Objective To investigate the clinical feasibility and safety of endoscopic ultrasonography(EUS)combined with modified endoscopic mucosal resection(EMR)in the treatment of rectal neuroendo-crine tumors(RNETs).Methods A total of 48 patients diagnosed with RNETs by colonoscopy in the depart-ment of gastroenterology in this hospital from December 2021 to June 2023 were selected as the study objects.Patients were randomly divided into the study group(EUS combined with modified EMR,n=16),the control 1 group(traditional EMR,n=16)and the control 2 group[endoscopic submucosal dissection(ESD),n=16].The operation time,R0 resection rate and postoperative complications of each group were observed.Endoscop-ic ultrasonography was followed up 3 and 6 months after surgery to determine whether there was any recur-rence.Results The operative time of the study group[(17.813±0.379)min]was significantly shorter than that of the control 2 group[(36.250±3.296)min],the difference was statistically significant(P＜0.05),but compared with the control 1 group[(16.375±1.996)min],there was no significant difference(P＞0.05).The incidence of complications in the study group(6.2％)was significantly lower than that in the control 2 group(37.5％),the difference was statistically significant(P＜0.05).while the incidence of complications in the study group was not significantly higher than that in the control 1 group(12.5％,P＞0.05).R0 removal rate in the study group(93.8％)was significantly higher than that in the control 1 group(62.5％)and the control 2 group(75.0％),the difference was statistically significant(P＜0.05).Conclusion EUS combined with modified EMR has more advantages than EMR and ESD in the treatment of RNETs,and has certain fea-sibility and safety,which is convenient for clinical application.

Objective To explore the applicability,safety and effectiveness of hepatic arterial infusion chemotherapy(HAIC)combined with sintilimab and bevacizumab in the patients with intermediate and ad-vanced hepatocellular carcinoma(HCC)failed by lenvatinib treatment.Methods A total of 62 patients with intermediate and advanced liver cancer failed by lenvatinib treatment in this hospital from February 2023 to February 2024 were selected as the study subjects and divided into the HAIC group(n=13),HAIC+targeted therapy group(n=18)and HAIC+combined therapy group(n=31)according to different treatment regi-mens.The HAIC group only received the HAIC treatment,the HAIC+targeted therapy group adopted the HAIC+lenvatinib combined treatment and the HAIC+combined treatment group received the HAIC+sintil-imab and bevacizumab combined treatment.The objective remission rate(ORR),disease control rate(DCR),median progression-free survival time(mPFS),median overall survival time(mOS),carcinoembryonic antigen(CEA),vascular endothelial growth factor(VEGF),carbohydrate antigen 125(CA125)levels after treatment were observed in 3 groups,and the treatment related adverse reactions were recorded.The Kaplan-Meier method was used for conducting the survival analysis.Results According to RECIST1.1 criteria,ORR of the HAIC+combined treatment group was higher than that of the HAIC group and HAIC+targeted therapy group(35.5％vs.23.1％vs.22.2％),DCR was lower than that of the other two groups(83.8％vs.92.3％vs.88.9％),but the differences were not statistically significant and the differences were not statistically sig-nificant(P＞0.05).mOS of the HAIC+combined treatment group was longer than that of the HAIC group and HAIC+targeted therapy group[18.1(95％CI:13.3-22.9)months vs.12.6(95％CI:9.0-16.2)months vs.15.9(95％CI:11.5-20.3)months].mPFS in the HAIC+combined treatment group was longer than that in the the HAIC group and HAIC+targeted therapy group[12.0(95％CI:9.4-14.6)months vs.9.7(95％CI:2.2-17.2)months vs.10.1(95％CI:8.3-11.9)months],and the differences were not statistically sig-nificant(P＞0.05).The levels of CEA,VEGF and CA125 after treatment in 3 groups were decreased com-pared with before treatment,moreover the levels in the HAIC+combined treatment group was the lowest(P＜0.05).There was no statistically significant difference in the incidence rate of adverse reactions among the three groups(P＞0.05).Conclusion The HAIC combined with immunotherapy regimen is effective in the pa-tients with intermediate and advanced HCC failed by lenvatinib treatment,moreover which has high safety.