Obesity is a worldwide public health challenge and its traditional treatments include lifestyle changes, drugs and surgery.Endoscopic bariatric and metabolic therapy (EBMT) has attracted much attention due to its advantages of being more minimally invasive and higher safety.This article reviews a variety of endoscopic weight loss techniques, which achieve weight loss through different mechanisms, such as restricting stomach space, promoting clearance of stomach contents, and reducing intestinal absorption.In addition, the combined application mode of endoscopic weight loss therapy with drugs or surgery was discussed.Overall, EBMT is effective and less invasive, but further research is needed to investigate its long-term effects and improve patient access to treatment.
To investigate the predictive value of visceral obesity (VO) for postoperative infection complications in patients undergoing radical resection of colorectal cancer.
Methods
A total of 132 patients who undergoing radical resection of colorectal cancer in Lishui Branch of Zhongda Hospital, Southeast University from July 2021 to February 2023 were retrospectively analyzed.According to whether the patients were diagnosed with VO [visceral fat area (VFA) ≥80 cm2 on CT], the patients were divided into VO group and non-VO group, including 69 and 63 patients, respectively.Demographic characteristics, comorbidities, preoperative biochemical data, tumor pathological features,perioperative conditions, and postoperative infection complications were collected.Postoperative infectious complications were defined as any infection that occurs during a patient's hospital stay, including both surgical and non-surgical site infections.Logistic regression analysis was used to find the influencing factors of postoperative infectious complications in patients with radical resection of colorectal cancer.ROC curve was drawn to analyze the clinical value of VFA and body mass index (BMI) in predicting postoperative infectious complications in patients undergoing radical resection of colorectal cancer.
Results
The incidence of postoperative infectious complications in VO group was significantly higher than that in non-VO group (P<0.05).Multivariate logistic regression results showed that smoking(OR=4.994, 95% CI 1.517-16.442, P=0.008), fasting blood glucose (increase of 1 mmol/L, OR=4.121, 95%CI 1.791-9.480, P<0.001), operation time>4 h (OR=4.462, 95% CI 1.410-14.117, P=0.011), VO (OR=3.532,95% CI 1.083-11.513, P=0.036) was risk factors for postoperative infectious complications in patients with radical resection of colorectal cancer.ROC curve results showed that the area under the curve (AUC) of VFA in predicting postoperative infectious complications in patients undergoing radical resection of colorectal cancer was 0.708, which was higher than that of BMI (0.606).
Conclusion
VO is a risk factor for postoperative infectious complications in patients undergoing radical resection of colorectal cancer.Compared with BMI, VFA exhibits higher sensitivity in predicting postoperative infectious complications in patients undergoing radical resection for colorectal cancer.However, the current study do not demonstrate a significant advantage in overall predictive ability, and further research is needed to validate these findings.
To analyze the relationship between RAB7A expression and clinicopathological features and liver metastasis of colorectal cancer (CRC) in elderly patients.
Methods
A total of 176 elderly CRC patients who underwent radical resection of CRC in Qinhuangdao Hospital of Peking University Third Hospital from January 2020 to December 2021 were retrospectively analyzed.Immunohistochemistry was used to detect the expression of RAB7A in cancer tissues, adjacent tissues and liver tissues of elderly CRC patients with liver metastasis.The clinicopathological characteristics of elderly CRC patients with different RAB7A expressions were analyzed.According to the status of liver metastasis within 3 years after prognosis, the elderly CRC patients were divided into the metastasis group (n=46) and the non-metastasis group (n=130), and the difference in RAB7A expression in cancer tissues between the two groups was analyzed.Receiver operating characteristic curve was used to analyze the predictive value of RAB7A expression in cancer tissues for the occurrence of liver metastasis in elderly CRC patients.Kaplan-Meier curve was used to analyze the effect of RAB7A expression on the occurrence of liver metastasis.
Results
The expression of RAB7A in CRC tissues of elderly patients was significantly higher than that in adjacent tissues (P<0.001).The expression of RAB7A in cancer tissues of elderly CRC patients was closely related to the depth of invasion and TNM stage (both P<0.05).RAB7A in cancer tissues of metastasis group was significantly higher than that in non-metastasis group (P<0.05).The expression of RAB7A in cancer tissues had a high predictive value for the occurrence of liver metastasis in elderly CRC patients (area under the curve=0.886, P<0.05).The Kaplan-Meier curve of liver metastasis in the RAB7A high expression group shifted to the left compared with the RAB7A low expression group (P<0.001),suggesting that the high expression of RAB7A in cancer tissues of elderly CRC patients increased the risk of liver metastasis.
Conclusion
RAB7A expression in cancer tissues of elderly CRC patients is significantly correlated with clinicopathological features.High expression of RAB7A increases the risk of liver metastasis and has a high predictive value for liver metastasis in elderly CRC patients, which can provide guidance for the treatment of clinical elderly CRC and the prevention and treatment of liver metastasis, and is expected to become a potential therapeutic target for liver metastasis in elderly CRC patients.
To evaluate the efficacy and safety of through-the-scope twin clip(TTS-TC) for endoscopic submucosal dissection (ESD) defect closure in the proximal colon.
Methods
A total of 113 patients underwent proximal colon ESD and had lesions >2 cm at Beijing Friendship Hospital Affiliated to Capital Medical University from March 1, 2022 to February 28, 2025 were retrospectively selected.The patients were divided into 26 cases in the TTS-TC group and 87 cases in the traditional metal clip group.The wound closure time, difficulty and effectiveness were statistically analyzed respectively,and the postoperative diet resumption time, duration of antibiotic use, and length of hospital stay of the two groups of patients were statistically analyzed.
Results
In terms of the time spent on wound closure, the TTS-TC group showed a shorter duration than the traditional metal clip group [(12.11±3.69) min vs.(13.85±3.96) min, P=0.04].Meanwhile, patients undergoing TTS-TC-assisted required fewer clips to achieve complete closure (P<0.01).In terms of postoperative recovery, the TTS-TC group showed earlier resumption of oral intake compared to the conventional clip group (P=0.03).Both novice endoscopists(coefficient 0.83, P<0.01) and experienced endoscopists (coefficient 0.79, P<0.01) agreed that TTS-TC facilitated closure.Novice endoscopists reported that TTS-TC was particularly beneficial for them(χ2=8.15, P=0.04).
Conclusion
TTS-TC has certain advantages over traditional metal clips.It can effectively reduce the defect closure time and the number of clips required, and shorten the time for patients to resume eating.TTS-TC appears to be particularly beneficial for novice endoscopists to close larger and more difficult wounds.
To investigate the predictive value of preoperative neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and systemic immunoinflammatory index (SII)for intestinal obstruction after radical resection of colorectal cancer under general anesthesia.
Methods
A total of 200 patients who underwent radical resection of colorectal cancer under general anesthesia in Baoji Central Hospital from January 2023 to January 2025 were selected as the study objects, according to whether postoperative intestinal obstruction occurred, they were divided into postoperative intestinal obstruction (POI) group (n=30) and non-POI group (n=170).Age, gender, body mass index, comorbidities(hypertension, diabetes, coronary heart disease), tumor site, tumor TNM stage, pathological type, degree of differentiation, tumor size, operation time, preoperative NLR, PLR and SII levels were collected.Logistic regression analysis was used to screen the influencing factors of intestinal obstruction after radical resection of colorectal cancer under general anesthesia, and receiver operating characteristics (ROC) curve was drawn to evaluate the predictive value of NLR, PLR and SII levels in postoperative intestinal obstruction.
Results
There was no significant difference in age, sex, body mass index, comorbidities,tumor site, pathological type, differentiation degree, tumor size and operation time between the two groups(P>0.05).The proportion of TNM stage Ⅲ in POI group was higher than that in non-POI group, and preoperative NLR, PLR and SII levels were higher than those in non-POI group (P<0.05).Logistic regression analysis showed that TNM stage Ⅲ, preoperative NLR, PLR and SII levels were all risk factors for postoperative intestinal obstruction after radical resection of colorectal cancer under general anesthesia(P<0.05).ROC curve analysis results showed that the AUC of preoperative NLR, PLR and SII predicting intestinal obstruction after radical resection of colorectal cancer under general anesthesia were 0.756 (95%CI 0.652-0.860), 0.836 (95% CI 0.739-0.932) and 0.752 (95% CI 0.650-0.853), the corresponding sensitivities were 56.7%, 76.7% and 46.7%, and the specificities were 90.0%, 87.1% and 97.6% (P<0.05).
Conclusion
The preoperative levels of NLR, PLR, and SII are closely related to the occurrence of intestinal obstruction after radical resection of colorectal cancer under general anesthesia, which can be used as potential indicators to predict postoperative intestinal obstruction and provide reference for early clinical intervention.
To analyze the efficacy of programmed death receptor-1(PD-1) inhibitor cindilizumab combined with multi-target receptor tyrosine kinase inhibitor ranvartinib and transcatheter arterial chemoembolization (TACE) in the treatment of patients with advanced liver cancer and its influence on cellular immune function.
Methods
A total of 100 patients with advanced liver cancer in Huangshan People's Hospital from June 2020 to June 2023 were selected for a controlled study.The observation group (n=50) and the control group (n=50) were included respectively by simple random sampling method.Both groups were treated with cindilizumab combined with ranvartinib, and the observation group was added with TACE.The short-term curative effect, changes of tumor markers and cellular immune function before and after treatment, and the incidence of adverse reactions were compared between the two groups, and their 1-year survival was recorded through follow-up.
Results
After 3 months of treatment, the objective remission rate and disease control rate of the observation group were 42.00% and 82.00% respectively, which were higher than those of the control group (20.00% and 64.00%,respectively) (P<0.05).After 3 months of treatment, AFP, PIVKA-Ⅱ, CEA and CA19-9 in both groups decreased compared with those before treatment, and the levels in the observation group were all lower than those in the control group (P<0.05).After 3 months of treatment, CD3+ and CD8+ in both groups decreased, while CD4+ and CD4+/CD8+ increased.CD3+ and CD8+ in the observation group were lower than those in the control group, and CD4+ and CD4+/CD8+ were higher than those in the control group(P<0.05).There was no statistical difference in the incidence of adverse reactions between the two groups(P>0.05).The average progression free survival [(10.17±2.08) months vs.(8.04±1.75) months] and overall survival [(18.83±3.19) months vs.(15.34±2.29) months]of the observation group were longer than those of the control group (P<0.05).
Conclusion
On the basis of cindilizumab combined with ranvartinib, TACE can achieve better short-term efficacy in patients with advanced liver cancer, and can improve tumor markers and immune function without increasing adverse reactions, and prolong survival period.
To investigate the relationship between intestinal flora characteristics and inflammation, immune function and intestinal function in patients with postoperative infection of liver cancer.
Methods
The medical records of 126 patients with liver cancer treated in Shandong Provincial Third Hospital from January 2022 to December 2023 were retrospectively analyzed, and the patients were divided into infection group (n=25) and control group (n=101) according to whether they had infection after surgery.Intestinal flora, inflammatory indicators [interleukin (IL)-6, IL-8, procalcitonin (PCT),C-reactive protein (CRP)], immune function indicators (CD3+, CD4+, CD4+/CD8+), intestinal function indicators [diamine oxidase (DAO), D-lactic acid] of the two groups were compared.In addition, Pearson correlation analysis was used to analyze the correlation between intestinal flora characteristics and body inflammation, immune function and intestinal function in postoperative infected patients with liver cancer.
Results
The level of Enterococcus in the infected group was significantly higher than that in the control group, while the levels of Bacteroides, Lactobacillus and Bifidobacterium were significantly lower than those in the control group, with statistically significant differences (P<0.05).The levels of IL-6, IL-8, PCT and CRP in the infected group were significantly higher than those in the control group, and the levels of CD3+, CD4+ and CD4+/CD8+ were significantly lower than those in the control group, with statistically significant differences (P<0.05).The levels of DAO and D-lactate in the infected group were significantly higher than those in the control group, with statistically significant differences (P<0.05).Pearson correlation analysis showed that Enterococcus in patients with postoperative infection of liver cancer was positively correlated with the levels of IL-6, IL-8, PCT, CRP, DAO, and D-lactic acid, and negatively correlated with the levels of CD3+, CD4+, and CD4+/CD8+ (P<0.05).Bacteroides, Lactobacillus and Bifidobacterium were negatively correlated with the levels of IL-6, IL-8, PCT, CRP, DAO and D-lactic acid, and positively correlated with the levels of CD3+, CD4+ and CD4+/CD8+ (P<0.05).
Conclusion
The proliferation of Enterococcus, the decrease of Bacteroides, and the decrease of Lactobacillus and Bifidobacterium in the intestinal flora of patients with postoperative infection of liver cancer are closely related to the increase of inflammatory factors, the decrease of immune function and the impairment of intestinal function.By regulating the balance of these flora, inflammatory responses can be reduced,immune function can be improved, intestinal barrier can be strengthened, and the risk of postoperative complications can be reduced.
To explore the risk factors of postoperative anastomotic fistula of esophageal cancer, establish a risk prediction nomogram model based on the risk factors, and evaluate the prediction efficiency and clinical application value of this model through clinical decision curve analysis(DCA).
Methods
A total of 342 patients undergoing esophageal cancer surgery in Nantong Cancer Hospital from January 2020 to September 2024 were retrospectively selected and divided into occurrence group (n=36) and non-occurrence group (n=306) according to whether postoperative anastomotic fistula was complicated.The differences in baseline data, perioperative relevant indicators and serological factors between the two groups were compared.Lasso and multivariate Logistic regression were used to screen the risk factors of postoperative anastomotic fistula for esophageal cancer, the risk prediction nomogram model was constructed, and the prediction accuracy was verified by receiver operating characteristic (ROC) curve.Bootstrap method and DCA decision curve were used for internal verification to verify the stability and benefits of the nomogram model.
Results
There were statistically significant differences in diabetes mellitus, smoking history, anastomosis mode, low density lipoprotein cholesterol (LDL-C) and albumin between the occurrence group and the non-occurrence group (all P<0.05).Lasso regression showed that diabetes mellitus, anastomotic mode and albumin could be included in the risk prediction model of anastomotic fistula after esophageal cancer surgery.Binary Logistic regression showed that diabetes mellitus, manual anastomosis and low albumin level were independent risk factors for anastomotic fistula after esophageal cancer surgery (all P<0.001).ROC results showed that the area under the curve predicted by diabetes, anastomotic mode, albumin and nomogram models was 0.713, 0.726, 0.787 and 0.904,respectively.The sensitivity was 0.583, 0.583, 0.735 and 0.889, respectively.The specificity was 0.843, 0.869,0.750 and 0.788, respectively.Internal verification was performed by Bootstrap method (B=1000), and C-indexwas 0.807, indicating that the early warning model of anastomotic fistula after esophageal cancer surgery had good stability.Decision analysis showed that the model can bring net benefits, which was obviously better than the ineffective strategy.
Conclusion
Diabetes mellitus, manual anastomosis and low albumin are independent risk factors for anastomotic fistula after esophageal cancer surgery.The established risk prediction model is effective, stable and has net benefit, which is better than the control without strategy.
To investigate the relationship between preoperative nutritional status,early postoperative systemic immunoinflammatory index, C-reactive protein/albumin ratio (CRP/Alb),neutrophil to lymphocyte ratio (NLR) and anastomotic fistula after esophageal cancer surgery.
Methods
The clinical records of 202 patients with esophageal cancer treated in Qingdao Municipal Hospital from February 2019 to February 2024 were retrospectively reviewed.According to whether anastomotic fistula occurred after surgery, these patients were divided into two groups, 19 patients with postoperative anastomotic fistula were considered as the observation group, and the remaining 183 patients without anastomotic fistula were considered as the control group.Preoperative nutritional status [prognostic nutritional index (PNI), serum albumin (ALB), prealbumin (PA)] and early postoperative systemic immunoinflammatory index (SII), CRP/Alb, NLR were detected in all patients.Pearson correlation was used to analyze the correlation between each index and postoperative anastomotic fistula.Receiver operating characteristic (ROC) curve was plotted, the area under the curve (AUC) value was calculated,and the predictive value of PNI, ALB, PA, SII, CRP/Alb and NLR for postoperative anastomotic fistula of esophageal cancer was analyzed.
Results
There were no statistically significant differences in gender,age, smoking history, drinking history, hypertension, diabetes, tumor location and TNM stage between the observation group and the control group (P<0.05).Compared with the control group, the PNI and CRP/Alb in the observation group was significantly reduced, while SII and NLR were significantly increased(P<0.05).The results of Pearson correlation analysis showed that PNI, CRP/Alb were negatively correlated with postoperative anastomotic fistula (r=-0.477, -0.655, P<0.05), and SII and NLR were positively correlated with postoperative anastomotic fistula (r=0.632, 0.518, P<0.05).Logistic multivariate regression analysis showed that PNI<45.45, SII≥556.54, CRP/Alb<0.44, NLR≥10.20 were all risk factors for predicting anastomotic fistula after esophageal cancer surgery (P<0.05).The ROC curve showed that the AUC for predicting anastomotic fistula after esophageal cancer surgery by combining preoperative PNI<45.45 and early postoperative SII≥556.54, CRP/Alb<0.44, and NLR≥10.20 was 0.824, and the sensitivity and specificity were 82.38% and 84.16%, respectively.
Conclusion
Preoperative PNI and early postoperative SII, CRP/Alb, NLR are closely related to anastomotic fistula after esophageal cancer surgery.These indicators play an important role in predicting the risk of anastomotic fistula after esophageal cancer surgery.
To investigate the characteristics of gastric contrast-enhanced ultrasound and intestinal flora in children with gastroesophageal reflux disease (GERD) manifested by chronic cough.
Methods
A retrospective selection was made of 258 children with chronic cough who visited Tangshan Maternal and Child Health Hospital from April 2022 to April 2024.All of them underwent gastric contrast-enhanced ultrasound examination, and 158 children with GERD were taken as the study group.According to DeMeester scores, the patients were divided into mild-to-moderate group (n=106) and severe group (n=52), 100 children without GERD were selected as the control group.The changes of His angle,abdominal esophageal length and intestinal flora in each group were compared, and Spearman rank correlation analysis was used to analyze the correlation between gastric contrast-enhanced ultrasound and intestinal flora characteristics and disease severity in GERD children with chronic cough.
Results
In the study group, the His angle of the children was larger than that of the control group, the length of the abdominal esophagus was shorter than that of the control group, the levels of Enterococcus and Escherichia coli were significantly higher than those of the control group, and the levels of Lactobacillus and Bifidobacterium were significantly lower than those of the control group (all P<0.05).In the severe group, the His angle of the children was larger than that of the mild-to-moderate group, the length of the abdominal esophagus was shorter than that of the mild-to-moderate group, the levels of Enterococcus and Escherichia coli were significantly higher than those of the control group, and the levels of Lactobacillus and Bifidobacterium were significantly lower than those of the mild-to-moderate group (all P<0.05).Spearman rank correlation analysis showed that His horn, Enterococcus and Escherichia coli were positively correlated with the severity of the disease in GERD children with chronic cough, while abdominal esophageal length, Lactobacillus and Bifidobacterium were negatively correlated with the severity of the disease (P<0.05).
Conclusion
Among GERD children with chronic cough, the enlargement of His angle,the shortening of the abdominal esophagus and the imbalance of intestinal flora are all correlated with the severity of the disease.These indicators can provide important references for clinical intervention.
To explore the application value of newly added Helicobacter pylori (Hp)related endoscopic signs in Kyoto gastritis under white light and magnifying endoscopy in Hp infection.
Methods
A total of 200 patients with Kyoto gastritis and Hp infection who underwent white light and magnifying endoscopy examination, as well as 14C/13C breath test or histopathological examination, at the First People's Hospital of Neijiang City from April 2024 to December 2024 were selected as the study subjects.The detection rate of Hp in patients was compared.Based on the presentation of the patient's gastric mucosa, the regular arrangement of collecting venules (RAC), gastric fundus gland polyps, ridge like redness, protruding erosions, intestinal metaplasia, atrophy, fold widening, chicken skin like changes,diffuse redness, map like redness, multiple white flat elevations, scratch sign, barnacle sign, and gastric body erosion were recorded, and the diagnostic value of Hp infection in Kyoto gastritis was compared.The diagnostic efficacy of different mucosal manifestations was compared using receiver operating characteristic(ROC) curves.
Results
Among the 200 study subjects, 121 were found to be HP positive and 79 were HP negative based on 14C/13C breath test or histopathological examination results.In the mucosal manifestations under white light and magnifying endoscopy, the absence of atrophy and intestinal metaplasia, presence of RAC, gastric fundus gland polyps, ridge like redness, multiple white flat elevations, map like redness, barnacles sign, and scratch sign were independent predictive factors for Hp negativity (P<0.05).Endoscopic fold enlargement, chicken skin like changes, and diffuse redness were independent predictive factors for Hp positivity (P<0.05).The patient's protruding erosion and gastric erosion had no effect on predicting Hp infection (P>0.05).
Conclusion
The newly added Hp related endoscopic features in Kyoto gastritis under white light and magnifying endoscopy have diagnostic basis for Hp infection and have certain auxiliary significance in determining Hp infection.
To investigate the associations between single Ig interleukin-1-related receptor (SIGIRR), interleukin-1 (IL-1), regulatory T cells (Treg)/helper T cell 17 (Th17) and neutrophil/lymphocyte ratio (NLR) and the severity and prognosis of patients with acute pancreatitis.
Methods
The clinical data of 120 patients with acute pancreatitis admitted to Ankang People's Hospital from January 2021 to January 2024 were retrospectively analyzed.According to the severity of the patients' conditions,they were divided into two groups: 56 patients in the secondary sepsis group and 64 patients in the non-secondary sepsis group, and 50 healthy patients with physical examination during the same period were selected as the control group.The patients were followed up for 1 month.According to the prognosis of the patients, they were divided into a survival group (86 cases) and a death group (34 cases).SIGIRR,IL-1, Treg/Th17, NLR and other data in peripheral blood of all subjects were collected, and the difference of indicator levels among different groups of patients was compared.Spearman was used to analyze the correlation between SIGIRR, IL-1, Treg/Th17 and NLR in peripheral blood and the severity and prognosis of patients with acute pancreatitis secondary sepsis.Logistic multi-factor regression model was used to evaluate the performance.Receiver operating characteristic (ROC) curve was drawn and the area under the curve was calculated to evaluate the prognostic value of each index in acute pancreatitis secondary sepsis.
Results
The levels of SIGIRR, IL-1, Treg/Th17 and NLR in acute pancreatitis secondary sepsis group were higher than those in non-secondary sepsis group and control group, and the levels of all indexes in non-secondary sepsis group were higher than those in control group (P<0.05).The levels of SIGIRR, IL-1,Treg/Th17 and NLR in the death group were all higher than those in the survival group (P<0.05).Univariate and Logistic multivariate regression analyses showed that SIGIRR≥80.45 pg/L, IL-1≥576.54 ng/L, Treg/Th17≥0.26, and NLR≥10.14 were all risk factors for predicting the prognosis of patients with secondary sepsis due to acute pancreatitis (P<0.05).The ROC curve showed that the AUC of SIGIRR was the highest (0.856, 95% CI 0.810-0.902), followed by Treg/Th17 (0.841, 95% CI 0.793-0.889), the combined AUC of the four indicators reached 0.886 (95% CI 0.828-0.931), which was significantly higher than that of any single indicator (Delong test, P<0.05), the sensitivity of the combined model was 84.4%and the specificity was 86.7%.
Conclusion
Peripheral blood SIGIRR, IL-1, Treg/Th17 and NLR are significantly correlated with the severity and prognosis of patients with secondary sepsis due to acute pancreatitis.The combined detection of the four indicators has excellent predictive efficacy.Meanwhile,monitoring is helpful to reflect clinical diagnosis and treatment as well as prognosis assessment.
To explore the correlation of serum high mobility group protein B1(HMGB1) level with the severity of liver cirrhosis complicated with hepatic encephalopathy (HE) and its diagnostic value.
Methods
A total of 276 patients with liver cirrhosis admitted to Shaoyang Central Hospital from January 2021 to July 2024 were retrospectively selected, and 203 patients were finally selected as the research objects according to the inclusion and exclusion criteria.According to the presence or absence of HE, the patients were divided into HE group (n=97) and non-HE group (n=106).According to the West Haven classification criteria, the HE group was further divided into minimal hepatic encephalopathy (MHE) group (n=58) and overt hepatic encephalopathy (OHE) group (n=39).The baseline data of the patients were selected.Serum HMGB1 level was detected by enzyme-linked immunosorbent assay (ELISA).Spearman coefficient was used to analyze the correlation between serum HMGB1 level and psychometric scores of hepatic encephalopathy (PHES), Child-Pugh and model for end-stage liver disease(MELD) scores.Multivariate logistic regression model was established to analyze the influencing factors of HE in patients with liver cirrhosis.ROC curve was drawn to analyze the application value of serum HMGB1 level in the diagnosis and disease evaluation of HE.
Results
The serum level of HMGB1 in the OHE group was significantly higher than that in the MHE group and the non-HE group, and the serum level of HMGB1 in the MHE group was significantly higher than that in the non-HE group (all P<0.001).Serum HMGB1 level was positively correlated with Child-Pugh score and MELD score (r=0.510, r=0.662, all P<0.001), and negatively correlated with PHES score (r=-0.415, all P<0.001).MELD score, elevated blood ammonia, total bilirubin (TBIL) and serum HMGB1 levels were independent risk factors for HE in patients with liver cirrhosis (all P<0.05).The AUC of serum HMGB1 in the auxiliary diagnosis of HE was 0.829, the sensitivity was 83.96%, and the specificity was 69.07%.In the assessment of MHE and OHE, the AUC of serum HMGB1 was 0.845, the sensitivity was 79.49%, and the specificity was 86.21%.
Conclusion
Serum HMGB1 level is significantly increased in patients with HE, and its changes have a high application value in the diagnosis and disease evaluation of HE.
To analyze and monitor the characteristics of peripheral inflammatory factors and coagulation function indexes in patients with Parkinson's disease complicated with Helicobacter pylori (Hp) infection and their correlation with the disease condition, and to explore the relationship between Hp and the disease course of Parkinson's disease.
Methods
From March 2021 to March 2023, 70 Parkinson's disease patients admitted to Fuyang Fifth People's Hospital were included as the observation group, and 50 healthy individuals undergoing physical examination during the same period were selected as the control group, and all participants underwent the 13C urea breath test.According to the occurrence of Hp infection in the observation group, patients were divided into the Hp infection group(n=41) and the non-Hp infection group (n=29), the levels of peripheral inflammatory factors [interleukin(IL)-1β, IL-6, IL-10, tumor necrosis factor-α (TNF-α)] and coagulation function indicators [prothrombin time, thrombin time (TT), activated partial thromboplastin time (APTT), and fibrinogen (FIB)] were compared between different groups, at the same time, Hoehn-Yahr (H-Y) rating scale, unified Parkinson's disease rating scale (UPDRS) Ⅲ and Ⅳ were used to evaluate the severity of the patients' disease and motor function status, and to analyze Hp infection and the changes in the characteristics of peripheral inflammatory factors and coagulation function indicators of Parkinson's disease.Sprearman model was used to analyze the correlation between Hp infection and the severity of Parkinson's disease.
Results
IL-1β,IL-6, IL-10, TNF-α and FIB in observation group were higher than those in control group, and TT and APTT were lower than those in control group, with statistically significant differences (P<0.05).There were no statistically significant differences in age, body mass index, hypertension, diabetes, drinking history, smoking history and positive 13C breath test between the two groups (P>0.05).IL-1β, IL-6, IL-10,TNF-α and FIB in Hp infection group were higher than those in non-Hp infection group, and TT and APTT were lower than those in non-Hp infection group, with statistically significant differences (P<0.05).There were no statistically significant differences in age, body mass index, hypertension, diabetes, drinking history and smoking history between the two groups (P>0.05).H-Y grading scale, UPDRS-Ⅲ and UPDRS-Ⅳ scores of Hp infection group were higher than those of non-Hp infection group, and the severity ratio of disease was also higher than that of non-Hp infection group, with statistical significant differences (P<0.05).Sprearman analysis showed that Hp infection was positively correlated with the severity of Parkinson's disease (r=0.483, P<0.05).
Conclusions
Hp infection in patients with Parkinson's disease is closely related to inflammatory state and coagulation dysfunction, and is positively correlated with the severity of Parkinson's disease.For people with Parkinson's disease, controlling Hp infection may help improve inflammatory symptoms and disease management.
To explore the application value of quantitative and qualitative fecal immunochemical test (FIT) in screening colorectal cancer (CRC) and advanced adenoma.
Methods
A total of 100 patients with suspected CRC undergoing colonoscopy in Huainan Xinhua Hospital were enrolled as the research objects between January 2023 and June 2024.The stool samples were collected before colonoscopy for detection by quantitative and qualitative FIT.Taking colonoscopy+pathological diagnosis as the golden standard, detection rates of CRC and advanced adenoma by quantitative and qualitative FIT, as well as sensitivity, specificity, positive predictive values and negative predictive values of quantitative and qualitative FIT in the diagnosis of CRC and advanced adenoma under different cut-off values were compared.The basic clinical data of patients in progressive tumor group, polyp group and normal group were analyzed by univariate analysis, and risk factors of progressive tumor were analyzed by multivariate Logistic regression analysis.
Results
The results of colonoscopy and pathological examination showed that among the 100 patients, there were 4 cases (4.00%) with CRC and 19 cases (19.00%) with advanced adenoma.The detection rates of CRC and advanced adenoma by quantitative FIT were 4.00%and 19.00%, while which by qualitative FIT were 2.00% and 16.00%, respectively.When cut-off values of fecal hemoglobin were 20, 50 and 100 ng/mL, sensitivity of quantitative FIT in the diagnosis of CRC was decreased from 100% to 66.67%, the sensitivity of qualitative FIT for detecting CRC was 66.67%, lower than that of quantitative FIT under cut-off value of 20 ng/mL.The results of McNemar's test with paired chi-square test showed that when the cut-off value was 20 ng/mL, the difference in consistency between qualitative and quantitative FIT was statistically significant (χ2=4.00, P=0.046).When cut-off values were 50 and 100 ng/mL, the difference in consistency between qualitative and quantitative FIT was not statistically significant (P>0.05).Under the same hemoglobin concentration gradient, the sensitivity of FIT in the diagnosis of advanced adenoma was decreased from 76.00% (20 ng/mL) to 57.14% (100 ng/mL).The sensitivity of qualitative FIT for detecting advanced adenoma was 50.00%, lower than that of quantitative FIT under cut-off value of 20 ng/mL.The results of McNemar's test with paired chi-square test showed that the difference in consistency between qualitative and quantitative FIT was not statistically significant under different cut-off values (P>0.05).
Conclusion
The detection rates of CRC and advanced adenoma are higher by quantitative FIT, and detection sensitivity is higher when cut-off value of fecal hemoglobin is 20 ng/mL, it significantly tends to determine more samples as positive when judging CRC
To investigate the relationship between the changes of serum intestinal fatty acid binding protein (I-FABP), high mobility group protein B1 (HMGB1), T lymphocyte subsets and the severity of disease in children with rotavirus enteritis (RE).
Methods
A total of 210 children with RE admitted to Yulin First Hospital from April 2021 to April 2024 were selected as the study group, according to the severity of dehydration, the children were divided into mild to moderate group (n=151) and severe group (n=59), and 180 healthy children were selected as the control group.The changes of I-FABP,HMGB1 and T lymphocyte subsets in serum of all groups were compared, Pearson correlation analysis was used to analyze the correlation between the changes of serum I-FABP, HMGB1 and T lymphocyte subsets and the severity of RE in children.
Results
The levels of I-FABP, HMGB1 and CD8+ in study group were significantly higher than those in control group, while the levels of CD3+, CD4+ and CD4+/CD8+ in study group were significantly lower than those in control group (P<0.05); the levels of I-FABP, HMGB1 and CD8+ in severe group were significantly higher than those in mild to moderate group, while the levels of CD3+, CD4+ and CD4+/CD8+ were significantly lower than those in mild to moderate group (P<0.05).The results of Pearson correlation analysis showed that the serum levels of I-FABP, HMGB1 and CD8+ were positively correlated with the severity of the disease, while the levels of CD3+, CD4+ and CD4+/CD8+ were negatively correlated with the severity of the disease (P<0.05).
Conclusion
The levels of I-FABP,HMGB1, and T lymphocyte subsets in the serum of children with RE are closely related to the severity of the condition, and monitoring these indicators can provide an important reference for the evaluation and treatment of children with RE.
To explore the effects of compound Lactobacillus acidophilus tablets combined with montmorillonite powder on diarrhea symptoms and intestinal microbiota in children with rotavirus enteritis.
Methods
A total of 80 children with rotavirus enteritis admitted to Jieshou People's Hospital from January 2022 to February 2024 were selected, and divided into two groups according to the random number table method.The control group (40 cases) received treatment with montmorillonite powder, while the observation group (40 cases) received treatment with compound Lactobacillus acidophilus tablets combined with montmorillonite powder.After treatment, the efficacy, clinical symptom relief time (fever, diarrhea, antiemesis, dehydration, stool characteristics), gut microbiota (Bifidobacterium,Lactobacillus, Escherichia coli), and immune function (CD4+, CD8+, CD3+, CD4+/CD8+), inflammatory response [C-reactive protein (CRP), tumor necrosis factor alpha (TNFα), interleukin (IL-1β, IL-18)] were compared between the two groups.
Results
The total clinical effective rate of the observation group was 95.00%, which was higher than that of the control group 77.50% (χ2=5.441, P<0.05).The observation group had shorter fever, diarrhea, dehydration, stool characteristics relief time, and antiemetic time compared to the control group (t=3.038, 3.167, 4.284, 2.738, 3.241, P<0.05).After 3 days of treatment, the number of Lactobacilli and Bifidobacteria in the observation group increased compared to the control group, while the number of Escherichia coli decreased (t=2.164, 2.843, 3.016, P<0.05).CD3+, CD4+, and CD4+/CD8+ in the observation group were all higher than those in the control group, and CD8+ was lower than that in the control group (t=3.152, 4.274, 3.975, 4.628, P<0.05).After 3 days of treatment, the levels of serum CRP, IL-1β, TNFα, and IL-18 in the observation group were lower than those in the control group(t=5.729, 5.823, 10.962, 5.317, P<0.05).
Conclusion
The combination of compound Lactobacillus acidophilus tablets and montmorillonite powder significantly improves clinical symptoms such as diarrhea and fever in rotavirus enteritis, and restores the balance of intestinal microbiota.
To observe the effect of Xingpi Yang'er Granules combined with conventional Western medicine on gastrointestinal dysfunction in children with pneumonia and its impact on syndrome scores.
Methods
A total of 100 pediatric patients with gastrointestinal dysfunction after pneumonia admitted to Jieshou People's Hospital from January 2021 to January 2024 were selected, and were divided into two groups using a random number table method.The control group of 50 cases received conventional Western medicine treatment, while the study group of 50 cases received combined treatment with Xingpi Yang'er Granules.The clinical efficacy, pulmonary infection score (CPIS), pulmonary spleen qi deficiency syndrome score, serum inflammatory factors [procalcitonin (PCT), interferon gamma (IFN-γ),high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor alpha (TNF-α) levels], and gastrointestinal dysfunction between two groups were compared.
Results
The total clinical effective rate of the research group was significantly higher than that of the control group (P<0.05).After treatment, the CPIS, ulmonary spleen qi deficiency syndrome score of the study group was significantly lower than those of the control group (P<0.05).The levels of serum PCT, IFN-γ, TNF-α, and hs-CRP in the study group improved more significantly than those in the control group (P<0.05).The incidence of gastrointestinal dysfunction in the study group was significantly lower than that in the control group (10.00% vs. 26.00%,P<0.05).
Conclusion
On the basis of conventional Western medicine treatments such as anti infection,the combination of Xingpi Yang'er Granules has shown good efficacy in treating gastrointestinal dysfunction in children with pneumonia and has good clinical value.
