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Successful emergency surgical intervention in acute non-STsegment elevation myocardial infarction with rupture:A case report

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World Journal of Clinical Cases 2025年第4期13卷 41-47页

作者： Xing-Po Li Zi-Shan Wang Hong-Xia Yu Shan-Shan Wang department of cardiovascular medicine Huantai County Hospital of Traditional Chinese MedicineZibo 256400Shandong ProvinceChina department of cardiovascular medicine Zibo Hospital of Integrated Traditional Chinese and Western MedicineZibo 255500Shandong ProvinceChina

BACKGROUND The incidence of acute myocardial infarction(AMI)is rising,with cardiac rupture accounting for approximately 2%of deaths in patients with acute ST-segment elevation myocardial infarction(STEMI).Ventricular free wall rupture(FWR)occurs in approximately 2%of AMI patients and is notably rare in patients with *** of cardiac rupture include left ventricular FWR,ventricular septal rupture,and papillary muscle *** FWR usually leads to acute cardiac tamponade or electromechanical dissociation,where standard resuscitation efforts may not be *** septal rupture and papillary muscle rupture often result in refractory heart failure,with mortality rates over 50%,even with surgical or percutaneous repair *** SUMMARY We present a rare case of an acute non-STEMI patient who suffered sudden FWR causing cardiac tamponade and loss of consciousness immediate before undergoing coronary *** resuscitation and emergency open-heart repair along with coronary artery bypass grafting resulted in successful patient *** This case emphasizes the risks of AMI complications,shares a successful treatment scenario,and discusses measures to prevent such complications.

关键词： Acute non-ST segment elevation myocardial infarction Cardiac rupture Acute myocardial infarction Free wall rupture Case report

Kangfuxin solution alleviates esophageal stenosis after endoscopic submucosal dissection:A natural ingredient strategy

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World Journal of Gastroenterology 2025年第1期31卷 110-125页

作者： Xin Zhou Dan Ma Yi-Xiang He Jing Jin Hong-Lian Wang Yun-Feng Wang Fan Yang Jian-Qin Liu Jie Chen Zhi Li department of Spleen and Stomach Diseases the Affiliated Traditional Chinese Medicine HospitalSouthwest Medical UniversityLuzhou 646000Sichuan ProvinceChina The Key Laboratory of Integrated Traditional Chinese and Western medicine for Prevention and Treatment of digestive System Diseases of Luzhou City The Affiliated Traditional Medicine HospitalSouthwest Medical UniversityLuzhou 646000Sichuan ProvinceChina department of Gastroenterology Changhai HospitalNaval Medical UniversityShanghai 20082China Research Center of Integrated Chinese and Western medicine The Affiliated Traditional Chinese Medicine HospitalSouthwest Medical UniversityLuzhou 646000Sichuan ProvinceChina School of Integrated Traditional Chinese and Western Clinical medicine North Sichuan Medical CollegeNanchong637100Sichuan ProvinceChina

BACKGROUND Esophageal stricture ranks among the most significant complications following endoscopic submucosal dissection(ESD).Excessive fibrotic repair is a typical pathological feature leading to stenosis after *** To examine the effectiveness and underlying mechanism of Kangfuxin solution(KFX)in mitigating excessive fibrotic repair of the esophagus *** Pigs received KFX at 0.74 mL/kg/d for 21 days after esophageal full circumferential *** examinations occurred on days 7 and 21 *** vitro,recombinant transforming growth factor(TGF)-β1(5 ng/mL)induced a fibrotic microenvironment in primary esophageal fibroblasts(pEsF).After 24 hours of KFX treatment(at 1.5%,1%,and 0.5%),expression ofα-smooth muscle actin-2(ACTA2),fibronectin(FN),and type collagen I was *** signaling was analyzed,including TGF-β1,Smad2/3,and phosphor-smad2/3(p-Smad2/3).RESULTS Compared to the Control group,the groups treated with KFX and prednisolone exhibited reduced esophageal stenosis,lower weight loss rates,and improved food tolerance 21 d after *** treatment,Masson staining revealed thinner and less dense collagen fibers in the submucosal ***,the expression of fibrotic effector molecules was notably ***,KFX downregulated the transduction levels of fibrotic functional molecules such as TGF-β1,Smad2/3,and p-Smad2/*** vitro,pEsF exposed to TGF-β1-induced fibrotic microenvironment displayed increased fibrotic activity,which was reversed by KFX treatment,leading to reduced activation of ACTA2,FN,and collagen *** 1.5%KFX treatment group showed decreased expression of p-Smad 2/3 in TGF-β1-activated *** KFX showed promise as a therapeutic option for post-full circumferential esophageal ESD strictures,potentially by suppressing fibroblast fibrotic activity through modulation of the TGF-β1/Smads signaling pathway.

关键词： Kangfuxin solution Natural component Endoscopic submucosal dissection Esophagus stricture Fibrosis

Effect of cholesterol metabolism on hepatolithiasis

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World Journal of Gastroenterology 2025年第1期31卷 157-162页

作者： Lin Zheng Zi-Yu Ye Jun-Ji Ma department of Gastroenterology The Second Hospital of Hebei Medical UniversityHebei Key Laboratory of GastroenterologyHebei Institute of GastroenterologyHebei Clinical Research Center for Digestive DiseasesNo.215 Heping West RoadShijiazhuang 050000Hebei ProvinceChina

Surgical intervention is currently the primary treatment for hepatolithiasis;how-ever,some patients still experience residual stones and high recurrence rates after *** metabolism seems to play an important role in hepatoli-thiasis pathogenesis.A high cholesterol diet is one of the significant reasons for the increasing incidence of ***,regular diet and appropriate medical intervention are crucial measures to prevent hepatolithiasis and reduce recurrence rate after *** dietary cholesterol and drugs that increase cholesterol stone solubility are key therapeutic approaches in treating *** article discusses the cholesterol metabolic pathways related to the pathogenesis of hepatolithiasis,as well as food intake and targeted therapeutic drugs.

关键词： Hepatolithiasis Cholesterol metabolism High-fat diet 3-hydroxy-3-methylglutaryl-coenzyme A reductase Interlobular bile duct

Gut microbiota-astrocyte axis: new insights into age-related cognitive decline

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Neural Regeneration Research 2025年第4期20卷 990-1008页

作者： Lan Zhang Jingge Wei Xilei Liu Dai Li Xiaoqi Pang Fanglian Chen Hailong Cao Ping Lei Haihe Laboratory of Cell Ecosystem Department of GeriatricsTianjin Medical University General HospitalTianjinChina Tianjin Geriatrics Institute Tianjin Medical University General HospitalTianjinChina department of Gastroenterology and Hepatology Tianjin Medical University General HospitalNational Key Clinical SpecialtyTianjin Institute of Digestive DiseasesTianjin Key Laboratory of Digestive DiseasesTianjinChina department of Urology Tianjin Medical University General HospitalTianjinChina Tianjin Neurological Institution Tianjin Medical University General HospitalTianjinChina

With the rapidly aging human population,age-related cognitive decline and dementia are becoming increasingly prevalent *** is considered the main risk factor for cognitive decline and acts through alterations in the composition of the gut microbiota,microbial metabolites,and the functions of *** microbiota–gut–brain axis has been the focus of multiple studies and is closely associated with cognitive *** article provides a comprehensive review of the specific changes that occur in the composition of the gut microbiota and microbial metabolites in older individuals and discusses how the aging of astrocytes and reactive astrocytosis are closely related to age-related cognitive decline and neurodegenerative *** article also summarizes the gut microbiota components that affect astrocyte function,mainly through the vagus nerve,immune responses,circadian rhythms,and microbial ***,this article summarizes the mechanism by which the gut microbiota–astrocyte axis plays a role in Alzheimer’s and Parkinson’s *** findings have revealed the critical role of the microbiota–astrocyte axis in age-related cognitive decline,aiding in a deeper understanding of potential gut microbiome-based adjuvant therapy strategies for this condition.

关键词： age aging Alzheimer’s disease astrocytes cognitive decline dementia gut microbiota gut–brain axis microbial metabolites neuroinflammation Parkinson’s disease

Intestinal Behcet's disease with esophageal ulcers and colonic longitudinal ulcers

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World Journal of Gastroenterology 2006年第16期12卷 2622-2624页

作者： Soichiro Fujiwara Ichiro Shimizu Momoko Ishikawa Kohzo Uehara Hirofumi Yamamoto Michiyo Okazaki Takahiro Horie Arata luchi Susumu Ito department of Internal medicine Miyoshi Prefectural HospitalTokushimaJapan department of digestive and cardiovascular medicine Tokushima University Graduate School of MedicineTokushimaJapan

Intestinal Behcet＇s disease in a 38-year-old woman was diagnosed because of the history of recurrent oral aphthous ulcers, erythema nodosum-like eruptions, genital ulcer, and endoscopic findings of esophageal and Ueocolonic punched-out ulcers with colonic longitudinal ulcers. Esophageal lesions and colonic longitudinal ulcers are rarely seen in intestinal Behcet＇s disease. The ulcers of esophagus and ileocolon healed with 3 wk of treatment with prednisolone and mesalazine without any adverse effect. Mesalazine may decrease the total dose of prednisolone required to treat the disease.

关键词： Colonic longitudinal ulcer Esophageal ulcer Intestinal Behcet's disease Mmesalazine

Endoscopic techniques for the diagnosis of pancreatic cystic lesions

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World Journal of Gastroenterology 2025年第1期31卷 1-7页

作者： Sahib Singh Saurabh Chandan Rakesh Vinayek Jahnvi Dhar Jayanta Samanta Gabriele Capurso Ivo Boskoski Cristiano Spada Jorge D Machicado Stefano Francesco Crinò Antonio Facciorusso department of Internal medicine Sinai HospitalBaltimoreMD 21215United States Division of Gastroenterology and Hepatology Creighton University School of MedicineOmahaNE 68131United States department of Gastroenterology Sinai Hospital of BaltimoreBaltimoreMD 21215United States department of Gastroenterology Postgraduate Institute of Medical Education and ResearchChandigarh 160012India Division of Pancreato-Biliary Endoscopy and Endosonography Pancreas Translational and Clinical Research CenterIRCCS San Raffaele Scientific InstituteVita-Salute San Raffaele UniversityMilano 20132Italy digestive Endoscopy Unit Fondazione Policlinico Universitario Agostino Gemelli IRCSSUniversitàCattolica del Sacro Cuore di RomaCenter for Endoscopic Research Therapeutics and TrainingRoma 00168Italy department of Gastroenterology and Endoscopy Catholic UniversityRoma 00168Italy department of Gastroenterology University of Michigan HealthAnn ArborMI 48107United States department of Endoscopy University of VeronaVerona 37121VenetoItaly Gastroenterology Unit Department of Medical and Surgical SciencesUniversity of FoggiaFoggia 71122Italy

Pancreatic cysts are mostly incidental findings on computed tomography or magnetic resonance imaging scans,with few patients presenting with abdominal pain or other *** accurate diagnosis of cysts is important as management depends on the type(neoplastic or non-neoplastic).Cross-sectional imaging is fast being replaced with endoscopic ultrasound(EUS)and various techniques based on that such as EUS-guided fine needle aspiration,EUS-guided needle confocal laser endomicroscopy,EUS-through-the-needle biopsy,and contrast-enhanced *** studies have reported varying diagnostic and adverse event rates with these *** addition,American,European,and Kyoto guidelines for the diagnosis and management of pancreatic cysts have provided different *** this editorial,we elaborate on the clinical guidelines,recent studies,and comparison of different endoscopic methods for the diagnosis of pancreatic cysts.

关键词： Endoscopic ultrasound Fine needle aspiration Needle confocal laser endomicroscopy Through-the-needle biopsy Contrast-enhanced endoscopic ultrasound

Relationship between longitudinal changes in lipid composition and ischemic stroke among hypertensive patients

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World Journal of Clinical Cases 2025年第4期13卷 18-27页

作者： Cheng-Cheng Wei Yu-Qing Huang Cheng-Hong Yu department of Cardiology Tongxiang First People's HospitalTongxiang 314500Zhejiang ProvinceChina department of Cardiology Guangdong Cardiovascular InstituteGuangzhou 510080Guangdong ProvinceChina

BACKGROUND Dyslipidemia was strongly linked to stroke,however the relationship between dyslipidemia and its components and ischemic stroke remained *** To investigate the link between longitudinal changes in lipid profiles and dyslipidemia and ischemic stroke in a hypertensive *** Between 2013 and 2014,6094 hypertension individuals were included in this,and ischemic stroke cases were documented to the end of *** changes of lipid were stratified into four groups:(1)Normal was transformed into normal group;(2)Abnormal was transformed into normal group;(3)Normal was transformed into abnormal group;and(4)Abnormal was transformed into abnormal *** examine the link between longitudinal changes in dyslipidemia along with its components and the risk of ischemic stroke,we utilized multivariate Cox proportional hazards models with hazard ratio(HR)and 95%*** The average age of the participants was 62.32 years±13.00 years,with 329 women making up 54.0%of the *** the course of a mean follow-up of 4.8 years,143 ischemic strokes *** normal was transformed into normal group was used as a reference,after full adjustments,the HR for dyslipidemia and ischemic stroke among abnormal was transformed into normal group,normal was transformed into abnormal group and abnormal was transformed into abnormal Wei CC et *** changed and ischemic stroke WJCC https://*** 2 February 6,2025 Volume 13 Issue 4 group were 1.089(95%CI:0.598-1.982;P=0.779),2.369(95%CI:1.424-3.941;P<0.001)and 1.448(95%CI:1.002-2.298;P=0.047)(P for trend was 0.233),*** In individuals with hypertension,longitudinal shifts from normal to abnormal in dyslipidemia-particularly in total and low-density lipoprotein cholesterol-were significantly associated with the risk of ischemic stroke.

关键词： Longitudinal change Hypertension Dyslipidemia Lipid profile Ischemic stroke

Enhancing postoperative pain control by surgically-initiated rectus sheath block in abdominal aortic aneurysm open repair: A case report

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World Journal of Clinical Cases 2025年第6期13卷 41-47页

作者： Kuan-Hua Chen Ming-Yuan Kang Yi-Ting Chang Sheng-Yang Huang Yung-Szu Wu Center for cardiovascular Disease Taichung Veterans General HospitalTaichung 407219TaiwanChina department of Anesthesiology Taichung Veterans General HospitalTaichung 407219TaiwanChina Division of Pediatric Surgery Department of SurgeryTaichung Veterans General HospitalTaichung 407219TaiwanChina School of medicine National Yang Ming Chiao Tung UniversityTaipei 112304TaiwanChina department of Post-Baccalaureate medicine National Chung Hsing UniversityTaichung 402202TaiwanChina

BACKGROUND Abdominal aortic aneurysm(AAA)repair often involves significant postoperative pain,traditionally managed with systemic opioids,which can cause undesirable side *** case report explores the novel use of a surgically-initiated rectus sheath block with a catheter-over-needle assembly for pain management in AAA *** SUMMARY A 67-year-old female with hypertension and previous aortic dissection underwent elective open repair of an infrarenal AAA,which had grown from 3.4 cm to 4.3 cm over 14 months.A rectus sheath block was initiated surgically for postoperative pain *** patient reported low pain scores and did not require systemic intravenous opioids,enabling early ambulation and discharge on postoperative day seven without *** preventing complications of systemic opi-oids,the method indicating a promising direction for postoperative pain management in major vascular *** Surgically-initiated rectus sheath block as a valuable tool for managing postoperative pain in AAA repair.

关键词： Abdominal aortic aneurysm Postoperative pain management Rectus sheath block Surgical anesthesia Opioid-sparing techniques Case report

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World Journal of Gastroenterology 2008年第40期14卷 6115-6121页

作者： Didier Merlin department of medicine Division of Digestive DiseasesEmory University School of Medicine

Recently, inflammatory bowel disease （IBD） has been the subject of considerable research, with increasing attention being paid to the loss of intestinal epithelial cell barrier function as a mechanism of pathogenesis. Ste20-related proline/alanine-rich kinase （SPAK） is involved in regulating barrier function. SPAK is known to interact with inflammation-related kinases （such as p38, JNK, NKCC1, PKCS, WNK and MLCK）, and with transcription factor AP-1, resulting in diverse biological phenomena, including cell differentiation, cell transformation and proliferation, cytoskeleton rearrangement, and regulation of chloride transport. This review examines the involvement of Ste20-1ike kinases and downstream mitogen-activated protein kinases （MAPKs） pathways in the pathogenesis and control of intestinal inflammation. The primary focus will be on the molecular features of intestinal inflammation, with an emphasis on the interaction between SPAK and other molecules, and the effect of these interactions on homeostatic maintenance, cell volume regulation and increased cell permeability in intestinal inflammation.

关键词： Inflammatory bowel diseases WNK NKCCl Barrier function Ste20-related proline/alanine-rich kinase