Objective To investigate the efficacy and safety of modified endoscopic submucosal dissection (ESD) and rubber band ligation assisted endoscopic dissection for treatment of small gastric submucosal tumors (SMT) originating from the muscularis propria layer. Methods A total of ninety-two patients diagnosed as gastric SMT (6 mm≤diameter≤13 mm) originating from the muscularis propria layer by EUS in our hospital were enrolled in this study. With intravenous anesthesia and tracheal intubation in all patients, modified ESD was performed firstly to stripe the small tumors. After being exposed to a certain extent, the tumors were ligated by rubber band and snared for endoscopic dissection. The situation of bleeding, perforation in both intraoperative and postoperative, the integrity and size of the resected specimens were observed and recorded. The resected specimens were identified with histopathological detection and immunohistochemistry assay. At the 6-month and 12-month after the operation, all patients were reviewed by gastroscopy and EUS in our hospital. Results All the 92 tumors were resected completely and successfully. The mean operating time was (19.2±2.3) min and the mean blood loss in operation was (2.6±0.5) mL. Perforation after resection occurred in 3 cases, which were closed with metal hemostatic clips and nylon ropes. No delayed bleeding and perforation occurred in one week after the operation. The tumor sizes ranged from 6 mm × 5 mm to 13 mm × 12 mm. Seventy-three gastric stromal tumors (risk classification:all were very low risk), 18 gastric leiomyomas and 1 gastric neurofibroma were identified. There were no residue or recurrence in all cases during the 12-month follow-up period. Conclusion The modified ESD and rubber band ligation assisted endoscopic dissection are effective and safe for treatment of small gastric submucosal tumors originating from the muscularis propria layer. The tumors are resected completely and successfully, showing certain significance to assess the nature, degree of malignancy of the tumor and prognosis of the patients.

Monoclonal antibodies have been successfully incorporated into the current therapeutical landscape of lung cancer in the last decades. Recently, with technological advances, bispecific antibodies (bsAbs) have also shown robust efficacy in the treatment of malignant cancers, including lung cancer. These antibodies target two independent epitopes or antigens and have been extensively explored in translational and clinical studies in lung cancer. Here, we outline the mechanisms of action of bsAbs, related clinical data, ongoing clinical trials, and potent novel compounds of various types of bsAbs in clinical studies, especially in lung cancer. We also propose future directions for the clinical development of bsAbs, which might bring a new era of treatment for patients with lung cancer.

Objective To explore the effect of head acupuncturing therapy combined with massaging key head acupoints on language and cognitive function in children with autism.Methods 60 children with autism who visited the Department of Pediatric Rehabilitation of our hospital from January 2021 to June 2022 were selected as subjects,who were then randomly divided into the conventional group treated with the conventional rehabilitation training and the combination group treated with head acupuncturing therapy combined with massaging the key acu-points,apart from conventional rehabilitation training 30 cases in each group.The cognitive function,developmental status,and parental quality of life before and after the treatment were compared between the two groups,and so were the language function and safety.Results There were no significant differences in the scores by Autism Behavior Checklist(ABC)and Childhood Autism Rating Scale(CARS),adaptability scores,language scores,and individual-social interaction scores between the conventional group and the combination group before the treatment(P>0.05).After the treatment,the scores by ABC and CARS were significantly decreased in both groups,and the scores of the combination group were significantly lower than those in the conventional group(P<0.05);The adaptability scores,language,individual-social interaction scores were significantly increased in both groups,and the scores of the combined group were significantly higher than those of the conventional group(P<0.05).The abnormal rates of symbolic expression,language comprehension,action-oriented subjects,and language development delay in the combined group were all significantly lower than those in the conventional group(P<0.05).There was no significant difference in the scores by the QL-Index between the conventional group and the combined group before the treatment(P>0.05),but after the treatment,the QL-Index scores of the conventional group and the combination group were increased,and the score of the combination group was significantly higher than that of the conventional group(P<0.05).The results of blood routine,urine routine,stool routine,liver function,and kidney function in both groups were not significantly abnormal.There was one case of mild swelling and pain at the acupunctured site in the combination group,which was improved without intervention.Conclusion Head acupuncturing therapy combined with massaging the key head acupoints can improve language function,cognitive function,and development of autis-tic children.In addition,it can enhance parental quality of life and have a high level of safety.

The purpose of our study is to evaluate the diagnostic performance of radiomics in multi-class discrimination of lymphadenopathy based on elastography and B-mode dual-modal ultrasound images. We retrospectively analyzed a total of 251 lymph nodes (89 benign lymph nodes, 70 lymphoma and 92 metastatic lymph nodes) from 248 patients, which were examined by both elastography and B-mode sonography. Firstly, radiomic features were extracted from multimodal ultrasound images, including shape features, intensity statistics features and gray-level co-occurrence matrix texture features. Secondly, three feature selection methods based on information theory were used on the radiomic features to select different subsets of radiomic features, consisting of conditional infomax feature extraction, conditional mutual information maximization, and double input symmetric relevance. Thirdly, the support vector machine classifier was performed for diagnosis of lymphadenopathy on each radiomic subsets. Finally, we fused the results from different modalities and different radiomic feature subsets with Adaboost to improve the performance of lymph node classification. The results showed that the accuracy and overall 1 score with five-fold cross-validation were 76.09%±1.41% and 75.88%±4.32%, respectively. Moreover, when considering on benign lymph nodes, lymphoma or metastatic lymph nodes respectively, the area under the receiver operating characteristic curve of multi-class classification were 0.77, 0.93 and 0.84, respectively. This study indicates that radiomic features derived from multimodal ultrasound images are benefit for diagnosis of lymphadenopathy. It is expected to be useful in clinical differentiation of lymph node diseases.
Elasticity Imaging Techniques ; Humans ; Lymph Nodes ; Lymphadenopathy ; Retrospective Studies ; Ultrasonography

Humans ; Aminoquinolines/therapeutic use* ; Carcinoma, Non-Small-Cell Lung/genetics* ; Lung Neoplasms/genetics* ; Mutation/genetics* ; Standard of Care