Role of TNF-α -308G/A gene polymorphism in gastric cancer risk: A case control study and meta-analysis.

BACKGROUND/AIMS: In the Chinese population, gastric cancer (GC) is ranked as the third most common type of cancer. Although the exact etiology of GC development is unclear, several factors, including genetic and environmental, have been identified as risk factors. Variations in cytokine genes and their receptors have been related to a higher risk of GC. A single nucleotide polymorphism in the promoter region of tumor necrosis factor-α (TNF-α) (-308G>A) has been associated with a higher risk of GC and in the present study we evaluated its possible association with GC in a Chinese cohort. In addition, we performed a meta-analysis to draw a firm conclusion about the association between TNF-α gene polymorphisms and GC. MATERIALS AND METHODS: We enrolled 400 Chinese GC patients and matched healthy controls hailing from similar geographical areas. The TNF-α -308G/A polymorphism was genotyped by allele-specific polymerase chain reaction (AS-PCR). For the meta-analysis, earlier published articles were searched and eligible studies were included. RESULTS: Prevalence of the heterozygous mutant (GA) and minor allele (A) were significantly higher in GC cases compared to healthy controls (GA: p<0.0001, odds ratio (OR)=4.90; A: p<0.0001, OR=2.84). A total of 36 eligible studies including the present report, encompassing of 8353 GC patients and 12099 controls, were analyzed for the meta-analysis. A significant association of the TNF-α polymorphism (-308G>A) with susceptibility to GC was only found in the Caucasian population (A vs G: p=0.001; AA vs GG: p=0.01; AG vs GG: p<0.0001; AA vs AG+GG: p=0.01; AA+AG vs p=0.003). CONCLUSION: The results of the present case control study and meta-analysis showed that associations between TNF-a variants with susceptibility to GC development is population and ethnic specific.

[Treating Moderately Severe Acute Pancreatitis with Raw Rhubarbs by Intranasal Jejuna Injection: a Randomized Clinical Analysis].

Objective To observe clinical efficacy of raw rhubarbs (by intranasal jejuna injection) for moderately severe acute pancreatitis (MSAP) , and its effects on gastrointestinal tract and coagulation fibrinolysis. Methods Totally 84 MSAP patients were randomly assigned to the control group and the treatment group by random number table, 42 in each group. All patients received routine medica- tion. Enteral nutrition by intranasal jejuna injection was input under the endoscope within 48 h of onset. Pa- tients in the treatment group additionally used raw rhubarbs (by intranasal jejuna injection) , 100 mL each time, twice per day, with the treatment duration for 3 -7 days. The recovery of gastrointestinal tract func- tion (passage of gas by anus, recovery time of bowel sound, distension disappearance time, abdominal pain disappearance time) was observed, prothrombin time (PT) , activated partial thromboplastin time (APTT), thrombin time (TT) , fibrinogen (Fib) content, platelet (PLT) count, D-dimer (DD), protein C were determined. Clinical efficacy was assessed as well. Results Compared with the control group, time for gas passage by anus, recovery time of bowel sound, distension disappearance time, and ab- dominal pain disappearance time were shortened, PT, APTT, Fib content, thrombin time, and DD decreased, and protein C increased in the treatment group (P <0. 05). The incidence rate of complications was lower in the treatment group than in the control group (P <0. 05). The cure rate was elevated (P < 0. 05). There was no statistical difference in the total effective rate between the two groups (P >0. 05). Conclusion Intranasal jejuna injection of raw rhubarbs in treating moderately severe acute pancreatitis could improve symptoms of gastrointestinal tract and coagulation fibrinolysis.