Cryoablation therapy with explicit anti-tumor mechanisms and histopathological manifestations has a long history.A large number of clinical practice has shown that cryoablation therapy is safe and effective,making it an ideal tumor treatment method in theory.Previously,its efficacy and clinical application were constrained by the limitations of refrigerants and refrigeration equipment.With the development of the new generation of cryoablation equipment represented by argon helium knives,significant progress has been made in refrigeration efficien-cy,ablation range,and precise temperature measurement,greatly promoting the progression of tumor cryoablation technology.This consensus systematically summarizes the mechanism of cryoablation technology,indications for oral mucosal melanoma(OMM)cryotherapy,clinical treatment process,adverse reactions and management,cryotherapy combination therapy,etc.,aiming to provide reference for carrying out the standardized cryoablation therapy of OMM.

Sialic acid is a member of the nine-carbonic acidic monosaccharide family, which is abnormally expressed in various malignant tumors and significantly associated with prognosis of patients. The addition of sialic acid to glycoproteins and glycolipids causes sialylation, which is a post-translational modification usually found at the end of glycan chains and regulates various physiological and pathological processes. Abnormal sialylation would affect many critical processes in tumors, including immune evasion, resistance to apoptosis, metastasis and proliferation. Therefore, exploring the mechanisms of sialylation in tumors is beneficial for finding new cancer treatment methods. This article reviews the relationship between sialylation and tumors.

Objective:To study the expression of methyltransferase-like protein 14 (METTL14) in epithelial ovarian cancer and its clinical significance, and to explore the effect of METTL14 expression on the proliferation, invasion and migration of ovarian cancer cells.Methods:Immunohistochemistry (IHC) was used to detect METTL14 expression in tumor tissue samples, and analyze the relationships among METTL14 expression, clinicopathological factors, and prognosis in ovarian cancer. Lentiviral vectors and small interfering RNA (siRNA) were used to up-regulate and down-regulate the METTL14 expression in ovarian cancer cell lines A2780 and SKOV3, respectively. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was used to detect the N6-methyladenosine (m6A) content in ovarian cancer cells. Cell counting kit-8 (CCK-8), wound healing assay, and transwell assay were used to examine the function of METTL14 expression in the cells.Results:(1) The IHC score of METTL14 protein was 6.2±3.7 in 20 samples of ovarian cancer tissues and 3.3±2.5 in 15 samples of normal ovarian tissues, and the difference was statistically significant ( t=-2.64, P=0.012). Among the patients who suffered from ovarian cancer, there were 69 cases with high expression of METTL14 protein (IHC score≥6), accounting for 57.0% (69/121), and the cases with low expression of METTL14 protein (IHC score<6) accounting for 43.0% (52/121). Compared with the patients with low expression of METTL14, the patients with high expression of METTL14 had later stages, higher rates of lymph node metastasis, abdominal metastasis, and more ascite amount. The differences were statistically significant (all P<0.05). The overall survival rate was significantly lower in patients with high METTL14 expression than the low expression ( P=0.009). (2) LC-MS/MS data showed that the relative expression of m6A in A2780 and SKOV3 cells in the lentivirus (LV)-METTL14 group were 0.213±0.024 and 0.181±0.018, which were significantly higher than those in the LV-normal control (NC) group (0.109±0.022 and 0.128±0.020; all P<0.05). While the relative expression of m6A in A2780 and SKOV3 cells in the si-METTL14 group were 0.063±0.012 and 0.069±0.015, which were significantly lower than the expression in si-NC group of 0.108±0.014 and 0.121±0.014 (all P<0.05). CCK-8 assay showed that the absorbance values were significantly lower in the si-METTL14 group compared with the si-NC group at 36, 48, 60 hours (all P<0.05); while were significantly increased in the LV-METTL14 group compared with the LV-NC group at 48, 60 hours (all P<0.01). Scratch wound assays showed that the migration rate of the si-METTL14 group was lower than those of the si-NC group, while the LV-METTL14 group were higher than the LV-NC group by 24 hours, the differences were statistically significant (all P<0.01). Cell migration and invasion were detected by transwell migration and invasion assays. After cultivated for 24 hours, the invasion cell number and the migration cell number in the si-METTL14 group were less than those in the si-NC group. While the invasion cell number and the migration cell number in the LV-METTL14 group were more than those in the LV-NC group, respectively. The differences were statistically significant (all P<0.01). Conclusion:Patients with high METTL14 expression have a worse prognosis in ovarian cancer, which may increase the m6A modification of ovarian cancer cells and promote cells proliferation, invasion and migration.

Objective:To investigate ultrasonographic manifestations of gonococcal infections of the penile skin and accessory glands in men, and to assess their clinical significance.Methods:From January 2014 to January 2021, male patients with gonococcal infections of the penile skin and accessory glands were collected from Department of Dermatology, Changshu No.1 People′s Hospital. The diagnosis had been confirmed by laboratory examinations, and these patients had not received relevant treatment. The real-time ultrasound imaging system SIEMENS ACUSON X300 was used to examine the penile skin and accessory gland lesions infected with Neisseria gonorrhoeae, with the probe frequency ranging from 7.5 to 15 MHz. Patients with tubular anechoic fluid-filled areas on the high-frequency ultrasound images received a single dose of intramuscular ceftriaxone (1 g) ; those with oval-shaped anechoic fluid-filled areas on the high-frequency ultrasound images received incision and drainage followed by intramuscular injection of ceftriaxone at a dose of 1 g once a day for 5 consecutive days; those with hypoechoic or mixed echoic areas on the high-frequency ultrasound images received intramuscular injection of ceftriaxone at a dose of 1 g once a day for 5 consecutive days, and if the nodules did not regress after 1-month treatment, local resection would be performed. One month after the treatment, the patients were followed up, and the efficacy was evaluated. Results:A total of 32 male patients with gonococcal infections of the penile skin and accessory glands were collected. They were aged 28.54 ± 3.27 years, all had a history of non-marital sexual contact, and the duration from non-marital sexual contact to the onset of symptoms was 4.45 ± 1.03 days. The disease course was 8.64 ± 1.87 days. Lesions were all solitary, and located at the external urethral meatus in 16 cases (50.00%) , at the glans penis in 7 cases (21.88%) , beside the foreskin frenulum in 5 cases (15.62%) , and at the penile raphe in 4 cases (12.50%) . Sixteen patients (50.00%) presented with sinus-like lesions, 9 (28.13%) with abscesses, 7 (21.87%) with nodules, and all had tenderness on palpation. High-frequency ultrasound examination showed tubular anechoic fluid-filled areas in 16 cases (50.00%) , oval-shaped anechoic fluid-filled areas in 7 cases (21.88%) , hypoechoic areas in 5 cases (15.62%) , and mixed echoic areas in 4 cases (12.50%) . Gonococcal infections involved the cavernous body of the urethra in 16 cases (50.00%) , cavernous body of the penis in 5 cases (15.62%) , and subcutaneous tissue of the penis in 11 cases (34.38%) . After the treatment, all the patients were cured.Conclusion:High-frequency ultrasound can be used in the assessment of skin lesions and selection of treatment regimens for male patients with gonococcal infections of the penile skin and accessory glands.

Objective:To analyze the results of self-assessment on the position competency of residents in a certain hospital, and to provide reference for improving the quality of training.Methods:From June 2021 to October 2021, a whole-group questionnaire survey was conducted among 224 residents who participated in the standardized training in Beijing Friendship Hospital, Capital Medical University. The questionnaire consists of general information questionnaire, position competency questionnaire. The position competency questionnaire contains eight dimensions. Measurement data were expressed as mean ± standard deviation ( ± s), t-test was used for comparison between two groups, and one-way analysis of variance was used for comparison between multiple groups. Results:The position competency score of residents was (3.94±1.07) points, among which the scores of interpersonal communication ability was the highest (4.42±0.68) points. The scores of scientific research ability [(3.26±1.30) points] was the lowest among the eight dimensions. There were statistically significant differences among residents of different genders in post competency, disease prevention and health promotion and interpersonal communication ability ( P<0.05). There were statistically significant differences in the scores of medical knowledge and lifelong learning ability and scientific research ability among residents with different identity ( P<0.05). There was statistical significance in the score of scientific research ability among residents with different educational backgrounds ( P<0.05). There were statistically significant differences in the scores of position competency, disease prevention and health promotion, interpersonal communication ability, medical knowledge and lifelong learning ability among residents of different majors ( P<0.05). Conclusions:The position competency of residents should be further improved. To guarantee the quality of training, it was suggested to establish a competence-oriented training mechanism, strengthen the construction of teachers′ training teams, enrich and innovate training contents and methods.

Objective:To investigate the satisfaction degree of surgical resident in standardized training and to explore the existing problems and influencing factors. It provides references for improving the system and quality of standardized training.Methods:The Self-designed Satisfaction scale was used to investigate the satisfaction degree of 137 residents who attended the standardized training of surgical residents in Beijing Friendship Hospital, Capital Medical University from September 2015 to June 2018. There were 108 males (78.8%) and 29 females (21.2%). The mean age was (26.78±1.83) years. The measurement data of normal distribution were expressed as mean ± standard deviation. Counting data was expressed by frequency and constituent ratio. The differences between groups were analyzed by t test and one-way anova.Results:The overall satisfaction score of the surgical residents to the standardized training was 3.71±0.83, among which the residents scored the highest on the working condition (4.12±0.67), while the training effect (3.53±0.85) was the last in all dimensions. The overall satisfaction of third-year residents was lower than that of first-year and second-year residents, and the differences were statistically significant ( F=3.27, P=0.04). The scores of first-year residents in standardized management was higher than that of second-year and third-year residents, and the difference was statistically significant ( F=3.30, P=0.04). The scores of professional degree postgraduate in overall satisfaction, standardized management and research training were higher than those of enrolled resident, and the differences were statistically significant ( P<0.05). The score in enrolled resident (3.78±0.85) was higher than that of professional degree postgraduate (3.44±0.63)in the dimension of salary, and the difference was statistically significant ( P=0.02). Conclusion:Surgical residents expressed satisfaction with the general condition of standardized training, training condition, research training, training effect and postgraduate salary were still need be strengthen.

Objective:To investigate the current situation of job burnout and depression among surgical residents, with a view to reduding or alleviating the burnout and depression of surgical residents.Methods:The job burnout scale and depression scale were used to investigate the burnout and depression of 137 residents who attended the standardized training of surgical residents in Beijing Friendship Hospital, Capital Medical University from September 2016 to January 2019, there were 108 males and 29 females, aged (26.57±1.77) years, and the age ranged from 23 to 28 years. The distribution differences of the incidence of job burnout and depression in gender, time status and the correlation between the three dimensions of job burnout and depression were analyzed. The measurement data were expressed as mean±standard deviation ( Mean± SD). Counting data were expressed as percentage(%). The differences in the distribution of job burnout and depression in gender, time and status were analyzed by chi-square test. Pearson correlation analysis was used to analyze the correlation among the three dimensions of job burnout and depression. Results:Of the 137 surgical residents, 10 (7.3%) had severe job burnout requiring intervention . In the emotional exhaustion dimension, 67 (48.9%) had mild burnout, 53 (38.7%) had moderate burnout, and 17 (12.4%) had severe burnout. In the cynicism dimension, 86 (62.8%) had mild burnout, 37 (27.0%) had moderate burnout, and 14 (10.2%) had severe burnout. In the reduced personal accomplishment dimension, 64(46.7%) had mild burnout, 43(31.4%) had moderate burnout, 30(21.9%) had severe burnout. The results of the depression survey showed that 27 (19.7%) of the 137 surgical residents were depressed. There were no statistically significant differences in the incidence of job burnout in gender, time and status( P>0.05). There were no statistically significant differences in the incidence of depression in gender and status( P>0.05). The incidence of depression was higher among 1-year residents (14, 35.0%) than among 2-year (8, 15.7%) and 3-year(5, 10.9%) residents ( P<0.01). Depression is associated with emotional exhaustion, cynicism and reduced sense of achievement ( r=0.248, r=0.301, r=0.201, respectively, P<0.05). Conclusions:The job burnout and depression of surgical residents are not optimistic. There were differences in the time distribution of depression incidence, among which the incidence of depression is higher among the residents in the first year. The occurrence of depression is positively correlated with three dimensions of job burnout.

Objective: To observe the changes of skin lesion, neuralgia and blood pressure in hypertension patients and non-hyperension patients before and after the early formal treatment on herpes zoster in the head and face. Methods: Clinical data were collected from June 2015 to May 2018 in the Department of Dermatology, the First People＇s Hospital, Changshu, Jiangsu province. In 104 cases of hospitalized patients with herpes zoster, 46 cases had high blood pressure (hypertension group); 58 cases did not have high blood pressure (non-hypertension group). The skin lesion, numerical rating scale (NRS) and blood pressure changes were compared between the two groups before and after treatment. Results: A total of 99 patients completed treatment; 45 cases in the hypertensive group included 25 males, 20 females, aged 35 to 71 (52.40±12.51) years; 54 cases in the non-hypertensive group included 30 males and 24 females, aged 36 to 75 (52.62±12.67) years. There was no statistically significant difference in the time of control, improving and healing of skin lesion (t=-0.457, -0.607 and 1.399, P>0.05) . There was no statistically significant difference in NRS between the two groups before treatment (t=-0.009, P=0.993 >0.05). After treatment, the NRS of both groups decreased compared with those before treatment, and the difference was statistically significant (F=151.130, 181.444, P<0.05). There was no significant difference in NRS between the two groups after treatment (Z=-0.032, -0.154, -0.149 and -0.426, P>0.05). In the hypertension group, the rate of blood pressure increase before treatment was 62.22%, and the blood pressure decreased after treatment compared with that before treatment. The difference was statistically significant (P<0.05). In the non-hypertension group, the rate of increase of blood pressure before treatment was 5.56%, and the blood pressure after treatment was lower than before treatment. The difference was not statistically significant before and after treatment (P>0.05). Conclusions Blood pressure can be increased when herpes zoster occurs. After early formal treatment of herpes zoster, skin lesion healed, neuralgia reduced and blood pressure can return to normal. The history of hypertension and the increase of blood pressurd before treatment has no effect on the recovery of skin lesion and neuralgia.

Objective: To explore the effect of ambient fine particulate matters (PM_2.5) and temperature interaction on schizophrenia admission. Methods: All admission data were retrieved from the Psychiatric Hospital and Municipal Hospital of TongLing from January 1, 2014 to December 31, 2017. Daily air pollution and meteorological data were collected from the Tongling Environmental Protection Agency and Meteorological Bureau, respectively. A distributed lag non-linear model combined with the generalized additive model were applied to explore the effects of PM_2.5, multi-pollutants, and the interaction between temperature and PM_2.5 on schizophrenia admission. The stratification of temperature was divided by three criteria. The low temperature layer was defined as <P₅ or <P₁₀ or <P₂₀; P₅-P₉₅ or P₁₀-P₉₀ or P₂₀-P₈₀ was defined as the middle temperature layer; >P₉₅ or >P₉₀ or >P₈₀ was defined as the high temperature layer. Results: From 2014 to 2017, 6 642 patients were admitted for schizophrenia in Tongling, and the median of PM_2.5 and temperature were 47.0 μg/m³ and 17.5 ℃, respectively. The median concentration of PM_2.5 (P₅₀) was taken as a reference. When the exposure concentration of PM_2.5 was P₉₀, the lagged effect appeared in the first day with RR=1.03 (95%CI: 1.00-1.07) and reached the maximum in the fifth day with RR=1.16 (95%CI: 1.13-1.19). In the multi-pollutant models, it was found that the simultaneous inclusion of PM_2.5 and NO₂ had higher risk of schizophrenia admission, with the RR=1.18 (95%CI: 1.15-1.22), P<0.001. The risk of schizophrenia admission caused by PM_2.5 exposure at high temperature was greatest under the three temperature stratification standards, which were 12.1% (8.5%-15.7%), 9.7% (6.9%-12.6%) and 17.1% (11.6%-22.8%), all P values <0.001. Conclusion With the increase of PM_2.5 concentration, the risk of schizophrenia admission is increased, and the risk effect of PM_2.5 is stronger at high temperature.

Objective To verify the change of the anxiety and depression of patients anteriorposterior treatment at paraurethral duct dilitation after gonococcal infection of paraurethral duct.Methods Twenty-eight patients of paraurethral duct dilatation after male gonococcal infection of paraurethral duct were enrolled,and the patients were treated in the Department of Dermatology and Venerology,the First People's Hospital of Changshu City.The anxiety and depression of patients anteriorposterior treatment were assessed and compared with Hamilton depression scale and Hamilton anxiety scale.Results The total scores of Hamilton depression scale and Hamilton anxiety scale before treatment were positively correlated with course of disease (r =0.481,P =0.0095;r =0.549,P =0.0025).The total scores of Hamilton depression and anxiety before treatment were from 1 to 31 (18.9±7.5) and from 4 to 30 (14.9±6.8).The symptoms of depression and anxiety appeared in 11 patients and 15 patients respectively.The total scores of Hamilton depression andanxiety after treatment were from 0 to 8 (4.3±1.7) and from 0 to 8 (3.3±1.7).There was no symptom of depression and anxiety.The difference of the total score of Hamilton depression and anxiety before and after treatment had statistical significance (t =12.270,P＜0.001,t =10.626,P＜0.001).The difference of positive rate of depressive and anxious symptom before and after treatment had statistical significance too (x2 =9.05,P=0.003;x2 =13.06,P=0.000).Conclusions The sequelae of gonococcal paraurethral duct infection in male paraurethral duct dilatation can result in the anxiety and depression of patients,which should be treated.Effective therapy can relieve or cure the anxiety and depression of patients without the assistance of psychotropic drugs.