Gastric cancer ranks among the most prevalent and lethal malignancies in China， with approximately 30%-40% of patients diagnosed at stage.Although systemic therapy has modestly improved survival in some cases， the overall prognosis remains poor.In recent years， advancements in precision surgical concepts and oncology research have introduced novel individualized treatment strategies centered on immunotherapy， precision molecular subtyping， and multi-omics testing， offering new opportunities for managing stage gastric cancer.However， there is currently no established consensus in China on the standardized implementation of conversion therapy for stage disease.To address this gap， the Chinese Expert Consensus on Precision Surgery for Gastric Cancer Conversion Therapy （2025 Edition） is developed through multidisciplinary collaboration among experts in gastrointestinal surgery， medical oncology，radiology， and pathology.This consensus systematically reviews the latest clinical evidence on conversion therapy， incorporates insights into critical challenges in Chinese clinical practice， and refines key aspects including patient stratification， molecular guided precision therapy， prediction of conversion success， surgical planning， and perioperative management.The document aims to standardize clinical practices for stage gastric cancer conversion therapy and provide clinicians with scientifically robust and practical decisionmaking guidance.

Objective

To investigate the role of pseudouridine synthase 7 （PUS7） and its molecular mechanism in colon cancer clinical specimens and cells.

Methods

Data profiles including colon cancer tissue samples and normal tissue samples were downloaded from the Cancer Genome Atlas database.Subsequently， 200 differentially expressed genes were investigated by protein-protein interaction （PPI）network.RT-PCR and Western blotting were used to detect the gene expression level.CCK-8 assay， colony formation assay， Transwell assay and flow cytometry were used to detect cell activity， proliferation， invasion and apoptosis， respectively.

Results

PUS7 was a key gene in the most important module of the PPI network.The expression of PUS7 was upregulated in colon cancer tissues and cell lines.In 60 colon cancer patients， overexpression of PUS7 was significantly associated with low survival （P＜0.05）.Inhibition of PUS7 significantly reduced cell proliferation and invasive capacity， while overexpression of PUS7 promoted cell proliferation and invasive capacity （P＜0.05）.In PUS7-disrupted or overexpressed colon cancer cells， the protein levels of activated cysteine-containing aspartate protein hydrolase 3/9 （cleaved caspase-3/9）， c-myc，E-cadherin， and Vimentin were significantly regulated （P＜0.01）.Overexpression of PUS7 significantly upregulated the phosphorylation levels of PI3K， AKT and mTOR （P＜0.01）.

Conclusion

Overexpression of PUS7 can upregulate the proliferation and invasion ability of colon cancer cells and inhibit apoptosis by activating the PI3K/AKT/mTOR signaling pathway.

Objective

To explore the causal link among gut microbiome， blood metabolites and gastric cancer by mediated Mendelian randomization （MR） analysis in East Asian population.

Methods

At first， summary statistics of 500 gut microbiomes， 112 blood metabolites， 7 921 gastric cancer patients， and 159 201 controls were obtained from the publicly available genome-wide association studies （GWAS） database for two-sample MR analysis.In addition， a two-step approach was used to quantify the proportion of blood metabolite-mediated effects of gut microbiome on gastric cancer.The inverse variance weighted （IVW）method was the primary effect estimation method， while the MR-Egger， weighted median， simple mode，and weighted mode were used as supplements to the IVW method， and sensitivity analyses were utilized to validate the reliability of the MR results.

Results

14 gut microbes were significantly associated with gastric cancer in East Asians， of which 8 were identified as risk factors.Two-step MR analysis identified three metabolic functional pathways （rhamnose degradation， arginine degradation I， and pentose phosphate pathway of non-oxidative branch） that were causally associated with gastric cancer in East Asians through the mediation of two blood metabolites （hydrocortisone and vitamin K）， with vitamin K showing the highest mediation proportion （13.5% and 16.2%）.

Conclusion

Blood metabolites represented by hydrocortisone and vitamin K， may mediate the pathogenic process of gastric cancer by gut microbiota， providing new ideas for the diagnosis， treatment， and early prevention of gastric cancer.

Objective

To establish a simulated hypoxia model of venous smooth muscle cells（SMCs）， and to investigate the effect of hypoxia on the behaviorial characteristics of SMCs derived from the human normal great saphenous veins （GSVs）.

Methods

Fifteen tissue samples were collected from patients undergoing distal arterial bypass grafting surgery without GSVs injuries in the 80th Group Army Hospital of the People’s Liberation Army from May 2020 to May 2021.SMCs were isolated and cultured， then the cobalt chloride （CoCl₂） group and the control group were assigned.Using specific staining， proliferation，migration， adhesion， senescence and the structure of cytoskeletal filaments in SMCs were observed.mRNA and protein expression of Bax， Bcl-2， caspase-3， matrix metalloproteinases （MMP）-2， MMP-9， tissue inhibitor of metalloproteinases （TIMP）-1， and TIMP-2 were detected by fluorescent quantitative polymerase chain reaction and immunoblotting.

Results

The quantity of adhesion， migration， senescence， proliferation and mRNA and protein expression of Bcl-2， MMP-2， MMP-9， TIMP-1， and TIMP-2 in SMCs in the CoCl₂ group were significantly increased compared with the control group （t=5.994， 5.687， 13.898， 25.979，11.704， 20.705， 16.363， 12.228， 11.473， 9.618， 14.780， 14.691， 64.185， 14.915， all P＜0.05）.mRNA and protein expression of Bax and caspase-3 were significantly decreased （t=27.297， 15.430， 17.851， 17.801， all P＜0.05）.

Conclusion

Under hypoxic conditions， the phenotype and function of SMCs derived from the human NGSVs are dysregulated， suggesting that SMCs switch from the contractile phenotype to the secretory or synthetic phenotype， and more dedifferentiate， and apoptotic decrease through the intrinsic pathway.

Over recent decades， the emergence of immunotherapy has brought new hope to patients with advanced gastric cancer， particularly those with unresectable late-stage disease.Immune checkpoint inhibitors， especially antibodies against programmed cell death protein 1 （PD-1） and its ligand （PDL1）， are playing an increasingly critical role in the treatment of advanced gastric cancer.Based on the epidemiological characteristics of gastric cancer and the fundamental principles of immunotherapy for this disease， this article systematically organizes and summarizes the use of commonly available immune checkpoint inhibitors in clinical trials involving advanced gastric cancer.It also discusses the advantages and limitations of immunotherapy in the treatment of advanced gastric cancer and proposes future directions and research focuses.Building on this foundation， the article further explores the outlook for research in the field of gastric cancer immunotherapy， aiming to offer valuable references for both related research and clinical practice.

Gastric cancer is one kind of malignant tumors with high global incidence and mortality rates.Patients with gastric cancer often experience malnutrition， which adversely affects postoperative recovery， chemotherapy tolerance， and overall prognosis.In recent years， immunonutrition， as a nutritional intervention method aimed at enhancing immune function， has gained widespread attention.Immunonutrition not only improves nutritional status， but also regulates immune function， reduces inflammatory responses，promotes wound healing and intestinal repair， and aids in the treatment of gastric cancer.This paper systematically reviews the application of arginine and glutamine in the treatment of gastric cancer and their impact on patients’ prognosis， trying to provide references for clinical practice and research while exploring future research directions.

Indocyanine green （ICG） fluorescence imaging has been increasingly used in surgical procedures， and in recent years， ICG fluorescence imaging has been gradually applied to gastrointestinal tumor surgery.The main roles include tumor localization， lymph node tracing， anastomotic blood supply assessment， and detection of liver and peritoneal metastases， which further improves the surgical quality of gastrointestinal oncologic surgery and brings benefits to patients.However， the clinical application of ICG fluorescence imaging technology in gastrointestinal surgery has limitations of relatively short-term， lack of standardized specification， and there are still controversies over some of the applications.In this paper，the progress of the application of ICG fluorescence imaging technology in gastrointestinal tumor surgery is reviewed in the light of the relevant literatures at home and abroad.

Anal fistula is a common anorectal disorder with various treatment modalities.Traditional procedures such as fistulotomy may cause anal sphincter injury and subsequent fecal incontinence.In order to balance radical treatment with functional preservation， sphincter-preserving techniques have emerged as research focus in recent years.However， only two approaches - ligation of intersphincteric fistula tract （LIFT）and transanal opening of intersphincteric space （TROPIS） - have satisfactorily demonstrated in complex anal fistulas.This article will comprehensively review the pathophysiological basis of fistula formation， procedural details， research advancements， and comparative advantages/limitations of LIFT and TROPIS techniques，aiming to provide optimized therapeutic options for patients with anal fistulas.

Hepatocellular carcinoma （HCC） is a common malignant tumor in the world， and most patients are at the advanced stage of the disease when diagnosed， especially those with portal vein tumor thrombosis （PVTT）.For the treatment of HCC complicated with portal vein cancer thrombus， the treatment strategy is not uniform.At present， systematic treatment is mainly used at home and abroad， and some patients can be surgically resected after systemetic treatment.This article reviews the progress of systemetic treatment， interventional therapy， radiotherapy， surgical treatment for HCC patients with PVTT.

Long non-coding RNA breast cancer anti-estrogen resistance 4 （lncRNA BCAR4） was found in the anti-estrogen resistance of breast cancer tumor cells for the first time.It has been identified with abnormal expression in various types of cancer， which is closely associated with tumor progression and drug resistance.Although its role in tumor development is widely recognized， the detailed molecular mechanisms remain to be further explored.This review analyzes the expression patterns of BCAR4 in a variety of cancers including breast cancer， liver cancer， colorectal cancer， lung cancer， esophageal cancer， and bladder cancer，and its impact on tumor biology， providing a comprehensive perspective on its role in tumor progression， and offering theoretical basis for future research directions and clinical applications.

Objective

To explore the clinical guidance value of preoperative CT angiography （CTA）combined with three-dimensional reconstruction for colorectal cancer patients.

Methods

A comprehensive search of the literature in PubMed， Embase， Wanfang Database， and China National Knowledge Infrastructure （CNKI） databases up to December 1， 2024 was conducted to identify studies on whether preoperative CTA and three-dimensional vascular reconstruction improving the safety of abdominal surgery in colorectal cancer patients and its clinical application values.Two reviewers independently extracted outcome indicators such as intraoperative blood loss， the number of lymph nodes removed， abdominal drainage volume， time to first flatus， operation time， hospital stay， postoperative intestinal obstruction，anastomotic infection， and anastomotic leakage.Depending on the heterogeneity， a random-effects model or a fixed-effects model was used for analysis.Standardized mean difference （SMD）， odds ratio （OR）， and their 95% confidence interval （CI） were used as summary statistics for Meta-analysis.Subsequently， bias analysis and sensitivity analysis were performed.

Results

A total of 1 845 patients in 22 articles were included in this study.The Meta-analysis results showed that the operation time， hospital stay， intraoperative blood loss，time to first flatus， and postoperative abdominal drainage volume in the observation group were less than those in the control group， with statistically significant differences （P＜0.01）.The number of lymph nodes removed during surgery in the observation group was significantly more than that in the control group， and the incidence of postoperative intestinal obstruction， anastomotic infection， and anastomotic fistula were also significantly lower in the observation group （P＜0.05）.

Conclusion

Preoperative CTA combined with threedimensional reconstruction can clearly delineate the anatomy of the mesenteric vessels and the location of the tumor， which helps in formulating the surgical plan for colorectal cancer and improves the safety of the surgery， thus having clinical guidance value for the conduct of the operation.