Objective: To evaluate the role of folic acid supplementation in prevention of colorectal adenoma recurrence. Methods: Weconducted computer search of the Cochrane Central Register of Clinical Trails, Pubmed, Embase, CBMdisc and CNKI. Hand search of relevant journals and conference proceedings was also conducted. Based on the predefined inclusion and exclusion criteria, randomized controlled trials(RCT) about folic acid in treatment of patients after adenoma resection were included in the present study. After evaluating the quality of studies, meta-analyses were performed by RevMan 5. 0. 24 software for the pooled recurrence risks of colorectal adenoma and progressive colorectal adenoma. Results: A total of 6 RCT studies, including 2,002 patients, were enrolled in this study. The results of meta-analysis showed that the recurrence risks of colorectal adenomas were not significantly different between folic acid supplementation and placebo groups [RR=0.97, 95%CI(0.79, 1.19), P = 0.76]; but there were significant differences in the risks of progressive adenomas between the two groups[RR=1.33, 95%CI (1.01, 1.74), P = 0.04]; and this effect of folic acid supplementation appeared when 1 mg/d folic acid supplementation was applied for ≥3 years [RR=1.49, 95%CI(1.07, 2.09), P = 0.02]. Conclusion: Folic acid supplementation fails to reduce the risk of colorectal adenoma recurrence, and it might increase the recurrence risk of advanced adenoma.

Objective: To provide a reference for differential diagnosis of orbit tumors in extraconal compartment by analyzing the parameters of contrast-enhanced ultrasonography (CEUS). Methods: A total of 76 patients with orbit tumors in extraconal compartment who underwent CEUS examination were retrospectively analyzed. These patients were divided into two groups depending on histological diagnosis including 27 cases with malignant tumor and 49 cases with benign tumor. CEUS images were analyzed using Sonoliver software. The time-intensity curve (TIC) and dynamic vascular pattern curve (DVPC) were acquired and the characteristics of the arterial flow infusion of these were analyzed. The related parameters such as time of arrival time(AT), rise time (RT), time to peak(TTP), mean transit time(mTT), slope of rise(K₁), the absolute value for slope of down (K₂) were also obtained. The differences of DVPC, TIC and quantitative parameters between the two groups were compared. Receiver operating curve analysis was used to acquire the cut-off values of these parameters for differential diagnosis. Results: ①TICs of the benign tumors were mainly fast rise and slow drop and DVPCs were mainly positive biphasic, while TICs of the malignant tumors were mainly fast rise and fast drop and DVPCs were mainly biphasic. ②The differences of quantitative parameters IMAX, K₁, K₂, mTT and RT of TICs were statistically significant between the two groups (P<0.05), while those of AT and TTP were not (P>0.05). ③IMAX=456.2%, K₁=109.6, K₂=35.2, RT=7.9 s, mTT=28.1 s were the best cut-off values for differential diagnosis. Among these parameters, mTT with 28.1 s had the highest diagnostic value(sensitivity: 81%, specificity: 77%). Conclusions The quantitative CEUS parameters can provide effective reference for differential diagnosis of orbit tumors in extraconal compartment.

Objective To provide a reference for differential diagnosis of orbit tumors in extraconal compartment by analyzing the parameters of contrast‐enhanced ultrasonography ( CEUS) . Methods A total of 76 patients with orbit tumors in extraconal compartment w ho underwent CEUS examination were retrospectively analyzed . T hese patients were divided into two groups depending on histological diagnosis including 27 cases with malignant tumor and 49 cases with benign tumor . CEUS images were analyzed using Sonoliver software . T he time‐intensity curve ( T IC ) and dynamic vascular pattern curve ( DVPC ) were acquired and the characteristics of the arterial flow infusion of these were analyzed . T he related parameters such as time of arrival time( AT ) ,rise time ( RT ) ,time to peak( T T P) ,mean transit time( mT T ) ,slope of rise( K1 ) ,the absolute value for slope of down ( K 2 ) were also obtained . T he differences of DVPC ,TIC and quantitative parameters between the two groups were compared . Receiver operating curve analysis was used to acquire the cut‐off values of these parameters for differential diagnosis . Results ① T ICs of the benign tumors were mainly fast rise and slow drop and DVPCs were mainly positive biphasic ,w hile T ICs of the malignant tumors were mainly fast rise and fast drop and DVPCs were mainly biphasic . ② T he differences of quantitative parameters IM AX ,K 1 ,K2 ,mT T and RT of T ICs were statistically significant between the two groups ( P ＜0 .05) ,w hile those of A T and T T P were not ( P ＞ 0 .05 ) . ③ IM AX＝ 456 .2% ,K1 ＝109 .6 ,K2 ＝35 .2 ,RT＝7 .9 s ,mT T＝28 .1 s were the best cut‐off values for differential diagnosis . Among these parameters ,mT T with 28 .1 s had the highest diagnostic value ( sensitivity :81% ,specificity :77% ) . Conclusions The quantitative CEUS parameters can provide effective reference for differential diagnosis of orbit tumors in extraconal compartment .

BACKGROUNDThe prevalence of malnutrition is very high in patients with cancer. The purpose of this study was to investigate whether or not a nutrition support team (NST) could benefit esophageal cancer patients undergoing chemoradiotherapy (CRT).

METHODSBetween June 2012 and April 2014, 50 esophageal cancer patients undergoing concurrent CRT were randomly assigned into two groups: The NST group and the control group. The nutritional statuses of 25 patients in the NST group were managed by the NST. The other 25 patients in the control group underwent the supervision of radiotherapy practitioners. At the end of the CRT, nutritional status, the incidence of complications, and completion rate of radiotherapy were evaluated. Besides, the length of hospital stay (LOS) and the in-patient cost were also compared between these two groups.

RESULTSAt the completion of CRF, the nutritional status in the NST group were much better than those in the control group, as evidenced by prealbumin (ALB), transferrin, and ALB parameters (P = 0.001, 0.000, and 0.000, respectively). The complication incidences, including bone marrow suppression (20% vs. 48%, P = 0.037) and complications related infections (12% vs. 44%, P = 0.012), in the NST group were lower and significantly different from the control group. In addition, only one patient in the NST group did not complete the planned radiotherapy while 6 patients in the control group had interrupted or delayed radiotherapy (96% vs. 76%, P = 0.103). Furthermore, the average LOS was decreased by 4.5 days (P = 0.001) and in-patient cost was reduced to 1.26 ± 0.75 thousand US dollars person-times (P > 0.05) in the NST group.

CONCLUSIONSA NST could provide positive effects in esophageal cancer patients during concurrent CRT on maintaining their nutrition status and improving the compliance of CRF. Moreover, the NST could be helpful on reducing LOS and in-patient costs.

Adult ; Chemoradiotherapy ; Esophageal Neoplasms ; drug therapy ; therapy ; Female ; Humans ; Length of Stay ; Male ; Middle Aged ; Nutritional Status ; Nutritional Support ; methods ; Patient Care Team ; Treatment Outcome

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Logistic Models ; Lung Diseases, Interstitial ; diagnostic imaging ; Male ; Radiography, Thoracic ; methods ; Tomography, X-Ray Computed ; methods

OBJECTIVETo compare the complications of direct and antirefluxing techniques of ureterointestinal anastomosis in continent urinary diversion.

METHODSSixty-three patients underwent continent urinary diversion. Twenty-four patients were treated by the direct ureteroenteric anastomosis and the others treated by the antirefluxing technique. The follow up studies included following-up the information of ureteric stricture, ureteric reflux, renal function and acute urinary infection. It was assessed for 3 months to 6 years with a mean follow up of 26 months after operation.

RESULTSOf 78 ureters reimplanted using antirefluxing technique. A total of 12 ureters had anastomotic stricture formation postoperatively. Only one of 48 ureters reimplanted using direct anastomoses had anastomotic stricture. The difference between the direct and antirefluxing technique groups was remarkable (chi2 = 4.375, P < 0.05). Furthermore, there was no significant difference between the direct and antirefluxing technique groups in regard to ureteric reflux, renal function and acute urinary infection.

CONCLUSIONSAntirefluxing anastomoses resulted in obviously higher rate of ureterointestinal anastomotic stricture in comparison with the direct anastomosis. The direct ureteroenteric anastomosis may be the suitable choice for patients undergoing continent urinary diversion.

Adult ; Aged ; Anastomosis, Surgical ; methods ; Female ; Follow-Up Studies ; Humans ; Intestines ; surgery ; Male ; Middle Aged ; Postoperative Complications ; epidemiology ; Retrospective Studies ; Ureter ; surgery ; Urinary Diversion ; methods

Objective:To analyze the epidemiological and clinical characteristics of respiratory syncytial virus (RSV) infection in children in Jiangsu Province from 2014 to 2023.Methods:The acute respiratory infection cases in children aged 0-14 years were selected from outpatient/emergency or inpatient departments in 2 surveillance sentinel hospitals, respectively, in Nanjing, Suzhou and Taizhou of Jiangsu from 1 July 2014 to 31 December 2023, and RSV nucleic acid test was conducted and the intensity of the RSV infection was accessed by WHO influenza epidemiological threshold method, and case information and clinical data were collected. χ2 test was used to compare the differences between groups, and the Bonferroni method was used for pairwise comparisons between groups. Results:In 4 946 cases of acute respiratory infections, the RSV positive rate was 8.21% (406/4 946), and the age M( Q1, Q3) of the cases was 1 (0, 3) years. The RSV positive rate was 10.92% (258/2 362) during 2014-2019 and 6.06% (118/1 948) during 2019-2023, the difference was significant ( χ2=31.74, P<0.001). RSV infection mainly occurred from October to March during 2014-2019, with the incidence peak in December and moderate or higher intensity. The seasonality of RSV infection was not obvious during 2019-2023, with low intensity. The RSV positive rate was highest in children in age group 0- years (17.85%, 151/846), and the positive rate declined gradually with age ( χ2=184.51, P<0.001). The RSV positive rate was higher in inpatient cases (9.84%, 244/2 480) than in outpatient/emergency cases (6.57%, 162/2 466) ( χ2=17.54, P<0.001). In the 155 RSV infection cases with complete clinical data, the clinical symptoms mainly included cough (99.35%, 154/155), fever (55.48%, 86/155), and shortness of breath (45.16%, 70/155). In the cases aged <6 months, the proportion of those with fever was low, but the proportion of those with shortness of breath, transferred to intensive care units, and receiving oxygen therapy were higher (all P<0.05). Children aged <6 months and those with underlying diseases were more likely to have severe RSV infection (all P<0.05). Conclusions:RSV infection in children in Jiangsu Province showed seasonal prevalence in winter from 2014 to 2019. Since 2020, the seasonal characteristics of the epidemic have changed, the epidemic period has been dispersed and the epidemic intensity has decreased. Infants <1 year old were at high risk for RSV infection, and those <6 months old and with underlying diseases might have severe infection.

Objective: Autologous peripheral blood stem cells (PBSC) derived from bone marrow can promote liver regeneration and improve the liver function of patients, but there are few studies on its effect on the long-term outcomes in patients with decompensated cirrhosis. Based on previous work, this study observed the clinical outcomes of PBSC treatment in patients with decompensated cirrhosis for 10 years, in order to provide more data support for the safety and efficacy of stem cells in clinical applications. Methods: Data of patients with decompensated liver cirrhosis who completed PBSC treatment in the Department of Gastroenterology of the First Affiliated Hospital of Air Force Military Medical University from August 2005 to February 2012 were included. The follow-up endpoint was death or liver transplantation, and patients who did not reach the follow-up endpoint were followed-up for at least 10 years. The patients with decompensated liver cirrhosis who met the conditions for PBSC treatment but did not receive PBSC treatment in our hospital during the same period were used as controls. Results: A total of 287 cases with decompensated liver cirrhosis had completed PBSC treatment, and 90 cases were lost to follow-up within 10 years after surgery. A total of 151 cases with complete survival follow-up data were included in the control group. There were no statistically significant differences in baseline information such as gender, age, etiological composition and liver function score between the two groups. The 10-year survival rate was higher in PBSC than control group (37.56% vs. 26.49%, P<0.05). Cholinesterase, albumin, international normalized ratio, Child-Turcotte-Pugh score, model for end-stage liver disease score, and other indicators were gradually recovered within 3 months to 1 year after PBSC treatment, and stabilized at a more desirable level in the long-term after follow-up for up to 10 years. There was no statistically significant difference in the incidence of liver cancer between the two groups (25.22% vs.31.85%, P=0.267). The age of onset of hepatocellular carcinoma was later in PBSC than control group [(56.66±7.21) years vs. (52.69±8.42) years, P<0.05]. Conclusions: This long-term observational follow-up study of more than ten years confirms that PBSC treatment can bring long-term benefits to patients with decompensated cirrhosis, with good long-term safety, thus providing more data support on the safety and efficacy of stem cells for clinical applications.
End Stage Liver Disease ; Follow-Up Studies ; Humans ; Liver Cirrhosis/drug therapy* ; Middle Aged ; Peripheral Blood Stem Cells ; Severity of Illness Index ; Treatment Outcome