Fasting Neurotensin Levels in Pediatric Celiac Disease Compared with a Control CohortRead the full article
Gastroenterology Research and Practice provides a forum for researchers and clinicians working in the areas of gastroenterology, hepatology, pancreas and biliary, and related cancers.
Chief Editor, Dr Kahaleh’s research is focused on interventional endoscopy and the use of new devices to diagnose and treat biliary and pancreatic diseases primarily focusing on preventing and treating complications of advanced endoscopic procedures.
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Endoscopic Submucosal Dissection of the Angiolipoma at Hypopharynx-Esophageal Introitus
Angiolipoma in the region of the hypopharynx-esophageal introitus is a rare occurrence. Surgical treatment was performed in the few cases reported in the literature. Endoscopic submucosal dissection (ESD) is a minimally invasive treatment for hypopharyngeal and esophageal lesions. Our objective was to evaluate the feasibility, safety, and efficacy of ESD for treatment of angiolipoma at the hypopharynx-esophageal introitus. The patients with submucosal tumors at the hypopharynx-esophageal introitus were diagnosed as angiolipoma by preoperative evaluation with endoscopy, endoscopic ultrasonography, and computed tomography (CT). The patients who were diagnosed with angiolipoma agreed to undergo endoscopic submucosal dissection. Under general anesthesia and endotracheal intubation, ESD was used to remove the lesions. Preoperative, intraoperative, and postoperative data were collected and analyzed to evaluate the feasibility, safety, and effectiveness of endoscopic submucosal dissection. From January 2013 to December 2018, 6 cases of angiolipoma were treated with ESD with a success rate of 100%. The average operation time was minutes. Intraoperative blood loss is the main risk. Endoscopic thermocoagulation successfully stopped bleeding in all cases. Pharyngeal pain and painful swallowing were the main clinical signs. There was no stricture at the hypopharynx-esophageal introitus after the operation. ESD treatment of angiolipoma at hypopharynx-esophageal introitus is feasible, safe, and effective.
Poor Prognoses of Young Hepatocellular Carcinoma Patients with Microvascular Invasion: A Propensity Score Matching Cohort Study
The relationship between age and the prognosis of patients with hepatocellular carcinoma (HCC) has been widely investigated. However, few studies have focused on the influence of patient age on the prognosis of HCC with microvascular invasion (MVI). Patients with histologically confirmed HCC with MVI who underwent hepatectomy between 2008 and 2016 were retrospectively enrolled in this study and allocated to younger (young group) and older age groups (old group) according to age< or ≥60 years. A propensity score matching analysis was performed, and prognostic factors evaluated by Kaplan–Meier curves and Cox proportional hazards regression. Intraoperative and postoperative characteristics were compared between the two groups. A total of 374 patients were enrolled in this study. There were 84 patients in each group after a 1 : 1 propensity score matching analysis. The rates of both disease-free survival (DFS) and overall survival (OS) differed significantly between the age groups. By univariate and multivariate analyses, years was significantly associated with DFS (hazard ratio, 1.590; 95% CI, 1.135–2.228) and OS (hazard ratio, 1.837; 95% CI, 1.259–2.680). There were no significant differences in intraoperative or postoperative characteristics between the two age groups. In patients with histologically confirmed HCC with MVI, the prognosis is poorer for those aged younger than 60 years than for those aged 60 years or older. Hepatectomy can be safely performed in selected older patients.
Effects of Bacterial Translocation and Autophagy on Acute Lung Injury Induced by Severe Acute Pancreatitis
Aim. To reveal the role of bacterial translocation (BT) and autophagy in severe acute pancreatitis-induced acute lung injury (SAP-ALI). Methods. Rats were separated into a control (sham-operation) group () and a SAP group (). Sodium taurocholate (5%) was retrogradely injected into the cholangiopancreatic duct to induce SAP-ALI in rats. Then, 16S rDNA sequencing was used to detect bacterial translocation (BT). Hematoxylin eosin staining (HE) was used to detect morphological changes to the pancreas, intestine, and lung. And lung tissue wet/dry weight ratio (W/D ratio) was used to assess the extent of pulmonary edema. The expressions of LC3II and Beclin1 proteins were analyzed by western blot and immunofluorescence. Glutathione peroxidase (GPx), malondialdehyde (MDA), and superoxide dismutase (SOD) were used to assess oxidative stress in lung tissue. Results. Levels of TNF-α, IL-6, lipase, and amylase in the SAP group were significantly higher than those in the control group (). Histopathological score and W/D ratio of the lung in the SAP-BT(+) group were significantly higher than that in the SAP-BT(-) group (). LC3II expression was higher in the SAP-BT(-) group than that in the SAP-BT(+) group (). The results were consistent with those of LC3II immunofluorescence assay. The expression of Beclin1 was similar to that of LC3II (). MDA content in the SAP-BT(+) group was significantly higher than that in the SAP-BT(-) group (), whereas SOD and GPX activities were opposite (). Conclusions. BT can aggravate SAP-ALI with the increasing oxidative stress level, which may be related to the decrease of autophagy level.
Effect of Gender and Age on the Correlation between Helicobacter pylori and Colorectal Adenomatous Polyps in a Chinese Urban Population: A Single Center Study
Objectives. To investigate whether Helicobacter pylori (H. pylori) infection increases the risk of colorectal adenomatous polyp (CAP) in the context of age and gender. Methods. A total of 563 study subjects (male/female, 368/195) from Beijing, China, with higher nursing level who underwent colonoscopy were retrospectively collected. H. pylori and CAP were detected by carbon-13 urea breath test and colorectal colonoscopy. The correlations between the number, size, distribution, and pathological grade of CAP and H. pylori infection were analyzed. The population was further stratified by age and gender in order to examine the risk of H. pylori and CAP in the context of these variables. The influence of H. pylori on the risk of CAP was assessed by logistic regression model. Results. 315 participants were diagnosed with CAP, and 207 participants were classified as healthy controls. The prevalence of H. pylori in the CAP group was significantly higher than that in the healthy control group (119/315, 37.8% versus 44/207, 21.3%) (). The proportion of H. pylori positive plus CAP in participants <50 years old was significantly higher than that in participants >50 years old (87/250; 34.8% versus 32/65; 49.2%) (). Furthermore, H. pylori infection was identified as one of the major risk factors of CAP (; 95% CI: 1.717-4.179, ), independent of age, sex, and body mass index and was correlated with size, distribution, and pathological grading of CAP (). Conclusions. H. pylori is a major risk factor for CAP. Further studies are needed to assess the effects of H. pylori treatment or persistent infection on the occurrence or recurrence of CAP.
Abnormal Uroguanylin Immunoreactive Cells Density in the Duodenum of Patients with Diarrhea-Predominant Irritable Bowel Syndrome Changes following Fecal Microbiota Transplantation
Altered densities of enteroendocrine cells play an important role in patients with irritable bowel syndrome (IBS). Uroguanylin activates guanylate cyclase-C to regulate intestinal electrolyte and water transport. Aim. To quantify uroguanylin immunoreactive cells density in the duodenum of diarrhea-predominant IBS (IBS-D) patients compared to controls and to investigate the effect of fecal microbiota transplantation (FMT) on these cell densities. Method. Twelve patients with IBS-D according to Rome III criteria were included. The cause was identified as post infectious (PI, ) or idiopathic (). They completed the IBS-symptom questionnaire before and 3 weeks after FMT. Thirty grams of fresh feces donated from healthy relatives were diluted with 60 ml normal saline and instilled via endoscope into the duodenum. Biopsies were taken from the patients’ duodenum before and 3 weeks after FMT. Duodenal biopsies taken from eight healthy controls were also included. The biopsies were immunostained for uroguanylin and quantified using computerized image analysis. Results. Uroguanylin immunoreactive cells were found both in duodenal villi and crypts in both controls and IBS-D patients. The densities of uroguanylin immunoreactive cells were significantly lower in the villi () and higher in the crypts () for the patients than the controls. Following FMT, the densities of uroguanylin immunoreactive cells for the total group and idiopathic subgroup decreased significantly in the duodenal crypts ( and 0.04, respectively) but not in the villi. No significant changes were shown in the PI-IBS subgroups. The cells density in only the crypts correlated with diarrhea (, ) and bloating (, ) in the PI-IBS subgroup before FMT and with abdominal pain (, ) in the total group of IBS-D patients after FMT. Conclusion. Altered uroguanylin immunoreactive cells density was found in IBS-D patients compared to controls. Changes in these cells density following FMT correlated with IBS symptoms (diarrhea, bloating, and abdominal pain).
Suppression of IRE1α Attenuated the Fatty Degeneration in Parenteral Nutrition-Related Liver Disease (PNALD) Cell Model
Aims. To model the parenteral nutrition-associated liver disease (PNALD) in rat normal hepatocytes BRL and investigate the role of endoplasmic reticulum stress- (ERS-) related IRE1α signal in the process of PNALD. Methods. The BRL cells were treated with different concentrations of soybean oil emulsion (SO) to induce hepatocyte fatty degeneration. The PNALD cell disease model was further confirmed by analysis of Oil Red O staining and biochemical parameters. Next, the IRE1α was silenced by specific shRNAs via lentivirus and the role of IRE1α in anticytotoxicity and the expression level of ERS-related protein IRE1α and p-IRE1α were measured. Results. The results of Oil Red O staining indicated that the PNALD was successfully established in BRL cells and the CCK-8 data indicated which 0.6% that SO was further applied to the experiment owing to its better induction of PNALD and less toxicity to the cells. Besides, the value of biochemical parameters (TBIL, DBIL, ALT, and AST) was also elevated in the SO group compared with the NG group. After knockdown of IRE1α, the PNALD was also induced while the cells were more tolerant to SO. The less positive Oil Red O staining and reduced values of biochemical parameters were observed in the shIRE1α group when compared to the shControl, both of which accepted SO treatment. Conclusion. IRE1α was induced in PNALD cell model and suppression of IRE1α resulted in reduced steatosis in this cell disease model. Taken together, our data suggested that the IRE1α pathway may be involved in the development of PNALD.