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gastrointestinal and liver disease in patients with schizophrenia:A narrative review

World Journal of Gastroenterology 2022年第38期28卷 5515-5529页

作者： Rebecca K Grant William M Brindle Mhairi C Donnelly Pauline M McConville Thomas G Stroud Lorenzo Bandieri John N Plevris The Centre for Liver and Digestive Disorders Royal Infirmary of EdinburghEdinburghEH164SAUnited Kingdom General Adult Psychiatry Royal Edinburgh HospitalEdinburghEH105HFUnited Kingdom

Schizophrenia is a severe mental illness which can have a devastating impact onan individual’s quality of life. Comorbidities are high amongst patients and lifeexpectancy is approximately 15 years less than the general population. Despite thewell-known increased mortality, little is known about the impact of gastrointestinaland liver disease on patients with schizophrenia. We aimed to reviewthe literature and to make recommendations regarding future care. Literaturesearches were performed on PubMed to identify studies related to gastrointestinaland liver disease in patients with schizophrenia. High rates of chronic liverdisease were reported, with Non-Alcoholic Fatty Liver disease being of particularconcern;antipsychotics and metabolic syndrome were contributing factors. Ratesof acute liver failure were low but have been associated with antipsychotic useand paracetamol overdose. Coeliac disease has historically been linked to schizophrenia;however, recent research suggests that a causal link is yet to be proven.Evidence is emerging regarding the relationships between schizophrenia andpeptic ulcer disease, inflammatory bowel disease and irritable bowel syndrome;clinical vigilance regarding these conditions should be high. Patients with schizophreniapoorly engage with bowel cancer screening programmes, leading to latediagnosis and increased mortality. Clozapine induced constipation is a significantissue for many patients and requires close monitoring. There is a significantburden of gastrointestinal and liver disease amongst patients with schizophrenia.Better levels of support from all members of the medical team are essential toensure that appropriate, timely care is provided.

关键词： Schizophrenia Gastrointestinal disease Liver disease Mental health

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Gastrointestinal disease in children with autism spectrum disorders:Etiology or consequence?

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World Journal of Psychiatry 2021年第9期11卷 605-618页

作者： Arthur Krigsman Stephen J Walker Pediatric Gastroenterology Resources of New York and Texas GeorgetownTX 78628United States Institute for Regenerative Medicine Wake Forest Baptist Medical CenterWinston SalemNC 27157United States

Chronic gastrointestinal(GI)symptoms and disorders are common in children with autism spectrum disorder and have been shown to be significantly correlated with the degree of behavioral and cognitive impairment.In this unique population,GI symptoms often arise very early in development,during infancy or toddlerhood,and may be misdiagnosed-or not diagnosed at all–due in part to the challenges associated with recognition of symptoms in a minimally or noncommunicative child.Evidence demonstrating that the gut-brain-axis can communicate gut dysbiosis and systemic immune dysregulation in a bidirectional manner raises the question as to whether an untreated gastrointestinal disorder can directly impact neurodevelopment or,conversely,whether having a neurodevelopmental disorder predisposes a child to chronic GI issues.From the data presented in this mini review,we conclude that the preponderance of available evidence would suggest the former scenario is more strongly supported.

关键词： Autism spectrum disorder Gastrointestinal disease Immune dysregulation Neurodevelopment

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Efficacy and safety of Weichang’an pill(胃肠安丸)combined with Western Medicine on Gastrointestinal diseases:a systematic review and Meta-analysis

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Journal of Traditional Chinese Medicine 2023年第6期43卷 1057-1067页

作者： WANG Jiabao ZHANG Lishuang NIU Baihan YU Yajun YANG Fengwen MIAO Lin CHAI Lijuan DING Xinya SUN Yingjie WANG Yujing WANG Lin ZHANG Han WANG Yi LI Lin Institute of Traditional Chinese Medicine Key Laboratory of Pharmacology of Traditional Chinese Medical FormulaeState Key Laboratory of Component-based Chinese MedicineTianjin University of Traditional Chinese MedicineTianjin 301617China Department of Cardiology Tianjin Binhai New Area Hospital of Traditional Chinese MedicineTianjin 300451China Scientific Research Department the First Affiliated Hospital of Henan University of Chinese MedicineZhengzhou 450000China Tianjin Zhongxin Pharmaceutical Group Co. Ltd.Lerentang Pharmaceutical FactoryTianjin 413204China

OBJECTIVE:To systematically evaluate the efficacy and safety of Weichang’an pill(胃肠安丸,WCA)combined with Western Medicine(WM)for the treatment of Gastrointestinal diseases.METHODS:Eight databases,including China National Knowledge Infrastructure Database,Wanfang Data,China Science and Technology Journal Database,SinoMed,PubMed,Web of Science,Cochrane Library,and Embase,were searched for randomized controlled trials(RCTs)of WCA from inception to 30 September 2021.We independently screened the literature,extracted data,and then evaluated the bias risk,effectiveness,safety,and other indicators of the included articles.RESULTS:A total of 33 RCTs were included in this study with 3368 patients.After analysis,it was found that WCA combined with WM could effectively prevent and treat antibiotic-associated gastrointestinal reaction,functional dyspepsia(FD),irritable bowel syndrome,rotavirus diarrhea(RVD),and ulcerative colitis(UC);no serious adverse reactions occurred.Moreover,compared with the control group,the experimental group showed significantly improved symptoms and some biochemical parameters.CONCLUSIONS:WCA combined with WM for the treatment of Gastrointestinal diseases had better clinical efficacy than the control group,without serious adverse reactions.Notably,in the treatment of FD,RVD,and UC,WCA improved clinical symptoms and biochemical indicator expression.Nevertheless,owing to the restricted quality and quantity of the literature,the results need to be further studied using high-quality RCTs.

关键词： Gastrointestinal disease integrative medicine Meta-analysis systematic review Weichang’an pill

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Global whole family based-Helicobacter pylori eradication strategy to prevent its related diseases and gastric cancer

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World Journal of Gastroenterology 2020年第10期26卷 995-1004页

作者： Song-Ze Ding Department of Gastroenterology and Hepatology People’s Hospital of Zhengzhou University Henan Provincial People’s Hospital and Henan University School of Medicine

Helicobacter pylori (H.pylori) infects approximately 50% of the world population.The multiple gastrointestinal and extra-Gastrointestinal diseases caused by H.pylori infection pose a major healthcare threat to families and societies;it is also a heavy economic and healthcare burden for countries that having high infection rates.Eradication of H.pylori is recommended for all infected individuals.Traditionally,"test and treat"and"screen and treat"strategies are available for various infected populations.However,clinical practice has noticed that these strategies have some shortfalls and may need refinement,mostly due to the fact that they are not easily manageable,and are affected by patient compliance,selection of treatment population and cost-benefit estimations.Furthermore,it is difficult to control infections from the source,therefore,development of additional,compensative strategies are encouraged to solve the above problems and facilitate bacteria eradication.H.pylori infection is a family-based disease,but few studies have been performed in a whole family-based approach to curb its intra-familial transmission and the development of related diseases.In this work,a third,novel whole family-based H.pylori eradication strategy is introduced.This approach screens,identifies,treats and follows up on all H.pylori-infected individuals in entire families to control H.pylori infection among family members,and reduce its long-term complications.This strategy is high-risk population-oriented,and able to reduce H.pylori spread among family members.It also has good patient-family compliance and,importantly,is practical for both high and low H.pylori-infected communities.Future efforts in these areas will be critical to initiate and establish healthcare policies and management strategies to reduce H.pylori-induced disease burden for society.

关键词： Helicobacter pylori Intra-familial infection Gastrointestinal disease Gastric cancer

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Prediction of the Impacts of Climate Change on the Geographical Distribution of Dysentery in Iran

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Chinese Journal of Urban and Environmental Studies 2022年第3期10卷 74-91页

作者： Giti BAHRAMI Homeira SAJADI Hassan RAFIEE Mehdi NOROUZI Alireza SHAKIBA Social Determinants of Health Research Center Alborz University of Medical Sciences Department of Social Welfare Management University of Social Welfare and Rehabilitation Sciences Social Welfare Management Research Center University of Social Welfare and Rehabilitation Sciences Social Determinants of Health Research Center University of Social Welfare and Rehabilitation Sciences Center for Remote Sensing & GIS Research Faculty of Earth Sciences Shahid Beheshti University

Dysentery is a water-and food-borne infectious disease and its incidence is sensitive to climate change. Although the impact of climate change on dysentery is being studied in specific areas, a study in Iran is lacking. In this study, RCP 4.5 and RCP 8.5 scenarios were used to predict the prevalence of dysentery in Iran between 2050 and 2070. This study is a secondary analysis using Geographically Weighted Regression, and 273 cities of Iran were analyzed between March 2011 and March 2017. Bioclimate variables were used as independent variables. Ecological data about the prevalence and incidence of dysentery, which were collected between 2011 and 2017, were used as the dependent variables. The result shows the incidence of dysentery is significantly associated with bioclimate change exposure, in 2050 and 2070, based on RCP 4.5 and RCP 8.5.Our findings showed that in the absence of adaptation of the population, an increase in the risk of bioclimate-related diseases is expected by around 95.6% in the mid-century compared with the beginning of the century with regional variations. Based on these findings, the geographical distribution of the disease will also change. In 2050, the pattern of disease distribution would be changed, and the north of Iran will be included in the vulnerable regions. In 2070, the southeastern and northern parts of Iran will have the most vulnerability to climate change. Our study contributes important knowledge to this perspective by providing insightful findings and pieces of evidence for climate change adaptation and mitigation.

关键词： Climate change health Geographically Weighted Regression dysentery Gastrointestinal disease

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Bio-inspired intestinal scavenger from microfluidic electrospray for detoxifying lipopolysaccharide

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Bioactive Materials 2021年第6期6卷 1653-1662页

作者： Cheng Zhao Guopu Chen Huan Wang Yuanjin Zhao Renjie Chai Department of Rheumatology and Immunology Institute of Translational MedicineThe Affiliated Drum Tower Hospital of Nanjing University Medical SchoolNanjing210002China State Key Laboratory of Bioelectronics School of Life Sciences and TechnologyJiangsu Province High-Tech Key Laboratory for Bio-Medical ResearchSoutheast UniversityNanjing210096China Department of Endocrinology Shenzhen Second People’s HospitalCenter for DiabetesObesity and Metabolic Diseases of Shenzhen UniversityHealth Science Center of Shenzhen UniversityShenzhen518035PR China Co-Innovation Center of Neuroregeneration Nantong UniversityNantong226001China Institute for Stem Cell and Regeneration Chinese Academy of ScienceBeijingChina Beijing Key Laboratory of Neural Regeneration and Repair Capital Medical UniversityBeijing100069China

Lipopolysaccharide(LPS)plays an important role in metabolic syndrome(MetS)and other gut-derived diseases,and detoxifying LPS is considered to be a fundamental approach to prevent and treat these diseases.Here,inspired by the feeding behaviour of scavenger,novel microfluidic microcapsules with alkaline phosphatase(ALP)encapsulation and the scavenger-like molecular sieve shell are presented for cleaning intestinal LPS.Benefiting from the precisely controlled of the pore size and microfluidic electrospray,the generated microcapsules were imparted with porous molecular-sieve shells and ALP encapsulated active cores.These microcapsules could continuously work as an intestinal scavenger after colonized in intestine.It has been demonstrated that the microcapsules could englobe LPS while inhibit the permeation of digestive enzyme,and this ability contributes to promising ALP’s activity,protecting cells at the presence of LPS and reducing inflammation.In addition,this scavenger inspired microcapsule could effectively decrease the LPS in organs,reduce inflammation and regulating fat metabolism in vivo.These features make the ALP encapsulated microcapsules an ideal candidate for treating MetS and other LPS related diseases.

关键词： Biomimetic Intestinal barrier Microfluidics Microcapsule Gastrointestinal disease

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Delayed diagnosis of abdominal Henoch-Schonlein purpura in children:A case report

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世界临床病例杂志 2023年第26期11卷 6311-6317页

作者： Hui Guo Zhi-Ling Wang Zhu Tao Department of Pediatrics West China Second University HospitalChengdu 610041Sichuan ProvinceChina Key Laboratory of Birth Defects and Related diseases of Women and Children Sichuan UniversityChengdu 610000Sichuan ProvinceChina

BACKGROUND For children with abdominal Henoch-Schonlein purpura presenting abdominal pain as an initial symptom and severe clinical manifestations,but without purpura appearance on the skin,the diagnosis and treatment are relatively difficult.This study summarized the characteristics of this group of patients by literature review and provided additional references for further refinement of glucocorticoid therapy in this vasculitis.CASE SUMMARY A 6-year-old girl presented mainly with repeated abdominal pain and had received short-term out-of-hospital treatment with hydrocortisone.On day 7 after onset,gastroscopy revealed chronic non-atrophic gastritis and erosive duodenitis without purpuric rash,and no obvious resolution of the abdominal pain was found after treatment against infection and for protection of gastric mucosa.On day 14 the inflammatory indices continued to rise and the pain was relieved after enhanced anti-infective therapy,but without complete resolution.On day 19,the patient presented with aggravated abdominal pain with purplish-red dots on the lower limbs,by which Henoch-Schonlein purpura was confirmed.After 5 d of sequential treatment with methylprednisolone and prednisone,abdominal pain disappeared and she was discharged.CONCLUSION Henoch-Schonlein purpura-related rash may appear after long-term abdominal pain,and should be distinguished from acute and chronic Gastrointestinal diseases at the early stage without typical rash.For bacterial infection-induced Henoch-Schonlein purpura,glucocorticoid therapy alone without clearing the infection may not relieve symptoms.

关键词： Henoch-Schonlein purpura Delayed diagnosis Rash Abdominal pain Gastrointestinal disease Case report

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Diabetic gastroenteropathy:An underdiagnosed complication

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World Journal of Diabetes 2021年第6期12卷 794-809页

作者： Marcio JoséConcepción Zavaleta Jhean Gabriel Gonzáles Yovera Diego Martín Moreno Marreros Luciana del Pilar Rafael Robles Kely Roxana Palomino Taype Karen Nohelly Soto Gálvez Luis Fernando Arriola Torres Julia Cristina Coronado Arroyo Luis Alberto Concepción Urteaga Division of Endocrinology Hospital Nacional Guillermo Almenara IrigoyenLima 12590Peru Division of Gastroenterology Hospital Nacional Guillermo Almenara IrigoyenLima 12590Peru Division of Medicine Universidad Nacional de TrujilloTrujillo 13011Peru Division of Endocrinology Hospital Nacional Dos de MayoLima 150101Peru Division of Endocrinology Instituto de Neurología y Endocrinología AvanzadaAndahuaylas 03700Peru Clinical Management Unit Hospital Nacional Guillermo Almenara IrigoyenLima 12590Peru Division of Neurology Instituto de Neurología y Endocrinología AvanzadaAndahuaylas 03700Peru Division of Obstetrics and Gynaecology Clínica VesalioLima 15036Peru Division of Neumology Hospital Regional Docente de TrujilloTrujillo 13011Peru

This article is an extensive review that provides an update on the pathophysiology,symptoms,diagnosis,and treatment of diabetic gastroenteropathy.There is no reported prevalence,but it has been described that patients with type 1 diabetes have a cumulative incidence at 10 years of 5.2%,and type 2 patients,1%.Also,in the group of type 1 diabetes,it has been observed that women are more likely to present this condition(5.8%vs 3.5%).Many factors are associate with its development(e.g.,hyperglycemia,vagal dysfunction,loss of expression of neural nitric oxide synthase in the myenteric plexus,alterations in the Cajal interstitial cell network,and oxidative stress).gastrointestinal discomfort could be perceived 70% higher in diabetic patients,describing that 25%of diabetic patients experience gastrointestinal symptoms.Diabetic enteropathy could affect any portion of the gastrointestinal tract,but esophageal alterations were described in more than 60% of diabetic patients,also 60% of them present constipation,and 20%,diarrhea.Gastric emptying scintigraphy is useful to evaluate gastroparesis,therefore,gastric retention of more than 60%at 2 h has a sensitivity of 100% and specificity of 20% for diagnosis;however,other studies such as breath tests,with a sensitivity of 89% and a specificity of 80%,or the endoscopic capsule contribute to the diagnosis.There is no cure;however,management must be multidisciplinary,focused on slowing the progression of diabetic gastroenteropathy,reducing symptoms,and restoring function;that includes nutritional recommendation,maintain glucose levels kept below 180 mg/dL,use of prokinetics,anti-emetics;nowadays,it has been special interest in surgical treatment,such as pyloroplasty,also gastric electrical stimulation appears to be another alternative.

关键词： Gastroenteropathy Gastroparesis Diabetes mellitus Complication Gastrointestinal disease Treatment

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Digital surgery for gastroenterological diseases

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World Journal of Gastroenterology 2021年第42期27卷 7240-7246页

作者： Niall Philip Hardy Ronan Ambrose Cahill UCD Centre for Precision Surgery University College DublinDublin D07 Y9AWIreland

Advances in machine learning,computer vision and artificial intelligence methods,in combination with those in processing and cloud computing capability,portend the advent of true decision support during interventions in real-time and soon perhaps in automated surgical steps.Such capability,deployed alongside technology intraoperatively,is termed digital surgery and can be delivered without the need for high-end capital robotic investment.An area close to clinical usefulness right now harnesses advances in near infrared endolaparoscopy and fluorescence guidance for tissue characterisation through the use of biophysics-inspired algorithms.This represents a potential synergistic methodology for the deep learning methods currently advancing in ophthalmology,radiology,and recently gastroenterology via colonoscopy.As databanks of more general surgical videos are created,greater analytic insights can be derived across the operative spectrum of gastroenterological disease and operations(including instrumentation and operative step sequencing and recognition,followed over time by surgeon and instrument performance assessment)and linked to value-based outcomes.However,issues of legality,ethics and even morality need consideration,as do the limiting effects of monopolies,cartels and isolated data silos.Furthermore,the role of the surgeon,surgical societies and healthcare institutions in this evolving field needs active deliberation,as the default risks relegation to bystander or passive recipient.This editorial provides insight into this accelerating field by illuminating the nearfuture and next decade evolutionary steps towards widespread clinical integration for patient and societal benefit.

关键词： Digital surgery Artificial intelligence Gastrointestinal disease Biophysics Deep learning Fluorescence-guided surgery

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Status quo and future prospects of artificial neural network from the perspective of gastroenterologists

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World Journal of Gastroenterology 2021年第21期27卷 2681-2709页

作者： Bo Cao Ke-Cheng Zhang Bo Wei Lin Chen Department of General Surgery&Institute of General Surgery Chinese People’s Liberation Army General HospitalBeijing 100853China

Artificial neural networks(ANNs)are one of the primary types of artificial intelligence and have been rapidly developed and used in many fields.In recent years,there has been a sharp increase in research concerning ANNs in gastrointestinal(GI)diseases.This state-of-the-art technique exhibits excellent performance in diagnosis,prognostic prediction,and treatment.Competitions between ANNs and GI experts suggest that efficiency and accuracy might be compatible in virtue of technique advancements.However,the shortcomings of ANNs are not negligible and may induce alterations in many aspects of medical practice.In this review,we introduce basic knowledge about ANNs and summarize the current achievements of ANNs in GI diseases from the perspective of gastroenterologists.Existing limitations and future directions are also proposed to optimize ANN’s clinical potential.In consideration of barriers to interdisciplinary knowledge,sophisticated concepts are discussed using plain words and metaphors to make this review more easily understood by medical practitioners and the general public.

关键词： Artificial neural network Gastrointestinal disease Diagnosis Treatment Prognosis Endoscopy

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