BMC Gastroenterology最新文献

{"title":"Association between the TyG/HDL-C ratio and non-alcoholic fatty liver disease: a single-centre retrospective study.","authors":"Xiao-Shuan Xiong, Fang-Zhou Cheng, Wei-Nan Qi, Jing Cheng, Wen-Long Jiang, Yong Wang","doi":"10.1186/s12876-026-05127-3","DOIUrl":"10.1186/s12876-026-05127-3","url":null,"abstract":"<p><strong>Background: </strong>Triglyceride-glucose index to high density lipoprotein cholesterol ratio (TyG/HDL-C ratio) is a novel surrogate indicator for insulin resistance. However, the predictive value of TyG/HDL-C ratio for the presence of non-alcoholic fatty liver disease (NAFLD) remains unclear. In this study, we aimed to investigate the relationship between TyG/HDL-C ratio and NAFLD in health check-up populations from China.</p><p><strong>Methods: </strong>A total of 1592 participants aged ≥ 40 years were included. Patients were divided into three groups according to the tertiles of TyG/HDL-C ratio, the indicators were compared among the three groups. The univariate linear regression model and the multivariate models were performed to investigate the association between TyG/HDL-C ratio and NAFLD. Smoothed curve fit analysis was used to explore the linear or non-linear relationship between TyG/HDL-C ratio and NAFLD. The modification and interaction of subgroups were inspected by the likelihood ratio test.</p><p><strong>Results: </strong>After adjusting for confounders, there was a non-linear relationship between TyG/HDL-C ratio and NAFLD. The inflection point was 10.0. When TyG/HDL-C ratio < 10.0, the relationship was as (OR = 1.23, 95%CI: 1.13 to 1.33, P < 0.0001) ,while when ≥ 10.0, the association was not statistically significant (OR = 0.89, 95%CI: 0.80 to 1.00, P = 0.0553). Subgroup analysis suggested that no significant interactions were observed. TyG/HDL-C ratio presented moderate discriminative capacity for NAFLD.</p><p><strong>Conclusions: </strong>We discovered that there was a non-linear positive association between TyG/HDL-C ratio and NAFLD. When TyG/HDL-C ratio was less than 10.0, a positive association was found.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148454634","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":"Gut microbiota dysbiosis in the pathogenesis of ulcerative colitis and the therapeutic efficacy of fecal microbiota transplantation: a meta-analysis.","authors":"Chaolun Zhu, Mengyuan Wang, Lingfei Meng, Zixu Zhao, Haitao Han, Yi Chang, Shuangxi Zhang, Yun Yang","doi":"10.1186/s12876-026-05091-y","DOIUrl":"10.1186/s12876-026-05091-y","url":null,"abstract":"<p><strong>Objective: </strong>To explore the correlation between gut microbiota dysbiosis and the pathogenesis of ulcerative colitis (UC), and to provide an evidence-based basis for clinical diagnosis and treatment.</p><p><strong>Methods: </strong>Randomized controlled trials (RCTs) were included through a systematic search of the PubMed, Medline, Web of Science, Cochrane Library, and EMBASE databases. The Cochrane Risk of Bias Tool (RoB 2) was used to evaluate the quality of the literature. RevMan 5.3 software was employed to conduct a Meta-analysis, and the pooled effect size (OR/RR) and 95% confidence interval (CI) were calculated. The primary outcome measures included the associations between gut microbial diversity, changes in the abundance of specific microbial groups and the onset of UC.</p><p><strong>Results: </strong>A total of 6 literatures were included, involving 171 study subjects (100 cases in the fecal microbiota transplantation (FMT) group and 71 cases in the control group), all of which were randomized controlled trials. There was no significant difference in the clinical response between the FMT group (ulcerative colitis patients receiving fecal microbiota transplantation intervention) and the control group (ulcerative colitis patients receiving conventional treatment or placebo) (RD = 0.17, 95% CI [-0.05-0.40], P = 0.14); the clinical remission in the FMT group was significantly better than that in the control group (OR = 2.20, 95% CI [1.05-4.59], P = 0.04); the changes in the microbiota composition in the FMT group were significantly higher than those in the control group (MD = 0.20, 95% CI [0.11-0.28], P < 0.001); there was no significant difference in the occurrence of adverse events between the FMT group and the control group (RD=-0.00, 95% CI [-0.15-0.14], P = 0.98); there was no significant difference in endoscopic remission between the FMT group and the control group (OR = 1.53, 95% CI [0.57-4.11], P = 0.40).</p><p><strong>Conclusion: </strong>This exploratory meta-analysis suggested that gut microbiota dysbiosis may be associated with the onset of UC, manifested as reduced diversity, imbalanced microbiota structure, and changes in the abundance of specific microbial groups. However, given the limited number of included studies, these findings are hypothesis-generating and require validation in larger, well‑powered trials. Further exploration of the potential value of microbiota intervention in the treatment of UC is needed.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148454651","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":"Development and validation of a risk model for non-fatty chronic liver disease in middle-aged and older adults with metabolic syndrome.","authors":"Xiumei Zhou, Xiaoxin Wu, Lingxiao Jin, Xuhong Zhao, Qiaozhen Zhang, Junfeng Yin","doi":"10.1186/s12876-026-05129-1","DOIUrl":"10.1186/s12876-026-05129-1","url":null,"abstract":"<p><strong>Background: </strong>Non-fatty chronic liver disease (CLD) is a major global health burden. Individuals with metabolic syndrome (MetS) have a substantially increased risk of developing non-fatty CLD. This study aimed to develop and validate risk prediction models for non-fatty CLD among middle-aged and older adults with MetS.</p><p><strong>Methods: </strong>Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS). The dataset was randomly divided into a training set (70%) and a testing set (30%). Least absolute shrinkage and selection operator (LASSO) logistic regression with ten-fold cross-validation was applied for predictor selection. Two risk prediction models and nomograms were constructed to predict the 9-year risk of incident non-fatty CLD: a non-laboratory model and a laboratory-based model. Model performance was evaluated using receiver operating characteristic curves and the area under the curve (AUC), calibration curves, decision curve analysis (DCA), and clinical impact curves (CIC).</p><p><strong>Results: </strong>Among 4,748 participants, 253 developed non-fatty CLD during the approximately 9-year follow-up period, yielding a cumulative incidence of 5.33%. LASSO regression identified six non-laboratory predictors (male sex, dyslipidemia, heart disease, kidney disease, digestive system disease, and lack of piped water) in non-laboratory model and two additional laboratory indicators (low platelet count and high triglyceride level) in laboratory model. The non-laboratory model achieved AUCs of 0.762 (95% CI: 0.720-0.803) and 0.744 (95% CI: 0.680-0.808) in the training and testing sets, respectively, while the laboratory model showed improved discrimination with AUCs of 0.792 (95% CI: 0.754-0.830) and 0.769 (95% CI: 0.712-0.825). Calibration curves demonstrated good agreement between predicted and observed risks. DCA and CIC indicated that both models provided meaningful clinical net benefit across a wide range of risk thresholds.</p><p><strong>Conclusion: </strong>Both the non-laboratory and laboratory-based risk prediction models for 9-year risk of non-fatty CLD in individuals with MetS demonstrated good predictive performance. However, given the reliance on self-reported outcome data without objective confirmation, these findings should be considered exploratory and hypothesis-generating. Pending external validation, these models may eventually serve as practical tools for early risk stratification in this high-risk population.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13576323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148454653","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":"Point shear wave elastography for non-invasive detection of advanced fibrosis in metabolic dysfunction-associated steatotic liver disease: a prospective histologically validated study.","authors":"Wolfgang Kratzer, Andreas Binzberger, Stefan G Kauschke, Finn Dolze, Markus Werner, Thomas F E Barth, Heike Neubauer, Eric Simon, Andreas David Brunner, Benedikt Haggenmüller, Mark M Haenle","doi":"10.1186/s12876-026-05123-7","DOIUrl":"10.1186/s12876-026-05123-7","url":null,"abstract":"<p><strong>Background: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease worldwide, and fibrosis stage is the strongest predictor of liver-related outcomes. Point shear wave elastography (pSWE), based on acoustic radiation force impulse technology, is widely available in routine ultrasound systems; however, histologically validated data in well-characterized MASLD cohorts remain limited. This study aimed to evaluate the diagnostic performance of pSWE for the detection of advanced fibrosis (≥ F3) using histology as the reference standard.</p><p><strong>Methods: </strong>In this prospective single-center study, adult patients with MASLD undergoing clinically indicated liver biopsy were included. Liver stiffness was assessed using pSWE on a Siemens ultrasound system. Histological fibrosis staging (F0-F4) was performed by three blinded liver pathologists. Diagnostic performance for advanced fibrosis (≥ F3) was evaluated using receiver operating characteristic (ROC) analysis. Clinically applicable rule-in and rule-out thresholds were determined using predefined sensitivity- and specificity-based criteria.</p><p><strong>Results: </strong>A total of 59 patients with MASLD and numerically evaluable pSWE measurements were included. Advanced fibrosis (≥ F3) was present in 18/59 patients (30.5%). pSWE demonstrated excellent diagnostic performance for the detection of advanced fibrosis, with an AUROC of 0.90 (95% CI 0.82-0.97). A threshold of 1.255 m/s achieved 100% sensitivity and 100% negative predictive value, supporting a rule-out strategy. A threshold of 1.96 m/s achieved 97.6% specificity and 91.7% positive predictive value, supporting a rule-in strategy. Shear wave velocity correlated significantly with histological fibrosis stage (Spearman ρ = 0.68, p < 0.001).</p><p><strong>Conclusion: </strong>Point shear wave elastography provides reliable non-invasive detection of advanced fibrosis in MASLD. Technique-specific thresholds enable clinically meaningful rule-in and rule-out strategies and may support integration of pSWE into stepwise non-invasive fibrosis risk stratification pathways.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13374146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148454644","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":"Risk prediction models for acute kidney injury in patients with acute pancreatitis: a systematic review.","authors":"Lumei Huang, Jinfeng Zang, Juan Li, Yufeng Li, Zhenqing Ren","doi":"10.1186/s12876-026-05121-9","DOIUrl":"10.1186/s12876-026-05121-9","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is a life-threatening complication of acute pancreatitis (AP), significantly increasing mortality and extending hospital stay. Early identification of high-risk patients is crucial for timely intervention yet remains clinically challenging. Although several prediction models have been developed, their methodological quality, predictive performance, and clinical applicability vary greatly and lack comprehensive evaluation. A systematic synthesis of existing evidence is therefore imperative to inform clinical practice and guide future research.</p><p><strong>Methods: </strong>Two reviewers examined Chinese databases (including CNKI, VIP, SinoMed, and Wanfang), along with PubMed, Web of Science, the Cochrane Library, Embase, and Scopus, to identify risk prediction models for AKI in patients with AP published from inception to December 2025. Two reviewers independently reviewed the literature, retrieved relevant information, and evaluated the risk of bias using the PROBAST tool. The main performance measures of the models, including AUC, calibration, validation method, and predictors, were retrieved.</p><p><strong>Results: </strong>Our review assessed 20 studies with 9481 patients. The prevalence of AKI varied between 13.8% and 72.8%. The reported AUCs of the prediction models ranged from 0.735 to 0.920. All 20 studies were assessed as having high overall risk of bias according to the PROBAST tool, primarily owing to retrospective study designs, lack of external validation, and incomplete model development processes.</p><p><strong>Conclusions: </strong>Existing AKI prediction models for AP patients show moderate to good apparent discrimination but are based on studies with uniformly high risk of bias. No model can be recommended for routine clinical use without prospective external validation.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148454629","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":"Post-ERCP adverse events in children: a systematic review and meta-analysis of post-ERCP pancreatitis incidence with synthesis of risk factors and prevention strategies.","authors":"Xin Wang, Ruiying Li, Wenhai Li, Peng Huang, Hu Yang, Hongxi Guo, Hua Liu","doi":"10.1186/s12876-026-05124-6","DOIUrl":"10.1186/s12876-026-05124-6","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic retrograde cholangiopancreatography (ERCP) is increasingly used in children with pancreatobiliary disease, but pediatric adverse-event estimates remain variable. We updated the evidence on post-ERCP adverse events in children, pooled post-ERCP pancreatitis (PEP) incidence when study-level data allowed, and summarized reported risk factors and prevention strategies.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis of English-language literature published from January 2015 to June 2025 in PubMed, Embase, Web of Science, and the Cochrane Library. Eligible quantitative analyses included non-overlapping pediatric primary studies reporting extractable numerators and denominators for post-ERCP adverse events. Prior systematic reviews and meta-analyses were used for background comparison and reference checking only. Random-effects meta-analysis of proportions was planned for outcomes with at least three eligible studies. Risk-factor and prevention data were summarized narratively when definitions or adjustment strategies were too heterogeneous for pooling.</p><p><strong>Results: </strong>Sixty-five sources were included in the qualitative synthesis, and 15 non-overlapping primary studies contributed extractable PEP numerators and denominators for quantitative synthesis. PEP was the most frequent adverse event, with a pooled incidence of approximately 7.3% (95% CI, 5.1% to 10.4%; I-squared = 83.7%). Study-level PEP percentages, denominator units, and available adverse-event definition or reporting notes are now shown in Table 1. Bleeding was uncommon and perforation was rare but clinically important. Recurrent or chronic pancreatitis, pancreatic duct manipulation, pancreatic contrast injection, sphincterotomy, difficult cannulation, younger age, lower procedural volume, and trainee involvement or operator experience were recurring risk domains, although not all studies reported stratified event counts. Pediatric evidence for NSAIDs and prophylactic pancreatic stenting remains limited compared with adult data, and both strategies require child-specific dosing, equipment selection, and contraindication assessment.</p><p><strong>Conclusions: </strong>Pediatric ERCP carries measurable adverse-event risk, particularly PEP. The pooled estimate provides a current benchmark, but heterogeneity and inconsistent reporting limit certainty. Standardized pediatric definitions, non-overlapping reporting, and prospective multicenter datasets are needed.</p><p><strong>Trial registration: </strong>PROSPERO CRD420251084264.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148454692","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 utility of endoscopic ultrasound features in pancreatic tumors: a retrospective observational study focusing on tumor size and imaging characteristics.","authors":"Ming-Sheng Chien, Ting-Chung Wo, Jian-Han Lai","doi":"10.1186/s12876-026-05085-w","DOIUrl":"10.1186/s12876-026-05085-w","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic ultrasound (EUS) is a highly sensitive imaging modality for detecting pancreatic tumors, particularly small lesions. However, its ability to distinguish malignant from benign lesions remains a diagnostic challenge. This study aimed to evaluate the imaging characteristics observed via EUS in differentiating malignancy and to assess the influence of tumor size on diagnostic accuracy.</p><p><strong>Methods: </strong>This retrospective study included 315 patients who underwent EUS evaluation for pancreatic tumors between January 2019 and July 2024. The final diagnosis was established based on surgical pathology, EUS-FNB results, or clinical follow-up ≥ 6 months. Key imaging features assessed included echogenicity, lesion margins, pancreatic duct dilatation, and distal pancreatic atrophy. Tumors were categorized by size (< 2 cm or > 2 cm), and statistical analyses were conducted to identify predictive factors of malignancy.</p><p><strong>Results: </strong>Of the 315 tumors, 205 (65.1%) were malignant. Five EUS imaging features-hypoechoic pattern, heterogeneous echotexture, irregular margins, pancreatic duct dilatation, and distal pancreatic atrophy-were identified as predictive of malignancy. The ROC-derived cutoff of 3.5 corresponds clinically to ≥ 4 features. AUC was 0.807 (95% CI: 0.759-0.849). Using a ≥ 4-feature threshold, sensitivity was 87.8%, specificity 54.5%, PPV 78.6%, and NPV 69.4%. Subgroup multivariable analysis revealed that heterogeneous echotexture and pancreatic duct dilatation were significant predictors of malignancy in tumors < 2 cm. However, in tumors > 2 cm, no individual feature significantly distinguished malignancy.</p><p><strong>Conclusion: </strong>Among pancreatic tumors, those exhibiting four or more of the five EUS features should be prioritized for malignancy evaluation. In small tumors, heterogeneous echotexture and pancreatic duct dilatation offer valuable diagnostic insight. Conversely, larger tumors present greater diagnostic challenges due to overlapping features on B-mode imaging alone.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148454707","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":"Early antibiotic exposure reduces progression-free survival in unresectable hepatocellular carcinoma patients treated with TACE plus TKI and ICI therapy: a propensity score-matched analysis.","authors":"Liying Ren, Mireyi Suwanbai, Lisha Shi, Shuman Yan, Chuanzhi Deng, Weilong Xie, Li Li, Guangde Yang, Xia Wang, Xiucheng Pan","doi":"10.1186/s12876-026-05126-4","DOIUrl":"10.1186/s12876-026-05126-4","url":null,"abstract":"<p><strong>Background/objective: </strong>The combination of immune checkpoint inhibitors (ICIs) with transarterial chemoembolization (TACE) and tyrosine kinase inhibitors (TKIs) has emerged as a promising treatment strategy for unresectable HCC; however, the impact of concurrent antibiotic use on treatment efficacy remains controversial and poorly understood. This study aimed to evaluate the impact of early antibiotic (ATB) exposure on the long-term efficacy of TACE, TKI and ICI therapy in patients with unresectable intermediate-to-advanced HCC.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of patients with hepatitis B virus (HBV)-related advanced HCC who received combination therapy with TACE, TKIs, and ICIs at the Affiliated Hospital of Xuzhou Medical University from January 1, 2019, to December 31, 2024. Patients were classified into the ATB group and non-ATB group based on whether they had received ATB therapy within 30 days prior to or 30 days after ICI initiation. The median follow-up duration was 20 months (interquartile range: 12-28 months). Follow-up assessments were performed every 3 months through outpatient reviews, re-admissions, or telephone contact.</p><p><strong>Results: </strong>After PSM, 20 matched pairs were analyzed. No significant difference in overall survival (OS) between the ATB and non-ATB groups (median OS:18.2vs24.0 months; P = 0.692). However, progression-free survival (PFS) was significantly shorter in the ATB group (median PFS:7.6vs12.3 months; P = 0.006). Multivariable analysis revealed that ATB exposure, Child-Pugh class B, and baseline HBV DNA level ≥ 2000 IU/mL were independent predictors of shorter PFS. Subgroup analyses demonstrated that the negative impact of ATB exposure on PFS was more pronounced among patients aged > 60 years, Child-Pugh class B, BCLC stage C, HBV DNA levels between 20 and 2000 IU/mL, and alpha-fetoprotein (AFP) ≥ 400 ng/mL. Incidence of adverse events (P = 0.266) did not significantly differ between the ATB and non-ATB groups.</p><p><strong>Conclusion: </strong>Early ATB exposure did not affect OS but was independently associated with reduced PFS in unresectable intermediate-to-advanced HCC patients receiving TACE + TKI+ICI. Prophylactic antibiotics should be used cautiously, especially in high-risk subgroups.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148454637","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 and metabolic correlates of gallbladder stones among community-dwelling older adults in Chongqing, China: a repeated cross-sectional study, 2018-2025.","authors":"Yi Zeng, Hui Wu, Jingzhi Zhong","doi":"10.1186/s12876-026-05107-7","DOIUrl":"10.1186/s12876-026-05107-7","url":null,"abstract":"<p><strong>Background: </strong>Gallstone disease is a common biliary disorder and an important source of morbidity in older adults. However, evidence on the burden and metabolic correlates of gallbladder stones among older adults undergoing community-based health examinations in China remains limited. We aimed to estimate the prevalence of gallbladder stones and identify associated metabolic factors in older adults undergoing community health examinations in Chongqing, China.</p><p><strong>Methods: </strong>In this repeated cross-sectional study, we analyzed annual health examination records from community-dwelling adults aged 60 years or older in Chongqing, China, from 2018 to 2025. Data were obtained from the Health Examination Center of the Second People's Hospital of Yubei District, Chongqing. Gallbladder stones were identified using abdominal ultrasonography. Participants with previous cholecystectomy, absent gallbladder, or unavailable gallbladder findings were excluded. Multivariable logistic regression was used to evaluate demographic and metabolic factors associated with gallbladder stones.</p><p><strong>Results: </strong>A total of 72,040 eligible examination records were included in the primary record-level analysis, of which 6,120 had ultrasonographically detected gallbladder stones, yielding an overall record-level prevalence of 8.50%. Gallstone prevalence increased with age, from 7.44% in participants aged 60-69 years to 8.49% in those aged 70-79 years and 10.15% in those aged 80 years or older. Women had a higher prevalence than men (9.21% vs. 7.63%). In multivariable analysis, older age (adjusted odds ratio [OR] 1.020 per year, 95% CI 1.016-1.024), diabetes (1.306, 1.226-1.392), hypertension (1.168, 1.106-1.234), hypertriglyceridaemia (1.126, 1.061-1.195), low HDL cholesterol (1.076, 1.002-1.155), and fatty liver (1.442, 1.363-1.526) were independently associated with higher odds of gallbladder stones, whereas male sex was associated with lower odds than female sex (0.825, 0.781-0.871). Crude annual record-level prevalence fluctuated modestly from 2018 to 2025, without a clear monotonic increase.</p><p><strong>Conclusions: </strong>Gallbladder stones are common among community-dwelling older adults in Chongqing and are closely associated with adverse metabolic profiles, particularly fatty liver and diabetes. These findings suggest that ultrasonographically detected gallbladder stones in later life are associated with a broader hepatometabolic risk profile and may inform future studies of risk stratification and community-based screening strategies.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148435012","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":"Short term detection of de novo gastroesophageal reflux disease after laparoscopic sleeve gastrectomy.","authors":"Mostafa Mamdouh Mohamed Abdel-Salam, Alaa Abbas Sabry Moustafa, Ahmed Helmy Youssef, Moheb Shoraby Eskandaros","doi":"10.1186/s12876-026-05018-7","DOIUrl":"10.1186/s12876-026-05018-7","url":null,"abstract":"<p><strong>Background: </strong>The escalating global prevalence of obesity presents a significant public health concern, driving increased rates of obesity-associated comorbidities. Timely identification and management are essential to reduce long-term health and economic consequences.</p><p><strong>Objective: </strong>This study sought to evaluate the short-term emergence of gastroesophageal reflux disease (GERD) in patients with severe obesity undergoing laparoscopic sleeve gastrectomy (LSG) early in the first 6 months postoperatively.</p><p><strong>Methods: </strong>We conducted a prospective case series involving 60 patients with severe obesity who received LSG at the Bariatric Surgery Unit, Department of Surgery, Ain Shams University Hospitals (June 2018-June 2021). Postoperative follow-up included clinical evaluation and diagnostic testing to detect new-onset GERD.</p><p><strong>Results: </strong>GERD developed in 26.7% of patients (16 of 60) following LSG. Based on these findings, LSG should be avoided in individuals with preoperative evidence of erosive esophagitis, Barrett's esophagus, or an incompetent lower esophageal sphincter (LES), where Roux-en-Y gastric bypass may represent a more suitable alternative. For selected patients with a BMI of 30-35 and associated comorbidities, LSG combined with anti-reflux procedures or concurrent hiatal hernia repair could be considered.</p><p><strong>Conclusion: </strong>The study reinforces the need for thorough preoperative evaluation, including routine upper gastrointestinal endoscopy, to screen for GERD, hiatal hernia, and premalignant conditions. Careful patient selection and individualized surgical planning remain critical to optimizing outcomes after bariatric surgery.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13371026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148444449","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}