Gastroenterology and Hepatology From Bed to Bench最新文献

Indirect immunofluorescence on HEp-2 cell line (HEp-2-IIF) remains "gold standard" method for the detection of antinuclear antibodies (ANA). ANA is an operative definition, showing the possibility of autoantibodies (Aab) to bind nuclear, and cytoplasmic antigens. One of the major examples is represented by anti-mitochondrial antibodies (AMAs), which target proteins of the inner and outer mitochondrial membranes, located into the cytoplasm. The standard IIF on rat kidney/stomach/liver tissue sections, with the combined use of other commercial assays, may all be used in ordinary lab life to validate the AC-21 pattern on Hep-2 cells. The routine lab experience teaches that commercial kits cannot always be detected and define specific AMAs. In these cases the literature proposes the use of other homemade assays to detect AMAs as immunoprecipitation (IP) and Western blot (IP-WB). However, using IP or IP-WB is difficult to apply in a routine laboratory, because of numerous cases to process and the related troubles. Where find confirmation of the AC-21 pattern if line-immunoblot and other routine methods (ELISA, CLIA/FEIA assays) fail? We review AC-21 AMA-like sera from our patients (year 2022) and propose a revised diagnostic algorithm based on the combined use of IIF on Hep-2 cells, line immunoblot and IIF on rodent tissue as a third line method. We demonstrated that, particularly in cases where the second level test was unsuccessful, the application of IFI on rodent tissues became indispensable to verify the existence of AMAs.

Meckel diverticulum is the most common congenital anomaly of the gastrointestinal tract which is located in small bowel within 2 feet of the ileocecal valve. Nevertheless, an inverted Meckel's diverticulum is an uncommon condition believed to result from aberrant peristalsis in that specific area. This article showed signs, symptoms, and possible clinical presentations using CARE guidelines in a case of inverted Meckel's diverticulum and reviews other possible features lastly, definitive treatment, results, and case follow-up were shown to refresh, and raise surgeons' awareness of this rare disorder.

Aim: Our goal was to assess the need for vaccination and preventive measures in this vulnerable population.

Background: HAV is the most common form of acute viral hepatitis, transmitted primarily via fecal-oral route. Therefore, poor hygiene and close contact among institutionalized people are associated with higher HAV infection prevalence. We sought to determine the seroprevalence of anti-HAV antibodies among institutionalized individuals with intellectual impairments in light of Iran's falling trend in HAV antibody prevalence.

Methods: In this cross-sectional study, we evaluated the seroprevalence of total and IgM anti-HAV antibodies of 254 institutionalized people with intellectual disabilities. Total and IgM anti-HAV antibodies of the blood samples of these people were determined by ELISA method.

Results: The seroprevalence of total and IgM anti-HAV antibodies among institutionalized people with intellectual disability were 15.4% and 0.4% respectively. In comparison to other institutionalized patients, individuals who were elderly and had spent more time in the institutions exhibited a higher prevalence of anti-HAV antibodies (p-values= 0.011 and <0.001, for example).

Conclusion: Based on our study, intellectually disabled people have a low prevalence of anti-HAV antibodies, which increases with age and the duration of institutionalization. Therefore, vaccination is necessary to prevent serious infection in these people.

Aim: Molecular mechanism detection of stage I to stage II transition of esophageal squamous cell carcinoma via protein-protein interaction (PPI) network analysis is the main aim of this study.

Background: Esophageal cancer (EC) is recognized as cancer with a very poor prognosis and malignancy. It is characterized by a high prevalence rate within the world and a very low survival rate, even with treatment.

Methods: To detect esophageal squamous cell carcinoma (ESCC) related genes, gene expression profiles (GEPs) of GSE161533 from the Gene Expression Omnibus (GEO) database were considered to be analyzed. Data was evaluated via the GEO2R program to explore the significant differential genes (DEGs) associated to stages I and II of esophageal squamous cell carcinoma. Each analysis's top 250 significant DEGs were evaluated, and the non-common genes were assessed via PPI network analysis. The hub-bottleneck DEGs were determined and enriched via gene ontology.

Results: Results indicate 373 significant DEGs discriminate stage I from stage II. PPI network analysis associated with gene expression assessment showed that COL1A1, SERPINE1, PDGFRB, AURKA, TGFBI, LGALS3, BRCA1, and TFRC are the critical DEGs which are related to ESCC transition state from stage I to II of disease. A total of 13 biological processes and molecular functions were related to the crucial genes.

Conclusion: In conclusion, the Upregulation of COL1A1, SERPINE1, PDGFRB, AURKA, TGFB1, and LGALS3 and downregulation of BRCA1 and TFRC in stage II of ESCC relative to stage I were pointed out as the key events which are associated with promotion of stage I to stage II transition.

Aim: Due to the capabilities of the mobile application in the self-care of patients, the present study was conducted to design and evaluate a mobile-based self-care application for patients with liver cirrhosis.

Background: Liver cirrhosis is a progressive and chronic disease that, if left untreated, leads to liver cancer and, finally, the death of the patient.

Methods: This study was conducted in six phases, including determining and confirming the validity of the minimum data set and capabilities for the application, designing a conceptual and logical model and determining the technical capabilities, designing the application, evaluating the prototype usability in a laboratory environment by technical experts, evaluation of the application usability in a real environment by 30 patients with QUIS (Questionnaire of User Interface Satisfaction) questionnaire.

Results: The designed application has capabilities such as calculating the patient's MELD score (Model for End-Stage Liver Disease), medication reminder, location in emergency, and conversation with the physician. The results showed that the patients evaluated the application with a score of 7.94 (out of 9 points) at a good level.

Conclusion: The self-care application can help patients with liver cirrhosis and their families access the necessary information related to the special care of the patient at any time and place; it also helps better manage the patient's life, improve the quality of life, and monitor the patient. These applications can effectively manage chronic diseases by reducing the burden of referrals and costs.

Aim: We aim to investigate the relationship between hsa_circ_0009361 plus hsa_circ_0009362 expression levels and the clinicopathological features of colorectal cancer (CRC) patients.

Background: Circular RNAs (circRNAs) are implicated in the progression and development of CRC. CircRNAs have been recognized as diagnostic and prognostic biomarkers, opening up a new window to comprehend the molecular basis of CRC. Given the significance of circRNAs and the G protein subunit b1 (GNB1) gene in malignancies, the goal of the current investigation was to determine the expression levels of GNB1 derivative circular RNAs circGNB1 (hsa_circ_0009361 and hsa_circ_0009362) in CRC and adjacent control tissues.

Methods: The expression levels of the GNB1 derivative circular RNAs (hsa_circ_0009361 and hsa_circ_0009362) were evaluated using the quantitative real-time PCR (qRT-PCR) method in 45 CRC tissues and adjacent control tissues. Furthermore, we analyzed the diagnostic power of the mentioned circRNAs by plotting the receiver operating characteristic (ROC) curve. The association between the expression levels of hsa_circ_0009361 and hsa_circ_0009362 was evaluated using correlation analysis.

Results: Our results revealed that the expression levels of hsa_circ_0009361 and hsa_circ_0009362 were significantly down-regulated in CRC tissues compared to the adjacent control group. Analysis of patients' clinicopathological features indicated that expressions of hsa_circ_0009361 and hsa_circ_0009362 were differently related to lymph vascular invasion (P<0.001). ROC curve results showed that these circRNAs are good candidate diagnostic biomarkers in CRCs. Pearson's correlation test revealed a positive correlation between hsa_circ_0009361 and hsa_circ_0009362 expression levels (P<0.0001).

Conclusion: These results demonstrated that hsa_circ_0009361 and hsa_circ_0009362 expression levels may be used as possible diagnostic biomarkers for CRC.

Aim: The study was aimed to find out the efficacy of a stool color card (SCC) in differentiating biliary atresia (BA) from non-BA in resource-limited countries.

Background: stool color screening system was introduced in 2004 which lead to marked improvement in sensitivity of detecting BA.

Methods: This cross-sectional observational study was conducted from January, 2019 through July, 2022 on purposively sampled infants who developed jaundice before three months of age, had direct bilirubin of > 20 % of total with pale stool and dark urine.

Results: 144 cases (male, 96) were included in the study and their mean age at admission was 87.3±37.2 days and mean age at onset of jaundice was 6.1±7.7 days. BA was confirmed in 106 (73.6%) cases and 38 (26.4%) children were in non-BA group. Frequency of persistent pale stool between BA and non- BA were 88 vs 8 (83.0 % Vs 21.0 %) which was highly significant (p=0.000). Mean difference of total and direct serum bilirubin, median alanine transferase and alkaline phosphatase were not statistically significant between two groups. Median of serum gamma glutamyl transpeptidase (GGT) in BA was 570 U/L and in non-BA it was 138.0 U/L which was statistically significant (p=0.000). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of SCC were 83%, 78.9%, 91.7%, 62.5% and 81.9% respectively.

Conclusion: SCC has good sensitivity to diagnose BA but failed to prove better specificity to rely simply on it. SCC may be used as early screening tool for prompt referral to appropriate medical care centers for final evaluation of BA.

Aim: In this multicenter study, we investigated all causes of mortality in hospitalized inflammatory bowel disease (IBD) patients.

Background: The widespread use of biologics and immune suppressive treatments, along with the longer lifespan of patients with IBD, may have changed the cause of death in this population. Knowing this may lead to better preventive and therapeutic strategies for IBD patients.

Methods: This cross-sectional study reviewed records of 1926 IBD patients hospitalized in referral hospitals in Isfahan and Shiraz during 2013-2021. In nine years, 84 patients, 39 from Isfahan and 45 from Shiraz, died. We retrospectively gathered data on demographic, clinical, and laboratory information, as well as the cause of death. We extracted the cause of death from the death sheets and classified it using the International Classification of Diseases (ICD-10). Using the Kaplan-Meier model, we estimated the median survival time from disease diagnosis to death.

Results: Males accounted for 47 (55%) of the deceased patients. The mean age of the patients was 48.63 ± 18.7 years. The mortality rates among hospitalized UC and CD patients were 7.2% and 7.8%, respectively. The median duration of admission to death was 8 days, with 19 (22.6%) of IBD patients dying on the first day of their hospital admission. Half of the cohort of deceased IBD patients had survived for 8 years following their disease diagnosis. 32.7% of all recorded causes of death were due to certain infectious diseases. The second and third most common causes of death were diseases of the digestive system and diseases of the circulatory system, including pulmonary embolism, accounting for 30.1% and 14.2%, respectively.

Conclusion: According to this study from Iran, infectious diseases are the leading cause of death among hospitalized IBD patients. Prevention and clinical management of pulmonary embolism in IBD patients require more careful consideration. We strongly encourage population-based cohort studies to enhance the findings.

Aim: To better understand the molecular mechanism of Helicobacter pylori (H. pylori) in adenocarcinoma, the gene expression profile of AGS cells was analyzed by complementary study.

Background: Gastric cancer, as one of the most lethal malignancies in the world, is important to be studied in terms of biomarkers. On the other hand, Helicobacter pylori is one of the key risk factors in this type of disease.

Methods: In this cross-sectional study, we evaluated the seroprevalence of total and IgM anti-HAV antibodies of 254 institutionalized people with intellectual disabilities. Total and IgM anti-HAV antibodies of the blood samples of these people were determined by ELISA method. Protein-protein interaction (PPI) network analysis is a bioinformatic study with validation values for biomarker identification and clarification of molecular mechanisms. Cytoscape V 3.10.2 and its application identified potential central elements of the PPI network and its corresponding roles.

Results: GAPDH and P53 are the most promising candidates in this study. In addition, the microRNA signatures assessment provided more information about these biomarkers and added more value.

Conclusion: Consequently, a new outlook for the relationship between gastric cancer and H. pylori was explored based on the new key biomarkers.

Continuing studies related to Abdominal Compartment Syndrome (ACS) is imperative in terms of its significant effect on morbidity and mortality rates. To establish bibliometric analysis as a comprehensive review of ACS literature. The process encompasses many phases, such as delineating search terms, beginning and refining search results, creating preliminary statistics from the data, and performing data evaluation. Scopus database was selected as the primary source, and VOSviewer software was used to visualize author networks, country affiliations, journal affiliations, and keyword associations. The analysis was conducted on January 16th, 2023, and yielded a total of 855 documents spanning the period from 1993 to 2022. Studies on ACS showed an annual increase, but it has not yet reached a mature stage. United States leads the world in terms of the highest number of publications, h-index, citations, and the involvement of renowned authors and organizations. Through an analysis of less frequently used keywords, this study identified potential themes for future investigation, including histopathology, biological markers, interleukin 6, alanine aminotransferase, early diagnosis, scoring systems, the severity of illness indices, clinical practices, patient monitoring, preoperative evaluations, minimally invasive surgery, inter-method comparisons, multicenter studies, follow-up investigations, systematic reviews, and meta-analyses. While publications in ACS journals are crucial, they alone are not exhaustive, necessitating further research.