Objective To explore the application of plasma 7 microRNA (miR7) testing in the differential diagnosis of very early-stage hepatocellular carcinoma (HCC). Methods This study is a multicenter real-world study. Patients with single hepatic lesion (maximum diameter≤2 cm) who underwent plasma miR7 testing at Zhongshan Hospital, Fudan University, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Anhui Provincial Hospital, and Peking University People’s Hospital between January 2019 and December 2024 were retrospectively enrolled. Patients were divided into very early-stage HCC group and non-HCC group, and the clinical pathological characteristics of the two groups were compared. The value of plasma miR7 levels, alpha-fetoprotein (AFP), and des-gamma-carboxy prothrombin (DCP) in the differential diagnosis of very early-stage HCC was evaluated using receiver operating characteristic (ROC) curves and area under the curve (AUC). In patients with both negative AFP and DCP (AFP＜20 ng/mL, DCP＜40 mAU/mL), the diagnostic value of plasma miR7 for very early-stage HCC was analyzed. Results A total of 64 528 patients from 4 hospitals underwent miR7 testing, and 1 682 were finally included, of which 1 073 were diagnosed with very early-stage HCC and 609 were diagnosed with non-HCC. The positive rate of miR7 in HCC patients was significantly higher than that in non-HCC patients (67.9% vs 24.3%, P＜0.001). ROC curves showed that the AUCs for miR7, AFP, and DCP in distinguishing HCC patients from the non-HCC individuals were 0.718, 0.682, and 0.642, respectively. The sensitivities were 67.85%, 43.71%, and 44.45%, and the specificities were 75.70%, 92.78%, and 83.91%, respectively. The pairwise comparison of AUCs showed that the diagnostic efficacy of plasma miR7 detection was significantly better than that of AFP or DCP (P＜0.05). Although its specificity was slightly lower than AFP and DCP, the sensitivity was significantly higher. Among patients negative for both AFP and DCP, miR7 maintained an AUC of 0.728 for diagnosing very early-stage HCC, with 67.82% sensitivity and 77.73% specificity. Conclusions Plasma miR7 testing is a potential molecular marker with high sensitivity and specificity for the differential diagnosis of small hepatic nodules. In patients with very early-stage HCC lacking effective molecular markers (negative for both AFP and DCP), miR7 can serve as a novel and effective molecular marker to assist diagnosis.

Hepatocellular carcinoma(HCC),commonly known as primary liver cancer,is a major cause of malignant tumors and cancer-related deaths in China,accounting for approximately 85％of all cancer cases in the country.Several guidelines have been used to diagnose and treat liver cancer.However,these guidelines provide a broad definition for classifying advanced liver cancer,with an emphasis on a singular approach,without considering treatment options for individual patients.Therefore,it is necessary to establish a comprehensive and practical expert consensus,specifically for China,to enhance the diagnosis and treatment of HCC using the Delphi method.The classification criteria were refined for Chinese patients with HCC,and the corresponding optimal treatment regimen recommendations were developed.These recommendations took into account various factors,including tumor characteristics,vascular tumor thrombus grade,distant metastasis,liver function status,portal hypertension,and the hepatitis B virus replication status of patients with primary HCC,along with treatment prognosis.The findings and rec-ommendations provide detailed,scientific,and reasonable individualized diagnosis and treatment strategies for clinicians.

Lenvatinib mesylate is an oral receptor tyrosine kinase inhibitor against targets of vascular endothelial growth factor receptors 1-3, fibroblast growth factor receptors 1-4, platelet-derived growth factor receptor α, stem cell growth factor receptor, and rearranged during transfection, et al. Lenvatinib has been approved by the National Medical Products Administration of China on September 4, 2018, for the first-line treatment of patients with unresectable hepatocellular carcinoma who have not received systematic treatment before. Up to February 2023, Lenvatinib has been listed in China for more than 4 years, accumulating a series of post-marketing clinical research evidences. Based on the clinical practice before and after the launch of lenvatinib and referring to the clinical experience of other anti-angiogenesis inhibitors, domestic multidisciplinary experts and scholars adopt the Delphi method to formulate the Chinese Expert Guidance on Overall Application of Lenvatinib in Hepatocellular Carcinoma after repeated discussions and revisions, in order to provide reference for reasonable and effective clinical application of lenvatinib for clinicians.

Lenvatinib mesylate is an oral receptor tyrosine kinase inhibitor against targets of vascular endothelial growth factor receptors 1-3, fibroblast growth factor receptors 1-4, platelet-derived growth factor receptor α, stem cell growth factor receptor, and rearranged during transfection, et al. Lenvatinib has been approved by the National Medical Products Administration of China on September 4,2018, for the first-line treatment of patients with unresectable hepatocellular carcinoma who have not received systematic treatment before. Up to February 2023, Lenvatinib has been listed in China for more than 4 years, accumulating a series of post-marketing clinical research evidences. Based on the clinical practice before and after the launch of lenvatinib and referring to the clinical experience of other anti-angiogenesis inhibitors, domestic multidisciplinary experts and scholars adopt the Delphi method to formulate the Chinese Expert Guidance on Overall Application of Lenvatinib in Hepatocellular Carcinoma after repeated discussions and revisions, in order to provide reference for reasonable and effective clinical application of lenvatinib for clinicians.

Objective:To study the clinical efficacy of ultrasound-guided radiofrequency acupotomy in early and middle-stage knee osteoarthritis (KOA).Methods:A total of 62 patients with KOA were enrolled and then randomly divided into the radiofrequency acupuncture group and the control group. The two groups were treated with radiofrequency acupotomy and conventional acupotomy under ultrasound guidance, respectively. The treatments were conducted once a week, twice in total. The Western Ontario and McMaster Universities Arthritis Index (WOMAC) of all the patients was evaluated before the treatment as well as the day, 2 weeks, and 1 month after the treatment.Results:Before the treatment, the differences between the two groups in gender, age, body mass index (BMI), WOMAC pain score, WOMAC stiffness score, WOMAC function score, and WOMAC total score were not statistically significant (all P>0.05), indicating the two groups were comparable. On the day, 2 weeks, and 1 month after the treatment, the above WOMAC scores of the two groups were lower than those before the treatment, and the differences were statistically significant (all P<0.01). The WOMAC scores of the radiofrequency acupotomy group were lower than those of the control group at the same period, and the differences were statistically significant (all P<0.05). Conclusions:For patients with early and middle-stage KOA, ultrasound-guided radiofrequency acupotomy therapy has proven clinical efficacy in relieving pain and improving knee joint function.

Objective:To explore the effect of individualized nursing based on the ADOPT problem solving model on the mental health and adaptive ability of patients undergoing orthognathic surgery.Methods:150 patients undergoing orthognathic surgery from January 2017 to April 2019 in the Oral and Maxillofacial Surgery of the First Affiliated Hospital of Zhengzhou University was selected as subjects by convenient sampling, they were divided into observation group and control group with 75 cases each. The mental health of patients before the intervention was surveyed and compared with the domestic adult norms. The control group received routine inpatient care, and the observation group received ADOPT model individualized care. Intervention was continuous from admission to 3-month follow-up. Symptom Check List-90 (SCL-90) and Social Psychological Adjustment Scale (SPAS) were performed to evaluate and compare psychological health symptoms and adaptability in both groups.Results:The scores of the five dimensions of obsessive-compulsive symptoms, interpersonal sensitivity, anxiety, hostility, and paranoia on the SCL-90 of 150 patients before the intervention were higher than those of domestic adult norms, the differences were statistically significant ( P<0.05) . After the intervention, the obsessive-compulsive symptoms, interpersonal sensitivity, anxiety, hostility, and paranoia in the observation group were lower than those in the control group with statistically significant differences ( P<0.05) . The dimissions scores and total scores of SPAS of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The application of individualized nursing based on ADOPT problem-solving model in patients undergoing orthognathic treatment can improve their mental health, especially obsessive-compulsive symptoms, interpersonal sensitivity, anxiety, hostility, and paranoia.

Objective: To provide reference for promoting the use of Tengyao in the treatment of pelvic inflammatory diseases (PID). Methods: From January to March 2017, 111 health workers in department of gynaecology were investigated. The quantitative research of KAP questionnaire was used, and the content of questionnaire included personal information, knowledge, attitudes and practices. Results: A total of 111 copies of questionnaire were distributed and 95. 5% of them were effective. Interviewees' overall knowledge was at low level while the attitude was at high level; the main way to obtain knowledge was coming from colleagues (76. 42% ); working lifetime and speciality classification had significant impacts on the level of knowledge (P<0. 05); the majority of interviewees were willing to learn the relevant knowledge through training sessions (54. 72% ) and new media (27. 36% ); 48 inter-viewees would like to continue to use Tengyao for treating PID. The main problem of Tengyao in the treatment of PID was inconvenient operation (63. 64% ). Totally 83. 96% of interviewees considered that the dosage forms of Tengyao should be improved, and 50. 94% of interviewees considered that the clinical efficiency evaluation should be studied. Conclusion: Interviewees'overall knowledge is still at low level, especially in the junior medical staff. Pharmacists should improve the knowledge level of medical staff by meeting train-ing, and study how to improve the dosage forms and evaluate the clinical efficiency of Tengyao.

OBJECTIVE:To investigate clinical efficacy and safety of Teng medicine combined with Gongyankang granules in the treatment of chronic pelvic inflammatory disease(CPID). METHODS:A total of 141 CPID outpatients were selected from our hospital during Jul. 2015-Jun.2016,other patients were divided into control group(65 cases)and observation group(76 cases)ac-cording to random number table. Control group was given Gongyankang granules 9 g orally,bid;observation group additionally re-ceived Teng medicine hot compress on lower abdomen for 30 min until it was cool,once a day,on the basis of control group. Both groups began the medication since third day after the menstrual period,for consecutive 20 d. TCM syndrome,local sign scores and clinical efficacies were compared between 2 groups before and after treatment,and the occurrence of ADR and recur-rence were observed in 2 groups. RESULTS:Before treatment,there was no statistical significance in TCM syndrome scores or lo-cal sign scores between 2 groups (P>0.05). After treatment,TCM syndrome scores and local sign scores of 2 groups were de-creased significantly,and the observation group was significantly lower than the control group,with statistical significance (P<0.05). Clinical total response of observation group were 92.11％,which were significantly higher than 70.77％ of control group, rate recurrence rate of observation group were 2.99％,which were significantly under than 15.79％ of control group,with statistical significance (P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Teng medicine hot compress combined with Gongyankang granules show significant efficacy for CPID,can improve TCM syndrome and local sign and reduce recurrence rate with good safety.

Objective:To investigate the effect of long-chain non-coding CDKN2B targeting miR-19 on the biological behavior of chronic myeloid leukemia cells and its mechanism.Methods: The expression of CDKN2B in different leukemia cells were detected by qPCR.Double luciferase reporter gene was used to detect the interaction between CDKN2B and miR-19.MTT proliferation assay and flow cytometry were used to detect the effect of CDKN2B on the proliferation and apoptosis of HL-60 cells.The changes of migration ability of leukemia HL-60 cells after overexpress of CDKN2B were detected by scratch test.The changes of invasion ability of leukemia HL-60 cells after silencing CDKN2B were detected by Transwell invasion assay.Scaling healing experiment and Transwell invasion assay were used to detect the effect of miR-19 on the migration and invasion of leukemia cells after silencing CDKN2B.The morphological changes of cytoskeleton microfilament microtubules after silencing CDKN2B were detected by phalloidin staining.Western blot was used to detect the expression of PI3K/AKT signaling pathway after silencing CDKN2B.Results: The expression level of CDKN2B was the lowest in leukemia cell HL-60.CDKN2B binds specifically to the 3′UTR of miR-19;overexpression of CDKN2B could inhibit the proliferation and enhance the apoptosis of leukemia HL-60 cells.Overexpression of CDKN2B can inhibit the invasion and migration of leukemia HL-60 cells.After overexpressed of CDKN2B,the cytoskeleton showed decreased pseudopodia and decreased exercise capacity.The expression of actin was down-regulated.The expression of PI3K/AKT pathway protein was down-regulated after overexpressed of CDKN2B.Conclusion: CDKN2B can target the regulation of miR-19 to regulate the biological behavior of leukemia cells.

OBJECTIVETo investigate the safety, feasibility, clinical value, indication, and distribution of diagnostic diseases in different age groups of colonoscopy in pediatric patients.

METHODSA retrospective analysis was performed on the data of pediatric patients receiving colonoscopy from April 2013 to June 2016 at The Sixth Affiliated Hospital of Sun Yat-sen University. Pediatric patients were divided into 0-6 years group (n=57) and 7-14 years group (n=172). Indication for colonoscopy, detective events and diagnostic diseases distribution were compared between two groups.

RESULTSA total of 229 pediatric patients (male 157 and female 72) were divided into 0-6 years group (57/229, 24.9%) and 7-14 years group(172/229, 75.1%). The main Indications for colonoscopy included abdominal pain (81/229, 35.4%), hematochezia (64/229, 27.9%), crissum abscess or fistula (40/229, 17.5%). Hematochezia was the most common complaint in 0-6 years group (40/57, 70.2%), while abdominal pain in 7-14 years group (74/172, 43.0%). Completion rate between 0-6 years group and 7-14 years group was not significantly different (87.72% vs. 85.47%, χ=0.181, P=0.671). Only one pediatric patient (1/229, 0.4%) developed transient oxygen desaturation and recovered quickly after oxygen supply and aspiration of sputum. No serious complications such as bleeding, perforation or death occurred. Including 45 pediatric patients in 0-6 years group and 102 pediatric patients in 7-14 years group, a total of 147 pediatric patients (147/229, 64.2%) were found to have colorectal lesions. Inflammatory bowel disease (57/147, 38.8%), colonic polyps (40/147, 27.2%) and other intestinal inflammation (39/147, 26.5%) were the main findings. The most frequent diagnosis in 0-6 years group was colonic polyps (28/57, 49.1%), among them, 25 pediatric patients (25/28, 89.3%) were with the complaint of hematochezia. The most frequent diagnosis in 7-14 years group was Inflammatory bowel disease (54/172, 31.4%), among them, 29 pediatric patients (29/54, 53.7%) were with the complaint of abdominal pain.

CONCLUSIONSPediatric colonoscopy is safe and effective. Hematochezia and abdominal pain are the most common complaints in 0-6 years group and 7-14 years group respectively. Colonic polyps and inflammatory bowel disease are the most frequent diagnosis in 0-6 years group and 7-14 years group respectively.