1.Application of exhaled gas analysis in the diagnosis of clinical diseases
Abudureheman ABUDUKADIER ; Aipire ALIYEGULI ; Abudureyimu KELIMU
Journal of Chinese Physician 2021;23(3):470-473
There are more than 3 000 kinds of volatile organic compounds (VOCs) in human exhaled gas, which are directly or indirectly related to the pathophysiological process of the body. Therefore, the detection and quantitative analysis of VOCs in vivo is helpful for the early detection, diagnosis and evaluation of treatment results. Breath analysis is a simple, noninvasive, painless, economic and time-saving detection method. It is a new field of rapid development, and has great potential in disease screening and clinical diagnosis. In this paper, the application of human exhaled gas analysis in clinical disease diagnosis and the latest progress in this field will be summarized.
2.Clinical study of argon plasma coagulation combined with laparoscopic hiatal hernia repair and fundoplication in the treatment of hiatal hernia with Barrett esophagus.
Cheng ZHANG ; Kelimu ABUDUREYIMU ; Yiliang LI ; Fuzeng SU ; Huiling LI ; Zhi WANG ; Zanlin LI ; Aikebaier AILI ; Azhati JIANG ; Alimu JIANG
Chinese Journal of Gastrointestinal Surgery 2015;18(11):1084-1087
OBJECTIVETo investigate the clinical efficacy of argon plasma coagulation (APC) combined with laparoscopic hiatal hernia repair and fundoplication in the treatment of hiatal hernia associated with Barrett esophagus.
METHODSA total of 61 cases of hiatal hernias with Barrett esophagus from June 2010 to January 2014 in the Department of Minimal Invasive Surgery, Hernia and Abdominal wall Surgery, People's Hospital of Xinjiang Uyhur Autonomous Region were prospectively enrolled and were randomly allocated into two groups by computer system. Twenty-nine patients received esomeprazole 40 mg/d after APC treatment for 8 weeks (APC with medicine group). Thirty-two patients underwent laparoscopic hiatal hernia repair and Nissen fundoplication after APC treatment (APC with surgery group). All the patients were reviewed by gastroscope and pathologic examination at half a year and one year after operation respectively. Differences of disease improvement and recurrence between the two groups were evaluated.
RESULTSIn APC with medicine group, the Barrett's esophagus was relieved after one or two times of APC treatment, however, gastroscope and pathology revealed recurrence of Barrett's esophagus in 7 cases at half a year, and cumulative 16 cases of recurrences were detected after one year follow-up(16/29, 55.2%). In APC with surgery group, only one patient had recurrent Barrett's esophagus at half a year, and a total of two at one year follow-up by gastroscope examination(2/32, 6.3%). Significantly low recurrence rate of Barrett's esophagus was observed in APC with surgery group compared to APC with medicine group(P<0.01). Furthermore, recurrent hiatal hernia was detected in only one case in APC with surgery group. No esophageal cancer was found in both groups during follow-up.
CONCLUSIONAPC combined with laparoscopic hiatal hernia repair and fundoplication is an ideal method for patients with hiatal hernia and Barrett's esophagus.
3.The role of Nox-4 in gastric mucosal inflammation induced by chronic restraint stress in mice
Yisireyili MAIMAITI ; Alimujiang AZIGULI· ; Wulamu WUBULIKASIMU· ; Yiliang LI ; Aili AIKEBAIER ; Xinsheng ZHAO ; Maisiyiti ALIMUJIANG ; Yuan JIANG ; Abudureyimu KELIMU
Chinese Journal of Behavioral Medicine and Brain Science 2019;28(4):316-321
Objective To investigate the expression of NADPH oxidase Nox-4 induced by stress in gastric mucosa and its role in inflammation.Methods Twenty male SPF Kunming mice were randomly divided into chronic restraint stress group(stress group) and control group.Stress mice were restrained in selfmade restraint device for 2 hours each day.The rest of the time,the mice in the two groups had free access to food and water normally,experiment lasted 14 days.The histopathological changes of gastric mucosa were assessed by HE staining under light microscope.The expression of Nox-4 in gastric mucosa of mice was carried out by immunohistochemical method.The relative expression levels of Nox-4,antioxidant protein (Mn-SOD,GSH,Catalase) and inflammatory factors(IL-8,IL-1β,TNF-α) in gastric mucosa were detected by real-time quantitative RT-PCR and ELISA.Results Basal cell proliferation,neutrophil,eosinophil and plasma cell infiltration and inflammatory changes were observed in the lamina propria and glandular epithelium of stress mice,while no obvious abnormalities were found in control mice.The expression of Nox-4 in stress group was deeper and more abundant than that in control group,mainly expressed in lamina propria and glandular epithelium.The mRNA expression levels of Nox-4 in gastric mucosa of stress group was(2.42±0.51) times higher than that of control group,and blood concentration of stress group was(2.23±0.67) times higher than that of control group(t=-46.32,P<0.001).The RT-PCR of antioxidant proteins in gastric mucosa showed that the transcription levels of Mn SOD,GSH and Catalase in stress group were significantly lower than that of control group (Mn-SOD:0.59± 0.10,GSH:0.58± 0.11,Catalase:0.57± 0.09),and there were significant differences between the two groups(t=13.57,11.67,15.01,P<0.01).RT-PCR results showed that the transcription levels of IL-8,IL-1β,TNF-α in stress group were significantly higher than those in control group (IL-8:1.47±0.34,IL-1β:1.48 ± 0.42,TNF-α:1.51 ± 0.37),and there were significant differences in two groups(t=-18.45,-19.14,-20.85,P<0.01).ELISA results showed that the serum levels of inflammatory factors in stress group were significantly higher than those in control group(2.25±0.37,3.59±0.45,3.41±0.34),and the differences were statistically significant(t=-47.11,-79.36,-96.32,P<0.01).Pearson correlation analysis showed that there was a positive correlation between serum concentration of Nox-4 and inflammatory factors(IL-8,IL-1β,TNF-αt) in stress group(r=0.97,0.99,0.98,P<0.01).Spearman rank correlation analysis showed that the grade of gastric mucosal inflammation was positively correted with serum levels of Nox-4 and inflammatory factors (IL-8,IL-1β,TNF-α) (r =0.96,0.92,0.91,0.94,all P< 0.01)Conclusion Stress may lead to gastric mucosal lesion by overexpression of proinflammatory factors through destroying the balance of oxidation/antioxidant system in gastric mucosa.
4.Expression and its clinical significance of immunological markers in tumor tissues of 338 patients with gastrointestinal stromal tumor
Abudureyimu · KELIMU ; Wulamu · WUBULIKASIMU ; Maimaiti · YUSUFU ; Maimaitiming · MAIMAITIAILI
Chinese Journal of Digestion 2018;38(1):20-24
Objective To analyze the expressions and clinical significance of CD117,CD34,smooth muscle actin (SMA),DOG-1 and desmin in tumor tissues of patients with gastrointestinal stromal tumor (GIST).Methods From May 2008 to December 2016,338 GIST patients were enrolled and the clinicopathological characteristics were recorded.The expressions of CDl17,CD34,SMA,DOG-1 and desmin in tumor tissues of the enrolled patients were detected by immunohistochemistry.Chi-square test and rank-sum test were performed for statistical analysis.Results Among 338 GIST patients,cases positive for CD117,CD34,SMA,DOG-1 and desmin were 332 (98.2%),308 (91.1%),133 (39.3%),322 (95.3%) and 48 (14.2%),respectively.There were significant differences in CD34 expression among tumors with different maximum diameter,risk grade and primary site (Z=-3.085,-3.064,x2 =57.110;all P<0.05).The difference in CD117 expression among different nationalities was statistically significant (x2=10.641,P<0.05).The differences in desmin expression among tumors with different maximum diameter,risk grade and mitotic counting were statistically significant (Z=-2.343,-2.625and-2.005,all P<0.05).Among all 338 GIST patients,six cases for CD117 were negative,five of them for CD34 were positive,three SMA positive and five DOG-1 positive.The co-expression positive rates of CD117 with CD34,SMA,DOG-1 were 89.6%(303/338),38.5%(130/338),93.8%(317/338)and 14.2%(48/338),respectively.Conclusions CD117 is an essential immunological marker for the diagnosis of GIST.For CD117-negative GIST patients,CD34,SMA,DOG-1 and desmin are helpful in improving the accuracy of GIST diagnosis and differentiated diagnosis.
5.The esophageal expression of fibrotic cytokines and NADPH oxidase in stress induced esophageal fibrosis and its significance
Yisireyili MAIMAITI ; Wulamu WUBULIKASIMU ; Aili AIKEBAIER ; Yiliang LI ; Abudureyimu KELIMU
Journal of Chinese Physician 2019;21(5):672-676
Objective To detect the expression levels of collagen1 (colla-1),transforming growth factor-β1 (TGF-β1),a-smooth muscle actin (α-SMA) and nicotinamide adenine dinucleotide phosphate oxidase 4 (NOX-4) in mouse esophagus submitted to chronic restraint stress (CRS),in order to discuss stress-induced esophageal fibrosis and the role of oxidative stress.Methods 20 male Kunming mice were randomly divided into two groups,CRS and normal control (NC).The mice in CRS group were submitted to 2 h per day of restraint stress using home-made device for a period of 14 days,and the mice in both group were treated the same at rest of the time.Fibrotic changes of esophageal tissue were observed using Masson staining.The expression levels of NOX-4 and related fibrotic cytokines in esophageal tissues were detected by several methods such as immunohistochemistry,enzyme-linked immunosorbent assay (ELISA) and realtime polymerase chain reaction (qRT-PCR).Results Body weight in CRS group was significantly lower than NC group (8.75 ± 1.69 vs 12.69 ± 3.16),with statistically significant difference (t =3.11,P < 0.05).Masson staining revealed that CRS mice showed distinct fibrosis of epithelial interstitium,while there was no distinct changes observed in NC mice.Immunohistochemical staining revealed intense staining for NOX-4 in epithelial,mucosal and submucosal layers of esophagi in CRS mice.ELISA showed that the serum level of NOX-4 in CRS mice was higher than NC mice (1.442 ± 0.05 vs 0.449 ± 0.08),with statistically significant difference (t =-27.32,P < 0.01).Real-time PCR results showed that the expression of colla-1,TGF-β1,α-SMA and NOX-4 in CRS mice were as (2.443 ±0.36,2.78 ±0.13,2.244 ±0.18,2.448 ±0.440) times higher than NC mice,with statistically significant difference (t =-11.19,-38.86,-19.90,-10.37,P < 0.01).Conclusions Fibrotic cytokines such as colla-1,TGF-β1 and α-SMA may participate in formation of stress induced esophageal fibrosis,and oxidative stress may play crucial role in the process of esophageal fibrosis.
6.Role of MDA in the pathogenesis of GERD esophagus mucosal inflammatory injury
Mijiti ABULAJIANG ; Yisireyili MAIMAITI ; Aili AIKEBAIER ; Wulamu WUBULIKASIMU ; Zhengyi CAO ; Yiliang LI ; Alimujiang AZIGULI ; Yuan JIANG ; Abudureyimu KELIMU
Journal of Chinese Physician 2019;21(7):997-1001,1006
Objective To investigate the expression of malondialdehyde ( MDA) in esophageal mu-cosa of different types of gastroesophageal reflux disease ( GERD) patients and its role in the esophageal in-flammation. Methods According to the inclusion and exclusion criteria, 42 patients hospitalized in the the Xinjiang Uygur Autonomous Region People's Hospital from December 2017 to October 2018 were selected as the research group. 8 healthy subjects completed physical examination were set up as healthy control group. GERD completed GERDQ score, 24 h pH monitoring, and taken 3 cm on the dentate line of the esophagus as a specimen. The study group was divided into non-erosive reflux disease (NERD) group (17 cases) and Ero-sive reflux disease [erosive esophagitis (RE)] group (25 cases). Then hematoxylin-eosin (HE) staining, immunohistochemistry, real-time polymerase chain reaction ( qPCR ) , enzyme-linked immunosorbent assay (ELISA) methods were used to detect inflammation, oxidative stress (MDA), antioxidant enzyme [manga-nese superoxide dismutase (Mn SOD), glutathione (GSH), catalase (CAT)], and proinflammatory cyto-kines [monocyte chemotactic protein-1 (MCP-1), interlukin-8 (IL-8), tumor necrosis factorα(TNF-α)]. Results There was no significant difference in body mass index ( BMI ) between the three groups ( P >0. 05). 24 h pH monitoring of esophagus showed that the indexes of weak acid reflux (4
7.Research progress on the role of intestinal flora in the pathogenesis of gastroesophageal reflux disease
Kasimu AIHEMAITI ; Yisireyili MAIMAITI ; Abudureyimu KELIMU
Journal of Chinese Physician 2022;24(8):1273-1276
Gastroesophageal reflux disease (GERD) is a global digestive system disease caused by the reflux of gastric contents into the esophagus and the injury of esophageal mucosa. At present, the pathogenesis of GERD is not completely clear. Studies have found that GERD is closely related to intestinal flora disorder and small intestine bacterial overgrowth (SIBO). Changes in intestinal flora can participate in the occurrence and development of GERD by activating immune and inflammatory reactions, affecting gastroesophageal motility and other mechanisms. In addition, intestinal flora can also indirectly regulate and affect the pathogenesis of GERD by causing some metabolic diseases. This paper aims to review the relationship between GERD and intestinal flora.
8.Research process on pathogenesis of gastroesophageal reflux disease
Tuerhong YALIKUN ; Yisireyili MAIMAITI ; Abudureyimu KELIMU
Journal of Chinese Physician 2022;24(9):1425-1428
Gastroesophageal reflux disease (GERD) is a gastrointestinal motility disorder that results from the reflux of stomach contents into the esophagus or oral cavity, causing symptoms or complications. The typical symptoms of GERD are heartburn and regurgitation of gastric contents into the oropharynx. Heartburn is the sensation of burning or discomfort behind the sternum. Heartburn may radiate into the neck, is typically worse after meals or when in a reclining position, and may be eased by antacids. Regurgitation is the backflow of gastric contents into the mouth or hypopharynx. Epigastric pain can also be a symptom of GERD. Extraesophageal symptoms of GERD include dental erosions, laryngitis, cough, and asthma. In recent years, great progress has been made in understanding the molecular basis of GERD, suggesting that its pathogenesis is more complex and multifactorial. In this paper, the molecular pathogenesis was taken as the starting point, including the mechanism of genes in the pathogenesis and development of GERD, the mechanism of NF-κB pathway in the pathogenesis and development of GERD, the role of proteinase-activated receptor-2 in the pathogenesis of GERD, the association between abnormal serotonin pathway and GERD, and the relationship between reactive oxygen species and GERD, to summarize the pathogenesis of gastroesophageal reflux disease.
9.Review and prospect of anti-reflux surgery for gastroesophageal reflux disease in China
Kelimu ABUDUREYIMU ; Maimaitiaili MAIMAITIMING
Chinese Journal of Digestive Surgery 2021;20(6):639-642
Gastroesophageal reflux disease and its complications are harmful to human health. In recent years, due to the rising living standards and the changing diet structure of Chinese people, the incidence rate of gastroesophageal reflux disease in China is on the rise, and the awareness of clinicians on these diseases gradually increased. Laparoscopic anti-reflux surgery has become the main surgical method for the treatment of gastroesophageal reflux disease, and its curative effect has been widely recognized. At present, laparoscopic anti-reflux surgery for gastro-esophageal reflux disease has been carried out for more than 10 years in China, which has accumulated valuable experience and achieved rapid development, providing Chinese evidences for the academic community. Anti-reflux surgery for gastroesophageal reflux disease in China is also facing challenges and opportunities. How to promote anti-reflux surgery comprehensively, train professional clinicians, and improve the surgical efficacy is an important research topic of anti-reflux surgery in China. Based on the literatures at home and abroad and team experience, the authors reviewe the development of gastroesophageal reflux disease anti-reflux surgery in China, and look forward to the future development direction.
10.The role of chronic restrain stress induced Nox-4 expression and its significances in adipose inflammation
Yisireyili MAIMAITI ; Aizezi MAIMAITIAILI ; Wulamu WUBULIKASIMU ; Aili AIKEBAIER ; Yiliang LI ; Alimujiang AZIGULI ; Xinsheng ZHAO ; Jing YAN ; Wupuer SHADIGULUI ; Yuan JIANG ; Abudureyimu KELIMU
Chinese Journal of Endocrinology and Metabolism 2019;35(5):410-416
Objective To investigate stress induced Nox-4 expression and to explore its role in adipose inflammation. Methods Twenty male Kunming mice were randomly divided into two groups ( n=10 each) , chronic restraint stress group and control group. Stress mice were restrained in self-made restraint device for 2 hours per day for 14 days. HE staining, immunohistochemistry, RT-PCR, and ELISA were used to analyze the expression of Nox-4, CD11b, antioxidant protein ( Mn SOD, GSH-Px, Catalase), adipocytokines ( adiponectin, MCP-1, IL-6, TNF-a). Results White adipose tissue (WAT) of stress mice inguinal fat pad significantly shrank compared to control group. HE staining showed that there were a large number of mononuclear cells, neutrophils, eosinophils, and cell infiltration reactions and inflammatory changes in WAT of stress mice. The stress significantly increased CD11b-positive cells and the expression of mF4/80, CD68. The concentration of serum FFA in stress group increased significantly, nearly twice of the control group ( P<0.01) . Nox-4 positive staining cells in stress WAT were deeper and more abundant. The level of Nox-4 in stress WAT was significantly higher than that of control group(P<0.01). The levels of antioxidant proteins such as Mn-SOD, GSH-Px, and catalase in stress WAT were significantly lower than those of control group (P<0.01). The expression levels of adiponectin in stress WAT were significantly reduced as compared to control group ( P<0.01) . The levels of MCP-1, IL-6 and TNF-α in stress WAT were significantly higher than those in control group (P<0.01). Conclusion Stress may lead to imbalance of adipose oxidation/antioxidant system and abnormal expression of adipocytokines, which may result in adipose inflammation.