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Liver parasites:A global endemic and journey from infestation to intervention

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World Journal of gastroenterology 2025年第1期31卷 8-15页

作者： Yumna Shahid Bushra Emman Shahab Abid Department of Medicine Section of GastroenterologyAga Khan University HospitalKarachi 75500SindhPakistan Aga Khan Medical College Aga Khan University HospitalKarachi 75500SindhPakistan

Parasites have coexisted with humans throughout history,forming either symbiotic relationships or causing significant morbidity and *** liver is particularly vulnerable to parasitic infections,which can reside in,pass through,or be transported to the liver,leading to severe *** editorial explores various parasites that infect the liver,their clinical implications,and diagnostic considerations,as discussed in the article“Parasites of the liver:A global problem?”.Parasites reach the liver primarily through oral ingestion,mucosal penetration,or the bloodstream,with some larvae even penetrating the *** parasites such as cestodes(Echinococcus),trematodes(Clonorchis,Opisthorchis),nematodes(Ascaris),and protozoa(Entamoeba histolytica)can also cause systemic infections like visceral leishmaniasis,malaria,cryptosporidiosis,and *** infections like clonorchiasis and opisthorchiasis are linked to persistent hepatobiliary inflammation,potentially progressing to cholangiocarcinoma,a fatal bile duct cancer,particularly prevalent in Southeast *** global nature of liver parasite infestations is alarming,with hundreds of millions affected ***,control over treatment quality remains *** the significant public health threat posed by these parasites,international medical organizations must prioritize improved diagnosis,treatment,and preventive *** educational efforts and enhancing healthcare provider training are critical steps toward mitigating the global impact of parasitic liver diseases.

关键词： Liver flukes Nematodes Cestodes Trematodes Protozoa Parasites

Prevalence of Helicobacter pylori infection in Chinese military personnel:A cross-sectional,multicenter-based study

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World Journal of gastroenterology 2025年第3期31卷 42-49页

作者： Han-Chen Min Chun-Yan Zhang Fang-Yu Wang Xiao-Hui Yu Shan-Hong Tang Hong-Wu Zhu Ya-Gang Zhao Ji-Luo Liu Jian Wang Jing-Han Guo Xiao-Mei Zhang Yun-Sheng Yang Chinese People’s Liberation Army Medical School Chinese People’s Liberation Army General HospitalBeijing 100853China Department of gastroenterology and Hepatology The First Medical CenterChinese People’s Liberation Army General HospitalBeijing 100853China Sixth Healthcare Department The Second Medical CenterChinese People’s Liberation Army General HospitalBeijing 100853China Department of gastroenterology The 940th Hospital of Joint Logistic Support Force of Chinese People’s Liberation ArmyLanzhou 730050Gansu ProvinceChina Department of gastroenterology General Hospital of Western Theater CommandChengdu 610011Sichuan ProvinceChina Department of gastroenterology General Hospital of Southern Theater CommandGuangzhou 510010Guangdong ProvinceChina Department of Epidemiology Naval Medical UniversityShanghai 200433China School of Medicine Nankai UniversityTianjin 300071China National Clinical Research Center for Geriatric Diseases Chinese People’s Liberation Army General HospitalBeijing 100853China

BACKGROUND Helicobacter pylori(***)infection is a prevalent disease encountered in military internal medicine and recognized as the main cause of dyspepsia,gastritis,and peptic ulcer,which are common diseases in military *** guidelines in China state all patients with evidence of active infection with *** are offered ***,the prevalence of *** infection and its regional distribution in the military population remain unclear,which hinders effective prevention and treatment *** the prevalence of *** infection in the military population will aid in the development of customized strategies to better manage this infectious *** To investigate the prevalence of *** infection in the Chinese military population in different geographic *** This multicenter,retrospective study included 22421 individuals from five tertiary hospitals located in north,east,southwest,and northwest cities of *** infection was identified using the urea breath test,which had been performed between January 2020 and December *** Of the 22421 military service members,7416(33.1%)were urea breath *** highest prevalence of *** was in the 30-39 years age group for military personnel,with an infection rate of 34.9%.The majority of infected subjects were younger than 40-years-old,accounting for 70.4%of the infected *** individuals serviced in Lanzhou and Chengdu showed a higher infection prevalence than those in Beijing,Nanjing,and Guangzhou,with prevalence rates of 44.3%,37.9%,29.0%,31.1%,and 32.3%,*** *** infection remains a common infectious disease among military personnel in China and has a relatively high prevalence rate in northwest China.

关键词： Helicobacter pylori Prevalence Military personnel Urea breath test Multicenter study

Biologics in the management of pediatric inflammatory bowel disease:When and what to choose

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World Journal of Clinical Pediatrics 2025年第1期14卷 21-45页

作者： Arghya Samanta Anshu Srivastava Department of Pediatric gastroenterology Sanjay Gandhi Postgraduate Institute of Medical SciencesLucknow 226014Uttar PradeshIndia

Pediatric inflammatory bowel disease(PIBD)is a chronic inflammatory disorder of the gastrointestinal tract,with rising global incidence and *** the past two decades,biologics have added to the therapeutic armamentarium and revolutionized the approach to treatment of inflammatory bowel *** available biologics include monoclonal antibodies which target inflammatory cytokines(anti-tumor necrosis factor alpha,anti-interleukin 12/23)or recruitment of leucocytes to the gastrointestinal tract(anti-alpha4beta7 integrin)and small molecules(Janus kinase inhibitors,sphingosine 1-phosphate-inhibitors)which modify the proinflammatory *** their potential disease-modifying ability,recent pediatric guidelines from the West have advocated upfront use of biologics in appropriate clinical scenarios as a top-down approach rather than the conventional step-up *** real-world studies are available regarding the clinical efficacy of biologics in PIBD,there is paucity of long-term outcome and safety data in ***,little information is available about the best approach in the newly industrialized-developing countries where PIBD is rising but at the same time,infections are prevalent and resources are *** this review,we summarize the efficacy and safety profile of biologics and small molecule drugs and discuss the challenges in the management of PIBD,especially in the developing world,and future directions.

关键词： Biologics Children Inflammatory bowel disease Therapeutic drug monitoring Dual biologic

Real-world evidence on the efficacy and safety of vonoprazanamoxicillin dual therapy for Helicobacter pylori treatment in elderly patients

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World Journal of gastroenterology 2025年第1期31卷 68-78页

作者： Wen Gao Jing-Wen Li Hui Ye Xue-Zhi Zhang Jian-Xiang Liu Hong Cheng Department of gastroenterology Peking University First HospitalBeijing 100034China School of Medicine Tsinghua MedicineTsinghua UniversityBeijing 100034China Department of Traditional Chinese Medicine and Integrative Medicine Peking University First HospitalBeijing 100034China

BACKGROUND A dual therapy regimen containing amoxicillin is a common treatment option for the eradication of Helicobacter pylori(***).While substantial research supports the efficacy and safety of vonoprazan and amoxicillin(VA)dual therapy in the general population,there is still a lack of studies specifically focusing on its safety in elderly *** To evaluate efficacy and safety of VA dual therapy as first-line or rescue treatment for *** in elderly *** As a real-world retrospective study,data were collected from elderly patients aged 60 years and above who accepted VA dual therapy(vonoprazan 20 mg twice daily+amoxicillin 1000 mg thrice daily for 14 days)for *** eradication in the Department of gastroenterology at Peking University First Hospital between June 2020 and January *** status was evaluated by^(13)C-urease breath test 6 weeks after *** adverse events(AEs)during treatment were *** In total,401 cases were ***-one cases were excluded due to loss to follow-up,lack of re-examination,or unwillingness to take *** total of 380 included cases comprised 250 who received VA dual therapy as first-line treatment and 130 who received VA dual therapy as rescue *** was successfully eradicated in 239 cases(95.6%)in the first-line treatment group and 116 cases(89.2%)in the rescue treatment *** overall incidence of AEs was 9.5%for both ***,9.2%of patients experienced an AE in the first-line treatment group and 10.0%in the rescue treatment *** patients discontinued treatment due to AE,with a discontinuation rate of 1.3%.No serious AE *** The VA dual therapy regimen as a first-line treatment and a rescue therapy was effective and safe for elderly patients aged 60 and older.

关键词： Helicobacter pylori Vonoprazan Amoxicillin Dual therapy Elderly

Predictive findings forHelicobacter pylori-uninfected, -infected and -eradicated gastric mucosa: Validation study

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World Journal of gastroenterology 2013年第27期19卷 4374-4379页

作者： Kazuhiro Watanabe Naoyoshi Nagata Ryo Nakashima Etsuko Furuhata Takuro Shimbo Masao Kobayakawa Toshiyuki Sakurai Koh Imbe Ryota Niikura Chizu Yokoi Junichi Akiyama Naomi Uemura Department of gastroenterology and Hepatology National Center for Global Health and Medicine Department of Clinical Research and Informatics National Center for Global Health and Medicine Department of gastroenterology and Hepatology National Center for Global Health and MedicineKohnodai Hospital

AIM:To validate the usefulness of screening endoscopy findings for predictingHelicobacter pylori (H. pylori) infection status. METHODS:H. pylori infection status was determined by histology, serology, and the urea breast test in 77 consecutive patients who underwent upper endoscopy. Based on the findings, patients were categorized as H. pylori -uninfected, -infected, or -eradicated cases. Using six photos of certain sites in the stomach per case, we determined the presence or absence of the following endoscopic findings:regular arrangement of collecting venules (RAC), linear erythema, hemorrhage, fundic gland polyp (FGP), atrophic change, rugal hyperplasia, edema, spotty erythema, exudate, xanthoma, and mottled patchy erythema (MPE). The diagnostic odds ratio (DOR) and inter-observer agreement (Kappa value) for these 11 endoscopic findings used in the determination of H. pylori infection status were calculated. RESULTS:Of the 77 patients [32 men and 45 women; mean age (SD), 39.7 (13.4) years] assessed, 28 were H. pylori uninfected, 28 were infected, and 21 were eradicated. DOR values were significantly high (< 0.05) for the following H. pylori cases:uninfected cases with RAC (11.5), linear erythema (24.5), hemorrhage (4.1), and FGP (34.5); for infected cases with atrophic change (8.67), rugal hyperplasia (15.8), edema (14.2), spotty erythema (11.5), and exudate (3.52); and for eradicated cases with atrophic change (32.4) and MPE (103.0). Kappa values were excellent for FGP (0.93), good for RAC (0.63), hemorrhage (0.79), atrophic change (0.74), and MPE (0.75), moderate for linear erythema (0.51), rugal hyperplasia (0.49), edema (0.58), spotty erythema (0.47), and exudate (0.46), and poor for xanthoma (0.19). CONCLUSION:The endoscopic findings of RAC, hemorrhage, FGP, atrophic change, and MPE will be useful for predicting H. pylori infection status.

关键词： Diagnostic odds ratio Endoscopic finding Eradication therapy Helicobacter pylori Inter-observer agreement

Gender disparities and woman-specific trends in Barrett’s esophagus in the United States:An 11-year nationwide populationbased study

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World Journal of Methodology 2025年第1期15卷 60-71页

作者： Karina Fatakhova Faisal Inayat Hassam Ali Pratik Patel Attiq Ur Rehman Arslan Afzal Muhammad Sarfraz Shiza Sarfraz Gul Nawaz Ahtshamullah Chaudhry Rubaid Dhillon Arthur Dilibe Benjamin Glazebnik Lindsey Jones Emily Glazer Division of gastroenterology and Hepatology Mather Hospital and Zucker School of Medicine at Hofstra UniversityPort JeffersonNY 11777United States Department of Internal Medicine Allama Iqbal Medical CollegeLahorePunjab 54550Pakistan Division of gastroenterology and Hepatology East Carolina University Brody School of MedicineGreenvilleNC 27834United States Division of gastroenterology and Hepatology Geisinger Wyoming Valley Medical CenterWilkes-BarrePA 18711United States Department of Internal Medicine East Carolina University Brody School of MedicineGreenvilleNC 27834United States Department of Internal Medicine St.Dominic's HospitalJacksonMS 39216United States Department of gastroenterology Hepatologyand NutritionCleveland Clinic FoundationClevelandOH 44195United States Department of Internal Medicine Mather Hospital and Hofstra University ZuckerSchool of MedicinePort JeffersonNY 11777United States

BACKGROUND Barrett's esophagus(BE)is a known premalignant precursor to esophageal adenocarcinoma(EAC).The prevalence rates continue to rise in the United States,but many patients who are at risk of EAC are not *** practice guidelines include male gender as a predisposing factor for BE and *** population-based clinical evidence regarding female gender remains *** To study comparative trends of gender disparities in patients with BE in the United *** A nationwide retrospective study was conducted using the 2009-2019 National Inpatient Sample(NIS)*** with a primary or secondary diagnosis code of BE were *** major outcome of interest was determining the gender disparities in patients with *** analysis for respective outcomes for females was also reported to ascertain any time-based *** We identified 1204190 patients with BE for the study *** the included patients,717439(59.6%)were men and 486751(40.4%)were *** mean age was higher in women than in men(67.1±0.4 vs 66.6±0.3 years,P<0.001).The rate of BE per 100000 total NIS hospitalizations for males increased from 144.6 in 2009 to 213.4 in 2019(P<0.001).The rate for females increased from 96.8 in 2009 to 148.7 in 2019(P<0.001).There was a higher frequency of obesity among women compared to men(17.4%vs 12.6%,P<0.001).Obesity prevalence among females increased from 12.3%in 2009 to 21.9%in 2019(P<0.001).A lower prevalence of smoking was noted in women than in men(20.8%vs 35.7%,P<0.001).However,trend analysis showed an increasing prevalence of smoking among women,from 12.9%in 2009 to 30.7%in 2019(P<0.001).Additionally,there was a lower prevalence of alcohol abuse,Helicobacter pylori(***),and diabetes mellitus among females than males(P<0.001).Trend analysis showed an increasing prevalence of alcohol use disorder and a decreasing prevalence of *** and diabetes mellitus among women(P<0.001).CONCLUSION The prevalence of BE among

关键词： Barrett’s esophagus Gender disparity Epidemiological trends Esophageal adenocarcinoma Screening endoscopy Female gender Risk factors

Risk factors for adverse in-hospital outcomes in acute colonic diverticular hemorrhage

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World Journal of gastroenterology 2015年第37期21卷 10697-10703页

作者： Naoyoshi Nagata Ryota Niikura Tomonori Aoki Shiori Moriyasu Toshiyuki Sakurai Takuro Shimbo Katsunori Sekine Hidetaka Okubo Kazuhiro Watanabe Chizu Yokoi Junichi Akiyama Mikio Yanase Masashi Mizokami Kazuma Fujimoto Naomi Uemura Department of gastroenterology and Hepatology National Center for Global Health and Medicine Department of Clinical Research and Informatics National Center for Global Health and Medicine Department of gastroenterology and Hepatology National Center for Global Health and Medicine Kohnodai Hospital Kohnodai Department of Internal Medicine and Gastrointestinal Endoscopy Saga Medical School

AIM: To investigate the factors associated with transfusion, further bleeding, and prolonged length of ***: In total, 153 patients emergently hospitalized for diverticular bleeding who were examined by colonoscopy were prospectively enrolled. Patients in whom the bleeding source was identified received endoscopic treatment such as clipping or endoscopic ligation. After spontaneous cessation of bleeding withconservative treatment or hemostasis with endoscopic treatment, all patients were started on a liquid food diet and gradually progressed to a solid diet over 3d, and were discharged. At enrollment, we assessed smoking, alcohol, medications [non-steroidal antiinflammatory drugs(NSAIDs)], low-dose aspirin, and other antiplatelets, warfarin, acetaminophen, and oral corticosteroids), and co-morbidities [hypertension,diabetes mellitus, dyslipidemia, cerebro-cardiovascular disease, chronic liver disease, and chronic kidney disease(CKD)]. The in-hospital outcomes were need for transfusion, further bleeding after spontaneous cessation of hemorrhage, and length of hospital *** odds ratio(OR) for transfusion need, further bleeding, and prolonged length of stay were estimated by logistic regression ***: No patients required angiographic embolization or surgery. Stigmata of bleeding occurred in 18% of patients(27/153) and was treated by endoscopic procedures. During hospitalization, 40patients(26%) received a median of 6 units of packed red blood cells. Multivariate analysis revealed that female sex(OR = 2.5, P = 0.02), warfarin use(OR= 9.3, P 70years(OR = 2.1, P = 0.04) and NSAID use(OR = 2.7,P = 0.03) were

关键词： In-hospital adverse clinical outcomes Antithrombot

Comparative effectiveness of traditional chemoembolization with or without sorafenib for hepatocellular carcinoma

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World Journal of Hepatology 2013年第7期5卷 364-371页

作者： Adnan Muhammad Manish Dhamija Gitanjali Vidyarthi Donald Amodeo William Boyd Branko Miladinovic Ambuj Kumar Department of gastroenterology University of South Florida Department of gastroenterology James A Haley VA Hospital Department of Internal Medicine Morsani College of Medicine Center for Evidence Based Medicine

AIM: To compare the overall survival (OS) and progression-free survival (PFS) with associated adverse events (AE) in patients with unresectable hepatocellular carcinoma (HCC) treated with transarterial chemoembolization (TACE) + sorafenib vs TACE alone. METHODS: In this retrospective cohort study we collected data on all consecutive patients with a diagnosis of unresectable HCC between 2007 and 2011 who had been treated with TACE + sorafenib or TACE alone. We hypothesized that the combination therapy is superior to TACE alone in improving the survival in these patients. Data extracted included patient's demographics, etiology of liver disease, histology of HCC, stage of liver disease with respect to model of end stage liverdisease score and Child-Turcotte-Pugh (CTP) classification and Barcelona Clinic Liver Cancer (BCLC) staging for HCC. Computed tomography scan findings, alpha fetoprotein levels, number of treatments and related AE were also recorded and analyzed. RESULTS: Of the 43 patients who met inclusion criteria, 13 were treated with TACE + sorafenib and 30 with TACE alone. There was no significant difference in median survival: 20.6 mo (95%CI: 13.4-38.4) for the TACE + sorafenib and 18.3 mo (95%CI: 11.8-32.9) for the TACE alone (P = 0.72). There were also no statistically significant differences between groups in OS (HR = 0.82, 95%CI: 0.38-1.77; P = 0.61), PFS (HR = 0.93, 95%CI: 0.45-1.89; P = 0.83), and treatment-related toxicities (P = 0.554). CTP classification and BCLC staging for HCC were statistically significant (P = 0.001, P = 0.04 respectively) in predicting the survival in patients with HCC. The common AE observed were abdominal pain, nausea, vomiting and mild elevation of liver enzymes. CONCLUSION: Combination therapy with TACE + sorafenib is safe and equally effective as TACE alone in patients with unresectable HCC. CTP classification and BCLC staging were the significant predictors of survival. Future trials with large number of patients are nee

关键词： Hepatocellular carcinoma Transarterial chemoembolization Sorafenib Survival Adverse events

Prognostic model for esophagogastric variceal rebleeding after endoscopic treatment in liver cirrhosis: A Chinese multicenter study

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World Journal of gastroenterology 2025年第2期31卷 85-101页

作者： Jun-Yi Zhan Jie Chen Jin-Zhong Yu Fei-Peng Xu Fei-Fei Xing De-Xin Wang Ming-Yan Yang Feng Xing Jian Wang Yong-Ping Mu Cell Biology Laboratory Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese MedicineShanghai 201203China Institute of Liver Diseases Shanghai Academy of Chinese MedicineShanghai 201203China Clinical Key Laboratory of Traditional Chinese Medicine of Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese MedicineShanghai 201203China Key Laboratory of Liver and Kidney Disease of the Ministry of Education Shanghai University of Traditional Chinese MedicineShanghai 201203China Department of gastroenterology and Hepatology Zhongshan Hospital Affiliated to Fudan UniversityShanghai 200032China Shanghai Institute of Liver Disease Fudan UniversityShanghai 200032China evidence-Based Medicine Center Fudan UniversityShanghai 200032China Department of Gastrointestinal Endoscopy Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese MedicineShanghai 201203China Department of Hepatology Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese MedicineShanghai 201203China

BACKGROUND Rebleeding after recovery from esophagogastric variceal bleeding(EGVB)is a severe complication that is associated with high rates of both incidence and *** its clinical importance,recognized prognostic models that can effectively predict esophagogastric variceal rebleeding in patients with liver cirrhosis are *** To construct and externally validate a reliable prognostic model for predicting the occurrence of esophagogastric variceal *** This study included 477 EGVB patients across 2 cohorts:The derivation cohort(n=322)and the validation cohort(n=155).The primary outcome was rebleeding events within 1 *** least absolute shrinkage and selection operator was applied for predictor selection,and multivariate Cox regression analysis was used to construct the prognostic *** validation was performed with bootstrap *** assessed the discrimination,calibration and accuracy of the model,and performed patient risk *** Six predictors,including albumin and aspartate aminotransferase concentrations,white blood cell count,and the presence of ascites,portal vein thrombosis,and bleeding signs,were selected for the rebleeding event prediction following endoscopic treatment(REPET)*** predicting rebleeding within 1 year,the REPET model ex-hibited a concordance index of 0.775 and a Brier score of 0.143 in the derivation cohort,alongside 0.862 and 0.127 in the validation ***,the REPET model revealed a significant difference in rebleeding rates(P<0.01)between low-risk patients and intermediate-to high-risk patients in both *** We constructed and validated a new prognostic model for variceal rebleeding with excellent predictive per-formance,which will improve the clinical management of rebleeding in EGVB patients.

关键词： Esophagogastric variceal bleeding Variceal rebleeding Liver cirrhosis Prognostic model Risk stratification Secondary prophylaxis