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.

Objective To analyze the evidence of risk factors and health and rehabilitation intervention strategies for lower back inju-ries in adult golfers. Methods A thematic search method was employed,retrieving literature related to low back pain in adult golfers from PubMed,Web of Science,EBSCO,Scopus,the Cochrane Library,CNKI,VIP and Wanfang Data,with publica-tion dates ranging from inception to April 1st,2024.Authors,country,publication time,study subjects,risk fac-tors for low back pain and intervention strategies were extracted from the literature for systematic review. Results Nine English articles from the United States,Australia,South Korea,Portugal and South Africa were included,involving 237 golfers,three survey studies,one prospective cohort study,five randomized controlled trial(RCT)and quasi-RCT articles were enrolled.The study subjects included adult professional and amateur golfers.The primary risk factors were excessive repetition of non-standard golf swinging movements resulting in excessive lumbar torsion and overuse of the lumbar musculature;abnormal activation patterns of the rectus abdominis,erec-tor spinae and latissimus dorsi muscles;and functional limitation of the trunk and hip joints,causing excessive lumbar compensation during the swinging motion.Health and rehabilitation intervention strategies included the comprehensive application of electromyography and ultrasound biofeedback technologies with a focus on screen-ing the lumbar weak muscle groups and swinging actions,optimizing training load,and standardizing swinging technical movements;strengthening functional training of the trunk and hip joints;and enhancing strength train-ing of the abdominal and core muscle groups,as well as the deep muscle groups. Conclusion The risk factors for low back pain in adult golfers are primarily associated with excessive repetition of im-proper golf swing techniques,insufficient strength in the abdominal and core muscle groups,and functional limi-tations of the trunk and hip joints.Key intervention strategies include optimizing training load using electromyog-raphy and ultrasound biofeedback techniques,standardizing swing techniques,enhancing trunk and hip joint functional training,and strengthening waist,abdominal,core and deep muscle group strength training.The imple-mentation of these strategies helps to reduce the risk of low back pain in golfers,enhance athletic performance,and promote physical and mental health.

Chronic constipation is one of the common diseases in clinic. For the complicated causes and pathophysiology, the overall efficacy is not satisfactory in the traditional medical model. Multidisciplinary-team (MDT) approach is a new team medical model, which is also an important systematic and modular medical approach. Treating patients with chronic constipation by multidisciplinary-team approach is an effective way to improve the overall efficacy. In diagnosis, MDT approach can get more accurate and explicit diagnosis and type of the constipation by gathering patients' detailed medical history, complete physical examination, laboratory and image test, patients' mental and nutritional condition. In treatment, MDT members can cooperate in various fields, such as basic research, medicine, physics, psychology, surgery and conversion therapy, and that may provides more thoughts and methods for the treatment of chronic constipation.

Objective To assess the efficacy and safety of morinidazole combined with appendectomy in treating purulent or gangrenous appendicitis.Methods Double-blind randomized controlled multicenter clinical trial was designed and conducted.Totally 437 patients were included,219 in the control group and 218 in the experimental group.Cases of purulent or gangrenous appendicitis were enrolled and assigned to each of the two groups.The control group received ornidazole injection for 5 to 7 days while the experimental group received morinidazole injection.Both groups underwent appendectomy.Clinical response,micrombiological outcomes,overall response were evaluated.Adverse events and side effects were recorded.Results No significant difference was observed between the two groups regarding the clinical healing rate at 5-10 days after medicine withdrawal,anaerobia clearance and overall healing rates.Adverse events occurred in 140 patients (32.1％).Incidence of adverse events in the control group and the experimental group was 34.7％ and 29.4％,respectively (P ＞ 0.05).The overall incidence of side effects was 15.1％ (66 cases).Side effects were less seen in the experimental group compared with that in the control group (11.5％ vs.18.7％,P ＜ 0.05).The most frequent side effects were aminotransferase rising,thrombocytosis,nausea,vomiting and electrocardiographic abnormality.Conclusions The effect of morinidazole plus operation was comparable with ornidazole in treating purulent or gangrenous appendicitis.The safety of morinidazole is better than ornidazole.

Supervisory sampling inspection is one of the administrative supervision measures for medical devices. As the reinspection work affects the final conclusion of sampling inspection, inappropriate overturn during the reinspection has already impaired the impartiality and authority of the supervisory inspection work. By the statistics of survey materials, this article analyzes the reasons for requesting reinspection and making overturns,and proposes a scheme for eliminating the interference factors such as the understanding divergences and the defects of standards,the inspection capacity and the issues of sampled devices, etc. To enhance the authoritative of reinspection, this article also proposes principals of evasion, precedence, arbitration and assessment, and the improvement of the reinspection workflow in order to make the reinspection work more appropriate, more efficient and more impartial.

OBJECTIVETo investigate the application value of colonic transit test (CTT) combined with anorectal manometry (ARM), barium enema (BE) and defecography (DFG) in accurately evaluating colonic lesions of slow transit constipation complicated with adult megacolon.

METHODSClinical data of 47 above patients admitted between October 2007 and February 2015 in the People's Hospital of Hunan Province were analyzed retrospectively. All the patients were examined with≥2 times of CTT combined with ARM and BE, and 42 cases received additional DFG at the same time, to evaluate colonic lesions before operation. Operative biopsy pathology was used as the standard. The sensitivity, specificity, positive predictive value(PPV) and negative predictive value(NPV) of positioning in the ascending colon and caecum, transverse colon and descending colon were calculated, and the consistency was represented by Kappa test(Kappa value≥0.75 indicates good consistency, meanwhile higher Kappa value indicates better consistency). The Heikkinen score was used to evaluate defecation function at postoperative 6 months.

RESULTSThe age of 47 patients was from 18 to 56 years old. Compared with intraoperative findings and biopsy pathology, the diagnostic coincidence rate was 89.4% by CTT combined with BE and DFG positioning, which suggested pathology-changed colonic segment locating in the ascending colon and cecum (n=12), transverse colon (n=26) and descending colon (n=9), while intraoperative findings and biopsy pathology suggested pathology-changed colonic segment locating in the ascending colon and cecum (n=11), transverse colon (n=23) and descending colon (n=13). The sensitivity was 88.3%, specificity 93.5%, PPV 92.1%, NPV 94.9% and Kappa value was 0.827(P<0.001). Procedures performed included segmental colectomy (n=8), subtotal colectomy (n=29), total colectomy (n=10). There was no serious complication during and after operation. Defecatory function was excellent in 24 cases (60.0%), good in 10 (25.0%), and moderate in 6 (15.0%) evaluated by Heikkinen score at postoperative 6 months. A total of 40 patients were followed up from 1 to 7 years (median 3 years) and there was no long-term diarrhea and recurrence of constipation or giant colon after operation.

CONCLUSIONPreoperative detection of CTT combined with ARM, BE and DFG in patients with slow transit constipation complicated with adult megacolon can make a more precise assessment of the extent of colonic lesions in advance, which has a good clinical predictive value.

Adolescent ; Adult ; Barium Enema ; Cecum ; pathology ; physiopathology ; surgery ; Colectomy ; methods ; Colon ; pathology ; physiopathology ; surgery ; Constipation ; complications ; diagnosis ; pathology ; surgery ; Defecography ; Female ; Gastrointestinal Transit ; physiology ; Humans ; Male ; Manometry ; Megacolon ; complications ; pathology ; surgery ; Middle Aged ; Predictive Value of Tests ; Preoperative Period ; Prognosis ; Recovery of Function ; physiology ; Retrospective Studies ; Sensitivity and Specificity

Slow transit constipation (STC) is one kind of chronic constipation. Medical treatment is adopted by most patients, but many patients do not respond to conservative treatment and require surgical intervention. There are several problems in clinical paratice, including non-rigorous patient selection, less standard preoperative assessment, less standard operation or insufficient post operative treatments and follow-up, which may lead to the overtreatment or serious complications. As the changes of living habits and diet, the incidence of STC increases gradually. Therefore it is important to make a standardized surgical treatment of STC. Because lots of factors may cause STC and the pathophysiology of STC is complicated, multidisciplinary treatment is recommended. This paper will discuss the standardized surgical treatment of STC base on the new literature and author's experience, concerning operative indications, preoperative assessment, choice of operation procedure, postoperative evaluation and follow-up.

Objective To explore the effects of 5-Aza-2'-deoxycytidine (5-Aza-CdR) on the proliferation of BCG-823 human gastric cancer cells and the expression of HOXA5.Methods The methylation status of the promoter of HOXA5 was measured by methylmion specific PCR (MSP).The BCG-823 cells were treated with different concentrations of 5-Aza-CdR,and then the changes of expression and methylation status of HOXA5 gene were detected by quantitative real-time polymerase chain reaction (QRT-PCR),Western-blot,and MSP.Cells proliferation was assessed by methyl thiazolyl tetrazolium (MTT) assay.Results (1) Different methylation status of HOXA5 gene promoter was detected in BCG-823 cells.The mathylation rate of HOXA5 gene promoter were reduced after treatment with 5-Aza-CdR,and also were negatively related to the concentration of 5-Aza-CdR (F =438.307,P ＜ 0.01).(2) Compared to the control groups,the expressions of HOXA5 mRNA and protein were increased after treatment with 5-Aza-CdR,with statistical significance (P ＜ 0.05).(3) The proliferation rate of BCG-823 cells was significantly inhibited (P ＜0.05).Conclusions The methylation status of HOXA5 promoter was detected in BCG-823 cells.5-AzaCdR is able to inhibit BCG-823 cells growth in vitro,which might be related to the expression of HOXA5.It may be a new way to treat gastric cancer.

Objective To analyze the clinical manifestations and treatment for toxic megacolon induced by drastic cathartics inpatients with an unknown history of ulcerative colitis. Methods The clinical data of 5 patients with toxic megacolon induced by ulcerative colitis with initial onset type from June 2003 to October 2008 were analyzed retrospectively. Results In 5 cases, the first symptom was abdominal pain and distention. After taking cathartics, these 5 cases were complicated with toxic megaeolon and 2 cases suffering from intestinal perforation. Four female patients suffered from transient unconsciousness, in which 3 patients were found with cerebral lacunal infarction identified by magnetic field diffusion-weighted imaging. All 5 cases underwent exploration, colectomy and ostomy, one patient died perioperatively, anastomotic fistula and anastomotic constriction developed in one each cases. Conclusions The most common clinical manifestations of toxic megacolon induced by ulcerative colitis are abdominaigia, abdominal distention. Emergency therapeutic strategy consists of partial culectomy and ostomy.

Objective: In order to observe the therapeutic effect of acupuncture in reducing muscular tension of the limb in apoplectic hemiplegia. Methods:Yin-meridian electroacupuncture was used to treat 37 cases of high muscular tension of limbs in apoplectic hemiplegia. Results:The total effective rate was 83.3% in reducing muscular tension and was 86.5% in increasing the index in the activity of daily life (ADL). Conclusion: The findings show that yin- meridian electro- acupuncture has a good effect in reducing muscular tension and improving the activity of daily living and is beneficial to rehabilitation of paralyzed limb.