Volume 8

Acute Tumor Inflammation with CD4/8+ and CD11+ Prolong The Survival Effect Induced by Intratumral Injection Optimum Combination of Chemotherapy Drugs with Hydralazine as Hapten in Animal Model

Research Article

1. Abstract
1.1. Purpose
To study the survival time of mice with tumor by intratumoral injection with chemotherapy drug Adr plus hapten of DNP or Hydra and find a combination of drugs of Adr with DNP or Hydra can prolong their life, and which one of DNP or Hydra can provide a long life extension of mice with tumor.
1.2. Method
After inoculation of tumor cells into mice, tumor reach at 4~5mm size as the experiment day 0, the random groups was performed for intratumoral injection with corresponding drugs combination of Adr+DNP or Hydra and Adr or ARA-C control group, follow up to 90 days to find which combination of drugs could provide a longer their life extension of mice with tumor.
1.3. Result
Comparison the body weight between the groups, there is not significantly different but the control group maintains the stable of weight. it indicated that PYM could not alone induce a expression of immunity at all and DNP as hapten is playing a important role in stimulation of immunity reaction. There is a significant difference between the tumor volume in treatment group and control group from day1 to day 41, it showed that local injection of combination drug can control tumor growth in the difference drugs group. There is a significant difference between survival time in treatment group and the control group. The life extension rate is 31.4% for group of A1 (Adr+Hydra I) is bigger than A2 (Adr+Hydra II) which has same formulation with high dose of Hydra, and A3 (Adr+Ara-C+Hydra) which has one more drug of Ara-CA2; life extension rate for B group, B1 (Adr+DNP) is 24.4%, it is bigger than B2 (Adr+Ara-C+DNP) which has one more drug of Ara-C; Both of A1 and B1 is better than D (Adr+Ara-C) in the life extension rate, it indicated that best Hydra dose in A1 and DNP in B1 played an important role in the life extension, Hydra is a better hapten than DNP.

 

DOI:http://dx.doi.org/10.47829/JJGH.2022.81701

Efficacy of Rifaximin Add-On Levofloxacin Regimen as Third-Line Rescue Therapy of Helicobacter Pylori Eradication

Clinical Paper

1. Abstract
1.1. Background/Aims
Levofloxacin–amoxicillin triple therapy was known as a choice of third-line regimen for Helicobacter pylori (H. pylori) eradication. But it does not achieve the satisfactory eradication success rate. The objective of this study was to determine the efficacy of rifaximin add-on levofloxacin regimen.
1.2. Method
We performed retrospective, observational study from June 2017 to June 2020. The patients treated for 14 days as third-line rescue therapy were enrolled. Those patients had experienced treatment failure of two consecutive times of H. pylori eradication therapies, which were standard triple therapy as first-line therapy and bismuth based quadruple regimen as second-line therapy. The patients were divided in the two group: PPI, amoxicillin, levofloxacin and rifaximin (PAL-R) and PPI, amoxicillin, levofloxacin (PAL) regimen. The 13C- urea breath test was performed at least 4 weeks after the completion of eradication therapy. We compared the eradication rate of the PAL-R and PAL therapy.

A COVID crisis and its consequences

Editorial

Editorial
Dear colleagues, my name is ZivkaMadzic, I am president of society of enterostomal therapists and I work as nurse on a colorectal department in the First Surgical Clinic.
Serbia’s population numbers approximately seven million and its capital, Belgrade, ranks among the largest and oldest citiеs in southeastern Europe.
The first case of COVID positive patient in Serbia was registered on March 6th and the second one three days after. At that time, in Italy, country with most COVID cases in European Union, more than 4600patientswere registered with almost 200 deaths.
Coached by Chinese and particularly Italian experience, where sudden and extraordinary increase of new cases and deaths highly stressed their health care system, on March 15ththe President of the republic of Serbia declared the state of emergency. At that time, nine days after the initial positive patient, there were 41 confirmed cases and still no deaths from COVID in Serbia. State of emergency implied that all nonessential business, industry and services where shut down together with schools, restaurants, shopping malls, public transportation etc. Borders were closed and rigorous restrictions of public movement were initiated. All persons older than 65 years were not allowed to leave their houses at any time. Volunteers and other public services were included to help them in basic procurement. Younger than 65 were not allowed to leave their apartments from 8pm to 5am during business days and weekends, except those with special permissions /police, healthcare workers, food markets, etc./. As the number of positive cases increased, movement restrictions were extended from 5pm to 5am and during all weekends and public holidays. All public manifestations were suspended, and a policy of distance of at least 2 meters, with obligatory face masks and gloves in closed areas were introduced. Authorities repeatedly asked and urged for collective support of policy to keep distance and stay at home whenever possible. In schools and high schools on line teaching platforms were created under the auspices of the government. During movement restrictions our towns looked like ghost towns.

Association of IL-32 Isoforms Responses with Pegifn Therapy in Chronic HBV Infection

Research Article

1. Abstract
Interleukin-32 is a proinflammatory cytokine with immune protective effect. IL-32γ mediates antiviral activity of cytokines against HBV. However, the dynamic expression level of IL-32 isoforms in CHB and whether they are affected by drug therapy is not clear. Here we show that the persistent increased expression of plasma IL-32 is related to the progression of HBV-related liver diseases (from CHB, HBV-LC, HCC to HBV-ACLF). And by detecting the differential expression of PBMCs IL-32 mRNA and its transcripts variants, IL-32 was decreased in CHB patients with PegIFN therapy than in the health donor and the initial CHB patients without treatment. But for its transcript variants, IL-32α and IL-32ε were overexpressed in CHB patients and low expression in CHB with interferon treatment. Compared with healthy controls, IL-32β and IL-32δ were significantly expressed in the CHB patients with interferon therapy and followed by in the initial CHB, while IL-32ζ and IL-32γ were no signiant expression unless IL-32ζ was overexpressed in treated CHB patients. Collectively, IL-32 isoforms plays an important role in patients with CHB and interferon therapy. It also can be used as a marker for the diagnosis of interferon therapy and prediction of sustained virologic response in patients with chronic hepatitis B.

Health-Related Quality of Life Among Rural Chinese Patients with Upper Gastrointestinal Diseases at Different Pathological Stages: A Cross-Sectional Study

Research Article

1. Abstract
1. Aims: This study aims to compare the HR-QoL among rural Chinese patients with upper GI diseases at different pathological stages and to determine the factors influencing HR-QoL in this population.
1.2. Methods: A cross-sectional survey was conducted in two counties in Shandong province in China from July to September 2018. Demographic and clinical characteristics were collected, and HR-QoL of patients was assessed using a set of questionnaires, including the EORTC QLQ-C30 (V3.0), the QLQ-OES18 and the QLQ-STO22. Multivariate analysis of variance (MANOVA) and Kruskal–Wallis test were used to compare the HR-QoL of patients of different pathological stage subgroups, and multivariate regression analyses were used to determine influencing factors.

Management of Internal Hemorroids by Elastic Ligature in Brazzaville

Case Report

1. Abstract
1.1. Patients and Methods
This was a retrospective, descriptive multicenter study on 132 patients treated with ligation of hemorrhoids. The study took place from January 2015 to July 2020 at the Medico-Social Center of the Schnell Foundation and at the Brazzaville University Hospital. Study variables were epidemiological, clinical and therapeutic. Microsoft Excel version 20016 software for the compilation of the database and the development of graphs as well as the SPSS.07 software for data processing. The quantitative variables will be expressed as an average, the qualitative variables as a percentage.

Prevalence and Characterization of Hepatitis C infection and Determination of Liver Damage in Patients on Chronic Hemodialysis at the Largest Reference Center for Renal Health, EsSalud, Lima, Peru

Research Article

1. Abstract
1.1. Background: Hepatitis C (HCV) is a serious public health problem with approximately 3% of the world’s population infected. Patients on chronic hemodialysis are known to be a population at risk of HCV infection worldwide.
1.2. Aims: This study aimed to estimate the serological prevalence of HCV and characterize the HCV viral load and genotype; as well as to determine the stage of liver fibrosis in patients on chronic hemodialysis at the largest Peruvian Social Security reference center for hemodialysis in Lima, Peru.
1.3. Materials and Methods: Observational case series study approved by the Ethics Committee of the Guillermo Almenara National Hospital (EsSalud). All patients who received chronic hemodialysis at the study center were invited to participate. Subjects who provided written consent were enrolled. Patients with HCV-positive serology determined with the Cobas® analyzer y and the immunoassay 601 from Roche Diagnostics, underwent determination of HCV viral load by means of RT-PCR (Abbott Realtime m2000 system / Xpert® HCV Viral Load). In subjects with detectable viral load, the HCV genotype was determined (Abbott HCV Real Time Genotype II / Roche Applied Science). Then subjects underwent determination of liver fibrosis using transitional elastography (Fibroscan 402 with E and XL probes): Metavir score: F0-F1: 2.5-7.5 kPa, F2: 7.6-9.5 Kpa, F3: 9.6-12 Kpa, F4 (Cirrhosis): 12,1-75 Kpa.
1.4. Results: Of all the subjects invited to participate (303 patients), 174 (57.4%) gave their written consent. Mean age was 52 years (range 22-91) and 116 (66.6%) were male. HCV serology was positive in 35.1% of patients (61/174), however, the prevalence of active HCV (positive serology and detectable viral load) was 20.11% (35/174). Genotype 1a was the most prevalent (85%). The majority (83.6%) of subjects with detectable viral load had values below 800.000 IU/ml. Twenty-nine of those 35 subjects underwent Fibroscan evaluation, and 13 (44.8%) had stage F2-F4 fibrosis.

Related Factors of Jaundice Reduction Effect in Patients with High Biliary Obstruction Caused by Hilar Cholangiocarcinoma Using Endoscopic Retrograde Cholangiopancreatography

Clinical Paper

1. Abstract
1.1.
Background: The purpose of this study was to explore the risk factors of poor jaundice reduction effect in patients with high biliary malignant obstruction (HBMO) caused by unresectable hilar cholangiocarcinoma (u-HC) treated with endoscopic retrograde cholangiopancreatography (ERCP).
1.2.
Methods: Total of 39 cases were retrospectively reviewed from March 2016 to January 2022. We analyzed the effects of age, gender, the level of alpha fetoprotein, carcinoembryonic antigen, carbohydrate antigen 125, carbohydrate antigen 199, albumin, alanine transaminase, aspartate aminotransferase, alkaline phosphatase, gamma glutamyltranspeptidase, cholinesterase, total bile acids, total bilirubin, direct bilirubin, indirect bilirubin and prothrombin pre-ERCP, the highest value of amylase, white blood cell count, C-reactive protein and temperature post-ERCP, longest stricture length, Bismuth type, sphincterotomy status, intra-hepatic dissemination, gallstones, unilateral/bilateral drainage and percutaneous transhepatic biliary drainage on jaundice reduction effect. The decrease of TB and DB both by 20% was considered to be good jaundice reducing effect during the first endoscopic treatment process.

Acute Liver Injury Due to Amanita Phalloides Toxicity in The National Capital Region of the United States

Case Report

1. Abstract
Amatoxin poisoning is considered a life-threatening medical emergency beginning with delayed onset of gastrointestinal symptoms followed by acute liver injury that may progress to acute liver failure requiring a liver transplantation. Here we report a case of a 69-year-old male who initially presented with nausea and watery diarrhea after previous ingestion of wild mushrooms. He was transferred to our liver transplant center in the National Capital Region of the United States for further management of his acute liver injury. The mushroom specimens were analyzed by a local mycologist and confirmed to be consistent with the Amanita phalloides species. The patient was successfully treated with n-acetylcysteine and silibinin infusions avoiding the need for liver transplantation. His course was complicated by acute renal failure requiring the initiation of intermittent hemodialysis and a rare pancolitis thought to be secondary to amatoxin.

The Influence of Anaemia and Perioperative Blood Transfusion in The Outcomes of Gastric Cancer

Research Article

1. Abstract
1.1. Background: Gastric cancer is often associated with anaemia, at the time of diagnosis, which may contribute to worse outcomes after surgery. This study aims to evaluate the impact of preoperative anaemia and the need of perioperative transfusions in surgical and oncological outcomes among patients undergoing gastric cancer surgery.
1.2. Methods: This single centre study retrospectively analyses 195 consecutive patients with gastric cancer who underwent curative intent gastric resection, between January 2017 and June 2021.Pre-operative anaemia was defined as Hb<12mg/dL in women and Hb<13mg/dL in men and perioperative blood transfusion was defined as any transfusion within 7 days pre-operatively, during surgery, or during the postoperative hospitalization period. Patient and tumour characteristics, surgical and oncological outcomes were compared (length of stay, complications and survival).
1.3. Results: A total of 195 consecutive patients were included in the study. Anaemia was present in 45.1% of patients, was normocytic in 69.3% and 26.6% received perioperative transfusions. The patients of the anaemic group presented higher age, ASA stage and T and N stages. This group also presented higher perioperatively rates of packed red blood cells (pRBC) transfusion (p<0.01) and had longer length of stay (p=0.01). The group of transfused patients had higher age (p=0.03), higher T (p<0.001) and N (p=0.04) stages, larger tumour size (p<0.001), lower pre-operatory Hb (p<0.01) and haematocrit (p<0.01), and longer hospital length of stay (p<0.01). Cumulative survival curves were significantly different according to anaemia status (p=0.004) and the need for transfusion p<0.001). The need for blood transfusion was identified as a negative prognostic factor for the outcome of gastric cancer (HR 0.43; 95% CI 0.23-0.80) (p=0.008).
1.4. Conclusions: This study suggests that anaemia and perioperative blood transfusions influence the survival of patients with gastric cancer. As blood transfusion emerges as an independent prognostic factor, it is crucial to design a rational approach to control anaemia in patients undergoing gastrectomy.