[Objective] To investigate the clinical application of microscope-assisted subinguinal hierarchical dissection in the treatment of varicocele (VC), so as to provide reference for clinicians. [Methods] The clinical data of 113 VC patients admitted to our hospital during Jul.2021 and Jun.2022 were retrospectively analyzed.All patients were treated with microscope-assisted hierarchical anatomical spermatic vein ligation under the external ring, with layered isolation.The number of intraoperative ligations of the internal spermatic veins and external spermatic vein, preserved arteries as well as the number of lymphatic vessels were recorded. [Results] Among the 13 patients with a mean age of (28.7±6.0) years, 98 had left-side lesion and 15 had bilateral lesion.The degree of varicocele: degree Ⅱ in 44 cases and degree Ⅲ in 69 cases.Intraoperative ligation of the internal spermatic veins: (9.18±3.21) on the left side and (9.02±3.39) on the right side.Intraoperative ligation of the external spermatic veins: (1.47±0.93) on the left side and (1.41±1.10) on the right side.Preservation of the internal spermatic arteries: (2.03±1.07) on the left side, (1.97±0.99) on the right side.Preservation of the external spermatic arteries: (1.42±0.50) on the left side and (1.40±0.50) on the right side.Preservation of lymphatics: (3.87±2.07) on the left and (3.89±1.99) on the right. [Conclusion] Hierarchical dissection ensures the integrity of the vas deferens and its vascular system, and tubular isolation aids in intraoperative reference identification, avoid omission of tiny veins and injury to lymphatic vessels, which helps to improve the surgical skills of beginners or less experienced surgeons.

Objective To explore the current research situation,hotspots and development trend in the field of acupuncture and mox-ibustion intervention for post-stroke dysphagia(PSD). Methods The literature on acupuncture and moxibustion intervention for PSD was retrieved from CNKI,VIP and Wan-fang database from 1994 to December 31st,2023,and analyzed with VOSviewer and CiteSpace. Results A total of 1 816 articles were included,and the number of publications increased year by year,reaching a peak in 2021 with 180 articles.There were 274 core authors included in the literature,among which Cheng Hongliang,Zhou Hongfei and Feng Weixing were the authors with the highest publication volume.The First Affiliated Hos-pital of Tianjin University of Chinese Medicine was the most productive institution,and the connections between institutions were relatively scattered.The high-frequency keywords were swallowing dysfunction,stroke,acu-puncture and moxibustion therapy,as well as rehabilitation therapy,among which tongue triple acupuncture,elec-troacupuncture,nape acupuncture and scalp acupuncture were the most commonly used methods.In addition,acupuncture combined with rehabilitation training,electrical stimulation,or other methods for PSD and acupoint selection rules were also research hotspots.When evaluating the efficacy of acupuncture intervention for PSD,the focus gradually shifted from the effective rate to the use of videofluorographic swallowing study,water swal-lowing test,standardized swallowing assessment,surface electromyography and other indicators to evaluate the swallowing function and the severity of dysphagia. Conclusion Research on acupuncture and moxibustion interventions for PSD has developed rapidly,with hotspots in-cluding the selection of specific acupuncture and moxibustion techniques,the combination of acupuncture and moxibustion with other rehabilitation therapies,outcome indicators for acupuncture and moxibustion interven-tions in PSD,and the rules of acupoint selection.In the future,it is essential to strengthen academic exchanges and collaborations across institutions and regions.Greater emphasis should be placed on objective evaluation in-dicators of acupuncture and moxibustion therapies for improving the swallowing function in PSD patients,as well as on optimizing combinations of acupuncture and moxibustion with modern rehabilitation approaches,so as to better guide clinical practice.

To investigate the relationship between salt-inducible kinase 2 (SIK2) and lymph node metastasis in colorectal cancer patients complicated with chronic schistosomiasis. Tissue specimens were collected from 363 patients who were diagnosed as colorectal cancer by clinical and pathological examination in Wuhu Second People's Hospital from June 2015 to June 2020. Fifty-six patients were colorectal cancer complicated with schistosomiasis (CRC-S) and 307 patients were colorectal cancer not complicated with schistosomiasis (CRC-NS). The clinical and pathological data of the patients were analyzed to explore the relationship between chronic schistosomiasis and colorectal cancer. Immunohistochemistry and Western blotting were used to detect the distribution and expression of SIK2 in colorectal cancer specimens. The relationship between SIK2 and lymph node metastasis of CRC-S was analyzed. The rate of lymph node metastasis in CRC-S group was significantly higher than that in CRC-NS group (62.5% vs. 47.2%, <0.05). In CRC-S patients with lymph node metastasis, schistosome eggs were distributed mainly in tumor tissues (25/35, 71.4%), while in patients with CRC-S without lymph node metastasis, schistosome eggs were distributed mainly in paracancerous tissues (17/21, 81.0%) (14.243, <0.01). The SIK2 was mainly located in cytosol, and its expression in tumor tissues was higher than that in paracancerous tissues. Compared with CRC-NS patients, the expression of SIK2 in CRC-S patients was significantly increased; the expression of SIK2 in patients with lymph node metastasis was higher than that in patients without lymph node metastasis; and the expression of SIK2 in patients with schistosome eggs in cancer tissues was higher than that in patients with schistosome eggs in paracancerous tissues (all <0.01). Lymph node metastasis is more likely to be occurred in colorectal cancer patients with schistosomiasis, especially in those with schistosome eggs in tumor tissues. The expression of SIK2 may be correlated with chronic schistosomiasis, egg distribution and lymphatic metastasis.
Biomarkers, Tumor ; Colorectal Neoplasms/complications* ; Humans ; Immunohistochemistry ; Lymphatic Metastasis ; Neoplasm Staging ; Prognosis ; Schistosomiasis/complications*

Objective:To analyze the feasibility, safety and clinical efficacy of laparoscopic side-to-side jejunoileal anastomosis in the treatment of non-obese type 2 diabetes patients (BMI≤32.5 kg/m 2). Methods:The clinical data of 135 patients who underwent laparoscopic side-to-side jejunoileal anastomosis at our hospital from Jan 2018 to Oct 2018 were retrospectively analyzed. They were followed up for 12 months until the end of Oct 2019. SPSS software was used to compare patients′ fasting blood glucose, glycosylated hemoglobin, c-peptide, insulin, body weight, BMI with the values after 12 months of the surgery, and then evaluate factors affecting the prognosis.Results:135 patients successfully completed laparoscopic side-to-side jejunoileal anastomosis without conversion to open surgery. After 12 months of the operation, the patients′ fasting blood glucose was (5.80±0.18)mmol/L, glycosylated hemoglobin was 5.9%±0.4%, fasting c-peptide was(1.32±0.21) nmol/L, and fasting insulin was (42±54) mU/L ( t=10.654, 12.657, 11.214, 10.698, all P<0.05). The body weight was (72.4±9.9)kg, BMI was( 25.6±2.8)kg/m 2, and the difference was not statistically significant ( t=7.658, 6.958, P>0.05). In patients with preoperative glycosylated hemoglobin controlled below 8% and the duration of T2DM less than 10 years, the chances being cured was better than that of those with glycosylated hemoglobin>8% and the medical history >10 years. Conclusion:Laparoscopic side-to-side jejunoileal anastomosis in the treatment of non-obese type 2 diabetes is effective, safe and reliable.

Objective: To understand the current situation and associated factors of myopia among primary school students, and to provide scientific basis for prevention and control of myopia among primary school students. Methods: In Gansu, Guangdong, Guangxi, Guizhou, Liaoning, Shandong, Shanxi and other provinces, 1 prefecture was selected, and a number of primary schools were selected from each region. All the students in the class were selected as the object of this survey. A total of 8 365 middle school students were examined for their eyesight, and the data of general population economic indicators and natural environment indicators were obtained through the statistical yearbook of various provinces and cities. The influencing factors of primary school students myopia were analyzed by chi-square test and multivariate Logistic regression. Results: Univariate analysis showed that different provinces and different sex, different nationalities, different grade, parents average salary, sunshine duration, air temperature, altitude, longitude, latitude, different economic zone(χ2=116.22, 18.08, 26.33, 1 059.04, 14.86, 10.28, 16.95, 10.01, 23.15, 29.43, 88.14, P<0.05). Multivariate analysis results showed that gender, grade, sunshine duration, longitude were risk factor for poor vision(OR=1.31, 1.71, 1.45, 1.54, P<0.05); Economic zone and parents salary were protective factors for poor eyesight of students (OR=0.65, 0.86, P<0.05). Conclusion Myopia of primary school students is affected by a variety of factors, economic and social factors and natural environmental factors have an impact on the screening.

Objective To investigate the effect of genistein on the proliferation of human lung cancer PC14 cells and the underlying mechanisms. Methods Cell proliferation was examined using the MTT and colony formation assays. Western blotting was used to analyze protein expression levels. Results Genistein significantly inhibited the proliferation of PC14 cells in a concentration and time dependent manner. PD98059, SB203580, and SP100625, three specific inhibitors of the MAPK pathway, significantly inhibited the proliferation of PC14 cells. Moreover, genistein inhibited the phosphorylation of ERK and JNK in a dose dependent manner. Conclusion Genistein can inhibit the proliferation of PC14 cells, which may be related to its inhibitory effect on ERK and JNK activation.

Objective To investigate the effect of hepatitis B virus(HBV)infection on serum iron markers in pregnant women.Methods A total of 188 pregnant women with HBV infection and 157 normal pregnant women were recruited in this study.Serum levels of iron,ferritin,transferrin,HBV DNA,alanine aminotrans-ferase(ALT)and aspartate aminotransferase(AST)were measured and compared.Results At the same stage of pregnancy,the serum ferritin level in pregnant women with HBV infection was higher than that of normal pregnant women(Z= -1.72,P=0.04;Z= -2.33,P=0.01;Z= -4.42,P=0.01),while the serum transfer-rin concentration increased in normal pregnant women in the second and third trimesters,and the differences between the two groups were statistically significant(Z= -3.26,P<0.01;Z= -2.25,P=0.01).In pregnant women with HBV infection,the serum ferritin levels in patients with positive results of ALT and AST were higher than those in patients with negative results(ALT:P=0.01;AST:P=0.02),however,there was no change in healthy pregnant women.Conclusion There is iron metabolism imbalance in pregnant women with HBV infection.We should monitor serum iron markers to guide pregnant women for appropriate iron supple-mentation in gestation period.

OBJECTIVETo summarize the treatment status of gastric gastrointestinal stromal tumor (GIST) in Shandong province,by analyzing the clinicopathological features and prognostic factors.

METHODSClinicopathological and follow-up data of 1 165 patients with gastric GIST between January 2000 and December 2013 from 23 tertiary referral hospitals in Shandong Province were collected to establish a database. The risk stratification of all cases was performed according to the National Institutes of Health(NIH) criteria proposed in 2008. Kaplan-Meier method was used to calculate the survival rate. Log-rank test and Cox regression model were used for univariate and multivariate prognostic analyses.

RESULTSAmong 1 165 cases of gastric GIST, 557 were male and 608 were female. The median age of onset was 60 (range 15-89) years. Primary tumors were located in the gastric fundus and cardia in 623 cases(53.5%), gastric body in 346 cases(29.7%), gastric antrum in 196 cases(16.8%). All the cases underwent resection of tumors, including endoscopic resection (n=106), local resection (n=589), subtotal gastrectomy(n=399), and total gastrectomy(n=72). Based on the NIH risk stratification, there were 256 cases (22.0%) at very low risk, 435 (37.3%) at low risk, 251 cases (21.5%) at intermediate risk, and 223 cases (19.1%) at high risk. A total of 1 116 cases(95.8%) were followed up and the median follow-up period was 40 (range, 1-60) months. During the period, 337 patients relapsed and the median time to recurrence was 34 (range 1-60) months. The 1-, 3-, and 5-year survival rates were 98.6%, 86.1% and 73.4%, respectively. The 5-year survival rates of patients at very low, low, intermediate, and high risk were 93.1%, 85.8%, 63.0% and 42.3% respectively, with a statistically significant difference (P=0.000). Multivariate analysis showed that primary tumor site (RR=0.580, 95%CI:0.402-0.835), tumor size (RR=0.450, 95%CI:0.266-0.760), intraoperative tumor rupture(RR=0.557, 95%CI:0.336-0.924), risk classification (RR=0.309, 95%CI:0.164-0.580) and the use of imatinib after surgery (RR=1.993, 95%CI:1.350-2.922) were independent prognostic factors.

CONCLUSIONSThe choice of surgical procedure for gastric GIST patients should be based on tumor size. All the routine procedures including endoscopic resection, local excision, subtotal gastrectomy and total gastrectomy can obtain satisfactory curative outcomes. NIH classification has a high value for the prediction of prognosis. Primary tumor site, tumor size, intraoperative tumor rupture, risk stratification and postoperative use of imatinib are independent prognostic factors in gastric GIST patients.

Objective:To investigate the effect of sorafenib on the proliferation of human oral cancer TCA8113 cells and to explore the underlying mechanisms.Methods:Mter treated with sorafenib at 2.5,5,10,20 μg/ml respectively for48 h,TCA8113 cell proliferation was examined by MTT and colony formation assay.Western blotting was employed to examine the p38MAPK expression in the cells.TCA8113 cells were pretreated with 10 μmol/L of SB203580 (a specific inhibitor of p38MAPK) for 30 min,and then by different concentrations of sorafenib for 48 h,cell proliferation was tested by MTT assay.Results:Sorafenib significantly inhibited the proliferation of TCA8113 cells in a concentration dependent fashion.Sorafenib also remarkably promoted the activation of p38MAPK of the cells.SB203580 significantly alleviated soiafenib induced TCA8113 cell viability decrease.Conclusion:Sorafenib can inhibit the proliferation of TCA8113 cells,which may be related to the activation of p38MAPK.

Objective To study the clinical value of combined detection of D-dimer,PT,FIB and Cyc-C in the patients with nephrotic syndrome(NS) complicating thromboembolism.Methods Sixty-five patients with clinically diagnosed NS(observation group) in the Huangshi Municipal Central Hospital from April 2013 to March 2016 were selected and divided into the non-thromboembolism group(group A,45 cases) and thromboembolism group(group B,20 cases).Contemporaneous 43 individuals undergoing physical examination served as the control group(group C).The levels of Cys-C and 24 h urine protein were tested by the electrochemical luminescence method;meanwhile PT,FIB and D-dimmer levels were detected by the nephelometry method.Their changes in the patients with NS complicating thromboembolism were observed.Results The levels of Cys-C,24 h urine protein and D-dimer in the observation group were significantly higher than those in the control group (P＜0.01).The difference of PT and FIB levels were not statistically significant(P＞0.05);the D-dimer and Cys-C levels in the observation B group was significantly higher than that in the observation A group(P＜0.05),moreover the D-dimer level was positively correlated with Cys-C.Conclusion D-dimer and Cys-C can be used as the predictive factors of thromboembolism occurrence in NS patients.