OBJECTIVE To explore the APOA5 gene polymorphisms,serum lipase(LPS),soluble programmed death ligand 1(sPD-L1)and procalcitonin(PCT)in the severe acute pancreatitis(SAP)patients with secondary infectious pancreatic necrosis(IPN).METHODS A total of 122 patients with SAP who were treated in the First Affiliated Hospital of Hebei North University from Jan.2020 to Nov.2023 were recruited as the research subjects and were divided into the secondary group with 31 cases and the non-secondary group with 91 cases according to the status of secondary IPN.The APOA5 gene polymorphisms were detected for the two groups of patients by means of polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP).The levels of LPS,sPD-L1 and PCT as well as Ranson score were compared between he two groups.The association of the serum LPS,sPD-L1 and PCT with Ranson score was observed by Spearman analysis.The value of the joint detection of LPS,sPD-L1 and PCT in diagnosis of secondary IPN in the SAP patients was analyzed by means of receiver oper-ating characteristic(ROC)curves.RESULTS The frequencies of AA genotype and A allele at rs619054 locus of APOA5 gene were higher in the secondary group than in the non-secondary group(P＜0.05),and the frequency of G allele of the secondary group was lower than that of the non-secondary group(P＜0.05).There were significant differences in the levels of serum LPS,sPD-L1 and PCT as well as Ranson score between the secondary group and the non-secondary group(P＜0.05).Spearman analysis showed that the Ranson score was positively correlated with the levels of serum LPS,sPD-L1 and PCT(r=0.738,0.701,0.721,P＜0.05).ROC curve analysis indicated that the area under the curve(AUC)of the joint detection of the three indexes was higher than that of the single detection in diagnosis of secondary IPN in the SAP patients(P＜0.05),with the sensitivity 90.30％,the specifici-ty 84.60％.CONCLUSIONS The SAP patients with secondary IPN show the high expressions of LPS,sPD-L1 and PCT.The joint detection of the indexes may facilitate the diagnosis of the secondary IPN in the SAP patients.There is association between the levels of LPS,sPD-L1 and PCT and the Ranson score.The rs619054 locus of APOA5 gene may be involved in pathogenesis of secondary IPN in the SAP patients.

Objective:To document the effectiveness of ultrasound-guided genicular nerve block (GNB) in treating knee osteoarthritis (KOA).Methods:A total of 92 KOA patients were randomly divided into an observation group and a control group with 46 in each. Those in both groups were treated conventionally, including with non-steroidal anti-inflammatory drugs, acupuncture, ultrasound, laser irradiation and manipulation therapy. The observation group additionally underwent ultrasound-guided genicular nerve block treatment, once a week for 2 weeks. Pain scoring on a visual analog scale (VAS), the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and a 6-minute walk test (6MWT) were used to evaluate everyone before and after the treatment, and then 8 weeks later.Results:In the observation group the average VAS rating [(3.54±2.00) at week 2 and (4.13±2.04) at week 8] and the average WOMAC subscale and total scores [(36.91±16.91) at week 8] had improved significantly right after the experiment and 8 weeks later. But in the control group this was true only right after the treatment. The observation group also demonstrated superior improvements in 6MWT distance at week 2 [(434.22±125.19)m] and week 8 [(446.35±126.45)m] compared to both its own baseline and the control group.Conclusions:Ultrasound-guided genicular nerve block is a rapid, precise, effective, and long-lasting intervention for alleviating pain, improving knee function and enhancing walking endurance in KOA patients.

Objective To explore the therapeutic effect of precise disconnection of pargastric varices guided by endoscopic ultrasound in the treatment of esophagogastric variceal bleeding.Method A retrospective analysis was conducted on 20 patients with cirrhosis esophagogastric variceal bleeding treated with endoscopic ultrasound-guided precise disconnection of pargastric varices from January 1,2024 to December 31,2024.The efficacy was analyzed.Result All 20 patients successfully completed the precise disconnection of pargastric varices under the guidance of endoscopic ultrasound.The injection of tissue gel combined with the placement of spring coils(14 cases)and the injection of tissue gel alone(4 cases)successfully blocked the pargastric varices.All patients did not experience perforation,esophageal and cardia stenosis,massive bleeding,septicemia,or ectopic embolization.One patient who received tissue gel alone had slight bleeding from the pargastric varices after surgery and improved after 3 days of treatment to reduce portal vein pressure.Another one patient who received tissue gel alone had a low-grade fever and normal body temperature after 3 days of anti-infection treatment.Conclusion Precise disconnection of pargastric varices under the guidance of endoscopic ultrasound has a good therapeutic effect on esophagogastric variceal bleeding,with fewer complications such as ectopic embolization,massive bleeding,infection,and perforation.However,close follow-up observation is still needed to address the issue of pargastric varices.

Purpose To investigate the clinicopathological characteristics of the gastric oxyntic gland adenoma(GOGA).Methods We collected 18 samples of GOGA,histopathological features and immunohistochemical staining were assessed.Main features of pathological diagnosis,treatment methods and follow-up were retrospectively analyzed.Results There were 18 patients,including 9 females and 9 males,aged from 36 to 86 years old.The endoscopic im-age showed a flat lesion with whitish in color or a polypoid protrusions.The size ranged from 0.3 cm to 0.8 cm.Hema-toxylin and eosin staining showed irregular glandular structures in the mucosal lamina propria,with branched and anas-tomosed patterns.The tumour demonstrating composed of chief cells hyperplasia with mild nuclear atypia.All lesions were confined to the mucous lamina propria.There was no atrophic within the peripheral gastic mucosa.Immunohisto-chemical examination showed positive for Pepsinogen-Ⅰ and MUC6.Gene mutation were analyzed in 2 cases using next generation sequence technology,and no KRAS and GNAS mutation had been detected.Endoscopic surgical treatment was performed in 11 cases,and biopsy forceps removal was carried out in 7 cases.No recurrence or metastasis was ob-served during the follow-up period of 1 to 58 months.Conclusion GOGA is a rare lesion,and appears to behave bio-logically benign.A full understanding of its histological morphology and biological behavior can improve the diagnostic ability of clinincans,and facilitate further research in the future.

The objective of this study was to develop a rapid and precise detection technique for por-cine Senecavirus A(SVA)employing reverse transcription recombinase polymerase amplification(RT-RAA)in conjunction with CRISPR Cas13a technology.Additionally,the study aimed to opti-mize the assay's reaction conditions to enhance amplification efficiency.Eight RT-RAA primer sets were designed based on the conserved gene sequence of porcine SVA,and a series of reaction condi-tions were evaluated to refine the RT-RAA reaction system.Subsequently,CRISPR-derived RNA(crRNA)sequences were developed and selected to construct the RT-RAA-CRISPR reaction sys-tem.The method's specificity was determined by examining six prevalent porcine pathogenic nucleic acids,while its sensitivity was assessed using SVA cRNA standards quantified by digital PCR.The method's stability and the consistency of clinical sample analysis were also evaluated.The findings revealed that the optimized RT-RAA and CRISPR reaction systems exhibited the highest amplifi-cation efficiency at a reaction temperature of 37 ℃.Among the eight crRNAs,five were identified as exhibiting the strongest detection signals.The formulated RT-RAA-CRISPR Cas13a method demonstrated exceptional specificity,showing no cross-reactivity with other common porcine disea-ses,including ASFV,PRRSV,PEDV,PCV2,CSFV,and PRV.The method achieved high sensitivi-ty,detecting as low as 0.86 copies/μL of SVA,and exhibited stable fluorescence output,robust re-producibility,and the ability to complete clinical sample analysis within 50 minutes.Consistency e-valuation with six positive and 58 negative samples indicated 100％agreement in outcomes.These results substantiate that the study successfully established a rapid and specific RT-RAA-CRISPR Cas13a detection method for the on-site identification of porcine Senecavirus A,demonstrating high specificity and sensitivity,and holds promise for application in SVA monitoring and control initia-tives.

Objective:To explore the application effect of risk anticipation and coping intervention model in patients with cervical spondylosis undergoing anterior decompression and bone grafting with internal fixation.Methods:A convenience sampling method was used to select 132 patients with cervical spondylosis who underwent the aforementioned surgical procedure at the First Affiliated Hospital of Anhui Medical University between January 2022 and June 2024. Patients admitted between January 2022 and March 2023 ( n=66) formed the control group and received routine nursing care, while those admitted between April 2023 and June 2024 ( n=66) formed the observation group and received nursing interventions based on the risk anticipation and coping model. Both groups were followed until three months after discharge. Pain intensity, swallowing function, nutritional status, cervical spine function, and quality of life were compared between the two groups. Results:Pain scores were lower in the observation group than in the control group at 6, 12, 24, and 48 hours postoperatively ( P<0.05) . At 24 and 48 hours postoperatively, the observation group had significantly better scores on the Kubota Water Swallowing Test compared to the control group ( P<0.05) . On the day before discharge and three months post-discharge, body mass index, plasma albumin, total protein, Japanese Orthopaedic Association score, and quality of life score were all significantly higher in the observation group than in the control group ( P<0.05) . Conclusions:The risk anticipation and coping intervention model can effectively reduce postoperative pain and improve swallowing function in patients undergoing anterior decompression and bone grafting with internal fixation for cervical spondylosis. It also promotes the recovery of cervical spine function and enhances quality of life.

OBJECTIVE To explore the APOA5 gene polymorphisms,serum lipase(LPS),soluble programmed death ligand 1(sPD-L1)and procalcitonin(PCT)in the severe acute pancreatitis(SAP)patients with secondary infectious pancreatic necrosis(IPN).METHODS A total of 122 patients with SAP who were treated in the First Affiliated Hospital of Hebei North University from Jan.2020 to Nov.2023 were recruited as the research subjects and were divided into the secondary group with 31 cases and the non-secondary group with 91 cases according to the status of secondary IPN.The APOA5 gene polymorphisms were detected for the two groups of patients by means of polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP).The levels of LPS,sPD-L1 and PCT as well as Ranson score were compared between he two groups.The association of the serum LPS,sPD-L1 and PCT with Ranson score was observed by Spearman analysis.The value of the joint detection of LPS,sPD-L1 and PCT in diagnosis of secondary IPN in the SAP patients was analyzed by means of receiver oper-ating characteristic(ROC)curves.RESULTS The frequencies of AA genotype and A allele at rs619054 locus of APOA5 gene were higher in the secondary group than in the non-secondary group(P＜0.05),and the frequency of G allele of the secondary group was lower than that of the non-secondary group(P＜0.05).There were significant differences in the levels of serum LPS,sPD-L1 and PCT as well as Ranson score between the secondary group and the non-secondary group(P＜0.05).Spearman analysis showed that the Ranson score was positively correlated with the levels of serum LPS,sPD-L1 and PCT(r=0.738,0.701,0.721,P＜0.05).ROC curve analysis indicated that the area under the curve(AUC)of the joint detection of the three indexes was higher than that of the single detection in diagnosis of secondary IPN in the SAP patients(P＜0.05),with the sensitivity 90.30％,the specifici-ty 84.60％.CONCLUSIONS The SAP patients with secondary IPN show the high expressions of LPS,sPD-L1 and PCT.The joint detection of the indexes may facilitate the diagnosis of the secondary IPN in the SAP patients.There is association between the levels of LPS,sPD-L1 and PCT and the Ranson score.The rs619054 locus of APOA5 gene may be involved in pathogenesis of secondary IPN in the SAP patients.

Purpose To investigate the clinicopathological characteristics of the gastric oxyntic gland adenoma(GOGA).Methods We collected 18 samples of GOGA,histopathological features and immunohistochemical staining were assessed.Main features of pathological diagnosis,treatment methods and follow-up were retrospectively analyzed.Results There were 18 patients,including 9 females and 9 males,aged from 36 to 86 years old.The endoscopic im-age showed a flat lesion with whitish in color or a polypoid protrusions.The size ranged from 0.3 cm to 0.8 cm.Hema-toxylin and eosin staining showed irregular glandular structures in the mucosal lamina propria,with branched and anas-tomosed patterns.The tumour demonstrating composed of chief cells hyperplasia with mild nuclear atypia.All lesions were confined to the mucous lamina propria.There was no atrophic within the peripheral gastic mucosa.Immunohisto-chemical examination showed positive for Pepsinogen-Ⅰ and MUC6.Gene mutation were analyzed in 2 cases using next generation sequence technology,and no KRAS and GNAS mutation had been detected.Endoscopic surgical treatment was performed in 11 cases,and biopsy forceps removal was carried out in 7 cases.No recurrence or metastasis was ob-served during the follow-up period of 1 to 58 months.Conclusion GOGA is a rare lesion,and appears to behave bio-logically benign.A full understanding of its histological morphology and biological behavior can improve the diagnostic ability of clinincans,and facilitate further research in the future.

Objective To explore the therapeutic effect of precise disconnection of pargastric varices guided by endoscopic ultrasound in the treatment of esophagogastric variceal bleeding.Method A retrospective analysis was conducted on 20 patients with cirrhosis esophagogastric variceal bleeding treated with endoscopic ultrasound-guided precise disconnection of pargastric varices from January 1,2024 to December 31,2024.The efficacy was analyzed.Result All 20 patients successfully completed the precise disconnection of pargastric varices under the guidance of endoscopic ultrasound.The injection of tissue gel combined with the placement of spring coils(14 cases)and the injection of tissue gel alone(4 cases)successfully blocked the pargastric varices.All patients did not experience perforation,esophageal and cardia stenosis,massive bleeding,septicemia,or ectopic embolization.One patient who received tissue gel alone had slight bleeding from the pargastric varices after surgery and improved after 3 days of treatment to reduce portal vein pressure.Another one patient who received tissue gel alone had a low-grade fever and normal body temperature after 3 days of anti-infection treatment.Conclusion Precise disconnection of pargastric varices under the guidance of endoscopic ultrasound has a good therapeutic effect on esophagogastric variceal bleeding,with fewer complications such as ectopic embolization,massive bleeding,infection,and perforation.However,close follow-up observation is still needed to address the issue of pargastric varices.

The objective of this study was to develop a rapid and precise detection technique for por-cine Senecavirus A(SVA)employing reverse transcription recombinase polymerase amplification(RT-RAA)in conjunction with CRISPR Cas13a technology.Additionally,the study aimed to opti-mize the assay's reaction conditions to enhance amplification efficiency.Eight RT-RAA primer sets were designed based on the conserved gene sequence of porcine SVA,and a series of reaction condi-tions were evaluated to refine the RT-RAA reaction system.Subsequently,CRISPR-derived RNA(crRNA)sequences were developed and selected to construct the RT-RAA-CRISPR reaction sys-tem.The method's specificity was determined by examining six prevalent porcine pathogenic nucleic acids,while its sensitivity was assessed using SVA cRNA standards quantified by digital PCR.The method's stability and the consistency of clinical sample analysis were also evaluated.The findings revealed that the optimized RT-RAA and CRISPR reaction systems exhibited the highest amplifi-cation efficiency at a reaction temperature of 37 ℃.Among the eight crRNAs,five were identified as exhibiting the strongest detection signals.The formulated RT-RAA-CRISPR Cas13a method demonstrated exceptional specificity,showing no cross-reactivity with other common porcine disea-ses,including ASFV,PRRSV,PEDV,PCV2,CSFV,and PRV.The method achieved high sensitivi-ty,detecting as low as 0.86 copies/μL of SVA,and exhibited stable fluorescence output,robust re-producibility,and the ability to complete clinical sample analysis within 50 minutes.Consistency e-valuation with six positive and 58 negative samples indicated 100％agreement in outcomes.These results substantiate that the study successfully established a rapid and specific RT-RAA-CRISPR Cas13a detection method for the on-site identification of porcine Senecavirus A,demonstrating high specificity and sensitivity,and holds promise for application in SVA monitoring and control initia-tives.