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Vonoprazan-amoxicillin dual therapy for Helicobacter pylori eradication in Chinese population:A prospective,multicenter,randomized,two-stage study

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World Journal of gastroenterology 2024年第27期30卷 3304-3313页

作者： Xue-Ping Huang Zhi-Hui Lin Yi-Juan Liu Shao-Wei Lin Yan-Feng Shao Feng Qiu Qing-Wu Qiu Zhang-Kun Xu Jin-Xian Chen Liang-Huo Chen Zhen-Qun Lin Wen-Hua Dai Ming-Qing Zhang Qi Jiang Zhong-Qin Xiao Xian-Xing Cheng Xiang-Fei Zhang Wen-Bin You Wei Chen Long-Qin Li Wei-Xing Lin Yong-Fu Wang Fu-Jin Lai Long-Qun Chen Zhong-Hua Huang Wen-Qi Zheng Jin-Qi Wei department of gastroenterology Shengli Clinical Medical College of Fujian Medical UniversityFuzhou 350000Fujian ProvinceChina department of gastroenterology Fujian Provincial HospitalFuzhou 350001Fujian ProvinceChina department of gastroenterology The First Affiliated Hospital of Fujian Medical UniversityFuzhou 350000Fujian ProvinceChina School of Public Health Fujian Medical UniversityFuzhou 350000Fujian ProvinceChina department of gastroenterology The Third People’s Hospital of Fujian ProvinceFuzhou 350000Fujian ProvinceChina department of gastroenterology Fujian Provincial Hospital North Brance Fujian Provincial Geriatric HospitalFuzhou 350000Fujian ProvinceChina department of gastroenterology Xiaoao HospitalFuzhou 350000Fujian ProvinceChina department of gastroenterology The General Hospital of Fujian Energy GroupFuzhou 350000Fujian ProvinceChina department of gastroenterology The Second Hospital of ZhangzhouZhangzhou 363000Fujian ProvinceChina department of gastroenterology Anxi Country HospitalQuanzhou 362000Fujian ProvinceChina department of gastroenterology Zhangzhou Municipal Hospital of TCMZhangzhou 363000Fujian ProvinceChina department of gastroenterology Zhangpu HospitalZhangzhou 363000Fujian ProvinceChina department of gastroenterology The Affiliated Dongnan Hospital of Xiamen UniversityZhangzhou 363000Fujian ProvinceChina department of gastroenterology First Hospital of Nanping CityNanping 353000Fujian ProvinceChina department of gastroenterology Fujian Nanping Second HospitalNanping 353000Fujian ProvinceChina department of gastroenterology Wuyishan Municipal HospitalNanping 353000Fujian ProvinceChina department of gastroenterology Fuzhou Changle District HospitalFuzhou 350000Fujian ProvinceChina department of gastroenterology Changle City Second HospitalFuzhou 350000Fujian ProvinceChina department of gastroenterology Jinjiang Municipal HospitalQuanzhou 362000Fujian ProvinceChina department of gastroenterology Fuding Hospital Affiliated to Fuj

BACKGROUND The efficacy of Vonoprazan-amoxicillin dual therapy(VAT)in the treatment of Helicobacter pylori(***)is *** To evaluate the efficacy of VAT in the Chinese *** This prospective,multicenter,randomized,open-label,and two-stage study was conducted at 23 centers in Fujian,China(May 2021-April 2022).***-infected patients were randomized to bismuth quadruple therapy(BQT),BQT-Vonoprazan(BQT-V),seven-day VAT(VAT-7),ten-day VAT(VAT-10),and fourteen-day VAT(VAT-14)*** primary endpoint was the *** eradication *** secondary endpoint was the frequency of adverse *** study was registered with the Chinese Clinical Trial Registry,*** In the first stage,VAT-7 and BQT-V groups were selected for early termination because less than 23 among 28 cases were *** the second stage,the eradication rates for BQT,VAT-10,and VA-14 were 80.2%[95%confidence interval(95%CI):71.4%-86.8%],93.2%(86.6%-96.7%),92.2%(85.3%-96.0%)in the intention-to-treat(ITT)analysis,and 80.9%(95%CI:71.7%-87.5%),94.0%(87.5%-97.2%),and 93.9%(87.4%-97.2%)in the per-protocol *** ITT analysis showed a higher eradication rate in the VAT-10 and VAT-14 groups than in the BQT group(P=0.022 and P=0.046,respectively).The incidence of adverse events in the VAT-10 and VAT-14 groups was lower than in the BQT group(25.27%and 13.73%vs 37.62%,respectively;P<0.001).CONCLUSION VAT with a duration of 10 or 14 days achieves a higher eradication rate than the BQT,with a more tolerable safety profile in ***-infected patients in *** XP et *** for *** eradication.

关键词： Helicobacter pylori Vonoprazan Amoxicillin Dual therapy Bismuth quadruple therapy

A BBS4 mutation causes autosomal dominant polycystic liver disease

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Genes & Diseases 2024年第1期11卷 72-75页

作者： Yalu Cui Wenping Xu Jinpei Liu Shuqing Liu Wei Huang Yihai Shi Xin Zhang Cuihua Lu Weifen Xie department of gastroenterology Changzheng HospitalNaval Medical UniversityShanghai 200003China department of gastroenterology Gongli Hospital of Shanghai Pudong New AreaShanghai 200135China department of gastroenterology Affiliated Hospital of Nantong UniversityNantong UniversityNantongJiangsu 226001China

Autosomal dominant polycystic liver disease(ADPLD)refers to a condition characterized by the presence of numerous cholangiocytes-lined and fluid-filled cysts in the liver and the absence of polycystic kidney disease.1 Although patients with ADPLD may be asymptomatic,some patients suffer from abdominal pain,gastroesophageal reflux,and nausea,because of hepatomegaly.

关键词： liver polycystic patients

Effects of Transjugular Intrahepatic Portosystemic Shunt on Renal and Pulmonary Function in Hepatic Decompensation with and without Hepatorenal and Hepatopulmonary Syndromes:A Review

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Journal of Clinical and Translational Hepatology 2024年第9期12卷 780-791页

作者： Ahmed H.Abdelwahed Moataz Aboeldahb George Y.Wu department of Medicine Division of Gastroenterology-HepatologyUniversity of Connecticut Health CenterFarmingtonCTUSA department of gastroenterology and Hepatology Mayo ClinicRochesterMNUSA

Cirrhosis is often characterized by decreased liver function,ranging from a compensated,typically asymptomatic phase to a decompensated phase characterized by the appearance of ascites or variceal bleeding,and ultimately hepatorenal syndrome(HRS)or hepatopulmonary syndrome(HPS).The latter two complications are associated with a poor prognosis and limited treatment *** cases of ascites or variceal bleeding resistant to medical therapy,transjugular intrahepatic portosystemic shunt(TIPS)is effective and *** blood by TIPS diverts portal blood to the systemic circulation,potentially increasing systemic blood volume and benefiting renal ***,TIPS could also divert nitric oxide to the systemic circulation,potentially worsening systemic hypotension and perfusion,which could be detrimental to renal *** evidence indicates that TIPS often improves renal function in patients with portal hypertension,with or without *** studies have shown persistently decreased renal function after ***,these data are insufficient to support a recommendation for the use of TIPS specifically for *** patients without pre-existing HPS,TIPS does not appear to significantly affect pulmonary gas *** of TIPS in HPS have been inconsistent;some studies have shown improvement,but effects were *** studies have shown a persistent decline in pulmonary function after *** evidence supports the need for large randomized controlled trials to investigate the beneficial effects of TIPS for *** pulmonary function data are less clear regarding TIPS for *** aim of the current report was to review the literature regarding the effects of TIPS on renal and pulmonary function in hepatic decompensation,with or without the development of HRS or HPS.

关键词： Cirrhosis Hepatorenal syndrome Hepatopulmonary syndrome Transjugular intrahepatic portosystemic shunt

Risk factors for lymph node metastasis in superficial esophageal squamous cell carcinoma

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World Journal of gastroenterology 2024年第13期30卷 1810-1814页

作者： Yan-Bo Yu department of gastroenterology Laboratory of Translational GastroenterologyQilu HospitalShandong UniversityJinan 250012Shandong ProvinceChina

In this editorial,we comment on the article by Wang et al published in the recent issue of the World Journal of gastroenterology in *** focused on identifying risk factors for lymph node metastasis(LNM)in superficial esophageal squamous cell carcinoma(SESCC)patients and how to construct a simple and reliable clinical prediction model to assess the risk of LNM in SESCC patients,thereby helping to guide the selection of an appropriate treatment *** current standard treatment for SESCC is radical esophagectomy with lymph node ***,esophagectomy is associated with considerable morbidity and *** resection(ER)offers a safer and less invasive alternative to surgical resection and can enable the patient's quality of life to be maintained while providing a satisfactory ***,since ER is a localized treatment that does not allow for lymph node dissection,the risk of LNM in SESCC limits the effectiveness of *** LNM status can aid in determining whether patients with SESCC can be cured by ER without the need for additional *** studies have shown that tumor size,macroscopic type of tumor,degree of differentiation,depth of tumor invasion,and lymphovascular invasion are factors associated with LNM in patients with *** addition,tumor budding is commonly associated with LNM,recurrence,and distant metastasis,but this topic has been less covered in previous *** comprehensively evaluating the above risk factors for LNM,useful evidence can be obtained for doctors to select appropriate treatments for SESCC patients.

关键词： Superficial esophageal squamous cell carcinoma Endoscopic resection Lymph node metastasis Risk factors Tumor budding Predictive model

Insights into the role of RNA m^(6)A modification in the metabolic process and related diseases

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Genes & Diseases 2024年第4期11卷 270-295页

作者： Haiming Hu Zhibin Li Xia Xie Qiushi Liao Yiyang Hu Chunli Gong Nannan Gao Huan Yang Yufeng Xiao Yang Chen department of gastroenterology Xinqiao HospitalArmy Medical UniversityChongqing 400037China

According to the latest consensus,many traditional diseases are considered meta-bolic diseases,such as cancer,type 2 diabetes,obesity,and cardiovascular ***,metabolic diseases are increasingly prevalent because of the ever-improving living standards and have become the leading threat to human *** therapy methods have been applied to treat these diseases,which improves the quality of life of many patients,but the overall effect is still ***,intensive research on the metabolic process and the pathogenesis of metabolic diseases is imperative.N6-methyladenosine(m^(6)A)is an important modification of eukaryotic *** is a critical regulator of gene expression that is involved in different cellular functions and physiological *** studies have indi-cated that m^(6)A modification regulates the development of many metabolic processes and metabolic *** this review,we summarized recent studies on the role of m^(6)A modifica-tion in different metabolic processes and metabolic ***,we highlighted the potential m^(6)A-targeted therapy for metabolic diseases,expecting to facilitate m^(6)A-targeted strategies in the treatment of metabolic diseases.

关键词： Cancer mm^(6)A-targeted therapy Metabolic disease Metabolism N6-methyladenosine

Optimized sequential therapy vs 10- and 14-d concomitant therapy for eradicating Helicobacter pylori: A randomized clinical trial

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World Journal of gastroenterology 2024年第6期30卷 556-564页

作者： Hassan Seddik Jihane Benass Sanaa Berrag Asmae Sair Reda Berraida Hanae Boutallaka department of gastroenterology II Mohammed V Military Teaching Hospital of RabatRabat 10100Morocco department of gastroenterology Mohammed V University in RabatRabat 10100Morocco department of gastroenterology I Mohammed V Military Teaching Hospital of RabatRabat 10100Morocco

BACKGROUND A cure for Helicobacter pylori(***)remains a problem of global *** prevalence of antimicrobial resistance is widely rising and becoming a challenging issue *** sequential therapy seems to be one of the most attractive strategies in terms of efficacy,tolerability and *** most common sequential therapy consists of a dual therapy[proton-pump inhibitors(PPIs)and amoxicillin]for the first period(5 to 7 d),followed by a triple therapy for the second period(PPI,clarithromycin and metronidazole).PPIs play a key role in maintaining a gastric pH at a level that allows an optimal efficacy of antibiotics,hence the idea of using new generation *** open-label prospective study randomized 328 patients with confirmed *** infection into three groups(1:1:1):The first group received quadruple therapy consisting of twice-daily(bid)omeprazole 20 mg,amoxicillin 1 g,clarith-romycin 500 mg and metronidazole 500 mg for 10 d(QT-10),the second group received a 14 d quadruple therapy following the same regimen(QT-14),and the third group received an optimized sequential therapy consisting of bid rabe-prazole 20 mg plus amoxicillin 1 g for 7 d,followed by bid rabeprazole 20 mg,clarithromycin 500 mg and metronidazole 500 mg for the next 7 d(OST-14).AEs were recorded throughout the study,and the *** eradication rate was determined 4 to 6 wk after the end of treatment,using the 13C urea breath *** In the intention-to-treat and per-protocol analysis,the eradication rate was higher in the OST-14 group compared to the QT-10 group:(93.5%,85.5%P=0.04)and(96.2%,89.5%P=0.03)***,there was no statist-ically significant difference in eradication rates between the OST-14 and QT-14 groups:(93.5%,91.8%P=0.34)and(96.2%,94.4%P=0.35),*** overall incidence of AEs was significantly lower in the OST-14 group(P=0.01).Furthermore,OST-14 was the most cost-effective among the three *** The optimized 14-

关键词： Helicobacter pylori Quadruple therapy Sequential Proton-pump inhibitor Optimization

Treat to target in Crohn’s disease:A practical guide for clinicians

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World Journal of gastroenterology 2024年第1期30卷 50-69页

作者： Ashish R Srinivasan department of gastroenterology Austin HealthVictoriaMelbourne 3083Australia department of gastroenterology Eastern HealthVictoriaMelbourne 3128Australia department of Medicine University of MelbourneVictoriaMelbourne 3052Australia

A treat-to-target(T2T)approach applies the principles of early intervention and tight disease control to optimise long-term outcomes in Crohn's *** Selecting Therapeutic Targets in Inflammatory Bowel Disease(STRIDE)-II guidelines specify short,intermediate,and long-term treatment goals,documenting specific treatment targets to be achieved at each of these *** appraisal of Crohn’s disease activity against pre-defined treatment targets at these timepoints remains central to determining whether current therapy should be continued or *** treatment targets in Crohn’s disease comprise combination clinical and patient-reported outcome remission,in conjunction with biomarker normalisation and endoscopic *** the STRIDE-II guidelines endorse the pursuit of endoscopic healing,clinicians must consider that this may not always be appropriate,acceptable,or achievable in all *** underscores the need to engage patients at the outset in an effort to personalise care and individualise treatment *** use of non-invasive biomarkers such as faecal calprotectin in conjunction with cross-sectional imaging techniques,particularly intestinal ultrasound,holds great promise;as do emerging treatment targets such as transmural *** randomised clinical trials,namely,CALM and STARDUST,have evaluated the efficacy of a T2T approach in achieving endoscopic endpoints in patients with Crohn’s *** from these studies reflect that patient subgroups and Crohn’s disease characteristics likely to benefit most from a T2T approach,remain to be ***,outside of clinical trials,data pertaining to the real-world effectiveness of a T2T approach remains scare,highlighting the need for pragmatic real-world *** the obvious promise of a T2T approach,a lack of guidance to support its integration into real-world clinical practice has the potential to limit its *** highlights the need to describe st

关键词： Treat to target Inflammatory bowel disease Crohn’s disease Treatment targets Endoscopic remission Transmural healing Time to response Intestinal ultrasound

Topic highlight on texture and color enhancement imaging in gastrointestinal diseases

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World Journal of gastroenterology 2024年第14期30卷 1934-1940页

作者： Osamu Toyoshima Toshihiro Nishizawa Keisuke Hata department of gastroenterology Toyoshima Endoscopy ClinicTokyo 157-0066Japan department of gastroenterology and Hepatology International University of Health and WelfareNarita HospitalNarita 286-8520Japan department of gastroenterology Nihonbashi Muromachi Mitsui Tower Midtown ClinicTokyo 103-0022Japan

Olympus Corporation developed texture and color enhancement imaging(TXI)as a novel image-enhancing endoscopic *** topic highlights a series of hot-topic articles that investigated the efficacy of TXI for gastrointestinal disease identification in the clinical setting.A randomized controlled trial demonstrated improvements in the colorectal adenoma detection rate(ADR)and the mean number of adenomas per procedure(MAP)of TXI compared with those of white-light imaging(WLI)observation(58.7%vs 42.7%,adjusted relative risk 1.35,95%CI:1.17-1.56;1.36 vs 0.89,adjusted incident risk ratio 1.48,95%CI:1.22-1.80,respectively).A cross-over study also showed that the colorectal MAP and ADR in TXI were higher than those in WLI(1.5 vs 1.0,adjusted odds ratio 1.4,95%CI:1.2-1.6;58.2%vs 46.8%,1.5,1.0-2.3,respectively).A randomized controlled trial demonstrated non-inferiority of TXI to narrow-band imaging in the colorectal mean number of adenomas and sessile serrated lesions per procedure(0.29 vs 0.30,difference for non-inferiority-0.01,95%CI:-0.10 to 0.08).A cohort study found that scoring for ulcerative colitis severity using TXI could predict relapse of ulcerative colitis.A cross-sectional study found that TXI improved the gastric cancer detection rate compared to WLI(0.71%vs 0.29%).A cross-sectional study revealed that the sensitivity and accuracy for active Helicobacter pylori gastritis in TXI were higher than those of WLI(69.2%vs 52.5%and 85.3%vs 78.7%,res-pectively).In conclusion,TXI can improve gastrointestinal lesion detection and qualitative ***,further studies on the efficacy of TXI in clinical practice are required.

关键词： Endoscopy Texture and color enhancement imaging White-light imaging Narrow-band imaging Colorectal neoplasm Gastric cancer Adenoma Ulcerative colitis Helicobacter infections Colonoscopy

Nonsteroidal anti-inflammatory drugs before endoscopic ultrasound guided tissue acquisition to reduce the incidence of post procedural pancreatitis

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World Journal of gastroenterology 2024年第8期30卷 811-816页

作者： Mike de Jong Foke van Delft Christine Roozen Erwin-Jan van Geenen Tanya Bisseling Peter Siersema Marco Bruno department of gastroenterology and Hepatology Radboud University Medical CenterNijmegen 6525 GANetherlands department of gastroenterology and Hepatology Erasmus University Medical CenterRotterdam 3015 GDNetherlands

Endoscopic ultrasound(EUS)with fine needle aspiration or fine needle biopsy is the gold standard for sampling tissue to diagnose pancreatic cancer and auto-immune pancreatitis or to analyze cyst *** most common reported adverse event of fine needle aspiration and/or fine needle biopsy is acute pancreatitis,which is likely induced by the same pathophysiological mechanisms as after en-doscopic retrograde cholangiopancreatography(ERCP).According to the current European Society of Gastrointestinal Endoscopy guideline,nonsteroidal anti-inflammatory drugs are administered prior to ERCP as a scientifically proven treatment to reduce post-ERCP pancreatitis incidence rate.A single suppository of diclofenac or indomethacin prior to EUS guided tissue acquisition(TA)is harm-less in healthy *** it is associated with low costs and,most important,may prevent a dreadsome complication,we strongly recommend the adminis-tration of 100 mg diclofenac rectally prior to *** will explain this recom-mendation in more detail in this review as well as the risk and pathophysiology of post-EUS TA pancreatitis.

关键词： Pancreatitis Endoscopic ultrasound Tissue acquisition Nonsteroidal antiinflammatory drugs Pancreatic cancer