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Clinical manifestation,lifestyle,and treatment patterns of chronic erosive gastritis:A multicenter real-world study in China

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World Journal of gastroenterology 2024年第9期30卷 1108-1120页

作者： Ying-Yun Yang Ke-Min Li Gui-Fang Xu Cheng-Dang Wang Hua Xiong Xiao-Zhong Wang Chun-Hui Wang Bing-Yong Zhang Hai-Xing Jiang Jing Sun Yan Xu Li-Juan Zhang Hao-Xuan Zheng Xiang-Bin Xing Liang-Jing Wang Xiu-Li Zuo Shi-Gang Ding Rong Lin Chun-Xiao Chen Xing-Wei Wang Jing-Nan Li department of gastroenterology Peking Union Medical College HospitalPeking Union Medical CollegeChinese Academy of Medical SciencesBeijing 100730China department of gastroenterology Nanjing Drum Tower HospitalNanjing 21000Jiangsu ProvinceChina department of gastroenterology The First Affiliated Hospital of Fujian Medical UniversityFuzhou 350005Fujian ProvinceChina department of gastroenterology Renji HospitalShanghai 200127China department of gastroenterology Union Hospital of Fujian Medical UniversityFuzhou 350000Fujian ProvinceChina department of gastroenterology West China Hospital of Sichuan UniversityChengdu 610041Sichuan ProvinceChina department of gastroenterology and Hepatology The People’s Hospital of Zhengzhou UniversityThe Henan Provincial People’s HospitalZhengzhou 450003Henan ProvinceChina department of gastroenterology The First Affiliated Hospital of Guangxi Medical UniversityNanning 530021Guangxi Zhuang Autonomous RegionChina Ruijin Hospital Shanghai Jiaotong University School of medicine Shanghai Jiao Tong UnivesrityRuijin HospitalSchool MedicineShanghai 200025China department of gastroenterology and Hepatology China-Japan Union Hospital of Jilin UniversityChangchun 130033Jilin ProvinceChina department of gastroenterology Fujian Medical University Union HospitalFuzhou 350001Fujian ProvinceChina department of gastroenterology Nanfang HospitalGuangzhou 510080Guangdong ProvinceChina department of gastroenterology The First Affiliated HospitalSun Yat-sen UniversityGuangzhou 510080Guangdong ProvinceChina department of gastroenterology The Second Affiliated Hospital Zhejiang University School of MedicineHangzhou 310000Zhejiang ProvinceChina department of gastroenterology Shandong University Qilu HospitalJinan 250012Shandong ProvinceChina department of gastroenterology Peking University Third HospitalBeijing 100191China department of gastroenterology Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430022Hubei Pr

BACKGROUND Although chronic erosive gastritis(CEG)is common,its clinical characteristics have not been fully *** lack of consensus regarding its treatment has resulted in varied treatment *** To explore the clinical characteristics,treatment patterns,and short-term outcomes in CEG patients in *** We recruited patients with chronic non-atrophic or mild-to-moderate atrophic gastritis with erosion based on endoscopy and *** and treating physicians completed a questionnaire regarding history,endoscopic findings,and treatment plans as well as a follow-up questionnaire to investigate changes in symptoms after 4 wk of *** Three thousand five hundred sixty-three patients from 42 centers across 24 cities in China were *** pain(68.0%),abdominal distension(62.6%),and postprandial fullness(47.5%)were the most common presenting *** was classified as chronic non-atrophic in 69.9%of *** those with erosive lesions,72.1%of patients had lesions in the antrum,51.0%had multiple lesions,and 67.3%had superficial flat *** patients with epigastric pain,the combination of a mucosal protective agent(MPA)and proton pump inhibitor was more *** those with postprandial fullness,acid regurgitation,early satiety,or nausea,a MPA appeared more *** CEG is a multifactorial disease which is common in Asian patients and has non-specific *** may play a major role in its detection and *** should be individualized based on symptom profile.

关键词： Chronic erosive gastritis Symptom Endoscopic findings Treatment pattern Real-world

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Alanine aminotransferase predicts incident steatotic liver disease of metabolic etiology: Long life to the old biomarker!

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World Journal of gastroenterology 2024年第24期30卷 3016-3021页

作者： Amedeo Lonardo department of internal medicine Azienda Ospedaliero-Universitaria of Modena(2023)Modena 41126Italy

Alanine aminotransferase(ALT)serum levels increase because of hepatocellular *** dysfunction-associated fatty liver disease(MAFLD),which identifies steatotic liver disease(SLD)associated with≥2 metabolic abnormalities,has prominent sexual *** Metabolic Syndrome defines a cluster comprising abdominal obesity,altered glucose metabolism,dyslipidemia,and *** sex,body mass index,glucose,lipids,ferritin,hypertension,and age independently predict ALT levels among blood *** the last few decades,the reference range of ALT levels has been animatedly debated owing to attempts to update sex-specific reference *** this backset,Chen et al have recently published a study which has two main ***,>80%of indi-viduals with MAFLD had normal ALT ***,there was a linear increa-sing trend in the association between cumulative excess high-normal ALT levels and the rate of incident *** study has biologically credible ***,it inaccurately considered sex differences in the MAFLD ***,future studies on SLD owing to metabolic dysfunction should adopt locally determined and prospectively validated reference ranges of ALT and carefully consider sex differences in liver enzymes and MAFLD pathobiology.

关键词： Alanine aminotransferase Biomarker History of medicine Metabolic dysfunction-associated fatty liver disease Metabolism Nonalcoholic fatty liver disease Reference range Sex differences Steatotic liver disease

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Urgent one-stage endoscopic treatment for choledocholithiasis related moderate to severe acute cholangitis: A propensity scorematched analysis

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World Journal of gastroenterology 2024年第15期30卷 2118-2127页

作者： Yang Zhou Yin-Qiu Zhang Shuai-Jing Huang Yan Liang Xiao Liang Masoom Wali Ya-Dong Feng department of gastroenterology Zhongda HospitalSchool of MedicineSoutheast UniversityNanjing 210009Jiangsu ProvinceChina department of gastroenterology BenQ Medical CenterThe Affiliated BenQ Hospital of Nanjing Medical UniversityNanjing 210019Jiangsu ProvinceChina

BACKGROUND During emergency endoscopic retrograde cholangiopancreatography(ERCP),the safety and feasibility of performing one-stage endoscopic treatment for patients with acute cholangitis(AC)due to choledocholithiasis are *** To investigate the safety and feasibility of one-stage endoscopic treatment for moderate to severe *** We enrolled all patients diagnosed with moderate to severe cholangitis due to common bile duct stones from January 2019 to July *** outcomes were compared in this study between patients who underwent ERCP within 24 h and those who underwent ERCP 24 h later,employing a propensity score(PS)*** primary outcomes were intensive care unit(ICU)admission rates,ICU length of stay,and duration of antibiotic *** In total,we included 254 patients and categorized them into two groups based on the time elapsed between admission and intervention:The urgent group(≤24 h,n=102)and the elective group(>24 h,n=152).Ninety-three pairs of patients with similar characteristics were selected by PS *** urgent ERCP group had more ICU admissions(34.4%vs 21.5%,P=0.05),shorter ICU stays(3 d vs 9 d,P<0.001),fewer antibiotic use(6 d vs 9 d,P<0.001),and shorter hospital stays(9 d vs 18.5 d,P<0.001).There were no significant differences observed in adverse events,in-hospital mortality,recurrent cholangitis occurrence,30-d readmission rate or 30-d *** Urgent one-stage ERCP provides the advantages of a shorter ICU stay,a shorter duration of antibiotic use,and a shorter hospital stay.

关键词： Acute cholangitis Endoscopic retrograde cholangiopancreatography One-stage treatment Optimal time

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Pipeline of New Drug Treatment for Non-alcoholic Fatty Liver Disease/Metabolic Dysfunction-associated Steatotic Liver Disease

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Journal of Clinical and Translational Hepatology 2024年第9期12卷 802-814页

作者： Ye Hu Chao Sun Ying Chen Yu-Dong Liu Jian-Gao Fan department of gastroenterology Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiChina department of Geriatrics Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiChina department of gastroenterology Changxing branch of Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiChina

Given the global prevalence and rising incidence of metabolic dysfunction-associated steatotic liver disease(MASLD),the absence of licensed medications is striking.A deeper understanding of the heterogeneous nature of MASLD has recently contributed to the discovery of novel groups of agents and the potential repurposing of currently available *** therapies center on four major *** the close relationship between MASLD and type 2 diabetes,the first approach involves antidiabetic medications,including incretins,thiazolidinedione insulin sensitizers,and sodium-glucose cotransporter 2 *** second approach targets hepatic lipid accumulation and the resultant metabolic *** in this group include peroxisome proliferatoractivated receptor agonists(e.g.,pioglitazone,elafibranor,saroglitazar),bile acid-farnesoid X receptor axis regulators(obeticholic acid),de novo lipogenesis inhibitors(aramchol,NDI-010976),and fibroblast growth factor 21/19 *** third approach focuses on targeting oxidative stress,inflammation,and *** in this group include antioxi-dants(vitamin E),tumor necrosis factor a pathway regulators(emricasan,pentoxifylline,ZSP1601),and immune modulators(cenicriviroc,belapectin).The final group targets the gut(IMM-124e,solithromycin).Combination therapies targeting different pathogenetic pathways may provide an alternative to MASLD treatment with higher efficacy and fewer side *** review aimed to provide an update on these medications.

关键词： NAFLD MASLD Clinical trial Medication Hypoglycemic agents Intermediary metabolism

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Perianal Crohn’s disease:Still more questions than answers

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World Journal of gastroenterology 2024年第39期30卷 4260-4266页

作者： Akhilesh Swaminathan Miles P Sparrow department of medicine University of OtagoChristchurch 8011CanterburyNew Zealand department of gastroenterology Alfred HealthMelbourne 3004VictoriaAustralia department of gastroenterology The Alfred HospitalMelbourne 3004VictoriaAustralia department of gastroenterology Alfred Health and School of Translational MedicineMonash UniversityMelbourne 3004VictoriaAustralia

In this editorial we comment on the article by Pacheco et al published in a recent issue of the World Journal of *** focus specifically on the burden of illness associated with perianal fistulizing Crohn’s disease(PFCD)and the diagnostic and therapeutic challenges in the management of this ***-ving evidence has shifted the diagnostic framework for PFCD from anatomical classification systems,to one that is more nuanced and patient-focused to drive ongoing decision *** editorial aims to reflect on these aspects to help clinicians face the challenge of PFCD in day-to-day clinical practice.

关键词： Perianal Crohn’s disease Crohn’s disease classification Disease severity Crohn’s disease treatment Anorectal malignancy

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Metabolic syndrome’s new therapy:Supplement the gut microbiome

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World Journal of Diabetes 2024年第4期15卷 793-796页

作者： Yong-Wei Xu Jun Tian Yan Song Ba-Cui Zhang Jing Wang department of gastroenterology Songjiang HospitalSchool of MedicineShanghai Jiaotong UniversityShanghai 201600China

This letter to the editor discusses the publication on gut microbiome supple-mentation as therapy for metabolic *** microbiome dysbiosis disrupts intestinal bacterial homeostasis and is related to chronic inflammation,insulin resistance,cardiovascular diseases,type 2 diabetes mellitus,and *** research has found that increasing the abundance of beneficial microbiota in the gut modulates metabolic syndrome by reducing chronic inflammation and insulin ***,probiotics,synbiotics,and postbiotics are often used as supplements to increase the number of beneficial microbes and thus the produc-tion of short-chain fatty acids,which have positive effects on the gut microbiome and metabolic *** this review article,the author summarizes the available supplements to increase the abundance of beneficial gut microbiota and reduce the abundance of harmful microbiota in patients with metabolic *** group is also researching the role of the gut microbiota in chronic liver *** article will be of great help to our *** the end of the letter,the mechanism of the gut microbiota in chronic liver disease is discussed.

关键词： Gut microbiome Metabolic syndrome Diabetes mellitus Short-chain fatty acids Chronic liver disease

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Clinical pathological characteristics of“crawling-type”gastric adenocarcinoma cancer:A case report

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World Journal of Gastrointestinal Oncology 2024年第4期16卷 1660-1667页

作者： Yong-Wei Xu Yan Song Jun Tian Ba-Cui Zhang Yu-Sheng Yang Jing Wang department of gastroenterology Songjiang HospitalSchool of MedicineShanghai Jiaotong UniversityShanghai 201600China department of Pathology Songjiang HospitalSchool of MedicineShanghai Jiaotong UniversityShanghai 201600China

BACKGROUND Gastric cancer(GC)is a significant health problem worldwide,and early detection and accurate diagnosis are crucial for improving patient ***-type gastric adenocarcinoma is a rare subtype of GC that has unique histopathological and clinical characteristics,and its diagnosis and management can be *** pathological type of GC is also *** SUMMARY Here,we report the case of a patient who underwent ordinary endoscopy,na-rrow-band imaging,and endoscopic ultrasonography intending to determine the extent of tumor invasion and upper abdominal enhanced computed tomography and whether there was tumor ***,endoscopic submucosal dissection was *** pathological and immunohistochemical examination,the pathological diagnosis was crawling-type gastric *** is a very rare and special pathological type of *** case highlights the importance of using advanced endoscopic techniques and pathological examination in diagnosing and managing gastric crawling-type ***,the findings underscore the need for continued research and clinical experience in this rare subtype of GC to improve patient *** The“crawling-type”GC is a rare and specific tumor *** is difficult to identify and diagnose gliomas via *** tumor is ill-defined,with a flat appearance and indistinct borders due to the lack of contrast against the background *** revealed that the tumor cells were hand-like,so the patient has diagnosed with“crawling-type”gastric adenocarcinoma.

关键词： Clinicopathological Crawling-type gastric Pathology Gastric cancer Gastric adenocarcinoma cancer Case report

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Clinical and socioeconomic determinants of survival in biliary tract adenocarcinomas

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World Journal of Gastrointestinal Oncology 2024年第4期16卷 1374-1383页

作者： Laura Sahyoun Kay Chen Cynthia Tsay George Chen Petr Protiva department of gastroenterology and Hepatology Weill Cornell MedicineNew YorkNY 10065United States gastroenterology Section Jennifer Moreno VA San Diego Healthcare SystemSan DiegoCA 92161United States Division of gastroenterology Department of MedicineUniversity of California San DiegoLa JollaCA 92093United States department of gastroenterology and Hepatology John Hopkins HospitalBaltimoreMD 21287United States department of Digestive Diseases Yale New Haven HospitalNew HavenCT 06520United States department of gastroenterology VA Connecticut Health Care SystemWest HavenCT 06516United States

BACKGROUND Despite advances in detection and treatments,biliary tract cancers continue to have poor survival ***,there is limited data investigating the significance of socioeconomic status,race/ethnicity,and environmental factors in biliary tract cancer *** from the Surveillance,Epidemiology,and End Results database for biliary and gallbladder adenocarcinomas were extracted from 1975 to ***-conomic data included smoking,poverty level,education,adjusted household income,and percentage of foreign-born persons and urban *** was calculated with Cox proportional hazards models for death in the 5-year period following *** Our study included 15883 gallbladder,11466 intrahepatic biliary,12869 extrahepatic biliary and 7268 ampulla of Vater adenocarcinoma *** analyzing county-specific demographics,patients from counties with higher incomes were associated with higher survival rates[hazard ratio(HR)=0.97,P<0.05].Similarly,counties with a higher percentage of patients with a college level education and counties with a higher urban population had higher 5-year survival rates(HR=0.96,P=0.002 and HR=0.97,P=0.004,respectively).CONCLUSION Worse survival outcomes were observed in lower income counties while higher income and education level were associated with higher 5-year overall survival among gallbladder and biliary malignancies.

关键词： Biliary tract cancers Survival Outcomes research Socioeconomic factors Healthcare disparities

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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

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Trauma to the solid abdominal organs:The missed dark box of colonoscopy

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World Journal of gastroenterology 2024年第7期30卷 624-630页

作者： Mohamed H Emara Usama Mazid Yasmine A Elshaer Mahmoud A Elkerdawy Dilaver Farooq Malik Aya M Mahros department of Hepatology Gastroenterologyand Infectious DiseasesKafrelsheikh UniversityKafr-Elshikh 33516Egypt department of medicine Alyousif HospitalAlkhobar 31952Saudi Arabia

Colonoscopy is an integral part of the lower bowel care and is generally considered a potentially safe diagnostic and therapeutic procedure performed as a daycare outpatient *** is associated with different complications that are not limited to adverse events related to the bowel preparation solutions used,the sedatives used,but to the procedure related as well including bleeding and *** to the extra-luminal abdominal organs during colonoscopy are uncommon,however,serious complications related to the procedure have been reported infrequently in the *** threatening injuries to the spleen,liver,pancreas,mesentery,and urinary bladder have been reported as early as in *** injuries should not be overlooked by clinicians and *** increasing abdominal pain,abdominal distension,and hemodynamic instability in absence of rectal bleeding should raise the possibility of severe organ *** and hepatic injury following colonoscopy are usually serious and may be life *** conservative management may help,yet they usually need interventional radiology or surgical *** pancreatitis following colonoscopy is usually mild and is mostly managed *** mechanism of abdominal organ injuries during colonoscopy is not fully understood,however many risk factors have been identified,which can be classified as-organ related,procedure related,and local abdominal *** colonoscopy and prior intra-abdominal adhesions are probably the most relevant risk factors for these *** lateral position,avoidance of looping and excessive force during the procedure would probably reduce the risk of such injuries.

关键词： Colonoscopy Pancreatitis Trauma Complications Adhesions

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