Objective To investigate the correlation between the triglyceride-glucose index(TyG),atherogenic index of plasma(AIP),systemic immune-inflammation index(SII),serum creatinine(SCr)and the severity of hyperlipidemic acute pancreatitis(HLAP).Methods A total of 156 HLAP patients admitted to Huzhou First People's Hospital from January 2020 to December 2024 were enrolled as subjects.They were divided into mild group(n=89)and moderately-severe/severe group(n=67)based on disease severity.Logistic regression analysis was used to identify independent risk factors.Spearman correlation analysis was used to examine the correlation between TyG,AIP,SCr,and HLAP severity.The predictive value of TyG,AIP,and SCr for HLAP were evaluated using receiver operating characteristic(ROC)curves.Results Levels of TyG,AIP,SII,and SCr were significantly higher in moderate-severe/severe group than in mild group(P＜0.05).Logistic regression analysis revealed that TyG,AIP,and SCr were independent risk factors for moderate-severe/severe HLAP(P＜0.05),whereas SII was not an independent risk factor.The severity of HLAP was positively correlated with early admission levels of TyG,AIP,and SCr.ROC curve analysis demonstrated that TyG showed superior diagnostic value compared to SCr and AIP.The combined indicators(SCr+AIP and SCr+TyG)outperformed single indicators in predictive value,with SCr+TyG exhibiting the highest predictive efficacy.Conclusion Early TyG,AIP,and SCr levels can serve as effective indicators for predicting disease severity in HLAP patients,and combined detection improves predictive accuracy.

Objective To investigate the correlation between the triglyceride-glucose index(TyG),atherogenic index of plasma(AIP),systemic immune-inflammation index(SII),serum creatinine(SCr)and the severity of hyperlipidemic acute pancreatitis(HLAP).Methods A total of 156 HLAP patients admitted to Huzhou First People's Hospital from January 2020 to December 2024 were enrolled as subjects.They were divided into mild group(n=89)and moderately-severe/severe group(n=67)based on disease severity.Logistic regression analysis was used to identify independent risk factors.Spearman correlation analysis was used to examine the correlation between TyG,AIP,SCr,and HLAP severity.The predictive value of TyG,AIP,and SCr for HLAP were evaluated using receiver operating characteristic(ROC)curves.Results Levels of TyG,AIP,SII,and SCr were significantly higher in moderate-severe/severe group than in mild group(P＜0.05).Logistic regression analysis revealed that TyG,AIP,and SCr were independent risk factors for moderate-severe/severe HLAP(P＜0.05),whereas SII was not an independent risk factor.The severity of HLAP was positively correlated with early admission levels of TyG,AIP,and SCr.ROC curve analysis demonstrated that TyG showed superior diagnostic value compared to SCr and AIP.The combined indicators(SCr+AIP and SCr+TyG)outperformed single indicators in predictive value,with SCr+TyG exhibiting the highest predictive efficacy.Conclusion Early TyG,AIP,and SCr levels can serve as effective indicators for predicting disease severity in HLAP patients,and combined detection improves predictive accuracy.

Objective To investigate the incidence of colorectal serrated lesions(SL)combined with advanced neoplasia(AN)and to analyze the risk factors for SL combined AN.Methods A total of 297 patients with colorectal polyps detected by endoscopy and pathologically suggestive of SL from 1st October 2021 to 30th September 2023 in the First People's Hospital of Huzhou.They were divided into combined group(n=33)and uncomplicated group(n=264)according to whether they were combined with AN or not,and the clinicopathologic differences between two groups were compared and the coexisting risk factors were analyzed.Results Age ≥ 50 years,male,history of polyps,polyp size and different SL subtypes were all risk factors for SL combined with AN,and the difference was statistically significant(P＜0.05).Logistic regression analysis revealed that age,male,history of polypos,and SL size were independent risk factors for SL combined with AN.Conclusion Males,older age,previous history of polyps,and larger SL lesions were more likely to have combined AN.

Objective To investigate the incidence of colorectal serrated lesions(SL)combined with advanced neoplasia(AN)and to analyze the risk factors for SL combined AN.Methods A total of 297 patients with colorectal polyps detected by endoscopy and pathologically suggestive of SL from 1st October 2021 to 30th September 2023 in the First People's Hospital of Huzhou.They were divided into combined group(n=33)and uncomplicated group(n=264)according to whether they were combined with AN or not,and the clinicopathologic differences between two groups were compared and the coexisting risk factors were analyzed.Results Age ≥ 50 years,male,history of polyps,polyp size and different SL subtypes were all risk factors for SL combined with AN,and the difference was statistically significant(P＜0.05).Logistic regression analysis revealed that age,male,history of polypos,and SL size were independent risk factors for SL combined with AN.Conclusion Males,older age,previous history of polyps,and larger SL lesions were more likely to have combined AN.

Objective To explore the efficacy and safety of antiplatelet therapy in patients with acute ischemic stroke(AIS)complicated with gastric cancer.Methods Clinical data of 89 patients with AIS complicated with gastric cancer who were hospitalized in the First People's Hospital of Huzhou from January 2018 to October 2022 were retrospectively analyzed.The patients were divided into treatment group(59 cases)and untreated group(30 cases)according to whether they received antiplatelet therapy or not,and the clinical characteristics and prognosis of the two groups were compared.To analyze the clinical features and influencing factors of gastrointestinal bleeding complicated by antiplatelet therapy in AIS patients with gastric cancer.Results The patients in treatment group were younger than those in untreated group,and had more history of antiplatelet therapy,hypertension and cardiovascular disease,the difference was statistically significant(P<0.05).The National Institute of Health stroke scale(NHISS)and modified Rankin scale(mRs)of patients in treatment group were lower than those in untreated group after antiplatelet therapy,the difference was statistically significant(P<0.05).The incidence of bleeding in treated group was significantly higher than that in untreated group(P<0.05),most of the patients had mild hemoglobin decline.Multivariate Logistic analysis suggested that chronic renal insufficiency,gastric cancer lesion diameter≥2cm and T1-T2 stage are risk factors for gastrointestinal bleeding in AIS patients with gastric cancer after taking aspirin for antiplatelet therapy.Conclusion In AIS patients with gastric cancer,aspirin antiplatelet therapy can effectively improve cerebrovascular function and reduce the degree of brain nerve damage.However,when these patients are combined with T1-T2 stage,chronic renal insufficiency and gastric cancer lesion diameter≥2cm,gastrointestinal bleeding is easy to occur.

Objective:To seek a correlation between short-chain fatty acids (SCFAs) and skill in the activities of daily living (ADL) after an ischemic stroke.Methods:Ninety ischemic stroke survivors were assessed using the Barthel Index (BI). Fecal samples were collected and analyzed for the concentration of acetic acid, propionic acid, butyric acid, isobutyric acid, valeric acid, and isovaleric acid using gas chromatography. Spearman correlation analysis was conducted to identify SCFAs that correlated with the total BI score. Linear regressions were evaluated to explore the correlation between the total BI score and SCFAs.Results:The concentrations of propionic and butyric acids in the feces were found to correlate significantly with the total BI scores. Data including propionic acid and butyric acid levels, age, gender, body mass index, disease duration, any history of hypertension or diabetes, and other SCFAs were included in the regression models. Propionic and butyric acid levels were found to be potentially useful predictors of total BI scores.Conclusions:The concentration of propionic and butyric acids in the feces after an ischemic stroke can predict the survivor′s total BI score. Those concentrations could therefore be useful for predicting ADL ability.

We reported a case of a patient dignosed as tuberculosis and severe malnutrition with coronavirus disease 2019 （critical type） treated with a combination of Chinese medicine and Western medicine. Through the retrospective analysis of the diagnosis and treatment process of this patient， on the basis of Chinese medicine's understanding of the etiology and pathogenesis of “old state” and “deficient state”， the critical coronavirus pneumonia combined with pulmonary tuberculosis and severe malnutrition was mostly due to the physical condition and the invasion of epidemic toxin， resulting in dysfunctions of the internal organs such as the lungs， spleens， kidneys and other organs. Based on the understanding of the cause and mechanism of the coronavirus disease， the treatment combined Chinese and Western medical therapies was given. The western medicine was used with the main treatments of oxygen therapy， anti-viral， intestinal nutritional support， and anti-coagulation， while the Chinese medicine was used by tonifying qi， blood， yin， and yang， warming yang and dissipating cold， and clearing heat and dampness， then tonifying qi， nourishing yin and eliminating heat， in which tonifying middle and replenishing qi ran through the whole process. The integrated treatment eventually improved the patient's symptoms and accelerated the negative conversion of nucleic acid of the coronavirus.

Balance impairment is a common complication after stroke, which often leads to difficulty in walking function recovery and high risk of fall, seriously affecting the independent activity ability and quality of life of stroke patients. Accurate assessment of balance is conducive to better formulation of rehabilitation plans, evaluation of rehabilitation effects, and guidance of safer daily living activities of stroke patients. This article reviews the research progress of various methods for accurate assessment of balance function in patients with stroke.

Objective:To observe any effect of dynamic motor instability training on the balance and postural control of stroke survivors.Methods:Forty stroke survivors with poor balance were randomly divided into a control group and an observation group, each of 20. In addition to routine rehabilitation, the observation group was given 20 minutes of dynamic motor instability training, 5 days a week for 8 weeks, while the control group underwent routine rehabilitation for the same length of time. Before and after the intervention, surface electromyogram of the rectus femoris, biceps femoris, and erector spinae were recorded during perturbation. Activation time and the intensity of the anticipatory and complementary postural adjustments (APAs and CPAs) were also observed. Balance and lower limb motor functioning were assessed using the Berg balance scale (BBS), the Fugl-Meyer lower extremity assessment (FMA-LE), and GaitWatch analysis.Results:After the treatment the average activation time of the rectus femoris, biceps femoris in the affected side and those of the biceps femoris [(-84.31±5.74)s] and erector spinae in the intact side in APAs were all significantly shorter in the observation group than in the control group, while the average activation intensity of the rectus femoris and erector spinae was significantly greater. There was no significant difference in the activation intensity of each muscle group in CPAs after the treatment. After the intervention the average BBS score, FMA-LE score, stride length and walking speed of the observation group all were significantly better than the control group′s averages.Conclusions:Supplementing traditional rehabilitation training with dynamic motor instability training can further improve the posture control of stroke survivors and promote recovery of their balance and walking ability.

Objective:To investigate the application value of pepsinogen, Helicobacter pylori combined with endoscopic Kimura-Takemoto classification in the diagnosis of early gastric cancer. Methods:Sixty patients with gastric cancer who received treatment in the Department of Gastroenterology, the First People's Hospital of Huzhou from January to June 2022 were included in the gastric cancer group. An additional 60 patients with benign gastric lesions (benign gastric lesion group) and 60 patients with precancerous lesions of the stomach (precancerous lesion group) were also included in this study. Serologic testing for pepsinogen and Helicobacter pylori antibody combined with endoscopic Kimura-Takemoto classification was performed to evaluate their application value in the diagnosis of early gastric cancer. Results:Compared with the benign gastric lesion and precancerous lesion groups, the pepsinogen I/pepsinogen II ratio was significantly lower, and the pepsinogen II level and Helicobacter pylori infection rate [71.67% (43/60)] were significantly higher in the gastric cancer group ( F = 108.14, 71.75, 38.43, χ2 = 6.89, all P < 0.05). Compared with the benign gastric lesion and precancerous lesion groups, the Kimura-Takenmoto classification in the gastric cancer group was significantly higher ( H = 38.91, P < 0.05). In the gastric cancer group, pepsinogen I level and pepsinogen I/pepsinogen II ratio decreased and pepsinogen II level increased with the increase of pathological stage ( F = 65.79, 5.66, 53.32, all P < 0.01). There was no significant difference in Helicobacter pylori infection rate between different stages of gastric cancer ( P < 0.05) in the gastric cancer group. There was no significant difference in Kimura-Takenmoto classification between different stages of gastric cancer (all P > 0.05) in the gastric cancer group. The area under the receiver operating characteristic curve plotted for evaluating pepsinogen I, pepsinogen II, and pepsinogen I/pepsinogen II ratio for diagnosis of gastric cancer was 0.865, 0.664, and 0.881, respectively. Conclusion:Serum pepsinogen, Helicobacter pylori combined with endoscopic Kimura-Takemoto classification can increase the diagnostic rate of early gastric cancer. The Kimura Takemoto classification is helpful for risk stratification in the endoscopic screening of gastric cancer, and its results are consistent with pepsinogen levels. The combined application is of a high application value.