Objective To investigate the efficacy and safety of self-help inflatable balloon in the treatment of refractory benign upper digestive tract stricture.Methods From November 2022 to February 2024,10 patients with refractory benign upper digestive tract stricture underwent self-help inflatable balloon were retrospectively analyzed.Preoperative treatment,intraoperative and postoperative complications,dysphagia score before and after surgery,wearing time of external self-help inflatable balloon,and the clinical efficacy were evaluated.Results All the 10 patients received self-help inflatable balloon treatment.No complications such as bleeding and perforation occurred in all patients during the wearing of the balloon.The placement time of the balloon was 60～180 d,and the average wearing time was 104.9 d.Before surgery,nine cases had a stricture segment length less than 2 cm,and one case had a stricture segment length of 6 cm.The dysphagia score before surgery was(3.60±0.52),and the dysphagia score after removal of the self-help inflatable balloon was(0.60±0.52),and there was statistical significance in preoperative and postoperative comparison(P＜0.05).The dysphagia score 3 months after removal of the external self-help inflatable balloon was(0.70±0.48),there was no significant difference in dysphagia score between the day after surgery and 3 months after surgery(P＞0.05).The diameter of the stricture before and after operation was(5.09±2.02)mm and(10.35±0.73)mm respectively,and the difference was statistically significant(P＜0.05).Sore throat,wing of nose pain and balloon displacement were the most common adverse events,with 30.0％(3/10),50.0％(5/10)and 70.0％(7/10),respectively.Conclusion It is safe,effective and feasible to treat refractory benign upper digestive tract stricture with self-help inflatable balloon in vitro.It is worthy for clinical application.

Objective To investigate the efficacy and safety of self-help inflatable balloon in the treatment of refractory benign upper digestive tract stricture.Methods From November 2022 to February 2024,10 patients with refractory benign upper digestive tract stricture underwent self-help inflatable balloon were retrospectively analyzed.Preoperative treatment,intraoperative and postoperative complications,dysphagia score before and after surgery,wearing time of external self-help inflatable balloon,and the clinical efficacy were evaluated.Results All the 10 patients received self-help inflatable balloon treatment.No complications such as bleeding and perforation occurred in all patients during the wearing of the balloon.The placement time of the balloon was 60～180 d,and the average wearing time was 104.9 d.Before surgery,nine cases had a stricture segment length less than 2 cm,and one case had a stricture segment length of 6 cm.The dysphagia score before surgery was(3.60±0.52),and the dysphagia score after removal of the self-help inflatable balloon was(0.60±0.52),and there was statistical significance in preoperative and postoperative comparison(P＜0.05).The dysphagia score 3 months after removal of the external self-help inflatable balloon was(0.70±0.48),there was no significant difference in dysphagia score between the day after surgery and 3 months after surgery(P＞0.05).The diameter of the stricture before and after operation was(5.09±2.02)mm and(10.35±0.73)mm respectively,and the difference was statistically significant(P＜0.05).Sore throat,wing of nose pain and balloon displacement were the most common adverse events,with 30.0％(3/10),50.0％(5/10)and 70.0％(7/10),respectively.Conclusion It is safe,effective and feasible to treat refractory benign upper digestive tract stricture with self-help inflatable balloon in vitro.It is worthy for clinical application.

Objective:To investigate the incidence and prothrombotic risk factors of postoperative venous thromboembolism(VTE) in Cushing′s disease and to further develop an assessment model to identify those at high risk of postoperative VTE events.Methods:A retrospective study was performed in 82 patients who were admitted to Huashan Hospital, Fudan University during January 2019 and January 2020 and diagnosed with Cushing′s disease. These patients underwent the evaluation about their clinical, hormonal, and coagulation parameters, as well as ultrasonography and pulmonary angio-CT when necessary. The least absolute shrinkage and selection operator(LASSO) regression analysis was used to screen independent risk factors, and a nomogram model for postsurgical VTE risk assessment in Cushing′s disease was initially established, and Bootstrap method was used for internal verification. Finally, the predictive model was evaluated for calibration and clinical applicability in the study cohort.Results:Nineteen patients(23.17%) developed VTE events, with 14 cases occurring after endoscopic transsphenoidal surgery. Compared to patients without VTE, those in the VTE group were older( P<0.001), had longer postoperative bed rest, higher rates of current infection, higher HbA 1C levels, and more severe glucose tolerance impairment(all P<0.05). Through LASSO regression analysis, two independent risk factors for postoperative VTE were identified: Age and current infection. Then a VTE risk assessment nomogram model was established to predict the patients at high risk of VTE. In the nomogram model for VTE risk assessment, the area under the receiver operating characteristic curve was 0.868(95% CI 0.787-0.949), with the calibration curve closely aligning with the ideal diagonal line and the clinical decision curve exceeding the two extreme curves. Conclusions:Advanced perioperative assessment needs to be taken to screen those with high VTE risks in patients diagnosed with Cushing′s disease. Additionally, during the perioperative period, patients with Cushing′s disease should undergo mandatory physical activity or prophylactic anticoagulant therapy.

Objective To investigate the efficacy and safety of endoscopic dilatation in treatment of esophageal stenosis after esophageal varices sclerotherapy.Methods Clinical data of 17 patients with esophageal stenosis after sclerotherapy for esophageal varices from January 2014 to December 2023 were retrospectively analyzed,and they were divided into balloon expansion group and bougie expansion group.The remission rate and recurrence rate of esophageal stenosis after endoscopic dilation were analyzed,as well as the incidence of intraoperative complications such as intraoperative bleeding,perforation,infection and chest pain.Results 50 endoscopic dilation treatments were performed in 17 patients.The stenosis remission rate after the first dilation was 76.47％,and the recurrence rate was 53.85％.The total number of dilation required for complete remission of esophageal stenosis ranged from 1 to 15 times,and the median required dilation was 2 times,and 35.29％ (6/17)only needed 1 dilation to complete remission.Intraoperative laceration bleeding occurred in 4.00％ (2/50) requiring endoscopic hemostasis.Fever occurred in 6.00％ (3/50),chest pain occurred in 2.00％ (1/50),and no other complications such as perforation and mediastinal infection occurred.The relief rate of balloon dilatation was higher than that of bougiate dilatation,and the difference was statistically significant (P<0.05).There were no significant differences in recurrence rate and complication rate between the two groups (P>0.05).Conclusion Endoscopic dilatation is generally safe and effective in the treatment of esophageal stenosis after sclerotherapy for esophageal varices,and balloon dilatation is superior to bougiate dilatation in the relief of stenosis.

Objective To investigate the efficacy and safety of endoscopic dilatation in treatment of esophageal stenosis after esophageal varices sclerotherapy.Methods Clinical data of 17 patients with esophageal stenosis after sclerotherapy for esophageal varices from January 2014 to December 2023 were retrospectively analyzed,and they were divided into balloon expansion group and bougie expansion group.The remission rate and recurrence rate of esophageal stenosis after endoscopic dilation were analyzed,as well as the incidence of intraoperative complications such as intraoperative bleeding,perforation,infection and chest pain.Results 50 endoscopic dilation treatments were performed in 17 patients.The stenosis remission rate after the first dilation was 76.47％,and the recurrence rate was 53.85％.The total number of dilation required for complete remission of esophageal stenosis ranged from 1 to 15 times,and the median required dilation was 2 times,and 35.29％ (6/17)only needed 1 dilation to complete remission.Intraoperative laceration bleeding occurred in 4.00％ (2/50) requiring endoscopic hemostasis.Fever occurred in 6.00％ (3/50),chest pain occurred in 2.00％ (1/50),and no other complications such as perforation and mediastinal infection occurred.The relief rate of balloon dilatation was higher than that of bougiate dilatation,and the difference was statistically significant (P<0.05).There were no significant differences in recurrence rate and complication rate between the two groups (P>0.05).Conclusion Endoscopic dilatation is generally safe and effective in the treatment of esophageal stenosis after sclerotherapy for esophageal varices,and balloon dilatation is superior to bougiate dilatation in the relief of stenosis.

Apoptosis ; Autophagy ; Ferroptosis ; Iron/metabolism* ; Sequestosome-1 Protein/metabolism* ; Ubiquitin-Specific Proteases/metabolism*

Objective To observe the peroxidase body growth activated receptor γ (PPARγ) agonist rosiglitazone on acute pancreatitis in mice with hepatic injury and to investigate the mechanism of hepatic injury .Methods Seventy‐two male Kunming mice were randomly allocated into three groups(24 cases for each group):acute pancreatitis group(AP group) ,rosiglitazone group (AP‐ROS group) ,saline group(NS group) .Mice were killed at 6 ,12 and 24 h after induction of acute pancreatitis .Serum amylase , ALT and AST activities were measured .The expressions of NF‐κB and PPARγmRNA were assessed by RT‐PCR .The expressions of NF‐κB and PPARγ protein were assessed by Western blot .Results Compared with NS group ,serum amylase ,ALT and AST levels at each time point significantly increased in AP group(P< 0 .01);serum amylase ,ALT and AST levels in AP‐ROS group were significantly lower than those in AP group(P<0 .01) .Compared with NS group ,the expressions of liver PPARγ mRNA and protein in AP group were markedly lower at 6 h and 12 h(P<0 .05) ,and the expressions of PPARγmRNA and protein in AP‐ROS group were significantly higher than those in NS group and AP group(P<0 .01) .The expressions of liver NF‐κB mRNA and NF‐κB p65 protein in AP group were significantly higher than those in NS group and AP‐ROS group at all time points(P<0 .01) .Con‐clusion There are clear relationships between NF‐κB and hepatic injury in acute pancreatitis .The expressions of PPARγin injuried hepatic decreased .Rosiglitazone can increase the expressions of PPARγand prevent the expressions of NF‐κB in hepatic during the early phase of acute pancreatitis .