Peroral Endoscopic Myotomy (POEM) has become the first-line minimally invasive treatment for achalasia. Its short-term and mid-term (1–5 years) efficacy has been consistently demonstrated, but long-term follow-up data (≥ 5 years) remain limited. This systematic review and meta-analysis aims to comprehensively evaluate the long-term (median follow-up ≥ 5 years) clinical efficacy and safety of POEM. Using medical literature databases, we retrieved randomized controlled trials (RCTs) and non-randomized comparative studies from the inception of the databases through September 2025. Data were extracted using the Cochrane Risk of Bias 2.0 tool and the Newcastle–Ottawa Scale to assess risk of bias for RCTs and cohort studies, respectively. Meta-analyses were conducted using either fixed-effect or random-effects models. A total of 16 studies involving 2421 patients (50.4

ObjectiveTo characterize antibiotic resistance, virulence genotypes and phylogenetic lineages of Helicobacter pylori (H. pylori) isolates from Eastern China and identify resistance/virulence-associated genetic variants.MethodsWhole-genome sequencing (WGS) and phenotypic antimicrobial susceptibility testing (AST) for 6 antibiotics were performed on 141 H. pylori isolates from Hangzhou, China. Genetic analysis (resistance mutations, virulence genotyping, phylogenetic tree) and the assessment of antibiotic resistance related phenotype-genotype concordance were conducted.ResultsMetronidazole resistance was highest (85.1%), followed by levofloxacin (57.4%), clarithromycin (53.9%) and amoxicillin (21.3%); tetracycline and furazolidone resistance was low at 2.8% and 0.7%, respectively. Key resistance mutations included 23S rRNA A2143G (clarithromycin, 92.91% phenotype-genotype concordance), gyrA N87K (levofloxacin, 89.13% concordance) and pbp1A 1785_1786insAGC (amoxicillin, 83.69% concordance). Dominant virulence genotypes: cagA ABD (86.26%), vacA s1-type (100%, 58.02% s1m2, 41.22% s1m1), htrA 171S (61.07%). 95.4% of strains clustered in hpEastAsia lineage; 3.8% in hpEurope, 0.76% in hpAsia2.ConclusionH. pylori isolate in Eastern China show high resistance to common antibiotics and dominant high-virulence genotypes. WGS identifies key resistance markers, aiding targeted H. pylori treatment.

Using paeoniflorin is a promising strategy for irritable bowel syndrome (IBS) therapy due to its natural origin and pharmacological activity. This study explored its therapeutic effects and mechanisms in corticotropin-releasing factor (CRF)-induced IBS models. In vitro, CRF disrupted tight junction (TJ) in T84 cells via the CRFR1/ROCK2/MLC pathway, downregulating occludin and claudin-1. Paeoniflorin targeted CRFR1, inhibited ROCK2 and MLC phosphorylation, and restored TJ integrity. In vivo, paeoniflorin alleviated anxiety-like behaviors and visceral hypersensitivity in CRF-induced IBS mice, reduced FITC-dextran levels, enhanced goblet cell mucus secretion, and improved intestinal permeability. It also upregulated occludin and claudin-1, restored TJ structure, and modulated the CRFR1/ROCK2/MLC pathway. These findings suggest paeoniflorin as a potential therapeutic agent for IBS-related intestinal barrier dysfunction.

The development of foundation models (FMs) is crucial for advancing endoscopic image analysis. However, existing endoscopy FMs mainly rely on self-supervised learning from uni-modal images or videos, overlooking the rich semantic knowledge contained in clinical reports. Furthermore, effectively leveraging these records is hindered by a fundamental modality gap: structured anatomical descriptions are not naturally mapped to specific frames within the high-redundancy, uncurated visual streams. In this paper, we present EndoVLM, a novel vision-language FM pre-trained on over 348K endoscopic examinations, each pairing a clinical report with its corresponding image collection. An Anatomy-Guided Sparse Pooling mechanism utilizes textual descriptions as queries to drive sparse attention, efficiently aggregating semantically salient frames into anatomy-specific visual representations across redundant image-sets. Next, a Progressive Semantic-Aware Alignment strategy models clinical taxonomy (anatomy and pathological status) via structured soft targets, bridging the gap from global patient-level matching to fine-grained localized alignment. Finally, a Semantic-Concentrated Masked Autoencoder is applied exclusively to these semantic-rich frames, integrating low-level visual precision with robust high-level semantic representation. Extensive experiments across various downstream tasks demonstrate that EndoVLM outperforms existing foundation models and remains competitive with task-specific methods. Remarkably, EndoVLM also exhibits robust zero-shot generalization capabilities, highlighting its potential for broader clinical application.

Background & Aims Helicobacter pylori (H pylori) eradication significantly reduces gastric cancer risk but offers limited benefit for patients with advanced atrophic gastritis. After eradication, a persistent inflammatory-cancer-transformation microenvironment (ICTM) drives gastric carcinogenesis, warranting further investigation. Methods We constructed a single-cell atlas of 22 gastric antral mucosae across disease stages, including normal controls, H pylori-infected non-atrophic gastritis, H pylori-infected chronic atrophic gastritis, and post-eradication chronic atrophic gastritis (stratified by pathological improvement). Key findings were validated via multiplex immunofluorescence and primary cancer-associated fibroblast (CAF) experiments. Results H pylori infection profoundly alters the ICTM within immune and stromal cells during and after eradication. Following eradication, epithelial cells exhibit distinct trajectories after eradication, with the pathological improvement group showing increased MUC5AC expression and the non-improvement group displaying a malignant trajectory. Immunomodulatory CAFs (iCAFs) critically promote epithelial malignancy and immunosuppression. CCN2+ iCAF1 and C3+ iCAF3 are enriched in infected tissues and persist in post-eradication patients with CAG. H pylori infection reprograms iCAFs, leading to extracellular matrix reorganization and senescence with senescence-associated secretory phenotype. This reprogramming promotes epithelial malignant transformation and stemness. Infection-driven reprogramming of the iCAF-epithelial niche is accompanied by an immunosuppressive state after eradication. Conclusions H pylori infection induces persistent ICTM after eradication. Infection-driven iCAF differentiation contributes to epithelial malignant transformation and a potential immunosuppressive microenvironment, linking to gastric carcinogenesis. Our findings underscore the critical role of ICTM transformation, highlighting the need to improve ICTM for post-H pylori eradication therapies, and indicate that specific iCAF subtypes represent promising intervention targets.

Objective To reveal the detection status and molecular characteristics of Clostridium perfringens in food in Pudong New Area, providing a scientific basis for the risk assessment and prevention of this pathogen. MethodsIn 2023, 111 samples of raw and cooked food were randomly collected monthly from traditional markets and supermarkets at six monitoring sites (Dongming, Tangqiao, etc.) in Pudong New Area, totaling 1 332 samples across the year. C. perfringens was isolated via sulfite-polymyxin-sulfadiazine (SPS) agar and Columbia blood agar. Next-generation sequencing was employed to obtain the whole genome sequences of the strains. Virulence genes, multi-locus sequence typing (MLST), and drug resistance genes were analyzed based on VFDB, PubMLST, and CGE ResFinder. A phylogenetic tree was established based on single nucleotide polymorphisms (SNPs). ResultsIn 2023, the detection rate of C. perfringens in food in Pudong New Area was 5.78% (77/1 332). All positive samples were meat and meat products, and the detection rate in poultry meat was the highest (28.57%, 29/144). Nine antibiotic resistance genes were detected and the carriage rate of tetA(P) was the highest (89.61%, 69/77). All the isolates carried plc, while 74.03% (57/77) carried cpb2. The 77 isolates were classified into 63 sequence types (STs), with multiple strains clustering closely with human-derived isolates from Shenzhen and Wuhan. ConclusionsIsolates of Clostridium perfringens from meat and meat products in Pudong New Area carry diverse virulence factors and antibiotic resistance genes, indicating potential food safety risks.

This review synthesizes current evidence on autonomic nervous system (ANS) dysfunction in irritable bowel syndrome (IBS). Patients with IBS often exhibit sympathovagal imbalance–reduced vagal tone with relative sympathetic hyperactivity–which correlates with symptom severity and shows subtype specificity. The ANS orchestrates bidirectional brain–gut communication via interactions with psychosocial factors, low-grade neuroinflammation, and the gut microbiota. Key mechanisms include vagal afferent signaling by microbial metabolites, sympathetic regulation of mucosal immunity, stress-induced disruption of autonomic homeostasis, and neuroplastic changes in intestinal and central pain pathways. Emerging evidence supports therapeutic targeting of autonomic circuits through vagus nerve stimulation, pharmacological modulation of serotonin and adrenergic receptors, and microbiome-based interventions. Current challenges include methodological limitations in assessing neural dynamics and insufficient integration of multi-system interactions. Future research should employ multi-omics approaches to elucidate pathway-specific mechanisms and develop precision medicine strategies for this heterogeneous disorder.

Background: Although Upadacitinib has proven success in inflammatory bowel diseases (IBD), there is less data on its efficacy and safety in Asian patients with refractory IBD. Methods: This multicenter study evaluated the real-world effectiveness and safety of UPA in patients with refractory IBD. This multicenter retrospective cohort analysis included adult refractory IBD patients who received UPA therapy at three tertiary hospitals from January 2023 to March 2025. Clinical, endoscopic, and laboratory outcomes were effectiveness goals. Safety measures included AEs and and rates of discontinuation. Results: A total of 80 eligible patients were enrolled, including 52 with CD and 28 with UC. During the induction period, for CD: steroid-free clinical remission: 59.6%; clinical response: 61.5%; endoscopic remission: 30.8%; endoscopic response: 57.7%. For UC, steroid-free clinical remission: 67.9%; clinical response: 71.4%; endoscopic remission: 46.4%; endoscopic response: 60.7%. In the maintenance phase (12 months), CD had 78.8% steroid-free clinical remission and 75.0% endoscopic remission. UC had 85.7% steroid-free clinical remission and 78.6% endoscopic remission. Inflammatory indicators and nutritional parameters improved significantly. The incidence of adverse events in CD and UC was 23.1% and 14.3%, respectively, and the discontinuation rates during the 12-month maintenance treatment period were 7.1% and 21.5%, respectively. The most common adverse reaction is acne (8.75%). Conclusion: UPA demonstrated robust real-world effectiveness and an acceptable safety profile in Asian patients with refractory IBD.

ObjectiveChronic stress can disrupt the body's internal homeostasis and increase the risk of developing various diseases. Leptin, as an adipokine, has been shown to be associated with alterations in intestinal permeability and the gut microbiota; however, its role in chronic stress-induced intestinal barrier dysfunction and its potential link to microbiota alterations remain unclear.MethodsChronic social defeat stress was induced in C57BL/6 wild-type mice and leptin-deficient ob/ob mice, followed by intraperitoneal administration of exogenous leptin. Visceral sensitivity, behavioral changes, intestinal barrier function, and intestinal leptin/receptor levels were assessed. Faecal samples were analysed using 16S rRNA sequencing and non-targeted metabolomics techniques. In vitro experiments involved treating Caco-2 monolayers with the JAK2 inhibitor AG490 or the STAT3 inhibitor BP-1-102 prior to leptin intervention to assess permeability, tight junction proteins, proliferation and apoptosis.ResultsChronic stress increased visceral sensitivity, induced anxiety- and depression-like behaviors, reduced jejunal levels of the tight junction proteins claudin-1 and occludin, promoted intestinal cell apoptosis, and increased intestinal IL-1β and IL-6 levels, while decreasing intestinal leptin and its receptor. Exogenous leptin reduced visceral sensitivity and alleviated anxiety- and depression-like behaviors. Leptin supplementation increased occludin protein levels in wild-type mice; reduced intestinal IL-1β and IL-6 levels, enhanced intestinal cell proliferation in ob/ob mice; and inhibited intestinal cell apoptosis in both genotypes. Exogenous leptin enhanced intestinal STAT3 phosphorylation in wild-type mice, while JAK2 inhibition increased Caco-2 cell permeability. However, combined leptin and inhibitor intervention caused an imbalance in Caco-2 cell proliferation and apoptosis, rather than affecting tight junction protein levels. 16S rRNA analysis revealed that under chronic stress, increased Akkermansia abundance in wild-type mice and Escherichia increased in ob/ob mice. Non-targeted metabolomics indicated that chronic stress and leptin deficiency primarily affected lipid and pyrimidine metabolism as well as mTOR/cAMP signaling, with leptin supplementation partially restoring metabolic profiles in ob/ob mice.ConclusionChronic stress reduces intestinal leptin levels, impairs the intestinal barrier and disrupts the gut microbiota, thereby inducing anxiety- and depression-like behavior and visceral hypersensitivity in mice. However, these changes can be reversed by the administration of exogenous leptin.

Helicobacter pylori (H. pylori) infection is a major risk factor for gastric carcinogenesis, requiring holistic endoscopic assessment of distributed mucosal abnormalities. While patient-level diagnostic labels are accessible, obtaining large-scale fine-grained annotations is constrained due to high inter-observer variability and the labor-intensive nature of the process. This naturally formulates the task as a multiple instance learning (MIL) problem. Existing image-level approaches often rely on noisy supervisory signals without modeling sequence context, while standard embedding-based MIL methods suffer from suboptimal feature representations and insufficient integration of H. pylori-specific phenotypes. To address these challenges, we propose PhenoMIL, a two-stage framework emulating clinical hierarchical reasoning. First, the Fine-grained Phenotype-level Semi-Supervised Learning (FPS-SL) stage uses multi-label supervised contrastive learning and prototype-based pseudo-label generation to acquire phenotype-specific knowledge and learn transferable representation from limited instance-level annotations. Subsequently, the Clinically Informed MIL (CIMIL) stage performs holistic bag-level diagnosis using Consensus-aware Feature Modulation (CFM) to exploit latent neighborhood structures, and Phenotype-guided Attention Aggregation (PAA) to align instance weighting with diagnostic priors. Extensive evaluation on a large-scale multi-center dataset (303,910 images from 6388 patients) demonstrates PhenoMIL’s superiority in both multi-label phenotype classification and H. pylori infection diagnosis. Notably, in a real-world reader study, PhenoMIL achieved 81.63% sensitivity and 87.84% specificity, outperforming both junior and senior endoscopists.

IntroductionHigh-quality bowel preparation is a crucial prerequisite for ensuring the effectiveness of colonoscopy. Although polyethylene glycol (PEG) remains the first-line cleansing regimen recommended by clinical guidelines, its practical application still faces challenges in achieving adequate bowel preparation rates. Transcutaneous electrical acupoint stimulation (TEAS) shows promise in enhancing intestinal motility through gut-brain-microbiota modulation. However, its role in the field of intestinal cleansing remains unclear.Methods and analysisThis randomized controlled trial will enroll 404 patients undergoing elective colonoscopy. The participants will be randomly allocated to either the TEAS group or the sham-TEAS group, in a 1:1 ratio. TEAS was applied to stimulate the Zusanli (ST36) and Neiguan (PC6) acupoints using a clinically validated stimulation mode, administered concomitantly with PEG in a combined treatment protocol. The primary outcome measure was the rate of adequate bowel preparation, evaluated with the Boston Bowel Preparation Scale (BBPS). Secondary endpoints encompass colonoscope insertion and withdrawal times, cecal intubation rate (CIR), adenoma detection rate (ADR), first defecation time, total defecation frequency, final stool characteristics, adverse event incidence, and satisfaction.DiscussionBy bridging traditional acupoint therapy with quantifiable neurogastroenterological outcomes, this study aims to establish TEAS as a scalable adjunct in bowel preparation protocols.Trial registrationInternational Traditional Medicine Clinical Trial Registry, ITMCTR2025001121. Registered on April 30, 2025, http://itmctr.ccebtcm.org.cn/.

BACKGROUND:This study aimed to investigate the current knowledge, attitudes, and practices of Chinese physicians regarding the management of Helicobacter pylori infection through a large-scale national survey. MATERIALS AND METHODS:This national, multicenter cross-sectional survey was conducted from October 2024 to May 2025 among physicians from over 2200 medical institutions across 31 provinces using an online questionnaire. The survey comprised four dimensions: basic information, knowledge, attitudes, and practices. Results were compared with the Sixth Chinese National Consensus Report on the Management of H. pylori infection and the Maastricht VI/Florence guidelines. Further, subgroup analyzes were conducted. RESULTS:A total of 6030 valid responses were included. Knowledge: Only 27.5% of participants correctly estimated the H. pylori infection rate as 40%-50%, and 13.5% accurately understood the reinfection rate as 2%. Attitude: Overall, 93.4% of participants reported familiarity with Chinese H. pylori guidelines and consensus statements, and 84.1% supported replacing proton pump inhibitors with potassium-competitive acid blockers. PRACTICE:Gaps were observed in recognizing indications for H. pylori eradication, including unexplained iron deficiency anemia (43.9%), primary immune thrombocytopenia (39.6%), vitamin B12 deficiency (32.3%), and H. pylori infection without countervailing factors (36.8%). The bismuth-based quadruple regimen was the most commonly selected first-line treatment (86.7%); however, 74.5% still selected the amoxicillin + clarithromycin combination, despite the high resistance rate associated with clarithromycin. The dual regimen is gradually gaining acceptance (53.9%). Subgroup analyzes: Greater adherence to guideline recommendations was observed among physicians from higher-level medical institutions, gastroenterologists, those with more years of practice, higher professional titles, and educational levels, as well as those practicing in economically developed regions. CONCLUSION:Chinese physicians generally follow guideline-recommended core practices for the diagnosis and treatment of H. pylori. However, notable gaps persist in understanding reinfection rates, identifying appropriate eradication indications, and selecting optimal treatment regimens. Therefore, strengthened educational interventions are warranted.

ObjectiveTo study the effect of MMF(Massa Medicata Fermentata)on the secretion of cytokines of colon mucosa and visceral sensitivity in rats with IBS-D(diarrhea-predominant irritable bowel syndrome).Methods45 adult male SD rats (Spragua-dawley) were randomly divided into Normal control group (NC). IBS-D model group (Model); MMF intervention group (MMF). qPCR (quantitative real-time polymerase chain reaction) was used to detect the quantity of fecal Bifidobacterium, Lactobacillus, and Escherichia coli; FITC-Dextran (Fluorescein Isothiocyanate-Dextran) was used to detect intestinal permeability; Immunofluorescence was used to detect the localization of FliC (Flagellin main component) and TLR5 (Toll-like receptor 5) in the intestinal mucosa; qPCR and WB (Western blot) were used to detect the mRNA and protein expression of TLR5, TRIF (Toll/Interleukin-1 Receptor Domain-Containing Adapter Inducing Interferon-β), EPK1/2 (Extracellular signal-regulated kinase 1/2) in LPDCs (Lamina Propria Dendritic Cells); CCK8 (Cell Counting Kit-8) was used to detect the proliferation of CD4+ T lymphocytes stimulated by LPDCs; ELISA (Enzyme-Linked Immunosorbent Assay) was used to detect the secretion of IL-12, IL-4, IL-6, IL-9, IL-17A, IL-10 (Interleukin-12, 4, 6, 9, 10, 17A), IFN-γ (interferon-gamma), TGF-β (Transforming Growth Factor - beta), from CD4+ T lymphocytes.ResultsAfter IBS-D modeling, When compared with the NC group, the visceral sensitivity of rats in model group and MMF group were increased; The quantities of fecal Lactobacillus and Bifidobacterium decreased, The quantities of fecal Escherichia coli increased; The permeability of colonic mucosa was enhanced, accompanied with Flagellin and TLR5 protein upregulated; The expression of TLR5, TRIF, EPK1/2 signals inside LPDCs were increased; CD4+ T lymphocytes proliferation ability was hyperfunction, followed by the excessive secretion of IL-6, IL-17A, TGF-β, IL-12, IFN-γ, and IL-4 from CD4+ T lymphocytes, in contrast IL-10 was hyposecretion (p<0.05 for all). While when compared with the Model group, the above situations have been found recovered in the MMF group. (p<0.05 for all).ConclusionMMF can alleviate the abnormal immune response and cytokine secretion of colon and relieve visceral hypersensitivity symptoms in rats with IBS-D. Its target may be closely related to the FliC-TLR5-TRIF-ERK1/2 pathway.

BACKGROUND Bone marrow-derived mesenchymal stem cells (BMSCs) are a promising therapy for ulcerative colitis (UC). However, their clinical benefit is limited by inefficient homing to the inflamed colonic mucosa. Improving the migration of BMSCs to sites of intestinal inflammation remains a key challenge in the development of cell-based treatments for UC. Tongxie Yaofang (TXYF), a traditional Chinese medicine formula, has been shown to relieve symptoms in UC patients. Our previous in vitro studies also showed that TXYF enhances the migratory capacity of BMSCs. However, whether TXYF enhances the therapeutic effect of BMSCs transplantation in UC, and the mechanisms involved, remain unclear. AIM To determine whether TXYF promotes the homing of BMSCs and improves experimental colitis, and to explore the underlying mechanisms. METHODS BMSCs from Sprague-Dawley rats were characterized via flow cytometry, and TXYF’s effects on migration were evaluated using scratch and Transwell assays. In a colitis model, the synergistic efficacy of TXYF and BMSCs was assessed through disease activity index, histology, immunohistochemistry, tracing, reverse transcription-quantitative polymerase chain reaction, and western blotting. Furthermore, the stromal cell-derived factor 1 (SDF-1)/C-X-C chemokine receptor type 4 (CXCR4) axis was investigated using specific antagonists to elucidate the molecular mechanisms of this combinatorial therapy. RESULTS TXYF promoted the in vitro migration of BMSCs. In vivo , the combination of TXYF with BMSCs transplantation alleviated colitis symptoms in rats, improving inflammatory responses, colonic tissue damage, and mucosal barrier function. Our findings suggest that TXYF may enhance the migratory capacity of BMSCs by modulating the SDF-1/CXCR4 axis, thereby increasing their homing to the colonic mucosa. CONCLUSION This study demonstrates that TXYF can enhance the homing efficiency of exogenous BMSCs to the colonic mucosa, likely through the SDF-1/CXCR4 axis, which contributes to the mitigation of experimental colitis.

Irritable bowel syndrome is a chronic functional gastrointestinal disorder characterized by recurrent abdominal pain and altered bowel habits, a condition significantly influenced by stress. Based on the brain's perception and response to stressors, stress can be categorized into physical stress and psychological stress. Accordingly, this narrative review focuses on elucidating the effects of different stress paradigms on irritable bowel syndrome. Stress activates the locus coeruleus-norepinephrine system and hypothalamic-pituitary-adrenal axis, contributing to symptom onset and progression. Physically, stress disrupts intestinal homeostasis and promotes low-grade inflammation, leading to the emergence of gastrointestinal symptoms, which typically occur following intestinal infection or in the context of inflammatory bowel disease. Psychologically, stress can trigger mental symptoms such as anxiety and depression, which share a bidirectional causal relationship with irritable bowel syndrome; antidepressants and cognitive behavioral therapy have been shown to be effective in managing irritable bowel syndrome. Early adverse life events may heighten stress sensitivity and increase irritable bowel syndrome risk. Animal models employing psychosocial or physical stressors have demonstrated that stress induces visceral hypersensitivity and brain-gut axis dysregulation through mechanisms including intestinal barrier impairment, mild inflammation, microbiota disruption, and altered neural signaling. These insights support integrated strategies for the prevention and management of irritable bowel syndrome.

Background: The presence of metabolic dysfunctions defines metabolic syndrome. While the epidemiology of depression and metabolic abnormalities has been studied, the role of sex remains unclear. Methods: Adults aged 20 and above (N = 3162 (202,474,260 after weighting)) from the 2017-2020 National Health and Nutrition Examination Survey were included. Depression severity was measured using the Patient Health Questionnaire-9 (PHQ-9) score, which was first treated as a continuous variable, with restricted cubic splines plotted. It was then analyzed as quartiles and four levels, adjusting for covariates. The first percentile and non-depressed individuals served as the between depression severity and metabolic dysfunction. In females, clinical threshold analysis showed increased diabetes (moderate: OR = 2.45, 95% CI: 1.22-4.93, Q: 0.048) and hypertension (moderate: OR = 2.75, 95% CI: 1.27-5.94, Q: 0.042). In males, major depression was strongly associated with metabolic syndrome (OR = 4.83, 95% CI: 2.26-10.31, Q: 0.003), hypertension (OR = 4.23, 95% CI: 1.80-9.98, Q: 0.009), and hypertriglyceridemia (OR = 3.53, 95% CI: 1.37-9.10, Q: 0.039). Quartile analysis showed that in males, the highest depression quartile (Q4) was also linked to nonalcoholic fatty liver disease (NAFLD (OR = 2.42, 95% CI: 1.46-4.01, Q: 0.006)) and metabolic dysfunction-associated steatotic Liver Disease (MASLD (OR = 2.22, 95% CI: 1.44-3.42, Q: 0.003)). Conclusions: Depression is associated with sex-specific metabolic risks: in females, risk is most pronounced at the moderate severity threshold, centered on diabetes and hypertension; in males, risk shows a severity-dependent gradient, strongest for metabolic syndrome, hypertension, hypertriglyceridemia, and fatty liver diseases.

PURPOSE:To investigate the relationship between the consumption of live microbes in the diet and adult periodontitis. MATERIALS AND METHODS:Utilising data from the National Health and Nutrition Examination Survey (NHANES) spanning 1999-2004 and 2009-2014, 16,600 adults who underwent 24-h face-to-face dietary recall and oral health examinations were identified. Dietary live microbe intake was categorised into low, medium, and high levels. To examine the relationship between different levels of dietary live microbe intake and periodontitis, we employed logistic regression, subgroup and restricted cubic spline models. RESULTS:Upon comprehensive covariate adjustment, low dietary live microbe intake (104 CFU/g) demonstrated a positive association with periodontitis prevalence, while medium intake (104 to 107 CFU/g) showed a negative association. Conversely, no significant associations were observed between high dietary live microbe intake (>107 CFU/g) and periodontitis. Restricted cubic spline analysis confirmed a linear association between low dietary live microbe intake. Moreover, a U-shaped dose-response relationship was identified between medium dietary live microbe intake and periodontitis prevalence. CONCLUSIONS:Moderate intake of medium live microbe food may be more conducive to avoiding the occurrence of periodontitis.

BACKGROUND:Lifestyle factors are closely associated with the onset and progression of inflammatory bowel disease (IBD). Studies have demonstrated the positive effects of exercise on clinical outcomes and quality of life in individuals with IBD. Despite the well-documented role of exercise in improving IBD outcomes, the underlying mechanisms remain unclear. AIM:To compare the efficacy of different exercise modalities and explore their potential physiological mechanisms in rodent models of colitis. METHODS:We conducted a comprehensive search of five databases from inception to September 24, 2024, which yielded 19 animal studies in rodent colitis models. We compared the efficacy of various forms of exercise and explored the possible physiological mechanisms. The effects of different exercise modalities, namely forced treadmill running (FTR), voluntary wheel running (VWR), swimming, climbing, and jumping, on both macroscopic symptoms (e.g., body weight, disease activity, and colon length) and microscopic parameters (e.g., histopathology, immune markers, oxidative/antioxidant balance, and gut microbiota) in colitis models were compared. RESULTS:VWR (simulated recreational physical activity), swimming (aerobic exercise), and strength training (climbing and jumping) consistently promoted overall health in animal colitis models. However, evidence for FTR remains inconsistent, with a notable number of studies suggesting potential exacerbation of colitis symptoms, possibly due to stress or fatigue resulting from its coercive nature. Overall, various exercise (e.g., VWR, swimming, strength training) ameliorates colitis symptoms possibly by suppressing immune hyperactivation, enhancing antioxidant defenses, and modulating gut microbiota composition. In contrast, FTR was inconsistent, with several studies indicating a potential exacerbation of colitis symptoms, possibly due to stress or fatigue induced by its coercive nature. CONCLUSION:Exercise modality is critical in influencing colitis outcomes, with voluntary and low-stress forms generally being beneficial, while forced exercise may yield adverse effects. These findings highlight the importance of exercise type and individual tolerance in designing therapeutic exercise interventions for IBD. Further research is warranted to establish a robust therapeutic framework for exercise-based interventions in IBD management.