BMC Gastroenterology最新文献

{"title":"Clinical and pathological characteristics of mucinous adenocarcinoma in colon cancer: comparison with classic adenocarcinoma.","authors":"Berkan Acar, Ali Muhtaroğlu, Tuğrul Kesi̇ci̇oğlu, Serdar Acar, Elif Yilmaz, Yavuz Çeki̇ç","doi":"10.1186/s12876-026-05194-6","DOIUrl":"https://doi.org/10.1186/s12876-026-05194-6","url":null,"abstract":"<p><strong>Background: </strong>Mucinous adenocarcinoma of the colon is defined by extracellular mucin occupying at least 50% of the tumour. Although it is often regarded as a distinct histological subtype, its clinicopathological profile remains variable across published series. We compared mucinous and classic adenocarcinoma in a colon-only surgical cohort.</p><p><strong>Methods: </strong>We retrospectively reviewed patients who underwent oncological resection for colon adenocarcinoma between October 2021 and March 2026. Rectal tumours, neoadjuvant-treated cases and signet ring cell carcinoma were excluded. Clinicopathological variables were compared using Mann-Whitney U, Pearson chi-square or Fisher exact tests. Multivariable analyses were revised as parsimonious logistic regression models, with model size and event counts reported.</p><p><strong>Results: </strong>The final cohort included 155 colon cancers: 29 mucinous and 126 classic adenocarcinomas. Mucinous tumours were more often right-sided (75.9% vs. 44.4%; p = 0.002) and more frequently poorly differentiated (24.1% vs. 4.8%; p = 0.003). Advanced pT stage was common in both groups (86.2% vs. 82.5%; p = 0.786). Nodal metastasis was numerically less frequent in mucinous adenocarcinoma (31.0% vs. 50.8%; p = 0.055), while lymphovascular invasion was significantly less common (10.3% vs. 32.5%; p = 0.017). Deficient mismatch repair was recorded in 13.8% of mucinous tumours and 8.7% of classic adenocarcinomas (p = 0.484). In parsimonious adjusted models, mucinous histology was not independently associated with advanced pT stage (adjusted OR 1.51, 95% CI 0.46-4.92; p = 0.496) or nodal metastasis (adjusted OR 0.48, 95% CI 0.19-1.19; p = 0.113).</p><p><strong>Conclusions: </strong>In this colon-only cohort, mucinous adenocarcinoma was associated with right-sided location and poor differentiation, but not with independently higher local invasion or nodal spread. These findings support a cautious, clinicopathology-based interpretation of mucinous histology and should not be extrapolated to prognosis without molecular and survival data.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104114","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":"Identification of IL1RN, MUC1, and SERPINA1 as key NET-related biomarkers in ulcerative colitis-associated intestinal fibrosis via bioinformatics and experimental validation.","authors":"Qiang Chuai, Xiaohong Jiang, Kaixuan Li, Xin Liu, Jia Guo, Jianping Liu","doi":"10.1186/s12876-026-05179-5","DOIUrl":"https://doi.org/10.1186/s12876-026-05179-5","url":null,"abstract":"<p><strong>Background: </strong>Long-term recurrent episodes of ulcerative colitis (UC) can lead to intestinal fibrosis (IF), which severely affects patient prognosis. Neutrophil extracellular traps (NETs) have been identified as critical drivers of various fibrotic diseases; however, their precise role and regulatory mechanisms in UC-associated intestinal fibrosis (UC-IF) remain to be systematically elucidated. Therefore, identifying the key regulatory genes through which NETs participate in UC-IF is highly important for the diagnosis and treatment of this condition.</p><p><strong>Methods: </strong>In this study, we analyzed the gene expression profiles of UC patients via publicly available databases and screened for neutrophil extracellular trap-related differentially expressed genes (NET-DEGs), identifying a total of 99 NET-DEGs. Enrichment analysis was then performed to explore the biological processes involving these genes. Furthermore, this study identified 5 potentially key NET-DEGs using machine learning algorithms. On the basis of these 5 genes, combined with protein-protein interaction (PPI) network analysis, intestinal fibrosis-related gene set variation analysis (GSVA), and immune infiltration analysis, we identified NET-related biomarkers associated with UC-IF. Finally, we established a mouse model of UC-IF in vivo to validate the bioinformatics findings.</p><p><strong>Results: </strong>This analysis revealed that IL1RN, MUC1, and SERPINA1 represent a novel panel of NET-related biomarkers for UC-IF. These genes were enriched in immune responses, interleukin signaling pathways, O-glycan biosynthesis, and mucosal barrier-related pathways. Furthermore, these genes were positively correlated with several immune cell types, including neutrophils, macrophages (M0 and M1), and dendritic cells, collectively mediating immune dysregulation in UC and thereby contributing to the pathogenesis of UC-IF. Notably, animal experiments further validated the aberrantly high expression of these genes in the intestinal tissues of UC-IF mice, which was consistent with the bioinformatics findings.</p><p><strong>Conclusions: </strong>As UC-IF-associated NET biomarkers, IL1RN, MUC1 and SERPINA1 provide novel insights into the clinical diagnosis, treatment, and translational research of UC-IF.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13483529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788364","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":"Characteristics of small early colorectal cancer in the non-pedunculated lesions and its relationship with the depth of invasion.","authors":"Yu-Bei Li, Wen Song, Wen-Jun Zhao, Hua Liu, Xiao-Yu Li, Xiao-Yan Yin","doi":"10.1186/s12876-026-05094-9","DOIUrl":"10.1186/s12876-026-05094-9","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Colorectal cancer (CRC) exhibits high morbidity and mortality globally among malignant tumors. Early diagnosis and treatment can improve prognosis. Previously, tumor size was considered correlated with colorectal cancer invasion. However, whether small CRCs exhibit lower aggressiveness remains uncertain. To investigate the endoscopic features and risk factors for deep submucosal invasion in early, non-pedunculated CRCs with a diameter &lt; 2 cm, and to establish a preliminary nomogram to inform clinical diagnosis and treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We retrospectively analyzed clinical, endoscopic, and pathological data from 289 patients who underwent endoscopic submucosal dissection (ESD) or surgical resection for non-pedunculated polyps or early-stage colorectal cancer with a diameter &lt; 2 cm at the Affiliated Hospital of Qingdao University between January 2015 and November 2024. Patients were grouped based on the nature and invasion depth of the lesion. Statistical descriptions were performed for each group, and a preliminary nomogram was constructed to evaluate its predictive value for deep submucosal invasion in colorectal lesions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The mean age of patients was 63 years, with a higher proportion of males (60.9%). Lesions measuring 10-20 mm were predominant (83.7%). The majority were located in the left colon. Flat lesions were the most common endoscopic appearance (57.8%). The final pathology results showed precancerous lesions, intramucosal cancers, superficial submucosal invasion carcinoma and deep submucosal invasion carcinoma were 40.1%, 38.4%, 8.3% and 13.2% respectively. ESD was directly performed in 95.2% of cases (275 lesions). Surface fullness (OR = 13.81), dilated blood vessels in tumor periphery (OR = 6.44), JNET2B (OR = 6.43), JNET3 (OR = 22.94), and de novo carcinoma pathway (OR = 21.61) were independent risk factors for deep submucosal invasion in early colorectal cancer. Chicken skin mucosa (CSM) (OR = 5.71), surface depression (OR = 12.38), and invasive pit pattern (OR = 161.18) were independent risk factors for malignancy in non-pedunculated colorectal polyps less than 2 cm. The preliminary nomogram constructed based on these independent risk factors demonstrated predictive value for deep submucosal invasion in early-stage colorectal cancer.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Non-pedunculated colorectal lesions smaller than 2 cm carry risks of malignancy and deep submucosal invasion. Surface fullness, dilated blood vessels in tumor periphery, type JNET2B/3, and de novo carcinoma pathway are independent risk factors for deep submucosal invasion. CSM, surface depression, and invasive pit pattern are independent risk factors for malignancy. The nomogram prediction model constructed based on these findings provides a basis for clinical decision-making. The preliminary nomogram developed from these findings could offer some guidance for clinical decision-making","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13422327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148629273","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":"\"The role of red cell distribution width in inflammatory bowel disease evaluation: a comprehensive systematic review and meta-analysis\".","authors":"Yasser Khalil, Mohamed A Elhodhod, Mohammed Barghash, Mark Zaki, Abdelbaki Idriss Ibrahim, Mohamed Elserougi, Ahmed Ghanem, Khaled Ashraf Mohamed, Florian Gebauer, Ahmed Abdelsamad","doi":"10.1186/s12876-026-05156-y","DOIUrl":"10.1186/s12876-026-05156-y","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory markers are routinely used in the evaluation of inflammatory bowel disease (IBD). Red blood cell distribution width (RDW) has previously been proposed as a potential biomarker in the evaluation of IBD. This meta-analysis and systematic review challenges the utility of RDW in IBD evaluation.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis following PRISMA guidelines. A search strategy was formulated based on Medical Subject Headings (MeSH) terms and other relevant medical terms. A comprehensive search of PubMed, Web of Science, and Scopus was performed up to 4th of September 2025. Data were extracted for identifying the role of RDW in IBD detection and its association with disease activity. Statistical analysis employed a random-effects model, with subgroup analysis performed according to different levels of disease activity.</p><p><strong>Results: </strong>RDW was significantly elevated in patients suffering from Crohn's disease (CD) (MD = 2.2, p < 0.001) and ulcerative colitis (UC) (MD = 1.36, p < 0.001) compared to healthy controls. Both diseases showed significantly higher RDW in active disease versus remission (CD: MD = 1.29, p < 0.001; UC: MD = 1.11%, p < 0.001). For differentiating active CD from remission, an RDW cut-off > 14% showed a sensitivity of 0.86 and specificity of 0.78 (AUC = 0.83). RDW levels were also significantly higher in active CD compared to active UC (MD = 0.59, p < 0.005).</p><p><strong>Conclusion: </strong>RDW levels were markedly increased in patients with IBD compared to healthy controls. Furthermore, RDW showed a consistent association with both disease activity and severity. Given its wide availability, low cost, and reliable diagnostic performance, RDW could represent a practical and valuable biomarker for evaluating inflammatory bowel disease.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13412027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148599115","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":"Epigenetic regulation of INPP5D and its downstream molecular network in autoimmune pancreatitis.","authors":"Takeshi Uehara, Mai Iwaya, Shiho Asaka, Tomoyuki Nakajima, Shotaro Komamura, Hiroshi Sawaguchi, Shunsuke Imamura, Akira Nakamura, Shinsuke Sugenoya, Akira Shimizu, Hiroyoshi Ota","doi":"10.1186/s12876-026-05170-0","DOIUrl":"https://doi.org/10.1186/s12876-026-05170-0","url":null,"abstract":"<p><strong>Aims: </strong>Autoimmune pancreatitis (AIP) is a representative manifestation of IgG4-related disease characterized by lymphoplasmacytic inflammation and storiform fibrosis. Although epigenetic dysregulation has been implicated in autoimmune diseases, its contribution to the pathogenesis of AIP remains unclear.</p><p><strong>Methods and results: </strong>Genome-wide DNA methylation profiling was performed using the Infinium MethylationEPIC array in tissues affected by AIP and obstructive pancreatitis (OP). Differentially methylated regions (DMRs) were identified and subjected to pathway enrichment analysis. Among the significantly enriched gene sets, GNF2_INPP5D showed the strongest enrichment and was selected for further investigation. INPP5D promoter methylation was analyzed, and its protein expression was evaluated by immunohistochemistry. Single-cell RNA sequencing (scRNA-seq) was performed to identify the cells expressing INPP5D. Pathway enrichment analysis showed significant enrichment of the INPP5D-associated immune-regulatory network in AIP. Promoter-associated CpG probes within the INPP5D locus showed predominant hypomethylation in AIP compared with the findings in OP (adjusted p < 0.05). In contrast, immunohistochemistry demonstrated reduced INPP5D expression in spindle-shaped stromal macrophage/histiocyte-lineage cells in AIP tissues. scRNA-seq analysis identified INPP5D expression predominantly in C1QC-positive macrophages and lymphocytes.</p><p><strong>Conclusions: </strong>AIP is characterized by epigenetic remodeling of the INPP5D-associated immune-regulatory network accompanied by reduced INPP5D expression in stromal macrophage-lineage cells. These findings provide evidence for an association between altered INPP5D-related epigenetic regulation and the characteristic fibro-inflammatory microenvironment of AIP. INPP5D may represent a candidate biomarker and a potential therapeutic target in IgG4-related disease.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227192","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":"The diagnostic yield of endoscopic ultrasound-guided fine-needle biopsy in autoimmune pancreatitis: a systematic review and meta-analysis.","authors":"Huiling Yu, Jingwei Kou, Qijin He, Dongxuan Zhang, Yalan Chen, Jie Liang","doi":"10.1186/s12876-026-05164-y","DOIUrl":"10.1186/s12876-026-05164-y","url":null,"abstract":"<p><strong>Background and aim: </strong>Autoimmune pancreatitis (AIP) is a rare chronic form of pancreatitis mediated by autoimmune mechanisms. Evidence regarding the diagnostic performance of endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) in AIP remains limited. This study aimed to estimate the pooled diagnostic accuracy of EUS-FNB in patients with AIP.</p><p><strong>Methods: </strong>PubMed, Embase, Cochrane Library, CNKI, and Wanfang Database were systematically searched to identify fully published studies evaluating EUS-FNB for tissue sampling in AIP. Pooled estimates were generated using a random-effects model. The assessed outcomes included diagnostic accuracy, sample adequacy, contribution to AIP diagnosis, and adverse events.</p><p><strong>Results: </strong>Sixteen studies, including one randomized controlled trial and four prospective studies, comprising 732 patients, were included. The overall diagnostic accuracy was 79% (73%-83%). Diagnostic accuracy was higher for the Franseen needle (83%, 75%-90%) and Fork-tip needle (90%, 80%-99%) compared with the reverse/forward‑bevel (51%, 31%-71%), with a statistically significant difference (P < 0.001). The 22G needle also demonstrated superior diagnostic accuracy (85%, 79%-91%) compared with 19G/20G needles (70%, 42%-98%) (P < 0.001). The pooled sample adequacy rate was 97% (95%-98%). EUS-FNB contributed to the diagnosis in 69% (50%-88%) of cases where diagnosis could not be established using imaging, serology, or involvement of other organs. The overall adverse event rate was 4% (1%-8%).</p><p><strong>Conclusions: </strong>EUS-FNB demonstrates excellent histological tissue acquisition and moderate diagnostic accuracy in AIP, with a low rate of adverse events. The 22G Franseen or Fork-tip needles may be a reasonable option, though direct comparative evidence is lacking.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13418762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148599190","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":"Effectiveness of personalized positioning management in preventing hypoxemia during sedated endoscopy: a retrospective study.","authors":"Yuan Chen, Jia Zhu","doi":"10.1186/s12876-026-05168-8","DOIUrl":"https://doi.org/10.1186/s12876-026-05168-8","url":null,"abstract":"<p><strong>Background: </strong>To investigate the preventive effects of personalized positioning management on hypoxemia during sedated endoscopic examination in elderly patients with esophageal cancer (EC).</p><p><strong>Methods: </strong>A retrospective observational study was conducted. We retrospectively reviewed the medical records of elderly patients with esophageal cancer who underwent sedated gastroscopy between January 2023 and June 2024. Patients who received personalized positioning management were assigned to the intervention group (n = 67), while those who underwent conventional left lateral decubitus positioning were assigned to the control group (n = 67). The incidence of hypoxemia, lowest peripheral oxygen saturation (SpO₂), severe hypoxemic events, examination time, sedative dosage, comfort scores, and incidence of adverse events were compared between the two groups. Binary logistic regression analysis was performed to identify factors associated with hypoxemia.</p><p><strong>Results: </strong>In the intervention group, the incidence of hypoxemia was significantly lower; the lowest SpO₂ was distinctly higher; and the incidences of severe hypoxemia and hypoxemic events requiring intervention were lower. Personalized positioning management was identified as an independent protective factor against hypoxemia. A higher American Society of Anesthesiologists physical status classification (Class III) was an independent risk factor for hypoxemia. The intervention group had a shorter examination time, lower propofol dosage, higher comfort scores, and a lower incidence of adverse events.</p><p><strong>Conclusion: </strong>Personalized positioning management effectively reduces both the incidence and severity of hypoxemia during sedated endoscopic examination in elderly patients with EC. This strategy demonstrates high clinical safety and feasibility.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227213","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":"Item analysis of the gastroesophageal reflux disease quality of life instrument QLICD-GERD based on classical test theory and item response theory.","authors":"ZaiXue Mu, Ting Song, YanXiang Gao, QiaoYun Huang, XiRan Xia, TianLe Fu, JinJin Xu, HuaYu Sun, Yan Liu, Ying Chen","doi":"10.1186/s12876-026-05165-x","DOIUrl":"https://doi.org/10.1186/s12876-026-05165-x","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Gastroesophageal reflux disease (GERD) is a common digestive disorder that severely affects patients' physical and psychological health, leading to a substantial decline in health-related quality of life (HRQoL). The Quality of Life Instrument for Chronic Diseases-Gastroesophageal Reflux Disease (QLICD-GERD, V1.0) was developed to comprehensively assess the impact of GERD using both generic and disease-specific modules. This study aimed to analyze the psychometric properties and item performance of the QLICD-GERD (V1.0) using both Classical Test Theory (CTT) and Item Response Theory (IRT), in order to provide theoretical and empirical support for its further refinement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 207 patients with gastroesophageal reflux disease (GERD) were recruited from the Department of Gastroenterology of a tertiary hospital in Yunnan Province, China, between January 2022 and December 2024. A total of 207 patients with GERD from the Department of Gastroenterology of a tertiary hospital in Yunnan Province (January 2022-December 2024) were investigated using the self-administered QLICD-GERD (V1.0). CTT methods-including Cronbach's alpha, split-half reliability, standard deviation (SD) analysis, correlation analysis, and factor analysis-were applied to evaluate reliability and validity. IRT was used to estimate item discrimination (a), difficulty parameters (b1-b4), and average information (I), using the Samejima graded response model. SPSS 27.0, AMOS, and Multilog 7.03 were used for data analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In CTT analysis, 42 out of 48 items met the criteria of at least three statistical methods and were rated as good, while six items were rated as poor. The overall Cronbach's alpha of the scale was 0.848, and the split-half reliability was 0.905, indicating satisfactory internal consistency. The KMO value was 0.755, with a cumulative variance contribution of 68.51%. The revised confirmatory factor analysis (CFA) model achieved improved fit indices (χ²/df = 2.493, RMSEA = 0.084, GFI = 0.700, CFI = 0.691, TLI = 0.666, IFI = 0.697). Under IRT analysis, item discrimination ranged from 0.89 to 1.44, and most difficulty parameters increased monotonically with grade levels (B1→B4). Average information values ranged from 0.064 to 0.529: 9 items in the physical domain, 2 in social, 1 in spiritual, and 14 in the disease-specific domain were classified as poor, 20 good, and 2 excellent.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The QLICD-GERD (V1.0) demonstrates overall good psychometric properties, with strong reliability, validity, and discrimination. The psychological and social domains performed best, while several items in the physical and spiritual domains require refinement to improve measurement precision. The combination of CTT and IRT provides a comprehensive framework for optimizing the instrument's structure and enhancing its clinical applicability for assessing quality of life ","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227172","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":"PlasmaLyte, Lactated Ringer's, or Normal Saline resuscitation in acute pancreatitis: a single-center, pragmatic, cluster-randomized trial.","authors":"Seung-Ho Sin, Hyung-Keun Kim, Hyun-Ho Choi, Sung-Soo Kim","doi":"10.1186/s12876-026-05172-y","DOIUrl":"https://doi.org/10.1186/s12876-026-05172-y","url":null,"abstract":"<p><strong>Background/aims: </strong>The optimal resuscitation fluid for acute pancreatitis (AP) remains uncertain. This study evaluated the effects of PlasmaLyte (PL), Lactated Ringer's solution (LR), and Normal Saline (NS) in patients with early AP.</p><p><strong>Methods: </strong>A single-center, pragmatic, unblinded, monthly cluster-randomized trial compared PL, LR, and NS in patients with AP who presented within 6 h of symptom onset and had no evidence of overt severe disease at enrollment. The primary outcome was the change in systemic inflammatory response syndrome (SIRS) prevalence at 24 h. Secondary outcomes included clinical outcomes and biochemical changes after fluid resuscitation.</p><p><strong>Results: </strong>Sixty-six patients were enrolled (PL 21, LR 24, NS 21). Baseline SIRS prevalence was 23.8% in the PL group, 29.2% in the LR group, and 19.0% in the NS group; at 24 h, SIRS prevalence decreased to 4.8%, 12.5%, and 9.5%, respectively. This corresponded to relative reductions of 80.0% in PL, 57.1% in LR, and 50.0% in NS, without a statistically significant between-group difference (P = 0.668). No significant differences were observed in major clinical outcomes. At 24 h, potassium was higher in PL than in LR, chloride was higher in NS than in PL, and pH, bicarbonate, and base excess were lower in NS than in balanced crystalloid groups. These biochemical differences should be interpreted cautiously because of the small sample size and cluster design.</p><p><strong>Conclusions: </strong>In this small pragmatic trial, PL, LR, and NS showed no significant difference in the primary clinical endpoint. However, balanced crystalloids were associated with more favorable acid-base profiles than NS. These findings are exploratory and hypothesis-generating and require confirmation in larger multicenter trials with appropriate cluster-adjusted or individually randomized designs.</p><p><strong>Trial registration: </strong>Clinical Research Information Service (CRIS), KCT0007422. Registered June 20, 2022, https://cris.nih.go.kr .</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223255","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":"Combined TIPS and TACE for patients with hepatocellular carcinoma and variceal bleeding secondary to portal vein tumor thrombus.","authors":"Zhuyu Feng, Bifei Wu, Zhongwei Xu, Wei Yang, Haifeng Zhou, Haibin Shi, Sheng Liu, Weizhong Zhou","doi":"10.1186/s12876-026-05100-0","DOIUrl":"https://doi.org/10.1186/s12876-026-05100-0","url":null,"abstract":"<p><strong>Purpose: </strong>The study aimed to assess the safety and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) combined with transarterial chemoembolization (TACE) for treating hepatocellular carcinoma (HCC) patients who have portal vein tumor thrombus (PVTT) and variceal bleeding secondary to portal hypertension.</p><p><strong>Methods: </strong>This retrospective study analysed 39 patients with HCC and PVTT who experienced variceal bleeding and were treated with TIPS and TACE from June 2018 to April 2025. The evaluated outcomes included the technical success, clinical success and overall survival (OS).</p><p><strong>Results: </strong>The technical success rate was 100%. Variceal bleeding was successfully controlled in all patients. Among these patients, 13 (33.3%) developed overt hepatic encephalopathy (HE) after TIPS. There were no other significant procedure-related complications. The recurrence rate of variceal bleeding was 25.6% at 1 year. After TACE, all patients exhibited a reduction in tumor size, with 26 (66.7%) patients achieving partial response (PR) and 13 (33.3%) patients achieving stable disease (SD). The median OS was 12.2 (95% CI: 10.9-13.5) months and OS rates were 89.7% at 1 month, 76.9% at 3 months, 56.4% at 6 months, and 46.2% at 12 months.</p><p><strong>Conclusion: </strong>TIPS combined with TACE appears to be safe and effective for patients who had HCC and PVTT complicated with variceal bleeding secondary to portal hypertension.</p><p><strong>Clinical significance: </strong>This study found that the combination of TIPS and TACE is a safe and effective treatment for patients with HCC and PVTT. The treatment successfully stopped the bleeding in all patients, helped shrink the tumors in most, and improved overall survival. This approach not only manages the life-threatening bleeding but also allows for further treatment of the liver cancer itself.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227256","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}