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OBJECTIVE To systematically evaluate the efficacy and safety of vonoprazan （VPZ） for Helicobacter pylori （Hp） eradication therapy. METHODS Retrieved from The Cochrane Library， Embase， PubMed， CNKI， VIP and Wanfang database， randomized controlled trials about VPZ for Hp eradication therapy （trial group） versus proton pump inhibitor （PPI） （control group） were collected during the inception to July 2022. After data extraction and quality evaluation with bias risk assessment tool recommended by Cochrane System Evaluation Manual 5.1.0， meta-analysis was performed by using RevMan5.3 software. RESULTS Nine studies with 2 134 patients were included. Compared with control group， the overall Hp eradication rate of trial group increased significantly in either the ITT analysis or PP analysis， being 87.5% vs. 76.2% [RR＝1.14， 95%CI （1.06，1.21）， P＜0.001] and 92.4% vs. 80.5% [RR＝1.11， 95%CI （1.03，1.21）， P＜0.01]， respectively. According to ITT and PP analysis of primary treatment subgroup， compared with control group， the overall Hp eradication rate of trial group increased significantly， being 88.4% vs. 76.5% [RR＝1.15， 95%CI （1.09，1.22）， P＜0.000 01] and 92.8% vs. 80.9% [RR＝1.12， 95%CI（1.03，1.23）， P＜ 0.05]； according to ITT and PP analysis of rescue therapy subgroup， there was no significant difference in the overall Hp eradication rate between control group and trial group （P＞0.05）. According to ITT and PP analysis of triple therapy subgroup， compared with control group， overall Hp eradication rate of trial group increased significantly， being 88.3% vs. 75.6% [RR＝1.16， 95%CI （1.08， 1.25）， P＜0.000 1] and 92.6% vs. 77.6% [RR=1.15， 95%CI （1.04， 1.28）， P＜0.01]； according to ITT and PP analysis of quadruple therapy subgroup， there was no significant difference in the overall Hp eradication rate between control group and trial group （P＞0.05）. Compared with control group， the incidence of adverse events in trial group decreased significantly， being 34.2% vs. 40.9% [RR＝0.84， 95%CI（0.70，0.99）， P＜ 0.05]. There was no statistical significance in the incidence of serious adverse events between 2 groups （P＞0.05）. CONCLUSIONS Compared with PPI therapy， the efficacy of VPZ-based triple therapy is better， particularly in primary treatment patients. However， VPZ has no significant advantage in rescue treatment and bismuth-containing quadruple regimen. And the safety and tolerance of VPZ for Hp eradication therapy are well， even better than PPI.
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Objective:To evaluate the efficacy and safety of rubber band traction-assisted endoscopic submucosal dissection (ESD).Methods:A total of 49 patients with rectal endocrine tumor who underwent ESD at Beijing Friendship Hospital Affiliated to Capital Medical University from January 2016 to December 2019 were reviewed. Thirty-two patients who underwent traditional ESD from January 2016 to May 2018 were assigned to the non-traction group. Seventeen patients who underwent the operation with a rubber band as auxiliary traction from June 2018 to December 2019 were assigned to the traction group. Basic information, ESD procedure time, complications were compared between the two groups.Results:There were no significant differences in age, gender or lesion size between the traction group and the non-traction group ( P>0.05). The ESD operation time of the traction group was significantly shorter than that of the non-traction group (13.76±5.71 min VS 22.99±10.32 min, t=-3.408, P=0.001). There were no postoperative complications in the traction group, but 3 cases of perforation occurred in the non-traction group. There was no significant difference in the incidence of perforation between the two groups ( P=0.542). Conclusion:Rubber band traction can safely improve the efficiency of ESD.
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Objective:To investigate the clinical, endoscopic and pathological characteristics of early Barrett esophageal adenocarcinoma (BEA) and to evaluate the treatment efficacy of endoscopic submucosal dissection (ESD).Methods:Data of 13 patients who were diagnosed as early BEA and treated by ESD in Beijing Friendship Hospital from November 2015 to June 2018 were retrospectively analyzed, including clinical data, endoscopic manifestations and pathological information.Results:Out of 13 patients, 10 were male. One had underlying long-segment Barrett esophagus (LSBE), 6 had short-segment Barrett esophagus (SSBE), and 6 had super short-segment Barrett esophagus (less than 1 cm). Two arose from circumferential Barrett esophageal (BE) and 11 from tongue-like BE. Ten lesions were located on the right anterior side wall (12-2 o′clock) of the esophagogastric junction (EGJ), and 12 lesions were superficial type (0-Ⅱ). ESD was successfully conducted in all the patients without any complication. The en bloc and curative resection rate was 100% (13/13) and 92% (12/13), respectively. Pathology examination found 9 well-differentiated adenocarcinoma and 10 intramucosal cancer. No recurrence was detected in 11 patients during follow-up of 3.3-29.3 months.Conclusion:Early BEA tends to occur in elderly male, and mostly originated from non-LSBE and tongue-like BE. Most lesions are superficial type and located on the right anterior side wall of EGJ. In pathology, most lesions are well-differentiated adenocarcinoma and limited to the mucosa. ESD is a safe and efficient treatment for BEA.
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Objective To verify the genes screened by the polymerase chain reaction (PCR) chip of cell cycle. Methods The colon cancer cells SW480 were randomized into two groups, the test group (with gastrin stimulation) and con-trol group (without gastrin stimulation). The method of Western blot was used to detect the expression of calcylin binding pro-tein/Siah-1 interacting protein (Cacybp/SIP) before and after gastrin stimulation. The differential expression genes, cyclin de-pendent kinase 8 (CDK8) and cyclin dependent kinase subunit (CKS2), were verified by using real-time quantitative PCR (qRT-PCR). Results It was found that before the stimulation, CacyBP/SIP was located and expressed in cytoplasm, and then in both cytoplasm and nucleus after gastrin stimulation. The qRT-PCR results of CDK8 and CKS2 genes were consis-tent with those of microarray detection. The expressions of CDK8 and CKS2 were up-regulated (P < 0.05). Conclusion The stimulation of human gastrin can lead to the nuclear translocation of CacyBP/SIP. The results of microarray are reliable, and the differentially expressed genes screened through gene chip deserve further study.
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Objective To evaluate the potential utility of PⅢpeptide in anti peritoneum metastasis in gastric carcinoma cells with high peritoneal metastasis potential(GC9811 P).Methods The adhesion and invasion inhibitory effects of PⅢpeptide on GC9811-P cells were detected by in vitro matrix adhe- sion and cell invasion experiments.By using nude mice metastatic model of human gastric cancer,the effects of PⅢpeptide on peritoneal metastasis of gastric cancer GC9811 P were evaluated.Mice were randomly divided into the experimental(GC9811-P+peptide PⅢgroup)and control groups(GC9811-P +0.9% NaCl solution group),12 mice in each group.At the exhaustion time after inoculation,mice were sacrificed to observe the incidence of peritoneal metastasis,the number of the metastasis foci and the volume of primary tumor.Results Two hours after 40?g PⅢpeptide incubation,the adhesion in hibitory rate reached 86.30%.The adhesion inhibitory effects were in a time dependent manner.The in- vasion inhibitory effects became apparent(81.4%)48 hours after PⅢpeptide insult.After the GC9811- P cells were orthotopic implanted in nude mice and treated with PⅢpeptide,the number of peritoneal metastatic nodes were significantly reduced as compared with control group(3.2?6.5 vs.26.3?5.2) ( P＜0.01).But the mass of primary tumor were (1.9?1.2) g in PⅢpeptide treated group and (2.1?1.0) g in the control group,no difference was noted between two groups(P＞0 05 ).Conclusion PⅢpeptide can markedly inhibit the adhesion,invasion and peritoneal metastasis of gastric carcinoma cell line GC29811-P with high peritoneal metastasis potential
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Objective To study the effect of ribosomal protein S13(RPS13) encoding genes on the development of mutidrug resistance (MDR) in human gastric cancer cell line. Methods RPS13 cDNA was amplified by RT-PCR. The sense and antisense eukaryotic expression vectors were constructed by DNA recombination. Gastric cancer cell line SGC7901 and Vincristine-resistant SGC7901/VCR cells were transfected with the sense and antisense recombinant vectors respectively using liposome-mediated method. RNA dot blotting assay was used to verify the changes of mRNA level in stable clones. To investigate effects of the sense, antisense vector transfection on the chemotherapeutic drug sensitivity, thiazolyl blue (MTT) cytotoxicity assay was used. Cell cycle was detected by flow cytometry (FCM). Results Whole length of RPS13 cDNA gene was amplified by RT-PCR. The sense, antisense eukaryotic expression vectors were constructed by the directed cloning of the target genes into eukaryotic expression vector pcDNA 3.1(+). RNA dot blotting assay suggested that mRNA level of the RPS13 was up-regulated in the sense recombinant vector transfected cells, and down-regulated in the antisense recombinant vector transfected cells. By MTT cytotoxicity assay, the enhanced resistance to adriamycin, 5-fluorouracil and vincristine was found in the RPS13 sense recombinant vector transfected SGC7901 cells. RPS13 antisense recombinant vector rendered SGC7901/VCR cells partially sensitive to mitomycin and vincristine. Cell cycle analysis suggested that the proportion of G1, S, and G2 cells was 47.0%, 33.2% and 19.8% respectively in up-regulated RPS13 cells; the proportion of G1, S and G2 cells was 62.9%, 1.0% and 36.1% respectively in down-regulated RPS13 cells. Conclusions RPS13 may take part in the mediation of MDR in gastric cancer cells.