Journal of Digestive Diseases最新文献

{"title":"Chinese Consensus on Clinical Diagnosis and Management of Covert Hepatic Encephalopathy","authors":"Chinese Society of Gastroenterology, Chinese Medical Association","doi":"10.1111/1751-2980.70005","DOIUrl":"10.1111/1751-2980.70005","url":null,"abstract":"<div>\u0000 \u0000 <p>Covert hepatic encephalopathy (CHE) is one of the important entities of hepatic encephalopathy (HE). In contrast to those with overt hepatic encephalopathy (OHE), patients with CHE have no readily identifiable clinical symptoms and signs, such as disorientation and asterixis, but present with neurocognitive abnormalities detected by neuropsychological and/or neurophysiological tests. Some patients may experience mild cognitive impairment, euphoria, or anxiety, and decreased attention and calculation abilities. CHE is not only prone to OHE development, but also has harmful impacts on fitness to drive and fine operation ability, impairs health-related quality of life, and increases the risk of accidental injury, thereby resulting in worse financial status and a heavy burden to both the family and society as well as reducing the survival of cirrhotic patients. To further improve the understanding of CHE and standardize its clinical diagnosis and management, the Chinese Society of Gastroenterology, Chinese Medical Association organized experts to establish a consensus based on the updated relevant guidelines, expert consensus, research advance in the diagnosis and management of the disease, and clinical practice in China. This consensus contains 19 statements on the definition, epidemiology, etiology, precipitating factors, pathogenesis, clinical manifestations, diagnosis, treatment, prognosis, and chronic disease management of CHE. This consensus may provide the best available evidence to guide clinical practice in the diagnosis and management of patients with CHE.</p>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 7-8","pages":"268-285"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144956436","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 Standardized Surgical Management of Gastrointestinal Stromal Tumors (2025 Edition)","authors":"Expert Working Group on Diagnosis and Treatment of Gastrointestinal Stromal Tumors, Chinese College of Surgeons, Chinese Medical Doctor Association","doi":"10.1111/1751-2980.70003","DOIUrl":"10.1111/1751-2980.70003","url":null,"abstract":"<div>\u0000 \u0000 <p>Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor of the gastrointestinal (GI) tract and has been regarded as one of the most successful models of targeted therapy in solid tumors to date. In recent years, a deeper understanding of GIST biology, coupled with innovations in molecular pathology, imaging studies, endoscopic and minimally invasive techniques, as well as the development of targeted medications, has led to the evolution of the treatment paradigm into a multidisciplinary approach centered around surgery, which involves pathology, gastroenterology (including endoscopy), oncology, radiology, and interventional radiology, etc. Among all these modalities, surgical resection remains the primary and most effective treatment modality. Surgeons are expected to play a leading role in the comprehensive management of patients with GISTs. Recently, the Expert Working Group on Diagnosis and Treatment of Gastrointestinal Stromal Tumors under the Chinese College of Surgeons, Chinese Medical Doctor Association has released the <i>Chinese Expert Consensus on Standardized Surgical Management of Gastrointestinal Stromal Tumors</i> <i>(2025 Edition)</i>, integrating the latest evidence and clinical insights to provide authoritative guidance for the surgical treatment of GISTs in clinical practice.</p>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 7-8","pages":"286-304"},"PeriodicalIF":2.3,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144956563","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":"IgG4-Related Autoimmune Pancreatitis With Pancreatic Honeycomb-Like Cystic Lesions: A Case Report","authors":"Han Tao Yang,&nbsp;Qing Jing Zhao,&nbsp;Shu Wen Han,&nbsp;Hui Chao Wu","doi":"10.1111/1751-2980.70006","DOIUrl":"10.1111/1751-2980.70006","url":null,"abstract":"<p>This case report highlights a rare presentation of IgG4-related autoimmune pancreatitis with honeycomb-like cystic lesions in the pancreatic parenchyma. It discusses differential diagnoses such as VHL syndrome, emphasizing the need for clinical evaluation and corticosteroid responsiveness, which may offer insights for clinicians when managing such cases.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 7-8","pages":"385-388"},"PeriodicalIF":2.3,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873444","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":"Declining Bowel Surgery Rates and Predictors for Surgery of Crohn's Disease: A Prospective Inception Cohort in Eastern China","authors":"Wen Hu,&nbsp;Shu Yan Li,&nbsp;Jin Jin Luo,&nbsp;Jiao Jiao Xin,&nbsp;Dong Yan Shi,&nbsp;Jing Jiang,&nbsp;Ze Xin Chen,&nbsp;Yue Yu,&nbsp;Xiu Jun Liao,&nbsp;Ke Ren Shen,&nbsp;Jia Kai Luo,&nbsp;Ze Lin Yan,&nbsp;Qiu Zhi Wang,&nbsp;Shi Yuan Lu,&nbsp;Ding Ting Xu,&nbsp;Qiao Yu,&nbsp;Han Yun Zhang,&nbsp;Xiao Ying Wang,&nbsp;Jun Li,&nbsp;Yan Chen","doi":"10.1111/1751-2980.70002","DOIUrl":"10.1111/1751-2980.70002","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the rate of Crohn's disease (CD)-related bowel surgery within an inception cohort in Eastern China in the era of evolving diagnostic and therapeutic expertise.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A single-center, prospective cohort study was conducted from July 2019 to June 2022 in China. Patients with newly diagnosed CD were followed annually. Risk factors of bowel surgery for complications such as obstruction, fistula, perforation, and bleeding were evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The cohort consisted of 438 patients with newly diagnosed CD, with a male predominance (73.5%) and a median age of 28 years. Of these, 68 patients underwent bowel surgery, with the 1-, 2-, and 3-year cumulative surgery rates being 11.8%, 14.3%, and 15.4%. Multivariate analysis identified patient enrollment in the third year (adjusted hazard ratio [aHR] 0.45, 95% confidence interval [CI] 0.21–0.99), smoking (aHR 3.57, 95% CI 1.70–7.47), stricturing (aHR 31.38, 95% CI 10.93–90.07) or penetrating behavior (aHR 39.83, 95% CI 13.16–120.58), and hypoalbuminemia (aHR 1.95, 95% CI 1.12–3.38) as independent predictors. Patients enrolled in 2019–2020, 2020–2021, and 2021–2022 had 1-year surgery rates of 18.4%, 14.2%, and 5.3%, respectively. Significant differences were observed among the three cohorts in age at diagnosis, onset symptoms, disease location, and behavior.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Disease behavior, year of enrollment, smoking, and hypoalbuminemia were independent factors related to bowel surgery in CD. First-year bowel surgery rate and age at diagnosis decreased over the 3 years, while the proportions of patients with onset perianal symptoms, inflammatory behavior, and perianal disease increased.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 7-8","pages":"348-358"},"PeriodicalIF":2.3,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882994","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":"Tegoprazan as First- and Second-Line Therapy for Eradication of Helicobacter pylori Infection: A Systematic Review and Meta-Analysis","authors":"Sujata Purja,&nbsp;Yousong Lee,&nbsp;Eunyoung Kim","doi":"10.1111/1751-2980.70004","DOIUrl":"10.1111/1751-2980.70004","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the efficacy and safety of tegoprazan (TPZ) compared to conventional proton pump inhibitors (PPIs) for <i>Helicobacter pylori</i> eradication as first- and second-line therapies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Four databases were searched for randomized controlled trials (RCTs) and retrospective studies comparing TPZ- and PPI-based regimens for <i>H. pylori</i> eradication published until October 15, 2024. A random-effects model was used to calculate pooled odds ratio (OR) and 95% confidence interval (CI) based on intention-to-treat and per-protocol analyses. The PROSPERO registration number of the study is CRD42024622705.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Nine studies (three RCTs and six retrospective studies) involving 5228 treatment-naïve patients were included. TPZ was non-inferior to PPIs as a first-line therapy (intention-to-treat: odds ratio [OR] 1.066, 95% confidence interval [CI] 0.929–1.224; per-protocol: OR 1.142, 95% CI: 0.967–1.349). Subgroup analyses showed no significant differences based on study design, therapeutic regimen, or treatment duration. In patients with clarithromycin-resistant strains confirmed by 23S rRNA sequencing, TPZ achieved a higher eradication rate (OR 4.961, 95% CI 1.024–24.030). TPZ was associated with significantly lower odds of abdominal discomfort compared to PPIs (OR 0.490, 95% CI 0.268–0.897). Regarding treatment duration, a 14-day regimen was linked to a lower risk of diarrhea, while a 7-day regimen was associated with a higher risk of abdominal pain. No significant differences were observed in second-line therapeutic outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>TPZ represents a non-inferior alternative to PPIs for <i>H. pylori</i> eradication, with potential benefits in clarithromycin-resistant infections and favorable safety profiles. Future studies are warranted to assess higher dosages and address pharmacokinetic limitations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 7-8","pages":"305-317"},"PeriodicalIF":2.3,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1751-2980.70004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873445","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":"CXCL13 as a Prognostic Biomarker and Modulator of the Tumor Microenvironment in Colorectal Cancer","authors":"Fang Fang Guo,&nbsp;Yu Qing Yan,&nbsp;Wei Wei Chen,&nbsp;Yao Cheng,&nbsp;Rui Zhang,&nbsp;Chao Qin Shen,&nbsp;Yun Cui,&nbsp;Yan Shen Peng,&nbsp;Hao Yan Chen,&nbsp;Lin Hua Ji,&nbsp;Bao Qin Xuan,&nbsp;Xiao Qiang Zhu","doi":"10.1111/1751-2980.70001","DOIUrl":"10.1111/1751-2980.70001","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Immunotherapy yields limited results in patients with colorectal cancer (CRC), emphasizing the need for a deeper understanding of the immune landscape within the tumor microenvironment. Although the C-X-C motif chemokine ligand 13 (CXCL13) recruits B cells and promotes tertiary lymphoid structure (TLS) formation, its immune function and prognostic value in CRC remain unclear. This study investigated the impact of CXCL13 on patient outcomes and CRC immune landscape.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Four independent cohorts were recruited in this study. The Cancer Genome Atlas Program (TCGA) cohort evaluated survival differences as well as immune contexture associated with CXCL13 expression in CRC. Immunohistochemistry (IHC) in the Renji Hospital (RJ) cohort was used to validate CXCL13 and CD8 levels, while multiplex IHC assessed their spatial correlation. Two single-cell RNA sequencing (scRNA-seq) cohorts were used for evaluating the potential roles of CXCL13 and CXCL13⁺CD8⁺T cells in the immune context of CRC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our study revealed a positive correlation between CXCL13 expression and improved survival among CRC patients. Elevated CXCL13 levels and CXCL13⁺CD8⁺T cells were linked to a favorable immune context that impeded tumor growth in CRC. Moreover, CXCL13 expression was more prevalent in microsatellite instability-high (MSI-H)/mismatch repair-deficient (MMRd) tumors, demonstrating its potential role in enhancing the response to anti-programmed death-1 ligand (PD-L1) treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CXCL13 plays a critical role in shaping a favorable immune tumor microenvironment in CRC. Further research should elucidate how CXCL13 modulates CD8⁺T cell function to improve antitumor immunity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 7-8","pages":"334-347"},"PeriodicalIF":2.3,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144847067","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":"Recurrent Liver Dysfunction in Erythropoietic Protoporphyria: A Case With Compound Heterozygous FECH Mutations","authors":"Ya Jun Zhang,&nbsp;Shao Ping Huang,&nbsp;Zhi Yin Shang,&nbsp;Min Liu,&nbsp;Chuan Tao Tu","doi":"10.1111/1751-2980.70000","DOIUrl":"10.1111/1751-2980.70000","url":null,"abstract":"","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 5-6","pages":"260-263"},"PeriodicalIF":2.3,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794569","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":"GLOBE Score and UK-PBC Risk Score Predict Long-Term Clinical Outcomes of Patients With Primary Biliary Cholangitis and Receiving Ursodeoxycholic Acid and Fenofibrate","authors":"Shu Xiang Li,&nbsp;Bu Er Li,&nbsp;Min Li,&nbsp;Sha Chen,&nbsp;Ting Ting Lyu,&nbsp;Qian Yi Wang,&nbsp;Xiao Ming Wang,&nbsp;Yu Wang,&nbsp;Hong Ma,&nbsp;Xiao Juan Ou,&nbsp;Yuan Yuan Kong,&nbsp;Xin Yan Zhao,&nbsp;Hong You,&nbsp;Wei Jia Duan,&nbsp;Ji Dong Jia","doi":"10.1111/1751-2980.13359","DOIUrl":"10.1111/1751-2980.13359","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Fenofibrate is widely used as add-on therapy for patients with primary biliary cholangitis (PBC) who have a suboptimal response to ursodeoxycholic acid (UDCA). We aimed to evaluate whether the UDCA biochemical response criteria, especially the GLOBE and UK-PBC risk scoring systems, could predict the long-term prognosis of PBC patients who received fenofibrate add-on therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PBC patients receiving fenofibrate add-on therapy were included in this retrospective–prospective study. We compared the utility of nine biochemical response criteria and two scoring systems to predict clinical outcomes by Kaplan–Meier plots and the receiver operating characteristic (ROC) curve analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty-three patients were included in this study, of whom 11 had a poor outcome (hepatic decompensation, liver-related death, or liver transplantation) and 52 had a good outcome. After a median follow-up of 45 months, fenofibrate add-on therapy steadily decreased the serum levels of alkaline phosphatase, γ-glutamyl transferase, and alanine aminotransferase in both groups. The patients with poor outcomes had a higher GLOBE score and UK-PBC risk score than those with good outcomes after 12 months of treatment. More importantly, both scores had better predictive performance for hepatic decompensation- and transplant-free survival than the other criteria. The areas under the ROC curve of the GLOBE and UK-PBC risk scores at 12 months were 0.878 (95% confidence interval [CI] 0.751–0.955) and 0.919 (95% CI 0.803–0.978), respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The GLOBE and UK-PBC risk scores outperformed the other biochemical response criteria in predicting the clinical outcomes of PBC patients with suboptimal response to UDCA and receiving fenofibrate add-on therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 5-6","pages":"250-259"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760215","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":"Genetic and Clinical Characteristics of Difficult-To-Treat Crohn's Disease: Trio-Based Exome Sequencing in 24 Families","authors":"Hui Bo Wu,&nbsp;Zhao Yuan Xu,&nbsp;Wei Wang,&nbsp;Qi Zhang,&nbsp;Jue Lin,&nbsp;Yi Tong Cui,&nbsp;Jun Hu,&nbsp;Tao Liu,&nbsp;Xiang Peng,&nbsp;Jun Deng,&nbsp;Jia Yin Yao,&nbsp;Min Zhang,&nbsp;Xi Xi Chen,&nbsp;Min Zhi","doi":"10.1111/1751-2980.13358","DOIUrl":"10.1111/1751-2980.13358","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Difficult-to-treat Crohn's disease (DTT-CD) represents a critical unmet need in inflammatory bowel disease (IBD) management. However, its genetic architectures remain poorly understood. We aimed to evaluate the genetic characteristics and clinical manifestations of DTT-CD cases through integrated trio-based whole exome sequencing (WES) and longitudinal phenotyping.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this cross-sectional cohort study, DTT-CD patients who met the International Organization for the Study of Inflammatory Bowel Disease (IOIBD) criteria and their first-degree relatives underwent trio-WES analysis. Treatment persistence and remission rates were analyzed. Genetic variants were prioritized via cosegregation analysis, the American College of Medical Genetics and Genomics (ACMG) guidelines, and functional prediction algorithms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 24 patients with DTT-CD, 87.5% failed at least two biologics, 33.3% required dual targeted therapy, and drug persistence declined across treatment lines (<i>p</i> = 0.0193). Remission rates were suboptimal (clinical: 41.7%; endoscopic: 50.0%). Trio-WES analysis identified 15 likely pathogenic candidate variants across 12 genes, including the established monogenic IBD gene <i>XIAP</i> (two novel variants: p.Asp247Glufs*19, p.Ser43X; two known variants: p.Arg381X, p.Arg238X), genome-wide association studies-implicated IBD risk genes (<i>MAML2</i> and <i>PLA2R1</i>), and novel candidate variants (<i>KIZ</i>, <i>LAMA5</i>, <i>SAMD9</i>, etc.) that were potentially linked to epithelial-immune dysregulation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This is the first trio-WES study of DTT-CD that reveals a high prevalence of monogenic <i>XIAP</i> deficiency (16.7%), advocating for genetic screening in refractory cases. Novel candidate genes implicate polygenic mechanisms of therapeutic resistance. Family-based sequencing may be used to elucidate the genetic background of DTT-CD cases to guide molecular diagnosis and personalized therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 5-6","pages":"230-240"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760214","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 a Clinical Nomogram for Predicting Surgery in Newly Diagnosed Crohn's Disease","authors":"Chao Li,&nbsp;Xi Zhang,&nbsp;Jie Qi Zheng,&nbsp;Yi Zhe Tie,&nbsp;Zhi Rong Zeng,&nbsp;Min Hu Chen,&nbsp;Ri Rong Chen,&nbsp;Sheng Hong Zhang","doi":"10.1111/1751-2980.13357","DOIUrl":"10.1111/1751-2980.13357","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To develop a nomogram with easily available parameters to predict the risk of Crohn's disease (CD)-related bowel resection in patients with newly diagnosed CD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a retrospective cohort study by recruiting patients with newly diagnosed CD between 2005 and 2022. The patients were divided into the training and internal test sets in a 7:3 ratio. Adjusted multivariate Cox regression and least absolute shrinkage and selection operator analyses were used for feature selection. A nomogram was developed and evaluated using 10-fold cross-validation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Altogether 490 patients were included, among whom 67 (13.7%) received CD-related bowel resection during a median follow-up of 45.2 months. Stricturing or penetrating behavior, perianal involvement, and higher C-reactive protein (CRP) were independently associated with a higher risk of CD-related bowel resection, while higher white blood cell (WBC) and lymphocyte levels and hemoglobin levels were protective factors. The nomogram including disease behavior, hemoglobin, CRP, and lymphocyte and WBC counts yielded a C-statistic of 0.80 (95% confidence interval [CI] 0.74–0.86) in 10-fold cross-validation of the training set. Using the internal test set, the robust performance was verified with C-statistic, calibration slope, and calibration-in-the-large of 0.80 (95% CI 0.70–0.89), 1.10 (95% CI 0.61–1.56), and 0.28 (95% CI −0.17 to 0.67). Decision curve analyses indicated its potential clinical utility.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The nomogram integrating disease behavior and laboratory data might be a promising approach for early risk stratification of CD-related bowel resection, hence facilitating personalized treatment for newly diagnosed CD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"26 5-6","pages":"203-211"},"PeriodicalIF":2.3,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553643","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}