简介：Overthepastfewdecades,non-alcoholicfattyliverdisease(NAFLD)hasbecomeone,ifnotthemostcommon,causeofchronicliverdiseaseaffectingbothadultsandchildren.Theincreasingnumberofcasesatanearlyageisthemostworryingaspectofthispathology,sinceitprovidesmoretimeforitsevolution.Thespectrumofthisdiseaserangesfromliversteatosistosteatohepatitis,fibrosisandinsomecases,hepatocellularcarcinoma.NAFLDmaynotalwaysbeconsideredabenigndiseaseandhepatologistsmustbecautiousinthepresenceoffattyliver.Thisshouldprompttheuseoftheavailableexperimentalmodelstounderstandbetterthepathogenesisandtodeveloparationaltreatmentofadiseasethatisdangerouslyincreasing.Inspiteofthegrowingefforts,thepathogenesisofNAFLDisstillpoorlyunderstood.InthepresentarticlewereviewthemostrelevanthypothesesandevidencethataccountfortheprogressionofNAFLDtonon-alcoholicsteatohepatitis(NASH)andfibrosis.TheavailableinvitroandinvivoexperimentalmodelsofNASHarediscussedandrevisedintermsoftheirvalidityintranslationalstudies.Thesestudiesmustbeaimedatthediscoveryofthestillunknowntriggersormediatorsthatinducetheprogressionofhepaticinflammation,apoptosisandfibrosis.

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简介：Nonceliacglutensensitivity(NCGS)isasyndromecharacterizedbyacohortofsymptomsrelatedtotheingestionofgluten-containingfoodinsubjectswhoarenotaffectedbyceliacdisease(CD)orwheatallergy.Thepossibilityofsystemicmanifestationsinthisconditionhasbeensuggestedbysomereports.Inmostcasestheyarecharacterizedbyvaguesymptomssuchas‘foggymind’,headache,fatigue,jointandmusclepain,legorarmnumbnessevenifmorespecificcomplaintshavebeendescribed.NCGShasanimmune-relatedbackground.IndeedthereisastrongevidencethataselectiveactivationofinnateimmunitymaybethetriggerforNCGSinflammatoryresponse.ThemostcommonlyautoimmunedisordersassociatedtoNCGSareHashimotothyroiditis,dermatitisherpetiformis,psoriasisandrheumatologicdiseases.ThepredominanceofHashimotothyroiditisrepresentsaninterestingfinding,sinceithasbeenindirectlyconfirmedbyanItalianstudy,showingthatautoimmunethyroiddiseaseisariskfactorfortheevolutiontowardsNCGSinagroupofpatientswithminimalduodenalinflammation.Onthesebases,anautoimmunestigmainNCGSisstronglysupported;itcouldbeacharacteristicfeaturethatcouldhelpthediagnosisandbesimultaneouslymanaged.ApossibleneurologicalinvolvementhasbeenunderlinedbyNCGSassociationwithglutenataxia,glutenneuropathyandglutenencephalopathy.NCGSpatientsmayshowevenpsychiatricdiseasessuchasdepression,anxietyandpsychosis.Finally,alinkwithfunctionaldisorders(irritablebowelsyndromeandfibromyalgia)isatopicunderdiscussion.Inconclusion,thenoveltyofthismatterhasgeneratedanexpansionofliteraturedatawiththeunavoidableconsequencethatsomereportsareoftenbasedonlowlevelsofevidence.Therefore,onlystudiesperformedonlargesampleswiththeinclusionofcontrolgroupswillbeabletoclearlyestablishwhetherthelargeinformationfromtheliteratureregardingextra-intestinalNCGSmanifestationscouldbesupportedbyevidence-basedagreements.

简介：瞄准：评估影响多囊肝疾病的非侵略、侵略的治疗的结果的因素。方法：有到2006年6月的从1986年7月的完全的后续的病人的临床的文件的分析。结果：41个病人(男性，7；女性，34)，11.9年变老的47.8+/-，和5.7+/-6.7年后续，被学习。硷性磷酸酯酶(AP)举起(15%病人)与侵略治疗的要求被联系(信息技术，P=0.005)。信息技术率是更高的在比非征兆的病人征兆(65.4%对14.3%，P=0.002)，并且在拿神经质的代替治疗(HRT)的女人(P=0.001)。包囊复杂并发症(CC)是更经常的(22%)在征兆的病人组织(P=0.023)。有身体质量的病人索引(BMI)>(59%)25在它以后有一个趋势到复杂并发症(P=0.075)。腹的疼痛为信息技术(78%)是最普通的症状(56%)和指示。十九个病人(46%)要求了第一种信息技术：12开的开窗术()，4laparoscopic开窗术(LF)和有肝的切除术(FHR)的3开窗术。三要求了第二种信息技术，并且一个人要求了第三个过程。复杂并发症在32%由于第一种信息技术被发现(16.7%，LF25%，FHR66.7%)，并且在在66.7%的第二种信息技术(100%)。后续死亡率是0。结论：症状，提高的AP，和CC的存在与信息技术要求被联系。HRT与症状和信息技术要求的存在被联系。有BMI>的病人25有一个趋势产生信息技术复杂并发症。复杂并发症的比例在FHR和秒信息技术组是更高的。RS是更经常的在以后。

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简介：Superficialnon-ampullaryduodenalepithelialtumor(SNADET)isdefinedasasporadictumorthatisconfinedtothemucosaorsubmucosathatdoesnotarisefromVater’spapilla,anditincludesadenomaandadenocarcinoma.Recentdevelopmentsinendoscopictechnology,suchashigh-resolutionendoscopyandimage-enhancedendoscopy,mayincreasethechancesofdetectingSNADETlesions.However,becauseSNADETisrare,littleisknownaboutitspreoperativeendoscopicdiagnosis.TheuseofendoscopicresectionforSNADET,whichhasnoriskofmetastasis,isincreasing,buttheincidenceofcomplications,suchasperforation,issignificantlyhigherthaninanyotherpartofthedigestivetract.Apreoperativediagnosisisrequiredtodistinguishbetweenlesionsthatshouldbefollowedupandthosethatrequiretreatment.Retrospectivestudieshaverevealedcertainendoscopicfindingsthatsuggestmalignancy.Inrecentyears,severalnewimagingmodalitieshavebeendevelopedandexploredforrealtimediagnosisoftheselesiontypes.EstablishinganendoscopicdiagnostictooltodifferentiatebetweenadenomaandadenocarcinomainSNADETlesionsisrequiredtoselectthemostappropriatetreatment.ThisreviewdescribesthecurrentstateofknowledgeaboutpreoperativeendoscopicdiagnosisofSNADETs,suchasduodenaladenomaandduodenaladenocarcinoma.Newerendoscopictechniques,includingmagnifyingendoscopy,mayhelptoguidethesediagnostics,buttheiradditionaladvantagesremainunclear,andfurtherstudiesarerequiredtoclarifytheseissues.

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简介：AIM:Toinvestigatetheeffectsofthefreeradicalscavengerbis(1-hydroxy-2,2,6,6-tetramethyl-4-piperidinyl)decandioate(IAC)inthedextransodiumsulphate(DSS)experimentalmodelofulcerativecolitis.METHODS:ColitiswasinducedinSpragueDawleymaleratsbyadministrationof5%DSSindrinkingwater.IAC(30mg/kg,lipophilicorhydrophilicform)wasadministereddaily(orallyorip)for6duntilsacrifice.Colonicdamagewasassessedbymeansofindirect(DiseaseActivityIndexscore)anddirectmeasures(macroscopicandmicroscopicscores)andmyeloperoxidase(MPO)activity.NeutrophilinfiltrationwithinthetissueandglutathioneS-transferaseactivitywerealsoinvestigated.RESULTS:DSS-inducedcolitisimpairedbodyweightgainandmarkedlyincreasedallinflammatoryparameters.Six-daytreatmentwithlipophilicIACsignificantlyreducedintestinaldamagecausedbyinflammation,inducedadown-regulationinMPOactivity(0.72±0.12and0.45±0.12withlipophilicIACpoandip,respectively,vs1.10±0.27inuntreatedDSScolitisanimals)andminimizedDSS-inducedneutrophilinfiltration,whilehydrophilicIACadministeredorallydidnotameliorateDSS-induceddamage.CONCLUSION:TheseresultssupportthehypothesisthatreactiveoxygenmetabolitescontributetoinflammationandthattheradicalscavengerIAChastherapeuticpotentialininflammatoryboweldisease.

简介：AIM:TotestthehypothesisthatE-cadheringene(CDH1)C-160Apromotervariantgenotypeisassociatedwithanincreasedriskfordevelopinggastriccancer.METHODS:Inthispopulation-basedcase-controlstudyofgastriccancerinJiangsuProvince,China,weperformedpolymerasechainreaction-restrictionfragmentlengthpolymorphism(PCR-RFLP)togenotypetheC-160ApolymorphismofCDH1promoterin206non-cardiagastriccancerpatientsand261age-andsex-matchedbutunrelatedcancer-freecontrols.RESULTS:ThefrequenciesofgenotypesCC,CAandAAwere57.8%,36.4%and5.8%ingasfriccancercases,respectively,and58.2%,34.9%and6.9%incontrolsrespectively.ThedistributionsofCDH1genotypeswerenotsignificantlydifferentbetweengastriccancercasesandcontrols(P=0.87forgenotypefrequencyandP=0.92forallelefrequency).ComparedwiththeCCgenotype,theCAandAAgenotypeswerenotassociatedwithanincreasedriskfornon-cardiagastriccancer(adjustedoddsratios(OR)=1.15,and95%confidenceinterval(95%CI)=0.78-1.72forCAgenotype,andOR=0.90and95%CI=0.42-2.01forAAgenotype).CONCLUSION:E-cadheringeneC-160Apromoterpolymorphismmaynotplayamajorroleintheetiologyofnon-cardiagastriccancerinChinesepopulation.

简介：AIM：Toestablishaprognosticformulathatdistinguishesnon-hypervascularhepaticnodules（NHNs）withhigheraggressivenessfromlesshazardousone.METHODS：Seventy-threeNHNsweredetectedingadoliniumethoxybenzyldiethylene-triamine-pentaaceticacidmagneticresonanceimaging（Gd-EOB-DTPA-MRI）studyandconfirmedtochange2mmormoreinsizeand/ortogainhypervascularity.Allimageswereinterpretedindependentlybyanexperienced,board-certifiedabdominalradiologistandhepatologist;bothknewthatthepatientswereatriskforhepatocellularcarcinomadevelopmentbutwereblindedtotheclinicalinformation.AformulapredictingNHNdestinywasdevelopedusingageneralizedestimatingequationmodelwiththirteenexplanatoryvariables：age,gender,backgroundliverdiseases,Child-Pughclass,NHNdiameter,T1-weightedimaging/T2-weightedimagingdetectability,fatdeposition,lowersignalintensityinarterialphase,lowersignalintensityinequilibriumphase,α-fetoprotein,des-γ-carboxyprothrombin,α-fetoprotein-L3,andcoexistenceofclassicalhepatocellularcarcinoma.Theaccuracyoftheformulawasvalidatedinbootstrapsamplesthatwerecreatedbyresamplingof1000iterations.RESULTS：Duringamedianfollow-upperiodof504d,73NHNswithamediandiameterof9mm（interquartilerange：8-12mm）greworshrankby68.5%（fiftynodules）or20.5%（fifteennodules）,respectively,whereashypervascularitydevelopedin38.4%（twentyeightnodules）.Inthefifteenshranknodules,twelvenodulesdisappeared,while11.0%（eightnodules）werestableinsizebutacquiredvascularity.AgeneralizedestimatingequationanalysisselectedfiveexplanatoriesfromthethirteenvariablesassignificantfactorstopredictNHNprogression.Theestimatedregressioncoefficientswere0.36forage,6.51forlowersignalintensityinarterialphase,8.70or6.03forpositivityofhepatitisBvirusorhepatitisCvirus,9.37fordes-γ-carboxyprothrombin,and-4.05forfatdeposition.Aformulaincorpora