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Objective:To observe the effects of ultrasound intermediate frequency acupoint targeted drug guiding technology on the recovery of gastrointestinal function and serum gastrin levels in elderly patients after lumbar spine surgery under general anesthesia.Methods:This study used prospective research methods.A total of 90 elderly patients undergoing lumbar spine surgery after general anesthesia in the orthopaedic ward of Beijing Geriatrics Hospital from June 2019 to June 2021 were randomly divided into blank control group, drug control group, and drug-guided treatment group, with 30 cases each group. After the operation, no intervention was given to the blank control group, the drug control group received oral mosapride citrate tablets, the drug-guided treatment group used the D patch to guide the medicine at the two acupoints of Zusanli and Zhongwan with ultrasound medium frequency guided medicine instrument for 1 week each. The serum gastrin levels of the patients in each group were detected 1 d before operation, 3 d after operation, and 1 week after operation, and the time of first exhaust and first defecation after operation were recorded.Results:The results showed that the level of serum gastrin preoperativein the three groups was not significantly different ( P>0.05). On the third day after operation, the levelof serum gastrin in the drug guide treatment group, drug control group and blank control group were lower than those at 1 d before operation: (66.51 ± 5.34) ng/L vs. (69.36 ± 6.50) ng/L, (58.34 ± 5.71) ng/L vs. (68.75 ± 5.13) ng/L, (55.76 ± 6.23) ng/L vs. (70.20 ± 6.71) ng/L, the differences were statistically significant ( P<0.05), and showed a decreasing trend in turn. Among them, the level of serum gastrin in the drug guide treatment group was higher than that in the drug control group and blank control group, the difference was statistically significant ( P<0.05). One week after operation, the level of serum gastrin in the three groups increased compared with the third day after operation ( P<0.05), and the drug guiding treatment group was higher than the drug control group and the blank control group: (72.38 ± 6.78) ng/L vs. (67.15 ± 6.27) ng/L, (63.52 ± 5.38) ng/L, the differences were statistically significant ( P<0.05). The time of first exhaust and defecation after the operation of the three groups of patients, the drug-guided treatment group was significantly shorter than the drug control group and the blank control group: (15.25 ± 3.10) h vs. (20.38 ± 4.21) h and (28.52 ± 3.69) h, (24.14 ± 3.53) h vs. (36.15 ± 3.54) h and (49.51 ± 4.37) h, the differences were statistically significant ( P<0.05). Conclusions:Ultrasound intermediate frequency acupoint drug guiding technology can increase the patient′s serum gastrin level and promote the recovery of gastrointestinal function in elderly patients with lumbar spine surgery after general anesthesia.
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Objective:To investigate the correlation between serum gastrin, C-reactive protein (CRP), tumor necrosis factor α (TNF-α) and the degree of peptic ulcer bleeding.Methods:The clinical data of 90 peptic ulcer bleeding patients (test group) from April 2019 to September 2020 in Hangzhou Hospital of Zhejiang Medical and Health Group were retrospectively analyzed, including 15 cases with low-risk, 40 cases with intermediate-risk and 35 cases with high-risk of Blatchford score; 40 physical examination volunteers were selected as the control group during the same period. The serum levels of CRP and TNF-α were measured by enzyme-linked immunosorbent assay, and the serum level of gastrin was measured by radioimmunoassay. The correlation between CRP, TNF-α, gastrin and the Blatchford score was analyzed by Pearson method; the independent risk factors affecting high-risk peptic ulcer bleeding were analyzed by multivariate Logistic regression; the value of CRP, TNF-α and gastrin in predicting high-risk peptic ulcer bleeding was analyzed by the receiver operating characteristic (ROC) curve.Results:The CRP, TNF-α and gastrin in test group were significantly higher than those in control group: (19.69 ± 3.41) mg/L vs. (2.28 ± 0.64) mg/L, (26.63 ± 4.24) ng/L vs. (1.35 ± 0.31) ng/L and (149.77 ± 21.41) μg/L vs. (72.65 ± 12.39) μg/L, and there were statistical differences ( P<0.01). The hemoglobin and platelets in intermediate-risk and high-risk patients were significantly lower than those in low-risk patients: (59.21 ± 4.63) and (28.94 ± 4.69) g/L vs. (89.68 ± 5.12) g/L, (162.14 ± 12.47) and (122.05 ± 10.39) × 10 9/L vs. (213.58 ± 16.98) × 10 9/L, the indexes in high-risk patients were significantly lower than those in intermediate-risk patients, and there were statistical differences ( P<0.05); the prothrombin time, CRP, TNF-α and gastrin in intermediate-risk and high-risk patients were significantly higher than those in low-risk patients: (13.98 ± 1.29) and (16.97 ± 1.15) s vs. (11.00 ± 2.07) s, (18.87 ± 4.68) and (22.69 ± 2.96) mg/L vs. (15.45 ± 5.54) mg/L, (27.43 ± 5.05) and (31.02 ± 4.56) ng/L vs. (21.39 ± 8.54) ng/L, (140.89 ± 22.36) and (160.58 ± 25.52) μg/L vs. (121.39 ± 15.17) μg/L, the indexes in high-risk patients were significantly higher than those in intermediate-risk patients, and there were statistical differences ( P<0.05). Multivariate Logistic regression analysis result showed that hemoglobin, platelets, CRP, TNF-α and gastrin were independent risk factors for high-risk peptic ulcer bleeding ( OR = 0.224, 0.321, 3.687, 3.058 and 4.051; 95% CI 0.004 to 0.894, 0.121 to 8.547, 1.912 to 5.525, 3.012 to 10.609 and 2.012 to 7.525; P<0.05 or <0.01). Pearson correlation analysis result showed that CRP, TNF-α and gastrin were positive correlation with the Blatchford score ( r = 0.501, 0.526 and 0.542; P<0.01). ROC curve analysis result showed that the areas under the curve of CRP, TNF-α and gastrin for predicting high-risk peptic ulcer bleeding was 0.890, 0.825 and 0.901, with optimal cut-off values of 17.95 mg/L, 22.16 ng/L and 135.36 μg/L, sensitivity of 97.14%, 94.29% and 82.86%, and specificity of 80.00%, 66.67% and 86.67%. Conclusions:CRP, TNF-α and gastrin are correlated to the degree of peptic ulcer bleeding, and can be used as indexes to evaluate the bleeding degree of peptic ulcer.
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Objective:To investigate the curative effects of omeprazole combined with amoxicillin on chronic gastritis and patients' quality of life.Methods:A total of 350 patients with chronic gastritis who received treatment in Jinan Seventh People's Hospital from May 2018 to August 2020 were included in this study. They were randomly divided into control and observation groups ( n = 175/group). The control group was treated with omeprazole, and the observation group was treated with omeprazole combined with amoxicillin. Curative effects, inflammatory factor levels, gastric motility, quality of life score, and the incidence of adverse reactions were compared between the two groups. Results:The response rate in the observation group was significantly higher than that in the control group [95.43% (167/175) vs. 86.86% (155/175), χ2 = 5.59, P = 0.018). Before treatment, there were no significant differences in C-reactive protein, interleukin-6, and tumor necrosis factor-α levels between the two groups (all P > 0.05). After treatment, C-reactive protein, interleukin-6, and tumor necrosis factor-α levels in the observation group were (47.97 ± 8.59) mg/L, (38.82 ± 6.29) μg/L, and (38.77 ± 5.92) μg/L, respectively, which were significantly lower than (51.34 ± 9.77) mg/L, (41.20 ± 7.53) μg/L, (41.09 ± 6.85) μg/L in the control group ( t = 3.42, 3.20, 3.39, all P < 0.05). Before treatment, there were no significant differences in serum gastrin-17 and motilin levels between the two groups (both P > 0.05). After treatment, serum gastrin-17 and motilin levels in the observation group were (380.49 ± 61.27) ng/L and (514.42 ± 68.73) ng/L, respectively, which were significantly higher than (362.25 ± 50.16) ng/L and (495.43 ± 61.36) ng/L in the control group ( t = 3.04, 2.72, both P < 0.05). After treatment, the quality of life score in the observation group was significantly higher than that in the control group ( P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups ( P > 0.05). Conclusion:Omeprazole combined with amoxicillin is highly effective on chronic gastritis. The combined therapy can reduce inflammatory responses, improve gastric motility, improve patients' quality of life, and is highly safe.
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Objective:To investigate the value of serum gastrin-17 (G-17), pepsinogen (PG) I and II, and narrow-band imaging endoscopy in combination for identifying early gastric cancer.Methods:A total of 86 patients with suspected gastric cancer admitted to Zhoushan Hospital from January to September 2021 were included in this study. These patients underwent serum G-17, PG I, and PG II examination and narrow-band imaging endoscopy. PG I/PG II ratio (PGR) was calculated. Taking pathological results as a gold standard, the sensitivity, specificity, and accuracy of serum G-17, PG I, PG II, and narrow-band imaging endoscopy in combination for identifying early gastric cancer were calculated.Results:Serum G-17 level and PGR in the gastric cancer group were (20.14 ± 4.59) pmol/L and (20.21 ± 4.50) μg/L, respectively, which were significantly higher than (17.06 ± 4.05) pmol/L and (17.15 ± 4.08) μg/L in the atrophic gastritis group ( q = 4.12, 3.77, both P < 0.05) and (12.35 ± 3.31) pmol/L and (10.82 ± 5.26) μg/L in the non-atrophic gastritis group ( q = 9.34, 10.39, both P < 0.05). PG I and PGR in the gastric cancer group were (63.90 ± 14.41) μg/L and (3.17 ± 2.08), respectively, which were significantly lower than (79.34 ± 16.25) μg/L and (5.04 ± 3.61) in the atrophic gastritis group ( q = 5.33, 3.44, both P < 0.05) and (106.42 ± 20.18) μg/L and (9.22 ± 4.06) in the non-atrophic gastritis group ( q = 13.16, 9.97, both P < 0.05). Among the 86 patients included, gastric cancer was determined by biopsy in 43 patients. Pathological results showed that 37 patients had early gastric cancer and 6 patients had gastric cancer involving the muscle layer or serous layer. Narrow-band imaging endoscopy results showed that 83.78% (31/37) of patients had early gastric cancer. Serum G-17, PG, and narrow-band imaging endoscopy in combination showed that 91.89% (34/37) of patients had early gastric cancer. Taking pathological results as a gold standard, the sensitivity, specificity, positive predictive value, and negative predictive value of serum G-17 combined with PG for screening early gastric cancer were 72.97% (27/37), 77.55% (38/49), 71.05% (27/38), and 79.17% (38/48), respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of narrow-band imaging endoscopy for screening early gastric cancer were 83.78% (31/37), 85.71% (42/49), 83.10% (31/38), and 87.50% (42/48). The sensitivity and specificity of serum G-17, PG, and narrow-band imaging endoscopy in combination for screening early gastric cancer were 91.89% (34/37) and 91.84% (45/49), respectively. Conclusion:Serum G-17, pepsinogen, and narrow-band imaging endoscopy in combination can improve the diagnostic accuracy of early gastric cancer and is an effective method for screening early gastric cancer.
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Objective:To investigate the clinical efficacy of quadruple therapy combined with probiotics for helicobacter pylori-positive erosive gastritis.Methods:A total of 350 patients with helicobacter pylori-positive erosive gastritis who received treatment in Jinan Seventh People's Hospital from January 2020 to January 2021 were included in this study. They were randomly assigned to receive a quadruple therapy (clarithromycin, ribavirin, amoxicillin and rabeprazole) alone (control group, n = 175) or in combination with probiotics (observation group, n = 175) for 2 weeks. Clinical efficacy was compared between the two groups. Results:Total response rate was 90.86% (150/175) in the observation group, which was significantly higher than that in the control group [72.57% (127/175), χ 2 = 19.58, P < 0.001]. After treatment, gastrointestinal microbiota were improved in both groups, but the improvements were greater in the observation group than in the control group ( t = 15.14, 14.30, 17.37, all P < 0.001). At 3 and 6 months after treatment, conversion rates from helicobacter pylori-positive to helicobacter pylori-negative in the observation group were 72.57% (127/175) and 95.43% (167/175) respectively, which were significantly higher than 50.29% (88/175) and 79.43% (139/175) in the control group (χ 2 = 18.34, 20.38, both P < 0.001). After treatment, the amplitude of decrease in serum level of gastrin, motilin, tumor necrosis factor-α and interleukin-6 in the observation group were greater than those in the control group ( t = 35.15, 44.91, 16.76, 5.73, all P < 0.001). Conclusion:Quadruple therapy combined with probiotics is highly effective on helicobacter pylori-positive erosive gastritis. The combined therapy can increase conversion rate from helicobacter pylori-positive to helicobacter pylori-negative, improve gastrointestinal function, and greatly inhibit inflammatory reaction.
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Objective:To investigate the risk factors of type 1 gastric neuroendocrine tumor (g-NET) in patients with autoimmune gastritis(AIG).Methods:From September 1, 2016 to February 28, 2022, 123 patients with AIG visited the First Affiliated Hospital of Zhengzhou University were retrospectively enrolled, including 37 cases with type 1 g-NET and 86 cases without type 1g-NET. The clinical data, serological indicators, and endoscopic manifestation of all the patients were analyzed, including the age at the time of AIG diagnosis (hereinafter referred to as the age at diagnosis), levels of gastrin 17 and pepsinogen Ⅰ (PGⅠ), presence or absence of gastric fundus and gastric body polyps, etc. The independent risk factors of type 1 g-NET in AIG patients were analyzed by univariate and multivariate logistic regression. The receiver operating characteristic curve (ROC) was plotted to analyze the optimal cut-off value, sensitivity and specificity of the independent risk factors in predicting type 1 g-NET in AIG patients. Independent sample t test, Mann-Whitney U test and chi-square test were used for statistical analysis. Results:Compared with those of the AIG patients without type 1 g-NET, the age at diagnosis of AIG patients with type 1 g-NET was younger ((57.49±11.16) years old vs. (48.49±10.96) years old), the level of gastrin 17 was higher (200.21 ng/L, 121.85 ng/L to 244.40 ng/L vs. 244.40 ng/L, 182.50 ng/L to 248.02 ng/L), and the proportion of patients with gastric fundus and gastric body polyps was higher(18.6%, 16/86 vs. 56.8%, 21/37), and the differences were statistically significant( t=-4.13, Z=-3.06, χ2=17.90; P<0.001, =0.002 and <0.001). The results of univariate logistic analysis showed that the age at diagnosis ( OR=0.931, 95% confidence interval (95% CI)0.895 to 0.967), gastrin 17( OR=1.012, 95% CI 1.005 to 1.019), PGⅠ( OR=0.974, 95% CI 0.950 to 0.998)and gastric fundus and gastric body polyps( OR=5.742, 95% CI 2.461 to 13.399)were the influencing factors of type 1 g-NET in AIG patients ( P<0.001, =0.001, =0.033 and <0.001). The results of multivariate logistic regression analysis indicated that the age at diagnosis( OR=0.921, 95% CI 0.881 to 0.964), gastrin 17( OR=1.011, 95% CI 1.001 to 1.020), gastric fundus and gastric body polyps( OR=7.696, 95% CI 2.710 to 21.857)were the independent risk factors of type 1 g-NET in AIG patients ( P<0.001, =0.024 and <0.001). The results of ROC analysis demonstrated that the optimal cut-off values for the age at diagnosis and gastrin 17 in predicting type 1 g-NET were 56.50 years old and 206.40 ng/L, respectively; with sensitivity of 83.8% and 70.3%, respectively, and specificity of 54.7% for both ( P<0.001 and=0.003). Conclusion:The age at diagnosis< 56.50 years old, gastrin 17>206.40 ng/L and the presence of gastric fundus and gastric body polyps are independent risk factors of type 1 g-NET in AIG patients.
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Objective:To explore the effects and underlying mechanisms of azintamide on gastric emptying and gastrointestinal hormone secretion in proton pump inhibitor related low gastric acid environment.Methods:A total of 60 rats were selected and randomly divided into low gastric acid control group, low gastric acid model group, low gastric acid and azintamide intervention group, high gastric acid control group, high gastric acid model group and high gastric acid and azintamide intervention group by random number table, with 10 rats in each group. The rats of low gastric acid control group and high gastric acid control group were all treated with 0.9% sodium chloride solution. The rats of low gastric acid model group and high gastric acid model group were established by intraperitoneal injection of 20 mg/kg omeprazole once per day for seven days, and subcutaneous injection of 2 mg/kg penta gastrin once per day for three days, respectively. The rats of low gastric acid and azintamide intervention group and high gastric acid and azintamide intervention group were gavaged with azintamide 50 mg/kg once per day for three days on the basis of low gastric acid model group and high gastric acid model group, respectively. Only the rats in three low gastric acid groups were analyzed. At Day 0, 2nd, 4th, 6th and 8th after modeling, the body weight of rats were compared. After modeling, the weight of gastric contents and pH of gastric fluid was measured and compared, and the peripheral blood levels of pepsinogen A (PGA), gastrin and cholecystokinin (CCK) were detected by enzyme linked immunosorbent assay. One-way analysis of variance and Tukey′s honestly significant difference post-hoc test were used for statistical analysis.Results:The pH value of gastric fluid in low gastric acid model group and low gastric acid and azintamide intervention group were both higher than that in the low gastric acid control group (2.17±0.53, 2.03±0.69 vs. 1.32±0.17), and the differences were statistically significant ( P=0.026 and 0.041, respectively). While there was no significant difference in pH value between the low gastric acid model group and low gastric acid and azintamide intervention group ( P>0.05). On the Day 0, 2nd, 4th, 6th and 8th after modeling, the body weight of rats of low gastric acid control group, low gastric acid model group and low gastric acid and azintamide intervention group was (285.40±10.86), (283.40±6.38), (282.00±5.04) g; (287.10±10.73), (283.20±5.83), (284.00±5.72) g; (292.20±11.18), (281.90±6.23), (289.00±5.82) g; (296.40±11.12), (277.70±6.96), (292.00±6.82) g; (300.80±11.29), (274.30±8.84), (297.00±4.17) g, respectively. On the Day 6th and 8th after modeling, the body weight of rats of low gastric acid model group was lower than that of the low gastric acid control group; and the body weight of rats of low gastric acid and azintamide intervention group was higher than that of low gastric acid model group, and the differences were statistically significant (both P<0.01). On the Day 0, 2nd, 4th, 6th and 8th, there was no statistically significant difference in body weight of rats between low gastric acid and azintamide intervention group and low gastric acid control group ( P>0.05). On the Day 0, 2nd, 4th, there were no statistically significant differences in body weight of rats between low gastric acid and azintamide intervention group and low gastric acid model group, and between low gastric acid model group and low gastric acid control group (both P>0.05). The weight of gastric contents of low gastric acid model group was heavier than that of low gastric acid control group ((2.36±0.11) g vs. (1.85±0.20) g), the weight of gastric contents of low gastric acid and azintamide intervention group was lighter than that of low gastric acid model group ((1.87±0.42) g vs. (2.36±0.11) g), and the differences were statistically significant ( P=0.019 and 0.016, respectively), and there was no statistically significant difference in weight of gastric contents between the low gastric acid and azintamide intervention group and the low gastric acid control group ( P>0.05). The peripheral blood level of PGA of rats of low gastric acid model group was lower than that of low gastric acid control group ((551.80±190.00) ng/L vs. (857.00±164.80) ng/L), while the peripheral blood level of PGA of the low gastric acid and azintamide intervention group was higher than that of the low gastric acid model group ((799.90±97.80) ng/L vs. (551.80±190.00) ng/L), and the differences were statistically significant ( P=0.011 and 0.037, respectively). There was no significant difference in peripheral blood level of PGA between the low gastric acid control group and the low gastric acid and azintamide intervention group ( P>0.05). The peripheral blood level of gastrin of the low gastric acid model group was higher than that of the low gastric acid control group ((49.31±11.93) ng/L vs. (35.59±5.29) ng/L), and the CCK level of the low gastric acid model group was lower than that of low gastric acid control group ((10.26±5.32) ng/L vs. (25.55±11.62) ng/L), and the differences were statistically significant ( P=0.037 and 0.035, respectively). The peripheral blood level of gastrin of the low gastric acid and azintamide intervention group was lower than that of low gastric acid model group ((35.65±6.49) ng/L vs. (49.31±11.93) ng/L), the level of CCK of the low gastric acid and azintamide intervention group was higher than that of low gastric acid model group ((27.59±11.22) ng/L vs. (10.26±5.32) ng/L), and the differences were statistically significant ( P=0.048 and 0.021, respectively). There were no significant differences in CCK and gastrin between low gastric acid and azintamide intervention group and low gastric acid control group (both P>0.05). Conclusion:Azintamide regulates the levels of gastrointestinal hormones CCK and gastrin under the condition of low gastric acid and affects the expression of pepsinogen A, thereby promoting gastric emptying in a low gastric acid environment.
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Objective:To explore the clinical significance of standardized screening for diagnosis and treatment of early gastric cancer in Qinghai Province.Methods:Opportunistic early gastric cancer screening was conducted in outpatients of Digestive Department, Physical Examination Center and inpatients of Qinghai Provincial People′s Hospital from January 2016 to December 2020, according to the optimal cut-off values of serum pepsinogen (PG)Ⅰ, PGⅠ/PGⅡ ratio (PGR) and serum gastrin 17 (G17) obtained from the previous screening study of gastric cancer and precancerous diseases in different areas of Qinghai Province. At the same time, the standardized early gastric cancer screening program was applied in 10 municipal (county-level) hospitals in Qinghai Province. The detection rate, early diagnosis rate and endoscopic treatment rate of early gastric cancer in Qinghai Provincial People′s Hospital and the above 10 hospitals in the past five years were analyzed respectively.Results:In the five years, the total detection rate, early diagnosis rate and endoscopic treatment rate of early gastric cancer in Qinghai Provincial People′s Hospital were 0.214% (407/190 178), 17.54% (407/2 321) and 81.82% (333/407), respectively. The above indices in 10 other hospitals were 0.085% (264/309 217), 12.94% (264/2 040) and 37.12% (98/264), respectively. The overall detection rate of early gastric cancer was higher than 0.024% reported previously.Conclusion:The standardized early gastric cancer screening program can not only improve the diagnosis rate of early gastric cancer in Qinghai Province, but also save medical resources. It is an economical, efficient and feasible program, suitable for the highin-cidence area of gastric cancer in Qinghai Province.
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ABSTRACT BACKGROUND: It has been proposed that the combination of gastrin-17 (G-17), pepsinogens I and II (PGI and PGII), and anti-Helicobacter pylori (H. pylori) antibodies (GastroPanel®, BIOHIT HealthCare, Helsinki, Finland) could serve as biomarkers of atrophic gastritis. OBJECTIVE: This study aimed to ensure the diagnostic accuracy of GastroPanel® and evaluate the effect of proton pump inhibitors (PPIs) on these biomarkers. METHODS: Dyspeptic patients who underwent gastrointestinal endoscopy were enrolled in the present study. Histological findings, which were the gold standard to stratify groups, were as follows: no atrophy (controls); antrum atrophy; corpus atrophy; multifocal atrophy; and neoplasia. G-17, PGI, PGII, and anti-H. pylori immunoglobulin (Ig)G antibodies were assayed using commercially available kits. The ratio of PGI/PGII was calculated. RESULTS: Among 308 patients, 159 (51.6%) were PPI users. The overall prevalence of atrophy was 43.8% (n=135). Ninety-two (29.9%) patients were H. pylori positive according to anti-H. pylori IgG levels. G-17 levels were not low in those with antrum atrophy but were high in those with corpus and multifocal atrophies. PGI levels were significantly lower in those with corpus and multifocal atrophies. The sensitivity of PGI <30 µg/L to detect corpus atrophy was 50% (95% CI 27.8-72.1%), with a specificity of 93.2% (95% CI 84.3-97.5%), a positive likelihood ratio of 7.4 (95% CI 2.9-19.2), and a negative likelihood ratio of 0.5 (95% CI 0.3-0.8). A small number of subjects (n=6) exhibited moderate to intense atrophy (4%), among whom 66.7% exhibited decreased PGI levels. PPI significantly increased the levels of G-17 and PGI, except in those with corpus and multifocal atrophies, in whom PGI levels were not increased by PPIs. CONCLUSION: GastroPanel® (Gastrin-17, PGI, and PGI/PGII ratio) did not demonstrate high sensitivity for detecting gastric atrophy.
RESUMO CONTEXTO: Foi proposto que a combinação de gastrina 17 (G-17), pepsinogênios I e II (PGI e PGII), e anticorpos anti-Helicobacter pylori (H. pylori) (GastroPanel®, BIOHIT HealthCare), poderiam indicar gastrite atrófica. OBJETIVO: Portanto, o objetivo foi averiguar a acurácia diagnóstica do painel gástrico e avaliar o efeito dos inibidores de bomba de prótons (IBP) nesses marcadores. MÉTODOS: Pacientes dispépticos que se submeteram à endoscopia gastrointestinal entraram no estudo. Os achados histológicos foram o padrão ouro para estratificar os grupos: sem atrofia (controles), atrofia de antro, atrofia de corpo, atrofia multifocal e neoplasia. G-17, PGI, PGII, e anticorpos IgG anti-H. pylori foram determinados por kits comerciais. A razão PGI/PGII foi calculada. RESULTADOS: Entre 308 pacientes que foram incluídos, 159 estavam usando IBP (51,6%). A prevalência de atrofia foi de 43,8% (135 pacientes). H. pylori foi positivo em 92 (29,9%) pacientes por IgG anti-H. pylori. G-17 não estava diminuída na atrofia do antro, mas estava elevada nas atrofias do corpo e multifocal. PGI estava significantemente menor nas atrofias de corpo e multifocal. A sensibilidade da PGI <30 µg/L de indicar atrofia do corpo foi 50% (95%IC 27,8-72,1%) com especificidade de 93,2% (95%IC 84,3-97,5%), razão de verossimilhança positiva de 7,4 (95%IC 2,9-19,2) e razão de verossimilhança negativa de 0,5 (95%IC 0,3-0,8). O número de indivíduos com atrofia moderada para intensa foi pequeno (n=6;4%), dos quais 66,7% tinham diminuição dos níveis de PGI. IBP significantemente aumentou os níveis de G-17 e PGI, exceto nas atrofias de corpo e multifocal que não apresentaram aumento de PGI. CONCLUSÃO: O painel gástrico não teve alta sensibilidade de indicar gastrite atrófica.
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Humans , Proton Pump Inhibitors , Gastritis, Atrophic/diagnosis , Brazil , Helicobacter pylori , Helicobacter Infections , Antibodies, BacterialABSTRACT
Background: The prognosis of early gastric cancer is significantly better than that of advanced gastric cancer. Because of the lacking of rational screening means, the detection rate of early gastric cancer is low. Serum pepsinogen Ⅰ (PGⅠ), PGⅡ, gastrin-17 (G-17) can be used for the screening of early gastric cancer. Aims: To investigate the value of new screening scoring system of gastric cancer for detecting patients with early gastric cancer in local region. Methods: A total of 393 patients from April 2017 to December 2018 were enrolled. According to pathological findings, patients were divided into control group, gastric ulcer group, dysplasia group and early gastric cancer group. Levels of PGⅠ, PGⅡ, G-17, Hp antibody were detected, and PGR was calculated. ROC curve was used to analyze the value of parameters for detecting early gastric cancer. Detection rates of early gastric cancer via serum ABC method, new ABC method and new screening scoring system were compared. Results: Compared with control group, serum PGⅠ and PGⅡ in gastric ulcer group were significantly increased, PGR was significantly decreased (P12.80 pmol/L and ≤6.90, respectively, the combination of these three indices for screening early gastric cancer had a sensitivity of 90.6%, specificity of 91.1%, and AUC of 0.965. The detection rate of early gastric cancer via new screening scoring system was significantly increased than that of serum ABC method, however, no significant difference was found between new screening scoring system and new ABC method (P>0.05). Conclusions: Decreased serum PGⅠ, PGR and increased G-17 may suggest the occurrence of early gastric cancer. New screening scoring system of gastric cancer is an efficient method for screening early gastric cancer.
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OBJECTIVE: To evaluate the predictive value of various gastric cancer risk scoring systems based on the detection of pepsinogen and gastrin 17 for the risk of developing gastric cancer. METHODS: One hundred and forty-four patients were enrolled into the study from the First Affiliated Hospital of Anhui Medical University between April 2018 and October 2018.Among them, seventyfour patients were diagnosed with early gastric cancer while seventy patients didn't have gastric cancer(control group). The levels of serum pepsinogen I(PGI)/pepsinogen II(PGII), gastrin-17(G-17) and H.pylori antibody were measured. Patients were scored according to the Japanese ABC method, the modified ABC method, and the Chinese new gastric cancer risk scoring system. Compare the accuracy of the three methods for predicting the risk of developing gastric cancer. RESULTS: Compared with the control group, there was no significant difference in PG levels between the two groups, the serum G-17 levels were lower in gastric cancer patients than those in control group(P<0.05). According to the ABC method, the incidence rates of gastric cancer in the four groups of ABCD were 48.6%,59.4%, 0.0% and 100% respectively; the incidence rates of gastric cancer in the three groups of modified ABC method were 57.6%, 35.9% and 50% respectively. The cut-off value of new gastric cancer risk scoring system to diagnose gastric cancer was 11. The sensitivity,specificity, accuracy, positive predictive value and negative predictive value were 64.8%, 71.4%, 68.1%, 70.6 and 65.8% respectively. But in the low risk group, there were 26 cases(35.1%) of gastric cancer. Comparing the low-risk with the middle-high-risk population of gastric cancer, there were more females in the low risk group. CONCLUSION: The Japanese ABC method and the modified ABC method have value for limited screening gastric cancer and are not suitable for China's national conditions. The screening efficacy of the new gastric cancer scoring system for gastric cancer is significantly higher than the other two methods; however we should be vigilant when it is used in women with low risk.
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Objective To compare the diagnostic value of the old "ABC" method [serum pepsinogen(PG) combined with Helicobacter pylori (Hp) IgG antibody] and the new "ABC" method [serum pepsinogen plus gastrin-17(G-17)] in screening gastric cancer and its precancerous condition. Methods Serum PG, G-17 and Hp-IgG were quantified by enzyme-linked immunosorbent assay (ELISA) in 278 subjects. Subjects were grouped according to the criteria of two methods. The gastroscopy and pathological biopsy were gold standard. Results The positive rate of old "ABC" method was 74.46% (207/278), which was 54.68% of new "ABC" method (151/278). For the diagnosis of gastric cancer, the sensitivity and specificity of the old "ABC" method were 90.74% and 29.46% respectively, with diagnostic coincidence rate 41.37%. The sensitivity and specificity of the new "ABC" method were 92.59% and 54.46% respectively, with diagnostic coincidence rate 61.87%. As to the diagnosis of pre-cancerous state, the sensitivity and specificity of the old "ABC" method were 75.81% and 36.00%, with diagnostic coincidence rate 58.03%. The sensitivity and specificity of the new "ABC" method were 62.10% and 75.00%, with diagnostic coincidence rate 67.86%. Conclusions Compared with the old "ABC" method, the new "ABC" method has higher sensitivity, specificity and diagnostic coincidence rate for the diagnosis of gastric cancer, yet higher specificity and lower sensitivity for the diagnosis of precancerous conditions.
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Objective To investigate weight, ghrelin changes following transcatheter left gastric artery embolization in rabbit model of obesity, and evaluate its safety. Methods Thirty New Zealand rabbits were randomly divided into three groups, ten New Zealand rabbits in each group, group A:left gastric artery embolization using gelatin sponge, group B:left gastric artery and gastroduodenal artery embolization using gelatin sponge, group C (control group): left gastric artery and gastroduodenal artery perfusion using normal saline. Ghrelin, weight and liver and kidney function were measured at preoperative and postoperative 1, 2, 3, 4 weeks. T test was used to compare the differences in the levels of preoperative and postoperative average ghrelin, weight, alanine transaminase (ALT), aspartate transaminase (AST), creatinine and urea in each group. The ANOVA of repeated measurement was used to compare the difference of preoperative and postoperative each time points between the three groups. Results The preoperative and postoperative ghrelin levels in group A were (4057±61)and (3708±141) pg/ml with statistically significant differences (t=4.5, P<0.05). The preoperative and postoperative ghrelin levels in group B were (4137 ± 89) and (3608 ± 239) pg/ml with statistically significant differences (t=6.8, P<0.05). The preoperative and postoperative ghrelin levels in the control group were (3986 ± 82)and (4044 ± 72) pg/ml with no statistically significant differences (t=0.7, P>0.05). The level of ghrelin in group B decreased significantly compared with group A and the difference was statistically significant (t=3.8, P<0.05). There was a statistically significant difference in postoperative ghrelin levels between the three groups (F=15.6, P<0.05). The preoperative and postoperative weight in group A were (6.12±0.38)and (5.66±0.39) kg with statistically significant differences (t=2.7, P<0.05). The preoperative and postoperative weight in group B were (5.99 ± 0.57)and (5.24 ± 0.61) kg with statistically significant differences (t=3.1, P<0.05). The preoperative and postoperative weight in the control group were (5.94 ± 0.45)and (6.24 ± 0.42) kg with no statistically significant differences (t=1.2, P>0.05). The weight loss of group B was significantly greater than that of group A and the difference was statistically significant (t=5.2, P<0.05). There was a statistically significant difference in postoperative weight between the three groups (F=5.1, P<0.05). There were no statistically significant differences in ALT, AST, creatinine and urea levels at preoperative and postoperative each time points in each group (P>0.05). Conclusion Left gastric artery embolization can become a safe and effective minimally invasive treatment for obesity and left gastric artery and gastroduodenal artery embolization at the same time could achieve more weight loss.
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Background:Chronic atrophic gastritis(CAG)is a common disease of digestive system and is a precancerous lesion of the intestinal type gastric cancer. Serum pepsinogens(PGs)and gastrin 17(G17)are biological markers of gastric mucosal lesions,which have a prominent role in diagnosis of CAG and screening of early gastric cancer. Aims:To study the correlation of serum PGs and G17 with age in patients with CAG. Methods:A total of 582 CAG patients admitted from Jan. 2016 to Sep. 2017 at the Baoding First Central Hospital were enrolled. The levels of serum PGⅠ,PGⅡ and G17 were determined by ELISA,and the PGⅠ/ PGⅡ ratio(PGR)was calculated. The correlations of these indices with the clinical data of CAG patients were analyzed. Results:The levels of serum PGⅠ and PGⅡ were increased with age(P<0.01),and the levels of PGR and G17 were decreased with age(P <0.05). Spearman rank correlation coefficient analysis showed that the levels of PGⅠ and PGⅡ were positively correlated with age(rs=0.374,P<0.01;rs=0.559, P<0.01),and the levels of PGR and G17 were negatively correlated with age(rs= -0.649,P<0.01;rs= -0.141, P<0.05). Conclusions:The levels of serum PGⅠ,PGⅡand G17 in patients with CAG were correlated with age. When serum PGs and G17 are used as serological indicators for diagnosis of CAG and screening of early gastric cancer,the impact of age on these indices should be taken into account.
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Gastric cancer is one of the most common malignant tumors in China. The 5-year survival rate of advanced gastric cancer is less than 30%,while the 10-year survival rate of early gastric cancer can reach 90%. Gastric cancer screening is the primary means of detecting early gastric cancer and reducing its mortality. Helicobacter pylori(H. pylori) infection is the most important cause of gastric cancer. Eradication of H. pylori can reduce the incidence of gastric cancer and its mortality. This review summarized recent advances in screening methods,screening subjects,screening procedures, and the combination of gastric cancer screening with H. pylori detection/eradication strategy.
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Objective To investigate the effect of XELOX chemotherapy protocols on the prognosis of patients with advanced gastric cancer .Methods From May 2014 to May 2016,a total of 52 patients with advanced gastric cancer in the Western Branch of the Second Hospital of Shanxi Medical University were selected and divided into control group and study group according to the random number table , with 26 cases in each group .The control group was treated with the FOLFOX chemotherapy protocols , and the study group was treated with the XELOX chemotherapy protocols.All the patients were treated for 3 cycles.After treatment,the clinical efficacy and serum gastrin-17 (GAS-17) levels before and after treatment of the two groups were statistically analyzed .At the end of the treatment and following up until now ,the survival rate of the two groups was statistically analyzed .Results The effective rate of the study group (76.92％) was significantly higher than that of the control group (50.00％)(χ2 =4.064,P<0.05).After treatment,the serum level of GAS -17 of the two groups decreased compared with before treatment,and which of the study group was lower than that of the control group (t=7.399,P<0.05).The median progression free survival (9.3 months) and median total survival (12.6 months) in the study group were longer than those in the control group(all P<0.05).Conclusion XELOX chemotherapy in the treatment of advanced gastric cancer can effectively reduce the level of serum GAS -17 ,improve the therapeutic effect and prolong the duration of life of the patients .
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Objective To investigate the effects of different extracts of pericarpium citri reticulatae (PCR) and pogostemon cablin benth (PCB) on the contraction of gastrointestinal smooth muscle and the level of gastrointestinal hormones in rat model of gastrointestinal motility disorder. Methods Seventy Wistar rats were randomly divided into groups of control, model, water extractive of PCR, hesperidin, water extractive of PCB, water extractive of PCB plus volatile oil and patchouli alcohol, ten rats in each group. Except the control group, the rest groups were established gastrointestinal motor disorder model via limb ischemia-reperfusion (LIR). After modeling rats of groups were intervened with corresponding extracts. The effects of different extracts on contraction amplitude of corpora ventriculi and small intestine smooth muscle were observed. The levels of gastrointestinal hormones including motilin (MOT), gastrin (GAS), cholecystokinin (CCK) and somatostatin (SS) were detected by radioimmunoassay. Results The contraction amplitudes of corpora ventriculi and small intestine smooth muscle were decreased (P<0.05), the serum level of GAS and plasma level of MOT were also significantly decreased, while CCK and SS levels in the gastric antrum were significantly increased in model group than those of the control group (P < 0.05). Water extractive of PCR, hesperidin, water extractive of PCB and water extractive of PCB +patchouli oil can increase the contraction amplitudes of corpora ventriculi and small intestine smooth muscle, increase the serum level of GAS and reduce levels of CCK and SS in the gastric antrum (P<0.05), whereas showed no influence in the plasma level of MOT (P>0.05)]. Compared with model group, patchouli alcohol showed no influence in the contraction of gastrointestinal smooth muscle and levels of MOT, GAS, CCK and SS (P>0.05). In the aspect of regulating the contraction of gastrointestinal smooth muscle and the level of GAS, CCK and SS, the pharmacological effect of PCR water extract was better than that of hesperidin (P<0.05), while water extractive of PCB+volatile oil was better than that of water extractive of PCB (P < 0.05). Conclusion The active ingredients of PCR and PCB have variant regulative effects on the contraction of gastrointestinal smooth muscle and the serum level of GAS, CCK and SS in the gastric antrum in rat model of gastrointestinal motility disorder.
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Objective To explore the relationship between serum pepsinogen (PG), PGⅡ, PG ratio (PGR), gastrin 17 (G17) and gastric cancer, and to provide the basis for the early diagnosis and differential diagnosis of gastric cancer. Methods Two hundred and forty-eight cases of gastric disease diagnosed with gastroscopy in Baoji Central Hospital from December 2015 to February 2017 were selected as study subjects. According to the results of histopathology, the patients were divided into 4 groups: gastric cancer group (47 cases), chronic atrophic gastritis group (52 cases), chronic non-atrophic gastritis group (81 cases), gastric ulcer group (68 cases). Meanwhile, 50 cases healthy people were enrolled as the control group. The levels of serum PGⅠ, PGⅡ and G17 were measured by enzyme linked immunosorbent assay (ELISA). Results The levels of PGⅠ and PGR in gastric cancer group were lower than those in other groups [PGⅠ: (43±7) vs. (47±7), (69±14), (75±17), (112±22) μg/L; PGR: 5.6±0.5 vs. 10.3±2.6, 10.5±2.5, 11.9±2.7, 14.6± 3.5], and there was a significant difference (PGⅠ: F= 58.42, P = 0.000; PGR: F= 6.15, P = 0.034). The level of serum G17 in gastric cancer group was significantly higher than that in other groups [(43.8±4.3) vs. (22.4±3.6), (10.7±2.1), (13.2±2.4), (5.8±1.3) pmol/L, F= 43.22, P = 0.000]; The PGⅠ, PGR and G17 combined detection of sensitivity(88.6 %), specificity(97.5 %), area under the curve(0.986) was significantly higher than that of single detection(78.3 %, 89.0 %, 88.4 %; 72.9 %, 87.0 %, 73.2 %; 0.848, 0.912, 0.923, respectively; χ2= 7.86, 6.42, 9.10; P = 0.019, 0.044, 0.012). The regression equation provided a basis for confirmation or exclusion of gastric cancer. Conclusions Serum PGⅠ, PGR, G17 and gastric cancer has a good correlation. Combined detection of serum PGⅠ, PGR and G17 could be used for the diagnosis and differential diagnosis of gastric cancer.
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Objective To study the changes of gastrin 17 (G17) and pepsinogen (PG) after gastric bypass surgery in gastric antrum resection, and the influences of different surgical methods on postoperative peptic ulcer. Methods Clinical data of 63 patients with gastric bypass surgery in our hospital from October 2013 to October 2015 were divided into resection of pyloric antrum group (n=33) and preserved pyloric antrum group (n=30). The values of G17, PGⅠ, PGⅡand PGⅠ/PGⅡwere detected by enzyme linked immunosorbent assay at 1 month, 6 months and 12 months after operation. The correlation between the different surgical methods and the incidence of peptic ulcer was analyzed between two groups. Results The G17 levels were significantly decreased in resection of pyloric antrum group 6 and 12 months after operation than those in preserved pyloric antrum group (P0.05). There was no significant difference in postoperative peptic ulcer between two groups (P>0.05). Conclusion Gastric bypass after resection of the pyloric antrum can reduce the postoperative secretion of G17, PGⅠ and PGⅡ, but which can not reduce the incidence of postoperative anastomotic ulcer.
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Objective To investigate the effects of blocking gastrin receptor on the proliferation,apoptosis and expression of key proteins in the related pathway in gastric cancer cell lines.Methods In the experimental group,the gastric cancer cell lines SGC-7901 and AGS cells were treated with 5 mmol/L proglumide,a kind of a gastrin receptor antagonist.And the normal cultured gastric cancer cells SGC-7901 and AGS were used in control group.The growth of each group was detected by MTT assay;the cell growth curve was drawn by flow cytometry;the cell cycle of each group was detected by flow cytometry.Annexin V-FITC/PI double staining was used to detect the cell growth of apoptosis.The relative mRNA expression of β-catenin,nuclear factor-P65,mammalian target of rapamycin and glycogen synthase kinase 3 beta in Wnt,NF-κB and PI3K-AKT-MTOR pathways were detected by RT-qPCR.The expression of β-catenin protein was detected by Western blotting.Results After treatment with proglumide,the growth of the cells in the experimental group was lower than that in the control group;and the proportion of S phase cells in the cell cycle was also lower than that in the control group,but the proportion of cells in G0/G1 phase was higher than that in the control group(P<0.05).The percentage of apoptotic cells was also increased after treatment with proglumide(P<0.05).Furthermore,proglumide treatment significantly reduced the expression of β-catenin at both mRNA and protein levels(P<0.05).Conclusion Blocking gastrin receptor can down-regulate the expression of β-catenin,inhibit the cell proliferation and promote the cell apoptosis in gastric cancer cells.