Early rectal cancer is defined as any size of rectal epithelial tumor with infiltration depth limited to the mucosa and submucosa,regardless of with or without lymph node metastasis.Local resection is one of the main treatment methods for early rectal cancer without local lymph node metastasis.The development of endoscopic mucosal resection(EMR),endoscopic submucosal dissection(ESD),transanal endoscopic microsurgery(TEM),and transanal minimally invasive surgery(TAMIS)has brought more options for the treatment of early rectal cancer.About 8%-12%of early rectal cancer patients have local lymph node metastasis and therefore still require total mesorectal excision(TME).The current guidelines recommend that early rectal cancer with high-risk pathological features requires additional salvage radical surgery.Various minimally invasive and anal sphincter-preserving surgical techniques,such as natural orifice specimen extraction surgery(NOSES),transanal total mesorectal excision(TaTME),intersphincteric resection(ISR),and conformal sphincter-preserving operation(CSPO),have better achieved the goal of anal sphincter preservation and anal function preservation.The overall prognosis of early rectal cancer is good,but full-process surveillance is equally important.With the innovation of early diagnosis,early treatment and full-process surveillance,the development of endoscopic and surgical techniques will further improve the standardization of diagnosis and treatment for early rectal cancer.

Objectives:The purpose of this study is to evaluate the impact of the cumulative workload of HUTT testing physicians on diagnostic outcomes. Methods:This study retrospectively and consecutively included the data of testing physicians and patients who underwent HUTT at Fuwai Hospital,Chinese Academy of Medical Sciences,from January 2016 to December 2022.Based on the cumulative workload of physicians during the period from the initiation of tilt tests at the hospital to the end of the study,the physicians were categorized into low (50-100 sases),moderate (100-350 sases),and high (1000-4000 sases) cumulative workload groups,the cumulatie workload of no physician is 351-999 sases.Additionally,physicians were grouped by sex,educational background,and professional title to analyze differences in diagnostic rates of tilt table test reports within and between these groups. Results:The study included 22 testing physicians and 6122 patients.There were statistically significant differences in the rates of positive,suspicious positive,and negative reports among the 22 physicians (P<0.001).The average suspicious positive report rate in the moderate cumulative workload group was significantly higher than in the low and high cumulative workload groups (3.21％ vs.1.09％ vs.1.62％,P=0.001).The suspicious positive report rate was higher in the female physician group compared to the male physician group (2.25％ vs.1.07％,P=0.017),in the undergraduate physician group compared to the postgraduate physician group (2.46％ vs.1.52％,P=0.013),and in the junior title group compared to the intermediate and senior title groups (3.40％ vs.1.75％ vs.2.53％,P=0.024).Multivariate logistic regression analysis showed that a moderate cumulative workload was an influencing factor for suspicious positive reports,regardless of whether negative or positive was used as the reference (all P<0.05). Conclusions:There are certain differences in the diagnostic report rates of HUTT among different individual physicians.Physicians with a moderate cumulative workload are more likely to issue suspicious positive HUTT diagnostic reports.

Objective To explore the predictive markers of senescence-associated secretory phenotype(SASP)in osteoarthritis(OA).Methods OA datasets were screened by the Gene Expression Omnibus(GEO)database,while SASP-related genes were collected by PubMed.Three machine learning algorithms,including least absolute shrinkage and selection operator(LASSO),support vector machines recursive feature elimination(SVM-RFE),and random forest(RF),were used to screen the candidate predictive markers of SASP genes in OA,and the OA prediction model was constructed using the overlapping genes identified by the machine learning algo-rithms.CIBERSORT was used to explore the degree of peripheral blood immune cell infiltration in OA versus normal samples.The miRNA-transcription factor-mRNA regulatory network of the model genes was predicted using Cytoscape.The most valuable genes of the predic-tion model were experimentally verified by real-time quantitative polymerase chain reaction(RT-qPCR)in OA rats and normal control rats(n= 6 per group).Results One OA dataset was screened by the GEO database,and 125 OA-related SASP genes were isolated.A total of seven intersection genes were obtained by the three machine learning algorithms.The area under the curve of the prediction model was 0.891.The CIBERSORT immune infiltration results showed a significant difference in plasma cell infiltration level between OA and normal samples(P= 0.001 3).The RT-qPCR results showed that the expression level of TNFRSF1Awas significantly higher in the OA versus normal group(P<0.0001).Conclusion TNFRSF1Ais highly expressed in OA and may be a potential predictive marker for it.

OBJECTIVE: To summarize the biomechanical characteristics, diagnosis, and hip arthroscopic treatment of borderline developmental dysplasia of hip (BDDH) with Cam-type femoroacetabular impingement (Cam FAI). METHODS: The literature on BDDH with Cam FAI at home and abroad in recent years was extensively reviewed and analyzed. RESULTS: In patients with BDDH and Cam FAI, the femoral neck anteversion angle and femoral neck shaft angle increase, the pelvis tilts, and the acetabulum rotates, resulting in instability of the hip joint. In order to maintain the stability of the hip joint, the direction of biomechanical action of the hip joint has changed, which further affects the anatomical structures such as the proximal femur and acetabular morphology. BDDH with Cam FAI can be diagnosed clinically by combining lateral center edge angle, anterior center edge angle, and acetabular index. BDDH with Cam FAI can be effectively treated through arthroscopic polishing of the edges of the acetabular proliferative bone, excision of Cam malformations, and minimally invasive repair of the glenoid lip and cartilage of the hip joint. CONCLUSION Currently, there is no unified standard for the diagnosis and treatment of BDDH with Cam FAI. Minimally invasive treatment of the hip under arthroscopy can achieve good early- and medium-term effectiveness, and has certain advantages in repairing and maintaining the integrity of the glenoid lip and suturing/compression joint capsule. However, the long-term effectiveness needs to be further followed up to determine. The timing of surgery, intraoperative bone edge depth polishing, and joint capsule suturing/compression techniques also need to be further explored.
Humans ; Femoracetabular Impingement/surgery* ; Arthroscopy/methods* ; Hip Joint/surgery* ; Acetabulum/surgery* ; Hip Dislocation, Congenital/surgery* ; Treatment Outcome ; Retrospective Studies

Background/Aims: The aim of this study was to analyze the chronological changes in postoperative complications in surgical ulcerative colitis patients over the past decade in China and to investigate the potential parameters that contributed to the changes. Methods: Ulcerative colitis patients who underwent surgery during 2008–2017 were retrospectively enrolled from 13 hospitals in China. Postoperative complications were compared among different operation years. Risk factors for complications were identified by logistic regression analysis. Results: A total of 446 surgical ulcerative colitis patients were analyzed. Fewer short-term complications (24.8% vs. 41.0%, P=0.001) and more laparoscopic surgeries (66.4% vs. 25.0%, P<0.001) were found among patients who received surgery during 2014–2017 than 2008–2013. Logistic regression suggested that independent protective factors against short-term complications were a higher preoperative body mass index (odds ratio [OR], 0.870; 95% confidence interval [CI], 0.785–0.964; P=0.008), laparoscopic surgery (OR, 0.391; 95% CI, 0.217–0.705; P=0.002) and elective surgery (OR, 0.213; 95% CI, 0.067–0.675; P=0.009). The chronological decrease in short-term complications was associated with an increase in laparoscopic surgery. Conclusions Our data revealed a downward trend of short-term postoperative complications among surgical ulcerative colitis patients in China during the past decade, which may be due to the promotion of minimally invasive techniques among Chinese surgeons.

The secondary damage after traumatic brain injury (TBI) involves a variety of pathological processes, and the inflammatory response in the nervous system is an important factor which affects nerve repair and regeneration. As the innate immune cell in the nervous system, microglia (MG) plays an important role in the entire neuroinflammatory environment by regulating the activation state of MG and changing the inflammatory response in the direction of promoting nerve repair and regeneration, which has great potential in treatment of TBI. This article reviews the inflammatory response of the nervous system after TBI and the reactivity of MG, as well as their significance in nerve repair and regeneration.

Optic nerve gliomas (ONGs) are one type of optic pathway gliomas (OPGs), enjoying low incidence; they accounts for only 1% of intracranial tumors in children. They can either occur sporadically or complicate with neurofibromatosis type 1 (NF1). ONGs have unique clinical features, and the courses of diseases are variable and difficult to predict. Accurate diagnosis and reasonable treatment are controversial. This review focuses on the clinical features, diagnosis, and treatment of ONGs, in order to provide references for the treatment and follow-up research of ONGs.

Objective:To investigate the survival prognosis of patients with primary liver cancer and its influencing factors.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 3 106 patients with primary liver cancer who had health insurance for special illness in the Chongqing Malignant Tumor Treatment System from January 2000 to August 2018 were collected. There were 2 559 males and 547 females, aged (60±13)years, with a range from 19 to 95 years. Observation indicators: (1) demographic characteristics; (2) clinical treatment and pathological examination; (3) follow-up and survival; (4) analysis of prognostic factors. Follow-up using telephone interview, outpatient or inpatient reexamination was preformed to detect survival of patients. Follow-up was done once every 3 months within the first year and once a year thereafter up to December 2018. Measurement data with normal distribution were represented as Mean± SD. Measurement data with skewed distribution were represent as M (range). Count data were expressed as absolute numbers or percentages. Survival analysis was done after excluding missing data of follow-up. The survival rate was calculated and survival curve was drawn by Kaplan-Meier method. The prognostic factors were analyzed after excluding missing data of follow-up, pathological type, and TNM staging. The log-rank test was used for univariate analysis, and COX proportional hazard model was used for multivariate analysis. Results:(1) Demographic characteristics: of the 3 106 patients with primary liver cancer, the number of males and females (gender), cases with age < 30 years, from 30 to 44 years, from 45 to 59 years, from 60 to 74 years, ≥75 years, cases of Han nationality or other ethnic groups, cases being married or other status (marital status), cases with occupation as enterprise unit staff and (or) workers, public institution personnel and (or) civil servants, freelancers and (or) self-employed entrepreneurs, unemployed, company staff, and other professionals were 2 559, 547, 35, 362, 1 131, 1 163, 415, 3 053, 53, 2 896, 210, 880, 342, 130, 101, 124, and 1 529, respectively. (2) Clinical treatment and pathological examination: of the 3 106 patients with primary liver cancer, cases with hospitalization time < 10 days, from 10 to 19 days, from 20 to 29 days, ≥30 days, cases without surgery or with surgery, cases with hepatocellular carcinoma, cholangiocarcinoma, hybrid type and other pathological types, cases of stage Ⅰ, Ⅱ, Ⅲ, Ⅳ of TNM staging were respectively 771, 1 312, 661, 362, 915, 2 191, 836, 63, 24, 29, 28, 90, 624. There were 2 183 out of 3 106 patients without pathological data and 2 335 without TNM staging data. (3) Follow-up and survival: of the 3 106 patients with primary liver cancer, 2 561 were followed up for 3.0-96.0 months, with a median follow-up time of 27.6 months. The 2 561 patients had survived for 1.0-96.0 months, with a median survival time of 24.7 months. The 1-, 3-, 5-year survival rates were 63.2%, 42.3%, 29.5%, respectively. (4) Analysis of prognostic factors: results of univariate analysis showed that age, marital status, occupation, hospitalization time, surgical treatment, pathological types, and TNM staging were related factors for prognosis of patients ( χ2=31.820, 6.752, 39.100, 120.889, 226.700, 10.452, 48.602, P<0.05). Results of multivariate analysis showed that being married, hospitalization time no less than 30 days, surgical treatment were independent protective factors for prognosis ( hazard ratio=1.463, 0.572, 0.575, 95% confidence interval: 1.044-2.049, 0.413-0.793, 0.438-0.755, P<0.05), stage Ⅲ and Ⅳ of TNM staging were independent risk factors for prognosis of patients ( hazard ratio=3.941, 5.036, 95% confidence interval: 1.687-9.211, 2.237-11.335, P<0.05). Conclusions:Patients with primary liver cancer have poor prognosis. Being married, hospitalization time no less than 30 days, and surgical treatment are independent protective factors for prognosis, stage Ⅲ and Ⅳ of TNM staging are independent risk factors for prognosis.

The primary fourth ventricle meningiomas (FVMs) are rare fourth intraventricular tumors. Meningiomas account for approximately 13%-20% of all intracranial tumors; 0.5%-3% of meningiomas locate in the ventricle, whereas only 5% of meningiomas locate in the ventricle occur in the fourth ventricle. To date, the report about the FVMs is less than 80 cases all over the world, and most of the literatures about this disease are case reports. The clinical manifestations, imaging features, intraoperative findings and prognoses are lack of comprehensive understanding. In this paper, based on the FVMs case reports and research progress in recent years, we aim to summarize the clinical characteristics and treatment of FVMs to provide a beneficial reference for the diagnoses and treatments of FVMs.

As a kind of neuroectodermal tumor, ependymoma usually occurs in the spine in adults. However, 90% of children's ependymomas are intracranially located, and two thirds of them are located in the posterior fossa. The most commonly used clinical treatment for posterior fossa ependymomas is surgery combined with postoperative adjuvant therapy, but the high recurrence rate and poor prognosis suggest that it is urgent to explore more targeted and efficient treatment methods. In recent years, molecular biology technology has developed rapidly, the molecular biological characteristics of posterior fossa ependymomas are partially elucidated, and the molecular typing has been preliminarily determined and many potential therapeutic targets have been proposed. This review focuses on the role of histone H3 lysine 27 trimethylation in posterior fossa ependymoma and its potential therapeutic targets to provide references for treatments and follow-up researches of this disease.