Treatment Of Digestive Diseases Research Articles

CircRNA in Digestive Diseases: Recent Advances in Fundamental Mechanism and Clinical Potential.

Circular RNAs (circRNAs), a class of non-coding RNAs characterized by their closed-loop structure, are widely present in the body and exhibit greater stability compared to conventional linear RNAs. With the development of molecular biology, circRNAs are gradually considered as a prognostic indicator and therapeutic target for various diseases. Research on the mechanism of circRNA in various diseases has become an important direction. In addition, digestive diseases are becoming more common as people's eating habits change, and the incidence and mortality of severe digestive system tumors are increasing year by year. The study of circRNA in digestive diseases provides us with a new way to improve the diagnosis and treatment of digestive diseases. This article provides a comprehensive review of the research literature on circRNAs in digestive system diseases over the past five years (2019- 2023) and covers aspects such as circRNA functions and underlying mechanisms. CircRNA has been implicated in a variety of digestive diseases. In these diseases, circRNA primarily acts as a microRNA (miRNA) sponge, interacting with miRNA to regulate the expression levels of genes associated with signaling pathways, and there is abundant research on the effects of circRNAs on drug resistance, cell proliferation, invasion, apoptosis, and poor prognosis. This article aima to discuss the current status of research on circular RNA and its key areas in digestive system diseases. The review aims to provide valuable insights for further research on the role of circular RNA in digestive system diseases and a reference for subsequent research.

Nanodrug delivery materials for digestive system diseases

Digestive system diseases, such as gastritis, gastric ulcers, chronic liver disease, inflammatory bowel disease (IBD), and colorectal cancer, represent a major group of diseases that have high morbidity and death rates worldwide. Their incidence continues to rise owing to factors such as dietary structure changes, accelerated lifestyles, increased environmental pollution, and population aging. Despite the rapid development of the medical technology, the treatment of digestive diseases still faces many challenges, such as addressing drug-resistant Helicobacter pylori infections, treating IBD, and improving the efficacy of advanced gastrointestinal tumor therapies. Fortunately, the emergence of drug-releasing materials has provided new insights that can be used in the treatment of digestive disorders. Drug-releasing materials are a category of specially designed carriers or systems capable of carrying drugs and controlling their release at specific time intervals on demand to achieve the desired therapeutic effect. This article reviews recent research progress of drug-releasing materials used to diagnose and treat digestive disorders. First, the limitations of traditional oral drug delivery methods, such as low bioavailability and nonspecific distribution, are discussed. Second, different types of drug-releasing materials, such as liposomes, dendritic polymers, micelles, nanogels, inorganic nanoparticles, and extracellular vesicles, along with their advantages in terms of improved drug stability, biocompatibility, targeting, and controlled release, are outlined. In addition, the application strategies and preclinical findings of various drug release materials for different digestive disorders are discussed in detail. This Review could help researchers explore more advanced nanomaterials for personalized treatment of drug delivery for digestive disorders.

NEDD4 and NEDD4L: Ubiquitin Ligases Closely Related to Digestive Diseases.

Protein ubiquitination is an enzymatic cascade reaction and serves as an important protein post-translational modification (PTM) that is involved in the vast majority of cellular life activities. The key enzyme in the ubiquitination process is E3 ubiquitin ligase (E3), which catalyzes the binding of ubiquitin (Ub) to the protein substrate and influences substrate specificity. In recent years, the relationship between the subfamily of neuron-expressed developmental downregulation 4 (NEDD4), which belongs to the E3 ligase system, and digestive diseases has drawn widespread attention. Numerous studies have shown that NEDD4 and NEDD4L of the NEDD4 family can regulate the digestive function, as well as a series of related physiological and pathological processes, by controlling the subsequent degradation of proteins such as PTEN, c-Myc, and P21, along with substrate ubiquitination. In this article, we reviewed the appropriate functions of NEDD4 and NEDD4L in digestive diseases including cell proliferation, invasion, metastasis, chemotherapeutic drug resistance, and multiple signaling pathways, based on the currently available research evidence for the purpose of providing new ideas for the prevention and treatment of digestive diseases.

Risk Perception, Acceptance, and Trust of Using AI in Gastroenterology Practice in the Asia-Pacific Region: Web-Based Survey Study

Background The use of artificial intelligence (AI) can revolutionize health care, but this raises risk concerns. It is therefore crucial to understand how clinicians trust and accept AI technology. Gastroenterology, by its nature of being an image-based and intervention-heavy specialty, is an area where AI-assisted diagnosis and management can be applied extensively. Objective This study aimed to study how gastroenterologists or gastrointestinal surgeons accept and trust the use of AI in computer-aided detection (CADe), computer-aided characterization (CADx), and computer-aided intervention (CADi) of colorectal polyps in colonoscopy. Methods We conducted a web-based questionnaire from November 2022 to January 2023, involving 5 countries or areas in the Asia-Pacific region. The questionnaire included variables such as background and demography of users; intention to use AI, perceived risk; acceptance; and trust in AI-assisted detection, characterization, and intervention. We presented participants with 3 AI scenarios related to colonoscopy and the management of colorectal polyps. These scenarios reflect existing AI applications in colonoscopy, namely the detection of polyps (CADe), characterization of polyps (CADx), and AI-assisted polypectomy (CADi). Results In total, 165 gastroenterologists and gastrointestinal surgeons responded to a web-based survey using the structured questionnaire designed by experts in medical communications. Participants had a mean age of 44 (SD 9.65) years, were mostly male (n=116, 70.3%), and mostly worked in publicly funded hospitals (n=110, 66.67%). Participants reported relatively high exposure to AI, with 111 (67.27%) reporting having used AI for clinical diagnosis or treatment of digestive diseases. Gastroenterologists are highly interested to use AI in diagnosis but show different levels of reservations in risk prediction and acceptance of AI. Most participants (n=112, 72.72%) also expressed interest to use AI in their future practice. CADe was accepted by 83.03% (n=137) of respondents, CADx was accepted by 78.79% (n=130), and CADi was accepted by 72.12% (n=119). CADe and CADx were trusted by 85.45% (n=141) of respondents and CADi was trusted by 72.12% (n=119). There were no application-specific differences in risk perceptions, but more experienced clinicians gave lesser risk ratings. Conclusions Gastroenterologists reported overall high acceptance and trust levels of using AI-assisted colonoscopy in the management of colorectal polyps. However, this level of trust depends on the application scenario. Moreover, the relationship among risk perception, acceptance, and trust in using AI in gastroenterology practice is not straightforward.

Smart capsule for monitoring inflammation profile throughout the gastrointestinal tract

Inflammatory bowel disease (IBD) has become alarmingly prevalent in the last two decades affecting 6.8 million people worldwide with a starkly high relapse rate of 40% within 1 year of remission. Existing visual endoscopy techniques rely on subjective assessment of images that are error-prone and insufficient indicators of early-stage IBD, rendering them unsuitable for frequent and quantitative monitoring of gastrointestinal health necessary for detecting regular relapses in IBD patients. To address these limitations, we have implemented a miniaturized smart capsule (2.2 cm × 11 mm) that allows monitoring reactive oxygen species (ROS) levels as a biomarker of inflammation for quantitative and frequent profiling of inflammatory lesions throughout the gastrointestinal tract. The capsule is composed of a pH and oxidation reduction potential (ORP) sensor to track the capsule's location and ROS levels throughout the gastrointestinal tract, respectively, and an optimized electronic interface for wireless sensing and data communication. The designed sensors provided a linear and stable performance within the physiologically relevant range of the GI tract (pH: 1–8 and ORP: −500 to +500 mV). Additionally, systematic design optimization of the wireless interface electronics offered an efficient sampling rate of 10 ms for long-running measurements up to 48 h for a complete evaluation of the entire gastrointestinal tract. As a proof-of-concept, the capsule the capsule's performance in detecting inflammation risks was validated by conducting tests on in vitro cell culture conditions, simulating healthy and inflamed gut-like environments. The capsule presented here achieves a new milestone in addressing the emerging need for smart ingestible electronics for better diagnosis and treatment of digestive diseases.

Editorial introductions.

Current Opinion in Gastroenterology was launched in 1985. It is one of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The field of gastroenterology is divided into 12 sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the Section Editors for this issue. SECTION EDITORS Matthew A. CiorbaMatthew A. CiorbaDr Matthew Ciorba is a gastroenterologist and biomedical researcher dedicated to advancing care in the Inflammatory Bowel Diseases (IBD) and Colon Cancer. His clinical expertise is in caring for patients with Crohn's and ulcerative colitis and preventing colon cancer. He is Director of the IBD Center at Washington University, USA, and leads one of the largest clinical teams in the USA dedicated to providing comprehensive and cutting-edge clinical care to more than 8000 patients affected by IBD. His basic-translational research program is dedicated to defining pathways and mechanisms of intestinal inflammation and the transition to colon cancer. His lab has developed methods to study intestinal organoids and tumoroids to facilitate studies of the epithelial response to inflammation, injury and repair. His lab investigations have spawned four ground-breaking Bench-to-Bedside clinical trials addressing unmet patient needs in colitis, enteritis and rectal cancer using probiotics, novel immunotherapies and manipulating bile acids. In addition to his own lab, Dr Ciorba is also Director of IBD Research at Washington University and use this platform to foster collaborative discovery between the world-class scientific investigators and the robust IBD clinical program. Finally, he is deeply committed to training the next generation of medical investigators who will advance discovery and treatment of digestive diseases. Supporting this mission, he serves as Associate Director of the GI Fellowship's T32 Research Training grant and serves on several training grant review committees for several organizations including the CCF, AGA and NIH. Stuart J. SpechlerStuart J. SpechlerStuart Jon Spechler, MD is Chief of the Division of Gastroenterology and Co-Director of the Center for Esophageal Diseases at Baylor University Medical Center at Dallas, as well as the Co-Director of the Center for Esophageal Research at the Baylor Scott and White Research Institute. Prior to joining Baylor University Medical Center in January 2017, Dr Spechler was the Chief of the Division of Gastroenterology for the VA North Texas Healthcare System, Professor of Medicine, and holder of the Berta M. and Cecil O. Patterson Chair in Gastroenterology at the University of Texas Southwestern Medical Center, and he had been the Director of the Center for Swallowing Disorders at the Beth Israel Deaconess Medical Center and Harvard Medical School in Boston, Massachusetts. Dr Spechler's research has focused primarily on disorders of the esophagus, especially GERD and its complications, and eosinophilic esophagitis. He has chaired three VA Cooperative Studies on medical and surgical treatments for gastroesophageal reflux disease. He described the condition known as “short-segment Barrett's esophagus” in 1994. Dr. Spechler has published more than 300 scientific reports, editorials, review articles, and book chapters on esophageal disorders. He is best known for his work in the areas of GERD, Barrett's esophagus, and eosinophilic esophagitis. Dr Spechler has served on the editorial boards of numerous journals including Gastroenterology, Gut, Alimentary Pharmacology and Therapeutics, Digestive Diseases and Sciences and Diseases of the Esophagus, and he has served as Chair of the Gastroenterology Teaching Project and the Esophago-Gastro-Duodenal Section of the American Gastroenterological Association.

Evaluation of the effectiveness of telemedical technologies in patients with digestive diseases

BACKGROUND: The use of telemedical technologies (TMT) is widespread in providing care to patients of various profiles. However, TMTs are hardly ever used in gastroenterology, despite the extensive digitalization of healthcare. Potential sites for the use of TMTs among gastroenterological patients were assessed.
 AIM: The study aimed to assess the effectiveness and benefits of TMTs in patients with digestive diseases.
 
 Patients with colorectal cancer (CRC): Screening and postoperative management. The TMT intervention increased the number of patients screened for CRC compared to standard face-to-face counseling. In addition, the quality of preparation for colonoscopy was higher in patients who interacted with the physician via TMTs compared to the control group. Most studies reported positive effects of TMTs on quality of life and physical activity in patients with CRC. However, the study by K. Beaver et al. showed that the incidence of CRC recurrence did not differ in the TMT and face-to-face groups.
 Patients with nonalcoholic fatty liver disease (NAFLD): Correction of lifestyle. When assessing the use of TMTs among NAFLD patients, a significant decrease in alanine aminotransferase and aspartate aminotransferase activity was found compared to that in face-to-face management. The results of the body mass index reduction are contradictory. The most pronounced tendency towards weight loss was observed with the telemedical follow-up of patients over a 6-month period.
 Patients with irritable bowel syndrome (IBS): Treatment and monitoring of symptoms. Two directions are distinguished in the treatment of IBS by ТМТs. The first is cognitive behavioral therapy (CBT). H. Everitt et al. showed clinically significant improvement in 72.8% of cases after 12 months of web-based CBT. The advantages of using telemedicine in the delivery of CBT include the geographical independence of the physician and the patient, personalization of treatment, and the possibility of ongoing support for the patient and his or her family. The second direction is the use of special diets, such as low-fermentable nutrient diets (FODMAP). Patients following the FODMAP diet supervised by the mobile app reduced symptom severity (odds ratio 55; 95% confidence interval 1198, p=0.01). Special mobile apps (IBS Constant Care) were used to monitor the condition of patients with IBS, which analyze input data and assess severity, providing information to both the patient and the physician.
 Patients with inflammatory bowel disease (IBD): Patient training and telemonitoring. The study by L. Pang et al. proved that the patients quality of life in the telemedicine intervention group was significantly higher (p=0.03). Another advantage of using TMTs is the provision of access to educational materials about IBD and the possibility of remote contact with the treating physician. The patients ability to obtain necessary information reduces the need for unplanned visits to medical facilities, thus reducing the cost of organizing medical care for patients with IBD. The degree of IBD activity and risk of recurrence and adherence to therapy did not differ significantly between the telemedicine intervention group and the standard face-to-face follow-up group.
 
 METHODS: A literature search relevant to the review was conducted in the PubMed database. The studies taken for assessment were those on the use of TMTs among patients with IBD, IBS, NAFLD, and CRC. TMTs were used to access educational information and dietary recommendations, provide information on lifestyle adjustments and physical activity, remind patients to take medicines, consult with physicians, and assess disease activity by completing online questionnaires. The various studies used text messaging, e-mail, mobile apps, websites, and videoconferencing apps as a means of communication.
 RESULTS: The use of telemedicine in the management of patients with digestive diseases showed high efficiency. TMTs contribute to:
 
 Improved quality of life in patients with digestive diseases.
 Increasing physical activity of patients with CRC and NAFLD.
 Improved quality of CRC screening.
 Maintaining remission of IBD and CRC as effectively as face-to-face monitoring.
 
 Moreover, the use of TMTs allows personalized treatment, ensures the ongoing support of the patient and his or her family by the medical staff, and provides patients with access to quality educational materials about the disease.
 CONCLUSIONS: Thus, the use of TMTs is promising in the treatment of digestive diseases and requires wider introduction into practice.

Systematic review and Meta-analysis of Biling Weitong Granules in treatment of stomach ache disorder

This study aimed to evaluate the efficacy and safety of Biling Weitong Granules in the treatment of stomach ache disorder. Randomized controlled trial(RCT) of Biling Weitong Granules in the treatment of digestive diseases with stomach ache disorder as the primary symptom was retrieved from Chinese and English electronic databases and trial registration platforms from database inception to June 10, 2022. Two investigators conducted literature screening and data extraction according to the screening criteria. The Cochrane risk-of-bias tool(v 2.0) was used to assess the risk of bias in the included studies. Analyses were performed using RevMan 5.4 and R 4.2.2, with summary estimates measured using fixed or random effects models. The primary outcome indicators were the visual analogue scale(VAS) scores and stomach ache disorder symptom scores. The secondary outcome indicators were clinical recovery rate, Helicobacter pylori(Hp) eradication rate, and adverse reaction/events. Twenty-seven RCTs were included with a sample size of 2 902 cases. Meta-analysis showed that compared with conventional western medicine treatments or placebo, Biling Weitong Granules could improve VAS scores(SMD=-1.90, 95%CI[-2.18,-1.61], P<0.000 01), stomach ache disorder symptom scores(SMD=-1.26, 95%CI[-1.71,-0.82], P<0.000 01), the clinical recovery rate(RR=1.85, 95%CI[1.66, 2.08], P<0.000 01), and Hp eradication rate(RR=1.28, 95%CI[1.20, 1.37], P<0.000 01). Safety evaluation revealed that the main adverse events in the Biling Weitong Granules included nausea and vomiting, rash, diarrhea, loss of appetite, and bitter mouth, and no serious adverse events were reported. Egger's test showed no statistical significance, indicating no publication bias. The results showed that Biling Weitong Granules in the treatment of digestive system diseases with stomach ache disorder as the primary symptom could improve the VAS scores and stomach ache disorder symptom scores of patients, relieve stomach ache disorder, and improve the clinical recovery rate and Hp eradication rate, with good safety and no serious adverse reactions. However, the quality of the original studies was low with certain limitations. Future studies should use unified and standardized detection methods and evaluation criteria of outcome indicators, pay attention to the rigor of study design and implementation, and highlight the clinical safety of the medicine to provide more reliable clinical evidence support for clinical application.

A Literature Review of Bhujangasana and its Physioanatomical Aspect

Yoga is an ancient and profound Indian philosophy-based practise. The word "yoga" comes from the Sanskrit root "Yuj," which meaning "to unite" or "to yoke." Yoga is the practise of calming down mental fluctuations and patterns. Asanas are certain postures used in yoga. An asana is a body posture that is used to improve one's health and mental well-being. Asanas lubricate the muscles, joints, ligaments, and other parts of the body. This aids in the circulation and flexibility of the body. Bhujangasana, or "cobra position," is a meditation and pranayama asana It is utilised in meditation and Pranayama. It aids in the maintenance of the digestive system and the treatment of digestive diseases. It also offers Strengthening the spine, stretching the chest and lungs, shoulders and abdomen, toning the buttocks, and stimulating the abdominal organs can all assist to relieve tension and weariness. The second chapter of the Gheranda Samhita describes Bhujangasana

IMPACT OF DIAGNOSTIC AND INTERVENTIONAL ENDOSCOPIC ULTRASONOGRAPHY IN CHILDREN.

Endoscopic ultrasonography is used in the diagnosis and treatment of digestive diseases in adults. In children, its use is limited due to a lack of available expertise. This study aimed to evaluate the clinical impact of endoscopic ultrasonography on diagnostic and therapeutic strategy changes in pediatric patients. Over ten years, this study retrospectively and consecutively analyzed children aged ≤18 years who underwent endoscopic ultrasonography because of inconclusive imaging or laboratory tests. The indications, results, occurrence of adverse events, and clinical impact of the procedures were analyzed. The clinical impact was classified as major (when the findings led to changes in diagnosis and management), minor (change in diagnosis but not in management), or none (no change in diagnosis or management). Overall, 107 children [77 (72%) of whom were female; mean age: 11.7 ± 4 years] underwent upper [102 (95.3%)] and lower [5 (4.7%)] endoscopic ultrasonography; 64 (58%) patients underwent diagnostic endoscopic ultrasonography, and 43 (42%) underwent interventional endoscopic ultrasonography. Endoscopic ultrasonography was used to investigate pancreaticobiliary, gastric, rectal, esophageal, duodenal, and mediastinal diseases in 81 (76%), 14 (13%), 5 (4.6%), 3 (2.8%), 2 (1.8%), and 2 (1.8%) patients, respectively. The clinical impact was significant in 81% of the children. Major and no clinical impact on pancreaticobiliary, gastrointestinal diseases, and mediastinal masses occurred in 50 (62%) and 13 (16%), 13 (54%) and 9 (37%), and 2 (100%) and 0 (0%) of the patients, respectively. This study evaluated the impact of diagnostic and interventional endoscopic ultrasonography in pediatric patients. When clinically and appropriately indicated, these procedures are safe and effective diagnostic or therapeutic interventions in pediatric patients with gastrointestinal or pancreaticobiliary disorders.

The tibetan medicine Zuozhu-Daxi can prevent Helicobacter pylori induced-gastric mucosa inflammation by inhibiting lipid metabolism

BackgroundTibetan medicine has been used in clinical practice for more than 3800 years. Zuozhu-Daxi (ZZDX), a classic traditional Tibetan medicine, has been proved to be effective in the treatment of digestive diseases, such as chronic gastritis, gastric ulcer, etc. Helicobacter pylori (H. pylori), one of the most common pathogenic microbes, is regarded as the most common cause of gastritis. Researching on the effects of ZZDX on H. pylori-induced gastric mucosa inflammation could provide more evidences on H. pylori treatment and promote the development of Tibetan medicine. This study aimed to explore whether ZZDX could rescue H. pylori-induced gastric mucosa inflammation and its mechanism.MethodsMale C57BL/6 mice were infected with H. pylori, and orally treated with ZZDX to rescue gastric mucosa inflammation induced by H. pylori infection. Pathology of gastric mucosa inflammation was evaluated under microscopy by hematoxylin–eosin (HE) staining. The infection status of H. pylori was evaluated by immunohistochemical (IHC) staining. The reactive oxygen species (ROS) level in serum was evaluated using a detection kit. IL-1α, IL-6, and PGE2 expression levels in serum were measured using ELISA. IL-1α, IL-8, TNF-α, and NOD1 expression levels in gastric tissues were measured using real-time PCR. RNA sequencing and gene certification of interest were performed to explore the mechanisms in vivo and in vitro.ResultsThe results showed that ZZDX could significantly inhibit H. pylori-induced gastric mucosa inflammation using HE staining. IL-1α, IL-6, and PGE2 expression levels in serum were significantly decreased after treatment with ZZDX. ZZDX treatment significantly decreased the mRNA expression of IL-8 induced by H. pylori infection in gastric tissues. Elovl4, Acot1 and Scd1 might be involved in the mechanisms of ZZDX treatment. However, the H. pylori infection status in the gastric mucosa was not reduced after ZZDX treatment.ConclusionsZZDX reversed gastric mucosal injury and alleviated gastric mucosa inflammation induced by H. pylori infection.

Efficacy and safety of subanesthetic doses of esketamine combined with propofol in painless gastrointestinal endoscopy: a prospective, double-blind, randomized controlled trial

BackgroundPainless gastrointestinal endoscopy is widely used for the diagnosis and treatment of digestive diseases. At present, propofol is commonly used to perform painless gastrointestinal endoscopy, but the high dose of propofol often leads to a higher incidence of cardiovascular and respiratory complications. Studies have shown that the application of propofol combined with ketamine in painless gastrointestinal endoscopy is beneficial to reduce the dosage of propofol and the incidence of related complications. Esketamine is dextrorotatory structure of ketamine with a twice as great anesthetic effect as normal ketamine but fewer side effects. We hypothesized that esketamine may reduce the consumption of propofol and to investigate the safety of coadministration during gastrointestinal endoscopy.MethodsA total of 260 patients undergoing painless gastrointestinal endoscopy (gastroscope and colonoscopy) were randomly divided into P group (propofol + saline), PK1 group (propofol + esketamine 0.05 mg/kg), PK2 group (propofol + esketamine 0.1 mg/kg), and PK3 group (propofol + esketamine 0.2 mg/kg). Anesthesia was achieved by 1.5 mg/kg propofol with different doses of esketamine. Propofol consumption per minute was recorded. Hemodynamic index, pulse oxygen saturation, operative time, induction time, awakening status, orientation recovery time, adverse events, and Mini-Mental State Examination (MMSE) were also recorded during gastrointestinal endoscopy.ResultsPropofol consumption per minute was 11.78, 10.56, 10.14, and 9.57 (mg/min) in groups P, PK1, PK2, and PK3, respectively; compared with group P, groups PK2 and PK3 showed a decrease of 13.92% (P = 0.021) and 18.76% (P = 0.000), respectively. In all four groups, systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), but not pulse oxygen saturation (SpO2) significantly decreased (P = 0.000) immediately after administration of induction, but there were no significant differences between the groups. The induction time of groups P, PK1, PK2, and PK3 was 68.52 ± 18.394, 64.83 ± 13.543, 62.23 ± 15.197, and 61.35 ± 14.470 s, respectively (P = 0.041). Adverse events and psychotomimetic effects were observed but without significant differences between the groups.ConclusionsThe combination of 0.2 mg/kg esketamine and propofol was effective and safe in painless gastrointestinal endoscopy as evidenced by less propofol consumption per minute, shorter induction time, and lower incidence of cough and body movement relative to propofol alone. The lack of significant differences in hemodynamic results, anesthesia-related indices, adverse events, and MMSE results showed the safety to apply this combination for painless gastrointestinal endoscopy.Trial registration This study was registered with China Clinical Trial Registration on 07/11/2020 (registration website: chictr.org.cn; registration numbers: ChiCTR https://clinicaltrials.gov/ct2/show/2000039750).

Artificial intelligence: Emerging player in the diagnosis and treatment of digestive disease.

Given the breakthroughs in key technologies, such as image recognition, deep learning and neural networks, artificial intelligence (AI) continues to be increasingly developed, leading to closer and deeper integration with an increasingly data-, knowledge- and brain labor-intensive medical industry. As society continues to advance and individuals become more aware of their health needs, the problems associated with the aging of the population are receiving increasing attention, and there is an urgent demand for improving medical technology, prolonging human life and enhancing health. Digestive system diseases are the most common clinical diseases and are characterized by complex clinical manifestations and a general lack of obvious symptoms in the early stage. Such diseases are very difficult to diagnose and treat. In recent years, the incidence of diseases of the digestive system has increased. As AI applications in the field of health care continue to be developed, AI has begun playing an important role in the diagnosis and treatment of diseases of the digestive system. In this paper, the application of AI in assisted diagnosis and the application and prospects of AI in malignant and benign digestive system diseases are reviewed.

STUDY OF THE EFFECT OF FEED ADDITIVE OF SODIUM HUMATE FOR STERLET BY THE CAGE METHOD OF GROWING

The article presents the results of an experiment to assess the effect of feed additive of humates on the growth rate and survival of different age groups of sterlet (Acipenser ruthenus L., 1758) and the conversion of fish feed for keeping in aquaculture. Based on the analysis of sources of scientific and technical information, it was found that humic drugs have long been used in crop production as growth stimulants and microfertilizers, and in animal husbandry - to normalize metabolism, treatment of digestive diseases and general stimulating effect on the body as a whole. Analysis of data on the use of humates in aquaculture indicated the presence of a positive effect of these compounds on individual cultivation objects. The small amount of information on the use of humates in fish farming has led to the conclusion that this direction of fish farming intensification is still insufficiently studied, and that studies of the impact of humic substances on aquaculture objects are not comprehensive and mainly concern the assessment of individual effects of biologically active action of the compounds on fish. The available information gave grounds to speculate about the prospects for the use of humates in sturgeon farming. To test this assumption, a series of experiments was conducted on the feeding of sterlet feed with the addition of sodium humate. The research was conducted in 2018, 2020 and 2021, in the production conditions of the cage fishery, located on the Kaniv Reservoir. The effect of different concentrations of sodium humate feed additives on one- and two year old sterlet was evaluated. It was found that the addition of sodium humate to fish feed in concentrations of 60, 100, 120 and 200 mg / kg of feed did not significantly affect the growth rate of sterlet. Thus, the advantage of experimental variants over the control for this indicator was insignificant, in the range of 1.0-1.6%. The effect of sodium humate on the survival of this year sterlet, for their cultivation in gardens. At the same time, the best, by 6.7-17.4%, feed conversion with the addition of humates by one- and two-year-old sterlet was noted. According to the results of the experiments, the best result was obtained in the variant using a feed additive of humates at a concentration of 200 mg / kg of feed. It is considered promising to continue the study of the impact of feed additives of humates on the growth and survival of valuable aquaculture objects under different housing conditions, in particular in closed recirculation aquasystems (RAS), as well as finding the optimal concentration of these additives in feed for different species and age groups of fish.

Effect and Safety Analysis of Painless Gastroenteroscopy in the Diagnosis and Treatment of Digestive Diseases

Effect and Safety Analysis of Painless Gastroenteroscopy in the Diagnosis and Treatment of Digestive Diseases

G Protein-Coupled Estrogen Receptor, GPER1, Offers a Novel Target for the Treatment of Digestive Diseases.

There are gender differences between men and women in many physiological functions and diseases, which indicates that female sex hormones may be important. Traditionally, estrogen exerts its biological activities by activating two classical nuclear estrogen receptors, ESR1 and ESR2. However, the roles of estrogen in the regulation of physiological functions and the pathogenesis of diseases become more complicated with the identification of the G protein-coupled estrogen receptor (GPER1). Although many GPER1-specific ligands have been developed, the therapeutic mechanisms of exclusively targeting GPER1 are not yet well understood. Translational applications and clinical trial efforts for the identified GPER1 ligands have been focused primarily on the reproductive, cardiovascular, nervous, endocrine, and immune systems. More recently, research found that GPER1 may play an important role in regulating the digestive system. Cholesterol gallstone disease, a major biliary disease, has a higher prevalence in women than in men worldwide. Emerging evidence implies that GPER1 could play an important role, independent of the classical ESR1, in the pathophysiology of cholesterol gallstones in women. This review discusses the complex signaling pathways of three estrogen receptors, highlights the development of GPER1-specific ligands, and summarizes the latest advances in the role of GPER1 in the pathogenesis of gallstone formation.

Multicomponent Agents for Prevention and Treatment of Digestive Diseases

Introduction . In recent years, there has been a steady increase in gastroenterological diseases in many countries due to adverse environmental conditions and unsustainable nutrition. Diseases of digestive organs are not only chronic, but also combined, and varieties of synthetic drugs are widely used in therapy. The range of official multicomponent plant collections recommended in the therapy of diseases of the digestive system is limited, and their disadvantage is especially felt in the treatment of chronic hepatitis, gastric ulcer, cholecystitis. Aim . Search and creation of new multicomponent agents for prevention and complex treatment of digestive system diseases. Materials and methods . The objects of the study were developed multi-component means: «Pentafit», «Octafit», «Hexafit». To assess the pharmacotherapeutic effect of the developed agents «Pentafit» hepatoprotective activity studied in experimental models tetrachloromethane and D-galactosamine hepatitis, «Octafit» gastroprotective activity studied in models of acute aspirins, neurogenic and chronic butadione ulcer, с holeretic activity of «Hexafit» as studied in models of experimental cholecystitis and toxic liver damage using laboratory animals. The results of the studies processed statistically using the Statistica 10 program. Results and discussion . Based on the obtained data, the general patterns in molecular biological action of the studied multicomponent agents revealed, which consist in their ability to inhibit the free radical oxidation of lipids and stabilize the biological membranes of gastric cells and organs of the hepatobiliary system. «Pentafit» profitably distinguished by its multilateral nature of influence on the functional state and structure of the organs of the liver. «Octafit» provides accelerated healing and restoration of damaged structures of functional systems of the stomach. «Hexafit» secreted by the polyvalent spectrum of action in case of damage to the hepatobiliary system. Conclusion . Developed multicomponent drugs will expand the register of medicines of plant origin of domestic production for the prevention and treatment of digestive diseases.

Design and implementation of a novel wireless modular capsule robotic system in pipe

Capsule endoscopy is a new type of technology in the diagnosis and treatment of digestive diseases, with painless and low invasive features. However, current capsule robots have many problems, such as over-sized, single function and lack of active locomotion control. This study proposed and designed a new wireless modular capsule robotic system in pipe. The modular capsule robots could move forward and backward in the pipe in the axial direction, turn in a bending environment, and achieve the rendezvous and separation action through the three-dimensional rotating magnetic field generated by the three-axis Helmholtz coils. In this paper, the drive system of the three-axis Helmholtz coils, the power supply control system, and the modular capsule robot structure were analyzed and designed respectively. Finally, a series of characterization experiments were carried out to evaluate the motion characteristics of the modular capsule robots, including the influence of the flow environment imitated to human body's gastrointestinal motility, the frequency of the input signal, and the different structure of the robots on the movement characteristics of the modular capsule robot in this study. The study also evaluated the turning characteristics of robots. Experimental results showed that under different circumstances, modular capsule robots had good motion characteristics, and the effectiveness of the modular functionality had also been verified.

Antacids and their role in treatment of digestive diseases in pregnant women

Antacids are drugs that can neutralize or buffer the hydrochloric acid of the stomach without affecting its production. History of the clinical use of antacids dates back several centuries. The article discusses the advantages and disadvantages of modern antacids, provides a classification of drugs of this group, considers the mechanisms of their action, explains the term “acid-neutralizing activity”, lists indications for the use of antacids and possible adverse effects of antacid therapy. The results of various foreign and domestic studies on the use of acid-suppressive drugs, including antacids, are presented.
 Currently, antacids continue to be used for the symptomatic treatment of certain acid-dependent diseases, including gastroesophageal reflux disease (GERD). Due to a number of physiological reasons, GERD often worries pregnant women, most often in the third trimester of pregnancy. The choice of acid-suppressing agents in pregnant women is extremely limited, because the possibility of prescribing any drugs in this category of patients is determined by the safety of the drug, its tolerability, and the absence of teratogenic effects. Features of the mechanism of action of antacids, their favorable pharmacological properties determine the possibility of using modern combined drugs of this group during pregnancy. Relieving heartburn in pregnant women through the use of non-absorbable combined antacids is supported by the FDA, the European guidelines for the treatment of GERD. The article lists antacid drugs registered in the pharmaceutical market, special attention is paid to drugs approved for use during pregnancy.

Is gastrointestinal motility related to alkaloids of Charred Semen Arecae?

Ethnopharmacological relevanceSemen Arecae (SA) is one of the most commonly used Traditional Chinese Medicine. Charred Semen Arecae (CSA) is the processed product of SA. Alkaloids are considered as pharmacological mechanisms of SA and CSA on gastrointestinal motility. Recent studies have shown alkaloids decreased quickly after procession. However, the promoting on gastrointestinal motility were not decreased.Is gastrointestinal motility related to alkaloids of CSA? This study explored the effects of SA, CSA, Semen Arecae-Removal (SA-R), and Charred Semen Arecae-Removal (CSA-R) on gastrointestinal motility, Gastric Inhibitory Polypeptide (GIP), Glucagon Like Peptide-1 (GLP-1), gastric juice and bile in rats. Material and methodsRats were randomly divided into six groups, including the Control group, SA group, CSA group, SA-R group, CSA-R group, and Positive drug group (Mosapride). Alkaloids of samples were knocked out by using the “target constituent removal” strategy. Gastric residue and intestinal propulsion rate were evaluated in rats. Serum levels of GIP and GLP-1 were measured by Enzyme-Linked Immunosorbent Assay (ELISA). Gastric juice and bile were examined, respectively. ResultsCSA-R and SA-R have been investigated by the Preparative Thin-layer Chromatography (PTLC) method. Intestinal propulsion and gastric residue assessments confirmed the effectiveness of CSA and CSA-R. CSA-R was higher than SA-R in the GLP-1, pepsin activity, the secretion of bile, Bilirubin (BIL), and Cholesterol (CHO). The statistical comparison demonstrated that there is no difference between the CSA group and CSA-R group. ConclusionsAfter processing, the promoting gastrointestinal motility might be not related to alkaloids. Maillard reaction could be produced to promote the secretion of GLP-1, bile, and CHO for gastrointestinal motility. Our findings provide a pharmacological reference for the clinical application of SA and CSA in the treatment of digestive diseases.