The burden of obesity in Saudi Arabia is partly addressed with Laparoscopic Sleeve Gastrectomy (LSG), a bariatric surgical option, but perioperative complications and prolonged hospital stays persist. Enhanced Recovery After Surgery (ERAS) aims to improve postoperative outcomes.

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are extensively used in the management of type 2 diabetes mellitus (T2DM) and obesity. While these medications offer glycemic control and cardiovascular benefits, the risks have increased because of their potential impact on cancer risk, particularly colorectal cancer (CRC). This meta-analysis aimed to evaluate the association between GLP-1 RAs and CRC risk in patients receiving GLP-1 RAs.

The Notch signaling pathway plays a crucial role in intrahepatic bile duct development. Here, we aimed to investigate the effect of the Notch receptor, NOTCH2, on intrahepatic bile duct development to better understand congenital intrahepatic bile duct dysplasia.

Autoimmune hepatitis (AIH) is a chronic progressive inflammatory liver disease of immune-mediated origin, which causes long-term liver inflammation and damage. Traditionally, treatment includes azathioprine (AZA) combined with steroids, but recent studies have highlighted mycophenolate mofetil (MMF) as a potential alternative, particularly for patients who do not respond well to AZA.

Advanced gastric cancer frequently leads to severe complications, such as bleeding, which severely impacts patients' quality of life and prognosis. Traditional approaches for hemostasis include endoscopic treatments and surgery, but their invasive nature and potential for significant morbidity have made less invasive options like radiation therapy (RT) and transarterial embolization (TAE) appealing. Nonetheless, studies comparing the therapeutic effects and prognosis of RT and TAE are limited, underscoring a significant gap in research and clinical practice.

Programmed death-1 (PD-1) inhibitors combined with chemotherapy show certain clinical benefits in advanced gastric cancer patients, but more evidence is still needed. The present study aimed to investigate the efficacy and safety of PD-1 inhibitors combined with chemotherapy in these patients.

While laparoscopic sleeve gastrectomy (LSG) is an established bariatric procedure for obesity, postoperative gastroesophageal reflux disease (GERD) remains a significant complication. This study evaluates the short-term efficacy of a novel technique combining LSG with acute angle of His reconstruction (LSG-His) versus conventional LSG.

Intestinal anastomosis is a common surgical procedure, but anastomotic leaks remain significant postoperative complications, causing morbidity, prolonged hospital stays, and readmissions. This study aimed to identify the rate, determinant factors, and outcomes associated with anastomotic leakage for patients undergo gastrointestinal anastomoses in two major hospitals in Addis Ababa, Ethiopia.

Chronic liver disease (CLD) and complications of cirrhosis are responsible for the deaths of approximately two million people per year worldwide. Abnormal intestinal permeability in the intestinal-liver axis and development of intestinal dysbiosis increase disease progression contributing to chronic systemic inflammation in CLD patients. The intestinal microbiota acts as a bioreactor for autonomous metabolic and immunological functions in regulating the host's response to external stimuli in the intestinal microbiota. The study aimed to analyze the gut microbiota profile from colonic mucosal biopsy materials in CLD patients using a metagenomic application.

Bowel disorders of gut-brain interaction (DGBIs) are a highly stigmatized group of disorders. Although the link between stigma and shame is acknowledged overall, few studies focusing on health-related stigma mention shame, and research on shame in bowel DGBIs is nonexistent. The aim of this study was to examine the implications of shame in bowel DGBIs.

This study aims to evaluate the association between IDO index and the prognosis of colorectal cancer (CRC). We searched databases such as PubMed, to collect relevant English studies on the association between IDO level and the prognosis of CRC published before October 10, 2024. This meta-analysis included 11 studies involving 2068 patients. The results showed that IDO levels were not significantly correlated with OS in CRC patients (HR0.85, 95%CI 0.54-1.33, P = 0.488), but elevated IDO was associated with reduced disease-free survival (DFS) in CRC patients (HR 0.61, 95%CI 0.38-0.99, P = 0.044).Elevated IDO was significantly associated with the incidence of liver metastasis (HR 4.66, 95%CI 1.72-12.64, P = 0.003) and lymphatic infiltration (HR 2.75, 95%CI 1.52-4.97, P < 0.001) in CRC patients. In conclusion, high expression of IDO is significantly associated with DFS, liver metastasis and lymphatic infiltration in CRC patients, and may serve as a biomarker and therapeutic target for DFS, liver metastasis, and lymphatic metastasis in CRC.

Background Metabolic dysfunction-associated steatotic liver disease (MASLD)-formerly known as non-alcoholic fatty liver disease-is the leading cause of chronic liver disease globally. However, early diagnosis and specific treatment have not yet been achieved. Plasminogen activator inhibitor-1 (PAI-1) is closely related to MASLD and may be an important indicator for its diagnosis and treatment. This updated meta-analysis aimed to comprehensively explore the relationship between circulating PAI-1 levels and MASLD. Methods Article retrieval was carried out in seven provenances (PubMed, Cochrane Library, EMBASE, CNKI, WANFANG, Clinical Trials Database, and Grey Literature Database) using free text words and MeSH terms. The meta-analysis was performed using RevMan 5.3 and Stata 12. Outcomes were presented as standardised mean difference (SMD) with 95% confidence intervals (CI). Results A total of 23 studies were included in the meta-analysis. The levels of circulating PAI-1 in patients with MASLD were significantly higher than those in healthy controls (SMD = 1.44, 95% CI [1.06, 1.83]). Subgroup and meta-regression analyses based on key factors, such as area, age, and BMI, were performed to explore the sources of heterogeneity. In the BMI subgroup analysis, the participants were divided into two groups. While the subgroup results were inconclusive, the meta-regression suggested that the area (i.e. the geographic region of the study population) may be a major contributor to heterogeneity (p < 0.001). Conclusions Patients with MASLD have significantly high circulating PAI-1 levels; however, this correlation may vary in different regions, thereby providing a reference for further research on MASLD.

Esophageal squamous cell carcinoma (ESCC) is characterized by a complex tumor microenvironment (TME). Cancer-associated fibroblasts (CAFs) play a crucial role in the TME that facilitate tumor progression via interactions with cancer cells. However, the mechanisms underlying the activation of CAFs in TME remain largely unknown. Here, we characterized the exosomes derived from normoxic and hypoxic ESCC cells using electron microscopy and western blot. The impact of exosomes on CAF activation and the motility of ESCC cells was examined in vitro. The molecular complex involving circNRIP1 was explored using RNA pull-down. We demonstrated that exosomes derived from ESCC cells, including KYSE-150 and TE-10 cells, exhibited a significantly increase in secretion under hypoxic conditions. These hypoxic exosomes were internalized by fibroblasts and further promoted the transformation of normal fibroblasts into CAFs, as evidenced by enhanced migration and secretion of pro-inflammatory cytokines. circNRIP1 was enriched in hypoxic exosomes, and its absence abolished the effect of hypoxic exosomes to activate CAFs. Furthermore, the CAFs activated by exosomal circNRIP1 further promoted the migration and invasion of ESCC cells. Mechanistically, circNRIP1 bound to the N1-methyladenosine (m1A) methyltransferase TRMT6 and activated CAFs in a TRMT6-dependent manner. This study revealed the role of hypoxia-induced exosomal circNRIP1 in the activation of CAFs, which contributes to ESCC development. These findings shed light on the mechanisms of the CAF activation in ESCC, positioning hypoxia-induced exosomal circNRIP1 as a potential molecular target for ESCC.

Tyrosine kinase inhibitors (TKIs) impairs factor Xa (FXa)-mediated coagulation. This study aims to assess the safety and feasibility of reduced thromboprophylaxis with low molecular weight heparin (LMWH) for hepatocellular carcinoma (HCC) converted by Lenvatinib treatment.

The purpose of this American Gastroenterological Association (AGA) Clinical Practice Update is to facilitate understanding and improve clinical management of patients with hepatitis delta virus infection.