Ulcerative colitis (UC) is a chronic relapsing inflammatory bowel disease. Its pathogenesis involves multiple factors including gut microbiota imbalance, immune dysfunction, and metabolic disturbances in the intestine. Intestinal gas detection has recently emerged as a research focus in UC due to its non-invasive nature, potential for dynamic monitoring, and ability to assess disease prognosis. This study systematically examines four key gases: hydrogen (H₂), methane (CH₄), hydrogen sulfide (H₂S), and nitric oxide (NO). We propose that multi-gas ratio models (such as H₂/CH₄ and H₂S/NO) show diagnostic and therapeutic evaluation potential in UC. These models could reduce dependence on endoscopic examinations while providing new strategies for UC diagnosis and treatment management.

To investigate the effects of microRNA-146a (miR-146a) targeted protein tyrosine phosphatase 1B (PTP1B) on the proliferation, migration and invasion of colorectal cancer cells (HCT-116).

Human colorectal cancer cell line HCT-116 and normal colon epithelial cell line NCM460 were cultured in vitro, HCT-116 cells were randomly divided into control group, miR-146a NC group and miR-146a mimics group. The expression of miR-146a and PTP1B mRNA in HCT-116 cells was detected by real-time quantitative PCR (RT-qPCR). Cell counting kit (CCK-8) and flow cytometry were used to detect cell survival rate and apoptosis. The migration of HCT-116 cells was detected by scratch test. The invasion of HCT-116 cells was detected by Transwell chamber method. The expression changes of PTP1B, matrix metalloproteinase (MMP)-2 and MMP-9 were detected by Western blotting. Double luciferase reporter assay was used to verify the targeting relationship between miR-146a and PTP1B.

Compared with those in NCM460 cells, the expression level of miR-146a in HCT-116 cells were significantly lower, and the expression of PTP1B mRNA was significantly higher (P<0.05). Dual luciferase assay confirmed that miR-146a has a targeted binding site with PTP1B. Compared with those in control group and miR-146a NC group, the miR-146a expression level and apoptosis rate of HCT-116 cells in miR-146a mimics group were significantly higher (P<0.05), the cell survival rate, scratch migration rate, invasion rate, expression levels of PTP1B mRNA and protein, MMP-2 and MMP-9 protein were significantly lower (P<0.05).

Overexpression of miR-146a may inhibit malignant behavior of colorectal cancer cells by targeting negative regulation of PTP1B expression.

To measure the expression level of plasma exosome circLPAR1 in the serum of gastric cancer patients, and to analyze the clinical value of circLPAR1 in the diagnosis and prognosis assessment of gastric cancer.

A retrospective cohort study design was adopted. A total of 98 gastric cancer patients newly diagnosed at the Dongcheng Campus of the First Affiliated Hospital of Anhui Medical University from March 2018 to March 2019 were selected as the research subjects. At the same time, 60 patients with chronic gastritis and 60 healthy examinees were selected. The expression level of plasma exosomal circLPAR1 in each group was detected by real-time quantitative polymerase chain reaction (RT-qPCR). The diagnostic values of plasma exosomal circLPAR1, serum carcinoembryonic antigen (CEA), and serum carbohydrate antigen 19-9 (CA19-9) in gastric cancer were analyzed. The relationship between plasma exosomal circLPAR1 and the clinicopathological characteristics of gastric cancer patients was analyzed, and the survival curve was drawn by the Kaplan-Meier method.

The expression level of plasma exosomal circLPAR1 in gastric cancer patients was lower than that in patients with chronic gastritis and healthy examinees, with statistically significant differences (P<0.05). The level of plasma exosomal circLPAR1 was correlated with tissue differentiation, tumor diameter, vascular invasion, lymph node metastasis, and TNM stage (P<0.05). The average survival time of gastric cancer patients with high expression of serum exosomal circLPAR1 was longer than that of the low expression group. Receiver operating characteristic (ROC) curve analysis showed that the area under the ROC curve (AUC) of plasma exosomal circLPAR1 was 0.960 (95% CI: 0.916-0.984), which was significantly higher than the AUC value of single serum CEA detection (0.708, 95% CI: 0.630-0.777) and single serum CA19-9 detection (0.724, 95% CI: 0.647-0.792).

The expression level of plasma exosomal circLPAR is increased in gastric cancer patients. The level of plasma exosomal circLPAR is related to the clinicopathological characteristics and prognosis of gastric cancer patients. The detection of plasma exosomal circLPAR has high sensitivity and specificity in the diagnosis of gastric cancer, and has certain clinical application value.

To investigate the prognostic status and influencing factors of radical and palliative surgery in patients with initial resectable gastric cancer with liver metastasis (GCLM).

A total of 150 patients with initially resectable GCLM admitted to Gong'an Hospital of Traditional Chinese Medicine Affiliated to Hubei University of Chinese Medicine from January 2021 to December 2024 were selected as the study objects, and the patients were divided into radical treatment group (n=89) and palliative group (n=61) according to surgical treatment methods. The prognosis and postoperative complications of the two groups of patients were compared. The survival curves were plotted using the Kaplan-Meier method, and the effects of different treatment regimens on the survival rate of patients with initially resectable GCLM were analyzed by the Log-rank test. Univariate and multivariate analyses were used to explore the factors influencing prognosis.

The median overall survival for the curative group was 32.6 months, with 1-year and 3-year survival rates of 84.3% and 44.9%, respectively. For the palliative group, the median overall survival was 18.4 months, with 1-year and 3-year survival rates of 62.2% and 21.3% (P<0.05). Among 150 patients with initially resectable GCLM, the favorable prognosis group included those who underwent complete surgical resection with few liver metastases, effective postoperative adjuvant therapy, and lower levels of biomarkers. The unfavorable prognosis group included patients with multiple liver metastases, those who could not undergo complete resection, those with postoperative recurrence or metastasis, poor chemotherapy response, and elevated biomarker levels. Among the 150 cases, 60 had a good prognosis and 90 had a poor prognosis. Comparisons of age, gender, smoking history, alcohol history, primary gastric tumor location, maximum diameter of the primary gastric tumor, WHO classification, number of liver metastases, liver metastasis distribution, and maximum diameter of liver metastases between the two groups showed no statistically significant differences (P>0.05). The favorable prognosis group had higher proportions of tumors with moderate to high differentiation and curative surgeries than the unfavorable prognosis group. Additionally, the number of metastatic lesions, abdominal metastasis, and vascular invasion were significantly lower in the favorable prognosis group compared to the unfavorable prognosis group (P<0.05). Logistic regression analysis showed that poorly differentiated tumors, multiple liver metastases, abdominal metastasis, and vascular invasion were risk factors affecting the prognosis of initially resectable GCLM patients undergoing curative and palliative surgical treatments, with curative surgery being a protective factor for prognosis (P<0.05). There was no statistically significant difference in the incidence of postoperative complications between the two groups (χ²=0.180, P=0.672).

For initially resectable GCLM, radical surgical treatment can significantly prolong survival, but high-risk patients with a large number of liver metastases, peritoneal metastasis or vascular invasion should be strictly excluded.

To investigate the expression of MYCT1 (Myc target 1) and tumor necrosis factor receptor superfamily member 6 (FAS) in HBV infection-associated hepatocellular carcinoma (HCC) and their relationship with clinicopathological parameters on the basis of previous studies.

A total of 48 HBV infection-associated HCC patients diagnosed at the 960th Hospital of the PLA Joint Support Force from June 2018 to August 2023 were collected. Real-time quantitative PCR was used to detect mRNA levels in the samples, and immunohistochemistry was used to detect the expression of MYCT1 and FAS, and the differences between cancerous tissues and adjacent tissues were compared. The correlation between clinicopathological parameters and MYCT1 and FAS was analyzed statistically. The GEPIA database was used to analyze the expression level of MYCT1 in HCC and the prognosis of patients.

The mRNA and protein expression levels of MYCT1 and FAS were significantly decreased in liver cancer tissues compared with paracancer tissues (P<0.05). The expression of MYCT1 was significantly correlated with age, sex and tumor size (P<0.05). FAS expression was significantly correlated with TNM stage (P<0.05). The expression intensity of MYCT1 and FAS in HCC tissues was positively correlated (r=0.333, P<0.05). GEPIA database analysis showed that MYCT1 expression was lower in hepatocellular carcinoma (LIHC) compared with paracancer tissues. The expression of MYCT1 was different in different stages. The survival of patients with high MYCT1 expression was significantly better than those with low MYCT1 expression (all P<0.05).

In HCC associated with HBV infection, the expression of FAS is correlated with the TNM stage of the patients; MYCT1 may mediate apoptosis through the FAS pathway. MYCT1 may potentially become a new biomarker for the auxiliary diagnosis and prognosis assessment of HCC.

To analyze the correlation between multimodal parameters of gadoxetic acid disodium (Primovist) enhanced MRI and the severity of primary hepatocellular carcinoma in patients.

A total of 90 patients with primary hepatocellular carcinoma admitted to Xianyang Central Hospital from October 2021 to October 2022 were included as the study subjects, all patients underwent Primovist enhanced MRI examination and underwent Child Pugh grading of liver function, disease grading, vascular infiltration, and prognosis quality evaluation, and the correlation between MRI multimodal quantitative parameters [apparent diffusion coefficient (ADC), true diffusion coefficient (D), perfusion related diffusion coefficient (D*), perfusion fraction (f), rate constant (K_ep), volume transfer constant (K^trans), and percentage of extracellular space volume (V_e)] and patient disease severity (liver function, disease grading, vascular infiltration, prognosis quality) was analyzed.

There were statistically significant differences in ADC, D, D*, f, K_ep, K^trans and V_e among patients with different Child-Pugh grades of liver function and disease stages (P<0.05). ADC and D in the non-invasive group were higher than those in the vascular invasion group, and D*, f, K^trans, K_ep and V_e were higher than those in the vascular invasion group (P<0.05). ADC and D in the good prognosis group were higher than those in the poor prognosis group; D*, f, K^trans, K_ep, V_e were higher than those in the poor prognosis group; ADC and D in the death group were lower than those in the survival group; D*, f, K^trans, K_ep, V_e were higher than those in the survival group (P<0.05). According to Spearman model, ADC and D values were negatively correlated with liver function grade, disease stage, vascular infiltration and prognostic quality (P<0.05), while D*, f, K_ep and V_e values were positively correlated with them (P<0.05). Logistic multivariate regression analysis showed that ADC<1.6×10^-3 mm²/s, D<1.45×10^-3 mm²/s, D*≥59×10^-3 mm²/s, f≥25%, K_ep≥1.35/min, K^trans≥0.41/min, V_e≥0.36 were all risk factors affecting poor prognosis of patients with primary hepatocellular carcinoma (P<0.05). Combined ADC, D, D*, f, K_ep, K^trans and V_e predicted the AUC of poor prognosis in patients with primary hepatocellular carcinoma was 0.936, and the sensitivity and specificity were 91.89% and 89.69% (P<0.05).

The multimodal quantitative parameters of Primovist-enhanced MRI exhibits a significant correlation with liver function, disease grading, vascular invasion, and quality of prognosis in patients, these parameters are instrumental in assessing the severity of the disease and provide a more reliable imaging reference for predicting patient prognosis.

To investigate the effect of ulinastatin on Janus kinase 2/signal transducer and activator of transcription 3 (JAK2/STAT3)-mediated pyroptosis alleviates intestinal mucosal barrier injury in rats with severe acute pancreatitis (SAP).

Using the random number table method, 72 SD rats were randomly divided into sham operation group, SAP model group, low-dose ulinastatin group (5 000 U/kg), medium-dose ulinastatin group (10 000 U/kg), high-dose ulinastatin group (30 000 U/kg) and high-dose ulinastatin+BE (Broussonin E, JAK2 activator) group (30 000 U/kg+Broussonin E), 12 animals in each group. Except for the sham operation group, the other four groups were injected with 5% sodium taurocholate through the pancreatic duct to establish the SAP rat model. At 0, 6 and 12 h after modeling, the rats in low-dose ulinastatin group, middle-dose ulinastatin group, high-dose ulinastatin group, and high-dose ulinastatin+BE group were intraperitoneally injected with corresponding doses of drugs, and the rats in sham operation group and SAP model group were intraperitoneally injected with the same volume of PBS. After 24 hours of modeling, the ascites volume and the dry/wet mass ratio of pancreatic and intestinal tissues were measured; HE staining was used to observe the pathological changes of pancreatic and intestinal mucosa tissues; ELISA was used to detect serum tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, IL-18, diamine oxidase (DAO) and intestinal fatty acid binding protein (IFABP) levels; immunohistochemical method and WB were used to detect the positive cells and protein expression of JAK2, STAT3, cleaved-caspase-1, and Gasdermin D-N (GSDMD-N). The experimenter was blinded during pathological scoring (Schmidt score, Chiu's score) and data measurement.

Compared with the sham operation group, the SAP model group had the lower pancreas and intestinal dry/wet mass ratio, pathological scores (Schmidt score, Chiu’s score), serum indicators (TNF-α, IL-1β, IL-18, DAO, IFABP) and JAK2, STAT3, cleaved-caspase-1, GSDMD-N positive cell expression and protein levels were significantly increased (all P<0.05). Compared with the SAP model group, the ascites volume, pathological scores, serum indicators, and positive cell expression and protein levels of JAK2, STAT3, cleaved-caspase-1 and GSDMD-N in rats treated with ulinastatin significantly reduced, and the dry/wet mass ratio of pancreas and intestine was increased in a dose-dependent manner (all P<0.05). Compared with the high-dose ulinastatin group, the ascites volume, pathological score, serum indexes, the positive cell expression and protein levels of JAK2, STAT3, cleaved-caspase-1 and GSDMD-N in the high-dose ulinastatin+BE group were significantly increased, and the dry/wet mass ratio of pancreas and intestine was decreased (all P<0.05).

Ulinastatin dose-dependently inhibits JAK2/STAT3 mediated intestinal cell pyroptosis, improves the inflammatory response of intestinal mucosa in SAP rats, and reduces mucosal barrier damage, with the optimal dose of 30 000 U/kg.

To analyze the value of lactic acid, the ratio of lactate dehydrogenase to albumin (LAR), visceral fat index (VAI) and systemic immune inflammatory index (SII) in evaluating the condition and prognosis of elderly patients with acute pancreatitis (AP).

A total of 215 elderly AP patients admitted to Zhangjiagang First People's Hospital from January 2020 to January 2024 were divided into mild, moderate and severe AP groups according to their illness. According to the prognosis of patients, they were divided into survival and death groups. The differences of blood lactic acid, LAR, VAI and SII in patients with different conditions and different prognosis were compared, and the area under the curve (AUC) and efficacy of each index in evaluating the conditions and prognosis of elderly AP patients were evaluated by receiver operating characteristic (ROC) curve.

Among 215 patients, there were 99 patients with mild, 53 patients with moderate and 63 patients with severe AP; 24 cases died and 191 cases survived. With the progress of the patient's condition, the blood lactic acid, LAR, VAI and SII gradually increased, and there were statistically significant differences between groups (P<0.05). The blood lactic acid, LAR, VAI and SII in the dead group were significantly higher than those in the surviving group, and there were statistically significant differences between the two groups (P<0.05). Logistic multivariate regression analysis showed that the increase of blood lactic acid, LAR, VAI and SII were independent risk factors for the progress of the elderly AP patients, and also for their death (P<0.05). The ROC curve showed that the AUC of blood lactic acid, LAR, VAI and SII combined in evaluating the condition (severity) of elderly AP patients was 0.912, and the sensitivity and specificity were 85.35% and 89.04% respectively. The AUC of joint prediction of the prognosis (death) of elderly AP patients was 0.842, and the sensitivity and specificity were 81.99% and 86.28% respectively.

The combination of lactic acid, LAR, VAI and SII can guide the comprehensive evaluation of the condition and prognosis of elderly AP patients from multiple dimensions, such as self-organization injury, abnormal glucose and lipid metabolism and inflammatory reaction, and its evaluation and prediction efficiency are worthy of recognition.

To investigate the imaging features of preoperative multislice CT angiography (MSCTA), neutrophil to lymphocyte ratio (NLR), Glasgow-Blatchford score (GBS), pre-endoscopic Rockall score (PRS) and AIMS65 score changes and their prognostic significance in patients with esophageal and gastric variceal bleeding (EVB) due to cirrhosis.

A total of 100 liver cirrhosis patients with EVB admitted to Baoji High-tech Hospital from January 2022 to August 2024 were included as study objects, all patients received treatments such as endoscopic esophageal variceal ligation, ligation combined with sclerotherapy injection or interventional embolization, and completed MSCTA examination before the operation. The two groups of patients were followed up for 6 months, according to the prognosis and survival status of the patients, they were divided into the survival group (n=88) and the death group (n=12). Preoperative MSCTA imaging features [maximum transverse diameters of left gastric vein (LGV), main portal vein (MPV), superior mesenteric vein (SMV) and splenic vein (SPV)], NLR, GBS, PRS and AIMS65 scores were compared between the two groups. Pearson correlation analysis was used to analyze the correlation between imaging features, NLR, GBS, PRS, AIMS65 scores and prognosis of EVB patients with cirrhosis. Receiver operating characteristic (ROC) curve was used to evaluate the prognostic value of MSCTA imaging features, NLR, GBS, PRS and AIMS65 scores in EVB patients with cirrhosis.

The maximum transverse diameters of LGV, MPV, SMV, SPV, NLR, GBS, PRS and AIMS65 scores in the death group were significantly higher than those in the survival group (P<0.05). LGV, MPV, SMV, SPV, NLR, GBS, PRS, AIMS65 were positively correlated with the prognosis of EVB patients with cirrhosis (P<0.05); ROC curve analysis results showed that the area under the curve (AUC) of LGV, MPV, SMV, SPV, NLR, GBS, PRS and AIMS65 were 0.837, 0.675, 0.695, 0.861, 0.694, 0.857, 0.974 and 0.972. The sensitivity was 0.750, 0.500, 0.583, 0.667, 0.667, 0.917, 0.833, 0.917, and the specificity was 0.989, 0.841, 0.773, 0.955, 0.773, 0.682, 0.989, 0.989 (P<0.05).

Preoperative MSCTA imaging features, NLR and GBS, PRS, AIMS65 scoring systems can effectively predict the prognosis of EVB patients with cirrhosis, the comprehensive application of these indicators can improve the accuracy of prognosis assessment, optimize treatment plan, and improve the survival rate of patients.

To investigate the correlation between serum Syndecan-1 level and cardiac function and severity of cirrhosis in patients with cardiogenic cirrhosis (CC).

A total of 139 patients with chronic congestive heart failure admitted to the Third Affiliated Hospital of Xi'an Medical University from January 2022 to October 2024 were retrospectively selected as the research objects. The patients were divided into CC group (n=42) and non-CC group (n=97) according to whether they were complicated with liver cirrhosis. Baseline data of patients were collected, and serum Syndecan-1 levels were detected by enzyme-linked immunosorbent assay (ELISA). Pearson/Spearman coefficient was used to analyze the correlation between serum Syndecan-1 level and echocardiographic parameters [left ventricular ejection fraction (LVEF), left ventricular fractional shortening (LVFS), mitral early diastolic inflow velocity/mitral late diastolic inflow velocity (E/A)] and cardiac function indicators [cardiac troponin I (cTnI), N-terminal pro-B-type natriuretic peptide (NT-pro BNP), creatine kinase isoenzyme (CK-MB)] and liver function [model for end-stage liver disease (MELD) score, Child-Pugh score] in CC patients.

There were significant differences between the two groups of patients in terms of blood ammonia, total bilirubin (TBIL), direct bilirubin (DBIL), aspartate aminotransferase (AST), alanine aminotransferase (ALT), echocardiogram parameters (LVEF, LVFS, E/A), cardiac function indicators (cTnI, NT-pro BNP, CK-MB) (all P<0.05). Serum Syndecan-1 level was negatively correlated with LVEF, LVFS and E/A (r=-0.692, r=-0.580, r=-0.695, all P<0.001). Serum Syndecan-1 levels was positively correlated with cTnI, NT-pro BNP and CK-MB (r=0.458, r=0.349, r=0.473, all P<0.001). Serum Syndecan-1 level was positively correlated with MELD and Child-Pugh scores (r=0.457, r=0.693, all P<0.001).

Serum Syndecan-1 level is significantly increased in patients with CC, and its change is closely related to cardiac function and the severity of cirrhosis. In clinical diagnosis and treatment, it is necessary to pay attention to the changes in serum Syndecan-1 levels.

To research the predictive value of AIMS65 score, Child-Pugh score, model for end-stage liver disease (MELD) score combined with coagulation indices in identifying acute-on-chronic liver failure (ACLF) among patients with cirrhosis.

The study was a retrospective cohort study, 247 patients with liver cirrhosis admitted to Yan'an University Affiliated Hospital from August 2019 to July 2024 were selected as the research objects, among which 44 patients were excluded because they did not meet the inclusion criteria, and finally 203 patients were enrolled. The basic demographic characteristics, medical history, laboratory indicators such as coagulation function and the scores of AIMS 65, Child-Pugh and MELD were collected and analyzed. Through univariate analysis and multivariate Logistic regression analysis, the influencing factors of ACLF in patients with liver cirrhosis were clarified. The receiver operating characteristic (ROC) curve was drawn for each scoring indicator and the combined detection in the diagnosis of liver cirrhosis complicated with ACLF, and the area under the curve (AUC) was calculated. The diagnostic efficacy of each scoring index and joint detection in the diagnosis of liver cirrhosis complicated with ACLF was evaluated.

Among the 203 patients, 47 cases developed ACLF (the ACLF group), while 156 cases did not have ACLF (the non-ACLF group). The levels of Child-Pugh grade, AIMS65 score, MELD score, alanine aminotransferase, aspartate aminotransferase, total bilirubin, prothrombin time (PT), activated partial thromboplastin time (APTT) and thrombin time (TT) in ACLF group were significantly higher than those in non-ACLF group, while the levels of albumin and fibrinogen (FIB) were significantly lower than those in non-ACLF group (P<0.05). Multivariate Logistic regression analysis showed that Child-Pugh grade, AIMS65 score, MELD score, PT, APTT and TT were independent risk factors (P<0.05), while FIB was a protective factor (P<0.05). In the diagnosis of liver cirrhosis complicated with ACLF, the AUC of the combined diagnosis of Child-Pugh score, AIMS65 score, MELD score and coagulation test was 0.847, which was significantly higher than that of the single detection of each scoring index (P<0.05). The combined prediction model showed good prediction efficiency in viral hepatitis, alcoholic liver disease and metabolic-related fatty liver disease. DeLong test showed that there was no significant difference in AUC among the three groups (viral vs. alcoholic: P=0.712; viral vs. metabolic correlation: P=0.802; alcoholic vs. metabolic correlation: P=0.915).

AIMS65 score, Child-Pugh score and MELD score combined with coagulation test indexes can effectively predict the risk of patients with liver cirrhosis complicated with ACLF, which is helpful for the clinical implementation of timely intervention measures and improving the prognosis of patients.

To investigate the influence factors of liver fibrosis reversal in patients with chronic hepatitis B (CHB) who received tenofovir alafenamide fumarate and received virological response.

A retrospective analysis was conducted on the medical records of 120 patients with CHB who received tenofovir propofol marinate treatment in Xuzhou Infectious Disease Hospital from November 2023 to Febuary 2024, and all patients received treatment for 12 months. According to the presence or absence of hepatic fibrosis reversal, 120 patients who received a virological response were divided into a hepatic fibrosis reversal group (n=44) and a non-hepatic fibrosis reversal group (n=76). The viral load, liver function indexes [alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL)], liver fibrosis indexes [hyaluronic acid (HA), laminin (LN), type Ⅲ procollagen (PC-Ⅲ), type Ⅳ collagen (Ⅳ-C)] and liver hardness of 120 patients were compared before treatment and 3 months after treatment. The viral load, liver function indexes and liver hardness values of patients with and without liver fibrosis reversal were compared. Logistic regression was used to analyze the factors influencing the reversal of liver fibrosis in CHB patients who received tenofovir alafenamide fumarate and received virological response.

The HBV DNA, ALT, AST, TBIL, HA, LN, PCⅢ, Ⅳ-C and liver hardness values of CHB patients after 3 months of treatment were significantly lower than those before treatment, with statistically significant differences (P<0.05). There was no significant difference in gender, age, drinking history, smoking history, pre-treatment ALT, pre-treatment AST and pre-treatment TBIL levels between the two groups (P>0.05). The HBV DNA and liver hardness values before treatment of patients without liver fibrosis reversal group were significantly higher than those of patients with liver fibrosis reversal group, with statistically significant differences (P<0.05). Logistic regression analysis showed that the high levels of HBV DNA and liver hardness before treatment were the factors influencing the reversal of liver fibrosis in CHB patients treated with tenofovir alafenamide fumarate and receiving virological response (P<0.05).

The high expression of HBV DNA and liver hardness before treatment are influential factors for the reversal of liver fibrosis in CHB patients who receive tenofovir alafenamide fumarate treatment and obtain virological response, early intervention and close monitoring should be carried out in clinical practice to improve the therapeutic effect and delay the progression of fibrosis.

To investigate the changes of Glasgog-Bradchford score (GBS), post-endoscopic Rockall score (RS), AIMS65 score, lactate/albumin ratio (LAR), monocyte/high-density lipoprotein cholesterol ratio (MHR) and their prognostic value in patients with acute upper gastrointestinal bleeding (AUGIB).

A total of 220 AUGIB patients admitted to Zhangjiagang First People's Hospital from September 2021 to September 2024 were included as study objects, according to the prognosis during hospitalization, the patients were divided into survival group (n=205) and death group (n=15). The GBS, RS and AIMS65 scores, LAR and MHR levels were compared between the two groups, Point-Biserial correlation analysis was used to analyze the correlation between GBS, RS and AIMS65 scores, LAR and MHR and prognosis of AUGIB patients, and the predictive value of GBS, RS and AIMS65 scores, LAR and MHR in AUGIB patients was evaluated by receiver operating characteristic (ROC) curve.

The scores of GBS, RS and AIMS65, LAR and MHR in death group were higher than those in survival group, with statistically significant differences (P<0.05); Pearson correlation analysis showed that GBS, RS and AIMS65 scores, LAR and MHR were positively correlated with prognosis in AUGIB patients (P<0.05); ROC curve analysis results showed that the area under the curve of GBS, RS and AIMS65 scores, LAR and MHR detection were 0.979, 1.000, 0.957, 0.960 and 0.999, respectively, and the sensitivity were 0.930, 0.813, 0.867, 0.821 and 0.902, the specificity was 0.888, 0.995, 0.976, 0.849, 0.980 (P<0.05).

GBS, RS, AIMS65 scores, LAR, and MHR in patients with AUGIB are effective predictors of prognosis, and high scores and elevated markers are associated with poor outcomes and contribute to clinical risk assessment.

To investigate the value of ultrasound fat fraction (UDFF) in evaluating the severity of disease and glucose lipid metabolism in young and middle-aged patients with metabolism-related fatty liver disease (MAFLD).

A retrospective analysis was carried out on the clinical data of 152 young and middle-aged MAFLD patients admitted to the Second People's Hospital of Neijiang City from March 2022 to March 2025. All patients were examined for UDFF and magnetic resonance proton density fat fraction (MRI-PDFF). According to the pathological grade of liver steatosis, all patients were divided into two groups: 102 cases in the mild fatty liver disease group (PDFF S1) and 50 cases in the moderate-to-severe fatty liver disease group (PDFF S2、S3); the relevant indicators related to glycolipid metabolism [fasting blood glucose (FBG), glycated hemoglobin (HbA1c), insulin resistance index (HOMA-IR), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C)] of the patients were collected; and the patients with MAFLD were grouped based on the different degrees of glycolipid metabolism, they were also grouped based on whether there was obvious liver fibrosis, among them, patients with obvious liver fibrosis were classified as group A and patients without/with minor liver fibrosis were classified as group B, and the UDFF differences between different groups were compared. The receiver operating characteristic (ROC) curve was plotted, and the area under the curve (AUC) was calculated to evaluate the diagnostic value of UDFF for the disease classification and glycolipid metabolism of MAFLD patients.

The levels of FBG, HOMA-IR, TC, TG and LDL-c in the mild group were higher than those in the moderate to severe group, while HbA1c, HDL-c and UDFF were lower than those in the moderate to severe group, with statistically significant differences (P<0.05). The UDFF in group A was (7.66±1.20)%, which was lower than that in group B [(12.23±3.49)%], with a statistically significant difference (t=11.400, P<0.001). The results of Logistic regression analysis showed that UDFF was positively correlated with the severity of MAFLD (OR=7.503, 95% CI: 3.427-16.456, P<0.001), the ROC curve showed that the AUC of UDFF in evaluating the severity of the disease in patients with MAFLD was 0.856 (95% CI: 0.825-0.886), the optimal cut-off value was 18.5%, the sensitivity was 86%, and the specificity was 82%. The results of Logistic regression analysis showed that UDFF was significantly positively correlated with abnormal glycolipid metabolism (P<0.001), for every 1% increase in UDFF, the risk of abnormal glycolipid metabolism in patients with MAFLD increased by 132% (OR=2.325, 95% CI: 1.852-2.912, P<0.001), the ROC curve showed that the AUC of UDFF in evaluating the degree of glycolipid metabolism in patients with MAFLD was 0.873, the optimal cut-off value was 9.5%, the sensitivity was 80.3%, and the specificity was 76.5%.

By quantifying liver fat content, UDFF has a good diagnostic efficacy for MAFLD patients with different severity of disease, which helps to evaluate the degree of abnormal glucose and lipid metabolism and liver fibrosis, and provides an important reference for clinical diagnosis and treatment.

To explore the diagnostic value of ultrasound combined with serum gastrin 17 (G-17) and pepsin for gastroesophageal reflux diseases (GERD).

A retrospective analysis was conducted on the clinical data of 402 patients with GERD admitted to Yan'an University Affiliated Hospital from March 2022 to March 2024, they were included in the observation group, and another 130 healthy individuals who underwent physical examinations during the same period were selected as the control group. According to the 24-hour esophageal pH monitoring examination results of the patients in the observation group, they were divided into the non-erosive reflux disease group (n=228) and the reflux esophagitis group (n=174), all subjects underwent ultrasound examination, and the ultrasound examination parameters [gastric cardia (His) angle, abdominal esophageal length] and the levels of indicators such as serum G-17 and pepsin of all subjects were collected; the differences of each index among subjects in different groups were compared; the receiver operating characteristic (ROC) curve was drawn, and the area under the curve (AUC) was calculated to evaluate the diagnostic value of multiple ultrasound parameters combined with G-17 and pepsin for gastroesophageal reflux diseases.

The His angle in the reflux esophagitis group was larger than that in the non-erosive reflux disease group and the control group, the His angle in the non-erosive reflux disease group was larger than that in the control group, the length of the abdominal esophagus in the reflux esophagitis group was shorter than that in the non-erosive reflux disease group and the control group, the length of the abdominal esophagus in the non-erosive reflux disease group was shorter than that in the control group, with statistically significant differences (P<0.05). The levels of G-17 and pepsin in the reflux esophagitis group were higher than those in the non-erosive reflux disease group and the control group, the non-erosive reflux disease group was higher than the control group, with statistically significant differences (P<0.05). The AUC of His angle, abdominal esophageal length, G-17 and pepsin in the diagnosis of gastroesophageal reflux disease was 0.602, 0.590, 0.581 and 0.567 respectively, all of which had diagnostic value for gastroesophageal reflux disease (P<0.05). The cutoff was calculated based on the Youden index principle, the His angle, abdominal esophageal length, G-17, and pepsin were 95.32°, 2.50 cm, 5.56 pmol/L, and 25.50 ng/ml, respectively, among them, the combined diagnostic value was the best, and the corresponding sensitivity and specificity were 76.3% and 84.6%, respectively. The results of univariate and multivariate Logistic regression analyses showed that His angle<95.32°, abdominal esophageal length≥2.50 cm, G-17<5.56 pmol/L, and pepsin<25.50 ng/ml were protective factors for gastroesophageal reflux disease (P<0.05).

Ultrasound detection of the His angle and the length of the abdominal esophagus combined with serum G-17 and pepsin can improve the detection rate of gastroesophageal reflux disease to a certain extent, the combination of multiple indicators provides a more reliable reference basis for the diagnosis and prognosis evaluation of clinical patients.

To investigate the long-term efficacy and safety of endoscopic ligation and sclerotherapy for grade Ⅰ-Ⅱ internal hemorrhoids.

Clinical data of patients with grade Ⅰ-Ⅱ internal hemorrhoids admitted to the 960th Hospital of Chinese PLA Joint Logistics Support Force from January 2019 to June 2021 were retrospectively analyzed. They were divided into ligation group (32 cases) and sclerotic group (45 cases) according to different endoscopic treatment methods. The follow-up time was 36-63 months, with a median follow-up time of 47.5 months. The therapeutic effect, recurrence, satisfaction and complications of the two groups were compared.

The cure rate, effective rate and total effective rate of the two groups were compared, which were 84.4%, 12.5% and 96.9% in the ligation group and 77.8%, 20.0% and 97.8% in the sclerotic group, respectively. There was no statistically significant difference between the two groups (P>0.05). Among the patients with effective treatment, the recurrence rate in the ligation group was higher than that in the sclerotic group (22.6% vs. 13.6%), but there was no statistically significant difference (P>0.05). The median recurrence time was 13.5 months in the ligation group and 12.0 months in the sclerotic group. Satisfaction was 93.8% in the ligation group and 95.6% in the sclerotic group, and there was no statistically significant difference between the two groups (P>0.05). Postoperative anal pain and anal distension in the ligation group were significantly more severe than those in the sclerotic group (41.6% vs. 2.2%, 56.2% vs. 6.7%), with a statistically significant difference (P<0.05). The incidence of postoperative hemorrhage and fever was lower between the two groups, but there was no statistical difference (P>0.05). During the follow-up period, there were 3 cases of anal fistula and perianal abscess in the ligation group, which occurred 1 month, 6 months, and 12 months after surgery, respectively, and were cured after additional surgery, while no such cases occurred in the sclerotic group.

Both ligation and sclerotherapy have excellent curative effect in the treatment of grade Ⅰ-Ⅱ internal hemorrhoids, with similar effective rate and recurrence rate, but sclerotherapy has a lower incidence of postoperative complications. For mild internal hemorrhoids such as grade Ⅰ-Ⅱ, sclerotherapy may be more advantageous.

To construct a risk factor model for restlessness during the recovery period after general anesthesia in patients with advanced colon cancer and verify its application effect.

A total of 360 patients with advanced colon cancer admitted to Xi'an People's Hospital from March 2021 to March 2024 were prospectively included, all of them were treated with radical resection under general anesthesia, and they were divided into a training group (n=252) and a validation group (n=108) at a ratio of 7∶3. The occurrence of postoperative restlessness during the recovery period of general anesthesia was evaluated, and the clinical data of patients with and without restlessness in the training group were compared. Logistic multivariate regression analysis was used to summarize the risk factors for restlessness during the recovery period after general anesthesia in patients with advanced colon cancer. Univariate and multivariate screenings were conducted respectively to identify the key predictors, and the risk factors were incorporated into the Nomogram prediction model to establish the risk prediction model. The predictive accuracy of the model was measured using the receiver operating characteristic curve, and the calibration of the model was verified using the bootstrap method and clinical decision curve analysis (DCA).

Among the 360 patients, 102 experienced postoperative restlessness during the recovery period of general anesthesia, with an incidence rate of 28.33%. In the training group, 73 patients experienced postoperative restlessness, and the remaining 179 were without restlessness. There were statistically significant differences in age, self-rating anxiety scale (SAS) score, use of dexmedetomidine, anesthesia method, combined epidural block, intraoperative hypothermia, postoperative immobilization, and visual analogue scale (VAS) score during the recovery period between the restlessness group and the non-restlessness group (P<0.05). Logistic multivariate analysis showed that age >60 years, SAS ≥50 points, no use of dexmedetomidine, anesthesia method of general anesthesia with tracheal intubation, combined epidural block, intraoperative hypothermia, no postoperative immobilization, and VAS score ≥5 points during the recovery period were independent risk factors for postoperative restlessness during the recovery period of general anesthesia in patients with advanced colorectal cancer (P<0.05). The Nomogram model constructed based on risk factors showed good predictive efficacy in the training group and the validation group respectively, with AUCs of 0.866 (95% CI: 0.812-0.920) and 0.833 (95% CI: 0.762-0.904). Delong test indicated that there was no significant difference in AUC between the two groups (P=0.263). The sensitivity and specificity of the model in the verification group were 82.32% and 83.38%. The DCA curve further confirmed that when the threshold probability was > 30%, the clinical net benefit of the model was significantly better than the default strategy (with a 12.3% increase in net benefit), supporting its application value in actual decision-making.

Patients with advanced colon cancer have a relatively high risk of restlessness during the recovery period after general anesthesia, and it is related to factors such as age, SAS, the use of dexmedetomidine, anesthesia method, the adoption of combined epidural block, intraoperative hypothermia, postoperative immobilization, and VAS score during the recovery period. The prediction model established based on the above factors can provide a reference for the risk assessment of restlessness reduction during the recovery period after general anesthesia in patients with advanced colon cancer.

To investigate the effects of ultrasound-guided lumbar muscle block and erector spine muscle plane block on stress indicators, inflammatory factors, and T lymphocyte subsets in patients with colorectal cancer after laparoscopic radical surgery.

From May 2023 to May 2024, 92 patients who underwent laparoscopic radical surgery for colorectal cancer in Xi'an International Medical Center Hospital were selected for observation and study. All samples were assigned into two groups using a random number table method. The experimental group (n=46) received ultrasound-guided lumbar muscle block, while the control group (n=46) received ultrasound-guided erector spine muscle plane block. The stress indicators, inflammation indicators, T lymphocyte subsets, pain scores, cognitive function, and adverse reaction events of the two groups were compared.

After treatment, the CD4⁺ and CD4⁺/CD8⁺ in the two groups were significantly increased (P<0.05), and the increase in the experimental group was better than that in the control group (P<0.05). After treatment, the levels of cortisol, angiotensin Ⅱ, and CD8⁺ in the two groups were significantly decreased (P<0.05), and the reduction in the experimental group was better than that in the control group (P<0.05). Compared with the control group, the experimental group showed a decrease in tumor necrosis factor-α, interleukin-6, and C-reactive protein levels 12 hours after surgery (P<0.05). The visual analog scale score of the experimental group was obviously lower than that of the control group at 2 and 12 hours after surgery (P<0.05). The Mini Mental State Examination (MMSE) of the experimental group was obviously higher than that of the control group 12 hours after surgery (P<0.05). The incidence of adverse reactions was not statistically obviously different between the two groups (P>0.05).

Ultrasound-guided lumbar muscle block is superior to ultrasound-guided erector spine muscle plane block in reducing stress response, inhibiting inflammatory cytokine production, and improving immune regulation in patients with colorectal cancer after minimally invasive radical surgery, with obvious comprehensive effects.

To establish the risk factor model of postoperative delirium in elderly patients with gastric cancer and verify its application effect.

A total of 390 elderly patients with gastric cancer admitted to Xuzhou Central Hospital from March 2021 to March 2024 were included in the training group (n=273) and verification group (n=117) according to a ratio of 7∶3. The occurrence of postoperative delirium was evaluated, and the difference of clinical data between the postoperative delirium occurrence and no postoperative delirium was compared in the training group. Multivariate Logistic regression analysis was used to summarize the risk factors of postoperative delirium in elderly patients with gastric cancer, and the risk factors were incorporated into the Nomogram prediction model. The receiver operating characteristic (ROC) curve was drawn to predict the occurrence of postoperative delirium in the validation group, and the calibration degree of the model was verified by Bootstarp method and clinical decision curve analysis (DCA).

Among the 390 included patients, 80 patients developed delirium after the operation, with an incidence rate of 20.51%. In the training group, those with postoperative delirium were classified as the delirium group (n=50), and the remaining 223 cases were classified as the non-delirium group. There were statistically significant differences in preoperative hypertension history, respiratory rate (RR), creatinine value, surgical methods, operation time, intraoperative blood loss, mechanical ventilation, and acute physiology score (APS) Ⅲ between the delirium group and the non-delirium group (P<0.05). Logistic multivariate analysis showed that preoperative history of hypertension, RR level, creatinine value, surgical method, operation time, intraoperative blood loss, mechanical ventilation, and APS Ⅲ score were all independent risk factors affecting postoperative delirium in elderly patients with gastric cancer (P<0.05). The areas under the curve of the model applied in the training group and the validation group were 0.854 (95% CI 0.812-0.896) and 0.812 (95% CI 0.763-0.861), respectively. The sensitivity and specificity applied in the validation group were 80.53% (95% CI 73.7-86.2%, 81.53% (95% CI 75.0-87.0%), and presented a positive net benefit within the full threshold range (5-95%).

The risk of postoperative projection in elderly patients with gastric cancer is higher, and it is related to preoperative hypertension history, RR level, creatinine value, operation method, operation time, intraoperative blood loss, mechanical ventilation, APS Ⅲ score and other factors, and the prediction model established based on the above factors can provide a reliable reference for the assessment of postoperative delirium reduction in elderly patients with gastric cancer.

To analyze the anesthetic effect and the correlation with gastrointestinal function of stellate ganglion block (SGB) combined with dexmedetomidine in gastrointestinal tumor surgery.

A total of 135 patients who underwent gastrointestinal surgery at Yongzhou Central Hospital (Yongzhou Hospital Affiliated to University of South China) from January 2019 to January 2023 were selected as the research subjects of this study. According to the different intraoperative anesthesia methods of the patients, they were divided into the control group (n=64) and the study group (n=71). The control group was given dexmedetomidine hydrochloride injection, while the study group was treated with SGB combined with dexmedetomidine. On this basis, all patients were induced with conventional anesthesia during the operation. The hemodynamic indicators [heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP)] and oxidative stress indicators [malondialdehyde (MDA), superoxide dismutase (SOD), cortisol] of the two groups of patients before surgery, after anesthesia and at the end of surgery were compared. The pain scores (VAS) at 12 hours, 24 hours and 48 hours after the operation were compared, as well as the anesthesia recovery status (extubation time, eye-opening time and awakening time) and the recovery of gastrointestinal function (exhaust time, defecation time and liquid food consumption time) of patients under general anesthesia. The scores of the postoperative Gastrointestinal Symptom Rating Scale (I-FEED) of the patients and the levels of inflammatory factors 24 hours after the operation were recorded. Spearman analysis was used to evaluate the relationship between the stress indicators of the patients and the postoperative gastrointestinal function.

The indicators of HR, SBP, DBP, MAP, the levels of MDA, SOD, cortisol, IL-6, TNF-α and IL-1β, and the LF/HF value of the patients in the study group during and after the operation were all lower than those in the control group, and the RMSSD value was higher than that in the control group (P<0.05), and the VAS scores at each time point in the study group were significantly lower than those in the control group. The extubation time, eye-opening time, awake time, exhaust time, defecation time and liquid food intake time were shortened (P<0.05). The postoperative I-FEED score of all patients was positively correlated with the stress index level at the end of operation (P<0.05).

For patients undergoing gastrointestinal surgery, postanesthesia stress disorder will affect the recovery of gastrointestinal function after surgery, and SGB combined with dexmedetomidine anesthesia can effectively relieve oxidative stress and pain after surgery, which is conducive to promoting the patients’ gastrointestinal function recovery.

To evaluate the application value of dietary management combined with exercise therapy in the rehabilitation of patients with functional dyspepsia (FD).

A total of 161 patients diagnosed with functional dyspepsia at Taihe County People's Hospital from March 2021 to March 2024 were prospectively selected, with 100 patients meeting the inclusion criteria. They were randomly assigned to the control group (50 cases, receiving routine treatment) and the observation group (50 cases, receiving dietary management combined with exercise therapy in addition to routine treatment). Clinical efficacy was assessed using the Rome Ⅳ Criteria, and the time to symptom resolution was recorded. Gastrin, motilin, and somatostatin (SS) levels were measured. The Nipin Indigestion Index (NDI) and the Pittsburgh Sleep Quality Index (PSQI) were used to evaluate quality of life and sleep quality.

In terms of clinical efficacy, the postprandial bloating, early satiety, upper abdominal pain, and upper abdominal burning sensation scores in the observation group were significantly lower than those in the control group. Regarding the resolution time of clinical symptoms, the recovery time for each symptom in the observation group was significantly shorter than that in the control group. After intervention, the gastrin and motilin of the observation group were higher than those of the control group, and the SS level was lower than that of the control group. The symptom index (NDSI) of the observation group after intervention was significantly lower, while the quality of life index (NDLQI) was significantly higher compared to the control group. Additionally, the PSQI score of the observation group was significantly lower than that of the control group after the intervention.

Dietary management combined with exercise therapy can effectively enhance the clinical efficacy and rehabilitation outcomes for FD patients, shorten symptom resolution time, improve gastrointestinal hormone levels, and enhance both quality of life and sleep quality. It can be used as a beneficial supplement to routine rehabilitation treatment.