BMC Gastroenterology最新文献

{"title":"Remimazolam for procedural sedation in gastrointestinal endoscopy: real-life, single center observational study.","authors":"Conigliaro Rita, Pigò Flavia, Caiazzo Anna, Grande Giuseppe, Russo Salvatore, Cocca Silvia, Lupo Marinella, Marocchi Margherita, Marsico Maria, Sculli Simone, Bertani Helga","doi":"10.1186/s12876-025-03636-1","DOIUrl":"10.1186/s12876-025-03636-1","url":null,"abstract":"<p><strong>Background and aim: </strong>Remimazolam has proved to be a very promising sedative drug in randomized clinical trials for usage in a wide spectrum of patients, including critically ill ones. The purpose of our study was to verify efficacy and safety of remimazolam for procedural sedation during diagnostic and first level operative endoscopy in a real-world setting.</p><p><strong>Methods: </strong>This single centre prospective study evaluated sedation regimen with remimazolam for EGDS and fentanyl and remimazolam for colonoscopy in consecutive ASA 1-3 patients.</p><p><strong>Results: </strong>Seventy-one patients underwent 73 procedures (25 EGDS, 48 colonoscopies) with a total amount of 13.2 ± 8.7 mg and 10.2 ± 6.2 mg of remimazolam administered respectively. In 6 EGDS, rescue sedation with propofol was needed. Transient hypotension was frequent (37%) and no cases of hypoxia occurred. One case of suspected allergy (erythema of the trunk) without anaphylaxis was reported.</p><p><strong>Conclusions: </strong>Procedural sedation can be applied with remimazolam without the use of propofol, obtaining effective sedation in colonoscopies while in EGDS remimazolam alone guarantees the result in a percentage of around 70-75% of cases.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"41"},"PeriodicalIF":2.5,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063750","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":"Cardiometabolic index as a predictor of gallstone incidence in U.S. adults: insights from NHANES 2017-2020.","authors":"Ji Li, Shou-Jun Bai","doi":"10.1186/s12876-025-03642-3","DOIUrl":"10.1186/s12876-025-03642-3","url":null,"abstract":"<p><strong>Background: </strong>Gallstone disease (GSD) is associated with obesity. The Cardiometabolic Index (CMI), a metric that accurately assesses central adiposity and visceral fat, has not been extensively studied in relation to GSD risk. This study investigates the link between CMI and GSD incidence in U.S. adults.</p><p><strong>Methods: </strong>This study utilized data from the National Health and Nutrition Examination Survey(NHANES)(2017-2020) to assess the association between CMI and GSD, adjusting for confounders such as age, sex, race, chronic diseases, and lifestyle factors. Multivariable logistic regression models and subgroup analyses were employed. Generalized Additive Models (GAM) and advanced curve fitting techniques were used to explore potential non-linear relationships, with threshold effects determined via piecewise linear regression if such relationships were identified. Receiver Operating Characteristic (ROC) curves evaluated and compared the predictive performance of CMI, Body Mass Index (BMI), and Waist Circumference (WC), establishing optimal cutoff values along with their sensitivity and specificity.</p><p><strong>Results: </strong>This study included 3,706 participants, of whom 10.6% (392) had GSD. Participants with GSD showed significantly higher CMI values (0.57 vs. 0.44, P = 0.0002). The GSD group included more females and older adults, with increased risks for hypertension, diabetes, higher serum cholesterol and creatinine levels, and a higher risk of cancer. Logistic regression analysis revealed that higher CMI was significantly associated with greater GSD incidence (OR = 1.19, 95% CI = 1.02-1.38, P < 0.0001). The ROC curve demonstrated superior predictive performance (AUC = 0.778), outperforming conventional metrics like BMI and WC. GAM analysis indicated a non-linear positive correlation between CMI and GSD, with an optimal threshold of 0.996. Subgroup analysis found the strongest association among females, individuals aged 20-39, non-Hispanic Whites, those without a history of coronary heart disease, and alcohol consumers.</p><p><strong>Conclusion: </strong>Our study reveals a nonlinear positive correlation between the CMI and the incidence of GSD among U.S. adults, with a threshold value of 0.996. Despite limitations in sample size that constrained the analysis of a fully adjusted model, after adjusting for confounding factors, the AUC for predicting GSD using CMI reached 0.778, surpassing traditional metrics. These findings underscore the importance of CMI as a critical risk factor and emphasize the necessity of targeted interventions for high-risk populations.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"45"},"PeriodicalIF":2.5,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11781038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063736","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":"Prevalence of common diarrheagenic enterobacteriaceae in Iran (2000-2023): a systematic review and meta-analysis.","authors":"Mozhgan Derakhshan-Sefidi, Fereshteh Eidy, Somayyeh Nadi-Ravandi, Sareh Bagheri-Josheghani, Maryam Mirfakhraei","doi":"10.1186/s12876-025-03634-3","DOIUrl":"10.1186/s12876-025-03634-3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Bacterial gastroenteritis is a significant public health concern, capable of causing severe infections. Among the various pathogens involved, those belonging to the Enterobacteriaceae family are the most frequently isolated and associated with gastrointestinal disorders. This study aimed to investigate the prevalence of common diarrheagenic Enterobacteriaceae in Iran over the past two decades, from 2000 to 2023.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A comprehensive systematic search was conducted across multiple databases, including EMBASE, HINARI, MEDLINE, PubMed, Google Scholar, and the Cochrane Library. The focus was on observational published studies reporting the prevalence of diarrheagenic Enterobacteriaceae in Iran during 2000 and 2023. The criteria did not restrict patient demographics such as age, gender, health conditions, or occupation. This meta-analysis employed a 95% confidence interval (CI) for analysis. Evidence of heterogeneity was determined using an I² value greater than 50%. To explore potential sources of heterogeneity, subgroup analysis and meta-regression analysis were performed. Statistical analyses were executed using R version 4.3.2 along with the meta package. A p-value less than 0.05 was considered statistically significant.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Out of 3,701 papers reviewed, 56 studies met the inclusion criteria and were analyzed. The overall pooled prevalence of diarrheagenic Enterobacteriaceae species from 2000 to 2023 was 14.0% (95% CI: 0.11-0.17). Subgroup analysis revealed Shigella spp. had the highest prevalence at 18.0% (95% CI: 0.13-0.24; I²=99%), followed by diarrheagenic Escherichia coli at 11.0% (95% CI: 0.09-0.15; I²=97%), Salmonella spp. at 9.0% (95% CI: 0.05-0.17; I²=99%), and Yersinia spp. at 2.0% (95% CI: 0.00-0.10; I²=94%). Prevalence trends showed Shigella spp. increasing from 4% (95% CI: 0.03-0.08) in 2000-2004 to 36% (95% CI: 0.20-0.55) in 2021-2023. Diarrheagenic E. coli (DEC) showed no clear pattern, ranging from 5% (95% CI: 0.01-0.24) to 17% (95% CI: 0.07-0.36). Salmonella spp. exhibited more significant fluctuations, rising from 6% (95% CI) in both 2000-2004 and 2005-2008 periods to 20% (95% CI: 0.03-0.66) in 2009-2012 and 30% (95% CI: 0.11-0.60) in 2017-2020. Yersinia spp. was only determined in 2000-2004 with a pool prevalence of 12% (95% CI: 0.00-0.91). Sub-species analysis revealed Shigella sonnei was the most prevalent species among Shigella spp. in Iran, accounting for 42% of cases (95% CI: 0.33-0.52). Regarding DEC species, Enteroaggregative E. coli (EAEC) and Enterotpathogenic E. coli (EPEC) had the highest rate at 15% (95% CI). Furthermore, a pool prevalence of 2% (95% CI: 0.00-0.89) was reported for Yersinia enterocolitica among diarrheagenic Enterobacteriaceae in Iran.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This meta-analysis provides valuable insights into the prevalence of diarrheagenic Enterobacteriaceae in Iran over the past two decades. The finding","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"43"},"PeriodicalIF":2.5,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063740","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":"Establishing of a risk prediction model for metabolic dysfunction-associated steatotic liver disease: a retrospective cohort study.","authors":"Nan Li, Chenbing Liu, Zhangfan Lu, Wenjian Wu, Feng Zhang, Lihong Qiu, Chao Shen, Di Sheng, Zhong Liu","doi":"10.1186/s12876-025-03598-4","DOIUrl":"10.1186/s12876-025-03598-4","url":null,"abstract":"<p><strong>Objectives: </strong>Over 30% of people worldwide suffer from metabolic dysfunction-associated steatotic liver disease (MASLD), a significant global health issue. Identifying and preventing high-risk individuals for MASLD early is crucial. The purpose of our study is to investigate the factors related to the development of MASLD and develop a risk prediction model for its occurrence.</p><p><strong>Methods: </strong>The study included 5107 subjects, divided into training and validation groups in a 7:3 ratio using a random number table method. Collinearity diagnosis and Cox regression were used to identify factors associated with MASLD incidence, and a risk prediction model was created. The model's accuracy, reliability, and clinical applicability were assessed.</p><p><strong>Results: </strong>Our study indicated that male, body mass index (BMI), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), fasting plasma glucose (FPG), serum uric acid to creatinine ratio (SUA/Cr) and white blood cell (WBC) were associated with MASLD incidence. The elements were determined to be crucial for creating a risk prediction model. The model showed strong discriminative potential with a C-index of 0.783 and the time-dependent AUCs of 0.781, 0.789, 0.814 and 0.796 for 1-4 years in the training group, and a C-index of 0.788 and the time-dependent AUCs of 0.798, 0.782, 0.787 and 0.825 for 1-4 years in validation. Calibration curves confirmed the model's accuracy, and decision curve analysis (DCA) validated its clinical utility.</p><p><strong>Conclusions: </strong>The model may provide clinical physicians with a reliable method for identifying high-risk populations for MASLD and serve as a guide for developing prediction models for other diseases.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"39"},"PeriodicalIF":2.5,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143057996","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":"CT features with histopathological correlation in inflammatory versus benign & malignant neoplastic appendiceal mucoceles: a retrospective cross-sectional study.","authors":"Kumail Khandwala, Nida Sajjad, Dawar Burhan Khan, Amyn A Malik, Wasim Ahmed Memon, Muhammad Owais Rao, Nasir Ud Din, Faheemullah Khan, Khabab Abbasher Hussien Mohamed Ahmed","doi":"10.1186/s12876-025-03630-7","DOIUrl":"10.1186/s12876-025-03630-7","url":null,"abstract":"<p><strong>Background & objectives: </strong>Differentiation of histologic subtypes of appendiceal mucoceles may prove to be difficult on computed tomography (CT). The main objective of this study was to identify the CT features of mucocele of the appendix and correlate the imaging findings with histopathology in inflammatory, benign, and malignant neoplastic lesions, and whether these entities can be accurately differentiated on CT imaging.</p><p><strong>Materials and methods: </strong>CT scans of 31 patients with diagnosis of appendiceal mucocele were retrospectively reviewed and compared with histopathology. The appendix was evaluated for maximal luminal diameter, cystic dilatation, luminal attenuation, appendicolith, mural calcification and enhancement, periappendiceal fat stranding and fluid. CT findings were compared by use of Mann-Whitney U and Fisher's exact tests. Receiver operating characteristics analysis was performed to assess the diagnostic utility of appendiceal luminal diameter in differentiating different types of mucoceles.</p><p><strong>Results: </strong>Patients were classified into three groups: those with inflammatory mucoceles (n = 10), benign mucoceles (simple mucocele, mucosal hyperplasia and low-grade appendiceal mucinous neoplasm (n = 17), and those with malignant mucinous adenocarcinoma (n = 4). The mean diameter was found to be significantly different in the three groups with the largest diameter in the benign subgroup. Soft tissue thickening (p-value 0.01), mural calcification (p-value < 0.01), internal septation (p-value 0.02) and fat stranding (p-value 0.05) was found to be of statistical significance among the various groups. The best cut-off diameter for diagnosis of inflammatory mucoceles to be ≤ 2.3 cm with a sensitivity of 71% and specificity of 90%.</p><p><strong>Conclusion: </strong>Our study suggests that CT findings such as appendiceal diameter less than 2.3 cm, absence of soft tissue thickening, mural calcification and internal septation may be useful in preoperative diagnosis of inflammatory appendiceal mucocele.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"40"},"PeriodicalIF":2.5,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143057995","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":"Effect of probiotics combined with immune checkpoint suppressors and chemotherapeutic agents on digestive system function, intestinal immunity and prognosis in patients with metastatic colorectal carcinoma: a quasi-experimental study.","authors":"Xiaolei Wang, Yuxia Huang, Zhen Yang, Yang Yang, Fenfen Wei, Min Yan, Fanfan Li, Chenghao Wang","doi":"10.1186/s12876-025-03604-9","DOIUrl":"10.1186/s12876-025-03604-9","url":null,"abstract":"<p><strong>Objective: </strong>An exploration of the influence of probiotics combined with immune checkpoint suppressors and chemotherapeutic agents on digestive system function, intestinal immunity and prognosis in patients with metastatic colorectal carcinoma.</p><p><strong>Methods: </strong>This was a quasi-experimental study. During March 2019 to March 2020, 96 patients with metastatic colorectal carcinoma were arbitrarily classified into control group (n = 48) and intervention group (n = 48). The control group received only immune checkpoint inhibitors or chemotherapy, while the intervention group received immune checkpoint inhibitors or chemotherapy, plus probiotic therapy. Survival and complication rates after 6 months, 12 months and 2 years of treatment were calculated. Intestinal barrier function, immune function and quality of life were analyzed before and after treatment.</p><p><strong>Results: </strong>Ninety-six patients were recorded at the follow-up demonstrating superior survival in the intervention group after 6 months, 12 months and 2 years of therapy. D-lactate and diamine oxidase (DAO) levels were elevated in the intervention group after treatment, with smaller elevations (P < 0.05). The levels of Bifidobacterium and Lactobacillus were remarkably higher in the intervention group after treatment compared to the control group prior to and following therapy (P < 0.05). The amount of Enterococcus and Escherichia coli in the intervention group after treatment was obviously lower compared to the pre-treatment and control groups (P < 0.05). CD3⁺, CD4⁺, and CD4⁺/CD8⁺ levels were found to be higher in the intervention group (P < 0.05), while CD8⁺ levels were reduced in the intervention group (P < 0.05). All dimensions of the QLQC-30 scale were higher in the intervention group (P < 0.05). The incidence of complications such as nausea and vomiting, loss of appetite, bloating and diarrhea was considerably reduced in the intervention group (P < 0.05).</p><p><strong>Conclusion: </strong>Immune checkpoint suppressors combined with chemotherapeutic agents or probiotic regimens can obviously enhance the prognosis of patients with metastatic colorectal carcinoma. This combination therapeutic strategy can balance the imbalanced intestinal flora, improve intestinal function, and lessen the incidence of adverse events, so it is worthy of clinical application and can lessen the incidence of adverse reactions.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"38"},"PeriodicalIF":2.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051538","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":"Effect of KRAS mutation status on clinicopathological characteristics and overall survival in patients with rectal cancer.","authors":"Shengbin Zheng, Zhijie You, Guodon Guo, Zhijing Lin, Siming Wang, Guohua Yang","doi":"10.1186/s12876-025-03615-6","DOIUrl":"10.1186/s12876-025-03615-6","url":null,"abstract":"<p><strong>Background: </strong>KRAS mutations in rectal cancer are associated with a conflict prognosis. This study aimed to compare clinicopathological outcomes of patients and tumor criteria between wKRAS and mKRAS, as well as overall survival in the two groups.</p><p><strong>Methods: </strong>The research retrospectively analyzed a cohort of 193 patients who received surgical treatment for rectal adenocarcinoma between May 2015 and December 2023. The patients were categorized into two groups according to their KRAS status: wild-type KRAS (wKRAS) and mutant KRAS (mKRAS), with performing research on mKRAS ^G12D and mKRAS ^G13D mutation.</p><p><strong>Results: </strong>The mKRAS group included 100 patients(51.8%) and had no significantly difference in age, sex, distance from anus, tumor node metastasis(TNM), lymphovascular invasion(LVI), grade differentiation, and perineural invasion(PNI), carcinoembryonic antigen(CEA) level than that in wKRAS group.KRAS^G12D group had significantly more poorer differentiation(9/34,26.5% vs. 10/93,10.7%,p = 0.046), PNI(24/34,70.6%vs.42/93,45.2%,p = 0.016) and higher TD(8/34,23.5% vs.8/93,8.6%,p = 0.035) respectively, p < 0.05. Compared with the wKRAS group, the mean OS of mKRAS group was worse(58.07 m vs.57.55 m), but had no significant difference(p = 0.0866). In comparison to the wKRAS group, the overall survival duration was notably reduced in the KRAS^G12D group (p = 0.0482), whereas no significant difference was observed in the KRAS^G13D group (p = 0.1848). Additionally, a COX survival analysis was conducted, revealing that KRAS^G12D, along with higher TNM stage, LVI, tumor deposits, and PNI, were all associated with a decrease in survival time for patients with rectal cancer; however, these factors did not reach statistical significance (p > 0.05).</p><p><strong>Conclusion: </strong>The overall survival duration for wKRAS was superior to that of mKRAS; however, the difference between the two groups was not statistically significant. In contrast, the survival time for KRAS^G12D was significantly poorer than that for wKRAS, while no such difference was observed for KRAS^G13D.</p><p><strong>Retrospectively registered: </strong>K2024-07-037.2024,7.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"37"},"PeriodicalIF":2.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051537","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":"Capecitabine enhances sensitivity to oxaliplatin in advanced gastric cancer and the effects on patients' FOXP1 and GGT levels.","authors":"Xinyu Guo, Yi Liu","doi":"10.1186/s12876-025-03624-5","DOIUrl":"10.1186/s12876-025-03624-5","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effect of capecitabine on the sensitivity of oxaliplatin and on the level of transcription factor forkhead box P1 (FOXP1) and gamma-glutamyl transpeptidase (GGT) in patients with intermediate and advanced gastric cancer.</p><p><strong>Methods: </strong>A total of 152 Patients with advanced gastric cancer who were continuously diagnosed and treated in our hospital were selected as the study objects. The general data were retrospectively analyzed. The patients in the control group received oxaliplatin, while the patients in the study group received capecitabine on the basis of the control group. The FOXP1 expression level was detected using immunohistochemistry. Serum levels of GGT were measured by chemiluminescence. Protein levels were detected by Western blot. The prognostic factors were analyzed by the COX regression model. The Kaplan-Meier survival curve was used to analyze the survival of gastric cancer.</p><p><strong>Results: </strong>The effective rates (complete response, partial response, and stability) of the study group and the control group were 94.74% and 76.32%, respectively. Compared with adjacent normal tissues, the expression level of FOXP1 in gastric cancer tissues was lower (P < 0.05). After treatment, the average expression level of FOXP1 in the gastric cancer tissue of the study group was higher than the control group (P < 0.05). Moreover, lower FOXP1 expression was associated with lower overall survival (OS) (1-year survival and 3-year survival were 75.76% and 53.03%, respectively) (P < 0.05). Further analysis showed that capecitabine combined with oxaliplatin down-regulated the expression of DNA repair related-proteins and up-regulated the expression of key molecules of the apoptosis pathway, thus enhancing the killing effect of oxaliplatin on gastric cancer cells (P < 0.05). Both the 1-year and 3-year survival rates of the study group were higher than that in the control group (P < 0.05). The 1-year survival rate of 152 patients with gastric cancer was 84.87% (129/152) and the 3-year survival rate was 63.17% (96/152). Age, tumor-node-metastasis (TNM) stage, lymph node metastasis, chemotherapy regimen, FOXP1, and GGT levels were important factors in determining OS.</p><p><strong>Conclusion: </strong>Capecitabine effectively enhanced the sensitivity of intermediate and advanced gastric cancer to oxaliplatin, improved the therapeutic effect and ameliorated the prognosis of patients.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"35"},"PeriodicalIF":2.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11759413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143036888","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":"Magnitude, patterns, and factors associated with liver disease among clinically suspected clients in Eastern Ethiopia: hidden public health tragedy.","authors":"Aliya Nuri, Sufian Jeilu, Yared Teklu, Kadir Abdu, Ahmed Muhye, Milkiyas Solomon Getachew, Imam Dagne, Muluken Yigezu, Sewmehon Amsalu Adugna, Vanisha S Nambiar, Abdu Oumer","doi":"10.1186/s12876-025-03628-1","DOIUrl":"10.1186/s12876-025-03628-1","url":null,"abstract":"<p><strong>Background: </strong>Liver diseases are a public health problem in developing regions, and the majority of them are asymptomatic. Evidence on the current burden of liver disease and associated context-specific risk factors is scarce in the study area, where various risk factors for liver disease, including khat chewing, smoking, and aflatoxin exposure, are common. This study was to assess the magnitude, patterns, and factors associated with liver disease among patients visiting governmental hospitals in eastern Ethiopia.</p><p><strong>Methods: </strong>A facility-based cross-sectional study was conducted among randomly selected 388 clinically suspected adults for liver disease visiting a public hospital in Dire Dawa, Ethiopia. Data was collected using a combination of structured questionnaires, physical examinations, and investigations through interviews, medical chart reviews, liver enzymes, and the results of ultrasound examinations. Bivariable and multivariable logistic regression analyses were employed to determine the factors associated with liver disease. Candidate variables in bivariable analysis were selected based on p-values < 0.25, biological plausibility, and evidence of associations from previous studies. The level of significance was considered at a P-value < 0.05, and the adjusted odds ratio with a 95% confidence interval was reported.</p><p><strong>Results: </strong>A total of 388 (92%) adults were included and liver disease was diagnosed among 295 (76%; 71.5-80.2) of the study participants, where chronic liver disease due to non-viral (65.1%) and viral causes (34.9%) were prevalent. The risk of liver disease was higher among females (AOR = 3.43; 1.80-6.55) and under grade twelve (AOR = 3.90; 1.95-7.82) compared to counterparts. Furthermore, alcohol consumption (AOR = 3.14; 1.33-7.32), khat chewing (AOR = 1.69; 0.91-3.15), a history of hospitalization (AOR = 4.20; 2.29-7.11), and a history of intestinal parasite infection (AOR = 1.17; 0.55-2.49) were found to be positively associated with an increased risk of liver disease among adults.</p><p><strong>Conclusions: </strong>Liver disease detection rate was found to be high and could be associated with substance use (alcohol and khat), history of hospitalization, and worm infection, which can be incorporated into the prevention strategies of liver diseases.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"36"},"PeriodicalIF":2.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11760694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143036906","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 prognostic value of systemic inflammation response index in digestive system carcinomas: a systematic review and meta-analysis.","authors":"Zuo-Hu Niu, Li Lin, Hong-Ye Peng, Xin-Zhuo Zheng, Mi-Yuan Wang, Feng-Xia Sun, Chun-Jun Xu","doi":"10.1186/s12876-025-03635-2","DOIUrl":"10.1186/s12876-025-03635-2","url":null,"abstract":"<p><strong>Background: </strong>Digestive system carcinomas (DSC) constitute a significant proportion of solid tumors, with incidence rates rising steadily each year. The systemic inflammation response index (SIRI) has been identified as a potential prognostic marker for survival in various types DSC. This meta-analysis aimed to evaluate the prognostic value of SIRI in patients with DSC.</p><p><strong>Methods: </strong>We conducted a comprehensive literature search of PubMed, Web of Science Core Collection, Embase, and Cochrane Library databases, searching for studies published from inception to May 30, 2023. Eligible studies included cohort studies that assessed the association between pre-treatment SIRI levels and DSC prognosis. We extracted and synthesized hazard ratios (HRs) and 95% confidence intervals (CIs) using STATA/SE 12.0, stratifying HRs based on univariable and multivariable analysis. Due to substantial heterogeneity, we applied a random-effect model for all pooled analyses. The primary outcome of interest was the overall survival (OS), while secondary outcomes included progression-free survival (PFS), disease-free survival (DFS), time to progression (TTP), and disease specific survival (DSS). Publication bias was evaluated using Begg's test and Egger's tests.</p><p><strong>Results: </strong>A total of 34 cohort studies encompassing 9628 participants were included in this meta-analysis. Notable heterogeneity was observedin the OS (I² = 76.5%, p < 0.001) and PFS (I² = 82.8%, p = 0.001) subgroups, whereas no significant heterogeneity was detected in the DFS, TTP, and DSS subgroups. Elevated SIRI was found to be significantly associated with shorter OS (HR = 1.98, 95% CI: 1.70-2.30, tau² = 0.0966) and poorer PFS (HR = 2.36, 95% CI: 1.58-3.53, tau² = 0.1319), DFS (HR = 1.80, 95% CI: 1.61-2.01, tau² < 0.0001), TTP (HR = 2.03, 95% CI: 1.47-2.81, tau² = 0.0232), and DSS (HR = 1.99, 95% CI: 1.46-2.72, tau² < 0.0001). Furthermore, an increase in SIRI following treatment was linked to reduced OS, TTP, and DFS, while a decrease in SIRI post-treatment corresponded with improved OS, TTP, and DFS compared to baseline levels.</p><p><strong>Conclusions: </strong>Elevated SIRI is associated with poorer clinical outcomes in patients with DSC. This index may serve as a valuable prognostic biomarker, offering a promising tool for predicting survival in DSC patients.</p><p><strong>Prospero: </strong>REGISTRATION NUMBER: CRD42023430962.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"34"},"PeriodicalIF":2.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11761727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143036925","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}