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Serum urate is associated with an increased risk of inflammatory bowel disease: A bidirectional Mendelian randomization study

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World Journal of Clinical Cases 2024年第5期12卷 891-902页

作者： Song Zhang Xue Fang Le Kang Xiang-Yu Sui Miao Liu Yu-Jia Luo Shuo Fu Zhao-Shen Li Sheng-BingZhao Yu Bai department of gastroenterology Changhai HospitalShanghai 200433China department of gastroenterology Changhai HospitalSecond Military Medical University/Naval Medical UniversityShanghai 200433China Digestive endoscopy Center Changhai HospitalNaval/Second Military Medical UniversityShanghai 200433China National Clinical Research Center for Digestive Diseases Shanghai 200433China

BACKGROUND Previous studies have indicated bidirectional associations between urate levels and inflammatory bowel disease(IBD),including ulcerative colitis(UC)and Crohn’s disease(CD).However,it remains unclear whether the observations are causal because of confounding *** To investigate the causal associations between urate levels and IBD using bidirec-tional Mendelian randomization(MR).METHODS Independent genetic variants for urate levels and IBD were selected as instru-mental variables from published genome-wide association studies(GWASs).Summary statistics for instrument-outcome associations were retrieved from three separate databases for IBD(the UK Biobank,the FinnGen database and a large GWAS meta-analysis)and one for urate levels(a large GWAS meta-analysis).MR analyses included the inverse-variance-weighted method,weighted-median estimator,MR-Egger and sensitivity analyses(MR-PRESSO).A meta-analysis was also conducted to merge the data from separate outcome databases using a fixed-effects *** Genetically higher serum urate levels were strongly associated with an increased risk of UC[odds ratio(OR):1.95,95%confidence interval(CI):1.86-2.05]after outlier correction,and the ORs(95%CIs)for IBD and CD were 0.94(95%CI:0.86-1.03)and 0.91(95%CI:0.80-1.04),*** studies have confirmed the positive association between urate levels and ***,genetically predicted IBD was inversely related to urate levels(OR:0.97,95%CI:0.94-0.99).However,no association was observed between genetically influenced UC or CD and urate *** Urate levels might be risk factors for UC,whereas genetically predicted IBD was inversely associated with urate *** findings provide essential new insight for treating and preventing IBD.

关键词： Inflammatory bowel disease Urate levels Antioxidant Mendelian randomization Single nucleotide polymorphism

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Novel classification of gastric polyps:The good,the bad and the ugly

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World Journal of gastroenterology 2024年第31期30卷 3640-3653页

作者： Deborah Costa Daryl Ramai Alberto Tringali department of Digestive endoscopy and gastroenterology AULSS2Conegliano HospitalConegliano 31015Italy department of gastroenterology Division of Hepatology and EndoscopyBrigham and Women's HospitalBostonMA 02115United States

Gastric polyps(GPs)are increasingly *** upper endoscopy,they should be examined with white light and occasionally chromoendoscopy,and their morphology classified according to the Paris *** GPs have a typical endoscopic appearance and can be associated with diseases like Helicobacter pylori *** examination is necessary for an accurate *** most polyps are non-neoplastic and do not require treatment,some carry a risk of malignancy or are already ***,understanding the diagnosis,classification,and management of GPs is crucial for patient *** new classification categorizes GPs into"good","bad",and"ugly"based on their likelihood of becoming *** aim to provide descriptions of the endoscopic appearance,pathology,treatment,and follow-up for different GPs,as well as clinical management flowcharts.

关键词： Gastric polyps Fundic gland polyps Hyperplastic polyps Adenomas Neuroendocrine tumors Early gastric cancer

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Endoscopic polidocanol foam sclerobanding for the treatment of grade Ⅱ-Ⅲ internal hemorrhoids:A prospective,multi-center,randomized study

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World Journal of gastroenterology 2024年第38期30卷 3326-3335页

作者： Chun-Ying Qu Fei-Yu Zhang Yi Zhang Ming-Ming Li Zheng-Hong Li Mei-Hong Cai Lei-Ming Xu Feng Shen Wen Wang Wu-Lian Lin Feng-Yu Gao Hao Zhang Guang-Yu Chen department of gastroenterology&endoscopy Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai 200092China department of gastroenterology The 900th Hospital of the People’s Liberation Army Joint Service Support ForceFuzhou 350025Fujian ProvinceChina department of endoscopy Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao UniversityJinan 250014Shandong ProvinceChina department of endoscopy Baoshan People’s Hospital of Yunnan ProvinceBaoshan 678000Yunnan ProvinceChina department of gastroenterology Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai 200092China

BACKGROUND Endoscopic rubber band ligation(ERBL)is a nonsurgical technique for the treatment of symptomatic internal hemorrhoids but is limited by recurrence and post-procedural *** To evaluate satisfaction,long-term recurrence,and post-procedural pain in managing internal hemorrhoids using a combination of polidocanol foam sclerotherapy and *** This was a prospective,multicenter,randomized study.A total of 195 consecutive patients diagnosed with grade II-III internal hemorrhoids were enrolled from four tertiary hospitals and randomly divided into a cap-assisted endoscopic polidocanol foam sclerobanding(EFSB)or an ERBL *** patients were followed-up for 12 ***-based severity and post-procedural pain were assessed using a hemorrhoid severity score(HSS)and a visual analog scale(VAS).Continuous variables were reported as medians and interquartile *** One hundred and ninety-five patients were enrolled,with 98 in the EFSB *** was lower in the EFSB group than in the ERBL group at 8 weeks[4.0(3.0-5.0)vs 5.0(4.0-6.0),P=0.003]and 12-month[2.0(1.0-3.0)vs 3.0(2.0-3.0),P<0.001]of *** prolapse recurrence rate was lower in the EFSB group at 12 months(11.2%vs 21.6%,P=0.038).Multiple linear regression analysis demonstrated that EFSB treatment[B=-0.915,95%confidence interval(CI):−1.301 to−0.530,P=0.001]and rubber band number(B=0.843,95%CI:0.595-1.092,P<0.001)were negatively and independently associated with the VAS score 24 hours *** median VAS was lower in the EFSB group than in the ERBL[2.0(1.0-3.0)vs 3.0(2.0-4.0),P<0.001].CONCLUSION Cap-assisted EFSB provided long-term satisfaction and effective relief from the recurrence of prolapse and pain 24 hours post-procedure.

关键词： Internal hemorrhoids Endoscopic therapy Polidocanol foam Sclerotherapy Rubber band ligation Sclerobanding

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Endoscopic band ligation or endoscopic tissue adhesive injection in the treatment of gastric varices:Which is better?

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World Journal of gastroenterology 2024年第21期30卷 2827-2828页

作者： Li-Zhi Yi Sheng-Bing Zhao department of gastroenterology The People’s Hospital of LeshanLeshan 614000Sichuan ProvinceChina department of gastroenterology Changhai HospitalThe Second Military Medical University/Naval Medical UniversityShanghai 200433China

The combination of endoscopic ultrasound with endoscopic treatment of type 1 gastric variceal hemorrhage may improve the robustness and generalizability of the findings in future ***,the esophageal varices should also... 详细信息

关键词： Gastric varices Esophageal varices Endoscopic band ligation Endoscopic tissue adhesive injection Endoscopic ultrasound

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An antibiotic-free platform for eliminating persistent Helicobacter pylori infection without disrupting gut microbiota

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Acta Pharmaceutica Sinica B 2024年第7期14卷 3184-3204页

作者： Yongkang Lai Tinglin Zhang Xiaojing Yin Chunping Zhu Yiqi Du Zhaoshen Li Jie Gao department of gastroenterology Shanghai Changhai HospitalNaval Medical UniversityShanghai 200433China changhai Clinical Research Unit Shanghai Changhai HospitalNaval Medical UniversityShanghai 200433China department of gastroenterology Ganzhou People’s Hospital Affiliated to Nanchang UniversityGanzhou 341000China National Key Laboratory of Immunity and Inflammation Naval Medical UniversityShanghai 200433China Shanghai Key Laboratory of Nautical Medicine and Translation of Drugs and Medical Devices Shanghai 200433China

Helicobacter pylori(***)infection remains the leading cause of gastric adenocarcinoma,and its eradication primarily relies on the prolonged and intensive use of two ***,antibiotic resistance has become a compelling health issue,leading to *** eradication treatment failure ***,the powerlessness of antibiotics against biofilms,as well as intracellular *** and the long-term damage of antibiotics to the intestinal microbiota,have also created an urgent demand for antibiotic-free ***,we describe an antibiotic-free,multifunctional copperorganic framework(HKUST-1)platform encased in a lipid layer comprising phosphatidic acid(PA),rhamnolipid(RHL),and cholesterol(CHOL),enveloped in chitosan(CS),and loaded in an ascorbyl palmitate(AP)hydrogel:AP@CS@Lip@*** platform targets inflammatory sites where *** aggregates through electrostatic ***,hydrolysis by matrix metalloproteinases(MMPs)releases CS-encased nanoparticles,disrupting bacterial urease activity and membrane ***,RHL disperses biofilms,while PA promotes lysosomal acidification and activates host autophagy,enabling clearance of intracellular ***,AP@CS@Lip@HKUST-1 alleviates inflammation and enhances mucosal repair through delayed Cu^(2+) release while preserving the intestinal ***,this platform presents an advanced therapeutic strategy for eradicating persistent *** infection without inducing drug resistance.

关键词： Helicobacter pylori infection Antibiotic-free Biofilms Autophagy Gastric mucosal repair Drug resistance Intestinal microbiota Anti-inflammation

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Bowel function and inflammation: Is motility the other side of the coin?

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World Journal of gastroenterology 2024年第14期30卷 1963-1967页

作者： Alba Panarese Division of gastroenterology and Digestive endoscopy Department of Medical SciencesCentral Hospital-Azienda OspedalieraTaranto 74123Italy

Digestion and intestinal absorption allow the body to sustain itself and are the emblematic functions of the *** the flip side,functions also arise from its role as an interface with the ***,the gut houses microorganisms,collectively known as the gut microbiota,which interact with the host,and is the site of complex immune *** role in human pathology is complex and scientific evidence is progressively elucidating the functions of the gut,especially regarding the pathogenesis of chronic intestinal diseases and inflammatory conditions affecting various organs and *** editorial aims to highlight and relate the factors involved in the pathogenesis of intestinal and systemic inflammation.

关键词： Motility Inflammation Pathogenesis Vitamin D Microbiota Gut Chronic intestinal pseudo-obstruction

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Association between physical activity and risk of gastroesophageal reflux disease:A systematic review and meta-analysis

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Journal of Sport and Health Science 2024年第5期13卷 687-698页

作者： Chuting Yu Tinglu Wang Ye Gao Yunfei Jiao Huishan Jiang Yan Bian Wei Wang Han Lin Lei Xin Luowei Wang department of gastroenterology Changhai HospitalNaval Medical UniversityShanghai 200433China National Clinical Research Center for Digestive Diseases(Shanghai) Shanghai 200433China

Background:Lifestyle plays an important role in preventing and managing gastroesophageal reflux disease(GERD).In response to the conflicting results in previous studies,we performed a systematic review and meta-analysis to investigate this ***:Relevant studies published until January 2023 were retrieved from 6 databases,and the prevalence of symptomatic gastroesophageal reflux(GER)or GERD was determined from the original studies.A random effects model was employed to meta-analyze the association by computing the pooled relative risk(RR)with 95%confidence intervals(95%CIs).Furthermore,subgroup and dose-response analyses were performed to explore subgroup differences and the association between cumulative physical activity(PA)time and ***:This meta-analysis included 33 studies comprising 242,850 participants.A significant negative association was observed between PA and the prevalence of symptomatic GER(RR=0.74,95%CI:0.66-0.83;p<0.01)or GERD(RR=0.80,95%CI:0.76-0.84;p<0.01),suggesting that engaging in PA might confer a protective benefit against *** analyses consistently indicated the presence of this association across nearly all subgroups,particularly among the older individuals(RR_(<40 years):RR_(≥40 years)=0.85:0.69,p<0.01)and smokers(RR_(smoker):RR_(non-smoker)=0.67:0.82,p=0.03).Furthermore,a dose-response analysis revealed that individuals who engaged in 150 min of PA per week had a 72.09%lower risk of developing ***:Maintaining high levels of PA decreased the risk of GERD,particularly among older adults and *** the recommended PA level of 150 min per week may significantly decrease the prevalence of GERD.

关键词： Physical activity Gastroesophageal reflux disease Prevalence Systematic review

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Device-assisted enteroscopy: Are we ready to dismiss the spiral?

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World Journal of gastroenterology 2024年第26期30卷 3185-3192页

作者： Alessandro Mussetto Elettra Merola Cesare Casadei Daniele Salvi Fabiola Fornaroli Silvia Cocca Margherita Trebbi Armando Gabbrielli Cristiano Spada Andrea Michielan department of gastroenterology S Maria della Croci HospRavenna 48121Italy department of gastroenterology Unit G.B.Grassi Hospital(ASL Roma 3)Roma 00122Italy Section of Digestive endoscopy and gastroenterology Fondazione PoliambulanzaBrescia 25124Italy gastroenterology and endoscopy Unit Department of Medicine and SurgeryUniversity of ParmaParma 43125Italy gastroenterology and endoscopy Unit Azienda Ospedaliero Universitaria Policlinico di ModenaModena 41121Italy Center for Medical Sciences(CISMed) University of TrentoTrento 38122Italy gastroenterology and Digestive endoscopy Unit Santa Chiara HospitalAzienda Provinciale per i Servizi SanitariTrento 38122Italy Digestive endoscopy Unit Fondazione Policlinico Universitario A.Gemelli IRCSSRoma 00168Italy

Motorized spiral enteroscopy(MSE)is the latest advance in device-assisted *** events related to MSE were discussed in a recent large systematic review and meta-analysis and were directly compared with those of balloon enteroscopy in a case-matched study and a randomized controlled *** the real-life application of MSE,an unexpected safety issue emerged regarding esophageal injury and the technique has been withdrawn from the global market,despite encouraging results in terms of diagnostic and therapeutic *** conducted an Italian multicenter real-life prospective study,which was prematurely terminated after the withdrawal of MSE from the *** primary goals were the evaluation of MSE performance(both diagnostic and therapeutic)and its safety in routine endoscopic practice,particularly in the early phase of introduction in the endoscopic unit.A subanalysis,which involved patients who underwent MSE after unsuccessful balloon enteroscopy,demonstrated,for the first time,the promising performance of MSE as a rescue *** its remarkable performance in clinical practice and its potential role as a backup technique following a previously failed enteroscopy,it may be more appropriate to refine and enhance MSE in the future rather than completely abandoning it.

关键词： Motorized spiral enteroscopy Rescue enteroscopy Diagnostic yield Adverse events AGREE classification

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Two big orifices in the second duodenal portion:A case of an atypical double papilla

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Hepatobiliary & Pancreatic Diseases International 2024年第1期23卷 83-85页

作者： Salvatore Francesco Vadalàdi Prampero Nikola Panic Marco Massidda Chiara Rocchi Pierluigi Maria Rinaldi Ana Malenkovic Milutin Bulajic gastroenterology and GI endoscopy department Mater Olbia HospitalOlbia 07026Italy Digestive endoscopy Unit University Clinic"Dr Dragisa Misovic-Dedinje"Belgrade 11000Serbia Radiology department Mater Olbia HospitalOlbia 07026Italy

With the advent of endoscopic retrograde cholangiopancreatography(ERCP)in the early 1970s,anatomic anomalies of the Vaterian system were described endoscopically[1].Although the occurrence is rare,the common bile duct(CBD)and the pancreatic duct may fail to coalesce during embryologic *** leads to double major papilla because both ducts open into the duodenum separately[1].In this way the cranial duct communicates with the CBD,while the caudal orifice communicates with the pancreatic duct[2].

关键词： orifice Vater atypical

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Use of endoscopic ultrasound-guided gallbladder drainage as a rescue approach in cases of unsuccessful biliary drainage

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World Journal of gastroenterology 2024年第1期30卷 70-78页

作者： Alessandro Fugazza Kareem Khalaf Katarzyna M Pawlak Marco Spadaccini Matteo Colombo Marta Andreozzi Marco Giacchetto Silvia Carrara Chiara Ferrari Cecilia Binda Benedetto Mangiavillano Andrea Anderloni Alessandro Repici Division of gastroenterology and Digestive endoscopy Humanitas Research Hospital-IRCCSRozzano 20089MilanoItaly Division of gastroenterology St.Michael’s HospitalUniversity of TorontoToronto M5B 1W8ONCanada department of Anesthesia Humanitas Research Hospital-IRCCSRozzano 20089MilanoItaly gastroenterology and Digestive endoscopy Unit Forlì-Cesena HospitalsRomagna 47121Italy Gastrointestinal endoscopy Unit Humanitas Mater DominiCastellanza 21100Italy gastroenterology and Digestive endoscopy Unit Fondazione IRCCS Policlinico San MatteoPavia 27100Italy

This narrative review provides an overview of the utilization of endoscopic ultrasound-guided gallbladder drainage(EUS-GBD)as a salvage approach in cases of unsuccessful conventional ***-GBD is a minimally invasive and effective technique for drainage in patients with acute cholecystitis with high risk of *** procedure has demonstrated impressive technical and clinical success rates with low rates of adverse events,making it a safe and effective option for appropriate ***,EUS-GBD can also serve as a rescue option for patients who have failed endoscopic retrograde cholangiopancreatography or EUS biliary drainage for relief of jaundice in malignant biliary ***,patient selection is critical for the success of EUS-GBD,and proper patient selection and risk assessment are important to ensure the safety and efficacy of the *** the field continues to evolve and mature,ongoing research will further refine our understanding of the benefits and limitations of EUS-GBD,ultimately leading to improved outcomes for patients.

关键词： Endoscopic ultrasound-guided gallbladder drainage Gallbladder drainage Acute cholecystitis Malignant obstruction Interventional endoscopic ultrasound Lumen-apposing metal stents

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