BMC Gastroenterology最新文献

{"title":"Real-world study of posaconazole tablets for the prophylaxis of invasive fungal disease in patients with end-stage liver disease.","authors":"Yunru Chen, Lei Shi, Xi Zhang, Xiaojing Liu, Yinghua Niu, Yingli He, Tianyan Chen","doi":"10.1186/s12876-026-05131-7","DOIUrl":"10.1186/s12876-026-05131-7","url":null,"abstract":"<p><strong>Background: </strong>Data on the pharmacokinetics and tolerability of posaconazole delayed-release tablets in patients with end-stage liver disease (ESLD)(including liver failure and decompensated cirrhosis) remain limited. This study aimed to characterize trough concentrations (Cmin) and describe clinical outcomes during antifungal prophylaxis in this population.</p><p><strong>Methods: </strong>In this prospective, single-arm study, ESLD patients receiving posaconazole prophylaxis were enrolled between October 2023 and July 2024. Serial Cmin were measured, and hepatic and renal function parameters were monitored. Breakthrough invasive fungal disease (IFD) events were descriptively recorded.</p><p><strong>Results: </strong>Twenty-one patients contributed 79 Cmin measurements. The mean Cmin was 1.60 ± 0.68 mg/L, with 81.0% of samples ≥ 1.0 mg/L; 95.2% of patients achieved at least one target concentration. Substantial interindividual variability was observed, while dose adjustments were infrequent. Breakthrough IFD occurred in 2 patients (9.5%), with no IFD-related deaths. Liver and renal function parameters remained generally stable during follow-up. Reductions in total bilirubin were observed in patients with more advanced liver dysfunction (Model for End-Stage Liver Disease (MELD) > 18 or Child-Pugh C), although these changes were not attributable to posaconazole.</p><p><strong>Conclusion: </strong>Posaconazole exposure in patients with ESLD showed considerable interindividual variability, despite most Cmin measurements were within the predefined reference range of 0.5-2.5 mg/L. The drug was generally well tolerated in this cohort. These findings support the role of therapeutic drug monitoring (TDM) in characterizing exposure variability in ESLD. Given the small sample size and observational design, the results are descriptive, and further studies are needed to define optimal dosing and monitoring strategies in this high-risk population.</p><p><strong>Trial registration: </strong>ChiCTR2200063000. Registration on 27 August 2022.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469003","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":"Ectopic gastric squamous metaplasia with concomitant well-differentiated adenocarcinoma: a case report.","authors":"Kenichi Takahashi, Satoshi Osawa, Rei Ishikawa, Ryoji Kushima, Yusuke Asai, Natsuki Ishida, Mihoko Yamade, Moriya Iwaizumi, Yasushi Hamaya, Takanori Yamada, Kazuya Shinmura, Ken Sugimoto","doi":"10.1186/s12876-026-05135-3","DOIUrl":"10.1186/s12876-026-05135-3","url":null,"abstract":"<p><strong>Background: </strong>Gastric squamous metaplasia is a rare condition whose clinical significance and malignant potential remain unclear. Most reported cases are located in the cardia and are continuous with the esophageal squamous epithelium. Ectopic gastric squamous metaplasia, defined as lesions discontinuous from the esophagus, is exceedingly rare, and its association with gastric neoplasms has not been well characterized.</p><p><strong>Case presentation: </strong>An 81-year-old woman with a history of Helicobacter pylori eradication underwent esophagogastroduodenoscopy for gastric cancer screening. A 20-mm discolored, slightly depressed lesion was identified on the greater curvature of the upper gastric body. The lesion was discontinuous from the esophageal mucosa and appeared as an iodine-unstained area. Magnifying endoscopy with narrow-band imaging revealed intrapapillary capillary loop-like vascular dilation with background coloration. Biopsy specimens suggested squamous metaplasia with reactive atypia, and en bloc resection was performed by endoscopic submucosal dissection. Postoperative histopathological examination identified mature stratified squamous epithelium consistent with gastric squamous metaplasia, and incidentally identified a well-differentiated adenocarcinoma confined to the mucosa adjacent to the metaplastic lesion without lymphovascular invasion. Immunohistochemical analysis revealed a linear arrangement of p63-positive cells along the basal layer of the metaplastic epithelium with a subset of Ki-67-positive cells indicating proliferative activity at the basal layer. p53 expression showed a wild-type pattern.</p><p><strong>Conclusions: </strong>We report an extremely rare case of ectopic gastric squamous metaplasia associated with well-differentiated adenocarcinoma. Although a direct histogenetic relationship between the two lesions remains uncertain, their coexistence raises important considerations regarding the pathogenesis of gastric squamous metaplasia and its potential clinical significance. The immunohistochemical findings may support a possible role of competitive epithelial replacement in the development of gastric squamous metaplasia. Careful endoscopic and histopathological evaluation is warranted when this rare lesion is encountered.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497179","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 VISION-AI Trial: protocol for a pragmatic randomized controlled non-inferiority trial comparing artificial intelligence-guided colonoscopy to pancolonic chromoendoscopy for neoplasia detection in adults with colorectal inflammatory bowel disease.","authors":"Lisa M A Laforce-van Lierop, Rebecca Dang, Neeraj Narula, Richard J M Ingram, Sanjay K Murthy, Frank Hoentjen","doi":"10.1186/s12876-026-05046-3","DOIUrl":"10.1186/s12876-026-05046-3","url":null,"abstract":"<p><strong>Background: </strong>Current guidelines recommend pancolonic chromoendoscopy (pCE) over white light endoscopy (WLE) alone for colorectal neoplasia (CRN) detection in individuals with inflammatory bowel diseases (IBD). However, these techniques are poorly adopted due to technical and logistical limitations. Artificial intelligence-based computer-aided detection (CADe) is a promising new technology integrated into modern endoscopy platforms that has been shown to increase CRN detection in the non-IBD population. We aim to compare CADe-guided colonoscopy to chromoendoscopy in a randomized controlled trial (RCT) in individuals with IBD undergoing surveillance colonoscopy.</p><p><strong>Methods: </strong>This is a pragmatic, multicenter, parallel-group, open-label, non-inferiority RCT comparing CADe-guided colonoscopy (intervention) to pCE (virtual or dye spray) (standard of care). Consenting adults (≥ 18 years) with longstanding (≥ 8 years) IBD (or any duration with primary sclerosing cholangitis) involving ≥ 1/3 of the colorectum, in clinical remission and undergoing surveillance colonoscopy, will be included. Those who undergo a high-quality colonoscopy (adequate preparation, minimal inflammation, complete intubation) will be included in the primary analysis. Patients will be centrally randomized by permuted blocks, stratified by endoscopist. The anticipated CRN rate is 15% in both groups. To demonstrate non-inferiority with a 7.5% margin, at a one-sided alpha of 2.5% and 80% power, and allowing for a 5% loss of eligibility, a total of 752 participants are required. The primary outcome will be visible CRN detected at colonoscopy; secondary outcomes include the mean number of CRN, proportion of individuals with high-risk CRN, procedural time, adverse events, and endoscopist acceptance, with per-protocol (primary) and intention-to-treat (secondary) analyses. This protocol follows the SPIRIT 2025 guidelines.</p><p><strong>Discussion: </strong>AI has shown potential in enhancing CRN detection, but current AI systems are not specifically trained for IBD-related lesions, limiting effectiveness. This multicenter non-inferiority RCT will, for the first time, directly compare CADe-guided colonoscopy to pCE for CRN detection in individuals with IBD. This approach may increase adoption of AI-enhanced endoscopy and improve cancer prevention strategies.</p><p><strong>Trial registration: </strong>Australian New Zealand Clinical Trials Registry (ANZCTR) registration number: ACTRN12626000102370. At the time of initial submission (November 2025), recruitment for this study had not started. Participant enrollment began in April 2026, and as of June 8, 2026, 19 out of the target 752 participants have been recruited. The study is currently in the active recruitment phase and has not yet transitioned to follow-up only.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468683","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":"FBXW8 is upregulated in hepatocellular carcinoma and promotes HCC cell malignancy.","authors":"Duanzhuo Li, Yanli Liao, Silin Yao, Hangzhi Li, Yi Quan, Mi Huang","doi":"10.1186/s12876-026-05146-0","DOIUrl":"10.1186/s12876-026-05146-0","url":null,"abstract":"<p><strong>Aim: </strong>Investigate FBXW8 expression levels in hepatocellular carcinoma (HCC), its biological roles and prognostic significance.</p><p><strong>Methods: </strong>Based on the analysis of The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus databases, the expression level of FBXW8 was investigated. The results were verified in clinical samples using quantitative polymerase chain reaction (qPCR) and immunohistochemistry (IHC). Functional experiments (Cell Counting Kit-8, wound healing, and Transwell) were conducted on Huh7 and MHCC-97 H cells. Immune infiltration and methylation status were also evaluated.</p><p><strong>Results: </strong>FBXW8 was significantly overexpressed in HCC tissues across multiple cohorts (TCGA, GSE25097, GSE54236; all p < 0.001), with consistent validation by qPCR and IHC in clinical specimens. Elevated FBXW8 expression correlated with aggressive clinicopathological characteristics, specifically, advanced tumor-node-metastasis staging, poor histological grade, and higher alpha-fetoprotein levels (all p < 0.05). High FBXW8 expression was associated with worse overall survival (hazard ratio [HR] = 1.52, p = 0.024), with Progression-free interval (HR = 1.45, p = 0.013) also adversely affected. Receiver operating characteristic analysis demonstrated that FBXW8 had diagnostic value. The areas under the curve in the TCGA, GSE25097 and GSE54236 datasets were 0.875, 0.837 and 0.716, respectively. The in vitro functional experiments demonstrated that FBXW8 overexpression promoted cell proliferation, migration, and invasion (all p < 0.05). The FBXW8 expression was positively correlated with T helper cells (r = 0.342), while it was negatively correlated with dendritic cells (r = - 0.379). Promoter hypermethylation of FBXW8 was observed in HCC, with three CpG sites associated with prognosis.</p><p><strong>Conclusion: </strong>FBXW8 functions as a prognostic biomarker and promotes HCC progression, indicating its therapeutic potential.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468951","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":"Sessile serrated lesions of the appendix: a contemporary review of the literature.","authors":"Berkenye Csonka, Tamás Lantos, Anita Sejben","doi":"10.1186/s12876-026-05117-5","DOIUrl":"10.1186/s12876-026-05117-5","url":null,"abstract":"<p><strong>Introduction: </strong>Sessile serrated lesions (SSLs) of the appendix remain a controversial entity due to evolving definitions, diagnostic criteria, and nomenclature. Shifts in diagnostic thresholds - from multiple serrated crypts to a single unequivocally serrated and distorted crypt - have led to discrepancies in lesion classification and retrospective analyses. These controversies, compounded by inconsistent adherence to updated criteria, highlight the need for studies and reviews applying contemporary standards to accurately assess incidence and clinical significance.</p><p><strong>Methods: </strong>The review protocol was registered in PROSPERO (CRD420261299191). Systematic searches of PubMed, Web of Science, Scopus and Ovid were performed for studies published between 2007 and 2025. Eligible studies reporting clinicopathological features of appendiceal SSLs were included.</p><p><strong>Results: </strong>The reported prevalence of appendiceal SSLs is low (approximately 1.11-5.22‰), but increases with age and is markedly higher in patients with serrated polyposis syndrome. Most lesions are incidentally detected histologically, are often macroscopically inconspicuous, and show dysplasia in a minority of cases (~ 28%). Compared with colonic SSLs, appendiceal lesions are less common, show female predominance, and more frequently harbour KRAS rather than BRAF mutations, suggesting partially distinct molecular pathways. Although occasional co-occurrence with mucinous neoplasms and adenocarcinoma may suggest possible biological links, current evidence is insufficient to define a consistent progression pathway or establish their true malignant potential.</p><p><strong>Conclusions: </strong>Overall, the current literature is constrained by small sample sizes, heterogeneous study designs, inconsistent reporting, and substantial publication bias, particularly toward unusual or concurrent neoplastic findings. These limitations preclude definitive conclusions regarding the true prevalence, natural history, and malignant potential of appendiceal SSLs. Further large-scale, systematically characterised, and longitudinally followed cohorts with comprehensive molecular profiling are required to clarify their biological behaviour and clinical significance.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468696","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":"Inflammatory mediators are predictors of clinical outcomes in cirrhotic patients with non-acute decompensation.","authors":"Xixuan Wang, Jiale Shen, Jun Guo, Xiaoying Dong, Feng Yang, Shuling Chen, Hao Ren, Hui Zhou, Xiaoning Feng, Zihao Liang, Dawei Yang, Caiyun Zhang, Qingfang Xiong, Ruiqi Li, Yongfeng Yang","doi":"10.1186/s12876-026-05105-9","DOIUrl":"10.1186/s12876-026-05105-9","url":null,"abstract":"<p><strong>Background: </strong>Non-acute decompensation (NAD) has been proposed as a distinct pathway of decompensation. This study evaluated the prognostic value of inflammatory mediators for subsequent clinical outcomes in patients with NAD.</p><p><strong>Methods: </strong>Outpatients with NAD were included in this ambispective cohort study (Cohort 1 retrospectively; Cohort 2: prospectively). Patients were followed for 24 months. The primary endpoints were the occurrence of acute decompensation (AD), acute-on-chronic liver failure (ACLF), and liver-transplantation-free mortality.</p><p><strong>Results: </strong>Cohort 1 ultimately comprised 373 patients. Cohort 2 included 192 patients. In multivariable analysis of cohort 1, both IL-10 and IL-6 levels independently predicted AD (log-transformed-IL-10, HR: 1.26; 95% confidence interval, CI: 1.16-1.36; P < 0.001; log-transformed-IL-6, HR: 1.13; 95% CI: 1.01-1.27; P = 0.03) and ACLF (log-transformed-IL-10, HR: 2.03; 95% CI: 1.57-2.64; P < 0.001; log-transformed-IL-6, HR: 2.21; 95% CI: 1.57-3.11; P < 0.001). Patients were stratified into three groups: no systemic inflammation (SI), SI without immunodeficiency (ID), and SI with ID (elevated IL-6 + IL-10). While SI alone increased AD risk, the coexistence of ID markedly amplified the risk of severe outcomes. Compared to SI alone, patients with SI + ID had a substantially higher risk of ACLF (Cohort 1 (training) HR: 28.02; 95% CI: 12.54-62.62; Cohort 2 (validating) HR: 39.78; 95% CI: 10.97-144.30). Nearly all deaths occurred in the SI + ID subgroup [Cohort 1: 10/10; Cohort 2: 4/5].</p><p><strong>Conclusions: </strong>A combined biomarker profile of SI (IL-6) and ID (IL-10) identifies a distinct high-risk subgroup among NAD outpatients, characterized by a markedly elevated risk of progression to AD, ACLF and liver-transplantation-free mortality.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13628722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469000","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":"Diagnostic performance of fecal eosinophil-derived neurotoxin and lipocalin-2 in pediatric inflammatory bowel disease.","authors":"Ragaey Ahmad Eid, Nada Atteya Fakhry, Doaa Mabrouk Ahmed, Mahmoud Hodeib","doi":"10.1186/s12876-026-05024-9","DOIUrl":"10.1186/s12876-026-05024-9","url":null,"abstract":"<p><strong>Background: </strong>Non-invasive biomarkers for inflammatory bowel disease (IBD) diagnosis in children are needed to reduce dependence on invasive procedures. This study examined fecal eosinophil-derived neurotoxin (fEDN), lipocalin-2 (LCN-2), and calprotectin (FC) as potential non-invasive supportive markers in pediatric IBD.</p><p><strong>Methods: </strong>This case-control study included 90 participants: 30 IBD patients (12 Crohn's disease, 18 ulcerative colitis), 30 acute diarrhea patients, and 30 healthy controls. Fecal samples were analysed for fEDN, LCN-2, and FC levels (ng/mL) using ELISA. Biomarker levels were correlated with clinical and endoscopic activity scores, and diagnostic performance was assessed using receiver operating characteristic (ROC) analysis with pairwise AUC comparisons by DeLong's test.</p><p><strong>Results: </strong>All three biomarkers were significantly elevated in IBD compared to acute diarrhea and healthy controls (p < 0.001). LCN-2 uniquely correlated with disease duration (r = 0.43, p = 0.017) and CRP (r = 0.46, p = 0.011). All markers significantly correlated with the Crohn's Disease Activity Index, with LCN-2 showing the strongest correlation (r = 0.75, p = 0.005). Only FC significantly correlated with the simple endoscopic score (r = 0.63, p = 0.004). For distinguishing IBD from healthy controls, all three markers showed high diagnostic accuracy: calprotectin (AUC = 0.98), fEDN (AUC = 0.95), and LCN-2 (AUC = 0.9), with no statistically significant difference among them (DeLong's test, all p > 0.05). For discriminating IBD from acute diarrhea, FC demonstrated the highest specificity (90%) and overall accuracy (AUC = 0.86), while fEDN performed poorly (AUC = 0.56). All markers showed limited ability to differentiate between IBD subtypes.</p><p><strong>Conclusions: </strong>In this exploratory study, fEDN, LCN-2, and FC were significantly elevated in pediatric IBD and showed variable but complementary discriminative performance across clinical comparisons, with calprotectin demonstrating the strongest overall accuracy for distinguishing IBD from acute diarrhea. LCN-2 was the only marker that correlated with disease duration, suggesting it may reflect chronic inflammatory processes. These findings support the potential utility of these biomarkers as non-invasive supportive tools in the pre-endoscopic assessment of pediatric IBD; however, formal combined-marker analyses were not performed, and the results require validation in larger prospective multicenter studies before clinical application.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13378010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468842","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":"Endoscopic retrograde appendicitis therapy versus sub-endoscopic retrograde appendicitis therapy for acute appendicitis: a retrospective observational cohort study.","authors":"Shouli Cao, Song Li, Jinming Yan, Dongyun Xue, Fanlu Meng, Junshan Li, Xiaopei Li","doi":"10.1186/s12876-026-05030-x","DOIUrl":"10.1186/s12876-026-05030-x","url":null,"abstract":"<p><strong>Background: </strong>Acute appendicitis is a common acute abdominal emergency. Laparoscopic appendectomy (LA) carries risks such as bleeding, infection, and negative procedures. Endoscopic retrograde appendicitis therapy (ERAT) is minimally invasive but cannot directly visualize the appendiceal cavity. The novel eyeMax disposable biliary imaging system enables direct observation of the appendix cavity during sub-endoscopic retrograde appendicitis therapy (SERAT), overcoming key limitations of ERAT. The aim of this study is to compare the effectiveness and clinical outcomes of ERAT with SERAT in treating acute appendicitis.</p><p><strong>Method: </strong>This retrospective study analyzed 60 patients undergoing ERAT and 97 undergoing SERAT for acute appendicitis at Shandong Provincial Third Hospital, China, from November 2021 to September 2024. Propensity score matching (PSM, 1:1) was performed to balance baseline characteristics, yielding 55 pairs of patients. Baseline data, procedural indicators, short-term recovery, and long-term recurrence were compared.</p><p><strong>Results: </strong>Baseline characteristics were generally comparable between the two groups before and after PSM. After matching, SERAT was associated with significantly shorter operation time and intubation time than ERAT (24.69 vs. 42.65 min, P < 0.001; 96.38 vs. 241.38 s, P < 0.001). The technical success rate was significantly higher in the SERAT group than in the ERAT group (53/55 vs. 47/55, P = 0.047). No significant differences were found in fecalith removal, 6-hour VAS score, hospital stay, or hospitalization cost. Direct visualization in the SERAT group showed inner-wall congestion and edema in 100% of cases, intracavitary fecaliths in 54.4%, and intraluminal pus in 89%. During follow-up, recurrence-free survival was significantly better in the SERAT group ( P = 0.036). Among patients with follow-up data, recurrence occurred in 3/55 (5.4%) patients in the SERAT group and 11/55(20%) patients in the ERAT group. No long-term adverse events were observed in either group.</p><p><strong>Conclusion: </strong>SERAT is an effective and safe approach for the diagnosis and treatment of acute appendicitis, offering shorter operation and intubation times, a lower recurrence rate, and minimally invasive treatment.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469015","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":"Relationship between sacroiliac joint involvement and intestinal disease activity in newly diagnosed Crohn's disease.","authors":"Gökhan Tonkaz, Hasan Hüseyin Can, Esma Çinar, Özgür Önal, Mehmet Tonkaz, Serdar Aslan, Duygu Erkal, Gökhan Aydın, Aykut Güruf, Ahmet Yasin Yitik","doi":"10.1186/s12876-026-05122-8","DOIUrl":"10.1186/s12876-026-05122-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Axial musculoskeletal involvement represents an important component among the extraintestinal manifestations of Crohn's disease (CD). Sacroiliac joint (SIJ) involvement can be detected at an early stage using imaging modalities. The aim of this study was to evaluate the relationship between SIJ involvement and laboratory parameters, intestinal disease activity, and SIJ anatomical variations in patients with newly diagnosed CD.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this single-center retrospective imaging-pathology correlation study, 68 adult patients with a multidisciplinary diagnosis of Crohn's disease established through clinical, endoscopic, radiological, and histopathological evaluation who underwent magnetic resonance enterography (MRE) and pelvic computed tomography (CT) examinations at the time of diagnosis were included. SIJ findings were classified as MRE-detected bone marrow edema-like findings, CT-detected structural SIJ abnormalities, or no involvement. SIJ anatomical forms were evaluated according to the morphological variation classification described by Ziegeler et al. Intestinal disease activity was analyzed using endoscopic (Mayo-based categories), histopathological (Geboes grading system), and clinical phenotype classification (Montreal classification) parameters.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;MRE-detected bone marrow edema-like SIJ findings were detected in 9 patients (13.2%), CT-detected structural SIJ abnormalities in 9 patients (13.2%), and no SIJ involvement in 50 patients (73.5%). Platelet count, ferritin levels, and total iron-binding capacity (TIBC) differed significantly among the groups (p &lt; 0.05). A statistically significant association was observed between endoscopic disease activity categories and SIJ findings (Fisher's exact p &lt; 0.001); however, the distribution pattern did not demonstrate a consistent increase in SIJ abnormalities with increasing endoscopic activity. In histopathological evaluation, a statistically significant association was found between SIJ involvement patterns and histopathological activity (Fisher's exact p &lt; 0.001); however, this association was primarily driven by the complete absence of severe histological activity in the CT-detected structural SIJ abnormalities group. In contrast, no significant relationship was found between disease location or behavior according to the Montreal classification and SIJ involvement patterns (p &gt; 0.05). Similarly, no significant association was identified between SIJ anatomical variations and involvement patterns (p = 0.845).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;In patients with newly diagnosed CD, SIJ involvement appears to be most closely associated with histopathological disease activity. The association with endoscopic categories was statistically significant but showed an inverse, non-monotonic pattern, with SIJ findings clustering predominantly among patients with lower Mayo scores. In contrast, SIJ anatomical variations d","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468642","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":"Prognostic value of lncRNA DARS-AS1 in colorectal cancer and its regulatory effect on tumor progression.","authors":"Qiaoyu Chen, Qijin Xu, Li Zhang","doi":"10.1186/s12876-026-05110-y","DOIUrl":"10.1186/s12876-026-05110-y","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) has high incidence and mortality with limited diagnostic and prognostic methods. This study explored the diagnostic and prognostic significance of the DARS-AS1 in CRC, and its regulatory mechanism via miR-188-5p.</p><p><strong>Methods: </strong>The clinical significance of serum DARS-AS1 was analyzed using receiver operator characteristic (ROC) curves, Cox regression, the Kaplan-Meier method, and chi-square tests. DARS-AS1 silencing effects on CRC cell behavior were analyzed via CCK-8/Transwell assays. This study identified and validated miR-188-5p target genes using online databases and dual-luciferase reporter assays.</p><p><strong>Results: </strong>Serum DARS-AS1 was elevated in CRC patients (P < 0.001), and distinguished them with an area under the curve (AUC) of 0.856. High DARS-AS1 was associated with adverse clinicopathological features (P < 0.05), shorter low disease-free survival (P = 0.008), and worse prognosis [hazard ratio (HR) = 2.400, P = 0.011]. DARS-AS1 was up-regulated in CRC cells (P < 0.001), and silencing it suppressed malignant behavior (P < 0.05). Serum miR-188-5p was down-regulated in CRC patients (P < 0.001), and had a target relationship with DARS-AS1 (r = - 0.733, P < 0.001). miR-188-5p target genes-including PTEN, ESR1, and FBXW7-were enriched in CRC-related pathways; FBXW7 was experimentally validated as a direct target (P < 0.05).</p><p><strong>Conclusions: </strong>This study identifies serum DARS-AS1 as a non-invasive diagnostic and prognostic biomarker for CRC with superior performance to conventional markers, and elucidates the DARS-AS1/miR-188-5p/FBXW7 axis as a novel mechanistic framework for CRC progression, providing both a clinical tool for risk stratification and targets for molecular therapy.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469023","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}