Mucosal patterns of Helicobacter pylori-related gastritis without atrophy in the gastric corpus using standard endoscopy

AIM:To identify the mucosal patterns of Helicobacter pylori(H.pylori )-related gastritis in the gastric corpus using standard endoscopy and to evaluate their reproducibility.METHODS:A total of 112 consecutive patients underwent upper gastrointestinal endoscopy.The endoscopists classified the endoscopic findings into 4 patterns.In the second part of the study,90 images were shown to 3 endoscopists in order to evaluate the inter-observer and intra-observer variability in image assessment.RESULTS:The mucosal p...     

Isolation,identification and molecular docking as cyclooxygenase (COX) inhibitors of the main constituents of Matricaria chamomilla L. extract and its synergistic interaction with diclofenac on nociception and gastric damage in rats

Chamomile (Matricaria chamomilla L., Asteraceae) is a medicinal plant widely used as remedy for pain and gastric disorders. The association of non-steroidal anti-inflammatory drugs (NSAIDs) with medicinal plant extracts may increase its antinociceptive activity, permit the use of lower doses and limit side effects. The aim was to isolate and identify the main chemical constituents of Matricaria chamomilla ethanolic extract (MCE) as well as to explore their activity as cyclooxygenase (COX) inhibitors in silico; besides, to examine the interaction between MCE and diclofenac on nociception in the formalin test by isobolographic analysis, and to determine the level of gastric injury in rats. Three terpenoids, α-bisabolol, bisabolol oxide A, and guaiazulene, were isolated and identified by ¹H NMR. Docking simulation predicted COX inhibitory activity for those terpenoids. Diclofenac, MCE, or their combinations produced an antinociceptive effect. The sole administration of diclofenac and the highest combined dose diclofenac-MCE produced significant a gastric damage, but that effect was not seen with MCE alone. An isobologram was constructed and the derived theoretical ED₃₅ for the antinociceptive effect was significantly different from the experimental ED₃₅; hence, the interaction between diclofenac and MCE that mediates the antinociceptive effect is synergist. The MCE contains three major terpenoids with plausible COX inhibitory activity in silico, but α-bisabolol showed the highest affinity. Data suggest that the diclofenac-MCE combination can interact at the systemic level in a synergic manner and may have therapeutic advantages for the clinical treatment of inflammatory pain.     

R0 resection in the treatment of gastric cancer: Room for improvement

Gastric carcinoma is one of the most frequent malignancies in the world and its clinical behavior especially depends on the metastatic potential of the tumor.In particular,lymphatic metastasis is one of the main predictors of tumor recurrence and survival,and current pathological staging systems reflect the concept that lymphatic spread is the most relevant prognostic factor in patients undergoing curative resection.This is compounded by the observation that two-thirds of gastric cancer in the Western world...     

Correlation between pre-miR-146a C/G polymorphism and gastric cancer risk in Chinese population

AIM:To investigate the association between pre-miR- 146a C/G polymorphism and gastric cancer risk. METHODS:We performed a hospital-based,case-control study using polymerase chain reaction-restriction fragment length polymorphism method in 608 individuals(304 gastric cancer patients and 304 age and sex matched cancer-free controls).RESULTS:The frequencies of pre-miR-146a C/G genotypes in the case group were significantly different from those in the control groups(P=0.037).Compared with CC genotype carriers,s...     

表皮生长因子与胃肠道疾病

表皮生长因子(EGF)是重要的促细胞生长因子之一,消化道中EGF的含量远远高于血液循环中的浓度,本文就EGF的结构、性质、生理作用、合成部位、分布情况以及与良恶性胃病的关系和对胃肠道疾病的治疗作用做一综述。     

胃十二指肠溃疡大出血的外科手术疗效

目的观察外科手术治疗胃十二指肠溃疡大出血的临床疗效。方法根据58例胃十二指肠溃疡大出血患者的临床表现及身体状况选择适宜的时机行急诊手术或择期手术治疗。结果本组58例患者中行急诊胃大部切除术治疗者37例,行择期胃大部切除术者21例。术后57例患者痊愈出院,痊愈率达98.28%;死亡1例,占1.72%。有3出例患者术后出现了并发症,并发症发生率5.26%。结论对于胃十二指肠溃疡大出血患者在手术治疗时应严格把握手术适应证,并选择适宜的手术时机和手术方式进行治疗能迅速止血,提高其痊愈率。     

Gastric Choristoma of the Oropharynx

Heterotopic gastric mucosa tissue is also called gastric choristoma, and this type of lesion can be found anywhere in the alimentary tract. However, gastric choristoma in the pharynx is very rare; only 10 cases of pharyngeal gastric choristoma have been reported in the English medical literature. A 32-yr-old woman was referred to our institution for the evaluation of a large mass that originated from the posterior wall of the oropharynx. The mass did not cause any symptoms except for the occasional sensation of a foreign body. Gadolinium-enhanced T1 weighted imaging showed a 5 cm-sized mass with central enhancement and hypointense portions, yet the radiological diagnosis was not clear. Transoral mass excision was performed with using electrocautery for making the diagnosis and for treating the mass. The microscopic analysis revealed gastric choristoma.     

Helicobacter pylori and gastric carcinogenesis

Gastric carcinoma is the second leading cause of cancer-related deaths in the world, accounting for more than 700,000 deaths each year. Recent studies have revealed that infection with cagA-positive Helicobacter pylori plays an essential role in the development of gastric carcinoma. The cagA-encoded CagA protein is delivered into gastric epithelial cells via the bacterial type IV secretion system, where it undergoes tyrosine phosphorylation by Src and Abl kinases. Tyrosine-phosphorylated CagA then acquires the ability to interact with and deregulate SHP-2 phosphatase, a bona-fide oncoprotein, deregulation of which is involved in a variety of human malignancies. CagA also binds to and inhibits PAR1b/MARK2 polarity-regulating kinase to disrupt tight junctions and epithelial apical-basolateral polarity. These CagA activities may collectively contribute to the transformation of gastric epithelial cells. Indeed, transgenic expression of CagA in mice results in the development of gastrointestinal and hematological malignancies, indicating that CagA is the first bacterial oncoprotein that acts in mammalian cells. The oncogenic potential of CagA may be further potentiated in the presence of chronic inflammation, which aberrantly induces activation-induced cytidine deaminase (AID), a member of the DNA/RNA-editing enzyme family. Ectopically expressed AID may contribute to H. pylori-initiated gastric carcinogenesis by increasing the risk of likelihood of epithelial cells acquiring mutations in cancer-related genes.     

Complications of gastric bypass surgery,a Northern Ireland experience.

Amongst western nations there are increasing levels of adult obesity. In Northern Ireland the majority of patients who undergo bariatric surgery travel to centres in the UK mainland. Thus, local experience of this type of surgery and the complications which can arise is limited.We report the case of a young woman who had previous bariatric surgery and a significant complication. In the future, greater numbers of patients will undergo this type of surgery. Therefore all emergency doctors need to be familiar with these procedures and the common complications.