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Objective:To investigate the prevalence of malnutrition in hospitalized patients with ulcerative colitis (UC) using the Global Leadership Initiative on Malnutrition (GLIM) criteria, compare the body composition, clinical indicators, and occurrence of poor UC outcomes between the malnutrition group and the non-malnutrition group, and analyze the risk factors of malnutrition.Methods:A total of 104 UC patients hospitalized in the Affiliated Hospital of Qingdao University during 2019 to 2021 and with relevant data collected through UC-sarcopenia Prospective Study were included. Data including nutritional risk screening 2002 (NRS 2002) scores, diagnosis of malnutrition per GLIM criteria, body composition data, clinical data and occurrence of poor outcomes were extracted. All patients were screened for nutritional risk using NRS 2002 at admission, and those at nutritional risk were further evaluated for malnutrition diagnosis per GLIM criteria. The prevalence of malnutrition in UC inpatients, the differences in indicators between malnutrition and non-malnutrition groups, and the risk factors of malnutrition were analyzed.Results:Among the enrolled UC patients , 35 (33.7%) were at nutritional risk, and 30 (28.8%) were diagnosed as malnutrition by GLIM criteria. Compared with the non-malnutrition group, the body composition indexes, including body fat mass, protein, skeletal muscle mass, segmental muscle mass, body water, waist circumference, arm circumference, visceral fat area, basal metabolic rate and body cell mass, all decreased to some extent in the malnutrition group ( P < 0.05). Prealbumin and albumin levels were lower ( P < 0.01). The modified Mayo endoscopic score (MMES), C-reactive protein level and erythrocyte sedimentation rate were higher ( P < 0.01). The rates of re-admission and surgery due to disease activity at 90 days were higher ( P < 0.05). High MMES ( OR =1.534, P = 0.044) and low albumin level ( OR =0.781, P = 0.013) were risk factors for malnutrition in UC patients. Conclusions:GLIM criteria is suitable for the diagnosis of malnutrition in hospitalized UC patients, and malnutrition patients are more likely to experience poor outcomes such as short-term re-admission and surgery. UC patients with higher MMES and lower albumin level are more likely to suffer from malnutrition.
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Objective:To investigate the predictive value of systemic immune inflammation index (SII) for the overall survival of patients with pancreatic cancer by propensity score matching analysis.Methods:The clinical data of 457 patients with pancreatic cancer admitted to the Affiliated Hospital of Qingdao University from August 2000 to December 2019 were retrospectively analyzed. The age, gender, presence of jaundice, pancreatitis and diabetes, serum CA19-9, total bilirubin level, neutrophil count, platelet count, lymphocyte count in blood, presence of radical surgery, tumor TNM stage, tumor location and the like were recorded. The cut-off value of SII was determined by Youden index. The patients were divided into high and low SII groups accroding to the cut-off value. The propensity score matching was applied to reduce the selection bias of patients. Patients were 1∶2 matched and the caliper value was 0.1. The difference on overall survival between the two groups was compared. The prognostic factors were analyzed by univariate and multivariate Cox regression analysis. Kaplan-Meier was used to draw the overall survival curve to calculate the cumulative survival rate, and the differences between the curves were analyzed by Log-Rank test.Results:The cut-off value of SII was 765. There were statistically significant differences between the high SII group ( n=125) and the low SII group ( n=332) on the presence or absence of pancreatitis, the level of total bilirubin in blood, radical surgery, and TNM stage before the propensity score matching (all P value <0.05). After propensity score matching, there was no statistically significant difference between the high SII group ( n=113) and the low SII group ( n=182) on all the clinical parameters mentioned above except for CA19-9, indicating that the two groups were comparable. Univariate analysis showed that the level of CA19-9, SII, radical surgery and different TNM stage were all related to the overall survival of pancreatic cancer patients. Multivariate analysis showed that high CA19-9 level, high SII, no radical surgery, and worse TNM stage were independent risk factors for short overall survival, and high SII ( HR=1.882, 95% CI 1.446-2.450, P<0.001) was significantly associated with poor prognosis. The overall survival of patients with high SII was obviously shorter than the low SII group ( P<0.001), and the average survival time of patients with high and low SII were 8.86 and 11.38 months, respectively. Conclusions:SII is of great value in evaluating the overall survival of pancreatic cancer patients. Higher SII is associated with shorter overall survival.
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Objective To observe the effect of tiopronin combined with glutathione on the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), glutamyltransferase (GGT),blood fat and laminin (LN) in patients with non-alcoholic fatty liver. Methods A total of 84 non-alcoholic fatty liver patients admitted to our hospital from March 2018 to September 2019 were selected and randomly divided into control group and observation group, with 42 cases in each group. The control group was treated with tiopronin, and the observation group was treated with glutathione and tiopronin. The levels of ALT, AST, GGT and blood fat were recorded and compared before and after treatment. Results After treatment, the levels of ALT, AST and GGT in the two groups were significantly lower than before treatment (P<0.05). After treatment, the levels of ALT, AST, and GGT in the observation group were different from those in the control group, which was statistically significant (P<0.05). Before treatment, there was no difference in serum TC, TG, and LDL levels between the two groups, which was not statistically significant (P>0.05). The above-mentioned serum levels of the observation group after treatment were lower than those in the control group, and there was a difference, which was statistically significant (P<0.05); the levels of PCⅢ, PCⅣ, and LN in the treatment group after treatment were significantly lower than those of the control group. The difference was statistically significant (P<0.05). Conclusion The application of tiopronin combined with glutathione in the treatment of non-alcoholic fatty liver can promote the recovery of liver function and reduce the concentrations of TC, TG and LDL, which is worthy of clinical promotion.
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Objective:To determine the prevalence of Helicobacter pylori (Hp) infection in orthotopic liver transplantation (LT) recipients, and to study the efficacy and safety of Hp eradication therapy.Methods:13C-urea breath test was carried out between July 2018 and October 2019. There were 104 males and 26 females with an average age of 52.1 year for these LT recipients who were regularly followed-up in the Organ Transplant Center, the Affiliated Hospital of Qingdao University. Propensity scoring was used to match age and gender in a ratio of 1∶3. A healthy group of individuals consisting of 299 males and 91 females, with an average age of 51.8 years, were selected as the control group also in a ratio of 1∶3. All patients underwent 13C-urea breath test to evaluate Hp infection and results of quadruple therapy. Results:The prevalence of Hp infection among the LT recipients was 18.5%(24/130) which was significantly lower than the control group 36.4% (142/390) (χ 2=14.400, P<0.001). Among the recipients who received LT and 13C-urea breath test for less than 1 year, 1-3 years and more than 3 years, the prevalences of Hp infection were 14.3% (6/42), 17.8%(8/45) and 23.3%(10/43), respectively. Although the prevalence of Hp showed a gradually increasing trend, no correlation between Hp infection and duration from LT was observed (χ 2=1.321, P=0.517). Seventeen Hp positive recipients underwent Hp eradication therapy. The success rate of Hp eradication was 100.0%(17/17). Immunosuppressant concentration was monitored regularly in 10 patients. During Hp eradication, the blood concentration of immunosuppressant increased from 1.7 to 3.6 times, and the drug dosage was reduced to one half to one third of what it was before Hp eradication. Seven of these 17 recipients suffered from adverse effects caused by increased levels of blood concentration of immunosuppressants, including headache, hypertension, insomnia and irritability. Normal liver and kidney functions were observed during eradication. Conclusion:In this study, the prevalence of Hp infection among liver transplant recipients was 18.5%. The success rate of Hp eradication was 100% using bismuth-containing quadruple therapy. The dosage of immunosuppressant required to be monitored, and if necessary, adjusted during eradication to reduce adverse side effects.
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Objective@#To evaluate the feasibility of expanded indication for endoscopic submucosal dissection (ESD) in undifferentiated early gastric cancer, to investigate the risk factors of lymph node metastasis (LNM), so as to provide the theoretical evidence for the choice of treatment.@*Methods@#From June 2007 to December 2018, at the Affiliated Hospital of Qingdao University, the clinical and pathological data of 807 patients with undifferentiated early gastric cancer and undergoing gastrectomy plus lymphadenectomy were retrospectively analyzed. Chi-square test was performed to analyze the correlation between clinicopathologic characteristics of early gastric cancer and LNM. Multivariate logistic regression model was used to analyze the independent risk factor of LNM.@*Results@#LNM was found in 17.2% (139/807) patients with undifferentiated early gastric cancer. And no LNM was detected in 110 patients who met the expanded indication of ESD. The results of univariate analysis indicated that LNM was significantly associated with increased carcinoembryonic antigen (CEA), tumour size, gross type, ulcer, invasion depth, lymphovascular invasion and perineural invasion (χ2=4.500, 13.332, 16.611, 6.083, 51.064, 0.564 and 17.006, all P<0.05). The results of multivariate analysis demonstrated that the maximum diameter of tumor over 20 mm (odds ratio (OR)=1.606, 95% confidence interval (CI) 1.021 to 2.526, P=0.040), lymphovascular invasion (OR=16.835, 95%CI 10.510 to 26.966, P<0.01), the depth of submucosal superficial invasion (≤500 μm ; OR=1.962, 95%CI 1.022 to 3.765, P=0.043) and the depth of submucosal deep invasion (>500 μm ; OR=3.014, 95%CI 1.753 to 5.181, P<0.01) were independent risk factors of LNM in early gastric cancer.@*Conclusions@#The expanded ESD indication of undifferentiated early gastric cancer is applicable for endoscopic treatment considering the low risk of LNM. In early undifferentiated gastric cancer, maximum diameter of tumor over 20 mm, lymphovascular invasion, submucosal superficial and deep invasion are the independent risk factors of LNM.
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Objective:To evaluate the feasibility of expanded indication for endoscopic submucosal dissection (ESD) in undifferentiated early gastric cancer, to investigate the risk factors of lymph node metastasis (LNM), so as to provide the theoretical evidence for the choice of treatment.Methods:From June 2007 to December 2018, at the Affiliated Hospital of Qingdao University, the clinical and pathological data of 807 patients with undifferentiated early gastric cancer and undergoing gastrectomy plus lymphadenectomy were retrospectively analyzed. Chi-square test was performed to analyze the correlation between clinicopathologic characteristics of early gastric cancer and LNM. Multivariate logistic regression model was used to analyze the independent risk factor of LNM.Results:LNM was found in 17.2% (139/807) patients with undifferentiated early gastric cancer. And no LNM was detected in 110 patients who met the expanded indication of ESD. The results of univariate analysis indicated that LNM was significantly associated with increased carcinoembryonic antigen (CEA), tumour size, gross type, ulcer, invasion depth, lymphovascular invasion and perineural invasion ( χ2=4.500, 13.332, 16.611, 6.083, 51.064, 0.564 and 17.006, all P<0.05). The results of multivariate analysis demonstrated that the maximum diameter of tumor over 20 mm (odds ratio ( OR)=1.606, 95% confidence interval ( CI) 1.021 to 2.526, P=0.040), lymphovascular invasion ( OR=16.835, 95% CI 10.510 to 26.966, P<0.01), the depth of submucosal superficial invasion (≤500 μm ; OR=1.962, 95% CI 1.022 to 3.765, P=0.043) and the depth of submucosal deep invasion (>500 μm ; OR=3.014, 95% CI 1.753 to 5.181, P<0.01) were independent risk factors of LNM in early gastric cancer. Conclusions:The expanded ESD indication of undifferentiated early gastric cancer is applicable for endoscopic treatment considering the low risk of LNM. In early undifferentiated gastric cancer, maximum diameter of tumor over 20 mm, lymphovascular invasion, submucosal superficial and deep invasion are the independent risk factors of LNM.
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Objective To evaluate the clinical application value of serum high sensitive α-fetoprotein variant ratio (hs-AFP-L3％) in the diagnosis and treatment of hepatocellular carcinoma.Methods From October 2016 to March 2018,at Affiliated Hospital of Qingdao University,160 patients diagnosed with hepatocellular carcinoma,32 patients with intrahepatic cholangiocarcinoma (ICC),52 patients with post-hepatitis B liver cirrhosis,53 patients with chronic hepatitis B and 50 healthy controls were enrolled.The serum levels of hs-AFP-L3％ and α-fetoprotein were measured.Mann-Whitney U test,Spearman correlation analysis,Wilcoxon signed rank test and chi-square test were performed for statistical analysis.Results The serum levels of hs-AFP-L3％ and α-fetoprotein in hepatocellular carcinoma group were 24.90％ (4.68％ to 61.85％) and 113.45 μg/L (11.18 μg/L to 1 803.48 μg/L),respectively,which were higher than those in ICC group (0.50％,0.50％ to 0.50％;and 2.79 μg/L,1.72 μg/L to 4.04 μg/L),cirrhosis group (0.50％,0.50％ to 5.25％;and 18.35 μg/L,3.95 μg/L to 31.93 μg/L),chronic hepatitis group (0.50％,0.50％ to 4.25％;and 2.70 μg/L,1.80 μg/L to 17.00 μg/L),and healthy control group (0.50％,0.50％ to 0.50％;and 1.94 μg/L,1.46 μg/L to 2.63 μg/L),and the differences were statistically significant (U =461.00,1 485.50,1 141.00,625.00;401.50,2 207.00,1 254.00,266.00;all P ＜0.01).The sensitivity of hs-AFP-L3％ and α-fetoprotein in the diagnosis of hepatocellular carcinoma was 66.3％ and 70.0％,respectively;and the difference was not statistically significant (x2 =0.54,P ＞ 0.05).The sensitivity of the combined detection was 82.5％,which was higher than that of the separate detection,and the differences were statistically significant (x2 =24.04 and 18.05,both P ＜0.01).The specificity of hs-AFP-L3％ was 95.2％,which was higher than that of α-fetoprotein (68.6％),and the difference was statistically significant (x2 =26.04,P ＜ 0.01).The specificity of the combined detection of these two markers was 68.6％,which was lower than that of hs-AFP-L3％ alone (95.2％),and the difference was statistically significant (x2 =26.04,P ＜ 0.01).There was no statistically significant difference in the specificity between the combined detection and α-fetoprotein detection alone (68.6％,P ＞ 0.05).The sensitivity of hs-AFP-L3％ in the diagnosis of patients with α-fetoprotein-negative (α-fetoprotein ＜ 20 μg/L) hepatocellular carcinoma was 41.7％.The serum levels of hs-AFP-L3％ and α-fetoprotein were both positively correlated with tumor size and clinical stage (hs-AFP-L3％ r =0.272 and 0.436;α-fetoprotein r =0.375 and 0.458;all P ＜ 0.01).The reduction of serum hs-AFP-L3％ in 38 patients with hepatocellular carcinoma after operation was 82.2％,which was higher than that of oα-fetoprotein (69.2％),and the difference was statistically significant (U =532.50,P =0.049).There was no correlation between serum level of hs-AFP-L3％ and α-fetoprotein level (r =0.077,P ＞ 0.05).Conclusions The sensitivity of hs-AFP-L3％ is similar to that of α-fetoprotein in the diagnosis of hepatocellular carcinoma,while the specificity of hs-AFP-L3％ is higher than that of α-fetoprotein.The combined detection of the two markers can improve the diagnostic rate of hepatocellular carcinoma.The hs-AFP-L3％ has a high diagnostic value in α-fetoprotein-negative hepatocellular carcinoma.
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PURPOSE: This study was aimed to investigate the effect of pseudolaric acid B (PAB) on proliferation, invasion and epithelial-to-mesenchymal transition (EMT) in pancreatic cancer cells and to explore the possible mechanism. MATERIALS AND METHODS: The pancreatic cancer cell line SW1990 was cultured and treated with PAB dose- and time-dependent manners. Cell proliferation and invasion ability were measured by MTT assay and Matrigel/Transwell test, respectively. Semi-quantitative real-time polymerase chain reaction and Western blotting were conducted to detect the expression of EMT markers and the key molecules. Finally, nude mice subcutaneous transplantation tumor model was used to confirm the therapy efficacy of PAB. RESULTS: PAB could inhibit SW1990 cell proliferation and invasion in time- and dose-dependent manners. Vimentin, fibronectin, N-cadherin, Snail, Slug, YAP, TEAD1, and Survivin were down-regulated (p < 0.01), while E-cadherin, caspase-9, MST1, and pYAP were up-regulated (p < 0.05). Combined PAB and gemcitabine treatment markedly restricted the tumor growth compared with gencitabin or PAB alone groups. CONCLUSION: PAB could inhibit the proliferation and invasion ability of pancreatic cancer cells through activating Hippo-YAP pathway and inhibiting the process of EMT.
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Animals , Female , Humans , Antineoplastic Agents/pharmacology , Antineoplastic Agents/therapeutic use , Biomarkers, Tumor/metabolism , Cadherins , Cell Line, Tumor , Cell Movement , Cell Proliferation/drug effects , Cytokines , Deoxycytidine/analogs & derivatives , Deoxycytidine/pharmacology , Deoxycytidine/therapeutic use , Diterpenes/pharmacology , Diterpenes/therapeutic use , Epithelial-Mesenchymal Transition/drug effects , Mice, Nude , Neoplasm Invasiveness , Pancreatic Neoplasms/diet therapy , Pancreatic Neoplasms/pathology , Real-Time Polymerase Chain Reaction , Signal Transduction/drug effects , Vimentin/metabolismABSTRACT
Objective To investigate the risk factors of pancreatic pseudocysts(PPC) in patients with acute pancreatitis (AP) in a retrospective cohort study. Methods 460 AP patients with complete follow-up data admitted in Affiliated Hospital of Qingdao University from January 2004 to March 2012 were retrospectively analyzed,who were divided into PPC group and control group. Age,gender,body mass index(BMI),history of diabetes,etiology,the presence of ascites and hydrothorax,the presence of abdominal mass,the presence of acute fluid collection, APACHEⅡ score at 48 h admission, CT severity index (CTSI), serum albumin, amylase,LDH,ALP, BUN, Cr, TG, TB, conjugated bilirubin, CRP, serum calcium and other laboratory markers were recorded. Univariate logistic regression analysis was used to select the factors that were statistically different between two groups, and multivariate logistic regression analysis was performed to determine the independent risk factors for AP complicated with PPC. Results 143(31.1%) of 460 AP patients developed PPC. On univariate analysis, a total of 11 factors including male sex, BMI ≥28 kg/m2, history of diabetes, alcoholic pancreatitis, ascites, pleural effusion, palpable abdominal mass, acute fluid collections,APACHEⅡscore,CTSI≥7 and serum albumin were statistically different between two groups. On multiple logistic regression analysis, it was shown that male sex (OR 3.23, 95% CI 1.560~ 6.301, P=0.03),history of diabetes (OR 2.23,95% CI 1.021~3.920,P=0.04), ascites (OR 1.62,95% CI 0.652~2.432, P=0.01), pleural effusion (OR 2.43, 95% CI 1.201~7.201, P=0.03), a palpable abdominal mass(OR 1.83,95% CI 0.737~4.320,P<0.001) and CTSI≥7(OR 5.12,95% CI 1.890~14.012, P<0.001) were independent risk factors significantly associated with the PPC formation. Conclusions The male sex, diabetic history, ascites, pleural effusion, palpable abdominal mass and high CTSI score were the independent risk factors of PPC formation in AP.
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Objective To summarize the etiology and clinical features of recurrent acute pancreatitis (RAP) in the recent l0 years in China.Methods Pubmed,Medline,EMbase,CNKI,Wan fang and VIP database were searched for relevant articles published from January 2001 to December 2016 using Pancreatitis,Recurrence and Etiology as term index words.Meta analysis was conducted by RevManS.3 software.Results A total of 16 studies involving 3 980 patients (RAP n =1 231,AP n =2 749) were included.The age and sex were not correlated with AP recurrence.Biliary diseases,alcohol,inappropriate diets were associated with AP recurrence,but these were not the factors influencing RAP.Hyperlipidemia was responsible for the occurrence of pancreatitis in 17.00％ of RAP and 10.20％ of AP,with statistically significant difference (P =0.002).Hyperlipidemia was an important risk factor influencing AP relapse.The percentage of SAP in AP and RAP patients was 16.83％ and 24.13％,respectively,and the complication rate was 11.43％ and 15.13％,and the percentage of jaundice was 28.20％ and 32.53％.Those in RAP were higher than those in AP,and the differences were statistically significant (all P ＜ 0.05).Conclusions Hyperlipidemia was the predominant risk factor for RAP in China,and the patients with RAP tend to progress into SAP,and have jaundice and complications.
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Background:Accumulating evidence links colorectal cancer (CRC) with the gut microbiota.Fusobacterium nucleatum (F.nucleatum) has been revealed to be involved in the development of CRC, however, the mechanism of F.nucleatum in mediating colorectal tumorigenesis is still poorly understood.Aims:To investigate the effect and potential mechanism of F.nucleatum on CRC.Methods:Wild type C57BL/6 mice and APC(Min/+) mice characterized by multiple intestinal neoplasia were used in this animal study.After administered with F.nucleatum intragastrically and/or 1,2-dimethylhydrazine (DMH, a carcinogen) subcutaneously, the aberrant crypt foci (ACF) and colonic tumor were counted at 8th and 20th week, respectively.Structural alteration of intestinal microbiota and mucosal immune factors were detected in wild type C57BL/6 mice receiving different interventions by using Roche 454 GS FLX pyrosequencing and Bio-Plex ProTM cytokine assay, respectively.Results:In DMH-treated wild type C57BL/6 mice or APC(Min/+) mice, number of ACF and colonic tumor in those administered with F.nucleatum were significantly higher than those without (P<0.05).F.nucleatum colonization significantly altered the lumen microbial structure, with decreased Cyanobacterium and increased Tenericutes and Verrucomicrobia (P all <0.05).Furthermore, F.nucleatum up-regulated expressions of tumor-related immune factors in colonic mucosa, such as IL-21, IL-22, IL-31 and CD40L (P<0.05).Conclusions:F.nucleatum colonization in intestine may prompt colonic tumorigenesis in mice via inducing intestinal dysbiosis and modulating tumor-related immune factors expression.
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Nutrition support therapy plays an important role in the treatment of severe acute pancreatitis (SAP).This article reviews the hot topics and new ideas in nutrition support therapy for SAP in recent years.Damage of intestinal mucosal barrier plays an important role in the progression of pancreatitis.Enteral nutrition can protect the function of intestinal mucosal barrier and early enteral nutrition can significantly reduce patients′mortality rate and incidence rate of complications.Nutrition support for SAP patients via a nasogastric tube has comparable safety and effect to the nutrition support via a nasojejunal tube.At present,there are no enough experience and clinical studies on semi -el-emental or elemental enteral nutrition preparations,and immune -enhancing enteral nutrition preparations and probiotics are not recommen-ded as conventional means.
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Obesity is growing rapidly and becomes an important public health problem worldwide. Epidemiologic data revealed that obesity increased the risk of a variety of disease,including digestive system tumor. Therefore,investigating the molecular mechanism of carcinogenic effect of obesity may provide new clues for management of obesity-associated digestive system tumor. In this article,the progress in research on effect of obesity on digestive system tumorigenesis and its potential mechanism were summarized.
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Objective To investigate the effects of Saccharomyces boulardii ( S. boulardii) on the col-onization of Helicobacter suis ( H. suis) in stomach and the formation of gastric mucosa associated lymphoid tissue (MALT) during H. suis infection. Methods Sixty C57BL/6 wild type mice were randomly divided into six groups. The mice in group A and group B were respectively given sterile distilled water and S. boulardii twice by gavage and then infected with H. suis for one week. The mice in group C and group E were given sterile phos-phate buffer saline by gavage for one week and then respectively given sterile distilled water and S. boulardii by gavage twice a week for 12 weeks. The mice in group D and group F were infected with H. suis for one week and then respectively given sterile distilled water and S. boulardii by gavage twice a week for 12 weeks. Serum and gastric tissue samples were collected from each mouse. Results The bacterial loads of H. suis in the stomachs of mice in group B were significantly lower than those in group A. No significant differences in the levels of se-creted IgA( sIgA) in serum and gastric tissue samples and the expression of IFN-γat mRNA level in gastric mu-cosa samples were found between the two groups. The expression of H. suis 16S RNA and the formation of gastric lymphoid follicles were detected in mice in groups D and F. The levels of sIgA in serum and gastric tissue sam-ples and the expression of IFN-γ and CXCL13 at mRNA level in gastric mucosa samples increased significantly in groups D and F as compared with groups C and E. Compared with the mice in group D, the bacterial loads of H. suis in stomachs, the numbers of MALT per unit length of gastric mucosa and the expression of IFN-γ and CXCL13 at mRNA level in gastric mucosa decreased significantly in mice from group F, but the levels of sIgA in serum and gastric tissue samples increased significantly. Conclusion S. boulardii could inhibit the colonization of H. suis in stomach and suppress the formation of gastric MALT during H. suis infection.
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Objective To determine the expression of CD24 in colorectal carcinoma, and to explore the relationship between CD24 and the clinicopathological features of colorectal carcinoma.Methods The expression of CD24 in 62 cases of colorectal carcinoma, 47 cases of adenomas, 15 cases of colorectal polyps and 30 cases of the adjacent non-cancerous tissues were observed by immunohistochemical assay.The relationship between CD24 and the clinicopathological features was analyzed.Results The positive rates of CD24 in colorectal carcinoma 72.6％ and adenomas 63.8％ were significantly higher than those in colorectal hyperplastic polyps 13.3％ (x2 =17.83, P =0.00;x2 =11.61, P =0.00) and adjacent non-cancerous tissues 6.7％ (x2 =35.15, P =0.00;x2 =24.64, P =0.00).The expression of CD24 in colorectal carcinoma had a significant correlation with the tumor diameter (x2 =5.48, P =0.02), tumor differentiation (x2 =8.86, P =0.00), Duke staging (x2 =11.47, P =0.00) and lymph node metastasis (x2 =8.92, P =0.00).Conclusion The expression of CD24 is high in colorectal carcinoma, having a significant correlation with the size of tumor, degree of differentiation, Duke stage and lymph node metastasis.
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Objective To investigate the differences of miRNA-21 and miRNA-146a expression between colorectal neoplasms tissues and serum of the patients with colorectal neoplasm,and the clinical significance was analyzed.Methods The endoscopic biopsy tissues and serum samples of 100 colorectal cancer (CRC),80 colorectal adenoma (CRA)patients and 65 healthy controls were collected.The expressions of miRNA-21 and miRNA-146a were detected by quantitative real time polymerase chain reaction.The relationship between the expression and clinicopathological features were analyzed.And then,the diagnostic value of expression difference of serum miRNA in colorectal neoplasm were evaluated. The Mann-WhitneyU test and Kruskal-Wallis test were performed for comparisons between groups,and the correlation of miRNA expression between tissues and serum was analyzed by Spearman test.Results The expressions of miRNA-21 in the tissues of CRC and CRA were 8.573 ±0.898 and 7.746 ±1 .183, respectively,which were significantly higher than that of healthy controls 6.160 ±0.835 (U =120.129 and 33.230,both P 0.05 ).The expression of miRNA-146a in the tissues and serum of CRC patients were both lower than those of CRA patients (U =73.809 and 21 .123, both P <0.01).The degree of decreased expression of miRNA-146a in CRC patients was correlated with TNM staging and tumor differentiation degree,however there was no correlation between the expression in CRA and clinical features.According to receiver operating characteristic (ROC)curve analysis,the AUC of miRNA-21 ,miRNA-146a and a combination of them in CRC and health individuals was 0.889, 0.791 and 0.863,respectively;in CRA and health individuals was 0.784,0.692 and 0.761 ,respectively;in CRC and CRA was 0.705 ,0.820 and 0.713,respectively.Conclusion The different expressions of miRNA-21 and miRNA-146a had potential values in early detection of colorectal cancer.
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Objective To evaluate the effectiveness and predictive value of high-resolution manometry(HRM) for POEM in treating achalasia. Methods A total of 84 achalasia patients categorized into subtypes by HRM, who also underwent POEM, were enrolled in our study. Eckardt score, Barium esophagogram and HRM were performed before, 6 months and 1 year after POEM. Results POEM was successfully performed in all 84 patients. No perforation occurred in any patient. The Eckardt scores and esophageal diameter after POEM significantly reduced compared with those before(P<0. 05). The 4s-IRP decreased from 33. 4±9. 0 mmHg (1 mmHg =0. 133 kPa) to 14. 6±3. 8 mmHg six months after POEM (P<0. 05) and to 16. 4±3. 9 mmHg one year after POEM (VS preoperate, P<0. 05). The LESP before treatment was 41. 8±15. 4 mmHg, decreasing to 18. 4±7. 1 mmHg six months after POEM (P<0. 05) and 20. 7±7. 6 mmHg one year after POEM (VS preoperate, P <0. 05) . When categorizing patients into 3 subtypes by HRM, 4s-IRP of type II showed the most dramatic decrease six months after POEM(62. 8%), followed by typeⅠ(53. 5%), while type III had the least decrease(41. 8%). The mean decreasing rate of LESP in type III was 42. 3% six months after POEM, followed by typeⅠ(55. 3%) , while type II showed the highest rate(57. 8%). Conclusion POEM is a safe treatment for achalasia and has significant short-term efficacy with Type II responding best to POEM. HRM plays a vital role in typing AC and predicting the effectiveness of POEM and can be useful in selecting an appropriate treatment.
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Objective To determine the expression of c-myc and CD24 in colorectal carcinoma,colo-rectal polyp and normal mucosa,and to explore the role and correlation of them in the carcinogenesis of colorec-tal carcinoma. Methods The expression of c-myc and CD24 in colorectal carcinoma(n = 60),colorectal ade-nomatous polyp(n = 45),colorectal hyperplastic polyp(n = 15)and the adjacent non-cancerous tissue(n =30)was observed by immunohistochemical assay. Results The positive rate of c-myc in colorectal carcinoma were 73. 3% ,significantly higher than that in colorectal adenomatous polyp 44. 4%( χ2 = 9. 016 8,P <0. 01),colorectal hyperplastic polyp 13. 3%(χ2 = 18. 215 9,P < 0. 01)and adjacent non-cancerous tissue 6. 7%(χ2 = 25. 133 0,P < 0. 01);the positive rate of CD24 in colorectal carcinoma was 76. 7% ,significantly higher than that in colorectal hyperplastic polyp 6. 7%(χ2 = 25. 133 0,P < 0. 01)and adjacent non-cancerous tissue 3. 3%(χ2 = 43. 107 4,P < 0. 01). c-myc expression in colon cancer was significantly correlated with cancer site(χ2 = 8. 352 3,P < 0. 01),lymph node metastasis(χ2 = 4. 275 1,P < 0. 05),differentiation (χ2 = 4. 115 3,P < 0. 05)and TNM stage(χ2 = 5. 739 9,P < 0. 05). CD24 expression in colon cancer was significantly correlated with cancer size(χ2 = 9. 333 6,P < 0. 01),lymph node metastasis(χ2 = 7. 693 0,P <0. 01),differentiation(χ2 = 5. 870 0,P < 0. 05)and TNM stage(χ2 = 4. 498 7,P < 0. 05). There was a pos-itive correlation relationship between CD24 and c-myc in colorectal carcinoma tissue(χ2 = 10. 824 9,r = 0. 39, P < 0. 05). Conclusion The expression of c-myc and CD24 are high in colorectal cancer,having a significant correlation with some of the clinicaopathological features. c-myc is likely to act as a downstream target gene of CD24 signaling pathway,whose expression is probably regulated by CD24 in colorectal carcinoma tissue.
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Objective To study the efficacy and safety of oral calcium carbonate suspension and proton pump inhibitors (PPI) in symptoms relief of acid related diseases.Methods The multi-center,randomized and controlled study was carried out.A total of 400 acid-related diseases patients from 14 to 70 years old with at least one of moderate or severe symptoms such as acid regurgitation,epigastric pain,epigastric discomfort,upper abdominal burning or distension were equally divided into two groups and treated with oral calcium carbonate suspension or omeprazole enteric-coated tablets.The onset of symptoms relief of all patients of the first time after taking medicine was observed.The relief of clinical symptoms at the third day and seventh day after taking medicine was also observed.The adverse events were recorded.Analysis of variance was performed for statistical analysis.Results The onset of symptoms relief of oral calcium carbonate suspension group in acid regurgitation,epigastric pain,epigastric discomfort,upper abdominal burning or distension of the first time after taking medicine were significantly faster than those of PPI group (F=4.866,8.142,41.366,6.955,35.252; all P＜0.05).At the third day after taking medicine,the treatment efficiency of oral calcium carbonate suspension group and PPI group were 69.50％ and 72.50％,and at the seventh day the treatment efficiency of oral calcium carbonate suspension group and PPI group were 92.00％ and 96.50％.There was no significant difference in treatment efficiency and comprehensive efficacy between two groups at day three and seven after taking medicine (both P＞ 0.05).There were 14 cases of mild adverse events and two cases of moderate adverse events in oral calcium carbonate suspension group.There were 10 cases of mild adverse events in PPI group.There was no significant difference between two groups (P＞0.05).Conclusion Oral calcium carbonate suspension provides faster symptom relief than PPI and can effectively improve the symptoms of acid-related diseases.
ABSTRACT
Objective To detect serum biomarkers for pancreatic cancer associated diabetes and establish a model for diagnosis.Methods SELDI-TOF-MS was used to detect the differentially expressed serum proteins from 17 pancreatic cancer associated diabetes patients,17 new-onset type Ⅱ diabetes patients and 17 healthy controls,then a model of biomarkers was constructed and validated by Biomarker Patterns Software 5.0.Results Twelve discriminating m/z peaks were identified in the protein fingerprints in 10 pancreatic cancer associated diabetes patients,10 new-onset type Ⅱ diabetes patients and 10 healthy controls.Among them,the three biomarkers of mass/charge ratio 6116,6695 and 8936 were used to construct the model,which could diagnose 90％ pancreatic cancer associated diabetes form control groups.Blind test of other7 samples of three groups showed that 100％ pancreatic cancer associated diabetes,71％ new-onset diabetes and 86％ healthy controls were correctly classified.After searching protein database,there were metallothionein,pancreatic progenitor cell differentiation and proliferation factor-like protein,and fibroblastic growth factor 1,which were close to the weights of the above mentioned 3 differentially expressed proteins.Conclusions SELDI can identify 3 biomarkers for pancreatic cancer associated diabetes and a reliable model for diagnosis of pancreatic cancer associated diabetes is established.