The Prognostic value of the Fibrinogen to pre-albumin ratio in malignant tumors of the digestive system: a systematic review and meta-analysis

Background In recent years, the Fibrinogen to pre-albumin ratio (FPR) has been reported in many studies to be significantly associated with the prognosis of various cancers. This systematic review and meta-analysis aimed to investigate the prognostic value of FPR in malignant tumors of the digestive system based on available evidence. Methods The relevant articles published before July 1, 2021, were systematically retrieved from electronic databases to evaluate the effect of Fibrinogen to pre-albumin ratio (FPR) on the prognosis of patients with malignant digestive system tumors and calculate the hazard ratio (HR) and the corresponding 95% confidence interval (CI). Result Thirteen articles, all from China, including 15 cohort studies and a total of 5116 cases, were included in this study. A high FPR was associated with poor overall survival (HR = 1.88, 95%CI 1.53–2.32, P < 0.001), recurrence-free survival (HR = 2.29, 95%CI 1.91–2.76, P < 0.001), progression-free survival (HR = 1.96, 95%CI: 1.33–2.90, P = 0.001), complications (HR = 1.78, 95%CI: 1.06–3.00, P = 0.029), disease-free survival (HR = 1.46, 95%CI: 1.08–1.97, P = 0.013) was significantly associated with cancer-specific survival (HR = 1.44, 95%CI: 1.15–1.79, P = 0.001). Even though intergroup differences were present, FPR was strongly associated with overall and relapse-free survival, and sensitivity analysis suggested that our results were stable. Conclusion FPR can be used as a valuable indicator to predict the prognosis of patients with malignant digestive system tumors.

Interactions of Environmental Chemicals and Natural Products With ABC and SLC Transporters in the Digestive System of Aquatic Organisms

An organism’s diet is a major route of exposure to both beneficial nutrients and toxic environmental chemicals and natural products. The uptake of dietary xenobiotics in the intestine is prevented by transporters of the Solute Carrier (SLC) and ATP Binding Cassette (ABC) family. Several environmental chemicals and natural toxins have been identified to induce expression of these defense transporters in fish and aquatic invertebrates, indicating that they are substrates and can be eliminated. However, certain environmental chemicals, termed Transporter-Interfering Chemicals or TICs, have recently been shown to bind to and inhibit fish and mammalian P-glycoprotein (ABCB1), thereby sensitizing cells to toxic chemical accumulation. If and to what extent other xenobiotic defense or nutrient uptake transporters can also be inhibited by dietary TICs is still unknown. To date, most chemical-transporter interaction studies in aquatic organisms have focused on ABC-type transporters, while molecular interactions of xenobiotics with SLC-type transporters are poorly understood. In this perspective, we summarize current advances in the identification, localization, and functional analysis of protective MXR transporters and nutrient uptake systems in the digestive system of fish and aquatic invertebrates. We collate the existing literature data on chemically induced transporter gene expression and summarize the molecular interactions of xenobiotics with these transport systems. Our review emphasizes the need for standardized assays in a broader panel of commercially important fish and seafood species to better evaluate the effects of TIC and other xenobiotic interactions with physiological substrates and MXR transporters across the aquatic ecosystem and predict possible transfer to humans through consumption.

Does Augmented Reality Also Augment Knowledge Acquisition? Augmented Reality Compared to Reading in Learning About the Human Digestive System?

Augmented Reality (AR) has become an emerging educational technology in classroom practice and science education. While most research and contemporary meta-analyses reveal benefits with regard to knowledge acquisition and motivation of Augmented Reality–based learning environments, most of the studies lack a clear and fair control condition. In this research, we compared an AR-based learning environment with a paper-based learning environment for self-directed learning about the human digestive system. In an experiment, we examined the effects of these two conditions for knowledge acquisition, cognitive load, and experience of flow and immersion. Results reveal significantly higher outcomes in favor of the text-based instruction with regard to conceptual domain knowledge and mental representation of the human digestive system and its involved organs. Positive effects of the AR learning environment are limited to a higher experience of immersion.

A Risk Signature Established From Three Coagulation-fibrinolysis Genes Predicts Prognosis in Digestive System Pancancer

Venous thromboembolism (VTE) is one of the major complications of digestive system cancer, and coagulation-fibrinolysis genes play an important role in VTE. We used univariate Cox analysis, least absolute shrinkage and selection operator (LASSO), and multivariate Cox analysis to construct 3-PCFGs (prognostic coagulation-fibrinolysis genes) model based on six prognostic coagulation-fibrinolysis genes. Gene set enrichment analysis (GSEA) was used to analyze the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways of the high- and low-risk groups. In addition, we classified digestive system pancancer patients into three clusters A, B, and C based on 3-PCFGs by K means. High-risk group and cluster C were associated with poor prognosis in digestive system pancancer. The m6A-related genes ALKBH5, FTO, RBM15, YTHDC1, and YTHDC2 (P<0.001) were highly expressed in the high-risk group and cluster C. The risk score was positively correlated with cancer-associated fibroblasts and endothelial cells. Cluster C had the highest immune score and stromal score. The poor prognosis in the high-risk group and cluster C may be affected by m6A epigenetic modification and immune microenvironment components in the digestive system pancancer.

“Worm within worm”: acute appendicitis containing an adult Ascaris lumbricoïdes

Appendicitis is the first aetiology for abdominal surgical emergency. Ascariasis is the most common helminth infection in tropical countries where it is endemic. The ability of intestinal helminths to wander through the digestive system means that it can end up in the appendix lumen and lead to appendicitis by luminal obstruction. However, this presentation is still rarely described in the literature. In fact, most of the diagnoses of roundworm associated with appendicitis are made retrospectively by the discovery of its eggs on the pathological examination of an appendectomy specimen. We report the case of a 7-year-old patient living in a tropical area who consulted for acute right lower quadrant pain. The ultrasound suspected the diagnosis of appendicitis and also revealed multiple intestinal worms including one in contact with the inflamed appendix. Surgical exploration confirmed appendicitis associated with roundworm partly in the appendicular lumen through a perforation.

Novel Effects Associated with the Use of Probiotics, Synbiotics and Prebiotics

To maintain the wellbeing of the human gut, the role of its microflora and their metabolites is fundamental. Probiotics is a Greek term, which is used to define non-living microbes that are beneficial in nature and exert numerous advantages on the host body. The intestinal microflora’s function and activity may also be improved by administering some of the prebiotics (indigestible dietary fibers) independently or in a c combination with probiotics. The term “Synbiotics” is used to denote the combination of both prebiotics and probiotics. It should always be noted that numerous disorders are being associated with the abnormal function of microbiota/microflora that can be regulated and stabilized with the help of ingestion of probiotics, prebiotics or their combination. Multiple benefits are associated with the use of these probiotics, synbiotics and prebiotics including healthier digestive system, proper immune response of the gut and treatment of numerous GI tract disorders. All these issues are encountered because of treatments with new synthetic drugs that affect the digestive system as well as numerous organs in the body. Ulcerative colitis is a term that refers to chronic inflammation of the colon emerging as a result of improper immune response to intestinal microflora of the host. Researchers have studied the effects of synbiotics to treat this chronic condition1. As for the action mechanism of the synbiotics is concerned, it is assumed that they modulate the inflammatory response through expression of the cytokines, probiotic bacteria assisted modulation of the immune cells and prebiotics assisted production of certain short chain fatty acids. Jayanama and Theou studied the consequences of improper ingestion of probiotics and prebiotics in elderly patients. They revealed that physical inactivity, sarcopenia, and polypharmacy could be treated with the help of probiotics, prebiotics or a combination of both2. All the aforementioned disorders can lead to gut dysbiosis. The researchers have also revealed that the gut microbiota homeostasis can be improved with the help of probiotics and prebiotics and they can be a helping hand in the prevention of aging and frailty. It is evident that left and right prescriptions of antibiotics and their use caused antibiotic resistance in the pathogens. This issue can be best resolved with the ingestion of probiotics and prebiotics. The systematic evidence to treat infected chronic wounds has been provided by Brognara et al3. Similarly, chronic wounds and burns treatment is done widely with the use of Lactobacillus plantarum. Some other researchers have reviewed the available data associated with the use of numerous prebiotics in the treatment of idiopathic constipation, and highly prevalent GIT disorrderrs4-6. This is due to the capability of prebiotics to improve the consistency of the stool, bloating and number of bowel movements. A limited data is available regarding the efficacy of prebiotics in the treatment of ulcerative colitis and pouchitis. It is concluded that probiotics, prebiotics and synbiotics have been imparting a role in treating GIT disorders including indigestion, traveler’s diarrhea, IBD etc. Scientific reports have revealed their role in the treatment of cancerous disease, obesity, kidney and brain disorders. Many tools for the research of probiotics, prebiotics and synbiotics are now available; therefore, the future bio-therapeutics are going to be changed with the passage of time.

Prognostic effect of lncRNA SNHG7 on cancer outcome: a meta and bioinformatic analysis

Background New evidence from clinical and fundamental researches suggests that SNHG7 is involved in the occurrence and development of carcinomas. And the increased levels of SNHG7 are associated with poor prognosis in various kinds of tumors. However, the small sample size was the limitation for the prognostic value of SNHG7 in clinical application. The aim of the present meta-analysis was to conduct a qualitative analysis to explore the prognostic value of SNHG7 in various cancers. Methods Articles related to the SNHG7 as a prognostic biomarker for cancer patients, were comprehensive searched in several electronic databases. The enrolled articles were qualified via the preferred reporting items for systematic reviews and meta-analysis of observational studies in epidemiology checklists. Additionally, an online database based on The Cancer Genome Atlas (TCGA) was further used to validate our results. Results We analyzed 2418 cancer patients that met the specified criteria. The present research indicated that an elevated SNHG7 expression level was significantly associated with unfavorable overall survival (OS) (HR = 2.45, 95% CI: 2.12–2.85, p <0.001). Subgroup analysis showed that high expression levels of SNHG7 were also significantly associated with unfavorable OS in digestive system cancer (HR = 2.31, 95% CI: 1.90–2.80, p <0.001) and non-digestive system cancer (HR = 2.67, 95% CI: 2.12–3.37, p <0.001). Additionally, increased SNHG7 expression was found to be associated with tumor stage and progression (III/IV vs. I/II: HR = 1.76, 95% CI: 1.57–1.98, p <0.001). Furthermore, elevated SNHG7 expression significantly predicted lymph node metastasis (LNM) (HR = 1.98, 95% CI: 1.74–2.26, p <0.001) and distant metastasis (DM) (HR = 2.49, 95% CI: 1.88–3.30, p <0.001) respectively. No significant heterogeneity was observed among these studies. SNHG7 was significantly upregulated in four cancers and the elevated expression of SNHG7 predicted shorter OS in four cancers, worse DFS in five malignancies and worse PFI in five carcinomas based on the validation using the GEPIA on-line analysis tool. Conclusions The present analysis suggests that elevated SNHG7 is significantly associated with unfavorable OS, tumor progression, LNM and DM in various carcinomas, and may be served as a promising biomarker to guide therapy for cancer patients.