Objective:To identify the factors influencing the diagnostic accuracy of endoscopic ultrasonography (EUS) for colorectal submucosal tumors (SMT).Methods:A retrospective analysis was conducted on 330 colorectal SMT lesions (from 323 patients) diagnosed by EUS at Shenzhen Hospital of Southern Medical University from December 2015 to October 2023. Pathological diagnosis were confirmed through endoscopic resection, EUS-guided fine needle aspiration (EUS-FNA) or surgical resection. Diagnostic accuracy was calculated for each type of colorectal SMT. Univariate and multivariate logistic regression analysis were performed to identify factors affecting EUS diagnostic accuracy.Results:The overall diagnostic accuracy of EUS for colorectal SMT was 73.6% (243/330). Among 19 SMT subtypes enrolled, neuroendocrine neoplasms (51.2%, 169/330) and lipomas (15.5%, 51/330) were most prevalent, while 17 rare subtypes each accounted for <6%. Seven rare SMT (mucosal chronic inflammation, colorectal schwannoma, xanthogranulomatous inflammation, capillary hemangioma, colonic xanthoma, lymphadenoid complex, and angiomyolipoma) showed 0% diagnostic accuracy. Seven other subtypes (granular cell tumor, leiomyoma, rectal tonsil, intestinal schistosomiasis, fibrous tissue hyperplasia, gastrointestinal stromal tumor, and lymphangioma) showed accuracy <30%, whereas five subtypes (cyst, bowel endometriosis, neuroendocrine neoplasm, lipoma, and pneumatosis cystoides intestinalis) achieved >60% accuracy. Multivariate logistic regression analysis confirmed that the lesion location (left colon VS rectum: OR=0.06, 95% CI: 0.02-0.17, P<0.001; right colon VS rectum: OR=0.04, 95% CI: 0.01-0.13, P<0.001; ileocecal valve VS rectum: OR=0.09, 95% CI: 0.02-0.42, P=0.002); echogenicity (anechoic VS hypoechoic: OR=6.26, 95% CI: 1.31-29.97, P=0.022; hyperechoic VS hypoechoic: OR=13.39, 95% CI: 4.16-43.09, P<0.001) and ultrasonic layer (layer 4 VS layer 3: OR=0.22, 95% CI: 0.06-0.81, P=0.023) were independent influencing factors of EUS diagnostic accuracy for colorectal SMT. Conclusion:Neuroendocrine neoplasms and lipomas represent the most common colorectal SMT, whereas rare and uncommon SMT exhibit low EUS diagnostic accuracy. Lesion location, echogenicity, and ultrasonic layer significantly influence EUS diagnostic accuracy for colorectal SMT.

Objective:To identify the factors influencing the diagnostic accuracy of endoscopic ultrasonography (EUS) for colorectal submucosal tumors (SMT).Methods:A retrospective analysis was conducted on 330 colorectal SMT lesions (from 323 patients) diagnosed by EUS at Shenzhen Hospital of Southern Medical University from December 2015 to October 2023. Pathological diagnosis were confirmed through endoscopic resection, EUS-guided fine needle aspiration (EUS-FNA) or surgical resection. Diagnostic accuracy was calculated for each type of colorectal SMT. Univariate and multivariate logistic regression analysis were performed to identify factors affecting EUS diagnostic accuracy.Results:The overall diagnostic accuracy of EUS for colorectal SMT was 73.6% (243/330). Among 19 SMT subtypes enrolled, neuroendocrine neoplasms (51.2%, 169/330) and lipomas (15.5%, 51/330) were most prevalent, while 17 rare subtypes each accounted for <6%. Seven rare SMT (mucosal chronic inflammation, colorectal schwannoma, xanthogranulomatous inflammation, capillary hemangioma, colonic xanthoma, lymphadenoid complex, and angiomyolipoma) showed 0% diagnostic accuracy. Seven other subtypes (granular cell tumor, leiomyoma, rectal tonsil, intestinal schistosomiasis, fibrous tissue hyperplasia, gastrointestinal stromal tumor, and lymphangioma) showed accuracy <30%, whereas five subtypes (cyst, bowel endometriosis, neuroendocrine neoplasm, lipoma, and pneumatosis cystoides intestinalis) achieved >60% accuracy. Multivariate logistic regression analysis confirmed that the lesion location (left colon VS rectum: OR=0.06, 95% CI: 0.02-0.17, P<0.001; right colon VS rectum: OR=0.04, 95% CI: 0.01-0.13, P<0.001; ileocecal valve VS rectum: OR=0.09, 95% CI: 0.02-0.42, P=0.002); echogenicity (anechoic VS hypoechoic: OR=6.26, 95% CI: 1.31-29.97, P=0.022; hyperechoic VS hypoechoic: OR=13.39, 95% CI: 4.16-43.09, P<0.001) and ultrasonic layer (layer 4 VS layer 3: OR=0.22, 95% CI: 0.06-0.81, P=0.023) were independent influencing factors of EUS diagnostic accuracy for colorectal SMT. Conclusion:Neuroendocrine neoplasms and lipomas represent the most common colorectal SMT, whereas rare and uncommon SMT exhibit low EUS diagnostic accuracy. Lesion location, echogenicity, and ultrasonic layer significantly influence EUS diagnostic accuracy for colorectal SMT.

Objective The multiple malformation of upper eyelid,including the excessive width of fold line,sunken and/or multiple folded upper eyelid are the common complications after blepharoplasty.The aim of this study was to investigate the clinical effect of orbital septum fat redistribution on correcting these deformities.Methods From September 2015 to September 2017,38 patients with multiple malformations of upper eyelid were treated.The incision of upper eyelid and the excessive skin was designed and resected.After completely relieving the scar adhesion zones,we set the lateral orbital septum fat free and transposed it to the inner side of orbital septum or superior border of tarsus with suturing fixation.Then we routinely completed the double eyelid operation.Results Thirty-eight patients with multiple malformations of upper eyelid were treated successfully.The patients were followed up for 6 months to one year,and the results were totally satisfactory.The operation was not performed again.Conclusions The orbital septum fat redistribution can successfully correct the multi ple malformation of upper eyelid.It should become a regular procedure in blepharoplasty.

Objective To explore expression of IL -33 and IL -33 mRNA in peripheral blood of patients with ankylosing spondylitis,and analyze the clinical significance,so as to provide scientific reference for the treatment and prognosis of the disease.Methods From February 201 4 to May 201 6,32 patients with ankylosing spondylitis were included as study group,30 healthy persons were selected as control group.Real -time quantitative PCR and enzyme -linked immunosorbent assay were used to detect IL -33 mRNA level in peripheral blood and IL -33 level in plasma of subjects.Results Compared with the control group (1 .23 ±0.58),IL -33 mRNA in peripheral blood of patients in the study group was higher(1 .74 ±0.75),and the difference was statistically significant (t =2.981 , P =0.004).ELISA results showed that IL -33 level in plasma of the study group was higher (227.30 ±45.67)pg/mL than the the control group (1 1 4.70 ±39.58)pg/mL,the difference was statistically significant (t =1 0.344,P <0.01 ).Compared with the control group,the ESR,CRP and PLT of the study group were significantly higher[(47.80 ± 4.73)mm/h,(42.60 ±3.38)mg/L,(329.60 ±48.39)×1 09 /L](t =42.542,54.722,1 4.040,all P <0.01 ).IL -33 in plasma and IL -33 mRNA in peripheral blood of ankylosing spondylitis patients were positively correlated with BASDAI(r =0.472,0.457,all P <0.05),CRP(r =0.71 3,0.687,all P <0.05).Conclusion IL -33 and IL -33 mRNA in patients with ankylosing spondylitis significantly increase,indicates that they should play important role in the occurrence and development of ankylosing spondylitis.

Objective: To study the VP1 gene of coxsackievirus A6 (CVA6) and to reveal the molecular epidemiologic characteristics of CVA6 related to hand, foot and mouth disease (HFMD) in Anyang city from 2011 to 2015. Methods: Serotypes of human enterovirus (HEV) were detected with the real-time RT-PCR from the clinical specimens. Primers were designed and used to amply and sequence the VP1 region of CVA6. Phylogenetic tree was constructed and phylogenetic analysis was performed. Selection pressures of the VP1 gene were evaluated for different subgenotypes of CVA6 circulating in China in recent years. Results: A total of 365 specimens with CVA6 positivity were identified in Anyang city during 2011—2015. CVA6 specimens accounted for 19.59% of all HEV-positive specimens. Phylogenetic analysis showed that all CVA6 strains were divided into four genotypes and the genotype D was further divided into two subgenotypes. Among the twenty-two Anyang sequences involved in the phylogeny of CVA6, five sequences belonged to subgenotype D1 and the other seventeen sequences belonged to subgenotype D2. The values of selection pressure of the Chinese CVA6 strains within subgenotype D1 and subgenotype D2 were 0.031 and 0.075, respectively. Only one positively selected site was detected in the VP1 gene of subgenotype D1, meanwhile four were detected in the VP1 gene of subgenotype D2. Conclusions Subgenotype D1 and its successor, subgenotype D2, circulated in Anyang city during 2011—2015. The subgenotype replacement from CVA6 subgenotype D1 to CVA6 subgenotype D2 and the continuous transmission of CVA6 subgenotype D2 were the two major causes of HFMD epidemic related to CVA6 in Anyang city during 2013—2015.

Objective To investigate the expression of T help cell 1(Th1),T help cell 2(Th2)and related cytokines interleukin 12 (IL -12)and interleukin 4 (IL -4)in the lumbar disc herniation and their clinical significance. Methods 30 postoperative patients with lumbar disc herniation were included as observation group.The control group included 10 patients with lumbar fracture.Flow cytometry was used to distinguish the Th1 and Th2 cells.ELISA was used to measure the expression of interferon γ(IFN -γ),IL -12(the cytokines secreted by Th1 cells)and IL -4 (the cytokine secreted by Th2 cells).RT -PCR was used to detect the mRNA levels of STAT4 and STAT6.Results The distribution of Th1 /Th2 cells was higher in patients with lumbar disc herniation compared to the control group [(6.24 ±2.89)vs (25.12 ±3.20),t =16.26,P <0.05;(2.68 ±0.58)vs (8.16 ±1.20),t =3.84,P <0.05]. The levels of IFN -γand IL -12 in the study group were significantly higher than the control group,the differences were statistically significant[(23.47 ±5.61)vs (7.65 ±3.21),t =8.422,P <0.05;(1.52 ±0.87)vs (5.34 ± 1.39),t =8.135,P <0.05].The level of IL -4 was undetectable in the control group,however,IL -4 expressed in the study group.The expressions of IL -12,IFN -γand IL -4 in the study group were negatively correlated by Spearman correlation analysis (r =-0.57,P <0.05;r =-0.23,P <0.05).In addition,the mRNA level of STAT4 was higher in patients with lumbar disc herniation compared to the control group[(3.21 ±0.49)vs (1.12 ±0.24), t =13.15,P <0.05].Conclusion The expressions of Th1 cells,Th2 cells and related cytokines were participated in the pathogenesis of lumbar disc herniation.

Objective To investigate the influence of clinical results of early low frequency training for acute Achilles tendon rupture after anchors repair.Methods A total of 35 patients with acute Achilles tendon rupture were treated with early low frequency training after anchors repair,including 28 males and 7 females.Aged 18 to 37 years, mean 26 years old.Duration 2h to 5d from injury to therapy.All patients palpated the discontinuity of Achilles tendon, limitative activity of ankle plantar flexion,Thompson test was positive,and MRI examination was taken.Results 35 patients were followed up for 12 to 18 months,with an average follow -up of 14.5 months.According to the Amer-Lindholm score,excellent in 30 cases,good in 5 cases,the good rate was 100%.All the wounds were healed, without infection,dehiscence,sural nerve injury and re -rupture occurred.Conclusion Early low frequency training after anchors repair for acute Achilles tendon rupture is safe and reliable,patients can receive a better functional outcome.

Objective To investigate the effect of Helicobacter pylori ( Hp) infection on the growth and nutritional status in children.Methods A total of 174 children with Hp infections were collected from Jinhua Hospital of Zhejiang University during March 2010 to September 2012, and 100 healthy children were also enrolled as the controls.The differences in age and gender between Hp-infected group and control group were not significant.All Hp-infected children were given first-line anti-Hp therapy and followed-up for two years.t test, repeated measure ANOVA and LSD test were used to analyze the growth and nutritional status between Hp infected children and healthy controls, as well as between HP-infection eradication group and relapse group.Results Among 174 Hp-infected children, 2 were diagnosed as true precocious puberty, 6 abandoned treatment and 8 were lost to follow-up.Among 158 children who completed the study, Hp infection was eradicated in 128 (eradication group), and relapsed in 30 (relapse group).The height, weight, peripheral levels of hematoglobin ( Hb) , Albumin ( Alb) , blood urea nitrogen ( BUN) , Fe and Zn in 158 Hp-infected children at the baseline were significantly lower than those in the healthy control group (t=2.674, 1.657, 12.709, 3.662, 4.227, 4.210 and 14.820, all P <0.05).The height, weight, peripheral levels of Hb, Alb, BUN, Fe and Zn in eradication group were increased in 1-and 2-year of the follow-up (F=8.350, 14.998, 50.875, 37.584, 22.701, 8.295 and 41.791, all P<0.01), while there were no significant increase in the levels of Hb, Alb, BUN and Fe in the relapse group (F=1.826, 1.659, 2.613 and 2.495, all P>0.05).In the second year of the follow-up, the increases of Alb, BUN, Fe and Zn in eradication group were significantly higher than those in the relapse group ( t=7.86, 5.17, 8.80, 5.92, 2.17 and 7.28, all P <0.05).Conclusion Hp infection may affect the growth and nutritional status of children, and the eradication of Hp infection may help to improve the development and nutritional status of the children.

Objective To explore the methods and clinical effects of dimple plasty with syringe needle guiding.Methods From February 2008 to May 2012,36 dimple plasties in 21 patients were performed with using a syringe needle guiding the absorbable suture,including 15 cases in bilateral side and 6 cases in unilateral side.There were 4 cases in unilaterally right side and 2 cases in unilaterally left side.Two patients with inborn dimple in unilateral side received the dimple plasty in the other side for facial symmetry.Results 34 dimples in 21 patients were satisfied with the results.Two dimples were re-operated after three months because of disappearance.There were scleromas in 2 cases,which was disappeared by hot compress in three months.There were no hemotoma and infection in 21 patients.Conclusions The procedure of dimple plasty under syringe neddle guiding is safe,reusable and effective.It is a minimally invasive surgery and the patients are satisfied with the dynamic results after operation.

Objective To observe the effect of Glycyrrhizic acid phospholipid complex self emulsifying preparation against carbon tetrachloride induced acute and chronic liver injury in rats and C57 BL/6J mouse.Method A cute hepatic injury rat model and a chronic hepatic injury were established by intraperitoneal (ip) injection with carbon tetrachloride (CCl4),the level of ALT and AST in serum were determined.The pathologic changes of hepatic tissue were observed with light microscope.Results The liver function results showed that Glycyrrhizic acid phospholipid complex self emulsifying preparation can significantly lower ALT and AST after acute and chronic liver injury (P ＜ 0.01).Hepatic pathology study showed Glycyrrhizic acid phospholipid complex self emulsifying preparation could alleviate hepatic inflammation and effectively protect liver cells.Conclusion It was revealed that Glycyrrhizic acid phospholipid complex self emulsifying preparation could prevent carbon tetrachloride from inducing liver injury.