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Advances and challenges in diagnosing and managing adult autoimmune enteropathy

World Journal of Gastroenterology 2025年第2期31卷 128-131页

作者： Grigorios Christodoulidis Sara E Agko Marina N Kouliou Konstantinos E Koumarelas Dimitris Zacharoulis department of General Surgery University Hospital of LarissaLarissa 41110Greece department of intensive care unit Asklepios Paulinen Clinic WiesbadenWiesbaden 65197Germany department of Emergency Medicine General Hospital of LarissaLarissa 41221Greece department of Surgery University Hospital of LarissaLarissa 41334Greece

Autoimmune enteropathy(AIE)is a rare immune mediated disorder primarily affecting children,characterized by chronic diarrhea,malabsorption,vomiting,weight loss and villous *** has also been observed in adults presenting diagnostic and treatment challenges due to its overlap with other gastrointestinal disorders such as celiac *** diagnostic criteria for AIE include small bowel villous atrophy,lack of response to dietary restrictions,presence of anti-enterocyte antibodies,and predisposition to autoimmunity without severe *** criteria emphasize characteristic histological findings and exclusion of other causes of villous *** is associated with various autoimmune disorders and can present with overlapping features with Celiac disease,including villous atrophy but without significant intraepithelial *** primarily involves immunosuppression using corticosteroids,calcineurin inhibitors,and anti-tumor necrosis factor therapy,alongside nutri-tional *** the challenges,understanding AIE’s diverse manifest-ations and improving diagnostic criteria are essential for effective management and improved patient *** research is needed to elucidate the pathogenesis,disease progression and long-term outcomes of AIE.

关键词： Autoimmune enteropathy Diagnosis Prognosis Adult autoimmune enter-opathy and challenges Autoimmune enteropathy and treatment Autoimmune enteropathy and diagnostic criteria Pathophysiology of autoimmune enteropathy

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Effect of dietary fibre on the gastrointestinal microbiota during critical illness:A scoping review

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World Journal of Critical care Medicine 2025年第1期14卷 49-59页

作者： Angajendra N Ghosh Calum J Walsh Matthew J Maiden Tim P Stinear Adam M Deane department of intensive care The Northern HospitalEpping 3076VictoriaAustralia department of Microbiology and Immunology The Peter Doherty Institute for Infection and ImmunityMelbourne 3052VictoriaAustralia department of intensive care The Royal Melbourne HospitalThe University of MelbourneParkville 3050VictoriaAustralia department of intensive care Medicine The Royal Melbourne HospitalParkville 3050VictoriaAustralia

The systemic effects of gastrointestinal(GI)microbiota in health and during chronic diseases is increasingly *** strategies to modulate the GI microbiota during chronic diseases have demonstrated *** changes in dietary intake can rapidly change the GI microbiota,the impact of dietary changes during acute critical illness on the microbiota remain *** fibre is metabolised by carbohydrate-active enzymes and,in health,can alter GI *** aim of this scoping review was to describe the effects of dietary fibre supplementation in health and disease states,specifically during critical *** controlled trials and prospective cohort studies that include adults(>18 years age)and reported changes to GI microbiota as one of the study outcomes using non-culture methods,were *** show dietary fibres have an impact on faecal microbiota in health and *** fibre,inulin,has a marked and specific effect on increasing the abundance of faecal *** chain fatty acids produced by Bifidobacteria have been shown to be beneficial in other patient *** few trials have evaluated the effect of dietary fibre on the GI microbiota during critical *** research is necessary to establish optimal fibre type,doses,duration of intervention in critical illness.

关键词： Gastrointestinal microbiota Dietary fibre Health Critical illness Short chain fatty acids

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Hypoxia-preconditioned bone marrow-derived mesenchymal stem cells protect neurons from cardiac arrest-induced pyroptosis

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Neural Regeneration Research 2025年第4期20卷 1103-1123页

作者： Xiahong Tang Nan Zheng Qingming Lin Yan You Zheng Gong Yangping Zhuang Jiali Wu Yu Wang Hanlin Huang Jun Ke Feng Chen Shengli Clinical Medical College of Fujian Medical University Fujian Medical UniversityFuzhouFujian ProvinceChina department of Emergency Fujian Provincial HospitalFuzhouFujian ProvinceChina Fujian Provincial Key Laboratory of Emergency Medicine FuzhouFujian ProvinceChina The Second department of intensive care unit Fujian Provincial Hospital South BranchFuzhouFujian ProvinceChina

Cardiac arrest can lead to severe neurological impairment as a result of inflammation,mitochondrial dysfunction,and post-cardiopulmonary resuscitation neurological *** preconditioning has been shown to improve migration and survival of bone marrow–derived mesenchymal stem cells and reduce pyroptosis after cardiac arrest,but the specific mechanisms by which hypoxia-preconditioned bone marrow–derived mesenchymal stem cells protect against brain injury after cardiac arrest are *** this end,we established an in vitro co-culture model of bone marrow–derived mesenchymal stem cells and oxygen–glucose deprived primary neurons and found that hypoxic preconditioning enhanced the protective effect of bone marrow stromal stem cells against neuronal pyroptosis,possibly through inhibition of the MAPK and nuclear factor κB ***,we transplanted hypoxia-preconditioned bone marrow–derived mesenchymal stem cells into the lateral ventricle after the return of spontaneous circulation in an 8-minute cardiac arrest rat model induced by *** results showed that hypoxia-preconditioned bone marrow–derived mesenchymal stem cells significantly reduced cardiac arrest–induced neuronal pyroptosis,oxidative stress,and mitochondrial damage,whereas knockdown of the liver isoform of phosphofructokinase in bone marrow–derived mesenchymal stem cells inhibited these *** conclude,hypoxia-preconditioned bone marrow–derived mesenchymal stem cells offer a promising therapeutic approach for neuronal injury following cardiac arrest,and their beneficial effects are potentially associated with increased expression of the liver isoform of phosphofructokinase following hypoxic preconditioning.

关键词： bone marrow–derived mesenchymal stem cells cardiac arrest cardiac resuscitation hypoxic preconditioning liver isoform of phosphofructokinase mitochondria neuroinflammation oxidative stress pyroptosis reactive oxygen species

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Transient extreme insulin resistance in a critically ill patient:A case report

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World Journal of Clinical Cases 2025年第8期13卷 35-40页

作者： Xiu-Yu Wei Hsiu-Nien Shen department of Internal Medicine Taichung Veterans General HospitalTaichung 407TaiwanChina department of intensive care Medicine Chi Mei Medical CenterTainan 710TaiwanChina

BACKGROUND Acute hyperglycemia due to insulin resistance is common in critically ill patients,typically managed with insulin ***,the occurrence of transient extreme insulin resistance(EIR)requiring exceptional high-dose insulin is *** SUMMARY We present the case of a 68-year-old woman with pneumonia who suffered an out-of-hospital cardiac arrest,subsequently developing transient EIR following a new episode of ***,insulin resistance rapidly reversed when the insulin infusion rate peaked at 960 units/hour(a total of 18224 units on that day),and it was promptly titrated down to zero upon achieving the target glucose *** Exceptional high-dose insulin infusion may be required in critically ill patients with stress-related EIR,which is typically *** should be aware of the phenomenon and cautious to avoid hypoglycemia and fluid overload during the steep titration of high-dose insulin infusion.

关键词： Hyperglycemia Insulin Insulin resistance Sepsis Critical illness Case report

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Urinary tract infections in neonates with jaundice in their first two weeks of life

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World Journal of Pediatrics 2014年第2期10卷 164-167页

作者： Mehmet Mutlu Yasemin Cayır Yakup Aslan department of Neonatology Erzurum Regional Training and Research HospitalNeonatal Intensive Care UnitErzurumTurkey department of Family Physician Erzurum Regional Training and Research HospitalNeonatal Intensive Care UnitErzurumTurkey department of Neonatology Karadeniz Technical UniversityNeonatal Intensive Care UnitTrabzonTurkey

Background:Hyperbilirubinemia is a frequently seen condition in *** study was undertaken to determine the role of urinary tract infections(UTIs)in the etiology of indirect hyperbilirubinemia in neonates with jaundice in their fi rst two weeks of ***:The study was conducted *** subjects were neonates aged 4-14 days with hyperbilirubinemia which could not be detected by routine tests and was suffi ciently severe to necessitate ***:The study was performed in 104 neonates,of whom 18%(n=19)had *** most frequently identified micro-organism was Escherichia coli(43%).Phototherapy duration and rebound bilirubin level were higher in neonates with UTI(P<0.05).Conclusion:UTI should be investigated in neonates with hyperbilirubinemia of unknown etiology in the fi rst two weeks of life.

关键词： hyperbilirubinemia neonate urinary tract infection

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Forging an easier path through graduation:Improving the patient transition from paediatric to adult critical care

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World Journal of Critical care Medicine 2025年第1期14卷 82-90页

作者： Stephen Warrillow Ben Gelbart Jess Stevens Gordon Baikie Mark E Howard department of intensive care Austin HealthHeidelberg 3084VictoriaAustralia department of Critical care The University of MelbourneParkville 3010VictoriaAustralia department of intensive care Royal Children’s HospitalParkville 3010VictoriaAustralia Living with Disability Research Centre La Trobe UniversityBundoora 3086VictoriaAustralia department of Neurodevelopment&Disability Royal Children’s HospitalParkville 3010VictoriaAustralia department of Paediatrics The University of MelbourneParkville 3010VictoriaAustralia department of Respiratory and Sleep Medicine Austin HealthHeidelberg 3084VictoriaAustralia department of Medicine Austin HealthThe University of MelbourneHeidelberg 3084VictoriaAustralia

Adolescence and the journey to adulthood involves exciting opportunities as well as psychosocial stress for young people growing *** normal experiences are potentially magnified for teenagers living with chronic illness or disability and their *** in care have improved survival for children with a variety of serious chronic medical conditions such that many who may once have died in childhood now survive well into adulthood with ongoing *** those with highly complex needs,care is often provided at major paediatric hospitals with expertise,specially trained personnel,and resources to support young people and their families for the first decades of *** the end of adolescence,however,it is generally appropriate and necessary for young adults and their caregivers to transition to the care of clinicians trained in the care of adults at general *** there are some well-managed models to support this journey of transition,these are often specific to certain conditions and usually do not involve intensive *** patients may encounter considerable challenges during this *** may include the loss of established therapeutic relationships,a perception of austerity and reduced amenity in facilities oriented to caring for adult patients,and care by clinicians with less experience with more common paediatric *** addition,there is a risk of potential conflict between clinicians and families regarding goals of care in the event of a critical illness when it occurs in a young adult with major disability and long-term health *** challenges present genuine opportunities to better understand the transition from paediatric to adult-based care and to improve processes that assist clinicians who support patients and families as they shift between healthcare settings.

关键词： Paediatric intensive care Disability Adult intensive care Transition Critical care

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Weaning preterm infants from continuous positive airway pressure: evidence for best practice

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World Journal of Pediatrics 2015年第3期11卷 212-218页

作者： Hesham Abdel-Hady Basma Shouman Nehad Nasef neonatal intensive care unit Mansoura University Children's HospitalMansouraEgypt

Background:Nasal continuous positive airway pressure(NCPAP)is frequently used in preterm ***,there is no consensus on when and how to wean them from *** sources:Based on recent publications,we have reviewed the criteria of readiness-to-wean and factors affecting weaning success.A special focus is placed on the methods of weaning from NCPAP in preterm ***:Practical points of when and how to wean from NCPAP in preterm infants are *** infants are ready to be weaned from NCPAP when they are stable on a low NCPAP pressure with no(or minimal)oxygen *** used to wean from NCPAP include:sudden weaning of NCPAP,gradual decrease of NCPAP pressure,graded-time-off NCPAP(cycling),weaning to high or low flow nasal cannula,and a combination of these *** best strategy for weaning is yet to be ***-off NCPAP increases the duration of NCPAP and length of hospital stay without beneficial effect on success of *** decrease of NCPAP pressure is more physiological and better tolerated than cycling-off ***:Further studies are needed to reach a consensus regarding the optimal timing and the best method for weaning from NCPAP in preterm infants.

关键词： continuous positive airway pressure preterm infant weaning

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Prognostic value of circulating tumor cells in esophageal cancer

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World Journal of Gastroenterology 2017年第7期23卷 1310-1318页

作者： Hai-Tao Xu Jing Miao Jian-Wei Liu Lian-Guo Zhang Qing-Guang Zhang department of Thoracic Surgery Affiliated Hospital of Binzhou Medical University department of neonatal intensive care unit Binzhou People’s Hospital

AIM To perform a meta-analysis of the related studies to assess whether circulating tumor cells(CTCs) can be used as a prognostic marker of esophageal *** Pub Med, Embase, Cochrane Library and references in relevant studies were searched to assess the prognostic relevance of CTCs in patients with esophageal cancer. The primary outcome assessed was overall survival(OS). The meta-analysis was performed using the random effects model, with hazard ratio(HR), risk ratio(RR) and 95% confidence intervals(95%CIs) as effect *** Nine eligible studies were included involving a total of 911 esophageal cancer patients. Overall analyses revealed that CTCs-positivity predicted disease progression(HR = 2.77, 95%CI: 1.75-4.40, P < 0.0001) and reduced OS(HR = 2.67, 95%CI: 1.99-3.58, P < 0.00001). Further subgroup analyses demonstrated that CTCs-positive patients also had poor OS in different subsets. Moreover, CTCs-positivity was also significantly associated with TNM stage(RR = 1.48, 95%CI: 1.07-2.06, P = 0.02) and T stage(RR = 1.44, 95%CI: 1.13-1.84, P = 0.003) in esophageal *** Detection of CTCs at baseline indicates poor prognosis in patients with esophageal cancer. However, this finding relies on data from observational studies and is potentially subject to selection bias. Prospective trials are warranted.

关键词： Circulating tumor cells Esophageal cancer Prognosis Meta-analysis

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Changes in intestinal microflora in rats with acute respiratory distress syndrome

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World Journal of Gastroenterology 2014年第19期20卷 5849-5858页

作者： Yan Li Xiang-Yong Liu Ming-Ming Ma Zhi-Jiang Qi Xiao-Qiang Zhang Zhi Li Guo-Hong Cao Jun Li Wei-Wei Zhu Xiao-Zhi Wang department of Respiratory Medicine and intensive care unit Affiliated Hospital of Binzhou Medical University department of intensive care unit Zhangqiu People’s Hospital department of Cell Biology Binzhou Medical University department of intensive care unit Dezhou People’s Hospital

AIM: To implement high-throughput 16S rDNA sequencing to study microbial diversity in the fecal matter of rats with acute lung injury/acute respiratory distress syndrome (ALI/ARDS).

关键词： Lipopolysaccharide Acute lung injury Acute respiratory distress syndrome Intestinal microflora High-throughput sequencing

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Early neonatal complications in pregnant women with gestational diabetes mellitus and the effects of glycemic control on neonatal infection

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World Journal of Diabetes 2023年第9期14卷 1393-1402页

作者： Bei-Bei Wang Mei Xue department of neonatal intensive care unit Taizhou People’s Hospital of Jiangsu ProvinceTaizhou 225300Jiangsu ProvinceChina

BACKGROUND Gestational diabetes mellitus(GDM)has become increasingly prevalent *** control in pregnant women with GDM has a critical role in neonatal *** To analyze the early neonatal complications in GDM,and examine the effect of blood glucose control level on neonatal *** The clinical data of 236 pregnant women with GDM and 240 healthy pregnant women and newborns during from March 2020 to December 2021 the same period were retrospectively analyzed,and the early complications in newborns in the two groups were *** patients were divided into the conforming glycemic control group(CGC group)and the non-conforming glycemic control group(NCGC group)based on whether glycemic control in the pregnant women with GDM conformed to *** data,immune function,infectionrelated markers,and infection rates in neonates were compared between the two *** The incidence of neonatal complications in the 236 neonates in the GDM group was significantly higher than that in the control group(P0.05).Additionally,the NCGC group had significantly decreased peripheral blood CD3^(+),CD4^(+),CD8^(+)T cell ratios,CD4/CD8 ratios and immunoglobulin G in neonates compared with the CGC group(Pneonatal infection rate was also significantly increased in the NCGC group(Pneonatal complications increased in pregnant women with *** glycemic control decreased neonatal immune function,and increased the incidence of neonatal infections.

关键词： Gestational diabetes mellitus Early neonatal complications Glycemic control neonatal infection

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