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Journal of clinical and Translational hepatology 2024年第5期12卷 534-538页

作者： Shalini Bansal Tamar Taddei Rebecca Wells Marina Serper Theresa Bittermann Nadim Mahmud David E.Kaplan Sidney Kimmel Medical College at Thomas Jefferson University PhiladelphiaPAUSA Division of gastroenterology and hepatology Perelman School of Medicine University of PennsylvaniaPhiladelphiaPAUSA Corporal Michael J.Crescenz VA Medical Center PhiladelphiaPAUSA Division of gastroenterology and hepatology Yale University School of MedicineNew HavenCTUSA VA Connecticut Healthcare System West HavenCTUSA

Hepatocellular carcinoma(HCC)is the most common primary tumor of the liver and often evolves from regenerating nodules in liver *** there have been significant advances in the treatment of HCC,the overall prognosis in patients with a large tumor burden,vascular invasion,or extrahepatic spread remains poor.1 The magnitude of liver stiffness in cirrhosis has been consistently associated with an increased risk of development of HCC.

关键词： Carcinoma invasion cirrhosis

clinical features of gastroesophageal reflux disease and erosive esophagitis:Insights from patients undergoing esophagogastroduodenoscopy in resource-limited Ethiopia

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World Journal of gastroenterology 2024年第34期30卷 3883-3893页

作者： Firehiwot A Mengistie Abate B Shewaye Abel T Tasamma Zekarias S Ayalew Department of Internal Medicine Addis Ababa UniversityAddis Ababa 1176Addis AbabaEthiopia Department of Internal Medicine Rheum Rheumatology and Internal Medicine Specialty ClinicAddis Ababa 1000Addis AbabaEthiopia Division of gastroenterology and hepatology Department of Internal MedicineAdera Medical and Surgical CenterAddis Ababa 1000Addis AbabaEthiopia

BACKGROUND Gastroesophageal reflux disease(GERD)is a common disease worldwide with varying clinical presentations and risk *** data for Africa is lacking,but an increasing trend is expected due to demographic and epidemiological *** endoscopic studies for general gastrointestinal disorders have shown some patients with erosive esophagitis(EE),no studies in Ethiopia have investigated the clinical characteristics,risk factors,and severity of GERD using esophagogastroduodenoscopy(EGD).AIM To assess the clinical features of GERD in Ethiopian patients who underwent EGD and determine the severity and risk factors of *** We conducted a multicenter,retrospective cross-sectional study of 221 patients diagnosed with GERD and endoscopic findings of EE at Trauma Associated Severe Hemorrhage and Amniotic Membrane Stem Cell between January 2019 and August *** were collected from electronic medical records and phone call *** used descriptive statistics and binary logistic regression analysis with SPSS version 26 to identify the association between variables with a statistical significance set at P value<*** The mean±SD age of the patients was 44.8(±15.9)years,with a male-to-female ratio of 1.6:*** most commonly reported symptom was epigastric pain(80.5%),followed by heartburn(43%).Los Angeles(LA)-A EE was diagnosed in 71.1%of patients,followed by LA-B(14.9%),LA-C(7.7%),and LA-D(5.9%).Multivariate analysis showed that age 50 or above,presence of bleeding,and endoscopic findings of duodenitis/duodenopathy were significantly associated with severe EE(P<0.05).Stricture and Barrett’s esophagus were observed in 4.5%and 1.36%of patients with EE,*** Most of the patients had milder EE with fewer ***,severe EE was more prevalent in older patients and those with duodenitis/duodenopathy.

关键词： Gastroesophageal reflux disease Erosive esophagitis Hiatal hernia Esophagogastroduodenoscopy Heart burn

Diagnostic tools for fecal incontinence: Scoring systems are the crucial first step

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World Journal of gastroenterology 2024年第6期30卷 516-522页

作者： Peter Liptak Martin Duricek Peter Banovcin clinic of Internal Medicine-gastroenterology University Hospital in MartinJessenius Faculty of Medicine in MartinComenius UniversityMartin 03601Slovakia

The main aim of this editorial is to comment on the recent article published by Garg et al in the World Journal of gastroenterology 2023;29:*** original research presents a new scoring system for fecal *** incontinence is a chronic disease with a severe impact on the quality of life of the *** social stigmatization often leads to significant underreporting of the condition even during visits to a specialist and could lead to further misman-agement or non-existent management of the *** important fact is that patients are often unable to describe their condition when not asked precisely defined *** problem is partially resolved by scoring *** scoring systems are commonly used;however,each of them has their *** example,the absence of different kinds of leakage besides flatus and stool could further lead to underscoring the incontinence ***,there has long been a call for a more precise scoring *** correct identification of the presence and severity of fecal incontinence is paramount for further diagnostic approach and for choosing the appropriate therapy *** editorial describes fecal incontinence,its effect on quality of life in general and further evaluates the diagnostic approach with a particular focus on symptom scoring systems and their implications for clinical practice.

关键词： Incontinence Fecal Scoring system Questionary Quality of life

Digesting gluten with oral endopeptidases to improve the management of celiac disease

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World Journal of gastroenterology 2024年第26期30卷 3201-3205页

作者： Katelin Durham Mirac Nedim Ince Department of Internal Medicine Division of Gastroenterology and HepatologyUniversity of IowaCarver College of Medicineand the Iowa City Veterans Affairs Medical CenterIowa CityIA 52242United States

In our editorial,we want to comment on the article by Stefanolo et al titled“Effect of Aspergillus niger prolyl endopeptidase in patients with celiac disease on a long-term gluten-free diet”.Celiac disease is an immune-mediated disorder triggered by dietary gluten in genetically predisposed *** avoiding gluten can permit patients to live symptom-free,ongoing voluntary or involuntary exposure to gluten is common and associated with persistent villous atrophy in small bowel *** villous atrophy predisposes patients to life threatening complications,such as osteoporotic fractures or malignancies,therapeutic adjuncts to gluten-free diet become important to improve patients’quality of life and,if these adjuncts can be shown to improve villous atrophy,avoid *** administration of enzyme preparations,such as endopeptidases that digest gluten and mitigate its antigenicity to trigger inflam-mation,is one clinical strategy under *** article is about the utility of one endopeptidase isolated from Aspergillus *** critique findings of this clinical trial and also summarize endopeptidase-based as well as other strategies and how they can complement gluten-free diet in the management of celiac disease.

关键词： Celiac disease Gluten-free diet Endopeptidase Villous atrophy Aspergillus niger Adjunct therapy

The combination of gut microbiota-depleted treatment and fecal microbiota transplantation is an important strategy to verify the efficacy of Traditional Chinese Medicine though modulation of gut dysbiosis

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Journal of Traditional Chinese Medicine 2024年第1期44卷 222-223页

作者： XING Yunqi LI Junxiang YUAN Yali MAO Tangyou gastroenterology Department Dongfang HospitalBeijing University of Chinese MedicineBeijing 100078China Department of hepatology Yueyang Hospital of Integrated Traditional Chinese and Western MedicineShanghai University of Traditional Chinese MedicineShanghai 201203China

To the Editors:We read with great interest the study recently published by Sun et al 1 entitled“Electroacupuncture at Tianshu(ST25)and Zusanli(ST36)alleviates stress-induced irritable bowel syndrome in mice by modulating gut microbiota and corticotropin-releasing factor”in which the microbial details of electroacupuncture(EA)-induced protection in irritable bowel syndrome(IBS)were investigated.

关键词： releasing treatment details

Impact of Onset Time, Number, Type, and Sequence of Extrahepatic Organ Failure on Prognosis of Acute-on-chronic Liver Failure

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Journal of clinical and Translational hepatology 2024年第3期12卷 257-265页

作者： Shaotian Qiu Qian Zhang Jiaxuan Hu Lewei Wang Rui Chen Yingying Cao Fang Liu Zhenjun Yu Caiyan Zhao Liaoyun Zhang Wanhua Ren Shaojie Xin Yu Chen Zhongping Duan Tao Han The School of Medicine Nankai UniversityTianjinChina Department of gastroenterology and hepatology Tianjin Union Medical Center Affiliated to Nankai UniversityTianjinChina Department of gastroenterology and hepatology Tianjin Union Medical CenterTianjinChina Tianjin Medical University TianjinChina Department of gastroenterology and hepatology Tianjin Union Medical Center of Tianjin Medical UniversityTianjinChina Department of hepatology and gastroenterology The Third Central Clinical College of Tianjin Medical UniversityTianjinChina Department of Infectious Disease The Third Hospital of Hebei Medical UniversityShijiazhuangHebeiChina Department of Infection Disease First Hospital of Shanxi Medical UniversityTaiyuanShanxiChina Infectious Department of Shandong First Medical University Affiliated Shandong Provincial Hospital JinanShandongChina Liver Failure Treatment and Research Center The Fifth Medical Center of Chinese PLA General HospitalBeijingChina Liver Disease Center(Difficult&Complicated Liver Diseases and Artificial Liver Center) Beijing You’an Hospital Affiliated to Capital Medical UniversityBeijingChina

Background and Aims:The impact of the characteristics of extrahepatic organ failure(EHOF)including the onset time,number,type,and sequence on the prognosis of acute-onchronic liver failure(ACLF)patients remains *** study aimed to identify the association between the characteristics of EHOF and the prognosis of ACLF ***:ACLF subjects enrolled at six hospitals in China were included in the *** risk of mortality based on the characteristics of EHOF was *** of study groups was compared by Kaplan–Meier analysis and log-rank ***:A total of 736 patients with ACLF were *** was observed in 402 patients(54.6%),of which 295(73.4%)developed single EHOF(SEHOF)and 107(26.6%)developed multiple EHOF(MEHOF).The most commonly observed EHOF was coagulation failure(47.0%),followed by renal(13.0%),brain(4.9%),respiratory(4.3%),and circulatory(2.3%)*** analysis found that MEHOF or SEHOF patients with brain failure had a worse ***,no significant outcome was found in the analysis of the effect of onset time and sequence of failed organs on *** were further divided into three risk subgroups by the EHOF ***–Meier analysis showed that risk stratification resulted in the differentiation of patients with different risks of mortality both in the training and validation ***:The mortality of ACLF patients was determined by the number and type,but not the onset time and sequence of *** stratification applicable to clinical practice was established.

关键词： Extrahepatic organ failure Acute-on-chronic liver failure Prognosis Brain failure

A Revised Classification of Primary Iron Overload Syndromes

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Journal of clinical and Translational hepatology 2024年第4期12卷 346-356页

作者： Yasuaki Tatsumi Motoyoshi Yano Shinya Wakusawa Hiroaki Miyajima Tetsuya Ishikawa Shinsaku Imashuku Atsuko Takano Wataru Nihei Ayako Kato Koichi Kato Hisao Hayashi Kentaro Yoshioka Kazuhiko Hayashi Department of Medical Biochemistry Faculty of Pharmaceutical SciencesToho UniversityFunabashiJapan Department of gastroenterology Yokkaichi Municipal HospitalYokkaichiJapan Department of Medical Technology Shubun UniversityIchinomiyaJapan Department of Medicine and Neurology Tenryu Kohseikai ClinicHamamatsuJapan Department of gastroenterology and hepatology Nagoya University Graduate School of MedicineNagoyaJapan Department of Laboratory Medicine Uji-Tokushukai Medical CenterUjiJapan Department of Medicine Saiseikai Takaoka HospitalTakaokaJapan Department of Medicine Aichi-Gakuin University School of PharmacyNagoyaJapan Department of gastroenterology FNPS Meijo HospitalNagoyaJapan

Background and Aims:The clinical introduction of hepcidin25(Hep25)has led to a more detailed understanding of its relationship with ferroportin(FP)and divalent metal transporter1 in primary iron overload syndromes(PIOSs).In 2012,we proposed a classification of PIOSs based on the Hep25/FP system,which consists of prehepatic aceruloplasminemia,hepatic hemochromatosis(HC),and posthepatic FP disease(FP-D).However,in consideration of accumulated evidence on PIOSs,we aimed to renew the ***:We reviewed the 2012 classification and retrospectively renewed it according to new information on ***:Iron-loading anemia was included in PIOSs as a prehepatic form because of the newly discovered erythroferrone-induced suppression of Hep25,and the state of traditional FP-D was remodeled as the BIOIRON *** key molecules responsible for prehepatic PIOSs are low transferrin saturation in aceruloplasminemia and increased erythroferrone production by erythroblasts in iron-loading *** PIOSs comprise four genotypes of HC,in each of which the synthesis of Hep25 is inappropriately reduced in the *** Hep25 synthesis is adequate in posthepatic PIOSs;however,two mutant FP molecules may resist Hep25 differently,resulting in SLC40A1-HC and FP-D,*** phenotypes are diagnosed using laboratory tests,including circulating Hep25,followed by suitable *** sequencing of the candidate genes may be outsourced to gene centers when *** kits for the prevalent mutations,such as C282Y,may be the first choice for a genetic analysis of HC in ***:The revised classification may be useful worldwide.

关键词： Ethnicity Ferroportin Hemochromatosis Hepcidin25 Iron overload syndrome

Safety and efficacy of Kaffes intraductal self-expanding metal stents in the management of post-liver transplant anastomotic strictures

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World Journal of Transplantation 2024年第2期14卷 88-98页

作者： Chee Lim Jonathan Ng Babak Sarraf Rhys Vaughan Marios Efthymiou Leonardo Zorron Cheng Tao Pu Sujievvan Chandran Department of gastroenterology and hepatology Austin HealthMelbourne HeidelbergVIC 3084Australia Melbourne Medical School The University of MelbourneMelbourne ParkvilleVIC 3052Australia

BACKGROUND Endoscopic management is the first-line therapy for post-liver-transplant anas-tomotic *** the optimal duration of treatment with plastic stents has been reported to be 8-12 months,data on safety and duration for metal stents in this setting is *** to limited access to endoscopic retrograde cholan-giopancreatography(ERCP)during the coronavirus disease 2019 pandemic in our centre,there was a change in practice towards increased usage and length-of-stay of the Kaffes biliary intraductal self-expanding stent in patients with suitable *** was mainly due to the theoretical benefit of Kaffes stents allowing for longer indwelling periods compared to the traditional plastic *** Adult liver transplant recipients aged 18 years and above who underwent ERCP were retrospectively identified during a 10-year period through a database *** admissions post-Kaffes stent insertion were identified manually through electronic and scanned medical *** main outcome was the incidence of complications when stents were left indwelling for 3 months vs 6 *** efficacy was calculated via rates of stricture recurrence between patients that had stenting courses for≤120 d or>120 *** During the study period,a total of 66 ERCPs with Kaffes insertion were performed in 54 patients throughout their stenting *** 33 ERCPs,the stent was removed or exchanged on a 3-month *** pancreatitis,perfor-ations or deaths *** post-ERCP complications were similar between the 3-month(abdominal pain and intraductal migration)and 6-month(abdominal pain,septic shower and embedded stent)groups-6.1%vs 9.1%respectively,P=*** strictures resolved at the end of the stenting course,but the stenting course was variable from 3 to 22 *** recurrence rate for stenting courses lasting for up to 120 d was 71.4%and 21.4%for stenting courses of 121 d or over(P=0.03).There were 28 patients that were treated with a sin

关键词： Liver transplantation Cholangiopancreatography Endoscopic retrograde Constriction Pathologic Self expandable metallic stents Bile duct diseases Cholestasis

Pro and anti-inflammatory diets as strong epigenetic factors in inflammatory bowel disease

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World Journal of gastroenterology 2024年第27期30卷 3284-3289页

作者： Adele Rostami Kristen White Kamran Rostami Digestive Health clinic Palmerston North 4410New Zealand Digestive Health clinic&Kōtare Wellness Ltd Palmerston North 4410New Zealand Department of gastroenterology Palmerston North HospitalPalmerston North 4442New Zealand

Inflammatory bowel disease(IBD)is the consequence of a complex interplay between environmental factors,like dietary habits,that alter intestinal microbiota in response to luminal antigens in genetically susceptible *** represents an auspicious area for the discovery of how environmental factors influence the pathogenesis of inflammation,prognosis,and response to ***,it relates to gene expression control in response to environmental *** increasing number of patients with IBD globally is indicative of the negative effects of a food supply rich in trans and saturated fats,refined su-gars,starches and additives,as well as other environmental factors like seden-tarism and excess bodyweight,influencing the promotion of gene expression and increasing DNA hypomethylation in *** many genetic variants are now associated with Crohn's disease(CD),new therapeutic strategies targeting modi-fiable environmental triggers,such as the implementation of an anti-inflammatory diet that involves the removal of potential food antigens,are of growing interest in the current ***,as a strong epigenetic factor in the pathogenesis of inflammatory disorders like IBD,provides novel insights into the pathophysio-logy of intestinal and extraintestinal inflammatory disorders.

关键词： Inflammatory bowel disease Epigenetic Anti-inflammatory diet Immunogenetics Microbiome Polymeric diet Elemental diet

Diagnostic and therapeutic role of endoscopic ultrasound in liver diseases:A systematic review and meta-analysis

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World Journal of gastroenterology 2024年第7期30卷 742-758页

作者： Eyad Gadour Abeer Awad Zeinab Hassan Khalid Jebril Shrwani Bogdan Miutescu Hussein Hassan Okasha Department of gastroenterology and hepatology King Abdulaziz Hospital-National GuardAhsa 31982Saudi Arabia Department of Internal Medicine Faculty of MedicineZamzam University CollegeKhartoum 11113Sudan Department of Hepatogastroenterology Kasar Alainy HospitalFaculty of MedicineCairo UniversityCairo 11451Egypt Department of Internal Medicine Stockport Hospitals NHS Foundation TrustManchester SK27JEUnited Kingdom Public Health Authority Saudi Center for Disease Prevention and ControlJazan 45142Saudi Arabia Department of clinical Infection Microbiology and ImmunologyInstitute of Infection and Global HealthSchool of Medicine and Life SciencesUniversity of LiverpoolLiverpoolUnited Kingdom Department of gastroenterology and hepatology Victor Babes University of Medicine and PharmacyTimisoara 300041Romania Advanced Regional Research Center in gastroenterology and hepatology Victor Babes University of Medicine and PharmacyTimisoara 30041Romania Department of Internal Medicine Division of Gastroenterology and HepatologyKasr Al-Aini School of MedicineCairo UniversityCairo 11562Egypt

BACKGROUND In hepatology,the clinical use of endoscopic ultrasound(EUS)has experienced a notable increase in recent *** applications range from the diagnosis to the treatment of various liver ***,this systematic review summarizes the evidence for the diagnostic and therapeutic roles of EUS in liver *** To examine and summarize the current available evidence of the possible roles of the EUS in making a suitable diagnosis in liver diseases as well as the therapeutic accuracy and *** PubMed,Medline,Cochrane Library,Web of Science,and Google Scholar databases were extensively searched until October *** methodological quality of the eligible articles was assessed using the Newcastle-Ottawa scale or Cochrane Risk of Bias *** addition,statistical analyses were performed using the Comprehensive Meta-Analysis *** Overall,45 articles on EUS were included(28 on diagnostic role and 17 on therapeutic role).Pooled analysis demonstrated that EUS diagnostic tests had an accuracy of 92.4%for focal liver lesions(FLL)and 96.6%for parenchymal liver ***-guided liver biopsies with either fine needle aspiration or fine needle biopsy had low complication rates when sampling FLL and parenchymal liver diseases(3.1%and 8.7%,respectively).Analysis of data from four studies showed that EUS-guided liver abscess had high clinical(90.7%)and technical success(90.7%)without significant ***,EUS-guided interventions for the treatment of gastric varices(GV)have high technical success(98%)and GV obliteration rate(84%)with few complications(15%)and rebleeding events(17%).CONCLUSION EUS in liver diseases is a promising technique with the potential to be considered a first-line therapeutic and diagnostic option in selected cases.

关键词： Focal liver lesion Liver abscess drainage Fine needle aspiration Gastric varices Endoscopic ultrasound