BMC Gastroenterology最新文献

Background: Chronic gastritis is a common gastrointestinal disorder and a potential precursor to gastric cancer. Although environmental factors have been associated with its occurrence, the combined relationships of soil characteristics and demographic variables with its spatial distribution remain unclear. This study aims to quantify associations between soil properties and the spatial distribution of chronic gastritis after accounting for population structure and spatial dependence.

Methods: Based on 15,836 chronic gastritis cases from 2021 to 2023 in Yanshan County, we explored the disease's spatial characteristics and its links to soil and demographic factors. GeoDetector was used to quantify factor explanatory power and interactions, supported by sensitivity analyses of spatial scales and data sources. Additionally, Generalized Additive Models (GAMs) were constructed to identify nonlinear relationships. By combining point-level risk estimation with grid-based aggregation (square and hexagonal), the study effectively addressed the Modifiable Areal Unit Problem (MAUP) while controlling for potential environmental and socioeconomic confounders.

Results: The spatial distribution of chronic gastritis exhibited significant geographic clustering, primarily centered in urbanized areas, with notable age-related heterogeneity. Individuals aged 65 and above showed the highest relative risk, with high-risk clusters concentrated along the county's eastern boundary. GeoDetector and GAM analyses revealed that soil organic carbon, pH, soil type, and texture were key drivers of spatial variation. Notably, interaction effects-particularly between soil type and texture or age-enhanced the explanatory power for disease risk. GAM further identified nonlinear associations between soil properties and disease occurrence, suggesting complex ecological pathways.

Conclusions: This study demonstrates that chronic gastritis risk in Yanshan County is shaped by complex interdependencies between demographic characteristics (primarily age) and soil environmental factors. The findings highlight the significant role of soil physicochemical properties and their interactive effects in disease spatial epidemiology. These results provide a scientific basis for identifying geographic hotspots and high-risk populations, emphasizing the necessity of integrating environmental management into targeted public health strategies and resource allocation for gastric disease prevention.

Introduction: The early diagnosis of infections in acute-on-chronic liver failure (ACLF) is still difficult. mNGS(metagenomic next-generation sequencing) is a no-bias, sensitive pathogen diagnosis method, and further research on mNGS in ACLF is needed.

Methods: A total of 275 ACLF patients with suspected or confirmed infections were recruited and divided into the mNGS group and the non-mNGS group. Differences between the two groups were assessed.

Results: The 1:1 Propensity score matching (PSM) for balancing the baseline variables produced 86 patients in each group. From these 86 patients in the mNGS group, 134 samples were collected and analyzed. The overall microbiological positive rate (103/134, 76.9%) detected by mNGS was higher than that detected by culture (24/134, 17.9%), particularly for fungi (14.9% vs. 2.2%). The etiological diagnosis rates for pulmonary and thoracoabdominal infections detected by the mNGS method were higher than those of the culture method (47.9% vs. 11.4%; 52.0% vs. 18.4%, respectively). The etiological diagnosis can be confirmed 22.83 ± 26.27 h ahead of time. mNGS testing did not significantly improve 90-day transplant-free survival in the overall cohort (sHR 0.96, 95% CI 0.72-1.27; P = 0.76). In the subgroup where mNGS guided therapy, numerically higher resolution rates were observed for pulmonary (53.8% vs 37.1%), abdominal (63.2% vs 52.6%), and bloodstream infections (66.7% vs 50.0%), though these differences were not statistically significant.

Conclusions: mNGS is a valuable diagnostic tool for ACLF with infections, especially for viruses and fungi. mNGS allows for precise and earlier pathogen diagnosis, enabling timely and targeted anti-infective therapy. mNGS may be associated with improved clinical outcomes in ACLF patients with co-infections, though this potential association requires further validation.

Trial registration: The study was registered on Clinicaltrials.gov (registration number: NCT05740696, release date: February22,2023). Accessible at: https://classic.

Clinicaltrials: gov/ct2/show/NCT05740696.

Background: Tumor growth rate (TGR) is a dynamic biomarker for evaluating therapeutic response and prognosis in unresectable hepatocellular carcinoma (uHCC) with triple therapy, yet its clinical utility and role in guiding treatment optimization require further validation.

Methods: This study included 68 uHCC patients receiving transarterial chemoembolization (TACE) with systemic combination therapy. Propensity score matching (PSM) was applied to balance baseline confounders. Cubic spline models explored nonlinear associations between TGR and survival risk and found the ideal cut-off points. Kaplan-Meier (KM) analysis compared overall survival (OS) and progression-free survival (PFS) between TGR subgroups, Cox multivariate regression evaluated the independent prognostic value of TGR.

Results: Cox analysis confirmed TGR0 as an independent prognostic factor for OS (hazard ratio (HR) 1.035, 95% confidence interval (CI): 1.013-1.057, p = 0.020) and PFS (HR 1.033, 95%CI: 1.014-1.053, p = 0.001). After stratified for TGR0/TGR1 and matched, the low-TGR0 group showed significantly longer median OS (not reached vs. 13.09 months, p = 0.002) and PFS (12.11 vs. 4.38 months, p = 0.006) than the high-TGR0 group. In the subgroup analysis, after propensity score matching(PSM), the low-TGR1 group demonstrated a more favorable prognosis compared with high-TGR1(mOS: not reached vs. 16.97 months, p = 0.024; mOS1: not reached vs. 11.78 months, p = 0.022).

Conclusions: Dynamic TGR monitoring identifies heterogeneous therapeutic responses, guiding timely personalized treatment adjustments and prognostic stratification in uHCC.

Background: Crohn's disease (CD) and ulcerative colitis (UC), the two major forms of inflammatory bowel disease (IBD), are associated with emotional disturbances, but their shared and distinct neurobiological substrates remain unclear. This neuroimaging study aimed to characterize shared and distinct patterns of spontaneous neural activity in CD and UC patients using resting-state functional MRI (rs-fMRI).

Methods: Using cortical surface-based analysis of rs-fMRI data, we compared intrinsic neural activity, measured by amplitude of low-frequency fluctuations (ALFF) and regional homogeneity (ReHo), in 248 patients with IBD (180 CD, 68 UC) and 190 healthy controls (HC), controlling for gray matter volume. Demographic, clinical, and neuropsychological data were collected. Group comparisons and correlation analyses were performed.

Results: Compared to HC, both CD and UC patients exhibited reduced ALFF and ReHo in bilateral somatosensory and motor cortices. Disease-specific patterns emerged: CD showed lower ReHo in lateral temporal cortices, while UC demonstrated higher ReHo in medial temporal and superior parietal regions. Correlation analyses revealed that in CD, motor cortex activity was linked to systemic symptoms and emotional function, whereas in UC, it correlated primarily with somatization.

Conclusion: This study identifies a common neural signature of sensory-motor dysfunction in IBD, alongside subtype-specific cortical patterns. By directly comparing CD and UC with a multimodal, surface-based approach and controlling for structural differences, our findings provide novel evidence for distinct brain-gut pathophysiology, highlighting neuroimaging as a potential tool for mechanistic insight and patient stratification.