摘要：2025年3月，第二季“中国之声，创新力量——中国原创优秀临床研究展播”活动再次起航。本次活动将立足新起点，通过更立体化的传播形式、更国际化的视角，展现中国医务工作者破解临床难题的智慧与担当，助力科研成果转化。为此，我们推出“Global Perspectiv

作者：《柳叶刀·胃肠病学和肝脏病学》主编 Rob Brierley

2025年3月，第二季“中国之声，创新力量——中国原创优秀临床研究展播”活动再次起航。本次活动将立足新起点，通过更立体化的传播形式、更国际化的视角，展现中国医务工作者破解临床难题的智慧与担当，助力科研成果转化。为此，我们推出“Global Perspectives, Dialogue with Editors-in-Chief”权威期刊主编对话环节，以期搭建一架中国学者与权威期刊主编的沟通桥梁。

本期为大家带来《中国医学论坛报》与《柳叶刀·胃肠病学和肝脏病学》主编 Rob Brierley的对话。Rob Brierley为我们深入剖析当前胃肠病学和肝脏病学领域的研究趋势，分享他对中国在该领域研究进展的看法，并对中国青年学者如何在国际期刊上发表高质量研究成果方面给出宝贵建议，敬请关注！

中国原创，世界回响。让我们共同期待这场跨越时空的学术对话，如何点燃临床创新的星星之火，又如何照见人类抗击消化系统疾病的共同未来。

Global Perspectives,Dialogue with the Editor-in-Chief of The Lancet Gastroenterology & Hepatology

《柳叶刀·胃肠病学和肝脏病学》主编Rob Brierley

Q1

《柳叶刀·胃肠病学和肝脏病学》主编

Rob Brierley

There have been several trends in gastroenterology and hepatology research over the past few years. One area has been the growth in efforts to address the rising burden of metabolic dysfunction-associated steatotic liver disease (MASLD), which continues to grow in parallel with the global obesity epidemic. As the most prevalent form of chronic liver disease, research in this area—particularly in terms of treatment and prevention—is likely to have a substantial impact on medical care in the coming years.

近年来，胃肠病学和肝脏病学领域的研究呈现几大趋势。首先，一个重要方向是针对代谢相关脂肪变性肝病（MASLD）的研究日益增多，其疾病负担随全球肥胖流行持续加重。作为最常见的慢性肝病，这一领域的研究，特别是在治疗和预防方面的研究，可能会在未来几年对医疗实践产生深远影响。

The microbiome continues to be a fertile area of research, with the potential to shed light on disease pathogenesis, diagnosis, and management. Although still at a relatively early stage, and predominantly not quite ready to translate to clinical practice, research into the microbiome has great potential.

其次，肠道微生物群仍是极具潜力的研究方向，可能为疾病机制、诊断和管理提供新的见解。尽管目前这一领域的研究仍处于早期阶段，且大部分成果尚未转化为临床应用，但其发展前景十分广阔。

Elsewhere, there has been substantial growth in treatment options for individuals living with inflammatory bowel disease (IBD), and a growing recognition that IBD is a global disease, not limited to high-income countries.

再次，炎症性肠病（IBD）的治疗选择显著增多，人们也越来越认识到IBD是一种全球性疾病，而不仅限于高收入国家。

And finally, it is hard to ignore the growth in AI-related research, not only in gastroenterology and hepatology, but more broadly across all medical disciplines.

最后，人工智能（AI）相关研究的快速增长也不容忽视，这一趋势不仅存在于胃肠病学和肝脏病学领域，而是广泛覆盖所有的医学学科。

Q2

Rob Brierley

Research in gastroenterology and hepatology in China has gathered pace in terms of quality and impact in recent years. The focus on the development of immunotherapeutic options for gastrointestinal cancers—not only for hepatocellular carcinoma but also for oesophageal, gastric, and colorectal tumours—has been notable, with many new drugs breaking through to being approved internationally and not just in China. In line with global research trends, there has also been clear growth in high quality work from China on MASLD and IBD, and (although it falls outside the scope of The Lancet Gastroenterology & Hepatology) a huge amount of basic and translational research.

近年来，中国在胃肠病学和肝脏病学领域研究的质量和影响力正在迅速提升。针对胃肠道肿瘤（不仅限于肝细胞癌，还包括食管、胃和结直肠肿瘤）免疫治疗方案的研发备受瞩目，许多新药不仅在中国获批，更突破性地取得国际上多国药品监管机构的批准。与全球研究趋势一致，中国在MASLD和IBD领域的高质量研究同样有显著增长，并且还涌现了大量基础研究与转化研究成果，尽管后者不在《柳叶刀·胃肠病学与肝脏病学》的收录范围内。

Q3

Rob Brierley

AI holds great potential in gastroenterology and hepatology—indeed, gastrointestinal endoscopy was one of the first areas to rigorously explore the potential of AI in clinical practice, with computer-aided detection of polyps in routine colonoscopy. There are many potential opportunities for AI to change clinical practice for gastroenterologists and hepatologists, including detection and diagnosis of disease with medical imaging, improving our ability to predict treatment response or determine prognosis, and estimating risk of disease recurrence.

AI在胃肠病学和肝脏病学领域具有巨大潜力。事实上，消化内镜是率先开始严格探索AI在临床实践中应用潜力的领域之一，例如在常规结肠镜检查中利用计算机辅助检查息肉。AI有许多潜在的机会改变胃肠病学家和肝脏病学专家的临床实践，通过医学影像提升疾病检测与诊断能力、优化治疗应答预测和预后判断，以及评估疾病复发风险等。

However, progress with AI is not without its challenges. For instance, training on poor quality datasets can result in data bias, and in many instances, validation (especially in external, independent populations) remains suboptimal. The “black box” nature of many AI algorithms—ie, the inability to understand how they have reached a decision—is a concern, and a move to greater explainability is needed to improve trust in AI tools. Concerns also remain about how AI can be implemented into practice and what effect that might have on practitioners (for instance, there are concerns that the adoption of computer-aided detection in endoscopy could result in deskilling and impact on training of the next generation of endoscopists).

然而，AI发展也并非没有挑战。例如，基于低质量的数据集训练可能导致算法偏见，而且在许多情况下，验证仍然不够理想，尤其是在外部、独立人群中。许多人工智能算法的“黑箱”特性，即无法理解它们的决策过程，这同样是一个问题，需要提高可解释性以提高人们对人工智能工具的信任度。此外，如何将AI融入临床实践，以及这一变化可能对从业者带来的影响，仍然是重要问题。例如，在内镜检查中采用计算机辅助检测可能会导致医生技能退化，并且对培养下一代内镜医师产生不利影响。

Q4

Rob Brierley

A key aspect is addressing a question of wide relevance or potential impact, perhaps in a hot area of interest or in an under-researched clinical area. Reading broadly, attending webinars and conferences, and discussion with peers and colleagues is crucial to help identify and fine tune a question.

对于年轻的中国胃肠病学和肝脏病学研究者来说，我认为关键之一在于选择具有广泛相关性或潜在影响力的研究问题。这些问题可能是一个热门的研究领域，也可能是一个研究较少的临床领域。为了确定并优化这个研究问题，广泛阅读文献、参加网络研讨会和学术会议，以及与同伴和同事的讨论是至关重要的。

Once you’ve identified a question, it is essential that you design your study to answer it in as robust a fashion as possible—again, learn about appropriate study methodology from mentors and colleagues, seek early statistical advice, and seek potential collaborators; teamwork is vital. You are likely to need to start small, with simpler studies (eg, retrospective analyses of databases, case-control studies, etc) to help focus your area of interest and research.

一旦确定了研究问题，就必须以尽可能严谨的方式设计研究方案来回答它——再次强调，向导师和同事学习合适的研究方法、尽早寻求统计学建议以及寻求潜在的合作者非常重要；团队合作亦是关键。建议大家可以从较小的、更简单的研究开始，例如数据库的回顾性分析、病例对照研究等，通过这些研究来逐步聚焦和明确自己的研究兴趣点。

Writing up your research can seem a daunting prospect but thankfully resources to provide advice and support are increasingly available—for instance, The Lancet Group offers publishing excellence webinars (https://www.thelancet.com/publishing-excellence-webinars) and our Editors frequently deliver talks and workshops on publishing in high-impact journals.

此外，《柳叶刀》系列期刊的编辑也经常举办关于如何在高影响力期刊发表论文的讲座和研讨会。

第二季“中国之声，创新力量——中国原创优秀临床研究展播”活动即将再次起航，敬请期待！

来源：壹生