简介：AIM:Tounderstandthecorrelationofserumcholinesterase(CHE)activitywithgastriccancerandtoassesstheirclinicalsignificance.METHODS:ThevelocitymethodwasadoptedtodetecttheactivityofserumCHEinpatientswithgastriccancerandinpatientswithnon-malignanttumorascontrols.RESULTS:TheserumCHEactivityinthetreatmentgroupwassignificantlylowerthanthatinthecontrolgroupwithaverysignificantdifferencebetweenthetwogroups(83.3:113.1,P=0.0003).Agewassignificantlyassociatedwiththeincidenceofgastriccaner.CONCLUSION:SerumCHEactivityhasacloserelationwiththeincidenceofgastriccancer.

简介：Arecentreportintroducedthephosphodiesterase-5inhibitionbyvardenafilasanoveltreatmentofportalhypertensioninpatientswithcirrhosis.Inthehereinpresented'lettertotheeditor',theadministrationoftadalafildidnotinfluenceportalhaemodynamicsbutimpairedsystemichaemodynamicsinpatientswithcirrhosis.OurobservationsconcurwiththeresultsofareportinapreviousissueofWorldJournalofGastroenterology(October2008).Moreover,tadalafiladverselyaffectedrenalfunctioninpatientswithdecompensatedliverdisease.

简介：瞄准：为了评估磁性的回声cholangiopancreatography(MRCP)，与磁性的回声(先生)一起的调查结果在自体免疫的胰腺炎(AIP)想象病人。方法：有AIP的九个病人经历了MRI，MRCP，内视镜后退cholangiopancreatography(ERCP)，计算断层摄影术，和ultrasonography。在类固醇治疗前后拿的MRCP和先生图象被考察并且与另外的成像形式相比。AIP盒子的MRCP调查结果与有胰的头的癌的10个盒子的那些相比。结果：在MRCP上，在ERCP上注意的主要的胰腺的管的缩小的部分没被设想，当主要的胰腺的管的非包含的片断被设想时。近似的主要的胰腺的管的在上游的膨胀的度比在胰腺的癌的情况下看温和。更低的胆汁管的狭窄或阻塞在8个病人被检测。先生图象在T1加权的先生图象上与减少的信号紧张显示出胰的增大，T2加权的先生图象上的增加的信号紧张，并且，在3个病人，低亚硫酸钠强烈像囊的边界。在类固醇治疗以后，以前没设想主要的胰腺的管的部分被看见，与胆汁管狭窄的改进一起。胰腺的增大减少了，并且T1加权、T2加权的先生图象上的反常信号紧张成为了isointense。结论：MRCP不能区分从与胰腺的癌看见的主要的胰腺的管的狭窄与AIP看见的主要的胰腺的管的不规则的变窄。然而，与在T1加权、T2加权的先生图象上显示出反常信号紧张的胰腺的增大的先生成像一起的MRCP调查结果在支持AIP的诊断是有用的。

简介：瞄准：在糖尿病的病人调查倒流食道炎(RE)和Hpylori感染的发生。方法：RE和Hpylori感染的发生与糖尿病在85个病人被调查，结果与控制相比。结果：在糖尿病的病人的RE的发生是17.6%。尽管这趋于在糖尿病的病人更高，有没有统计上在糖尿病的病人和控制之间的有效差量。在糖尿病的病人的Hpylori感染的发生是53.7%，但是不，统计上，有效差量在Hpylori感染的发生在糖尿病的病人和控制之间被看见。结论：没有有效差量能在RE和Hpylori感染的发生在糖尿病的病人和控制之间被看见。

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简介：瞄准：低剂量的阿司匹林的使用很好被建立阻止心血管的疾病事件。然而，上面的胃肠的流血的发生和有它的使用的预言者(UGIB)是未知的。我们有希望地在低剂量的阿司匹林用户学习了消化剂溃疡的发生和结果。方法：有低剂量的阿司匹林上的冠的动脉疾病(CAD)的991个病人的一个总数是有希望地跟随起来的为出现和UGIB的首先就医的事件的临床的特征的二年了。结果：UGIB有一个双性人有45%发生在四月阿司匹林开始以内的形式的表示并且每年有1.5%的全面流行。没有UGIB相关的死亡。高血压(或=4.6，95%CI1.5-14.7，P=0.009)，消化剂溃疡的历史(或=3.1，95%CI1.1-9.0，P=0.039)，第三级的教育(或=3.08，95%CI1.1-9.0，P=0.039)并且更高瘦的身体质量(P=0.016)独立因素与UGIB被联系。硝酸盐的使用没减少UGIB。结论：在有长期的低剂量的阿司匹林上的CAD的病人的UGIB的发生是低的，但是伴有重要病态。与阿司匹林的延长使用，UGIB继续是为有风险因素并且特别在有消化性溃疡，UGIB在趋于在阿司匹林治疗以后早发生的历史的病人的那些的一个问题。

简介：AIM:Toinvestigatethelifetimeriskofdevelopmentofesophagealadenocarcinomaand/orhigh-gradedysplasiainpatientsdiagnosedwithBarrett’sesophagus.METHODS:DatawereextractedfromtheUnitedKingdomNationalBarrett’sOesophagusRegistryondateofdiagnosis,patientageandgenderof7877patientsfromwhohadbeenregisteredfrom35UnitedKingdomcenters.LifeexpectancywasevaluatedfromUnitedKingdomNationalStatisticsdatabasedupongenderandageatyearatdiagnosis.Thesedatawerethenusedwithpublishedestimatesofannualadenocarcinomaandhigh-gradedysplasiaincidencesfrommetaanalysesandlargepopulation-basedstudiestoestimateoveralllifetimeriskofdevelopmentofthesestudyendpoints.RESULTS:ThemeanageatdiagnosisofBarrett’sesophaguswas61.6yearsinmalesand67.3yearsinfemales.Themeanlifeexpectancyatdiagnosiswas23.1yearsinmales,20.7yearsinfemalesand22.2yearsoverall.Usingdatafrompublishedmeta-analyses,thelifetimeriskofdevelopmentofadenocarcinomawasbetween1in8and1in14andthelifetimeriskofhigh-gradedysplasiaoradenocarcinomawas1in5to1in6.Usingdatafrom3largerecentpopulation-basedcohortstudiesthelifetimeriskofadenocarcinomawasbetween1in10and1in37andofthecombinedendpointofhigh-gradedysplasiaandadenocarcinomawasbetween1in8and1in20.AgeatBarrett’sesophagusdiagnosisisreducingandlifeexpectancyisincreasing,whichwillpartiallycounter-balancelowerannualcancerincidence.CONCLUSION:Thereisasignificantlifetimeriskofdevelopmentofhigh-gradedysplasiaandadenocarcinomainBarrett’sesophagus.

简介：Splanchniccirculationistheprimarymechanismthatregulatesvolumesofcirculatingbloodandsystemicbloodpressureinpatientswithcirrhosisaccompaniedbyportalhypertension.Recently,interesthasbeenexpressedinmodulatingsplanchniccirculationinpatientswithlivercirrhosis,becausethiscapabilitymightproducebeneficialeffectsincirrhoticpatientsundergoingalivertransplant.Pharmacologicmodulationofsplanchniccirculationbyuseofvasoconstrictorsmightminimizevenouscongestion,replenishcentralbloodflow,andthusoptimizemanagementofbloodvolumeduringalivertransplantoperation.Moreover,splanchnicmodulationminimizesanyhighportalbloodflowthatmayoccurfollowingliverresectionandthesubsequentlivertransplant.Thiseffectissignificant,becausehighportalflowimpairsliverregeneration,andthusadverselyaffectsthepostoperativerecoveryofatransplantpatient.Anincreaseinportalbloodflowcanbeminimizedbyeithersurgicalmethods（e.g.,splenicarteryligation,splenectomyorportocavalshunting）oradministrationofsplanchnicvasoconstrictordrugssuchasVasopressinorterlipressin.Finally,modulationofsplanchniccirculationcanhelpmaintainperioperativerenalfunction.Splanchnicvasoconstrictorssuchasterlipressinmayhelpprotectagainstacutekidneyinjuryinpatientsundergoinglivertransplantationbyreducingportalpressureandtheseverityofahyperdynamicstate.Theseeffectsareespeciallyimportantinpatientswhoreceiveatoosmallforsizegraft.TerlipressinselectivelystimulatesV1receptors,andthuscausesarteriolarvasoconstrictioninthesplanchnicregion,withaconsequentshiftofbloodfromsplanchnictosystemiccirculation.Asaresult,terlipressinenhancesrenalperfusionbyincreasingbotheffectivebloodvolumeandmeanarterialpressure.

简介：瞄准：在与足够的胆汁的排水在胆汁郁积的病人减少胆管炎在以后决定ciprofloxacin的角色内视镜后退cholangiopancreatography(ERCP)。方法：A使随机化的、控制试用在Rajavithi医院在48个胆汁郁积的病人被执行(ERCP的第三级的工作分派中心：600个案例每年)。所有48个病人在开始任何过程前为30min收到了200mgciprofloxacin静脉注射，然后随机在二个组被划分。在学习的22个病人在ERCP以后组织不断地收到的ciprofloxacin直到48h。胆汁的阻塞的原因，胆汁和血的细菌学(在胆管炎)并且临床的胆管炎被记录。结果：48个病人被注册并且划分了成连续ciprofloxacin治疗组(n=22)并且不连续的ciprofloxacin治疗组(n=26)。在ERCP期间，石头在5个病人在22个病人，在24个病人的恶性病和另外的病理学的损害被发现。谁的22个病人的(4.5%)收到了ciprofloxacin，(6.3%)2在ERCP以后中止了ciprofloxacin的26个病人开发了胆管炎(相对风险=0.71；95%CI=0.14-3.65；P=0.88)。Bacterobilia在27被发现(56.3%)从48个病人。E。关口i和链球菌青绿色的ans是最普通的有机体。结论：在有在足够的胆汁的排水过程以后的胆汁郁积的病人的ciprofloxacin的不断的使用不在减少胆管炎起作用。

简介：AIM:Toanalyzethepotentialrelationshipbetweengastroesophagealrefluxdisease(GERD)andthedevelopmentofatrialfibrillation(AF).METHODS:Usingthekeywords'atrialfibrillationandgastroesophagealreflux','atrialfibrillationandesophagitis,peptic','atrialfibrillationandhernia,hiatal'thePubMed,EMBASE,CochraneLibrary,OVIDSP,WILEYdatabaseswerescreenedforrelevantpublicationsonGERDandAFinadultsbetweenJanuary1972-December2013.StudieswritteninlanguagesotherthanEnglishorFrench,studiesnotperformedinhumans,reviews,casereports,abstracts,conferencepresentations,letterstotheeditor,editorials,commentsandopinionswerenottakenintoconsideration.ArticlestreatingthesubjectofradiofrequencyablationofAFandtheconsecutivedevelopmentofGERDwerealsoexcluded.RESULTS:Twothousandonehundredsixty-onetitleswerefoundofwhich8articlesmettheinclusioncriteria.ThepresenceofAFinpatientswithGERDwasreportedtobebetween0.62%-14%,highercomparedtothosewithoutGERD.EpidemiologicaldataprovidedbytheseobservationalstudiesshowedthatpatientswithGERD,especiallythosewithmoresevereGERD-relatedsymptoms,hadanincreasedriskofdevelopingAFcomparedwiththosewithoutGERD,butacausalrelationshipbetweenGERDandAFcouldnotbeestablishedbasedonthesestudies.ThemechanismsofAFasaconsequenceofGERDremainlargelyunknown,withinflammationandvagalstimulationplayingapossibleroleinthedevelopmentofthesedisorders.TreatmentwithprotonpompinhibitorsmayimprovesymptomsrelatedtoAFandfacilitateconversiontosinusrhythm.CONCLUSION:AlthoughlinksbetweenAFandGERDexist,largerandomizedclinicalstudiesarerequiredforabetterunderstandingoftherelationshipbetweenthesetwoentities.

简介：AIM:ToinvestigateFusobacteriumnucleatum（F.nucleatum）abundanceincolorectalcancer（CRC）tissuesanditsassociationwithCRCinvasivenessinChinesepatients.METHODS:Theresectedcancerandadjacentnormaltissues（10cmbeyondcancermargins）from101consecutivepatientswithCRCwerecollected.Fluorescentquantitativepolymerasechainreaction（FQ-PCR）wasappliedtodetectF.nucleatuminCRCandnormaltissues.ThedifferenceofF.nucleatumabundancebetweencancerandnormaltissuesandtherelationshipofF.nucleatumabundancewithclinicalvariableswereevaluated.Fluorescenceinsituhybridization（FISH）analysiswasperformedon22CRCtissueswiththehighestF.nucleatumabundancebyFQ-PCRtestingtoconfirmFQ-PCRresults.RESULTS:ThemedianabundanceofF.nucleatuminCRCtissues[0.242（0.178-0.276）]wassignificantlyhigherthanthatinnormalcontrols[0.050（0.023-0.067）]（P<0.001）.F.nucleatumwasover-representedin88/101（87.1%）CRCsamples.TheabundanceofF.nucleatumdeterminedby2-ΔCTwassignificantlygreaterintumorsamples[0.242（0.178,0.276）]thaninnormalcontrols[0.050（0.023,0.067）]（P<0.001）.Thefrequencyofpatientswithlymphnodemetastaseswashigherintheover-abundancegroup[52/88（59.1%）]thanintheunder-abundancegroup[0/13（0%）]（P<0.005）.NosignificantassociationofF.nucleatumwithotherclinico-pathologicalvariableswasobserved（P>0.05）.FISHanalysisalsofoundmoreF.nucleatuminCRCthaninnormaltissues(mediannumber6,25th3,75th10vs2,25th1,75th5)（P<0.01）.CONCLUSION:F.nucleatumwasenrichedinCRCtissuesandassociatedwithCRCdevelopmentandmetastasis.

简介：瞄准：在先进或变形的颜色加irinotecan+/-bevacizumab调查cape-citabine的功效和安全表面的癌症病人。方法：四十六个病人与以前未经治疗，局部地进展或变形颜色表面的癌症(mCRC)在未来的开标签的阶段II试用在2001-2006之间被招募，在德国基于社区的门诊病人诊所。病人们加bevacizumab(CAPIRI十亿电伏)加irinotecan(CAPIRI)或CAPIRI收到了标准capecitabine政体每3wk。剂量减小从在>等级2毒性的情况下的第一个周期是强制的。bevacizumab的治疗选择依据见解医生。主要端点是反应和毒性，第二等的端点包括了没有前进的幸存和全面幸存。结果：在CAPIRI组对CAPRI十亿电伏组，比男病人(47%对24%)有更多的女性，并且更多的病人与作为主要肿瘤地点(5.9%对20.7%)有S字形的冒号的更少病人一起作为主要肿瘤地点(58.8%对48.2%)有冒号。等级3/4毒性比CAPIRI十亿电伏与CAPIRI是更高的：82%对58.6%。部分反应率是29.4%和34.5%，并且肿瘤控制率分别地是70.6%和75.9%。没有完全的回答被观察。中部的没有前进的幸存分别地为CAPIRI和CAPIRI十亿电伏是11.4瞬间和12.8瞬间。为CAPIRI的中部的全面幸存是15瞬间(458d)并且为CAPIRI十亿电伏24瞬间(733d)。这些差别不是统计上不同的。在CAPIRI十亿电伏，组织，二个病人在治疗以后经历了完整的第二等的肿瘤切除术，而在CAPIRI组没有盒子经历了这个过程。结论：政体很好被容忍并且在这门诊病人设置为有效肿瘤提供了生长控制。严重胃肠的毒性和thromboembolic事件是稀罕的并且如果观察从来不是致命的。

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简介：瞄准：与积极浆液a-fetoprotein(法新社)在病人探索肝内cholangiocarcinoma(国际计算中心)的临床病理特征。方法：为病理地证实的国际计算中心经历了外科的解剖的一百和三十一个病人被划分成一个积极法新社(>20ng/mL)组(n=32)并且一个否定法新社组(n=99)，特征其临床病理被分析并且比较。结果：HBsAg的积极的率和积极法新社组的肝肝硬化比否定法新社组的高，当时CA19-9的积极的率(>37U/mL)并且淋巴节点转移率更低。结论：有积极法新社的国际计算中心病人与肝细胞癌分享许多临床病理类似。

简介：AIM:ToevaluatetheimpactofadvancedageonoutcomeMETHODS:Twohundredsandelevenpatientsundergonehepatectomy,gastrectomyandpancreatoduodenectomyfromJanuary1998toSeptember2002wereanalyzedretrospectively.Clinicopathologicfeaturesandoperativeoutcomeof83patientsaged65yearsormorewerecomparedwiththatin128youngerpatientsagedlessthan65years.RESULTS:Thenutritionalstate,suchaspre-operationlevelofserumalbuminandhemoglobinintheolderpatientswaspoorerthanthatintheyoungerpatients.Theolderpatientshadhighercomorbiditiesthantheyoungerpatients(48.2%vs15.6%).Nosignificantdifferencewasobservedinpedoperativemortality,andcomplicationratebetweentheolderandyoungerpatients(2.4%vs1.6%and22.9%vs20.3%,respectively).Multivariateanalysisdemonstratedthatpancreatoduodenectomy,hepatectomywithresectionofmorethan2segmentsandcomorbiditieswereindependentpredictorsofpostoperativecomplication,whereasagewasnot(P=0.3172).CONCLUSION:Itissafeforpatientsaged65yearsormoretoundergohepatic,pancreaticandgastricresectionifgreatcareistakenduringperioperativeperiod.

简介：AIM:NitrativeandoxidativeDNAdamagesuchas8-nitroguanineand8-oxo-7,8-dihydro-2'-deoxyguanosine(8-oxodG)formationhasbeenimplicatedininitiationand/orpromotionofinflammation-mediatedcarcinogenesis.TheaimofthisstudyistoclarifywhethertheseDNAlesionsparticipateintheprogressionofintrahepaticcholangiocarcinoma.METHODS:Weinvestigatedtherelationoftheformationof8-nitroguanineand8-oxodGandtheexpressionofhypoxia-induciblefactor-1α(HIF-1α)withtumorinvasionin37patientswithintra-hepaticcholangiocarcinoma.RESULTS:Immunohistochemicalanalysesrevealedthat8-nitroguanineand8-oxodGformationoccurredtoamuchgreaterextentincanceroustissuesthaninnon-canceroustissues.HIF-1αcouldbedetectedincanceroustissuesinallpatients,suggestinglowoxygentensioninthetumors.HIF-1αexpressionwascorrelatedwithinduciblenitricoxidesynthase(iNOS)expression(r=0.369andP=0.025)and8-oxodGformation(r=0.398andP=0.015).DoubleimmunofluorescencestudyrevealedthatiNOSandHIF-1αco-localizedincanceroustissues.Notably,theformationof8-oxodGwascorrelatedsignificantlywithlymphaticinvasion(r=0.386andP=0.018).Moreover,8-nitroguanineand8-oxodGinnon-canceroustissueswereassociatedsignificantlywithneuralinvasion(P=0.042andP=0.026,respectively).TheseresultssuggestthatreciprocalactivationbetweenHIF-1αandiNOSmediatespersistentDNAdamage,whichinducestumorinvasivenessviamutations,resultinginpoorprognosis.CONCLUSION:Theformationof8-nitroguanineand8-oxodGplaysanimportantroleinmultiplestepsofgeneticchangesleadingtotumorprogression,includinginvasiveness.

简介：AIM:Toevaluateshort-termoutcomesfollowingintraoperativebiliarylavageforhepatolithiasis.METHODS:Atotalof932patientswhowereadmittedtotheWestChinaMedicalCenterofSichuanUniversitybetweenJanuary2010andJanuary2014andunderwentbileductexplorationandlithotomywereretrospectivelyincludedinourstudy.Thepatientsweredividedintothelavagegroupandthecontrolgroup.Relatedpre-,intra-,andpostoperativefactorswererecorded,analyzed,andcomparedbetweenthetwogroupsinordertoverifytheeffectsofbiliarylavageontheshort-termoutcomeofpatientswithhepatolithiasis.RESULTS:Amongstthepatientswhowereincluded,678patientswithhepatolithiasiswereincludedinthelavagegroup,andtheother254patientswereenrolledinthecontrolgroup.Dataanalysesrevealedthatpreoperativebaselineandrelatedintraoperativevariableswerenotsignificantlydifferent.However,patientswhounderwentintraoperativebiliarylavagehadprolongedpostoperativehospitalstays(6.67dvs7.82d,P=0.024),higherhospitalizationfees(RMB28437.1vsRMB32264.2,P=0.043),higherpositiveratesofbacterialculturesfromblood(13.3%vs25.8%,P=0.001)andbile(23.6%vs40.7%,P=0.001)samples,andincreasedusageofadvancedantibiotics(26.3%vs38.2%,P=0.001).Inaddition,inthelavagegroup,morepatientshadfever(>37.5℃,81.4%vs91.1%,P=0.001)andhyperthermia(>38.5℃,39.7%vs54.9%,P=0.001),andhigherwhitebloodcellcountswithin7daftertheoperationcomparedtothecontrolgroup.CONCLUSION:Intraoperativebiliarylavagemightincreasetheriskofpostoperativeinfection,whilenotsignificantlyincreasinggallstoneremovalrate.

简介：关于为心脏性的吃惊的处理的levosimendan的使用的编辑的一封信被介绍。

简介：Asubstantialproportionofpatientswithirritablebowelsyndrome(IBS)associatetheirsymptomswiththeingestionofspecificfoods.Therefore,inrecentyears,scientificresearchhasincreasinglyfocusedontheroleofdietinIBSanddietarymanagementisnowconsideredanimportanttoolinIBStreatment.ThisarticlereviewsthemaindietaryapproachesinIBSemphasizingevidencefromexperimentalandobservationalstudiesandsummarizingthemaindietandlifestylerecommendationsprovidedbydietaryguidelinesandscientificliterature.Despitethelimitedevidenceforabeneficialrole,generaladviceonhealthyeatingandlifestyleisrecommendedasthefirst-lineapproachinthedietarymanagementofIBS.Standardrecommendationsincludeadheringtoaregularmealpattern,reducingintakeofinsolublefibers,alcohol,caffeine,spicyfoods,andfat,aswellasperformingregularphysicalactivityandensuringagoodhydration.Second-linedietaryapproachshouldbeconsideredwhereIBSsymptomspersistandrecommendationsincludefollowingalowFODMAPdiet,tobedeliveredonlybyahealthcareprofessionalwithexpertiseindietarymanagement.Theefficacyofthisdietissupportedbyagrowingbodyofevidence.Incontrast,theroleoflactoseorglutendietaryrestrictioninthetreatmentofIBSremainssubjecttoongoingresearchwithalackofhigh-qualityevidence.Likewise,furtherclinicaltrialsareneededtoconcludetheefficacyofprobioticsonIBSsymptoms.