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Management of chylous ascites after liver cirrhosis: A case report

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World Journal of Hepatology 2025年第1期17卷 150-157页

作者： Zong-Qiang Chen Shu-Jun Zeng Chun Xu department of gastroenterology Guangdong Medical UniversityZhanjiang 524000Guangdong ProvinceChina department of gastroenterology Huizhou Central People’s HospitalHuizhou 516000Guangdong ProvinceChina

BACKGROUND Chylous ascites is an uncommon condition,occurring in less than 1%of ascites *** results from traumatic or obstructive disruption of the lymphatic system,causing the leakage of thoracic or intestinal lymph into the abdominal *** leads to the accumulation of a milky,triglyceride-rich *** adults,malignancy and cirrhosis are the primary causes of chylous ***,chylous ascites accounts for only 0.5%to 1%of all cirrhosis-related ascites *** present,there is a limited understanding of this condition,and effective timely management in clinical practice remains *** SUMMARY This case report presents a patient with hepatic cirrhosis complicated by chylous ascites,who had experienced multiple hospitalizations due to abdominal *** admission,comprehensive examinations and assessments were *** treatment strategy focused on nutritional optimization through a low-sodium,low-fat,and high-protein diet supplemented with medium-chain triglycerides,therapeutic paracentesis,and *** a multidiscip-linary discussion and thorough evaluation of the patient’s condition,surgical indications were *** informing the patient about the benefits and risks,and obtaining consent,a transjugular intrahepatic portosystemic shunt procedure was performed,successfully alleviating the abdominal swelling *** article details the clinical characteristics and treatment approach for this uncommon case,summarizing current management methods for hepatic cirrhosis complicated by chylous *** aim is to provide valuable insights for clinicians encountering similar *** Optimizing nutrition and addressing the underlying cause are essential in the treatment of chylous *** conservative approaches prove ineffective,alternative interventions such as transjugular intrahepatic portosystemic shunt may be considered.

关键词： Chylous ascites Liver cirrhosis Management Transjugular intrahepatic portosystemic shunt Case report

Diet fortification for mild and moderate picky eating in typically developed children:Opinion review of Middle East consensus

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World Journal of Clinical Pediatrics 2025年第1期14卷 139-148页

作者： Mohammed Al-Beltagi Elie Choueiry Najat Alahmadi Zeinab Demerdash Wafaa Helmi Ayesh Khoula Al-Said Fatima Al-Haddad Sanaa Y Shaaban Eslam Tawfik department of Pediatric Faculty of MedicineTanta UniversityTanta 31511Egypt department of Pediatric University Medical CenterKing Abdulla Medical CityArabian Gulf UniversityManama 26671ManamaBahrain Paediatric Intensive and Critical Care Unit Hospital Hôtel Dieu de FranceBeirut 166830BeyrouthLebanon department of Pediatric gastroenterology Hepatology and NutritionMadina Maternity and Children HospitalKing Salman Medical CityAlmadina Almonawarh 41412Almadina AlmonawarhSaudi Arabia department of gastroenterology Hepatology and NutritionAl Amiri HospitalKuwait City 999044Kuwait department of nutrition Altadawi Speciality HospitalDubai 1853DubayyUnited Arab Emirates department of Paediatric gastroenterology Royal HospitalMuscat 1331MuscatOman department of Dietetic Salmaniya Medical ComplexGovernment HospitalsAl Salmaniya 12ManamaBahrain department of Pediatrics Faculty of MedicineAin Shams UniversityCairo 11591Egypt department of Paediatric Faculty of MedicineSuez UniversitySuez 41522Egypt department of Paediatric Sheikh Khalifa Medical CityAbu Dhabi 00000Abu DhabiUnited Arab Emirates

BACKGROUND Picky eating is a commonly observed behavior among children globally,negatively impacting their physical and mental *** common characteristics distinguish peaky eaters,including food selectivity,food neophobia,and food avoidance,there is no clear definition to assess this *** to the unavailability of data regarding picky eating,it wasn’t easy to estimate its *** To develop a regional protocol to help healthcare professionals identify and manage mild and moderate picky eating *** A virtual roundtable discussion was held in April 2021 to gather the opinions of seven pediatricians and two pediatric dietitians from eight Middle Eastern countries who had great experience in the management of picky *** discussion covered different topics,including clearly defining mild and moderate picky eating,identifying the role of diet fortification in these cases,and the possibility of developing a systematic approach to diet *** The panel identified picky eating as consuming an inadequate amount and variety of foods by rejecting familiar and unfamiliar *** of the time,moderate picky eating cases had micronutrient deficiencies with over-or undernutrition;the mild cases only showed inadequate food consumption and/or poor diet *** attention to the organic red flags like growth faltering and development delay and behavioral red flags,including food fixation and anticipatory gagging,will help healthcare professionals evaluate the picky eaters and the caregivers to care for their *** dietary supplementation and commercial food fortification play an important role in picky eating,they were no benefit in the Middle *** The panel agreed that food fortification through a food-first approach and oral nutritional supplements would be the best for Middle Eastern *** recommendations would facilitate identifying and managing picky-eating children in the Middle East.

关键词： Picky eating Diet fortification Children Protocol Roundtable discussion Middle East

Effects of Bifidobacterium lactis BLa80 on fecal and mucosal flora and stem cell factor/c-kit signaling pathway in simulated microgravity rats

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World Journal of gastroenterology 2025年第1期31卷 93-109页

作者： Ping Zhang Ying Zhu Pu Chen Tong Zhou Zhe-Yi Han Jun Xiao Jian-Feng Ma Wen Ma Peng Zang Ying Chen Graduate School Hebei North UniversityZhangjiakou 075000Hebei ProvinceChina Key Laboratory of Aerospace nutrition and Food Engineering China Astronaut Research and Training CenterBeijing 100094China department of gastroenterology The Air Force Medical CenterBeijing 100142China department of Blood Transfusion Air Force Medical CenterBeijing 100142China

BACKGROUND Simulated microgravity environment can lead to gastrointestinal motility *** pathogenesis of gastrointestinal motility disorders is closely related to the stem cell factor(SCF)/c-kit signaling pathway associated with intestinal flora and Cajal stromal ***,intestinal flora can also affect the regulation of SCF/c-kit signaling pathway,thus affecting the expression of Cajal stromal *** cells are the pacemakers of gastrointestinal *** To investigate the effects of Bifidobacterium lactis(***)BLa80 on the intestinal flora of rats in simulated microgravity and on the gastrointestinal motility-related SCF/c-kit *** The internationally recognized tail suspension animal model was used to simulate the microgravity environment,and 30 rats were randomly divided into control group,tail suspension group and drug administration tail suspension group with 10 rats in each group for a total of 28 *** tail group was given *** BLa80 by intragastric administration,and the other two groups were given water intragastric administration,the concentration of intragastric administration was 0.1 g/mL,and each rat was 1 mL/***&eosin staining was used to observe the histopathological changes in each segment of the intestine of each group,and the expression levels of SCF,c-kit,extracellular signal-regulated kinase(ERK)and p-ERK in the gastric antrum of each group were detected by Western blotting and *** fecal flora and mucosal flora of rats in each group were detected by 16S *** Simulated microgravity resulted in severe exfoliation of villi of duodenum,jejunum and ileum in rats,marked damage,increased space between villi,loose arrangement,shortened columnar epithelium of colon,less folds,narrower mucosal thickness,reduced goblet cell number and crypts,and significant improvement after probiotic *** microgravity reduced the expressions of SCF and c-kit,and increased the express

关键词： Simulated microgravity Rat Intestinal flora Gastrointestinal motility Stem cell factor/c-kit signaling pathway

What is the role of nonalcoholic fatty liver disease in pulmonary carcinoma development?

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World Journal of gastroenterology 2025年第5期31卷 7-12页

作者： Qin Pan Qing-Yang Xu Lang-Hua Zhang Ya-Fang He Shanghai Institute of Pediatric Research Shanghai Key Laboratory of Pediatric Gastroenterology and NutritionXinhua HospitalShanghai Jiao Tong UniversitySchool of MedicineShanghai 200092China department of gastroenterology Xinhua HospitalShanghai Jiao Tong UniversitySchool of MedicineShanghai 200092China School of Health Science and Engineering University of Shanghai for Science and TechnologyShanghai 200093China department of gastroenterology Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical UniversityLinhai 317000Zhejiang ProvinceChina School of Medical Technology Shanghai University of Medicine and Health SciencesShanghai 201318China department of Pediatric Respiratory Xinhua HospitalShanghai Jiao Tong UniversitySchool of MedicineShanghai 200092China

This article summarizes the epidemiological characteristics and clinical manifest-ations of nonalcoholic fatty liver disease(NAFLD).The incidence of NAFLD has been increased dramatically and become the leading cause of chronic liver disease *** addition to its adverse outcomes of liver fibrosis,cirrhosis,and hepatocellular carcinoma,and related complications,NAFLD has recently been found to be associated with the high-risk extrahepatic carcinomas,such as various types of lung cancer(i.e.,lung adenocarcinoma,squamous cell carcinoma,and small cell lung cancer).The presence of hepatic steatosis also predisposes lung cancer to liver metastasis,but has better response to immune checkpoint *** other factors(i.e.,gender,smoking,etc.)are associated with NAFLD and lung cancer remains *** also comment on the reciprocal rela-tionships between NAFLD and components of metabolic *** meta-bolic syndrome components are suggested to facilitate lung cancer development via activating insulin/insulin-like growth factor *** addition,suppressed anti-tumor immunity and accelerated tumor progression could be attributed to the cell-specific metabolic reprogramming in condition of high-fat diet and related *** findings may reveal the role of NAFLD in pulmonary carcinoma and help develop new treatment strategies for this disease.

关键词： Nonalcoholic fatty liver disease Lung Cancer Adenocarcinoma Metabolic syndrome Component

Advances and challenges in peroral endoscopic myotomy:Safety,precision,and post-procedure management

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World Journal of gastroenterology 2025年第5期31卷 1-6页

作者： Grigorios Christodoulidis Kyriaki Tsagkidou Konstantinos Eleftherios Koumarelas Marina Nektaria Kouliou department of General Surgery University Hospital of LarissaLarissa 41110Greece department of gastroenterology General Hospital of LarissaLarisa 41221ThessalíaGreece department of Emergency Medicine General Hospital of LarissaLarissa 41221Greece

Peroral endoscopic myotomy(POEM)has revolutionized the treatment of upper gastrointestinal tract motility disorders,particularly *** editorial explores the efficacy,safety,and challenges of POEM,emphasizing its role as a primary treatment with excellent long-term outcomes and minimal adverse *** evolution of POEM underscores the need for precision in myotomy techniques and the importance of interdisciplinary collaboration,especially regar-ding anesthetic *** significant advances,challenges remain in standardizing safety protocols and managing *** POEM appli-cations expand,precision endoscopy continues to enhance therapeutic outcomes,promising a transformative impact on gastrointestinal motility disorder manage-ment.

关键词： Peroral endoscopic myotomy Complications after peroral endoscopic myoto-my Procedural safety Interdisciplinary collaboration Adverse events Therapeutic out-comes

Advances in gastrointestinal vascular bleeding disorders:Successful sirolimus treatment in colonic angioectasia

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World Journal of gastroenterology 2025年第4期31卷 123-136页

作者： Qi Sun Xiao-Ying Wang Dong-Hao Li Bai-Rong Li Xin-Zhuo Tu Zhi-Meng Jiang Shou-Bin Ning Tao Sun department of gastroenterology Air Force Medical CenterBeijing 100142China College of Life Science Northwest UniversityXi’an 710069Shaanxi ProvinceChina department of Pathology Air Force Medical CenterBeijing 100142China

BACKGROUND Gastrointestinal(GI)vascular bleeding disorders pose significant clinical challenges due to their complex pathogenesis and varied treatment *** advancements in diagnostic and therapeutic techniques,optimal mana-gement strategies remain elusive,necessitating further *** To assess research trends and clinical advancements in GI vascular bleeding disorders,highlighting key themes and therapeutic *** A bibliometric analysis was conducted using the Web of Science Core Collection database,reviewing publications from 2000 to 2024 to identify trends,highfrequency keywords,and key contributions from leading research *** addition,a case study highlighted the effective application of sirolimus in managing colonic angioectasia in a patient with recurrent GI bleeding who had not responded to previous *** The analysis reviewed 470 scholarly articles from 203 countries,involving 2817 authors across 1502 *** United States led in publication contributions,with strong collaborations with countries like China,England,and Germany.A significant trend was observed in the shift from traditional endoscopic interventions to pharmacological therapies,particularly highlighting the successful use of sirolimus in treating colonic angioectasia. High-frequency keywords such as “angiodysplasia”,“colon”, and “management” were identified, indicating key research themes. The study also noted a growinginterest in drug therapies, as evidenced by the increasing prominence of keywords like “thalidomide” since *** study links bibliometric analysis and clinical insights, highlighting the shift to pharmacological managementin GI vascular bleeding disorders to improve patient outcomes.

关键词： Gastrointestinal bleeding Vascular anomalies Angioectasia Pharmacological Sirolimus

累及全身多系统的疾病：代谢相关(非酒精性)脂肪性肝病

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中华肝脏病杂志 2025年第01期33卷 77-87页

作者： Kaya Eda Yilma Yusuf department of Internal Medicine Ruhr University Bochum University Hospital Knappschaftskrankenhaus Bochum Bochum Germany department of gastroenterology School of Medicine Marmara University Istanbul Turkey Liver Research Unit Institute of Gastroenterology Marmara University Istanbul Turkey

非酒精性脂肪性肝病(NAFLD)是一种累及全身多个系统的临床疾病, 其疾病谱包括肥胖、2型糖尿病、代谢综合征、心血管疾病、慢性肾病、非肝脏恶性肿瘤、认知障碍和多囊卵巢综合征等诸多肝外表现。心血管疾病是NAFLD患者最常见的死亡原因,... 详细信息

非酒精性脂肪性肝病(NAFLD)是一种累及全身多个系统的临床疾病, 其疾病谱包括肥胖、2型糖尿病、代谢综合征、心血管疾病、慢性肾病、非肝脏恶性肿瘤、认知障碍和多囊卵巢综合征等诸多肝外表现。心血管疾病是NAFLD患者最常见的死亡原因, 其次是非肝脏恶性肿瘤、2型糖尿病和其他肝脏相关并发症。不仅如此, 这些肝外疾病的严重程度与NAFLD的严重程度密切相关。在临床中, 认识并了解合并疾病之间的相互关系对疾病谱启动迅速且及时的筛查和多学科治疗管理具有重要意义。2020年, 来自22个国家的专家达成共识, 将NAFLD重新定义为代谢(功能障碍)相关性脂肪性肝病(MAFLD), 这也导致了这一患者群体得到重新定义。尽管MAFLD患者和NAFLD患者大部分重合, 但两个群体仍具有一定的差异性。因此, 将NAFLD患者和MAFLD患者发生的主要肝外合并症进行对比, 并探讨其相互间的影响。

关键词：脂肪肝代谢性疾病肝纤维化 2型糖尿病诊断治疗心血管代谢风险因素

Gender disparities and woman-specific trends in Barrett’s esophagus in the United States:An 11-year nationwide populationbased study

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World Journal of Methodology 2025年第1期15卷 60-71页

作者： Karina Fatakhova Faisal Inayat Hassam Ali Pratik Patel Attiq Ur Rehman Arslan Afzal Muhammad Sarfraz Shiza Sarfraz Gul Nawaz Ahtshamullah Chaudhry Rubaid Dhillon Arthur Dilibe Benjamin Glazebnik Lindsey Jones Emily Glazer Division of gastroenterology and Hepatology Mather Hospital and Zucker School of Medicine at Hofstra UniversityPort JeffersonNY 11777United States department of Internal Medicine Allama Iqbal Medical CollegeLahorePunjab 54550Pakistan Division of gastroenterology and Hepatology East Carolina University Brody School of MedicineGreenvilleNC 27834United States Division of gastroenterology and Hepatology Geisinger Wyoming Valley Medical CenterWilkes-BarrePA 18711United States department of Internal Medicine East Carolina University Brody School of MedicineGreenvilleNC 27834United States department of Internal Medicine St.Dominic's HospitalJacksonMS 39216United States department of gastroenterology Hepatologyand NutritionCleveland Clinic FoundationClevelandOH 44195United States department of Internal Medicine Mather Hospital and Hofstra University ZuckerSchool of MedicinePort JeffersonNY 11777United States

BACKGROUND Barrett's esophagus(BE)is a known premalignant precursor to esophageal adenocarcinoma(EAC).The prevalence rates continue to rise in the United States,but many patients who are at risk of EAC are not *** practice guidelines include male gender as a predisposing factor for BE and *** population-based clinical evidence regarding female gender remains *** To study comparative trends of gender disparities in patients with BE in the United *** A nationwide retrospective study was conducted using the 2009-2019 National Inpatient Sample(NIS)*** with a primary or secondary diagnosis code of BE were *** major outcome of interest was determining the gender disparities in patients with *** analysis for respective outcomes for females was also reported to ascertain any time-based *** We identified 1204190 patients with BE for the study *** the included patients,717439(59.6%)were men and 486751(40.4%)were *** mean age was higher in women than in men(67.1±0.4 vs 66.6±0.3 years,P<0.001).The rate of BE per 100000 total NIS hospitalizations for males increased from 144.6 in 2009 to 213.4 in 2019(P<0.001).The rate for females increased from 96.8 in 2009 to 148.7 in 2019(P<0.001).There was a higher frequency of obesity among women compared to men(17.4%vs 12.6%,P<0.001).Obesity prevalence among females increased from 12.3%in 2009 to 21.9%in 2019(P<0.001).A lower prevalence of smoking was noted in women than in men(20.8%vs 35.7%,P<0.001).However,trend analysis showed an increasing prevalence of smoking among women,from 12.9%in 2009 to 30.7%in 2019(P<0.001).Additionally,there was a lower prevalence of alcohol abuse,Helicobacter pylori(***),and diabetes mellitus among females than males(P<0.001).Trend analysis showed an increasing prevalence of alcohol use disorder and a decreasing prevalence of *** and diabetes mellitus among women(P<0.001).CONCLUSION The prevalence of BE among

关键词： Barrett’s esophagus Gender disparity Epidemiological trends Esophageal adenocarcinoma Screening endoscopy Female gender Risk factors

Return to work in young and middle-aged colorectal cancer survivors:Factors influencing self-efficacy,fear,resilience,and financial toxicity

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World Journal of gastroenterology 2025年第1期31卷 79-92页

作者： Dan Hu Yue Li Hua Zhang Lian-Lian Wang Wen-Wen Liu Xin Yang Ming-Zhao Xiao Hao-Ling Zhang Juan Li department of Nursing The First Affiliated Hospital of Chongqing Medical UniversityChongqing 400016China department of Nursing National Clinical Research Center for Child Health and DisordersMinistry of Education Key Laboratory of Child Development and DisordersChildren’s Hospital of Chongqing Medical UniversityChongqing 400014China department of Gastrointestinal Surgery The First Affiliated Hospital of Chongqing Medical UniversityChongqing 400016China department of Biomedical Science Advanced Medical and Dental InstituteUniversity Sains MalaysiaPenang 13200Malaysia Academic Affairs Office The First Affiliated Hospital of Chongqing Medical UniversityChongqing 400016China

BACKGROUND Return to work(RTW)serves as an indication for young and middle-aged colorectal cancer(CRC)survivors to resume their normal social ***,these survivors encounter significant challenges during their RTW ***,scientific research is necessary to explore the barriers and facilitating factors of returning to work for young and middle-aged CRC *** To examine the current RTW status among young and middle-aged CRC survivors and to analyze the impact of RTW self-efficacy(RTW-SE),fear of progression(FoP),eHealth literacy(eHL),family resilience(FR),and financial toxicity(FT)on their RTW *** A cross-sectional investigation was adopted in this *** September 2022 to February 2023,a total of 209 participants were recruited through a convenience sampling method from the gastrointestinal surgery department of a class A tertiary hospital in *** investigation utilized a general information questionnaire alongside scales assessing RTW-SE,FoP,eHL,FR,and *** analyze the factors that influence RTW outcomes among young and middle-aged CRC survivors,Cox regression modeling and Kaplan-Meier survival analysis were *** A total of 43.54%of the participants successfully returned to work,with an average RTW time of 100 *** regression univariate analysis revealed that RTW-SE,FoP,eHL,FR,and FT were significantly different between the non-RTW and RTW groups(P<0.05).Furthermore,Cox regression multivariate analysis identified per capita family monthly income,job type,RTW-SE,and FR as independent influencing factors for RTW(P<0.05).CONCLUSION The RTW rate requires further *** levels of RTW-SE and FR were found to significantly increase RTW among young and middle-aged CRC *** professionals should focus on modifiable factors,such as RTW-SE and FR,to design targeted RTW support programs,thereby facilitating their timely reintegration into mainstream society.

关键词： Return to work Colorectal neoplasms Return-to-work self-efficacy Fear of progression Family resilience Financial toxicity