Objective:To investigate the anatomic origin of juvenile nasopharyngeal angiofibroma（JNA） through radiologic analysis of tumor invasion patterns, providing insights into tumor etiology and surgical recurrence prevention. Methods:This retrospective cohort study included primary JNA cases at the Department of Otorhinolaryngology, Eye and ENT Hospital of Fudan University from March 2015 to September 2024. All patients underwent preoperative high-resolution CT（HRCT） scans, and some underwent enhanced magnetic resonance imaging. The study retrospectively analyzed the patients' imaging data to examine tumor invasion into the pterygopalatine fossa and the vidian canal. These sites were categorized into non-invaded, partially invaded, and completely invaded for the pterygopalatine fossa and the vidian canal. The study analyzed the proportions of invasion at these sites to further speculate on the origin of JNA. Results:A total of 105 JNA patients were included in the study. Among them, 100% of the patients had complete tumor invasion in the pterygopalatine fossa. For the vidian canal, the proportions of complete invasion, partial invasion, and non-invasion were 54.3%, 27.6%, and 18.1%, respectively. As the staging of JNA tumors increased, the proportion of vidian canal invasion also increased. Conclusion:Our evidence suggests that the pterygopalatine fossa, rather than the vidian canal, might be the likely origin of JNA, which is enlightening for the study of the etiological mechanisms of JNA.
Humans ; Nasopharyngeal Neoplasms/pathology* ; Retrospective Studies ; Angiofibroma/pathology* ; Neoplasm Invasiveness ; Pterygopalatine Fossa/pathology* ; Female ; Magnetic Resonance Imaging ; Male ; Tomography, X-Ray Computed ; Adolescent

Allergen-specific immunotherapy（AIT） remains the only therapeutic approach with the potential to modify the natural course of allergic rhinitis（AR）. Nevertheless, considerable inter-individual variability exists in patients'responses to AIT. To facilitate more reliable assessment of treatment efficacy, the China Rhinopathy Research Cooperation Group（CRRCG） convened young and middle-aged nasal experts in China to formulate the present consensus. The recommended subjective outcome measures for AIT comprise symptom scores, medication scores, combined symptom and medication scores, quality-of-life assessments, evaluation of disease control, and assessment of comorbidities. Objective indicators may supplement these measures. Currently available objective approaches include skin prick testing, nasal provocation testing, and allergen exposure chambers. However, these methods remain constrained by practical limitations and are not yet appropriate for routine implementation in clinical efficacy evaluation. In addition, several biomarkers, including sIgE and the sIgE/tIgE ratio, sIgG4, serum IgE-blocking activity, IgA, cytokines and chemokines, as well as immune cell surface molecules and their functional activity, have been shown to have associations with AIT outcomes. While these biomarkers may complement subjective assessments, they are subject to significant limitations. Consequently, large-scale multicenter trials and real-world evidence are required to strengthen the evidence base. The present consensus underscores the necessity of integrating patients'subjective experiences with objective testing throughout the treatment process, thereby providing a more comprehensive and accurate framework for efficacy evaluation. Looking forward, future investigations should prioritize the incorporation of multi-omics data and artificial intelligence methodologies, which hold promise for overcoming current limitations in assessment strategies and for advancing both the standardization and personalization of AIT.
Humans ; Allergens/immunology* ; China ; Consensus ; Desensitization, Immunologic ; Immunoglobulin E ; Quality of Life ; Rhinitis, Allergic/therapy* ; Treatment Outcome ; East Asian People

Radiomics-based early prediction and treatment efficacy evaluation is critical for personalized treatment strategies in patients with colorectal cancer liver metastases(CCLM).Owing to the high artificial intelligence(AI)participation,repeatability,and reliable perform-ance,deep learning(DL)based on convolutional neural networks enhances the predictive efficacy of the models,enabling its potential clinic-al application more promising.Subsequent to the gradual construction of a multimodal fusion model and multicenter large sample database,radiomics and DL will become increasingly essential in the management of CCLM.This review focuses on the main steps of radiomics and DL,and summarizes the value of its application in early state prediction and treatment efficacy evaluation of different treatment modalities in CCLM,we also look forward to the potential of its in-depth application in the clinical management of CCLM.

Objectives:To investigate the risk factors of cage retropulsion(CR)after posterior lumbar inter-body fusion(PLIF).Methods:Retrospective analysis was made on 17 patients(13 males and 4 females,with an average age of 63.7±9.9 years)who underwent revision surgery due to CR after PLIF in our hospital from September 2017 to September 2021.And the patients were included into the CR group.Another 34 patients without CR were matched in a ratio of 2∶1 according to the same fusion and fixation segments,time of initial surgery(±1 year),gender,and age(±2 years),including 26 males and 8 females,with an average age of 65.2±10.2 years.They were included in the control group.In the CR group,the average number of fixed segments was 1.8±0.8,and the average number of fused segments was 1.5±0.6;The time of CR was 7(0.75-132)months after the first operation;15 patients had single segmental CR and 2 patients had two segmental CR.The lumbar lordosis(LL),pelvic tilt(PT),sacral slope(SS),and pelvic incidence(PI)were measured on full-spine X-ray before operation of the two groups of patients,the disc height(DH)of the diseased segment was mea-sured on lateral lumbar X-ray,and the intervertebral range of motion(ROM)was measured on flexion-exten-sion X-ray.The CT value of lumbar vertebrae was measured in CT examination before operation;The shape of disc was defined through MRI examination.The cage position was measured on X-ray immediately after operation(The ratio of the distance between the marker line of the posterior margin of the cage and the pos-terior upper margin of the lower vertebral body to the length of the upper endplate of the lower vertebra).The paired sample t-test was used for single factor analysis to analyze the data of the two groups,after which,the parameters with statistical significance were analyzed with logistic regression to determine the inde-pendent risk factors of CR.Results:The mean vertebral CT value in the CR group was lower than that in the control group(124.8±39.7 vs 147.7±38.2,P=0.011);The cage position in the CR group was more posterior than that in the control group(0.15±0.09 vs 0.31±0.07,P＜0.001).There was no significant difference between the two groups in LL(40.8°±12.9° vs 42.4°±7.5°,P=0.717),PT(19.6°±7.1° vs 17.1°±6.7°,P=0.356),SS(27.7°±6.5° vs 31.0°±4.3°,P=0.144),PI(44.3°±13.8° vs 44.7°±13.9°,P=0.926),DH(10.1±2.4mm vs 8.8±1.4mm,P=0.066),ROM(4.3°±2.8° vs 4.4°±2.2°,P=0.950),and Pear-shaped intervertebral discs(33.3％vs 21.4％,P=0.40).Logistic regression analysis showed that low vertebral CT value(osteoporosis)(OR=0.975,P=0.043)and cage po-sition(OR=28.393,P=0.003)were the independent risk factors.Conclusions:Osteoporosis and posterior placement of cage are the risk factors for CR after PLIF.

PURPOSE: Recent evidence suggests that B cells can both promote and inhibit the development and progression of allergic disease. However, the characteristics of B cell subsets in patients with allergic rhinitis (AR) have not been well documented. This study aimed to analyze the characteristics of B cell subsets in the peripheral blood of AR patients. METHODS: Forty-seven AR patients and 54 healthy controls were enrolled in this study, and the B cell subsets in peripheral blood of all subjects were analyzed by flow cytometry. Moreover, the serum total immunoglobulin E (IgE) and IgE concentrations secreted into the cultured peripheral blood mononuclear cells (PBMCs) were measured by using enzyme-linked immunosorbent assay. RESULTS: We found the peripheral blood of AR patients contained higher percentages of memory B cells, plasma cells, and CD19+CD24hiCD27+ regulatory B cells (Bregs) than those of age-matched healthy controls (P < 0.05), while the percentages of naïve B cells and CD19+CD24hiCD38hi Bregs were significantly lower in AR patients than in healthy individuals (P < 0.05). In addition, the serum total IgE and IgE concentrations secreted into the cultured PBMCs were elevated in AR patients than in the healthy controls (P < 0.05). CONCLUSIONS: Our findings indicate that AR patients were characterized by increase in terminally differentiated memory B cells or plasma cells and decreases in CD19+CD24hiCD38hi Breg cells in the peripheral blood.
B-Lymphocyte Subsets* ; B-Lymphocytes ; B-Lymphocytes, Regulatory ; Enzyme-Linked Immunosorbent Assay ; Flow Cytometry ; Humans ; Immunoglobulin E ; Immunoglobulins ; Memory ; Plasma Cells ; Rhinitis, Allergic*

Objective To study the effect of matrine on the expression of a proliferation-inducing ligand (APRIL) in colorectal cancer cell line (SW480 cell). Methods MTT assay was used to evaluate the inhibitory effect of matrine on SW480 cells. The protein and mRNA levels of APRIL in SW480 cells were determined by immunohistochemistry and real-time fluorescence quantitative PCR (RFQ-PCR). SW480 cells were treated with 0.5,1.0,2.0 mg/ml of matrine for 24 h, 48 h and 72 h. FU and blank were served as drug control and blank control groups, respectively. Results Matrine had obviously inhibitory effect on proliferation of SW480 cells in a time- and dose-dependant manner. The expression of APRIL was strong in SW480 cells. When treated with 50,100,200 ug/ml of FU, the APRIL mRNA levels in SW480 cells raised gradually and reached the highest levels at 72 h after treatment, which were significantly higher than those in blank control group (all P value<0.001). When treated with 0. 5,1.0, 2.0 mg/ml of matrine, the APRIL mRNA levels in SW480 cells increased at 24 h after treatment, which were significantly higher than those in blank control group (all P value<0. 001), and then decreased gradually and almost equal to level of blank control group at 72 h. Conclusion In treatment with FU, the survival cells.may have stronger ability of proliferation due to higher expression of APRIL in SW480 cells. Anti-APRIL therapy might be an important assistant treatment to counter the impact of APRIL. Matrine will not cause persistent increase of APRIL mRNA levels in SW480 cells, so it might be a helpful drug in anti-tumor theraphy.

Objective To investigate the value of emergent endoscopy in the acute nonvariceal gastrointestinal bleeding.Methods Retrospective analysis was done in patients with melena or haematemesis in the ward from Jan 1st 2003 to Dec 31st 2007.For emergent group,the patients took endoscopy in 48 h after bleeding.For selective group,the patients took endoscopy after 48 h.Medical outcomes and resource utilization were compared between two groups.Results The average age of 332 patients(246 males and 86 females)was(45.9?18.8)years old.In the median and low risk patients,the length and the cost of hospitalization,blood transfution and the use of PPI were lower in the emergent group than in the selective group.In the high risk patients,the above variables had no statistical difference.Conclusion For the patients whose Rockall Score were less than 5,emergent endoscopy could decrease the length and the costs of hospitalization,the transfusion volumes and the use of PPI.However,for the patients whose Rockall Score were more than 5,the advantage of emergent endoscopy need further discussion.