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 effects of the folate-polyethylene glycol-doxorubicin (FA-PEG-hyd-DOX) linker on the growth and cardiac toxicity of subcutaneous transplanted tumors of nude mice with liver cancer.

A total of 60 4-6 weeks nude mice were randomly divided into 5 groups, which were control group, DOX group, linker 1 group, linker 2 group and linker 3 group, with 12 mice in each group. The control group was injected with physiological saline solution, the DOX group was injected with DOX (dose 5.0 mg/kg), while the linker 1 group, linker 2 group and linker 3 group were injected with FA-PEG-hyd-DOX linker (dose 2.5, 5.0 and 10.0 mg/kg) was injected in groups 1, 2 and 3, respectively. The tumor volume and body mass were compared in nude mice at different time points, and the morphological changes of tumor tissue in nude mice after administration were compared. The relative expression levels of B-cell lymphoma-2 (Bcl-2), Bcl2-associated X (Bax)、myeloid cell leukemia-1 (Mcl-1), cleaved cysteine-dependent aspartate-specific protease-3 (cleaved caspase-3) and Ki-67 in nude mice after administration were compared. The distribution of DOX in the hearts, livers, and kidneys of nude mice and the hematological indexes were compared.

After 20 days of administration, the tumor volume of control group, DOX group and linker 1 group were significantly higher than that of linker 2 group and linker 3 group (P<0.05). After 20 days of administration, the body weight of DOX group and linker 3 group was significantly lower than that of linker 2 group, linker 1 group and control group (P<0.05). The expressions of Bcl-2, Mcl-1 and Ki-67 in linker 2 and linker 3 groups were significantly lower than those in DOX group and linker 1 group, and the expressions of Bax and cleaved caspase-3 were significantly higher than those in control group and linker 1 group (P<0.05). Compared with the DOX group, the distribution of DOX in the heart was reduced in the linker 2 group. The levels of CK in linker 1 group, linker 2 group and linker 3 group were significantly lower than those in DOX group (P<0.05).

Compared with DOX, the FA-PEG-hyd-DOX linker can effectively inhibit the volume of subcutaneous transplanted tumors in nude mice with liver cancer, having good anti-tumor effects, and can more effectively promote tumor cell apoptosis, reducing damage to the heart.

To explore the evaluation value of the texture features of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) combined with gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) MRI in the therapeutic response after transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC).

A total of 80 patients with HCC treated with TACE admitted to Yulin Traditional Chinese Medicine Hospital between February 2023 and March 2025 were selected retrospectively for the study, and DCE-MRI and Gd-EOB-DTPA MRI were performed 1 week before and 1 month after the operation. DCE-MRI quantitative parameters [volumetric transit constant (Ktrans), rate constant (Kep), extravascular extracellular interstitial volume ratio (Ve)] and hepatobiliary phase texture characteristics (entropy, contrast, energy) were analyzed. The patients were divided into the effective group (n=52) and ineffective group (n=28) according to the modified solid tumor efficacy evaluation criteria (mRECIST), and the differences of each parameter between the effective group and ineffective group were compared, and the value of each parameter and the combined indexes in the assessment of the response to the efficacy of the post-TACE treatment was assessed by the receiver operating characteristic (ROC) curve.

One month after the operation, the Ktrans, Kep, Ve, entropy and contrast of the patients in the effective group were all lower than those in the ineffective group, while the energy was higher than that in the ineffective group (P<0.05); ROC curve analysis indicated that the area under the curve (AUC) of Ktrans, Kep, Ve, and MRI texture feature parameters entropy, contrast, and energy for jointly predicting the therapeutic response after TACE was 0.932, with a sensitivity of 86.50% and a specificity of 89.00%, which were all higher than those of each single parameter (P<0.05).

The quantitative parameters of DCE-MRI combined with the texture features of Gd-EOB-DTPA MRI have a high evaluation value for the therapeutic response of HCC patients after TACE, which is helpful for accurately judging the therapeutic effect in clinical practice and provides an important basis for formulating subsequent treatment plans.

To construct a risk factor model of chemotherapy-induced nausea and vomiting (CINV) in patients with pancreatic cancer and verify its application effect.

A retrospective collection was made of 138 patients with pancreatic cancer admitted to First Affiliated Hospital of Air Force Medical University of the People's Liberation Army from February 2022 to February 2024. The patients were divided into the CINV group (n=57) and the non-CINV group (n=81) based on whether CINV occurred, the differences in clinical data between the two groups were analyzed, and statistically significant variables were screened through univariate analysis, it was further verified through multivariate Logistic regression. The patients were divided into a training group (n=104) and a validation group (n=34) at a 3∶1 ratio. A nomogram prediction model was constructed, and the receiver operating characteristic (ROC) curve and decision curve analysis (DCA) were used to verify the predictive efficacy and calibration degree of the model.

The terms of age, history of motion sickness, history of nausea and vomiting during pregnancy, sleep status (Pittsburgh Sleep Quality Index, PSQI score), anxiety level (Self-Rating Anxiety Scale, SAS score), number of chemotherapy cycles, gastrointestinal diseases, psychological anticipation of CINV, hypokalemia, hypomagnesemia, and malnutrition between the CINV group and the non-CINV group were significantly different (P<0.05). Logistic multivariate analysis showed that age 18-50 years old, previous motion sickness, history of nausea and vomiting during pregnancy, PSQI score ≥8 points, SAS score ≥50 points, chemotherapy frequency <3 times, combined gastrointestinal diseases, psychological anticipation of CINV, hypokalemia, hypomagnesemia, and malnutrition were all independent risk factors affecting the occurrence of CINV in pancreatic cancer (P<0.05). The areas under the curve of the model applied in the training group and the verification group were 0.843 and 0.838 respectively, and the sensitivity and specificity applied in the verification group were 82.70% and 83.19% respectively, and DCA analysis showed that the clinical net rate of return of the model was relatively high. Through calibration curve analysis and Hosmer-Lemeshow test (P=0.372) verification, the predicted probability of the model was highly consistent with the actual observed probability, suggesting a good calibration degree.

Patients with pancreatic cancer have a relatively high risk of CINV occurrence, and it is related to factors such as age, previous motion sickness, history of nausea and vomiting during pregnancy, PSQI score, SAS score, number of chemotherapy sessions, gastrointestinal diseases, psychological anticipation of CINV occurrence, hypokalemia, hypomagnesemia, and malnutrition, and the prediction model established based on the above factors can provide a reliable reference for the risk assessment of reducing the occurrence of CINV in patients with pancreatic cancer.

To investigate the incidence and analyze the risk factors of organ/space surgical site infection (SSI) in patients with advanced digestive system cancer after surgery treatment, so as to establish a nomogram risk predictive model and verify the predictive efficiency.

A total of 852 patients with advanced digestive system cancer admitted into Hai'an People's Hospital from February 2018 to February 2023 were retrospectively reviewed. Among them, 505 were males and 347 were females, with an average of (58.9+6.6) years, 90 cases of esophageal cancer, 178 cases of gastric cancer, 259 cases of colorectal cancer, 250 cases of liver cancer, and 75 cases of pancreatic cancer. The surgical methods included open surgery and laparoscopic surgery. The patients were divided into two groups based on whether surgical site SSIs occurred within 30 days after the operation. The clinical data between the infected group and non-infected group were compared, then the risk factors were screened.

Within 30 days after the operation, 53 cases (6.2%, 53/852) of organ/cavity SSI occurred. A total of 69 pathogenic bacteria were detected. Among them, 40 cases were single infection and 13 cases were mixed infections. Among the 69 pathogens, there were 50 Gram-negative bacteria, 16 Gram-positive bacteria and 3 fungi. Compared with the non-infected group, the infected group had older patients, greater intraoperative blood loss, higher proportions of diabetes, parenteral nutrition, gastric cancer and colorectal cancer resections, longer anesthesia time, ICU stay time, operation time and abdominal drainage time, and lower preoperative hemoglobin and albumin levels, with statistically significant differences (P<0.05). Multivariate Logistic regression analysis showed that operative types [gastric cancer (OR=4.526, 95% CI: 2.264-6.023, P<0.001) and colorectal cancer (OR=5.021, 95% CI: 3.345-6.642, P<0.001) resection], anesthesia time≥4 h (OR=2.235, 95% CI: 1.568-3.235, P<0.001), ICU stay time≥24 h (OR=3.754, 95% CI: 2.569-5.201, P<0.001) and preoperative albumin<30 g/L (OR=1.859, 95% CI: 1.234-3.125, P<0.001) were all the independent risk factors to organ/space SSI. R software was used to establish the quantitative nomogram model and total score was 220. The area under the curve (AUC) of the nomogram for predicting organ/space SSI was 0.856 by receiver operating curve (ROC), suggesting that the predictive efficiency of the model was good. Calibration curve showed that the incidence of organ/space SSI predicted by nomogram was in good agreement with the actual incidence. The C-index calculated by Bootstrap internal verification method was 0.861 (95% CI: 0.810-0.903), suggesting that the nomogram had good discrimination.

There is a certain incidence of organ/space SSI in patients with advanced digestive system cancer after surgery, gastric cancer and colon cancer resection, anesthesia time≥4 h, ICU stay time≥24 h and preoperative albumin<30 g/L are the independent risk factors. The establishment of a visualized nomogram model is effective in predicting organ/space SSI and has good clinical value.

To explore the predictive value of quantitative parameters of diffusion- weighted imaging (DWI) combined with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for pathological complete response (pCR) in patients with locally advanced rectal cancer (LARC) after neoadjuvant therapy.

A retrospective analysis was conducted on the medical records of 120 patients with LARC admitted to Xidian Group Hospital from January 2022 to January 2025, tumor regression grade (TRG) was adopted, TRG grade 0 was defined as the pCR group (n=38), and the rest were defined as the non-PCR group (n=82). The quantitative parameters of apparent diffusion coefficient (ADC), transport constant (Ktrans), percentage of extracellular space volume outside the blood vessels (Ve), and rate constant (Kep) before and after neoadjuvant therapy were compared between the two groups. Spearman correlation analysis was used to analyze the correlation between quantitative parameters of DWI and DCE-MRI and pCR after neoadjuvant therapy for LARC. ROC curve was used to analyze the predictive value of DWI combined with quantitative parameters of DCE-MRI before treatment for pCR after neoadjuvant therapy for LARC.

After treatment, the ADC of patients in the pCR group was higher than that in the non-pCR group, while Kep, Ve and Ktran were all lower than those in the non-pCR group (P<0.05). The results of Spearman correlation analysis showed that ADC before treatment was positively correlated with pCR after neoadjuvant therapy for LARC, while Kep, Ve, and Ktrans were all negatively correlated with pCR after neoadjuvant therapy for LARC (P<0.05). ROC curve analysis indicated that the areas under the curve (AUC) of ADC, Kep, Ve, Ktrans and their combined detections before treatment for predicting pCR after neoadjuvant therapy for LARC were 0.667, 0.511, 0.797, 0.666 and 0.880, respectively. The sensitivities were 76.32%, 78.95%, 68.42%, 73.68%, and 81.58% respectively, and the specificities were 75.61%, 78.05%, 70.73%, 72.07%, and 86.59% respectively. Before treatment, the AUC of ADC, Kep, Ve, and Ktrans was the largest, and their sensitivity and specificity were also the highest (P<0.05).

The quantitative parameters of DWI combined with DCE-MRI can effectively predict pCR in patients with LARC after neoadjuvant therapy, and the combined detection can improve the predictive efficacy.

To evaluate the clinical efficacy of Lianyang Decoction enema in the treatment of mild to moderate ulcerative colitis (UC), and to explore its mechanism of promoting mucosal healing based on the interleukin-37b/nuclear factor κB (IL-37b/NF-κB) axis.

A prospective, randomized, double-blind, placebo-controlled trial was conducted in this study. A total of 204 patients with mild to moderate UC admitted to Tongde Hospital of Zhejiang Province from March 2021 to December 2024 were selected as the research subjects and randomly divided into a control group of 102 cases (oral mesalazine+placebo enema) and an observation group of 102 cases (oral mesalazine+Lianyang Decoction enema), with a treatment course of 30 days. The following clinical indicators such as UC endoscopic severity index (UCEIS) score, TCM syndrome score, modified Mayo score for disease activity, fecal calprotectin (FC), intestinal mucosal barrier function [endotoxin (ET), D-lactic acid, diamine oxidase (DAO)] of the two groups of patients before and after treatment were observed and compared. Meanwhile, the levels of serum inflammatory factors [tumor necrosis factor-α (TNF-α), interleukin (IL)-6, IL-1β] and the levels of IL-37b and NF-κB p65 were detected by ELISA method, and the adverse reactions during the treatment were recorded.

After treatment, the UCEIS score, TCM syndrome score, modified Mayo score and FC level of both groups of patients were significantly decreased, and the reduction was significantly greater in the observation group than that in the control group (P<0.05). Meanwhile, the observation group was also superior to the control group in improving intestinal mucosal barrier function indicators (ET, D-lactic acid, DAO) and down-regulating serum inflammatory factors (TNF-α, IL-6, IL-1β) (P<0.05). In addition, after treatment, compared with the control group, the serum IL-37b level in the observation group was significantly upregulated, and the NF-κB p65 level was significantly downregulated (P<0.05). In terms of safety, there was no significant difference in the incidence of adverse reactions between the two groups (9.80% vs. 17.65%, P>0.05).

Enema with Lianyang Decoction combined with mesalazine can effectively promote intestinal mucosal healing in patients with mild to moderate ulcerative colitis. Its mechanism of action may be related to upregulating IL-37b and inhibiting the activity of the NF-κB signaling pathway, thereby reducing intestinal inflammatory responses and improving intestinal mucosal barrier function, and it has good safety.

To explore the therapeutic effect of Huangqi Jianzhong decoction combined with mesalazine enteric-coated tablets and bifidobacterium triplex live bacteria enteric-coated capsules on patients with ulcerative colitis (UC) and its impact on intestinal mucosal barrier function.

From June 2022 to March 2025, 120 patients with UC who visited Shangluo Hospital of Traditional Chinese Medicine were randomly assigned into a control group and a monitored group, with 60 cases in each group. The control group used oral bifidobacterium triplex live bacteria enteric-coated capsules and mesalazine enteric coated tablets, while the monitored group used Huangqi Jianzhong decoction in addition to the control group. The therapeutic effect, pre-and post-treatment TCM symptom scores, Baron score, intestinal mucosal barrier function indicators, inflammatory factors, immune function indicators, and adverse reactions of the two groups were compared.

The monitored group showed better total effective rate (91.67% vs. 76.67%, P<0.05). After treatment, the TCM syndrome score, Baron score, endotoxin, diamine oxidase, D-lactate, interleukin-6, C-reactive protein, and tumor necrosis factor-α reduced prominently in both groups, while CD₃⁺, CD₄⁺, and CD₄⁺/CD₈⁺ increased prominently, and the monitored group was better (P<0.05). The adverse reactions showed no prominent difference between the two groups (13.33% vs. 8.33%, P>0.05).

Huangqi Jianzhong decoction combined with mesalazine enteric-coated tablets and bifidobacterium triplex live bacteria enteric-coated capsules has obvious curative effect in the treatment of UC patients, which can improve the intestinal mucosal barrier function and immune function of patients, reduce inflammatory reactions, and have good safety.

To investigate the efficacy and safety of early endoscopic hemostasis for ulcer bleeding after cyanoacrylate injection in gastric varices.

The clinical data of patients with ulcer bleeding after cyanoacrylate injection treated in the 960th Hospital of Chinese PLA Joint Logistics Support Force from August 2015 to February 2024 were retrospectively analyzed, and they were divided into control group and observation group according to different treatment methods. The control group received conservative drug treatment after admission, and the observation group received endoscopic hemostatic treatment within 48 hours after admission in addition to drug treatment. The success rate of hemostasis, hemostatic time, early rebleeding rate, late rebleeding rate and complication rate between the two groups were compared.

A total of 61 patients were included in the study, 31 in the control group and 30 in the observation group. The success rate of hemostasis in the observation group was 100.0%, higher than that in the control group (80.6%). The average hemostasis time in the observation group was (1.23±0.43) days, shorter than that in the control group which was (2.58±0.72) days. The early rebleeding rate in the observation group was 3.3%, lower than that in the control group (28.0%), with statistically significant differences (P<0.05). There were no statistically significant differences in the rate of late rebleeding and complication between the two groups (P>0.05).

For patients with ulcer bleeding after cyanoacrylate injection for gastric varices, early endoscopic hemostasis treatment, compared with conservative drug therapy, can increase the success rate of hemostasis, shorten the hemostasis time, and reduce the early rebleeding rate. It is a safe and effective treatment method.

To investigate the prognostic risk factors associated with acute lower gastrointestinal bleeding, construct a risk score and validate its predictive ability.

A retrospective analysis was conducted on the clinical data of 754 patients who were hospitalized for acute lower gastrointestinal bleeding at the First Medical Center and the Fourth Medical Center of the Chinese People's Liberation Army General Hospital from January 2015 to December 2020. After excluding the cases that did not meet the criteria, a total of 355 patients were included in the training set. These patients were divided into the safe discharge group (n=197) and the non-safe discharge group (n=158) based on whether they were discharged safely. From January 2021 to October 2023, 235 patients who were hospitalized and treated for acute LGIB were prospectively collected. After excluding the patients who did not meet the criteria, a total of 133 patients were finally included to establish the validation set. Univariate analysis and multivariate Logistic regression were used to identify the independent risk factors influencing safe discharge. A risk score was constructed, and the predictive value of this score was evaluated using receiver operating characteristic curve.

Through univariate analysis and multivariate Logistic regression analysis, it was found that history of liver disease, history of lower gastrointestinal bleeding, fresh bleeding, decrease in hemoglobin, and decrease in albumin were independent risk factors affecting safe discharge (P<0.05). The area under the risk score curve constructed based on these factors was 0.827, which was superior to the prediction models such as the Oakland score.

History of liver disease, history of lower gastrointestinal bleeding, fresh bleeding, decreased hemoglobin, and decreased albumin are independent risk factors affecting the safe discharge of patients with acute lower gastrointestinal bleeding. The risk score constructed based on these factors has a high predictive value for the safe discharge of patients and is helpful for the prognosis risk assessment of patients with acute lower gastrointestinal bleeding.

To retrospectively analyze the occurrence of complications in endoscopic removal of sharp foreign bodies in the upper gastrointestinal tract of adults and explore its risk factors.

A retrospective analysis was conducted on the data of adult patients who underwent endoscopic removal of sharp foreign bodies in the upper digestive tract at Pinggu District Hospital of Beijing from March 2021 to March 2025. Among them, 29 patients had complications (8 cases of perforation, 9 cases of bleeding, 7 cases of abscess, 5 cases of ulcer), and 188 patients had no complications. The age, gender, underlying diseases, size and shape of foreign bodies, location, retention time, endoscopy physician experience, selection of auxiliary instruments, preoperative mucosal injury, operation time, and antibiotic use of the two groups of patients were compared. Logistic multivariate regression analysis and receiver operating characteristic (ROC) curve were used to analyze the predictive value of the above factors for the occurrence of complications during endoscopic removal of sharp foreign bodies in the upper gastrointestinal tract of adults.

There were statistically significant differences between the two groups in terms of age, combined hypertension, foreign body size, foreign body shape, foreign body location, retention time, and preoperative mucosal injury (P<0.05). Multivariate Logistic regression analysis showed that age >48 years old, combined hypertension, foreign body size >22 mm, foreign body shape of needle/fish bone, retention time >16 hours, preoperative mucosal injury, and foreign body location in the upper segment of the esophagus were all independent risk factors affecting postoperative complications of sharp foreign bodies in the upper digestive tract of adults (P<0.05). ROC curve analysis showed that the combined AUC of indicators such as age >48 years, combined hypertension, foreign body size >22 mm, foreign body shape of needle/fish bone, retention time >16 hours, preoperative mucosal injury, and foreign body location in the upper segment of the esophagus for predicting postoperative complications of sharp foreign bodies in the upper gastrointestinal tract of adults was 0.872. Its sensitivity and specificity were 85.10% and 83.61% respectively.

Complications in adult patients undergoing endoscopic removal of sharp foreign bodies in the upper gastrointestinal tract are closely related to age, combined hypertension, foreign body size, foreign body shape, foreign body location, retention time, and preoperative mucosal injury, combined monitoring of the above factors can provide a reliable reference for the prevention and intervention of complications.

To explore the correlation between dietary inflammation index (DII), nutritional parameters and the risk of frailty in elderly patients with compensated liver cirrhosis, and to provide a reference for early clinical intervention.

A total of 120 elderly patients with compensated liver cirrhosis who were admitted to the department of liver disease and the department of gastroenterology of Xingtai People's Hospital from January 2023 to January 2025 were selected retrospectively as the research subjects, and they were divided into the frail group (Fried frailty scale score ≥3 points, n=42) and the non-frail group (Fried frailty scale score 0-2 points, n=78) based on the Fried frailty scale. DII, nutritional parameters (total protein, albumin, prealbumin) and average daily nutritional intake (energy, protein, carbohydrates, dietary fiber, polyunsaturated fatty acids) of the two groups were compared. The Spearman rank correlation analysis method was used to analyze the correlations between DII, nutritional parameters, nutritional intake and the risk of frailty in elderly patients with compensated liver cirrhosis.

The proportion of T1+T2 in the DII classification of the frailty group was lower than that of the non-frailty group, and the proportion of T3 was higher than that of the non-frailty group, the levels of total protein, albumin and prealbumin in the frailty group were all lower than those in the non-frailty group (P<0.05); the intake of energy, protein, carbohydrates, dietary fiber and polyunsaturated fatty acids in the frail group was all lower than those in the non-frail group (P<0.05). The results of Spearman correlation analysis showed that in elderly patients with compensated liver cirrhosis, DII was positively correlated with the risk of frailty, while total protein, albumin, prealbumin, energy intake, protein, carbohydrates, dietary fiber, and polyunsaturated fatty acids were negatively correlated with the risk of frailty (P<0.05).

Elevated DII levels and reduced nutritional parameters significantly increase the risk of frailty in elderly patients with compensated liver cirrhosis, clinicians should monitor these indicators and implement anti-inflammatory dietary and nutritional support interventions.

To investigate the effects of sevoflurane and propofol on lipid metabolism and to analyze the relationship between lipid metabolism-related indicators and cognitive function.

A total of 80 elderly patients scheduled for laparoscopic radical resection of colorectal cancer in Qidong Hospital of Traditional Chinese Medicine from January 2023 to March 2025 were enrolled. According to a random number table, patients were allocated to the sevoflurane group (S group) or the propofol group (P group), with 40 patients in each group. Anesthesia induction: Patients in the S group received inhalation of 8% sevoflurane (oxygen flow 6-8 L/min, oxygen concentration 40%), intravenous rocuronium 0.3 mg/kg, and sufentanil 0.3 μg/kg. Patients in the P group received intravenous propofol 1.5-2.0 mg/kg, rocuronium 0.6-1.0 mg/kg, and sufentanil 0.6-1.0 μg/kg. Anesthesia maintenance: Patients in the S group received inhaled sevoflurane at 0.8-1.3 MAC, continuous intravenous infusion of remifentanil 0.05-2.0 μg/(kg·min), and intermittent intravenous rocuronium 0.3 mg/kg. Patients in the P group received continuous intravenous infusion of propofol 4.0-12.0 mg/(kg·h) and remifentanil 0.05-2.0 μg/(kg·min), with intermittent intravenous rocuronium 0.6 mg/kg. MMSE scores were assessed at 1 day before anesthesia (T0), and on postoperative day 1 (T1), day 3 (T3), and day 7 (T7). Venous blood samples were collected at the same time points to measure lipid metabolism-related indicators, including total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), apolipoprotein A1, and lipoprotein (a). In addition, intra-induction hypotension, bradycardia, induction time, postoperative nausea and vomiting (PONV), and recovery time were recorded.

At T1 and T3, MMSE scores, apolipoprotein A1 in the S group were significantly lower than those in the P group (P<0.05), while lipoprotein (a) levels were significantly higher (P<0.05). Spearman correlation analysis showed that apolipoprotein A1 was positively correlated with MMSE scores at T1 and T3 (ρ=0.797, P<0.001; ρ=0.590, P<0.001), whereas lipoprotein (a) was negatively correlated with MMSE scores at T1 and T3 (ρ=-0.734, P<0.001; ρ=-0.388, P=0.001). During anesthesia induction, the incidence of hypotension was significantly lower in the S group compared with the P group (P<0.05), while the induction time was significantly longer (P<0.05).

Sevoflurane can reduce the incidence of hypotension during anesthesia induction, but may increase the risk of early postoperative cognitive decline in elderly patients undergoing colorectal cancer surgery. Propofol shows advantages in cognitive protection and lipid metabolism stability. Lipid metabolism-related indicators, especially apolipoprotein A1 and lipoprotein (a), are closely associated with cognitive function, suggesting that lipid metabolism may play a key role in mediating the impact of anesthetic techniques on postoperative cognition.