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Referral for anorectal function evaluation is indicated in 65% and beneficial in 92% of patients

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World Journal of Gastroenterology 2008年第2期14卷 272-277页

作者： Maria M Szojda Erik Tanis Chris jj Mulder Richelle JF Felt-Bersma Department of Gastroenterology and Hepatology VU University Medical Centre PO Box 7057 1007 MB Amsterdam The Netherlands

AIM: To determine the indicated referrals to a tertiary centre for patients with anorectal symptoms, the effect of the advised treatment and the discomfort of the ***: In a retrospective study, patients referred for anorectal function evaluation (AFE) between May 2004 and October 2006 were sent a questionnaire, as were the doctors who referred them. AFE consisted of anal manometry, rectal compliance measurement and anal endosonography. An indicated referral was defined as needing AFE to establish a diagnosis with clinical consequence (fecal incontinence without diarrhea, 3rd degree anal sphincter rupture, congenital anorectal disorder, inflammatory bowel disease with anorectal complaints and preoperative in patients for re-anastomosis or enterostoma, anal fissure, fistula or constipation). Anal ultrasound is always indicated in patients with fistula, anal manometry and rectal compliance when impaired continence reserve is suspected. The therapeutic effect was noted as improvement, no improvement but reassurance, and ***: From the 216 patients referred, 167 (78%) returned the questionnaire. The referrals were indicated in 65%. Of these, 80% followed the proposed advice. Improvement was achieved in 35% and a reassurance in 57% of the patients, no difference existed between patient groups. On a VAS scale (1 to 10) symptoms improved from 4.0 to 7.2. Most patients reported no or little discomfort with AFE. CONCLUSION: Referral for AFE was indicated in 65%. Beneficial effect was seen in 92%: 35% improved and 57% was reassured. Advice was followed in 80%. Better instruction about indication for AFE referral is warranted.

关键词： Anorectal function evaluation Fecal incontinence Anal endosonography Anal manometry

Nonalcoholic fatty liver disease: An overview of current insights in pathogenesis, diagnosis and treatment

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World Journal of Gastroenterology 2008年第16期14卷 2474-2486页

作者： Tim CMA Schreuder Bart J Verwer Carin MJ van Nieuwkerk Chris jj Mulder Department of Gastroenterology and Hepatology VU University Medical Center

Estimates of people suffering from overweight (one billion) and obesity (300 million) are increasing. The accumulation of triglycerides in the liver, in the absence of excess alcohol intake, has been described in the early sixties. It was not until 1980, however, that Ludwig et al named this condition nonalcoholic steatohepatitis (NASH). Subsequently, nonalcoholic fatty liver disease (NAFLD) has been used as a general name for conditions ranging from simple steatosis through steatohepatitis to end-stage liver disease (cirrhosis). Many studies have demonstrated the significant correlation with obesity and insulin resistance. Other studies have revealed a signifi- cant correlation between hepatic steatosis, cardiovascu- lar disease and increased intima-media thickness. WHO estimated that at least two million patients will develop cirrhosis due to hepatic steatosis in the years to come. Longitudinal cohort studies have demonstrated that those patients with cirrhosis have a similar risk to devel- op hepatocellular carcinoma as those with other causes of cirrhosis. Taken all together, NAFLD has become the third most important indication for liver transplantation. There- fore, training programmes in internal medicine, gastroen- terology and hepatology should stress the importance of diagnosing this entity and treat properly those at risk for developing complications of portal hypertension and con- comittant cardiovascular disease. This review will focus on the clinical characteristics, pathophysiology, imaging tech- niques and the readily available therapeutic options.

关键词： Non-alcoholic fatty liver disease Non-alcoholicsteatohepatitis Insulin resistance Liver Obesity Steatosis

Expression of IGF-Ⅱ,p53,p21 and HBxAg in precancerous events of hepatocarcinogenesis induced by AFBI and/or HBV in tree shrews

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World Journal of Gastroenterology 2000年第1期6卷 138-139页

作者： Qin LL Su jj Li Y Yang C Ban KC Yian RQ Department of Pathology Guangxi Cancer InstituteNanning 530021China Department of Pathology Cancer InstituteSun Yat-Sen University of Medical SciencesGuangzhou510060China

INTRODUCTIONIn order to study the relationship between oncogeneexpression and HCC generation,we observed theprecancerous hepatic GGT loci,IGF-Ⅱ,p53 andp21 expression during hepatocarcinogenesis of treeshrew induced b... 详细信息

关键词： Subject heading liver neoplasms carcinoma hepatocellular hepatitis B virus IGF-Ⅱ p53 gene p21 gene HBxAg aflatoxin B1

Inheritance of resistance to race 7 of Cercospora sojina in soybeans and RAPD tagging of the resistance gene

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Chinese Science Bulletin 1999年第5期44卷 452-456页

作者： Zou, jj Dong, W Yang, QK Cao, YP Chen, SY Chinese Acad Sci Inst Genet Plant Biotechnol Lab Beijing 100101 Peoples R China NE Agr Univ Soybean Res Inst Harbin 150030 Peoples R China

Frog-eye leaf spot of soybean caused by Cercospora sojina Hara is a kind of worldwide disease. Resistance to race 7 of C. sojina was found to be due to a single dominant gene through analyzing resistant behavior of the cross NEAU91212 （susceptible to race 7）× NEAU9674 （resistant to all races）. 3 RAPD markers linked to the resistant gene Rcsc 7 were identified using the BSA method. 2 fragments of OPS03620 and OPS03580 amplified with primer OPS03 co-dominantly segregated in the F2 individuals. The genetic distance between OPS03620 and the resistant gene is 8.7 cM. According to the co-dominant marker, the accuracy of predicting the homozygous and heterozygous resistant F2 individuals were 100% and 97.6%, respectively.

关键词： Cercospora sojina Hara resistant gene molecular markers co-dominance.

Analysis of Chlorogenic Acid in Herbal Medicines by Capillary Electrophoresis

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Chinese Chemical Letters 1998年第10期9卷 941-944页

作者： Long, H Yang, jj Liu, HW Wang, TS Huang, AJ Sun, YL Peking Univ Dept Chem Beijing 100871 Peoples R China

A simple, rapid and accurate capillary zone electrophoresis method was developed for the determination of chlorogenic acid as a marker in traditional Chinese medicines. The buffer solution comprised of 10 mmol/L sodium phosphate and 20 mmol/L boric acid containing 5% ethanol with the pH value adjusted to 7.00. The contents of chlorogenic acid in Flos Lonicerae and Flos Lonicerae containing herbal preparations were determined within 15 min.

关键词： chlorogenic acid quantitation herbal medicines capillary zone electrophoresis

Small bowel capsule endoscopy in 2007:Indications,risks and limitations

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World Journal of Gastroenterology 2007年第46期13卷 6140-6149页

作者： Emanuele Rondonotti Federica Villa Chris jj Mulder Maarten AJM Jacobs Roberto de Franchis Università degli Studi di Milano IRCCS Fondazione PoliclinicoMangiagalliRegina Elena.UnitàOperativa di Gastroenterologia 3 via Pace 9Milano 20122Italy VU University Medical Centre Department of Gastroenterology and HepatologyBoelelaan 11171081 HV AmsterdamThe Nederlands Universitàdegli Studi di Milano IRCCS Fondazione PoliclinicoMangiagalliRegina Elena.UnitàOperativa di Gastroenterologia 3 via Pace 9Milano 20122Italy

Capsule endoscopy has revoluzionized the study of the small bowel by providing a reliable method to evaluate, endoscopically, the entire small bowel. In the last six years several papers have been published exploring the possible role of this examination in different clinical conditions. At the present time capsule endoscopy is generally recommended as a third examination, after negative bidirectional endoscopy, in patients with obscure gastrointestinal bleeding. A growing body of evidence suggests also an important role for this examination in other clinical conditions such as Crohn＇s disease, celiac disease, small bowel polyposis syndromes or small bowel tumors. The main complication of this examination is the retention of the device at the site of a previously unknown small bowel stricture. However there are also some other open issues mainly due to technical limitations of this tool （which is not driven from remote control, is unable to take biopsies, to insufflate air, to suck fluids or debris and sometimes to correctly size and locate lesions）.The recently developed double balloon enteroscope, owing to its capability to explore a large part of the small bowel and to take targeted biopsies, although being invasive and time consuming, can overcome some limitations of capsule endoscopy. At the present time, in the majority of clinical conditions （i.e. obscure GI bleeding）, the winning strategy seems to be to couple these two techniques to explore the small bowel in a painless, safe and complete way （with capsule endoscopy） and to define and treat the lesions identified （with double balloon enteroscopy）.

关键词： Capsule endoscopy Double balloon

Hematopoietic stem cell transplantation for non-malignant gastrointestinal diseases

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World Journal of Gastroenterology 2014年第46期20卷 17368-17375页

作者： Abdulbaqi Al-toma Petula Nijeboer Gerd Bouma Otto Visser Chris jj Mulder Department of Internal Medicine and Gastroenterology 3430 EM NieuwegeinThe Netherlands Department of Gastroenterology VU University Medical Centre1005 MB AmsterdamThe Netherlands Department of Hematology VU University Medical Centre1005 MB AmsterdamThe Netherlands

Both, autologous and allogeneic hematopoietic stem cell transplantation (HSCT) can be used to cure or ameliorate a variety of malignant and non-malignant diseases. The rationale behind this strategy is based on the concept of immunoablation using high-dose chemotherapy, with subsequent regeneration of naive T-lymphocytes derived from reinfused hematopoietic progenitor cells. In addition, the use of HSCT allows for the administration of high-dose chemotherapy (whether or not combined with immunomodulating agents such as antithymocyte globulin) resulting in a prompt remission in therapy-refractory patients. This review gives an update of the major areas of successful uses of HSCT in non-malignant gastrointestinal disorders. A Medline search has been conducted and all relevant published data were analyzed. HSCT has been proved successful in treating refractory Crohn’s disease (CD). Patients with refractory celiac disease type II and a high risk of developing enteropathy associated T-cell lymphoma have shown promising improvement. Data concerning HSCT and mesenchymal SCT in end-stage chronic liver diseases are encouraging. In refractory autoimmune gastrointestinal diseases high-dose chemotherapy followed by HSCT seems feasible and safe and might result in long-term improvement of disease activity. Mesenchymal SCT for a selected group of CD is promising and may represent a significant therapeutic alternative in treating fistulas in CD.

关键词： Hematopoietic stem cell transplantation Mesenchymal stem cells Non-malignant gastrointestinal diseases Celiac disease Refractory celiac disease Lymphoma Crohn’ s Ulcerative colitis Cirrhosis

Mechanism of voltage tunable electroluminescence of porous silicon

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Chinese Science Bulletin 1997年第8期42卷 648-652页

作者： Wang, RQ Li, jj Chen, Y Cai, SM Liu, ZF Zhang, SL BEIJING UNIV COLL CHEM & MOL ENGNCTR INTELLIGENT MAT RESBEIJING 100871PEOPLES R CHINA

ALTHOUGH electroluminescence(EL)from silicon anodes in contact with various electrolyteswas first reported by Gee in 1960,it did not attract much attention until Canham in 1990obtained highly efficient visible photolu... 详细信息

关键词： porous silicon voltage tunable electroluminescence quantum confinement effect.

Gastroenterology in developing countries:Issues and advances

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World Journal of Gastroenterology 2009年第23期15卷 2839-2854页

作者： Kate L Mandeville Justus Krabshuis Nimzing Gwamzhi Ladep Chris jj Mulder Eamonn MM Quigley Shahid A Khan Centre for Infectious Diseases Epidemiology Department of Primary Care and Population Sciences University College London Hampstead Campus Royal Free Hospital London NW3 2PF United Kingdom Highland Data Les Charleix 24390 Tourtoirac Dordogne France Department of Medicine University of Jos and Jos University Teaching Hospital Jos Plateau State P.M.B. 2076 Nigeria Department of Gastroenterology VU University Medical Center Amsterdam 1081 HV Holland World Gastroenterology Organisation and Department of Medicine National University of Ireland Cork University Hospital Clinical Sciences Building Wilton Cork Ireland Department of Hepatology and Gastro-enterology Faculty of Medicine Imperial College London St Mary's Campus London W2 1NY United Kingdom

Developing countries shoulder a considerable burden of gastroenterological disease. Infectious diseases in particular cause enormous morbidity and mortality. Diseases which afflict both western and developing countries are often seen in more florid forms in poorer countries. Innovative techniques continuously improve and update gastroenterological practice. However, advances in diagnosis and treatment which are commonplace in the West, have yet to reach many developing countries. Clinical guidelines, based on these advances and collated in resource-rich environments, lose their relevance outside these settings. In this two-part review, we first highlight the global burden of gastroenterological disease in three major areas： diarrhoeal diseases, hepatitis B, and Helicobacter pylori. Recent progress in their management is explored, with consideration of future solutions. The second part of the review focuses on the delivery of clinical services in developing countries. Inadequate numbers of healthcare workers hamper efforts to combat gastroenterological disease. Reasons for this shortage are examined, along with possibilities for increased specialist training. Endoscopy services, the mainstay of gastroenterology in the West, are in their infancy in many developing countries. The challenges faced by those se^ing up a service are illustrated by the example of a Nigerian endoscopy unit. Finally, we highlight the limited scope of many clinical guidelines produced in western countries. Guidelines which take account of resource limitations in the form of ＂cascades＂ are advocated in order to make these guidelines truly global. Recognition of the different working conditions facing practitioners worldwide is an important step towards narrowing the gap between gastroenterology in rich and poor countries.

关键词： Helicobacter pylori Developing countries Gastrointestinal diseases Health care delivery Practice guidelines