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Objective To analyze the forkhead box L2 neighbor (FOXL2NB) expression in colorectal cancer (CRC) and its potential clinical significance, and to explore the role of FOXL2NB in CRC cells. Methods Real time qPCR and Western blot were used to analyze the expression of FOXL2NB in CRC tissues and cells. Transwell and CCK-8 assay were used to investigate the effect of FOXL2NB on the proliferation and migration in SW620 cell line. Kaplan-Meier and multivariate Cox regression analysis were used to evaluate the prognostic significance of FOXL2NB in CRC patients. CIBERSORT R package was used to calculate the correlation between FOXL2NB expression and immune cell infiltration in CRC tissues. limma R package was used to calculate the genes that significantly correlated with FOXL2NB expression. Results The mRNA and protein levels of FOXL2NB were significantly increased in CRC cell lines and tissues (P＜ 0.05). High level of FOXL2NB was associated with shorter overall survival and progression free survival in CRC patients (P＜ 0.05), which could be used as an independent risk factor for CRC prognosis (HR=2.27, 95% CI=1.78-2.9, P＜ 0.001). FOXL2NB knockdown inhibited the migration and proliferation of CRC cells. Cell adhesion molecules and tumor immune-related pathways were significantly enriched in CRC with high FOXL2NB expression, CD8+ T cells and activated dendritic cells were significantly increased, while M0 macrophages were significantly decreased. FOXL2NB expression was positively correlated with SCRT2, MGAT5B, SELENOV, FOXB1, KCNA4, LRRC14B and SLC32A1 genes. Conclusions FOXL2NB is highly expressed in CRC and potentially predicts poor prognosis. FOXL2NB might promote CRC cell proliferation and migration.

Objective: Tegoprazan represents a newly developed potassium-competitive acid blocker utilized for the treatment of acid-related disorders. The present study aimed to explore the therapeutic effectiveness of tegoprazan in Chinese individuals with duodenal ulcers (DU). Methods: In the current multicenter, randomized, double-blind, double-dummy, parallel-group, non-inferiority, phase III clinical trial, individuals with DU underwent randomization 1:1 to be administered tegoprazan 50 mg or lansoprazole 30 mg once daily. The primary efficacy endpoint was the 6-week cumulative endoscopic ulcer healing rate. Secondary endpoints included 4-week endoscopic ulcer healing rate and relief of DU-related gastrointestinal symptoms at weeks 2, 4, and 6. Safety analysis encompassed adverse events (AEs) and laboratory indexes. Results: The 6-week cumulative endoscopic ulcer healing rates were 96.9% (188/194) and 99.0% (189/191) in the tegoprazan and lansoprazole groups, respectively, indicating a difference of −2.0% (95% confidence interval (CI) = −4.9 to 0.8) in the full analysis set (FAS). The corresponding healing rates were 98.4% (185/188) and 99.5% (183/184) in the per-protocol set, respectively, indicating a difference of −1.1% (95% CI = −3.1 to 1.0). The 4-week healing rates in the tegoprazan and lansoprazole groups were 89.2% (173/194) and 88.5% (169/191) in the FAS, respectively, with a difference of 0.7% (95% CI = −5.6 to 7.0). Treatment-related AEs, all mild-to-moderate, were reported in 38.2% (78/204) and 48.2% (94/195) of participants in the tegoprazan and lansoprazole groups, respectively. Conclusions: Tegoprazan 50 mg once daily is effective and non-inferior to lansoprazole 30 mg once daily in Chinese patients with DU, showing a promising safety and tolerability profile. ClinicalTrials.gov registration number: NCT05010954. [ABSTRACT FROM AUTHOR]

Aim: To examine the bidirectional association between type 2 diabetes (T2D) and irritable bowel syndrome (IBS) in a large prospective population cohort. Methods: Participants free of IBS at baseline in the UK Biobank were included in the analysis of T2D and incident IBS (cohort 1), with 11 140 T2D patients and 413 979 non‐T2D patients. Similarly, those free of T2D at baseline were included in the analysis of IBS and incident T2D (cohort 2), with 21 944 IBS patients and 413 979 non‐IBS patients. Diagnoses of T2D and IBS were based on International Classification of Disease‐10 codes. The Cox proportional hazards model was used to estimate adjusted hazard ratios (HRs). Results: In cohort 1, 8984 IBS cases were identified during a median 14.5‐year follow‐up. Compared with non‐T2D, T2D patients had a 39.0% increased risk of incident IBS (HR = 1.39, 95% confidence interval [CI]: 1.23‐1.56, P <.001), with a higher IBS risk in those with higher fasting blood glucose levels (HR = 1.43, 95% CI: 1.19‐1.72, P <.001) or longer T2D duration (HR = 1.47, 95% CI: 1.23‐1.74, P <.001). In cohort 2, 29 563 incident T2D cases were identified. IBS patients had an 18.0% higher risk of developing T2D versus non‐IBS patients (HR = 1.18, 95% CI: 1.12‐1.24, P <.001). A similar excess T2D risk was observed in IBS patients with a duration of either less than 10 years, or of 10 years or longer. Further sensitivity analysis and subgroup analysis indicated consistent findings. Conclusions: T2D and IBS exhibit a bidirectional association, with an increased risk of co‐morbidity. Awareness of this association may improve the prevention and management of both diseases. [ABSTRACT FROM AUTHOR]

Particle-enhanced turbidimetric immunoassay (PETIA) is a new measurement procedure for detecting fecal calprotectin (FC). We aimed to investigate the accuracy and clinical performance of PETIA for FC. We assessed the accuracy of PETIA for FC measurements through concordance analysis, Passing-Bablok regression and Bland-Altman analysis, using enzyme-linked immunosorbent assay (ELISA) as the reference. To evaluate the clinical performance of PETIA, the FC levels of individuals with significant and non-significant bowel diseases were compared. The receiver operating characteristic (ROC) analysis was performed to determine the appropriate cut-off value of FC detected by PETIA for discriminating subjects with significant and non-significant colorectal lesions. Of the 413 cases analyzed, 340 (82.3%) were concordant between PETIA and ELISA. No significant discordance was observed. There was a good agreement (y = −7.710+0.957x) between PETIA and ELISA for detecting FC. The FC level detected by PETIA in patients with significant bowel diseases (159.1 [31.3, 821.0] µg/g) was significantly higher than that of subjects with non-significant bowel diseases (10.3 [4.2, 38.5] µg/g) (p < 0.001). The AUC of FC for identifying significant bowel diseases detected by PETIA was 0.82 (p < 0.001). With a cut-off value of 77.6µg/g, the specificity and positive predictive value were 92.2% and 97.1%, respectively. The PETIA for FC measurement showed good clinical performance for detecting bowel diseases. [ABSTRACT FROM AUTHOR]

Background: To examine the cardiovascular disease (CVD) risks associated with metabolic dysfunction‐associated steatotic liver disease (MASLD) and different numbers of cardiometabolic risk factors (CMRFs) in patients with inflammatory bowel disease (IBD) based on a long‐term prospective cohort. Methods: Prevalent IBD patients at baseline who were free of CVD, cancer, alcoholic liver disease, cancer and hepatitis B/C virus seropositive were included (N = 4204). MASLD, MASLD subtypes [pure MASLD, MASLD with increased alcohol intake (MetALD)], lean/non‐lean MASLD and CMRFs at baseline were defined according to the latest criteria proposed by AASLD and EASL. The primary outcome was incident CVD, including ischaemic heart disease (IHD), heart failure (HF) and stroke. Multivariable Cox proportional hazard models were used to estimate the relationship. Results: Overall, 1528 (36.4%) were diagnosed with MASLD at baseline. During a median of 13.1‐year follow‐up, 503 incident CVDs were identified. Compared with IBD‐only, IBD‐MASLD patients had an increased risk of CVD (HR = 1.77, 95%CI: 1.26–2.49), especially in those with MetALD (HR = 2.34, 1.34–4.11) and lean MASLD (HR = 2.30, 1.13–4.66). As the number of CMRFs increased, the risks of CVD were significantly increased (ptrend <0.001), with a 116% and 92% excess risk in MASLD with 3 CMRFs (HR = 2.16, 1.48–3.15) and ≥4 CMRFs (HR = 1.92, 1.27–2.91). Similar excess risk of incident IHD and HF was observed in IBD‐MASLD, either pure MASLD or MetALD, as well as lean/non‐lean MASLD. Conclusions: MASLD is associated with increased CVD risk in IBD patients, with greater risk as number of CMRFs increased and evidently higher risk in MetALD and lean MASLD patients. [ABSTRACT FROM AUTHOR]

Background With the increasing prevalence of antibiotic resistance, real-world data on the optimal empirical second-line therapy for Helicobacter pylori are still limited. Objectives To evaluate the real-world efficacy of various second-line therapies for H. pylori. Patients and methods This was a retrospective population-based cohort study of all H. pylori -infected patients who had received the second-line treatment after the failure of primary clarithromycin triple therapy in Hong Kong between 2003 and 2018. The retreatment success rates of different second-line therapies were evaluated. Results A total of 7591 patients who received second-line treatment were included. Notably, the most commonly prescribed regimen was still clarithromycin triple therapy, but the frequency of use had decreased from 59.5% in 2003–06 to 28.7% in 2015–18. Concomitant non-bismuth quadruple therapy had emerged as the commonest regimen (from 3.3% to 43.9%). In a validation analysis, the sensitivity and specificity of retreatment-inferred second-line treatment failure were 88.3% and 97.1%, respectively. The overall success rate of second-line therapies was 73.6%. Bismuth quadruple therapy had the highest success rate of 85.6%, while clarithromycin triple therapy had the lowest success rate of 63.5%. Specifically, bismuth/metronidazole/tetracycline quadruple, metronidazole/tetracycline triple, levofloxacin/metronidazole/tetracycline quadruple, rifabutin/amoxicillin triple and amoxicillin/levofloxacin triple therapies had relatively higher success rates over 80%. Age, treatment duration, baseline conditions and first-line treatment used were associated with success rate. Conclusions Bismuth quadruple therapy was the most effective second-line regimen for H. pylori in this real-world study. Despite a very low success rate, clarithromycin-containing triple therapies were still commonly used as second-line regimens. [ABSTRACT FROM AUTHOR]

Magnetic compression anastomosis (MCA) is a new method that provides sutureless passage construction for tubular organs. Due to the high recurrence rate of conventional endoscopic treatment and the high morbidity and mortality of surgical procedures, the MCA technique shows promise. The aim of this review is to comprehensively examine the literature related to the use of MCA in different gastrointestinal diseases over the past few years, categorizing them according to the anastomotic site and describing in detail the various methods of magnet delivery and the clinical outcomes of MCA. MCA is an innovative technique, and its use represents an advancement in the field of minimally invasive interventions. Comparison studies have shown that the anastomosis formed by MCA is comparable to or better than surgical sutures in terms of general appearance and histology. Although most of the current research has involved animal studies or studies with small populations, the safety and feasibility of MCA have been preliminarily demonstrated. Large prospective studies involving populations are still needed to guarantee the security of MCA. For technologies that have been initially used in clinical settings, effective measures should also be implemented to identify, even prevent, complications. Furthermore, specific commercial magnets must be created and optimized in this emerging area. [ABSTRACT FROM AUTHOR]