Helicobacter pylori is a gram-negative bacterium that was first isolated in 1982. Since then, H. pylori infection in humans has been shown to be associated with gastritis, peptic ulcer disease, gastric carcinoma, and mucosa-associated lymphoid tissue (MALT) lymphoma as well. The epidemiology, transmission, and pathogenicity of H. pylori has been a subject of intensive study. Successful treatment improves the cure rate of peptic ulcerations and treatment with antimicrobials also decreases the recurrence rate of these diseases. Better regimens having less toxicity and a good eradication rate have also been developed. A better understanding of the pathophysiologic mechanisms relating to H. pylori induced mucosal damages would result in more options for the prevention of peptic ulcers and carcinogenesis. Korea has a relatively high incidence of H. pylori infection and gastric cancer. Growing interest has developed in view of its importance in being associated with various gastroduodenal diseases. Furthermore, along with a high incidence of H. pylori-related disease in Korea, because the interaction between H. pylori, host factors and environmental factors is important in disease pathogenesis, we need to have precise data on the characteristics of H. pylori-related diseases that occur in Korea. In the present report we review the epidemiology, transmission route, diagnosis, pathogenesis, treatment methods and relationship with gastroduodenal diseases with in special references to basic and clinical data that have been published.
Dyspepsia/etiology ; Helicobacter Infections/*complications/diagnosis/etiology ; *Helicobacter pylori ; Human ; Korea ; Peptic Ulcer/etiology ; Stomach Neoplasms/etiology

OBJECTIVETo explore the application value of correspondence analysis in ecological study.

METHODSWe adopted correspondence analysis method to analyze the relationship between the amount of food intake in some cities in China and the male gastric carcinoma mortality.

RESULTSAccording to scatter plots of row and column points, there were regional differences among the male gastric carcinoma mortality in different cities of China.

CONCLUSIONThe scatter plot of row and column points indicated directly that there were regional differences among the male gastric carcinoma mortality in different cities of China. Males from the Southern part of the country ate more rice and salt, less wheaten food and fewer light vegetables than those from the northern parts, suggesting that there might be some carcinogenic factors in some food stuff involved.

Carcinoma ; etiology ; mortality ; China ; epidemiology ; Diet Surveys ; Humans ; Male ; Stomach Neoplasms ; etiology ; mortality

OBJECTIVETo investigate cachexia in hospitalized patients with digestive system cancer and evaluate its impact on clinical outcomes.

METHODSBy analyzing the clinical data of 5118 hospitalized patients with digestive system cancer in Zhongshan Hospital of Fudan University from January 2012 to December 2013, cachexia was investigated and clinical outcomes between cachexia patients and non-cachexia patients was compared.

RESULTSThe total cachexia rate of hospitalized patients with digestive system cancer was 15.7%(803/5118). The highest rate of cachexia was 34.0%(89/262) in patients with pancreatic cancer followed by gastric cancer 22.4%(261/1164), colon cancer 21.7%(146/672), and rectal cancer 20.1%(117/581). In cachexia group and non-cachexia group, the overall completion rate of radical resection was 67.1%(539/803) and 74.5%(3214/4315) respectively(P<0.05). Compared to the non-cachexia group, the cachexia group was associated with longer postoperative hospital stay [(11.5±6.2) d vs. (9.4±4.9) d, P<0.05], slower postoperative recovery of bowel function [(3.4±0.9) d vs. (3.2±0.8) d, P<0.05], longer postoperative time to intake of semifluid [(4.4±1.5) d vs. (3.9±1.1) d, P<0.05], and more postoperative complications within 28 days after radical surgery [8.9%(48/539) vs. 5.8%(186/3214), P<0.05]. After radical surgery, the ICU admission rate of the cachexia group [24.3%(131/539)] was higher than that of the non-cachexia group [20.1%(646/3214)] with significant difference(P<0.05). Compared to non-cachexia group, the reoperation rate [3.2%(17/539) vs. 1.5%(48/3214), P<0.05], ventilator support rate [8.0%(43/539)vs. 5.7%(184/3214), P<0.05] and mortality [2.4%(13/539) vs. 1.1%(35/3214), P<0.05] in the cachexia group were all significantly higher(all P<0.05).

CONCLUSIONSCachexia is commen in patients with digestive system cancer. Cachexia has significant adverse effects on clinical outcomes in hospitalized patients with digestive system cancer.

Cachexia ; etiology ; Colonic Neoplasms ; complications ; Defecation ; Humans ; Postoperative Complications ; Rectal Neoplasms ; complications ; Reoperation ; Stomach Neoplasms ; complications

Seven patients with giant cavernous hemangioma of the liver were treated surgically with success at Pusan Gospel Hospital, Kosin Medical College, Pusan, from 1980 through 1989. They were 3 males and 4 females, and their ages ranged from 6 to 59 years. The tumors were located on the right lobe of the liver in 5 patients and on the left lobe in 2. The lesions were solitary in all patients, and their sizes varied from 4cm to 15cm in diameter. All patients underwent hepatic resection: 1 right hepatic lobectomy and 4 partial resections for tumors on the right lobe, and 1 left lobectomy and 1 left lateral segmentectomy for tumors on the left lobe. There was no surgical death, but 1 patient had a postoperative complication: multiple stress ulcers on the stomach and ileum. The pathologic diagnosis was cavernous hemangioma in all cases. In the long-term follow-up, there was no recurrence of preoperative symptoms in any patient.
Adult ; Child ; Female ; Hemangioma, Cavernous/*surgery ; Humans ; Ileal Diseases/etiology ; Liver Neoplasms/*surgery ; Male ; Middle Aged ; Postoperative Complications/etiology ; Prognosis ; Stomach Ulcer/etiology ; Stress, Physiological/etiology ; Ulcer/etiology

OBJECTIVETo explore the major risk factors for upper gastrointestinal cancer in high occurrence areas of esophageal and gastric cancer in China.

METHODSFour high occurrence areas of esophageal cancer, namely Cixian and Shexian from Hebei province, Linxian from Henan province, Feicheng from Shandong province, and Zhuanghe from Liaoning province, which is a high occurrence area of gastric cancer, were selected for the study. The newly-diagnosed cases whose date of onset were after January 1st, 2009 were selected from the Cancer Registration Database in each district, and 751 cases diagnosed as cancers in lower segment of esophagus, cardiac and other subsite of stomach were randomly recruited. 2253 matched controls were selected to pair the cases at the ratio of 3:1. The relative information of the study objects were collected from the face-to-face interviews with trained staff by designed questionnaires, and the data was input by EpiData software. Statistic software SPSS 13.0 was applied to conduct both univariate and multivariate logistic regression analysis to evaluate odd ratios (OR) and 95% confident interval (CI).

RESULTSAs univariate analysis shown, 66 objects in case group had irregular diet habit; while 90 in control group had (OR = 3.177; 95%CI: 2.127 - 4.745). A higher percentage in case group (83 objects) preferred fried food in comparison with only 214 in control group did (OR = 3.190; 95%CI: 2.061 - 4.927). 369 objects in case group, but only 119 in control group had history of gastrointestinal diseases (OR = 14.660; 95%CI: 11.342 - 18.948). 282 objects in case group had history of gastroesophageal reflux disease (GERD), which was much higher than the percentage in control group (432 objects), with OR = 3.137 (95%CI: 2.546 - 3.864). All the above factors could increase the risk for upper gastrointestinal cancer. 387 objects in case group and 1278 in control group reported they preferred fresh vegetables in daily diet, which was found to be a protective factor (OR = 0.609; 95%CI: 0.473 - 0.785). As multivariate analysis shown, history of gastrointestinal tract diseases (OR = 21.420; 95%CI: 15.484 - 29.632), irregular food diet (OR = 3.097; 95%CI: 1.740 - 5.514), pickled food (OR = 3.005; 95%CI: 1.873 - 4.819), and GERD (OR = 2.261; 95%CI: 1.673 - 3.057) were found to be risk factors for upper gastrointestinal cancer; while frequent fresh-vegetable diet was a protective factor (OR = 0.562; 95%CI: 0.396 - 0.800).

CONCLUSIONIrregular lifestyle and unhealthy diet habit could be the major risk factors for upper gastrointestinal cancers among the residents from high occurrence areas of esophageal cancer and gastric cancer in China.

Case-Control Studies ; China ; epidemiology ; Esophageal Neoplasms ; epidemiology ; etiology ; Feeding Behavior ; Gastrointestinal Neoplasms ; epidemiology ; etiology ; Humans ; Life Style ; Risk Factors ; Stomach Neoplasms ; epidemiology ; etiology ; Surveys and Questionnaires

The overall prognosis of gastric cancer has gradually improved over the past decades with growing awareness of potential carcinogens, surveillance programs and early diagnosis, as well as advances in surgical techniques and multimodality treatments. Nevertheless, the outcome of advanced stage disease still remains poor with currently available treatments, and a worldwide consensus on the standard management thereof has not been established. To improve prognosis and quality of life in gastric cancer patients, both standardization and individualization of managements are imperative. Diagnostic tests and surgical procedures need to be further sophisticated and standardized based on more recent evidences from ongoing and future randomized controlled trials, while comprehensive management should be individualized to each patient. Future challenges lie with how to optimize personalized therapies by deciphering biological complexity of gastric cancer and incorporating molecular biomarkers in clinical practice to forecast prognosis and to guide targeted therapeutics in adjunct to current standards of care.
Disease Management ; Gastrectomy ; Humans ; Lymph Node Excision ; Stomach Neoplasms/*diagnosis/drug therapy/etiology/surgery

Radical gastrectomy for gastric cancer results in various post-operative complications, and the influencing factors are complicated. The diagnosis, treatment and prevention of common complications have been reported in many literatures. However, there are few reports on the prevention and treatment of rare complications. Rare complications after radical gastrectomy are often overlooked due to their low incidence. In addition, there are few guidelines and expert consensus regarding to the rare complications. Therefore, clinicians may lack experience in the diagnosis, treatment and prevention of rare complications after radical gastrectomy. Based on the literature review and the author's experience, this article systematically reviews seven rare complications after radical gastrectomy (duodenal stump fistula, pancreatic fistula, chyle leakage, esophagomediastinal fistula, internal hernia, gastroparesis, and intussusception). This article aims to provide a comprehensive reference for the diagnosis, treatment and prevention of rare complications after radical gastrectomy for gastric cancer patients.
Humans ; Stomach Neoplasms/complications* ; Gastrectomy/methods* ; Postoperative Complications/etiology* ; Duodenal Diseases ; Laparoscopy/adverse effects* ; Retrospective Studies

Surgical resection plays pivotal role in the treatment of gastric cancer. Adequate preoperative evaluation, precise intraoperative maneuver and delicate postoperative management lay the foundation for successful gastrectomy. The aim of preoperative evaluation is to stage tumor and identify potential risk factors (including preoperative factors like age, ASA status, body mass index, comorbidity, hypoalbuminemia, and intraoperative factors like blood loss and combined resection) which could lead to postoperative complication. With the management of prehabilitation, adequate medical decision could be made and patient's fast recovery could be ensured. With the rapid adoption of ERAS concept, there is increasing attention to prehabilitation which focus on optimization of cardio-pulmonary capacity and muscular-skeletal capacity. Despite of the efficacy of prehabilitation demonstrated by randomized controlled trials, consensus has yet to be reached on the following items: specific intervention, optimal measurement, candidate population and optimal timing for intervention. Balancing the efficiency and safety, preoperative evaluation could be put into clinical practice smoothly.
Humans ; Stomach Neoplasms/complications* ; Preoperative Care/adverse effects* ; Postoperative Complications/etiology* ; Gastrectomy/adverse effects* ; Risk Factors

BACKGROUND: Early detection of gastric cancer (GC) has been the topic of major efforts in China. This study aimed to explore the risk factors associated with GC and to provide evidence for the selection of a high-risk population of GC. METHODS: Based on the cancer screening cohort of the National Cancer Screening Program in Urban China, GC patients diagnosed by endoscopy and pathological examinations constituted the case group, and controls were 1:3 matched by sex and age (±5 years) individually. The variables were selected by univariable analysis of factors such as body mass index (BMI), dietary habits, lifestyle, stomach disease history, and family history of GC; and multivariable logistic regression was used to analyze the influencing factors of GC and to calculate the odds ratio (OR) of related factors and its 95% confidence interval (CI). RESULTS: A total of 215 GC cases and 645 matched healthy controls were included in the final analysis, with a median age of 61 years for the case and control groups. Overall analysis showed that high educational level (above primary school) (OR = 0.362, 95% CI = 0.219-0.599, P < 0.001), overweight/obesity (BMI ≥24 kg/m2; OR = 0.489, 95% CI = 0.329-0.726, P < 0.001), cigarette smoking (OR = 3.069, 95% CI = 1.700-5.540, P < 0.001), alcohol consumption (OR = 1.661, 95% CI = 1.028-2.683, P = 0.038), history of stomach disease (OR = 6.917, 95% CI = 4.594-10.416, P < 0.001), and family history of GC in first-degree relatives (OR = 4.291, 95% CI = 1.661-11.084, P = 0.003) were significantly correlated with the occurrence of GC. Subgroup analyses by age and gender indicated that GC risk was still increased in the presence of a history of stomach disease. A history of chronic gastritis, gastric ulcer, or gastric polyposis was positively associated with GC, with adjusted ORs of 4.155 (95% CI = 2.711-6.368), 1.839 (95% CI = 1.028-3.288), and 2.752 (95% CI = 1.197-6.326). CONCLUSIONS Subjects who smoke, drink, with history of stomach disease and family history of GC in first-degree relatives are the high-risk populations for GC. Therefore, attention should be paid to these subjects for GC screening.
Case-Control Studies ; Humans ; Middle Aged ; Overweight ; Risk Factors ; Stomach Neoplasms/etiology*

DNA Methylation ; Helicobacter Infections ; complications ; Helicobacter pylori ; Humans ; Stomach Neoplasms ; etiology ; genetics ; Telomerase ; physiology