简介：AIM:Toinvestigatetheclinicalcharacteristicsoffulminanthepatitisinpregnancy.METHODS:Wecomparedandanalyzedtheetiology,clinicalcharacteristics,andlaboratoryexaminationsof25casesoffulminanthepatitisinpregnancyand30casesoffulminanthepatitisnotinpregnancy.RESULTS:HBVinfectionandchronicfulminanthepatitisweremostcommonbothinthepregnantandinthenon-pregnantgroups.Jaundice,digestivetractsymptoms,increaseofbilirubinandthrombinogenactivitywerethemainmanifestations.Theincidenceofhepaticencephalopathy(HE)andhepato-renalsyndrome(HRS)wassignificantlydifferentbetweenthetwogroups.Theincidenceofpretermlabor,deadfetusandneonatalasphyxiawashigh.CONCLUSION:Fulminanthepatitisislikelytooccurinlatepregnancywithmoreseverecomplications,whichsignificantlyinfluencesmaternity,perinatalfetus,andnewborn.

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简介：AIM:Tostudytheearlydiagnosisandmanagementoffamilialadenomatouspolyposis(FAP).METHODS:EightpedigreesofFAPwerecollectedandtheirpedigreetreeswereprotracted.ClinicalcharacteristicsandtreatmentoutcomesofFAPpatientsinthesekindredswereanalysed.RESULTS:Atotalof157memberswereinvestigatedineightkindredsand25patientswithFAPwerediagnosed.Theratioofmalepatientsandfemalepatientswas16:9andtheaverageageatonsetwas38years.Amongthem,sixpatientsdiedofcancerwithamortalityrateof28%,and36%(9/25)FAPpatientswerediagnosedassynchronouscolorectalcanceronthebasisofFAP.Aprobandwasdiagnosedassynchronouscolorectalcancerwithlivermetastasisanddied11molaterafterpartialcolectomyandhepaticmetastaticlesionbiopsy.Theothersevenprobandsreceivedtotalabdominalcolectomyandrectalmucosectomywithilealpouch-analanastomosis(IPAA),andoneofthemwasdiagnosedassynchronouscoloncanceronthebasisofFAPandwasstillaliveafter7.5yearsfollow-up.AmongtheothersevenpatientswithsynchronouscolorectalcanceronthebasisofFAPunderwenttotalabdominalcolectomywithileorectalanastomosis(IRA),oneunderwenttotalremnantrectumresectionandileostomyforrecurrentcarcinomaintheretainedrectum2.5yearslateraftertheIRAandwasstillalive,whiletheothersalldiedofrecurrencewithamediansurvivaltimeof4.6years.Throughclosefollow-upandtermlyendoscopicsurveillance,threeFAPpatientsweredetectedbeforepresentingsymptomsattheageof18,20and23years,respectively.ProphylacticIPAAwasperformedandresultsweresatisfactoryafterthepatientswerefollowed-upfor6,1,and8years,respectively.CONCLUSION:Pedigreeinvestigation,closefollow-upandtermlyendoscopicsurveillanceareveryimportantforearlydetectionofFARProphylacticIPAAcangivesatisfactoryresultstoFAPpatients.

简介：Fermentedfoodshavebeenconsumedforcenturiesacrossmanygeographicallocalesandhavetraditionallybeenconsideredhealthyfoods,partlybecauseofthelivemicrobescontainedinthem.Theconceptof'probiotics'furtherrequiresthatthemicrobesbedefinedandtheirhealtheffectsbedemonstratedthroughhumaninterventionstudiesorothersuitableinvestigationsbeforemarketingwithcorrespondinghealthmessages.Here,wereviewrecommendationsforfermentedfoodsandprobioticsinseveralcountriesoutsidetheEU,focusingonfood-baseddietaryguidelines.Weemphasizerecommendationsonyoghurtandprobioticsmadebyexpertbodies.Wefoundthatdietaryguidelinescommonlyadvocatetheconsumptionofyoghurtorsimilarproducts,butspecificcommentsonprobioticsarerare.Further,wereviewedguidelinesfromclinicalassociations.Ingeneral,theyacknowledgethebeneficialeffectsofprobiotics,butoftensuggesttheneedforfurtherresearch.Thisistruedespitegoodqualityevidencesupportingtheroleofprobioticsforcertainhealtheffects,suchaspreventionofeczemaininfants,managementofsideeffectsfromantibioticsandalleviationoffunctionalbowelsymptoms.Additionalresearchtosupportfuturedietaryrecommendationsshouldfocusondeterminingeffectsize,identifyingrespondersandnon-responders,clarifyingstrain-specificityofeffectsandconfirmingmechanisms.

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简介：瞄准：在食道的有鳞的房间癌(ESCC)调查midkine的表示并且与clinicopathological特征分析它的关系。方法：RT-PCR和免疫细胞化学的染色被用来分别地在EC109房间检测midkinemRNA和蛋白质的表示。然后，在ESCC样品的66种情况中的midkine的表示被免疫组织化学对人的midkine用单音的同种细胞的抗体检测。结果：Midkine被RT-PCR和免疫细胞化学在EC109房间表示。免疫反应在56.1%被检测(37/66)ESCC样品。midkine的表示在肿瘤房间的细胞质被发现。尤其是，midkine的紧张在充满容器和肿瘤的入侵的边阶的区域是更强壮的。Midkine更强烈地比在中等并且糟糕区分的肿瘤在很好区分的肿瘤(76.9%)被表示(43.1%和41.2%，分别地)(P<0.05)。在midkine之间没有统计上重要的关联在ESCC的表示和性，年龄，临床的阶段，淋巴节点转移或幸存。结论：Midkine完了在ESCC表示了。它可以在肿瘤血管生成和侵略起一个作用。midkine的表示在ESCC与肿瘤细胞分化被相关。肿瘤房间区分越多糟糕，midkine表示越多weaker。

简介：Onetosixpercentofpatientswithmicroscopiccolitisarerefractorytomedicaltreatment.Theeffectoffaecalmicrobiotatransplantation(FMT)inactivecollagenouscolitis(CC)has,tothebestofourknowledge,neverbeenreportedbefore.Here,wereporttheeffectofrepeatedFMTinapatientwithCC.Thepatientpresentedwithseveresymptomsincludingprofusediarrheaandprofoundweightloss.Althoughsherespondedtobudesonideinthebeginning,shebecamegraduallyrefractorytomedicaltreatment,andwasthereforetreatedwithFMT.Thepatientremainedinremissionfor11moafterthethirdfaecaltransplantation.Theimmunomodulatoryeffectofthetherapywasevaluatedusingflowcytometry,whichshowedalterationsintheprofileofintraepithelialandlaminaproprialymphocytesubsetsafterthesecondtransplantation.OurobservationsindicatethatFMTcanhaveaneffectinCC,whichsupportthehypothesisthatluminalfactors,influencingtheintestinalmicrobiota,areinvolvedinthepathogenesisofCC.

简介：Laparoscopicrectalsurgerycontinuestobeachallengingoperationassociatedtoasteeplearningcurve.Roboticsurgicalsystemshavedramaticallychangedminimallyinvasivesurgery.Three-dimensional,magnifiedandstableview,articulatedinstruments,andreductionofphysiologictremorsleadingtosuperiordexterityandergonomics.Therefore,roboticplatformscouldpotentiallyaddresslimitationsoflaparoscopicrectalsurgery.Itwasaimedatreviewingcurrentliteratureonshort-termclinicalandoncological(pathological)outcomesafterroboticrectalcancersurgeryincomparisonwithlaparoscopicsurgery.Asystematicreviewwasperformedfortheperiod2002to2014.Atotalof1776patientswithrectalcancerunderwentminimallyinvasiverobotictreatmentin32studies.Afterroboticandlaparoscopicapproachtooncologicrectalsurgery,respectively,meanoperatingtimevariedfrom192-385min,andfrom158-297min;meanestimatedbloodlosswasbetween33and283mL,andbetween127and300mL;meanlengthofstayvariedfrom4-10d;andfrom6-15d.Conversionafterroboticrectalsurgeryvariedfrom0%to9.4%,andfrom0to22%afterlaparoscopy.Therewasnodifferencebetweenrobotic(0%-41.3%)andlaparoscopic(5.5%-29.3%)surgeryregardingmorbidityandanastomoticcomplications(respectively,0%-13.5%,and0%-11.1%).Regardingimmediateoncologicoutcomes,respectivelyamongroboticandlaparoscopiccases,positivecircumferentialmarginsvariedfrom0%to7.5%,andfrom0%to8.8%;themeannumberofretrievedlymphnodeswasbetween10and20,andbetween11and21;andthemeandistalresectionmarginwasfrom0.8to4.7cm,andfrom1.9to4.5cm.Roboticrectalcancersurgeryisbeingundertakenbyexperiencedsurgeons.However,thequalityoftheassembledevidencedoesnotsupportdefiniteconclusionsaboutmoststudiesvariables.Roboticrectalcancersurgeryisassociatedtoincreasedcostsandoperatingtime.Italsoseemstobeassociatedtoreducedconversionrates.Othershort-termo

简介：AIM:Toevaluatetheclinicalusefulnessofendoscopicultrasonography(EUS)forthediagnosisoftheinvasiondepthofulcerativecolitis-associatedtumors.METHODS:Thestudygroupcomprised13patientswith16ulcerativecolitis(UC)-associatedtumorsforwhichthedepthofinvasionwaspreoperativelyestimatedbyEUS.Thelesionswerethenresectedendoscopicallyorbysurgicalcolectomyandwereexaminedhistopathologically.Themeanageofthesubjectswas48.2±17.1years,andthemeandurationofUCwas15.8±8.3years.Twolesionsweretreatedbyendoscopicresectionandtheother14lesionsbysurgicalcolectomy.ThedepthofinvasionofUCassociatedtumorswasestimatedbyEUSusinganultrasonicprobeandwasevaluatedonthebasisofthedeepestlayerwithnarrowingorruptureofthecolonicwall.RESULTS:ThediagnosisofUC-associatedtumorsbyEUSwascarcinomafor13lesionsanddysplasiafor3lesions.Theinvasiondepthofthecarcinomaswasintramucosalfor8lesions,submucosalfor2,themuscularispropriafor2,andsubserosalfor1.Eleven(69%)ofthe16lesionsaroseintherectum.Themacroscopicappearancewasthelaterallyspreadingtumor-non-granulartypefor4lesions,sessiletypefor4,laterallyspreadingtumor-granulartypefor3,semipedunculatedtype(Isp)for2,type1for2,andtype3for1.ThedepthofinvasionwascorrectlyestimatedbyEUSfor15lesions(94%)butwasmisdiagnosedasintramucosalfor1carcinomawithhigh-gradesubmucosalinvasion.The2lesionstreatedbyendoscopicresectionwereintramucosalcarcinomaanddysplasia,andbothwerediagnosedasintramucosallesionsbyEUS.CONCLUSION:EUSprovidesagoodestimationoftheinvasiondepthofUC-associatedtumorsandmaythusfacilitatetheselectionoftreatment.

简介：InthiseditorialwecommentonthearticlebyFukushiKetalpublishedintherecentissueoftheWorldJournalofGastroenterology2018;24(34):3908-3918.Wefocusspecificallyonthemechanismsoftheanti-thromboticactionofaspirin,gastricmucosalinjuryandaging-relatedincreasedsusceptibilityofgastricmucosatoinjury.Aspiriniswidelyusednotonlyforthemanagementofacuteandchronicpainandarthritis,butalsoimportantlyfortheprimaryandsecondarypreventionofcardiovasculareventssuchasmyocardialinfarctsandstrokes.Clinicaltrialshaveconsistentlyshownthatantiplatelettherapywithlongterm,lowdoseaspirin(LDA)-75to325mgdaily,dramaticallyreducestheriskofnon-fatalmyocardialinfarcts,strokeandmortalityinpatientswithestablishedarterialdiseases.However,suchtreatmentconsiderablyincreasestheriskofgastrointestinal(GI)ulcerationsandseriousbleedingby>2-4fold,especiallyinagingindividuals.ThisriskisfurtherincreasedinpatientsusingLDAtogetherwithotherantiplateletagents,othernonsteroidalanti-inflammatoryagents(NSAIDs)and/oralcohol,orinpatientswithHelicobacterpylori(H.pylori)infection.Previousstudiesbyourgroupandothershavedemonstratedprominentstructuralandfunctionalabnormalitiesingastricmucosaofagingindividuals(whichwerefertoasaginggastricmucosaor“aginggastropathy”)comparedtothegastricmucosaofyoungerindividuals.Aginggastricmucosahasimpairedmucosaldefense,increasedsusceptibilitytoinjurybyavarietyofnoxiousagentssuchasaspirin,otherNSAIDsandethanol,anddelayedandimpairedhealingofinjury.Themechanismunderlyingtheseabnormalitiesofaginggastricmucosaincludereducedmucosalbloodflowcausinghypoxia,upregulationofPTEN,activationofproapoptoticcaspase-3andcaspase-9,andreducedsurvivin(anti-apoptosisprotein),importin-α(nucleartransportprotein),vascularendothelialgrowthfactor,andnervegrowthfactor.Thedecisionregardinginitiationofalong-termLDAtherapyshould

简介：AIM:ToevaluatehowwidelyHelicobacterpylori(H.pylori)HopEandHopVporinsareexpressedamongChileanisolatesandhowseroprevalenttheyareamonginfectedpatientsinChile.METHODS:H.pylorihopEandhopVgenesderivedfromstrainCHCTX-1wereclonedbypolymerasechainreaction(PCR),sequencedandexpressedinEscherichiacoliAD494(DE3).Gel-purifiedporinswereusedtopreparepolyclonalantibodies.ThepresenceofbothgeneswastestedbyPCRinacollectionofH.pyloriclinicalisolatesan...

简介：瞄准：讨论CT的临床的价值三维(3-D)在诊断胃肠道疾病的成像。方法：52个病人的Three-D成像调查结果回顾地被分析。Three-D成像方法包括的遮的表面显示(SSD)，显示的体积(VR)，虚拟内视镜检查法(VE)(MPR)并且多平面的重新格式化。CT3-D的诊断结果被比较内视镜检查法或外科的发现与那些评估。结果：有胃肠道疾病的52个病人被CT3-D成像，50个盒子正确地被诊断诊断，2被误诊。有胃的疾病的33个盒子(27与癌，5与消化性溃疡并且1与平滑肌瘤)并且19大肠的疾病(10与结肠癌，2与直肠的癌，5与结肠息肉并且2与回盲肠连接的肺结核)。有突出的损害的22个盒子(9与随后的空损害)，20与洞的狭窄(8与伴随物突出的损害)并且10与空损害(5与伴随物突出的损害)在3-D图象被显示出。显示出的最小的损害是1.0厘米x0.8厘米x0.5厘米。结论：CT3-D成像，没有疼痛的非侵略的考试，能清楚地并且直接与精确地点和高诊断精确性显示胃肠道的损害。它是到内视镜检查法的一种重要互补技术。

简介：INTRODUCTIONInterventiontherapyhasbecomeoneofthemaintherapiesofhepaticcancer.Theintroductionofhepaticarterialperfusionandembolizationhasprovidedopportunitiesforasecondaryoperationonpatientswithintermediateandadvancedcancer,thusprolonging

简介：Colorectalcancerhepaticmetastasesrepresentthefinalstageofamulti-stepbiologicalprocess.Thisprocessstartswithaseriesofmutationsincolonicepithelialcells,continueswiththeirdetachmentfromthelargeintestine,disseminationthroughthebloodand/orlymphaticcirculation,attachmenttothehepaticsinusoidsandinteractionswiththesinusoidalcells,suchassinusoidalendothelialcells,Kupffercells,stellatecellsandpitcells.Themetastaticsequenceterminateswithcolorectalcancercellinvasion,adaptationandcolonisationofthehepaticparenchyma.Alltheseevents,termedthecolorectalcancerinvasion-metastasiscascade,includemultiplemolecularpathways,intercellularinteractionsandexpressionofaplethoraofchemokinesandgrowthfactors,andadhesionmolecules,suchastheselectins,theintegrinsorthecadherins,aswellasenzymesincludingmatrixmetalloproteinases.Thisreviewaimstopresentrecentadvancesthatprovideinsightsintothesecell-biologicaleventsandemphasizesthosethatmaybeamenabletotherapeutictargeting.

简介：瞄准：在根据操作特征(巨鸟)曲线分析的接收装置预言胰腺的癌的体面评估浆液CA19-9层次的临床的价值。方法：浆液CA19-9层次与可能根据成像是resected的胰腺的癌症在104个病人被测量。巨鸟曲线为CA19-9层次被阴谋。最近到图的上面的左边的角落的点被选择为截止的点。敏感，特性，在这个截止的点的CA19-9的积极、否定的预兆的价值被计算。结果：可切除的胰腺的癌症在58被检测(55.77%)病人和unresectable胰腺的癌症在46被检测(44.23%)病人。在ROC曲线下面的区域是0.918和95%CI是0.843-0.992。CA19-9水平是353.15U/mL，和敏感，在这个截止的点的CA19-9的特性分别地是93.1%和78.3%。积极、否定的预兆的价值分别地是84.38%和90%。结论：外科手术前的浆液CA19-9水平是为进一步评估胰腺的癌症的将切除能力的一个有用标记。CA19-9的显然增加的浆液层次(>353.15U/mL)能为unresectable被认为是一个辅助参数胰腺的癌症。

简介：瞄准：为了为在肝炎B估计肝的纤维变性决定结缔组织生长因素(CCN2/CTGF)的用途，病毒(HBV)导致了长期的肝疾病(CLD-B)。方法：连接酶的immunosorbent试金被用来与导致HBV的活跃的肝肝硬化和30个健康个人与长期的肝炎B(CHB)和39个病人从107个病人在sera测量CCN2。从有CHB，有导致HBV的肝肝硬化的8个病人和有正常的肝组织学的8个HBV搬运人的31个病人的肝样品为转变生长因素-1(TGF-1)或CCN2mRNA层次由被检验在situ杂交，并且计算机图象分析被执行在肝纸巾测量CCN2mRNA积极的房间的综合最佳的密度(IOD)。组织学的发炎分级和纤维变性阶段被H并且E染色和凡·吉森斯方法评估。结果：分别地，浆液CCN2集中作为与健康个人相比在有CHB或活跃的肝肝硬化的病人更高是4.0褶层或4.9褶层(P<0.01)。在肝纸巾在在sera和CCN2mRNA表示的CCN2的层次之间有好一致性(r=0.87，P<0.01)。在sera的CCN2的层次与CLD-B在病人与组织学的纤维变性阶段的改进被增加(r=0.85，P<0.01)。浆液CCN2是为对肝纤维变性的评价的一个可靠标记，与在操作为从有F1阶段肝纤维变性的病人的分别地，区分的正常的肝控制的0.94或0.85的特征(巨鸟)曲线(AUC)或在温和、重要的纤维变性之间区别的接收装置下面的区域。结论：在有CLD-B的病人的浆液CCN2的察觉可以为对肝的纤维变性的严厉的评价有临床的意义。

简介：INTRODUCTIONInChina,liverfibrosisinmostpatientsresultedfromthevirusesofhepatitisB.Bothanti-virusandanti-fibrosisshouldbeconsideredindesigningaprogramforthetreatmentofliverfibrosis.Therefore,40casesofliverfibrosisduetohepatitisBweretreatedbyusingIFN-α1andtraditionalmedicinalpreparationsfromFebruary1994toApril1996.Goodcurativeeffectwasachieved.

简介：瞄准：为了在病人调查胰岛素抵抗和糖尿病的临床的参数的流行，由长期的丙肝(CHC)或长期的肝炎B(CHB)影响了。方法：我们回顾地评估了经历了肝活体检视的852个连续病人(726CHC和126CHB)。我们记录了年龄，性别，中高音，类型2糖尿病或新陈代谢的症候群(MS)，身体团索引(BMI)，和明显的疾病持续时间(增加)。结果：年龄，增加，BMI，在有温和/中等的肝纤维变性的病人的MS和糖尿病的流行在CHC是显著地更高的。然而，脂肪变性的度和在肝活体检视评估的肝纤维变性没在CHC和CHB病人之间不同。在多变量分析，年龄，性别，BMI，中高音和糖尿病是为在CHC的肝纤维变性的独立风险因素，而仅仅年龄与在CHB的肝纤维变性有关。我们也评估了在重要脂肪变性之间的协会(>30%)并且年龄，性别，BMI，糖尿病，MS和肝纤维变性。糖尿病，BMI和肝纤维变性与脂肪变性>被联系30%在CHC，而仅仅年龄和BMI与在CHB的脂肪变性有关。结论：这些数据可以显示丙肝病毒感染是为胰岛素抵抗的一个风险因素。