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World Journal of Emergency Medicine 2024年第4期15卷 316-318页

作者： Yidan Shan Weijia Huang department of Oral and Maxillofacial Surgery the Second Affiliated Hospital of Zhejiang University School of MedicineHangzhou 310009China

Central venous catheterization(CVC)is an invasive medical procedure used to measure central venous pressure and provides a stable route for continuous drug *** is widely used in the emergency department and intensive care *** is typically performed by inserting a catheter through the internal jugular vein(IJV)into the superior vena cava near the right atrium.[1,2]While catheterization is a fundamental skill proficiently performed by healthcare professionals,lethal complications may occasionally occur because of undesirable positioning,depth and diameter.

关键词： venous catheter jugular

Delayed diagnosis in inflammatory bowel disease:Time to consider solutions

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World Journal of Gastroenterology 2024年第35期30卷 3954-3958页

作者： Hao Lv Hao-Yu Li Hao-Nan Zhang Yang Liu department of General Surgery Xi'an Jiaotong University Second Affiliated HospitalXi'an 710004Shaanxi ProvinceChina

In this editorial,we discuss a recently published manuscript by Blüthner et al in the World Journal of Gastroenterology,with a specific focus on the delayed diagnosis of inflammatory bowel disease(IBD).IBD,which includes Crohn's disease and ulcerative colitis,is a chronic intestinal disorder.A time lag may exist between the onset of inflammation and the appearance of signs and symptoms,potentially leading to an incorrect or delayed diagnosis,a situation referred to as the delayed diagnosis of *** diagnosis is crucial for effective patient treatment and prognosis,yet delayed diagnosis remains *** reasons for delayed diagnosis of IBD are numerous and not yet fully *** key factor is the nonspecific nature of IBD symptoms,which can easily be mistaken for other ***,the lack of specific diagnostic methods for IBD contributes to these *** diagnosis of IBD can result in numerous adverse consequences,including increased intestinal damage,fibrosis,a higher risk of colorectal cancer,and a decrease in the quality of life of the ***,it is essential to diagnose IBD promptly by raising physician awareness,enhancing patient education,and developing new diagnostic methods.

关键词： Inflammatory bowel disease Delayed diagnosis Diagnostic methods Early diagnosis Consequences of inflammatory bowel disease

Management of non-alcoholic fatty liver disease:Lifestyle changes

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World Journal of Gastroenterology 2024年第22期30卷 2829-2833页

作者： Hao Lv Yang Liu department of General Surgery Xi'an Jiaotong University Second Affiliated HospitalXi'an 710004Shaanxi ProvinceChina

In this editorial,we commented on a recently released manuscript by Zeng et al in the World Journal of *** focused specifically on lifestyle changes in patients with non-alcoholic fatty liver disease(NAFLD).NAFLD is a hepatic manifestation of the metabolic syndrome,which ultimately leads to advanced hepatic fibrosis,cirrhosis,and hepatocellular carcinoma and affects more than 25%of the population *** therapeutic strategies against NAFLD such as pharmacologic therapies focus on liver protection,anti-inflammation,and regulating disease-related metabolic disorder *** several drugs are in late-stage development,potent drugs against the diseases are ***,existing surgical approaches such as bariatric surgery are not routinely used to treat *** in patients’unhealthy lifestyles,such as weight loss through dietary changes and exercises to ameliorate patientassociated metabolic disorders and metabolic syndrome,is the first-line treatment for patients with *** sufficient intrinsic motivation and adherence,the management of unhealthy lifestyles can reduce the severity of the disease,improve the quality of life,and increase the survival expectancy of patients with NAFLD.

关键词： Non-alcoholic fatty liver disease Lifestyle physical activity Physical exercise Low-calorie diet Mediterranean diet

Evaluation of teplizumab's efficacy and safety in treatment of type 1 diabetes mellitus:A systematic review and meta-analysis

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World Journal of Diabetes 2024年第7期15卷 1615-1626页

作者： Xiao-Lan Ma Dan Ge Xue-Jian Hu department of Endocrinology and Metabolism The Second Affiliated Hospital of Lanzhou UniversityLanzhou 730000Gansu ProvinceChina

BACKGROUND Islets of Langerhans beta cells diminish in autoimmune type 1 diabetes mellitus(T1DM).Teplizumab,a humanized anti-CD3 monoclonal antibody,may help *** long-term implications on clinical T1DM development,safety,and efficacy are *** To assess the effectiveness and safety of teplizumab as a therapeutic intervention for individuals with *** A systematic search was conducted using four electronic databases(PubMed,Embase,Scopus,and Cochrane Library)to select publications published in peerreviewed journals written in *** odds ratio(OR)and risk ratio(RR)were calculated,along with their 95%*** assessed heterogeneity using Cochrane Q and I2 statistics and the appropriate P *** There were 8 randomized controlled trials(RCTs)in the current meta-analysis with a total of 1908 T1DM patients from diverse age cohorts,with 1361 patients receiving Teplizumab and 547 patients receiving a *** was found to have a substantial link with a decrease in insulin consumption,with an OR of 4.13(95%CI:1.72 to 9.90).Teplizumab is associated with an improved Cpeptide response(OR 2.49;95%CI:1.62 to 3.81)and a significant change in Glycated haemoglobin A1c(HbA1c)levels in people with type 1 diabetes[OR 1.75(95%CI:1.03 to 2.98)],and it has a RR of 0.71(95%CI:0.53 to 0.95).CONCLUSION In type 1 diabetics,teplizumab decreased insulin consumption,improved C-peptide response,and significantly changed HbA1c levels with negligible side *** appears to improve glycaemic control and diabetes management with good safety and efficacy.

关键词： Type-1 diabetes mellitus Teplizumab Anti-CD3 monoclonal antibody Insulin Glycated haemoglobin A1c Cpeptide

HSP110 aggravates ischemia-reperfusion injury after liver transplantation by promoting NF-κB pathway

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Hepatobiliary & Pancreatic Diseases International 2024年第4期23卷 344-352页

作者： Qing-Zhi Hu Zhen-Rui Cao Wei-Xiong Zheng Min-Jie Zhao Jun-Hua Gong Cong Chen Zhong-Jun Wu Rui Tao department of Hepatobiliary Surgery Bishan Hospital of Chongqing Medical UniversityChongqing 402760China department of Cardiothoracic Surgery the First Affiliated Hospital of Chongqing Medical UniversityChongqing 400016China c department of Hepatobiliary Surgery the First Affiliated Hospital of Chongqing Medical UniversityChongqing 400016China department of Hepatobiliary Surgery the Second Affiliated Hospital of Chongqing Medical UniversityChongqing 400010China

Background:Ischemia-reperfusion injury(IRI)poses a significant challenge to liver transplantation(LT).The underlying mechanism primarily involves overactivation of the immune *** shock protein 110(HSP110)functions as a molecular chaperone that helps stabilize protein ***:An IRI model was established by performing LT on Sprague-Dawley rats,and HSP110 was silenced using ***-eosin staining,TUNEL,immunohistochemistry,ELISA and liver enzyme analysis were performed to assess IRI following *** blotting and quantitative reverse transcription-polymerase chain reaction were conducted to investigate the pertinent molecular ***:Our findings revealed a significant increase in the expression of HSP110 at both the mRNA and protein levels in the rat liver following LT(P<0.05).However,when rats were injected with siRNAHSP110,IRI subsequent to LT was notably reduced(P<0.05).Additionally,the levels of liver enzymes and inflammatory chemokines in rat serum were significantly reduced(P<0.05).Silencing HSP110 with siRNA resulted in a marked decrease in M1-type polarization of Kupffer cells in the liver and downregulated the NF-κB pathway in the liver(P<0.05).Conclusions:HSP110 in the liver promotes IRI after LT in rats by activating the NF-κB pathway and inducing M1-type polarization of Kupffer *** HSP110 to prevent IRI after LT may represent a promising new approach for the treatment of LT-associated IRI.

关键词： Ischemia-reperfusion injury Liver transplantation Inflammation HSP110 Heat shock proteins NF-κB

Clinical efficacy of endovascular revascularization combined with vacuum-assisted closure for the treatment of diabetic foot

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World Journal of Diabetes 2024年第7期15卷 1499-1508页

作者： Feng-Rui Lei Xiao-Fei Shen Chuang Zhang Xin-Qing Li Hao Zhuang Hong-Fei Sang department of Vascular Surgery The Second Affiliated Hospital of Soochow UniversitySuzhou 215004Jiangsu ProvinceChina

BACKGROUND The diabetic foot is a common cause of disability and death,and comorbid foot infections usually lead to prolonged hospitalization,high healthcare costs,and a significant increase in amputation *** most diabetic foot trauma is complicated by lower extremity arteriopathy,which becomes an independent risk factor for major amputation in diabetic foot *** To establish the efficacy and safety of endovascular revascularization(ER)combined with vacuum-assisted closure(VAC)for the treatment of diabetic *** Clinical data were collected from 40 patients with diabetic foot admitted to the second affiliated hospital of Soochow University from April 2018 to April *** foot lesions were graded according to Wagner’s classification,and blood flow to the lower extremity was evaluated using the ankle-brachial index test and computerized tomography angiography of the lower extremity *** subcutaneous insulin infusion pumps were used to achieve glycemic *** limb revascularization was facilitated by percutaneous transluminal balloon angioplasty(BA)or *** were cleaned by nibbling *** granulation tissue growth was induced by VAC,and wound repair was performed by skin grafting or skin flap *** Of the 35 cases treated with lower limb revascularization,34 were successful with a revascularization success rate of 97%.Of these,6 cases underwent stenting after BA of the superficial femoral artery,and 1 received popliteal artery stent *** the 25 cases treated with infrapopliteal artery revascularization,39 arteries were reconstructed,7 of which were treated by drug-coated BA and the remaining 32 with plain old *** was performed in 32 ***-four cases of skin grafting and 2 cases of skin flap transplantation were *** patients underwent major amputations,whereas 17 had minor amputations,accounting for a success limb salvage rate of 95%.CONCLUSION ER in

关键词： Diabetic foot Revascularization Vacuum-assisted closure Balloon angioplasty Wound repair

Effect of the extrahepatic bile duct anatomy on choledocholithiasis and its clinical significance

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World Journal of Gastrointestinal Surgery 2024年第5期16卷 1363-1370页

作者： Zheng Cao Jia Zhou Li Wei Hai-Yu He Jun Li department of Gastroenterology The Second Affiliated Hospital of Kunming Medical UniversityKunming 650000Yunnan ProvinceChina

BACKGROUND A comprehensive understanding of the extrahepatic bile duct anatomy is vital to guide surgical procedures and perform endoscopic retrograde *** irregularities within the extrahepatic bile duct may increase susceptibility to bile duct *** To investigate the anatomical risk factors associated with extrahepatic bile ducts in patients diagnosed with choledocholithiasis,with a specific focus on preventing stone recurrence after surgical intervention and endoscopic *** We retrospectively analyzed the medical records of 124 patients without choledocholithiasis and 108 with confirmed choledocholithiasis who underwent magnetic resonance cholangiopancreatography examinations at our center between January 2022 and October *** regression analyses were conducted to identify the anatomical risk factors influencing the incidence of common bile duct *** Multivariate logistic regression analysis revealed that several factors independently contributed to choledocholithiasis *** independent risk factors for choledocholithiasis were diameter of the common hepatic[adjusted odds ratio(aOR)=1.43,95%confidence interval(CI):1.07-1.92,adjusted P value=0.016]and common bile(aOR=1.68,95%CI:1.27-2.23,adjusted P value<0.001)ducts,length of the common hepatic duct(aOR=0.92,95%CI:0.84-0.99,adjusted P value=0.034),and angle of the common bile duct(aOR=0.92,95%CI:0.89–0.95,adjusted P value<0.001).The anatomical features of the extrahepatic bile duct were directly associated with choledocholithiasis *** risk factors include an enlarged diameter of the common hepatic and bile ducts,a shorter length of the common hepatic duct,and a reduced angle of the common bile duct.

关键词： Bile ducts Extrahepatic Choledocholithiasis Cholangiopancreatography Magnetic resonance Cholangiopancreatography Endoscopic retrograde

Advances in the treatment of diabetic peripheral neuropathy by modulating gut microbiota with traditional Chinese medicine

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World Journal of Diabetes 2024年第8期15卷 1712-1716页

作者： Ye-Yao Li Rui-Qian Guan Zhi-Bo Hong Yao-Lei Wang Li-Min Pan department of Endocrinology The Second Affiliated Hospital of Heilongjiang University of Chinese MedicineHarbin 150001Heilongjiang ProvinceChina department of Tuina The Second Affiliated Hospital of Heilongjiang University of Chinese MedicineHarbin 150001Heilongjiang ProvinceChina

Diabetic peripheral neuropathy(DPN)is one of the strongest risk factors for diabetic foot ulcers(neuropathic ulcerations)and the existing ulcers may further deteriorate due to the damage to sensory ***,the resulting numbness in the limbs causes difficulty in discovering these ulcerations in a short *** is associated with gut microbiota *** Chinese medicine(TCM)compounds such as Shenqi Dihuang Decoction,Huangkui Capsules and Qidi Tangshen Granules can reduce the clinical symptoms of diabetic nephropathy by modulating gut *** current review discusses whether TCM compounds can reduce the risk of DPN by improving gut microbiota.

关键词： Diabetes Peripheral neuropathy Traditional Chinese medicine Gut microbiota Diabetic foot ulcer Treatment

Effect of pediatric Tuina on children's recurrent acute respiratory tract infections: a retrospective cohort study in Southern China

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Journal of Traditional Chinese Medicine 2024年第3期44卷 586-594页

作者： YIN Lingjia STALSBY LUNDBORG Cecilia WU Darong YANG Jinghua ALVESSON Helle Molsted CAI Jianxiong LU Taoying XIE Qianwen MARRONE Gaetano department of Global Public Health Karolinska InstitutetStockholm 17177Swede State Key Laboratory of Dampness Syndrome of Chinese Medicine the Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhou 510120China Outcome Assessment Research Team in Chinese Medicine the Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhou 510120China Health Construction Administration Centre Guangdong Provincial Hospital of Chinese MedicineGuangzhou 510120China Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome the Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhou 510120China department of Pediatrics the Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhou510120China

OBJECTIVE: To determine the effectiveness of pediatric Tuina(PT) in preventing recurrent acute respiratory tract infections(ARTIs) in children. METHODS: This is a retrospective cohort study based on the electronic medical records of children with recurrent ARTIs in 2016. Children were divided into a PT group or a non-PT group, according to whether they had received PT or not in 2016. The primary outcome was the number of ARTI episodes in 2017 and 2018. The secondary outcomes were the number of ARTIs leading to outpatient department visits and outpatient antibiotic prescriptions due to ARTIs in the same time period. Negative binomial regressions were used to detect the association between PT and the outcomes. RESULTS: A total of 2303 children were included in the analysis, including 94 in the PT group and 2209 in the non-PT group. Children who received PT six or more times in 2016 had fewer episodes of ARTIs in 2017 [incidence rate ratio(IRR): 0.59, 95% confidence interval(CI)(0.42-0.84)] and 2018 [IRR: 0.58, 95% CI(0.36-0.94)] and fewer outpatient department visits due to ARTIs in 2017 [IRR: 0.56, 95% CI(0.38-0.83)] than children who had not received PT in 2016. There was no significant difference in the number of outpatient antibiotic prescriptions between the two groups. CONCLUSIONS: Receiving PT six or more times within one year is associated with a decrease in recurrent ARTIs in children in the following two years. Randomized controlled trials are needed for effect evaluation prior to establishing PT as a method for preventing recurrent ARTIs among children.

关键词： child massage pediatric Tuina respiratory tract infections

Characteristics of early gastric tumors with different differentiation and predictors of long-term outcomes after endoscopic submucosal dissection

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World Journal of Gastroenterology 2024年第14期30卷 1990-2005页

作者： Hong-Yi Zhu Jie Wu Yuan-Miao Zhang Fang-Lan Li Jin Yang Bin Qin Jiong Jiang Ning Zhu Meng-Yao Chen Bai-Cang Zou department of Gastroenterology The Second Affiliated Hospital of Xi'an Jiaotong UniversityXi'an 710004Shaanxi ProvinceChina department of Pathology The Second Affiliated Hospital of Xi'an Jiaotong UniversityXi'an 710004Shaanxi ProvinceChina department of Gastroenterology Xianyang Hospital of Yan'an UniversityXianyang 712000Shaanxi ProvinceChina department of Gastroenterology The First Hospital of Xi'anXi'an 710000Shaanxi ProvinceChina

BACKGROUND Gastric cancer is a common malignant tumor of the digestive tract,and endosco-pic submucosal dissection(ESD)is the preferred treatment for early-stage gastric *** analysis of the epidemiological characteristics of gastric mucosal tumors with different differentiation degrees and the influencing factors of long-term ESD efficacy may have certain significance for revealing the development of gastric cancer and *** To analyze the features of gastric mucosal tumors at different differentiation levels,and to explore the prognostic factors of *** We retrospectively studied 301 lesions in 285 patients at The second affiliated hospital of Xi'an Jiaotong University from 2014 to 2021,according to the latest Japanese guidelines(sixth edition),and divided them into low-grade intrae-pithelial neoplasia(LGIN),high-grade intraepithelial neoplasia(HGIN),and computed tomography at 3,6 and 12 months after *** compared clinicopathologic characteristics,ESD efficacy,and complications with different degrees of differentiation,and analyzed the related factors associated with *** HGIN and differentiated carcinoma patients were significantly older compared with LGIN patients(P<0.001)and accounted for more 0-IIc(P<0.001),atrophic gastritis was common(P<0.001),and irregular microvascular patterns(IMVPs)and demarcation lines(DLs)were more obvious(P<0.001).There was more infiltration in the undifferentiated carcinoma tissue(P<0.001),more abnormal folds and poorer mucosal peristalsis(P<0.001),and more obvious IMVPs,irregular microsurface patterns and DLs(P<0.05)than in the LGIN and HGIN *** disease-free survival rates at 2,5,and 8 years after ESD were 95.0%,90.1%,and 86.9%,***-tiated lesions(HR 5.066),white moss(HR 7.187),incomplete resection(HR 3.658),and multiple primary cancers(HR 2.462)were significantly associated with poor *** Differentiations of gastric mucosal tumors have different epidemiological and

关键词： Gastric mucosal epithelial neoplasia Differentiated early gastric cancer Undifferentiated early gastric cancer Endoscopic submucosal dissection Long-term outcomes