Objective To investigate the incidence of colorectal serrated lesions(SL)combined with advanced neoplasia(AN)and to analyze the risk factors for SL combined AN.Methods A total of 297 patients with colorectal polyps detected by endoscopy and pathologically suggestive of SL from 1st October 2021 to 30th September 2023 in the First People's Hospital of Huzhou.They were divided into combined group(n=33)and uncomplicated group(n=264)according to whether they were combined with AN or not,and the clinicopathologic differences between two groups were compared and the coexisting risk factors were analyzed.Results Age ≥ 50 years,male,history of polyps,polyp size and different SL subtypes were all risk factors for SL combined with AN,and the difference was statistically significant(P＜0.05).Logistic regression analysis revealed that age,male,history of polypos,and SL size were independent risk factors for SL combined with AN.Conclusion Males,older age,previous history of polyps,and larger SL lesions were more likely to have combined AN.

Objective To investigates the inhibitory and cytotoxic effects of chimeric antigen receptor-engineered natural killer(CAR-NK)cells targeting cellular-mesenchymal epithelial transition factor(c-Met)against gastric cancer(GC)cells in vitro.Methods c-Met expression at protein and mRNA levels was evaluated in GC cell lines(MKN-45,GTL-16,NCI-N87)and gastric mucosal epithelial cells(GES-1)by using flow cytometry(FCM),Western blot,and reverse transcription quantitative polymerase chain reaction.Immunofluorescence assays were conducted to confirm c-Met CAR-mediated specificity toward c-Met-overexpressing GTL-16 cells.Lentiviral vectors were utilized to construct c-Met-targeting CAR-NK cells,with transduction efficiency and phenotypic integrity verified by FCM.Cytotoxic activity against GC cells and normal epithelial cells was quantified via lactate dehydrogenase(LDH)release assays and cytokine secretion measured by enzyme-linked immunosorbent assay.Results c-Met exhibited significantly higher expression in GTL-16 and MKN-45 cells at both transcriptional and protein levels compared to NCI-N87 and GES-1 cells(P＜0.05).CAR-NK cells demonstrated a transduction efficiency of(14.97±0.25)％ without altering NK-92 cell phenotypes.Immunofluorescence confirmed specific binding of c-Met CAR-expressing Lenti-X-293T cells to GTL-16 targets.LDH assays revealed enhanced cytotoxicity of c-Met CAR-NK cells against c-Met-high GC cells(GTL-16,MKN-45)versus untransduced NK-92 controls(P＜0.05).At a 10∶1 effector-to-target ratio,c-Met CAR-NK cells co-cultured with c-Met-high GC cells secreted significantly elevated tumor necrosis factor(TNF-α)and interferon(IFN)-γ(P＜0.05).Conclusion The c-Met CAR-NK cells constructed in this study have the ability to specifically recognize and target to kill gastric cancer cells with high expression of c-Met,and have a strong killing effect function,which can release more TNF-α and IFN-γ.

Objective To investigate the impact of linked color imaging(LCI)combined with a transparent cap on the detection rate of colorectal sessile serrated lesion(SSL).Methods A total of 492 patients who underwent colonoscopy the First People's Hospital of Huzhou from February 2024 to January 2025 were randomly assigned to three groups:White light imaging(WLI)group,LCI group,and LCI combined with transparent cap group,with 164 cases in each group.The general clinical data,cecal intubation time(CIT),withdrawal time,SSL detection rate,small(≤5mm)SSL detection rate,and proximal colon SSL detection rate were analyzed and compared among three groups.Results There were no significant differences in general clinical data,CIT,or withdrawal time among three groups(P>0.05).Statistical analysis revealed that the SSL detection rates for WLI group,LCI group,and LCI combined with transparent cap group were 6.10％,12.20％,and 18.90％,respectively;In the proximal colon,the SSL detection rates for WLI group,LCI group,and LCI combined with transparent cap group were 3.66％,9.15％,and 16.46％,respectively;For small(≤5mm)SSL,the detection rates were 1.22％,2.44％,and 7.32％in WLI group,LCI group,and LCI combined with transparent cap group,respectively also showing statistically significant differences(P<0.001).Conclusion Colonoscopy using LCI combined with a transparent cap significantly improves the detection rate of SSL,particularly for small SSL.

Objective:To develop a nomogram model based on the preoperative neutrophil-to-lymphocyte ratio and gamma-glutamyl transpeptidase (GGT) -to-platelet ratio (NLR-GPR) score to predict the prognosis of patients with hepatocellular carcinoma (HCC) undergoing hepatectomy.Methods:Clinical data of 284 patients with HCC who underwent curative resection at Taizhou Hospital of Zhejiang Province between January 2012 and September 2016 were retrospectively analyzed, including 235 males and 49 females, aged 57(51, 65) years. Clinical data, including gender, age, neutrophil count, lymphocyte count, platelet count, GGT, and total bilirubin, were collected. The Cox proportional hazards regression model was employed to assess the relationship between the preoperative NLR-GPR score and patient disease-free survival (DFS) and overall survival (OS). A nomogram was constructed based on the results of the multivariate analysis. Survival curves were generated using the Kaplan-Meier method, and differences between groups were evaluated using the log-rank test. The performance of the model was assessed by the concordance index (C-index).Results:The NLR-GPR score was found to be negatively correlated with both DFS and OS (both P<0.05), where a higher score indicated a poorer prognosis. Multivariate analysis identified the NLR-GPR score as an independent risk factor for both DFS ( HR=1.463, 95% CI: 1.135-1.887, P=0.003) and OS ( HR=1.734, 95% CI: 1.300-2.313, P<0.001). A nomogram was deve-loped based on the variables selected from the multivariate Cox regression analysis, including postoperative pleural effusion, AJCC stage, vascular invasion, and the NLR-GPR score. This nomogram demonstrated good predictive accuracy, with C-indices for DFS and OS of 0.676 and 0.726, respectively. Conclusion:The nomogram model, constructed based on the preoperative NLR-GPR score and relevant clinicopathological factors, can effectively predict the postoperative survival of patients with HCC undergoing hepatectomy.

Objective To investigate the incidence of colorectal serrated lesions(SL)combined with advanced neoplasia(AN)and to analyze the risk factors for SL combined AN.Methods A total of 297 patients with colorectal polyps detected by endoscopy and pathologically suggestive of SL from 1st October 2021 to 30th September 2023 in the First People's Hospital of Huzhou.They were divided into combined group(n=33)and uncomplicated group(n=264)according to whether they were combined with AN or not,and the clinicopathologic differences between two groups were compared and the coexisting risk factors were analyzed.Results Age ≥ 50 years,male,history of polyps,polyp size and different SL subtypes were all risk factors for SL combined with AN,and the difference was statistically significant(P＜0.05).Logistic regression analysis revealed that age,male,history of polypos,and SL size were independent risk factors for SL combined with AN.Conclusion Males,older age,previous history of polyps,and larger SL lesions were more likely to have combined AN.

Objective To investigates the inhibitory and cytotoxic effects of chimeric antigen receptor-engineered natural killer(CAR-NK)cells targeting cellular-mesenchymal epithelial transition factor(c-Met)against gastric cancer(GC)cells in vitro.Methods c-Met expression at protein and mRNA levels was evaluated in GC cell lines(MKN-45,GTL-16,NCI-N87)and gastric mucosal epithelial cells(GES-1)by using flow cytometry(FCM),Western blot,and reverse transcription quantitative polymerase chain reaction.Immunofluorescence assays were conducted to confirm c-Met CAR-mediated specificity toward c-Met-overexpressing GTL-16 cells.Lentiviral vectors were utilized to construct c-Met-targeting CAR-NK cells,with transduction efficiency and phenotypic integrity verified by FCM.Cytotoxic activity against GC cells and normal epithelial cells was quantified via lactate dehydrogenase(LDH)release assays and cytokine secretion measured by enzyme-linked immunosorbent assay.Results c-Met exhibited significantly higher expression in GTL-16 and MKN-45 cells at both transcriptional and protein levels compared to NCI-N87 and GES-1 cells(P＜0.05).CAR-NK cells demonstrated a transduction efficiency of(14.97±0.25)％ without altering NK-92 cell phenotypes.Immunofluorescence confirmed specific binding of c-Met CAR-expressing Lenti-X-293T cells to GTL-16 targets.LDH assays revealed enhanced cytotoxicity of c-Met CAR-NK cells against c-Met-high GC cells(GTL-16,MKN-45)versus untransduced NK-92 controls(P＜0.05).At a 10∶1 effector-to-target ratio,c-Met CAR-NK cells co-cultured with c-Met-high GC cells secreted significantly elevated tumor necrosis factor(TNF-α)and interferon(IFN)-γ(P＜0.05).Conclusion The c-Met CAR-NK cells constructed in this study have the ability to specifically recognize and target to kill gastric cancer cells with high expression of c-Met,and have a strong killing effect function,which can release more TNF-α and IFN-γ.

Objective To investigate the impact of linked color imaging(LCI)combined with a transparent cap on the detection rate of colorectal sessile serrated lesion(SSL).Methods A total of 492 patients who underwent colonoscopy the First People's Hospital of Huzhou from February 2024 to January 2025 were randomly assigned to three groups:White light imaging(WLI)group,LCI group,and LCI combined with transparent cap group,with 164 cases in each group.The general clinical data,cecal intubation time(CIT),withdrawal time,SSL detection rate,small(≤5mm)SSL detection rate,and proximal colon SSL detection rate were analyzed and compared among three groups.Results There were no significant differences in general clinical data,CIT,or withdrawal time among three groups(P>0.05).Statistical analysis revealed that the SSL detection rates for WLI group,LCI group,and LCI combined with transparent cap group were 6.10％,12.20％,and 18.90％,respectively;In the proximal colon,the SSL detection rates for WLI group,LCI group,and LCI combined with transparent cap group were 3.66％,9.15％,and 16.46％,respectively;For small(≤5mm)SSL,the detection rates were 1.22％,2.44％,and 7.32％in WLI group,LCI group,and LCI combined with transparent cap group,respectively also showing statistically significant differences(P<0.001).Conclusion Colonoscopy using LCI combined with a transparent cap significantly improves the detection rate of SSL,particularly for small SSL.

Objective:To develop a nomogram model based on the preoperative neutrophil-to-lymphocyte ratio and gamma-glutamyl transpeptidase (GGT) -to-platelet ratio (NLR-GPR) score to predict the prognosis of patients with hepatocellular carcinoma (HCC) undergoing hepatectomy.Methods:Clinical data of 284 patients with HCC who underwent curative resection at Taizhou Hospital of Zhejiang Province between January 2012 and September 2016 were retrospectively analyzed, including 235 males and 49 females, aged 57(51, 65) years. Clinical data, including gender, age, neutrophil count, lymphocyte count, platelet count, GGT, and total bilirubin, were collected. The Cox proportional hazards regression model was employed to assess the relationship between the preoperative NLR-GPR score and patient disease-free survival (DFS) and overall survival (OS). A nomogram was constructed based on the results of the multivariate analysis. Survival curves were generated using the Kaplan-Meier method, and differences between groups were evaluated using the log-rank test. The performance of the model was assessed by the concordance index (C-index).Results:The NLR-GPR score was found to be negatively correlated with both DFS and OS (both P<0.05), where a higher score indicated a poorer prognosis. Multivariate analysis identified the NLR-GPR score as an independent risk factor for both DFS ( HR=1.463, 95% CI: 1.135-1.887, P=0.003) and OS ( HR=1.734, 95% CI: 1.300-2.313, P<0.001). A nomogram was deve-loped based on the variables selected from the multivariate Cox regression analysis, including postoperative pleural effusion, AJCC stage, vascular invasion, and the NLR-GPR score. This nomogram demonstrated good predictive accuracy, with C-indices for DFS and OS of 0.676 and 0.726, respectively. Conclusion:The nomogram model, constructed based on the preoperative NLR-GPR score and relevant clinicopathological factors, can effectively predict the postoperative survival of patients with HCC undergoing hepatectomy.

Objective To compare the clinical efficacy of cold snare endoscopic mucosal resection(CS-EMR)with conventional endoscopic mucosal resection(EMR)in the treatment of＜20 mm colorectal laterally spreading tumor(CLST).Methods A total of 248 CLST patients undergoing endoscopic resection treated in the First People's Hospital of Huzhou from January 2020 to June 2022 were selected and divided into EMR group and CS-EMR group according to random number table method,with 124 cases in each group.The general data,focal features,surgical indicators and complication rate of two groups were statistically compared.Results There were no significant differences in en bloc resection rate,complete resection rate and postoperative recurrence rate between two groups(P＞0.05).The operation time and hospital stay in CS-EMR group were significantly shorter than those in EMR group,the number of titanium clips and hospitalization costs were significantly lower than those in EMR group,and the incidence of intraoperative bleeding,delayed bleeding and delayed perforation were significantly lower than those in EMR group(P＜0.05).Conclusion In treatment of CLST with a maximum diameter of＜20mm,CS-EMR not only retains the advantages of fewer surgery-related complications,but also has similar therapeutic effect as EMR,and reduces the cost burden of patients,which is worthy of clinical reference and promotion.

Objective:To retrospectively analyze the clinical characteristics of 193 Chinese patients with McCune-Albright syndrome (MAS).Methods:By using keywords " McCune-Albright syndrome", " Albright syndrome", or " fibrous dysplasia " as the search terms, 193 cases of MAS reported in China from January 1990 to November 2022 from the Wanfang data, CNKI, VIP, PubMed, and Embase databases were obtained, and their clinical data was retrospectively analyzed. Intergroup comparisons were carried out by using t test, Mann-Whitney U test, and χ2 test. Results:The 193 MAS patients had included 42 males and 151 females, with the median first-visit age of females being younger than males. The typical triad group had accounted for 46.1% of patients, and the middle first-visit and diagnosis age was younger than the atypical group. The primary reason for first-visit in males of MAS was fibrous dysplasia (FD), whilst that in females of MAS was peripheral precocious puberty (PPP). FD has occurred in 84.5% of the patients, with an average age of onset age being 6.1 years old, and 90% was ≤ 16 years of age. Endocrine hyperfunction was found in 79.3% of the patients, with a higher proportion in females compared with males ( P<0.05). Pituitary involvement was seen in 21.8% of the patients, and the incidence of craniofacial FD and cranial nerve compression was significantly higher in those with elevated growth hormone (GH) than without ( P<0.05). Café-au-Lait Spots were noted in 86.5% of the patients, and 28.3% (28/99) had located on the different side of FD. Conclusion:Most MAS patients had atypical manifestations and multi-systemic involvement. It is more common and occurs earlier in females. The most common reasons for initial diagnosis in male and female patients were FD and PPP, respectively. Patients with elevated GH should be examined for cranial nerve compression.