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.

Abnormal neuroregulation of coronary microcirculation is one of the important mechanisms leading to myocardial ischemia symptoms, but coronary angiography shows no obstructive lesions. Studies have shown that sympathetic and parasympathetic nerves dynamically regulate microvascular tension through α/β adrenergic receptors, cholinergic receptors and various neurotransmitters (such as neuropeptide Y and calcitonin gene-related peptide). And their dysfunction is closely related to non-obstructive coronary artery ischemia. Based on the anatomical and functional characteristics of coronary microcirculation innervation, this paper systematically summarizes its regulation mechanism, which provides theoretical basis for clinical diagnosis and optimization of treatment strategy.

Heat stroke represents the most severe manifestation of heat-related illnesses, characterized by a core body temperature exceeding 40 ℃, accompanied by central nervous system dysfunction and multiple organ dysfunction syndrome. This condition is highly fatal, and results from exposure to high-temperature environments or strenuous physical activity, which leads to excessive heat production and an imbalance between heat generation and dissipation, culminating in multi-system damage. As global temperatures continue to rise, the incidence of heat stroke is anticipated to increase, with a concomitant rise in mortality rates. The cardiovascular system plays a pivotal role in thermoregulation, and the primary pathological features of myocardial tissue injury in heat stroke include systemic inflammatory responses, endothelial cell damage, ferroptosis, myocardial metabolic disorders, and dysregulation of heat shock proteins. This article provides a comprehensive review of the pathophysiological effects of heat stroke on the cardiovascular system, with the aim of informing future research on the mechanisms underlying cardiac damage induced by heat stroke.

To explore the tumor growth of breast cancer (BC) during the interval from the completion of neoadjuvant therapy (NAT) to surgery.

The clinical data of 106 breast cancer patients after neoadjuvant therapy treated between January 2020 and November 2025 were retrospectively analyzed. Among them, 68.9% received chemotherapy alone (chemotherapy-only group), and 31.1% received chemotherapy combined with anti-human epidermal growth factor receptor 2 (HER2) therapy (combined therapy group). Continuous variables with normal distribution were expressed as （

The interval from the end of neoadjuvant therapy to surgery ranged from 8 to 28 days, with a mean of (15.0±3.2) days. The 95% reference range of the interval was 9 to 21 days, and all patients underwent surgery within 4 weeks (28 days) after NAT completion. No significant correlations were observed between each time interval (interval from NAT completion to surgery, interval from NAT completion to MRI examination, interval from post-NAT MRI to surgery) and tumor size recorded in pathological reports. The only parameter significantly correlated with pathological tumor size was the tumor size measured by MRI after neoadjuvant therapy (r=0.820), (P<0.001). The difference in tumor size between post-NAT MRI measurement and surgical pathology showed no correlation with the time interval from NAT completion to surgery (P>0.05). The ratio of residual tumor size on post-NAT MRI to the interval from NAT completion to surgery was significantly correlated with pathological tumor size (P<0.001), indicating that neoadjuvant therapy still exerted favorable effects for several weeks after treatment completion.

All enrolled patients underwent surgery within 4 weeks after neoadjuvant therapy. No significant correlation was found between time interval and tumor progression. Combined with the conventional surgical window of 2-4 weeks in domestic and international clinical practice for breast cancer after neoadjuvant therapy, performing surgery within 2 to 4 weeks after the completion of neoadjuvant chemotherapy is reasonable. This time window is unlikely to cause clinically meaningful changes in residual tumor size.

To explore the characteristics of lymph node metastasis distribution, risk factors, and prognostic differences between upper and lower gastric cancers.

A retrospective analysis was conducted on the clinical case data of 1 318 patients with gastric adenocarcinoma who underwent radical gastrectomy from January 2018 to January 2020. The patients were divided into the upper gastric cancer group (n=612) and the lower gastric cancer group (n=706) based on the tumor location. SPSS 26.0 statistical software and R 4.2.2 software were used to analyze the data. The characteristics of lymph node metastasis in the two groups were compared. Logistic regression and Cox regression were used to analyze the risk factors and prognostic influencing factors.

The lymph node metastasis rate of upper gastric cancer was higher than that of lower gastric cancer (35.3% vs 28.3%, P=0.009), and the number of metastatic lymph nodes was greater (3.9±3.2 vs 3.0±2.8, P<0.001). The upper gastric cancer mainly metastasized to the 1st, 2nd, 3rd, and 7th groups of lymph nodes, while the lower gastric cancer mainly metastasized to the 3rd, 6th, 7th, and 4th groups. Tumor length ≥ 4 cm, low differentiation, pT3-4 stage, vascular invasion, and nerve invasion were independent risk factors for lymph node metastasis (all P<0.05). The 3-year survival rate of upper gastric cancer was lower than that of lower gastric cancer (88.7% vs 96.0%, P<0.001); age ≥ 60 years, upper gastric tumor, low differentiation, pTNM stage Ⅲ, positive vascular invasion, and no receiving adjuvant chemotherapy were independent prognostic factors (all P<0.05).

There are significant differences in the lymph node metastasis patterns and prognosis between upper and lower gastric cancers.

To explore the application effect of non-sectored Roux-en-Y anastomosis during the operation of resectable gastric cancer (T1-4aN0-3M0) under total 3D laparoscopy in digestive tract reconstruction.

The medical records of 102 patients with resectable gastric cancer from June 2022 to June 2025 were retrospectively analyzed. The patients were divided into the observation group (non-sectored Roux-en-Y anastomosis, n=57) and the control group (traditional anastomosis, n=45) based on different surgical methods. The surgical indicators, serum tumor markers, inflammatory factor levels, gastroscopy conditions, and complications were compared between the two groups. The data were analyzed using SPSS21.0 statistical software. The measurement data with normal distribution were expressed as (

The total operation time, digestive tract reconstruction time, time of first oral intake after surgery, intraoperative blood loss, and number of lymph nodes detected after surgery in the observation group were significantly different from those in the control group (P<0.05); there were no statistically significant differences in the postoperative anal exhaust time, gastric tube retention time, and postoperative hospital stay between the two groups (P>0.05); the postoperative carcinoembryonic antigen (CEA), cytokeratin 19 fragment (CYFRA21-1), and carbohydrate antigen 125 (CA125) in the observation group were lower than those in the control group, and the differences were statistically significant (P<0.05); the postoperative interleukin-6 (IL-6), C-reactive protein (CRP), and white blood cell count (WBC) in the observation group were lower than those in the control group, and the differences were statistically significant (P<0.05); the total incidence of complications in the observation group was lower than that in the control group, and the incidences of food retention and residual gastritis were lower, and the differences were statistically significant (P<0.05); the incidence of bile reflux was not statistically significant (P>0.05).

In the total 3D laparoscopic radical resection of resectable gastric cancer, patients with non-sectored Roux-en-Y anastomosis have better intraoperative and early postoperative indicators than those with traditional anastomosis, and have lower tumor markers and inflammatory factor levels after surgery, with good short-term efficacy and safety.

To investigate the impact of anastomosis with a loop and the Roux-en-Y anastomosis on the quality of life of patients after total gastrectomy, and to provide a reference for the selection of clinical surgical methods.

A total of 495 patients with gastric cancer who underwent total gastrectomy from January 2022 to December 2023 were included. According to the different methods of digestive tract reconstruction, the patients were divided into the loop anastomosis group (with loop anastomosis, n = 40) and the Roux-en-Y anastomosis group (with Roux-en-Y anastomosis, n=455). To control confounding factors between the groups and reduce the selection bias in the retrospective study, this study used propensity score matching (PSM) to match the patients in the two groups. The data were based on the cohort after PSM matching (n=80). The perioperative indicators, complications, and the Postoperative Gastric Resection Syndrome Assessment Scale-45 (PGSAS-45) score at 1 year after gastric resection were compared between the two groups using the χ² test or t test. P<0.05 was considered statistically significant.

The operation time of the loop anastomosis group was significantly shorter than that of the Roux-en-Y group, and the time to start liquid diet and the time to remove the drainage tube were shorter in the loop anastomosis group than in the Roux-en-Y group, but the duration of gastric tube retention was longer (P<0.05). In the PGSAS-45 scale, the esophageal reflux scale score of the Roux-en-Y group was better than that of the loop anastomosis group (P<0.05).

Both anastomosis with a loop and Roux-en-Y anastomosis are safe and feasible after total gastrectomy, and the overall quality of life is similar. The loop anastomosis is conducive to early postoperative recovery, while the Roux-en-Y anastomosis has a greater advantage in controlling esophageal reflux. Clinicians should choose the surgical method based on the individual circumstances of the patients.

To compare the therapeutic effects of primary suture and T-tube drainage in the treatment of common bile duct stones using laparoscopic common bile duct exploration and drainage (LCBDE).

The clinical data of 103 patients with common bile duct stones who underwent LCBDE from January 2023 to May 2025 were retrospectively analyzed. The patients were divided into the primary suture group (n=55, with primary suture) and the T-tube drainage group (n=48, with T-tube drainage) based on the suture method of the common bile duct during LCBDE. χ² test or t test was used to compare the surgical indicators, liver function indicators, pain degree, stress response indicators, and complications between the two groups. P<0.05 was considered statistically significant.

The suture time of the common bile duct, operation time, drainage tube removal time, and hospital stay in the primary suture group were significantly shorter than those in the T-tube drainage group (all P<0.001). On the 3rd day after surgery, there was no statistically significant difference in the total bilirubin (TBIL), alkaline phosphatase (ALP), and alanine aminotransferase (ALT) levels between the two groups (P>0.05), but the levels of interleukin-6 (IL-6), cortisol (Cor), C-reactive protein (CRP), and visual analogue scale (VAS) score in the primary suture group were lower than those in the T-tube drainage group (all P<0.001); there was no statistically significant difference in the total incidence of complications between the two groups at 6 months after surgery (P>0.05).

Compared with T-tube drainage, primary suture during LCBDE can shorten the operation time of patients with common bile duct stones, promote postoperative recovery, alleviate postoperative pain, and reduce stress response.

Based on the propensity score matching (PSM) method, this study aims to explore the efficacy differences between emergency and elective surgeries for patients with gallbladder stones and common bile duct stones in high-altitude areas, as well as the impact of the high-altitude environment on prognosis.

The clinical data of 386 patients with gallbladder stones and common bile duct stones from January 2015 to December 2020 were retrospectively analyzed. The patients were divided into the emergency group (n=152) and the elective group (n=234) according to the timing of surgery. PSM was used to balance age, ASA classification, comorbidities, and preoperative laboratory indicators as the main confounding factors, and finally, 138 cases were successfully matched in each group. t tests or χ² tests were used to compare and analyze short-term complications, liver function recovery, etc. between the two groups.

The total incidence of postoperative complications, 5-year cumulative stone recurrence rate, reoperation rate, and hospitalization costs in the elective group were significantly lower than those in the emergency group (P<0.05); the postoperative recovery rate of liver function in the elective group was significantly faster than that in the emergency group, and the final SF-36 quality of life score at follow-up was higher (P<0.05). There was no statistically significant difference in the 30-day postoperative mortality and 5-year cumulative survival rate between the two groups (P>0.05).

For patients with stable conditions of gallbladder stones and common bile duct stones in high-altitude areas, elective surgery is significantly superior to emergency surgery in reducing short-term complications, reducing long-term stone recurrence, and improving quality of life.

To observe the application effect of laparoscopy combined with ultra-thin choledochoscope in patients with common bile duct stones and gallbladder stones.

118 patients with common bile duct stones and gallbladder stones were selected and divided into the observation group (treated with laparoscopy + ultra-thin choledochoscope for exploration and stone removal through the gallbladder and common bile duct) and the control group (treated with laparoscopy + choledochoscope incision for stone removal). Each group consisted of 59 patients. The differences in perioperative indicators and postoperative complications between the two groups were compared using the χ² test; the differences in inflammatory and stress response indicators between the two groups were compared using the independent sample t test.

The total effective rate of the observation group and the control group was 96.6% and 93.2% respectively, with no statistically significant difference (P>0.05), but the improvement rate of the observation group was higher than that of the control group (P<0.05). Compared with the control group, the observation group had less intraoperative blood loss, better intestinal recovery and shorter hospital stay (P<0.05), and lower levels of postoperative procalcitonin (PCT), C-reactive protein (CRP), norepinephrine (NE), cortisol (COR), epinephrine (AD) and complication rates (P<0.05).

Laparoscopy combined with ultra-thin choledochoscope exploration and stone removal through the gallbladder and common bile duct can effectively reduce the intraoperative trauma of patients with common bile duct stones and gallbladder stones, improve inflammation and stress response, and have fewer complications.

To explore the risk factors for intestinal obstruction after laparoscopic ventral incisional hernia repair with synthetic anti-adhesion mesh, and summarize relevant prevention and treatment strategies.

A total of 296 patients who underwent laparoscopic ventral incisional hernia repair using synthetic anti-adhesion mesh from September 2018 to March 2024 were enrolled as research subjects. Patients were divided into the intestinal obstruction group (n=35) and the non-intestinal obstruction group (n=261) according to whether postoperative intestinal obstruction occurred. Statistical analyses were conducted with SPSS 22.0 software. The least absolute shrinkage and selection operator (LASSO) regression was adopted to screen potential influencing factors of postoperative intestinal obstruction. Multivariate Logistic regression was used to identify independent risk factors, and fitting curves were plotted to analyze the correlation between each risk factor and the incidence of postoperative intestinal obstruction. A predictive model was established based on the screened risk factors, and the diagnostic performance of the model was evaluated. A P value less than 0.05 was defined as statistically significant.

The average age of the 296 patients was (62.5±14.6) years old. Among them, 66 cases (22.3%) were complicated with ascites, 62 cases (20.9%) with chronic cough, 35 cases (11.8%) with chronic constipation, 38 cases (12.8%) with benign prostatic hyperplasia, and 95 cases (32.1%) without any comorbidities. Compared with the non-intestinal obstruction group, the intestinal obstruction group presented significantly prolonged time to recovery of intestinal peristalsis and bowel sounds, first flatus, first defecation and first oral feeding, impaired intestinal function, and elevated levels of β-endorphin (β-EP); meanwhile, the levels of motilin, gastrin, insulin (InS), growth hormone (GH) and total antioxidant capacity (T-AOC) were markedly decreased (P<0.05). LASSO regression and multivariate Logistic regression analyses demonstrated that body mass index (BMI), hernia defect size, operative duration, and factors leading to elevated intra-abdominal pressure were independent risk factors for postoperative intestinal obstruction (all (P<0.05). Fitting curve analysis indicated that the incidence of postoperative intestinal obstruction was positively correlated with BMI, hernia defect size and operative duration. A predictive model was constructed, and receiver operating characteristic (ROC) curve analysis revealed that the area under the curve (AUC) of this model was 0.825 [95% confidence interval (95%CI): 0.775~0.899], with a sensitivity of 0.846 and a specificity of 0.699.

Patients with BMI >25 kg/m², hernia defect size ≥8 cm, operative duration ≥120 min, or predisposing factors for elevated intra-abdominal pressure carry a high risk of intestinal obstruction after laparoscopic ventral incisional hernia repair with synthetic anti-adhesion mesh. Early clinical interventions should be implemented to reduce the incidence of this postoperative complication.

To investigate the protective effect of No.253 lymph node dissection centered on the inferior mesenteric artery (IMA) on autonomic nerves during radical resection of rectal cancer with preservation of the left colic artery (LCA).

A total of 90 patients undergoing radical resection for rectal cancer were prospectively enrolled from January 2020 to June 2025. The patients were divided into three groups using the random number table combined with block randomization, with 30 cases in each group. Group A: LCA non-preservation plus conventional No.253 lymph node dissection; Group B: LCA preservation plus conventional No.253 lymph node dissection; Group C: LCA preservation plus IMA-centered No.253 lymph node dissection. Measurement data conforming to normal distribution were expressed as (

Compared with Group A, Group B and Group C had longer operative time, shorter time to first flatus and shorter postoperative hospital stay (P<0.05). Group C presented less intraoperative blood loss and faster gastrointestinal function recovery (P<0.05). Compared with Group B, Group C had a shorter recovery time of gastrointestinal function (P<0.05). There were no significant differences among the three groups in the total number of dissected lymph nodes, number of No.253 lymph nodes, lymph node positive rate and circumferential resection margin (CRM) positive rate (P>0.05). For male patients in Group C, the incidence of urinary retention, International Prostate Symptom Score (IPSS), incidence of erectile dysfunction and International Index of Erectile Function-5 (IIEF-5) score were all superior to those in Group A and Group B (P<0.05). For female patients in Group C, the incidence of urinary retention, International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms (ICIQ-FLUTS) score and Female Sexual Function Index (FSFI) score were also better than those in the other two groups (P<0.05). No significant difference was found in the cumulative disease-free survival rate among the three groups (P>0.05).

In radical resection of rectal cancer with LCA preservation, IMA-centered No.253 lymph node dissection can effectively protect autonomic nerves and improve perioperative recovery indicators, while ensuring adequate lymph node dissection. This surgical technique does not affect patients' disease-free survival, and possesses advantages in nerve protection as well as oncological safety.

The aim of this study was to develop and validate a practical prognostic nomogram integrating preoperative inflammatory and nutritional indicators to assess the survival outcomes of patients with early-onset rectal cancer (EORC).

A total of 326 patients with EORC who underwent radical resection were retrospectively included and randomly divided into a training cohort and a validation cohort. Preoperative inflammatory and nutritional indicators were calculated based on routine laboratory test data, and an inflammatory-nutritional risk score (RS) was constructed. The RS was obtained through a weighted linear combination of the LASSO-sellected neutrophil/lymphocyte ratio (NLR), systemic inflammatory response index (SIRI), systemic immune-inflammatory index (SII), platelet/lymphocyte ratio (PLR), nutritional immune-inflammatory index (ALI), and prognostic nutritional index (PNI). Multivariate survival analysis was used to screen independent prognostic factors, and a nomogram for predicting overall survival (OS) was established. The performance of the model was evaluated using discrimination, calibration, and clinical decision curve analysis (DCA).

Multivariate analysis showed that age, TNM stage, serum albumin level, and the inflammatory-nutritional risk score were independent predictors of OS. The constructed nomogram demonstrated good discrimination and calibration for 1-year, 3-year, and 5-year OS in both the training cohort and validation cohort.

This study developed and validated a simple and clinically practical inflammatory-nutritional nomogram that can integrate routine preoperative indicators, providing an auxiliary decision-making basis for postoperative risk stratification and individualized follow-up management of patients with EORC.