Objective:To evaluate the efficacy and safety of endoscopic injection sclerotherapy (EIS) and endoscopic rubber band ligation (ERBL) for the treatment of grade Ⅰ-Ⅲ internal hemorrhoids.Methods:A prospective study was conducted on patients with grade Ⅰ-Ⅲ internal hemorrhoids who sought treatment at Renmin Hospital of Wuhan University or the NO.2 People's Hospital of Fuyang City from November 2021 to November 2022. Eligible patients were continuously enrolled based on inclusion and exclusion criteria and randomized into 2 groups using a central randomization system: the EIS group and the ERBL group. The primary outcomes included symptom improvement rate, recurrence rate, incidence of adverse events (bleeding, anal distension, pain, urinary retention, etc.), surgical costs, patient satisfaction, hemorrhoidal disease symptom score (HDSS), European quality of life 5-dimensions (EQ-5D) score, and self-rated health status score.Results:A total of 203 patients were enrolled (86 from Renmin Hospital of Wuhan University and 117 from the NO.2 People's Hospital of Fuyang City), with 103 in the EIS group and 100 in the ERBL group. Both groups successfully completed endoscopic treatment for internal hemorrhoids. The surgical cost in the EIS group was significantly lower than that in the ERBL group (1 044.77±522.77 yuan VS 2 538.44±465.63 yuan, t=-21.660, P<0.001). The incidence of perioperative pain and moderate-to-severe pain in the EIS group was significantly lower than that in the ERBL group [2.91% (3/103) VS 25.00% (25/100), χ2=20.817, P<0.001; 0.97% (1/103) VS 18.00% (18/100), χ2=17.344, P<0.001]. There were no significant differences in the incidence of perioperative bleeding, anal distension, or urinary retention between the two groups [0.97% (1/103) VS 1.00% (1/100), 11.65% (12/103) VS 19.00% (19/100), 0.00% (0/103) VS 2.00% (2/100), P>0.05]. During the 12-week follow-up, 4 patients were lost to follow-up (all from the EIS group). There were no significant differences in symptom improvement rate, recurrence rate, or patient satisfaction rate between the two groups [96.97% (96/99) VS 96.00% (96/100), 3.03% (3/99) VS 5.00% (5/100), 97.98% (97/99) VS 95.00% (95/100), P>0.05]. At 12 weeks postoperatively, the HDSS in the EIS group significantly decreased compared to preoperative levels [0.0 (0.0, 1.0) VS 5.0 (3.0, 7.0), Z=-18.270, P<0.010], the EQ-5D score in the ERBL group significantly increased compared to preoperative levels (1.00±0.01 VS 0.98±0.03, F=27.527, P<0.010), and self-rated health status score in the ERBL group significantly increased compared to preoperative levels (92.31±6.89 VS 82.62±10.98, F=115.025, P<0.010). At 12 weeks postoperatively, the HDSS in the ERBL group significantly decreased compared to preoperative levels [0.0 (0.0, 1.0) VS 5.0 (4.0, 8.0), Z=-16.110, P<0.010], the EQ-5D score in the ERBL group significantly increased compared to preoperative levels (1.00±0.00 VS 0.98±0.05, F=13.718, P<0.010), and self-rated health status score in the ERBL group significantly increased compared to preoperative levels (93.46±6.35 VS 84.15±10.71, F=123.695, P<0.010). Conclusion:Both EIS and ERBL are safe and effective treatments for grade Ⅰ-Ⅲ internal hemorrhoids, with high patient satisfaction. Comparatively, EIS demonstrates lower surgical costs and a reduced incidence and severity of perioperative pain.

Objective:To evaluate the efficacy and safety of endoscopic injection sclerotherapy (EIS) and endoscopic rubber band ligation (ERBL) for the treatment of grade Ⅰ-Ⅲ internal hemorrhoids.Methods:A prospective study was conducted on patients with grade Ⅰ-Ⅲ internal hemorrhoids who sought treatment at Renmin Hospital of Wuhan University or the NO.2 People's Hospital of Fuyang City from November 2021 to November 2022. Eligible patients were continuously enrolled based on inclusion and exclusion criteria and randomized into 2 groups using a central randomization system: the EIS group and the ERBL group. The primary outcomes included symptom improvement rate, recurrence rate, incidence of adverse events (bleeding, anal distension, pain, urinary retention, etc.), surgical costs, patient satisfaction, hemorrhoidal disease symptom score (HDSS), European quality of life 5-dimensions (EQ-5D) score, and self-rated health status score.Results:A total of 203 patients were enrolled (86 from Renmin Hospital of Wuhan University and 117 from the NO.2 People's Hospital of Fuyang City), with 103 in the EIS group and 100 in the ERBL group. Both groups successfully completed endoscopic treatment for internal hemorrhoids. The surgical cost in the EIS group was significantly lower than that in the ERBL group (1 044.77±522.77 yuan VS 2 538.44±465.63 yuan, t=-21.660, P<0.001). The incidence of perioperative pain and moderate-to-severe pain in the EIS group was significantly lower than that in the ERBL group [2.91% (3/103) VS 25.00% (25/100), χ2=20.817, P<0.001; 0.97% (1/103) VS 18.00% (18/100), χ2=17.344, P<0.001]. There were no significant differences in the incidence of perioperative bleeding, anal distension, or urinary retention between the two groups [0.97% (1/103) VS 1.00% (1/100), 11.65% (12/103) VS 19.00% (19/100), 0.00% (0/103) VS 2.00% (2/100), P>0.05]. During the 12-week follow-up, 4 patients were lost to follow-up (all from the EIS group). There were no significant differences in symptom improvement rate, recurrence rate, or patient satisfaction rate between the two groups [96.97% (96/99) VS 96.00% (96/100), 3.03% (3/99) VS 5.00% (5/100), 97.98% (97/99) VS 95.00% (95/100), P>0.05]. At 12 weeks postoperatively, the HDSS in the EIS group significantly decreased compared to preoperative levels [0.0 (0.0, 1.0) VS 5.0 (3.0, 7.0), Z=-18.270, P<0.010], the EQ-5D score in the ERBL group significantly increased compared to preoperative levels (1.00±0.01 VS 0.98±0.03, F=27.527, P<0.010), and self-rated health status score in the ERBL group significantly increased compared to preoperative levels (92.31±6.89 VS 82.62±10.98, F=115.025, P<0.010). At 12 weeks postoperatively, the HDSS in the ERBL group significantly decreased compared to preoperative levels [0.0 (0.0, 1.0) VS 5.0 (4.0, 8.0), Z=-16.110, P<0.010], the EQ-5D score in the ERBL group significantly increased compared to preoperative levels (1.00±0.00 VS 0.98±0.05, F=13.718, P<0.010), and self-rated health status score in the ERBL group significantly increased compared to preoperative levels (93.46±6.35 VS 84.15±10.71, F=123.695, P<0.010). Conclusion:Both EIS and ERBL are safe and effective treatments for grade Ⅰ-Ⅲ internal hemorrhoids, with high patient satisfaction. Comparatively, EIS demonstrates lower surgical costs and a reduced incidence and severity of perioperative pain.

Objective To investigate the risk factors and CT manifestations of primary varicella pneumonia(PVP),and to provide clinical evidence for early diagnosis of PVP.Methods A total of 99 patients with varicella were retrospectively selected,and all patients were divided into pneumonia group(53 cases)and control group(46 cases).The correlations between factors such as gender,age,febrile days before hospitalization,maximum body temperature,respiratory symptoms,white blood cell(WBC)count,absolute lymphocyte count(ALC)and PVP were analyzed.Multivariate logistic analysis was used to determine the risk factors of PVP,and the CT fea-tures of PVP patients were summarized.Results There were significant differences in age,respiratory symptoms and ALC between pneumonia group and control group(P＜0.05).Age and respiratory symptoms were independent risk factors for PVP(P＜0.05).The main features of CT were scattered small solid nodules in both lungs with halo sign,which could be combined with ground glass shadow or small solid shadow,and axillary lymph node enlargement.Conclusion Age and respiratory symptoms can be used as inde-pendent risk factors for predicting PVP in varicella patients,and combined with CT features of patients,it is of great value for the early diagnosis of PVP.

Objective: The purpose of our study was to investigate the predictive abilities of clinical and computed tomography (CT)features for outcome prediction in patients with coronavirus disease (COVID-19). Materials and Methods: The clinical and CT data of 238 patients with laboratory-confirmed COVID-19 in our two hospitalswere retrospectively analyzed. One hundred sixty-six patients (103 males; age 43.8 ± 12.3 years) were allocated in thetraining cohort and 72 patients (38 males; age 45.1 ± 15.8 years) from another independent hospital were assigned in thevalidation cohort. The primary composite endpoint was admission to an intensive care unit, use of mechanical ventilation, ordeath. Univariate and multivariate Cox proportional hazard analyses were performed to identify independent predictors. Anomogram was constructed based on the combination of clinical and CT features, and its prognostic performance wasexternally tested in the validation group. The predictive value of the combined model was compared with models built on theclinical and radiological attributes alone. Results: Overall, 35 infected patients (21.1%) in the training cohort and 10 patients (13.9%) in the validation cohortexperienced adverse outcomes. Underlying comorbidity (hazard ratio [HR], 3.35; 95% confidence interval [CI], 1.67–6.71;p < 0.001), lymphocyte count (HR, 0.12; 95% CI, 0.04–0.38; p < 0.001) and crazy-paving sign (HR, 2.15; 95% CI, 1.03–4.48;p = 0.042) were the independent factors. The nomogram displayed a concordance index (C-index) of 0.82 (95% CI, 0.76–0.88),and its prognostic value was confirmed in the validation cohort with a C-index of 0.89 (95% CI, 0.82–0.96). The combinedmodel provided the best performance over the clinical or radiological model (p < 0.050). Conclusion Underlying comorbidity, lymphocyte count and crazy-paving sign were independent predictors of adverseoutcomes. The prognostic nomogram based on the combination of clinical and CT features could be a useful tool for predictingadverse outcomes of patients with COVID-19.

ObjectiveTo investigate the clinical significance of co-infection with hepatitis B virus (HBV) and Epstein-Barr virus (EBV) in HBV-related liver diseases such as chronic hepatitis B (CHB), liver cirrhosis, and hepatocellular carcinoma (HCC). MethodsA retrospective analysis was performed for the clinical data of 487 patients with HBV infection who were diagnosed in Zhongnan Hospital of Wuhan University from May 2016 to August 2018, among whom 194 (39.8%) had co-infection with HBV and EBV. The patients were divided into groups according to the copy number of EBV DNA (＞400 IU/ml), Child-Pugh class (Child-Pugh class A, B, and C), and progression of liver disease (CHB, liver cirrhosis, and HCC), and related indices were compared between groups. The t-test was used for comparison of normally distributed continuous data between two groups; an analysis of variance was used for comparison between multiple groups, and the least significant difference t-test was used for further comparison between two groups. The Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between groups, and the Dunn-Bonferroni test was used for further comparison between two groups. The chi-square test was used for comparison of categorical data between groups. ResultsThe patients with CHB had a significantly higher copy number of HBV-DNA than those with liver cirrhosis or HCC (t=2.417 and 3.258, P=0.017 and 0.001), while the patients with HCC tended to have a higher copy number of EBV DNA than those with CHB or liver cirrhosis, but there was no significant difference between the three groups (F=1.161, P=0.315). After adjustment for liver function based on Child-Pugh class, the HCC patients with Child-Pugh class A liver function had a significantly higher copy number of EBV DNA than the CHB patients and the patients with liver cirrhosis (t=2.062 and 2.615, P=0.041 and 0.010)， the liver cirrhosis patients with Child-Pugh class C liver function had a significantly higher copy number of EBV DNA than the CHB patients (t=2.647,P=0.012). ALT/AST, globulin, and lymphocyte percentage were specific clinical indices for co-infection with HBV and EBV. ConclusionThere is an increase in EBV load in HCC patients, and both EBV and HBV are involved in the progression of liver diseases. Dynamic quantification of EBV DNA in patients with HBV infection has a certain significance in early intervention of the progression of liver diseases.