Diseases Of Digestive System Research Articles

Efficacy and safety of Piwei Peiyuan Prescription in the treatment of chronic atrophic gastritis: A multicenter, double-blind, double-simulated, randomized, controlled clinical trial.

The incidence of chronic atrophic gastritis (CAG) is on the rise due to the growing pressure in modern social life, increasing bad living habits and emotional disorders (such as anxiety and depression), and the aging of the population. Of note, digestive system diseases are the dominant diseases in the field of traditional Chinese medicine (TCM). Therefore, this study evaluated the efficacy and safety of Piwei Peiyuan Prescription, a TCM prescription, in the treatment of CAG through a multicenter, double-blind, randomized, controlled design. This research was organized by the Second Affiliated Hospital of Anhui University of TCM and simultaneously performed in 6 centers. A total of 120 CAG patients were included and randomized into 2 groups: group A (treatment with Piwei Peiyuan granules plus Weifuchun Simulant) and Group B (treatment with Weifuchun Tablets plus Piwei Peiyuan Simulant). These 2 groups were compared in terms of gastroscopy scores, TCM syndrome scores, and serological indicators at baseline and within 12 weeks after treatment. According to endoscopic biopsy for pathological observation, atrophy (2.56 ± 1.08 vs 3.00 ± 1.00, P = .028) and intestinal epithelial hyperplasia (1.00 ± 1.43 vs 1.69 ± 1.80, P = .043) scores were lower in group A than in group B. For the more, group A had higher effective rates for inflammation, atrophy, and intestinal metaplasia (IM) in various regions of the stomach, especially for atrophy/IM of the gastric angle (64%, P = .034) and atrophy/IM of the lesser curvature of gastric antrum (63%, P = .042) than group B. According to TCM syndrome scores, Piwei Peiyuan Prescription improved the scores of gastric distension (2.30 ± 1.13 vs 2.80 ± 0.99, P = .022), preference for warmth and pressure (1.44 ± 1.06 vs 1.36 ± 1.10, P = .041), and poor appetite and indigestion (0.78 ± 0.66 vs 1.32 ± 0.72, P = .018). GAS, MTL, and PGE2 expression was significantly elevated after treatment with Piwei Peiyuan Prescription (P < .001). Piwei Peiyuan Prescription is effective for CAG treatment with high safety.

Bioactive arabinogalactan from Ferulopsis hystrix roots: characterization of gastroprotective and antioxidant potentials against drug-induced gastropathy

Bristled ferula (Ferulopsis hystrix (Bunge) Pimenov) is a perennial plant belonging to the Apiaceae family, and its aqueous extract is utilised in Eastern medicine to treat digestive system diseases. In this study, water-soluble polysaccharides from F. hystrix were isolated for the first time, and the basic polymer FH-3 was separated and characterised. FH-3 was found to contain arabinose and galactose in a 1:5 ratio, with a molecular weight of 52.3 kDa. Methylation analysis confirmed the structure of FH-3 to be arabino-3,6-galactan. Administration of FH-3 at 10 and 30 mg/kg doses in rats with drug-induced gastropathy effectively limited the development of large and strip-like erosions in the gastric mucosa. FH-3 prevented the development of oxidative stress, normalising malondialdehyde (MDA) and catalase (CAT) and reducing glutathione (GSH) serum levels. Arabinogalactan FH-3 is a new gastroprotective and antioxidant plant component in F. hystrix roots, offering promising prospects for treating stomach diseases.

Medication adherence and costs of medical care among patients with Parkinson's disease: an observational study using electronic medical records.

Adherence to antiparkinsonian drugs (APDs) is critical for patients with Parkinson's disease (PD), for which medication is the main therapeutic strategy. Previous studies have focused on specific disorders in a single system when assessing clinical factors affecting adherence to PD treatment, and no international comparative data are available on the medical costs for Chinese patients with PD. The present study aimed to evaluate medication adherence and its associated factors among Chinese patients with PD using a systematic approach and to explore the impact of adequate medication adherence on direct medical costs. A retrospective analysis was conducted using the electronic medical records of patients with PD from a medical center in China. Patients with a minimum of two APD prescriptions from January 1, 2016 to August 15, 2018 were included. Medication possession ratio (MPR) and proportion of days covered were used to measure APD adherence. Multiple linear regression analysis was used to identify factors affecting APD adherence. Gamma regression analysis was used to explore the impact of APD adherence on direct medical costs. In total, 1,712 patients were included in the study, and the mean MPR was 0.68 (± 0.25). Increased number of APDs and all medications, and higher daily levodopa-equivalent doses resulted in higher MPR (mean difference [MD] = 0.04 [0.03-0.05]; MD = 0.02 [0.01-0.03]; MD = 0.03 [0.01-0.04], respectively); combined digestive system diseases, epilepsy, or older age resulted in lower MPR (MD = -0.06 [-0.09 to -0.03]; MD = -0.07 [-0.14 to -0.01]; MD = -0.02 [-0.03 to -0.01], respectively). Higher APD adherence resulted in higher direct medical costs, including APD and other outpatient costs. For a 0.3 increase in MPR, the two costs increased by $34.42 ($25.43-$43.41) and $14.63 ($4.86-$24.39) per year, respectively. APD adherence rate among Chinese patients with PD was moderate and related primarily to age, comorbidities, and healthcare costs. The factors should be considered when prescribing APDs.

Exploration of Teaching Styles in a Digestive System Integration Course

Purpose: To explore the innovation of teaching methods in digestive system courses and its application effect in the context of curriculum integration. Methods: 60 undergraduate majors of digestive system diseases in the class of 2023 (orientation) of our hospital were divided into 30 students each in the general class and the experimental class using the random grouping method. The general class adopted the case-based learning (CBL) teaching mode, and the experimental class adopted the integrated course mode of CBL + “organ-systems-based curriculum” (OSBC). The teaching effects of the two classes were compared through basic theory and clinical five-station examination. Results: The differences in the basic theory scores and excellence rates of the students in the experimental class were significant (P &lt; 0.05); the clinical 5-station examination suggested that there was no statistical significance in the physical examination of the two classes (P &gt; 0.05); and the differences in the scores of the clinical questioning, case writing, auxiliary examination, and oral examination of the two classes were statistically significant (P &lt; 0.05). Conclusion: The teaching method based on CBL + OSBC integrated course is effective in the teaching reform of the digestive system course and has popularization value.

Revealing the mechanism of Dahuang Huanglian Xiexin Decoction attenuates dysbiosis via IL-17 signaling pathway based on network pharmacology and experimental validation

Ethnopharmacological relevanceDahuang Huanglian Xiexin Decoction (XXD), derived from Zhang Zhongjing's Treatise on Typhoid Fever, has a long history of medicinal use and is widely used for digestive system diseases. It is mainly composed of three natural medicines, including Dahuang (Rheum palmatum L.), Huanglian (Coptis chinensis Franch.), and Huangqin (Scutellaria baicalensis Georgi). Modern pharmacological research shows that the active ingredients of XXD can have a positive effect on intestinal flora regulatory effect, but its mechanism of action is unclear. Aims of this studyClarify the effect of XXD on regulating dysbiosis, and elucidate the mechanism of XXD in alleviating dysbiosis based on network pharmacology, molecular docking and experimental verification. MethodsHistopathological observation and intestinal high-throughput sequencing were used to observe the effect. Preliminary prediction of the mechanism of action of XXD in treating dysbiosis through network pharmacology and molecular docking. Finally, the effect of XXD on the IL-17 signaling pathway was verified through in vivo experiments. ResultsHistopathology and high-throughput sequencing of intestinal flora indicated that XXD has a good regulatory effect on bacterial dysbiosis. At the same time, network pharmacology identified a total of 40 active compounds, 14 of which may be key compounds for XXD to treat dysbiosis. In addition, the study also revealed 14 potential key targets as well as the top 5 therapeutic targets: IL-6, TNF-α, IL-1β, TP53 and PTGS2. GO and KEGG predicted the key pathway for IL-17 signaling pathway to play a role in XXD. In the verification of the prediction results, it was found that the above targets and the IL-17 target showed strong activity in molecular docking. Furthermore, it was found that XXD can reduce the levels of IL-17, IL-6, TNF-α, IL-1β, p53 and COX-2 in serum, while inhibiting the expression of IL-17, IL-17RA, Act-1 and NF-κB protein and the mRNA expression of IL-17, IL-17RA and Act-1 in colon tissue. ConclusionsThis study found that XXD has a good regulatory effect on dysbiosis and its induced symptoms. Network pharmacology was used to predict the key compounds and therapeutic targets of XXD, and preliminary experiments confirmed that XXD may regulate bacterial dysbiosis by inhibiting the IL-17 signaling pathway.

Multimorbidity disease clusters are associated with venous thromboembolism: an extended cross-sectional national study

Multimorbidity, i.e., two or more non-communicable diseases (NCDs), is an escalating challenge for society. Venous thromboembolism (VTE) is a common cardiovascular disease and it is unknown which multimorbidity clusters associates with VTE. Our aim was to examine the association between different common disease clusters of multimorbidity and VTE. The study is an extended (1997–2015) cross-sectional Swedish study using the National Patient Register and the Multigeneration Register. A total of 2,694,442 Swedish-born individuals were included in the study. Multimorbidity was defined by 45 NCDs. A principal component analysis (PCA) identified multimorbidity disease clusters. Odds ratios (OR) for VTE were calculated for the different multimorbidity disease clusters. There were 16% (n = 440,742) of multimorbid individuals in the study population. Forty-four of the individual 45 NCDs were associated with VTE. The PCA analysis identified nine multimorbidity disease clusters, F1-F9. Seven of these multimorbidity clusters were associated with VTE. The adjusted OR for VTE in the multimorbid patients was for the first three clusters: F1 (cardiometabolic diseases) 3.44 (95%CI 3.24–3.65), F2 (mental disorders) 2.25 (95%CI 2.14–2.37) and F3 (digestive system diseases) 4.35 (95%CI 3.63–5.22). There was an association between multimorbidity severity and OR for VTE. For instance, the occurrence of at least five diseases was in F1 and F2 associated with ORs for VTE: 8.17 (95%CI 6.32–10.55) and 6.31 (95%CI 4.34–9.17), respectively. In this nationwide study we have shown a strong association between VTE and different multimorbidity disease clusters that might be useful for VTE prediction.Graphical abstract

Causal relationships between gut microbrome and digestive system diseases: A two-sample Mendelian randomization study.

Growing evidences of recent studies have shown that gut microbrome are causally related to digestive system diseases (DSDs). However, causal relationships between the gut microbiota and the risk of DSDs still remain unclear. We utilized identified gut microbiota based on class, family, genus, order and phylum information and digestive system diseases genome-wide association study (GWAS) dataset for two-sample Mendelian randomization (MR) analysis. The inverse variance weighted (IVW) method was used to evaluate causal relationships between gut microbiota and 7 DSDs, including chronic gastritis, colorectal cancer, Crohn's disease, gastric cancer, gastric ulcer, irritable bowel syndrome and esophageal cancer. Finally, we verified the robustness of MR results based on heterogeneity and pleiotropy analysis. We discovered 15 causal associations with genetic liabilities in the gut microbiota and DSDs, such as genus Victivallis, genus RuminococcaceaeUCG005, genus Ruminococcusgauvreauiigroup, genus Oxalobacter and so on. Our MR analysis revealed that the gut microbiota is causally associated with DSDs. Further researches of the gut microbiota and the pathogenesis of DSDs are still significant and provide new methods for the prevention and treatment of DSDs.

Trends in pediatric emergency department transfers from Indian Health Service and tribal health systems.

To describe the frequency and observed trends for all Indian Health Service (IHS) and tribal emergency department (ED) transfers to a pediatric referral center from January 1, 2017, to December 31, 2020, with a secondary analysis to describe trends in final dispositions, lengths of stay (LOS), and the most common primary ICD-10 diagnoses. We performed a retrospective chart review of IHS and tribal ED transfers to a pediatric referral center from 2017 to 2020 (n = 2433). The data were summarized using frequencies and percentages and we used generalized estimating equations to analyze patient characteristics over time. IHS and tribal ED transfers accounted for 6.5%-7.1% of all transfers each year between 2017 and 2020 without significant changes over time. Within this group, 60% were admitted and 62% experienced a LOS greater than 24 h. The most common diagnostic code groups for these patients were respiratory conditions, injuries and poisonings, nonspecific abnormal clinical findings and labs, digestive system diseases, and nervous system diseases. This study addresses important knowledge gaps regarding transfers from IHS and tribal EDs, highlights potential high-impact areas for pediatric readiness, and emphasizes the need for more granular data to inform resource allocation and educational interventions. Further studies are needed to delineate potentially avoidable transfers seen within this population.

Medical reasons for permanent and temporary disqualification of Turkish civil aviation pilots

The aim of this study was to identify diseases that result in permanent and temporary medical disqualification for civil aviation pilots and their changes over the years. A retrospective analysis was conducted on the medical examination records performed in Turkey from 2018 to 2022, in accordance with ICAO and EASA standards. The permanent disqualification rate was 1.3%, and the temporary disqualification rate was 6.6%. The most common reasons for permanent disqualification among pilots were circulatory system diseases (24%), mental and behavioral disorders (22.9%), and nervous system diseases (11.5%). The most common reasons for temporary disqualification among pilots were circulatory system diseases (17.9%), digestive system diseases (11.8%), and health problems related to COVID-19 infection (9.5%). The data obtained from this study may be useful in developing preventive medicine approaches to prevent medical disqualifications and in-flight medical incapacitation.

Goat milk exosomal microRNAs alleviate LPS-induced intestinal inflammation in mice

Intestinal inflammation is a common digestive system disease. Milk-derived exosomes can participate in intercellular communication and transport a variety of bioactive components, and the microRNAs (miRNAs) they carry play important roles in a variety of biological processes in the body. At present, the preventive effect and mechanism of action of goat milk exosomes and their derived miRNAs on intestinal inflammation are still unclear. In this study, the protective effect of goat milk exosomes on LPS-induced intestinal inflammation was investigated using mouse intestinal inflammation model and IEC-6 cell inflammation model. Small RNA sequencing was used to analyze the miRNA expression profile of goat milk exosomes. In this study, C-Exo and M-Exo alleviated intestinal inflammation by reducing the LPS-induced release of proinflammatory cytokines, inhibiting the increase in the NLRP3 protein and the activation of the TLR4/NFκB signaling pathway. C-Exo has a more significant inhibitory effect on them, and better therapeutic efficacy than M-Exo. Notably, the target genes of miRNAs in C-Exo and M-Exo were significantly enriched in immune-related pathways. Furthermore, their derived miR-26a-5p and miR-30a-5p were found to ameliorate the IEC-6 inflammatory response. These findings suggest that miRNAs in goat milk exosomes have the potential to attenuate LPS-induced intestinal inflammation.

CHIA SEEDS (SALVIA HISPANICA L.): A COMPREHENSIVE LOOK AT THEIR ATTRIBUTES, PHYTOCHEMICAL PROFILE, AND IMPACT ON HEALTH

This article presents a comprehensive review of the characteristics, phytochemical profile and health effects of chia seeds. Chia seeds belong to the Lamiaceae family, and are small, oval and colored seeds that grow in tropical and temperate climates. Chia seeds are rich in protein, fiber, minerals, phenolic compounds and polyunsaturated fatty acids. These nutrients give chia seeds functional properties such as antioxidant, anti-inflammatory, hypolipidemic, hypoglycemic and prebiotic. Chia seeds may play a potential role in the prevention and treatment of chronic diseases such as cardiovascular diseases, diabetes, obesity, digestive system diseases and cancer. Chia seeds can be consumed whole, ground into flour or extracted into oil and added to various foods. Moreover, chia seeds have technological functions such as water retention, emulsification and viscosity enhancement in the food industry. Chia seeds have become a popular functional food in recent years and are being researched. However, more clinical studies and meta-analysis studies are needed on the health effects of chia seeds.

323 Applying MeSH Tree Structures and Condition-to-MeSH Mapping to Catalog and Characterize Clinical Trials Research Focus Areas

OBJECTIVES/GOALS: Characterizing and analyzing research studies presents several challenges given the various ways studies may be labeled or organized. The Medical Subject Headings (MeSH) thesaurus is a hierarchical vocabulary that can index and organize research foci using common business intelligence tools to enable rapid exploration of research portfolios. METHODS/STUDY POPULATION: Metadata from ClinicalTrials.gov on 455,437 trials were downloaded and all MeSH terms associated with trials in the condition_browse section were loaded into a database. The corresponding MeSH trees for each term were then identified and mapped to their ancestor terms within the tree. Trials were then indexed based on top four hierarchical levels for each associated MeSH term. Trials performed at the University of Miami (UM) were identified based on locations associated with the trial as well as matching National Clinical Trial (NCT) numbers identified from internal research administration systems. Business intelligence software (Microsoft PowerBI) was applied to the corresponding dataset to enable end user exploration and analysis of the trials within ClinicalTrials.gov. RESULTS/ANTICIPATED RESULTS: A total of 3,271 studies associated with UM were identified, of which, 3,054 (93.3%) had at least one condition MeSH term linked. A total of 7,711 MeSH terms were associated with the trials overall, representing 1,112 unique MeSH terms; the most common terms were carcinoma (164), lymphoma (155), HIV Infections (139), neoplasms (136), and leukemia (122). Utilizing MeSH hierarchy, trials were characterized were categorized into 36 different trees. The most common top tree nodes were neoplasms (1,181), followed by pathological conditions/signs and symptoms (913), immune system diseases (574), nervous system diseases (513), and digestive system diseases (483). Within trees, a total of 184, 681, and 1057 different MeSH terms were specified at the second, third, and fourth nodes in the hierarchy respectively. DISCUSSION/SIGNIFICANCE: Utilizing existing metadata from trials posted on ClinicalTrials.gov and MeSH tree structures can enable organizations to readily explore the foci of clinical trials research. High rates of MeSH term association to research study conditions are necessary to ensure adequate representation of research foci.

Information heterogeneity between progress notes by physicians and nurses for inpatients with digestive system diseases

This study focused on the heterogeneity in progress notes written by physicians or nurses. A total of 806 days of progress notes written by physicians or nurses from 83 randomly selected patients hospitalized in the Gastroenterology Department at Kagawa University Hospital from January to December 2021 were analyzed. We extracted symptoms as the International Classification of Diseases (ICD) Chapter 18 (R00–R99, hereinafter R codes) from each progress note using MedNER-J natural language processing software and counted the days one or more symptoms were extracted to calculate the extraction rate. The R-code extraction rate was significantly higher from progress notes by nurses than by physicians (physicians 68.5% vs. nurses 75.2%; p = 0.00112), regardless of specialty. By contrast, the R-code subcategory R10–R19 for digestive system symptoms (44.2 vs. 37.5%, respectively; p = 0.00299) and many chapters of ICD codes for disease names, as represented by Chapter 11 K00–K93 (68.4 vs. 30.9%, respectively; p < 0.001), were frequently extracted from the progress notes by physicians, reflecting their specialty. We believe that understanding the information heterogeneity of medical documents, which can be the basis of medical artificial intelligence, is crucial, and this study is a pioneering step in that direction.

Ethnobotanical study of Zhuang medicinal herbs of Ardisia: variety systematization, traditional uses, phytochemistry, pharmacology, clinical application, and toxicity.

This study aimed to systematize the Zhuang medicinal herbs of Ardisia (ZMHA) in China, to clarify the traditional use in Zhuang medicine and the dynamics of international research on phytochemistry, pharmacology, clinical application, and toxicity. There are 25 species of ZMHA, approximately 938 compounds from the different part, including triterpenoids, phenolics, volatile oils, etc. Pharmacological activity studies have also shown that this genus has anti-tumour, anti-inflammatory, anti-oxidant, anti-bacterial, anti-microbial, etc., and significant effects on respiratory, digestive, urinary, and musculoskeletal system diseases without toxic side effects. The Ardisia has a medicinal history of nearly a thousand years, mainly for treating diseases of the injuries, musculoskeletal, and symptomatic system in Zhuang medicine. Some plants, such as A. crenata, A. gigantifolia, and A. japonica, are also commonly used in folk Zhuang medicine formulas, to treat musculoskeletal, injury, respiratory, and urinate systems disease. These diseases are related to inflammation. These could provide a new direction for future new drug development research. Therefore, species identification and resource investigation should be strengthened, and conducted in vitro mechanism, in vivo pharmacology, clinical efficacy, and toxicology studies and establish a perfect quality standard system.

Progress in artificial intelligence assisted digestive endoscopy diagnosis of digestive system diseases

Progress in artificial intelligence assisted digestive endoscopy diagnosis of digestive system diseases

The Role of Inflammatory Biomarkers in Mediating the Effect of Inflammatory Bowel Disease on nonmalignant Digestive System Diseases: A Multivariable Mendelian Randomized Study.

While observation studies have shown a positive correlation between inflammatory bowel disease (IBD) and the risk of nonmalignant digestive system diseases, a definitive causal relationship has not yet been clearly established. Mendelian randomization (MR) was employed to investigate the potential causal association between genetic susceptibility to IBD and nonmalignant gastrointestinal diseases. Genetic variants were extracted as instrumental variables (IVs) from a genome-wide association study (GWAS) meta-analysis, which included 12,194 cases of Crohn's disease (CD) and 28,072 control cases of European ancestry. The GWAS for ulcerative colitis (UC) included 12,366 UC and 33,609 control cases of European ancestry. All IVs reached genome-wide significance (GWAS p value <5 × 10-8). Summary-level data for acute pancreatitis (AP), irritable bowel syndrome (IBS), gastroesophageal reflux disease, cholelithiasis, and CeD (celiac disease) were obtained from the GWAS meta-analysis and the FinnGen dataset. Summary-level data on relevant inflammatory factors were provided by the International Genetic Consortium. Univariate MR analysis was conducted using inverse variance weighting as the primary method for estimating causal effects. Multivariate MR analyses were also performed to detect possible mediators. Genetic susceptibility to UC was associated with an increased risk of AP (OR = 1.08; 95% CI = 1.03-1.13; p=0.002) and IBS odds ratio (OR] = 1.07; 95% confidence interval (CI] = 1.03-1.11; (p < 0.001). In terms of potential mediators, interleukin 6 (IL-6) had a driving effect on the association between UC and AP. There was no apparent evidence of increased risk with CD. Meanwhile, genetic susceptibility to CD increases the risk of CeD (OR = 1.14; 95% CI = 1.03-1.25; p=0.01). The evidence suggests that UC is associated with an elevated risk of AP and IBS, and IL-6 may be responsible in AP. CD is associated with an increased risk of developing CeD. Implementing a proactive monitoring program for assessing the risk of gastrointestinal diseases in UC patients, particularly those with elevated IL-6 levels, may be of interest. In addition, the presence of AP and IBS may indicate the presence of UC. Preventing CeD is an essential consideration in the therapeutic management of patients with CD.

Research progress on the roles of dopamine and dopamine receptors in digestive system diseases.

Dopamine (DA) is a neurotransmitter synthesized in the human body that acts on multiple organs throughout the body, reaching them through the blood circulation. Neurotransmitters are special molecules that act as messengers by binding to receptors at chemical synapses between neurons. As ligands, they mainly bind to corresponding receptors on central or peripheral tissue cells. Signalling through chemical synapses is involved in regulating the activities of various body systems. Lack of DA or a decrease in DA levels in the brain can lead to serious diseases such as Parkinson's disease, schizophrenia, addiction and attention deficit disorder. It is widely recognized that DA is closely related to neurological diseases. As research on the roles of brain-gut peptides in human physiology and pathology has deepened in recent years, the regulatory role of neurotransmitters in digestive system diseases has gradually attracted researchers' attention, and research on DA has expanded to the field of digestive system diseases. This review mainly elaborates on the research progress on the roles of DA and DRs related to digestive system diseases. Starting from the biochemical and pharmacological properties of DA and DRs, it discusses the therapeutic value of DA- and DR-related drugs for digestive system diseases.

Reflections on the strategy of hospital development based on the characteristics of new hospitals.

The disease spectrum is constantly changing, meaning patients' medical characteristics are complex and varied, and hospital operations are facing great challenges. To provide a basis for formulating relevant policies, promoting the continuous improvement of medical quality, improving the efficiency of medical services and proposing corresponding countermeasures. Information on the first page of the medical cases of patients discharged from 2020-2021 in the case management system of The Second People's Hospital of Zhangye City was collected, and statistical analysis was performed in terms of the origin, age, gender, occupation and main diagnosis of the patients. The database was established using Excel software, and statistical description was performed using SPSS 23.0 software, in which the main indicators were the number of cases and relative numbers (%). The total number of inpatients in the hospital exhibited an overall upward trend, with the number in 2021 increasing by 40.53% compared with the previous year. Among them, 0.75% of the inpatients resided outside the province and 99.25% resided within the province. The proportion of inpatients within the city was 98.86%, including 85.50% in Ganzhou District and 14.5% in the five surrounding counties (districts). In 2021, the number of inpatients in the five surrounding districts increased by 60.67% compared with the previous year. The occupational structure of the inpatients was mainly farmers, accounting for 64.68%, which was higher than all other occupational groups, while public employees accounted for 17.9%. Inpatients aged 60 years and above accounted for 37.75%. In terms of disease spectrum ranking, circulatory, digestive, respiratory, injury and oncological system diseases ranked in the top five of the presented diseases, accounting for 64.47% of the total number of inpatients. The patients of the new hospital are mainly elderly patients and local farmers. The hospital development should be based on the disease characteristics of this group, improving the diagnosis and treatment capacity of the departments and strengthening the capacity building of the hospital and the level of the medical services.

The methodological quality of systematic reviews regarding the Core Outcome Set (COS) development

BackgroundThe Core Outcome Measures in Effectiveness Trials (COMET) working group proposed core outcome sets (COS) to address the heterogeneity in outcome measures in clinical studies. According to the recommendations of COMET, performing systematic reviews (SRs) usually was the first step for COS development. However, the SRs that serve as a basis for COS are not specifically appraised by organizations such as COMET regarding their quality. Here, we investigated the status of SRs related to development of COS and evaluated their methodological quality.MethodsWe conducted a search on PubMed to identify SRs related to COS development published from inception to May 2022. We qualitatively summarized the disease included in SR topics, and the studies included in the SRs. We evaluated the methodological quality of the SRs using AMSTAR 2.0 and compared the overall quality of SRs with and without protocols using the Mann-Whitney U test.ResultsWe included 175 SRs from 23 different countries or regions, and they mainly focused on five diseases: musculoskeletal system or connective tissue disease (n = 19, 10.86%), injury, poisoning, or certain other consequences of external causes (n = 18, 10.29%), digestive system disease (n = 16, 9.14%), nervous system disease (n = 15, 8.57%), and genitourinary system disease (n = 15, 8.57%). Although 88.00% of SRs included randomized controlled trials (RCTs), only a few SRs (23.38%) employed appropriate tools to assess the risk of bias in RCTs. The assessment results on the basis of AMSTAR 2.0 indicated that most SRs (93.71%) were rated as ‘’critically low’’ to ‘’low’’ in terms of overall confidence. The overall confidence of SRs with protocols was significantly higher than that without protocols (P <.001). Compared to the SRs with protocols on Core Outcome Measures in Effectiveness Trials (COMET), SRs with protocols on PROSPERO were of better overall confidence (P = .017).ConclusionThe overall quality of published SRs regarding COS development was poor. Our findings emphasize the need for researchers to carefully select the disease topic and strictly adhere to the requirements of optimal methodology when conducting a SR for the establishment of a COS.

Intestinal microecology in pediatric surgery-related gastrointestinal diseases: Current insights and future perspectives

Intestinal microecology is established from birth and is constantly changing until homeostasis is reached. Intestinal microbiota is involved in the immune inflammatory response of the intestine and regulates the intestinal barrier function. The imbalance of intestinal microecology is closely related to the occurrence and development of digestive system diseases. In some gastrointestinal diseases related to pediatric surgery, intestinal microbiota and its metabolites undergo a series of changes, which can provide a certain basis for the diagnosis of diseases. The continuous development of microecological agents and fecal microbiota transplantation technology has provided a new means for its clinical treatment. We review the relationship between pathogenesis, diagnosis and treatment of pediatric surgery-related gastrointestinal diseases and intestinal microecology, in order to provide new ideas and methods for clinical diagnosis, treatment and research. Level of evidence: This is a review study, hence not applicable.