ObjectiveTo investigate the value of intestinal fatty acid-binding protein （I-FABP） in predicting 6-week mortality in patients with liver cirrhosis after successful endoscopic hemostasis for esophagogastric variceal bleeding （EVB）. MethodsA retrospective analysis was performed for the clinical data of 207 patients with liver cirrhosis who underwent successful endoscopic treatment for EVB （including ligation and sclerotherapy） in The Affiliated Hospital of Yanbian University from September 2020 to June 2025， with the endpoint of 6-week bleeding-related mortality. ELISA was used to measure the serum level of I-FABP on admission， and a stratified analysis was performed based on the quartiles of I-FABP measurements. The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups； the chi-square test was used for comparison of categorical data between two groups. The Kaplan-Meier survival analysis， Cox regression analysis， and restricted cubic spline （RCS） curve were used to investigate the association between I-FABP and mortality. Machine learning models were used to further quantify the impact of I-FABP on mortality. The integrated Brier score and an integrated cumulative/dynamic area under the curve were used to assess the importance of time-dependent variables， and the receiver operating characteristic （ROC） curve was used to assess the performance of the predictive model. ResultsDuring the study， 29 patients （14.0%） died within 6 weeks after successful endoscopic hemostasis， with a median time to death of 16 （8—26） days. The mortality group had a significantly higher serum level of I-FABP than the survival group （Z=-3.731， P<0.001）. The Kaplan-Meier survival analysis showed that there was a significant difference in 6-week mortality between the groups of patients based on I-FABP quartiles （χ²=12.78， P=0.005）. The multivariable Cox regression analysis showed that an increase in I-FABP （hazard ratio=1.87， P=0.003） was an independent influencing factor for 6-week mortality. The RCS analysis showed a linear relationship between I-FABP and 6-week mortality （P_non-linear=0.280， P_overall=0.029）. Machine learning models showed that there was a dynamic change in the importance of I-FABP over time， and Brier score loss and the loss of cumulative/dynamic area under the curve after permutation showed that I-FABP was an important variable affecting 6-week mortality rate. ConclusionI-FABP level is independently associated with the risk of 6-week mortality endoscopic hemostasis for EVB in patients with liver cirrhosis， and therefore， it can be used as a potential biomarker for poor short-term prognosis.

Objective:To explore the clinical predicting value of serum intestinal fatty acid-binding protein (I-FABP) in the development of esophageal varices (EV) in patients with chronic hepatitis B cirrhosis.Method:We used case-control study. A retrospective analysis was performed on the clinical data of 169 patients with hepatitis B cirrhosis who were admitted to the Affiliated Hospital of Yanbian University from September 2020 to October 2023. EV diagnosis and grades were based on gastroscopy. Enzyme-linked immunosorbent assay was used to measure the serum level of I-FABP on admission. Spearman correlation analysis was used to investigate the correlation among variables. Contributing factors of EV were evaluated using univariate and multivariate logistic regression analysis. Receiver operating characteristic (ROC) curves were used to evaluate the predictive performance of I-FABP for EV presence.Results:The gastroscopy showed 59 patients without EV. The median of I-FABP in the EV Group was significantly higher than that in the no-EV Group [2.01 (1.39, 2.89) μg/L vs 0.96 (0.77, 1.91) μg/L], and the difference was statistically significant ( Z=5.585, P<0.001). I-FABP showed significant positive correlations between model for end-stage liver disease sore and Von Willebrand Factor Antigen/thrombocyte Ratio ( r=0.523, 0.328, both P<0.001). Multiple logistic regression analysis identified I-FABP as the independent factor contributing to the presence of EV ( OR=1.73, P=0.045). The area under the curve of I-FABP predicting EV was 0.76. The cut-off was 1.46 μg/L. Conclusion:I-FABP is a potential marker for the formation of EV in patients with hepatitis B cirrhosis, and its increased concentration is related to reduced hepatic reserve and portal hypertension.

Objective:To explore the clinical value of serum intestinal fatty acid-binding protein (I-FABP) for the formation and development of portal vein thrombosis (PVT) in patients with chronic hepatitis B (CHB) cirrhosis complicated with esophageal varices (EV).Methods:A retrospective analysis was performed for the clinical data of patients with CHB cirrhosis complicated with EV who were admitted to the Affiliated Hospital of Yanbian University from September 2020 to October 2023 in this cohort study. PVT was diagnosed and graded according to the imaging examination, and patients were divided into PVT group and non-PVT group. The thrombus recanalization of PVT in PVT group and newly occurring PVT events in non-PVT group was observed during twelve-month follow-up. Enzyme linked immunosorbent assay was used to measure the baseline level of I-FABP. Mann-Whitney U test was used for comparison between two groups. Kaplan-Meier curves and receiver operator characteristic (ROC) curves were used to evaluated the predictive performance of I-FABP for newly occurring PVT event. The cumulative incidence was compared by log-rank test. Results:A total of 161 patients with CHB cirrhosis complicated with EV were included, with an average age of (57.71±11.12) years old, including 46 patients with PVT and 115 patients without PVT. During the follow-up period, 11 PVT patients had thrombus recanalization. Meanwhile, 17 patients without PVT had newly occurring PVT events. The I-FABP level was 2.59 (1.63, 3.18) μmol/L in the PVT group and 1.94 (1.44, 2.81) μmol/L in the non-PVT group, and the difference was statistically significant ( Z=2.12, P=0.034). The baseline I-FABP level in patients with newly occurring PVT event was higher than that in patients without PVT (2.78(1.86, 3.20) μmol/L vs 1.92 (1.18, 2.74) μmol/L), while the I-FABP level in patients with thrombus recanalization was lower than that in patients without thrombus recanalization (2.06 (1.16, 2.69) μmol/L vs 2.84 (1.92, 3.27) μmol/L). The differences were both statistically significant ( Z=2.61 and 2.25, respectively, both P<0.05). The non-PVT patients were stratified according to the median level of I-FABP, and the Kaplan-Meier curve showed that patients with I-FABP<1.94 μmol/L in the non-PVT group had a significantly lower cumulative rate of newly occurring PVT during follow-up compared to those with I-FABP≥1.94 μmol/L (7.1% (4/56) vs 22.0% (13/59), χ2=5.03, P=0.025). The ROC curve showed that I-FABP had a certain predictive efficacy for the occurrence PVT. The area under the curve were 0.698 (95% confidence interval 0.606 to 0.780) and the optimal cut-off of 2.36 μmol/L, with sensitivity of 70.59% and specificity of 69.39%. Conclusion:I-FABP is not only associated with PVT recanalization in CHB cirrhosis, but also a potential biomarker for predicting PVT formation and development.

Objective:To explore the clinical predicting value of serum intestinal fatty acid-binding protein (I-FABP) in the development of esophageal varices (EV) in patients with chronic hepatitis B cirrhosis.Method:We used case-control study. A retrospective analysis was performed on the clinical data of 169 patients with hepatitis B cirrhosis who were admitted to the Affiliated Hospital of Yanbian University from September 2020 to October 2023. EV diagnosis and grades were based on gastroscopy. Enzyme-linked immunosorbent assay was used to measure the serum level of I-FABP on admission. Spearman correlation analysis was used to investigate the correlation among variables. Contributing factors of EV were evaluated using univariate and multivariate logistic regression analysis. Receiver operating characteristic (ROC) curves were used to evaluate the predictive performance of I-FABP for EV presence.Results:The gastroscopy showed 59 patients without EV. The median of I-FABP in the EV Group was significantly higher than that in the no-EV Group [2.01 (1.39, 2.89) μg/L vs 0.96 (0.77, 1.91) μg/L], and the difference was statistically significant ( Z=5.585, P<0.001). I-FABP showed significant positive correlations between model for end-stage liver disease sore and Von Willebrand Factor Antigen/thrombocyte Ratio ( r=0.523, 0.328, both P<0.001). Multiple logistic regression analysis identified I-FABP as the independent factor contributing to the presence of EV ( OR=1.73, P=0.045). The area under the curve of I-FABP predicting EV was 0.76. The cut-off was 1.46 μg/L. Conclusion:I-FABP is a potential marker for the formation of EV in patients with hepatitis B cirrhosis, and its increased concentration is related to reduced hepatic reserve and portal hypertension.

Objective:To explore the clinical value of serum intestinal fatty acid-binding protein (I-FABP) for the formation and development of portal vein thrombosis (PVT) in patients with chronic hepatitis B (CHB) cirrhosis complicated with esophageal varices (EV).Methods:A retrospective analysis was performed for the clinical data of patients with CHB cirrhosis complicated with EV who were admitted to the Affiliated Hospital of Yanbian University from September 2020 to October 2023 in this cohort study. PVT was diagnosed and graded according to the imaging examination, and patients were divided into PVT group and non-PVT group. The thrombus recanalization of PVT in PVT group and newly occurring PVT events in non-PVT group was observed during twelve-month follow-up. Enzyme linked immunosorbent assay was used to measure the baseline level of I-FABP. Mann-Whitney U test was used for comparison between two groups. Kaplan-Meier curves and receiver operator characteristic (ROC) curves were used to evaluated the predictive performance of I-FABP for newly occurring PVT event. The cumulative incidence was compared by log-rank test. Results:A total of 161 patients with CHB cirrhosis complicated with EV were included, with an average age of (57.71±11.12) years old, including 46 patients with PVT and 115 patients without PVT. During the follow-up period, 11 PVT patients had thrombus recanalization. Meanwhile, 17 patients without PVT had newly occurring PVT events. The I-FABP level was 2.59 (1.63, 3.18) μmol/L in the PVT group and 1.94 (1.44, 2.81) μmol/L in the non-PVT group, and the difference was statistically significant ( Z=2.12, P=0.034). The baseline I-FABP level in patients with newly occurring PVT event was higher than that in patients without PVT (2.78(1.86, 3.20) μmol/L vs 1.92 (1.18, 2.74) μmol/L), while the I-FABP level in patients with thrombus recanalization was lower than that in patients without thrombus recanalization (2.06 (1.16, 2.69) μmol/L vs 2.84 (1.92, 3.27) μmol/L). The differences were both statistically significant ( Z=2.61 and 2.25, respectively, both P<0.05). The non-PVT patients were stratified according to the median level of I-FABP, and the Kaplan-Meier curve showed that patients with I-FABP<1.94 μmol/L in the non-PVT group had a significantly lower cumulative rate of newly occurring PVT during follow-up compared to those with I-FABP≥1.94 μmol/L (7.1% (4/56) vs 22.0% (13/59), χ2=5.03, P=0.025). The ROC curve showed that I-FABP had a certain predictive efficacy for the occurrence PVT. The area under the curve were 0.698 (95% confidence interval 0.606 to 0.780) and the optimal cut-off of 2.36 μmol/L, with sensitivity of 70.59% and specificity of 69.39%. Conclusion:I-FABP is not only associated with PVT recanalization in CHB cirrhosis, but also a potential biomarker for predicting PVT formation and development.

Objective To investigate the value of intestinal fatty acid binding protein(I-FABP)in predicting the development and progression of acute-on-chronic liver failure(ACLF).Methods A retrospective analysis was performed for the clinical data of 168 patients with decompensated liver cirrhosis who were admitted to The Affiliated Hospital of Yanbian University from September 2020 to March 2023.The conditions of the patients with ACLF on admission were observed,and the patients were followed up for 6 months to identify new-onset ACLF cases.ELISA was used to measure the serum level of I-FABP on admission.The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups,and the Kruskal-Wallis H rank sum test was used for comparison between multiple groups;the chi-square test was used for comparison of categorical data between groups;the Jonckheere-Terpstra test was used for trend analysis.The Spearman correlation analysis was used to investigate the correlation between two variables,and the multivariate Cox regression analysis was used to investigate the influencing factors for new-onset ACLF during follow-up.The Kaplan-Meier curve was used to analyze the onset of ACLF in different groups,and the log-rank test was used for the analysis of such differences.The receiver operating characteristic(ROC)curve and the area under the ROC curve(AUC)were used to investigate the performance of I-FABP in predicting the development and progression of ACLF.Results Among the 168 patients enrolled in this study,there were 43 patients with ACLF and 125 patients without ACLF,among whom 19 developed ACLF during follow-up.The patients with ACLF on admission had a significantly higher level of I-FABP than those without ACLF(Z=4.359,P<0.001).The patients with new-onset ACLF had a significantly higher level of I-FABP than those without new-onset ACLF(Z=3.414,P<0.001).The level of I-FABP increased with the increase in ACLF severity grade(H=17.385,P<0.001,Ptrend<0.001).The multivariate Cox regression analysis showed that I-FABP was independently associated with new-onset ACLF during follow-up(hazard ratio=2.138,95%confidence interval[CI]:1.297-3.525,P=0.003),and the tertile of I-FABP showed a good discriminatory ability(χ2=12.16,P<0.001).The ROC curve showed that I-FABP had a good performance in predicting the development and progression of ACLF,with an area under the ROC curve of 0.854(95%CI:0.791-0.903)and 0.747(95%CI:0.661-0.820),respectively,and an optimal cut-off value of 2.07 μg/L and 1.86 μg/L,respectively.Conclusion I-FABP can be used as a biomarker to predict the development and progression of ACLF,and it may help to identify high-risk patients and improve clinical management.

Objective:To explore the clinical symptoms, imaging and histopathological features of fibroadipose vascular anomaly (FAVA), and to propose the differential diagnostic criteria for FAVA and intramuscular venous malformation (IMVM).Methods:Clinical data of FAVA and IMVM patients admitted to the Department of Burn and Plastic Surgery, Jinling Hospital of Nanjing Medical University, General Hospital of Eastern Theater Command from January 2016 to December 2020 were retrospectively analyzed. The patients were divided into FAVA group and IMVM group, and the clinical symptoms, coagulation function and imaging results of the two groups were analyzed. The pathological characteristics of the surgically resected specimens were observed by HE staining, and the similarities and differences between FAVA and IMVM were summarized. Pearson chi-square test was used to investigate the occurrence of local intravascular coagulation (LIC) between the two groups, and P<0.05 was considered statistically significant. Results:Fourteen patients were included in FAVA group, including 4 males and 10 females. The age of treatment was (28.2 ± 13.2) years old and the age of onset was (20.5 ± 10.1) years old. A total of 39 patients were included in the IMVM group, including 16 males and 23 females. The age of treatment was (28.5 ± 14.1) years old and the age of onset was (18.8 ± 9.5) years old. The clinical symptoms of FAVA and IMVM patients were pain, swelling and paresthesia. MRI images of the FAVA group showed fat signal in muscle and varicose vascular shadow. The IMVM group showed large irregular vascular shadows in muscle without fat signal. Histopathological observation revealed fibroadipose hyperplasia accompanied by varicose veins in FAVA group. However, in IMVM group, the lesions showed a large number of malformed veins mixed with muscle, without fibroadipose hyperplasia. There were 2 cases of LIC in FAVA group and 21 cases of LIC in IMVM group, the difference was statistically significant ( χ2 =4.39, P=0.036). Conclusion:The clinical symptoms of FAVA and IMVM are similar. The differential diagnosis of FAVA and IMVM requires MRI and pathological examination. The main difference is that there is fibroadipose hyperplasia in FAVA lesion, while there is no fibroadipose hyperplasia in IMVM lesion.

Objective:To explore the clinical symptoms, imaging and histopathological features of fibroadipose vascular anomaly (FAVA), and to propose the differential diagnostic criteria for FAVA and intramuscular venous malformation (IMVM).Methods:Clinical data of FAVA and IMVM patients admitted to the Department of Burn and Plastic Surgery, Jinling Hospital of Nanjing Medical University, General Hospital of Eastern Theater Command from January 2016 to December 2020 were retrospectively analyzed. The patients were divided into FAVA group and IMVM group, and the clinical symptoms, coagulation function and imaging results of the two groups were analyzed. The pathological characteristics of the surgically resected specimens were observed by HE staining, and the similarities and differences between FAVA and IMVM were summarized. Pearson chi-square test was used to investigate the occurrence of local intravascular coagulation (LIC) between the two groups, and P<0.05 was considered statistically significant. Results:Fourteen patients were included in FAVA group, including 4 males and 10 females. The age of treatment was (28.2 ± 13.2) years old and the age of onset was (20.5 ± 10.1) years old. A total of 39 patients were included in the IMVM group, including 16 males and 23 females. The age of treatment was (28.5 ± 14.1) years old and the age of onset was (18.8 ± 9.5) years old. The clinical symptoms of FAVA and IMVM patients were pain, swelling and paresthesia. MRI images of the FAVA group showed fat signal in muscle and varicose vascular shadow. The IMVM group showed large irregular vascular shadows in muscle without fat signal. Histopathological observation revealed fibroadipose hyperplasia accompanied by varicose veins in FAVA group. However, in IMVM group, the lesions showed a large number of malformed veins mixed with muscle, without fibroadipose hyperplasia. There were 2 cases of LIC in FAVA group and 21 cases of LIC in IMVM group, the difference was statistically significant ( χ2 =4.39, P=0.036). Conclusion:The clinical symptoms of FAVA and IMVM are similar. The differential diagnosis of FAVA and IMVM requires MRI and pathological examination. The main difference is that there is fibroadipose hyperplasia in FAVA lesion, while there is no fibroadipose hyperplasia in IMVM lesion.

Objective:Animal models of sepsis are mainly established by cecal ligation and puncture which causes mixed bacterial infections in the abdominal cavity. However in internal clinic, sepsis is more common to be caused by respiratory bacterial infections. Therefore, it is necessary to establish animal models of sepsis caused by lung Infection.Methods:According to the concentration of Staphylococcus aureus (S. aureus) suspension and Pseudomonas aeruginosa (P. aeruginosa) suspension, Sprague Dawley (SD) rats were equally divided into 10 groups, including S-Cont group, S-0.75 group, S-1.5 group, S-3 group, S-6 group and P-Cont group, P-1 group, P-2 group, P-4 group, P-8 group. Rats in the control group were treated with normal saline nasal drip. Rats in each experimental group were infected by nasal dripping bacterial suspension with 0.75×10 8 CFU/ml, 1.5×10 8 CFU/ml, 3×10 8 CFU/ml, 6×10 8 CFU/ml of S. aureus suspension or 1×10 8 CFU/ml, 2×10 8 CFU/ml, 4×10 8 CFU/ml, 8×10 8CFU/ml P. aeruginosa suspension. Our study detected the body temperature (T), blood pressure (BP), heart rate (HR) of rats in each group before and after infection, as well as blood lactic acid (Lac) and procalcitonin (PCT) level after infection. The lung infections of rats in each group were observed by hematoxylin-eosin (HE) staining. Results:The blood pressure(BP) of S-1.5 group, S-3 group, S-6 group and P-8 group was lower than before infection (all P<0.05). The Lac and PCT of each S. aureus experimental group were higher than that of the S-Cont group (all P<0.01); and they showed an increasing trend with the increase of the bacterial suspension concentration ( P<0.05), except for the S-3 and S-6 group ( P>0.05). The Lac and PCT of each P. aeruginosa experimental group were higher than that of the P-Cont group (all P<0.01); and they showed an increasing trend with the increase of the bacterial suspension concentration (all P<0.05), except for the Lac in the P-4 group and P-8 group ( P>0.05). HE staining showed that different degrees of inflammatory infiltration can be seen in the lungs of the experimental rats in each group. Conclusions:Infection of rats by nasal dripping with 3×10 8 CFU/ml of S. aureus suspension or 4×10 8 CFU/ml of P. aeruginosa suspension could establish relatively stable rat sepsis model induced by lung bacterial infection, of which the former could also establish a relatively stable septic shock model.

Microbial ecosystem comprises a complex community in which bacteria interact with each other. The potential roles of the intestinal microbiome play in human health have gained considerable attention. The imbalance of gut microbial community has been looked to multiple chronic diseases. Cardiovascular diseases (CVDs) are leading causes of morbidity worldwide and are influenced by genetic and environmental factors. Recent advances have provided scientific evidence that CVD may also be attributed to gut microbiome. In this review, we highlight the complex interplay between microbes, their metabolites, and the potential influence on the generation and development of CVDs. The therapeutic potential of using intestinal microbiomes to treat CVD is also discussed. It is quite possible that gut microbes may be used for clinical treatments of CVD in the near future.