2018年 · 第38卷第01期

At the end of the year and the beginning of the year, it is a time to summarize the past and look forward to the future. On the occasion of waving goodbye to 2017, it coincides with the 100th anniversary of Shanghai Medical Association. Looking back at the arduous development of the Society for a century, I am happy to see the fruitful achievements of this journal today, and even more remember those sages who have worked together and helped together for the development of the Society and the journal. Chinese Journal of Digestion was founded in Shanghai in 1981. Under the correct guidance and direct leadership of Shanghai Medical Association, the journal has made great progress in academic influence, editing quality and journal operation, and won many important awards in the industry.

Dysphagia refers to pharyngeal or retrosternal obstruction, adhesion, and discomfort caused by obstruction of the transport of solid or liquid food from the mouth to the cardia and stomach^[1]。 Dysphagia can originate from the oropharynx or esophagus. The former is often caused by neuropathy, and the latter can be roughly divided into mechanical obstruction and motility disorder^[2]。 Non-obstructive dysphagia of esophageal origin is an esophageal origin with a sensation of obstruction or adhesion within the esophagus when swallowing solid or liquid food, while endoscopic or imaging examination lacks evidence of stenosis. Esophageal manometry is one of the important examination methods for the etiological diagnosis of non-obstructive esophageal dysphagia. High-resolution esophageal manometry is a new technique to assess esophageal motility, which can provide more comprehensive, detailed and accurate results than traditional manometry. Chicago Classification Standard is a new classification method for esophageal motility disorders based on high-resolution esophageal manometry. It is the most influential diagnostic standard in the field of high-resolution esophageal manometry^[3]。 At present, there are few studies to analyze the characteristics of esophageal motility in patients with non-obstructive esophageal dysphagia using Chicago classification criteria. In this study, 48 patients with non-obstructive esophageal dysphagia were analyzed with high resolution esophageal manometry, and the characteristics of esophageal motility were analyzed by Chicago classification.

UC is a kind of IBD, and its pathogenesis is not very clear. It is generally believed that it is related to genetic, environmental, infection, immune and other factors. The main clinical manifestations of UC are diarrhea, abdominal pain, mucus, pus and bloody stool, etc., and often combined with different degrees of hypocalcemia. As a chronic intestinal lesion, patients with UC inevitably have malabsorption and massive loss of calcium. Patients with UC who need parenteral nutrition support may have more serious problems of calcium absorption and loss. However, there are few related studies and reports on the incidence of hypocalcemia in IBD patients. In this study, the incidence of hypocalcemia and related risk factors were retrospectively analyzed in patients with UC before receiving parenteral nutrition support, so as to provide a basis for the rational clinical formulation of parenteral nutrition regimen.

Dieulafoy disease (Dieulafoy disease) is one of the rare causes of gastrointestinal bleeding, especially the upper gastrointestinal tract is more prominent, which can lead to massive bleeding and endanger patients' lives. The disease has acute onset, heavy bleeding, hidden lesions, easy misdiagnosis and misdiagnosis, and high mortality if not treated in time. In the past, most reports of Dieulafoy's disease at home and abroad were individual cases. With the popularization of endoscopy, endoscopic ultrasound and histopathological examination, the diagnosis rate of Dieulafoy's disease has also increased. The First Affiliated Hospital of Nanjing Medical University treated 21 patients with Dieulafoy's disease from April 2009 to September 2016. Now, the clinical characteristics, diagnosis and treatment of Dieulafoy's disease are analyzed and summarized based on the clinical data of the above patients, aiming to deepen clinicians' understanding of Dieulafoy's disease.

With the rapid development of orthopedic surgery, the clinical application of metal implants is increasingly widespread, and the complications brought by them cannot be ignored. Although dental implants rarely have adverse reactions, there are still reports of local skin and mucosa damage in the oral cavity. Severe esophageal inflammatory reaction or even high-grade intraepithelial neoplasia caused by dental implants are rarely reported. An elderly patient with strong rejection after titanium tooth implant was admitted. After multidisciplinary discussion, the esophageal lesion healed after successful removal of the dental implant and there was no abnormality in the follow-up for nearly 2 years. The report is now as follows.

Artificial intelligence is undoubtedly the research hotspot at present, and it will bring a new round of revolutionary changes to human society. As one of the important branches of modern artificial intelligence, artificial neural network (neural network for short) is the focus of research. Neural network is a computer program that can simulate the way the human brain processes information, identify patterns and relationships through data training like humans, gain experience from them and learn by themselves. Neural networks are a very promising modeling tool, with applications including classification or pattern recognition, prediction, and modeling^[1]。 Recently published inNatureA study showed that the neural network system trained with 129,450 pictures was able to differentiate keratinocytic carcinoma from benign seborrheic keratosis, and malignant melanoma from benign pigmented nevus. The AUC value in all cases exceeded 91%, which was comparable to or even higher than the diagnostic ability of 21 dermatologists^[2]。 In the field of digestive diseases, the application of neural network mainly focuses on prognosis analysis and image recognition. Now, focusing on these two aspects, the application progress of neural network in the diagnosis and treatment of digestive diseases is introduced.

thyroid hormone receptor interactor 6 (TRIP6), also known as Zyxin-related protein 1 (ZRP-1), is a regulatory protein belonging to the Zyxin family of LIM proteins. TRIP6 was first discovered as a protein that interacts with the nuclear thyroxine receptor, and later was recognized as a local adhesion molecule, which can recruit various molecules and participate in actin cytoskeleton reorganization, cell adhesion, cell migration, anti-apoptotic response and transcriptional regulation. TRIP6 can participate in lysophosphatidic acid-2 (LPA2) -Fas/CD95-mediated cell migration, and can increase cell invasiveness by interacting with MAGI-1b PDZ scaffold protein; It can also regulate LPA2-mediated anti-apoptotic signaling pathway, counter Fas/CD95-induced apoptosis, and regulate NF-κ B signaling pathway^[1]。 In addition, TRIP6 also exerts telomere protection functions by affecting human protection of telomere 1 (POT1) and telomeric repeat binding factor-2 (TRF2). Although many physiological functions of TRIP6 are still unclear, recent studies have shown that TRIP6 plays an important role in tumor progression and may become a new therapeutic target.