Objective:To evaluate the association between preoperative systemic inflammatory response index (SIRI) and postoperative complications in patients with obstructive colorectal cancer (OCCRC) undergoing self-expanding metal stent (SEMS) as a bridge to surgery, and to develop and assess a predictive model for postoperative complication risk based on key clinical factors.Methods:Clinical data of 104 OCCRC patients who underwent radical surgery following SEMS placement at the Department of Colorectal Surgery, the First Affiliated Hospital of Fujian Medical University, from August 2019 to December 2024 were retrospectively analyzed. Logistic regression was used to identify independent predictors of postoperative complications, and a nomogram was constructed to evaluate predictive performance.Results:The optimal SIRI cutoff value was determined by ROC analysis, and patients were classified into low- ( n=51) and high-SIRI ( n=53) groups.Postoperative complications occurred more frequently in the high-SIRI group than in the low-SIRI group (39.62% vs 13.73%, χ2=8.86, P=0.003). Multivariate logistic regression identified age ( OR=1.05, 95% CI: 1.01-1.09, P=0.027), intraoperative blood loss ( OR=4.45, 95% CI: 1.56-12.75, P=0.005), and high SIRI ( OR=3.73, 95% CI: 1.29-10.83, P=0.015) as independent predictors. The nomogram incorporating these variables showed good predictive ability with an AUC of 0.736. Conclusions:Preoperative elevated SIRI is an independent risk factor for postoperative complications in OCCRC patients treated with SEMS as a bridge to surgery. A nomogram combining SIRI, age and intraoperative blood loss provides effective risk stratification.

Objective To investigate the accuracy and feasibility of shear wave elastography(SWE)combined with superb microvascular imaging(SMI)for the differential diagnosis of benign and malignant thyroid nodules.Methods A total of 190 patients with thyroid nodu-les detected in the Ultrasound Department of our hospital from January 2021 to December 2022 who underwent ultrasound-guided fine-needle aspiration biopsy or exhibited postoperative histopathological improvement were selected as the study subjects.Among them,a total of 224 thyroid nodules(74 benign and 150 malignant nodules)were detected,all of whom underwent thyroid ultrasonography,SWE,and SMI.The parameters related to the Young's modulus of the tissue as well as the condition of fine blood flow and perforating vessels were calculated.Using histopathological results as the gold standard to construct receiver operating characteristic(ROC)curves,observe the effectiveness of SWE combined with SMI in the differential diagnosis of thyroid nodules,and compare the efficacy of different examination methods in the diagnosis of thyroid nodules.Results There were significant differences in the internal composition,echo,margin,cal-cification,and aspect ratio between the benign and malignant thyroid nodules(all P<0.05);however,there was no significant difference in the average diameter of the benign and malignant nodules(P>0.05).There were statistically significant differences in maximum elas-ticity,mean elasticity,elasticity ratio,microvascular score,peak shear wave velocity,and average shear wave velocity between the benign and malignant thyroid nodules(all P<0.05).The ROC curve showed that the area under the curve of the maximum elastic value was the highest,while the optimal diagnostic threshold was 29.52 kPa.The optimal diagnostic threshold for the microvascular flow score was 2.3 points.In terms of diagnostic efficacy,SWE combined with SMI showed the highest sensitivity(94.67%)and specificity(94.59%).Conclusion SWE combined with SMI can further improve the diagnostic efficiency of benign and malignant thyroid nodules and achieve quantitative evaluation and dynamic observation of lesions,which has application and promotion value.

Objective:To investigate the feasibility,moderate-and short-term efficacies of laparoscopic surgery in the resection of the gastric gastrointestinal stromal tumors(GIST)with the tumor diameter more than 5 cm.Methods:The clinicopathological data of 26 gastric GIST patients with the diameter more than 5 cm underwent laparoscopic complete resection were retrospectively analyzed.The postoperative recovery,complications and moderate-and short-term prognosis of the patients were observed.Results:All the patients underwent laparoscopic surgery resection without open operation.According to the location and growth types of tumors,the total gastrectomy was performed in 1 case,the approximal gastrectomy was performed in 2 cases,the distal gastrectomy was performed in 2 cases,and the gastric local resection was performed in the rest 20 cases.The mean diameter of tumors was (5.94±1.28) cm,the mean operational time was (84.23±27.02) min,and the mean blood loss was (72.38±34.24) mL.The postoperative recovery time of bowel function was (2.77±0.65)d and the mean length of postoperative hospitalization time was (7.04±2.24) d.There was 1 case of intraperitoneal hemorrhage and 1 case of anastomotic stenosis;they recovered after conservative therapy.The postoperative pathology results(according to the modified NIH standard) indicated the number of moderate-risk patients was 18(69.23%),and the number of high-risk patients was 8(30.77%).A total of 12 cases accepted the adjuvant therapy with imatinib.There was 1 case of hepatic multimetastasis,and there was no local recurrence or death in the other patients.Conclusion:The moderate-and short-term efficacies of laparoscopic surgery in the gastric GIST patients with the tumor diameter more than 5 cm is safe and feasible.