Dyslipidemia is common in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) and, along with other metabolic comorbidities, accounts for an increased cardiovascular risk. Effective treatment of dyslipidemia not only reduces such risk but may have a beneficial effect on MASLD as well. Here we reviewed published data on the efficacy and safety of available hypolipidemic treatments for MASLD. Statins are the mainstay of hypolipidemic therapy for MASLD. In patients with compensated cirrhosis, statins are safe and can improve the risks of decompensation and hepatocellular carcinoma as well as mortality. However, in those with decompensated cirrhosis, statins should not be used unless there are strong indications that outweigh the risk of adverse events. Studies on proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors acting as the second-line therapy in MASLD remain scarce. Preliminary clinical data support their protective roles in MASLD; however, preclinical data raise concerns regarding safety, in particular with complete PCSK9 inhibition due to hepatocyte lipid accumulation. While more evidence is required to elucidate the role of PCSK9 inhibitors, statins should be used for the treatment of hyperlipidemia in patients with MASLD according to their cardiovascular risk stratification.

Ulcerative colitis (UC) is a multifactorial inflammatory bowel disease influenced by genetic susceptibility, environmental triggers, impaired intestinal epithelial barrier function, dysbiosis of gut microbiota, and immune dysregulation. Ubiquitination, a crucial post-translational modification, plays a significant role in the initiation and progression of UC. Gaining a deeper understanding of the molecular mechanisms underlying ubiquitination may help establish novel therapeutic strategies for UC. This review emphasizes the role of ubiquitination in regulating the intestinal epithelial barrier, nuclear factor (NF)-κB signaling, and immune responses, with the aim of providing new perspectives and potential directions for targeted therapies in UC.

The global prevalence of inflammatory bowel disease (IBD) has been increasing in recent years, paralleling a growing recognition of gut dysbiosis as a pivotal etiological factor. Emerging evidence reveals intricate crosstalk between the oral and gut microbial ecosystems, with oral-derived microbiota potentially translocating to the intestinal tract through hematogenous or enteral routes. This microbial crosstalk has crystallized into an “oral–gut axis” pattern, providing novel mechanistic insights into the pathogenesis of IBD. In this review, we summarize currently available studies on the oral–gut axis and the relationship between the oral–gut axis and IBD to evaluate the role of the axis in the pathogenesis of IBD development.

Objective: We conducted this systematic review and meta-analysis to summarize the prevalence of celiac disease (CeD) among high-risk populations in China.

Methods: A systematic search was conducted in PubMed, EMBASE, Cochrane Library, Web of Science, and four Chinese databases to identify studies published up to December 10, 2024 on the prevalence of CeD in different regions of China. The high-risk populations included patients with irritable bowel syndrome, gastrointestinal symptoms, autoimmune disease, low body mass index, short stature, etc. Data were extracted from the included studies by two reviewers independently using a standardized data extraction form. Regional prevalence estimates were weighted using China Population Census Yearbook 2020 data. The pooled prevalence of CeD was summarized using random-effects models.

Results: Twenty-eight studies involving 9531 individuals were included. Biopsy-confirmed prevalence and seroprevalence varied widely by region. Central China had the highest biopsy-confirmed prevalence of CeD in high-risk populations (4.55%, 95% confidence interval [CI] 0.66%–8.44%), followed by North China (3.60%, 95% CI 1.75%–6.08%) and East China (2.50%, 95% CI 1.39%–3.94%). Northeast China led in seroprevalence (7.10%, 95% CI 1.14%–13.05%), followed by Central China (4.42%, 95% CI 1.04%–9.98%), East China (4.37%, 95% CI 2.12%–7.38%), and North China (4.35%, 95% CI 2.39%–6.86%). The biopsy-confirmed prevalence and seroprevalence of CeD among high-risk populations in China were 3.69% and 4.43%, respectively.

Conclusion: CeD prevalence appears to be significant among high-risk populations and varies by geographical regions in China.

Objectives: Upadacitinib (UPA) and vedolizumab (VDZ) have been approved to treat moderate-to-severe ulcerative colitis (UC); however, direct comparative data between these two regimens are lacking. We aimed to compare the effectiveness and safety of UPA and VDZ among patients with moderate-to-severe UC who had previously been treated with advanced therapies.

Methods: Patients with moderate-to-severe UC receiving VDZ or UPA for at least 14 weeks following advanced therapy failure, including at least one anti-tumor necrosis factor (TNF) agent, between 2015 and 2024, were retrospectively recruited. Clinical response and remission were defined by the Partial Mayo Score and the Simple Clinical Colitis Activity Index. The safety profile during the treatment was also compared.

Results: Altogether 66 patients treated with VDZ and 22 patients with UPA were included. The median age of the VDZ and UPA groups was 38 and 37 years, respectively. Patients receiving UPA achieved significantly higher rates of corticosteroid-free remission after 52-week therapy (75.0% vs. 25.0%; adjusted odds ratio [aOR] 5.68, 95% confidence interval [CI] 1.50–21.00, p = 0.011); however, these patients were more likely to experience adverse events (AEs) (40.9% vs. 9.1%; aOR 4.60, 95% CI 1.20–17.00, p = 0.02), although medication discontinuation due to AEs was only noted in two (3.0%) patients receiving VDZ. No patients were hospitalized during the treatment period.

Conclusion: UC patients receiving UPA achieved significantly higher rates of corticosteroid-free clinical remission but with more AEs, suggesting that decision-making based on disease severity and comorbidities can help guide the positioning of these therapies in UC.

Objectives: Digestive system cancer (DSC) continues to pose a significant global health challenge, and cost-effective biomarkers for its early detection remain scarce. We aimed to evaluate the potential of two biological aging indicators, namely the Klemera–Doubal method age (KDMAge) and the phenotypic age (PhenoAge), for predicting DSC risk.

Methods: Using the National Health and Nutrition Examination Survey (NHANES) dataset (1999–2018), biological age acceleration for KDMAge and PhenoAge was calculated as residuals from linear regression models of each biological age on chronological age. Accelerated aging was defined as positive residuals. Their associations with DSC risk were evaluated using weighted logistic regression and restricted cubic spline (RCS) analysis. Predictive performance was assessed via area under the receiver operating characteristic curve (AUROC), and robustness was examined using propensity score matching (PSM) analysis.

Results: A significant positive linear association was observed between KDMAge acceleration and DSC risk (odds ratio 1.59, 95% confidence interval 1.05–2.39, p = 0.027). While PhenoAge acceleration showed a U-shaped nonlinear relationship (p = 0.0197), with minimal risk at −2.95. Both indices showed moderate predictive accuracy (AUROC: KDMAge 0.683 and PhenoAge 0.682). PSM analysis confirmed the robustness of the nonlinear relationship between PhenoAge acceleration and DSC, although the linear trend of KDMAge was attenuated after matching.

Conclusion: There was a significant association between accelerated biological aging, as assessed by KDMAge acceleration and PhenoAge acceleration, and DSC risk. Given the cross-sectional study design, causal inference is precluded; however, both indices may be used to develop novel risk assessment tools and guide future research on interventional strategies.

Objectives: Factors such as Helicobacter pylori eradication and the implementation of widespread early cancer screening have significantly influenced clinicopathological features and patient outcomes in gastric cancer (GC) in China. We aimed to evaluate the characteristics of GC and their evolving trends over 16 years (2007–2022) at a single center in China.

Methods: Altogether 14 943 patients diagnosed with primary gastric adenocarcinoma who underwent endoscopic or surgical resection from 2007 to 2022 were included. Clinicopathological data of these patients were collected, and the patients were divided into three groups according to the time period when GC was diagnosed, with broken line charts illustrating trends.

Results: There was a significant increase in the detection rates of early gastric cancer (EGC) and stage I GC over time, as well as a considerable increase in T1 GC. Although there was a male predominance in GC (69.85%), the proportion of female patients also increased over time. The age of patients with GC also significantly increased. There was a marked increase in differentiated EGC, while there was also an increase in poorly differentiated advanced GC. Gastric body cancer showed a gradual increase over the years. The size of both EGC and advanced GC decreased gradually. Furthermore, the rates of lymph node metastasis and vascular involvement significantly reduced.

Conclusions: The clinicopathological characteristics of GC in China have undergone significant changes over the past 16 years. This suggests the potential progress made through EGC screening initiatives in China.