Background/Aims: Endoscopic radiofrequency ablation (ERFA) is a treatment option for superficial esophageal squamous cell neoplasia (ESCN), with a relatively low risk of stenosis; however, the long-term outcomes remain unclear. We aimed to compare the long-term outcomes of patients with widespread superficial ESCN who underwent endoscopic submucosal dissection (ESD) or ERFA. Methods: We retrospectively analyzed the clinical data of patients with superficial ESCN who underwent ESD or ERFA between January 2015 and December 2021. The primary outcome measure was recurrence-free survival. Results: Ninety-two and 33 patients with superficial ESCN underwent ESD and ERFA, respectively. The en bloc, R0, and curative resection rates for ESD were 100.0%, 90.2%, and 76.1%, respectively. At 12 months, the complete response rate was comparable between the two groups (94.6% vs 90.9%, p=0.748). During a median follow-up of 66 months, recurrence-free survival was significantly longer in the ESD group than in the ERFA group (p=0.004), while no significant differences in overall survival (p=0.845) and disease-specific survival (p=0.494) were observed.Preoperative diagnosis of intramucosal cancer (adjusted hazard ratio, 5.55; vs high-grade intraepithelial neoplasia) was an independent predictor of recurrence. Significantly fewer patients in the ERFA group experienced stenosis compare to ESD group (15.2% vs 38.0%, p=0.016). Conclusions The risk of recurrence was higher for ERFA than ESD for ESCN but overall survival was not affected. The risk of esophageal stenosis was significantly lower for patients who underwent ERFA.

Risk prediction models for postoperative pulmonary complications (PPCs) can assist healthcare professionals in assessing the likelihood of PPCs occurring after surgery, thereby supporting rapid decision-making. This study evaluated the merits, limitations, and challenges of these models, focusing on model types, construction methods, performance, and clinical applications. The findings indicate that current risk prediction models for PPCs following lung cancer surgery demonstrate a certain level of predictive effectiveness. However, there are notable deficiencies in study design, clinical implementation, and reporting transparency. Future research should prioritize large-scale, prospective, multi-center studies that utilize multiomics approaches to ensure robust data for accurate predictions, ultimately facilitating clinical translation, adoption, and promotion.

BACKGROUND:Mesenchymal stem cells can regulate the tumor microenvironment by secreting extracellular vesicles containing cytokines,growth factors and exosomes for the precise regulation of biological behavior of tumor cells. OBJECTIVE:To investigate the effects of human umbilical cord-derived mesenchymal stem cell conditioned medium and their released exosomes on the biological properties of hepatocellular carcinoma cells. METHODS:Human umbilical cord mesenchymal stem cell supernatant was collected,centrifuged and filtered at high speed to obtain human umbilical cord mesenchymal stem cell conditioned medium.Human umbilical cord mesenchymal stem cell supernatant was collected and human umbilical cord mesenchymal stem cell exosomes were extracted by ultra-high speed gradient centrifugation.Human umbilical cord mesenchymal stem cell exosomes were labeled with PKH26 and co-cultured with hepatocellular carcinoma cell MHCC97-H.The uptake of exosomes by MHCC97-H cells was observed by fluorescence microscopy.The effects of human umbilical cord mesenchymal stem cell conditioned medium and human umbilical cord mesenchymal stem cell exosomes on biological functions of hepatocellular carcinoma cells were assessed by the CCK-8 proliferation assay,Transwell migration and invasion assay,and the apoptosis assay. RESULTS AND CONCLUSION:(1)Human umbilical cord mesenchymal stem cell exosomes could be uptaken by MHCC97-H cells and was mainly distributed in the cytoplasm.(2)After treatment with human umbilical cord mesenchymal stem cell conditioned medium,MHCC97-H cells showed a significant increase in proliferation,migration,and invasion(P<0.001,P<0.05,P<0.01),and a significant decrease in apoptosis(P<0.001),while after treatment with human umbilical cord mesenchymal stem cell exosomes,MHCC97-H cells showed a decrease in proliferation(P<0.001)and migration,invasion,and apoptosis were significantly enhanced(P<0.001).(3)The results indicated that human umbilical cord mesenchymal stem cell conditioned medium had the ability to promote the proliferation,migration,invasion,and inhibit apoptosis of MHCC97-H cells,while human umbilical cord mesenchymal stem cell exosomes had the properties of promoting the migration,invasion and apoptosis of MHCC97-H cells,inhibiting the proliferation.

OBJECTIVE: To explore the clinical characteristics and genetic etiology of a child with Oral-facial-digital syndrome type Ⅰ(OFDSⅠ). METHODS: A child with OFDSⅠ who received treatment at the Women and Children's Hospital Affiliated to Ningbo University in March 2023 was selected as the study subject. A retrospective research method was used to collect the clinical data of the child. Peripheral venous blood samples were collected from the child, her parents and sister. Genomic DNA was extracted, and whole exome sequencing (WES) was performed. Candidate variants were validated using Sanger sequencing for familial verification. According to the Standards and Guidelines for the Interpretation of Sequence Variants developed by the American College of Medical Genetics and Genomics (ACMG) (hereinafter referred to as the "ACMG Guidelines"), the pathogenicity of the candidate variant was rated. This study was approved by the Medical Ethics Committee of Ningbo University Affiliated Women and Children's Hospital (Ethic No.: EC 2024-063). RESULTS: The child was a prematurely born female with deformities of the oral cavity, fingers, and toes. She was admitted to the Neonatal Department of the Hospital where she was born due to shortness of breath 15 minutes after birth. The WES results indicated that the child has harbored a heterozygous c.710dup (p.Y238Vfs*2) frameshifting variant of the OFD1 gene. Sanger sequencing confirmed that neither of the child's parents nor her sister had carried the same variant. According to the ACMG guidelines, the variant was rated as pathogenic (PVS1+PS4_Moderate+PM2-Supporting+PM6_Supporting+PP4). CONCLUSION Children with OFDSⅠ have clinical features such as oral, finger, and toe deformities. The c.710dup (p.Y238Vfs*2) variant of the OFD1 gene probably underlay the OFDSⅠ in this child. Above result has enriched the mutational spectrum of the OFD1 gene.
Humans ; Female ; Orofaciodigital Syndromes/genetics* ; Exome Sequencing ; Retrospective Studies ; Mutation ; Child ; Proteins

Objective:To investigate the clinical efficacy of autologous costal cartilage rhinoplasty combined with costal cartilage block grafting to the alar base in the correction of saddle nose deformity with alar-columellar base depression.Methods:A retrospective analysis was performed on patients who underwent autologous costal cartilage rhinoplasty combined with alar base augmentation at the Department of Plastic Surgery, Zhejiang Provincial People’s Hospital, from January 2022 to December 2023. All patients presented with alar-columellar base depression combined with saddle nose deformity. Through bilateral marginal incisions of the lower lateral cartilage and an inverted V-shaped columellar incision, the 6th costal cartilage near the sternal end was harvested and sculpted into two alar base grafts, one columellar strut graft in an inverted V shape, two septal extension grafts, and one cap graft. On the basis of block costal cartilage grafting to the alar base, a nasal tip support framework and septal extension graft were constructed, combined with implantation of an expanded polytetrafluoroethylene (ePTFE) prosthesis, to correct the aesthetic defects of saddle nose with alar-columellar base depression. Postoperative complications and recovery were recorded. Standardized pre- and 6-month postoperative photographs were analyzed using Adobe Photoshop and Image J to measure nasal base elevation, nasolabial angle, nasofrontal angle, nasal tip angle, nasal tip projection-to-length ratio, and columella-lobule angle. Patient satisfaction was evaluated preoperatively and at 6 months postoperatively using the visual analogue scale (VAS, 0-10 points; higher scores indicate greater satisfaction) and the rhinoplasty outcome evaluation (ROE) questionnaire (total score 0-24; higher scores indicate greater satisfaction). Paired t-tests were used for statistical analysis, with P<0.05 considered statistically significant. Results:A total of 48 patients were enrolled, including 3 males and 45 females, aged from 19 to 37 years (27.3±5.9 years). The postoperative follow-up period ranged from 6 to 12 months. No infections, hemorrhage, or other complications occurred. Swelling subsided substantially within 4-5 weeks postoperatively, and no significant nasal airway obstruction, sensory abnormalities, or olfactory disturbances were observed. Patients were satisfied with their postoperative appearance and outcomes. At 6 months postoperatively, the nasal base elevation was increased compared with preoperative measurements (6.08 ± 0.85) mm. Compared with preoperative values, significant improvements were observed at 6 months postoperatively in nasolabial angle (84.69° ± 4.24° vs. 96.81° ± 5.80°), nasofrontal angle (143.91° ± 3.91° vs. 136.24° ± 2.66°), nasal tip angle (84.13° ± 5.25° vs. 78.20° ± 5.40°), nasal tip projection-to-length ratio (0.45 ± 0.05 vs. 0.53 ± 0.07), columella-lobule angle (49.22° ± 5.29° vs. 44.25° ± 3.52°), VAS score (4.69 ± 0.90 vs. 8.45 ± 0.80), and ROE score (11.99 ± 1.47 vs. 21.50 ± 1.31) (all P<0.05). Conclusion:Autologous costal cartilage rhinoplasty combined with costal cartilage block grafting to the alar base can effectively correct saddle nose deformity with alar-columellar base depression, achieving comprehensive improvement in midfacial aesthetics.

Congenital infiltrating lipomatosis of the face (CIL-F) represents a rare lipomatous lesion, as evidenced by a case admitted to the Department of Plastic and Reconstructive Surgery at the Second Affiliated Hospital of Kunming Medical University in August 2023. The patient, a 7-year-old male, presented with diffuse enlargement of the right middle and lower face and a forehead mass since birth. Imaging assessments including CT scan with three dimensional reconstruction and MRI revealed infiltrative fatty growth in the right middle and lower face, abnormal subcutaneous fat hyperplasia in the forehead, and asymmetric abnormal hyperplasia of the right mandible. Following surgical resection, genetic testing of the excised tissue identified a mutation of the PIK3CA gene. Remarkably, the patient demonstrated satisfactory recovery six months post-surgery. Given its rarity in clinic, this case offers valuable clinical insights for managing similar disease.

OBJECTIVE To observe the causal association between colorectal cancer and sepsis by means of bidirec-tional two-sample Mendelian randomization(MR).METHODS The Genome Wide Association Study(GWAS)datasets for colorectal cancer and sepsis were retrieved from the GWAS databases between its establishment and Feb.1,2024.MR was carried out for the colorectal cancer and sepsis interacting as exposure and outcome factors.The single nucleotide polymorhpism(SNPs)that were significantly associated with the exposure factors were screened out by setting P as less than 5.0× 10-8,r2 less than 0.001,the genetic distance 10,000 kb.The SNPs that were remarkably associated with the exposure factors were extracted from the GWAS datasets of the outcome variables,the instrumental variable were finally obtained,the inverse variance weighting(IVW)was taken as the main approach for the causal inference.The level pleiotropy was tested by using MR Egger method and MR-PRESSO,the heterogeneity was tested by IVW method and MR-Egger method,the sensitivity was analyzed by leave-one-out method,and the robustness of the result was tested.RESULTS A total of 30 SNPs were screed out by setting the colorectal cancer as exposure factor and the sepsis as outcome variable(F＞10);there was causal as-sociation between the colorectal cancer and the sepsis(OR=28.955,95％CI:1.215 to 690.052,P=0.037).Totally 14 SNPs were screened out by setting the sepsis as exposure factor and the colorectal cancer as treatment variable(F＞10),and there was no causal association between the colorectal cancer and the sepsis(OR=0.999,95％CI:0.997 to 1.002,P=0.674).There was no level pleiotropy in the instrumental variables during the two times of MR analysis;there was no heterogeneity in the instrumental variables,and the result of the MR analysis was robust.CONCLUSION There is causal association between the colorectal cancer and the increases of risk of sepsis.But there is no causal association between the sepsis and the increase of risk of colorectal cancer.

Soy is a vital source of plant carbohydrates.However,it poses significant allergenic risks,particularly to young children and animals.Among the various proteins in soy,β-conglycinin,which con-stitutes approximately 30％of total soy carbohydrates,is a primary allergen.Undigested β-conglycinin can lead to intestinal damage by inhibiting cell growth,disrupting the cytoskeleton,and inducing apopto-sis.It can also enter the lymphatic and circulatory systems,triggering allergic reactions.Conventional ELISA methods for detecting β-conglycinin rely on polyclonal or monoclonal antibodies,which are limited by their large molecular weight,difficulty in accessing the protein core,and sensitivity to acidic and bas-ic conditions.To address these limitations,this study aimed to develop nanobodies(Nbs)against β-con-glycinin.Nbs,derived from the variable regions of heavy-chain antibodies found in camelids,have a mo-lecular weight approximately one-tenth that of conventional antibodies.They offer advantages such as small size,stable structure,high specificity,and strong affinity.A female alpacas was immunized five times using β-conglycinin,which showed a heavy chain antibody potency of 1∶16 000 by ELISA.Pe-ripheral blood lymphocytes were subsequently isolated and total RNA was extracted.The variable region of the heavy-chain antibody was amplified via PCR,and recombinant plasmids were constructed and transformed into the E.coli competency strain ER2738.The resulting library contained about 3.5×108 CFU/mL,which increased to 1.15×1012 PFU/mL after phage rescue,with a 100％Nbs gene insertion rate,indicating high diversity.Its Nbs phage output was significantly enriched by four rounds of solid-phase elution with an enrichment rate of 155.9.Four rounds of solid-phase panning yielded 35 positive clones,all of which shared the same amino acid sequence upon sequencing.The selected Nb was ex-pressed in a prokaryotic system,and its binding ability to β-conglycinin was confirmed using Western blotting and ELISA.The results demonstrated excellent specificity and affinity.This research lays the groundwork for developing a rapid and efficient detection method for β-conglycinin using Nbs,potentially enhancing food safety and allergen management.

Objective To construct a nomogram model for predicting pulmonary hemorrhage associated with the positioning of pulmonary nodules with the new four-hook positioning needle based on clinical-CT imaging features and evaluate its predictive efficacy.Methods We made a retrospective analysis of the clinical,imaging and pathological data of 449 patients with pulmonary nodules positioned by the new four-hook positioning needle.According to the random number table method(7∶3),they were divided into a training set of 314 cases and a validation set of 135 cases.Each data set was further divided into positive group and negative group for pulmonary hemorrhage according to the presence or absence of pulmonary hemorrhage.We evaluated the CT imaging features of pulmonary nodules,including nodule nature(pure ground-glass density,mixed ground-glass density,solid nodule),nodule diameter,distance from the nodule to the pleural surface(hereinafter referred to as length),nodule positioning time,and association with pulmonary hemorrhage.Independent sample t-test,Mann-Whitney U test and x2 test were used to compare the correlations of clinical and CT features of pulmonary nodules with pulmonary hemorrhage.LASSO regression and multivariate Logistic regression were employed to screen the independent risk factors related to pulmonary hemorrhage and construct a nomogram model.The receiver operating characteristic(ROC)curve was used to evaluate the predictive efficacy of the model,and the calibration curve and decision curve were respectively used for the verification of the nomogram model and evaluation of the clinical net benefit.Results The results of LASSO regression showed that the nature of pulmonary nodules,underlying diseases,smoking and length were the characteristic variables related to pulmonary hemorrhage.Based on the minimum akaike information criterion(AIC),the screened characteristic variables were included in the multivariate Logistic backward stepwise regression analysis.The results showed that the nature of pulmonary nodules,underlying diseases,smoking and length were all independent risk factors related to pulmonary hemorrhage.A nomogram was established according to the above independent risk factors and the ROC curve was drawn.The AUC of the training set was 0.86(95％CI:0.80-0.91),and the AUC of the validation set was 0.88(95％CI:0.80-0.96),with no statistically significant difference(P＞0.05).The calibration curve suggested that the predicted values of the nomogram were close to the actual values,and the decision curve analysis showed that the net benefit of the model was good.Conclusion The nomogram model established by combining clinical-CT features such as the nature of pulmonary nodules,underlying diseases,smoking and length can effectively predict pulmonary hemorrhage associated with the positioning of pulmonary nodules with the new four-hook positioning needle.

An assay was established for detection of toxigenic Clostridioides difficile by combining microfluidic chip analysis with immunochromatography,and its performance was evaluated and compared with those of the Xpert C.difficile/Epi and VIDAS CD AB tests.Primer pairs were designed according to the tcdB and tpi genes in C.difficile.The specificity,limit of detection,reproducibility,and stability were evaluated.A total of 215 stool samples from patients with diarrhea were collected and tested in parallel with the Xpert C.difficile/Epi,VIDAS CDAB,and our assay.C.difficile was isolated from samples,and the tcdB gene was identified when discrepant results were obtained from the three above assays.Our assay showed no cross-reaction with other diarrhea-associated pathogens.Its reproducibility was 100％in testing of two standard plasmids containing tcdB and tpi genes at two concentrations(105 and 102 copies/μL).Two standard plasmids were detected after the PCR and immunochromatography reagents had been stored for 3,6,9,and 12 months,and all the results were posi-tive.The limit of detection was 10 copies/μL for toxigenic C.difficile.Testing of 33 samples positive for C.difficile with our assay(33/215,15.3％)yielded findings statistically coherent with those of the Xpert C.difficile/Epi test(kappa value=0.965).The sensitivity,specificity,positive predictive value,and negative predictive value of our assay,with respect to Xpert C.difficile/Epi as the standard,were 94.3％,100.0％,100.0％,and 98.9％;these values were significantly higher than those of VIDAS CDAB(60.0％,98.9％,91.3％,and 92.7％)(Kappa=0.714,OR=157.50,95％CI:62.03-847.28,P=0.013).In conclusion,our newly developed assay is specific,stable,and reproducible,and may be used for rapid and accu-rate detection of toxigenic C.difficile.The assay could be used for C.difficile infection screening in outpatient and emergen-cy,community medical service center,and epidemiological settings.