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.

To investigate the learning curve characteristics, influencing factors, and optimization strategies of domestic single-port robotic assisted gynecological surgery, and to analyze proficiency inflection points under different surgical procedures and surgeon backgrounds.

A prospective, multicenter, single-arm clinical trial was conducted at six hospitals across China between Jan. 2023 and Oct. 2025. A total of 97 patients undergoing robotic assisted gynecological surgery using the Shurui SR-ENS-600 system were enrolled, including 32 cases of ovarian cystectomy, 11 cases of myomectomy, 45 cases of hysterectomy, and 9 cases of endometrial cancer staging. Docking time was recorded and compared with literature data. The cumulative sum (CUSUM) method was used to analyze the trend of console time and to identify proficiency inflection points.

In this study, the median age of patients undergoing endometrial cancer staging was lower than that reported in the literature (45 years vs. 61 years), while the age of myomectomy group was higher (42.27 years vs. 36.98 years). The learning curve for docking time was short, with median docking times ranging from 3.00 to 6.00 minutes across hospitals, and 80.4% of cases completed docking within 5 minutes. Significant inter-hospital differences in the learning curves of console time were observed: hospital 1 exhibited a "decline-rebound-decline" pattern, entering the proficiency phase after approximately 25 cases; hospital 5 achieved proficiency from the first case but showed limited subsequent improvement; hospital 6 demonstrated the most typical learning curve, reaching a stable plateau at 5-6 cases. Significant heterogeneity in learning curve inflection points was also found across different surgical procedures: routine procedures (Type 1) achieved proficiency quickly, while difficult procedures (Type 3) required 22 cases to reach a stable plateau (median console time of 105 minutes).

The learning curve for domestic single-port robotic gynecological surgery exhibits significant procedure-dependency and inter-individual heterogeneity. Difficult procedures require more than 20 cases to achieve proficiency, while routine procedures can reach a stable level within 5 cases. Surgeons′ prior experience in single-port laparoscopy and multi-port robotic surgery can significantly shorten the learning cycle for single-port robotic surgery. The domestic Shurui SR-ENS-600 system demonstrates comparable docking time and operative time to the da Vinci SP system, indicating good clinical accessibility and potential for widespread adoption. Dual-console teaching and augmented reality-assisted feedback techniques can help optimize the learning curve.

To compare the safety and efficacy of the KangDuo surgical robotic system (KD-SR-01/KD-SR-02) and the da Vinci surgical robotic system (Si/Xi) in single-position robot-assisted laparoscopic radical nephroureterectomy.

A retrospective review was conducted of 117 patients with upper tract urothelial carcinoma (UTUC) who underwent single-position robot-assisted laparoscopic radical nephroureterectomy at the Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, between Dec. 2021 and Dec. 2024. Among them, 52 patients underwent surgery with the KangDuo robotic system (K-RRNU group), and 65 patients underwent surgery with the da Vinci robotic system (D-RRNU group). Demographic characteristics, clinical data, perioperative outcomes, and follow-up results were collected and compared between the two groups.

There were no significant differences in baseline demographic characteristics or preoperative clinical data between the two groups (P>0.05). Both groups had a 100% surgical success rate, with no conversions to open or conventional laparoscopic surgery. In terms of perioperative outcomes, the K-RRNU group had significantly longer operative time and console time than the D-RRNU group (P<0.05). However, no significant differences were observed between the two groups in complication rates, postoperative length of hospital stay, or oncological outcomes, including recurrence-free survival (RFS) and cancer-specific survival (CSS) (P>0.05). The K-RRNU group had significantly lower hospitalization costs than the D-RRNU group (P<0.05).

Compared with the da Vinci robotic system, the KangDuo robotic system demonstrated comparable safety and efficacy in single-position robot-assisted laparoscopic radical nephroureterectomy.

To compare the clinical outcomes of da Vinci Xi-vNOTES and domestic Shurui SP-vNOTES in hysterectomy.

A retrospective analysis was conducted on 141 patients who underwent hysterectomy at the Second Affiliated Hospital of Nanjing Medical University from Oct. 2024 to Feb. 2026. Among them, 87 patients were in the da Vinci group and 54 patients were in the Shurui group. Baseline data, surgical indicators, perioperative complications, and postoperative recovery were compared between the two groups.

The setup time in the Shurui group was significantly shorter than that in the da Vinci group (3.2±0.8 min vs. 8.1±1.5 min, P<0.001). There were no statistically significant differences between the two groups in operative time, intraoperative bleeding volume, postoperative pain score, time to first ambulation, time to first urination, time to first flatus, and complication rate (P>0.05). In the da Vinci group, there was one case of bladder injury and one case of transumbilical single-port surgery; no such events occurred in the Shurui group.

The domestic Shurui SP-vNOTES demonstrates good safety and efficacy in hysterectomy, with superior setup efficiency compared to da Vinci Xi-vNOTES. Its clinical outcomes are comparable to those of the da Vinci group, making it a feasible alternative for minimally invasive gynecological surgery in China.

To compare the clinical efficacy of three-port reduced-port laparoscopic surgery with conventional five-port laparoscopic surgery for radical resection of colorectal cancer, and to evaluate the safety, effectiveness, and clinical value of the three-port approach.

A retrospective analysis was conducted on the clinicopathological data of 84 patients who underwent laparoscopic radical resection for colorectal cancer at our institution between Jan. 2024 and Mar. 2025. According to the port configuration used during surgery, patients were divided into a three-port group (reduced-port group, n=26) and a five-port group (conventional group, n=58). Baseline characteristics, intraoperative parameters, oncological outcomes, postoperative recovery, and complication rates were compared between the two groups.

No significant differences were observed in baseline characteristics, including sex, age, BMI, NRS 2002 score, history of prior abdominal surgery, preoperative hemoglobin levels, or tumor location (all P>0.05), indicating good baseline comparability. The total abdominal incision length was significantly shorter in the three-port group(5.2±1.2 cm) compared to the five-port group(7.8±0.8 cm) (P<0.001). The time to first postoperative flatus was significantly earlier in the three-port group compared with the five-port group (48.5 ± 8.2 h vs. 56.8±10.5 h; P<0.001). There were no statistically significant differences in operative time, intraoperative blood loss, tumor size, pathological T stage, or number of harvested lymph nodes (all P>0.05). The overall postoperative complication rate was comparable between the two groups (P>0.05).

The three-port reduced-port laparoscopic approach for radical resection of colorectal cancer achieves comparable oncological outcomes and safety to the conventional five-port method. It offers distinct advantages in terms of shorter incision length and faster recovery of gastrointestinal function, without increasing operative time, blood loss, or complication risk. This technique is safe, effective, and minimally invasive, and represents a promising surgical option worthy of broader clinical adoption in high-volume centers with established laparoscopic expertise.

Artificial intelligence is reshaping the landscape of gastric cancer surgery. Deep learning-based technologies, with their powerful capabilities in multidimensional data mining and pattern recognition, have demonstrated significant value across key clinical scenarios, including preoperative accurate staging, screening of occult peritoneal metastasis, prediction of neoadjuvant therapy response, intraoperative lymph node dissection and functional preservation, and postoperative individualized adjuvant therapy decision-making. The integration of radiomics and deep learning has increased the area under the curve (AUC) for predicting occult peritoneal metastasis to over 0.92. Intraoperative AI combined with indocyanine green fluorescence navigation and three-dimensional reconstruction offers a novel approach to preserve tumor-draining lymph nodes (TDLNs) without compromising oncological radicality. In the field of adjuvant therapy, AI can efficiently identify molecular features such as microsatellite instability-high (MSI-H), Epstein-Barr virus positivity, and HER2 expression from routine histopathological sections, facilitating precise selection of patients who are most likely to benefit from immunotherapy and targeted therapy. However, clinical translation of AI still faces challenges, including a lack of high-quality datasets, insufficient model interpretability, and weak prospective validation. In the future, surgeons should engage deeply in the development and iteration of AI models as definers of clinical problems and producers of high-quality data, and promote innovation through multimodal integration, federated learning, and explainable algorithms, thereby driving gastric cancer surgery from an experience-driven discipline toward a new paradigm of data-driven precision minimally invasive surgery.

As a product of the profound integration of medicine and engineering, robotic surgery has evolved over more than three decades into a cornerstone of minimally invasive procedures, now widely applied in urology, general surgery, gynecology, and neurosurgery. Robotic platforms exemplified by the da Vinci system have markedly enhanced operative precision, three-dimensional visualization, and procedural stability; however, limitations persist in haptic feedback, human–machine interaction, and system integration. Looking ahead, robotic surgery is poised to advance toward greater subspecialization, miniaturization, natural orifice approaches, and intelligent functionality. The integration of artificial intelligence will catalyze breakthroughs in autonomous navigation, optimized force feedback, data-driven decision-making, and postoperative surveillance, enabling a transition from master–slave assistance to higher levels of automation. This evolution promises not only enhanced safety and accuracy, but also a profound transformation of personalized medicine and contemporary models of diagnosis and treatment.

To investigate the role and molecular mechanism of the transcription factor Krüppel-like factor 4 (KLF4) in acinar cell injury in acute pancreatitis (AP), and whether it mediates pyroptosis through the TXNIP/mtROS/NLRP3 axis.

AR42J cells were stimulated with cerulein (100 nmol/L, 3 h) to establish an AP model. The cells were divided into control, model, si-NC, si-KLF4, and si-KLF4+MitoPQ groups. Cell viability, injury markers, pyroptosis-related proteins, mitochondrial function, mtROS, TXNIP-NLRP3 colocalization were detected.

KLF4 was upregulated in AP. Knockdown of KLF4 improved cell viability and reduced injury, inhibited NLRP3 inflammasome activation, pyroptosis, downregulated TXNIP, improved mitochondrial function, decreased mtROS, and attenuated TXNIP-NLRP3 colocalization. Exogenous mtROS partially reversed these protective effects.

KLF4 activates the NLRP3 inflammasome by regulating the TXNIP/mtROS axis, thereby mediating pyroptosis of acinar cells in AP.

To analyze the relationship between Helicobacter pylori (Hp) infection and gene polymorphisms of CYP2C19 and leukocyte differentiation antigen 14 (CD14) in patients with early gastric cancer and analyze its influence on short-term recurrence after endoscopic submucosal dissection (ESD).

A total of 201 patients with early gastric cancer who underwent ESD in the First Affiliated Hospital of Harbin Medical University were selected retrospectively between July 2018 and July 2023, and were divided into Hp infection group (n=93) and non-Hp infection group (n=108) according to Hp infection status. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to detect the gene polymorphisms of CYP2C19 and CD14. The relationship between Hp infection and short-term recurrence of patients with early gastric cancer after ESD was analyzed, and multivariate Cox regression analysis was used to analyze the risk factors affecting the short-term recurrence after ESD.

The composition ratio of PM in Hp infection group was significantly higher than that in non-Hp infection group (P<0.05). The frequencies of TT genotype and T allele were significantly higher in Hp infection group than those in non-Hp infection group (P<0.05). The short-term recurrence rate after ESD in Hp infection group was significantly higher compared with that in non-Hp infection group (P<0.05). In patients with early gastric cancer, Hp infection (HR=2.783, 95% CI: 1.214-6.430) and gene polymorphisms of CD14 (HR=2.894, 95% CI: 1.101-7.614) were risk factors affecting the short-term recurrence after ESD (P<0.05).

The gene polymorphisms of CYP2C19 and CD14 in patients with early gastric cancer are related to Hp infection. The PM of CYP2C19 gene and TT genotype and T allele of CD14 gene may increase the risk of Hp infection, and Hp infection, gene polymorphisms of CD14 are risk factors that affect the short-term recurrence of patients with early gastric cancer after ESD.

To explore the association between Helicobacter pylori (Hp) infection and cardiovascular health scores based on the "Life's Simple Seven" (LS7), and to analyze the mediating effect of systemic inflammation and the moderating effect of gender.

This study was designed as a retrospective study, enrolling 206 subjects each from the Hp-infected group and non-Hp-infected group who visited Beijing Hospital from December 2023 to December 2025, and demographic data, LS7 component scores, blood biochemical indicators and inflammatory markers were collected. Multivariate linear regression analysis was performed to assess the independent association between Hp infection and total LS7 score. Structural equation modeling (SEM) was utilized to investigate the mediating role of high-sensitivity C-reactive protein (hs-CRP), and gender differences were analyzed via a moderated mediation model.

The total LS7 score was significantly lower in the Hp-infected group than that in the non-Hp-infected group (8.2±2.1 vs. 10.5±2.0, P<0.001), and the Hp infection rate increased progressively as LS7 health grades deteriorated (28.1% in the ideal group, 50.5% in the moderate group, and 75.0% in the poor group). Mediation analysis demonstrated that hs-CRP partially mediated the adverse effect of Hp infection on LS7 scores, contributing to approximately 38% of the total effect (standardized β=-0.38, P<0.001). Moderation effect analysis showed that the detrimental effect of Hp infection on cardiovascular health was significantly more pronounced in males (β=-0.955) than that in females (β=-0.875).

Hp infection is significantly associated with suboptimal cardiovascular health, and systemic inflammation acts as a crucial mediating pathway. This association is characterized by gender differences, with more marked adverse effects in males. This implies that evaluating inflammatory status and implementing comprehensive interventions for Hp-infected individuals may be of potential value in cardiovascular health management.

To explore the efficacy of Baiji Yulian decoction combined with triple therapy in the treatment of helicobacter pylori (Hp)-infected gastric ulcer with syndrome of spleen and stomach damp-heat.

This study was a prospective randomized controlled trial. Ninety-six Hp-positive gastric ulcer patients admitted to Dongguan People's Hospital from February of 2023 to June of 2024 were selected and divided into observation group (48 cases) and control group (48 cases) by random number table method. The control group received triple therapy, and the observation group was given with Baiji Yulian decoction on the basis of control group. Both groups were treated continuously for 4 weeks. The curative effect of syndrome, gastroscopic effect, single symptom scores of spleen and stomach damp-heat, Hp clearance rate, stool occult blood conversion rate after 3 days of treatment, inflammatory factors, pepsinogenⅠ (PGⅠ), trefoil factor 2 (TFF2), vascular endothelial growth factor (VEGF), and occurrence of adverse reactions were compared between the two groups.

After 4 weeks of treatment, the total curative effect of syndrome of observation group (91.67%) was significantly higher than that of control group (72.92%) (P<0.05). The gastroscopic effect of syndrome of observation group (89.58%) was significantly higher than that of control group (70.83%) (P<0.05). The spleen and stomach damp-heat syndrome score was significantly decreased in two groups, and the decrease was more significant in the observation group (P<0.05). The Hp clearance rate of observation group was 95.83%, which was significantly higher than that of control group (79.17%) (P<0.05). After 3 days of treatment, stool test results turned negative in 26 cases (54.17%) of the observation group and 17 cases (35.42%) of the control group, and the number of negative conversion cases was significantly higher in the observation group than in the control group (P<0.05). The serum levels of tumor necrosis factor-α, interleukin (IL)-6, IL-10 and PGⅠ in two groups were significantly decreased, and the decrease was more significant in observation group (P<0.05). The levels of serum TFF2 and VEGF significantly increased, and the increase was more pronounced in the observation group (P<0.05). The incidence of adverse reactions was 20.00% in the observation group and 6.67% in the control group, and there was no statistically significant difference between the two groups (P>0.05).

Baiji Yulian decoction combined with triple therapy is highly effective in treating Hp-infected gastric ulcer with syndrome of spleen and stomach damp-heat. It can improve the symptoms of spleen and stomach damp-heat syndrome, increase Hp clearance rate, promote the conversion of occult blood in the stool to negative, inhibit inflammatory response, regulate gastrointestinal hormone level, with safe and reliable drug use.

To explore the value of the combined application of color Doppler flow imaging (CDFI) and shear wave elastography (SWE) in the diagnosis and fibrosis staging of non-alcoholic fatty liver disease (NAFLD).

This study was a retrospective cohort study. A total of 80 cases of patients with NAFLD admitted to Honghui Hospital, Xi'an Jiaotong University from August 2022 to August 2025 were selected as the observation group, and 80 healthy individuals who underwent physical examinations in our hospital during the same period were selected as the control group. The liver CDFI examination parameter [portal vein main inner diameter (PVD), portal vein mean blood flow velocity (PVVmean), portal vein blood flow (PVQ), splenic vein inner diameter (SVD), splenic vein mean blood flow velocity (SVVmean), splenic vein blood flow (SVQ)] and SWE (Young's modulus value) between the two groups were compared, the occurrence of liver fibrosis in the observation group was recorded, and the liver CDFI examination parameter and SWE results of patients with different degrees of liver fibrosis were compared. The receiver regression curve (ROC) was used to analyze the diagnostic value of liver CDFI and SWE for NAFLD and liver fibrosis respectively.

The PVD, PVQ, SVD, SVQ and Young's modulus values in the observation group were greater than those in the control group, while the PVVmean and SVVmean were lower than those in the control group (P<0.05). In the observation group, there were 40 cases of liver fibrosis in stage S0, 26 cases in stage S1, 9 cases in stage S2, 3 cases in stage S3, and 2 cases in stage S4, and the comparisons of PVD, PVVmean, PVQ, SVD, SVVmean, and SVQ among patients with different liver fibrosis grades revealed statistically significant differences (P<0.05). ROC analysis showed that the area under the curve (AUC) of liver CDFI parameters combined with SWE for diagnosing NAFLD was higher than that of single detection, and the AUC of liver CDFI parameters combined with SWE for diagnosing liver fibrosis in NAFLD patients was also higher than that of single detection (P<0.05).

Liver CDFI combined with SWE has a high diagnostic value for both NAFLD and liver fibrosis, and should be closely monitored in clinical practice.

To explore the diagnostic value of two-dimensional shear wave elastography (2D-SWE) combined with the fibrosis-4 (FIB-4) score in diagnosing significant liver fibrosis in patients with non-alcoholic fatty liver disease (NAFLD).

This study was a retrospective study. A total of 150 patients with NAFLD from the First Hospital of Yulin City from January 2023 to January 2025 were selected as the research subjects. patients were classified into two groups according to the Metavir staging criteria for liver fibrosis: non-significant liver fibrosis (F0-F1 stage, n=88) and significant liver fibrosis (F2-F4 stage, n=62). All patients underwent 2D-SWE examination, recording Young's modulus and shear wave velocity (SWV), while serum markers were measured and the FIB-4 score was calculated. Receiver operating characteristic (ROC) curve analysis was employed to evaluate the diagnostic efficacy of individual and combined application of various indicators for significant fibrosis in NAFLD.

The aspartate aminotransferase and alanine aminotransferase levels in the significant liver fibrosis group were significantly higher than those in the non-significant liver fibrosis group, while the platelet count was significantly lower (P<0.05); the Young's modulus, SWV, and FIB-4 scores in the significant liver fibrosis group were significantly higher than those in the non-significant liver fibrosis group (P<0.05); ROC curve analysis showed that the area under the curve (AUC) for the combined diagnosis of significant liver fibrosis in NAFLD using Young's modulus value, SWV, and FIB-4 score was 0.934, with sensitivity and specificity of 90.70% and 85.94%. The AUC for each single indicator diagnosis was 0.890, 0.858, and 0.823; the Delong test showed that the AUC of the combined diagnosis was significantly higher than that of each single indicator (P<0.05).

The 2D-SWE parameter, including Young's modulus value and SWV combined with FIB-4 score, can effectively improve the diagnostic sensitivity and specificity. They can be used as a preferred non-invasive clinical assessment of the degree of liver fibrosis in patients with NAFLD.