Clin Gastroenterology H:射频消融术后Barrett食管复发的相关因素

2019-01-11 MedSci MedSci原创

射频消融(RFA)是Barrett食管(BE)的有效治疗方法。然而,一些患者在完全根除肠上皮化生(CEIM)后也会出现Barrett食管的复发。因此,本项研究旨在探究RFA和CEIM之间的关系并调查了伴有或不伴有瘤形成的BE复发的发生率和相关因素。

背景与目的
射频消融(RFA)是Barrett食管(BE)的有效治疗方法。然而,一些患者在完全根除肠上皮化生(CEIM)后也会出现Barrett食管的复发。因此,本项研究旨在探究RFA和CEIM之间的关系并调查了伴有或不伴有瘤形成的BE复发的发生率和相关因素。

方法
研究人员对2005年至2016年经RFA进行BE治疗的退伍军人进行了一项回顾性队列研究,并进行了随访内镜检查。随访的终点为受试者出现BE复发或出现肿瘤瘤的形成或是死亡。通过回顾医疗记录确定CEIM,BE复发和与复发相关的因素。研究人员在CEIM后计算了BE复发的发生率,有和没有瘤形成,并使用Cox比例风险模型确定了预测因子。

结果
研究人员共分析了了430名接受过RFA治疗的BE退伍军人; 其中337名接受CEIM(78.4%)治疗。大多数是男性(98.6%),白人占83.7%,66.0%有基线发育不良。在CEIM患者中,98例患者(29.1%)在CEIM后复发了BE。基线发育不良(HR,1.71; 95%CI,1.03-2.84)和长段BE(HR,1.59; 95%CI,1.01-2.51)增加BE复发风险,而RFA治疗降低BE复发的风险(HR,0.19; 95%CI,0.05-0.68)。

结论
在本项回顾性研究中研究人员发现基线发育不良,长段BE和低容量RFA的治疗与CEIM后BE的复发相关联。

原始出处:

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    2019-03-01 许安
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    2019-12-22 ysjykql
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  5. 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  7. 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  8. 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  9. 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    2019-01-13 zhouqu_8
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尽管有报道称某些不可吸收的可发酵膳食产品(益生元)为结肠细菌提供营养基础,可以减轻肠功能失调患者的症状。但可发酵的低聚糖,二糖,单糖和多元醇(低FODMAP饮食)饮食也可以减轻功能性胃肠道疾病患者的症状,而目前对于这两者的治疗效果学界还没有一个统一的认识。

GUT: 术前给予5-HT4受体激动剂普卢卡必利可以减少术后肠梗阻的发生

通过刺激迷走神经(VNS)可以抑制手术引起的肠道炎症来预防术后肠梗阻(POI)。因此,研究人员在本篇文章中探究5-HT4受体(5-HT4R)激动剂普卢卡必利是否可以在小鼠和人体中模拟这种作用,减少术后肠梗阻。

IBD: 5标记预测模型可以鉴别肠结核与克罗恩病

肠结核(ITB)和克罗恩病(CD)之间的鉴别是临床工作中的一个挑战。本研究的目的是开发出一种可以在ITB和CD之间实行鉴别诊断的预测模型。

GUT:ω-3多不饱和脂肪酸补充剂可以增加人类肠道中产短链脂肪酸的微生物群

Omega-3多不饱和脂肪酸(PUFA)具有抗结直肠癌(CRC)发生的作用,而且肠道微生物群与结肠直肠癌发生有很大的关系。有文献报道,膳食中的ω-3 PUFA改变了与抗肿瘤活性相容的小鼠肠道微生物组成。因此,研究人员研究了ω-3 PUFA补充剂对中年健康志愿者粪便微生物组的影响。

J Gastroenterology:连锁彩色成像可以通过与周围胃肠化生组织的高颜色对比增强对早期胃癌的识别

连锁彩色成像(LCI)增加了早期胃癌的诊断率,这与紫色粘膜的特征性发现有关。早期胃癌的病变存在于慢性胃炎和周围粘膜区域。本研究的目的是使用LCI通过颜色差异和颜色成分值客观地表征这些病变组织。

J Gastroenterology: 肠道微生物群失调导致患者和小鼠急性胰腺炎的严重程度恶化

肠道与急性胰腺炎(AP)的发病机制有关,AP的感染性并发症通常与肠道细菌有关,但AP严重程度的肠道微生物群生态失调是否有关还不清楚,因此,本项研究旨在探明这种关系。