Gastric mucormycosis presenting as diffuse thickening of the gastric wall with enhancement

We report the case of a 63-year-old woman who presented with abdominal distension and pain two months ago, which worsened after eating. An abdominal CT examination revealed uneven thickening of the gastric wall on the greater curvature side of the gastric body, with progressive obviously enhancement. She was then examined by an upper endoscopy, which showed mucosal swelling on the greater curvature side of the lower gastric body with exudation of necrotic materials. Biopsies of the lesion were taken and histological results revealed a large number of broad-based and non-septate hyphae, with positive expression of PAS (Periodic Acid-Schiff) and hexamine silver stains, The patient was treated with amphotericin B liposomal antifungal therapy and remained under surveillance for six months without evidence of disease progression by follow-up upper endoscopy. (AU)

The regulation roles of miRNAs in Helicobacter pylori infection

Helicobacter pylori is a kind of Gram-negative bacteria that parasitizes on human gastric mucosa. Helicobacter pylori infection is very common in human beings, which often causes gastrointestinal diseases, including chronic gastritis, duodenal ulcer and gastric cancer. MicroRNAs are a group of endogenous non-coding single stranded RNAs, which play an important role in cell proliferation, differentiation, autophagy, apoptosis and inflammation. In recent years, relevant studies have found that the expression of microRNA is changed after Helicobacter pylori infection, and then regulate the biological process of host cells. This paper reviews the regulation role of microRNAs on cell biological behavior through different signal pathways after Helicobacter pylori infection (AU)

Endoscopic submucosal dissection versus surgery for patients with undifferentiated early gastric cancer

Background and aims: endoscopic submucosal dissection (ESD) is the standard treatment for differentiated early gastric cancer (EGC). However, its expanded indication for undifferentiated EGC is controversial. In this study, the efficacy and safety of ESD versus surgery in patients with undifferentiated EGC were compared. Methods: four databases were searched until February 24, 2022, for studies assessing patients with undifferentiated EGC that met an expanded indication for endoscopic resection and who were treated with ESD or surgery. Primary outcomes were all-cause mortality and any recurrence. Secondary outcomes were complete histological resection, local recurrence, metachronous recurrence, synchronous recurrence, distant metastasis, overall complication, and bleeding. All meta-analyses were performed using a random-effects models. Unadjusted (risk ratio [RR]) and adjusted (aRR and hazard ratio [aHR]) estimates with 95 % confidence interval (CI) were calculated. Results: seven cohort studies were included (n = 2637). The use of ESD was significantly associated with higher all-cause mortality compared to surgery (RR, 2.17; 95 % CI, 1.24-3.81); adjusted all-cause mortality effects were not significant (aRR, 2.28; 95 % CI, 0.95-5.47 and aHR, 1.97; 95 % CI, 0.85-4.53). ESD was associated with a higher risk of any recurrence using unadjusted (RR, 5.24; 95 % CI, 1.49-18.46) and adjusted (aRR, 7.89; 95 % CI, 1.52-40.95 and aHR, 3.73; 95 % CI, 1.17-11.90) estimates. The risk of local recurrence, synchronous recurrence and bleeding were significantly higher for ESD versus surgery. No significant differences were found for other secondary outcomes. Conclusions: although ESD is associated with a higher risk of any recurrence, adjusted all-cause mortality is similar during follow-up. Overall complications were similar between ESD and surgery (AU)

The role of endoscopic submucosal dissection in the management of gastric inflammatory fibroid polyps: a single-center experience

Background and aim: gastric inflammatory fibroid polypsconstitute only 0.1 % of all gastric polyps. They are usually amenable to resection by snare polypectomy. However,on rare occasions, these lesions may require resection byendoscopic submucosal dissection. This study aimed toevaluate the effectiveness and safety of endoscopic submucosal dissection in the management of gastric inflammatory fibroid polyps not amenable to resection with snarepolypectomy.Methods: a retrospective observational study of all consecutive patients who underwent endoscopic submucosaldissection for gastric inflammatory fibroid polyps betweenJanuary 2011 and December 2020 was performed.Results: there were nine cases of gastric inflammatoryfibroid polyps resected by endoscopic submucosal dissection. Most patients were female (7/9) with a mean ageof 62.2 years. All gastric inflammatory fibroid polyps weredescribed as solitary antral subepithelial lesions with amean diameter of 16.7 mm, which appeared well-circumscribed and homogeneous lesions located at muscularismucosa and submucosa without deeper invasion on endoscopic ultrasound. All lesions were successfully resected byen bloc and complete resection with free margins obtainedin 8/9 specimens. Adverse events were reported in 2/9 casesincluding one intra-procedural bleeding successfully controlled with hemostatic clips and one aspiration pneumonia that evolved favorably. Mean follow-up duration was 33.7 months and no delayed complications or cases ofrecurrence were reported.Conclusions: endoscopic submucosal dissection appearssafe and effective for the resection of gastric inflammatoryfibroid polyps that present as large subepithelial lesions,if performed by experienced endoscopists after adequatecharacterization by endoscopic ultrasound, with high ratesof technical success and low recurrence rates. (AU)

Antiradical and antiulcer effect of Sonneratia apetala Buch-Ham leaves against alcohol induced gastric mucosal injury / Efecto antirradical y antiulceroso de las hojas de Sonneratia apetala Buch-Ham contra la lesión de la mucosa gástrica inducida por el alcohol

Introducción: Sonneratia apetala Buch-Ham es un verdadero habitante de los manglares en Sunderban indio y se utiliza en la medicina popular para los trastornos digestivos. Método: El extracto hidrometanólico (20:80) de hojas de Sonneratia apetala (SA) se estandarizó químicamente por HPTLC y se evaluó por sus propiedades antirradicales y gastroprotectoras. Se determinaron los fenólicos y flavonoides presentes en SA y se evaluaron las actividades antirradicales mediante métodos in vitro como, DPPH (1,1-difenil-2-picrilhidrazilo), óxidos nítricos, superóxidos, hidroxilo y ABTS (2,2 / -azino-bis- Ácido 3-etilbenztiazolin-6-sulfónico). Además, se evaluó la eficacia gastroprotectora de SA en la ulceración oxidativa inducida por alcohol (50% v / v, 5 ml / kg) en ratas. Resultados: El SA químicamente estandarizado mostró presencia de compuestos polifenólicos. También mostró fuertes propiedades antirradicales. Las administraciones orales de SA (125 mg / kg y 250 mg / kg) protegieron significativamente la membrana mucosa gástrica del daño ulcerativo causado por el alcohol, similar al omeprazol (20 mg / kg) en ratas. Además, el tratamiento con SA redujo significativamente la elevación de los peróxidos de lípidos; mientras que aumentó la concentración de glutatión y catalasa en la mucosa gástrica con respecto a las ratas de control no tratadas inducidas por etanol. Conclusiones: Los resultados obtenidos de este estudio sugieren que la hoja de Sonneratia apetala tiene propiedades antioxidantes y tiene capacidad para proteger la lesión de la mucosa gástrica causada por la ingestión de alcohol. (AU)

Introduction: Sonneratia apetala Buch-Ham is a true mangrove inhabitant in Indian Sunderban and it is used in folk medicine for digestive disorders. Method: Hydro-methanolic (20:80) extract of Sonneratia apetala leaves (SA) was chemically standardized by HPTLC and evaluated for its antiradical and gastro-protective properties. Phenolics and flavonoids present in SA were determined and antiradical activities were assessed by in vitro methods like, DPPH (1,1-diphenyl-2-picrylhydrazyl), nitric oxides, superoxides, hydroxyl and ABTS (2,2/-azino-bis-3-ethyl benzthiazoline-6-sulphonic acid). Further, gastro-protective efficacy of SA was assessed in alcohol (50% v/v, 5 ml/kg) induced oxidative ulceration in rats. Results: Chemically standardized SA exhibited presence of polyphenolic compounds. It also showed strong antiradical properties. Oral administrations of SA (125 mg/kg and 250 mg/kg) significantly protected gastric mucosal membrane from ulcerative damage caused by alcohol, similar to Omeprazole (20 mg/kg) in rats. Moreover, SA treatment significantly reduced the elevation of lipid peroxides; while enhanced the concentration of glutathione and catalase in gastric mucosa in respect to ethanol induced untreated control rats. Conclusions The results obtained from this study suggest Sonneratia apetala leaf has antioxidant properties and has capabilities to protect gastric mucosal injury caused by alcohol ingestion. (AU)

Propofol inhibited gastric cancer proliferation via the hsa-miR-328-3p/STAT3 pathway

Purpose The aim of the present study was to elucidate the functional role of hsa-miR-328-3p/STAT3 pathway in the effects of propofol on gastric cancer proliferation. Methods Bioinformatics was used to analyze the molecular expression differences of hsa-miR-328-3p/STAT3 axis in stomach adenocarcinoma (n = 435) and normal samples (n = 41) from TCGA database. The expression of the above molecules in gastric cancer cells SGC-7901 and normal gastric mucosal cells GES-1 was verified via qPCR. The dual-luciferase assay was carried out to confirm the interaction between hsa-miR-328-3p and STAT3. Subsequently, the cell proliferation and the expression of the above molecules in SGC-7901 and GES-1 cells were evaluated after 10 μM propofol treatment. Finally, we analyzed whether propofol still inhibited the proliferation of gastric cancer by suppressing STAT3 pathway after hsa-miR-328-3p down-regulation. Results Compared with normal samples, the expression of hsa-miR-328-3p was significantly down-regulated in stomach adenocarcinoma samples, while the expression of STAT3 and downstream target genes (MMP2, CCND1 and COX2) was up-regulated. The results were consistent with those in GES-1 and SGC-7901 cell lines. Meanwhile, we found that hsa-miR-328-3p can bind to the 3′-UTR of the potential target gene STAT3. Furthermore, propofol significantly inhibited the proliferation of gastric cancer cell line SGC-7901, where hsa-miR-328-3p was up-regulated and the expression of STAT3 and downstream proliferation-related target genes were down-regulated. However, the growth inhibition of propofol on SGC-7901 cell was significantly reversed after the inhibition of hsa-miR-328-3p. Conclusions To sum up, propofol suppressed the STAT3 pathway via up-regulating hsa-miR-328-3p to inhibit gastric cancer proliferation (AU)

Sangrado digestivo masivo por heterotopia gástrica. Reporte de un caso / Massive digestive bleeding as a result of gastric heterotopy: a case repor

Introducción: La heterotopia gástrica es una entidad infrecuente enla población pediátrica. Se presenta en el tracto gastrointestinal llevandoa cuadros clínicos de sangrado digestivo. Caso clínico: Se reporta el caso de un escolar de 10 años, el cualpresentó tejido gástrico en el yeyuno proximal, originando sangradodigestivo masivo en dos ocasiones. La secuencia de apoyos diagnósti-cos requirió cápsula endoscópica, enteroscopia y biopsia. Fue llevadoa laparotomía y resección de la lesión. En el seguimiento al año semantuvo asintomático. Discusión: Su abordaje genera un reto diagnóstico. Debido a suinfrecuente presentación no hay un consenso global para el tratamien-to, sin embargo, la intervención quirúrgica es la terapia definitiva. Eneste caso no se hizo resección intestinal y anastomosis sino resecciónde la pared intestinal comprometida. No se reportó malignidad en laliteratura revisada.(AU)

Introduction: Gastric heterotopy is a rare entity in the pediatricpopulation. It occurs in the gastrointestinal tract, leading to digestivebleeding. Clinical case: This is the case of a 10-year-old boy with gastrictissue in the proximal jejunum, which caused two massive digestivebleeding episodes. Diagnostic techniques included endoscopic capsule,enteroscopy, and biopsy. The patient was scheduled for laparotomyand resection. After one year of follow-up, he remained asymptomatic. Discussion: Gastric heterotopy approach represents a diagnosticchallenge. Owing to how rare it is, there is no global consensus in termsof treatment. However, surgery is the definitive therapy. In this case,decision was made not to perform intestinal resection and anastomosis,but resection of the compromised intestinal wall. No malignity wasreported in the literature reviewed.(AU)

Hemangioma capilar duodenal como causa atípica de ferropenia. Caso clínico / Duodenal capillary hemangioma as an atypical cause of iron deficiency. Case report

Los hemangiomas son tumores gastrointestinales de naturaleza vascular y benignos. Son infrecuentes, se localizan en la submucosa, y su presentación varía desde casos asintomáticos hasta casos con obstrucción intestinal, anemia o ferropenia. Su diagnóstico inicial suele ser endoscópico a pesar de no presentar características patognomónicas. Tradicionalmente su tratamiento ha sido quirúrgico, si bien en la actualidad es posible su resección endoscópica. Presentamos un caso de ferropenia resuelta tras resección endoscópica de un hemangioma capilar duodenal

Hemangiomas are benign vascular gastrointestinal tumours. They are infrequent, located in the submucosa, and can be asymptomatic or cause intestinal obstruction, anaemia or ferropenia. Their initial diagnosis is usually endoscopic despite the absence of pathognomonic features. Traditionally their treatment has been surgical although endoscopic resection is now possible. We present a case of ferropenia resolved after endoscopic resection of a capillary duodenal hemangioma

miR-144-3p increases radiosensibility of gastric cancer cells by targeting inhibition of ZEB1

Purpose This study set out to probe into the effect and mechanism of miR-144-3p on radiosensitivity of gastric cancer (GC) cells. Methods Cancer tissue and paracancerous tissue of GC patients admitted to our hospital were collected, their miR-144-3p expression was tested, GC cells were transfected, and survival and biological behavior of those cells under radiation were detected. Results After detection, miR-144-3p expression was down-regulated in GC tissue, while ZEB1 was up-regulated. There was no remarkable difference in the survival fraction of cells in each group before receiving radiation, but that of tumor cells decreased obviously (p < 0.05) after radiation exposure. Survival fraction of cells overexpressing miR-144-3p or silencing ZEB1 decreased more obviously, while the inhibition of miR-144-3p or overexpressing ZEB1 was weaker. Biological behavior of cells under 6 Gy radiation was detected. It was found that miR-144-3p overexpression or silencing ZEB1 dramatically inhibited the proliferation activity of GC cells under 6 Gy radiation, increased the levels of pro-apoptotic Bax and caspase-3 proteins (p < 0.05) and decreased the anti-apoptotic protein Bcl-2 level (p < 0.05), resulting in an increase in the apoptosis rate of cells. miR-144-3p was confirmed to be ZEB1 targeting site by dual luciferase report. Moreover, rescue experiments prove that it can increase the radiosensitivity of GC cells by regulating ZEB1 expression. Conclusion miR-144-3p expression was down-regulated in GC, and it can increase the radiosensitivity of those cells by inhibiting ZEB1 expression (AU)