Objective:To evaluate the effectiveness and safety of fistula-tract lase closure (FiLaC TM) surgery combined with the infliximab (IFX) for treating complex perianal fistulizing Crohn's disease (pfCD) . Methods:A retrospective was conducted. Patients with pfCD undergoing FiLaC TM at Renji Hospital, Shanghai Jiaotong University School of Medicine between February 2019 and August 2020 were retrospectively enrolled. The preoperative protocol included seton drainage and pharmacological induction, utilizing IFX alone or in combination with immunosuppressants. After achieving remission in CD, patients underwent definitive surgery with FiLaC TM. Clinical outcomes and adverse events such as bleeding, pain, and fecal incontinence following FiLaC TM were recorded. The Wexner fecal incontinence score and Crohn's anal fistula quality of life scale (CAF-QoL) were assessed both preoperatively and 24 months postoperatively. Results:The study included 30 patients (23 males, 7 females) with a median age of 23.6 (18.0, 30.5) years. At 24 months postoperatively, 21 patients (70.0%) achieved clinical cure; 2 patients (6.7%) showed improvement; 2 patients (6.7%) did not heal, with one eventually healing after a repeat FiLaC TM procedure and the other requiring re-seton placement; 5 patients (16.7%) relapsed and required re-seton. The Wexner fecal incontinence score at 24 months postoperatively was lower compared to preoperative scores [2.0 (1.8, 3.0) vs. 2.0 (2.0, 3.0), P = 0.001]. The postoperative CAF-QoL scores were higher as compared to the preoperative score[39.5 (33.8, 62.3) vs. 37.5 (30.0, 56.3), P = 0.03]. There were no complications such as fecal incontinence, urinary incontinence, or bleeding postoperatively. Twenty-seven patients (90%) experienced mild pain, and 1 (3.3%) reported moderate pain, all resolving without intervention. Conclusion:Combined treatment with FiLaC TM and IFX is both effective and safe for managing complex pfCD.

Objective:To evaluate the effectiveness and safety of fistula-tract lase closure (FiLaC TM) surgery combined with the infliximab (IFX) for treating complex perianal fistulizing Crohn's disease (pfCD) . Methods:A retrospective was conducted. Patients with pfCD undergoing FiLaC TM at Renji Hospital, Shanghai Jiaotong University School of Medicine between February 2019 and August 2020 were retrospectively enrolled. The preoperative protocol included seton drainage and pharmacological induction, utilizing IFX alone or in combination with immunosuppressants. After achieving remission in CD, patients underwent definitive surgery with FiLaC TM. Clinical outcomes and adverse events such as bleeding, pain, and fecal incontinence following FiLaC TM were recorded. The Wexner fecal incontinence score and Crohn's anal fistula quality of life scale (CAF-QoL) were assessed both preoperatively and 24 months postoperatively. Results:The study included 30 patients (23 males, 7 females) with a median age of 23.6 (18.0, 30.5) years. At 24 months postoperatively, 21 patients (70.0%) achieved clinical cure; 2 patients (6.7%) showed improvement; 2 patients (6.7%) did not heal, with one eventually healing after a repeat FiLaC TM procedure and the other requiring re-seton placement; 5 patients (16.7%) relapsed and required re-seton. The Wexner fecal incontinence score at 24 months postoperatively was lower compared to preoperative scores [2.0 (1.8, 3.0) vs. 2.0 (2.0, 3.0), P = 0.001]. The postoperative CAF-QoL scores were higher as compared to the preoperative score[39.5 (33.8, 62.3) vs. 37.5 (30.0, 56.3), P = 0.03]. There were no complications such as fecal incontinence, urinary incontinence, or bleeding postoperatively. Twenty-seven patients (90%) experienced mild pain, and 1 (3.3%) reported moderate pain, all resolving without intervention. Conclusion:Combined treatment with FiLaC TM and IFX is both effective and safe for managing complex pfCD.

Objective:To study the medication rules of treating cervical spondylosis by National TCM master Liu Bailing based on data mining and network pharmacology, and explore the potential action mechanism of its core compounds.Methods:By collecting the prescriptions of National TCM master Liu Bailing treating cervical spondylosis in the past 8 years, this paper analyses the frequency, nature, flavor, meridian, hierarchical clustering and association rules of those prescriptions by RStudio to obtain the core prescription. Then, the effective components of the core prescription were collected by using TCMSP, and the network of "medicine-component-target" was constructed by using Cytoscape 3.8.0; by searching for databases like GEO, DisGeNET, TTD HPO and Genecards were retrieved to obtain the target data set of cervical spondylosis; by using STRING 11.0 platform to construct protein interaction network; by using DAVID platform to cary out gene ontology (GO) and KEGG pathway enrichment analysis; by using Auto Dock software for molecular docking.Results:In the 844 prescriptions, there are 199 Chinese medicines and the properties are mainly warm, plain and cold; the flavors were mainly sweet, pungent and bitter; mainly belong to the liver, spleen, and kidney meridians. The Association Rule shows that the core compound is made up of Salvia miltiorrhiza, Gastrodia elata, Rhizoma corydalis, Alisma rhizoma, centipede, Astragalus membranaceus and Rhizome of Pueraria. Besides, 140 effective constituents and 247 targets of the core prescription were screened, and the main constituents were quercetin, kamanol, luteolin, tanshinone ⅡA, β-sitosterol, etc. 13 core targets among the core prescription treating cervical spondylosis were obtained, which were enriched into 30 pathways including toll-like receptor signaling pathway, TNF signaling pathway and HIF-1 signaling pathway. Conclusion:National TCM master Liu Bailing treatment of cervical spondylosis mainly focuses on expelling wind and relieving pain, dredging meridians and soothing tendons, and the mechanism of action of the core prescription may focus on inhibiting inflammatory response and relieving oxidative stress, providing guidance and reference for the clinical treatment of cervical spondylosis.

Objective:To study the risk factors of hemodynamically significant patent ductus arteriosus (hsPDA) in extremely preterm infants (EPI).Method:From July 2017 to April 2020, EPI (gestational age <28 weeks) admitted to the Department of Neonatology of our hospital were included and analyzed retrospectively. According to whether hsPDA existed or not, the infants were assigned into non-hsPDA group and hsPDA group. Demographic findings and possible risk factors of hsPDA were collected.The cumulative fluid overload (FO) within 3 days after birth was calculated. Univariate and multivariate analysis were used to determine the risk factors of hsPDA.Result:A total of 79 infants with gestational age of (27.0±0.9) weeks and birth weight of (987±173)g were enrolled, including 23 cases in non-hsPDA group and 56 cases in hsPDA group. Univariate analysis showed that thrombocytopenia ( P=0.044), respiratory distress syndrome (RDS) treated with pulmonary surfactant (PS) ( P=0.006) and high FO level ( P=0.002) were associated with hsPDA. Multivariate analysis showed that RDS treated with PS ( OR=5.933, 95% CI 1.360~25.883, P=0.018) and high FO level ( OR=1.261, 95% CI 1.063~1.496, P=0.008) were independent risk factors for hsPDA in EPIs. ROC curve analysis showed that the cut-off value of FO was -0.2%, with 85.7% sensitivity and 56.5% specificity distinguishing the presence of hsPDA (AUC=0.712, Youden index=0.422). Conclusion:High level of FO within the first 3 days of life and RDS treated with PS are independent risk factors for hsPDA in EPI. After PS treatment, hemodynamic changes of infants with RDS should be monitored closely. During early fluid management of EPI, FO should be strictly monitored to avoid high FO level.

Anti- N-methyl- D-aspartic acid (NMDA) receptor encephalitis is an autoimmune encephalitis mediated by anti-NMDA receptor antibody. At present, the diagnosis of the disease depends mainly on typical clinical symptoms and detection of specific antibodies in cerebrospinal fluid. Early and timely treatment can curb the disease progression and improve the prognosis of the disease. However, because of the atypical clinical manifestations of patients and long waiting time for antibody detection, early identification is difficult. Imaging equipment is more popular in primary hospitals in China, and it is easier to perform imaging examination for suspected patients in the early stage; therefore, this article aims to review the imaging characteristics and current imaging research progress of anti-NMDA receptor encephalitis in recent years, so as to improve clinicians' understanding and early recognition of this disease.

Autoimmune encephalitis (AE) is a novel form of encephalitis associated with antibodies to cell-surface or synaptic proteins. Epileptic seizures act as the predominant manifestation of AE which are triggered by interaction between kinds of antibodies and antigens on cell-surface or intracellular. Patients with AE-related epilepsy are insensitive to antiepileptic drugs but sensitive to immunotherapy. Early initiation of immunotherapy can significantly improve the prognosis. To date, there are few reports on the treatment plan of antiepileptic drug to the patients with AE-related epilepsy. In this review we report the most relevant data about the morbidity, pathogenesis and treatment of AE-related epilepsy with aim of providing better treatment options.

Objective To determine the protein expression level of p-STAT1 and STAT1 in thyroid cancer and its correlation with clinical pathological parameters,especially with lymph node metastasis and relapse-free survival.Methods p-STAT1 and STAT1 protein were measured by immunohistochemical staining in 80 cases of primary thyroid carcinoma and matched normal controls.All samples were selected from the pathological storage in the Jiangdong 22nd Zone,of Zhuji People's Hospital.The correlation between p-STAT1,STAT1 and patients clinical pathological parameters was analyzed.74 out of 80 patients were followed up over 3 years to analyze the potential relationship between expression of p-STAT1 and STAT1 and relapse-free survival.Results The positive expression of p-STAT1 and STAT1 was 28.8％ and 90.0％ in thyroid cancer tissue versus 85.0％ and 50.0％ in normal thyroid tissue.The difference was statistically significant(P ＜ 0.05).The positve expression of p-STAT1 in stage Ⅲ and Ⅳ thyroid cancers was significantly lower than in stage Ⅰ and stage Ⅱ thyroid cancer(P ＜ 0.05).There was negative correlation between the expression of p-STAT1 and tumor stage and lymph node metastasis,while the expression of STAT1 was irrelevant.Furthermore,the relapse-free survival was 100％ in p-STAT1 positive patients,and 92.65％ in STAT1 positive group.Conclusion p-STAT1 protein level,negatively correlating with tumor stage and lymph node metastasis,down regulates in primary thyroid cancers,and may be a novel biomarker for thyroid cancer metatstasis.