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Background: Tumor mutational burden (TMB) is a promising predictor, which can evaluate the efficacy of immune checkpoint inhibitors (ICIs) for tumor patients. MicroRNAs (miRNAs) act as the key regulators of anti - cancer immune response. However, the relationship between TMB and miRNAs expression profiles in gastric cancer is not elucidated. Aims: To construct and validate the TMB prediction model of gastric cancer by analyzing the sequencing data and clinical data in TCGA database. Methods: Gastric cancer patients in TCGA database were divided into TMB high group and TMB low group, and differentially expressed miRNAs were screened. Gastric cancer patients were randomly divided into training group and validation group. A miRNAs prediction model for predicting TMB level was developed by lasso regression analysis method in training group, and was validated in validation group. KEGG functional enrichment analysis was used to analyze the screening related miRNAs. The correlation between miRNAs and three ICIs was analyzed. Results: Fifty-four differentially expressed miRNAs were screened, and 20 of them were identified as TMB-related miRNAs. The sensitivity, specificity, AUC in the miRNAs prediction model were relatively high. Functional enrichment results revealed that TMB-related miRNAs were mainly involved in biological process associated with immune response and signaling pathways related with cancer. The miRNAs prediction model showed a median positive correlation with PD-L1 (r=0.36, P<0.01), a median negative correlation with PD-1 (r=-0.31, P<0.01) and no significant correlation with CTLA4 (r=0.14, P<0.01). Conclusions: This study presents a miRNAs prediction model which can stratify gastric cancer patients with different TMB levels.
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Hepatic venous pressure gradient (HVPG) is the "gold standard" for diagnosing portal hypertension and determining its severity, but its wide clinical application is limited due to its invasiveness and difficulties in operation. The replacement of HVPG by noninvasive methods has become a research hotspot in recent years; however, the accuracy of the existing serological and imaging methods remains to be discussed, and such methods cannot completely replace HVPG in clinical practice. Liver biopsy has been widely used in clinical practice for many years and is still an indispensable method for the diagnosis of some liver diseases. Recent studies have found that several pathological indicators after liver biopsy, such as collagen area, fibrous septal thickness, nodule size, microvascular density, and density and area of bile ducts and lymphatic vessels, can not only judge the severity of liver fibrosis, but also have a good correlation with portal venous pressure, which provides new ideas for diagnosing cirrhotic portal hypertension and evaluating the severity of portal hypertension.
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Digestive endoscopy is an important approach for the diagnosis and treatment of digestive tract diseases. With the expansion of gastrointestinal tumor screening projects, more and more patients and asymptomatic healthy people will receive digestive endoscopy, and digestive endoscopy training has become particularly important. The traditional patient-based training mode will be replaced by more standardized training mode. Due to the objectivity, safety and economic advantages, virtual reality (VR) simulation will be helpful for promoting and perfecting the standardized training mode of digestive endoscopists in China. This article reviewed the application, research progress, advantages, current limitations, and potential prospects of VR technique in the digestive endoscopy training.
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Background: Artificial intelligence (AI) is a research hotspot in various fields of medicine at present. Its powerful image recognition and processing ability make it having a strong advantage in the field of digestive endoscopy. Aims: To construct a gastroscopy image recognition system based on AI, and to explore its value in the diagnosis of chronic atrophic gastritis (CAG). Methods: A total of 3 813 gastroscopy images were collected from patients who underwent gastroscopy and biopsy for pathological examination from April 2018 to August 2020 at Qingdao Municipal Hospital, including 1 927 images of CAG and 1 886 images of chronic non-atrophic gastritis (CNAG). Among them, 3 055 images were selected as training set (CAG/CNAG, 1 541/1 514) and 379 images (CAG/CNAG, 193/186) as the adjustment set, the remaining images as the test set. Deeping learning model was trained and verified. The receiver operating characteristic curve (ROC curve) and P-R curve were calculated. The sensitivity, specificity and accuracy of deep learning model and that of 3 less experienced endoscopists, 3 experienced endoscopists for diagnosis of CAG were compared. Results: The area under ROC curve of deep learning model for CAG was 0.916 8, the area under P-R curve was 0.931 6, and sensitivity was 89.1%, specificity was 74.2%, accuracy was 81.8%. The sensitivity, specificity and accuracy of deep learning model were superior to the three less experienced endoscopists, and even superior to some of the experienced endoscopists. Conclusions: The CAG diagnostic model based on deep learning technology has high sensitivity, specificity and accuracy, and can effectively identify CAG and assist the clinical endoscopists to diagnose CAG in gastroscopy.
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Background:Colorectal polyps(CRP)has nonspecific clinical manifestation,and is closely related to the pathogenesis of colorectal cancer. Studies have shown that abnormalities of serum uric acid(UA),serum lipids are closely related to pathogenesis of CRP,but is still in controversial. Aims:To investigate the correlation between serum UA,TG, TC,LDL-C,HDL-C and incidence of CRP. Methods:A total of 142 CRP patients from Jan. 2016 to Oct. 2016 at Qingdao Municipal Hospital were enrolled,and 116 patients without CRP were served as controls. The serum levels of UA, TG,TC,LDL-C,HDL-C were determined,and correlation between UA and serum lipids was analyzed. Results:Compared with controls,serum levels of TG,UA were significantly increased in CRP patients(P<0.05),HDL-C level was significantly decreased(P<0.05),however,no significant differences in TC,LDL-C levels were found between the two groups. Serum UA level was positively correlated to TG,TC,LDL-C levels in patients with CRP(r=0.32,r=0.21, r=0.15;P<0.05),and negatively correlated to HDL-C level(r= -0.07,P<0.05). Conclusions:Increased serum TG and UA levels and decreased serum HDL-C level may be correlated to the pathogenesis of CRP. The interaction between serum UA,TG,TC,LDL-C and HDL-C may increase the risk of CRP.
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Background:The morbidity and mortality of gastric cancer remain high worldwide,and it is urgent to explore new targets for the diagnosis and treatment of gastric cancer. Nuclear protein 1 (Nupr1)has a variety of biological functions, especially in the tumorigenesis and development of the malignancies. Aims:To investigate the expression and clinical significance of Nupr1 in gastric cancer. Methods:Quantitative RT-PCR was used to determine the mRNA expression of Nupr1 in 72 cases of gastric cancerous tissue and the paired paracancerous tissue. Western blotting and immunohisto-chemistry were employed to detect the protein expression and cellular localization of Nupr1. The correlation of Nupr1 with the clinicopathological characteristics of gastric cancer was analyzed. Results:Expressions of Nupr1 mRNA and protein in gastric cancer were both significantly higher than those in paracancerous tissue (P 0. 05). Conclusions:Nupr1 is overexpressed and correlated with invasion, metastasis and progression of gastric cancer. It can be used as a novel biomarker for early diagnosis and prognosis evaluation,and as a potential target for treatment of gastric cancer.
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Background:Studies have shown that promoter methylation of MGMT gene is closely related to many malignant tumor including gastric cancer.DNA methyltransferase 1 (DNMT1) is highly expressed in many malignant tumor tissues.However, studies on relationship between methylation of MGMT gene and DNMT1 expression in gastric cancer are rare.Aims:To investigate the relationship between methylation of MGMT gene, protein expression of DNMT1 and gastric cancer.Methods:Promoter methylation status of MGMT gene in 60 gastric adenocarcinoma tissues and corresponding paracancerous tissues were detected by methylation-specific PCR (MSP).RT-PCR and immunohistochemistry were used to measure mRNA and protein expressions of MGMT and DNMT1, respectively.Results:Methylation rate of MGMT gene promoter in gastric cancer was significantly higher than that in paracancerous tissue (45.0% vs.13.3%, P<0.001).The positivity rate of MGMT mRNA in gastric cancer was significantly lower than that in paracancerous tissue (41.7% vs.93.3%, P<0.001), while the positivity rate of DNMT1 mRNA expression in gastric cancer was significantly higher than that in paracancerous tissue (76.7% vs.18.3%, P<0.001).Methylation rate of MGMT promoter in MGMT mRNA-negative expressed gastric cancer tissue was significantly higher than that in MGMT mRNA-positive expressed gastric cancer tissue (57.1% vs.28.0%, P<0.05).It showed a negative correlation between MGMT protein expression and DNMT1 protein expression in gastric cancer tissue (r=-0.795, P<0.01).Conclusions:Promoter methylation of MGMT gene and high expression of DNMT1 may be associated with the development and progression of gastric cancer.
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<p><b>OBJECTIVE</b>To investigate the role and mechanism of action of fibroblast growth factor-21 (FGF-21) in reducing triglyceride (TG) in the in vitro and in vivo models of nonalcoholic fatty liver disease (NAFLD).</p><p><b>METHODS</b>(1) A mixture of free fatty acids was used to establish a model of steatosis in L02 cells, and the cells were treated with various concentrations of FGF-21 or fenofibrate. Twenty-four hours later, oil red O staining was performed to observe the degree of steatosis, and intracellular TG content was determined. RT-PCR and Western blot were applied to measure the mRNA and protein expression of sterol regulatory element-binding protein-1c (SREBP-1c). (2) High-fat diet was used to establish a mouse model of steatosis, and these mice were intraperitoneally injected with FGF-21 or fenofibrate. Eight weeks later, whole blood and liver samples were collected, and HE staining was performed to observe steatosis. Meanwhile, the serum levels of TG, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) were measured, and TG content in the liver was also measured. One-way analysis of variance was used for comparison of data between multiple groups, and the least significant difference t-test was used for comparison between any two groups.</p><p><b>RESULTS</b>(1) Compared with the control group, the model group showed significant steatosis, with significant increases in intracellular lipid droplets and TG content (t = -20.57, P < 0.01), while FGF-21 reduced the number of intracellular lipid droplets and TG content (F = 98.16, P < 0.01) in a dose-dependent manner. In addition, the model group had significantly increased mRNA and protein expression of SREBP-1c compared with the control group (t = -10.73 and -0.1006, both P < 0.01), while FGF-21 down-regulated the mRNA and protein expression of SREBP-1c (F = 161.35 and 36.72, both P < 0.01). (2) Compared with the mice in the control group, those in the model group showed significant steatosis and had significant increases in serum TG level and TG content in the liver (t = -18.84 and 15.71, both P < 0.01). FGF-21 relieved hepatic steatosis and reduced the serum TG level and TG content in the liver (t = 18.11 and 9.46, both P < 0.01). Moreover, FGF-21 reduced the serum levels of ALT and AST in NAFLD mice (t = 25.93 and 12.50, both P < 0.01).</p><p><b>CONCLUSION</b>FGF-21 can inhibit the synthesis of TG through suppressing the expression of SREBP-1c, which further confirms the potential therapeutic effect of FGF-21 in the treatment of NAFLD. This may provide new ideas for the treatment of NAFLD.</p>
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Animais , Camundongos , Alanina Transaminase , Sangue , Aspartato Aminotransferases , Sangue , Linhagem Celular , Dieta Hiperlipídica , Modelos Animais de Doenças , Fenofibrato , Farmacologia , Fatores de Crescimento de Fibroblastos , Farmacologia , Hepatopatia Gordurosa não Alcoólica , Sangue , Tratamento Farmacológico , Proteína de Ligação a Elemento Regulador de Esterol 1 , Metabolismo , Triglicerídeos , SangueRESUMO
Background:Gastric cancer is the result of comprehensive interactions among Helicobacter pylori(Hp)infection, environmental factors and host genetic factors. It has been demonstrated that rs2294008 polymorphism in prostate stem cell antigen(PSCA)gene is associated with increased risk of non-cardia gastric cancer. Aims:To investigate the relationship between PSCA rs2294008 polymorphism and precursors of gastric cancer. Methods:A total of 398 patients with gastric intestinal metaplasia( n = 328)and intraepithelial neoplasia( n = 70)from Nov. 2009 to Nov. 2015 at the Qingdao Municipal Hospital were enrolled,and 416 healthy subjects were served as controls. Genotype of PSCA rs2294008 was determined by direct DNA sequencing of PCR products,and Hp infection was examined by rapid urease test. Results:Significant difference in frequencies of CC,CT and TT genotypes of PSCA rs2294008 was observed between case and control groups(P = 0. 011);the frequency of TT genotype was significantly higher in case group than in control group (16. 3% vs. 9. 4% ,P = 0. 003). Compared with individuals carrying CC genotype,TT genotype carriers were found to be associated with a higher risk of precursors of gastric cancer(oR = 1. 840,95% CI:1. 174 ~ 2. 886). Taken individuals negative for Hp infection and carrying C allele(CC + CT)as reference,risk of precursors of gastric cancer was significantly increased by Hp infection(oR = 2. 389,95% CI:1. 799 ~ 3. 173)and Hp infection in combination with TT genotype (OR = 3. 335,95% CI:1. 935 ~ 5. 749),whereas TT genotype alone only slightly increased the risk(OR = 1. 783,95%CI:0. 900 ~ 3. 530). Conclusions:PSCA rs2294008 polymorphism is significantly associated with susceptibility to precursors of gastric cancer and Hp infection might further increase the risk in TT carriers.
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<p><b>OBJECTIVE</b>To investigate the relationship between SREBP-1c and the risk of liver disease associated with the triacylglyceride lipase PNPLA3 I148M variant using a human hepatoma cell line model transfected with recombinant lentiviruses.</p><p><b>METHODS</b>Huh7 cells were transfected with control lentivirus or lentivirus containing the PNPLA3 I148M variant (variant). The two cell groups were compared to assess differences in triglyceride content (using oil red O staining), levels of triglyceride and cholesterol (using automated biochemical analyzer), expression of SREBP-lc mRNA (using fluorescence quantitative PCR), and expression of SREBP-1c protein (using western blot.</p><p><b>RESULTS</b>Cells expressing the PNPLA3 I148M variant showed higher triglyceride content (0.54+/-0.03 mmol/L vs. control cells: 0.23+/-0.02 mmol/L; t=22.58, P<0.001), cholesterol level (0.28+/-0.03 mmol/L vs. control cells: 0.13+/-0.02 mmol/L; t =11.83, P<0.001), SREBP-1cmRNA expression (13.59+/-0.60 vs. 11.81+/-0.82; [The abstract and text in the paper say variant increases, but the data shown says the higher value is in the control cells. Please correct to properly express the data.] P=0.001), and SREBP-1c protein expression. The level of SREBP-1c was positively correlated with serum triglyceride in the cells expressing the PNPLA3 I148M variant (r=0.912, P<0.01).</p><p><b>CONCLUSION</b>The risk of liver disease associated with the PNPLA3 I148M variant, which increases lipogenesis, may involve SREBP-1c and a pathway that increases triglycerides.</p>
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Humanos , Linhagem Celular Tumoral , Lipase , Hepatopatias , Proteínas de Membrana , Fatores de Risco , Proteína de Ligação a Elemento Regulador de Esterol 1 , TriglicerídeosRESUMO
The development and progress of gastric mucosal diseases is a complex process associated with multiple factors and underlying mechanisms,and individuals may present different genetic susceptibilities to gastric mucosal diseases. Various studies have demonstrated a strong link between Toll-like receptors( TLRs),as pattern recognition receptors,and the development and progress of gastric mucosal diseases. The gene polymorphisms of TLRs may change its encoded proteins or related signaling pathways,which results in different susceptibilities to gastric mucosal diseases;this might affect the development,progress and clinical outcome of the disease. In this review article,the advances in study on TLRs and its gene polymorphisms in gastric mucosal diseases were summarized.
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Objective To investigate the association between (beta-parvin) PARVB gene rs5764455 polymorphism and susceptibility to non-alcoholic fatty liver disease (NAFLD). Methods A total of 230 patients with NAFLD (NAFLD, n = 230) and 230 control subjects (control, n = 330) were genotyped by PCR and direct sequencing. Clinical information was detected and compared in different groups. Genotypic frequency and gene frequency distribution in the two groups and relative risks to NAFLD susceptibility were assessed statistically , respectively. Results No statistical differences were observed between PARVB gene rs5764455 genotypic frequency with gene frequency distribution and the two groups, respectively (Genotypic frequency χ2 = 0.182, P = 0.913; gene frequency χ2 = 0.180, P = 0.672). Comparing C/T + T/T genotype carrier with C/C genotype carrier, there were no differences concerning the relative risks to NAFLD susceptibility (OR = 1.266, P =0.178;adjusted OR =1.631, P =0.096) before and after adjusting body mass, BMI and so on. In the latter group, there are significant differences in the increases of body mass, BMI, TG, ALT and AST (P < 0.05). Conclusion Non-relationship was observed between PARVB gene rs5764455 polymorphism and the risk of NAFLD in Qingdao Han Chinese.
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<p><b>OBJECTIVE</b>To investigate the association between the PNPLA3 rs738409 polymorphism and chronic hepatitis B (CH[B) in a Han Chinese population residing in Qingdao.</p><p><b>METHODS</b>Peripheral blood samples were collected from 185 CHB patients and 164 healthy controls and subjected to polymerase chain reaction (PCR) and DNA sequencing to determine the PNPLA3 genotypes. The relative risk of the rs738409 polymorphism for CHB was estimated by calculating the odds ratio (OR) and 95% confidence interval.</p><p><b>RESULTS</b>The rs738409 G allele frequency was significantly different between the CHB and control groups (31.9% vs.21.9% respectively, P less than 0.05). Compared to he rs738409 C allele, the G allele was associated with an increased risk of developing CHB (OR =1.67, 95% CI:1.18-2.34, P =0.003). Logistic regression model analysis, with adjustment for confounding factors, indicated that carriers of the PNPLA3 rs738409 GG + GC genotype had increased risk of CHB than carriers of the CC genotype (OR =1.76 ,95% CI:1.14-2.71, P =0.011).</p><p><b>CONCLUSION</b>Qingdao Han Chinese who are carriers of the rs738409 G allele are at increased risk of CHB.</p>
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Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Povo Asiático , Genética , Estudos de Casos e Controles , China , Epidemiologia , Frequência do Gene , Predisposição Genética para Doença , Genótipo , Hepatite B Crônica , Epidemiologia , Genética , Lipase , Genética , Proteínas de Membrana , Genética , Polimorfismo de Nucleotídeo Único , Fatores de RiscoRESUMO
<p><b>OBJECTIVE</b>To investigate the association between two polymorphisms of the APOC3 gene (T-455C and C-482T) and hereditary risk of non-alcoholic fatty liver disease (NAFLD).</p><p><b>METHODS</b>A total of 287 patients with NAFLD and 310 control subjects were genotyped by PCR and direct sequencing. Serum lipid profiles were also detected by standard biochemical</p><p><b>METHODS</b>One-hundred-and-eighty of the study participants were used to measure the APOC3 content by enzyme-linked immunosorbent assay. Inter-group differences and associations were assessed statistically using Chi square and t tests and logistic and linear regression analyses.</p><p><b>RESULTS</b>The frequencies of neither the genotypes or alleles were significantly different between the NAFLD cases and the controls. Compared with the most common genotypes-455TT or-482CC, none of the variants showed a significant increase in risk of NAFLD or for the clinical and biochemical parameters. The adjusted odds ratios (with 95% confidence intervals) of NAFLD were 1.25 (0.79-1.96) and 1.20 (0.76-1.89) for carriers of the APOC3-455C and-482 T variants respectively (P more than 0.05).</p><p><b>CONCLUSION</b>The T-455C and C-482T polymorphisms of the APOC3 gene are not associated with risk of NAFLD, pathogenic changes in lipid profiles, or insulin resistance in Han Chinese.</p>
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Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Alelos , Apolipoproteína C-III , Genética , Estudos de Casos e Controles , Frequência do Gene , Genótipo , Resistência à Insulina , Lipídeos , Sangue , Hepatopatia Gordurosa não Alcoólica , Genética , Metabolismo , Polimorfismo de Nucleotídeo Único , Regiões Promotoras GenéticasRESUMO
Background and purpose:Runt-related transcription factor 3 (RUNX3) has a signiifcant relation with gastric cancer. Many researches have confirmed that rs760805 AA can increase the risk of gastric cancer. The purpose of the study was to investigate the relationship between the rs760805 polymorphism of the RUNX3 gene and gastric cancer. Methods: The rs760805 genotypes were determined by PCR-based DNA sequence measuring analysis and direct DNA sequencing in 310 incident cases with gastric cancer and 327 controls recruited in Shandong. Results:The frequency of TT genotype was 15.16%in gastric cancer patients and 20.49%in normal controls, and the corresponding percentages for AT and AA genotypes were 48.39%and 36.45%, and 52.60%and 26.91%, respectively. Compared to TT genotype, AT genotypes were associated with an increased risk of gastric cancer (OR=1.24, 95%CI`:0.81-1.92;OR=1.83, 95%CI:1.15-2.92). Conclusion:The rs760805 polymorphism of the RUNX3 gene is associated with increased susceptibility to gastric cancer.
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Objective To study the effect of retention enema with Huanghu Decotion on infantile rotavirus enteritis and summarize the nursing strategies.Method One hundred and sixty nine infants with infantile rotavirus enteritis were randomly divided into observation group(n=86)and control group(n=83).On the basis of conventional treatment,the observation group was treated with retention enema with Huanghu Decotion and the control group with Smecta 3 d for a course of treatment.The two groups were compared in terms of the total effective rate.Results There was significant difference in the total effectives rate between the two groups(P<0.05).The rate in the observation group was highter than that in the control group.Conclusions Retention enema with Huanghu Decotion is superior to that by Smecta in treating infantile rotavirus enteritis.The comprehensive nursing care is helpful for the improved curative compliance and therapeutic effect.
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Objective To study the diagnostic value of porphobilin staining of gastric mucus for primary pathologic duodenogastric reflux (DGR). Methods A total of 58 DGR patients diagnosed from January, 2007 to April, 2008 were recruited to the study as DGR group, and 21 healthy volunteers as control.All subjects underwent 24-hour intragastric bilirubin monitor and gastroscopy. Bilirubin absorption value of 0. 25 and median reflux time of 23.60% were taken as thresholds to differentiate low reflux group ( reflux time ＜ 23.60% ) and high reflux group (reflux time ≥23.60% ). Porphobilin staining of gastric mucosa was quantitatively analyzed. Results Deposition of porphobilin in mucosa of gastric antrum, gastric angle and gastric body in primary pathologi DGR group was significantly higher than those in healthy group (P ＜0. 05 ). The occurrence of atrophic and intestinal metaplasia of gastric antrum in high reflux group was significantly higher than that of low reflux group (P ＜ 0. 05). Deposition of porphobilin in mucosa of gastric antrum, gastric angle and gastric body in high reflux group was significantly higher than that of low reflux group (P ＜ 0. 05 ). The New Sydney system pathological scores of gastric antrum and angle of high reflux group was higher than that of low reflux group ( P ＜ 0. 05 ). The deposition of porphobilin in mucosa of gastric antrum and gastric angle was positively correlated with New Sydney system pathological scores in primary pathological DGR group (r=0.59, P=0.041 andr=0.73, P=0.038). Conclusion Porphobilin staining of mucosa in gastric antrum can reflect the severity of bile reflux, and is positively correlated with the extent of gastric mucosal lesion, which may be helpful in diagnosis of primary pathological DGR.
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Background and purpose:The prognosis of advanced esophageal carcinoma is poor,there are no standard regimens for these patients. This study was to observe and evaluate the clinical feasibility and effi cacy of combined esophageal stent insertion with radiotherapy and concurrent chemotherapy in the treatment of locally advanced esophageal carcinoma. Methods:66 patients with esophageal carcinoma who were not suitable for operation were analyzed retrospectively. In the therapy group,stent was placed in order to relieve esophageal stenosis,and then followed by 3D-CRT and concurrent chemotherapy,while patients in the control group were treated with the placement of stent alone. According to the evaluating standards of WHO and Stooler classifi cation,we evaluated the effi cacy. Results:In the study group,72.2% of 36 cases was observed as partial response(PR),and 13.9% with complete response(CR),overall response rate was 86.1%. 6 and 12 months survival rates were 88.9% and 72.2% in the study group,compared to 53.3% and 26.7% in the control group,respectively(P