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Fructose as a key player in the development of fatty liver disease

World Journal of gastroenterology 2013年第8期19卷 1166-1172页

作者： Metin Basaranoglu Gokcen Basaranoglu Tevfik Sabuncu Hakan Sentürk department of gastroenterology and Hepatology Bezmialem Vakif UniversityIstanbul 34400Turkey department of Anaesthesiology Bezmialem Vakif UniversityIstanbul 34400Turkey department of endocrinology Harran UniversitySanliurfa 68000Turkey

We aimed to investigate whether increased consumption of fructose is linked to the increased prevalence of fatty *** prevalence of nonalcoholic steatohepatitis(NASH) is 3% and 20% in nonobese and obese subjects,*** is a low-grade chronic inflam-m-atory condition and obesity-related cytokines such as interleukin-6,adiponectin,leptin,and tumor necrosis factor-α may play important roles in the developm-ent of nonalcoholic fatty liver disease(NAFLD).Additionally,the prevalence of NASH associated with both cirrhosis and hepatocellular carcinom-a was reported to be high am-ong patients with type 2 diabetes with or without *** research group previously showed that consumption of fructose is associated with adverse alterations of plasma lipid profiles and metabolic changes in m-ice,the Am-erican Lifestyle-Induced Obesity Syndrom-e m-odel,which included consum-ption of a high-fructose corn syrup in amounts relevant to that consum-ed by som-e *** observation reinforces the concerns about the role of fructose in the obesity *** availability of fructose(e.g.,high-fructose corn syrup) increases not only abnorm-al glucose flux but also fructose m-etabolism-in the ***,the anatomic position of the liver places it in a strategic buffering position for absorbed carbohydrates and am-ino *** was previously accepted as a beneficial dietary com-ponent because it does not stim-ulate insulin ***,since insulin signaling plays an important role in central m-echanism-s of NAFLD,this property of fructose m-ay be *** has a selective hepatic m-etabolism,and provokes a hepatic stress response involving activation of c-Jun N-term-inal kinases and subsequent reduced hepatic insulin *** high fat diet alone produces obesity,insulin resistance,and som-e degree of fatty liver with m-inim-al inflam-m-ation and no fibrosis,the fast food diet which includes fructose and fats produces a

关键词： Nonalcoholic Fatty liver Diabetes Insulin resistance Cytokines Obesity Fructose

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Endoscopic management of unresectable malignant gastroduodenal obstruction with a nitinol uncovered metal stent: a prospective Japanese multicenter study

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World Journal of gastroenterology 2016年第14期22卷 3837-3844页

作者： Reina Sasaki Yuji Sakai Toshio Tsuyuguchi Takao Nishikawa Tatsuya Fujimoto Shigeru Mikami Harutoshi Sugiyama Osamu Yokosuka department of gastroenterology and Nephrology Graduate School of Medicine Chiba University department of gastroenterology Kimitsu Chuo Hospital department of gastroenterology Kikkoman General Hospital

AIM: To determine the safety and efficacy of endoscopic duodenal stent placement in patients with malignant gastric outlet ***: This prospective, observational, multicenter study included 39 consecutive patients with malignant gastric outlet obstruction. All patients underwent endoscopic placement of a nitinol, uncovered, selfexpandable metal stent. The primary outcome was clinical success at 2 wk after stent placement that was defined as improvement in the Gastric Outlet Obstruction Scoring System score relative to the ***: Technical success was achieved in all duodenal stent procedures. Procedure-related complications occurred in 4 patients(10.3%) in the form of mild pneumonitis. No other morbidities or mortalitieswere observed. The clinical success rate was 92.3%. The mean survival period after stent placement was 103 d. The mean period of stent patency was 149 d and the patency remained acceptable for the survival period. Stent dysfunction occurred in 3 patients(7.7%) on account of tumor ***: Endoscopic management using duodenal stents for patients with incurable malignant gastric outlet obstruction is safe and improved patients' quality of life.

关键词： Duodenal stenosis Gastrointestinal stent Gastric stenosis Malignant tumors Metallic stent

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Beneficial effect of probiotics supplements in reflux esophagitis treated with esomeprazole: A randomized controlled trial

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World Journal of gastroenterology 2019年第17期25卷 2110-2121页

作者： Qing-Hua Sun Hong-Yan Wang Shi-Dong Sun Xin Zhang Han Zhang department of gastroenterology Peking University Third Hospital department of gastroenterology PKUCare Luzhong Hospital

BACKGROUND Reflux esophagitis(RE) is a common digestive disorder, and its frequent recurrences cause significant physical pain and are financially burdensome to patients. However, studies on the natural history of treated RE are few. Although proton pump inhibitors(PPIs) as the first-line treatment provide notable symptomatic relief, disordered gut microbiota has been observed among PPI users. Probiotics are commonly administered to patients to regulate the disordered intestinal *** To evaluate the therapeutic effects in RE patients treated with a combination of esomeprazole and probiotics [Bacillus subtilis(B. subtilis) and Enterococcus faecium(E. faecium)].METHODS One hundred and thirty-four RE patients were randomized into two groups of 67 subjects each. The probiotics group was administered with esomeprazole 20 mg b.i.d. and live combined B. subtilis and E. faecium enteric-coated capsules 500 mg t.i.d. for eight weeks; the placebo group was administered with esomeprazole 20 mg b.i.d. and placebo for eight weeks. Subsequently, 12-wk follow-up was carried out on patients who achieved both endoscopic and clinical cure. Endoscopy,reflux diagnostic questionnaire(RDQ), gastrointestinal symptom rating scale(GSRS), and lactulose hydrogen breath test were performed to evaluate the therapeutic effects. A difference of P 0.05). However, the GSRS diarrhea syndrome score was decreased significantly in the probiotics group(P = 0.002),and the small intestinal bacterial overgrowth negative rate in the probiotics group was significantly higher than that in the placebo group(P = 0.002). Of 114 endoscopically and clinically cured patients, 96 completed the follow-up. The logrank test showed that the time to relapse was shorter

关键词： Proton pump inhibitors Probiotics Small intestinal bacterial overgrowth Reflux esophagitis Relapse

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Effect of IFN-γ, IL-4 on proliferation and synthesis of hyaluronic acid and collagen in cultured human retroorbital fibroblasts in vitro

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Chinese Medical Journal 2000年第10期113卷 43-46页

作者：王丽滕卫平单忠艳 department of endocrinology The Second Hospital of China Medical University department of endocrinology The First Hospital of China Medical University

Obejctive To investigate the cellular immune mechanism of thyroid associated ophthalmopathy (TAO) and provide a basis for treating TAO with cytokine or anti cytokine agents, we determined whether interferon (IFN) γ and interleukin (IL) 4, representative cytokines of Th1 and Th2 cells, may have some effect on the development and progression of TAO Method Retroorbital fibroblasts (RF) proliferation and the synthesis of hyaluronic acid (HA) and type Ⅳ collagen were measured with liquid scintillation and radioimmunoassay Results IFN γ stimulated RF proliferation and HA synthesis and had a significant inhibitory effect on type Ⅳ collagen synthesis IL 4 stimulated proliferation and type Ⅳ collagen synthesis in RF and had inhibitory effect on HA synthesis When IFN γ (100?U/ml) and IL 4 (1?μg/L) were incubated together with RF, they antagonized their respective stimulatory or inhibitory effect on the proliferation and synthesis of HA and type Ⅳ collagen Thyrotropin (TSH) stimulated RF proliferation and type Ⅳ collagen synthesis in a dose dependent manner, while only at high dose (100?U/L and 200?U/L), stimulated RF to synthesize HA Conclusions IFN γ, a representative cytokine of Th1 cells, is responsible for the inflammatory process of TAO; whereas IL 4, a representative cytokine of Th2 cells, has some effect on the repair process IL 4 could antagonize the inflammatory effect of IFN γ on RF TSH may have aggravating effect on the pathogenesis of TAO

关键词： exophthalmos fibroblasts interferon-gamma recombinant interleukin-4 thyrotropin

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Birthplace is not a determinant of colorectal adenomas

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World Journal of gastroenterology 2014年第26期20卷 8606-8611页

作者： Fiona Tran Jenn Hian Koo department of gastroenterology and Hepatology Liverpool Hospital department of gastroenterology The University of New South Wales

AIM: To examine the impact of the patient’s birthplace on the prevalence of colonic polyps and histopathological subtypes.

关键词： Ethnicity Polyps Adenomas Advanced adenomas Colorectal cancer

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Hypothyroidism with elevated pancreatic amylase and lipase without clinical symptoms: A case report

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World Journal of Clinical Cases 2020年第15期8卷 3299-3304页

作者： Yong-Wei Xu Ran Li Shu-Chang Xu department of gastroenterology Tongji HospitalTongji University School of MedicineShanghai 200065China department of endocrinology and Metabolism Tongji HospitalTongji University School of MedicineShanghai 200065China

BACKGROUND Hypothyroidism is an endocrine disorder that has worldwide prevalence and can affect multiple organ *** report a case of hypothyroidism with elevated pancreatic amylase and trypsin without acute *** such case has been previously *** SUMMARY A 29-year-old woman did not pay much attention to a fever 4 d *** this time,she experienced anorexia and only drank a small amount of water every *** did not present with abdominal distension,postprandial nausea,vomiting,cough or *** physical and laboratory examinations,the patient was diagnosed with *** the course of the disease,hypothyroidism was generally accompanied by constantly increased pancreatic amylase and *** admission,the possible etiology of the patient was excluded and the concentrations of pancreatic lipase and amylase in serum were>2000U/L(reference range 23-300 U/L)and 410 U/L(reference range 30-110 U/L),*** we highly suspected that it may be acute ***,she never developed any complications associated with acute pancreatitis despite high levels of serum pancreatic amylase and trypsin,and she reported no symptoms of abdominal *** amylase and lipase decreased gradually after active thyroxine supplementation,and the patient was discharged from the hospital after active *** This case suggests that clinicians should pay attention to hypothyroidism with elevated pancreatic amylase and trypsin,even if no complications of acute pancreatitis are reported.

关键词： Hypothyroidism Amylase Trypsin Acute pancreatitis Clinical symptoms Case report

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Is laparoscopy an advantage in the diagnosis of cirrhosis in chronic hepatitis C virus infection?

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World Journal of gastroenterology 2003年第4期9卷 745-750页

作者： Perdita Wietzke-Braun Felix Braun Peter Schott Giuliano Ramadori department of Internal Medicine Division of Gastroenterology and EndocrinologyUniversity of GoettingenGermany

AIM:To evaluate the potential of laparoscopy in the diagnosis of cirrhosis and outcome of interferon treatment in HCV-infected patients. METHODS:In this retrospective study,diagnostic laparoscopy with laparoscopic liver biopsy was performed in 72 consecutive patients with chronic HCV *** presence or absence of drrhosis was analyzed macroscopically by laparoscopy and microscopically by liver biopsy *** and laboratory data and outcome of interferon-alfa treatment were compared between cirrhotic and noncirrhotic patients. RESULTS:Laparoscopically,cirrhosis was seen in 29.2 % (21/72)and non-cirrhosis in 70.8 %(51/72)of patients. Cirrhotic patients were significantly older with a significant longer duration of HCV infection than noncirrhotic patients. Laboratory parameters(AST,y-GT,y-globulin fraction)were measured significantly higher as well as significantly lower (prothrombin index,platelet count)in cirrhotic patients than in non-cirrhotic ***,cirrhosis was confirmed in 11.1%(8/72)and non cirrhosis in 88.9 %(64/72).Patients with macroscopically confirmed cirrhosis(n=21)showed histologically cirrhosis in 38.2 %(8/21)and histologically non- cirrhosis in 61.9 %(13/21).In contrast,patients with macroscopically non-cirrhosis(n=51)showed histologically non cirrhosis in all cases(51/51).Thirty-nine of 72 patients were treated with interferon-alfa,resulting in 35.9 %(14/39) patients with sustained response and 64.1%(25/39)with non ***-responders showed significantly more macroscopically cirrhosis than sustained *** contrast,there were no significant histological differences between non-responders and sustained responders. CONCLUSION:Diagnostic laparoscopy is more accurate than liver biopsy in recognizing cirrhosis in patients with chronic HCV *** biopsy is the best way to assess inflammatory grade and fibrotic *** invasive marker for staging,prognosis and management,and treatment outcome of chro

关键词： Adult Biopsy Comparative Study Female Genotype Hepacivirus purification Hepatitis C, Chronic Humans Interferon-alpha Laparoscopy Liver Cirrhosis Male Middle Aged RNA, Viral Reproducibility of Results Retrospective Studies Treatment Outcome

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Suramin Inhibits the In Vitro Expression of Encephalitis B Virus Proteins NS3 and E

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2003年第4期23卷 375-379页

作者：徐可树任宏宇朱剑文杨昀廖芳 department of gastroenterology department of Microbiology

In this study, the mechanism by which Suramin inhibits the replication of epidemic encephalitis B virus was explored to provide a theoretical basis for its further application in clinical practice. After viral infection of HepG2 and IMR 32 cells, different concentrations of Suramin were added to the culture media, and then the cultural supernatants and infected cells were collected 48 h later. For the evaluation of the curative effect, cytopathic effect (CPE), virus titers, the expression of viral protein and viral RNA were determined by Western blot, RT PCR and in vitro RNA synthesis, respectively. At the concentration of 50 μg/ml of Suramin, HepG2 and IMR 32 infected with epidemic encephalitis B virus decreased by 51.8 % and 0.03 % respectively, as compared with controls. It was suggested that expression of encephalitis B virus proteins NS3 and E was notably reduced by Suramin. This is especially true of E protein. At RNA level, however, no difference in RNA virus was found between Suramin treated virus and non treated cells. Our results suggest that Suramin can inhibit viral replication by blocking the production of viral proteins.

关键词： Suramin antiviral activity encephalitis B virus

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Efficacy of combination therapy with natriuretic and aquaretic drugs in cirrhotic ascites patients: A randomized study

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World Journal of gastroenterology 2017年第45期23卷 8062-8072页

作者： Haruki Uojima Hisashi Hidaka Tsuyoshi Nakayama Ji Hyun Sung Chikamasa Ichita Shinnosuke Tokoro Sakue Masuda Akiko Sasaki Kazuya Koizumi Hideto Egashira Makoto Kako department of gastroenterology Shonan Kamakura General Hospital department of gastroenterology Internal MedicineKitasato University School of Medicine department of gastroenterology Shonan Atsugi Hospital

AIM To assess the effects of a combination therapy with natriuretic and aquaretic drugs in cirrhotic ascites *** A two-center,randomized,open-label,prospective study was conducted. Japanese patients who met the criteria were randomized to trial group and the combination diuretic group(received 7.5 mg of tolvaptan) or the conventional diuretic group(received 40 mg of furosemide) for 7 d in addition to the natriuretic drug which was used prior to enrolment in this study. The primary endpoint was the change in body weight from the baseline. Vital signs,fluid intake,and laboratory and urinary data were assessed to determine the pharmacological effects after administration of aquaretic and natriuretic *** A total of 56 patients were randomized to receive either tolvaptan(n = 28) or furosemide(n = 28). In the combination and conventional diuretic groups,the average decrease in body weight from the baseline was 3.21 ± 3.17 kg(P < 0.0001) and 1.75 ± 2.36 kg(P = 0.0006),respectively,when measured on the final dosing day. Following 1 wk of treatment,a significantly greater reduction in body weight was observed in the combination diuretic group compared to that in the conventional diuretic group(P = 0.0412).CONCLUSION Compared to a conventional diuretic therapy with only a natriuretic drug,a combination diuretic therapy with natriuretic and aquaretic drugs is more effective for patients with cirrhotic ascites.

关键词： Tolvaptan Liver cirrhosis Diuretic effect Ascites Hepatic edema

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Endotoxin receptor CD14 gene variants and histological features in chronic HCV infection

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World Journal of gastroenterology 2009年第31期15卷 3884-3890页

作者： Eva Askar Giuliano Ramadori Sabine Mihm department of gastroenterology and endocrinology University Medical CenterGeorg-August-University

AIM:To analyze the correlation between CD14 rs2569190/C-159T single nucleotide polymorphism (SNP) and disease progression in chronic hepatitis ***: Liver biopsy specimens from a total of 137 and 349 patients with chronic hepatitis C were separately evaluated with respect to necroinflammatory activity (grading) and architectural changes (staging). In one group, further histological lesions characteristic for hepatitis C, hepatitis C virus subtypes, and biochemical parameters of liver disease were also investigated. Samples of genomic DNA were genotyped for the respective SNP by 5'-nuclease assays using fluorescent dye-labeled allele-specif ic ***: Genotype distribution did not deviate from the Hardy-Weinberg equilibrium. In the first group, patients homozygous for the variant allele T were found to be younger than C allele carriers (39.6±12.5 vs 45.7±11.5, P=0.008). Among the histological lesions studied, portal lymphoid aggregates were more frequently observed among TT homozygotes than among C carriers (21/37 vs 32/100, P=0.008). The presence of portal lymphoid aggregates was closely correlated with hepatic inflammation (P=0.003) and with bile duct damage (P<0.001). The degree of fibrosis, in contrast, was not found to be related to the CD14 gene C-159T ***: The data suggest a possible relationship between CD14 C-159T polymorphism and the formation of portal lymphoid aggregates, but not liver fibrosis progression in chronic hepatitis C.

关键词： CD14 Endotoxins Hepatitis C virus Inflammation Lipopolysaccharides Liver fibrosis Portal system Single nucleotide polymorphism

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