Journal of Digestive Diseases最新文献

{"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}

{"title":"Long-Term Outcomes of Double-Balloon Enteroscopy Polypectomy for Large Small Bowel Polyps Detected During Surveillance Imaging in Patients With Peutz–Jeghers Syndrome","authors":"Min Kyu Kim,&nbsp;Seung Wook Hong,&nbsp;Sung Wook Hwang,&nbsp;Sang Hyoung Park,&nbsp;Dong-Hoon Yang,&nbsp;Byong Duk Ye,&nbsp;Seung-Jae Myung,&nbsp;Suk-Kyun Yang,&nbsp;Jeong-Sik Byeon","doi":"10.1111/1751-2980.13335","DOIUrl":"10.1111/1751-2980.13335","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Double-balloon enteroscopy (DBE) is effective for managing small bowel (SB) diseases. We aimed to evaluate the patient outcomes of DBE polypectomy in Peutz–Jeghers syndrome (PJS) with large SB polyps at surveillance imaging studies and to identify the risk factors for SB surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Forty-five PJS patients who underwent regular SB surveillance imaging studies from 2005 to 2023 were retrospectively included. DBE was performed for polyps &gt; 15 mm detected by imaging studies, and DBE polypectomy was conducted for those &gt; 10 mm or symptomatic ones.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients' average age at PJS diagnosis and surveillance initiation was 19.9 and 27.8 years, respectively. Thirty-one (68.9%) patients had laparotomy before surveillance. Each patient underwent 2.7 DBE procedures at a 31.0-month interval. An average of 7.8 and 4.4 polyps were removed during the first and second DBE procedures (<i>p</i> = 0.070). During 9 (8.2%) DBE procedures, complications, including two perforations requiring surgery, occurred. During the follow-up period, 11 patients required SB surgery, with a median time to surgery of 155 months. Patients with ≥ 5 polyps removed at initial DBE had a higher cumulative probability of SB surgery than those with &lt; 5 polyps (hazard ratio [HR] 9.65, <i>p</i> = 0.031). Patients with ≥ 3 laparotomies before surveillance tended to have an increased surgery risk (HR 9.98, <i>p</i> = 0.078).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>DBE polypectomy effectively manages large SB polyps detected by imaging surveillance in PJS over the long term. Early initiation of surveillance should be emphasized to minimize the risk of SB surgery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 1-2","pages":"44-51"},"PeriodicalIF":2.3,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542212","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":"Splenic Infarction After Sclerotherapy for Gastric Varices due to Anatomical Variation of Left Gastric Artery: A Case Report and Literature Review","authors":"Shuai Jie Qian,&nbsp;Zhi Yin Huang,&nbsp;Yang Tai,&nbsp;Cheng Wei Tang,&nbsp;Hao Wu","doi":"10.1111/1751-2980.13334","DOIUrl":"10.1111/1751-2980.13334","url":null,"abstract":"&lt;p&gt;Endoscopic sclerotherapy with cyanoacrylate has been recommended as the first-line therapeutic option for gastric varices with acute bleeding [&lt;span&gt;1&lt;/span&gt;]. However, endoscopic injection of cyanoacrylate for treating gastric varices may cause splenic infarction [&lt;span&gt;2&lt;/span&gt;], the etiology of which remains unclear. Here we reported a case of a 24-year-old man who presented with splenic infarction after endoscopic sclerotherapy with cyanoacrylate due to splenic arterial occlusion and compensatory dilatation of the left gastric artery (LGA) with collateral branch arteries.&lt;/p&gt;&lt;p&gt;A 24-year-old man was admitted to our hospital due to recurrent gastric variceal bleeding caused by inherited thrombophilia-related cavernous transformation of the portal vein. Inherited thrombophilia was diagnosed 3 years prior to his admission, with extensive arterial thrombosis involving the celiac trunk and its branches as well as venous thrombosis involving the portal vein, superior mesenteric vein, and splenic vein on abdominal computed tomography (CT) scan at diagnosis (Figure 1a). The patient was prescribed warfarin as the long-term anticoagulant therapy, although disease improvement was hardly observed, which was withdrawn 18 months later due to noncompliance of the patient. He was rushed to our Emergency Center due to massive hematemesis and hematochezia 8 months after cessation of treatment. At that admission, esophagogastroduodenoscopy (EGD) showed severe gastroesophageal varices (Figure 1b,c). And abdominal contrast-enhanced CT scan suggested a cavernous transformation of the portal vein (Figure 1a) and abundant collateral vessels. Considering the presence of prehepatic portal hypertension, two sessions of endoscopic band ligation combined with sclerotherapy were performed to treat hemorrhage and prevent rebleeding.&lt;/p&gt;&lt;p&gt;At admission, physical examination and laboratory tests of the patient revealed no remarkable abnormalities. The patient was then hospitalized for sclerotherapy to prevent rebleeding. During the procedure, severe gastric varices were observed (Figure 2a). Spurting hemorrhage occurred immediately after sclerosing agent cyanoacrylate (B. Braun, Melsungen, Germany) was injected (Figure 2b). Although emergency hemostasis was successfully performed by using a titanium clip (Figure 2c), the patient complained of persistent severe pain in the left upper quadrant of the abdomen and left waist accompanied by mild fever (37.4°C) at 30 h after the endoscopic treatment. Peripheral blood tests revealed an elevated white blood cell (WBC) count (15.5 × 10&lt;sup&gt;9&lt;/sup&gt;/L; normal range 3.5–9.5 × 10&lt;sup&gt;9&lt;/sup&gt;/L) and neutrophil percent (84.1%; normal range 40%–75%). A repeat abdominal contrast-enhanced CT scan revealed a large hypodense area of the spleen (Figure 2d). Splenic infarction due to arterial embolism was then diagnosed.&lt;/p&gt;&lt;p&gt;To investigate the reason why ectopic embolism of the artery occurred in this case, computed tomography angiography (C","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 1-2","pages":"88-91"},"PeriodicalIF":2.3,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1751-2980.13334","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537271","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":"Artificial intelligence in pancreaticobiliary endoscopy: Current applications and future directions","authors":"Huan Jiang,&nbsp;Lian Song Ye,&nbsp;Xiang Lei Yuan,&nbsp;Qi Luo,&nbsp;Nuo Ya Zhou,&nbsp;Bing Hu","doi":"10.1111/1751-2980.13324","DOIUrl":"10.1111/1751-2980.13324","url":null,"abstract":"<p>Pancreaticobiliary endoscopy is an essential tool for diagnosing and treating pancreaticobiliary diseases. However, it does not fully meet clinical needs, which presents challenges such as significant difficulty in operation and risks of missed diagnosis or misdiagnosis. In recent years, artificial intelligence (AI) has enhanced the diagnostic and treatment efficiency and quality of pancreaticobiliary endoscopy. Diagnosis and differential diagnosis based on endoscopic ultrasound (EUS) images, pathology of EUS-guided fine-needle aspiration or biopsy, need for endoscopic retrograde cholangiopancreatography (ERCP) and assessment of operational difficulty, postoperative complications and prediction of patient prognosis, and real-time procedure guidance. This review provides an overview of AI applications in pancreaticobiliary endoscopy and proposes future development directions in aspects such as data quality and algorithmic interpretability, aiming to provide new insights for the integration of AI technology with pancreaticobiliary endoscopy.</p>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"25 9-10","pages":"564-572"},"PeriodicalIF":2.3,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909653","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":"Risk of comorbidity of autoimmune liver disease in patients with inflammatory bowel disease: A single-center case–control study in China","authors":"Meng Yuan Zhang,&nbsp;Tian Ming Xu,&nbsp;Ying Hao Sun,&nbsp;Xiao Tian Chu,&nbsp;Ge Chong Ruan,&nbsp;Xiao Yin Bai,&nbsp;Hong Lv,&nbsp;Hong Yang,&nbsp;Hui Jun Shu,&nbsp;Jia Ming Qian","doi":"10.1111/1751-2980.13321","DOIUrl":"10.1111/1751-2980.13321","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the prevalence of autoimmune hepatitis (AIH), primary biliary cholangitis (PBC), and primary sclerosing cholangitis (PSC), and the impact of comorbidity of AIH, PBC, and PSC on hospitalization burden in patients with inflammatory bowel disease (IBD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Inpatients admitted to Peking Union Medical College Hospital from January 1, 1998 to December 31, 2021 were included. Odds ratio (OR) and the corresponding 95% confidence interval (CI) were calculated to compare the risk of AIH, PBC, and PSC between IBD and non-IBD patients. Medical cost and length of hospitalization were compared between IBD patients with and without AIH, PBC, or PSC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the included 858 967 inpatients, there were 3059 patients with IBD. Additionally, there were 117 patients with AIH, 879 patients with PBC, and 35 patients with PSC, regardless of having IBD or not. Patients with IBD had a significantly higher risk of AIH (OR 4.87, 95% CI 1.20–19.71, <i>p</i> = 0.03) and PSC (OR 112.28, 95% CI 53.88–233.98, <i>p</i> &lt; 0.01) than those without IBD. While there was no significant difference in the risk of PBC between patients with and without IBD (OR 1.60, 95% CI 0.67–3.86, <i>p</i> = 0.29). The medical cost of each hospitalization did not differ between IBD patients with and without AIH, PBC, or PSC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>IBD patients had a higher risk of AIH and PSC. Comorbidity of AIH, PBC, or PSC has no significant effect on the average cost of each hospitalization in IBD patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"25 9-10","pages":"587-593"},"PeriodicalIF":2.3,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893701","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":"Comparison of the diagnostic efficacy between virtual portal pressure gradient and hepatic venous pressure gradient in patients with cirrhotic portal hypertension","authors":"Wei Ping Song,&nbsp;Shuo Zhang,&nbsp;Jing Li,&nbsp;Yu Yang Shao,&nbsp;Ji Chong Xu,&nbsp;Chang Qing Yang","doi":"10.1111/1751-2980.13319","DOIUrl":"10.1111/1751-2980.13319","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to evaluate the performance of virtual portal pressure gradient (vPPG) and its associated hemodynamic parameters of 3-dimensional (3D) model in patients with cirrhosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Seventy cirrhotic patients who underwent both hepatic venous pressure gradient (HVPG) measurement and vPPG calculation were prospectively collected. The ideal-state model (ISM; n = 44) was defined by sinusoidal PH without hepatic vein shunt or portal vein thrombosis, whereas those not conforming to the criteria were classified as non-ISM (n = 26). Correlation analyses were conducted to determine the relationship between vPPG or its associated 3D hemodynamic parameters and HVPG. The diagnostic and predictive performance of vPPG and HVPG for cirrhotic-related complications was evaluated using the receiver operating characteristic (ROC) curve and Kaplan–Meier analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the ISM group, vPPG-associated hemodynamic parameters including total branch cross-sectional area (S2), average branch cross-sectional area (S), and average portal vein model length (h) were correlated with HVPG (<i>r</i> = 0.592, 0.536, −0.497; all <i>p</i> &lt; 0.001), whereas vPPG was strongly correlated with HVPG (<i>r</i> = 0.832, <i>p</i> &lt; 0.001). In the non-ISM group, vPPG, S2, S, and h were not related to HVPG (all <i>p</i> &gt; 0.05). In the ISM group, both vPPG and HVPG showed significant diagnostic and predictive capabilities for cirrhosis-related complications. While in the non-ISM group, the diagnostic accuracy and predictive efficacy of vPPG surpassed those of HVPG.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>HVPG exhibited superior diagnostic and predictive efficacy for cirrhotic PH in the ISM, whereas vPPG showed enhanced performance in non-ISM.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"25 9-10","pages":"603-614"},"PeriodicalIF":2.3,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894987","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 decision support tool-guided, selective intensive induction strategy of ustekinumab in patients with Crohn's disease: A multicenter cohort study","authors":"Qing Li,&nbsp;Jian Tang,&nbsp;Zhao Peng Huang,&nbsp;Li Shuo Shi,&nbsp;Xiao Ping Lyu,&nbsp;Xue Min Chen,&nbsp;Wen Ke Chen,&nbsp;An Ying Xun,&nbsp;Qin Guo,&nbsp;Miao Li,&nbsp;Xiang Gao,&nbsp;Kang Chao","doi":"10.1111/1751-2980.13318","DOIUrl":"10.1111/1751-2980.13318","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We aimed to evaluate the effectiveness and safety of clinical decision support tool (CDST)-guided initial selective intensive induction therapy (IIT) for patients with Crohn's disease (CD) who were treated with ustekinumab (UST) and to identify those most likely to benefit from IIT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with active CD were included in this multicenter retrospective study and were categorized as low-, intermediate-, and high-probability responders according to the UST-CDST. IIT was defined as intensive induction by two or three initial doses of weight-based intravenous UST administration. Patients treated with standard therapy (ST) served as controls. The primary end-point was corticosteroid-free clinical remission (CFCR) at Week 24. Secondary end-points included clinical remission, clinical response, endoscopic remission, endoscopic response, and C-reactive protein (CRP) normalization at Week 24. Propensity score adjustments was conducted to ensure comparability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 296 patients were included. At Week 24, IIT was associated with higher rates of CFCR (72.3% vs 43.0%, <i>p</i> &lt; 0.001), clinical remission (77.3% vs 47.1%, <i>p</i> &lt; 0.001), clinical response (78.1% vs 60.1%, <i>p</i> = 0.001), endoscopic remission (26.1% vs 9.9%, <i>p</i> = 0.024), and endoscopic response (58.6% vs 36.9%, <i>p</i> = 0.018) in low–intermediate-probability responders compared with ST. CRP normalization was comparable between groups. No significant differences were found in any end-points in high-probability responders. No serious adverse events were observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The efficacy of IIT was superior to that of ST in patients with predicted poor response to UST, which may be regarded as a novel strategy for stratifying patients at baseline.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"25 9-10","pages":"594-602"},"PeriodicalIF":2.3,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877037","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}