Journal of Digestive Diseases

Publisher: Chinese Society of Gastroenterology, Blackwell Publishing

Description

  • Impact factor
    1.85
  • 5-year impact
    1.81
  • Cited half-life
    2.80
  • Immediacy index
    0.28
  • Eigenfactor
    0.00
  • Article influence
    0.49
  • Other titles
    Journal of digestive diseases (Online)
  • ISSN
    1751-2980
  • OCLC
    123124871
  • Material type
    Document, Periodical, Internet resource
  • Document type
    Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details

Blackwell Publishing

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    • 'Blackwell Publishing' is an imprint of 'Wiley'
  • Classification
    ​ yellow

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: AimsCerebral venous thrombosis (CVT) is a rare but devastating complication of inflammatory bowel disease (IBD) that is estimated to occur in 1.3-6.4% of patients.MethodsA retrospective chart review was performed from April 2009 through May 2014 to identify IBD patients who had CVT diagnosed during their lifetime.ResultsSix IBD patients with cerebral venous thrombosis were identified. The patients presented with hours to days of headache and were found to have venous thrombosis. Four of the six patients had ulcerative colitis and two had Crohn's disease. All six patients were treated with therapeutic anticoagulation. There were two deaths; one patient became comatose and died despite anticoagulation while the other recovered well from the sinus thrombosis but died after a bowel perforation three weeks later.Conclusion This case series demonstrates the critical need for early recognition of neurologic symptoms in patients with IBD during disease flares. It is important to recognize the clinical signs in order to start anticoagulation expeditiously and improve neurological outcomes.
    Journal of Digestive Diseases 11/2014;
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    ABSTRACT: Objective Superficial colorectal tumors can be treated effectively by endoscopic submucosal dissection (ESD). Few data are available concerning ESD for residual or recurrent tumors after first endoscopic resection. This study was aimed to evaluate the efficacy of ESD for these lesions.Methods Twenty-eight patients with residual or recurrent colorectal superficial tumors were referred at the Kobe University Hospital for ESD. The therapeutic outcomes and the possible factors predictive of procedure difficulties for ESD were analyzed.ResultsIn total, 27/28 lesions (96%) were successfully treated. There was no related immediate complication. One patient had a delayed perforation treated surgically. En bloc R0 resection was possible in all the patients and curative resection in 26/28 patients (92.8%). One invasive cancer was treated surgically. More than one previous endoscopic resection was the only significant predictive factor for the ESD difficulty. None of the patients experienced recurrence after 22 months (range 3-41) follow-up.Conclusions This study showed that ESD allowed a high rate of en bloc resection for residual or locally recurrent colorectal tumors. Furthermore, these lesions should be treated by ESD as the first-line treatment.
    Journal of Digestive Diseases 11/2014;
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    ABSTRACT: Objective To evaluate risk factors and clinical outcomes for spontaneous rupture of pyogenic liver abscess.MethodsA total of 602 patients diagnosed with pyogenic liver abscess between January 2004 and July 2013 were retrospectively analyzed. Among the 602 patients, 23 patients experienced spontaneous rupture of pyogenic liver abscess.ResultsThe prevalence of spontaneous rupture of pyogenic liver abscess was 3.8%. In multivariate analysis, underlying liver cirrhosis (OR 4.65, P = 0.009), gas forming abscess (OR 3.65, P = 0.026), abscess size (≥6 cm) (OR 10.99, P = 0.002), and other septic metastasis (OR 1.71, P = 0.047) were risk factors for spontaneous rupture of pyogenic liver abscess. Regarding the site of rupture, 20 patients (87%) had localized rupture, specifically, sub-phrenic abscess 3 patients (13%), peri-hepatic abscess 10 patients (43.5%), localized peritoneal abscess 3 patients (13%) and empyema 4 patients (17.4%); and 3 patients (13%) had peritonitis. Ruptures resulting in peritonitis require urgent surgery, whereas localized rupture can be managed with percutaneous drainage in addition to appropriate antibiotics. The mortality rate of spontaneous rupture of pyogenic liver abscess was 4.3%.Conclusions Patients with cirrhosis, abscess size (≥6 cm), gas forming abscess, and other septic metastasis who have pyogenic liver abscess should be monitored closely and may need early intervention for spontaneous rupture of liver abscess.
    Journal of Digestive Diseases 11/2014;
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    ABSTRACT: OBJECTIVE We aimed to evaluate the efficacy of liver stiffness measurement (LSM) in predicting the presence and severity of esophgeal varices (EV) and its association with liver function in patients with liver cirrhosis.METHODS Medical records of 90 cirrhotic patients who underwent LSM by transient elastography were retrospectively reviewed. The relationship between LSM and the presence and severity of EV were evaluated by esophagogastroduodenoscopy (EGD) and multislice spiral computed tomography (CT). Another 25 healthy individuals were also included.RESULTSLSM was significantly associated with the grading of Child-Pugh score in cirrhotic patients, with the highest LSM in those at Child-Pugh C. Morever, patients with clinically decompensated cirrhosis had higher LSM than those with compensated cirrhosis (36.75 ± 16.54 kPa vs 17.65 ±10.87 kPa, P < 0.01). However, there was no significant difference in LSM value between patients with severe EV and those having no or non-severe EV determined by endoscopy (31.00 ± 18.44 kPa vs 28.18 ± 17.44 kPa) and multislice spiral CT (29.71 ± 18.39 kPa vs 24.90 ± 14.80 kPa), respectively. The diagnostic value of LSM for predicting severe EV was low in unselected cirrhotic patients. The presence of EV examined by EGD and multislice spiral CT was similar to each other.CONCLUSIONSLSM could serve to evaluate continuously the disease progression. However, its role in assessing the EV grades in advanced cirrhosis needs further confirmation. Multislice spiral CT can assess EV accurately and serve as an alternative to endoscopy in the assessment of portal hypertension.
    Journal of Digestive Diseases 11/2014;
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    ABSTRACT: Ulcerative colitis (UC) and Crohn's disease (CD) are the two major types of inflammatory bowel disease (IBD). Despite intensive study, it is still challenging because the precise aetiology and pathogenesis remains unclear. Studies showed IBD is associated with changes in the composition of intestinal microbiota, either as a cause or consequence of abnormal host immune response in genetic susceptible population. Two specific microorganisms (Mycobacterium avium subspecies paratuberculosis and E. coli) get more widely studied, but till now no single microorganism has been identified as the only pathogen. Genetic susceptibility data also suggest impaired handling of bacteria as well as an improper immune response to potential pathogens. The microbiota also provides new therapeutic methods. Fecal microbiota transplantation (FMT) may restore the balance of intestinal flora to supplement or optimize current therapies.
    Journal of Digestive Diseases 11/2014;
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    ABSTRACT: Objective To determine the long-term outcome after endoscopic submucosal dissection (ESD) in early gastric cancer (EGC) patients, we analyzed the results and the clinical outcomes after ESD of EGC according to the pathologic extent.MethodsESDs were performed in 309 EGCs of 280 patients. They were classified by pathological severity based on absolute indication (AI), expanded indication (EI) or beyond expanded indication (BEI). The therapeutic outcomes were compared among the three groups.ResultsThe complete resection rates were 96.4% in the AI-EGCs, 78.7% in the EI-EGCs, and 41.2% in the BEI-EGCs (P = 0.000). The en bloc resection rates were 97.6% in the AI-EGCs, 87.4% in the EI-EGCs, and 86.3% in the BEI-EGCs (P = 0.023). The 5-year tumor recurrence rates were 1.8% in the AI-group, 1.5% in the EI-group and 15.4% in the BEI-group (P = 0.000). The 5-year disease-specific survival rates were 100% in the AI-group, 100% in the EI-group, and 97.4% in the BEI-group (P = 0.088). The 5-year disease-free survival rates were 98.2% in the AI-group, 98.5% in the EI-group, and 84.6% in the BEI-group (P = 0.000).ConclusionsESD was effective and safe in the AI or EI-EGCs but a comparatively high rate of recurrence resulted from ESD in the BEI-EGCs. However, the long-term outcome of BEI-EGCs that did not receive additional surgery was better compared with the natural course of EGCs. Thus, ESD may be considered in specific BEI-EGCs patients at high-risk for surgery.
    Journal of Digestive Diseases 11/2014;
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    ABSTRACT: Pancreatic acinar cell necrosis and subsequent inflammatory response aggravate acute pancreatitis (AP), its underlying mechanism has not been fully elucidated. The tetraspanin CD9 was reported to mediate inflammatory signaling through regulating molecular organization at cell surface. This study aimed to investigate the role of CD9 during caerulein-induced experimental AP in mice.
    Journal of Digestive Diseases 10/2014;
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    ABSTRACT: Objective This study aimed to investigate the association of interleukin 28B (IL28B) single nucleotide polymorphisms (SNPs) with sustained response (SVR) in Chinese Han patients with chronic hepatitis C (CHC) and to analysz the correlations between IL28B SNPs and their demographic, virological and clinical characteristics.Methods Altogether 631 Chinese Han individuals including 297 CHC patients treated with pegylated interferon α plus ribavirin, 14 spontaneous hepatitis C virus (HCV) responders and 320 healthy controls were enrolled in the study. Two main SNPs of IL28B, rs12979860 and rs8099917, were genotyped using SNaPshot Multiplex assay. Associations between IL28B and treatment outcomes as well as demographic, virological and clinical characteristics of the patients were assessed by multivariate logistic regression.ResultsThe proportion of individuals with rs12979860 CC genotype or rs8099917 TT genotype was similar in healthy controls and CHC patients, although all spontaneous responders presented with these two genotypes. Patients with IL28B genotypes had a significantly high rate of rapid virological response (RVR) and SVR. Multivariate analysis revealed that IL28B SNP rs12979860 CC genotype (odds ratio [OR] 14.986, 95% confidence interval (CI) 5.056–44.422, P < 0.001), age <40 years (OR 0.239, 95% CI 0.600–0.954, P = 0.043) and non-G1 genotype (OR 0.122, 95% CI 0.015–0.985, P = 0.048) were independent predictors for SVR. And rs12979860 CC genotype (OR 25.754, 95% CI 3.315–200.101, P = 0.002) and rs8099917 TT genotype (OR 15.740, 95% CI 2.101–118.07, P < 0.001) were the predictors for RVR. rs12979860 CC genotype and rs8099917 TT genotype were more prevalent in patients with non-G1 genotype than those with G1 genotype.ConclusionsIL-28B rs12979860 CC genotype is a significant predictor for SVR and RVR in Chinese Han patients with CHC. Non-G1 HCV genotype is associated with favorable IL28B genotypes.
    Journal of Digestive Diseases 10/2014;
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    ABSTRACT: Objective Emerging evidences have shown that MiR-146a rs2910164 polymorphism might be associated with susceptibility to colorectal cancer. However, previous published studies failed to achieve a comprehensive conclusion. To address this issue, an updated meta-analysis was performed.MethodsA comprehensive electronic search was conducted in the following resources: PubMed, Embase,China BioMedicine (CBM),the Cochrane Library, and Google Scholar for eligible studies. Odds ratio (OR) and corresponding 95% confidence interval (CI) was used in the quantitative synthesis.ResultsThe database search identified 93 eligible studies, of which seven (comprising 2978 cases and 3576 controls) were included. The results indicate that there is no association between miR-146a rs2910164 polymorphism and colorectal cancer risk neither in the overall analysis nor among Asians when stratified on the basis of ethnicity.Conclusion The current study revealed that miR-146a G/C genetic polymorphism was not related to susceptibility to colorectal cancer.
    Journal of Digestive Diseases 10/2014;
  • Journal of Digestive Diseases 10/2014;
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    ABSTRACT: Background Inflammatory bowel diseases (IBD) are chronic diseases of unknown etiology, in which genetic factors contribute to the pathogenesis. The cornerstone of conventional treatment is glucocorticoid (GCs) whose sensitivity varies from patient to patient. Genes such as Multidrug resistance 1 (MDR1), NACHT leucine-rich-repeat protein 1 (NALP1), Glucocorticoid receptor (GR) and its co-chaperone FKBP5 participate in the anti-inflammatory mechanism of GCs. Variations of these genes are related to GCs response, and MDR1 polymorphisms are also associated with the susceptibility to IBD in Caucasians. However, whether similar relationships exist in Chinese population remains unclear. Thus, the aims of this research were to investigate the polymorphisms of these genes influence the response to GCs in Chinese IBD patients and the relationships between MDR1 and IBD susceptibility.Methods8 Single-nucleotide polymorphisms (SNPs) were selected and genotyped in 156 IBD patients treated with GCs and 223 healthy controls by MALDI-TOF MS assay. Patients were defined as GCs responders, dependants or resistants after one year follow up.ResultsThe CC genotypes of rs1128503 and rs1045642 in MDR1 gene were more frequent in GC dependants compared with the responsive patients of Crohn's Disease (CD) (OR 6.583, 95%CI 1.760-24.628, P=0.019 and OR 3.873, 95%CI 1.578-9.506, P=0.009, respectively). The G allele of MDR1 rs2032582 was less frequent among CD cases than in controls (OR 0.668, 95%CI 0.484-0.921, P=0.014). G allele carriers were also less likely to develop non-stricturing and non-penetrating CD (OR 0.661, 95% CI 0.462-0. 946, P=0.023) and ileocolonic CD (OR 0.669, 95%CI 0.472-0.948, P=0.024). There was no significant finding in Ulcerative Colitis ( UC).Conclusion Polymorphisms of MDR1 associated with GCs response and the predisposition to CD in Chinese population. More studies are needed to elucidate the functions of MDR1 polymorphisms in IBD and their role as genetic markers for GCs response.
    Journal of Digestive Diseases 10/2014;
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    ABSTRACT: GoalsTo explore the prevalence and risk factors of upper gastrointestinal bleeding(UGIB) in patients with severe acute pancreatitis(SAP).Background The treatment strategy of SAP changed greatly during the past decade, but the prevalence and risk factors of the complicated UGIB are still unclear.StudyFrom July 2006 to June 2010, retrospective data on 101 patients with SAP admitted to Changhai Hospital were collected. The prevalence and risk factors of UGIB were analyzed.ResultsEighteen patients(17.8%) developed UGIB. Thirteen patients received endosopic examinations which yielded 6 cases of acute gastric mucosal lesions(AGML), and 5 cases of peptic ulcer. The mortality rate of UGIB patients was much higher than that in non-UGIB patients (44.4% vs 10.8%, P=0.0021). Univariate analysis revealed that the risk factors for UGIB included acute physiology and chronic health evaluation II (APACHE II) score, computed tomography severity index, Ranson score, arterial blood pH values and oxygen pressures (PaO2), serum blood urea nitrogen and creatinine concentrations, prothrombin and activated partial thromboplastin times, platelet counts, the presence of shock, sepsis and organ failure other than UGIB, mechanical ventilation, heparinized continuous renal replacement therapy and total parental nutrition. By multivariate logistic regression analysis, APACHE II scores and CT severity indices(CTSI) were found to be significant risk factors, while PaO2 was the only protective factor.ConclusionsUGIB is a common complication with a poor prognosis due mainly to peptic ulcer and AGML. Patients with high APACHE II scores, and CTSI or low PaO2 should be considered to be at high risk for UGIB.
    Journal of Digestive Diseases 10/2014;
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    ABSTRACT: Objective To determine the association of dietary behaviors with refractory functional dyspepsia (RFD) and its subtypes in Chinese patients.Methods Medical records of patients admitted to the Outpatient Department of Gastroenterology of the Guangzhou First People's Hospital, Guangzhou Nansha Central Hospital, Guangdong No. 2 Provincial People's Hospital and Meizhou Municipal People's Hospital due to upper gastrointestinal (GI) symptoms from June to September 2012 were reviewed, and their characteristics were collected. Functional dyspepsia (FD) was diagnosed based on the Rome III criteria. Refractory FD (RFD) was defined as FD with continuous symptoms for at least 6 months that was unresponsive to at least two kinds of medications. Another 100 healthy volunteers were included as controls. Dietary behaviors of the participants were investigated using a questionnaire survey.ResultsOverall 1341 FD patients were enrolled in the study, including 327 RFD and 1014 non-RFD (NRFD). Unhealthy dietary behaviors were more prevalent in both RFD and NRFD than in healthy controls. Meal skipping, extra meals and taste preference to sweets and gas-producing foods were more commonly seen in RFD patients (P < 0.05). Compared with NRFD, RFD-epigastric pain syndrome (EPS) patients preferred spicy food, whereas those with postprandial distress syndrome (PDS) preferred sweets and gas-producing foods, and patients having a subtype of EPS plus PDS were found to have more meal skipping and extra meals. Logistic regression analysis showed meal skipping, extra meal and taste preference to sweets and gas-producing foods were the risk factors for RFD.Conclusion Unhealthy dietary behaviors, especially meal skipping, extra meals and taste preferences to sweets and gas-producing food were correlated with RFD and its subtypes.
    Journal of Digestive Diseases 10/2014;
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    ABSTRACT: The aim of this study was to evaluate the performances of three criteria, the Paris criteria, the revised diagnostic criteria and the simplified diagnostic scoring system for the diagnosis of primary biliary cirrhosis (PBC)-autoimmune hepatitis (AIH) overlap syndrome in Chinese patients.
    Journal of Digestive Diseases 09/2014;
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    ABSTRACT: Anti-TNF- α agents emerge as the hot spot in the last decade in treatment for inflammatory bowel disease (IBD). The effect of anti TNF- α agents is satisfactory, however, some patients failed to achieve clinical response due to these agents. Fortunately, in recent years, a great deal of invention and development has been made and multiple novel therapies have been developed in the treatment for IBD. In this study, we aim to introduce anti-TNF- α drugs as well as other novel treatment currently undergoing clinical trial for IBD.
    Journal of Digestive Diseases 09/2014;
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    ABSTRACT: OBJECTIVE To evaluate the eradication rates, side effects and the compliance of patients of a dual therapy with rabeprazol and amoxicillin in different doses as the first-line therapy in patients with Helicobacter pylori (H. pylori) infection.METHODS One hundred and twenty patients who were diagnosed with non-ulcer dyspepsia with H. pylori infection endoscopically were randomly assigned into two groups who were treated with amoxicillin 1 g thrice daily plus rabeprazole either 10 mg twice daily (the R10A group) or 20 mg twice daily (the R20A group) for 14 days. H. pylori eradication was evaluated by 13C-urea breath test (UBT) at 4–6 weeks after the completion of the treatment. The H. pylori eradication rate was analyzed by per-protocol (PP) and intention-to-treat (ITT) analyses together with 95% confidence interval (CI). And the patients’ compliance and side effects were recorded.RESULTSOverall, 117 patients (58 in the R10A group and 59 in the R20A group) completed the study, among whom 5 missed the UBT. H. pylori eradication was achieved in 89.8% of the R20A group by ITT analysis and 93.0% by PP analysis, which were significantly higher than those in the R10A group (75.9% and 80.0%, respectively, P < 0.05). Side effects including skin rash, abdominal discomfort, headache, insomnia and nausea were all mild and were treated symptomatically without the need to discontinue the treatment.CONCLUSION The modified dual therapy with a high dose of rabeprazole and amoxicillin is considered an effective and safe primary therapy for H. pylori eradication and could be recommended as the first line eradication regimen for certain patients.
    Journal of Digestive Diseases 09/2014;
  • Journal of Digestive Diseases 09/2014;
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    ABSTRACT: Objective Early cholecystectomy is the gold standard treatment for acute cholecystitis (AC). However, the acceptability and safety of this treatment strategy are by no means satisfactory. The aim of this study was to clarify the role of percutaneous transhepatic gallbladder aspiration (PTGBA) in the early management of AC in a single center.MethodsA total of 147 consecutive patients who were treated with PTGBA for AC between 2008 and 2012 were included in the study. The therapeutic outcomes and adverse events were evaluatedResultsA single PTGBA was sufficient in 96 (65.3%) patients with AC. Of the remaining 51 patients, 43 (29.3%) showed improvement after repetitive PTGBA or percutaneous transhepatic gallbladder drainage (PTGBD), while semi-emergent cholecystectomy was needed in only 8 patients. Although five patients experienced adverse events (intra-abdominal hemorrhage in two, bile leakage in two and gallbladder hemorrhage in one), no patients died of any treatment-related complications. Subsequently, 87 patients (59%) underwent cholecystectomy after PTGBA (single PTGBA in 48 patients and repetitive PTGBA and/or PTGBD in 39 patients). No significant differences were observed in the conversion rate from laparoscopic to open cholecystectomy, operative time, and intraoperative hemorrhage volume between the two groups.Conclusions The present study demonstrated the safety and acceptable treatment results of PTGBA for AC at our center. This elective treatment strategy for AC may be a useful alternative in the treatment algorithm of AC.
    Journal of Digestive Diseases 09/2014;
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    ABSTRACT: IntroductionEarly tumor recurrence, either local tumor recurrence or intrahepatic distant recurrence (IDR), after successful radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) remains a significant problem.Aim of the studyto determine the potential risk factors for intrahepatic distant recurrence (IDR) within one year after successful RFAPatient and methodsOne hundred and five patients with 138 lesions who underwent RFA and were followed up for at least 1 year were included in this study. The data of patients has been retrospectively reviewed. Multiple host and tumoral potential risk factors were reviewed and analyzed.Resultscumulative IDR free survival rates in all studied patients were 81.9 %, 45.4% and 35.2% at 1, 2 and 3 year respectively after RFA. Univariate and multivariate analysis showed that both tumor size > 2.8 cm and primary multinodular tumor (P < 0.05) were significant risk factors for IDR within 1 year.Conclusionpatients with large tumors >2.8cm and/ or multinodular HCC should be closely monitored for early recurrence after RFA. Combined and/or systemic therapies should be tried for those patients to improve their disease free and overall survival.
    Journal of Digestive Diseases 09/2014;
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    ABSTRACT: Background Ursodeoxycholic acid (UDCA) is widely used in clinic to treat chronic liver diseases and shown its cytoprotective effect on normal hepatocytes. This study investigated the pro-apoptotic effects of UDCA on hepatocellular carcinoma cells and the underlying molecular events in vitro.MethodsHCC cells were cultured and treated by UDCA at different doses and period of time for assaying the changed cell morphology, viability, apoptosis, and gene expression using MTT, Annexin V/PI staining, TUNEL, ELISA, immunocytochemistry, and quantitative RT-PCR, respectively.ResultsUDCA treatment reduced cell viability, but induced HCC cell apoptosis at dose-dependent and time-dependent manners. UDCA arrested HepG2 cells at phase S of the cell cycle. At the gene levels, UDCA down-regulated expressions of bcl-2 and Smac proteins, but up-regulated Bax and Livin proteins in HCC cells. At the highest concentration, UDCA inhibited expression of Livin mRNA, but increased expressions of Smac and caspase-3 mRNA and activity of caspase-3 in HCC cells.Conclusions The data from the current study demonstrated that induction of HCC cell apoptosis by UDCA was at dose-dependent and time-dependent manners and mediated by regulation of Bax to bcl-2 ratio, expression of Smac and Livin, and expression and activity caspase-3.
    Journal of Digestive Diseases 09/2014;