This study investigates the functional outcomes of patients with low rectal cancer undergoing inter-sphincteric resection (ISR) following brachytherapy boost radiotherapy (BoRT), compared to those who underwent ISR after standard chemoradiotherapy. BoRT is an alternative to total neoadjuvant therapy for increasing organ preservation rates in low rectal cancers. However, its impact on sphincter function following stoma reversal remains unclear.

Pemafibrate helps regulate fatty acid dynamics in the liver, potentially preventing metabolic dysfunction-associated steatohepatitis (MASH). However, its effect on intestinal long-chain fatty acid (LCFA) metabolism in MASH remains unclear. Thus, we aimed to examine the influence of pemafibrate on intestinal LCFA metabolism and hepatic fibrosis in a MASH rat model.

Cholangiocarcinoma (CCA) has a low survival rate of 5-17%, despite advancements in diagnosis and treatment. Liver function impacts disease prognosis, and the albumin-bilirubin (ALBI) score is a new assessment model for this purpose. While research suggests a correlation between ALBI score, liver failure and mortality in intrahepatic CCA (iCCA), predicting outcomes for extrahepatic CCA (eCCA) is challenging. Our objective was to assess the prognostic role of ALBI grade in predicting overall survival of eCCA patients.

Endoscopic submucosal dissection (ESD) is a common treatment for early esophageal cancer. Although ESD is considered safe, same-day discharge (SDD) is only feasible in selected patients. Therefore, identifying factors associated with the likelihood of SDD is crucial for optimizing patient selection and clinical management.

In the rapidly evolving landscape of gastrointestinal health care, the integration of artificial intelligence (AI) presents unprecedented opportunities for enhancing patient outcomes, improving efficiency, and driving innovation. Effective collaboration among clinicians, academia, and industry is crucial to harness the full potential of AI technologies. Clinicians offer invaluable insights from real-world practice, ensuring that AI solutions address genuine clinical needs and improve patient care. Academia plays a pivotal role in advancing research, developing new methodologies, and training the next generation of professionals who will navigate this transformative field. Industry drives the commercialization of AI tools, providing the resources and infrastructure necessary for widespread adoption. Achieving these synergies is challenging. Issues including data privacy, regulatory hurdles, and interdisciplinary communication must be addressed to foster effective partnerships. By embracing collaborative models, including public-private partnerships, clinical trials, and innovation hubs, stakeholders can work together to overcome barriers and promote responsible AI integration in gastroenterology.

The Barrett's Oesophagus Surveillance Study (BOSS) was the first randomized study of surveillance. This study reports the costs and quality of life outcomes from the BOSS trial and models the outcomes and cost-effectiveness of surveillance beyond the follow-up period of the BOSS study. This trial showed similar stages and rates of esophageal cancer in both arms, but the regular surveillance arm did identify more high-grade dysplasia after a median of 12.8 years follow-up.

There is a large heterogeneity among individuals in their therapeutic responses to the same drug and in the occurrence of adverse events. A key factor increasingly recognized to contribute to this variability is the gut microbiome. The gut microbiome can be regarded as a second genome, holding significant metabolic capacity. Consequently, the field of pharmacomicrobiomics has emerged as a natural extension of pharmacogenomics for studying variations in drug responses. Pharmacomicrobiomics explores the interaction of microbiome variation with drug response and disposition. The interaction between microbes and drugs is, however, complex and bidirectional. While drugs can directly alter microbial growth or influence gut microbiome composition and functionality, the gut microbiome also modulates drug responses directly through enzymatic activities and indirectly via host-mediated immune and metabolic mechanisms. Here we review recent studies that demonstrate the interaction between drugs and the gut microbiome, focusing on cancer immunotherapy and immunomodulation in the context of inflammatory bowel disease and solid organ transplantation. Because the gut microbiome is modifiable, pharmacomicrobiomics presents promising opportunities for optimizing therapeutic outcomes, with recent clinical trials highlighting fecal microbiota transplantation as a strategy to enhance the efficacy of immune checkpoint blockade. We also shed light on the future perspectives for patients arising from this field. Although multiple lines of evidence already demonstrate that the gut microbiome interacts with drugs, and vice versa, thereby affecting treatment efficacy and safety, well-designed clinical studies and integrated in vivo and ex vivo models are necessary to obtain consistent results, improve clinical translation, and further unlock the gut microbiome's potential to improve drug responses.

Colorectal cancer (CRC) is a common malignant tumor. Immune checkpoint inhibitors (ICIs), particularly those targeting programmed cell death protein 1(PD-1) and programmed cell death ligand 1(PD-L1), have shown promising potential in the treatment of CRC. Specific gut microbiota can modulate the efficacy of ICIs through immune or metabolic pathways. This review summarizes recent advances in the combined application of gut microbiota and PD-1/PD-L1 inhibitors in the treatment of CRC, aiming to provide insights for expanding clinical treatment options for CRC.

To explore the application and clinical value of liver transient elastography (TE) in diagnosing and assessing the degree of liver cirrhosis combined with esophageal and gastric varices (EGV).

This systematic review aims to comprehensively assess the epidemiology and identify risk factors associated with the severity and recurrence of hypertriglyceridemia-induced acute pancreatitis (HTG-AP). A search of PubMed, Web of Science, and Cochrane databases was conducted to identify all relevant randomized controlled trials (RCTs), prospective, or retrospective cohort studies on HTG-AP. Data related to epidemiology and risk factors for severity and recurrence of HTG-AP were extracted and analyzed. Seventy-seven studies met the inclusion criteria, comprising 1 RCT, 21 prospective studies, and 55 retrospective studies. A total of 56,617 acute pancreatitis (AP) patients were included, of which 19.99% were diagnosed with HTG-AP (n = 11,315). Compared to non-HTG-AP patients, HTG-AP patients were more likely to be male (68.7% vs. 57.3%) and younger (mean age 41.47 ± 4.32 vs. 50.25 ± 7.70 years). HTG-AP patients exhibited higher mortality rates (up to 20% vs. 15.2%), increased severity (8.3% to 100% vs. 3.8% to 47.2%), and higher recurrence rates (up to 64.8% vs. 23.3%). Analysis of temporal trends from 2002 to 2023 showed a range of HTG-AP prevalence in overall AP patients from 1.6% to 47.6%, with a slight upward trend that was not statistically significant (P = 0.1081). Regional analysis indicated relatively stable prevalence in North America (P = 0.5787), Europe (P = 0.0881), other regions (P = 0.738), while prevalence in China showed a significant increase (P = 0.0119). Thirteen studies investigated risk factors affecting HTG-AP severity, with elevated serum triglyceride (TG) levels associated with increased risk of complications such as pancreatic necrosis, systemic inflammatory response syndrome (SIRS), shock, and multi-organ failure. Additional factors including high neutrophil-to-lymphocyte ratio (NLR), elevated levels of amylase and C-reactive protein (CRP), hypocalcemia, and hypoalbuminemia were also implicated in HTG-AP severity. Smoking history, poor lipid control (TG > 3.1 mmol/L), or recurrent hypertriglyceridemia during follow-up were identified as potential predictors of HTG-AP recurrence. Our findings indicate a stable global prevalence of HTG-AP within AP patients, but a notable increase in China, possibly attributed to socio-economic and dietary factors.

The incidence of early-onset colorectal cancer (eoCRC), defined as CRC diagnosed in individuals under 50, is rising globally. Younger patients often face diagnostic delays and receive care pathways designed for older populations. These gaps highlight the need for tailored approaches to diagnosis, treatment, and support.

Endoscopic retrograde cholangiopancreatography (ERCP) in patients with Billroth II anastomosis is challenging due to post-surgical anatomical alterations. This study aims to compare the clinical outcomes of using a duodenoscope and a cap-assisted gastroscope in these patients.

High salt diet (HSD) has been considered as a risk factor for the development of metabolic disorders. However, less is known about long-term implications of HSD. Therefore, the aim of this study was to conduct a preliminary investigation into the effects of mice feeding with long-term HSD on gut microbial and metabolic profiles.

Esophagogastroduodenoscopy (EGD) is an effective technique for diagnosing gastric cancer (GC). However, it is estimated that 10% of GCs are unnoticed, constituting missed gastric cancer (MGC). To analyse the incidence of MGC in our area, the characteristics of GC and factors related to MGC were evaluated.

The mortality burden of metabolic dysfunction-associated fatty liver disease (MAFLD) is rising, making it crucial to predict mortality and identify the factors influencing it. While advanced machine learning algorithms are gaining recognition as effective tools for clinical prediction, their ability to predict all-cause mortality of MAFLD individuals remains uncertain. This study aimed to develop different machine learning models to predict all-cause mortality of MAFLD individuals, compare the predictive performance of these models, and identify the risk factors contributing all-cause mortality, which is crucial for management of MAFLD individuals.

Our objective was to compare the clinical features of Metabolic dysfunction-associated steatotic liver disease (MASLD) /metabolic alcohol-related liver disease (MetALD)/metabolic associated fatty liver disease (MAFLD)/nonalcoholic fatty liver disease (NAFLD) and the relative risk analysis of metabolic disorders.

Non-alcoholic fatty liver disease (NAFLD), a metabolic liver disorder closely associated with obesity and diabetes, urgently requires early screening. This population-based study is the first to explore the relationship between glycemic control and a novel dyslipidemia composite index-the glycated hemoglobin/high-density lipoprotein cholesterol (HbA1c/HDL-C) ratio in individuals with NAFLD and liver fibrosis.

The practice of endoscopic ultrasound-guided liver biopsy (EUS-LB) is becoming more common due to its proven safety and effectiveness. For accurate diagnosis, it is vital to secure ample tissue specimens. However, gauging the volume of tissue specimens accurately poses a challenge with existing methods. Additionally, determining the most suitable fine-needle biopsy (FNB) needle requires further study. Our aim was to contrast the tissue surface areas obtained using Franseen and Fork-tip needles and to identify factors affecting tissue volume.

Advanced gastric cancer (AGC) with unresectable factors presents a significant treatment challenge. Conventional treatments such as systemic chemotherapy, radiotherapy, and immunotherapy can delay disease progression but often yield limited outcomes. For stage III-IV gastric cancer with unresectable factors, conversion therapy based on chemotherapy can achieve tumor downstaging, providing a subset of patients with the opportunity for curative surgery. However, the efficacy of multimodal approaches combining chemotherapy, with or without immunotherapy, and conversion surgery compared to chemotherapy alone remains controversial.

To examine the relationship between biological aging and the prevalence of NAFLD.