New insights into digestive tract tumors

Digestive tract tumors,ranging from esophageal to colorectal cancers(CRCs),pose a substantial challenge in oncology because of their high global incidence and mortality.1,2 The heterogeneity of these malignancies underscores the complexity of their etiology,which is influenced by a combination of genetic,epigenetic,and environmental factors.3 Unraveling the molecular complexities and clinical implications of these tumors is of growing importance,as they provide insights that can inform the development of more effective diagnostic,therapeutic,and preventative approaches.The Special Issue,titled“Basic research and clinical practice on gastrointestinal cancer”,aims to highlight the recent advances in molecular mechanisms and clinical research in the field of digestive tract oncology.We hope that by presenting these findings we can foster collaboration and dialog among experts in the field,ultimately leading to innovative perspectives on the diagnosis and treatment of these cancers.

Analysis of sleep quality,disease uncertainty,and psychological tolerance in patients undergoing chemotherapy for digestive tract malignancies

BACKGROUND Colorectal cancer is the second leading cause of cancer-related deaths among digestive tract malignancies,following gastric cancer.Sleep is of great significance for maintaining human health.The incidence of sleep disorders in patients with cancer is approximately twice that observed in the general population.Lack of sleep can prolong hospital stays,increase the likelihood of infection,and increase mortality rates.Therefore,studying the factors related to sleep quality is significant for improving the quality of life of patients with malignant tumors of the digestive tract.AIM To investigate the relationships among sleep quality,disease uncertainty,and psychological resilience in patients undergoing chemotherapy for digestive tract malignancies.METHODS A total of 131 patients with malignant digestive tract tumors who were treated at Hefei BOE Hospital between April 2021 and September 2022 were selected as research participants.Based on their Pittsburgh Sleep Quality Index(PSQI)scores,participants were divided into either the sleep disorder group(PSQI score>7)or the normal sleep group(PSQI score≤7).The clinical data—together with the Mishel Uncertainty in Illness Scale for Adults(MUIS-A)and Connor-Davidson Resilience Scale(CD-RISC)scores—were compared.RESULTS In this study,78(59.54%)patients with digestive tract malignancies developed sleep disorders after chemotherapy.Sleep disorder incidence was higher in patients with colorectal cancer than in those with gastric and esophageal cancers(P<0.05).The total MUIS-A score and those for each item in the sleep disorder group were higher than those in the normal sleep group.The total CD-RISC score and those for each item in the sleep disorder group were lower than those in the normal sleep group(P<0.05).The PSQI scores of patients with malignant digestive tract tumors were positively correlated with the scores for lack of disease information,disease uncertainty,and unpredictability in the MUIS-A and negatively correlated with the scores for tenacity,self-improvement,and optimism in the CD-RISC(P<0.05).CONCLUSION Patients undergoing chemotherapy for digestive tract malignancies are prone to sleep problems related to disease uncertainty and psychological resilience.Therefore,interventions can be implemented to improve their sleep quality.

Optimal choice of stapler and digestive tract reconstruction method after distal gastrectomy for gastric cancer:A prospective case–control study

BACKGROUND Gastric cancer is the most common cause of cancer-related deaths,and is classified according to its location in the proximal,middle,or distal stomach.Surgical resection is the primary approach for treating gastric cancer.This prospective study aimed to determine the best reconstruction method after distal gastrectomy for gastric cancer.AIM To explore the efficacy of different staplers and digestive tract reconstruction(DTR)methods after radical gastrectomy and their influence on prognosis.METHODS Eighty-seven patients who underwent radical gastrectomy for distal gastric cancer at our institution between April 2017 and April 2020 were included in this study,with a follow-up period of 12-26 mo.The patients were assigned to four groups based on the stapler and DTR plan as follows:BillrothⅠ(B-I)reconstruction+linear stapler group(group A,22 cases),B-I reconstruction+circular stapler group(group B,22 cases),Billroth II(B-II)reconstruction+linear stapler group(group C,22 cases),and B-II reconstruction+circular stapler group(group D,21 cases).The pathological parameters,postoperative gastrointestinal function recovery,postoperative complications,and quality of life(QOL)were compared among the four groups.RESULTS No significant differences in the maximum diameter of the gastric tumors,total number of lymph nodes dissected,drainage tube removal time,QLQ(QOL questionnaire)-C30 and QLQ-STO22 scores at 1 year postoperatively,and incidence of complications were observed among the four groups(P>0.05).However,groups A and C(linear stapler)had significantly lower intraoperative blood loss and significantly shorter anastomosis time,operation time,first fluid diet intake time,first exhaust time,and length of postoperative hospital stay(P<0.05)than groups B and D(circular stapler).CONCLUSION Linear staplers offer several advantages for postoperative recovery.B-I and B-II reconstruction methods had similar effects on QOL.The optimal solution can be selected according to individual conditions and postoperative convenience.

Analysis of load status and management strategies of main caregivers of patients with malignant tumors of digestive tract

Caregiver load refers to the subjective and objective negative impact of caregivers in the care of patients,and excessive load will have a serious impact on patients and caregivers themselves and can reduce their quality of life.For the main caregivers,it not only needs to care for the patients in life and daily life,but also needs to pay the cost of treatment for the patients,coupled with the need to carry out their own original work,life,etc.excessive life pressure,economic pressure,work pressure,emotional pressure,etc.lead to heavy load of the main caregivers,which can easily cause caregivers to have different degrees of psychological problems,which will cause serious adverse effects on the caregivers themselves and cancer patients,not conducive to the construction of a harmonious family and society.This article analyzes the current situation of primary caregiver burden in patients with gastrointestinal malignant tumors,analyzes its influencing factors,and specifies specific treatment strategies.It is hoped to provide scientific guidance for later related research and application.

Three-dimensional computed tomography reconstruction diagnosed digestive tract perforation and acute peritonitis caused by Monopterus albus:A case report

BACKGROUND Few reports have described living foreign bodies in the human body.The current manuscript demonstrates that computed tomography(CT)is an effective tool for accurate preoperative evaluation of living foreign bodies in clinic.The threedimensional(3D)reconstruction technology could clearly display anatomical structures,lesions and adjacent organs,improving diagnostic accuracy and guiding the surgical decision-making process.CASE SUMMARY Herein we describe a 68-year-old man diagnosed with digestive tract perforation and acute peritonitis caused by a foreign body of Monopterus albus.The patient pre-sented to the emergency department with complaints of dull abdominal pain,profuse sweating and a pale complexion during work.A Monopterus albus had entered the patient’s body through the anus two hours ago.During hospitalization,the 3D reconstruction technology revealed a perforation of the middle rectum complicated with acute peritonitis and showed a clear and complete Monopterus albus bone morphology in the abdominal and pelvic cavities,with the Monopterus albus biting the mesentery.Laparoscopic examination detected a large(diameter of about 1.5 cm)perforation in the mid-rectum.It could be seen that a Monopterus albus had completely entered the abdominal cavity and had tightly bitten the mesentery of the small intestine.During the operation,the dead Monopterus albus was taken out.CONCLUSION The current manuscript demonstrates that CT is an effective tool for accurate preoperative evaluation of living foreign bodies in clinic.

Immunomodulatory and chemopreventive effects of resveratrol on the digestive system cancers

Resveratrol(RSV),the primary polyphenol found in grapes,has been revealed to have anti-inflammatory properties by reducing the capacity of the peripheral blood mononuclear cells to produce pro-inflammatory cytokines,including IL-1β,IL-6,IL-1ra and TNFα.Considering the close association between chronic inflammation and cancer development,RSV’s immunomodulatory properties are one way by which the polyphenol may inhibit cancer initiation,proliferation,neovascularization,and migration.Resveratrol influences the generation of microtumor environment which is one of the key factors in cancer progress.In addition to immunomodulation,RSV inhibits cancer development by expressing anti-oxidant effects,causing cell cycle arrest,stimulating the function of certain enzymes,and activating cell signaling pathways.The end outcome is one of the various forms of cell death,including apoptosis,pyroptosis,necroptosis,and more,as it has been observed in vitro.RSV has been shown to act against cancer in practically every organ,while its effects on colon cancer have been documented more frequently.It is remarkable that longer-term clinical studies that may have established the potential for this natural substance to serve as a therapeutic adjuvant to traditional anti-cancer medications were not prompted by the encouraging outcomes seen with cancer cells treated with non-toxic doses of resveratrol.The current review aims to assess the recent findings about the immunological and anti-cancer characteristics of RSV,with a particular emphasis on cancers of the digestive tract,as a challenge for future clinical research that may contribute to the better prognosis of cancer.

Applications of gastric peroral endoscopic myotomy in the treatment of upper gastrointestinal tract disease

Gastric peroral endoscopic myotomy(G-POME)is an emerging minimally invasive endoscopic technique involving the establishment of a submucosal tun-nel around the pyloric sphincter.In 2013,Khashab et al used G-POME for the first time in the treatment of gastroparesis with enhanced therapeutic efficacy,prov-iding a new direction for the treatment of gastroparesis.With the recent and rapid development of G-POME therapy technology,progress has been made in the treatment of gastroparesis and other upper digestive tract diseases,such as congenital hypertrophic pyloric stenosis and gastric sleeve stricture,with G-POME.This article reviews the research progress and future prospects of G-POME for the treatment of upper digestive tract gastrointestinal diseases.

Immunohistochemical Location of Six Kinds of Endocrine Cell from Digestive Tract of Misgurnus anguillicaudatus

[Objective] The study was to immunohistochemical localize the endocrine cells from digestive tract of Misgurnus [ Method ] Using six gastrointestinal hormone antisera, the endocrine cells from digestive tract of M. anguillicaudatus was localized. [ Result ]The 5-hydroxytryptamine immunoreactive（5-HT-IR） cells distribute in oesophagus, foregut and midgut; the distribution density was determined to be forepart of foregut 〉 oesophagus and hindpart of foregut 〉 gut, and the differences in the three density gradients reached significant level. Like PP-IR, SS-IR cells were observed mostly in oesophagus, followed by hindpart of foregut, least in forepart of foregut, but never found in gut and hindgut. The three kinds of immunocompetent cells Gas-IR, Glu-IR and SP-IR were not detected in each part of digestive tract. [ Conctusion] This study may provide basic data for studying the nutritional and digestive physiology, as well as the preparation of meridic diets for M. anguillicaudatus.

Winter diet and digestive tract of the Golden Pheasant(Chrysolophus pictus) in the Qinling Mountains,China

The winter diet and morphological structure of the gastrointestinal tract of the Golden Pheasant(Chrysolophus pictus) was investigated in the Qinling Mountains,Shaanxi Province in 2002/2003.Individual food items in crops were identified by species,where possible,using standard taxonomic methods.The Golden Pheasant consumes exclusively vegetarian foods in the winter,of at least 14 plant species,such as crops and other vegetable species.The digestive tract of the Golden Pheasant is composed of an oesophagus,a stomach,a relatively long intestine measuring 3.4 × standard body length,two fully-developed caeca and a relatively short colon,typical for herbivorous birds.Pebbles of different sizes(0.5-3 mm in diameter) were very frequent in the gizzard.The average dry weight of the pebbles was 10.4±2.5 g and was positively correlated with the weight of digesta in the gizzard(Pearson r = 0.747,p < 0.01,n = 37).The mucosa surface pH of the digestive tract of the Golden Pheasant was slightly acidic,but higher in the crop and gizzard.

Digestive tract reconstruction options after laparoscopic gastrectomy for gastric cancer

In addition to the popularity of laparoscopic gastrectomy(LG),many reconstructive procedures after LG have been reported.Surgical resection and lymphatic dissection determine long-term survival;however,the election of a reconstruction procedure determines the postoperative quality of life for patients with gastric cancer(GC).Presently,no consensus exists regarding the optimal reconstructive procedure.In this review,the current state of digestive tract reconstruction after LG is reviewed.According to the determining influence of the tumor site on the procedures of surgical resection and reconstruction,we divide these reconstruction procedures into three categories consistent with the resection procedures.We focus on the technical tips of every reconstruction procedure and examine the surgical outcomes(length of surgery and blood loss)and postoperative complications(anastomotic leakage and stricture)to facilitate gastrointestinal surgeons to understand the merits and demerits of every reconstruction procedure.

Digestive tract reconstruction pattern as a determining factor in postgastrectomy quality of life

Postgastrectomy quality of life (QoL) is affected by various symptoms, and compared with the preoperative baseline QoL, is typically impaired for the first 6 mo after surgery. Thereafter, improvement to a stable QoL is observed at approximately 12 mo postoperatively. We consider the digestive tract reconstruction pattern to be a determining factor in postgastrectomy QoL among gastric cancer patients, and believe it requires further discussion. Proximal gastrectomy is associated with the worst postoperative QoL among gastrectomy procedures and should be performed cautiously. The trend of better QoL provided by the pouch procedure of total gastrectomy requires further robust support. Whether the use of Billroth-I gastroduodenostomy or Roux-en-Y gastrojejunostomy for distal gastrectomy is optimal remains controversial, but Roux-en-Y gastrojejunostomy is likely to be preferable. (c) 2014 Baishideng Publishing Group Co., Limited. All rights reserved.

Altitudinal Variation in Digestive Tract Lengh in Feirana quadranus

Selective pressures favor variation in organ size in response to environmental changes and evolutionary process. In particular, changes in environmental temperature and rainfall at different altitudes often affect food resources, thereby mediating energy intake and allocation. The digestive tract provided a functional relationship between energy intake and allocation, of which gut morphology was associated with diet changes and food quality under different environments. Here we studied altitudinal variation in the digestive tract across four Feirana quadranus populations and tested the hypothesis that relative size of digestive tract should increase with increasing altitude. The results showed that although significant variation in length of the digestive tract was observed in females among populations, altitudinal variation in relative length of digestive tract or gut was non-significant. In addition, the digestive tract length was not correlated with temperature and precipitation across the four populations. Our findings suggest that individuals living in low-temperature and-precipitation populations at high altitudes did not display longer digestive tract than high temperature and precipitation populations at low altitudes, possibly because of small populations or sample sizes.

Impact of comorbid anxiety and depression on quality of life and cellular immunity changes in patients with digestive tract cancers

AIM:A study was performed to investigate the impact of comorbid anxiety and depression (CAD) on quality of life (QOL) and cellular immunity changes in patients with digestive tract cancers. METHODS: One hundred and fifty-six cases of both sexes with cancers of the digestive tract admitted between March 2001 and February 2004 in the Department of Medical Oncology, First Affiliated Hospital of Xi'an Jiaotong University were randomly enrolled in the study. Depressive and anxiety disorder diagnoses were assessed by using the Structured Clinical Interview for DSM-IV. All adult patients were evaluated with the Hamilton depressive scale (HAMD, the 24-item version), the Hamilton anxiety scale (HAMA, a modified 14-item version), quality of life questionnaire-core 30 (QLQ-C30), social support rating scale (SSRS), simple coping style questionnaire (SCSQ), and other questionnaires, respectively. In terms of HAMD ≥ 20 and HAMA ≥ 14, the patients were categorized, including CAD (n = 31) in group A, anxiety disorder (n = 23) in group B, depressive disorder (n = 37) in group C, and non-disorder (n = 65) in group D. Immunological parameters such as T-lymphocyte subsets and natural killer (NK) cell activities in peripheral blood were determined and compared among the four groups. RESULTS: The incidence of CAD was 21.15% in patients with digestive tract cancers. The average scores of social support was 43.67±7.05 for 156 cases, active coping 20.34±7.33, and passive coping 9.55±5.51. Compared with group D, subjective support was enhanced slightly in group A, but social support, objective support, and utilization of support reduced, especially utilization of support with significance (6.16 vs7.80, P<0.05); total scores of active coping decreased, while passive coping reversed; granulocytes proliferated, monocytes declined, and lymphocytes declined significantly (32.87 vs 34.00, P<0.05); moreover, the percentage of CD3, CD4, CD8 and CD56 in T lymphocyte subsets was in lower level, respectively, and CD56 showed a significant decline in group A (26.02 vs 32.20, P<0.05), however, CD4/CD8 ratio increased. Physical function, role function, fatigue, sleeplessness and constipation had significant changes among different groups by one-way ANOVA, and group A was in poor QOL. It revealed that global health-related quality of life (QL) were positively correlated with active coping and CD56; CAD was negatively correlated with QL, active coping and CD56. Furthermore, the step-wise regression analysis suggested that utilization of support, CD56, active coping, fatigue, sleeplessness and depression were significant factors contributing to QOL. CONCLUSION: CAD, which can impair QOL and cellular immunity, occurs with a higher incidence in patients with digestive tract cancers. Hence, it is essential to improve mental health for them with specifically tailored interventions.

Horizontal transfer of vanA between probiotic Enterococcus faecium and Enterococcus faecalis in fermented soybean meal and in digestive tract of growing pigs

Background: The aim of this study was to investigate the intergeneric transfer of vancomycin resistance gene vanA between probiotic enterococci in the fermentation progress of soybean meal and in the digestive tract of growing pigs.One vanA genotype vancomycin resistant E.faecium strain,Efm4,and one chloramphenicol-resistant E.faecalis strain,Efs2,were isolated from twenty-nine probiotic basis feed material/additive samples.For in vitro conjugation,Efm4 and Efs2 were used as starter to ferment soybean meal.For in vivo conjugation,thirty growing pigs were randomly assigned to five groups(n = 6),treated with a basic diet,or supplemented with 10% fermented soybean meal,1% Efm4,5% Efs2 or a combination of 1% Efm4 + 5% Efs2 for 7 d,respectively.Fecal samples of pigs in each group were collected daily for the isolation and dynamic analysis of Efm4,Efs2 and transconjugants.The sequence types(STs) of Efm4,Efs2 and transconjugants were analyzed by multilocus sequence typing(MLST).The vanA harboring plasmid in Efm4 and transconjugants was analyzed by S1-pulsed field gel electrophoresis(PFGE)and further verified by multiple alignments.Results: The results showed that,in FSBM,transconjugants were detected 1 h after the fermentation,with a conjugation frequency of ~ 10^-3 transconjugants/recipient.Transconjugants proliferated with Efm4 and Efs2 in the first 8 h and maintained steadily for 10 d till the end of the experiment.Additionally,in vivo experiment showed that transcojugants were recovered in one of six pigs in both FSBM and Efm4 + Efs2 groups,with conjugation frequency of ~ 10^-5 and ~ 10^-4,respectively.MLST revealed the ST of Efm4,Efs2 and transconjugants was ST1014,ST69 and ST69,respectively.S1-PFGE confirmed the existence of the vanA-harboring,142,988-bp plasmid,which was also a multi-drug resistant plasmid containing Tn1546-like transposon.Conclusions: The findings revealed the potential safety hazard existing in the commercial probiotic enterococci in China,because the horizontal transfer from farm to fork could potentially pose a safety risk to the public.

Chinese expert consensus and practice guideline of totally implantable access port for digestive tract carcinomas

Totally implantable access port is a fully implantable drug delivery system that is implanted subcutaneously and can be retained for a long time.Advantages of ports include a simple nursing process,low risk of infection and embolism,and high patient comfort.In order to promote the standardized application of ports in the treatment of digestive tract tumors and reduce port-related complications,the Chinese Research Hospital Association Digestive Tumor Committee,the Chinese Association of Upper Gastrointestinal Surgeons,the Chinese Gastric Cancer Association,and the Gastrointestinal Surgical Group of Chinese Surgical Society Affiliated to Chinese Medical Association have organized multidisciplinary expert discussions at the General Hospital of the People’s Liberation Army and nationwide expert letter reviews and on-site seminars,and formulated an expert consensus of the operation guidelines.

Community diversity of bacteria in digestive tract of mud snail (Bullacta exarata Philippi) and its rearing shoal

The bacterial flora in the digestive tract of B. exarata Philippi and its rearing shoal were investigated, respectively. A total of 107 strains of heterotrophic bacteria, isolated from crop, stomach and intestine, mainly belong to genera Photobacterium, Bacillus, Pseudomonas and Vibrio. Varieties of bacteria in crop were significantly more than that in stomach and in intestine. A total of 173 strains of bacteria were isolated from the rearing shoal, belonging to 13 genera. The 5 predominant genera are Photobacterium, Bacillus, Pseudomonas, Vibrio and some genera of Enterobacteriaceae. The number of heterotrophic bacteria and Vibrio in rearing shoal changed in line with the alteration of the temperature, and were significantly affected by the use of pesticide.

Effects of Exogenous NSP Enzymes(Xylanase, β-glucanase and Cellulase) on Morphology and Functions of Digestive Tract in Growing Pigs Fed with Paddy-Based Diets

Ninety Landrace×Jia 35±0. 40 kg weight growing pigs were randomly allotted to three treatments , each of which was replicated three times with ten pigs per replicate. The pigs were reared on either a conventional corn-based diet (control I ) or a paddy-based diet (control I ) or a paddy diet supplemented with 0.2% NSP enzymes (test group). All pigs were given ad libitum access to both feed and water. The results of feeding trial showed that supplementation of NSP enzymes significantly increased ADG by 8.78% (P< 0.05) and decreased F/G by 9. 42% (P<0. 05) over the control group Ⅱ. No significant differences were found in ADG and F/G between control group I and the test group. The digestive trial showed that adding NSP enzymes significantly improved apparent digestibility of CP, EE and CF by 18. 76 (P<0. 01), 16.04 (P <0.05) and 108. 57%(P<0. 05), respectively, compared to control Ⅱ. The activities of proteolytic enzyme and α-amylase in duodenal contents were increased by 99. 07 (P<0. 01) and 18. 41% (P<0. 05) with the addition of NSP enzymes. No significant differences between test and control Ⅱ group were found in activities of the pepsin in the gastric content, the trypsin and lipase in duodenal contents. the disaccharidase and y-glutany transferase (γ-GT) in intestinal mucosa, but there was a tendency towards higher activities associated with the NSP enzymes diet(P>0. 05). The lengths of the villi within the duodenal, jejunal and ileal sections of the small intestine of pigs receiving the NSP enzymes diet were increased by 23. 68 (P<0. 05), 56. 00 (P<0. 01) and 76. 90%(P<0. 01) respectively, relative to the pigs in controlⅡ.

Expression Pattern of Peptide and Amino Acid Genes in Digestive Tract of Transporter Juvenile Turbot(Scophthalmus maximus L.)

Turbot(Scophthalmus maximus L.),a carnivorous fish species with high dietary protein requirement,was chosen to examine the expression pattern of peptide and amino acid transporter genes along its digestive tract which was divided into six segments including stomach,pyloric caeca,rectum,and three equal parts of the remainder of the intestine.The results showed that the expression of two peptide and eleven amino acid transporters genes exhibited distinct patterns.Peptide transporter 1(Pep T1) was rich in proximal intestine while peptide transporter 2(PepT2) was abundant in distal intestine.A number of neutral and cationic amino acid transporters expressed richly in whole intestine including B^0-type amino acid transporter 1(B^0AT1),L-type amino acid transporter 2(LAT2),T-type amino acid transporter 1(TAT1),proton-coupled amino acid transporter 1(PAT1),y^+L-type amino acid transporter 1(y^+LAT1),and cationic amino acid transporter 2(CAT2) while ASC amino acid transporter 2(ASCT2),sodium-coupled neutral amino acid transporter 2(SNAT2),and y^+L-type amino acid transporter 2(y^+LAT2) abundantly expressed in stomach.In addition,system b^(0,+) transporters(rBAT and b^(0,+)AT) existed richly in distal intestine.These findings comprehensively characterized the distribution of solute carrier family proteins,which revealed the relative importance of peptide and amino acid absorption through luminal membrane.Our findings are helpful to understand the mechanism of the utilization of dietary protein in fish with a short digestive tract.

Effects on the pouch of different digestive tract reconstruction modes assessed by radionuclide scintigraphy

AIM: To determine the effect of three digestive tract reconstruction procedures on pouch function, after radical surgery undertaken because of gastric cancer, as assessed by radionuclide dynamic imaging. METHODS: As a measure of the reservoir function, with a designed diet containing technetium-99m (99mTc), the emptying time of the gastric substitute was evaluated using a 99mTc-labeled solid test meal. Immediately after the meal, the patient was placed in front of a γ camera in a supine position and the radioactivity was measured over the whole abdomen every minute. A frame image was obtained. The emptying sequences were recorded by the microprocessor and then stored on a computer disk. According to a computer processing system, the half-emptying actual curve and the fitting curve of food containing isotope in the detected region were depicted, and the half-emptying actual curves of the three reconstruction procedures were directly compared. RESULTS: Of the three reconstruction procedures, the half-emptying time of food containing isotope in the Dual Braun type esophagojejunal anastomosis procedure (51.86±6.43 min) was far closer to normal, signif icantly better than that of the proximal gastrectomy orthotopic reconstruction (30.07±15.77 min, P=0.002) and P type esophagojejunal anastomosis (27.88±6.07 min, P=0.001) methods. The half-emptying actual curve and f itting curves for the Dual Braun type esophagojejunal anastomosis were fairly similar while those of the proximal gastrectomy orthotopic reconstruction and P type esophagojejunal anastomosis were obviously separated, which indicated bad food conservation in the reconstructed pouches. CONCLUSION: Dual Braun type esophagojejunal anastomosis is the most useful of the three procedures for improving food accommodation in patients with a pouch and can retard evacuation of solid food from the reconstructed pouch.

HIF-1α-1790G>A polymorphism significantly increases the risk of digestive tract cancer:A meta-analysis

AIM:To investigate the association between hypoxiainducible factor-1α(HIF-1α) polymorphisms(-1772C>T and-1790G>A) and the risk of digestive tract cancer.METHODS:A total of 13 eligible studies were retrieved from Pub Med,EMBASE,and the ChinaNational Knowledge Infrastructure database.The odds ratios(ORs) and 95% confidence intervals(CIs) were calculated to estimate the strength of the associations.RESULTS:By pooling the eligible studies,we found that the HIF-1α-1772C>T polymorphism was not associated with the risk of developing digestive tract cancer(dominant comparison,OR:1.156; 95%CI:0.839-1.593; P heterogeneity = 0.007),and no significant association was found in the Asian population or the Caucasian population.However,for the-1790G>A polymorphism,carriers of the variant-1790 A allele had a significantly increased risk of digestive tract cancer compared with those with the wildtype-1790 G allele(dominant comparison,OR:3.252; 95%CI:1.661-6.368; P heterogeneity < 0.001).Additionally,this increased risk of digestive cancer was only detected in Asians; there was no significant association in Caucasians.CONCLUSION:This meta-analysis demonstrates that the HIF-1α-1790G>A polymorphism is associated with a significantly increased risk of digestive tract cancer,while the-1772C>T polymorphism is not.