On the occasion of the 110^th anniversary of the Chinese Medical Association, this article reviews the development of minimally invasive surgery in China, with a focus on the innovative journey of natural orifice specimen extraction surgery (NOSES). As an original Chinese minimally invasive technique, NOSES utilizes natural orifices to extract surgical specimens, eliminating the need for traditional abdominal incisions and achieving "minimally invasive within minimally invasive." The paper systematically details the evolution of NOSES from conceptualization to global dissemination, covering its technical origins, theoretical framework, domestic promotion, international influence, and future prospects. Under the leadership and support of the Chinese Medical Association, NOSES has become a global exemplar of Chinese medical innovation, contributing a "Chinese solution" to the advancement of minimally invasive surgery worldwide. The success of NOSES not only reflects the glorious 110-year history of the Chinese Medical Association but also exemplifies the pioneering and excellence-seeking spirit of Chinese medical professionals.

On the occasion of the 110^th anniversary of the Chinese Medical Association, this paper focuses on the Chinese series of medical journals and systematically sorts out their practices and contributions to promoting the development of high-quality original medical academic achievements in China from the perspectives of academic journals and medical journals. By analyzing the interaction mechanism between journals and experts, the application path of the Association’s influence, the value of formulating medical guidelines and norms, as well as the innovative practices of the Chinese medical electronic series journals in digital publishing and multimedia communication, this paper reveals the internal logic of empowering the cultivation of original achievements. Through such measures as diversified expert cooperation, special topic planning, guideline formulation, and resource digital upgrading, the Chinese series of medical journals have significantly improved the quality and influence of original achievements, providing important support for the development of medical science in China. In the future, continuous breakthroughs need to be made in international communication and interdisciplinary integration to help Chinese original medical achievements go global.

Establishing an all-round development model centered on publishing and promoting characteristic technologies is a key measure for specialized journals to enhance their influence and contribute to disciplinary development. Since its founding, Chinese Journal of Colorectal Diseases (Electronic Edition) has always taken the natural orifice specimen extraction surgery (NOSES) as the core, and built an all-round development model covering concept dissemination, research verification, standard formulation, and achievement promotion. Years of practice have shown that this model has effectively improved the academic quality and influence of the journal, promoted the popularization and application of NOSES technology, and realized the coordinated development of the journal and the discipline of colorectal diseases. This paper analyzes the journal's publishing practices centered on NOSES technology, including taking the lead in publishing relevant concepts, publishing multi-center research results, releasing expert consensus and guidelines, integrating achievements to support monograph publication, promoting technology popularization through surgical competitions, and building a sound conference system to promote cutting-edge technologies. It aims to provide reference for the publishing practices of specialized journals and promote them to better serve academic exchanges and disciplinary progress.

The liver is the main target organ for hematogenous metastases of colorectal cancer, and colorectal liver metastasis is one of the most difficult and challenging situations in the treatment of colorectal cancer. In order to improve the diagnosis and comprehensive treatment in China, the guidelines have been edited and revised for seven times since 2008, including the overall evaluation, personalized treatment goals and comprehensive treatments, to prevent the occurrence of liver metastases, increase the local damage rate of liver metastases, prolong long-term survival, and improve quality of life. The revised guideline version 2025 includes the diagnosis and follow-up, prevention, multidisciplinary team, surgery and local ablative treatment, neoadjuvant and adjuvant therapy, and comprehensive treatment. The revised guideline emphasizes precision treatment based on genetic molecular typing, especially recommending immune checkpoint inhibitors for mismatch repair defects/microsatellite instability-high(dMMR/MSI-H) patients, and enriched local treatment methods, such as liver transplantation, yttrium-90 microsphere selective internal radiotherapy, etc. The revised guideline includes state-of-the-art experience and findings, detailed content, and strong operability.

The guideline for integrated diagnosis and treatment of cancer-NOSES technology (colorectal cancer section) was jointly developed by the NOSES Professional Committee and the Colorectal Cancer Professional Committee of the Chinese Anti-Cancer Association. It systematically elaborates on the nomenclature of NOSES procedures, indications and contraindications, aseptic and non-tumor surgical protocols, digestive tract reconstruction, and prevention and management of complications for natural orifice specimen extraction surgery (NOSES) in colorectal cancer. The guideline details 10 categories and 21 types of NOSES procedures, covering tumors in various segments of the colorectum, and clarifies the key technical points and applicable conditions for each procedure. The guideline emphasizes that surgical teams must possess extensive laparoscopic experience, strictly adhere to indications, and standardize aseptic and non-tumor techniques, including preoperative preparation, intraoperative skills, and postoperative management. Additionally, it summarizes strategies for preventing and managing major complications such as anastomotic leakage and intra-abdominal infections, providing critical references for the clinical application of NOSES in colorectal cancer.

This consensus focuses on summarizing the standardized diagnosis and treatment guidelines for colon cancer in primary medical, aiming to provide scientific and standardized guidance for primary medical service institutions. The content covers the background of consensus development, early screening, clinical manifestations, diagnostic criteria, and evaluation methods of colon cancer. It also elaborates on treatment approaches, including surgery, radiotherapy, chemotherapy, targeted therapy, and immunotherapy. The consensus highlights the critical role of primary medical workers in colon cancer prevention and treatment, proposing diagnostic pathways and follow-up management recommendations. The goal is to improve the early diagnosis rate and treatment outcomes of colon cancer at the primary medical service institutions, reduce patient mortality, and enhance patients’ quality of life.

Colorectal cancer is the second most common malignancy in China, with recurrence and metastasis being the leading causes of poor prognosis. Brain metastases from colorectal cancer are relatively rare among distant metastatic sites but exert a profound adverse impact on patient survival. Despite their low incidence, the prognosis of colorectal cancer patients with brain metastases is significantly worse than that of patients with other metastatic patterns. In recent years, with the advancement of imaging technologies and improvements in diagnostic and therapeutic approaches, the detection rate of colorectal cancer brain metastases has shown a gradual increase. This review aims to summarize the latest findings on the epidemiological features, clinical manifestations, diagnostic methods, novel treatment strategies, and prognostic factors of colorectal cancer brain metastases. It highlights the importance of implementing individualized and precision-based treatment plans through multidisciplinary collaboration, incorporating surgery, radiotherapy, chemotherapy, targeted therapy, and immunotherapy. Furthermore, future research should focus on elucidating the underlying molecular mechanisms and developing novel therapeutic approaches to improve both the quality of life and overall survival of affected patients.

To compare the perioperative efficacy and postoperative anal function of natural orifice specimen extraction surgery (NOSES) versus minimal laparotomy (Mini-Lapar) in treating rectal cancer in middle-aged and elderly patients.

Retrospective analysis of data from 124 rectal cancer surgery patients at Affiliated Hospital of Inner Mongolia Medical University between June 2020 and September 2023 (62 in the NOSES group and 62 in the Mini-Lapar group). The preoperative baseline data, perioperative information, pathological data, postoperative inflammatory markers, and Wexner, Vaizey, and LARS scores within one year were compared to evaluate anal function.

The first postoperative gas release time (t=−3.958, P<0.001), defecation time (t=−3.403, P<0.001), intake of liquid diet time (t=−3.232, P=0.001), and time out of bed (t=−2.648, P=0.005) in the study group(NOSES group) were all earlier than those in the control group(Mini-Lapar group) (all P<0.05). The postoperative VAS scores in the study group were lower (all P<0.05), and the hospital stay was shorter (t=−3.936, P<0.001). On the second day after surgery (t=2.107, P=0.039) and the third day, the body temperature (t=2.618, P=0.011) in the study group was higher than that in the control group. On the first day (t=3.286, P=0.002) and the third day, the neutrophil levels (t=2.227, P=0.030), as well as on the third day (t=2.584, P=0.012) and the fifth day, the CRP levels (t=2.094, P=0.040) were also higher in the study group than in the control group. Within 6 months after the operation, the overall anal function of the study group was worse than that of the control group (all P<0.05). At one year after the operation, there was no difference between the two groups (all P>0.05).

NOSES can accelerate the postoperative recovery of middle-aged and elderly patients with rectal cancer, and does not affect the long-term anal function after surgery. It is worth further promotion in middle-aged and elderly patients with rectal cancer.

To explore the impact of deep learning reconstruction (DLR) technology on image quality and the diagnostic performance of preoperative rectal cancer.

A retrospective analysis was conducted on patients with rectal cancer confirmed by postoperative pathology in our hospital from July 2017 to March 2022, focusing on their clinical, pathological, and pre-treatment MRI data. The DLR technology was used to reconstruct and optimize the T₂WI, DWI, and CE-T₁WI sequences in MRI. Five readers with different diagnostic experiences separately assessed the image quality of the original-MRI and DLR-MRI image sets. Objective quantitative evaluation of the images was conducted by calculating the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the lesions, while subjective qualitative analysis was performed on overall image quality and lesion display performance. Finally, subjective diagnosis of preoperative TN staging and comparison of diagnostic performance of deep learning models were performed for the two groups of images.

A total of 178 patients were included. The DLR-MRI images showed significantly higher values in both objective quantitative metrics (SNR and CNR) and subjective evaluations (overall image quality and lesion display performance) compared to the original images (P<0.0001). In terms of the diagnostic efficacy of MRI images, DLR-MRI increased the AUC values of preoperative T staging for rectal cancer in readers 3 and 5, reaching up to 0.921 (reader 3), but the difference was not statistically significant (P>0.05). Among them, the diagnostic efficacy of reader 4 was significantly improved (Z=2.971, P=0.003). Moreover, DLR-MRI significantly enhanced the diagnostic efficacy of the deep learning classification model, with the AUC value increasing from 0.797 to 0.937 (Z=2.505, P=0.043). However, neither the subjective assessment nor the DL classification model achieved statistically significant improvements in preoperative N-staging for rectal cancer. Further analysis using DCA showed that in preoperative T-staging of rectal cancer, the DLR-DL model demonstrated higher clinical net benefit, while the clinical benefits of the two models were similar in preoperative staging.

DLR technology can optimize MRI image quality to enhance lesion display capabilities. Furthermore, the deep learning classification model based on DLR can improve the preoperative diagnostic performance of rectal cancer to a certain extent.

To evaluate the efficacy of 2D and 3D radiomics models based on contrast-enhanced CT and a combined model incorporating clinical features for preoperative assessment of lymphovascular invasion(LVI) in colorectal cancer.

A retrospective study included 303 patients who underwent radical surgery for colorectal cancer at Shanghai General Hospital from January 2015 to December 2019. Patients were categorized into LVI-positive (n=122) and LVI-negative (n=181) groups. The cohort was randomly divided into a training set (n=212; 90 LVI-positive, 122 LVI-negative) and a test set (n=91; 32 LVI-positive, 59 LVI-negative) in a 7:3 ratio. Clinical predictors of LVI were identified using chi-square tests, Mann-Whitney U tests, and multivariate logistic regression. Two radiologists manually delineated 2D regions of interest (ROI) and 3D volumes of interest (VOI) on venous-phase contrast-enhanced CT images. Radiomic features were selected via Mann-Whitney U test, intraclass correlation coefficient(ICC) and least absolute shrinkage and selection operator(LASSO) regression. Based on selected features, support vector machine(SVM), logistic regression(LR), random forest(RF), and extreme gradient boosting(XGBoost) algorithms were employed to construct 2D, 3D radiomics models, and combined models. Model performance was assessed using receiver operating characteristic(ROC) curves, area under the curve(AUC), and the DeLong test. Calibration curves and decision curve analysis were used to evaluate diagnostic accuracy and clinical utility.

N stage, perineural invasion, and tumor deposits were identified as independent clinical risk factors for LVI. Models built with the LR classifier demonstrated superior performance. The 2D radiomics model achieved AUC of 0.734 (95%CI: 0.660~0.798) and 0.683 (95%CI: 0.562~0.805) in the training and test sets, respectively. The 3D radiomics model yielded AUC of 0.784 (95%CI: 0.720~0.843) and 0.726 (95%CI: 0.602~0.830). The 2D combined model (integrating N stage, perineural invasion, and tumor deposits) achieved AUC of 0.843 (95%CI: 0.786~0.899) and 0.819 (95%CI: 0.723~0.905), while the 3D combined model showed AUC of 0.907 (95%CI: 0.865~0.943) and 0.874 (95%CI: 0.790~0.941). Calibration curves indicated comparable predictive accuracy between 2D and 3D models. Decision curve analysis revealed greater clinical net benefit for the 3D combined model. DeLong tests showed no significant performance differences between classifiers for 2D/3D models, but the 3D combined model outperformed the 2D radiomics model (P<0.05).

While 2D and 3D segmentation methods exhibit distinct advantages and limitations, the 3D combined model constructed with LR demonstrats superior predictive performance. Both 2D and 3D radiomics models enable effective preoperative prediction of LVI in colorectal cancer, offering valuable guidance for clinical decision-making.

To evaluate the clinical efficacy of lateral mucosal advancement flap (LMAF) surgery versus ligation of inter-sphincteric fistula tract (LIFT) in the treatment of complex anal fistulas and provide evidence for clinical decision-making.

In this retrospective cohort, propensity score matching was used to balance baseline characteristics. Patients were divided into LMAF group (n=42) and LIFT group (n=48). Clinical cure rate, anal function (Wexner score), complications, and recurrence were analyzed, with subgroup analyses based on fistula number and Parks classification.

The clinical cure rate was 83.3% in the LMAF group and 72.9% in the LIFT group, with no statistically significant difference (χ²=1.413, P=0.235). Anal continence function, assessed using the Wexner incontinence score at 3 (t=0.748, P=0.458) and 6 months (t=1.906, P=0.059) postoperatively, showed no significant differences between the groups. At 12-month follow-up, the recurrence rate in the LMAF group (4.8%) was lower than that in the LIFT group (16.7%), though the difference did not reach statistical significance (χ²=3.245, P=0.072). The postoperative complication rate was significantly lower in the LMAF group (14.3%) compared to the LIFT group (33.3%) (χ²=4.295, P=0.034). Subgroup analysis by the number of fistula tracts demonstrated that there was no statistically significant difference in the incidence of complications and recurrence rate between the LMAF group and the LIFT group in patients with single fistulas. Both techniques showed comparable efficacy when stratified by Parks classification(P>0.05).

LMAF reduces complications with a trend toward lower recurrence, and comparable anal functional outcomes to LIFT, though long-term efficacy requires further validation.

Mesenchymal stem cells-derived exosome have shown significant potential in treating inflammatory bowel disease, with effects including protecting the intestinal barrier, counteracting intestinal inflammation, and alleviating intestinal fibrosis. Although current research indicates that mesenchymal stem cell-derived exosomes have good efficacy in animal and clinical trials, their mechanisms of action are complex, involving various pathophysiological processes, and still warrant further investigation. This article aims to systematically explore the specific efficacy and deep mechanism of inflammatory bowel disease (IBD) treatment of MSCs-Ex, and provide a theoretical basis for its clinical application.