Purpose To explore the clinicopathological features and endoscopic manifestations of cap polyposis(CP).Methods Clinical,endoscopic,pathological,and follow-up data of 17 cases of CP were collected and ana-lyzed.Results There were 14 males and 3 females,aged 15-67 years,with a mean age of 36.5 years.The disease duration ranged from 2 weeks to 5 years,and most patients(64.7％,11/17)had symptoms for more than l year.The most common clinical manifestation was hematochezia(82.4％,14/17),while constipation was generally absent.En-doscopically,all lesions(100％,17/17)were located in the anal canal and lower rectum.The surface was invariably covered with a thick whitish exudate(100％,17/17),and annular growth was the most frequent pattern(76.5％,13/17).Pathologically,the mucosal layer was almost entirely replaced by granulation tissue,and the surface showed extensive inflammatory necrosis forming a cap-like structure.Conclusion CP predominantly occurrs in the anal canal and lower rectum of young men.The presence of abundant whitish exudate under endoscopy is differential diagnostic value.Complete endoscopic resection followed by pathological examination is required for definitive diagnosis.

Objective:A prognosis prediction model for pancreatic cancer was constructed based on multi-scale radiomics combined with deep learning, and the prediction effect of the model was evaluated.Methods:A retrospective analysis was conducted on the clinical data of 215 patients who underwent radical resection of pancreatic cancer at the First Affiliated Hospital of Naval Medical University from January 2017 to December 2017. Among them, 134 were male and 81 were female, with an age of (61.9±9.2) years. Patients were randomly divided into the training set ( n=151) and the test set ( n=64) in a ratio of 7: 3. Habitat features, peritumoral radiomics features, 3D radiomics features, and 2.5D deep learning features were extracted from preoperative CT images respectively. After feature screening, a survival prediction model was constructed using the CoxBoost machine learning algorithm that integrated the Boosting algorithm and the Cox proportional hazards model. The performance of the model was evaluated using the area under the time-dependent receiver operating characteristic curve and the consistency index. The clinical benefits of the model were evaluated using decision curve analysis. The survival curves were plotted using the Kaplan-Meier method, and the log-rank test was used for the comparison of survivals between groups. Results:The LASSO, random forest and extreme gradient boosting models were each used to screen out the top 10 most important features and take the union, ultimately obtaining 20 radiomics features for modeling. In the training set and test set, the consistency index of the CoxBoost model in predicting overall survival was 0.717 (95% CI: 0.669-0.765) and 0.688 (95% CI: 0.610-0.766), respectively, and the area under the curve for predicting overall survival at 1, 2, and 3 years after surgery was 0.830 (95% CI: 0.752-0.898), 0.753 (95% CI: 0.665-0.833), 0.828 (95% CI: 0.735-0.908) and 0.690 (95% CI: 0.549-0.824), 0.780 (95% CI: 0.649-0.887 and 0.793 (95% CI: 0.660-0.897), respectively. The area under the curve for predicting long-term survival after surgery (≥40 months) was above 0.8. Based on the optimal cutoff value of -0.19 for the predicted value of the CoxBoost model calculated by the R package " survminer", the patients were divided into high-risk (predicted value >-0.19) and low-risk (predicted value <-0.19) groups. In both the training set and the test set, the survival of patients in the low-risk group was better than that in the high-risk group (training set: χ2=39.01, P<0.001; test set: χ2=12.34, P<0.001). The median survival period of patients in the high-risk group was lower than that in the low-risk group (training set: 15.80 vs 34.07 months; test set: 16.87 vs 43.07; months). Decision curve analysis shows that patients obtain survival benefit when the threshold probability of the training set is greater than 0.25 and that of the test set is greater than 0.45. Conclusion:The CoxBoost model has a good predictive ability for the overall survival of pancreatic cancer patients after surgery and can effectively screen out patient subgroups that may significantly benefit from surgical treatment.

Objective:To investigate the impact of tumor origin (ventral pancreatic origin and dorsal pancreatic origin) on prognosis in patients with pancreatic head cancer.Methods:A retrospective analysis was performed on the clinical data of 150 patients with pancreatic head cancer who received surgical treatment at the First Affiliated Hospital of the Naval Medical University from October 2014 to December 2017. Among these patients, 92 were male and 58 were female, aged (61.2±8.8) years. The 150 patients were divided into two groups based on tumor origin: the ventral pancreatic cancer group ( n=72) and the dorsal pancreatic cancer group ( n=78). A comparative analysis of clinical, pathological, and imaging charac-teristics was conducted between the two groups. Univariate and multivariable Cox proportional hazards models were used to analyze the association between pancreatic head cancer origin and overall survival (OS). Results:Patients with pancreatic head carcinoma arising from the ventral and dorsal pancreas accounted for 48%(72/150) and 52%(78/150) of the study cohort, respectively. Pancreatic head carcinoma arising from the dorsal pancreas were more likely to show pathological features of pancreatic parenchymal atrophy [73.1%(57/78) vs. 47.2%(34/72), χ2=10.49, P=0.001] and pancreatitis [44.9%(35/78) vs. 29.2%(21/72), χ2=3.95, P=0.047]. In contrast, patients with pancreatic head carcinoma arising from the ventral pancreas was more frequently associated with contact with the superior mesenteric artery [25.0%(18/72) vs. 1.3%(1/78), χ2=19.04, P<0.001], perineural invasion [100%(72/72) vs. 88.5%(69/78), χ2=8.84, P=0.003], and positive surgical margins [15.3%(11/72) vs. 2.6%(2/78), χ2=7.65, P=0.006], with all differences statistically significant. The ventral pancreatic cancer group demonstrated cumulative survival rates of 33.2% and 0 at 1-year and 2-year postoperative intervals, respectively, while the dorsal pancreatic cancer group exhibited rates of 56.7% and 24.8% at the corresponding timepoints. Comparison of Kaplan-Meier survival curves between the two groups showed a statistically significant difference ( χ2=6.00, P=0.014). Multivariable Cox proportional hazards analysis identified dorsal pancreatic origin pancreatic head cancer as an independent predictor of increased mortality risk compared to ventral origin tumors ( HR=2.75, 95% CI: 1.52-4.98, P=0.001). Conclusion:The embryonic origin of pancreatic head cancer determines its clinical, pathological, and imaging heterogeneity, and pancreatic head cancer arising from the ventral pancreas demonstrates significantly worse prognostic outcomes compared to dorsal pancreatic origin.

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder and its symptoms are subject to the composition of the gut microbiota. However, it is not yet clear how probiotics relieve IBS, and there is no well-acknowledged standards concerning the clinical application of probiotics. This systematic review was conducted on the literature published from January 2020 to December 2023 and included 12 randomized controlled trials on probiotics in the treatment of IBS. Compared with placebo, the probiotic preparations improved the overall efficacy in IBS patients and was also well tolerated, suggesting the potential of probiotics in IBS management. Nevertheless, different probiotic strains, dosages, combinations, and dosing schedules may affect the outcomes. In the future, large-scale, multi-center, long-term follow-up studies are still needed to clarify the effective strains and methods of use and to promote the use of probiotics in the treatment of IBS.

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder and its symptoms are subject to the composition of the gut microbiota. However, it is not yet clear how probiotics relieve IBS, and there is no well-acknowledged standards concerning the clinical application of probiotics. This systematic review was conducted on the literature published from January 2020 to December 2023 and included 12 randomized controlled trials on probiotics in the treatment of IBS. Compared with placebo, the probiotic preparations improved the overall efficacy in IBS patients and was also well tolerated, suggesting the potential of probiotics in IBS management. Nevertheless, different probiotic strains, dosages, combinations, and dosing schedules may affect the outcomes. In the future, large-scale, multi-center, long-term follow-up studies are still needed to clarify the effective strains and methods of use and to promote the use of probiotics in the treatment of IBS.

Purpose To explore the clinicopathological features and endoscopic manifestations of cap polyposis(CP).Methods Clinical,endoscopic,pathological,and follow-up data of 17 cases of CP were collected and ana-lyzed.Results There were 14 males and 3 females,aged 15-67 years,with a mean age of 36.5 years.The disease duration ranged from 2 weeks to 5 years,and most patients(64.7％,11/17)had symptoms for more than l year.The most common clinical manifestation was hematochezia(82.4％,14/17),while constipation was generally absent.En-doscopically,all lesions(100％,17/17)were located in the anal canal and lower rectum.The surface was invariably covered with a thick whitish exudate(100％,17/17),and annular growth was the most frequent pattern(76.5％,13/17).Pathologically,the mucosal layer was almost entirely replaced by granulation tissue,and the surface showed extensive inflammatory necrosis forming a cap-like structure.Conclusion CP predominantly occurrs in the anal canal and lower rectum of young men.The presence of abundant whitish exudate under endoscopy is differential diagnostic value.Complete endoscopic resection followed by pathological examination is required for definitive diagnosis.

Objective:To investigate the impact of tumor origin (ventral pancreatic origin and dorsal pancreatic origin) on prognosis in patients with pancreatic head cancer.Methods:A retrospective analysis was performed on the clinical data of 150 patients with pancreatic head cancer who received surgical treatment at the First Affiliated Hospital of the Naval Medical University from October 2014 to December 2017. Among these patients, 92 were male and 58 were female, aged (61.2±8.8) years. The 150 patients were divided into two groups based on tumor origin: the ventral pancreatic cancer group ( n=72) and the dorsal pancreatic cancer group ( n=78). A comparative analysis of clinical, pathological, and imaging charac-teristics was conducted between the two groups. Univariate and multivariable Cox proportional hazards models were used to analyze the association between pancreatic head cancer origin and overall survival (OS). Results:Patients with pancreatic head carcinoma arising from the ventral and dorsal pancreas accounted for 48%(72/150) and 52%(78/150) of the study cohort, respectively. Pancreatic head carcinoma arising from the dorsal pancreas were more likely to show pathological features of pancreatic parenchymal atrophy [73.1%(57/78) vs. 47.2%(34/72), χ2=10.49, P=0.001] and pancreatitis [44.9%(35/78) vs. 29.2%(21/72), χ2=3.95, P=0.047]. In contrast, patients with pancreatic head carcinoma arising from the ventral pancreas was more frequently associated with contact with the superior mesenteric artery [25.0%(18/72) vs. 1.3%(1/78), χ2=19.04, P<0.001], perineural invasion [100%(72/72) vs. 88.5%(69/78), χ2=8.84, P=0.003], and positive surgical margins [15.3%(11/72) vs. 2.6%(2/78), χ2=7.65, P=0.006], with all differences statistically significant. The ventral pancreatic cancer group demonstrated cumulative survival rates of 33.2% and 0 at 1-year and 2-year postoperative intervals, respectively, while the dorsal pancreatic cancer group exhibited rates of 56.7% and 24.8% at the corresponding timepoints. Comparison of Kaplan-Meier survival curves between the two groups showed a statistically significant difference ( χ2=6.00, P=0.014). Multivariable Cox proportional hazards analysis identified dorsal pancreatic origin pancreatic head cancer as an independent predictor of increased mortality risk compared to ventral origin tumors ( HR=2.75, 95% CI: 1.52-4.98, P=0.001). Conclusion:The embryonic origin of pancreatic head cancer determines its clinical, pathological, and imaging heterogeneity, and pancreatic head cancer arising from the ventral pancreas demonstrates significantly worse prognostic outcomes compared to dorsal pancreatic origin.

Objective:A prognosis prediction model for pancreatic cancer was constructed based on multi-scale radiomics combined with deep learning, and the prediction effect of the model was evaluated.Methods:A retrospective analysis was conducted on the clinical data of 215 patients who underwent radical resection of pancreatic cancer at the First Affiliated Hospital of Naval Medical University from January 2017 to December 2017. Among them, 134 were male and 81 were female, with an age of (61.9±9.2) years. Patients were randomly divided into the training set ( n=151) and the test set ( n=64) in a ratio of 7: 3. Habitat features, peritumoral radiomics features, 3D radiomics features, and 2.5D deep learning features were extracted from preoperative CT images respectively. After feature screening, a survival prediction model was constructed using the CoxBoost machine learning algorithm that integrated the Boosting algorithm and the Cox proportional hazards model. The performance of the model was evaluated using the area under the time-dependent receiver operating characteristic curve and the consistency index. The clinical benefits of the model were evaluated using decision curve analysis. The survival curves were plotted using the Kaplan-Meier method, and the log-rank test was used for the comparison of survivals between groups. Results:The LASSO, random forest and extreme gradient boosting models were each used to screen out the top 10 most important features and take the union, ultimately obtaining 20 radiomics features for modeling. In the training set and test set, the consistency index of the CoxBoost model in predicting overall survival was 0.717 (95% CI: 0.669-0.765) and 0.688 (95% CI: 0.610-0.766), respectively, and the area under the curve for predicting overall survival at 1, 2, and 3 years after surgery was 0.830 (95% CI: 0.752-0.898), 0.753 (95% CI: 0.665-0.833), 0.828 (95% CI: 0.735-0.908) and 0.690 (95% CI: 0.549-0.824), 0.780 (95% CI: 0.649-0.887 and 0.793 (95% CI: 0.660-0.897), respectively. The area under the curve for predicting long-term survival after surgery (≥40 months) was above 0.8. Based on the optimal cutoff value of -0.19 for the predicted value of the CoxBoost model calculated by the R package " survminer", the patients were divided into high-risk (predicted value >-0.19) and low-risk (predicted value <-0.19) groups. In both the training set and the test set, the survival of patients in the low-risk group was better than that in the high-risk group (training set: χ2=39.01, P<0.001; test set: χ2=12.34, P<0.001). The median survival period of patients in the high-risk group was lower than that in the low-risk group (training set: 15.80 vs 34.07 months; test set: 16.87 vs 43.07; months). Decision curve analysis shows that patients obtain survival benefit when the threshold probability of the training set is greater than 0.25 and that of the test set is greater than 0.45. Conclusion:The CoxBoost model has a good predictive ability for the overall survival of pancreatic cancer patients after surgery and can effectively screen out patient subgroups that may significantly benefit from surgical treatment.

ObjectiveTo observe the effectiveness and safety of the Chinese herbal medicine Mingshi Granules （明视方颗粒） for low myopia in children with heart yang insufficiency. MethodsA multicentre， prospective， double-blind randomised controlled study was conducted， in which 290 children with low myopia from 8 centres were randomly divided into 145 cases in the treatment group and 145 cases in the control group， and the treatment group was given education， dispensing glasses， and Chinese herbal medicine Mingshi Granules， while the control group was given education， dispensing glasses， and granules placebo. Both Mingshi Granules and placebo granules were taken orally， 1 bag each time， twice daily， 4 weeks of oral intake and 2 weeks of rest as 1 course of treatment， a total of 4 courses of treatment （24 weeks）. Equivalent spherical lenses， best naked-eye distance visual acuity， ocular axis， corneal curvature K1， adjustment amplitude， traditional Chinese medicine （TCM） symptom scores， calculate the amount of progression of equivalent spherical lenses， were observed at the 12th and the 24th week of treatment， at the 36th week and 48th week of follow-up， resectively， the control rate of myopia progression was evaluated at the 24th week， and safety indexes were observed before treatment. ResultsThe amount of progression of equivalent spherical lenses was lower in the treatment group than in the control group at the 48-week follow-up （P＜0.05）. The control rate of myopia progression at 24 weeks after treatment in the treatment group was higher （57.60%， 72/125） than that in the control group （44.63%， 54/121） （P＜0.05）. The best naked-eye distance visual acuity at 36-week follow-up in the treatment group was higher than that in the control group （P＜0.05）. Equivalent spherical lenses were significantly lower in both groups at all observation time points compared with pre-treatment （P＜0.05）， and were higher in the treatment group than in the control group at the 48-week follow-up （P＜0.05）. The ocular axes of both groups were significantly higher at each observation time point after treatment and at follow-up compared with before treatment （P＜0.05）. The amount of eye axis growth in the treatment group was lower than that in the control group at 24 weeks after treatment and at the 48-week follow-up （P＜0.05）. Corneal curvature K1 was significantly lower in the treatment group at the 24th week of treatment compared to pre-treatment （P＜0.05）. The magnitude of adjustment in the treatment group was significantly higher at the 36-week follow-up and at the 48-week follow-up than before treatment （P＜0.05）. The scores of white/dark complexion， white coating thin pulse， fatigue and total TCM symptom scores of children in both groups at the 12th， 24th， 36th and 48th weeks of follow-up were significantly lower than those before treatment （P＜0.05）； the scores of blurred vision at the 24th and 36th weeks of follow-up were significantly lower than those before treatment （P＜0.05）； and the scores of blurred vision in the treatment group at the 48th week of follow-up were signi-ficantly lower than those before treatment （P＜0.05）. In the treatment group， the score of fatigue was higher than that of the control group at the 36-week follow-up， and the score of blurred vision was lower than that of the control group at the 48-week follow-up （P＜0.05）. No adverse reactions or obvious abnormalities of the safety indexes were observed of the two groups during the treatment. ConclusionChinese herbal medicine Mingshi Granules showed the effect of controlling the progression of low myopia， improving the best naked eye distance visual acuity， slowing down the growth of the eye axis， improving some of the TCM symptoms， with good safety.