Traditional tumor biology has predominantly focused on the pathological characteristics and evolution of localized lesions. However, with the deepening of research, solid tumors should be redefined as a systemic disease entity that originates locally but exerts systemic influence.This paper systematically elaborates the core connotation of this concept: the occurrence and development of a tumor is a dynamic process involving the remodeling of systemic signaling networks. From the precancerous lesion stage, biomarkers released by dysplastic cells can be detected in the circulation.Neoplastic tissues continuously disseminate individual cancer cells, most of which are effectively cleared by the immune system; only when cell microspheres (e.g., circulating tumor cell clusters) with stronger survival and metastatic potential successfully escape and colonize, can distant metastasis occur. Based on this, the essence of cancer therapy should be the synergistic initiation of local lesion eradication and systemic anti-cancer mechanisms, especially immune surveillance.For advanced cancers, it is necessary to integrate local resection, chemotherapy, targeted therapy, and the rebuilding and enhancement of systemic anti-cancer immunity to form a multimodal combination therapy strategy.This systemic concept provides a new theoretical framework for cancer prevention, early diagnosis, treatment, and prognosis evaluation.

This review systematically elucidates the integrated treatment paradigm of Super Minimally Invasive Surgery (SMIS) for Gastrointestinal Cancer (GIC) based on the concept that "cancer is a systemic disease". The fundamental innovation of SMIS lies in shifting the treatment goal from traditional organ resection to lesion clearance with preservation of organ function, which is grounded in the reconceptualization of solid tumors as an aberrant organ composed of "tumor micro-spheroids". For early-stage GIC, precise patient stratification enables the identification of individuals at low risk of metastasis, allowing the application of SMIS techniques such as non-full-thickness or full-thickness resection to achieve local cure and organ preservation.In advanced GIC, the therapeutic rationale transforms: following tumor downstaging and systemic control via neoadjuvant therapy, SMIS is employed to eradicate residual drug-resistant lesions, thereby consolidating efficacy and preventing recurrence.This staged and individualized SMIS framework marks a significant transition in GIC management from traditional radical resection toward precise functional preservation.Future efforts should focus on overcoming technical bottlenecks such as precise lymph node dissection and multimodal efficacy evaluation, shifting the paradigm of lymph node management from "anatomic dissection" to "immunomodulation of the metastatic niche", promoting the evolution of SMIS from local treatment to comprehensive regional disease control, and ultimately achieving the dual optimization of oncological safety and quality of life.

Hemorrhoidal disease is the most common anorectal condition, with internal hemorrhoids being the predominant subtype.Since the establishment of the Internal Hemorrhoid Diagnosis and Treatment Collaboration Group under the Digestive Endoscopy Branch of the Chinese Medical Association in 2019, minimally invasive endoscopic treatment for internal hemorrhoids has developed rapidly with the promotion of numerous clinical endoscopists.In recent years, the multifaceted advantages of this technique have been well demonstrated, and it has been gradually implemented at various levels of medical institutions across China.In 2021, the Collaboration Group released the Chinese Guidelines and Expert Consensus on Gastrointestinal Endoscopic Diagnosis and Treatment of Internal Hemorrhoids (2021), which systematically clarified the clinical value of endoscopic treatment for internal hemorrhoids, established a standardized operational framework, and provided a solid theoretical basis for clinical practice.As the technique has become more widely adopted, endoscopists have encountered a number of practical issues in daily practice that call for further refinement and clarification.In 2024, the Internal Hemorrhoid Collaboration Group of the Digestive Endoscopy Branch of the Chinese Medical Association convened experts to discuss and update the previous consensus, resulting in the Expert Consensus on Minimally Invasive Endoscopic Treatment of Internal Hemorrhoids (Guangzhou, 2025), hereinafter referred to as "the Consensus". This Consensus proposes a new endoscopic classification for internal hemorrhoids, namely the PBR classification, and updates several key aspects, including endoscopic sclerotherapy for internal hemorrhoids and the management of postoperative complications.On this basis, in order to further refine and standardize endoscopic sclerosing agent injection for internal hemorrhoids-particularly with respect to technical details, perioperative management, and the handling of postoperative complications-the Hemorrhoid Working Group of the Digestive Endoscopy Branch of the Cross-Strait Medicine and Health Exchange Association organized 69 nationally recognized experts in 2025 to conduct extensive discussion and ultimately formulate the present Consensus.The aim is to standardize the application of sclerosing agent injection in the treatment of internal hemorrhoids.The Consensus is composed of 13 sections and addresses 19 clinical questions with corresponding recommendations.

The endoscopic management of multiple gastric submucosal tumors (SMT) remains insufficiently systematically evaluated. This study aimed to assess the efficacy and safety of super minimally invasive surgery(SMIS), including endoscopic submucosal dissection (ESD), endoscopic submucosal excision (ESE), endoscopic full-thickness resection (EFTR), and submucosal tunneling endoscopic resection (STER), for treating multiple gastric SMT.

We retrospectively analyzed 53 patients diagnosed with multiple gastric SMT who underwent initial SMIS at the Department of Gastroenterology, First Medical Center of Chinese PLA General Hospital, between January 2013 and March 2025. Clinical-pathological characteristics, surgical approaches, en bloc resection rate, R0 resection rate, operative duration, major adverse events, hospitalization length, surgical costs, and follow-up outcomes were evaluated.

This study enrolled 53 patients with multiple gastric SMT, including 39 (73.6%) females and 14 (26.4%) males, with a mean age of 55.1±8.8 years.A total of 141 tumor lesions were detected, with 139(98.6%) successfully removed by endoscopic resection.The median tumor size was 8 mm (range: 2-30 mm). Histopathological analysis revealed 51(36.7%) leiomyomas, 46(33.1%) neuroendocrine tumors, 34 (24.5%) gastrointestinal stromal tumors, 4 (2.9%) lipomas, and one case each (0.7%) of ectopic pancreas, schwannoma, myofibroblastoma, and hyperplastic smooth muscle nodule. Peroral super minimally invasive non-full-thickness resection was performed on 124 (89.2%) lesions, peroral super minimally invasive full-thickness resection on 8 (5.8%) lesions, and super minimally invasive resection via tunnel approach on 7 (5.0%) lesions.The mean operative duration was 58.4±25.4 minutes.The en bloc resection rate reached 99.3% (138/139), with an R0 resection rate of 97.1% (135/139). No severe adverse events occurred during the perioperative period.Among 51 patients who completed follow-up (median: 22 months; range: 3-119 months), the recurrence rate was 2.56%(1/39)for non-neuroendocrine tumors but significantly higher for neuroendocrine tumors at 50.00%(5/10). The median postoperative hospital stay was 6 days (IQR: 5-7), with median surgical costs of ￥11, 187.3 (IQR: 8, 851.8-14, 348.3) and total hospitalization costs of ￥27, 035.1 (IQR: 24, 671.4-36, 580.8).

This study demonstrates that SMIS is a safe and effective therapeutic approach for multiple gastric SMT.

To evaluate the efficacy and safety of clip band ligation anti-reflux therapy(C-BLART) in the treatment of gastroesophageal reflux disease (GERD).

A retrospective analysis was conducted on GERD patients who underwent C-BLART at the Gastroenterology Department (Endoscopy Center), China-Japan Union Hospital of Jilin University between February 2023 and December 2024.

Twenty-one patients were enrolled, all of whom successfully received C-BLART with a mean operative time of (10.8 ± 6.2) minutes. Postoperative complications included localized inflammation in 1 patient (4.8%) and mild dysphagia in 2 patients (9.5%), all of which resolved with appropriate management.All 21 patients completed 3- and 6-month follow-up assessments.Significant reductions in Reflux Disease Questionnaire (RDQ), GERD-Health Related Quality of Life (GERD-HRQL), and GERD Questionnaire (GERD-Q) scores were observed in 20 patients (95.2%) (P<0.05), accompanied by symptom improvement and sustained remission after medication reduction/ discontinuation.Among 16 patients (76.2%) who completed extended 12-month follow-up, these therapeutic benefits persisted (P<0.05).

C-BLART demonstrates a favorable safety profile and stable mid term efficacy for GERD management, indicating promising clinical applicability.

This study aims to evaluate the hemostatic efficacy of an endoscopy-compatible polydopamine-functionalized cellulose-based cryogel hemostatic microsphere in large animal hemorrhage models, proposing a novel hemostatic strategy for managing non-compressible torso hemorrhage(NCTH) via portable endoscopic intervention.

This study selected six healthy female Bama miniature pigs (weight: 30-35 kg, age: 13-15 months) from September 1 to November 30, 2024.The pigs were randomly divided into an experimental group (n=3, treated with hemostatic microspheres) and a control group (n=3, no intervention). A standardized liver injury model (3 cm×1.5 cm ×1 cm) was created to simulate a clinically significant bleeding scenario.The experimental group received microsphere application to the wound post-hemorrhage, with recording of hemostasis time, blood loss, and material usage, while the control group received no treatment. Postoperative monitoring included 48-hour survival rates, rebleeding incidence, coagulation parameters (PT, APTT, TT, FIB), liver function markers (ALT, AST), hematologic indices, and histologic evaluation via HE staining.

The experimental group achieved hemostasis within 315.67±57.24 seconds using only 5.26 ±0.95 g of microspheres, with blood loss of 35.95±6.53 g significantly lower than the control group (>361.43± 42.41 g, P<0.001). The control group failed to achieve hemostasis within 900 seconds, progressing to shock with sustained blood pressure decline.In contrast, the experimental group exhibited transient blood pressure elevation followed by stabilization, no rebleeding within 48 hours, and 100% survival (n=3).

Polydopamine- functionalized cellulose-based cryogel microspheres offer advantages of rapid hemostasis, strong tissue adhesion, and low dosage requirement, demonstrating feasibility for future application in portable endoscopy to control non-compressible torso hemorrhage (NCTH). Their uniform particle size and sprayable properties make them compatible with endoscopic procedures, showing potential to address the limitations of conventional hemostatic techniques.Future studies should expand sample sizes, extend observation periods, and validate applicability across multiple models to facilitate clinical translation.

To analyze the indications and outcomes of sequential super minimally invasive stepwise endoscopic full-thickness resection after neoadjuvant therapy for locally advanced rectal cancer (LARC).

Clinical data of LARC patients after neoadjuvant therapy who were treated with sft-SMIR at the First Medical Center of PLA General Hospital from June 2024 to June 2025 were retrospectively analyzed. Indicators of indication selection (rectal auscultation, rectal-enhanced MRI, endoscopic performance and carcinoembryonic antigen level), perioperative complications, pathological results, healing status of wounds, anal function and quality of life were mainly analyzed.

A total of 8 patients with stage cT_2-4N_0-2M₀ LARC were included, all of whom were treated with neoadjuvant therapy with or without immunotherapy.After neoadjuvant therapy to achieve near clinical complete remission in 5 and clinical complete remission in 3, super minimally invasive stepwise endoscopic full-thickness resection was performed in 8.The sft-SMIR bloc resection rate and R0 resection rate were 100%.Postoperative pathologic results showed inflammatory or residual moderate heterogeneous hyperplasia in 5 cases, residual carcinoma invading the mucosal layer in 2 cases (ypTis stage), and residual carcinoma invading the muscular layer in 1 case (ypT2 stage). The mean duration of surgery was at 71 minutes, with a mean pain score(VAS)of 1.75 and a mean rectal function assessment LARS score of 20 (0-41). No adverse events such as delayed perforation or gastrointestinal fistula were observed during the follow-up period of 1-12 months (median interval 4 months).

Super minimally invasive stepwise endoscopic full-thickness resection is safe and effective for rectal cancer that reaches clinical complete remission or near clinical complete remission after neoadjuvant therapy.

To identify risk factors through clinical features to aid in the early diagnosis and risk stratification of suspected superficial duodenal papillary neoplasms.

A retrospective analysis was conducted on clinical data from 168 patients with suspected superficial duodenal papillary tumors who underwent endoscopic or surgical resection at the First Medical Center of the General Hospital of the People′s Liberation Army between December 2014 and December 2024.Based on pathological classification, the patients were categorized into two groups: a low-grade intraepithelial neoplasia group and an early carcinoma group.

Univariate analysis showed that the early cancer group was older and had significantly higher rates of jaundice and weight loss, elevated levels of CA199, ALT, AST, ALP, γ-GGT, and TBIL, as well as decreased lymphocyte count and hemoglobin (Hb) levels.In terms of imaging findings, the early cancer group demonstrated higher positive imaging rates, more significant biliary dilation, and pancreatic duct dilation.Multivariate analysis identified age, jaundice, biliary dilation, and elevated CA199 as independent risk factors for early tumor progression.

Old age, jaundice, biliary dilation, and elevated CA199 are independent risk factors for progression in patients with suspected superficial duodenal papillary neoplasms.Early and accurate identification of lesions based on clinical data, along with improved diagnostic accuracy, can facilitate early intervention and optimize treatment strategies.

Green fluorescent protein (GFP) can be split into multiple fragments that reconstitute fluorescence upon spatial proximity, making it a powerful tool for probing biomolecular interactions.This study aimed to design and optimize a tripartite split-GFP system for monitoring natural product-target protein interactions in vivo.

The high-affinity interaction between rapamycin and FKBP12 was used as a model system to evaluate split-GFP reconstitution efficiency in yeast cells.A chloroalkane-modified rapamycin derivative was employed to enable HaloTag labeling, and fluorescence output was assessed.To improve system performance, solubility tags were introduced to enhance the stability of the GFP1-9 fragment, and the HaloTag labeling system was replaced with a streptavidin-biotin system with higher binding affinity.

Chemical modification of rapamycin with a chloroalkane moiety significantly enhanced fluorescence intensity without compromising HaloTag labeling efficiency. Nevertheless, the tripartite split-GFP system exhibited substantial background fluorescence in vivo, resulting in weak effective signal and limiting its applicability in high-throughput screening. Improving the solubility and structural stability of the GFP1-9 core fragment increased reconstitution efficiency with the other GFP fragments. Furthermore, replacing the HaloTag system with the higher-affinity streptavidin-biotin labeling system led to a pronounced enhancement of fluorescence signal.

This study establishes and optimizes a tripartite split-GFP platform for detecting natural product-target protein interactions.By improving GFP fragment solubility and incorporating a high-affinity labeling system, signal intensity was significantly enhanced while background interference was reduced, supporting the potential application of this system in high-throughput screening and chemical biology research.GFP reconstitution has been well studied and applied widely as a report system.Since natural products are promising drug candidates, a robust split GFP report system can be valuable for drug development.

To explore the professional dimensions and scientific management model of the digestive endoscopy nursing studio and evaluate its clinical effectiveness.

The digestive endoscopy nursing studio was established, forming a multidisciplinary team led by specialized digestive care nurses.A specialized team-based management approach was implemented, enhancing the scope of continuous care and enriching both online education and interaction, as well as offline follow-ups, assessments, and consultations.

From 2021 to 2024, the digestive endoscopy nursing studio cumulatively managed 3, 293 patient encounters.The digestive endoscopy nursing health consultation clinic provided nursing diagnosis and treatment for 1, 301 patients, while the IBD nursing clinic conducted 1, 934 follow-up visits (including 709 nursing education sessions). The nutrition support group provided long-term follow-up care for 31 patients, and 1, 251 internet-based nursing consultations were completed.Significant achievements were made in discipline-related research, education, and scientific outcomes, promoting disciplinary development, the training of specialized nursing talent, and the demonstration of nursing value.

The specialized management pathway established by the digestive endoscopy nursing studio serves as an effective approach to standardizing patient care management, professionalizing specialized development, and enhancing team collaboration efficiency, demonstrating significant clinical reference value.

Design a specialized instrument table for ERCP, and explore its application value in shortening surgical preparation time, ensuring a rational layout of the operating table surface, and enhancing the efficiency of surgical coordination.

A convenience sampling method was employed to select 100 patients who underwent ERCP for bile duct stone removal at the Gastroenterology Endoscopy Center of our hospital from March 2024 to July 2024 as the study subjects.These patients were then randomly divided into a control group and an observation group using a random number method, with 50 patients in each group.The observation group underwent operative procedures in ERCP Operating Room 2, whereas the control group completed their surgeries in ERCP Operating Room 1.In the control group, a traditional dedicated instrument table was used during the procedure, whereas the observation group utilized a specialized ERCP instrument table. Comparison between the two groups regarding the degree of instrument table area segmentation preoperatively, Intraoperatively and postoperatively, the number of intraoperative instrument scattering incidents, the degree of postoperative tabletop contamination, and the satisfaction level of medical staff.

The observation group demonstrated significantly higher scores for the degree of instrument table area segmentation (preoperatively, intraoperatively, and postoperatively) compared to the control group, with all differences being statistically significant(P<0.05). The observation group exhibited significantly fewer incidents of surgical instrument scattering compared to the control group, and this difference was statistically significant(P< 0.05). The observation group had a significantly higher score for postoperative tabletop contamination compared to the control group, with the difference being statistically significant(P<0.05). The satisfaction scores of the observation group staff in all dimensions were higher than those of the control group, with statistically significant differences.

Through scientific design, the dedicated ERCP instrument table enables clear segmentation of surgical instruments, effectively reduces the frequency of instrument scattering, ensures the rationality of the operating table layout, further improves work efficiency, significantly reduces the level of postoperative tabletop contamination, and enhances staff satisfaction, demonstrating remarkable clinical application advantages.