A total of 581 patients with age ranged from 16 to 81 were retrospectively analyzed, who were admitted to Tianjin Medical University General Hospital with AILD during January 2000 to December 2017. Age at diagnosis, diagnostic method and cirrhosis at diagnosis were compared in different groups according to admission period as 2000-2005, 2006-2011, 2012-2017. Results: The diagnostic rate of AILD showed an upward trend during the past near two decades. The proportion of AILD patients diagnosed via health examination was increasing year by year mainly by elevated transaminases (P<0.001). The mean age at diagnosis in our AILD patients were younger at present, especially in men (P=0.044). The proportion of cirrhosis at diagnosis was gradually reduced in three different periods respectively [77.78%(21/27), 41.58% (79/190), 25.00%(91/364), P<0.001], which were coincident in patients with autoimmune hepatitis (AIH) and primary biliary cirrhosis (PBC) (P<0.001). The shrinking trend of cirrhosis at diagnosis was significantly correlated with the increasing application of health examination (r=-0.549, P<0.001). Conclusions: Extensive application of health examination expands the diagnostic rate of AILD. During the past 18 years, more young patients are diagnosed with AILD. The proportion of severe cases such as cirrhosis at diagnosis is decreasing. Screening of immunological examinations in patients with abnormal transaminases is needed and critical to the early diagnosis of asymptomatic AILD.
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Affiliation(s)
- Y N Li
- Department of Gastroenterology and Hepotology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - L Zhou
- Department of Gastroenterology and Hepotology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - J Zhang
- Department of Gastroenterology and Hepotology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Y Wang
- Department of Gastroenterology and Hepotology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - X Y Wang
- Department of Gastroenterology and Hepotology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - L P Guo
- Department of Gastroenterology and Hepotology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - S Q Li
- Health Management Center, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - B M Wang
- Department of Gastroenterology and Hepotology, Tianjin Medical University General Hospital, Tianjin 300052, China
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Liu HM, Zhang HW, Lin R, Song Y, Zhou L, Wang BM, Liu WT. Clinical features of patients with refractory primary biliary cholangitis. Shijie Huaren Xiaohua Zazhi 2019; 27:238-244. [DOI: 10.11569/wcjd.v27.i4.238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM To analyze the clinical characteristics of refractory primary biliary cholangitis (PBC) and explore the factors affecting the therapeutic effect of ursodeoxycholic acid (UDCA), so as to provide new ideas for the clinical diagnosis and treatment of PBC.
METHODS A retrospective analysis was performed on 53 patients with PBC following UDCA treatment. Fifteen patients (28.30%) who had a poor response were included in a refractory group, and 38 patients (71.70%) who had a complete response were included in a typical group. Clinical characteristics, biochemical parameters, autoantibodies, abdominal ultrasonography, liver pathology, and response to treatment were analyzed and compared between the two groups.
RESULTS There was a female predominance in both groups. There was no significant difference between the two groups in the gender distribution, the average age of onset, or general conditions such as comcomitant extra-hepatic autoimmune diseases. The levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), glutamyltransferase (GGT), total bilirubin (TBIL), direct bilirubin (DBIL), and anti-mitochondrial antibodies (AMA) in the refractory group were significantly higher than those in the typical group before treatment (P < 0.05). The proportion of patients with intrahepatic cirrhosis was 46.7% in the refractory group and 18.4% in the typical group; the proportion of patients with splenomegaly was 60% and 26.3%, respectively; the proportion of patients with intrahepatic cholestasis was 66.7% and 5.3%, respectively; the difference between the two groups was statistically significant (P < 0.05). Logistic regression analysis demonstrated that ALP and cholestasis were independent risk factors affecting the efficacy of initial treatment of UDCA.
CONCLUSION High levels of ALT, AST, ALP, GGT, TBIL, DBIL and AMA at the initial treatment as well as concomitant cirrhosis, splenomegaly, and intrahepatic cholestasis may be closely related to a poor response to UDCA-based treatment.
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Affiliation(s)
- Hui-Min Liu
- Department of Gastroenterology, General Hospital of Tianjin Medical University, Tianjin 300052, China
| | - Hong-Wen Zhang
- Department of Gastroenterology, General Hospital of Tianjin Medical University, Tianjin 300052, China
| | - Rui Lin
- Department of Gastroenterology, General Hospital of Tianjin Medical University, Tianjin 300052, China
| | - Yan Song
- Department of Gastroenterology, General Hospital of Tianjin Medical University, Tianjin 300052, China
| | - Lu Zhou
- Department of Gastroenterology, General Hospital of Tianjin Medical University, Tianjin 300052, China
| | - Bang-Mao Wang
- Department of Gastroenterology, General Hospital of Tianjin Medical University, Tianjin 300052, China
| | - Wen-Tian Liu
- Department of Gastroenterology, General Hospital of Tianjin Medical University, Tianjin 300052, China
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Guo LP, Zhou L, Li HX, Zhang J, Wang BM. [The study of liver macrophages polarization in patients with autoimmune hepatitis]. Zhonghua Nei Ke Za Zhi 2019; 56:763-765. [PMID: 29036959 DOI: 10.3760/cma.j.issn.0578-1426.2017.10.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
To explore the functional phenotype of liver macrophages in patients with autoimmune hepatitis (AIH). Compared with patients with nonalcoholic fatty liver disease (NAFLD) and chronic hepatitis B (CHB), the absolute CD(68)(+) cell count in patients with AIH was significantly higher (all P<0.05). It was positively correlated with ALT and IgG levels (the correlation coefficients 0.600 and 0.700, P=0.285 and 0.188 respectively). Additionally, compared with patients with NAFLD, the absolute iNOS positive cell count in patients with AIH and CHB were significantly higher (all P<0.05). The expression of TNFα, iNOS and IL-1β in patients with AIH and CHB were significantly higher than in patients with NAFLD (all P<0.05). Interestingly, compared with patients with AIH and CHB, the absolute CD(206)(+) cell count in patients with NAFLD were significantly higher (all P<0.05). CD(206) expression in patients with NAFLD was higher than patients with AIH and CHB, but with no statistical significance. M1 type macrophages over-expressed and played a major role in the inflammatory reaction and liver injury in patients with AIH.
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Affiliation(s)
| | | | | | | | - B M Wang
- Department of Gastroenterology and Hepatology, General Hospital of Tianjin Medical University, Tianjin 300052, China
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Yang X, Gu Y, Cao XC, Wang BM, Cao HL. Smoldering Multiple Myeloma Arising in Ulcerative Colitis. Chin Med J (Engl) 2018; 131:2628-2629. [PMID: 30381604 PMCID: PMC6213847 DOI: 10.4103/0366-6999.244114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Affiliation(s)
- Xue Yang
- Department of Gastroenterology and Hepatology, General Hospital, Tianjin Medical University, Tianjin 300052; Department of Leukaemia, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin 300020, China
| | - Yu Gu
- Department of Gastroenterology and Hepatology, General Hospital, Tianjin Medical University, Tianjin 300052, China
| | - Xiao-Cang Cao
- Department of Gastroenterology and Hepatology, General Hospital, Tianjin Medical University, Tianjin 300052, China
| | - Bang-Mao Wang
- Department of Gastroenterology and Hepatology, General Hospital, Tianjin Medical University, Tianjin 300052, China
| | - Hai-Long Cao
- Department of Gastroenterology and Hepatology, General Hospital, Tianjin Medical University, Tianjin 300052, China
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Song Y, Yang H, Jiang K, Wang BM, Lin R. miR-181a regulates Th17 cells distribution via up-regulated BCL-2 in primary biliary cholangitis. Int Immunopharmacol 2018; 64:386-393. [DOI: 10.1016/j.intimp.2018.09.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 08/16/2018] [Accepted: 09/17/2018] [Indexed: 12/12/2022]
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Chang M, Jiang K, Wang BM, Chang YX. Clinical efficacy of ultrasound-guided anhydrous ethanol vs lauromacrogol sclerotherapy in treatment of large simple hepatic cysts. Shijie Huaren Xiaohua Zazhi 2018; 26:1463-1469. [DOI: 10.11569/wcjd.v26.i24.1463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM To compare the clinical efficacy and adverse reactions of anhydrous ethanol and lauromacrogol injection in the treatment of simple hepatic cysts.
METHODS One hundred and twelve patients with simple hepatic cysts ≥ 8 cm in diameter treated at our hospital from September 2009 to September 2016 were randomly divided into two groups to receive either anhydrous ethanol (group A, 69 cases) or lauromacrogol treatment (group B, 43 cases). Clinical efficacy and adverse reactions were compared in the two groups. The two groups was further divided into three subgroups each according to the size of the cyst: 8-12 cm, 13-16 cm, and 17-20 cm. The incidence of adverse reactions and abnormal liver function were compared among different subgroups.
RESULTS The total effective rate did not differ significantly between groups A and B (95.7% vs 95.4%, P > 0.05). The cure rate of group B (67.4%) was significantly higher than that of group A (47.8%, P < 0.05). The incidence of adverse reactions in group A (39.1%) was also significantly higher than that of group B (18.6%, P < 0.05). The incidence of abdominal pain, abdominal distension, and abnormal liver function was significantly higher in group A than in group B (P < 0.05 or P < 0.01). The incidence of adverse reactions in the 8-12 cm, 13-16 cm, and 17-20 cm subgroups treated with absolute ethanol was 15.4%, 43.8%, and 81.8%, respectively (P < 0.01), and the incidence in group C was significantly higher than that of groups A and B (P < 0.05 or P < 0.001). The incidence of abnormal liver function in the 8-12 cm, 13-16 cm, and 17-20 cm subgroups treated with absolute ethanol was 11.5%, 37.5%, and 81.8%, respectively (P < 0.001), and the incidence in group C was significantly higher than that of groups A and B (P < 0.05 or P < 0.001). There were no significant difference in the incidence of adverse reactions or abnormal liver function between the three subgroups treated with lauromacrogol (P > 0.05).
CONCLUSION The total effective rate of anhydrous alcohol and lauromacrogol in the treatment of large hepatic cysts is comparable, but lauromacrogol is associated with a higher cure rate and lower incidence of adverse reactions.
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Affiliation(s)
- Meng Chang
- Tianjin Medical University Graduate School, Tianjin 300070, China,Department of General Internal Medicine, Offshore Oil General Hospital, Tianjin 300452, China
| | - Kui Jiang
- Department of Gastroenterology, General Hospital of Tianjin Medical University, Tianjin 300052, China
| | - Bang-Mao Wang
- Department of Gastroenterology, General Hospital of Tianjin Medical University, Tianjin 300052, China
| | - Yi-Xiang Chang
- Department of Gastroenterology, General Hospital of Tianjin Medical University, Tianjin 300052, China
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Zhu LP, Zhao JW, Chen X, Wang BM. Proton pump inhibitor usage and nonsteroidal anti-inflammatory drugs-associated small intestinal injury: How to balance risks and benefits. Shijie Huaren Xiaohua Zazhi 2018; 26:1334-1339. [DOI: 10.11569/wcjd.v26.i22.1334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Proton pump inhibitors (PPIs) are widely used in the treatment of acid-related diseases and can effectively prevent upper gastrointestinal damage associated with nonsteroidal anti-inflammatory drugs (NSAIDs). However, recent studies have shown that PPIs cannot protect from NSAIDs-associated small bowel injury, and may even aggravate intestinal injury by altering the intestinal flora. This article will discuss the risks associated with the combined use of NSAIDs and PPIs, as well as how to balance risks and benefits of PPIs treatment, and provide a brief review of strategies for the prevention of NSAIDs-associated small bowel injury.
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Affiliation(s)
- Lan-Ping Zhu
- Department of Gastroenterology and Hepatology, General Hospital of Tianjin Medical University, Tianjin 300052, China
| | - Jing-Wen Zhao
- Department of Gastroenterology and Hepatology, General Hospital of Tianjin Medical University, Tianjin 300052, China
| | - Xin Chen
- Department of Gastroenterology and Hepatology, General Hospital of Tianjin Medical University, Tianjin 300052, China
| | - Bang-Mao Wang
- Department of Gastroenterology and Hepatology, General Hospital of Tianjin Medical University, Tianjin 300052, China
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Liu MJ, Jiang K, Zhang J, Zhou L, Zhao JW, Wang BM. RIP3 mediates IL-33 production in gastric epithelial cells with intestinal metaplasia. Shijie Huaren Xiaohua Zazhi 2018; 26:964-971. [DOI: 10.11569/wcjd.v26.i16.964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM To explore the relationship between receptor-interacting protein kinase 3 (RIP3) signaling pathway and gastric intestinal metaplasia (GIM), and the regulatory effect of this signaling pathway on inflammatory cytokines.
METHODS Gastric tissues from healthy controls, patients with chronic non-atrophic gastritis, patients with GIM, and patients with dysplasia were collected to detect the expression of RIP3 in GIM by immunohistochemistry and RT-PCR. Human gastric epithelial cell line GES-1 was stimulated with sodium deoxycholate (DCA) to observe the relationship between CDX2, a key gene involved in intestinal metaplasia, and RIP3 signaling pathway. The regulation of inflammatory cytokines by RIP3 was also assessed.
RESULTS Compared with the control and chronic non-atrophic gastritis groups, the expression of RIP3 mRNA in the gastric mucosa of GIM patients and dysplasia patients was up-regulated, and the expression of RIP3 protein in the gastric epithelium of GIM patients and dysplasia patients was also up-regulated. In GES-1 cells stimulated with DCA, the expression of CDX2 protein and the RIP3 signaling pathway-associated proteins was increased in a concentration-dependent manner, accompanied by up-regulation of IL-33 expression. Necrostatin-1 (Nec-1), a specific inhibitor of the RIP3 signaling pathway, had no effect on CDX2 expression, but significantly down-regulated the expression of RIP3 and IL-33.
CONCLUSION RIP3 has no effect on the occurrence of GIM, but it may affect GIM progression by regulating the expression of IL-33 in gastric epithelial cells with intestinal metaplasia, suggesting that it may be a potential therapeutic target for preventing GIM progression.
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Affiliation(s)
- Meng-Jing Liu
- Department of Gastroenterology, General Hospital of Tianjin Medical University, Tianjin 300052, China
| | - Kui Jiang
- Department of Gastroenterology, General Hospital of Tianjin Medical University, Tianjin 300052, China
| | - Jun Zhang
- Department of Gastroenterology, General Hospital of Tianjin Medical University, Tianjin 300052, China
| | - Lu Zhou
- Department of Gastroenterology, General Hospital of Tianjin Medical University, Tianjin 300052, China
| | - Jing-Wen Zhao
- Department of Gastroenterology, General Hospital of Tianjin Medical University, Tianjin 300052, China
| | - Bang-Mao Wang
- Department of Gastroenterology, General Hospital of Tianjin Medical University, Tianjin 300052, China
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Wang F, Liu TS, Yuan X, Gu K, Yuan Y, Deng Y, Xu JM, Bai YX, Wang Y, Liao W, Zhang HL, Bi F, Wang BM, Zhuang Z, Luo H, Xu RH. Trastuzumab plus docetaxel and capecitabine for first-line treatment of Her2-positive advanced gastric cancer: A phase II, multi-center, open-label, single-arm study. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.4045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- Feng Wang
- Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Tian Shu Liu
- Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xianglin Yuan
- Tongji Hospital Tongji Medical College Huazhong UN, Wuhan, China
| | - Kangsheng Gu
- First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Ying Yuan
- Department of Medical Oncology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | | | - Jian-Ming Xu
- Cancer Center, 307 Hospital, Academy of Military Medical Science, Beijing, China
| | - Yu-Xian Bai
- Harbin Medical University Cancer Hospital, Department of Medical Oncology, Harbin, China
| | - Ying Wang
- Shengjing Hospital, China Medical University, Shenyang, China
| | - Wangjun Liao
- Department of Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - He-Long Zhang
- Department of Oncology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Feng Bi
- West China Hospital Sichuan University, Chengdu, China
| | - Bang-Mao Wang
- Tianjin Medical University General Hospital, Tianjin, China
| | - Zhixiang Zhuang
- The Second Hospital Affiliated to Soochow University, Suzhou, China
| | - Huiyan Luo
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Rui-hua Xu
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
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Khan S, Zhu LP, Zhang Y, Chen X, Wang BM. Laterally spreading tumour of the distal stomach: a case report. BMC Cancer 2018; 18:502. [PMID: 29716579 PMCID: PMC5930566 DOI: 10.1186/s12885-018-4425-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 04/23/2018] [Indexed: 11/19/2022] Open
Abstract
Background Laterally spreading tumours (LSTs) are superficial neoplasms that usually extend laterally along the intra-luminal wall of the gastrointestinal tract. Recently, the incidence of LSTs in the colorectal mucosa has greatly increased. However, LSTs in the stomach are exceedingly rare and have never been previously reported. Case presentation Here, we report a 69-year-old male with epigastric pain and a gastric LST 6 cm in diameter located in the distal stomach and grossly extended into the duodenal bulb. The stomach lesion was initially diagnosed as high-grade intraepithelial neoplasia, while the duodenal lesion was diagnosed as a tubulovillous adenoma. A therapeutic strategy of endoscopic submucosal dissection and distal gastrectomy was applied. The surgeries and postoperative course were uneventful, and the patient remained asymptomatic 1 year after surgery. Conclusions This is a clinically significant case, as it provides detailed information regarding laterally spreading early gastric cancer and emphasizes the diagnostic and therapeutic approaches for early gastric cancerous lesions.
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Affiliation(s)
- Samiullah Khan
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, 154 Anshan Road Heping District, 300052, Tianjin, People's Republic of China
| | - Lan-Ping Zhu
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, 154 Anshan Road Heping District, 300052, Tianjin, People's Republic of China
| | - Yujie Zhang
- Department of Pathology, Tianjin Medical University General Hospital, Tianjin, People's Republic of China
| | - Xin Chen
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, 154 Anshan Road Heping District, 300052, Tianjin, People's Republic of China.
| | - Bang-Mao Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, 154 Anshan Road Heping District, 300052, Tianjin, People's Republic of China.
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Zhou Z, Jing Y, Ran Y, Zhao J, Zhou L, Wang BM. [Role of Rac1 signaling pathway of azathioprine and peptidoglycan in the regulation of monocyte-macrophage apoptosis in Crohn's disease]. Zhonghua Nei Ke Za Zhi 2018; 57:279-284. [PMID: 29614587 DOI: 10.3760/cma.j.issn.0578-1426.2018.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To evaluate the changes of macrophages and expression of Rac1 in the inflammatory site of Crohn's disease, and to investigate the effects of 6-thioguanine (6-TG) and peptidoglycan on apoptosis of human peripheral blood monocyte-macrophage by regulating Rac1 signaling pathway. Methods: Ten patients with Crohn's disease and eight healthy controls diagnosed were enrolled at Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital from January 2013 to January 2014. The number of macrophages, apoptosis and expression of Rac1 in the inflammation sites and non-inflammation sites of intestinal mucosa were detected in both patients and controls. Peripheral blood mononuclear cells (PBMCs) were sorted by CD14 immunomagnetic beads. The apoptosis of monocytes, expression of Rac1 and related apoptosis signaling molecules were detected in patients treated with peptidoglycan, 6-TG and Rac1 inhibitor NSC23766 and another 15 healthy donors. Results: The number of macrophages and apoptotic cells significantly increased in the inflammatory group of Crohn's disease patients compared with the non-inflammatory group. The expression of PAK1, downstream molecular of Rac1 signaling pathway of macrophages was also significantly higher in the inflammatory group of Crohn's disease patients than that in healthy controls and non-inflammatory group. Compared with control group, anti-apoptotic signals (NF-κB, Bcl-xL and STAT-3) in PBMCs increased in the peptidoglycan group, while slightly decreased in 6-TG group. 6-TG and NSC23766 significantly promoted peptidoglycan-related anti-apoptosis [peptidoglycan group (8.6±3.7)%, peptidoglycan+ 6-TG group (42.0±2.7)%, peptidoglycan+ NSC23766 group (58.5±6.9)%, P<0.05]. Conclusions: Peptidoglycan plays a role in the pathogenesis of Crohn's disease by recruiting macrophages. However, 6-TG inhibits peptidoglycan-induced activation of Rac1 signaling pathway leading to macrophage apoptosis.
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Affiliation(s)
| | | | | | | | | | - B M Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
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Cao YN, Feng LJ, Liu YY, Jiang K, Zhang MJ, Gu YX, Wang BM, Gao J, Wang ZL, Wang YM. Effect of Lactobacillus rhamnosus GG supernatant on serotonin transporter expression in rats with post-infectious irritable bowel syndrome. World J Gastroenterol 2018; 24:338-350. [PMID: 29391756 PMCID: PMC5776395 DOI: 10.3748/wjg.v24.i3.338] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 12/06/2017] [Accepted: 12/12/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To evaluate the effect of Lactobacillus rhamnosus GG supernatant (LGG-s) on the expression of serotonin transporter (SERT) in rats with post-infectious irritable bowel syndrome (PI-IBS).
METHODS Campylobacter jejuni 81-176 (1010 CFU/mL) was used to induce intestinal infection to develop a PI-IBS model. After evaluation of the post-infectious phase by biochemical tests, DNA agarose gel electrophoresis, abdominal withdrawal reflex (AWR) test, and the intestinal motility test, four PI-IBS groups received different concentrations of LGG-s for 4 wk. The treatments were maintained for 1.0, 2.0, 3.0 or 4.0 wk during the experiment, and the colons and brains were removed for later use each week. SERT mRNA and protein levels were detected by real-time PCR and Western blot, respectively.
RESULTS The levels of SERT mRNA and protein in intestinal tissue were higher in rats treated with LGG-s than in control rats and PI-IBS rats gavaged with PBS during the whole study. Undiluted LGG-s up-regulated SERT mRNA level by 2.67 times compared with the control group by week 2, and SERT mRNA expression kept increasing later. Double-diluted LGG-s was similar to undiluted-LGG-s, resulting in high levels of SERT mRNA. Triple-diluted LGG-s up-regulated SERT mRNA expression level by 6.9-times compared with the control group, but SERT mRNA expression decreased rapidly at the end of the second week. At the first week, SERT protein levels were basically comparable in rats treated with undiluted LGG-s, double-diluted LGG-s, and triple-diluted LGG-s, which were higher than those in the control group and PBS-treated PI-IBS group. SERT protein levels in the intestine were also comparable in rats treated with undiluted LGG-s, double-diluted LGG-s, and triple-diluted LGG-s by the second and third weeks. SERT mRNA and protein levels in the brain had no statistical difference in the groups during the experiment.
CONCLUSION LGG-s can up-regulate SERT mRNA and protein levels in intestinal tissue but has no influence in brain tissue in rats with PI-IBS.
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Affiliation(s)
- Ya-Nan Cao
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Li-Juan Feng
- Department of Functional Division, Xingtai People’s Hospital, Xingtai 054031, Hebei Province, China
| | - Yuan-Yuan Liu
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Kui Jiang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Mao-Jun Zhang
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Yi-Xin Gu
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Bang-Mao Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Jia Gao
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Ze-Lan Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Yu-Ming Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China
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Cao YN, Feng LJ, Wang BM, Jiang K, Li S, Xu X, Wang WQ, Zhao JW, Wang YM. Lactobacillus acidophilus and Bifidobacterium longum supernatants upregulate the serotonin transporter expression in intestinal epithelial cells. Saudi J Gastroenterol 2018; 24:59-66. [PMID: 29451186 PMCID: PMC5848327 DOI: 10.4103/sjg.sjg_333_17] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND/AIMS Probiotics play a role in relieving irritable bowel syndrome (IBS); however, the underlying mechanism is yet unclear. The aim of the study was to investigate the effects of the supernatants of Lactobacillus acidophilus and Bifidobacterium longum on the expression of serotonin transporter (SERT) messenger ribonucleic acid (mRNA) and protein. MATERIALS AND METHODS HT-29 and Caco-2 cells were treated with different concentrations of L. acidophilus and B. longum supernatants for 12 h and 24 h, respectively. SERT mRNA and proteins levels were detected by real-time polymerase chain reaction (real-time PCR) and Western-blotting. RESULTS The mRNA levels of SERT in HT-29 and Caco-2 cells treated with different concentrations of L. acidophilus or B. longum supernatants for 12 h and 24 h, each, were higher than that in the control groups. In addition, the expression of the protein in both cells was also upregulated, which was approximately similar to that of the corresponding mRNA. CONCLUSIONS L. acidophilus and B. longum supernatants can upregulate SERT mRNA and protein levels in intestinal epithelial cells.
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Affiliation(s)
- Ya-Nan Cao
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
| | - Li-Juan Feng
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
| | - Bang-Mao Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
| | - Kui Jiang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
| | - Shu Li
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xin Xu
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
| | - Wei-Qiang Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jing-Wen Zhao
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yu-Ming Wang
- Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China,Address for correspondence: Dr. Yu-Ming Wang, Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China. E-mail:
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Wang Y, Li YN, Zhang J, Wang BM, Zhou L. [Advances in clinical differentiation between immunological and drug-induced liver injury]. Zhonghua Gan Zang Bing Za Zhi 2017; 25:717-720. [PMID: 29108197 DOI: 10.3760/cma.j.issn.1007-3418.2017.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The differentiation between autoimmune hepatitis (AIH) and drug-induced liver injury (DILI) is a difficult task in clinical practice. Some AIH patients had a medication history before disease onset, and some DILI patients may have positive serum antibody. In addition, these two groups of patients have similar clinical symptoms, serological examination results, and liver histopathology, which lead to the difficulties in differentiation. However, correct differential diagnosis is of great significance in making clinical treatment decisions and preventing liver cirrhosis. Therefore, it is necessary to investigate the association between immunological and drug-induced liver injury from the perspectives of pathogenesis, similarities and differences in clinical features, serological examination results, and histological changes, prospects of new biomarkers in differentiation, and the significance of hormone therapy and clinical follow-up in differential diagnosis and treatment, in order to provide a reference for clinical decision-making and research in future.
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Affiliation(s)
- Y Wang
- Department of Gastroenterology and Hepotology, Tianjin Medical University General Hospital, Tianjin 300052, China
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Wang BM, Yao SZ. [Enhancing the quality of screening colonoscopy to improve the early detection for colorectal cancer]. Zhonghua Nei Ke Za Zhi 2017; 56:564-566. [PMID: 28789487 DOI: 10.3760/cma.j.issn.0578-1426.2017.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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