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Clinical issues and challenges in imaging of gastrointestinal diseases:A minireview and our experience

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World Journal of Clinical Cases 2024年第18期12卷 3304-3313页

作者： Milena Gulinac Georgi Kiprin Ivan Tsranchev Vasko Graklanov Lyubomir Chervenkov Tsvetelina Velikova Department of General and Clinical Pathology Medical University of PlovdivPlovdiv 4002Bulgaria Medical Faculty Sofia University St.Kliment OhridskiSofia 1407Bulgaria Department of Gastroenterology MHAT EurohospitalPlovdiv 4000Bulgaria Department of Forensic Medicine and Deontology Medical University of PlovdivPlovdiv 4000Bulgaria Department of Diagnostic Imaging Medical University PlovdivPlovdiv 4000Bulgaria

Imaging techniques play a crucial role in the modern era of medicine,particularly in gastroenterology.Nowadays,various non-invasive and invasive imaging modalities are being routinely employed to evaluate different gastrointestinal(GI)diseases.However,many instrumental as well as clinical issues are arising in the area of modern GI imaging.This minireview article aims to briefly overview the clinical issues and challenges encountered in imaging GI diseases while highlighting our experience in the field.We also summarize the advances in clinically available diagnostic methods for evaluating different diseases of the GI tract and demonstrate our experience in the area.In conclusion,almost all imaging techniques used in imaging GI diseases can also raise many challenges that necessitate careful consideration and profound expertise in this field.

关键词： Imaging methods gastrointestinal diseases gastrointestinal tract Radiology Tumors of the gastrointestinal tract

From macroautophagy to mitophagy:Unveiling the hidden role of mitophagy in gastrointestinal disorders

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World Journal of Gastroenterology 2024年第23期30卷 2934-2946页

作者： Duo-Lun Gao Meng-Ran Lin Nan Ge Jin-Tao Guo Fan Yang Si-Yu Sun Department of Gastroenterology Engineering Research Center of Ministry of Education for Minimally Invasive Gastrointestinal Endoscopic TechniquesShengjing Hospital of China Medical UniversityShenyang 110004Liaoning ProvinceChina

In this editorial,we comment on an article titled“Morphological and biochemical characteristics associated with autophagy in gastrointestinal diseases”,which was published in a recent issue of the World Journal of Gastroenterology.We focused on the statement that“autophagy is closely related to the digestion,secretion,and regeneration of gastrointestinal cells”.With advancing research,autophagy,and particularly the pivotal role of the macroautophagy in maintaining cellular equilibrium and stress response in the gastrointestinal system,has garnered extensive study.However,the significance of mitophagy,a unique selective autophagy pathway with ubiquitin-dependent and independent variants,should not be overlooked.In recent decades,mitophagy has been shown to be closely related to the occurrence and development of gastrointestinal diseases,especially inflammatory bowel disease,gastric cancer,and colorectal cancer.The interplay between mitophagy and mitochondrial quality control is crucial for elucidating disease mechanisms,as well as for the development of novel treatment strategies.Exploring the pathogenesis behind gastrointestinal diseases and providing individualized and efficient treatment for patients are subjects we have been exploring.This article reviews the potential mechanism of mitophagy in gastrointestinal diseases with the hope of providing new ideas for diagnosis and treatment.

关键词： Mitophagy gastrointestinal diseases Parkin Autophagic receptor Colorectal cancer Gastric cancer Inflammatory bowel disease

Gut microbiota in gastrointestinal diseases during pregnancy

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World Journal of Clinical Cases 2022年第10期10卷 2976-2989页

作者： Zhong-Zhen Liu Jing-Hua Sun Wen-Jing Wang BGI-Shenzhen Shenzhen 518083Guangdong ProvinceChina College of Life Sciences University of Chinese Academy of SciencesBeijing 100049China

Gut microbiota(GM)is a micro-ecosystem composed of all microorganisms in the human intestine.The interaction between GM and the host plays an important role in maintaining normal physiological functions in the host.Dysbiosis of the GM may cause various diseases.GM has been demonstrated to be associated with human health and disease,and changes during individual development and disease.Pregnancy is a complicated physiological process.Hormones,the immune system,metabolism,and GM undergo drastic changes during pregnancy.gastrointestinal diseases during pregnancy,such as hepatitis,intrahepatic cholestasis of pregnancy,and pre-eclampsia,can affect both maternal and fetal health.The dysregulation of GM during pregnancy may lead to a variety of diseases,including gastrointestinal diseases.Herein,we review recent research articles on GM in pregnancy-related gastrointestinal diseases,discuss the interaction of the GM with the host under normal physiological conditions,gastrointestinal diseases,and pregnancy-specific disorders.As more attention is paid to reproductive health,the pathogenic mechanism of GM in gastrointestinal diseases during pregnancy will be further studied to provide a theoretical basis for the use of probiotics to treat these diseases.

关键词： Gut microbiota Microbiome Pregnancy gastrointestinal diseases Hormones Immunity Metabolites

Dynamic contrast enhanced ultrasound in gastrointestinal diseases:A current trend or an indispensable tool?

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World Journal of Gastroenterology 2023年第25期29卷 4021-4035页

作者： Mattia Paratore Matteo Garcovich Maria Elena Ainora Laura Riccardi Antonio Gasbarrini Maria Assunta Zocco Medicina Interna e Gastroenterologia CEMAD Digestive Disease CenterFondazione Policlinico Universitario A.Gemelli IRCCSRome 00168Italy Medicina Interna e Gastroenterologia CEMAD Digestive Disease CenterUniversità Cattolica del Sacro CuoreFondazione Policlinico Universitario A.Gemelli IRCCSRome 00168Italy

Contrast enhanced ultrasound(CEUS)has been widely implemented in clinical practice because of the enormous quantity of information it provides,along with its low cost,reproducibility,minimal invasiveness,and safety of the secondgeneration ultrasound contrast agents.To overcome the limitation of CEUS given by the subjective evaluation of the contrast enhancement behaviour,quantitative analysis of contrast kinetics with generation of time-intensity curves has been introduced in recent years.The quantification of perfusion parameters[named as dynamic-CEUS(D-CEUS)]has several applications in gastrointestinal neoplastic and inflammatory disorders.However,the limited availability of large studies and the heterogeneity of the technologies employed have precluded the standardisation of D-CEUS,which potentially represents a valuable tool for clinical practice in management of gastrointestinal diseases.In this article,we reviewed the evidence exploring the application of D-CEUS in gastrointestinal diseases,with a special focus on liver,pancreas,and inflammatory bowel diseases.

关键词： Quantitative perfusion analysis gastrointestinal diseases Time-intensity curve Multiparametric ultrasound

Prevention and Treatment of gastrointestinal diseases in College Students

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Journal of Clinical and Nursing Research 2023年第5期7卷 124-130页

作者： Ziquan Wang GDPU Undergraduate Red Post Campus Zhuhai 510310Guangdong ProvinceChina

Objective:This paper aims to discuss the prevention and treatment strategies of gastrointestinal diseases in college students.Methods:A sample of 60 college students suffering from gastrointestinal diseases,from August 2021 to August 2022,was used to discuss the symptoms,causes,prevention strategies,and treatment strategies of gastrointestinal diseases based on questionnaire survey.Results:The high-incidence types of gastrointestinal diseases in college students mainly included chronic gastritis,acute gastritis,duodenal ulcer,and dyspepsia,which were closely related to mental state,diet,and living habits.Conclusion:There are many causes of gastrointestinal diseases in college students.During the period of active symptomatic treatment,it is necessary to focus on the prevention of gastrointestinal diseases in colleges and universities,correct the unhealthy lifestyle of students,and reduce the risk of gastrointestinal diseases.

关键词： gastrointestinal diseases College students Prevention and treatment plan

Effects of acupuncture on functional gastrointestinal disorders:special effects,coeffects,synergistic effects in terms of single or compatible acupoints

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Journal of Traditional Chinese Medicine 2023年第2期43卷 397-408页

作者： ZHAO Jun LI Xia ZHENG Hui YE Kun WANG Xin WANG Xuefei SUN Runquan LI Zhigang School of Acupuncture-Moxibustion and Tuina Beijing University of Chinese MedicineBeijing 100029China Chengdu University of Traditional Chinese Medicine Chengdu 610075China Department of Acupuncture and Moxibustion The Sixth Medical Center of PLA General HospitalBeijing 100048China Department of Acupuncture and Moxibustion Beijing Hospital of Traditional Chinese MedicineCapital Medical UniversityBeijing 100010China

OBJECTIVE:To investigate how the“special effect”/“coeffect”/“synergistic effect”can achieve a positive result using an“acupuncture prescription”for functional gastrointestinal disorders(FGIDs)in clinical practice,based on the characteristics of single/compatible acupoints and acupuncture techniques.METHODS:According to the search strategy,we searched six electronic bibliographic databases and provided a summary for this overview.RESULTS:A large body of evidence has shown that acupuncture has positive effects in the treatment of FGIDs.However,the“prescription”intervention involved different single acupoints,compatible acupoints and acupoints based on expert consensus.CONCLUSIONS:The core acupoints,including Tianshu(ST25),Zusanli(ST36),and Shangjuxu(ST37),emphasize the application of special acupoints,meridian points and nerve segments,and the two-way regulatory effect found in this study is often used as the basis of acupoint selection and acupoint prescription for acupuncture treatment of FGIDs.

关键词： acupuncture gastrointestinal diseases acupuncture points special effects co-effects synergistic effects

Practical points that gastrointestinal fellows should know in management of COVID-19

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World Journal of Clinical Cases 2022年第16期10卷 5133-5145页

作者： Tevhide Sahin Cem Simsek Hatice Yasemin Balaban Department of Gastroenterology Hacettepe UniversityFaculty of MedicineAnkara 06100Turkey

Pandemics obligate providers to transform their clinical practice.An extensive effort has been put to find out feasible approaches for gastrointestinal diseases and also to manage coronavirus disease 2019(COVID-19)related gastrointestinal conditions.Diarrhea,hepatitis,and pancreatitis can be seen in the COVID-19 course.Endoscopic procedures increase the risk of contamination for medical staff and patients despite precautions,therefore indications should be tailored to balance risks vs benefits.Furthermore,whether the immunosupression in inflammatory bowel diseases,liver transplantation,and autoimmune liver diseases increases COVID-19 related risks and how to modify immunosupression are topics of ongoing debate.This review aims to provide most up to date practical approaches that a gastrointestinal fellow should be aware on the problems and management of gastrointestinal and hepatobiliary diseases during the COVID-19 pandemic.

关键词： COVID-19 gastrointestinal diseases Practical points Endoscopy gastrointestinal fellows

Trends in gastrointestinal disease hospitalizations and outcomes during the first year of the coronavirus pandemic

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World Journal of Gastroenterology 2023年第4期29卷 744-757页

作者： Ayooluwatomiwa Deborah Adekunle Muni Rubens Mary Sedarous Tahniyat Tariq Philip N Okafor Division of Internal Medicine St.Luke's HospitalChesterfieldMI 63017United States Office of Clinical Research Miami Cancer InstituteMiamiFL 33176United States Division of Internal Medicine McMaster UniversityHamilton ON L8S 4L8OntarioCanada Division of Gastroenterology Stanford University School of MedicineRedwood CityCA 94063United States Division of Gastroenterology Stanford University College of MedicineRedwood CityCA 94063United States

BACKGROUND The impact of the coronavirus on hospitalizations for gastrointestinal(GI)disease,particularly at a population level is understudied.AIM To investigate trends in hospitalizations,inpatient endoscopy resource utilization,and outcomes during the first year of the coronavirus pandemic and subsequent lockdowns.METHODS Using the California State Inpatient Database for 2018-2020,we explored year-toyear and 2020 month-to-month trends in hospitalizations,length of stay,and inpatient mortality(all-cause&viral pneumonia-specific)for common inpatient GI diagnoses including acute pancreatitis,diverticulitis,cholelithiasis,noninfectious gastroenteritis,upper and lower GI bleeding(LGIB),Clostridium difficile,viral gastroenteritis,inflammatory bowel disease,and acute cholangitis.RESULTS Disease-specific hospitalizations decreased for all included conditions except nonvariceal upper GI bleeding(NVUGIB),LGIB,and ulcerative colitis(UC)(ptrend<0.0001).Allcause inpatient mortality was higher in 2020 vs 2019,for acute pancreatitis(P=0.029),diverticulitis(P=0.04),NVUGIB(P=0.003),and Crohn’s disease(P=0.004).In 2020,hospitalization rates were lowest in April,November,and December.There was no significant corresponding increase in inpatient mortality except in UC(ptrend=0.048).Viral pneumonia and viral pneumonia complicated by respiratory failure increased(P<0.001)among GI hospitalizations.Endoscopy utilization within 24 h of admission was unchanged for GI emergencies except NVUGIB(P<0.001).CONCLUSION Our findings suggest that hospitalization rates for common GI conditions significantly declined in California during the COVID pandemic,particularly in April,November and December 2020.Allcause mortality was significantly higher among acute pancreatitis,diverticulitis,NVUGIB,and Crohn’s disease hospitalizations.Emergency endoscopy rates were mostly comparable between 2020 and 2019.

关键词： COVID-19 Shelter-in-place Procedure utilization Outcomes Hospitalizations gastrointestinal diseases

Exosomes:A new frontier under the spotlight for diagnosis and treatment of gastrointestinal diseases

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World Journal of Meta-Analysis 2021年第1期9卷 12-28页

作者： Maliha Naseer Syeda Hadi Ali Syed Amer Safdari Veysel Tahan Division of Gastroenterology and Hepatology Department of Internal MedicineEast Carolina UniversityGreenvilleNC 27834United States Rawalpindi Medical University School of MedicineRawalpindi 46000PunjabPakistan Division of Gastroenterology and Hepatology Department of Internal MedicineUniversity of MissouriColumbiaMO 65212United States Illinois College of Medicine School of MedicineChicagoIL 60612United States

Exosomes are small plasma membrane-bound multivesicular bodies ranging in size from 20-100 nm.Exosomes are degraded fragments of mRNA,microRNA,and enriched in proteins,lipids,and nucleic acid.They are produced in the endosomes of most eukaryotic cells and once secreted,exosomes are involved in cell to cell communication and remodeling of the matrix in the extracellular compartment.Exosome biogenesis plays a crucial role in cellular development,inflammation,immunity,hemostasis,carcinogenesis,and degeneration.Due to their unique biochemical and biophysical properties,exosomes serve a variety of functions including biomarkers of diagnostic and prognostic significance.Besides,there is an increasing level of evidence to expand our understanding of the exosomes as novel therapeutic agents.Inflammatory bowel disease(IBD)such as Crohn's disease and ulcerative colitis,hepatic fibrosis,and gastrointestinal malignancies such as colorectal cancer are the potential avenues where exosomes can be applied as cell therapy and immunotherapy and have shown promising results in several in-vitro and animal models.The purpose of this review article is to highlight the emerging role of exosomes as the diagnostic and therapeutic tool in various diseases involving the gastrointestinal tract like IBD,hepatocellular carcinoma,and colon cancer.A thorough literature search was performed on databases such as PubMed,Ovid Medline,and EMBASE to achieve the objectives of this review article.

关键词： Exosomes gastrointestinal diseases Inflammatory bowel disease Colorectal cancer Hepatocellular carcinoma