Objective To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) for digestive tract mucosal lesions,and risk factor of complications.Methods The data of 154 consecutive patients who underwent ESD for superficial digestive tract mucosal lesions were analyzed prospectively for therapeutic effect and rate of complications.Risk factors for bleeding was analyzed.Results The enbloc resection rate in 145 completed ESD procedures was 100.0％.Histologically,complete resection rate was 99.3％.ESD was not completed in 9 patients due to bleeding ( n =5) and perforation ( n =4).Acute massive bleeding occurred in 6 patients (6/154,3.9％),mild bleeding in 5 (3.2％),delayed bleeding in l (0.6％ ),perforation in 4 (2.6％ ) and post-ESD stenosis in 1 (0.6％ ).All complications were cured.The post-ESD ulcer-healing was achieved in 100％ at 8 weeks after treatment.During follow-up of 10.6months( ranged from 8 to 18 months),no residual or local recurrence was found.Statistic analysis showed independent risk factors for bleeding in ESD were lesion location (cardiac fundus),and lesion size.Conclusion ESD is an effective and safe procedure in treatment of digestive tract mucosal lesions.The complications of ESD are preventable and curable.Strictly controlling operation indications,individualized treatment and the proficient operation skills of physicians are the keys to success.

Philadelphia chromosome_like acute lymphoblastic leukemia (Ph_like ALL) characterized by a high rate of relapse and poor outcome of chemotherapy and prognosis, also known as BCR_ABL1_like ALL, is a kind of B_ALL subtypes, a pattern of gene expression profiling similar to that of BCR_ABL1 ALL positive but lacking BCR_ABL1 fusion gene. With the better understanding of gene expression profiling, the World Health Organization (WHO) (2016) has regarded Ph_like ALL as an independent subtype of B_ALL. The diagnosis highly depends on the laboratory techniques, and a wide range of diagnostic methods can be applied in clinic, which may bring a big challenge for the clinicians. This paper reviews the various laboratory techniques of Ph_like ALL and subtype group analysis, to provide a basis for target therapy and to improve the prognosis.

OBJECTIVETo screen the hepatocyte proteins that interact with hepatitis B virus X protein (HBx).

METHODSThe recombinant plasmid pSos-HBx was constructed by inserting Sos-HBx fragment into the bait vector, and after sequence verification the plasmid was transformed into competent yeast cells. The expression and self-activation of Sos-HBx protein was detected in the yeast cells. The hepatocyte proteins interacting with the bait protein was screened with CytoTrap yeast two-hybrid technique.

RESULTSThe reconstructed plasmid harboring HBx gene expressed Sos-HBx protein in the yeast cells without self-activation of the protein. CytoTrap yeast two-hybrid system identified 6 hepatocyte proteins that interacted with HBx, including fibronectin 1, translationally controlled tumor protein, IQ motif and WD repeats 1, follistatin, orosomucoid 1, and disulfide isomerase family A member 3.

CONCLUSIONSix HBx-binding hepatocyte proteins have been identified using the CytoTrap yeast two-hybrid system, which provides clues for further investigation of the role of HBx protein in hepatitis and liver cancer.

Genetic Vectors ; Hepatocytes ; metabolism ; Humans ; Plasmids ; Protein Interaction Domains and Motifs ; Proteins ; metabolism ; Trans-Activators ; metabolism ; Two-Hybrid System Techniques

Objective: To analyze the influence of atmospheric particulate matters (PM_2.5 and PM₁₀) on low-birth-weight (LBW) infants at different periods of gestation. Methods: We conducted a systematic literature search for 2 471 articles related to particulate matter and LBW published from January 1st 2000 to January 1st 2016 using the PubMed, Cochrane Library, Web of Science, Science Direct, Chinese Web of Knowledge, Wanfang and Weipu, and the keywords were" air pollution" , "adverse birth outcomes" , "adverse pregnancy outcomes" , "low birth weight/LBW" . According to criteria, 27 literatures were selected and included. Metafor package of the R 3.1.1 Software was used to check the heterogeneity and merge the effect value of the selected literatures, and sensitivity analysis and publication bias were detected and adjusted. Results: A total of 2 471 studies selected form the databases, 27 enrolled in this analysis according to the inclusion and exclusion criteria. Each 10 μg/m³ increase in PM_2.5 was associated with combined OR values of 1st trimester, 2nd trimester, 3rd trimester and entire gestation at 1.02(95% CI: 0.87-1.19), 1.03 (95% CI: 0.91-1.16) , 1.07 (95%CI: 1.04-1.11) and 1.09 (95%CI: 1.04-1.15), respectively. And 10 μg/m³ increase in PM₁₀ was associated with combined OR values of 1st trimester, 2nd trimester, 3rd trimester and entire gestation at 1.66 (95%CI: 1.06-2.61), 1.58 (95%CI:1.28-1.95) , 1.38 (95%CI: 1.23-1.56) and 1.04 (95%CI: 0.99-1.09), respectively. After adjusting the bias of publication, each 10 μg/m³ increase in PM_2.5 was associated with the risk of low birth weight at 1.11 (95%CI: 1.02-1.21). Conclusion This meta analysis supports an adverse impact of maternal exposure to particulate air pollution on low birth weight, varying in effects by exposure period.

Objective To investigate the clinicopathological features,diagnosis,differential diagnosis and prognosis of renal collecting duct carcinoma (CDC).Methods The clinical data of 3 patients with renal collecting duct carcinoma,during the period from January 2015 to November 2017,were retrospectively analyzed.3 patients were male with age ranged from 42 to 73 years old,mean of 57.5 years.Two lesions were located in the right kidney and one in the left kidney.Clinical manifestations were hematuria,abdominal mass and waist and abdomen pain.No laboratorial abnormality was found.CT examination showed the tumor diameter ranged from 3.1 to 5.1 cm,mean 3.9 cm.The tumors located in the medullary and renal pelvis with low density or mixed density.Those tumors extended to the peripheral of the kidney,which the boundary was unclear.During enhancement CT,the uneven enhancement effect could be observed.Radical nepheroectomy was performed in all patients.Results Postoperative pathological examination showed surface of incision was gray.The texture of tumor was hard.The invasive growth pattern could be noticed.Under the microscope,the tumors had small ducts and papillary structures of tubules with interstitial fibrosis and some sarcomatous differentiation.Immunohistochemical staining showed strong positive expression of vimentin,CK-L,CKpan and P504S,and positive expression of PAX-2,CK7 and EMA in different degrees.RCC,KSP,CD10,CD117,MOC-31 and TFE3 were all negative.All 3 cases were followed up from 1 to 15 months with an average of 6 months.One case was treated with chemotherapy because of extensive metastases after surgery.Chemotherapy was performed by dissolving 1 500 mg of fluorouracil in 1 000 ml of 5％ normal saline and instillation.It was administered once every 10-12 hours and once a day for 5 days in one cycle.However,the outcome was poor.1 patient died of tumor metastasis and recurrence 7 months after surgery.1 patient had no tumor remaining after surgery.Conclusions CDC is a very rare malignant epithelial neoplasm in kidney.It has obvious clinical symptoms,strong invasive pattern and poor prognosis.Imaging and ultrasonography only play an auxiliary role in diagnosis.CDC's unique histopathology is the main basis of diagnosis and differential diagnosis.

Objective: To improve the N biomarker in the amyloid/taueurodegeneration system by radiomics and study its value for predicting cognitive progression in individuals with mild cognitive impairment (MCI). Materials and Methods: A group of 147 healthy controls (HCs) (72 male; mean age ± standard deviation, 73.7 ± 6.3 years), 197 patients with MCI (114 male; 72.2 ± 7.1 years), and 128 patients with Alzheimer’s disease (AD) (74 male; 73.7 ± 8.4 years) were included. Optimal A, T, and N biomarkers for discriminating HC and AD were selected using receiver operating characteristic (ROC) curve analysis. A radiomics model containing comprehensive information of the whole cerebral cortex and deep nuclei was established to create a new N biomarker. Cerebrospinal fluid (CSF) biomarkers were evaluated to determine the optimal A or T biomarkers. All MCI patients were followed up until AD conversion or for at least 60 months. The predictive value of A, T, and the radiomics-based N biomarker for cognitive progression of MCI to AD were analyzed using Kaplan-Meier estimates and the log-rank test. Results: The radiomics-based N biomarker showed an ROC curve area of 0.998 for discriminating between AD and HC. CSF Aβ42 and p-tau proteins were identified as the optimal A and T biomarkers, respectively. For MCI patients on the Alzheimer’s continuum, isolated A+ was an indicator of cognitive stability, while abnormalities of T and N, separately or simultaneously, indicated a high risk of progression. For MCI patients with suspected non-Alzheimer’s disease pathophysiology, isolated T+ indicated cognitive stability, while the appearance of the radiomics-based N+ indicated a high risk of progression to AD. Conclusion We proposed a new radiomics-based improved N biomarker that could help identify patients with MCI who are at a higher risk for cognitive progression. In addition, we clarified the value of a single A/T/N biomarker for predicting the cognitive progression of MCI.

Objective:To analysis the difficulties and complications emerged during transurethral ureteroscopy and offer their management strategies. Methods: A total of 900 patients accepting rigid transurethral ureteroscopy from May 1998 to October 2008, were evaluated retropspeetively. Results: Among 900 cases, 83 cases were found difficulties during transurethral ureteroscopy, of which 45 cases were early cases. 2.6% cases (24 cases) were converted to open surgery, of which 14 cases were early cases. The causes of conversion to open include: ureteral orifice of 3 patients could not be found (12.5%), ureteroscopy failed to enter ureteral orific in 5 patients (20.9%), ureteroscopy failed to get to the ill place in 5 patients (20.9%), ureter perforation occurred in 7 pa-tients (29.1%) , ureter avulsion occurred in 2 patients (8.3%), stones shifted to renal pelvis in 2 patients (8.3%). Conclusions: There are more difficulties and complications during ureteroscopy at early stage. Strictly mastering surgical indications, strengthening preoperative training, mastering the surgical technique is the key to reduce the failure rate and complications of ureteroscopy.

Objective:To evaluate the clinical efficacy and safety of endoscopic submucosal dissection (ESD) for early colorectal cancer and its precancerous lesions by using novel lifting clip-assisted traction.Methods:From March to July 2021, 42 patients with colorectal lesions who received ESD at the Digestive Endoscopy Center of Shanghai Tenth People's Hospital were included in the retrospective study. Nineteen patients were enrolled as the observation group using the novel lifting clip, and 23 others in the control group without the help of an auxiliary method. The operation time, the hospital stay, hospital expenses and the incidence of complications of the two groups were compared.Results:All 42 patients successfully received ESD. The operation time of the observation group was significantly shorter than that of the control group [31.00 (21.00, 58.00) min VS 60.00 (30.00, 75.00) min, Z=-2.04, P=0.04]. The postoperative hospital stay of the observation group was significantly shorter than that of the control group [2.00 (1.00, 2.00) d VS 2.00 (2.00, 3.00) d, Z=-1.99, P=0.04]. The hospital cost was lower than that of the control group, but the difference was not statistically significant (19 331.42 ± 3 481.20 yuan VS 19 802.40 ± 2 548.50 yuan, t=-0.49, P=0.63). No intraoperative perforation occurred in either group. There was no significant difference in intraoperative blood loss between the observation group and the control group [0.00 (0.00, 5.00) mL VS 3.00 (0.00, 7.00) mL, Z=-1.42, P=0.16]. There was 1 case of postoperative abdominal pain in the observation group, 2 cases of postoperative abdominal pain and 1 case of fever in the control group. There was no significant difference in the overall incidence of postoperative complications between the observation group and the control group [5.3% (1/19) VS 13.0% (3/23), χ2=0.73, P=0.39]. Conclusion:The novel lifting clip-assisted colorectal ESD is safe and effective, which can significantly shorten the ESD operation time and postoperative hospital stay without increasing the economic burden of patients.

With the continuous development of healthcare industry,hospital publicity plays a pivotal role in brand con-struction,image shaping,and fostering harmonious doctor-patient relationships.This article highlights the strategic approach of The First Affiliated Hospital/School of Clinical Medicine of Guangdong Pharmaceutical University to bolstering its correspondent team and enhancing its publicity efforts.By establishing a"1+2+3"working system--one principle,two systems,and three types of training--the goal is to build a correspondent team that is politically steadfast,high-quality,and dedicated.From 2021 to 2023,the hospital has witnessed a notable improvement in submissions from the correspondents.These advancements have not only elevated the hospital's media output but also significantly contributed to the broader dissemination of its publicity materials and the advancement of its brand identity.These efforts support the favorable development of news and public opinion within the health industry.

Objective:To determine the risk factors for permanent nerve damage (PND) after aortic arch surgery in patients with acute type A aortic dissection (AAAD).Methods:This was a retrospective case-control study. The medical records from patients of both sexes with AAAD, aged > 18 yr, of American Society of Anesthesiologists Physical Status classification IV, who underwent aortic arch surgery in the Second Hospital of Hebei Medical University from December 2018 to December 2023, were collected. The patients were divided into non-PND group and PND group according to whether PND occurred after operation. The preoperative data of patients were collected, including age, gender, body mass index; comorbidities (hypertension, coronary heart disease, diabetes mellitus), history of smoking, history of stroke, and history of cardiovascular surgeries; syncope at onset, preoperative low SpO 2, preoperative low systolic blood pressure, and preoperative low diastolic blood pressure. The intraoperative data included surgical procedure (total aortic arch replacement or half aortic arch replacement), selective antegrade cerebral perfusion during operation, cardiopulmonary bypass (CPB) time, aortic cross-clamp time, post-parallel time, moderate hypothermia circulatory arrest time, nasopharyngeal temperature and rectal temperature during circulatory arrest, and BIS value during circulatory arrest; blood pressure during cardiopulmonary bypass and after restoration of heart beat; the incidence of dysfunction after recovery of heart beat and difficulty in hemostasis after termination of CPB. The aforementioned indicators were analyzed for difference, and the indicators with P<0.05 were included in the multivariate logistic regression analysis. Results:A total of 292 patients were ultimately included, among which 73 developed postoperative PND, resulting in an incidence of 25.0%. The results of multivariate logistic regression analysis showed that age ≥62 yr ( OR=3.783, 95% confidence interval [ CI] 1.513-10.346, P=0.006), preoperative hypertension ( OR=2.230, 95% CI 1.118-4.715, P=0.028), syncope at onset ( OR=3.001, 95% CI 1.343-6.710, P=0.007), BIS value > 14 during circulatory arrest ( OR=2.439, 95% CI 1.249-4.755, P=0.009) and difficult hemostasis after termination of CPB ( OR=3.465, 95% CI 1.758-6.882, P<0.001) were risk factors for PND after surgery. Conclusions:Age ≥ 62 yr, history of hypertension, syncope at onset, BIS value greater than 14 during circulatory arrest and difficulty in hemostasis after termination of CPB are risk factors for PND after aortic arch surgery in patients with AAAD.