摘要：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。

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《胃肠病学》主编Dr.David S. Weinberg的对话。Dr.David S. Weinberg为我们深入分析了当前胃肠病学领域的研究趋势，同时也诚恳指出中国研究投稿在选题及影响力考量上的提升空间。此外，他还对AI在胃肠病学领域的应用前景、临床研究的难点与重要性等发表了独到见解。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 Gastroenterology

Q1

《胃肠病学》杂志主编

David S. Weinberg 博士

I think there are at least two major areas of research in gastroenterology that are moving forward quickly and will have a great impact on many patients.

我认为在胃肠病学领域至少有两个主要的研究方向正在迅速发展，并将对许多患者产生重大影响。

Ⅰ. Research on Liver Diseases

Ⅰ.肝脏疾病研究

The first is the study of metabolic-associated liver disease or MASLD (used to be called NAFLD, also known as fatty liver by some). It affects millions globally. In the West, it’ll soon be the leading cause for liver transplantation. In China, though obesity isn’t as big a health concern as in the West for now, MASLD is still important. As Chinese diets evolve and obesity levels rise, it’ll be more of a problem.

首先是代谢相关脂肪变性肝病的研究，即MASLD（以前被称为NAFLD，也被一些人称为脂肪肝）。这种疾病影响着全球数百万人。在西方国家，它即将成为肝移植的主要原因。在中国，虽然目前肥胖问题没有西方国家那么严重，但MASLD依然是一个重要的问题。随着中国饮食结构的改变和肥胖率的上升，这一问题将变得更加突出。

Much progress has been made against viral hepatitis B and C, they are still major global issues. Two significant papers by Chinese authors in Gastroenterology this year focused on a new animal model and treatment for hepatitis E, which has been cited multiple times and is likely an important contribution. So liver disease, I think, is one of the very important things.

病毒性肝炎领域同样值得关注，乙肝和丙肝防治已取得显著进展，但仍是全球的重大公共卫生挑战。得关注的是，近两年《胃肠病学》刊登的中国学者关于戊型肝炎新型动物模型及治疗方案的论文引发学界高度关注，这项突破性研究已获多次引用。

Ⅱ. Advancements in Endoscopy

Ⅱ.内镜技术新进展

The other area are the continued advances in endoscopy. These advances can be due to AI helping identify colon polyps better or technological improvements making interventional endoscopists more capable of doing what previously required surgery.

另一个方向是内镜技术的持续突破。这些进展既包括人工智能辅助更精准地识别结肠息肉，也包括技术改进使介入内镜医生能完成过去需外科手术的复杂操作。

In my hospital with many cancer patients and bowel obstructions from cancer, when I started, most obstructions were fixed by surgery or, sometimes, stent placement via endoscopy. Now, many are fixed by endoscopically connecting two parts of the bowel to bypass the obstruction, which is a more durable advance and requires less patient recovery time.

I can give lots of examples of how endoscopy is expanding our ability to minimize patient disease and suffering that was previously only possible through surgery.

以我所在医院为例，过去治疗癌症患者肠梗阻多依赖外科手术或内镜支架置入，而现在，许多病例可通过内镜下肠道吻合术实现梗阻段旁路治疗，这一进展不仅显著提升治疗效果的持久性，更能将患者术后恢复时间缩短。类似的例子不胜枚举，内镜正不断扩展我们的能力边界，让越来越多患者避免了手术的痛苦。

I think these are two major areas, though others exist. To be honest, I don’t think this is the most impressive time for global gastroenterology research. There are advances in inflammatory bowel disease (IBD) and gastrointestinal malignancy treatment, but it seems unlikely there’ll be a huge breakthrough in treating Crohn’s disease, other types of colitis, or colon cancer in the next 5 years. I wish there were. At this point, the liver and endoscopy areas are more likely to progress faster.

坦率讲，我认为当前全球胃肠病学研究的发展正处于相对平缓期。尽管在炎症性肠病（IBD）和胃肠恶性肿瘤治疗方面也在进步，但在未来5年内，克罗恩病、溃疡性结肠炎或结肠癌治疗出现重大突破的可能性较小。目前来看，肝病和内镜领域更有可能取得更快的进展，值得临床工作者特别关注。

Q2

《胃肠病学》杂志主编

David S. Weinberg 博士

Ⅰ. Positive Aspects of Chinese Research in Gastroenterology

Ⅰ. 中国胃肠病学研究的亮点

There have been in our journal, a couple of important papers from China over the last 2 years or so that I think will have a great impact. One advantage Chinese clinical researchers potentially have is a large population to study. Those can be difficult research projects to do, but if done effectively, they’ll have a great impact.

在过去大约两年的时间里，我们的期刊上刊登了几篇来自中国的重要论文，我认为它们会产生重大影响。中国临床研究人员潜在的一大优势在于拥有庞大的研究人群。开展这类研究项目可能颇具难度，但如果能有效推进，将会带来巨大的影响力。

So the year before last, , we had a paper on the role of air pollution in various gastrointestinal diseases. The study involved 500,000 people in China. It’s an important study that would be difficult to conduct in many other places. You can argue about the specific air pollutants in China versus those in New York City, but air pollution is a problem in both places, and its impact on patients has some similarities. So, the large-scale Chinese study has generalizable value regardless of where the results are interpreted.

前年，我们发表了一篇有关空气污染在各类胃肠道疾病中所起作用的论文。这项研究涵盖了中国的50万名受试者。这是一项意义重大的研究，在很多其他地方都很难开展。或许有人会争论中国与纽约市具体空气污染物的差异，但不可否认的是，空气污染在这两个地方都是问题，而且它对患者的影响也存在一些共性。所以，无论在何处解读研究结果，中国的这项大规模研究都具有普遍适用的价值。

I’ve already mentioned the hepatitis E model. Animal models are very important for studying human diseases. What’s interesting about this hepatitis E model is that, it’s the first model of an important viral hepatitis illness that could presumably help develop better treatments.

我刚刚提到的戊型肝炎模型也很有意思。动物模型对于研究人类疾病非常重要。这个戊型肝炎模型是首个可能有助于开发更好治疗方法的严重病毒性肝炎疾病的模型。

Ⅱ. Challenges and Improvement Opportunities for Chinese Research Submissions

Ⅱ.中国研究投稿的现存挑战

I’m less impressed by the large number of papers we receive from China, which focus on generally important but not central aspects of cancer or cancer development. These papers often follow the same format. There are many laboratory-based experiments using cutting-edge techniques, but the research demonstrates more of the ability to perform laboratory techniques than to think about the problem people are trying to treat.

我们收到了大量来自中国的论文，这些论文大多聚焦于癌症或癌症发展中一些普遍重要但并非核心领域。而且这些论文往往有着相似的模式。其中有很多运用前沿技术开展的实验室实验，但这些研究更多地展现了操作实验室技术的能力，而不是对人们试图治疗的问题进行深入思考。

We receive papers from more than 100 countries with some regularity. For original research articles (I’m not referring to letters to the editor or editorials) , we accept about 9% of submissions from around the world .In fact, we truly are and would like to think that we are the leading international journal for gastroenterology in our field. There are other excellent journals such as Gut and The Lancet Gastroenterology & Hepatology, but we believe we hold the leading position.

However, we accept less than 9% of Chinese submissions to Gastroenterology. That’s because we’re less concerned about their origin and more focused on overall quality and impact. These two last factors are crucial. When rejecting a paper from China, the US, or anywhere else, sometimes its simply because it’s not well-done. But often, our reason isn’t that the paper is incorrect or could have been executed better. Instead, we reject it because we believe its potential impact on the field of gastroenterology and general health doesn’t meet our expectations.

作为全球领先的胃肠病学期刊，我们会定期收到来自100多个国家的投稿，其中原创研究论文（不包括编辑信函或社论）的接收率约为9%。然而，尽管如此，源自中国并投稿至本刊《胃肠病学》的论文占比尚未达到这一水平。出现这一情况的原因在于，我们评估稿件时并不偏重其地域来源，而更关注其整体质量和影响力，这两个因素至关重要。我们拒绝的原因不是论文错误或还有提升空间，而是因为我们认为它对推动胃肠病学领域发展和对人类健康的影响潜力不符合我们的期望。

I’m very impressed by the quality of research by Chinese investigators. Laboratory studies are done correctly, and the methodology for clinical trials is fine. Where the deficit often occurs is in the potential for impact. Sometimes,the studies are in less important areas or involve less important signaling pathways compared to papers from other investigators. I think Chinese investigators can improve in choosing what to study and how they think it will impact science in general.

当然，中国研究人员的研究质量给我留下了深刻印象。实验室研究操作规范，临床试验的方法学也没有问题，但不足之处往往是在影响力方面。与其他研究人员的论文相比，有时这些研究涉及的领域不够关键，或者所研究的信号通路重要性相对较低。我认为中国研究人员可以在选择研究课题以及思考研究对整个科学界的影响方面加以改进。

My colleague Paul Moayyedi, my co-editor-in-chief of Gastroenterology, and I are really intent on improving the journal’s ability to attract the best scientific papers from China. We hope to make at least two trips to China in 2025, meet investigators who’ve sent papers and those who haven’t, and have a useful discussion about the importance of publishing in Gastroenterologyand what editors look for in a publication.

我的同事保罗·莫亚耶迪（Paul Moayyedi），也就是《胃肠病学》杂志的另一位主编，和我都非常希望提升期刊吸引中国优秀科学论文的能力。我们计划在2025年至少前往中国两次，与已经投稿和尚未投稿的研究人员会面，就《胃肠病学》期刊发表文章的重要性以及编辑对稿件的要求展开有益的讨论。

I think we can make a lot of progress on both from our side and from the Chinese investigators’side. But like many things, we need more communication about what each side can offer and how we can help each other.

我认为，无论是我们期刊方，还是中国的研究人员，都有很大的进步空间。但和很多事情一样，我们需要更多的交流，了解双方能够提供什么，以及如何相互助力。

Q3

That’s a hard question, and I’m not sure I have a definitive answer. I think artificial intelligence can play a role in supporting physicians’ diagnosis and other decision-making. However, whether it will serve as an ongoing tool or have a place in teaching is yet to be determined.

这是一个复杂的问题，我可能无法给出确切答案。AI在辅助医生诊断决策方面确有潜力，但它究竟会成为持续性诊疗工具还是教学辅助手段，仍需时间验证。

Ⅰ. AI in Endoscopy for Detecting Colon Polyps

Ⅰ.内镜领域的AI应用现状

I’m not aware of any journal-published papers showing that AI can notably enhance the ability to detect important colon polyps during endoscopy. This assumption hinges on the idea that when doctors learn to perform colonoscopies, they do it proficiently and don’t miss colon polyps.

目前尚无权威期刊论文证实AI能显著提升结肠镜检查中重要息肉的检出率。这种设想的前提是医生本身已具备熟练的结肠镜操作技能。

What AI does seem better at is finding smaller polyps, sometimes more effectively than humans. However, it’s unclear whether this has clinical significance. Tiny colon polyps usually will never be a problem. So finding them slightly better using AI might make for a nice research paper, but I’m not sure that it improves health care at all.

现有数据显示，AI在微小息肉识别方面或许略胜人类。但关键在于：这些微小息肉是否具有临床意义？多数情况下它们不会引发健康问题。因此，AI的这种“超能力”可能仅具有科研论文价值，对实际诊疗改善有限。

Ⅱ. AI in Medical Research

Ⅱ.AI在医学研究中的应用

On the other hand, AI, which drives large language models and is a different form of machine learning, may prove to be extremely useful in facilitating research. It can enable someone to review the charts of 1 million people. Manually reviewing these charts would be an impossible task. However, with the help of a computer-aided program, this task suddenly becomes feasible.

另一方面，驱动大型语言模型的人工智能，作为机器学习的一种不同形式，可能会在推动科研进步方面展现出巨大价值。它可以让研究人员审查多达100万人的病历，而这在手动操作下简直是难以想象的任务。

The reliable handling of very large volumes of data will unlock numerous potential research areas. Currently, even if you rely on a team of research coordinators and associates to review charts, these areas are out of reach.

凭借可靠处理海量数据的能力，它将开启无数潜在的研究领域。即便是配备了专业研究人员的团队，采用传统方法也难以达到如此规模的数据分析能力。

Ⅲ. Electronic Medical Records and AI

Ⅲ.电子病历与AI

As most medical records are becoming electronic, I’m not certain about the progress in China on this front. I’m confident it will happen if it hasn’t already. In the United States, though, nearly all paper charts have been replaced by electronic ones.

In theory, with electronic charts, you can conduct searches. However, you need computer programs to facilitate this. So, I see this as another promising area.

随着病历电子化的不断推进，在美国，几乎所有纸质病历都已被电子病历所取代。我不确定中国在这方面的发展情况，但相信即便尚未完全实现电子化，也正处于实现这一目标的阶段。

理论上，电子病历支持数据检索，但需要特定的软件程序来辅助完成。在我看来，这是另一个蕴藏着巨大的发展潜力的领域。

Ⅳ. AI in Direct Patient Care

Ⅳ. AI在直接患者护理中的应用

It’s true that people are often attracted by the idea that machines can be helpful. But in direct patient care, I predict that while AI models will likely complement physicians, it’s hard to envision them replacing doctors.

人们总容易被“机器辅助医疗”的概念吸引。但在直接护理场景中，我预计AI模型更多是作为医生的辅助工具，而非替代者。很难想象AI能完全取代医生的工作。

Q4

《胃肠病学》杂志主编

David S. Weinberg 博士

Ⅰ. Difficulties in Clinical Research

Ⅰ.临床研究的现实挑战

I would love to see more outstanding clinical research in gastroenterology and have it applied. As I’ve mentioned before, around 80%~90% of Chinese submissions to Gastroenterology fall into either basic research or translational research. They aren’t clinical research in the traditional sense, which involves studying direct interventions on patients or the impact of external forces on them.

我非常希望看到更多优秀的胃肠病学领域的临床研究，并能够将其应用到临床。大约80%~90%的中国向《胃肠病学》杂志提交的论文属于基础研究或转化研究，而非传统意义上的临床研究，即直接干预患者或研究外部因素对患者影响的研究。

Good clinical research is extremely difficult to carry out, regardless of where in the world you are. This doesn’t imply that basic and translational research is easy. To some extent, in basic and translational research, especially when working with animal models, you can more easily control the factors and conduct studies under the conditions you set. However, in clinical research, I can’t control whether a patient will take a medication or not in a trial. I can make suggestions, but patients will act according to their own will.

无论在世界哪个地方，优秀的临床研究都极其难以开展，当然这并不意味着基础和转化研究简单。在某种程度上，在基础和转化研究中，尤其是使用动物模型时，你可以更容易地控制因素，并在你设定的条件下进行研究。但是在临床研究中，我们无法控制患者在试验中是否服药。我可以提出建议，但患者会根据自己的意愿行事。

Ⅱ. Importance and Challenges of Clinical Research

Ⅱ.临床研究的重要性和挑战

I hope that the showcase of outstanding original clinical research not only highlights the excellent research being done in China but also shows your readers how challenging it is to conduct such clinical studies and how important they are.

我希望这次“中国原创优秀临床研究展播”活动不仅能展示中国正在进行的优秀研究，还能向读者展示开展这类临床研究的挑战性和重要性。

In the United States, where I practice, patients participate in clinical research out of their own will, not because they are forced. The same goes for China. This means that we rely on people’s altruism to take part in trials that may or may not have immediate value for them. If someone is in a tough situation with cancer and there are no good treatment options, participating in a clinical trial can be not only an act of altruism but also a desire to find a better-or longer-way to live through a different treatment and compare it with the current standard of care.

无论在我执业的美国，还是在中国，患者参与临床研究是出于自己的意愿，而不是被迫。这意味着我们依赖于人们的利他主义来参与可能对他们没有直接价值的试验。对于那些患有癌症且缺乏有效治疗手段的患者而言，参与临床试验既是贡献社会，也是为自身寻求生存机会，并与现有标准疗法对比疗效。

So, to answer your question, I’d like your showcase to not only talk about specific trials but also emphasize how difficult it is to conduct this kind of research and how important it is for all of us. When people get the chance to participate in these trials, they should think seriously about it. In the United States, many people simply say no to participating in a trial without considering what that decision means. I won’t force anyone to join a trial as it’s always their choice. But I believe that the challenges of conducting these studies well are often under-appreciated. Investigators whose research gets featured in your newspaper should be very proud of themselves.

所以，对于您的问题，我希望本次展播活动不仅能讨论具体的临床试验，还要着重强调开展此类研究的难度以及其对我们所有人的重要性。当人们有机会参与这些试验时，他们应该认真考虑。在美国，许多人会毫不犹豫地拒绝参与试验，却没有意识到这个决定意味着什么。我始终尊重每个人的选择，不会强迫任何人加入试验。然而研究者需要付出巨大努力来克服这些挑战，而这些挑战常常被低估。因此我认为，那些被《中国医学论坛报》特别报道的研究人员，应该为自己的成就感到自豪。

编辑手札：当“中国原创优秀临床研究展播”活动筹备组将《胃肠病学》主编访谈列为重点选题时，我们面对的是一个看似闭环的难题：如何让国际权威期刊掌舵者真正听见中国学者的声音？这个问题的答案，最终由北京友谊医院消化内科施海韵老师的帮助下得以书写。

作为《中国医学论坛报》与首都医科大学附属北京友谊医院合作专栏——《胃肠病学》前沿速递的学术负责人，施老师身上有着新一代中国医学学者的典型特质——既有深耕消化疾病研究的学术锐度，更对胃肠病学领域的学术交流充满热情。在得知我们的困境后，她第一时间联动其博士导师、香港中文大学陈家亮教授。作为《胃肠病学》Senior Associate Editor，陈教授不仅是亚洲胃肠病学界的重磅专家，更是国际学术共同体中备受尊敬的“架桥者”。正是这条跨越京港的学术链，让我们的采访提纲最终呈现在Dr. David S. Weinberg案头。

特别触动我的是施老师那句：“非常愿意帮助，好研究不该困在语言屏障里。”这句话恰如其分地注解了此次合作——从专栏建设到顶刊对话，本质上都是为了让中国医学创新的“地质层”被世界看见。当Weinberg主编在访谈中数次提及中国学者的大规模队列研究优势时，我仿佛看见无数个“施海韵”在实验室与临床间奔走的剪影。

这次珍贵的采访机会得以实现给了我们最珍贵的启示：当中国学者以解决真实世界问题为锚点，当学术媒体以架桥为己任，那些曾经遥不可及的国际权威期刊对话，终将成为推动医学进步的寻常风景。

来源：壹生