Gastroenterology Research and Practice

INTRODUCTION: Balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography (BE-ERCP) is a useful therapeutic procedure that provides promising results in patients with surgically altered anatomy. However, biliary cannulation in BE-ERCP remains challenging. Therefore, in patients with Roux-en-Y gastrectomy, this study aimed to evaluate a BE-ERCP cannulation strategy that includes the newly developed alpha-retroflex scope position. METHODS: This was a retrospective review of 52 patients with Roux-en-Y gastrectomy who underwent BE-ERCP at two centers between April 2017 and December 2022...

BACKGROUND: Jejunostomy is the main form of enteral nutritional support after McKeown-type esophagectomy. However, this requires the jejunum to be secured to the abdominal wall, which can lead to catheter-related complications. Here, we present a new type of jejunostomy, ultra-proximal jejunostomy, which does not require fixation of the jejunum to the abdominal wall. METHODS: Patients who underwent McKeown-type esophagectomy between January 2021 and March 2022 were included in this study...

OBJECTIVE: To clarify the relationship between preoperative platelet count/(lymphocyte count × prealbumin count) ratio (PLPR) and the prognosis of patients with gastric cancer undergoing a radical operation, combined with Tumor Node Metastasis (TNM) staging, a scoring system was established to guide clinical application. METHODS: The clinical data of 238 patients receiving radical operations for gastric cancer were retrospectively analyzed. According to the area under the Receiver operating characteristic curve, the predictive value of the preoperative PLPR for the 5-year overall survival (OS) of gastric cancer was determined, and the best cut-off value of the ratio was corresponding to the maximum value of Yoden index...

AIM: In clinical practice, a considerable proportion of patients with chronic hepatitis B (CHB) who do not conform to any immune status are considered to be in the "indeterminate phase". In this study, we aim to study the clinical distribution characteristics and identification of significant liver inflammation in patients in indeterminate phase. METHODS: This study retrospectively analyze clinical data of 1226 patients with CHB at two medical centers in Zhejiang province...

Upper gastrointestinal postsurgical leaks are challenging to manage and often require radiological, endoscopic, or surgical intervention. Nowadays, endoscopy is considered the first-line approach for their management, however, there is no definite consensus on the most appropriate therapeutic approach. There is a wide diversity of endoscopic options, from close-cover-divert approaches to active or passive internal drainage approaches. Theoretically, all these options can be used alone or with a multimodality approach, as each of them has different mechanisms of action...

BACKGROUND: New serum pepsinogen (PG) criteria have been shown to indicate more accurately infection with Helicobacter pylori ( H. pylori ). We sought to improve risk classification for gastric cancer by adopting the new PG criteria with the addition of an H. pylori antibody test. METHODS: The study participants were 275 patients with gastric cancer and 275 apparently healthy controls from case-control study data. We cross-sectionally compared the results of gastric cancer risk classifications that were based on a combination of the new PG criteria (PG II ≥ 10 ng/mL or PG I/II ≤ 5) and an H...

OBJECTIVES: Acupuncture is therapeutic for refractory gastroesophageal reflux disease by an unclear mechanism. This study was aimed at investigating the effect of acupuncture on esophageal motility in patients with symptoms of refractory gastroesophageal reflux disease. METHODS: Sixty-eight patients with refractory gastroesophageal reflux disease symptoms were prospectively enrolled from August 2014 to December 2018 and randomized into acupuncture and control groups ( n = 33 and 35, respectively)...

Patients with end-stage renal disease (ESRD) have a five times higher risk of gastrointestinal bleed (GIB) and mortality than the general population. Aortic stenosis (AS) has been associated with GIB from intestinal angiodysplasia. In this retrospective analysis, we obtained data from the 2012 and 2019 National Inpatient Sample. The primary outcome of interest was all-cause in-hospital mortality and risk factors of mortality in patients with ESRD with GIB with aortic valve disorders especially AS. We identified all patients (≥18 years of age) with ESRD ( n = 1,707,452) and analyzed based on discharge diagnosis of valvular heart disease ( n = 6521) in patients with GIB compared with those without GIB ( n = 116,560)...

Inflammatory bowel disease (IBD) is a complex chronic immune disease with two subtypes: Crohn's disease and ulcerative colitis. Considering the differences in pathogenesis, etiology, clinical presentation, and response to therapy among patients, gastroenterologists mainly rely on endoscopy to diagnose and treat IBD during clinical practice. However, as exemplified by the increasingly comprehensive ulcerative colitis endoscopic scoring system, the endoscopic diagnosis, evaluation, and treatment of IBD still rely on the subjective manipulation and judgment of endoscopists...

AIMS: To evaluate the value of endoscopic screening during endoscopic submucosal dissection (ESD) in the detection of synchronous multiple early gastric cancer (SMEGC) and the risk factors for missed diagnosis of SMEGC. METHODS: We conducted gastric endoscopic screening during ESD operation in 271 patients with early gastric cancer (EGC) referred for ESD, and endoscopic follow-up within 1 year after the operation. The detection and characteristics of SMEGC were analyzed in three stages: before ESD, during ESD operation, and within 1 year after ESD...

BACKGROUND: Necrotizing enterocolitis (NEC) is often associated with exaggerated activation of inflammatory response. Astaxanthin has been shown in studies to have a positive and advantageous effect on anti-inflammatory response. Hence, it is of great significance to study the protective effect of astaxanthin in NEC disease and its molecular mechanism. OBJECTIVE: The present study was to investigate whether astaxanthin attenuates NEC rats and to explore its potential mechanism...

Liver fibrosis is a wound-healing response to chronic injury, which may result in cirrhosis and liver failure. Studies have been carried on the mechanisms and pathogenesis of liver fibrosis. However, the potential cell-specific expressed marker genes involved in fibrotic processes remain unknown. In this study, we combined a publicly accessible single-cell transcriptome of human liver with microarray datasets to evaluate the cell-specific expression patterns of differentially expressed genes in the liver. We noticed that EMP1 (epithelial membrane protein 1) is significantly active not only in CCl4 (carbon tetrachloride)-treated mouse liver fibrosis but also in BDL (bile duct ligation)-induced liver fibrosis and even in human fibrotic liver tissues such as alcoholic hepatitis, NASH (nonalcoholic steatohepatitis), and advanced stage liver fibrosis...

BACKGROUND: On September 5, 2019, British Columbia announced a new policy (the Biosimilars Initiative) to switch from originator to biosimilar infliximab for patients with inflammatory bowel diseases. OBJECTIVE: To monitor the impacts of the policy on the use of medications and health services during the first year of the policy. METHODS: In this population-based cohort study, we used administrative health data to construct three historical cohorts and one policy cohort of patients with inflammatory bowel diseases who used the originator infliximab...

OBJECTIVES: Endoscopic submucosal dissection (ESD) has become a well-established treatment method for gastric submucosal tumors (SMTs). However, there existed some challenges to perform ESD for prepyloric SMTs on account of the special location. Recently, submucosal tunneling endoscopic resection (STER) provided a novel option for prepyloric SMTs. This study aimed to make a comprehensive comparison between prepyloric STER (P-STER) and ESD for the treatment of prepyloric SMTs. METHODS: Patients with prepyloric SMTs undergoing P-STER treatment between January 2016 and October 2021 were retrospectively reviewed and individually matched at 1 : 1 ratio with those with ESD treatment according to lesion size, lesion location, pathologic diagnosis, lesion origin, and surgery date, forming P-STER and ESD group, respectively...

BACKGROUND AND AIMS: Most patients develop adhesions after abdominal surgery, some will be hospitalized with small bowel obstruction (SBO), and some also require surgery. The operations and follow-up are expensive, but recent data of costs are scarce. The aim of this study was to describe the direct costs of SBO-surgery and follow-up, in a population-based setting. The association between cost of SBO and peri- and postoperative data was also studied. METHODS: In a retrospective cohort study, all patients ( n = 402) operated for adhesive SBO in Gävleborg and Uppsala counties (2007-2012) were studied...

BACKGROUND: There is controversy regarding whether patients with single hepatocellular carcinoma (HCC) should be offered radiofrequency ablation (RFA) as a first-line treatment option. Thus, this study compared overall survival after surgical resection (SR) and RFA for single HCC. METHODS: The Surveillance, Epidemiology, and End Results (SEER) database was used for this retrospective study. The study included 30- to 84-year-old patients diagnosed with HCC from 2000 to 2018...

BACKGROUND AND AIMS: Currently sedation is a common practice in colonoscopy to reduce pain of patients and improve the operator satisfaction, whereas its impact on examination quality, especially adenoma detection rate (ADR) is still controversial. Thus, we aimed to investigate the association of sedation with ADR. METHODS: Consecutive patients receiving colonoscopy between January 2017 and January 2020 at the Nanjing Drum Tower Hospital, Nanjing, China, were collected...

BACKGROUND: Primary esophageal lymphoma (PEL) is a rare disorder. The objective of this study was to document the clinicopathological features of PEL at two tertiary hospitals in the western region of the Kingdom of Saudi Arabia. METHODS: All PELs diagnosed between May 2002 and June 2022 were retrieved. Histopathological and immunohistochemical slides were reviewed. Additional immunohistochemistry stains were performed in selected cases. Follow-up data were collected...

BACKGROUND: Gastrointestinal dysfunction is one of the most common non-motor symptoms in Parkinson's disease (PD). The exact mechanisms behind these symptoms are not clearly understood. Studies in the well-established 6-hydroxydopamine (6-OHDA) lesioned rats of PD have shown altered contractility in isolated circular and longitudinal smooth muscle strips of distal colon. Contractile changes in proximal colon and distal ileum are nevertheless poorly studied. Moreover, segments may serve as better tissue preparations to understand the interplay between circular and longitudinal smooth muscle...

Long noncoding RNAs are a novel class of regulators in human cancers. It has been reported that small nucleolar RNA hostgene 7 (SNHG7) can sponge microRNAs to regulate colorectal cancer (CRC) progression. Given its important regulatory role in cancer biology, we wondered whether SNHG7 is involved in drug resistance to anlotinib (ATB) in CRC. To answer this, we quantified the expression of SNHG7 by quantitative real-time PCR. We performed the Cell Counting Kit-8 and Colony formation assay, flow cytometric analysis, RNA pull-down, RNA-binding protein immunoprecipitation assay, and Luciferase reporter assay to confirm the interaction among SNHG7, miR-181a-5p, and GATA6...