中华消化杂志最新文献

{"title":"Correlation between the severity of peptic ulcer bleeding and Helicobacter pylori type","authors":"He Yuan, L. Yong, N. Yuqiang, Z. Yongjian, Li Yuyuan","doi":"10.3760/CMA.J.ISSN.0254-1432.2019.11.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2019.11.003","url":null,"abstract":"Objective \u0000To investigate the correlation between the severity of peptic ulcer bleeding (PUB) and the serum antibody typing of Helicobacter pylori (H.pylori). \u0000 \u0000 \u0000Methods \u0000From January 1, 2009 to December 31, 2018, at Guangzhou First People′s Hospital, 1 444 patients diagnosed with PUB and received H. pylori serum antibody test at the same time were enrolled and divided into high-risk group (324 cases) and low-risk group (1 120 cases) according to Forrest classification, and according to recurrent bleeding, the patients were divided into recurrent bleeding group (32 cases) and non-rebleeding group (1 412 cases). Serum H. pylori specific antibodies cytotoxin-associated gene A (CagA), vacuolating cytotoxin A (VacA) and urease were detected by protein array. The correlation between H. pylori positive rate, H. pylori type, PUB and rebleeding were analyzed. Chi-square test and logistic regression analysis were used for statistical analysis. \u0000 \u0000 \u0000Results \u0000Among 1 444 PUB patients, there were 709 patients with gastric ulcer bleeding (GUB) and 735 patients with duodenal ulcer bleeding (DUB). Previous history of peptic ulcer disease (odds ratio (OR)=1.501, P=0.006), the maximum diameter of ulcer over 2 cm (OR=2.484, P 0.05). According to H. pylori antibody type, H. pylori type Ⅰ infection was mainly in both high-risk group and low-risk group. The positive rate of H. pylori type Ⅰ strain of high-risk group was higher than that of low-risk group (67.28%, 218/324 vs. 60.45%, 677/1 120), and the difference was statistically significant (χ2=4.986, P=0.026). There was no statistically significant difference in the positive rate of H. pylori between GUB group and DUB group (68.41%, 485/709 vs. 68.57%, 504/735; χ2=0.005, P>0.05). \u0000 \u0000 \u0000Conclusions \u0000The infection of H. pylori is positively correlated with the severity of PUB, but not correlated with early ulcer rebleeding. H. pylori type Ⅰ is the main pathogenic strain of GUB and DUB, and CagA and VacA double positive strain is the most common strain. \u0000 \u0000 \u0000Key words: \u0000Helicobacter pylori; Urease; Peptic ulcer hemorrhage; Cytotoxin-associated gene A; Vacuolating cytotoxin A","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"74 1","pages":"735-740"},"PeriodicalIF":0.0,"publicationDate":"2019-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86009640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of estrogen on bicarbonate secretion of duodenal mucosa","authors":"Xin Wang, Guorong Wen, Xubiao Nie, B. Tuo","doi":"10.3760/CMA.J.ISSN.0254-1432.2019.11.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2019.11.005","url":null,"abstract":"Objective \u0000To study the effects of estrogen on bicarbonate secretion of duodenal mucosal, and to observe estrogen receptor (ER) subtypes of estrogen. \u0000 \u0000 \u0000Methods \u0000Sixteen 4-week-old male C57 mice were divided into control group and estrogen group, with eight mice in each group. The mice serum level of estrogen was detected by chemiluminescence. The expression of cystic fibrosis transmembrane conductance regulator (CFTR), solute carrier family 26 (SLC26) A3 and SLC26A6 in the duodenum tissues were determined by real-time polymerase chain reaction (RT-PCR). After SCBN cells treated with estrogen, ERα and ERβ blocking agent, and transfected with silenced ERα and ERβ for 24 and 48 hours, the expression levels of CFTR, SLC26A3 and SLC26A6 mRNA in cells were detected by RT-PCR. The effects of estrogen before and after silenced ERα and ERβ on bicarbonate secretion of SCBN cells were observed by high-speed ion imaging system. T test and rank sum test were used for statistical analysis. \u0000 \u0000 \u0000Results \u0000Compared with that of control group, the serum estrogen level of estrogen group was significantly high ((4 874±942) pmol/L vs. (657±187) pmol/L, t=-11.579, P<0.01). The expression levels of CFTR, SLC26A3 and SLC26A6 mRNAs in duodenum tissues of estrogen group were higher than those of control group (0.856±0.302 vs. 0.452±0.246, 2.910±1.680 vs. 1.120±0.540, 1.272±0.667 vs. 0.319±0.114), and the differences were statistically significant (t=-2.317, -2.483 and -3.721, all P<0.05). Compared with those treated with estrogen for 24 and 48 hours, the levels of CFTR mRNA and SLC26A6 mRNA were lower after the ERβ blocking agent were added into estrogen for 24 and 48 hours (CFTR mRNA: 0.171±0.059 vs. 0.522±0.260 and 0.111±0.014 vs. 0.578±0.297; SLC26A6 mRNA: 0.486±0.289 vs. 1.118±0.571 and 0.492±0.231 vs. 1.551±0.605), and the differences were statistically significant (tCFTRmRNA=2.974 and 2.655, tSLC26A6 mRNA=2.393 and 3.272; all P<0.05). Compared with those of silenced ERα group, the levels of CFTR mRNA, SLC26A3 mRNA and SLC26A6 mRNA were higher after ERα silenced and then added estrogen for 24 and 48 hours (24 h: 5.073±2.270 vs. 1.185±0.494, 1.796±1.168 vs. 0.468±0.108 and 3.085±1.357 vs. 0.706±0.347; 48 h: 5.025±1.998 vs. 1.185±0.494, 1.557±0.653 vs. 0.468±0.108 and 3.290±1.750 vs. 0.706±0.347), and the differences were statistically significant (t24 h=-4.122, -2.773 and -4.162, t48 h=-4.604, -4.034 and -3.250; all P<0.05). Compared with that of silenced ERα group, the bicarbonate secretion increased after ERα silenced and then added estrogen for 24 and 48 hours (0.72±0.17 and 1.15±0.25 vs. 0.35±0.17), and pH also elevated, and the differences were statistically significant (t=-6.516 and -12.387, both P<0.01). \u0000 \u0000 \u0000Conclusion \u0000Estrogen mainly up-regulates the expression of bicarbonate transporter protein in duodenal mucosal epithelial cells through ERβ, and promotes the bicarbonate secretion of duodenal mucosa. \u0000 \u0000 \u0000Key words: \u0000Estrogens; Bicarbonates; Estrogen re","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"24 1","pages":"746-751"},"PeriodicalIF":0.0,"publicationDate":"2019-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86550461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of tumor necrosis factor-related apoptosis-inducing ligand gene knock-out on the gut microbiota in mice with dextran sodium sulphate induced colitis","authors":"S. Zheng, Kaiyu Huang, Hao Wu, Jing Cai, Fang-peng Ye, Yi Jiang","doi":"10.3760/CMA.J.ISSN.0254-1432.2019.11.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2019.11.007","url":null,"abstract":"Objective \u0000To investigate the influence of tumor necrosis factor-related apoptosis-inducing ligant (TRAIL) deficiency on mice colitis and the gut microbiota composition by inclding the expermental colitis model in tumor necrosis factor-related apoptosis-inducing ligand gene knockout (TRAIL-/-) mice. \u0000 \u0000 \u0000Methods \u0000C57BL/6 TRAIL-/- mice and wild type (WT) mice were selected and assigned into TRAIL-/- control group (eight mice), TRAIL-/- colitis group (16 mice), WT control group (eight mice) and WT colitis group (16 mice). The mice of two colitis groups were oral administrated with 3.5% dextran sulphate sodium (DSS) in drinking water for seven consecutive days to induce experimental colitis model. The severity of colitis was evaluated by clinical appearance and histopathological examination. The colonic tissue samples of mice were collected and microbiota profile was analyzed by 16S rDNA sequencing method. USEARCH software and R language were used to analyze the difference of gut microbiota among TRAIL-/- control group, TRAIL-/- colitis group, WT control group and WT colitis group. T test and Mann-Whitney U test were used for statistical analysis. \u0000 \u0000 \u0000Results \u0000After modeling, the disease activity index (DAI) of WT colitis mice and TRAIL-/- colitis mice both gradually increased over time. Furthermore, compared with colitis mice, TRAIL-/- colitis mice developed body weight loss, diarrhea and hemafecia earlier. On the seventh day after modeling, the percentage of body weight loss of TRAIL-/- colitis mice and WT colitis mice was (28.98±2.84)% and (17.87±3.70)%, respectively; and the difference was statistically significant (t=9.53, P<0.01). The length of colon of TRAIL-/- colitis mice was shorter than that of WT colitis mice ((4.63±0.28) cm vs. (6.02±0.41) cm), and the difference was statistically significant (t=11.20, P<0.01). The DAI of TRAIL-/- colitis mice was higher than that of WT colitis mice (3.00±0.00 vs. 2.32±0.05), and the difference was statistically significant (t=54.40, P<0.01). The histological score of TRAIL-/- colitis mice was higher than that of WT colitis mice (6.19±0.25 vs. 3.87±0.22), and the difference was statistically significant (t=27.87, P<0.01). Under the microscope, colonic mucosal epithelial injury, crypt structure destruction and inflammatory cell infiltration were more obvious in TRAIL-/- colitis mice than in WT colitis mice. The alpha diversity of colonic flora was more significant in TRAIL-/- colitis group compared with that of WT colitis group. At the family level, the relative richness of Deferribacteraceae, Ruminococcaceae, Rikenellaceae, F16 and Paraprevotellaceae significantly increased in TRAIL-/- colitis group, but the relative richness of Enterococcaceae obviously reduced ((19.839±19.991)% vs. (7.224±11.241)%, (3.564±2.543)% vs.(2.861±3.821)%, (0.123±0.066)% vs. (0.068±0.049)%, (0.032±0.033)% vs. (0.006±0.011)%, (0.153±0.098)% vs. (0.062±0.054)% and (0.013±0.027)% vs. (0.054±0.121)%, respectively; U=51, 69, 53, ","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"44 1","pages":"759-764"},"PeriodicalIF":0.0,"publicationDate":"2019-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77833399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicopathological features, diagnosis and treatment of primary and metastatic hepatic neuroendocrine neoplasm originating from digestive tract","authors":"Xiaoxiao Jiao, Zhao-Di Wang, Tengfei Zhang, Lianfeng Zhang, Wang Ma, Lin Zhou","doi":"10.3760/CMA.J.ISSN.0254-1432.2019.11.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2019.11.006","url":null,"abstract":"Objective \u0000To explore the clinicopathological characteristics of primary hepatic neuroendocrine neoplasm (HNEN) and metastatic HNEN from digestive tract, to screen the risk factors of hepatic metastasis of gastroenteropancreatic neuroendocrine neoplasm (GEP-NEN) and to analyze the differences between primary and metastatic HNEN in clinical features, diagnosis, treatment and prognosis. \u0000 \u0000 \u0000Methods \u0000From January 2010 to June 2017, the clinical data of 182 patients with HNEN admitted at The First Affiliated Hospital of Zhengzhou University were retrospectively analyzed, including 39 cases of primary HNEN, 129 cases of metastatic HNEN and 14 cases of HNEN with unknown primary lesions. Chi-square test and t test were performed to analyze the pathologic characteristics among groups. Logistic regression method was used to analyze the risk factors of hepatic metastasis. Kaplan-Meier method and log-rank test were used for survival analysis. Cox model was used for the prognostic multivariate survival analysis. \u0000 \u0000 \u0000Results \u0000Metastatic HNEN from digestive tract was more common in male (70.5%, 91/129). The case number of serological tumor biomarkers neuronspecific enolase and alpha-fetoprotein positive in primary HNEN were two cases and one case, respectively, and the positive rates in metastatic HNEN were 37.2% (32/86) and 6.4% (7/110). Most primary HNEN was single lesion (61.5%, 24/39), while multiple lesions were more common in metastatic HNEN (78.3%, 90/115). Primary HNEN mainly occurred in the right lobe of the liver (44.7%, 17/38), while metastatic HNEN located simultaneously in the left and right lobes of the liver (68.4%, 78/114). There were significant differences between primary HNEN and metastatic HNEN in tumor number, pathological grading, location of tumors and maximum diameter of tumors (χ2=21.264, 11.696, 19.461 and 4.547, all P<0.05). The median survival time of patients with primary HNEN and metastatic HNEN were 17.0 months and 10.0 months, and there was a significant difference in survival curves between the two groups (χ2=7.235, P=0.007). The type of hepatic tumors (primary or metastatic)(P=0.002), pathological grading of hepatic tumors (P=0.044), lymph node metastasis (P=0.024), the growth pattern of tumors (P<0.01) and treatment methods (P=0.018) were the independent factors for the prognosis of patients. \u0000 \u0000 \u0000Conclusions \u0000There are significant differences between primary HNEN and metastatic HNEN in tumor number, size and location. The type of hepatic tumors, pathological grading, lymph node metastasis, growth pattern of tumors and treatment methods are the independent factors for the prognosis of patients. Early topical treatment and combination treatment can help to prolong survival time of HNEN patients. \u0000 \u0000 \u0000Key words: \u0000Liver neoplasm; Carcinoma, neuroendocrine; Pathology; Neoplasm metastasis; Prognosis","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"50 1","pages":"752-758"},"PeriodicalIF":0.0,"publicationDate":"2019-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85584909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of goblet cells in the progression of Barrett′s esophagus","authors":"Yang-yang Hui, Lanping Zhu, Bianxia Li, Sai-yu Wang, Bo Yang, Jingwen Zhao, Yujie Zhang, Xin Chen, Bangmao Wang","doi":"10.3760/CMA.J.ISSN.0254-1432.2019.11.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2019.11.002","url":null,"abstract":"Objective \u0000To investigate the clinical pathological features of Barrett′s esophagus in China, and to study the relationship between the number of goblet cells and the severity of Barrett′s esophageal dysplasia. \u0000 \u0000 \u0000Methods \u0000From January 2008 to October 2018, in the Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, the clinical and pathological data of 453 patients who underwent gastroscopy and pathologically diagnosed with Barrett′s esophagus were retrospectively analyzed. The clinical pathological features were compared between patients with goblet cells and patients without goblet cells. Periodic acid Schiff reaction (PAS) staining was performed on pathological slides of Barrett′s esophagus with goblet cells, and the relationship between the number of goblet cells, the number of positive crypts of goblet cells and the severity of Barrett′s esophageal dysplasia was analyzed. T test and chi-square test were performed for statistical analysis. \u0000 \u0000 \u0000Results \u0000Among 453 patients with Barrett′s esophagus, 251 (55.4%) were males and 202 (44.6%) were females. There were 218 Barrett′s esophagus with goblet cells, including 128 males (58.7%) and 90 females (41.3%). The average onset age was (60.6±11.9) years old, and the peak onset age was between 60 and 69 years old. The appearance under endoscopy mainly was circumferential type (58.2%, 127/218). There were 235 Barrett′s esophagus without goblet cells, 123 males (52.3%) and 112 females (47.7%). The average onset age was (56.1±14.4) years old, and the peak onset age was between 50 and 59 years old. The appearance under endoscopy was mainly circumferential type (40.0%, 94/235). The incidence of dysplasia in Barrett′s esophagus with goblet cells was higher than that without goblet cells (75.7%, 165/218 vs. 37.0%, 87/235), and the difference was statistically significant (χ2=68.501, P<0.01). PAS staining showed that goblet cells were stained purplish red. The number of goblet cells, total number of crypts, the number of positive crypts of goblet cells and the proportion of positive crypts of goblet cells of Barrett′s esophagus with mild dysplasia were all significantly higher than those of Barrett′s esophagus with moderate dysplasia (95.50±40.56 vs. 40.00±13.34, 21.00±8.31 vs. 11.83±2.92, 16.50±6.17 vs. 7.50±2.47 and 0.79±0.42 vs. 0.63±0.12, respectively), and the differences were statistically significant(t=-4.503, -3.605, -4.690 and -4.340, all P<0.01). \u0000 \u0000 \u0000Conclusion \u0000Barrett′s esophageal dysplasia may be related with appearance of goblet cells, and the decrease or disappearance of goblet cells may indicate the progression of Barrett′s esophagus. \u0000 \u0000 \u0000Key words: \u0000Barrett′s esophagus; Goblet cells; Dysplasia; Esophageal adenocarcinoma","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"24 1","pages":"731-734"},"PeriodicalIF":0.0,"publicationDate":"2019-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90970354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of low dose and short-term rifaximin on irritable bowel syndrome related with small intestinal bacterial overgrowth","authors":"Jian Chen, Huilu Zhang, Zhibing Qiu, Zhongguang Luo, Dongni Qiu","doi":"10.3760/CMA.J.ISSN.0254-1432.2019.10.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2019.10.008","url":null,"abstract":"Objective \u0000To investigate the efficacy of low dose and short-term oral rifaximin in patients with small intestinal bacterial overgrowth (SIBO) related irritable bowel syndrome (IBS). \u0000 \u0000 \u0000Methods \u0000From June 2017 to June 2018, at the Department of Gastroenterology of Huashan Hospital, Fudan University in Shanghai, a total of 37 patients with SIBO related IBS were sequentially enrolled and divided into three groups: diarrhea type, constipation type and mixed type. All the patients received rifaximin 200 mg each time, three times per day for 14 days. The clinical efficacy before and after treatment were compared by the scores of irritable bowel syndrome symptom severity scale (IBS-SSS) and irritable bowel syndrome associated quality of life (IBS-QoL). The efficacy of rifaximin on SIBO clearance and SIBO related chronic low-grade inflammation was evaluated by lactulose breath test (LBT) and exhaled nitric oxide (eNO). T test and variance analysis were used for statistical analysis. \u0000 \u0000 \u0000Results \u0000Among 39 patients with SIBO related IBS, 24 patients were diarrhea type, seven were constipation type and six were mixed type. Except one patient quitted the study because of chest tightness and palpitation, the IBS-SSS score of the left 36 patients before treatment was (250.83±55.10), and decreased to (151.11±33.96), and the difference was statistically significant (t=13.686, P 0.05). After treated by rifaximin, the negative conversion rate of SIBO was 52.8%(19/36). The negative conversion rate of hydrogen LBT was 54.5%(12/22) and among 11 methane LBT positive patients, six cases turned negative; and one of three patients with both positive hydrogen LBT and methane LBT turned negative. The negative conversion rate of eNO was 41.7%(15/36). \u0000 \u0000 \u0000Conclusions \u0000Low dose and short term rifaximin treatment can improve the severity of clinical symptoms and quality of life in SIBO-related IBS patients, and the efficacy is not related with the subtypes of IBS. \u0000 \u0000 \u0000Key words: \u0000Irritable bowel syndrome; Small intestinal bacterial overgrowth; Lactulose breath test; Low-grade inflammation; Rifaximin","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"7 1","pages":"678-682"},"PeriodicalIF":0.0,"publicationDate":"2019-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87127832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation between type 2 diabetes mellitus and hepatocellular carcinoma: a case-control study","authors":"Xiaoli Li, Rui Lin, L. Cui, Jichang Li, Jiansheng Li","doi":"10.3760/CMA.J.ISSN.0254-1432.2019.10.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2019.10.009","url":null,"abstract":"Objective \u0000To investigate the correlation between type 2 diabetes mellitus (T2DM) and hepatocellular carcinoma (HCC) by case-control study. \u0000 \u0000 \u0000Methods \u0000From January 2006 to December 2015, the data of 1 350 first diagnosis HCC patients at the First Affiliated Hospital of Zhengzhou University were collected and analyzed. The univariate and multivariate logistic regression were performed to analyze the risk factors of HCC genesis, and the risk factors were further stratified. \u0000 \u0000 \u0000Results \u0000The results of univariate logistic regression analysis showed that smoking and obesity were not risk factors of HCC genesis (both P>0.05). Alcoholism, hepatitis B virus (HBV) infection, hepatitis C virus (HCV) infection, T2DM, and family history of HCC were the risk factors of HCC genesis (odds ratio (OR)=2.593, 4.583, 3.732, 1.955 and 1.622, 95% confidence interval (CI) 1.883 to 3.549, 3.026 to 6.940, 2.544 to 5.367, 1.708 to 2.477 and 1.314 to 2.267, all P<0.05). The results of multivariate logistic regression analysis indicated that alcoholism, HBV infection, HCV infection, T2DM and family history of HCC were independent risk factors of HCC genesis (OR=2.034, 4.564, 2.831, 1.881 and 1.616, 95%CI 1.507 to 2.745, 2.672 to 7.765, 1.562 to 5.047, 1.314 to 2.671 and 1.177 to 2.228, all P<0.01), and T2DM could increase the risk of HCC genesis (P<0.01). In order to exclude the interference of alcoholism, HBV infection and HCV infection on above results, further stratified analysis showed that T2DM was one of the independent risk factors of HCC genesis (χ2=5.190, P=0.023), and had synergistic effect with alcoholism, HBV infection and HCV infection (χ2=32.848, P<0.01). There were significant differences in the propovtion, duration of disease and hemoglobin A1c level of T2DM patients between the case group and the control group (χ2=46.618, 81.644 and 43.092, all P<0.01). \u0000 \u0000 \u0000Conclusions \u0000T2DM is one of the independent risk factors or HCC genesis. T2DM is correlated with the pathogenesis of HCC. The clinical desease course and blood glucose control in patients with T2DM are also correlated with the pathogenesis of HCC. \u0000 \u0000 \u0000Key words: \u0000Diabetes mellitus, type 2; Carcinoma, hepatocellular; Risk factors","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"10 1","pages":"683-687"},"PeriodicalIF":0.0,"publicationDate":"2019-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83425611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of clinical features and motility characteristics of ineffective esophageal motility","authors":"N. Zhang, Wenting Lu, H. Li, Lihong Wu, Jianxiang Liu, Hongmei Jiao","doi":"10.3760/CMA.J.ISSN.0254-1432.2019.10.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2019.10.006","url":null,"abstract":"Objective \u0000To clarify the correlation between the clinical characteristics, esophageal motility features and esophageal acid exposure in patients with ineffective esophageal motility (IEM). \u0000 \u0000 \u0000Methods \u0000From January 2016 to March 2018, at Peking University First Hospital, 22 IEM patients diagnosed by esophagus high-resolution manometry (HRM) and 24 individuals with normal HRM results were enrolled. Clinical features, parameters of esophageal HRM and results of esophageal 24-hour pH monitoring of IEM patients and the individuals with normal HRM results were compared. According to the median distal contraction integral (DCI) of ten swallows, the IEM patients were divided into mild-IEM group (DCI 250-450 mmHg·s·cm (1 mmHg=0.133 kPa)) (14 cases) and severe-IEM group (DCI<250 mmHg·s·cm) (eight cases). The clinical features and esophageal motility were compared between normal HRM group, mild-IEM group and severe-IEM group. T test, chi-square test and one-way analysis of various were used for statistical analysis. \u0000 \u0000 \u0000Results \u0000The age of IEM group was older than that of normal HRM group ((64.5±11.2) years vs. (50.3±18.2) years), and the difference was statistically significant (t=-3.135, P=0.003). The lower esophageal sphincter pressure (LESP) of IEM group was lower than that of normal HRM group ((17.0±6.8) mmHg vs. (22.3±7.2) mmHg), and the difference was statistically significant (t=2.516, P=0.016). There were 15 cases in normal HRM group and 14 patients in IEM group who underwent esophageal 24-hour pH monitoring and there were five and two patients with abnormal acid exposure time (AET) in normal HRM group and IEM group, respectively. The length of proximal esophageal body (PEB) pressure zone of severe-IEM group was shorter than those of normal HRM group and mild-IEM group ((2.8±1.5) cm vs.(4.2±0.7) cm and (4.6±0.9) cm), and the differences were statistically significant (t=2.397 and 3.432, P=0.044 and 0.003). The integrated relaxation pressure (IRP) and LESP of normal HRM group were both higher than those of mild-IEM group ((9.3±2.9) mmHg vs. (7.2±3.3) mmHg, (22.3±7.2) mmHg vs. (15.4±7.1) mmHg), and the differences were statistically significant (t=2.148 and 2.843, P=0.038 and 0.007). There were six and eight patients in mild-IEM group and severe-IEM group who underwent esophageal 24-hour pH monitoring, respectively, and two patients in mild-IEM had abnormal AET. \u0000 \u0000 \u0000Conclusions \u0000The LESP of IEM patients is low. The clinical features and AET of IEM patients are not associated with the severity of IEM. In patients with severe IEM, the proximal and distal esophageal contractility is weakened, and the length of PEB pressure zone is shortened. \u0000 \u0000 \u0000Key words: \u0000Esophageal sphincter, upper; Ineffective esophageal motility; High-resolution manometry; Proximal esophageal body","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"54 1","pages":"669-673"},"PeriodicalIF":0.0,"publicationDate":"2019-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84213019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"endoscopic surgical treatment for bile leakage","authors":"Xun Li","doi":"10.3760/CMA.J.ISSN.0254-1432.2019.10.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2019.10.002","url":null,"abstract":"胆漏是肝胆外科常见的手术并发症，内镜逆行胰胆管造影术(ERCP)因微创、安全、有效，是医源性胆漏推荐的一线治疗方案。针对不同类型的胆漏，如何选择ERCP治疗并将其规范化有重要临床意义，现对其应用进行评价，以供临床参考。","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"64 1","pages":"652-657"},"PeriodicalIF":0.0,"publicationDate":"2019-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80926564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Chinese clinical practice guideline/consensus for digestive diseases","authors":"Ning-ping Zhang, Ji-yao Wang, Shi-yao Chen, Chouwen Zhu, Qiang Wang","doi":"10.3760/CMA.J.ISSN.0254-1432.2019.09.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2019.09.004","url":null,"abstract":"Objective \u0000To evaluate Chinese clinical practice guideline/consensus for digestive diseases published in the past five years in order to recommend the high-quality guidelines and help with the promotion and implementation of them. \u0000 \u0000 \u0000Methods \u0000From January 2013 to June 2018, the officially published Chinese practice guideline/consensus for digestive diseases were selected. The inclusion and exclusion criteria of the guideline/consensus was evaluated by \"Evaluation Criteria for Chinese Clinical Practice Guidelines 2017(AGREE-China 2017)\" . The guideline/consensus were independently scored by three evaluators and then calculated the average value. Descriptive analysis methods were used to analyze the Chinese clinical practice guideline/consensus for digestive diseases. Those with the total score more than 40.0 points were included in the recommended list. \u0000 \u0000 \u0000Results \u0000A total of 119 officially published clinical practice guideline/consensus of digestive diseases were retrieved, and 74 clinical practice guideline/consensus for digestive diseases were included in the evaluation. Among them, 18 (24.3%, 18/74) scored over 60.0 points, 31 (41.9%, 31/74) scored between 40.0 and 59.9 points. Finally 48 guideline or consesus were selected for the recommended list 19 cases of esophagus and gastrointestinal diseases, 18 cases of liver diseases, five cases of biliary and pancreafic diseases, and six cases of digestive endoscopy. The three guideline/consensus with the high scores (> 80.0 points) were The Fifth Chinese National Consensus Report on the Maragement of Helicobacter pylori Infection, Consensus on the Diagnosis and Treatmeat of Cholestatic Liver Disease (2015) and Guidelines for the Prevention and Treatment of Chroaic Hepatitis B (2015 Update). The higher the score of the guideline/consensus, the more scientific and rigorous the method, and the clearer the evaluation of evidence grade and the description of the formation of recommendations. Compared with international standards of guideline/consensus development, there are still some problems in Chinese guidelines or consensus such as no explanation of retrieval strategy, no basis of evidence classification and no description of the formation process from evidence to recommendation. \u0000 \u0000 \u0000Conclusions \u0000The quality of Chinese clinical practice guideline/consensus for digestive diseases has been improved year by year. However the scientific aspects need to be further improved. AGREE-China which demonstrates good validity, realiability and practicability is easy and clear to use. \u0000 \u0000 \u0000Key words: \u0000Guideline evaluation; Evaluation criteria for Chinese clinical practice guidelines; AGREE-China; Clinical practice guideline of digestive disease","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"38 1","pages":"613-618"},"PeriodicalIF":0.0,"publicationDate":"2019-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88012330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}