Irritable bowel syndrome （IBS） is a common intestinal dysfunction disease，which brings a heavy burden to patients' life，spirit and economy. The pathogenesis of IBS is still unclear. The main clinical treatment is to regulate gastrointestinal motility and relieve intestinal spasm，but the effect is not good. In recent years，traditional Chinese medicine such as oral Chinese medicine，massage and acupuncture have been proved to have a good effect on the treatment of IBS. Among them，massage therapy，as a non-drug and non-invasive means，acts on the body surface through specific techniques，harmonizing qi and blood，dredging meridians，and adjusting zangfu organs，which has been confirmed by many studies to alleviate IBS symptoms and improve the quality of life of patients. This review systematically combs the research progress of massage therapy for IBS，covering the theoretical basis of massage therapy for IBS，discussion of mechanism of action，clinical operation methods and skills，efficacy evaluation system，current problems and future research directions. The aim is to provide more scientific，systematic and comprehensive reference and guidance for clinical massage treatment of IBS，and promote the in-depth application and development of massage therapy in the treatment of IBS.

Objective

To construct and verify the prediction model for recurrence of young and middle-aged patients with liver cancer in different periods after radical surgery，and then provide more effective postoperative monitoring and intervention strategies for clinic.

Methods

From January 2017 to December 2021，341 cases of primary hepatocellular carcinoma （PHC） were selected as the research object，and the cases were screened according to certain inclusion and exclusion criteria，and detailed clinical data were collected. Five machine learning algorithms，including logistic regression （LR），decision tree （DT），support vector machine （SVM），random forest （RF） and extreme gradient lifting algorithm （XGBoost），were used to construct the prediction model. All patients were divided into training set and validation set，and the data of training set were trained and optimized by 50% cross validation. Receiver operating characteristic curve （ROC） was used to evaluate the prediction performance of each model，and the area under the curve （AUC），sensitivity，specificity and Jordan index of each model for predicting recent recurrence and long-term recurrence were counted.

Results

Of the 341 PHC patients，173 （50.73%） had postoperative recurrence，of which 78 （22.87%） had recent recurrence and 95 （27.86%） had long-term recurrence. The levels of neutrophil to lymphocyte ratio （NLR），platelet to lymphocyte ratio （PLR），alanine aminotransferase，aspartate transaminase，total bilirubin and alpha fetoprotein in recent and long-term relapses were significantly higher than those in patients without recent and long-term relapses. At the same time，there were significant differences between those with recent recurrence and those without recent recurrence，and between those with long-term recurrence and those without long-term recurrence in portal vein tumor thrombus，tumor envelope integrity，BCLC staging and tumor differentiation （P＜0.05）. The model prediction results showed that XGBoost algorithm had the best performance in predicting recent recurrence （AUC=0.989） and long-term recurrence （AUC=0.983），followed by RF （AUC=0.926，0.939）and SVM algorithm （AUC=0.914，0.904）.

Conclusion

LR，DT，SVM，RF and XGBoost can all predict the recurrence possibility of young and middle-aged patients with liver cancer in different periods after radical surgery. Among them，the prediction performance of RF，SVM and XGBoost model is relatively good，especially XGBoost model shows high prediction accuracy. In addition，NLR，PLR，related liver function indexes，portal vein tumor thrombus，tumor capsule integrity，BCLC stage and tumor differentiation degree may be predictive factors for recurrence.

Objective

To explore the effects of compound Lactobacillus acidophilus tablets combined with montmorillonite powder on diarrhea symptoms and intestinal microbiota in children with rotavirus enteritis.

Methods

A total of 80 children with rotavirus enteritis admitted to Jieshou People's Hospital from January 2022 to February 2024 were selected, and divided into two groups according to the random number table method.The control group (40 cases) received treatment with montmorillonite powder, while the observation group (40 cases) received treatment with compound Lactobacillus acidophilus tablets combined with montmorillonite powder.After treatment, the efficacy, clinical symptom relief time (fever, diarrhea, antiemesis, dehydration, stool characteristics), gut microbiota (Bifidobacterium,Lactobacillus, Escherichia coli), and immune function (CD4⁺, CD8⁺, CD3⁺, CD4⁺/CD8⁺), inflammatory response [C-reactive protein (CRP), tumor necrosis factor alpha (TNFα), interleukin (IL-1β, IL-18)] were compared between the two groups.

Results

The total clinical effective rate of the observation group was 95.00%, which was higher than that of the control group 77.50% (χ²=5.441, P<0.05).The observation group had shorter fever, diarrhea, dehydration, stool characteristics relief time, and antiemetic time compared to the control group (t=3.038, 3.167, 4.284, 2.738, 3.241, P<0.05).After 3 days of treatment, the number of Lactobacilli and Bifidobacteria in the observation group increased compared to the control group, while the number of Escherichia coli decreased (t=2.164, 2.843, 3.016, P<0.05).CD3⁺, CD4⁺, and CD4⁺/CD8⁺ in the observation group were all higher than those in the control group, and CD8⁺ was lower than that in the control group (t=3.152, 4.274, 3.975, 4.628, P<0.05).After 3 days of treatment, the levels of serum CRP, IL-1β, TNFα, and IL-18 in the observation group were lower than those in the control group(t=5.729, 5.823, 10.962, 5.317, P<0.05).

Conclusion

The combination of compound Lactobacillus acidophilus tablets and montmorillonite powder significantly improves clinical symptoms such as diarrhea and fever in rotavirus enteritis, and restores the balance of intestinal microbiota.

本文报道1 例伴肠母细胞分化的胃黏膜内腺癌的病例。患者男，59 岁，胃镜检查示胃窦小弯侧见一直径约2 cm 不规则凹陷，周围黏膜隆起，中央见结节样隆起，行内镜黏膜下剥离术，肿瘤组织镜下为胃黏膜内中分化管状腺癌，伴有乳头状腺癌，免疫组化染色显示肿瘤细胞SALL4 弥漫（＋）、Hepatocyte 部分（＋）、AFP 局部（＋）、Ki-67 指数约70%；结合免疫组化染色结果，符合伴肠母细胞分化的胃腺癌。伴肠母细胞分化的胃癌少见，且以进展期胃癌为主，黏膜内癌发现率极低;免疫组化表达具有一定特异性；该肿瘤可以行内镜下治疗，预后较差。

Objective

To evaluate the efficacy of lenvatinib combined with transcatheter arterial chemoembolization （TACE） in the treatment of unresectable advanced liver cancer，and to analyze the risk factors affecting the survival rate of patients.

Methods

The clinical data of 160 patients with unresectable advanced liver cancer admitted to the Department of Oncology and Department of Intervention of our hospital from January 2023 to July 2023 were retrospectively analyzed. All patients received lenvatinib combined with TACE. The clinical efficacy of all patients after 8 weeks of treatment and the changes of alanine aminotransferase （ALT），aspartate aminotransferase （AST），total bilirubin （TBIL），alpha-fetoprotein（AFP），carcinoembryonic antigen （CEA），carbohydrate antigen 199 （CA199） were recorded，and the 12-month survival rate and progression-free survival （PFS） were recorded，the multivariate Logistic regression analysis was used to analyze the risk factors affecting the survival rate of patients.

Results

Among the 160 patients，the objective response rate （ORR） was 36.25% and the disease control rate （DCR） was 73.13%. ALT，AST，TBIL，AFP，CEA and CA199 after treatment were all lower than before treatment，with statistically significant differences （P＜0.05）. The follow-up analysis showed that 54 patients died and 106 survived，the 12-month survival rate was 63.75%，and PFS was 7.55 months. Multivariate Logistic regression analysis showed that Barcelona （BCLC） stage （OR： 5.801，95% CI： 2.345-14.347），portal vein cancer embolus （OR：6.328，95% CI： 2.509-15.961），peripheral blood neutrophil/lymphocyte ratio （NLR） （OR： 4.978，95% CI：2.350-10.545） and systemic immunoinflammatory Index （SII） （OR： 4.773，95% CI： 2.275-10.013） were the risk factors affecting the prognosis of patients （P＜0.05）.

Conclusion

Lenvatinib combined with TACE improves liver function in patients with unresectable advanced liver cancer，BCLC stage，portal vein cancer embolus，NLR and SII are risk factors affecting the survival rate of patients，and should be paid attention to clinically.

Objective

To analyze and monitor the characteristics of peripheral inflammatory factors and coagulation function indexes in patients with Parkinson's disease complicated with Helicobacter pylori (Hp) infection and their correlation with the disease condition, and to explore the relationship between Hp and the disease course of Parkinson's disease.

Methods

From March 2021 to March 2023, 70 Parkinson's disease patients admitted to Fuyang Fifth People's Hospital were included as the observation group, and 50 healthy individuals undergoing physical examination during the same period were selected as the control group, and all participants underwent the ¹³C urea breath test.According to the occurrence of Hp infection in the observation group, patients were divided into the Hp infection group(n=41) and the non-Hp infection group (n=29), the levels of peripheral inflammatory factors [interleukin(IL)-1β, IL-6, IL-10, tumor necrosis factor-α (TNF-α)] and coagulation function indicators [prothrombin time, thrombin time (TT), activated partial thromboplastin time (APTT), and fibrinogen (FIB)] were compared between different groups, at the same time, Hoehn-Yahr (H-Y) rating scale, unified Parkinson's disease rating scale (UPDRS) Ⅲ and Ⅳ were used to evaluate the severity of the patients' disease and motor function status, and to analyze Hp infection and the changes in the characteristics of peripheral inflammatory factors and coagulation function indicators of Parkinson's disease.Sprearman model was used to analyze the correlation between Hp infection and the severity of Parkinson's disease.

Results

IL-1β,IL-6, IL-10, TNF-α and FIB in observation group were higher than those in control group, and TT and APTT were lower than those in control group, with statistically significant differences (P<0.05).There were no statistically significant differences in age, body mass index, hypertension, diabetes, drinking history, smoking history and positive ¹³C breath test between the two groups (P>0.05).IL-1β, IL-6, IL-10,TNF-α and FIB in Hp infection group were higher than those in non-Hp infection group, and TT and APTT were lower than those in non-Hp infection group, with statistically significant differences (P<0.05).There were no statistically significant differences in age, body mass index, hypertension, diabetes, drinking history and smoking history between the two groups (P>0.05).H-Y grading scale, UPDRS-Ⅲ and UPDRS-Ⅳ scores of Hp infection group were higher than those of non-Hp infection group, and the severity ratio of disease was also higher than that of non-Hp infection group, with statistical significant differences (P<0.05).Sprearman analysis showed that Hp infection was positively correlated with the severity of Parkinson's disease (r=0.483, P<0.05).

Conclusions

Hp infection in patients with Parkinson's disease is closely related to inflammatory state and coagulation dysfunction, and is positively correlated with the severity of Parkinson's disease.For people with Parkinson's disease, controlling Hp infection may help improve inflammatory symptoms and disease management.

Objective

To observe the effect of Xingpi Yang'er Granules combined with conventional Western medicine on gastrointestinal dysfunction in children with pneumonia and its impact on syndrome scores.

Methods

A total of 100 pediatric patients with gastrointestinal dysfunction after pneumonia admitted to Jieshou People's Hospital from January 2021 to January 2024 were selected, and were divided into two groups using a random number table method.The control group of 50 cases received conventional Western medicine treatment, while the study group of 50 cases received combined treatment with Xingpi Yang'er Granules.The clinical efficacy, pulmonary infection score (CPIS), pulmonary spleen qi deficiency syndrome score, serum inflammatory factors [procalcitonin (PCT), interferon gamma (IFN-γ),high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor alpha (TNF-α) levels], and gastrointestinal dysfunction between two groups were compared.

Results

The total clinical effective rate of the research group was significantly higher than that of the control group (P<0.05).After treatment, the CPIS, ulmonary spleen qi deficiency syndrome score of the study group was significantly lower than those of the control group (P<0.05).The levels of serum PCT, IFN-γ, TNF-α, and hs-CRP in the study group improved more significantly than those in the control group (P<0.05).The incidence of gastrointestinal dysfunction in the study group was significantly lower than that in the control group (10.00% vs. 26.00%,P<0.05).

Conclusion

On the basis of conventional Western medicine treatments such as anti infection,the combination of Xingpi Yang'er Granules has shown good efficacy in treating gastrointestinal dysfunction in children with pneumonia and has good clinical value.

Objective

To investigate the correlation between early blood routine，coagulation function indicators，and spiral CT perfusion parameters in patients with acute pancreatitis （AP），as well as their predictive ability for the prognosis of AP patients.

Methods

A retrospective analysis was conducted on 100 AP patients admitted between June 2023 and June 2024. The patients were divided into two groups based on their mortality status： the non-death group and the death group. Differences in early blood routine，coagulation indicators，and spiral CT perfusion parameters between the two groups were compared. The correlation between blood routine，coagulation indicators，and spiral CT perfusion parameters was analyzed using Pearson correlation. The predictive ability of blood routine and coagulation indicators for the prognosis of AP patients was evaluated using ROC curves and multivariate logistic regression analysis.

Results

In the death group，neutrophil count，neutrophil-to-lymphocyte ratio （NLR），platelet count，activated partial thromboplastin time （APTT），fibrinogen （FIB），D-dimer （DD），and computed tomography severity index （Balthazar CTSI） score were significantly higher than those in the non-death group. The lymphocyte count，MPV level，blood flow （BF） and blood volume （BV） from the spiral CT perfusion parameters were significantly lower in the death group compared to the non-death group （P＜0.05）. Logistic regression analysis showed that NLR （OR=1.224，95% CI： 1.116-2.368），DD （OR=1.962，95% CI：1.438-2.529），BF （OR=0.569，95% CI： 0.258-0.815），BV （OR=0.462，95% CI： 0.316-0.927），and Balthazar CTSI （OR=1.485，95% CI： 1.345-3.973） were independent risk factors affecting the prognosis of AP patients. Pearson correlation analysis showed that NLR and DD were negatively correlated with spiral CT perfusion parameters BF and BV，and positively correlated with Balthazar CTSI score （P＜0.05）. ROC curve analysis showed that the area under the curve （AUC） for NLR was 0.752 （95% CI： 0.641-0.863），for DD was 0.779 （95% CI： 0.675-0.883），and for the combined NLR+DD was 0.923 （95% CI： 0.861-0.984）.

Conclusion

NLR and DD are correlated with spiral CT perfusion parameters BF and BV and Balthazar CTSI score，and they can be used as indicators for predicting the prognosis of AP patients.

Objective

To investigate the relationship between the changes of serum intestinal fatty acid binding protein (I-FABP), high mobility group protein B1 (HMGB1), T lymphocyte subsets and the severity of disease in children with rotavirus enteritis (RE).

Methods

A total of 210 children with RE admitted to Yulin First Hospital from April 2021 to April 2024 were selected as the study group, according to the severity of dehydration, the children were divided into mild to moderate group (n=151) and severe group (n=59), and 180 healthy children were selected as the control group.The changes of I-FABP,HMGB1 and T lymphocyte subsets in serum of all groups were compared, Pearson correlation analysis was used to analyze the correlation between the changes of serum I-FABP, HMGB1 and T lymphocyte subsets and the severity of RE in children.

Results

The levels of I-FABP, HMGB1 and CD8⁺ in study group were significantly higher than those in control group, while the levels of CD3⁺, CD4⁺ and CD4⁺/CD8⁺ in study group were significantly lower than those in control group (P<0.05); the levels of I-FABP, HMGB1 and CD8⁺ in severe group were significantly higher than those in mild to moderate group, while the levels of CD3⁺, CD4⁺ and CD4⁺/CD8⁺ were significantly lower than those in mild to moderate group (P<0.05).The results of Pearson correlation analysis showed that the serum levels of I-FABP, HMGB1 and CD8⁺ were positively correlated with the severity of the disease, while the levels of CD3⁺, CD4⁺ and CD4⁺/CD8⁺ were negatively correlated with the severity of the disease (P<0.05).

Conclusion

The levels of I-FABP,HMGB1, and T lymphocyte subsets in the serum of children with RE are closely related to the severity of the condition, and monitoring these indicators can provide an important reference for the evaluation and treatment of children with RE.

Objective

To explore the risk factors of postoperative anastomotic fistula of esophageal cancer, establish a risk prediction nomogram model based on the risk factors, and evaluate the prediction efficiency and clinical application value of this model through clinical decision curve analysis(DCA).

Methods

A total of 342 patients undergoing esophageal cancer surgery in Nantong Cancer Hospital from January 2020 to September 2024 were retrospectively selected and divided into occurrence group (n=36) and non-occurrence group (n=306) according to whether postoperative anastomotic fistula was complicated.The differences in baseline data, perioperative relevant indicators and serological factors between the two groups were compared.Lasso and multivariate Logistic regression were used to screen the risk factors of postoperative anastomotic fistula for esophageal cancer, the risk prediction nomogram model was constructed, and the prediction accuracy was verified by receiver operating characteristic (ROC) curve.Bootstrap method and DCA decision curve were used for internal verification to verify the stability and benefits of the nomogram model.

Results

There were statistically significant differences in diabetes mellitus, smoking history, anastomosis mode, low density lipoprotein cholesterol (LDL-C) and albumin between the occurrence group and the non-occurrence group (all P<0.05).Lasso regression showed that diabetes mellitus, anastomotic mode and albumin could be included in the risk prediction model of anastomotic fistula after esophageal cancer surgery.Binary Logistic regression showed that diabetes mellitus, manual anastomosis and low albumin level were independent risk factors for anastomotic fistula after esophageal cancer surgery (all P<0.001).ROC results showed that the area under the curve predicted by diabetes, anastomotic mode, albumin and nomogram models was 0.713, 0.726, 0.787 and 0.904,respectively.The sensitivity was 0.583, 0.583, 0.735 and 0.889, respectively.The specificity was 0.843, 0.869,0.750 and 0.788, respectively.Internal verification was performed by Bootstrap method (B=1000), and C-indexwas 0.807, indicating that the early warning model of anastomotic fistula after esophageal cancer surgery had good stability.Decision analysis showed that the model can bring net benefits, which was obviously better than the ineffective strategy.

Conclusion

Diabetes mellitus, manual anastomosis and low albumin are independent risk factors for anastomotic fistula after esophageal cancer surgery.The established risk prediction model is effective, stable and has net benefit, which is better than the control without strategy.

Objective

To investigate the correlation of fecal bacteria，fecal calprotectin （FC），systemic immunoinflammatory index （SII），D-dimer （D-D） levels and disease severity in patients with ulcerative colitis （UC）.

Methods

A total of 115 UC patients admitted to Xijing Hospital from October 2018 to December 2019 were selected as the study objects，and they were divided into the mild group（n=46），the moderate group （n=39），and the severe group （n=30） according to the severity of the disease.The distribution of fecal bacteria，FC，SII，and D-D levels of patients in the three groups were compared，and the distribution of fecal bacteria，FC，SII and D-D levels in patients with different prognosis were compared. Pearson correlation analysis was used to analyze the correlation between fecal bacteria，FC，SII and D-D levels and disease severity and prognosis in UC patients.

Results

The levels of Enterococcus，Escherichia coli and Bacteroides in the severe UC group were higher than those in the moderate and mild UC groups； the levels of Lactobacillus and Bifidobacteria were significantly lower than those in the moderate and mild UC groups，the levels of Enterococcus，Escherichia coli and Bacteroides in the moderate UC group were higher than those in the mild UC group； the levels of Lactobacillus and Bifidobacteria in the moderate UC group were significantly lower than those in the mild UC group，with statistically significant differences （P＜0.05）； the levels of FC，SII and D-D in the severe UC group were higher than those in the moderate and mild UC groups，and the levels of FC，SII and D-D in the moderate UC group were higher than those in the mild UC group，with statistically significant differences （P＜0.05）.After 6 months of outpatient follow-up of 115 UC patients，88 cases had good prognosis and 27 cases had poor prognosis. The levels of Enterococcus，Escherichia coli，Bacteroides，FC，SII and D-D in UC patients with poor prognosis were higher than those in UC patients with good prognosis，while Lactobacillus and Bifidobacterium were significantly lower than those in UC patients with good prognosis，with statistically significant differences （P＜0.05）. The results of Pearson correlation analysis showed that the levels of Enterococcus，Escherichia coli，Bacteroides，FC，SII and D-D were positively correlated with disease severity and negatively correlated with prognosis in UC patients （P＜0.05）. The levels of Lactobacillus and Bifidobacterium were negatively correlated with disease severity and positively correlated with prognosis（P＜0.05）.

Conclusion

Significantly elevated levels of fecal bacterial dysbiosis，FC，SII，and D-D in UC patients are closely associated with disease severity，and clinical testing of these indicators can help to accurately assess the condition and treatment efficacy of UC patients.

Tracheoesophageal fistula （TEF） is an abnormal pathological connection between the esophagus and trachea and/or bronchus caused by various benign and malignant factors. Benign TEF in adults is mainly caused by iatrogenic injury，infectious diseases，trauma，esophageal foreign bodies，etc.The main treatment options for benign TEF in adults are surgical and non-surgical treatments，aiming to close the fistula. This article deals with the management of benign TEF in adults from the perspective of gastroendoscopist.

Objective

To investigate the relationship between preoperative nutritional status,early postoperative systemic immunoinflammatory index, C-reactive protein/albumin ratio (CRP/Alb),neutrophil to lymphocyte ratio (NLR) and anastomotic fistula after esophageal cancer surgery.

Methods

The clinical records of 202 patients with esophageal cancer treated in Qingdao Municipal Hospital from February 2019 to February 2024 were retrospectively reviewed.According to whether anastomotic fistula occurred after surgery, these patients were divided into two groups, 19 patients with postoperative anastomotic fistula were considered as the observation group, and the remaining 183 patients without anastomotic fistula were considered as the control group.Preoperative nutritional status [prognostic nutritional index (PNI), serum albumin (ALB), prealbumin (PA)] and early postoperative systemic immunoinflammatory index (SII), CRP/Alb, NLR were detected in all patients.Pearson correlation was used to analyze the correlation between each index and postoperative anastomotic fistula.Receiver operating characteristic (ROC) curve was plotted, the area under the curve (AUC) value was calculated,and the predictive value of PNI, ALB, PA, SII, CRP/Alb and NLR for postoperative anastomotic fistula of esophageal cancer was analyzed.

Results

There were no statistically significant differences in gender,age, smoking history, drinking history, hypertension, diabetes, tumor location and TNM stage between the observation group and the control group (P<0.05).Compared with the control group, the PNI and CRP/Alb in the observation group was significantly reduced, while SII and NLR were significantly increased(P<0.05).The results of Pearson correlation analysis showed that PNI, CRP/Alb were negatively correlated with postoperative anastomotic fistula (r=-0.477, -0.655, P<0.05), and SII and NLR were positively correlated with postoperative anastomotic fistula (r=0.632, 0.518, P<0.05).Logistic multivariate regression analysis showed that PNI<45.45, SII≥556.54, CRP/Alb<0.44, NLR≥10.20 were all risk factors for predicting anastomotic fistula after esophageal cancer surgery (P<0.05).The ROC curve showed that the AUC for predicting anastomotic fistula after esophageal cancer surgery by combining preoperative PNI<45.45 and early postoperative SII≥556.54, CRP/Alb<0.44, and NLR≥10.20 was 0.824, and the sensitivity and specificity were 82.38% and 84.16%, respectively.

Conclusion

Preoperative PNI and early postoperative SII, CRP/Alb, NLR are closely related to anastomotic fistula after esophageal cancer surgery.These indicators play an important role in predicting the risk of anastomotic fistula after esophageal cancer surgery.

Objective

To investigate the characteristics of intestinal flora and the clinical significance of serum neuron-specific enolase （NSE），nitric oxide （NO），interleukin-1 （IL-1） and interleukin-6 （IL-6） in children with benign infantile convulsion associated with mild gastroenteritis（BICE）.

Methods

A total of 40 children with BICE treated in Yulin First Hospital from November 2022 to November 2023 were selected as the study group，and 40 children with mild gastroenteritis were selected as the control group. The levels of intestinal flora，serum NSE，NO，IL-1 and IL-6 in children with BICE were compared between the two groups，and the levels of intestinal flora，serum NSE，NO，IL-1 and IL-6 in children with BICE with different disease degrees and recurrence conditions were compared. Pearson correlation analysis was used to analyze the correlation between intestinal flora，serum NSE，NO，IL-1，IL-6 and disease and recurrence in children with BICE.

Results

The levels of Enterococcus，Escherichia coli，Lactobacillus and Bifidobacterium in the study group were lower than those in the control group，and serum NSE，NO，IL-1 and IL-6 were higher than those in the control group，with statistically significant differences （P＜0.05）. The levels of Enterococcus，Escherichia coli，Lactobacillus and Bifidobacterium in the intestinal flora of children with BICE in severe group were lower than those in normal group，and serum NSE，NO，IL-1 and IL-6 were higher than those in normal group，with statistically significant differences （P＜0.05）. The levels of Enterococcus，Escherichia coli，Lactobacillus and Bifidobacterium in the intestinal flora of children with BICE in the relapsed group were lower than those in the non-relapsed group，and the serum NSE，NO，IL-1 and IL-6 were higher than those in the non-relapsed group，with statistically significant differences （P＜0.05）. The results of Pearson correlation analysis showed that Enterococcus，Escherichia coli，Lactobacillus and Bifidobacterium were negatively correlated with disease and recurrence in children with BICE，while serum NSE，NO，IL-1 and IL-6 were positively correlated with disease and recurrence in children with BICE （P＜0.05）.

Conclusion

The changes of intestinal flora，serum NSE，NO，IL-1 and IL-6 in children with BICE are closely related to the severity and recurrence of the disease，and monitoring these indicators is helpful for early clinical intervention and treatment.

Objective

To analyze the clinical characteristics and course differences between smokers and non-smokers in patients with idiopathic chronic pancreatitis，in order to clarify the impact of smoking on the clinical characteristics of patients with idiopathic chronic pancreatitis.

Methods

Prospective clinical data were collected from 966 patients with idiopathic chronic pancreatitis admitted to the Department of Gastroenterology at the First Affiliated Hospital of Naval Medical University from January 2010 to December 2013. Patients were divided into a smoking group and a non-smoking group based on their smoking history，and their clinical characteristics were compared between the two groups.Kaplan-Meier method was used to calculate the cumulative incidence of steatorrhea，diabetes，pancreatic pseudocysts，pancreatic stones and biliary stricture after the onset of idiopathic chronic pancreatitis.

Results

Among 966 patients with idiopathic chronic pancreatitis，274 were smokers and 692 were non-smokers. The clinical characteristics of smokers are significantly different from non-smokers，with significant differences in the age of onset，age of diagnosis，adolescent onset，main pancreatic duct morphology，pain type，successful drainage of the pancreatic duct，treatment methods，pancreatic duct stones，and pancreatic pseudocysts （all P＜0.05）. The incidence of pancreatic duct stones （P=0.002） and pancreatic pseudocysts （P＜0.001） in the smoking group was significantly higher than that in the non-smoking group.

Conclusion

There is a significant difference in the clinical characteristics of patients with idiopathic chronic pancreatitis between the smoking group and the non-smoking group. The smoking group has a higher incidence of complications related to chronic pancreatitis and accelerates the occurrence of pancreatic pseudocysts. Therefore，smoking may have a significant impact on the clinical characteristics of patients with idiopathic chronic pancreatitis.