Gastroenterology & Endoscopy最新文献

Previously, I have reported the efficacy of whole stomach observation using magnifying narrow-band imaging at low magnification (LM-NBI) after routine white-light imaging (WLI). LM-NBI can detect lesions overlooked by WLI. However, the effectiveness of annual examinations remains unexplored. I conducted this case-control study at a single institution. In LM-NBI group, patients with chronic gastritis underwent a LM-NBI scan, defined as the minimal magnification offering maximal visual field coverage to unveil to the microsurface pattern of gastric mucosa, of the whole stomach following WLI. Historical control was used as the conventional magnifying endoscopy (CE) group. In both groups, index endoscopy, which equalizes the status, was performed first, and subsequently annually endoscopies up to five times were conducted. The first annual examination was performed from April 2019 to March 2020 in LM-NBI group and from April 2015 to March 2016 in CE group. The detection of gastric neoplasia was analyzed according to medical records. Among 388 patients in the LM-NBI group, and 381 in the CE group, 15 and 5 patients with gastric neoplasia were respectively identified. Except for one mucosa-associated lymphoid tissue lymphoma, all were epithelial neoplasias. All endoscopic examinations were performed safely without complications which needed additional medical interventions. Through a Cox proportional hazards model, the hazard ratio of 2.78 (95% CE, 1.01–7.64) was determined. Kaplan–Meier analysis (p ​= ​0.039, log-rank test) revealed superior efficacy of annual LM-NBI over CE in detecting gastric neoplasia. This is the first study to report the efficacy of annual endoscopy using LM-NBI.

The integration of artificial intelligence (AI) into healthcare, particularly GPT-4, opens up transformative opportunities for enhancing physician-patient communication, especially in the field of gastroenterology. This advanced language model can automate routine tasks, thereby freeing up physicians' time for complex patient care. Additionally, GPT-4 plays a pivotal role in patient education, simplifying complex medical jargon into understandable language, resulting in an informed patient base more likely to adhere to their care plans. This is crucial for gastroenterology, where patient understanding significantly influences treatment outcomes. Moreover, GPT-4's ability to provide continuous patient care bridges the gap inherent in traditional healthcare models, ensuring regular interaction and a proactive approach to patient care. Nonetheless, as we usher in this transformative era, it is crucial to remember that technology should augment, not replace, the human touch in healthcare. Physicians' empathy, emotional understanding, and judgement are irreplaceable. Furthermore, implementing AI technologies, such as GPT-4, in healthcare settings must be carried out responsibly, abiding by ethical considerations, data privacy standards, and accountability guidelines. This balance allows the exploitation of AI's true potential in healthcare, without compromising ethical standards.

In recent years, with the rapid development of deep learning, artificial intelligence (AI) has gradually become a powerful assistant for humans in various aspects. The maturity and advancement of natural language models led to the birth of Chat Generative Pre-Trained Transformer (ChatGPT), generating great potential for healthcare applications. This review summarized the possible application prospects of ChatGPT in healthcare, assessed the limitations that still exist, and suggested possible improvements. In conclusion, the current version of ChatGPT can provide accurate and practical information for doctors and patients, help healthcare professionals to diagnose and treat, promote medical education, and improve the accuracy and efficiency of the healthcare system, etc. However, ChatGPT still has some limitations, as issues such as the accuracy of the information, privacy of data, ethical and moral sentiments still need to be solved. In the future, scientists still need to make efforts to achieve more accurate and effective medical applications with ChatGPT or other AI model by enhancing model performance, filling the data gap, and promoting the standardization of ethical and copyright issues.

New chatbot models, built on the transformer architecture and trained on large amounts of data, have the potential to transform healthcare, including gastroenterology. In this paper, we synthesized current literature reports on the roles of chatbots, and evaluated their potential applications in various areas such as clinical diagnosis and treatment plans, patient triage, scientific research, and academic writing. We believe that chatbots can improve efficiency and patient outcomes in these fields. However, it is important to acknowledge some challenges that need to be addressed, such as privacy concerns and emotional considerations. Overall, chatbots are expected to have a significant influence on gastroenterology and require more research to comprehensively examine their capabilities.

Gastroparesis is a common functional disorder characterized by chronic upper gastrointestinal symptoms and objective evidence of non-mechanically obstructive delayed gastric emptying. Oxidative stress and inflammation are the core mechanisms of gastroparesis, and it has pathological changes such as loss of Interstitial Cajal Cell (ICC), decreased innervation, immune infiltration, and myofibrosis. In recent years, there has been innovation and development in endoscopic treatment of gastroparesis, among which G-POEM has shown good clinical efficacy. Other endoscopic treatments, such as gastric electrical stimulation, intra-pyloric botulinum toxin injection, pyloric stenting, gastrostomy or anastomosis, also contribute to improving delayed gastric emptying and alleviating symptoms of gastroparesis. This article reviews the physiological changes and pathological mechanisms of gastroparesis and the latest progress in treatment. The review aims to evaluate the effectiveness of current endoscopic therapies and explore possible improvements in the treatment of gastroparesis.