Recent Situation of Acupuncture and Moxibustion in the Treatment of Stomach Pain with Deficiency and Cold of Spleen and Stomach

Stomachache is one of the most common diseases of digestive system, among which stomach pain of deficiency cold of spleen and stomach is the most common. Acupuncture and moxibustion therapy as an external treatment of traditional Chinese medicine for relieving stomach pain due to deficiency of spleen and stomach, has the advantages of convenient operation, small adverse reactions and remarkable curative effect, which is easy for patients to accept. In this paper, acupuncture and moxibustion therapy such as moxibustion and warm acupuncture therapy for stomach pain of spleen and stomach deficiency cold type is summarized to provide evidence-based basis for clinical treatment of stomach pain of spleen and stomach deficiency cold type.

Metastatic stomach lymphoepithelioma-like carcinoma and immune checkpoint inhibitor therapy:A case report

BACKGROUND Pulmonary lymphoepithelioma-like carcinoma(PLELC)is a rare type of nonsmall-cell lung cancer.Stomach lymphoepithelioma-like carcinoma(LELC)metastasis secondary to PLELC has not been reported recently.CASE SUMMARY A 64-year-old female was admitted to our hospital for a regular gastroscopy examination with a 6-year history of surgical resection for left PLELC.Positron emission tomography/computed tomography suggested high accumulation of 18F-fludeoxyglucose in the gastric cardia region.Upper gastrointestinal endoscopy confirmed a large mass at the stomach fundus.Immunohistochemistry(IHC)of the biopsy suggested metastatic stomach LELC.Proximal gastrectomy showed that this 6.5 cm×5.0 cm mass was located in the stomach fundus near the cardia.Histopathological examination showed a poorly differentiated carcinoma with prominent lymphoplasmacytic infiltration.IHC demonstrated that the tumor was positive for CK(AE1/AE3),p63,p40,p53,Ki-67(70%),and EGFR(3+)and negative for CK7,CK20,Her2,and CD10.In situ hybridization analysis showed positive staining Epstein-Barr virus-encoded RNA.Tumor programmed cell death ligand 1(PD-L1)expression score was 98%,and the combined positive score was 100,with no evidence of microsatellite instability.Thus,the patient was unequivocally diagnosed with metastatic stomach LELC secondary to pulmonary LELC.After discharge,this patient underwent PD-1 inhibitor treatment(toripalimab,240 mg)every 3 wk for ten cycles,and she has had no tumor recurrence.CONCLUSION For gastric LELC metastasis,PD-1 inhibitor therapy could become a new therapeutic approach,though there is still no evidence from large data sets to support this.

The early life immune dynamics and cellular drivers at single-cell resolution in lamb forestomachs and abomasum

Background Four-chambered stomach including the forestomachs(rumen,reticulum,and omasum)and abomasum allows ruminants convert plant fiber into high-quality animal products.The early development of this four-chambered stomach is crucial for the health and well-being of young ruminants,especially the immune development.However,the dynamics of immune development are poorly understood.Results We investigated the early gene expression patterns across the four-chambered stomach in Hu sheep,at 5,10,15,and 25 days of age.We found that forestomachs share similar gene expression patterns,all four stomachs underwent widespread activation of both innate and adaptive immune responses from d 5 to 25,whereas the metabolic function were significantly downregulated with age.We constructed a cell landscape of the four-chambered stomach using single-cell sequencing.Integrating transcriptomic and single-cell transcriptomic analyses revealed that the immune-associated module hub genes were highly expressed in T cells,monocytes and macrophages,as well as the defense-associated module hub genes were highly expressed in endothelial cells in the four-stomach tissues.Moreover,the non-immune cells such as epithelial cells play key roles in immune maturation.Cell communication analysis predicted that in addition to immune cells,non-immune cells recruit immune cells through macrophage migration inhibitory factor signaling in the forestomachs.Conclusions Our results demonstrate that the immune and defense responses of four stomachs are quickly developing with age in lamb's early life.We also identified the gene expression patterns and functional cells associated with immune development.Additionally,we identified some key receptors and signaling involved in immune regulation.These results help to understand the early life immune development at single-cell resolution,which has implications to develop nutritional manipulation and health management strategies based on specific targets including key receptors and signaling pathways.

Progress and current perspectives of diagnosis and treatment of hepatoid adenocarcinoma of the stomach

Hepatoid adenocarcinoma of the stomach(HAS)is a rare malignant gastric tumor exhibiting both hepatocellular and adenocarcinomatous differentiation.Patients are often diagnosed at an advanced stage,and their clinical symptoms closely resemble those of gastric adenocarcinoma.Because of its rarity,misdiagnosis and missed diagnoses are prevalent.Compared with gastric adenocarcinoma,HAS typically exhibits higher invasiveness and amore unfavorable prognosis.This review aimed to elaborate on the pathological features,potential mechanisms,clinical characteristics,diagnosis,and prognosis of HAS.The insights provided aimed to contribute robust guidance for the clinical management of patients with HAS.

Clinical Effect of Modified Shengyang Yiwei Decoction in the Treatment of Diarrhea-Predominant Irritable Bowel Syndrome due to Spleen and Stomach Weakness

Objective:To explore the therapeutic effect of Shengyang Yiwei Decoction in patients with diarrhea-predominant irritable bowel syndrome(IBS)due to spleen and stomach weakness.Methods:40 patients with diarrhea-predominant IBS who were treated from April 2018 to April 2020 were taken as samples.TCM(traditional Chinese medicine)syndrome differentiation found that they were all due to spleen and stomach weakness.They were randomly divided into two groups.Group A was treated with modified prescriptions of Shengyang Yiwei Decoction,while Group B was treated with Western medicine.The therapeutic effects in the two groups were compared.Results:The treatment efficacy in Group A was higher than that in Group B(P<0.05);the symptom scores of Group A such as loose stools,chills,physical weakness,poor appetite,and abdominal distension after meals were all lower than those in Group B(P<0.05);the SF-36(36-Item Short Form Health Survey)scores of patients with diarrhea-predominant IBS in Group A were higher than those in Group B(P<0.05);the treatment satisfaction of Group A was higher than that of Group B(P<0.05).Conclusion:Treatment of diarrhea-predominant IBS patients with spleen and stomach weakness by Shengyang Yiwei Decoction can promote the disappearance of gastrointestinal discomfort symptoms,improve the quality of life,and enhance treatment efficacy.Hence,it is an efficient and feasible treatment for diarrhea-predominant IBS due to spleen and stomach weakness.

Stomach cancer burden in China: Epidemiology and prevention

In 2020, stomach cancer was the fifth most commonly diagnosed cancer and the fourth leading cause of cancer-related death worldwide. Due to the relatively huge population base and the poor survival rate, stomach cancer is still a threat in China, and accounts for nearly half of the cases worldwide. Fortunately, in China, the incidence and mortality rates of stomach cancer presented a declining trend owing to the change of individual life styles and the persistent efforts to prevent stomach cancer from the governments at all levels. Helicobacter pylori(H. pylori)infection, poor eating habits, smoking, history of gastrointestinal disorders, and family history of stomach cancer are the main risk factors for stomach cancer in China. As a result, by taking risk factors for stomach cancer into account, specific preventive measures, such as eradicating H. pylori and implementing stomach cancer screening projects, should be taken to better prevent and decrease the burden of stomach cancer.

Cohort profile: design and methods of the Chinese colorectal, breast, lung, liver, and stomach cancer screening trial(C-BLAST)

Given the rapid changes in social structure(urbanization),economic structure(industrialization),and demographic structure(population aging)in China,cancer has become a major public health problem1.Extensive evidence has indicated that screening can decrease cancer mortality,particularly among high-risk groups,and several representative national and regional cancer screening programs have been launched in China to cope with the increasing burden of cancer.

Breast cancer metastasizing to the upper gastrointestinal tract(the esophagus and the stomach):A comprehensive review of the literature

Breast cancer can infrequently metastasize to the upper gastrointestinal(GI)tract but the exact incidence is not well established-there is considerable variation between incidence reported from clinical studies and incidence noted in autopsy series.Clinical presentation can be very non-specific and often mimics primary gastrointestinal conditions.Endoscopy alone may not be sufficient to make a diagnosis and misdiagnosis is also common.A high degree of awareness and clinical suspicion is required to establish metastases to the upper GI tract.We undertook a comprehensive review of the available literature on breast cancer metastases to the esophagus and stomach including the clinical symptoms and presentation,endoscopic features,additional diagnostic imaging modalities,treatment and outcomes.

Metabolomics characterization of Qingwei San on oral ulcer in db/db mice with stomach heat pattern

Objective:To characterize the effects of Qingwei San(QWS)on diabetic oral ulcer(OU)mice with stomach heat pattern through metabolomic analysis.Methods:A stomach heat pattern mouse model was established by treating C57BLKS/J Leprdb/db(db/db)mice with dried Zingiber officinale Rosc.rhizome(Z.officinale,Gan Jiang)decoction by gavage.All model mice had blood glucose levels of≥11.1 m M.Subsequently,OU was induced by Na OH cauterization.After 1 week of administration of QWS,non-targeted metabolomic analysis of serum was conducted using ultra high performance liquid chromatography coupled with mass spectrometry(UHPLC-MS/MS).Results:The non-targeted metabolomics results indicated that tryptophan metabolism,2-oxocarboxylic acid metabolism,serotonergic synapses,amino sugar and nucleotide sugar metabolism,and amino acid biosynthesis were involved in the therapeutic effects of QWS,with tryptophan metabolism playing a predominant role.Conclusion:QWS treatment can significantly improve the pathological status of diabetic OU mice with stomach heat pattern.QWS may regulate the release of inflammatory factors through the tryptophan metabolism pathway.

Comprehensive bioinformatic analysis of mind bomb 1 gene in stomach adenocarcinoma

BACKGROUND The carcinogenesis of stomach adenocarcinoma(STAD)involves many different molecules and multiple pathways,including the NOTCH signaling pathway.As a key factor that functions as a critical link in the NOTCH pathway,mind bomb 1(MIB1)is upregulated in various tumors and has been reported to promote cell metastasis and invasion.However,studies on the role of MIB1 in STAD are limited.Here,we evaluated the prognostic value of MIB1 in STAD and its association with immune infiltration and copy number variation.AIM To elucidate the relationship between MIB1 gene and gastric cancer(GC)and provide a new idea for the treatment of GC.METHODS We identified mutations in the MIB1 gene by searching the cBioPortal database and then analyzed their relationship with the overall survival rate and diseasefree survival rate using the Kaplan-Meier method.The Cancer Genome Atlas(TCGA)database provided transcript levels for MIB1 in STADs and normal tissues.As a method of distinguishing the STAD tissues from adjacent normal tissues,a receiver operating characteristic(ROC)curve was generated.Kaplan-Meier plotter was used to determine the effect of MIB1 expression on survival.Based on the LinkedOmics database,we were able to identify the coexpressed genes of the MIB1 gene,the top 50 positively correlated genes,and the top 50 negatively correlated genes.STRING was used to construct protein-protein interaction networks related to the MIB1 gene.An analysis of functional enrichment was carried out using the R package“Cluster Profiler”.The relationships between mRNA expression of MIB1 and immune infiltrates were assessed by Tumor IMmune Estimation Resource(TIMER)and the“GSVA package”in R.RESULTS According to the cBioPortal database,the MIB1 mutation rate in 287 patients in the TCGA dataset was approximately 6%.Kaplan-Meier survival analysis showed that patients with STAD in the mutated group had a worse prognosis than those in the unmutated group(P=0.0156).There was a significant upregulation of MIB1 expression in STAD tissues compared to adjacent normal tissues.A high T stage was associated with increased MIB1 mRNA expression.The ROC curve analysis revealed 59.4%sensitivity and 85.6%specificity of MIB1 for differentiating STAD tissues from adjacent normal tissues at a truncation level of 2.248.Kaplan-Meier plotter indicated that patients with higher MIB1 levels had a worse prognosis than those with lower levels(26.4 mo vs 56.2 mo,P=0.0330).A correlation analysis demonstrated an association between immune infiltrates and MIB1 mRNA expression.CONCLUSION Upregulation of MIB1 expression is significantly associated with poor survival rate and immune infiltration in gastric adenocarcinoma.MIB1 may be a biomarker for the poor prognosis of STAD patients and a potential immunotherapeutic target.

Stomach perforation-induced general occlusion/occlusion-like syndrome and stable gastric pentadecapeptide BPC 157 therapy effect

BACKGROUND Using rat stomach perforation as a prototypic direct lesion applied in cytoprotection research,we focused on the first demonstration of the severe occlusion/occlusion-like syndrome induced by stomach perforation.The revealed stomachinduced occlusion/occlusion-like syndrome corresponds to the previously described occlusion/occlusion-like syndromes in rats suffering multicausal pathology and shared severe vascular and multiorgan failure.This general point was particularly reviewed.As in all the described occlusion/occlusion-like syndromes with permanent occlusion of major vessels,peripheral and central,and other similar noxious procedures that severely affect endothelium function,the stable gastric pentadecapeptide BPC 157 was resolving therapy.AIM To reveal the stomach perforation-induced general occlusion/occlusion-like syndrome and BPC 157 therapy effect.METHODS The procedure included deeply anesthetized rats,complete calvariectomy,laparotomy at 15 min thereafter,and stomach perforation to rapidly induce vascular and multiorgan failure occlusion/occlusion-like syndrome.At 5 min post-perforation time,rats received therapy[BPC 157(10μg or 10 ng/kg)or saline(5 mL/kg,1 mL/rat)(controls)]into the perforated defect in the stomach).Sacrifice was at 15 min or 60 min post-perforation time.Assessment(gross and microscopy;volume)included:Brain swelling,peripheral vessels(azygos vein,superior mesenteric vein,portal vein,inferior caval vein)and heart,other organs lesions(i.e.,stomach,defect closing or widening);superior sagittal sinus,and peripherally the portal vein,inferior caval vein,and abdominal aorta blood pressures and clots;electrocardiograms;and bleeding time from the perforation(s).RESULTS BPC 157 beneficial effects accord with those noted before in the healing of the perforated defect(raised vessel presentation;less bleeding,defect contraction)and occlusion/occlusion-like syndromes counteraction.BPC 157 therapy(into the perforated defect),induced immediate shrinking and contraction of the whole stomach(unlike considerable enlargement by saline application).Accordingly,BPC 157 therapy induced direct blood delivery via the azygos vein,and attenuated/eliminated the intracranial(superior sagittal sinus),portal and caval hypertension,and aortal hypotension.Thrombosis,peripherally(inferior caval vein,portal vein,abdominal aorta)and centrally(superior sagittal sinus)BPC 157 therapy markedly reduced/annihilated.Severe lesions in the brain(swelling,hemorrhage),heart(congestion and arrhythmias),lung(hemorrhage and congestion),and marked congestion in the liver,kidney,and gastrointestinal tract were markedly reduced.CONCLUSION We revealed stomach perforation as a severe occlusion/occlusion-like syndrome,peripherally and centrally,and rapid counteraction by BPC 157 therapy.Thereby,further BPC 157 therapy may be warranted.

Extraskeletal Ewing sarcoma of the stomach:A rare case report

BACKGROUND Extraskeletal Ewing sarcoma(EES)is a rare and highly malignant small round cell tumor associated with a poor clinical outcome.Ewing sarcoma(ES)involving the stomach is an uncommon presentation and can be easily confused with other small round cell tumors.We herein present a rare case of ES involving the gastric area.CASE SUMMARY We report a case of gastric ES in a 19-year-old female patient who initially presented with a complaint of a tender epigastric mass for 5 d.Contrast-enhanced abdominal computed tomography revealed a soft-tissue-density mass with a diameter of 8.5 cm between the liver and stomach;the mass was connected to the gastric antrum.Then,the mass was surgically excised completely.Upon histopathological,immunophenotype and molecular analysis,the mass was identified to be a primary gastric ES.CONCLUSION EES is an aggressive tumor with poor prognosis.Therefore,early diagnosis and timely intervention are essential for a good prognosis.It is imperative for us to raise awareness about this rare tumor.Surgical resection is still the best treatment option.

Migration of the distal ventriculoperitoneal shunt catheter into the stomach with or without trans-oral extrusion:A systematic literature review and meta-analysis

BACKGROUND Intra-gastric migration of the distal ventriculoperitoneal shunt(VPS)catheter clinically presenting with or without trans-oral extrusion is one of the rare complications of VPS catheter insertion.AIM To identify the demographics,clinical presentation,clinical findings,and results of surgical therapy offered for the treatment of intra-gastric migration of the distal VPS catheter,clinically presented with or without trans-oral extrusion.METHODS An online search was performed for the extraction/retrieval of the published/available literature pertaining to the above-mentioned VPS complication.Manuscripts were searched from PubMed,PMC(PubMed Central),ResearchGate,and Google Scholar databases using various terminology relating to the VPS complications.The first case of migration of a VPS catheter into the stomach was reported in the year 1980,and the data were retrieved from 1980 to December 2022.Cases were categorized into two groups;Group A:Cases who had migration of the distal VPS catheter into the stomach and clinically presented with trans-oral extrusion of the same,and Group B:Cases who had migration of the distal VPS catheter into the stomach,but presented without trans-oral extrusion.RESULTS A total of n=46 cases(n=27;58.69%male,and n=19;41.3%females)were recruited for the systematic review.Group A included n=32,and Group B n=14 cases.Congenital hydrocephalus was the indication for the primary VPS insertion for approximately half of the(n=22)cases.Approximately sixty percent(n=27)of them were children≤5 years of age at the time of the diagnosis of the complication mentioned above.In seventy-two percent(n=33)cases,this complication was detected within 24 mo after the VPS insertion/last shunt revision.Clinical diagnosis was evident for the entire group A cases.Various diagnostic modalities were used to confirm the diagnosis for Group B cases.Various surgical procedures were offered for the management of the complication in n=43 cases of both Groups.In two instances,intra-gastric migration of the distal VPS catheter was detected during the autopsy.This review documented four deaths.CONCLUSION Intra-gastric migration of the peritoneal end of a VPS catheter is one of the rare complications of VPS catheter implantation done for the treatment of hydrocephalus across all age groups.It was more frequently reported in children,although also reported in adults and older people.A very high degree of clinical suspicion is required for the diagnosis of a case of an intra-gastric migration of the distal VPS catheter clinically presenting without transoral extrusion.

Clinical effects of a traditional Chinese medicine nursing programme to intervene in gastric pain of the spleen and stomach with Qi deficiency

BACKGROUND Gastroparesis is a common digestive disorder characterized by delayed gastric emptying,which can lead to symptoms such as nausea,vomiting,abdominal pain,and poor appetite.Traditional Chinese medicine(TCM)has been used for centuries to treat gastrointestinal disorders,including gastroparesis.TCM theory suggests that spleen and stomach qi deficiency syndrome is one of the main pathogenic factors in gastroparesis.Nursing care plays an important role in the treatment of gastroparesis,and TCM nursing interventions have shown promising results in improving patient outcomes.However,there is limited research on the clinical effectiveness of TCM nursing interventions for gastroparesis with spleen stomach deficiency syndrome.This study aimed to evaluate the clinical effect of TCM nursing intervention in the treatment of gastroparesis with spleen stomach deficiency syndrome and to compare it with routine nursing interventions.AIM To analyze the clinical effect of traditional Chinese medicine nursing intervention in the treatment of gastric paraplegia with spleen stomach deficiency syndrome.METHODS From January 2020 to July 2021,80 patients with gastroparesis of spleen stomach qi deficiency type diagnosed in our hospital were selected for the study.The 80 patients were randomly divided into a control group and an experimental group,with 40 cases in each group.During the treatment period,the control group received routine nursing interventions,while the experimental group received traditional Chinese medicine nursing procedures.Compare the nursing effects of the two groups and observe the changes in traditional Chinese medicine symptom scores,pain levels,and sleep quality before and after treatment.RESULTS After treatment,comparing the treatment effects of the two groups,the total effective rate of the experimental group was significantly higher than that of the control group,with statistical significance(P<0.05).There was no statistically significant difference in the TCM symptom score,visual analogue scale(VAS)score,and Pittsburgh sleep quality index(PSQI)score between the two groups before treatment(P>0.05).However,after treatment,the TCM syndrome scores,VAS scores,and PSQI scores of the experimental group were significantly lower than those of the control group,with a statistically significant difference(P<0.05).CONCLUSION In the clinical nursing intervention of patients with mild gastroparesis due to spleen and stomach qi deficiency,the traditional Chinese medicine nursing plan has good clinical application value and nursing effect,and has a good effect on improving patients’pain and sleep quality.

A Clinical Study of Integrated Traditional Chinese and Western Medicine in the Treatment of Liver-Stomach Disharmony Functional Dyspepsia

Objective:To explore the clinical effect of integrated traditional Chinese and Western medicine in the treatment of liver-stomach disharmony functional dyspepsia.Methods:Sixty patients with functional dyspepsia of liver-stomach disharmony type admitted to our hospital from January to August 2022 were selected as research subjects and randomly divided into two groups,a study group and a control group,with 30 cases in each group.The main observations were stomachache or pain over bilateral flanks,emotionally depressed,belching,fullness and discomfort over the abdomen and flanks,acid regurgitation,loss of appetite,frequent sighing,noisy epigastric,and the treatment effect.Results:According to the classification of symptom severity on the traditional Chinese medicine(TCM)symptom score table,statistics were made on the corresponding severity of the main symptoms and secondary symptoms of the two groups of patients,and the data of the two groups were compared by Wilcoxon test.The results showed that there was no significant difference in the distribution of TCM symptoms between the two groups;the study group’s total effective rate of pain relief(recovery+markedly effective+effective)was 96.67%,and Fisher’s χ^(2) test indicated a significant difference in the total effective rate of pain relief between the two groups(P=0.027<0.05).Conclusion:The use of integrated traditional Chinese and western medicine is clearly better than the simple application of western medicine.It is safe and has no side effects.It can be used as a treatment for patients with functional dyspepsia.

基于“胃不和则卧不安”理论探讨肠道菌群对失眠的作用机制

《素问·逆调论》中记载“胃不和则卧不安”。然而由饮食不节引起的失眠,此病症的发病机制尚不清楚。现代研究发现,肠道菌群作为肠和脑的中间纽带,将胃肠道系统与中枢神经系统联系起来,这与中医论述的“胃不和则卧不安”的观点不谋而合。本文以肠道菌群为出发点,探讨胃肠不舒与失眠发生的内在联系,将现代发病机制与中医理论结合起来,以明确“胃不和则卧不安”的发病机制,为治疗失眠提供新思路。

基于倾向性评分匹配的T_(4a)期胃癌腔镜辅助与开腹手术近期疗效的对比分析

目的:探讨T_(4a)期胃癌行腹腔镜辅助D2根治术的近期疗效。方法:采用倾向性评分匹配,分析2014年1月至2020年12月为T_(4a)期胃腺癌患者行D2淋巴结清扫的临床资料。将患者分为开腹组(n=362)与腹腔镜组(n=134),通过倾向性评分匹配对数据进行1∶1匹配,匹配容差设为0.03。最终获得两组病例各134例。比较两组手术情况、术后并发症、术后炎性指标变化及2年总生存率。结果:倾向性匹配后,两组基线资料具有可比性(P>0.05)。两组术后首次进食时间、住院时间、并发症情况差异均无统计学意义(P>0.05);腹腔镜组与开腹组手术时间[240(203.75,256.25)min vs.140(120,190)min,P<0.05]、术中出血量[200(100,300)mL vs.200(200,300)mL,P<0.05]、淋巴结清扫数量[20.5(17,27.25)vs.16(10,23),P<0.05]、切口长度[5(5,6)cm vs.12(10,15)cm,P<0.05]、术后排气时间[4(3,6)d vs.5(3,6)d,P<0.05]、术后下床活动时间[2(2,3)d vs.3(2,3)d,P<0.05]差异均有统计学意义。两组术前中性粒细胞-淋巴细胞比值、血小板-淋巴细胞比值、淋巴细胞-单核细胞比值差异无统计学意义(P>0.05),术后血小板-淋巴细胞比值差异无统计学意义,腹腔镜组中性粒细胞-淋巴细胞比值低于开腹组,淋巴细胞-单核细胞比值高于开腹组,差异有统计学意义。开腹组与腹腔镜组术后2年总生存率为53.3%与48.3%,差异无统计学意义(P=0.211)。结论:对于T_(4a)期胃癌,腹腔镜手术后并发症发生率、2年生存率与开腹手术相当,但腹腔镜手术具有创伤小、美观、术后康复快的优势。

血清miR-345、miR-138及miR-22与晚期胃癌患者化疗敏感性的相关性分析

【目的】探讨血清微小RNA-345(miR-345)、miR-138及miR-22与晚期胃癌患者化疗敏感性的相关性。【方法】100例均接受同一化疗方案治疗的晚期胃癌患者,依据疗效分为有效组(n=69)及无效组(n=31),比较两组临床病理特征及血清相关指标,绘制受试者工作特征(ROC)曲线分析血清miR-345、miR-138及miR-22预测晚期胃癌化疗效果的价值,采用多因素Logistic回归分析影响患者化疗效果的因素。【结果】Ⅲ期患者的血清miR-345相对表达量低于Ⅳ期患者,miR-138及miR-22相对表达量高于Ⅳ期患者(P<0.05);有效组miR-345低于无效组,miR-138、miR-22高于无效组(P<0.05)。经ROC曲线分析证实,血清miR-345、miR-138及miR-22能用于预测晚期胃癌的化疗效果,其敏感度与特异性分别为0.855、0.935、0.971、0.839和0.884、0.903(均P<0.05)。多因素Logistic回归分析显示,病理分期为Ⅳ期、miR-345≥14.5、miR-138≤2及miR-22≤3.12为晚期胃癌患者化疗效果不佳的危险因素(P<0.05)。【结论】血清miR-345≥14.5、miR-138≤2、miR-22≤3.12均为导致化疗效果不佳的危险因素,其可作为评估患者化疗效果的生物学标志物。

左枳六君汤治疗肝胃不和型幽门螺杆菌阳性慢性胃炎的效果

目的探讨左枳六君汤治疗肝胃不和型幽门螺杆菌(Hp)阳性慢性胃炎的效果。方法选取2021年1月至2022年12月江西中医药高等专科学校附属医院(抚州市中医医院)收治的70例慢性胃炎患者(肝胃不和型Hp阳性)作为研究对象,按照随机数字表法分为观察组(35例)与对照组(35例),观察组采用常规西药四联治疗+左枳六君汤治疗方法,对照组采用常规西药四联治疗方法。比较两组的临床疗效、中医证候积分、Hp根除及复发率、血清生化指标。结果观察组的治疗总有效率(97.15%)、Hp根除率(94.28%)均高于对照组(82.85%、77.14%),Hp复发率(2.86%)低于对照组(17.14%),差异有统计学意义(P<0.05)。治疗后,观察组的中医证候积分低于对照组,血清胃泌素、胃动素水平均高于对照组,炎症因子(C反应蛋白、白介素-6、肿瘤坏死因子-α)水平低于对照组,差异有统计学意义(P<0.05)。结论在基础对症治疗上,将左枳六君汤引入肝胃不和型Hp阳性慢性胃炎患者的治疗中,能够提升临床综合治疗效果,作用显著,推荐参考使用。

1例初始表现为急性弥散性血管内凝血的胃低分化腺癌伴多发转移:^(18)F-FDG PET/CT显像所见

患者女,20岁,无明显诱因阵发性下腹部疼痛伴牙龈出血、皮肤散在瘀斑及肛门坠胀感9天;既往体健。查体:贫血貌,全身皮肤散在片状瘀斑,四肢皮肤干燥;腹部柔软,无压痛及反跳痛。实验室检查:红细胞2.49×10^(12)/L,血小板36×10^(9)/L,血红蛋白70 g/L,血浆鱼精蛋白副凝固实验(+),D-二聚体>20 mg/L,纤维蛋白原降解产物>150.00 mg/L,糖类抗原12573.40 U/ml。