Objective: Systemic immune-inflammation index (SII) is a new systemic inflammatory prognostic indicator associated with outcomes in patients with different tumors. Studies have shown an association between SII and many chronic/acute inflammatory diseases. This study aimed at exploring whether SII can be used as an effective parameter for predicting the severity of acute pancreatitis (AP). Methods: A total of 101 acute pancreatitis patients were enrolled in this study (mild acute pancreatitis (MAP): n = 73 and severe acute pancreatitis (SAP): n = 28). Patient demographics and SII were analyzed using the chi-square test, Student’s t-test, and Mann–Whitney U-test. A receiver operating characteristic curve was generated to test the potential of using neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and SII to predict AP’s severity. Logistic regression analysis was performed to determine major risk factors. Results: Patients with SII value ≥ 2207.53 had a higher probability of having SAP (sensitivity = 92.9%, specificity = 87.7%, and AUC = 0.920), and SII was a significantly better predictive value than PLR and NLR. Logistic regression analysis results showed SII could differentiate MAP from SAP as a major risk factor. Conclusion: This study has shown that SII is a potential indicator for predicting the severity of acute pancreatitis. The findings suggested that SII is more sensitive and specific than NLR and PLR in predicting the severity of acute pancreatitis.

Bioinformatics analysis reveals the clinical significance of GIPC2/GPD1L for colorectal cancer using TCGA database Zhengdong Zhao, Xinye Cui, Guoxin Guan, Yaqing Liu, Xingming Liu, Zhao Chen, Shili Ning, Fuwen Luo

Acute mesenteric ischemia (AMI) is a life-threatening vascular disorder that demands greater clinical and research attention due to its significant morbidity and mortality risks. Clinicians should maintain a high index of suspicion for AMI in patients presenting with severe abdominal pain disproportionate to physical findings, particularly those with atrial fibrillation or recent vasoconstrictor use. In such cases, prompt computed tomography angiography is recommended as the initial diagnostic modality, given its high sensitivity, specificity, efficiency, and favorable safety profile. Multi-disciplinary treatment plays a critical role in elucidating disease etiology and guiding therapeutic decision-making. For confirmed cases of intestinal necrosis, open surgical intervention remains the gold standard. Laparoscopic exploration offers a minimally invasive alternative for assessing bowel viability while reducing unnecessary surgical trauma in equivocal presentations. In the pre-necrotic phase of intestinal ischemia, emerging endovascular therapies demonstrate increasing promise due to their minimally invasive nature and improved clinical outcomes, warranting further investigation. Continuous clinical vigilance is essential throughout management. Persistent abdominal pain or signs of peritonitis may indicate disease progression, necessitating urgent reassessment for possible ischemic necrosis and therapeutic strategy adjustments. This review synthesizes current evidence by examining AMI pathophysiology, anatomical considerations, risk factors, and diagnostic-therapeutic advancements, with an emphasis on optimizing clinical decision-making in this critical condition.

BACKGROUND Women are at an increased risk of developing venous thrombosis during gestation and the postpartum period, due to physiological and anatomical changes. Superior mesenteric vein thrombosis (SMVT) is a rare and severe complication with a dangerous course and a high mortality rate. Heparin-induced thrombocytopenia (HIT) is also rare in patients treated with heparin and presents with thrombosis and thrombocytopenia. We report a patient with SMVT diagnosis who was treated with heparin anticoagulation after surgery and eventually developed HIT. CASE REPORT The patient was a 30-year-old woman with a diagnosis of SMVT 10 days after giving birth to her second child. She was treated with heparin anticoagulation and interventional catheter-based thrombolysis and thrombectomy, which was ineffective, and she showed peritonitis. We therefore performed an emergency laparotomy, during which we found partial small intestine necrosis and performed a partial small bowel resection. However, the systemic thrombosis worsened postoperatively, and after a multidisciplinary team consultation, HIT was diagnosed. After switching to non-heparin anticoagulation, the patient's condition improved, and she was discharged from the hospital. CONCLUSIONS This is the first case report of HIT secondary to heparin anticoagulation in a parturient who underwent surgery for intestinal necrosis caused by SMVT. Our case highlights the challenge of treating SMVT and the difficulty of diagnosis of HIT. SMVT is a serious condition that requires sufficient experience to judge the timing of surgery. HIT is a rare complication that occurs during heparin use, and its timely diagnosis and treatment have a significant impact on patient prognosis.

Objectives: Acute mesenteric ischemia (AMI) is a rare disease with a relatively high mortality rate. We aimed to investigate the factors influencing in-hospital mortality in AMI patients and develop a nomogram for early risk stratification. Methods: Clinical data of AMI patients hospitalized from January 2013 to October 2025 were retrospectively analyzed. Univariate and multivariate logistic regression identified independent pre-treatment risk factors, and a nomogram was constructed. Discrimination, calibration, and clinical utility were evaluated using receiver operating characteristic curve analysis, Hosmer-Lemeshow test, calibration curves, and decision curve analysis (DCA), with Bootstrap internal validation. Subgroup validation was performed by age, sex, and other subgroups. A further adjusted multivariate model examined associations of early clinical characteristics and treatments with mortality. Results: Among 235 patients, 44 died in hospital (18.7%). Advanced age, heart failure, higher white blood cell (WBC), and creatinine were independent predictors. The model showed good discrimination (Bootstrap area under the curve: 0.849, 95% CI: 0.780–0.909) and fit (Hosmer-Lemeshow: χ ² = 10.111, P = 0.257), with good calibration and net benefit on DCA. Performance remained stable across subgroups. Further analysis that incorporated early clinical characteristics and treatment measures found that age, heart failure, WBC, aspartate aminotransferase, anticoagulation therapy, and vasopressor use were associated with mortality. Anticoagulation therapy was negatively correlated with mortality risk, whereas vasopressor use was positively correlated with mortality risk. Conclusions: This study identified risk factors for in-hospital mortality in AMI patients and developed a predictive nomogram model. This aids in early high-risk patient identification, timely intervention, optimized treatment decisions, and improved patient outcomes.