Currently, obesity has emerged as a significant global public health issue and ranks as the sixth leading risk factor for death and disability in China. Nowadays, the treatment of obesity primarily revolves around three aspects: lifestyle modification, pharmacological therapy, and bariatric and metabolic surgery. As an emerging treatment for obesity, endoscopic weight reduction technology boasts ultra-minimal invasiveness, low cost, and a reduced risk of complications, earning widespread recognition both domestically and internationally. This article briefly evaluates common endoscopic weight reduction techniques, aiming to offer novel insights into the treatment of obesity.

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.

To investigate the hemostatic effect and safety of endoscopic cyanoacrylate injection on esophageal variceal jet bleeding.

Clinical data of 44 patients with esophageal variceal jet bleeding admitted to the 960th Hospital of Chinese PLA Joint Logistics Support Force From December 2014 to July 2024 were retrospectively analyzed, and they were divided into ligation group (24 cases) and cyanoacrylate injection group (20 cases) according to different endoscopic hemostasis methods. The success rate of hemostasis, the time required for hemostasis, the incidence of re-bleeding within 14 days after surgery, and the incidence of complications of the two groups were compared.

The success rate of hemostasis in the cyanoacrylate injection group was 90.0%, which was similar to 91.7% in the ligation group, with no statistically significant difference (P>0.05). The time required for hemostasis in cyanoacrylate injection group was shorter than that in ligation group [(2.67±2.26) min vs. (6.40±3.20) min], with a statistically significant difference (P<0.05). The rebleeding rate within 14 days after operation (10.0% vs. 8.3%) and complication rate were similar between the two groups, with no statistical significance (P>0.05).

Endoscopic cyanoacrylate injection is a safe and effective treatment for esophageal variceal jet bleeding.

To research the role of the CXCL12/CXCR4 signaling pathway in inflammation and pain associated with chronic pancreatitis (CP), aiming to provide new therapeutic targets for the disease.

A total of 72 SD rats were randomly divided into 4 groups (18 rats in each group): control group (saline treatment); CP model group (TNBS induced); CP model+solvent treatment group; CP model+AMD3100 treatment group. CP was induced by intraductal injection of trinitrobenzene sulfonic acid (TNBS). Von Frey filaments were used to assess the pancreatic hyperalgesia in rats. The expression levels of CXCL12 and CXCR4 in the rat pancreas were analyzed using Western blot and PCR. HE staining was used to observe the histopathology of pancreatic tissue, and the expressions of substance P (SP) and calcitonin gene-related peptide (CGRP) was detected via immunohistochemistry.

Three weeks after TNBS injection, the expressions of CXCL12 and CXCR4 in the rat pancreas significantly increased, with CXCL12 mRNA levels doubling (P<0.05) and CXCL12 protein expression also significantly rising (P<0.05). HE staining revealed that TNBS injection exacerbated pancreatic edema, inflammation, and necrosis. Immunohistochemical findings indicated that the expression of SP and CGRP significantly increased after TNBS treatment (P<0.05). DIL labeling techniques confirmed that CXCR4, as the receptor for CXCL12, was expressed on specific dorsal root ganglion (DRG) neurons in the pancreas. When the CXCL12 signaling pathway was inhibited using CXCR4 antagonist AMD3100, the pain sensitivity in rats significantly decreased, as shown by a marked reduction in the frequency of positive responses to von Frey filament stimuli (P<0.05). Additionally, after AMD3100 treatment, the expression of SP and CGRP in the pancreas notably declined (P<0.05), and the pathological damage to the pancreatic tissue was clearly mitigated, characterized by a decrease in inflammatory cell infiltration and the restoration of acinar structure.

The CXCL12/CXCR4 signaling pathway plays an important role in the inflammation and pain of chronic pancreatitis (CP). By inhibiting the CXCL12 signaling pathway, the use of the CXCR4 antagonist AMD3100 can effectively alleviate pancreatic inflammation, reduce pain sensitivity, and improve the pathological damage of the pancreatic tissue. The CXCL12/CXCR4 signaling pathway may serve as a potential therapeutic target for chronic pancreatitis, offering a scientific foundation for further research and clinical application.

To investigate the predictive value of multi-slice spiral CT perfusion parameters combined with serum microRNA-92a-3p (miR-92a-3p) and microRNA-361-5p (miR-361-5p) in severe acute pancreatitis.

The medical records of 98 patients with acute pancreatitis admitted to Tongchuan People's Hospital from January 2019 to January 2024 were retrospectively reviewed. According to the severity of the disease, the patients were divided into two groups, 36 patients in the severe group and 62 patients in the mild group, another 40 subjects who underwent physical examination during the same period were selected as the healthy control group. Multi-slice spiral CT perfusion parameters [blood flow, blood volume, mean transit time (MTT), permeability of capillary surface (PS)] and serum miR-92a-3p and miR-361-5p of all subjects were collected, and the differences of parameter indexes among different groups of patients were compared. The receiver operating characteristic (ROC) curve was plotted and the area under the curve (AUC) was calculated to evaluate the predictive value of multi-slice spiral CT perfusion parameters combined with serum miR-92a-3p and miR-361-5p in severe acute pancreatitis.

The PS, miR-92a-3p and miR-361-5p of patients with acute pancreatitis were higher than those of the control group, while the MTT, blood flow and blood volume were lower than those of the control group, with statistically significant differences (P<0.05). The Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score, MTT, PS, miR-92a-3p, and miR-361-5p in the severe acute pancreatitis group were higher than those in the mild group, while MTT, blood flow, and blood volume were lower than those in the mild group, with statistically significant differences (P<0.05). Logistic multivariate regression analysis showed that APACHE Ⅱ score ≥29 points, blood flow<62 ml·min^-1·100 mg^-1, blood volume<11 ml/100 mg, MTT<10 s, PS≥47 ml·min^-1·100 mg^-1, miR-92a-3≥2.1, miR-361-5p≥0.54 were all risk factors for predicting severe acute pancreatitis (P<0.05). ROC curve showed that the AUC of the combined APACHE Ⅱ score, blood flow, blood volume, MTT, PS, miR-92a-3 and miR-361-5p in predicting severe acute pancreatitis was 0.831 (95% CI: 0.782-0.912), and the sensitivity and specificity were 85.37% and 86.16%, respectively.

Multi-slice spiral CT perfusion parameters can accurately identify the severity of the disease, the combination of serum miR-92a-3p and miR-361-5p has higher predictive value, providing an important reference for clinical diagnosis and treatment.

To establishment a risk prediction model for delayed recovery from general anesthesia in elderly patients with colorectal cancer after laparoscopic radical surgery and verify its application effect.

A total of 257 elderly patients with colorectal cancer admitted to Baoji Central Hospital from March 2021 to March 2024 were enrolled retrospectively, all of whom were treated with laparoscopic radical surgery. They were included in the training group (n=180) and the verification group (n=77) according to a ratio of 7∶3. The recovery from general anesthesia of patients were evaluated, and the clinical data of patients with delayed and normal recovery from general anesthesia in the training group (n=180) were compared. Multivariate Logistic regression analysis was used to summarize the risk factors for delayed recovery from general anesthesia in elderly patients with colorectal cancer after laparoscopic radical surgery. Univariate and multivariate screening were performed to identify key predictors, and the risk factors were incorporated into the Nomogram prediction model to establish a risk prediction model. The predictive accuracy of the model was measured using receiver operating characteristic (ROC) curve, and the calibration of the model was verified using Bootstarp and Clinical decision curve analysis.

Among 257 patients, 105 had delayed recovery after operation, with an incidence of 40.87%. In the training group, those who experienced delayed recovery after surgery were classified as the delayed recovery group (n=72), and the other 108 cases were in the normal recovery group. There were statistically significant differences between the delayed recovery group and the normal recovery group in American Society of Anesthesiologists (ASA) classification, preoperative respiratory dysfunction, anesthesia time, propofol dosage, sufentanil dosage, intraoperative infusion volume, intraoperative hypothermia and postoperative hypokalemia (P<0.05). Logistic multivariate analysis showed that ASA classification, preoperative respiratory dysfunction, anesthesia time, propofol dosage, sufentanil dosage, intraoperative infusion volume, intraoperative hypothermia, and postoperative hypokalemia were all independent risk factors for delayed recovery from general anesthesia after laparoscopic radical surgery in elderly patients with colorectal cancer (P<0.05). The area under the curve of the Nomogram model was 0.860 in the training group and 0.823 in the verification group, the sensitivity and specificity applied to the verification group were 82.53% and 83.46%, respectively.

The risk of delayed recovery from general anesthesia after laparoscopic radical surgery in elderly patients with colorectal cancer is higher, and it is related to ASA classification, preoperative respiratory dysfunction, anesthesia time, propofol dosage, sufentanil dosage, intraoperative infusion volume, intraoperative hypothermia, postoperative hypokalemia and other factors. The prediction model based on the above factors can provide a reliable reference for the risk assessment of delayed recovery from general anesthesia in elderly patients with colorectal cancer after laparoscopic radical surgery.

To investigate the anesthetic effect of different doses of esketamine combined with sufentanil in laparoscopic radical gastrectomy for gastric cancer.

A total of 120 patients who received laparoscopic radical gastrectomy in Dongguan Integrated Traditional Chinese and Western Medicine Hospital from January 2023 to May 2024 were selected, they were divided into group A, group B and group C according to the randomly sealed envelope, with 40 cases in each group. Sufentanil and other drugs were used to induce anesthesia in the three groups, on this basis, esketamine 0.2 mg·kg^-1 in group A, 0.3 mg·kg^-1 in group B and 0.4 mg·kg^-1 in group C were used for anesthesia induction, and esketamine 0.2 mg·kg^-1·h^-1 was used to maintain anesthesia in group A, 0.3 mg·kg^-1·h^-1 was used in group B, and 0.4 mg·kg^-1·h^-1 was used group C. The perioperative conditions, hemodynamic changes, postoperative digital pain scale (NRS) score and adverse reactions were compared among three groups.

There were no statistically significant differences in the intraoperative dosage of sufentanil, ephedrine and norepinephrine among the three groups (P>0.05), the recovery time and extubation time in the group C were longer than those in the group A and group B (P<0.05), and there was no statistically significant difference in the recovery time and extubation time between group A and group B (P>0.05). The comparison of before entering the room (T0) and the end of the surgery (T3) time-point mean arterial pressure (MAP) among the three groups showed no statistical significance (P>0.05). The comparison of 5 minutes after tracheal intubation (T1) and 5 minutes after the start of the surgery (T2) time-point MAP in group A was lower than those in group B and C (P<0.05), and the comparison of T1 and T2 time-point MAP in group B showed no statistical significance (P>0.05). The comparison of heart rates at different time points among the three groups showed no statistical significance (P>0.05). There was no statistical significance in 6 h, 12 h, 24 h and 48 h NRS scores among the three groups after operation (P>0.05). There was a statistically significant difference in the incidence of agitation among the three groups (P<0.05).

In laparoscopic radical gastrectomy for gastric cancer, esketamine 0.3 mg·kg^-1 combined with sufentanil is used to induce anesthesia, and esketamine 0.3 mg·kg^-1·h^-1 is used to maintain better anesthesia effect, which can not only maintain hemodynamic stability, but also reduce the incidence of postoperative agitation.

To evaluate the dose-effect relationship of ciprofol combined with remifentanil to inhibit responses to gastroscope insertion.

Patients who planned to undergo gastroscopy from January 2024 to April 2024 were included. Inclusion criteria: age 18-65 years old, American Society of Anesthesiologists (ASA) grade Ⅰ to Ⅱ, body mass index (BMI) 18.5-27.9 kg/m². Ciprofol was injected intravenously for 30 s, remifentanil was injected intravenously for 1.0 μg/kg for 60 s. The patients' ciprofol dose was adjusted by Dixon sequential method. The initial dose was set at 0.30 mg/kg and the adjustment range was ±0.02 mg/kg. Probit regression was used to calculate the ED50 and ED95 of ciprofol combined with 1.0 μg/kg remifentanil to inhibit gastroscope insertion. The heart rate, noninvasive mean arterial pressure (MAP) and oxyhemoglobin saturation (SpO₂) of patients were recorded immediately after entering the endoscopy room (T0), 1 min after ciprofol injection (T1), immediately after gastroscope insertion (T2), immediately after gastroscope withdrawal (T3), and at the time of recovery (T4). Recovery time, length of postanesthesia care unit (PACU) stay and perioperative complications were recorded.

According to the Dixon sequential method, the study was terminated after 28 patients were enrolled. Probit regression results showed that the ED50 of cipofol combined with 1.0 μg/kg remifentanil inhibited responses to gastroscope insertion was 0.254 mg/kg (95% CI: 0.242-0.266 mg/kg). The ED95 was 0.290 mg/kg (95% CI: 0.260-0.320 mg/kg). The MAP of T1, T2 and T3 was significantly lower than that of T0, with statistically significant differences (P<0.05). The recovery time of patients was (5.3±1.8) min and the length of PACU stay was (46.4±11.1) min. Bradycardia, hypoxemia and hypotension occurred in 2, 2 and 3 patients, respectively.

The ED50 and ED95 of cipofol combined with 1.0 μg/kg remifentanil to inhibit responses to gastroscope insertion are 0.254 mg/kg and 0.290 mg/kg, respectively. This anesthesia program has a low incidence of perioperative complications and has high efficacy and safety.

To explore the diagnostic value of combined detection of serum interleukin-27 (IL-27), transforming growth factor-β (TGF-β) and fecal calprotectin (FC) in children with food protein-induced enterocolitis syndrome (FPIES).

A total of 123 children with FPIES admitted to Suzhou Wujiang District Children's Hospital from March 2020 to August 2023 were retrospectively analyzed as the FPIES group. In addition, 154 children with common diarrhea who were admitted to the hospital during the same period were selected as the common diarrhea group, and 84 children who underwent health check-ups were selected as the healthy group. The baseline data and serum levels of IL-27, TGF-β and FC were compared among the three groups. The relationship between platelet count (PLT), eosinophil count (EOS), duration of vomiting and serum IL-27, TGF-β, FC in children with FPIES was analyzed. The relationship between serum IL-27, TGF-β and FC in FPIES children was analyzed. The diagnostic value of serum IL-27, TGF-β, FC and combined detection of the three indexes in FPIES was analyzed.

There were no statistically significant differences in gender, age and body mass index among the three groups (all P>0.05). However, the levels of PLT and EOS in the FPIES group were significantly higher than those in the common diarrhea group and the healthy group (all P<0.001), and the levels of PLT and EOS in the common diarrhea group were significantly higher than those in the healthy group (both P<0.001). The serum levels of IL-27, TGF-β and FC in the three groups showed a trend of FPIES group>general diarrhea group > healthy group (all P<0.001). In children with FPIES, PLT, EOS and vomiting duration were positively correlated with serum IL-27 (r=0.594, 0.617, 0.563), TGF-β (r=0.537, 0.633, 0.492) and FC (r=0.673, 0.773, 0.697) (all P<0.001). Serum IL-27 (r=0.444) and TGF-β (r=0.486) were positively correlated with FC in FPIES children (all P<0.001). There was a positive correlation between serum IL-27 and TGF-β (r=0.426, P<0.001). The diagnostic value of serum IL-27, TGF-β combined with FC (AUC=0.913) for FPIES was significantly higher than that of the individual detections of serum IL-27 (AUC=0.859), TGF-β (AUC=0.882), FC (AUC=0.901) (P<0.001, 0.006, 0.021).

Serum IL-27, TGF-β and FC are abnormally increased in children with FPIES. The combined detection of serum IL-27, TGF-β and FC has a high clinical diagnostic value for FPIES.

To explore the dual regulatory effects of extracorporeal shock wave stimulation of Zusanli and Jianyu acupoints on gastrointestinal motility and autonomic nerve function in patients with diabetic gastroparesis (GDP).

A total of 180 patients with GDP admitted to First Hospital of Qinhuangdao from June 2023 to February 2025 were selected as the research subjects and randomly divided into three groups by random number table method, with 60 cases in each group. Group A received conventional diabetes management. Group B was treated with extracorporeal shock wave stimulation of the Zusanli acupoint. Group C was treated with extracorporeal shock wave stimulation of the Zusanli acupoint combined with the Jianyu acupoint. The treatment course was 8 weeks. The general data of three groups were collected and the clinical efficacy of the three groups after 8 weeks of treatment were compared. The scores of the Gastroparesis Symptom Severity Index (GCSI) before and after treatment, gastrointestinal motility indicators (gastric emptying time, gastric emptying rate, antral contraction frequency), gastrointestinal hormone levels (gastrin, motility, somatostatin), electrogastrogram indicators [gastric main power ratio (PDP), gastric main frequency ratio (PDF)], and heart rate variability performance indicators [standard deviation of RR interval mean (SDANN), root mean square of difference between adjacent RR intervals (RMSSD), standard deviation of RR intervals of all sinus beats (SDNN), ratio of power in the low-frequency range to power in the high-frequency range (LF/HF)] and adverse reaction conditions were compared.

There were no statistically significant differences in general data among groups A, B and C (P>0.05), and the baseline data were comparable. The total effective rate of group C (93.33%) was significantly higher than that of group B (80.00%) and group A (66.67%), with a statistically significant difference (P=0.023). Before treatment, there were no significant differences among the three groups in GCSI scores, gastrointestinal motility indicators, gastrointestinal hormone levels, electrogastrography indicators, and heart rate variability indicators (all P>0.05). After treatment, the GCSI scores of all three groups decreased significantly (all P<0.001), with group C showing the greatest improvement. The gastric emptying time of all three groups was shortened, the gastric emptying rate increased, and the antral contraction frequency rose. Moreover, the improvements in these indicators in group C were more significant than those in groups A and B (all P<0.001). The levels of gastrin and motility in group C were significantly higher, while the level of somatostatin was significantly lower than those in groups A and B (all P<0.001). The values of PDP and PDF in all three groups increased significantly, and those in group C were significantly higher than those in groups A and B (all P<0.05). SDANN, RMSSD, and SDNN in group C were significantly higher, and LF/HF was significantly lower than those in groups A and B (all P<0.001). There was no statistically significant difference in the total incidence of adverse reactions among the three groups (P>0.05).

Extracorporeal shock wave stimulation of Zusanli acupoint combined with Jianyu acupoint in the treatment of GDP can significantly improve the clinical efficacy, effectively improve the gastrointestinal motility and autonomic nerve function of patients.

To explore the relationship between self-efficacy, sleep quality and mental state in patients with inflammatory bowel disease (IBD), and analyze the related factors affecting mental state in patients with IBD.

A total of 103 IBD patients diagnosed and treated in the First People's Hospital of Huai'an, Nanjing Medical University from June 2021 to June 2024 were retrospectively selected as the study objects. The mental state of the patients was assessed using the Hospital Anxiety and Depression Scale (HADS), and the patients were divided into the poor mental state group (n=35, ≥11 points) and the good mental state group (n=68, <11 points) according to the HADS score. The general information, self-efficacy and sleep quality scores of different groups were compared. Spearman correlation analysis was conducted to analyze the relationship between self-efficacy, sleep quality and mental state in IBD patients, and multi-factor Logistic regression model was used to analyze the influencing factors of mental state in IBD patients.

Univariate results showed that there were statistically significant differences in disease duration, family per capita monthly income, disease severity, recurrence frequency and IBD quality of life questionnaire (IBDQ) scores between the poor mental state group and the good mental state group (all P<0.05). The score of IBD self-efficacy scale (IBD-SES) in the poor mental state group was significantly lower than that in the good mental state group, and the score of Pittsburgh Sleep Quality Index Scale (PSQI) was significantly higher than that in the good mental state group (both P<0.001). Spearman correlation analysis showed that IBD-SES score (r=-0.653) was significantly negatively correlated with poor mental state, and PSQI score (r=0.581) was significantly positively correlated with poor mental state (both P<0.001). Multivariate Logistic regression showed that the severity of the disease (moderate and severe active period), the number of recurrence ≥2, low IBD-SES score and high PSQI score were all independent risk factors for poor mental state in IBD patients (all P<0.05).

The self-efficacy and sleep quality of IBD patients are closely related to their mental state, and the severity of the disease, the number of relapses, self-efficacy and sleep quality are important independent factors affecting their mental state.

Three-dimensional (3D) printing technology has been applied in orthopedics, maxillofacial surgery, neurosurgery, cardiac surgery and other medical fields, which has become a research hotspot, but the research and application in the field of gastrointestinal tumors are still lacking in bulk literature reports. In this review, the clinical application and basic research status and prospect of 3D printing technology in the field of gastrointestinal tumors are summarized, and the problems existing in the process of research and application are preliminarily suggested.

Primary peritoneal mesothelioma, especially malignant peritoneal mesothelioma (MPM), is clinically rare. It is characterized by insidious onset, lack of specific symptoms, and poor treatment effect. Rapid and definite diagnosis is of great significance for follow-up treatment of peritoneal mesothelioma. According to the pathogenesis characteristics of one MPM patient, this case report presents a rapid diagnosis method guided by strong logic, and in order to provide reference for the rapid diagnosis of similar clinical cases.