To evaluate the features of carotid web (CW) by ultrasonography.

A total of 66 patients with CW were retrospectively enrolled from January 2018 to June 2019 at Xuanwu Hospital, Capital Medical University. All patients were examined by both ultrasonography and CTA, and were divided into either a<50% stenosis group (54 cases) or a ≥50% stenosis group (12 cases). The ultrasonographic characteristics of CW, including the length, thickness, direction (forward or backward to the flow), acute angle between the web and carotid wall, and thrombus between the web and carotid wall were compared between the two groups. The stenosis degrees of carotid artery were compared between patients with and without ischemic stroke.

Forty-two (42/66, 63.6%) patients were diagnosed with CW by initial CDFI examination, of whom 21 (21/66, 31.8%) were diagnosed with ulcerative plaque and 3 (3/66, 4.5%) were diagnosed with carotid dissection at first but confirmed by second examination. There were no differences in the web length, thickness, direction, or thrombus detected between the two groups (P>0.05). The angle between the web and carotid wall in the<50% stenosis group was significantly smaller than that of the ≥50% stenosis group (median angel 39o vs 73o, P=0.002), and the percentage of patients with an angle≤ 60o in the<50% stenosis group was significantly higher than that of the ≥50% stenosis group (74.1% vs 41.7%, P=0.042). The diameter of the residual carotid artery at CW location in the<50% stenosis group was significantly larger and peak systolic velocity was significantly higher in the<50% stenosis group than in the≥50% stenosis group (P<0.001). The stenosis degrees of carotid artery were not statistically different between patients with and without ischemic stroke (P=0.321).

Ultrasonography can be used to evaluate the characteristics of carotid web in 2D and color mode. When the angle between the CW and carotid wall is large, the carotid artery stenosis ≥ 50% is more likely to happen, but carotid artery stenosis is not the main cause of ischemic stroke.

The aim of the present study was to evaluate the efficiency of sling exercise, therapeuticultrasound, therapeuticultrasound and sling exercise in patients to alleviate pain and improve lumbar function with lumbar disc herniation.

Individuals were selected from a list of patients being followed at the department of Rehabilitation in the third hospital of Hebei Medical University. 30 patients who were diagnosed with lumbar disc herniation were collected, the diagnoses were established upon medical history, physical examination, and results of imaging studies. The patients were randomly divided into three groups: therapeuticultrasound group received 14 sessions of ultrasonic therapy to the lumbar region, Sling exercise group received 14 sessions of sling exercise, and therapeuticultrasound and sling exercise group received therapeuticultrasound and sling exercise therapy 14 sessions of therapeuticultrasound to the lumbar region,7 sessions per week, 2 weeks. The VAS and ODI were compared with the assessment of the patients before and at the end of the therapy.

At the end of treatment, three groups VAS scores (F=3.069, P=0.043) and ODI scores (t=12.676, P<0.001) was lower than that at the beginning of treatment (P<0.05), at the end of treatment the VAS scores (F=59.400, P<0.001) and of the ODI scores (t=12.737, P<0.001) of ultrasonic and sling exercise therapy group was lower than the other group, the difference is significantly.

All three groups could reduce pain and improve lumbar function, and the ultrasonic and sling exercise therapy was most effective for lumbar disc herniation treatment in the three groups.

To analyze the treatment of different types of traumatic cerebral infarction in children, and explore its pathogenesis in combination with literature so as to improve the cure rate and reduce disability rate.

The clinical data of 42 cases of traumatic cerebral infarction in children were retrospectively analyzed in The Hospital of 81^st Group Army PLA from January 2015 to December 2019. The diagnosis of traumatic cerebral infarction in children was made by CT scan and MRI scan. According to different conditions, children with traumatic cerebral infarction were classified, and different treatment strategies were selected. Children with lacunar infarction were treated with calcium antagonists and neurotrophic drugs, supplemented by hyperbaric oxygen and exercise rehabilitation. The children of focal cerebral infarction and complex cerebral infarction treated by junior dehydrant and hormone also included the calcium antagonist and nutritional nerve drugs. The therapeutic regimen perhaps adjusted by the evolution of the disease. The children of extensive cerebral infarction underwent emergency cranial decompression, and was treated by reducing intracranial pressure and preventing complications after operation. The treatment results and recovery were observed.

In 42 cases of traumatic cerebral infarction in children, 35 cases (83.3%) were good recovery, 4 cases (9.5%) were moderate disability, 2 cases (4.8%) were severe disability, 1 case (2.4%) died, and no vegetative state. The good recovery rate of lacunar infarction was 100%, that of focal cerebral infarction was 62.5%, that of mixed cerebral infarction was 60%, and that of extensive cerebral infarction was 50%.

It is of great significance to improve the therapeutic effect and prognosis of children with traumatic cerebral infarction to adopt different treatment schemes for different types of cerebral infarction.

To characterize the patients with supratentorial hypertensive intracerebral hemorrhage (ICH) in the Tibetan Plateau over an altitude of 4000 meters.

A total of 68 cases with supratentorial hypertensive ICH were retrospectively included in Ali Regional People’s Hospital from January 2017 to September 2018. The clinical and laboratory data were collected. A simple linear correlation analysis was applied to analyze the correlation between the amount of bleeding and sex, age, nationality, time from onset , systolic blood pressure (SBP), diastolic blood pressure (DBP), hemoglobin (Hb), serum triglyceride (TG), and cholesterol. According to computed tomography (CT) findings, 68 cases were divided into the basal ganglia ICH group (33 cases) and the lobar ICH group (35 cases). The characteristics between two groups were analyzed using t-test or χ² test.

The data of sex, age, nationality, time from onset, SBP, DBP, Hb, TG, and cholesterol of 68 cases on admission did not show any definitive correlation with the hematoma volumes (P＞0.05). The SBP and DBP of patients in the basal ganglia ICH group were significantly higher than that in the lobar ICH group, respectively [(184.9±28.5) mmHg vs (164.6±24.4) mmHg; (113.0±18.1) mmHg vs (103.0±18.4) mmHg] (t=0.499, 0.486; P=0.002, 0.033).

The relevant factors of hematoma volumes in patients with ICH in plateau area were not yet clear. Diastolic and systolic blood pressure of patients in the basal ganglia ICH group was higher than that in those in lobar ICH group.

To compare the efficacy evaluation of electrospun composite biomaterials and a porcine small intestine submucosa mesh for hernia repair.

A randomized, single-blind, controlled multicenter trial was performed in 3 hospitals in Shanghai. Eligible adult patients with primary unilateral reducible groin hernias were randomly assigned (1∶1) to electrospun composite biomaterials (experimental group) or porcine small intestine submucosa (control group) mesh groups. Patients were treated with the tARB technique and assessed at 1,3 and 6 months after the surgery. The primary endpoint was hernia recurrence. The secondary endpoints were postoperative complications including groin pain and operative site infections.

172 patients were assigned to experimental (n=86) and control (n=86) groups. At 6 months follow-up, postoperative complications occurred in 5 patients (5/86, 5.95%) and 2 (2/86, 2.35%) patients in the control and experimental groups, respectively (P>0.05). There was no significant difference in VAS or SVS score between the two groups.

We demonstrate that electrospun composite biomaterial mesh can be used as a ideal choice for inguinal hernia repair. Electrospun composite biomaterial has the characteristics of low recurrence rate, absorbability and long-term comfort.It can be further applied in clinical practice in the future.

Pancreaticoduodenectomy(PD)remains one of the most complicated hepatobiliary operations. The development of minimally invasive surgery for PD has always been an hot spot. Laparoscopic pancreaticoduodenectomy(LPD) has not been widespread carried out due to its difficulty and long learning curve. LPD accounts for 9% of all PD, according to the National Cancer Data base. Compared with laparoscopic surgery, robotic surgery system has significant advantages in the field of minimally invasive PD, including stereotactic amplified vision, filtering hand tremor and simulating the wrist. The article would review the surgical techniques and notes, which could provide clinical reference for other surgeons.

Autism spectrum disorder (ASD) is primarily characterized by impairments in social communication and the presence of restricted, repetitive behavioral patterns. In recent years, there has been growing recognition of the significance of autobiographical memory (AM) in the development of children's self-awareness and social skills. This review comprehensively summarizes the atypical manifestations of AM observed in children with ASD, specifically highlighting their difficulty in retrieving detailed event information, limited capacity for emotional expression, and tendency to produce fragmented personal narratives. These memory deficits may hinder the establishment of a coherent self-concept and negatively affect social capabilities, including sharing personal experiences and understanding others' perspectives. At the cognitive level, these memory impairments have been linked to deficits in executive functions, language abilities, and emotional regulation. From a neurobiological perspective, dysfunction within the default mode network (DMN) may disrupt effective processing and integration of self-related information. Furthermore, this review discusses potential interventions, such as parent-guided elaborative reminiscing and narrative-based training programs tailored specifically for children with ASD, aimed at enhancing their autobiographical memory skills and subsequently improving self-awareness and social competence. Clarifying the connection between AM impairments and core ASD symptoms can guide more precise clinical and educational interventions, ultimately facilitating comprehensive cognitive, emotional, and social development in affected children.

Brain abscess is a localized suppurative infection within the cranial cavity. Although its incidence is low, it is a critical condition associated with high mortality and disability rates. The widespread application of CT, MRI, and molecular pathogen detection has revolutionized its diagnostic paradigm, Nevertheless,, clinical management still faces challenges such as shifting epidemiological characteristics and poor long-term functional outcomes. As a complex clinical syndrome, the treatment strategy for brain abscess should be tailored to pathogen characteristics, host immune status, and individual patient differences, adopting a comprehensive intervention approach that integrates multidisciplinary collaboration, minimally invasive neurosurgery, and targeted antimicrobial strategies. With continuous advances in imaging and molecular diagnostic technologies, along with the deepening adoption of individualized treatment concepts, the diagnosis and treatment of brain abscess are expected to further improve, thereby reducing mortality and improving long-term prognosis. This article aims to provide a systematic review of research progress on the epidemiology, diagnostic techniques, treatment strategies, and long-term prognostic management of brain abscess.

JC polyomavirus (JCPyV) is a widely distributed DNA virus in the human population, typically remaining latent in immunocompetent hosts. When the immune function of the host is compromised, JCPyV can be reactivated and cause progressive multifocal leukoencephalopathy (PML), a severe central nervous system demyelinating disease. This review summarizes the global epidemiological characteristics, molecular biological properties, pathogenesis and related disease research progress of JCPyV, and discusses current diagnostic methods, therapeutic strategies and future research directions, providing theoretical references for the prevention and treatment of JCPyV-associated diseases.

To investigate the distribution characteristics of pathogens causing community-acquired pneumonia (CAP) in children in Zunyi region from 2020 to 2024, and to analyze their variations by year, age and season, in order to provide evidence for empirical anti-infection therapy.

Clinical data of hospitalized children with bacterial CAP from five hospitals in Zunyi were collected, retrospectively. Total of 21 546 cases with positive sputum cultures and meeting CAP diagnostic criteria were included. The pathogen spectrum and its distribution across different years, age groups and seasons were analyzed. The characteristics of pathogen composition across different ages and seasons were analyzed by Pearson Chi-square test, and the pathogen distribution across different years was analyzed by Chi-square trend test.

Total of 21 546 children with CAP who had positive sputum cultures were enrolled, including 13 307 males (61.8%) and 8 239 females (38.2%). There were statistically significant differences in the distribution of children among different years, seasons and age groups (χ²=1 103.4, 1 083.9, 3 733.9; all P<0.001). The detection rates of Gram-negative bacteria and Gram-positive bacteria showed significant differences in distribution among different years (χ²=189.5, P<0.001), and the detection rate of Gram-negative bacteria (53.0%) exceeded that of Gram-positive bacteria (47.0%) in 2024. The top 5 pathogens in terms of detection rate were Haemophilus influenzae (6 972 cases, 32.4%), Streptococcus pneumoniae (5 746 cases, 26.7%), Staphylococcus aureus (3 825 cases, 17.8%), methicillin-resistant Staphylococcus aureus (MRSA) (2 027 cases, 9.4%) and Escherichia coli (852 cases, 4.0%). Age distribution: children in infant group were mainly infected with Haemophilus influenzae (3 344/11 073, 30.2%), Staphylococcus aureus (2 702/11 073, 24.4%) and Escherichia coli (742/11 073, 6.5%); children in the toddler and preschool group were mainly infected with Streptococcus pneumoniae [37.9% (2 228/5 879) and 33.1% (1 217/3 672)] and Haemophilus influenzae [39.3% (2 308/5 879) and 31.2% (1 145/3 672)]; children in the school-age group had the highest detection rate of MRSA (348/922, 37.7%). Seasonal distribution: the bacterial infection rate was higher in autumn and winter. Haemophilus influenzae and Streptococcus pneumoniae were the main pathogens in all four seasons, among which Haemophilus influenzae had the highest detection rate in winter (2 627/6 238, 42.1%) and Streptococcus pneumoniae had the highest proportion in autumn (1 821/5 435, 33.4%). Drug resistance analysis showed that Haemophilus influenzae was highly resistant to trimethoprim-sulfamethoxazole, ampicillin and cefuroxime [resistance rates were 95.3% (6 644/6 972), 89.6% (6 247/6 972) and 73.4% (5 142/6 972)]. The resistance rates of Escherichia coli to ampicillin, cefuroxime and ceftriaxone were 91.1% (752/825), 83.0% (685/825) and 78.4% (647/825), respectively, and Escherichia coli was sensitive to piperacillin/tazobactam and meropenem; The resistance rate of Streptococcus pneumoniae to tetracycline was 100% (5 746/5 746), while the resistance rate of Staphylococcus aureus to penicillin was 92% (3 519/3 825), and the resistance rate of MRSA to clindamycin and erythromycinhad were both higher than 90%, and all the above Gram-positive bacteria were sensitive to vancomycin, linezolid, etc.

There were significant differences in the detection rates of pathogens from children with CAP in Zunyi region among different years, seasons and age groups. In 2024, the detection rate of Gram-negative bacteria exceeded that of Gram-positive bacteria. The dominant pathogenic bacteria varied among different age groups, and the infection rates were higher in autumn and winter. Common pathogenic bacteria were highly resistant to various conventional antibiotics. It is necessary to select reasonable antibiotics according to the drug sensitivity test results.

To investigate the diagnostic value of plasma methylation levels of human Runt-related transcription factor 3 (RUNX3), E-cadherin and Ras-association domain family 1A (RASSF1A) genes in hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC).

Clinical data of 30 patients with HCV-related HCC (HCC group), 30 patients with HCV-related liver cirrhosis (liver cirrhosis group), 30 patients with simple HCV infection (HCV group) and 30 healthy individuals undergoing physical examination (healthy control group) admitted to Huzhou First People’s Hospital from June 2022 to February 2024 were analyzed, retrospectively. General data, alpha-fetoprotein (AFP) which was a traditional indicator for HCC screening, and methylation levels of gene RUNX3, E-cadherin and RASSF1A were compared among the four groups, respectively. The levels of AFP corresponding to high and low methylation levels of the three genes were compared in each group. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic efficacy of the three gene methylations and AFP alone or in combination for HCV-related HCC. Multivariate Logistic regression was applied to analyze whether the three gene methylations and AFP level were influencing factors for HCV-related HCC.

There were significant differences in total bilirubin (TBil) (F=339.823, P<0.001), alanine aminotransferase (ALT) (F=681.714, P<0.001), AFP (F=1488.962, P<0.001), and methylation levels of RUNX3 (F=92.207, P<0.001), E-cadherin (F=39.316, P<0.001) and RASSF1A (F=21.705, P<0.001) among the four groups. The area under the ROC curve (AUC) of the combined diagnosis of HCV-related HCC by hypermethylation of RUNX3, E-cadherin and RASSF1A genes plus AFP was 0.916, with the sensitivity of 82.50% and specificity of 55.00%. In the HCC group, AFP levels corresponding to low (<0.23%) and high (≥0.23%) RUNX3 methylation levels, low (<0.14%) and high (≥0.14%) E-cadherin methylation levels, as well as low (<0.41%) and high (≥0.41%) RASSF1A methylation levels all showed significant differences (t=3.304, P=0.002; t=4.495, P<0.001; t=3.158, P=0.003). Multivariate Logistic regression analysis showed that RUNX3 methylation (OR=8.306, 95%CI: 1.862-37.058, P=0.006), RASSF1A methylation (OR=7.205, 95%CI: 2.080-25.268, P=0.002), and AFP level (OR=8.793, 95%CI: 1.725-44.825, P=0.009) were all risk factors for HCC in HCV-infected patients, while E-cadherin methylation was a protective factor (OR=0.457, 95%CI: 0.122-0.897, P=0.025).

Plasma methylation levels of RASSF1A, E-cadherin and RUNX3 gene can serve as effective diagnostic indicators for HCV-related HCC and may play important roles in predicting the progression of liver cirrhosis to HCC.

To investigate the relationship between lactate dehydrogenase (LDH) levels and abnormal liver function as well as glucose metabolism characteristics of children with Mycoplasma pneumoniae pneumonia (MPP) of different ages.

Total of 199 children with MPP hospitalized at Woyang Branch of Anhui Provincial Hospital from May 2020 to November 2023 were selected. All children were divided into infant group (≤3 years old, 75 cases), preschool group (3-6 years old, 64 cases) and school-age group (≥6 years old, 60 cases) according to age. Additionally, the children were divided into normal liver function group (119 cases) and abnormal liver function group (80 cases) based on whether their serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were abnormal. The mediating effect of LDH on the relationship between fasting blood glucose and glycated hemoglobin (HbA1c) was tested by the Bootstrap method; the nonlinear association between LDH and the risk of liver dysfunction was analyzed by the restricted cubic spline regression method; and the relationship between LDH and liver function in children of different age groups was analyzed by the generalized linear mixed-effects model (GLMMs).

There were statistically significant differences among different age groups. Age, duration of hospital stay, days of fever, C-reactive protein (CRP), neutrophils (NEU), procalcitonin (PCT), erythrocyte sedimentation rate (ESR), LDH, ALT, AST, fasting blood-glucose and HbA1c were significantly different among infant group, preschool group and school-age group (all P<0.05). Levels of CRP, NEU, ESR, PCT, LDH, ALT, AST, fasting blood-glucose and HbA1c were significantly different between children of normal liver function group and abnormal liver function group (all P<0.05). Bootstrap method test results showed that LDH played a partial mediating role between blood glucose and HbA1c: during normal liver function group, the mediating effect value of LDH was 0.082 (95%CI: 0.041-0.132), and the proportion of mediating effect in the total effect was 38.26%; During the abnormal liver function group, the mediating effect value of LDH was 0.105 (95%CI: 0.057-0.158), and the proportion of mediating effect in the total effect was 41.47%. The restricted cubic spline regression analysis showed that there was a significant nonlinear relationship between LDH and the risk of liver function (P_overall<0.001, P_nonlinear=0.023). GLMMs results showed that among different age groups of children with MPP, LDH levels deviating from the normal range were associated with an increased risk of abnormal liver function, with significant differences (all P<0.05).

There is a significant mediating effect between LDH level of children with MPP of different age groups and the indicators of glucose metabolism. Moreover, LDH level shows a significant nonlinear dose-response relationship with the risk of liver dysfunction. LDH can be used as a potential biomarker for assessing the risk of liver function impairment and glucose metabolism disorders among children with MPP.

To explore the value of preoperative combined monitoring of platelet aggregation function and coagulation indexes in predicting postoperative complications in elderly patients with gastrointestinal tumors.

A retrospective selection was made of 252 elderly patients with gastrointestinal tumors who were scheduled to undergo radical surgery for gastrointestinal tumors in Jieshou People's Hospital and Bozhou People's Hospital from January 2021 to May 2024. The platelet aggregation function [maximum platelet aggregation rate induced by adenosine diphosphate (ADP-MAR), maximum platelet aggregation rate induced by arachidonic acid (AA-MAR)] and coagulation indicators [prothrombin time (PT), D-dimer (D-D), fibrinogen (FIB), activated partial thromboplastin time (APTT)] of all patients 1 day before the operation were collected. The occurrence of complications within 30 days after the operation was recorded, and the patients were divided into the complication group (74 cases) and the non-complication group (178 cases). The clinical data of the two groups and the factors influencing the occurrence of complications were analyzed, and the predictive efficacy of the influencing factors was evaluated.

The overall incidence of postoperative complications was 29.36% (74/252). There were significant differences between the complication group and the non-complication group in terms of age, ASA classification, TNM stage, surgical method, ADP-MAR, AA-MAR, PT, APTT, FIB, and D-D (P<0.05). Spearman correlation analysis showed that preoperative platelet aggregation function indicators and coagulation indicators were significantly positively correlated with the occurrence of complications (P<0.05). Multivariate Logistic regression model analysis showed that age, ADP-MAR, AA-MAR, FIB, D-D levels, and ASA classification were risk factors affecting the occurrence of postoperative complications in elderly patients with gastrointestinal tumors (P<0.05). ROC curve analysis showed that the AUC of the nomogram model for predicting overall complications was 0.906 (95% CI: 0.860-0.953). The AUC for predicting thrombosis-related complications was 0.923 (95% CI: 0.881-0.965), and the AUC for predicting non-thrombosis-related complications was 0.878 (95% CI: 0.821-0.935).

Preoperative combined monitoring of platelet aggregation function and coagulation indexes, combined with clinical characteristics such as age and ASA classification, can effectively identify patients at high risk of postoperative complications in elderly patients with gastrointestinal tumors. This combined monitoring mode can provide evidence-based basis for clinical development of individualized perioperative management plan, thereby reducing the incidence of postoperative complications and improving the prognosis of patients.

To explore the clinical effect of local radiotherapy in patients with recurrent and metastatic colorectal cancer.

The clinical data of 31 patients with recurrent and metastatic colorectal cancer admitted to the Affiliated Hospital of Inner Mongolia Medical University from January 2020 to August 2025 were analyzed retrospectively. These patients received salvage local radiotherapy after multiple lines of treatment failure, with the main goals being palliative symptom relief and local control. Radiotherapy was performed with CT simulation machine enhance scanning for positioning. The target area was delineated using the Pinnacle planning system. The prescription dose of the target area was formulated according to different lesion sites, with the prescription dose of 24-62.5 Gy/10-30 fraction. Different radiotherapy schemes calculated the biologically effective dose (BED, α/β=10) according to the segmentation method, so as to improve the comparability between doses. Chemotherapy and/or targeted immunotherapy were combined during radiotherapy. The clinical efficacy of local lesions was evaluated one month after radiotherapy, and the overall survival time after comprehensive treatment was followed up. At the same time, the adverse reactions of patients were observed during radiotherapy, and the adverse reactions were graded according to the common adverse event evaluation standard (CTCAE 5.0). Kaplan-Meier method was used for survival analysis, and the survival differences between different groups were compared by Log-rank test.

Among the 31 patients in the entire group, the average age was 61 years old, and the median follow-up time was 7.4 months. Up to the end of follow-up, 23 patients died and 8 patients survived. One month after the end of radiotherapy, the clinical effects were: partial remission in 14 cases (45.16%), stable disease in 16 cases (51.61%), progressive disease in 1 case (3.13%), with an objective response rate of 45.2% and a disease control rate of 96.8%. After comprehensive treatment, the median overall survival was 7.2 months, and the one-year overall survival rate was 23%. At the end of radiotherapy, 9 patients had grade 1-2 adverse reactions.

Local radiotherapy has high local control rate and tolerable safety for patients with recurrent and metastatic colorectal cancer after failure of ≥2-line system treatment, and can be used as a salvage treatment option.

To explore the preoperative precise predictive value of multi-parameter combined detection of transrectal ultrasound (TRUS) for lymph node metastasis of middle and low rectal cancer.

The medical records of 200 patients with middle and low rectal cancer who were treated in Hanzhong People's Hospital from March 2022 to March 2024 were retrospectively collected, according to the postoperative pathological results, they were divided into the metastasis group (89 cases) and the non-metastasis group (111 cases). All patients underwent TRUS examination before the operation, and TRUS-related parameters were collected, the predictive efficacy of each parameter and combined detection was analyzed using the receiver operating characteristic (ROC) curve.

The long diameter of lymph nodes, short diameter of lymph nodes, and the ratio of long to short diameter in the metastasis group were significantly larger than those in the non-metastasis group, and the number of cases where rectal masses accounted for more than 1/2 of the intestinal lumen circumference and the number of cases with ultrasound T₃ or above stages were significantly higher than those in the non-metastasis group (P<0.05). ROC curve analysis showed that the AUC, sensitivity and specificity of combined detection of long diameter of lymph nodes, short diameter of lymph nodes, ratio of long to short diameter, rectal mass accounting for more than 1/2 of the intestinal lumen circumference, and ultrasound T₃ and above stages were significantly higher than those of individual detection of each index (P<0.05).

The joint prediction model constructed based on TRUS multi-parameters can effectively improve the preoperative prediction accuracy of lymph node metastasis in middle and low rectal cancer, combined with the nomogram, it can provide reliable references for clinical condition assessment and individualized treatment plan formulation.

To explore the diagnostic value of liver blood flow ultrasound parameters jointed with serum endothelin-1 (ET-1) and nuclear factor-κB (NF-κB) for esophageal gastric variceal bleeding (EVB) in patients with liver cirrhosis.

From February 2022 to May 2024, 98 patients with liver cirrhosis admitted to the First Hospital of Yulin were served as the research subjects (all patients underwent ultrasound examination). Complying with whether the patients developed EVB, they were assigned into EVB group and cirrhosis group, and complying with the severity of EVB patients, they were assigned into mild, moderate, and severe groups. ELISA method was used to detect levels of serum ET-1 and NF-κB. Logistic method was used to analyze the influencing factors of EVB in patients with liver cirrhosis. In addition, ROC curve was used to analyze the diagnostic value of liver blood flow ultrasound parameters jointed with serum ET-1 and NF-κB for EVB in patients with liver cirrhosis.

Compared with the cirrhosis group, the EVB group had prominently higher partal vein diameter(PVD), hepatic venous damping index(HV-DI), serum ET-1, and NF-κB (P<0.05), and prominently lower portal vein flow velocity (PVV) and intrahepatic circulatory time (IHCT) (P<0.05). The PVD, HV-DI, serum ET-1, and NF-κB increased sequentially in the mild, moderate, and severe groups (P<0.05), while the PVV and IHCT decreased sequentially (P<0.05). Logistic analysis showed that prothrombin time, ET-1, and NF-κB were risk factors for EVB in patients with liver cirrhosis (P<0.05), while platelet was a protective factor (P<0.05). ROC curve results showed that the joint of PVD, PVV, HV-DI, IHCT, and serum ET-1 and NF-κB had an AUC of 0.969 for diagnosing EVB in patients with liver cirrhosis, in addition, the AUC of joint diagnosis was better than that of individual indicator detection (Z=2.696, 2.723, 2.706, 2.718, 2.705, 2.699, P<0.05).

Changes in PVD, PVV, HV-DI, IHCT, serum ET-1, and NF-κB levels are all related to EVB in patients with cirrhosis. The combination of hepatic blood flow ultrasound parameters with serum ET-1 and NF-κB has certain clinical value in diagnosing EVB in patients with cirrhosis.

To analyze the risk factors for recurrence in patients with hyperlipidemic acute pancreatitis (HLAP) and to construct a nomogram based on these factors.

A total of 500 patients with HLAP treated in Hanzhong Central Hospital from January 2020 to December 2023 were selected retrospectively and followed up until February 28, 2025. According to the recurrence status during the follow-up period, the patients were divided into non-recurrence group and recurrence group. Baseline data, laboratory indicators, chronic disease history, and HLAP onset information were compared between the two groups. Univariate and multivariate logistic regression analyses were used to identify risk factors for HLAP recurrence, and a nomogram prediction model was established.

The non-recurrence group consisted of 325 patients, while the recurrence group comprised 175 patients. Multivariate logistic regression analysis indicated that body mass index (BMI) >28.24 kg/m² (OR=3.263), C-reactive protein (CRP) >44.12 mg/L (OR=9.215), neutrophil-to-lymphocyte ratio (NLR) >8.93 (OR=8.100), severe acute pancreatitis (SAP) (OR=12.213), and serum calcium (Ca) ≤2.38 mmol/L (OR=8.574) were independent risk factors for HLAP recurrence (P<0.05). The receiver operating characteristic (ROC) curve showed that the area under the curve of this prediction model for HLAP recurrence was 0.992 in the training set and 0.961 in the validation set. The calibration curve indicated that the C-index of the prediction model for HLAP recurrence was 0.788 in the training set and 0.813 in the validation set, and the Hosmer-Lemeshow goodness-of-fit test values were 0.930 (P=0.335) and 0.930 (P=0.628), respectively. The decision curve analysis (DCA) suggested that the model was far from the extreme curves in both the training and validation sets. Sensitivity analysis confirmed that when continuous variables were included in the model in their original form, its predictive performance showed no significant difference from that of the original model (DeLong test P>0.05).

The nomogram prediction model constructed based on the five risk factors (BMI, CRP, NLR, SAP, and Ca) has been validated by ROC curve, calibration curve, and DCA curve, demonstrating significant application value. Additionally, sensitivity analysis confirms that the model is robust and reliable, offering promising clinical benefits.

To explore the risk factors for colonic diverticular disease and construct a risk early warning model.

A retrospective selection was made of 163 patients with colonic diverticular disease diagnosed and treated in Bozhou People's Hospital from January 2022 to January 2024 as the occurrence group. During the same period, 163 individuals who underwent colonoscopy and whose examination results excluded colonic diverticular disease, inflammatory bowel disease and intestinal tumors were selected as the non-occurrence group. For the two groups of clinical data, univariate and multivariate Logistic regression analyses were used to screen for independent risk factors of colonic diverticular disease, and a risk early warning model was constructed. Bootstrap internal validation was used to evaluate the model performance, and the training set and test set were divided in a 7∶3 ratio for validation.

The results of univariate analysis showed that there were significant differences between the two groups of patients in terms of gender, age, dietary habits, family history, constipation, inflammatory polyps, C-reactive protein (CRP), and fecal calprotectin (FC) levels (all P<0.05). The results of multivariate analysis showed that male gender, advanced age, inflammatory polyps and high FC levels were independent risk factors for colonic diverticular disease (all P<0.001). Based on the above factors, a nomogram model was constructed. The C-indices of the training set and the test set were 0.835 and 0.808 respectively. ROC analysis showed that the AUC of the model in the training set was 0.918 and that in the test set was 0.904. The model has good calibration, and the decision curve showed a positive net gain within a wide threshold range.

Male gender, advanced age, and inflammatory polyps are independent risk factors for the occurrence of colonic diverticular disease. FC can serve as a potential biomarker for identifying related subclinical inflammatory activities or predicting the risk of complications. The risk early warning model constructed based on this has good discrimination and calibration, and has certain potential for clinical risk stratification. However, its applicability needs to be further verified in prospective cohorts.