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| 1 | Intestinal microbiota in health and disease: Role of bifidobacteria in gut homeostasis显示文摘The pool of microbes inhabiting our body is known as 'microbiota' and their collective genomes as 'microbiome'. The colon is the most densely populated organ in the human body, although other parts, such as the skin, vaginal mucosa, or respiratory tract, also harbour specific microbiota. This microbial community regulates some important metabolic and physiological functions of the host, and drives the maturation of the immune system in early life, contributing to its homeostasis during life. Alterations of the intestinal microbiota can occur by changes in composition(dysbiosis), function, or microbiota-host interactions and they can be directly correlated with several diseases. The only disease in which a clear causal role of a dysbiotic microbiota has been demonstrated is the case of Clostridium difficile infections. Nonetheless, alterations in composition and function of the microbiota have been associated with several gastrointestinal diseases(inflammatory bowel disease, colorectal cancer, or irritable bowel syndrome), as well as extra-intestinal pathologies, such as those affecting the liver, or the respiratory tract(e.g., allergy, bronchial asthma, and cystic fibrosis), among others. Species of Bifidobacterium genus are the normal inhabitants of a healthy human gut and alterations in number and composition of their populations is one of the most frequent features present in these diseases. The use of probiotics, including bifidobacteria strains, in preventive medicine to maintain a healthy intestinal function is well documented. Probiotics are also proposed as therapeutic agents for gastrointestinal disorders and other pathologies. The World Gastroenterology Organization recently published potential clinical applications for several probiotic formulations, in which species of lactobacilli are predominant. This review is focused on probiotic preparations containing Bifidobacterium strains, alone or in combination with other bacteria, which have been tested in human clinical studies. In spite of extensive literature on and research into this topic, the degree of scientific evidence of the effectiveness of probiotics is still insufficient in most cases. More effort need to be made to design and conduct accurate human studies demonstrating the efficacy of probiotics in the prevention, alleviation, or treatment of different pathologies. | Rafael Tojo Adolfo Suárez Marta G Clemente Clara G de los Reyes-Gavilán Abelardo Margolles Miguel Gueimonde Patricia Ruas-Madiedo | 2014 | World Journal of Gastroenterology2014，20，41： | 33 |
| 2 | Short-term clinical outcomes of laparoscopic vs open rectal excision for rectal cancer: A systematic review and metaanalysis显示文摘AIM To review evidence on the short-term clinical outcomes of laparoscopic(LRR) vs open rectal resection(ORR) for rectal cancer.METHODS A systematic literature search was performed using Cochrane Central Register, MEDLINE, EMBASE, Scopus, Open Grey and Clinical Trials.gov register for randomized clinical trials(RCTs) comparing LRR vs ORR for rectal cancer and reporting short-term clinical outcomes. Articles published in English from January 1, 1995 to June, 30 2016 that met the selection criteria were retrieved and reviewed. The Preferred Reporting Items for Systematic reviews and Meta-Analysis(PRISMA) statements checklist for reporting a systematic review was followed. Random-effect models were used to estimate mean differences and risk ratios. The robustness and heterogeneity of the results were explored by performing sensitivity analyses. The pooledeffect was considered significant when P < 0.05.RESULTS Overall, 14 RCTs were included. No differences were found in postoperative mortality(P = 0.19) and morbidity(P = 0.75) rates. The mean operative time was 36.67 min longer(95%CI: 27.22-46.11, P < 0.00001), the mean estimated blood loss was 88.80 ml lower(95%CI:-117.25 to-60.34, P < 0.00001), and the mean incision length was 11.17 cm smaller(95%CI:-13.88 to-8.47, P < 0.00001) for LRR than ORR. These results were confirmed by sensitivity analyses that focused on the four major RCTs. The mean length of hospital stay was 1.71 d shorter(95%CI:-2.84 to-0.58, P < 0.003) for LRR than ORR. Similarly, bowel recovery(i.e., day of the first bowel movement) was 0.68 d shorter(95%CI:-1.00 to-0.36, P < 0.00001) for LRR. The sensitivity analysis did not confirm a significant difference between LRR and ORR for these latter two parameters. The overall quality of the evidence was rated as high. CONCLUSION LRR is associated with lesser blood loss, smaller incision length, and longer operative times compared to ORR. No differences are observed for postoperative morbidity and mortality. | Aleix Martínez-Pérez Maria Clotilde Carra Francesco Brunetti Nicola de'Angelis | 2017 | World Journal of Gastroenterology2017，23，44： | 33 |
| 3 | Comparative review of vertebroplasty and kyphoplasty显示文摘The aim of this review is to compare the effectiveness of percutaneous vertebroplasty and kyphoplasty to treat pain and improve functional outcome from ver-tebral fractures secondary to osteoporosis and tumor conditions. In 2009, two open randomized controlled trials published in the New England Journal of Medicine questioned the value of vertebroplasty in treating ver-tebral compression fractures. Nevertheless, the prac-tice of physicians treating these conditions has barely changed. The objective of this review is to try to clarify the most important issues, based on our own experi-ence and the reported evidence about both techniques, and to guide towards the most appropriate choice of treatment of vertebral fractures, although many ques-tions still remain unanswered. | Ferno Ruiz Santiago Alicia Santiago Chinchilla Luis Guzmán álvarez Antonio Luis Pérez Abela Maria del Mar Castellano García Miguel Pajares López | 2014 | World Journal of Radiology2014，6，6： | 30 |
| 4 | Endoscopic management of esophageal varices显示文摘The rupture of gastric varices results in variceal hemorrhage, which is one the most lethal complications of cirrhosis. Endoscopic therapies for varices aim to reduce variceal wall tension by obliteration of the varix. The two principal methods available for esophageal varices are endoscopic sclerotherapy (EST) and band ligation (EBL). The advantages of EST are that it is cheap and easy to use, and the injection catheter fits through the working channel of a diagnostic gastroscope. Endoscopic variceal ligation obliterates varices by causing mechanical strangulation with rubber bands. The following review aims to describe the utility of EBL and EST in different situations, such as acute bleeding, primary and secondary | Joaquin Poza Cordon Consuelo Froilan Torres Aurora Burgos García Francisco Gea Rodriguez Jose Manuel Suárez de Parga | 2012 | World Journal of Gastrointestinal Endoscopy2012，4，7： | 27 |
| 5 | Risk factors associated with the development of ischemic colitis显示文摘AIM:To ascertain the role of cardiovascular risk factors,cardiovascular diseases,standard treatments and other diseases in the development of ischemic colitis(IC).METHODS:A retrospective,case-control study was designed,using matched data and covering 161 incident cases of IC who required admission to our hospital from 1998 through 2003.IC was diagnosed on the basis of endoscopic findings and diagnostic or compatible his-tology.Controls were randomly chosen from a cohort of patients who were admitted in the same period and required a colonoscopy,excluding those with diagnosis of colitis.Cases were matched with controls(ratio 1:2),by age and sex.A conditional logistic regression was performed.RESULTS:A total of 483 patients(161 cases,322 con-trols)were included;mean age 75.67±10.03 years,55.9%women.The principal indications for colonos-copy in the control group were lower gastrointestinal hemorrhage(35.4%),anemia(33.9%),abdominal pain(19.9%)and diarrhea(9.6%).The endoscopic findings in this group were hemorrhoids(25.5%),diverticular disease(30.4%),polyps(19.9%)and colorectal cancer(10.2%).The following variables were associated with IC in the univariate analysis:arterial hypertension(P= 0.033);dyslipidemia(P<0.001);diabetes mellitus(P =0.025);peripheral arterial disease(P=0.004);heart failure(P=0.026);treatment with hypotensive drugs(P=0.023);angiotensin-converting enzyme inhibitors;(P=0.018);calcium channel antagonists(P=0.028);and acetylsalicylic acid(ASA)(P<0.001).Finally,the following variables were independently associated with the development of IC:diabetes mellitus[odds ratio(OR)1.76,95%confidence interval(CI):1.001-3.077,P=0.046];dyslipidemia(OR 2.12,95%CI:1.26-3.57,P=0.004);heart failure(OR 3.17,95%CI:1.31-7.68,P=0.01);peripheral arterial disease(OR 4.1,95%CI:1.32-12.72,P=0.015);treatment with digoxin(digitalis)(OR 0.27,95%CI:0.084-0.857,P=0.026);and ASA(OR 1.97,95%CI:1.16-3.36,P=0.012).CONCLUSION:The development of an episode of IC was independently associated with diabetes,dyslipid-emia,presence of heart failure,peripheral arterial dis-ease and treatment with digoxin or ASA. | Joaquín Cubiella Fernández Luisa Núez Calvo Elvira González Vázquez Maria Jesús García García Maria Teresa Alves Pérez Isabel Martínez Silva Javier Fernández Seara | 2010 | World Journal of Gastroenterology2010，16，36： | 27 |
| 6 | Diagnosis and treatment of hepatocellular carcinoma: An update显示文摘Hepatocellular carcinoma(HCC) is one of the most common malignancies leading to high mortality rates in the general population; in cirrhotic patients, it is the primary cause of death. The diagnosis is usually delayed in spite of at-risk population screening recommendations, i.e., patients infected with hepatitis B or C virus. Hepatocarcinogenesis hinges on a great number of genetic and molecular abnormalities that lead to tumor angiogenesis and foster their dissemination potential. The diagnosis is mainly based on imaging studies such as computed tomography and magnetic resonance, in which lesions present a characteristic classical pattern of early arterial enhancement followed by contrast medium 'washout' in late venous phase. On occasion, when imaging studies are not conclusive, biopsy of the lesion must be performed to establish the diagnosis. The Barcelona Clinic Liver Cancer staging method is the most frequently used worldwide and recommended by the international guidelines of HCC management. Currently available treatments include tumor resection, liver transplant, sorafenib and locoregional therapies(alcoholization, radiofrequency ablation, chemoembolization). The prognosis of hepatocarcinoma is determined according to the lesion's stage and in cirrhotic patients, on residual liver function. Curative treatments, such as liver transplant, are sought in patients diagnosed in early stages; patients in more advanced stages, were not greatly benefitted by chemotherapy in terms of survival until the advent of target molecules such as sorafenib. | Javier Tejeda-Maldonado Ignacio García-Juárez Jonathan Aguirre-Valadez Adrián González-Aguirre Mario Vilatobá-Chapa Alejandra Armengol-Alonso Francisco Escobar-Penagos Aldo Torre Juan Francisco Sánchez-ávila Diego Luis Carrillo-Pérez | 2015 | World Journal of Hepatology2015，7，3： | 22 |
| 7 | The timing of bowel preparation before colonoscopy determines the quality of cleansing,and is a significant factor contributing to the detection of flat lesions:A randomized study显示文摘AIM: To compare the cleansing quality of polyethylene glycol electrolyte solution and sodium phosphate with different schedules of administration, and to evaluate whether the timing of the administration of bowel preparation affects the detection of polyps. METHODS: One hundred and seventy-seven consecutive outpatients scheduled for colonoscopy were randomized in one of four groups to receive polyethylene glycol electrolyte solution or oral sodium phosphate with two different timing schedules. Quality of cleansing, polyp detection, and tolerance were evaluated. RESULTS: Patients receiving polyethylene glycol or sodium phosphate on the same day as the colonoscopy, obtained good to excellent global cleansing scores more frequently than patients who received polyethylene glycol or sodium phosphate on the day prior to the procedure (P < 0.001). Flat lesions, but not flat adenomas, were more frequent in patients prepared on the same day (P = 0.02). CONCLUSION: The quality of colonic cleansing and the detection of flat lesions are significantly improved when the preparation is taken on the day of the colonoscopy. | Adolfo Parra-Blanco David Nicolás-Pérez Antonio Gimeno-García Begoa Grosso Alejandro Jiménez Juan Ortega Enrique Quintero | 2006 | World Journal of Gastroenterology2006，12，38： | 19 |
| 8 | Role of microRNAs in alcohol-induced liver disorders and non-alcoholic fatty liver disease显示文摘MicroRNAs(miRNAs) are small non-coding RNAs that regulate multiple physiological and pathological functions through the modulation of gene expression at the post-transcriptional level. Accumulating evidence has established a role for miRNAs in the development and pathogenesis of liver disease. Specifically, a large number of studies have assessed the role of miRNAsin alcoholic liver disease(ALD) and non-alcoholic fatty liver disease(NAFLD), two diseases that share common underlying mechanisms and pathological characteristics. The purpose of the current review is to summarize and update the body of literature investigating the role of miRNAs in liver disease. In addition, the potential use of miRNAs as biomarkers and/or therapeutic targets is discussed. Among all miRNAs analyzed, miR-34 a, miR-122 and miR-155 are most involved in the pathogenesis of NAFLD. Of note, these three miRNAs have also been implicated in ALD, reinforcing a common disease mechanism between these two entities and the pleiotropic effects of specific miRNAs. Currently, no single miRNA or panel of miRNAs has been identified for the detection of, or staging of ALD or NAFLD. While promising results have been shown in murine models, no therapeutic based-miRNA agents have been developed for use in humans with liver disease. | Jorge-Luis Torres Ignacio Novo-Veleiro Laura Manzanedo Lucía Alvela-Suárez Ronald Macías Francisco-Javier Laso Miguel Marcos | 2018 | World Journal of Gastroenterology2018，24，36： | 19 |
| 9 | 在 laparoscopic 肝外科的快轨道的节目: 理论或事实?显示文摘 AIM:To analyze our results after the introduction of a fast-track(FT) program after laparoscopic liver surgery in our Hepatobiliarypancreatic Unit.METHODS:All patients(43) undergoing laparoscopic liver surgery between March 2004 and March 2010 were included and divided into two consecutive groups:Control group(CG) from March 2004 until December 2006 with traditional perioperative cares(17 patients) and fast-track group(FTG) from January 2007 until March 2010 with FT program cares(26 patients).Primary endpoint was the influence of the program on the postoperative stay,the amount of re-admissions,morbidity and mortality.Secondarily we considered duration of surgery,use of drains,conversion to open surgery,intensive cares needs and transfusion.RESULTS:Both groups were homogeneous in age and sex.No differences in technique,time of surgery or conversion to open surgery were found,but more malignant diseases were operated in the FTG,and then transfusions were higher in FTG.Readmissions and morbidity were similar in both groups,without mortality.Postoperative stay was similar,with a median of 3 for CG vs 2.5 for FTG.However,the 80.8% of patients from FTG left the hospital within the first 3 d after surgery(58.8% for CG).CONCLUSION:The introduction of a FT program after laparoscopic liver surgery improves the recovery of patients without increasing complications or re-admissions,which leads to a reduction of the stay and costs. | Belinda Sánchez-Pérez José Manuel Aranda-Narváez Miguel Angel Suárez-Muoz Moises elAdel-delFresno José Luis Fernández-Aguilar Jose Antonio Pérez-Daga Ysabel Pulido-Roa Julio Santoyo-Santoyo | 2012 | World Journal of Gastrointestinal Surgery2012，4，11： | 18 |
| 10 | Serrated colorectal cancer: Molecular classification, prognosis, and response to chemotherapy显示文摘Molecular advances support the existence of an alternative pathway of colorectal carcinogenesis that is based on the hypermethylation of specific DNA regions that silences tumor suppressor genes. This alternative pathway has been called the serrated pathway due to the serrated appearance of tumors in histological analysis. New classifications for colorectal cancer(CRC) were proposed recently based on genetic profiles that show four types of molecular alterations: BRAF gene mutations, KRAS gene mutations, microsatellite instability, and hypermethylation of Cp G islands. This review summarizes what is known about the serrated pathway of CRC, including CRC molecular and clinical features, prognosis, and response to chemotherapy. | Oscar Murcia Miriam Juárez Eva Hernández-Illán Cecilia Egoavil Mar Giner-Calabuig María Rodríguez-Soler Rodrigo Jover | 2016 | World Journal of Gastroenterology2016，22，13： | 18 |
| 11 | Liver transplantation for hilar cholangiocarcinoma显示文摘The most appropriate treatment for Klatskin tumor(KT)with a curative intention is multimodal therapy based on achieving resection with tumour-free margins(R0resections)combined with other types of neoadjuvant or adjuvant treatment(the most important factor affecting KT survival is the possibility of R0 resections,achieving 5-year survival rate of 40%-50%).Thirty to forty percent of patients with KT are inoperable and present a 5-year survival rate of 0%.In irresectable non-disseminated KT patients,using liver transplantation without neoadjuvant treatment,the 5-year survival rate increase to 38%,reaching 50%survival in early stage.In selected cases,with liver transplantation and neoadjuvant treatment(chemotherapy and radiotherapy),the actuarial survival rate is 65%at 5 years and 59%at 10 years.In conclusion,correct staging,neoadjuvant treatment,living donor and priority on the liver transplant waiting list may lead to improved results. | Ricardo Robles Francisco Sánchez-Bueno Pablo Ramírez Roberto Brusadin Pascual Parrilla | 2013 | World Journal of Gastroenterology2013，19，48： | 17 |
| 12 | Hyperthermic intraperitoneal chemotherapy:Rationale and technique显示文摘The combination of complete cytoreductive surgery and perioperative intraperitoneal chemotherapy provides the only chance for long-term survival for selected patients diagnosed with a variety of peritoneal neoplasms,either primary or secondary to digestive or gynecologic malignancy.Hyperthermic intraperitoneal chemotherapy (HIPEC) delivered in the operating room once the cytoreductive surgical procedure is fi nalized,constitutes the most common form of administration of perioperative intraperitoneal chemotherapy.This may be complemented in some instances with early postoperative intraperitoneal chemotherapy (EPIC).HIPEC combines the pharmacokinetic advantage inherent to the intracavitary delivery of certain cytotoxic drugs,which results in regional dose intensification,with the direct cytotoxic effect of hyperthermia.Hyperthermia exhibits a selective cell-killing effect in malignant cells by itself,potentiates the cytotoxic effect of certain chemotherapy agents and enhances the tissue penetration of the administered drug.The chemotherapeutic agents employed in HIPEC need to have a cell cycle nonspecific mechanism of action and should ideally show a heat-synergistic cytotoxic effect.Delivery of HIPEC requires an apparatus that heats and circulates the chemotherapeutic solution so that a stable temperature is maintained in the peritoneal cavity during the procedure.An open abdomen (Coliseum) or closed abdomen technique may be used,with no signif icant differences in eff icacy proven to date.Specif ic technical training and a solid knowledge of regional chemotherapy management are required.Concerns about safety of the procedure for operating room personnel are expected but are manageable if universal precautions and standard chemotherapy handling procedures are used.Different HIPEC drug regimens and dosages are currently in use.A tendency for concurrent intravenous chemotherapy administration (bidirectional chemotherapy,so-called 'HIPEC plus') has been observed in recent years,with the aim to further enhance the cytotoxic potential of HIPEC.Future trials to ascertain the ideal HIPEC regimen in different diseases and to evaluate the efficacy of new drugs or drug combinations in this context are warranted. | Santiago González-Moreno Luis A González-Bayón Gloria Ortega-Pérez | 2010 | World Journal of Gastrointestinal Oncology2010，2，2： | 15 |
| 13 | Role of quorum sensing in bacterial infections显示文摘Quorum sensing(QS) is cell communication that is widely used by bacterial pathogens to coordinate the expression of several collective traits, including the production of multiple virulence factors, biofilm formation, and swarming motility once a population threshold is reached. Several lines of evidence indicate that QS enhances virulence of bacterial pathogens in animal models as well as in human infections; however, its relative importance for bacterial pathogenesis is still incomplete. In this review, we discuss the present evidence from in vitro and in vivo experiments in animal models, as well as from clinical studies, that link QS systems with human infections. We focus on two major QS bacterial models, the opportunistic Gram negative bacteria Pseudomonas aeruginosa and the Gram positive Staphylococcus aureus, which are also two of the main agents responsible of nosocomial and wound infections. In addition, QS communication systems in other bacterial, eukaryotic pathogens, and even immune and cancer cells are also reviewed, and finally, the new approaches proposed to combat bacterial infections by the attenuation of their QS communication systems and virulence are also discussed. | Israel Castillo-Juárez Toshinari Maeda Edna Ayerim Mandujano-Tinoco María Tomás Berenice Pérez-Eretza Silvia Julieta García-Contreras Thomas K Wood Rodolfo García-Contreras | 2015 | World Journal of Clinical Cases2015，3，7： | 15 |
| 14 | I.31, a new combination of probiotics, improves irritable bowel syndrome-related quality of life显示文摘AIM:To determine the dose-related effects of a novel probiotic combination,I.31,on irritable bowel syndrome(IBS)-related quality of life(IBS-QoL).METHODS:A multicenter,randomized,double-blind,placebo-controlled intervention clinical trial with three parallel arms was designed.A total of 84 patients(53female,31 male;age range 20-70 years)with IBS and diarrhea according to Rome-Ⅲcriteria were randomly allocated to receive one capsule a day for 6 wk containing:(1)I.31 high dose(n=28);(2)I.31 low dose(n=27);and(3)placebo(n=29).At baseline,and 3and 6 wk of treatment,patients filled the IBSQoL,Visceral Sensitivity Index(VSI),and global symptom relief questionnaires.RESULTS:During treatment,IBS-QoL increased in all groups,but this increment was significantly larger in patients treated with I.31 than in those receiving placebo(P=0.008).After 6 wk of treatment,IBS-QoL increased by 18±3 and 22±4 points in the high and the low dose groups,respectively(P=0.041 and P=0.023vs placebo),but only 9±3 in the placebo group.Gutspecific anxiety,as measured with VSI,also showed a significantly greater improvement after 6 wk of treatment in patients treated with probiotics(by 10±2 and14±2 points,high and low dose respectively,P<0.05for both vs 7±1 score increment in placebo).Symptom relief showed no significant changes between groups.No adverse drug reactions were reported following the consumption of probiotic or placebo capsules.CONCLUSION:A new combination of three different probiotic bacteria was superior to placebo in improving IBS-related quality of life in patients with IBS and diarrhea. | Vicente Lorenzo-Zú?iga Elba Llop Cristina Suárez Beatriz álvarez Luis Abreu Jordi Espadaler Jordi Serra | 2014 | World Journal of Gastroenterology2014，20，26： | 13 |
| 15 | Circular RNAs in colorectal cancer:Possible roles in regulation of cancer cells显示文摘Colorectal cancer(CRC) is the third most commonly diagnosed cancer in the world and the fourth principal cause of cancer deaths worldwide. Currently, there is a lack of low cost and noninvasive screening tests for CRC, becoming a serious health problem. In this context, a potential biomarker for the early detection of CRC has recently gained attention. Circular RNAs(circ RNA), a re-discovered, abundant RNA specie, is a type of noncoding covalent closed RNAs formed from both exonic and intronic sequences. These circular molecules are widely expressed in cells, exceeding the abundance of the traditional linear m RNA transcript. They can regulate gene expression, acting as real sponges for mi RNAs and also regulate alternative splicing or act as transcriptional factors and inclusive encoding for proteins. However, little is known about circ RNA and its relationship with CRC. In this review, we focus on the biogenesis, function and role of these circ RNAs in relation to CRC, including their potential as a new biomarker. | María Isabel Taborda Sebastián Ramírez Giuliano Bernal | 2017 | World Journal of Gastrointestinal Oncology2017，9，2： | 13 |
| 16 | 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 |
| 17 | Posterior approach (Kraske procedure) for surgical treatment of presacral tumors显示文摘Presacral tumors are rare,but can comprise a great variety of histological types.Congenital tumors are the most common.Once the diagnosis is established,surgical resection is essential because of the potential for malignancy or infection.Previous biopsy is not necessary or may be even harmful.To decide the best surgical approach(abdominal,sacral or combined) an individual and multidisciplinary analysis must be carried out.We report three cases of cystic presacral masses in which a posterior approach(Kraske procedure) enabled complete resection,the only way to decrease local recurrence.All patients had a satisfactory recovery.A brief overview of retrorectal tumors is presented,focusing on classification,clinical presentation,diagnosis and surgical management. | José Manuel Aranda-Narváez Antonio Jesús GonzálezSánchez Custodia Montiel-Casado Belinda Sánchez-Pérez Carolina Jiménez-Mazure Marta Valle-Carbajo Julio Santoyo-Santoyo | 2012 | World Journal of Gastrointestinal Surgery2012，4，5： | 12 |
| 18 | Validation of Fujinon intelligent chromoendoscopy with high definition endoscopes in colonoscopy显示文摘AIM:To validate high definition endoscopes with Fujinon intelligent chromoendoscopy(FICE) in colonoscopy.METHODS:The image quality of normal white light endoscopy(WLE),that of the 10 available FICE filters and that of a gold standard(0.2% indigo carmine dye) were compared.RESULTS:FICE-filter 4 [red,green,and blue(RGB) wavelengths of 520,500,and 405 nm,respectively] provided the best images for evaluating the vascular pattern compared to white light.The mucosal surface was best assessed using filter 4.However,the views obtained were not rated significantly better than those observed with white light.The 'gold standard',indigo carmine(IC) dye,was found to be superior to both white light and filter 4.Filter 6(RGB wavelengths of 580,520,and 460 nm,respectively) allowed for exploration of the IC-stained mucosa.When assessing mucosal polyps,both FICE with magnification,and magnification following dye spraying were superior to the same techniques without magnification and to white light imaging.In the presence of suboptimal bowel preparation,observation with the FICE mode was possible,and endoscopists considered it to be superior to observation with white light.CONCLUSION:FICE-filter 4 with magnification improves the image quality of the colonic vascular patterns obtained with WLE. | Adolfo Parra-Blanco Alejandro Jiménez Bjrn Rembacken Nicolás González David Nicolás-Pérez Antonio Z Gimeno-García Marta Carrillo-Palau Takahisa Matsuda Enrique Quintero | 2009 | World Journal of Gastroenterology2009，15，42： | 12 |
| 19 | Steroid hyperglycemia: Prevalence, early detection and therapeutic recommendations: A narrative review显示文摘Steroids are drugs that have been used extensively in a variety of conditions. Although widely prescribed for their anti-inflammatory and immunosuppressive properties, glucocorticoids have several side effects, being hyperglycemia one of the most common and representative. In the present review, we discuss the main epidemiologic characteristics associated with steroid use, with emphasis on the identification of high risk populations. Additionally we present the pathophysiology of corticosteroid induced hyperglycemia as well as the pharmacokinetics and pharmacodynamics associated with steroid use. We propose a treatment strategy based on previous reports and the understanding of the mechanism of action of both, the different types of glucocorticoids and the treatment options, in both the ambulatory and the hospital setting. Finally, we present some of the recent scientific advances as well as some options for future use of glucocorticoids. | Héctor Eloy Tamez-Pérez Dania Lizet Quintanilla-Flores René Rodríguez-Gutiérrez José Gerardo González-González Alejandra Lorena Tamez-Pena | 2015 | World Journal of Diabetes2015，6，8： | 12 |
| 20 | 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 |
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