Canadian Journal of Gastroenterology最新文献

{"title":"Relationship between the number of positive fecal occult blood tests and the diagnostic yield of colonoscopy.","authors":"Ahmad Muinuddin,&nbsp;Ramona Aslahi,&nbsp;Wilma M Hopman,&nbsp;William G Paterson","doi":"10.1155/2013/612314","DOIUrl":"https://doi.org/10.1155/2013/612314","url":null,"abstract":"<p><strong>Background: </strong>In 2007, Ontario launched a colon cancer screening program for average-risk individuals based on biennial fecal occult blood tests (FOBTs) on three fecal samples, followed by colonoscopy for individuals who tested positive.</p><p><strong>Objective: </strong>To determine whether >1 positive screening FOBT was predictive of finding advanced neoplasia at colonoscopy.</p><p><strong>Methods: </strong>A retrospective chart review of outpatient colonoscopic procedures performed at Hotel Dieu Hospital (Kingston, Ontario) in the first two years of the colon cancer screening program was conducted, focusing on endoscopic and pathological findings.</p><p><strong>Results: </strong>Of 5556 individuals undergoing colonoscopy, 346 were referred for positive FOBT. Overall, 41 (11.8%) patients with a positive FOBT had colon cancer. In 16 (4.6%) cases, the number of positive FOBTs was not reported. For the 330 individuals in whom the number of positive tests was specified, 198, 71 and 61 cases had one, two and three positive results, respectively. Cancer was found at colonoscopy in 11 (5.6%), 11 (15.5%) and 18 (29.5%) of individuals with one, two and three positive FOBT results, respectively (OR 3.0 [95% CI 1.2 to 7.3] and 6.5 [95% CI 2.8 to 15.0] for two or three positive FOBTs compared with one; P=0.015 and P<0.001, respectively). High-risk adenomas (>1 cm in diameter, villous component and⁄or high-grade dysplasia) were found in 41 (20.8%), 29 (42.0%) and 25 (41.0%) individuals with one, two and three positive FOBTs, respectively (OR 2.8 [95% CI 1.5 to 5.0] and 2.4 [95% CI 1.3 to 4.5] for two or three positive FOBTs compared with one; P=0.001 and P=0.006, respectively).</p><p><strong>Conclusions: </strong>The diagnostic yield of colonoscopy varied directly with the number of positive FOBTs. This information may be useful in assigning scheduling priority for patients with positive FOBTs.</p>","PeriodicalId":55285,"journal":{"name":"Canadian Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2013-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2013/612314","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31291592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shifting from normal to abnormal: transformation of clinical presentation of post-laparoscopic Roux-en-Y gastric bypass surgery complications.","authors":"David Widjaja,&nbsp;Bhavna Balar","doi":"10.1155/2013/951469","DOIUrl":"https://doi.org/10.1155/2013/951469","url":null,"abstract":"Bariatric surgery can lead to considerable weight loss in patients with morbid obesity who have failed to achieve or maintain weight loss with supervised programs. Laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic adjustable gastric banding are common bariatric surgeries. The former results in better weight loss and a reduced number of failures compared with the latter, despite its significantly longer operative time and life-threatening complications (1). We present a case involving a 32-year-old woman with history of LRYGB who presented with intractable abdominal pain. The initial abdominal imaging study was unremarkable; however, subsequent imaging studies showed volvulus of the midgut requiring surgical intervention.","PeriodicalId":55285,"journal":{"name":"Canadian Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2013-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2013/951469","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31291587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The 2012 SAGE wait times program: Survey of Access to GastroEnterology in Canada.","authors":"Desmond Leddin,&nbsp;David Armstrong,&nbsp;Mark Borgaonkar,&nbsp;Ronald J Bridges,&nbsp;Carlo A Fallone,&nbsp;Jennifer J Telford,&nbsp;Ying Chen,&nbsp;Palma Colacino,&nbsp;Paul Sinclair","doi":"10.1155/2013/143018","DOIUrl":"https://doi.org/10.1155/2013/143018","url":null,"abstract":"<p><strong>Background: </strong>Periodically surveying wait times for specialist health services in Canada captures current data and enables comparisons with previous surveys to identify changes over time.</p><p><strong>Methods: </strong>During one week in April 2012, Canadian gastroenterologists were asked to complete a questionnaire (online or by fax) recording demographics, reason for referral, and dates of referral and specialist visits for at least 10 consecutive new patients (five consultations and five procedures) who had not been seen previously for the same indication. Wait times were determined for 18 indications and compared with those from similar surveys conducted in 2008 and 2005.</p><p><strong>Results: </strong>Data regarding adult patients were provided by 173 gastroenterologists for 1374 consultations, 540 procedures and 293 same-day consultations and procedures. Nationally, the median wait times were 92 days (95% CI 85 days to 100 days) from referral to consultation, 55 days (95% CI 50 days to 61 days) from consultation to procedure and 155 days (95% CI 142 days to 175 days) (total) from referral to procedure. Overall, wait times were longer in 2012 than in 2005 (P<0.05); the wait time to same-day consultation and procedure was shorter in 2012 than in 2008 (78 days versus 101 days; P<0.05), but continued to be longer than in 2005 (P<0.05). The total wait time remained longest for screening colonoscopy, increasing from 201 days in 2008 to 279 days in 2012 (P<0.05).</p><p><strong>Discussion: </strong>Wait times for gastroenterology services continue to exceed recommended targets, remain unchanged since 2008 and exceed wait times reported in 2005.</p>","PeriodicalId":55285,"journal":{"name":"Canadian Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2013-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2013/143018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31291591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cholangiocarcinoma masquerading as an ovarian tumour.","authors":"Darshan Khangura,&nbsp;Camelia Stefanovici,&nbsp;Mayur Brahmania,&nbsp;Dana Moffatt","doi":"10.1155/2013/159254","DOIUrl":"https://doi.org/10.1155/2013/159254","url":null,"abstract":"Department of Medicine (Division of Gastroenterology), St Boniface General Hospital, University of Manitoba, Winnipeg, Manitoba Correspondence: Dr Mayur Brahmania, Department of Medicine (Division of Gastroenterology), St Boniface General Hospital, 804F-175 McDermot Avenue, Winnipeg, Manitoba R3E 3P4. Telephone 204-789-3369, fax 204-789-3972, e-mail mbrahmania@gmail.com Received for publiction September 24, 2012. Accepted October 1, 2012 Case Presentation A 76-year-old woman presented to the emergency department complaining of nausea, vomiting, diarrhea, right-sided abdominal pain and early satiety. Her physical examination was within normal limits, with the exception of nodularity in the cul-de-sac and right parametrium on pelvirectal examination. Liver enzyme levels were elevated: aspartate aminotransferase 150 U/L; alanine amonotransferase 369 U/L; gammaglutamyl transferase 953 U/L; alkaline phosphatase 370 U/L; and a direct bilirubin level of 12 umol/L. A computed tomography scan of the abdomen and pelvis showed minimal dilation of the biliary system, with no obvious mass lesions or obstruction (Figure 1). However, multiple soft tissue nodules within the omentum and a prominent cystic lesion within the right adnexa were apparent. Pelvic ultrasound revealed a multiseptated right adnexal mass 6.2 cm in size, which raised concern for an ovarian cystic neoplasm. A subsequent carbohydrate antigen (CA) 125 level of 129 U/mL was measured. The patient underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy with pelvic lymph node dissection, omentectomy, appendectomy, and resection of the retroperitoneal mass in the posterior cul-de-sac and left uterosacral ligament. A frozen section of the right adnexal mass intraoperatively showed a mucinous cystadenoma with no evidence of malignancy (Figure 2). However, final pathology results yielded a well-differentiated mucinous adenocarcinoma consistent with metastasis from a primary cholangiocarcinoma. Metastatic cholangiocarcinoma was also identified in the cervix, uterine serosa, left fallopian tube, retroperitoneal posterior cul-de-sac lesion, left uterosacral lesion and the omentum. Both the ovarian neoplasm and omental deposits stained negative for CA 125. A serum CA 19.9 level of 30,000 U/mL was measured, necessitating an endoscopic retrograde cholangiopancreatography (ERCP) for further evaluation. ERCP demonstrated a complete obstruction/stricture 3 cm in size in the proximal common hepatic duct up to the hilum. A biliary stent was successfully placed above the stricture with adequate drainage of bile. DisCussion Cholangiocarcinoma (CC) is a rare malignancy of the biliary epithelium within the intrahepatic or extrahepatic bile ducts. It carries a poor prognosis and surgical management is the only curative treatment currently available. However, surgery is often extensive and is associated with significant morbidity and mortality (1). CC with metastasis to the ovary can present a dia","PeriodicalId":55285,"journal":{"name":"Canadian Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2013-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2013/159254","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31291588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A blueprint for quality.","authors":"Mark R Borgaonkar","doi":"10.1155/2013/872070","DOIUrl":"https://doi.org/10.1155/2013/872070","url":null,"abstract":"It is clear that enhancing the quality of endoscopic services improves patient outcomes. Benefits include shorter wait times, more appropriate screening and surveillance intervals, higher adenoma detection rates and fewer interval (or missed) cancers.","PeriodicalId":55285,"journal":{"name":"Canadian Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2013-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2013/872070","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31291589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Younger age and prognosis in diverticulitis: a nationwide retrospective cohort study.","authors":"Roshan Razik,&nbsp;Christopher A Chong,&nbsp;Geoffrey C Nguyen","doi":"10.1155/2013/341501","DOIUrl":"https://doi.org/10.1155/2013/341501","url":null,"abstract":"<p><strong>Background: </strong>Traditionally regarded as a disease of the elderly, the incidence of diverticulitis of the colon has been on the rise, especially in younger cohorts. These patients have been found to experience a more aggressive disease course with more frequent hospitalization and greater need for surgical intervention.</p><p><strong>Objective: </strong>To characterize factors that portend a poor prognosis in patients diagnosed with diverticulitis; in particular, to evaluate the role of demographic variables on disease course.</p><p><strong>Methods: </strong>Using the Canadian Institute for Health Information Discharge Abstract Databases, readmission rates, length of stay, colectomy rates and mortality rates in patients hospitalized for diverticulitis were examined. Data were stratified according to age, sex and comorbidity (as defined by the Charlson index).</p><p><strong>Results: </strong>In the cohort ≤30 years of age, a clear male predominance was apparent. Colectomy rate in the index admission, stratified according to age, demonstrated a J-shaped curve, with the highest rate in patients ≤30 years of age (adjusted OR 2.3 [95% CI 1.62 to 3.27]) compared with the 31 to 40 years of age group. In-hospital mortality increased with age. Cumulative rates of readmission at six and 12 months were 6.8% and 8.8%, respectively.</p><p><strong>Conclusion: </strong>In the present nationwide cohort study, younger patients (specifically those ≤30 years of age) were at highest risk for colectomy during their index admission for diverticulitis. It is unclear whether this observation was due to more virulent disease among younger patients, or surgeon and patient preferences.</p>","PeriodicalId":55285,"journal":{"name":"Canadian Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2013-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2013/341501","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31291593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of hepatic expression of STAT1, SOCS3 and PIAS1 in the response of chronic hepatitis C patients to therapy.","authors":"Sherif El-Saadany,&nbsp;Dina H Ziada,&nbsp;Hanan El Bassat,&nbsp;Wael Farrag,&nbsp;Hesham El-Serogy,&nbsp;Manal Eid,&nbsp;Manal Abdallah,&nbsp;Medhat Ghazy,&nbsp;Hoda A Salem","doi":"10.1155/2013/562765","DOIUrl":"https://doi.org/10.1155/2013/562765","url":null,"abstract":"<p><strong>Background: </strong>The underlying mechanisms of hepatitis C virus (HCV) resistance to treatment are unknown. Signal transducers and activators of transcription (STAT) proteins play a critical role in antiviral defense.</p><p><strong>Objective: </strong>To explore some of the mechanisms of HCV resistance to interferon, the expression of STAT1 and its negative regulators, protein inhibitor of activated STAT (PIAS1) and suppressor of cytokine signalling (SOCS3), in liver tissues of both inteferon responders and nonresponders in chronic HCV patients.</p><p><strong>Methods: </strong>Sixty patients were divided into the following groups: group 1a comprised 38 treatment-responder chronic HCV patients; group 1b consisted of 22 treatment-nonresponder chronic HCV patients; and group 2 consisted of six control subjects. Liver biopsies were examined for histological scoring; STAT1, SOCS3 and PIAS1 expression was analyzed using Western blotting methods.</p><p><strong>Results: </strong>STAT1 expression in the liver tissue of patients in group 1 was significantly increased compared with group 2 patients (P=0.001), while no significant difference in expression was observed between group 1a and group 1b patients (P=0.747). However, phosphorylated STAT1 protein was expressed at a significantly higher level in liver tissue of patients in group 1a compared with patients in group 1b (P=0.001). Western blot analysis of PIAS1 and SOCS3 protein expression in liver tissues from groups 1 and 2 revealed significantly increased expression in group 1 compared with group 2 (P=0.001). In addition, PIAS1 and SOCS3 protein expression was significantly higher in the liver tissues of patients in group 1b compared with patients in group 1a.</p><p><strong>Conclusion: </strong>Levels of STAT1 and⁄or the protein expression of its negative regulators, PIAS1 and SOCS3, may be a good predictor of response to therapy. These could be used as biomarkers that are easily detected by Western blotting or immunostaining during standard histopathological liver biopsy analysis.</p>","PeriodicalId":55285,"journal":{"name":"Canadian Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2013-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2013/562765","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31291595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstracts of Canadian Digestive Diseases Week 2013 and the Annual CASL (Canadian Association for the Study of the Liver) Winter Meeting. March 1-4, 2013. Victoria, British Columbia, Canada.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":55285,"journal":{"name":"Canadian Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2013-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31385136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of recurrent ingestion of gastrointestinal foreign bodies.","authors":"Ian C Grimes,&nbsp;Bret J Spier,&nbsp;Lisa R Swize,&nbsp;Mary J Lindstrom,&nbsp;Patrick R Pfau","doi":"10.1155/2013/671273","DOIUrl":"https://doi.org/10.1155/2013/671273","url":null,"abstract":"<p><strong>Background: </strong>Gastrointestinal foreign bodies are commonly encountered; however, little knowledge exists as to the causes of foreign body ingestions and why they occur repeatedly in some patients.</p><p><strong>Objective: </strong>To identify and define patients at high risk for recurrent foreign body ingestion.</p><p><strong>Methods: </strong>A retrospective chart review of foreign body ingestion was conducted at a tertiary care medical centre over an 11-year period. Variables analyzed included age, sex, incarceration status, Diagnostic and Statistical Manual of Mental Disorders-IV diagnosis, success of endoscopy, type of sedation used, method of extraction, complications, presence of gastrointestinal pathology, and incidence of recurrent food impaction or foreign body.</p><p><strong>Results: </strong>A total of 159 patients with a foreign body ingestion were identified. One hundred fourteen (77%) experienced a single episode of ingestion and 45 (23%) experienced multiple ingestions. Of the patients with multiple ingestions, 27 (60%) had recurrent food impactions while 18 (40%) ingested foreign objects. In the recurrent ingestor group, a psychiatric disorder had been diagnosed in 16 patients (35.6%) and there were 13 incarcerated individuals (28.9%). The average number of recurrences was 2.6 per patient (117 total recurrences). Individuals with a psychiatric disorder experienced 3.9 recurrences per patient, while prisoners averaged 4.1 recurrences per patient. The combination of a psychiatric disorder and being incarcerated was associated with the highest recurrence rate (4.33 per patient). Multivariable logistic regression revealed that male sex (OR 2.9; P=0.022), being incarcerated (OR 3.0; P=0.024) and the presence of a psychiatric disorder (OR 2.5; P=0.03) were risk factors for recurrent ingestion.</p><p><strong>Conclusion: </strong>Risk factors for recurrent ingestion of foreign bodies were male sex, being incarcerated and the presence of a psychiatric disorder.</p>","PeriodicalId":55285,"journal":{"name":"Canadian Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2013/671273","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31212961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rituximab for the treatment of patients with autoimmune hepatitis who are refractory or intolerant to standard therapy.","authors":"Kelly W Burak, Mark G Swain, Tania Santodomingo-Garzon, Tania Santodomino-Garzon, Samuel S Lee, Stefan J Urbanski, Alexander I Aspinall, Carla S Coffin, Robert P Myers","doi":"10.1155/2013/512624","DOIUrl":"10.1155/2013/512624","url":null,"abstract":"<p><strong>Background: </strong>Although most patients with autoimmune hepatitis (AIH) respond to treatment with prednisone and⁄or azathioprine, some patients are intolerant or refractory to standard therapy. Rituximab is an anti-CD20 monoclonal antibody that depletes B cells and has demonstrated efficacy in other autoimmune conditions.</p><p><strong>Aims: </strong>To evaluate the safety and efficacy of rituximab in patients with refractory AIH in an open-label, single-centre pilot study.</p><p><strong>Methods: </strong>Six patients with definite, biopsy-proven AIH who failed prednisone and azathioprine treatment received two infusions of rituximab 1000 mg two weeks apart and were followed for 72 weeks.</p><p><strong>Results: </strong>Rituximab was well tolerated with no serious adverse events. By week 24, mean (± SD) aspartate aminotransferase (AST) levels had significantly improved (90.0±23.3 U⁄L versus 31.3±4.2 U⁄L; P=0.03) and mean immunoglobulin G levels had fallen (16.4±2.0 g⁄L versus 11.5±1.1 g⁄L; P=0.056). The prednisone dose was weaned in three of four subjects, with one subject flaring after steroid withdrawal. Inflammation grade improved in all four subjects who underwent repeat liver biopsy at week 48. Regulatory T cell levels examined by FoxP3 immunohistochemistry paralleled inflammatory activity and did not increase on follow-up biopsies. There was no significant change in serum chemokine or cytokine levels from baseline to week 24 (n=5), although interferon-gamma-induced protein 10 levels improved in three of five subjects.</p><p><strong>Conclusions: </strong>Rituximab was safe, well tolerated and resulted in biochemical improvement in subjects with refractory AIH. These results support further investigation of rituximab as a treatment for AIH.</p>","PeriodicalId":55285,"journal":{"name":"Canadian Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3735730/pdf/cjg27273.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31552696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}