Diseases Of Digestive System Research Articles

Impact of Environmental Exposure on Chronic Diseases in China and Assessment of Population Health Vulnerability

Although numerous epidemiological studies have demonstrated a relationship between environmental factors and chronic diseases, there is a lack of comprehensive population health vulnerability assessment studies from the perspective of environmental exposure, population sensitivity and adaptation on a regional scale. To address this gap, this study focused on six high-mortality chronic diseases in China and constructed an exposure–sensitivity–adaptability framework-based index system using multivariate data. The constructed system effectively estimated health vulnerability for the chronic diseases. The R-square between vulnerability and mortality rates for respiratory diseases and malignant tumors exceeded 0.7 and was around 0.6 for the other four chronic diseases. In 2020, Chongqing exhibited the highest vulnerability to respiratory diseases. For heart diseases, vulnerability values exceeding 0.5 were observed mainly in northern and northeastern provinces. Vulnerability values above 0.5 were observed in Jiangsu, Shanghai, Tianjin, Shandong and Liaoning for cerebrovascular diseases and malignant tumors. Shanghai had the highest vulnerability to endogenous metabolic diseases, and Tibet exhibited the highest vulnerability to digestive system diseases. The main related factor analysis results show that high temperature and humidity, severe temperature fluctuations, serious air pollution, high proportion of middle-aged and elderly population, as well as high consumption of aquatic products, red meat and eggs increased health vulnerability, while increasing per capita educational resources helped reduce vulnerability.

Characteristics and health service utilization of children most at risk for prolonged temporary tube feeding.

This study aimed to describe children at risk of prolonged temporary tube feeding and evaluate associations between tube feeding duration and child and health service variables. A prospective medical hospital records audit was conducted between November 1, 2018, and November 30, 2019. Children at risk of prolonged temporary tube feeding were identified as having a tube feeding duration of >5 days. Information was collected on patient characteristics (eg, age) and service delivery provision (eg, tube exit plans). Data were collected from the pretube decision-making phase until tube removal (if applicable) or until 4 months after tube insertion. Descriptively, 211 at-risk children (median, 3.7 years; interquartile range [IQR], 0.4-7.7) differed from 283 not-at-risk children (median age, 0.9 years; IQR, 0.4-1.8) in terms of age, geographical location of residence, and tube exit planning. Medical diagnoses of neoplasms, congenital abnormalities, perinatal problems, and digestive system diseases in the at-risk group were individually associated with longer than average tube feeding duration, as were the primary reasons for tube feeding of nonorganic growth faltering and inadequate oral intake related to neoplasms. Yet, variables independently associated with greater odds of lengthier tube feeding durations were consultations with a dietitian, speech pathologist, or interdisciplinary feeding team. Children at risk of prolonged temporary tube feeding access interdisciplinary management because of their complexity. Identified descriptive differences between at-risk and not-at-risk children may be useful when selecting patients for tube exit planning and developing tube feeding management education programs for health professionals.

Systematic review and Meta-analysis of Biling Weitong Granules in treatment of stomach ache disorder

This study aimed to evaluate the efficacy and safety of Biling Weitong Granules in the treatment of stomach ache disorder. Randomized controlled trial(RCT) of Biling Weitong Granules in the treatment of digestive diseases with stomach ache disorder as the primary symptom was retrieved from Chinese and English electronic databases and trial registration platforms from database inception to June 10, 2022. Two investigators conducted literature screening and data extraction according to the screening criteria. The Cochrane risk-of-bias tool(v 2.0) was used to assess the risk of bias in the included studies. Analyses were performed using RevMan 5.4 and R 4.2.2, with summary estimates measured using fixed or random effects models. The primary outcome indicators were the visual analogue scale(VAS) scores and stomach ache disorder symptom scores. The secondary outcome indicators were clinical recovery rate, Helicobacter pylori(Hp) eradication rate, and adverse reaction/events. Twenty-seven RCTs were included with a sample size of 2 902 cases. Meta-analysis showed that compared with conventional western medicine treatments or placebo, Biling Weitong Granules could improve VAS scores(SMD=-1.90, 95%CI[-2.18,-1.61], P<0.000 01), stomach ache disorder symptom scores(SMD=-1.26, 95%CI[-1.71,-0.82], P<0.000 01), the clinical recovery rate(RR=1.85, 95%CI[1.66, 2.08], P<0.000 01), and Hp eradication rate(RR=1.28, 95%CI[1.20, 1.37], P<0.000 01). Safety evaluation revealed that the main adverse events in the Biling Weitong Granules included nausea and vomiting, rash, diarrhea, loss of appetite, and bitter mouth, and no serious adverse events were reported. Egger's test showed no statistical significance, indicating no publication bias. The results showed that Biling Weitong Granules in the treatment of digestive system diseases with stomach ache disorder as the primary symptom could improve the VAS scores and stomach ache disorder symptom scores of patients, relieve stomach ache disorder, and improve the clinical recovery rate and Hp eradication rate, with good safety and no serious adverse reactions. However, the quality of the original studies was low with certain limitations. Future studies should use unified and standardized detection methods and evaluation criteria of outcome indicators, pay attention to the rigor of study design and implementation, and highlight the clinical safety of the medicine to provide more reliable clinical evidence support for clinical application.

Diet as a Source of Acrolein: Molecular Basis of Aldehyde Biological Activity in Diabetes and Digestive System Diseases.

Acrolein, a highly reactive α,β-unsaturated aldehyde, is a compound involved in the pathogenesis of many diseases, including neurodegenerative diseases, cardiovascular and respiratory diseases, diabetes mellitus, and the development of cancers of various origins. In addition to environmental pollution (e.g., from car exhaust fumes) and tobacco smoke, a serious source of acrolein is our daily diet and improper thermal processing of animal and vegetable fats, carbohydrates, and amino acids. Dietary intake is one of the main routes of human exposure to acrolein, which is a major public health concern. This review focuses on the molecular mechanisms of acrolein activity in the context of its involvement in the pathogenesis of diseases related to the digestive system, including diabetes, alcoholic liver disease, and intestinal cancer.

Genus <i>Ceiba</i> Mill. in Brazil: A comprehensive review on its ethnopharmacology, phytochemistry and bioactivities

<b>Introduction</b>: Neotropical genus <i>Ceiba</i> Mill. is known for having tall trees, trunks with a robust part and fruits of economic interest. In Brazil, there are eleven native species, from those five are endemic. It is used in folk medicine to treat diabetes, inflammation, pain and diarrhea; however, most of the species have no scientific validation for such activities. This review aims to compile information about the genus <i>Ceiba</i> in Brazil, to update and allow an integrated understanding of its medicinal uses, chemical composition, and biological activities. <b>Methodology</b>: <i>Ceiba</i> species reported in Flora e Funga do Brasil were used for this literature review, using ScienceDirect, PubMed, and Google Scholar as articles databases. <b>Results</b>: In traditional use, the most cited species was <i>C. pentandra</i> (25 citations), the most used part was stem/bark (30 citations), preparation method was decoction (19 citations), and main administration route was oral ingestion (12 reports) for digestive system, skin and subcutaneous tissues diseases treatment. Genus chemical composition is wide, presenting metabolites such as proteins, sugars, fatty acids, tannins, flavonoids, and alkaloids. Bioactivities as antidiabetic, antioxidant, antitumor and antimicrobial were observed, especially for <i>C. pentandra</i>. <b>Conclusion</b>: Some species of <i>Ceiba</i> have extensive scientific literature, presenting several isolated compounds and bioactivities. On the other hand, some species, especially those that are endemics only in Brazil, do not have studies that evaluate their biological properties. Such knowledge is essential to confirm the medicinal potential cited in ethnobotanical reports, and the possibility of new compounds of biotechnological interest

Is upper gastrointestinal system screening necessary in kidney transplant candidates?

BACKGROUND
 The aim of this study is to present and discuss upper gastrointestinal tract endoscopy findings in renal transplant candidates with a high incidence of gastrointestinal system diseases.
 METHODS
 Between January 2014 and December 2019, patients over the age of 18 who were on dialysis for chronic renal failure and renal transplant candidates at xxx University xxx Hospital were included in the study. Upper gastrointestinal endoscopic findings and pathology results (atrophy, helicobacter pylori and intestinal metaplasia) of the patients were retrospectively evaluated by scanning from the electronic archive system of the hospital.
 RESULTS
 The study included 105 patients. 53 (50.5%) of the patients were male. The mean age of the patients was 44.09 ± 14.16 years and there was no statistically significant difference between male and female sexes (p=0.961). The most common endoscopic findings were pangastritis (44.8%), antral gastritis (27.6%) and esophagitis (16.2%). Only 4 (3.8%) patients had duodenal ulcer. Atrophy was positive in 3 (13%) of 23 patients, HP was positive in 19 (27.1%) of 67 patients and IM was positive in 17 (24.3%) of 56 patients.
 CONCLUSIONS
 Patients who are renal transplant candidates should be reviewed for indication of routine upper endoscopic examination before transplantation to prevent upper GI tract complications that may develop after transplantation.

Fructus Aurantii Extracts Ameliorate Intestinal Inflammation and Regulate the Intestinal Barrier through Fc Epsilon RI Signaling Pathway

Fructus Aurantii (FA) is the dry and immature fruit of Citrus aurantium L. and its rutaceous cultivars. FA has been widely used to treat digestive system diseases since ancient China, and it promotes gastrointestinal (GI) motility in functional dyspepsia (FD), but its potential therapeutic mechanisms remain unclear. We examined the effects of FA ethanol extracts in an iodoacetamide (IA)-induced FD rat model. Firstly, key FA therapy targets for FD were gathered using systematic pharmacology. Combined with systemic pharmacological analyses, plasma metabolomics based on UPLC-QTOF-MS were conducted. Then, MetaboAnalyst was used to jointly analyze systemic pharmacology targets and metabolomic metabolites to select key metabolic pathways. Finally, the key path is verified by experiments. FA exerted distinct therapeutic effects in anti-inflammation and promoting gastrointestinal motility in our IA-induced FD rat model. When compared with the model group, FA down-regulated the inflammatory factors interleukin 1β and tumor necrosis factor-α. At the same time, FA up-regulated tight junction proteins in the intestinal epithelial barrier. Through the integrated analysis of metabolomics and systemic pharmacology, we conducted experimental verification on Fc epsilon RI signaling pathway. When compared with the model group, FA down-regulatedphospho-mitogen activated protein kinase, phospho-extracellular signal regulated kinase1/2, myosin light chain kinase, and phospho-myosin regulatory light chain protein levels. Thus, FA ameliorated FD by regulating the Fc epsilon RI signaling pathway. Our integrated strategy identified underlying FA mechanisms toward FD treatment and provided a foundation for FA development as a clinical agent for FD.

In vitro susceptibility profiles of Candida parapsilosis species complex subtypes from deep infections to nine antifungal drugs.

Introduction. The Candida parapsilosis complex can be divided into C. parapsilosis sensu stricto, C. orthopsilosis, and C. metapsilosis subtypes. It is uncommon for drug sensitivity tests to type them.Gap Statement. In routine susceptibility reports, drug susceptibility of C. parapsilosis complex subtypes is lacking.Aim. The aim of this study is to investigate the antifungal susceptibility and clinical distribution characteristics of the C. parapsilosis complex subtypes causing deep infection in patients.Methodology. Non-repetitive strains of C. parapsilosis complex isolated from deep infection from 2017 to 2019 were collected. Species-level identification was performed using a matrix-assisted laser desorption/ionization time-of-flight mass spectrometer and confirmed using ITS gene sequencing, when necessary. Antifungal susceptibility testing was performed using the Sensititre YeastOne system method.Results. A total of 244 cases were included in the study, including 176 males (72.13 %, 60.69±13.43 years) and 68 females (27.87 %, 60.21±10.59 years). The primary diseases were cancer (43.44 %), cardiovascular disease (25.00 %), digestive system diseases, (18.44 %), infection (6.97 %), and nephropathy (6.15 %). Strains were isolated from the bloodstream (63.11 %), central venous catheters (15.16 %), pus (6.56 %), ascites (5.74 %), sterile body fluid (5.33 %), and bronchoalveolar lavage fluid (BALF, 4.09 %). Of the 244 C. parapsilosis complex strains, 179 (73.26 %) were identified as C. parapsilosis sensu stricto, 62 (25.41 %) were C. orthopsilosis, and three (1.23 %) were C. metapsilosis. Only one C. parapsilosis sensu stricto strain was resistant to anidulafungin, micafungin, caspofungin, and voriconazole, and it was non-wild-type (NWT) to amphotericin B. Furthermore, six C. parapsilosis sensu stricto strains were resistant to fluconazole, and one was dose-dependent susceptible. Five C. parapsilosis sensu stricto strains were NWT to posaconazole. Only one C. orthopsilosis strain was NWT for anidulafungin, micafungin, caspofungin, fluconazole, voriconazole, amphotericin B, and posaconazole, while the rest of the strains were wild-type.Conclusion. C. parapsilosis sensu stricto was the main clinical isolate from the C. parapsilosis complex in our hospital. Most strains were isolated from the bloodstream. The susceptibility rate to commonly used antifungal drugs was more than 96 %. Furthermore, most of the infected patients were elderly male cancer patients.

Characteristics of malignant tumors of digestive system and autoimmune diseases.

With the development of preoperative examination technology, endoscopic ultrasonography-guided fine-needle aspiration biopsy (EUS-FNA) has been widely used in preoperative pathological diagnosis. However, challenges remain in obtaining appropriate tissue samples and obtaining accurate pathological results to predict disease risk. Therefore, this study aimed to analyze the characteristics of digestive system malignancies and their autoimmune diseases, and to analyze the clinicopathological features, preoperative CT imaging features and pathological grades of pNENs of different pathological degrees of pNENs on the prognosis of pNENs. Experimental results showed that non-functioning pancreatic neuroendocrine tumors showed prominent surrounding hypervascular lesions on multiphase CT examination. Among them, arterial phase and portal venous phase were most clearly imaged at the end, and the degree of local vascular invasion could be used as an index to evaluate its resectability. The sensitivity of CT examination was 63% to 82%, and the specificity was 83% to 100%, depending on the size.

Xiaojianzhong decoction prevents gastric precancerous lesions in rats by inhibiting autophagy and glycolysis in gastric mucosal cells

Gastric precancerous lesions (GPL) precede the development of gastric cancer (GC). They are characterized by gastric mucosal intestinal metaplasia and dysplasia caused by various factors such as inflammation, bacterial infection, and injury. Abnormalities in autophagy and glycolysis affect GPL progression, and their effective regulation can aid in GPL treatment and GC prevention. Xiaojianzhong decoction (XJZ) is a classic compound for the treatment of digestive system diseases in ancient China which can inhibit the progression of GPL. However, its specific mechanism of action is still unclear. To investigate the therapeutic effects of XJZ decoction on a rat GPL model and the mechanisms underlying its effects on autophagy and glycolysis regulation in GPLs. Wistar rats were randomly divided into six groups of five rats each and all groups except the control group were subjected to GPL model construction for 18 wk. The rats' body weight was monitored every 2 wk starting from the beginning of modeling. Gastric histopathology was examined using hematoxylin-eosin staining and Alcian blue-periodic acid-Schiff staining. Autophagy was observed using transmission electron microscopy. The expressions of autophagy, hypoxia, and glycolysis related proteins in gastric mucosa were detected using immunohistochemistry and immunofluorescence. The expressions of the following proteins in gastric tissues: B cell lymphoma/Leukemia-2 and adenovirus E1B19000 interacting protein 3 (Bnip-3), microtubule associated protein 1 light chain 3 (LC-3), moesin-like BCL2-interacting protein 1 (Beclin-1), phosphatidylinositol 3-kimase (PI3K), protein kinase B (AKT), mammalian target of rapamycin (mTOR), p53, AMP-activated protein kinase (AMPK), and Unc-51 like kinase 1 (ULK1) were detected using western blot. The relative expressions of autophagy, hypoxia, and glycolysis related mRNA in gastric tissues was detected using reverse transcription-polymerase chain reaction. Treatment with XJZ increased the rats' body weight and improved GPL-related histopathological manifestations. It also decreased autophagosome and autolysosome formation in gastric tissues and reduced Bnip-3, Beclin-1, and LC-3II expressions, resulting in inhibition of autophagy. Moreover, XJZ down-regulated glycolysis-related monocarboxylate transporter (MCT1), MCT4, and CD147 expressions. XJZ prevented the increase of autophagy level by decreasing gastric mucosal hypoxia, activating the PI3K/AKT/mTOR pathway, inhibiting the p53/AMPK pathway activation and ULK1 Ser-317 and Ser-555 phosphorylation. In addition, XJZ improved abnormal gastric mucosal glucose metabolism by ameliorating gastric mucosal hypoxia and inhibiting ULK1 expression. This study demonstrates that XJZ may inhibit autophagy and glycolysis in GPL gastric mucosal cells by improving gastric mucosal hypoxia and regulating PI3K/AKT/mTOR and p53/ AMPK/ULK1 signaling pathways, providing a feasible strategy for the GPL treatment.

An assessment of consumer demand for medicinal plants: A case of Istanbul

Non-wood forest products (NWFPs) are collected or harvested for commercial and medical purposes from forests. These plants can be diversified into wild food plants, medicinal and aromatic plants, bulbous plants, mushrooms, dye plants and honey. The aim of this study is to assess the demand of consumers who buy medicinal plants in Istanbul and to reveal the relationships between the variables affecting the demand. For this purpose, face-to-face interviews were conducted with consumers (n=384) who purchased medicinal plants in 20 randomly selected districts of Istanbul. Descriptive analysis, correlation analysis and Chi-square independence test were used in data analysis. These analyses were carried out with the SPSS 22.0 statistical package program. According to the results, the most demanded medicinal plants are linden, mint and ginger, respectively. People buy medicinal plants mostly for the treatment of respiratory system and digestive system diseases and the demand is generally high in winter and autumn. The most important factor affecting the purchasing preferences of consumers is freshness. The consumers mostly buy the medicinal plants from herbalists. According to the Chi-square analysis findings, there is a significant relationship between the gender of consumers and the purpose of using medicinal plants. In addition, while there was no relationship between gender and price, brand, quality, there was a statistically significant relationship between expiration date and visuality.

Effects of dexmedetomidine combined with sufentanil on injury and expression of high mobility group box protein B1/toll-like receptors signaling pathway in rats with pancreatitis

Pancreatitis is a common disease of digestive system, easy to deteriorate, acute onset, poor prognosis, high fatality rate. Analgesic and sedative drugs are often used to treat pancreatitis. Dexmedetomidine is an adrenergic receptor agonist, and Sufentanil is a common analgesic sedative. However, the mechanism of their combined use in the treatment of pancreatitis injury has not been fully elucidated. Wistar rat pancreatitis Model was established and randomly divided into 4 groups: Dex group, Dex+Suf group, model group and Sufentanil group. Compare and analyze heart rate, oxygen saturation, body temperature, and respiration. The onset time, duration, analgesic time and adverse reactions were recorded. Serum amylase, creatinine and alanine aminotransferase were detected. Serum IL-6 and IL-1β levels were detected, and apoptotic activity was detected by Caspase 3 activity kit. The expression of HMGB1, TLR2 and TLR4 mRNA in pancreatic tissues. Dexmedetomide alone or combined with sufentanil can improve the general indicators, sedation and analgesia time is shorter, longer duration. Serum secretion of IL-6 and IL-1β decreased, expression of HMGB1, TLR2 and TLR4 decreased, pancreatic serological serum amylase, creatinine, alanine aminotransferase activities decreased, Caspase 3 activity decreased. The curative effect of combination group was significantly higher than that of model group (p < 0.01). Dexmedetomidine combined with sufentanil can affect the expression of HMGB1/TLRs, inhibit inflammation, improve sedation and analgesia, and inhibit apoptosis, so as to alleviate the injury of acute pancreatitis.

National Mortality Tendencies of Population in Ukraine and the Kharkiv Region

The purpose of the study was to determine national tendencies of mortality in Ukraine and the Kharkiv region. Materials and methods. Data from official sources of statistical information of Ukraine were used and systematic analysis and generalization of the obtained data was performed and tendencies of mortality in Ukraine were calculated. Results and discussion. According to the dynamics of mortality rates of the population of Ukraine in 2010–2019, there was a decrease in almost all nosological forms of disease. For some groups of diseases there was a tendency of increasing mortality per 100 thousand population with tendencies for the general population +3.0% and +3.9%, for men +3.4% and +1.1% and women +2.2% and 8.3%. Obtained results on the overall dynamics of declining tendencies in mortality due to major diseases in recent years and their growth due to some nosologies and structural characteristics of the main causes of mortality are in complete agreement with other studies. The study noted an increase in tendencies of mortality of population of Ukraine in 2010–2019 (per 100 thousand population) in several disease groups: neoplasms (tendency +3.0%: males +3.4 %, females +2.2%) and diseases of digestive system (respectively +3.9%: +1.1% and +8.3%). The Kharkiv region leads among other regions in 2019 in such classes: overall – 3rd place (40,611 cases), diseases of the circulatory system – 2nd (28,079), coronary heart disease – 2nd (21,154), diseases of the digestive system – 2nd (1,624), external causes of death – 2nd (2,225), neoplasms – 3rd (5,714), cerebrovascular disease – 4th (5,009), diseases of the respiratory system – 4th (810), diseases of the genitourinary system – 4th (196) and congenital malformations, deformities and chromosomal abnormalities – 4th (69). Significant increase in tendencies found in the Kharkiv region during 2018–2019 both in absolute counts and per 100 thousand: complications of pregnancy, childbirth and postpartum period (+300.0 and +293.8%), certain conditions that occur in the perinatal period (+14.3 and +24.3%), other causes (+13.8 and +14.5%) and urolithiasis (+12.0 and +12.9%) with defined structural characteristics of mortality in diseases of the circulatory system (69.09%), neoplasms (14.04%) and accidents and trauma (5.26%). Conclusion. The obtained results of the general dynamics of decreasing mortality tendencies due to major diseases and their growth due to some nosologies and structural characteristics of the main causes of mortality in Ukraine completely coincide with the data of other studies

Domestic researchers who significantly contributed in the study of digestive system diseases: images in art. Vasyl Parmenovich Obraztsov

Vasyl Parmenovich Obraztsov (1849 — 1920) was an outstanding therapist, Professor of Medicine, and innovator in the field of techniques for diagnosing diseases of the cardiovascular and digestive systems. The research interests of V. P. Obraztsov were mainly focused on studying the most important issues in general and specific gastroenterology and cardiology. At the same time, he aimed to invent reliable techniques for the physical diagnosis of diseases of the abdominal organs and heart.
 Palpation of the abdominal organs, invented and introduced into clinical practice by V. P. Obraztsov, is based on four principles. During deep breathing, especially when the patient is lying down, the abdominal press occasionally relaxes. During the exhalation phase, the researcher tries to reach deep into the abdominal cavity with a palpating hand and press an organ that needs to be felt against the posterior abdominal wall. The first principle of the research technique that V. P. Obraztsov came up with is deep palpation. It is usually possible to palpate any organ in the abdomen when the fingertips of the palpating hand slide off the edge of the organ being examined. The palpable part of the gastrointestinal tract is pressed against the posterior abdominal wall with a strong downward movement of the hand that is perpendicular to the organ’s long axis. When the fingers slip from the organ, the localization of the organ, as well as its consistency, shape, width, and mobility, can be determined; at the same time, the patient may report unpleasant or painful sensations. Sliding palpation is the second principle of the research technique by V. P. Obraztsov. According to topographic anatomy, each organ in the abdominal cavity has its own normal localization. Now, X‑rays confirm this, but V. P. Obraztsov had to do experiments to develop a typical topography of certain segments of the digestive tract in the abdominal cavity of a healthy person and find typical projections of internal organs on the anterior wall of the abdomen. Further studies by his students proved the correctness of his description of the topography of the abdominal organs. Of course, both V. P. Obraztsov and his students repeatedly emphasized the possibility of individual differences or physiological variants in the localization of the digestive tract organs in patients. Topographic palpation has become the third guiding principle of the research technique developed by V. P. Obraztsov. V. P. Obraztsov suggested that a study of the organs in the abdomen be done in a certain sequence. First, the sigmoid colon is examined, then the cecum, the terminal segment of the small intestine, the appendix, the stomach, with an attempt to palpate its small and large curvatures, and the pylorus. After that, the palpation of the transverse colon and the ascending and descending sections of the large intestine starts. The examination is completed by determining the localization, consistency, shape, mobility, and other features of the parenchymal organs — the liver, spleen, and kidneys. Thus, systematic palpation is the fourth principle of the examination of the abdominal organs.
 V. P. Obraztsov made a significant contribution to the history of cardiology. Systematic cardiac auscultation with a stethoscope and directly with the ear let him describe some features of the tone I, report the presence of a normal tone III, and point out the relatively frequent detection of bifurcation and splitting of heart tones. A series of works by V. P. Obraztsov on the study of the gallop rhythm is of particular importance for cardiology.
 In 1950, on the centenary of his birth, the government of the Ukrainian SSR decided to publish his «Selected Works», build a monument, and assign his name to the Department of Internal Diseases No. 1 of the Kyiv Medical Institute. By the same date, the country’s medical journals had published his students’ memoirs, as well as articles and essays about his life path.

Molecular insights into the glucose transporter GLUT5

<p indent="0mm">Glucose transporter 5 (GLUT5) is the only membrane transporter that specifically transports fructose in the human body. GLUT5 is mainly expressed in small intestinal epithelial cells and plays an important role in dietary fructose uptake and metabolism. In recent years, with the continuous improvement of living standards, the global per capita fructose intake has increased dramatically, resulting in a gradual increase in obesity and metabolic diseases. Due to the critical role of GLUT5 in dietary fructose absorption and metabolism, the relationship between GLUT5 and human diseases is receiving increasing attention. Increasing evidence suggests that GLUT5 plays a significant role in diseases ranging from digestive system diseases to a variety of human cancers. However, due to various difficulties and shortcomings, the molecular structure of GLUT5 has not been fully elucidated. Further understanding of the molecular structure and biological function of GLUT5 will help us to better understand the mechanism of GLUT5-related diseases and design more targeted therapeutic drugs. In this review, we mainly introduce the molecular structure and transport mechanism of mammalian GLUT5, and provide an outlook for potential application of GLUT5 from the perspective of basic molecular biology, in order to provide a better strategy for the clinical treatment of fructose metabolism-related diseases.

The gut microbiota: A new perspective for tertiary prevention of hepatobiliary and gallbladder diseases.

The gut microbiota is a complex ecosystem that has coevolved with the human body for hundreds of millions of years. In the past 30 years, with the progress of gene sequencing and omics technology, the research related to gut microbiota has developed rapidly especially in the field of digestive system diseases and systemic metabolic diseases. Mechanical, biological, immune, and other factors make the intestinal flora form a close bidirectional connection with the liver and gallbladder, which can be called the "gut-liver-biliary axis." Liver and gallbladder, as internal organs of the peritoneum, suffer from insidious onset, which are not easy to detect. The diagnosis is often made through laboratory chemical tests and imaging methods, and intervention measures are usually taken only when organic lesions have occurred. At this time, some people may have entered the irreversible stage of disease development. We reviewed the literature describing the role of intestinal flora in the pathogenesis and biotherapy of hepatobiliary diseases in the past 3-5 years, including the dynamic changes of intestinal flora at different stages of the disease, as well as the signaling pathways involved in intestinal flora and its metabolites, etc. After summarizing the above contents, we hope to highlight the potential of intestinal flora as a new clinical target for early prevention, early diagnosis, timely treatment and prognosis of hepatobiliary diseases. GRAPHICAL ABSTRACT.

Analysis of clinical diagnosis and treatment of Behet's disease with sore throat as the first symptom

Objective:To summarize the clinical and diagnostic characteristics of Behet's disease with sore throat as the first symptom, so as to improve clinicians' understanding of the disease. Methods:The clinical data of 28 patients with Behet's disease who were first treated in Department of Otorhinolaryngology, Peking Union Medical College Hospital from January 2015 to January 2022 were analyzed retrospectively. All patients were examined by electronic laryngoscopy at the first visit and treated with local symptomatic therapy. Twenty-one patients were examined for C-reactive protein and blood sedimentation, and some patients were examined for immunological parameters. After the diagnosis of leukoaraiosis was confirmed, treatment was based on immunosuppression and could be supplemented with oral hormone therapy depending on the extent of the lesion and other organ involvement. Results:Sore throat was the first symptom of all patients, which could be accompanied by dysphagia or dyspnea. Endoscopy revealed oropharyngeal ulcer in 25 cases（89.3%）, laryngeal ulcer in 15 cases（53.6%）, hypopharyngeal ulcer in 14 cases（50.0%）, and adhesion of nasopharynx or throat in 8 cases（28.6%）. All patients had oral ulcer at the same time, including 21 cases（75.0%） with genital ulcer, 18 cases（64.3%） with skin damage, and 11 cases（39.3%） with eye disease. In the course of disease, there were 4 cases（14.3%） with joints involvement, 3 cases（10.7%） with nervous system disease, and 1 case（3.6%） with digestive system disease. The treatment is mainly immunosuppressive, and oral hormone therapy can be supplemented according to the extent of the disease and the involvement of other organs. Conclusion:The clinical manifestations of Behet's disease, with sore throat as the first symptom, are diverse. The ulcer may involve multiple parts of the throat, and a few patients may involve multiple systems of the whole body. Clinical attention should be paid to the early diagnosis and timely treatment to prevent or delay the involvement of the lesion in important organs or systems.

Berberine inhibits RA-FLS cell proliferation and adhesion by regulating RAS/MAPK/FOXO/HIF-1 signal pathway in the treatment of rheumatoid arthritis.

Rheumatoid arthritis (RA) is a common chronic immune disease. Berberine, as its main active ingredient, was also contained in a variety of medicinal plants such as Berberaceae, Buttercup, and Rutaceae, which are widely used in digestive system diseases in traditional Chinese medicine with anti-inflammatory and antibacterial effects. The aims of this article were to explore the therapeutic effect and mechanism of berberine on rheumatoid arthritis. Cell Counting Kit-8 was used to evaluate the effect of berberine on the proliferation of RA fibroblast-like synoviocyte (RA-FLS) cells. The effect of berberine on matrix metalloproteinase (MMP)-1, MMP-3, receptor activator of nuclear factor kappa-Β ligand (RANKL), tumour necrosis factor alpha (TNF-α), and other factors was determined by enzyme-linked immunoassay (ELISA) kit. Transcriptome technology was used to screen related pathways and the potential targets after berberine treatment, which were verified by reverse transcription-polymerase chain reaction (RT-qPCR) and Western blot (WB) technology. Berberine inhibited proliferation and adhesion of RA-FLS cells, and significantly reduced the expression of MMP-1, MMP-3, RANKL, and TNF-α. Transcriptional results suggested that berberine intervention mainly regulated forkhead box O (FOXO) signal pathway, prolactin signal pathway, neurotrophic factor signal pathway, and hypoxia-inducible factor 1 (HIF-1) signal pathway. The effect of berberine on RA was related to the regulation of RAS/mitogen-activated protein kinase/FOXO/HIF-1 signal pathway in RA-FLS cells.Cite this article: Bone Joint Res2023;12(2):91-102.

Key Drivers of Long-Term Rates of Mortality Improvements in the United States: Period, Cohort, and Cause of Death Analysis, 1959–2016

The main objective of this article is to identify significant mortality drivers in the U.S. population that have a high likelihood of being linked to the historical improvement or deterioration of mortality over the 1959 to 2016 period. To achieve this objective, we integrate cause of death modeling with epidemiological evidence to explain the underlying drivers. In particular, we analyze cause of death data for six broad groups of causes including circulatory diseases, neoplasms, respiratory diseases, digestive system diseases, external causes, and other causes. We also identify and analyze some key causes that serve as markers of trends in behavioral risk factors that could drive mortality change. These risk factors are AIDS and tuberculosis, alcohol abuse, dementia and Alzheimer’s disease, diabetes and obesity, drug dependency, homicide, hypertensive disease, self-harm, and smoking. We analyze these different groupings of causes of death using life expectancy decomposition techniques and formal age–period–cohort decomposition of both mortality rates and mortality improvement rates. We find that the story of mortality evolution in the United States in the second half of the 20th century, which continued into the first decade of the 21st century, has been mainly a story of mortality improvements from circulatory diseases. Nevertheless, despite the clear dominance of circulatory diseases as a leading cause of death and as the main contributor to mortality improvements between 1959 and 2016, the decline in mortality has been more complex. The trajectories of other major causes have ebbed and flowed, and the patterns of behavioral risk factors that contribute to overall mortality change have seen changes between generations.

Isoalantolactone protects against ethanol-induced gastric ulcer via alleviating inflammation through regulation of PI3K-Akt signaling pathway and Th17 cell differentiation

Gastric ulcer (GU) is one of the most prevalent digestive system diseases in humans, and it has been linked to inflammation. Previous studies have demonstrated the anti-inflammatory potential of isoalantolactone (IAL), a sesquiterpene lactone isolated from Radix Inulae. However, the pharmacological effects of IAL on GU and its mechanism of action are still unclear. Hence, the present study is aimed to investigate the anti-inflammatory potential of IAL on GU. Firstly, we assessed the effect of IAL on ethanol-induced injury of human gastric epithelial cells and the levels of inflammatory cytokines in cell culture supernatants. Then, the anti-inflammatory effects of IAL were confirmed in vivo using zebrafish inflammation models. Furthermore, the mechanism of IAL against GU was preliminarily discussed through network pharmacology and molecular docking studies. Quantitative real-time PCR assays were also used to confirm the mechanism of IAL action. ALB, EGFR, SRC, HSP90AA1, and CASP3 were found for the first time as the key targets of the IAL anti-GU. PI3K-Akt signaling pathway and Th17 cell differentiation were identified to play a crucial role in the anti-GU effects of IAL. In conclusion, we found that IAL has anti-inflammatory effects both in vitro and in vivo, and showed potential protective effects against ethanol-induced GU.