Publications by authors named "Xingshun Qi"

321 Publications

Identification of Hepatic Dendritic Cells in Liver Biopsies Showing Steatosis in Patients with Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD) Associated with Obesity.

Med Sci Monit 2022 Aug 8;28:e937528. Epub 2022 Aug 8.

Liver Research Unit, Medica Sur Clinic Foundation, Mexico City, Mexico.

BACKGROUND Metabolic dysfunction-associated fatty liver disease (MAFLD) is now the term used for hepatic steatosis in patients who are overweight or obese, have type 2 diabetes mellitus (T2DM), or evidence of metabolic dysregulation. The prevalence of MAFLD among morbidly obese subjects is 65-93%. Hepatic dendritic cells (hDCs) are antigen-presenting cells that induce T cell-mediated immunity. MAFLD pathogenesis involves numerous immune cell-mediated inflammatory processes, while the particular role of hDCs is yet to be well defined. This study aimed to identify hDCs in liver biopsies from 128 patients with MAFLD associated with obesity. MATERIAL AND METHODS In this cross-sectional study, 128 liver biopsies from 128 patients with MAFLD (diagnosed as presence of hepatic steatosis, plus T2DM, metabolic dysregulation or overweight/obesity) were collected and assessed for CD11c⁺ immunoreactivity degree (CD11c as dendritic cell biomarker), through antigen retrieval, reaction with CD11c antibodies (primary), and marking with diaminobenzidine chromogen. RESULTS Among the 128 patients with MAFLD, 64 (50%) had MAFLD and fibrosis and 72 (56.2%) positively expressed hDCs (CD11c⁺). Among morbidly obese patients, 49 (64.5%) positively expressed hDCs (CD11c⁺) in liver tissue; from patients with obesity grade I- grade II (GI-II), 18 (54.5%) positively expressed hDCs (CD11c⁺) in liver tissue; and from non-obese patients with MAFLD, 5 (26.3%) positively expressed hDCs (CD11c⁺) in liver tissue. CONCLUSIONS hDC expression increases significantly in morbidly obese patients with MAFLD compared with non-obese patients, independent of the degree of fibrosis, suggesting the role of adaptive changes within hDCs in the perpetuation of inflammatory insults in chronic liver diseases.
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http://dx.doi.org/10.12659/MSM.937528DOI Listing
August 2022

Impact of insufficient doses of medications on eradication: a retrospective observational study.

Postgrad Med 2022 Jul 26:1-7. Epub 2022 Jul 26.

Department of Gastroenterology, General Hospital of Northern Theater Command (formerly General Hospital of Shenyang Military Area), Shenyang, Liaoning, China.

Background And Aims: The doses of medications may influence the success of () eradication. This real-world observational study aimed to explore the impact of insufficient doses of medications prescribed for the bismuth-containing quadruple therapy (BQT) regimen on successful eradication.

Methods: We retrospectively screened the patients who were diagnosed with infection and received BQT regimens for eradication at our department between January 2017 and July 2020. The rate of successful eradication was compared according to the doses of medications prescribed. Standard doses were defined according to the clinical guidelines.

Results: Overall, 1054 patients were included. The rate of successful eradication was 78.2% (824/1054). Among them, proton pump inhibitors (PPIs) and antibiotics were prescribed at insufficient doses in 37.0% (390/1054) and 6.7% (71/1054) of patients, respectively. Furthermore, pantoprazole (98.7% [385/390]) was the most common type of PPIs prescribed at insufficient doses, and nitroimidazoles (85.9% [61/71]) were the most common type of antibiotics prescribed at insufficient doses. Among the patients receiving colloidal bismuth pectin (CBP) (200 mg tid) and standard-dose antibiotics, the rate of successful eradication was lower in insufficient-dose PPIs group than standard-dose PPIs group (78.1% [271/347] versus 82.6% [438/530], P = 0.095). Among the patients receiving CBP (200 mg tid) and standard-dose PPIs, the rate of successful eradication was significantly lower in insufficient-dose antibiotics group than standard-dose antibiotics group (37.8% [14/37] versus 82.6% [438/530], P < 0.0001). Among the patients receiving CBP 200 mg tid, the rate of successful eradication was significantly lower in patients receiving both PPIs and antibiotics at insufficient doses than those at standard doses (46.4% [13/28] versus 82.6% [438/530], P < 0.0001).

Conclusion: Among the BQT regimens, PPIs and/or antibiotics, especially pantoprazole and metronidazole, are often prescribed at insufficient doses, compromising the success of eradication.

Abbreviations: ; UBT, urea breath test; DPM, disintegrations per minute; BQT, bismuth-containing quadruple therapy; PPI, proton pump inhibitor; CBP, colloidal bismuth pectin; qd, once daily; bid, twice daily; tid, three times daily; qid, four times daily.
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http://dx.doi.org/10.1080/00325481.2022.2105094DOI Listing
July 2022

Two-year risedronate treatment for osteoporosis in patients with esophageal varices: a non-randomized clinical trial.

Hepatol Int 2022 Jun 29. Epub 2022 Jun 29.

Internal Medicine Department, Botucatu Medical School, Gastroenterology Division-São Paulo State University (UNESP), Rubião Júnior s/n, Botucatu, SP, CEP 18618-687, Brazil.

Background: Bisphosphonates are the mainstay of osteoporosis treatment, but their use for patients with esophageal varices has been avoided due to the risk of esophagitis, which may cause variceal bleeding. Since most clinical trials assessing osteoporosis treatment last 2-3 years, this study aimed to evaluate a 2-year risedronate treatment for patients with esophageal varices and liver cirrhosis.

Methods: The study received Institutional Review Board approval, and the sample was divided into two groups according to bone mineral density (BMD). Cirrhosis severity and endoscopic findings at baseline were similar between the groups. The intervention group had 51 patients with osteoporosis, who received oral risedronate 35 mg weekly plus calcium and vitamin D supplements. The control group had 51 patients with osteopenia, receiving only the supplements. Scheduled esophagogastroduodenoscopies and BMD measurements were carried out.

Results: The adjusted esophagitis risk was higher in the intervention group; however, none of the subjects had digestive bleeding. Lumbar spine BMD increased in the intervention group (- 3.06 ± 0.71 to - 2.33 ± 0.90; p < 0.001) and in the control group (- 1.38 ± 0.77 to - 1.10 ± 1.05; p = 0.012). Femoral neck BMD did not change in the intervention group (- 1.64 ± 0.91 to - 1.71 ± 0.95; p = 0.220), but tended to decrease in the control group (- 1.00 ± 0.74 to - 1.09 ± 0.82; p = 0.053).

Conclusion: Oral risedronate was effective and did not cause gastrointestinal bleeding in cirrhotic patients with esophageal varices under endoscopic surveillance.
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http://dx.doi.org/10.1007/s12072-022-10366-zDOI Listing
June 2022

Impact of proton pump inhibitors on the in-hospital outcome of COVID-19 patients: a retrospective study.

Therap Adv Gastroenterol 2022 14;15:17562848221104365. Epub 2022 Jun 14.

COVID-19 Study Group, General Hospital of Northern Theater Command, Shenyang 110840, P.R. China.

Background: Coronavirus disease 2019 (COVID-19) has triggered a global public health crisis. Proton pump inhibitors (PPIs) are one of the most commonly prescribed drugs. However, the effect of PPIs on the clinical outcomes of COVID-19 patients remains unclear.

Methods: All COVID-19 patients admitted to the Wuhan Huoshenshan Hospital from February 2020 to April 2020 were retrospectively collected. Patients were divided into PPIs and non-PPIs groups. Logistic regression analyses were performed to explore the effects of PPIs on the outcomes of COVID-19 patients, including transfer to intensive care unit, mechanical ventilation, and death. Subgroup analyses were performed according to the presence of upper gastrointestinal symptoms potentially associated with acid and the routes, types, median total dosage, and duration of PPIs. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated.

Results: Of the 3024 COVID-19 patients included, 694 and 2330 were in PPIs and non-PPIs groups, respectively. Univariate logistic regression analysis showed that PPIs significantly increased the risk of reaching the composite endpoint in COVID-19 patients (OR = 10.23, 95% CI = 6.90-15.16,  < 0.001). After adjusting for age, sex, comorbidities, other medications, and severe/critical COVID-19, PPIs were independently associated with an increased risk of reaching the composite endpoint (OR = 7.00, 95% CI = 4.57-10.71,  < 0.001). This association remained significant in patients with upper gastrointestinal symptoms and those who received an intravenous omeprazole alone, but not those who received oral lansoprazole or rabeprazole alone. It was not influenced by dosage or duration of PPIs.

Conclusion: The use of intravenous PPIs alone during hospitalization may be associated with worse clinical outcome in COVID-19 patients.
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http://dx.doi.org/10.1177/17562848221104365DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9201367PMC
June 2022

Computed Tomography Images of Spontaneous Portosystemic Shunt in Liver Cirrhosis.

Can J Gastroenterol Hepatol 2022 8;2022:3231144. Epub 2022 Jun 8.

Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command (formerly called General Hospital of Shenyang Military Area), Shenyang 110840, China.

Spontaneous portosystemic shunt (SPSS) refers to collateral vessels that communicate between the portal vein system and systemic circulation. SPSS mainly includes esophageal varices, gastric varices, left gastric vein, recanalized paraumbilical vein, abdominal wall varices, and spontaneous splenorenal shunt. SPSS contributes to the development of hepatic encephalopathy caused by portal vein inflow bypassing and carries a higher risk of death in liver cirrhosis. Abdominal contrast-enhanced computed tomography is a major imaging approach to establish a diagnosis of SPSS and evaluate its location and feature. This review primarily describes the main contrast-enhanced CT features of SPSS in liver cirrhosis.
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http://dx.doi.org/10.1155/2022/3231144DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9200601PMC
June 2022

Review article: thromboelastography in liver diseases.

Aliment Pharmacol Ther 2022 Aug 14;56(4):580-591. Epub 2022 Jun 14.

Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, China.

Background: Patients with liver diseases have complicated haemostatic alternations, resulting in both bleeding and thromboembolic complications, which cannot be sufficiently evaluated by conventional coagulation tests (CCTs), such as platelet count or prothrombin time. Thromboelastography (TEG) is a whole blood viscoelastic test which globally reflects changes in the haemostatic system, and its utility in evaluating patients with liver disease is increasingly recognised.

Aims: To review the current evidence and clinical significance of TEG in liver diseases.

Methods: Literature regarding TEG and liver diseases was comprehensively searched.

Results: TEG is associated closely with the severity and aetiology of liver disease, the course of infection and the risk of bleeding and death, but not the risk of portal venous system thrombosis. Additionally, TEG-guided transfusion protocols can significantly decrease the requirement for blood products compared to those guided by CCTs.

Conclusion: TEG can reflect the haemostatic status of liver diseases more comprehensively than CCTs. It has the potential to assess the severity of liver diseases, predict the risk of bleeding and death in patients with liver disease and guide blood product transfusion. Future studies should standardise the use of TEG for assessing disease severity and development of clinical events and guiding blood product transfusion in patients with liver diseases.
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http://dx.doi.org/10.1111/apt.17080DOI Listing
August 2022

Epidemiology of portal vein thrombosis in liver cirrhosis: A systematic review and meta-analysis.

Eur J Intern Med 2022 Jun 7. Epub 2022 Jun 7.

Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang 110840, PR China; Postgraduate College, Shenyang Pharmaceutical University, Shenyang 110016, PR China; Postgraduate College, China Medical University, Shenyang 110122, PR China. Electronic address:

Background: Portal vein thrombosis (PVT) may be associated with negative outcomes in patients with liver cirrhosis. However, the prevalence and incidence of PVT in liver cirrhosis are heterogeneous among studies and have not been sufficiently determined yet.

Methods: The PubMed, EMBASE, and Cochrane Library databases were searched. Eligible studies would explore the prevalence and/or incidence of PVT in liver cirrhosis without hepatocellular carcinoma or abdominal surgery. Pooled proportion with 95% confidence interval (CI) was calculated using a random-effect model. Factors associated with the presence/occurrence of PVT were also extracted.

Results: Among the 8549 papers initially identified, 74 were included. Fifty-four studies explored the prevalence of PVT in liver cirrhosis with a pooled prevalence of 13.92% (95%CI=11.18-16.91%). Based on cross-sectional data, Child-Pugh class B/C, higher D-dimer, ascites, and use of non-selective beta-blockers (NSBBs) were associated with the presence of PVT in liver cirrhosis. Twenty-three studies explored the incidence of PVT in liver cirrhosis with a pooled incidence of 10.42% (95%CI=8.16-12.92%). Based on cohort data, Child-Pugh class B/C, higher model of end-stage liver disease score, higher D-dimer, lower platelets count, decreased portal flow velocity, ascites, use of NSBBs, and moderate or high-risk esophageal varices could predict the occurrence of PVT in liver cirrhosis.

Conclusion: Approximately one seventh of cirrhotic patients have PVT, and one tenth will develop PVT. Progression of liver cirrhosis and portal hypertension seems to be in parallel with the risk of PVT. Prospective studies with detailed information about classification and extension of PVT in liver cirrhosis are needed.
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http://dx.doi.org/10.1016/j.ejim.2022.05.032DOI Listing
June 2022

Practice guidance for the use of terlipressin for liver cirrhosis-related complications.

Therap Adv Gastroenterol 2022 18;15:17562848221098253. Epub 2022 May 18.

Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, China.

Background: Liver cirrhosis is a major global health burden worldwide due to its high risk of morbidity and mortality. Role of terlipressin for the management of liver cirrhosis-related complications has been recognized during recent years. This article aims to develop evidence-based clinical practice guidance on the use of terlipressin for liver cirrhosis-related complications.

Methods: Hepatobiliary Study Group of the Chinese Society of Gastroenterology of the Chinese Medical Association and Hepatology Committee of the Chinese Research Hospital Association have invited gastroenterologists, hepatologists, infectious disease specialists, surgeons, and clinical pharmacists to formulate the clinical practice guidance based on comprehensive literature review and experts' clinical experiences.

Results: Overall, 10 major guidance statements regarding efficacy and safety of terlipressin in liver cirrhosis were proposed. Terlipressin can be beneficial for the management of cirrhotic patients with acute variceal bleeding and hepatorenal syndrome (HRS). However, the evidence regarding the use of terlipressin in cirrhotic patients with ascites, post-paracentesis circulatory dysfunction, and bacterial infections and in those undergoing hepatic resection and liver transplantation remains insufficient. Terlipressin-related adverse events, mainly including gastrointestinal symptoms, electrolyte disturbance, and cardiovascular and respiratory adverse events, should be closely monitored.

Conclusion: The current clinical practice guidance supports the use of terlipressin for gastroesophageal variceal bleeding and HRS in liver cirrhosis. High-quality studies are needed to further clarify its potential effects in other liver cirrhosis-related complications.
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http://dx.doi.org/10.1177/17562848221098253DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9121451PMC
May 2022

May Silymarin be selectively considered for nonalcoholic fatty liver disease without elevated transaminases? Comment re. "Impact of Silymarin in individuals with nonalcoholic fatty liver disease: a systematic review and meta-analysis".

Nutrition 2022 Mar 2:111648. Epub 2022 Mar 2.

Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, China. Electronic address:

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http://dx.doi.org/10.1016/j.nut.2022.111648DOI Listing
March 2022

Association of endoscopic variceal treatment with portal venous system thrombosis in liver cirrhosis: a case-control study.

Therap Adv Gastroenterol 2022 11;15:17562848221087536. Epub 2022 May 11.

Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command (formerly called General Hospital of Shenyang Military Area), No. 83 Wenhua Road, Shenyang 110840, Liaoning Province, China.

Background: The association of endoscopic variceal treatment (EVT) with portal venous system thrombosis (PVST) in liver cirrhosis is still unclear.

Methods: PVST was assessed by contrast-enhanced CT or MRI in 406 cirrhotic patients from our prospective database. Case and control groups, which are defined as patients with and without PVST, respectively, were matched at a ratio of 1:1 according to age, gender, Child-Pugh class, and MELD score. History of EVT was reviewed. Logistic regression analysis was used to identify the risk factors for PVST. Odds ratios (ORs) were calculated. Subgroup analyses were further performed in terms of degree and location of PVST.

Results: Overall, 109 patients each were included in case and control groups. The case group had a significantly higher proportion of patients who had undergone EVT than the control group (53.2% 18.3%;  < 0.001). In detail, the case group had significantly higher proportions of patients who had undergone EVT for controlling bleeding (45.9% 14.7%;  < 0.001), endoscopic variceal ligation (EVL) alone (19.3% 9.2%;  = 0.033), and EVL combined with endoscopic cyanoacrylate glue injection (24.8% 5.5%;  < 0.001). EVT was independently associated with PVST (OR = 4.258;  < 0.001). In subgroup analyses, EVT remained independently associated with partial PVST (OR = 10.063;  < 0.001), complete PVST/fibrotic cord (OR = 4.889;  = 0.008), thrombosis within main portal vein (OR = 5.985;  < 0.001), and thrombosis within superior mesenteric and splenic veins (OR = 5.747;  < 0.001).

Conclusions: EVT may lead to a higher risk of PVST, especially more severe PVST, in liver cirrhosis. Screening for and prophylaxis of PVST after EVT should be further explored.
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http://dx.doi.org/10.1177/17562848221087536DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9102139PMC
May 2022

Inflammatory Indexes for Assessing the Severity and Disease Progression of Ulcerative Colitis: A Single-Center Retrospective Study.

Front Public Health 2022 10;10:851295. Epub 2022 Mar 10.

Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, China.

Background: Active and severe ulcerative colitis (UC) and non-response to 5-aminosalicylic acid (5-ASA) are related to poor outcomes and should be accurately identified. Several integrated inflammatory indexes are potentially useful to assess the disease severity in patients with acute or critical diseases but are underexplored in patients with UC.

Methods: Patients with UC consecutively admitted to our hospital between January 2015 and December 2020 were retrospectively grouped according to the activity and severity of UC and response to 5-ASA. The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), neutrophil-to-platelet ratio (NPR), platelet-to-albumin ratio (PAR), C-reactive protein-to-albumin ratio (CAR), and C-reactive protein-to-lymphocyte ratio (CLR) were calculated. The areas under receiver operating characteristic curves (AUC) were calculated.

Results: Overall, 187 patients with UC were included, of whom 151 were active, 55 were severe, and 14 were unresponsive to 5-ASA. The active UC group had significantly higher NLR, PLR, SII, and PAR levels. SII had the greatest predictive accuracy for active UC, followed by PLR, PAR, and NLR (AUC = 0.647, 0.641, 0.634, and 0.626). The severe UC group had significantly higher NLR, PLR, SII, PAR, CAR, and CLR levels. CLR had the greatest predictive accuracy for severe UC, followed by CAR, PLR, SII, NLR, and PAR (AUC = 0.732, 0.714, 0.693, 0.669, 0.646, and 0.63). The non-response to the 5-ASA group had significantly higher CAR and CLR levels. CAR had a greater predictive accuracy for non-response to 5-ASA than CLR (AUC = 0.781 and 0.759).

Conclusion: SII, CLR, and CAR may be useful for assessing the severity and progression of UC, but remain not optimal.
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http://dx.doi.org/10.3389/fpubh.2022.851295DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8963422PMC
March 2022

Case Report: Pancreatic Neuroendocrine Tumor With Liver Metastasis and Portal Vein Thrombosis.

Front Oncol 2021 14;11:809129. Epub 2022 Feb 14.

Department of Interventional radiology, the First Hospital of China Medical University, Shenyang, China.

Introduction: Pancreatic neuroendocrine neoplasms (PNENs) are rare pancreatic tumors originating from pancreatic neuroendocrine cells. There is no consensus on the treatment for PNENs with unresectable liver metastases. Transcatheter arterial chemoembolization (TACE) is the preferred treatment for unresectable primary liver cancer. But the efficacy of TACE and anticoagulation in PNENs with unresectable liver metastases and portal vein thrombosis has never been reported.

Methods And Results: We present the case of a 50-year-old male patient with hepatitis C who was found to have a single liver mass during a regular physical examination in 2016. The liver mass was surgically removed. Postoperative pathology suggested a neuroendocrine tumor of the liver, and it was suggested to look for the primary tumor. The patient was followed up until 2020, and the primary pancreatic tumor was found, along with multiple liver metastases and portal vein thrombosis. After transcatheter arterial embolization, anticoagulation, and endocrine therapy, the patient's tumor load was relieved, and the portal vein was recanalized.

Conclusion: The article reports the disease course in a case of a functional pancreatic neuroendocrine tumor with liver metastasis and portal vein thrombosis and reviews previous literature. To our knowledge, we reported for the first time the efficacy of TACE and anticoagulation in PNENs with unresectable liver metastases and portal vein thrombosis.
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http://dx.doi.org/10.3389/fonc.2021.809129DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8882680PMC
February 2022

Acute kidney injury defined by cystatin C may be superior for predicting the outcomes of liver cirrhosis with acute gastrointestinal bleeding.

Ren Fail 2022 Dec;44(1):398-406

Department of Gastroenterology, General Hospital of Northern Theater Command (formally called General Hospital of Shenyang Military Area), Shenyang, China.

Background & Aims: Acute kidney injury (AKI) is conventionally evaluated by a dynamic change of serum creatinine (Scr). Cystatin C (CysC) seems to be a more accurate biomarker for assessing kidney function. This retrospective multicenter study aims to evaluate whether AKI re-defined by CysC can predict the in-hospital outcomes of patients with liver cirrhosis and acute gastrointestinal bleeding.

Methods: Overall, 677 cirrhotic patients with acute gastrointestinal bleeding, in whom both Scr and CysC levels were detected at admissions, were screened. eGFR, eGFR, and eGFR were calculated. MELD-Na score and AKI were re-evaluated by CysC instead of Scr. Odds ratios (ORs) were calculated in the logistic regression analyses. The receiver operating characteristic (ROC) curve analyses were performed.

Results: Univariate logistic regression analyses demonstrated that baseline Scr and CysC levels, eGFR, eGFR, eGFR, original MELD-Na score defined by Scr, MELD-Na score re-defined by CysC, and AKI re-defined by CysC, but not conventional AKI defined by Scr, were significantly associated with in-hospital death. ROC analyses showed that baseline CysC level, eGFR, eGFR, eGFR, original MELD-Na score defined by Scr, and MELD-Na score re-defined by CysC, but not baseline Scr level, could significantly predict the risk of in-hospital death.

Conclusions: AKI re-defined by CysC may be superior for predicting the in-hospital mortality of cirrhotic patients with acute gastrointestinal bleeding.
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http://dx.doi.org/10.1080/0886022X.2022.2039193DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8890530PMC
December 2022

Epidemiology and Risk Factors of Portal Venous System Thrombosis in Patients With Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis.

Front Med (Lausanne) 2021 17;8:744505. Epub 2022 Jan 17.

Department of Gastroenterology, General Hospital of Northern Theater Command (formerly called General Hospital of Shenyang Military Area), Shenyang, China.

Background: Patients with inflammatory bowel disease (IBD) may be at risk of developing portal venous system thrombosis (PVST) with worse outcomes. This study aims to explore the prevalence, incidence, and risk factors of PVST among patients with IBD.

Methods: PubMed, Embase, and Cochrane Library databases were searched. All the eligible studies were divided according to the history of colorectal surgery. Only the prevalence of PVST in patients with IBD was pooled if the history of colorectal surgery was unclear. The incidence of PVST in patients with IBD after colorectal surgery was pooled if the history of colorectal surgery was clear. Prevalence, incidence, and risk factors of PVST were pooled by only a random-effects model. Subgroup analyses were performed in patients undergoing imaging examinations. Odds ratios (ORs) with 95% CIs were calculated.

Results: A total of 36 studies with 143,659 patients with IBD were included. Among the studies where the history of colorectal surgery was unclear, the prevalence of PVST was 0.99, 1.45, and 0.40% in ulcerative colitis (UC), Crohn's disease (CD), and unclassified IBD, respectively. Among the studies where all the patients underwent colorectal surgery, the incidence of PVST was 6.95, 2.55, and 3.95% in UC, CD, and unclassified IBD after colorectal surgery, respectively. Both the prevalence and incidence of PVST became higher in patients with IBD undergoing imaging examinations. Preoperative corticosteroids therapy (OR = 3.112, 95% CI: 1.017-9.525; = 0.047) and urgent surgery (OR = 1.799, 95% CI: 1.079-2.998; = 0.024) are significant risk factors of PVST in patients with IBD after colorectal surgery. The mortality of patients with IBD with PVST after colorectal surgery was 4.31% (34/789).

Conclusion: PVST is not rare, but potentially lethal in patients with IBD after colorectal surgery. More severe IBD, indicated by preoperative corticosteroids and urgent surgery, is associated with a higher risk of PVST after colorectal surgery. Therefore, screening for PVST by imaging examinations and antithrombotic prophylaxis in high-risk patients should be actively considered.

Systematic Review Registration: Registered on PROSPERO, Identifier: CRD42020159579.
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http://dx.doi.org/10.3389/fmed.2021.744505DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8801813PMC
January 2022

Prevalence and risk factors of infection in military personnel: a systematic review and meta-analysis.

Indian J Pathol Microbiol 2022 Jan-Mar;65(1):23-28

Department of Gastroenterology, General Hospital of Northern Theater Command (formerly General Hospital of Shenyang Military Area), Shenyang, China.

Background And Aims: Helicobacter pylori infection is prevalent and recognized as a major cause of gastrointestinal diseases in the world. Previous studies on the prevalence of H. pylori infection in military personnel have shown some conflicting results. This study aimed to estimate the pooled prevalence of H. pylori infection and evaluate its risk factors in military personnel.

Methods: The PubMed, EMBASE, and Cochrane Library databases were searched. We pooled the prevalence of H. pylori infection in military personnel using a random-effect model. Metaregression analysis was used to explore the sources of heterogeneity. Pooled proportion of H. pylori infection with 95% confidence interval (CI) was calculated.

Results: Sixteen studies were included. Meta-analysis showed that the overall prevalence of H. pylori infection was 32% (95% CI = 31-33) in military personnel. There was a significant heterogeneity. Metaregression analysis showed that study region (P = 0.0004) and publication year (P = 0.023) were the potential sources of heterogeneity. In the subgroup analysis by study region, the highest prevalence was found in Asia (50.2%; 95% CI = 49-51.4). In the subgroup analysis by diagnostic methods for H. pylori, the highest prevalence was found when urea breath test was employed (47.9%; 95% CI = 46.5-49.3). The most common risk factor for H. pylori infection was familial aggregation, followed by living environment and age.

Conclusion: H. pylori infection is common in military personnel. In future, we may require appropriate population screening for H. pylori infection by multiple diagnostic tests and increase the knowledge and awareness of the bacterial transmission among military personnel.
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http://dx.doi.org/10.4103/IJPM.IJPM_1084_20DOI Listing
February 2022

Outcomes of early versus delayed endoscopy in cirrhotic patients with acute variceal bleeding: a systematic review with meta-analysis.

Eur J Gastroenterol Hepatol 2021 12;33(1S Suppl 1):e868-e876

Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command & Department of Life Sciences and Biopharmaceutics, Shenyang Pharmaceutical University, Shenyang.

Objectives: Endoscopy is the mainstay treatment option for acute variceal bleeding (AVB) in liver cirrhosis. However, the optimal timing of endoscopy in such patients remains unclear.

Methods: PubMed, EMBASE and Cochrane Library databases were searched. We compared the mortality, incidence of rebleeding, length of stay, endoscopic hemostasis, need for salvage and units of transfusion between cirrhotic patients with AVB who underwent early and delayed endoscopy. Meta-analyses were performed by using a random-effect model. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Subgroup analysis was performed in studies where early endoscopy was defined as <12 h.

Results: Nine retrospective studies involving 2824 patients were included. The early endoscopy group had a significantly lower overall mortality than the delayed endoscopy group in overall analysis (OR = 0.56, 95% CI, 0.33-0.95, P = 0.03), but the difference between them was NS in subgroup analysis (OR = 0.72, 95% CI, 0.38-1.38, P = 0.33). In-hospital (OR = 0.77, 95% CI, 0.26-2.32, P = 0.65) and 6-week (OR = 0.78, 95% CI, 0.42-1.47, P = 0.45) mortality were not significantly different between them. Overall rebleeding was not significantly different between early and delayed endoscopy groups in both overall (OR = 0.88, 95% CI, 0.51-1.51, P = 0.63) and subgroup (OR = 1.04, 95% CI, 0.55-1.95, P = 0.90) analyses. In-hospital (OR = 1.41, 95% CI, 0.67-2.96, P = 0.37) and 6-week (OR = 0.93, 95% CI, 0.40-2.17, P = 0.86) rebleeding remained not significantly different between them. Additionally, the length of stay, endoscopic hemostasis, need for salvage and units of transfusion were not significantly different between them.

Conclusions: Early endoscopy may improve the survival of cirrhotic patients with AVB, but has no remarkable benefit on the prevention of rebleeding. These findings should be further validated by high-quality studies.
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http://dx.doi.org/10.1097/MEG.0000000000002282DOI Listing
December 2021

Risk Factors for Esophageal Collateral Veins in Cirrhosis with and without Previous Endoscopic Esophageal Variceal Therapy.

Can J Gastroenterol Hepatol 2022 4;2022:6666791. Epub 2022 Jan 4.

Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang 110840, China.

Background: Portosystemic collateral vessels are a sign of portal hypertension in liver cirrhosis. Esophageal collateral veins (ECVs) are one major type of portosystemic collateral vessels, which increase the recurrence of esophageal varices and bleeding after variceal eradication. However, the risk factors for ECVs were still unclear.

Methods: We retrospectively screened cirrhotic patients who had contrast-enhanced computed tomography (CT) images to evaluate ECVs and upper gastrointestinal endoscopic reports to evaluate gastroesophageal varices at our department. Univariate and multivariate logistic regression analyses were performed to explore the independent risk factors for ECVs. Odds ratios (ORs) were calculated. Subgroup analyses were performed in patients with and without previous endoscopic variceal therapy which primarily included endoscopic variceal ligation (EVL) and endoscopic injection sclerotherapy (EIS).

Results: Overall, 243 patients were included, in whom the prevalence of ECVs was 53.9%. The independent risk factors for ECVs were hepatitis C virus infection (OR = 0.250,  = 0.026), previous EVL (OR = 1.929,  = 0.044), platelet (OR = 0.993,  = 0.008), and esophageal varices needing treatment (EVNTs) (OR = 2.422,  = 0.006). The prevalence of ECVs was 60.8% (73/120) in patients undergoing EVL, 50% (10/20) in those undergoing EIS, and 47.5% (48/101) in those without previous endoscopic variceal therapy. The independent risk factors for ECVs were the use of nonselective beta-blockers (OR = 0.294,  = 0.042) and EVNTs (OR = 3.714,  = 0.006) in subgroup analyses of patients with and without previous endoscopic variceal therapy, respectively.

Conclusions: The presence of ECVs should be closely associated with the severity of portal hypertension in liver cirrhosis. Risk of ECVs might be increased by previous EVL.
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http://dx.doi.org/10.1155/2022/6666791DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8752234PMC
January 2022

Metabolic associated fatty liver disease and acute-on-chronic liver failure: common themes for common problems.

Eur J Gastroenterol Hepatol 2021 12;33(1S Suppl 1):e84-e93

Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico.

Metabolic associated fatty liver disease (MAFLD) affects 20-30% of the worldwide population and is becoming the most common cause of chronic liver disease, cirrhosis and hepatocellular carcinoma (HCC). MAFLD is the hepatic expression of metabolic dysfunction correlated with a variety of metabolic comorbidities including obesity, dyslipidemia, hypertension and type 2 diabetes (T2DM). Obesity, altered gut permeability, chronic inflammation and dysbiosis related to MAFLD might predispose patients with cirrhosis to the development of acute-on-chronic liver failure (ACLF); however, this relationship remains unclear. ACLF is a syndrome with high short-term mortality, presenting with acute hepatic decompensation associated with organ failures in patients with underlying chronic liver disease with or without an identifiable precipitating event. While this syndrome can occur in any patient with cirrhosis, the increasing prevalence of cirrhosis due to MAFLD is of great concern because, in a recent analysis, MAFLD was the fastest rising cause of cirrhosis associated with ACLF among patients listed for LT in the US. In this review, we will discuss the current knowledge on MAFLD and the development of ACLF.
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http://dx.doi.org/10.1097/MEG.0000000000002335DOI Listing
December 2021

Association between infection and irritable bowel syndrome: a systematic review and meta-analysis.

Postgrad Med J 2021 Dec 20. Epub 2021 Dec 20.

Meta-Analysis Interest Group, Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, China

Background: infection and irritable bowel syndrome (IBS) negatively affect the quality of life. Some previous studies found that infection should be positively associated with the risk of IBS, but others did not. The present study aims to clarify this association, and to further analyse whether treatment can improve IBS symptoms.

Materials And Methods: The PubMed, EMBASE, Cochrane library, Chinese National Knowledge Infrastructure, China Science and Technology Journal and Wanfang databases were searched. Meta-analysis was performed using a random-effect model. The pooled odds ratios (ORs)/risk ratios (RRs) and their 95% CIs were calculated. Heterogeneity was evaluated using the Cochran's Q test and I statistics. Meta-regression analysis was used to explore the sources of heterogeneity.

Results: Thirty-one studies with 21 867 individuals were included. Meta-analysis of 27 studies found that patients with IBS had a significantly higher risk of infection than those without (OR=1.68, 95% CI 1.29 to 2.18; p<0.001). The heterogeneity was statistically significant (I=85%; p<0.001). Meta-regression analyses indicated that study design and diagnostic criteria of IBS might be the potential sources of heterogeneity. Meta-analysis of eight studies demonstrated that eradication treatment had a higher improvement rate of IBS symptoms (RR=1.24, 95% CI 1.10 to 1.39; p<0.001). The heterogeneity was not significant (I=32%; p=0.170). Meta-analysis of four studies also demonstrated that successful eradication had a higher improvement rate of IBS symptoms (RR=1.25, 95% CI 1.01 to 1.53; p=0.040). The heterogeneity was not significant (I=1%; p=0.390).

Conclusion: infection is associated with an increased risk of IBS. eradication treatment can improve IBS symptoms.
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http://dx.doi.org/10.1136/postgradmedj-2021-141127DOI Listing
December 2021

Comparison of Clinical Efficacy and Safety Between da Vinci Robotic and Laparoscopic Intersphincteric Resection for Low Rectal Cancer: A Meta-Analysis.

Front Surg 2021 2;8:752009. Epub 2021 Dec 2.

Department of General Surgery, General Hospital of Northern Theater Command (Formerly Called General Hospital of Shenyang Military Area), Shenyang, China.

The intersphincteric resection (ISR) is beneficial for saving patients' anus to a large extent and restoring original bowel continuity. Laparoscopic ISR (L-ISR) has its drawbacks, such as two-dimensional images, low motion flexibility, and unstable lens. Recently, da Vinci robotic ISR (R-ISR) is increasingly used worldwide. The purpose of this article is to compare the feasibility, safety, oncological outcomes, and clinical efficacy of R-ISR vs. L-ISR for low rectal cancer. PubMed, EMBASE, Cochrane Library, and Web of Science were searched to identify comparative studies of R-ISR vs. L-ISR. Demographic, clinical, and outcome data were extracted. Mean difference (MD) and risk ratio (RR) with their corresponding confidence intervals (CIs) were calculated. Five studies were included. In total, 510 patients were included, of whom 273 underwent R-ISR and 237 L-ISR. Compared with L-ISR, R-ISR has significantly lower estimated intraoperative blood loss (MD = -23.31, 95% CI [-41.98, -4.64], = 0.01), longer operative time (MD = 51.77, 95% CI [25.68, 77.86], = 0.0001), hospitalization days (MD = -1.52, 95% CI [-2.10, 0.94], < 0.00001), and postoperative urinary complications (RR = 0.36, 95% CI [0.16, 0.82], = 0.02). The potential benefits of R-ISR are considered as a safe and feasible alternative choice for the treatment of low rectal tumors.
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http://dx.doi.org/10.3389/fsurg.2021.752009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8674929PMC
December 2021

Diagnostic utility of CT for abdominal injury in the military setting: A systematic review and meta-analysis.

Medicine (Baltimore) 2021 Dec;100(50):e28150

Military Medical Research Group, General Hospital of Northern Theater Command, Shenyang, Liaoning Province, China.

Background: It is critical to accurately identify patients with abdominal injury who truly need to undergo laparotomy during the war in timely fashion. The diagnostic utility of computed tomography (CT) for evaluating abdominal injury in the military setting remains uncertain.

Methods: PubMed, EMBASE, and Cochrane Library databases were searched. Meta-analyses were performed by using a random-effect model. We pooled the area under the summary receiver operating characteristic curves with standard errors, the Q indexes with standard errors, the sensitivities with 95% confidence intervals (CIs), the specificities with 95% CIs, the positive likelihood ratios with 95% CIs, the negative likelihood ratios with 95% CIs, and the diagnostic odds ratios with 95% CIs. The heterogeneity among studies were evaluated by the I2 and P value.

Results: Overall, 5 retrospective studies were included. The area under the summary receiver operating characteristic curve was 0.9761 ± 0.0215 and the Q index was 0.9302 ± 0.0378. The pooled sensitivity was 0.97 (95% CI = 0.92-0.99) without a significant heterogeneity among studies (I2 = 0%, P = .4538). The pooled specificity was 0.95 (95% CI = 0.93-0.97) with a significant heterogeneity among studies (I2 = 90.6%, P < .0001). The pooled positive likelihood ratio was 10.71 (95% CI: 2.91-39.43) with a significant heterogeneity among studies (I2 = 89.2%, P < .0001). The pooled negative likelihood ratio was 0.07 (95% CI = 0.02-0.27) with a significant heterogeneity among studies (I2 = 57.5%, P = .0516). The pooled diagnostic odds ratio was 177.48 (95% CI = 18.09-1741.31) with a significant heterogeneity among studies (I2 = 75.9%, P = .0023).

Conclusion: Diagnostic accuracy of CT for abdominal injury is excellent in the military setting. Further work should explore how to shrink CT equipment for a wider use in wartime.
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http://dx.doi.org/10.1097/MD.0000000000028150DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8677980PMC
December 2021

Proton pump inhibitors may reduce the risk of high-grade dysplasia and/or esophageal adenocarcinoma in Barrett's esophagus: a systematic review and meta-analysis.

Expert Rev Clin Pharmacol 2022 Jan 27;15(1):79-88. Epub 2021 Nov 27.

Department of Gastroenterology, General Hospital of Northern Theater Command (formerly called General Hospital of Shenyang Military Area), Shenyang, China.

Background: Barrett's esophagus (BE) is an important risk factor for high-grade dysplasia (HGD) and/or esophageal adenocarcinoma (EAC). The effect of proton pump inhibitors (PPIs) on the chemoprevention of HGD and/or EAC arising from BE remains controversial.

Research Design And Methods: PubMed, EMBASE, and Cochrane Library databases were systematically searched. Risk ratios (RRs) or odds ratios (ORs) with 95% confidence intervals (CIs) were pooled by a random-effect model. Heterogeneity and its potential source were assessed.

Results: Fifteen studies with 26,291 BE patients were included. Meta-analysis of eight cohort studies showed that PPIs can significantly reduce the risk of HGD and/or EAC in BE patients (RR = 0.46; P < 0.001), but meta-analysis of six case-control studies showed no significant benefit of PPIs (OR = 0.64; P = 0.334). Heterogeneity was significant among both cohort and case-control studies, which might be attributed to the information sources of PPIs. There was no significant protective effect of high-dose PPIs on HGD and/or EAC in one RCT (RR = 0.84; P = 0.21), meta-analysis of two cohort studies (RR = 0.61; P = 0.28), or meta-analysis of two case-control studies (OR = 0.32; P = 0.08).

Conclusions: Chemoprevention of HGD and/or EAC by PPIs may be considered in BE patients. However, there might not be further preventive effect of high-dose PPIs.
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http://dx.doi.org/10.1080/17512433.2022.2008909DOI Listing
January 2022

Role of Galectins in the Liver Diseases: A Systematic Review and Meta-Analysis.

Front Med (Lausanne) 2021 27;8:744518. Epub 2021 Oct 27.

Meta-Analysis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, China.

Galectins, a family of β-galactoside-binding proteins, are related to the development and progression of various human diseases such as cancer, heart failure, and chronic kidney disease. However, its role in liver diseases is unclear. The PubMed, Embase, and Cochrane Library databases were searched. Hazard ratios (HRs), odds ratios (ORs), and mean differences (MDs) with 95% CIs were pooled to evaluate the association of the galectins with the outcomes and risk of liver diseases by a random effects model. Thirty three studies involving 43 cohorts and 4,168 patients with liver diseases were included. In the patients with hepatocellular carcinoma (HCC), high expression of galectin-1 and -3 in the tissues was significantly associated with worse overall survival (galectin-1: HR = 1.94, 95% CI = 1.61-2.34, < 0.001; galectin-3: HR = 3.29, 95% CI = 1.62-6.68, < 0.001) and positive vascular invasion (galectin-1: OR = 1.74, 95% CI = 1.18-2.58, = 0.005; galectin-3: OR = 2.98, 95% CI = 1.58-5.60, = 0.001); but, high expression of galectin-4 and -9 in the tissues was significantly associated with better overall survival (galectin-4: HR = 0.53, 95% CI = 0.36-0.79, = 0.002; galectin-9: HR = 0.56, 95% CI = 0.44-0.71, < 0.001) and negative vascular invasion (galectin-4: OR = 0.36, 95% CI = 0.19-0.72, = 0.003; galectin-9: OR = 0.60, 95% CI = 0.37-0.97, = 0.037). Serum galectin-3 level was significantly higher in HCC (MD = 3.06, 95% CI = 1.79-4.32, < 0.001), liver failure (MD = 0.44, 95% CI = 0.23-0.66, < 0.001), liver cirrhosis (MD = 1.83, 95% CI = 1.15-2.51, < 0.001), and chronic active hepatitis B (MD = 18.95, 95% CI = 10.91-27.00, < 0.001); serum galectin-9 level was significantly higher in HCC (MD = 3.74, 95% CI = 2.57-4.91, < 0.001) and autoimmune hepatitis (MD = 8.80, 95% CI = 7.61-9.99, < 0.001). High galectin-1 and -3 and low galectin-4 and -9 expression indicate worse outcomes of patients with HCC. Serum galectin-3 and -9 levels are positively associated with the risk of chronic liver diseases.
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http://dx.doi.org/10.3389/fmed.2021.744518DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8578830PMC
October 2021

Gastrointestinal Bleeding, but Not Other Gastrointestinal Symptoms, Is Associated With Worse Outcomes in COVID-19 Patients.

Front Med (Lausanne) 2021 13;8:759152. Epub 2021 Oct 13.

COVID-19 Study Group, General Hospital of Northern Theater Command, Shenyang, China.

Patients with coronavirus disease 2019 (COVID-19) can present with gastrointestinal (GI) symptoms. However, the prevalence of GI symptoms and their association with outcomes remain controversial in COVID-19 patients. All COVID-19 patients consecutively admitted to the Wuhan Huoshenshan hospital from February 2020 to April 2020 were collected. Disease severity and outcomes were compared between COVID-19 patients with and without GI symptoms. Logistic regression analyses were performed to evaluate the association of GI symptoms with the composite endpoint and death in COVID-19 patients. A composite endpoint was defined as transfer to intensive care unit, requirement of mechanical ventilation, and death. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Overall, 2,552 COVID-19 patients were included. The prevalence of GI symptoms was 21.0% (537/2,552). Diarrhea (8.9%, 226/2,552) was the most common GI symptom. Patients with GI symptoms had significantly higher proportions of severe COVID-19 and worse outcomes than those without. Univariate logistic regression analyses demonstrated that GI symptoms were significantly associated with the composite endpoint (OR = 2.426, 95% CI = 1.608-3.661; < 0.001) and death (OR = 2.137, 95% CI = 1.209-3.778; = 0.009). After adjusting for age, sex, and severe/critical COVID-19, GI symptoms were still independently associated with the composite endpoint (OR = 2.029, 95% CI = 1.294-3.182; = 0.002), but not death (OR = 1.726, 95% CI = 0.946-3.150; = 0.075). According to the type of GI symptoms, GI bleeding was an independent predictor of the composite endpoint (OR = 8.416, 95% CI = 3.465-20.438, < 0.001) and death (OR = 6.640, 95% CI = 2.567-17.179, < 0.001), but not other GI symptoms (i.e., diarrhea, abdominal discomfort, nausea and/or vomiting, constipation, acid reflux and/or heartburn, or abdominal pain). GI symptoms are common in COVID-19 patients and may be associated with their worse outcomes. Notably, such a negative impact of GI symptoms on the outcomes should be attributed to GI bleeding.
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http://dx.doi.org/10.3389/fmed.2021.759152DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8548414PMC
October 2021

Adherence to Non-Selective Beta Blockers for Prevention of Variceal Bleeding in Cirrhotic Patients.

Int J Gen Med 2021 13;14:6713-6724. Epub 2021 Oct 13.

Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, 110840, People's Republic of China.

Background And Aim: Long-term use of non-selective beta blockers (NSBBs) is essential for the prevention of esophageal variceal bleeding in liver cirrhosis but may impair the patient's adherence. The present study aimed to investigate the adherence to NSBBs to prevent variceal bleeding in cirrhotic patients.

Methods: All patients who had an indication of NSBBs for the prophylaxis of variceal bleeding between February 2018 and June 2019 were screened. Clinical pharmacists gave pre-medication education and recorded the adherence to NSBBs during the patients' hospitalizations. Factors associated with poor adherence were evaluated by univariate logistic regression analysis. Odds ratios (OR) with 95% confidence intervals (CI) were calculated. The relationship between poor adherence during follow-up and variceal bleeding after discharge was also evaluated.

Results: Overall, 108 patients were screened, of whom 12 were intolerant to NSBBs. Among the 96 remaining patients who could take NSBBs, the average change of heart rate after NSBBs was -10.49 b.p.m. Twenty-two (22.9%) patients had poor adherence to NSBBs due to their refusal to take NSBBs (n = 2), complete forgetfulness to take NSBBs (n = 10), and refusal or forgetfulness to monitor heart rate (n = 10). Univariate logistic regression analysis demonstrated that only older age was significantly associated with poor adherence (OR: 1.065, 95% CI: 1.019-1.114, P = 0.005). Patients with poor adherence during follow-up were more likely to develop variceal bleeding after discharge.

Conclusion: A significant proportion of cirrhotic patients had poor adherence to NSBBs during their hospitalizations. Further studies should explore how to improve the patient's adherence to NSBBs.
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http://dx.doi.org/10.2147/IJGM.S326192DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8520848PMC
October 2021

Metabolomic Detection Between Pancreatic Cancer and Liver Metastasis Nude Mouse Models Constructed by Using the PANC1-KAI1/CD Cell Line.

Technol Cancer Res Treat 2021 Jan-Dec;20:15330338211045204

General Hospital of Northern Theater Command of China Medical University, Shenyang, Liaoning Province, P.R. China.

Pancreatic cancer (PC) has a poor prognosis and is prone to liver metastasis. The KAI1/CD gene inhibits PC metastasis. This study aimed to explore differential metabolites and enrich the pathways in serum samples between PC and liver metastasis nude mouse models stably expressing KAI1/CD. KAI1/CD-PLV-EF1α-MCS-IRES-Puro vector and PANC1 cell line stably expressing KAI1/CD were constructed for the first time. This cell line was used to construct 3 PC nude mouse models and 3 liver metastasis nude mouse models. The different metabolites and Kyoto encyclopedia of genes and genomes (KEGG) and human metabolome database (HMDB) enrichment pathways were analyzed using the serum samples of the 2 groups of nude mouse models on the basis of untargeted ultra-performance liquid chromatography-tandem mass spectrometry platform. KAI1/CD-PLV-EF1α-MCS-IRES-Puro vector and PANC1 cell line stably expressing KAI1/CD were constructed successfully, and all nude mouse models survived and developed cancers. Among the 1233 metabolites detected, 18 metabolites (9 upregulated and 9 downregulated) showed differences. In agreement with the literature data, the most significant differences between both groups were found in the levels of bile acids (taurocholic acid, chenodeoxycholic acid), glycine, prostaglandin E2, vitamin D, guanosine monophosphate, and inosine. Bile recreation, primary bile acid biosynthesis, and purine metabolism KEGG pathways and a series of HMDB pathways ( < .05) contained differential metabolites that may be associated with liver metastasis from PC. However, the importance of these metabolites on PC liver metastases remains to be elucidated. Our findings suggested that the metabolomic approach may be a useful method to detect potential biomarkers in PC.
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http://dx.doi.org/10.1177/15330338211045204DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8493323PMC
February 2022

Evolution of Nonmalignant Portal Vein Thrombosis in Liver Cirrhosis: A Pictorial Review.

Clin Transl Gastroenterol 2021 10 1;12(10):e00409. Epub 2021 Oct 1.

Liver Cirrhosis Study Group, Department of Gastroenterology, The General Hospital of Northern Theater Command (formerly General Hospital of Shenyang Military Area), Shenyang, China.

Portal vein thrombosis (PVT) is a common complication in liver cirrhosis, especially in advanced cirrhosis. It may be related to a higher risk of liver-related events and liver function deterioration. Imaging examinations can not only provide an accurate diagnosis of PVT, such as the extent of thrombus involvement and the degree of lumen occupied, but also identify the nature of thrombus (i.e., benign/malignant and acute/chronic). Evolution of PVT, mainly including development, recanalization, progression, stability, and recurrence, could also be assessed based on the imaging examinations. This article briefly reviews the pathophysiology, diagnosis, classification, and evolution of PVT with an emphasis on their computed tomography imaging features.
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http://dx.doi.org/10.14309/ctg.0000000000000409DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8483868PMC
October 2021

Pharmacotherapy for the Treatment of Gastric Antral Vascular Ectasia: A Narrative Review.

Adv Ther 2021 10 15;38(10):5065-5077. Epub 2021 Sep 15.

Department of Gastroenterology, General Hospital of Northern Theater Command (formerly General Hospital of Shenyang Military Area), No. 83 Wenhua Road, Shenyang, 110840, Liaoning, People's Republic of China.

Gastric antral vascular ectasia (GAVE) is an uncommon clinical entity leading to recurrent gastrointestinal bleeding. There is no consensus regarding treatment of GAVE. Endoscopic therapy is the preferred treatment option, but has a fairly high recurrence rate. Surgical resection can completely resolve GAVE, but is invasive with a relatively high risk of postoperative complications. Recently, the role of pharmacotherapy for GAVE has been recognized. However, the evidence is limited to scattered case reports or small case series. This review comprehensively summarizes the efficacy and side effects of drugs commonly used for the treatment of GAVE, including octreotide, cyproheptadine, cyclophosphamide, prednisolone, estrogen-progesterone, thalidomide, bevacizumab, and tranexamic acid.
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http://dx.doi.org/10.1007/s12325-021-01912-6DOI Listing
October 2021

Effect of Body Mass Index on the Prognosis of Liver Cirrhosis.

Front Nutr 2021 20;8:700132. Epub 2021 Aug 20.

Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command (formerly called General Hospital of Shenyang Military Area), Shenyang, China.

At present, the association of body mass index (BMI) with the prognosis of liver cirrhosis is controversial. Our retrospective study aimed to evaluate the impact of BMI on the outcome of liver cirrhosis. In the first part, long-term death was evaluated in 436 patients with cirrhosis and without malignancy from our prospectively established single-center database. In the second part, in-hospital death was evaluated in 379 patients with cirrhosis and with acute gastrointestinal bleeding (AGIB) from our retrospective multicenter study. BMI was calculated and categorized as underweight (BMI <18.5 kg/m), normal weight (18.5 ≤ BMI < 23.0 kg/m), and overweight/obese (BMI ≥ 23.0 kg/m). In the first part, Kaplan-Meier curve analyses demonstrated a significantly higher cumulative survival rate in the overweight/obese group than the normal weight group ( = 0.047). Cox regression analyses demonstrated that overweight/obesity was significantly associated with decreased long-term mortality compared with the normal weight group [hazard ratio (HR) = 0.635; 95% CI: 0.405-0.998; = 0.049] but not an independent predictor after adjusting for age, gender, and Child-Pugh score (HR = 0.758; 95%CI: 0.479-1.199; = 0.236). In the second part, Kaplan-Meier curve analyses demonstrated no significant difference in the cumulative survival rate between the overweight/obese and the normal weight groups ( = 0.094). Cox regression analyses also demonstrated that overweight/obesity was not significantly associated with in-hospital mortality compared with normal weight group (HR = 0.349; 95%CI: 0.096-1.269; = 0.110). In both of the two parts, the Kaplan-Meier curve analyses demonstrated no significant difference in the cumulative survival rate between underweight and normal weight groups. Overweight/obesity is modestly associated with long-term survival in patients with cirrhosis but not an independent prognostic predictor. There is little effect of overweight/obesity on the short-term survival of patients with cirrhosis and with AGIB.
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http://dx.doi.org/10.3389/fnut.2021.700132DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8417598PMC
August 2021
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