BACKGROUND Gastrointestinal(GI)vascular bleeding disorders pose significant clinical challenges due to their complex pathogenesis and varied treatment responses.Despite advancements in diagnostic and therapeutic techn...BACKGROUND Gastrointestinal(GI)vascular bleeding disorders pose significant clinical challenges due to their complex pathogenesis and varied treatment responses.Despite advancements in diagnostic and therapeutic techniques,optimal mana-gement strategies remain elusive,necessitating further research.AIM To assess research trends and clinical advancements in GI vascular bleeding disorders,highlighting key themes and therapeutic progress.METHODS A bibliometric analysis was conducted using the Web of Science Core Collection database,reviewing publications from 2000 to 2024 to identify trends,highfrequency keywords,and key contributions from leading research institutions.In addition,a case study highlighted the effective application of sirolimus in managing colonic angioectasia in a patient with recurrent GI bleeding who had not responded to previous treatments.RESULTS The analysis reviewed 470 scholarly articles from 203 countries,involving 2817 authors across 1502 institutions.The United States led in publication contributions,with strong collaborations with countries like China,England,and Germany.A significant trend was observed in the shift from traditional endoscopic interventions to pharmacological therapies,particularly highlighting the successful use of sirolimus in treating colonic angioectasia. High-frequency keywords such as “angiodysplasia”,“colon”, and “management” were identified, indicating key research themes. The study also noted a growinginterest in drug therapies, as evidenced by the increasing prominence of keywords like “thalidomide” since 2018.CONCLUSIONThis study links bibliometric analysis and clinical insights, highlighting the shift to pharmacological managementin GI vascular bleeding disorders to improve patient outcomes.展开更多
BACKGROUND Esophageal stricture is a prevalent condition affecting the digestive system,primarily marked by dysphagia and the obstruction of food passage through the esophagus.This narrowing of the esophageal lumen ca...BACKGROUND Esophageal stricture is a prevalent condition affecting the digestive system,primarily marked by dysphagia and the obstruction of food passage through the esophagus.This narrowing of the esophageal lumen can significantly impact a person’s ability to eat and drink comfortably,often leading to a decrease in nutritional intake and quality of life.AIM To explore the current research status and future trends of esophageal stricture through bibliometric analysis.METHODS Literature on esophageal stricture from 2004 to 2023 was retrieved from the Web of Science Core Collection.Statistical analysis was performed using Excel,VOSviewer,CiteSpace,and RStudio.This study provides data on annual production trends,countries/regions,influential authors,institutions,journals,references,and keywords.RESULTS The study included 1485 publications written by 7469 authors from 1692 institutions across 66 countries/regions,published in 417 journals.The United States,China,and Japan are the major contributors to this field,with many quality papers.Song Ho-young,Diseases of the Esophagus,Gastrointestinal Endoscopy,and Mayo Clinic are the top authors,journals,co-cited journals,and institutions,respectively.The most frequent keywords are stent,endoscopy,management,etiology,and prevention;regenerative medicine,endoscopic injection,and autologous tissue transplantation are the latest research frontiers.These keywords reflect continuous advancements in technical innovation,treatment strategies,preventive measures in the esophageal stricture research field,and a sustained focus on improving patient prognosis.In contrast,the basic sciences were underrepresented.CONCLUSION This study provides an insightful analysis of the developments in the field of esophageal stricture over the past twenty years,with stent placement is currently a hot research topic.展开更多
BACKGROUND Gastrointestinal angiodysplasias(GIAD)causes recurrent bleeding,and current treatments have limitations.Sirolimus,a mammalian target of rapamycin inhibi-tor,shows promise in inhibiting abnormal angiogenesis...BACKGROUND Gastrointestinal angiodysplasias(GIAD)causes recurrent bleeding,and current treatments have limitations.Sirolimus,a mammalian target of rapamycin inhibi-tor,shows promise in inhibiting abnormal angiogenesis.AIM To evaluate the efficacy and safety of sirolimus in reducing bleeding episodes and improving clinical outcomes in patients with GIAD.METHODS We conducted a self-controlled study with 11 patients taking oral sirolimus.Retrospective data were collected prior to treatment,and prospective data were gathered during the study.Efficacy was assessed primarily by comparing blee-ding episodes before and after sirolimus,with measurements at 3 and 6 months post-administration.The initial dose was 0.8 mg/m^(2)once daily,adjusted to main-tain trough blood concentrations between 5-10 ng/mL.Secondary outcomes included hemoglobin(Hb)levels,blood transfusion volume,and vascular lesions.Safety was monitored by tracking adverse reactions.RESULTS The average number of bleeding episodes decreased significantly from 2.09±1.04 to 1.00±0.75 in the 3 months preceding treatment,and from 3.80±1.93 to 2.00±1.63 in the 6 months preceding treatment.Sirolimus also increased Hb levels,reduced the need for transfusions,and decreased vascular lesions,improving clinical outcomes.All adverse effects were mild and resolved or improved within 1 week to 1 month without stopping sirolimus or needing lipid-lowering treatment.CONCLUSION Sirolimus reduced bleeding and transfusion needs while improving Hb levels in GIAD patients.Although these findings are encouraging,the limited sample size and lack of a control group warrant caution.Future controlled trials with larger populations are needed to validate sirolimus’s potential in GIAD.展开更多
BACKGROUND Hemolymphangiomas are rare malformations composed of both lymphatic and vascular vessels and are located in the pancreas,spleen,mediastinum,etc.Small intestinal hemolymphangioma is extremely rare and often ...BACKGROUND Hemolymphangiomas are rare malformations composed of both lymphatic and vascular vessels and are located in the pancreas,spleen,mediastinum,etc.Small intestinal hemolymphangioma is extremely rare and often presents as obscure gastrointestinal bleeding.It is rarely diagnosed correctly before the operation.Endoscopic injection sclerotherapy is usually used as a management of bleeding in esophageal varices and was occasionally reported as a treatment of vascular malformation.The treatment of small intestinal hemolymphangioma with enteroscopic injection sclerotherapy has not been reported.CASE SUMMARY A 42-year-old male complained of recurrent episodes of melena and dizziness,fatigue and reduced exercise capacity for more than 2 mo.Gastroduodenoscopy and blood test revealed a gastric ulcer and anemia.Treatment with oral protonpump inhibitors and iron did not improve symptoms.We then performed a capsule endoscopy and anterograde balloon-assisted enteroscopy and revealed a hemolymphangioma.Considering it is a benign tumor without malignant potential,we performed enteroscopic injection sclerotherapy.He was discharged 4 days later.At follow-up 3 mo later,the melena disappeared.Balloon-assisted enteroscopy revealed an atrophied tumor atrophied and no bleeding.Argon plasma coagulation was applied to the surface of the hemolymphangioma to accelerated healing.When he returned for follow-up 1 year later,anemia was resolved and the tumor had been cured.CONCLUSION Balloon-assisted enteroscopy and capsule endoscopy are effective methods for diagnosis of hemolymphangioma.Enteroscopic injection sclerotherapy is an effective treatment.展开更多
BACKGROUND Most small intestinal lipomas are treated surgically,and some require repeated surgeries for multiple lipomas.However,application of endoscopic submucosal dissection(ESD)technology in the deep small intesti...BACKGROUND Most small intestinal lipomas are treated surgically,and some require repeated surgeries for multiple lipomas.However,application of endoscopic submucosal dissection(ESD)technology in the deep small intestine is rarely reported owing to the special anatomical structure of the small intestine,medical equipment limitations,and the lack of relevant experience among endoscopists.CASE SUMMARY Two patients with small intestinal lipomas treated at the Air Force Medical Center from November 2015 to September 2019 were selected to undergo balloonassisted ESD to treat the lipomas and explore the technical feasibility and safety of ESD for treating small intestinal lipomas.The two patients successfully underwent balloon-assisted ESD to treat four small intestinal lipomas,with a complete resection rate of 100%(4/4),without intraoperative or postoperative bleeding,perforation,or other complications.After 3-6 mo of postoperative follow-up,the clinical symptoms caused by the lipomas were significantly relieved or disappeared after treatment.CONCLUSION Balloon-assisted ESD is a safe and reliable new method for treating deep intestinal lipomas and shows good clinical feasibility.展开更多
基金Air Force Medical Center Youth Talent Program Project,No.22YXQN034Capital Health Development Research Special Project,No.2020-4-5123Beijing Haidian District Health and Wellness Development Scientific Research Cultivation Program,No.HP2021-03-80803.
文摘BACKGROUND Gastrointestinal(GI)vascular bleeding disorders pose significant clinical challenges due to their complex pathogenesis and varied treatment responses.Despite advancements in diagnostic and therapeutic techniques,optimal mana-gement strategies remain elusive,necessitating further research.AIM To assess research trends and clinical advancements in GI vascular bleeding disorders,highlighting key themes and therapeutic progress.METHODS A bibliometric analysis was conducted using the Web of Science Core Collection database,reviewing publications from 2000 to 2024 to identify trends,highfrequency keywords,and key contributions from leading research institutions.In addition,a case study highlighted the effective application of sirolimus in managing colonic angioectasia in a patient with recurrent GI bleeding who had not responded to previous treatments.RESULTS The analysis reviewed 470 scholarly articles from 203 countries,involving 2817 authors across 1502 institutions.The United States led in publication contributions,with strong collaborations with countries like China,England,and Germany.A significant trend was observed in the shift from traditional endoscopic interventions to pharmacological therapies,particularly highlighting the successful use of sirolimus in treating colonic angioectasia. High-frequency keywords such as “angiodysplasia”,“colon”, and “management” were identified, indicating key research themes. The study also noted a growinginterest in drug therapies, as evidenced by the increasing prominence of keywords like “thalidomide” since 2018.CONCLUSIONThis study links bibliometric analysis and clinical insights, highlighting the shift to pharmacological managementin GI vascular bleeding disorders to improve patient outcomes.
基金Supported by Beijing Science and Technology Planning Project,No.Z221100007422061the Natural Science Foundation of Shaanxi Province,General Project,No.2018SF-159.
文摘BACKGROUND Esophageal stricture is a prevalent condition affecting the digestive system,primarily marked by dysphagia and the obstruction of food passage through the esophagus.This narrowing of the esophageal lumen can significantly impact a person’s ability to eat and drink comfortably,often leading to a decrease in nutritional intake and quality of life.AIM To explore the current research status and future trends of esophageal stricture through bibliometric analysis.METHODS Literature on esophageal stricture from 2004 to 2023 was retrieved from the Web of Science Core Collection.Statistical analysis was performed using Excel,VOSviewer,CiteSpace,and RStudio.This study provides data on annual production trends,countries/regions,influential authors,institutions,journals,references,and keywords.RESULTS The study included 1485 publications written by 7469 authors from 1692 institutions across 66 countries/regions,published in 417 journals.The United States,China,and Japan are the major contributors to this field,with many quality papers.Song Ho-young,Diseases of the Esophagus,Gastrointestinal Endoscopy,and Mayo Clinic are the top authors,journals,co-cited journals,and institutions,respectively.The most frequent keywords are stent,endoscopy,management,etiology,and prevention;regenerative medicine,endoscopic injection,and autologous tissue transplantation are the latest research frontiers.These keywords reflect continuous advancements in technical innovation,treatment strategies,preventive measures in the esophageal stricture research field,and a sustained focus on improving patient prognosis.In contrast,the basic sciences were underrepresented.CONCLUSION This study provides an insightful analysis of the developments in the field of esophageal stricture over the past twenty years,with stent placement is currently a hot research topic.
基金Supported by the Air Force Medical Center Youth Talent Program Project,No.22YXQN034Capital Health Development Research Special Project,No.2020-4-5123Beijing Haidian District Health and Wellness Development Scientific Research Cultivation Program,No.HP2021-03-80803.
文摘BACKGROUND Gastrointestinal angiodysplasias(GIAD)causes recurrent bleeding,and current treatments have limitations.Sirolimus,a mammalian target of rapamycin inhibi-tor,shows promise in inhibiting abnormal angiogenesis.AIM To evaluate the efficacy and safety of sirolimus in reducing bleeding episodes and improving clinical outcomes in patients with GIAD.METHODS We conducted a self-controlled study with 11 patients taking oral sirolimus.Retrospective data were collected prior to treatment,and prospective data were gathered during the study.Efficacy was assessed primarily by comparing blee-ding episodes before and after sirolimus,with measurements at 3 and 6 months post-administration.The initial dose was 0.8 mg/m^(2)once daily,adjusted to main-tain trough blood concentrations between 5-10 ng/mL.Secondary outcomes included hemoglobin(Hb)levels,blood transfusion volume,and vascular lesions.Safety was monitored by tracking adverse reactions.RESULTS The average number of bleeding episodes decreased significantly from 2.09±1.04 to 1.00±0.75 in the 3 months preceding treatment,and from 3.80±1.93 to 2.00±1.63 in the 6 months preceding treatment.Sirolimus also increased Hb levels,reduced the need for transfusions,and decreased vascular lesions,improving clinical outcomes.All adverse effects were mild and resolved or improved within 1 week to 1 month without stopping sirolimus or needing lipid-lowering treatment.CONCLUSION Sirolimus reduced bleeding and transfusion needs while improving Hb levels in GIAD patients.Although these findings are encouraging,the limited sample size and lack of a control group warrant caution.Future controlled trials with larger populations are needed to validate sirolimus’s potential in GIAD.
文摘BACKGROUND Hemolymphangiomas are rare malformations composed of both lymphatic and vascular vessels and are located in the pancreas,spleen,mediastinum,etc.Small intestinal hemolymphangioma is extremely rare and often presents as obscure gastrointestinal bleeding.It is rarely diagnosed correctly before the operation.Endoscopic injection sclerotherapy is usually used as a management of bleeding in esophageal varices and was occasionally reported as a treatment of vascular malformation.The treatment of small intestinal hemolymphangioma with enteroscopic injection sclerotherapy has not been reported.CASE SUMMARY A 42-year-old male complained of recurrent episodes of melena and dizziness,fatigue and reduced exercise capacity for more than 2 mo.Gastroduodenoscopy and blood test revealed a gastric ulcer and anemia.Treatment with oral protonpump inhibitors and iron did not improve symptoms.We then performed a capsule endoscopy and anterograde balloon-assisted enteroscopy and revealed a hemolymphangioma.Considering it is a benign tumor without malignant potential,we performed enteroscopic injection sclerotherapy.He was discharged 4 days later.At follow-up 3 mo later,the melena disappeared.Balloon-assisted enteroscopy revealed an atrophied tumor atrophied and no bleeding.Argon plasma coagulation was applied to the surface of the hemolymphangioma to accelerated healing.When he returned for follow-up 1 year later,anemia was resolved and the tumor had been cured.CONCLUSION Balloon-assisted enteroscopy and capsule endoscopy are effective methods for diagnosis of hemolymphangioma.Enteroscopic injection sclerotherapy is an effective treatment.
文摘BACKGROUND Most small intestinal lipomas are treated surgically,and some require repeated surgeries for multiple lipomas.However,application of endoscopic submucosal dissection(ESD)technology in the deep small intestine is rarely reported owing to the special anatomical structure of the small intestine,medical equipment limitations,and the lack of relevant experience among endoscopists.CASE SUMMARY Two patients with small intestinal lipomas treated at the Air Force Medical Center from November 2015 to September 2019 were selected to undergo balloonassisted ESD to treat the lipomas and explore the technical feasibility and safety of ESD for treating small intestinal lipomas.The two patients successfully underwent balloon-assisted ESD to treat four small intestinal lipomas,with a complete resection rate of 100%(4/4),without intraoperative or postoperative bleeding,perforation,or other complications.After 3-6 mo of postoperative follow-up,the clinical symptoms caused by the lipomas were significantly relieved or disappeared after treatment.CONCLUSION Balloon-assisted ESD is a safe and reliable new method for treating deep intestinal lipomas and shows good clinical feasibility.
