Objective:To investigate the efficacy and safety of percutaneous trans-hepatic choledochoscopic lithotripsy (PTCSL) in the treatment of recurrent hepatobiliary calculi under enhanced recovery after surgery (ERAS) mode.Methods:Clinical data of 88 patients with recurrent hepatobiliary calculi, who were treated with PTCSL at Zhengzhou Central Hospital Affiliated to Zhengzhou University and the First Affiliated Hospital of Xi'an Jiaotong University between June 2022 and June 2024 were retrospectively analyzed, including 34 males and 54 females, aged (52.0±13.8) years. The scheme includes preoperative education, prophylactic antibiotic application, ensuring the quality of surgery, early postoperative feeding and activity, etc. The operation can be divided into two fashions: percutaneous transhepatic cholangial drainage and PTCSL, which can be completed in one stage (one-stage expansion method) or in two stages (staged expansion method). Clinical data such as gender, age, operative time, intraoperative blood loss, residual stone, and surgical complications were recorded.Results:All 88 patients underwent PTCSL under ERAS mode successfully, including 52 cases using one-stage expansion method and 36 cases using staged expansion method. The operative time was (53±20) min, the intraoperative blood loss was (9.7±3.8) ml, the postoperative hospital stay was (3.6±1.7) d, and the hospitalization cost was (17 500±4 700) yuan. Sixty-nine patients (78.4%, 69/88) had one-time stone removal in the first PTCSL. A total of 19 cases of residual stones were managed again by percutaneous sinus soft choledochoscopy, of which 12 cases were managed by one-time choledochoscopy, five cases by two-time choledochoscopy, and two cases by three-time choledochoscopy. The rate of residual stone was significantly higher in one-stage expansion method compared to staged expansion method [28.8% (15/52) vs. 11.1% (4/36), P=0.040]. No death, conversion to open surgery, or severe complications such as intra-abdominal hemorrhage or bile leakage occurred in the patients. No residual stones or recurrence were found during the follow-ups of (7.5±2.1) months after discharge. Conclusion:PTCSL under ERAS mode is safe and effective in the treatment of recurrent hepatobiliary calculi.

Objective:To investigate the efficacy and safety of percutaneous trans-hepatic choledochoscopic lithotripsy (PTCSL) in the treatment of recurrent hepatobiliary calculi under enhanced recovery after surgery (ERAS) mode.Methods:Clinical data of 88 patients with recurrent hepatobiliary calculi, who were treated with PTCSL at Zhengzhou Central Hospital Affiliated to Zhengzhou University and the First Affiliated Hospital of Xi'an Jiaotong University between June 2022 and June 2024 were retrospectively analyzed, including 34 males and 54 females, aged (52.0±13.8) years. The scheme includes preoperative education, prophylactic antibiotic application, ensuring the quality of surgery, early postoperative feeding and activity, etc. The operation can be divided into two fashions: percutaneous transhepatic cholangial drainage and PTCSL, which can be completed in one stage (one-stage expansion method) or in two stages (staged expansion method). Clinical data such as gender, age, operative time, intraoperative blood loss, residual stone, and surgical complications were recorded.Results:All 88 patients underwent PTCSL under ERAS mode successfully, including 52 cases using one-stage expansion method and 36 cases using staged expansion method. The operative time was (53±20) min, the intraoperative blood loss was (9.7±3.8) ml, the postoperative hospital stay was (3.6±1.7) d, and the hospitalization cost was (17 500±4 700) yuan. Sixty-nine patients (78.4%, 69/88) had one-time stone removal in the first PTCSL. A total of 19 cases of residual stones were managed again by percutaneous sinus soft choledochoscopy, of which 12 cases were managed by one-time choledochoscopy, five cases by two-time choledochoscopy, and two cases by three-time choledochoscopy. The rate of residual stone was significantly higher in one-stage expansion method compared to staged expansion method [28.8% (15/52) vs. 11.1% (4/36), P=0.040]. No death, conversion to open surgery, or severe complications such as intra-abdominal hemorrhage or bile leakage occurred in the patients. No residual stones or recurrence were found during the follow-ups of (7.5±2.1) months after discharge. Conclusion:PTCSL under ERAS mode is safe and effective in the treatment of recurrent hepatobiliary calculi.

Objective:To study lncRNA MEG3 expression and its relationship with Th17/CD4+T cells in patients with non-small cell lung cancer(NSCLC)with different pleural effusion severity and prognosis.Methods:A total of 104 NSCLC malignant pleural effusion patients admitted to Quanzhou First Hospital Affiliated to Fujian Medical University from January 2020 to December 2022 were selected as research subjects,and divided into three groups based on amount of pleural effusion,including small amount of pleural effusion group(35 cases),moderate amount of pleural effusion group(42 cases)and large amount of pleural effusion group(27 cases).According to actual development and prognosis of patient's disease,they were divided into good prognosis group(29 cases without recurrence and metastasis)and poor prognosis group(75 cases with recurrence and metastasis).Another 60 patients with benign pleural effusion due to pneumonia who were treated in Quanzhou First Hospital Affiliated to Fujian Medical University at same time were selected as control group.MEG3 expression in pleural effusion of two groups was detected by real-time fluorescent quantita-tive PCR,and peripheral venous blood of subjects was collected.Th17 cell and CD4+T cell ratios of peripheral blood were detected by flow cytometry,and Th17/CD4+T was calculated.lncRNA MEG3 and peripheral blood Th17 and CD4+T levels in each group of patients compared.Logistic regression analysis was used to analyze pleural effusion and prognostic factors in NSCLC.Results:lncRNA MEG3 expression and CD4+T percentage in pleural effusion in NSCLC group were lower than control group,while Th17 percentage and Th17/CD4+T were higher than control group(P<0.05).lncRNA MEG3 expression and CD4+T percentage in large pleural effusion group were lower than small and moderate pleural effusion groups.lncRNA MEG3 expression and CD4+T percentage in modarate pleural effusion group were lower than small pleural effusion group,while Th17 percentage and Th17/CD4+T in large pleural effusion group were higher than small and moderate pleural effusion groups.Th17/CD4+T was higher in small amount pleural effusion group(P<0.05).lncRNA MEG3 expression and CD4+T percentage in poor prognosis group were lower than those in good prognosis group,while Th17 percentage and Th17/CD4+T were higher than good prognosis group(P<0.05).Logistic regression analysis showed that lncRNA MEG3 was a protective factor for NSCLC pleural effusion,and Th17/CD4+T was a risk factor(P<0.05),lncRNA MEG3 was a protective factor of NSCLC prognosis,and Th17/CD4+T was a risk factor(P<0.05).Conclusion:lncRNA MEG3 expression and Th17/CD4+T in NSCLC patients with different pleural effusion severity and prognosis is not same.lncRNA MEG3 is a risk factor for NSCLC pleural effusion and prognosis,while Th17/CD4+T is a risk factor,which can be used as an effective biomarker for pleural effusion severity and progno-sis diagnosis.

Objective:To analyze the effects of esophageal cancer screening in Henan rural areas with cancer screening program from 2014 to 2018.Methods:From July 2014 to June 2019, according to the National Early Diagnosis and Treatment of Upper Gastrointestinal Cancer in Rural Areas Project, cluster sampling method was adopted in 16 counties/county-level cities in rural areas with high incidence of esophageal cancer in Henan province. Endoscopic iodine staining and indicative biopsy were used to screen esophageal cancer. The patients with mild and moderate dysplasia confirmed in screening were followed up. The distribution of esophageal diseases in the screening population was calculated, and Chi-square test was used to compare the differences of detection rate and early diagnosis rate between the primary screening population and the follow-up population.Results:The age of 116 630 primary screening population was (54.29±7.70) years old, and the proportion of males was 41.2% (48 108). In the primary screening population, patients with normal esophagus, mild to moderate dysplasia, severe dysplasia and above accounted for 92.91% (108 363), 6.03% (7 035) and 1.06% (1 232), respectively. The detection rate of esophageal cancer was 1.06% (1 232/116 630), and the rate of early diagnosis was 85.80% (1 057). Among the follow-up population of 6 154 people, those with normal esophagus, mild to moderate dysplasia, severe dysplasia and above diseases accounted for 63.45% (3 905), 33.13% (1 519) and 3.41% (210), respectively. The detection rate of esophageal cancer was 3.41% (210/6 154), and the rate of early diagnosis was 91.90% (1 939). Compared with the primary screening population, the risk of esophageal cancer was higher in the overall follow-up population, people either with mild or with moderate dysplasia diagnosed in primary screening, with OR values (95 %CI) of 3.23 (2.78, 3.75), 1.85 (1.49, 2.29) and 8.13 (6.69, 9.88), respectively. Conclusion:From 2014 to 2018, in the early diagnosis and early treatment of upper digestive tract cancer project in rural areas of Henan Province, the detection rate of the follow-up population is significantly higher than that of the primary screening population. Improving follow-up rate and paying more attention to the screening of people who need follow-up could further improve the screening effect.

Objective:To evaluate the compliance of colonoscopy screening and the detection rate of colorectal lesions with colonoscopy in urban areas of Henan province from 2013 to 2019.Methods:The study objects were derived from the Cancer Screening Program in Urban Henan Province, China. From October 2013 to October 2019, 282 377 residents, who had lived in the local area for more than three years, were recruited from Zhengzhou, Zhumadian, Anyang, Luoyang, Nanyang, Jiaozuo, Puyang and Xinxiang. The cancer risk assessment questionnaire was used to collect basic demographic characteristics, eating habits, living environment and habits, psychology and emotions, past disease history and family history of cancer, and women′s physiological and reproductive history. The cancer risk assessment model was used for evaluating the risk of colorectal cancer. The data related to colonoscopy screening was obtained from the participating hospitals. Chi-square test was used to analyze the compliance rate among different groups.Results:The 282 377 subjects were (55.26±8.68) years old, of which 44.80% (126 505) were males, and 67.63% (190 694) had junior/senior/tertiary education background. A total of 39 834 (14.11%) subjects were assessed to be at high risk for colorectal cancer, of which 7 454 took the following colonoscopy screening, yielding a participation rate of 18.71%. The screening rate was higher in those aged 50 to 54 (20.42%) and 55 to 59 (20.43%) years, and lowest in those aged 70 years and older (12.30%) ( P<0.001). A total of 17 colorectal cancer cases were detected, with a detection rate of 0.23% (17/7 454). Conclusion:Colonoscopy as a means of screening for colorectal cancer is helpful for early detection of colorectal lesions, but the participation rate is poor.

Objective:To analyze the effects of esophageal cancer screening in Henan rural areas with cancer screening program from 2014 to 2018.Methods:From July 2014 to June 2019, according to the National Early Diagnosis and Treatment of Upper Gastrointestinal Cancer in Rural Areas Project, cluster sampling method was adopted in 16 counties/county-level cities in rural areas with high incidence of esophageal cancer in Henan province. Endoscopic iodine staining and indicative biopsy were used to screen esophageal cancer. The patients with mild and moderate dysplasia confirmed in screening were followed up. The distribution of esophageal diseases in the screening population was calculated, and Chi-square test was used to compare the differences of detection rate and early diagnosis rate between the primary screening population and the follow-up population.Results:The age of 116 630 primary screening population was (54.29±7.70) years old, and the proportion of males was 41.2% (48 108). In the primary screening population, patients with normal esophagus, mild to moderate dysplasia, severe dysplasia and above accounted for 92.91% (108 363), 6.03% (7 035) and 1.06% (1 232), respectively. The detection rate of esophageal cancer was 1.06% (1 232/116 630), and the rate of early diagnosis was 85.80% (1 057). Among the follow-up population of 6 154 people, those with normal esophagus, mild to moderate dysplasia, severe dysplasia and above diseases accounted for 63.45% (3 905), 33.13% (1 519) and 3.41% (210), respectively. The detection rate of esophageal cancer was 3.41% (210/6 154), and the rate of early diagnosis was 91.90% (1 939). Compared with the primary screening population, the risk of esophageal cancer was higher in the overall follow-up population, people either with mild or with moderate dysplasia diagnosed in primary screening, with OR values (95 %CI) of 3.23 (2.78, 3.75), 1.85 (1.49, 2.29) and 8.13 (6.69, 9.88), respectively. Conclusion:From 2014 to 2018, in the early diagnosis and early treatment of upper digestive tract cancer project in rural areas of Henan Province, the detection rate of the follow-up population is significantly higher than that of the primary screening population. Improving follow-up rate and paying more attention to the screening of people who need follow-up could further improve the screening effect.

Objective:To evaluate the compliance of colonoscopy screening and the detection rate of colorectal lesions with colonoscopy in urban areas of Henan province from 2013 to 2019.Methods:The study objects were derived from the Cancer Screening Program in Urban Henan Province, China. From October 2013 to October 2019, 282 377 residents, who had lived in the local area for more than three years, were recruited from Zhengzhou, Zhumadian, Anyang, Luoyang, Nanyang, Jiaozuo, Puyang and Xinxiang. The cancer risk assessment questionnaire was used to collect basic demographic characteristics, eating habits, living environment and habits, psychology and emotions, past disease history and family history of cancer, and women′s physiological and reproductive history. The cancer risk assessment model was used for evaluating the risk of colorectal cancer. The data related to colonoscopy screening was obtained from the participating hospitals. Chi-square test was used to analyze the compliance rate among different groups.Results:The 282 377 subjects were (55.26±8.68) years old, of which 44.80% (126 505) were males, and 67.63% (190 694) had junior/senior/tertiary education background. A total of 39 834 (14.11%) subjects were assessed to be at high risk for colorectal cancer, of which 7 454 took the following colonoscopy screening, yielding a participation rate of 18.71%. The screening rate was higher in those aged 50 to 54 (20.42%) and 55 to 59 (20.43%) years, and lowest in those aged 70 years and older (12.30%) ( P<0.001). A total of 17 colorectal cancer cases were detected, with a detection rate of 0.23% (17/7 454). Conclusion:Colonoscopy as a means of screening for colorectal cancer is helpful for early detection of colorectal lesions, but the participation rate is poor.

Objective:To evaluate the compliance rate and its impact factors of liver cancer screening for high-risk groups in urban areas of Henan Province from 2013 to 2019.Methods:Residents of 40-74 years old in 8 cities of Henan province were selected to investigate the risk factors and liver cancer risk assessment. Subjects with high risk of liver cancer received AFP combined ultrasonography for screening. Chi-square tests were used to compare the differences in liver cancer screening participation rates between groups. Multivariate logistic regression models were applied to explore the potential factors correlating to the compliance of liver cancer screening.Results:Overall, 3 6781 participants who met the inclusion criteria were included in this analysis, and 17 241 of them took the following liver cancer screening, yielding a participation rate of 46.87%. The participation rate varied greatly across cities, ranging from 62.50% to 38.59%. Moreover, the participation rate varied greatly across periods, ranging from 52.77% in 2014-2015 to 38.14% in 2013-2014. The multivariate Logistic regression analyses showed that: female, older, high education degree, cigarette and alcohol intake, infrequent physical exercise, chronic hepatitis B, chronic hepatitis C, fatty liver, gallstones and a family history of liver cancer were inclined to accept liver cancer screening ( P<0.05). Conclusions:The overall participation rate of liver cancer screening among high-risk population is less than 50% in urban areas of Henan Province. Implement of effective interventions targeting the specific high-risk populations might improve the overall compliance rate of liver cancer screening in the future.

Objective:To evaluate the performance of high risk human papilloma virus (HR-HPV) E6/E7 mRNA in triaging women with atypical squamous cells of undetermined signification (ASCUS).Methods:The ASCUS cohort determined by liquid-based cytology test in the cervical cancer screening queue in Luoshan County, Xinyang City, Henan Province 2017 were selected. The population underwent colposcopy biopsy and pathological tests, combined with HPV16 or 18 (HPV16/18), HR-HPV DNA and HPV E6/E7 mRNA test. By using the pathological result as the gold standard, the sensitivity, specificity, positive predictor (PPV), negative prediction (NPV), referral rate and 95% confident interval ( CI) of HPV E6/E7 mRNA, HR-HPV DNA, HPV16/18 were calculated, respectively. Results:The average age of 312 ASCUS women was 52.6±7.3 years old. Among the 290 women diagnosed as normal by pathology, 64 (22.1%) were HPV E6/E7 mRNA positive, 86 (29.7%) were HR-HPV DNA positive, and 19 (6.6%) were HPV16/18 positive. All of the cervical intraepithelial neoplasia (CIN) cases determined by pathology were both HPV E6/E7 mRNA and HR-HPV DNA positive. The sensitivity, specificity, PPV, NPV and referral rate of HPV E6/E7 mRNA for predicting CIN2+ lesion in women with ASCUS were 100.0% (95% CI: 72.3, 100.0), 77.8% (95% CI: 72.8, 82.1), 13.0% (95% CI: 7.2, 22.3), 100.0% (95% CI: 98.4, 100.0) and 24.7%. Compared with HPV E6/E7 mRNA, the sensitivity of HR-HPV DNA was similar with HPV E6/E7 mRNA, but with a lower specificity [70.2% (95% CI: 64.8, 75.1), P<0.05], a higher referral rate (32.1%, P<0.05); while HPV 16/18 had a high specificity (93.4%, 95% CI: 90.0, 95.7) and a low sensitivity (30.0%, 95% CI: 10.8, 60.3). Based on the age stratification by age 45, the sensitivity of HPV E6/E7 mRNA in both age groups was 100.0%. The specificity of HPV E6/E7 mRNA in group of ≥45 years was a little higher than that in group of <45 years [79.0% (95% CI: 73.7, 83.5) versus 68.3% (95% CI: 53.0, 80.4)], but the difference was not statistically significant ( P>0.05). Conclusions:The ASCUS woman triaging effect of HPV E6/E7 mRNA detection is better than those of HR-HPV and HPV16/18 under certain conditions. The application of HPV E6/E7 mRNA detection to triage ASCUS population can avoid unnecessary colposcopy referral and reduce the missed diagnosis of cervical lesions.

Objective:To evaluate the compliance rate and its impact factors of liver cancer screening for high-risk groups in urban areas of Henan Province from 2013 to 2019.Methods:Residents of 40-74 years old in 8 cities of Henan province were selected to investigate the risk factors and liver cancer risk assessment. Subjects with high risk of liver cancer received AFP combined ultrasonography for screening. Chi-square tests were used to compare the differences in liver cancer screening participation rates between groups. Multivariate logistic regression models were applied to explore the potential factors correlating to the compliance of liver cancer screening.Results:Overall, 3 6781 participants who met the inclusion criteria were included in this analysis, and 17 241 of them took the following liver cancer screening, yielding a participation rate of 46.87%. The participation rate varied greatly across cities, ranging from 62.50% to 38.59%. Moreover, the participation rate varied greatly across periods, ranging from 52.77% in 2014-2015 to 38.14% in 2013-2014. The multivariate Logistic regression analyses showed that: female, older, high education degree, cigarette and alcohol intake, infrequent physical exercise, chronic hepatitis B, chronic hepatitis C, fatty liver, gallstones and a family history of liver cancer were inclined to accept liver cancer screening ( P<0.05). Conclusions:The overall participation rate of liver cancer screening among high-risk population is less than 50% in urban areas of Henan Province. Implement of effective interventions targeting the specific high-risk populations might improve the overall compliance rate of liver cancer screening in the future.