Objective To explore the application value of simple manual rubber traction device in endoscopic submucosal dissection(ESD)of colorectal laterally spreading tumor(LST).Methods A retrospective cohort study was used to collect patients who underwent ESD for colorectal LST from June 1,2022 to June 9,2023.According to the use of the manual rubber traction device,patients were divided into colorectal traction ESD group(tESD group,n=22)and colorectal conventional ESD group(cESD group,n=44),the differences were compared between the two groups in the number of intraoperative hemostasis,the number of titanium clips used,the success rate of ESD,incidence of postoperative complications,hospital stay time,and treatment costs.Results The tESD group had relatively longer operation time and shorter hospitalization days than those of cESD group,but the difference was not statistically significant(P>0.05);There were no statistically significant differences in the number of titanium clips used,postoperative complication rates,and hospitalization costs between the two groups(P>0.05).Conclusion Colorectal traction ESD can be used as a remedial plan when traditional ESD is difficult to perform,and the use of traction does not increase the hospitalization cost of patients,and the postoperative complications of the two methods are similar.It is worthy of clinical application.

Objective To summarize the endoscopic and clinical diagnosis and treatment of 4 cases of gastric fundus adenocarcinoma.Method A retrospective analysis was conducted on the clinical data of four cases of gastric fundus adenocarcinoma from July 2021 to December 2023.Result All the 4 cases of gastric fundus adenocarcinoma were completely removed by endoscopic submucosal dissection(ESD),with good postoperative recovery,no surgical complications,and no recurrence or metastasis during follow-up.Conclusion ESD treatment for gastric fundus adenocarcinoma is safe,reliable,and can completely remove the lesion.

Objective:To investigate the characteristics of lung function impairment and its influencing factors in smoking men with non-chronic obstructive pulmonary disease (COPD).Methods:A total of 230 non-COPD men who attended the smoking cessation clinic of the Second Affiliated Hospital of Chongqing Medical University from October 2021 to August 2022 were prospectively assessed. Participants were categorized into three age groups:<40 years old group (65 cases), including smokers (53 cases) and non-smokers (12 cases); 40-60 years old group (109 cases), including smokers (73 cases) and non-smokers (36 cases);>60 years old group (56 cases), including smokers (20 cases) and non-smokers (36 cases). In this study, we compared the lung function indices of male smokers and non-smokers in different age groups , analyzed the possible factors affecting the lung function of smokers by linear regression , and compared the changes in the lung function of male smokers before and after smoking cessation. Results:In the<40 years old group, smokers′ forced vital capacity ratio (FVC)% predicted value (%pred), maximal mid expiratory flow (MMEF)%pred, forced expiratory flow after 75%/50% of the FVC has been exhaled (FEF 75, FEF 50)%pred, diffusing capacity of the lungs for carbon monoxide (DLCO)%pred, and the ratio of DLCO to alveolar volume (DLCO/VA)%pred were all lower than non-smokers (all P<0.05). Similarly, in the 40-60 years old and>60 years old groups, compared with non-smokers, forced expiratory volume in one second (FEV 1)%pred was significantly lower in smokers than in non-smokers ( P<0.05). FEV 1%pred ( β=-0.728, 95% CI:-0.026, 0.011), FVC%pred ( β=-0.332, 95% CI:-0.012, 0.003), FEF 50%pred ( β=-0.455, 95% CI:-0.03, -0.007), residual volume (RV)%pred ( β=0.371, 95% CI: 0.008, 0.041), RV to total lung capacity ratio (RV/TLC)%pred ( β=0.454, 95% CI: 0.011, 0.035) and MMEF%pred ( β=-0.324, 95% CI:-0.022, -0.002) were all influenced by the smoking index. All small airway function indices improved after smoking cessation (all P<0.05). Conclusion:Impairment of lung function in male smokers with non-COPD is characterized by early impairment of lung volume, lung diffusion function and small airway function, which progresses to impairment of lung flow rate with age, as influenced by smoking index and age.

With the development of clinical related disciplines, the update and establishment of relevant standards/guidelines at home and abroad, GBZ 185-2006 Diagnostic Criteria for Occupational Medicamentose-like Dermatitis due to Trichloroethylene (hereinafter referred to as “GBZ 185-2006”) was unable to meet clinical needs. Therefore, the GBZ 185-2006 was revised based on the principles of evidence-based medicine, in accordance with relevant laws/regulations and relevant standards/guidelines in combination with review of research data on occupational medicamentose-like dermatitis due to trichloroethylene (OMDT) home and abroad, and the development of clinical practice and clinical related disciplines. The main modifications include: adding terms and definitions of OMDT, modifying the description of clinical manifestations of the diagnostic principles, adjusting the description of latency, deleting the diagnostic requirement of the incidence probability, adding the specific allergen patch test as the etiological diagnostic index, standardizing the application scope, operating procedure and precautions of the specific allergen patch test. In addition, the relevant content of “Basic Characteristics and Clinical Types of Skin Damage of Medicamentose-like Dermatitis due to Trichloroethylene” in Appendix A is improved, the treatment principles are revised, and the content of new progress in treatment, artificial liver application, are added. The revised GBZ 185-2024 Diagnostic Standard for Occupational Medicamentose-like Dermatitis due to Trichloroethylene is more scientific and practical, and can provide technical basis for the standardized diagnosis and treatment of OMDT in medical and health institutions.

Objective To evaluate the impact of optimizing the stroke green channel on the efficiency of acute ischemic stroke management in a county hospital. Methods A retrospective analysis of the emergency stroke green channel treatment data from Sixian People’s Hospital from May 2020 to April 2021 (before optimization of the green channel) and from May 2021 to April 2022 (after optimization of the green channel) was conducted. The rates of intravenous thrombolysis (IVT) and mechanical thrombectomy (MT) patients, as well as door-to-needle time (DNT), door-to-puncture time (DPT), and the modified Rankin scale (mRS) scores of patients three months post-treatment before and after the optimization of the stroke green channel were compared. Results Within one year before and after optimization of the green channel, the number of acute visits for ischemic stroke was 3 143 and 2 623, respectively. Before optimization, 84 and 51 underwent IVT and MT, respectively. After optimization of the green channel, the ratios of patients underwent IVT (n＝215) and MT (n＝103) significantly increased, and both DNT and DPT were significantly shortened (P＜0.000 1); the proportion of MT patients with an mRS score of 0-2 at 3 months post-discharge significantly increased (46/99 vs 13/46, P＝0.038). Conclusion After optimizing the green channel at Sixian People’s Hospital, the efficiency of stroke treatment has significantly improved, and the patients’ prognosis improved.

BACKGROUND: LY01005 (Goserelin acetate sustained-release microsphere injection) is a modified gonadotropin-releasing hormone (GnRH) agonist injected monthly. This phase III trial study aimed to evaluated the efficacy and safety of LY01005 in Chinese patients with prostate cancer. METHODS: We conducted a randomized controlled, open-label, non-inferiority trial across 49 sites in China. This study included 290 patients with prostate cancer who received either LY01005 or goserelin implants every 28 days for three injections. The primary efficacy endpoints were the percentage of patients with testosterone suppression ≤50 ng/dL at day 29 and the cumulative probability of testosterone ≤50 ng/dL from day 29 to 85. Non-inferiority was prespecified at a margin of -10%. Secondary endpoints included significant castration (≤20 ng/dL), testosterone surge within 72 h following repeated dosing, and changes in luteinizing hormone, follicle-stimulating hormone, and prostate specific antigen levels. RESULTS: On day 29, in the LY01005 and goserelin implant groups, testosterone concentrations fell below medical-castration levels in 99.3% (142/143) and 100% (140/140) of patients, respectively, with a difference of -0.7% (95% confidence interval [CI], -3.9% to 2.0%) between the two groups. The cumulative probabilities of maintaining castration from days 29 to 85 were 99.3% and 97.8%, respectively, with a between-group difference of 1.5% (95% CI, -1.3% to 4.4%). Both results met the criterion for non-inferiority. Secondary endpoints were similar between groups. Both treatments were well-tolerated. LY01005 was associated with fewer injection-site reactions than the goserelin implant (0% vs . 1.4% [2/145]). CONCLUSION: LY01005 is as effective as goserelin implants in reducing testosterone to castration levels, with a similar safety profile. TRIAL REGISTRATION ClinicalTrials.gov, NCT04563936.
Humans ; Male ; Antineoplastic Agents, Hormonal/therapeutic use* ; East Asian People ; Gonadotropin-Releasing Hormone/agonists* ; Goserelin/therapeutic use* ; Prostate-Specific Antigen ; Prostatic Neoplasms/drug therapy* ; Testosterone

ObjectiveTo investigate the efficacy of Bushen Shengxue prescription and Yiqi Yangxue prescription in the treatment of chronic aplastic anemia and the effect on T cell subsets and the expression of T-box expressed in T cells （T-bet） and GATA binding protein 3 （GATA3）. MethodA total of 585 patients with chronic aplastic anemia who were treated in 19 hospitals in China from May 2018 to June 2021 were enrolled. With the prospective， double-blind and randomized control methods， the patients were randomized into three groups： kidney deficiency group， Qi and blood deficiency group， and control group. The three groups were respectively treated with Bushen Shengxue prescription granule， Yiqi Yangxue prescription granule， and Placebo （half the dose of Bushen Shengxue formula granules）. In addition， all of them were given oral cyclosporin and androgen. The treatment lasted 6 months， with 3 months as a course. The blood routine indexes， T cell subsets， and fusion genes T-bet and GATA3 before and after treatment were analyzed， and the safety indexes were monitored. ResultDuring the observation， a total of 75 cases dropped out and 18 were rejected. Finally， 161 cases in the kidney deficiency group， 164 in the Qi and blood deficiency group， and 167 in the control group were included. After 6 months of treatment， the total effective rate was 98.8% （159/161） in the kidney deficiency group， which was higher than the 79.9% （131/164） in the Qi and blood deficiency group （χ²=30.135， P<0.01） and the 61.7% （103/167） in the control group （χ²=70.126， P<0.01）. The total effective rate was higher in the Qi and blood deficiency group than in the control group （χ²=13.232， P<0.01）. After treatment， the hemoglobin （HGB） content increased significantly in three groups （P<0.05） as compared with that before treatment， particularly the kidney deficiency group （P<0.01）. After treatment， the white blood cell （WBC） count and platelet （PLT） count in the kidney deficiency group and the control group increased compared with those in the Qi and blood deficiency group （P<0.01）. There was no specific difference in neutrophils （ANC） after treatment among the three groups. At the same time point， the level of T helper type 1 （Th1） cells， Th1/Th2 ratio （P<0.05）， level of CD4⁺， and CD4⁺/CD8⁺ ratio （P<0.05） were significantly low in the kidney deficiency group among three groups. There was no significant difference in CD19^-， HLA/DR⁺， and CD25⁺ between the kidney deficiency group and the other two groups， but the T-bet of the kidney deficiency group and the control group was lower than that of the Qi and blood deficiency group （P<0.05）. ConclusionBushen Shengxue prescription exerts therapeutic effect on the aplastic anemia by improving the immunoregulatory mechanism， inhibiting the activity of immune system， modulating T cell subsets， suppressing Th1 and CD4⁺， and promoting bone marrow hematopoiesis. Moreover， it is safe with little side effects， which is worthy of further promotion.

OBJECTIVE To explore the effects of naringin on the proliferation and differentiation of osteoblasts in T cell - osteoblast co -culture system under simulated microgravity . METHODS This experiment was setting normal gravity control group ， normal gravity naringin group ，simulated microgravity control group and simulated microgravity naringin group .In the control group，T cells were co -cultured with osteoblasts under normal gravity or simulated microgravity conditions . In the naringin group ， 1×10－5 mol/L naringin solution was added additionally on the basis of control group .The morphology of osteoblasts was observed under the microscope . The proliferation rate of osteoblasts was detected by CCK -8 method. The alkaline phosphatase （ALP）activity was detected by ALP kit . mRNA relative expressions of Runt related transcription factor 2（Runx2）and interleukin -6（IL-6）were detected by real -time fluorescence quantitative polymerase chain reaction . The relative expression of Runx 2 and IL -6 protein were detected by Western blot . RESULTS Compared with normal gravity control group ，the density of osteoblasts in the simulated microgravity control group decreased ，only a small number of cells were aggregated ，and the cell morphology was mostly round ； compared with the simulated microgravity control group ，the osteoblasts in the simulated microgravity naringin group formed spindle or polygonal ，plump in shape ，and clustered in groups of fish . Compared with normal gravity control group ，the proliferation rate of osteoblasts ，ALP activity ，relative expressions of Runx 2 mRNA and protein in the normal gravity naringin group were significantly increased ，while the relative expressions of IL -6 mRNA and protein were significantly decreased （P＜ 0.05）；the proliferation rate of osteoblasts ，ALP activity ，relative expressions of Runx 2 mRNA and protein in the simulated microgravity control group were significantly decreased ，while relative expressions of IL -6 mRNA and protein were significantly increased（P＜0.05）. Compared with the simulated microgravity control group ，the proliferation rate of osteoblasts ，ALP activity ， relative expressions of Runx 2 mRNA and protein in the simulated microgravity naringin group were significantly increased ，while relative expressions of IL -6 mRNA and protein were significantly decreased （P＜0.05）. CONCLUSIONS In the T cell -osteoblast co-culture system ，simulated microgravity can inhibit the proliferation and differentiation of osteoblasts ；naringin can improve the proliferation and differentiation ability of osteoblasts under this condition， and its mechanism of action is related to the decrease of IL -6 level and the increase of Runx 2 level.

Sarcopenia causes significant changes inskeletal muscle mass and function in the elderly, and leads to an increased incidence of related diseases, which has affected the quality of life in the elderly.The causes and mechanisms of sarcopenia are closely related to genetic and innate factors, endocrine disorders, reduced number of muscle fibers, nutritional deficiency, inflammation, immune dysfunction and other factors.This paper systematically describes the progress of studying the effects of intestinal microecology on sarcopenia, so as to provide potential targets for the prevention and treatment of sarcopenia.

Abstract To investigate the curative effects of modified submucosal tunnel endoscopic resection(STER) and endoscopic submucosal resection(ESE) in the treatment of paracardial submucosal tumors. Eighty-four patients with paracardial submucosal tumors diagnosed through digestive endoscopy and endoscopic ultrasonography signed informed consent forms, and they were randomly divided into observation group(n=42) and control group(n=42) with the help of the table of random numbers. Patients in the control group received ESE treatment. Patients in the observation group received modified STER surgery.The operation time, average hospitalization time and treatment cost of patients in STER group were(61.32±32.01) min,(8.11±2.42) d and(21.7±3.4) thousand Chinese Yuan respectively, which were better than those in ESE group(87.63±34.09) min,(10.05±2.84) d and(25.9±3.9) thousand Chinese Yuan. The difference was statistically significant(P<0.05). The average number of titanium clips used in the observation group was(5.00±1.37), and in the control group the average number was(4.68±1.25). The difference was not statistically significant. In the STER group, there were 2 cases of intraoperative perforation and 1 case of delayed bleeding. In the ESE group, there were 4 cases of intraoperative perforation and 3 cases of intraoperative uncontrollable bleeding. The incidence of postoperative complications in the STER group was lower than that in the ESE group. The postoperative pathological examination revealed that in both groups the tumors were mostly stromal tumor and leiomyoma. A few of the patients were suffering from lipomas and schwannomas. There was no significant difference in terms of the pathological composition of the patients between the two groups.