Objective To explore the effectiveness and safety of endoscopic retrograde cholangiopancreatography(ERCP)in the super-older patients(≥ 90 years old)with calculus of common bile duct.Methods This study retrospectively analyzed the data of elderly patients ≥ 65 years old with calculus of common bile duct who received ERCP treatment from January 2011 to December 2023.Among of them,patients ≥ 90 years old were in the super-older group,and patients over 65 years old but under 90 years old were in the non-super-older group.Subsequently,the baseline data of gender,number of stones,stone size,cholecystolithiasis,periampullary diverticulum,and common bile duct intubation of patients in the two groups were matched by the 1∶1 propensity score matching method.After successful matching,the surgical success rate,stone removal rate,complication rate,and hospital stay in the two groups were compared.Results 428 older patients with calculus of common bile duct were included in this study,including 45 patients in the super-older group and 383 patients in the non-super-older group.After matching baseline data with a 1∶1 propensity score matching,44 patients were included in both the super-older group and non-super-older group.There was no statistically significant difference in the total underlying disease rate between the two groups[81.82％(36/44)vs 65.91％(29/44),P=0.189],but the incidence rate of stroke[34.09％(15/44)vs 6.82％(3/44)]and the ASA grading(grade Ⅲ or Ⅳ)[97.73％(43/44)vs 38.64％(17/44)]in the super-older group were significantly higher than those in the non-super-older group(P＜0.01).There were no statistically significant differences between the two groups in terms of ERCP surgical success rate[90.91％(40/44)vs 93.18％(41/44)],stone removal rate[65.91％(29/44)vs 81.82％(36/44)],complication rate[43.18％(19/44)vs 27.27％(12/44)],and median length of stay(15.00dvs 14.50 d)(P＞0.05).Conclusion ERCP is safe and effective in the super-older patients with calculus of common bile duct.

Objective To explore the effectiveness and safety of endoscopic retrograde cholangiopancreatography(ERCP)in the super-older patients(≥ 90 years old)with calculus of common bile duct.Methods This study retrospectively analyzed the data of elderly patients ≥ 65 years old with calculus of common bile duct who received ERCP treatment from January 2011 to December 2023.Among of them,patients ≥ 90 years old were in the super-older group,and patients over 65 years old but under 90 years old were in the non-super-older group.Subsequently,the baseline data of gender,number of stones,stone size,cholecystolithiasis,periampullary diverticulum,and common bile duct intubation of patients in the two groups were matched by the 1∶1 propensity score matching method.After successful matching,the surgical success rate,stone removal rate,complication rate,and hospital stay in the two groups were compared.Results 428 older patients with calculus of common bile duct were included in this study,including 45 patients in the super-older group and 383 patients in the non-super-older group.After matching baseline data with a 1∶1 propensity score matching,44 patients were included in both the super-older group and non-super-older group.There was no statistically significant difference in the total underlying disease rate between the two groups[81.82％(36/44)vs 65.91％(29/44),P=0.189],but the incidence rate of stroke[34.09％(15/44)vs 6.82％(3/44)]and the ASA grading(grade Ⅲ or Ⅳ)[97.73％(43/44)vs 38.64％(17/44)]in the super-older group were significantly higher than those in the non-super-older group(P＜0.01).There were no statistically significant differences between the two groups in terms of ERCP surgical success rate[90.91％(40/44)vs 93.18％(41/44)],stone removal rate[65.91％(29/44)vs 81.82％(36/44)],complication rate[43.18％(19/44)vs 27.27％(12/44)],and median length of stay(15.00dvs 14.50 d)(P＞0.05).Conclusion ERCP is safe and effective in the super-older patients with calculus of common bile duct.

Objective:To investigate the expression of zinc finger protein 22 (ZNF22) gene in hepatocellular carcinoma (HCC) and its effect on tumor proliferation, apoptosis, invasion and metastasis of HCC.Methods:The expression of ZNF22 in 32 HCC specimens, and 371 HCC samples from the cancer genome atlas database were analyzed. ZNF22 knockdown and negative control SNU-449 and JHH-7 HCC cell lines were constructed. The effects of ZNF22 on HCC cells were observed by cell proliferation assay, plate clone formation assay, apoptosis assay, scratch healing assay, Transwell invasion assay, subcutaneous tumor formation, tail vein injection transfer, and small animal live imaging assay in nude mice.Results:The expression of ZNF22 gene is higher in HCC tissues than in paracellular carcinoma tissues, and the difference was statistically significant ( P<0.001). The growth rate of SNU-449 and JHH-7 cells in ZNF22 knockdown group was lower than that in control group, and the difference was statistically significant ( P<0.001). Compared with negative control group, the clone number formed by SNU-449 cells in ZNF22 knockdown group decreased (26±8 vs. 59±5, P<0.01), the level of apoptosis increased (6.60%±0.22% vs. 2.38%±0.30%, P<0.001), the migration rate decreased (14.47%±6.42% vs. 68.84%±8.01%, P<0.001), and the number of invasive cells decreased (48.00±2.23 vs. 179.00±4.81, P<0.001). There was no obvious tumor growth after subcutaneous injection of JHH-7 cells into nude mice in ZNF22 knockdown group, and the systemic fluorescence expression was lower than that of the negative control group, and the difference was statistically significant ( P<0.05). No metastases were observed on autopsy in knockdown group nude mice. Conclusion:ZNF22 is highly expressed in HCC while knockdowing ZNF22 gene inhibited the growth, proliferation, invasion, metastasis of HCC cells, and induced apoptosis of HCC cells.

【Objective】 To understand the current situation of blood components distribution in domestic prefecture-level blood stations through analyzing the components distribution data of 24 prefecture-level blood stations in China. 【Methods】 The data of components distribution of 24 blood stations from 2017 to 2020 as well as the data of blood deployment of 24 blood stations from 2019 to 2020 were collected and analyzed. 【Results】 From 2017 to 2020, positive annual growth in red blood cells, plasma and cryoprecipitate was observed in 22, 19 and 15 out of the 24 blood stations, and the annual growth median rate of above three components was 5.24%, 3.80% and 3.25%, respectively. Among the 24 prefecture-level blood stations, 23 carried out the preparation of cryoprecipitate. 【Conclusion】 The distribution of red blood cells, cryoprecipitate and plasma in prefecture-level blood stations is increasing year by year. However, there is a overstock of plasma, and most blood stations need blood employment.

Objective:To evaluate the in vitro cross-neutralization of serum antibodies in human and mice immunized with inactivated SARS-CoV-2 vaccine against Delta and Beta variants. Methods:Human serum samples after a second and a third dose of inactivated SARS-CoV-2 vaccine and mouse serum samples after a two-dose vaccination were collected. The neutralizing antibodies in the samples against SARS-CoV-2 strains of prototype, Delta and Beta variants were detected using micro-neutralization assay in biosafety level Ⅲ laboratory. The seroconversion rates and geometric mean titers (GMTs) of antibodies were calculated.Results:The seroconversion rates of antibodies in human serum samples against different SARS-CoV-2 strains were all above 95%. After two-dose vaccination, the GMTs of neutralizing antibodies against the prototype, Delta and Beta strains were 109, 41 and 15, respectively. The GMTs decreased by 2.7 folds and 7.3 folds for the Delta and Beta variants as compared with the prototype strain. After the booster vaccination, the GMTs of neutralizing antibodies against the prototype, Delta and Beta strains were 446, 190 and 86, respectively. The GMTs of neutralizing antibodies against Delta and Beta variants decreased by 2.3 folds and 5.2 folds as compared with that against the prototype strain. The seroconversion rates of antibodies against different SARS-CoV-2 strains in mouse serum samples were all 100%. The GMTs of neutralizing antibodies against the prototype, Delta and Beta strains were 2 037, 862 and 408, respectively. The GMTs decreased by 2.4 folds and 5.0 folds for the Delta and Beta variants.Conclusions:Inactivated SARS-CoV-2 vaccine could induce a certain level of neutralizing antibodies against Delta and Beta variants in both human and mouse models. Moreover, a third dose of vaccine induced higher levels of neutralizing antibodies against Delta and Beta variants in human. This study provided valuable data for the clinical application and protective evaluation of the inactivated SARS-CoV-2 vaccine.

T he recent development of imaging and sequencing technologies enables systematic advances in the clinical study of lung cancer.Meanwhile,the human mind is limited in effectively handling and fully utilizing the accumulation of such enormous amounts of data.Machine learning-based approaches play a critical role in integrating and analyzing these large and complex datasets,which have extensively characterized lung cancer through the use of different perspectives from these accrued data.In this review,we provide an overview of machine learning-based approaches that strengthen the varying aspects of lung cancer diagnosis and therapy,including early detection,auxiliary diagnosis,prognosis prediction,and immunotherapy practice.Moreover,we highlight the challenges and opportunities for future applications of machine learning in lung cancer.

Objective:To investigate the clinical effect of 595 nm pulsed dye laser treatment for superficial hemangiomas on different sites of infants(≤3 years old) .Methods:From January 2018 to January 2020, we retrospectively analyzed the data of infants with superficial hemangioma in our hospital. They were treated with 595 nm pulsed dye laser. The energy and frequency of laser treatment, the effects and adverse reactions were recorded. t-test, SNK- q test and Chi-square test were used to analyze the data. Results:A total of 437 infants were enrolled, including 168 male and 269 female. The ages ranged from 0 to 36 months. They were divided into different lesion sites as head (34 cases) , forehead (37 cases) , cheek (61 cases) , periocular (30 cases) , nose (21 cases) , lip (12 cases) , perioral (10 cases) , ear (16 cases) , neck (26 cases) , chest (36 cases) , abdomen (24 cases) , back (21 cases) , buttocks (12 cases) , perineum (14 cases) , upper arm and forearm (30 cases) , hand (25 cases) , thigh (18 cases) , and foot (10 cases) . The average treatment energy of each sites was 8.0 J/cm 2 , with no significant difference( P>0.05) . The average number of treatments on the head, forehead, cheek, periocular, nasal, lip, perioral and foot was higher than that on other sites, showing a statistical significance ( P<0.05) ; among them, the nasal and perioral parts had most treatments. The total effective rate was 96.57%(422/437). The complications happened in 35 cases(8.01%), including hypopigmentation(22 cases), hyperpigmentation(5 cases), atrophic scar (8 cases). Conclusions:595 nm pulsed dye laser has a good therapeutic effect on infantile superifcial hemangioma with low adverse effect. Hemangioma on different sites requires different times of treatment.

Objective:To investigate the clinical effect of 595 nm pulsed dye laser treatment for superficial hemangiomas on different sites of infants(≤3 years old) .Methods:From January 2018 to January 2020, we retrospectively analyzed the data of infants with superficial hemangioma in our hospital. They were treated with 595 nm pulsed dye laser. The energy and frequency of laser treatment, the effects and adverse reactions were recorded. t-test, SNK- q test and Chi-square test were used to analyze the data. Results:A total of 437 infants were enrolled, including 168 male and 269 female. The ages ranged from 0 to 36 months. They were divided into different lesion sites as head (34 cases) , forehead (37 cases) , cheek (61 cases) , periocular (30 cases) , nose (21 cases) , lip (12 cases) , perioral (10 cases) , ear (16 cases) , neck (26 cases) , chest (36 cases) , abdomen (24 cases) , back (21 cases) , buttocks (12 cases) , perineum (14 cases) , upper arm and forearm (30 cases) , hand (25 cases) , thigh (18 cases) , and foot (10 cases) . The average treatment energy of each sites was 8.0 J/cm 2 , with no significant difference( P>0.05) . The average number of treatments on the head, forehead, cheek, periocular, nasal, lip, perioral and foot was higher than that on other sites, showing a statistical significance ( P<0.05) ; among them, the nasal and perioral parts had most treatments. The total effective rate was 96.57%(422/437). The complications happened in 35 cases(8.01%), including hypopigmentation(22 cases), hyperpigmentation(5 cases), atrophic scar (8 cases). Conclusions:595 nm pulsed dye laser has a good therapeutic effect on infantile superifcial hemangioma with low adverse effect. Hemangioma on different sites requires different times of treatment.

Objective To investigate the correlation between NOTCH3 polymorphic locus rs1043994 and white matter lesions (WML). Methods The enrolled subjects were elderly in the outpatient clinic for health check-up from January 2015 to January 2017. According to the results of cranial MR examination, 337 elderly people were divided into the WML group (n=172) and normal control group (n=165). The inclusion criteria were: (1) age ≥ 50 years old; (2) those who can cooperate with head MRI examination; (3) those who understand the study and agree to retain blood samples for SNP testing. Exclusion criteria were: (1) previous neurological diseases such as cerebrovascular disease, intracranial infection, dementia, and trauma; (2) having a history of mental illness; (3) suffering from serious diseases such as liver and kidney dysfunction, heart disease, tumors. The clinical data of the subjects were collected and the peripheral venous blood was extracted for DNA extraction. The cognitive function was evaluated by the Mini-mental State Examination. The genotyping of the subjects was carried out by restriction endonuclease. The correlation between rs1043994 polymorphism and WML was analyzed by Logistic regression. Results There was no significant difference in gender, education level, diabetes, hyperlipidemia, smoking, uric acid and Hcy between the two groups (P>0.05). Compared with the control group, the WML group had a higher average age and a higher proportion of hypertension (P<0.05), and the Mini-mental State Examination scores between the two groups were statistically significant different (P<0.01). The genotypes (AA, AG, GG) frequency and allele (A, G) frequency distribution of rs1043994 were statistically different between the two groups (P<0.05). Multivariate Logistic regression analysis showed that age (P=0.001), hypertension (P=0.012) and AA genotype (P=0.019) were independent risk factors of WML (P<0.05). The risk of WML in AA genotype is 2.512 times higher than that in AG/GG genotype. Conclusions The rs1043994 polymorphism of NOTCH3 gene is associated with WML in the elderly population, and the A allele is a susceptibility gene for WML. The rs1043994 polymorphism of the NOTCH3 gene may be a genetic risk factor for WML in the Chinese elderly population.

Background and objective Lung cancer is one of the most serious disease and the incidence of non-small cell lung cancer (NSCLC) is the highest in lung cancer. The main reason for the failure of chemotherapy is the tolerance to cisplatin. Transcriptional regulator SOX4 plays an important role in the occurrence and development of many tumors, and regulates Wnt signaling pathway by regulating the expression of β-catenin. We aimed to investigate the role of SOX4 on cisplat-in-resistance in NSCLC cell A549 cell. Methods The cisplatin-resistance lung cancer cell line A549/DDP was constructed by induction method in vitro, and cisplatin-resistance detected by CCK8 assay. Growth curves of A549 and A549/DDP was cal-culated. The expression level of SOX4 in A549 and A549/DDP cells were detected by Western blot. A549/DDP were knock-down of SOX4 by siRNA transfection, and the cisplatin-resistance of detected by CCK-8 assay, the expression level of β-catenin and Survivin were detected by real-time PCR and Western blot. Results The cisplatin-resistance cell line A549/DDP was constructed successfully, and its cisplatin-resistance is 13.7 times higher than in A549. There was no significance difference between A549 and A549/DDP in cell proliferation. The expression level of SOX4 is higher in A549/DDP than in A549. The cisplatin-resistance significantly decreased in A549/DDP cells after knockdown of SOX4 by siRNA transfection. The expres-sion level of β-catenin and Survivin significantly decreased in A549/DDP cells after knockdown of SOX4. Conclusion SOX4 can strengthen cisplatin-resistance of non-small cell lung cancer cell A549.