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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

Role of endoscopic ultrasound-guided biliary drainage for palliation of malignant biliary obstruction

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World Journal of Gastrointestinal Surgery 2024年第8期16卷 2369-2373页

作者： Sahib Singh Saurabh Chandan Antonio Facciorusso department of Internal Medicine Sinai HospitalBaltimoreMD 21215United States Center for Interventional Endoscopy(CIE) Advent HealthOrlandoFL 32803United States gastroenterology unit Department of Medical and Surgical SciencesUniversity of FoggiaFoggia 71122Italy

Endoscopic ultrasound-guided biliary drainage(EUS-BD)directs bile flow into the digestive tract and has been mostly used in patients with malignant biliary obstruction(MBO)where endoscopic retrograde cholangiopancreatography-guided biliary drainage was unsuccessful or was not *** apposing metal stents(LAMS)are deployed during EUS-BD,with the newer electrocautery-enhanced LAMS reducing procedure time and complication rates due to the inbuilt cautery at the catheter ***-BD with electrocautery-enhanced LAMS has high technical and clinical success rates for palliation of MBO,with bleeding,cholangitis,and stent occlusion being the most common adverse *** studies have even suggested comparable efficacy between EUS-BD and endosc-opic retrograde cholangiopancreatography as the primary approach for distal *** this editorial,we commented on the article by Peng et al published in the recent issue of the World Journal of Gastrointestinal Surgery in 2024.

关键词： Endoscopic ultrasound Endoscopic ultrasound guided biliary drainage Cancer Pancreas Bile duct Endoscopy

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

Protective and Adverse Roles of DDX3X in Different Cell Types in Nonalcoholic Steatohepatitis Progression

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Research 2024年第3期6卷 561-574页

作者： Suzhen Yang Lin Zhou Tianming Zhao Hanlong Zhu Tingting Luo Kang Jiang Xiaoxiao Shi Chunyan Chen Han Zhang Si Zhao Xiaoping Zou Yuzheng Zhuge Fangyu Wang Lei Wang Mingzuo Jiang Bing Xu department of gastroenterology the Affiliated Drum Tower Hospital of Nanjing University Medical SchoolJiangsuNanjing210002China. department of gastroenterology and Hepatology the Affiliated Jinling Hospital of Nanjing University Medical SchoolJiangsuNanjing210002China School of Medicine Northwest UniversityShaanxiXi’an710069China. department of gastroenterology Nanjing Drum Tower HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeJiangsuNanjing210008China.

Persistent hepatic cellular metabolic stress and liver inflammatory stimuli are key signatures of nonalcoholic steatohepatitis(NASH).DDX3X is a vital molecule involved in cell fate decisions in both pro-survival stress granule(SG)and pro-death NOD-like receptor family pyrin domain containing 3(NLRP3)inflammasome assembly in response to stress ***,the role of DDX3X in NASH remains *** characterized the cell type-specific roles of DDX3X in *** liver tissues from NASH patients and normal control subjects were collected to assess DDX3X expression and *** steatohepatitis models were constructed by feeding macrophage-specific DDX3X knockout(DDX3^(XΔMφ)),hepatocyte-specific DDX3X knockout(DDX3X^(Δhep)),and wild-type control(DDX3X^(fl/fl))mice a high-fat and high-cholesterol(HFHC)diet,a methionine-and choline-deficient(MCD)diet,and a high-fat/high-iron/high-fructose/high-cholesterol,low-methionine,and choline-deficient(HFHIHFHC-MCD)*** study demonstrated that DDX3X was predominantly expressed in macrophages and hepatocytes in control liver tissues,and its expression was down-regulated in patients or mice with *** to DDX3X^(fl/fl) littermates,DDX3^(XΔMφ)mice showed improved liver histology in nutritional steatohepatitis *** of macrophage DDX3X inhibited NLRP3 inflammasome-mediated pyroptosis,causing anti-inflammatory M2 polarization and alleviating hepatocyte steatohepatitic ***3X^(Δhep) mice developed marked steatohepatitis in multiple nutritional steatohepatitis models compared to DDX3X^(fl/fl) ***3X-deleted hepatocytes showed impaired SG assembly,leading to increased sensitivity and intolerance to metabolic stimulation and resultant *** conclusion,DDX3X plays opposite roles in different cell types during the progression of NASH.A better understanding of the cell-specific differences in the crosstalk between SG formation and NLRP3 activation is crucial for developing pr

关键词： NLRP3 impaired inhibited

Chronic hepatitis B:Prevent,diagnose,and treat before the point of no return

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World Journal of Hepatology 2024年第10期16卷 1151-1157页

作者： Sudheer Marrapu Ramesh Kumar department of gastroenterology All India Institute of Medical SciencesPatna 801507India

Hepatitis B remains a significant global health challenge,contributing to substantial morbidity and *** 254 million people world-wide live with Chronic hepatitis B(CHB),with the majority of cases occurring in sub-Saharan Africa and the Western Pacific ***,only about 13.4%of the individuals infected with this disease have been diagnosed,and awareness of hepatitis B virus(HBV)infection status is as low as 1%in sub-Saharan *** 2022,CHB led to 1.1 million deaths *** World Health Organization(WHO)has set a target of eliminating hepatitis B as a public health concern by 2030;however,this goal appears increasingly unattainable due to multiple *** challenges include low vaccination coverage;a large number of undiagnosed cases;a low proportion of patients eligible for treatment under current guidelines;limited access to healthcare;and the costs associated with lifelong *** of HBV can yield significant clinical benefits within a long window of ***,the benefits of therapy are markedly diminished when the disease is detected at the advanced cirrhosis *** editorial aim to highlight the current challenges in hepatitis care and the necessary steps to achieve the WHO's hepatitis elimination goals for 2030.

关键词： Chronic hepatitis B Hepatitis B virus Cirrhosis Decompensation Hepato-cellular carcinoma

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

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(<30 d)and long-term *** In this retrospective,population-based cohort study,individuals that had received a gastrostomy between 1998-2019 in Sweden were *** were identified in the Swedish National Patient Register,and survival analysis was possible by cross-referencing the Swedish Death *** cohort was divided into three age groups: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(P<0.001).The use of PEG more than doubled(about 800 to 1800/year),with a corresponding decrease in open gastrostomy(about 700 to 340/year).Laparoscopic gastrostomy increased more than ten-fold(about 20 to 240/year).Overall,PEG,open gastrostomy,and laparoscopic gastrostomy constituted 70.0%(n=34060),23.3%(n=11336),and 4.9%(n=2404),***-related mortality was 0.1%(n=44)overall(PEG:0.05%,open:0.24%,laparoscopic:0.04%).The overall 30-d mortality rate was 10.0%(PEG:9.8%,open:12.4%,laparoscopic:1.7%)and decreased from 11.6%in 1998-2009 vs 8.5%in 2010-2019(P<0.001).One-year and ten-year survival rates for children,adults,and elderly were 93.7%,67.5%,a

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

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

Targeting GPR65 alleviates hepatic inflammation and fibrosis by suppressing the JNK and NF-κB pathways

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Military medical Research 2024年第4期11卷 500-520页

作者： Kun Zhang Meng-Xia Zhang Xiao-Xiang Meng Jing Zhu Jia-Jun Wang Yi-Fan He Ye-Hua Li Si-Cong Zhao Zhe-Min Shi Li-Na Zheng Tao Han Wei Hong department of Histology and Embryology School of Basic Medical SciencesTianjin Medical UniversityTianjin 300070China department of Hepatology and gastroenterology Tianjin Union Medical CenterTianjin Medical UniversityTianjin Union Medical Center Affiliated to Nankai UniversityTianjin 300000China

Background:G-protein coupled receptors(GPCRs)are recognized as attractive targets for drug ***,it remains poorly understood how GPCRs,except for a few chemokine receptors,regulate the progression of liver ***,we aimed to reveal the role of GPR65,a proton-sensing receptor,in liver fibrosis and to elucidate the underlying ***:The expression level of GPR65 was evaluated in both human and mouse fibrotic ***,Gpr65-deficient mice were treated with either bile duct ligation(BDL)for 21 d or carbon tetrachloride(CCl4)for 8 weeks to investigate the role of GPR65 in liver fibrosis.A combination of experimental approaches,including Western blotting,quantitative real-time reverse transcription-polymerase chain reaction(qRT-PCR),and enzyme-linked immunosorbent assay(ELISA),confocal microscopy and rescue studies,were used to explore the underlying mechanisms of GPR65’s action in liver ***,the therapeutic potential of GPR65 inhibitor in the development of liver fibrosis was ***:We found that hepatic macrophage(HM)-enriched GPR65 was upregulated in both human and mouse fibrotic ***,knockout of Gpr65 significantly alleviated BDL-and CCl4-induced liver inflammation,injury and fibrosis in vivo,and mouse bone marrow transplantation(BMT)experiments further demonstrated that the protective effect of Gpr65knockout is primarily mediated by bone marrow-derived macrophages(BMMs).Additionally,in vitro data demonstrated that Gpr65 silencing and GPR65 antagonist inhibited,while GPR65 overexpression and application of GPR65 endogenous and exogenous agonists enhanced the expression and release of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and transforming growth factor-β(TGF-β),all of which subsequently promoted the activation of hepatic stellate cells(HSCs)and the damage of hepatocytes(HCs).Mechanistically,GPR65 overexpression,the acidic pH and GPR65 exogenous agonist induced up-regulation of

关键词： GPR65 Hepatic fibrosis Hepatic macrophages Inflammation c-Jun N-terminal kinase Nuclear factorκB