BACKGROUND Gastrointestinal endoscopy has been widely used in the diagnosis and treatment of gastrointestinal diseases.A great many of studies on gastrointestinal endoscopy have been done.AIM To analyze the characteri...BACKGROUND Gastrointestinal endoscopy has been widely used in the diagnosis and treatment of gastrointestinal diseases.A great many of studies on gastrointestinal endoscopy have been done.AIM To analyze the characteristics of top 100 cited articles on gastrointestinal endoscopy.METHODS A bibliometric analysis was conducted.The publications and their features were extracted from the Web of Science Core Collection,Science Citation Index-Expanded database.Excel,Web of Science database and SPSS software were used to perform the statistical description and analysis.VOSviewer software and Map-Chart were responsible for the visualizations.RESULTS The top 100 cited articles were published between 1976 and 2022.The guidelines(52%)and clinical trials(37%)are the main article types,and average publication year of the guidelines is much later than that of the clinical trials(2015 vs 1998).Among the clinical trials,diagnostic study(27.0%),cohort study(21.6%),case series(13.5%)and cross-sectional study(10.8%)account for a large proportion.Average citations of different study types and designs of the enrolled studies are of no significant differences.Most of the 100 articles were published by European authors and recorded by the endoscopic journals(65%).Top journals in medicine,such as the Lancet,New England Journal of Medicine and JAMA,also reported studies in this field.The hot spots of involved diseases include neoplasm or cancer-related diseases,inflammatory diseases,obstructive diseases,gastrointestinal hemorrhage and ulcer.Endoscopic surgery,endoscopic therapy and stent placement are frequently studied.CONCLUSION Our research contributes to delineating the field and identifying the characteristics of the most highly cited articles.It is noteworthy that there is a significantly smaller number of clinical trials included compared to guidelines,indicating potential areas for future high-quality clinical trials.展开更多
BACKGROUND Upper gastrointestinal cancer(UGIC),including esophageal and gastric cancers,poses a major global health challenge due to its high morbidity and mortality.During the preoperative period,patients often face ...BACKGROUND Upper gastrointestinal cancer(UGIC),including esophageal and gastric cancers,poses a major global health challenge due to its high morbidity and mortality.During the preoperative period,patients often face functional decline,malnutrition,and psychological stress,which can impair recovery.Prehabilitation,a multidisciplinary preoperative intervention,shows promise in optimizing patients'physical and mental status.AIM To evaluate the impact of prehabilitation on patients undergoing UGIC surgery and provide a basis for implementation of the prehabilitation compound plan.METHODS A computerized search of databases including Web of Science,PubMed,EMBASE,The Cochrane Library,Cumulative Index to Nursing and Allied Health Literature,China National Knowledge Infrastructure,Wanfang,and Chinese Science and Technology Journal Database was used to collect clinical trials on the impact of prehabilitation on patients undergoing UGIC surgery.After screening,a meta-analysis was conducted using Review Manager 5.0 software,and linear regression analysis was performed on the prehabilitation duration and outcome indicators.RESULTS A total of 13 clinical trials were ultimately included,with 8 literature quality evaluations at A level and 5 literature quality evaluations at B level.The meta-analysis results showed that compared with conventional nursing,the prehabilitation group had higher six-minute walk distance,lower postoperative complications and mortality rates,and shorter hospital stays,with statistically significant differences;there were no statistically significant differences in intensive care unit monitoring time and albumin levels between the two groups;regression analysis between prehabilitation duration and outcome indicators showed no significant relationship.CONCLUSION Prehabilitation can improve the perioperative functional ability of patients with UGIC and promote postoperative recovery,but its impact on nutrition,psychology,and quality of life needs to be further explored through more high-quality trials;in addition,further research is needed on the prehabilitation time,location,and specific plan.展开更多
Confocal laser endomicroscopy(CLE)has become an indispensable tool in the diagnosis and detection of gastrointestinal(GI)diseases due to its high-resolution and high-contrast imaging capabilities.However,the early-sta...Confocal laser endomicroscopy(CLE)has become an indispensable tool in the diagnosis and detection of gastrointestinal(GI)diseases due to its high-resolution and high-contrast imaging capabilities.However,the early-stage imaging changes of gastrointestinal disorders are often subtle,and traditional medical image analysis methods rely heavily on manual interpretation,which is time-consuming,subject to observer variability,and inefficient for accurate lesion identification across large-scale image datasets.With the introduction of artificial intelligence(AI)technologies,AI-driven CLE image analysis systems can automatically extract pathological features and have demonstrated significant clinical value in lesion recognition,classification diagnosis,and malignancy prediction of GI diseases.These systems greatly enhance diagnostic efficiency and early detection capabilities.This review summarizes the applications of AI-assisted CLE in GI diseases,analyzes the limitations of current technologies,and explores future research directions.It is expected that the deep integration of AI and confocal imaging technologies will provide strong support for precision diagnosis and personalized treatment in the field of gastrointestinal disorders.展开更多
BACKGROUND Cardiovascular(CV)complications are common in intensive care unit(ICU)patients after gastrointestinal surgery and are associated with increased mortality and prolonged hospital stay.The optimization of post...BACKGROUND Cardiovascular(CV)complications are common in intensive care unit(ICU)patients after gastrointestinal surgery and are associated with increased mortality and prolonged hospital stay.The optimization of postoperative nursing interventions,particularly pain management,is crucial for reducing such complications.AIM To investigate the effects of enhanced recovery nursing on CV complications after gastrointestinal surgery in ICU patients and associated risk factors.METHODS A retrospective analysis was conducted on 78 adult patients who underwent gastrointestinal surgery in the ICU of our hospital between February 2023 and September 2024.Among them,40 patients received standard care(control group),while 38 received enhanced recovery nursing(observation group).We compared the incidence of CV complications and nursing satisfaction between the two groups.Patients were divided into CV complication and non-complication groups based on complication occurrence,and logistic regression analysis was used to identify risk factors.RESULTS In the control and observation groups,the incidence of CV complications was 30.0%(12/40)and 18.4%(7/38),with a nursing satisfaction rate of 70.0%(28/40)and 92.1%(35/38),respectively.The postoperative pain score at 14 days was significantly lower in the observation group(0.27±0.15)compared to the control group(1.65±0.37),with all differences being statistically significant(P<0.05).Univariate analysis indicated significant differences in age,body mass index,hypertension,diabetes,smoking history,history of heart failure,and previous myocardial infarction(P<0.05).Multivariate logistic regression identified heart failure history,previous myocardial infarction,age,hypertension,and diabetes as independent risk factors,with odds ratios of 1.195,1.528,1.062,1.836,and 1.942,respectively(all P<0.05).CONCLUSION Implementing enhanced recovery nursing for ICU patients after gastrointestinal surgery is beneficial in reducing the incidence of CV complications and improving nursing satisfaction.展开更多
BACKGROUND Primary gastrointestinal diffuse large B-cell lymphoma(PGI-DLBCL),the most prevalent extranodal non-Hodgkin lymphoma,poses significant diagnostic and therapeutic challenges due to its non-specific symptoms ...BACKGROUND Primary gastrointestinal diffuse large B-cell lymphoma(PGI-DLBCL),the most prevalent extranodal non-Hodgkin lymphoma,poses significant diagnostic and therapeutic challenges due to its non-specific symptoms and poor prognosis.AIM To develop and validate a risk model for the early identification of PGI-DLBCL using Least Absolute Shrinkage and Selection-Cox regression,with the aim of guiding clinical decision-making.METHODS The clinical data of patients diagnosed with PGI-DLBCL at the Tumor Hospital Affiliated to Xinjiang Medical University were analyzed retrospectively from January 2010 to April 2022.RESULTS A total of 319 patients with PGI-DLBCL were included and divided into training(n=223)and validation(n=96)cohorts.The median age was 55 years,with 48.9%male and 51.1%female patients.Key clinical features included Eastern Cooperative Oncology Group performance status≥2(40.8%),advanced-stage disease(stage IV:27.6%),extranodal involvement≥2 sites(47%),tumor>5 cm(46.1%),elevated beta-2 microglobulin(50.5%),elevated lactate dehydrogenase(27%),high International Prognostic Index(3-5:69.9%),non-germinal center B-cell-like subtype(59.9%),and B symptoms(55.8%).Immunohistochemical analysis showed frequent expression of CD10(51.1%),B-cell lymphoma 6(53.3%),multiple myeloma oncogene 1(40.1%),Bcell lymphoma 2(49.2%),myelocytomatosis viral oncogene homolog(48.3%),Ki-67(67.1%),and CD5(42.6%);Epstein-Barr virus-encoded RNA was positive in 3.1%.Based on Least Absolute Shrinkage and Selection regression and subsequent univariate and multivariate Cox regression analyses,extranodal sites≥2,B symptoms,mixed lesion type,and negative multiple myeloma oncogene 1 expression were identified as independent risk factors for PGI-DLBCL.The risk model stratified patients into high-and low-risk groups with significantly different overall survival(P<0.05).Area under the curve values for 1-,3-,and 5-year overall survival were 0.625,0.663,and 0.723 in the training cohort,with consistent performance in the validation cohort.Decision curve analysis indicated favorable clinical utility.CONCLUSION PGI-DLBCL in our cohort showed distinctive clinical features and a predominance of the non-germinal center Bcell-like subtype.Decision curve analysis confirmed the clinical applicability of our prognostic model.Although molecular biomarkers will be needed to improve predictive precision,our model offers a practical tool for early risk identification and individualized management in clinical practice.展开更多
Objective:Deep learning is employed increasingly in Gastroenterology(GI)endoscopy computer-aided diagnostics for polyp segmentation and multi-class disease detection.In the real world,implementation requires high accu...Objective:Deep learning is employed increasingly in Gastroenterology(GI)endoscopy computer-aided diagnostics for polyp segmentation and multi-class disease detection.In the real world,implementation requires high accuracy,therapeutically relevant explanations,strong calibration,domain generalization,and efficiency.Current Convolutional Neural Network(CNN)and transformer models compromise border precision and global context,generate attention maps that fail to align with expert reasoning,deteriorate during cross-center changes,and exhibit inadequate calibration,hence diminishing clinical trust.Methods:HMA-DER is a hierarchical multi-attention architecture that uses dilation-enhanced residual blocks and an explainability-aware Cognitive Alignment Score(CAS)regularizer to directly align attribution maps with reasoning signals from experts.The framework has additions that make it more resilient and a way to test for accuracy,macro-averaged F1 score,Area Under the Receiver Operating Characteristic Curve(AUROC),calibration(Expected Calibration Error(ECE),Brier Score),explainability(CAS,insertion/deletion AUC),cross-dataset transfer,and throughput.Results:HMA-DER gets Dice Similarity Coefficient scores of 89.5%and 86.0%on Kvasir-SEG and CVC-ClinicDB,beating the strongest baseline by+1.9 and+1.7 points.It gets 86.4%and 85.3%macro-F1 and 94.0%and 93.4%AUROC on HyperKvasir and GastroVision,which is better than the baseline by+1.4/+1.6macro-F1 and+1.2/+1.1AUROC.Ablation study shows that hierarchical attention gives the highest(+3.0),followed by CAS regularization(+2–3),dilatation(+1.5–2.0),and residual connections(+2–3).Cross-dataset validation demonstrates competitive zero-shot transfer(e.g.,KS→CVC Dice 82.7%),whereas multi-dataset training diminishes the domain gap,yielding an 88.1%primary-metric average.HMA-DER’s mixed-precision inference can handle 155 pictures per second,which helps with calibration.Conclusion:HMA-DER strikes a compromise between accuracy,explainability,robustness,and efficiency for the use of reliable GI computer-aided diagnosis in real-world clinical settings.展开更多
Soil alkalinity is a major factor that restricts the growth of apple roots.To analyze the response of apple roots to alkali stress, the root structure and endogenous hormones of two apple rootstocks, Malus prunifolia ...Soil alkalinity is a major factor that restricts the growth of apple roots.To analyze the response of apple roots to alkali stress, the root structure and endogenous hormones of two apple rootstocks, Malus prunifolia (alkali-tolerant) and Malus hupehensis (alkali-sensitive), were compared. To understand alkali tolerance of M. prunifolia at the molecular level, transcriptome analysis was performed. When plants were cultured in alkaline conditions for 15 d, the root growth of M. hupehensis with weak alkali tolerance decreased significantly. Analysis of endogenous hormone levels showed that the concentrations of indole-3-acetic acid (IAA) and zeatin riboside (ZR) in M. hupehensis under alkali stress were lower than those in the control. However, the trend for IAA and ZR in M. prunifolia was the opposite. The concentration of abscisic acid (ABA) in the roots of the two apple rootstocks under alkali stress increased, but the concentration of ABA in the roots of M. prunifolia was higher than that in M. hupehensis. The expression of IAA-related genes ARF5, GH3.6, SAUR36, and SAUR32 and the Cytokinin (CTK)-related gene IPT5 in M. prunifolia was higher than those in the control, but the expression of these genes in M. hupehensis was lower than those in the control. The expression of ABA-related genes CIPK1 and AHK1 increased in the two apple rootstocks under alkali stress, but the expression of CIPK1 and AHK1 in M. prunifolia was higher than in M. hupehensis. These results demonstrated that under alkali stress, the increase of IAA, ZR, and ABA in roots and the increase of the expression of related genes promoted the growth of roots and improved the alkali tolerance of apple rootstocks.展开更多
IM To study the plasma level of gastrointestinal hormones and gastric emptying in patients with peptic ulcer. METHODS Thirty patients with gastric ulcer (GU), and 29 duodenal ulcer (DU) and 12 controls were studie...IM To study the plasma level of gastrointestinal hormones and gastric emptying in patients with peptic ulcer. METHODS Thirty patients with gastric ulcer (GU), and 29 duodenal ulcer (DU) and 12 controls were studied. Plasma levels of SS, VIP and SP were measured by radioimmunoassay, and gastric emptying half time (GET1/2) was determined with TC99mresin solid meal method. RESULTS GET1/2(min) was significantly longer in GU than that in controls (659±148 vs 533±43, P<001) and plasma VIP levels (ng/L) were significantly higher than in controls (375±107 vs 184±59, P<005). There was a significant positive correlation between GET1/2 and plasma VIP levels (r=055,P<001). No significant changes were found in SS and SP in GU compared with controls (P>005). GET1/2 in DU was markedly shorter than the control group (417±102 vs 533±43, P<001), and plasma SS levels (ng/L) significantly lower than those in controls (64±25 vs 119±34,P<001), there was a significant positive correlation between GET1/2 and SS levels (r=056,P<001). Plasma SP levels (ng/L) in DU were significantly higher than the controls (544±127 vs 416±58,P<001),there was a significant negative correlation between GET1/2 and SP levels (r=-068,P<001). No significant difference was found in the plasma VIP levels between DU and controls (P>005).CONCLUSION VIP elevation may contribute to the GET1/2 delay and the occurrence of GU. The increased SP and lowered SS may play important roles in the GET1/2 acceleration and the pathogensis of DU.展开更多
AIM: To correlate gastric contractility, gastrointestinal transit, and hormone levels in non-pregnant(estrous cycle) and pregnant rats using noninvasive techniques. METHODS: Female rats(n = 23) were randomly divided i...AIM: To correlate gastric contractility, gastrointestinal transit, and hormone levels in non-pregnant(estrous cycle) and pregnant rats using noninvasive techniques. METHODS: Female rats(n = 23) were randomly divided into(1) non-pregnant,(contractility, n =6; transit, n = 6); and(2) pregnant(contractility, n = 5; transit, n = 6). In each estrous cycle phase or at 0, 7, 14, and 20 d after the confirmation of pregnancy, gastrointestinal transit was recorded by AC biosusceptometry(ACB), and gastric contractility was recorded by ACB and electromyography. After each recording, blood samples were obtained for progesterone and estradiol determination. RESULTS: In the estrous cycle, despite fluctuations of sex hormone levels, no significant changes in gastrointestinal motility were observed. Days 7 and 14 of pregnancy were characterized by significant changes in the frequency of contractions(3.90 ± 0.42 cpm and 3.60 ± 0.36 cpm vs 4.33 ± 0.25 cpm) and gastric emptying(168 ± 17 min and 165 ± 15 min vs 113 ± 15 min) compared with day 0. On these same days, progesterone levels significantly increased compared with control(54.23 ± 15.14 ng/m L and 129.96 ± 30.52 ng/mL vs 13.25 ± 6.31 ng/mL). On day 14, we observed the highest level of progesterone and the lowest level of estradiol compared with day 0(44.3 ± 15.18 pg/mL vs 24.96 ± 5.96 pg/mL). CONCLUSION: Gastrointestinal motility was unaffected by the estrous cycle. In our data, high progesterone and low estradiol levels can be associated with decreased contraction frequency and slow gastric emptying.展开更多
Objective:To observe the effect and mechanism of Xiangsha Liujunzi decoction(XSLJZD)drug serum on gastric antrum smooth muscle cells(SMCs)in rats with functional dyspepsia(FD).Methods:Gastric antrum SMCs from rats wit...Objective:To observe the effect and mechanism of Xiangsha Liujunzi decoction(XSLJZD)drug serum on gastric antrum smooth muscle cells(SMCs)in rats with functional dyspepsia(FD).Methods:Gastric antrum SMCs from rats with FD were isolated,cultured,and then divided into six groups as follows:control,model,domperidone,low-dose XSLJZD(LXSLJZD),medium-dose XSLJZD(MXSLJZD),and high-dose XSLJZD(HXSLJZD).Each group was administered the corresponding drug serum for intervention.Drug serum intervention conditions and proliferative activity of SMCs were tested by cholecystokinin octapeptide.Ghrelin,gastrin,somatostatin,and substance P(SP)levels were measured by ELISA.Somatostatin and SP mRNA expression was measured by real-time PCR.Results:A concentration of 10%drug serum for 24 h was decided to be the best intervention condition for later study.The mean optical density value in the model group was lower than that in the control group(P紏.001).Optical density values in the domperidone and HXSLJZD groups were higher than those in the model group(P?.025,P?.032,respectively).Gastrin,SP,and ghrelin levels in the model group were lower(P?.007,P?.037,P?.005,respectively),but somatostatin levels were higher,compared with those in the control group(P?.031).Gastrin,SP,and ghrelin levels in the domperidone,MXSLJZD,and HXSLJZD groups were higher than those in the model group(all P<.05).Somatostatin levels in the four drug-treated groups were lower than those in the model group(P?.002,P?.007,P?.001,P?.009,respectively).SP mRNA levels in the model group were lower than those in the control,domperidone,MXSLJZD,and HXSLJZD groups(P?.037 P?.016,P?.025,P?.002,respectively).Somatostatin mRNA levels in the model group were higher than those in the control and MXSLJZD groups(P紏.042,P紏.035).Conclusions:XSLJZD and domperidone drug serum effectively promote proliferative activity of gastric antrum SMCs in an FD model.The mechanism of this activity may be regulated by gastrointestinal hormones.展开更多
Sendur et al pointed out the attention on the importance of mutational analysis for adjuvant treatment of gastrointestinal stromal tumor (GIST) in an article published in World Journal of Gastroenterology . In particu...Sendur et al pointed out the attention on the importance of mutational analysis for adjuvant treatment of gastrointestinal stromal tumor (GIST) in an article published in World Journal of Gastroenterology . In particular, they suggested that the optimal dose and duration of adjuvant therapy could be defined by the mutational status of the primary disease. This comment would underline the importance of centralised laboratories, given the increasingly important role of molecular analysis in the work-flow of all GIST, and the need of retrospective analyses for subgroups population stratified for the mutational status from the available studies in the adjuvant setting, in order to define the role of mutational analysis in choosing the optimal dose and duration of adjuvant therapy.展开更多
Gastrointestinal stromal tumors(GISTs) are the most common soft tissue sarcoma of the gastrointestinal tract,resulting from an activating mutation of stem cell factor receptor(KIT),and an activating mutation of the ho...Gastrointestinal stromal tumors(GISTs) are the most common soft tissue sarcoma of the gastrointestinal tract,resulting from an activating mutation of stem cell factor receptor(KIT),and an activating mutation of the homologous platelet-derived growth factor receptor alpha(PDGFRA) kinase.Most GISTs(90%-95%) are KIT-positive.About 5% of GISTs are truly negative for KIT expression.GISTs have been documented to resistant conventional chemotherapeutics.Due to the KIT activation that occurs in the majority of the cases,KIT inhibition is the primary treatment approach in the adjuvant treatment of metastatic GISTs.Imatinib mesylate is an oral agent that is a selective protein tyrosine kinase inhibitor of the KIT protein tyrosine kinase,and it has demonstrated clinical benefit and objective tumor responses in most GIST patients in phase Ⅱ and Ⅲ trials.The presence and the type of KIT or PDGFRA mutation are predictive of response to imatinib therapy in patients with advanced and metastatic disease.Molecular analysis in phaseⅠ-Ⅱ trials revealed significant differences in objective response,progression-free survival,and overall survival between GISTs with different kinase mutations.The aim of this letter is to touch on the need for exon mutation analysis for adjuvant treatment with imatinib in GIST patients.展开更多
AIM： To investigate the effect of firing noise on gastrointestinal transit and probe its mechanism by measuring the levels of plasma polypeptide hormones. METHODS： A total of 64 SD rats were randomly divided into a ...AIM： To investigate the effect of firing noise on gastrointestinal transit and probe its mechanism by measuring the levels of plasma polypeptide hormones. METHODS： A total of 64 SD rats were randomly divided into a control group and three stimulating groups. Firing noise of different intensity by sub-machine guns was used as inflicting factor. The effect of firing noise on liquid substance gastrointestinal transit and solid substance gastrointestinal transit was observed by measuring the ratio of carbon powder suspension transmitting and barium sticks transmitting respectively. Plasma levels of polypeptide hormones were measured by radio-immunoassay. RESULTS： The noise accelerated gastrointestinal transit of solid food by more than 80 db;and accelerated gastrointestinal transit of liquid food significantly by more than 120 db. Meantime, plasma levels of plasma motilin （MTL）（157.47±16.08; 151.90±17.08）, somatostatin （SS）（513.97±88.77; 458.25±104.30）, substance P （SP）（115.52±20.70; 110.28±19.96） and vasoactive intestinal peptide （VIP） （214.21±63.17; 251.76±97.24） remarkably changed also. CONCLUSION： Within a certain intensity range, the firing noise changes the levels of rat plasma gastrointestinal hormones, but the gastrointestinal transit is still normal. Beyond the range, the noise induces plasma hormone levels disturbance and gastrointestinal transit disorder. ~展开更多
BACKGROUND Multiple gastrointestinal stromal tumors(MGISTs)are a very rare type of gastrointestinal stromal tumor(GIST)and are usually observed in syndrome.AIM The paper aimed to describe the clinical and oncological ...BACKGROUND Multiple gastrointestinal stromal tumors(MGISTs)are a very rare type of gastrointestinal stromal tumor(GIST)and are usually observed in syndrome.AIM The paper aimed to describe the clinical and oncological features of MGISTs and to offer evidence for the diagnosis and treatment.METHODS Data of consecutive patients with MGISTs who were diagnosed at Peking University People’s Hospital(PKUPH)from 2008 to 2019 were retrospectively evaluated.Further,a literature search was conducted by retrieving data from PubMed,EMBASE,and the Cochrane library databases from inception up to November 30,2019.RESULTS In all,12 patients were diagnosed with MGISTs at PKUPH,and 43 published records were ultimately included following the literature review.Combined analysis of the whole individual patient data showed that female(59.30%),young(14.45%),and syndromic GIST(63.95%)patients comprised a large proportion of the total patient population.Tumors were mainly located in the small intestine(58.92%),and both CD117 and CD34 were generally positive.After a mean 78.32-mo follow-up,the estimated median overall survival duration(11.5 years)was similar to single GISTs,but recurrence-free survival was relatively poorer.CONCLUSION The clinical and oncological features are potentially different between MGISTs and single GIST.Further studies are needed to explore appropriate surgical approach and adjuvant therapy.展开更多
AIM: To analyze the accuracy of computed tomography (CT) angiography in the diagnosis of acute gastrointestinal (GI) bleeding. METHODS: The MEDLINE, EMBASE, Cancerlit, Cochrane Library database, Sciencedirect, Springe...AIM: To analyze the accuracy of computed tomography (CT) angiography in the diagnosis of acute gastrointestinal (GI) bleeding. METHODS: The MEDLINE, EMBASE, Cancerlit, Cochrane Library database, Sciencedirect, Springerlink and Scopus, from January 1995 to December 2009, were searched for studies evaluating the accuracy of CT angiography in diagnosing acute GI bleeding. Studies were included if the ycompared CT angiography to a reference standard of upper GI endoscopy, colonoscopy, angiography or surgery in the diagnosis of acute GI bleeding. Meta-analysis methods were used to pool sensitivity and specificity and to construct summary receiver-operating characteristic. RESULTS: A total of 9 studies with 198 patients were included in this meta-analysis. Data were used to form 2 × 2 tables. CT angiography showed pooled sensi-tivity of 89% (95% CI: 82%-94%) and specificity of 85% (95% CI: 74%-92%), without showing significant heterogeneity (χ2 = 12.5, P = 0.13) and (χ2 = 22.95, P = 0.003), respectively. Summary receiver operating characteristic analysis showed an area under the curve of 0.9297. CONCLUSION: CT angiography is an accurate, costeffective tool in the diagnosis of acute GI bleeding and can show the precise location of bleeding, thereby directing further management.展开更多
Objective: To systematically evaluate the effects of heating infusion on gastrointestinal complications of patients with enteral nutrition. Methods: The domestic and foreign databases including Cochrane Library, PubMe...Objective: To systematically evaluate the effects of heating infusion on gastrointestinal complications of patients with enteral nutrition. Methods: The domestic and foreign databases including Cochrane Library, PubMed, EMBASE, Web of Science, Chinese biomedical literature database (CBM), Wan Fang database (Wan Fang), China National Knowledge Infrastructure (CNKI) and VIP Database for Chinese Technical Periodicals(VIP) were retrieved. The retrieval contents were randomized controlled trials on improving gastrointestinal complications of patients with enteral nutrition by heating infusion of nutrient solution. Data were collected by two reviewers according to the data extraction tables. Results: A total of 17 randomized controlled trials with 1683 subjects were chosen. The results of meta analysis showed that the rate of abdominal pain, abdominal distension and nausea in patients with enteral nutrition could be reduced by warm infusion of nutrient solution, but the effect of the infusion on vomiting, constipation, stomach retention and diarrhea was not superior. Conclusion: Heating infusion of nutrient solution can reduce the incidence of abdominal pain, abdominal distension and nausea in patients with enteral nutrition.展开更多
AIM To determine the therapeutic effect of photodynamic therapy(PDT) for middle-advanced stage upper gastrointestinal carcinomas. METHODS We searched PubM ed, EMBASE, the Cochrane Library, China National Knowledge Inf...AIM To determine the therapeutic effect of photodynamic therapy(PDT) for middle-advanced stage upper gastrointestinal carcinomas. METHODS We searched PubM ed, EMBASE, the Cochrane Library, China National Knowledge Infrastructure, China Science and Technology Journal Database, and Wanfang Database from inception to April 2018 for randomized controlled studies. These studies compared PDT with other palliative therapies(radiotherapy, chemotherapy, or Nd:YAG laser) and compared PDT, radiotherapy, or chemotherapy alone with PDT combined with chemotherapy/radiotherapy. In our meta-analysis, both fixed and random effects models were used to estimate the risk ratio(RR) for dichotomous outcomes(the response rate and one-year survival rate).RESULTS Ten random controlled clinical studies with 953 patients were included in the analysis. The effective rate for PDT was better than that of radiotherapy or Nd:YAG laser for the treatment of middle-advanced upper gastrointestinal carcinomas [RR = 1.36; 95% confidence interval(CI): 1.13-1.65; P = 0.001]. In addition, PDT combined with chemotherapy had significantly better efficacy and a higher one-year survival rate than PDT or chemotherapy alone(significant remission rate, RR = 1.62; 95%CI: 1.34-1.97; P < 0.00001; one-year survival rate, RR = 1.81; 95%CI: 1.13-2.89; P = 0.01).CONCLUSION PDT is a useful method for the treatment of middleadvanced stage upper gastrointestinal carcinomas. PDT combined with chemotherapy or radiotherapy can enhance its efficacy and prolong survival time.展开更多
AIM:To evaluate the efficacy of high-dose proton pump inhibitors(PPIs)vs low-dose PPIs for patients with upper gastrointestinal bleeding.METHODS:PubMed,Embase,the Cochrane Library,and Web of Science were searched to i...AIM:To evaluate the efficacy of high-dose proton pump inhibitors(PPIs)vs low-dose PPIs for patients with upper gastrointestinal bleeding.METHODS:PubMed,Embase,the Cochrane Library,and Web of Science were searched to identify relevant randomized controlled trials(RCTs).Eligible trials were RCTs that compared high-dose PPI with low-dose PPI following endoscopic hemostasis.The primary endpoint was rebleeding;secondary endpoints were patient numbers that needed surgery,and mortality.The meta-analysis was performed with a fixed effects model or random effects model.RESULTS:Nine eligible RCTs including 1342 patients were retrieved.The results showed that high-dose intravenous PPI was not superior to low-dose intra-venous PPI in reducing rebleeding[odds ratio(OR)= 1.091,95%confidential interval(CI):0.777-1.532],need for surgery(OR=1.522,95%CI:0.643-3.605) and mortality(OR=1.022,95%CI:0.476-2.196).Subgroup analysis according to different region revealed no difference in rebleeding rate between Asian patients(OR=0.831,95%CI,0.467-1.480)and European patients(OR=1.263,95%CI:0.827-1.929).CONCLUSION:Low-dose intravenous PPI can achieve the same efficacy as high-dose PPI following endoscopic hemostasis.展开更多
AIM To perform a meta-analysis to investigate the association between cyclooxygenase-2(COX-2)-1195G>A gene polymorphism and gastrointestinal cancers. METHODS Publications related to the COX-2-1195G>A gene polymo...AIM To perform a meta-analysis to investigate the association between cyclooxygenase-2(COX-2)-1195G>A gene polymorphism and gastrointestinal cancers. METHODS Publications related to the COX-2-1195G>A gene polymorphism and gastrointestinal cancers published before July 2016 were retrieved from Pub Med, EMBASE, Web of Science, China Biological Medicine Database, China National Knowledge Infrastructure, and CQVIP Database. Meta-analysis was performed using Stata11.0 software. The strength of the association was evaluated by calculating the combined odds ratios(ORs) and the corresponding 95%CIs. The retrieved publications were excluded or included one by one for sensitivity analysis. In addition, the funnel plot, Begg's rank correlation test, and Egger's linear regression method were applied to analyse whether the included publications had publication bias. RESULTS A total of 24 publications related to the COX-2-1195G>A gene polymorphism were included, including 28 studies involving 11043 cases and 18008 controls. The meta-analysis results showed that the COX-2-1195G>A gene polymorphism significantly correlated with an increased risk of gastrointestinal cancers, particularly gastric cancer(A vs G: OR = 1.35; AA/AG vs GG: OR = 1.54; AA vs GG/AG: OR = 1.43; AA vs GG: OR = 1.80; AG vs GG: OR = 1.35). Compared to the Caucasian population in America and Europe, the COX-2-1195G>A gene polymorphism in the Asian population(A vs G: OR = 1.30; AA/AG vs GG: OR= 1.50; AA vs GG/AG: OR = 1.35; AA vs GG: OR = 1.71; AG vs GG: OR = 1.37) significantly increased gastrointestinal cancer risk. The sensitivity analysis(P < 0.05) and the false positive report probability(P < 0.2) confirmed the reliability of the results. CONCLUSION The results showed that the COX-2-1195G>A gene polymorphism might be a potential risk factor for gastrointestinal cancers. Further validation by a large homogeneous study is warranted.展开更多
AIM:To perform a meta-analysis to derive a more precise estimation of imatinib treatment for different genotypes of gastrointestinal stromal tumors(GIST).METHODS:Studies were identified by searching PubMed and Embase....AIM:To perform a meta-analysis to derive a more precise estimation of imatinib treatment for different genotypes of gastrointestinal stromal tumors(GIST).METHODS:Studies were identified by searching PubMed and Embase.Inclusive criteria were patients with exon 9-mutant,exon 11-mutant or wide type(WT) GIST,receiving chemotherapy of imatinib for clinical trial,and efficacy evaluation was cumulative response (CR)including complete response and partial response.The odds ratios(OR)for CR in stem cell factor receptor (KIT)mutation patients vs WT genotype patients,KIT exon 11-mutant genotype patients vs KIT exon 9-mutant genotype patients and KIT exon 9-mutant genotype patients vs WT genotype patients were calculated with 95%confidence interval(CI)for each study as an estimation of the efficacy of imatinib.RESULTS:Five studies including 927 patients were involved in this meta-analysis.The overall OR(KIT group vs WT group)was 3.34(95%CI:2.30-4.86,P <0.00001,P heterogeneity=0.04).The overall OR in KIT exon 11 group vs KIT exon 9 group was 3.29(95%CI: 2.17-5.00,P<0.00001,P heterogeneity=0.33).The overall OR in KIT exon 9 group vs WT group was 1.23(95% CI:0.73-2.10,P=0.44,P heterogeneity=0.42).CONCLUSION:Most patients with different genotypes of GIST and KIT exon 11-mutant will benefit from the individualized treatment of imatinib.展开更多
文摘BACKGROUND Gastrointestinal endoscopy has been widely used in the diagnosis and treatment of gastrointestinal diseases.A great many of studies on gastrointestinal endoscopy have been done.AIM To analyze the characteristics of top 100 cited articles on gastrointestinal endoscopy.METHODS A bibliometric analysis was conducted.The publications and their features were extracted from the Web of Science Core Collection,Science Citation Index-Expanded database.Excel,Web of Science database and SPSS software were used to perform the statistical description and analysis.VOSviewer software and Map-Chart were responsible for the visualizations.RESULTS The top 100 cited articles were published between 1976 and 2022.The guidelines(52%)and clinical trials(37%)are the main article types,and average publication year of the guidelines is much later than that of the clinical trials(2015 vs 1998).Among the clinical trials,diagnostic study(27.0%),cohort study(21.6%),case series(13.5%)and cross-sectional study(10.8%)account for a large proportion.Average citations of different study types and designs of the enrolled studies are of no significant differences.Most of the 100 articles were published by European authors and recorded by the endoscopic journals(65%).Top journals in medicine,such as the Lancet,New England Journal of Medicine and JAMA,also reported studies in this field.The hot spots of involved diseases include neoplasm or cancer-related diseases,inflammatory diseases,obstructive diseases,gastrointestinal hemorrhage and ulcer.Endoscopic surgery,endoscopic therapy and stent placement are frequently studied.CONCLUSION Our research contributes to delineating the field and identifying the characteristics of the most highly cited articles.It is noteworthy that there is a significantly smaller number of clinical trials included compared to guidelines,indicating potential areas for future high-quality clinical trials.
基金Supported by Key Project of Jiangsu Provincial Health(ZD2022052).
文摘BACKGROUND Upper gastrointestinal cancer(UGIC),including esophageal and gastric cancers,poses a major global health challenge due to its high morbidity and mortality.During the preoperative period,patients often face functional decline,malnutrition,and psychological stress,which can impair recovery.Prehabilitation,a multidisciplinary preoperative intervention,shows promise in optimizing patients'physical and mental status.AIM To evaluate the impact of prehabilitation on patients undergoing UGIC surgery and provide a basis for implementation of the prehabilitation compound plan.METHODS A computerized search of databases including Web of Science,PubMed,EMBASE,The Cochrane Library,Cumulative Index to Nursing and Allied Health Literature,China National Knowledge Infrastructure,Wanfang,and Chinese Science and Technology Journal Database was used to collect clinical trials on the impact of prehabilitation on patients undergoing UGIC surgery.After screening,a meta-analysis was conducted using Review Manager 5.0 software,and linear regression analysis was performed on the prehabilitation duration and outcome indicators.RESULTS A total of 13 clinical trials were ultimately included,with 8 literature quality evaluations at A level and 5 literature quality evaluations at B level.The meta-analysis results showed that compared with conventional nursing,the prehabilitation group had higher six-minute walk distance,lower postoperative complications and mortality rates,and shorter hospital stays,with statistically significant differences;there were no statistically significant differences in intensive care unit monitoring time and albumin levels between the two groups;regression analysis between prehabilitation duration and outcome indicators showed no significant relationship.CONCLUSION Prehabilitation can improve the perioperative functional ability of patients with UGIC and promote postoperative recovery,but its impact on nutrition,psychology,and quality of life needs to be further explored through more high-quality trials;in addition,further research is needed on the prehabilitation time,location,and specific plan.
基金Supported by Interdisciplinary Program of Shanghai Jiao Tong University,No.YG2024 LC01National Natural Science Foundation of China,No.62406190.
文摘Confocal laser endomicroscopy(CLE)has become an indispensable tool in the diagnosis and detection of gastrointestinal(GI)diseases due to its high-resolution and high-contrast imaging capabilities.However,the early-stage imaging changes of gastrointestinal disorders are often subtle,and traditional medical image analysis methods rely heavily on manual interpretation,which is time-consuming,subject to observer variability,and inefficient for accurate lesion identification across large-scale image datasets.With the introduction of artificial intelligence(AI)technologies,AI-driven CLE image analysis systems can automatically extract pathological features and have demonstrated significant clinical value in lesion recognition,classification diagnosis,and malignancy prediction of GI diseases.These systems greatly enhance diagnostic efficiency and early detection capabilities.This review summarizes the applications of AI-assisted CLE in GI diseases,analyzes the limitations of current technologies,and explores future research directions.It is expected that the deep integration of AI and confocal imaging technologies will provide strong support for precision diagnosis and personalized treatment in the field of gastrointestinal disorders.
文摘BACKGROUND Cardiovascular(CV)complications are common in intensive care unit(ICU)patients after gastrointestinal surgery and are associated with increased mortality and prolonged hospital stay.The optimization of postoperative nursing interventions,particularly pain management,is crucial for reducing such complications.AIM To investigate the effects of enhanced recovery nursing on CV complications after gastrointestinal surgery in ICU patients and associated risk factors.METHODS A retrospective analysis was conducted on 78 adult patients who underwent gastrointestinal surgery in the ICU of our hospital between February 2023 and September 2024.Among them,40 patients received standard care(control group),while 38 received enhanced recovery nursing(observation group).We compared the incidence of CV complications and nursing satisfaction between the two groups.Patients were divided into CV complication and non-complication groups based on complication occurrence,and logistic regression analysis was used to identify risk factors.RESULTS In the control and observation groups,the incidence of CV complications was 30.0%(12/40)and 18.4%(7/38),with a nursing satisfaction rate of 70.0%(28/40)and 92.1%(35/38),respectively.The postoperative pain score at 14 days was significantly lower in the observation group(0.27±0.15)compared to the control group(1.65±0.37),with all differences being statistically significant(P<0.05).Univariate analysis indicated significant differences in age,body mass index,hypertension,diabetes,smoking history,history of heart failure,and previous myocardial infarction(P<0.05).Multivariate logistic regression identified heart failure history,previous myocardial infarction,age,hypertension,and diabetes as independent risk factors,with odds ratios of 1.195,1.528,1.062,1.836,and 1.942,respectively(all P<0.05).CONCLUSION Implementing enhanced recovery nursing for ICU patients after gastrointestinal surgery is beneficial in reducing the incidence of CV complications and improving nursing satisfaction.
基金Supported by the Natural Science Foundation of Xinjiang Uygur Autonomous Region,No.2022D01D21“Tianshan Talents”Cultivation Program of Xinjiang Uygur Autonomous Region,No.2024TSYCLJ0025National Natural Science Foundation of China,No.82360037.
文摘BACKGROUND Primary gastrointestinal diffuse large B-cell lymphoma(PGI-DLBCL),the most prevalent extranodal non-Hodgkin lymphoma,poses significant diagnostic and therapeutic challenges due to its non-specific symptoms and poor prognosis.AIM To develop and validate a risk model for the early identification of PGI-DLBCL using Least Absolute Shrinkage and Selection-Cox regression,with the aim of guiding clinical decision-making.METHODS The clinical data of patients diagnosed with PGI-DLBCL at the Tumor Hospital Affiliated to Xinjiang Medical University were analyzed retrospectively from January 2010 to April 2022.RESULTS A total of 319 patients with PGI-DLBCL were included and divided into training(n=223)and validation(n=96)cohorts.The median age was 55 years,with 48.9%male and 51.1%female patients.Key clinical features included Eastern Cooperative Oncology Group performance status≥2(40.8%),advanced-stage disease(stage IV:27.6%),extranodal involvement≥2 sites(47%),tumor>5 cm(46.1%),elevated beta-2 microglobulin(50.5%),elevated lactate dehydrogenase(27%),high International Prognostic Index(3-5:69.9%),non-germinal center B-cell-like subtype(59.9%),and B symptoms(55.8%).Immunohistochemical analysis showed frequent expression of CD10(51.1%),B-cell lymphoma 6(53.3%),multiple myeloma oncogene 1(40.1%),Bcell lymphoma 2(49.2%),myelocytomatosis viral oncogene homolog(48.3%),Ki-67(67.1%),and CD5(42.6%);Epstein-Barr virus-encoded RNA was positive in 3.1%.Based on Least Absolute Shrinkage and Selection regression and subsequent univariate and multivariate Cox regression analyses,extranodal sites≥2,B symptoms,mixed lesion type,and negative multiple myeloma oncogene 1 expression were identified as independent risk factors for PGI-DLBCL.The risk model stratified patients into high-and low-risk groups with significantly different overall survival(P<0.05).Area under the curve values for 1-,3-,and 5-year overall survival were 0.625,0.663,and 0.723 in the training cohort,with consistent performance in the validation cohort.Decision curve analysis indicated favorable clinical utility.CONCLUSION PGI-DLBCL in our cohort showed distinctive clinical features and a predominance of the non-germinal center Bcell-like subtype.Decision curve analysis confirmed the clinical applicability of our prognostic model.Although molecular biomarkers will be needed to improve predictive precision,our model offers a practical tool for early risk identification and individualized management in clinical practice.
文摘Objective:Deep learning is employed increasingly in Gastroenterology(GI)endoscopy computer-aided diagnostics for polyp segmentation and multi-class disease detection.In the real world,implementation requires high accuracy,therapeutically relevant explanations,strong calibration,domain generalization,and efficiency.Current Convolutional Neural Network(CNN)and transformer models compromise border precision and global context,generate attention maps that fail to align with expert reasoning,deteriorate during cross-center changes,and exhibit inadequate calibration,hence diminishing clinical trust.Methods:HMA-DER is a hierarchical multi-attention architecture that uses dilation-enhanced residual blocks and an explainability-aware Cognitive Alignment Score(CAS)regularizer to directly align attribution maps with reasoning signals from experts.The framework has additions that make it more resilient and a way to test for accuracy,macro-averaged F1 score,Area Under the Receiver Operating Characteristic Curve(AUROC),calibration(Expected Calibration Error(ECE),Brier Score),explainability(CAS,insertion/deletion AUC),cross-dataset transfer,and throughput.Results:HMA-DER gets Dice Similarity Coefficient scores of 89.5%and 86.0%on Kvasir-SEG and CVC-ClinicDB,beating the strongest baseline by+1.9 and+1.7 points.It gets 86.4%and 85.3%macro-F1 and 94.0%and 93.4%AUROC on HyperKvasir and GastroVision,which is better than the baseline by+1.4/+1.6macro-F1 and+1.2/+1.1AUROC.Ablation study shows that hierarchical attention gives the highest(+3.0),followed by CAS regularization(+2–3),dilatation(+1.5–2.0),and residual connections(+2–3).Cross-dataset validation demonstrates competitive zero-shot transfer(e.g.,KS→CVC Dice 82.7%),whereas multi-dataset training diminishes the domain gap,yielding an 88.1%primary-metric average.HMA-DER’s mixed-precision inference can handle 155 pictures per second,which helps with calibration.Conclusion:HMA-DER strikes a compromise between accuracy,explainability,robustness,and efficiency for the use of reliable GI computer-aided diagnosis in real-world clinical settings.
基金supported by the earmarked fund for the China Agriculture Research System (CARS-27)
文摘Soil alkalinity is a major factor that restricts the growth of apple roots.To analyze the response of apple roots to alkali stress, the root structure and endogenous hormones of two apple rootstocks, Malus prunifolia (alkali-tolerant) and Malus hupehensis (alkali-sensitive), were compared. To understand alkali tolerance of M. prunifolia at the molecular level, transcriptome analysis was performed. When plants were cultured in alkaline conditions for 15 d, the root growth of M. hupehensis with weak alkali tolerance decreased significantly. Analysis of endogenous hormone levels showed that the concentrations of indole-3-acetic acid (IAA) and zeatin riboside (ZR) in M. hupehensis under alkali stress were lower than those in the control. However, the trend for IAA and ZR in M. prunifolia was the opposite. The concentration of abscisic acid (ABA) in the roots of the two apple rootstocks under alkali stress increased, but the concentration of ABA in the roots of M. prunifolia was higher than that in M. hupehensis. The expression of IAA-related genes ARF5, GH3.6, SAUR36, and SAUR32 and the Cytokinin (CTK)-related gene IPT5 in M. prunifolia was higher than those in the control, but the expression of these genes in M. hupehensis was lower than those in the control. The expression of ABA-related genes CIPK1 and AHK1 increased in the two apple rootstocks under alkali stress, but the expression of CIPK1 and AHK1 in M. prunifolia was higher than in M. hupehensis. These results demonstrated that under alkali stress, the increase of IAA, ZR, and ABA in roots and the increase of the expression of related genes promoted the growth of roots and improved the alkali tolerance of apple rootstocks.
文摘IM To study the plasma level of gastrointestinal hormones and gastric emptying in patients with peptic ulcer. METHODS Thirty patients with gastric ulcer (GU), and 29 duodenal ulcer (DU) and 12 controls were studied. Plasma levels of SS, VIP and SP were measured by radioimmunoassay, and gastric emptying half time (GET1/2) was determined with TC99mresin solid meal method. RESULTS GET1/2(min) was significantly longer in GU than that in controls (659±148 vs 533±43, P<001) and plasma VIP levels (ng/L) were significantly higher than in controls (375±107 vs 184±59, P<005). There was a significant positive correlation between GET1/2 and plasma VIP levels (r=055,P<001). No significant changes were found in SS and SP in GU compared with controls (P>005). GET1/2 in DU was markedly shorter than the control group (417±102 vs 533±43, P<001), and plasma SS levels (ng/L) significantly lower than those in controls (64±25 vs 119±34,P<001), there was a significant positive correlation between GET1/2 and SS levels (r=056,P<001). Plasma SP levels (ng/L) in DU were significantly higher than the controls (544±127 vs 416±58,P<001),there was a significant negative correlation between GET1/2 and SP levels (r=-068,P<001). No significant difference was found in the plasma VIP levels between DU and controls (P>005).CONCLUSION VIP elevation may contribute to the GET1/2 delay and the occurrence of GU. The increased SP and lowered SS may play important roles in the GET1/2 acceleration and the pathogensis of DU.
基金Supported by Fundacao de Amparo à Pesquisa do Estado de Sao Paulo(Fapesp),No.2010/14845-4 and No.2015/14923-9Conselho Nacional de Desenvolvimento Científico e Tecnológico(CNPq),No.150456/2009-3
文摘AIM: To correlate gastric contractility, gastrointestinal transit, and hormone levels in non-pregnant(estrous cycle) and pregnant rats using noninvasive techniques. METHODS: Female rats(n = 23) were randomly divided into(1) non-pregnant,(contractility, n =6; transit, n = 6); and(2) pregnant(contractility, n = 5; transit, n = 6). In each estrous cycle phase or at 0, 7, 14, and 20 d after the confirmation of pregnancy, gastrointestinal transit was recorded by AC biosusceptometry(ACB), and gastric contractility was recorded by ACB and electromyography. After each recording, blood samples were obtained for progesterone and estradiol determination. RESULTS: In the estrous cycle, despite fluctuations of sex hormone levels, no significant changes in gastrointestinal motility were observed. Days 7 and 14 of pregnancy were characterized by significant changes in the frequency of contractions(3.90 ± 0.42 cpm and 3.60 ± 0.36 cpm vs 4.33 ± 0.25 cpm) and gastric emptying(168 ± 17 min and 165 ± 15 min vs 113 ± 15 min) compared with day 0. On these same days, progesterone levels significantly increased compared with control(54.23 ± 15.14 ng/m L and 129.96 ± 30.52 ng/mL vs 13.25 ± 6.31 ng/mL). On day 14, we observed the highest level of progesterone and the lowest level of estradiol compared with day 0(44.3 ± 15.18 pg/mL vs 24.96 ± 5.96 pg/mL). CONCLUSION: Gastrointestinal motility was unaffected by the estrous cycle. In our data, high progesterone and low estradiol levels can be associated with decreased contraction frequency and slow gastric emptying.
基金We are grateful for the technical support provided by Dr.Lin Lv and Dr.FengyunWang(Xiyuan Hospital,affiliated with the Chinese Academy of TCM,Beijing,China)and Xin Ma(Beijing University of Chinese Medicine,Beijing,China).
文摘Objective:To observe the effect and mechanism of Xiangsha Liujunzi decoction(XSLJZD)drug serum on gastric antrum smooth muscle cells(SMCs)in rats with functional dyspepsia(FD).Methods:Gastric antrum SMCs from rats with FD were isolated,cultured,and then divided into six groups as follows:control,model,domperidone,low-dose XSLJZD(LXSLJZD),medium-dose XSLJZD(MXSLJZD),and high-dose XSLJZD(HXSLJZD).Each group was administered the corresponding drug serum for intervention.Drug serum intervention conditions and proliferative activity of SMCs were tested by cholecystokinin octapeptide.Ghrelin,gastrin,somatostatin,and substance P(SP)levels were measured by ELISA.Somatostatin and SP mRNA expression was measured by real-time PCR.Results:A concentration of 10%drug serum for 24 h was decided to be the best intervention condition for later study.The mean optical density value in the model group was lower than that in the control group(P紏.001).Optical density values in the domperidone and HXSLJZD groups were higher than those in the model group(P?.025,P?.032,respectively).Gastrin,SP,and ghrelin levels in the model group were lower(P?.007,P?.037,P?.005,respectively),but somatostatin levels were higher,compared with those in the control group(P?.031).Gastrin,SP,and ghrelin levels in the domperidone,MXSLJZD,and HXSLJZD groups were higher than those in the model group(all P<.05).Somatostatin levels in the four drug-treated groups were lower than those in the model group(P?.002,P?.007,P?.001,P?.009,respectively).SP mRNA levels in the model group were lower than those in the control,domperidone,MXSLJZD,and HXSLJZD groups(P?.037 P?.016,P?.025,P?.002,respectively).Somatostatin mRNA levels in the model group were higher than those in the control and MXSLJZD groups(P紏.042,P紏.035).Conclusions:XSLJZD and domperidone drug serum effectively promote proliferative activity of gastric antrum SMCs in an FD model.The mechanism of this activity may be regulated by gastrointestinal hormones.
文摘Sendur et al pointed out the attention on the importance of mutational analysis for adjuvant treatment of gastrointestinal stromal tumor (GIST) in an article published in World Journal of Gastroenterology . In particular, they suggested that the optimal dose and duration of adjuvant therapy could be defined by the mutational status of the primary disease. This comment would underline the importance of centralised laboratories, given the increasingly important role of molecular analysis in the work-flow of all GIST, and the need of retrospective analyses for subgroups population stratified for the mutational status from the available studies in the adjuvant setting, in order to define the role of mutational analysis in choosing the optimal dose and duration of adjuvant therapy.
文摘Gastrointestinal stromal tumors(GISTs) are the most common soft tissue sarcoma of the gastrointestinal tract,resulting from an activating mutation of stem cell factor receptor(KIT),and an activating mutation of the homologous platelet-derived growth factor receptor alpha(PDGFRA) kinase.Most GISTs(90%-95%) are KIT-positive.About 5% of GISTs are truly negative for KIT expression.GISTs have been documented to resistant conventional chemotherapeutics.Due to the KIT activation that occurs in the majority of the cases,KIT inhibition is the primary treatment approach in the adjuvant treatment of metastatic GISTs.Imatinib mesylate is an oral agent that is a selective protein tyrosine kinase inhibitor of the KIT protein tyrosine kinase,and it has demonstrated clinical benefit and objective tumor responses in most GIST patients in phase Ⅱ and Ⅲ trials.The presence and the type of KIT or PDGFRA mutation are predictive of response to imatinib therapy in patients with advanced and metastatic disease.Molecular analysis in phaseⅠ-Ⅱ trials revealed significant differences in objective response,progression-free survival,and overall survival between GISTs with different kinase mutations.The aim of this letter is to touch on the need for exon mutation analysis for adjuvant treatment with imatinib in GIST patients.
文摘AIM： To investigate the effect of firing noise on gastrointestinal transit and probe its mechanism by measuring the levels of plasma polypeptide hormones. METHODS： A total of 64 SD rats were randomly divided into a control group and three stimulating groups. Firing noise of different intensity by sub-machine guns was used as inflicting factor. The effect of firing noise on liquid substance gastrointestinal transit and solid substance gastrointestinal transit was observed by measuring the ratio of carbon powder suspension transmitting and barium sticks transmitting respectively. Plasma levels of polypeptide hormones were measured by radio-immunoassay. RESULTS： The noise accelerated gastrointestinal transit of solid food by more than 80 db;and accelerated gastrointestinal transit of liquid food significantly by more than 120 db. Meantime, plasma levels of plasma motilin （MTL）（157.47±16.08; 151.90±17.08）, somatostatin （SS）（513.97±88.77; 458.25±104.30）, substance P （SP）（115.52±20.70; 110.28±19.96） and vasoactive intestinal peptide （VIP） （214.21±63.17; 251.76±97.24） remarkably changed also. CONCLUSION： Within a certain intensity range, the firing noise changes the levels of rat plasma gastrointestinal hormones, but the gastrointestinal transit is still normal. Beyond the range, the noise induces plasma hormone levels disturbance and gastrointestinal transit disorder. ~
文摘BACKGROUND Multiple gastrointestinal stromal tumors(MGISTs)are a very rare type of gastrointestinal stromal tumor(GIST)and are usually observed in syndrome.AIM The paper aimed to describe the clinical and oncological features of MGISTs and to offer evidence for the diagnosis and treatment.METHODS Data of consecutive patients with MGISTs who were diagnosed at Peking University People’s Hospital(PKUPH)from 2008 to 2019 were retrospectively evaluated.Further,a literature search was conducted by retrieving data from PubMed,EMBASE,and the Cochrane library databases from inception up to November 30,2019.RESULTS In all,12 patients were diagnosed with MGISTs at PKUPH,and 43 published records were ultimately included following the literature review.Combined analysis of the whole individual patient data showed that female(59.30%),young(14.45%),and syndromic GIST(63.95%)patients comprised a large proportion of the total patient population.Tumors were mainly located in the small intestine(58.92%),and both CD117 and CD34 were generally positive.After a mean 78.32-mo follow-up,the estimated median overall survival duration(11.5 years)was similar to single GISTs,but recurrence-free survival was relatively poorer.CONCLUSION The clinical and oncological features are potentially different between MGISTs and single GIST.Further studies are needed to explore appropriate surgical approach and adjuvant therapy.
基金Supported by Shanghai Leading Academic Discipline Project,No.S30203Shanghai Jiaotong University School of Medi-cine Leading Academic Discipline Project
文摘AIM: To analyze the accuracy of computed tomography (CT) angiography in the diagnosis of acute gastrointestinal (GI) bleeding. METHODS: The MEDLINE, EMBASE, Cancerlit, Cochrane Library database, Sciencedirect, Springerlink and Scopus, from January 1995 to December 2009, were searched for studies evaluating the accuracy of CT angiography in diagnosing acute GI bleeding. Studies were included if the ycompared CT angiography to a reference standard of upper GI endoscopy, colonoscopy, angiography or surgery in the diagnosis of acute GI bleeding. Meta-analysis methods were used to pool sensitivity and specificity and to construct summary receiver-operating characteristic. RESULTS: A total of 9 studies with 198 patients were included in this meta-analysis. Data were used to form 2 × 2 tables. CT angiography showed pooled sensi-tivity of 89% (95% CI: 82%-94%) and specificity of 85% (95% CI: 74%-92%), without showing significant heterogeneity (χ2 = 12.5, P = 0.13) and (χ2 = 22.95, P = 0.003), respectively. Summary receiver operating characteristic analysis showed an area under the curve of 0.9297. CONCLUSION: CT angiography is an accurate, costeffective tool in the diagnosis of acute GI bleeding and can show the precise location of bleeding, thereby directing further management.
文摘Objective: To systematically evaluate the effects of heating infusion on gastrointestinal complications of patients with enteral nutrition. Methods: The domestic and foreign databases including Cochrane Library, PubMed, EMBASE, Web of Science, Chinese biomedical literature database (CBM), Wan Fang database (Wan Fang), China National Knowledge Infrastructure (CNKI) and VIP Database for Chinese Technical Periodicals(VIP) were retrieved. The retrieval contents were randomized controlled trials on improving gastrointestinal complications of patients with enteral nutrition by heating infusion of nutrient solution. Data were collected by two reviewers according to the data extraction tables. Results: A total of 17 randomized controlled trials with 1683 subjects were chosen. The results of meta analysis showed that the rate of abdominal pain, abdominal distension and nausea in patients with enteral nutrition could be reduced by warm infusion of nutrient solution, but the effect of the infusion on vomiting, constipation, stomach retention and diarrhea was not superior. Conclusion: Heating infusion of nutrient solution can reduce the incidence of abdominal pain, abdominal distension and nausea in patients with enteral nutrition.
基金Supported by the National Natural Science Foundation of China,No.81372628,No.81773293,and No.31660266the Natural Science Foundation of Hunan Province,No.12JJ5048the Science and Technology Plan Fund of Hunan Province,P.R.China,No.2018JJ3758,No.2017WK2063,No.2017DK2011,No.2015GK3117,and No.2014WK2016
文摘AIM To determine the therapeutic effect of photodynamic therapy(PDT) for middle-advanced stage upper gastrointestinal carcinomas. METHODS We searched PubM ed, EMBASE, the Cochrane Library, China National Knowledge Infrastructure, China Science and Technology Journal Database, and Wanfang Database from inception to April 2018 for randomized controlled studies. These studies compared PDT with other palliative therapies(radiotherapy, chemotherapy, or Nd:YAG laser) and compared PDT, radiotherapy, or chemotherapy alone with PDT combined with chemotherapy/radiotherapy. In our meta-analysis, both fixed and random effects models were used to estimate the risk ratio(RR) for dichotomous outcomes(the response rate and one-year survival rate).RESULTS Ten random controlled clinical studies with 953 patients were included in the analysis. The effective rate for PDT was better than that of radiotherapy or Nd:YAG laser for the treatment of middle-advanced upper gastrointestinal carcinomas [RR = 1.36; 95% confidence interval(CI): 1.13-1.65; P = 0.001]. In addition, PDT combined with chemotherapy had significantly better efficacy and a higher one-year survival rate than PDT or chemotherapy alone(significant remission rate, RR = 1.62; 95%CI: 1.34-1.97; P < 0.00001; one-year survival rate, RR = 1.81; 95%CI: 1.13-2.89; P = 0.01).CONCLUSION PDT is a useful method for the treatment of middleadvanced stage upper gastrointestinal carcinomas. PDT combined with chemotherapy or radiotherapy can enhance its efficacy and prolong survival time.
基金Supported by First Affiliated Hospital,Guangxi Medical University
文摘AIM:To evaluate the efficacy of high-dose proton pump inhibitors(PPIs)vs low-dose PPIs for patients with upper gastrointestinal bleeding.METHODS:PubMed,Embase,the Cochrane Library,and Web of Science were searched to identify relevant randomized controlled trials(RCTs).Eligible trials were RCTs that compared high-dose PPI with low-dose PPI following endoscopic hemostasis.The primary endpoint was rebleeding;secondary endpoints were patient numbers that needed surgery,and mortality.The meta-analysis was performed with a fixed effects model or random effects model.RESULTS:Nine eligible RCTs including 1342 patients were retrieved.The results showed that high-dose intravenous PPI was not superior to low-dose intra-venous PPI in reducing rebleeding[odds ratio(OR)= 1.091,95%confidential interval(CI):0.777-1.532],need for surgery(OR=1.522,95%CI:0.643-3.605) and mortality(OR=1.022,95%CI:0.476-2.196).Subgroup analysis according to different region revealed no difference in rebleeding rate between Asian patients(OR=0.831,95%CI,0.467-1.480)and European patients(OR=1.263,95%CI:0.827-1.929).CONCLUSION:Low-dose intravenous PPI can achieve the same efficacy as high-dose PPI following endoscopic hemostasis.
文摘AIM To perform a meta-analysis to investigate the association between cyclooxygenase-2(COX-2)-1195G>A gene polymorphism and gastrointestinal cancers. METHODS Publications related to the COX-2-1195G>A gene polymorphism and gastrointestinal cancers published before July 2016 were retrieved from Pub Med, EMBASE, Web of Science, China Biological Medicine Database, China National Knowledge Infrastructure, and CQVIP Database. Meta-analysis was performed using Stata11.0 software. The strength of the association was evaluated by calculating the combined odds ratios(ORs) and the corresponding 95%CIs. The retrieved publications were excluded or included one by one for sensitivity analysis. In addition, the funnel plot, Begg's rank correlation test, and Egger's linear regression method were applied to analyse whether the included publications had publication bias. RESULTS A total of 24 publications related to the COX-2-1195G>A gene polymorphism were included, including 28 studies involving 11043 cases and 18008 controls. The meta-analysis results showed that the COX-2-1195G>A gene polymorphism significantly correlated with an increased risk of gastrointestinal cancers, particularly gastric cancer(A vs G: OR = 1.35; AA/AG vs GG: OR = 1.54; AA vs GG/AG: OR = 1.43; AA vs GG: OR = 1.80; AG vs GG: OR = 1.35). Compared to the Caucasian population in America and Europe, the COX-2-1195G>A gene polymorphism in the Asian population(A vs G: OR = 1.30; AA/AG vs GG: OR= 1.50; AA vs GG/AG: OR = 1.35; AA vs GG: OR = 1.71; AG vs GG: OR = 1.37) significantly increased gastrointestinal cancer risk. The sensitivity analysis(P < 0.05) and the false positive report probability(P < 0.2) confirmed the reliability of the results. CONCLUSION The results showed that the COX-2-1195G>A gene polymorphism might be a potential risk factor for gastrointestinal cancers. Further validation by a large homogeneous study is warranted.
文摘AIM:To perform a meta-analysis to derive a more precise estimation of imatinib treatment for different genotypes of gastrointestinal stromal tumors(GIST).METHODS:Studies were identified by searching PubMed and Embase.Inclusive criteria were patients with exon 9-mutant,exon 11-mutant or wide type(WT) GIST,receiving chemotherapy of imatinib for clinical trial,and efficacy evaluation was cumulative response (CR)including complete response and partial response.The odds ratios(OR)for CR in stem cell factor receptor (KIT)mutation patients vs WT genotype patients,KIT exon 11-mutant genotype patients vs KIT exon 9-mutant genotype patients and KIT exon 9-mutant genotype patients vs WT genotype patients were calculated with 95%confidence interval(CI)for each study as an estimation of the efficacy of imatinib.RESULTS:Five studies including 927 patients were involved in this meta-analysis.The overall OR(KIT group vs WT group)was 3.34(95%CI:2.30-4.86,P <0.00001,P heterogeneity=0.04).The overall OR in KIT exon 11 group vs KIT exon 9 group was 3.29(95%CI: 2.17-5.00,P<0.00001,P heterogeneity=0.33).The overall OR in KIT exon 9 group vs WT group was 1.23(95% CI:0.73-2.10,P=0.44,P heterogeneity=0.42).CONCLUSION:Most patients with different genotypes of GIST and KIT exon 11-mutant will benefit from the individualized treatment of imatinib.
