Objective To explore the effect of the diagnosis and endoscopic minimally invasive surgical treatment of non-cystic congenital pyriform sinus fistula(CPSF)in children.Methods Clinical data of 76 children with non-cystic CPSF were retrospectively analyzed from October 2017 to May 2022.Larygoscope,neck color ultrasound,esophageal barium meal,neck CT,and magnetic resonance imaging(MRI)were performed,and temperature-controlled ablation radio-frequency was performed under general anesthesia supported by laryngoscope guidance.Results The internal fistula in the pyriform fossa was seen under laryngoscope.Imaging examination shows that the fistula was connected to the pharynx.Postoperative complications:hoarseness in 3 cases and deciduous tooth loss in 3 cases.After a follow-up period of 12～40 months,there was 1 recurrence in 46 newly treated patients and 1 recurrence in 30 non newly treated patients.No recurrence was observed during the follow-up period after re-endoscopic radiofrequency plasma surgical electrodes plasma cauterization.Conclusion The symptoms of CPSF are non-specific.The discovery of the internal fistula under endoscopy is the gold standard for diagnosis.Ultrasound can be used as the initial screening method for diagnosis.Esophageal barium meal combined with CT examination can improve the diagnostic rate,and MRI can assist in diagnosis.The temperature-controlled ablation radio-frequency technique under supportive laryngoscope has the advantages of safety,minimally invasive,aesthetic,convenient,and repeatable operation,and can be used as the preferred method for the treatment of non-cystic CPSF in children.

Objective To summarize the endoscopic and clinical diagnosis and treatment of 4 cases of gastric fundus adenocarcinoma.Method A retrospective analysis was conducted on the clinical data of four cases of gastric fundus adenocarcinoma from July 2021 to December 2023.Result All the 4 cases of gastric fundus adenocarcinoma were completely removed by endoscopic submucosal dissection(ESD),with good postoperative recovery,no surgical complications,and no recurrence or metastasis during follow-up.Conclusion ESD treatment for gastric fundus adenocarcinoma is safe,reliable,and can completely remove the lesion.

Objective:To investigate the pathological characteristics, treatment and prognosis of synovial sarcoma of head and neck.Methods:The clinical data of 24 patients with synovial sarcoma of the head and neck treated in the First Affiliated Hospital of Zhengzhou University from January 2012 to December 2020 were retrospectively analyzed. There were 16 males and eight females, aged 17 to 75 years. The pathological features, treatment and follow-up were summarized. Cumulative survival was estimated by Kaplan-Meier method.Results:All patients′ diagnoses were confirmed by pathological examinations. Most cases showed the tumors were composed of spindle cells under microscope, with the characteristics of malignant tumor cells, and some tumors also showed epithelioid cell morphology, forming the typical pathological characteristics of biphasic differentiation. Except for one patient who could not tolerate surgery and the diagnosis was only confirmed by biopsy, the remaining 23 patients received surgical treatment, including three patients receiving surgical treatment alone, five patients receiving post-operative adjuvant radiotherapy, seven patients receiving post-operative adjuvant chemotherapy, and eight patients receiving post-operative adjuvant radiotherapy. Follow-up time was 3.0-114.1 months (median follow-up time: 25.2 months), including two cases of loss to follow-up, 10 cases of recurrence, five cases of lung metastases, one case of bone metastasis, and 12 cases of death. The 1-year, 3-year and 5-year survival rates for the 24 patients with synovial sarcoma of head and neck were 74.4%, 58.9% and 39.2%, respectively.Conclusion:Synovial sarcoma of the head and neck has a high recurrence rate, common distant metastasis and poor prognosis. Histopathology and immunohistochemical examinations are an important basis for diagnosis, if necessary, combined with molecular genetics. Surgical resection is the main treatment, preferring radical or expanded resection.

BACKGROUND: The immunosuppressant drugs (ISDs), tacrolimus and cyclosporine, are vital for solid organ transplant patients to prevent rejection. However, toxicity is a concern, and absorption is highly variable across patients; therefore, ISD levels need to be precisely monitored. In the Asia-Pacific (APAC) region, tacrolimus and cyclosporine concentrations are typically measured using immunoassays. The objective of this study was to assess the analytical performance of Roche Elecsystacrolimus and cyclosporinee electrochemiluminescence immunoassays (ECLIAs). METHODS: This evaluation was performed in seven centers across China, South Korea, and Malaysia. Imprecision (repeatability and reproducibility), assay accuracy, and lot-to-lot reagent variability were tested. The Elecsys ECLIAs were compared with commercially available immunoassays (Architect, Dimension, and Viva-E systems) using whole blood samples from patients with various transplant types (kidney, liver, heart, and bone marrow). RESULTS: Coefficients of variation for repeatability and reproducibility were ≤5.4% and ≤12.4%, respectively, for the tacrolimus ECLIA, and ≤5.1% and ≤7.3%, respectively, for the cyclosporine ECLIA. Method comparisons of the tacrolimus ECLIA with Architect, Dimension, and Viva-E systems yielded slope values of 1.01, 1.14, and 0.897, respectively. The cyclosporine ECLIA showed even closer agreements with the Architect, Dimension, and Viva-E systems (slope values of 1.04, 1.04, and 1.09, respectively). No major differences were observed among the different transplant types. CONCLUSIONS: The tacrolimus and cyclosporine ECLIAs demonstrated excellent precision and close agreement with other immunoassays tested. These results show that both assays are suitable for ISD monitoring in an APAC population across a range of different transplant types.
Absorption ; China ; Cyclosporine* ; Drug Monitoring ; Heart ; Humans ; Immunoassay* ; Korea ; Liver ; Malaysia ; Methods ; Tacrolimus* ; Transplants

Objective To set up a computer-assisted polyp detection system under colonoscopy,and to preliminarily verify its effectiveness.Methods Based on Faster R-CNN algorithm and the open source implementation of the open source framework tensorflow and Faster R-CNN,a computer-assisted polyp detection system under colonoscopy was constructed.According to the size and difficulty of the training set,five test groups were set up:test group one,two,three and four contained 1 000,2 000,4 000 and 6 000 training samples,respectively.Test group five increased the probability of selecting the difficult samples based on 6 000 training samples.In different training sets,the sensitivity,specificity,other classification evaluation parameters,and the evaluation parameters of target detection such as recall and precision of this polyps detection system were calculated.Results Classification evaluation parameters showed that the sensitivities of test group one,two,three,four and five were 90.1％,93.3％,93.3％,93.3 ％ and 93.5 ％,respectively,and the difference was statistically significant (x2 =25.324,P＜0.01).The sensitivities of test group two,three,four and five were all higher than that of test group one,and the differences were statistically significant (x2 =13.964,13.508,13.508 and 13.386,all P＜ 0.006 25).There were no significant differences in specificity and positive predictive value among test groups (both P＞0.05).The negative predictive values of test group one,two,three,four and five were 90.4％,93.3％,93.3％,93.3％ and 93.5％,respectively,and the differences were statistically significant (x2 =21.862,P＜0.01).The negative predictive values of test group two,three,four and five were higher than that of test group one,and the differences were statistically significant (x2=11.447,11.564,11.755,13.760;all P＜0.006 25).As the training sample size increased from 1 000 to 2 000,the area under curve (AUC) increased by 2％,and further increased the sample size to 6 000,AUC increased by less than 1 ％.At this point maintaining the same sample size while increasing the proportion of difficult samples,AUC increased by 0.4％.The results of evaluation parameters of target detection showed that the recall rate of each test group was 73.6％,79.8％,79.5％,79.8％ and 83.3％,respectively,and the differences were statistically significant (x2 =71.936,P＜0.01).Among them,the recall rates of test group two,three and four were higher than that of test group one,and the differences were statistically significant (x2 =25.960,23.492 and 25.960,all P＜0.006 25),and the recall rate of test group five was higher than those of test group one,two,three and four,and the differences were statistically significant (x2=67.361,9.899,11.527 and 9.899;all P＜0.006 25).In addition,the precision rates of test group one,two,three,four and five were 87.9％,85.3％,90.2％,91.4％ and 89.2％,respectively,and the difference was statistically significant (x2=48.194,P＜0.01).The precision rates of test group three and five were higher than that of test group two,and the differences were statistically significant (x2 =24.508 and 15.223,both P＜0.006 25),and the precision rate of test group four was higher than those of test group one and two,and the differences were statistically significant (x2=13.524 and 39.120,both P＜0.006 25).As samples size and training difficulty increased,the values of F1-score and mean average precision increased steadily.Conclusions This study initially constructed a computer-assisted polyp detection system under colonoscopy.Currently the maximum sensitivity reached 93.5％,and the maximum recall rate reached 83.3％.Increasing the training set size may improve the polyp detection result to a certain degree,however it will reach a bottleneck.At this time,increasing the training difficulty can further improve the detection scores,especially the recall rate.

Objective To explore the efficacy of sequential endoscopic variceal ligation plus endoscopic variceal sclerotheropy and the factors associated with the prognosis.Methods 106 cases with esophageal varices in control group was treated with drugs alone;study group had 113 cases, was given endoscopic therapy add drugs, The study group randomly divided into two groups, one was treated with endoscopic variceal ligation all the time (EVL group), another was treated with sequential endoscopic variceal ligation plus endoscopic variceal sclerotheropy (sequential group). After the treatment, the rate of removal of varicose veins, the rate of rebleeding, the number of total treatment,mortality and intra-operative complications and postoperative complications were compared. And compared rebleeding rate and mortality with the control group and study groups with different CTP and MELD, analyze the factors of prognosis, and evaluate their prognostic value.Results Rebleeding, rate in control group, EVL group and sequential group were 41.51%,10.53% and 10.64%,sequential group was significantly better than control group (P = 0.000); mortality in control group, EVL group and sequential group were 15.09%, 5.26% and 2.13%, sequential group was also significantly better than control group (P = 0.001); rate of recurrence in EVL group and sequential group within half a year were 73.68% and 44.68%, sequential group was significantly better than EVL group (P = 0.021). In all control group and EVL group and the sequential group, rebleeding rate and mortality of the liver function Child-Turcotte-Pugh (CTP) class C was significantly higher than that of calss A; In MELD model, AUC area under the ROC curve of rebleeding rate in control group and sequential group were 0.944 and 0.851, mortality of the two groups were 0.881 and 0.984, while the rate of recurrence in the EVL group and sequential group were respectively 0.914 and 0.765, the MELD score has the important value to the prediction of rebleeding and death.Conclusion The rebleeding rate and mortality in cirrhotic patients with esophageal varices treated with sequential endoscopic variceal ligation plus endoscopic variceal sclerotheropy were significantly decreased and the recurrence rate was lower than that of the patients with endoscopic variceal ligation all the time. Liver function Child-Turcotte-Pugh (CTP) score and the MELD score have important value in prediction of rebleeding and death, ligation and sclerosing sequential therapy can significantly reduced rebleeding and mortality in CTP class B and C, and improve the MELD threshold of rebleeding and death.

Objective To observe and study the therapeutic effect of ctreotide combined with omeprazole in the treatment of liver cirrhosis with upper gastrointestinal bleeding.Methods 76 cases of patients with upper gastrointestinal bleeding caused by liver cirrhosis were selected in our hospital from January 2013 to December 2014 to be separated into the observation group and control group randomly, with each group having 38 patients.Patients in two groups were all given symptomatic treatment first.Patients in control group were given 0.1 mg octreotide dissolved 20 mL 0.9% sodium chloride solution by intravenous injection in the first administration.And the rest octreotide was given by intravenous drip at the speed of 25μg/h.The treatment lasted for 72 h.On the base of control group, patients in observation group were given 40 mg omeprazole dissolved 100 mL 0.9%sodium chloride solution additionally, twice daily, for 3 d.Then the therapeutic effect, hemostatic time, blood transfusion, rebleeding rate and adverse reactions of patients in two groups were observed.Results The total effective rate of observation group 89.47%was much more than control group 63.16% (P<0.05).And the apparent rate of observation group 55.26%was also more than control group 31.58% ( P <0.05 ) .Both the hemostatic time and blood transfusion of observation group is less than control group ( P <0.05 ) .Besides, the rebleeding rate of observation group 5.26% is much less than control group 21.05% ( P<0.05 ) ., Incidence rates of adverse reactions in two groups were 10.53% and 7.89%, with no statistically significant difference. Conclusions Treatment of octreotide combined with omeprazole on patients with upper gastrointestinal bleeding caused by liver cirrhosis can improve the therapeutic effect, shorten the hemostatic time and decrease the blood transfusion with low rebleeding rate and few adverse reaction.

OBJECTIVE: To detect the expressions of p-Stat3 and c-myc in human laryngeal squamous cell carcinoma (LSCC) tissue and Hep2 cell line, and to find the relationship between them. METHOD: Immunohistochemistry was used to detect the expressions of p-Stat3 and c-myc in 60 cases of LSCC and 30 cases of vocal cord polyp tissue. The protein levels of p-Stat3 and c-myc in Hep2 cell line was determined by immunocytochemistry. Western blotting was used to determine the protein levels of p-Stat3 and c-myc in Hep2 after treating with different concentrations of Stattic. RESULT: The positive rates of p-Stat3 and c-myc were 65% and 70% in the LSCC tissue, compared with that in the vocal cord polyp tissue, with significant difference (P < 0.05). The expression of p-Stat3 in LSCC tissue was associated with that of c-myc (r = 0.273, P < 0.05). The protein levels of p-Stat3 and c-myc were detected in the Hep2 cell line. Stattic inhibited Stat3 phosphorylation and c-myc in the Hep2 cell line in a concentration-dependent manner. CONCLUSION p-Stat and c-myc were up regulated in the tissue of laryngeal squamous cell carcinoma and the Hep2 cell line. Stattic inhibits the constitutively active p-Stat3 signaling pathway, and downregulats the expression of c-myc. The strong constitutive p-Stat3 signaling pathway in LSCC makes p-Stat3 a target for the development of novel therapeutic strategies.
Carcinoma, Squamous Cell ; metabolism ; pathology ; Cell Line, Tumor ; Head and Neck Neoplasms ; metabolism ; pathology ; Humans ; Immunohistochemistry ; Laryngeal Neoplasms ; metabolism ; pathology ; Phosphorylation ; Proto-Oncogene Proteins c-myc ; metabolism ; STAT3 Transcription Factor ; metabolism ; Signal Transduction ; Squamous Cell Carcinoma of Head and Neck

Objective To investigate the effect of RNA interference (RNAi) targeting NRP-1 gene on the growth and proliferation of nasopharyngeal carcinoma(NPC) CNE-2Z cells.Methods Short hairpin RNA(shRNA) plasmids targeting NRP-1 were designed and synthesized.These plasmids were respectively transfected into human NPC CNE-2Z cells and xenograft tumors in nude mice.The expressions of Fluorescein-labeled plasmids in NPC CNE-2Z cells and xenograft tumors were observed by fluorescence microscopy.Cell proliferation was detected by MTT assay.The inhibitory effects on target genes were evaluated with RT-PCR and Western blotting,respectively.The inhibitory effect of plasmids with the most effective sequence on xenograft tumors in nude mice was observed.Results CNE-2Z cell proliferation was significantly inhibited by NRP-1/shRNA silencing.RT-PCR showed NRP-1 mRNA expression was significantly decreased.Western blotting demonstrated the NRP-1/shRNA silencing can effectively inhibit the expression of target proteins in CNE-2Z cells.After six weeks,there were significant differences in the mean tumor volumes in nude mice between plasmid group and negative control group [(0.599 ± 0.002) vs (1.141 ± 0.013) cm3,P ＜ 0.05] or blank control group [(0.599 ± 0.002) vs (1.165 ± 0.308) cm3,P ＜0.05],and the inhibitory rate of tumor growth was 48.6％.Conclusion RNA interference targeting NRP-1 can remarkably inhibit the growth of CNE-2Z cells in vitro and in vivo.

OBJECTIVE: To investigate the inhibitory effect of NF-kappaB p65siRNA on human laryngeal carcinoma xenograft model in nude mice. METHOD: Human laryngeal carcinoma cell line Hep-2 was seeded in the subcutaneous layer of 15 nude mice to build laryngeal carcinoma xenograft model. Then they were randomly divided into three groups. NF-kappaB p65siRNA was given in siRNA group and FAM-Control siRNA was given in negative control group while phosphoric-buffered saline (PBS) was used in normal control group for 3 weeks. Tumor size and body weight of the mice were measured. TUNEL method and immunohistochemical S-P method were used for detecting the expression of NF-kappaB p65 and Bcl-xL protein. RESULT: The volume of tumors in siRNA group was reduced and the average weight of tumors in siRNA group was lower than the other two groups (P < 0.05). In siRNA group, the expression of NF-kappaB p65 and Bcl-xL protein was down-regulated and the apoptotic rate was increased obviously as compared with the negative control group and the normal control group. CONCLUSION NF-kappaB p65siRNA can significantly inhibit the expression of NF-kappaB p65 and the growth of human laryngeal carcinoma xenograft in nude mice. Its mechanism may be related to inducing the apoptosis in tumor cells by down-regulating the expression of Bcl-xL protein.
Animals ; Apoptosis ; Carcinoma, Squamous Cell ; genetics ; pathology ; Cell Line, Tumor ; Female ; Gene Expression Regulation, Neoplastic ; Humans ; Laryngeal Neoplasms ; genetics ; pathology ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; RNA, Small Interfering ; Transcription Factor RelA ; genetics ; Xenograft Model Antitumor Assays ; bcl-X Protein ; metabolism