Objective To observe the effect of knee arthroscopic enlarged valve resection(AEVR)combined with cyst wall resection(CWR)on popliteal cyst.Methods A retrospective analysis was conducted on the clinical data of 80 patients with popliteal cyst from June 2022 to June 2023.They were divided into two groups based on different surgical methods.Group A received 39 cases of traditional open cystectomy(TOC),while group B received 41 cases of AEVR-CWR.The perioperative indicators,length of hospital stay,pain status,knee joint function,knee joint range of motion,popliteal cyst grading,postoperative complications,and cyst survival were compared between the two groups.Results The surgical bleeding volume,total incidence of postoperative complications,and residual cyst rate at 6 months after surgery in group B were lower than those in group A,the incision length,and hospital stay in group B were shorter than those in group A,surgery time in group B was longer than that in group A,the differences were statistically significant(P＜0.05).After surgery,the visual analogue scale(VAS)of both groups was lower than that before surgery,and group B was lower than group A,the difference was statistically significant(P＜0.05).After surgery,the Lysholm score of both groups were higher than that before surgery,and group B was higher than group A,the knee range of motion of both groups were greater than that before surgery,and group B was greater than group A,the differences were statistically significant(P＜0.05).After surgery,the Rauschning-Lindgren grading of both groups was better than that before surgery,and group B was better than group A,the difference was statistically significant(P＜0.05).Conclusion The combination of AEVR and CWR can reduce surgical bleeding,shorten incision length and hospital stay,alleviate pain,improve knee joint range of motion,knee joint function,and grading of popliteal cysts,reduce the total incidence of postoperative complications and the residual rate of cysts at 6 months after surgery,but the surgery time has been extended.

Objective To observe the effect of knee arthroscopic enlarged valve resection(AEVR)combined with cyst wall resection(CWR)on popliteal cyst.Methods A retrospective analysis was conducted on the clinical data of 80 patients with popliteal cyst from June 2022 to June 2023.They were divided into two groups based on different surgical methods.Group A received 39 cases of traditional open cystectomy(TOC),while group B received 41 cases of AEVR-CWR.The perioperative indicators,length of hospital stay,pain status,knee joint function,knee joint range of motion,popliteal cyst grading,postoperative complications,and cyst survival were compared between the two groups.Results The surgical bleeding volume,total incidence of postoperative complications,and residual cyst rate at 6 months after surgery in group B were lower than those in group A,the incision length,and hospital stay in group B were shorter than those in group A,surgery time in group B was longer than that in group A,the differences were statistically significant(P＜0.05).After surgery,the visual analogue scale(VAS)of both groups was lower than that before surgery,and group B was lower than group A,the difference was statistically significant(P＜0.05).After surgery,the Lysholm score of both groups were higher than that before surgery,and group B was higher than group A,the knee range of motion of both groups were greater than that before surgery,and group B was greater than group A,the differences were statistically significant(P＜0.05).After surgery,the Rauschning-Lindgren grading of both groups was better than that before surgery,and group B was better than group A,the difference was statistically significant(P＜0.05).Conclusion The combination of AEVR and CWR can reduce surgical bleeding,shorten incision length and hospital stay,alleviate pain,improve knee joint range of motion,knee joint function,and grading of popliteal cysts,reduce the total incidence of postoperative complications and the residual rate of cysts at 6 months after surgery,but the surgery time has been extended.

Circular RNAs (circRNAs) are a new class of non-coding RNAs, which have been confirmed to regulate insect gene expression and immune response through multiple manners such as competing endogenous RNA (ceRNA) regulatory network. Currently, function of circRNA in honey bee immune response remains unclear. In this study, PCR and Sanger sequencing were performed to validate the back splicing (BS) site of ame_circ_000115 (in short ac115). RT-qPCR was used to detect the expression profile of ac115 in larval guts of Apis mellifera ligustica stressed by Ascosphaera apis. Dual-luciferase reporter gene assay was conducted to verify the binding relationship between ac115 and ame-miR-13b. Interference of ac115 in larval guts was carried out by feeding specific siRNA, followed by determination of the effect of ac115 interference on expression of six genes relevant to host immune response. The results confirmed the existence of BS site within ac115. Compared with the un-inoculated group, the expression of ac115 in 4-day-old larval gut of the A. apis-inoculated group was up-regulated with extreme significance (P < 0.000 1), while that in 5- and 6-day-old larval guts were significantly up-regulated (P < 0.05). The brightness of specific band for ac115 in 4-, 5- and 6-day-old larval guts of the siRNA-circ_000115-fed group gradually became weak, whereas that of the siRNA-scrambl-fed group was pretty high without obvious variation. Compared with that of the siRNA-scramble-fed group, the expression of ac115 in 4-day-old larval gut of the siRNA-circ_000115-fed group was significantly down-regulated (P < 0.05), whereas that of the 5- and 6-day-old larval guts were down-regulated with extreme significance (P < 0.001). Ame-miR-13b was truly existed and expressed in A. m. ligustica larval guts, and there was true binding relationship between ac115 and ame-miR-13b. Compared with that of the siRNA-scramble-fed group, the expression of antimicrobial peptide genes hymenoptaecin and abaecin in 6-day-old larval gut of the siRNA-circ_000115-fed group was significantly up-regulated (P < 0.05), while that of ecdysone receptor (Ecr) was down-regulated with extreme significance (P < 0.01). These results indicate that ac115 is truly expressed in A. m. ligustica larval guts, BS site truly exists within ac115, and effective interference of ac115 in A. m. ligustica larval guts can be achieved via feeding siRNA. Moreover, ac115 potentially regulates Ecr expression through adsorption of ame-miR-13b and expression of hymenoptaecin and abaecin using a non-ceRNA manner, further participating in host stress-response.
Bees/genetics* ; Animals ; Larva/metabolism* ; RNA, Circular/genetics* ; RNA, Small Interfering/genetics* ; MicroRNAs/genetics*

Objective:To investigate the effect of sarcopenia on the perioperative clinical outcomes of esophageal squamous cell carcinoma (ESCC).Methods:The retrospective case-control study was conducted. The clinicopathological data of 1 148 ESCC patients who were admitted to the Affiliated Huaian No.1 People′s Hospital of Nanjing Medical University from January 2020 to December 2021 were collected. There were 789 males and 359 females, aged (67±7)years. All patients under-went thoracoscopic and laparoscopic radical esophagectomy for esophageal cancer. Observation indicators: (1) incidence of sarcopenia in patients with ESCC; (2) comparison of general data between ESCC patients complicated with sarcopenia and those without sarcopenia; (3) comparison of clinical outcomes between ESCC patients complicated with sarcopenia and those without sarcopenia; (4) analysis of influencing factors for sarcopenia in ESCC patients. Measurement data of normal distri-bution were represented by Mean± SD, and comparison between groups was conducted using the t test. Count data were represented as absolute numbers, and comparison between groups was conducted using the chi-square test. Ordinal data was analyzed using the Mann-Whitney U test. Logistic regression analysis was used to conduct univariate analysis. Logistic backward stepwise regression model was used to conduct multivariate analysis. Results:(1) Incidence of sarcopenia in patients with ESCC. Among 1 148 ESCC patients, 469 cases were complicated with sarcopenia, 679 were without sarcopenia. The incidence of sarcopenia was 40.854%(469/1 148). Among the 469 patients with sarcopenia, there were 313 males and 156 females. There were 125 cases <65 years old, 145 cases ≥65 years old but <70 years old, 106 cases ≥70 years old but<75 years old, 93 cases ≥75 years old, respectively. (2) Comparison of general data between patients with ESCC complicated with sarco-penia and those without sarcopenia. The age, tumor diameter, body mass index, cases in stage T1, T2, T3, preoperative albumin, preoperative serum prealbumin, psoas muscle index, psoas muscle density were (68±7)years, (3.3±1.5)cm, (22.4±2.9)kg/m 2, 100, 105, 264, (43±4)g/L, (193±38)mg/dL, (3.9±0.8)cm 2/m 2, (48±8)HU of 469 ESCC patients complicated with sarcopenia, versus (66±7)years, (3.2±1.4)cm, (23.8±3.0)kg/m 2, 173, 170, 336, (44±4)g/L, (206±37)mg/dL, (6.0±2.2)cm 2/m 2, (50±7)HU of 679 ESCC patients without sarcopenia, showing significant differences between the two groups ( t=5.74, 2.11, 7.57, Z=-2.93, t=2.25, 5.52,20.36, 4.18, P<0.05). (3) Comparison of clinical outcomes between patients with ESCC complicated with sarcopenia and those without sarcopenia. The duration of postoperative hospital stay, cases with postoperative hospital stay>30 days, pneumonia, acute respiratory failure, anastomotic fistula, and abnormal heart rhythm were (17±9)days, 32, 158, 39, 33, and 103 of 469 ESCC patients complicated with sarcopenia, respectively, versus (15±6)days, 15, 102, 18, 19, and 85 of 679 ESCC patients without sarcopenia, showing significant differences between the two groups ( t=4.89, χ2=15.04, 55.17, 18.86, 11.52, 18.06, P<0.05). (4) Analysis of influencing factors for sarcopenia in ESCC patients. Results of multivariate analysis showed that age ≥65 years was an independent risk factor for sarcopenia in ESCC patients ( odds ratio=1.64, 95% confidence interval as 1.26-2.14, P<0.05). Preoperative serum prealbumin ≥200 mg/dL, psoas muscle density ≥48 HU and body mass index >24 kg/m 2 were independent protective factors for sarcopenia in ESCC patients ( odds ratio=0.64, 0.72, 0.53, 95% confidence interval as 0.50-0.82, 0.56-0.92, 0.41-0.69, P<0.05). Conclusions:Age ≥65 years is an independent risk factor for sarcopenia in ESCC patients. Preoperative serum prealbumin ≥200 mg/dL, psoas muscle density ≥48 HU and body mass index >24 kg/m 2 are independent protective factors for sarcopenia in ESCC patients. Compared with patients without sarcopenia, ESCC patients with sarcopenia are more prone to postoperative compli-cations such as pneumonia, acute respiratory failure, anastomotic fistula, and arrhythmia, and have a longer postoperative hospital stay.

Objective:To investigate the oncological efficacy and functional evaluation of total elbow arthroplasty (TEA) for the reconstruction of tumor around elbow joint.Methods:A retrospective case series study was made on the clinical data of 26 patients who underwent total elbow joint replacement after tumor resection in Beijing Jishuitan Hospital from June 1988 to June 2019. According to the inclusion and exclusion criteria, 23 patients were enrolled in the final study, there were 14 males and 9 females, the mean and median age was 37.6±19.9 and 35.0 years respectively. 23 patients included 3 cases of giant cell tumor, 4 cases of metastatic cancer, 4 cases of Ewing's sarcoma, 2 cases of osteosarcoma, 2 cases of aneurysmal bone cyst, 1 angiosarcoma, 1 primary malignacy in giant cell tumor, 1 low-grade central osteosarcoma, 1 parosteosarcoma, 1 synovial sarcoma, 1 plasma cell myeloma, 1 tendon sheath giant cell tumor and 1 case of mixed tumor. There were 6 cases of benign tumor, 4 cases of low grade sarcoma and 13 cases of high grade malignancy. With 19 cases of distal humerus, 3 cases of proximal ulna and 1 case of elbow. Each patient underwent tumor resection followed by restrictive tumor prosthesis and semi-restrictive of coonrad-morrey prosthesis were used for reconstruction.The duration of the operation, the amount of blood loss, epidemiological data, reconstruction length, oncology parameter, complications and functional evaluation were enrolled and statistical analyzed.Results:The mean length of the osteotomy followed by reconstruction was 12.5±3.9 cm, the mean operative time was 154.1±50.1 minutes, and the mean bleeding was 262.2±100.9 ml. Thirteen patients were treated with customized tumor limited prosthesis while 10 patients with Coonrad-Morrey semi-limited prosthesis. The 5-year survival rates of 23 patients was 64.3%, benign tumors, low-grade and high-grade malignancies were 100%, 100% and 39.7%, respectively. Three cases of lung cancer and three cases of Ewing's sarcoma died during the follow-up period (6/23, 26.1%), one case of giant cell tumor and one case of synovial sarcoma developed local recurrence (2/23, 8.7%). The median range of motion for the elbow increased from 35 to 85 degrees ( t=-13.787, P<0.05), the median NRS score decreased from 5.0 to 0.5 ( t=14.391, P<0.05). Postoperative complications occurred in 9 cases (9/23, 39.1%), the recent complications were nerve injury in 4 cases and infection in 1 case, late complications were prosthesis loosening and failure in 4 cases, the 5 year survival rate of prosthesis was 82.0%. The mean and median MSTS 93 score was 84.5%±11.0% and 88.3% respectively. Conclusion:The local control around the elbow is satisfactory after tumor resection. Total elbow arthroplasty can relieve pain and significantly improve function.

BACKGROUND: The mortality rate of lung cancer meningeal metastasis is extremely high. Circulating tumor DNA (ctDNA) has been confirmed to be contain the genomic alterations present in tumors and has been used to monitor tumor progression and response to treatments. Due to the presence of blood-brain barrier and other factors, peripheral blood ctDNA cannot reflect the information of brain lesions for patients with meningeal metastases. However, cerebrospinal fluid ctDNA as a test sample can better reflect the genetic status of intracranial tumors and guide clinical targeted treatment of intracranial lesions. This study explored the feasibility of cerebrospinal fluid ctNDA for evaluating non-small cell lung cancer (NSCLC) meningeal metastasis and the potential clinical value of cerebrospinal fluid ctDNA detection in NSCLC meningeal metastasis. METHODS: A total of 21 patients with NSCLC meningeal metastasis were included. Tumor genomic variation was performed on the cerebrospinal fluid and peripheral blood samples of patients by second-generation gene sequencing technology. The situation was examined, and pathological evaluation of cerebrospinal fluid cytology and head magnetic resonance imaging (MRI) enhanced examination were performed. RESULTS: ctDNA was detected in the cerebrospinal fluid of 21 patients. The sensitivity of cerebrospinal fluid ctDNA detection was superior to cytology in the diagnosis of meningeal metastasis (P<0.001). The detection rate and gene mutation abundance of cerebrospinal fluid were higher than plasma (P<0.001). Cerebro-spinal fluid had a unique genetic profile. In 6 patients with dynamic detection, changes of ctDNA allele fraction occurred at the same time or earlier than clinical disease changes, which could timely monitor drug resistance mechanism and relapse trend. CONCLUSIONS The detection rate of ctDNA in cerebrospinal fluid is higher than that in cytology and imaging. The detection of ctDNA in cerebrospinal fluid can reveal the specific mutation map of meningeal metastasis lesions. The dynamic monitoring of ctDNA in cerebrospinal fluid has hint significance for clinical response of lung cancer patients.

To discuss therapeutic effect of intravenous drip of monosialic tetrahexose ganglioside (MTG) combined comprehensive rehabilitation on patients with stroke hemiplegia and its impact on neurologic impairment score (NIS).Methods : A total of 100 patients with stroke hemiplegia treated in our hospital were randomly and e‐qually divided into routine treatment group (received routine comprehensive training treatment including work ther‐apy ,exercise therapy etc .) and combined treatment group (received intravenous drip of MTG based on routine treatment group) ,both groups were continuously treated for four weeks .Limb and neurologic function ,and im‐provement of quality of life (QOL) were compared between two groups .Results : Oneight weeks after treatment , total effective rate of limb function in combined treatment group was significantly higher than that of routine treat‐ment group (94. 0% vs.76. 0%, P＝0.030) ;after one ,four and eight‐week treatment ,along with time went on , there was significant rise in Glasgow coma scale (GCS) score in two groups ,and those of combined treatment group were significantly higher than those of routine treatment group [one week :(8. 56 ± 2. 47) scores vs .(7.24 ± 2.01) scores ,four weeks :(11.26 ± 2.81) scores vs .(9.23 ± 2. 01) scores ,eight weeks :(13.28 ± 3.43) scores vs .(11. 43 ± 2.65) scores] , P＜0. 01 all ;compared with before treatment ,there were significant rise in each dimension score of QOL in two groups after eight‐week treatment ,and each dimension score of combined treatment group was sig‐nificantly higher than that of routine treatment group , P＝0. 001 all.Conclusion : Intravenous drip of MTG com‐bined comprehensive rehabilitation possesses significant therapeutic effect on patients with stroke hemiplegia .It can significantly improve limb and neurologic function state ,improve quality of life in these patients .

Objective To investigate the predictive value of CT signs in the pathological Fuhrman grading of clear cell renal carcinoma (ccRCC).Methods The clinicopathological features and CT findings of 72 patients with ccRCC which confirmed by operation and pathology were analyzed retrospectively.According to the WHO Fuhrman grading,all patients were divided into low-grade(Fuhrman gradeⅠorⅡ)or high-grade (Fuhrman gradeⅢorⅣ).ChiG square test and t-test were used to compare the clinical data and CT findings between the two groups,including morphological features (site,whether the renal medulla invasion,morphology,growth pattern,border,pseudo-envelope,lobulation sign,interface,perirenal fascia and the same lateral adrenal invasion,renal sinus and perirenal fat invasion,venous invasion,lymphadenopathy, maximum diameter),density (bleeding,necrosis ratio,calcification,fat)and enhancement characteristics (the degree of enhancement, strengthening method).And the pathological Fuhrman grading was the gold standard.The ROC was used to analyze the diagnostic efficacy of CT signs on Fuhrman grading.The Delong test was used to compare the AUC of different CT signs.Results There were significant differences in tumor maximum diameter,the renal medulla invasion,and lobulation sign between the Fuhrman low-grade and high-grade group(χ2/t＝－4.31 7,9.794,7.325,P＜0.05).There were no differences in gender,age,location sign,morphology,growth pattern, border,pseudo-envelope,interface,perirenal fascia and ipsilateral adrenal invasion,renal sinus and perirenal fat invasion,necrosis ratio,degree of enhancement,strengthening method between two groups (P＞0.05). The largest diameter of the tumor,the renal medulla invasion and the lobulation sign were useful for Fuhrman diagnosis.The AUC was 0.778,0.647 and 0.644,respectively.And there were significant differences between the maximum diameter and the renal medulla invasion or lobulation sign (P＜0.05).Conclusion The maximum diameter,medulla and lobular sign can predict the Fuhrman grading of ccRCC,and the maximum diameter prediction is the most accurate.

Objective To investigate the application of bundles of intervention in the treatment of postoperative delirium in esophageal cancer.Methods Thirty-six cases of delirium associated with esophageal cancer(study group)after the application of bundles of intervention in the Affiliated Huaian No.1 People's Hospital of Nanjing Medical University from November 2015 to August 2016 were analyzed,and 41 cases of postoperative delirium(control group)from January 2015 to October 2015 were treated by routine treatment.Results The mean duration of postoperative delirium was(3.6±0.8)d in the study group and(4.7± 1.2)d in the control group,and the difference was statistically significant(t =4.783,P<0.01).The incidence rates of other complications in the study group and control group were 19.4％(7/36)and 34.1％(14/41),respectively,and there was no significant difference(χ2=2.089,P=0.148).The incidence rates of accidental events in the study group and control group were 13.9％(5/36)and 31.7％(13/41),respectively,and the difference was statistically significant(χ2= 4232,P= 0.040).There was no significant difference in the postoperative exhaust time and removal of chest tube drainage time between the two groups(both P＞ 0.05),but there was a significant difference in postoperative hospital stay and hospital costs between the two groups(t values were 4.726 and 2.065,both P<0.05).Conclusions In the treatment of postoperative delirium in esophageal cancer,applying the bundles of intervention concept is feasible and effective.It can significantly reduce postoperative delirium duration and accelerate the rehabilitation of patients.

OBJECTIVETo compare the difference in CT manifestations between primary colorectal mucinous adenocarcinoma and signet ring cell carcinoma in order to improve radiologic diagnosis.

METHODSClinicopathological data and CT findings of 109 patients with colorectal mucinous adenocarcinoma and 46 patients with primary colorectal signet-ring cell carcinoma confirmed by surgery and pathology from March 2008 to February 2015 in the Tumor Hospital of Yunnan Province were retrospectively collected. Differences in age, gender, tumor location, length and thickness of the involved intestinal wall, thickening pattern of the intestinal wall, lesion density, calcification, contrast-enhanced form, peri-intestinal invasion, occurrence of intestinal obstruction and metastasis of other organs were compared between the two groups.

RESULTSAmong 109 patients with colorectal mucinous adenocarcinoma, 68 were men and 41 were women with a mean age of (56.8±15.4) years. Among 46 patients with primary colorectal signet-ring cell carcinoma, 26 were men and 20 were women with a mean age of (42.9±15.6) years. Compared with mucinous adenocarcinoma group, signet-ring cell carcinoma group showed more concentric bowel-wall thickening[93.5%(43/46) vs. 81.6%(89/109), χ=9.19, P=0.030], higher lesion density [(42.0±3.0) Hu vs. (28.5±1.5) Hu, t=37.30, P=0.000], more marked enhancement [54.3%(25/46) vs. 12.8%(14/109), χ=35.21, P=0.000], less vast-low-density region in enhanced CT imaging[2.2%(1/46) vs. 45.0%(49/109), χ=73.31, P=0.000] and more severe peri-intestinal invasion [41.3% (19/46) vs. 17.4%(19/109), χ=10.25, P=0.006]. Calcification was found in 18.3%(20/109) of mucinous adenocarcinoma cases, but was not found in signet-ring cell carcinoma cases (χ=9.69, P=0.002). Target ring sign in contrast-enhanced scan was observed in 15.2%(7/46) of signet-ring cell carcinoma cases, while in none of mucinous adenocarcinoma cases (χ=17.37, P=0.000). There were no statistically significant differences in lesion location, length and thickness of the involved intestinal wall, occurrence of intestinal obstruction, lymph node metastasis, liver or peritoneum metastasis between two groups(all P>0.05).

CONCLUSIONSSignet-ring cell carcinoma is often found in younger patients, whose CT manifestation is characterized by the target ring sign in contrast-enhanced scan, while primary colorectal mucinous adenocarcinoma is often in older patients, whose CT manifestation is characterized by calcification in unenhanced scan and low density region in enhanced CT show.

Adenocarcinoma, Mucinous ; diagnostic imaging ; pathology ; Adult ; Age Factors ; Aged ; Calcinosis ; diagnostic imaging ; pathology ; Carcinoma, Signet Ring Cell ; diagnostic imaging ; pathology ; China ; Colorectal Neoplasms ; diagnostic imaging ; pathology ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Retrospective Studies ; Tomography, X-Ray Computed ; methods