Journal of Gastroenterology and Hepatology最新文献

Esophageal cancer remains a global health burden with poor survival, largely due to late diagnosis. The two main subtypes—esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC)—differ in their epidemiology, risk factors, and geographic distribution, highlighting the importance of region-specific screening. In areas with a high incidence of ESCC, population-based endoscopic screening has improved early detection and outcomes. In contrast, in Western countries where EAC predominates, targeted screening for Barrett's esophagus (BE) offers the most practical approach. Advances in high-definition endoscopy, virtual chromoendoscopy, and minimally invasive resection have enhanced diagnostic precision and treatment efficacy. At the same time, novel nonendoscopic methods such as swallowable devices, biomarker assays, and artificial intelligence–assisted imaging are reshaping screening paradigms. This review outlines current and emerging strategies for early detection of ESCC and EAC, emphasizing technological innovation and its potential to improve global outcomes.

Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related mortality worldwide. Malnutrition is highly prevalent among people living with HCC and has a substantial impact on morbidity and mortality. Nutrition influences the development of HCC and is also a consequence of chronic liver disease and liver cancer. Routine screening and nutritional assessment using validated tools, along with evaluation of muscle mass and functional status, are essential in the optimal care of patients with HCC. Nutritional interventions may change throughout the disease trajectory depending on the stage of HCC, the severity of liver cirrhosis, and the overall treatment options and intent. Evidence supports the use of oral nutritional supplements, branched-chain amino acids, exercise interventions, and the preferential use of enteral over parenteral nutrition. Optimizing nutrition is integral to HCC management across all disease stages and is best accomplished with a multidisciplinary team to individualize the nutritional care across the disease continuum. In this review, we summarize current evidence on the impact and role of nutritional therapy in HCC and provide actionable recommendations for clinical practice. We highlight the current challenges and provide future directions for future HCC nutritional care pathways.

Background and aim: Tegoprazan has shown great potential in the eradication of Helicobacter pylori infection. This study aims to evaluate the efficacy and safety of Tegoprazan-based dual therapy for H. pylori eradication.

Methods: This was a noninferiority, multicenter, randomized controlled trial in China. Subjects were randomly assigned to three groups: the 14-THA group, the 10-THA group (Tegoprazan 50 mg twice/day, Amoxicillin 1 g 3 times/day, for 14 and 10 days), and the B-quadruple group (esomeprazole 20 mg, bismuth 220 mg, Amoxicillin 1 g, twice/day, tetracycline 0.5 g 3 times/day, for 14 days). The three groups' eradication rates, adverse events, and compliance were compared.

Results: A total of 228 individuals were included in the randomization. According to the per-protocol analysis (PP), modified intention-to-treat (MITT) analysis, and intention-to-treat (ITT) analysis, there was no statistically significant difference between the 14-THA group and B-quadruple group (PP: 90.3% vs. 91.8%, MITT: 84.8% vs. 90.5%, ITT: 73.7% vs. 75.0%, p > 0.05). However, the 10-THA group has a lower eradication rate than the B-quadruple group (PP: 67.2% vs. 91.8%, MITT: 64.1% vs. 90.5%, ITT: 53.9% vs. 75.0%, p < 0.05). Additionally, the efficacy of the 14-THA group was not inferior to that of the B-quadruple group in PP (p = 0.0488). Adverse events and compliance rates did not differ among the three groups (p > 0.05).

Conclusion: The eradication rate of the 14-THA group is > 90%, which is not inferior to the current bismuth-containing quadruple regimen, with a favorable safety profile. However, the efficacy of the 10-THA dual therapy is unacceptable.

Nonalcoholic fatty liver disease (NAFLD) is commonly associated with overweight and obesity. But an increasing number of cases involve lean individuals, who tend to experience worse liver outcomes. In this study, we established mouse models of both obese and lean NAFLD by feeding mice a Western diet (WD) ad libitum and a WD with 30% caloric restriction (CR), respectively, to investigate the effects of piperine. After 12 weeks, hepatocyte lipid deposition and liver injury were similar in lean and obese NAFLD mice. Piperine treatment significantly reduced serum ALT levels and hepatic triglyceride (TG) content, alleviating hepatic steatosis in both groups. The mechanism of action involved the downregulation of fatty acid uptake, as evidenced by reduced expression of PPARγ and CD36, as well as the promotion of lipolysis through upregulation of hormone-sensitive lipase (HSL) and adipose triglyceride lipase (ATGL). Additionally, piperine enhanced hepatic mitochondrial β-oxidation in the obese NAFLD model by upregulating carnitine palmitoyltransferase 1A (CPT1A). In conclusion, feeding a WD with 30% CR successfully induced lean NAFLD in mice, and piperine effectively alleviated NAFLD in both lean and obese mice.

This patient guidance document is intended for all people at risk of or living with chronic hepatitis B (CHB) infection. Globally, CHB is one of the leading causes of cirrhosis and hepatocellular carcinoma, the most common form of liver cancer. However, less than one in five infected individuals is aware of their condition and only a small fraction of these individuals receive proper assessment and management. Safe and effective treatment is available in many countries and regions and is recommended for infected individuals who have evidence of liver damage or are at risk of complications. Several essential measures are advised for all people living with CHB, including lifestyle habits, screening for coinfection, managing comorbidities, fibrosis assessment, preventing HBV transmission, and surveillance for liver cancer. There are also recent shifts in the treatment paradigm and novel drug development. In those living with CHB, a better understanding of the disease can empower them to play an active role in management in partnership with their physicians. This guidance document has been developed in collaboration with clinicians, scientists, patients, and patient representatives to summarize updated salient knowledge to inform people at risk of or living with CHB.