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| 1 | Solitary fibrous tumors in abdomen and pelvis:Imaging characteristics and radiologic-pathologic correlation显示文摘AIM:To describe the imaging features of solitary fibrous tumors(SFTs)in the abdomen and pelvis,and the clinical and pathologic correlations.METHODS:Fifteen patients with pathologically confirmed SFTs in the abdomen and pelvis were retrospectively studied with imaging techniques by two radiologists in consensus.Patients underwent unenhanced and contrast-enhanced imaging,as follows:3 with computed tomography(CT)and magnetic resonance imaging(MRI)examination,8 with CT examination only,and 4 with MRI examination only.Image characteristics such as size,shape,margin,attenuation or intensity,and pattern of enhancement were analyzed and correlated with the microscopic findings identified from surgical specimens.In addition,patient demographics,presentation,and outcomes were recorded.RESULTS:Of the 15 patients evaluated,local symptoms related to the mass were found in 11 cases at admission.The size of the mass ranged from 3.4 to 25.1cm(mean,11.5 cm).Nine cases were round or oval,6were lobulated,and 10 displaced adjacent organs.Unenhanced CT revealed a heterogeneous isodense mass in 7 cases,homogeneous isodense mass in 3 cases,and punctuated calcification in one case.On MRI,most of the lesions(6/7)were heterogeneous isointense and heterogeneous hyperintense on T1-weighted images and T2-weighted images,respectively.All tumors showed moderate to marked enhancement.Heterogeneous enhancement was revealed in 11 lesions,and 7of these had cysts,necrosis,or hemorrhage.Early nonuniform enhancement with a radial area that proved to be a fibrous component was observed in 4 lesions,which showed progressive enhancement in the venous and delayed phase.No statistical difference in the imaging findings was observed between the histologically benign and malignant lesions.Three patients had local recurrence or metastasis at follow-up.CONCLUSION:Abdominal and pelvic SFTs commonly appeared as large,solid,well-defined,hypervascular masses with variable degrees of necrosis or cystic change that often displaced adjacent structures. | Xue-Ming Li Jing Reng Peng Zhou Ying Cao Zhu-Zhong Cheng Yan Xiao Guo-Hui Xu | 2014 | World Journal of Gastroenterology2014，20，17： | 27 |
| 2 | Chinese Trauma Surgeon Association for management guidelines of vacuum sealing drainage application in abdominal surgeries-Update and systematic review显示文摘Vacuum sealing drainage (VSD) is frequently used in abdominal surgeries. However, relevant guidelines are rare. Chin ese Trauma Surge on Associati on orga nized a committee composed of 28 experts across China in July 2017, aiming to provide an evidence-based recommendation for the application of VSD in abdominal surgeries.Eleven questions regarding the use of VSD in abdominal surgeries were addressed:(1) which type of materials should be respectively chosen for the intraperitoneal cavity, retroperitoneal cavity and superficial incisions?(2) Can VSD be preventively used for a high-risk abdominal incision w让h primary suture?(3) Can VSD be used in severely contaminated/infected abdominal surgical sites?(4) Can VSD be used for temporary abdominal cavity closure under some special conditions such as severe abdominal trauma, infection, liver transplantation and intra-abdominal volume increment in abdominal compartment syndrome?(5) Can VSD be used in abdominal organ inflammation, injury, or postoperative drainage?(6) Can VSD be used in the treatment of intestinal fistula and pancreatic fistula?(7) Can VSD be used in the treatment of intra-abdominal and extra-peritoneal abscess?(8) Can VSD be used in the treatment of abdominal wall wounds, wound cavity, and defects?(9) Does VSD in crease the risk of bleeding?(10) Does VSD increase the risk of intestinal wail injury?(11) Does VSD increase the risk of peritoneal adhesion? Focusing on these questions, evidence-based recommendations were given accordingly. VSD was strongly recommended regarding the questions 2-4. Weak recommendations were made regarding questions 1 and 5-11. Proper use of VSD in abdominal surgeries can lower the risk of infection in abdominal incisions with primary suture, treat severely contaminated/infected surgical sites and facilitate temporary abdominal cavity closure. | Yang Li Pei-Yuan Li Shi-Jing Sun Yuan-Zhang Yao Zhan-Fei Li Tao Liu Fan Yang Lian-Yang Zhang Xiang-Jun Bai Jing-Shan Huo Wu-Bing He Jun Ouyang Lei Peng Ping Hu Yan-An Zhu Ping Jin Qi-Feng Shao Yan-Feng Wang Rui-Wu Dai Pei-Yang Hu Hai-Ming Chen Ge-Fei Wang Yong-Gao Wang Hong-Xu Jin Chang-Ju Zhu Qi-Yong Zhang Biao Shao Xi-Guang Sang Chang-Lin Yin | 2019 | Chinese Journal of Traumatology2019，22，1： | 26 |
| 3 | Multiple imaging techniques in the diagnosis of ampullary carcinoma显示文摘BACKGROUND:Ampullary carcinoma is a neoplasia with a good prognosis compared to pancreatic cancer. But it is difficult to early diagnose because it lacks clear clinical symptoms.This study aimed to evaluate the efficacy of abdominal ultrasonography(US),enhanced computed tomography(CT),magnetic resonance cholangiopancreatography(MRCP)and endoscopic retrograde cholangiopancreatography(ERCP)in detecting ampullary carcinoma. METHODS:Forty-one patients with ampullary carcinoma who had been confirmed pathologically among the inpatients at the First Affiliated Hospital of Zhejiang University School of Medicine from February 2003 to March 2007 were analyzed retrospectively.The accuracy of US,CT,MRCP and ERCP were compared in the diagnosis of ampullary carcinoma. RESULTS:The accurate rate for detection of ampullary carcinoma with US was 26.83%.The accuracy of CT and ERCP in detection of ampullary tumors was 84.62%and 100%,respectively,which were significantly higher than that of US(P<0.05).The accuracy of MRCP in detection of ampullary tumors was similar to that of US in spite of visualization of obstruction and dilatation of the pancreaticobiliary duct with MRCP. CONCLUSIONS:Because of the obscure and late onset of symptoms,ampullary carcinoma is difficult to diagnose early.Multiple imaging techniques should be carried out appropriately in order to early diagnose the disease and improve the prognosis. | Chen, Wei-Xing Xie, Qi-Gui Zhang, Wei-Fang Zhang, Xian Hu, Tian-Tian Xu, Ping Gu, Zhu-Ying | 2008 | Hepatobiliary & Pancreatic Diseases International2008，7，6： | 20 |
| 4 | Abdominal paracentesis drainage ameliorates severe acute pancreatitis in rats by regulating the polarization of peritoneal macrophages显示文摘AIM To investigate the role of peritoneal macrophage(PM) polarization in the therapeutic effect of abdominal paracentesis drainage(APD) on severe acute pancreatitis(SAP).METHODS SAP was induced by 5% Na-taurocholate retrograde injection in Sprague-Dawley rats. APD was performed by inserting a drainage tube with a vacuum ball into the lower right abdomen of the rats immediately after the induction of SAP. To verify the effect of APD on macrophages, PMs were isolated and cultured in an environment, with the peritoneal inflammatory environment simulated by the addition of peritoneal lavage in complete RPMI 1640 medium. Hematoxylin and eosin staining was performed. The levels of pancreatitis biomarkers amylase and lipase as well as the levels of inflammatory mediators in the blood and peritoneal lavage were determined. The polarization phenotypes of the PMs were identified by detecting the marker expression of M1/M2 macrophages via flow cytometry, qPCR and immunohistochemical staining. The protein expression in macrophages that had infiltrated the pancreas was determined by Western blot.RESULTS APD treatment significantly reduced the histopathological scores and levels of amylase, lipase, tumor necrosis factor-α and interleukin(IL)-1β, indicating that APD ameliorates the severity of SAP. Importantly, we found that APD treatment polarized PMs towards the M2 phenotype, as evidenced by the reduced number of M1 macrophages and the reduced levels of proinflammatory mediators, such as IL-1β and L-selectin, as well as the increased number of M2 macrophages and increased levels of anti-inflammatory mediators, such as IL-4 and IL-10. Furthermore, in an in vitro study wherein peritoneal lavage from the APD group was added to the cultured PMs to simulate the peritoneal inflammatory environment, PMs also exhibited a dominant M2 phenotype, resulting in a significantly lower level of inflammation. Finally, APD treatment increased the proportion of M2 macrophages and upregulated the expression of the anti-inflammatory protein Arg-1 in the pancreas of SAP model rats.CONCLUSION These findings suggest that APD treatment exerts antiinflammatory effects by regulating the M2 polarization of PMs, providing novel insights into the mechanism underlying its therapeutic effect. | Ruo-Hong Liu Yi Wen Hong-Yu Sun Chun-Yu Liu Yu-Fan Zhang Yi Yang Qi-Lin Huang Jia-Jia Tang Can-Chen Huang Li-Jun Tang | 2018 | World Journal of Gastroenterology2018，24，45： | 20 |
| 5 | Irritable bowel syndrome in children:Current knowledge, challenges and opportunities显示文摘Irritable bowel syndrome(IBS) is a common and troublesome disorder in children with an increasing prevalence noted during the past two decades. It has a significant effect on the lives of affected children and their families and poses a significant burden on healthcare systems. Standard symptom-based criteria for diagnosis of pediatric IBS have changed several times during the past two decades and there are some differences in interpreting symptoms between different cultures. This has posed a problem when using them to diagnose IBS in clinical practice. A number of potential patho-physiological mechanisms have been described, but so far the exact underlying etiology of IBS is unclear. A few potential therapeutic modalities have been tested in children and only a small number of them have shown some benefit. In addition, most of the described patho-physiological mechanisms and treatment options are based on adult studies. These have surfaced as challenges when dealing with pediatric IBS and they need to be overcome for effective management of children with IBS. Recently suggested top-down and bottom-up models help integrating reported patho-physiological mechanisms and will provide an opportunity for better understanding of the diseases process. Treatment trials targeting single treatment modalities are unlikely to have clinically meaningful therapeutic effects on IBS with multiple integrating patho-physiologies. Trials focusing on multiple combined pharmacological and non-pharmacological therapies are likely to yield more benefit. In addition to treatment, in the future, attention should be paid for possible prevention strategies for IBS. | Niranga Manjuri Devanarayana Shaman Rajindrajith | 2018 | World Journal of Gastroenterology2018，24，21： | 14 |
| 6 | Encapsulating peritoneal sclerosis显示文摘Encapsulating peritoneal sclerosis(EPS) is a debilitating condition characterized by a fibrocollagenous membrane encasing the small intestine, resulting in recurrent small bowel obstructions. EPS is most commonly associated with long-term peritoneal dialysis, though medications, peritoneal infection, and systemic inflammatory disorders have been implicated. Many cases remain idiopathic. Diagnosis is often delayed given the rarity of the disorder combined with non-specific symptoms and laboratory findings. Although cross-sectional imaging with computed tomography of the abdomen can be suggestive of the disorder, many patients undergo exploratory laparotomy for diagnosis. Mortality approaches 50% one year after diagnosis. Treatment for EPS involves treating the underlying condition or eliminating possible inciting agents(i.e. peritoneal dialysis, medications, infections) and nutritional support, frequently with total parenteral nutrition. EPSspecific treatment depends on the disease stage. In the inflammatory stage, corticosteroids are the treatment of choice, while in the fibrotic stage, tamoxifen may be beneficial. In practice, distinguishing between stages may be difficult and both may be used. Surgical intervention, consisting of peritonectomy and enterolysis, is timeconsuming and high-risk and is reserved for situations in which conservative medical therapy fails in institutions with surgical expertise in this area. Herein we review the available literature of the etiology, pathogenesis, diagnosis, and treatment of this rare, but potentially devastating disease. | Christopher J Danford Steven C Lin Martin P Smith Jacqueline L Wolf | 2018 | World Journal of Gastroenterology2018，24，28： | 13 |
| 7 | Risk factors of gastroparesis syndrome after abdominal nongastroduodenal operation and its prevention显示文摘Objective:To investigate risk factors of gastroparesis syndrome(PGS) after abdominal nongastroduodenal operation and its prevention.Methods:Clinical data of 22 patients with PGS after abdominal non-gastroduodenal operation was analyzed retrospectively,and compared with the patients of non-PGS after abdominal non-gastroduodenal operation during the same time.The possible influencing factors of PCS were analyzed by single factor analysis and logistic regression analysis.Results:All t3 selected factors related with PGS,including age,disease category (benign and malignant),operation time,intraoperative blood loss,postoperative analgesic pump, postoperative enteral nutrition time,postoperative parenteral nutrition time,perioperative blood glucose level,perioperative nutrition status(anaemia or lower proleinemia),pylorus obstruction before surgery,intra-abdominal infection after surgery,and spiritual factor were related with PGS.The statistical analysis showed that the difference was statistical significant(P<0.05),and gender had no correlation with PCS(P>0.05);non-conditional multivariate analysis showed that malignant tumor,perioperative nutrition status,pylorus obstruction,operation time,blood loss, intra-abdominal infection after surgery,and mental factor were significant related with PGS as dependent variable and related risk factors in single factor analysis as independent variables (P <0.05).Conclusions:PGS is a result of multiple factors,and among these factors,malignant tumor,poor nutrition status,pylorus obstruction before surgery,longer operation—time,more blood loss,intra-abdominal infection after surgery,and mental factor are major risk factors of PGS. | Dong-Dong Yang Kun He Xue-Liang Wu Li-Kun Yang Shuang-Fa Nie | 2013 | Asian Pacific Journal of Tropical Medicine2013，6，6： | 13 |
| 8 | Serotonin transporter and cholecystokinin in diarrhea-predominant irritable bowel syndrome: Associations with abdominal pain, visceral hypersensitivity and psychological performance显示文摘BACKGROUND Visceral hypersensitivity and psychological performance are the main pathophysiological mechanisms of irritable bowel syndrome(IBS).Previous studies have found that cholecystokinin(CCK)can enhance colon movement and that serotonin transporter(SERT)is a transmembrane transport protein with high affinity for 5-hydroxytryptamine,which can rapidly reuptake 5-hydroxytryptamine and then regulate its action time and intensity.We speculate that SERT and CCK might play a role in the pathogenesis of diarrheapredominant IBS(IBS-D)by affecting visceral sensitivity and the brain-gut axis.AIM To determine SERT and CCK levels in IBS-D patients diagnosed using Rome IV criteria and to analyze their associations with abdominal pain,visceral hypersensitivity and psychological performance.METHODS This study collected data from 40 patients with IBS-D at the China-Japan Friendship Hospital from September 2017 to April 2018 and 18 healthy controls.The severity of abdominal pain,visceral sensitivity and psychological performance were evaluated in IBS-D patients and healthy controls,the levels of SERT and CCK in plasma and colonic mucosa were evaluated,and the correlations between them were analyzed.RESULTS There were significant differences in the initial sensation threshold(31.00±8.41 mL vs 52.22±8.09 mL,P<0.001),defecating sensation threshold(51.75±13.57 mL vs 89.44±8.73 mL,P<0.001)and maximum tolerable threshold(97.25±23.64 mL vs 171.11±20.83 mL,P<0.001)between the two groups.IBS-D patients had more severe anxiety(7.78±2.62 vs 2.89±1.02,P<0.001)and depressive(6.38±2.43 vs 2.06±0.73,P<0.001)symptoms than healthy controls.Significant differences were also found in mucosal CCK(2.29±0.30 vs 1.66±0.17,P<0.001)and SERT(1.90±0.51 vs 3.03±0.23,P<0.001)between the two groups.There was a significant positive correlation between pain scores and mucosal CCK(r=0.96,0.93,0.94,P<0.001).Significant negative correlations between anxiety(r=-0.98;P<0.001),depression(r=-0.99;P<0.001),pain evaluation(r=-0.96,-0.93,-0.95,P<0.001)and mucosal SERT were observed.CONCLUSION IBS-D patients had psychosomatic disorders and visceral hypersensitivity.SERT and CCK might be involved in the pathogenesis of IBS-D by regulating the braingut axis and affecting visceral sensitivity.This provides a new potential method for identifying a more specific and effective therapeutic target. | Geng Qin Yu Zhang Shu-Kun Yao | 2020 | World Journal of Clinical Cases2020，8，9： | 13 |
| 9 | Rare etiology of mechanical intestinal obstruction: Abdominal cocoon syndrome显示文摘Abdominal cocoon syndrome is a rare cause of intestinal obstruction with unknown etiology. Diagnosis of this syndrome, which can be summarized as the small intestine being surrounded by a fibrous capsule not containing the mesothelium, is difficult in the preoperative period. A 47-year-old male patient was referred to the emergency department with complaints of abdominal pain, nausea, and vomiting for two days. The abdominal computed tomography examination detected dilated small intestinal loops containing air-fluid levels clustered in the left upper quadrant of the abdomen and surrounded by a thick, saclike, contrast-enhanced membrane. During exploratory surgery, a capsular structure was identified in the upper left quadrant with a regular surface that was solid-fibrous in nature. Ab-dominal cocoon syndrome is a rarely seen condition, for which the preoperative diagnosis is difficult. The combination of physical examination and radiological signs, and the knowledge of 'recurrent characteristics of the complaints' that can be learned by a careful history, may be helpful in diagnosis. | Yener Uzunoglu Fatih Altintoprak Omer Yalkin Yasemin Gunduz Guner Cakmak Orhan V Ozkan Fehmi Celebi | 2014 | World Journal of Clinical Cases2014，2，11： | 13 |
| 10 | Cost-effectiveness analysis of population-based screening of hepatocellular carcinoma: Comparing ultrasonography with two-stage screening显示文摘AIM: To assess the cost-effectiveness of two populationbased hepatocellular carcinoma(HCC) screening programs, two-stage biomarker-ultrasound method and mass screening using abdominal ultrasonography(AUS).METHODS: In this study, we applied a Markov decision model with a societal perspective and a lifetime horizon for the general population-based cohorts in an area with high HCC incidence, such as Taiwan. The accuracy of biomarkers and ultrasonography was estimated from published meta-analyses. The costs of surveillance, diagnosis, and treatment were based on a combination of published literature, Medicare payments, and medical expenditure at the National Taiwan University Hospital. The main outcome measure was cost per lifeyear gained with a 3% annual discount rate. RESULTS: The results show that the mass screening using AUS was associated with an incremental costeffectiveness ratio of USD39825 per life-year gained, whereas two-stage screening was associated with an incremental cost-effectiveness ratio of USD49733 per life-year gained, as compared with no screening. Screening programs with an initial screening age of 50 years old and biennial screening interval were the most cost-effective. These findings were sensitive to the costs of screening tools and the specificity of biomarker screening.CONCLUSION: Mass screening using AUS is more cost effective than two-stage biomarker-ultrasound screening. The most optimal strategy is an initial screening age at 50 years old with a 2-year inter-screening interval. | Ming-Jeng Kuo Hsiu-Hsi Chen Chi-Ling Chen Jean Ching-Yuan Fann Sam Li-Sheng Chen Sherry Yueh-Hsia Chiu Yu-Min Lin Chao-Sheng Liao Hung-Chuen Chang Yueh-Shih Lin Amy Ming-Fang Yen | 2016 | World Journal of Gastroenterology2016，22，12： | 12 |
| 11 | Combined approach for spontaneous rupture of hepatocellular carcinoma显示文摘Ruptured hepatocellular carcinoma is a rare,emergency occurrence in western countries with high mortality risk.A number of hypotheses have been formulated in order to explain the precise mechanism that leads to hepatocellular carcinoma(HCC) rupture:sub-capsular location,dimensions,portal hypertension,tumour necrosis,local increase of venous pressure due to the outflow reduction caused by neoplastic invasion,and the presence of a previous vascular injury which might predispose to HCC rupture.There is still a debate in the literature concerning the best approach in cases of HCC rupture.Surgery is the first option for treatment of acute abdominal bleeding.However the advent of endovascular treatments widens the range of possible therapies for acute bleeding control and subsequent ablation purposes.We report a case of hemoperitoneum from spontaneous rupture of undiagnosed HCC,that was treated successfully by emergency surgical resection followed by transarterial chemo-embolizationfor local recurrence. | Anna Rossetto Gian Luigi Adani Andrea Risaliti Umberto Baccarani Vittorio Bresadola Dario Lorenzin Giovanni Terrosu | 2010 | World Journal of Hepatology2010，2，1： | 10 |
| 12 | 沙埃索美拉唑肠溶胶囊治疗十二指肠溃疡临床疗效分析显示文摘目的:总结分析埃索美拉唑肠溶胶囊在十二指肠溃疡治疗中的应用效果及作用机理。方法:随机将2013年1月至2013年12月收治的十二指肠溃疡110例患者分为观察组和对照组各55例,其中对照组患者给予奥美拉唑药物治疗,观察组患者给予埃索美拉唑肠溶胶囊治疗,观察比较两组患者用药后症状改善情况、临床疗效等。结果:观察组治疗总有效率98.18%高于对照组92.73%,但差异不具有统计学意义(P>0.05);观察组患者治疗1d后腹痛缓解率40.00%明显高于对照组治疗1d后腹痛缓解率21.85%,差异具有统计学意义(χ2=4.2569,P<0.05);观察组患者治疗3d后腹痛缓解率43.64%明显高于对照组治疗3d后腹痛缓解率40.00%,但差异不具有统计学意义(P>0.05);观察组幽门螺杆菌根除率78.18%高于对照组幽门螺杆菌根除率72.73%,但差异不具有统计学意义(P>0.05);观察组不良反应率为9.09%,对照组不良反应率为10.91%,两者不具有统计学差异(P>0.05)。结论:埃索美拉唑肠溶胶囊在十二指肠溃疡治疗中具有良好的疗效,临床值得推广使用。 | 苗得雨 | 2015 | 河北医学2015，21，10： | 10 |
| 13 | The single nucleotide polymorphisms of the chicken myostatin gene are associated with skeletal muscle and adipose growth显示文摘Myostatin, a new member of the TGF-β superfamily, is predominantly expressed in skeletal muscle cells and functions as a negative regulator of skeletal muscle growth in animals. Recently, we have reported three single nucleotide polymorphisms (SNPs) in the chicken myostatin gene. Herein, we investigate the association of those SNPs with the production traits in a F2 chicken line derived from Broilers crossing to Silky with the least square analysis. The results show that the BB and AA genotypes are strongly associated with abdominal fat weight (AFW), abdominal fat percentage (AFP), and birth weight (BW) (P < 0.05). Breast muscle percentage (BMP) of the AA type is higher than that of the AB type. The breast muscle weight and breast muscle percentages of F2 individuals have significant difference between CC and DD genotypes (P < 0.05). Breast muscle weight (BMW) of EF birds is higher than that of EE birds (P < 0.05). In this report, we present the first genetic evidence to show that chicken myostatin not only plays an important role in controlling skeletal muscle growth and differentiation, but also may be involved in regulation of adipose growth in chicken. | GU Zhiliang, ZHU Dahai, LI Ming, LI Hui, DENG Xuemei & WU ChangxinMolecular and Cellular Developmental Biology Laboratory, Harbin Institute of Technology, Harbin 150001, China College of Animal Science & Technology, Northeast Agricultural University, Harbin 150030, China National Laboratories for Agribiotechnology, China Agricultural University, Beijing 100094, China College of Animal Science & Technology, China Agricultural University, Beijing 100094, China Department of Life Science and Technology, Changshu Institute of Technology, Changshu 215500, China Department of Biochemistry and Molecular Biology, National Laboratory of Medical Molecular Biology, Peking Union Medical College, Beijing 100005, China | 2004 | Science China(Life Sciences)2004，47，1： | 9 |
| 14 | Open abdomen in gastrointestinal surgery:Which technique is the best for temporary closure during damage control?显示文摘AIM To compare the 3 main techniques of temporary closure of the abdominal cavity,vacuum assisted closure(vacuum-assisted closure therapy- VAC),Bogota bag and Barker technique,in damage control surgery.METHODS After systematic review of the literature,33 articles were selected to compare the efficiency of the three procedures.Criteria such as cost,infections,capacity of reconstruction of the abdominal wall,diseases associated with the technique,among others were analyzed.RESULTS The Bogota bag and Barker techniques present as advantage the availability of material and low cost,what is not observed in the VAC procedure.The VAC technique is the most efficient,not only because it reduces the tension on the boarders of the lesion,but also removes stagnant fluids and debris and acts at cellular level increasing cell proliferation and division.Bogota bag presents the higher rates of skin laceration and evisceration,greater need for a stent for draining fluids and wash-ups,higher rates of intestinal adhesion to the abdominal wall.The Barker technique presents lack of efficiency in closing the abdominal wall and difficulty on maintaining pressure on the dressing.The VAC dressing can generate irritation and dermatitis when the drape is applied,in addition to pain,infection and bleeding,as well as toxic shock syndrome,anaerobic sepsis and thrombosis.CONCLUSION The VAC technique,showed to be superior allowing a better control of liquid on the third space,avoiding complications such as fistula with small mortality,low infection rate,and easier capability on primary closure of the abdominal cavity. | Marcelo A F Ribeiro Junior Emily Alves Barros Sabrina Marques de Carvalho Vinicius Pereira Nascimento José Cruvinel Neto Alexandre Zanchenko Fonseca | 2016 | World Journal of Gastrointestinal Surgery2016，8，8： | 9 |
| 15 | Irritable bowel syndrome in children: Pathogenesis, diagnosis and evidence-based treatment显示文摘Irritable bowel syndrome(IBS)is the commonest cause of recurrent abdominal pain(RAP)in children in both more developed and developing parts of the world.It is defined by the RomeⅢcriteria for functional gastrointestinal disorders.It is characterized by abdominal pain that is improved by defecation and whose onset is associated with a change in stool form and or frequency and is not explained by structural or biochemical abnormalities.It is estimated that 10%-15%of older children and adolescents suffer from IBS.IBS can be considered to be a brain-gut disorder possibly due to complex interaction between environmental and hereditary factors.The diagnosis of IBS is made based on the RomeⅢcriteria together with ruling out organic causes of RAP in children such as inflammatory bowel disease and celiac disease.Once the diagnosis of IBS is made,it is important to explain to the parents(and children)that there is no serious underlying disease.This reassurance may be effective treatment in a large number of cases.Lifestyle modifications,stress management,dietary interventions and probiotics may be beneficial in some cases.Although there is limited evidence for efficacy of pharmacological therapies suchas antispasmodics and antidiarrheals;these have a role in severe cases.Biopsychosocial therapies have shown encouraging results in initial trials but are beset by limited availability.Further research is necessary to understand the pathophysiology and provide specific focused therapies. | Bhupinder Kaur Shu Siba Prosad Paul | 2014 | World Journal of Gastroenterology2014，20，20： | 8 |
| 16 | Pain sensation in pancreatic diseases is not uniform: The different facets of pancreatic pain显示文摘AIM: To systematically characterize specific pain patterns in the most frequent pancreatic diseases.METHODS: Pain in patients with chronic pancreatitis(n = 314), pancreatic cancer(n = 469), and other pancreatic tumors(n = 249) including mucinous(n = 20) and serous cystadenoma(n = 31), invasive(n = 37) and non-invasive intraductal papillary mucinous neoplasia(IPMN; n = 48), low stage(n = 18) and high stage neuroendocrine neoplasia(n = 44), and ampullary cancer(n = 51) was registered and correlated with clinicopathological data. Survival times were estimated by the Kaplan-Meier method. Patients alive at the follow-up time were censored. Survival curves were compared statistically using the log-rank test.RESULTS: Forty-nine point one percent of pancreatic cancer patients revealed no pain, whereas in chronic pancreatitis only 18.3% were pain free. In contrary, moderate/severe pain was registered in 15.1% in pancreatic cancer patients that was increased in chronic pancreatitis with up to 34.2%. Serous cystadenoma was asymptomatic in most cases(58.1%), whereas 78.9% of all mucinous cystadenoma patients suffered pain. In neuroendocrine neoplasia pain was not a key clinical symptom since 64% of low stage neuroendocrine neoplasia and 59% of high stage neuroendocrine neoplasia patients were pain free. Cancer localization in the pancreatic body and patients with malignant pancreatic neoplasms were associated with more severe pain. Tumor grading and stage did not show any impact on pain. Only in pancreatic cancer, pain was directly associated with impaired survival.CONCLUSION: Pancreatic pain depicts different patterns of abdominal pain sensation according to the respective pancreatic disorder and does not allow a unification of the term pancreatic pain. | Jan G D'Haese Mark Hartel Ihsan Ekin Demir Ulf Hinz Frank Bergmann Markus W Büchler Helmut Friess Güralp O Ceyhan | 2014 | World Journal of Gastroenterology2014，20，27： | 8 |
| 17 | ZD 7288,an HCN channel blocker,attenuates chronic visceral pain in irritable bowel syndrome-like rats显示文摘AIM:To investigate the effects of ZD 7288,a hyperpolarization-activated cyclic nucleotide-gated(HCN)channel blocker,on rats with chronic visceral pain.METHODS:Rats with visceral hypersensitivity were generated using neonatal colon irritation during postnatal days 8-15 as described previously.Visceral hypersensitivity was evaluated using electromyographic(EMG)responses of abdominal external oblique muscles to 20-80 mmHg colorectal distentions(CRD).Abdominal withdrawal reflex(AWR)scores and pain thresholds were also detected in adult rats.Different doses of ZD7288(25,50,and 100 nmol/L)were intrathecally administered in rats to study the role of spinal HCN channel in chronic visceral hypersensitivity.RESULTS:EMG responses to 20-80 mmHg CRD and AWR scores under 20-60 mmHg CRD significantly increased in rats with visceral hypersensitivity compared to control rats(P<0.05).The pain threshold in rats with visceral hypersensitivity significantly decreased compared to control rats(P<0.05).Treatment with50-100 nmol/L ZD 7288 significantly inhibited EMG responses(16%-62%,80-20 mmHg CRD,P<0.05)and AWR scores(24%-37%,40-20 mmHg CRD,P<0.05;12%-61%,80-20 mmHg CRD,P<0.05,respectively),and significantly increased pain thresholds(32%-77%,P<0.05).CONCLUSION:Spinal HCN channels may play an important role in chronic visceral hypersensitivity. | Yu Chen Chun Lin Ying Tang Ai-Qin Chen Cui-Ying Liu Da-Li Lu | 2014 | World Journal of Gastroenterology2014，20，8： | 7 |
| 18 | Irritable bowel syndrome symptom severity improves equally with probiotic and placebo显示文摘AIM To determine the effects of Lactobacillus acidophilus NCFM on irritable bowel syndrome(IBS) symptoms and quality of life(Qo L).METHODS In this randomized triple-blind trial, adult IBS volunteerswho were recruited according to Rome Ⅲ criteria received 109 or 1010 colony-forming units of NCFM or placebo daily for 12 wk. IBS Symptom Severity Score(IBS-SSS), which constituted the primary outcome, and secondary outcomes, including individual IBS symptoms, IBS-related QoL questionnaire, anxiety and depression, defecation frequency, and stool consistency, were assessed at baseline at the end of the 8-wk runin period, after 4 and 12 wk of intervention, and after a 4-wk washout.RESULTS A total of 340 of 391 randomized volunteers completed the trial. IBS-SSS improved over 12 wk of treatment in all treatment groups, decreasing by a mean ± SD of 44.0 ± 80.2, 50.8 ± 82.4, and 48.3 ± 72.2 in the placebo, active low-dose, and active high-dose groups, respectively. Similarly, secondary outcomes did not differ between treatment groups. However, in a post hoc analysis of volunteers with moderate to severe abdominal pain at baseline(VAS > 35/100), the treatment significantly reduced the sensation of abdominal pain. Pain scores fell by 20.8 ± 22.8, 29.4 ± 17.9, and 31.2 ± 21.9 in the placebo, active low-dose, and active high-dose groups, respectively(P value for placebo vs combined active doses = 0.0460).CONCLUSION NCFM alleviates moderate to severe abdominal pain, consistent with earlier observations of this strain mitigating visceral pain through increased analgesic receptor expression. | Anna Lyra Markku Hillila Teppo Huttunen Sofia Mannikko Mikko Taalikka Julia Tennila Anneli Tarpila Sampo Lahtinen Arthur C Ouwehand Lea Veijola | 2016 | World Journal of Gastroenterology2016，22，48： | 7 |
| 19 | Does flexible small-diameter colonoscope reduce insertion pain during colonoscopy?显示文摘AIM It is well known that colonoscopy can bedifficult due to abdominal pain induced duringcolonoscope insertion,if sedative agents are notgiven.Recently,an extra-flexible,small-diameter colonoscope(CF-SV,Olympus Inc.,Japan)was developed in order to improve safetyand comfort.The aim of this study was toaccess the usefulness of the CF-SV.METHODS One hundred patients undergoingsigmoidoscopy were recruited and colonoscopywas performed by one experiencedcolonoscopist.First,a routine-type colonoscope(CF-2301)was inserted into the colon withoutsedation.When the patient complained ofabdominal pain(even if mild),the scope wasnot advanced further and was withdrawn afterthe anatomic location of its tip was determinedfluoroscopically.Then,the CF-SV was inserteduntil it reached the cecun or the site whereabdominal pain occurred.Previous abdominalsurgery and abdominal disease were consideredas unfavorable factors(UF)and the relationshipbetween abdominal pain and UF,age and genderwere investigated.Furthermore,the colonicinsertion pressures in 36 patients with abdominalpain were measured with a force gauge.RESULTS Thirty-four cases(34%)felt no painwith the CF-2301 and successful pancolon-0scopies to the cecum were performed.Sixty-six cases(66%)complained of abdominal pain.The procedure was painless for 47% of men and24% of women,respectively.The CF-2301 scopefailed to reach the sigmoid-descending colon junctions in 59(89.4%)of the 66 patientscomplaining of abdominal pain.However,CF-SVreached proximal area in 94.9% of those whofailed with CF-2301.The median pressure forpain-inducing was 700 g/cm^2.CONCLUSION Unsedated patients with UFwere prone to complain of pain when thestandard-type CF-2301 scope was used.Thenewly developed extra-flexible CF-SV is usefulfor the aged and for those with UF or being proneto suffer from abdominal pain.Sedative agentsmay be unnecessary if this new type ofcolonoscope is used. | Yoshiharu Uno Akihiro Munakata | 2000 | World Journal of Gastroenterology2000，6，5： | 7 |
| 20 | Etiology of non-traumatic acute abdomen in pediatric emergency departments显示文摘Acute abdominal pain is a common complaint in pediatric emergency departments. A complete evaluation is the key factor approaching the disease and should include the patient's age, any trauma history, the onset and chronicity of the pain, the related symptoms and a detailed physical examination. The aim of this review article is to provide some information for physicians in pediatric emergency departments, with the age factors and several causes of non-traumatic acute abdominal pain. The leading causes of acute abdominal pain are divided into four age groups: infants younger than 2 years old, children 2 to 5, children 5 to 12, and children older than 12 years old. We review the information about acute appendicitis, intussusception, HenochSchnlein purpura, infection, Meckel's diverticulum and mesenteric adenitis. In conclusion, the etiologies of acute abdomen in children admitted to the emergency department vary depending on age. A complete history and detailed physical examination, as well as abdominal imaging examinations, could provide useful information for physicians in the emergency department to narrow the differential diagnosis of abdominal emergencies and give a timely treatment. | Wen-Chieh Yang Chun-Yu Chen Han-Ping Wu | 2013 | World Journal of Clinical Cases2013，1，9： | 7 |
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