Journal of Digestive Diseases最新文献_第3页

Insight into the therapeutic effects of artesunate in relieving metabolic-associated steatohepatitis from transcriptomic and lipidomics analyses 通过转录组学和脂质组学分析深入了解青蒿琥酯缓解代谢相关性脂肪性肝炎的治疗效果

IF 2.3 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Journal of Digestive Diseases

Pub Date : 2024-09-09 DOI: 10.1111/1751-2980.13311

Jing Yang, Lei Jie Huang, Tian Yi Ren, Jing Zeng, Yi Wen Shi, Jian Gao Fan

Objectives

Artesunate (ART) is a water-soluble derivative of artemisinin, which has shown anti-inflammatory, anti-tumor, and immunomodulating effects. We aimed to investigate the potential therapeutic effects and mechanisms of ART in metabolic dysfunction-associated steatohepatitis (MASH).

Methods

The mice were randomly divided into the control group, high-fat, high-cholesterol diet-induced MASH group, and the MASH treated with ART (30 mg/kg once daily) group. Liver enzymes, lipids, and histological features were compared among groups. The molecular mechanisms were studied by transcriptomic and lipidomics analyses of liver tissues.

Results

The mice of the MASH group had significantly increased hepatic fat deposition and inflammation in terms of biochemical indicators and pathological manifestations than the control group. The ART-treated group had improved plasma liver enzymes and hepatic cholesterol, especially at week 4 of intervention (p < 0.05). A total of 513 differentially expressed genes and 59 differentially expressed lipids were identified in the MASH group and the MASH+ART group. Gene Ontology analysis and Kyoto Encyclopedia of Genes and Genomes pathway enrichment test showed that ART regulated glycerolipid metabolism pathway and enhanced fatty acid degradation. Peroxisome proliferator-activated receptor (PPAR)-α acted as a key transcription factor in the treatment of MASH with ART, which was confirmed by cell experiment.

Conclusions

ART significantly improved fat deposition and inflammatory manifestations in MASH mice, with potential therapeutic effects. The mechanism of artemisinin treatment for MASH may involve extensive regulation of downstream genes by upstream transcription factors, such as PPAR-α, to restore hepatic lipid homeostasis.

目的青蒿琥酯（ART）是青蒿素的一种水溶性衍生物，具有抗炎、抗肿瘤和免疫调节作用。我们旨在研究青蒿琥酯对代谢功能障碍相关性脂肪性肝炎（MASH）的潜在治疗作用和机制。比较各组的肝酶、血脂和组织学特征。结果MASH组小鼠的肝脏脂肪沉积和炎症在生化指标和病理表现方面均明显高于对照组。ART治疗组的血浆肝酶和肝胆固醇有所改善，尤其是在干预第4周时（p < 0.05）。MASH组和MASH+ART组共发现了513个差异表达基因和59个差异表达脂质。基因本体分析和京都基因组百科全书通路富集测试表明，ART可调控甘油脂代谢通路并促进脂肪酸降解。结论ART能显著改善MASH小鼠的脂肪沉积和炎症表现，具有潜在的治疗作用。青蒿素治疗MASH的机制可能涉及上游转录因子（如PPAR-α）对下游基因的广泛调控，从而恢复肝脏脂质平衡。

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引用次数: 0

Selection strategy for endoscopic necrosectomy approaches of infected walled-off pancreatic necrosis: Analysis of 101 patients from a single center with long-term follow-up 感染性胰腺脱壁坏死内镜下坏死切除术的选择策略：对来自单一中心的 101 例患者的长期随访分析。

IF 2.3 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Journal of Digestive Diseases

Pub Date : 2024-09-03 DOI: 10.1111/1751-2980.13310

Jie Luo, Sheng Wei Zhang, Jia Lin He, Li Xing Tian, Xue Peng, Xu Biao Nie, Shao Song Ye, Ying Zuo, Hui Lin, Jian Ying Bai, En Liu, Shi Ming Yang, Chao Qiang Fan

Objectives

Endoscopic necrosectomy (EN) is a promising minimally invasive approach for treating infected walled-off pancreatic necrosis (WOPN). Multiple EN approaches are currently available, though criteria for selecting the optimal approaches are lacking. We aimed to propose a rational selection strategy of EN and to retrospectively evaluate its safety and effectiveness.

Methods

Altogether 101 patients who underwent EN for infected WOPN at a tertiary hospital between June 2009 and February 2023 were retrospectively included for analysis. Demographic characteristics, details of the EN procedures, procedure-related adverse events, and clinical outcomes were investigated.

Results

Among these 101 patients with WOPN, 56 (55.4%) underwent transluminal EN, 38 (37.6%) underwent percutaneous EN, and seven (6.9%) underwent combined approach, respectively. Clinical success was achieved in 94 (93.1%) patients. Seven (6.9%) experienced procedure-related adverse events, and seven (6.9%) died during the treatment period. During a median follow-up of 50 months, 5 (5.3%) of the 94 patients had disease recurrence, 17.0% (16/94) had new-onset diabetes mellitus, and 6.4% (6/94) needed oral pancreatic enzyme supplementation. The clinical success rate, procedure-related adverse event rate, and long-term follow-up outcomes were not significantly different among the three groups. High APACHE-II scores (≥15) and organ failure were identified as factors related to treatment failure.

Conclusions

A selection strategy for EN approaches, based on the extent of necrosis and its distance from the gastrointestinal lumen (using a threshold of 15 mm), is safe and effective for treating infected WOPN in both short-term and long-term outcomes.

目的：内镜坏死切除术（EN）是治疗感染性胰腺壁脱落坏死（WOPN）的一种很有前景的微创方法。目前有多种内镜坏死切除术方法，但缺乏选择最佳方法的标准。我们旨在提出一种合理的EN选择策略，并对其安全性和有效性进行回顾性评估：我们回顾性地纳入了 2009 年 6 月至 2023 年 2 月期间在一家三甲医院因感染 WOPN 而接受耳鼻喉手术的 101 例患者进行分析。结果：在这 101 例 WOPN 感染患者中，有 1 例患者接受了耳鼻喉手术，有 1 例患者接受了耳鼻喉手术，有 1 例患者接受了耳鼻喉手术，有 1 例患者接受了耳鼻喉手术：结果：在这 101 例 WOPN 患者中，56 例（55.4%）接受了经腔镜EN，38 例（37.6%）接受了经皮EN，7 例（6.9%）接受了联合方法。94例（93.1%）患者获得了临床成功。7例（6.9%）患者出现了与手术相关的不良反应，7例（6.9%）患者在治疗期间死亡。在中位随访 50 个月期间，94 名患者中有 5 人（5.3%）疾病复发，17.0%（16/94）新发糖尿病，6.4%（6/94）需要口服胰酶补充剂。三组患者的临床成功率、手术相关不良事件发生率和长期随访结果无明显差异。高APACHE-II评分（≥15分）和器官衰竭被认为是治疗失败的相关因素：根据坏死程度及其与胃肠管腔的距离（阈值为 15 毫米）选择 EN 方法的策略对治疗感染性 WOPN 在短期和长期结果上都是安全有效的。

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引用次数: 0

Inhibition of FoxO1 ameliorates hepatic steatosis and hepatitis in nonalcoholic steatohepatitis mice through regulation of gut microbiota 抑制 FoxO1 可通过调节肠道微生物群改善非酒精性脂肪性肝炎小鼠的肝脏脂肪变性和肝炎。

IF 2.3 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Journal of Digestive Diseases

Pub Date : 2024-08-30 DOI: 10.1111/1751-2980.13306

Di Wen Shou, Ying Quan, Jie Min Cheng, Si Qi Yang, Jia Wei Chen, Yong Qiang Li, Chen Huang, Hui Ting Chen, Yong Jian Zhou

Objective

We aimed to investigate the role of forkhead box O1 (FoxO1) inhibitor AS1842856 (AS) in nonalcoholic steatohepatitis (NASH) mice and the potential mechanisms.

Methods

Mice were given methionine-choline-sufficient (MCS), or methionine- and choline-deficient (MCD) diet for 5 weeks, along with AS (60 mg/kg) or vehicle gavage treatment (0.2 mL/day). Body and liver weight, serum triglyceride (TG), low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), alanine aminotransferase (ALT), aspartate aminotransferase (AST), fasting glucose and insulin levels were measured. Liver macrophage infiltration and ileal ZO-1 protein expression were also detected. Interleukin (IL)-6, IL-1β, and tumor necrosis factor (TNF)-α, sterol regulatory element binding protein (SREBP)-1c, phosphoenolpyruvate carboxykinase (PEPCK), and glucose-6-phosphatase (G6Pase), α-smooth muscle actin (SMA), recombinant collagen type III α1 (Col3a1), and connective tissue growth factor (Ctgf) expressions were measured. Stool samples were collected for 16S rDNA sequencing.

Results

Compared to the MCD group, AS attenuated liver weight, reduced serum TG, ALT, and AST levels, increased HDL-C levels, mitigated hepatic steatosis, decreased macrophage infiltration, and augmented ileal ZO-1 proteins in NASH mice. It also reduced the levels of IL-6, IL-1β, and TNF-α, alongside with the Srebp-1c mRNA expression. However, no significant effects on Pepck, G6Pase, α-SMA, Col3a1, or Ctgf were observed. Furthermore, AS promoted diversity and altered gut microbiota composition in NASH mice, causing increased beneficial bacteria like Akkermansia muciniphila, Parabacteroides distasonis, and Prevotellamassilia, which were associated with metabolic functions.

Conclusion

FoxO1 inhibitor AS ameliorated hepatic steatosis, inflammation, and intestinal dysbiosis in NASH mice, making it a potentially promising treatment for NASH.

研究目的我们旨在研究叉头框O1（FoxO1）抑制剂AS1842856（AS）在非酒精性脂肪性肝炎（NASH）小鼠中的作用及其潜在机制：给小鼠喂食蛋氨酸胆碱不足（MCS）或蛋氨酸胆碱缺乏（MCD）饮食 5 周，同时给予 AS（60 毫克/千克）或载体灌胃治疗（0.2 毫升/天）。测定了体重和肝脏重量、血清甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）、空腹血糖和胰岛素水平。还检测了肝脏巨噬细胞浸润和回肠 ZO-1 蛋白表达。还检测了白细胞介素（IL）-6、IL-1β、肿瘤坏死因子（TNF）-α、甾醇调节元件结合蛋白（SREBP）-1c、磷酸烯醇丙酮酸羧激酶（PEPCK）、葡萄糖-6-磷酸酶（G6Pase）、α-平滑肌肌动蛋白（SMA）、重组胶原Ⅲ型α1（Col3a1）和结缔组织生长因子（Ctgf）的表达。采集粪便样本进行16S rDNA测序：与 MCD 组相比，AS 减轻了 NASH 小鼠的肝脏重量，降低了血清 TG、ALT 和 AST 水平，提高了 HDL-C 水平，减轻了肝脏脂肪变性，减少了巨噬细胞浸润，增加了回肠 ZO-1 蛋白。它还降低了 IL-6、IL-1β 和 TNF-α 的水平，以及 Srebp-1c mRNA 的表达。然而，没有观察到对 Pepck、G6Pase、α-SMA、Col3a1 或 Ctgf 的明显影响。此外，AS还促进了NASH小鼠肠道微生物群的多样性并改变了其组成，导致Akkermansia muciniphila、Parabacteroides distasonis和Prevotellamassilia等与代谢功能相关的有益菌增加：结论：FoxO1抑制剂AS可改善NASH小鼠的肝脏脂肪变性、炎症和肠道菌群失调，是一种治疗NASH的潜在药物。

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引用次数: 0

Role of artificial intelligence in Crohn's disease intestinal strictures and fibrosis 人工智能在克罗恩病肠道狭窄和纤维化中的作用。

IF 2.3 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Journal of Digestive Diseases

Pub Date : 2024-08-27 DOI: 10.1111/1751-2980.13308

Yi Fei Chen, Liu Liu, Bin Lyu, Ye Yang, Si Si Zheng, Xuan Huang, Yi Xu, Yi Hong Fan

Crohn's disease (CD) is a chronic inflammatory disorder of the gastrointestinal tract. Intestinal fibrosis or stricture is one of the most prevalent complications in CD with a high recurrence rate. Manual examination of intestinal fibrosis or stricture by physicians may be biased or inefficient. A rapid development of artificial intelligence (AI) technique in recent years facilitates the detection of existing or possible intestinal fibrosis and stricture in CD through various modalities, including endoscopy, imaging examination, and serological biomarkers. We reviewed the articles on AI application in diagnosing intestinal fibrosis and stricture in CD during the past decade and categorized them into three aspects based on the detection methods, and found that AI helps accurate and expedient identification and prediction of intestinal fibrosis and stenosis in CD.

克罗恩病（CD）是一种慢性胃肠道炎症性疾病。肠纤维化或狭窄是 CD 最常见的并发症之一，复发率很高。医生对肠纤维化或狭窄的人工检查可能存在偏差或效率低下。近年来，人工智能（AI）技术发展迅速，通过内窥镜检查、影像学检查和血清学生物标志物等多种方式，有助于发现 CD 患者已经存在或可能存在的肠纤维化和肠狭窄。我们回顾了近十年来有关人工智能应用于诊断 CD 肠纤维化和狭窄的文章，并根据检测方法将其分为三个方面，发现人工智能有助于准确、快速地识别和预测 CD 肠纤维化和狭窄。

引用次数: 0

Dramatic ruxolitinib efficacy in chronic enteropathy associated with SLCO2A1 gene (CEAS) Ruxolitinib对SLCO2A1基因相关慢性肠病（CEAS）的显著疗效。

IF 2.3 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Journal of Digestive Diseases

Pub Date : 2024-08-27 DOI: 10.1111/1751-2980.13309

Laure Ricard, Fabienne Charbit-Henrion, Alice Courties, Mohamad Mohty, Ollivier Legrand, Victor Benady, Anne Bourrier, Geneviève Baujat, Florent Malard

引用次数: 0

Concordance of phenotypic characteristics among patients with familial Crohn's disease in China 中国家族性克罗恩病患者表型特征的一致性。

IF 2.3 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Journal of Digestive Diseases

Pub Date : 2024-08-21 DOI: 10.1111/1751-2980.13304

Xiao Xia Deng, Min Zhi Lin, Xiang Gao, Xin Yu Liu, Yan Hui Wu, Kang Chao, Jian Tang

Objectives

Familial Crohn's disease (CD) accounts for approximately 1.5%–22.5% of all CD cases worldwide. We aimed to assess the concordance in disease subtype and phenotypic features among patients with CD and their relatives based on data from a large, well-characterized, referral center-based cohort in China.

Methods

A retrospective study was conducted on patients with familial CD who were admitted to the Sixth Affiliated Hospital of Sun Yat-sen University between January 2012 and June 2022. We analyzed the disease characteristics and performed a concordance analysis within the same family among patients with familial CD.

Results

Among 5150 patients, 70 (1.4%) had a family history of Crohn's disease. The median age of the patients at initial diagnosis did not differ significantly between the probands and successors of family members with CD (p = 0.25). At the initial diagnosis, 54 first-degree relatives showed moderate concordance in age (κ = 0.50) and disease location (κ = 0.44). At the last follow-up visit, all family members and first-degree relatives showed good concordance in upper gastrointestinal involvement (κ = 0.67 and 0.62) and stricturing or penetrating behavior (κ = 0.69 and 0.77), respectively. Patients with familial CD within the same family showed moderate agreement regarding anti-tumor necrosis factor α monoclonal antibody use and treatment efficacy (κ = 0.44 and 0.42) and mild agreement regarding the efficacy and adverse reactions of thiopurine (κ = 0.26 and 0.35).

Conclusions

The proportion of patients with familial CD in China may be relatively low. The consistency of certain disease features in familial CD may be associated with the degree of kinship and convergence with longer follow-up duration.

目的：家族性克罗恩病（CD）约占全球所有 CD 病例的 1.5%-22.5%。我们的目的是基于中国一个大型、特征明确、以转诊中心为基础的队列数据，评估克罗恩病患者及其亲属在疾病亚型和表型特征方面的一致性：我们对中山大学附属第六医院2012年1月至2022年6月期间收治的家族性CD患者进行了回顾性研究。我们分析了家族性 CD 患者的疾病特征，并对同一家族内的患者进行了一致性分析：在5150名患者中，70人（1.4%）有克罗恩病家族史。初次确诊时患者的中位年龄在克罗恩病家族成员的原发者和继发者之间没有显著差异（P = 0.25）。在初次诊断时，54 名一级亲属在年龄（κ = 0.50）和发病部位（κ = 0.44）方面表现出中等程度的一致性。在最后一次随访时，所有家庭成员和一级亲属在上消化道受累（κ = 0.67和0.62）和严格或穿透行为（κ = 0.69和0.77）方面分别显示出良好的一致性。同一家族中的家族性 CD 患者在抗肿瘤坏死因子 α 单克隆抗体的使用和疗效方面表现出中等程度的一致性（κ = 0.44 和 0.42），在硫嘌呤的疗效和不良反应方面表现出轻度的一致性（κ = 0.26 和 0.35）：结论：中国家族性 CD 患者的比例可能相对较低。结论：中国家族性 CD 患者的比例可能相对较低，家族性 CD 患者某些疾病特征的一致性可能与亲缘关系程度有关，随访时间越长越趋同。

{"title":"Concordance of phenotypic characteristics among patients with familial Crohn's disease in China","authors":"Xiao Xia Deng, Min Zhi Lin, Xiang Gao, Xin Yu Liu, Yan Hui Wu, Kang Chao, Jian Tang","doi":"10.1111/1751-2980.13304","DOIUrl":"10.1111/1751-2980.13304","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Familial Crohn's disease (CD) accounts for approximately 1.5%–22.5% of all CD cases worldwide. We aimed to assess the concordance in disease subtype and phenotypic features among patients with CD and their relatives based on data from a large, well-characterized, referral center-based cohort in China.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective study was conducted on patients with familial CD who were admitted to the Sixth Affiliated Hospital of Sun Yat-sen University between January 2012 and June 2022. We analyzed the disease characteristics and performed a concordance analysis within the same family among patients with familial CD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 5150 patients, 70 (1.4%) had a family history of Crohn's disease. The median age of the patients at initial diagnosis did not differ significantly between the probands and successors of family members with CD (<i>p</i> = 0.25). At the initial diagnosis, 54 first-degree relatives showed moderate concordance in age (κ = 0.50) and disease location (κ = 0.44). At the last follow-up visit, all family members and first-degree relatives showed good concordance in upper gastrointestinal involvement (κ = 0.67 and 0.62) and stricturing or penetrating behavior (κ = 0.69 and 0.77), respectively. Patients with familial CD within the same family showed moderate agreement regarding anti-tumor necrosis factor α monoclonal antibody use and treatment efficacy (κ = 0.44 and 0.42) and mild agreement regarding the efficacy and adverse reactions of thiopurine (κ = 0.26 and 0.35).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The proportion of patients with familial CD in China may be relatively low. The consistency of certain disease features in familial CD may be associated with the degree of kinship and convergence with longer follow-up duration.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"25 7","pages":"444-452"},"PeriodicalIF":2.3,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142008845","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}

引用次数: 0

Clinical and endoscopic characteristics of colorectal sessile serrated lesions with or without dysplasia/carcinoma: A systematic review and meta-analysis 有或无发育不良/癌的结直肠无柄锯齿状病变的临床和内镜特征：系统综述和荟萃分析。

IF 2.3 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Journal of Digestive Diseases

Pub Date : 2024-08-05 DOI: 10.1111/1751-2980.13302

Qing Qing Zhang, Jian Di Wu, Xue Yan Li, Fei Fei Fang, Gang Ping Li, Tao Bai, Jun Song

Objective

We aimed to compare the clinical and endoscopic characteristics of sessile serrated lesions (SSLs) with dysplasia/carcinoma (SSLD/Cs) and SSLs without dysplasia in this systematic review and meta-analysis.

Methods

MEDLINE, EMBASE, and Cochrane Library databases and Clinicaltrials.gov were searched for relevant studies published up to August 28, 2023. The primary outcome was lesion size in SSLD/Cs and SSLs without dysplasia. The secondary outcomes included risk of dysplasia/carcinoma, morphology (classified based on the Paris classification), and lesion features such as mucus cap and nodules/protrusions in the two groups.

Results

Thirteen studies with 14 381 patients were included. The proportion of SSLD/Cs ≥10 mm was significantly higher than that of SSLs without dysplasia (odds ratio [OR] 3.82, 95% confidence interval [CI] 1.21–12.02, p = 0.02). There was no significant difference in the risk of dysplasia/carcinoma between the proximal (OR 0.80, 95% CI 0.57–1.14) and distal colon (OR 1.25, 95% CI 0.88–1.77, p = 0.21). The 0-Ip (OR 2.47, 95% CI 1.50–4.09) and 0-IIa + Is (OR 10.38, 95% CI 3.08–34.98) morphologies were more prevalent among SSLD/Cs, whereas the 0-IIa morphology (OR 0.38, 95% CI 0.22–0.65) was more prevalent among SSLs without dysplasia (all p < 0.001). Furthermore, mucus cap (OR 0.61, 95% CI 0.42–0.89, p = 0.01) was more common among SSLs without dysplasia, whereas nodules/protrusions (OR 7.80, 95% CI 3.07–19.85, p < 0.001) were more common in SSLD/Cs.

Conclusion

SSLs >10 mm, 0-Ip or 0-IIa + Is morphologies, and those with nodules/protrusions are significantly associated with dysplasia/carcinoma.

目的：我们旨在通过本系统综述和荟萃分析比较伴有发育不良/癌（SSLD/Cs）的无柄锯齿状病变（SSLs）和不伴有发育不良的无柄锯齿状病变（SSLs）的临床和内窥镜特征：检索了 MEDLINE、EMBASE 和 Cochrane Library 数据库以及 Clinicaltrials.gov 中截至 2023 年 8 月 28 日发表的相关研究。主要研究结果为 SSLD/Cs 和 SSLs 中病变的大小，无发育不良。次要结果包括两组患者发生发育不良/癌变的风险、形态（根据巴黎分类法分类）以及病变特征，如粘液帽和结节/突起：结果：共纳入 13 项研究，14 381 名患者。SSLD/Cs≥10毫米的比例明显高于无发育不良的SSL（几率比[OR]3.82，95%置信区间[CI]1.21-12.02，P = 0.02）。近端结肠（OR 0.80，95% CI 0.57-1.14）和远端结肠（OR 1.25，95% CI 0.88-1.77，P = 0.21）发生发育不良/癌变的风险无明显差异。0-Ip（OR 2.47，95% CI 1.50-4.09）和 0-IIa + Is（OR 10.38，95% CI 3.08-34.98）形态在 SSLD/Cs 中更为常见，而 0-IIa 形态（OR 0.38，95% CI 0.22-0.65）在无发育不良的 SSL 中更为常见（所有 p 均为结论）：大于 10 毫米的 SSL、0-Ip 或 0-IIa + Is 形态以及伴有结节/突起的 SSL 与发育不良/癌明显相关。

{"title":"Clinical and endoscopic characteristics of colorectal sessile serrated lesions with or without dysplasia/carcinoma: A systematic review and meta-analysis","authors":"Qing Qing Zhang, Jian Di Wu, Xue Yan Li, Fei Fei Fang, Gang Ping Li, Tao Bai, Jun Song","doi":"10.1111/1751-2980.13302","DOIUrl":"10.1111/1751-2980.13302","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We aimed to compare the clinical and endoscopic characteristics of sessile serrated lesions (SSLs) with dysplasia/carcinoma (SSLD/Cs) and SSLs without dysplasia in this systematic review and meta-analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>MEDLINE, EMBASE, and Cochrane Library databases and Clinicaltrials.gov were searched for relevant studies published up to August 28, 2023. The primary outcome was lesion size in SSLD/Cs and SSLs without dysplasia. The secondary outcomes included risk of dysplasia/carcinoma, morphology (classified based on the Paris classification), and lesion features such as mucus cap and nodules/protrusions in the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirteen studies with 14 381 patients were included. The proportion of SSLD/Cs ≥10 mm was significantly higher than that of SSLs without dysplasia (odds ratio [OR] 3.82, 95% confidence interval [CI] 1.21–12.02, <i>p</i> = 0.02). There was no significant difference in the risk of dysplasia/carcinoma between the proximal (OR 0.80, 95% CI 0.57–1.14) and distal colon (OR 1.25, 95% CI 0.88–1.77, <i>p</i> = 0.21). The 0-Ip (OR 2.47, 95% CI 1.50–4.09) and 0-IIa + Is (OR 10.38, 95% CI 3.08–34.98) morphologies were more prevalent among SSLD/Cs, whereas the 0-IIa morphology (OR 0.38, 95% CI 0.22–0.65) was more prevalent among SSLs without dysplasia (all <i>p</i> < 0.001). Furthermore, mucus cap (OR 0.61, 95% CI 0.42–0.89, <i>p</i> = 0.01) was more common among SSLs without dysplasia, whereas nodules/protrusions (OR 7.80, 95% CI 3.07–19.85, <i>p</i> < 0.001) were more common in SSLD/Cs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>SSLs >10 mm, 0-Ip or 0-IIa + Is morphologies, and those with nodules/protrusions are significantly associated with dysplasia/carcinoma.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"25 7","pages":"424-435"},"PeriodicalIF":2.3,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141893558","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}

引用次数: 0

Are biologics beneficial alternatives for cryptogenic multifocal ulcerous stenosing enteritis? A case report and literature review 生物制剂是治疗隐源性多灶性溃疡性狭窄肠炎的有益替代品吗？病例报告和文献综述。

IF 2.3 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Journal of Digestive Diseases

Pub Date : 2024-08-01 DOI: 10.1111/1751-2980.13305

Shao Heng Zhang, Qing Qing, Huo Wang Ye, Xin Ying Wang

引用次数: 0

Development of a risk scoring system for predicting advanced colorectal neoplasia within subcentimetric polyps: A population-based study 开发风险评分系统，用于预测亚厘米息肉中的晚期结直肠肿瘤：一项基于人群的研究。

IF 2.3 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Journal of Digestive Diseases

Pub Date : 2024-07-30 DOI: 10.1111/1751-2980.13303

Junjie Huang, Eman Y. M. Leung, Sam C. C. Chun, Zhaojun Li, Xianjing Liu, Chao Ying Zhong, Jian Li Lin, Jun Jie Hang, Claire C. W. Zhong, Jin Qiu Yuan, Martin C. S. Wong

Objective

To determine a risk scoring system for predicting advanced colorectal neoplasia (ACN) within subcentimetric polyps in a large Asian population.

Methods

A retrospective study was conducted in Hong Kong SAR, China involving participants who underwent colonoscopy between 2008 and 2015. A random sample of 20 072 subjects were included as the derivation cohort to assess ACN-associated independent factors using logistic regression modeling. Another 8603 subjects formed a validation cohort. A risk scoring system was developed and its performance was assessed using the area under the receiver operating characteristic curve (AUROC).

Results

The risk scores were assigned based on the following criteria: (a) patients who were admitted from inpatient colonoscopy (2.2) or not (1); (b) with three or more chronic diseases (hypertension, diabetes mellitus, hyperlipidemia, heart disease, or cancer) (1.7) or not (1); (c) anemia (1.3) or without anemia (1); (d) receiving aspirin (0.5) or not (1); (e) receiving other nonsteroidal anti-inflammatory drugs (0.3) or not (1); (f) male (1.2) or female gender (1); (g) age <55 (1), 55–64 (1.4), 65–69 (2), 70 years or above (2.2). ACN was more common in those with scores of 2.192 or higher, and they were classified as high risk (HR). The prevalence of ACN in the validation cohort was 13.28% and 3.56% in the HR and low-risk groups, respectively. In both the derivation and validation cohorts, AUROC of the risk-scoring model was 0.7138.

Conclusion

Physicians are recommended to utilize this validated score for risk-stratification of patients having subcentimetric polyps.

目的确定一个风险评分系统，用于预测大量亚洲人群中的亚厘米息肉内的晚期结直肠肿瘤（ACN）：在中国香港特别行政区开展了一项回顾性研究，研究对象包括在 2008 年至 2015 年期间接受过结肠镜检查的人。随机抽取 20 072 名受试者作为衍生队列，使用逻辑回归模型评估与 ACN 相关的独立因素。另外 8603 名受试者组成验证队列。研究人员开发了一套风险评分系统，并利用接收者操作特征曲线下面积（AUROC）对其性能进行了评估：风险评分标准如下(结果：根据以下标准进行风险评分：(a) 住院患者接受结肠镜检查（2.2）或未接受结肠镜检查（1）；(b) 患有三种或三种以上慢性疾病（高血压、糖尿病、高脂血症、心脏病或癌症）（1.7）或未患慢性疾病（1）；(c) 贫血（1.3）或无贫血（1）；（d）服用阿司匹林（0.5）或未服用（1）；（e）服用其他非甾体抗炎药（0.3）或未服用（1）；（f）男性（1.2）或女性（1）；（g）年龄结论：建议医生使用该有效评分法对亚高危息肉患者进行风险分级。

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引用次数: 0

Interaction of Th17 differentiations-related gene polymorphisms and environmental factors contributing to the disease classification, complications, and surgical risks of Crohn's disease in the Chinese Han population Th17分化相关基因多态性与环境因素对中国汉族克罗恩病的疾病分类、并发症和手术风险的交互作用。

IF 2.3 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Journal of Digestive Diseases

Pub Date : 2024-07-29 DOI: 10.1111/1751-2980.13301

Ru Ning Zhou, Ge Chong Ruan, Mei Xu Wu, Ming Yue Guo, Hao Zheng Liang, Xiao Yin Bai, Hong Yang

Objectives

Few studies have been conducted on gene–environment interactions in the Chinese population with Crohn's disease (CD). We aimed to investigate the association between single nucleotide polymorphisms (SNPs) on the T helper 17 (Th17) cell and CD susceptibility/performance in Chinese individuals.

Methods

We conducted a case–control and case-only study at the Peking Union Medical College Hospital. Four SNPs related to the Th17 cell pathway genes were prioritized, including rs2284553 (interferon gamma receptor 2), rs7517847 (interleukin 23 receptor), rs7773324 (interferon regulatory factor 4), and rs4263839 (tumor necrosis factor superfamily 15). SNP frequency was calculated, and gene–environment interaction was assessed by multifactor dimensionality reduction analysis.

Results

Altogether 159 CD patients and 316 healthy controls were included. All analyzed SNPs were found in Hardy–Weinberg equilibrium (P > 0.05). The frequency of rs2284553-A allele and rs4263839-A allele were lower in CD patients compared with controls (P < 0.05). While the rs4263839-A allele was more prevalent in ileocolonic CD patients than in those with isolated small intestinal or colonic disease (P = 0.035). Gene–environment interactions revealed associations between rs2284553 and breastfeeding, sunshine exposure, and fridge-stored food, affecting age at diagnosis, intestinal involvement, and intestinal stricture. Interaction of rs4263839 and breastfeeding influenced small intestinal lesions and intestinal stricture in CD.

Conclusions

This study provided information on the genetic background in Chinese CD patients. Incorporating these SNPs into predictive models may improve risk assessment and outcome prediction. Gene–environment interaction contributes to the understanding of CD pathogenesis.

研究目的有关中国克罗恩病（CD）患者基因与环境相互作用的研究很少。我们的目的是研究中国人T辅助细胞17（Th17）的单核苷酸多态性（SNPs）与克罗恩病易感性/表现之间的关系：方法：我们在北京协和医院进行了一项病例对照和纯病例研究。方法：我们在中国协和医科大学附属北京协和医院进行了一项病例对照和病例纯合研究，优先选择了 4 个与 Th17 细胞通路基因相关的 SNP，包括 rs2284553（γ 干扰素受体 2）、rs7517847（白细胞介素 23 受体）、rs7773324（干扰素调节因子 4）和 rs4263839（肿瘤坏死因子超家族 15）。计算了SNP频率，并通过多因素降维分析评估了基因与环境的相互作用：结果：共纳入了 159 名 CD 患者和 316 名健康对照者。所有分析的SNP均处于哈代-温伯格平衡状态（P>0.05）。与对照组相比，rs2284553-A等位基因和rs4263839-A等位基因在CD患者中的频率较低（P 结论：该研究为CD患者的遗传背景提供了信息：本研究提供了中国 CD 患者的遗传背景信息。将这些 SNPs 纳入预测模型可改善风险评估和预后预测。基因与环境的相互作用有助于了解 CD 的发病机制。

{"title":"Interaction of Th17 differentiations-related gene polymorphisms and environmental factors contributing to the disease classification, complications, and surgical risks of Crohn's disease in the Chinese Han population","authors":"Ru Ning Zhou, Ge Chong Ruan, Mei Xu Wu, Ming Yue Guo, Hao Zheng Liang, Xiao Yin Bai, Hong Yang","doi":"10.1111/1751-2980.13301","DOIUrl":"10.1111/1751-2980.13301","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Few studies have been conducted on gene–environment interactions in the Chinese population with Crohn's disease (CD). We aimed to investigate the association between single nucleotide polymorphisms (SNPs) on the T helper 17 (Th17) cell and CD susceptibility/performance in Chinese individuals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a case–control and case-only study at the Peking Union Medical College Hospital. Four SNPs related to the Th17 cell pathway genes were prioritized, including rs2284553 (interferon gamma receptor 2), rs7517847 (interleukin 23 receptor), rs7773324 (interferon regulatory factor 4), and rs4263839 (tumor necrosis factor superfamily 15). SNP frequency was calculated, and gene–environment interaction was assessed by multifactor dimensionality reduction analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Altogether 159 CD patients and 316 healthy controls were included. All analyzed SNPs were found in Hardy–Weinberg equilibrium (<i>P</i> > 0.05). The frequency of rs2284553-A allele and rs4263839-A allele were lower in CD patients compared with controls (<i>P</i> < 0.05). While the rs4263839-A allele was more prevalent in ileocolonic CD patients than in those with isolated small intestinal or colonic disease (<i>P</i> = 0.035). Gene–environment interactions revealed associations between rs2284553 and breastfeeding, sunshine exposure, and fridge-stored food, affecting age at diagnosis, intestinal involvement, and intestinal stricture. Interaction of rs4263839 and breastfeeding influenced small intestinal lesions and intestinal stricture in CD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study provided information on the genetic background in Chinese CD patients. Incorporating these SNPs into predictive models may improve risk assessment and outcome prediction. Gene–environment interaction contributes to the understanding of CD pathogenesis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"25 6","pages":"368-379"},"PeriodicalIF":2.3,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141792623","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}

引用次数: 0