ObjectiveTo investigate the clinical effect of endoscopic application of tissue adhesive and ligation in the treatment of esophagogastric variceal bleeding in children. MethodsA retrospective analysis was performed for the clinical data of 16 children who underwent endoscopic treatment due to esophagogastric variceal bleeding from May 2010 to May 2017. Preoperative conditions and physiological indices and postoperative hemostasis rate, rebleeding rate, complications, and further treatment. ResultsThe mean age of these children was 8.50±4.97 years. Of all children, 5 had esophageal varices alone, among whom 1 had moderate (GII) type and 4 had severe (GIII) type, and 11 had esophageal varices complicated by gastric varices, among whom 6 had GOV1 type (1 complicated by GI type, 3 complicated by GII type, and 2 complicated by GIII type) and 5 had GOV2 type (2 complicated by GII type and 3 complicated by GIII type). There were a total of 50 varicose veins in these 16 children, with a mean number of 4 veins (range 1-5) in each child, and ligation was performed for 70 sites in total, with a mean number of 5 sites (range 0-8) in each child. Tissue adhesive injection was performed for 9 children at a total of 15 sites, and 20 ml of tissue adhesive was used in total, with 2.22 ml for each child and 1.33 ml for each site. The hemostasis rate immediately after endoscopic therapy was 100%, and the rebleeding rate was 6.25% (1/16) within 3 months and 12.5% (2/16) after 3 months. The follow-up time ranged from 3 months to 7 years, and during follow-up, 4 children underwent liver transplantation and 1 underwent endoscopic treatment again due to bleeding. No obvious complications were observed. ConclusionIn the treatment of esophagogastric variceal bleeding in children, endoscopic application of tissue adhesive and ligation has a marked hemostatic effect and few complications and provides valuable time for long-term treatment.

Objective To investigate the computed tomography (CT) features of clear cell papillary renal cell carcinoma (CCPRCC).Methods The CT features of 6 patients with CCPRCC were analyzed retrospectively.The size,location,growth pattern,shape,texture,calcification,necrosis,hemorrhage,CT value,enhancement form and enhancement degree of the tumor and perirenal lymph nodes were observed.Results All 6 cases of CCPRCC were solitary lesions,of which 3 were located in the left kidney and 3 in the right kidney.Maximum tumor diameter ranged from 1.5 cm to 4.0 cm.The tumor margin was well-defined in 4 cases and ill-defined in two cases.All tumors showed expansive growth without invasion.There were three cases of endophytic growth and three cases of exophytic growth.Regarding tumor composition,only one case was cystic and the other five cases were solid.No calcification,necrosis and hemorrhage occurred in all the tumors.The CT value of tumors in unenhanced phase ranged from 31.2 HU to 42.5 HU.During the enhanced CT scan,5 cases showed highly enhancement and 1 case showed moderate enhancement.The CT value of tumors in corticomedullary phase ranged from 75.1 HU to 150.1 HU.In nephrographic phase,the enhancement degree in 1 case continued to increase,but it decreased in the other 5 cases.The CT value ranged from 73.3 HU to 102.2 HU.The enhancement degree in all 6 cases decreased in excretory phase and the CT value ranged from 52.6 HU to 79.1 HU.In the aspect of tumor enhancement form,only one case showed homogeneous enhancement and the other five cases showed heterogeneous enhancement.In addition,the peripheral renal lymph nodes were not enlarged in all patients,and no tumor invasion or tumor thrombus formation occurred in the renal vein.Conclusions CCPRCC has a relatively specific CT features that are easily distinguished from papillary renal cell carcinoma or chromophobe renal cell carcinoma,but it is difficult to identify from early-stage clear cell renal cell carcinoma.

【Objective】 To clarify the role and molecular mechanism of Tanshinone ⅡA (TanⅡA) in the pathological integration of granule cells in the dentate gyrus (DG) by using the mouse model of temporal lobe epilepsy (TLE). 【Methods】 Status epilepticus (SE) was induced in the mice with pilocarpine and treated with TanⅡA 5 mg/kg. After two months, Morris water maze was used to examine the spatial learning and memory ability and video surveillance was used to monitor spontaneous seizures. The DG was removed for staining of Timm, Prox-1, DCX and SynⅠ. PTEN, p-AKT, and p-S6 expressions were observed by Western blotting. 【Results】 TanⅡA decreased Timm score, SynⅠ, PSD-95 and pS6 levels, and increased the level of PTEN in the DG, and attenuated the formation of mossy fiber sproutings and basal dendrites of the granule cells. Video surveillance showed that TanⅡA reduced the frequency of Racine’ grade 5 seizures. 【Conclusion】 TanⅡA can effectively attenuate the abnormal integration of the granule cells in the DG by regulating PTEN/AKT/mTOR pathway and thus plays an anti-epileptic role.