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| 1 | An overview of animal models for investigating the pathogenesis and therapeutic strategies in acute hepatic failure显示文摘Acute hepatic failure (AHF) is a severe liver injury accompanied by hepatic encephalopathy which causes multiorgan failure with an extremely high mortality rate, even if intensive care is provided. Management of severe AHF continues to be one of the most challenging problems in clinical medicine. Liver transplantation has been shown to be the most effective therapy, but the procedure is limited by shortage of donor organs. Although a number of clinical trials testing different liver assist devices are under way, these systems alone have no significant effect on patient survival and are only regarded as a useful approach to bridge patients with AHF to liver transplantation. As a result, reproducible experimental animal models resembling the clinical conditions are still needed. The three main approaches used to create an animal model for AHF are: surgical procedures, toxic liver injury and infective procedures. Most common models are based on surgical techniques (total/partial hepatectomy, complete/transient devascularization) or the use of hepatotoxic drugs (acetaminophen, galactosamine, thioacetamide, and others), and very few satisfactory viral models are available. We have recently developed a viral model of AHF by means of the inoculation of rabbits with the virus of rabbit hemorrhagic disease. This model displays biochemical and histological characteristics, and clinical features that resemble those in human AHF. In the present article an overview is given of the most widely used animal models of AHF, and their main advantages and disadvantages are reviewed. | María Jesús Tuón Marcelino Alvarez Jesús M Culebras Javier González-Gallego | 2009 | World Journal of Gastroenterology2009，15，25： | 29 |
| 2 | Risk factors associated with the development of ischemic colitis显示文摘AIM:To ascertain the role of cardiovascular risk factors,cardiovascular diseases,standard treatments and other diseases in the development of ischemic colitis(IC).METHODS:A retrospective,case-control study was designed,using matched data and covering 161 incident cases of IC who required admission to our hospital from 1998 through 2003.IC was diagnosed on the basis of endoscopic findings and diagnostic or compatible his-tology.Controls were randomly chosen from a cohort of patients who were admitted in the same period and required a colonoscopy,excluding those with diagnosis of colitis.Cases were matched with controls(ratio 1:2),by age and sex.A conditional logistic regression was performed.RESULTS:A total of 483 patients(161 cases,322 con-trols)were included;mean age 75.67±10.03 years,55.9%women.The principal indications for colonos-copy in the control group were lower gastrointestinal hemorrhage(35.4%),anemia(33.9%),abdominal pain(19.9%)and diarrhea(9.6%).The endoscopic findings in this group were hemorrhoids(25.5%),diverticular disease(30.4%),polyps(19.9%)and colorectal cancer(10.2%).The following variables were associated with IC in the univariate analysis:arterial hypertension(P= 0.033);dyslipidemia(P<0.001);diabetes mellitus(P =0.025);peripheral arterial disease(P=0.004);heart failure(P=0.026);treatment with hypotensive drugs(P=0.023);angiotensin-converting enzyme inhibitors;(P=0.018);calcium channel antagonists(P=0.028);and acetylsalicylic acid(ASA)(P<0.001).Finally,the following variables were independently associated with the development of IC:diabetes mellitus[odds ratio(OR)1.76,95%confidence interval(CI):1.001-3.077,P=0.046];dyslipidemia(OR 2.12,95%CI:1.26-3.57,P=0.004);heart failure(OR 3.17,95%CI:1.31-7.68,P=0.01);peripheral arterial disease(OR 4.1,95%CI:1.32-12.72,P=0.015);treatment with digoxin(digitalis)(OR 0.27,95%CI:0.084-0.857,P=0.026);and ASA(OR 1.97,95%CI:1.16-3.36,P=0.012).CONCLUSION:The development of an episode of IC was independently associated with diabetes,dyslipid-emia,presence of heart failure,peripheral arterial dis-ease and treatment with digoxin or ASA. | Joaquín Cubiella Fernández Luisa Núez Calvo Elvira González Vázquez Maria Jesús García García Maria Teresa Alves Pérez Isabel Martínez Silva Javier Fernández Seara | 2010 | World Journal of Gastroenterology2010，16，36： | 27 |
| 3 | Triglyceride levels and apolipoprotein E polymorphism in patients with acute pancreatitis显示文摘BACKGROUND:Hypertriglyceridemia is an unusual cause of acute pancreatitis and sometimes considered to be an epiphenomenon.This study aimed to investigate the clinical and analytical features and the APOE genotypes in patients with acute pancreatitis and severe hypertriglyceridemia.METHODS:We undertook a one-year,prospective study of patients with acute pancreatitis whose first laboratory analysis on admission to the emergency department included measurement of serum triglycerides.The APOE genotype was determined and the patients answered an established questionnaire within the first 24 hours concerning their alcohol consumption,the presence of co-morbidities and any medications being taken.The patients' progression,etiological diagnosis,hospital stay and clinical and radiological severity were all recorded.RESULTS:Hypertriglyceridemia was responsible for 7 of 133 cases of pancreatitis (5%);the remaining cases were of biliary (53%),idiopathic (26%),alcoholic (11%) or other (5%) origin.Compared with these remaining cases,the patients with hypertriglyceridemia were significantly younger,had more relapses,and more often had diabetes mellitus.They usually consumed alcohol or consumed it excessively on the days before admission.Also,the ε4 allele of the APOE gene was more common in this group (P<0.05).CONCLUSION:One of 20 episodes of acute pancreatitis is caused by hypertriglyceridemia and it is linked to genetic (ε4 allele) and comorbid factors such as diabetes and,especially,alcohol consumption. | Radka Ivanova Susana Puerta Alfonso Garrido Ignacio Cueto Ana Ferro María José Ariza Andrés Cobos Pedro González-Santos Pedro Valdivielso | 2012 | Hepatobiliary & Pancreatic Diseases International2012，11，1： | 26 |
| 4 | Advances in immunotherapy for treatment of lung cancer显示文摘Different approaches for treating lung cancer have been developed over time, including chemotherapy, radiotherapy and targeted therapies against activating mutations. Lately, better understanding of the role of the immunological system in tumor control has opened multiple doors to implement different strategies to enhance immune response against cancer cells. It is known that tumor cells elude immune response by several mechanisms. The development of monoclonal antibodies against the checkpoint inhibitor programmed cell death protein 1(PD-1) and its ligand(PD-L1), on T cells, has led to high activity in cancer patients with long lasting responses. Nivolumab, an anti PD-1 inhibitor, has been recently approved for the treatment of squamous cell lung cancer patients, given the survival advantage demonstrated in a phase III trial. Pembrolizumab, another anti PD-1 antibody, has received FDA breakthrough therapy designation for treatment of non-small cell lung cancer(NSCLC), supported by data from a phase I trial. Clinical trials with anti PD-1/PD-L1 antibodies in NSCLC have demonstrated very good tolerability and activity, with response rates around 20% and a median duration of response of 18 months. | Jean G.Bustamante Alvarez María González-Cao Niki Karachaliou Mariacarmela Santarpia Santiago Viteri Cristina Teixidó Rafael Rosell | 2015 | Cancer Biology & Medicine2015，12，3： | 22 |
| 5 | Device-associated infection rates, mortality, length of stay and bacterial resistance in intensive care units in Ecuador: International Nosocomial Infection Control Consortium's findings显示文摘AIM To report the results of the International Nosocomial Infection Control Consortium(INICC) study conducted in Quito, Ecuador.METHODS A device-associated healthcare-acquired infection(DAHAI) prospective surveillance study conducted from October 2013 to January 2015 in 2 adult intensive care units(ICUs) from 2 hospitals using the United States Centers for Disease Control/National Healthcare Safety Network(CDC/NHSN) definitions and INICC methods. RESULTS We followed 776 ICU patients for 4818 bed-days. The central line-associated bloodstream infection(CLABSI) rate was 6.5 per 1000 central line(CL)-days, the ventilator-associated pneumonia(VAP) rate was 44.3 per 1000 mechanical ventilator(MV)-days, and the catheterassociated urinary tract infection(CAUTI) rate was 5.7 per 1000 urinary catheter(UC)-days. CLABSI and CAUTI rates in our ICUs were similar to INICC rates [4.9(CLABSI) and 5.3(CAUTI)] and higher than NHSN rates [0.8(CLABSI) and 1.3(CAUTI)]- although device use ratios for CL and UC were higher than INICC and CDC/NSHN's ratios. By contrast, despite the VAP rate was higher than INICC(16.5) and NHSN's rates(1.1), MV DUR was lower in our ICUs. Resistance of A. baumannii to imipenem and meropenem was 75.0%, and of Pseudomonas aeruginosa to ciprofloxacin and piperacillin-tazobactam was higher than 72.7%, all them higher than CDC/NHSN rates. Excess length of stay was 7.4 d for patients with CLABSI, 4.8 for patients with VAP and 9.2 for patients CAUTI. Excess crude mortality in ICUs was 30.9% for CLABSI, 14.5% for VAP and 17.6% for CAUTI. CONCLUSION DA-HAI rates in our ICUs from Ecuador are higher than United States CDC/NSHN rates and similar to INICC international rates. | Estuardo Salgado Yepez Maria M Bovera Victor D Rosenthal Hugo A González Flores Leonardo Pazmino Francisco Valencia Nelly Alquinga Vanessa Ramirez Edgar Jara Miguel Lascano Veronica Delgado Cristian Cevallos Gasdali Santacruz Cristian Pelaéz Celso Zaruma Diego Barahona Pinto | 2017 | World Journal of Biological Chemistry2017，8，1： | 23 |
| 6 | Epidemiological Evolution of Lung Cancer in the South of Spain from 1990 to 2010显示文摘Background: Changes in lung cancer has been characterized by the increase of cases among women and the increase in adenocarcinomas among other histological subtypes.Methods: Descriptive analysis of cases diagnosed with lung cancer in Hospital Virgen de las Nieves(Spain) from 1990 to 2010,based on five variables(age, sex, smoking, histology and pathological anatomy). The study establishes associations between these variables and compares the results with the literature.Results: 2,026 patients were diagnosed with lung cancer in this period; 1,838 were males(90.7%) and 188 women(9.3%); 1,892 patients(93.4%) were smokers or ex-smokers and 134(6.6%) had never smoked; the most frequent non-small cell histology types were squamous cell carcinoma and adenocarcinoma and it was the most frequent neoplasia in women and were associated with a lower tobacco consumption.Conclusion: The large majority of lung cancer cases is associated with a history of smoking tobacco and there are histopathological differences according to gender and cumulative tobacco smoke load. | Alberto Caballero Vázquez Ana Dolores Romero Ortiz Jose Manuel González de Vega San Román Raimundo García del Moral Bernardino Alcázar Navarrete | 2018 | 中国肺癌杂志2018，21，1： | 17 |
| 7 | Phylogenetic alpha and beta diversity in tropical tree assemblages along regionalscale environmental gradients in northwest South America显示文摘Aims Environmental gradients are drivers of species diversity;however,we know relatively little about the evolutionary processes underlying these relationships.A potentially powerful approach to studying diversity gradients is to quantify the phylogenetic structure within and between assemblages arrayed along broad spatial and environmental gradients.Here,we evaluate the phylogenetic structure of plant assemblages along an environmental gradient with the expectation that the habitat specialization of entire lineages is an important evolutionary pattern influencing the structure of tree communities along environmental gradients.Methods We evaluated the effect of several environmental variables on the phylogenetic structure of plant assemblages in 145 plots distributed in northwestern South America that cover a broad environmental gradient.The phylogenetic alpha diversity was quantified for each plot and the phylogenetic beta diversity between each pair of plots was also quantified.Both the alpha and beta diversity measures were then related to spatial and environmental gradients in the study system.Important Findings We found that gradients in temperature and potential evapotranspiration have a strong relationship with the phylogenetic alpha diversity in our study system,with phylogenetic overdispersion in low temperatures and phylogenetic clustering at higher temperatures.Further,the phylogenetic beta diversity between two plots increases with an increasing difference in temperature,whereas annual precipitation was not a significant predictor of community phylogenetic turnover.We also found that the phylogenetic structure of the plots in our study system was related to the degree of seasonal flooding and seasonality in precipitation.In particular,more stressful environments such as dry forests and flooded forests showed phylogenetic clustering.Finally,in contrast with previous studies,we find that phylogenetic beta diversity was not strongly related to the spatial distance separating two forest plots,which may be the result of the importance of the three independent mountain ranges in our study system,which generate a high degree of environmental variation over very short distances.In conclusion,we found that environmental gradients are important drivers of both phylogenetic alpha and phylogenetic beta diversities in these forests over spatial distance. | Sebastián González-Caro María Natalia Umaña Esteban Álvarez Pablo R.Stevenson Nathan G.Swenson | 2014 | Journal of Plant Ecology2014，7，2： | 17 |
| 8 | Tenofovir vs lamivudine plus adefovir in chronic hepatitis B:TENOSIMP-B study显示文摘AIM To demonstrate the non-inferiority(15% non-inferiority limit) of monotherapy with tenofovir disoproxil fumarate(TDF) vs the combination of lamivudine(LAM) plus adefovir dipivoxil(ADV) in the maintenance of virologic response in patients with chronic hepatitis B(CHB) and prior failure with LAM.METHODS This study was a Phase IV prospective, randomized, open, controlled study with 2 parallel groups(TDF and LAM+ADV) of adult patients with hepatitis B e antigen(HBe Ag)-negative CHB, prior failure with LAM, on treatment with LAM+ADV for at least 6 mo, without prior resistance to ADV and with an undetectable viral load at the start of the study, in 14 Spanish hospitals. The follow-up time for each patient was 48 wk after randomization, with quarterly visits in which the viral load, biochemical and serological parameters, adverse effects, adherence to treatment and consumption of hospital resources were analysed.RESULTS Forty-six patients were evaluated [median age: 55.4 years(30.2-75.2); 84.8% male], including 22 patients with TDF and 24 with LAM+ADV. During study development, hepatitis B virus DNA(HBV-DNA) remained undetectable, all patients remained HBe Ag negative, and hepatitis B surface antigen(HBs Ag) positive. Alanine aminotransferase(ALT) values at the end of the study were similar in the 2 groups(25.1± 7.65, TDF vs 24.22 ± 8.38, LAM+ADV, P = 0.646). No significant changes were observed in creatinine or serum phosphorus values in either group. No significant differences between the 2 groups were noted in the identification of adverse effects(AEs)(53.8%, TDF vs 37.5%, LAM+ADV, P = 0.170), and none of the AEs which occurred were serious. Treatment adherence was 95.5% and 83.3% in the TDF and the LAM+ADV groups, respectively(P = 0.488). The costs associated with hospital resource consumption were significantly lower with the TDF treatment than the LAM+ADV treatment(€4943 ± 1059 vs €5811 ± 1538, respectively, P < 0.001).CONCLUSION TDF monotherapy proved to be safe and not inferior to the LAM+ADV combination therapy in maintaining virologic response in patients with CHB and previous LAM failure. In addition, the use of TDF generated a significant savings in hospital costs. | Manuel Rodríguez Juan Manuel Pascasio Enrique Fraga Javier Fuentes Martín Prieto Gloria Sánchez-Antolín Jose Luis Calleja Esther Molina María Luisa García-Buey María Angeles Blanco Javier Salmerón María Lucía Bonet Jose Antonio Pons Jose Manuel González Miguel Angel Casado Francisco Jorquera 无 | 2017 | World Journal of Gastroenterology2017，23，41： | 16 |
| 9 | Hyperthermic intraperitoneal chemotherapy:Rationale and technique显示文摘The combination of complete cytoreductive surgery and perioperative intraperitoneal chemotherapy provides the only chance for long-term survival for selected patients diagnosed with a variety of peritoneal neoplasms,either primary or secondary to digestive or gynecologic malignancy.Hyperthermic intraperitoneal chemotherapy (HIPEC) delivered in the operating room once the cytoreductive surgical procedure is fi nalized,constitutes the most common form of administration of perioperative intraperitoneal chemotherapy.This may be complemented in some instances with early postoperative intraperitoneal chemotherapy (EPIC).HIPEC combines the pharmacokinetic advantage inherent to the intracavitary delivery of certain cytotoxic drugs,which results in regional dose intensification,with the direct cytotoxic effect of hyperthermia.Hyperthermia exhibits a selective cell-killing effect in malignant cells by itself,potentiates the cytotoxic effect of certain chemotherapy agents and enhances the tissue penetration of the administered drug.The chemotherapeutic agents employed in HIPEC need to have a cell cycle nonspecific mechanism of action and should ideally show a heat-synergistic cytotoxic effect.Delivery of HIPEC requires an apparatus that heats and circulates the chemotherapeutic solution so that a stable temperature is maintained in the peritoneal cavity during the procedure.An open abdomen (Coliseum) or closed abdomen technique may be used,with no signif icant differences in eff icacy proven to date.Specif ic technical training and a solid knowledge of regional chemotherapy management are required.Concerns about safety of the procedure for operating room personnel are expected but are manageable if universal precautions and standard chemotherapy handling procedures are used.Different HIPEC drug regimens and dosages are currently in use.A tendency for concurrent intravenous chemotherapy administration (bidirectional chemotherapy,so-called 'HIPEC plus') has been observed in recent years,with the aim to further enhance the cytotoxic potential of HIPEC.Future trials to ascertain the ideal HIPEC regimen in different diseases and to evaluate the efficacy of new drugs or drug combinations in this context are warranted. | Santiago González-Moreno Luis A González-Bayón Gloria Ortega-Pérez | 2010 | World Journal of Gastrointestinal Oncology2010，2，2： | 15 |
| 10 | IL28B polymorphisms associated with therapy response in Chilean chronic hepatitis C patients显示文摘AIM:To analyze the association of three IL28B single nucleotide polymorphisms with response to therapy in Chilean patients infected with hepatitis C virus CV.METHODS:We studied two groups of patients with chronic CV infection genotype 1,under standard combined treatment with pegylated interferon plus ribavirin.One group consisted of 50 patients with sustained virological response,whereas the second group consisted of 49 null responders.In order to analyze the IL28B single nucleotide polymorphisms rs12979860,rs12980275 and rs8099917,samples were used for polymerase chain reaction amplification,and the genotyping was performed by restriction fragment lengthpolymorphism.RESULTS:The IL28B rs12979860 CC,rs12980275 AA and rs8099917 TT genotypes were much more frequently found in patients with sustained virological response compared to null responders 38%,44% and 50% vs 2%,8.2% and 8.2%,respectively.These differences were highly significant in all three cases(P < 0.0001.CONCLUSION:The three IL28B polymorphisms studied are strongly associated with sustained virological response to therapy in Chilean patients with chronic CV genotype 1. | Mauricio Venegas Rodrigo A Villanueva Katherine González Javier Brahm | 2011 | World Journal of Gastroenterology2011，17，31： | 13 |
| 11 | Efficacy of neoadjuvant therapy and surgical rescue for locally advanced hepatoblastomas:10 year single-center experience and literature review显示文摘AIM:To report our experience with long-term outcomes after multimodal management therapy.METHODS:An observational retrospective study was performed containing seven patients with hepatoblastoma(Hbl)treated in our institution,a tertiary referral center,from 2003 to 2011.Demographic,preoperative,surgical,and outcome variables were collected.A survival analysis and a review of the current literature related to combination neoadjuvant chemotherapy and surgical resection on Hbl were performed.RESULTS:The median age at surgery was 14.4 mo,with a male to female ratio of 4:3.Pretext staging at diagnosis was as follows:stageⅠ,4 cases;stageⅡ,2 patients;and stageⅢ,1 case.Mean pretreatment tumor volume was 735 cm3.Five out of seven patients received neoadjuvant chemotherapy according to SIOPEL-3 or SIOPEL-6 protocols.Tumor volume and alphafetoprotein levels significantly dropped after neoadjuvant therapy.Surgical procedures performed included hemihepatectomies,segmentectomies and atypical resection.All patients received chemotherapy after surgery.Median postoperative hospital stay was 8 d.All patients were alive and disease-free after a median follow-up period of 23 mo.With regards to the literature review,seventeen articles were found that were related to our search.CONCLUSION:Our series shows how multimodal management of Hbl,exhaustive control and a meticulous surgical approach leads to almost 100%complete resection with optimal postoperative results. | Dolores Ayllon Teran Oscar Gómez Beltran Rubén Ciria Bru Elena Mateos González María José Pea Rosa Antonio Luque Molina Pedro López Cillero Javier Briceo Delgado | 2014 | World Journal of Gastroenterology2014，20，29： | 12 |
| 12 | Non invasive blood flow measurement in cerebellum detects minimal hepatic encephalopathy earlier than psychometric tests显示文摘AIM: To assess whether non invasive blood flow measurement by arterial spin labeling in several brain regions detects minimal hepatic encephalopathy. METHODS: Blood flow(BF) was analyzed by arterial spin labeling(ASL) in different brain areas of 14 controls, 24 cirrhotic patients without and 16 cirrhotic patients with minimal hepatic encephalopathy(MHE). Images were collected using a 3 Tesla MR scanner(Achieva 3T-TX, Philips, Netherlands). Pulsed ASL was performed. Patients showing MHE were detected using the battery Psychometric Hepatic Encephalopathy Score(PHES) consisting of five tests. Different cognitive and motor functions were also assessed: alterations in selective attention were evaluated using the Stroop test. Patients and controls also performed visuo-motor and bimanual coordination tests. Several biochemical parameters were measured: serum pro-inflammatory interleukins(IL-6 and IL-18), 3-nitrotyrosine, cGMP and nitrates+nitrites in plasma, and blood ammonia. Bivariate correlations were evaluated.RESULTS: In patients with MHE, BF was increased in cerebellar hemisphere(P = 0.03) and vermis(P = 0.012) and reduced in occipital lobe(P = 0.017). BF in cerebellar hemisphere was also increased in patients without MHE(P = 0.02). Bimanual coordination was impaired in patients without MHE(P = 0.05) and much more in patients with MHE(P < 0.0001). Visuo-motor coordination was impaired only in patients with MHE(P < 0.0001). Attention was slightly affected in patients without MHE and more strongly in patients with MHE(P< 0.0001). BF in cerebellar hemisphere and vermis correlated with performance in most tests of PHES [(number connection tests A(NCT-A), B(NCT-B)and line tracing test] and in the congruent task of Stroop test. BF in frontal lobe correlated with NCT-A. Performance in bimanual and visuomotor coordination tests correlated only with BF in cerebellar hemisphere. BF in occipital lobe correlates with performance in the PHES battery and with CFF. BF in cerebellar hemisphere correlates with plasma cGMP and nitric oxide(NO) metabolites. BF in vermis cerebellar also correlates with NO metabolites and with 3-nitrotyrosine. IL-18 in plasma correlates with BF in thalamus and occipital lobe.CONCLUSION: Non invasive BF determination in cerebellum using ASL may detect MHE earlier than the PHES. Altered NO-cGMP pathway seems to be associated to altered BF in cerebellum. | Vicente Felipo Amparo Urios Carla Giménez-Garzó Omar Cauli Maria-Jesús Andrés-Costa Olga González Miguel A Serra Javier Sánchez-González Roberto Aliaga Remedios Giner-Durán Vicente Belloch Carmina Montoliu | 2014 | World Journal of Gastroenterology2014，20，33： | 12 |
| 13 | Hepatoprotective effect of silymarin显示文摘The use of medicinal plants in treating illnesses has been reported since ancestral times.In the case of hepatic diseases,several species such as Silybum marianum,Phyllanthus niruri,and Panus giganteus(Berk.)have been shown to ameliorate hepatic lesions.Silymarin is a natural compound derived from the species Silybum marianum,which is commonly known as Milk thistle.This plant contains at least seven flavoligands and the flavonoid taxifolin.The hepatoprotective and antioxidant activity of silymarin is caused by its ability to inhibit the free radicals that are produced from the metabolism of toxic substances such as ethanol,acetaminophen,and carbon tetrachloride.The generation of free radicals is known to damage cellular membranes and cause lipoperoxidation.Silymarin enhances hepatic glutathione and may contribute to the antioxidant defense of the liver.It has also been shown that silymarin increases protein synthesis in hepatocytes by stimulating RNA polymerase I activity.A previous study on humans reported that silymarin treatment caused a slight increase in the survival of patients with cirrhotic alcoholism compared with untreated controls. | Nancy Vargas-Mendoza Eduardo Madrigal-Santillán ngel Morales-González Jaime Esquivel-Soto Cesar Esquivel-Chirino Manuel García-Luna y González-Rubio Juan A Gayosso-de-Lucio José A Morales-González | 2014 | World Journal of Hepatology2014，6，3： | 12 |
| 14 | Validation of Fujinon intelligent chromoendoscopy with high definition endoscopes in colonoscopy显示文摘AIM:To validate high definition endoscopes with Fujinon intelligent chromoendoscopy(FICE) in colonoscopy.METHODS:The image quality of normal white light endoscopy(WLE),that of the 10 available FICE filters and that of a gold standard(0.2% indigo carmine dye) were compared.RESULTS:FICE-filter 4 [red,green,and blue(RGB) wavelengths of 520,500,and 405 nm,respectively] provided the best images for evaluating the vascular pattern compared to white light.The mucosal surface was best assessed using filter 4.However,the views obtained were not rated significantly better than those observed with white light.The 'gold standard',indigo carmine(IC) dye,was found to be superior to both white light and filter 4.Filter 6(RGB wavelengths of 580,520,and 460 nm,respectively) allowed for exploration of the IC-stained mucosa.When assessing mucosal polyps,both FICE with magnification,and magnification following dye spraying were superior to the same techniques without magnification and to white light imaging.In the presence of suboptimal bowel preparation,observation with the FICE mode was possible,and endoscopists considered it to be superior to observation with white light.CONCLUSION:FICE-filter 4 with magnification improves the image quality of the colonic vascular patterns obtained with WLE. | Adolfo Parra-Blanco Alejandro Jiménez Bjrn Rembacken Nicolás González David Nicolás-Pérez Antonio Z Gimeno-García Marta Carrillo-Palau Takahisa Matsuda Enrique Quintero | 2009 | World Journal of Gastroenterology2009，15，42： | 12 |
| 15 | Clinical assessment and management of liver fibrosis in nonalcoholic fatty liver disease显示文摘Non-alcoholic fatty liver disease(NAFLD)is among the most frequent etiologies of cirrhosis worldwide,and it is associated with features of metabolic syndrome;the key factor influencing its prognosis is the progression of liver fibrosis.This review aimed to propose a practical and stepwise approach to the evaluation and management of liver fibrosis in patients with NAFLD,analyzing the currently available literature.In the assessment of NAFLD patients,it is important to identify clinical,genetic,and environmental determinants of fibrosis development and its progression.To properly detect fibrosis,it is important to take into account the available methods and their supporting scientific evidence to guide the approach and the sequential selection of the best available biochemical scores,followed by a complementary imaging study(transient elastography,magnetic resonance elastography or acoustic radiation force impulse)and finally a liver biopsy,when needed.To help with the selection of the most appropriate method a Fagan′s nomogram analysis is provided in this review,describing the diagnostic yield of each method and their post-test probability of detecting liver fibrosis.Finally,treatment should always include diet and exercise,as well as controlling the components of the metabolic syndrome,+/-vitamin E,considering the presence of sleep apnea,and when available,allocate those patients with advanced fibrosis or high risk of progression into clinical trials.The final end of this approach should be to establish an opportune diagnosis and treatment of liver fibrosis in patients with NAFLD,aiming to decrease/stop its progression and improve their prognosis. | Alejandro Campos-Murguía Astrid Ruiz-Margáin JoséA González-Regueiro Ricardo U Macías-Rodríguez | 2020 | World Journal of Gastroenterology2020，26，39： | 12 |
| 16 | Alcoholism: A systemic proinflammatory condition显示文摘Excessive ethanol consumption affects virtually any organ,both by indirect and direct mechanisms.Considerable research in the last two decades has widened the knowledge about the paramount importance of proinflammatory cytokines and oxidative damage in the pathogenesis of many of the systemic manifestations of alcoholism.These cytokines derive primarily from activated Kupffer cells exposed to Gram-negative intestinal bacteria,which reach the liver in supra-physiological amounts due to ethanol-mediated increased gut permeability.Reactive oxygen species(ROS)that enhance the inflammatory response are generated both by activation of Kupffer cells and by the direct metabolic effects of ethanol.The effects of this increased cytokine secretion and ROS generation lie far beyond liver damage.In addition to the classic consequences of endotoxemia associated with liver cirrhosis that weredescribed several decades ago,important research in the last ten years has shown that cytokines may also induce damage in remote organs such as brain,bone,muscle,heart,lung,gonads,peripheral nerve,and pancreas.These effects are even seen in alcoholics without significant liver disease.Therefore,alcoholism can be viewed as an inflammatory condition,a concept which opens the possibility of using new therapeutic weapons to treat some of the complications of this devastating and frequent disease.In this review we examine some of the most outstanding consequences of the altered cytokine regulation that occurs in alcoholics in organs other than the liver. | Emilio González-Reimers Francisco Santolaria-Fernández María Candelaria Martín-González Camino María Fernández-Rodríguez Geraldine Quintero-Platt | 2014 | World Journal of Gastroenterology2014，20，40： | 12 |
| 17 | Liver expression of steroid hormones and Apolipoprotein D receptors in hepatocellular carcinoma显示文摘AIM: To evaluate the tissular expression of Androgen (A), Estrogen (E) and Progesterone (Pg) receptors, and Apolipoprotein D (ApoD), in liver tumors from resected hepatocellular carcinoma (HCC) cases in order to assess their possible relationship to prognosis. METHODS: We performed an immunohistochemical study using tissue microarrays (containing more than 260 cancer specimens, from 31 HCC patients and controls) to determine the presence of specif ic antibodies against AR, ER, PgR and ApoD, correlating their findings with several clinico-pathological and biological variables. The staining results were categorized using a semi-quantitive score based on their intensity, and the percentage of immunostained cells was measured. RESULTS: A total of 21 liver tumors (67.7%) were positive for AR; 16 (51.6%) for ER; 26 (83.9%) for PgR and 12 (38.7%) stained for ApoD. We have found a wide variability in the immunostaining score values for each protein, with a median (range) of 11.5 (11.5-229.5) for AR; 11.1 (8.5-65) for ER; 14.2 (4-61) for PgR; and 37.7 (13.8-81.1) for ApoD. A history of heavy ethanol consumption, correlated positively with AR and PgR and negatively with ER status. HCV chronic infection also correlated positively with AR and PgR status. However, the presence of ApoD immunostaining did not correlate with any of these variables. Tumors with a positive immuno-staining for PgR showed a better prognosis. CONCLUSION: Our results indicate a moderate clinical value of the steroid receptor status in HCC, emphasizing the need to perform further studies in order to evaluate the possible role of new hormonal-based therapies. | FJ Vizoso M Rodriguez A Altadill ML González-Diéguez A Linares LO González S Junquera F Fresno-Forcelledo MD Corte L Rodrigo | 2007 | World Journal of Gastroenterology2007，13，23： | 11 |
| 18 | Ear therapy and massage therapy in the elderly with dementia: a pilot study显示文摘OBJECTIVE: To assess the impact of massage versus ear acupuncture on behavior and participation in occupational therapy of dementia patients. METHODS: We performed a controlled, randomized longitudinal trial approved by the Bioethics Commission of the University of Extremadura. One hundred twenty elderly subjects with dementia institutionalized in residential homes in Extremadura (Spain) received treatment based on massage and ear acupuncture over three months. Behavior alterations, sleep disturbance, and participation in rehabilitation and eating were assessed every month during the three months of intervention, and at one and two months of follow-up after the end of treatment. The assessment was performed through a structured questionnaire with closed format ques-tions done by an occupational therapist not involved in the study. RESULTS: There was a statistically significant positive effect of massage and ear acupuncture (P< 0.001) on measured variables in the third month of intervention, which were maintained at two months after completing the treatment (P<0.021), when compared to the control group. CONCLUSION: Massage therapy and ear acupuncture can improve behavior and sleep disturbances, and increase the participation in eating and rehabilitation organized in residential homes, in dementia patients. | Juan Rodríguez-Mansilla María Victoria González-LópezArza Enrique Varela-Donoso Jesús Montanero-Fernández María Jiménez-Palomares Elisa Maria Garrido-Ardila | 2013 | Journal of Traditional Chinese Medicine2013，33，4： | 11 |
| 19 | Review of natural products with hepatoprotective effects显示文摘The liver is one of the most important organs in the body,performing a fundamental role in the regulationof diverse processes,among which the metabolism,secretion,storage,and detoxification of endogenous and exogenous substances are prominent.Due to these functions,hepatic diseases continue to be among the main threats to public health,and they remain problems throughout the world.Despite enormous advances in modern medicine,there are no completely effective drugs that stimulate hepatic function,that offer complete protection of the organ,or that help to regenerate hepatic cells.Thus,it is necessary to identify pharmaceutical alternatives for the treatment of liver diseases,with the aim of these alternatives being more effective and less toxic.The use of some plants and the consumption of different fruits have played basic roles in human health care,and diverse scientific investigations have indicated that,in those plants and fruits so identified,their beneficial effects can be attributed to the presence of chemical compounds that are called phytochemicals.The present review had as its objective the collecting of data based on research conducted into some fruits(grapefruit,cranberries,and grapes)and plants[cactus pear(nopal)and cactus pear fruit,chamomile,silymarin,and spirulina],which are consumed frequently by humans and which have demonstrated hepatoprotective capacity,as well as an analysis of a resin(propolis)and some phytochemicals extracted from fruits,plants,yeasts,and algae,which have been evaluated in different models of hepatotoxicity. | Eduardo Madrigal-Santillán Eduardo Madrigal-Bujaidar Isela álvarez-González María Teresa Sumaya-Martínez José Gutiérrez-Salinas Mirandeli Bautista ángel Morales-González Manuel García-Luna y González-Rubio J Leopoldo Aguilar-Faisal José A Morales-González | 2014 | World Journal of Gastroenterology2014，20，40： | 10 |
| 20 | Acute necrotizing pancreatitis: Surgical indications and technical procedures显示文摘Necrosis of pancreatic parenchyma or extrapancreatic tissues is present in 10%-20% of patients with acute pancreatitis, defining the necrotizing presentation frequently associated with high morbidity and mortality rates. During the initial phase of acute necrotizing pancreatitis the most important pillars of medical treatment are fluid resuscitation, early enteral nutrition, endoscopic retrograde colangiopancreatography if associated cholangitis and intensive care unit support. When infection of pancreatic or extrapancreatic necrosis occurs, surgical approach constitutes the most accepted therapeutic option. In this context, we have recently assited to changes in time for surgery(delaying the indication if possible to around 4 wk to deal with 'walledoff' necrosis) and type of access for necrosectomy: from a classical open approach(with closure over large-bore drains for continued postoperative lavage or semiopen techniques with scheduled relaparotomies), trends have changed to a 'step-up' philosophy with initial percutaneous drainage and posterior minimally invasive or endoscopic access to the retroperitoneal cavity for necrosectomy if no improvement has been previously achieved. These approaches are progressively gaining popularity and morbidity and mortality rates have decreased significantly. Therefore, a staged, multidisciplinary, step-up approach with minimally invasive or endoscopic access for necrosectomy is widely accepted nowadays for management of pancreatic necrosis. | José Manuel Aranda-Narváez Antonio Jesús González-Sánchez María Custodia Montiel-Casado Alberto Titos-García Julio Santoyo-Santoyo | 2014 | World Journal of Clinical Cases2014，2，12： | 10 |
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