To develop and evaluate a clinical and enhanced CT based nomogram for the differentiation of lymphoepithelioma-like gastric carcinoma associated with Epstein-Barr virus (EBV) from gastric adenocarcinoma.

The clinical and imaging data of 25 patients with pathohistology- confirmed lymphoepithelioma-like gastric carcinoma were retrospectively analyzed, and 50 patients with gastric adenocarcinoma were included as the control group. Univariate analysis and multivariate Logistic regression were used to screen the predictors for identifying the two types of tumors. A personalized nomogram was constructed, and the distinction degree, calibration degree, and clinical utility value of the nomogram were evaluated by drawing the ROC curve, calibration curve, and decision curve analysis (DCA). Internal validation was performed using the Bootstrap method.

The location of the tumor (middle vs. upper, OR=1.866, 95% CI: 0.457-7.626; lower vs. upper, OR=14.454, 95% CI: 2.619-79.778), CT enhancement peak (OR=6.965, 95% CI: 1.796-27.016) and the lymph node status defined by CT (OR=4.242, 95% CI: 1.270-14.164) were independent differential factors in patients with lymphoepithelioma- like carcinoma. The AUC value of the nomogram was 0.815 (95% CI: 0.718-0.912). The nomogram showed a good calibration and a clinical benefit. For bootstrapping validation (internal validation) with 200 bootstrap-resampling, the nomogram showed good discriminatory accuracy and the AUC value of internal model validation was 0.823 (95% CI: 0.817-0.830).

The nomogram established in this study has great potential in identifying EBV related lymphoepithelioma-like gastric carcinoma from gastric adenocarcinoma and warrants clinical decision making.

To identify the independent risk factors associated with advanced fibrosis (S3-S4) in patients suffering from chronic hepatitis B (CHB) complicated with hepatic steatosis, and to develop and validate a nomogram risk prediction model.

A total of 439 treatment-naïve CHB patients who had hepatic steatosis and underwent liver biopsy in the Third Affiliated Hospital of Sun Yat-sen University between August 2008 and December 2020 were recruited as research objects. These patients were then randomly allocated at a 2∶1 ratio into the training set (n=293) and the validation set (n=146). Logistic regression was used to identify the risk factors of advanced fibrosis. A nomogram prediction model was subsequently created.

Logistic regression analysis revealed that platelet (OR=0.987, P=0.003), prothrombin time (OR=1.952, P=0.011), and globulin (OR=1.260, P=0.001) were the independent risk factors for advanced fibrosis. The area under the receiver operating characteristic (ROC) curve for the proposed nomogram model in the training group, which predicted advanced fibrosis, was noted to be 0.866. This was considerably higher than the aspartate aminotransferase-to-platelet ratio index (0.782, P=0.017), gamma-glutamyl transpeptidase-to-platelet ratio (0.753, P=0.004), fibrosis-4 score (0.780, P=0.024), non-alcoholic fatty liver disease fibrosis score (0.737, P<0.001), and BARD score (0.595, P<0.001) models; similar findings were observed in the validation set (P<0.05). Calibration curve and decision curve demonstrated that the nomogram model had high consistency and clinical net benefit.

A nomogram risk prediction model based on independent risk factors of advanced liver fibrosis patients with CHB combined with hepatic steatosis is constructed in this study. After verification, the model has high predictive efficiency, consistency, and clinical net gain.

To analyze the clinical characteristics and prognosis in different subtypes of upper gastrointestinal Crohn's disease (CD) patients.

CD patients treated at Shanghai Ruijin Hospital from 2017 to 2021 were enrolled. They were divided into the upper gastrointestinal tract involvement (UGI+) group and non-upper gastrointestinal tract involvement (UGI-) group based on endoscopic and pathological findings. The upper gastrointestinal tract involvement rate of CD patients, the endoscopic characteristics and severity of UGI+ group were analyzed. Kaplan Meier method was used to survival curve, and the differences of 3-year continuous operation-free rate and complication free rate between UGI+ and UGI- group were analyzed. Patients in the UGI+ group were further divided according to whether duodenal bulb was involved, and the difference of prognosis among different subtypes was compared.

A total of 76 patients were included in this study, among which 46 cases had 68 positive endoscopic findings. Endoscopic features were diverse and the bamboo joint-like appearance of the gastric fundus had the highest incidence (20.6%), followed by duodenal ulcers (17.6%) and protruding lesions of the duodenal bulb (14.7%). After follow-up, there was no significant difference between the UGI+ group and the UGI- group in the 3-year continuous operation-free rate (P>0.05). Further subgroup analysis showed that the 3-year event-free rate in the UGI- group, CD upper digestive tract involving non-duodenal bulb group (UGI+DB- group) and CD upper digestive tract involving duodenal bulb group (UGI+DB+ group) were 88.9%, 87.9% and 68.0%, respectively. The 3-year event-free rate of the UGI+DB+ group was significantly lower than that in the UGI- group and UGI+DB- group (P<0.05).

Upper gastrointestinal involvement is not uncommon in newly diagnosed CD patients, and its endoscopic manifestations are varied. Endoscopy should be recommended to newly diagnosed CD patients regardless of asymptomatic gastrointestinal symptoms. UGI+ patients with duodenal bulb involvement have significantly higher rates of surgery or complications. Therefore, active treatment should be promptly provided to this subgroup of patients to improve their prognosis.

To investigate the correlation between triglyceride-glucose index and upper gastrointestinal bleeding complicated by peptic ulcer.

A total of 217 patients with peptic ulcer were selected as the study subjects and these subjects were divided into bleeding group (observation group) and non-bleeding group (control group). The correlation between age, gender, body mass index (BMI), Helicobacter pylori (Hp) infection, serum blood glucose (Glu), triglyceride (TG), hemoglobin, red blood cell count, platelet and other indicators of patients in the two groups and gastrointestinal bleeding was analyzed respectively.

The age, TyG index and Hp infection of the observation group were higher than those of the control group (all P<0.05); the hemoglobin and hematocrit value of the observation group were lower than those of the control group (both P<0.05). There were no significant differences in gender, BMI, smoking, heart rate, platelet count, hypertension and diabetes between the two groups (all P>0.05). The ROC curve showed that the area under the curve (AUC) of TyG index, Hp infection, hemoglobin and hematocrit value in predicting peptic ulcer bleeding were 0.708 (95% CI: 0.639-0.777), 0.641 (95% CI: 0.568-0.715), 0.099 (95% CI: 0.056-0.142) and 0.083 (95% CI: 0.045-0.121).

TyG index is a risk factor for peptic ulcer patients complicated with upper gastrointestinal bleeding, and observation of TyG index can play a certain role in predicting the development of peptic ulcer patients.

To analyze the preventive effects of early enteral nutrition and microecological immune enteral nutrition on renal injury in patients with severe acute pancreatitis (SAP), and to explore the risk factors affecting renal injury in patients.

A total of 296 patients with SAP admitted to Huai'an First People's Hospital from January 2020 to December 2022 were randomly divided into combined group (n=148) and control group (n=148). Both groups received routine treatment and early enteral nutrition support, while the combined group received staged microecological immune enteral nutrition support. The incidence of renal injury was compared between the two groups, and the clinical data and nutritional support programs of patients with and without renal injury were compared. Logistic regression model was used to summarize the risk factors related to renal injury.

After 7 days of intervention, the total protein, albumin, prealbumin and transferrin in the two groups were higher than those before intervention, while those in the combined group were higher than those in the control group after 7 days of intervention (P<0.05). The incidence of renal injury in the combined group was 22.30% (33/148), which was lower than that in the control group (36.49%, 54/148), with statistically significant difference (χ²=7.179, P<0.05). Multivariate regression analysis showed that age, APACHE Ⅱ score, C-reactive protein and cystatin C, as well as CT grade E, diabetes, mechanical ventilation and shock were all independent risk factors for renal injury in SAP patients, and microecological immune enteral nutrition was the protective factor (P<0.05).

The nutritional status of SAP patients is generally poor, and the nutritional status is improved more obviously after receiving microecological immune enteral nutrition support than simple enteral nutrition support, and the risk of renal injury is also reduced. At the same time, the occurrence of renal injury in SAP patients is also related to baseline characteristics such as age, severity of illness, severity of inflammatory reaction and complications.

To evaluate the effect of Helicobacter pylori (Hp) infection on nonalcoholic fatty liver disease (NAFLD) and coronary atherosclerosis (CA) in middle-aged and elderly people and analyze the correlation.

A total of 234 middle-aged and elderly patients who underwent physical examinations between August 2018 and July 2022 were selected as the research subjects. Based on the presence of Hp infection, the subjects were divided into Hp uninfected group and Hp infected group. The clinical data, fatty liver levels, coronary artery calcification levels, and blood biochemical indicators levels between the two groups were compared. The relationship between NAFLD, CA, and Hp infection through Logistic multiple factor regression analysis was explored. The correlation between NAFLD and CA through Spearman test was explored.

Body mass index (BMI), age, proportion of hypertension, proportion of diabetes, proportion of hyperlipidemia, blood glucose, alanine aminotransferase (ALT), aspartic transaminase (AST), total bilirubin (TBiL), direct bilirubin (DBiL), total cholesterol (TC), triacylglycerol (TG), low density lipoprotein (LDL), tumor necrosis factor-α (TNF-α), interleukin (IL)-6 and IL-12 in Hp infected group were significantly higher than those in Hp uninfected group, while high-density lipoprotein (HDL) and IL-10 in Hp infected group were significantly lower than those in Hp uninfected group (P<0.05). The incidence rate and severity of NAFLD and CA in Hp infection group were significantly higher than those in Hp uninfected group (P<0.05). Multivariate Logistic regression analysis showed that BMI, ALT, TBiL, TNF-α, IL-10, NAFLD, and CA were independent risk factors affecting Hp infection in subjects. Spearman test showed a positive correlation between NAFLD and CA severity in the Hp infected and non-infected groups.

There is a strong correlation between Hp infection and NAFLD and CA in the middle-aged and elderly population. The liver and cardiovascular complications of Hp should be given more attention in clinical practice.

To analyze the correlation between preoperative plasma fibrinogen (FIB), blood lipid level and DNA mismatch repair (MMR) expression and pathological characteristics and prognosis quality of colorectal cancer.

A total of 226 patients with colorectal cancer admitted to Xuzhou Central Hospital from March 2018 to September 2020 were included. The general data and the preoperative plasma FIB, blood lipid and MMR expression in tumor tissues and adjacent tissues of patients with different pathological characteristics and different prognosis quality were compared. Logistic multivariate regression analysis was used to summarize the related factors affecting the pathological characteristics and prognosis quality of patients.

Logistic multivariate regression analysis showed that the increase of FIB, lipoprotein a [LP(a)] and low-density lipoprotein cholesterol/high-density lipoprotein cholesterol (L/H), MMR of the lesion, the high or low microsatellite instability (MSI) of MMR adjacent to cancer, and the decrease of HDL-C were independent risk factors for TNM staging increase and 3-year death in patients with colorectal cancer. triglyceride (TC), apolipoprotein (ApoA), L/H, MMR of the lesion, high or low MSI of MMR adjacent to cancer, and decrease of HDL-C were independent risk factors for colorectal cancer (P<0.05).

The difference of plasma FIB, blood lipid level and MMR expression before operation are closely related to TNM staging, lesion location and prognosis quality of colorectal cancer patients.

To observe the value of serum amyloid A (SAA) and glycoprotein antigen (CA)19-9 combined with endoscopic ultrasonography (EUC) in diagnosing preoperative stages of colorectal cancer (CRC).

A total of 116 patients with pathologically confirmed CRC who were admitted to Nanjing Mingji Hospital from July 2020 to December 2022 were selected as the study subjects. All of them received EUC and detection of serum SAA and CA19-9 levels. ROC curve was used to analyze the value of serum SAA and CA19-9 levels combined with EUC in preoperative staging of CRC. The correlation between serum SAA level and CA19-9 level was analyzed.

For the 116 patients with CRC, the results of pathological staging showed 22 cases in T1 stage, 28 cases in T2 stage, 46 cases in T3 stage and 20 cases in T4 stage, 66 cases in N0 stage, 30 cases in N1 stage and 20 cases in N2 stage, 100 cases in M0 stage and 16 cases in M1 stage. The diagnostic results of EUC showed 18 cases in T1 stage, 24 cases in T2 stage, 40 cases in T3 stage and 15 cases in T4 stage, 50 cases in N0 stage, 22 cases in N1 stage and 14 cases in N2 stage, 71 cases in M0 stage and 10 cases in M1 stage. The coincidence rates of EUC for diagnosing TNM stages of CRC were 83.62%, 74.14%, and 69.83%, respectively. Serum SAA and CA19-9 levels in T4, T3 and T2 stages were higher than those in T1 stage. Serum SAA and CA19-9 levels in T4 and T3 stages were higher than those in T1 and T2 stages. Serum SAA and CA19-9 levels in T4 stage were higher than those in T1, T2 and T3 stages (P<0.05). Serum SAA and CA19-9 levels in N2 and N1 stages were higher than those in N0 stage. Serum SAA and CA19-9 levels in N2 stage were higher than those in N0 and N1 stages (P<0.05). Serum SAA and CA19-9 levels in M1 stage were higher than those in M0 stage (P<0.05). ROC curve analysis showed that the sensitivity and AUC of serum SAA and CA19-9 levels combined with EUC in diagnosing preoperative stages of CRC were higher than those of diagnosis alone (P<0.05). Pearson correlation analysis showed that serum SAA level was positively correlated with CA19-9 level (P<0.05).

EUC combined with serum SAA and CA19-9 levels is of high value in diagnosing preoperative stages of CRC. It can provide reference for treatment.

To explore the effects of ultrasound-guided and CT-guided radiofrequency ablation (RFA) on serum alpha-fetoprotein (AFP), transferrin (TRF) and prognosis in patients with hepatocellular carcinoma.

A total of 89 patients with hepatocellular carcinoma undergoing RFA in Yulin Red Cross Hospital were enrolled as the research objects between September 2015 and September 2019, including 45 cases undergoing ultrasound-guided RFA in ultrasound group and 44 cases undergoing CT-guided RFA in CT group. The perioperative data in the two groups were recorded. AFP and TRF levels were detected. All patients were followed up regularly for 36 months. The survival curves were drawn by Kaplan-Meier method to compare prognosis in the two groups.

The complete ablation rate in CT group was higher than that in ultrasound group, ablation frequency was higher than that in ultrasound group, and ablation time was longer than that in ultrasound group, with statistically significant differences (P<0.05). After surgery, recurrence rate and local recurrence rate in ultrasound group were 31.1% and 20.0%, significantly higher than those in CT group (13.6%, 4.6%), with statistically significant differences (P<0.05). After surgery, the levels of AFP and TRF in both groups were decreased, which were lower in CT group than ultrasound group, with statistically significant differences (P<0.05). At 3 years after surgery, progression-free survival rate in CT group was significantly higher than that in ultrasound group [84.1% (37/44) vs. 46.7% (21/45)], with a statistically significant difference (P<0.05).

Curative effect of CT-guided RFA is significant on hepatocellular carcinoma, which can increase survival rate. The mechanism may be significantly related to reducing AFP and TRF levels.

To explore the therapeutic effect of Huanglian Wendan decoction on chronic atrophic gastritis (CAG) patients with anxiety and depression, and its impact on traditional Chinese medicine syndrome score and anxiety and depression scale score.

A total of 104 CAG patients with anxiety and depression admitted to Fuyang Cancer Hospital in Anhui Province from January 2019 to January 2022 were selected and randomly divided into the observation group (52 cases treated with conventional Western medicine) and the control group (52 cases treated with Huanglian Wendan decoction on the basis of Western medicine). The clinical efficacy, traditional Chinese medicine syndrome score, anxiety and depression score and gastric mucosa function related indexes were compared between the two groups.

After treatment, the clinical treatment effectiveness rate of the observation group was significantly higher than that of the control group (P<0.05), and the traditional Chinese medicine syndrome scores such as epigastric distension and pain in the observation group were significantly lower than those of the control group (P<0.05). The anxiety scale (Hamilton Anxiety Scale, HAMA) and depression scale (Hamilton Depression Scale, HAMD) scores of the observation group were lower than those of the control group (P<0.05), and the pepsinogen (PG) Ⅰ and PGⅠ/PGⅡ ratio of the observation group were higher than those of the control group (P<0.05). There was no significant difference in PGⅡ between the observation group and the control group (P>0.05).

Huanglian Wendan decoction is effective in the treatment of CAG patients with anxiety and depression, and can effectively improve the clinical symptoms, anxiety and depression and gastric mucosa function.

To investigate the incidence of preoperative anxiety and postoperative recovery restlessness in patients with gastrointestinal cancer, and to analyze the influencing factors and their correlations.

Using the single center prospective cohort study method, gastrointestinal cancer patients who underwent surgical treatment in Nuclear Industry 416 Hospital from January 1, 2020 to December 31, 2022 were selected as the research subjects. All patients were evaluated for preoperative anxiety state using the Hamilton Anxiety Scale (HAMA), and for postoperative recovery restlessness using the Richmond Agitation-Sedation Scale (RASS). Clinical data was collected from patients, and univariate and multivariate logistic regression analysis was used to analyze the factors influencing preoperative anxiety and postoperative recovery restlessness in gastrointestinal cancer patients. The correlation between preoperative anxiety and postoperative recovery restlessness was analyzed.

A total of 202 gastrointestinal cancer patients were enrolled in this study. The preoperative anxiety score was (10.68±2.18) points, and the incidence of preoperative anxiety was 64.85%. Univariate and multivariate logistic regression analysis showed that age, education level, expected surgical duration, and payment method were independent factors affecting preoperative anxiety in patients with gastrointestinal cancer (P<0.05). The postoperative recovery RASS score of gastrointestinal cancer patients was (0.35±0.06) points, and the incidence of postoperative recovery restlessness was 14.35%. Univariate and multivariate logistic regression analysis showed that age, surgical time, anesthesia method, and intraoperative hypothermia were independent factors for postoperative recovery restlessness in gastrointestinal cancer patients (P<0.05). There was a significant correlation between preoperative anxiety and postoperative recovery restlessness in patients with gastrointestinal cancer (r=0.511, P<0.001).

For patients with gastrointestinal cancer, age, education level, expected surgical duration, and payment method are independent risk factors for preoperative anxiety. Age, surgical time, anesthesia method, and intraoperative hypothermia are independent risk factors for postoperative recovery restlessness. There is a significant correlation between preoperative anxiety and postoperative recovery restlessness.

To systematically evaluate the clinical efficacy of probiotics combined with antiviral drug entecavir in the treatment of hepatitis B cirrhosis and its effect on liver function and the degree of liver fibrosis.

The high-quality literature on the randomized controlled study of probiotics combined with entecavir in the treatment of hepatitis B cirrhosis published in Chinese and foreign databases such as CNKI, Wanfang, China biomedical literature service system, PubMed and EMBase from the establishment of the database to January 2022 were searched. The literatures were screened according to the inclusion and exclusion criteria. The quality of the 14 articles finally included was analyzed, and the collected data were meta analyzed using the statistical software revman 5.4.

A total of 14 randomized controlled studies (1 222 patients) were included in this study for statistical processing. Probiotics combined with entecavir in the treatment of hepatitis B cirrhosis could improve the total effective rate of patients (OR=5.62, 95% CI: 2.75-11.48, Z=4.74, P<0.000 001); Probiotics combined with entecavir had a higher negative conversion rate of HBV-DNA (OR=2.43, 95% CI: 1.39-4.25, Z=3.12, P<0.01). Liver function index: ALT (OR=-8.74, 95% CI: -12.56~-4.91, Z=4.48, P<0.01); AST (OR=-24.27, 95% CI: -33.5~-15.03, Z=5.75, P<0.01); ALB (OR=4.17, 95% CI: 3.32-5.02, Z=9.62, P<0.01). Liver fibrosis index: HA (OR=-33.09, 95% CI: -40.08~-25.35, Z=11.48, P<0.01); LN (OR=-20.47, 95% CI: -23.03~-17.90, Z=15.66, P<0.01).

Probiotics combined with entecavir in the treatment of hepatitis B cirrhosis can improve the clinical efficacy of patients with hepatitis B cirrhosis and the negative conversion rate of hepatitis B HBV-DNA, and improve the liver function and the degree of liver fibrosis.

Clostridium difficile is the primary pathogenic bacterium associated with pseudomembranous colitis (PMC). During an imbalance in the gut microbiota, Clostridium difficile proliferates and releases a large amount of toxins, leading to PMC. Diagnosis can be confirmed based on recent antibiotic use, diarrhea, and detection of Clostridium difficile pathogens or toxins. CT can assist in evaluating the extent and severity of the lesions. The CT manifestations of PMC overlap to some extent with other causes of colitis, but certain imaging features can help differentiate these conditions. This article provides a comprehensive review of the imaging features and differential diagnosis of PMC.

Liver metastasis is the main cause of death in patients with colorectal cancer. Surgical resection is the most effective treatment for colorectal liver metastasis (CRLM), but radical surgical resection is not possible in most patients. In recent years, with the continuous development of interventional techniques, interventional therapy has significant effects on local control and overall survival of patients with CRLM, and has become an important means of individual treatment and multidisciplinary team treatment of CRLM. This article mainly reviews the latest research and development trend of interventional therapy for CRLM.

Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) is a liver-specific MRI contrast agent. In recent years, a large number of studies at home and abroad have shown that Gd-EOB-DTPA enhanced MRI has great advantages in liver function assessment, which can not only accurately assess liver function in chronic liver diseases, but also be used to predict liver failure after liver resection. The review systematically describes the application status of Gd-EOB-DTPA- enhanced MRI in the diffuse lesions of the liver, such as nonalcoholic fatty liver diseases, liver fibrosis, cirrhosis and preoperative evaluation of residual liver function in patients with partial liver resection, and forecasts the future of Gd-EOB-DTPA.

To explore the effects of internet, telephone support and regular family follow-up on the recovery of gastrointestinal function after esophageal cancer surgery.

A total of 120 patients with esophageal cancer undergoing thoracoscopic radical resection in Beijing Daxing District People's Hospital from January 2019 to January 2022 were prospectively enrolled. Patients were randomly divided into the control group and the observation group, with 60 cases in each group. In the control group, routine follow-up was used after operation, and the principle of diet addition, food choice and outpatient follow-up time were informed by responsible doctors and nurses. On the basis of routine follow-up, the patients in the observation group were followed up by doctors and nurses after discharge. One-to-one telephone guidance on lifestyle and dietary matters needing attention was conducted regularly, and family follow-up was conducted once a month. In the wechat group, responsible doctors and nurses regularly educated patients on postoperative health knowledge of esophageal cancer, guided patients on recovery and diet matters needing attention, and answered patients' postoperative rehabilitation questions regularly. Self-Rating Anxiety Scale (SAS) and Self-rating depression scale (SDS) scores, serum prealbumin, transferrin, and albumin levels, Simplified dietary self-assessment tool score (SDSAT), quality of life questionnaire (EORCT QLQ-C30), cancer fatigue score (CFS), and satisfaction with care were evaluated at outpatient follow-up after 6 months in both groups.

Both groups completed the intervention and follow-up 6 months after surgery. The evaluation results after follow-up showed that the SDS and SAS scores of the observation group were significantly lower than those of the control group (P<0.01). The SDSAT score of the observation group was significantly higher than that of the control group (P<0.05). The levels of serum prealbumin, transferrin and albumin in the observation group were significantly higher than those in the control group (P<0.05). The EORCT QLQ-C30 score in the observation group was significantly higher than that in the control group (P<0.05). CFS score in the observation group was significantly higher than that in the control group (P<0.01). The satisfaction of nursing in the observation group was significantly higher than that in the control group (P<0.01).

Regular family follow-up based on telephone and internet can improve the dietary function and quality of life of patients with esophageal cancer after surgery, and reduce the level of anxiety and depression of patients.