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Hepatitis C virus point-of-care microelimination approach in a vulnerable population in the South of Spain. 西班牙南部易感人群中的丙型肝炎病毒护理点微量消除方法。
IF 3.8 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-01-22 eCollection Date: 2024-01-01 DOI: 10.1093/gastro/goad077
José María Pinazo-Bandera, Jesús Aranda, Alberto Manuel García-García, Ramiro Alcántara, Aida Ortega-Alonso, Enrique Del Campo-Herrera, Encarnación Clavijo, M Dolores García-Escaño, Juan Jesús Ruiz Ruiz, Mónica Morales-Herrera, Vanesa Valle-López, Rosa Martín-Alarcón, Isabel Viciana, Juan Bautista Jiménez, Felix Fernández-García, Juan Pedro Toro-Ortiz, Elena Sánchez-Yáñez, Ismael Álvarez-Álvarez, Raúl J Andrade, Mercedes Robles-Díaz, Miren García-Cortés

Background: Since the introduction of direct-acting antivirals, thousands of chronic hepatitis C patients have been successfully treated. However, vulnerable populations have a higher prevalence of hepatitis C virus (HCV) infection and face barriers that impede their access to antivirals. We carried out an HCV microelimination program focused on vulnerable population groups in Malaga.

Methods: People in drug addiction treatment centers and homeless shelters in Malaga who participated in the program between October 2020 and October 2021 were included. After providing participants with educational information on HCV, a dry drop test (DDT) was used to collect blood for subsequent screening for HCV infection. The participants who were diagnosed with HCV infection were scheduled for comprehensive healthcare assessments, including blood tests, ultrasonography, elastography, and the prescription of antivirals, all conducted in a single hospital visit. Sustained viral response (SVR) was analysed 12 weeks after end of treatment.

Results: Of the 417 persons invited to participate, 271 (65%) agreed to participate in the program. These participants were screened for HCV infection and 28 of them were diagnosed with HCV infection (10%). These hepatitis C-infected patients had a mean age of 53 ± 9 years; 86% were males and 93% were or had been drug users. Among 23 patients with HCV infection, HCV genotype 1a predominated (74%). Medical exams showed that 19% (4/21) had advanced fibrosis (F3-4), and 5% (1/21) had portal hypertension. Finally, 23 infected patients received treatment with glecaprevir/pibrentasvir or sofosbuvir/velpatasvir and SVR was confirmed in 22 patients (96%).

Conclusions: Drug users and homeless people have a higher prevalence of HCV infection than the general population. The microelimination program with educational activity and screening tools achieved a high participation rate, easy healthcare access, and a high rate of SVR despite the SARS-CoV-2 pandemic.

背景:自直接作用抗病毒药物问世以来,数以千计的慢性丙型肝炎患者得到了成功治疗。然而,弱势群体的丙型肝炎病毒(HCV)感染率较高,并且面临着阻碍他们获得抗病毒药物的障碍。我们在马拉加开展了一项针对弱势群体的丙型肝炎病毒微量消除计划:方法:马拉加的戒毒治疗中心和无家可归者收容所的人员在 2020 年 10 月至 2021 年 10 月期间参与了该计划。在向参与者提供有关丙型肝炎病毒(HCV)的教育信息后,采用干滴试验(DDT)采集血液,以便随后进行丙型肝炎病毒感染筛查。确诊感染 HCV 的参与者将在医院接受一次全面的医疗评估,包括血液检测、超声波检查、弹性成像和抗病毒药物处方。治疗结束 12 周后对持续病毒应答(SVR)进行分析:在受邀参加的 417 人中,有 271 人(65%)同意参加该计划。这些参与者接受了丙型肝炎病毒感染筛查,其中 28 人被确诊为丙型肝炎病毒感染者(10%)。这些丙型肝炎感染者的平均年龄为 53 ± 9 岁,86% 为男性,93% 是或曾经是吸毒者。在 23 名丙型肝炎病毒感染者中,丙型肝炎病毒基因型 1a 占多数(74%)。体检结果显示,19%(4/21)的患者有晚期纤维化(F3-4),5%(1/21)的患者有门脉高压。最后,23名感染者接受了格列卡普瑞韦/皮布巴韦或索非布韦/韦帕他韦治疗,22名患者(96%)确诊为SVR:吸毒者和无家可归者的丙型肝炎病毒感染率高于普通人群。尽管SARS-CoV-2大流行,但通过教育活动和筛查工具开展的微观消除项目参与率高,易于获得医疗服务,SVR率也很高。
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引用次数: 0
Association between low-normal thyroid function and advanced liver fibrosis in metabolic dysfunction-associated fatty liver disease patients: a retrospective cohort study. 代谢功能障碍相关性脂肪肝患者低正常甲状腺功能与晚期肝纤维化之间的关系:一项回顾性队列研究。
IF 3.6 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-01-22 eCollection Date: 2024-01-01 DOI: 10.1093/gastro/goad076
Zixuan Li, Xiaoying Wu, Zebin Chen, Xiuqing Wei, Weiqing Chen

Background: Recent studies have found that thyroid function may be associated with the occurrence and development of advanced liver fibrosis in patients with metabolic dysfunction-associated fatty liver disease (MAFLD). However, the majority of such research has consisted of cross-sectional studies. This retrospective cohort study aimed to investigate the effect of low-normal thyroid function on advanced liver fibrosis in MAFLD patients over a 5-year period.

Methods: This retrospective cohort study enrolled 825 outpatients and inpatients with MAFLD who attended the Third Affiliated Hospital of Sun Yat-sen University (Guangzhou, China) between January 2011 and December 2018. Based on plasma thyroid hormone and thyroid-stimulating hormone levels, these patients were divided into two groups, namely a low-normal thyroid function group and a strict-normal thyroid function group. The fibrosis-4 score was used to assess advanced liver fibrosis. A chi-square test was conducted to compare the occurrence of advanced fibrosis between the groups.

Results: Among the 825 MAFLD patients, 117 and 708 were defined as having low-normal thyroid function and strict-normal thyroid function, respectively. Follow-up data were available for 767 patients (93.0%) during a 5-year period. Eight (7.5%) MAFLD patients with low-normal thyroid function and 26 (3.9%) with strict-normal thyroid function developed advanced liver fibrosis and the cumulative incidence was not significantly different (P =0.163). Stratification analysis showed that the lean MAFLD patients (body mass index ≤ 23 kg/m2) with low-normal thyroid function had a higher risk of advanced liver fibrosis than the lean MAFLD patients with strict-normal thyroid function (P <0.05).

Conclusion: Low-normal thyroid function is associated with advanced liver fibrosis among lean MAFLD patients.

背景:最近的研究发现,甲状腺功能可能与代谢功能障碍相关性脂肪肝(MAFLD)患者晚期肝纤维化的发生和发展有关。然而,大多数此类研究都是横断面研究。这项回顾性队列研究旨在调查甲状腺功能低正常在5年内对代谢功能障碍相关性脂肪肝患者晚期肝纤维化的影响:这项回顾性队列研究纳入了2011年1月至2018年12月期间在中山大学附属第三医院(中国广州)就诊的825例门诊和住院MAFLD患者。根据血浆甲状腺激素和促甲状腺激素水平,这些患者被分为两组,即甲状腺功能低正常组和甲状腺功能严格正常组。采用纤维化-4评分来评估晚期肝纤维化。通过卡方检验比较两组间晚期肝纤维化的发生率:在825名MAFLD患者中,分别有117人和708人被定义为甲状腺功能低正常组和甲状腺功能严格正常组。767名患者(93.0%)获得了为期5年的随访数据。8例(7.5%)甲状腺功能低正常的MAFLD患者和26例(3.9%)甲状腺功能严格正常的MAFLD患者出现了晚期肝纤维化,累计发生率无显著差异(P = 0.163)。分层分析显示,甲状腺功能低正常的瘦MAFLD患者(体重指数≤23 kg/m2)比甲状腺功能严格正常的瘦MAFLD患者发生晚期肝纤维化的风险更高(P 0.05):结论:甲状腺功能低正常与瘦弱的MAFLD患者的晚期肝纤维化有关。
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引用次数: 0
Independent and additive effects of binge drinking and obesity on liver enzymes: a cross-sectional analysis using the Korean National Health Insurance Service data 暴饮和肥胖对肝酶的独立和叠加影响:利用韩国国民健康保险服务数据进行的横断面分析
IF 3.6 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-01-09 DOI: 10.1093/gastro/goad074
Anthony Kityo, Sang-Ah Lee
Abstract Background Binge drinking (BD) has been associated with elevated liver enzymes, but the joint association of BD and adiposity with liver enzymes is understudied. We aimed to examine the combined association of BD and obesity with elevated liver enzymes. Methods Data were obtained from 285,600 patients in the Korean National Health check-up program during 2009–2015. Level I BD (BD I) was defined as alcohol consumption of >60 g (men) or >40 g (women) on one occasion in the previous year. High-intensity BD (HIBD) corresponded to at least two times the BD I levels. General and abdominal obesity were defined by body mass index and waist circumference. Logistic regression was used to examine the independent and joint associations of BD and obesity with elevated alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transferase (GGT) levels. Relative excess risk (RERI), attributable proportion (AP), and synergy index (SI) were calculated to estimate the additive interaction effects. Results The mean age was 42.1 ± 0.03 years and 50.2% were women. Elevated ALT [odds ratio (OR) 1.09, 95% confidence interval (CI) 1.02–1.16], AST (OR 1.16, 95% CI 1.11–1.23), and GGT (OR 1.84, 95% CI 1.05–1.94) were associated with HIBD. Higher odds of elevated ALT (OR 3.57, 95% CI 3.43–3.71), AST (OR 3.47, 95% CI 3.37–3.58), and GGT (OR 2.10, 95% CI 1.98–2.12) were observed in individuals with general obesity. A similar trend was observed for abdominal obesity. The RERI, AP, and SI for the interaction effect of BD and general obesity were 23%, 7%, and 13% for elevated AST levels, and 67%, 24%, and 58% for elevated GGT levels, respectively. Similar effects were observed for the interaction between BD and abdominal obesity. Conclusions Obesity aggravated the odds of elevated liver AST and GGT levels in HIBD.
摘要 背景 暴饮(BD)与肝酶升高有关,但暴饮和肥胖与肝酶升高的联合关系研究不足。我们旨在研究暴饮暴食和肥胖与肝酶升高的联合关系。方法 我们从 2009-2015 年期间韩国国民健康体检项目的 28.56 万名患者中获得了数据。I 级 BD(BD I)的定义是上一年的一次饮酒量大于 60 克(男性)或大于 40 克(女性)。高强度饮酒(HIBD)相当于饮酒量 I 级的至少两倍。全身肥胖和腹部肥胖以体重指数和腰围来定义。采用逻辑回归法检测 BD 和肥胖与丙氨酸氨基转移酶 (ALT)、天冬氨酸氨基转移酶 (AST) 和γ-谷氨酰转移酶 (GGT) 水平升高之间的独立关联和联合关联。计算了相对超额风险(RERI)、可归因比例(AP)和协同指数(SI),以估计相加的交互效应。结果 平均年龄为 42.1 ± 0.03 岁,50.2% 为女性。谷丙转氨酶(ALT)[几率比(OR)1.09,95% 置信区间(CI)1.02-1.16]、谷草转氨酶(AST)(OR 1.16,95% CI 1.11-1.23)和谷草转氨酶(GGT)(OR 1.84,95% CI 1.05-1.94)升高与 HIBD 相关。在全身肥胖者中观察到更高的谷丙转氨酶(OR 3.57,95% CI 3.43-3.71)、谷草转氨酶(OR 3.47,95% CI 3.37-3.58)和谷草转氨酶(OR 2.10,95% CI 1.98-2.12)升高几率。腹部肥胖也有类似趋势。在 BD 和全身肥胖的交互效应中,AST 水平升高的 RERI、AP 和 SI 分别为 23%、7% 和 13%,GGT 水平升高的 RERI、AP 和 SI 分别为 67%、24% 和 58%。在 BD 和腹型肥胖之间的交互作用中也观察到类似的效果。结论 肥胖会增加 HIBD 患者肝脏 AST 和 GGT 水平升高的几率。
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引用次数: 0
An unusual interventional approach to treat Type 2 Abernethy malformation in children: two case reports. 治疗儿童 2 型阿伯内西畸形的不寻常介入方法:两份病例报告。
IF 3.6 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-01-05 eCollection Date: 2024-01-01 DOI: 10.1093/gastro/goad075
Jiayu Yan, Jie Yin, Dan Zhang, Chuankai Lv, Wenbo Pang, Yajun Chen
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引用次数: 0
Amino acid-based enteral nutrition is effective for pediatric Crohn’s disease: a multicenter prospective study 以氨基酸为基础的肠内营养对小儿克罗恩病有效:一项多中心前瞻性研究
IF 3.6 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2023-12-22 DOI: 10.1093/gastro/goad072
Qingfan Yang, Ting Zhang, Na Diao, Kang Chao, Huijun Shu, Jie Wu, Dexiu Guan, Li Wang, Xiwei Xu, Zhenghong Li, Xiang Gao
Abstract Background Exclusive enteral nutrition (EEN) therapy effectively induces remission in pediatric Crohn’s disease (CD). However, this may depend on the type of enteral formula used. Moreover, data on the efficacy of amino acid-based EEN are limited. Thus, we aimed to prospectively evaluate the efficacy of amino acid-based formulas for EEN in pediatric patients with active CD. Methods Patients with active CD aged between 6 and 17 years were recruited into this prospective study from four hospitals in China between March 2019 and December 2021. Patients received EEN for 8 weeks. Inflammatory and nutrition-associated indices were evaluated at 0, 4, and 8 weeks after treatment. Paired t-tests and Wilcoxon signed-rank tests were used to compare continuous and categorical variables before and after intervention, respectively. Results Twenty-four patients were included in the analysis. After an 8-week intervention period, the CD activity index significantly decreased (26.3 ± 12.2 vs 7.1 ± 8.3, P < 0.001). Most patients (66.7%) achieved complete clinical remission. Among the 22 patients who had ulcers and erosions diagnosed endoscopically at baseline, 10 (45.5%) achieved complete mucosal healing. The degree of thickening of the intestinal wall was significantly reduced after EEN intervention, with a transmural healing rate of 42.9%. Furthermore, the serum inflammatory markers decreased and there was a significant improvement in the nutrition-related indices (P < 0.05). There were no severe adverse effects. Conclusions Amino acid-based EEN is effective and safe for treating pediatric-onset CD. Studies with larger sample sizes and mechanistic and follow-up studies are required to further validate these findings.
摘要 背景 纯肠内营养(EEN)疗法可有效诱导小儿克罗恩病(CD)病情缓解。然而,这可能取决于所使用的肠内配方的类型。此外,基于氨基酸的 EEN 的疗效数据也很有限。因此,我们旨在前瞻性地评估基于氨基酸的配方对活动性 CD 儿童患者肠内营养素吸收的疗效。方法 在2019年3月至2021年12月期间,我们从中国的四家医院招募了6至17岁的活动性CD患者参与这项前瞻性研究。患者接受为期 8 周的 EEN 治疗。在治疗后的 0、4 和 8 周评估炎症和营养相关指数。采用配对 t 检验和 Wilcoxon 符号秩检验分别比较干预前后的连续变量和分类变量。结果 24 名患者参与了分析。经过 8 周的干预后,CD 活动指数明显下降(26.3 ± 12.2 vs 7.1 ± 8.3,P < 0.001)。大多数患者(66.7%)的临床症状完全缓解。在基线时经内镜诊断为溃疡和糜烂的 22 名患者中,10 人(45.5%)的粘膜完全愈合。EEN 干预后,肠壁增厚程度明显减轻,跨壁愈合率为 42.9%。此外,血清中的炎症指标也有所下降,营养相关指标也有明显改善(P < 0.05)。没有出现严重的不良反应。结论 以氨基酸为基础的 EEN 治疗小儿 CD 既有效又安全。为进一步验证这些研究结果,需要进行样本量更大的研究以及机理研究和随访研究。
{"title":"Amino acid-based enteral nutrition is effective for pediatric Crohn’s disease: a multicenter prospective study","authors":"Qingfan Yang, Ting Zhang, Na Diao, Kang Chao, Huijun Shu, Jie Wu, Dexiu Guan, Li Wang, Xiwei Xu, Zhenghong Li, Xiang Gao","doi":"10.1093/gastro/goad072","DOIUrl":"https://doi.org/10.1093/gastro/goad072","url":null,"abstract":"Abstract Background Exclusive enteral nutrition (EEN) therapy effectively induces remission in pediatric Crohn’s disease (CD). However, this may depend on the type of enteral formula used. Moreover, data on the efficacy of amino acid-based EEN are limited. Thus, we aimed to prospectively evaluate the efficacy of amino acid-based formulas for EEN in pediatric patients with active CD. Methods Patients with active CD aged between 6 and 17 years were recruited into this prospective study from four hospitals in China between March 2019 and December 2021. Patients received EEN for 8 weeks. Inflammatory and nutrition-associated indices were evaluated at 0, 4, and 8 weeks after treatment. Paired t-tests and Wilcoxon signed-rank tests were used to compare continuous and categorical variables before and after intervention, respectively. Results Twenty-four patients were included in the analysis. After an 8-week intervention period, the CD activity index significantly decreased (26.3 ± 12.2 vs 7.1 ± 8.3, P < 0.001). Most patients (66.7%) achieved complete clinical remission. Among the 22 patients who had ulcers and erosions diagnosed endoscopically at baseline, 10 (45.5%) achieved complete mucosal healing. The degree of thickening of the intestinal wall was significantly reduced after EEN intervention, with a transmural healing rate of 42.9%. Furthermore, the serum inflammatory markers decreased and there was a significant improvement in the nutrition-related indices (P < 0.05). There were no severe adverse effects. Conclusions Amino acid-based EEN is effective and safe for treating pediatric-onset CD. Studies with larger sample sizes and mechanistic and follow-up studies are required to further validate these findings.","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"26 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138944446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A new membrane anatomy-oriented classification of radical surgery for rectal cancer. 以膜解剖学为导向的直肠癌根治术新分类。
IF 3.6 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2023-12-21 eCollection Date: 2023-01-01 DOI: 10.1093/gastro/goad069
Jiaqi Wang, Hailong Liu, Ajian Li, Huihong Jiang, Yun Pan, Xin Chen, Lu Yin, Moubin Lin

For patients with different clinical stages of rectal cancer, tailored surgery is urgently needed. Over the past 10 years, our team has conducted numerous anatomical studies and proposed the "four fasciae and three spaces" theory to guide rectal cancer surgery. Enlightened by the anatomical basis of the radical hysterectomy classification system of Querleu and Morrow, we proposed a new classification system of radical surgery for rectal cancer based on membrane anatomy. This system categorizes the surgery into four types (A-D) and incorporates corresponding subtypes based on the preservation of the autonomic nerve. Our surgical classification unifies the pelvic membrane anatomical terminology, validates the feasibility of classifying rectal cancer surgery using the theory of "four fasciae and three spaces," and lays the theoretical groundwork for the future development of unified and standardized classification of radical pelvic tumor surgery.

对于不同临床分期的直肠癌患者,迫切需要有针对性的手术治疗。近十年来,我们团队进行了大量解剖学研究,提出了 "四筋膜三间隙 "理论来指导直肠癌手术。受 Querleu 和 Morrow 子宫根治术分类系统解剖学基础的启发,我们根据膜解剖学提出了新的直肠癌根治术分类系统。该系统将手术分为四种类型(A-D),并根据自主神经的保留情况纳入相应的亚型。我们的手术分类统一了盆腔膜解剖术语,验证了利用 "四筋膜三间隙 "理论对直肠癌手术进行分类的可行性,为今后制定统一规范的盆腔肿瘤根治术分类奠定了理论基础。
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引用次数: 0
Single-cell analysis for identification of T-cell clonotypes associated with IgG4 production of autoimmune pancreatitis 通过单细胞分析鉴定与自身免疫性胰腺炎 IgG4 生成相关的 T 细胞克隆型
IF 3.6 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2023-12-08 DOI: 10.1093/gastro/goad071
Kensuke Shibata, N. Fujimori, T. Oono, Daisuke Motooka, Daisuke Okuzaki, Koh-hei Sonoda, Yoshihiro Ogawa, Sho Yamasaki
{"title":"Single-cell analysis for identification of T-cell clonotypes associated with IgG4 production of autoimmune pancreatitis","authors":"Kensuke Shibata, N. Fujimori, T. Oono, Daisuke Motooka, Daisuke Okuzaki, Koh-hei Sonoda, Yoshihiro Ogawa, Sho Yamasaki","doi":"10.1093/gastro/goad071","DOIUrl":"https://doi.org/10.1093/gastro/goad071","url":null,"abstract":"","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"5 3","pages":""},"PeriodicalIF":3.6,"publicationDate":"2023-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138586597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association between adjuvant chemotherapy and survival in stage I gastric cancer patients after curative resection. 一期胃癌根治后辅助化疗与生存的关系。
IF 3.6 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2023-12-05 eCollection Date: 2023-01-01 DOI: 10.1093/gastro/goad070
Qiuying Chen, Hua Xiao, Lu Zhang, Jingjing You, Zhe Jin, Bin Zhang

Background: The efficacy of adjuvant chemotherapy (AC) on survival outcomes of patients with stage I gastric cancer (GC) after curative resection remains controversial. We aimed to determine whether these patients would benefit from AC.

Methods: This retrospective study included patients with pathologically confirmed stage I GC who underwent curative resection between November 2010 and December 2020. Patients were divided into AC and non-AC groups, then a 1:1 propensity score matching (PSM) analysis was performed to minimize the selection bias. Potential risk factors including age, pN stage, pT stage, lymphovascular invasion, perineural invasion, tumor size, histological type, and carcinoembryonic antigen level were used as matching covariates. The recurrence-free survival (RFS) and disease-specific survival (DSS) were compared between groups using the Kaplan-Meier method.

Results: A total of 902 consecutive patients were enrolled and 174 (19.3%) patients were treated with AC. PSM created 123 pairs of patients. Before PSM, patients receiving AC had lower 10-year RFS rates (90% vs 94.6%, P =0.035) than those who did not receive AC; the two groups had similar 10-year DSS rates (93.8% vs 95.0%, P =0.240). After PSM, there were no statistical differences in the 10-year RFS (90.9% vs 93.0%, P =0.507) or DSS rates (93.5% vs 93.6%, P =0.811) between the two groups. Similar results were found in the stage IA and IB subgroups. Moreover, these findings were not affected by AC cycles.

Conclusions: The addition of AC could not provide survival benefits for patients with stage I GC after surgery and follow-up is thus recommended. However, large-scale randomized clinical trials are required.

背景:辅助化疗(AC)对一期胃癌(GC)根治性切除后患者生存结局的影响仍有争议。方法:本回顾性研究纳入了2010年11月至2020年12月间行根治性切除的病理证实的I期胃癌患者。将患者分为交流组和非交流组,然后进行1:1倾向评分匹配(PSM)分析,以尽量减少选择偏差。潜在危险因素包括年龄、pN分期、pT分期、淋巴血管侵犯、神经周围侵犯、肿瘤大小、组织学类型和癌胚抗原水平作为匹配协变量。采用Kaplan-Meier法比较各组无复发生存期(RFS)和疾病特异性生存期(DSS)。结果:共有902例患者连续入组,174例(19.3%)患者接受AC治疗。PSM产生123对患者。在PSM之前,接受AC治疗的患者的10年RFS率低于未接受AC治疗的患者(90% vs 94.6%, P = 0.035);两组10年DSS率相似(93.8% vs 95.0%, P = 0.240)。PSM后,两组10年RFS (90.9% vs 93.0%, P = 0.507)和DSS (93.5% vs 93.6%, P = 0.811)比较,差异均无统计学意义。在IA期和IB期亚组中也发现了类似的结果。此外,这些发现不受交流周期的影响。结论:对于I期GC术后患者,添加AC不能提供生存益处,因此建议随访。然而,需要大规模的随机临床试验。
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引用次数: 0
Dual function of fungi-derived cytokines in inflammatory bowel diseases: protection or inflammation. 真菌来源的细胞因子在炎症性肠病中的双重功能:保护或炎症。
IF 3.6 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2023-12-05 eCollection Date: 2023-01-01 DOI: 10.1093/gastro/goad068
Niusha Sharifinejad, Elaheh Mahmoudi

Inflammatory bowel disease (IBD) is an immune-mediated inflammatory condition involving both the innate and adaptive immune systems. Recently, the role of intestinal fungal flora and their downstream immune pathways has been highlighted in the pathogenesis of IBD. Cytokines as primary immune mediators require a delicate balance for maintaining intestinal homeostasis. Although most cytokines have a predictable role in either amplifying or attenuating inflammation in IBD, a few cytokines have shown a dual function in the inflammatory state of the intestine. Some of these dual-faced cytokines are also involved in mucosal anti-microbial defense pathways, particularly against intestinal fungal residents. Here, we reviewed the role of these cytokines in IBD pathogenesis to achieve a better understanding of the fungal interactions in the development of IBD.

炎症性肠病(IBD)是一种免疫介导的炎症,涉及先天和适应性免疫系统。近年来,肠道真菌菌群及其下游免疫途径在IBD发病机制中的作用已得到重视。细胞因子作为主要的免疫介质,需要一个微妙的平衡来维持肠道内稳态。尽管大多数细胞因子在IBD中具有可预测的放大或减弱炎症的作用,但少数细胞因子在肠道炎症状态中显示出双重功能。这些双面细胞因子中的一些也参与粘膜抗微生物防御途径,特别是针对肠道真菌居民。在这里,我们回顾了这些细胞因子在IBD发病机制中的作用,以更好地了解真菌在IBD发展中的相互作用。
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引用次数: 0
Ileorectal intussusception in an adult: a case report of an anal mass. 成人回肠直肠肠套叠:肛门肿块一例报告。
IF 3.6 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2023-10-31 eCollection Date: 2023-01-01 DOI: 10.1093/gastro/goad067
Azin Kalani, Mina Alvandipour
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引用次数: 0
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Gastroenterology Report
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