D. Kikuchi, H. Odagiri, Y. Hoshihara, Y. Ochiai, Yugo Suzuki, J. Hayasaka, Masami Tanaka, K. Nomura, S. Yamashita, A. Matsui, T. Iizuka, S. Hoteya
Background Gastroesophageal reflux disease is diagnosed endoscopically based on the presence of mucosal breaks. However, mucosal breaks can be judged differently depending on the endoscopist, even in the same image. We investigated how narrow-band imaging (NBI) and magnified endoscopy affect the judgment of mucosal breaks. Methods A total of 43 consecutive patients were enrolled who had suspected mucosal breaks on white-light images (WLI) and underwent nonmagnified NBI (N-NBI) and magnified NBI (M-NBI) by a single endoscopist. From WLI, N-NBI, and M-NBI, 129 image files were created. Eight endoscopists reviewed the image files and judged the presence of mucosal breaks. Results The 8 endoscopists determined mucosal breaks were present in 79.4 ± 9.5% (67.4%–93.0%) on WLI, and 76.7 ± 12.7% (53.5%–90.7%) on N-NBI. However, the percentage of mucosal breaks on M-NBI was significantly lower at 48.8 ± 17.0% (18.6%–65.1%) (p < 0.05). Intraclass correlation between observers was 0.864 (95% CI 0.793–0.918) for WLI and 0.863 (95% CI 0.791–0.917) for N-NBI but was lower for M-NBI at 0.758 (95% CI 0.631–0.854). Conclusion Rates of detection and agreement for mucosal breaks on WLI and N-NBI were high among endoscopists. However, these rates were lower on M-NBI.
{"title":"Definition of Mucosal Breaks in the Era of Magnifying Endoscopy with Narrow-Band Imaging","authors":"D. Kikuchi, H. Odagiri, Y. Hoshihara, Y. Ochiai, Yugo Suzuki, J. Hayasaka, Masami Tanaka, K. Nomura, S. Yamashita, A. Matsui, T. Iizuka, S. Hoteya","doi":"10.1155/2022/3952962","DOIUrl":"https://doi.org/10.1155/2022/3952962","url":null,"abstract":"Background Gastroesophageal reflux disease is diagnosed endoscopically based on the presence of mucosal breaks. However, mucosal breaks can be judged differently depending on the endoscopist, even in the same image. We investigated how narrow-band imaging (NBI) and magnified endoscopy affect the judgment of mucosal breaks. Methods A total of 43 consecutive patients were enrolled who had suspected mucosal breaks on white-light images (WLI) and underwent nonmagnified NBI (N-NBI) and magnified NBI (M-NBI) by a single endoscopist. From WLI, N-NBI, and M-NBI, 129 image files were created. Eight endoscopists reviewed the image files and judged the presence of mucosal breaks. Results The 8 endoscopists determined mucosal breaks were present in 79.4 ± 9.5% (67.4%–93.0%) on WLI, and 76.7 ± 12.7% (53.5%–90.7%) on N-NBI. However, the percentage of mucosal breaks on M-NBI was significantly lower at 48.8 ± 17.0% (18.6%–65.1%) (p < 0.05). Intraclass correlation between observers was 0.864 (95% CI 0.793–0.918) for WLI and 0.863 (95% CI 0.791–0.917) for N-NBI but was lower for M-NBI at 0.758 (95% CI 0.631–0.854). Conclusion Rates of detection and agreement for mucosal breaks on WLI and N-NBI were high among endoscopists. However, these rates were lower on M-NBI.","PeriodicalId":12597,"journal":{"name":"Gastroenterology Research and Practice","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2022-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42150591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Omori, Y. Sasaki, M. Koroku, H. Kambayashi, S. Murasugi, M. Yonezawa, Shinichi Nakamura, K. Tokushige
Objective Intestinal motility may be different in obese and nonobese patients, but this has not been determined. Here, we sought to evaluate the effect of obesity on small bowel capsule endoscopy (SBCE). Patients and Methods. We retrospectively analyzed the cases of the 340 patients who underwent SBCE for small intestinal disease (excluding cases of unobservable total small bowel, small bowel stenosis, and bowel resection) at our hospital during the period January 2014 to December 2020 to extract patient background factors and the bowel transit times of SBCE according to the presence/absence of obesity (defined as a body mass index (BMI) ≥ 25 kg/m2). Results The obese group was 54 patients (nonobese, n = 286). The small bowel transit time (SBTT) was significantly shorter in the obese patients compared to the nonobese patients (p = 0.0026), and when we divided the patients by their short/long SBTTs using 216.5 min as the cutoff, we observed significant between-group differences in the patients' age (≥60 years) and in the patients' hospitalization status at the time of the SBCE examination. A multivariate analysis revealed that hospitalized status at the examination is a factor contributing significantly to a long SBTT (OR 0.25, 95% CI: 0.15–0.42, p < 0.0001). An analysis using the outpatient/inpatient conditions showed that obesity was an independent factor in the inpatient status at the SBCE examination with a significant short SBTT (OR 2.91, 95% CI: 1.06–7.97, p = 0.0380). Constipation at the examination was also a factor contributing to a long SBTT (OR 0.26, 95% CI: 0.07–0.99, p = 0.0493). Conclusion The SBTT of the SBCE was significantly shorter in the obese patients. This tendency was especially evident in the hospitalized state.
{"title":"The Influence of Obesity on Small Bowel Capsule Endoscopy","authors":"T. Omori, Y. Sasaki, M. Koroku, H. Kambayashi, S. Murasugi, M. Yonezawa, Shinichi Nakamura, K. Tokushige","doi":"10.1155/2022/6396651","DOIUrl":"https://doi.org/10.1155/2022/6396651","url":null,"abstract":"Objective Intestinal motility may be different in obese and nonobese patients, but this has not been determined. Here, we sought to evaluate the effect of obesity on small bowel capsule endoscopy (SBCE). Patients and Methods. We retrospectively analyzed the cases of the 340 patients who underwent SBCE for small intestinal disease (excluding cases of unobservable total small bowel, small bowel stenosis, and bowel resection) at our hospital during the period January 2014 to December 2020 to extract patient background factors and the bowel transit times of SBCE according to the presence/absence of obesity (defined as a body mass index (BMI) ≥ 25 kg/m2). Results The obese group was 54 patients (nonobese, n = 286). The small bowel transit time (SBTT) was significantly shorter in the obese patients compared to the nonobese patients (p = 0.0026), and when we divided the patients by their short/long SBTTs using 216.5 min as the cutoff, we observed significant between-group differences in the patients' age (≥60 years) and in the patients' hospitalization status at the time of the SBCE examination. A multivariate analysis revealed that hospitalized status at the examination is a factor contributing significantly to a long SBTT (OR 0.25, 95% CI: 0.15–0.42, p < 0.0001). An analysis using the outpatient/inpatient conditions showed that obesity was an independent factor in the inpatient status at the SBCE examination with a significant short SBTT (OR 2.91, 95% CI: 1.06–7.97, p = 0.0380). Constipation at the examination was also a factor contributing to a long SBTT (OR 0.26, 95% CI: 0.07–0.99, p = 0.0493). Conclusion The SBTT of the SBCE was significantly shorter in the obese patients. This tendency was especially evident in the hospitalized state.","PeriodicalId":12597,"journal":{"name":"Gastroenterology Research and Practice","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2022-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49538931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective This study was aimed at exploring the ameliorating effect of curcumin (Cur) on inflammatory bowel disease (IBD) in mice induced by 3% dextran sodium sulfate (DSS) by regulating intestinal epithelial cell autophagy. Methods 45 BALB/c mice were randomly divided into three groups: control group, DSS group, and Cur group, with 15 mice in each group. Expect for the control group, 3% DSS was freely drunk by the mice for 7 days to induce acute IBD, and the Cur group was given Cur gavage treatment. Hematoxylin-Eosin (HE) staining was performed to observe the pathological changes of mice colon tissue. The formation of autophagosomes in intestinal epithelial cells was detected by transmission electron microscopy (TEM). The protein expressions of LC3-II/LC3-I, p62, and Beclin1 were detected by Western blot. Results Compared with that of the control group, body weight of mice in DSS group was significantly reduced, stool was not formed or presented with loose stools, there was occult blood or blood in the stool, hair color lost luster, disease activity index (DAI) score was significantly increased, and colonic mucosal epithelial cells showed colitis; LC3-II/LC3-I and Beclin1 expression were significantly decreased (P < 0.05), p62 was significantly increased, and autophagy was not obvious. In addition, compared with that of the DSS group, the diet of mice in the Cur group was improved, the decline of body weight was slowed down, the hair glossiness was restored, the blood in the stool gradually decreased or occulted, the DAI score was decreased, the colon tissue was significantly improved, the expressions of LC3-II/LC3-I and Beclin1 were significantly increased (P < 0.05), and the p62 was significantly decreased. Conclusions The effect of Cur on IBD mice was related to the regulation of the expression of autophagy pathway proteins LC3-II/LC3-I, Beclin1, and p62 in intestinal epithelial cells.
{"title":"Protective Effects of Curcumin-Regulated Intestinal Epithelial Autophagy on Inflammatory Bowel Disease in Mice","authors":"Jian-dong Hong","doi":"10.1155/2022/2163931","DOIUrl":"https://doi.org/10.1155/2022/2163931","url":null,"abstract":"Objective This study was aimed at exploring the ameliorating effect of curcumin (Cur) on inflammatory bowel disease (IBD) in mice induced by 3% dextran sodium sulfate (DSS) by regulating intestinal epithelial cell autophagy. Methods 45 BALB/c mice were randomly divided into three groups: control group, DSS group, and Cur group, with 15 mice in each group. Expect for the control group, 3% DSS was freely drunk by the mice for 7 days to induce acute IBD, and the Cur group was given Cur gavage treatment. Hematoxylin-Eosin (HE) staining was performed to observe the pathological changes of mice colon tissue. The formation of autophagosomes in intestinal epithelial cells was detected by transmission electron microscopy (TEM). The protein expressions of LC3-II/LC3-I, p62, and Beclin1 were detected by Western blot. Results Compared with that of the control group, body weight of mice in DSS group was significantly reduced, stool was not formed or presented with loose stools, there was occult blood or blood in the stool, hair color lost luster, disease activity index (DAI) score was significantly increased, and colonic mucosal epithelial cells showed colitis; LC3-II/LC3-I and Beclin1 expression were significantly decreased (P < 0.05), p62 was significantly increased, and autophagy was not obvious. In addition, compared with that of the DSS group, the diet of mice in the Cur group was improved, the decline of body weight was slowed down, the hair glossiness was restored, the blood in the stool gradually decreased or occulted, the DAI score was decreased, the colon tissue was significantly improved, the expressions of LC3-II/LC3-I and Beclin1 were significantly increased (P < 0.05), and the p62 was significantly decreased. Conclusions The effect of Cur on IBD mice was related to the regulation of the expression of autophagy pathway proteins LC3-II/LC3-I, Beclin1, and p62 in intestinal epithelial cells.","PeriodicalId":12597,"journal":{"name":"Gastroenterology Research and Practice","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2022-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45875189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Septic pulmonary embolism (SPE) is an associated complication of Klebsiella pneumoniae liver abscess (KPLA). However, previous studies have reported that its incidence varies widely. We conducted a systematic review and meta-analysis to investigate the incidence of SPE in patients with KPLA. We further analyzed their clinical and computed tomography (CT) features. Methods: Two researchers reviewed PubMed, EMBASE, Web of Science, and Cochrane Library databases to identify the articles that reported SPE in patients with KPLA. The search was conducted from the date of establishment of each database up to January 2021. After screening the articles and extracting the data, we used Review Manager 5.3 for analysis and processing. Results: We selected six articles that included 1,158 patients with KPLA. Of these, 70 patients had SPE. The pooled incidence of SPE was 6% (95% confidence interval, 3%–9%). Among patients with SPE, 85% were men, 72% had diabetes, and 52% displayed the feeding vessel sign on the chest CT. The mortality rate was 12%. Quality assessment revealed that half of the included studies had a high quality. Conclusion: The pooled incidence of SPE in patients with KPLA was 6%. Men and patients with diabetes were more prone to SPE. For patients with KPLA who had SPE as an associated complication, the mortality rate was approximately 12%.
背景:脓毒性肺栓塞(SPE)是肺炎克雷伯菌肝脓肿(KPLA)的相关并发症。然而，先前的研究报告其发病率差异很大。我们进行了系统回顾和荟萃分析，以调查KPLA患者中SPE的发生率。我们进一步分析了他们的临床和计算机断层扫描(CT)特征。方法:两名研究人员回顾了PubMed、EMBASE、Web of Science和Cochrane Library数据库，以确定报道KPLA患者SPE的文章。检索从每个数据库建立之日起至2021年1月止。在筛选文章和提取数据后，我们使用Review Manager 5.3进行分析和处理。结果:我们选择了6篇文章，包括1158例KPLA患者。其中70例患有SPE。SPE的合并发生率为6%(95%可信区间，3%-9%)。在SPE患者中，85%为男性，72%为糖尿病患者，52%在胸部CT上显示进食血管征象。死亡率为12%。质量评估显示，纳入的研究中有一半具有高质量。结论:KPLA患者SPE的总发生率为6%。男性和糖尿病患者更容易发生SPE。对于伴有SPE相关并发症的KPLA患者，死亡率约为12%。
{"title":"The Incidence of Septic Pulmonary Embolism in Patients with Klebsiella pneumoniae Liver Abscess: A Systematic Review and Meta-analysis","authors":"Yunan Wang, Hairui Wang, Zhaoyu Liu, Z. Chang","doi":"10.1155/2022/3777122","DOIUrl":"https://doi.org/10.1155/2022/3777122","url":null,"abstract":"Background: Septic pulmonary embolism (SPE) is an associated complication of Klebsiella pneumoniae liver abscess (KPLA). However, previous studies have reported that its incidence varies widely. We conducted a systematic review and meta-analysis to investigate the incidence of SPE in patients with KPLA. We further analyzed their clinical and computed tomography (CT) features. Methods: Two researchers reviewed PubMed, EMBASE, Web of Science, and Cochrane Library databases to identify the articles that reported SPE in patients with KPLA. The search was conducted from the date of establishment of each database up to January 2021. After screening the articles and extracting the data, we used Review Manager 5.3 for analysis and processing. Results: We selected six articles that included 1,158 patients with KPLA. Of these, 70 patients had SPE. The pooled incidence of SPE was 6% (95% confidence interval, 3%–9%). Among patients with SPE, 85% were men, 72% had diabetes, and 52% displayed the feeding vessel sign on the chest CT. The mortality rate was 12%. Quality assessment revealed that half of the included studies had a high quality. Conclusion: The pooled incidence of SPE in patients with KPLA was 6%. Men and patients with diabetes were more prone to SPE. For patients with KPLA who had SPE as an associated complication, the mortality rate was approximately 12%.","PeriodicalId":12597,"journal":{"name":"Gastroenterology Research and Practice","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45078675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ken Inoue, N. Yoshida, Reo Kobayashi, Y. Tomita, Hikaru Hashimoto, Satoshi Sugino, R. Hirose, O. Dohi, H. Yasuda, Ritsu Yasuda, T. Murakami, Yutaka Inada, Yoshito Itoh
Background: A compact and cost-effective light source-processor combined 3-color light-emitting diode (LED) endoscopic system (ELUXEO-Lite: EP-6000, Fujifilm Co., Tokyo) with a magnified colonoscope (EC-6600ZP, Fujifilm Co.) has been released. Aims: In this study, we analyzed the efficacy of this system for colorectal tumor characterization with magnified blue light imaging (BLI-LED) and image's subjective and objective evaluations, compared to a magnified blue laser imaging (BLI-LASER) using a standard LASER endoscopic system. Methods: We retrospectively reviewed 37 lesions observed with both BLI-LED and BLI-LASER systems from 2019 using the Japanese narrow band imaging classification. Two representative magnified images, one BLI-LED and one BLI-LASER, of the same area of a lesion were evaluated for diagnostic accuracy and visualization quality by three experts and three non-experts. Their color difference values (CDVs) and brightness values (BVs) were also calculated as objective indicators. Results: Among 37 lesions, mean tumor size was 18.9 ± 13.1 mm, and 21 lesions were nonpolypoid. Histopathology revealed 14 sessile serrated lesions, 7 adenomas, 12 high-grade dysplasias and T1a cancers, and 4 T1b cancers. The diagnostic accuracy rates of BLI-LED/BLI-LASER of experts and non-experts were 90.1% and 87.4% (p = 0.52) and 89.2% and 89.2% (p = 0.99). The percentages of instances where BLI-LED images were better, the two imaging types were equivalent, or BLI-LASER images were better were 16%/83%/1% for experts and 19%/58%/23% for non-experts (p < 0.001). CDVs and BVs between BLI-LED and BLI-LASER were not significantly different (CDVs: p = 0.653, BVs: p = 0.518). Conclusions: BLI-LED using the compact system was noninferior to BLI-LASER for colorectal tumor characterization and image quality.
背景:一款紧凑且具有成本效益的光源处理器组合三色发光二极管(LED)内窥镜系统(ELUXEO-Lite: EP-6000，富士胶片公司，东京)与放大结肠镜(EC-6600ZP，富士胶片公司)已经发布。目的:在本研究中，我们分析了该系统在使用放大蓝光成像(BLI-LED)进行结直肠肿瘤表征的有效性以及图像的主客观评价，并与使用标准激光内镜系统的放大蓝光成像(BLI-LASER)进行比较。方法:回顾性分析2019年以来BLI-LED和BLI-LASER系统观察到的37个病变，采用日本窄带成像分类。由三名专家和三名非专家对病变同一区域的两幅代表性放大图像(一幅BLI-LED和一幅BLI-LASER)的诊断准确性和可视化质量进行评估。并计算其色差值(cdv)和亮度值(bv)作为客观指标。结果:37例病变中，平均肿瘤大小为18.9±13.1 mm，非息肉样病变21例。组织病理学显示14例无梗锯齿状病变，7例腺瘤，12例高度发育不良和T1a癌，4例T1b癌。专家和非专家BLI-LED/BLI-LASER的诊断准确率分别为90.1%和87.4% (p = 0.52)和89.2%和89.2% (p = 0.99)。BLI-LED图像更好、两种成像类型等效或BLI-LASER图像更好的实例百分比在专家中为16%/83%/1%，在非专家中为19%/58%/23% (p < 0.001)。BLI-LED与BLI-LASER的cdv和bv差异无统计学意义(cdv: p = 0.653, bv: p = 0.518)。结论:使用紧凑系统的BLI-LED在结直肠肿瘤特征和图像质量方面优于BLI-LASER。
{"title":"The Efficacy of Tumor Characterization for Colorectal Lesions with Blue Light Imaging of a Compact Light-Emitting Diode Endoscopic System Compared to a Laser Endoscopic System: A Pilot Study","authors":"Ken Inoue, N. Yoshida, Reo Kobayashi, Y. Tomita, Hikaru Hashimoto, Satoshi Sugino, R. Hirose, O. Dohi, H. Yasuda, Ritsu Yasuda, T. Murakami, Yutaka Inada, Yoshito Itoh","doi":"10.1155/2022/9998280","DOIUrl":"https://doi.org/10.1155/2022/9998280","url":null,"abstract":"Background: A compact and cost-effective light source-processor combined 3-color light-emitting diode (LED) endoscopic system (ELUXEO-Lite: EP-6000, Fujifilm Co., Tokyo) with a magnified colonoscope (EC-6600ZP, Fujifilm Co.) has been released. Aims: In this study, we analyzed the efficacy of this system for colorectal tumor characterization with magnified blue light imaging (BLI-LED) and image's subjective and objective evaluations, compared to a magnified blue laser imaging (BLI-LASER) using a standard LASER endoscopic system. Methods: We retrospectively reviewed 37 lesions observed with both BLI-LED and BLI-LASER systems from 2019 using the Japanese narrow band imaging classification. Two representative magnified images, one BLI-LED and one BLI-LASER, of the same area of a lesion were evaluated for diagnostic accuracy and visualization quality by three experts and three non-experts. Their color difference values (CDVs) and brightness values (BVs) were also calculated as objective indicators. Results: Among 37 lesions, mean tumor size was 18.9 ± 13.1 mm, and 21 lesions were nonpolypoid. Histopathology revealed 14 sessile serrated lesions, 7 adenomas, 12 high-grade dysplasias and T1a cancers, and 4 T1b cancers. The diagnostic accuracy rates of BLI-LED/BLI-LASER of experts and non-experts were 90.1% and 87.4% (p = 0.52) and 89.2% and 89.2% (p = 0.99). The percentages of instances where BLI-LED images were better, the two imaging types were equivalent, or BLI-LASER images were better were 16%/83%/1% for experts and 19%/58%/23% for non-experts (p < 0.001). CDVs and BVs between BLI-LED and BLI-LASER were not significantly different (CDVs: p = 0.653, BVs: p = 0.518). Conclusions: BLI-LED using the compact system was noninferior to BLI-LASER for colorectal tumor characterization and image quality.","PeriodicalId":12597,"journal":{"name":"Gastroenterology Research and Practice","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2022-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47295499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Weina Jing, Xinyue Luo, Jin-lin Yang, Junchao Wu, Yuxiang Chen, Kai Deng
Introduction Currently, there are few studies on the efficacy of peroral endoscopic myotomy (POEM) in the anterior or posterior approach; however, limited studies have shown contradictory findings. Thus, the goal was to obtain more quantitative and objective outcomes and further compare the clinical efficacy of these two approaches in this meta-analysis. Methods A comprehensive search of PubMed, Embase, Cochrane Library, and Web of Science was conducted to find studies relevant to POEM. The retrieval time was from database inception to September 2021. Studies reporting the effects of POEM according to the anterior or posterior approach were included. STATA 16.0 was used to perform statistical analysis, mainly comparing the quantitative objective indicators (lower esophageal sphincter (LES) pressure and Eckardt scores, etc.) in anterior and posterior approaches by meta-analysis. Result A total of 19 studies with 1261 patients were finally included. Except for shorter procedure time in the posterior approach, other factors (pooled difference of LES pressure, Eckardt scores, clinical success, length of total myotomy, hospital stays, gastroesophageal reflux (GERD), and adverse event) were compared, and all above confirmed that there is no difference between anterior and posterior approaches, and the safety of POEM is ensured. In addition, both anterior and posterior myotomy can improve LES pressure and Eckardt scores, and the difference in anterior and posterior myotomy was unconspicuous. Conclusion The terms of the pooled difference in LES pressure, Eckardt scores, and other factors (clinical success, length of total myotomy, hospital stays, GERD, adverse events, and procedure time) seemed to be similar for the anterior and posterior approaches. However, the further prognosis after POEM via anterior and posterior approaches needs to be answered in the future.
目前，关于经口内窥镜下肌切开术(POEM)在前、后入路中的疗效研究较少;然而，有限的研究显示出矛盾的结果。因此，本荟萃分析的目的是获得更多定量和客观的结果，并进一步比较这两种方法的临床疗效。方法综合检索PubMed、Embase、Cochrane Library和Web of Science，查找与POEM相关的研究。检索时间为数据库建立至2021年9月。包括了根据前路或后路报道POEM效果的研究。采用STATA 16.0进行统计分析，主要对前后入路的定量客观指标(食管下括约肌(LES)压力、Eckardt评分等)进行meta分析比较。结果共纳入19项研究，1261例患者。除后路手术时间较短外，比较其他因素(LES压、Eckardt评分、临床成功、全肌切开术时间、住院时间、胃食管反流(GERD)、不良事件)，均证实前后路无差异，保证了POEM的安全性。此外，前后肌切开术均可改善LES压和Eckardt评分，且前后肌切开术差异不显著。结论前后入路的LES压、Eckardt评分和其他因素(临床成功、全肌切开术时间、住院时间、反流、不良事件和手术时间)的综合差异似乎相似。然而，经前后路行POEM后的进一步预后需要在未来回答。
{"title":"An Updated Meta-analysis: Similar Clinical Efficacy of Anterior and Posterior Approaches in Peroral Endoscopic Myotomy (POEM) for Achalasia","authors":"Weina Jing, Xinyue Luo, Jin-lin Yang, Junchao Wu, Yuxiang Chen, Kai Deng","doi":"10.1155/2022/8357588","DOIUrl":"https://doi.org/10.1155/2022/8357588","url":null,"abstract":"Introduction Currently, there are few studies on the efficacy of peroral endoscopic myotomy (POEM) in the anterior or posterior approach; however, limited studies have shown contradictory findings. Thus, the goal was to obtain more quantitative and objective outcomes and further compare the clinical efficacy of these two approaches in this meta-analysis. Methods A comprehensive search of PubMed, Embase, Cochrane Library, and Web of Science was conducted to find studies relevant to POEM. The retrieval time was from database inception to September 2021. Studies reporting the effects of POEM according to the anterior or posterior approach were included. STATA 16.0 was used to perform statistical analysis, mainly comparing the quantitative objective indicators (lower esophageal sphincter (LES) pressure and Eckardt scores, etc.) in anterior and posterior approaches by meta-analysis. Result A total of 19 studies with 1261 patients were finally included. Except for shorter procedure time in the posterior approach, other factors (pooled difference of LES pressure, Eckardt scores, clinical success, length of total myotomy, hospital stays, gastroesophageal reflux (GERD), and adverse event) were compared, and all above confirmed that there is no difference between anterior and posterior approaches, and the safety of POEM is ensured. In addition, both anterior and posterior myotomy can improve LES pressure and Eckardt scores, and the difference in anterior and posterior myotomy was unconspicuous. Conclusion The terms of the pooled difference in LES pressure, Eckardt scores, and other factors (clinical success, length of total myotomy, hospital stays, GERD, adverse events, and procedure time) seemed to be similar for the anterior and posterior approaches. However, the further prognosis after POEM via anterior and posterior approaches needs to be answered in the future.","PeriodicalId":12597,"journal":{"name":"Gastroenterology Research and Practice","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2022-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43425071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Elevated platelet volume is the risk factor for the development and poor overall survival of colorectal cancer (CRC) patients. Both microsatellite status and platelet glycoprotein Ibα (GPIbα) are related to platelet volume in CRC patients. This study aimed to investigate platelet GPIbα ectodomain (termed glycocalicin) levels among CRC patients and the association between the glycocalicin levels and microsatellite status in CRC. Methods The clinical and laboratory data of 430 CRC patients between January 2018 and December 2018 in Harbin Medical University Cancer Hospital were collected. The microsatellite status was determined with a polymerase chain reaction. The participants were separated into high microsatellite instability (MSI-H) and microsatellite stable (MSS) groups according to microsatellite status. The glycocalicin levels were measured with an enzyme-linked immunosorbent assay, and the cut-off point was determined with the receiver-operating characteristics curve. The clinical and pathological characteristics were collected via electronic medical records. Logistic regression was used to explore the association between glycocalicin and microsatellite status. Results Among the 430 CRC patients enrolled, 64 patients (14.9%) were identified as MSI-H and others as MSS CRC. Glycocalicin levels were significantly reduced in patients with MSI-H than those with MSS. After controlling for potential confounders, logistic regression analysis revealed that glycocalicin levels were independently associated with MSI-H CRC. Conclusions Reduced glycocalicin levels are associated with the MSI-H subtype of CRC. Further research is needed to elucidate the mechanisms of the association between glycocalicin and MSI-H in CRC patients.
{"title":"The Association between Platelet Glycocalicin and High Microsatellite Instability in Colorectal Cancer","authors":"Zengyao Liu, Qing-Chun Jia, Wen Wang, Yu-Xi Liu, Rui‐tao Wang, Jia-Yu Li","doi":"10.1155/2022/9012063","DOIUrl":"https://doi.org/10.1155/2022/9012063","url":null,"abstract":"Background Elevated platelet volume is the risk factor for the development and poor overall survival of colorectal cancer (CRC) patients. Both microsatellite status and platelet glycoprotein Ibα (GPIbα) are related to platelet volume in CRC patients. This study aimed to investigate platelet GPIbα ectodomain (termed glycocalicin) levels among CRC patients and the association between the glycocalicin levels and microsatellite status in CRC. Methods The clinical and laboratory data of 430 CRC patients between January 2018 and December 2018 in Harbin Medical University Cancer Hospital were collected. The microsatellite status was determined with a polymerase chain reaction. The participants were separated into high microsatellite instability (MSI-H) and microsatellite stable (MSS) groups according to microsatellite status. The glycocalicin levels were measured with an enzyme-linked immunosorbent assay, and the cut-off point was determined with the receiver-operating characteristics curve. The clinical and pathological characteristics were collected via electronic medical records. Logistic regression was used to explore the association between glycocalicin and microsatellite status. Results Among the 430 CRC patients enrolled, 64 patients (14.9%) were identified as MSI-H and others as MSS CRC. Glycocalicin levels were significantly reduced in patients with MSI-H than those with MSS. After controlling for potential confounders, logistic regression analysis revealed that glycocalicin levels were independently associated with MSI-H CRC. Conclusions Reduced glycocalicin levels are associated with the MSI-H subtype of CRC. Further research is needed to elucidate the mechanisms of the association between glycocalicin and MSI-H in CRC patients.","PeriodicalId":12597,"journal":{"name":"Gastroenterology Research and Practice","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2022-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43305923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xudong Ren, Yu Zhou, Yunling Luo, Chaoqun Wang, Anna Pan, Y. Ju, Haoting Sun, Zhifei Lin, Beiyuan Hu, G. Sun, Wenwei Zhu, L. Hong
Interleukin-6 (IL-6), an important inflammatory cytokine, is a key factor regulating cancer metastasis. Cancer cells can modulate their tumorigenic abilities by sorting specific microRNAs (miRNAs) as exosomes into the tumor microenvironment. The relationship between IL-6 and exosomal miRNAs related to hepatocellular carcinoma (HCC) metastasis remains to be elucidated. We examined the metastatic ability of HCC cells after IL-6 treatment and found that miR-133a-3p was sorted into exosomes after IL-6 stimulation and was subsequently released into the tumor microenvironment. In vitro analysis confirmed that exosomal miR-133a-3p acted as a tumor suppressor in HCC. Bioinformatic analysis revealed several signaling pathways and hub genes (CREB1, VCP, CALM1, and YES1) regulated by miR-133a-3p. Survival curves further verified the important roles of hub genes in the prognosis of patients with HCC. It is envisaged that the IL-6/miR-133a-3p axis may be related to the activation of CREB1, VCP, CALM1, and YES1. Our findings provide new insights into the role of exosomal miRNA-mediated tumor progression under inflammatory conditions.
{"title":"IL-6 Promotes Hepatocellular Carcinoma Invasion by Releasing Exosomal miR-133a-3p","authors":"Xudong Ren, Yu Zhou, Yunling Luo, Chaoqun Wang, Anna Pan, Y. Ju, Haoting Sun, Zhifei Lin, Beiyuan Hu, G. Sun, Wenwei Zhu, L. Hong","doi":"10.1155/2022/4589163","DOIUrl":"https://doi.org/10.1155/2022/4589163","url":null,"abstract":"Interleukin-6 (IL-6), an important inflammatory cytokine, is a key factor regulating cancer metastasis. Cancer cells can modulate their tumorigenic abilities by sorting specific microRNAs (miRNAs) as exosomes into the tumor microenvironment. The relationship between IL-6 and exosomal miRNAs related to hepatocellular carcinoma (HCC) metastasis remains to be elucidated. We examined the metastatic ability of HCC cells after IL-6 treatment and found that miR-133a-3p was sorted into exosomes after IL-6 stimulation and was subsequently released into the tumor microenvironment. In vitro analysis confirmed that exosomal miR-133a-3p acted as a tumor suppressor in HCC. Bioinformatic analysis revealed several signaling pathways and hub genes (CREB1, VCP, CALM1, and YES1) regulated by miR-133a-3p. Survival curves further verified the important roles of hub genes in the prognosis of patients with HCC. It is envisaged that the IL-6/miR-133a-3p axis may be related to the activation of CREB1, VCP, CALM1, and YES1. Our findings provide new insights into the role of exosomal miRNA-mediated tumor progression under inflammatory conditions.","PeriodicalId":12597,"journal":{"name":"Gastroenterology Research and Practice","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2022-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48363274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective Astragalus mongholicus Bunge [Fabaceae] (AMB), a traditional Chinese medicine (TCM), has been widely used to treat liver diseases in the clinic. However, the efficacy and mechanism of AMB in the treatment of nonalcoholic fatty liver disease (NAFLD) remain unclear. The purpose of this study was to systematically investigate the active components and mechanisms of AMB against NAFLD based on network pharmacology, molecular docking, and experimental verification. Methods First, the bioactive components and relevant targets of AMB were screened from the Traditional Chinese Medicine Systematic Pharmacology (TCMSP) database, and NAFLD-related targets were obtained from the GeneCards database. Then, the AMB-NAFLD protein target interaction network was built by the STRING database. GO and KEGG pathway enrichment analyses were performed using the DAVID database. The component targets were visualized using Cytoscape software. Finally, molecular docking and experiments were used to verify the results of network pharmacological prediction. Results Network pharmacology predicted that quercetin may be the main active component in AMB, and the TNF and MAPK signaling pathways may be the key targets of AMB against NAFLD. Molecular docking validation results demonstrated that quercetin, as the main active component of AMB, had the highest binding affinity with TNF. Furthermore, quercetin played a distinct role in alleviating NAFLD through in vitro experiments. Quercetin upregulated the phosphorylation levels of AMPK and inhibited the expression of p-MAPK and TNF-α. In addition, we further discovered that quercetin could increase ACC phosphorylation and CPT1α expression in PA-induced HepG2 cells. Conclusions Our results indicated that quercetin, as the main active component in AMB, exerts an anti-NAFLD effect by regulating the AMPK/MAPK/TNF-α and AMPK/ACC/CPT1α signaling pathways to inhibit inflammation and alleviate lipid accumulation.
{"title":"Explore the Mechanism of Astragalus mongholicus Bunge against Nonalcoholic Fatty Liver Disease Based on Network Pharmacology and Experimental Verification","authors":"Lili Fu, Zhongming Wu, Y. Chu, Wenbin Chen, Ling Gao, Shumin Mu, Jiajun Zhao","doi":"10.1155/2022/4745042","DOIUrl":"https://doi.org/10.1155/2022/4745042","url":null,"abstract":"Objective Astragalus mongholicus Bunge [Fabaceae] (AMB), a traditional Chinese medicine (TCM), has been widely used to treat liver diseases in the clinic. However, the efficacy and mechanism of AMB in the treatment of nonalcoholic fatty liver disease (NAFLD) remain unclear. The purpose of this study was to systematically investigate the active components and mechanisms of AMB against NAFLD based on network pharmacology, molecular docking, and experimental verification. Methods First, the bioactive components and relevant targets of AMB were screened from the Traditional Chinese Medicine Systematic Pharmacology (TCMSP) database, and NAFLD-related targets were obtained from the GeneCards database. Then, the AMB-NAFLD protein target interaction network was built by the STRING database. GO and KEGG pathway enrichment analyses were performed using the DAVID database. The component targets were visualized using Cytoscape software. Finally, molecular docking and experiments were used to verify the results of network pharmacological prediction. Results Network pharmacology predicted that quercetin may be the main active component in AMB, and the TNF and MAPK signaling pathways may be the key targets of AMB against NAFLD. Molecular docking validation results demonstrated that quercetin, as the main active component of AMB, had the highest binding affinity with TNF. Furthermore, quercetin played a distinct role in alleviating NAFLD through in vitro experiments. Quercetin upregulated the phosphorylation levels of AMPK and inhibited the expression of p-MAPK and TNF-α. In addition, we further discovered that quercetin could increase ACC phosphorylation and CPT1α expression in PA-induced HepG2 cells. Conclusions Our results indicated that quercetin, as the main active component in AMB, exerts an anti-NAFLD effect by regulating the AMPK/MAPK/TNF-α and AMPK/ACC/CPT1α signaling pathways to inhibit inflammation and alleviate lipid accumulation.","PeriodicalId":12597,"journal":{"name":"Gastroenterology Research and Practice","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2022-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48486468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yi Yin, Xiaofeng Lu, Zhun Li, Song Liu, L. Shao, Lei Cao, Rui-Qing Liu, Liangyu Huang, Zheng Hua Zhu, Zhen Guo, Yi Li, Weiming Zhu
Background Bone loss is common in patients with inflammatory bowel disease (IBD). The aim of the present study was to determine the prevalence of metabolic bone disease in patients newly diagnosed with IBD and to identify the risk factors for bone loss over time. Methods We performed a retrospective, both cross-sectional and longitudinal, study to extract the risk factors of bone loss (including osteopenia and osteoporosis) in patients newly diagnosed with IBD, using dual-energy X-ray absorptiometry (DXA). Results A total of 639 patients newly diagnosed with IBD that had at least one DXA were included in the cross-sectional study. Osteopenia and osteoporosis were diagnosed in 24.6% and 5.4% of patients, respectively. Age at diagnosis, body mass index, and serum phosphorus were identified as independent factors associated with bone loss at baseline. A total of 380 of the 639 IBD patients (including 212 CD patients and 168 UC patients) with at least a second DXA scan were included in the longitudinal study. 42.6% of the patients presented a worsening of bone loss in the follow-up study. Menopause, albumin, and use of corticosteroids were identified as independent factors associated with worsening of bone loss. Conclusions Metabolic bone disease is common in IBD patients, and there is a significant increase in prevalence of bone loss over time. Postmenopausal female, malnourished patients, and those requiring corticosteroid treatment are at risk for persistent bone loss. Therefore, BMD measurements and early intervention with supplementation of calcium and vitamin D are recommended in IBD patients with high-risk factors.
{"title":"Risk Factors for Worsening of Bone Loss in Patients Newly Diagnosed with Inflammatory Bowel Disease","authors":"Yi Yin, Xiaofeng Lu, Zhun Li, Song Liu, L. Shao, Lei Cao, Rui-Qing Liu, Liangyu Huang, Zheng Hua Zhu, Zhen Guo, Yi Li, Weiming Zhu","doi":"10.1155/2022/1498293","DOIUrl":"https://doi.org/10.1155/2022/1498293","url":null,"abstract":"Background Bone loss is common in patients with inflammatory bowel disease (IBD). The aim of the present study was to determine the prevalence of metabolic bone disease in patients newly diagnosed with IBD and to identify the risk factors for bone loss over time. Methods We performed a retrospective, both cross-sectional and longitudinal, study to extract the risk factors of bone loss (including osteopenia and osteoporosis) in patients newly diagnosed with IBD, using dual-energy X-ray absorptiometry (DXA). Results A total of 639 patients newly diagnosed with IBD that had at least one DXA were included in the cross-sectional study. Osteopenia and osteoporosis were diagnosed in 24.6% and 5.4% of patients, respectively. Age at diagnosis, body mass index, and serum phosphorus were identified as independent factors associated with bone loss at baseline. A total of 380 of the 639 IBD patients (including 212 CD patients and 168 UC patients) with at least a second DXA scan were included in the longitudinal study. 42.6% of the patients presented a worsening of bone loss in the follow-up study. Menopause, albumin, and use of corticosteroids were identified as independent factors associated with worsening of bone loss. Conclusions Metabolic bone disease is common in IBD patients, and there is a significant increase in prevalence of bone loss over time. Postmenopausal female, malnourished patients, and those requiring corticosteroid treatment are at risk for persistent bone loss. Therefore, BMD measurements and early intervention with supplementation of calcium and vitamin D are recommended in IBD patients with high-risk factors.","PeriodicalId":12597,"journal":{"name":"Gastroenterology Research and Practice","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2022-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42972680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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