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OBJECTIVE: It is known that the vacuolating cytotoxin (VacA) could induce apoptosis. However, the mechanism remained to be elucidated. The aim of this study is to investigate the role of Bcl family of proteins (Bcl-2 and Bax) and the mitochondrial voltage-dependent anion channel (VDAC) in VacA-induced apoptosis of AGS cells. METHODS: Plasmid pGBKT7-VacA p58 was constructed and transfected into the AGS cells. RT-PCR and Western blotting were used to determine the expressions of cytochrome c, caspase-3, Bax, Bcl-2 and VDAC1 mRNA and proteins. RESULTS: VacA p58 can induce cytochrome c release and activate caspase-3 in AGS cells. It up-regulated the expressions of Bax and VDAC1 mRNA and proteins, and decreased the expression of Bcl-2 in AGS cells. CONCLUSION: VacA p58 induces apoptosis in AGS cells. This apoptotic process is associated with the up-regulation of Bax/VDAC1 and downregulation of Bcl-2. These findings suggest that the release of cytochrome c by VacA p58 is mainly through VDAC-dependent and Bcl-2 family-dependent pathways. [ABSTRACT FROM AUTHOR]

The article describes an illusory feat for endoscopic submucosal dissection (ESD) of the extensive fibrosis in gastrointestinal neoplams with severe scarring which can help prevent complications and lower en bloc resection rate.

The article presents a case study regarding the ways for the utilization of a clip-with-line (CWL) method in facilitating enucleation of an gastrointestinal submucosal tumors (SMTs) in a 30-year-old man with dyspepsia.

Background/Aims: Colonoscopy screening has been accepted broadly to evaluate the risk and incidence of colorectal cancer (CRC) during health examination in outpatients. However, the intrusiveness, complexity and discomfort of colonoscopy may limit its application and the compliance of patients. Thus, more reliable and convenient diagnostic methods are necessary for CRC screening. Genome instability, especially copy-number variation (CNV), is a hallmark of cancer and has been proved to have potential in clinical application. Methods: We determined the diagnostic potential of chromosomal CNV at the arm level by wholegenome sequencing of CRC plasma samples (n = 32) and healthy controls (n = 38). Arm level CNV was determined and the consistence of arm-level CNV between plasma and tissue was further analyzed. Two methods including regular z score and trained Support Vector Machine (SVM) classifier were applied for detection of colorectal cancer. Results: In plasma samples of CRC patients, the most frequent deletions were detected on chromosomes 6, 8p, 14q and 1p, and the most frequent amplifications occurred on chromosome 19, 5, 2, 9p and 20p. These arm-level alterations detected in plasma were also observed in tumor tissues. We showed that the specificity of regular z score analysis for the detection of colorectal cancer was 86.8% (33/38), whereas its sensitivity was only 56.3% (18/32). Applying a trained SVM classifier (n = 40 in trained group) as the standard to detect colorectal cancer relevance ratio in the test samples (n = 30), a sensitivity of 91.7% (11/12) and a specificity 88.9% (16/18) were finally reached. Furthermore, all five early CRC patients in stages I and II were successfully detected. Conclusion: Trained SVM classifier based on arm-level CNVs can be used as a promising method to screen early-stage CRC. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 60-year-old man who was found on computed tomography (CT) to have multiple masses in his esophagus, stomach, and liver. The conducted gastroscopy revealed a hard, fixed mass in the lower esophagus covered with normal appearing mucosa as well as a giant stomach ulcer with a clean and hard base. It notes that immunoglobulin G4-related disease (IgG4-RD) should be considered as a possible diagnosis for multiple masses in the gastrointestinal tract.

Background/Aims: This was a Phase 2 study (NCT02015793) to evaluate the pharmacokinetics, safety, and efficacy of adalimumab in Chinese patients with Crohn's disease (CD). Methods: Thirty, adult Chinese patients with CD (CD Activity Index [CDAI] 220-450; high-sensitivity [hs]-C-reactive protein [CRP] ≥3 mg/L) received double-blind adalimumab 160/80 mg or 80/40 mg at weeks 0/2, followed by 40 mg at weeks 4 and 6. An open-label extension period occurred from weeks 8-26; patients received 40 mg adalimumab every other week. Serum adalimumab concentration and change from baseline in fecal calprotectin (FC) were measured during the double-blind period. Clinical remission (CDAI <150), response (decrease in CDAI ≥70 points from baseline), and change from baseline in hs-CRP were assessed through week 26. Nonresponder imputation was used for missing categorical data and last observation carried forward for missing hs-CRP/FC values. Noformal hypothesis was tested. Adverse events were monitored. Results: Mean adalimumab serum concentrations during the induction phase were 13.9-18.1 μg/mL (160/80 mg group) and 7.5-9.5 μg/mL (80/40 mg group). During the double-blind period, higher remission/ response rates and greater reductions from baseline in hs-CRP and FC were observed with adalimumab 160/80 mg compared to that with 80/40 mg. Adverse event rates were similar among all treatment groups. Conclusions: Adalimumab serum concentrations in Chinese patients with CD were comparable to those observed previously in Western and Japanese patients. Clinically meaningful remission rates and improvement in inflammatory markers were achieved with both dosing regimens; changes occurred rapidly with adalimumab 160/80 mg induction therapy. No new safety signals were reported. [ABSTRACT FROM AUTHOR]

Background/Aims: Early colorectal (CR) neoplasm can be cured by endoscopic submucosal dissection (ESD), but clinical experience and factors associated with complications from ESD for CR neoplasms in China have not been reported . Methods: Seventy-eight cases of early CR neoplasm treated with endoscopic resection performed between December 2012 and December 2013 at Beijing Military General Hospital were included. Factors associated with ESD complications and procedure times were evaluated. Results: The en bloc resection rate was 88.5% (69/78), tumor size was 32.1±10.7 mm, and procedure time was 71.8±49.5 minutes. The major complication was perforation, which occurred in 8.97% of the ESD procedures. Multivariate logistic regression analysis indicated that only tumor size (p=0.022) was associated with ESD perforation. Tumor size (p<0.001) and the non-lifting sign (p=0.017) were independent factors for procedure time, and procedure time (p=0.016) was a key factor for en bloc resection. After a median 10 months (range, 4 to 16) of follow-up, no patients had local recurrence. Conclusions: This study indicated that ESD is an applicable method for large early CR neoplasm in the colon and rectum. Tumor size and the non-lifting sign might be considerable factors for increased complication rate and procedural time of ESD. [ABSTRACT FROM AUTHOR]

Background A higher prevalence of chronic atrophic gastritis (CAG) occurs in younger adults in Asia. We used Stomach Age to examine the different mechanisms of CAG between younger adults and elderly individuals, and established a simple model of cancer risk that can be applied to CAG surveillance. Methods Stomach Age was determined by FISH examination of telomere length in stomach biopsies. Δψm was also determined by flow cytometry. Sixty volunteers were used to confirm the linear relationship between telomere length and age while 120 subjects were used to build a mathematical model by a multivariate analysis. Overall, 146 subjects were used to evaluate the validity of the model, and 1,007 subjects were used to evaluate the relationship between prognosis and Δage (calculated from the mathematical model). ROC curves were used to evaluate the relationship between prognosis and Δage and to determine the cut-off point for Δage. Results We established that a tight linear relationship between the telomere length and the age. The telomere length was obvious different between patients with and without CAG even in the same age. Δψm decreased in individuals whose Stomach Age was greater than real age, especially in younger adults. A mathematical model of Stomach Age (real age + Δage) was successfully constructed which was easy to apply in clinical work. A higher Δage was correlated with a worse outcome. The criterion of Δage >3.11 should be considered as the cut-off to select the subgroup of patients who require endoscopic surveillance. Conclusion Variation in Stomach Age between individuals of the same biological age was confirmed. Attention should be paid to those with a greater Stomach Age, especially in younger adults. The Δage in the Simple Model can be used as a criterion to select CAG patients for gastric cancer surveillance. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 60-year-old man diagnosed with esophageal stricture due to mediastinal hamartoma. Topics discussed include the medical history of the patient, his medical examination, and treatment options. Information about the disease such as its symptoms and causes is also provided.

The article presents a case study of a 65-year-old man diagnosed with amebic colitis. Topics discussed include the medical history of the patient, his medical examination, drug administration instruction, and treatment options. Information about the disease such as its symptoms and causes is also provided.

The article presents a case study of a 64-year-old man who developed second primary esophageal squamous cell carcinoma (SCC) of the head and neck (HNSCC). The patient underwent endoscopy after surgical treatment of esophageal SCC which revealed HNSCC. The article also discusses the role of narrow-band imaging (NBI) in identifying HNSCC at an early stage.

The article presents a case study of a 49-year-old man with a five-month history of epigastric distension after meals. The patient underwent into gastroscopy and ultrasonic endoscopy and has been diagnosed with Helicobacter pylori infection and hypertrophic gastric mucosa. The article discusses Ménétrier's disease, gastric polyposis syndrome, and hypoproteinemia.

The article presents a case study of a 61-year-old woman who experienced a throat irritation, chest pain and difficulty of swallowing for one week. The patient was given a mucosa-protecting treatments and semi-liquid diet including talcid, esomeprazole and magnesium hydroxide. An overview of the patient's medical history, endoscopic diagnosis and follow-up observations are also explored.

The article presents a case study of an 18-year-old male with a history of osteosarcoma of the proximal part of the left tibia presented complaining of upper abdominal pain and vomiting.

The article discusses a case study of a 49-year-old woman who was admitted to the hospital emergency department due to abdominal pain for 16 hours. The patient had a history of esophageal achalasia which was treated with the placement of a fully covered anti-reflux metal stent. The removal of the stent by single-balloon endoscopy is described.