Objective To screen and identify serum protein biomarkers for the differential diagnosis between ischemic colitis (IC) and ulcerative colitis (UC) by tandem mass tag (TMT) combined with liquid chromatography/tandem mass spectrometry (LC-MS/MS). Methods From January 2018 to January 2019, at the First Affiliated Hospital of School of Medicine of Zhejiang University, patients with UC or IC, and health controls, each 10 cases, were enrolled into UC group, IC group and normal control (NC) group, respectively. Fasting serum samples of all the subjects were collected. After removal of high-abundance protein, followed by proteolysis, peptide labeling and fractionating, the samples were then processed by mass spectrometry. The protein with TMT data of three groups was obtained and protein with TMT value 0 were removed. Heat map of protein was constructed. The differential protein was defined as the protein fold change over 1.5 or less than 0.67. The Reactome database was used to cluster the pathways of differential proteins among groups. Statistical methods included t test, hypergeometry test and corrected by BH multiple test. Results A total of 357 serum proteins were identified by proteomic profiling. There were 27 differential proteins between the IC group and the NC group, including six up-regulated proteins and 21 down-regulated proteins. There were 228 differential proteins between the UC group and the NC group, including 75 up-regulated proteins and 153 down-regulated proteins. There were 49 differential proteins between UC group and IC group, including 22 up-regulated proteins and 27 down-regulated proteins. In the comparison of differential proteins between the NC group, IC group and UC group, only the expression of fibrin 3 was statistically significant (the fold change between UC and NC, between UC and IC, between IC and NC were 0.24, 0.46 and 0.53, respectively; t=-5.089, -7.298 and -3.919, all P<0.01). The results of pathway cluster analysis showed that in the comparison of differential proteins between IC group and NC group, only the platelet degranulation pathway was enriched, and 10 proteins were involved in this pathway (P<0.01). In the comparison of differential proteins between UC group and NC group, there were 58 pathways enriched, of which 38 proteins were involved in the platelet degranulation pathway, 16 proteins were involved in the initial complement trigger pathway, 13 proteins were involved in the complement cascade pathway, and 11 proteins were involved in antibody-mediated complement activation pathway (all P<0.01). In the comparison of differential proteins between UC group and IC group, three different pathways were obtained. Among them, nine proteins were involved in the platelet degranulation pathway, seven proteins were involved in the initial complement trigger pathway, and five proteins were involved in the complement cascade pathway (all P<0.01). Conclusions The difference in serum proteome between I
{"title":"Screening of serological markers for differential diagnosis ischemic colitis and ulcerative colitis by proteomic techniques","authors":"Longgui Ning, Jinghua Yu, Guo-dong Shan, Zeyu Sun, Wen-guo Chen, Fenming Zhang, F. Hu, Hong-tan Chen, Guoqiang Xu","doi":"10.3760/CMA.J.ISSN.0254-1432.2019.12.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2019.12.009","url":null,"abstract":"Objective \u0000To screen and identify serum protein biomarkers for the differential diagnosis between ischemic colitis (IC) and ulcerative colitis (UC) by tandem mass tag (TMT) combined with liquid chromatography/tandem mass spectrometry (LC-MS/MS). \u0000 \u0000 \u0000Methods \u0000From January 2018 to January 2019, at the First Affiliated Hospital of School of Medicine of Zhejiang University, patients with UC or IC, and health controls, each 10 cases, were enrolled into UC group, IC group and normal control (NC) group, respectively. Fasting serum samples of all the subjects were collected. After removal of high-abundance protein, followed by proteolysis, peptide labeling and fractionating, the samples were then processed by mass spectrometry. The protein with TMT data of three groups was obtained and protein with TMT value 0 were removed. Heat map of protein was constructed. The differential protein was defined as the protein fold change over 1.5 or less than 0.67. The Reactome database was used to cluster the pathways of differential proteins among groups. Statistical methods included t test, hypergeometry test and corrected by BH multiple test. \u0000 \u0000 \u0000Results \u0000A total of 357 serum proteins were identified by proteomic profiling. There were 27 differential proteins between the IC group and the NC group, including six up-regulated proteins and 21 down-regulated proteins. There were 228 differential proteins between the UC group and the NC group, including 75 up-regulated proteins and 153 down-regulated proteins. There were 49 differential proteins between UC group and IC group, including 22 up-regulated proteins and 27 down-regulated proteins. In the comparison of differential proteins between the NC group, IC group and UC group, only the expression of fibrin 3 was statistically significant (the fold change between UC and NC, between UC and IC, between IC and NC were 0.24, 0.46 and 0.53, respectively; t=-5.089, -7.298 and -3.919, all P<0.01). The results of pathway cluster analysis showed that in the comparison of differential proteins between IC group and NC group, only the platelet degranulation pathway was enriched, and 10 proteins were involved in this pathway (P<0.01). In the comparison of differential proteins between UC group and NC group, there were 58 pathways enriched, of which 38 proteins were involved in the platelet degranulation pathway, 16 proteins were involved in the initial complement trigger pathway, 13 proteins were involved in the complement cascade pathway, and 11 proteins were involved in antibody-mediated complement activation pathway (all P<0.01). In the comparison of differential proteins between UC group and IC group, three different pathways were obtained. Among them, nine proteins were involved in the platelet degranulation pathway, seven proteins were involved in the initial complement trigger pathway, and five proteins were involved in the complement cascade pathway (all P<0.01). \u0000 \u0000 \u0000Conclusions \u0000The difference in serum proteome between I","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"91 1","pages":"840-845"},"PeriodicalIF":0.0,"publicationDate":"2019-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82301687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-15DOI: 10.3760/CMA.J.ISSN.0254-1432.2019.12.007
Xiao-cong Zhang, Jinhua Yang, Qi-long Li, Zenghao Xu, Shu-juan Lin, Jiayu Li, S. Qian, L. You, M. Jin, Kun Chen
Objective To explore the correlation between obesity and the risk of colorectal adenoma, so as to provide theoretic evidence for the intervention of the high-risk population for colorectal cancer. Methods Based on the Screen Project of Early Diagnosis and Treatment of Colorectal Cancer in Jiashan County, from August 2012 to March 2018, the results of colonoscopy and body measurement information of the high-risk population for colorectal cancer were collected. According to the results of colonoscopy, 3 895 patients with colorectal adenoma and 11 232 healthy controls were enrolled. Multivariate logistic regression was used to analyze the correlation between overweight (body mass index (BMI) 24.0 to 27.9 kg/m2), obesity (BMI≥28.0 kg/m2) and the risk of colorectal adenoma. Results After adjusting for gender and age, compared with that of individuals with normal weight (BMI 18.5 to 23.9 kg/m2), the risk of colorectal adenoma of obese patients increased by 36% (odds ratio (OR)=1.36, 95% confidence interval (CI) 1.18 to 1.56). After stratifing by gender, compared with that of individuals with normal weight, the risk of colorectal adenoma of obese males increased by 30% (OR=1.30, 95%CI 1.07 to 1.59), the risk of colorectal adenoma of overweight females and obese females increased by 15% (OR=1.15, 95%CI 1.01 to 1.31) and 40% (OR=1.40, 95%CI 1.14 to 1.71), respectively. After stratifing by age, compared with that of individuals with normal weight, the risk of colorectal adenoma of obese patients aged between 40 and 59 years increased by 31% (OR=1.31, 95%CI 1.07 to 1.61), and the risk of colorectal adenoma of overweight and obese patients aged between 60 and 74 years increased by 13% (OR=1.13, 95%CI 1.01 to 1.27) and 39% (OR=1.39, 95%CI 1.15 to 1.70), respectively. The results of subgroup analysis according to pathological types indicated that the risk of non-advanced adenoma and advanced adenoma of obese patients increased by 35% (OR=1.35, 95%CI 1.16 to 1.57) and 39% (OR=1.39, 95%CI 1.06 to 1.83), respectively. Conclusions Obesity is correlated with colorectal adenoma, which is more significant in women, individuals aged between 60 and 74 years and advanced adenoma. The intervention of high-risk population for colorectal cancer should include body mass control. Key words: Colorectal adenoma; Body mass index; Obesity; Correlation
{"title":"Correlation between obesity and colorectal adenoma","authors":"Xiao-cong Zhang, Jinhua Yang, Qi-long Li, Zenghao Xu, Shu-juan Lin, Jiayu Li, S. Qian, L. You, M. Jin, Kun Chen","doi":"10.3760/CMA.J.ISSN.0254-1432.2019.12.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2019.12.007","url":null,"abstract":"Objective \u0000To explore the correlation between obesity and the risk of colorectal adenoma, so as to provide theoretic evidence for the intervention of the high-risk population for colorectal cancer. \u0000 \u0000 \u0000Methods \u0000Based on the Screen Project of Early Diagnosis and Treatment of Colorectal Cancer in Jiashan County, from August 2012 to March 2018, the results of colonoscopy and body measurement information of the high-risk population for colorectal cancer were collected. According to the results of colonoscopy, 3 895 patients with colorectal adenoma and 11 232 healthy controls were enrolled. Multivariate logistic regression was used to analyze the correlation between overweight (body mass index (BMI) 24.0 to 27.9 kg/m2), obesity (BMI≥28.0 kg/m2) and the risk of colorectal adenoma. \u0000 \u0000 \u0000Results \u0000After adjusting for gender and age, compared with that of individuals with normal weight (BMI 18.5 to 23.9 kg/m2), the risk of colorectal adenoma of obese patients increased by 36% (odds ratio (OR)=1.36, 95% confidence interval (CI) 1.18 to 1.56). After stratifing by gender, compared with that of individuals with normal weight, the risk of colorectal adenoma of obese males increased by 30% (OR=1.30, 95%CI 1.07 to 1.59), the risk of colorectal adenoma of overweight females and obese females increased by 15% (OR=1.15, 95%CI 1.01 to 1.31) and 40% (OR=1.40, 95%CI 1.14 to 1.71), respectively. After stratifing by age, compared with that of individuals with normal weight, the risk of colorectal adenoma of obese patients aged between 40 and 59 years increased by 31% (OR=1.31, 95%CI 1.07 to 1.61), and the risk of colorectal adenoma of overweight and obese patients aged between 60 and 74 years increased by 13% (OR=1.13, 95%CI 1.01 to 1.27) and 39% (OR=1.39, 95%CI 1.15 to 1.70), respectively. The results of subgroup analysis according to pathological types indicated that the risk of non-advanced adenoma and advanced adenoma of obese patients increased by 35% (OR=1.35, 95%CI 1.16 to 1.57) and 39% (OR=1.39, 95%CI 1.06 to 1.83), respectively. \u0000 \u0000 \u0000Conclusions \u0000Obesity is correlated with colorectal adenoma, which is more significant in women, individuals aged between 60 and 74 years and advanced adenoma. The intervention of high-risk population for colorectal cancer should include body mass control. \u0000 \u0000 \u0000Key words: \u0000Colorectal adenoma; Body mass index; Obesity; Correlation","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"18 1","pages":"828-833"},"PeriodicalIF":0.0,"publicationDate":"2019-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86296478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-15DOI: 10.3760/CMA.J.ISSN.0254-1432.2019.12.004
Mengdi Li, Zi-Juan Wang, Songbai Zheng
Objective To observe the efficacy and safety of rifabutin and furazolidone included triple regimen and minocycline plus furazolidone included quadruple regimen in eradicating refractory H. pylori infection. Methods A total of 146 patients who failed (≥two times) to treat H. pylori with standard anti-H.pylori therapy were selected and divided into esomeprazole, rifabutin and furazolidone treatment group (ERF group, n=74) and esomeprazole, minocycline, furazolidone and bismuth potassium citrate group (EMFB group, n=72). The duration of treatment were both 10 days. Liver and renal functions were examined within three days after therapy. 13C or 14C-urease breath test was performed one month after the medication withdrawal. The patients were followed up once every two weeks during the treatment period. The medication and adverse reactions were recorded in detail. The compliance and rates of adverse events in two groups were compared and analyzed. The eradication rates of the two groups and subgroups were compared by intention-to-treat (ITT) and per-protocol (PP) analyses. The cost-effectiveness of the two groups was evaluated with cost effectiveness analysis (CEA). The cost/effectiveness (C/E) ratio was calculated by PP. Chi-square test and t test were used for statistical analysis. Results There was no significant difference in complicance between ERF group and EMFB group (90.5% vs. 90.3%, P>0.05). There was no significant difference in H. pylori eradication rate between ERF group and EMFB group analyzed by ITT (82.4% vs. 84.7%, P>0.05). Analyzed by PP, there were no significant differences in H. pylori eradication rate between ERF group and EMFB group (91.0% vs. 93.8%), between male subgroup and female subgroup of ERF group (87.9% vs. 94.1%), between subgroup with age less than 60 years and subgroup with age over 60 years of ERF group (89.7% vs. 92.9%), between male subgroup and female subgroup of EMFB group (89.7% vs. 97.2%) and between subgroup with age less than 60 years and subgroup with age over 60 years of EMFB group (93.6% vs. 94.4%) (all P>0.05). There were no statistically significant differences in the rate of adverse events between ERF group and EMFB group (20.3% vs. 22.2%), between male subgroup and female subgroup of ERF group (25.0% vs. 15.8%), between subgroup with age less than 60 years and subgroup with age over 60 years of ERF group (26.2% vs. 12.5%), between male subgroup and female subgroup of EMFB group (19.4% vs. 24.4%) and between subgroup with age less than 60 years and subgroup with age over 60 years of EMFB group (24.5% vs. 15.8%) (all P>0.05). Fixed daily cost, total cost and C/E of ERF group was RMB 59.0 yuan, RMB 590.5 yuan and 648.9, respectively; and the eradication rate was 91.0%(61/67). Fixed daily cost, total cost and C/E of EMFB group was RMB 32.9 yuan, RMB 329.1 yuan and 350.9, respectively; and the eradication rate was 93.8%(61/65). Conclusions Rifabutin and furazolidone included triple regimen
目的观察利福布汀联合呋喃唑酮三联用药和米诺环素联合呋喃唑酮四联用药根除难治性幽门螺杆菌感染的疗效和安全性。方法采用标准抗幽门螺杆菌治疗幽门螺杆菌失败(≥2次)患者146例。选择幽门螺杆菌治疗方法，分为埃索美拉唑、利福布汀、呋喃唑酮治疗组(ERF组，n=74)和埃索美拉唑、米诺环素、呋喃唑酮、柠檬酸铋钾治疗组(EMFB组，n=72)。治疗时间均为10天。治疗后3天内检查肝肾功能。停药1个月后进行13C或14c脲酶呼气试验。治疗期间每两周随访1次。详细记录用药情况及不良反应。比较分析两组患者的治疗依从性和不良事件发生率。通过意向治疗(ITT)和每个方案(PP)分析比较两组和亚组的根除率。采用成本-效果分析(cost-effectiveness analysis, CEA)评价两组患者的成本-效果。成本/效果(C/E)比值采用PP计算，采用卡方检验和t检验进行统计分析。结果ERF组与EMFB组患者的依从性比较差异无统计学意义(90.5% vs 90.3%， P>0.05)。ITT分析ERF组与EMFB组幽门螺杆菌根除率差异无统计学意义(82.4% vs 84.7%， P>0.05)。经PP分析，ERF组与EMFB组幽门螺杆菌根除率(91.0%比93.8%)、ERF组男性亚组与女性亚组(87.9%比94.1%)、ERF组年龄小于60岁亚组与年龄大于60岁亚组(89.7%比92.9%)无显著差异。EMFB组男性亚组与女性亚组之间(89.7% vs 97.2%)、60岁以下亚组与60岁以上亚组之间(93.6% vs 94.4%)(均P>0.05)。ERF组与EMFB组不良事件发生率(20.3% vs. 22.2%)、ERF组男性亚组与女性亚组不良事件发生率(25.0% vs. 15.8%)、ERF组60岁以下亚组与60岁以上亚组不良事件发生率(26.2% vs. 12.5%)差异均无统计学意义。EMFB组男性亚组与女性亚组间差异(19.4%比24.4%)，60岁以下亚组与60岁以上亚组间差异(24.5%比15.8%)(均P>0.05)。ERF组固定日成本59.0元，总成本590.5元，C/E为648.9元;根除率为91.0%(61/67)。EMFB组固定日成本为32.9元，总成本为329.1元，成本成本比为350.9元;根除率为93.8%(61/65)。结论利福布汀联合呋喃唑酮三联用药方案和米诺环素联合呋喃唑酮四联用药方案对根除难治性幽门螺杆菌感染均具有良好的疗效、安全性和依从性，且后者较好。关键词:瑞法布汀;呋喃唑酮;二甲胺四环素;难治性幽门螺杆菌感染;功效
{"title":"Efficacy and safety of rifabutin and furazolidone included triple regimen and minocycline plus furazolidone included quadruple regimen in eradicating refractory Helicobacter pylori infection","authors":"Mengdi Li, Zi-Juan Wang, Songbai Zheng","doi":"10.3760/CMA.J.ISSN.0254-1432.2019.12.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2019.12.004","url":null,"abstract":"Objective \u0000To observe the efficacy and safety of rifabutin and furazolidone included triple regimen and minocycline plus furazolidone included quadruple regimen in eradicating refractory H. pylori infection. \u0000 \u0000 \u0000Methods \u0000A total of 146 patients who failed (≥two times) to treat H. pylori with standard anti-H.pylori therapy were selected and divided into esomeprazole, rifabutin and furazolidone treatment group (ERF group, n=74) and esomeprazole, minocycline, furazolidone and bismuth potassium citrate group (EMFB group, n=72). The duration of treatment were both 10 days. Liver and renal functions were examined within three days after therapy. 13C or 14C-urease breath test was performed one month after the medication withdrawal. The patients were followed up once every two weeks during the treatment period. The medication and adverse reactions were recorded in detail. The compliance and rates of adverse events in two groups were compared and analyzed. The eradication rates of the two groups and subgroups were compared by intention-to-treat (ITT) and per-protocol (PP) analyses. The cost-effectiveness of the two groups was evaluated with cost effectiveness analysis (CEA). The cost/effectiveness (C/E) ratio was calculated by PP. Chi-square test and t test were used for statistical analysis. \u0000 \u0000 \u0000Results \u0000There was no significant difference in complicance between ERF group and EMFB group (90.5% vs. 90.3%, P>0.05). There was no significant difference in H. pylori eradication rate between ERF group and EMFB group analyzed by ITT (82.4% vs. 84.7%, P>0.05). Analyzed by PP, there were no significant differences in H. pylori eradication rate between ERF group and EMFB group (91.0% vs. 93.8%), between male subgroup and female subgroup of ERF group (87.9% vs. 94.1%), between subgroup with age less than 60 years and subgroup with age over 60 years of ERF group (89.7% vs. 92.9%), between male subgroup and female subgroup of EMFB group (89.7% vs. 97.2%) and between subgroup with age less than 60 years and subgroup with age over 60 years of EMFB group (93.6% vs. 94.4%) (all P>0.05). There were no statistically significant differences in the rate of adverse events between ERF group and EMFB group (20.3% vs. 22.2%), between male subgroup and female subgroup of ERF group (25.0% vs. 15.8%), between subgroup with age less than 60 years and subgroup with age over 60 years of ERF group (26.2% vs. 12.5%), between male subgroup and female subgroup of EMFB group (19.4% vs. 24.4%) and between subgroup with age less than 60 years and subgroup with age over 60 years of EMFB group (24.5% vs. 15.8%) (all P>0.05). Fixed daily cost, total cost and C/E of ERF group was RMB 59.0 yuan, RMB 590.5 yuan and 648.9, respectively; and the eradication rate was 91.0%(61/67). Fixed daily cost, total cost and C/E of EMFB group was RMB 32.9 yuan, RMB 329.1 yuan and 350.9, respectively; and the eradication rate was 93.8%(61/65). \u0000 \u0000 \u0000Conclusions \u0000Rifabutin and furazolidone included triple regimen","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"73 1","pages":"812-816"},"PeriodicalIF":0.0,"publicationDate":"2019-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86399866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-15DOI: 10.3760/CMA.J.ISSN.0254-1432.2019.12.010
Fang-chun Chen
Objective To investigate the characteristics of pathogens and risk factors of severe acute pancreatitis (SAP) complicated with infection, so as to provide reference for clinical diagnosis and treatment. Methods From February 2011 to January 2018, at the First Affiliated Hospital of Chongqing Medical University, 438 patients with SAP were selected. The samples including ascites, sputum and blood were collected and cultured. Distribution and drug resistance of pathogens were analyzed. Chi-square test and logistic regression analysis were used for analyzing the risk factors related to SAP complicated with infection. Results The total infection rate of SAP was 49.09% (215/438), of which the bacterial infection rate was 44.29% (194/438) and the fungal infection rate was 22.60% (99/438). A total of 625 pathogens were cultured, including 333 (53.28%) strains of Gram-negative bacteria, 171 (27.36%) strains of Gram-positive bacteria and 121 (19.36%) strains of fungi. Gram-negative bacteria were extremely resistant to β-lactams antibiotics, among them Acinetobacter baumannii was the highest (63.93% to 100.00%), and resistance rate to enzyme inhibitors was slightly lower (11.54% to 48.15%). The resistance rates of Gram-positive bacteria to penicillin and erythromycin were both high, which were 92.86% to 100.00% and 81.25% to 95.00%, respectively, and Gram-positive bacteria resistant to vancomycin, linezolid, and tigecycline were not found. The resistance rate of fungi was generally low (0 to 28.57%). The results of logistic regression analysis showed that multiple organ dysfunction syndrome (MODS) (odds ratio (OR)=2.031, 95% confidence interval (CI)1.230 to 3.356), acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) score≥11 (OR=1.780, 95%CI 1.129 to 2.806), fasting time more than three weeks (OR=3.437, 95%CI 2.119 to 5.574), mechanical ventilation (OR=2.697, 95%CI 1.643 to 4.427) and surgery (OR=3.464, 95%CI 1.806 to 6.643) were the independent risk factors of SAP complicated with infection (all P<0.05). The results of stratified analysis indicated that MODS, fasting time more than three weeks, mechanical ventilation and surgery were the independent risk factors of more locus infection (all P<0.05). Conclusions The infection rate of SAP is high and the risk factors are complex. Early prevention, improvement of the pathogen detection and guiding the reasonable use of antibiotics are necessary. For patients with invasive procedures and treatment, aseptic awareness should be strengthen to prevent iatrogenic infection. Key words: Infection; Drug resistance; Risk factors; Severe acute pancreatitis
{"title":"Analysis of pathogens and risk factors of severe acute pancreatitis complicated with infection","authors":"Fang-chun Chen","doi":"10.3760/CMA.J.ISSN.0254-1432.2019.12.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2019.12.010","url":null,"abstract":"Objective \u0000To investigate the characteristics of pathogens and risk factors of severe acute pancreatitis (SAP) complicated with infection, so as to provide reference for clinical diagnosis and treatment. \u0000 \u0000 \u0000Methods \u0000From February 2011 to January 2018, at the First Affiliated Hospital of Chongqing Medical University, 438 patients with SAP were selected. The samples including ascites, sputum and blood were collected and cultured. Distribution and drug resistance of pathogens were analyzed. Chi-square test and logistic regression analysis were used for analyzing the risk factors related to SAP complicated with infection. \u0000 \u0000 \u0000Results \u0000The total infection rate of SAP was 49.09% (215/438), of which the bacterial infection rate was 44.29% (194/438) and the fungal infection rate was 22.60% (99/438). A total of 625 pathogens were cultured, including 333 (53.28%) strains of Gram-negative bacteria, 171 (27.36%) strains of Gram-positive bacteria and 121 (19.36%) strains of fungi. Gram-negative bacteria were extremely resistant to β-lactams antibiotics, among them Acinetobacter baumannii was the highest (63.93% to 100.00%), and resistance rate to enzyme inhibitors was slightly lower (11.54% to 48.15%). The resistance rates of Gram-positive bacteria to penicillin and erythromycin were both high, which were 92.86% to 100.00% and 81.25% to 95.00%, respectively, and Gram-positive bacteria resistant to vancomycin, linezolid, and tigecycline were not found. The resistance rate of fungi was generally low (0 to 28.57%). The results of logistic regression analysis showed that multiple organ dysfunction syndrome (MODS) (odds ratio (OR)=2.031, 95% confidence interval (CI)1.230 to 3.356), acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) score≥11 (OR=1.780, 95%CI 1.129 to 2.806), fasting time more than three weeks (OR=3.437, 95%CI 2.119 to 5.574), mechanical ventilation (OR=2.697, 95%CI 1.643 to 4.427) and surgery (OR=3.464, 95%CI 1.806 to 6.643) were the independent risk factors of SAP complicated with infection (all P<0.05). The results of stratified analysis indicated that MODS, fasting time more than three weeks, mechanical ventilation and surgery were the independent risk factors of more locus infection (all P<0.05). \u0000 \u0000 \u0000Conclusions \u0000The infection rate of SAP is high and the risk factors are complex. Early prevention, improvement of the pathogen detection and guiding the reasonable use of antibiotics are necessary. For patients with invasive procedures and treatment, aseptic awareness should be strengthen to prevent iatrogenic infection. \u0000 \u0000 \u0000Key words: \u0000Infection; Drug resistance; Risk factors; Severe acute pancreatitis","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"17 1","pages":"846-849"},"PeriodicalIF":0.0,"publicationDate":"2019-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78463828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-15DOI: 10.3760/CMA.J.ISSN.0254-1432.2019.12.011
Xiufang Zha, Shunfu Xu, Hong-xia Zhu, Xiaoxing Chen, Wenfang Cheng, Bin Xiao, Guosheng Chen, Jin-liang Ni
Objective To investigate the correlation between the diversity of biliary bacterial flora and the recurrence of common bile duct stones. Methods From September 2018 to March 2019, 48 patients underwent endoscopic retrograde cholangiopancreatography (ERCP) at the First Affiliated Hospital of Nanjing Medical University were enrolled and divided into primary choledocholithiasis (primary group, 38 patients) and recurrent choledocholithiasis group (recurrent group, 10 patients). The bile of the patients of the two groups was collected and analyzed with high-throughput sequencing of 16S rRNA. The Chao1 estimator indicated the richness of the biliary bacterial flora, and Shannon index and Simpson index demonstrated the diversity of biliary bacterial flora. The bacterial flora distribution was explored from different levels of phylum, class, order, family, genus and species. Chi-square test and t test were performed for statistical analysis. Results The Chao1 estimator of the primary group was higher than that of the recurrent group (419.413±118.704 vs. 396.000±70.483), and the difference was statistically significant (t=3.130, P=0.003). At the level of the phylum, the highest abundance of bacteria in the primary group was Firmicute (56.48%), the highest abundance of bacteria in the recurrent group was Proteobacteria (57.79%). The dominant bacteria of the recurrent group was Proteobacteria, which was inconsistent with that of the primary group, and there were significant differences in the distribution of Proteobacteria and Firmicute between two groups (χ2=0.962 and -2.619, both P<0.05). At the genus level, the abundance of Bacillus and Lactococcus of the recurrent group were both lower than those of the primary group (9.75% vs. 20.77%, 10.86% vs. 22.01%, respectively), and the differences were statistically significant (χ2=0.354 and 0.503, both P<0.05). The abundance of Morganella of the recurrent group was higher than that of the primary group (9.00% vs. 0.44%), and the difference was statistically significant (χ2=-2.025, P=0.049). At the species level, the abundance of Bacillus unclassified, Carnobacterium maltaromaticum and Bacillus circulans of the primary group were all higher than those of the recurrent group (17.78% vs. 8.84%, 2.39% vs. 1.11%, 2.59% vs. 0.74%, respectively), and the differences were all statistically significant (χ2=2.540, 2.643 and 2.515, all P<0.05). The abundance of Aeromonas veronii of recurrent group was higher than that of the primary group (2.04% vs. 0.01%), and the difference was statistically significant (χ2=-2.397, P=0.021). The bacteria that had significant effects in the primary group included Lactococcus (P=0.012), Lactobacillus (P=0.033) and Geobacillus (P=0.021), while in the recurrent group, which included Enterobacter (P=0.007), Aeromonadaceae (P=0.001), Actinomycetes (P=0.009), and Aeromonas (P=0.001). Conclusions There are differences in abundance and composition of biliary bacterial flora be
目的探讨胆道菌群多样性与胆总管结石复发的关系。方法选择2018年9月至2019年3月在南京医科大学第一附属医院行内镜逆行胆管造影(ERCP)的患者48例，分为原发性胆总管结石组(原发性组，38例)和复发性胆总管结石组(复发组，10例)。收集两组患者胆汁，采用16S rRNA高通量测序进行分析。Chao1估计值反映了胆道菌群的丰富度，Shannon指数和Simpson指数反映了胆道菌群的多样性。从门、纲、目、科、属、种等不同层次探讨了细菌区系分布。采用卡方检验和t检验进行统计学分析。结果首发组的Chao1估计值高于复发组(419.413±118.704比396.000±70.483)，差异有统计学意义(t=3.130, P=0.003)。在门水平上，原生组细菌丰度最高的是厚壁菌门(56.48%)，复发组细菌丰度最高的是变形菌门(57.79%)。复发组的优势菌群为变形菌门(Proteobacteria)，与初发组不一致，两组间Proteobacteria和Firmicute的分布差异有统计学意义(χ2=0.962、-2.619,P<0.05)。在属水平上，复发组Bacillus和Lactococcus的丰度均低于原发组(分别为9.75%∶20.77%、10.86%∶22.01%)，差异均有统计学意义(χ2=0.354、0.503,P<0.05)。复发组摩氏菌丰度高于原发组(9.00%比0.44%)，差异有统计学意义(χ2=-2.025, P=0.049)。在菌种水平上，原发组未分类芽孢杆菌、恶性肉杆菌和环状芽孢杆菌的丰度均高于复发组(分别为17.78%比8.84%、2.39%比1.11%、2.59%比0.74%)，差异均有统计学意义(χ2=2.540、2.643、2.515,P均<0.05)。复发组维氏气单胞菌丰度高于原发组(2.04%比0.01%)，差异有统计学意义(χ2=-2.397, P=0.021)。原发组有显著作用的细菌有乳球菌(P=0.012)、乳杆菌(P=0.033)、地杆菌(P=0.021)，复发组有肠杆菌(P=0.007)、气单胞菌科(P=0.001)、放线菌(P=0.009)、气单胞菌(P=0.001)。结论复发组与原发组胆道菌群的丰度和组成存在差异。某些菌群的改变是否与胆总管结石的复发有关，有待进一步研究。关键词:胆总管结石;胆总管结石复发;胆道植物;16 s rRNA
{"title":"Preliminary study on the correlation between diversity of biliary flora and recurrence of common bile duct stones","authors":"Xiufang Zha, Shunfu Xu, Hong-xia Zhu, Xiaoxing Chen, Wenfang Cheng, Bin Xiao, Guosheng Chen, Jin-liang Ni","doi":"10.3760/CMA.J.ISSN.0254-1432.2019.12.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2019.12.011","url":null,"abstract":"Objective \u0000To investigate the correlation between the diversity of biliary bacterial flora and the recurrence of common bile duct stones. \u0000 \u0000 \u0000Methods \u0000From September 2018 to March 2019, 48 patients underwent endoscopic retrograde cholangiopancreatography (ERCP) at the First Affiliated Hospital of Nanjing Medical University were enrolled and divided into primary choledocholithiasis (primary group, 38 patients) and recurrent choledocholithiasis group (recurrent group, 10 patients). The bile of the patients of the two groups was collected and analyzed with high-throughput sequencing of 16S rRNA. The Chao1 estimator indicated the richness of the biliary bacterial flora, and Shannon index and Simpson index demonstrated the diversity of biliary bacterial flora. The bacterial flora distribution was explored from different levels of phylum, class, order, family, genus and species. Chi-square test and t test were performed for statistical analysis. \u0000 \u0000 \u0000Results \u0000The Chao1 estimator of the primary group was higher than that of the recurrent group (419.413±118.704 vs. 396.000±70.483), and the difference was statistically significant (t=3.130, P=0.003). At the level of the phylum, the highest abundance of bacteria in the primary group was Firmicute (56.48%), the highest abundance of bacteria in the recurrent group was Proteobacteria (57.79%). The dominant bacteria of the recurrent group was Proteobacteria, which was inconsistent with that of the primary group, and there were significant differences in the distribution of Proteobacteria and Firmicute between two groups (χ2=0.962 and -2.619, both P<0.05). At the genus level, the abundance of Bacillus and Lactococcus of the recurrent group were both lower than those of the primary group (9.75% vs. 20.77%, 10.86% vs. 22.01%, respectively), and the differences were statistically significant (χ2=0.354 and 0.503, both P<0.05). The abundance of Morganella of the recurrent group was higher than that of the primary group (9.00% vs. 0.44%), and the difference was statistically significant (χ2=-2.025, P=0.049). At the species level, the abundance of Bacillus unclassified, Carnobacterium maltaromaticum and Bacillus circulans of the primary group were all higher than those of the recurrent group (17.78% vs. 8.84%, 2.39% vs. 1.11%, 2.59% vs. 0.74%, respectively), and the differences were all statistically significant (χ2=2.540, 2.643 and 2.515, all P<0.05). The abundance of Aeromonas veronii of recurrent group was higher than that of the primary group (2.04% vs. 0.01%), and the difference was statistically significant (χ2=-2.397, P=0.021). The bacteria that had significant effects in the primary group included Lactococcus (P=0.012), Lactobacillus (P=0.033) and Geobacillus (P=0.021), while in the recurrent group, which included Enterobacter (P=0.007), Aeromonadaceae (P=0.001), Actinomycetes (P=0.009), and Aeromonas (P=0.001). \u0000 \u0000 \u0000Conclusions \u0000There are differences in abundance and composition of biliary bacterial flora be","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"8 4","pages":"850-854"},"PeriodicalIF":0.0,"publicationDate":"2019-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72467957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-15DOI: 10.3760/CMA.J.ISSN.0254-1432.2019.12.005
Yuting Jia, Shiping Zhou, Xi Zhao, Xiaowen Xu, Hong Xu
Objective To evaluate esophageal motility and anti-reflux barrier function in patients with different phenotypes of heartburn and negative endoscopic findings based on the Rome Ⅳ criteria. Methods From March 2011 to November 2018, 136 patients with heartburn and negative endoscopic findings were retrospectively analyzed. The patients underwent high-resolution manometry (HRM), 24-hour pH monitoring and proton pump inhibitor (PPI) test and according to the Rome Ⅳ criteria and new diagnostic procedures, they were divided into non-erosive reflux disease (NERD) group, reflux hypersensitivity (RH) group, functional heartburn (FH) group and unclassified group. During the same period, 20 healthy volunteers were selected as healthy control group. The changes of esophageal motility and HRM were analyzed among different groups. Statistical analysis was performed using one-way analysis of variance, Kruskal-Wallis H test and chi-square test. Results According to Rome Ⅳ criteria, 35 patients were enrolled into the NERD group, 43 patients were enrolled into the RH group, 48 patients were included in the FH group, and 10 patients were enrolled into unclassified group. There were no significant differences between the NERD group, the RH group, the FH group, the unclassified group and healthy control group in the length of the lower esophageal sphincter (LES), end lower esophageal sphincter resting pressure (LESP), mean LESP, 4-second-integrated relaxation pressure (4 s-IRP), distal latency (DL) , upper esophageal sphincter residual pressure (UES-RP), upper esophageal sphincter relaxation time to nadir, upper esophageal sphincter (UES) recovery time and esophagogastric junction contractile integral (EGJ-CI, all P>0.05). The distal contractile integral (DCI) of NERD group and unclassified group were both lower than that of healthy control group (919.7 mmHg·s·cm (411.7, 1 417.9) mmHg·s·cm (1 mmHg=0.133 kPa), 535.6 mmHg·s·cm (321.4, 1 513.4) mmHg·s·cm vs. 1 322.1 mmHg·s·cm (841.6, 1 918.5) mmHg·s·cm), and the differences were statistically significant (Z=-2.62 and -2.20, P=0.01 and 0.03). The upper esophageal sphincter pressure (UESP) of the unclassified group was lower than that of the healthy control group(57.0 mmHg (31.3, 77.8) mmHg vs. 70.4 mmHg (49.4, 97.8) mmHg), and the difference was statistically significant (Z=-2.64, P=0.02). There was significant difference in esophagogastric junction (EGJ) subtypes between the NERD group, the RH group, the FH group and the unclassified group (χ2=10.85, P=0.02); the proportion of type Ⅲ patients was highest in unclassified group, followed by NERD group, which were both higher than those of RH group and FH group. There was no significant difference in the proportion of esophageal motility subtypes between NERD group, RH group, FH group and unclassified group (P>0.05). Conclusions Patients with different phenotypes of heartburn and negative endoscopy finding should be classified by efficient diagnostic pro
{"title":"Study on esophageal motility and anti-reflux barrier function in patients with heartburn symptom and negative endoscopic findings based on Rome IV criteria","authors":"Yuting Jia, Shiping Zhou, Xi Zhao, Xiaowen Xu, Hong Xu","doi":"10.3760/CMA.J.ISSN.0254-1432.2019.12.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2019.12.005","url":null,"abstract":"Objective \u0000To evaluate esophageal motility and anti-reflux barrier function in patients with different phenotypes of heartburn and negative endoscopic findings based on the Rome Ⅳ criteria. \u0000 \u0000 \u0000Methods \u0000From March 2011 to November 2018, 136 patients with heartburn and negative endoscopic findings were retrospectively analyzed. The patients underwent high-resolution manometry (HRM), 24-hour pH monitoring and proton pump inhibitor (PPI) test and according to the Rome Ⅳ criteria and new diagnostic procedures, they were divided into non-erosive reflux disease (NERD) group, reflux hypersensitivity (RH) group, functional heartburn (FH) group and unclassified group. During the same period, 20 healthy volunteers were selected as healthy control group. The changes of esophageal motility and HRM were analyzed among different groups. Statistical analysis was performed using one-way analysis of variance, Kruskal-Wallis H test and chi-square test. \u0000 \u0000 \u0000Results \u0000According to Rome Ⅳ criteria, 35 patients were enrolled into the NERD group, 43 patients were enrolled into the RH group, 48 patients were included in the FH group, and 10 patients were enrolled into unclassified group. There were no significant differences between the NERD group, the RH group, the FH group, the unclassified group and healthy control group in the length of the lower esophageal sphincter (LES), end lower esophageal sphincter resting pressure (LESP), mean LESP, 4-second-integrated relaxation pressure (4 s-IRP), distal latency (DL) , upper esophageal sphincter residual pressure (UES-RP), upper esophageal sphincter relaxation time to nadir, upper esophageal sphincter (UES) recovery time and esophagogastric junction contractile integral (EGJ-CI, all P>0.05). The distal contractile integral (DCI) of NERD group and unclassified group were both lower than that of healthy control group (919.7 mmHg·s·cm (411.7, 1 417.9) mmHg·s·cm (1 mmHg=0.133 kPa), 535.6 mmHg·s·cm (321.4, 1 513.4) mmHg·s·cm vs. 1 322.1 mmHg·s·cm (841.6, 1 918.5) mmHg·s·cm), and the differences were statistically significant (Z=-2.62 and -2.20, P=0.01 and 0.03). The upper esophageal sphincter pressure (UESP) of the unclassified group was lower than that of the healthy control group(57.0 mmHg (31.3, 77.8) mmHg vs. 70.4 mmHg (49.4, 97.8) mmHg), and the difference was statistically significant (Z=-2.64, P=0.02). There was significant difference in esophagogastric junction (EGJ) subtypes between the NERD group, the RH group, the FH group and the unclassified group (χ2=10.85, P=0.02); the proportion of type Ⅲ patients was highest in unclassified group, followed by NERD group, which were both higher than those of RH group and FH group. There was no significant difference in the proportion of esophageal motility subtypes between NERD group, RH group, FH group and unclassified group (P>0.05). \u0000 \u0000 \u0000Conclusions \u0000Patients with different phenotypes of heartburn and negative endoscopy finding should be classified by efficient diagnostic pro","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"64 1","pages":"817-823"},"PeriodicalIF":0.0,"publicationDate":"2019-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84080992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-15DOI: 10.3760/CMA.J.ISSN.0254-1432.2019.12.008
Dandan Zhao, F. Yin, Jinbo Guo
Objective To analyze the clinical features and risk factors of ulcerative colitis (UC)complicated with Epstein-Barr(EB)-viremia and the effect of antiviral therapy on the remission of the symptoms. Methods From April 2014 to January 2018, data of 239 UC patients hospitalized at the Department of Gastroenterology of Second Hospital of Hebei Medical University were collected. The patients were divided into EB-viremia group (trial group, n=43) and non-EB-viremia group (control group, n=196) according to EB virus-DNA detection. The general condition, clinical characteristics and therapeutic efficacy of the two groups were compared. The risk factors and the effect of antiviral therapy on the remission of symptoms of UC complicated with EB-viremia were analyzed. Chi-square test and logistic analysis were used for statistical analysis. Results There were no significant differences in gender, age, clinical type, lesion range, the proportion of patients treated with 5-aminosalicylic acid or corticosteroids, the percentage of patients with diarrhea and bloody stool, the proportion of patients with spontaneous bleeding, platy ulcer and longitudinal ulcer under colonoscopy, the course of disease or Mayo score between the trial group and control group (all P>0.05). The proportions of patients with smoking history and severe disease, treatment with azathioprine and 6-mertocapurine (6-MP), treatrnent with infliximab, symptoms of fever or abdominal pain and deep and large ulcer under colonoscopy in the trial group were all higher than those in the control group, and the differences were all statistically significant (χ2=5.304, 6.608, 6.718, 6.939, 8.783, 4.493 and 5.425, all P 0.05). Conclusions Smoking history and purine treatment are risk factors of UC complicated with EB-viremia. Key words: Colitis, ulcerative; Risk factors; Epstein-Barr virus; Clinical manifestations; Endoscopic features
{"title":"Clinical features and risk factors of ulcerative colitis complicated with EB-viremia","authors":"Dandan Zhao, F. Yin, Jinbo Guo","doi":"10.3760/CMA.J.ISSN.0254-1432.2019.12.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2019.12.008","url":null,"abstract":"Objective \u0000To analyze the clinical features and risk factors of ulcerative colitis (UC)complicated with Epstein-Barr(EB)-viremia and the effect of antiviral therapy on the remission of the symptoms. \u0000 \u0000 \u0000Methods \u0000From April 2014 to January 2018, data of 239 UC patients hospitalized at the Department of Gastroenterology of Second Hospital of Hebei Medical University were collected. The patients were divided into EB-viremia group (trial group, n=43) and non-EB-viremia group (control group, n=196) according to EB virus-DNA detection. The general condition, clinical characteristics and therapeutic efficacy of the two groups were compared. The risk factors and the effect of antiviral therapy on the remission of symptoms of UC complicated with EB-viremia were analyzed. Chi-square test and logistic analysis were used for statistical analysis. \u0000 \u0000 \u0000Results \u0000There were no significant differences in gender, age, clinical type, lesion range, the proportion of patients treated with 5-aminosalicylic acid or corticosteroids, the percentage of patients with diarrhea and bloody stool, the proportion of patients with spontaneous bleeding, platy ulcer and longitudinal ulcer under colonoscopy, the course of disease or Mayo score between the trial group and control group (all P>0.05). The proportions of patients with smoking history and severe disease, treatment with azathioprine and 6-mertocapurine (6-MP), treatrnent with infliximab, symptoms of fever or abdominal pain and deep and large ulcer under colonoscopy in the trial group were all higher than those in the control group, and the differences were all statistically significant (χ2=5.304, 6.608, 6.718, 6.939, 8.783, 4.493 and 5.425, all P 0.05). \u0000 \u0000 \u0000Conclusions \u0000Smoking history and purine treatment are risk factors of UC complicated with EB-viremia. \u0000 \u0000 \u0000Key words: \u0000Colitis, ulcerative; Risk factors; Epstein-Barr virus; Clinical manifestations; Endoscopic features","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"5 1","pages":"834-839"},"PeriodicalIF":0.0,"publicationDate":"2019-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84624646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-15DOI: 10.3760/CMA.J.ISSN.0254-1432.2019.12.012
Xiaoke Jiang, Jun Li, Yangqiu Bai, H. Ding, Zhiyu Yang, Suofeng Sun, Shuangyin Han, Xiuling Li, Xiaoying Luo
Objective To investigate the development of hepatocyte senescence during liver fibrogenesis and to explore the effect and possible mechanism of insulin-like growth factor 1 (IGF-1) on hepatocyte senescence and liver fibrosis. Methods A total of 42 male Sprague Dawley (SD) rats were selected. Eighteen rats were induced by carbon tetrachloride (CCl4) to establish the rat model of liver fibrosis. On the day 0, six and 28 after the establishment of the model, six rats were executed respectively to analyze the liver fibrosis and hepatocyte senescence in CCl4-induced liver fibrosis rat models. Twenty-four rats were divided into control group, CCl4 group, CCl4+ lentivirus vector (LV-CTR) group and CCl4+ LV-IGF-1 group, with six rats in each group.The rats were sacrificed on the 28th day after the establishment of the model. The liver tissues were obtained and the inferior vena cava blood was collected to analyze the effect of IGF-1 overexpression on liver fibrosis and hepatocyte senescence. Analysis variance (ANOVA), least significant difference (LSD) and Dunnett T3 test were performed for statistical analysis. Results Steatohepatitis on the 6th day and early stage of hepatic fibrosis on the 28th day, which indicated the model was successfully established. The results of the effects of IGF-1 overexpression on hepatic fibrosis and hepatocyte senescence showed that on the 28th day, compared with those of control group, both the score of Ishak liver inflammation and necrosis and the score of Ishak liver fibrosis were increased in the CCl4 group, CCl4+ LV-CTR group and CCl4+ LV-IGF-1 group (0, 14.55±1.94, 15.43±2.19 and 10.29±1.47, respectively; 0, 3.51±0.51, 3.21±0.79 and 1.32±0.40, respectively). The area of liver tissues by Masson staining (0.45±0.40, 5.62±1.08, 6.03±0.65 and 2.88±1.54), SA-β-Gal staining (1.75±0.80, 4.28±1.19, 4.92±1.14, 3.11±0.79), p53 (2.02±0.81, 4.36±1.02, 4.72±0.72 and 3.58±0.70) and progerin (0.72±0.40, 4.52±1.01, 4.01±1.25 and 2.66±0.80) all were increased. The levels of serum IGF-1 all were decreased ((632.00±6.04), (503.00±40.42), (508.00±21.94) and (572.40±5.94) ng/L). However the levels of ALT all were increased ((11.20±5.97), (214.00±73.90), (245.00±76.06) and (30.00±5.00) U/L). The relative expression levels of p53 (0.58±0.06, 1.78±0.18, 1.72±0.10 and 1.23±0.22) and progerin (0.12±0.02, 0.78±0.15, 1.32±0.20 and 0.81±0.16) in the primary hepatocytes were increased. The differences were all statistically significant (F=91.674, 90.778, 32.982, 9.726, 10.640, 17.029, 103.910, 30.059, 64.707 and 97.457, all P<0.05). Compared with those of CCl4+ LV-CTR group, the score of Ishak liver inflammation and necrosis and the score of Ishak liver fibrosis were decreased in the rats′ liver tissues of CCl4+ LV-IGF-1 group, the areas of Masson staining, SA-β-Gal staining, p53 and progerin in the liver tissues were decreased, the level of serum IGF-1 was increased, the level of ALT was decreased, and the relative expression levels
{"title":"Effect of insulin-like growth factor 1 on hepatocyte senescence in carbon tetrachloride-induced liver fibrosis rats","authors":"Xiaoke Jiang, Jun Li, Yangqiu Bai, H. Ding, Zhiyu Yang, Suofeng Sun, Shuangyin Han, Xiuling Li, Xiaoying Luo","doi":"10.3760/CMA.J.ISSN.0254-1432.2019.12.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2019.12.012","url":null,"abstract":"Objective \u0000To investigate the development of hepatocyte senescence during liver fibrogenesis and to explore the effect and possible mechanism of insulin-like growth factor 1 (IGF-1) on hepatocyte senescence and liver fibrosis. \u0000 \u0000 \u0000Methods \u0000A total of 42 male Sprague Dawley (SD) rats were selected. Eighteen rats were induced by carbon tetrachloride (CCl4) to establish the rat model of liver fibrosis. On the day 0, six and 28 after the establishment of the model, six rats were executed respectively to analyze the liver fibrosis and hepatocyte senescence in CCl4-induced liver fibrosis rat models. Twenty-four rats were divided into control group, CCl4 group, CCl4+ lentivirus vector (LV-CTR) group and CCl4+ LV-IGF-1 group, with six rats in each group.The rats were sacrificed on the 28th day after the establishment of the model. The liver tissues were obtained and the inferior vena cava blood was collected to analyze the effect of IGF-1 overexpression on liver fibrosis and hepatocyte senescence. Analysis variance (ANOVA), least significant difference (LSD) and Dunnett T3 test were performed for statistical analysis. \u0000 \u0000 \u0000Results \u0000Steatohepatitis on the 6th day and early stage of hepatic fibrosis on the 28th day, which indicated the model was successfully established. The results of the effects of IGF-1 overexpression on hepatic fibrosis and hepatocyte senescence showed that on the 28th day, compared with those of control group, both the score of Ishak liver inflammation and necrosis and the score of Ishak liver fibrosis were increased in the CCl4 group, CCl4+ LV-CTR group and CCl4+ LV-IGF-1 group (0, 14.55±1.94, 15.43±2.19 and 10.29±1.47, respectively; 0, 3.51±0.51, 3.21±0.79 and 1.32±0.40, respectively). The area of liver tissues by Masson staining (0.45±0.40, 5.62±1.08, 6.03±0.65 and 2.88±1.54), SA-β-Gal staining (1.75±0.80, 4.28±1.19, 4.92±1.14, 3.11±0.79), p53 (2.02±0.81, 4.36±1.02, 4.72±0.72 and 3.58±0.70) and progerin (0.72±0.40, 4.52±1.01, 4.01±1.25 and 2.66±0.80) all were increased. The levels of serum IGF-1 all were decreased ((632.00±6.04), (503.00±40.42), (508.00±21.94) and (572.40±5.94) ng/L). However the levels of ALT all were increased ((11.20±5.97), (214.00±73.90), (245.00±76.06) and (30.00±5.00) U/L). The relative expression levels of p53 (0.58±0.06, 1.78±0.18, 1.72±0.10 and 1.23±0.22) and progerin (0.12±0.02, 0.78±0.15, 1.32±0.20 and 0.81±0.16) in the primary hepatocytes were increased. The differences were all statistically significant (F=91.674, 90.778, 32.982, 9.726, 10.640, 17.029, 103.910, 30.059, 64.707 and 97.457, all P<0.05). Compared with those of CCl4+ LV-CTR group, the score of Ishak liver inflammation and necrosis and the score of Ishak liver fibrosis were decreased in the rats′ liver tissues of CCl4+ LV-IGF-1 group, the areas of Masson staining, SA-β-Gal staining, p53 and progerin in the liver tissues were decreased, the level of serum IGF-1 was increased, the level of ALT was decreased, and the relative expression levels","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"11 1","pages":"855-861"},"PeriodicalIF":0.0,"publicationDate":"2019-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87830621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-15DOI: 10.3760/CMA.J.ISSN.0254-1432.2019.12.006
Cuiping Yang, Ping‐Hsien Chen, Mengyin Zhang, Boer Cai
Objective To observe the endoscopic morphology of gastric varices of patients with portal hypertension type one isolated gastric varices (IGV-1) and to explore the etiology, treatment and prognosis of portal hypertension IGV-1. Methods From January 2006 to June 2018, at Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine and North Branch of Ruijin Hospital, 54 patients with portal hypertension IGV-1 were retrospectively analyzed. The varices were classified according to the endoscopic morphology and the etiology treatment, therapeutic efficacy and prognosis were also analyzed. Descriptive method was used for statistical analysis. Results Among the 54 patients with portal hypertension IGV-1, the endoscopic morphology of varices were tuber type in 24 patients (44.4%), grape string type in nine patients (16.7%), strip type in five patients (9.3%), dendritic type in three patients (5.6%) and mixed type in 13 patients(24.1%). Etiological analysis showed that the primary disease of 34 cases (63.0%) were hepatogenic, 11 cases (20.4%) were pancreatic origin, and nine cases (16.7%) were from other diseases. As to treatment, three cases (5.6%) were treated with adhesive, two cases (3.7%) were treated with sclerotherapy, and 49 cases (90.7%) were treated with combination of adhesive and sclerotherapy. Therapeutic efficacy evaluation showed that 46 cases (85.2%) were significantly effective, eight cases were effective, 0 case was ineffective, and all the 54 cases (100.0%) were improved. The prognostic analysis showed that 35 cases (64.8%) had no bleeding in five years and eight cases (14.8%) had no bleeding in 10 years. Nine patients (16.7%) died, including six cases of pancreatic cancer, two cases of liver failure and one case of gastrointestinal bleeding. Conclusions The endoscopic morphology of IGV-1 portal hypertension in mainly tuber type. The main cause is hepatogenic and the combination of adhesive and sclerotherapy is beneficial to the regression of gastric varices. Key words: Hypertension, portal; Type one isolated gastric varices; Classification; Endoscopic therapy
{"title":"Endoscopic observation of varices in 54 patients with type one isolated gastric varices","authors":"Cuiping Yang, Ping‐Hsien Chen, Mengyin Zhang, Boer Cai","doi":"10.3760/CMA.J.ISSN.0254-1432.2019.12.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2019.12.006","url":null,"abstract":"Objective \u0000To observe the endoscopic morphology of gastric varices of patients with portal hypertension type one isolated gastric varices (IGV-1) and to explore the etiology, treatment and prognosis of portal hypertension IGV-1. \u0000 \u0000 \u0000Methods \u0000From January 2006 to June 2018, at Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine and North Branch of Ruijin Hospital, 54 patients with portal hypertension IGV-1 were retrospectively analyzed. The varices were classified according to the endoscopic morphology and the etiology treatment, therapeutic efficacy and prognosis were also analyzed. Descriptive method was used for statistical analysis. \u0000 \u0000 \u0000Results \u0000Among the 54 patients with portal hypertension IGV-1, the endoscopic morphology of varices were tuber type in 24 patients (44.4%), grape string type in nine patients (16.7%), strip type in five patients (9.3%), dendritic type in three patients (5.6%) and mixed type in 13 patients(24.1%). Etiological analysis showed that the primary disease of 34 cases (63.0%) were hepatogenic, 11 cases (20.4%) were pancreatic origin, and nine cases (16.7%) were from other diseases. As to treatment, three cases (5.6%) were treated with adhesive, two cases (3.7%) were treated with sclerotherapy, and 49 cases (90.7%) were treated with combination of adhesive and sclerotherapy. Therapeutic efficacy evaluation showed that 46 cases (85.2%) were significantly effective, eight cases were effective, 0 case was ineffective, and all the 54 cases (100.0%) were improved. The prognostic analysis showed that 35 cases (64.8%) had no bleeding in five years and eight cases (14.8%) had no bleeding in 10 years. Nine patients (16.7%) died, including six cases of pancreatic cancer, two cases of liver failure and one case of gastrointestinal bleeding. \u0000 \u0000 \u0000Conclusions \u0000The endoscopic morphology of IGV-1 portal hypertension in mainly tuber type. The main cause is hepatogenic and the combination of adhesive and sclerotherapy is beneficial to the regression of gastric varices. \u0000 \u0000 \u0000Key words: \u0000Hypertension, portal; Type one isolated gastric varices; Classification; Endoscopic therapy","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"25 1","pages":"824-827"},"PeriodicalIF":0.0,"publicationDate":"2019-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74721051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-15DOI: 10.3760/CMA.J.ISSN.0254-1432.2019.11.004
H. Na, F. Gong, Qian Meirui, Dou Jianhua, W. Jian, Wu Kaichun
Objective To explore the expression and clinical significance of plasma methylated Septin9 gene (mSEPT9) in patients with gastric cancer. Methods From March to October in 2018, 380 patients visited Xijing Hospital of Digestive Diseases were selected. The patients were divided into gastric cancer (GC) group, atrophic gastritis (AG) group and non-atrophic gastritis (NAG) group. The positive expression rate of plasma circulating mSEPT9 of the three groups were detected by polymerase chain reaction (PCR) fluorescence probe method, its correlation with clinicopathological characteristics of gastric cancer were analyzed and also compared with the positive rate of carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9). Chi-square test and continuity correction chi-square test were performed for statistical analysis. Results The actual number of valid samples was 357 including 147 of GC group, 83 of AG group and 127 of NAG group. The positive rate of plasma mSEPT9 of GC group was higher than those of AG group and NAG group (46.9%, 69/147 vs. 4.8%, 4/83 and 3.9%, 5/127), and the differences were statistically significant (χ2=43.438 and 63.912, both P<0.016). The sensitivity and specificity of plasma mSEPT9 in patients with gastric cancers were 46.9%(69/147) and 95.7%(201/210), respectively. The positive rate of mSEPT9 was higher in gastric cancer patients with tumor maximum diameter over 5.0 cm, intestinal-type gastric cancer in Lauren classification, lymphatic metastasis, vascular and neurological invasion, middle-late stage (stage Ⅲ and Ⅳ) in clinical classification, which were 57.6% (38/66) vs. 35.6% (26/73), 52.6%(51/97) vs. 31.0% (13/42), 53.0% (61/115) vs. 25.0% (8/32), 55.6% (65/117) vs. 13.3% (4/30), 50.8% (65/128) vs. 4/19 and 53.5% (61/114) vs. 24.2% (8/33), respectively; and the differences were statistically significant (χ2=6.728, 5.517, 7.905, 17.091, 5.871 and 8.998, all P<0.05). The positive rate of plasma mSEPT9 in gastric cancer patients was higher than those of CEA and CA19-9 (46.9%, 69/147 vs. 32.0%, 47/147 and 17.7%, 26/147, respectively), and the differences were statistically significant (χ2=6.892 and 17.437, both P<0.016). Conclusions The positive expression of plasma mSEPT9 in gastric cancer patients has not only high sensitivity but good specificity as well, and it is also related to the clinical stage. The detection of this gene may have important clinical significance in non-invasive diagnosis and prognosis evaluation in patients with advanced gastric cancer. Key words: Methylation; Stomach neoplasms; SEPT9; Pathological characteristics; Clinical significance
{"title":"Expression and clinical significance of plasma methylated Septin9 gene in patients with gastric cancer","authors":"H. Na, F. Gong, Qian Meirui, Dou Jianhua, W. Jian, Wu Kaichun","doi":"10.3760/CMA.J.ISSN.0254-1432.2019.11.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2019.11.004","url":null,"abstract":"Objective \u0000To explore the expression and clinical significance of plasma methylated Septin9 gene (mSEPT9) in patients with gastric cancer. \u0000 \u0000 \u0000Methods \u0000From March to October in 2018, 380 patients visited Xijing Hospital of Digestive Diseases were selected. The patients were divided into gastric cancer (GC) group, atrophic gastritis (AG) group and non-atrophic gastritis (NAG) group. The positive expression rate of plasma circulating mSEPT9 of the three groups were detected by polymerase chain reaction (PCR) fluorescence probe method, its correlation with clinicopathological characteristics of gastric cancer were analyzed and also compared with the positive rate of carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9). Chi-square test and continuity correction chi-square test were performed for statistical analysis. \u0000 \u0000 \u0000Results \u0000The actual number of valid samples was 357 including 147 of GC group, 83 of AG group and 127 of NAG group. The positive rate of plasma mSEPT9 of GC group was higher than those of AG group and NAG group (46.9%, 69/147 vs. 4.8%, 4/83 and 3.9%, 5/127), and the differences were statistically significant (χ2=43.438 and 63.912, both P<0.016). The sensitivity and specificity of plasma mSEPT9 in patients with gastric cancers were 46.9%(69/147) and 95.7%(201/210), respectively. The positive rate of mSEPT9 was higher in gastric cancer patients with tumor maximum diameter over 5.0 cm, intestinal-type gastric cancer in Lauren classification, lymphatic metastasis, vascular and neurological invasion, middle-late stage (stage Ⅲ and Ⅳ) in clinical classification, which were 57.6% (38/66) vs. 35.6% (26/73), 52.6%(51/97) vs. 31.0% (13/42), 53.0% (61/115) vs. 25.0% (8/32), 55.6% (65/117) vs. 13.3% (4/30), 50.8% (65/128) vs. 4/19 and 53.5% (61/114) vs. 24.2% (8/33), respectively; and the differences were statistically significant (χ2=6.728, 5.517, 7.905, 17.091, 5.871 and 8.998, all P<0.05). The positive rate of plasma mSEPT9 in gastric cancer patients was higher than those of CEA and CA19-9 (46.9%, 69/147 vs. 32.0%, 47/147 and 17.7%, 26/147, respectively), and the differences were statistically significant (χ2=6.892 and 17.437, both P<0.016). \u0000 \u0000 \u0000Conclusions \u0000The positive expression of plasma mSEPT9 in gastric cancer patients has not only high sensitivity but good specificity as well, and it is also related to the clinical stage. The detection of this gene may have important clinical significance in non-invasive diagnosis and prognosis evaluation in patients with advanced gastric cancer. \u0000 \u0000 \u0000Key words: \u0000Methylation; Stomach neoplasms; SEPT9; Pathological characteristics; Clinical significance","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"108 1","pages":"741-745"},"PeriodicalIF":0.0,"publicationDate":"2019-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75671421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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