BACKGROUND The incidence of type I gastric neuroendocrine neoplasms(gNENs)has increased significantly over the past 50 years.Although autoimmune gastritis(AIG)increases the likelihood of developing gNENs,the exact inc...BACKGROUND The incidence of type I gastric neuroendocrine neoplasms(gNENs)has increased significantly over the past 50 years.Although autoimmune gastritis(AIG)increases the likelihood of developing gNENs,the exact incidence and prevalence of this association remain unclear.AIM To evaluate the incidence and prevalence of type I gNENs in a cohort of patients with a histological diagnosis of AIG.METHODS Patients with a histological diagnosis of AIG were enrolled between October 2020 and May 2022.Circulating levels of CgA and gastrin were assessed at enrollment.Included patients underwent regular endoscopic follow-up to detect gastric neoplastic lesions,enterochromaffin-like(ECL)cell hyperplasia,and the development of gNEN.RESULTS We included 176 patients[142 women(80.7%),median age 64 years,interquartile range(IQR)53–71 years]diagnosed with AIG between January 1990 and June 2022.At enrollment.One hundred and sixteen patients(65.9%)had ECL hyperplasia,of whom,29.5%had simple/linear,30.7%had micronodular,and 5.7%had macronodular type.The median follow-up time was 5(3–7.5)years.After 1032 person-years,33 patients developed a total of 50 type I gNENs,with an incidence rate of 0.057 person-years,corresponding to an annual cumulative incidence of 5.7%.Circulating CgA levels did not significantly differ between AIG patients who developed gNENs and those who did not.Conversely,gastrin levels were significantly higher in AIG patients who developed gNENs[median 992 pg/mL IQR=449–1500 vs 688 pg/mL IQR=423–1200,P=0.03].Calculated gastrin sensitivity and specificity were 90.9%and 1.4%,respectively,with an overall diagnostic accuracy of 30%and a calculated area under the gastrin receiver operating characteristic curve(AUROC or AUC)of 0.53.CONCLUSION Type I gNENs are a significant complication in AIG.Gastrin’s low diagnostic accuracy prevents it from serving as a marker for early diagnosis.Effective strategies for early detection and treatment are needed.展开更多
AIM To study the role of cholecystokinin octapeptide ( CCK-8), β-endorphin ( β-EP), and gastrin in an anorexic infantile rat model and no subsequent regulation of nose peptides by the Yunpi complex prescription ErB...AIM To study the role of cholecystokinin octapeptide ( CCK-8), β-endorphin ( β-EP), and gastrin in an anorexic infantile rat model and no subsequent regulation of nose peptides by the Yunpi complex prescription ErBao Granule.METHODS We fed infantile rats with special prepared forage. A liquid extract of ErBao Granule was administered to the rats daily for 3weeks, CCK-8, β-EP, and gastrin concentrations in hypothalamus, gastric antrum, and plasma of the rats were measured by radioimmunoassay,and were compared with controls.RESULTS Treatment of rats with ErBao Granule inhibited CCK-8 secretion and increased β-EP and gastrin secretion. CCK-8 concentration in hypothalamus and plasma of model control group increased significantly and correlated negatively with food intake of models.respectively. β-EP concentration in gastric antrum and plasma of model control group decreased significantly and showed a positive correlation with food intake of models,respectively. Hypothalamus concentration of β-EP was similar in models and controls. Gastrin concentration in gastric antrum of models was lower than in the blank control group, and correlated positively to food intake of models.Finally, CCK-8 concentrations in plasma of rats showed a positive correlation with plasma β-EP(r- 0.68, P＜0.05).CONCLUSION The increased plasma and hypothalamus concentration of CCK-8,decreased gastric antrum and plasma level of β-EP. and decreased gastric antrum concentration of gastrin are associated significantly with the anorexia of infantile anorexic rat models produced by special forage. ErBao Granule can reverse these changes, which may be the major mechanisms of ErBao Granule simulating feeding.展开更多
INTRODUCTIONHelicobacter pylori(Hp)infection is closely relatedto gastrointestinal hormones and involves theformation of gastritis,gastric carcinoma and pepticulcer.Its pathogenesis relevant
AIM To investigate the changes of gastricmucosal ascorbic acid secretion in patients withnonulcer dyspepsia and the effect of gastrin onit,and to relate any observed changes to H.pylori infection and mucosal histology...AIM To investigate the changes of gastricmucosal ascorbic acid secretion in patients withnonulcer dyspepsia and the effect of gastrin onit,and to relate any observed changes to H.pylori infection and mucosal histology.METHODS Ascorbic acid secretions in patientswere examined by collecting continuouslygastric juice for one hour after having aspiratedand discarded fasting gastric juice.Using theclearance rate(mL/min)of ascorbic acid fromblood to gastric juice represented ascorbic acidsecretion in the gastric mucosa.Ascorbic acidconcentrations in plasma and juice weremeasured by ferric reduced method.RESULTS Gastric ascorbic acid secretions inH.pylori-positive patients(1.46 mL/min,range0.27-3.78)did not significantly differ fromthose in H.pylori-negative patients(1.25 mL/min,0.47-3.14)(P】0.05).There were nosignificant differences in ascorbic acidsecretions between patients with mild(1.56 mL/min,0.50-3.30),moderate(1.34 mL/min,0.27-2.93)and severe(1.36 mL/min,0.47-3.78)inflammation(P】0.05).There were nosignificant differences in ascorbic acidsecretions between patients without activity(l.45mL/min,0.27-3.14)and with mild(1.32mL/min,0.61-2.93),moderate(1.49mL/min,0.50-3.78)and severe(1.43 mL/min,0.51-3.26)activity of chronic gastritis either(P】0.05).Ascorbic acid secretions in patientswith severe atrophy(0.56 mL/min,0.27-1.20)were markedly lower than those in patientswithout atrophy(1.51 mL/min,0.59-3.30)and with mild(1.43 mL/ min,0.53-3.78)andmoderate(1.31 mL/min,0.47-3.16)atrophy(P【0.005).There was a significant negativecorrelation between ascorbic acid secretion andseverity of atrophy(correlation coefficient=-0.43,P【0.005).After administration ofpentagastrin,ascorbic acid secretions weremarkedly elevated(from 1.39 mL/min,0.36-2.96 to 3.53mL/min,0.84-5.91)(P【0.001).CONCLUSION Ascorbic acid secretion ingastric mucosa is not affected by H.pyloriinfection.Gastric ascorbic acid secretion ismarkedly related to the severity of atrophy,whereas not related to the severity ofinflammation and activity.Gastrin may stimulategastric ascorbic acid secretion.A decreasedascorbic acid secretion may be an importantfactor in the link between atrophic gastritis andgastric carcinogenesis.展开更多
INTRODUCTIONKupffer cells are residential macrophages in the liver ,which play a critical role in the maintenance of normal liver function and in immunal surveilance of hepatocellular carcinoma (HCC) and other cancers...INTRODUCTIONKupffer cells are residential macrophages in the liver ,which play a critical role in the maintenance of normal liver function and in immunal surveilance of hepatocellular carcinoma (HCC) and other cancers[1].The biological immune modulants have cancers[2].In our previous studies ,the combined use of biological immune modulants showed better dffects .展开更多
The changes of gastric acid secretion and the levels of gastrin(Gn) and somatostatin(SS) in the serum, gastric juice and mucous membrane of pyrolic antrum were determined in 10 cases with cholangioduodenostomy with ar...The changes of gastric acid secretion and the levels of gastrin(Gn) and somatostatin(SS) in the serum, gastric juice and mucous membrane of pyrolic antrum were determined in 10 cases with cholangioduodenostomy with artificial papilla and interposed jejunum(Inter-JCD) and 28 cases with cholangiojenunostomy with Roux-en-Y (CJR-Y). It was found that the secondary gastric hypersecretion did not occur and the levels of Gn and SS showed no significant changes after Inter-JCD but there was secondary high secretion of gastric acid, significant reduction of the synthesis and release of SS and significant elevation of the synthesis and release of Gn after CJR-Y. These findings indicate that Inter-JCD is superior to CJR-Y since it induces no disturbance of gastric acid secretion postoperatively.展开更多
Ever since Helicobacter pylori(H. pylori) was recognized as an infectious cause of gastric cancer, there has been increasing interest in examining its potential role in colorectal carcinogenesis. Data from casecontrol...Ever since Helicobacter pylori(H. pylori) was recognized as an infectious cause of gastric cancer, there has been increasing interest in examining its potential role in colorectal carcinogenesis. Data from casecontrol and cross-sectional studies, mostly relying on hospital-based samples, and several meta-analyses have shown a positive statistical relationship between H. pylori infection and colorectal neoplasia. However, the possibility exists that the results have been influenced by bias, including the improper selection of patients and disparities with respect to potential confounders. While the evidence falls short of a definitive causal link, it appears that infection with H. pylori /H. pylori-related gastritis is associated with an increased, although modest, risk of colorectal adenoma and cancer. The pathogenic mechanisms responsible for this association remain uncertain. H. pylori has been detected in colorectal malignant tissues; however, the possibility that H. pylori is a direct activator of colonic carcinogenesis remains purely hypothetical. On the other hand, experimental data have indicated a series of potential oncogenic interactions between these bacteria and colorectal mucosa, including induction and perpetuation of inflammatory responses, alteration of gut microflora and release of toxins and/or hormonal mediators, such as gastrin, which may contribute to tumor formation.展开更多
Gastric cancer(GC)is one of the major cancers in China and all over the world.Most GCs are diagnosed at an advanced stage with unfavorable prognosis.Along with some other countries,China has developed the government-f...Gastric cancer(GC)is one of the major cancers in China and all over the world.Most GCs are diagnosed at an advanced stage with unfavorable prognosis.Along with some other countries,China has developed the government-funded national screening programs for GC and other major cancers.GC screening has been shown to effectively decrease the incidence of and mortality from GC in countries adopting nationwide screening programs(Japan and Korea)and in studies based on selected Chinese populations.The screening of GC relies mostly on gastroendoscopy,the accuracy,reliability and safety of which have been indicated by previous studies.However,considering its invasive screening approach,requirements on skilled endoscopists and pathologists,and a high cost,developing noninvasive methods to amend endoscopic screening would be highly needed.Numerous studies have examined biomarkers for GC screening and the combination of biomarkers involving pepsinogen,gastrin,and Helicobacter pylori antibodies has been proposed for risk stratification,seeking to narrow down the high-risk populations for further endoscopy.Despite all the achievements of endoscopic screening,evidence on appropriate screening age,intervals for repeated screening,novel biomarkers promoting precision prevention,and health economics need to be accumulated to inform policymakers on endoscopic screening in China.With the guide of Health China 2030 Planning Outline,we have golden opportunities to promote prevention and control of GC.In this review,we summarize the characteristics of screening programs in China and other East Asian countries and introduce the past and current approaches and strategies for GC screening,aiming for featuring the latest advances and key challenges,and illustrating future visions of GC screening.展开更多
AIM: To study the neural mechanism by which electroacupuncture(EA) at RN12(Zhongwan) and BL21(Weishu) regulates gastric motility.METHODS: One hundred and forty-four adult Sprague Dawley rats were studied in four separ...AIM: To study the neural mechanism by which electroacupuncture(EA) at RN12(Zhongwan) and BL21(Weishu) regulates gastric motility.METHODS: One hundred and forty-four adult Sprague Dawley rats were studied in four separate experiments. Intragastric pressure was measured using custommade rubber balloons, and extracellular neuron firing activity, which is sensitive to gastric distention in the dorsal vagal complex(DVC), was recorded by an electrophysiological technique. The expression levels of c-fos, motilin(MTL) and gastrin(GAS) in the paraventricular hypothalamic nucleus(PVN) were assayed by immunohistochemistry, and the expression levels of motilin receptor(MTL-R) and gastrin receptor(GAS-R) in both the PVN and the gastric antrum were assayed by western blotting.RESULTS: EA at RN12 + BL21(gastric Shu and Mu points), BL21(gastric Back-Shu point), RN12(gastric Front-Mu point), resulted in increased neuron-activating frequency in the DVC(2.08 ± 0.050, 1.17 ± 0.023, 1.55 ± 0.079 vs 0.75 ± 0.046, P < 0.001) compared with a model group. The expression of c-fos(36.24 ± 1.67, 29.41 ± 2.55, 31.79 ± 3.00 vs 5.73 ± 2.18, P < 0.001), MTL(22.48 ± 2.66, 20.76 ± 2.41, 19.17 ± 1.71 vs 11.68 ± 2.52, P < 0.001), GAS(24.99 ± 2.95, 21.69 ± 3.24, 23.03 ± 3.09 vs 12.53 ± 2.15, P < 0.001), MTL-R(1.39 ± 0.05, 1.22 ± 0.05, 1.17 ± 0.12 vs 0.84 ± 0.06, P < 0.001), and GAS-R(1.07 ± 0.07, 0.91 ± 0.06, 0.78 ± 0.05 vs 0.45 ± 0.04, P < 0.001) increased in the PVN after EA compared with the model group. The expression of MTL-R(1.46 ± 0.14, 1.26 ± 0.11, 0.99 ± 0.07 vs 0.65 ± 0.03, P < 0.001), and GAS-R(1.63 ± 0.11, 1.26 ± 0.16, 1.13 ± 0.02 vs 0.80 ± 0.11, P < 0.001) increased in the gastric antrum after EA compared with the model group. Damaging the PVN resulted in reduced intragastric pressure(13.67 ± 3.72 vs 4.27 ± 1.48, P < 0.001). These data demonstrate that the signals induced by EA stimulation of acupoints RN12 and BL21 are detectable in the DVC and the PVN, and increase the levels of gastrointestinal hormones and their receptors in the PVN and gastric antrum to regulate gastric motility. CONCLUSION: EA at RN12 and BL21 regulates gastric motility, which may be achieved through the PVN-DVCvagus-gastric neural pathway.展开更多
Gastric cancer is one of the most frequent neoplasms and a main cause of death worldwide, especially in China and Japan. Numerous epidemiological, animal and experimental studies support a positive association between...Gastric cancer is one of the most frequent neoplasms and a main cause of death worldwide, especially in China and Japan. Numerous epidemiological, animal and experimental studies support a positive association between chronic Helicobacter pylori(H. pylori) infection and the development of gastric cancer. However, the exact mechanism whereby H. pylori causes gastric carcinogenesis remains unclear. It has been demonstrated that expression of cyclooxygenase-2(COX-2) is elevated in gastric carcinomas and in their precursor lesions. In this review, we present the latest clinical and experimental evidence showing the role of gastrin and COX-2 in H. pylori-infected patients and their possible association with gastric cancer risk.展开更多
AIM To observe changes in gastric biomarker levels with age and effects of Helicobacter pylori(H. pylori) infection in a healthy population, and explore factors associated with gastric biomarkers.METHODS Three hundred...AIM To observe changes in gastric biomarker levels with age and effects of Helicobacter pylori(H. pylori) infection in a healthy population, and explore factors associated with gastric biomarkers.METHODS Three hundred and ninety-five subjects were selected and underwent physical examinations, biochemical tests, and measurement of serum pepsinogen(PG)Ⅰ and Ⅱ, gastrin-17(G-17) and H. pylori antibody levels. Analyses were made by Student's t-test, ANOVA, Pearson's correlation and multiple linear regressions.RESULTS PGII levels were higher in the ≥ 65-years-old age group(P < 0.05) and PGI/PGII were lower in the ≥ 75-years-old age group(P = 0.035) compared to the 35-44-years-old age group. Levels of low-density lipoprotein cholesterol(LDL-C) were higher(P = 0.009) in H. pylori-infected subjects that were male. LDL-C levels were higher in 55-74-years-old age group(P < 0.05) for H. pylori-infected subjects and 45-64-yearsold age group(P < 0.05) for non-infected subjects compared to 35-44-years-old age group. Hp-Ig G level positively correlated with PGⅠ, PGⅡ and G-17(P < 0.001, P < 0.001, P = 0.006), and negatively correlated with PGI/PGII(P < 0.001). Creatinine positively correlated with PGⅠ, PGⅡ and G-17(P < 0.001, P < 0.001, P < 0.001). Fasting blood glucose(FBG) positively correlated with PGⅠ/PGⅡ and G-17(P < 0.001, P = 0.037). Age positively correlated with PGII and G-17(P = 0.005, P = 0.026).CONCLUSION PGII levels increased while PGI/PGII declined with age in a healthy population. H. pylori infection had an effect on raising LDL-C levels to increase the risk of atherosclerosis in males, especially those of elderly age. Age, H. pylori infection, levels of renal function and FBG were associated with levels of pepsinogens and gastrin.展开更多
文摘BACKGROUND The incidence of type I gastric neuroendocrine neoplasms(gNENs)has increased significantly over the past 50 years.Although autoimmune gastritis(AIG)increases the likelihood of developing gNENs,the exact incidence and prevalence of this association remain unclear.AIM To evaluate the incidence and prevalence of type I gNENs in a cohort of patients with a histological diagnosis of AIG.METHODS Patients with a histological diagnosis of AIG were enrolled between October 2020 and May 2022.Circulating levels of CgA and gastrin were assessed at enrollment.Included patients underwent regular endoscopic follow-up to detect gastric neoplastic lesions,enterochromaffin-like(ECL)cell hyperplasia,and the development of gNEN.RESULTS We included 176 patients[142 women(80.7%),median age 64 years,interquartile range(IQR)53–71 years]diagnosed with AIG between January 1990 and June 2022.At enrollment.One hundred and sixteen patients(65.9%)had ECL hyperplasia,of whom,29.5%had simple/linear,30.7%had micronodular,and 5.7%had macronodular type.The median follow-up time was 5(3–7.5)years.After 1032 person-years,33 patients developed a total of 50 type I gNENs,with an incidence rate of 0.057 person-years,corresponding to an annual cumulative incidence of 5.7%.Circulating CgA levels did not significantly differ between AIG patients who developed gNENs and those who did not.Conversely,gastrin levels were significantly higher in AIG patients who developed gNENs[median 992 pg/mL IQR=449–1500 vs 688 pg/mL IQR=423–1200,P=0.03].Calculated gastrin sensitivity and specificity were 90.9%and 1.4%,respectively,with an overall diagnostic accuracy of 30%and a calculated area under the gastrin receiver operating characteristic curve(AUROC or AUC)of 0.53.CONCLUSION Type I gNENs are a significant complication in AIG.Gastrin’s low diagnostic accuracy prevents it from serving as a marker for early diagnosis.Effective strategies for early detection and treatment are needed.
基金Project supported by the National Natural Science Foundation of China,No.39670896
文摘AIM To study the role of cholecystokinin octapeptide ( CCK-8), β-endorphin ( β-EP), and gastrin in an anorexic infantile rat model and no subsequent regulation of nose peptides by the Yunpi complex prescription ErBao Granule.METHODS We fed infantile rats with special prepared forage. A liquid extract of ErBao Granule was administered to the rats daily for 3weeks, CCK-8, β-EP, and gastrin concentrations in hypothalamus, gastric antrum, and plasma of the rats were measured by radioimmunoassay,and were compared with controls.RESULTS Treatment of rats with ErBao Granule inhibited CCK-8 secretion and increased β-EP and gastrin secretion. CCK-8 concentration in hypothalamus and plasma of model control group increased significantly and correlated negatively with food intake of models.respectively. β-EP concentration in gastric antrum and plasma of model control group decreased significantly and showed a positive correlation with food intake of models,respectively. Hypothalamus concentration of β-EP was similar in models and controls. Gastrin concentration in gastric antrum of models was lower than in the blank control group, and correlated positively to food intake of models.Finally, CCK-8 concentrations in plasma of rats showed a positive correlation with plasma β-EP(r- 0.68, P＜0.05).CONCLUSION The increased plasma and hypothalamus concentration of CCK-8,decreased gastric antrum and plasma level of β-EP. and decreased gastric antrum concentration of gastrin are associated significantly with the anorexia of infantile anorexic rat models produced by special forage. ErBao Granule can reverse these changes, which may be the major mechanisms of ErBao Granule simulating feeding.
文摘INTRODUCTIONHelicobacter pylori(Hp)infection is closely relatedto gastrointestinal hormones and involves theformation of gastritis,gastric carcinoma and pepticulcer.Its pathogenesis relevant
基金the Youth Scientific Found of Ministry of Healthy.
文摘AIM To investigate the changes of gastricmucosal ascorbic acid secretion in patients withnonulcer dyspepsia and the effect of gastrin onit,and to relate any observed changes to H.pylori infection and mucosal histology.METHODS Ascorbic acid secretions in patientswere examined by collecting continuouslygastric juice for one hour after having aspiratedand discarded fasting gastric juice.Using theclearance rate(mL/min)of ascorbic acid fromblood to gastric juice represented ascorbic acidsecretion in the gastric mucosa.Ascorbic acidconcentrations in plasma and juice weremeasured by ferric reduced method.RESULTS Gastric ascorbic acid secretions inH.pylori-positive patients(1.46 mL/min,range0.27-3.78)did not significantly differ fromthose in H.pylori-negative patients(1.25 mL/min,0.47-3.14)(P】0.05).There were nosignificant differences in ascorbic acidsecretions between patients with mild(1.56 mL/min,0.50-3.30),moderate(1.34 mL/min,0.27-2.93)and severe(1.36 mL/min,0.47-3.78)inflammation(P】0.05).There were nosignificant differences in ascorbic acidsecretions between patients without activity(l.45mL/min,0.27-3.14)and with mild(1.32mL/min,0.61-2.93),moderate(1.49mL/min,0.50-3.78)and severe(1.43 mL/min,0.51-3.26)activity of chronic gastritis either(P】0.05).Ascorbic acid secretions in patientswith severe atrophy(0.56 mL/min,0.27-1.20)were markedly lower than those in patientswithout atrophy(1.51 mL/min,0.59-3.30)and with mild(1.43 mL/ min,0.53-3.78)andmoderate(1.31 mL/min,0.47-3.16)atrophy(P【0.005).There was a significant negativecorrelation between ascorbic acid secretion andseverity of atrophy(correlation coefficient=-0.43,P【0.005).After administration ofpentagastrin,ascorbic acid secretions weremarkedly elevated(from 1.39 mL/min,0.36-2.96 to 3.53mL/min,0.84-5.91)(P【0.001).CONCLUSION Ascorbic acid secretion ingastric mucosa is not affected by H.pyloriinfection.Gastric ascorbic acid secretion ismarkedly related to the severity of atrophy,whereas not related to the severity ofinflammation and activity.Gastrin may stimulategastric ascorbic acid secretion.A decreasedascorbic acid secretion may be an importantfactor in the link between atrophic gastritis andgastric carcinogenesis.
基金Supported by the National Natural Science Foundation of China,No.39270379
文摘INTRODUCTIONKupffer cells are residential macrophages in the liver ,which play a critical role in the maintenance of normal liver function and in immunal surveilance of hepatocellular carcinoma (HCC) and other cancers[1].The biological immune modulants have cancers[2].In our previous studies ,the combined use of biological immune modulants showed better dffects .
文摘The changes of gastric acid secretion and the levels of gastrin(Gn) and somatostatin(SS) in the serum, gastric juice and mucous membrane of pyrolic antrum were determined in 10 cases with cholangioduodenostomy with artificial papilla and interposed jejunum(Inter-JCD) and 28 cases with cholangiojenunostomy with Roux-en-Y (CJR-Y). It was found that the secondary gastric hypersecretion did not occur and the levels of Gn and SS showed no significant changes after Inter-JCD but there was secondary high secretion of gastric acid, significant reduction of the synthesis and release of SS and significant elevation of the synthesis and release of Gn after CJR-Y. These findings indicate that Inter-JCD is superior to CJR-Y since it induces no disturbance of gastric acid secretion postoperatively.
文摘Ever since Helicobacter pylori(H. pylori) was recognized as an infectious cause of gastric cancer, there has been increasing interest in examining its potential role in colorectal carcinogenesis. Data from casecontrol and cross-sectional studies, mostly relying on hospital-based samples, and several meta-analyses have shown a positive statistical relationship between H. pylori infection and colorectal neoplasia. However, the possibility exists that the results have been influenced by bias, including the improper selection of patients and disparities with respect to potential confounders. While the evidence falls short of a definitive causal link, it appears that infection with H. pylori /H. pylori-related gastritis is associated with an increased, although modest, risk of colorectal adenoma and cancer. The pathogenic mechanisms responsible for this association remain uncertain. H. pylori has been detected in colorectal malignant tissues; however, the possibility that H. pylori is a direct activator of colonic carcinogenesis remains purely hypothetical. On the other hand, experimental data have indicated a series of potential oncogenic interactions between these bacteria and colorectal mucosa, including induction and perpetuation of inflammatory responses, alteration of gut microflora and release of toxins and/or hormonal mediators, such as gastrin, which may contribute to tumor formation.
基金supported by the National Key R&D Program of China(No.2018YFC1313105)the third batch of public welfare development and reform pilot projects of Beijing Municipal Medical Research Institutes(Beijing Medical Research Institute,2019-1)Beijing Municipal Administration of Hospitals’Ascent Plan(No.DFL 20181102)。
文摘Gastric cancer(GC)is one of the major cancers in China and all over the world.Most GCs are diagnosed at an advanced stage with unfavorable prognosis.Along with some other countries,China has developed the government-funded national screening programs for GC and other major cancers.GC screening has been shown to effectively decrease the incidence of and mortality from GC in countries adopting nationwide screening programs(Japan and Korea)and in studies based on selected Chinese populations.The screening of GC relies mostly on gastroendoscopy,the accuracy,reliability and safety of which have been indicated by previous studies.However,considering its invasive screening approach,requirements on skilled endoscopists and pathologists,and a high cost,developing noninvasive methods to amend endoscopic screening would be highly needed.Numerous studies have examined biomarkers for GC screening and the combination of biomarkers involving pepsinogen,gastrin,and Helicobacter pylori antibodies has been proposed for risk stratification,seeking to narrow down the high-risk populations for further endoscopy.Despite all the achievements of endoscopic screening,evidence on appropriate screening age,intervals for repeated screening,novel biomarkers promoting precision prevention,and health economics need to be accumulated to inform policymakers on endoscopic screening in China.With the guide of Health China 2030 Planning Outline,we have golden opportunities to promote prevention and control of GC.In this review,we summarize the characteristics of screening programs in China and other East Asian countries and introduce the past and current approaches and strategies for GC screening,aiming for featuring the latest advances and key challenges,and illustrating future visions of GC screening.
基金Supported by The National Nature Science Foundation Council of ChinaNo.81473784+3 种基金the Natural Science Foundation of Anhui ProvinceNo.1408085MH166the Natural Science Foundation of Anhui University of Traditional Chinese MedicineNo.2013qn002
文摘AIM: To study the neural mechanism by which electroacupuncture(EA) at RN12(Zhongwan) and BL21(Weishu) regulates gastric motility.METHODS: One hundred and forty-four adult Sprague Dawley rats were studied in four separate experiments. Intragastric pressure was measured using custommade rubber balloons, and extracellular neuron firing activity, which is sensitive to gastric distention in the dorsal vagal complex(DVC), was recorded by an electrophysiological technique. The expression levels of c-fos, motilin(MTL) and gastrin(GAS) in the paraventricular hypothalamic nucleus(PVN) were assayed by immunohistochemistry, and the expression levels of motilin receptor(MTL-R) and gastrin receptor(GAS-R) in both the PVN and the gastric antrum were assayed by western blotting.RESULTS: EA at RN12 + BL21(gastric Shu and Mu points), BL21(gastric Back-Shu point), RN12(gastric Front-Mu point), resulted in increased neuron-activating frequency in the DVC(2.08 ± 0.050, 1.17 ± 0.023, 1.55 ± 0.079 vs 0.75 ± 0.046, P < 0.001) compared with a model group. The expression of c-fos(36.24 ± 1.67, 29.41 ± 2.55, 31.79 ± 3.00 vs 5.73 ± 2.18, P < 0.001), MTL(22.48 ± 2.66, 20.76 ± 2.41, 19.17 ± 1.71 vs 11.68 ± 2.52, P < 0.001), GAS(24.99 ± 2.95, 21.69 ± 3.24, 23.03 ± 3.09 vs 12.53 ± 2.15, P < 0.001), MTL-R(1.39 ± 0.05, 1.22 ± 0.05, 1.17 ± 0.12 vs 0.84 ± 0.06, P < 0.001), and GAS-R(1.07 ± 0.07, 0.91 ± 0.06, 0.78 ± 0.05 vs 0.45 ± 0.04, P < 0.001) increased in the PVN after EA compared with the model group. The expression of MTL-R(1.46 ± 0.14, 1.26 ± 0.11, 0.99 ± 0.07 vs 0.65 ± 0.03, P < 0.001), and GAS-R(1.63 ± 0.11, 1.26 ± 0.16, 1.13 ± 0.02 vs 0.80 ± 0.11, P < 0.001) increased in the gastric antrum after EA compared with the model group. Damaging the PVN resulted in reduced intragastric pressure(13.67 ± 3.72 vs 4.27 ± 1.48, P < 0.001). These data demonstrate that the signals induced by EA stimulation of acupoints RN12 and BL21 are detectable in the DVC and the PVN, and increase the levels of gastrointestinal hormones and their receptors in the PVN and gastric antrum to regulate gastric motility. CONCLUSION: EA at RN12 and BL21 regulates gastric motility, which may be achieved through the PVN-DVCvagus-gastric neural pathway.
基金Supported by The National Natural Science Foundation of China,No.81072030 and No.81372659Project Funded by the Priority Academic Program Development of Jiangsu Higher Education Institutions(PAPD)
文摘Gastric cancer is one of the most frequent neoplasms and a main cause of death worldwide, especially in China and Japan. Numerous epidemiological, animal and experimental studies support a positive association between chronic Helicobacter pylori(H. pylori) infection and the development of gastric cancer. However, the exact mechanism whereby H. pylori causes gastric carcinogenesis remains unclear. It has been demonstrated that expression of cyclooxygenase-2(COX-2) is elevated in gastric carcinomas and in their precursor lesions. In this review, we present the latest clinical and experimental evidence showing the role of gastrin and COX-2 in H. pylori-infected patients and their possible association with gastric cancer risk.
基金Supported by the National Basic Research Program of China(973 Program)No.2007CB507405,No.2013CB530803 and No.2013CB530804
文摘AIM To observe changes in gastric biomarker levels with age and effects of Helicobacter pylori(H. pylori) infection in a healthy population, and explore factors associated with gastric biomarkers.METHODS Three hundred and ninety-five subjects were selected and underwent physical examinations, biochemical tests, and measurement of serum pepsinogen(PG)Ⅰ and Ⅱ, gastrin-17(G-17) and H. pylori antibody levels. Analyses were made by Student's t-test, ANOVA, Pearson's correlation and multiple linear regressions.RESULTS PGII levels were higher in the ≥ 65-years-old age group(P < 0.05) and PGI/PGII were lower in the ≥ 75-years-old age group(P = 0.035) compared to the 35-44-years-old age group. Levels of low-density lipoprotein cholesterol(LDL-C) were higher(P = 0.009) in H. pylori-infected subjects that were male. LDL-C levels were higher in 55-74-years-old age group(P < 0.05) for H. pylori-infected subjects and 45-64-yearsold age group(P < 0.05) for non-infected subjects compared to 35-44-years-old age group. Hp-Ig G level positively correlated with PGⅠ, PGⅡ and G-17(P < 0.001, P < 0.001, P = 0.006), and negatively correlated with PGI/PGII(P < 0.001). Creatinine positively correlated with PGⅠ, PGⅡ and G-17(P < 0.001, P < 0.001, P < 0.001). Fasting blood glucose(FBG) positively correlated with PGⅠ/PGⅡ and G-17(P < 0.001, P = 0.037). Age positively correlated with PGII and G-17(P = 0.005, P = 0.026).CONCLUSION PGII levels increased while PGI/PGII declined with age in a healthy population. H. pylori infection had an effect on raising LDL-C levels to increase the risk of atherosclerosis in males, especially those of elderly age. Age, H. pylori infection, levels of renal function and FBG were associated with levels of pepsinogens and gastrin.
