Journal of Digestive Diseases最新文献

{"title":"Validation of Drum Tower Severity Scoring (DTSS) System for Pyrrolizidine Alkaloid-Induced Hepatic Sinusoidal Obstruction Syndrome","authors":"Li Li Zhang,&nbsp;Feng Zhang,&nbsp;Kai Wang,&nbsp;Yu Hu Song,&nbsp;Ying Zhang,&nbsp;Zhen Yu Zhou,&nbsp;Wei Jie Dai,&nbsp;Lei Wang,&nbsp;Huan Chen,&nbsp;Qin Yin,&nbsp;Yu Zheng Zhuge,&nbsp;Wei Zhang","doi":"10.1111/1751-2980.13347","DOIUrl":"10.1111/1751-2980.13347","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The Drum Tower Severity Scoring (DTSS) system is a novel tool designed for assessing the outcome of anticoagulation therapy and disease severity in patients with pyrrolizidine alkaloid-induced hepatic sinusoidal obstruction syndrome (PA-HSOS). The aim of this study was to validate the predictive performance of the DTSS system in PA-HSOS patient outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective analysis of 111 PA-HSOS patients who received standard anticoagulation–transjugular intrahepatic portosystemic shunt (TIPS) stepwise therapy from six hospitals in China. Patients were categorized into two groups based on whether they responded to anticoagulation therapy. The predictive performance of the DTSS system was evaluated through the efficacy of anticoagulation therapy, the area under the receiver operating characteristic curve (AUROC), calibration curve, decision curve analysis (DCA), and clinical impact curve (CIC) analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The response rates to anticoagulation therapy varied among patients with DTSS of different severity, being 94.12% for mild, 57.81% for moderate, and 13.33% for severe cases. The DTSS system demonstrated a robust predictive performance, with an AUROC of 0.864. The calibration curve indicated a close match between the predicted and observed effects of the DTSS system. Good calibration was confirmed by the Hosmer–Lemeshow test (<i>p</i> = 0.704), and both the DCA and CIC analysis indicated high clinical utility of the DTSS system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The DTSS system is a practical tool that uses easily accessible data to predict the initial response to anticoagulation therapy in PA-HSOS patients, showing robust predictive performance and significant clinical benefit in guiding personalized management strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 3-4","pages":"150-157"},"PeriodicalIF":2.3,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Future Therapeutic Landscape of Gastroesophageal Reflux Disease","authors":"Michael Kurin,&nbsp;Ronnie Fass","doi":"10.1111/1751-2980.13345","DOIUrl":"10.1111/1751-2980.13345","url":null,"abstract":"","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 3-4","pages":"94-99"},"PeriodicalIF":2.3,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Study of a Novel Disposable Endoscopic Purse-String Suture Auxiliary Instrument for the Treatment of Full-Thickness Gastric Wall Defects","authors":"Ying Zhou,&nbsp;Bai Sheng Chen,&nbsp;Qi Jiang,&nbsp;Na Shan Li,&nbsp;Pei Hong Zhang,&nbsp;Dan Feng Zhang,&nbsp;Yuan Ling Ruan,&nbsp;Ping Li,&nbsp;Xia Wu,&nbsp;Ping Hong Zhou,&nbsp;Wei Feng Chen","doi":"10.1111/1751-2980.13338","DOIUrl":"https://doi.org/10.1111/1751-2980.13338","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>In this study, we aimed to evaluate the effectiveness of a novel endoscopic purse-string suture auxiliary instrument compared with traditional methods for closure of a full-thickness defect of the stomach in an ex vivo model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twelve perforation sites (10–20 mm in diameter) were created in the ex vivo porcine stomach models. Two physicians (A and B had performed endoscopic surgery for 6 and 3 years) performed suturing using both the experimental and traditional (control) instruments. Operation time, success rate, and number of attempts for successful suture required were recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>For physician A, the median suturing time was 56.50 s (interquartile range [IQR] 40.50 s, 134.50 s) and 215.50 s (IQR 63.75 s, 254.75 s) in the experimental and control groups. For physician B, they were 53.00 s (IQR 38.50 s, 87.75 s) and 174.00 s (IQR 104.50 s, 279.25 s), respectively. The differences between experimental and control groups were statistically significant for both physicians A (<i>p</i> = 0.010) and B (<i>p</i> = 0.004). The median number of attempts required for successful suturing in the experimental and control groups was 1 (IQR 1, 2) and 2 (IQR 1, 3) for physician A, and 1 (IQR 1, 1) and 3 (IQR 2, 3) for physician B, which were statistically significant for both physicians (<i>p</i> = 0.026 and 0.006). The overall success rate was significantly higher in the experimental group (100% vs. 75.0%, <i>p</i> = 0.022).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This novel purse-string suture auxiliary instrument may assist in single-channel endoscopic suturing operations, improve the suture success rate, reduce the number of operations required, and shorten the operation time.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 1-2","pages":"74-79"},"PeriodicalIF":2.3,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1751-2980.13338","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143884081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DREADDs-Based Chemogenetics Induced Slow Transit Constipation via Inhibition of Enteric Neurons","authors":"Xin Yi Lu,&nbsp;Yu Xiang Wen,&nbsp;Ni Jiang,&nbsp;Si Qi Zhou,&nbsp;Tian Yang,&nbsp;Liang Liang Shi,&nbsp;Hui Min Guo,&nbsp;Wei Zhang,&nbsp;Qi Peng Zhang,&nbsp;Ni Na Zhang","doi":"10.1111/1751-2980.13344","DOIUrl":"https://doi.org/10.1111/1751-2980.13344","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Designer receptors exclusively activated by designer drugs (DREADDs)-based chemogenetic tools are commonly used to activate or silence targeted neurons by the agonistic ligand deschloroclozapine (DCZ). This study aimed to establish a Gi-DREADD-based murine model of slow transit constipation (STC) and elucidate its pathophysiological mechanisms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Adeno-associated virus (AAV) 9-hM4Di was injected into the intestinal wall of mice, and colonic motility was evaluated. The efficiency and immunogenicity of AAV9-hM4Di transduction in the enteric nervous system (ENS) were evaluated. Nitric oxide (NO), acetylcholine (ACh), and substance P (SP) in the colonic tissues and serum samples were analyzed. Calcium (Ca²⁺) imaging was performed to evaluate the responses of AAV9-hM4Di on enteric nerves.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>AAV9-hM4Di-treated mice showed gastrointestinal motility dysfunction, including reduced fecal pellets and decreased fecal mass and water content. Electrophysiological recording of muscle contraction in the isolated colonic tissues from the chemogenetic mice showed decreased frequency and amplitude after DCZ treatment. The mice treated with AAV9-hM4Di showed the highest levels of transduction in the myenteric plexuses of the ENS. There were no differences in transduction in neuronal nitric oxide synthase (nNOS) and choline acetyltransferase (ChAT) neurons. Gi-DREADDs significantly downregulated ACh but not NO or SP expression in the distal colon in the chemogenetic mice. Ca²⁺ transient in neurons of ENS in chemogenetic mice was strongly inhibited by DCZ.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>It is feasible to apply the DREADDs-based chemogenetic tools to the ENS. Gi-DREADDs can selectively modulate the ENS, inducing STC without excitatory-neural bias, offering targeted neuromodulation for gastrointestinal motility disorders.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 1-2","pages":"62-73"},"PeriodicalIF":2.3,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1751-2980.13344","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143883781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Future of Telehealth-Based Psychological and Mind–Body Interventions for People With Inflammatory Bowel Disease: A Systematic Review","authors":"Kaitlyn Delaney Chappell,&nbsp;Otgonbayar Chinbaatar,&nbsp;Karen J. Goodman,&nbsp;Karen I. Kroeker","doi":"10.1111/1751-2980.13342","DOIUrl":"10.1111/1751-2980.13342","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>People with inflammatory bowel disease (IBD) suffer from relapsing and remitting symptoms of gastrointestinal upset and are at substantial risk of experiencing comorbid mental distress symptoms. We aimed to conduct a systematic review of the evidence surrounding mental health telehealth interventions for IBD patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched EMBASE, MEDLINE, CINAHL, Scopus, and PsychINFO to systematically identify studies that evaluated the feasibility and acceptability of telehealth-based psychological and mind–body interventions to treat the physical and psychosocial symptoms of IBD patients. Predefined data extraction variables included descriptions of the interventions, participation and dropout rates, and preliminary effectiveness. The data was synthesized using tabular data displayed for quantitative variables and presented as narrative summaries to allow for comparison.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seven studies including 313 participants met our criteria and were included in the review. All studies evaluated distinct interventions. Participation rates ranged 32.4%–75%, and drop-out rates ranged 0%–33%. Most participants reported improvements in their quality of life and mental symptoms, and high satisfaction within their interventions. The authors of all included studies concluded that their interventions were feasible.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The evidence to support using telehealth-based psychological and mind–body interventions to support individuals with IBD is limited, but promising. Interventions were positively evaluated, strongly adhered to, and preliminary effectiveness data suggest that these interventions could improve the psychosocial well-being of people with IBD. Future research is warranted to assess the effectiveness of these interventions and to evaluate the barriers to integrating them into IBD care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 3-4","pages":"100-112"},"PeriodicalIF":2.3,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1751-2980.13342","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Etiology Control for Reducing Hepatic Vein Pressure Gradient in Patients With Cirrhosis and Portal Hypertension: A Systematic Review and Meta-Analysis","authors":"Shuai Xia,&nbsp;Zhi Ying He,&nbsp;Xiao Ning Wu,&nbsp;Xiao Fei Tong,&nbsp;Min Li,&nbsp;Shan Shan Wu,&nbsp;Wen Zhang,&nbsp;Ji Dong Jia,&nbsp;Bing Qiong Wang,&nbsp;Hong You","doi":"10.1111/1751-2980.13343","DOIUrl":"https://doi.org/10.1111/1751-2980.13343","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Etiological therapy has been documented to improve portal hypertension. We aimed to analyze the effectiveness of etiological therapy on hepatic venous pressure gradient (HVPG) reduction by conducting a systematic review and meta-analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Literature search of the PubMed, EMBASE, and Cochrane Library was performed to identify studies involving patients with PHT published up to January 2024. The absolute HVPG reduction and the HVPG response rate were assessed. Pooled analyses were performed using random-effects models, and the heterogeneity was evaluated using sensitivity and subgroup analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Altogether 21 studies were included for analysis. After etiological therapy, the absolute reduction in HVPG was 2.25 mmHg (95% confidence interval [CI] 1.80–2.71). Longer (&gt; 1 year) duration of etiological therapy showed more significant HVPG reduction compared with those treated with 1 year or less (3.02 mmHg vs. 2.24 mmHg, <i>p =</i> 0.001). A more pronounced HVPG reduction was also observed in patients with viral hepatitis-induced cirrhosis than in those with non-viral hepatitis-induced cirrhosis (2.39 mmHg vs. 1.27 mmHg, <i>p =</i> 0.001). Furthermore, 64% and 41% of patients showed ≥ 10% HVPG reduction and a reduction of ≥ 20% or to ≤ 12 mmHg, respectively, after etiology control.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Effective etiology control can significantly decrease HVPG and increase the HVPG response rate, which may contribute to the improvement of the prognosis of cirrhotic patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 1-2","pages":"31-43"},"PeriodicalIF":2.3,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143884101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chinese Guideline for the Diagnosis and Management of Drug-Induced Liver Injury in Primary Care (2024)","authors":"Yi Min Mao,&nbsp;Jie Ting Tang,&nbsp;Zhong Hua Lu,&nbsp;Ming Shao,&nbsp;Wei Feng Zhao,&nbsp;Jun Zhan,&nbsp;Zu Xiong Huang,&nbsp;Qing Hui Niu,&nbsp;Lin Chen,&nbsp;Zhan Feng Chen,&nbsp;Chun Hui Guo,&nbsp;Zi Hui Jia,&nbsp;Hai Li,&nbsp;Bo Liu,&nbsp;Jing Miao,&nbsp;Zhong Tian Peng,&nbsp;Yong Lan Pu,&nbsp;Li Hong Qu,&nbsp;Xiao Ming Shen,&nbsp;Wei Sun,&nbsp;Hong Wu Wang,&nbsp;Xiao Lan Lu,&nbsp;Jian Jun Xue,&nbsp;Ya Yun Yang,&nbsp;Zheng Yang,&nbsp;Zhong Hui Yang,&nbsp;Qing Ge Zhang,&nbsp;Tao Niu,&nbsp;Wei Dong Zhu,&nbsp;Xiao Lin Liu,&nbsp;Wei Zhong,&nbsp;Yi Nuo Dong,&nbsp;Yang Zhi,&nbsp;Xiao Yun Li,&nbsp;the Technology Committee on DILI Prevention, Management, Chinese Medical Biotechnology Association; Committee on Drug Liver Safety, China Primary Health Care Foundation; Study Group on Drug Induced Liver Disease, Chinese Society of Hepatology, Chinese Medical Association","doi":"10.1111/1751-2980.13337","DOIUrl":"10.1111/1751-2980.13337","url":null,"abstract":"<div>\u0000 \u0000 <p>Drug-induced liver injury (DILI) is a drug-induced disease that not only complicates the treatment of the primary disease but may also lead to acute liver failure or even death in severe cases. Drugs commonly used in primary care, such as anti-infective agents and nonsteroidal anti-inflammatory drugs, are major causes of DILI. In addition, a large elderly population, comorbidities, and combination therapy with multiple drugs increase the risk of DILI in primary care. Therefore, primary care providers should proactively screen and monitor high-risk patients to identify potential DILI timely. Currently, diagnosis of DILI relies on the exclusion of liver diseases of other etiologies. Collection of detailed medical history of the patients and careful exclusion of other potential liver injury of other etiologies are crucial for accurate diagnosis. This guideline, developed based on evidence-based medicine from the latest research, aimed to provide primary care providers with professional guidance on the timely identification of suspected DILI cases and standardized diagnosis and management in clinical practice.</p>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 1-2","pages":"2-21"},"PeriodicalIF":2.3,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Impact of Primary Sclerosing Cholangitis on Outcomes of Inflammatory Bowel Disease Hospitalization: A Propensity Score Matching Analysis of the Nationwide Inpatient Sample","authors":"Xing Yu,&nbsp;Juan Guo,&nbsp;Meng Li Xue,&nbsp;Cheng Dang Wang,&nbsp;Wei Wei Zheng","doi":"10.1111/1751-2980.13339","DOIUrl":"10.1111/1751-2980.13339","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We aimed to evaluate the effect of primary sclerosing cholangitis (PSC) on hospitalization outcomes of inflammatory bowel disease (IBD) patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study used data from the Nationwide Inpatient Sample (NIS) database from January 1, 2019, to December 31, 2020, including adults (≥ 18 years) admitted and diagnosed with IBD. Key outcomes included length of hospital stay (LOS), in-hospital mortality, hospitalization cost, and complications. The propensity score matching (PSM) analysis was used to balance characteristics between IBD patients with and without PSC, followed by logistic regression for analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After PSM analysis, 4950 patients (PSC: 990; non-PSC: 3960) were analyzed. IBD patients with PSC showed higher odds of any complication (odds ratio [OR] 2.08, 95% confidence interval [CI] 1.80–2.39), including acute kidney injury (OR 1.31, 95% CI 1.10–1.55), septic shock (OR 1.84, 95% CI 1.33–2.54), liver cirrhosis (OR 18.19, 95% CI 14.23–23.25), and liver failure (OR 8.33, 95% CI 5.93–11.70) (all <i>p</i> &lt; 0.05). These associations were consistently observed across subgroups with stronger associations in the Crohn's disease subgroup.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PSC significantly increases the risk of short-term complications in hospitalized IBD patients and the likelihood of chronic liver disease-related complications. These findings highlight the need for targeted management strategies for IBD patients with co-existing PSC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 1-2","pages":"52-61"},"PeriodicalIF":2.3,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of an Automated Deep Learning Program to A Diagnostic Classification Model: Differentiating High-Risk Adenomas Among Colorectal Polyps 10 mm or Smaller","authors":"Da Yeon Ham,&nbsp;Hyun Joo Jang,&nbsp;Sea Hyub Kae,&nbsp;Chang Kyo Oh,&nbsp;Sungjin Hong,&nbsp;Jae Gon Lee","doi":"10.1111/1751-2980.13340","DOIUrl":"10.1111/1751-2980.13340","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to develop a computer-aided diagnosis (CADx) model using an automated deep learning (DL) program to classify low- and high-risk adenomas among colorectal polyps ≤ 10 mm with standard white-light endoscopy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Still images of colorectal adenomas ≤ 10 mm were extracted. High-risk adenomas were defined as high-grade dysplasia or adenomas with villous histology. Neuro-T version 3.2.1 (Neurocle Inc., Seoul, Republic of Korea), an automated DL software, was used for DL. Accuracy, precision, recall, and F1 score of the DL model were calculated. Endoscopy experts and trainees were invited to diagnose endoscopic images to compare their diagnostic accuracy with that of the DL model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 2696 endoscopic images (2460 images of low-grade and 236 of high-grade adenomas) were used for training the DL model. In classifying high- and low-risk adenomas in the external validation dataset (398 images of low-grade and 41 images of high-grade adenomas), the model demonstrated 93.8% accuracy, 81.0% precision, 85.7% recall, and 83.3% F1 score overall. The area under the receiver operating characteristic curve for classifying high- and low-risk adenomas was 0.910 and 0.914, respectively. The expert endoscopists and trainees showed an overall accuracy of 95.1% and 79.7%, respectively, for discriminating high- and low-risk adenomas in the external validation dataset.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The CADx model established by the automated DL program showed high diagnostic performance in differentiating high- and low-risk adenomas among colorectal polyps ≤ 10 mm. The performance of the model was comparable to the experts and superior to the trainees.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 1-2","pages":"80-87"},"PeriodicalIF":2.3,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastric Cardiac Carcinoma: Recent Progress in Clinicopathology, Prognosis, and Early Diagnosis","authors":"Qin Huang,&nbsp;Yu Qing Cheng,&nbsp;Kong Wang Hu,&nbsp;Yan Ding","doi":"10.1111/1751-2980.13336","DOIUrl":"10.1111/1751-2980.13336","url":null,"abstract":"<div>\u0000 \u0000 <p>Gastric cardiac carcinoma (GCC), also known as gastroesophageal junction (GEJ) carcinoma, is a slow-growing fatal cancer that arises in gastric cardiac mucosa in a region of about 2 cm above and 3 cm below the GEJ line. This carcinoma shows clinicopathologic and genomic features similar, but not identical, to gastric noncardiac carcinoma (GNCC). In contrast, GCC is much more complicated than esophageal adenocarcinoma (EA) in clinicopathology, genomics, and prognosis. GCC is heterogeneous geographically, accounting for 20%–50% of all gastric carcinomas in endemic regions in China. Compared with EA, GCC shows a much broader histopathologic spectrum and worse prognosis. Although detailed mechanisms of GCC pathogenesis remain elusive, advanced age, \u0000 <i>Helicobacter pylori</i>\u0000 infection, and gastroesophageal reflux disease are key risk factors. Intriguingly, goblet cell intestinal metaplasia may not be an essential initial step toward carcinogenesis in all GCC cases. At present, an accurate diagnosis of early GCC with prompt curative resection is the only realistic hope for dramatically improving patient outcomes. The recently developed liquid biopsy technology for serum cell-free DNA is a promising tool for the detection of early GCC, though many challenges remain and an in-depth investigation is required. Given the recent rapid advances in artificial intelligence, endoscopic technology, and a better understanding of endoscopists for subtle mucosal/vascular changes in early GCC, accurate detection of early GCC in a high proportion of cases would be possible.</p>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 1-2","pages":"22-30"},"PeriodicalIF":2.3,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}