Journal of Gastroenterology and Hepatology最新文献_第9页

Fourteen-and Ten-Day Tegoprazan–Amoxicillin Dual Therapy vs. Bismuth Quadruple Therapy for Helicobacter pylori Eradication—A Noninferiority, Multicenter, Randomized Controlled Trial 14天和10天替戈拉桑-阿莫西林双重治疗vs铋四联治疗根除幽门螺杆菌——一项非劣效性、多中心、随机对照试验

IF 3.4 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Journal of Gastroenterology and Hepatology

Pub Date : 2025-12-10 DOI: 10.1111/jgh.70180

Yan Fan, Chuanfei Li, Wenguang Zhang, Jinlian Shi, Renzheng Liang, Meng Deng, Shengtao Liao, Xiao Xiao, Ke Zhan, Liewang Qiu, Zhechuan Mei, Lin Lv

Background and Aim

Tegoprazan has shown great potential in the eradication of Helicobacter pylori infection. This study aims to evaluate the efficacy and safety of Tegoprazan-based dual therapy for H. pylori eradication.

Methods

This was a noninferiority, multicenter, randomized controlled trial in China. Subjects were randomly assigned to three groups: the 14-THA group, the 10-THA group (Tegoprazan 50 mg twice/day, Amoxicillin 1 g 3 times/day, for 14 and 10 days), and the B-quadruple group (esomeprazole 20 mg, bismuth 220 mg, Amoxicillin 1 g, twice/day, tetracycline 0.5 g 3 times/day, for 14 days). The three groups' eradication rates, adverse events, and compliance were compared.

Results

A total of 228 individuals were included in the randomization. According to the per-protocol analysis (PP), modified intention-to-treat (MITT) analysis, and intention-to-treat (ITT) analysis, there was no statistically significant difference between the 14-THA group and B-quadruple group (PP: 90.3% vs. 91.8%, MITT: 84.8% vs. 90.5%, ITT: 73.7% vs. 75.0%, p > 0.05). However, the 10-THA group has a lower eradication rate than the B-quadruple group (PP: 67.2% vs. 91.8%, MITT: 64.1% vs. 90.5%, ITT: 53.9% vs. 75.0%, p < 0.05). Additionally, the efficacy of the 14-THA group was not inferior to that of the B-quadruple group in PP (p = 0.0488). Adverse events and compliance rates did not differ among the three groups (p > 0.05).

Conclusion

The eradication rate of the 14-THA group is > 90%, which is not inferior to the current bismuth-containing quadruple regimen, with a favorable safety profile. However, the efficacy of the 10-THA dual therapy is unacceptable.

背景与目的：替戈拉赞在根除幽门螺杆菌感染方面显示出巨大的潜力。本研究旨在评价替戈拉赞双重治疗根除幽门螺杆菌的有效性和安全性。方法：这是一项在中国进行的非劣效性、多中心、随机对照试验。受试者随机分为3组：14- tha组、10- tha组（替戈拉散50 mg 2次/天，阿莫西林1 g 3次/天，连用14天和10天）和b -四联组（艾索美拉唑20 mg，铋220 mg，阿莫西林1 g 2次/天，四环素0.5 g 3次/天，连用14天）。比较三组的根除率、不良事件和依从性。结果：共有228人被纳入随机分组。根据方案分析（per-protocol analysis， PP）、改良意向治疗分析（modified intention-to- treatment analysis， MITT）和意向治疗分析（intention-to- treatment analysis， ITT）， 14-THA组和b -四组间的差异无统计学意义（PP: 90.3% vs. 91.8%, MITT: 84.8% vs. 90.5%, ITT: 73.7% vs. 75.0%, p > 0.05）。但10-THA组的根除率低于b -四倍组（PP: 67.2% vs. 91.8%, MITT: 64.1% vs. 90.5%, ITT: 53.9% vs. 75.0%, p < 0.05）。此外，14-THA组在PP方面的疗效不低于b -四联体组（p = 0.0488）。三组患者不良事件发生率及依从率无显著差异（p < 0.05）。结论：14-THA组的根除率为90%，不低于目前的含铋四联方案，具有良好的安全性。然而，10-THA双重治疗的疗效是不可接受的。

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引用次数: 0

Effects of Piperine on Obese and Lean Nonalcoholic Fatty Liver Disease in Mice 胡椒碱对小鼠肥胖和瘦型非酒精性脂肪肝的影响。

IF 3.4 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Journal of Gastroenterology and Hepatology

Pub Date : 2025-12-09 DOI: 10.1111/jgh.70201

Jing-Bo Fan, Li-Qiang Qin, Li Ding, Lin Zhang, Miao-Miao Shao, Xing Tong, Jia-Ying Xu

Nonalcoholic fatty liver disease (NAFLD) is commonly associated with overweight and obesity. But an increasing number of cases involve lean individuals, who tend to experience worse liver outcomes. In this study, we established mouse models of both obese and lean NAFLD by feeding mice a Western diet (WD) ad libitum and a WD with 30% caloric restriction (CR), respectively, to investigate the effects of piperine. After 12 weeks, hepatocyte lipid deposition and liver injury were similar in lean and obese NAFLD mice. Piperine treatment significantly reduced serum ALT levels and hepatic triglyceride (TG) content, alleviating hepatic steatosis in both groups. The mechanism of action involved the downregulation of fatty acid uptake, as evidenced by reduced expression of PPARγ and CD36, as well as the promotion of lipolysis through upregulation of hormone-sensitive lipase (HSL) and adipose triglyceride lipase (ATGL). Additionally, piperine enhanced hepatic mitochondrial β-oxidation in the obese NAFLD model by upregulating carnitine palmitoyltransferase 1A (CPT1A). In conclusion, feeding a WD with 30% CR successfully induced lean NAFLD in mice, and piperine effectively alleviated NAFLD in both lean and obese mice.

非酒精性脂肪性肝病（NAFLD）通常与超重和肥胖有关。但越来越多的病例涉及瘦人，他们往往会经历更糟糕的肝脏后果。在本研究中，我们建立了肥胖和瘦弱NAFLD小鼠模型，分别饲喂西方饮食（WD）和30%热量限制（CR）的WD，以研究胡椒碱的作用。12周后，瘦型和肥胖型NAFLD小鼠的肝细胞脂质沉积和肝损伤相似。胡椒碱治疗显著降低两组血清ALT水平和肝脏甘油三酯（TG）含量，减轻肝脂肪变性。其作用机制包括下调脂肪酸摄取，如PPARγ和CD36的表达降低，以及通过上调激素敏感脂肪酶（HSL）和脂肪甘油三酯脂肪酶（ATGL）来促进脂肪分解。此外，在肥胖NAFLD模型中，胡椒碱通过上调肉碱棕榈酰转移酶1A （CPT1A）增强肝脏线粒体β-氧化。综上所述，饲喂含30% CR的WD成功诱导小鼠瘦型NAFLD，胡椒碱能有效缓解瘦型和肥胖小鼠的NAFLD。

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引用次数: 0

Integrated Multiomics Analysis and Experimental Validation Identify ITPRIPL1 as an Immunoregulatory and Prognostic Biomarker in Gastric Adenocarcinoma 综合多组学分析和实验验证：ITPRIPL1是胃腺癌的免疫调节和预后生物标志物。

IF 3.4 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Journal of Gastroenterology and Hepatology

Pub Date : 2025-12-09 DOI: 10.1111/jgh.70183

Zixuan Jia, Kangqiao Xiong, You Zhou, Rong Chen, Daofeng Wang, Shaohang Cai, Wei Liao

Background

Inositol 1,4,5-trisphosphate receptor-interacting protein-like 1 (ITPRIPL1) has been identified as an inhibitory ligand of CD3ε, but its role in stomach adenocarcinoma (STAD) remains unclear.

Aims

This study aims to elucidate the oncogenic and immunoregulatory roles of ITPRIPL1 in STAD.

Materials and Methods

Integrative bioinformatic analyses, including transcriptomic and spatial transcriptomic data, were performed to assess ITPRIPL1 expression, prognostic relevance, and immune interactions. Experimental approaches, including proliferation, migration, and invasion assays, were used to validate the functional effects.

Results

We found that ITPRIPL1 was significantly upregulated in STAD and associated with an unfavorable prognosis. Although enriched in T cell activation pathways, ITPRIPL1-expressing tumor cells predominantly interacted with regulatory T cells (Tregs) and exhausted T cells (Tex), while showing limited communication with cytotoxic or naïve T cells. Spatial analyses revealed positive correlations between ITPRIPL1 expression and both tumor malignancy and T cell exhaustion signatures, but a negative correlation with CD274 expression. Functional assays confirmed the role of ITPRIPL1 in promoting tumor cell proliferation, migration, and invasion.

Discussion

Collectively, ITPRIPL1 promotes STAD progression by increasing tumor aggressiveness and fostering interactions with immunosuppressive T cell subsets.

Conclusion

These findings suggest that ITPRIPL1 is a potential prognostic marker and immunosuppressive target in STAD.

背景：肌醇1,4,5-三磷酸受体相互作用蛋白样1 （ITPRIPL1）已被确定为CD3ε的抑制配体，但其在胃腺癌（STAD）中的作用尚不清楚。目的：本研究旨在阐明ITPRIPL1在STAD中的致癌和免疫调节作用。材料和方法：采用综合生物信息学分析，包括转录组学和空间转录组学数据，评估ITPRIPL1表达、预后相关性和免疫相互作用。实验方法，包括增殖、迁移和侵袭试验，用于验证功能效应。结果：我们发现ITPRIPL1在STAD中显著上调，并与不良预后相关。虽然在T细胞活化途径中富集，但表达itpripl1的肿瘤细胞主要与调节性T细胞（Tregs）和耗竭T细胞（Tex）相互作用，而与细胞毒性或naïve T细胞的交流有限。空间分析显示ITPRIPL1表达与肿瘤恶性和T细胞衰竭特征呈正相关，但与CD274表达负相关。功能分析证实了ITPRIPL1在促进肿瘤细胞增殖、迁移和侵袭中的作用。讨论：总的来说，ITPRIPL1通过增加肿瘤侵袭性和促进与免疫抑制性T细胞亚群的相互作用来促进STAD的进展。结论：ITPRIPL1是STAD患者潜在的预后标志物和免疫抑制靶点。

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引用次数: 0

Chronic Hepatitis B Infection: Patient Guidance 慢性乙型肝炎感染：患者指导。

IF 3.4 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Journal of Gastroenterology and Hepatology

Pub Date : 2025-12-08 DOI: 10.1111/jgh.70177

Lung-Yi Mak, Jimmy Che-To Lai, Ken Liu, Rashid Lui, Sakkarin Chirapongsathorn, Kuo Chao Yew, Mara Teresa Panlilio, Cosmas Rinaldi Adithya Lesmana, Ruveena Bhavani Rajaram, Liang Shen, Desmond Cheung, Lung-Fai Wong, Hye Won Lee, Madhumita Premkumar, Anand V. Kulkarni, Nobuharu Tamaki, Yao Chun Hsu, Daniel Q. Huang

This patient guidance document is intended for all people at risk of or living with chronic hepatitis B (CHB) infection. Globally, CHB is one of the leading causes of cirrhosis and hepatocellular carcinoma, the most common form of liver cancer. However, less than one in five infected individuals is aware of their condition and only a small fraction of these individuals receive proper assessment and management. Safe and effective treatment is available in many countries and regions and is recommended for infected individuals who have evidence of liver damage or are at risk of complications. Several essential measures are advised for all people living with CHB, including lifestyle habits, screening for coinfection, managing comorbidities, fibrosis assessment, preventing HBV transmission, and surveillance for liver cancer. There are also recent shifts in the treatment paradigm and novel drug development. In those living with CHB, a better understanding of the disease can empower them to play an active role in management in partnership with their physicians. This guidance document has been developed in collaboration with clinicians, scientists, patients, and patient representatives to summarize updated salient knowledge to inform people at risk of or living with CHB.

本患者指导文件适用于所有有慢性乙型肝炎（CHB）感染风险或患有慢性乙型肝炎（CHB）感染的人。在全球范围内，慢性乙型肝炎是导致肝硬化和肝细胞癌（最常见的肝癌形式）的主要原因之一。然而，不到五分之一的感染者了解自己的病情，其中只有一小部分人得到了适当的评估和治疗。许多国家和地区都提供安全有效的治疗，并建议对有肝损害证据或有并发症风险的感染者进行治疗。建议对所有慢性乙型肝炎患者采取几项基本措施，包括生活习惯、筛查合并感染、管理合并症、纤维化评估、预防HBV传播和肝癌监测。最近治疗模式和新药开发也发生了变化。对于慢性乙型肝炎患者，更好地了解这种疾病可以使他们与医生合作，在管理中发挥积极作用。本指导文件是与临床医生、科学家、患者和患者代表合作编写的，旨在总结最新的重要知识，告知有慢性乙型肝炎风险或患有慢性乙型肝炎的人。

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引用次数: 0

Endoscopic Ultrasound-Guided Coiling Plus Glue Injection Compared With Other Endoscopic Modalities in Managing Gastric Varices: A Systematic Review and Meta-Analysis 超声内镜引导下盘绕加胶注射与其他内镜治疗胃静脉曲张的比较：一项系统综述和荟萃分析。

IF 3.4 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Journal of Gastroenterology and Hepatology

Pub Date : 2025-12-08 DOI: 10.1111/jgh.70190

Zinat Mohammadpour, Maria Castrejon Moreno, Bobak Moazzami, Sanjivan Mudaliar, Roberto Trasolini, Arka De, Sahaj Rathi, Rajit Aziz Gilhotra

Background and Aims

Gastric varices (GV) are a major complication of portal hypertension, with a high risk of severe bleeding. Conventional endoscopic glue injection or endoscopic ultrasound (EUS) directed therapies have been used for treatment. However, each has its limitations. EUS-guided combination of coil and glue injection has emerged as a potential strategy to improve outcomes. This meta-analysis compares the efficacy and safety of EUS-coil and glue to other endoscopic modalities in GV management.

Methods

Five databases were systematically searched until October 2024. Data were pooled using risk ratios (RRs) with 95% confidence intervals (CIs) via a random-effect model. Heterogeneity was assessed using the I² statistic, and subgroup and sensitivity analyses were performed. The risk of bias in studies and the certainty of the evidence were evaluated.

Results

Nine studies with 579 patients met the inclusion criteria. Compared with other modalities, EUS-coil and glue had a lower risk of reintervention (RR = 0.32, 95% CIs = 0.21–0.50) and a higher rate of GV obliteration (RR = 1.18, 95% CIs = 1.03–1.37). There was no significant difference in mortality risk (RR = 0.87, 95% CIs = 0.54–1.40). The overall risk of adverse events (RR = 0.55, 95% CIs = 0.34–0.90) was lower, particularly rebleeding (RR = 0.36, 95% CIs = 0.22–0.59). The certainty of evidence ranged from very low to moderate due to bias and study heterogeneity.

Conclusions

EUS-coil and glue injection offers superior efficacy and a favorable safety profile compared with other endoscopic treatments for GV. However, the quality of the evidence warrants further well-designed studies to assess long-term outcomes.

背景和目的：胃静脉曲张（GV）是门脉高压的主要并发症，具有严重出血的高风险。传统的内镜注射胶或内镜超声（EUS）指导治疗已被用于治疗。然而，每种方法都有其局限性。eus引导下线圈和胶水注射的结合已成为改善预后的潜在策略。本荟萃分析比较了EUS-coil和glue与其他内镜治疗GV的疗效和安全性。方法：系统检索5个数据库至2024年10月。通过随机效应模型，采用95%置信区间的风险比（rr）合并数据。采用I2统计量评估异质性，并进行亚组分析和敏感性分析。评估了研究的偏倚风险和证据的确定性。结果：9项研究579例患者符合纳入标准。与其他方式相比，EUS-coil和glue的再干预风险较低（RR = 0.32, 95% ci = 0.21-0.50）， GV闭塞率较高（RR = 1.18, 95% ci = 1.03-1.37）。两组死亡风险无显著差异（RR = 0.87, 95% ci = 0.54 ~ 1.40）。不良事件的总风险（RR = 0.55, 95% ci = 0.34-0.90）较低，尤其是再出血（RR = 0.36, 95% ci = 0.22-0.59）。由于偏倚和研究异质性，证据的确定性从非常低到中等。结论：与其他内镜治疗方法相比，EUS-coil联合胶水注射治疗GV具有更好的疗效和良好的安全性。然而，证据的质量保证了进一步精心设计的研究来评估长期结果。

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引用次数: 0

Psychosine Alleviates Colitis via Inhibiting Th1 and Th17 Cell Immune Responses in Inflammatory Bowel Diseases 通过抑制炎症性肠病患者的Th1和Th17细胞免疫应答来缓解结肠炎。

IF 3.4 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Journal of Gastroenterology and Hepatology

Pub Date : 2025-12-08 DOI: 10.1111/jgh.70199

Ritian Lin, Jiayi Tu, Shan Li, Qinjuan Sun, Lan Zhong

Background

Aberrant T-helper 1 (Th1) and Th17 cell activation is involved in the pathogenesis of inflammatory bowel disease (IBD). Psychosine is known to induce apoptosis, promote astrocyte activation, and inhibit osteoclastogenesis. However, the role of psychosine on Th1 and Th17 cell immune responses has not been previously reported. In this study, we investigate the role of psychosine in the modulation of CD4⁺ T cells.

Methods

Peripheral blood CD4⁺ (PB-CD4⁺) T cells were isolated from both IBD patients and healthy controls and cultured with psychosine, and the expression of IFN-γ and IL-17A was analyzed using a flow cytometer and enzyme-linked immunosorbent assay. The DSS-induced colitis model was established in mice; the expression of inflammatory cytokines was determined by flow cytometer and quantitative real-time polymerase chain reaction.

Results

We found that psychosine suppresses the expression of IFN-γ and IL-17A and Th1 and Th17 cell differentiation in PB-CD4⁺ T cells. Meanwhile, psychosine was observed to inhibit the proliferation of PB-CD4⁺ T cells and intestinal mucosal inflammation. In vivo, psychosine alleviated DSS-induced colitis in mice by inhibiting Th1 and Th17 cell immune responses.

Conclusion

Our data reveal that psychosine reduces mucosal inflammation by preventing excessive Th1 and Th17 cell-mediated immune responses. Supplementation of psychosine may serve as a novel therapeutic approach for the treatment of IBD.

背景：异常t -辅助性1 （Th1）和Th17细胞活化参与炎症性肠病（IBD）的发病机制。众所周知，精神碱可以诱导细胞凋亡，促进星形胶质细胞活化，抑制破骨细胞的发生。然而，精神素在Th1和Th17细胞免疫应答中的作用尚未见报道。在这项研究中，我们研究了精神素在CD4+ T细胞调节中的作用。方法：分别从IBD患者和健康对照者外周血中分离CD4+ (PB-CD4+) T细胞，用精神素培养，采用流式细胞仪和酶联免疫吸附法分析IFN-γ和IL-17A的表达。建立dss诱导小鼠结肠炎模型；采用流式细胞仪和实时定量聚合酶链反应检测炎症因子的表达。结果：我们发现精神素能抑制PB-CD4+ T细胞中IFN-γ和IL-17A的表达以及Th1和Th17的细胞分化。同时观察到精神素对PB-CD4+ T细胞增殖和肠黏膜炎症的抑制作用。在体内，精神素通过抑制Th1和Th17细胞免疫应答来减轻dss诱导的小鼠结肠炎。结论：我们的数据显示，精神素通过防止过量的Th1和Th17细胞介导的免疫反应来减轻粘膜炎症。补充精神素可能成为治疗IBD的一种新的治疗方法。

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引用次数: 0

Bile Acid Metabolites Control Th17/Treg Balance in Primary Biliary Cholangitis: Mechanisms of Disease Progression and Therapeutic Targets 原发性胆道胆管炎中胆汁酸代谢物控制Th17/Treg平衡：疾病进展机制和治疗靶点

IF 3.4 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Journal of Gastroenterology and Hepatology

Pub Date : 2025-12-07 DOI: 10.1111/jgh.70189

Zhiqian Liu, Haitao Jiang, Fuqing Li, Rui Xie, Hong Wang

Primary biliary cholangitis (PBC) is a prototypical autoimmune hepatobiliary disease that is pathologically characterized by persistent cholestasis and selective obliteration of the interlobular bile ducts. T helper cell 17 (Th17) and regulatory T cells (Treg) are critically implicated in the immunopathogenesis of PBC. Accumulated bile acid metabolites, such as isoalloLCA, in patients with PBC modulate the differentiation and functional dynamics of Tregs and Th17 cells. Notably, disruption of the Th17/Treg balance in PBC exacerbates biliary inflammation, accelerates the deterioration of hepatic fibrosis, and increases the likelihood of evolving hepatocellular carcinoma (HCC). Recent advances in targeting the bile acid metabolites to control the Th17/Treg balance have unveiled novel therapeutic avenues. Pharmacological agents have demonstrated efficacy in maintaining the Th17/Treg rebalance, showing significant therapeutic promise for PBC. This review provides new insights into the treatment of PBC by systematically summarizing the central role of bile acid metabolites in the differentiation of Th17 and Treg cells and investigating the feasibility of related targeted therapies.

原发性胆道胆管炎（PBC）是一种典型的自身免疫性肝胆疾病，其病理特征是持续性胆汁淤积和选择性小叶间胆管阻塞。辅助性T细胞17 （Th17）和调节性T细胞（Treg）在PBC的免疫发病机制中起关键作用。PBC患者积累的胆汁酸代谢物，如异allolca，调节Tregs和Th17细胞的分化和功能动态。值得注意的是，PBC中Th17/Treg平衡的破坏加剧了胆道炎症，加速了肝纤维化的恶化，并增加了发展为肝细胞癌（HCC）的可能性。针对胆汁酸代谢物控制Th17/Treg平衡的最新进展揭示了新的治疗途径。药物已被证明在维持Th17/Treg平衡方面有效，显示出对PBC的显著治疗前景。本文系统总结了胆汁酸代谢物在Th17和Treg细胞分化中的核心作用，并探讨了相关靶向治疗的可行性，为PBC的治疗提供了新的思路。

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引用次数: 0

Objective Assessment of Visibility of Colorectal Lesions Using Eye Tracking for New Image-Enhanced Endoscopy Observation 目的评价眼动追踪在新型图像增强内镜观察中对结直肠病变可见性的影响。

IF 3.4 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Journal of Gastroenterology and Hepatology

Pub Date : 2025-12-05 DOI: 10.1111/jgh.70191

Aiji Hattori, Hiroaki Ikematsu, Hiroki Yamashita, Takuma Oguro, Mitsuhiro Goto, Takeaki Yamazaki, Maasa Sasabe, Nobuhisa Minakata, Takashi Watanabe, Tomohiro Mitsui, Atsushi Inaba, Hironori Sunakawa, Keiichiro Nakajo, Tatsuro Murano, Tomohiro Kadota, Kensuke Shinmura, Hayato Nakagawa, Tomonori Yano

Background and Aim

This study aimed to objectively evaluate colorectal lesion visibility using white-light imaging (WLI), narrow-band imaging (NBI), and texture and color enhancement imaging (TXI) with an eye tracking system.

Methods

Twelve endoscopists assessed 120 images of 30 colorectal lesions (29 adenomas, one sessile serrated lesion) captured using WLI, NBI, TXI mode-1, and TXI mode-2. Eye movements were recorded to analyze the lesion detection ability and time taken. The miss rate (calculated as the ratio of missed lesions from 360 images) and detection time (defined as the time from displaying the image to the start of gaze on lesions) were compared among the four modalities.

Results

The miss rates of WLI, NBI, TXI mode-1, and TXI mode-2 were 16.4%, 6.4%, 11.7%, and 16.7%, respectively. The miss rate of NBI was significantly lower than those of WLI and TXI mode-2 (p < 0.001). The detection times (median [interquartile range]) of WLI, NBI, TXI mode-1, and TXI mode-2 were 0.71 (0.43–1.37) s, 0.54 (0.34–0.89) s, 0.63 (0.44–1.13) s, and 0.64 (0.37–1.28) s, respectively. NBI had the shortest detection time among the four modalities (p < 0.001 compared with WLI and TXI mode-2; p = 0.005 compared with TXI mode-1).

Conclusions

Objective assessment using the eye tracking system revealed that NBI provided the best colorectal lesion visibility, with the lowest miss rate and shortest detection time.

背景与目的：本研究旨在利用眼动追踪系统的白光成像（WLI）、窄带成像（NBI）和纹理和色彩增强成像（TXI）客观评价结直肠病变的可见性。方法：12名内镜医师评估了使用WLI、NBI、TXI -1和TXI -2捕获的30个结直肠病变（29个腺瘤，1个无底锯齿状病变）的120张图像。记录眼球运动，分析病变检测能力和所需时间。比较四种模式的缺失率（以360张图像中缺失病灶的比例计算）和检测时间（定义为从显示图像到开始注视病灶的时间）。结果：WLI、NBI、TXI模式1、TXI模式2的漏检率分别为16.4%、6.4%、11.7%、16.7%。结论：采用眼动追踪系统进行客观评价，NBI的结直肠病变可见性最佳，漏检率最低，检测时间最短。

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引用次数: 0

Rome III Versus Rome IV Criteria for Diagnosing Irritable Bowel Syndrome in a Southeast Asian Population: Insights From the Rome Foundation Global Epidemiology Study Household Survey 在东南亚人群中诊断肠易激综合征的罗马III与罗马IV标准：来自罗马基金会全球流行病学研究家庭调查的见解

IF 3.4 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Journal of Gastroenterology and Hepatology

Pub Date : 2025-12-04 DOI: 10.1111/jgh.70174

Daniel Martin Simadibrata, Thai Hau Koo, Amanda Pitarini Utari, Mina Ayad, Kueh Yee Cheng, Ami D. Sperber, Bangdiwala Shrikant I, Olafur S. Palsson, Ari Fahrial Syam, Yeong Yeh Lee

Introduction

Previous Asian studies have reported a substantial decline in irritable bowel syndrome (IBS) prevalence following the adoption of the Rome IV diagnostic criteria. However, comparative data on IBS prevalence using Rome III and Rome IV criteria remain sparse, especially in Southeast Asia.

Methods

We analyzed household survey data from the Rome Foundation Global Epidemiology Study conducted in Malaysia and Indonesia, the only Southeast Asian countries included in the study, utilizing household-based sampling. We compared diagnostic sensitivity between Rome III and Rome IV criteria for IBS and examined demographic characteristics, symptom severity, psychological distress, quality of life (QoL), healthcare utilization, and dietary habits among identified IBS participants.

Result

Of 3411 participants (Malaysia: 2072; Indonesia: 1339), 177 (5.2%) fulfilled IBS criteria according to either Rome III or IV criteria. Among these, 115 (65%) met only the Rome III criteria, 50 (28%) met both the Rome III and IV criteria, and 12 (7%) exclusively met the Rome IV criteria. Compared with those diagnosed by Rome III, individuals identified by Rome IV criteria were younger and predominantly female. Only 31% of the Rome III IBS cases remained classified as IBS under the Rome IV criteria, while others were reclassified as unspecified bowel disorder (24%) or functional constipation (17%). While healthcare utilization rates were similar across groups, Rome IV IBS participants exhibited significantly higher symptom severity, lower anxiety levels, and poorer mental health-related QoL. Dietary assessments revealed significantly lower intake of milk, meat products, fish, eggs, vegetables and legumes, fruit, bread, and pasta among Rome IV IBS participants.

Conclusion

The Rome IV criteria for IBS demonstrate reduced diagnostic sensitivity compared with the Rome III criteria in the Southeast Asian populations. Individuals meeting the Rome IV criteria displayed distinct demographic and clinical characteristics, including greater symptom severity and reduced mental health-related QoL.

导言：先前的亚洲研究报道，采用罗马IV诊断标准后，肠易激综合征（IBS）患病率大幅下降。然而，使用罗马III和罗马IV标准的IBS患病率的比较数据仍然很少，特别是在东南亚。方法：我们分析了罗马基金会全球流行病学研究在马来西亚和印度尼西亚进行的家庭调查数据，这是该研究中唯一的东南亚国家，采用基于家庭的抽样。我们比较了罗马III和罗马IV标准对IBS的诊断敏感性，并检查了确定的IBS参与者的人口统计学特征、症状严重程度、心理困扰、生活质量（QoL）、医疗保健利用和饮食习惯。结果：在3411名参与者中（马来西亚：2072名；印度尼西亚：1339名），177名（5.2%）符合罗马III或IV标准的IBS标准。其中，115家（65%）仅符合罗马III标准，50家（28%）同时符合罗马III和罗马IV标准，12家（7%）完全符合罗马IV标准。与罗马III诊断的患者相比，罗马IV诊断的患者更年轻，且以女性为主。根据Rome IV标准，只有31%的Rome III型IBS病例被归类为IBS，而其他病例被重新归类为未明确的肠道疾病（24%）或功能性便秘（17%）。虽然各组之间的医疗保健使用率相似，但Rome IV IBS参与者表现出明显更高的症状严重程度，更低的焦虑水平和更差的精神健康相关生活质量。饮食评估显示，在罗马IV型IBS参与者中，牛奶、肉制品、鱼、蛋、蔬菜和豆类、水果、面包和面食的摄入量显著降低。结论：在东南亚人群中，IBS的Rome IV标准的诊断敏感性低于Rome III标准。符合Rome IV标准的个体表现出明显的人口学和临床特征，包括更严重的症状和更低的精神健康相关生活质量。

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引用次数: 0

The Saline-Immersion/Irrigation TEchnique for Endoscopic Submucosal Dissection of Colorectal Lesions: Outcomes From a Large Western Cohort 盐水浸泡/冲洗技术用于内镜下结肠直肠病变粘膜下剥离：来自西方大型队列的结果。

IF 3.4 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Journal of Gastroenterology and Hepatology

Pub Date : 2025-12-03 DOI: 10.1111/jgh.70163

Elisabet Maristany Bosch, Georgios Kalopitas, Alessandro Rimondi, Hironori Yamamoto, Alberto Murino, Edward J. Despott

Background and Study Aims

Endoscopic submucosal dissection (ESD) is increasingly used for the resection of complex lesions of the gastrointestinal tract. However, its adoption in the management of colonic lesions in Western practice remains challenging, mainly due to the anatomical complexities of the colon. The saline-immersion/irrigation technique (SITE), combined with the pocket-creation method (PCM) may help to overcome these challenges. This study evaluates outcomes of SITE-PCM ESD in a Western tertiary center.

Methods

We analyzed consecutive colorectal ESD procedures performed at our center between 2017 and 2024. SITE-PCM was used in all cases. Lesion characteristics, procedural outcomes, histopathological findings, adverse events, and follow-up data were analyzed.

Results

A total of 181 lesions in 177 patients were resected en bloc using SITE-PCM ESD. Sixty lesions (33.1%) were located in the proximal colon, while 79 (43.6%) were rectal lesions. R0 and curative resection rates were 92.3% and 90.6%, respectively. The median procedure time was 120 min. Adverse events occurred in 4.4% of cases, with only three patients necessitating hospitalization and nonsurgical intervention due to delayed bleeding, and one patient requiring surgical management after a delayed perforation. Notably, 93.4% of the procedures were performed under conscious sedation.

Conclusions

In our experience SITE-PCM-ESD appears to be a safe and effective minimally invasive approach for complex colorectal lesions. It achieves high R0 and curative resection rates with low adverse events and is feasible under conscious sedation. These findings support broader adoption of SITE-PCM in Western practice and justify prospective multicenter validation.

背景与研究目的：内镜下粘膜剥离术（ESD）越来越多地用于胃肠道复杂病变的切除。然而，在西方实践中，结肠病变的治疗仍然具有挑战性，主要是由于结肠解剖的复杂性。盐水浸泡/灌溉技术（SITE）与口袋创造方法（PCM）相结合，可能有助于克服这些挑战。本研究评估了西部三级中心SITE-PCM ESD的结果。方法：我们分析了2017年至2024年在我中心连续进行的结直肠ESD手术。所有病例均采用SITE-PCM。分析病变特征、手术结果、组织病理学结果、不良事件和随访数据。结果：177例患者共181个病灶采用SITE-PCM ESD整体切除。60例（33.1%）位于结肠近端，79例（43.6%）位于直肠。R0和治愈率分别为92.3%和90.6%。中位手术时间为120分钟。4.4%的病例发生了不良事件，只有3例患者因延迟出血需要住院和非手术干预，1例患者因延迟穿孔需要手术治疗。值得注意的是，93.4%的手术是在清醒镇静下进行的。结论：根据我们的经验，SITE-PCM-ESD是一种安全有效的微创治疗复杂结直肠病变的方法。该方法具有较高的R0和治愈率，不良事件发生率低，在清醒镇静下可行。这些发现支持SITE-PCM在西方实践中的广泛采用，并证明了前瞻性的多中心验证。

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引用次数: 0