BACKGROUND:Early-onset gastric cancer (EOGC), diagnosed before age 45, demonstrates distinct clinicopathological features and poorer prognosis. Current screening strategies lack sensitivity in young populations, while Helicobacter pylori (H. pylori) virulence genotypes (e.g., cagA, vacA) remain underutilized in risk stratification. To develop and validate a diagnostic model combining clinical characteristics and H. pylori virulence serological detection of virulence factors to optimize EOGC risk stratification. METHODS:In this multicenter case-control study, 200 histologically confirmed EOGC patients and 600 age-matched controls (non-malignant gastric conditions) were enrolled from LiShui Hospital (2023-2024). Clinical parameters, H. pylori infection status (13C-urea breath test), and virulence genotypes (cagA, vacA; ELISA) were analyzed. Multivariable logistic regression identified independent risk factors, followed by risk score development and internal validation (1000 bootstrap replicates). RESULTS:EOGC patients exhibited higher prevalence of persistent epigastric pain (68.5% vs. 32.1%; P<0.001), significant weight loss (6.2 vs. 2.1 kg; P<0.01), and H. pylori infection (85.0% vs. 52.3%; P<0.001). Virulent genotypes were enriched in EOGC: cagA+ (72.5% vs. 45.6%; P<0.01) and vacA s1/m1 (65.0% vs. 38.2%; P<0.01). The final model included five predictors: persistent pain (adjusted odds ratio [aOR]=2.85, 95% CI:1.92-4.23), cagA+ (aOR=3.12, CI: 2.01-4.85), anemia (Hb<110 g/L; aOR=2.34, CI: 1.56-3.51), thrombocytosis (>300×109/L; aOR=1.98, CI: 1.32-2.96), and weight loss >2.1 kg (aOR=2.57, CI: 1.21-2.73). A score ≥3 indicated high risk, achieving 86.5% sensitivity and 82.3% specificity (AUC=0.89, CI: 0.85-0.93). CONCLUSIONS:This novel model integrates accessible clinical and microbiological markers to stratify EOGC risk with high accuracy, providing a cost-effective tool for prioritizing endoscopic evaluation in young symptomatic individuals.

OBJECTIVE:High triglyceride (TG) levels complicate the diagnosis of acute pancreatitis (AP) due to delayed lipid testing. This study evaluates the diagnostic value of inflammatory indices, particularly the platelet-to-lymphocyte ratio (PLR) and systemic inflammation response index (SIRI), for identifying hyperlipidemic acute pancreatitis (HLAP). METHODS:A retrospective cohort study analyzed 140 AP patients (59 HLAP, 81 non-HLAP) admitted between January 2023 and December 2024. The HLAP group was further stratified into gray-zone (HLAP-G) and typical (HLAP-S) subgroups. Healthy controls (HC, n=80) and individuals with simple hypertriglyceridemia (HTG, n=80) were included for comparison. Inflammatory indices (PLR, SIRI, NLR, MLR, SII) were calculated from admission blood counts. Diagnostic performance was assessed using ROC analysis, and a combined model (PLR+SIRI+TG) was developed and validated in an external cohort. Dynamic changes of PLR and SIRI were evaluated at 1, 6, and 12 hours post-admission. RESULTS:PLR, SIRI, and other indices were significantly higher in the HLAP group than in the non-HLAP, HTG, and HC groups (all P < 0.01), showing a stepwise increase from HC to HLAP-S. SIRI demonstrated the highest diagnostic efficacy for HLAP (AUC=0.973, sensitivity =91.5%, specificity =96.3%), followed by PLR (AUC=0.960). The combined model achieved the highest AUC (0.988), with external validation confirming generalizability (AUC=0.845). Dynamic profiles revealed peak PLR and SIRI at 6 hours post-admission. Multivariate analysis identified PLR and SIRI as independent risk factors for HLAP. CONCLUSIONS:PLR and SIRI are valuable, easily accessible tools for early HLAP diagnosis. Their high diagnostic accuracy, particularly when combined with TG, provides a robust method for prompt identification and targeted therapy.

Background: Qijiao Shengbai Capsule is a traditional multi-herb formulation composed of natural products including Jujube (Ziziphus jujuba), Donkey-hide gelatin (Colla corii asini), Pseudostellaria heterophylla, Epimedium brevicornum, Sophora flavescens, Astragalus membranaceus, and Angelica sinensis. These botanical and animal-derived ingredients are traditionally used to tonify Qi and blood, enhance immunity, and promote hematopoiesis. Purpose: This study aimed to evaluate the therapeutic efficacy and immunomodulatory effects of Qijiao Shengbai Capsule in combination with recombinant human granulocyte colony-stimulating factor (rhG-CSF) for the treatment of chemotherapy-induced leukopenia in patients with hematologic malignancies. Materials and Methods: A total of 90 patients with post-chemotherapy leukopenia were randomly assigned to receive either rhG-CSF alone or rhG-CSF combined with Qijiao Shengbai Capsule for 5 days. Key outcome measures included hematologic parameters, inflammatory cytokines (tumor necrosis factor alpha (TNF-alpha), interleukin (IL)-6, high-sensitivity C-reactive protein (hs-CRP)), immune function markers (CD3(+), CD4(+), NK cells), and adverse events. Results: The observation group demonstrated a significantly higher total effectiveness rate (93.33% vs. 75.56%, p < .001). Compared with rhG-CSF alone, the addition of Qijiao Shengbai Capsule significantly increased leukocyte, platelet, and hemoglobin levels, enhanced immune cell populations, and reduced pro-inflammatory cytokines (p < .01 for all). Adverse reaction rates were low and comparable between groups. Conclusion: Qijiao Shengbai Capsule, composed of bioactive natural ingredients, exhibits potent hematopoietic and immunomodulatory properties when combined with rhG-CSF over a 5-day treatment course, presenting a promising adjunctive treatment option for chemotherapy-induced leukopenia. These findings support the clinical and pharmacognostic relevance of this traditional herbal formulation in oncology care.

OBJECTIVE:Oxidative stress exerts an essential role in the pathogenesis of ulcerative colitis (UC). This study aims to unveil the heterogeneity in oxidative stress among immune cell subpopulations in UC. METHODS:Human colon epithelial cells were exposed to 100 ng/mL LPS to stimulate UC, which were administrated with antioxidants 500 mM butylated hydroxyanisole or 20 μM N-acetylcysteine. A single-cell atlas was constructed across UC, and heterogeneous cell subpopulations were evaluated at single-cell and bulk levels. RESULTS:Activation of oxidative stress and inflammatory response, enhanced migration capacity, and impaired tight junction were observed in LPS-induced UC cell models, which were ameliorated by antioxidants. Five cell types: plasma cells, T cells, myeloid cells, and B cells were clustered across UC and control gut biopsies, which were tightly interacted. Myeloid cells were sub-clustered into conventional dendritic cells, M1 macrophages, IL23R+ myeloid cells, mast cells, and follicular dendritic cells; T cells were sub-clustered into Th17, CD4+ naïve T cells, CD8+ cytotoxic T cells, CD4+ exhausted T cells, CD8+ memory T cells, Tregs, and Th1. The heterogeneous myeloid and T cells was confirmed at the single-cell and bulk levels. The activity of oxidative stress was heterogeneous among diverse myeloid cell or T cell subpopulations, with the strongest activity in M1 macrophages and CD4+ exhausted T cells, respectively. It was also found the specific transcriptional programs of M1 macrophages and CD8+ cytotoxic T cells. CONCLUSION:Overall, our findings unveil the heterogeneity in oxidative stress and transcriptional programs among diverse myeloid and T cell subpopulations in UC.

This prospective study evaluated the efficacy and safety of Paksun Combination in combination with lisdexamfetamine versus lisdexamfetamine monotherapy for the treatment of chemotherapy-induced leukopenia. A 12-month randomized controlled trial (January to December 2022) assigned 96 patients with leukopenia to two treatment groups by computer-generated block randomization. The intervention group (48 patients) received lisdexamfetamine (20 mg, TID) plus leucovorin (20 mL, TID), while the control group (48 patients) received lisdexamfetamine only. The primary outcomes included hematologic recovery parameters, TCM symptom improvement and immunologic indices. The combination therapy demonstrated significantly higher clinical response rates (93.75% vs 75.00%; χ²=15.507, P<0.001), with accelerated leukocyte recovery (5.46±0.41 vs 4.07±0.50×109/L; P<0.001) and neutrophil restoration (2.78±0.69 vs 2.17±0.73×109/L; P=0.025). Immunological improvements included increased IgG (20.81±2.77 vs 17.95±3.10 g/L; P<0.001) and IgM levels (1.59±0.30 vs 1.07±0.24 g/L; P<0.001). No significant difference in adverse events was observed between groups (10.42% vs 18.75%; P=0.247). The combination of Shengbai mixture and leucogen demonstrates significantly enhanced myeloprotective efficacy with safety profiles comparable to those of leucogen monotherapy, thereby underscoring its potential as a highly effective therapeutic modality.

Multi-classification of colorectal polyps using endoscopic images is crucial for enhancing clinical diagnostic accuracy and reducing colorectal cancer mortality. Accurately classifying colorectal polyps poses significant challenges due to blurred lesion boundaries, varying intra-class scales, and high inter-class similarities. To address these challenges, we propose the Fused Residual Attention Network (FRAN) for colorectal polyp classification. FRAN employs a dual-branch structure to emphasize both semantic and detailed information. The Residual Attention Learning mechanism enhances lesion region detection, while Global Dependent Self-Attention captures global context. Additionally, the Edge Feature Fusion module, combined with Semantic Alignment, mitigates semantic loss during upsampling and captures edge-detailed features. We evaluated FRA on a private four-class colorectal polyp dataset, the three-class public Kvasir dataset, the three-class public HyperKvasir dataset, and the four-class public PICCOLO dataset. The overall classification accuracies achieved are 85.73

Accurate abnormality classification in intestinal images is critical for the diagnosis and treatment of early-stage intestinal cancers, but remains challenging due to the large intra-lesion variability and high similarity between abnormal lesions and normal tissue. To solve the above problems, a multi-scale high and low feature fusion attention network is proposed to efficiently utilize the features extracted by the backbone network. First, a multi-scale feature extraction module is used to extract features, and then a detail capture attention module and a dense sampling fusion module are used to focus on and fuse the lesion information hidden in the superficial and deep layers. Finally, classification effect is obtained by fusing the lesion information. Experiments show that the method achieves 98% classification accuracy on the Kvasir dataset with three types of normal, polyp and ulcer. In addition, the classification accuracy in the private dataset reaches 97.52% and the experimental effect is better than other existing deep learning classification methods.

Objective: This study investigated the role of dexmedetomidine (DEX) in dextran sulfate sodium (DSS)-induced NCM460 cells. Material and Methods: The viability and apoptosis of NCM460 cells treated with DEX with or without DSS were detected by CCK-8 and terminal deoxynucleotidyl transferase (TdT) dUTP nick-end labeling (TUNEL) assay. The level of inflammatory factors and expression of inflammation-related proteins, tight junction proteins and Ras homolog gene family, member A/Rho-associated coiled-coil containing protein kinase (RhoA/ROCK) signaling-related proteins in NCM460 cells treated with DEX and/or U46619 (RhoA/ROCK agonist) and/or DSS were detected by the respective enzyme-linked immunosorbent assay (ELISA) kits and Western blot analysis. The permeability of NCM460 monolayers was examined with transepithelial electrical resistance (TEER) assay. Results: DEX had no effect on NCM460 cell viability. However, DEX improved the viability and barrier damage and suppressed the apoptosis and inflammation of DSS-induced NCM460 cells. Correspondingly, the expression of inflammation-related proteins was reduced and the expression of tight junction proteins was increased in DSS-induced NCM460 cells after treatment with DEX. In addition, RhoA/ROCK signaling was activated in NCM460 cells induced by DSS, which was suppressed by DEX. The protective effects of DEX on DSS-indued NCM460 cells were reversed by U46619. Conclusion: DEX improved viability and barrier damage while suppressed apoptosis and inflammation in DSS-indued NCM460 cells by inhibiting RhoA/ROCK signaling pathway.

Phosphatidylinositol and several other phospholipids were tested for their ability to influence the (Na++K+)-ATPase activity of the cortical synaptic membrane from rats at various levels of free Ca2+. Phosphatidylinositol, but not phosphatidylethanolamine, phosphatidylcholine nor phosphatidylserine, markedly inhibited this enzyme activity, when the free Ca2+ concentration in the incubation media was less than 2.5 × 10−6 M. This result suggests that phosphatidylinositol may play a role in the depolarization and/or the release of neurotransmitters or intracellular substances in the brain.

目的:观察化瘀解毒健脾汤联合胃复春片治疗胃癌前病变的临床疗效及对患者血清胃泌素(GAS)和生长抑素(SST)表达的影响.方法:选择胃癌前病变患者82例,按随机数字表法分为观察组和对照组各41例.对照组给予胃复春片治疗,观察组在对照组基础上给予化瘀解毒健脾汤治疗.比较2组临床疗效,分析治疗前后主要症状积分、胃黏膜病理积分、血清GAS及SST水平变化.结果:观察组总有效率为92.68％,高于对照组70.73％,差异有统计学意义(P＜0.05).2组治疗前的胃脘疼痛、胃脘胀满、纳呆及胃脘灼热评分比较,差异无统计学意义(P＞0.05).2组治疗后的胃脘疼痛、胃脘胀满、纳呆及胃脘灼热评分较治疗前降低(P＜0.05),且观察组胃脘疼痛、胃脘胀满、纳呆和胃脘灼热评分均低于对照组(P＜0.05).治疗前,2组肠上皮化生及异型增生积分比较,差异均无统计学意义(P＞0.05).治疗后,2组肠上皮化生及异型增生积分较治疗前降低(P＜0.05),且观察组肠上皮化生及异型增生积分低于对照组(P＜0.05).2组治疗前的血清GAS、SST水平比较,差异均无统计学意义(P＞0.05).2组治疗后的血清GAS水平较治疗前降低而SST水平较治疗前升高(P＜0.05),且观察组血清GAS水平低于对照组而SST水平高于对照组(P＜0.05).结论:化瘀解毒健脾汤治疗胃癌前病变临床疗效较好,可减轻患者症状,降低肠上皮化生和异型增生,降低GAS而提高SST表达.

目的 探讨整合素 β1与Kindlin-2蛋白在胃炎、癌前病变和胃癌组织中的表达差异及相关性.方法 选取2016年1月—2019年1月在丽水市人民医院消化内科、肿瘤科就诊的80例胃癌、80例癌前病变及50例慢性非萎缩性胃炎患者分别作为胃癌组、癌前病变组和胃炎组.采用免疫组织化学法检测整合素β1与Kindlin-2蛋白的表达,并分析与癌前病变者和胃癌患者临床病理因素的关系.采用Spearman秩相关性检验分析整合素β1与Kindlin-2蛋白表达的关系.结果 整合素β1和Kindlin-2蛋白在胃癌组的阳性表达率分别为60.0％(48/80)和76.25％(61/80),高于胃炎组和癌前病变组(P<0.05),而且癌前病变组整合素β1和Kindlin-2蛋白阳性表达率高于胃炎组(P<0.05).胃癌组整合素 β1与Kindlin-2蛋白表达呈正相关(rs=0.444,P=0.000).癌前病变组不同临床病理因素的整合素β1和Kindlin-2蛋白阳性表达率比较,差异无统计学意义(P>0.05);而胃癌组不同浸润深度、临床病理分期、肿瘤直径及淋巴结转移的阳性表达率比较,差异有统计学意义(P<0.05),且不同肿瘤浸润深度、临床病理分期、肿瘤直径及血管侵袭患者的Kindlin-2蛋白阳性表达率比较,差异有统计学意义(P<0.05).结论 整合素β1和Kindlin-2蛋白在胃癌组织中呈异常高表达,而且阳性表达率与胃癌患者肿瘤浸润深度、临床病理分期及肿瘤直径等临床病理因素有关,推测可能与胃癌的发生存在一定的相关性.

肠道功能衰竭(intestinal failure,IF)的概念1986年首次被研究者提出来,Okada、雷鑫明等分别将肠功能衰竭分为两型及三型[1-2].IF主要病理机制为肠实质或功能损害后导致消化、吸收或黏膜屏障功能产生障碍[3-4].

Objective To?understand?the?fatigue?status?of?patients?with?inflammatory?bowel?disease,and?to?analyze?the?correlation?between?fatigue,self-management?behavior?and?resilience?in?patients?with?inflammatory?bowel?disease.?Methods Using?convenience?sampling,114?patients?with?inflammatory?bowel?disease?were?treated?in?the?undergraduate?room?from?April?2017?to?March?2018.?Multidimensional?Fatigue?Scale(MFI),chronic?disease?self-management?behavior?scale(CDSMS)and?Resilience?Scale(CD-RISC)were?used?to?conduct?a?questionnaire?survey.?Results? The?total?fatigue?score?of?IBD?patients?was(55.72±13.28)points,of?which?the?score?of?physiological?fatigue?dimension?was?the?highest(13.34±4.02), and?the?lowest?score?of?positive?fatigue?dimension?was(9.16±3.26)points.?The?total?score?of?self?management?behavior?in?IBD?patients?was (37.13±7.73),the?total?score?of?mental?resilience?was(52.22±8.78),and?the?total?score?of?fatigue?and?general?fatigue?in?IBD?patients.?There?was?a?negative?correlation?between?physical?fatigue,reduced?physical?activity,reduced?enthusiasm?and?the?total?score?of?self?management,exercise, cognitive?symptoms?management?practice,and?communication?with?doctors(P<0.05).?There?was?a?negative?correlation?between?mental?fatigue?and?self?management?total?score,exercise,and?communication?with?doctors(P<0.05).?The?total?score?of?fatigue?in?IBD?patients.?General?fatigue,decreased?enthusiasm?and?mental?fatigue?were?negatively?correlated?with?mental?resilience,tenacity,self?strength?and?optimism(P<0.05).?Physiological?fatigue?was?negatively?correlated?with?mental?resilience,tenacity?and?optimism(P<0.05).?The?decrease?of?physical?activity?was?negatively?correlated?with?mental?resilience,tenacity,and?self-improvement(P<0.05).?Conclusion The?symptoms?of?fatigue?in?patients?with?inflammatory?bowel?disease?are?more?obvious.?Improving?the?patient's?self?management?and?mental?resilience?through?health?education?can?effectively?reduce?the?fatigue?symptoms?of?the?patients?and?improve?the?quality?of?life?of?the?patients.

背景:胃癌(gastric cancer,GC)是常见的消化系统肿瘤之一,而肿瘤化疗耐药是制约GC癌治疗效果的瓶颈,探索逆转GC化疗耐药机制对于GC的治疗具有重大意义.目的:探讨敲低miR-214表达对GC细胞SGC-7901/DDP顺铂耐药性、迁移以及上皮间质转化(epithelial mesenchymal transformation,EMT)的影响,并讨论初步作用机制.方法:采用LipofectamineTM2000法转染miR-214 inhibitor至SGC-7901/DDP细胞后,CCK-8法评估细胞对顺铂耐药性的改变;划痕试验检测细胞迁移能力;免疫印迹法检测细胞中E-钙黏蛋白(E-cad)、波形蛋白(Vimentin)和N-钙黏蛋白(N-cad),以及NF-κB与Bcl-2蛋白表达水平.结果:转染miR-214 inhibitor后,SGC-7901/DDP细胞对顺铂耐药性明显降低(P＜0.05);且细胞迁移能力明显降低(P＜0.05),E-cad蛋白表达显著升高(P＜0.05),Vimentin 与N-cad蛋白表达均显著降低(均P＜0.05).另外,SGC-7901/DDP细胞中NF-κB与Bcl-2的表达明显降低(均P＜0.05).结论:下调miR-214表达具有降低GCSGC-7901/DDP细胞对顺铂耐药性,抑制细胞迁移与EMT的作用.而这种作用可能与下调NF-κB与Bcl-2的表达有关.

目的 探索早期肠内营养对肺癌患者肺部感染血清炎症因子与高迁移率族蛋白1(High Mobility Group Box-1 protein,HMGB1)的临床影响.方法 选取2014年1月-2017年1月于医院接受治疗的肺癌并发肺部感染患者288例为研究对象,按照是否接受早期肠内营养分为营养组132例和对照组156例,对照组接受常规治疗,肠内营养组接受早期肠内营养治疗,比较两组患者血常规指标[包括:前白蛋白(PA)、血蛋白(ALB)、谷草转氨酶(AST)、尿素氮(BUN),肌酐(SCR)等]和HMGB1水平.结果 治疗前两组患者PA、ALB、AST、BUN、SCR、C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、降钙素原(PCT)、白细胞介素-6(IL-6)HMGB1、CEA差异无统计学意义;治疗后营养组患者PA、ALB、AST和SCR分别为(228.43±21.55)g/L、(32.34±4.94)g/L、(41.38±7.04)IU/L和(83.44±12.18)μmol/L均高于对照组,BUN为(4.19±1.58)mmol/L低于对照组(P均＜0.001).治疗后营养组患者CRP、TNF-α、PCT、IL-6、分别为(33.72±12.55)g/L、(93.57±14.66)ng/ml、(6.13±4.68)ng/ml、(22.03±15.33)pg/ml低于对照组(P均＜0.001).治疗后营养组患者HMGB1、CEA分别为(8.03±2.06)ng/ml和(17.29±6.98)ng/ml高于对照组(P＜0.001).结论 早期肠内营养能有效改善血清炎症因子水平,而血清HMGB1水平在肺癌合并肺部感染患者接受早期肠内营养中升高,可能在肺癌及肺部感染疾病发病机制中起重要作用,具有一定的临床意义.

目的 对比腹腔镜手术与内镜黏膜下剥离术在早期结肠癌治疗中的临床效果.方法 以我院2016年7月～2017年7月收治的84例早期结肠癌患者为研究对象,通过随机数字表法将患者均分为观察组(n=42)及对照组(n=42),观察组行内镜黏膜下剥离术治疗,对照组行腹腔镜结肠癌根治术进行治疗.对比两组患者治疗效果、手术治疗情况以及两组并发症发生情况.结果 观察组与对照组患者治疗总有效率依次为90.48％、73.81％,差异有统计学意义(P<0.05).观察组与对照组术中出血量存在明显差异,且观察组手术时间及住院时间均比对照组短,观察组住院费用比对照组少,差异有统计学意义(P<0.05).观察组患者并发症发生率(4.76％)比对照组低(21.42％),差异有统计学意义(P<0.05).结论 内镜黏膜下剥离术治疗早期结肠癌疗效显著,能减少手术及住院时间,降低并发症发生率,值得推广使用.

本研究采用自拟益胃温阳健脾方治疗慢性萎缩性胃炎(CAG),取得良好的效果.现报道如下. 1 一般资料 选取2016年1月～2017年1月本院收治的140例慢性萎缩性胃炎患者,随机分为两组,各70例.对照组男36例,女34例;年龄42～65岁,平均56.7±5.5岁;病程25～55个月,平均30.2±4.4个月.观察组男38例,女32例;年龄43～64岁,平均56.0±5.1岁;病程23～57个月,平均31.0±4.6个月.两组一般资料比较,差异无统计学意义(P>0.05),具有可比性.

目的 探讨患者行胃镜检查前后常规生命体征变化,进而评估常规胃镜检查对患者生命体征影响.方法 将220名无相对禁忌并需进行胃镜检查的病人实施传统胃镜检查,在整个围检查期严密观察及测定所有病例收缩压(SBP)、舒张压(DBP)、心率(HR)、血氧饱和度(SpO2)及呼吸(R)的变化.结果 及结论 胃镜检查前后血氧饱和度、呼吸变化无明显差异,舒张压、收缩压及心率有显著差异(P<0.01).

急性胰腺炎(AP)是比较常见的一种急腹症,其发病率占急腹症的第3～5位.2013年亚特兰大国际消化学术会议上对AP的分类进行了修订,将AP按照严重程度分为轻症急性胰腺炎(MAP)、中度重症急性胰腺炎(MSAP)和重症急性胰腺炎(SAP),根据患者入院后24h内有无器官功能衰竭来区分MAP和SAP,及脏器衰竭在48h内是否能恢复区分MSAP和SAP.对此,笔者临床采用中西医结合方法治疗36例,获效良好.现报道如下.