The Lactulose Breath Test Can Predict Refractory Gastroesophageal Reflux Disease by Measuring Bacterial Overgrowth in the Small Intestine.

OBJECTIVE: The diagnosis of RGERD in patients typically involves 24-hour esophageal pH monitoring, but due to its invasiveness and low patient compliance, new screening methods are needed. In this study, a lactulose breath test (LBT) was conducted to detect the growth of small intestine bacteria (SIBO) and explore the potential relationship between LBT and RGERD to identify a new treatment method for RGERD. METHODS: A total of 178 patients with gastroesophageal reflux were enrolled from June 2020 to December 2022 in the Gastroenterology Department, Building 3, the First Affiliated Hospital of Kunming Medical University; these patients included 96 patients with nonrefractory GERD (NRGERD) and 82 patients with RGERD. The Gerd Q score, reflux symptom index (RSI) score, gastroscopy results, clinical symptoms, and other related indicators were collected. Statistical methods were used to analyze the gathered data. RESULTS: The incidence of acid reflux and heartburn in patients with RGERD was significantly greater than that in patients with NRGERD (67.10% vs. 42.70%, P<0.01 and 65.00% vs. 34.40%, P<0.01). The CH4 values of patients with RGERD were significantly greater than those of patients with NRGERD at each time point, and there was a correlation between the CH4 values at 60 min and RGERD (P<0.05). For patients with RGERD, the incidence of abdominal pain, acid regurgitation, and heartburn was greater in the CH4-positive group than in the CH4-negative group (61.90% vs. 57.50%, 69.05% vs. 65.00%, 69.05% vs. 57.50%, P>0.05). The incidence of nausea was also greater in the CH4-positive group than in the CH4-negative group (61.90% vs. 35.00%, P<0.05). CONCLUSION: Increased CH4 levels are correlated with RGERD. In addition, patients with RGERD may develop SIBO after long-term use of PPIs, and interventions involving SIBO could provide new ideas for the treatment of RGERD.

Long non­coding RNA RP11­400N13.3 promotes the progression of colorectal cancer by regulating the miR­4722­3p/P2RY8 axis.

Accumulating evidence has shown that long non­coding RNAs (lncRNAs) play significant roles in the development and progression of many types of cancer including colorectal cancer. RP11­400N13.3 is a novel lncRNA discovered recently and its biological function and underlying mechanism in colorectal cancer remain elusive. This study aimed to reveal the relationship between RP11­400N13.3 and colorectal cancer. Our results demonstrated that the expression of RP11­400N13.3 was significantly upregulated in both colorectal cancer tissues and cell lines as compared to normal adjacent tissues and normal colonic epithelial cells by RT­qPCR, respectively. Upregulation of RP11­400N13.3 was found to be correlated with a poor overall survival rate. Functional studies revealed that RP11­400N13.3 facilitated the proliferation, migration, invasion and tumor growth of colorectal cancer cells while inhibiting the apoptosis of cancer cells in vitro and in vivo. We also observed that RP11­400N13.3 serves as a sponge for miR­4722­3p, and that P2Y receptor family member 8 (P2RY8) was predicted to be a target of miR­4722­3p by bioinformatics analysis. Western blot assay indicated that the expression of P2RY8 was negatively or positively regulated by miR­4722­3p or RP11­400N13.3. In addition, rescue experiments revealed that RP11­400N13.3 promoted proliferation, migration and invasion by directly regulating the expression of miR­4722­3p and P2RY8. In conclusion, our results revealed that RP11­400N13.3 promoted colorectal cancer progression via modulating the miR­4722­3p/P2RY8 axis, thus suggesting RP11­400N13.3 as a potential therapeutic target for the treatment of colorectal cancer.

Two new monoterpenoid indole alkaloids from the leaves and twigs of Ochrosia borbonica.

Two new monoterpenoid indole alkaloids, ochrobonines A (1) and B (2), together with five known compounds (3-7), were isolated from the leaves and twigs of Ochrosia borbonica. Their structures were determined by spectroscopic method, and the absolute configuration of compound 3 was first established by single-crystal X-ray diffraction. Compounds 1 and 2 represent a rare class of monoterpenoid indole alkaloids that with a 2-[1-(3-ethylpiperidin-4-yl)vinyl]-3-methyl-1H-indole skeleton.