Digestive Tract Diseases Research Articles

Взаимосвязь семьи и семейных отношений с заболеванием желудочно-кишечного тракта у детей 8-12 лет

The article represents the results of studying family and family relations of children suffering from functional dyspepsia. The development of children’s personality is influenced by a lot of factors, including the nature of family relationships and somatic health status of a child. The statistical and qualitative analysis of the received results indicates interrelation of family adaptation, family unity and the status of a family with a digestive tract disease (functional dyspepsia). The studies prove the need for psychocorrecting work with children suffering from functional dyspepsia aimed to harmonize social and psychological profile taking into account its features revealed.

Survey of Plant Species of Medical Importance to Treat Digestive Tract Diseases in Tabuk Region, Saudi Arabia

Survey of Plant Species of Medical Importance to Treat Digestive Tract Diseases in Tabuk Region, Saudi Arabia

In-vitro toxicity of carbon nanotube/polylysine colloids to colon cancer cells.

Single-walled carbon nanotubes (SWCNTs) are thoroughly purified and dispersed in an aqueous solution of high molecular weight poly-L-lysine (pLlys). Human intestinal epithelial Caco-2/TC7 cells are incubated with the SWCNT dispersions in pLlys, and their effects on cell viability are studied by image flow cytometry. No significant changes are observed in the cell culture wells up to pLlys concentrations of 10 μg ml-1. However, high mortality is detected at pLlys concentrations of 100 μg ml-1. The presence of oxygen-free SWCNTs does not modify the effects of pLlys on cell cultures at any of the tested concentrations (≤1 μg ml-1). In addition, SWCNTs having an 8 wt.% of surface oxygen are tested with identical results. Thus, purified SWCNTs, even bearing oxygen functional groups, act as inert particles in the cell culture medium. This result supports the applicability of SWCNTs as carriers in pharmacological formulations against digestive tract diseases.

Changes in the Disease Spectrum of Hospitalized Children in a County Hospital of China

Introduction: Considering the present situation of disease spectrum changes, it is very important to understand the changes of disease in primary settings, to find out the feature of disease area, to direct the decision making so as to allocate the medical resources accordingly. The objectives of this study were to understand the changing trends in disease spectrum and mortality rate of children hospitalised in the department of paediatrics in Shenmu hospital, and to provide scientific basis for the future medical care and prevention of childhood diseases.Material and Methods: A retrospective statistical analysis was done using the data regarding hospitalization of children in Shenmu County. The study lasted fifteen years, from January 1998 to December, 2012.Results: A total of 23,448 children were hospitalized below the age of 14. Majority of the patients were younger than three years old constituting 78.8% (which included age 1 month~1 year 57.2%). The average number of days of hospitalization was 6~8 days, with a median time of six days. The leading cause of hospitalization was respiratory disease. Other major illnesses causing hospitalization included: infectious diseases, digestive tract diseases, neonatal diseases and nervous system diseases. A total of 144 children died during this period. The top three causes of death were: asphyxia, premature birth and neonatal respiratory distress syndrome.Conclusion: The changing trends in paediatric disease hospitalisations and mortality rate over the 15 years are significant for clinicians so as to prevent and minimise such diseases by appropriate preventive and therapeutic options to contain them.J Nepal Paediatr Soc 2016;36(1):19-23

Low mutation percentage of KRAS and BRAF genes in Brazilian anal tumors.

Anal cancer is a rare type of digestive tract disease, which has had a crescent incidence in a number of regions. Carcinomas are most frequently found, with squamous cell carcinoma (SCC) comprising ~95% of all anal tumors. The major risk factor for development of this type of tumor is human papillomavirus (HPV) infection. However, previous studies have identified patients with anal cancer that are HPV‑/p16‑and observed that they have a poorer outcome compared with HPV+/p16+ patients. This suggests that molecular profile may drive anal cancer progression. The aim of the present study was to evaluate the mutational status of two important oncogenes, KRAS and BRAF, in a series of anal cancer lesions. Resected tumors of the anal canal (n=43) were evaluated, nine of these were high‑grade squamous intra‑epithelial lesion cases (HSIL), 11were adenocarcinomas, and 23SCCs. Direct sequencing of KRAS proto‑oncogene, GTPase (KRAS; codons12and13) and B‑Raf proto‑oncogene, serine/threonine kinase (BRAF; codon600) was performed and associated with patient clinicopathological and molecular features. There was a trend of poorer prognosis of adenocarcinoma compared with HSIL and SCC. Analysis indicated one SCC patient (2.3%) exhibited a KRAS p.G13D mutation, and one adenocarcinoma patient (2.3%) exhibited a BRAF p.V600E mutation. It was observed that, these mutations are rare in anal tumors, and certain patients may be at a disadvantage using targeted therapies based on KRAS and BRAF mutational status. As there is a low mutation percentage in SCCs, adenocarcinomas and HSIL, there may exist other underlying molecular alterations that result in anal cancer development, which require further elucidation.

Analysis of the risk factors of postoperative complications after endoscopic submucosal dissection

Objective To investigate the risk factors of postoperative complications of delayed hemorrhage, perforation and digestive tract stenosis after endoscopic submucosal dissection (ESD). Methods The complete data of 793 patients with digestive tract disease who underwent the endoscopic submucosal dissection in the Department of Digestive Surgery in our hospital from January 2011 to December 2014 were retrospectively analyzed. All of the patients were divided into delayed hemorrhage group (n=67) and non-bleeding group (n=726); perforation group (n=47) and non-perforation group (n=746); and digestive tract stenosis group (n=38) and non- stenosis group (n=755). The clinical basic data, lesion related data, and operation related data were independent risk factor and analyzed by single factor analysis and Logistic multiple factor regression analysis. Results The incidence of delayed bleeding, perforation and stenosis in patients with ESD were 8.45%, 5.93%, and 4.79%, respectively. The results of single factor analysis: the risk factors for delayed bleeding were long-term use of anticoagulant drugs, gastric sinus disease, lesion diameter, and lesion excision (P lesions graded resection > long-term use of anticoagulants > lesion diameter (≥5 mm). The risk ranking of risk factors for perforation was operation time (≥90 mm) > lesion diameter (≥5 mm). The risk ranking of risk factors for digestive tract stenosis was esophageal lesion > lesion diameter (≥5 mm) > lesions depth to the muscularis propria. Conclusions For long-term anticoagulation, gastric antrum and fractional resection lesions of patients should pay attention to delayed bleeding. Patients with long operation time are easy to cause postoperative perforation. For long-term anticoagulation, gastric antrum and fractional resection lesions of patients should pay attention to delayed bleeding. Key words: Endoscopy, digestive system; Gastric mucosa/SU; Postoperative complications; Risk factors

Overview of point-of-care abdominal ultrasound in emergency and critical care.

Point-of-care abdominal ultrasound (US), which is performed by clinicians at bedside, is increasingly being used to evaluate clinical manifestations, to facilitate accurate diagnoses, and to assist procedures in emergency and critical care. Methods for the assessment of acute abdominal pain with point-of-care US must be developed according to accumulated evidence in each abdominal region. To detect hemoperitoneum, the methodology of a focused assessment with sonography for a trauma examination may also be an option in non-trauma patients. For the assessment of systemic hypoperfusion and renal dysfunction, point-of-care renal Doppler US may be an option. Utilization of point-of-care US is also considered in order to detect abdominal and pelvic lesions. It is particularly useful for the detection of gallstones and the diagnosis of acute cholecystitis. Point-of-case US is justified as the initial imaging modality for the diagnosis of ureterolithiasis and the assessment of pyelonephritis. It can be used with great accuracy to detect the presence of abdominal aortic aneurysm in symptomatic patients. It may also be useful for the diagnoses of digestive tract diseases such as appendicitis, small bowel obstruction, and gastrointestinal perforation. Additionally, point-of-care US can be a modality for assisting procedures. Paracentesis under US guidance has been shown to improve patient care. US appears to be a potential modality to verify the placement of the gastric tube. The estimation of the amount of urine with bladder US can lead to an increased success rate in small children. US-guided catheterization with transrectal pressure appears to be useful in some male patients in whom standard urethral catheterization is difficult. Although a greater accumulation of evidences is needed in some fields, point-of-care abdominal US is a promising modality to improve patient care in emergency and critical care settings.

A Disease of the Digestive Tract: Esophageal Melanosis

A Disease of the Digestive Tract: Esophageal Melanosis

Dietary inflammatory index and ovarian cancer risk in a large Italian case-control study.

While inflammation has been shown to play an important etiologic role in ovarian carcinogenesis, little is known about the association between inflammatory properties of diet and ovarian cancer risk. We explored the association between the dietary inflammatory index (DII) and ovarian cancer risk in a multicentric Italian case-control study conducted between 1992 and 1999. Cases were 1,031 women with incident, histologically confirmed ovarian cancer from four areas in Italy. Controls were 2,411 women admitted to the same network of hospitals as the cases for acute, non-malignant and non-gynecological conditions, unrelated to hormonal or digestive-tract diseases or committed to long-term modifications of diet. DII scores were computed based on 31 nutrients and food items assessed using a reproducible and validated 78-item food frequency questionnaire. Odds ratios (ORs) were estimated through logistic regression models adjusting for age, total energy intake and other recognized confounding factors. Subjects in the highest quartile of DII scores (i.e., with the most pro-inflammatory diets) had a higher risk of ovarian cancer compared to subjects in the lowest quartile (i.e., with an anti-inflammatory diet) (ORQuartile4vs1 1.47, 95% confidence interval, CI, 1.07, 2.01; p trend=0.009). When analyses were carried out using continuous DII, a significant positive association with ovarian cancer was observed: the OR for one-unit increment in DII score (corresponding to approximately 8% of its range in the current study, +6.0 to -6.20) was 1.08 (95% CI 1.02, 1.14). A pro-inflammatory diet as indicated by higher DII scores is associated with increased ovarian cancer risk.

Differentially expressed microRNA identification and target gene function analysis in starvation-induced autophagy of AR42J pancreatic acinar cells.

Acute pancreatitis (AP) is a common acute digestive tract disease, with increased morbidity and mortality, and an unclear pathogenesis. Trypsinogen activation in pancreatic acinar cells may be the primary mechanism underlying the development of AP. Previous studies reported that autophagy participates in the formation of acinar cell vacuoles in AP and in the process of trypsinogen activation as an important cause of AP. Furthermore, microRNAs (miRNAs) maintain the autophagy process by regulating the expression of autophagy‑associated genes. In the present study, an in vitro pancreatic acinar cell autophagy model was established using the AR42J starvation‑induced pancreatic acinar cell line. Twenty differentially expressed microRNAs were identified using miRNA microarray. Bioinformatics analysis was used to predict the target genes of miRNAs and analyze the functions of differentially expressed miRNAs. The results demonstrated that only the downregulated miRNA rno‑miR‑148b‑3p predicted 593target genes with a statistical significance (P<0.05), from which 10genes were autophagy‑associated. The results of gene ontology and pathway analyses demonstrated that the target genes of miRNAs were enriched in the Response to insulin stimulus, Regulation of cell death and the Insulin signaling pathways (P<0.05, FDR<0.05). In addition, protein‑protein interaction network analysis demonstrated a widespread interaction among the 593target genes. The results of the present study may provide novel targets for research on the mechanisms of autophagy-promoted AP and AP treatment.

Evaluation of the diagnostic value of 64 simultaneously measured autoantibodies for early detection of gastric cancer.

Autoantibodies against tumor-associated antigens (TAAs) have been suggested as biomarkers for early detection of gastric cancer. However, studies that systematically assess the diagnostic performance of a large number of autoantibodies are rare. Here, we used bead-based multiplex serology to simultaneously measure autoantibody responses against 64 candidate TAAs in serum samples from 329 gastric cancer patients, 321 healthy controls and 124 participants with other diseases of the upper digestive tract. At 98% specificity, sensitivities for the 64 tested autoantibodies ranged from 0–12% in the training set and a combination of autoantibodies against five TAAs (MAGEA4 + CTAG1 + TP53 + ERBB2_C + SDCCAG8) was able to detect 32% of the gastric cancer patients at a specificity of 87% in the validation set. Sensitivities for early and late stage gastric cancers were similar, while chronic atrophic gastritis, a precursor lesion of gastric cancer, was not detectable. However, the 5-marker combination also detected 26% of the esophageal cancer patients. In conclusion, the tested autoantibodies and combinations alone did not reach sufficient sensitivity for gastric cancer screening. Nevertheless, some autoantibodies, such as anti-MAGEA4, anti-CTAG1 or anti-TP53 and their combinations could possibly contribute to the development of cancer early detection tests (not necessarily restricted to gastric cancer) when being combined with other markers.

Utility of different serum fibrosis markers in diagnosing patients with chronic pancreatitis and pancreatic adenocarcinoma.

To estimate the levels of serum cytokines in chronic pancreatitis (CP) and pancreatic ductal adenocarcinoma (PDAC) patients in order to evaluate their usefulness as possible biomarkers. The study included 167 Caucasian patients: 74 with PDAC (28 men and 42 women, aged 30-88 years), 78 with CP (50 men and 21 women, aged 20-79 years) and 15 age-matched healthy controls hospitalized in the Department of Digestive Tract Diseases, Medical University of Lodz, Poland between 2006 and 2013. Serum MCP-1, transforming growth factor (TGF)-β1, HA and s-Fr were measured in patients with CP (n = 78), PDAC (n = 74) and healthy controls (n = 15) using ELISA (Corgenix United Kingdom Ltd R and D Systems). The severity of CP was assessed according to the Cambridge classification. Both patients with CP and PDAC had a significantly higher mean TGF-β1 serum level (1066 ± 582 and 888 ± 356 vs 264 ± 93, P < 0.0001), mean s-Fr (2.42 ± 1.385 and 2.41 ± 1.275 vs 0.6 ± 0.370, P < 0.0001) and mean HA (199 ± 254 and 270 ± 358 vs 40 ± 26, P < 0.0001) compared to controls. There was no difference in mean MCP-1 between all the groups. There were no significant differences in any cytokine levels between the PC and PDAC groups. No significant differences between serum cytokines depending on age, gender or smoking status were found in CP patients. Mean s-Fr concentration was significantly higher in CP, lasting longer than 5 years compared to those with a shorter disease clinical course (2.639 ± 1.125 vs 1.870 ± 0.970, P < 0.03). There was no correlation between tumor size, localization or TNM classification and serum TGF-β1, MCP-1, s-Fr and HA levels in patients with PDAC. No significant differences between cytokines depending on diabetes presence in CP were found. Nevertheless, mean serum TGF-β1 concentration in PDAC patients was higher in those with diabetes compared to the remaining group (986 vs 839, P = 0.043). Serum TGF-β1, s-Fr and HA may be considered additional diagnostic markers of CP and PDAC. TGF-β1 may be useful to predict endocrine insufficiency in PDAC.

Randomized controlled study of the safety and efficacy of nitrous oxide-sedated endoscopic ultrasound-guided fine needle aspiration for digestive tract diseases

AIMTo evaluate the efficacy and safety of nitrous oxide-sedated endoscopic ultrasound-guided fine needle aspiration.METHODSEnrolled patients were divided randomly into an experimental group (inhalation of nitrous oxide) and a control group (inhalation of pure oxygen) and heart rate, blood oxygen saturation, blood pressure, electrocardiogram (ECG) changes, and the occurrence of complications were monitored and recorded. All patients and physicians completed satisfaction questionnaires about the examination and scored the process using a visual analog scale.RESULTSThere was no significant difference in heart rate, blood oxygen saturation, blood pressure, ECG changes, or complication rate between the two groups of patients (P > 0.05). However, patient and physician satisfaction were both significantly higher in the nitrous oxide compared with the control group (P < 0.05).CONCLUSIONNitrous oxide-sedation is a safe and effective option for patients undergoing endoscopic ultrasound-guided fine needle aspiration.

Septic Phlebitis: A Dangerous Complication of Diverticulitis

Colonic diverticulitis is an inflammation of the colon due to microperforation of a diverticulum, a sac-like protrusion of the colonic wall. This digestive tract disease is most common among the elderly people and affects predominantly the distal portion of the colon (sigmoid and descending). Pericolonic abscess, fistula formation, perforation, luminal obstruction, and peritonitis are well-known complications of diverticulitis. One of the most rare fistulas is enterovascular, which is a communication between a blood vessel and adjacent bowel. An uncommon complication and threatening condition of perforated diverticula is septic phlebitis, in which perforation spreads to the mesentery and erodes a blood vessel. We report a case of septic phlebitis due to enterovascular fistula. This is the case of a 79 year-old female, Latin American, past medical history of diverticulosis, arterial hypertension, and lumbar disk herniation who presented with low back pain, abdominal pain, fever, and nausea; she was treated symptomatically and discharged home from a hospital of the metropolitan area. She returned due to persistence of symptoms and multiple episodes of bright red blood per rectum. On examination, patient was acutely ill with positive digital rectal exam for blood. She was admitted and placed NPO with high dose of proton pump inhibitors plus antibiotic therapy. Abdominopelvic CT scan with IV contrast was performed which showed acute sigmoid diverticulitis with abscess formation, nodular liver appearance, and left portal vein thrombosis. Blood cultures were done and showed anaerobic gram-negative bacilli consistent with Porphyromonas spp. During hospitalization, patient developed septic shock and acute respiratory failure that required vasopressor therapy and intubation, respectively. Abdominopelvic CT with PO and IV contrast was repeated which showed portal venous thrombosis with sigmoid/inferior mesenteric vein fistula. Bowel rest was given and total parenteral nutrition was started. Patient was given intravenous fluids and broadspectrum antibiotics; end colectomy with Hartmann's pouch and partial colectomy was done with significant improvement of symptoms. Patient was discharged home to complete physical therapy rehabilitation. Septic phlebitis of the inferior mesenteric vein is an unusual complication of diverticular disease. History, physical examination, and radiographic imaging are helpful in identifying this entity. Prompt radiologic imaging is detrimental to the diagnosis, treatment, and management of abdominal pathology. Surgical intervention in a rapidly manner can be lifesaving. Early diagnosis and treatment should be emergent due to high-risk mortality from this complication.Figure 1Figure 2Figure 3

Risk factors associated with severe influenza virus infections in hospitalized children during the 2013 to 2014 season.

An outbreak of influenza virus infection occurred in Taiwan from October 2013 to May 2014. We conducted a clinical study to identify risk factors associated with severe influenza virus infections in children. During the outbreak period, data from 110 hospitalized children with influenza virus infection were collected. We analyzed the data, the need for intensive care, and patient outcome to identify clinical features and risk factors of severe infections, defined as the need of intensive care. Of the 110 inpatients, there were 57 male and 53 female patients; the median age was 2.6 (interquartile range, 1.0-6.3) years. Nineteen patients required intensive care and two patients died. Children who were underweight (p=0.01) or those with neuromuscular disease (p=0.007) and digestive tract disease (p=0.03) were prone to severe infection. Occurrence of seizure (p=0.004), conscious disturbance (p=0.02), or low oxygen saturation at admission (p=0.04) predicted the need for intensive care. Higher initial absolute neutrophil count (p=0.02) and patch or pleural effusion on chest X-ray examination (p=0.02) were associated with severe infection. In the multivariable analysis, digestive tract disease [p=0.03; adjusted odds ratio (OR), 12.37; 95% confidence interval (CI), 1.28-119.43], seizure (p=0.001; adjusted OR, 49.54; 95% CI, 4.61-532.76) and conscious disturbance (p=0.006; adjusted OR, 131.61; 95% CI, 4.18-4141.64) were most significantly associated with severe influenza virus infection. Close monitoring of the important risk factors including underlying digestive tract diseases, seizure attack and conscious disturbance were recommended during the influenza season.

Saliency based ulcer detection for wireless capsule endoscopy diagnosis.

Ulcer is one of the most common symptoms of many serious diseases in the human digestive tract. Especially for the ulcers in the small bowel where other procedures cannot adequately visualize, wireless capsule endoscopy (WCE) is increasingly being used in the diagnosis and clinical management. Because WCE generates large amount of images from the whole process of inspection, computer-aided detection of ulcer is considered an indispensable relief to clinicians. In this paper, a two-staged fully automated computer-aided detection system is proposed to detect ulcer from WCE images. In the first stage, we propose an effective saliency detection method based on multi-level superpixel representation to outline the ulcer candidates. To find the perceptually and semantically meaningful salient regions, we first segment the image into multi-level superpixel segmentations. Each level corresponds to different initial region sizes of the superpixels. Then we evaluate the corresponding saliency according to the color and texture features in superpixel region of each level. In the end, we fuse the saliency maps from all levels together to obtain the final saliency map. In the second stage, we apply the obtained saliency map to better encode the image features for the ulcer image recognition tasks. Because the ulcer mainly corresponds to the saliency region, we propose a saliency max-pooling method integrated with the Locality-constrained Linear Coding (LLC) method to characterize the images. Experiment results achieve promising 92.65% accuracy and 94.12% sensitivity, validating the effectiveness of the proposed method. Moreover, the comparison results show that our detection system outperforms the state-of-the-art methods on the ulcer classification task.

COMORBID CONDITIONS IN PRIMARY OBESITY AS A POSSIBLEPREDICTOR OF METABOLIC SYNDROME IN CHILDREN

Obesity and its attendant neurohormonal regulatory violations and play a leading role in the development and progression of insulin resistance (IR), which is the principal risk factors of the metabolic syndrome (MS). Identifying predictors of MS in childhood is of great clinical importance, since the adequate treatment of this condition is reversible. The aim of the study was to investigate the clinical manifestations, metabolic and hormonal disorders in primary obesity, depending on the presence of comorbid conditions in children. In the endocrinology department at Children's Hospital №1 of St. Petersburg in 2008-2011 observed 20 children aged 8 to 17 years (boys - 14, girls - 6) with primary obesity. The survey included children study of heredity; objective examination of the analysis of physical development, evaluation of blood pressure; study hemogram, biochemical analysis of blood parameters and hormonal status; the results of instrumental studies of the cardiovascular system and digestive tract. Patients have formed two groups: 13 children with primary obesity without comorbid conditions (group 1) and 7 children with complicated comorbidity primary form of obesity (group 2). Isolation of children in Group 2 of the total weight of obese patients was conducted taking into account the identification of IR. Studies have shown that the complicated form of primary comorbidity of obesity was more common in males and is characterized by hemodynamic and hormonal changes indicating a possible risk of developing MS. At the same time, the expression of lipid metabolism, the frequency of functional pathology of the cardiovascular system and digestive tract diseases did not differ among children in group 1 and group 2.

Endoscopic findings and psychometric abnormalities: what is the relationship in upper endoscopic outpatients?

Psychological disorders are often associated with diseases of the upper digestive tract. Although emotions can influence gastrointestinal function in healthy individuals, psychological setting in upper gastrointestinal patients are unclear. We evaluate the psychological alterations prevalence in outpatients submitted to upper endoscopy. A total of 130 patients (50 males and 80 females; mean age 54±17 years) submitted to upper gastrointestinal endoscopy, were enrolled over the period May 2009 - September 2010. Subjects were asked to complete questionnaires before endoscopic examination. Alexithymia, anxiety, depression and coping style were assessed using the Toronto Alexithymia Scale, Spielberger Trait Anxiety Inventory, Beck Depression Inventory and Coping Inventory for Stressful Situations, respectively. Coping impairment, Alexithymia, Anxiety and Depression were found respectively in 80.3%, 25.4%, 24.6% and 17.2%, often in association. Task-oriented, emotion-oriented and avoidance-oriented alterations were found in 41.8%, 40% and 30.6%, respectively. No correlations were demonstrated between diagnosis of upper gastrointestinal disease and psychometric results. In our study, a high prevalence of psychometric alterations in gastrointestinal outpatients was unconnected with endoscopic findings, especially considering coping style alterations. This aspect should be taken into account in patients management and a long-term follow-up should clarify a possible role of these factors in patients prognosis and compliance.

Sequence Comparison and Phylogenetic Analysis of Several Emerging Porcine Bocaviruses and a Proposal Regarding Nomenclature

The first Bocavirus (bovine parvovirus 1, BPV1) was discovered in calves with diarrhea in 1961. Since then, a series of bocaviruses have emerged in many animals including dogs, humans, swine, gorillas, California sea lions, and cats. These viruses are associated with digestive tract and respiratory tract diseases. Several emerging porcine bocaviruses (PBoVs) have been reported on pig farms in the past four years. However, the nomenclature used to describe these viruses has been confused and irregular. The goal of this study was to compare the sequences of these emerging PBoVs, perform phylogenetic analysis, and present a proposal regarding their nomenclature. Genome sequences of some PBoVs and other bocaviruses were downloaded from the GenBank database. Sequence similarity, sequence mutation, deletion, or insertion, and sequence recombination among reference bocaviruses were obtained using DNAStar software, and its genetic evolution was determined using MEGA 5.1 software. According to the differences in their sequences and genome structure, the nomenclature of PBoVs was proposed and they were divided into four different species (from PBoV1 to PBoV4) and many different genotypes. Among them, both PBoV1 and PBoV2 had two genotypes, PBoV1-a and PBoV1-b and PBoV2-a and PBoV2-a and PBoV2-b, respectively. PBoV3 included three genotypes, PBoV3-a, PBoV3-b and PBoV3-c, respectively. In addition, for PBoV4, there were at least eight genotypes (PBoV4-a to PBoV4-h) in intraspecies. In conclusion, PBoVs were highly genetically diversified. The proposed nomenclature of PBoVs was used in the present studies, it could help us to better understand and standardize the nomenclature of PBoVs.

New endoscopic ultrasound techniques for digestive tract diseases: A comprehensive review.

Endoscopic ultrasound (EUS) is one of the most important modalities for the diagnosis of digestive tract diseases. EUS has been evolving ever since it was introduced. New techniques such as elastography and contrast enhancement have emerged, increasing the accuracy, sensitivity and specificity of EUS for the diagnosis of digestive tract diseases including pancreatic masses and lymphadenopathy. EUS-elastography evaluates tissue elasticity and therefore, can be used to differentiate various lesions. Contrast-enhanced EUS can distinguish benign from malignant pancreatic lesions and lymphadenopathy using the intravenous injection of contrast agents. This review discusses the principles and types of these new techniques, as well as their clinical applications and limitations.