Intravascular papillary endothelial hyperplasia (IPEH), also known as Masson tumor, is a rare vascular benign tumor of blood vessels. It may occur in any part of the body, especially the deep dermis and subcutaneous tissue of the head, neck, fingers and trunk. The imaging and histopathology of IPEH are similar to hemangiosarcoma, especially in the case of active vascular endothelial hyperplasia. IPEH is a reactive proliferative lesion of vascular intima. The etiology is still unclear. After some studies showed that IPEH was a benign lesion, few reports on the etiology of it were reported. IPEH is usually limited to the thrombotic vessels or lumens of vascular malformations, usually accompanied by a clear history of trauma. IPEH usually does not cause any symptoms. It looks like a slow-growing lump. Some cases have been reported with pain and swelling. Although IPEH is relatively rare, its accurate diagnosis is crucial because it may be similar to malignant angiogenic lesions in clinical practice. There were few reports of cases related to intravascular papillary endothelial hyperplasia located in the sternocleidomastoid muscle after reviewing the domestic and foreign literature in recent 10 years. This case reports that a young male, who was admitted to the hospital one month after finding a subcutaneous tumor in the left neck. After admittance, relevant preoperative examinations were completed. After multi-disciplinary discussion and elimination of surgical contraindications, a specific surgical plan was formulated. The tumor was removed under local anesthesia on the second day after admission. During the operation, it was found that the tumor was located between the sternocleidomastoid muscle bundles, and it was sent for pathologic examination. Paraffin section pathology was reported after operation. Histological examination showed that the morphology was consistent with vascular endothelial papillary hyperplasia. There were no related surgical complications and recurrence in the 3-month follow-up. The purpose of this paper is to provide clinicians with a certain understanding of this rare disease through the report of this case of IPEH, and to identify it in later clinical work, and at the same time, to avoid confusion with malignant diseases, such as hemangiosarcoma, leading to unnecessary treatment and increase the cost of treatment.
Humans ; Male ; Endothelium, Vascular/pathology* ; Hemangioendothelioma/surgery* ; Hyperplasia/pathology* ; Neck Muscles/surgery* ; Vascular Neoplasms/pathology*

Objective:To construct fused cancer cell/neutrophil membrane-coated polydopamine nanoparticles chelated with manganese ions (Ⅱ) (PMNP@FMs) and explore the potential for targeted pancreatic cancer fluorescence imaging and MRI.Methods:Cancer cell membranes fused with neutrophil membranes were encapsulated on the surface of polydopamine nanoparticles chelated with manganese ions (Ⅱ) (PMNPs) to prepare PMNP@FMs. The morphology, structure, and MRI performance of the product were characterized. The cytotoxicity of PMNP@FMs towards human pancreatic cancer cells (PANC-1) and normal human pancreatic ductal epithelial cells (hTERT-HPNE) was evaluated using cell counting kit (CCK)-8, and in vivo toxicity was assessed in healthy mice. PANC-1 pancreatic cancer xenograft nude mouse models were established for in vivo fluorescence imaging and MRI. Data were analyzed using the independent-sample t test, repeated measures analysis of variance and the least significance difference method. Results:PMNP@FMs exhibited a core-shell structure with a diameter of (112.81±8.64) nm, negative surface charge, and good dispersibility. The T 1 relaxivity of PMNPs was 18.81±0.22, which was 4.1 times higher than that of gadopentetate dimeglumine (Gd-DTPA) (4.55±0.24; t=75.54, P<0.001). Co-culture of PMNPs and PMNP@FMs with hTERT-HPNE and PANC-1 cells for 24 h resulted in cell viability above 90% within the concentration range of 0-500 μg/ml. PMNP@FMs did not affect mouse survival and showed no apparent organ damage. In vivo fluorescence imaging and MRI revealed that PMNP@FMs accumulated highly in tumors and reached the peak 24 h post intravenous administration (relative MR signal: 1.35±0.01, fluorescence intensity: (1.20±0.25)×10 10), surpassing the peak observed in the control group (1.22±0.01, (3.87±0.50)×10 9;F values: 11.03-188.01, t values: 18.20, 5.64, all P<0.05), with hepatic metabolism being the primary route of clearance. Conclusion:PMNP@FMs demonstrate a potential for targeted pancreatic cancer fluorescence imaging and MRI, offering promising prospect for precise diagnosis of early-stage pancreatic cancer.

Objective:To construct fused cancer cell/neutrophil membrane-coated polydopamine nanoparticles chelated with manganese ions (Ⅱ) (PMNP@FMs) and explore the potential for targeted pancreatic cancer fluorescence imaging and MRI.Methods:Cancer cell membranes fused with neutrophil membranes were encapsulated on the surface of polydopamine nanoparticles chelated with manganese ions (Ⅱ) (PMNPs) to prepare PMNP@FMs. The morphology, structure, and MRI performance of the product were characterized. The cytotoxicity of PMNP@FMs towards human pancreatic cancer cells (PANC-1) and normal human pancreatic ductal epithelial cells (hTERT-HPNE) was evaluated using cell counting kit (CCK)-8, and in vivo toxicity was assessed in healthy mice. PANC-1 pancreatic cancer xenograft nude mouse models were established for in vivo fluorescence imaging and MRI. Data were analyzed using the independent-sample t test, repeated measures analysis of variance and the least significance difference method. Results:PMNP@FMs exhibited a core-shell structure with a diameter of (112.81±8.64) nm, negative surface charge, and good dispersibility. The T 1 relaxivity of PMNPs was 18.81±0.22, which was 4.1 times higher than that of gadopentetate dimeglumine (Gd-DTPA) (4.55±0.24; t=75.54, P<0.001). Co-culture of PMNPs and PMNP@FMs with hTERT-HPNE and PANC-1 cells for 24 h resulted in cell viability above 90% within the concentration range of 0-500 μg/ml. PMNP@FMs did not affect mouse survival and showed no apparent organ damage. In vivo fluorescence imaging and MRI revealed that PMNP@FMs accumulated highly in tumors and reached the peak 24 h post intravenous administration (relative MR signal: 1.35±0.01, fluorescence intensity: (1.20±0.25)×10 10), surpassing the peak observed in the control group (1.22±0.01, (3.87±0.50)×10 9;F values: 11.03-188.01, t values: 18.20, 5.64, all P<0.05), with hepatic metabolism being the primary route of clearance. Conclusion:PMNP@FMs demonstrate a potential for targeted pancreatic cancer fluorescence imaging and MRI, offering promising prospect for precise diagnosis of early-stage pancreatic cancer.

Objective:To explore the effect of nirmatrelvir/ritonavir (Paxlovid) on renal function in patients with coronavirus disease 2019 (COVID-19) and renal insufficiency.Methods:Clinical data of renal insufficiency patients with COVID-19, who were hospitalized at Beijing Ditan Hospital, Capital Medical University from March 23, 2022 to April 30, 2023 and received Paxlovid treatment, were collected. A retrospective analysis was conducted on the incidence of Paxlovid-related acute kidney injury (AKI) and changes of blood urea, serum creatinine (Scr), blood uric acid, and estimated glomerular filtration rate (eGFR) in patients before and after Paxlovid treatment.Results:A total of 386 patients were included in the analysis, including 220 males (57.0%) and 166 females (43.0%), with a median age of 79 years. COVID-19 was classified as asymptomatic in 42 patients (10.9%), mild in 175 patients (45.4%), moderate in 126 patients (32.6%), severe in 34 patients (8.8%), and critical in 9 patients (2.3%). The renal insufficiency was mild in 246 patients (63.7%), moderate in 110 patients (28.5%), and severe in 30 patients (7.8%). Among 386 patients, 16 (4.1%) developed AKI during Paxlovid treatment or within 48 hours after withdrawal, 5 (1.3%) of which were judged to be related to Paxlovid. The 5 patients aged 70 years and above, and all used nephrotoxic drugs. After Paxlovid treatment, the blood urea, Scr, blood uric acid, and eGFR in the 386 patients were all improved compared to before, and the differences were statistically significant [Scr: (133.8±9.3) μmol/L vs. (111.7±6.6) μmol/L; blood uric acid: (335.9±7.1) μmol/L vs. (291.9±5.8) μmol/L; eGFR: (63.4±1.1) ml/(min·1.73 m 2) vs. (69.1±1.2) ml/(min·1.73 m 2); all P<0.05]. Conclusions:The overall safety of Paxlovid treatment for COVID-19 in patients with renal insufficiency is good, and it has no significant impact on the renal function in the vast majority of patients. However, for elderly people aged 70 years and above, especially for those who have combination medications of nephrotoxic drugs, the occurrence of AKI should still be vigilant.

Objective:To explore the effect of nirmatrelvir/ritonavir (Paxlovid) on renal function in patients with coronavirus disease 2019 (COVID-19) and renal insufficiency.Methods:Clinical data of renal insufficiency patients with COVID-19, who were hospitalized at Beijing Ditan Hospital, Capital Medical University from March 23, 2022 to April 30, 2023 and received Paxlovid treatment, were collected. A retrospective analysis was conducted on the incidence of Paxlovid-related acute kidney injury (AKI) and changes of blood urea, serum creatinine (Scr), blood uric acid, and estimated glomerular filtration rate (eGFR) in patients before and after Paxlovid treatment.Results:A total of 386 patients were included in the analysis, including 220 males (57.0%) and 166 females (43.0%), with a median age of 79 years. COVID-19 was classified as asymptomatic in 42 patients (10.9%), mild in 175 patients (45.4%), moderate in 126 patients (32.6%), severe in 34 patients (8.8%), and critical in 9 patients (2.3%). The renal insufficiency was mild in 246 patients (63.7%), moderate in 110 patients (28.5%), and severe in 30 patients (7.8%). Among 386 patients, 16 (4.1%) developed AKI during Paxlovid treatment or within 48 hours after withdrawal, 5 (1.3%) of which were judged to be related to Paxlovid. The 5 patients aged 70 years and above, and all used nephrotoxic drugs. After Paxlovid treatment, the blood urea, Scr, blood uric acid, and eGFR in the 386 patients were all improved compared to before, and the differences were statistically significant [Scr: (133.8±9.3) μmol/L vs. (111.7±6.6) μmol/L; blood uric acid: (335.9±7.1) μmol/L vs. (291.9±5.8) μmol/L; eGFR: (63.4±1.1) ml/(min·1.73 m 2) vs. (69.1±1.2) ml/(min·1.73 m 2); all P<0.05]. Conclusions:The overall safety of Paxlovid treatment for COVID-19 in patients with renal insufficiency is good, and it has no significant impact on the renal function in the vast majority of patients. However, for elderly people aged 70 years and above, especially for those who have combination medications of nephrotoxic drugs, the occurrence of AKI should still be vigilant.

Background and purpose:The Shanghai Municipal Center for Disease Control and Prevention provides annual updates on cancer occurrence and trends in Shanghai.This study aimed to investigate the cancer incidence and mortality in 201 7 and their trends from 2002 to 2017 in Shanghai. Methods:Data of new cancer diagnoses and deaths from 2002 to 2017 were obtained from the Shanghai Municipal Center for Disease Control and Prevention population-based cancer registry and Vital Statistics System.Cancer incidence and mortality stratified by year of diagnosis or death,gender and age group were analyzed.Number,proportion,crude rate,age-specific rate,age-standardized rate and others were calculated.The number,proportion and rates of common cancers in different groups were also calculated.Trends in age-standardized rate of incidence and death rates for all cancers combined and for the common cancer types by gender were estimated by joinpoint analysis and characterized by the annual percent change(APC)and average annual percent change(AAPC).Segi's 1960 world standard population was used for calculating age-standardized incidence and mortality. Results:The new cancer cases and deaths were 79 378 and 37 186 in Shanghai in 2017.The crude rate of incidence was 546.55/105,and the age-standardized rate was 246.31/105.The age-standardized rate of incidence was higher among females than among males.The crude rate of mortality was 256.04/1 05,and the age-standardized rate was 88.41/105.The age-standardized rate of mortality was higher among males than among females.The age-specific numbers and rates of incidence and mortality increased with age.The age-specific number and rate of incidence reached the peak at the age groups of 60-64 years and older than 85 years,and those of mortality among males reached the peak at the age groups of 60-64 years and older than 85 years,and those of mortality among females reached the peak at the age groups of older than 85 years,respectively.The sites of top 10 common cancer types sorted by the number of incidence cases among males were lung,colorectum,stomach,prostate,liver,thyroid,pancreas,bladder,kidney and oesophagus,and among females were lung,breast,thyroid,colorectum,stomach,pancreas,liver,brain,central nervous system(CNS),cervix uteri and gallbladder,the sites of those sorted by the number of deaths among males were lung,stomach,colorectum,liver,pancreas,prostate,oesophagus,bladder,lymphoma and gallbladder,among females were lung,colorectum,breast,stomach,pancreas,liver,gallbladder,brain,CNS,ovary and lymphoma.The top 10 common cancer types stratified by gender and the top 5 common cancer types stratified by common age groups merged of incidence and mortality had wide variations.Overall,the age-standardized rates of incidence were stable from 2002 to 2009,and increased 2.88％on average per year from 2009 to 201 7.The age-standardized rates of mortality were stable from 2002 to 2011,and decreased 2.66％on average per year from 2011 to 201 7.The trends differed by gender and cancer type. Conclusion:Lung cancer,colorectal cancer,pancreatic cancer,thyroid cancer,female breast cancer,cervical cancer and male prostate cancer are the most common cancers in Shanghai,the appropriate screening technical scheme should be formulated according to the current situation of malignant tumors in Shanghai,promote cancer opportunistic screening,promote appropriate technologies for intervention and management of cancer patients in the community,reduce the disease burden of malignant tumors.

Objective:To analyze the expression of glial fibrillary acidic protein (GFAP) and neuronal nuclei (NeuN) antigen in hippocampus based on the depression model of juvenile rats caused by chronic unpredictable stress (CUS), and to explore the effect of electroacupuncture vagus nerve on CUS depression model.Methods:Six juvenile SD rats were selected as the control group (without any stimulation), and the rest were divided into CUS group, pseudo stimulation group, fluoxetine group and electroacupuncture group by random number method after CUS modeling, with 6 rats in each group. Fluoxetine group was given 10 mg/kg fluoxetine intervention; control group and CUS group were given the same amount of normal saline intervention; In the electroacupuncture group, the distal vagus nerve was stimulated after ligation, while in the pseudo stimulation group, only vagus nerve was isolated without electrical stimulation. After 28 d of intervention, the five groups were subjected to Open-field Test and Sucrose Preference Test. Hippocampal neurons were detected by hematoxylin and eosin (HE) staining, and the expressions of GFAP and NeuN in hippocampal were detected by immunohistochemistry.Results:After CUS modeling and before intervention, the number of vertical and horizontal movements, sucrose consumption and sucrose preference in CUS group, pseudo stimulation group, fluoxetine group and electroacupuncture group were significantly lower than those in the control group (all P<0.01); After the intervention, the above indexes in CUS group and pseudo stimulation group were still lower than those in the control group (all P<0.01), but the above indexes in fluoxetine group and electroacupuncture group were significantly higher than those in CUS group and pseudo stimulation group (all P<0.01). HE staining showed that the arrangement of hippocampal neurons in CUS group and pseudo stimulation group were loose, and there were cell swelling and pyknosis, which was significantly improved in fluoxetine group and electroacupuncture group. Immunohistochemical results showed that compared with the control group, the expression of GFAP increased and NeuN decreased in the hippocampus of CUS group and pseudo stimulation group (all P<0.01); Compared with CUS group and pseudo stimulation group, the expression of GFAP decreased and NeuN increased in fluoxetine group and electroacupuncture group (all P<0.01). Conclusions:Electroacupuncture of vagus nerve can obviously improve the depression symptoms of juvenile rats, which is similar to fluoxetine, and may be related to regulating the expression of GFAP and Neun in hippocampus.

Objective:To investigate the characteristics and influencing factors of esophageal stenosis after endoscopic submucosal dissection (ESD) for early esophageal carcinoma.Methods:Patients who underwent ESD in the Digestive Endoscopy Center of the Second Affiliated Hospital of Army Medical University from January 2011 to December 2018 were included. The data were obtained from medical records and follow-up. The influencing factors of stenosis were determined by single factor and Cox regression analysis.Results:A total of 654 patients underwent ESD and 79 (12.1%) of them developed postoperative esophageal stenosis. The median time of stenosis development was 27 (17, 43) days. The morphology and lesion circumferential proportion were independent factors for the occurrence of stenosis after ESD. The stenosis incidence of type Ⅱa was 6.601 times (95% CI: 1.518-28.709, P=0.012) compared with that of type Ⅱc. The incidence of stenosis in lesions with 75%-<100% and 100% circumference was 17.408 times (95% CI: 8.009-37.839, P<0.001)and 52.439 times (95% CI: 23.905-115.029, P<0.001) respectively compared with that of patients <75%. Among the 79 patients, 27 had severe stenosis, and the lesion circumferential proportion was an independent factor for stenosis. Compared with the group of lesion circumferential proportion of less than 75%, the incidences of stenosis of lesion circumferential proportion of 75%-<100% and 100% were 7.775 (95% CI: 1.977-30.577, P=0.003) and 70.062 (95% CI: 19.879-246.926, P<0.001) times respectively. Conclusion:The morphology and lesion circumferential proportion are two independent factors for the occurrence of esophageal stenosis after ESD. Additionally, lesion circumferential proportion is an independent factor for the occurrence of severe esophageal stenosis after ESD.

Objective: To investigate the efficacy and safety of magnesium aluminium carbonate, lansoprazole, amoxicillin and furazolidone in the treatment of Helicobacter pylori-related gastric ulcer. Methods: From March 2016 to December 2017, 120 patients with HP related gastric ulcer who met the inclusion criteria were enrolled in the digestive department of Linxi Hospital of Kailuan general hospital.They were divided into observation group and control group with random number table method, 60 cases in each group.The control group was given lansoprazole+ amoxicillin+ furazolidone triple therapy.On this basis, the observation group was added with magnesium aluminum carbonate.The clinical efficacy, clearance rate of Helicobacter pylori, the level of VEGF and EGF in gastric juice were compared between the two groups. Results: The total clinical effective rate of the observation group was 95.0% (57/60), which was significantly higher than that of the control group (83.3%) (50/60). The difference between the two groups was statistically significant (χ²=4.23, P<0.05). The comprehensive symptom scores of the two groups decreased significantly with the treatment time (observation group: before treatment(9.6±2.2), treatment 2 weeks (5.5±1.5), treatment 4 weeks (4.3±1.2), treatment 6 weeks (3.1±0.8), control group (9.4±2.5), treatment 2 weeks (7.2±1.3), treatment 4 weeks (6.6±1.4), treatment 6 weeks (4.5±1.0)), and observation group syndrome scores There was significant difference between the two groups (F_inter-group=23.54, P_inter-group<0.05; F_intra-group=87.62, P_intra-group<0.05; F_interaction=8.47, P_interaction<0.05). After treatment, VEGF level in gastric juice of the two groups increased significantly after treatment.In the observation group( (429.4±128.5) pg/ml )was significantly higher than that in the control group( (380.3±137.2) pg/ml, t=2.02, P<0.05). The EGF level in gastric juice of the two groups increased significantly after treatment.In the observation group( (658.1±164.0) pg/ml )was significantly higher than that in the control group ((583.5±135.1) pg/ml, t=2.72, P<0.05). The incidence of adverse reactions was 6.7% (4/60) in the observation group and 8.3% (5/60) in the control group.There was no significant difference (χ²=0.12, P>0.05). Conclusion The treatment of Helicobacter pylori related gastric ulcer with the combination of aluminum carbonate, lansoprazole, amoxicillin and furazolidone can obviously improve the clinical symptoms and promote the regeneration of ulcer mucosa.

Objective    To evaluate the strategy of chemoradiotherapy following endoscopic R0 resection for esophageal cancer in M3-T1b stage. Methods    There were 45 esophageal cancer patients with M3-T1b stage with endoscopic R0 resection followed by additional chemoradiotherapy from ECETC (Esophageal Cancer Endoscopic Therapy Consortium) as a trial group with 34 males and 11 females at age of 61.37±7.14 years. There were 90 patients with esophagectomy from Fudan University Shanghai Cancer Center as a control group with 63 males and 27 females at age of 61.04±8.17 years. Propensity score match (1:2) was used to balance the factors: gender, age, position, depth of invasion and lymphovascular invasion (LVI), which may influence the outcomes. Overall survival (OS) rate, relapse free survival (RFS) rate, and local recurrence rate were compared between the two groups. Result    There was no statistical difference (HR=2.66 with 95%CI 0.87 to 8.11, P=0.179) in terms of OS rate between the two groups. One, two and three years overall survival rate of patients in the control group was 93%, 86%, and 84%, respectively. Nobody died in the trial group within 3 years after surgery. The RFS rate between the two groups didn’t significantly differ (HR=1.48, 95% CI 0.66 to 3.33, P=0.389). One, two and three years RFS rate of patients in the contorl group was 87%, 78%, and 76%, respectively, while 97%, 93%, and 73% in the trial group, respectively. The local recurrence rates between the two groups didn’t significantly differ either ( HR=0.53，95%CI 0.13 to 2.18, P=0.314). One, two and three years local recurrence rate of patients in the control group was 5%, 6% and 6%, respectively, while 0%, 0% and 21% in the trial group, respectively. Conclusion    Similar outcomes are found regarding OS, RFS and local recurrence rates between the two groups. The strategy of endoscopic R0 resection followed by additional chemoradiotherapy has prospect for the treatment of esophageal cancer in M3-T1b stage. And this kind of therapy may be provided for those with risk factors or can not tolerate surgery.