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 effect of Huangqi Yijiang decoction combined with FOLFOX6 chemotherapy on immune function and quality of life in patients with Qi-deficiency and heat-toxin type after colorectal cancer surgery.

A total of 134 patients who underwent laparoscopic radical resection for colorectal cancer and received adjuvant chemotherapy at the Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from September 2022 to December 2024 were prospectively selected as the research objects. According to the random number table method, they were divided into conventional group (FOLFOX6+conventional treatment) and treatment group (FOLFOX6+Huangqi Yijiang decoction), with 67 cases in each group. The TCM syndrome score, CD4⁺, CD8⁺, carcino-embryonic antigen (CEA), carbohydrate antigen (CA)19-9, CA72-4 levels and KPS score before and after treatment were compared between the two groups.

After 6 treatment courses (14 days per course), compared with the conventional group, the TCM syndrome score and serum CEA, CA199 and CA724 levels in the treatment group were decreased (all P<0.05). Compared with the conventional group, CD4⁺, CD4⁺/CD8⁺ ratio and KPS score were increased, CD8⁺ cell level and the incidence and severity of nausea, vomiting and diarrhea were decreased in the treatment group (all P<0.05).

Huangqi Yijiang decoction combined with FOLFOX6 regimen can effectively improve the immune function and quality of life of patients with Qi-deficiency and heat-toxin after colorectal cancer surgery, and reduce adverse reactions of chemotherapy.

To investigate the application effects of different anastomosis methods in laparoscopic right hemicolectomy for colon cancer, and to analyze the prognosis.

A retrospective analysis was conducted on the medical records of 140 patients who underwent laparoscopic right hemicolectomy for colon cancer at Qingdao Central Hospital, University of Health and Rehabilitation Sciences from January 2020 to January 2022. According to different anastomosis methods, patients were divided into Overlap anastomosis group (n=70) and π anastomosis group (n=70). The operation status, postoperative recovery, postoperative complications, disease-free survival rate and cancer-free survival rate were compared between the two groups.

There was no difference in surgical duration and intraoperative blood loss between the two groups (P<0.05). The first anal exhaust, defecation, feeding, and hospitalization time in the Overlap anastomosis group were shorter than those in the π anastomosis group (P<0.05). During hospitalization, the incidence of postoperative intestinal obstruction in Overlap anastomosis group was lower than that in π anastomosis group (P<0.05). The 3-year disease-free and cancer-free survival rates in Overlap anastomosis group were higher than those in π anastomosis group (P<0.05).

After laparoscopic right hemicolectomy, the Overlap anastomosis technique can accelerate postoperative gastrointestinal recovery, reduce the incidence of postoperative intestinal obstruction, and improve long-term survival rates.

To explore the molecular mechanism by which LncRNA GABPB1-AS1 promotes the proliferation, invasion and migration of human colorectal cancer cells by targeting hsa-miR-30b-3p.

Human normal colorectal mucosal cell line FHC and human colorectal cancer cell lines HT-29, SW480, LOVO and WiDr were cultured in vitro. HT-29 cells were transfected with si-NC, si-LncRNA GABPB1-AS1, miR-30b-3p inhibitor control and miR-30b-3p inhibitor. The differential expression and potential target binding sites of GABPB1-AS1 and hsa-miR-30b-3p in colorectal cancer tissues and adjacent tissues were predicted through the Starbase database, and the impact of GABPB1-AS1 expression on the survival prognosis of colorectal cancer patients was predicted through the GSCA database. The expression levels of GABPB1-AS1 and miR-30b-3p were detected by RT-qPCR. The targeting relationship between GABPB1-AS1 and hsa-miR-30b-3p was verified by dual-luciferase assay. Cell viability was detected by CCK-8. Cell apoptosis was detected by flow cytometry. Cell invasion ability was detected by Transwell assay. Cell migration ability was detected by scratch assay.

Bioinformatics analysis indicated that compared with normal tissues, GABPB1-AS1 was upregulated in colorectal cancer tissues, while miR-30b-3p was downregulated. Patients with high expression of GABPB1-AS1 had significantly shorter overall survival and progression-free survival. The results of RT-qPCR and dual luciferase experiments showed that GABPB1-AS1 was upregulated in colorectal cancer tissues and miR-30b-3p was downregulated. GABPB1-AS1 negatively regulated the expression of miR-30b-3p. Knockdown of GABPB1-AS1 expression could significantly inhibit the viability, invasion and migration abilities of HT-29 cells, and promote the apoptosis of HT-29 cells. On this basis, inhibition of miR-30b-3p expression could partially reverse the effects of knockdown of GABPB1-AS1 on the viability, apoptosis level, invasion and migration ability of HT-29 cells.

The lncRNA GABPB1-AS1 promotes the proliferation, invasion and migration of human colorectal cancer cells by negatively regulating the expression of hsa-miR-30b-3p.

To analyze the evaluation of nutritional risk index (NRI), nutritional control status score (CONUT) and urea-creatinine ratio (UCR) on nutritional status and prognosis quality of gastric cancer patients.

A total of 197 patients with gastric cancer admitted to Xuzhou First People’s Hospital from January 2021 to January 2023 were selected and retrospectively analyzed, and their nutritional status were evaluated by the Nutrition Risk Screening Scale 2002 (NRS 2002). Those with NRS 2002 scores of ≥3 and <3 were respectively included in the nutrition risk group and the non-nutrition risk group. The differences of NRI, CONUT and UCR between the two groups were compared, and the correlations between NRI, CONUT, UCR and blood albumin (ALB), prealbumin (PA), hemoglobin (Hb), etc. were calculated using Pearson correlation analysis. According to the patients' prognosis after one-year follow-up, the patients were divided into the good prognosis group and the poor prognosis group, and the baseline data, nutritional status and UCR of the two groups were compared. Logistic multivariate regression model was used to summarize the related factors affecting the prognosis of the patients.

Among the 197 patients, 71 patients had NRS 2002 score ≥3. The NRI score, ALB, PA and Hb in the nutritional risk group were lower than those in the non-nutritional risk group, and their CONUT score and UCR were higher than those in the non-nutritional risk group (P<0.05). Pearson correlation analysis showed that NRS 2002 score, CONUT score and UCR were negatively correlated with ALB, PA and Hb, while NRI score was positively correlated with ALB, PA and Hb (P<0.05). All 197 patients were effectively followed up for 12 to 42 months, with a median follow-up time of 31 months. During the follow-up period, 37 patients had poor prognosis. Logistic regression analysis showed that body mass index<18.5 kg/m², TNM stage Ⅲ, NRS 2002 score ≥3, CONUT score ≥3 and UCR≥20 were all independent risk factors for poor prognosis of patients with gastric cancer, and NRI score ≥99 was a protective factor (P<0.05).

NRI, CONUT and UCR can guide the evaluation of nutritional status of patients with gastric cancer, and the above parameters combined with body mass index and TNM staging are expected to provide new ideas for predicting the prognosis quality of patients with gastric cancer.

To explore the diagnostic value of gastric filling contrast-enhanced ultrasound combined with serum transforming growth factor beta inducer (TGFBI) and programmed death molecule ligand 1 (PD-L1) in preoperative staging of elderly gastric cancer.

From March 2021 to March 2024, 205 elderly gastric cancer patients who visited our hospital were included as subjects. According to pathological results, they were assigned into an early gastric cancer group of 69 cases and an advanced gastric cancer group of 136 cases. All patients underwent gastric filling contrast-enhanced ultrasound examination. Enzyme linked immunosorbent assay was applied to detect the levels of TGFBI and PD-L1 in serum. The ROC curve was used to analyze the diagnostic value of gastric filling contrast-enhanced ultrasound, serum TGFBI, and PD-L1 levels alone and in combination for preoperative staging of elderly gastric cancer. Multivariate logistic regression analysis was used to screen independent risk factors for staging errors.

The levels of serum TGFBI and PD-L1 in the advanced gastric cancer group were higher than those in the early gastric cancer group (P<0.05). The AUC of preoperative staging for elderly gastric cancer diagnosed by gastric filling contrast-enhanced ultrasound, TGFBI, and PD-L1 alone were 0.866, 0.855, and 0.801, respectively. The AUC of combined diagnosis was 0.989, with the AUC of combined diagnosis being higher than that of the three diagnoses alone (Z=3.798, 5.061, 5.805, P<0.05). According to the diagnosis results of gastric filling ultrasound contrast imaging, there were 185 cases in the correct staging group and 20 cases in the incorrect staging group. The proportions of concave morphology and tumor diameter greater than 3 cm in the incorrect staging group were higher than those in the correct staging group (P<0.05). Concave type and tumor diameter greater than 3 cm were independent risk factors for staging errors (P<0.05).

Gastric filling contrast-enhanced ultrasound combined with serum TGFBI and PD-L1 has high diagnostic value for preoperative staging of elderly gastric cancer.

To evaluate the clinical efficacy of laparoscopic-assisted D2 lymphadenectomy combined with proximal complete mesocolic excision (CME) in the treatment of advanced gastric cancer, and to explore the influence of this combined operation on perioperative clinical outcome, tumor biological behavior and long-term survival and prognosis.

This study was a single-center retrospective cohort study. The samples were 172 patients with advanced gastric cancer admitted to Department of General Surgery, Changzhou Hospital of Traditional Chinese Medicine from January 2022 to December 2023. They were divided into the control group and the observation group based on different surgical methods. The control group underwent laparoscopic D2 radical gastrectomy, while the observation group received laparoscopic D2 radical gastrectomy combined with CME. Surgical-related indices and postoperative recovery were statistically analyzed, and the levels of tumor markers before surgery and 5 days after surgery, as well as postoperative complications were compared between the two groups of patients. All patients were followed up for one year, and the recurrence rate, metastasis rate and survival rate, progression-free survival and overall survival were recorded one year after operation.

Compared with the control group, the operation time of the patients in the observation group was significantly shorter, the blood loss during operation was significantly less, the distance near the incision margin was significantly shorter, and the number of lymph node dissection was significantly more (P<0.05). Compared with the control group, the first exhaust time, the first defecation time and the time of getting out of bed in the observation group were significantly earlier, and the hospitalization time was significantly shorter (P<0.05). The levels of carcino-embryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9) and neuronspecific enolase (NSE) in the two groups decreased significantly after operation compared with those before operation. The levels of tumor markers in the observation group were significantly lower than those in the control group at the same period, and the decrease in the observation group was even greater (P<0.05). There was no statistical difference in the incidence of overall complications between the two groups (P>0.05). The recurrence rate (19.77%) and metastasis rate (8.14%) in the observation group were significantly lower than those in the control group (36.05% and 19.77%) (P<0.05). The survival rate of the observation group (73.26%) was significantly higher than that of the control group (48.84%), and the progression-free survival and overall survival were significantly longer than those of the control group (P<0.05).

Laparoscopic D2 radical resection combined with CME can completely remove the mesangial unit where the tumor is located by following the theory of membrane anatomy, and realize accurate separation of anatomical plane and thorough cleaning of lymphatic drainage system. This operation not only significantly optimizes the perioperative indicators, but also provides a new treatment strategy for advanced gastric cancer with both radical and functional preservation by blocking the potential metastasis pathway in mesangium and remodeling the tumor microenvironment.

To construct a prediction model based on CT radiomics features to predict the recurrence risk of gastric cancer after radical operation, and to explore the clinical value of its preoperative dynamic evaluation.

A total of 215 patients with gastric adenocarcinoma who underwent radical gastrectomy from January 2020 to December 2023 were retrospectively selected as the research objects. All patients completed multi-phase (plain scan, arterial phase and venous phase) enhanced CT examination before operation. Siemens 256-slice CT was used for standardized scanning, and the three-dimensional volume of venous tumor was manually delineated by ITK-SNAP software (the consistency between observers was Kappa>0.85), and 1152 imaging features were extracted based on PyRadiomics. The core features were screened by intra-observer and inter-observer consistency test (ICC≥0.75), single factor analysis and LASSO regression (λ=0.032, 10 times cross-validation) and a Logistic regression model was constructed. The data set was randomly divided into training set (150 cases) and independent verification set (65 cases) according to the ratio of 7∶3, and the prediction efficiency of the model was evaluated.

Among 215 patients with gastric cancer, 67 patients had postoperative recurrence, and the remaining 148 patients did not have postoperative recurrence. The results of univariate analysis showed that there were significant differences in vascular infiltration, nerve infiltration, tumor differentiation, surgical margin status and receiving adjuvant chemotherapy between patients with recurrence and those without recurrence (P<0.05). After a series of screening, the model finally retained eight core image omics features, including morphology, first-order statistics, texture analysis and wavelet transform features. Receiver operating characteristic curve analysis showed that the area under the curve (AUC) of the CT image omics model in predicting the training set was 0.865, and the sensitivity and specificity were 69.4% and 88.1% respectively. The AUC in predicting validation set was 0.875, and the sensitivity and specificity were 94.4% and 63.8% respectively.

The prediction model based on the characteristics of CT imaging shows good diagnostic efficiency in the risk prediction of recurrence after radical gastrectomy, and realizes the preoperative dynamic risk assessment of gastric cancer patients. This model can provide objective decision support for intensive follow-up and accurate adjuvant treatment of high-risk patients.

To construct a risk factor model for postoperative skeletal muscle reduction in patients undergoing extensive hepatectomy for liver cancer and verify its application effect.

A retrospective analysis was conducted on the clinical data of 260 patients with extensive resection of liver cancer admitted to Shandong Provincial Third Hospital from March 2019 to March 2021, using the random number table method, all patients were included in the training group (n=182) and the validation group (n=78) in a ratio of 7∶3 respectively. CT imaging was used to evaluate the reduction of skeletal muscle, and the differences in clinical data between patients with and without skeletal muscle reduction in the training group (n=182) were compared. Logistic multivariate regression analysis was used to summarize the risk factors of postoperative skeletal muscle reduction in patients with extensive resection of liver cancer, and the risk factors were incorporated into the Nomogram prediction model. The receiver operating characteristic (ROC) curve of the predictive model for predicting postoperative skeletal muscle reduction in patients with extensive resection of liver cancer in the validation group was drawn, and the clinical decision curve analysis (DCA) was used to verify the clinical practical value of the model. The patients were followed up until 3 years after the operation. The survival status of the patients was recorded through outpatient reexamination and telephone follow-up, the Kaplan-Meier method was used to evaluate the impact of skeletal muscle reduction on overall survival, and the Cox proportional hazards model was used to correct for confounding factors such as operation time.

The incidences of postoperative skeletal muscle reduction in the training group and the validation group were 42.31% (33/78) and 44.51% (81/182), respectively, there was no statistically significant difference between the groups (P>0.05). In the training group, those with a postoperative skeletal muscle index change rate of ≤-3.6% were classified as the musculoskeletal reduction group (n=81), and the remaining 101 cases were classified as the normal musculoskeletal group. The incidences of preoperative muscle atrophy, postoperative WBC levels, operation time, blood loss volume, microvascular invasion, incidence of concurrent incision infection, incidence of concurrent organ/cavity infection, and incidence of concurrent bacteremia in the skeletal muscle reduction group and the skeletal muscle normal group were compared, with statistically significant differences (P<0.05). Logistic multivariate analysis showed that preoperative sarcopenia, WBC level, operation time, blood loss, microvascular invasion, concurrent incision infection, concurrent organ/cavity infection, and concurrent bacteremia were all independent risk factors affecting postoperative skeletal muscle reduction in patients with extensive resection of liver cancer (P<0.05). The area under the curve (AUC) of the model in the training group and the validation group was 0.853 (95% CI: 0.802-0.904) and 0.808 (95% CI: 0.721-0.895), respectively. The sensitivity and specificity of the validation group were 80.66% and 81.30%, respectively. The Hosmer-Lemeshow goodness-fit test was used to evaluate the calibration degree. Both the training group (χ²=6.32, P=0.612) and the validation group (χ²=5.84, P=0.665) showed good calibration performance, and DCA analysis indicated that the model had a high clinical net rate of return. At the follow-up, the median follow-up time for the surviving patients was 28 months, and the median overall survival of the total cohort was 35.7 months. In the univariate analysis, the overall survival period of the skeletal muscle reduction group was shorter than that of the normal skeletal muscle group (P=0.014). Multivariate analysis showed that skeletal muscle reduction was an independent risk factor for postoperative death (P<0.001).

Patients with extensive resection of liver cancer have a relatively high risk of postoperative skeletal muscle reduction, which is related to factors such as preoperative sarcopenia, inflammatory response, operation time, blood loss, microvascular invasion, and complications. The prediction model established based on the above factors can provide a reliable reference for the risk assessment of postoperative skeletal muscle reduction in patients with extensive resection of liver cancer.

To research the predictive value of contrast-enhanced ultrasound (CEUS), serum alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), γ-glutamyltransferase (GGT) and alkaline phosphatase (ALP) on microvascular invasion (MVI) and recurrence in patients with liver cancer after interventional therapy.

A total of 187 patients with primary liver cancer admitted to Affiliated Hospital of Jining Medical University from May 2021 to May 2023 were selected as the research objects. All patients successfully completed transcatheter arterial chemoembolization treatment in our hospital, and CEUS and serum biochemical indexes were detected one week before operation. The MVI and recurrence were diagnosed by postoperative pathological examination and postoperative follow-up, and the relationship between the imaging characteristics of CEUS, serum AFP, CEA, GGT and ALP levels and postoperative MVI and recurrence was analyzed.

Among 187 patients with liver cancer, 61 cases were confirmed as MVI. The results of univariate analysis showed that the incidence of no or incomplete capsule, rapid regression of portal vein signal and tumor necrosis in MVI group was significantly higher than that in non-MVI group. The levels of serum AFP, CEA, GGT and ALP in MVI group were significantly higher than those in non-MVI group (P<0.05). The results of multivariate Logistic regression analysis showed that no or incomplete capsule, rapid regression of portal vein signal, tumor necrosis, serum AFP≥20 μg/L, CEA≥5 μg/L, GGT≥60 U/L and ALP≥120 U/L were independent risk factors for MVI after interventional therapy (P<0.05). After a one-year follow-up survey, 45 of 187 patients with liver cancer recurred. The results of univariate analysis showed that the incidence of no or incomplete capsule, unsmooth edge, rapid fading of portal vein signal and internal necrosis of tumor in recurrent group were significantly higher than those in non-recurrent group, and the serum AFP, CEA, GGT and ALP levels in recurrent group were significantly higher than those in non-recurrent group (P<0.05). Multivariate Logistic regression analysis showed that no or incomplete capsule, unsmooth edge, rapid fading of portal vein signal, tumor necrosis, serum AFP≥20 μg/L, CEA≥5 μg/L, GGT≥60 U/L and ALP≥120 U/L were independent risk factors for postoperative recurrence (P<0.05).

Liver cancer patients with no or incomplete capsule in CEUS examination, rapid fading of portal vein signal and necrosis of tumor are at higher risk of MVI after operation. Liver cancer patients with no or incomplete capsule, unsmooth edge, rapid fading of portal vein signal and tumor necrosis are more likely to have postoperative recurrence. Specific CEUS imaging features combined with serum AFP, CEA, GGT, ALP and other biochemical markers have certain early predictive value for MVI and recurrence of liver cancer patients after interventional therapy.

To explore and analyze the risk factors for severe abdominal pain after transcatheter arterial chemotherapy embolization (TACE) in patients with HBV related primary liver cancer, and to construct a Logistic regression predictive model.

A total of 180 patients with HBV related primary liver cancer treated by TACE in Lishui Branch of Zhongda Hospital Affiliated to Southeast University from March 2021 to March 2023 were selected as the study objects. The patients were divided into no/mild abdominal pain group (VAS: 0-3, 45 cases) and severe abdominal pain group (VAS: 4-7, 135 cases) according to the visual analogue scale (VAS) score after TACE. The gender, age, TACE history and other clinical data of the two groups of patients were retrospectively collected and analyzed. SPSS software was used to conduct univariate analysis and binary Logistic regression analysis for postoperative abdominal pain in patients with HBV related primary liver cancer treated with TACE, and a Logistic model was constructed according to the results of factor analysis. ROC curve was used to analyze the prediction efficiency and verify the goodness of fit.

The results of univariate analysis showed that TACE history, vascular invasion, number of tumors, and maximum diameter of tumors were all influencing factors for postoperative severe abdominal pain in patients with HBV related primary liver cancer treated with TACE (P<0.05), and the results of binary Logistic regression analysis showed that TACE history, vascular invasion, number of tumors, and maximum diameter of tumors were all independent risk factors. Constructing a logistic prediction model, the AUC value of the area under the ROC curve was 0.907, 95% CI was 0.854-0.945 (P<0.001), sensitivity was 85.93%, and specificity was 84.44%. Hosmer-Lemeshow test showed good goodness of fit (χ²=7.239, P=0.511).

Severe postoperative abdominal pain in patients with HBV related primary liver cancer treated with TACE is closely related to TACE history, vascular invasion, number of tumors, and maximum tumor diameter. Constructing a predictive model can effectively identify high-risk postoperative abdominal pain patients and reduce the risk of severe abdominal pain.

To explore the correlation between interleukin 6 (IL-6), Golgi glycoprotein 73 (GP73), and cytokeratin 18 (CK-18) fragments and the clinical characteristics of simple hepatic cysts (SHC), and to analyze their predictive value for recurrence.

A retrospective analysis was conducted on the clinical data of 180 patients with SHC. The differences in IL-6, GP73, and CK18-M30 among SHC patients with different clinical characteristics were compared, and multivariate logistic regression analysis, multivariate Cox regression analysis, and receiver operating characteristic curve (ROC) analysis were conducted.

There were statistically significant differences in IL-6, GP73, and CK18-M30 levels in the pre-treatment cystic fluid and peripheral blood among patients of different ages, hepatic cyst diameter, and disease severity (P<0.05). There were statistically significant differences in the severity of the disease and the levels of IL-6, GP73, and CK18-M30 in peripheral blood between those who were effective and those who were ineffective in SHC treatment (P<0.05). Multivariate logistic regression analysis showed that severe SHC and postoperative peripheral blood IL-6, GP73, and CK18-M30 levels were independent risk factors for ineffective treatment of SHC patients after percutaneous puncture and drainage sclerotherapy under ultrasound localization (P<0.05). There were statistically significant differences in the severity of disease, cyst diameter, and peripheral blood IL-6, GP73, and CK18-M30 levels after treatment between SHC relapse and non-relapse patients after treatment (P<0.05). Multivariate Cox regression analysis showed that large cysts (diameter≥10 cm) and postoperative peripheral blood IL-6, GP73, and CK18-M30 levels were independent risk factors for recurrence in SHC patients undergoing percutaneous puncture and drainage sclerotherapy under ultrasound localization (P<0.05). The ROC curve analysis showed that IL-6, GP73, and CK18-M30 in peripheral blood after treatment could predict the recurrence of SHC patients (P<0.05).

There are statistically significant differences in IL-6, GP73, and CK18-M30 levels in the cystic fluid of patients with different clinical characteristics of SHC. After treatment, peripheral blood IL-6, GP73, and CK18-M30 levels can predict patient recurrence.

To explore the value of color Doppler ultrasound assessment of hepatic portal blood flow combined with liver hardness and platelet in evaluating the risk of hemorrhage in patients with esophageal and gastric varices in cirrhosis.

The clinical data of 110 cirrhotic patients with esophageal and gastric varices admitted to Shaanxi Provincial People's Hospital from March 2022 to March 2024 were retrospectively analyzed. Gastroscopy was used as the gold standard, and the patients were divided into the bleeding group (46 cases) and the non-bleeding group (64 cases) according to whether they had bleeding. All patients underwent color Doppler ultrasound. Portal vein blood flow parameters and splenic vein blood flow parameters of the two groups were recorded and compared to evaluate the hepatic portal blood flow of the patients. Liver shear wave velocity (Vs), liver elasticity test value (E), liver stiffness measurement (LSM), spleen diameter (SD) and serological indexes such as albumin (ALB), hemoglobin (Hb), total bilirubin (TBil), blood creatinine (SCr), blood urea nitrogen (SUN), activated partial thrombin time (APTT), and prothrombin time (PT) and platelet count (PLT) of all patients were collected. The LSPS score was calculated according to the ratio of LSM, PLT and SD, and the index differences between the two groups were compared. The receiver operating characteristic (ROC) curve was drawn, and the area under the curve (AUC) was calculated to evaluate the evaluation value of relevant influencing factors on the risk of hemorrhage in cirrhotic patients with esophageal and gastric varices.

DPV, QPV, DSV, QSV, LSM, SD, liver Vs and liver E in the bleeding group were higher than those in the non-bleeding group, and VPV and VSV were lower than those in the non-bleeding group, with statistically significant differences (P<0.05). The LSPS score of the bleeding group was significantly higher than that of the non-bleeding group, with statistically significant difference (P<0.05), but there were no statistically significant differences in ALB, Hb, TBil, SCr, SUN, APTT, PT and PLT between the two groups (P>0.05). Logistic multivariate regression analysis showed that DPV≥1.5 cm, VPV<10 cm/s, QPV≥1 390 mL/min, DSV≥1.4 cm, VSV<14 cm/s, QSV≥970 mL/min, LSPS≥3.9 points, liver Vs≥2.5 m/s, liver E≥15.8 kPa were independent risk factors for hemorrhage in cirrhotic patients with esophageal and gastric varices (P<0.05). ROC curve showed that the AUC in combination with DPV, VPV, QPV, DSV, VSV, QSV, LSPS, liver Vs, and liver E was 0.875 (95% CI: 0.860-0.902), and the specificity and sensitivity were 84.26% and 83.86%, respectively. The ultrasonic feature model was established based on the results of ultrasound examination (including color Doppler ultrasound and ultrasonic elastography), and the clinical model was constructed based on the LSPS score, the combined diagnostic efficiency of the two models was higher, with an AUC of 0.912 (95% CI: 0.905-0.952), which was significantly higher than that of single clinical model (LSPS) and single ultrasonic characteristic model.

Color Doppler ultrasound can help to predict the bleeding risk of patients with cirrhotic esophageal and gastric varices by measuring the blood flow dynamics of portal vein and splenic vein, and has higher prediction value in combination with liver hardness and platelet.