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.

The relationship between gastrointestinal(GI) diseases and sleep-related problems—such as sleep trouble and sleep disorders—remains insufficiently understood.

All major U.S. guidelines now validate average-risk colorectal cancer (CRC) screening at 45-49 years of age. We aimed to highlight the importance of promoting colonoscopy among younger populations as part of a comprehensive strategy to reduce the burden of CRC.

Uncovered self-expanding metal stents (SEMS) are generally utilized for malignant gastric outlet obstruction (GOO), while fully covered, retrievable SEMS can be placed for benign GOO as an alternative to surgical treatment. In this real-world study, balloon dilation and SEMS were used to treat benign GOO.

This study aimed to explore the relationship between the Prognostic Nutritional Index (PNI, a composite indicator of albumin and lymphocyte count reflecting nutritional and immune status) and inflammatory cytokines in predicting infections among liver failure patients, and to construct a predictive model based on these indicators.

Celiac disease (CeD) is an autoimmune disorder, causing significant gastrointestinal (GI) and non-GI symptoms. The only effective treatment is a gluten-free diet (GFD), but adherence can be challenging. This study investigates GFD adherence among CeD patients and the change in their clinical and pathological conditions over time.

Gallbladder and biliary tract cancers (GBTCs) represent aggressive malignancies with poor prognosis and rising global incidence. While previous studies have examined disease burden patterns, the relationship between health workforce capacity and GBTC outcomes remains unexplored, representing a critical knowledge gap in understanding healthcare system determinants of disease management effectiveness.

Colorectal carcinoma (CRC) screening has historically centered on the detection and removal of adenomas; however, serrated polyps, particularly sessile serrated polyps (SSPs), are increasingly acknowledged as pivotal contributors to CRC pathogenesis. This study comprehensively evaluates the prevalence, morphological characteristics, and clinical significance of serrated polyps.

Several studies have shown a connection between periodontal diseases and conditions such as heart disease, diabetes, and pregnancy. This study aimed to investigate the relationship between inflammatory bowel disease (IBD), including ulcerative colitis (UC), Crohn's disease (CD), and periodontitis.

To Explore the correlation between Continuous Renal Replacement Therapy (CRRT) and the prognostic outcomes of patients with Severe Acute Pancreatitis (SAP); to analyze the impact of CRRT initiation time on the final prognosis of SAP patients; to evaluate factors affecting the therapeutic effect of CRRT in SAP patients without absolute indications for CRRT, and to develop a multi-factorial predictive model for the efficacy of CRRT in treating SAP.

Fibrofatty proliferation of mesenteric fat is a common finding on magnetic resonance enterography (MRE) in Crohn's disease (CD) patients. Mesenteric fat may play a role in inflammation, fibrosis, and stricture formation, but its prognostic value in predicting complications remains unclear.

Care for patients with inflammatory bowel disease (IBD) has traditionally relied on in-person visits for disease management. However, technological advances have paved the way for innovation in healthcare delivery in the IBD space, most notably through mobile health applications (apps). These apps have many capabilities including, but not limited to, helping patients track symptoms and food intake, communicating with medical providers, connecting with nutritionists, providing access to mental health resources, and providing education about IBD. Given the ubiquity of smartphones and increasing prevalence of technology involvement in healthcare, there is a plethora of apps available for personal and professional use in IBD care. We reviewed and compared some of the most studied and popular apps available on the marketplace to help clinicians understand the state of mobile technologies for IBD and see the potential value of integrating apps in the traditional IBD care model. Furthermore, we review the current state of wearable technology and explore next steps in technology development to further augment care for patients with IBD. IBD is a lifelong disease, without a cure, and a multidisciplinary management approach is critical. Health apps offer unique opportunities for an integrated management strategy, empowering patients to have more involvement in their care, and providing clinicians with real-time clinical data to tailor more personalized treatment plans.

Adhesive intestinal obstruction is a common clinical condition caused by obstruction of the intestinal contents. Adhesiolysis is an effective treatment, but traditional open or laparoscopic adhesiolysis is traumatic and often causes a recurrence of adhesions. In this study, we investigate the feasibility and safety of adhesiolysis via transumbilical endoscopic surgery (TUES) with a gastric endoscopy.

Chronic eosinophilic esophagitis (EoE)-associated inflammation can lead to progressive tissue remodeling and fibrostenosis. Longitudinal studies are limited, and the impact of histologic disease control during childhood remains unknown. We aimed to evaluate the relationship between esophageal distensibility, histology, and fibrostenotic complications in a cohort of children with EoE.

Nutritional problems in patients with anorectal malformation (ARM) after anorectoplasty have not received sufficient attention. This study aimed to establish prediction model of postoperative undernutrition for patients with complex ARM.

The alpha-1-acid glycoprotein (AGP) is a novel inflammatory biomarker, and inflammation has been implicated in hepatic steatosis and fibrosis. The objective of this study was to investigate the relationship between AGP and hepatic steatosis and hepatic fibrosis and to assess its value as a potential biomarker.

Acute nonvariceal upper gastrointestinal bleeding (ANVUGIB) is a common clinical emergency disease with high morbidity and mortality. H. pylori (HP) testing during hospitalization increases the eradication rate of HP and improves the prognosis of patients. The use of stool samples to detect HP has potential clinical application value in ANVUGIB patients, but its accuracy has yet to be verified.

Malnutrition detrimentally impacts the prognosis of patients with cirrhotic portal hypertension (CPH). This study aimed to determine the prevalence of malnutrition using the Global Leadership Initiative on Malnutrition (GLIM) criteria, and its effect on post-transjugular intrahepatic portosystemic shunt (TIPS) hepatic encephalopathy (HE) occurrence and mortality in patients with CPH.