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Effects of Transjugular Intrahepatic Portosystemic Shunt on Renal and Pulmonary Function in Hepatic Decompensation with and without Hepatorenal and Hepatopulmonary Syndromes:A Review

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Journal of Clinical and Translational hepatology 2024年第9期12卷 780-791页

作者： Ahmed H.Abdelwahed Moataz Aboeldahb George Y.Wu Department of Medicine Division of Gastroenterology-HepatologyUniversity of Connecticut Health CenterFarmingtonCTUSA Department of gastroenterology and hepatology Mayo ClinicRochesterMNUSA

Cirrhosis is often characterized by decreased liver function,ranging from a compensated,typically asymptomatic phase to a decompensated phase characterized by the appearance of ascites or variceal bleeding,and ultimately hepatorenal syndrome(HRS)or hepatopulmonary syndrome(HPS).The latter two complications are associated with a poor prognosis and limited treatment *** cases of ascites or variceal bleeding resistant to medical therapy,transjugular intrahepatic portosystemic shunt(TIPS)is effective and *** blood by TIPS diverts portal blood to the systemic circulation,potentially increasing systemic blood volume and benefiting renal ***,TIPS could also divert nitric oxide to the systemic circulation,potentially worsening systemic hypotension and perfusion,which could be detrimental to renal *** evidence indicates that TIPS often improves renal function in patients with portal hypertension,with or without *** studies have shown persistently decreased renal function after ***,these data are insufficient to support a recommendation for the use of TIPS specifically for *** patients without pre-existing HPS,TIPS does not appear to significantly affect pulmonary gas *** of TIPS in HPS have been inconsistent;some studies have shown improvement,but effects were *** studies have shown a persistent decline in pulmonary function after *** evidence supports the need for large randomized controlled trials to investigate the beneficial effects of TIPS for *** pulmonary function data are less clear regarding TIPS for *** aim of the current report was to review the literature regarding the effects of TIPS on renal and pulmonary function in hepatic decompensation,with or without the development of HRS or HPS.

关键词： Cirrhosis Hepatorenal syndrome Hepatopulmonary syndrome Transjugular intrahepatic portosystemic shunt

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Focal Nodular Hyperplasia: A Comprehensive Review with a Particular Focus on Pathogenesis and Complications

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Journal of Clinical and Translational hepatology 2024年第2期12卷 182-190页

作者： Jaimy Villavicencio Kim George Y.Wu division of gastroenterology-hepatology University of Connecticut Health CenterFarmingtonCTUSA

Focal nodular hyperplasia is a benign tumor of the liver that is often found incidentally with *** purpose of this review is to discuss the pathophysiology,rare complications that can occur due to these lesions,and management options.A literature review was performed on clinical trials and case reports involving focal nodular hyperplasia complications and management of these,as well as the proposed pathogenesis underlying these *** exposure to oral contraceptive pills and endogenous hormones have been thought to play a role in the development of these lesions,this has not been *** recently,they are thought to arise as a consequence of a vascular anomaly causing alterations in the expression of angiopoietin *** are rare,but previous cases have reported associated pain,rupture and compression of nearby structures(hepatic vein,stomach,biliary system).Resection of focal nodular hyperplasia is not usually ***,if there is associated pain with no other identifiable cause or presence of a large or growing lesion with risk of causing a complication,then surgical resection,radiofrequency ablation or arterial embolization should be considered.

关键词： Focal nodular hyperplasia Oral contraceptives Liver lesion

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The Rising Burden of Hepatocellular Carcinoma: Is the Gender Gap Narrowing?

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Journal of Clinical and Translational hepatology 2024年第9期12卷 763-764页

作者： James K.H.Ho Prem H.Thurairajah Daniel Q.Huang Kristie H.Fan division of gastroenterology and hepatology National University HospitalNational University Health SystemSingaporeSingapore

Dear Editors,The landscape of hepatocellular carcinoma(HCC)is continuously *** global trends indicate a significant shift in the epidemiology of HCC from viral-related to non-viral-related ***-associated fatty liver disease has emerged as the fastest-growing contributor to HCC in recent years,due to the increased prevalence of obesity and metabolic risk factors.

关键词： Carcinoma epidemiology obesity

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Pretreating and normalizing metabolomics data for statistical analysis

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Genes & Diseases 2024年第3期11卷 188-205页

作者： Jun Sun Yinglin Xia division of gastroenterology and hepatology Department of MedicineDepartment of Microbiology/ImmunologyUIC Cancer CenterUniversity of Illinois ChicagoJesse Brown VA Medical Center Chicago(537)ChicagoIL 60612USA division of gastroenterology and hepatology Department of MedicineUniversity of Illinois ChicagoChicagoIL 60612USA

Metabolomics as a research field and a set of techniques is to study the entire small molecules in biological *** is emerging as a powerful tool generally for pre-cision ***,integration of microbiome and metabolome has revealed the mechanism and functionality of microbiome in human health and ***,metabo-lomics data are very ***/pretreating and normalizing procedures on metabolomics data are usually required before statistical *** this review article,we comprehensively review various methods that are used to preprocess and pretreat metabolo-mics data,including MS-based data and NMR-based data preprocessing,dealing with zero and/or missing values and detecting outliers,data normalization,data centering and scaling,data *** discuss the advantages and limitations of each *** choice for a suitable preprocessing method is determined by the biological hypothesis,the characteristics of the data set,and the selected statistical data analysis *** then provide the perspective of their applications in the microbiome and metabolome research.

关键词： Data centering and scaling Data normalization Data transformation Missing values MS-Baseddata preprocessing NMRData preprocessing Outliers Preprocessing/pretreatment

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Hepatocellular Carcinoma with Gastric Metastasis Mimicking a 4 cm Gastrointestinal Stromal Tumor After a 3-year Disease-free Interval

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Journal of Clinical and Translational hepatology 2024年第2期12卷 218-221页

作者： Wei-Ting Chen Shiu-Feng Kathy Huang Ming-Ling Chang Yun-Fan Liaw division of hepatology Department of Gastroenterology and HepatologyChang Gung Memorial HospitalTaoyuan Department of Medicine College of MedicineChang Gung UniversityTaoyuan division of Molecular and Genomic Medicine National Health Research InstitutesMiaoli

Hepatocellular carcinoma(HCC)is an aggressive tumor that usually occurs in patients with chronic liver disease and *** resection is an optimal treatment for HCC,but the 5-year recurrence rates are significantly *** majority of recurrent HCCs occur through intrahepatic metastasis with local tumor progression,and less than 20%of recurrences are extrahepatic *** with gastric metastasis is extremely rare,and it is easily misdiagnosed as primary gastric cancer with liver *** 80-yearold male chronic hepatitis B virus carrier had received lamivudine and entecavir for years and was regularly followed up in the *** had a 3.5 cm solitary HCC with microvascular invasion and received curative surgical resection in *** 2013,he developed a 1.3 cm solitary HCC again and was treated with combination therapy with radiofrequency ablation and pure ethanol ***,he was followed every 3–6 months and was *** years later,in 2016,endoscopy for intermittent epigastralgia showed a solitary 4 cm intraluminal gastric subepithelial tumor without mucosal ulcers or erosions over the gastric *** imaging studies,including computed tomography,favored the diagnosis of gastrointestinal stromal tumor(GIST),but the pathology of the tumor proved to be *** patient did not receive any systemic anticancer therapy but only wedge resection of the stomach and remained tumor-and HCC-free until his latest clinic visit in *** current case is unique and indicates the possibility of HCC with late solitary gastric metastasis mimicking *** gastric tumor resection ensured an extremely good outcome for the patient,which is different from the devastating prognosis of most cases of HCC with gastric metastasis.

关键词： Hepatocellular carcinoma Hepatitis B virus Gastric Gastrointestinal stromal tumor

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Nonsteroidal anti-inflammatory drugs before endoscopic ultrasound guided tissue acquisition to reduce the incidence of post procedural pancreatitis

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World Journal of gastroenterology 2024年第8期30卷 811-816页

作者： Mike de Jong Foke van Delft Christine Roozen Erwin-Jan van Geenen Tanya Bisseling Peter Siersema Marco Bruno Department of gastroenterology and hepatology Radboud University Medical CenterNijmegen 6525 GANetherlands Department of gastroenterology and hepatology Erasmus University Medical CenterRotterdam 3015 GDNetherlands

Endoscopic ultrasound(EUS)with fine needle aspiration or fine needle biopsy is the gold standard for sampling tissue to diagnose pancreatic cancer and auto-immune pancreatitis or to analyze cyst *** most common reported adverse event of fine needle aspiration and/or fine needle biopsy is acute pancreatitis,which is likely induced by the same pathophysiological mechanisms as after en-doscopic retrograde cholangiopancreatography(ERCP).According to the current European Society of Gastrointestinal Endoscopy guideline,nonsteroidal anti-inflammatory drugs are administered prior to ERCP as a scientifically proven treatment to reduce post-ERCP pancreatitis incidence rate.A single suppository of diclofenac or indomethacin prior to EUS guided tissue acquisition(TA)is harm-less in healthy *** it is associated with low costs and,most important,may prevent a dreadsome complication,we strongly recommend the adminis-tration of 100 mg diclofenac rectally prior to *** will explain this recom-mendation in more detail in this review as well as the risk and pathophysiology of post-EUS TA pancreatitis.

关键词： Pancreatitis Endoscopic ultrasound Tissue acquisition Nonsteroidal antiinflammatory drugs Pancreatic cancer

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Understanding acute kidney injury (AKI) in liver cirrhosis from the acute-on-chronic liver failure (ACLF) perspective

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Hepatobiliary Surgery and Nutrition 2024年第4期13卷 715-717页

作者： Jeong-Ju Yoo Sang Gyune Kim division of gastroenterology and hepatology Department of Internal MedicineSoonchunhyang University School of Medicine Bucheon HospitalBucheonKorea

In the field of hepatology,managing complications in patients with liver diseases is of paramount *** these,acute kidney injury(AKI)in patients with acute-on-chronic liver failure(ACLF)stands out due to its prevalence and significant impact on patient outcomes(1,2).AKI in ACLF differs substantially from AKI in simple liver cirrhosis in its clinical significance(3).AKI developed in ACLF is a manifestation of a multi-organ failure syndrome and is closely associated with a high mortality rate and severe complications.

关键词： Acute kidney injury(AKI) acute-on-chronic liver failure(ACLF) biomarker

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Intestinal microecological transplantation for a patient with chronic radiation enteritis:A case report

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World Journal of gastroenterology 2024年第19期30卷 2603-2611页

作者： Lin Wang Yan Li Yu-Jing Zhang Li-Hua Peng Department of gastroenterology and hepatology The First Medical CenterChinese PLA General HospitalBeijing 100853China Department of gastroenterology and hepatology Chinese PLA Medical SchoolBeijing 100853China

BACKGROUND The gut microbiota is strongly associated with radiation-induced gut *** study aimed to assess the effectiveness and safety of intestinal microecological transplantation for treating patients with chronic radiation *** SUMMARY A 64-year-old female with cervical cancer developed abdominal pain,diarrhea,and blood in the stool 1 year after *** electronic colonoscopy was performed to diagnose chronic radiation *** courses of intestinal microecological transplantation and full-length 16S rRNA microbiological analysis were *** patient experienced short-and long-term relief from symptoms without adverse *** 16S rRNA sequencing revealed significant differences in the intestinal flora’s composition between patient and healthy *** bacteria,such as Escherichia fergusonii and Romboutsia timonensis,were more in the *** bacteria such as Faecalibacterium prausnitzii,Fusicatenibacter saccharivorans,Ruminococcus bromii,and Bifidobacterium longum were more in the healthy *** microbiota transplantation resulted in a significant change in the patient's intestinal flora *** composition converged with the donor's flora,with an increase in core beneficial intestinal bacteria,such as Eubacterium rectale,and a decrease in pathogenic *** in the intestinal flora corresponded with the patients'alleviating clinical *** Intestinal microecological transplantation is an effective treatment for relieving the clinical symptoms of chronic radiation enteritis by altering the composition of the intestinal *** study provides a new approach for treating patients with chronic radiation enteritis.

关键词： Chronic radiation enteritis Gut microbial transplantation Intestinal microecology Cancer Quality of life Case report

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Innovative pathways allow safe discharge of mild acute pancreatitis from the emergency room

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World Journal of gastroenterology 2024年第11期30卷 1475-1479页

作者： Darshan J Kothari Sunil G Sheth division of gastroenterology Duke University Medical CenterDurhamNC 27710United States division of gastroenterology&hepatology Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMA 02215United States

Acute pancreatitis(AP)is a leading cause of gastrointestinal-related hospitalizations in the United States,resulting in 300000 admissions per year with an estimated cost of over$2.6 billion *** severity of AP is determined by the presence of pancreatic complications and end-organ *** moderate/severe pancreatitis can be associated with significant morbidity and mortality,the majority of patients have a mild presentation with an uncomplicated course and mortality rate of less than 2%.Despite favorable outcomes,the majority of mild AP patients are admitted,contributing to healthcare cost and *** this Editorial we review the performance of an emergency department(ED)pathway for patients with mild AP at a tertiary care center with the goal of reducing hospitalizations,resource utilization,and costs after several years of implementation of the *** discuss the clinical course and outcomes of mild AP patients enrolled in the pathway who were successfully discharged from the ED compared to those who were admitted to the hospital,and identify predictors of successful ED discharge to select patients who can potentially be triaged to the *** conclude that by implementing innovative clinical pathways which are established and reproducible,selected AP patients can be safely discharged from the ED,reducing hospitalizations and healthcare costs,without compromising clinical *** also identify a subset of patients most likely to succeed in this pathway.

关键词： Emergency department Mild pancreatitis Pathways Hospitalization Predictors

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MicroRNAs in hepatocellular carcinoma treatment:Charting the path forward

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World Journal of gastroenterology 2024年第11期30卷 1470-1474页

作者： Hong T Lin Antonio F Alvarez Castaneda Somashekar G Krishna Khalid Mumtaz division of gastroenterology Hepatology and NutritionDepartment of MedicineThe Ohio State University Wexner Medical CenterColumbusOH 43210United States

MicroRNAs(miRNAs)are recognized for their involvement in the regulation of gene expression and exhibit significant potential in both the prognostic assessment and treatment of hepatocellular carcinoma(HCC).HCC,like other tumors,seldom occurs in isolation;instead,it evolves within a microenvironment featuring oncogenic and tumor-suppressive *** combined with suitable delivery vehicles,miRNA technology provides the capability to directly engage with these elements,thereby hindering tumor formation and *** research in this domain holds the promise of enabling a more efficacious and multi-modal treatment approach for HCC in the near future.

关键词： Hepatocellular carcinoma Tumor microenvironment MicroRNA Mesenchymal stem cell Exosome

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