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Intestinal microecological transplantation for a patient with chronic radiation enteritis:A case report

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World Journal of gastroenterology 2024年第19期30卷 2603-2611页

作者： Lin Wang Yan Li Yu-Jing Zhang Li-Hua Peng Department of gastroenterology and hepatology The First Medical CenterChinese PLA General HospitalBeijing 100853China Department of gastroenterology and hepatology Chinese PLA Medical SchoolBeijing 100853China

BACKGROUND The gut microbiota is strongly associated with radiation-induced gut *** study aimed to assess the effectiveness and safety of intestinal microecological transplantation for treating patients with chronic radiation *** SUMMARY A 64-year-old female with cervical cancer developed abdominal pain,diarrhea,and blood in the stool 1 year after *** electronic colonoscopy was performed to diagnose chronic radiation *** courses of intestinal microecological transplantation and full-length 16S rRNA microbiological analysis were *** patient experienced short-and long-term relief from symptoms without adverse *** 16S rRNA sequencing revealed significant differences in the intestinal flora’s composition between patient and healthy *** bacteria,such as Escherichia fergusonii and Romboutsia timonensis,were more in the *** bacteria such as Faecalibacterium prausnitzii,Fusicatenibacter saccharivorans,Ruminococcus bromii,and Bifidobacterium longum were more in the healthy *** microbiota transplantation resulted in a significant change in the patient's intestinal flora *** composition converged with the donor's flora,with an increase in core beneficial intestinal bacteria,such as Eubacterium rectale,and a decrease in pathogenic *** in the intestinal flora corresponded with the patients'alleviating clinical *** Intestinal microecological transplantation is an effective treatment for relieving the clinical symptoms of chronic radiation enteritis by altering the composition of the intestinal *** study provides a new approach for treating patients with chronic radiation enteritis.

关键词： Chronic radiation enteritis Gut microbial transplantation Intestinal microecology Cancer Quality of life Case report

Effect of special types of bread with select herbal components on postprandial glucose levels in diabetic patients

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World Journal of Diabetes 2024年第4期15卷 664-674页

作者： Drasko M Gostiljac Srdjan S Popovic Vesna Dimitrijevic-Sreckovic Sasa M Ilic Jelena A Jevtovic Dragan M Nikolic Ivan A Soldatovic Clinic for Endocrinology Diabetes and Metabolic DiseasesUniversity Clinical Centre of SerbiaBelgrade 11000Serbia Faculty of Medicine University of BelgradeBelgrade 11000Serbia Clinic for gastroenterology and hepatology University Clinical Centre of SerbiaBelgrade 11000Serbia Clinic for Endocrinology Diabetes and Metabolic Diseases-Laboratory for Human Pancreatic Islets CultureUniversity Clinical Centre of SerbiaBelgrade 11000Serbia

BACKGROUND Nutrition recommendations in patients with type 2 diabetes mellitus(T2DM)are to consume rye or integral bread instead of white bread.A positive effect on glucoregulation has been achieved by enriching food with various biologically active substances of herbal origin,so we formulated an herbal mixture that can be used as a supplement for a special type of bread(STB)to achieve better effects on postprandial glucose and insulin levels in patients with *** To compare organoleptic characteristics and effects of two types of bread on postprandial glucose and insulin levels in T2DM *** This trial included 97 patients with T2DM.A parallel group of 16 healthy subjects was also *** participants were given 50 g of rye bread and the same amount of a STB with an herbal mixture on 2 consecutive *** blood glucose and insulin levels were compared at the 30^(th),60^(th),90^(th) and 120th min.A questionnaire was used for subjective estimation of the organoleptic and satiety features of the two types of *** Compared to patients who consumed rye bread,significantly lower postprandial blood glucose and insulin concentrations were found in T2DM patients who consumed *** relevant differences were found among the healthy *** estimated organoleptic and satiety characteristics are better for STB than for rye *** STB have better effects than rye bread on postprandial glucoregulation in T2DM *** estimated organoleptic and satiety characteristics are better for STB than for rye ***,STB can be recommended for nutrition in T2DM patients.

关键词： Special types of bread Postprandial glucoregulation Insulin Nutrition Type 2 diabetes mellitus

Innovative pathways allow safe discharge of mild acute pancreatitis from the emergency room

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World Journal of gastroenterology 2024年第11期30卷 1475-1479页

作者： Darshan J Kothari Sunil G Sheth Division of gastroenterology Duke University Medical CenterDurhamNC 27710United States Division of gastroenterology&hepatology Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMA 02215United States

Acute pancreatitis(AP)is a leading cause of gastrointestinal-related hospitalizations in the United States,resulting in 300000 admissions per year with an estimated cost of over$2.6 billion *** severity of AP is determined by the presence of pancreatic complications and end-organ *** moderate/severe pancreatitis can be associated with significant morbidity and mortality,the majority of patients have a mild presentation with an uncomplicated course and mortality rate of less than 2%.Despite favorable outcomes,the majority of mild AP patients are admitted,contributing to healthcare cost and *** this Editorial we review the performance of an emergency department(ED)pathway for patients with mild AP at a tertiary care center with the goal of reducing hospitalizations,resource utilization,and costs after several years of implementation of the *** discuss the clinical course and outcomes of mild AP patients enrolled in the pathway who were successfully discharged from the ED compared to those who were admitted to the hospital,and identify predictors of successful ED discharge to select patients who can potentially be triaged to the *** conclude that by implementing innovative clinical pathways which are established and reproducible,selected AP patients can be safely discharged from the ED,reducing hospitalizations and healthcare costs,without compromising clinical *** also identify a subset of patients most likely to succeed in this pathway.

关键词： Emergency department Mild pancreatitis Pathways Hospitalization Predictors

Diagnostic and prognostic performances of GALAD score in staging and 1-year mortality of hepatocellular carcinoma: A prospective study

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World Journal of gastroenterology 2024年第17期30卷 2343-2353页

作者： Oraphan Jitpraphawan Witchakorn Ruamtawee Mala Treewatchareekorn Supatsri Sethasine Division of gastroenterology and hepatology Department of MedicineNavamindradhiraj UniversityDusit 10300BangkokThailand clinical Research center Research Facilitation DivisionNavamindradhiraj UniversityDusit 10300BangkokThailand Division of clinical Chemistry and Immunology Navamindradhiraj UniversityDusit 10300BangkokThailand

BACKGROUND The GALAD score has improved early hepatocellular carcinoma(HCC)detection *** role of the GALAD score in staging and predicting tumor characteristics or clinical outcome of HCC remains of particular *** To determine the diagnostic/prognostic performances of the GALAD score at various phases of initial diagnosis,tumor features,and 1-year mortality of HCC and compare the performance of the GALAD score with those of other serum *** This prospective,diagnostic/prognostic study was conducted among patients with newly diagnosed HCC at the liver center of Vajira *** patients had HCC staging allocation using the Barcelona Clinic Liver Cancer(BCLC)***,HCC etiology,and HCC features were *** and the GALAD score were obtained at *** performance of the GALAD score and biomarkers were prospectively *** Exactly 115 individuals were diagnosed with *** GALAD score increased with disease *** BCLC-0/A and BCLC-B/C/D,the GALAD score predicted HCC staging with an area under the curve(AUC)of 0.868(95%CI:0.80–0.93).For identifying the curative HCC,the AUC of GALAD score was significantly higher than that of Alpha-fetoprotein(AFP)(0.753)and Lens culinaris agglutinin-reactive fraction of AFP-L3(0.706),and as good as that of Protein induced by vitamin K absence-II(PIVKA-II)(0.897).For detecting aggressive features,the GALAD score gave an AUC of 0.839(95%CI:0.75–0.92)and significantly outperformed compared to that of AFP(0.761)and AFP-L3(0.697),with a trend of superiority to that of PIVKA-II(0.772).The performance to predict 1-year mortality of GALAD score(AUC:0.711,95%CI:0.60–0.82)was better than that of AFP(0.541)and as good as that of PIVKA-II(0.736).The optimal cutoff value of GALAD score was≥6.83,with a specificity of 72.63%for exhibiting substantial reduction in the 1-year *** The GALAD model can diagnose HCC at the curative stage,includin

关键词： Alpha-fetoprotein Barcelona clinic liver cancer GALAD score Hepatocellular carcinoma Lens culinaris agglutinin-reactive fraction of alpha-fetoprotein Protein induced by vitamin K absence-II

Chinese national clinical practice guidelines on the prevention,diagnosis,and treatment of early gastric cancer

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Chinese Medical Journal 2024年第8期137卷 887-908页

作者： Peng Li Ziyu Li Enqiang Linghu Jiafu Ji Society of Digestive Endoscopy of the Chinese Medical Association Colorectal Surgery Group of the Chinese Medical Association Chinese Association of Gastroenterologists&Hepatologists National clinical Research center for Digestive Diseases Chinese Medical Journal clinical Practice Guideline Collaborative Department of gastroenterology Beijing Friendship HospitalCapital Medical UniversityNational Clinical Research Center for Digestive DiseaseBeijing 100050China Department of Gastrointestinal Surgery Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education)Peking University Cancer Hospital and InstituteBeijing 100142China Department of gastroenterology and hepatology the First Medical CenterChinese People’s Liberation Army General HospitalBeijing 100853China 不详

Background:Gastric cancer is one of the most common malignant tumors in the digestive system in *** comprehensive practice guidelines for early gastric cancer in China are currently ***,we created the Chinese national clinical practice guideline for the prevention,diagnosis,and treatment of early gastric ***:This clinical practice guideline(CPG)was developed in accordance with the World Health Organization’s recommended process and with the Grading of Recommendations Assessment,Development,and Evaluation(GRADE)in assessing evidence *** used the Evidence to Decision framework to formulate clinical recommendations to minimize bias and increase transparency in the CPG development *** used the Reporting Items for practice Guidelines in HealThcare(RIGHT)statement and the Appraisal of Guidelines for Research and Evaluation II(AGREE II)as reporting and conduct guidelines to ensure completeness and transparency of the ***:This CPG contains 40 recommendations regarding the prevention,screening,diagnosis,treatment,and follow-up of early gastric cancer based on available clinical studies and *** provide recommendations for the timing of Helicobacter pylori eradication,screening populations for early gastric cancer,indications for endoscopic resection and surgical gastrectomy,follow-up interval after treatment,and other ***:This CPG can lead to optimum care for patients and populations by providing up-to-date medical *** intend this CPG for widespread adoption to increase the standard of prevention,screening,diagnosis,treatment,and follow-up of early gastric cancer;thereby,contributing to improving national health care and patient quality of life.

关键词： Early gastric cancer Prevention Screening Diagnosis Treatment Follow-up

Prospective study of hepatitis B and D epidemiology and risk factors in Romania:A 10-year update

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World Journal of hepatology 2024年第4期16卷 640-649页

作者： Speranta Iacob Liana Gheorghe Mirela Onica Laura Huiban Corina Silvia Pop Ciprian Brisc Roxana Sirli Carmen Ester Cristina Mihaela Brisc Sorina Diaconu Ion Rogoveanu Larisa Sandulescu Deiana Vuletici Anca Trifan Department of gastroenterology Carol Davila University of Medicine and PharmacyBucharest 050474Romania Department of gastroenterology and hepatology Fundeni Clinical InstituteBucharest 022328Romania Department of gastroenterology Grigore T Popa University of Medicine and PharmacyIasi 700115Romania Institute of gastroenterology and hepatology Saint Spiridon County HospitalIasi 700111Romania Department of gastroenterology and Medical Oncology University Emergency Clinical HospitalBucharest 050098Romania Faculty of Medicine and Pharmacy University of OradeaOradea 410087Romania Department of gastroenterology Emergency County HospitalOradea 410169Romania center for Advanced Research in gastroenterology and hepatology Department of Gastroenterology and Hepatology“Victor Babeş”University of Medicine and PharmacyTimisoara 300041Romania Department of gastroenterology and hepatology TimişCounty Emergency Clinical Hospital"Pius Branzeu"Timisoara 300723Romania Department of Internal Medicine II and gastroenterology University Emergency Clinical HospitalBucharest 050098Romania Department of gastroenterology University of Medicine and PharmacyCraiova 200349Romania Department of Cardiology Emergency County HospitalCraiova 200642Romania Department of gastroenterology Research Center of Gastroenterology and HepatologyUniversity of Medicine and PharmacyCraiova 200349Romania Department of gastroenterology Emergency County HospitalCraiova 200642Romania Department of gastroenterology Faculty of MedicineGrigore T Popa University of Medicine and PharmacyIasi 700115Romania

BACKGROUND The global burden of hepatitis D virus(HDV)infection represents a major medical challenge and a public health crisis ***,there is a lack of accurate data on the epidemiology and risk factors for *** B virus(HBV)and HDV coinfection causes the most severe form of viral hepatitis,leading to a higher cumulative incidence of liver-related events compared with HBV monoinfection,including the need for liver transplantation and *** To investigate the epidemiology,natural history,risk factors and clinical management of HBV and HDV coinfection in Romanian *** This prospective study was conducted between January and July 2022 in six tertiary gastroenterology and hepatology referral centres in *** consecutive adults admitted for any gastroenterology diagnosis who were HBV-positive were *** with acute hepatitis or incomplete data were *** the 25390 individuals who presented with any type of gastroenterology diagnosis during the study period,963 met the inclusion *** for anti-HDV antibodies and HDV RNA was performed for all *** and risk factor data were collected by investigators using medical charts and patient *** data were stored in an anonymized online database during the *** The prevalence of HBV was 3.8%;among these patients,the prevalence of HBV/HDV coinfection was 33.1%.The median age of the study population was 54.0 years,and it consisted of 55.1%men.A higher prevalence of HBV/HDV coinfection was observed in patients 50–69 years *** with HBV/HDV coinfection were significantly older than those with HBV monoinfection(P=0.03).Multivariate multiple regression analysis identified female gender(P=0.0006),imprisonment(P<0.0001),older age at diagnosis(P=0.01)and sexual contact with persons with known viral hepatitis(P=0.0003)as significant risk factors for *** This study shows that HDV infection among those with HBV re

关键词： Epidemiology Hepatitis B Hepatitis D Natural history Risk factors Romania

Constipation and colonoscopy

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World Journal of Gastrointestinal Endoscopy 2024年第5期16卷 244-249页

作者： Dusan Dj Popovic Branka Filipovic Faculty of Medicine University of BelgradeBelgrade 11000Serbia Department of gastroenterology and hepatology Clinic for Internal MedicineUniversity Clinical Hospital Center“Dr.Dragisa Misovic-Dedinje”Belgrade 11000Serbia

Constipation is a significant sociomedical problem,which can be caused by various *** the diagnostic approach to patients with constipation,the following data are usually sufficient:History,complete physical examination(including rectal examination),and additional diagnostic tests.A colonoscopy is not a necessary diagnostic method for all patients with ***,if patients have alarm symptoms/signs,that suggest an organic reason for constipation,a colonoscopy is *** most important alarm symptoms/signs are age>50 years,gastrointestinal bleeding,new-onset constipation,a palpable mass in the abdomen and rectum,weight loss,anemia,inflammatory bowel disease,and family history positive for colorectal *** endoscopists do not like to deal with patients with *** are two reasons for this,namely the difficulty of endoscopy and the adequacy of *** are adversely affected by *** improve the quality of colonoscopy in these patients,good examination techniques and often more extensive preparation are *** colonoscopy technique implies adequate psychological preparation of the patient,careful insertion of the endoscope with minimal insufflation,and early detection and resolution of *** preparation for colonoscopy often requires prolonged preparation and sometimes the addition of other laxatives.

关键词： Constipation Functional constipation Colonoscopy Bowel preparation Polyethylene glycol

Microbiota treatment of functional constipation:Current status and future prospects

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World Journal of hepatology 2024年第5期16卷 776-783页

作者： Yan Li Xiao-Han Zhang Zi-Kai Wang Department of gastroenterology and hepatology The First Medical CenterChinese PLA General HospitalBeijing 100853China Medical School Nankai UniversityTianjin 300071China National clinical Research center for Geriatric Diseases Chinese PLA General HospitalBeijing 100853China

Functional constipation(FC)is a common disorder that is characterized by diffi-cult stool passage,infrequent bowel movement,or *** is highly prevalent,recurs often,accompanies severe diseases,and affects quality of life;therefore,safe and effective therapy with long-term benefits is urgently *** treatment has potential value for FC *** treatments include modulators such as probiotics,prebiotics,synbiotics,postbiotics,and fecal micro-biota transplantation(FMT).Some probiotics and prebiotics have been adopted,and the efficacy of other microbiota modulators is being *** is con-sidered an emerging field because of its curative effects;nevertheless,substantial work must be performed before clinical implementation.

关键词： Functional constipation Gut microbiota Microbiota modulators Fecal microbiota transplantation Dysbiosis

Microbiome and intestinal pathophysiology in post-acute sequelae of COVID-19

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Genes & Diseases 2024年第3期11卷 220-231页

作者： Jilei Zhang Yongguo Zhang Yinglin Xia Jun Sun Division of gastroenterology and hepatology Department of MedicineUniversity of Ilinois ChicagoIL60612USA Uic Cancer center Department of Microbiology and ImmunologyUniversity of Ilinois ChicagoChicagoIL60612USA Jesse Brown VA Medical center ChicagoIL60612USA

Long CoVID,also known for post-acute sequelae of CovID-19,describes the people who have the signs and symptoms that continue or develop after the acute coviD-19 *** CovID patients suffer from an inflammation or host responses towards the virus approx-imately 4 weeks after initial infection with the SARS CoV-2 virus and continue for an unchar-acterized *** infected with CovID-19 before could experience long-CcovID conditions,including the patients who were infected with SARS CoV-2 virus confirmed by tests and those who never knew they had an infection *** with long CoviD may experience health problems from different types and combinations of symptoms over time,such as fa-tigue,dyspnea,cognitive impairments,and gastrointestinal(Gl)symptoms(e.g.,nausea,vom-iting,diarrhea,decreased or loss of appetite,abdominal pain,and dysgeusia).The critical role of the microbiome in these Gl symptoms and long CovID were reported in clinical patients and experimental ***,we provide an overall view of the critical role of the Gl tract and microbiome in the development of long COVID,including the clinical Gl symptoms in patients,dysbiosis,viral-microbiome interactions,barrier function,and inflammatory bowel disease patients with long *** highlight the potential mechanisms and possible treatment based on Gl health and ***,we discuss challenges and future direction in the long CoVID clinic and research.

关键词： Gastrointestinal symptoms Gl tract Gut microbiome Inflammatorybowel diseases Intestinal barrier Long CoVID Metabolites Tight junctions