Gastroenterology Research and Practice

Objective. To explore the correlations of cancer-related fatigue (CRF) with clinicopathological features and quality of life in gastric cancer. Methods. Using a convenient sampling method, 230 patients with gastric cancer admitted to our hospital from March 2020 to July 2022 were collected. They were divided into the fatigue group () and the nonfatigue group () according to the presence/absence of CRF. Relevant data were collected and compared. Results. Statistically significant differences were found between the two groups in age ratio (, ), T stage ratio (, ), N stage ratio (), PS score (), and the degree of gastric cancer thickening ( vs.  mm, , ). Patients with gastric cancer had the lowest CRF Brief Fatigue Inventory (BFI) score for general activities () and high scores for work activities () and enjoyment of life (). Pearson’s correlation analysis revealed a positive correlation between patient emotions and the CRF BFI score (, ). Patients with mild, moderate, and severe CRF showed statistically significant differences in physical functioning ( vs. vs. , , ), role emotional ( vs. vs. , , ), fatigue ( vs. vs. , , ), bodily pain ( vs. vs. , , ), appetite reduction ( vs. vs. , , ), and overall health status and quality of life ( vs. vs. , , ). After chemotherapy, the average CRF BFI scores of the partial remission (PR), disease stability (SD), and disease progression (PD) groups all reduced than those before chemotherapy (all ). At 3 months of follow-up, a comparison of the average CRF BFI scores with those before chemotherapy revealed a decrease in the SD and PR groups and an increase in the PD group. Conclusion. In conclusion, CRF is correlated with age, T stage, and N stage in gastric cancer. The later the T and N stages, the more significant the effect on fatigue. Moreover, CRF can also affect the quality of life in gastric cancer, and the severer the CRF, the poorer the quality of life.

Background and Aims. Recurrence of gastroesophageal varices (GEVs) after sclerotherapy is a public health problem. However, mass screening of recurrence of GEVs through gastroscopy is a high-cost procedure. We aim to evaluate the changes in liver stiffness (LS) over time after endoscopic injection sclerotherapy (EIS) and determine its value in predicting the recurrence of GEVs. Methods. One hundred and thirty-five patients with GEVs who underwent EIS treatment were included in this study. The patients were divided into two groups, namely, the nonrecurrence and recurrence groups, based on endoscopic findings at 6 months after discharge. LS measurements were obtained on five occasions. Repeated measure analysis of variance was employed to assess LS differences at different time points and compare them between the two groups. Results. The LS values during the 6-month postdischarge period were consistently higher than the baseline value (measured on the day of hospitalization). The recurrence group demonstrated sustained elevated LS levels throughout the 6-month follow-up period, while the nonrecurrence group showed a gradual decline in LS. The difference in LS trend between the two groups was statistically significant (). The area under the curve (AUC) values for LS differences were 0.806, with a corresponding 95% confidence interval (CI) of 0.640-0.918 and a cut-off value of 0.556, indicating their potential utility in predicting GEV recurrence. Conclusions. Longitudinal assessment of LS values in post-EIS patients can provide valuable information for predicting the recurrence of GEVs.

Objective. This study is aimed at investigating the expression of Met and YAP in gastric cancer and their impact on clinical prognosis. Methods. Tissue samples and clinical data were collected from 89 patients with gastric cancer. Immunohistochemistry was performed to quantify the expression of Met and YAP using tissue microarray. The correlation between the expressions of Met, YAP, and clinicopathological characteristics of patients was determined using a chi-square test. Survival analysis was conducted using the Kaplan-Meier method, while multivariate survival analysis was performed using the Cox proportional hazard model. Bioinformatics analysis was carried out by downloading chip data from TCGA. Results. The expression levels of both Met and YAP were significantly higher in gastric cancer tissues compared to adjacent tissues (). Met expression showed a positive association with P53 and CD133, whereas YAP expression correlated positively with tumor grade and CD133 (). Pearson’s analysis revealed a significant correlation between Met expression and VEGFR as well as CD133, while YAP expression correlated with Ki67 and VEGFR (). Patients with high levels of both Met and YAP exhibited decreased survival time (). Furthermore, Met expression, N stage, and VEGFR were identified as independent risk factors for gastric cancer prognosis (), whereas no such association was observed for YAP expression. Bioinformatics analysis demonstrated a significant correlation between the expressions of Met and YAP; both proteins were highly expressed in gastric cancer patients accompanied by markedly reduced survival time. Conclusion. The expressions of Met and YAP are closely associated with the survival outcomes as well as clinicopathological features in patients with gastric cancer. Moreover, our findings highlight that Met serves as an independent prognostic factor for gastric cancer.

Objective. This study aimed at exploring the safety and timing of antithrombotic drugs in different age-group patients with UGIB. Methods. An observational study retrospectively based on the single-center database with 713 patients with UGIB. Result. Among the 713 patients, 62.13% were elderly patients ( years) and the mortality was 2.9%. In elderly patients with UGIB, we found that previous medication history, resumption of medication, and time of resumption did not affect the in-hospital mortality. The resumption of anticoagulants increased the risk of rebleeding. The independent risk factors of mortality were CHF, cirrhosis, creatine kinase, and albumin. The independent risk factors of rebleeding were the application of anticoagulants during hospitalization, variceal bleeding, black stool, red blood cells (lab), platelets (lab), and heart rate. Conclusions. In UGIB patients, a history of antiplatelet or antithrombotic drugs and the use of antiplatelet drugs after UGIB did not affect the patient’s prognosis. In elderly UGIB patients, although antithrombotic drugs did not increase the risk of death, the increased risk of rebleeding after resumption of use deserved careful treatment. It was safe to recover anticoagulant drugs as soon as possible in young UGIB patients.

Aim. To compare the clinical characteristics of survival and nonsurvival patients with severe acute pancreatitis (SAP) and explore the risk of mortality in SAP patients. Methods. This was a single-center retrospective study performed in a severe acute pancreatitis diagnosis and treatment center. According to the outcome, SAP patients were divided into survival group and nonsurvival group. One-way ANOVA or independent -test was used to compare the clinical characteristics of two groups of patients. Multivariate retrospective analysis was used to identify risk factors for mortality in SAP patients. Results. A total of 486 SAP patients were included in the study, and the 90-day mortality for SAP patients was 13.58%. The common etiologies of SAP are biliary tract diseases (69.75%) and hyperlipidemia (17.28%). The most common complications caused by SAP were organ failure (55.14%), ARDS (50.62%), AKI (30.45%), sepsis (27.16%), and abdominal fluid collection (27.57%). There were differences in age, complications, and medical intervention between the nonsurvival group and the survival group. The main causes of death were infection (46.97%), abdominal bleeding (28.79%), and organ failure (9.09%). The binary logistic regression analysis showed that there were significant differences in age, AKI, sepsis, abdominal hemorrhage, organ failure, laparotomy, creatinine, and APTT between the nonsurvival group and the survival group. Conclusion. Age, AKI, sepsis, abdominal hemorrhage, and organ failure are risk factors for mortality in SAP patients. SAP patients with high creatinine and prolonged APTT upon admission require doctors to be vigilant. The main cause of death in SAP patients is pancreatitis-related organ failure and secondary infection.

Purpose. Acute lower gastrointestinal bleeding (ALGIB) is a common emergency in gastroenterology. Currently, there is insufficient information to predict adverse outcomes in patients with acute lower gastrointestinal bleeding. Our study is aimed at comparing the effectiveness of the clinical risk scores currently utilized and their ability to predict significant outcomes in lower gastrointestinal bleeding. Methods. We conducted a retrospective observational study of patients who were admitted to ALGIB and underwent colonoscopy or angiography at a single center between January 2018 and December 2022. Adverse outcomes associated with ALGIB included rebleeding, blood transfusion, hemostatic interventions, and in-hospital death. We calculated six risk scores at admission (Oakland, Birmingham, SHA₂PE, Ramaekers, SALGIB, and CNUH-5). We measured the accuracy of these scores using the area under the receiver operating characteristic curve (AUC) and compared them with DeLong’s test. Results. 123 patients with confirmed LGIB (aged 65 years, 55-75) were finally included. The most common diagnoses were colorectal cancer (25%) and hemorrhoids (14%). All scores demonstrated sufficient and comparable effectiveness for hemostatic intervention but no discrimination for rebleeding. The Oakland and SALGIB scores were superior to the other scores in predicting blood transfusion (AUC: 0.97 and 0.95, respectively; ) and any adverse outcomes (AUC: 0.78 and 0.78, respectively; ). Conclusions. The Oakland and SALGIB scores outperform the other scores in predicting the requirement for blood transfusion in ALGIB patients, but no single prediction tool had the best ability across all outcomes. Novel risk stratification scores with higher performance are needed for better risk stratification in ALGIB.