Yan-Qing Wang

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a growing global health burden. Identifying robust prognostic biomarkers is crucial for

The rising prevalence of drug-resistant Helicobacter pylori (H. pylori ) strains necessitates the development of more effective treatment approaches for eradication, such as bismuth quadruple therapy (BQT). We aimed to evaluate the efficacy and safety of vonoprazan (VPZ)-based BQT as a first-line regimen for H. pylori eradication. We conducted a retrospective analysis of consecutive treatment-naïve patients with H. pylori infection who received VPZ-based BQT between March 2022 and September 2023. Patients received a 14-day BQT regimen consisting of VPZ (20 mg), bismuth potassium citrate (240 mg), amoxicillin (1.0 g), and clarithromycin (500 mg) twice daily. Demographics, eradication rates, compliance, and adverse events (AEs) were assessed. 231 patients were included in the study, with 87 males (37.7%) and an average age of 40.84 ± 10.72 years old. The eradication rates for the intention-to-treat, modified intention-to-treat, and per-protocol analyses were 92.2% (213/231; 95% confidence interval [CI] 88.7–95.7%), 97.3% (213/219; 95% CI 95.1–99.4%), and 99.1% (210/212; 95% CI 97.7–100.0%), respectively. Patient compliance with the treatment was 97.0% (224/231). The incidence of AEs was 22.1% (51/231). Most AEs were mild and tolerable. Poor compliance was found to be an independent factor predicting treatment failure. This study demonstrated that the 14-day VPZ-based BQT as a first-line treatment regimen was highly effective and safe for eradicating H. pylori in a Chinese setting, with excellent patient compliance.

Elevated albumin-corrected anion gap (ACAG) has been linked to increased mortality across various patient populations, but its prognostic value in the general population remains unclear. This study examined the association between ACAG and all-cause, cardiovascular disease (CVD), and cancer mortality among US adults. Data from 40,702 adults aged ≥ 20 years were analyzed from the National Health and Nutrition Examination Survey 1999–2018. ACAG was calculated as: anion gap + (4.4 − serum albumin [g/dL]) × 2.5. Cox proportional hazards models, restricted cubic splines, and Kaplan–Meier curves were used to assess associations. Subgroup and sensitivity analyses were conducted. Over a median 113 month follow-up, 6,087 deaths occurred, including 1,601 from CVD and 1,372 from cancer. Each 1-unit increase in ACAG was associated with higher risk of all-cause (HR = 1.08, 95% CI: 1.06–1.10), CVD (HR = 1.08, 95% CI: 1.05–1.12), and cancer mortality (HR = 1.06, 95% CI: 1.03–1.09). Participants in the highest ACAG quartile had significantly higher mortality risks compared to the lowest quartile. No evident nonlinear associations were observed for all-cause, CVD, and cancer mortality. The positive association with all-cause mortality was more pronounced among participants aged < 60 years, males, current smokers, and those with hyperlipidemia or diabetes. Sensitivity analyses confirmed robustness. Elevated ACAG is independently associated with increased risks of all-cause, CVD, and cancer mortality in US adults. ACAG has potential value in stratifying mortality risk in public health contexts.

Although endoscopic resection (ER) is an established technique for gastric subepithelial tumours (SETs), comprehensive data on its efficacy and safety remain limited. This study aimed to evaluate the efficacy and safety of ER in patients with gastric SETs and to identify risk factors associated with procedure-related complications. This retrospective study included 483 patients who underwent ER for gastric SETs between February 2012 and May 2023. Patient demographics, tumour characteristics, and clinical outcomes were evaluated. Multivariate analysis was performed to identify risk factors for complications. The median tumour size was 1.2 cm (range: 0.5–6.0 cm). The complete resection rate was 93.8%. Complications occurred in 6.8% of cases, including perioperative bleeding (2.1%), perforation (1.7%), and both (0.4%), with 0.8% of cases requiring conversion to surgery. Larger tumours notably increased the risks of incomplete resection (odds ratio [OR] = 1.605, 95% confidence interval [CI]: 1.066–2.416, p = 0.023), perioperative bleeding (OR = 2.004, 95% CI: 1.099–3.653, p = 0.023), and perforation (OR = 3.476, 95% CI: 1.830–6.602, p < 0.001). Additionally, an irregular tumour shape significantly elevated the risk of incomplete resection (OR = 10.771, 95% CI: 3.452–33.605, p < 0.001). Conversely, tumours located in the middle third (OR = 0.068, 95% CI: 0.014–0.341, p = 0.001) and the upper third (OR = 0.211, 95% CI: 0.051–0.884, p = 0.033) of the stomach substantially reduced the risk of incomplete resection. ER is an effective and generally safe treatment modality for managing gastric SETs. However, larger tumour size and irregular shape are significant risk factors for adverse outcomes.

Evidence concerning the effect of cardiovascular health (CVH) on the risk of metabolic dysfunctional-associated steatotic liver disease (MASLD) is scarce. This study aimed to investigate the association between CVH and MASLD. 5680 adults aged ≥ 20 years from the National Health and Nutrition Examination Survey 2017-March 2020 were included. Life’s essential 8 (LE8) was applied to assess CVH. Weighted binary logistic regression was employed to calculate the odds ratio (OR) and 95% confidence interval (CI) to investigate the association of CVH with MASLD. Restricted cubic spline (RCS) was conducted to explore the dose-response association between LE8 and its subscales scores with MASLD. Among 5680 participants, 724, 3901, and 1055 had low, moderate, and high CVH levels, respectively, with a MASLD diagnosis prevalence of 36.83%. In the fully adjusted logistic regression model, ORs for MASLD were 0.50 (95% CI, 0.37–0.69) for participants with moderate CVH and 0.21 (95% CI, 0.13–0.34) for those with high CVH, when compared to those with low CVH (P < 0.001 for trend). OR for MASLD was 0.68 (95% CI, 0.61–0.77) for each 10-point increase in LE8 score. RCS model demonstrated a non-linear dose-response relationship between LE8 score and health factors score with MASLD, while a linear relationship was found between health behaviors score and MASLD. Subgroup analysis showed a consistent negative correlation between LE8 score and MASLD, and sensitivity analysis validated the reliability of these findings. Higher LE8 score was associated with a lower risk of MASLD. Encouraging adherence to optimal CVH levels may help mitigate the burden of MASLD.

Metabolic dysfunction-associated steatotic liver disease (MASLD) has become the most common chronic liver disease worldwide. The pan-immune-inflammation value (PIV) has been proposed as a biomarker for assessing immune status and inflammation. There is currently no evidence regarding the effect of PIV on the risk of MASLD. This study aimed to investigate the association between PIV and MASLD. The cross-sectional study included 6462 adults aged ≥ 20 years from the National Health and Nutrition Examination Survey 2017–2020. PIV was calculated based on blood count data. Weighted multivariable logistic regression was employed to calculate the odds ratio (OR) and 95% confidence interval (CI) to investigate the association of PIV and MASLD. Restricted cubic spline (RCS) analysis was conducted to explore the dose-response relationship between PIV and MASLD. Stratified and sensitivity analyses were performed to confirm the robustness of our findings. Among 6462 participants, 2458 were diagnosed with MASLD. Positive associations between LnPIV and MASLD were observed in all three models (Model 1: OR = 1.46, 95% CI: 1.28–1.66, P < 0.001; Model 2: OR = 1.41, 95% CI: 1.24–1.60, P < 0.001; Model 3: OR = 1.39, 95% CI: 1.16–1.65, P = 0.004). When PIV was classified into quartiles, both Q3 and Q4 exhibited significantly increased risks of MASLD compared with the reference Q1 in full adjusted Model 3 (Q3: OR = 1.63, 95% CI: 1.20–2.22, P = 0.012; Q4: OR = 1.76, 95% CI: 1.28–2.41, P = 0.008; P for trend = 0.002). RCS analysis did not show a nonlinear relationship between LnPIV and MASLD (P = 0.093 for nonlinearity). Stratified analysis showed a consistent positive association between LnPIV and MASLD in all subgroups, and sensitivity analyses supported the reliability of these results. Higher PIV levels are significantly associated with an increased prevalence of MASLD, indicating that PIV is a potentially effective inflammatory marker for assessing MASLD in participants.