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Antioxidant enriched enteral nutrition and oxidative stress after major gastrointestinal tract surgery

World Journal of Gastroenterology 2008年第45期14卷 6960-6969页

作者： Mireille FM van Stijn Gerdien C Ligthart-Melis Petra G Boelens Peter G Scheffer Tom Teerlink Jos WR Twisk Alexander PJ Houdijk Paul AM van Leeuwen Department of surgery VU University Medical Center Amsterdam Amsterdam and Medical Center Alkmaar Department of surgery VU University Medical Center Amsterdam Department of surgery Catharina Hospital Department of Clinical Chemistry VU University Medical Center Amsterdam Department of Epidemiology and Biostatistics VU University Medical Center Amsterdam Department of surgery Medical Center Alkmaar

AIM: To investigate the effects of an enteral supple-ment containing antioxidants on circulating levels of antioxidants and indicators of oxidative stress after major gastrointestinal ***: Twenty-one patients undergoing major upper gastrointestinal tract surgery were randomised in a single centre, open label study on the effect of postoperative enteral nutrition supplementedwith antioxidants. The effect on circulating levels of antioxidants and indicators of oxidative stress, such as F2-isoprostane, was studied. RESULTS: The antioxidant enteral supplement showed no adverse effects and was well tolerated. After surgery a decrease in the circulating levels of antioxidant parameters was observed. Only selenium and glutamine levels were restored to pre-operative values one week after surgery. F2-isoprostane increased in the first three postoperative days only in the antioxidant supplemented group. Lipopolysaccharide binding protein (LBP) levels decreased faster in the antioxidant group after ***: Despite lower antioxidant levels there was no increase in the circulating markers of oxidative stress on the first day after major abdominal surgery. The rise in F2-isoprostane in patients receiving the antioxidant supplement may be related to the conversion of antioxidants to oxidants which raises questions on antioxidant supplementation. Module AOX restored the postoperative decrease in selenium levels. The rapid decrease in LBP levels in the antioxidant group suggests a possible protective effect on gut wall integrity. Further studies are needed on the role of oxidative stress on outcome and the use of antioxidants in patients undergoing major abdominal surgery.

关键词： Antioxidants Critical illness Enteral nutrition Oxidative stress surgery Upper gastrointestinal tract

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Iatrogenic bile duct injuries:Etiology,diagnosis and management

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World Journal of Gastroenterology 2009年第33期15卷 4097-4104页

作者： Beata Jab■ońska Pawe■ Lampe Department of Digestive tract surgery University Hospital of the Medical University of Silesia

Iatrogenic bile duct injuries (IBDI) remain an important problem in gastrointestinal surgery. They are most frequently caused by laparoscopic cholecystectomy which is one of the commonest surgical procedures in the world. The early and proper diagnosis of IBDI is very important for surgeons and gastroenterologists, because unrecognized IBDI lead to serious complications such as biliary cirrhosis, hepatic failure and death. Laboratory and radiological investigations play an important role in the diagnosis of biliary injuries. There are many classifications of IBDI. The most popular and simple classification of IBDI is the Bismuth scale. Endoscopic techniques are recommended for initial treatment of IBDI. When endoscopic treatment is not effective, surgical management is considered. Different surgical reconstructions are performed in patients with IBDI. According to the literature, Roux- en-Y hepaticojejunostomy is the most frequent surgical reconstruction and recommended by most authors. In the opinion of some authors, a more physiological and equally effective type of reconstruction is end- to-end ductal anastomosis. Long term results are the most important in the assessment of the effectiveness of IBDI treatment. There are a few classifications for the long term results in patients treated for IBDI; the Terblanche scale, based on clinical biliary symptoms, is regarded as the most useful classification. Proper diagnosis and treatment of IBDI may avoid many serious complications and improve quality of life.

关键词： Iatrogenic disease Biliary drainage Bile ducts Cholecystectomy Roux-en-Y anastomosis Surgical injuries Surgical anastomosis

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Effectiveness and tolerability of programmed cell death protein-1 inhibitor+chemotherapy compared to chemotherapy for upper gastrointestinal tract cancers

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World Journal of gastrointestinal Oncology 2024年第4期16卷 1613-1625页

作者： Xiao-Min Zhang Ting Yang Ying-Ying Xu Bao-Zhong Li Wei Shen Wen-Qing Hu Cai-Wen Yan Liang Zong Department of Central Laboratory Changzhi People’s HospitalThe Affiliated Hospital of Changzhi Medical CollegeChangzhi 046000Shanxi ProvinceChina Department of gastrointestinal surgery Yizheng People’s HospitalThe Affiliated Hospital of Yangzhou UniversityYangzhou 225000Jiangsu ProvinceChina Department of General surgery Anyang Tumor HospitalAnyang 455000Henan ProvinceChina Department of General surgery Wuxi People’s Hospital Affiliated to Nanjing Medical UniversityWuxi 214023Jiangsu ProvinceChina Department of gastrointestinal surgery Changzhi People’s HospitalThe Affiliated Hospital of Changzhi Medical CollegeChangzhi 046000Shanxi ProvinceChina Department of Gastroenterology Changzhi People’s HospitalThe Affiliated Hospital of Changzhi Medical CollegeChangzhi 046000Shanxi ProvinceChina

BACKGROUND The combination of programmed cell death protein-1(PD-1)inhibitor and che-motherapy is approved as a standard first-or second-line treatment in patients with advanced oesophageal or gastric ***,it is unclear whether this combination is superior to chemotherapy *** To assess the comparative effectiveness and tolerability of combining PD-1 inhibitors with chemotherapy vs chemotherapy alone in patients with advanced gastric cancer,gastroesophageal junction(GEJ)cancer,or oesophageal *** We searched the PubMed and Embase databases for studies that compared the efficacy and tolerance of PD-1 inhibitors in combination with chemotherapy vs chemotherapy alone in patients with advanced oesophageal or gastric *** employed either random or fixed models to analyze the outcomes of each clinical trial,en-compassing data on overall survival(OS),progression-free survival(PFS),objective response rate,and adverse events(AEs).RESULTS Nine phase 3 clinical trials(7016 advanced oesophageal and gastric cancer patients)met the inclusion *** meta-analysis demonstrated that the pooled PD-1 inhibitor+chemotherapy group had a significantly longer OS than the chemotherapy-alone group[hazard ratio(HR)=0.76,95%confidence interval(CI):0.71-0.81];the pooled PFS result was consistent with that of OS(HR=0.67,95%CI:0.61-0.74).The count of patients achieving an objective response in the PD-1 inhibitor+chemotherapy group surpassed that of the chemotherapy-alone group[odds ratio(OR)=1.86,95%CI:1.59-2.18].AE incidence was also higher in the combination-therapy group than in the chemotherapy-alone group,regardless of whether≥grade 3 only(OR=1.30,95%CI:1.07-1.57)or all AE grades(OR=1.88,95%CI:1.39-2.54)were *** performed a subgroup analysis based on the programmed death-ligand 1(PD-L1)combined positive score(CPS)and noted extended OS and PFS durations within the CPS≥1,CPS≥5,and CPS≥10 subgroups of the PD-1 inhibitor+chemotherapy ***

关键词： Programmed cell death protein-1 inhibitor Chemotherapy Oesophageal squamous cell carcinoma Gastric/gastroesophageal junction adenocarcinoma Overall survival Progression-free survival Objective response rate Adverse event

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Pancreatic intraductal papillary mucinous neoplasms:Current diagnosis and management

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World Journal of gastrointestinal Oncology 2021年第12期13卷 1880-1895页

作者： Beata Jabłońska PawełSzmigiel Sławomir Mrowiec Department of Digestive tract surgery Medical University of SilesiaKatowice 40-752Poland

Intraductal papillary mucinous neoplasms(IPMNs)represent approximately 1%of all pancreatic neoplasms and 25%of cystic *** are divided into three types:main duct-IPMN(MD-IPPMN),branch duct-IPMN(BD-IPMN),and mixed *** this review,diagnostics,including clinical presentation and radiological investigations,were *** resonance imaging is the most useful for most *** depends on the type and radiological features of *** is recommended for *** BD-IPMN,management involves surgery or surveillance depending on the tumor size,cyst growth rate,solid components,main duct dilatation,high-grade dysplasia in cytology,the presence of symptoms(jaundice,new-onset diabetes,pancreatitis),and CA 19.9 serum *** patient’s age and comorbidities should also be taken into ***,there are different guidelines regarding the diagnosis and management of *** this review,the following guidelines were presented:Sendai International Association of Pancreatology guidelines(2006),American Gastroenterological Association guidelines,revised international consensus Fukuoka guidelines(2012),revised international consensus Fukuoka guidelines(2017),and European evidence-based guidelines according to the European Study Group on Cystic Tumours of the Pancreas(2018).The Verona Evidence-Based Meeting 2020 was also presented and discussed.

关键词： Pancreatic cyst Pancreatic cystic neoplasm Intraductal papillary mucinous neoplasm Pancreatic cancer Pancreatectomy Guidelines

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Association between acute pancreatitis and COVID-19 infection:What do we know?

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World Journal of gastrointestinal surgery 2021年第6期13卷 548-562页

作者： Beata Jabłońska Marek Olakowski Sławomir Mrowiec Department of Digestive tract surgery Medical University of SilesiaKatowice 40-752Poland

The disease caused by severe acute respiratory syndrome coronavirus 2(SARSCoV-2),also called coronavirus disease 2019(COVID-19),first originated in Wuhan,China,displaying atypical pneumonia-like respiratory symptoms in affected ***-CoV-2 primarily attacks the respiratory system,and the most common symptoms include cough,shortness of breath,and ***,its impact on the digestive system has been shown,and various clinical gastrointestinal manifestations of this disease have been *** reports have shown acute pancreatitis(AP)as the initial symptom in patients with *** may be a consequence of direct pancreatic damage by the virus because pancreatic acinar cells contain angiotensin-converting enzyme 2 receptor proteins,and SARS-CoV-2 can bind to these receptors,causing pancreatic ***,AP may be a secondary indicator of cytokine storms and altered inflammatory *** review of the literature shows that SARS-CoV-2 appears to be a new etiological infectious factor related to *** this manuscript,a comprehensive review of case reports and case series of patients with AP and COVID-19 is *** reports on COVID-19-associated AP are *** cases are thoroughly analyzed and discussed in-depth.

关键词： SARS-CoV-2 COVID-19 Acute pancreatitis Angiotensin-converting enzyme 2

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The role of reactive oxygen species in gastric cancer

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Cancer Biology & Medicine 2024年第9期21卷 740-753页

作者： Yuqi Wang Jingli Xu Zhenjie Fu Ruolan Zhang Weiwei Zhu Qianyu Zhao Ping Wang Can Hu Xiangdong Cheng College of Pharmaceutical Sciences Zhejiang University of TechnologyHangzhou 310014China Department of Gastric surgery Zhejiang Cancer HospitalHangzhou 310022China Key Laboratory of Prevention Diagnosis and Therapy of Upper Gastrointestinal Cancer of Zhejiang ProvinceHangzhou 310022China Zhejiang Provincial Research Center for Upper gastrointestinal tract Cancer Zhejiang Cancer HospitalHangzhou 310022China

Gastric cancer(GC)ranks fifth in cancer incidence and fourth in cancer-related mortality *** oxygen species(ROS)are highly oxidative oxygen-derived products that have crucial roles in cell signaling regulation and maintaining internal *** are closely associated with the occurrence,development,and treatment of *** review summarizes recent findings on the sources of ROS and the bidirectional regulatory effects on GC and discusses various treatment modalities for GC that are related to ROS *** addition,the regulation of ROS by natural small molecule compounds with the highest potential for development and applications in anti-GC research is *** aim of the review is to accelerate the clinical application of modulating ROS levels as a therapeutic strategy for GC.

关键词： Gastric cancer reactive oxygen species ROSantitumor therapy natural products pharmacology

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Robotic vs laparoscopic abdominoperineal resection for rectal cancer:A propensity score matching cohort study and metaanalysis

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World Journal of gastrointestinal surgery 2024年第5期16卷 1280-1290页

作者： Li Song Wen-Qiong Xu Zheng-Qiang Wei Gang Tang Department of gastrointestinal surgery Chengdu Fifth People's HospitalChengdu 610000Sichuan ProvinceChina Department of Nephrology Chengdu Fifth People's HospitalChengdu 610000Sichuan ProvinceChina Department of gastrointestinal surgery The First Affiliated Hospital of Chongqing Medical UniversityChongqing 400000China Division of Biliary tract surgery Department of General SurgeryWest China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina

BACKGROUND Robotic surgery(RS)is gaining popularity;however,evidence for abdominoperineal resection(APR)of rectal cancer(RC)is *** To compare the efficacy of RS and laparoscopic surgery(LS)in APR for *** We retrospectively identified patients with RC who underwent APR by RS or LS from April 2016 to June *** regarding short-term surgical outcomes were compared between the two *** reduce the effect of potential confounding factors,propensity score matching was used,with a 1:1 ratio between the RS and LS groups.A meta-analysis of seven trials was performed to compare the efficacy of robotic and laparoscopic APR for RC *** Of 133 patients,after propensity score matching,there were 42 patients in each *** postoperative complication rate was significantly lower in the RS group(17/42,40.5%)than in the LS group(27/42,64.3%)(P=0.029).There wasno significant difference in operative time(P=0.564),intraoperative transfusion(P=0.314),reoperation rate(P=0.314),lymph nodes harvested(P=0.309),or circumferential resection margin(CRM)positive rate(P=0.314)between the two *** meta-analysis showed patients in the RS group had fewer positive CRMs(P=0.04),lesser estimated blood loss(P<0.00001),shorter postoperative hospital stays(P=0.02),and fewer postoperative complications(P=0.002)than patients in the LS *** Our study shows that RS is a safe and effective approach for APR in RC and offers better short-term outcomes than LS.

关键词： Robotic surgery Laparoscopic surgery Abdominoperineal resection Postoperative complications Propensity score

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Current status of early gastric cancer screening research

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Cancer Biology & Medicine 2024年第3期21卷 218-222页

作者： Can Hu Li Yuan Xiangdong Cheng Department of Gastric surgery Zhejiang Cancer HospitalHangzhou Institute of Medicine(HIM)Chinese Academy of SciencesHangzhouZhejiang 310022China Key Laboratory of Prevention Diagnosis and Therapy of Upper Gastrointestinal Cancer of Zhejiang ProvinceHangzhou 310022China Zhejiang Provincial Research Center for Upper gastrointestinal tract Cancer Zhejiang Cancer HospitalHangzhou 310022China

Gastric cancer is a predominant threat to the health and well-being of China's residents. Data from the World Health Organization(WHO) in 2020 revealed that gastric cancer in China notably accounted for 44.0% of new c... 详细信息

关键词： cancer Gastric gastric

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Is endoscopic therapy the treatment of choice in all patients with chronic pancreatitis?

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World Journal of Gastroenterology 2013年第1期19卷 12-16页

作者： Beata Jab ońska Department of Digestive tract surgery University Hospital of the Medical University of Silesia40-752 KatowicePoland

Chronic pancreatitis(CP) is a progressive inflammatory disease of the pancreas characterized by destruction of the pancreatic parenchyma with subsequent fibrosis that leads to pancreatic exocrine and endocrine *** pain and local complications(bile duct or duodenal stenosis and pancreatic tumor) secondary to CP are indications for *** the beginning,medical therapy is *** invasive treatment is recommended for patients with pancreatic duct stones(PDS) and pancreatic obstruction in whom standard medical therapy is not ***,Clarke et al assessed the long-term effectiveness of endoscopic therapy(ET) in CP *** authors compared ET with medical *** reported that ET was clinically successful in 50% of patients with symptomatic *** this commentary,current CP treatment,including indications for ET and surgery in CP patients,is *** for endoscopic treatment of CP according to the European Society of gastrointestinal Endoscopy Clinical Guidelines are *** surgical methods used in the treatment of CP patients are also *** is the most useful in patients with large PDS,pancreatic duct obstruction and *** should be the first-line option because it is less invasive than *** should be the first-line option in patients in whom ET has failed or in those with a pancreatic mass with suspicion of *** is a very effective and less invasive procedure,but it cannot be recommended as the treatment of choice in all CP patients.

关键词： Chronic pancreatitis Endoscopic therapy surgery Endoscopic retrograde cholangiopancreatography Endoscopy

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The effect of Shen-Fu on gastrointestinal tract injury and its potential mechanism during cardio-pulmonary bypass in patients undergoing cardiac surgery

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Chinese Journal of Traumatology 2003年第4期6卷 245-248页

作者：夏中元詹丽英何宇红刘先义 Department of Anesthesiology People’s HospitalWuhan UniversityWuhan 430060China Department of Anesthesiology People’s HospitalWuhan UniversityWuhan 430060Chinabjective: To investigate the effect of Shen-Fu (SF) injection on gastrointestinal tract injury and its potential mechanism.Methods: Thirty-eight patients undergoing elective open heart surgery were assigned to Group C (control group n = 18) and Group SF (n = 20) randomly. In Group SF the patients received intravenous injection of SF (0.5 ml/kg) at the beginning of the surgery followed by a continuous infusion of 100 ml SF (1.0 ml/kg) solution diluted by saline at a rate of 0.004 ml .Kg-1 .min-1 with a Grasby pump. The control group was injected with normal saline in the same volume. Gastric intramucosal pH (pHi) activity of blood diamine oxidase ( DAO ) and concentrations of blood LPS and IL-6 were measured before CPB ( S0) and 1 h ( S1 ) and 2 h ( S2) after aortic declamping respectively.Results: In Group C pHi value was significantly lower at S1 and S2 than at S0 ( mean P <0.01) and blood DAO and concentrations of LPS and IL-6 were significantly higher at S1 and S2 than at S0 ( meanP < 0.01). In Group SF pHi was obviously lower at S1 and S2 than at S0(P< 0.05) but LPS and IL-6 levels and DAO were higher at S (mean P<0.05). Blood DAO and LPS level demonstrated significant negative correlations with pHi ( mean P < 0.01) while LPS concentration showed a positive correlation with blood DAO (P < 0.01) and IL-6 concentration (P < 0.05). At S1 and S2 after aortic declamping the levels of pHi were higher in Group SF than in Group C (mean P <0.01 ) but DAO and LPS and IL-6 levels were significantly lower in Group SF than in Group C ( P <0.01).Conclusions: SF has a protective effect on gastrointestinal tract and can reduce inflammatory actions.

Objective: To investigate the effect of Shen-Fu (SF) injection on gastrointestinal tract injury and its potential mechanism.Methods: Thirty-eight patients undergoing elective open heart surgery were assigned to Group C (control group, n = 18) and Group SF (n = 20) randomly. In Group SF, the patients received intravenous injection of SF (0.5 ml/kg) at the beginning of the surgery followed by a continuous infusion of 100 ml SF (1.0 ml/kg) solution diluted by saline at a rate of 0.004 ml · Kg-1 · min-1 with a Grasby pump. The control group was injected with normal saline in the same volume. Gastric intramucosal pH (pHi), activity of blood diamine oxidase ( DAO ), and concentrations of blood LPS and IL-6 were measured before CPB ( S0) and 1 h ( S1 ) and 2 h ( S2) after aortic declamping, respectively.Results: In Group C, pHi value was significantly lower at S1 and S2 than at S0 ( mean P gastrointestinal tract and can reduce inflammatory actions.

关键词： gastrointestinal tract Wounds and injuries Cardiopulmonary bypass Shen-Fu injection

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