Obesity has evolved into a global public health crisis. It constitutes not only a distinct disease entity but also a significant risk factor for the development of type 2 diabetes, metabolic syndrome, cardiovascular and cerebrovascular diseases, various cancers, and psychosomatic disorders. Against the backdrop of the three-year action plan commencing with the "Year of Weight Management" launched in March 2025 in China, this article delineates the historical evolution and recent advancements in lifestyle and behavioral interventions, pharmacotherapy, and surgical and endoscopic procedures for weight reduction. It underscores the principles of multimodal combinatorial approaches and individualized treatment strategies in weight management. The synthesis aims to provide foundational insights and stimulate further innovation in the development of precise, clinically applicable combinatorial therapeutic regimens.

In recent years, with the rapid development of digestive endoscopic diagnosis and treatment technology and the widespread application of endoscopic surgical robots in minimally invasive surgery, digestive endoscopic robot technology has also made significant progress, becoming an important means to solve the problems of difficult operation, long learning curve, high risk of intraoperative bleeding and perforation in traditional endoscopic surgery. This article systematically analyzes the current technological progress in the field of digestive endoscopic robots, focusing on the functional characteristics and differences in autonomy levels of various systems. Digestive endoscopic robots have become an important development direction for realizing unmanned, remote, and intelligent digestive endoscopic diagnosis and treatment.

To analyze the effect of treating acute non-variceal upper gastrointestinal bleeding (ANVUGIB) by endoscopic nylon rope combined with titanium clip.

The clinical data of 65 patients with ANVUGIB treated in Affiliated Zhangjiagang Hospital of Soochow University from January 2021 to March 2024 were analyzed retrospectively, and they were divided into control group (34 cases) and observation group (31 cases) by different treatment methods. The control group was treated with endoscopic high-frequency electrocoagulation, while the observation group was treated with endoscopic nylon rope combined with titanium clip purse-string sealing ulcer surface. The clinical efficacy, hemoglobin and hematokrit levels before and after treatment, delayed bleeding rate, readmission rate and wound healing rate in the first and second months after operation were compared between the two groups.

The total effective rate in the observation group was higher than that in the control group (P<0.05). Before treatment, there were no differences in the levels of hemoglobin and hematokrit between the two groups (P>0.05). After treatment, the levels of hemoglobin and hematokrit in both groups increased, and the levels in the observation group were higher than those in the control group (P<0.05). The rate of delayed bleeding and readmission in the observation group were lower than those in the control group (P<0.05), and the hospitalization time was shorter than that in the control group (P<0.05). The wound healing rates in the observation group were higher than those in the control group at 1 month and 2 months after operation (P<0.05).

Endoscopic nylon rope combined with titanium clip is effective in the treatment of ANVUGIB, which can improve hemoglobin and hematokrit levels, reduce delayed bleeding, reduce readmission rate, and heal the wound faster after operation.

To develop and validate a nomogram prediction model for local recurrence in early-stage gastrointestinal cancer patients after endoscopic submucosal dissection (ESD), providing a quantitative tool for postoperative recurrence risk assessment.

A retrospective analysis was conducted on 377 patients with early-stage gastrointestinal cancer who underwent ESD at Gaochun People's Hospital of Nanjing between January 2020 and December 2022. Patients were divided into recurrence (46 cases) and non-recurrence (331 cases) groups based on recurrence status within 12 months postoperatively. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors. A nomogram prediction model was constructed and internally validated using the Bootstrap resampling method (1 000 iterations). The model's discrimination and calibration were evaluated using receiver operating characteristic (ROC) curve, calibration curve, and the Hosmer-Lemeshow test.

Univariate analysis revealed significant associations between recurrence and age ≥65 years, tumor size ≥2 cm, poor differentiation, submucosal invasion depth reaching the SM2 layer, lymphovascular invasion, perineural invasion, positive resection margin, abnormal preoperative carcino-embryonic antigen levels, and depressed tumor morphology (all P<0.05). Multivariate analysis ultimately identified positive resection margin (OR=13.135), tumor size ≥2 cm (OR=8.244), lymphovascular invasion (OR=7.802), poor differentiation (OR=6.556), abnormal preoperative carcino-embryonic antigen (OR=5.496), submucosal invasion depth reaching the SM1 or SM2 layer (OR=4.649 and 1.667, respectively), and depressed tumor morphology (OR=4.851) as independent risk factors. The nomogram achieved an area under the ROC curve (AUC) of 0.955 (95% CI: 0.928-0.982) with 89.1% sensitivity and 91.5% specificity. Bootstrap validation yielded a C-index of 0.932, and the calibration curve demonstrated good agreement between predicted and actual risks (P=0.261).

The nomogram model, incorporating tumor biological characteristics and surgical-pathological parameters, exhibits high predictive accuracy for local recurrence in early-stage gastrointestinal cancer patients after ESD. It significantly outperforms traditional single-indicator assessment systems and provides an objective quantitative tool for early identification of recurrence and personalized intervention. This model holds substantial clinical value for optimizing treatment decisions, reducing secondary surgery rates, and improving patient prognosis.

To explore the effect of different restart timing of antiplatelet drugs on the risk of rebleeding and cardiovascular events in patients with peptic ulcer bleeding complicated by coronary heart disease.

From January 2020 to December 2023, patients with peptic ulcer bleeding complicated with coronary heart disease who were admitted to Aerospace Center Hospital were selected. Among them, 150 patients whose antiplatelet drug restart time was ≤7 days were classified as the early restart group, and 150 patients whose antiplatelet drug restart time was >7 days were classified as the delayed restart group. A retrospective cohort analysis was conducted. The occurrence of rebleeding and major adverse cardiovascular events (MACE) within half a year between the two groups of patients, including myocardial infarction, stroke, and cardiovascular death were compared. The patients were further divided into the occurrence group (n=81, 36 cases of rebleeding and 45 cases of MACE) and the non-occurrence group (n=219) based on whether rebleeding and MACE occurred within half a year. Clinical data of patients were collected. COX regression was used to analyze the risk factors, and the ROC curve was used to evaluate each risk factor and the combined predictive efficacy.

The incidence of rebleeding within six months in the early restart group (8.00%) was lower than that in the delayed restart group (16.00%) (P<0.05), and the total incidence of MACE within six months in the early restart group (12.00%) was slightly lower than that in the delayed restart group (18.00%), but there was no statistical difference (P>0.05). The diameter of ulcers, the proportion of high-risk Forrest grading, the ratio of neutrophil to lymphocyte count (NLR), C-reactive protein (CRP), troponin I, N-terminal B-type natriuretic peptide precursor (NT-proBNP), the proportion of non-pharmacological hemostasis methods, and the proportion of antiplatelet drug restart time>7 days in the occurrence group were all higher than those in the non-occurrence group (all P<0.05). The left ventricular ejection fraction (LVEF) in the occurrence group was lower than that in the non-occurrence group (P<0.05). The results of COX regression analysis showed that ulcer diameter, Forrest classification, LVEF, NLR, and the timing of restarting antiplatelet drugs were all influencing factors for rebleeding and cardiovascular events (all P<0.05). The ROC results indicated that ulcer diameter, Forrest classification, LVEF, NLR, the timing of restarting antiplatelet drugs, and the combined predictive model could all predict the risk of rebleeding and cardiovascular events. The area under the curve of the combined prediction model was 0.953 (95% CI: 0.928-0.978). When the cut-off value was taken, its sensitivity and specificity were 0.945 and 0.827, respectively.

In terms of the time to restart antiplatelet drugs, the early restart group has a lower incidence of rebleeding and MACE. Ulcer diameter, Forrest classification, LVEF, NLR, and the timing of antiplatelet drug restart are all risk factors for rebleeding and cardiovascular events.

To investigate the clinical effect of Chaihu Shugan Powder in the treatment of gastroesophageal reflux disease (GERD), and analyze its effects on cytokines and intestinal flora.

A total of 120 GERD patients admitted to Baoji Traditional Chinese Medicine Hospital from January 2022 to December 2024 were selected as the study objects. The patients were divided into control group and study group by random number table method, with 60 cases in each group. The control group was treated with omeprazole combined with mosapride, and the study group was treated with Chaihu Shugan Powder, both groups were treated for 8 weeks. The clinical efficacy, cytokines, traditional Chinese medicine syndrome score, intestinal flora and adverse reaction were compared between the two groups.

After 8 weeks of treatment, the clinical efficacy of the study group was higher than that of the control group (P<0.05), and the levels of cytokines, traditional Chinese medicine syndrome scores, Enterococcus, Yeast, and Enterobacter were all lower than those of the control group (P<0.05), while the levels of Lactobacillus, Bifidobacterium, and Bacteroides were higher than those of the control group (χ²=1.081, P=0.298).

Chaihu Shugan Powder has remarkable effect on GERD, and can effectively regulate cytokines and intestinal flora levels.

To explore the relationship between microinflammatory state and intestinal flora characteristics and gastrointestinal dysfunction in patients with diabetic nephropathy (DN).

A total of 130 cases of DN patients admitted to Hengshui Second People's Hospital from September 2022 to November 2024 were selected retrospectively as the observation group, and 86 volunteers who underwent health checkups in our hospital during the same period were selected as the control group. The general data, glycemic and lipid metabolism-related indexes [glycosylated hemoglobin (HbA1c), fasting blood glucose (FBG), total cholesterol (TC), triglycerides (TG), low-density lipoproteins (LDL-C), high-density lipoproteins (HDL-C)] levels, serum inflammatory factors [interleukin-6 (IL-6), C-reactive protein (CRP)] levels, intestinal flora abundance, and the degree of gastrointestinal dysfunction [Gastrointestinal Symptom Rating Scale (GSRS)], and the relationship between patients' inflammatory factor levels and intestinal flora species was analyzed using Pearson correlation.

The levels of body mass index, diastolic blood pressure, systolic blood pressure, HbA1c, FBG, TC, TG, LDL-C, HDL-C, IL-6, and CRP in the observation group were higher than those in the control group (P<0.05). The relative abundances of Bifidobacterium, Coriobacteriaceae(Red Stink Bug Bacteria Family), and Lactobacillusin the observation group were lower than those in the control group (P<0.05), while the relative abundances of Lachnospira, Coprococcus, Fusobacterium, and Ruminococcaceae were higher than those in the control group (P<0.05). The scores for abdominal pain, regurgitation, dyspepsia, diarrhea, and constipation in the GSRS of the observation group were higher than those in the control group (P<0.05). Pearson correlation analysis showed that serum IL-6 levels were positively correlated with the abundance of Ruminococcaceae, and negatively correlated with the abundances of Coriobacteriaceae, Lactobacillus, and Bifidobacterium (P<0.05). Serum CRP levels were positively correlated with the abundances of intestinal Fusobacterium, Ruminococcaceae, Coprococcus, and Lachnospira, and negatively correlated with the abundance of Coriobacteriaceae (P<0.05).

Patients with DN have an interaction of metabolic abnormalities, intestinal flora dysregulation and microinflammatory state, and their gastrointestinal dysfunction may be related to the above pathologic changes.

To investigate the clinical effect of Jianpi Huashi Decoction on chronic non-atrophic gastritis (CNG) associated with spleen and stomach dampness-heat type Helicobacter pylori (Hp).

A total of 120 patients with spleen and stomach damp-heat type HP-related CNG admitted to Weinan Central Hospital from January 2021 to December 2024 were selected as the study objects, and were divided into control group (n=60) and observation group (n=60) according to different treatment methods. The control group was treated with standard quadruple therapy, and the observation group was treated with Jianpi Huashi Decoction on the basis of the control group, and the course of treatment in both groups was 2 weeks. The clinical efficacy, inflammatory factors [interleukin (IL)-2, IL-6, tumor necrosis factor-α (TNF-α)], immune function indexes, pepsinogen (PG)Ⅰ, PGⅡ, traditional Chinese medicine syndrome score and occurrence of adverse reactions were compared between the two groups.

The clinical total effective rate, CD₃⁺, CD₄⁺, CD₄⁺/CD₈⁺, PGI and PGⅡ levels in the observation group were higher than those in the control group after 2 weeks of treatment, and the levels of IL-2, IL-6, TNF-α, CD₈⁺ and traditional Chinese medicine syndrome score in the observation group were lower than those in the control group (P<0.05). There were no obvious adverse reactions in the two groups during treatment.

Jianpi Huashi Decoction has significant therapeutic effect on spleen and stomach dampness-heat type Hp-related CNG, which can effectively improve the symptoms of patients, increase the level of PG and reduce the level of serum inflammatory factors.

To analyze the detection results of drug resistance gene mutation of Helicobacter pylori (Hp) to find the more sensitive drug resistance gene mutation sites, and to discuss the correlation between drug resistance phenotype and drug resistance genotype of Hp.

A retrospective selection was made of patients with initial Hp eradication failure and positive urea breath test from October 2019 to January 2022 at Tongji hospital of Tongji university. Gastric mucosal tissues were collected through endoscopic biopsy for Hp isolation and culture, and 69 positive cases were identified. All patients were tested for drug resistance to the six antibiotics recommended by consensus (metronidazole, furazolidone, amoxicillin, tetracycline, clarithromycin, and levofloxacin) through both traditional drug sensitivity test and gene sequencing method.

The drug sensitivity test showed that the resistance rate of Hp to metronidazole was the highest, and the resistance rates to furazolidone, amoxicillin and tetracycline were low, with statistically significant differences (P<0.001). The results of drug resistance gene sequencing showed that 16 cases (23.2%) had amoxicillin gene mutations, including 5 mutation sites, namely AAT562TAT, GTT374TTT, ACC556ACG, GCC320ACC and GTT374ATT. There were 45 cases (65.2%) with clarithromycin gene mutation, with three mutation sites: A2143G, A2142G and A2142C, and A2143G was the main mutation form, accounting for 58.0%. There were 39 cases (56.5%) with levofloxacin gene mutation, including 6 mutation sites (T261A, T261G, A260T, G271A, G271T, A272G). There were 66 cases (95.7%) with metronidazole gene mutation, including 6 mutation sites (A61G, T62C, A91G, C92A, G392A, A610G). A total of 14 cases (20.3%) had tetracycline gene mutations, including 4 mutation sites (A926C, A926G, A926T, A928G). There were 63 cases (91.3%) with furazolidone gene mutation, including 6 mutation sites, which were G353A, A356G, G357T, G357C, A122G and A335G. The correlation analysis of drug resistance genes and drug resistance phenotypes showed that GTT374ATT was significantly associated with amoxicillin resistance (P<0.01), A2143G and A2142G were significantly correlated with clarithromycin resistance (P<0.05), T261A and T261G were significantly associated with levofloxacin resistance (P<0.05), C92A was significantly associated with metronidazole resistance (P<0.05). The eradication rate of Hp individualized remedial therapy guided by drug resistance gene mutation detection was 91.1%.

The resistance rate of Hp to metronidazole is the highest in our hospital. Detection of drug-resistant gene mutation has important clinical guiding significance in clarithromycin, levofloxacin and metronidazole used in Hp eradication, and can optimize individualized regimens for initial or salvage treatment.

To investigate the application value of gastrointestinal contrast-enhanced ultrasound in evaluating gastric motility and gastric wall morphological changes in patients with functional dyspepsia (FD) of different severity.

A total of 200 FD patients who visited Xidian Group Hospital from 2022 to 2024 were selected as the research group, the severity of the condition was classified according to the Rome Ⅳ criteria, dividing the FD patients into 78 cases of epigastric pain syndrome (EPS) and 122 cases of postprandial distress syndrome (PDS). Additionally, 100 healthy individuals were selected as the control group. The gastric emptying rate (GER), gastric emptying time (ET), gastric an/trum motility index (MI), incidence of duodenogastric reflux (DGR), gastric antrum wall thickness, and gastric wall layering clarity were compared among the groups. Point-Bisserial correlation analysis method was adopted to analyze the correlations between gastric motility indicators, gastric wall morphological parameters and the severity of the disease in patients of the EPS group and the PDS group respectively.

The research group showed that GER, MI, and gastric wall layering clarity were all lower than the control group, while GET, gastric antrum wall thickness, and DGR were all higher than the control group (P<0.05). In PDS patients, GER, MI, and gastric wall layering clarity were all lower than those in EPS patients, while GET, gastric antrum wall thickness, and DGR were all higher than those in EPS patients (P<0.05). Point-Biserial correlation analysis revealed that in FD patients, GER and MI were negatively correlated with the severity of the condition, while GET and gastric antrum wall thickness were positively correlated with the severity of the condition (P<0.05).

Gastrointestinal contrast ultrasound has high clinical value in evaluating gastric motility and gastric wall morphological changes in patients with different severity of FD, and can provide an important reference for the diagnosis and treatment of FD.

To investigate the relationship between hepatic hemodynamics and portal pressure gradient (PPG) by color Doppler ultrasound (CDUS) in cirrhotic patients with portal hypertension (PHT).

A retrospective analysis was conducted on 118 patients with liver cirrhosis complicated with PHT admitted to Shaanxi Kangfu Hospital from January 2022 to December 2024 as the study group, and 100 patients with liver cirrhosis without PHT were selected as the control group in our hospital during the same period. CDUS detection indexes [portal vein main diameter (PVD), portal vein blood velocity (PVV), portal vein blood flow (PVF), splenic vein main diameter (SVD), splenic vein blood velocity (SVV), splenic vein blood flow (SVQ) and PPG level] were compared between the two groups, and the correlation between liver hemodynamics and PPG in cirrhotic portal PHT patients was analyzed by Pearson correlation analysis.

The levels of PVD, SVD and SVQ in the study group were significantly higher than those in the control group, and the levels of PVV, PVF and SVV were significantly lower than those in the control group (P<0.05). The levels of portal vein pressure and PPG in the study group were significantly higher than those in the control group (P<0.05), but there was no significant difference in the level of inferior vena cava pressure between the two groups (P>0.05). The results of Pearson correlation analysis showed that PVD, SVD, SVQ were positively correlated with PPG, while PVV, PVF, SVV were negatively correlated with PPG (P<0.05).

There is a close correlation between liver hemodynamics and PPG in cirrhotic patients with PHT, which can provide reference for clinical diagnosis and treatment.

To explore the clinical value of modified CT severity index (MCTSI) score combined with serum neutrophil to lymphocyte ratio (NLR), fibrinogen to prealbumin ratio (FPR) and interleukin-6 (IL-6) levels on evaluating the prognosis of patients with hyperlipidemic acute pancreatitis.

A retrospective analysis was conducted on the clinical data of 100 patients with hyperlipidemic acute pancreatitis admitted to the First People's Hospital of Zhangjiagang City from January 2022 to June 2024. According to the severity of the disease, they were divided into the mild to moderate group (n=68) and the severe group (n=32). The baseline data and clinical indicators of the two groups were compared, including the MCTSI score and the levels of serum C-reactive protein (CRP), procalcitonin (PCT), D-dimer, total cholesterol (TC), triglycerides (TG), prealbumin (PAB), apolipoprotein A (ApoA), NLR, FPR, and IL-6. The Pearson method was used to analyze the correlations between the MCTSI score and the levels of serum NLR, FPR, and IL-6 and clinical indicators. According to the prognosis of the patients, they were divided into the survival group (n=89) and the death group (n=11). The MCTSI scores and the levels of serum NLR, FPR, and IL-6 of the two groups were compared. The ROC curve was used to analyze the predictive value of the MCTSI score and the levels of serum NLR, FPR, and IL-6 for the prognosis of the disease.

The Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score, CRP, PCT, D-dimer, TG and TC in the mild to moderate disease group were significantly lower than those in the severe disease group (P<0.05), while PAB and ApoA were significantly higher than those in the severe disease group (P<0.05). The MCTSI score, NLR, FPR and IL-6 in the mild group were significantly lower than those in the severe case group (P<0.05). In the severe group, the MCTSI score and the levels of serum NLR, FPR, and IL-6 were significantly positively correlated with the APACHEⅡ score, CRP, PCT, TG, and TC (P<0.05). The MCTSI score, NLR, FPR and IL-6 in the survival group were significantly lower than those in the death group (P<0.05). ROC curve analysis showed that the AUCs of MCTSI score, NLR, FPR, IL-6 alone and in combination for diagnosing poor prognosis in patients with hyperlipidemic acute pancreatitis were 0.816, 0.832, 0.720, 0.869, and 0.923, respectively. The sensitivities were 81.82%, 81.82%, 72.73%, 81.82%, and 90.91%, and the specificities were 73.03%, 75.28%, 71.91%, 76.40%, and 70.79%. The combined diagnostic value was higher.

MCTSI score and serum NLR, FPR and IL-6 levels are associated with the disease severity and prognosis of hyperlipidemic acute pancreatitis, which can be used as reference indicators for clinical diagnosis and treatment.

To investigate the correlation between dynamic changes in CT imaging features after neoadjuvant therapy and postoperative pathologic complete response (pCR) in esophageal cancer and to construct a prediction model based on CT radiomic features. ​

A total of 178 patients who underwent neoadjuvant therapy and radical esophagectomy at Wuxi People's Hospital were retrospectively enrolled between June 2020 and May 2024. According to the postoperative pathological results (ypT₀N₀ was defined as pCR), the patients were divided into pCR group (n=53) and non-pCR group (n=125). Philips 256-slice spiral CT was used for dual-phase enhanced scans before and 4 weeks after neoadjuvant therapy. Elastix5.0 software performed non-rigid registration to correct positional differences, and ITK-SNAP3.8.0 was utilized for 3D tumor volume delineation. A total of 1 426 radiomic features were extracted from non-contrast, arterial, and venous phase images using PyRadiomics3.0. Core CT radiomic features were identified through a three-step screening process (consistency testing, differential analysis, LASSO regression). A logistic regression-based predictive model was established to generate a standardized radiomics score (Rad-score). A combined model integrating clinical independent predictors was further developed. Patients were divided into training (124 cases) and validation (54 cases) sets via stratified random sampling (7:3), and the predictive performance of the models was evaluated.

Significant differences were observed between groups in cT stage, cN stage, tumor differentiation, and chemotherapy cycle completion rate (P<0.05). Compared to the non-pCR group, the pCR group had a higher proportion of cT2 stage, cN₀ status, well-differentiated tumors, and higher chemotherapy completion rates. The pCR group exhibited significantly greater reductions in tumor volume, arterial phase CT value changes, lymph node short-axis reduction rate, arterial phase gray-level co-occurrence matrix (GLCM) energy value, and long-axis reduction rate; the ratio of CT value of venous tumor to muscle ratio (T/M) was significantly lower than that of the non-pCR group, with statistical significance (P<0.001). Multivariate logistic regression revealed that among the baseline clinical characteristics, only the chemotherapy cycle completion rate was an independent clinical predictor of pCR (P=0.008). Among CT imaging features, lymph node short-axis reduction rate, arterial phase GLCM energy value, tumor volume reduction rate, long-axis reduction rate, and arterial CT value changes showed strong positive correlations with pCR (P<0.05), whereas venous phase T/M ratio correlated negatively (P<0.05). After a three-level screening process, six core radiomic features were identified, encompassing morphology (such as tumor volume and surface characteristics), first-order gray-level statistics (reflecting enhancement distribution), and high-order texture features (tumor heterogeneity). The CT radiomics model achieved AUCs of 0.868 (training set) and 0.841 (validation set), while the combined model improved significantly to 0.909 and 0.914, respectively (Z=2.470, 2.891; P=0.013, 0.004). In the validation set, the combined model demonstrated 88.2% sensitivity and 83.8% specificity, outperforming the radiomics-only model (88.2% vs. 67.6% sensitivity). Bootstrap validation confirmed higher stability for the combined model (95% CI: 0.841-0.987).

Dynamic changes in CT imaging features—including tumor volume reduction, arterial phase enhancement, and decreased venous T/M ratio—are strongly associated with pCR after neoadjuvant therapy in esophageal cancer. The combined model integrating chemotherapy cycle completion rate provides a quantitative tool for preoperative assessment of pathologic response.

To explore the predictive value of lymphocyte to monocyte ratio (LMR) and platelet-to-hemoglobin ratio (PHR) for the prognosis of hepatocellular carcinoma (HCC) patients undergoing radiofrequency ablation (RFA).

A total of 150 HCC patients who received RFA in Qidong Traditional Chinese Medicine Hospital from January 2021 to January 2022 were selected as the research objects. The time of first receiving RFA was taken as the starting point, and the time of recurrence or death within 3 years after the end of treatment was taken as the end point. The patients were grouped according to their disease conditions. The patients with tumor recurrence, progression or death were classified as poor prognosis group (n=56), and the patients without tumor recurrence, progression or death were classified as good prognosis group (n=94). The data of the above two groups were compared, and the statistically significant variables in the univariate comparison were included in the binary Logistic regression model to analyze the risk factors of poor prognosis within 3 years after RFA in HCC patients, and a prediction model was established. The receiver operating characteristic curve (ROC) was used to evaluate the predictive value of the prediction model for the poor prognosis of HCC patients within 3 years after RFA.

The tumor size, Barcelona Clinic Liver Cancer Staging (BCLC) B/C ratio, vascular invasion, PHR and alpha-fetoprotein (AFP) in the poor prognosis group were larger than those in the good prognosis group. The combined TACE interventional therapy and LMR in the poor prognosis group were lower than those in the good prognosis group (all P<0.05). Logistic regression analysis showed that BCLC staging, combined TACE interventional therapy, LMR, PHR, and AFP were all independent risk factors for poor prognosis within 3 years after RFA for HCC patients (P<0.05). Based on the above results, a nomogram prediction model for poor prognosis of HCC patients receiving RFA within 3 years after operation was constructed. The area under the curve (AUC) of the prediction model was 0.902 (95% CI: 0.851-0.953). When the cut-off value was taken, the sensitivity and specificity were 0.947 and 0.750, respectively. The Bootstrap method (B=1000) was used to internally validation on the poor prognosis prediction model of HCC patients receiving RFA within 3 years after operation. After bias correction, the prediction curve was close to the ideal state, and the C-index value reached 0.804, indicating that the model had a high predictive efficiency. The model achieved positive net benefits across the threshold probability range from 0.00 to 0.90, and its performance exceeded the two null lines used as a comparison.

LMR and PHR, as independent predictors, combined with BCLC staging, combined TACE interventional therapy and AFP to construct a prediction model has a high predictive efficiency for poor prognosis of HCC patients receiving RFA at 3 years after operation, which can provide a key basis for individualized risk stratification and intervention strategy formulation.

To construct a risk prediction model for chronic post-surgical pain (CPSP) after anorectal surgery based on traditional Chinese medicine (TCM) syndrome types.

A retrospective selection was made of 460 patients who underwent anorectal surgery from January 2022 to June 2024. The clinical baseline data and TCM syndrome types of the patients were collected and summarized. The patients were divided into two groups based on whether CPSP occurred: the CPSP group (76 cases) and the non-CPSP group (384 cases). Univariate and multivariate Logistic regression analyses were used to screen for independent risk factors of CPSP, and the predictive efficacy of each index and the combined model was evaluated by drawing the receiver operating characteristic (ROC) curve.

The total incidence of CPSP after surgery in this study was 16.52% (76/460). Among CPSP patients, those with mild, moderate and severe pain accounted for 42.11% (32/76), 39.47% (30/76) and 18.42% (14/76), respectively. The frequency of pain was mainly occasional (52.63%) and frequent (36.84%). The nature of pain was commonly distending pain (36.84%) and stabbing pain (31.58%). Univariate analysis showed that the visual analogue scale (VAS) pain score 24 hours after surgery, operation duration, intraoperative blood loss, postoperative analgesic pump usage rate, preoperative Hamilton Anxiety Scale (HAMD), the Pain Catastrophizing Scale (PCS) and the Pittsburgh Sleep Quality Index (PSQI) scores in the CPSP group were all higher than those in the non-CPSP group (all P<0.05), and the proportion of qi stagnation and blood stasis syndrome was also higher (P<0.001). Correlation analysis showed that the occurrence of CPSP after surgery was significantly positively correlated with the VAS pain score 24 hours after surgery, the operation duration, the preoperative Hamilton Depression Scale (HAMD) score, PCS, PSQI scores, the use of the postoperative analgesic pump, and the syndrome type of qi stagnation and blood stasis (all P<0.05). Multivariate Logistic regression confirmed that the VAS pain score 24 hours after surgery, operation duration, HAMD score, PCS score, PSQI score and qi stagnation and blood stasis syndrome were all independent risk factors for CPSP (all P<0.001). ROC analysis indicated that the AUC of the combined prediction model reached 0.948, the sensitivity was 0.855, and the specificity was 0.883. The prediction efficacy was significantly better than that of each individual indicator (all P<0.05).

The risk prediction model for chronic pain after anorectal surgery constructed based on TCM syndrome types has a high predictive efficiency. Among them, the syndrome type of qi stagnation and blood stasis and the VAS pain score 24 hours after surgery are all independent risk factors, which can provide a reference basis for the early clinical identification and intervention of CPSP.

To evaluate the predictive value of maximum subclavian vein diameter (dSCV_max) and collapsibility index of SCV (SCV-CI) in anaesthesia induced hypotension in elderly patients undergoing gastrointestinal surgery.

A total of 127 patients who planned to undergo gastrointestinal surgery in Nantong Affiliated Hospital of Nanjing University of Chinese Medicine from January 2020 to April 2023 were selected. Patients were included in hypotension group (H group) and non-hypotension group (NH group) according to the presence or absence of hypotension after anesthesia induction. SCV and inferior vena cava (IVC) were measured by ultrasound in all patients before anesthesia induction, dSCV_max was recorded before anesthesia induction, and SCV-CI was calculated. The incidence of hypotension and the percentage of MAP decrease during anesthesia induction were recorded. Spearman correlation analysis was used to evaluate the relationship between ultrasound parameters and the percentage of MAP decrease. Logistic regression was used to find the risk factors of anaesthesia induced hypotension in elderly patients undergoing gastrointestinal surgery. ROC curve was used to evaluate the predictive value of ultrasound parameters for anaesthesia induced hypotension in elderly gastrointestinal surgery patients.

There were 66 patients in group H and 61 patients in group NH. SCV-CI and collapsibility index of inferior vena cava(IVC-CI) in group H were significantly higher than those in group NH, with statistically significant differences (P<0.05). After induction, MAP of patients in group H was significantly lower than that in group NH, and the decrease percentage of MAP was significantly higher than that in group NH, with a statistically significant difference (P<0.05). SCV-CI (P=0.025, OR=1.109, 95% CI: 1.013-1.215), IVC-CI (P<0.001, HR=1.265, 95% CI: 1.138-1.406) elevation were risk factors for anaesthesia induced hypotension. Spearman correlation analysis showed that SCV-CI, IVC-CI were significantly positively correlated with the percentage of MAP decrease after anesthesia induction (r=0.341, P<0.001; r=0.347, P<0.001). There was no correlation between dSCV_max and the percentage of MAP decrease after anesthesia induction (P>0.05). The sensitivity and specificity of SCV-CI in predicting hypotension after anesthesia induction were 69.7% and 91.8%. The sensitivity and specificity of IVC-CI in predicting hypotension after anesthesia induction were 75.8% and 90.2%.

SCV-CI has a high predictive value for hypotension after anesthesia induction in elderly gastrointestinal surgery patients, but dSCV_max has no significant correlation with hypotension after anesthesia induction in elderly gastrointestinal surgery patients.

To investigate the prognostic value of the preoperative alanine aminotransferase to aspartate aminotransferase ratio (LSR) in gastrointestinal tumors.

A literature search was conducted in the China National Knowledge Infrastructure (CNKI), Wanfang, VIP, PubMed, Embase, and Web of Science databases from January 1, 2015 to January 1, 2025. Studies were screened, data analyzed, and literature quality evaluated according to inclusion and exclusion criteria. The hazard ratio (HR) and corresponding 95% confidence interval (CI) were used to assess the significance of LSR in gastrointestinal tumors.

Nine studies were ultimately selected, all of which were evaluated as having high quality according to the Newcastle-Ottawa Scale. Meta-analysis results showed that LSR was not associated with overall survival in gastric cancer (HR=1.20, 95% CI: 0.88-1.63, P>0.05). However, subgroup analysis showed that LSR>1 was associated with significantly shorter overall survival in gastric cancer patients (HR=1.27, 95% CI: 1.05-1.53, P=0.01). LSR was positively correlated with overall survival in liver cancer patients (HR=0.57, 95% CI: 0.52-0.62, P<0.000 01), and there was no statistically significant association between LSR and overall survival in colorectal cancer patients (HR=1.03, 95% CI: 0.32-3.38, P>0.05), but heterogeneity was high in all cases.

LSR was significantly associated with overall survival in patients with liver cancer and gastric cancer and may serve as a potential indicator for assessing the prognosis of gastrointestinal tumors.

Malignant obstructive jaundice is caused by the constriction or occlusion of the intrahepatic or extrahepatic bile duct due to the compression of the malignant tumor. Biliary drainage is an important treatment for malignant obstructive jaundice, including endoscopic retrograde cholangiopancreatography, percutaneous transhepatic biliary drainage and endoscopic ultrasonography-biliary drainage. However, different biliary drainage has its advantages and disadvantages. There is no consensus on the drainage strategy of malignant obstructive jaundice in the domestic and overseas, and there are still disputes about the best drainage method and the indications of preoperative biliary drainage. Therefore, this paper reviews the research progress of drainage strategies for malignant obstructive jaundice in order to provide reference for its clinical treatment.

Gastric cancer is a common and highly lethal cancer in China, where early diagnosis and treatment are crucial for patient prognosis. Currently, clinical physicians mainly rely on endoscopy, imaging, and histopathology for the diagnosis of gastric cancer, which are often image-based methods. These methods, however, are highly subjective, time-consuming with low accuracy. In recent years, artificial intelligence (AI) technology has gradually become more prevalent in the medical field. AI systems based on deep learning can extract features from large volumes of medical image data, assisting physicians in making rapid and accurate diagnoses. This article reviews the research progress of image-based AI in gastric cancer and discusses its future development directions.

Immunoglobulin G4 (IgG4)-related disease is a rare, systemic autoimmune disorder that can affect multiple organs. Gastric involvement is uncommon and often presents with non-specific clinical and radiological features, posing a diagnostic challenge and frequently leading to misdiagnosis as gastric neoplasms or lymphoma. In this report, we present a case of IgG4-related gastric disease diagnosed and managed with endoscopic submucosal dissection, resulting in complete lesion resection.