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Automatic detection of small bowel lesions with different bleeding risks based on deep learning models

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World Journal of gastroenterology 2024年第2期30卷 170-183页

作者： Rui-Ya Zhang Peng-Peng Qiang Ling-Jun Cai Tao Li Yan Qin Yu Zhang Yi-Qing Zhao Jun-Ping Wang department of gastroenterology The Fifth Clinical Medical College of Shanxi Medical UniversityTaiyuan 030012Shanxi ProvinceChina School of Computer and Information Technology Shanxi UniversityTaiyuan 030006Shanxi ProvinceChina School of Life sciences and Technology Mudanjiang Normal UniversityMudanjiang 157011Heilongjiang ProvinceChina

BACKGROUND Deep learning provides an efficient automatic image recognition method for small bowel(SB)capsule endoscopy(CE)that can assist physicians in ***,the existing deep learning models present some unresolved *** To propose a novel and effective classification and detection model to automatically identify various SB lesions and their bleeding risks,and label the lesions accurately so as to enhance the diagnostic efficiency of physicians and the ability to identify high-risk bleeding *** The proposed model represents a two-stage method that combined image classification with object ***,we utilized the improved ResNet-50 classification model to classify endoscopic images into SB lesion images,normal SB mucosa images,and invalid ***,the improved YOLO-V5 detection model was utilized to detect the type of lesion and its risk of bleeding,and the location of the lesion was *** constructed training and testing sets and compared model-assisted reading with physician *** The accuracy of the model constructed in this study reached 98.96%,which was higher than the accuracy of other systems using only a single *** sensitivity,specificity,and accuracy of the model-assisted reading detection of all images were 99.17%,99.92%,and 99.86%,which were significantly higher than those of the endoscopists’*** image processing time of the model was 48 ms/image,and the image processing time of the physicians was 0.40±0.24 s/image(P<0.001).CONCLUSION The deep learning model of image classification combined with object detection exhibits a satisfactory diagnostic effect on a variety of SB lesions and their bleeding risks in CE images,which enhances the diagnostic efficiency of physicians and improves the ability of physicians to identify high-risk bleeding groups.

关键词： Artificial intelligence Deep learning Capsule endoscopy Image classification Object detection Bleeding risk

Renal resistive index measurements by ultrasound in patients with liver cirrhosis:Magnitude and associations with renal dysfunction

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World Journal of Radiology 2024年第6期16卷 221-231页

作者： Himanshu Surya Ramesh Kumar Rajeev Nayan Priyadarshi Sabbu Surya Prakash Sudhir Kumar department of gastroenterology All India Institute of Medical SciencesPatna 801507India department of Radiodiagnosis All India Institute of Medical SciencesPatna 801507India

BACKGROUND The hemodynamic alterations seen in liver cirrhosis lead to renal vasoconstriction,ultimately causing acute kidney injury(AKI).The renal resistive index(RRI)is the most common Doppler ultrasound variable for measuring intrarenal vascular *** To evaluate the association of the RRI with AKI in patients with liver cirrhosis and to identify risk factors for high *** This was a prospective observational study,where RRI was measured using Doppler ultrasound in 200 consecutive hospitalized patients with *** association of RRI with AKI was *** receiver operating characteristic(ROC)curve analysis was utilized to determine discriminatory cut-offs of RRI for various AKI *** analysis was conducted to determine the predictors of high *** The mean patient age was 49.08±11.68 years,with the majority(79.5%)being male;the predominant etiology of cirrhosis was alcohol(39%).The mean RRI for the study cohort was 0.68±0.09,showing a progressive increase with higher Child-Pugh class of ***,AKI was present in 129(64.5%)*** mean RRI was significantly higher in patients with AKI compared to those without it(0.72±0.06 vs 0.60±0.08;P<0.001).A total of 82 patients(41%)had hepatorenal syndrome(HRS)-AKI,29(22.4%)had prerenal AKI(PRA),and 18(13.9%)had acute tubular necrosis(ATN)-*** mean RRI was significantly higher in the ATN-AKI(0.80±0.02)and HRS-AKI(0.73±0.03)groups than in the PRA(0.63±0.07)and non-AKI(0.60±0.07)*** demonstrated excellent discriminatory ability in distinguishing ATN-AKI from non-ATN-AKI(area under ROC curve:93.9%).AKI emerged as an independent predictor of high RRI(adjusted odds ratio[OR]:11.52),and high RRI independently predicted mortality among AKI patients(adjusted OR:3.18).CONCLUSION In cirrhosis patients,RRI exhibited a significant association with AKI,effectively differentiated between AKI phenotypes,and predicted AKI mortality.

关键词： Renal resistive index Cirrhosis Acute kidney injury Hepatorenal syndrome Renal Doppler

Alcohol associated liver disease and bariatric surgery:Current perspectives and future directions

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World Journal of Gastrointestinal Surgery 2024年第3期16卷 650-657页

作者： Katherine M Cooper Alessandro Colletta Nicholas Hebda Deepika Devuni department of Medicine UMass Chan Medical SchoolWorcesterMA 01655United States Division of gastroenterology UMass Chan Medical SchoolWorcesterMA 01655United States

Bariatric surgery is a routinely performed procedure and is associated with a reduction in all-cause mortality in patients with ***,bariatric sur-gery has also been linked to increased alcohol use with up to 30%of these patients developing alcohol use disorder(AUD).The mechanism of AUD after bariatric surgery is multifactorial and includes anatomic,metabolic,and neurohumoral changes associated with post-surgical *** patients are at increased risk of alcohol associated liver disease and,in some cases,require liver *** this article,we provide a scoping review of epidemiology,patho-physiology,and clinical outcomes of alcohol-related health conditions after bariatric surgery.

关键词： Obesity medicine Alcohol use disorder Roux-en-Y gastric bypass Vertical sleeve gastrectomy Liver transplant Simultaneous liver transplant and bariatric surgery

Paracrine function amplifies pro-tumor electrochemical signal within neuron-glioma synapses

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Science China(Life sciences) 2024年第6期67卷 1318-1320页

作者： Yan Hu Peishan Hu Xiaozhong Peng Key Laboratory of Birth Defects and Related Diseases of Women and Children of MOE State Key Laboratory of BiotherapyWest China Second University HospitalSichuan UniversityChengdu 610041China Guangdong Institute of gastroenterology Department of General SurgeryGuangdong Provincial Key Laboratory of Colorectal and Pelvic Floor DiseasesThe Sixth Affiliated HospitalSun Yat-sen UniversityGuangzhou 510655China department of Molecular Biology and Biochemistry Institute of Basic Medical SciencesMedical Primate Research CenterNeuroscience CenterChinese Academy of Medical SciencesSchool of Basic Medicine Peking Union Medical CollegeBeijing 100730China State Key Laboratory of Respiratory Health and Multimorbidity Institute of Basic Medical Sciences Chinese Academy of Medical SciencesSchool of Basic Medicine Peking Union Medical CollegeBeijing 100730China Institute of Laboratory Animal Science Chinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100730China

Neuronal activity plays a pivotal role in various physiological processes,including tissue development,homeostasis,and *** in recent years have improved our understanding of neuronal activity in brain cancers,such as glioblastoma(GBM)and diffuse midline gliomas(DMG),which are among the most prevalent and lethal cancers affecting children and ***,the neurons regulate brain cancers via two routes.

关键词： glioma homeostasis function

Reconsidering the role of depression and common psychiatric disorders as partners in the type 2 diabetes epidemic

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World Journal of Diabetes 2024年第6期15卷 1374-1380页

作者： Angelo Emilio Claro Clelia Palanza Marianna Mazza Alessandro Rizzi Andrea Corsello Linda Tartaglione Giuseppe Marano Giovanna Elsa Ute Muti Schuenemann Marta Rigoni Alfredo Pontecorvi Luigi Janiri Paola Muti Dario Pitocco Diabetes Care unit Department of Medical and Surgical SciencesFondazione Policlinico Universitario A Gemelli IRCCSRome 00168Italy department of Biomedical Surgical and Dental SciencesUniversity of MilanMilan 20122Italy Istituto Italiano di Antropologia ISItARome 00100Italy unit of Psychiatry Department of NeurosciencesFondazione Policlinico Universitario A Gemelli IRCCSUniversitàCattolica del Sacro CuoreRome 00168Italy Dipartimento di Medicina e Chirurgia Traslazionale UniversitàCattolica del Sacro CuoreRome 00168Italy Health Research Methods Evidence and Impact DepartmentMcMaster UniversityOntario 1280Canada department of Endocrine-Metabolic and Dermo-Rheumatology Fondazione Policlinico Universitario A Gemelli IRCCSUniversitàCattolica del Sacro CuoreRome 00168Italy

Common psychiatric disorders(CPDs)and depression contribute significantly to the global epidemic of type 2 diabetes(T2D).We postulated a possible pathophysiological mechanism that through Bridge-Symptoms present in depression and CPDs,promotes the establishment of emotional eating,activation of the reward system,onset of overweight and obesity and,ultimately the increased risk of developing *** plausibility of the proposed pathophysiological mechanism is supported by the mechanism of action of drugs such as naltrexonebupropion currently approved for the treatment of both obesity/overweight with T2D and as separate active pharmaceutical ingredients in drug addiction,but also from initial evidence that is emerging regarding glucagon-like peptide 1 receptor agonists that appear to be effective in the treatment of drug *** hope that our hypothesis may be useful in interpreting the higher prevalence of CPDs and depression in patients with T2D compared with the general population and may help refine the integrated psychiatric-diabetic therapy approach to improve the treatment and or remission of T2D.

关键词： Depression Glucagon-like peptide-1 receptor agonists Diabetes mellitus type 2 Stress psychological Sleep wake disorders Food addiction

Fecal microbiota transplantation in the treatment of hepatic encephalopathy:A perspective

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World Journal of Hepatology 2024年第5期16卷 678-683页

作者： Arghya Samanta Moinak Sen Sarma department of Pediatric gastroenterology Sanjay Gandhi Postgraduate Institute of Medical SciencesLucknow 226014India

Due to its complex pathogenesis,treatment of hepatic encephalopathy(HE)continues to be a therapeutic *** late,gut microbiome has garnered much attention for its role in the pathogenesis of various gastrointestinal and liver diseases and its potential therapeutic *** evidence suggests that gut micro-biota plays a significant role in cerebral *** in the gut microbiota has been documented in patients with HE in a number of clinical and experimental *** on gut dysbiosis in patients with HE has opened newer therapeutic avenues in the form of probiotics,prebiotics and the latest fecal microbiota transplantation(FMT).Recent studies have shown that FMT is safe and could be effective in improving outcomes in advanced liver disease patients presenting with ***,questions over the appropriate dose,duration and route of administration for best treatment outcome remains unsettled.

关键词： Fecal microbiota Dysbiosis Hepatic encephalopathy Cirrhosis

Metabolic dysfunction-associated steatotic liver disease:A silent pandemic

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World Journal of Hepatology 2024年第4期16卷 511-516页

作者： Arghya Samanta Moinak Sen Sarma department of Pediatric gastroenterology Sanjay Gandhi Postgraduate Institute of Medical SciencesLucknow 226014India

The worldwide epidemiology of non-alcoholic fatty liver disease(NAFLD)is showing an upward trend,parallel to the rising trend of metabolic syndrome,owing to lifestyle *** pathogenesis of NAFLD has not been fully understood ***,NAFLD has emerged as a public health concern in the field of hepatology and metabolisms *** changes in the nomenclature from NAFLD to metabolic dysfunction-associated steatotic liver disease have brought a positive outlook changes in the understanding of the disease process and doctor-patient *** changes are the main treatment ***,clinical trial using drugs that target‘insulin resistance’which is the driving force behind NAFLD,have shown promising *** translational research is needed to better understand the underlying pathophysiological mechanism of NAFLD which may open newer avenues of therapeutic *** role of gut dysbiosis in etiopathogenesis and use of fecal microbiota modification in the treatment should be studied *** of this silent epidemic by spreading awareness and early intervention should be our priority.

关键词： Metabolic dysfunction Fatty liver Obesity Insulin resistance

Endoscopic retrograde appendicitis treatment for periappendiceal abscess: A case report

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World Journal of Clinical Cases 2024年第4期12卷 801-805页

作者： Qiao-Mei Li Bin Ye Jun-Wei Liu Shang-Wen Yang department of gastroenterology Lishui Central HospitalThe Fifth Affiliated Hospital of Wenzhou Medical UniversityLishui 323000Zhejiang ProvinceChina

BACKGROUND Acute appendicitis is the most common abdominal *** present,the main treatments for periappendiceal abscess include antibiotics and ***,the complications and mortality of emergency surgery are *** preferred therapy is conservative treatment with antibiotics first,ultrasound-guided puncture drainage or surgical treatment is followed when *** retrograde appendicitis therapy(ERAT)for acute uncomplicated appendicitis have been proved clinically effective,but it is rarely used in periap-pendiceal *** SUMMARY We report a patient admitted to hospital because of“right lower abdominal pain for six days”.The computerized tomography(CT)of patient showed that appendicitis with fecaliths and abscess in the *** patient was treated by CT-guided puncture and drainage of abdominal abscess combined with ERAT to remove appendiceal fecaliths,irrigation and stent *** The patient did not receive surgery because of impoverished *** pain did not recur during the follow-up *** case confirms the value of ERAT in the treatment of periappendiceal abscess.

关键词： Transparent cap Colonoscopy Endoscopic retrograde appendicitis therapy Periappendiceal abscess Case report

Prospective study of hepatitis B and D epidemiology and risk factors in Romania:A 10-year update

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World Journal of Hepatology 2024年第4期16卷 640-649页

作者： Speranta Iacob Liana Gheorghe Mirela Onica Laura Huiban Corina Silvia Pop Ciprian Brisc Roxana Sirli Carmen Ester Cristina Mihaela Brisc Sorina Diaconu Ion Rogoveanu Larisa Sandulescu Deiana Vuletici Anca Trifan department of gastroenterology Carol Davila University of Medicine and PharmacyBucharest 050474Romania department of gastroenterology and Hepatology Fundeni Clinical InstituteBucharest 022328Romania department of gastroenterology Grigore T Popa University of Medicine and PharmacyIasi 700115Romania Institute of gastroenterology and Hepatology Saint Spiridon County HospitalIasi 700111Romania department of gastroenterology and medical Oncology University Emergency Clinical HospitalBucharest 050098Romania Faculty of Medicine and Pharmacy University of OradeaOradea 410087Romania department of gastroenterology Emergency County HospitalOradea 410169Romania Center for Advanced Research in gastroenterology and Hepatology Department of Gastroenterology and Hepatology“Victor Babeş”University of Medicine and PharmacyTimisoara 300041Romania department of gastroenterology and Hepatology TimişCounty Emergency Clinical Hospital"Pius Branzeu"Timisoara 300723Romania department of Internal Medicine II and gastroenterology University Emergency Clinical HospitalBucharest 050098Romania department of gastroenterology University of Medicine and PharmacyCraiova 200349Romania department of Cardiology Emergency County HospitalCraiova 200642Romania department of gastroenterology Research Center of Gastroenterology and HepatologyUniversity of Medicine and PharmacyCraiova 200349Romania department of gastroenterology Emergency County HospitalCraiova 200642Romania department of gastroenterology Faculty of MedicineGrigore T Popa University of Medicine and PharmacyIasi 700115Romania

BACKGROUND The global burden of hepatitis D virus(HDV)infection represents a major medical challenge and a public health crisis ***,there is a lack of accurate data on the epidemiology and risk factors for *** B virus(HBV)and HDV coinfection causes the most severe form of viral hepatitis,leading to a higher cumulative incidence of liver-related events compared with HBV monoinfection,including the need for liver transplantation and *** To investigate the epidemiology,natural history,risk factors and clinical management of HBV and HDV coinfection in Romanian *** This prospective study was conducted between January and July 2022 in six tertiary gastroenterology and hepatology referral centres in *** consecutive adults admitted for any gastroenterology diagnosis who were HBV-positive were *** with acute hepatitis or incomplete data were *** the 25390 individuals who presented with any type of gastroenterology diagnosis during the study period,963 met the inclusion *** for anti-HDV antibodies and HDV RNA was performed for all *** and risk factor data were collected by investigators using medical charts and patient *** data were stored in an anonymized online database during the *** The prevalence of HBV was 3.8%;among these patients,the prevalence of HBV/HDV coinfection was 33.1%.The median age of the study population was 54.0 years,and it consisted of 55.1%men.A higher prevalence of HBV/HDV coinfection was observed in patients 50–69 years *** with HBV/HDV coinfection were significantly older than those with HBV monoinfection(P=0.03).Multivariate multiple regression analysis identified female gender(P=0.0006),imprisonment(P<0.0001),older age at diagnosis(P=0.01)and sexual contact with persons with known viral hepatitis(P=0.0003)as significant risk factors for *** This study shows that HDV infection among those with HBV re

关键词： Epidemiology Hepatitis B Hepatitis D Natural history Risk factors Romania