BMC Gastroenterology最新文献

Background: The incidence of autoimmune gastritis (AIG) is low, and our understanding of the proliferation of neuroendocrine cells, specifically enterochromaffin-like (ECL) cells, is insufficient because of the reliance on chromogranin A (CgA) staining for diagnostic assistance. The purpose of this study was to analyze the morphological characteristics of neuroendocrine cell hyperplasia in H&E-stained sections and improve pathologists' diagnostic accuracy in its identification.

Methods: A total of 73 patients with AIG were reviewed in a single center-the Department of Pathology of Chuiyangliu Hospital affiliated with Tsinghua University from June 2023 to June 2024. We characterized patients with AIG, compared the identification of ECL hyperplasia between H&E-stained sections and CgA-stained sections, and analyzed the diagnostic concordance rate of pathologists before and after training on the diagnosis of ECL hyperplasia using H&E -stained sections.

Results: Age, sex and histopathological findings, such as the degree of inflammation, atrophy, and intestinal metaplasia, were not significantly related to the type of ECL hyperplasia. Fifty-three patients (72.6%) were confirmed by CgA staining to have ECL hyperplasia, and linear and micronodular forms were the most common types. After being trained on the morphology associated with ECL hyperplasia, pathologists with different years of experience significantly improved their ability to identify neuroendocrine cells in patients with AIG.

Conclusions: A better understanding of the morphological assessment of ECL hyperplasia using H&E -stained sections is necessary to improve the understanding and diagnosis of ECL hyperplasia, to avoid missed diagnoses, and to facilitate subsequent clinical monitoring and treatment.

Background: Abdominal bloating is a common gastrointestinal complaint, especially among women, and can significantly affect quality of life. Despite its high prevalence, the role of dietary fat intake in the development or exacerbation of bloating remains poorly characterized. This study aimed to examine the association between abdominal bloating and the consumption of various types of dietary fats among Iranian women.

Methods: A case-control study was performed on 229 women with bloating and 224 women without bloating in Tehran, Iran. Dietary intake was assessed using a validated 168-item food frequency questionnaire (FFQ), and nutrient analysis was conducted using Nutritionist IV software. A binary logistic regression method, adjusted for confounders was applied to assess the link between bloating and the intake of fats.

Results: An inverse association was found between abdominal bloating and omega‑3 PUFA intake (OR = 0.34, 95% CI: 0.13-0.87, p = 0.024), which remained significant after multivariable adjustment. Following correction for multiple comparisons using the Benjamini-Hochberg false discovery rate (FDR, q < 0.10), statistical significance was retained only in the fully adjusted model (q = 0.091). No significant associations were found for total fat, saturated fatty acids (SFAs), monounsaturated fatty acids (MUFAs), total PUFA, cholesterol, or omega‑6 PUFA.

Conclusion: Higher dietary intake of omega-3 PUFAs may be associated with reduced bloating, while other types of fats showed no significant association. This highlights the potential role of omega-3 fatty acids in managing bloating. Further research is needed to explore causal relationships and the therapeutic implications of these findings.

Introduction: Environmental Enteric Dysfunction (EED) is a subacute inflammation of the small intestinal (SI) mucosa associated with undernutrition and perturbation of the SI microbiota. Its diagnosis relies on histopathological assessment of small intestinal biopsies, with a lack of validated biomarkers contributing to underdiagnosis. This study assessed the prevalence and histological features of EED in undernourished Bangladeshi women living in an urban slum in Dhaka, compared to well-nourished women from slum and non-slum areas, and examined the factors associated with histologically confirmed EED.

Methods: This analysis included non-pregnant, non-lactating Bangladeshi women aged 18-45 years classified by location of residence and nutritional status: well-nourished non-slum residents (WNNS), well-nourished slum residents (WNS), and undernourished slum residents (UNS). Data were obtained from two ongoing studies and one completed study. Well-nourished women (BMI 20-24.9 kg/m²) who consented to upper gastrointestinal endoscopy for functional dyspepsia were also enrolled. During endoscopy, mucosal biopsies were collected from the distal duodenum, and the presence of EED was determined by histologic assessment of lymphocyte infiltration, villous atrophy, and/or crypt hyperplasia.

Results: Between October 2, 2022, and June 30, 2024, 1059 WNNS and 445 WNS women were screened for eligibility. Of these, 33 WNNS and 55 WNS women underwent endoscopic evaluation. Histological data were available from a prior study of 38 UNS women. Histological examination showed EED in 21% of WNNS, 18% of WNS, and 100% of UNS women. Multiple logistic regression analysis indicated that BMI (aOR: 0.70, 95% CI: 0.58-0.85; p < 0.001) was significantly associated with the presence of EED in women in this study.

Conclusion: Although EED was expectedly common in undernourished women, its detection in well-nourished women indicates that environmental conditions may influence intestinal health beyond nutritional status alone. These findings indicate that attention to environmental risks is important for wider groups of women and support further work to understand the pathways that lead to EED in different community settings.

Background: Sepsis is an infection-induced syndrome that is challenging to treat. Sepsis-induced intestinal injury can accelerate sepsis and increase patient mortality. SNHG16 is associated with the progression of sepsis. Therefore, this study explored the role of SNHG16 in sepsis-induced intestinal injury. This study aimed to provide valuable insights into the diagnosis and treatment of sepsis-induced intestinal injury.

Methods: Serum samples were collected from sepsis patients and healthy controls. Sepsis-induced intestinal injury cell model was constructed by treating Caco-2 cells using lipopolysaccharide (LPS). The qRT-PCR was used to measure lncRNA, miRNA, and gene expression. The biological functions of biomolecules on intestinal cells were estimated using flow cytometry, transwell permeability assay and Cell Counting Kit-8 (CCK-8). The oxidative stress status was measured using the antioxidant activity assay. ELISA measured inflammatory cytokines. The mechanism was investigated using dual luciferase reporter assay.

Results: In sepsis patients, SNHG16 downregulation discriminated patients with intestinal injury. SNHG16 downregulation led to upregulated expression of miR-15a-5p, which further led to downregulated expression of AKT3. The cell experiments showed that SNHG16 protected intestinal cells from the injury induced by LPS. MiR-15a-5p mediated the damaging impact of SNHG16 downregulation on intestinal cells. MiR-15a-5p affected intestinal cells by downregulating AKT3.

Conclusion: The downregulation of SNHG16 mediated the injury effect of LPS on intestinal cells by upregulating miR-15a-5p and further targeting AKT3. SNHG16 was a diagnostic biomarker and potential therapeutic target for sepsis-induced intestinal injury.

Background: Anxiety and depression are closely related to digestive system diseases. However, anxiety and depression in gastroenterology outpatients are not consistently recognized or managed. This study aimed to investigate the prevalence of anxiety, depression and associated risk factors in gastroenterology outpatients.

Methods: We conducted a cross-sectional study from June 2021 to June 2022 in the gastroenterology outpatients of three central hospitals. Professional researchers at each center collected data from patients through face-to-face interviews using a questionnaire. The Hamilton Anxiety Scale, Hamilton Depression Scale and Pittsburgh Sleep Quality Index were respectively used to assess anxiety, depression and sleep quality. Univariate and multivariate logistic regression were performed to identify associated risk factors.

Results: A total of 931 patients were finally included for analysis. The overall detection rates of anxiety and depression were 26.5% and 12.2%, respectively. Gastroesophageal reflux (AOR:1.559, 95%CI:1.084-2.244), dyspepsia (AOR:2.194, 95%CI:1.302-3.696), bile reflux (AOR:3.509, 95%CI:2.413-5.103), atrophic gastritis with intestinal metaplasia or intraepithelial neoplasia (AOR:3.814, 95%CI:1.399-10.402), biliary tract disease (AOR:1.584, 95%CI:1.042-2.410), liver disease (AOR:2.401, 95%CI:1.073-5.374), and poor sleep (AOR:5.578, 95%CI:3.859-8.063) were significantly associated with anxiety. Bile reflux (AOR:5.409, 95%CI:3.190-9.173), liver disease (AOR:3.177, 95%CI:1.183-8.531), and poor sleep (AOR:8.572, 95%CI:4.952-14.840) were significantly associated with depression. Physical exercise time ≥ 150 min/week (AOR:0.550, 95%CI:0.324-0.934) was inversely associated with depression.

Conclusion: Anxiety and depression were prevalent among gastroenterology outpatients. Gastroenterologists should pay close attention to the psychological status of patients, especially those with gastroesophageal reflux, dyspepsia, bile reflux, atrophic gastritis with intestinal metaplasia or intraepithelial neoplasia, biliary tract disease, liver disease, and poor sleep.

Background and objective: Transarterial chemoembolization (TACE) has become the standard treatment for moderately advanced hepatocellular carcinoma (HCC), but there are significant differences in postoperative survival rates, and the key factors influencing prognosis remain unclear. This article focuses on exploring the prognostic factors that affect the progression-free survival (PFS) and overall survival (OS) of patients with primary hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (D-TACE).

Methods: A retrospective cohort study design was adopted. A total of 114 HCC patients who received their first D-TACE treatment at our hospital from January 2021 to December 2023 and were followed up (with a follow-up period of 6 to 36 months) were included. Baseline data were collected, and survival rates were calculated using the Kaplan-Meier method and survival curves were plotted. Log-rank test was used for inter-group comparison. Multivariate analysis was conducted using methods such as Cox proportional hazards regression analysis to screen independent prognostic factors.

Results: The patients were divided into the survival group and the death group based on their survival status after 36 months. We found that there were significant differences in baseline characteristics such as the maximum tumor diameter, portal vein invasion, extrahepatic metastasis, CNLC stage, BCLC stage, ECOG score, liver function classification (Child-pugh score), multiple tumor foci, BMI, and several serum indicators between the survival group (46 cases) and the death group (68 cases) (P < 0.05). The KM survival analysis showed that the differences in PFS and OS between the two groups were statistically significant (Log-rank P < 0.001). Multivariate Cox analysis indicated that the maximum tumor diameter of the lesion (HR = 1.08, 95% CI: 1.01-1.18, P = 0.049) and portal vein invasion (HR = 1.99, 95% CI: 1.09-3.64, P = 0.025), ECOG score (HR = 1.91, 95% CI: 1.05-3.50, P = 0.035) were independent risk factors for PFS. Portal vein invasion (HR = 3.22, 95% CI: 1.66-6.26, P < 0.001) and HB (HR = 0.99, 95% CI: 0.97-0.99, P = 0.044), NLR (HR = 1.25, 95% CI: 1.02-1.53, P = 0.035) were independent risk factors for OS.

Conclusions: This study found that the maximum diameter of the tumor, invasion of the portal vein, and ECOG score were independent predictors of disease progression in HCC patients after D-TACE surgery. Meanwhile, invasion of the portal vein and HB, NLR were key factors affecting the overall survival of patients. In clinical practice, these indicators should be comprehensively evaluated. For high-risk patients, enhanced follow-up management and active consideration of combined systemic treatment and other comprehensive strategies should be adopted to improve their prognosis.