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Transition after pediatric liver transplantation-Perceptions of adults, adolescents and parents

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World Journal of gastroenterology 2017年第13期23卷 2365-2375页

作者： Norman Junge Katarina Migal Imeke Goldschmidt Ulrich Baumann department of Pediatric gastroenterology and hepatology Hannover Medical School

AIM To develop a locally adapted, patient-focused transitionprogram, we evaluated the perceptions of adult and adolescent patients and parents regarding transitionprograms and *** We evaluated these perceptions by analyzing the responses of pre-transfer adolescents(n = 57), their parents(n = 57) and post-transfer adults(n = 138) from a cohort of pediatric-liver-transplant-patients using a self-designed questionnaire. Furthermore, we compared a responder group with a non-responder group as well as the provided answers with baseline characteristics and clinical outcomes to exclude selection bias, characterize high-risk patients for nonadherence and test for gender differences. Included in our study were all pre-transfer liver transplant and combined liver-kidney transplant recipients aged 11-19 currently under our care and their parents, as well as all post-transfer liver transplant and combined liverkidney transplant recipients aged ≥ 17 years who had received a liver transplant and were treated at our center during *** Fifty-seven(24 female) pre-transfer patients who received a transplant in the previous 8-186 mo(mean 93.9 mo, median 92 mo, SD 53.8 mo) and 138(57 female) post-transfer patients who received a transplant in the preceding 2-29 years(mean 15.6 years, median 17, SD 6.90) met the inclusion criteria. A total of 67% of pre-transfer patients(71% of female; 64% of male; P = 0.78) and their parents replied. Additionally, 54% of post-transfer patients(26% of female; 48% of male; P = 0.01) replied. No differences in clinical outcomes were observed between the responder and non-responder groups, and responses did not differ significantly based on clinical complication rates, although they did differ based on gender and the location of medical follow-up after transfer. Adolescents were generally ambivalent toward transition programs. However, adults strongly supported transition programs. CONCLUSION Transition programs need to be develop

关键词： Pediatric liver transplant Transfer Transition Non-adherence Gender differences

Current understanding of the functional roles of aberrantly expressed micro RNAs in esophageal cancer

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World Journal of gastroenterology 2016年第1期22卷 1-7页

作者： Christine Kestens Peter D Siersema Jantine WPM van Baal department of gastroenterology and hepatology University Medical Center Utrecht

The incidence of esophageal cancer is rising,mostly because the increasing incidence of esophageal adenocarcino main Western *** eimprovements in diagnosis and treatment,the overall5-year survival rates remain *** RNAs(mi RNAs)are small non-coding RNA molecules that regulate the expression of target ***,disease specific mi RNAs have been identified,which act as tumor suppressors or *** this review,we will summarize the current knowledge about the function of aberrantly expressed mi RNAs in esophageal *** selected 5 mi RNAs(mi RNA-21,-143,-145,-196a and let-7)based on the available literature,and described their potential role in regulating pathways that are deregulated in esophageal *** we will highlight the current achievements of using and targeting mi *** these mi RNAs likely have important regulatory roles in cancer development,they open a therapeutic window for new treatment modalities.

关键词： Esophageal cancer Esophageal squamouscell carcinoma Esophageal adenocarcinoma MicroRNAs Target genes

Systematic review:Eosinophilic esophagitis in Asian countries

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World Journal of gastroenterology 2015年第27期21卷 8433-8440页

作者： Yoshikazu Kinoshita Norihisa Ishimura Naoki Oshima Shunji Ishihara department of gastroenterology and hepatology Shimane University School of Medicine

AIM: to investigate the prevalence and the clinical characteristics of Asian patients with eosinophilic ***: We conducted a systematic search of the Pub Med and Web of Science databases for original studies, case series, and individual case reports of eosinophilic esophagitis in Asian countries published from January 1980 to January 2015. We found 66 and 80 articles in the Pub Med and Web of Science databases, respectively; 24 duplicate articles were removed. After excluding animal studies, articles not written in English, and meeting abstracts, 25 articles containing 217 patients were selected for ***: Sample size-weighted mean values were determined for all pooled prevalence data and clinical characteristics. The mean age of the adult patients with eosinophilic esophagitis was approximately 50 years, and 73% of these patients were male. They frequently presented with allergic diseases including bronchial asthma, allergic rhinitis, food allergy, and atopic dermatitis. Bronchial asthma was the most frequent comorbid allergic disease, occurring in 24% of patients with eosinophilic esophagitis. Dysphagia was the primary symptom reported; 44% of the patients complained of dysphagia. Although laboratory blood tests are not adequately sensitive for an accurate diagnosis of eosinophilic esophagitis, endoscopic examinations revealed abnormal findings typical of this disease, including longitudinal furrows and concentric rings, in 82% of the cases. One-third of the cases responded to proton pump inhibitor ***: The characteristics of eosinophilicesophagitis in Asian patients were similar to those reported in Western patients, indicating that this disease displays a similar pathogenesis between Western and Asian patients.

关键词： Eosinophilic esophagitis Allergy Prevalence Symptom Endoscopy Asia Treatment

Extraintestinal manifestations and complications in inflammatory bowel diseases

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World Journal of gastroenterology 2006年第30期12卷 4819-4831页

作者： Katja S Rothfuss Eduard F Stange Klaus R Herrlinger department of gastroenterology Hepatology and Endocrinology Robert-Bosch-Hospital Stuttgart Germany

Crohn＇s disease （CD） and ulcerative colitis （UC） are chronic inflammatory bowel diseases （IBD） that often involve organs other than those of the gastrointestinal tract. These nonintestinal affections are termed extraintestinal symptoms. Differentiating the true extraintestinal manifestations of inflammatory bowel diseases from secondary extraintestinal complications, caused by malnutrition, chronic inflammation or side effects of therapy, may be difficult. This review concentrates on frequency, clinical presentation and therapeutic implications of extraintestinal symptoms in inflammatory bowel diseases. If possible, extraintestinal manifestations are differentiated from extraintestinal complications. Special attention is given to the more recently described sites of involvement; i.e. thromboembolic events, osteoporosis, pulmonary involvement and affection of the central nervous system.

关键词： Inflammatory bowel diseases Crohn's disease Ulcerative colitis Extraintestinal manifestations Complications Therapy

Urgent endoscopic ultrasound-guided choledochoduodenostomy for acute obstructive suppurative cholangitis-induced sepsis

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World Journal of gastroenterology 2016年第16期22卷 4264-4269页

作者： Kosuke Minaga Masayuki Kitano Hajime Imai Kentaro Yamao Ken Kamata Takeshi Miyata Shunsuke Omoto Kumpei Kadosaka Tomoe Yoshikawa Masatoshi Kudo department of gastroenterology and hepatology Kinki University Faculty of Medicine

Acute obstructive suppurative cholangitis(AOSC) due to biliary lithiasis is a life-threatening condition that requires urgent biliary decompression. Although endoscopic retrograde cholangiopancreatography(ERCP) with stent placement is the current gold standard for biliary decompression, it can sometimes be difficult because of failed biliary cannulation. In this retrospective case series, we describe three cases of successful biliary drainage with recovery from septic shock after urgent endoscopic ultrasound-guided choledochoduodenostomy(EUS-CDS) was performed for AOSC due to biliary lithiasis. In all three cases, technical success in inserting the stents was achieved and the patients completely recovered from AOSC with sepsis in a few days after EUS-CDS. There were no procedure-related complications. When initial ERCP fails, EUS-CDS can be an effective life-saving endoscopic biliary decompression procedure that shortens the procedure time and prevents post-ERCP pancreatitis, particularly in patients with AOSC-induced sepsis.

关键词： Endoscopic ultrasound-guided biliary drainage Choledochoduodenostomy Acute obstructive suppurative cholangitis Sepsis Life-saving endoscopy

Role of cyclooxygenase-2 in gastric cancer development and progression

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World Journal of gastroenterology 2013年第42期19卷 7361-7368页

作者： Jian Cheng Xiao-Ming Fan department of gastroenterology and hepatology Jinshan Hospital of Fudan University

Although the incidence of gastric cancer has been declining in recent decades,it remains a major public health issue as the second leading cause of cancer death *** China,gastric cancer is still the main cause of death in patients with malignant *** patients are diagnosed at an advanced stage and mortality is ***-2(COX-2)is a ratelimiting enzyme in prostanoid synthesis and plays an important role in the development and progression of gastric *** expression of COX-2 in gastric cancer is upregulated and its molecular mechanisms have been *** pylori infection,tumor suppressor gene mutation and the activation of nuclear factor-kappa B may be responsible for the elevated expression of COX-2 in gastric *** mechanisms of COX-2 in the development and progression of gastric cancer are probably through promoting the proliferation of gastric cancer cells,while inhibiting apoptosis,assisting angiogenesis and lymphatic metastasis,and participating in cancer invasion and *** review is intended to discuss,comment and summarize recent research progress on the role of COX-2 in gastric cancer development and progression,and elucidate the molecular mechanisms which might be involved in the carcinogenesis.

关键词： Cyclooxygenase-2 Gastric cancer Prostagladin Carcinogenesis Molecular mechanism

Detection of superficial esophageal squamous cell neoplasia by chromoendoscopy-guided confocal laser endomicroscopy

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World Journal of gastroenterology 2015年第22期21卷 6974-6981页

作者： Jin Huang Yun-Sheng Yang Zhong-Sheng Lu Shuang-Fang Wang Jing Yang Jing Yuan department of gastroenterology and hepatology Chinese PLA 153 Hospital department of gastroenterology and hepatology Chinese PLA General Hospital department of Pathology Chinese PLA General Hospital

AIM: To evaluate the diagnostic potential of Lugol'schromoendoscopy-guided confocal laser endomicroscopy(CLE) in detecting superficial esophageal squamous cell neoplasia(ESCN).METHODS: Between December 2008 and September2010, a total of 52 patients were enrolled at the Chinese PLA General Hospital in Beijing, China. First,Lugol's chromoendoscopy-guided CLE was performed in these patients and the CLE in vivo histological diagnosis was recorded. Then, chromoendoscopyguided biopsy was performed in the same patients by another endoscopist who was blinded to the CLE findings. Based on the biopsy and CLE diagnosis, en bloc endoscopic resection was performed. The CLE in vivo diagnosis and the histological diagnosis of biopsy of ESCN were compared, using a histological examination of the endoscopic resection specimens as the standard ***: A total of 152 chromoendoscopy-guided biopsies were obtained from 56 lesions. In the 56 lesions of 52 patients, a total of 679 CLE images were obtained vs 152 corresponding biopsies. The sensitivity, specificity, negative predictive value and positive predictive value of chromoendoscopy-guided CLE compared with biopsy were 95.7% vs 82%(P 0.05), *** was a significant improvement in sensitivity,specificity, negative predictive value, and accuracy when comparing chromoendoscopy-guided CLE with ***: Lugol's chromoendoscopy-guided CLE is a real-time, non-invasive endoscopic diagnostic technology; the accuracy of the detection of superficial ESCN is equivalent to or may be superior to biopsy histology.

关键词： Superficial esophageal neoplasia Squamous cell neoplasm Confocal endomicroscopy Endoscopicsubmucosal dissection Chromoendoscopy

Small intestine bacterial overgrowth and irritable bowel syndrome-related symptoms:Experience with Rifaximin

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World Journal of gastroenterology 2009年第21期15卷 2628-2631页

作者： Sergio Peralta Claudia Cottone Tiziana Doveri Piero Luigi Almasio Antonio Craxi Operative Unit of gastroenterology and hepatology

AIM： TO estimate the prevalence of small intestinal bacterial overgrowth （SIBO） in our geographical area （Western Sicily, Italy） by means of an observational study, and to gather information on the use of locally active, non-absorbable antibiotics for treatment of SIBO.METHODS： Our survey included 115 patients fulfilling the Rome II criteria for diagnosis of irritable bowel syndrome （IBS）; a total of 97 patients accepted to perform a breath test with lactulose （BTLact）, and those who had a positive test, received Rifaximin （Normix , Alfa Wassermann） 1200 mg/d for 7 d; 3 wk after the end of treatment, the BTLact was repeated.RESULTS： Based on the BTLact results, SIBO was present in about 56% of IBS patients, and it was responsible for some IBS-related symptoms, such as abdominal bloating and discomfort, and diarrhoea. 1-wk treatment with Rifaximin turned the BTLact to negative in about 50% of patients and significantly reduced the symptoms, especially in those patients with an alternated constipation/diarrhoea-variant IBS. CONCLUSION： SIBO should be always suspected in patients with IBS, and a differential diagnosis is done by means of a ＂breath test＂. Rifaximin may represent a valid approach to the treatment of SIBO.

关键词： Rifaximin Small intestinal bacterialovergrowth Irritable bowel syndrome Locally nonabsorbable antibiotics

Rising incidence of acute hepatitis A among adults and clinical characteristics in a tertiary care center of Pakistan

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World Journal of Virology 2025年第1期14卷 73-82页

作者： Yumna Shahid Amna Subhan Butt Iqra Jamali Faisal Wasim Ismail Division of gastroenterology Department of MedicineAga Khan University HospitalKarachi 74800Pakistan department of Medicine Aga Khan University HospitalKarachi 74800Pakistan

BACKGROUND For decades,hepatitis A virus(HAV)has been a leading cause of acute hepatitis among children and was less prevalent among ***,recently a paradigm shift has been observed in the epidemiology of HAV,as evident by cases of acute hepatitis due to HAV among *** To estimate frequency of HAV in acute viral hepatitis and compare characteristics in HAV and hepatitis E virus(HEV)*** This was a trend analysis conducted at Aga Khan University Hospital Karachi(Sindh,Pakistan)from February 2024 to May *** aged 18 years and older diagnosed with acute viral hepatitis attributed to hepatotropic viruses in 2024 were *** compare the trend patients admitted with acute hepatitis during 2019-2023 were also *** regarding clinical and laboratory parameters were *** yearly trend of acute hepatitis due to HAV and HEV was analyzed,and comparative analysis was done between HAV and HEV cases among *** A total of 396 patients were found to have acute hepatitis during our study *** was diagnosed in 234 patients(59%)while 157 patients(39.6%)were found to have acute HEV ***,acute hepatitis B virus infection was identified in 3 patients(0.7%),whereas acute hepatitis C virus infection was found in 2(0.5%)cases of acute *** trends showed increasing occurrence of HAV infection among adults over last 5 *** patients with acute HAV were younger than patients with HEV(28 years±8 years vs 30 years±8 years;P<0.01).Higher levels of total bilirubin were seen in HEV infection,while higher levels of alanine transaminase were seen in HAV ***,a higher proportion of acute liver failure(ALF),coagulopathy,and mortality were observed in *** An increase in acute hepatitis A cases among adults shows less severity than hepatitis E,highlighting the need for better sanitation,hygiene,and adult hepatitis A vaccination programs.

关键词： Acute hepatitis Hepatitis A virus Hepatitis E virus Acute liver failure Hepatotropic virus Vaccination