The impact of early gastroscopy examination on cardiovascular event-related indices in elderly patients with acute upper gastrointestinal bleeding.

BACKGROUND: To observe the effects of early gastroscopy examination on cardiovascular event-related indicators such as heart rate (HR), blood pressure, and electrocardiogram (ECG) in elderly patients with acute upper gastrointestinal bleeding. METHODS: Sixty patients with upper gastrointestinal bleeding admitted from July 2022 to December 2022 were selected. Patients with relevant contraindications were excluded. All patients underwent early gastroscopy examination. Among them, 30 patients were aged 60 or above (elderly group) and 30 patients were aged below 60 (non-elderly group). Dynamic blood pressure and ECG recordings were obtained before, during, and after gastroscopy examination to assess changes in HR, blood pressure, and ECG. RESULTS: The HR and blood pressure levels of the elderly group were significantly lower than those of the non-elderly group before, during, and after gastroscopy examination (P < .05). In the elderly group, blood pressure and HR were higher during gastroscopy examination compared to before, but lower than during the examination afterward, with statistically significant differences (P < .05). The diastolic blood pressure was lower after the examination compared to before, with statistical significance, while the systolic blood pressure was lower, and the HR was higher after the examination, but without statistical significance (P > .05). In the non-elderly group, systolic blood pressure and HR were higher during gastroscopy examination compared to before, with statistically significant differences (P < .05), while diastolic blood pressure was higher but without statistical significance (P > .05). Blood pressure and HR were lower after the examination compared to during, with statistically significant differences (P < .05). The occurrence rates of ECG changes were 70% in the elderly group and 30% in the non-elderly group, with a statistically significant difference (χ2 = 5.45, P = .02 < .05). CONCLUSION: Early gastroscopy examination in elderly patients with gastrointestinal bleeding did not result in severe cardiovascular adverse events and was relatively safe. However, special attention should be given to the occurrence of cardiac arrhythmias.

A single nucleotide polymorphism of the interferon-γ gene and susceptibility to hepatitis B virus-related cirrhosis: a randomized controlled trial.

OBJECTIVE: This study aimed to explore the correlation between a single nucleotide polymorphism (SNP) of the interferon-γ (IFN-γ) gene and susceptibility to hepatitis B virus (HBV) -related cirrhosis in the Chinese population. METHOD: PCR-LDR was employed for the genotyping of two SNPs, rs1861494 and rs2069718, of the IFN-γ gene in 230 patients with HBV-related cirrhosis and 320 inactive HBsAg carriers without cirrhosis. It was then determined whether the Hardy-Weinberg (H-W) equilibrium was satisfied. The odds ratio (OR) and 95% confidence interval (CI) were analyzed using the chi-square test and univariate non-conditional logistic regression. Haplotypes were established using SHEsis and SNPStats online software and their interaction with non-genetic factors was analyzed. RESULTS: Compared with the AA genotype of rs1861494 SNP, AG+GG genotypes increased the risk of HBV-related cirrhosis. There was a significant difference in the distribution of A and G alleles between the case group and the control group (P<0.05). There was also a significant difference in the distribution of AA, AG, GG, AA, and AG+GG genotypes and A/G alleles between the case group and the control group (P<0.05). This indicated that the G allele may be a risk factor for HBV-related cirrhosis. By analyzing the different distribution of haplotypes in the case group and the control group, we observed significant differences in the distribution of AA, AG and GA haplotypes between the case and control groups (P<0.05). Haplotypes of the IFN-γ gene did not interact with other relevant factors. CONCLUSION: The G allele of rs1861494 SNP as well as AG and GG genotypes and G allele of rs2069718 SNP may be risk factors of HBV-related cirrhosis. The AA haplotype may be a protective factor for HBV-related cirrhosis, while the AG haplotype is a risk factor for HBV-related cirrhosis.

Wip 1 inhibits intestinal inflammation in inflammatory bowel disease.

Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn's disease (CD), is a chronically intestinal autoimmune disease, the pathological mechanisms of which are not very clear. Wild type p-53 induced phosphatase 1 (Wip1), a serine/threonine protein phosphatase, has been reported to negatively regulate the inflammation in sepsis. However, the role of Wip1 in IBD is not very clear. Therefore, colonic tissues and peripheral blood from patients with IBD and healthy controls were collected to analyzed mRNA and protein expression of Wip1 using the method of qPCR and immunohistochemistry. Immune cells of neutrophils, CD4+ T cells, CD8+ T cells, B cells, monocytes and intestinal epithelial cells were isolated to analyze Wip1 expression by means of qPCR. Expression of Wip 1 was analyzed after the cells were stimulated by various of cytokines. DSS-colitis model was induced on the wild type (WT) and Wip 1 knock out (Wip1-/-) mice, and cytokines expression were analyzed in intestinal lamina propria from WT and Wip1-/- mice. Neutrophil specific markers were examined in intestinal lamina propria from WT and Wip1-/- mice. Moreover, neutrophils were isolated from bone marrow of WT and Wip1-/- mice to examine neutrophil migration with or without inhibitors of signaling pathway in vitro. The expression of Wip 1 mRNA and protein were found to be significantly decreased in patients with active IBD compared with healthy controls. And Wip 1 was mainly expressed on neutrophils from peripheral blood and colonic tissues. Moreover, expression of Wip1 was significantly decreased on neutrophils after the stimulation of TNF-α and IFN-γ. Wip1-/- mice were more susceptible to DSS induced colitis compared to WT mice, and expressed more pro-inflammatory cytokines (e.g. TNF-α, IFN-γ, IL-17A, etc). Moreover, expression of neutrophil specific markers (e.g. Ly6G, CD11b, elastase, etc) was also increased in Wip1-/- mice. The migration of neutrophils from the bone marrow of Wip1 mice was marked increased, which was mediated by MAPK-P38 signaling pathway. Wip1 plays an importantly protective role in the pathogenesis of IBD. Therefore, Wip1 may be used a new targets in the treatment for IBD in the future.