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Advancing hepatic recompensation:Baveno VII criteria and therapeutic innovations in liver cirrhosis management

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World Journal of Gastroenterology 2024年第23期30卷 2954-2958页

作者： Lorenzo Ridola Sara Del Cioppo department of medical and surgical sciences and Biotechnologies Sapienza University of RomePolo PontinoRome 00185Italy

The Baveno VII criteria redefine the management of decompensated liver cirrhosis,introducing the concept of hepatic recompensation marking a significant departure from the conventional view of irreversible *** to this concept is addressing the underlying cause of cirrhosis through tailored therapies,including antivirals and lifestyle *** on alcohol,hepatitis C virus,and hepatitis B virus-related cirrhosis demonstrate the efficacy of these interventions in improving liver function and patient *** intrahepatic portosystemic shunt(TIPS)emerges as a promising intervention,effectively resolving complications of portal hypertension and facilitating ***,optimal timing and patient selection for TIPS remain *** challenges,TIPS offers renewed hope for hepatic recompensation,marking a significant advancement in cirrhosis *** research is needed to refine its implementation and maximize its *** conclusion,TIPS stands as a promising avenue for improving hepatic function and patient outcomes in decompensated liver cirrhosis within the framework of the Baveno VII criteria.

关键词： Hepatic recompensation Baveno VII Transjugular intrahepatic portosystemic shunt Portal hypertension Cirrhosis Decompensation

Parasites of the liver:A global problem?

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World Journal of Gastroenterology 2024年第30期30卷 3554-3559页

作者： Vladislav V Tsukanov Alexander V Vasyutin Julia L Tonkikh Clinical department of the Digestive System Pathology of adults and children Federal Research Center“Krasnoyarsk Science Center”of the Siberian Branch of the Russian Academy of SciencesScientific Research Institute of Medical Problems of the NorthKrasnoyarsk 660022Russia

Parasitic liver diseases can be caused by trematodes,cestodes,nematodes,and *** pathology is significant because millions of people in different parts of the world have liver parasites,which can manifest themselves in the development of inflammation,liver cysts,cholecystitis,cholelithiasis,pancreatitis and liver cirrhosis that are often threatening their *** International Agency for Research on Cancer considers three species of trematodes,Schistosoma haematobium,Opisthorchis viverrini and Clonorchis sinensis,to be *** modern examination methods,in some cases including extensive screening of large populations,are required for diagnosing liver *** of parasitic liver diseases is differentiated and can involve a combination of surgical and therapeutic *** is no doubt that the clinical and epidemiological scale allows one to regard parasitic liver diseases as a global healthcare problem.

关键词： Liver Parasites Epidemiology Diagnosis Clinics Treatment Echinococcosis Opisthorchiasis Fascioliasis Schistosomiasis

Time trends and outcomes of gastrostomy placement in a Swedish national cohort over two decades

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World Journal of Gastroenterology 2024年第10期30卷 1358-1367页

作者： Martin Löfling Skogar Magnus Sundbom department of surgical sciences Uppsala UniversityUppsala 75185Sweden

BACKGROUND Percutaneous endoscopic gastrostomy(PEG)and laparoscopically inserted gastrostomy have become the gold standard for adult patients and children,respectively,requiring long-term enteral nutrition ***-related mortality is a rare event,often reported to be zero in smaller *** data on 30-d mortality and long-term survival rates after gastrostomy placement are scarce in the *** To study the use of gastrostomies in Sweden from 1998-2019 and to analyze procedure-related mortality and short-term(children(0-18 years);adults(19-64 years);and elderly(≥65 years).Kaplan-Meier with log-rank test and Cox regression were used for survival *** In total 48682 individuals(52%males,average age 60.9±25.3 years)were *** cohort consisted of 12.0%children,29.5%adults,and 58.5%*** increased use of gastrostomies was observed during the study period,from 13.7/100000 to 22.3/100000 individuals(Pchildren,adults,and elderly were 93.7%,67.5%,a

关键词： Gastrostomy Percutaneous endoscopic gastrostomy Dysphagia Enteral nutrition Long-term Survival Complication

Emerging molecules,tools,technology,and future of surgical knife in gastroenterology

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World Journal of Gastrointestinal Surgery 2024年第4期16卷 988-998页

作者： Ashok Kumar Anirudh Goyal department of surgical Gastroenterology Sanjay Gandhi Post Graduate Institute of Medical SciencesLucknow 226014Uttar PradeshIndia

The 21^(st) century has started with several innovations in the medical sciences,with wide applications in health care *** development has taken in the field of medicines(newer drugs/molecules),various tools and technology which has completely changed the patient management including abdominal *** for abdominal diseases has moved from maximally invasive to minimally invasive(laparoscopic and robotic)*** of the newer medicines have its impact on need for surgical *** article focuses on the development of these emerging molecules,tools,and technology and their impact on present surgical form and its future effects on the surgical intervention in gastroenterological diseases.

关键词： Newer molecules Tools and technology Gastroenterology Future of surgical knife

Amebic liver abscess: An update

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World Journal of Hepatology 2024年第3期16卷 316-330页

作者： Ramesh Kumar Rishabh Patel Rajeev Nayan Priyadarshi Ruchika Narayan Tanmoy Maji Utpal Anand Jinit R Soni department of Gastroenterology All India Institute of Medical SciencesPatna 801507India department of Radiodiagnosis All India Institute of Medical SciencesPatna 801507India department of surgical Gastroenterology All India Institute of Medical SciencesPatna 801507India

Amebic liver abscess(ALA)is still a common problem in the tropical world,where it affects over three-quarters of patients with liver *** is caused by an anaerobic protozoan Entamoeba hystolytica,which primarily colonises the *** is a non-suppurative infection of the liver consisting primarily of dead hepatocytes and cellular *** of the male gender,during their reproductive years,are most prone to ALA,and this appears to be due to a poorly mounted immune response linked to serum testosterone *** is more common in the right lobe of the liver,is strongly associated with alcohol consumption,and can heal without the need for *** majority of ALA patients have an uncomplicated course,a number of complications have been described,including rupture into abdomino-thoracic structures,biliary fistula,vascular thrombosis,bilio-vascular compression,and secondary bacterial *** on clinico-radiological findings,a classification system for ALA has emerged recently,which can assist clinicians in making treatment *** research has revealed the role of venous thrombosis-related ischemia in the severity of *** years have seen the development and refinement of newer molecular diagnostic techniques that can greatly aid in overcoming the diagnostic challenge in endemic area where serology-based tests have limited *** has been the drug of choice for ALA patients for many ***,concerns over the resistance and adverse effects necessitate the creation of new,safe,and potent antiamebic *** the indication of the drainage of uncomplicated ALA has become more clear,high-quality randomised trials are still necessary for robust *** drainage appears to be a viable option for patients with ruptured ALA and diffuse peritonitis,for whom surgery represents a significant risk of *** regard to all of the aforementioned issues,this article intends to present an u

关键词： Amebic liver abscess Amebiasis Ruptured liver abscess Percutaneous drainage Metronidazole

Exploration of pathogenic microorganism within the small intestine of necrotizing enterocolitis

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World Journal of Pediatrics 2024年第2期20卷 165-172页

作者： Yan Wang Kun Jiang Qiao Xia Xia Kang Shan Wang Ji-Hong Yu Wen-Feng Ni Xiao-Qin Qi Ying-Na Zhang Jin-Bao Han Gang Liu Lei Hou Zhi-Chun Feng Liu-Ming Huang Clinical Biobank Center Medical Innovation Research Division of ChinesePLA General HospitalBeijingChina Institute of Basic medical sciences Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Senior department of Pediatrics The Seventh Medical Center of PLA General HospitalBeijing 100700China department of Neurology The First Medical CenterChinese PLA General HospitalBeijing 100853China department of Emergency Center National Center for Children's HealthBeijing Children's HospitalCapital Medical UniversityBeijing 100045China

Background Necrotizing enterocolitis(NEC)is the most common severe gastrointestinal emergency in *** designed this study to identify the pathogenic microorganisms of NEC in the microbiota of the small intestine of *** Using the 16S ribosomal DNA(rDNA)sequencing method,we compared and analyzed the structure and diversity of microbiotas in the intestinal feces of different groups of neonates:patients undergoing jejunostomy to treat NEC(NP group),neonates undergoing jejunostomy to treat other conditions(NN group),and neonates with NEC undergoing conservative treatment(NC group).We took intestinal feces and saliva samples from patients at different time *** The beta diversities of the NP,NN,and NC groups were all *** comparing the beta diversities between different time points in the NP group,we found similar beta diversities at time points El to E3 but significant differences between the E2-E3 and E4 time points:the abundances of Klebsiella and Enterococcus(Proteobacteria)were higher at the E1-E3 time points;the abundance of Escherichia-Shigella(Proteobacteria)increased at the E2 time point,and the abundance of Klebsiella decreased significantly,whereas that of Streptococcus increased significantly at the E4 time *** Our results suggest that the pathological changes of intestinal necrosis in the small intestine of infants with NEC are not directly caused by excessive proliferation of pathogenic bacteria in the small *** sources of microbiota in the small intestine of neonates,especially in premature infants,may be affected by multiple factors.

关键词： Microbiota Necrotizing enterocolitis-Small intestine 16S rDNA

Application of exosomal miRNA mediated macrophage polarization in colorectal cancer:Current progress and challenges

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Oncology Research 2024年第1期32卷 61-71页

作者： YUN ZHANG SHALING TANG YUBO GAO ZHONGTING LU YUAN YANG JING CHEN TAO LI department of Oncology School of Clinical MedicineNingxia Medical UniversityYinchuanChina General Hospital of Ningxia medical University YinchuanChina School of Basic medical sciences Ningxia Medical UniversityYinchuanChina department of surgical Oncology Tumor HospitalThe General Hospital of Ningxia Medical UniversityYinchuanChina

Colorectal cancer(CRC)is a major global health problem with high morbidity and mortality *** resection is the main treatment for early-stage CRC,but detecting it early is ***,effective therapeutic targets for advanced patients are still ***,tiny vesicles in body fluids,play a crucial role in tumor metastasis,immune regulation,and drug ***,they can even serve as a biomarker for cancer diagnosis and *** have shown that exosomes can carry miRNA,mediate the polarization of M1/M2 macrophages,promote the proliferation and metastasis of cancer cells,and affect the prognosis of *** the gastrointestinal tract has many macrophages,understanding the mechanism behind exosomal miRNA-mediated macrophage polarization in CRC treatment is *** article summarizes recent advancements in the study of exosomal miRNAs in CRC and their potential as diagnostic and prognostic markers.

关键词： Colorectal cancer Exosomes microRNA Macrophages Treatment

Optimizing prediction models for pancreatic fistula after pancreatectomy:Current status and future perspectives

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World Journal of Gastroenterology 2024年第10期30卷 1329-1345页

作者： Feng Yang John A Windsor De-Liang Fu department of Pancreatic Surgery Huashan HospitalShanghai Medical CollegeFudan UniversityShanghai 200040China surgical and Translational Research Centre Faculty of Medical and Health SciencesUniversity of AucklandAuckland 1142New Zealand

Postoperative pancreatic fistula(POPF)is a frequent complication after pancre-atectomy,leading to increased morbidity and *** prediction models for POPF has emerged as a critical focus in surgical *** over sixty models following pancreaticoduodenectomy,predominantly reliant on a variety of clinical,surgical,and radiological parameters,have been documented,their predictive accuracy remains suboptimal in external validation and across diverse *** models after distal pancreatectomy continue to be pro-gressively reported,their external validation is eagerly ***,POPF prediction after central pancreatectomy is in its nascent stage,warranting urgent need for further development and *** potential of machine learning and big data analytics offers promising prospects for enhancing the accuracy of prediction models by incorporating an extensive array of variables and optimizing algorithm ***,there is potential for the development of personalized prediction models based on patient-or pancreas-specific factors and postoperative serum or drain fluid biomarkers to improve accuracy in identifying individuals at risk of *** the future,prospective multicenter studies and the integration of novel imaging technologies,such as artificial intelligence-based radiomics,may further refine predictive *** these issues is anticipated to revolutionize risk stratification,clinical decision-making,and postoperative management in patients undergoing pancre-atectomy.

关键词： Pancreatic fistula Pancreaticoduodenectomy Distal pancreatectomy Central pancreatectomy Prediction model Machine learning Artificial intelligence

A multicenter prospective study on the management of hepatoblastoma in children:a report from the Chinese children's Cancer Group

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World Journal of Pediatrics 2024年第6期20卷 590-601页

作者： Meng-Jie Tang Xiao-Li Ma Xiang-Ling He Wei-Hua Pan Xiao-Hong Zhang Sha-Yi Jiang Ju Gao Fu Lie Wei Yao Song Gu Wei-Ling Zhang Qiang Zhao Shi-Hao Huang Yong-Jun Fang Wei Liu Hui-Zhong Niu Chun-Mei Wang Li-Rong Sun Hui Gao Yun-Peng Dai Shun-Gen Huang Zhi-Yong Zhong Xi-Ge Wang Zhong-Rong Li Liang-Chun Yang Ye-Ming Wu Huan-Min Wang Xin Sun Xiao-Jun Yuan department of Pediatric Hematology/Oncology Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineNo.1665Kongjiang RoadYangpu DistrictShanghai 200092China medical Oncology department Pediatric Oncology CenterBeijing Children's HospitalCapital Medical UniversityNational Center for Children's HealthBeijing 100045China department of Hematology/Oncology Children's Medical CenterHunan Provincial People's HospitalThe First Affiliated Hospital of Hunan Normal UniversityChangsha 41005China department of Pediatric Surgery Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai 200092China department of Hematology/Oncology Guangzhou Women and Children's Medical CenterNational Children's Medical Center for South Central RegionGuangzhou 510623China department of Hematology Shanghai Children's HospitalShanghai Jiao Tong UniversityShanghai 200062China department of Pediatrics West China Second University HospitalSichuan UniversityChengdu 610041China department of Hematology/Oncology Qilu Children's Hospital of Shandong UniversityJinan 250022China department of Pediatric Surgery Children's Hospital of Fudan UniversityShanghai 201102China department of General Surgery Shanghai Children's Medical Center(National Children's Medical Center-Shanghai)Shanghai Jiao Tong University School of MedicineShanghai 200127China department of Pediatrics Beijing Tongren HospitalCapital Medical UniversityBeijing 100730China department of Pediatric Oncology Tianjin Medical University Cancer Institute and HospitalTianjin 300060China department of Hematology/Oncology Children's Hospital of Nanjing Medical UniversityNanjing 210008China department of Hematology/Oncology Henan Children's HospitalZhengzhou 450018China department of Pediatric General Surgery Hebei Children's Hospital of Hebei Medical UniversityShijiazhuang City 050031China children's Hospital the First Affliated Hospital of Zhengzhou UniversityZhengzhou 450052China department of Paediatric

Background This study aimed to identify survival risk factors in Chinese children with hepatoblastoma(HB)and assess the effectiveness of the new treatment protocol proposed by the Chinese children's Cancer Group(CCCG)in *** A multicenter,prospective study that included 399 patients with HB from January 2015 to June 2020 was *** demographics,treatment protocols,and other related information were *** regression models and Kaplan-Meier curve methods were *** The 4-year event-free survival(EFS)and overall survival(OS)were 76.9 and 93.5%,*** 4-year EFS rates for the very-low-risk,low-risk,intermediate-risk,and high-risk groups were 100%,91.6%,81.7%,and 51.0%,*** 4-year 0S was 100%,97.3%,94.4%,and 86.8%,*** regression analysis found that age,tumor rupture(R+),and extrahepatic tumor extension(E+)were independent prognostic factors.A total of 299 patients had complete remission,and 19 *** with declining alpha-fetoprotein(AFP)>75%after the first two cycles of neoadjuvant chemotherapy had a better EFS and OS than those≤75%.Conclusions The survival outcome of HB children has dramatically improved since the implementation of CCCG-HB-2016 ***≥8 years,R+,and E+were independent risk factors for *** with a declining AFP>75%after the first two cycles of neoadjuvant chemotherapy had better EFS and OS.

关键词： Alpha-fetoprotein Hepatoblastoma Multicenter Prospective study Survival