Journal of Digestive Diseases最新文献

{"title":"A Challenging Retrieval of a Chicken Bone: Resourcefulness in Action.","authors":"Ye Zhao, Min Min Zhang","doi":"10.1111/1751-2980.70048","DOIUrl":"https://doi.org/10.1111/1751-2980.70048","url":null,"abstract":"<p><p>For the challenging removal of foreign bodies with sharp ends lodged tightly in the esophageal wall, the mechanical lithotriptor-typically used for extracting bile duct stones-provides a valuable and safe option for endoscopists.</p>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progress in Gastric Cancer Screening: Distinguishing Methodological Shifts From Clinical Advancement.","authors":"Koji Takahashi","doi":"10.1111/1751-2980.70049","DOIUrl":"https://doi.org/10.1111/1751-2980.70049","url":null,"abstract":"","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of an Individualized Nomogram to Identify Undifferentiated-Predominant Mixed-Type Early Gastric Cancer.","authors":"Lin Lin Shao, Yu Miao Zheng, Qian Zhang, Chuan Guo Guo, Peng Li","doi":"10.1111/1751-2980.70047","DOIUrl":"https://doi.org/10.1111/1751-2980.70047","url":null,"abstract":"<p><strong>Objectives: </strong>Diagnosis of undifferentiated-type-predominant mixed-type early gastric cancer (UM-EGC) remains challenging due to its complex histological features and overlapping characteristics with other gastric cancer types. We aimed to develop a novel nomogram based on clinicopathological and endoscopic features and validate its performance in predicting UM-EGC prior to endoscopic treatment.</p><p><strong>Methods: </strong>In this retrospective single-center study, 808 patients with early gastric cancer (EGC) who underwent curative endoscopic submucosal dissection were included. Among them, 493 were assigned to the training cohort and 84 to the external validation cohort. Clinicopathological characteristics and endoscopic features were compared between differentiated EGC and UM-EGC using logistic regression analysis. A predictive nomogram was constructed and evaluated.</p><p><strong>Results: </strong>Multivariable regression analysis identified open-type atrophic gastritis (O1-O3) (odds ratio [OR] 0.25, 95% confidence interval [CI] 0.08-0.82), IIb (OR 9.72, 95% CI 3.01-31.35), IIc (OR 7.75, 95% CI 2.81-21.39), discolored lesion (OR 4.12, 95% CI 1.57-10.80), horizontal location at the greater curvature (OR 2.98, 95% CI 1.15-7.75) or anterior wall (OR 2.91, 95% CI 1.26-6.74), and previous H. pylori eradication (OR 0.23, 95% CI 0.09-0.55) as independently associated with UM-EGC. UM-EGC was also more susceptible to metachronous cancer (OR 5.50, 95% CI 1.30-23.21). The nomogram demonstrated good discriminative ability with an area under the receiver operating characteristic curve of 0.83 (95% CI 0.77-0.87) in the training cohort and 0.82 (95% CI 0.69-0.98) in the external validation cohort.</p><p><strong>Conclusion: </strong>This nomogram comprising clinicopathological and endoscopic features may assist in the preoperative prediction of UM-EGC risk.</p><p><strong>Trial registration: </strong>The clinical trial registration number for patient source in this study is ChiCTR1800017117.</p>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147772812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum Neutrophil Extracellular Trap-Related Proteins Serving as Potential Diagnostic and Disease Activity Biomarkers of Cronkhite-Canada Syndrome.","authors":"Run Feng Zhang, Yun Fei Zhi, Cheng Zhu Ou, Wen You, Shuang Liu, Qiu Shi Xu, Tian Ming Xu, Qi Pu Wang, Hao Tang, Jing Nan Li, Ji Li","doi":"10.1111/1751-2980.70046","DOIUrl":"https://doi.org/10.1111/1751-2980.70046","url":null,"abstract":"<p><strong>Objective: </strong>To explore the involvement of neutrophil dysregulation in Cronkhite-Canada syndrome (CCS) and to identify serum biomarkers for its diagnosis and disease activity assessment.</p><p><strong>Methods: </strong>We performed comprehensive serum proteomic analysis using data-independent acquisition (DIA) on samples from patients with active CCS (aCCS) and healthy controls (HCs). Candidate proteins were further evaluated by parallel reaction monitoring (PRM). An independent validation cohort including cases with aCCS, remitting CCS (rCCS), and HCs was then assessed using enzyme-linked immunosorbent assay (ELISA). In addition, previously generated transcriptomic data and immunofluorescence staining of colonic polyps were used to assess local neutrophil extracellular trap (NET)-related immune changes in intestinal tissues.</p><p><strong>Results: </strong>Proteomic screening identified 362 differentially expressed proteins, and bioinformatic analysis consistently highlighted pathways related to neutrophil activation, acute inflammation, and NET formation. Key neutrophil-associated proteins, including myeloperoxidase (MPO), lipocalin-2 (LCN2), and matrix metalloproteinase-9 (MMP-9), were significantly upregulated. PRM validated seven upregulated candidate proteins. In the independent validation cohort, compared with HCs, serum MPO-DNA complexes, LCN2, and MMP-9 were significantly elevated in aCCS patients, whereas MPO-DNA complexes and MMP-9 were significantly reduced in rCCS cases. Tissue-level transcriptomic and immunofluorescence analyses further supported NET-related immune activation in CCS colonic polyps. Receiver operating characteristic curve analysis demonstrated favorable diagnostic performance for these biomarkers.</p><p><strong>Conclusions: </strong>Our findings support the involvement of neutrophil dysregulation and NET-associated pathways in CCS pathobiology. Serum MPO-DNA complexes, LCN2, and MMP-9 may serve as promising non-invasive biomarkers for diagnosis and disease activity monitoring. Further studies incorporating disease control cohorts and mechanistic validation are warranted.</p>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147772838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parkinson's Disease: Is It Hidden in the Gut Ecology the Ariadne's Thread Leading to Help?","authors":"Francesco Marotta, Amir Moghadam Ahmadi, Almagul Kushugulova, Roberto Catanzaro, Reza Rastmanesh, Saida Rasulova, Leila Haghsnenas","doi":"10.1111/1751-2980.70043","DOIUrl":"https://doi.org/10.1111/1751-2980.70043","url":null,"abstract":"","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147592548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Slow Transit Constipation: Pathophysiological Perspectives and Management Updates.","authors":"Athanasios Syllaios, Stavros P Papadakos, Alexandros Ioannou, Maximos Frountzas, Dimosthenis Michelakis, Dimitrios Patsouras, Spyridon Dritsas, Manousos-Georgios Pramateftakis, Dimitrios Schizas","doi":"10.1111/1751-2980.70030","DOIUrl":"10.1111/1751-2980.70030","url":null,"abstract":"<p><p>Slow transit constipation (STC) is a chronic colonic motility disorder characterized by markedly delayed transit, leading to reduced bowel movements, abdominal discomfort, and significant quality-of-life impairment. It predominantly affects women and is associated with abnormalities in enteric neuronal signaling, smooth muscle contractility, interstitial cells of Cajal, gut peptides, bile acid homeostasis, and autonomic regulation. Secondary causes of constipation and structural lesions must be excluded before the diagnosis of STC, with colonic transit studies serving as the gold standard. Complementary investigations such as anorectal manometry and defecography help detect coexisting outlet obstruction, which can alter management. The treatment of STC should follow a stepwise approach, beginning with dietary and lifestyle modification, osmotic and stimulant laxatives, and prokinetics such as prucalopride. Secretagogues and bile acid modulators may offer additional benefit. Biofeedback therapy is primarily indicated for overlapping dyssynergic defecation. For refractory STC, interventional therapies, such as fecal microbiota transplantation, acupuncture, sacral nerve stimulation, and transanal irrigation, are found to have equivocal outcomes. Antegrade continence enema procedures can be an alternative for patients unsuitable for colectomy. Surgical options, including subtotal colectomy with ileosigmoid or cecorectal anastomosis, and total colectomy with ileorectal anastomosis, are reserved for carefully selected patients with medically intractable symptoms, following thorough physiological evaluation. Although advances in understanding STC pathophysiology are guiding novel therapeutic development, robust randomized controlled trials remain scarce. Optimal care requires multidisciplinary collaboration between gastroenterologists, colorectal surgeons, and pelvic floor specialists to ensure accurate diagnosis, tailored treatment, and improved long-term outcomes.</p>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":" ","pages":"15-30"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146125075","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":"A Novel Prognostic Score for 1-Year Adverse Outcomes in Non-ACLF Cirrhotic Patients After Discharge: A Multicenter Prospective Cohort Study.","authors":"Yue Xiang Bian, Xin Zhang, Xian Bo Wang, Xin Zheng, Wen Ting Tan, Xiu Hua Jiang, Yan Huang, Zhong Ji Meng, Yan Hang Gao, Zhi Ping Qian, Feng Liu, Xiao Bo Lu, Yu Shi, Yu Bao Zheng, Ying Li He, Jian Yi Wei, Pei Xuan Ji, Kai He, Adila Abuduaini, Ya Wen Lu, Liang Qiao, Hai Li","doi":"10.1111/1751-2980.70039","DOIUrl":"10.1111/1751-2980.70039","url":null,"abstract":"<p><strong>Objectives: </strong>Discharged cirrhotic patients hospitalized for acute decompensation (AD) without acute-on-chronic liver failure (ACLF) have heterogeneous long-term prognosis; however, reliable prognostic tools are lacking. We aimed to identify the risk factors associated with 1-year adverse outcomes including mortality and liver transplantation (LT) after patient's discharge and to develop an evidence-based prognostic model.</p><p><strong>Methods: </strong>We enrolled 1212 and 621 cirrhotic patients who clinically improved after AD without ACLF before discharge from the Chinese AcuTe-on-CHronic LIver FailurE (CATCH-LIFE) derivation and validation cohorts, respectively. The primary outcome was 1-year adverse outcomes (all-cause mortality or LT) post-discharge. Independent risk factors for 1-year post-discharge adverse outcomes were identified using multivariable analysis, and a prognostic model was derived and validated.</p><p><strong>Results: </strong>In the derivation cohort, 203 (16.7%) patients experienced 1-year adverse outcomes and 370 (30.5%) were readmitted within 90 days post-discharge. Age, prior decompensation, total bilirubin, international normalized ratio, albumin, and hemoglobin on discharge were independently associated with 1-year post-discharge adverse outcomes. The prognostic model achieved an area under the receiver operating characteristic curve (AUC) of 0.7767 (95% confidence interval [CI] 0.7408-0.8125) and 0.7274 (95% CI 0.6656-0.7892) in the derivation and validation cohorts. Using a risk threshold of ≥ 0.27, 17.70% of discharged non-ACLF cirrhotic patients with AD in the validation cohort were classified as high-risk, with 1-year adverse outcome rate being 43.96%.</p><p><strong>Conclusion: </strong>A prognostic model for predicting 1-year adverse outcomes in discharged non-ACLF cirrhotic patients was developed and validated, with a high-risk cut-off ≥ 0.27, which may effectively stratify adverse outcome risks at 1-year post-discharge and guide intensive post-discharge management.</p>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":" ","pages":"63-74"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147275892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chinese Expert Consensus on the Clinical Management of Bile Acid Diarrhea (2026 Version).","authors":"","doi":"10.1111/1751-2980.70038","DOIUrl":"10.1111/1751-2980.70038","url":null,"abstract":"<p><p>Chronic diarrhea is a common symptom of the digestive system and also a frequent reason for consultation among patients in gastroenterology outpatient clinics. As one of the common etiologies of chronic diarrhea, bile acid diarrhea (BAD) has a relatively high incidence rate. However, due to the current limitations in physicians' awareness, medical standards, and diagnostic methods, BAD is often underdiagnosed or misdiagnosed; therefore, patients often fail to receive timely and appropriate treatment. To further improve clinicians' understanding and management of BAD, the Chinese Society of Gastroenterology, Chinese Medical Association, on the basis of drawing on domestic and international diagnostic and therapeutic experiences as well as guidelines and consensuses, has organized domestic experts to formulate this expert consensus focusing on the pathogenesis, clinical classification, diagnosis, and management of BAD.</p>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":" ","pages":"2-14"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147306495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological Trends of Vascular Intestinal Disease in the Elderly (1990-2021): A Study on Its Causal Relationship With Hypertension.","authors":"Shao Han Li, Meng Zhen Yu, Hao Ming Xu, Si Qi Yang, Jia Wei Chen, Hong Li Huang, Yong Jian Zhou","doi":"10.1111/1751-2980.70041","DOIUrl":"10.1111/1751-2980.70041","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the disability-adjusted life-years (DALYs) and incidence of vascular intestinal disease (VID) in individuals aged 65 years and above and identify its causal relationship with hypertension.</p><p><strong>Methods: </strong>Analysis of VID burden focused on the incidence and DALYs in individuals aged 65 years and above. Socioeconomic inequalities were evaluated using the slope and concentration indices. Temporal trends of VID were evaluated with age-period-cohort (APC) modeling and Bayesian projections. Mendelian randomization (MR) analysis was employed to investigate the causal relationship between hypertension and VID.</p><p><strong>Results: </strong>From 1990 to 2021, the global age-standardized DALYs rate (ASDR) and age-standardized incidence rate (ASIR) for VID declined, while the absolute number of incident cases increased. In 2021, the incident cases and DALYs reached 789 979 (95% uncertainty interval [UI] 615 343-978 593) and 1 116 683 (95% UI 996 036-1 210 921), with ASIR and ASDR of 105.59 per 100 000 (95% UI [82.43-130.50] per 100 000) and 151.66 per 100 000 (95% UI [134.58-164.67] per 100 000), respectively. Eastern Europe showed the highest DALYs rates. Bayesian APC projections indicated declining age-standardized rates but rising absolute numbers by 2040. MR analysis revealed hypertension as a significant causal risk factor for VID, with an odds ratio of 2.817 for inverse-variance-weighted and 3.618 for weighted median methods.</p><p><strong>Conclusion: </strong>Although VID burden remains high in high-income regions, its overall ASDR and ASIR have been declining. Meanwhile, hypertension is a causal factor for VID.</p>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":" ","pages":"50-62"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147463395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic Score for Visceral Fat and Gallstone Disease Risk: A Multicenter Cohort Study and Mediation Analysis of Inflammatory Biomarkers.","authors":"Cui Hua Zhang, Meng Lin He, Hong Yu Li, Yi Jiang, Jing Luo, Hong Yang, Zi Jie Chen, Xuan Bai, Guo Heng Jiang, Lin Jun Xie, Yi Ting Xu, Xin Wang, Wen Qian Yu, Min Gao, Jiong Lu, Jin Zhou, Ding Zi Zhou, Jia Yuan Li, Xin Wang","doi":"10.1111/1751-2980.70044","DOIUrl":"10.1111/1751-2980.70044","url":null,"abstract":"<p><strong>Objectives: </strong>Gallstone disease (GSD), a prevalent digestive disorder, remains mechanistically underexplored in relation to visceral adipose. The Metabolic Score for Visceral Fat (METS-VF), a novel metric for quantifying visceral adipose tissue, has not yet been evaluated for its association with GSD in cohort studies. We aimed to investigate the METS-VF-GSD association across multicenter cohorts.</p><p><strong>Methods: </strong>Multicenter cohort analysis of 59 851 participants from two Chinese hospitals and 357 233 participants from the UK Biobank dataset was conducted using Cox models to investigate the association between METS-VF and GSD risk. Competing risk models were also applied to the UK Biobank cohort. Meta-analysis and mediation analysis were used to synthesize results from the cohort analysis and evaluate mediation effects of inflammatory biomarkers.</p><p><strong>Results: </strong>Cox models revealed a significant positive association between METS-VF and GSD risk, with a \"J-shaped\" nonlinearity, as confirmed by restricted cubic spline analysis (p < 0.05). Meta-analysis revealed that for each 1-unit and 1-standard deviation increase in METS-VF, GSD risk increased by 84% and 57%, respectively. Compared with participants in quantile 1 (Q1) of METS-VF, those in Q2 (pooled hazard ratio [HR] 1.65, 95% confidence interval [CI] 1.35-2.01), Q3 (pooled HR 2.16, 95% CI 1.83-2.54), and Q4 (pooled HR 3.00, 95% CI 2.82-3.19) were associated with progressively higher GSD risk. Mediation analysis revealed that certain inflammatory biomarkers partially mediated the effect of METS-VF on incident GSD.</p><p><strong>Conclusions: </strong>Increased METS-VF is associated with a higher risk of GSD. It may serve as an important indicator for identifying high-risk populations for GSD.</p>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":" ","pages":"87-98"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}