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Esophageal Perforation in Children: Experience in Kurdistan center for gastroenterology and Hepatology/Iraq

Open Journal of gastroenterology 2014年第5期4卷 221-227页

作者： Adnan M. H. Hamawandi Aram Baram Ali A. G. Ramadhan Taha A. Karboli Abdulsalam Y. Taha Ako Anwar Department of Anasthesia Sulaimani Teaching Hospital Kurdistan Center for Gastroenterology and Hepatology Sulaymaniyah Iraq Department of Medicine School of Medicine Faculty of Medical Sciences University of Duhok Kurdistan Center for Gastroenterology and Hepatology Duhok Iraq Department of Medicine School of Medicine Faculty of Medical Sciences University of Sulaimani Kurdistan Center for Gastroenterology and Hepatology Sulaymaniyah Iraq Department of Pediatrics School of Medicine Faculty of Medical Sciences University of Sulaimani Kurdistan Center for Gastroenterology and Hepatology Sulaymaniyah Iraq Department of Surgery School of Medicine Faculty of Medical Sciences University of Sulaimani Sulaimani Teaching Hospital Sulaymaniyah Iraq

Background: Esophageal perforation is a rare, but potentially life threatening injury. The etiology and management of this condition have changed overtime. Iatrogenic causes are increasingly recognized and management is evolving towards more conservative approaches. Objective: To review our experience in the management of esophageal perforation in pediatric patients. Patients and methods: This retrospective study was conducted in the Kurdistan center for gastroenterology and hepatology in Sulaimani city. Review of records for cases of esophageal perforation during the period from January 2006 to October 2013 was performed. Results: Ten cases were found to have esophageal perforation. The causes of esophageal perforation were complications of endoscopic dilation for esophageal stricture (n = 7), button battery ingestion (n = 2), complication of esophagoscopy for corrosive injury (n = 1). The mean age was 42 months (range, 18 - 75 months). The diagnosis was made during the procedure in 6 cases, within 12 hours in 2 cases and late in the two cases of battery ingestion. Subcutaneous emphysema and respiratory distress were the main presenting features. The location of perforation was thoracic in 9 cases and cervical in 1 case. Conservative management was successful in 7 patients and surgical closure was done in two patients. One death has been reported. Conclusion: Iatrogenic causes were the most common causes of esophageal perforation. Conservative management with interventions guided by clinical response can have a favorable outcome and may become the best initial treatment strategy in the future. Further larger scale studies are recommended to establish the best protocol for conservative management.

关键词： Dilatation Esophageal Perforation Children Conservative Management Sulaimani

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Effect of cholesterol metabolism on hepatolithiasis

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World Journal of gastroenterology 2025年第1期31卷 157-162页

作者： Lin Zheng Zi-Yu Ye Jun-Ji Ma Department of gastroenterology The Second Hospital of Hebei Medical UniversityHebei Key Laboratory of GastroenterologyHebei Institute of GastroenterologyHebei Clinical Research Center for Digestive DiseasesNo.215 Heping West RoadShijiazhuang 050000Hebei ProvinceChina

Surgical intervention is currently the primary treatment for hepatolithiasis;how-ever,some patients still experience residual stones and high recurrence rates after *** metabolism seems to play an important role in hepatoli-thiasis pathogenesis.A high cholesterol diet is one of the significant reasons for the increasing incidence of ***,regular diet and appropriate medical intervention are crucial measures to prevent hepatolithiasis and reduce recurrence rate after *** dietary cholesterol and drugs that increase cholesterol stone solubility are key therapeutic approaches in treating *** article discusses the cholesterol metabolic pathways related to the pathogenesis of hepatolithiasis,as well as food intake and targeted therapeutic drugs.

关键词： Hepatolithiasis Cholesterol metabolism High-fat diet 3-hydroxy-3-methylglutaryl-coenzyme A reductase Interlobular bile duct

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Gastric polyps are not created equal: Know your enemy

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World Journal of gastroenterology 2025年第2期31卷 144-146页

作者： Fady Daniel Department of gastroenterology and Hepatology American University of Beirut Medical CenterBeirut 11072020Lebanon

Gastric polyps are commonly detected during upper gastrointestinal *** are most often benign and rarely become ***,adequate knowledge,diagnostic modalities,and management strategies should be the endoscopist’s readily available“weapons”to defeat the potentially malignant“enemies”.This article sheds light on the valuable effort by Costa et al to generate a new classification system of gastric polyps as“good”,“bad”,and“ugly”.This comprehensive overview provides clinicians with a simplified decision-making process.

关键词： Gastric polyps Polypoid subepithelial lesions Early gastric cancer Endoscopic ultrasonography Electronic chromoendoscopy

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Bowel preparation before colonoscopy: Consequences, mechanisms, and treatment of intestinal dysbiosis

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World Journal of gastroenterology 2025年第2期31卷 13-26页

作者： Ze-Long Zheng Qing-Fan Zheng Li-Qiang Wang Yi Liu Department of gastroenterology(Endoscopy center) China-Japan Union Hospital of Jilin UniversityChangchun 130033Jilin ProvinceChina

The term“gut microbiota”primarily refers to the ecological community of various microorganisms in the gut,which constitutes the largest microbial community in the human *** adequate bowel preparation can improve the results of colonoscopy,it may interfere with the gut *** preparation for colonoscopy can lead to transient changes in the gut microbiota,potentially affecting an individual’s health,especially in vulnerable populations,such as patients with inflammatory bowel ***,measures such as oral pro-biotics may ameliorate these adverse *** focused on the bowel prepa-ration-induced changes in the gut microbiota and host health status,hypothesized the factors influencing these changes,and attempted to identify measures that may reduce dysbiosis,thereby providing more information for individualized bowel preparation for colonoscopy in the future.

关键词： Bowel preparation Colonoscopy Microbiota Inflammatory bowel disease Probiotics

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Exploring the performance of large language models on hepatitis B infection-related questions:A comparative study

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World Journal of gastroenterology 2025年第3期31卷 103-112页

作者： Yu Li Chen-Kai Huang Yi Hu Xiao-Dong Zhou Cong He Jia-Wei Zhong Department of gastroenterology Jiangxi Provincial Key Laboratory of Digestive DiseasesJiangxi Clinical Research Center for GastroenterologyDigestive Disease HospitalThe First Affiliated HospitalJiangxi Medical CollegeNanchang UniversityNanchang 330006Jiangxi ProvinceChina HuanKui Academy Nanchang UniversityNanchang 330006Jiangxi ProvinceChina

BACKGROUND Patients with hepatitis B virus(HBV)infection require chronic and personalized care to improve *** language models(LLMs)can potentially provide medical information for *** To examine the performance of three LLMs,ChatGPT-3.5,ChatGPT-4.0,and Google Gemini,in answering HBV-related *** LLMs’responses to HBV-related questions were independently graded by two medical professionals using a four-point accuracy scale,and disagreements were resolved by a third *** question was run three times using three *** was assessed via the Gunning Fog index and Flesch-Kincaid grade *** Overall,all three LLM chatbots achieved high average accuracy scores for subjective questions(ChatGPT-3.5:3.50;ChatGPT-4.0:3.69;Google Gemini:3.53,out of a maximum score of 4).With respect to objective questions,ChatGPT-4.0 achieved an 80.8%accuracy rate,compared with 62.9%for ChatGPT-3.5 and 73.1%for Google *** the six domains,ChatGPT-4.0 performed better in terms of diagnosis,whereas Google Gemini demonstrated excellent clinical ***,in the readability analysis,the mean Gunning Fog index and Flesch-Kincaid grade level scores of the three LLM chatbots were significantly higher than the standard level eight,far exceeding the reading level of the normal *** Our results highlight the potential of LLMs,especially ChatGPT-4.0,for delivering responses to HBV-related *** may be an adjunctive informational tool for patients and physicians to improve ***,current LLMs should not replace personalized treatment recommendations from physicians in the management of HBV infection.

关键词： ChatGPT-3.5 ChatGPT-4.0 Google Gemini Hepatitis B infection Accuracy

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Endoscopic techniques for the diagnosis of pancreatic cystic lesions

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World Journal of gastroenterology 2025年第1期31卷 1-7页

作者： Sahib Singh Saurabh Chandan Rakesh Vinayek Jahnvi Dhar Jayanta Samanta Gabriele Capurso Ivo Boskoski Cristiano Spada Jorge D Machicado Stefano Francesco Crinò Antonio Facciorusso Department of Internal Medicine Sinai HospitalBaltimoreMD 21215United States Division of gastroenterology and Hepatology Creighton University School of MedicineOmahaNE 68131United States Department of gastroenterology Sinai Hospital of BaltimoreBaltimoreMD 21215United States Department of gastroenterology Postgraduate Institute of Medical Education and ResearchChandigarh 160012India Division of Pancreato-Biliary Endoscopy and Endosonography Pancreas Translational and Clinical Research CenterIRCCS San Raffaele Scientific InstituteVita-Salute San Raffaele UniversityMilano 20132Italy Digestive Endoscopy Unit Fondazione Policlinico Universitario Agostino Gemelli IRCSSUniversitàCattolica del Sacro Cuore di RomaCenter for Endoscopic Research Therapeutics and TrainingRoma 00168Italy Department of gastroenterology and Endoscopy Catholic UniversityRoma 00168Italy Department of gastroenterology University of Michigan HealthAnn ArborMI 48107United States Department of Endoscopy University of VeronaVerona 37121VenetoItaly gastroenterology Unit Department of Medical and Surgical SciencesUniversity of FoggiaFoggia 71122Italy

Pancreatic cysts are mostly incidental findings on computed tomography or magnetic resonance imaging scans,with few patients presenting with abdominal pain or other *** accurate diagnosis of cysts is important as management depends on the type(neoplastic or non-neoplastic).Cross-sectional imaging is fast being replaced with endoscopic ultrasound(EUS)and various techniques based on that such as EUS-guided fine needle aspiration,EUS-guided needle confocal laser endomicroscopy,EUS-through-the-needle biopsy,and contrast-enhanced *** studies have reported varying diagnostic and adverse event rates with these *** addition,American,European,and Kyoto guidelines for the diagnosis and management of pancreatic cysts have provided different *** this editorial,we elaborate on the clinical guidelines,recent studies,and comparison of different endoscopic methods for the diagnosis of pancreatic cysts.

关键词： Endoscopic ultrasound Fine needle aspiration Needle confocal laser endomicroscopy Through-the-needle biopsy Contrast-enhanced endoscopic ultrasound

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Effects of Bifidobacterium lactis BLa80 on fecal and mucosal flora and stem cell factor/c-kit signaling pathway in simulated microgravity rats

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World Journal of gastroenterology 2025年第1期31卷 93-109页

作者： Ping Zhang Ying Zhu Pu Chen Tong Zhou Zhe-Yi Han Jun Xiao Jian-Feng Ma Wen Ma Peng Zang Ying Chen Graduate School Hebei North UniversityZhangjiakou 075000Hebei ProvinceChina Key Laboratory of Aerospace Nutrition and Food Engineering China Astronaut Research and Training CenterBeijing 100094China Department of gastroenterology The Air Force Medical CenterBeijing 100142China Department of Blood Transfusion Air Force Medical CenterBeijing 100142China

BACKGROUND Simulated microgravity environment can lead to gastrointestinal motility *** pathogenesis of gastrointestinal motility disorders is closely related to the stem cell factor(SCF)/c-kit signaling pathway associated with intestinal flora and Cajal stromal ***,intestinal flora can also affect the regulation of SCF/c-kit signaling pathway,thus affecting the expression of Cajal stromal *** cells are the pacemakers of gastrointestinal *** To investigate the effects of Bifidobacterium lactis(***)BLa80 on the intestinal flora of rats in simulated microgravity and on the gastrointestinal motility-related SCF/c-kit *** The internationally recognized tail suspension animal model was used to simulate the microgravity environment,and 30 rats were randomly divided into control group,tail suspension group and drug administration tail suspension group with 10 rats in each group for a total of 28 *** tail group was given *** BLa80 by intragastric administration,and the other two groups were given water intragastric administration,the concentration of intragastric administration was 0.1 g/mL,and each rat was 1 mL/***&eosin staining was used to observe the histopathological changes in each segment of the intestine of each group,and the expression levels of SCF,c-kit,extracellular signal-regulated kinase(ERK)and p-ERK in the gastric antrum of each group were detected by Western blotting and *** fecal flora and mucosal flora of rats in each group were detected by 16S *** Simulated microgravity resulted in severe exfoliation of villi of duodenum,jejunum and ileum in rats,marked damage,increased space between villi,loose arrangement,shortened columnar epithelium of colon,less folds,narrower mucosal thickness,reduced goblet cell number and crypts,and significant improvement after probiotic *** microgravity reduced the expressions of SCF and c-kit,and increased the express

关键词： Simulated microgravity Rat Intestinal flora Gastrointestinal motility Stem cell factor/c-kit signaling pathway

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Association between autoimmune gastritis and gastric polyps:Clinical characteristics and risk factors

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World Journal of Gastrointestinal Oncology 2025年第1期17卷 73-87页

作者： Jing-Zheng Jin Xiao Liang Shu-Peng Liu Rui-Lan Wang Qing-Wei Zhang Yu-Feng Shen Xiao-Bo Li Division of gastroenterology and Hepatology Renji HospitalShanghai Jiao Tong University School of MedicineShanghai 200127China Division of gastroenterology and Hepatology Shanghai Institute of Digestive DiseasesShanghai 200001China Division of gastroenterology and Hepatology Renji Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai 200127China Division of gastroenterology and Hepatology Sichuan Armed Police Corps HospitalLeshan 610041Sichuan ProvinceChina Division of gastroenterology and Hepatology NHC Key Laboratory of Digestive DiseasesRenji HospitalShanghai Jiao Tong University School of MedicineShanghai 200127China Department of gastroenterology Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine Shanghai Institute of Digestive DiseasesShanghai 200127China

BACKGROUND The relationship between autoimmune gastritis(AIG)and gastric polyps(GPs)is not well *** To explore the clinical characteristics and risk factors of AIG with GPs in *** This double center retrospective study included 530 patients diagnosed with AIG from July 2019 to July *** collected clinical,biochemical,serological,and demographic data were of each *** regression analyses,both multivariate and univariate,were conducted to pinpoint independent risk factors for GPs in patients with AIG *** operating characteristic curves were utilized to establish the optimal cutoff values,sensitivity,and specificity of these risk factors for predicting GPs in patients with *** Patients with GPs had a higher median age than those without GPs[61(52.25-69)years vs 58(47-66)years,P=0.006].The gastrin-17 levels were significantly elevated in patients with GPs compared with those without GPs[91.9(34.2-138.9)pmol/mL vs 60.9(12.6-98.4)pmol/mL,P<0.001].Additionally,the positive rate of parietal cell antibody(PCA)antibody was higher in these patients than in those without GPs(88.6%vs 73.6%,P<0.001).Multivariate and univariate analyses revealed that PCA positivity[odds ratio(OR)=2.003,P=0.017],pepsinogen II(OR=1.053,P=0.015),and enterochromaffin like cells hyperplasia(OR=3.116,P<0.001)were significant risk factors for GPs,while pepsinogen I was identified as a protective *** PCA positivity and enterochromaffin like cells hyperplasia are significant risk factor for the development of GPs in patients with *** gastrin-17 levels may also play a role in this *** findings suggest potential targets for further research and therapeutic intervention in managing GPs in patients with AIG.

关键词： Autoimmune gastritis Gastric polyps Neuroendocrine tumor Risk factors Nomogram

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Prevalence of Helicobacter pylori infection in Chinese military personnel:A cross-sectional,multicenter-based study

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World Journal of gastroenterology 2025年第3期31卷 42-49页

作者： Han-Chen Min Chun-Yan Zhang Fang-Yu Wang Xiao-Hui Yu Shan-Hong Tang Hong-Wu Zhu Ya-Gang Zhao Ji-Luo Liu Jian Wang Jing-Han Guo Xiao-Mei Zhang Yun-Sheng Yang Chinese People’s Liberation Army Medical School Chinese People’s Liberation Army General HospitalBeijing 100853China Department of gastroenterology and Hepatology The First Medical CenterChinese People’s Liberation Army General HospitalBeijing 100853China Sixth Healthcare Department The Second Medical CenterChinese People’s Liberation Army General HospitalBeijing 100853China Department of gastroenterology The 940th Hospital of Joint Logistic Support Force of Chinese People’s Liberation ArmyLanzhou 730050Gansu ProvinceChina Department of gastroenterology General Hospital of Western Theater CommandChengdu 610011Sichuan ProvinceChina Department of gastroenterology General Hospital of Southern Theater CommandGuangzhou 510010Guangdong ProvinceChina Department of Epidemiology Naval Medical UniversityShanghai 200433China School of Medicine Nankai UniversityTianjin 300071China National Clinical Research center for Geriatric Diseases Chinese People’s Liberation Army General HospitalBeijing 100853China

BACKGROUND Helicobacter pylori(***)infection is a prevalent disease encountered in military internal medicine and recognized as the main cause of dyspepsia,gastritis,and peptic ulcer,which are common diseases in military *** guidelines in China state all patients with evidence of active infection with *** are offered ***,the prevalence of *** infection and its regional distribution in the military population remain unclear,which hinders effective prevention and treatment *** the prevalence of *** infection in the military population will aid in the development of customized strategies to better manage this infectious *** To investigate the prevalence of *** infection in the Chinese military population in different geographic *** This multicenter,retrospective study included 22421 individuals from five tertiary hospitals located in north,east,southwest,and northwest cities of *** infection was identified using the urea breath test,which had been performed between January 2020 and December *** Of the 22421 military service members,7416(33.1%)were urea breath *** highest prevalence of *** was in the 30-39 years age group for military personnel,with an infection rate of 34.9%.The majority of infected subjects were younger than 40-years-old,accounting for 70.4%of the infected *** individuals serviced in Lanzhou and Chengdu showed a higher infection prevalence than those in Beijing,Nanjing,and Guangzhou,with prevalence rates of 44.3%,37.9%,29.0%,31.1%,and 32.3%,*** *** infection remains a common infectious disease among military personnel in China and has a relatively high prevalence rate in northwest China.

关键词： Helicobacter pylori Prevalence Military personnel Urea breath test Multicenter study

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Development of a nomogram for overall survival in patients with esophageal carcinoma:A prospective cohort study in China

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World Journal of Gastrointestinal Oncology 2025年第1期17卷 158-168页

作者： Shi-Shi Yu Xi Zheng Xiao-Sheng Li Qian-Jie Xu Wei Zhang Zhong-Li Liao Hai-Ke Lei Department of gastroenterology Chongqing University Cancer HospitalChongqing 400030China Chongqing Cancer Multi-omics Big Data Application Engineering Research center Chongqing University Cancer HospitalChongqing 400030China Department of Health Statistics School of Public HealthChongqing Medical UniversityChongqing 400016China

BACKGROUND Esophageal carcinoma(EC)presents a significant public health issue in China,with its prognosis impacted by myriad *** creation of a reliable prog-nostic model for the overall survival(OS)of EC patients promises to greatly advance the customization of treatment *** To create a more systematic and practical model that incorporates clinically significant indicators to support decision-making in clinical *** This study utilized data from a prospective longitudinal cohort of 3127 EC patients treated at Chongqing University Cancer Hospital between January 1,2018,and December 12,*** the least absolute shrinkage and selection operator regression alongside multivariate Cox regression analyses helped pinpoint pertinent variables for constructing the *** efficacy was assessed by concordance index(C-index),area under the receiver operating characteristic curve(AUC),calibration curves,and decision curve analysis(DCA).RESULTS Nine variables were determined to be significant predictors of OS in EC patients:Body mass index(BMI),Karnofsky performance status,TNM stage,surgery,radiotherapy,chemotherapy,immunotherapy,platelet-to-lymphocyte ratio,and albumin-to-globulin ratio(ALB/GLB).The model demonstrated a C-index of 0.715(95%CI:0.701-0.729)in the training cohort and 0.711(95%CI:0.689-0.732)in the validation *** the training cohort,AUCs for 1-year,3-year,and 5-year OS predictions were 0.773,0.787,and 0.750,respectively;in the validation cohort,they were 0.772,0.768,and 0.723,respectively,illustrating the model's *** curves and DCA verified the model's predictive accuracy and net *** A novel prognostic model for determining the OS of EC patients was successfully developed and validated to help clinicians in devising individualized treatment schemes for EC patients.

关键词： Esophageal carcinoma High-risk factors Prognosis Overall survival Prediction model

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