Metabolic dysfunction-associated steatotic liver disease (MASLD, formerly known as non-alcoholic fatty liver disease, NAFLD) and gallstone disease (GD) share common pathophysiological underpinnings of metabolic dysregulation. However, the epidemiological strength of their association, dose-response relationship, and subgroup differences remain incompletely assessed. This study aimed to quantify the association between MASLD/NAFLD and GD, and to explore the influence of sex, age, and study design. Following the PRISMA guidelines, a systematic search of PubMed, Embase, Cochrane Library, and Web of Science was conducted up to December 2025. Cohort and cross-sectional studies evaluating the risk of GD in relation to MASLD/NAFLD were included. A stratified analysis strategy was employed, pooling odds ratios (ORs), hazard ratios (HRs), and relative risks (RRs) separately. Summary effect estimates with 95
Hookworms are soil-transmitted nematode parasites that primarily cause anemia. Although adult hookworms typically inhabit the upper small intestine, colonization of the transverse colon or rectum is exceedingly rare. The clinical symptoms of ectopic parasitism may be atypical, which can lead to misdiagnosis or missed diagnosis. We reported a case of N. americanus infection in which adult worms were identified in the transverse colon and rectum, accompanied by atypical clinical manifestations. This case report describes a 56-year-old man with hookworm infection who presented primarily with a cough and watery, unformed stools for more than one month, but without anemia. Unexplained eosinophilia raised clinical suspicion for possible parasitic infection. Multiple gastroscopies did not detect parasites in any location. Hookworm infection was confirmed by stool microscopy and identified as N. americanus by molecular analysis. Colonoscopy revealed adult hookworms in the transverse colon and rectum. Following treatment with albendazole (400 mg daily) for three consecutive days, the patient’s clinical symptoms resolved. Ectopic parasitism often presents atypically, increasing misdiagnosis risk; heightened awareness, careful history-taking, and appropriate investigations are essential for definitive diagnosis.
This study investigates the advantages of preoperative colonoscopic tattooing using Spot® ink for patients with left-sided colon cancer undergoing laparoscopic surgery, aiming to assess its usefulness. Between November 2020 and January 2022, 216 patients undergoing elective laparoscopic resection were analysed: 74 received preoperative colonoscopic tattooing (Tattooed Group, TG) and 142 did not (Non-Tattooed Group, NTG). Propensity score matching yielded 40 matched pairs. Because matching generated explicit pairs, the matched cohort was analysed primarily with matched-pair methods (Wilcoxon signed-rank and McNemar’s tests), with independent-sample results reported alongside. Outcomes were operative time, blood loss, specimen characteristics, recovery metrics and postoperative complications. In the primary matched-pair analysis, a hospital stay of ≥ 5 days was less frequent in the TG (42.5
Quality of life (QoL) in people living with a stoma has been assessed by several patient-reported experience measures, but few studies have examined the quality of user experience (UX) associated with stoma care and management products specifically. This exploratory study aimed to characterise the lived experience and self-reported unmet needs of people with a stoma in relation to stoma care and management products. A two-stage, cross-sectional online survey was conducted. In Stage 1, an initial questionnaire drafted by healthcare professionals was reviewed in a patient focus group (n = 7), who assessed content relevance and clarity and suggested additional items; this stage refined content but did not constitute formal psychometric validation. In Stage 2, the resulting 20-item, non-validated Stoma Care and Management Questionnaire (SCMQ) was distributed via an open, non-unique link through Bowel Research UK and stoma-related social media groups. Data were analysed descriptively, with exploratory subgroup comparisons, using SPSS (v29.0.01); free-text responses underwent inductive, frequency-based qualitative content analysis informed by Braun and Clarke’s approach to identifying categories. Stage 1 produced a four-domain draft questionnaire (Demographics; Stoma Care and Management; Dietary Requirements; Design Features). In Stage 2, 406 of 790 screened respondents (51
This study aims to identify optimal liver segments for hepatic steatosis assessment using UltraSound Attenuation (USAT) imaging, with MRI-proton density fat fraction (PDFF) as the reference standard. The prospective study included 240 patients who received weight loss counseling at our hospital. All participants underwent USAT examination, among whom 112 also underwent MRI-PDFF examination. USAT measurements were taken in liver segments II/III, IV, V, VI, VII, and VIII, with medians calculated for analysis. In this study, a total of 240 patients were evaluated. The success rate of USAT measurements was significantly higher in the right liver lobes compared to the left liver lobes, with liver segment V and VIII demonstrating the highest success rate, which was statistically significantly different from segments II/III and VI (P<0.001). The USAT measurements in the right liver lobes were close to each other, with little variability and high repeatability. The correlation between the liver IV segment and the whole liver was statistically significant (Z = 2.286, P = 0.022). When hepatic steatosis grade ≥ 1 was diagnosed, the AUROC of liver segment VIII was the largest, reaching 0.863 (0.757 to 0.968). The AUROC of whole liver reached the maximum when the diagnosis of hepatic steatosis grade ≥ 2 and ≥ 3, reaching 0.914 (0.854–0.974) and 0.921 (0.850–0.992), respectively. For S ≥ 1, the right anterior lobe of the liver provides comparable performance to the entire liver and may be preferred given higher feasibility. For S ≥ 2 and S ≥ 3, the entire liver averaging offers the best diagnostic accuracy, though the right anterior lobe of the liver remains a clinically acceptable alternative when the entire liver acquisition is not feasible.
Triclosan exhibits broad-spectrum antibacterial and antifungal activities, but its application in personal care products has been restricted due to potential toxicity and environmental risks. Systematic evaluation of triclosan’s toxicity and underlying mechanisms is urgently needed. This is an integrative preclinical study. We combined computational prediction, cell experiments and animal tests. Computational analyses screened possible toxic targets of triclosan. We further verified these results using in vitro hepatocyte models and in vivo mouse liver injury models. During the investigation of the effects of triclosan on the liver of mice, we identified 27 target points related to liver injury and 19 target points related to immune injury. There was a significant overlap between these two sets of targets. And network analysis confirmed four key hub genes, namely COMT, HSP90AA1, GSTP1, and TTR. Molecular docking results demonstrated stable binding affinity between triclosan and these core targets, and the changes in gene and protein expression levels were further validated in both in vivo and in vitro models. We found the significant overlap between triclosan-induced liver injury and immune injury targets, revealing an inherent association between these two types of toxicity. This study provides a theoretical basis for comprehensively understanding the molecular mechanisms underlying triclosan-induced liver and immune injury. It also offers valuable guidance for developing strategies to mitigate triclosan’s toxicity to humans and the environment. Not applicable.
Hepatocellular carcinoma (HCC) is a major contributor to global cancer-related mortality, with the majority of patients diagnosed at unresectable stages. The STRIDE regimen (tremelimumab plus durvalumab) demonstrated superior survival benefits over sorafenib in the HIMALAYA trial. However, its cost-effectiveness within the Chinese healthcare system remains unverified. To evaluate the cost-effectiveness of first-line STRIDE versus sorafenib for unresectable HCC from the perspective of the Chinese healthcare payer. A comprehensive cost-effectiveness analysis was conducted using both partitioned survival (PartSA) and Markov state-transition models over a 10-year time horizon. Clinical efficacy parameters were derived from reconstructed HIMALAYA trial survival data. Direct medical costs were estimated based on post-negotiation drug pricing in China and published sources. Health utility weights were sourced from established literature. Scenario analyses (50
Racial and ethnic disparities in metabolic dysfunction-associated steatotic liver disease (MASLD) persist in the US population. We studied the impact of social determinants of health (SDOH) on the likelihood of developing MASLD and explored the contribution of SDOH to racial disparities in MASLD. Data on self-reported SDOH domains and sub-items based on Healthy People 2030 were collected from the US National Health and Nutrition Examination Survey (NHANES) across 10 NHANES cycles from 1999 to 2000 to 2017–2018. The participants were divided into four racial and ethnic groups: White, Black, Hispanic, and other. The primary outcome was MASLD, characterized by a US fatty liver index score exceeding 30. Survey-weighted logistic regression models were used to examine the relationship between SDOH and MASLD. The results were further analysed by race and ethnicity. A total of 22,585 participants (10115 White, 4431 Black, 5978 Hispanic, and 2061 other) were included in our analyses, of whom 7798 had MASLD (survey-weighted prevalence 32.0
The STRIDE II consensus recognizes histopathological healing in ulcerative colitis as a key therapeutic target. This study aimed to develop and internally evaluate a quantitative image-based model for the binary classification of mild versus moderate-to-severe UC based on histopathological features. Pathological slides from 167 ulcerative colitis patients (58 mild, 109 moderate-to-severe) were retrospectively collected from two medical centers. A U-Net model quantified glandular structures (number, area ratio), Gray-Level Co-occurrence Matrix analyzed texture features, and a five-interval grayscale histogram was modeled. Features selection was performed using LASSO regression. Patients were randomly divided into training and test sets in a 7:3 ratio. Machine learning models were constructed and their performance was evaluated. In the five-fold cross-validation analysis within the training set, SVM achieved the highest mean ROC-AUC and was selected as the final model. After refitting on the full training set, the final SVM model achieved an AUC of 0.891 (95
To investigate the associations of metabolic abnormalities and endoscopic features with sessile serrated lesions with dysplasia (SSLD), and to develop and validate a combined prediction model and simplified clinical risk score for individualized SSLD risk stratification. This retrospective study enrolled consecutive patients who underwent colonoscopy at the Affiliated Wuxi People’s Hospital of Nanjing Medical University between January 1, 2021, and December 31, 2024. Participants were categorized into SSL and SSLD groups based on pathological diagnosis. LASSO regression with 10-fold cross-validation was applied to construct a weighted Metabolic Risk Score (MRS). Seven logistic regression models integrating baseline, metabolic, and endoscopic variables were developed and compared. The final parsimonious model was used to derive a simplified integer-based clinical risk score. Internal validation was performed using 1000 bootstrap resamples. A total of 594 patients were included, comprising 190 (32.0
Metabolic dysfunction–associated steatotic liver disease (MASLD) affects approximately one-third of the global population. We aimed to evaluate the efficacy and safety of dual glucagon-like peptide-1 and glucagon receptor agonists (GLP-1/Gcg RAs) in patients with MASLD. PubMed, Web of Science, Scopus, and Cochrane Library were searched for randomized controlled trials (RCTs) comparing GLP-1/Gcg RAs with placebo or active comparators in patients with MASLD. Data were pooled using a random-effects model. The primary endpoint was relative change in liver fat content (LFC). Six RCTs (885 patients) were included. Compared with control, dual GLP-1/Gcg RAs significantly reduced relative LFC (mean difference [MD], -45.94
Celiac disease (CD), often associated with malabsorption, presents with a wide spectrum of gastrointestinal and extra-intestinal manifestations. It was aimed to investigate changes in the clinical presentation of CD in children over a 16-year period and to assess whether clinical forms (classical, non-classical and asymptomatic) vary according to age, sex, and histopathological severity. This retrospective study included 216 pediatric patients (aged 1–18 years) diagnosed with biopsy-confirmed CD at a tertiary center between January 2008 and November 2023. Patients were divided into two groups based on the year of diagnosis (group 1 = 2008–2015, group 2 = 2016–2023). Demographics, presenting symptoms, histopathological findings, Oslo-based clinical classifications were analyzed. The mean age at diagnosis was 92.0 ± 51.2 months, with female predominance (65
Liver cirrhosis and cancer are both major causes of morbidity and mortality worldwide. The presence of liver cirrhosis may complicate cancer management and adversely affect clinical outcomes. However, the long-term mortality burden among individuals with both cancer and liver cirrhosis remains poorly characterized in the United States. This study collected data from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database on deaths among adults aged ≥ 25 years in the United States from 1999 to 2023 with co-mention of cancer and cirrhosis. Joinpoint regression analysis was used to examine mortality trends overall and by gender, age, race, census region, urbanization, and state. Sensitivity and subgroup analyses were performed to assess the robustness of the findings. An autoregressive integrated moving average (ARIMA) model was used to project mortality trends from 2024 to 2033. A total of 149,340 deaths were identified during the study period. The age-adjusted mortality rate (AAMR) increased from 2.08 per 100,000 population in 1999 to 3.51 per 100,000 population in 2023 (AAPC = 2.13
Patient experience is a key quality indicator for colonoscopy, yet standardized assessment tools are lacking in China. The Newcastle ENDOPREM scale has shown promise internationally but requires validation in China. To translate, adapt, and preliminarily evaluate the psychometric properties of the Chinese version of the Newcastle ENDOPREM (ENDOPREM-CN) to assess colonoscopy patient experience in Chinese patients. This dual-center prospective study followed forward-backward translation principles and cognitive interviewing for adaptation. From April 2024 to April 2026, 296 patients undergoing colonoscopy completed the ENDOPREM-CN. Reliability and validity were assessed, and factors influencing experience were analyzed. Of 301 patients, 296 completed the ENDOPREM-CN. Positive experience was high (98.3
The optimal neoadjuvant or perioperative systemic strategy for resectable locally advanced gastric cancer (LAGC) and gastroesophageal junction adenocarcinoma (GEJA) remains uncertain. This study compared clinically defined treatment classes rather than individual regimens. PubMed, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science were searched through April 30, 2026. Eligible randomized controlled trials (RCTs) enrolled patients with resectable LAGC/GEJA and evaluated neoadjuvant or perioperative systemic therapy. Outcomes were overall survival (OS), event free survival (EFS), pathologic complete response (pCR), major pathologic response (MPR), R0 resection, and postoperative complications. Network meta-analysis pooled hazard ratios (HRs) and odds ratios (ORs) with 95
Recent literature indicated that the prevalence of colonic diverticulosis in China is increasing. However, there is limited information on colonic diverticulosis in China. Our study aims to determine the prevalence and characteristics of colonic diverticulosis in Southern China. Data of patients who underwent colonoscopy at Nanchang University’s first affiliation hospital between 2021 and 2023 were exported from a hospital endoscopic database. To assess the association between patients’ characteristics and diverticulosis, we used binary logistic regression to estimate odds ratios (OR) and 95
Chronic atrophic gastritis (CAG) is a well-established precancerous condition in the gastric carcinogenesis cascade. Helicobacter pylori (H. pylori) infection is the primary etiological factor for CAG; however, the differential impact of H. pylori virulence types on endoscopic and histopathological severity remains incompletely characterized. This study aimed to investigate the correlation between H. pylori antibody typing and endoscopic classification of CAG based on the Kimura-Takemoto system, as well as OLGA and OLGIM staging. We conducted a retrospective analysis of 742 patients diagnosed with CAG at the Department of Gastroenterology, Yunnan University Affiliated Hospital, between January 2023 and December 2025. Clinical data, including magnifying endoscopy findings, histopathological results, H. pylori infection status, and antibody typing, were systematically collected and analyzed. The relationships between H. pylori antibody types and Kimura-Takemoto endoscopic classification, OLGA staging, and OLGIM staging were evaluated using chi-square tests, Fisher’s exact tests, and multivariate ordinal logistic regression. Among the 742 patients with CAG, 601 (81.0
Crohn’s disease (CD) predominantly affects the terminal ileum and colon. Upper gastrointestinal (UGI) tract involvement in CD is uncommon, and its clinicopathological profile remains inadequately studied. This study aimed to investigate the characteristics and diagnostic value of two histological features: focally enhanced gastritis (FEG) and focally active inflammation (FAI), in adult CD. A total of 136 patients with CD were retrospectively included in this study. UGI endoscopies and histological reviews were performed. One specimen was routinely obtained from the gastric body and angulus, while two specimens were collected from each of the distal esophagus, gastric antrum, duodenal bulb, and descending duodenum. FEG and/or FAI were identified in 33
Plastic stents are widely used in endoscopic biliary drainage. However, limitations such as poor conformability, migration, biofilm-induced obstruction, and limited radiographic visibility remain unresolved. This study aimed to evaluate the efficacy and safety of the newly designed stent using in vitro mechanical tests and an in vivo porcine biliary stricture model. All stents were classified into four groups: Group 1, commercial double pigtail; Group 2, new double pigtail; Group 3, proximal half-bend with distal pigtail stent; and Group 4, double half-bend stent. The drainage performance and mechanical properties were assessed using in vitro evaluations. A mini-pig biliary stricture model was used for in vivo validation. Stents were endoscopically inserted and maintained for 4 weeks. Outcomes included radiographic migration, biochemical parameters, biofilm/sludge assessment, luminal patency, and histological analysis of bile duct tissue. Groups 3 and 4 showed favorable exploratory findings in tissue reactivity, luminal patency, and positional stability compared with Group 1. Stent migration occurred in 1/4 animals in Group 1 and in 0/4 animals in Groups 2–4. Because multiple structural modifications were introduced simultaneously, the observed findings could not be attributed to an individual design component. Radiopaque markers enhanced visibility under fluoroscopic guidance, facilitating real-time confirmation of the stent position. In this exploratory preclinical study, the newly developed stents showed favorable mechanical, histological, and luminal-patency findings. These results require confirmation in larger preclinical studies and prospective clinical investigations.
Perineural invasion (PNI) and lymphovascular invasion (LVI) are adverse prognostic factors in colorectal cancer (CRC), but their preoperative identification remains challenging. This study evaluated a comprehensive set of quantitative spectral computed tomography (CT) parameters, including arterial enhancement fraction (AEF) and normalized AEF (NAEF), for detecting an exploratory composite endpoint defined as the presence of either PNI or LVI. PNI and LVI were also evaluated separately. This single-center retrospective study included 120 patients with surgically confirmed colorectal adenocarcinoma who underwent preoperative dual-energy spectral CT between November 2023 and August 2024. For the exploratory composite endpoint, patients were classified as PNI/LVI-positive if either PNI or LVI was present (n = 48) and PNI/LVI-negative if both were absent (n = 72); PNI and LVI were also analyzed separately as secondary outcomes. Quantitative parameters—including iodine concentration (IC), normalized IC (NIC), monoenergetic attenuation at 40 and 100 keV, spectral slope (λ), effective atomic number (Eff-Z), AEF, and NAEF—were extracted from arterial- and venous-phase images. Parameters that differed significantly between groups in univariable analyses (P < 0.05) were entered jointly into multivariable logistic regression models. Discrimination was assessed using receiver operating characteristic (ROC) analysis. Internal validation used 1,000 bootstrap resamples in which the complete model-development process, including univariable screening and multivariable model fitting, was repeated. Optimism was estimated as the difference between performance in each bootstrap sample and the performance of the corresponding bootstrap-fitted model in the original cohort; mean optimism was subtracted from apparent performance to obtain optimism-corrected estimates. The same procedure was applied to the PNI/LVI, PNI-specific, and LVI-specific models. The PNI/LVI-positive group had significantly higher arterial- and venous-phase IC, NIC, 40-keV attenuation, and λ (all P < 0.001), as well as higher venous-phase 100-keV attenuation, Eff-Z, AEF, and NAEF (all P ≤ 0.036). Individual parameters yielded apparent areas under the ROC curve (AUCs) of 0.612–0.810. The combined PNI/LVI model had an apparent AUC of 0.874 (95
