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Infliximab stopped severe gastrointestinal bleeding in Crohn's disease

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World Journal of Gastroenterology 2012年第21期18卷 2730-2734页

作者： Satimai Aniwan Surasak Eakpongpaisit Boonlert Imraporn Surachai Amornsawadwatana Rungsun Rerknimitr division of Gastroenterology Department of MedicineKing Chulalongkorn Memorial HosptialBangkok 10330Thailand Institute of liver and Gastrointestinal diseases Samitivej HospitalBangkok 10330Thailand

To report the result of rapid ulcer healing by infliximab in Crohn's patients with severe enterocolic bleeding. During 2005 and 2010, inflammatory bowel disease database of King Chulalongkorn Memorial and Samitivej hospitals were reviewed. There were seven Crohn's disease (CD) patients (4 women and 3 men; mean age 52 ± 10.4 years; range: 11-86 years). Two of the seven patients developed severe gastrointestinal bleeding (GIB) as a flare up of CD whereas the other five patients presented with GIB as their first symptom for CD. Their mean hemoglobin level dropped from 12 ± 1.3 g/ dL to 8.7 ± 1.3 g/dL in a 3-d period. Median packed red blood cells units needed for resuscitation was 4 units. Because of uncontrolled bleeding, surgical resection was considered. However, due to the poor surgical candidacy of these patients (n = 3) and /or possible development of short bowel syndrome (n = 6), surgery was not pursued. Likewise angiographic embolization was not considered in any due to the risk of large infarction. All severe GIBs successfully stopped by one or two doses of intravenous infliximab. Our data suggests that infliximab is an alternative therapy for CD with severe GIB when surgery has limitation or patient is a high risk.

关键词： Crohn’s disease Gastrointestinal bleeding Complications Infliximab Biologic agents

Unique Genetic Features of Lean NAFLD: A Review of Mechanisms and Clinical Implications

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Journal of Clinical and Translational Hepatology 2024年第1期12卷 70-78页

作者： Jasmine Tidwell George Y.Wu Department of Medicine University of Connecticut Health CenterFarmingtonCTUSA division of Gastroenterology-Hepatology University of Connecticut Health CenterFarmingtonCTUSA

Non-alcoholic fatty liver disease(NAFLD)affects 25%of the global *** 20%have a normal body mass index(BMI)and a variant known as lean *** typical NAFLD cases associated with obesity and diabetes,lean NAFLD causes liver disease by mechanisms not related to excess weight or insulin *** disorders are among the major factors in developing lean NAFLD,and genome-wide association studies have identified several genes associated with the *** review aims to increase awareness by describing the genetic markers linked to NAFLD and the defects involved in developing lean NAFLD.

关键词： Lean nonalcoholic fatty liver disease Palatine-like phospholipase domain-containing-3 Transmembrane 6 superfamily member 2 Familial hypobetalipoproteinemia Abetalipoproteinemia

A literature review of genetics and epigenetics of HCV-related hepatocellular carcinoma: translational impact

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Hepatobiliary Surgery and Nutrition 2024年第4期13卷 650-661页

作者： Ziyan Pan Wai-Kay Seto Chun-Jen Liu Yilei Mao Saleh A.Alqahtani Mohammed Eslam Storr liver Centre Westmead Institute for Medical ResearchWestmead Hospital and University of SydneySydneyNSWAustralia Department of Medicine The University of Hong KongHong KongChina State Key Laboratory of liver Research The University of Hong KongHong KongChina Department of Internal Medicine National Taiwan University HospitalTaipei Hepatitis Research Center National Taiwan University HospitalTaipei Graduate Institute of Clinical Medicine National Taiwan University College of MedicineTaipei Department of liver Surgery Peking Union Medical College(PUMC)HospitalPUMC&Chinese Academy of Medical SciencesBeijingChina Organ Transplant Center of Excellence King Faisal Specialist Hospital&Research CenterRiyadhSaudi Arabia division of Gastroenterology&Hepatology Johns Hopkins UniversityBaltimoreMDUSA

Background and Objective:Hepatocellular carcinoma(HCC)poses a significant global health burden and ranks as the fifth most prevalent cancer on a global *** C virus(HCV)infection remains one of the major risk factors for HCC *** is a heterogeneous disease,and the development of HCC caused by HCV is intricate and involves various factors,including genetic susceptibility,viral factors,immune response due to chronic inflammation,alcohol abuse,and metabolic dysfunction associated with fatty liver *** this review,we provide a comprehensive and updated review of research on the genetics and epigenetic mechanisms implicated in developing HCC associated with HCV *** also discuss the potential translational implications,including novel biomarkers and drugs for ***:A comprehensive literature search was conducted in June 2023 in PubMed and Embase *** Content and Findings:Recent findings indicate that a variety of genetic and epigenetic processes are involved in the pathogenesis and continue to exist even after the complete elimination of *** deregulation of the epigenome has been identified as a significant factor in the deletrious effects of liver disease,especially during the initial stages when genetic alterations are *** enduring“epigenetic memory”of gene expression is believed to be regulated by epigenetic mechanisms,indicating that alterations caused by HCV infection continue to exist and are linked to the risk of development of liver cancer even after successful *** biology analytical methods will be required to delineate the magnitude and significance of both genetic and epigenomic alterations in tumor ***:By facilitating a more profound understanding of these aspects,this will ultimately foster the advancement of novel therapies and ultimately improve outcomes for patients.

关键词： Epigenetics genetics hepatitis C virus-related hepatocellular carcinoma(HCV-related HCC) translational implications

Heritable Chronic Cholestatic liver diseases:A Review

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Journal of Clinical and Translational Hepatology 2024年第8期12卷 726-738页

Chronic cholestasis due to heritable causes is usually diagnosedin ***,many cases can present andsurvive into *** time course varies considerablydepending on the underlying *** data usuallyreveal elevated conjugated hyperbilirubinemia,alkalinephosphatase,and gamma-glutamyl *** be asymptomatic;however,when present,the typicalsymptoms are pruritus,jaundice,fatigue,and *** diagnostic methods and management requireddepend on the underlying *** development of genome-wide associated studies has allowed the identificationof specific genetic mutations related to the pathophysiologyof cholestatic liver *** aim of this review was tohighlight the genetics,clinical pathophysiology,presentation,diagnosis,and treatment of heritable etiologies of chroniccholestatic liver disease.

关键词： Chronic cholestasis Cholestatic liver disease Congenital hepatic fibrosis Caroli disease Caroli syndrome Alagille syndrome Biliary atresia

Etiologies of Splenic Venous Hypertension:A Review

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Journal of Clinical and Translational Hepatology 2024年第6期12卷 594-606页

作者： Jasmine Tidwell Bianca Thakkar George Y.Wu Department of Medicine University of Connecticut Health CenterFarmingtonCTUSA division of Gastroenterology-Hepatology University of Connecticut Health CenterFarmingtonCTUSA

Splenic venous hypertension or left-sided portal hypertension is a rare condition caused by an obstruction of the splenic ***,it presents with upper gastrointestinal bleeding in the absence of liver *** can be classified based on the mechanism of development of splenic vein hypertension:compression,stenosis,inflammation,thrombosis,and surgically decreased splenic venous *** is established by various imaging modalities and should be suspected in patients with gastric varices in the absence of esophageal varices,splenomegaly,or *** management and prognosis vary depending on the underlying etiology but generally involve reducing splenic venous *** aim of this review was to summarize the etiologies of splenic venous hypertension according to the mechanism of development.

关键词： Splenic venous hypertension Left-sided portal hypertension Sinistral portal hypertension Splenic vein thrombosis Gastric varices Hematemesis Upper gastrointestinal bleeding

Subnormal Serum liver Enzyme Levels:A Review of Pathophysiology and Clinical Significance

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Journal of Clinical and Translational Hepatology 2024年第4期12卷 428-435页

作者： Elham M.Youssef George Y.Wu Biochemistry Department National Research CenterCairoEgypt Department of Medicine Division of Gastroenterology-HepatologyUniversity of Connecticut Health CenterFarmingtonCTUSA

Subnormal levels of liver enzymes,below the lower limit of normal on local laboratory reports,can be useful *** instance,subnormal levels of aminotransferases can be observed in vitamin B6 deficiency and chronic kidney *** alkaline phosphatase levels may indicate the presence of hypophosphatasia,Wilson's disease,deficiencies of divalent ions,or *** levels of gamma glutamyl transferase may be seen in cases of acute intrahepatic cholestasis,the use of certain medications,and in bone ***,subnormal levels of 5'-nucleotidase have been reported in lead poisoning and nonspherocytic hemolytic *** aim of this review is to bring attention to the fact that subnormal levels of these enzymes should not be ignored as they may indicate pathological conditions and provide a means of early diagnosis.

关键词： Transaminases Vitamin B6 Celiac disease Renal insufficiency Hepatolenticular Degeneration Crohn disease Malnutrition Clofibrate Bone diseases Lead poisoning Anemia Hemolytic

Necrolytic acral erythema in a human immunodeficiency virus/hepatitis C virus coinfected patient:A case report

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World Journal of Hepatology 2019年第2期11卷 226-233页

作者： Katerina G Oikonomou Dost Sarpel Alexandra Abrams-Downey Adnan Mubasher Douglas T Dieterich division of Infectious diseases Icahn School of Medicine at Mount Sinai Department of Pathology Icahn School of Medicine at Mount Sinai division of liver diseases Icahn School of Medicine at Mount Sinai

BACKGROUND Necrolytic acral erythema(NAE) is a rare dermatological disorder,which is associated with hepatitis C virus(HCV) infection or zinc *** is characterized by erythematous or violaceous lesions occurring primarily in the lower *** treatment includes systemic steroids and oral zinc *** report a case of NAE in a 66-year-old human immunodeficiency virus(HIV)/HCV co-infected woman with *** is rarely reported in co-infected patients and the exact mechanisms of pathogenesis are still *** SUMMARY A 66-year-old HIV/HCV co-infected female patient presented with painless,nonpruritic rash of extremities for one week and underwent extensive work-up for possible rheumatologic disorders including vasculitis and *** skin biopsies of right and left thigh revealed thickened parakeratotic stratum corneum most consistent with *** was started on prednisone and zinc supplementation with resolution of the lesions and improvement of *** Clinicians should maintain high clinical suspicion for early recognition of NAE in patients with rash and HCV.

关键词： Necrolytic acral erythema Human immunodeficiency virus Hepatitis C virus Zinc deficiency Case report

The impact of direct-acting antivirals on hepatitis C associated hepatocellular carcinoma

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Hepatoma Research 2020年第5期6卷 19-26页

作者： Tai-Ping Lee David Bernstein division of Hepatology and Sandra A.Bass Center for liver diseases at Northwell Health ManhassetNY 11030USA

The increased incidence of hepatocellular carcinoma(HCC)in the last several decades in the United States and worldwide has partly resulted from an increase in hepatitis C virus(HCV)*** carcinogenesis is speculated to be indirectly related to multiple steps from inflammation to fibrosis and advanced fibrosis/cirrhosis over 20 or more ***,the direct carcinogenic potential from HCV may explain HCC occurring in non-cirrhotic HCV *** potent direct-acting antivirals(DAAs)in recent years have changed hepatitis C treatment significantly and have resulted in the sustained virologic response(SVR)rate exceeding 90%.Although initial reports concerned the increase in de novo and recurrent HCC associated with DAAs,more recent studies showed that DAA-induced SVR on the contrary reduced risk of HCV-associated HCC without increasing its *** International Consortium of Hepatitis C Therapeutic Registry and Research Network(HCV-TARGET)database and other resources of HCV patients treated with DAA collectively in the near future most likely will be able to show definitive evidence on the risk of HCC occurrence and recurrence after DAA with *** long-term risk of HCC in chronic hepatitis C patients with advanced fibrosis or cirrhosis remains high after DAAs with ***,HCC surveillance on this sub-group of patients is important for early detection and intervention of HCC.

关键词： Direct-acting antivirals hepatitis C virus infection risk of hepatocellular carcinoma

Effect of smoking on the risk of gastrointestinal cancer after cholecystectomy: A national population-based cohort study

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World Journal of Gastrointestinal Surgery 2024年第9期16卷 2796-2807页

作者： Minseob Kim Kyung-Do Han Seung-Hyun Ko Yoonkyung Woo Jae Hyun Han Department of Surgery Graduate School of MedicineThe Catholic University of KoreaSeoul 06591South Korea Department of Statistics and Actuarial Science Soongsil UniversitySeoul 06978South Korea division of Endocrinology and Metabolism Department of Internal MedicineSt Vincent’s HospitalCollege of MedicineThe Catholic University of KoreaSuwon 16247South Korea division of Hepatobiliary-Pancreas Surgery and liver Transplantation Department of SurgerySt Vincent’s HospitalCollege of MedicineThe Catholic University of KoreaSuwon 16247South Korea

BACKGROUND The role of smoking in the incidence of colorectal cancer(CRC)or gastric cancer(GC)in populations undergoing cholecystectomy has not been *** To evaluate the effect of smoking on CRC or GC development in cholecystectomy *** A total of 174874 patients who underwent cholecystectomy between January 1,2010 and December 31,2017 were identified using the Korean National Health Insurance Service claims *** patients were matched 1:1 with mem-bers of a healthy population according to age and *** or GC risk after cholecystectomy and the association between smoking and CRC or GC risk in cholecystectomy patients were evaluated using adjusted hazard ratios(HRs)and 95%*** The risks of CRC(adjusted HR:1.15;95%CI:1.06-1.25;P=0.0013)and GC(adjusted HR:1.11;95%CI:1.01-1.22;P=0.0027)were significantly higher in cholecystectomy *** the population who underwent cholecystectomy,both CRC and GC risk were higher in those who had smoked compared to those who had never *** both cancers,the risk tended to increase in the order of non-smokers,ex-smokers,and current *** addition,a positive correlation was observed between the amount of smoking and the risks of both CRC and *** Careful follow-up and screening should be performed,focusing on the increased risk of gastrointestinal cancer in the cholecystectomy group,particularly considering the individual smoking habits.

关键词： Cholecystectomy Smoking,Gastric cancer Colon cancer Risk factor Hazard ratio