Report of 2017 Holistic Integrative Gastroenterology (HIG) forum

Nowadays, the Holistic Integrative Medicine (HIM) perspectives proposed by Chinese Academy of Engineering Academician Professor Daiming Fan have been increasingly recognized and extensively incorporated into medical practice (Figure 1) (1). The 2017 Chinese Congress of Holistic Integrative Medicine (CCHIM) was held in April 29, 2017 in Xi’an, China. A total of 52 academicians from the Chinese Academy of Sciences and Chinese Academy of Engineering, more than 200 University presidents or vice-presidents, and over 2,000 hospital presidents or vice-presidents participated in this congress. Notably, over 14,000 attendees from various subjects of medicine took part in 1 plenary lecture and 45 forums. The meeting report disseminates the major contents presented in the 2017 Holistic Integrative Gastroenterology (HIG) forum.

Figure 1 The founder of HIM, Professor Daiming Fan.

In the opening ceremony, Professor Kaichun Wu (State Key Laboratory of Cancer Biology & Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi’an, China) (Figure 2A), who was the honorary president of 2017 HIG forum, was invited to introduce the progress of HIM and HIG.

Figure 2 Speakers in the HIG forum.

Chinese Academy of Engineering Academician Professor Lanjuan Li (State Key Laboratory for Diagnosis and Treatment of Infectious Disease, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China) (Figure 2B), who also acted as the president of 2013 International Human Microbiome Consortium, summarized the research advances in the human microbiome, association of human microbiome with infective diseases, and impact of human microbiome on the development and management of liver diseases. She emphasized the characteristics of human gut microbiome in liver cirrhosis, which were published in Nature by her team (2). These findings were very important to guide the diagnostic algorithm of liver cirrhosis by characterizing the gut microbiome.

Professor Xiaozhong Guo (Department of Gastroenterology, General Hospital of Shenyang Military Area, Shenyang, China) (Figure 2C), who served as the president of HIG, reported the relationship between gut microbiome and pancreatic diseases, which primarily includes acute pancreatitis, chronic pancreatitis, and pancreatic cancer. By comprehensively reviewing the current status in this topic, he proposed that oral and salivary microbiome imbalance might increase the risk of various pancreatic diseases and that priobiotics might be effective for decreasing the risk of pancreatic diseases.

Professor Nonghua Lv (Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Jiangxi, China) (Figure 2D) reported the impact of helicobactor pylori infection on gastric and enteric microbiome and discussed the following major questions. (I) Is helicobactor pylori a component of normal flora in human beings? (II) Does helicobactor pylori infection lead to the gastric flora imbalance? (III) Does helicobactor pylori infection lead to the gut flora imbalance? (IV) Does helicobactor pylori eradication influence the gut flora? Based on the evidence based recommendations from the Kyoto global consensus and Maastricht V consensus on helicobactor pylori (3,4), she pointed out that helicobactor pylori eradication should be necessary, but may not influence the gut microbiome.

Professor Jianlin Ren (Department of Gastroenterology, Zhongshan Hospital, Xiamen University, Xiamen, China) (Figure 2E) reviewed the role of gut microbiome in human heath, advances in the techniques of fecal microbiota preparation, and clinical applications and future directions of fecal microbiota transplantation. He also presented the benefits of fecal microbiota transplantation in inducing hepatitis B virus e-antigen clearance after long-term antiviral therapy, which were published in Hepatology by his team (5).

Professor Duowu Zou (Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China) (Figure 2F) summarized the definition, epidemiology, pathogenesis, clinical presentations, laboratory tests, endoscopic findings, diagnostic criteria, and treatment strategy of antibiotics related diarrhea, which is also called as pseudomembranous enteritis. He also highlights the use of priobiotics and fecal microbiota transplantation in the management of antibiotics related diarrhea.

Professor Xin Wang (State Key Laboratory of Cancer Biology & Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi’an, China) (Figure 2G), who served as the executive president of 2017 HIG forum, reported the current perspectives on the management of colorectal cancer. He concluded that endoscopic screening could maximize the findings of early colonic cancer and the improvement of survival and that multidisciplinary team should be established to refine the management of advanced colorectal cancer.

In conclusion, the 2017 HIG forum focused on the role of gut microbiome in digestive diseases and highlighted the importance of HIM perspectives in the management of digestive diseases. As said by Professor Xiaozhong Guo, we are witnessing the spring of HIG and expecting its fruitful autumn.

Acknowledgements

The authors are indebted to the support from all HIG members.

Funding: None.

Footnote

Conflicts of Interest: The authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/amj.2017.05.01). Xingshun Qi serves as an Editor-in-Chief of AME Medical Journal. The other authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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References

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3. Sugano K, Tack J, Kuipers EJ, et al. Kyoto global consensus report on Helicobacter pylori gastritis. Gut 2015;64:1353-67. [Crossref] [PubMed]
4. Malfertheiner P, Megraud F, O'Morain CA, et al. Management of Helicobacter pylori infection-the Maastricht V/Florence Consensus Report. Gut 2017;66:6-30. [Crossref] [PubMed]
5. Ren YD, Ye ZS, Yang LZ, et al. Fecal microbiota transplantation induces hepatitis B virus e-antigen (HBeAg) clearance in patients with positive HBeAg after long-term antiviral therapy. Hepatology 2017;65:1765-8. [Crossref] [PubMed]