To investigate the clinical feasibility and postoperative outcomes of the laparoscopic modified Devine procedure for patients with advanced gastric cancer complicated by pyloric obstruction.

A retrospective analysis was performed on the clinical data of 35 patients with advanced gastric cancer complicated with pyloric obstruction admitted to the Gastrointestinal Center of Northern Jiangsu People’s Hospital Affiliated to Yangzhou University from March 2017 to March 2022. Among them, 15 patients underwent laparoscopic modified Devine procedure (LGP group) and 20 underwent traditional gastrojejunostomy (CGJ group). Postoperative follow-up continued until March 2025. The postoperative complications, nutritional status, and satisfaction rate between the two groups were analyzed. Univariate analysis and Cox proportional hazards regression models were performed to identify independent factors affecting patient survival. Survival data were analyzed using Kaplan-Meier curves and the Log-rank test.

A 1-month postoperative complication analysis showed that the incidences of gastric emptying disorder, tumor bleeding, and anastomotic recurrence were lower in the LGP group compared to those in the CGJ group (1/15 vs 5/20, 0/15 vs 1/20, 0/15 vs 1/20), although the differences were not statistically significant. 3 months postoperatively, the decrease values of hemoglobin, total protein, and body weight in the LGP group were all lower than those in the CGJ group, but the differences were not statistically significant. The patient satisfaction was significantly higher in the LGP group compared to the CGJ group (93.33% vs 50.00%, P=0.005). Survival analysis showed that the median survival time for the LGP group was 11 months, which was significantly longer than 6 months for the CGJ group (Log-rank χ²=9.823, P=0.002). Multivariate Cox regression analysis identified surgical method (HR=0.226, 95% CI: 0.087-0.590, P=0.002) and distant metastasis (HR=6.907, 95% CI: 2.640-18.069, P<0.001) as independent factors affecting survival time.

Laparoscopic modified Devine procedure is safe and feasible for patients with advanced gastric cancer complicated by pyloric obstruction, which effectively alleviates symptoms, improves postoperative nutritional status and quality of life, prolongs survival time, and achieves high levels of patient satisfaction, making it worthy of clinical promotion.

To explore the research progress, clinical application status, and future development trends of biomarkers in advanced gastric cancer.

The literature on biomarkers in advanced gastric cancer published from January 2000 to February 2025 was retrieved from the Web of Science Core Collection. CiteSpace 6.3.R1 software was used to conduct bibliometric visualization analysis of the literature in this field, focusing on the countries, institutions, authors, and keywords.

A total of 4 042 English-language articles related to biomarkers in advanced gastric cancer published from 2000 to 2025 were included in this study, with a steady increase in the number of publications since 2000. In terms of country distribution, China (1 849 articles), the United States (566 articles), and Japan (551 articles) were the top three highest countries with the number of publication output. Regarding institutional contributions, Nanjing Medical University (121 articles), Shanghai Jiao Tong University (119 articles), and Fudan University (108 articles) ranked among the top three. In terms of author impact, Lee J (38 papers), Kodera Y (28 papers), and Shen L (27 papers) were the core researchers, leading the most productive research groups in the field. Keyword analysis revealed that “gastric cancer” (2 331 occurrences), “expression” (927 occurrences), and “carcinoma” (440 occurrences) were the most frequently cited keywords. Through keyword burst detection, it was found that research hotspots in this field had gradually shifted from early “gene expression” to emerging directions such as “immune suppression” “tumor microenvironment”, and “gastroesophageal junction cancer”, reflecting the evolving research focus.

Researches on biomarkers of advanced gastric cancer focus on the three major hotspots: prognosis, immunotherapy, and targeted therapy, with China taking the lead. The in-depth integration of multidisciplinary research provides new strategies for the precise diagnosis and treatment of gastric cancer, which is an important trend for the future.

To investigate the effect of a new combined inflammatory-nutritional serum marker, (platelet×albumin) to lymphocyte ratio (PALR), on lymph node metastasis in colorectal cancer (CRC), and to establish a clinically applicable risk prediction model for column line drawing.

The clinical data of 235 CRC radical surgery patients in Zhongshan City People’s Hospital from July 2022 to July 2023 were collected, and the study subjects were randomly divided into the training set and the validation set according to the ratio of 7∶3. A single-factor analysis was used to initially screen the factors associated with CRC lymph node metastasis, and then a column-line graph prediction model was developed based on the independent risk factors identified by multifactor logistic regression analysis, and a validation set was used to internally validate the model, and receiver operating characteristic (ROC) curves, calibration plots, and decision analytic curves.

Patients in the training set were divided into metastasis positive group (116 cases) and metastasis negative group (48 cases) based on their lymph node metastasis status. The results of regression analysis showed that PALR, systemic immune-inflammation index (SII), carcinoembryonic antigen (CEA) level, degree of tumor differentiation, preoperative intestinal obstruction, and enhanced CT report of lymph node metastasis were all significantly correlated with the occurrence of lymph node metastasis in CRC patients (P<0.05). The areas under the curve of the training and validation sets of the model were 0.868 (95% CI: 0.813-0.922) and 0.854 (95% CI: 0.763-0.946), respectively, and the validation results of the model in the validation set showed that the calibration curves were in good agreement with the actual observed values, and meanwhile, the assessment based on the decision curves confirmed that the predictive tool had a higher practical value.

The nomogram prediction model based on PALR provides a key tool for CRC patients to assess the risk of lymph node metastasis before surgery, which is helpful to provide useful reference and support for personalized and precise treatment plans for patients.

To explore the effects of ultrasound-guided stellate ganglion block (SGB) combined with dexmedetomidine on postoperative inflammatory factor levels and fast-track recovery in elderly patients undergoing laparoscopic cholecystectomy (LC).

From January 2024 to April 2025, 80 elderly patients undergoing LC in the Affiliated Chuzhou Hospital of Anhui Medical University (the First People’s Hospital of Chuzhou) were selected and randomly allocated to a trial group and a control group, each comprising 40 cases. The trial group received right-sided SGB under ultrasound guidance with 6 ml of 0.3% ropivacaine injection, and a loading dose of dexmedetomidine at 0.5 μg/kg was administered 10 minutes before surgery. The infusion was completed within 10 minutes and then continued at a constant rate of 0.5 µg·kg^-1·h^-1 until 15 minutes before the end of surgery. The control group received the same volume of normal saline at the same site, and the use of dexmedetomidine was the same as in the trial group. The levels of inflammatory factors (IL-6, TNF-α, IL-10) were compared between the day before surgery, the 1st postoperative day, as well as the Pittsburgh sleep quality index (PSQI) on the day before surgery, postoperative day 1 and 2, the visual analog scale (VAS) scores for pain at 6, 12, and 24 h postoperatively, and the incidence of postoperative adverse reactions.

One day after surgery, the control group showed increased IL-6 and TNF-α and decreased IL-10 (all P<0.05). In the trial group, only IL-6 increased (P<0.05), remaining lower than in controls, while TNF-α was also lower and IL-10 higher (all P<0.05). PSQI rose in the control group on postoperative day 1 and 2, whereas the trial group increased only on the 1st day and stayed below controls (all P<0.05). VAS scores were consistently lower in the trial group at 6, 12, and 24 h postoperatively (all P<0.05), and the incidence of postoperative nausea and vomiting (PONV) was lower than in the control group (P<0.05).

Ultrasound-guided SCB combined with dexmedetomidine can effectively inhibit the excessive release of inflammatory factors in elderly patients following LC, reduce postoperative pain, improve sleep quality, decrease the incidence of PONV, and promote fast-track recovery with good safety. It has important clinical application values and a broad application prospect.

Gastrointestinal stromal tumor (GIST), the most common mesenchymal neoplasm of the digestive tract, relies heavily on imaging for clinical diagnosis and management. Spectral CT transcends the limitations of conventional CT through multi-energy imaging technologies, with core techniques—including virtual non-contrast (VNC) imaging, monoenergetic imaging, material decomposition, effective atomic number analysis, and spectral curve analysis—enable quantitative assessment of tumor vascularity, composition, and metabolic characteristics. This advancement provides novel insights into the diagnosis, genotype prediction, treatment response evaluation, and prognosis prediction of GIST. This review systematically examines the clinical utility of spectral CT in GIST, highlighting the distinctive advantages of iodine concentration, spectral curves, and VNC-derived parameters in characterizing tumor features. Additionally, limitations and future research directions are discussed.

Malignant tumors of the digestive system represent a class of diseases characterized by high malignancy, strong metastatic potential, and poor prognosis, with an incidence rate showing a continuous upward trend. Surgery-based comprehensive therapy remains the primary treatment modality. Although the application of emerging therapies such as immunotherapy and targeted therapy in recent years has improved patient survival rates, drug resistance and tolerance remain key bottlenecks limiting therapeutic efficacy. Therefore, exploring new alternative or adjuvant therapeutic strategies is crucial. Melatonin, a hormone secreted by the pineal gland, not only regulates circadian rhythms but also possesses significant anti-inflammatory and antioxidant properties. It also plays an important regulatory role in inhibiting tumorigenesis, development, and metastasis, demonstrating potential as a novel adjuvant anti-tumor agent. This article aims to review the research progress on the mechanisms of action and combined applications of melatonin in digestive system tumors, to provide new insights and theoretical foundation for expanding its clinical application in the treatment of these malignancies.

Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor of the gastrointestinal tract, with approximately 85% to 90% driven by mutations in the KIT or platelet derived growth factor receptor α (PDGFRA) genes. Although surgical resection is the preferred treatment for localized GIST, molecular targeted therapy has become the mainstay for unresectable or metastatic/recurrent GIST. Imatinib, the first-line standard therapeutic agent, has significantly improved patient outcomes; however, nearly all patients eventually develop resistance, leading to disease progression. Second-line therapy with sunitinib and third-line therapy with regorafenib can modestly extend progression-free survival (PFS), but their overall effectiveness remains limited. Ripretinib, a novel broad-spectrum KIT/PDGFRA inhibitor, exerts its antitumor effects through a unique dual mechanism of action—simultaneously inhibiting kinase activation loop and switch pocket mutations—and has significantly prolonged PFS in patients with advanced GIST. It has also become the first drug globally approved for fourth-line treatment. Nevertheless, clinical practice has shown that secondary resistance to ripretinib still occurs, leading to disease progression and severely compromising long-term therapeutic efficacy. This article systematically reviews the pharmacological mechanisms of ripretinib in treating GIST, the key signaling pathways associated with resistance, and the latest research advances in therapeutic strategies targeting resistance, aiming to provide both theoretical and practical references for optimizing clinical treatment regimens.

Gastrointestinal stromal tumor (GIST) presents significant challenges in its precise diagnosis and prognostic evaluation. In recent years, radiomics has enabled the construction of various high-performance predictive models by extracting and analyzing high-dimensional quantitative features from medical images such as endoscopic ultrasound, computed tomography, and magnetic resonance imaging, in combination with machine learning and deep learning algorithms. These models have demonstrated considerable values in the identification and differential diagnosis of GIST, risk stratification, proliferation activity prediction, inference of gene mutation types, assessment of therapeutic response, and prediction of recurrence and metastasis risks. This article provides a systematic review of the advances in radiomics-based predictive models for the diagnosis and prognosis of GIST.

Pancreatic neuroendocrine tumors (PanNETs) account for 2% to 5% of pancreatic tumors. The high heterogeneity of PanNETs makes it difficult to standardize treatment strategies and achieve the best therapeutic effect. Clinical treatment is highly dependent on disease staging and grading. Traditional imaging examinations have obvious limitations in the pathological grading and differential diagnosis of PanNETs. In recent years, radiomics technology has developed rapidly, and researchers have conducted extensive studies on its application value in the assessment of pathological invasiveness, differential diagnosis, treatment response monitoring, and prognosis prediction of PanNETs. This article reviews the relevant literature in the past 10 years, systematically summarizes the latest progress of radiomics in the clinical diagnosis and treatment of PanNETs, discusses the current research limitations and challenges, provides references for subsequent related research, and looks forward to future development directions.