DIGESTION消化
DIGESTION(英文缩写 DIGESTION),ISSN 0012-2823,eISSN 1421-9867,中文译名:消化 是一本学术期刊。本页汇总该期刊的最新影响因子、分区信息以及最新收录于 PubMed 的文献,帮助您快速了解期刊全貌。
发文量统计区间：2025-11-01 至 2026-10-31，按本站收录文献的发表日期统计。
期刊介绍
历年影响因子趋势
| JCR 数据年份 | 影响因子 | JCR 分区 |
|---|---|---|
| 2021 | 3.672 | Q3 |
| 2022 | 3.200 | Q3 |
| 2023 | 3.000 | Q2 |
| 2024 | 3.600 | Q2 |
| 2025 | 3.400 | Q2 |
DIGESTION 最新收录文献
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1. AI-generated guidance for non-specialist physicians managing inflammatory bowel disease: expert evaluation and case-based testing of GPT-4 and DeepSeek.
1. 面向管理炎症性肠病的非专科医生的AI生成指南：对GPT-4和DeepSeek的专家评估与基于病例的测试PMID:日期:2026-09-29Shortages of inflammatory bowel disease (IBD) specialists, particularly in China and other resource‑constrained settings, mean that many patients are managed by non‑specialist physicians. Artificial intelligence (AI) models may provide clinical guidance, but their practical value for non‑specialists remains uncertain. We evaluated the quality of AI‑generated IBD guidance and its utility for non‑specialist physicians using standardized, case‑based clinical vignettes. Twenty real-world IBD clinical questions submitted by non-specialist physicians and one standardized case vignette were entered into GPT-4 and DeepSeek using identical prompts. Seven IBD specialists independently rated response accuracy and completeness on 5-point Likert scales, and 12 non-specialist physicians rated clinical usefulness. The 12 non‑specialist physicians completed a two‑round cross‑over, pre-post case‑based test using 20 IBD clinical vignettes to evaluate whether reviewing AI outputs improves responses to common management vignettes. Both models produced generally accurate and complete answers (median expert scores ≥4.0/5). Experts rated DeepSeek higher for the accuracy and completeness of diagnosis,treatment and, and follow-up. After reviewing AI answers, non‑specialist physicians' case‑based test scores improved significantly: median per‑round score (0-10) increased from 5.5 to 8.0 for GPT‑4 (Δ=3.0, p<0.001) and from 6.0 to 8.0 for DeepSeek (Δ=2.5, p<0.001). The between‑model difference in score change was not significant (p=0.781). Across both models, common limitations included limited patient‑level individualization, inconsistent red‑flag/referral triggers, and lack of verifiable, time‑stamped references; no harmful recommendations were identified, but safety omissions were present in both models. GPT-4 and DeepSeek generated relatively accurate and comprehensive guidance and improved non-specialist physicians' performance in IBD case vignettes testing, supporting their potential as adjunct educational and reference tools for clinical reasoning. If implemented clinically, AI-based support should incorporate explicit safety prompts (red flags and referral triggers), and be validated prospectively within real-world workflows.
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2. Upadacitinib for Acute Severe Ulcerative Colitis: Real-World Tertiary Care Outcomes.
2. 乌帕替尼治疗急性重度溃疡性结肠炎：真实世界三级医疗中心结局PMID:日期:2026-09-29Background Acute severe ulcerative colitis (ASUC) affects up to 25% of patients with ulcerative colitis. Despite intravenous (IV) corticosteroids as first-line therapy, 30-40% require rescue treatment and up to 40% undergo colectomy within one year. Upadacitinib (UPA) has shown ability to induce rapid response in moderate-severe UC, but real-world data in ASUC remain limited. We aimed to describe outcomes of UPA initiation for ASUC across Mayo Clinic sites. Methods We conducted a descriptive study of 23 adults hospitalized with ASUC between 2022-2025 at Mayo Clinic. Patients with their first ASUC admission who were started on UPA were included. All patients received IV methylprednisolone (40-60 mg/day) within 24-48 hours of admission, followed by UPA initiation (inpatient or shortly after discharge). Clinical, laboratory, and treatment data were extracted from electronic medical records. Outcomes included colectomy during admission and colectomy within one year. Descriptive statistics were done using Microsoft Excel. Results Twenty-three patients received UPA (median age 35 years; 88% pancolitis; 4% PSC). Out of the 23, 18 were started on UPA during the ASUC admission. Before admission, 10 patients (43%) were receiving corticosteroids, three (13%) were on mesalamine, one (4%) on azathioprine, and 12 (52%) were on biologic therapy; four patients (17%) were already on lower dose UPA maintenance. The median number of prior advanced therapies was two (range 1-4). Admission labs showed a mean CRP of 56.3 mg/L (SD 44.9) and fecal calprotectin of 2521.9 µg/g (SD 783.9). Patients received IV corticosteroids for a mean of 3.7 days (SD 1.1), and UPA was initiated at a median of hospital day 3 (IQR 4). 2/18 patients (11.1%), who were started on UPA inpatient, required colectomy during admission. Of the 23 patients who received UPA during hospitalization or shortly after discharge, one year colectomy rate was 4/23 (17%). Conclusions In this cohort, initiation of UPA during hospitalization or shortly after discharge for ASUC was feasible and was associated with lower colectomy rates compared with published outcomes for patients treated with infliximab or cyclosporine, both during hospitalization (11.1% vs. 21% vs. 25%) and at one year (17% vs. 35% vs. 45%). These findings suggest that UPA may serve as an effective rescue option for hospitalized ASUC patients, particularly when rapid control of inflammation is needed. Larger prospective studies are warranted to confirm these observations and to define optimal timing, patient selection, and long-term safety in the ASUC setting.
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3. Efficacy and safety of remimazolam sedation for gastrointestinal endoscopy in elderly versus non-elderly patients.
PMID:日期:2026-09-29This study aimed to evaluate the efficacy, recovery profile, and safety of remimazolam sedation during gastrointestinal (GI) endoscopy in elderly and non-elderly patients. This post hoc secondary analysis used data from a multicenter randomized controlled trial of remimazolam vs. midazolam for sedated GI endoscopy in Japan (jRCTs071240062). Patients receiving remimazolam were divided into elderly (≥65 years, n=19) and non-elderly (n=20) groups. Outcomes included sedation success, sedative dose, time to awakening, time to ambulation, and adverse events. Sedation was successful in 100% of patients in both groups. ASA-PS class I was less common in the elderly group (26.3% vs. 65.0%, p=0.025), whereas the upper/lower GI endoscopy ratio did not differ (12/7 vs. 8/12, p=0.205). Total remimazolam dose was significantly lower in the elderly group (3.7 ± 0.9 vs. 5.7 ± 1.6 mg, p<0.001). More elderly patients were sedated with the initial dose alone (52.6% vs. 5.0%, p=0.001). Time to awakening (1.9 ± 3.5 vs. 0.8 ± 1.8 min, p=0.205) and ambulation (3.9 ± 3.7 vs. 2.0 ± 2.5 min, p=0.077) did not differ significantly. Adverse events were observed only in the elderly group (4/19 [21.1%] vs. 0/20, p=0.047), including hypoxemia (n=2), hypertension (n=1), and hypotension (n=1), all of which were mild and resolved with minimal intervention. Remimazolam provided effective sedation for GI endoscopy, and elderly patients received a lower total dose under the study protocol. Although these adverse events were mild and resolved with minimal intervention, their occurrence in elderly patients warrants careful monitoring. These exploratory findings warrant confirmation in adequately powered prospective studies.
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4. Epigenetic and Transcriptional Dysregulation of Ribosomal Genes in Esophageal Adenocarcinoma: A Multi-omics Mendelian Randomization Study.
4. 食管腺癌中核糖体基因的表观遗传和转录失调：一项多组学孟德尔随机化研究PMID:日期:2026-09-22The rising incidence and poor prognosis of esophageal adenocarcinoma (EAC) highlight the urgent need to identify novel molecular determinants. Ribosome heterogeneity has emerged as a potential factor in carcinogenesis, yet its causal relevance in EAC remains unclear. We aimed to systematically evaluate the causal effects of ribosome-related genes on EAC risk by integrating multi-omics data. We applied summary-data-based Mendelian randomization (SMR) to analyze 1,329 ribosome-related genes, integrating mQTL, eQTL, pQTL data and a large EAC GWAS. Bayesian colocalization and esophageal tissue transcriptome analyses validated causal signals. We compared mRNA/protein levels of candidate genes in normal HET-1A esophageal cells versus EAC cell lines OE33 and OE19, and validated methylation-gene correlations using the TCGA-ESCA cohort. Crucially, functional assays, including CCK-8, Transwell, colony formation, and apoptosis assays, were performed in OE33 cells following gene overexpression to verify their causal roles. SMR analyses identified EIF2B2 and RPS6KL1 as causal protective genes for EAC; genetically elevated expression of both reduced EAC risk. A regulatory cascade was uncovered, whereby specific CpG methylation repressed gene transcription to alter disease susceptibility. Consistently, EIF2B2 and RPS6KL1 mRNA and protein were markedly lower in OE33/OE19 tumor cells than HET-1A. TCGA data confirmed negative correlation between RPS6KL1 promoter cg19899223 methylation and gene expression (ρ = -0.27, p = 0.00015). Functionally, overexpression of EIF2B2 and RPS6KL1 in OE33 cells significantly suppressed cell viability, invasion, and colony formation, while inducing apoptosis, thereby experimentally validating their tumor-suppressive effects. By integrating multi-omics evidence with functional assays, this study identifies EIF2B2 and RPS6KL1 as causal protective factors in EAC etiology. These findings suggest that maintaining ribosomal homeostasis via these genes acts as a barrier against EAC, highlighting their potential for risk stratification and therapeutic targeting.
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5. High infiltration level of a prognostic improvement associated T cells is favorable for the prognosis of patients with gastric adenocarcinoma.
5. 一种与预后改善相关的T细胞高浸润水平有利于胃腺癌患者的预后PMID:日期:2026-09-22Gastric cancer is the fifth most common cancer and the third leading cause of cancer-related deaths worldwide. Currently, research on the tumor microenvironment of gastric cancer remains to be developed. In this study, we obtained scRNA-seq data of gastric cancer from the GEO database, and used the Seurat package for clustering. We used the Bayesian cell Proportion Reconstruction algorithm to calculate the cell subpopulation content in TCGA samples, and combined it with TCGA survival data to perform Kaplan-Meier and univariable Cox analyses. We further performed multivariable Cox regression analysis incorporating age, sex, TNM stage, and histological type to evaluate the independent prognostic value of PIA T-cells. We found that a prognostic improvement associated T cells (PIA T-cells) had a better prognosis in gastric adenocarcinoma tissues with higher levels of PIA T-cells. To further characterize the biological identity of this population, we analyzed canonical T-cell functional markers and found that PIA T-cells exhibited a distinct phenotypic profile (CD4(low/negative), CD8A(moderate), GZMB(moderate), IFNG(low)), distinguishing them from other T-cell subsets. Unlike other T cell subpopulations, PIA T-cells expressed significantly higher levels of eight genes (ASPM, ATAD2, CENPF, DUT, MKI67, NUSAP1, TOP2A, and TYMS). The study of PIA T-cells may provide insights into gastric cancer tumor microenvironment-related treatments and inform future therapeutic strategies.
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6. Follicular dendritic cell staining pattern as a prognostic marker for the watch-and-wait policy in patients with gastrointestinal follicular lymphoma.
6. 滤泡树突细胞染色模式作为胃肠道滤泡性淋巴瘤患者观察等待策略的预后标志物PMID:日期:2026-09-09Gastrointestinal follicular lymphoma (GI-FL) patients with low tumor burden are often managed with a "watch and wait" (W&W) strategy, but regular endoscopic examinations impose a significant burden. We investigated whether the follicular dendritic cell (FDC) staining pattern of GI-FL lesions could help identify a lower-risk subgroup of patients during W&W follow-up. We studied 76 Japanese patients with GI-FL (September 2003-July 2022), classified by CD21 staining into "duodenal pattern" (n=57) and "nodal pattern" (n=19) groups. All patients underwent regular clinical, endoscopic, and imaging follow-up. Progression-free survival (PFS), time to treatment required (TTR), and overall survival (OS) were compared between the two groups. Patients with a "duodenal pattern" had better outcomes than those with a "nodal pattern." In the "duodenal pattern" group, 25 of 57 patients (43.9%) progressed, but only 9 (15.8%) required treatment. In the "nodal pattern" group, 14 of 19 patients (73.7%) progressed and all required treatment; 8 (42.1%) developed local compressive symptoms necessitating immediate treatment, versus none in the "duodenal pattern" group. OS was excellent in both groups. The FDC staining pattern of the tumor is a useful marker for the management of patients with GI-FL. Patients with an FDC "duodenal pattern" have slower disease progression and rarely require treatment. These findings suggest that the "duodenal" FDC pattern may help identify candidates for future prospective studies of individualized or de-escalated surveillance, which could ultimately reduce the physical and financial burden of follow-up while maintaining good outcomes.
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7. Semaglutide and Tirzepatide for the treatment of MASH: What Works, What's Coming, and What's Missing.
7. 司美格鲁肽与替尔泊肽治疗MASH：哪些有效，哪些即将到来，哪些尚缺失PMID:日期:2026-09-09Metabolic dysfunction-associated steatotic liver disease (MASLD) and its progressive form, metabolic dysfunction-associated steatohepatitis (MASH), are increasingly prevalent conditions closely linked to obesity, insulin resistance, and cardiometabolic diseases. Although lifestyle modification remains the cornerstone of management, it frequently fails to achieve sustained histologic improvement, suggesting that patients require effective pharmacologic therapies. Incretin-based treatments, including glucagon-like peptide-1 (GLP-1) receptor agonists and newer dual agonists additionally targeting glucose-dependent insulinotropic polypeptide (GIP), have emerged as promising disease-modifying options. These agents improve hepatic steatosis primarily through weight reduction and enhanced insulin sensitivity, while also exerting pleiotropic effects on inflammation, and lipid metabolism. Phase 2 clinical trials consistently demonstrate improvement in steatohepatitis with GLP-1 receptor agonists, with encouraging signals of fibrosis improvement observed with dual agonists such as tirzepatide. Interim data from a phase 3 clinical trial with semaglutide show clinically meaningful benefits in both MASH resolution and fibrosis regression. These findings have led to accelerated regulatory approval of semaglutide for the treatment of non-cirrhotic MASH with stage F2-F3 fibrosis. In addition to hepatic effects, incretin-based therapies provide substantial cardiometabolic benefits, reinforcing their relevance in a disease strongly associated with cardiovascular risk. Overall, mono- and dual-incretin agonist therapies represent a significant advance in the treatment landscape of MASLD/MASH, although long-term outcome data are required to confirm durability, safety, and impact on major adverse liver-related outcomes.
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8. Lactose sensitivity and malabsorption in functional dyspepsia and functional dyspepsia-irritable bowel syndrome overlap.
8. 功能性消化不良及功能性消化不良-肠易激综合征重叠中的乳糖敏感性与吸收不良PMID:日期:2026-09-07Lactose intolerance is frequently suspected in disorders of gut-brain interaction, yet symptoms often do not align with objective malabsorption. While lactose-related symptoms have been investigated in irritable bowel syndrome, data on functional dyspepsia, particularly patients with overlapping irritable bowel syndrome, remain limited. This study examined the relative contribution of lactose sensitivity and lactose malabsorption to symptom burden, and evaluated whether functional dyspepsia-irritable bowel syndrome overlap is associated with greater symptom severity than functional dyspepsia alone. In this cross-sectional study, adults underwent standardized lactose hydrogen breath and symptom testing. Diagnoses followed Rome IV criteria. Lactose malabsorption was defined as ≥20 ppm hydrogen increase; lactose sensitivity as ≥20 mm rise on the adult Carbohydrate Perception Questionnaire. Group differences were tested non-parametrically; adjusted effects used a general linear model with age and gender. Among 587 patients, lactose sensitivity was more prevalent than lactose malabsorption (54.9% versus 41.2%; p < 0.001) and occurred more frequently in patients with functional dyspepsia-irritable bowel syndrome overlap than in those with functional dyspepsia alone (69.8% versus 52.7%; p < 0.001). Patients with overlap exhibited the highest symptom burden (p < 0.001). In multivariate analysis, lactose sensitivity and younger age were independently associated with functional dyspepsia-irritable bowel syndrome overlap, whereas lactose malabsorption and gender were not. Lactose sensitivity, not malabsorption, was closely associated with symptom burden in patients with functional dyspepsia. Functional dyspepsia-irritable bowel syndrome overlap was linked to amplified burden, underscoring the importance of validated symptom assessment alongside breath testing for diagnostic precision.
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9. The efficacy and safety of Helicobacter pylori eradication regimens in patients receiving hemodialysis: a systematic review and network meta-analysis.
9. 接受血液透析患者中幽门螺杆菌根除方案的有效性和安全性：系统评价和网络荟萃分析PMID:日期:2026-09-05Helicobacter pylori eradication is clinically important in patients on hemodialysis (HD), who are at risk for serious gastrointestinal complications. However, altered drug metabolism and antibiotic resistance in patients on HD complicate H. pylori eradication. This study aimed to perform a network meta-analysis to synthesize existing evidence on the efficacy and safety of H. pylori eradication regimens in patients on HD. We searched MEDLINE, the Cochrane Library, EMBASE, Ichushi-web, ICTRP, and ClinicalTrials.gov. Two reviewers independently selected randomized controlled trials that evaluated H. pylori eradication therapy in patients undergoing HD. We performed a frequentist random effects network meta-analysis. The primary outcome was eradication rate, and the secondary outcomes were treatment completion rates and all adverse events. We used CINeMA to assess the confidence in the evidence. The study protocol was registered at OSF (https://osf.io/gn978/). Ten trials involving 481 patients were included in the analysis. Seven eradication regimens were compared: six concomitant and one sequential regimen. Relative to standard-dose proton pump inhibitor/clarithromycin/amoxicillin regimens (PAC), the evidence is very uncertain about the effect of the proton pump inhibitor/clarithromycin regimen on the eradication rate (odds ratio, 0.11; 95% confidence interval, 0.01-1.07). For reduced-dose PAC (in which clarithromycin or amoxicillin is dose-reduced), alternative regimens (with azithromycin, metronidazole, or levofloxacin), and sequential regimens, the estimates were too imprecise to determine whether a difference from PAC exists (low certainty). Treatment completion rates were generally favorable (83-100%), and adverse events were most frequent with standard-dose PAC (45%). Reduced-dose PAC and alternative and sequential regimens may be considered for H. pylori eradication in patients on HD.
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10. Risk of Extra-Intestinal Solid Organ Malignancy in Patients with Inflammatory Bowel Disease: A Propensity-Matched Cohort Study.
PMID:日期:2026-08-27There is limited and conflicting data regarding the risk of thyroid, kidney and prostate cancer in patients with inflammatory bowel disease (IBD). This was a retrospective cohort study using the U.S. Collaborative Network comparing the risk of thyroid, kidney and prostate cancer in the IBD compared to non-IBD (control) cohort. One-to-one propensity score matching (PSM) was performed for demographics and co-morbid conditions. Cox proportional hazard model was used to identify risk factors for each cancer. There were 200,280 matched pairs in the IBD and control cohort (mean age 43.7 +/- 19.5, 46.1% male, 76% White). There was an increased risk of thyroid (aOR 1.37, 95% CI 1.19-1.59), kidney (aOR 1.37, 95% CI 1.22-1.54) and prostate (aOR 1.39, 95% CI 1.29-1.151) cancer in the IBD compared to the control cohort. This was consistent based on IBD sub-type and sex. Racial/ethnic disparities were observed with respect to risk of each cancer. IBD cohort aged 18-39 was associated with increased risk (aOR 1.41, 95% CI 1.08-1.84) of thyroid but not kidney or prostate cancer compared to control cohort. Long-term steroid use was associated with an increased risk of thyroid (HR 1.92, 95% CI 1.15-3.20) and kidney (HR 1.52, 95% CI 1.25-1.86) cancer. T2DM and obesity were associated with an increased risk of all three cancers in the IBD cohort. We observed an increased risk of extra-intestinal solid organ malignancy, specifically thyroid, kidney and prostate cancer in patients with IBD.