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World Journal of Clinical Cases 2025年第3期13卷 66-68页

作者： Takahiko Nagamine Department of Psychiatric internal medicine Sunlight Brain Research CenterHofu 7470066YamaguchiJapan

Medical procedures are inherently invasive and carry the risk of inducing pain to the mind and ***,efforts have been made to alleviate the discomfort associated with invasive medical procedures through the use of virtual reality(VR)*** has been demonstrated to be an effective treatment for pain associated with medical procedures,as well as for chronic pain conditions for which no effective treatment has been *** precise mechanism by which the diversion from reality facilitated by VR contributes to the diminution of pain and anxiety has yet to be ***,the provision of positive images through VR-based visual stimulation may enhance the functionality of brain *** salience network is diminished,while the default mode network is ***,the medial prefrontal cortex may establish a stronger connection with the default mode network,which could result in a reduction of pain and *** research into the potential of VR technology to alleviate pain could lead to a reduction in the number of individuals who overdose on painkillers and contribute to positive change in the medical field.

关键词： Virtual reality Pain Anxiety Salience network Default mode network

Improving postoperative outcomes in patients with pancreatic cancer:Inflammatory and nutritional biomarkers

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World Journal of Clinical Oncology 2025年第1期16卷 59-64页

作者： Chun-Han Cheng Wen-Rui Hao Tzu-Hurng Cheng Department of Medical Education Linkou Chang Gung Memorial HospitalTaoyuan 33305Taiwan Division of Cardiology Department of Internal MedicineShuang Ho HospitalMinistry of Health and WelfareTaipei Medical UniversityNew Taipei 23561Taiwan Division of Cardiology Department of Internal MedicineSchool of MedicineCollege of MedicineTaipei Medical UniversityTaipei 11002Taiwan Department of Biochemistry School of MedicineCollege of MedicineChina Medical UniversityTaichung 404328Taiwan

This editorial assesses the prognostic value of preoperative inflammatory and nutritional biomarkers in patients undergoing surgical resection for pancreatic *** et al evaluated the ability of seven biomarkers to predict postoperative recovery and long-term *** biomarkers were albumin-to-globulin ratio,prognostic nutritional index(PNI),systemic immune-inflammation index,neutrophil-to-lymphocyte ratio,platelet-to-lymphocyte ratio,nutritional risk index,and geriatric nutritional risk *** PNI was found to be a strong predictor of both overall and recurrence-free survival,underscoring its clinical relevance in managing patients with pancreatic cancer.

关键词： Pancreatic cancer Prognostic nutritional index Systemic immune-inflammation index Postoperative recovery Prognosis

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

The impact of alpha-fetoprotein (AFP), child-turcotte-pugh (CTP) score and disease staging on the survival of hepatocellular carcinoma (HCC) patients: a retrospective cohort from single oncology center

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Oncology research 2025年第1期33卷 149-160页

作者： Nasser Mulla Yousef Katib Asim M Almughamsi Duaa S Alkhayat Mohamed Mosaad Samir T Alfotih Rawan Alaofi Department of internal medicine Faculty of Medicine Taibah University Madinah 42278 Saudi Arabia. Department of Radiology Faculty of Medicine Taibah University Madinah 42278 Saudi Arabia. Department of Surgery Faculty of Medicine Taibah University Madinah 42278 Saudi Arabia. Department of Endemic and Infectious Diseases Suez Canal University Ismailia 41522 Egypt. King Salman bin Abdulaziz Medical City Madinah 42311 Saudi Arabia. Prince Mohammed Bin Abdulaziz Hospital Madinah 41511 Saudi Arabia.

Background:Hepatocellular carcinoma (HCC) is the most common cause of cancer-related death in Saudi Arabia. Our study aimed to investigate the patterns of HCC and the effect of TNM staging, Alfa-fetoprotein (AFP), and Child-Turcotte Pugh (CTP) on patients' overall survival (OS).Methods:A retrospective analysis was conducted on 43 HCC patients at a single oncology center in Saudi Arabia from 2015 to 2020. All patients had to fulfill one of the following criteria: (a) a liver lesion reported as definitive HCC on dynamic imaging and/or (b) a biopsy-confirmed diagnosis.Results:The mean patient age of all HCC cases was 66.8 with a male-to-female ratio of 3.3:1. All patients were stratified into two groups: viral HCC (n = 22, 51%) and non-viral HCC (n = 21, 49%). Among viral-HCC patients, 55% were due to HBV and 45% due to HCV. Cirrhosis was diagnosed in 79% of cases. Age and sex did not significantly statistically differ in OS among viral and non-viral HCC patients (-value > 0.05). About 65% of patients had tumor size >5 cm during the diagnosis, with a significant statistical difference in OS (-value = 0.027). AFP was >400 ng/ml in 45% of the patients. There was a statistically significant difference in the OS in terms of AFP levels (-value = 0.021). A statistically significant difference was also observed between the CTP score and OS (-value = 0.02). CTP class B had the longest survival. BSC was the most common treatment provided to HCC patients followed by sorafenib therapy. There was a significant statistical difference in OS among viral and non-viral HCC patients (-value = 0.008).Conclusions:The most common predictors for OS were the underlying cause of HCC, AFP, and tumor size. Being having non-viral etiology, a tumor size >5 cm, an AFP > 400 ng/mL, and a CTP score class C were all negatively associated with OS.

关键词： Alpha-fetoprotein (AFP) Child-turcotte-pugh Hepatocellular carcinoma Pattern Progression free survival

Radiomics and molecular analysis:Bridging the gap for predicting hepatocellular carcinoma prognosis

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World Journal of Clinical Cases 2025年第4期13卷 56-60页

作者： Chun-Han Cheng Wen-Rui Hao Tzu-Hurng Cheng Department of Medical Education Linkou Chang Gung Memorial HospitalTaoyuan 33305TaiwanChina Division of Cardiology Department of Internal MedicineShuang Ho HospitalMinistry of Health and WelfareTaipei Medical UniversityNew Taipei 23561TaiwanChina Division of Cardiology Department of Internal MedicineSchool of MedicineCollege of MedicineTaipei Medical UniversityTaipei 11002TaiwanChina Department of Biochemistry School of MedicineCollege of MedicineChina Medical UniversityTaichung 404333TaiwanChina

This editorial examines a recent study that used radiomics based on computed tomography(CT)to predict the expression of the fibroblast-related gene enhancer of zeste homolog 2(EZH2)and its correlation with the survival of patients with hepatocellular carcinoma(HCC).By integrating radiomics with molecular analysis,the study presented a strategy for accurately predicting the expression of EZH2 from CT *** findings demonstrated a strong link between the radiomics model,EZH2 expression,and patient *** noninvasive approach provides valuable insights into the therapeutic management of HCC.

关键词： Hepatocellular carcinoma Computed tomography Radiomics Enhancer of zeste homologue 2 expression Non-invasive imaging

Multilocular thymic cysts-a diagnostic challenge on computed tomography

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World Journal of Clinical Cases 2025年第3期13卷 61-65页

作者： Nirmal Kumar Reddy Onteddu Naga Sai Rasagna Mareddy Sai Swarupa R Vulasala Jayabharath Onteddu Mayur Virarkar Department of internal medicine University of Florida College of MedicineJacksonvilleFL 32209United States Department of Diagnostic Radiology University of AlabamaBirminghamAL 35294United States Department of Diagnostic Radiology University of Florida College of MedicineJacksonvilleFL 32209United States Department of Public Health Sciences University of FloridaGainesvilleFL 32611United States

A recent case report provided a patient scenario,wherein,a 39-year-old male patient presented with occasional palpitations,headache,and *** of tumor markers did not show any abnormal ***,a computed tomography(CT)scan was undertaken,and its findings were affirmative of thymic ***,the postoperative histopathological assessment of the mass,after its resection,confirmed it as an anterior mediastinal multilocular thymic cyst(MTC),with concurrent acute upper respiratory tract infection and acute ***,this case report advocates the need for a preoperative histopathological examination with CT imaging to minimize the risk of confusing an MTC with a malignant thymic tumor.

关键词： Imaging findings Multilocular thymic cyst Histopathology Thymic cancer Mediastinal mass

Post-liver transplant hepatitis C virus recurrence: An unresolved thorny problem

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World Journal of Gastroenterology 2014年第32期20卷 11095-11115页

作者： Alberto Grassi Giorgio Ballardini internal medicine and Hepatology Division Department of Internal Medicine "Infermi" Hospital internal medicine and Hepatology Division Department of Internal Medicine "Infermi" Hospita

Hepatitis C virus (HCV)-related cirrhosis represents the leading cause of liver transplantation in developed, Western and Eastern countries. Unfortunately, liver transplantation does not cure recipient HCV infection: reinfection universally occurs and disease progression is faster after liver transplant. In this review we focus on what happens throughout the peri-transplant phase and in the first 6-12 mo after transplantation: during this crucial period a completely new balance between HCV, liver graft, the recipient’s immune response and anti-rejection therapy is achieved that will deeply affect subsequent outcomes. Nearly all patients show an early graft reinfection, with HCV viremia reaching and exceeding pre-transplant levels; in this setting, histological assessment is essential to differentiate recurrent hepatitis C from acute or chronic rejection; however, differentiating the two patterns remains difficult. The host immune response (mainly cellular mediated) appears to be crucial both in the control of HCV infection and in the genesis of rejection, and it is also strongly influenced by immunosuppressive treatment. At present no clear immunosuppressive strategy could be strongly recommended in HCV-positive recipients to prevent HCV recurrence, even immunotherapy appears to be ineffective. Nonetheless it seems reasonable that episodes of rejection and over-immunosuppression are more likely to enhance the risk of HCV recurrence through immunological mechanisms. Both complete prevention of rejection and optimization of immunosuppression should represent the main goals towards reducing the rate of graft HCV reinfection. In conclusion, post-transplant HCV recurrence remains an unresolved, thorny problem because many factors remain obscure and need to be better determined.

关键词： Hepatitis C virus Liver transplantation Hepatitis C antigens Graft rejection Immunosuppression

Management of entecavir-resistant chronic hepatitis B with adefovir-based combination therapies

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World Journal of Gastroenterology 2015年第38期21卷 10874-10882页

作者： Hyoung Su Kim Hyung Joon Yim Myoung Kuk Jang Ji Won Park Sang Jun Suh Yeon Seok Seo Ji Hoon Kim Bo Hyun Kim Sang Jong Park Sae Hwan Lee Sang Gyune Kim Young Seok Kim Jung Il Lee Jin-Woo Lee In Hee Kim Tae Yeob Kim Jin-Wook Kim Sook-Hyang Jeong Young Kul Jung Hana Park Seong Gyu Hwang Department of internal medicine Hallym University College of Medicine Department of internal medicine Korea University Ansan Hospital Department of internal medicine Korea University Medical College Department of internal medicine Bundang Jesaeng Hospital Department of internal medicine Soon Chun Hyang University College of Medicine Department of internal medicine Inha University School of Medicine Department of internal medicine Chonbuk National University Medical School Department of internal medicine Hanyang University College of Medicine Department of internal medicine Seoul National University College of Medicine Department of internal medicine Gachon University School of Medicine Department of internal medicine CHA Bundang Medical CenterCHA University

AIM: To evaluate the long-term efficacy adefovir(ADV)-based combination therapies in entecavir(ETV)-resistant chronic hepatitis B(CHB) patients. METHODS: F i fty CHB pat ient s wi t h genotypic resistance to ETV at 13 medical centers in South Korea were included for the analysis. All the patients received rescue therapy with the combination of ADV plus ETV(ADV/ETV,n = 23) or ADV plus lamivudine(LMV)(ADV/LMV,n = 27) for more than 12 mo. Patients were monitored at least every 3-4 mo during ADV-based combination therapy by clinical examination as well as biochemical and virological assessments. Hepatitis B virus(HBV) DNA levels were measured by realtime PCR and logarithmically transformed for analysis. Cumulative rates of virologic response(VR; HBV DNA < 20 IU/m L) were calculated using the Kaplan-Meier method,and the difference was determined by a logrank test. Multivariate logistic regression and Cox proportional hazards models were used to identify independent risk factors significantly associated with short-term and long-term VR,***: Baseline median HBV DNA levels were 5.53(2.81-7.63) log10 IU/m L. The most commonly observed ETV genotypic mutation sites were rt184 and rt202. Patients were treated for a median of 27(12-45) mo. Overall,cumulative VR rates at 6,12,24,and 36 mo were 26%,36%,45%,and 68%,respectively. Patients treated with the ADV/ETV combination showed higher cumulative VR rates(35%,43%,65%,and 76%,respectively) than those with the ADV/LAM combination(18%,30%,30%,and 62%,respectively; P = 0.048). In the multivariate analysis,low baseline HBV DNA levels(< 5.2 log10 IU/m L) and initial virologic response at 3 mo(IVR-3; HBV DNA < 3.3 log10 IU/m L after 3 mo) were independent predictive factors for VR. Patients with favorable predictors achieved cumulative VR rates up to 90% at 36 mo. During the same period,the cumulative incidence of virologic breakthrough was as low as 6% in patients with the both favorable ***: If tenof

关键词： Adefovir Chronic hepatitis B Entecavir Lamivudine

Anti-Helicobacter pylori therapy significantly reduces Helicobacter py/ori-Induced gastric mucosal damage in Mongolian gerbils

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World Journal of Gastroenterology 2005年第7期11卷 982-985页

作者： Sheng-Hsuan Chen Gi-Shih Lien Yuarn-Jang Lee Horng-Yuan Lou Ching-Ruey Hsieh Chia-Lang Fang Shiann Pan Department of internal medicine

AIM: To investigate the effectiveness of 4 d' anti-Helicobacter pylori therapy on the H pylori-infected Mongolian gerbils based on physiological and pathological changes. METHODS: We used 6-wk-old male gerbils orally inoculated with H pylori (ATCC43504, 2×108 CFU/mL). Seven weeks after H pylori inoculation, the animals of study group received 4 d' anti-H pylori triple therapy (H pylori-eradicated group). Seven days later, all animals of the H pylori-eradicated and control groups (H pylori-infected & H pylori-uninfected groups) were sacrificed. We examined gastric mucosal lesions macroscopically, studied gastritis microscopically and determined the stomach weight ratio, myeloperoxidase (MPO) activity and prostaglandin (PG) E2 level. RESULTS: The results showed that both macroscopic and histological gastric damages were significantly less in H pylori-eradicated group than H pylori-infected group. Stomach weight ratio, MPO activity and PGE2 levels were significantly higher in H pylori-infected group than those in the other two groups. CONCLUSION: Four days' anti-H pylori therapy was effective in the improvement of H pylori-induced gastric lesions in Mongolian gerbils.

关键词： Helicobacter pylori anti-H pylori therapy Mongolian gerbils Gastritis

Comparison between combination therapy of percutaneous ethanol injection and radiofrequency ablation and radiofrequency ablation alone for patients with hepatocellular carcinoma

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World Journal of Gastroenterology 2005年第10期11卷 1426-1432页

作者： Kazutaka Kurokohchi Seishiro Watanabe Tsutomu Masaki Naoki Hosomi Yoshiaki Miyauchi Takashi Himoto Yasuhiko Kimura Seiji Nakai Akihiro Deguchi Hirohito Yoneyama Shuhei Yoshida Shigeki Kuriyama Third Department of internal medicine

AIM: In the present study, the characteristics of PEI-RFA treatment were further elucidated by analyzing the relationship between the volume of coagulated necrosis and the energy requirement for ablation or the amount of ethanol injected into ***: The volume of coagulated necrosis, total energy requirement and energy requirement for coagulation of per unit volume were examined in the groups of PEI-RFA and RFA alone using the Cool-tip RF ***: The results showed that the volume of coagulated necrosis induced was significantly larger in PEI-RFA group than in routine RFA group, when the total energy administered was comparable in both *** PEI-RFA, enlargement of coagulated necrosis was admitted in 3 dimensions and the amount of energy requirement per unit volume of coagulated necrosis was negatively correlated with the amount of ethanol injected into ***: These results suggest that, compared to RFA alone, PEI-RFA enables to induce comparable coagulated necrosis with smaller energy requirement, and that PEI-RFA is likely to be less invasive than RFA alone irrespective of inducing enhanced coagulated ***, simple prior injection of ethanol may make RFA treatment more effective and less invasive for the treatment of patients with HCC.

关键词： Combination therapy Percutaneous ethanol injection Radiofrequency ablation Energy requirement