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Objective To investigate the risk factors of gastric cancer in Hanzhong area and establish a gastric cancer risk prediction model based on gastric function indexes. Methods A questionnaire survey was conducted on 227 patients with gastric and non-gastric cancer admitted to the Department of Gastroenterology of Hanzhong Central Hospital from January 2018 to January 2019. The diet, lifestyle habits, family history, and past history of the subjects were collected. Serological tests (including serum PGⅠ,Ⅱ, and G-17), gastroscopy and pathological examination of the samples were carried out. Multi-factor Logistic regression analysis was performed to analyze the high risk factors. The efficacy of serum gastric function for gastric cancer screening was assessed through ROC curve. Results There were no significant differences in the distribution of age (χ2=0.054, P=0.816), gender (χ2=3.823, P=0.051) and BMI (χ2=5.569, P=0.135) between the gastric cancer and non-gastric cancer groups, suggesting that the clinical data between the two groups was comparable. Multivariate logistic regression analysis showed that smoked food intake (P=0.031, 95% CI: 1.150 ~ 17.545) and hyperlipidemia (P=0.039, 95% CI:0.216~0.960) were high risk factors for gastric precancerous lesions, other factors did not show significant high risk (P>0.05). The results of ROC curve showed that the diagnostic efficacy of combined PG I, PG II, and G-17 was significantly higher than that of PG I, PGⅡ, or G-17 alone (P<0.05). Conclusion The risk factors of gastric cancer in Hanzhong area mainly included the intake of smoked food and hyperlipidemia. Patients can be advised to pay attention to diet during clinical treatment. Based on gastric function indexes PG, PGⅡ and G-17, the diagnosis of gastric precancerous lesions had a good prediction. The combined diagnosis is more effective, which provided a theoretical basis for the early diagnosis of clinical gastric cancer.
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OBJECTIVE: To explore the effect of γ-aminobutyric acid (GABA)ergic neuronal circuit of the central amygdaloid nucleus (CeA) and the paraventricular nucleus of hypothalamus (PVN) on electroacupuncture (EA)-induced regulation of gastric function by way of CeA-PVN projection. METHODS: The present study included 3 parts: 1) C57BL/6 mice were randomly divided into control and EA groups (n=6 in each group). EA was applied to right "Weishu"(BL21, Back-shu point) and "Zhongwan"(CV12, Front-mu point) for 20 min, followed by detecting the expression of c-fos in the CeA and PVN by using immunofluorescence staining; 2) Microinjection of anterograde tracer (rAAV-EF1α-DIO-mcherry-WPRE-pA) into the CeA was conducted in GAD2-Cre mice for confirming the projection of GABAergic neurons from CeA to PVN; 3) GAD2-Cre mice were randomly divided into rAAV-DIO-mcherry (intra-CeA injection of rAAV-EF1α-DIO-mcherry-WPRE-pA), rAAV-DIO-hM3D（Gq）-mcherry(intra-CeA injection of rAAV-EF1α-DIO-hM3D(Gq)-mcherry-WPRE-pA) and rAAV-DIO-hM3D（Gq）-mcherry+EA groups(n=6 in each group). The food intake and gastric empty were detected, and the concentration of GABA in the PVN was assayed by using high performance liquid chromatography on the 28th day after intra-CeA injection. RESULTS: 1) The expression of c-fos in the CeA and PVN was significantly increased in the EA group relevant to the control group(P<0.01), suggesting an activation of neurons in both CeA and PVN after EA. 2) Following CeA injection of rAAV-EF1α-DIO-mcherry-WPRE-pA, the densely expressed virus GABAergic neurons were found in CeA and large number of projection fibers found in the PVN, suggesting a direct connection between CeA and PVN. 3) After activating the GABAergic neurons of CeA, the concentration of GABA in the PVN was obviously increased (P<0.01), the food intake and the gastric empty were considerably decreased relevant to the rAAV-DIO-mcherry group(P<0.01). Following EA intervention，the concentration of GABA in the PVN was obviously decreased(P<0.01), the food intake and the gastric empty were significantly increased relevant to the rAAV-DIO-hM3D（Gq）-mcherry group (P<0.01). CONCLUSION: EA of BL21 and CV12 (Back-shu and Front-mu acupoints) can increase food intake and gastric empty in GAD2-Cre mice, which may be achieved by suppressing the release of GABA in PVN through CeA-PVN GABAergic neural circuit.
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OBJECTIVE: To observe the effect of electroacupuncture (EA) stimulation of "Zusanli"(ST36)on gastric function (food consumption and gastric emptying rate) and excitability of hippocampal glutamatergic neurons in mice, so as to explore its mechanism underlying enhancing gastrointestinal function. METHODS: The present study includes 2 parts. 1) C57BL/6 mice were randomly divided into normal and EA groups (n=12 in each group). EA (2 Hz/15 Hz, 1-3 mA) was applied to bilateral ST36 for 20 min, once daily for 7 days. In each group, 6 mice were used to measure the food consumption and gastric emptying rate, and the other 6 mice used to detect the hippocampal glutamate secretion content by using in vivo microdialysis and high performance liquid chromatography. 2) Thirty CaMKIIα-Cre mice received microinjection of a recombinant adeno-associated viral vector containing inhibitory designer receptor exclusively activated by a designer drug (DREADD, AAV-DIO-hM4Di-eYFP) into the hippocampus. Twenty-one days later, 3 mice were selected to observe the expression of eYFP-labeled hM4Di by immunohistochemistry, and 15 mice employed to observe the electrical activities of hM4Di-eYFP positive neurons exposed in chemogenetic activating drug Clozapine N-oxide (CNO) perfusion conditions (n=3) and without CNO in the recording chamber (n=6 in the control and EA groups) by using whole cell patch clamp. The rest 12 CaMKII-Cre mice were equally randomized into AAV-DIO-hM4Di-eYFP+CNO group and AAV-DIO-hM4Di-eYFP+CNO+EA group, and CNO was given by intraperitoneal injection for observing the effect of EA on gastric function. RESULTS: 1) In C57BL/6 mice, compared with the normal group, the food consumption, gastric emptying rate, and the glutamate content in the hippocampus were obviously increased in the EA group (P0.05), suggesting an elimination of EA effect after acute DREADD-mediated activation of the CaMKIIα-positive hippocampal excitatory neurons. CONCLUSION: EA at ST36 can promote food intake and gastric emptying in normal mice but not in CaMKIIα-Cre mice with activated hippocampal hM4Di receptors，suggesting a contribution of the CaMKIIα-positive hippocampal excitatory neurons (glutamatergic neurons in particular) to the enhanced gastrointestinal function of EA at ST36.
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Acupuncture has remarkable effects on treating functional gastrointestinal diseases, but its central mechanism is not clear. At present, the research has mainly focused on several central nuclei, such as the dorsal vagus complex (DVC), nucleus raphe magnus (NRM), locus coeruleus (LC), subnucleus reticularis dorsalis (SRD), hypothalamic paraventricular nucleus (PVN), cerebellar fastigial nucleus (FN), central amygdala (CeA), etc. It is not clear whether the nuclei are involved in acupuncture regulation of gastric function through certain interrelation. A further summary of related literature indicates that many brain regions or nuclei in the central nervous system are closely related to gastric function, such as DVC, NRM, parabrachial nuclei (PBN), LC, periaqueductal gray (PAG), cerebellum, PVN, arcuate nucleus (Arc), hippocampus, CeA, etc. Most of these nuclei have certain fiber connections with each other, in which DVC is the basic center, and other nuclei are directly or indirectly involved in the regulation of gastric function through DVC. Is DVC the key target in acupuncture regulation of gastric function? Does other nuclei have direct or indirect neural circuit with DVC to participate in the regulation of gastric function by acupuncture, such as the possibility of CeA-DVC neural loop in acupuncture regulating gastric function. Therefore, more advanced techniques such as photogenetics, chemical genetics should be introduced and the central mechanism of acupuncture on regulating gastric function with DVC as center, from the view of nerve loop, will become the focus of further research, which could explain the central integration mechanism of acupoint compatibility by modern neuroscience technology.
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Terapia por Acupuntura , Locus Cerúleo , Núcleo Hipotalâmico Paraventricular , Nervo VagoRESUMO
@#Esophageal cancer is one of the most common malignant tumors in China. The comprehensive treatment of esophageal cancer based on operation is important. In recent ten years, with the development of surgical techniques and medical instruments, tubular stomach has been widely used. Although the advantages of tubular stomach are becoming more and more obvious, there are still many details and problems for the function and application of tubular stomach worthy of further discussion and study. In this paper, the technical progress, advantages, functions and applications of tubular stomach are reviewed and discussed, and the future prospect is predicted.
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Objective To evaluate the relationship of gastric function of its proximal portion and electrogastrogram in healthy youths with obesity.Methods A total of 35 healthy young volunteers with normal weight participated in the study,including 16 females and 19 males.On the first day,the water load test was performed.On the second day,determination of function of proximal portion of stomach was done using electronic barostat and electrogastrogram.Results Water load test:females were found to consume significantly less water than males(P0.05)between male group and female group in the minimal distention pressure(MDP),initial intragastric pressure(IP)and the maximal tolerance pressure(MP).The initial gastric compliance(IC)in female group was less than that in male group(P0.05).The parameter of EGG:with the intragastric pressure increased,DF in Normal Range(N%)showed decreasing tendency,while bradygastria(B%),tachygastria(T%),instable coefficient of dominant frequency(DFIC)and dominant power(DP)increased.Conclusion The gastric capacity,the parameters of visceral sensitivity and IC are remarkably different between sexes.The gastric electrical activity varies in different states of proximal gastric function.The gastric contraction may be enhanced by an improvement of dominant power(DP).