Objective To investigate the influence of metabolic associated fatty liver disease(MAFLD)on the severity of acute pan-creatitis(AP)by exploring the relationship between them.Methods The clinical data of 526 AP patients who were admitted to the Affil-iated Hospital of Xuzhou Medical University from January 2021 to March 2023 were retrospectively analyzed.The severity of AP was as-sessed by the revised Atlanta classification,bedside index for severity in acute pancreatitis(BISAP)score,and modified CT severity in-dex(MCTSI)score.The patients were divided into MAFLD group(n=294)and non-MAFLD group(n=232)according to the pres-ence or absence of MAFLD.The two groups were compared in terms of the the indices such as general data,laboratory indicators,severi-ty,complications,the length of hospital stay.Univariate and multivariate Logistic regression analysis were also used to screen the inde-pendent risk factors for the severity of AP.Results The incidence of moderately severe acute pancreatitis(MSAP)and severe acute pan-creatitis(SAP)in MAFLD group were higher than those in non-MAFLD group,the BISAP score,MCTSI score,the incidence of local and systemic complications and.the duration of hospitalization and hospital stay in ICU for patients in MAFLD were also higher than those in non-MAFLD.Multivariable Logistic regression analysis showed that MAFLD was an independent risk factor for MSAP and SAP.Conclusion MAFLD increases the risk of AP.The presence of MAFLD portends a higher risk of MSAP and SAP,as well as higher inci-dence of local and systemic complications.

Objective To study the predictive value of aspartate aminotransferase to platelet ratio index(APRI)combined with AIMS65score for death and rebleeding within 6 weeks in patients with cirrhosis with upper gastrointestinal bleeding(UGIB).Methods The clinical data of 302 patients with cirrhosis with UGIB who attended the Affiliated Hospital of Xuzhou Medical University from June 2019 to April 2024 were retrospectively collected.Binary Logistic regression was used to analyse the independent risk factors for death within 6 weeks and rebleeding.The receiver operating characteristic(ROC)curve was plotted and the area under the curve(AUC)was calculated to compare its efficacy in predicting death and rebleeding within 6 weeks.Results Univariate and multivariate Logistic regres-sion analyses showed that APRI and AIMS65score were independent risk factors for death within 6 weeks in cirrhosis with UGIB;ROC curves showed that the AUC values of APRI combined with AIMS65score were higher than those of APRI,AIMS65score,Child-Pugh score,and MELD score(P＜0.05),and their AUC values were 0.889,0.775,0.859,0.832 and 0.735.History of previous bleed-ing,APRI,and AIMS65score were independent risk factors for rebleeding within 6 weeks in cirrhosis with UGIB;ROC curves showed that the AUC values of APRI,AIMS65score,Child-Pugh score,MELD score,and APRI combined with AIMS65score had AUC values of 0.709,0.729,0.735,0.688 and 0.774,respectively.And the predictive efficacy of APRI combined with AIMS65score was better than that of APRI,AIMS65score,and MELD score(P＜0.05).Conclusion APRI and AIMS65score are independent risk factors for death and rebleeding within 6 weeks in cirrhosis with UGIB,and the combination of the two has better predictive value for the short-term prog-nosis of patients with cirrhosis with UGIB.

Objective To investigate the influence of metabolic associated fatty liver disease(MAFLD)on the severity of acute pan-creatitis(AP)by exploring the relationship between them.Methods The clinical data of 526 AP patients who were admitted to the Affil-iated Hospital of Xuzhou Medical University from January 2021 to March 2023 were retrospectively analyzed.The severity of AP was as-sessed by the revised Atlanta classification,bedside index for severity in acute pancreatitis(BISAP)score,and modified CT severity in-dex(MCTSI)score.The patients were divided into MAFLD group(n=294)and non-MAFLD group(n=232)according to the pres-ence or absence of MAFLD.The two groups were compared in terms of the the indices such as general data,laboratory indicators,severi-ty,complications,the length of hospital stay.Univariate and multivariate Logistic regression analysis were also used to screen the inde-pendent risk factors for the severity of AP.Results The incidence of moderately severe acute pancreatitis(MSAP)and severe acute pan-creatitis(SAP)in MAFLD group were higher than those in non-MAFLD group,the BISAP score,MCTSI score,the incidence of local and systemic complications and.the duration of hospitalization and hospital stay in ICU for patients in MAFLD were also higher than those in non-MAFLD.Multivariable Logistic regression analysis showed that MAFLD was an independent risk factor for MSAP and SAP.Conclusion MAFLD increases the risk of AP.The presence of MAFLD portends a higher risk of MSAP and SAP,as well as higher inci-dence of local and systemic complications.

Objective To study the predictive value of aspartate aminotransferase to platelet ratio index(APRI)combined with AIMS65score for death and rebleeding within 6 weeks in patients with cirrhosis with upper gastrointestinal bleeding(UGIB).Methods The clinical data of 302 patients with cirrhosis with UGIB who attended the Affiliated Hospital of Xuzhou Medical University from June 2019 to April 2024 were retrospectively collected.Binary Logistic regression was used to analyse the independent risk factors for death within 6 weeks and rebleeding.The receiver operating characteristic(ROC)curve was plotted and the area under the curve(AUC)was calculated to compare its efficacy in predicting death and rebleeding within 6 weeks.Results Univariate and multivariate Logistic regres-sion analyses showed that APRI and AIMS65score were independent risk factors for death within 6 weeks in cirrhosis with UGIB;ROC curves showed that the AUC values of APRI combined with AIMS65score were higher than those of APRI,AIMS65score,Child-Pugh score,and MELD score(P＜0.05),and their AUC values were 0.889,0.775,0.859,0.832 and 0.735.History of previous bleed-ing,APRI,and AIMS65score were independent risk factors for rebleeding within 6 weeks in cirrhosis with UGIB;ROC curves showed that the AUC values of APRI,AIMS65score,Child-Pugh score,MELD score,and APRI combined with AIMS65score had AUC values of 0.709,0.729,0.735,0.688 and 0.774,respectively.And the predictive efficacy of APRI combined with AIMS65score was better than that of APRI,AIMS65score,and MELD score(P＜0.05).Conclusion APRI and AIMS65score are independent risk factors for death and rebleeding within 6 weeks in cirrhosis with UGIB,and the combination of the two has better predictive value for the short-term prog-nosis of patients with cirrhosis with UGIB.

Objective To study the diagnostic efficacy of magnifying endoscopy with narrow-band imaging(ME-NBI)in the diagnosis of early gastric cancer and intraepithelial neoplasia,and their manifestations under ME-NBI.Methods In this retrospective research,we enrolled 131 cases of early gastric cancer and intraepithelial neoplasia.Then analyze the ME-NBI manifestations of lesions,compare the diagnostic efficacy of ME-NBI and white light endoscopy(WLI)+biopsy methods in early gastric cancer and intraepithelial neoplasia and study the ME-NBI manifestations of different degrees of lesions.Results The diagnostic accuracy of ME-NBI for diagnosing early gastric cancer,high grade intraepithelial neoplasia(HGIN)and low grade intraepithelial neoplasia(LGIN)was 77.96%,77.96%and 77.96%,respectively.The diagnostic accuracy of WLI+biopsy for above lesions was 60.53%,58.47%and 69.70%,respectively.There was no statistically significant difference in the accuracy of two diagnostic methods for LGIN(P>0.05),while there was a statistically significant difference in the accuracy of two diagnostic methods for early gastric cancer and HGIN(P<0.05).In LGIN,the highest rate of cerebral gyrus glandular duct emergence was 60.46%.The incidence of papillary and villous ducts is highest in HGIN and early gastric cancer,with rates of 57.14%and 52.00%,respectively.Conclusion ME-NBI has more diagnostic efficiency in early gastric cancer than WLI+biopsy.The demarcation line has better sensitivity in differentiated early gastric cancer and intraepithelial neoplasia.Micro-surface tube like villous,papillary structures has higher occurrence rates in early gastric cancer.The cerebral gyrus microglandular duct appeares significantly higher in LGIN than other groups.

Objective To establish and verify nomogram prediction model with portal vein thrombosis in patients with cirrhosis,so as to evaluate its clinical application value.Methods The clinical data of 464 patients with cirrhosis with or without PVT admitted by our hospital from January 2015 to October 2022 were collected,univariate and multivariate Logistic regression analysis were used to screen the independent risk factors for PVT in patients with liver cirrhosis,and a nomogram prediction model was established,and the nomogram pre-diction model was verified for discrimination,calibration and clinical validity.Results Univariate and multivariate Logistic regression a-nalysis showed that the history of splenectomy,portal vein diameter,D-dimer and C-reactive protein-to-albumin ratio(CAR)were independent risk factors for cirrhosis with portal vein thrombosis(P＜0.05),the above independent risk factors were incorporated and a nomogram prediction model was successfully established.The nomogram was verified in both the modeling and validation populations:the area under the receiver operating characteristic(ROC)curve were 0.846(95％CI:0.803-0.888)and 0.815(95％CI:0.743-0.887),respectively,and the prediction model had good discrimination.The P-values in Hosmer-Lemeshow test were 0.783 and 0.453,respectively,and the model fitted well.The calibration chart showed that the nomogram model showed good calibration for the pre-diction probability of liver cirrhosis with PVT.Decision curve analysis(DCA)showed that the nomogram had good application value.Conclusion By establishing and validating a simple and practical nomogram prediction model for the risk of PVT in patients with cirrho-sis,it can help clinicians identify and intervene high-risk patients early.

Objective:To investigate the effects of different semen sample collection methods on sperm DNA fragmentation index (DFI) test results, then to evaluate the accuracy of the current semen sample collection method in the assessment of male fertility.Methods:In this study, 50 semen sample obtained on the day of oocyte retrieval from patients undergoing in vitro fertilization at the Reproductive Medical Center in Maternity and Child Health Hospital of Guangxi Zhuang Autonomous Region from August 2021 to January 2022 were collected. For each semen, a small amount of samples were collected in three different retention methods for routine semen and sperm DFI testing. Three different ways of retaining samples were as follows: group A, after mixing of the semen, 50 μL sample was directly collected; group B, after density gradient centrifugation, 50 μL sample was collected at the interface between semen and gradient fluid; group C, after density gradient centrifugation, the sperm pellet was upstream, then 50 μL sample was collected from upstream liquid. After semen treatment, routine semen testing and sperm DFI testing were performed. Pearson was used to analyze the correlation between DFI and the percentage of immobile sperm and the percentage of forward sperm movement. Results:The sperm motility rate of group C [(96.83±2.28)%] was significantly higher than that of group A [(57.16±11.28)%, P<0.001] and group B [(22.54±9.35)%, P<0.001], and there was a statistical difference among the three groups. The immotile sperm rate of group B sample was (77.46±9.35)%, which was significantly higher than that of samples from group C [(3.14±2.31)%, P<0.001] and group A [(42.83±11.28)%, P<0.001]. There was also a statistical difference in DFI among the three groups ( P<0.001). The DFI of group B [37.18% (30.41%, 47.80%)] was significantly higher than that of group A [22.00% (14.75%, 29.25%), P<0.001] and group C [0.78% (0.00%, 2.07%), P<0.001]. Pearson analysis results showed that the DFI of group A and group B was positively correlated with the percentage of immobile sperm ( r=0.304, P=0.032; r=0.612, P<0.001), while the DFI of group B was negatively correlated with the percentage of sperm forward movement ( r=-0.517, P<0.001). Conclusion:For the same semen, the DFI of immotile sperm was significantly higher than that of motile sperm. Therefore, due to the interference of immotile sperm, the DFI value by the current sample retention method cannot accurately reflect the DNA status of active sperm participating in fertilization. This suggests that the samples used for DFI testing should be collected from motile sperm collected by gradient centrifugation, upstream or other methods, which can more accurately assess male fertility.

Objective:To investigate the effects of different semen sample collection methods on sperm DNA fragmentation index (DFI) test results, then to evaluate the accuracy of the current semen sample collection method in the assessment of male fertility.Methods:In this study, 50 semen sample obtained on the day of oocyte retrieval from patients undergoing in vitro fertilization at the Reproductive Medical Center in Maternity and Child Health Hospital of Guangxi Zhuang Autonomous Region from August 2021 to January 2022 were collected. For each semen, a small amount of samples were collected in three different retention methods for routine semen and sperm DFI testing. Three different ways of retaining samples were as follows: group A, after mixing of the semen, 50 μL sample was directly collected; group B, after density gradient centrifugation, 50 μL sample was collected at the interface between semen and gradient fluid; group C, after density gradient centrifugation, the sperm pellet was upstream, then 50 μL sample was collected from upstream liquid. After semen treatment, routine semen testing and sperm DFI testing were performed. Pearson was used to analyze the correlation between DFI and the percentage of immobile sperm and the percentage of forward sperm movement. Results:The sperm motility rate of group C [(96.83±2.28)%] was significantly higher than that of group A [(57.16±11.28)%, P<0.001] and group B [(22.54±9.35)%, P<0.001], and there was a statistical difference among the three groups. The immotile sperm rate of group B sample was (77.46±9.35)%, which was significantly higher than that of samples from group C [(3.14±2.31)%, P<0.001] and group A [(42.83±11.28)%, P<0.001]. There was also a statistical difference in DFI among the three groups ( P<0.001). The DFI of group B [37.18% (30.41%, 47.80%)] was significantly higher than that of group A [22.00% (14.75%, 29.25%), P<0.001] and group C [0.78% (0.00%, 2.07%), P<0.001]. Pearson analysis results showed that the DFI of group A and group B was positively correlated with the percentage of immobile sperm ( r=0.304, P=0.032; r=0.612, P<0.001), while the DFI of group B was negatively correlated with the percentage of sperm forward movement ( r=-0.517, P<0.001). Conclusion:For the same semen, the DFI of immotile sperm was significantly higher than that of motile sperm. Therefore, due to the interference of immotile sperm, the DFI value by the current sample retention method cannot accurately reflect the DNA status of active sperm participating in fertilization. This suggests that the samples used for DFI testing should be collected from motile sperm collected by gradient centrifugation, upstream or other methods, which can more accurately assess male fertility.

Objective:To use an isokinetic test to objectively evaluate the recovery of muscle strength and endurance after treatment of acute Achilles tendon rupture using a tunnel beneath paratenon.Methods:A retrospective study was conducted of the 23 patients who had been treated at Department of Orthopedics, The Forth Medical Center, General Hospital of Chinese PLA by a tunnel beneath paratenon for acute Achilles tendon rupture from January 2017 to January 2018. They were 22 males and one female, aged from 26 to 60 years (average, 35.7 years), with 11 right and 12 left sides involved. Surgery was performed 0.5 to 7.0 days (average, 2.7 days) after injury. Length of incision, skin necrosis, infection, re-rupture, ankle-hindfoot score of American Orthopedic Foot & Ankle Society (AOFAS) and Achilles tendon total rupture scores (ATRS) were followed up for 18 months. Surgical outcomes were objectively evaluated by an isokinetic test to compare the recovery of muscle strength and endurance between the affected and normal sides.Results:Skin necrosis, infection or re-rupture occurred in none of the patients. Incision length averaged 1.4 cm (from 1 to 2 cm), AOFAS 99.1 (from 93 to 100, giving an excellent and good rate of 100%), and ATRS 97.0 (from 88 to 100). Isokinetic evaluation showed that the peak torques of ankle plantar flexion and dorsal extension at 5 test speeds (30°/s, 60°/s, 90°/s, 120°/s and 240°/s) were not significantly different between the affected and normal sides ( P>0.05). In the endurance test, the total work of ankle plantar flexion was (691.2±258.8) J on the normal side and (670.6±304.2) J on the affected side, showing no significant difference between the 2 sides ( P>0.05); the total work of ankle dorsal extension at the normal side was (407.3±119.2) J, significantly larger than that at the affected side [(362.2±117.5) J] ( P=0.001). Conclusion:An isokinetic test can be used to objectively evaluate the recovery of muscle strength and endurance after treatment of acute Achilles tendon rupture using a tunnel beneath paratenon.

With the deepening of the research on intertrochanteric fracture, the importance of "lateral wall" of femur is gradually recognized. The integrity of the lateral wall can affect the stability of intertrochanteric fractures, the choice of surgical methods and internal fixation, and the outcome of patients after surgery, which has become a research hotspot. However, there is no unified understanding on the definition of lateral wall, the judgement of injury status and the treatment of lateral wall fracture. This article reviews the literature, and combines with the clinical understanding of the role of the lateral femoral wall, in order to provide reference for orthopaedic surgeons and relevant researchers.