Objective To evaluate the effect of manual massage on complications after endoscopic foam sclerotherapy injection for the treatment of internal hemorrhoids.Methods Consecutive 113 patients with grade Ⅰinternal hemorrhoids were prospectively enrolled and completed endoscopic foam sclerotherapy.The patients were randomly divided into a massage group(n=65)and a control group(n=68).Massage group performed manual perianal massage,Visual analogue scale(VAS)was used to evaluate perianal pain.The postoperative bleeding,short-term and long-term efficacy were also compared.Results The median VAS of 24 h postoperation was 1.0(0.0,3.0)in massage group,which was significantly lower than 2.0(1.0,4.0)in control group,the difference was statistically significant(P=0.014).The no bleeding rate of one week postoperation was 84.6％in massage group,which was significantly higher than 64.7％in control group,the difference was statistically significant(P=0.009).After 12 weeks,6 months and 12 months of follow-up,there were no significant differences in cure rate and remission rate between the two groups(P＞0.05).Conclusion Manual massage after endoscopic sclerosing agent injection is beneficial to relieve postoperative pain of grade Ⅰ internal hemorrhoids and reduce bleeding.

Objective:To evaluate the safety and long-term effectiveness of endoscopic foam sclerotherapy (FS) combined with endoscopic rubber band ligation (ERBL)in the treatment of grade Ⅱ-Ⅲ internal hemorrhoids.Methods:Consecutive patients diagnosed as having grade Ⅱ-Ⅲ internal hemorrhoids in Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January to December 2020 were prospectively enrolled in the study, and randomly divided into ERBL group and FS combined with ERBL group. The 24 h visual analogue scale (VAS) for pain and 1-week degree of bleeding were evaluated after the treatment. After follow-up of 6 months, the effectiveness of treatment was evaluated.Results:A total of 84 patients with age of 54.4±7.9 years were enrolled, 57.1% (48/84) males, and 73.8% (62/84)grade Ⅱ internal hemorrhoids. Forty-three patients were assigned to the ERBL group and 41 to the FS combined with ERBL group. There was no significant difference between the two groups in baseline data ( P>0.05). In the FS combined with ERBL group, the mean amount of polidocanol foam was 13.8±2.5 mL, the mean number of injection site was 4.7±1.2, and the median scores of VAS was 0 (0, 3), which was significantly lower than that of ERBL group [2 (0, 4), Z=-2.116, P=0.034]. The bleeding rate 1 week after treatment in the ERBL and FS combined with ERBL group were 20.9% (9/43) and 29.3% (12/41), respectively, and mild bleeding was the main symptom. There was no significant difference between the two groups in the bleeding degree ( U=807.0, P=0.378). After 6 months of follow-up, the total effective rates in the ERBL group and the FS combined with ERBL group were 81.4% (35/43) and 90.2% (37/41), respectively ( U=684.5, P=0.044). Conclusion:FS combined with ERBL can effectively relieve post-treatment perianal pain, and improve the long-term effectiveness.

Objective: To report the clinical and pathological features of primary proximal epithelioid sarcoma (PES) in skull base. Methods: The clinical and pathological features of four cases of PES in skull base from Sanbo Brain Institute of Capital Medical University and Kunming Sanbo Brain Institute were analysed retrospectively. Results: Three cases was female, and one male, the age ranged from 46 to 52 years.All cases occurred in skull base, and sellar region was the main site of involvement.Under the microscope, the tumor cells characterized by epithelioid cell changes, with or without rhabdoid tumor cells.Mitotic figure was active.Immunohistochemical staining showed that AE1/AE3, EMA and CD34 were variously expression in tumor cells.INI-1 protein was lost in all cases.Three cases were detected by FISH, and INI1 (22q11.2) gene locus was absent in them.Three patients died less than 3 months after surgery, and case 4 was under treatment after five months of surgery. Conclusions Primary PES in skull base mostly occurs in sellar region and its clinical prognosis is poor.It features with epithelioid/rhabdoid tumor cells with lack granuloma structure as distal ES.It has epithelial and mesenchymal differentiation characteristics.CD34 is always positive.INI1 gene deletion and protein loss expression are characteristic molecular alteration of PES.

Objective To investigate the effects of VCAM-1 on migration and invasion of glioma cell lines . Methods The techniques of lentivirus pSGU6/GFP/Neo-based VCAM-1 shRNA and EF1 a-GFP/puro-based VCAM-1 expression vector, the scratch wound healing migration and transwell invasion assays , and the Western blot and cell staining were applied to observe the effects of VCAM-1 expression levels on migration and invasion of glioma cell line cells.There are four groups in T98G cells including control, vector, scramble and shRNA-VCAM-1 groups and three groups in U251 cells covering control, vector and VCAM-1 overexpressed groups ( n=6 per group) .Results The stabled glioma cell lines of T98 G cells with down-regulated VCAM-1 and U251 cells with VCAM-1 overexpression were established by using lentivirus-based VCAM-1 shRNA and expression vector.The ability of scratch wound healing (migration activity) decreased significantly (P<0.01) in T98G cells with lower VCAM-1 expression levels, while the migration activity was obviously improved in U251 cells with overexpressed VCAM-1 ( P <0.05 ) .Similarly, the invasion ability was significantly inhibited ( P <0.05) in T98G cells with silenced VCAM-1, as well as VCAM-1 overexpression could enhance the invasion ability of U251 cells ( P<0.01 ) .Conclusions VCAM-1 improves the migration activity and invasion ability of human glioma cell line cells.

Objective: We aimed, in our prospective study, to assess the predictive value of serum non-invasive and biochemical markers for clinical diagnosis of significant fibrosis (including early stages). Methods: We measured sH2a levels in serum, comparing with routine liver function markers. We compared blindly pretreatment serum samples from a cohort of hepatitis B patients without non-alcoholic fatty liver disease(NAFLD), which had histological grades of liver fibrosis, with NAFLD individuals and CHB with NAFLD patients. Statistical analysis was by Student′s t test, and receiver-operating characteristic (ROC) curves were drawn. Results: ROC curves showed that serum sH2a had greater diagnostic performance than routine liver function markers compared with histological grades of liver fibrosis(S0, S1-2, S3-4). ROC curves showed that using a sH2a cut-off point of 0.79 was with highest sensitivity as 63% and highest specificity as 80%. And sensitivity as 96.7% and specificity as 75.5% when using a sH2a cut-off point of 0.77. Conclusions sH2a has the potential to be a uniquely sensitive and specific novel marker for liver fibrosis and function.

Objective: To investigate the value of 1H-magnetic resonance spectroscopy (¹H-MRS) in determining the content of liver triglyceride in patients with fatty liver disease (FLD), as well as its influencing factors. Methods: A total of 124 patients with nonalcoholic fatty liver disease (NAFLD), chronic hepatitis B (CHB), or hepatitis B complicated by FLD who underwent liver biopsy in the Affiliated Hospital of Hangzhou Normal University were enrolled, and the clinical data, serological markers, FibroScan results, and ¹H-MRS results were collected. A correlation analysis was performed with the results of liver biopsy as the gold standard, and the influence of factors including hepatitic B virus (HBV) infection and obesity on accuracy was analyzed. A one-way analysis of variance was used for comparison of means between the three groups, and the LSD or SNK test (for homogeneity of variance) or the Tamhane’s or Dunnett’s test (heterogeneity of variance) was used for comparison between any two groups. The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data. The MRS-PDFF receiver operating characteristic (ROC) curve was plotted, the area under the ROC curve (AUC) was calculated, the optimal cut-off points for the diagnosis of NAFLD were estimated, and sensitivity and specificity were calculated. Results: The NAFLD group (42 patients) and the CHB + NAFLD group (40 patients) had a significantly higher proton density fat fraction (PDFF, the content of triglyceride in the liver) than the CHB group (42 patients) (16.84±9.76/9.39 ± 5.50 vs 3.45 ± 1.63, P < 0.001). The results were significantly correlated with the degree of steatosis confirmed by liver biopsy (P < 0.001), but it was not significantly correlated with inflammation or fibrosis grade. The correlation analysis showed that the MRS-PDFF value measured by 1H-MRS was significantly correlated with body mass index (BMI), blood lipids, alkaline phosphatase, and blood glucose, while it was not significantly correlated with age, sex, or the presence or absence of hepatitis B. The ROC curve analysis showed that the AUCs of PDFF measured by 1H-MRS were 0.93, 0.974, and 0.976, respectively, for the diagnosis of steatosis S1(≥5%), S2(≥34%), and S3(≥66%), and the corresponding optimal thresholds were 5.14%, 11.16%, and 16.7%, respectively. Conclusion 1H-MRS has a high diagnostic value in quantitative evaluation of the degree of liver steatosis in patients with FLD and is not affected by the factors such as HBV infection, age, and sex, while it is correlated with BMI and lipid metabolism.

OBJECTIVETo study the expression level of folate receptor α (FR-α) in glioma tissue and its clinical significance.

METHODSForty-eight human glioma specimens were collected from patients who underwent surgery from March 2012 to March 2013. These specimens were as follows:12 cases of glioblastoma (WHO IV), 6 cases of astrocytoma of each malignancy grade(WHO II, III), 6 cases of oligodendroastrocytoma of each malignancy grade (WHO II, III), 6 cases of oligodendroglioma of each malignancy grade (WHO II, III ). In addition, 6 cases of normal brain tissue resected from brain traumatic patients were taken as negative control, and one case of placental tissue (had got the consent of the parents and their families) was taken as positive control. The expression level of FR-α in tumor tissues was evaluated by Western blot analysis. The results of Western blot analysis were analyzed by t-test. The expression level of FR-α and Ki-67 in tumor tissues was evaluated immunohistochemistry, the results were analyzed by Kruskal-Wallis test and Nemenyi test. The correlation between the expression level of FR-α and cell proliferation index Ki-67 was analyzed by Pearson correlation analysis.

RESULTSWestern blot analysis showed that the FR-α was not expressed in normal brain tissue and oligodendroglioma tissue, but highly expressed in astrocytoma, oligodendroastrocytoma and gliomablastoma. The expression level in WHO III astrocytoma was significantly higher than in WHO II (t = 4.497, P < 0.05). FR-α was also highly expressed in oligodendroastrocytoma and its expression level in WHO III was also significantly higher than in the WHO II (t = 2.876, P < 0.05). Foremore, immunohistochemistry analysis also showed that FR-α was not expressed in oligodendroglioma, but expressed in astrocytoma, oligodendroastrocytoma and gliomablastoma. The positive rate of FR-α of WHO III was significantly higher than the WHO II astrocytoma(57.8% ± 2.2% vs. 45.7% ± 2.3%,χ(2) = 3.871, P = 0.034). In oligodendroastrocytoma, the positive rate of FR-α of WHO III was significantly higher than the WHO II(56.5% ± 5.4% vs. 37.1% ± 5.2%,χ(2) = 4.454, P = 0.021). Moreover, the expression level of FR-α in gliomablastoma was highest in all histological types of gliomas, the positive rate of FR-α was up to 65.0% ± 4.5%. Pearson correlation analysis showed that the positive rate of FR-α was positively correlated with Ki-67 index (r = 0.903, P < 0.05).

CONCLUSIONSFR-α is expressed in astrocytoma, oligodendroastrocytoma and glioblastoma, and the expression level of FR-α is positively correlated with malignancy grade and Ki-67 index. Therefore, FR-α may be applied as a special target for diagnosis and treatment of glioma.

Adolescent ; Adult ; Biomarkers, Tumor ; metabolism ; Brain Neoplasms ; metabolism ; Case-Control Studies ; Child ; Child, Preschool ; Female ; Folate Receptor 1 ; metabolism ; Glioma ; metabolism ; Humans ; Infant ; Ki-67 Antigen ; metabolism ; Male ; Middle Aged ; Young Adult

Objective To observe the efficacy of high-energy red light combined with human-like collagen dressing in treatment of facial corticosteroid addictive dermatitis.Methods Eighty-three patients with facial corticosteroid addictive dermatitis were divided into treatment group (42 cases) and control group (41 cases) by random digits table method.All patients in 2 groups were treated with ebastine 10 mg,once a day,and vitamin E cream,twice a day.At the same time,the patients in control group were given human-like collagen dressing,once a day in the first week,then 3 times/week.On the basis of control treatment,the patients in treatment group were irradiated with high-energy red light 10 min in face,2-3 times/week.The treatment of both groups lasted for 12 weeks.The symptoms,skin lesions and untoward reaction were observed after treatment of 4,8 and 12 weeks.Results After treatment of 4 weeks,there was no statistical difference in the effective rate between 2 groups (P ＞ 0.05).After treatment of 8 and 12 weeks,the effective rates in treatment group were significantly higher than those in control group [83.3％(35/42) vs.58.5％ (24/41),90.5％ (38/42) vs.65.9％ (27/41)],there were statistical differences (P ＜ 0.05).No untoward reaction was found in 2 groups.Conclusion High-energy red light combined with human-like collagen dressing is effective and safe in treatment of facial corticosteroid addictive dermatitis.

The paper reports the development of a quality evaluation method for Angelica different processed products. The data of high-performance liquid chromatography, water, total ash and extract were analyzed with SPSS Clementine 11.0 software. Discriminant analysis (DA) established the classification model and parameter for Angelica different processed products. Fish's discriminant functions of Angelica different processed products were generated using 8 predictor variables selected from 59 indexes. The correct rate of discriminating back substitution is 96.7%. Angelica different processed products can be accurately and reliably recognized and validated with DA of SPSS Clementine 11.0 software.

Objective:To study whether sacral lymph nodes should be included in the target volume delineation for those patients with early (stageⅠB-ⅡA) uterus cervix cancer during postoperative radiotherapy. Methods:Forty-six patients with early uterus cervix cancer were given postoperative three dimensional conformal radiation therapy (3D-CRT) in our department for one month after radical resection. The patients were randomly divided into two groups. The sacral lymph nodes were not included in the target volume delineation in the treatment group. But they were delineated in control group. All the patents had no radiotherapy-related contraindications and signed the consent agreement. The patients were followed up. The local controlling rate and the incidence and degree of radioactive proctitis were compared between the two groups. Results:The local controlling rate of the two groups had no significant difference(t=0.000, P=1.000). The doses received by the 5% and 95% volume of the rectum(V_5, V_95), the average dose, and the minimum dose had significant difference between the two groups(t_(V5)=2.169, P_(V5)=0.041; t_(V95)=4.036, P_(V95)=0.001;t_(mean)=2.236, P_(mean)=0.036; t_(min)=2.265, P_(min=0.034), but the maximum dose received by the rectum had no obvious difference (t_(max)=0.518, P_(max)=0.610). The incidence of radioactive proctitis had significant difference between the two groups(t=2.174, P=0.190). Conclusion:For the early uterus cervix cancer patients who have recurrent risk after radical surgery, sacral lymph nodes should not be included in the delineation of target volume during 3D-CRT in order to decrease the incidence of radioactive proctitis.