Objective: To observe the curative effect of compound carraghenates cream(Titanoreine) combined with vitamin B₆ in the treatment of hand-foot syndrome caused by capecitabine(Xeloda). Methods: From December 2015 to December 2017, 97 cases of middle and advanced colorectal cancer in the First People's Hospital of Yongkang were selected.All patients were treated by chemotherapy regimens of capecitabine as priority after operation, but later hand-foot syndrome appeared and they were randomly divided into treatment group (48 cases) and control group (49 cases) according to the digital table.In control group, only vitamin B₆ 30 mg was taken orally, three times daily; while in treatment group, vitamin B₆(30 mg) combined with compound carraghenate cream (1g) were taken orally, three times daily after hand-foot syndrome occurred.The improvement, total efficiency, pain score during the treatment process (the first, fifth, ninth day after treatment), adverse reactions were observed before and after treatment in two groups. Results: After treatment, the hand-foot syndrome in the treatment group and the control group was improved, the difference was statistically significant (treatment group: Z=6.477, P=0.000; control group: Z=4.700, P=0.000). The total effective rate of the treatment group was 87.5%(42/48), which was significantly higher than 65.3%(32/49) of the control group (χ²=6.603, P=0.010). The pain score on the ist day after treatment had no statistically significant differences between the two group[treatment group: (2.88±1.82)points, control group: (3.14±1.74)points, t=0.741, P=0.461] The pain scores on 5th and 9th day after treatment in the treatment group were (2.29±1.52)points, (1.23±1.80)points, respectively, which were lower than those in the control group [(2.94±1.38)points, (2.14±1.90)points](t=2.200, 2.430, P=0.030, 0.017). There were no statistically significant differences between the two groups in general conditions and the incidence of adverse reactions after drugs uses(all P<0.05). Conclusion Compound carraghenate cream combined with vitamin B₆ has significant effect in the treatment of hand-foot syndrome caused by capecitabine, which can improve hand-foot syndrome better and help tumor patients to finish the chemotherapy successfully.

Objective:To assess the feasibility and effectiveness of transnasal ultra-thin gastrointestinal endoscope-guided ileus tube insertion for the treatment of adhesive intestinal obstruction in the elderly.Methods:Randomized controlled trial, a total of 81 elderly patients with adhesive intestinal obstruction were enrolled, with 46 receiving transnasal ultra-thin gastroscope-assisted tube placement(observation group)and 35 receiving conventional transoral gastroscope-assisted tube placement(control group). Tube insertion was carried out.Data on the time needed for tube placement, incidents of oral or nasal bleeding, rates of successful tube placement, physical signs of symptom relief and imaging signs of symptom relief were recorded and compared between the two groups.Results:The symptom remission rate within 3 d was 93.5%(43/46)in the observation group and 88.6%(31/35)in the control group, and the rate for imaging signs of symptom remission was 82.6%(38/46)in the observation group and 74.3%(26/35)in the control group.The differences in symptom remission and imaging signs of symptom remission within 3 d were not statistically significant between the two groups( χ2=0.144, 0.830, all P>0.05). In the observation group, the time needed for tube placement was(15.4±4.2)min, which was significantly shorter than that in the control group(21.3±3.1)min( t=6.984, P<0.01). The rate of successful tube placement was 100% in both groups.In terms of adverse reactions, the observation group had 1 patient with nasal bleeding, 2 with nausea and vomiting, and 1 with a sore throat, with an overall adverse reaction rate of 8.7%(4/46), while the control group had no patient with bleeding, 18 with nausea and vomiting, and 4 with a sore throat, with an overall adverse reaction rate of 62.9%(22/35). There was no statistically significant difference in nasal bleeding(Fisher's exact probability P=0.568)or a sore throat( χ2=1.559, P=0.212), but the differences in the incidence of nausea and vomiting as well as the incidence of total adverse reactions were statistically significant( χ2=23.694, 26.752, both P<0.01)between the two groups. Conclusions:Transnasal ultra-thin gastroscope-assisted tube placement can reduce discomfort such as nausea and vomiting during tube placement, the time needed for the procedure is short with a high success rate, and therefore has very good clinical value, especially for elderly patients.

OBJECTIVES: To explore the injury mechanism of ankle fracture inferred by the Lauge-Hansen classification with the application of medical imageology and its application value in forensic medicine. METHODS: A total of 32 ankle fracture cases with known injury mechanism were collected from January 2013 to May 2018, which were identified in Yongkang Public Security Bureau, Zhejiang Province. The Lauge-Hansen classification of ankle fracture was performed by three forensic experts based on the data of X-ray and CT image. Fisher's exact test and Kappa consistency analysis were performed by SPSS 20.0 statistical software to compare the results of the Lauge-Hansen classification with the injury mechanism of ankle fracture obtained through the criminal evidence. RESULTS: In 32 cases, 84.4% （27/32） ankle fractures were classified according to the Lauge-Hansen classification based on medical imaging. The mechanism of ankle fracture identified by the Lauge-Hansen classification was consistent with that obtained through the criminal evidence. CONCLUSIONS Based on medical imaging, the Lauge-Hansen classification can be well applied to infer the injury mechanism of ankle fracture in part cases, and provide objective evidence for the crime scene reconstruction of criminal cases.
Ankle Fractures/diagnostic imaging* ; Ankle Injuries ; Forensic Medicine ; Fractures, Bone ; Humans ; Radiography

Objective:To analyze and summarize the clinical manifestations, pathological characteristics, treatment, and outcomes of primary malignant melanoma of the esophagus(PMME)in elderly Chinese patients.Methods:A case study of an elderly patient with PMME was conducted at the Department of Gastroenterology in the China-Japan Friendship Hospital.Additionally, literature and case data on elderly PMME cases reported in China up to July 2023 were gathered and analyzed to summarize the epidemiological characteristics, endoscopic manifestations, clinical presentations, diagnosis, treatment, and prognosis of the disease.Results:A comprehensive review of the literature up to July 2023 documented a total of 114 cases of elderly patients with PMME in China, which also included cases from our hospital.Among these cases, there were 68 male patients(59.6%)and 46 female patients(40.4%), ranging in age from 60 to 81 years, with a median age of 65 years.The predominant clinical manifestations observed were dysphagia and choking while eating, followed by chest pain and retrosternal burning sensation.The majority of the lesions were found in the middle and lower segments of the esophagus, predominantly protruding into the lumen, with only 2 cases(1.8%)displaying esophageal mucosal pigmentation.Immunohistochemical analysis revealed that HMB45 was positive in 74 cases(64.9%)and negative in 3 cases(2.6%), while S-100 was positive in 66 cases(57.9%)and negative in 2 cases(1.8%), although data for some patients were not available.Lymph node or distant metastases were present in 45 cases(39.5%), while 38 patients(33.3%)had tumors confined to the esophagus without metastases.Of the 114 patients, 61(53.5%)had a follow-up period ranging from 0.3 to 39 months, with a median follow-up time of 6.75 months.Among the patients who survived during the follow-up period, there were 30 cases(26.3%), with a follow-up time of 1 to 39 months and a median follow-up time of 7.5 months.For the deceased patients, the time from consultation to death ranged from 0.3 to 31 months.Conclusions:Elderly individuals with PMME in China typically present with a gradual onset, nonspecific symptoms, frequent metastasis upon diagnosis, aggressive behavior, and unfavorable outcomes.

Objective:To investigate the value of ultrasonography in diagnosis of transposition of great arteries of the fetus at 11-13 + 6 weeks gestation. Methods:A prospective study was conducted on fetuses screened by ultrasound in the first trimester in Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region between January 2015 and March 2022. Fetal heart structure was screened by three-section screening method. Fetuses with suspected transposition of the great arteries at 11-13 + 6 weeks gestation underwent followed-up ultrasound examination, chromosome and gene test results. The ultrasound characteristics and prognosis pregnancy outcomes were summarized. Results:Twenty-one cases of transposition of the great arteries were detected by ultrasonography, including complete transposition of great arteries (20 cases) and congenitaly corrected transposition of the great arteries (1 case). Two cases were miss diagnosed. Twenty-one cases showed parallel signs of two major arteries on grayscale outflow section at 11-13 + 6 weeks gestation. There were 6 cases with aneuploid ultrasonographic soft markers abnormality, 2 cases with extracardiac malformation. Chromosome and microarray analysis were performed in 13 cases. 4 cases with chromosomal abnormality. Four cases of chromosomal abnormalities were associated with ultrasonographic soft markers abnormality, and 1 case with extracardiac malformation.In the 23 cases, 20 cases were induced, 1 miscarried, and 2 delivered to term. Among the fetuses delivered at term, 1 case died before neonatal operation and 1 case survived. Conclusions:Standardized ultrasound scan at 11-13 + 6 weeks has high accuracy in diagnosis of transposition of the great arteries. And the incidence of chromosomal abnormality is high with ultrasonographic soft markers abnormality or extracardiac malformation.

Alternative polyadenylation(APA)is a crucial step in post-transcriptional regulation.Previous bioinformatic studies have mainly focused on the recognition of polyadenylation sites(PASs)in a given genomic sequence,which is a binary classification problem.Recently,computa-tional methods for predicting the usage level of alternative PASs in the same gene have been pro-posed.However,all of them cast the problem as a non-quantitative pairwise comparison task and do not take the competition among multiple PASs into account.To address this,here we propose a deep learning architecture,Deep Regulatory Code and Tools for Alternative Polyadenylation(DeeReCT-APA),to quantitatively predict the usage of all alternative PASs of a given gene.To accommodate different genes with potentially different numbers of PASs,DeeReCT-APA treats the problem as a regression task with a variable-length target.Based on a convolutional neural network-long short-term memory(CNN-LSTM)architecture,DeeReCT-APA extracts sequence features with CNN layers,uses bidirectional LSTM to explicitly model the interactions among com-peting PASs,and outputs percentage scores representing the usage levels of all PASs of a gene.In addition to the fact that only our method can quantitatively predict the usage of all the PASs within a gene,we show that our method consistently outperforms other existing methods on three different tasks for which they are trained:pairwise comparison task,highest usage prediction task,and rank-ing task.Finally,we demonstrate that our method can be used to predict the effect of genetic variations on APA patterns and sheds light on future mechanistic understanding in APA regulation.

The accurate annotation of transcription start sites(TSSs)and their usage are critical for the mechanistic understanding of gene regulation in different biological contexts.To fulfill this,specific high-throughput experimental technologies have been developed to capture TSSs in a genome-wide manner,and various computational tools have also been developed for in silico pre-diction of TSSs solely based on genomic sequences.Most of these computational tools cast the problem as a binary classification task on a balanced dataset,thus resulting in drastic false positive predictions when applied on the genome scale.Here,we present DeeReCT-TSS,a deep learning-based method that is capable of identifying TSSs across the whole genome based on both DNA sequence and conventional RNA sequencing data.We show that by effectively incorporating these two sources of information,DeeReCT-TSS significantly outperforms other solely sequence-based methods on the precise annotation of TSSs used in different cell types.Furthermore,we develop a meta-learning-based extension for simultaneous TSS annotations on 10 cell types,which enables the identification of cell type-specific TSSs.Finally,we demonstrate the high precision of DeeReCT-TSS on two independent datasets by correlating our predicted TSSs with experimentally defined TSS chromatin states.The source code for DeeReCT-TSS is available at https://github.-com/JoshuaChou2018/DeeReCT-TSS_release and https://ngdc.cncb.ac.cn/biocode/tools/BT007316.