Objective:To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) for the treatment of ileocecal valve lipoma.Methods:A retrospective cohort study was performed on data of ileocecal lipoma patients who underwent ESD at the Endoscopy Center of Zhongshan Hospital, Fudan University from December 2013 to June 2023. According to the lesion location, the patients were divided into ileocecal valve group and cecum group. The operation time, operation speed, en bloc resection rate, complications, and follow-up outcomes between the two groups were compared.Results:A total of 59 patients with ileocecal lipoma were enrolled, including 31 patients in the ileocecal valve group and 28 patients in the cecum group.There were no significant differences in gender, age, specimen size, or lesion size between the two groups ( P>0.05). Lipomas in both the ileocecal valve group and the cecum group were successfully resected by ESD. The en bloc resection rates were 100.0% (31/31) and 92.9% (26/28) respectively, and the difference was not statistically significant ( χ2=0.033, P=0.133). Median operative duration significantly differed between the two groups ( ileocecal valve group 26 min VS cecum group 20 min, Z=-0.136, P=0.027), as did resection speed (ileocecal valve group 0.14 cm2/min VS cecum group 0.24 cm2/min, Z=-0.223, P=0.022). Adverse events included one postoperative fever in the ileocecal valve group and one delayed bleeding in the cecum group. During the median follow-up of 38 months (7-106 months), there was no case of residual tumor or recurrence. Conclusion:Despite technical challenges in ESD of ileocecal valve lipoma, it is still a safe, feasible and effective treatment method.

Objective:To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) for the treatment of ileocecal valve lipoma.Methods:A retrospective cohort study was performed on data of ileocecal lipoma patients who underwent ESD at the Endoscopy Center of Zhongshan Hospital, Fudan University from December 2013 to June 2023. According to the lesion location, the patients were divided into ileocecal valve group and cecum group. The operation time, operation speed, en bloc resection rate, complications, and follow-up outcomes between the two groups were compared.Results:A total of 59 patients with ileocecal lipoma were enrolled, including 31 patients in the ileocecal valve group and 28 patients in the cecum group.There were no significant differences in gender, age, specimen size, or lesion size between the two groups ( P>0.05). Lipomas in both the ileocecal valve group and the cecum group were successfully resected by ESD. The en bloc resection rates were 100.0% (31/31) and 92.9% (26/28) respectively, and the difference was not statistically significant ( χ2=0.033, P=0.133). Median operative duration significantly differed between the two groups ( ileocecal valve group 26 min VS cecum group 20 min, Z=-0.136, P=0.027), as did resection speed (ileocecal valve group 0.14 cm2/min VS cecum group 0.24 cm2/min, Z=-0.223, P=0.022). Adverse events included one postoperative fever in the ileocecal valve group and one delayed bleeding in the cecum group. During the median follow-up of 38 months (7-106 months), there was no case of residual tumor or recurrence. Conclusion:Despite technical challenges in ESD of ileocecal valve lipoma, it is still a safe, feasible and effective treatment method.

【Objective】 To study the safety, effectiveness and nursing of blood/fluid warmer during the process of plateletpheresis in winter. 【Methods】 The blood re-transfusion speed during plateletpheresis in winter and the time of blood passing through the blood return pipeline was counted. The vitro blood was heated with a blood/fluid warmer under different temperature settings, and the rising speed of blood temperature was recorded. The blood samples were tested for blood routine examination, free Hb and erythrocyte morphology at 0, 15 and 30 minutes. In the process of plateletpheresis in winter, the blood donors′ ear temperature and the skin temperature near the reinfusion needle in the observation group and the controls were measured, and the blood donors were observed for shivering, arm chills, pain or other discomfort. After the blood donation, the thermal comfort was evaluated. 【Results】 There was no difference in the results of routine blood test and plasma free Hb test of vitro blood after warming at 41℃, 42℃ and 43℃ for 0, 15 and 30 minutes (P>0.05), and no change in erythrocyte morphology was found. The skin temperature near the reinfusion needle (before vs. after the start of phlebotomy) was statistically different by applying blood/fluid warmer or not(P<0.05), and no difference in the temperature between the start and end of phlebotomy was observed in the observation group(P>0.05). The vitro blood heating experiment showed that when the room temperature was within 22~24℃, the blood retransfusion speed was (100-120) mL/min; after the application of blood/fluid warmer, the temperature of reinfusion blood could be raised from 27℃ to 33~37℃. The proportion of feeling comfortable and very comfortable and the score of thermal comfort in the blood donors who used the warmer were higher than those in the controls (P<0.05). When the temperature of the warmer was set above 38℃, the average score of thermal comfort of blood donors was above 8. 【Conclusion】 It is safe to apply the blood/fluid warmer during the plateletsapheresis in winter, which can significantly improve the comfort of blood donors and reflect the humanized service of blood stations, and is worth popularizing.

【Objective】 To analyze the demographic characteristics of whole blood donors who responded to blood donation initiatives launched by our blood center, so as to formulate an efficient recruitment strategy and provide scientific reference for solving seasonal, structural and acute blood supply tensions in this region. 【Methods】 Such characteristics as age, gender, household registration, occupation, blood type, education level, number of blood donations, blood donation location and recruitment method of 21 934 whole blood donors who responded to donation appointments issued by our blood center during January 2019 to June 2020 were analyzed, and the corresponding recruitment strategy in this region was established. 【Results】 39.79% of respondents were 36~45 years old, 69.61% were males, 70.49% were non-local permanent residents, and 62.96% were with education background from junior high school to high school. Workers accounted for 36.57%, 400 mL-donation accounted for 56.87%, the percentage of blood type O reached 42.18%, and blood donors with 2~5 donations accounted for 70.27%. The proportion of blood donors from Songshan Lake area(23.46%) ranked the highest, and that from Shuixiang area the lowest (3.26%). 76.42% of donation recruitment were issued via SMS. 【Conclusion】 Blood donors 36~45 years old, with 2~5 donations, donated 400 mL blood, non-local registered male, ordinary employees with the education level of junior high school, technical secondary school or high school should firstly be considered. The targeted areas are the Songshan Lake area, the main urban area coastal areas and southeastern Dongguan near Shenzhen.The corresponding recruitment strategies should be adjusted based on needs and emergency level.

Objective:To investigate the correlation between the muscle mass loss and severe postoperative pulmonary complications(PPC)in elderly patients with non-small cell lung cancer(NSCLC).Methods:Elderly patients with NSCLC undergoing lobectomy at the Lung Cancer Institute and the Department of Thoracic Surgery of Guangdong Provincial People's Hospital were recruited from Feb.2019 to Dec.2019.Data of the body composition, lung function, respiratory muscle strength test, cardiopulmonary exercise test were collected before operation.All patients were grouped into two groups: with versus without severe PPC at 30 d after operation.The differences of the above parameters were compared between the two groups.A multiple logistic regression analysis was used to analyze the risk factors for severe PPC.Results:In this study, 120 elderly NSCLC patients undergoing lobectomy were recruited, All evaluations were completed in 113 patients(aged 68.13±7.01 years)in whom, 21(18.58%, 21/113)patients had serious PPC.Compared with patients without PPC, patients with severe PPC had a lower appendicular skeletal muscle mass index(ASMI)(5.67±0.90 kg/m 2vs.7.71±1.40 kg/m 2, t=3.900, P=0.001), a lower forced expiratory volume in 1 second(FEV 1)(1.85±0.40 L vs.2.12±0.57 L, t=2.412, P=0.027), a lower maximal mid-expiratory flow(MMF)(1.40±0.69 L/s vs.2.11±1.09 L/s, t=2.502, P=0.021), a lower maximum inspiratory pressure(Pimax)(55.13±32.52 cmH 2O vs.64.71±20.60, t=0.778, P=0.047, 1 cmH 2O=0.098 kPa), a lower maximal oxygen consumption(Vo 2max)(1.14±0.41 L/min vs.1.40±0.34 L/min, t=0.779, P=0.046), a lower peak O 2 consumption(Vo 2max@kg)(20.00±1.91 L·min -1·kg -1vs.22.33±2.37 L·min -1·kg -1, t=0.813, P=0.041). Multiple logistic regression analysis showed that in addition to FEV 1( OR=2.824, 95% CI: 1.127-5.158, P=0.001)and Vo 2max@kg( OR=3.149, 95%CI: 1.829-6.592, P<0.001), ASMI was also an independent risk factor for serious PPC( OR=1.919, 95% CI: 1.604-3.466, P=0.006), in which the best cut-off value was 6.295 kg/m 2, the sensitivity and specificity were 0.816 and 0.818 respectively, and the area under the receiver operating characteristic(ROC)curve(AUC)was 0.887(95% CI: 0.793-0.981, P<0.0001). Conclusions:Muscle mass loss can increase the risk for the occurrence of severe PPC within 30 days after lobectomy in elderly patients with NSCLC.

Objective To evaluate the diagnostic value of lymph node fine-needle aspiration (FNA)Epstein-Barr virus (EBV)-DNA concentration detection in nasopharyngeal carcinoma (NPC) cervical lymph node metastasis.Methods From August to December 2016,36 cases of NPC and 9 cases of other tumors (not correlated with EBV infection) were enrolled in this study at the Sun Yat-sen University Cancer Center.All patients received magnetic resonance images (MRI),plasma and cervical lymph node FNA EBV-DNA detection.Results The median concentration of EBV-DNA in FNA fluid (1.39 × 105 copies/ml) in cervical lymph node metastasis was significantly higher than that in plasma (2.00 × 103 copies/ml),with a significant difference (x2 =16.723,P =0.004).The diagnosis sensitivity,specificity,accuracy of the lymph node FNA fluid of EBV-DNA were 86.2％ (25/29),71.4％ (10/14) and 81.4％ (35/43) respectively,which were better than those of MRI [72.4％ (21/29),50.0％ (7/14) and 65.1％ (28/43) respectively] and plasma EBV-DNA [55.2％ (16/29),71.4％ (10/14) and 60.5％ (26/43) respectively].The area under the curve (AUC) of level Ⅰ b cervical lymph node metastasis was calculated,and FNA fluid EBV-DNA (AUC =0.688)was better than MRI (AUC =0.583),with a significant difference (Z =2.476,P =0.008).The EBV-DNA concentration in FNA fluid in cervical lymph node metastasis of patients with other tumors (no correlated with EBV infection) was 0 copy/ml.Conclusion FNA fluid EBV-DNA may improve the diagnostic sensitivity of cervical lymph node metastasis in nasopharyngeal carcinoma,and help to explore the clinical target volume neck nodes at level Ⅰ b cervical lymph node in radiotherapy.

Objective To evaluate the efficiency of thyroid ultrasound grading formulated by American Thyroid Association (ATA) and fine-needle aspiration (FNA) biopsy in diagnosing benign and malignant thyroid nodules.Methods A retrospective analysis of 357 thyroid nodules in 342 patients underwent surgical excision or FNA biopsy after thyroid ultrasound was performed.All ultrasonograms were graded according to ATA diagnosis guideline for thyroid nodule versi on 2015.The diagnostic efficiency of ATA grading and FNA biopsy were evaluated comparing with postoperative pathological results.Results There were 248 of 357 thyroid nodules confirmed with postoperative pathology,including 233 malignant and 15 benign nodules.The diagnostic accuracy,sensitivity,specificity,positive and negative predictive value of ATA guideline in diagnosis of malignant thyroid nodules was 88.31％ (219/248),90.99％ (213/233),46.67％ (7/15),96.36％ (212/220)and 25.00％ (7/28),respectively,while of FNA biopsy was 98.81％ (83/84),100％ (75/75),88.89 ％ (8/9),98.68％ (75/76) and 100％ (8/8),respectively.The area under the curve (AUC) of ROC was 0.653 and 0.944 for ATA grading and FNA biopsy,respectively (Z=2.397,P=0.017).Conclusion ATA guideline has high diagnostic value in differential diagnosis of thyroid nodules,while FNA may be more effective in diagnosis of thyroid nodules.

Objective To detect the effect of oridonin(ORI)on the gene expression of human esophageal carcinoma cell SHEEC and to screen the tumor cell apoptosis target genes.Methods The gene expression of human esophageal carcinoma cell SHEEC without and with ORI induction for 1 hours and 8 hours were detected with microarray technique,respectively.The differentially expressed genes were identified and verified with fluorecent quantitative PCR.Results A total of 1011 genes showed up or down regulation more than twice after ORI induction(including 280 genes after 1 hour and 731 genes after 8 hours induction respectively).In these genes,17 genes with the top extent of up or down regulation were identified,which were involved in the cell signal transduction,transcription regulation,and cell apoptosis.These 17 differentially expressed genes were verified with real-time PCR,and 12 genes were statistically significant.Conclusion In the 12 differentially expressed genes with statistically significance,there may have tumor cell apoptosis target genes induced by ORI through mitochondrion route.