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| 1 | Helicobacter pylori infection as a cause of iron deficiency anaemia of unknown origin显示文摘AIM: To assess the aetiological role of Helicobacter pylori (H. pylori) infection in adult patients with ironrefractory or iron-dependent anaemia of previously unknown origin. METHODS: Consecutive patients with chronic irondeficient anaemia (IDA) with H. pylori infection and a negative standard work-up were prospectively evaluated. All of them had either iron refractoriness or iron dependency. Response to H. pylori eradication was assessed at 6 and 12 mo from follow-up. H. pylori infection was considered to be the cause of the anaemia when a complete anaemia resolution without iron supplements was observed after eradication. RESULTS: H. pylori was eradicated in 88 of the 89 patients. In the non-eradicated patient the four eradicating regimens failed. There were violations of protocol in 4 patients, for whom it was not possible to ascertain the cause of the anaemia. Thus, 84 H. pylori eradicated patients (10 men; 74 women) were available to assess the effect of eradication on IDA. H. pylori infection was considered to be the aetiology of IDA in 32 patients (38.1%; 95%CI: 28.4%-48.8%). This was more frequent in men/postmenopausal women than in premenopausal women (75% vs 23.3%; P < 0.0001) with an OR of 9.8 (95%CI: 3.3-29.6). In these patients, anaemia resolution occurred in the first follow-up visit at 6 mo, and no anaemia or iron deficiency relapse was observed after a mean follow-up of 21 ± 2 mo. CONCLUSION: Gastric H. pylori infection is a frequent cause of iron-refractory or iron-dependent anaemia of previously unknown origin in adult patients. | Helena Monzón Montserrat Forné Maria Esteve Mercé Rosinach Carme Loras Jorge C Espinós Josep M Viver Antonio Salas Fernando Fernández-Baares | 2013 | World Journal of Gastroenterology2013，19，26： | 13 |
| 2 | Subclinical abnormal glucose tolerance is a predictor of death in liver cirrhosis显示文摘AIM:To determine if subclinical abnormal glucose tolerance(SAGT)has influence on survival of non-diabetic patients with liver cirrhosis.METHODS:In total,100 patients with compensatedliver cirrhosis and normal fasting plasma glucose were included.Fasting plasma insulin(FPI)levels were measured,and oral glucose tolerance test(OGTT)was performed.According to OGTT results two groups of patients were formed:those with normal glucose tolerance(NGT)and those with SAGT.Patients were followed every three months.The mean follow-up was932 d(range of 180-1925).Survival was analyzed by the Kaplan-Meyer method,and predictive factors of death were analyzed using the Cox proportional hazard regression model.RESULTS:Of the included patients,30 showed NGT and70 SAGT.Groups were significantly different only in age,INR,FPI and HOMA2-IR.Patients with SAGT showed lower 5-year cumulated survival than NGT patients(31.7%vs 71.6%,P=0.02).Differences in survival were significant only after 3 years of follow-up.SAGT,Child-Pugh B,and high Child-Pugh and Model for EndStage Liver Disease(MELD)scores were independent predictors of death.The causes of death in 90.3%of cases were due to complications related to liver disease.CONCLUSION:SAGT was associated with lower survival.SAGT,Child-Pugh B,and high Child-Pugh and MELD scores were independent negative predictors of survival. | Diego García-Compeán Joel Omar Jáquez-Quintana Fernando Javier Lavalle-González José Alberto González-González Linda Elsa Mu?oz-Espinosa Jesús Zacarías Villarreal-PérezEndocrinology Service and Department of Internal Medicine University Hospital 'Dr. José E. González' and Medical School Universidad Autónoma de Nuevo León Monterrey 64320 México Héctor J Maldonado-Garza | 2014 | World Journal of Gastroenterology2014，20，22： | 12 |
| 3 | Hepatogenous diabetes: Is it a neglected condition in chronic liver disease?显示文摘Diabetes mellitus(DM) that occurs because of chronic liver disease(CLD) is known as hepatogenous diabetes(HD). Although the association of diabetes and liver cirrhosis was described forty years ago, it was scarcely studied for long time. Patients suffering from this condition have low frequency of risk factors of type 2 DM. Its incidence is higher in CLD of viral, alcoholic and cryptogenic etiology. Its pathophysiology relates to liver damage, pancreatic dysfunction, interactions between hepatitis C virus(HCV) and glucose metabolism mechanisms and genetic susceptibility. It associates with increased rate of liver complications and hepatocellular carcinoma, and decreased 5-year survival rate. It reduces sustained virological response in HCV infected patients. In spite of these evidences, the American Diabetes Association does not recognize HD. In addition, the impact of glucose control on clinical outcomes of patients has not been evaluated. Treatment of diabetes may be difficult due to liver insufficiency and hepatotoxicity of antidiabetic drugs. Notwithstanding, no therapeutic guidelines have been implemented up to date. In this editorial, authors discuss the reasons why they think that HD may be a neglected pathological condition and call attention to the necessity for more clinical research on different fields of this disease. | Diego García-Compeán José Alberto González-González Fernando Javier Lavalle-González Emmanuel Irineo González-Moreno Jesús Zacarías Villarreal-Pérez Héctor Jesús Maldonado-Garza | 2016 | World Journal of Gastroenterology2016，22，10： | 12 |
| 4 | Prognostic factors for recurrence of gastrointestinal bleeding due to Dieulafoy's lesion显示文摘AIM:To analyze the effectiveness of the endoscopic therapy and to identify prognostic factors for recurrent bleeding.METHODS:Retrospective study of patients with gastrointestinal bleeding secondary to Dieulafoy's lesion(DL) from 2005 to 2011.We analyzed the demographic characteristics of the patients,risk factors for gastrointestinal bleeding,endoscopic findings,characteristics of the endoscopic treatment,and the recurrence of bleeding.We included cases in which endoscopy described a lesion compatible with Dieulafoy.We excluded patients who had potentially bleeding lesions such as angiodysplasia in other areas or had undergone other gastrointestinal endoscopic procedures.RESULTS:Twenty-nine patients with DL were identified.Most of them were men with an average age of 71.5 years.Fifty-five percent of the patients received antiaggregatory or anticoagulant therapy.The most common location for DL was the stomach(51.7%).The main type of bleeding was oozing in 65.5% of cases.In 27.6% of cases,there was arterial(spurting) bleeding,and 6.9% of the patients presented with an adherent clot.A single endoscopic treatment was applied to nine patients(31%);eight of them with adrenaline and one with argon,while 69% of the patients received combined treatment.Six patients(20.7%) presented with recurrent bleeding at a median of 4 d after endoscopy(interquartile range = 97.75).Within these six patients,the new endoscopic treatment obtained a therapeutic success of 100%.The presence of arterial bleeding at endoscopy was associated with a higher recurrence rate for bleeding(50% vs 33.3% for other type of bleeding) [P = 0.024,odds ratio(OR) = 8.5,95% CI = 1.13-63.87].The use of combined endoscopic treatment prevented the recurrence of bleeding(10% vs 44.4% of single treatment)(P = 0.034,OR = 0.14,95% CI = 0.19-0.99).CONCLUSION:Endoscopic treatment of DL is safe and effective.Adrenaline monotherapy and arterial(spurting) bleeding are associated with a high rate of bleeding recurrence. | Yuliana Jamanca-Poma Antonio Velasco-Guardado Concepción Piero-Pérez Renzo Calderón-Begazo Josue Umaa-Mejía Fernando Geijo-Martínez Antonio Rodríguez-Pérez | 2012 | World Journal of Gastroenterology2012，18，40： | 11 |
| 5 | Watch and wait approach in rectal cancer:Current controversies and future directions显示文摘According to the main international clinical guidelines,the recommended treatment for locally-advanced rectal cancer is neoadjuvant chemoradiotherapy followed by surgery.However,doubts have been raised about the appropriate definition of clinical complete response(cCR)after neoadjuvant therapy and the role of surgery in patients who achieve a cCR.Surgical resection is associated with significant morbidity and decreased quality of life(QoL),which is especially relevant given the favourable prognosis in this patient subset. Accordingly, therehas been a growing interest in alternative approaches with less morbidity,including the organ-preserving watch and wait strategy, in which surgery isomitted in patients who have achieved a cCR. These patients are managed with aspecific follow-up protocol to ensure adequate cancer control, including the earlyidentification of recurrent disease. However, there are several open questionsabout this strategy, including patient selection, the clinical and radiologicalcriteria to accurately determine cCR, the duration of neoadjuvant treatment, therole of dose intensification (chemotherapy and/or radiotherapy), optimal followupprotocols, and the future perspectives of this approach. In the present review,we summarize the available evidence on the watch and wait strategy in thisclinical scenario, including ongoing clinical trials, QoL in these patients, and thecontroversies surrounding this treatment approach. | Fernando López-Campos Margarita Martín-Martín Roberto Fornell-Pérez Juan Carlos García-Pérez Javier Die-Trill Raquel Fuentes-Mateos Sergio López-Durán JoséDomínguez-Rullán Reyes Ferreiro AlejandroRiquelme-Oliveira Asunción Hervás-Morón Felipe Couñago | 2020 | World Journal of Gastroenterology2020，26，29： | 10 |
| 6 | Planetary Gear Profile Modification Design Based on Load Sharing Modelling显示文摘In order to satisfy the increasing demand on high performance planetary transmissions, an important line of research is focused on the understanding of some of the underlying phenomena involved in this mechanical system. Through the development of models capable of reproduce the system behavior, research in this area contributes to improve gear transmission insight, helping developing better maintenance practices and more efficient design processes. A planetary gear model used for the design of profile modifications ratio based on the levelling of the load sharing ratio is presented. The gear profile geometry definition, following a vectorial approach that mimics the real cutting process of gears, is thoroughly described. Teeth undercutting and hypotrochoid definition are implicitly considered, and a procedure for the incorporation of a rounding arc at the tooth tip in order to deal with corner contacts is described. A procedure for the modeling of profile deviations is presented, which can be used for the introduction of both manufacturing errors and designed profile modifications. An easy and flexible implementation of the profile deviation within the planetary model is accomplished based on the geometric overlapping. The contact force calculation and dynamic implementation used in the model are also introduced, and parameters from a real transmission for agricultural applications are presented for the application example. A set of reliefs is designed based on the levelling of the load sharing ratio for the example transmission, and finally some other important dynamic factors of the transmission are analyzed to assess the changes in the dynamic behavior with respect to the non-modified case. Thus, the main innovative aspect of the proposed planetary transmission model is the capacity of providing a simulated load sharing ratio which serves as design variable for the calculation of the tooth profile modifications. | IGLESIAS Miguel FERNáNDEZ DEL RINCóN Alfonso DE-JUAN Ana Magdalena GARCIA Pablo DIEZ Alberto VIADERO Fernando | 2015 | Chinese Journal of Mechanical Engineering2015，28，4： | 9 |
| 7 | Anemia and inflammatory bowel diseases显示文摘Too often anemia is considered a rare or unimportant manifestation in inflammatory bowel disease (IBD). However, over the last 10 years a number of studies have been conducted and the most relevant conclusions obtained are: (1) anemia is quite common in IBD; (2) although in many cases anemia parallels the clinical activity of the disease, many patients in remission have anemia, and iron, vitamin B12 and/or folic acid deficiency; (3) anemia, and also iron def iciency without anemia, have important consequences in the clinical status and quality of life of the patient; (4) oral iron can lead to gastrointestinal intolerance and failure of treatment; (5) intravenous iron is an effective and safe way to treat iron deficiency; (6) erythropoietin is needed in a significant number of cases to achieve normal hemoglobin levels. Thus, the clinician caring for IBD patients should have a comprehensive knowledge of anemia, and apply recently published guidelines in clinical practice. | Fernando Gomollón Javier P Gisbert | 2009 | World Journal of Gastroenterology2009，15，37： | 8 |
| 8 | Common misconceptions about 5-aminosalicylates and thiopurines in inflammatory bowel disease显示文摘Misconceptions are common in the care of patients with inflammatory bowel disease(IBD).In this paper,we state the most commonly found misconceptions in clinical practice and deal with the use of 5-aminosalicylates and thiopurines,to review the related scientificevidence,and make appropriate recommendations.Prevention of errors needs knowledge to avoid making such errors through ignorance.However,the amount of knowledge is increasing so quickly that one new danger is an overabundance of information.IBD is a model of a very complex disease and our goal with this review is to summarize the key evidence for the most common daily clinical problems.With regard to the use of 5-aminosalicylates,the best practice may to be consider abandoning the use of these drugs in patients withsmall bowel Crohn's disease.The combined approach with oral plus topical 5-aminosalicylates should be the first-line therapy in patients with active ulcerative colitis;once-daily treatment should be offered as a first choice regimen due to its better compliance and higher efficacy.With regard to thiopurines,they seem to be as effective in ulcerative colitis as in Crohn's disease.Underdosing of thiopurines is a form of undertreatment.Thiopurines should probably be continued indefinitely because their withdrawal is associated with a high risk of relapse.Mercaptopurine is a safe alternative in patients with digestive intolerance or hepatotoxicity due to azathioprine.Finally,thiopurine methyltransferase(TPMT)screening cannot substitute for regular monitoring because the majority of cases of myelotoxicity are not TPMT-related. | Javier P Gisbert María Chaparro Fernando Gomollón | 2011 | World Journal of Gastroenterology2011，17，30： | 8 |
| 9 | Review of the treatment of liver hydatid cysts显示文摘A review was carried out in Medline,LILACS and the Cochrane Library.Our database search strategy included the following terms: 'hydatid cyst','liver','management','meta-analysis' and 'randomized controlled trial'.No language limits were used in the literature search.The latest electronic search date was the 7th of January 2014.Inclusion and exclusion criteria: all relevant studies on the assessment of therapeutic methods for hydatid cysts of the liver were considered for analysis.Information from editorials,letters to publishers,low quality review articles and studies done on animals were excluded from analysis.Additionally,well-structured abstracts from relevant articles were selected and accepted for analysis.Standardized forms were designed for data extraction; two investigators entered the data on patient demographics,methodology,recurrence of HC,mean cyst size and number of cysts per group.Four hundred and fourteen articles were identified using the previously described search strategy.After applying the inclusion and exclusion criteria detailed above,57 articles were selected for final analysis: one meta-analysis,9 randomized clinical trials,5 non-randomized comparative prospective studies,7 non-comparative prospective studies,and 34 retrospective studies(12 comparative and 22 noncomparative).Our results indicate that antihelminthic treatment alone is not the ideal treatment for liver hydatid cysts.More studies in the literature support the effectiveness of radical treatment compared with conservative treatment.Conservative surgery with omentoplasty is effective in preventing postoperative complications.A laparoscopic approach is safe in some situations.Percutaneous drainage with albendazole therapy is a safe and effective alternative treatment for hydatid cysts of the liver.Radical surgery with preand post-operative administration of albendazole is the best treatment option for liver hydatid cysts due to low recurrence and complication rates. | Concepción Gomez i Gavara Rafael López-Andújar Tatiana Belda Ibáez José M Ramia ngel ngel Moya Herraiz Francisco Orbis Castellanos Eugenia Pareja Ibars Fernando San Juan Rodríguez | 2015 | World Journal of Gastroenterology2015，21，1： | 8 |
| 10 | 固定低剂量三联抗高血压药物与常规治疗对斯里兰卡轻度至中度高血压患者血压控制的疗效差异:一项随机临床试验显示文摘控制不良的高血压是全球领先的公共卫生问题,需要新的治疗策略。该研究评估低剂量三联抗高血压药物治疗是否能达到比常规治疗更好的血压控制。研究者纳入2016年2月至2017年5月在斯里兰卡11所城市医院诊所就诊的需要开始抗高血压治疗(未治疗的患者)或接受单药治疗的患者,进行低剂量三联降压与常规治疗比较的随机、开放性试验,随访至2017年10月。 | Web-ster R Salam A de Silva HA Selak V Stepien S Rajapakse S Amarasekara S Amarasena N Billot L de Silva AP Fernando M Guggilla R Jan S Jayawardena J Maulik PK Mendis S Munasinghe J Naik N Prabhakaran D Ranasinghe G Thom S Tisserra N Senaratne V Wijekoon S Wijeyasingam S Rodgers A Patel A 刘莉 叶鹏 | 2018 | 中华高血压杂志2018，26，12： | 7 |
| 11 | A short review of malabsorption and anemia显示文摘Anemia is a frequent finding in most diseases which cause malabsorption. The most frequent etiology is the combination of iron and vitamin B12 deficiency. Celiac disease is frequently diagnosed in patients referred for evaluation of iron deficiency anemia (IDA), being reported in 1.8%-14.6% of patients. Therefore, duodenal biopsies should be taken during endoscopy if no obvious cause of iron defi ciency (ID) can be found. Cobalamin defi ciency occurs frequently among elderly patients, but it is often unrecognized because the clinical manifestations are subtle; it is caused primarily by food-cobalamin malabsorption and pernicious anemia. The classic treatment of cobalamin deficiency has been parenteral administration of the vitamin. Recent data suggest that alternative routes of cobalamin administration (oral and nasal) may be useful in some cases. Anemia is a frequent complication of gastrectomy, and has been often described after bariatric surgery. It has been shown that banding procedures which maintain digestive continuity with the antrum and duodenum are associated with low rates of ID. Helicobacter pylori (H pylori) infection may be considered as a risk factor for IDA, mainly in groups with high demands for iron, such as some children and adolescents. Further controlled trials are needed before making solid recommendations about H pylori eradication in these cases. | Fernando Fernández-Baares Helena Monzón Montserrat Forné | 2009 | World Journal of Gastroenterology2009，15，37： | 6 |
| 12 | Physical activity in primary and secondary prevention of cardiovascular disease:Overview updated显示文摘Although the observed progress in the cardiovascular disease treatment, the incidence of new and recurrent coronary artery disease remains elevated and constitutes the leading cause of death in the developed countries. Three-quarters of deaths due to cardiovascular diseases could be prevented with adequate changes in lifestyle, including increased daily physical activity. New evidence confirms that there is an inverse dose-response relationship between physical activity and cardiovascular disease and mortality risk. However, participation in moderate to vigorous physical activity may not fully attenuate the independent effect of sedentary activities on increased risk for cardiovascular diseases. Physical activity also plays an important role in secondary prevention of cardiovascular diseases by reducing the impact of the disease, slowing its progress and preventing recurrence. Nonetheless, most of eligible cardiovascular patients still do not benefit from secondary prevention/cardiac rehabilitation programs. The present review draws attention to the importance of physical activity in the primary and secondary prevention of cardiovascular diseases. It also addresses the mechanisms by which physical activity and regular exercise can improve cardiovascular health and reduce the burden of the disease. | Alberto J Alves Joao L Viana Suiane L Cavalcante Nórton L Oliveira JoséA Duarte Jorge Mota JoséOliveira Fernando Ribeiro | 2016 | World Journal of Cardiology2016，8，10： | 6 |
| 13 | Multipotent mesenchymal stromal cells:A promisingstrategy to manage alcoholic liver disease显示文摘Chronic alcohol consumption is a major cause of liver disease.The term alcoholic liver disease(ALD)refers to a spectrum of mild to severe disorders including steatosis,steatohepatitis,cirrhosis,and hepatocellular carcinoma.With limited therapeutic options,stem cell therapy offers significant potential for these patients.In this article,we review the pathophysiologic features of ALD and the therapeutic mechanisms of multipotent mesenchymal stromal cells,also referred to as mesenchymal stem cells(MSCs),based on their potential to differentiate into hepatocytes,their immunomodulatory properties,their potential to promote residual hepatocyte regeneration,and their capacity to inhibit hepatic stellate cells.The perfect match between ALD pathogenesis and MSC therapeutic mechanisms,together with encouraging,available preclinical data,allow us to support the notion that MSC transplantation is a promising therapeutic strategy to manage ALD onset and progression. | Fernando Ezquer Flavia Bruna Sebastián Calligaris Paulette Conget Marcelo Ezquer | 2016 | World Journal of Gastroenterology2016，22，1： | 6 |
| 14 | Impact of an acute hemodynamic response-guided protocol for primary prophylaxis of variceal bleeding显示文摘AIM To evaluate the long-term outcome of an acute hemodynamic response-guided protocol in which acute responders to intravenous propranolol received traditional nonselective beta-blockers(NSBBs) and acute nonresponders received carvedilol.METHODS Retrospective review of a protocol for primary prophylaxis of variceal bleeding guided by the acute hemodynamic response to intravenous propranolol. Fifty-two acute responders treated with traditional NSBB(i.e. propranolol or nadolol) were compared with 24 acute nonresponders receiving carvedilol. A second hemodynamic study was performed in 27 and 13 patients, respectively. The primary endpoint was development of first or further decompensation. Secondary endpoints included death from any cause, association between acute and chronic hemodynamic response, and baseline clinical and laboratory variables related to the acute hemodynamic response.RESULTS Acute responders and acute nonresponders presented similar 1, 2, and 3-year probabilities of first decompensation(NSBB: 0%, 13.7%, 26.1% vs carvedilol: 0%, 20%, 20%, P = 0.968) or further decompensation(21.2%, 26.1%, 40.9% vs 21.2%, 50.0%, 50.0%, P = 0.525). A previous episode of hepatic encephalopathy was the only independent predictor of decompensation [hazard ratio(95% confidence interval): 8.03(2.76-23.37)]. Mortality rates were similar in acute responders and acute nonresponders with compensated(P = 0.428) or decompensated cirrhosis(P = 0.429). No clinical, laboratory, endoscopic or hemodynamic parameter predicted the acute hemodynamic response. In patients receiving traditional NSBB, the acute and chronic changes of hepatic venous pressure gradient were correlated(r = 0.59, P = 0.001). Up to 69.2% of acute nonresponders gained chronic response with carvedilol.CONCLUSION Early identification and treatment with carvedilol of acute nonresponders to intravenous propranolol improves the clinical outcome of this high-risk group of patients, probably due to its greater effects for reducing portal pressure. | José Ignacio Fortea ángela Puente Patricia Ruiz Iranzu Ezcurra Javier Vaquero Antonio Cuadrado María Teresa Arias-Loste Joaquín Cabezas Susana Llerena Paula Iruzubieta Carlos Rodríguez-Lope Patricia Huelin Fernando Casafont Emilio Fábrega Javier Crespo | 2018 | World Journal of Clinical Cases2018，6，13： | 6 |
| 15 | Enzymatic vitrectomy for diabetic retinopathy and diabetic macular edema显示文摘The aim of this paper is to determine the role of enzymatic vitrectomy performed by intravitreal injection of autologous plasmin enzyme(APE)in the management of diabetic retinopathy and diabetic macular edema(DME).Diabetic patients with proliferative diabetic retinopathy or DME and evident posterior hyaloid adherence to the retinal surface were included.All cases were treated with an initial intravitreal injection of APE and reevaluated one month later,measuring changes in best-corrected visual acuity(BCVA),macular thickness and the status of the posterior hyaloid.A second APE injection was performed in cases with no evident posterior vitreous detachment(PVD)after the initial treatment.Sixty-three eyes were included in the present review.A complete PVD appeared in 38%of cases(24 eyes)after one injection of plasmin and the total increased to 51%(32 eyes)after the second injection,separated at least by one month.The central macular thickness improved in all cases(100%)and BCVA in89%.Finally,in 50%of eyes with proliferative diabetic retinopathy,a high reduction of new vessels regression was observed.Enzymatic vitrectomy could be considered a good therapeutic alternative in diabetic retinopathy and macular edema. | Manuel Diaz-Llopis Patricia Udaondo Jose Maria Millán J Fernando Arevalo | 2013 | World Journal of Diabetes2013，4，6： | 6 |
| 16 | 废胶粉对热拌沥青混合料疲劳性能的影响显示文摘以废旧轮胎磨成的胶粉颗粒作为改性剂生产橡胶沥青是废物利用的有效措施。该文研究内容包括:沥青混合料疲劳开裂性能的改善措施;橡胶沥青混合料、普通沥青混合料及SBS改性沥青混合料的性能对比。通过借助UGR-FACT与拍照设备,观察裂缝在每一时刻的传播,研究了4种由相同矿物级配、不同沥青构成的沥青混合料的疲劳性能。结果表明:传统沥青路面一旦出现裂缝,路面损害将迅速发展。而掺入废胶粉延缓了路面表面开裂,因此,橡胶沥青混合料的疲劳开裂寿命远超传统沥青混合料。此外,采用干法工艺在混合料中添加胶粉,比其他添加方式产生的裂缝更窄、更少。 | 勾俊芳 韩森 杨晓飞 牛帅 Fernando MORENO-NAVARRO Maria Carmen RUBIO-GMEZ Ana JIMNEZ DEL BARCO-CARRIN | 2017 | 中外公路2017，37，2： | 6 |
| 17 | Superoxide dismutase prevents development of adenocarcinoma in a rat model of Barrett's esophagus显示文摘AIM: To test whether antioxidant treatment could prevent the progression of Barrett's esophagus to adenocarcinoma.METHODS: In a rat model of gastroduodenoesophageal reflux by esophagojejunal anastomosis with gastric preservation, groups of 6-10 rats were randomized to receive treatment with superoxide dismutase (SOD) or vehicle and followed up for 4 mo. Rat's esophagus was assessed by histological analysis, superoxide anion and peroxinitrite generation, SOD levels and DNA oxidative damage.RESULTS: All rats undergoing esophagojejunostomy developed extensive esophageal mucosal ulceration and inflammation by mo 4. The process was associated with a progressive presence of intestinal metaplasia beyondthe anastomotic area (9% 1st mo and 50% 4th mo) (94% at the anastomotic level) and adenocarcinoma(11% 1st mo and 60% 4th mo). These changes were associated with superoxide anion and peroxinitrite mucosal generation, an early and significant increase of DNA oxidative damage and a significant decrease in SOD levels (P<0.05). Exogenous administration of SOD decreased mucosal superoxide levels, increased mucosal SOD levels and reduced the risk of developing intestinal metaplasia beyond the anastomotic area (odds ratio = 0.326; 95%CI: 0.108-0.981; P = 0.046),and esophageal adenocarcinoma (odds ratio = 0.243;95%CI: 0.073-0.804; P = 0.021).CONCLUSION: Superoxide dismutase prevents the progression of esophagitis to Barrett's esophagus and adenocarcinoma in this rat model of gastrointestinal reflux, supporting a role of antioxidants in the chemoprevention of esophageal adenocarcinoma. | Elena Piazuelo Carmelo Cebrián Alfredo Escartín Pilar Jiménez Fernando Soteras Javier Ortego Angel Lanas | 2005 | World Journal of Gastroenterology2005，11，47： | 5 |
| 18 | Diabetic gastroenteropathy:An underdiagnosed complication显示文摘This article is an extensive review that provides an update on the pathophysiology,symptoms,diagnosis,and treatment of diabetic gastroenteropathy.There is no reported prevalence,but it has been described that patients with type 1 diabetes have a cumulative incidence at 10 years of 5.2%,and type 2 patients,1%.Also,in the group of type 1 diabetes,it has been observed that women are more likely to present this condition(5.8%vs 3.5%).Many factors are associate with its development(e.g.,hyperglycemia,vagal dysfunction,loss of expression of neural nitric oxide synthase in the myenteric plexus,alterations in the Cajal interstitial cell network,and oxidative stress).Gastrointestinal discomfort could be perceived 70% higher in diabetic patients,describing that 25%of diabetic patients experience gastrointestinal symptoms.Diabetic enteropathy could affect any portion of the gastrointestinal tract,but esophageal alterations were described in more than 60% of diabetic patients,also 60% of them present constipation,and 20%,diarrhea.Gastric emptying scintigraphy is useful to evaluate gastroparesis,therefore,gastric retention of more than 60%at 2 h has a sensitivity of 100% and specificity of 20% for diagnosis;however,other studies such as breath tests,with a sensitivity of 89% and a specificity of 80%,or the endoscopic capsule contribute to the diagnosis.There is no cure;however,management must be multidisciplinary,focused on slowing the progression of diabetic gastroenteropathy,reducing symptoms,and restoring function;that includes nutritional recommendation,maintain glucose levels kept below 180 mg/dL,use of prokinetics,anti-emetics;nowadays,it has been special interest in surgical treatment,such as pyloroplasty,also gastric electrical stimulation appears to be another alternative. | Marcio JoséConcepción Zavaleta Jhean Gabriel Gonzáles Yovera Diego Martín Moreno Marreros Luciana del Pilar Rafael Robles Kely Roxana Palomino Taype Karen Nohelly Soto Gálvez Luis Fernando Arriola Torres Julia Cristina Coronado Arroyo Luis Alberto Concepción Urteaga | 2021 | World Journal of Diabetes2021，12，6： | 4 |
| 19 | Non-alcoholic Steatohepatitis (NASH) and Hepatocellular Carcinoma显示文摘 | Antonio Cuadrado Aitor Orive Covadonga García-Suárez Agustín Domínguez Jose Carlos Fernández-Escalante Javier Crespo Fernando Pons-Romero | 2005 | Obesity Surgery2005，，3： | 4 |
| 20 | Second European evidence-based consensus on the diagnosis and management of ulcerative colitis: Special situations显示文摘 | Gert Van Assche Axel Dignass Bernd Bokemeyer Silvio Danese Paolo Gionchetti Gabriele Moser Laurent Beaugerie Fernando Gomollón Winfried H?user Klaus Herrlinger Bas Oldenburg Julian Panes Francisco Portela Gerhard Rogler Jürgen Stein Herbert Tilg Simon Tra | 2012 | Journal of Crohn’s and Colitis2012，，： | 4 |
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