In recent decades,the study of the mechanism of tumorigenesis has brought much progress to cancer treatment.However,cancer stem cell(CSC)theory has changed previous views of tumors,and has provided a new method for tr...In recent decades,the study of the mechanism of tumorigenesis has brought much progress to cancer treatment.However,cancer stem cell(CSC)theory has changed previous views of tumors,and has provided a new method for treatment of cancer.The discovery of CSCs and their characteristics have contributed to understanding the molecular mechanism of tumor genesis and development,resulting in a new effective strategy for cancer treatment.Gastric CSCs(GCSCs)are the basis for the onset of gastric cancer.They may be derived from gastric stem cells in gastric tissues,or bone marrow mesenchymal stem cells.As with other stem cells,GCSCs highly express drug-resistance genes such as aldehyde dehydrogenase and multidrug resistance,which are resistant to chemotherapy and thus form the basis of drug resistance.Many specific molecular markers such as CD44 and CD133 have been used for identification and isolation of GCSCs,diagnosis and grading of gastric cancer,and research on GCSC-targeted therapy for gastric cancer.Therefore,discussion of the recent development and advancements in GCSCs will be helpful for providing novel insight into gastric cancer treatment.展开更多
32 postoperative cases of gastric carcinoma were treated by traditional Chinese medicine (TCM) drugs for supporting healthy energy and removing blood stasis, and their therapeutic results were compared with those in t...32 postoperative cases of gastric carcinoma were treated by traditional Chinese medicine (TCM) drugs for supporting healthy energy and removing blood stasis, and their therapeutic results were compared with those in the control group treated by western medicine. After 6 months of treatment, in the TCM group, the rate of metastatic recurrence was significantly reduced, and the level of ornithine decarboxylase was also markedly lowered. Therefore, it is considered that the action of anti-metastatic recurrence of TCM drugs in postoperative cases of gastric carcinoma is probably related to the lowered activity of ornithine decarboxylase.展开更多
AIM: To evaluate the risk factors for postoperative bleeding after gastric endoscopic submucosal dissection(ESD) based on the latest guidelines.METHODS: A total of 262 gastric neoplasms were treated by ESD at our cent...AIM: To evaluate the risk factors for postoperative bleeding after gastric endoscopic submucosal dissection(ESD) based on the latest guidelines.METHODS: A total of 262 gastric neoplasms were treated by ESD at our center during a 2-year period from October 2012. We analyzed the data of these cases retrospectively to identify the risk factors for postESD bleeding.RESULTS: Of the 48(18.3%) cases on antithrombotic treatment, 10 were still receiving antiplatelet drugs perioperatively, 13 were on heparin replacement after oral anticoagulant withdrawal, and the antithrombotic therapy was discontinued perioperatively in 25 cases. Postoperative bleeding occurred in 23 cases(8.8%). The postoperative bleeding rate in the heparin replacement group was 61.5%, significantly higher than that in the non-antithrombotic therapy group(6.1%). Univariate analysis identified history of antithrombotic drug use, heparin replacement, hemodialysis, cardiovascular disease, diabetes mellitus, elevated prothrombin timeinternational normalized ratio, and low hemoglobin level on admission as risk factors for post ESD bleeding. Multivariate analysis identified only heparin replacement(OR = 13.7, 95%CI: 1.2-151.3, P = 0.0329) as a significant risk factor for post-ESD bleeding.CONCLUSION: Continued administration of antiplatelet agents, based on the guidelines, was not a risk factor for postoperative bleeding after gastric ESD; however, heparin replacement, which is recommended after withdrawal of oral anticoagulants, was identified as a significant risk factor.展开更多
Gastric lipomas are rare tumors, accounting for 2%-3% of all benign gastric tumors. They are of submucosal or extremely rare subserosal origin. Although most gastric lipomas are usually detected incidentally, they can...Gastric lipomas are rare tumors, accounting for 2%-3% of all benign gastric tumors. They are of submucosal or extremely rare subserosal origin. Although most gastric lipomas are usually detected incidentally, they can cause abdominal pain, dyspeptic disorders, obstruction, invagination, and hemorrhages. Subserosal gastric lipomas are rarely symptomatic. There is no report on treatment of subserosal gastric lipomas in the English literature. We present a case of a 50-year-old male with symptomatic subserosal gastric lipoma which was successfully managed with removal, enucleation of lipoma, explorative gastrotomy and edge resection for histology check of gastric wall. The incidence of gastric lipoma, advanced diagnostic possibilities and their role in treatment modalities are discussed.展开更多
The Maastricht IV/Florence Consensus Report and the Second Asia-Pacific Consensus Guidelines strongly recommend eradication of Helicobacter pylori(H.pylori)in patients with previous gastric neoplasia who have undergon...The Maastricht IV/Florence Consensus Report and the Second Asia-Pacific Consensus Guidelines strongly recommend eradication of Helicobacter pylori(H.pylori)in patients with previous gastric neoplasia who have undergone gastric surgery.However,the guidelines do not mention optimal timing,eradication regimens,diagnostic tools,and follow-up strategies for patients undergoing gastrectomy and do not indicate if eradication of H.pylori reduces the risk of marginal ulcer or stump cancer in the residual stomach after gastrectomy.The purpose of this review is to provide an update which may help physicians to properly manage H.pylori infection in patients who have undergone gastric surgery.This review focuses on(1)the microenvironment change in the stomach after gastrectomy;(2)the phenomenon of spontaneous clearance of H.pylori after gastrectomy;(3)the effects of H.pylori on gastric atrophy and intestinal metaplasia after gastrectomy;(4)incidence and clinical features of ulcers developing after gastrectomy;(5)does eradication of H.pylori reduce the risk of gastric stump cancer in the residual stomach?(6)does eradication of H.pylori reduce the risk of secondary metachronous gastric cancer in the residual stomach?and(7)optimal timing and regimens for H.pylori eradication,diagnostic tools and follow-up strategies for patients undergoing gastrectomy.展开更多
In the model rat with precancerous lesion of stomach induced by the combined method of insertion of a spring into the pylorus and high salt hot paste, effects of San Qi (三七 Radix Notoginseng) on gastric secretion an...In the model rat with precancerous lesion of stomach induced by the combined method of insertion of a spring into the pylorus and high salt hot paste, effects of San Qi (三七 Radix Notoginseng) on gastric secretion and protective factors of stomach were investigated.展开更多
Drug absorption represents an important factor affecting the efficacy of oral drug treatment.Gastric secretion and motility seem to be critical for drug absorption.A causal relationship between impaired absorption of ...Drug absorption represents an important factor affecting the efficacy of oral drug treatment.Gastric secretion and motility seem to be critical for drug absorption.A causal relationship between impaired absorption of orally administered drugs and Helicobacter pylori(H.pylori)infection has been proposed.Associations have been reported between poor bioavailability of l-thyroxine and l-dopa and H.pylori infection.According to the Maastricht Florence Consensus Report on the management of H.pylori infection,H.pylori treatment improves the bioavailability of both these drugs,whereas the direct clinical benefits to patients still await to be established.Less strong seems the association between H.pylori infection and other drugs malabsorption,such as delavirdine and ketoconazole.The exact mechanisms forming the basis of the relationship between H.pylori infection and impaired drugs absorption and/or bioavailability are not fully elucidated.H.pylori infection may trigger a chronic inflammation of the gastric mucosa,and impaired gastric acid secretion often follows.The reduction of acid secretion closely relates with the wideness and the severity of the damage and may affect drug absorption.This minireview focuses on the evidence of H.pylori infection associated with impaired drug absorption.展开更多
文摘In recent decades,the study of the mechanism of tumorigenesis has brought much progress to cancer treatment.However,cancer stem cell(CSC)theory has changed previous views of tumors,and has provided a new method for treatment of cancer.The discovery of CSCs and their characteristics have contributed to understanding the molecular mechanism of tumor genesis and development,resulting in a new effective strategy for cancer treatment.Gastric CSCs(GCSCs)are the basis for the onset of gastric cancer.They may be derived from gastric stem cells in gastric tissues,or bone marrow mesenchymal stem cells.As with other stem cells,GCSCs highly express drug-resistance genes such as aldehyde dehydrogenase and multidrug resistance,which are resistant to chemotherapy and thus form the basis of drug resistance.Many specific molecular markers such as CD44 and CD133 have been used for identification and isolation of GCSCs,diagnosis and grading of gastric cancer,and research on GCSC-targeted therapy for gastric cancer.Therefore,discussion of the recent development and advancements in GCSCs will be helpful for providing novel insight into gastric cancer treatment.
文摘32 postoperative cases of gastric carcinoma were treated by traditional Chinese medicine (TCM) drugs for supporting healthy energy and removing blood stasis, and their therapeutic results were compared with those in the control group treated by western medicine. After 6 months of treatment, in the TCM group, the rate of metastatic recurrence was significantly reduced, and the level of ornithine decarboxylase was also markedly lowered. Therefore, it is considered that the action of anti-metastatic recurrence of TCM drugs in postoperative cases of gastric carcinoma is probably related to the lowered activity of ornithine decarboxylase.
文摘AIM: To evaluate the risk factors for postoperative bleeding after gastric endoscopic submucosal dissection(ESD) based on the latest guidelines.METHODS: A total of 262 gastric neoplasms were treated by ESD at our center during a 2-year period from October 2012. We analyzed the data of these cases retrospectively to identify the risk factors for postESD bleeding.RESULTS: Of the 48(18.3%) cases on antithrombotic treatment, 10 were still receiving antiplatelet drugs perioperatively, 13 were on heparin replacement after oral anticoagulant withdrawal, and the antithrombotic therapy was discontinued perioperatively in 25 cases. Postoperative bleeding occurred in 23 cases(8.8%). The postoperative bleeding rate in the heparin replacement group was 61.5%, significantly higher than that in the non-antithrombotic therapy group(6.1%). Univariate analysis identified history of antithrombotic drug use, heparin replacement, hemodialysis, cardiovascular disease, diabetes mellitus, elevated prothrombin timeinternational normalized ratio, and low hemoglobin level on admission as risk factors for post ESD bleeding. Multivariate analysis identified only heparin replacement(OR = 13.7, 95%CI: 1.2-151.3, P = 0.0329) as a significant risk factor for post-ESD bleeding.CONCLUSION: Continued administration of antiplatelet agents, based on the guidelines, was not a risk factor for postoperative bleeding after gastric ESD; however, heparin replacement, which is recommended after withdrawal of oral anticoagulants, was identified as a significant risk factor.
文摘Gastric lipomas are rare tumors, accounting for 2%-3% of all benign gastric tumors. They are of submucosal or extremely rare subserosal origin. Although most gastric lipomas are usually detected incidentally, they can cause abdominal pain, dyspeptic disorders, obstruction, invagination, and hemorrhages. Subserosal gastric lipomas are rarely symptomatic. There is no report on treatment of subserosal gastric lipomas in the English literature. We present a case of a 50-year-old male with symptomatic subserosal gastric lipoma which was successfully managed with removal, enucleation of lipoma, explorative gastrotomy and edge resection for histology check of gastric wall. The incidence of gastric lipoma, advanced diagnostic possibilities and their role in treatment modalities are discussed.
文摘The Maastricht IV/Florence Consensus Report and the Second Asia-Pacific Consensus Guidelines strongly recommend eradication of Helicobacter pylori(H.pylori)in patients with previous gastric neoplasia who have undergone gastric surgery.However,the guidelines do not mention optimal timing,eradication regimens,diagnostic tools,and follow-up strategies for patients undergoing gastrectomy and do not indicate if eradication of H.pylori reduces the risk of marginal ulcer or stump cancer in the residual stomach after gastrectomy.The purpose of this review is to provide an update which may help physicians to properly manage H.pylori infection in patients who have undergone gastric surgery.This review focuses on(1)the microenvironment change in the stomach after gastrectomy;(2)the phenomenon of spontaneous clearance of H.pylori after gastrectomy;(3)the effects of H.pylori on gastric atrophy and intestinal metaplasia after gastrectomy;(4)incidence and clinical features of ulcers developing after gastrectomy;(5)does eradication of H.pylori reduce the risk of gastric stump cancer in the residual stomach?(6)does eradication of H.pylori reduce the risk of secondary metachronous gastric cancer in the residual stomach?and(7)optimal timing and regimens for H.pylori eradication,diagnostic tools and follow-up strategies for patients undergoing gastrectomy.
文摘In the model rat with precancerous lesion of stomach induced by the combined method of insertion of a spring into the pylorus and high salt hot paste, effects of San Qi (三七 Radix Notoginseng) on gastric secretion and protective factors of stomach were investigated.
基金Supported by"Sapienza"University of Roma grant,No.0006345
文摘Drug absorption represents an important factor affecting the efficacy of oral drug treatment.Gastric secretion and motility seem to be critical for drug absorption.A causal relationship between impaired absorption of orally administered drugs and Helicobacter pylori(H.pylori)infection has been proposed.Associations have been reported between poor bioavailability of l-thyroxine and l-dopa and H.pylori infection.According to the Maastricht Florence Consensus Report on the management of H.pylori infection,H.pylori treatment improves the bioavailability of both these drugs,whereas the direct clinical benefits to patients still await to be established.Less strong seems the association between H.pylori infection and other drugs malabsorption,such as delavirdine and ketoconazole.The exact mechanisms forming the basis of the relationship between H.pylori infection and impaired drugs absorption and/or bioavailability are not fully elucidated.H.pylori infection may trigger a chronic inflammation of the gastric mucosa,and impaired gastric acid secretion often follows.The reduction of acid secretion closely relates with the wideness and the severity of the damage and may affect drug absorption.This minireview focuses on the evidence of H.pylori infection associated with impaired drug absorption.