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Personalized treatment of well-differentiated gastric neuroendocrine tumors based on clinicopathological classification and grading:A multicenter retrospective study

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Chinese medical Journal 2024年第6期137卷 720-728页

作者： Ju Huang Huimin Liu Dekun Yang Tianming Xu Jing Wang Jingnan Li department of gastroenterology Peking Union Medical College HospitalChinese Academy of Medical SciencesPeking Union Medical CollegeBeijing 100730China Key Laboratory of Gut Microbiota Translational Medicine Research Chinese Academy of Medical SciencesBeijing 100730China department of gastroenterology Affiliated Yantai Yuhuangding Hospital of Qingdao University Medical CollegeYantaiShandong 264000China department of gastroenterology Beijing Zhong-Neng-Jian HospitalBeijing 102401China

Background:The incidence of well-differentiated gastric neuroendocrine tumors(G-NET)is increasing annually,and while they have a good prognosis and low mortality rate,their high recurrence rate makes treatment options *** study aims to determine the relationship between individualized treatment plans and the recurrence of ***:We performed a multicenter,retrospective study of 94 patients with highly differentiated G-NET and treated at Peking Union medical College Hospital,Yantai Yuhuangding Hospital,and Beijing Zhong-Neng-Jian Hospital from November 2015 to September *** factors for recurrence of G-NETs were investigated using chi-squared test and multifactorial logistic regression ***:After a median follow-up of 49 months,the overall recurrence rate among the 94 G-NET patients was 14%(13/94).The recurrence rates of endoscopic mucosal resection(EMR),endoscopic submucosal dissection(ESD),somatostatin analog(SSA)therapy,and surgery were 43%(6/14),10%(5/49),5%(1/22),and 11%(1/9),***-treatment recurrence rates were significantly different(P=0.014)among four treatments(EMR,ESD,SSA,and surgery),and further subgroup comparisons revealed lower recurrence rates in the ESD and SSA groups than in the EMR *** the second month onward,SSA therapy considerably reduced the gastrin levels from 1081.0(571.5,2472.8)pg/mL to 461.5(255.3,795.0)pg/mL(Z=-3.521,P<0.001).Both chi-squared test and multifactorial logistic regression analysis suggested that among the clinicopathological parameters studied,only the pre-treatment gastrin level(P=0.018 and 0.005)and the type of treatment(P=0.014 and 0.017)were significantly associated with G-NET ***:Individualized treatment strategies may reduce the risk of relapse after G-NET ***-term SSA therapy may be a secure and efficacious treatment option for type 1 G-NET with more than six lesions,and it substantially decreases the incidence of post-treatment rec

关键词： Well-differentiated G-NET Serum gastrin Personalized treatment Endoscopic submucosal dissection Endoscopic mucosal resection Somatostatin analog therapy surgical resection Recurrence

Epidemiological, Clinical Aspects and Factors Associated with Typical Gastroesophageal Reflux Disease in the General Population of Parakou, Republic of Benin

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Open Journal of gastroenterology 2024年第2期14卷 41-58页

作者： Saké Khadidjatou Tamou Sambo Bio Elie Zinsou Jocelyne Abla Dovonou Comlan Albert Sehonou Jean Kodjoh Nicolas department of Medicine and medical Specialties Faculty of Medicine University of Parakou Parakou Benin department of Surgery and surgical Specialties Faculty of Medicine University of Parakou Parakou Benin Teaching and Research unit of gastroenterology Faculty of Health Sciences University of Abomey-Calavi Abomey-Calavi Benin

Introduction: Gastroesophageal reflux disease (GERD) is a benign and chronic disease that can impair the quality of life. Objective: To study the epidemiological, clinical aspects and factors associated with typical GERD in the general population of Parakou in the Republic of Benin. Methods: This was a descriptive and analytical cross-sectional study with prospective data collection which took place from May 1, 2019 to June 30, 2019. The study population consisted of any subject aged at least 15 years and living in Parakou. Subjects aged at least 15 years, present on the day of the survey and having given their free and informed verbal consent were included. The Short form of QRS®(Reflux-Qual Short form) questionnaire and the “Hospital Anxiety and Depression” score were used to assess the quality of life and anxiety/depression, respectively. The sampling was probabilistic through a 2-stage cluster sampling. The variable of interest was the presence of GERD. Results: Out of 390 subjects surveyed, 28 had symptoms of typical GERD, representing a prevalence of 7.18%. The average age of these subjects was 27.11 ± 7.88 years. Fifteen subjects (53.57%) were male, giving a sex ratio of 1.15. Fourteen (50%) had a secondary level of education, 12 (42.86%) were pupils/students, 18 (64.29%) were single. The monthly income of 22 subjects (78.57%) was lower than the guaranteed interprofessional minimum wage (40,000 FCFA). The average duration of progression of symptoms was 15.89 ± 4.97 months. Symptoms occurred less than twice a week in 22 subjects (78.57%). The clinical manifestations were both diurnal and nocturnal in 12 subjects (42.86%). None of the 28 subjects with GERD had clinical warning signs. Asthma, diabetes, consumption of high fat or spice foods, carbonated drinks, non-steroidal anti-inflammatory drugs, alcoholic beverages and tobacco were statistically associated with the occurrence of GERD. Each of the 28 subjects had at least one associated factor. A significant i

关键词： Gastroesophageal Reflux Disease Epidemiology General Population Associated Factors Quality of Life Parakou

Necroptosis contributes to non-alcoholic fatty liver disease pathoetiology with promising diagnostic and therapeutic functions

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World Journal of gastroenterology 2024年第14期30卷 1968-1981页

作者： Hong-Ju Sun Bo Jiao Yan Wang Yue-Hua Zhang Ge Chen Zi-Xuan Wang Hong Zhao Qing Xie Xiao-Hua Song department of General Medicine Qingdao Central HospitalUniversity of Health and Rehabilitation Sciences(Qingdao Central Medical Group)Qingdao 266042Shandong ProvinceChina department of gastroenterology Qingdao Central HospitalUniversity of Health and Rehabilitation Sciences(Qingdao Central Medical Group)Qingdao 266042Shandong ProvinceChina department of medical Administration Qingdao Central HospitalUniversity of Health and Rehabilitation Sciences(Qingdao Central Medical Group)Qingdao 266042Shandong ProvinceChina Qingdao medical College Qingdao UniversityQingdao 266042Shandong ProvinceChina department of Infectious Diseases Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghai 200025China

Nonalcoholic fatty liver disease(NAFLD)is the most prevalent type of chronic liver ***,the disease is underappreciated as a remarkable chronic disorder as there are rare managing *** studies have focused on determining NAFLD-caused hepatocyte death to elucidate the disease pathoe-tiology and suggest functional therapeutic and diagnostic ***,ferroptosis,and necroptosis are the main subtypes of non-apoptotic regulated cell deaths(RCDs),each of which represents particular *** the complexity of the findings,the present study aimed to review these types of RCDs and their contribution to NAFLD progression,and subsequently discuss in detail the role of necroptosis in the pathoetiology,diagnosis,and treatment of the *** study revealed that necroptosis is involved in the occurrence of NAFLD and its progression towards steatohepatitis and cancer,hence it has potential in diagnostic and therapeutic ***,further studies are necessary.

关键词： Nonalcoholic fatty liver disease Apoptosis Necroptosis Cell death Diagnosis Treatment

Gastroesophageal reflux following per-oral endoscopic myotomy:Can we improve outcomes?

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World Journal of gastroenterology 2024年第22期30卷 2834-2838页

作者： Inian Samarasam Raj Kumar Joel Anna B Pulimood department of Surgery Upper Gastrointestinal Surgery UnitChristian Medical College&HospitalVellore 632004TamilnaduIndia department of Cardiothoracic Surgery Christian Medical College&HospitalVellore 632004TamilnaduIndia department of Gastrointestinal sciences Christian Medical College and HospitalVellore 632004Tamil NaduIndia

This editorial is an analysis the review article by Nabi et al recently published in this *** Cardia is a disease whose pathophysiology is still *** is known that there is inflammation of unknown aetiology leading to loss of ganglion cells in the muscularis *** end result is lower oesophageal sphincter spasm,loss of receptive relaxation,decreased oesophageal peristalsis,all leading on to varying degrees of *** treatment of this condition is palliative in nature,performed by myotomy of the lower oesophagus either surgically or *** reflux disease(GERD)has been associated with the myotomy performed,particularly with the Peroral Endoscopic Myotomy(POEM)*** et al have provided an excellent overview of the latest developments in predicting,preventing,evaluating,and managing GERD subsequent to *** on this theme,this review article explores the concept of using histology of the oesophageal muscle layer,to grade the disease and thereby help tailoring the length/type of myotomy performed during the POEM *** the future,will a histology based algorithm available preoperatively,help modify the POEM procedure,thereby decreasing the incidence of GERD associated with POEM?

关键词： Achalasia cardia Peroral endoscopic myotomy Laparoscopic Heller’s myotomy Histopathology Histologic grading

Characteristics and risk factor analyses of high-grade intraepithelial neoplasia in older patients with colorectal polyps

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World Journal of Gastrointestinal Oncology 2024年第10期16卷 4129-4137页

作者： Xin Zhang Ying Wang Tong Zhu Jian Ge Jun-Hua Yuan department of Geriatric gastroenterology Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinan 250021Shandong ProvinceChina department of gastroenterology Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinan 250021Shandong ProvinceChina

BACKGROUND According to the degree of intradermal neoplasia in the colorectal exhalation,it can be divided into two grades:Low-grade intraepithelial neoplasia(LGIN)and high-grade intraepithelial neoplasia(HGIN).Currently,it is difficult to accurately diagnose LGIN and HGIN through imaging,and clinical diagnosis depends on postoperative histopathological diagnosis.A more accurate method for evaluating HGIN preoperatively is urgently needed in the surgical treatment and nursing intervention of colorectal *** To explore the characteristics and risk factors of HGIN in older patients with colorectal *** We selected 84 older patients diagnosed with HGIN as the HGIN group(n=95 colonic polyps)and 112 older patients diagnosed with LGIN as the LGIN group(n=132 colonic polyps)from Shandong Provincial Hospital Affiliated to Shandong First medical *** endoscopic features,demographic characteristics,and clinical manifestations of the two patient groups were compared,and a logistic regression model was used to analyze the risk factors for HGIN in these *** The HGIN group was older and had a higher number of sigmoid colon polyps,rectal polyps,pedunculated polyps,polyps≥1.0 cm in size,polyps with surface congestion,polyps with surface depression,and polyps with villous/tubular adenomas,a higher proportion of patients with diabetes and a family history of colorectal cancer,patients who experienced rectal bleeding or occult blood,patients with elevated carcinoembryonic antigen(CEA)and cancer antigen 199(CA199),and lower nutritional levels and higher frailty *** polyp location(in the sigmoid colon or rectum),polyp diameter(≥1.0 cm),pathological diagnosis of(villous/tubular adenoma),family history of colorectal cancer,rectal bleeding or occult blood,elevated serum CEA and CA199 levels,lower nutritional levels and higher frailty levels also are independent risk factors for *** The occurrence of high-grade neoplastic transformat

关键词： Elderly Colorectal polyps High-grade intraepithelial neoplasia Low-grade intraepithelial neoplasia Risk factors

Methyl functionalization of trimesic acid in copper-based metal-organic framework for ammonia colorimetric sensing at high relative humidity

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Chinese Chemical Letters 2024年第6期35卷 211-215页

作者： Yuxin Wang Zhengxuan Song Yutao Liu Yang Chen Jinping Li Libo Li Jia Yao College of Chemical Engineering and Technology Shanxi Key Laboratory of Gas Energy Efficient and Clean UtilizationTaiyuan University of TechnologyTaiyuan 030024China department of gastroenterology Shanxi Bethune HospitalShanxi Academy of Medical SciencesTongji Shanxi HospitalThird Hospital of Shanxi Medical UniversityTaiyuan 030024China

Exhaled ammonia(NH_(3))can be used as a crucial biomarker of kidney and liver ***,the high humidity in the detection conditions remains a challenge for accurate detection by gas ***,a copper-based metal-organic framework(CH_(3)-Cu-BTC)with methyl(CH_(3)^(-))functionalization of trimesic acid was synthesized for NH_(3) colorimetric *** CH_(3)-Cu-BTC exhibited a strong response for 5 ppm NH_(3) with high selectivity under high relative humidity(75%RH).Density functional theory(DFT)simulations indicated that the NH_(3) molecules interacted more strongly with CH_(3)-Cu-BTC than H_(2)O molecules did,and the corresponding color switching was attributed to the lone-pair electron in NH_(3) changing the coordination environment of Cu^(2+)ions,leading to an obviously visible color switching response from ruby green to *** on the tailor-made pore chemistry,the precise detection of trace amounts of NH_(3) in exhaled air was realized through functionalized MOF *** strategy used in this study not only offers a new pathway for the rapid detection of low concentration NH_(3) under humid conditions,but also shows a method for early respiration diagnosis of kidney and liver diseases.

关键词： Metal-organic framework Ammonia sensing Naked-eye color switching High humidity Respiration diagnosis

The outcomes and safety of patients undergoing endoscopic retrograde cholangiopancreatography combining a single-use cholangioscope and a single-use duodenoscope:A multicenter retrospective international study

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Hepatobiliary & Pancreatic Diseases International 2024年第1期23卷 71-76页

作者： Alessandro Fugazza Matteo Colombo Michel Kahaleh V.Raman Muthusamy Bick Benjamin Wim Laleman Carmelo Barbera Carlo Fabbri Jose Nieto Abed Al-Lehibi Mohan Ramchandani Amy Tyberg Haroon Shahid Avik Sarkar Dean Ehrlich Stuart Shermand Cecilia Binda Marco Spadaccini Andrea Iannone Kareem Khalaf Nageshwar Reddy Andrea Anderloni Alessandro Repici Division of gastroenterology and Digestive Endoscopy Humanitas Research Hospital-IRCCSVia Manzoni 5620089RozzanoMilanoItaly gastroenterology Rutgers Robert Wood JohnsonNew BrunswickNew JerseyUSA Vatche and Tamar Manoukian Division of Digestive Diseases University of CaliforniaLos Angeles School of Medicine at UCLALos AngelesCaliforniaUSA Division of Digestive and Liver Disorders Indiana University School of MedicineIndianapolisINUSA department of gastroenterology and Hepatology University Hospitals LeuvenKU Leuven3000 LeuvenBelgium U.O.C.di Gastroenterologia ed Endoscopia Digestiva Ospedale Giuseppe MazziniASL TeramoItaly gastroenterology and Digestive Endoscopy unit Forlì-Cesena HospitalsAUSL RomagnaForlì-CesenaItaly Borland Groover Clinic JacksonvilleFloridaUSA department of gastroenterology and Hepatology King Fahad Medical CityRiyadhSaudi Arabia Asian Institute of gastroenterology HyderabadIndia Section of gastroenterology Department of Emergency and Organ TransplantationUniversity of BariBari 70124Italy department of Biomedical sciences Humanitas UniversityVia Rita Levi Montalcini 420090Pieve EmanueleMilanItaly

Background: Duodenoscope-related multidrug-resistant organism(MDRO) infections raise concerns. Disposable duodenoscopes have been recently introduced in the market and approved by regulatory agencies with the aim to reduce the risk of endoscopic retrograde cholangiopancreatography(ERCP) associated infections. The aim of this study was to evaluate the outcome of procedures performed with single-use duodenoscopes in patients with clinical indications to single-operator cholangiopancreatoscopy. Methods: This is a multicenter international, retrospective study combining all patients who underwent complex biliopancreatic interventions using the combination of a single-use duodenoscope and a single-use cholangioscope. The primary outcome was technical success defined as ERCP completion for the intended clinical indication. Secondary outcomes were procedural duration, rate of cross-over to reusable duodenoscope, operator-reported satisfaction score(1 to 10) on performance rating of the single-use duodenoscope, and adverse event(AE) rate. Results: A total of 66 patients(26, 39.4% female) were included in the study. ERCP was categorized according to ASGE ERCP grading system as 47(71.2%) grade 3 and 19(28.8%) grade 4. The technical success rate was 98.5%(65/66). Procedural duration was 64(interquartile range 15-189) min, cross-over rate to reusable duodenoscope was 1/66(1.5%). The satisfaction score of the single-use duodenoscope classified by the operators was 8.6 ± 1.3 points. Four patients(6.1%) experienced AEs not directly related to the single-use duodenoscope, namely 2 post-ERCP pancreatitis(PEP), 1 cholangitis and 1 ***: Single-use duodenoscope is effective, reliable and safe even in technically challenging procedures with a non-inferiority to reusable duodenoscope, making these devices a viable alternative to standard reusable equipment.

关键词： Single-operator cholangioscopy Single-use duodenoscope Endoscopic retrograde cholangiopancreatography Indeterminate biliary stricture Difficult biliary stones

Gastroesophageal reflux following peroral endoscopic myotomy for achalasia:Bumps in the road to success

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World Journal of gastroenterology 2024年第29期30卷 3461-3464页

作者： David Itskoviz Stephen David Howard Malnick Kaplan medical Center Institute of Gastroenterology and HepatologyHebrew University Medical School of JerusalemRehovot 76100Israel Kaplan medical Center Department of Internal Medicine CHebrew University Medical School of JerusalemRehovot 76100Israel

Achalasia can significantly impair the quality of *** clinical presentation typically includes dysphagia to both solids and liquids,chest pain,and *** can be delayed in patients with atypical presentations,and they might receive a wrong diagnosis,such as gastroesophageal reflux disease(GERD),owing to overlapping symptoms of both *** the cause of achalasia is poorly understood,its impact on the motility of the esophagus and gastroesophageal junction is well *** treatment modalities have been utilized,with the most common being surgical Heller myotomy with concomitant fundoplication and pneumatic balloon ***,peroral endoscopic myotomy(POEM)has gained popularity as an effective treatment for achalasia,despite a relatively high incidence of GERD occurring after treatment compared to other *** magnitude of post-POEM GERD depends on its definition and is influenced by patient and procedure-related *** longterm sequelae of post-POEM GERD are yet to be determined,but it appears to have a benign course and is usually manageable with clinically available *** risk factors for post-POEM GERD and modifying the POEM procedure in selected patients may improve the overall success of this technique.

关键词： Achalasia Per-oral endoscopic myotomy Gastroesophageal reflux Pneumatic dilatation Heller myotomy Proton pump inhibitor Acidic fermentation

Transurethral prostate surgery in prostate cancer patients: A population-based comparative analysis of complication and mortality rates

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Asian Journal of Urology 2024年第1期11卷 48-54页

作者： Michele Marchioni Giulia Primiceri Alessandro Veccia Marta Di Nicola Umberto Carbonara Fabio Crocerossa Ugo Falagario Ambra Rizzoli Riccardo Autorino Luigi Schips Laboratory of Biostatistics Department of MedicalOral and Biotechnological Sciences“G.d'Annunzio”University of ChietiChietiItaly Urology unit Department of MedicalOral and Biotechnological Sciences“G.d'Annunzio”University of ChietiChietiItaly Division of Urology VCU HealthRichmondVAUSA

Objective:Prostate cancer(PCa)patients might experience lower urinary tract symptoms as those diagnosed with benign prostatic hyperplasia(BPH).Some of them might be treated for their lower urinary tract symptoms instead of *** aimed to test the effect of PCa versus BPH on surgical outcomes after transurethral prostate surgery,namely complication and mortality ***:Within the American College of Surgeons National surgical Quality Improvement Program database(2011-2016),we identified patients who underwent transurethral resection of the prostate,photoselective vaporization,or laser *** were stratified according to postoperative diagnosis(PCa ***).Univariable and multivariable logistic regression models evaluated the predictors of perioperative morbidity and mortality.A formal test of interaction between diagnosis and surgical technique used was ***:Overall,34542 patients were *** all,2008(5.8%)had a diagnosis of *** multivariable logistic regression model failed to show statistically significant higher rates of postoperative complications in PCa patients(odds ratio:0.9,95%confidence interval:0.7-1.1;p=0.252).Moreover,similar rates of perioperative mortality(p=0.255),major acute cardiovascular events(p=0.581),transfusions(p=0.933),and length of stay of more than or equal to 30 days(p=0.174)were ***,all tests failed to show an interaction between post-operative diagnosis and surgical technique ***:Patients diagnosed with PCa do not experience higher perioperative morbidity or mortality after transurethral prostate surgery when compared to their BPH ***,the diagnosis seems to not influence surgical technique outcomes.

关键词： Prostatecancer Transurethral surgery of the prostate Prostate surgery Population-based analysis Benign prostatic hyperplasia Lasersurgery