Molecular therapy in gastroenterology and hepatology

During recent years, molecular techniques have significantly impacted our understanding and therapeutic concepts in gastrointestinal and liver disease. In a number of diseases, diagnostic work-up includes molecular data that supplements the phenotypical evaluation. This includes monogenic diseases as well as the identification of genetic risk factors (e. g. NOD2/CARD15 mutation in Crohn's disease) and viral disease. Attempts to replace liver transplantation in hereditary liver disease by targeted molecular interventions (e. g. via viral vectors) are still experimental, but the associated techniques have improved considerably. The molecular identification of therapeutic targets was followed by the development of specifically tailored therapeutics. These agents are mainly used in the treatment of chronic inflammatory bowel disease and gastrointestinal tumors.     

Scandinavian epidemiological research in gastroenterology and hepatology

Abstract

In the last decades, a large number of epidemiological studies in gastroenterology and hepatology have originated from the Scandinavian countries. With the help of large health databases, with good validity and other registries related to patient outcomes, researchers from the Scandinavian countries have been able to make some very important contributions to the field. These countries, Sweden, Norway, Finland, Denmark and Iceland, have all universal access to health care and have shown to be ideal for epidemiological research. Population-based studies have been frequent and follow-up studies have been able to describe the temporal trends and changes in phenotypes. Our ability in Scandinavia to follow up defined groups of patients over time has been crucial to learn the natural history of many gastrointestinal and liver diseases and often in a population-based setting. Patient-related outcomes measures will probably gain increasing importance in the future, but Scandinavian gastroenterologists and surgeons are likely to have a better infrastructure for such endeavors compared to most other populations. Thus, there is a bright future for international competitive research within the field of gastrointestinal and liver diseases in Scandinavia.     

Ultrasound-based artificial intelligence in gastroenterology and hepatology

Artificial intelligence (AI), especially deep learning, is gaining extensive attention for its excellent performance in medical image analysis. It can automatically make a quantitative assessment of complex medical images and help doctors to make more accurate diagnoses. In recent years, AI based on ultrasound has been shown to be very helpful in diffuse liver diseases and focal liver lesions, such as analyzing the severity of nonalcoholic fatty liver and the stage of liver fibrosis, identifying benign and malignant liver lesions, predicting the microvascular invasion of hepatocellular carcinoma, curative transarterial chemoembolization effect, and prognoses after thermal ablation. Moreover, AI based on endoscopic ultrasonography has been applied in some gastrointestinal diseases, such as distinguishing gastric mesenchymal tumors, detection of pancreatic cancer and intraductal papillary mucinous neoplasms, and predicting the preoperative tumor deposits in rectal cancer. This review focused on the basic technical knowledge about AI and the clinical application of AI in ultrasound of liver and gastroenterology diseases. Lastly, we discuss the challenges and future perspectives of AI.     

Gene therapy applications in gastroenterology and hepatology.

Advantages and disadvantages of viral vectors and nonviral vectors for gene delivery to digestive organs are reviewed. Advances in systems for the introduction of new gene expression are described, including self-deleting retroviral transfer vectors, chimeric viruses and chimeric oligonucleotides. Systems for inhibition of gene expression are discussed, including antisense oligonucleotides, ribozymes and dominant-negative genes.     

基于SCIE的胃肠病学及肝脏病学的计量统计分析

目的 分析胃肠病学及肝脏病学的整体发展状况和我国在该领域的全球地位、发展趋势与发达国家之间的差距及造成这些差距的原因.方法 运用文献计量学的方法,对SCIE数据库收录的2000年-2011年胃肠病学及肝脏病学的论文进行统计分析.结果 胃肠病学及肝脏病学学科发展已趋于成熟,文献数量进入线性增长阶段.美国、日本等国家是该领域的领军者,中国是该领域发展最快的国家.中国在文献绝对数量、被引频次、高影响因子文献数等方面与美国、日本相比仍存在较大差距.领域内科研机构和科研工作者数量相对较少、国际合作欠缺、资金资助力度不足等是造成差距的可能原因.结论 中国在胃肠病学及肝脏病学领域已取得长足进步,但仍需通过客观与主观两个方面的努力来提升我国在该领域的地位.     

Prospect of gastroenterology and hepatology in the next century

Subjectheadingsgastroenterology;hepatology;nextcenturyThetaskofpredictingwhatGastroenterologyandHepatologymaylooklikeinthecobingcenturyisagreatPersonalchallengeandatthesametimeanaweinspiringassignment.NotofilyhavethesetwomedicalspecialtiesbecomeverylargeanddiversifiedbuttherearesomanynewdiscoveriesandideasthatitisacapriciousundertakingtOattemptfore-tellingwhichofthemmaybecomepaftoftheneXtcensely'smedicalpractice.Ithereforewilltakethepersonalprivilegeofbeinghighlyselective,choosingonlytopicsf…     

Evidence-based Medicine and continuing education in gastroenterology and hepatology

Evidence Based Medicine (EBM) provide a new philosophy and useful tools to incorporate the scientific method to medical practice in Gastroenterology, Hepatology and Digestive Endoscopy. Large and well designed multicenter randomized clinical trials validated if necessary by metaanalysis, are the main support to the system; in spite of that individual decisions will owe to take into account interests and beliefs of patients and their relatives, doctors and society National or regional consensus and guide-lines elaborated by experts of scientific institutions are published in first line publications and easily available by computerized ways. Incorporation of econometric studies specially centered on quality of life quantification would be excellent weapons in the process of decision making Computers technology as a tool of fast access to scientific bases of medical problems and as a real participant of the process of health care, should owe to be inserted to educational programs at the universities and scientific institutions, at levels of specialization and continuing medical education.     

Japan's contribution to clinical research in gastroenterology and hepatology

Background. Although Japan's contributions to several biomedical fields have already been reported, little is known about Japan's contribution to gastroenterology and hepatology. Methods. Original articles published in 1991 through 2000 in highly reputed journals in the field of gastroenterology and hepatology were retrieved from the MEDLINE database. The number of articles having an affiliation with a Japanese institution was counted in total, and the number for each journal was also counted. Japan's share of articles regarding clinical trials and randomized controlled trials (RCTs) in this field was also determined, along with the trend over the past decade. Results. Japan's share of articles in this field was 10.6%, ranking third in the world, following the United States (35.1%) and the United Kingdom (11.5%). Japan's share of articles went up significantly as a whole (P = 0.01), while the share for RCTs showed no significant change (P = 0.57) during this period of time. Conclusions. Japan's contribution to the field of gastroenterology and hepatology is, in general, acceptable compared with that of other counties, but the contribution for RCTs not satisfactory.