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Linked Color Imaging of Barrett’s Esophageal Adenocarcinoma: Effects on Visibility 巴雷特食管腺癌的关联彩色成像:对可见度的影响
Pub Date : 2024-02-05 DOI: 10.3390/gastroent15010010
M. Saito, T. Koike, Yuki Ohara, Yohei Ogata, Takeshi Kanno, Xiaoyi Jin, W. Hatta, K. Uno, N. Asano, A. Imatani, Atsushi Masamune
Since linked color imaging (LCI) has been reported to increase the color differences in Barrett’s esophageal adenocarcinoma (BA) compared to white light imaging (WLI), a comparison of the visibility scores of various imaging techniques for BA is warranted to determine best practice standards. This study is to clarify the role of LCI, blue light imaging (BLI), and WLI in the evaluation of BA. A group of 19 endoscopists, comprised of 6 experts and 13 trainees, evaluated the visibility of WLI, BLI, and LCI images in 21 superficial BA cases. Visibility scores were compared between WLI, BLI, and LCI. Visibility scores were also evaluated for lesion morphology, background Barrett’s mucosa, and circumferential location. The visibility scores of experts and trainees were analyzed for comparison. The visibility scores of LCI and BLI were 3.83 and 3.31, respectively, compared to three points for WLI. The visibility of LCI was better than that of WLI regardless of lesion morphology, color, background Barrett’s mucosa, and circumferential location. The LCI improved visibility in BA more than the WLI for both experts and trainees. LCI improved the visibility of BA independent of lesion morphology, color, background Barrett’s mucosa, circumferential location, and the endoscopist’s experience.
据报道,与白光成像(WLI)相比,联动彩色成像(LCI)可增加巴雷特食管腺癌(BA)的颜色差异,因此有必要比较各种成像技术对巴雷特食管腺癌的可见度评分,以确定最佳实践标准。本研究旨在明确LCI、蓝光成像(BLI)和WLI在评估BA中的作用。由 6 名专家和 13 名实习生组成的 19 名内镜医师小组评估了 21 个浅表 BA 病例中 WLI、BLI 和 LCI 图像的可见度。对 WLI、BLI 和 LCI 的可见度评分进行了比较。还根据病变形态、背景巴雷特粘膜和周缘位置对可见度评分进行了评估。对专家和学员的可见度评分进行了分析比较。LCI 和 BLI 的可见度评分分别为 3.83 分和 3.31 分,而 WLI 为 3 分。无论病变形态、颜色、背景巴雷特粘膜和周缘位置如何,LCI 的可见度均优于 WLI。对专家和学员而言,LCI 比 WLI 更能提高 BA 的可见度。LCI提高了BA的可见度,与病变形态、颜色、背景Barrett粘膜、周缘位置和内镜医师的经验无关。
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引用次数: 0
Genetic Variation in Angiotensin II Type 1 Receptor Is Linked to Lipid Levels and Hepatic Steatosis in Alcohol-Associated Liver Disease, but Not to Cirrhosis or Hepatocellular Carcinoma 血管紧张素 II 1 型受体的基因变异与酒精相关性肝病的血脂水平和肝脏脂肪变性有关,但与肝硬化或肝细胞癌无关
Pub Date : 2024-01-03 DOI: 10.3390/gastroent15010002
H. Nischalke, F. Schmalz, J. Fischer, C. Möller, M. Matz-Soja, B. Krämer, B. Langhans, Jacob Nattermann, T. Berg, Christian P. Strassburg, P. Lutz
Background: Development of cirrhosis and hepatocellular carcinoma (HCC) in patients with high alcohol intake is modulated by genetic predispositions. Genetic variation in angiotensin II type 1 receptor (AGTR1) has been described as a risk factor for non-alcoholic fatty liver disease in Asian patients. Methods: We analysed Caucasian patients with alcohol–associated cirrhosis without (n = 238) and with (n = 339) HCC, healthy controls (n = 200), and HCV–infected cirrhotic patients with and without HCC (n = 263) for association with the polymorphisms rs3772622 and rs2276736 in AGTR1. Results: Rs2276736 in AGTR1 was associated with both low–density lipoprotein (LDL) cholesterol levels and hepatic steatosis in patients with alcohol–associated liver disease. The distribution of genotypes for both rs3772622 and rs2276736 in AGTR1 were comparable between controls, cirrhosis patients, and those with HCC. Minor allele frequencies were 32% (44%) in healthy controls, 35%/34% (46%/45%) in alcohol–associated liver disease without/with HCC and 31%/38% (43%/39%) in HCV cirrhosis and HCV HCC, respectively. The genotype of the most important genetic risk factor for fatty liver disease, PNPLA3 I148M, did not interact with the AGTR1 polymorphisms. Conclusion: Genetic variation in AGTR1, although associated with blood lipid levels and hepatic steatosis, is not a risk factor for alcohol–associated cirrhosis or HCC in Caucasians.
背景:酒精摄入量高的患者发生肝硬化和肝细胞癌(HCC)受遗传倾向的影响。血管紧张素 II 1 型受体(AGTR1)的基因变异已被描述为亚洲患者罹患非酒精性脂肪肝的风险因素。研究方法我们分析了不伴有(n = 238)和伴有(n = 339)HCC的酒精相关性肝硬化高加索患者、健康对照组(n = 200)以及伴有和不伴有HCC的HCV感染肝硬化患者(n = 263)与AGTR1中rs3772622和rs2276736多态性的关系。结果AGTR1中的rs2276736与酒精相关肝病患者的低密度脂蛋白(LDL)胆固醇水平和肝脏脂肪变性有关。在对照组、肝硬化患者和 HCC 患者中,AGTR1 中 rs3772622 和 rs2276736 的基因型分布相当。健康对照组的小等位基因频率为32%(44%),无/有HCC的酒精相关肝病患者的小等位基因频率为35%/34%(46%/45%),HCV肝硬化和HCV HCC患者的小等位基因频率分别为31%/38%(43%/39%)。脂肪肝最重要的遗传风险因素 PNPLA3 I148M 的基因型与 AGTR1 多态性没有相互作用。结论AGTR1 的基因变异虽然与血脂水平和肝脂肪变性有关,但并不是白种人酒精相关性肝硬化或 HCC 的风险因素。
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引用次数: 0
Enhancing the Quality of Upper Gastrointestinal Endoscopy: Current Indicators and Future Trends 提高上消化道内窥镜检查的质量:当前指标与未来趋势
Pub Date : 2023-12-24 DOI: 10.3390/gastroent15010001
Caesar Ferrari, Micheal Tadros
The quality of upper gastrointestinal endoscopy (EGD) is crucial and carries significant consequences for patient outcomes, the employment of healthcare resources, and the future course of gastroenterology as a medical specialty. In this review, we navigate through the terrain of the Quality Indicators (QIs) for EGD, shedding light on their indispensable function in ensuring and augmenting the quality of patient care throughout the pre-procedural, intra-procedural, post-procedural, and outcome-oriented facets of the practice. We delve into the comprehensive scope of the QIs and the challenges impeding the delivery of high-quality EGD, from variability in practitioner training and patient compliance to the systemic limitations of current QIs and the barriers hindering the adoption of advanced techniques. Future directions for bolstering the quality of EGD are highlighted, encapsulating the integration of emergent endoscopic technologies, the evolution of patient-centered metrics, the refinement of endoscopist training and credentialing processes, and the promise held by Artificial Intelligence (AI). Particular emphasis is placed on the role of advanced endoscopic techniques and equipment in enhancing EGD quality. This article presents a cogent narrative, promoting the pursuit of excellence in EGD as an ever-evolving endeavor that necessitates the collective dedication of clinicians, researchers, educators, and policymakers.
上消化道内窥镜检查(EGD)的质量至关重要,对患者的治疗效果、医疗资源的使用以及消化内科作为医学专科的未来发展都有重大影响。在这篇综述中,我们将介绍 EGD 质量指标(QIs),阐明这些指标在确保和提高整个术前、术中、术后和以结果为导向的患者护理质量方面所发挥的不可或缺的作用。我们深入探讨了质量指标的全面范围以及阻碍提供高质量胃肠造影术的挑战,包括从业人员培训和患者依从性方面的差异、当前质量指标的系统局限性以及阻碍采用先进技术的障碍。重点介绍了提高胃肠镜检查质量的未来方向,包括新兴内镜技术的整合、以患者为中心的衡量标准的发展、内镜医师培训和资格认证流程的完善以及人工智能(AI)的前景。文章特别强调了先进内窥镜技术和设备在提高胃肠造影质量方面的作用。这篇文章提出了一个有说服力的观点,提倡追求卓越的胃肠镜检查,认为这是一项不断发展的工作,需要临床医生、研究人员、教育工作者和政策制定者的共同努力。
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引用次数: 0
Autophagy and Apoptosis in Inflammatory Bowel Disease 炎症性肠病中的自噬和细胞凋亡
Pub Date : 2023-11-22 DOI: 10.3390/gastroent14040042
E. Kouroumalis, Ioannis Tsomidis, A. Voumvouraki
The pathogenesis of inflammatory bowel disease (IBD) implicates several interconnecting factors. Immunity and external factors interact, and most aspects are still under investigation. Autophagy and apoptosis are two critical pathways that decide the fate of the individual cells of the intestinal mucosa. Experimental and clinical data indicate that the two are closely interconnected and usually mutually exclusive. However, despite the abundant information on their role, very limited translation into therapeutic application has been seen during recent years. In this review, research on these two pathways is presented. After a general overview of autophagy and apoptosis, their association with IBD, including the important mitophagy and ferroptosis, is discussed. The influence of autophagy- and apoptosis-related genes is also discussed. Finally, the interplay of autophagy and apoptosis in IBD is presented and the implications for treatment applications are examined. It is shown that dysregulated autophagy leads to increased apoptosis of enterocytes and impairs the tight junction proteins of the protective intestinal barrier. Dysregulated autophagy also induces the downregulation of lysozyme and the other antimicrobial proteins’ production. Mucus production by the goblet cells is also reduced due to defective autophagy and increased apoptosis.
炎症性肠病(IBD)的发病机制涉及多个相互关联的因素。免疫和外部因素相互影响,大多数方面仍在研究之中。自噬和细胞凋亡是决定肠粘膜单个细胞命运的两个关键途径。实验和临床数据表明,自噬和凋亡密切相关,通常相互排斥。然而,尽管关于它们作用的信息很多,但近年来转化为治疗应用的却非常有限。本综述将介绍有关这两种途径的研究。在概述了自噬和细胞凋亡之后,讨论了它们与 IBD 的关联,包括重要的有丝分裂和铁凋亡。此外,还讨论了自噬和凋亡相关基因的影响。最后,介绍了自噬和细胞凋亡在 IBD 中的相互作用,并探讨了自噬和细胞凋亡对治疗应用的影响。研究表明,自噬失调会导致肠细胞凋亡增加,并损害肠道保护屏障的紧密连接蛋白。自噬失调还会诱导溶菌酶和其他抗微生物蛋白产量的下调。由于自噬缺陷和细胞凋亡增加,鹅口疮细胞分泌的粘液也会减少。
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引用次数: 0
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