Clinical manifestation, lifestyle, and treatment patterns of chronic erosive gastritis: A multicenter real-world study in China.

BACKGROUND: Although chronic erosive gastritis (CEG) is common, its clinical characteristics have not been fully elucidated. The lack of consensus regarding its treatment has resulted in varied treatment regimens. AIM: To explore the clinical characteristics, treatment patterns, and short-term outcomes in CEG patients in China. METHODS: We recruited patients with chronic non-atrophic or mild-to-moderate atrophic gastritis with erosion based on endoscopy and pathology. Patients and treating physicians completed a questionnaire regarding history, endoscopic findings, and treatment plans as well as a follow-up questionnaire to investigate changes in symptoms after 4 wk of treatment. RESULTS: Three thousand five hundred sixty-three patients from 42 centers across 24 cities in China were included. Epigastric pain (68.0%), abdominal distension (62.6%), and postprandial fullness (47.5%) were the most common presenting symptoms. Gastritis was classified as chronic non-atrophic in 69.9% of patients. Among those with erosive lesions, 72.1% of patients had lesions in the antrum, 51.0% had multiple lesions, and 67.3% had superficial flat lesions. In patients with epigastric pain, the combination of a mucosal protective agent (MPA) and proton pump inhibitor was more effective. For those with postprandial fullness, acid regurgitation, early satiety, or nausea, a MPA appeared more promising. CONCLUSION: CEG is a multifactorial disease which is common in Asian patients and has non-specific symptoms. Gastroscopy may play a major role in its detection and diagnosis. Treatment should be individualized based on symptom profile.

Chemotherapy effect on myocardial fibrosis markers in patients with gynecologic cancer and low cardiovascular risk.

Background: Patients with gynecologic cancers experience side effects of chemotherapy cardiotoxicity. We aimed to quantify cardiac magnetic resonance (CMR) markers of myocardial fibrosis in patients with gynecologic cancer and low cardiovascular risk who undergo chemotherapy. Methods: This study is part of a registered clinical research. CMR T1 mapping was performed in patients with gynecologic cancer and low cardiovascular risk undergoing chemotherapy. The results were compared with those of age-matched healthy control subjects. Results: 68 patients (median age = 50 years) and 30 control subjects were included. The median number of chemotherapy cycles of patients was 9.0 (interquartile range [IQR] 3.3-17.0). Extracellular volume fraction (ECV) (27.2% ± 2.7% vs. 24.5% ± 1.7%, P < 0.001) and global longitudinal strain (-16.2% ± 2.8% vs. -17.4% ± 2.0%, P = 0.040) were higher in patients compared with controls. Patients with higher chemotherapy cycles (>6 cycles) (n=41) had significantly lower intracellular mass indexed (ICMi) compared with both patients with lower chemotherapy cycles (≤6 cycles) (n=27) (median 27.44 g/m2 [IQR 24.03-31.15 g/m2] vs. median 34.30 g/m2 [IQR 29.93-39.79 g/m2]; P = 0.002) and the control group (median 27.44 g/m2 [IQR 24.03-31.15 g/m2] vs. median 32.79 g/m2 [IQR 27.74-35.76 g/m2]; P = 0.002). Patients with two or more chemotherapy regimens had significantly lower ICMi compared with both patients with one chemotherapy regimen (27.45 ± 5.16 g/m2 vs. 33.32 ± 6.42 g/m2; P < 0.001) and the control group (27.45 ± 5.16 g/m2 vs. 33.02 ± 5.52 g/m2; P < 0.001). The number of chemotherapy cycles was associated with an increase in the ECV (Standard regression coefficient [ß] = 0.383, P = 0.014) and a decrease in the ICMi (ß = -0.349, P = 0.009). Conclusion: Patients with gynecologic cancer and low cardiovascular risk who undergo chemotherapy have diffuse extracellular volume expansion, which is obvious with the increase of chemotherapy cycles. Myocyte loss may be part of the mechanism in patients with a higher chemotherapy load. Clinical trial registration: http://www.chictr.org.cn, identifier ChiCTR-DDD-17013450.

Myocardial edema during chemotherapy for gynecologic malignancies: A cardiac magnetic resonance T2 mapping study.

Objective: Myocardial edema is an early manifestation of chemotherapy-related myocardial injury. In this study, we used cardiac magnetic resonance (CMR) T2 mapping to assess myocardial edema and its changes during chemotherapy for gynecologic malignancies. Methods: We enrolled 73 patients receiving chemotherapy for gynecologic malignancies, whose the latest cycle was within one month before the beginning of this study, and 41 healthy volunteers. All participants underwent CMR imaging. Of the 73 patients, 35 completed CMR follow-up after a median interval of 6 (3.3 to 9.6) months. The CMR sequences included cardiac cine, T2 mapping, and late gadolinium enhancement. Results: Myocardial T2 was elevated in patients who were treated with chemotherapy compared with healthy volunteers [41ms (40ms to 43ms) vs. 41ms (39ms to 41ms), P = 0.030]. During follow-up, myocardial T2 rose further [40ms (39ms to 42ms) vs. 42.70 ± 2.92ms, P < 0.001]. Multivariate analysis showed that the number of chemotherapy cycles was associated with myocardial T2 elevation (ß = 0.204, P = 0.029). After adjustment for other confounders, myocardial T2 elevation was independently associated with a decrease in left ventricular mass (ß = -0.186; P = 0.024). Conclusion: In patients with gynecologic malignancies, myocardial edema developed with chemotherapy cycles increase, and was associated with left ventricular mass decrease. T2 mapping allows the assessment of myocardial edema and monitoring of its change during chemotherapy.

Myocardial microvascular function assessed by CMR first-pass perfusion in patients treated with chemotherapy for gynecologic malignancies.

OBJECTIVES: Cancer chemotherapy potentially increases the risk of myocardial ischemia. This study assessed myocardial microvascular function by cardiac magnetic resonance (CMR) first-pass perfusion in patients treated with chemotherapy for gynecologic malignancies. METHODS: A total of 81 patients treated with chemotherapy for gynecologic malignancies and 39 healthy volunteers were prospectively enrolled and underwent CMR imaging. Among the patients, 32 completed CMR follow-up, with a median interval of 6 months. The CMR sequences comprised cardiac cine, rest first-pass perfusion, and late gadolinium enhancement. RESULTS: There were no significant differences in the baseline characteristics between the patients and normal controls (all p > 0.05). Compared with the normal controls, the patients had a lower myocardial perfusion index (PI) (13.62 ± 2.01% vs. 12% (11 to 14%), p = 0.001) but demonstrated no significant variation with an increase in the number of chemotherapy cycles at follow-up (11.79 ± 2.36% vs. 11.19 ± 2.19%, p = 0.234). In multivariate analysis with adjustments for clinical confounders, a decrease in the PI was independently associated with chemotherapy treatment (ß = - 0.362, p = 0.002) but had no correlation with the number of chemotherapy cycles (r = - 0.177, p = 0.053). CONCLUSION: Myocardial microvascular dysfunction was associated with chemotherapy treatment in patients with gynecologic malignancies, and can be assessed and monitored by rest CMR first-pass perfusion. KEY POINTS: • Chemotherapy was associated with but did not aggravate myocardial microvascular dysfunction in patients with gynecologic malignancies. • Rest CMR first-pass perfusion is an ideal modality for assessing and monitoring alterations in myocardial microcirculation during chemotherapy treatment.

Relationship between clinical features and intestinal microbiota in Chinese patients with ulcerative colitis.

BACKGROUND: Dysbacteriosis may be a crucial environmental factor for ulcerative colitis (UC). Further study is required on microbiota alterations in the gastrointestinal tract of patients with UC for better clinical management and treatment. AIM: To analyze the relationship between different clinical features and the intestinal microbiota, including bacteria and fungi, in Chinese patients with UC. METHODS: Eligible inpatients were enrolled from January 1, 2018 to June 30, 2019, and stool and mucosa samples were collected. UC was diagnosed by endoscopy, pathology, Mayo Score, and Montreal classification. Gene amplicon sequencing of 16S rRNA gene and fungal internal transcribed spacer gene was used to detect the intestinal microbiota composition. Alpha diversity, principal component analysis, similarity analysis, and Metastats analysis were employed to evaluate differences among groups. RESULTS: A total of 89 patients with UC and 33 non-inflammatory bowel disease (IBD) controls were enrolled. For bacterial analysis, 72 stool and 48 mucosa samples were obtained from patients with UC and 21 stool and 12 mucosa samples were obtained from the controls. For fungal analysis, stool samples were obtained from 43 patients with UC and 15 controls. A significant difference existed between the fecal and mucosal bacteria of patients with UC. The α-diversity of intestinal bacteria and the relative abundance of some families, such as Lachnospiraceae and Ruminococcaceae, decreased with the increasing severity of bowel inflammation, while Escherichia-Shigella showed the opposite trend. More intermicrobial correlations in UC in remission than in active patients were observed. The bacteria-fungi correlations became single and uneven in patients with UC. CONCLUSION: The intestinal bacteria flora of patients with UC differs significantly in terms of various sample types and disease activities. The intermicrobial correlations change in patients with UC compared with non-IBD controls.

Ballistic thermal transport by phonons in three dimensional periodic nanostructures.

Ballistic thermal transport properties by phonons in three dimensional (3D) periodic nanostructures is investigated. Results show that thermal transport properties in 3D periodic nanostructures can be efficiently tuned by modulating structural parameters of systems. When the incident frequency is below the first cutoff frequency, the quasi/formal-periodic oscillations of the transmission coefficient versus the periodic number/length can be observed. When the incident frequency is above the first cutoff frequency, however, these quasi/formal-periodic oscillations cannot be observed. As the periodic number is increased, the thermal conductance undergoes a prominent transition from the decrease to the constant. We also observe other intriguing physics properties such as stop-frequency gaps and quantum thermal conductance in 3D periodic nanostructures. Some similarities and differences between 2D and 3D periodic systems are identified.

Cdc20 mediates D-box-dependent degradation of Sp100.

Cdc20 is a co-activator of the anaphase-promoting complex/cyclosome (APC/C complex), which recruits substrates at particular phases of the cell cycle and mediates their degradation. Sp100 is a PML-NB scaffold protein, which localizes to nuclear particles during interphase and disperses from them during mitosis, participates in viral resistance, transcriptional regulation, and apoptosis. However, its metabolism during the cell cycle has not yet been fully characterized. We found a putative D-box in Sp100 using the Eukaryotic Linear Motif (ELM) predictor database. The putative D-box of Sp100 was verified by mutational analysis. Overexpression of Cdc20 resulted in decreased levels of both endogenous Sp100 protein and overexpressed Sp100 mRNA in HEK 293 cells. Only an overexpressed D-box deletion mutant of Sp100 accumulated in HEK293 cells that also overexpressed Cdc20. Cdc20 knockdown by cdc20 specific siRNA resulted in increased Sp100 protein levels in cells. Furthermore, we discovered that the Cdc20 mediated degradation of Sp100 is diminished by the proteasome inhibitor MG132, which suggests that the ubiquitination pathway is involved in this process. However, unlike the other Cdc20 substrates, which display oscillating protein levels, the level of Sp100 protein remains constant throughout the cell cycle. Additionally, both overexpression and knockdown of endogenous Sp100 had no effect on the cell cycle. Our results suggested that sp100 is a novel substrate of Cdc20 and it is degraded by the ubiquitination pathway. The intact D-box of Sp100 was necessary for this process. These findings expand our knowledge of both Sp100 and Cdc20 as well as their role in ubiquitination.

[Clinical and pathological analysis on ovarian granulosa cell tumors].

OBJECTIVE: To identify different clinical and pathological features for adult and juvenile granulosa cell tumors. METHODS: The clinical records of 42 patients with granulosa cell tumors of ovary, including pathological features, treatments and follow up results between April 2001 and September 2009 were reviewed. RESULTS: 1) There were 38 newly diagnosed cases after 2001, and 4 cases were relapsed cases diagnosed before 2001. The 38 cases accounted for 3.13% of ovarian cancer cases treated in our hospital. 2) Twenty nine of the 38 cases (76.3%) were Adult Type, while the other 9 (23.7%) were Juvenile Type. The median onset age were 53 and 25 years old for the Adult Type and Juvenile Type, respectively, which shows significant difference (z = -2.990, P = 0.003). 3) The most common symptoms and signs were abdominal pain (44.7%), vaginal bleeding (42.1%), and abdominal mass (76.3%). The most common complications were endometrial hyperplasia (52.6%) and hysteromyoma (21.1%). 4) Stage I, II and III comprised 73.7%, 23.7% and 2.6% of the 38 cases, respectively. Ten patients ng the underwent conservative unilateral oophorectomy or ovarian enucleation. Twenty patients underwent total abdominal hysterectomy plus bilateral salpingo-oophorectomy. Eight patients underwent cytoreductive surgery. The 42 patients had been followed up for 7 to 175 months, with 14 patients lost of contact. No death was recorded. Inhibin, calretinin, and vimentin were demonstrated to be useful for the diagnosis of granulose cell tumors. CONCLUSION: With low incidence rate, ovarian granulosa cell tumor is a low-grade malignant and functional tumor. Most are unilateral diseases. Most Adult-type granulosa cell tumors occur in middle aged and elderly people, while most juvenile granulosa cell tumors occur in adolescents and children. Acute abdomen symptom may occur but ascites are less likely to occur in patients with granular cell tumors than those with epithelial ovarian cancers. Ovarian granulosa cell tumors are usually detected early, but easily relapse. Long-term follow-up is needed.

[The significance of HPV-DNA genotyping assays in the ASC].

OBJECTIVE: To disscuss different outcomes of ASC-UC and ASC-H, two subtypes of ASC, and the significance of HPV-DNA genotyping assays in these two subtypes. METHODS: We reviewed and analyzed colposcopic and biopsy results of 1256 cases of ASC between Jan. 2005 to Dec. 2007, of which 580 cases have results of HPV-DNA genotyping assays. RESULTS: In 1256 ASC cases, ASC-US and ASC-H cases account for 90.1% and 9.9% respectively, CIN2 and higher levels diagnosed via colposcopy and cervical biopsy are 8.5% and 24.2% respectively (P = 0.000). In ASC-US cases, the infection rate of HPV-DNA high risk types is 67.2%, there is statistic significance among different HPV-DNA results and biopsy pathology (P = 0.000). In ASC-H cases, the infection rate of HPV-DNA high risk types is 47.3%, there is no statistic significance among them (P = 0.054). CONCLUSION: The clinical outcomes of ASC-US and ASC-H are different, we should distinguish and treat. HPV-DNA genotyping assay is available in ASC-US triage, but Colposcopy is proposed for all ASC-H patients.

[Clinical comparison of transvaginal hysterectomy and laparoscopic hysterectomy].

OBJECTIVE: To compare the clinical characteristics of transvaginal hysterectomy (TVH) and total laparoscopic hysterectomy (TLH). METHOD: Clinical data about 301 cases who received TVH and TLH were collected and the hospital stay days, medical expenses, diagnoses, operation and recovery status were compared between TVH and TLH groups. RESULTS: The ratio of cervical atypical hyperplasia (9.64%), multipara (96.45%) in TVH was higher than that in TLH (2.88%, 89.42%). The ratio of adenoma (29.44%), adnexal disease (4.55%), pelvic endometriosis (4.06%), history of cesarean section (7.11%) in TVH were lower than that in TLH (43.27%, 31.73%, 12.50%, 24.04%). The operation time (76 +/- 28) minutes, bleeding during operation (170 +/- 125) ml, additional operations (5.08%), pelvic adhesion (4.57%), loosening of pelvic adhesion (0.51%), the diameter of the largest myoma or adenoma (49 +/- 17) mm, expenses for operation and hospitalization (1073 +/- 203) yuan in TVH were lower than those in TLH, which were (139 +/- 52) minutes, (206 +/- 153) ml, 36.54%, 41.35%, 17.31%, (57 +/- 22) mm, (1526 +/- 676) yuan respectively. The differences were significant (all P < 0.05). There was no difference of the uterine weight, complication and length of hospitalization duration between the two kinds of operation. CONCLUSIONS: TVH is recommended in cases of few pelvic adhesion, or adnexal disease, cervical disease and of multipara. The uterine weight is not a decisive factor.

[Expression of PDCD5 in tissues of normal cervix, CIN I-III and cervical cancer].

OBJECTIVE: To investigate the expression of PDCD5 in tissues of normal cervix, CIN I-III, cervical cancer and explore the relationship between PDCD5 and cervical cancer. METHODS: After we defined the most fitful condition, tissues from 18 cases of normal cervix, 19 of CIN I, 18 of CIN II, 20 of CIN III and 18 of cervical cancer were defined by indirect immunohistochemical technique. Positive expression rates and intensity of PDCD5 protein were investigated by observing under microscope and analyzing with computer imaging technique. The results were analyzed with one-way anova. RESULTS: The results of immunohistochemical staining showed that the percentage of strong positive cells in normal cervical tissue and CIN I were significant higher than those of CIN II, CIN III and cervical cancer. On the whole of the condition of immunohistochemical staining, the expressions of PDCD5 were downregulated along the progression of cervical atypical epithelia, but that in CIN I was upregulated. The ODs of normal cervix,CIN I-III,cervical cancer were 0.322, 0.366, 0.287, 0.252, and 0.206 respectively. The intensity of each group showed obvious differences. CONCLUSION: We found that the expression of PDCD5 was upregulated in CIN I and downregulated in CIN II, CIN III and cervical cancer. It suggests that PDCD5 is an important apoptosis regulating factor in the occurrence of cervical cancer.