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Objective: To investigate the establishment of a risk assessment system for peptic ulcer (PU) recurrence and implement an individualized intervention for PU patients with a moderate to high recurrence risk to reduce the recurrence of PU in patients with a moderate to high recurrence risk. Methods: The factors for PU recurrence were collected through consulting the literature, and a risk prediction model for PU recurrence was established using the univariate binary and multivariate multinomial Logistic stepwise regression analysis. According to the model, a total of 235 PU patients were divided into patients with high, moderate and low recurrence risks. A total of 71 PU patients with moderate to high recurrence risks were selected as the study subjects, and further divided into the control group (n=35) and the experimental group (n=36). The control group was not treated with intervention, while the experimental group was treated with individualized intervention. The PU recurrence, adverse emotions and changes of pain degree were assessed in the two groups at 3, 6, 9 and 12 months after intervention. Results: The univariate and multivariate Logistic regression analysis showed that drinking alcohol, smoking, chronic diseases, oral NSAIDS and depression were associated with the recurrence of PU. Individualized intervention improved the recurrence rate, anxiety, depression, pain degree and quality of life of patients with moderate to high PU recurrence risk. Conclusion: Drinking alcohol, smoking, chronic diseases, oral NSAIDS and depression were associated with the recurrence of PU. Individualized intervention can improve the quality of prognosis and the recurrence risk of PU in patients, which has positive clinical significance.

Liver cirrhosis is the terminal stage of most chronic liver conditions, with a high risk of mortality. Careful evaluation of the prognosis of cirrhotic patients and providing precise management are crucial to reduce the risk of mortality. Although the liver biopsy and hepatic venous pressure gradient (HVPG) can efficiently evaluate the prognosis of cirrhotic patients, their application is limited due to the invasion procedures. Child-Pugh score and the model for end-stage liver disease (MELD) score had been widely used in the assessment of cirrhotic prognosis, but the defects of subjective variable application in Child-Pugh score and unsuitability to all phases of liver cirrhosis in MELD score limit their prognostic values. In recent years, continuous efforts have been made to investigate the prognostic value of body fluid biomarkers for cirrhotic patients, and promising results have been reported. Since the collection of fluid specimens is easy, noninvasive, and repeatable, fluid biomarkers can be ideal indicators to predict the prognosis of cirrhosis. Here, we reviewed noninvasive fluid biomarkers in different prognostic functions, including the prediction of survival and complication development.

We investigate the correlation of serum brain-derived neurotrophic factor (BDNF) level and its gene polymorphism with liver function classification in patients with hepatitis B virus (HBV) induced liver cirrhosis. A total of 182 patients with HBV induced liver cirrhosis were collected as a case group, and 186 healthy subjects in the same period were used as the control group. ELISA measured serum BDNF levels. Polymerase chain reaction-restriction fragment length polymorphism was used to detect rs6265 (A/G) and rs10835210 (A/C) in the BDNF gene. The serum BDNF level was significantly lower in the case group than in the control group. With the elevation of Child-Pugh classification in patients with HBV induced liver cirrhosis, the decrease trend of serum BDNF level was even lower. The difference in frequency distribution between the case group and the control group was statistically significant regarding GG, GA, and AA genotypes, as well as G and A alleles in rs6265 (all P < 0.05). The frequency distribution of genotypes and alleles of rs6265 was statistically different in HBV induced liver cirrhosis patients with different liver function grades (P < 0.05). In patients with HBV induced liver cirrhosis, the AA genotype of BDNF gene rs6265 had the lowest level of serum BDNF. Our study suggests that serum BDNF plays an important role in the grading and early diagnosis of liver function in patients with HBV-induced liver cirrhosis, and AA genotype at rs6265 of BDNF gene is a negative factor for liver cirrhosis. Moreover, the polymorphism of this locus could affect the serum BDNF level.

Hai-Liang Yuan, Ting Wang, Kun-He Zhang Department of Gastroenterology, the First Affiliated Hospital of Nanchang University, Jiangxi Institute of Gastroenterology & Hepatology, Nanchang, People’s Republic of China Abstract: Despite the widespread use of endoscopy and conventional tumor biomarkers, gastric cancer (GC) remains one of the most frequent causes of cancer-related deaths worldwide due to its late diagnosis and poor response to treatment. Valuable and practical biomarkers are urgently needed to screen patients with a high risk of GC that can complement endoscopic diagnosis. Such biomarkers will enable the efficient prediction of therapeutic response and prognosis of GC patients and favor the establishment of an effective treatment strategy for each and every patient. MicroRNAs (miRNAs) are a class of small non-coding RNA sequences that play important roles in modulating key biological processes by regulating the expression of target genes. Expectedly, miRNAs are abnormally expressed within the tumor tissue and in associated biological fluids of GC patients including their blood, gastric juice, and urine. Accumulating evidence indicates that miRNAs are potential biomarkers with multiple diagnostic functions for GC. Here, we review recent advances and challenges in using miRNAs, particularly biofluid miRNAs, as GC biomarkers with potential clinical applications including diagnosing, clinically staging, and predicting malignant behaviors, therapy response, recurrence after surgery and survival time. Keywords: gastric cancer, microRNA, biomarker, diagnosis, prognosis