Objective: To explore the expression of collagen type 1 alpha 2 (COL1A2) in cervical cancer and its correlation with immune infiltration. Methods: Bioinformatics techniques were used to analyze the expression of COL1A2 in cervical cancer. Western blot and RT-qPCR were used to detect the expression of COL1A2 in cervical cancer tissues and cell lines. The correlation between the expression of COL1A2 and tumor immune cell infiltration was analyzed by tumor immune estimation resource (TIMER2. 0) . Gene set enrichment analysis (GSEA) was used to analyze the possible mechanism of COL1A2 in cervical cancer. Jaspar database was used to predict the transcrip- tion factors of COL1A2. Western blot and RT-qPCR were used to detect the expression of transcription factors in cervical cancer tissues and cell lines. Results: The expression of COL1A2 was down-regulated in cervical cancer (P < 0. 05) . The expression of COL1A2 was positively correlated with the levels of macrophages and myeloid den- dritic cells (P < 0. 01) . The proportions of 22 types of immune cells were different in different cervical cancer pa- tients. In addition , compared with the high expression group of COL1A2 , the proportion of M0 macrophages , M2 macrophages and resting memory CD4 + T cells increased in the low expression group of COL1A2 , while the propor- tion of CD8 + T cells , activated memory CD4 + T cells , follicular helper T cells , activated NK cells and activated myeloid dendritic cells decreased (P < 0. 05) . GSEA analysis showed that COL1A2 was related to immune-related signaling pathways , including Notch signaling pathway , interleukin-6/janus kinase/signal transducer and activator of transcription 3 (IL6/JAK/STAT3) , Wnt/β-catenin signaling pathway , etc. (P < 0. 01) . Jaspar database pre- dicted that the transcription factor of COL1A2 was paired box protein 5 (PAX5) , and the expression of PAX5 de- creased in cervical cancer (P < 0. 05) . Conclusion COL1A2 is expected to become a potential diagnostic biomar- ker and immunotherapy target for cervical cancer.

Objective To compare the efficacy and tolerability of the novel bowel-cleansing agent TCIC-001 and the traditional polyethylene glycol (PEG) regimen for bowel preparation prior to colonoscopy. Methods Prospective inclusion of 62 patients who were scheduled to undergo colonoscopy at Zhongshan Hospital, Fudan University from July 2021 to July 2022. They were randomly divided into TCIC-001 group (n=31) and PEG group (n=31) using a random number table method. The TCIC-001 group took TCIC-001 orally, drinking water in stages, with a total liquid intake of 1 500 mL; the PEG group took PEG orally, taking it in 4 doses, with a total liquid intake of 3 000 mL. The primary endpoint indicator is the quality of intestinal hygiene evaluated by the Boston Bowel Preparation Scale (BBPS), the secondary endpoint indicators were medication adherence, medication duration, frequency of bowel movements, duration of bowel movements, and incidence of adverse events between two groups. Results No significant differences were observed in sex, age, or defecation frequency between the two groups. For efficacy, both groups achieved equivalent bowel cleanliness, with a “good preparation” rate of 93.55% and comparable BBPS score of each intestinal segment and total scores. For tolerability, the TCIC-001 group had a shorter medication duration compared to the PEG group ([48.8±25.9] min vs [82.8±28.4] min, P<0.001), a longer defecation duration ([288.6±74.0] min vs [236.5±74.3] min, P<0.001), and a lower incidence of first defecation before medication completion (9.68% vs 41.94%, P=0.004). Regarding safety, no significant differences were observed between the TCIC-001 group and the PEG group in incidences of chloride disturbances (0% vs 9.68%) and calcium disturbances (3.23% vs 6.45%), and no other adverse events. Conclusions TCIC-001 demonstrated comparable bowel-cleansing efficacy to PEG while significantly improving tolerability (reduced medication time and lower risk of premature defecation) and maintaining favorable safety.

Objective:To investigate how gut microbiota changes during prostate cancer radiotherapy and decipher the relationship of gut microbiota with disease progression and chronic radiation enteritis.Methods:Thirty-one patients with prostate cancer were included in this study,admitted to The First Affiliated Hospital of Xinjiang Medical University from September 2022 to December 2023.The clinical data and stool samples of the patients were collected,and patients were followed up.The collected stool specimens were subjected to 16S rRNA se-quencing to detect gut microbiota and bioinformatics analysis.Results:The relative abundance of phyla such as Firmicutes and Actinobac-teria increased,and that of Bacteroidetes decreased(P<0.05)with an increasing radiotherapeutic dose,while beta diversity was significantly higher(P=0.001).The relative abundance of the phylum Actinobacteria was significantly higher in the prostate cancer progression group than in the non-progression group(P<0.05),the relative abundances of genera such as Sutterella and Haemophilus were significantly higher in the progression group(P<0.05).That of Verrucomicrobia and its offshoots in Akkermansia was higher in the chronic radiation enteritis than in the non-enteritis group(P<0.05),while the relative abundances of Coprococcus_1 and Catabacter in the non-enteritis group were higher than those in the enteritis group(P<0.05).Conclusions:Radiotherapy dose accumulation significantly remodeled the floral structure.Sutterella and Haemophilus of the phylum Proteobacteria might be key flora in prostate cancer recurring early after treatment.An augmen-ted abundance of Akkermansia might increase the risk of chronic radiation enteritis,whereas the flora under the Lachnospiraceae branch might exert aprotective effect against chronic radiation enteritis.

Objective:To evaluate the efficacy and safety of a new plasma radiofrequency generator and a disposable mucosal incision knife for endoscopic submucosal dissection (ESD) of gastrointestinal lesions.Methods:This study is a prospective, randomized, non-inferiority multicenter study (Chinese Clinical Trial Registry No.: ChiCTR2000041394). The inclusion criteria for cases are as follows: (1) being able to understand and voluntarily participate in this clinical trial, and voluntarily signing the informed consent form; (2) being 18-70 years old, regardless of gender; (3) having a gastrointestinal lesion and meeting the endoscopic treatment conditions for the indications of endoscopic submucosal dissection (ESD). The exclusion criteria are: (1) meeting the contraindications for ESD; (2) having a surgical contraindication due to coagulation dysfunction or still taking anticoagulants 1 week before surgery; (3) having coagulation dysfunction, that is, the prothrombin time is prolonged by more than 3 seconds (more than 5 seconds in patients with liver disease), or the activated partial thromboplastin time is prolonged by more than 10 seconds, and the platelet count is < 70×10?/L; (4) having severe cardiopulmonary insufficiency and being unable to tolerate the surgery; (5) being a reproductive-aged woman with a positive blood or urine pregnancy test or a lactating woman; (6) the investigator deems that there are other factors that are not suitable for inclusion or affect the subject's participation. Patients who underwent ESD treatment for gastrointestinal lesions from March 2019 to April 2023 at the Endoscopy Center of Zhongshan Hospital Affiliated to Fudan University, the Department of Gastroenterology of Minhang District Central Hospital in Shanghai, and the Department of Gastroenterology of Quzhou People's Hospital were prospectively included. The experimental group used a new plasma radiofrequency therapy instrument and a disposable mucosal incision knife, while the control group used a high-frequency electrosurgical system and a disposable mucosal incision knife. The primary efficacy indicator was the en bloc resection success rate, the secondary efficacy indicators included the coagulation success rate, and the operation stability of the plasma radiofrequency therapy instrument and the disposable mucosal incision knife; the safety indicators included the incidence of intraoperative bleeding, intraoperative perforation, and postoperative complications. Results:The study cohort comprised 194 patients, 95 in the experimental group and 99 in the control group. Analysis of the full set showed rates of en bloc resection of 97.89% (93/95) and 96.97% (96/99) in the experimental and control groups, respectively; the difference being 0.53% (-5.58%, 6.64%). Analysis of the compliance set showed rates of en bloc resection of 97.83% (90/92) and 96.88% (93/96) in the experimental and control groups, respectively; the difference being 0.58% (-5.79%, 6.94%). These data indicate that the rate of en bloc resection in the experimental group using plasma radiofrequency therapy and disposable mucosal incision was not inferior to that of the control group. The rates of achieving intraoperative coagulation in the experimental and control groups were 7.14% (5/70) and 5.97% (4/67), respectively; this difference is not statistically significant ( P=1.000). The control group had a significantly better rate of using the same instruments throughout the procedure than did the experimental group ( P<0.001). In the safety analysis set, the incidences of intraoperative and postoperative adverse events did not differ significantly between the two groups (both P>0.05). Conclusion:Plasma radiofrequency therapy equipment and a disposable mucosal incision knife are safe and effective instruments for performing ESD of gastrointestinal lesions.

Objective:To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) for hypopharyngeal hemangioma.Methods:A retrospective analysis was performed on data of patients with hypopharyngeal hemangioma who were treated with ESD at the endoscopy center of Zhongshan Hospital, Fudan University from October 2023 to February 2024. The en bloc resection rate, complete resection rate, procedure time, length of hospital stay, and incidence of adverse events were recorded.Results:A total of five patients were included, aged 28-78, four females and one male, with a median tumor long diameter of 1.5 cm (1.0-4.0 cm). All ESD procedures were successfully performed for hypopharyngeal hemangioma, and the rate of en bloc resection was 80.0% (4/5). Complete resection rate was 100.0% (5/5). The median procedure time was 35 minutes (18-60 minutes). None of them underwent prophylactic tracheotomy, and all of them were confirmed as hemangiomas by postoperative pathology. Open diet 1 day postoperatively, and the median length of hospital stay was 6 days (3-8 days). There were no serious adverse events related to ESD during or after the procedure.Conclusion:ESD can be a potential new method for the treatment of hypopharyngeal hemangioma, demonstrating satisfactory effectiveness and safety.

Objective:To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) for hypopharyngeal hemangioma.Methods:A retrospective analysis was performed on data of patients with hypopharyngeal hemangioma who were treated with ESD at the endoscopy center of Zhongshan Hospital, Fudan University from October 2023 to February 2024. The en bloc resection rate, complete resection rate, procedure time, length of hospital stay, and incidence of adverse events were recorded.Results:A total of five patients were included, aged 28-78, four females and one male, with a median tumor long diameter of 1.5 cm (1.0-4.0 cm). All ESD procedures were successfully performed for hypopharyngeal hemangioma, and the rate of en bloc resection was 80.0% (4/5). Complete resection rate was 100.0% (5/5). The median procedure time was 35 minutes (18-60 minutes). None of them underwent prophylactic tracheotomy, and all of them were confirmed as hemangiomas by postoperative pathology. Open diet 1 day postoperatively, and the median length of hospital stay was 6 days (3-8 days). There were no serious adverse events related to ESD during or after the procedure.Conclusion:ESD can be a potential new method for the treatment of hypopharyngeal hemangioma, demonstrating satisfactory effectiveness and safety.

Objective:To evaluate the efficacy and safety of a new plasma radiofrequency generator and a disposable mucosal incision knife for endoscopic submucosal dissection (ESD) of gastrointestinal lesions.Methods:This study is a prospective, randomized, non-inferiority multicenter study (Chinese Clinical Trial Registry No.: ChiCTR2000041394). The inclusion criteria for cases are as follows: (1) being able to understand and voluntarily participate in this clinical trial, and voluntarily signing the informed consent form; (2) being 18-70 years old, regardless of gender; (3) having a gastrointestinal lesion and meeting the endoscopic treatment conditions for the indications of endoscopic submucosal dissection (ESD). The exclusion criteria are: (1) meeting the contraindications for ESD; (2) having a surgical contraindication due to coagulation dysfunction or still taking anticoagulants 1 week before surgery; (3) having coagulation dysfunction, that is, the prothrombin time is prolonged by more than 3 seconds (more than 5 seconds in patients with liver disease), or the activated partial thromboplastin time is prolonged by more than 10 seconds, and the platelet count is < 70×10?/L; (4) having severe cardiopulmonary insufficiency and being unable to tolerate the surgery; (5) being a reproductive-aged woman with a positive blood or urine pregnancy test or a lactating woman; (6) the investigator deems that there are other factors that are not suitable for inclusion or affect the subject's participation. Patients who underwent ESD treatment for gastrointestinal lesions from March 2019 to April 2023 at the Endoscopy Center of Zhongshan Hospital Affiliated to Fudan University, the Department of Gastroenterology of Minhang District Central Hospital in Shanghai, and the Department of Gastroenterology of Quzhou People's Hospital were prospectively included. The experimental group used a new plasma radiofrequency therapy instrument and a disposable mucosal incision knife, while the control group used a high-frequency electrosurgical system and a disposable mucosal incision knife. The primary efficacy indicator was the en bloc resection success rate, the secondary efficacy indicators included the coagulation success rate, and the operation stability of the plasma radiofrequency therapy instrument and the disposable mucosal incision knife; the safety indicators included the incidence of intraoperative bleeding, intraoperative perforation, and postoperative complications. Results:The study cohort comprised 194 patients, 95 in the experimental group and 99 in the control group. Analysis of the full set showed rates of en bloc resection of 97.89% (93/95) and 96.97% (96/99) in the experimental and control groups, respectively; the difference being 0.53% (-5.58%, 6.64%). Analysis of the compliance set showed rates of en bloc resection of 97.83% (90/92) and 96.88% (93/96) in the experimental and control groups, respectively; the difference being 0.58% (-5.79%, 6.94%). These data indicate that the rate of en bloc resection in the experimental group using plasma radiofrequency therapy and disposable mucosal incision was not inferior to that of the control group. The rates of achieving intraoperative coagulation in the experimental and control groups were 7.14% (5/70) and 5.97% (4/67), respectively; this difference is not statistically significant ( P=1.000). The control group had a significantly better rate of using the same instruments throughout the procedure than did the experimental group ( P<0.001). In the safety analysis set, the incidences of intraoperative and postoperative adverse events did not differ significantly between the two groups (both P>0.05). Conclusion:Plasma radiofrequency therapy equipment and a disposable mucosal incision knife are safe and effective instruments for performing ESD of gastrointestinal lesions.

Objective:To investigate how gut microbiota changes during prostate cancer radiotherapy and decipher the relationship of gut microbiota with disease progression and chronic radiation enteritis.Methods:Thirty-one patients with prostate cancer were included in this study,admitted to The First Affiliated Hospital of Xinjiang Medical University from September 2022 to December 2023.The clinical data and stool samples of the patients were collected,and patients were followed up.The collected stool specimens were subjected to 16S rRNA se-quencing to detect gut microbiota and bioinformatics analysis.Results:The relative abundance of phyla such as Firmicutes and Actinobac-teria increased,and that of Bacteroidetes decreased(P<0.05)with an increasing radiotherapeutic dose,while beta diversity was significantly higher(P=0.001).The relative abundance of the phylum Actinobacteria was significantly higher in the prostate cancer progression group than in the non-progression group(P<0.05),the relative abundances of genera such as Sutterella and Haemophilus were significantly higher in the progression group(P<0.05).That of Verrucomicrobia and its offshoots in Akkermansia was higher in the chronic radiation enteritis than in the non-enteritis group(P<0.05),while the relative abundances of Coprococcus_1 and Catabacter in the non-enteritis group were higher than those in the enteritis group(P<0.05).Conclusions:Radiotherapy dose accumulation significantly remodeled the floral structure.Sutterella and Haemophilus of the phylum Proteobacteria might be key flora in prostate cancer recurring early after treatment.An augmen-ted abundance of Akkermansia might increase the risk of chronic radiation enteritis,whereas the flora under the Lachnospiraceae branch might exert aprotective effect against chronic radiation enteritis.

Objective:To study the effects of different doses of X-ray irradiation on the immune microenvironment and cGAS-STING signaling pathway of hepatocellular carcinoma cells.Methods:C57BL/C mice were subcutaneously injected with Hepa 1-6 hepatocellular carcinoma cells in the right axilla to establish a subcutaneous tumor-forming hepatocellular carcinoma model. The mice were randomly divided into 0, 4, 8, 12 Gy irradiation groups, with 10 mice in each group. The body weights and tumor volumes were monitored. Specimens were collected 28 d after irradiation. The ELLSA and Flow Cytometry method was used to compare the macrophage-associated cytokines tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), interleukin-6 (IL-6), chemokine ligand 5 (CCL5), IL-10, IL-13, transforming growth factor-β (TGF-β), IL-4 and macrophage M1, M2 phenotype ratio (M1/M2). Real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) and immunoblotting assay were used to detect the expression of genes and proteins related to the cGAS-STING signaling pathway in hepatoma cells.Results:With the increase of irradiation dose, the tumor volume was significantly reduced ( F=8.42, P<0.05), the proportion of cell necrosis increased ( F=3.89, P<0.05), the content of macrophage-associated cytokines other than IL-4 increased ( F=6.32-15.50, P<0.05), and the proportion of M1 and M2 types of macrophage in the immune microenvironment of hepatocellular carcinoma tumors was elevated ( F= 5.46, 5.14, P < 0.05).The gene expression and protein expression levels of cGAS-STING signaling pathway were elevated in hepatocellular carcinoma cells (mRNA expression of cGAS and STING: F=6.35, 16.10, P<0.05; protein expression of cGAS and STING: F=71.31, 37.15, P<0.05). Conclusions:X-ray irradiation activates the cGAS-STING signaling pathway in hepatocellular carcinoma cells and contributes to the remodeling of the tumor immune microenvironment.

Children and adults differ significantly in physiology,biochemistry and immune function,which leads to sig-nificant differences in blood transfusion strategies between children and adults.To guide the clinical transfusion practice of pediatric patients and improve the prognosis of children,the National Health Commission organized the formulation and re-lease of the health industry standard Guideline for Pediatric Transfusion(WS/T 795-2022).This paper will briefly introduce some concepts that help understand of the Standard and the preparation process of the Standard,and explain and interpret the preparation of the"scope","general provisions"and"factors to consider"of the Standard,hoping to contribute to the understanding and implementation of the Standard.