International Journal of Colorectal Disease最新文献

{"title":"Evaluating the influence of the obesity paradox on survival outcomes in patients being treated surgically for rectal cancer-a systematic review and meta-analysis.","authors":"Matthew G Davey, Noel E Donlon, Mark Donnelly, Eanna J Ryan, Odhran K Ryan, Ian S Reynolds, William P Joyce","doi":"10.1007/s00384-025-04957-z","DOIUrl":"10.1007/s00384-025-04957-z","url":null,"abstract":"<p><strong>Background: </strong>Obesity is a well-established risk factor for rectal cancer development. The association between obesity and survival outcomes in those undergoing resection for rectal cancer remains unclear. The objective of this study was to perform a systematic review and meta-analysis evaluating the association between obesity and overall (OS) and disease-free (DFS) in patients undergoing surgery for rectal cancer with curative intent.</p><p><strong>Methods: </strong>A systematic review was performed as per PRISMA guidelines. Descriptive statistics (Fisher's exact test (†)) were used. Meta-analyses were performed using Mantel-Haenszel and generic inverse variance methods using RevMan version 5.4.</p><p><strong>Results: </strong>Twenty-three studies with 22,520 patients were included (mean follow-up: 59.7 months). Overall, 18.5% of patients were living with obesity (4174/22,520). Obesity was associated with poorer DFS [60.5% (2289/3783) vs. 62.4% (9576/15,335), P = 0.029, †]; however, a non-significant difference was observed at meta-analysis [hazard ratio (HR): 1.12, 95% confidence interval (95% CI) 0.90-1.40, P = 0.320, heterogeneity (I²) = 77%]. Obesity was associated with enhanced OS [67.8% (2500/3687) vs. 59.8% (9048/15,125), P < 0.001, †], results which were replicated at meta-analysis [HR 1.24, 95% CI 1.03-1.50, P = 0.020, I² = 59%]. Using time-to-effect modelling, a non-significant difference in DFS [HR 0.93, 95% CI 0.69-1.24, P = 0.600, I² = 57%] and OS [HR 1.00, 95% CI 0.73-1.37, P = 1.000, I² = 69%] was observed at meta-analysis.</p><p><strong>Conclusion: </strong>Once diagnosed and being treated with curative intent for rectal cancer, patients living with obesity exhibit similar survival outcomes as those living without obesity. This study refutes hypotheses that an 'obesity paradox' is protective for survival in patients with rectal cancer. Given the current obesity epidemic, this concept may warrant incorporation into preoperative counselling.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"180"},"PeriodicalIF":2.3,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12361308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical use of vedolizumab subcutaneous formulation in inflammatory bowel diseases: a review of real-world evidence.","authors":"Kirk B Russ, Christian Agboton, Pravin Kamble, Abigail M Wojtowicz, Anita Afzali","doi":"10.1007/s00384-025-04966-y","DOIUrl":"10.1007/s00384-025-04966-y","url":null,"abstract":"<p><strong>Introduction: </strong>Vedolizumab is an advanced therapy indicated for the treatment of moderately to severely active Crohn's disease (CD) or ulcerative colitis (UC). After induction with vedolizumab intravenous (IV), maintenance is with vedolizumab 300 mg IV every 8 weeks, or patients can transition to vedolizumab 108 mg subcutaneous (SC) every 2 weeks.</p><p><strong>Methods: </strong>This was a literature review of the PubMed and Embase databases up to March 2024 to identify publications describing clinical practice experiences on the transition from vedolizumab IV to SC.</p><p><strong>Results: </strong>In total, 36 eligible publications were identified, comprising 4105 UC and CD patients treated with vedolizumab: 2718 with vedolizumab SC. Across studies, there was no loss of effectiveness after transition from vedolizumab IV to SC based on disease activity scores or biomarkers (C-reactive protein and fecal calprotectin). Higher vedolizumab trough levels were observed consistently with vedolizumab SC versus IV. Treatment persistence with vedolizumab SC ranged from 89.0% to 95.5% after 3 - 6 months and approximately 81% to 89% at 12 months. A willingness to transition to the SC formulation was reported by 47% to 59% of patients, due to time savings and fewer hospital visits. Patients who transitioned to vedolizumab SC showed a high level of satisfaction (75% - 95%) with the transition. The most frequently reported adverse events with vedolizumab SC were injection site reactions, with frequencies of 2.9% to 18.5%.</p><p><strong>Conclusions: </strong>Clinical practice experience in inflammatory bowel disease patients who transitioned from vedolizumab IV to SC showed no change in effectiveness or safety outcomes, and a high level of patient satisfaction overall.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"179"},"PeriodicalIF":2.3,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12356757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cytoreductive surgery for colorectal peritoneal metastasis in the era modern systemic therapies: a systematic review and meta-analysis of survival outcomes.","authors":"Mufaddal Kazi, Ajinkya Pawar, Avanish Saklani, Aditi Bhatt","doi":"10.1007/s00384-025-04978-8","DOIUrl":"10.1007/s00384-025-04978-8","url":null,"abstract":"<p><strong>Introduction: </strong>The value of surgical cytoreduction over modern systemic therapy in patients with colorectal peritoneal metastasis is debated. The present systematic review and meta-analysis aimed to determine the magnitude of the benefit of cytoreduction for peritoneal metastasis over varying intensities of palliative therapies.</p><p><strong>Methods: </strong>The databases searched were PubMed, Cochrane Library, Scopus, CINHAL (EBSCO) and Google Scholar. The risk of bias was assessed using the RoB2 tool for randomized studies and the Newcastle-Ottawa scale for non-randomised studies. The certainty of the evidence was assessed using the GRADE Pro tool. The analysis used the log hazard ratio as the outcome measure for survival data with the random-effects model. Sensitivity analyses and meta-regressions were performed to establish the robustness of the results.</p><p><strong>Results: </strong>The quantitative meta-analysis included two randomised and nine non-randomized studies with 3316 patients. The pooled hazard ratio for overall survival was 0.447 (95% CI: 0.387 to 0.595; p-< 0.001) favouring cytoreduction without statistical heterogeneity (I² = 0%) or publication bias. There was moderate certainty of evidence, that was downgraded due to clinical heterogeneity among studies and the risk of bias from non-randomized studies. Sensitivity analyses and meta-regression confirmed that the pooled hazard ratio remained unchanged irrespective of the systemic therapies used or the risk of bias of individual studies.</p><p><strong>Conclusions: </strong>Curative intent treatment of colorectal peritoneal metastasis by adding cytoreductive surgery over systemic chemotherapy alone, increased the OS by a large magnitude with moderate certainty of evidence, irrespective of the systemic therapy used.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"178"},"PeriodicalIF":2.3,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12354506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Textbook outcome in low rectal cancer patients undergoing laparoscopic or open surgery: 3-year results from the multicentric LASRE Trial.","authors":"Yanwu Sun, Zihan Tang, Weizhong Jiang, Xiaojie Wang, Ying Huang, Pan Chi","doi":"10.1007/s00384-025-04976-w","DOIUrl":"10.1007/s00384-025-04976-w","url":null,"abstract":"<p><strong>Purpose: </strong>The textbook outcome has emerged as a valuable metric for quality assessment in oncological surgery. However, its application and impact within randomized controlled trials involving patients with low rectal cancer remain underexplored. This study aimed to investigate the incidence and predictors of textbook outcome in patients with low rectal cancer undergoing laparoscopic or open resection.</p><p><strong>Methods: </strong>This post-hoc analysis included patients from the prospective, multicentric LASRE trial with clinically staged I-III rectal cancer located within 5 cm of the dentate line, tumor diameter < 6 cm, and undergoing radical laparoscopic or open resection. A total of 914 patients were analyzed.</p><p><strong>Results: </strong>A textbook outcome was achieved in 74.9% of patients, with a higher rate in the laparoscopic group (76.7%) than in the open group (71.2%, P = 0.07). Multivariate analysis identified independent predictors of textbook outcome failure, including BMI > 24 kg/m², surgical type (abdominoperineal resection), and operative time > 200 min. Achievement of a textbook outcome was associated with improved disease-free survival (DFS).</p><p><strong>Conclusion: </strong>Achieving a textbook outcome is significantly associated with improved DFS in patients with low rectal cancer. These findings highlight the importance of optimizing perioperative and intraoperative care to enhance surgical outcomes, particularly within the context of randomized controlled trials.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: https://clinicaltrials.gov/study/NCT01899547 .</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"177"},"PeriodicalIF":2.3,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12350523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144845895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of non-pharmacological interventions for the restoration of postoperative intestinal motility of patients with colorectal cancer: a systematic review and meta-analysis of randomized controlled trials.","authors":"Lanlan Zheng, Xuan Zhang, Baoyu Ma, Yuan Yuan, Hui Yang","doi":"10.1007/s00384-025-04968-w","DOIUrl":"10.1007/s00384-025-04968-w","url":null,"abstract":"<p><strong>Purpose: </strong>As a major indicator for rehabilitation progress, the restoration of postoperative intestinal motility of patients with colorectal cancer (CRC) is highly publicized. Various non-pharmacological interventions (NPIs) are helpful for bowel recovery. This study aims to evaluate the efficacy of NPIs in enhancing the restoration of postoperative intestinal motility.</p><p><strong>Methods: </strong>Systematic searches were conducted in the Cochrane Library, PubMed, EBSCO, and Embase databases from inception to March 2025, with language restrictions to English. Eligible studies that quantified the effect of NPIs for the restoration of postoperative intestinal motility of patients with colorectal cancer were selected. The primary outcomes were time to first flatus and time to first defecation. The secondary outcomes were time to tolerate fluid food or solid food and length of hospital stay (LOS). Statistical analysis was performed in Review Manager 5.4, Stata v.15.1, and R 4.4.3 software.</p><p><strong>Results: </strong>A total of 23 randomized controlled trials (RCTs) involving 3264 patients and 11 NPIs were selected. Gum chewing significantly shortened the time to first flatus (MD =  - 5.88, 95% CI - 10.33 to - 1.43; I² = 83.1%) and defecation (MD =  - 15.18, 95% CI - 21.67 to - 8.69; I² = 83.1%). Transcutaneous tibial nerve stimulation and electroacupuncture also significantly reduced the time to first flatus (MD =  - 14.95, 95% CI - 18.28 to - 11.61; I² = 39%) and defecation (MD =  - 7.29, 95% CI - 12.43 to - 2.14; I² = 0%), respectively. Network meta-analysis (NMA) identified 100 mg caffeine as the most effective intervention for shortening the time to first flatus, while decaffeinated coffee was the most effective for reducing the time to first defecation and length of hospital stay. In traditional pairwise meta-analysis and NMA, 65.7% (23/35) and 10% (1/10) of comparisons were rated as high confidence of evidence, respectively.</p><p><strong>Conclusion: </strong>Dietary treatments are characterized by their low cost, diverse taste profiles, and lack of dependence on medical settings, making them more amenable to large-scale clinical practice promotion. Particularly, 100 mg caffeine, decaffeinated coffee, and gum chewing are worth paying attention to and recommending. For physical treatments, the limited number of studies and restricted application countries, coupled with higher costs and more stringent implementation requirements, pose significant challenges; therefore, they should be approached with caution. Given the limited evidence currently available, clinical decision-making regarding NPIs should integrate these findings with a focused consideration of the clinical setting, patient needs and preferences, and professional judgment.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"176"},"PeriodicalIF":2.3,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12343698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing surveillance in Lynch syndrome: lesion detection and comparative performance of different colonoscopy modalities-a systematic review and network meta-analysis.","authors":"George Hanen, Hazem E Mohammed, Mohamed Nasser, Mohamed E Haseeb, Hatem Yaser, Shehab Yaser, Salma Allam","doi":"10.1007/s00384-025-04970-2","DOIUrl":"10.1007/s00384-025-04970-2","url":null,"abstract":"<p><strong>Purpose: </strong>Lynch syndrome patients are at a high risk for developing colorectal cancer; thus, optimal surveillance strategies are required. Although colonoscopic imaging methods differ in diagnostic performance, direct comparisons in this population are not very common. We aimed to evaluate and compare the detection capabilities of white-light endoscopy (WLE), chromoendoscopy, virtual chromoendoscopy (NBI: narrow band imaging, LCI: linked color imaging, I-SCAN), and AI-assisted colonoscopy in detecting neoplastic and non-neoplastic lesions in individuals diagnosed with Lynch syndrome.</p><p><strong>Methods: </strong>Up until March 2025, PubMed, WOS, and Scopus were searched. Relevant studies included observational or interventional designs that contrasted various forms of colonoscopy in adults with Lynch syndrome. The primary outcomes were the lesion detection rate and number of lesions per colonoscopy. Secondary outcomes included total procedure time and withdrawal time. Credibility of the evidence was assessed employing CINeMA.</p><p><strong>Results: </strong>Nine studies were included. LCI and chromoendoscopy demonstrated a significantly higher neoplastic lesion detection rate compared to WLE (RD 0.11, 95% CI [0.01, 0.21], P = 0.03) and (RD 0.07, 95% CI [0.01, 0.14], P = 0.03), respectively, and LCI significantly detected more lesions per procedure (MD = 0.23, 95% CI 0.01-0.45, P = 0.04). Chromoendoscopy was better at marking the non-neoplastic lesions (RD 0.16, 95% CI [0.05, 0.27], P = 0.005) but had the longest procedure and withdrawal times. AI-assisted, as well as virtual ones, were better than WLE but were not as effective as LCI or chromoendoscopy.</p><p><strong>Conclusion: </strong>In terms of efficiency, LCI and chromoendoscopy improved WLE in detecting neoplastic lesions in Lynch syndrome. Chromoendoscopy remains valuable for non-neoplastic detection, but procedural time is a major drawback. AI-assisted technologies are promising, which require additional investigation.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"175"},"PeriodicalIF":2.3,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12343729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can preoperative CT angiography and three-dimensional reconstruction of the mesenteric artery of the colon improve laparoscopic colectomy and postoperative rehabilitation in patients with colon cancer? A pilot randomized control study.","authors":"Peng Zhang, Jun Luo, Jiehui Huang, Jingjing Sun, Haiyang Feng, Yuping Zhu, Yong Liu","doi":"10.1007/s00384-025-04975-x","DOIUrl":"10.1007/s00384-025-04975-x","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To assess the effect of computed tomography angiography (CTA) and three-dimensional (3D) reconstruction on laparoscopic colectomy in patients with colon cancer.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Patients with colon cancer who were treated at Zhejiang Cancer Hospital between August 2020 and December 2022 were included in this pilot, randomized controlled trial. The participants were randomly assigned to either the CTA group, in which patients underwent preoperative CTA and 3D reconstruction, or the control group, in which patients underwent preoperative enhanced abdominal and pelvic CT examinations. The primary outcome was the duration of the operation. The secondary outcomes included intraoperative blood loss, length of hospital stay, number of lymph node dissections, fasting duration, duration of tube drainage, overall survival (OS), and progression-free survival (PFS). To minimize statistical bias, patients were stratified into subgroups on the basis of tumor location (left colon or right colon). Additionally, variations in the middle colonic artery (MCA), inferior mesenteric artery (IMA), and colonic branches of superior mesenteric artery (cbSMA) classifications were documented.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 82 patients (41 in each group) were included in the analysis. The CTA group had significantly shorter operation durations (123.68 ± 26.09 vs. 154.12 ± 33.15 min, P &lt; 0.001) and fasting durations (median 4.00 vs. 5.00 days, P &lt; 0.001) as well as reduced intraoperative blood loss (median 50.00 vs. 100.00 mL, P = 0.001) compared to the control group; these differences were observed in the overall colon cancer cohort and in the left and right colon subgroups. However, no significant differences were observed between the two groups in terms of lymph node dissection, tube drainage duration, hospitalization duration, OS or PFS. In the CTA group, the proportions of patients with different IMA types were as follows: Type A (60.97%), Type B (9.76%), Type C (17.07%), and Type D (12.20%); the proportions of patients with different MCA types were as follows: Type A (78.05%), Type B (12.20%), Type C (7.31%), and Type D (2.44%); and the proportions of patients with different cbSMA types were as follows: Type A (65.85%), Type B (7.32%), Type C (17.07%), and Type D (9.76%). Patients with a tumor size ≥ 5 cm, preoperative intestinal obstruction, postoperative pathological serosal invasion, lymph node metastasis, and stage III disease had significantly worse OS and PFS than those with a tumor size &lt; 5 cm (P = 0.007, P = 0.026), no preoperative intestinal obstruction (P = 0.015, P = 0.019), no serosal invasion (P = 0.001, P = 0.001), no lymph node metastasis (P = 0.016, P = 0.001), and stage I-II disease (P = 0.013, P = 0.001). However, no significant differences in OS or PFS were observed between patients who underwent preoperative CTA examination and the control group (P = 0.551, P = 0.591), between male and female pa","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"173"},"PeriodicalIF":2.3,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12334536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MRI-based radiomics for preoperative T-staging of rectal cancer: a retrospective analysis.","authors":"Vittorio Patanè, Umberto Atripaldi, Mario Sansone, Luca Marinelli, Sara Del Tufo, Gianluca Arrichiello, Davide Ciardiello, Francesco Selvaggi, Erika Martinelli, Alfonso Reginelli","doi":"10.1007/s00384-025-04969-9","DOIUrl":"10.1007/s00384-025-04969-9","url":null,"abstract":"<p><strong>Puropose: </strong>Preoperative T-staging in rectal cancer is essential for treatment planning, yet conventional MRI shows limited accuracy (~ 60-78). Our study investigates whether radiomic analysis of high-resolution T2-weighted MRI can non-invasively improve staging accuracy through a retrospective evaluation in a real-world surgical cohort.</p><p><strong>Methods: </strong>This single-center retrospective study included 200 patients (January 2024-April 2025) with pathologically confirmed rectal cancer, all undergoing preoperative high-resolution T2-weighted MRI within one week prior to curative surgery and no neoadjuvant therapy. Manual segmentation was performed using ITK‑SNAP, followed by extraction of 107 radiomic features via PyRadiomics. Feature selection employed mRMR and LASSO logistic regression, culminating in a Rad-score predictive model. Statistical performance was evaluated using ROC curves (AUC), accuracy, sensitivity, specificity, and Delong's test.</p><p><strong>Results: </strong>Among 200 patients, 95 were pathologically staged as T2 and 105 as T3-T4 (55 T3, 50 T4). After preprocessing, 26 radiomic features were retained; key features including ngtdm_contrast and ngtdm_coarseness showed AUC values > 0.70. The LASSO-based model achieved an AUC of 0.82 (95% CI: 0.75-0.89), with overall accuracy of 81%, sensitivity of 78%, and specificity of 84%.</p><p><strong>Conclusion: </strong>Radiomic analysis of standard preoperative T2-weighted MRI provides a reliable, non-invasive method to predict rectal cancer T-stage. This approach has the potential to enhance staging accuracy and inform personalized surgical planning. Prospective multicenter validation is required for broader clinical implementation.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"174"},"PeriodicalIF":2.3,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12334464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age-stratified diagnostic value of high-resolution anorectal manometry in women with severe rectocele: interactions between anal relaxation rate and maximum anal resting pressure.","authors":"Hong Zhi Geng, Xin Lin, Chen Xu, Jiying Cong, Zhao Zhang, Yuwei Li","doi":"10.1007/s00384-025-04963-1","DOIUrl":"10.1007/s00384-025-04963-1","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to assess the diagnostic accuracy of combining anal relaxation rate (ARR) and maximum anal resting pressure (MARP), measured by three-dimensional (3D) high-resolution anorectal manometry (HR-ARM), in identifying high-risk phenotypes of severe rectocele in women (SRW) aged ≥ 50 years compared with healthy female volunteers (HFVs).</p><p><strong>Methods: </strong>This retrospective comparative study was conducted at the Tianjin Union Medical Center (2018-2024) and included 50 SRW scheduled for surgery and 40 age-matched HFVs aged ≥ 50 years. Log-linear regression was used to assess interaction effects, and the Hosmer-Rothman additive model evaluated qualitative and quantitative interactions. Diagnostic accuracy was assessed using receiver operating characteristic curve analysis.</p><p><strong>Results: </strong>The concurrent elevation of ARR and MARP (R₁₁ phenotype) was an independent risk factor (P < 0.01), surpassing the diagnostic value of individual parameters. Interaction analysis showed improved diagnostic accuracy, achieving a sensitivity of 82.0%, specificity of 100.0%, area under the curve of 0.82, Youden index of 0.82, odds ratio of 6.14, and 95% confidence interval of 2.19-17.17. Defecography-based classification with SRW-concomitant diseases may be identified using 3D HR-ARM phenotypes, whereas the reverse diagnostic pathway is not feasible. The integration of these modalities holds promise for guiding evidence-based personalized treatment strategies.</p><p><strong>Conclusions: </strong>Age-stratified 3D HR-ARM analysis of ARR and MARP interactions may help identify high-risk R₁₁ phenotypes in SRW, providing enhanced diagnostic specificity. The R₁₁ phenotype identified in the preoperative X-ray defecography classification for SRW holds the potential for informing tailored therapeutic strategies.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"172"},"PeriodicalIF":2.3,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12331840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"β-Sitosterol improves murine ulcerative colitis by inhibiting the expression of ribosomal proteins and the attempted polarization of type 1 macrophages.","authors":"Runyi Geng, Yongqing Cao, Te Liu, Shenglan Zhong","doi":"10.1007/s00384-025-04974-y","DOIUrl":"10.1007/s00384-025-04974-y","url":null,"abstract":"<p><strong>Background: </strong>As the inflammatory bowel disease subtype, ulcerative colitis (UC) is the idiopathic chronic inflammatory condition affecting colonic mucosa. Characterized by high incidence and therapeutic challenges, UC imposes significant burdens on global health. β-Sitosterol, a phytosterol abundant in fruit and medicinal plants, has demonstrated potential anti-inflammatory properties.</p><p><strong>Methods: </strong>Herein, the UC mouse model was created by administering dextran sulfate sodium, followed by β-sitosterol treatment. Histopathology, single-cell RNA-sequencing (scRNA-seq), Kyoto Encyclopedia of Genes and Genomes (KEGG), flow cytometry (FCM), enzyme-linked immunosorbent assays (ELISAs), Western blotting, and quantitative real-time reverse transcription PCR (qRT-PCR) were implemented.</p><p><strong>Results: </strong>Oral administration of β-sitosterol markedly alleviated intestinal damage and inflammation in UC mice. The scRNA-seq assay revealed that the immune cell subpopulations in the colorectal tissues of mice treated by β-sitosterol gavage apparently decreased compared with them in UC mice, with the most significant difference in the number of macrophages. KEGG analysis predicted significant downregulation of ribosome pathway activity in CD68 + MΦ1 macrophages following β-sitosterol treatment. Both FCM and ELISA analyses showed that β-sitosterol significantly downregulated inflammatory factor generation like interleukin-1β (IL-1β) and inducible nitrous oxide synthase (iNOS) by RAW264.7-derived MΦ1 macrophages. In vitro, as confirmed by qRT-PCR and Western blotting analyses, β-sitosterol dramatically inhibited MΦ1 macrophage expression of ribosome pathway core factors.</p><p><strong>Conclusions: </strong>The present study confirmed that β-sitosterol inhibits MΦ1 macrophage polarization and inflammatory activity by downregulating the key gene transcriptional activity and expression in ribosome signaling pathway in MΦ1 macrophages, thereby ameliorating UC symptoms in mice.</p>","PeriodicalId":13789,"journal":{"name":"International Journal of Colorectal Disease","volume":"40 1","pages":"169"},"PeriodicalIF":2.3,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12325520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}