Efficacy analysis of the empathy-based attribution analysis-cognitive restructuring-pharmacological treatment model in the management of globus syndrome.

OBJECTIVE: The aim of this study is to investigate the clinical efficacy of the empathy-based attribution analysis-cognitive restructuring-pharmacological treatment model for the management of globus syndrome. METHOD: Sixty-nine newly diagnosed patients with globus syndrome at the Wenzhou People's Hospital Department of Gastroenterology outpatient clinic were enrolled in this study. After obtaining informed consent, patients were randomly assigned to either the observation group (attribution analysis-cognitive restructuring-classical pharmacotherapy; n = 35) or the control group (pharmacotherapy alone; n = 34), with a treatment course of 4 weeks. Efficacy assessments were conducted before and during treatment using the 9-item Patient Health Questionnaire-9 (PHQ-9), the 7-item Generalized Anxiety Disorder-7 (GAD-7), and the Patient Health Questionnaire-15 (PHQ-15). RESULTS: After four weeks of treatment, the total efficacy rate was 100 % in the observation group and 27.6 % in the control group, with a statistically significant difference between the groups (P < 0.05). Scores on the PHQ-9, GAD-7, and PHQ-15 significantly improved in the observation group compared to before treatment and were better than those in the control group, with statistically significant differences (P < 0.05). CONCLUSION: The empathy-based attribution analysis-cognitive restructuring-pharmacological treatment model for the management of globus syndrome demonstrated good clinical efficacy, providing strong evidence for further clinical promotion.

Assessing the predictive efficacy of noninvasive liver fibrosis indices and portal vein diameter in predicting esophageal variceal bleeding in patients with cirrhosis.

BACKGROUND: The objective of this study is to evaluate the diagnostic accuracy of noninvasive serum liver fibrosis markers and portal vein diameter (PVD) in predicting the occurrence of esophageal variceal bleeding (EVB) in patients with cirrhosis. METHODS: A cohort comprising 102 individuals diagnosed with cirrhosis was divided into two groups: the P group (without EVB) and the PE group (with EVB). We conducted a comprehensive analysis comparing various noninvasive serum liver fibrosis indices, the Child-Pugh classification, ratios of aspartate aminotransferase to alanine aminotransferase, aspartate aminotransferase to platelet ratio index, fibrosis index based on four factors (FIB-4), PVD, and spleen thickness (SPT) between these groups. Receiver operating characteristic (ROC) curves were constructed for variables showing significant differences between the two groups, with subsequent calculation of the area under the ROC curve (AUROC) for each variable. RESULTS: Significant distinctions were noted in the serum liver fibrosis markers between the P and PE groups, encompassing hyaluronic acid (HA), type III procollagen (PC-III), type IV collagen (IV-C), PVD, SPT, and FIB-4 (p < 0.05), as evidenced by univariate analysis findings. The respective AUROC values for these markers were 0.653, 0.706, 0.710, 0.730, 0.660, and 0.633. Additionally, upon integration with PVD, SPT, and FIB4, the AUROC values for liver fibrosis markers surged to 0.793, 0.763, and 0.706 correspondingly, highlighting the enhanced diagnostic potential. CONCLUSION: The integration of noninvasive liver fibrosis indices and PVD showcased remarkable diagnostic potential in EVB, underscoring its clinical relevance in predicting hemorrhagic events.

The impact of depression-mediated gut microbiota composition on Irritable Bowel Syndrome: A Mendelian study.

OBJECTIVE: This study uses a two-sample Mendelian randomization (MR) analysis to delineate the causal influence of gut microbiota on the occurrence of irritable bowel syndrome (IBS), concurrently assessing the potential mediating function of depression within this framework. METHODS: Several two-sample MR methods were used to assess the causal repercussions of gut microbiota on the onset of both IBS and depression. Following this, gut microbiota and depression, which demonstrated notable causal associations, were integrated as exposure variables in a multivariable Mendelian randomization (MVMR) framework to construct a model encompassing gut microbiota, depression, and IBS. Mediation effects were assessed by examining the indirect pathway of gut microbiota → depression → IBS. RESULTS: Two-sample MR analysis unveiled a statistically significant causal association (P < 0.05) between specific bacterial group within the gut microbiota, notably p_Actinobacteria(OR = 0.829225), c_Clostridia(OR = 0.798897), s_Desulfovibrio_piger(OR = 1.163912), g_Streptococcus(OR = 1.132735), c_Actinobacteria(OR = 0.829224), and the onset of IBS. In the MVMR analysis, the relationship between depression and IBS was significant across Model 3, Model 7, Model 8, and Model 13 (P < 0.05). Assessment of mediation effects revealed that c_Clostridia and o_Clostridiales indirectly impacted IBS through depression, with masking effect ratios of 168.46 % and 168.44 %, respectively. CONCLUSION: These findings underscore a resilient causal association between the composition of gut microbiota and the initiation of IBS. Furthermore, depression serves as a mediator for particular groups of gut bacteria, thereby contributing to the development of IBS. These observations imply that interventions targeting mental health may potentially alleviate the risk of IBS onset attributable to adverse configurations of gut microbiota.

Comprehensive analysis of circular RNA-associated competing endogenous RNA networks and immune infiltration in gastric cancer.

BACKGROUND: Circular RNA (circRNA) has been proved to be an important regulator of gastric cancer (GC). However, the role and regulatory mechanism of circrna related competitive endogenous RNA (ceRNA) in GC have not been established. METHODS: CircRNA data and clinical data were obtained from the GEO and TCGA databases. The ceRNA networks were constructed and a function enrichment analysis was completed. Additionally, correlations between hub genes expression, immune cell infiltration, and clinical phenotypes were determined. The differentially expressed circRNAs and their downstream microRNAs (miRNAs) were validated by quantitative real-time polymerase chain reaction, and the hub genes were validated by western blot analysis. The migration and invasion ability of overexpressed hsa_circ_0002504 was determined by a transwell assay. RESULTS: The ceRNA network contained 2 circRNAs, 3 miRNAs, and 55 messenger RNAs (mRNAs). 323 biological processes terms, 53 cellular components terms, 51 molecular functions terms, and 4 signaling pathways were revealed by the function enrichment analysis. The GSEA analysis revealed that the hub genes were positively correlated with the axon guidance and adhesion molecules pathways. The correlation analysis revealed that overexpressed EPHA4 and KCNA1 indicated poor tissue differentiation and were associated with clinically advanced stages of GC. The in vitro experiments showed that hsa_circ_0002504 was significantly down-regulated in GC cell lines. In addition, the overexpression of hsa_circ_0002504 led to a significant downregulation of hsa-miR-615-5p and hsa-miR-767-5p, as well as an upregulation of EPHA4, KCNA1, and NCAM1. Furthermore, it suppressed the migration and invasion ability of GC cells. CONCLUSIONS: Hsa_circ_0002504 is a potential diagnostic biomarker for GC. High expression of EPHA4 and KCNA1 may indicate poor prognosis.

Factors Affect the Eradication Rate of Helicobacter pylori by Modified Quadruple Therapy: A Prospective Cohort Study.

Objective: This study aimed to investigate related factors affecting the eradication rate of Helicobacter pylori (Hp) by modified quadruple therapy. Methods: Between September 2020 and March 2021, 341 patients who were diagnosed with Hp infection and whose infections were confirmed by gastroscopy, a histological examination, and a C13-UBT without culturing and antimicrobial susceptibility studies received a two-week anti-Hp treatment, a modified quadruple therapy, in our department. The result of C13-UBT was rechecked 4 weeks after the drug withdrawal, and the patients were divided into two groups-a success group and a failure group-according to the final breath result. The general clinical information and related laboratory indexes of each patient were collected, and the factors affecting the eradication rate were analyzed. Results: The total clinical eradication rate was 80.06% (273/341), and the failure rate was 19.94% (68/341), correspondingly. Univariate analysis identified statistically significant differences between the two groups in serum 25-hydroxyvitamin D levels, presence of oral diseases, positive cytotoxin-associated gene A (CagA), and medical compliance (P < 0.05). Meanwhile, the use of a proton pump inhibitor (PPIs) and antibiotics was statistically different (P < 0.05). Logistic regression analysis revealed that vitamin D level (<20 ng/mL) [OR = 98.56, 95% CI (29.01-334.83), P < 0.001] and medical compliance [OR = 148.18, 95% CI (37.64-583.33), P < 0.001] were independent effecting factors for eradication rate. Conclusion: Serum 25-hydroxyvitamin D level lower than 20 ng/mL may affect the success of eradication of Hp and is an independent risk factor for eradication failure.

The Relationship Between Upper Esophageal Sphincter Pressure and Psychological Status in Patients with Globus Sensation.

OBJECTIVE: To explore the correlation between changes in esophageal pressure and psychological status in patients with globus sensation. METHODS: A total of 40 patients with globus sensation who attended Wenzhou People's Hospital between August 2020 and February 2021 were divided into two groups based on the results of esophageal manometry: a high-pressure group and a non-high-pressure group. The duration of disease, clinical symptom score, and self-rating anxiety scale (SAS) were compared between the two groups to determine the relationship between changes in esophageal pressure and psychological status. RESULTS: All the patients before treatment were divided into a high-pressure group (n = 14) and a non-high-pressure group (n = 26) according to whether the resting pressure of the upper esophageal sphincter (UES) was greater than 104 mmHg. The differences between the high-pressure group and non-high-pressure group in duration of disease, clinical symptom score, and SAS were statistically significant (all P < 0.05). Anxiety was present in 12 patients in the high-pressure group and two patients in the non-high-pressure group. The difference between the the high-pressure group and non-high-pressure group in the incidence of anxiety was statistically significant (χ2 = 21.04 and P < 0.001). Pearson correlation analysis of the association between esophageal pressure and anxiety resulted in R = 0.74 and P < 0.001. CONCLUSION: Patients with globus sensation who develop anxiety were more likely to have high pressure in the upper esophageal sphincter.