Objective To analyze the risk factors associated with the occurrence of rectal neuroendocrine tumors (RNETs) and construct a risk prediction model. Methods Clinical data of patients who underwent electronic colonoscopy were collected. The clinical information on patients with and without RNETs were compared, and potential risk factors for RNETs were identified. Binary logistic regression was performed to analyze the relevant risk factors and construct a risk prediction model. Results Among 164 patients, 66 were diagnosed with RNETs, and 98 who did not have such a condition were randomly selected. Univariate logistic regression analysis revealed that age, fatty liver, anxiety and depression, total cholesterol, triglyceride levels, and carcinoembryonic antigen (CEA) were significant factors influencing the occurrence of RNETs (P<0.05). Multivariate logistic regression analysis identified age (P=0.015), anxiety and depression (P=0.031), cholesterol level (P=0.009), fatty liver (P=0.001), and CEA (P<0.001) as independent risk factors for RNETs. The participants were randomly divided into training and test sets at a 7:3 ratio. The training set was used to construct a nomogram-based risk prediction model, and the testing set was used for internal validation. The area under the curve values for the training and testing sets were 0.843 and 0.772, respectively (P>0.05). These findings indicate a good discriminative performance. The calibration curves for the training and testing sets were in good agreement with the 45° standard line, which suggests that the predicted probabilities were consistent with the actual outcomes. Decision curve analysis showed that the model provided a high net benefit within a threshold range of 0.2 to 0.7 for clinical decision making. Conclusion Young age, fatty liver, high CEA levels, high cholesterol levels, and anxiety and depression are independent risk factors for RNETs. The nomogram model constructed based on these risk factors exhibits a strong capability to predict the occurrence of RNETs, and clinical intervention can be considered based on the predicted probability values.

BACKGROUND: The role of inflammation in the development of gestational diabetes mellitus (GDM) has recently become a focus of research. The systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI), novel indices, reflect the body's chronic immune-inflammatory state. This study aimed to investigate the associations between the SII or SIRI and GDM. METHODS: A prospective birth cohort study was conducted at Beijing Obstetrics and Gynecology Hospital from February 2018 to December 2020, recruiting participants in their first trimester of pregnancy. Baseline SII and SIRI values were derived from routine clinical blood results, calculated as follows: SII = neutrophil (Neut) count × platelet (PLT) count/lymphocyte (Lymph) count, SIRI = Neut count × monocyte (Mono) count/Lymph count, with participants being grouped by quartiles of their SII or SIRI values. Participants were followed up for GDM with a 75-g, 2-h oral glucose tolerance test (OGTT) at 24-28 weeks of gestation using the glucose thresholds of the International Association of Diabetes and Pregnancy Study Groups (IADPSG). Logistic regression was used to analyze the odds ratios (ORs) (95% confidence intervals [CIs]) for the the associations between SII, SIRI, and the risk of GDM. RESULTS: Among the 28,124 women included in the study, the average age was 31.8 ± 3.8 years, and 15.76% (4432/28,124) developed GDM. Higher SII and SIRI quartiles were correlated with increased GDM rates, with rates ranging from 12.26% (862/7031) in the lowest quartile to 20.10% (1413/7031) in the highest quartile for the SII ( Ptrend <0.001) and 11.92-19.31% for the SIRI ( Ptrend <0.001). The ORs (95% CIs) of the second, third, and fourth SII quartiles were 1.09 (0.98-1.21), 1.21 (1.09-1.34), and 1.39 (1.26-1.54), respectively. The SIRI findings paralleled the SII outcomes. For the second through fourth quartiles, the ORs (95% CIs) were 1.24 (1.12-1.38), 1.41 (1.27-1.57), and 1.64 (1.48-1.82), respectively. These associations were maintained in subgroup and sensitivity analyses. CONCLUSION The SII and SIRI are potential independent risk factors contributing to the onset of GDM.
Humans ; Female ; Pregnancy ; Diabetes, Gestational/immunology* ; Prospective Studies ; Adult ; Inflammation/immunology* ; Glucose Tolerance Test ; Birth Cohort

Objective To explore the applicative value of blue Laser imaging combined with magnifying endoscope(BLI+ME)system for the lesion of esophagogastric junction(EGJ).Methods Retrospective study endoscopic and pathological reported during February 2022 to February 2024.6 803 patients who met the inclusion and exclusion criteria were enrolled.They were divided into BLI+ME group(2 931 cases)and white light imaging group(WLI group,3 872 cases)according to the different gastroscopy types used in the examination.Finally,the EGJ biopsy rate,positive biopsy rate,detection rate of various lesions and early diagnosis rate between the two groups were compared.Results The biopsy rate of the BLI+ME group was 27.60%,the positive biopsy rate was 68.73%,and the detection rate of all the lesions was 20.74%,the detection rate of non-cancerous lesions was 20.30%,the detection rate of early cancer was 0.10%,the detection rate of non-cancerous lesions above the dentate line was 5.53%,the detection rate of non-cancerous lesions below the dentate line was 14.77%,the detection rate of cancerous lesions below the dentate line was 0.27%,significantly higher than those of the WLI group,which the biopsy rate was 17.74%,the positive biopsy rate was 60.26%,and the detection rate of all the lesions was 11.90%,the detection rate of non-cancerous lesions was 11.67%,the detection rate of early cancer was 0.00%,the detection rate of non-cancerous lesions above the dentate line was 3.49%,the detection rate of non-cancerous lesions below the dentate line was 8.19%,the detection rate of cancerous lesions below the dentate line was 0.05%,the differences were statistically significant(P＜0.05).Conclusion The BLI+ME system can enhance the biopsy rate,positive biopsy rate,the detection rate of all the lesions,early cancer detection rate,non-cancerous lesions detection rate above and below the dentate line,and cancerous lesions detection rate below the dentate line at the EGJ.It is helpful to improve the early diagnosis rate and early treatment rate of EGJ.It is worthy of clinical application.

Objective:To investigate the association between exposed cardia glands and gastroesophageal reflux disease (GERD) and identify risk factors for exposed cardia glands.Methods:Patients who underwent gastroscopy at Chengde Central Hospital from December 2023 to March 2024 were prospectively enrolled. Patients with exposed cardia glands meeting inclusion criteria comprised the observation group, while controls had no exposed cardia glands but met identical criteria. Demographic, lifestyle, and endoscopic characteristics were compared between the two groups.Results:A total of 204 patients were included in the observation group, while 310 in the control group. Univariate analysis demonstrated statistically significant differences between the observation group and the control group in the following factors: body mass index, waist circumference, smoking, alcohol consumption, tea/coffee intake, spicy food preference, sleeping posture, use of calcium channel blockers, Helicobacter pylori infection, peptic ulcer disease, and GERD ( P<0.05). Binary logistic regression analysis identified the following independent risk factors for exposed cardia glands: waist circumference ( P=0.012, OR=1.070, 95% CI: 1.015-1.129), alcohol consumption ( P=0.003, OR=2.166, 95% CI: 1.293-3.631), spicy food preference ( P=0.048, OR=1.611, 95% CI: 1.004-2.582), right-side sleeping posture ( P<0.001, OR=3.219, 95% CI: 1.696-6.108), use of calcium channel blockers ( P<0.001, OR=3.871, 95% CI: 2.263-6.621), Helicobacter pylori infection ( P<0.001, OR=3.512, 95% CI: 1.953-6.317), and GERD ( P<0.001, OR=2.905, 95% CI: 1.829-4.613) .Conclusion:Exposed cardia glands demonstrates significant association with GERD. Key independent risk factors include waist circumference, alcohol consumption, spicy diet, right-side sleeping position, calcium channel blockers use, and Helicobacter pylori infection.

Objective To explore the efficacy of a model combining clinicopathological characteristics and multiparametric MRI features for predicting BRCA-mutated breast cancer(BC).Methods A total of 256 BC patients were retrospectively selected and divided into BRCA mutation group(116 cases)and BRCA wild group(140 cases)based on the BRCA results.Chi-square tests or independ-ent sample t-tests were used to compare the differences in clinicopathological characteristics and multiparametric MRI features between the BRCA mutation group and the wild group.Risk factors for BRCA-mutated BC were identified through univariate and multivariate logistic regression ananlyses,and a combined predictive model was constructed.Receiver operating characteristic(ROC)curve was used to ana-lyze the diagnostic efficacy of the model.Results There were statistically significant differences in T stage,human epidermal growth factor receptor 2(HER-2),Ki-67,non-mass enhancement,enhancement pattern,time-signal intensity curve(TIC)type,and apparent diffusion coefficient(ADC)values between the BRCA mutation group and the wild group.Univariate logistic regression analysis showed that T stage,HER-2,Ki-67,non-mass enhancement,enhancement pattern,TIC type,and ADC values were risk factors for BRCA-mutated BC(P<0.05).Multivariate logistic regression analysis revealed that T stage,HER-2,Ki-67,enhancement pattern,and TIC type were independent risk factors for BRCA-mutated BC(P<0.05).The combined model incorporating T stage,HER-2,Ki-67,enhancement pattern,and TIC type had the best diagnostic efficacy in predicting BRCA-mutated BC,with an area under the curve(AUC)of 0.751.Conclusion The combined model integrating T stage,HER-2,Ki-67,enhancement pattern,and TIC type has good efficacy in predicting BRCA-mutated BC.

Objective To explore the efficacy of a model combining clinicopathological characteristics and multiparametric MRI features for predicting BRCA-mutated breast cancer(BC).Methods A total of 256 BC patients were retrospectively selected and divided into BRCA mutation group(116 cases)and BRCA wild group(140 cases)based on the BRCA results.Chi-square tests or independ-ent sample t-tests were used to compare the differences in clinicopathological characteristics and multiparametric MRI features between the BRCA mutation group and the wild group.Risk factors for BRCA-mutated BC were identified through univariate and multivariate logistic regression ananlyses,and a combined predictive model was constructed.Receiver operating characteristic(ROC)curve was used to ana-lyze the diagnostic efficacy of the model.Results There were statistically significant differences in T stage,human epidermal growth factor receptor 2(HER-2),Ki-67,non-mass enhancement,enhancement pattern,time-signal intensity curve(TIC)type,and apparent diffusion coefficient(ADC)values between the BRCA mutation group and the wild group.Univariate logistic regression analysis showed that T stage,HER-2,Ki-67,non-mass enhancement,enhancement pattern,TIC type,and ADC values were risk factors for BRCA-mutated BC(P<0.05).Multivariate logistic regression analysis revealed that T stage,HER-2,Ki-67,enhancement pattern,and TIC type were independent risk factors for BRCA-mutated BC(P<0.05).The combined model incorporating T stage,HER-2,Ki-67,enhancement pattern,and TIC type had the best diagnostic efficacy in predicting BRCA-mutated BC,with an area under the curve(AUC)of 0.751.Conclusion The combined model integrating T stage,HER-2,Ki-67,enhancement pattern,and TIC type has good efficacy in predicting BRCA-mutated BC.

Objective To explore the applicative value of blue Laser imaging combined with magnifying endoscope(BLI+ME)system for the lesion of esophagogastric junction(EGJ).Methods Retrospective study endoscopic and pathological reported during February 2022 to February 2024.6 803 patients who met the inclusion and exclusion criteria were enrolled.They were divided into BLI+ME group(2 931 cases)and white light imaging group(WLI group,3 872 cases)according to the different gastroscopy types used in the examination.Finally,the EGJ biopsy rate,positive biopsy rate,detection rate of various lesions and early diagnosis rate between the two groups were compared.Results The biopsy rate of the BLI+ME group was 27.60%,the positive biopsy rate was 68.73%,and the detection rate of all the lesions was 20.74%,the detection rate of non-cancerous lesions was 20.30%,the detection rate of early cancer was 0.10%,the detection rate of non-cancerous lesions above the dentate line was 5.53%,the detection rate of non-cancerous lesions below the dentate line was 14.77%,the detection rate of cancerous lesions below the dentate line was 0.27%,significantly higher than those of the WLI group,which the biopsy rate was 17.74%,the positive biopsy rate was 60.26%,and the detection rate of all the lesions was 11.90%,the detection rate of non-cancerous lesions was 11.67%,the detection rate of early cancer was 0.00%,the detection rate of non-cancerous lesions above the dentate line was 3.49%,the detection rate of non-cancerous lesions below the dentate line was 8.19%,the detection rate of cancerous lesions below the dentate line was 0.05%,the differences were statistically significant(P＜0.05).Conclusion The BLI+ME system can enhance the biopsy rate,positive biopsy rate,the detection rate of all the lesions,early cancer detection rate,non-cancerous lesions detection rate above and below the dentate line,and cancerous lesions detection rate below the dentate line at the EGJ.It is helpful to improve the early diagnosis rate and early treatment rate of EGJ.It is worthy of clinical application.

Objective:To investigate the association between exposed cardia glands and gastroesophageal reflux disease (GERD) and identify risk factors for exposed cardia glands.Methods:Patients who underwent gastroscopy at Chengde Central Hospital from December 2023 to March 2024 were prospectively enrolled. Patients with exposed cardia glands meeting inclusion criteria comprised the observation group, while controls had no exposed cardia glands but met identical criteria. Demographic, lifestyle, and endoscopic characteristics were compared between the two groups.Results:A total of 204 patients were included in the observation group, while 310 in the control group. Univariate analysis demonstrated statistically significant differences between the observation group and the control group in the following factors: body mass index, waist circumference, smoking, alcohol consumption, tea/coffee intake, spicy food preference, sleeping posture, use of calcium channel blockers, Helicobacter pylori infection, peptic ulcer disease, and GERD ( P<0.05). Binary logistic regression analysis identified the following independent risk factors for exposed cardia glands: waist circumference ( P=0.012, OR=1.070, 95% CI: 1.015-1.129), alcohol consumption ( P=0.003, OR=2.166, 95% CI: 1.293-3.631), spicy food preference ( P=0.048, OR=1.611, 95% CI: 1.004-2.582), right-side sleeping posture ( P<0.001, OR=3.219, 95% CI: 1.696-6.108), use of calcium channel blockers ( P<0.001, OR=3.871, 95% CI: 2.263-6.621), Helicobacter pylori infection ( P<0.001, OR=3.512, 95% CI: 1.953-6.317), and GERD ( P<0.001, OR=2.905, 95% CI: 1.829-4.613) .Conclusion:Exposed cardia glands demonstrates significant association with GERD. Key independent risk factors include waist circumference, alcohol consumption, spicy diet, right-side sleeping position, calcium channel blockers use, and Helicobacter pylori infection.

Kidney deficiency syndrome is a common clinical syndrome in traditional Chinese medicine （TCM）. With the progress of science and technology， clinical and animal experiments on kidney deficiency syndrome have made remarkable progress. Research on kidney deficiency and the nature of "kidney" involves a large number of physiological and pathological bases， which are closely related to physiological and pathological links in the human body， among which the neuroendocrine-immune network shares the closest relationship. However， there are still many challenges in modern research on kidney deficiency syndrome， such as expert consensus on clinical diagnostic criteria and evaluation indexes and optimization of animal experimental models. In the past decade， a large number of clinical and animal experiments have been reported in the literature on kidney deficiency syndrome， among which the literature focusing on the combination of disease and syndrome is predominant， and most of them focus on kidney Yang deficiency and kidney Yin deficiency， involving the exploration of many pathological mechanisms. Research on the mechanisms related to kidney deficiency syndrome encompasses multiple signaling pathways and various biochemical indicators， including the phosphatidylinositol 3-kinase/protein kinase B/nuclear factor-erythroid 2-relatedfactor-2（PI3K/Akt/Nrf2） signaling pathway， the Toll-like receptor 4/myeloid differentiation factor88/nuclear factor-κB（TLR4/MyD88/NF-κB） signaling pathway， the Janus kinase 2/signal transducer and activator of transcription 3（JAK2/STAT3） signaling pathway， Osteoprotectin/nuclear factor-κB receptor activator ligand/receptor activator of nuclear factor-κB （OPG/RANKL/RANK） signaling pathway. The biochemical indicators cover the cyclic adenosine monophosphate/cyclic guanosine monophosphate （cAMP/cGMP） ratio， Na⁺-K⁺-ATPase activity， Ca²⁺-Mg²⁺-ATPase activity， adrenocorticotropic hormone （ACTH）， polycorticosterone （CORT）， 17-OHCS， and other sex hormone indicators， providing crucial reference values for diagnosing kidney Yang deficiency or kidney Yin deficiency. The literature related to kidney deficiency syndrome over the past decade was collated and excavated， with a view to providing a reference for research on kidney deficiency syndrome.

Objective To analyze the detection of helicobacter pylori(Hp)in different parts of gastric antrum,and to provide clinical guidance for finding the best biopsy site for Hp.Methods Patients who underwent 13C urea breath test and electronic gastroscopy from January 2020 to December 2022 were retrospectively analyzed and divided into 13C urea breath test positive group[delta over baseline(DOB)≥4]and 13C urea breath test negative group(DOB<4)according to DOB value.Gastroscopy reports and pathological data of patients were collected.According to different biopsy sites in gastric antrum,patients were divided into conventional biopsy site group,elevated erosive site group and flat erosive site group,and the detection rate of Hp in different biopsy sites was compared.13C urea breath test positive group was divided into group A(435)according to DOB value,and the gastric antral biopsy and pathology of each group were classified and analyzed.Combined with endoscopic reports and pathological data,patients were divided into atrophic gastritis group and non-atrophic gastritis group.Results In the 13C urea breath test positive group,the detection rate of Hp in the elevated erosive site group(96.4%)was higher than that in the conventional biopsy site group(92.7%)and the flat erosive site group(93.9%),and the difference was statistically significant(P = 0.036).In DOB group A,the detection rate of Hp was the highest at the site of elevated erosive and the lowest at the site of conventional biopsy,and the detection rate of Hp at the three biopsy sites was compared,the difference was statistically significant(P = 0.016);There was no significant difference in the detection rate of Hp at three biopsy sites between group B and group C(P = 0.622;P = 0.721);the non-atrophic gastritis group,the detection rate of Hp at the elevated erosive site(96.5%)was higher than that at the conventional biopsy site(91.2%)and the flat erosive site(92.0%),and the difference was statistically significant(P = 0.043).There was no significant difference in the detection rate of Hp at three biopsy sites in the atrophic gastritis group(P = 0.614).13C urea breath test negative group:There was no significant difference in Hp detection rate among the three biopsy sites(P = 0.255).Conclusion For patients with positive 13C urea breath test but low DOB value,the positive rate of Hp in the elevated erosive site is higher.For non-atrophic gastritis patients,the detection rate of Hp was higher in the elevated erosive sites than in the conventional biopsy sites.But for patients with atrophic gastritis,there was little difference in the detection rate of Hp in different parts of antrum.For patients with negative 13C urea breath test,there was no significant difference in Hp detection rate among the three biopsy sites.In future clinical work,for similar patients,precise biopsy can be performed to improve the detection rate of Hp.