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Gender disparities and woman-specific trends in Barrett’s esophagus in the United States:An 11-year nationwide populationbased study

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World Journal of Methodology 2025年第1期15卷 60-71页

作者： Karina Fatakhova Faisal Inayat Hassam Ali Pratik Patel Attiq Ur Rehman Arslan Afzal Muhammad Sarfraz Shiza Sarfraz Gul Nawaz Ahtshamullah Chaudhry Rubaid Dhillon Arthur Dilibe Benjamin Glazebnik Lindsey Jones Emily Glazer Division of gastroenterology and Hepatology Mather Hospital and Zucker School of Medicine at Hofstra UniversityPort JeffersonNY 11777United States Department of internal medicine Allama Iqbal Medical CollegeLahorePunjab 54550Pakistan Division of gastroenterology and Hepatology East Carolina University Brody School of MedicineGreenvilleNC 27834United States Division of gastroenterology and Hepatology Geisinger Wyoming Valley Medical CenterWilkes-BarrePA 18711United States Department of internal medicine East Carolina University Brody School of MedicineGreenvilleNC 27834United States Department of internal medicine St.Dominic's HospitalJacksonMS 39216United States Department of gastroenterology Hepatologyand NutritionCleveland Clinic FoundationClevelandOH 44195United States Department of internal medicine Mather Hospital and Hofstra University ZuckerSchool of MedicinePort JeffersonNY 11777United States

BACKGROUND Barrett's esophagus(BE)is a known premalignant precursor to esophageal adenocarcinoma(EAC).The prevalence rates continue to rise in the United States,but many patients who are at risk of EAC are not *** practice guidelines include male gender as a predisposing factor for BE and *** population-based clinical evidence regarding female gender remains *** To study comparative trends of gender disparities in patients with BE in the United *** A nationwide retrospective study was conducted using the 2009-2019 National Inpatient Sample(NIS)*** with a primary or secondary diagnosis code of BE were *** major outcome of interest was determining the gender disparities in patients with *** analysis for respective outcomes for females was also reported to ascertain any time-based *** We identified 1204190 patients with BE for the study *** the included patients,717439(59.6%)were men and 486751(40.4%)were *** mean age was higher in women than in men(67.1±0.4 vs 66.6±0.3 years,P<0.001).The rate of BE per 100000 total NIS hospitalizations for males increased from 144.6 in 2009 to 213.4 in 2019(P<0.001).The rate for females increased from 96.8 in 2009 to 148.7 in 2019(P<0.001).There was a higher frequency of obesity among women compared to men(17.4%vs 12.6%,P<0.001).Obesity prevalence among females increased from 12.3%in 2009 to 21.9%in 2019(P<0.001).A lower prevalence of smoking was noted in women than in men(20.8%vs 35.7%,P<0.001).However,trend analysis showed an increasing prevalence of smoking among women,from 12.9%in 2009 to 30.7%in 2019(P<0.001).Additionally,there was a lower prevalence of alcohol abuse,Helicobacter pylori(***),and diabetes mellitus among females than males(P<0.001).Trend analysis showed an increasing prevalence of alcohol use disorder and a decreasing prevalence of *** and diabetes mellitus among women(P<0.001).CONCLUSION The prevalence of BE among

关键词： Barrett’s esophagus Gender disparity Epidemiological trends Esophageal adenocarcinoma Screening endoscopy Female gender Risk factors

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Gene targeted and immune therapies for nodal and gastrointestinal follicular lymphomas

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World Journal of gastroenterology 2023年第48期29卷 6179-6197页

作者： Takuya Watanabe Department of internal medicine and gastroenterology Watanabe Internal Medicine Aoyama ClinicNiigata 9502002Japan

Follicular lymphoma(FL)is the most common indolent B-cell lymphoma(BCL)***,its incidence has increased in Europe,the United States,and Asia,with the number of gastrointestinal FL cases expected to *** abnormalities related to t(14;18)translocation,BCL2 overexpression,NF-κB pathway-related factors,histone acetylases,and histone methyltransferases cause FL and enhance its ***,microRNAs are commonly used in diagnosing FL and predicting patient *** clinical trials on novel therapeutics targeting these genetic abnormalities and immunomodulatory mechanisms have been conducted,resulting in a marked improvement in therapeutic outcomes for *** developing these innovative therapeutic agents targeting specific genetic mutations and immune pathways has provided hope for curative options,FL treatment has become more complex,requiring combinatorial therapeutic ***,optimal treatment combinations have not yet been achieved,highlighting the importance of a complete understanding regarding the pathogenesis of gastrointestinal ***,this article reviews key research on the molecular pathogenesis of nodal FL and novel therapies targeting the causative genetic ***,the results of clinical trials are summarized,with a particular focus on treating nodal and gastrointestinal FLs.

关键词： Gastrointestinal follicular lymphoma Genetic mutation analysis using nextgeneration sequencing MicroRNA Gene targeted therapy Immune therapy

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Short-and long-term outcome of interferon therapy for chronic hepatitis B infection

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World Journal of gastroenterology 2014年第37期20卷 13284-13292页

作者： Yasushi Seo Yoshihiko Yano Division of gastroenterology Department of Internal MedicineKobe University Graduate School of Medicine internal medicine and Ophthalmology clinic

Hepatitis B virus (HBV) infection is a serious clinical problem worldwide. Conventional interferon (IFN)-α has been approved for the treatment of chronic hepatitis B (CHB). Short-term studies have demonstrated that IFN-based therapy is moderately effective in inducing the loss of hepatitis e antigen (HBeAg) or seroconversion (30%-40%) in HBeAg-positive patients and also produces sustained HBV DNA suppression (20%-30%) in HBeAg-negative patients. Many studies have reported a correlation between the HBV genotype and response to IFN treatment. The highest response rate to IFN treatment was found in patients infected with HBV genotype A, followed by HBV genotypes B, C, and D. The long-term effect of IFN-α on CHB has not yet been elucidated. The ability of IFN-α treatment to prevent new cirrhosis, complications associated with cirrhosis, and development of hepatocellular carcinoma (HCC) is controversial. The beneficial effect of IFN-α treatment in reducing the development of HCC has mainly been observed in treatment responders who already have cirrhosis. These inconsistent findings may be attributed to the inevitable limitations of comparisons across studies, including differences in the baseline characteristics of the study and the moderate suppression of HBV replication by IFN-α relative to nucleoside/nucleos(t)ide analogs.

关键词： Chronic hepatitis B Hepatitis B virus Interferon α Long-term outcome Hepatocellular carcinoma

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Recent advances in treatment of nodal and gastrointestinal follicular lymphoma

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World Journal of gastroenterology 2023年第23期29卷 3574-3594页

作者： Takuya Watanabe Department of internal medicine and gastroenterology Watanabe Internal Medicine Aoyama ClinicNiigata-city 9502002Japan

Follicular lymphoma(FL)is the most common low-grade lymphoma,and although nodal FL is highly responsive to treatment,the majority of patients relapse repeatedly,and the disease has been incurable with a poor ***,primary FL of the gastrointestinal tract has been increasingly detected in Japan,especially due to recent advances in small bowel endoscopy and increased opportunities for endoscopic examinations and endoscopic ***,many cases are detected at an early stage,and the prognosis is good in many *** contrast,in Europe and the United States,gastrointestinal FL has long been considered to be present in 12%-24%of Stage-IV patients,and the number of advanced gastrointestinal cases is expected to *** editorial provides an overview of the recent therapeutic advances in nodal FL,including antibody-targeted therapy,bispecific antibody therapy,epigenetic modulation,and chimeric antigen receptor T-cell therapy,and reviews the latest therapeutic manuscripts published in the past *** on an understanding of the therapeutic advances in nodal FL,we also discuss future possibilities for gastroenterologists to treat gastrointestinal FL,especially in advanced cases.

关键词： Nodal and gastrointestinal follicular lymphoma Antibody-based therapy Bispecific antibody therapy Phosphatidylinositol-3 kinase inhibitor Epigenetic modulator Chimeric antigen receptor-T cell therapy

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Vitamin D in esophageal cancer: Is there a role for chemoprevention?

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World Journal of Gastrointestinal Oncology 2018年第1期10卷 23-30页

作者： Carol Rouphael Afrin Kamal Madhusudhan R Sanaka Prashanthi N Thota Department of internal medicine Cleveland Clinic Department of gastroenterology and Hepatology Cleveland Clinic

Vitamin D has emerged as a promising anti-cancer agent due to its diverse biological effects on tumor differentiation, apoptosis and suppression of cellular proliferation. Current evidence suggests a protective role of vitamin D in colon cancer. The effect of vitamin D on esophageal cancer remains controversial. Multiple studies investigated the association between vitamin D and esophageal cancer, employing different modes of assessment of vitamin D status such as serum 25-hydroxyvitamin D levels, vitamin D dietary intake or exposure to ultraviolet B(UVB) radiation. Genetic variations of the vitamin D receptor(VDR) gene and VDR expression in esophageal specimens have also been investigated. Ecological studies evaluating exposure to UVB radiation yielded an inverse correlation with esophageal cancer. When vitamin D dietary intake was assessed, direct association with esophageal cancer was observed. However, circulating 25-hydroxyvitamin D concentrations showed inconsistent results. In this review article, we present a detailed summary of the current data on the effects of vitamin D on various histological subtypes of esophageal cancer and their precursor lesions. Well-powered prospective studies with accurate measurement of vitamin D status are needed before chemoprevention with vitamin D is recommended, as current evidence does not support a chemopreventive role of vitamin D against esophageal cancer. Future studies looking at the incidence of esophageal cancer in patients with pre-cancerous lesions(Barrett's esophagus and squamous cell dysplasia) receiving vitamin D supplementation are needed.

关键词： vitamin D vitamin D receptor esophageal adenocarcinoma esophageal squamous cell carcinoma genetic polymorphism

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Recent advances in treatment of follicular lymphoma: efficacy of PI3Kα/δ inhibitor (TQ-B3525)

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Signal Transduction and Targeted Therapy 2024年第6期9卷 2341-2343页

作者： Takuya Watanabe Department of internal medicine and gastroenterology Watanabe Internal Medicine Aoyama ClinicNiigata-city 9502002Japan

The commented study reports the results of monotherapy using TQ-B3525,a novel phosphatidylinositol-3 kinase(PI3K)inhibitor developed in China,in patients with refractory/relapsed follicular lymphoma(r/r FL).

关键词： PI3K lymphoma treatment

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Cryotherapy in the management of premalignant and malignant conditions of the esophagus

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World Journal of gastroenterology 2018年第43期24卷 4862-4869页

作者： Pooja Lal Prashanthi N Thota Department of internal medicine Cleveland Clinic Department of gastroenterology Digestive Disease Surgery InstituteCleveland Clinic

Endoscopic cryotherapy is a relatively new thermal ablative modality used for the treatment of neoplastic lesions of the esophagus. It relies on cycles of rapid cooling and thawing to induce tissue destruction with a cryogen(liquid nitrogen or carbon dioxide) leading to intra and extra-cellular damage. Surgical treatment was once considered the standard therapeutic intervention for neoplastic diseases of the esophagus and is associated with considerable rates of morbidity and mortality. Several trials that evaluated cryotherapy in Barrett's esophagus(BE) associated neoplasia showed reasonable efficacy rates and safety profile. Cryotherapy has also found applications in the treatment of esophageal cancer, both for curative and palliative intent. Cryotherapy has also shown promising results as salvage therapy in cases refractory to radiofrequency ablation treatment. Cryoballoon focal ablation using liquid nitrogen is a novel mode of cryogen delivery which has been used for the treatment of BE with dysplasia and squamous cell carcinoma. Most common side effects of cryotherapy reported in the literature include mild chest discomfort, esophageal strictures and bleeding. In conclusion, cryotherapy is an effective and safe method for the treatment of esophageal neoplastic processes, ranging from early stages of low grade dysplasia to esophageal cancer.

关键词： Esophageal cancer Barrett's esophagus Palliative therapy Cryotherapy

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Frequency and risk factors of low immunoglobulin levels in patients with inflammatory bowel disease

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gastroenterology Report 2015年第2期3卷 115-121页

作者： Tarun Rai Xianrui Wu Bo Shen Departments of General internal medicine and gastroenterology/Hepatology the Cleveland Clinic FoundationClevelandOHUSA

Background and aims:Inflammatory bowel diseases(IBD)are considered to be dysregulated,immune-mediated disorders;and immunosuppressive medications are the mainstay of their ***,we have often observed low serum immunoglobulin(Ig)levels in these *** aim of this study was to assess the frequency and risk factors of secondary humoral immunodeficiency in IBD ***:We conducted a cross-sectional study of eligible IBD patients with Crohn’s disease(CD),ulcerative colitis(UC),indeterminate colitis(IC)or restorative proctocolectomy with ileal pouch,who having serum Ig *** and clinical variables were *** and multivariate analyses were ***:A total of 324 patients was included,with a mean age of 38.8 years and 158(48.8%)being *** IgG,IgG1,IgA,and IgM were found in 22.7%,23.4%,7.9%,and 10.9%of patients,*** shared risk factors for a low IgG or IgM level were increasing age[odds ratio(OR)=1.13;95%confidence interval(CI)1.03–1.23 for low IgG level and OR=1.33;95%CI 1.15–1.56 for low IgM level]and hypoalbuminemia(OR=1.83;95%CI 1.01–3.33 for low IgG level and OR=3.17;95%CI 1.23–8.15 for low IgM level).In addition,thioprine use was associated with low IgA level(OR=2.76;95%CI 1.03–7.39).IBD disease duration was a risk factor for low IgG1 level(OR=1.40;95%CI 1.12–1.76).The presence of concurrent primary sclerosing cholangitis(OR=0.064;95%CI 0.007–0.60)and the use of biologics(OR=0.16;95%CI 0.033–0.79)were associated with normal IgG1 *** level was lower in CD patients than that in UC/IC and ileal pouch patients(P=0.042).IgG and IgA levels were elevated in patients with inflammatory conditions of the pouch(P=0.01;P=0.003,respectively).Conclusions:Low Ig level appears to be common in IBD *** age,disease duration and hypoalbuminemia appeared to be risk *** findings may provide rationale for targeted therapy to boost humoral immunity in selected patients with IBD.

关键词： inflammatory bowel disease immunoglobulins biologics Crohn’s disease ulcerative colitis ileal pouch

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Refractory gastroesophageal reflux disease

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gastroenterology Report 2015年第1期3卷 41-53页

作者： Charumathi Raghu Subramanian George Triadafilopoulos internal medicine Guthrie ClinicSayrePAUSA Division of gastroenterology Stanford University School of MedicineStanfordCAUSA

Gastroesophageal reflux disease(GERD)is a condition that develops when the reflux of stomach contents into the esophagus causes troublesome symptoms,esophageal injury,and/or *** of proton pump inhibitors(PPI)remains the standard therapy for GERD and is effective in most *** whose symptoms are refractory to PPIs should be evaluated further and other treatment options should be considered,according to individual patient *** to PPIs could be total(no symptoms),partial(residual breakthrough symptoms),or absent(no change in symptoms).Patients experiencing complete response do not usually need further *** with partial response can be treated surgically or by using emerging endoscopic *** who exhibit no response to PPI need further evaluation to rule out other causes.

关键词： gastroesophageal reflux disease acid-related diseases pH monitoring endoscopy

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Red cell distribution width/platelet ratio predicts decompensation of metabolic dysfunction-associated steatotic liver disease-related compensated advanced chronic liver disease

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World Journal of gastroenterology 2025年第3期31卷 1-10页

作者： Ming-Hua Zheng Amedeo Lonardo Department of Hepatology MAFLD Research CenterThe First Affiliated Hospital of Wenzhou Medical UniversityWenzhou 325000Zhejiang ProvinceChina Department of internal medicine Azienda Ospedaliero-Universitaria of Modena(2023)Modena 41126Italy

Prognostication of compensated advanced chronic liver disease(cACLD)is of paramount importance for the physician-and-patient communication and for rational clinical *** paper published by Dallio et al reports on red cell distribution width(RDW)/platelet ratio(RPR)as a non-invasive biomarker in predicting decompensation of metabolic dysfunction-associated steatotic liver disease(MASLD)-related *** from other biomarkers and algorithms,RPR is inexpensive and widely available,based on parameters which are included in a complete blood *** is computed on the grounds of two different items,one of which,RDW,mirrors the host’s response to a variety of disease stimuli and is *** second parameter involved in RPR,platelet count,is more specific and has been used in the hepatological clinic to discriminate cirrhotic from non-cirrhotic chronic liver disease for *** disease is the primary cause of mortality among MASLD subjects,followed by extra-hepatic cancers and liver-related ***,MASLD biomarkers should be validated not only in terms of liver-related events but also in the prediction of major adverse cardiovascular events and cardiovascular mortality and extra-hepatic *** sized multi-ethnic confirmatory investigation is required to define the role and significance of RPR in the stratification of MASLD-cACLD.

关键词： Cirrhosis Liver fibrosis Natural course Prognostication Stratification

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