Objective To compare the short-term outcomes and postoperative complications of endoscopic submucosal dissection(ESD)and endoscopic mucosal resection(EMR)in the treatment of early colorectal cancer.Methods A total of 110 patients with early colorectal cancer who were admitted to Suining Central Hospital from June 2020 to June 2022 were prospectively enrolled and randomly assigned to two groups by random number table.Of them,58 patients underwent ESD and 52 patients underwent EMR.Operation related indexes,inflammatory factors(interleukin-6[IL-6],tumor necrosis factor-α[TNF-α],and C-reactive protein[CRP])before operation and 3 days after operation,and postoperative quality of life index(QL-Index)were compared between the two groups.The complications of the two groups were observed.Results The operation time,hospital stay,postoperative exhaust time,defecation time,and intraoperative blood loss in ESD group were lower than those in EMR group,and the rates of complete resection and en bloc resection in ESD group were higher than those in EMR group(P<0.05).The levels of IL-6,TNF-α and CRP were increased 3 d after operation in both groups,but the levels of IL-6,TNF-α and CRP in ESD group were lower than those in EMR group(P<0.05).The total score of QL-Index and the scores of activity,daily activities,health,and overall situation in ESD group were significantly higher than those in EMR group(P<0.05).The incidence of complications in ESD group was higher than that in EMR group,without significant difference(P>0.05).Conclusion The pocket ESD can effectively promote postoperative rehabilitation,increase resection rate,reduce postoperative inflammation,and improve the quality of life of patients with early colorectal cancer,and there is no obvious complication.

Objective:To investigate the value of transabdominal bowel ultrasonography (TBUS) in evaluating the active phase of Crohn′s disease (CD) and its complications, and to compare the diagnostic efficacy of the international bowel ultrasound segmental activity score (IBUS-SAS) and the multidetector computed tomography enterography (MDCTE) score in the active phase.Methods:A totle of 103 CD patients who were admitted to the Nanjing Drum Tower Hospital from March 2021 to May 2023 were retrospectively analyzed. All patients underwent TBUS and MDCTE examinations. TBU parameters such as bowel wall thickness (BWT), color Doppler imaging signal (CDS), inflammatory fat (i-fat), and bowel wall stratification (BWS) were recorded. The patients were divided into the remission group and the active group based on the Crohn′s disease activity index. The latter group was further divided into the mild active group and the moderate-to-severe active group.Receiver operating characteristic curves (ROC) were plotted, and the diagnostic efficacy of TBUS parameters and two scoring systems in assessment of the active phase of CD was evaluated by sensitivity, specificity, area under the curve (AUC), and optimal cut-off values. Endoscopic or histopathological results were served as the gold standard for the diagnosis of intestinal strictures. The diagnostic efficacy of TBUS and MDCTE in CD complicated with intestinal stenosis were evaluated by ROC analysis. Spearman correlation analysis was performed to analyze the correlation between TBUS parameters, imaging scores, and clinical laboratory indicators such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and faecal calprotectin (FC).Results:In distinguishing the active phase and the remission phase of CD, BWT (a sensitivity of 85.7%, specificity of 90.9%, and cut-off value of 4.4 mm), CDS (a sensitivity of 95.7%, and specificity of 63.6%), IBUS-SAS (a sensitivity of 91.4%, specificity of 84.8%, and cut-off value of 23.8), and MDCTE score (a sensitivity of 77.1%, specificity of 75.8%, and cut-off value of 6.5) had high diagnostic efficacies. In distinguishing mild and moderate-severe active phases of CD, BWT, CDS and i-fat demonstrated high sensitivity (81.4%, 69.8% and 62.8%) and specificity (81.5%, 77.8% and 100.0%); IBUS-SAS (a sensitivity of 83.7%, specificity of 88.9%, and cut-off value of 40.0) and MDCTE score (a sensitivity of 83.7%, specificity of 85.2%, and cut-off value of8.5) had high diagnostic efficacy. In the diagnosis of CD complicated with intestinal stenosis, the AUC, sensitivity, specificity, and accuracy of MDCTE was 0.942, 94.0%, 94.3%, and 94.2%, respectively. The AUC, sensitivity, specificity, and accuracy of TBUS in the diagnosis of CD complicated with intestinal stenosis was 0.952, 96.0%, 94.3%, and 95.1%, respectively. The results of Spearman correlation analysis revealed that BWT, CDS, and i-fat have positively correlated with ESR, CRP, and FC ( r value: 0.252 to 0.451, all P<0.05). Conclusions:TBUS demonstrates good application value in evaluating the activity of CD and intestinal stenosis. IBUS-SAS has the potential application for precise assessment of CD activity.

Objective:To compare the clinical outcomes of capsular closure versus those of non-closure in hip arthroscopy for femoroacetabular impingement (FAI) through a meta-analysis of randomized controlled trials (RCTs).Methods:A systematic search was conducted in Cochrane Library, PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang Database for RCTs comparing capsular closure with non-closure in hip arthroscopy for FAI, covering the period from database inception to October 2024. A meta-analysis was performed using RevMan 5.3 software to compare outcomes between patients undergoing hip arthroscopy with capsular closure versus those without capsular closure within 2 years postoperatively. The following parameters were evaluated: the modified Harris hip score (mHHS), 12-item International Hip Outcome Tool (iHOT-12), hip outcome score-activities of daily living (HOS-ADL), hip outcome score-sport specific (HOS-SSS), Copenhagen hip and groin outcome score (HAGOS), visual analog scale (VAS) for pain, reoperation rate, complication rate, and rate of patient satisfaction.Results:A total of 5 RCTs involving 432 patients were included, with 215 cases in the capsular closure group and 217 cases in the non-closure group. The follow-up duration for the patients in the included studies ranged from 12 to 24 months. Meta-analysis revealed no significant differences between the capsular closure and non-closure groups in postoperative functional scores (mHHS, iHOT-12, HOS-SSS, HAGOS), VAS pain score, reoperation rate, complication rate, or rate of patient satisfaction ( P>0.05). The capsular closure group demonstrated significantly better HOS-ADL at 2 years postoperatively than the non-closure group (MD=-3.57, 95% CI: -5.86 to -1.28, P=0.002). Conclusion:In patients with FAI undergoing hip arthroscopy, compared to the non-closure, capsular closure leads to significant improvements in mid-term daily activities, but similar outcomes in short-term hip function, pain control, reoperation rate, and complication incidence.

Objective:To compare the clinical outcomes of capsular closure versus those of non-closure in hip arthroscopy for femoroacetabular impingement (FAI) through a meta-analysis of randomized controlled trials (RCTs).Methods:A systematic search was conducted in Cochrane Library, PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang Database for RCTs comparing capsular closure with non-closure in hip arthroscopy for FAI, covering the period from database inception to October 2024. A meta-analysis was performed using RevMan 5.3 software to compare outcomes between patients undergoing hip arthroscopy with capsular closure versus those without capsular closure within 2 years postoperatively. The following parameters were evaluated: the modified Harris hip score (mHHS), 12-item International Hip Outcome Tool (iHOT-12), hip outcome score-activities of daily living (HOS-ADL), hip outcome score-sport specific (HOS-SSS), Copenhagen hip and groin outcome score (HAGOS), visual analog scale (VAS) for pain, reoperation rate, complication rate, and rate of patient satisfaction.Results:A total of 5 RCTs involving 432 patients were included, with 215 cases in the capsular closure group and 217 cases in the non-closure group. The follow-up duration for the patients in the included studies ranged from 12 to 24 months. Meta-analysis revealed no significant differences between the capsular closure and non-closure groups in postoperative functional scores (mHHS, iHOT-12, HOS-SSS, HAGOS), VAS pain score, reoperation rate, complication rate, or rate of patient satisfaction ( P>0.05). The capsular closure group demonstrated significantly better HOS-ADL at 2 years postoperatively than the non-closure group (MD=-3.57, 95% CI: -5.86 to -1.28, P=0.002). Conclusion:In patients with FAI undergoing hip arthroscopy, compared to the non-closure, capsular closure leads to significant improvements in mid-term daily activities, but similar outcomes in short-term hip function, pain control, reoperation rate, and complication incidence.

Objective:To investigate the value of transabdominal bowel ultrasonography (TBUS) in evaluating the active phase of Crohn′s disease (CD) and its complications, and to compare the diagnostic efficacy of the international bowel ultrasound segmental activity score (IBUS-SAS) and the multidetector computed tomography enterography (MDCTE) score in the active phase.Methods:A totle of 103 CD patients who were admitted to the Nanjing Drum Tower Hospital from March 2021 to May 2023 were retrospectively analyzed. All patients underwent TBUS and MDCTE examinations. TBU parameters such as bowel wall thickness (BWT), color Doppler imaging signal (CDS), inflammatory fat (i-fat), and bowel wall stratification (BWS) were recorded. The patients were divided into the remission group and the active group based on the Crohn′s disease activity index. The latter group was further divided into the mild active group and the moderate-to-severe active group.Receiver operating characteristic curves (ROC) were plotted, and the diagnostic efficacy of TBUS parameters and two scoring systems in assessment of the active phase of CD was evaluated by sensitivity, specificity, area under the curve (AUC), and optimal cut-off values. Endoscopic or histopathological results were served as the gold standard for the diagnosis of intestinal strictures. The diagnostic efficacy of TBUS and MDCTE in CD complicated with intestinal stenosis were evaluated by ROC analysis. Spearman correlation analysis was performed to analyze the correlation between TBUS parameters, imaging scores, and clinical laboratory indicators such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and faecal calprotectin (FC).Results:In distinguishing the active phase and the remission phase of CD, BWT (a sensitivity of 85.7%, specificity of 90.9%, and cut-off value of 4.4 mm), CDS (a sensitivity of 95.7%, and specificity of 63.6%), IBUS-SAS (a sensitivity of 91.4%, specificity of 84.8%, and cut-off value of 23.8), and MDCTE score (a sensitivity of 77.1%, specificity of 75.8%, and cut-off value of 6.5) had high diagnostic efficacies. In distinguishing mild and moderate-severe active phases of CD, BWT, CDS and i-fat demonstrated high sensitivity (81.4%, 69.8% and 62.8%) and specificity (81.5%, 77.8% and 100.0%); IBUS-SAS (a sensitivity of 83.7%, specificity of 88.9%, and cut-off value of 40.0) and MDCTE score (a sensitivity of 83.7%, specificity of 85.2%, and cut-off value of8.5) had high diagnostic efficacy. In the diagnosis of CD complicated with intestinal stenosis, the AUC, sensitivity, specificity, and accuracy of MDCTE was 0.942, 94.0%, 94.3%, and 94.2%, respectively. The AUC, sensitivity, specificity, and accuracy of TBUS in the diagnosis of CD complicated with intestinal stenosis was 0.952, 96.0%, 94.3%, and 95.1%, respectively. The results of Spearman correlation analysis revealed that BWT, CDS, and i-fat have positively correlated with ESR, CRP, and FC ( r value: 0.252 to 0.451, all P<0.05). Conclusions:TBUS demonstrates good application value in evaluating the activity of CD and intestinal stenosis. IBUS-SAS has the potential application for precise assessment of CD activity.

Intracerebral hemorrhage (ICH) is a hemorrhagic cerebrovascular disease with high incidence and mortality. Oxidative stress response plays an important role in the pathological and physiological processes of ICH, and is also a potential effective target for clinical treatment. In this paper, the pathogenesis of oxidative stress after ICH, mechanism of nerve and vascular injury in oxidative stress, and detection and treatment of oxidative stress are reviewed in order to provide references for basic research and clinical practice in ICH.

Objective To evaluate the effect of preoperative visits using virtual reality(VR)tech-nology on alleviating perioperative anxiety in children undergoing adenotonsillectomy for obstructive sleep ap-nea syndrome(OSAS).Methods Sixty children with OSAS scheduled for elective adenotonsillectomy were selected,including 32 males and 28 females,aged 6 to 12 years,ASA physical status Ⅰ or Ⅱ.The chil-dren were randomly divided into two groups using random number table:control group and VR group,30 children in each group.The control group received routine education and preoperative visits,while the VR group used VR smart glasses to play videos of three-dimensional scenes of the operating room in addition to routine visits.The modified Yale preoperative anxiety scale-short form(m-YPAS-SF)was used to assess perioperative anxiety levels.The heart rates(HR)of the children on the day before surgery,upon entering the preparation room,and immediately after anesthesia induction,and the induction compliance checklist(ICC)was used to evaluate anesthesia induction compliance,as well as the duration of stay in the recovery room and the length of hospital stay were recorded.Results Compared with control group,the m-YPAS-SF scores in VR group were significantly lower(P＜0.05),the HR was significantly lower upon entering the preparation room and immediately after anesthesia induction(P＜0.05),and the ICC scores were signifi-cantly lower(P＜0.05),recovery room stay duration and length of hospital stay were significantly short-ened(P＜0.05).Conclusion Preoperative visits using VR can effectively alleviate perioperative anxiety in children with OSAS undergoing adenotonsillectomy which can improve anesthesia compliance and reduce the length of hospital stay.

Orthodontic tooth movement elicits alveolar bone remodeling and orofacial pain that is manifested by tooth mechanical hyperalgesia. Nerve growth factor (NGF) is upregulated in periodontium and may modulate tooth mechanical hyperalgesia. The objectives were to examine the role of NGF in tooth mechanical hyperalgesia and to elucidate the underlying mechanisms. Tooth mechanical hyperalgesia was induced by ligating closed coil springs between incisors and molars in Sprague-Dawley rats. Retrograde labeling was performed by periodontal administration of fluor-conjugated NGF and the detection of fluorescence in trigeminal ganglia (TG). Lentivirus vectors carrying NGF shRNA were employed to knockdown the expression of NGF in TG. The administration of agonists, antagonists, and virus vectors into TG and periodontium was conducted. Tooth mechanical hyperalgesia was examined through the threshold of biting withdrawal. Our results revealed that tooth movement elicited tooth mechanical hyperalgesia that could be alleviated by NGF neutralizing antibody and that NGF was upregulated in periodontium (mainly in periodontal fibroblasts) and TG. Retrograde labeling revealed that periodontal NGF was retrogradely transported to TG after day 1. Acid-sensing ion channel 3 (ASIC3) and NGF were co-expressed in trigeminal neurons and the percentage of co-expression was significantly higher following tooth movement. The administration of NGF and NGF neutralizing antibody into TG could upregulate and downregulate the expression of ASIC3 in TG, respectively. NGF aggravated tooth mechanical hyperalgesia that could be alleviated by ASIC3 antagonist (APETx2). Moreover, NGF neutralizing antibody mitigated tooth mechanical hyperalgesia that could be recapitulated by ASIC3 agonist (GMQ). NGF-based gene therapy abolished tooth mechanical hyperalgesia and downregulated ASIC3 expression. Taken together, in response to force stimuli, periodontal fibroblasts upregulated the expressions of NGF that was retrogradely transported to TG, where NGF elicited tooth mechanical hyperalgesia through upregulating ASIC3. NGF-based gene therapy is a viable method in alleviating tooth-movement-induced mechanical hyperalgesia.

Objective To explore the CT features of pulmonary lymphangiomyomatosis (PLAM).Methods Clinical and high resolution CT (HRCT)data of 14 patients with pathologically proved PLAM were analyzed retrospectively.The clinical and CT features were summarized by combining the literatures.Results All 14 cases were female.They all presented with dyspnea in different degree after the activity. Scattered or widely distributed translucent and cystic lesions with indistinct walls in bilateral lungs were seen on routine CT images. HRCT showed homogeneous clear thin-walled cysts with diameter ranging from several millimeters to 25 mm,wall thickness of 1-2 mm,and surrounded by normal lung tissue.Meanwhile,blood vessels were found around the cysts,and there were no central lobular cores.The cysts were different sizes and irregular distribution.6 patients had extra-pulmonary CT manifestations:1 case with intracranial multiple sclerosis, hepatic and renal angiomyolipomas,and hepatic multiple hemangiomas,3 cases with mediastinal,hepatic and renal angiomyolipomas, and 2 cases with retroperitonea lymphangioleiomyomatosis.Conclusion The CT of PLAM is characterized by the diffuse distribution of thin-walled cystic cavities and the wall thickness is generally uniform.The typical manifestations of HRCT combined with clinical data have great values in the early diagnosis and differential diagnosis.

Objective To explore and analyze the risk factors affecting psychological status of adolescent orthodontic patients in stomatology department, and to develop intervention strategies according to the results. Methods A total of 186 cases of adolescent orthodontic patients in stomatology department from September 2012 to September 2015 were selected, and psychological status was investigated by Chinese Middle School Students Mental Health Scale (MMHI-60 scale) and Symptom Self-rating Scale (SCL-90).The patients were divided into observation group (with psychological problems) and control group (without psychological problems) according to the psychological status scale scores. Univariate descriptive analysis and multivariate Logistic regression analysis were used to determine related factors of the possible influencing factors, and the intervention strategies were developed. Results The factors such as social roles, living area, single parent, only child, internal and external tropism, neuroticism, being given health education, malocclusion severities of the deformities were closely related to psychological status of adolescent orthodontic patients in stomatology department (χ2=2.534-44.297, P<0.05 or 0.01). The independent risk factors were classified as high to low according to the degrees of danger: severe malocclusion (OR=3.578, P=0.000), instability emotional (OR=2.934,P=0.000), workers (OR=1.857, P=0.011) and rural life (OR=1.632, P=0.014), while the factors such as outgoing personality (OR=0.628, P=0.008) and being given health education (OR=0.746, P=0.010) were protective factors. Conclusions The factors such as severe malocclusion, instability emotional, workers,rural life,outgoing personality and health education are the related risk factors affecting psychological status of adolescent orthodontic patients in stomatology department, and psychological health intervention should be strengthened in the clinical practice to improve the psychological status and compliance.