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Prognostic factors and predictors of postoperative adjuvant transcatheter arterial chemoembolization benefit in patients with resected hepatocellular carcinoma

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World Journal of Gastroenterology 2020年第10期26卷 1042-1055页

作者： Ming-Yu Chen Sarun Juengpanich jia-hao hu Win Topatana jia-Sheng Cao Chen-hao Tong jian Lin Xiu-Jun Cai Department of General Surgery Sir Run-Run Shaw HospitalZhejiang University School of MedicineHangzhou 310000Zhejiang ProvinceChina School of Medicine Zhejiang UniversityHangzhou 310016Zhejiang ProvinceChina Engineering Research Center of Cognitive Healthcare of Zhejiang Province Hangzhou 310000Zhejiang ProvinceChina Department of General Surgery Shaoxing People’s HospitalZhejiang UniversityShaoxing 312000Zhejiang ProvinceChina Department of General Surgery Longyou People’s HospitalQuzhou 314400Zhejiang ProvinceChina

BACKGROUND Postoperative adjuvant transcatheter arterial chemoembolization (PA-TACE) has improved overall survival (OS) in patients with hepatocellular carcinoma (HCC).However,the prognostic and predictive factors remain *** To assess the prognostic factors and the predictors of PA-TACE benefit for OS in patients with resected *** Univariate and multivariate analyses were performed to identify the potential prognostic factors for *** order to assess the predictive factors of PA-TACE benefit,the interaction variables between treatments for each subgroup were evaluated using the Cox proportional hazards regression *** A total of 378 patients (PA-TACE vs surgery alone,189:189) from three centerswere included after a propensity-score 1:1 matching *** to the group receiving surgery alone,PA-TACE prolonged the OS rate in patients with resected HCC (P <0.001).The Barcelona Clinic Liver Cancer system and ferritinto-hemoglobin ratio (FHR) were used as the prognostic factors for OS in both *** (P=0.023) and microscopic vascular invasion (MVI)(P=0.002) were also identified in the PA-TACE group,while gender (P=0.027),hepatitis B virus(P=0.034) and albumin-bilirubin grade (P=0.027) were also selected in the surgery alone *** addition,PA-TACE resulted in longer OS than surgery alone across subgroups [all hazard ratios (PA-TACE-to-surgery alone)<1].Notably,a significantly prolonged OS following PA-TACE was observed in patients with high FHR (P=0.038) and without MVI (P=0.048).CONCLUSION FHR and Barcelona Clinic Liver Cancer stages were regarded as prognostic factors for ***,high FHR and the absence of MVI were important predictive factors,which can be used to assist clinicians in selecting which patients could achieve a better OS with PA-TACE.

关键词： Postoperative adjuvant transcatheter arterial chemoembolization Hepatocellular carcinoma Prognostic factors Predictive factors Overall survival

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Neurotoxicity and Biomarkers of Lead Exposure: a Review

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Chinese Medical Sciences Journal 2013年第3期28卷 178-188页

作者： Kang-sheng Liu jia-hu hao Yu Zeng Fan-chun Dai Ping-qing Gu State Key Laboratory of Reproductive Medicine Department of Clinical Laboratory Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University Department of Maternity and Child Health Care School of Public HealthAnhui Medical University Child Health Care Department Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University Obstetrical Department Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University Department of Epidemiological and Health Statistics School of Public Health of Nanjing Medical University

Appropriate selection and measurement of lead biomarkers of exposure are critically important for health care management purposes,public health decision making,and primary prevention *** is one of the neurotoxicants that seems to be involved in the etiology of *** are generally classified into three groups:biomarkers of exposure,effect,and *** main body compartments that store lead are the blood,soft tissues,and bone;the half-life of lead in these tissues is measured in weeks for blood,months for soft tissues,and years for *** the brain,lead-induced damage in the prefrontal cerebral cortex,hippocampus,and cerebellum can lead to a variety of neurological disorders,such as brain damage,mental retardation,behavioral problems,nerve damage,and possibly Alzheimer’s disease,Parkinson’s disease,and *** paper presents an overview of biomarkers of lead exposure and discusses the neurotoxic effects of lead with regard to children and adults.

关键词： lead poisoning biological monitoring neurotoxicity neurodevelopment

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Blood Lead Levels During Pregnancy and Its Influencing Factors in Nanjing,China

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Chinese Medical Sciences Journal 2013年第2期28卷 95-101页

作者： Kang-sheng Liu jia-hu hao Juan Shi Chun-fang Dai Xi-rong Guo State Key Laboratory of Reproductive Medicine Department of Clinical LaboratoryNanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University Department of Maternity Child Health Care School of Public HealthAnhui Medical University Child Health Care Department Nanjing Maternity and Child Health Care Hospital Department of Obstetrics Nanjing Maternity and Child Health Care Hospital Director's Office Nanjing Maternity and Child Health Care Hospital

Objective To investigate the blood lead levels （BLLs） in the duration of pregnancy and 6-12 weeks after delivery, and analyze the influencing factors of BLLs in healthy pregnant women. Methods Pregnant women were recruited from September 2009 to February 2010 at the prenatal clinic in Nanjing Maternity and Child Health Care Hospital. Altogether 174 healthy pregnant women without pregnant or obstetric complications or abnormal pregnancy outcomes were enrolled as the gravida group, and 120 healthy non-pregnant women as the control group. BLLs during pregnancy were determined by flame atomic absorption spectroscopy. Results BLLs in all the three pregnancy trimesters and postpartum were 59.8±24.3, 55.4±20.1, 55.9±19.7, and 67.6±17.4 μ/L, respectively, and the mean BLL in control group was 67.5±21.3 μg/L. BLLs during all the three trimesters were lower in the gravida group than in the control group （P=0.043, 0.021, and 0.028）. Furthermore, occupations, nutrients supplementation, and time of house/apartment painted were associated with BLLs in pregnant women. Lead-related occupations, cosmetics use, and living in a house painted less than 1 year before are risk factors of high BLLs among pregnant women, while calcium, iron, zinc, and milk supplements are protective factors. Conclusion Supplementing calcium, iron, zinc, and milk, or avoiding contact with risk factors may help people, especially pregnant women, to reduce lead exposure.

关键词： blood lead levels pregnancy lead exposure

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Biologic therapy for Crohn’s disease over the last 3 decades

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World Journal of Clinical Cases 2022年第2期10卷 594-606页

作者： Ji-Liang Shen Zheng Zhou jia-Sheng Cao Bin Zhang jia-hao hu jia-Ying Li Xiao-Ming Liu Sarun Juengpanich Ming-Song Li Xu Feng Department of General Surgery Sir Run-Run Shaw HospitalZhejiang University School of MedicineHangzhou 310016Zhejiang ProvinceChina Department of Gastroenterology Nan Fang HospitalSouthern Medical UniversityGuangzhou 510515Guangdong ProvinceChina Department of Gastroenterology Third Affiliated Hospital of Guangzhou Medical UniversityGuangzhou 510000Guangdong ProvinceChina

BACKGROUND Despite the overload of publications on Crohn’s disease(CD),no comprehensive analysis of biologic therapy for CD has been *** To determine knowledge gaps and identify areas of interest of biologic therapy for *** The top 100 highest-cited original articles were identified from January 1991 to December 2020 in the Clarivate Analytics Web of Science Core Collection *** conducted a bibliometric analysis of biologic therapy for CD based on total citations,summarized the bibliographic information of the articles related to CD biologic therapy,and explored the research *** The top 100 highest-cited original articles were identified with total citations ranging from 307 to *** 2000s(Period II,n=66)yielded the most influential original articles and saw the most dramatic *** the top 10 countries,including 8 European countries and 2 North American countries,the United States(n=37)and Belgium(n=20)contributed the most *** the top 10 institutions,the University Hospital Gasthuisberg in Belgium(n=23),the University of Chicago in the United States(n=20),and the Mayo Clinic in the United States(n=17)published the most *** authors,Rutgeerts P in Belgium(n=32),Sandborn WJ in the United States(n=23),and Feagan BG in Canada(n=18)published the highest number of *** cooperation relationships between the United States and Europe were most ***(impact factor=22.682)published the most articles on biologic therapy for CD(n=32)with 17654 total ***-tumor necrosis factor biologics and monoclonal antibodies were the most studied *** The bibliometric analysis emphasized the key contributions to the development of the specialized *** data would provide useful research insights into biologic therapy for CD for clinicians and researchers.

关键词： Biologic therapy Crohn’s disease Bibliometric analysis Most influential Insight

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Mediation Effects of Placental Inflammatory Transcriptional Biomarkers on the Sex-Dependent Associations between Maternal Phthalate Exposure and Infant Allergic Rhinitis: A Population-Based Cohort Study

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Biomedical and Environmental Sciences 2022年第8期35卷 711-721页

作者： WANG jian Qing LI Zhi Juan GAO hui SHENG Jie LIANG Chun Mei hu Ya Bin XIA Xun huANG Kun WANG Su Fang Zhu Peng hao jia hu TAO Fang Biao Department of Maiernal Child and Adolescent HealthSchool of Public HealthAnhui Medical UniversityHefei 230032AnhuiChina MOE Key Laboratory of Popularion Health across Life Cycle Hefei 230032AnhuiChina NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract Hefei 230032AnhuiChina Anhui Provincial Key Laboratory of Population Health and Aristogenics Anhui Medical UniversityHefei 230032AnhuiChina The Fourth Affiliated Hospital Anhui Medical UniversiyHefei 230022AnhuiChina Department of Pediatrics First Afiliated Hospital of Anhui Medical UniversityHefei 230022AnhuiChina

Objective Prenatal phthalate exposure has been associated with placental inflammatory factors and infant allergic rhinitis(AR).However,the results are *** designed a population-based cohort study to examine the effects of placental inflammatory biomarkers on the sex-dependent associations between maternal phthalate exposure and infant *** A total of 2,348 pregnant women from Ma’anshan,Anhui Province,China,who were screened before antenatal visits and met the inclusion criteria,were included in the present *** assessed AR in their offspring aged 36 months with a *** PCR was performed to measure placental inflammatory factor m *** independent samples t-test and multivariable logistic regression were used to determine the associations between infant AR and maternal *** Childhood AR may be related to education and family monthly income(P = 0.01).The phthalate metabolites,mono(2-ethylhexyl) phthalate(MEHP),mono(2-ethyl-5-hydroxyl) phthalate(MEHHP),in pregnant women were associated with a significantly increased risk for infant AR in males[P < 0.05;odds ratio(OR):1.285;95% confidence interval(CI):1.037-1.591,and OR:1.232,95% CI:1.008-1.507,respectively],but not ***,irritably-increased expression levels of HO-1 and IL-4 were associated with AR in male infants(OR:1.175;95% CI:1.038-1.329 and OR:1.181;95% CI:1.056-1.322,respectively).The association between maternal urinary MEHHP and placental HO-1 was marginally significant according to mediation *** The associations of maternal MEHHP and MEOHP levels with fetal AR in males were *** HO-1 was a fractional mediator in the associations between MEHHP and ***,the placenta should be further investigated as a potential mediator of maternal exposure-induced disease risk in children.

关键词： Phthalate Infants Allergic rhinitis Inflammation Sex difference

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Effects of propranolol or propranolol plus isosorbide-5-mononitrate on variceal pressure in schistosomiasis

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World Journal of Gastroenterology 2013年第26期19卷 4228-4233页

作者： De-Run Kong Chao Ma Min Wang Jing-Guang Wang Chen Chen Lei Zhang jia-hu hao Pan Li jian-Ming Xu Department of Gastroenterology First Affiliated Hospital of Anhui Medical University Department of Gastroenterology Fuyang Second People's Hospital Department of Medicine Tongling Vocational Technology College Department of Maternal Child and Adolescent Health School of Public Health Anhui Medical University

AIM: To compare the effects of propranolol (PR) to that of PR plus isosorbide-5-mononitrate (ISMN) on variceal pressure in patients with schistosomiasis. METHODS: Forty-eight patients with schistosomiasis who had no previous variceal bleeding were treated with PR alone or PR plus ISMN. Seven patients refused variceal pressure manometry (3 receiving PR and 4 receiving PR plus ISMN). One patient withdrew from the trial due to headache after taking ISMN. At the time of termination, twenty patients were randomly assigned to treatment with PR plus ISMN or PR alone. The dose of PR was adjusted until the resting heart rate had been reduced by 25% or was less than 55 bpm. In the PR plus ISMN group, after PR was titrated to the same target, the dose of ISMN was increased up to 20 mg orally twice a day. Variceal pressure was measured using a noninvasive endoscopic balloon technique at the end of the 6-mo treatment period. RESULTS: In 40 patients (20 in the PR group and 20 in the PR plus ISMN group), variceal pressure was measured before treatment and at the end of the 6-mo treatment period. PR or PR plus ISMN treatment caused a significant reduction in variceal pressure (PR group: from 24.15 ± 6.05 mmHg to 22.68 ± 5.70 mmHg, P = 0.001; PR plus ISMN group: from 25.69 ± 5.26 mmHg to 20.48 ± 5.43 mmHg; P < 0.001). The percentage decrease in variceal pressure was significant after PR plus ISMN compared with that after PR alone (15.93% ± 8.37% vs 6.05% ± 3.67%, P = 0.01). One patient in the PR plus ISMN group and two patients in the PR group had variceal bleeding during follow-up. There were no significant differences between the two groups regarding the incidence of variceal bleeding. In the PR plus ISMN group, three patients had headache and hypotension. The headache was mild and transient and promptly disappeared after continuation of the relevant drug in two patients. Only one patient withdrew from the trial due to severe and lasting headache after taking ISMN. No side effects

关键词： Esophageal varices Schistosomiasis Portal hypertension Bleeding Propranolol Variceal pressure Isosorbide-5-mononitrate

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Laparoscopic surgery for early gallbladder carcinoma:A systematic review and meta-analysis

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World Journal of Clinical Cases 2020年第6期8卷 1074-1086页

作者： Xu Feng jia-Sheng Cao Ming-Yu Chen Bin Zhang Sarun Juengpanich jia-hao hu Win Topatana Shi-Jie Li Ji-Liang Shen Guang-Yuan Xiao Xiu-Jun Cai Hong Yu Department of General Surgery Sir Run-Run Shaw HospitalZhejiang UniversityHangzhou 310016Zhejiang ProvinceChina Department of General Surgery Jiaxing Hospital of Traditional Chinese MedicineJiaxing 314000Zhejiang ProvinceChina

BACKGROUND There is a controversy as to whether laparoscopic surgery leads to a poor prognosis compared to the open approach for early gallbladder carcinoma (GBC)We hypothesized that the laparoscopic approach is an alternative for early *** To identify and evaluate the safety and feasibility of laparoscopic surgery in the treatment of early *** A comprehensive search of online databases,including MEDLINE (PubMed),Cochrane libraries,and Web of Science,was performed to identify noncomparative studies reporting the outcomes of laparoscopic surgery and comparative studies involving laparoscopic surgery and open surgery in early GBC from January 2009 to October 2019.A fixed-effects meta-analysis was performed for 1-and 5-year overall survival and postoperative complications,while 3-year overall survival,operation time,blood loss,the number of lymph node dissected,and postoperative hospital stay were analyzed by random-effects *** The review identified 7 comparative studies and 8 non-comparative studies.1068 patients (laparoscopic surgery:613;open surgery:455) were included in the meta-analysis of 1-,3-,and 5-year overall survival with no significant differences observed [(HR=0.54;95%CI:0.29-1.00;12=0.0%;P=0.051),(HR=0.75;95%CI:0.34-1.65;I^2=60.7%;P=0.474),(HR=0.71;95%CI:0.47-1.08;I^2=49.6%;P=0.107),respectively].There were no significant differences in operation time[weighted mean difference (WMD)=18.69;95%CI:-19.98-57.36;I^2=81.4%;P=0.343],intraoperative blood loss (WMD=-169.14;95%CI:-377.86-39.57;I2=89.5%;P=0.112),the number of lymph nodes resected (WMD=0.12;95%CI:-2.95-3.18;I^2=73.4%;P=0.940),and the complication rate (OR=0.69;95%CI:0.30-1.58;I2=0.0%;P=0.377) between the two groups,while patients who underwent laparoscopic surgery had a reduced length of hospital stay (WMD=-5.09;95%CI:-8.74--1.45;I2=91.0%;P=0.006).CONCLUSION This systematic review and meta-analysis confirms that laparoscopic surgery is a safe and feasible alternative to open sur

关键词： Laparoscopic surgery Open surgery Early gallbladder carcinoma Survival Meta-analysis

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Breast Milk Lead and Cadmium Levels in Suburban Areas of Nanjing,China

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Chinese Medical Sciences Journal 2013年第1期28卷 7-15页

作者： Kang-sheng Liu jia-hu hao Yu-qing Xu Xiao-qi Gu Juan Shi Chun-fang Dai Fei Xu Rong Shen State Key Laboratory of Reproductive Medicine Department of Clinical LaboratoryNanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University Department of Maternity and Child Health Care School of Public HealthAnhui Medical University Director's Office Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University Child Health Care Department Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University Obstetrical Department Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University Department of Clinical Laboratory Nanjing Children's Hospital

Objective To evaluate levels of lead(Pb) and cadmium(Cd) in the breast milk in the second postpartum month,to investigate the relationship between Pb/Cd levels in breast milk and some sociodemographic parameters,and to explore whether these levels affect the infants' physical status or the mothers' psychological status(postpartum depression).Methods A cross-sectional study was conducted between November 2009 and December *** 170 healthy mothers were enrolled from Nanjing Maternity and Child Health Care *** inclusion criteria were:voluntary to participate in this study,healthy,with no chronic disease,breastfeeding in the second postpartum month,living in a suburban but not non-industrial area of Nanjing,and not occupationally exposed to toxic *** the mothers completed a questionnaire and were evaluated based on the Edinburgh Postpartum Depression Scale(EPDS) to identify the risk of postpartum *** and Cd levels in breast milk were determined by inductively coupled plasma mass *** infants of these mothers were examined for their z scores of weight for age,length for age,head circumference for age,and body mass index for *** The median breast milk levels of Pb and Cd were 40.6 μg/L and 0.67 μg/L,*** 164(96.5%) of the 170 samples,Pb levels were higher than the limit reported by the World Health Organization(> 5 μg/L).Breast milk Cd level was > 1 μg/L in 54(31.8%) *** mothers with a history of anemia had a higher breast milk Pb level than those without a history of anemia(41.1 μg/L vs.37.9 μg/L,P = 0.050).The median breast milk Cd level in those who were active and passive smokers during pregnancy was significantly higher than that in non-smokers(0.88 μg/L vs.0.00 μg/L,P = 0.025).The breast milk Cd level in the mothers not taking iron and vitamin supplements for 2 months postpartum was higher than in those taking the supplements(iron supplement:0.74 μg/L vs.0.00 μg/L,P = 0.025;vitamin supplemen

关键词： lead cadmium suburban areas breast milk Edinburgh Postpartum Depres-sion Scale

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Adhesive cryogel particles for bridging confined and irregular tissue defects

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Military Medical Research 2023年第6期10卷 763-777页

作者： Yao-Ting Xue Ming-Yu Chen jia-Sheng Cao Lei Wang jia-hao hu Si-Yang Li Ji-Liang Shen Xin-Ge Li Kai-Hang Zhang Shu-Qiang hao Sarun Juengpanich Si-Bo Cheng Tuck-Whye Wong Xu-Xu Yang Tie-Feng Li Xiu-Jun Cai Wei Yang Department of Engineering Mechanics Zhejiang UniversityHang‑zhou 310027China Key Laboratory of Soft Machines and Smart Devices of Zhejiang Province Zhejiang UniversityHangzhou 310027China Center for X‑Mechanics Department of Engineering MechanicsZhejiang Univer‑sityHangzhou 310027China Department of General Surgery Sir Run-Run Shaw HospitalZhejiang UniversityHangzhou 310016China Soft Intelligent Materials Co. LtdSuzhou 215123China School of Biomedical Engineering and Health Sciences and Advanced Membrane Technology Research Centre Universiti Teknologi Malaysia81310 SkudaiMalaysia

Background Reconstruction of damaged tissues requires both surface hemostasis and tissue *** with damage resulting from physical trauma or surgical treatments may have arbitrary surface topographies,making tissue bridging *** This study proposes a tissue adhesive in the form of adhesive cryogel particles(ACPs) made from chitosan,acrylic acid,1-ethyl-3-(3-dimethylaminopropyl) carbodiimide(EDC) and N-hydroxysuccinimide(NHS).The adhesion performance was examined by the 180-degree peel test to a collection of tissues including porcine heart,intestine,liver,muscle,and *** of ACPs was evaluated by cell proliferation of human normal liver cells(LO2)and human intestinal epithelial cells(Caco-2).The degree of inflammation and biodegradability were examined in dorsal subcutaneous rat *** ability of ACPs to bridge irregular tissue defects was assessed using porcine heart,liver,and kidney as the ex vivo ***,a model of repairing liver rupture in rats and an intestinal anastomosis in rabbits were established to verify the effectiveness,biocompatibility,and applicability in clinical *** ACPs are applicable to confined and irregular tissue defects,such as deep herringbone grooves in the parenchyma organs and annular sections in the cavernous *** formed tough adhesion between tissues[(670.9±50.1) J/m^(2) for the heart,(607.6±30.0) J/m^(2) for the intestine,(473.7±37.0) J/m^(2) for the liver,(186.1±13.3) J/m^(2) for the muscle,and(579.3±32.3) J/m^(2) for the stomach].ACPs showed considerable cytocompatibility in vitro study,with a high level of cell viability for 3 d[(98.8±1.2)%for LO2 and(98.3±1.6)%for Caco-2].It has comparable inflammation repair in a ruptured rat liver(P=0.58 compared with suture closure),the same with intestinal anastomosis in rabbits(P=0.40 compared with suture anastomosis).Additionally,ACP-based intestinal anastomosis(less than 30 s) was remarkably faster than the convention

关键词： Tissue reconstruction Wet adhesion Adhesive hydrogel Bioadhesive

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Artificial intelligence in gastroenterology and hepatology:Status and challenges

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World Journal of Gastroenterology 2021年第16期27卷 1664-1690页

作者： jia-Sheng Cao Zi-Yi Lu Ming-Yu Chen Bin Zhang Sarun Juengpanich jia-hao hu Shi-Jie Li Win Topatana Xue-Yin Zhou Xu Feng Ji-Liang Shen Yu Liu Xiu-Jun Cai Department of General Surgery Sir Run-Run Shaw HospitalZhejiang UniversityHangzhou 310016Zhejiang ProvinceChina Zhejiang University School of Medicine Zhejiang UniversityHangzhou 310058Zhejiang ProvinceChina School of Medicine Wenzhou Medical UniversityWenzhou 325035Zhejiang ProvinceChina College of Life Sciences Zhejiang UniversityHangzhou 310058Zhejiang ProvinceChina

Originally proposed by John McCarthy in 1955,artificial intelligence(AI)has achieved a breakthrough and revolutionized the processing methods of clinical medicine with the increasing workloads of medical records and digital *** are paying attention to AI technologies for various diseases in the fields of gastroenterology and *** review will illustrate AI technology procedures for medical image analysis,including data processing,model establishment,and model ***,we will summarize AI applications in endoscopy,radiology,and pathology,such as detecting and evaluating lesions,facilitating treatment,and predicting treatment response and prognosis with excellent model *** current challenges for AI in clinical application include potential inherent bias in retrospective studies that requires larger samples for validation,ethics and legal concerns,and the incomprehensibility of the output ***,doctors and researchers should cooperate to address the current challenges and carry out further investigations to develop more accurate AI tools for improved clinical applications.

关键词： Artificial intelligence Gastroenterology Hepatology Status Challenges

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