Gastroenterology Report最新文献

{"title":"Preoperative assessment of fistula-in-ano using SonoVue enhancement during three-dimensional transperineal ultrasound.","authors":"Jun Yang, Qing Li, Hua Li, Heng Zhang, Donglin Ren, Zhiyi Zhang, Dan Su, Haihua Qian","doi":"10.1093/gastro/goae002","DOIUrl":"10.1093/gastro/goae002","url":null,"abstract":"<p><strong>Background: </strong>Accurate preoperative evaluation of fistula-in-ano can guide the choice of surgical procedure and may improve healing rates. This prospective study aimed to evaluate the accuracy of conventional 3D transperineal ultrasound (3D-TPUS) compared with SonoVue (SVE)-enhanced 3D-TPUS for the detection and classification of anal fistula.</p><p><strong>Methods: </strong>In this prospective study, 3D-TPUS reconstructions were performed before and after SVE enhancement in 60 patients with fistula-in-ano who intended to undergo surgery at the Department of Anorectal Surgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University (P. R. China) between January 2021 and October 2021. Accuracies of anal fistula classification, complexity classification, detection of anal fistula branches, and detection of internal opening between 3D-TPUS and SVE 3D-TPUS were compared based on a reference standard-intraoperative findings.</p><p><strong>Results: </strong>This study enrolled 60 patients (mean age, 37.1 ± 11.4 years; mean follow-up, 9 ± 3 months). Intraoperative findings showed that the fistula type was intersphincteric in 23 patients (38.3%), trans-sphincteric in 35 (58.3%; 12 high and 23 low), and suprasphincteric in 2 (3.3%). Moreover, 68 internal openings were found. Compared with the accuracy of 3D-TPUS, that of SVE 3D-TPUS was similar in fistula classification [95.0% (57/60) vs 96.7% (58/60), <i>P </i>=<i> </i>0.392], but significantly higher in internal opening evaluation [80.9% (55/68) vs 97.1% (66/68), <i>P </i>=<i> </i>0.001], complexity classification [85.0% (51/60) vs 98.3% (59/60), <i>P </i>=<i> </i>0.018], and detection of fistula branches [70.4% (19/27) vs 92.6% (25/27), <i>P </i>=<i> </i>0.031].</p><p><strong>Conclusions: </strong>SVE 3D-TPUS may be a useful examination for patients with perianal fistulae because of its high accuracy and consistency with intraoperative findings, especially in complex fistula-in-ano and difficult cases.</p>","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10899812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139991858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of immunocyte infiltration and prognosis in postoperative hepatitis B virus-related hepatocellular carcinoma patients using magnetic resonance imaging.","authors":"Chenyu Song, Mengqi Huang, Xiaoqi Zhou, Yuying Chen, Zhoulei Li, Mimi Tang, Meicheng Chen, Zhenpeng Peng, Shiting Feng","doi":"10.1093/gastro/goae009","DOIUrl":"10.1093/gastro/goae009","url":null,"abstract":"<p><strong>Background: </strong>The immune microenvironment (IME) is closely associated with prognosis and therapeutic response of hepatitis B virus-related hepatocellular carcinoma (HBV-HCC). Multi-parametric magnetic resonance imaging (MRI) enables non-invasive assessment of IME and predicts prognosis in HBV-HCC. We aimed to construct an MRI prediction model of the immunocyte-infiltration subtypes and explore its prognostic significance.</p><p><strong>Methods: </strong>HBV-HCC patients at the First Affiliated Hospital of Sun Yat-sen University (Guangzhou, China) with radical surgery (between 1 October and 30 December 2021) were prospectively enrolled. Patients with pathologically proven HCC (between 1 December 2013 and 30 October 2019) were retrospectively enrolled. Pearson correlation analysis was used to examine the relationship between the immunocyte-infiltration counts and MRI parameters. An MRI prediction model of immunocyte-infiltration subtypes was constructed in prospective cohort. Kaplan-Meier survival analysis was used to analyse its prognostic significance in the retrospective cohort.</p><p><strong>Results: </strong>Twenty-four patients were prospectively enrolled to construct the MRI prediction model. Eighty-nine patients were retrospectively enrolled to determine its prognostic significance. MRI parameters (relative enhancement, ratio of the apparent diffusion coefficient value of tumoral region to peritumoral region [rADC], T1 value) correlated significantly with the immunocyte-infiltration counts (leukocytes, T help cells, PD1+Tc cells, B lymphocytes). rADC differed significantly between high and low immunocyte-infiltration groups (1.47 ± 0.36 vs 1.09 ± 0.25, <i>P </i>=<i> </i>0.009). The area under the curve of the MRI model was 0.787 (95% confidence interval 0.587-0.987). Based on the MRI model, the recurrence-free time was longer in the high immunocyte-infiltration group than in the low immunocyte-infiltration group (<i>P </i>=<i> </i>0.026).</p><p><strong>Conclusions: </strong>MRI is a non-invasive method for assessing the IME and immunocyte-infiltration subtypes, and predicting prognosis in post-operative HBV-HCC patients.</p>","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10898339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139984496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variability of bile bacterial profiles and drug resistance in patients with choledocholithiasis combined with biliary tract infection: a retrospective study","authors":"Hang Zhang, Yuchen Cong, Lichao Cao, Kuijin Xue, Peng Qi, Qingdong Mao, Cong Xie, Yushan Meng, Bin Cao","doi":"10.1093/gastro/goae010","DOIUrl":"https://doi.org/10.1093/gastro/goae010","url":null,"abstract":"Abstract Background Biliary tract infection is a common complication of choledocholithiasis. This study aimed to analyse the distribution of pathogenic bacteria in bile cultures from patients with choledocholithiasis combined with biliary tract infection to guide clinical application of antimicrobials and reduce the emergence of drug resistance. Methods A total of 880 patients were enrolled in this retrospective study from 30 March 2017 to 31 August 2022 at the Affiliated Hospital of Qingdao University in China. Bile specimens were extracted for microbiological culture under aseptic conditions using endoscopic retrograde cholangiopancreatography. Bacterial culture, strain identification, and antimicrobial susceptibility testing were conducted according to the standard protocol. Baseline data were retrieved from patient files. Results Overall, 90.34% (795/880) of bile samples showed positive microbiological results and 37.50% (330/880) demonstrated polymicrobial infections. Among the 795 bile specimens with positive culture results, 1,216 pathogenic bacteria were detected, with gram-negative bacilli accounting for 56.33%, gram-positive cocci for 41.86%, and fungi for 1.81%. The predominant gram-negative bacilli in the bile cultures were Escherichia coli (30.43%) and Klebsiella pneumoniae (13.98%), whereas the main gram-positive cocci were Enterococcus faecium (14.04%) and E. casseliflavus (4.28%). The annual trend analysis revealed a gradual decrease in the proportion of gram-negative bacilli and a gradual increase in the proportion of gram-positive cocci, with a concomitant decrease in the dominance of E. coli. Both E. faecium and E. coli showed high resistance to conventional antibiotics but high sensitivity to piperacillin/tazobactam, carbapenems, amikacin, and vancomycin. Conclusions A significant change has occurred in the bile bacterial spectrum in patients with choledocholithiasis and biliary tract infection. The incidence of gram-positive cocci infections has increased annually, while that of gram-negative bacilli and E. coli infections has decreased. Antibiotic administration should be tailored based on the local bacterial profile.","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139957620","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}

{"title":"Laparoscopic cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for gastric cancer with intraoperative detection of limited peritoneal metastasis: a Phase II study of CLASS-05 trial.","authors":"Tian Lin, Xinhua Chen, Zhijun Xu, Yanfeng Hu, Hao Liu, Jiang Yu, Guoxin Li","doi":"10.1093/gastro/goae001","DOIUrl":"10.1093/gastro/goae001","url":null,"abstract":"<p><strong>Background: </strong>Systemic chemotherapy for gastric cancer with peritoneal metastasis has limited clinical benefit; for those with intraoperative detection of occult peritoneal metastasis, cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy (HIPEC) is an alternative treatment. However, the feasibility and effects of this modality and criteria for selecting suitable groups remain unclear. This study aimed to explore the safety and efficacy of laparoscopic cytoreductive surgery (L-CRS) followed by HIPEC in gastric cancer with limited peritoneal metastasis, and this study also aimed to determine the optimized cut-off of the peritoneal cancer index.</p><p><strong>Methods: </strong>Between March 2017 and November 2019, patients diagnosed with gastric cancer peritoneal metastases by using laparoscopy and the Sugarbaker peritoneal cancer index of ≤12 were eligible for inclusion. All patients received L-CRS (including gastrectomy with D2 lymph node dissection) and resection of visible peritoneal metastasis, followed by post-operative HIPEC, and systemic chemotherapy. The primary end points were median progression-free survival and median survival time, and the secondary outcomes were morbidity and mortality within 30 days after surgery.</p><p><strong>Results: </strong>Thirty patients were eligible for analysis, of whom 19 (63.3%) were female, and the overall mean age was 53.0 years. The post-operative morbidity was 20% and the severe complication rate was 10%. The median survival time was 27.0 months with a 2-year overall survival rate of 52.3% and median progression-free survival was 14.0 months with a 2-year progression-free survival of 30.4%.</p><p><strong>Conclusions: </strong>L-CRS followed by HIPEC can be safely performed for gastric cancer with limited peritoneal metastasis and potential survival benefits.</p>","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10882263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139934229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Esophageal mucosa exfoliation: a rare case during endoscopic submucosal dissection.","authors":"Li Tang, Rong Luo, Zhihan Wu, Jinlin Yang, Kai Deng","doi":"10.1093/gastro/goae007","DOIUrl":"10.1093/gastro/goae007","url":null,"abstract":"","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10882261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139934228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heterogeneity of immune infiltration and immunotherapy in colorectal cancer.","authors":"Yichen Li, Jun Hu, Min Zhi","doi":"10.1093/gastro/goad079","DOIUrl":"10.1093/gastro/goad079","url":null,"abstract":"","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10873571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139900898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel location classification system for Crohn's disease based on small bowel involvement: a better predictor of disease progression.","authors":"Huili Guo, Jian Tang, Xiusen Qin, Minzhi Lin, Miao Li, Qingfan Yang, Zicheng Huang, Xiang Gao, Kang Chao","doi":"10.1093/gastro/goae003","DOIUrl":"https://doi.org/10.1093/gastro/goae003","url":null,"abstract":"<p><strong>Background: </strong>Small bowel involvement is related to poor prognosis in Crohn's disease (CD), which may be a potential marker to stratify patients with a high risk of progression. This study aimed to establish a novel location classification system for CD and to develop a predictive model for disease progression.</p><p><strong>Methods: </strong>Consecutive patients with non-stricturing/non-penetrating CD were retrospectively included in the Sixth Affiliated Hospital, Sun Yat-sen University (Guangzhou, P. R. China) between January 2012 and January 2018. Patients were classified into two groups according to disease location: small bowel involvement group and isolated colon group. The primary outcome was disease progression to stricturing or penetrating phenotypes. Progression-free survival was estimated using Cox proportional hazards regression analysis and Kaplan-Meier method.</p><p><strong>Results: </strong>A total of 463 patients were analysed, with a median follow-up time of 55.3 months. Patients with small bowel involvement had a higher risk of disease progression than those with isolated colon disease (hazard ratio = 1.998, <i>P </i>=<i> </i>0.007), while no differences were found between Montreal location classification and disease progression. Median progression-free survival was higher in the isolated colon group than in the small bowel involvement group (84.5 vs 77.3 months, <i>P </i>=<i> </i>0.006). Four independent factors associated with disease progression were identified: small bowel involvement, duration of onset of >1 year, deep mucosal ulcer, and C-reactive protein levels of ≥10 mg/L (all <i>P </i><<i> </i>0.05). The nomogram model based on these factors showed good performance in predicting disease progression, with a C-index of 0.746 (95% confidence interval, 0.707-0.785).</p><p><strong>Conclusions: </strong>Classifying CD based on small bowel involvement and isolated colon was superior to the Montreal location classification for predicting disease progression.</p>","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10859182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139724998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysing the application of small intestinal endoscopic ultrasound in small intestinal diseases.","authors":"Liu Zhongcheng, Bo Peng, Qin Guo","doi":"10.1093/gastro/goae004","DOIUrl":"10.1093/gastro/goae004","url":null,"abstract":"","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10936749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140121337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcript selection for the genetic diagnosis of <i>KIF12-</i>associated progressive familial intrahepatic cholestasis.","authors":"Ye Cheng, Yi-Qiong Zhang, Bing-Xuan Wei, Lian Chen, Qing-He Xing, Jian-She Wang","doi":"10.1093/gastro/goad073","DOIUrl":"10.1093/gastro/goad073","url":null,"abstract":"","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10813742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139572166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatitis C virus point-of-care microelimination approach in a vulnerable population in the South of Spain.","authors":"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","doi":"10.1093/gastro/goad077","DOIUrl":"10.1093/gastro/goad077","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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%).</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10805342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139541596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}