Obesity has emerged as one of the most challenging public health issues of the 21st century, with its incidence continuing to rise. Bariatric and metabolic surgery (BMS), with its definitive and sustained weight loss effects as well as remarkable improvement in metabolic comorbidities, has become the most effective therapeutic approach and first-line treatment for moderate to severe obesity. Among these procedures, Roux-en-Y gastric bypass (RYGB) is one of the internationally recognized classic surgical techniques. This article systematically reviews the major advances in BMS over the past five years, covering the substantial expansion of surgical indications (including individuals with low body mass index, adolescents, and elderly patients), the evaluation and optimization of novel procedures (including one-anastomosis gastric bypass, single-anastomosis duodeno-ileal bypass with sleeve gastrectomy, and functional sleeve gastrectomy), as well as innovations in endoscopic bariatric therapies including endoscopic sleeve gastroplasty, transoral outlet reduction, the novel BARS system, duodenal mucosal surface resurfacing, are also discussed. Notably, the combined use of surgery with novel anti-obesity drugs represented by glucagon-like peptide-1 (GLP-1) receptor agonists is reshaping the landscape of obesity treatment. A 2024 network meta-analysis reported that the weight loss efficacy of tirzepatide (a dual glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 receptor agonist) is approaching that of sleeve gastrectomy. Meanwhile, endoscopic sleeve gastroplasty, with its favorable safety profile, fills the gap between pharmacotherapy and surgery, though further validation through multicenter, prospective studies is still needed. In the future, BMS will evolve towards greater precision, minimal invasiveness, and integration, enabling individualized, comprehensive management of obesity through multidisciplinary collaboration.

To determine whether microRNA (miR)-129 regulating colon cancer cell proliferation by targeting the cationic amino acid transporter 1(CAT-1) and thus modulating arginine metabolism.

Expression of CAT-1 and miR-129 was examined in 93 paired colon cancer tissues using real-time fluorogenic quantitative PCR (qPCR) and immunohistochemistry (tissue microarray) from Shanghai East Hospital. Bioinformatics predicted their targeting relationship. In RKO cells, gain-and loss-of-function models for miR-129 were established. Western blotting, enzyme-linked immunosorbent assay (ELISA), and CCK-8 assays were used to assess CAT-1 protein, intracellular arginine, and proliferation.

CAT-1 was upregulated and miR-129 downregulated in tumors. miR-129 was bioinformatically predicted to bind the 3'-UTR of CAT-1. Functionally, cell proliferation was arginine-dependent. Overexpression of miR-129 suppressed CAT-1, decreased intracellular arginine, and inhibited proliferation, while miR-129 knockdown had opposing effects.

miR-129 functions as a tumor suppressor in colon cancer by targeting CAT-1, thereby negatively regulating arginine uptake and cell proliferation. This defines a critical miR-129/CAT-1/arginine metabolic axis.

To analyze the clinical features and prognosis of patients with early-onset gastric cancer (EOGC).

A retrospective study was conducted, including 4 712 patients with gastric cancer who underwent surgical treatment in the First Affiliated Hospital of Anhui Medical University from January 2012 to December 2018. The difference in clinicopathological features between the patients with EOGC and those with non-EOGC was compared by propensity score matching. Follow-up data and survival curves were used to analyze the prognosis of patients, and the prognosis factors between the two groups was analyzed by univariate and multivariate regression analysis, ultimately establishing a nomogram model to predict overall survival in EOGC patients.

There were 298 EOGC patients and 4 414 non-EOGC patients. After propensity score matching analysis, 229 patients in the EOGC group and 458 patients in the non-EOGC group were enrolled. Vascular invasion and differentiation showed significantly differences between the two groups (P<0.05). The median survival time for the EOGC group was 56.06 months (1 682 days), significantly shorter than 69.1 months (2 073 days) for the non-EOGC group. Multivariate analysis results indicated that age, maximum tumor diameter, the number of lymph nodes retrieved, the number of positive lymph node, TNM staging, and history of stroke were the prognsic factors for EOGC patients (all P<0.05). Based on the the above factors, a nomogram model was established to predict the overall survival of EOGC patients. The AUC for the nomogram model predicting 1, 5, and 8-year survival rates were 0.770 (95% CI: 0.724-0.816), 0.791 (95% CI: 0.750-0.831), 0.802 (95% CI: 0.730-0.875), respectively, showing good prognostic accuracy.

EOGC is a rare disease with obviously worse prognosis than that of non-EOGC patients, warranting further clinical attention. The established nomogram model can effectively predict the prognosis of EOGC patients.

To analyze the expression of Netrin-1 (NTN1) in gastric adenocarcinoma and investigate its role in triggering the epithelial-mesenchymal transition (EMT) process.

Bioinformatics analysis was conducted on the GSE49051 dataset to investigate the expression and functional enrichment of NTN1 in gastric adenocarcinoma. Sixty-four samples of gastric adenocarcinoma and adjacent normal tissues were collected, and the expression of NTN1 was detected by real-time fluorogenic quantitative PCR (qPCR) and immunohistochemical staining. The correlation between NTN1 expression and clinicopathological characteristics was analyzed. By knockdown or overexpression of NTN1, MTS assay, colony formation assay, wound healing assay, and Transwell invasion assay, the proliferation, migration, and invasion abilities of gastric adenocarcinoma cells were evaluated. Additionally, the effects of knockdown and overexpression of NTN1 on the expression of EMT-related markers in gastric adenocarcinoma cells were analyzed.

Bioinformatics analysis showed that NTN1 was overexpressed in gastric adenocarcinoma tissues. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses revealed that NTN1 was involved in biological processes such as extracellular matrix construction and cell migration regulation. qPCR and immunohistochemistry results showed that the expression of NTN1 in gastric adenocarcinoma tissues was significantly higher than that in adjacent normal tissues, and was closely correlated with pathological characteristics such as lymph node metastasis and nerve invasion. Functional experiments indicated that knocking down NTN1 significantly inhibited the proliferation, migration, and invasion abilities of gastric adenocarcinoma cells, while overexpressing NTN1 enhanced these abilities. Knockdown of NTN1 inhibited the EMT process in gastric adenocarcinoma cells, specifically manifested as increased expression of E-Cadherin and decreased expression of mesenchymal markers such as Vimentin and N-Cadherin. Conversely, overexpression of NTN1 promoted the EMT process.

NTN1 is overexpressed in gastric adenocarcinoma and intervenes in the malignant progression of gastric adenocarcinoma by the EMT process. NTN1 is expected to become a novel target for molecular typing and targeted therapy of gastric adenocarcinoma, providing substantial theoretical support for the development of new treatment strategies.

To investigate the clinicogenomic characteristics, post-ESR1 alteration treatment patterns and prognostic factors for progression-free survival (PFS) in patients with ESR1-altered advanced breast cancer in a real-world cohort.

From January 2019 to January 2025, the clinicopathological and molecular data were retrospectively collected from patients with ESR1 alterations (including point mutations, amplifications, rearrangements and other ESR1-related abnormalities) in advanced breast cancer. Variables included age, disease-free survival (DFS), recurrence status, metastasis site, prior CDK4/6 inhibitor exposure (duration and lines of therapy), PIK3CA/TP53 co-mutations, tumor mutation burden (TMB) and post-ESR1 alteration treatment groups. Kaplan-Meier analysis was used to estimate PFS. Univariate and multivariable Cox proportional hazards models were used to identify variables associated with PFS exploratively.

A total of 36 patients were included in the analysis. The median real-world progression-free survival (rwPFS) was 9.0 months (95% CI: 4.0-12.0 months). In the univariate Cox regression, prior CDK4/6 inhibitor exposure was associated with shorter PFS (HR=2.47, 95% CI: 1.12-5.44, P=0.025), and bone metastasis showed a borderline association with shorter PFS (HR=1.88, 95% CI: 0.90-3.97, P=0.095). In the exploratory multivariate model, bone metastasis (adjusted HR=2.35, 95% CI: 1.08-5.11, P=0.030) and prior CDK4/6 inhibitor exposure (adjusted HR=3.11, 95% CI: 1.35-7.14, P=0.008) were associated with shorter PFS. No significant difference was observed among treatment groups (log-rank P=0.584).

ESR1-altered advanced breast cancer shows substantial clinical and molecular heterogeneity. This study suggests that bone metastasis and prior CDK4/6 inhibitor exposure may be associated with shorter PFS after detection of ESR1 alterations. The subsequent treatment strategy needs to be comprehensively judged in combination with transfer burden, prior treatment exposure and molecular features.

To explore the effect of optimized common ostium closure technique in Overlap anastomosis for 3D laparoscopic radical resection of right-sided colon cancer, and clarify its impact on surgical efficiency, postoperative complications and patient recovery.

The clinical data of 211 patients who underwent 3D laparoscopic radical resection of right-sided colon cancer (Overlap anastomosis) from July 2019 to December 2024 were retrospectively analyzed. The patients were divided into observation group (100 cases, barbed suture continuous suture + seromuscular reinforcement) and control group (111 cases, linear cutting stapler + seromuscular reinforcement) according to different common ostium closure methods. Intraoperative indicators, postoperative recovery, total costs, quality of life (QoL) score and complications were compared between the two groups.

Intraoperative blood loss, time to first flatus, postoperative hospital stay and total hospitalization costs in the observation group were significantly better than those in the control group (P<0.001). There were no significant differences in operation duration, QoL scores 1-6 months after surgery and complication rates between the two groups.

The optimized technique can reduce blood loss, accelerate recovery, reduce costs, and does not increase the risk of complications, which is worthy of promotion.

To develop and compare multiple risk prediction models for postoperative hypocalcemia in patients with thyroid cancer, identify core predictive factors, and provide a scientific tool for early clinical warning and precision intervention to optimize perioperative management.

A total of 767 patients who underwent surgery for differentiated thyroid cancer were retrospectively enrolled from April 1, 2022 to August 31, 2025 in Huizhou First People’s Hospital, with the occurrence of postoperative hypocalcemia as the primary outcome. Core predictors were selected using least absolute shrinkage and selection operator (LASSO) regression. Based on these predictors, three prediction models-a multivariate nomogram, a decision tree, and an extreme gradient boosting (XGBoost) model-were constructed. The dataset was split into training and testing sets at an 8∶2 ratio using stratified sampling. Model performance was evaluated using accuracy, precision, recall, F1 score, and the area under the receiver operating characteristic curve (AUC). SHapley additive explanations (SHAP) values were employed to interpret feature contributions in the XGBoost model.

Among the 767 patients, 233 (30.4%) developed postoperative hypocalcemia. LASSO regression identified nine core predictors: age, body mass index (BMI), postoperative parathyroid hormone (PTH) level, extent of surgery, recurrence risk, presence of papillary microcarcinoma, number of tumors, history of diabetes mellitus, and thyroiditis. All three models demonstrated good discriminative ability (AUC≥0.828). The XGBoost model achieved the highest AUC (0.851) but the lowest recall (0.435). The decision tree model showed the best recall (0.587) and F1 score (0.651). The nomogram model yielded the highest accuracy (0.816) and precision (0.781), and enabled convenient, visualized individualized risk assessment. SHAP analysis confirmed that postoperative PTH level and extent of surgery were the most influential predictors.

The nine core predictors identified in this study hold significant value for predicting postoperative hypocalcemia in thyroid cancer patients. Among the models evaluated, the nomogram offers the best balance of accuracy, usability, and clinical interpretability, making it the optimal tool for clinical application. It can effectively assist clinicians in identifying high-risk patients and implementing personalized interventions, thereby improving patient outcomes.

As the human body’s “second genome”, intestinal microecology plays a core role in maintaining host metabolic homeostasis, immune function and intestinal barrier integrity. Gastrointestinal surgery profoundly remodels the composition and function of gut microbiota through multiple approaches, including anatomical reconstruction, changes in digestive physiology and perioperative interventions. In recent years, with the rapid advancement of high-throughput sequencing technology, multi-omics analysis and clinical translational research, the effects of different gastrointestinal surgical procedures on intestinal microecology and their correlations with postoperative complications have been gradually clarified. This article systematically reviews domestic and international research progress on the relationship between major gastrointestinal surgical procedures (such as bariatric and metabolic surgery, radical gastrectomy, colorectal resection and ileostomy) and intestinal microecology. The review is conducted from four aspects: alterations in gut microbial composition, remodeling of metabolic functions, microecological mechanisms of surgical complications, and targeted intervention strategies, aiming to provide microecology-based evidence for clinical practice in gastrointestinal surgery.

To explore the current status and progress of immunotherapy for colorectal cancer (CRC), with “Colorectal Cancer”, “Immunotherapy”, and corresponding MeSH terms for various therapeutic modalities as core search keywords to retrieve literature published between 2015 and 2025 from databases including PubMed, with relevant studies on immune checkpoint inhibitors (ICIs), adoptive cell transfer (ACT), and tumor vaccines included for screening. Finally, 51 studies meeting the criteria were selected to comprehensively evaluate the efficacy, safety, and factors influencing the therapeutic effects of the aforementioned immunotherapeutic approaches. The results showed that ICIs exhibited significant efficacy in immunotherapy for patients with microsatellite instability-high/deficient mismatch repair (MSI-H/dMMR) metastatic CRC or those undergoing neoadjuvant therapy for CRC, while their therapeutic effect was limited in patients with microsatellite stability/proficient mismatch repair (MSS/pMMR) CRC, and the combined application of ICIs with chemotherapy, radiotherapy, or targeted therapy is expected to become a breakthrough direction for immunotherapy in MSS/pMMR CRC patients. Tumor vaccines demonstrated a certain ability to stimulate the body’s immune response but had not yet achieved the desired clinical efficacy. ACT showed promising prospects in preliminary studies yet required further optimization in terms of technology and safety. Additionally, various factors such as the tumor microenvironment and gene mutation status had significant impact on the efficacy of immunotherapy, and the rational combination of immunotherapy with other treatment methods may enhance its therapeutic effect. Currently, certain achievements have been made in CRC immunotherapy and therapeutic modalities are continuously developing, but in-depth research on therapeutic mechanisms, screening of populations with potential benefits, and optimization of treatment regimens is still necessary to promote CRC immunotherapy to a new stage and bring greater benefits to patients.