Objective It is difficult to differentiate tumors in upper GI muscularis proporia, such as GI stromal tumors (GISTs) , leiomyomas and schwannomas. We performed EUS guided fine needle aspirations (FNA) and immunohistochemical evaluation of these tumors in upper GI muscularis proporia. Methods We selected 35 Patients with lesions in upper GI muscularis proporia by EGD and EUS. We assessed the shape , size, and position of the lesions and the status of metastasis. After excluding blood vessel between the lesions and the fine needle, EUS FNA were carried out and immunohistochemical staining for CD-117 (c-kit) , CD34 and smooth muscle actin ( SMA) was performed. Results All patients were performed EUS FNA and enough specimens were obtained in 31 patients. The other 4 failed, although we tried it for several times. Among the 31 patients, Cytology and immunohistochemisty demonstrated 21 GISTs and 10 leiomyomas. All the results were evaluated by surgery. The sensitivity is 88. 6% , and the speciality is 100%. No complication occurred. Conclusion EUS-guided FNA and immunohistochemical evaluation is an accurate method for diferential diagnosis of tumors in upper GI muscularis propria.

OBJECTIVE To observe therapeutic efficacy and safety of transcatheter arterial chemoembolization (TACE) com-bined with high intensity focused ultrasound (HIFU) in the treatment of middle and advanced primary hepatocellular carcinoma (HCC). METHODS:76 patients with middle and advanced primary HCC were randomly divided into treatment group(36 cases) and control group(40 cases). Control group was given TACE alone,and treatment group was additionally given HIFU 2-3 weeks after TACE. Clinical efficacy,the content of alpha-fetoprotein(AFP)before and after operation,survival rate,survival period and ADR were compared between 2 groups. RESULTS:The efficiency rate and total effective rate of treatment group were 61.1% and 94.4%,which were significantly higher than those of control group(35.0%,77.5%),with statistical significance(P<0.05). The content of AFP in 2 groups decreased significantly after operation,with statistical significance(P<0.05);there also was statistical significance between 2 groups(P<0.05). Survival rate of treatment group was higher than that of control group 24 and 36 months after operation,with statistical significance (P<0.05). The median survival time was 11.3 months in treatment group and 9.2 month in control group,with no statistical difference(P>0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Com-pared with TACE alone,TACE combined with HIFU in the treatment of middle and advanced primary HCC can improve long-term survival rate and the short-term efficacy,with good safety.

This retrospective case-control study explored the factors associated with anaphylactic shock during surgery for cystic echinococcosis (CE) at the First Affiliated Hospital of Xinjiang Medical University between October 2008 and September 2013. Patients who suffered from anaphylactic shock (n=16) were age-matched 3:1 to patients who did not (n=43). Multivariate analysis suggested that IL-4 levels (odds ratio=1.096; 95% confidence interval=1.015–1.185; P=0.02) and cyst size (odds ratio=3.028, 95% confidence interval=1.259–7.283, P=0.013) were independently associated with CE-induced perioperative anaphylactic shock. Using the receiver operating characteristic (ROC) curves and a cut-off value of 415.7 ng/ml, IL-4 showed an area under the ROC (AUC) of 0.926, sensitivity of 75.0%, and specificity of 97.7%. Using a cut-off value of 7.8 cm, cyst size showed an AUC of 0.828, sensitivity of 81.3%, and specificity of 76.7%. In conclusion, results suggest that levels of IL-4 and cyst size were independently associated with echinococcosis-induced perioperative anaphylactic shock. These results could help identifying patients with echinococcosis at risk of anaphylactic shock in whom appropriate prophylaxis could be undertaken.
Anaphylaxis* ; Area Under Curve ; Case-Control Studies ; Echinococcosis ; Echinococcus granulosus ; Humans ; Interleukin-4 ; Multivariate Analysis ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity ; Zoonoses

BACKGROUND:Allogeneic hematopoietic stem cell transplantation is an effective and even the only way to cure various hematological diseases,but the short-term mortality rate is relatively high after transplantation. OBJECTIVE:To investigate the risk factors affecting the overall survival of patients with hematological diseases in the short term(within 100 days)after allogeneic hematopoietic stem cell transplantation,so as to reduce mortality and effectively prevent related risks in the short term(within 100 days)after allogeneic hematopoietic stem cell transplantation. METHODS:Clinical data of 585 patients with hematological diseases who underwent allogeneic hematopoietic stem cell transplantation at the Hematopoietic Stem Cell Transplantation Center of First Affiliated Hospital of Zhengzhou University from January 1,2018 to June 30,2021 were retrospectively analyzed.The risk factors that affected overall survival within 100 days after allogeneic hematopoietic stem cell transplantation were explored. RESULTS AND CONCLUSION:A total of 585 patients with hematologic diseases underwent allogeneic hematopoietic stem cell transplantation.92 patients died within 100 days after transplantation,with a mortality rate of 15.7%(92/585).The median age of death cases was 26.5 years old(1-56 years),and the median survival time of death cases was 48 days(0-97 days).Univariate analysis exhibited that age≥14 years old,acute graft-versus-host disease,grade IV acute graft-versus-host disease,bacterial bloodstream infection,as well as carbapenem-resistant organism bloodstream infection,were risk factors for overall survival within 100 days after allogeneic hematopoietic stem cell transplantation(P<0.05).Multivariate regression analysis showed that age≥14 years old,grades Ⅲ-Ⅳ acute graft-versus-host disease,bacterial bloodstream infection,and carbapenem-resistant organism bloodstream infections were independent risk factors for overall survival(within 100 days)in patients after allogeneic hematopoietic stem cell transplantation.Hazard ratios were 1.77(95%CI 1.047-2.991),7.926(95%CI 3.763-16.695),2.039(95%CI 1.117-3.722),and 3.389(95%CI 1.563-7.347),respectively.In conclusion,all-cause mortality rate after allogeneic hematopoietic stem cell transplantation is relatively high in the short term.A timely diagnosis and effective treatment of bacterial bloodstream infection and acute graft-versus-host disease are essential to improving allogeneic hematopoietic stem cell transplantation outcomes.

Objective To improve substantially the prediction accuracy of histopathology subgroup through combined analysis of clinical and biological features,and accordingly build a decision tree to predict the histopathology subgroup in intermediate and high - risk neuroblastoma. Methods A total of 62 intermediate and high - risk neuro-blastoma patients were included retrospectively in this study,who received chemotherapy and surgery at Beijing Chil-dren's Hospital (BCH),Capital Medical University between January 2015 and January 2017. The fin-dings of urinary vanillylmandelic acid (VMA),and homovanillic acid (HVA),serum neuron - specific enolase (NSE),lactate dehy-drogenase (LDH)and ferritin,ultrasound,CT,MRI,positron emission tomography - computed tomography (PET -CT),bone marrow aspiration and biopsy,MYCN gene,and histopathology were collected and analyzed retrospectively. Statistical analysis was performed by using SAS 9. 4. Univariate and multivariate Logistic regression analysis were con-ducted to select potentially useful characteristics for prediction. Based on the results of Logistic regression analysis,a classification tree was developed to predict histopathology subgroup. Results To identify the characteristics related to histopathology,tumor markers and six clinico - pathologic factors were evaluated by univariate analysis. The results showed that unfavorable histopathology(UH)was more frequently associated with bone marrow metastasis,older age,as well as higher serum NSE,ferritin and LDH levels. The result of multivariate analysis showed that age and NSE were significant independent predictors of histopathology. The adjusted odds ratio(OR)of NSE and age was 33. 2 and 13. 0, respectively. The area under the receiver - operating - characteristic (AUC)of the prediction mo-del was 0. 889. The sensitivity and specificity were 91. 90％ and 76. 00％,respectively. Furthermore,to provide a visua-lization of the sig-nificant predictors found by Logistic regression analysis,a decision tree was developed for predicating of histopathology. Conclusions Age and NSE are significant independent predictors of histopathology subgroup. The decision tree based on age and NSE can help to predict the histopathology subgroup in intermediate and high - risk neuroblastoma effective-ly.

Objective : To investigate the correlation between vitamin D levels and the risk of early childhood caries (ECC), and to provide a reference for the primary prevention of ECC in children. Methods : A total of 389 children aged 6 months to 48 months were enrolled in this study. Data of feeding patterns and oral health behaviors were collected, and decayed-missing-filled teeth (dmft) were recorded. The children were divided into an ECC group (dmft > 0, n= 146) and a caries-free group (dmft=0, n=243). Peripheral blood of fingertips was collected to detect the active form of vitamin D--25(OH)D in vivo, and the cariogenic activity of dental plaque was analyzed with the Cariostat test. Logistic regression analysis was carried out to analyze the correlation among caries related factors such as 25(OH)D levels and caries risk in patients with ECC. Results: There was no significant difference in the prevalence of dental caries among 25(OH)D deficiency, insufficiency and normal children (χ2=2.320, P=0.313). There was no correlation between dmft and 25(OH)D levels (dmft=1-3, r < 0.001, P > 0.05; dmft > 3, r= 0.009, P > 0.05). The risk factors for ECC were age (OR=1.082, 95% CI: 1.045-1.121, P < 0.001), breastfeeding within 6 months after birth (OR=2.789, 95% CI: 1.581-4.921, P < 0.001), nighttime milk consumption or sleeping with a nipple (OR=4.187, 95% CI: 1.938-9.048, P < 0.001), and a high Cariostat value of 1.5-3.0 (OR=4.173, 95% CI: 2.014-8.646, P < 0.001). Conclusion There was no correlation between 25(OH)D level and caries in children aged 6-48 months. The risk factors for ECC are age, breastfeeding before 6 months old, nighttime milk consumption or sleeping with a nipple and high cariogenic activity (Cariostat value of 1.5-3.0). It is necessary to establish good feeding habits and oral hygiene habits for children while promoting breastfeeding.

BACKGROUND:Bone is a remarkable natural material possessing piezoelectric properties.By harnessing the biomimetic piezoelectric effect,tissue engineering materials can be employed to effectively address bone tissue defects and facilitate their repair. OBJECTIVE:Using a solid-phase force chemistry technique,a piezoelectric scaffold with inherent osteogenic properties was meticulously fabricated.This unique scaffold was then assessed for its impact on osteoblast adhesion,proliferation,and osteogenic differentiation. METHODS:Polyvinylidene fluoride(PVDF)powders,along with commercially available NaCl(mass ratios are 60:40,50:50,40:60,and 30:70,respectively),were subjected to solid-phase shear milling technology,resulting in a homogenous mixture.Through a melting process,a substantial material was formed,and subsequent treatment with a pure water solution effectively eliminated the NaCl.Consequently,PVDF piezoelectric foam scaffolds with varying pore sizes were successfully prepared.These materials were categorized as PVDF-40,PVDF-50,PVDF-60,and PVDF-70,denoting the respective mass percentages of NaCl during preparation.The surface morphology,crystal phase composition,thermodynamic behavior,mechanical properties,and piezoelectric properties of each group were meticulously characterized.The four kinds of piezoelectric foam scaffolds were co-cultured with the MG63 osteoblast cell line to evaluate its biocompatibility and potential to promote bone differentiation. RESULTS AND CONCLUSION:(1)The scanning electron microscopy,four groups of scaffolds had multi-level pores.As the NaCl mass fraction in the mixed powder increased,the porosity of the scaffolds increased.X-ray energy dispersion spectrum,X-ray diffraction,Fourier transform infrared spectroscopy,and thermogravimetric analysis collectively revealed the scaffold predominantly comprised the α phase,which inherently lacked piezoelectric properties.However,the application of solid-phase force chemistry successfully stimulated the formation of the β phase,thereby enhancing the scaffold's piezoelectric properties.Notably,the PVDF-60 group exhibited the highest proportion of the β phase among all the tested groups.The results of cyclic compression testing and piezoelectric performance assessment demonstrated that the PVDF-60 group exhibited superior compressive strength and piezoelectric performance compared to the other groups.(2)The findings from scanning electron microscopy and laser confocal microscopy exhibited that MG63 cells adhered well to the surface of the four groups of scaffolds,with good morphology,extended more pseudopods,and secreted a large amount of extracellular matrix.CCK-8 assay revealed that the proliferative absorbance of PVDF-60 cells cultured for 4 days was higher than that of the other three groups(P<0.000 1).Alkaline phosphatase staining and alizarin red staining showed that the expression of alkaline phosphatase and the number of calcified nodules in the PVDF-60 group were higher than those in the other three groups(P<0.01,P<0.000 1).(3)The piezoelectric PVDF foam-based scaffolds demonstrated favorable cytocompatibility.Notably,the PVDF-60 group showed superior mechanical properties,piezoelectric performance,and bone-inducing capabilities.

ObjectiveTo investigate the effect of speech imagery therapy combined with traditional dysarthria training on dysarthria in children with cerebral palsy. MethodsFrom August to December, 2022, 21 children with cerebral palsy combined with dysarthria in Wuhu Fifth People's Hospital were randomly divided into three groups A, B and C. Group A was given traditional dysarthria training for 30 minutes everytime, group B was given implantable speech imagery combined with traditional dysarthria training for 40 minutes everytime, and group C was given additional speech imagery combined with traditional dysarthria training for 40 minutes everytime, five days a week, for three weeks. Articulation and Phonology Assessment Scale, Mouth Sensory-Motor Assessment Scale, and mandibular distance, tongue distance and vowel space area (VSA) were evaluated before and after treatment. ResultsThere was no significant difference in all the indexes among three groups before treatment (F < 1.247, P > 0.05). After treatment, the scores of phonological function and sensory-motor assessment scale increased (|t| > 2.575, P < 0.05), and the mandibular distance and VSA increased in groups A and B (|t| > 2.632, P < 0.05). The d-value of phonological function before and after treatment was more in groups B and C than in group A (P < 0.05), and no difference was found in the d-value of other indexes before and after treatment among three groups (P > 0.05). ConclusionBoth speech imagery therapies are effective in improving diction clarity, oral range of motion, and motion control ability in children with cerebral palsy, and are more effective in improving articulatory clarity than traditional speech-language training.

Objective To investigate the dietary patterns of rural residents in the high-incidence areas of esophageal cancer (EC), and to explore the clustering and influencing factors of risk factors associated with high-incidence characteristics. Methods A special structured questionnaire was applied to conduct a face-to-face survey on the dietary patterns of rural residents in Yanting county of Sichuan Province from July to August 2021. Univariate and multivariate logistic regression models were used to analyze the influencing factors of risk factor clustering for EC. Results There were 838 valid questionnaires in this study. A total of 90.8% of rural residents used clean water such as tap water. In the past one year, the people who ate fruits and vegetables, soybean products, onions and garlic in high frequency accounted for 69.5%, 32.8% and 74.5%, respectively; the people who ate kimchi, pickled vegetables, sauerkraut, barbecue, hot food and mildew food in low frequency accounted for 59.2%, 79.6%, 68.2%, 90.3%, 80.9% and 90.3%, respectively. The clustering of risk factors for EC was found in 73.3% of residents, and the aggregation of two risk factors was the most common mode (28.2%), among which tumor history and preserved food was the main clustering pattern (4.6%). The logistic regression model revealed that the gender, age, marital status and occupation were independent influencing factors for the risk factors clustering of EC (P<0.05). Conclusion A majority of rural residents in high-incidence areas of EC in Yanting county have good eating habits, but the clustering of some risk factors is still at a high level. Gender, age, marital status, and occupation are influencing factors of the risk factors clustering of EC.