Liver cancer,and in particular hepatocellular carcinoma(HCC)is a disease of rising prevalence and incidence.To date,definitive treatment options include either surgical excision or ablation of the affected area.With i...Liver cancer,and in particular hepatocellular carcinoma(HCC)is a disease of rising prevalence and incidence.To date,definitive treatment options include either surgical excision or ablation of the affected area.With increasing research on several pathways that could be involved in the progression of HCC,new elements within these pathways emerge as potential targets for novel therapies.The WNT/β-catenin pathway favors the presence of M2 tumor-associated macrophages which in turn promote tumor growth and metastasis.The inhibition of this pathway is considered a good candidate for such targeted therapeutic interventions.Interestingly,as Huang et al show in their recently published article,Calculus bovis which is used in traditional Chinese medicine can exert an inhibitory effect on theβ-catenin pathway and become a potential candidate for targeted pharmacotherapy against liver cancer.展开更多
We recently read with interest the article by Chi et al published in the World Journal of Gastroenterology.In this article,the authors reported a novel technique for re-establishing luminal continuity in a completely ...We recently read with interest the article by Chi et al published in the World Journal of Gastroenterology.In this article,the authors reported a novel technique for re-establishing luminal continuity in a completely occluded colorectal anastomosis involving two endoscopes,one for radial electrical incision and the other serving as a guide light.However,this technique can be applied only in selected cases.Given the absence of a standardized guideline-based algorithm for the management of complete anastomotic obstruction,by reviewing the available literature,we provide a brief overview of relevant endoscopic techniques while underlining their importance in the management of this postoperative complication to provide clinicians with the necessary knowledge to improve their daily practice.展开更多
Endoscopic bariatrics has emerged as a minimally invasive alternative to traditional bariatric procedures.Over the last decade,significant progress in endoscopic techniques and technologies has improved the safety,eff...Endoscopic bariatrics has emerged as a minimally invasive alternative to traditional bariatric procedures.Over the last decade,significant progress in endoscopic techniques and technologies has improved the safety,efficacy,and accessibility of these procedures.Current methods,such as intragastric balloons,endoscopic sleeve gastroplasty,and endoscopic-assisted gastrojejunostomy,have promoted weight loss,improving the metabolic health of obese individuals,with emerging evidence suggesting that their combination with pharmacological agents could further maximize their benefit.Emerging technologies,such as robotic-assisted endoscopic devices,advanced imaging systems,and biodegradable implants,could enhance procedural precision,minimize complications,and provide more personalized treatment options.In contrast,novel approaches such as microbiome modulation and tissue regeneration could have an adjunct role in improving patient outcomes.This review provides a brief overview of the current status of endoscopic bariatrics,highlighting the most common procedures and emerging technologies.It also discusses the challenges and future directions for the field,emphasizing the importance of multidisciplinary collaboration,patient selection,and research priorities to establish the long-term benefit and effectiveness of the available endoscopic bariatric interventions.展开更多
AIM To examine the impact of liver cirrhosis on QT interval and cardiac autonomic neuropathy(CAN). METHODS A total of 51 patients with cirrhosis and 51 controls were examined. Standard 12-lead electrocardiogram record...AIM To examine the impact of liver cirrhosis on QT interval and cardiac autonomic neuropathy(CAN). METHODS A total of 51 patients with cirrhosis and 51 controls were examined. Standard 12-lead electrocardiogram recordings were obtained and QT as well as corrected QT interval(QTc) and their dispersions(dQT, dQTc) were measured and calculated using a computer-based program. The diagnosis of CAN was based upon the battery of the tests proposed by Ewing and Clarke and the consensus statements of the American Diabetes Association. CAN was diagnosed when two out of the four classical Ewing tests were abnormal. RESULTS QT, QTc and their dispersions were significantly longer(P < 0.01) in patients with cirrhosis than in controls. No significant differences in QT interval were found among the subgroups according to the etiology of cirrhosis. Multivariate regression analysis after controlling for age, gender and duration of cirrhosis demonstrated significant association between QT and presence of diabetes mellitus [standardized regression coefficient(beta) = 0.45, P = 0.02] and treatment with diuretics(beta = 0.55, P = 0.03), but not with the Child-Pugh score(P = 0.54). Prevalence of CAN was common(54.9%) among patients with cirrhosis and its severity was associated with the Child-Pugh score(r = 0.33, P = 0.02). Moreover, patients with decompensated cirrhosis had more severe CAN that those with compensated cirrhosis(P = 0.03). No significant association was found between severity of CAN and QT interval duration.CONCLUSION Patients with cirrhosis have QT prolongation. Treatment with diuretics is associated with longer QT. CAN is common in patients with cirrhosis and its severity is associated with severity of the disease.展开更多
Gastric cancer represents a common and highly fatal malignancy,and thus a pathophysiology-based reconsideration is necessary,given the absence of efficient therapeutic regimens.In this regard,emerging data reveal a si...Gastric cancer represents a common and highly fatal malignancy,and thus a pathophysiology-based reconsideration is necessary,given the absence of efficient therapeutic regimens.In this regard,emerging data reveal a significant role of autophagy in gastric oncogenesis,progression,metastasis and chemoresistance.Although autophagy comprises a normal primordial process,ensuring cellular homeostasis under energy depletion and stress conditions,alterations at any stage of the complex regulatory system could stimulate a tumorigenic and promoting cascade.Among others,Helicobacter pylori infection induces a variety of signaling molecules modifying autophagy,during acute infection or after chronic autophagy degeneration.Subsequently,defective autophagy allows malignant transformation and upon cancer establishment,an overactive autophagy is stimulated.This overexpressed autophagy provides energy supplies and resistance mechanisms to gastric cancer cells against hosts defenses and anticancer treatment.This review interprets the implicated autophagic pathways in normal cells and in gastric cancer to illuminate the potential preventive,therapeutic and prognostic benefits of understanding and intervening autophagy.展开更多
The Baveno VII consensus,released in 2023,recommends that the endoscopic treatment of choice for managing bleeding gastric varices(GV)is endoscopic ultrasound(EUS)-guided treatment,specifically EUS-guided cyanoacrylat...The Baveno VII consensus,released in 2023,recommends that the endoscopic treatment of choice for managing bleeding gastric varices(GV)is endoscopic ultrasound(EUS)-guided treatment,specifically EUS-guided cyanoacrylate(CYA)glue injection.This approach has been endorsed due to its efficacy in controlling bleeding while reducing rebleeding rates,compared to other endoscopic techniques.Despite its efficacy,CYA injection for GV has been linked to rare but serious adverse events,such as glue embolization leading to pulmonary embolism,infection/bacteremia,splenic infarction,intra-procedural and post-procedural complications.The technique for endoscopic obliteration of GV was subsequently refined using EUS guidance,aiming to more accurately direct the injection into the varix,reduce the volume of injected glue,target the perforating vein when possible,and confirm obliteration of GV via Doppler examination.展开更多
文摘Liver cancer,and in particular hepatocellular carcinoma(HCC)is a disease of rising prevalence and incidence.To date,definitive treatment options include either surgical excision or ablation of the affected area.With increasing research on several pathways that could be involved in the progression of HCC,new elements within these pathways emerge as potential targets for novel therapies.The WNT/β-catenin pathway favors the presence of M2 tumor-associated macrophages which in turn promote tumor growth and metastasis.The inhibition of this pathway is considered a good candidate for such targeted therapeutic interventions.Interestingly,as Huang et al show in their recently published article,Calculus bovis which is used in traditional Chinese medicine can exert an inhibitory effect on theβ-catenin pathway and become a potential candidate for targeted pharmacotherapy against liver cancer.
文摘We recently read with interest the article by Chi et al published in the World Journal of Gastroenterology.In this article,the authors reported a novel technique for re-establishing luminal continuity in a completely occluded colorectal anastomosis involving two endoscopes,one for radial electrical incision and the other serving as a guide light.However,this technique can be applied only in selected cases.Given the absence of a standardized guideline-based algorithm for the management of complete anastomotic obstruction,by reviewing the available literature,we provide a brief overview of relevant endoscopic techniques while underlining their importance in the management of this postoperative complication to provide clinicians with the necessary knowledge to improve their daily practice.
文摘Endoscopic bariatrics has emerged as a minimally invasive alternative to traditional bariatric procedures.Over the last decade,significant progress in endoscopic techniques and technologies has improved the safety,efficacy,and accessibility of these procedures.Current methods,such as intragastric balloons,endoscopic sleeve gastroplasty,and endoscopic-assisted gastrojejunostomy,have promoted weight loss,improving the metabolic health of obese individuals,with emerging evidence suggesting that their combination with pharmacological agents could further maximize their benefit.Emerging technologies,such as robotic-assisted endoscopic devices,advanced imaging systems,and biodegradable implants,could enhance procedural precision,minimize complications,and provide more personalized treatment options.In contrast,novel approaches such as microbiome modulation and tissue regeneration could have an adjunct role in improving patient outcomes.This review provides a brief overview of the current status of endoscopic bariatrics,highlighting the most common procedures and emerging technologies.It also discusses the challenges and future directions for the field,emphasizing the importance of multidisciplinary collaboration,patient selection,and research priorities to establish the long-term benefit and effectiveness of the available endoscopic bariatric interventions.
文摘AIM To examine the impact of liver cirrhosis on QT interval and cardiac autonomic neuropathy(CAN). METHODS A total of 51 patients with cirrhosis and 51 controls were examined. Standard 12-lead electrocardiogram recordings were obtained and QT as well as corrected QT interval(QTc) and their dispersions(dQT, dQTc) were measured and calculated using a computer-based program. The diagnosis of CAN was based upon the battery of the tests proposed by Ewing and Clarke and the consensus statements of the American Diabetes Association. CAN was diagnosed when two out of the four classical Ewing tests were abnormal. RESULTS QT, QTc and their dispersions were significantly longer(P < 0.01) in patients with cirrhosis than in controls. No significant differences in QT interval were found among the subgroups according to the etiology of cirrhosis. Multivariate regression analysis after controlling for age, gender and duration of cirrhosis demonstrated significant association between QT and presence of diabetes mellitus [standardized regression coefficient(beta) = 0.45, P = 0.02] and treatment with diuretics(beta = 0.55, P = 0.03), but not with the Child-Pugh score(P = 0.54). Prevalence of CAN was common(54.9%) among patients with cirrhosis and its severity was associated with the Child-Pugh score(r = 0.33, P = 0.02). Moreover, patients with decompensated cirrhosis had more severe CAN that those with compensated cirrhosis(P = 0.03). No significant association was found between severity of CAN and QT interval duration.CONCLUSION Patients with cirrhosis have QT prolongation. Treatment with diuretics is associated with longer QT. CAN is common in patients with cirrhosis and its severity is associated with severity of the disease.
文摘Gastric cancer represents a common and highly fatal malignancy,and thus a pathophysiology-based reconsideration is necessary,given the absence of efficient therapeutic regimens.In this regard,emerging data reveal a significant role of autophagy in gastric oncogenesis,progression,metastasis and chemoresistance.Although autophagy comprises a normal primordial process,ensuring cellular homeostasis under energy depletion and stress conditions,alterations at any stage of the complex regulatory system could stimulate a tumorigenic and promoting cascade.Among others,Helicobacter pylori infection induces a variety of signaling molecules modifying autophagy,during acute infection or after chronic autophagy degeneration.Subsequently,defective autophagy allows malignant transformation and upon cancer establishment,an overactive autophagy is stimulated.This overexpressed autophagy provides energy supplies and resistance mechanisms to gastric cancer cells against hosts defenses and anticancer treatment.This review interprets the implicated autophagic pathways in normal cells and in gastric cancer to illuminate the potential preventive,therapeutic and prognostic benefits of understanding and intervening autophagy.
文摘The Baveno VII consensus,released in 2023,recommends that the endoscopic treatment of choice for managing bleeding gastric varices(GV)is endoscopic ultrasound(EUS)-guided treatment,specifically EUS-guided cyanoacrylate(CYA)glue injection.This approach has been endorsed due to its efficacy in controlling bleeding while reducing rebleeding rates,compared to other endoscopic techniques.Despite its efficacy,CYA injection for GV has been linked to rare but serious adverse events,such as glue embolization leading to pulmonary embolism,infection/bacteremia,splenic infarction,intra-procedural and post-procedural complications.The technique for endoscopic obliteration of GV was subsequently refined using EUS guidance,aiming to more accurately direct the injection into the varix,reduce the volume of injected glue,target the perforating vein when possible,and confirm obliteration of GV via Doppler examination.
