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Can patients with mild non-neoplastic lesions diagnosed at baseline screening be safely exempt from surveillance: evidence from multicenter community-based cohorts

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Science China Life Sciences 2025年第1期 263-271页

作者： Siyi He Zhiyi Zhang Guohui Song Zhenhai Wang Chunyun Dai Shipeng Yan Kun Jiang Bingbing Song He Li Maomao Cao Dianqin Sun Fan Yang Xinxin Yan Shaoli Zhang Yi Teng Qianru Li Changfa Xia Wanqing Chen Office of Cancer Screening National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical College Department of Gastroenterology Gansu Wuwei Tumor Hospital Cixian Cancer Institute Linzhou Cancer hospital Center for Disease Control and Prevention of Sheyang county Department of Cancer Prevention and Control Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of MedicineCentral South University Luoshan Center for Disease Control and Prevention Office for Cancer Control and Research Affiliated Cancer Hospital of Harbin Medical University

Surveillance recommendations for gastric cancer（GC） in current guidelines focused on advanced precancerous lesions and were based on precise diagnosis of severity/extent of baseline lesions. We aimed to develop a less endoscopy-related equipment-dependent risk-stratification tool, and assessed whether mild-precursor-lesion patients can be safely exempt from surveillance. In the multicenter communitybased cohort, 75,051 participants receiving baseline endoscopy were enrolled during 2015–2017 and followed-up until 2021. Cumulative incidence rates（CIRs） of GC for precancerous-conditions were calculated by Kaplan-Meier method and compared by Log-rank tests. Mixedeffects Cox regression models were used to detect potential factors for progression towards GC. A risk score was calculated as counts of selected factors. An independent cohort, including 26,586 participants was used for external validation. During a median follow-up of 6.25 years, CIRs of GC were 0.302%, 0.436%, and 4.756% for normal group, non-neoplastic（atrophic gastritis/intestinal metaplasia） and neoplastic lesions（low-grade/high-grade dysplasia）, respectively(Ptrend<0.001). Four predictors, including male, ≥60 years, smoking, and limited vegetable consumption, were selected for risk-stratification. High-risk patients（≥3 risk factors） with non-neoplastic lesions showed higher GC risks（adjusted HR=7.73, 95%CI: 4.29–13.92）, and their four-year CIR reached the one-year CIR of neoplastic lesions. Further categorizing non-neoplastic lesions by histological grade, both patients with moderate-to-severe lesions（aHR=3.07, 95%CI: 1.67–5.64） and high-risk patients with mild lesions（aHR=7.29, 95%CI: 3.58–14.86） showed higher risks. Consistent trends were observed in validation cohort. High-risk mild-precursor-lesion patients should receive surveillance within 3–5 years after baseline screening. Our study provides evidence on supplementing current guideline recommendations.

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Successful emergency surgical intervention in acute non-STsegment elevation myocardial infarction with rupture:A case report

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World Journal of Clinical Cases 2025年第4期13卷 41-47页

作者： Xing-Po Li Zi-Shan Wang Hong-Xia Yu Shan-Shan Wang Department of Cardiovascular Medicine Huantai County Hospital of Traditional Chinese MedicineZibo 256400Shandong ProvinceChina Department of Cardiovascular Medicine Zibo Hospital of Integrated Traditional Chinese and Western MedicineZibo 255500Shandong ProvinceChina

BACKGROUND The incidence of acute myocardial infarction(AMI)is rising,with cardiac rupture accounting for approximately 2%of deaths in patients with acute ST-segment elevation myocardial infarction(STEMI).Ventricular free wall rupture(FWR)occurs in approximately 2%of AMI patients and is notably rare in patients with *** of cardiac rupture include left ventricular FWR,ventricular septal rupture,and papillary muscle *** FWR usually leads to acute cardiac tamponade or electromechanical dissociation,where standard resuscitation efforts may not be *** septal rupture and papillary muscle rupture often result in refractory heart failure,with mortality rates over 50%,even with surgical or percutaneous repair *** SUMMARY We present a rare case of an acute non-STEMI patient who suffered sudden FWR causing cardiac tamponade and loss of consciousness immediate before undergoing coronary *** resuscitation and emergency open-heart repair along with coronary artery bypass grafting resulted in successful patient *** This case emphasizes the risks of AMI complications,shares a successful treatment scenario,and discusses measures to prevent such complications.

关键词： Acute non-ST segment elevation myocardial infarction Cardiac rupture Acute myocardial infarction Free wall rupture Case report

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Primary hepatic solitary fibrous tumor with histologically benign and malignant areas

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Hepatobiliary & Pancreatic Diseases International 2015年第6期14卷 665-668页

作者： Anna Silvanto Nariman D Karanjia Izhar N Bagwan Departments of Histopathology Royal Surrey County Hospital General Sugery Royal Surrey County Hospital

Extrapleural solitary fibrous tumor （SFT） is an uncommon mesenchymal neoplasm, presenting most commonly in the intrathoracic sites but which has been reported at nu- merous extrathoracic locations. The majority of intra-thoracic SFTs are benign, but 10%-15% behave aggressively. We report a case of primary hepatic SFT with histologically benign and ma- lignant areas. A 65-year-old man underwent an abdominal CT scan following a cerebrovascular accident, which demonstrated a sharply demarcated large liver mass with a heterogenous enhancing area and occupying most of the left lobe of the liver. Histological examination following a hemihepatectomy showed an SFT with morphological patterns ranging from benign to malignant areas, including pleomorphism, increased cellularity, herringbone pattern, necrosis and a raised mitotic count. On review of the literature, only an occasional case report with malignant areas in a hepatic SFT was identified. This case highlights that SFT should be included in the differential diagnosis of a hepatic spindle cell lesion, and that on rare occasions, malignant areas can occur in this already uncommon neoplasm.

关键词： liver tumors malignant (non-HCC) liver surgery pathological changes

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Retrospective analysis of pathological types and imaging features in pancreatic cancer: A comprehensive study

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World Journal of Gastrointestinal Oncology 2025年第1期17卷 121-129页

作者： Yang-Gang Luo Mei Wu Hong-Guang Chen Pathology Department Xuanhan County People’s HospitalDazhou 636150Sichuan ProvinceChina

BACKGROUND Pancreatic cancer remains one of the most lethal malignancies worldwide,with a poor prognosis often attributed to late *** the correlation between pathological type and imaging features is crucial for early detection and appropriate treatment *** To retrospectively analyze the relationship between different pathological types of pancreatic cancer and their corresponding imaging *** We retrospectively analyzed the data of 500 patients diagnosed with pancreatic cancer between January 2010 and December 2020 at our *** types were determined by histopathological examination of the surgical spe-cimens or biopsy *** imaging features were assessed using computed tomography,magnetic resonance imaging,and endoscopic *** analyses were performed to identify significant associations between pathological types and specific imaging *** There were 320(64%)cases of pancreatic ductal adenocarcinoma,75(15%)of intraductal papillary mucinous neoplasms,50(10%)of neuroendocrine tumors,and 55(11%)of other rare *** imaging features were identified in each pathological *** ductal adenocarcinoma typically presents as a hypodense mass with poorly defined borders on computed tomography,whereas intraductal papillary mucinous neoplasms present as characteristic cystic lesions with mural *** tumors often appear as hypervascular lesions in contrast-enhanced *** analysis revealed significant correlations between specific imaging features and pathological types(P<0.001).CONCLUSION This study demonstrated a strong association between the pathological types of pancreatic cancer and imaging *** findings can enhance the accuracy of noninvasive diagnosis and guide personalized treatment approaches.

关键词： Pancreatic cancer Pathological types Imaging features Retrospective analysis Diagnostic accuracy

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Barrett's oesophagus: Current controversies

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World Journal of Gastroenterology 2017年第28期23卷 5051-5067页

作者： chidi amadi piers gatenby Regional Oesophagogastric Unit Royal Surrey County Hospital

Oesophageal adenocarcinoma is rapidly increasing in Western countries. This tumour frequently presents late in its course with metastatic disease and has a very poor prognosis. Barrett's oesophagus is an acquired condition whereby the native squamous mucosa of the lower oesophagus is replaced by columnar epithelium following prolonged gastro-oesophageal reflux and is the recognised precursor lesion for oesophageal adenocarcinoma. There are multiple national and society guidelines regarding screening,surveillance and management of Barrett's oesophagus,however all are limited regarding a clear evidence base for a well-demonstrated benefit and cost-effectiveness of surveillance,and robust risk stratification for patients to best use resources. Currently the accepted risk factors upon which surveillance intervals and interventions are based are Barrett's segment length and histological interpretation of the systematic biopsies. Further patient risk factors including other demographic features,smoking,gender,obesity,ethnicity,patient age,biomarkers and endoscopic adjuncts remain under consideration and are discussed in full. Recent evidence has been published to support earlier endoscopic intervention by means of ablation of the metaplastic Barrett's segment when the earliest signs of dysplasia are detected. Further work should concentrate on establishing better risk stratification and primary and secondary preventative strategies to reduce the risk of adenocarcinoma of the oesophagus.

关键词： Barrett’s oesophagus Gastroenterology Endoscopy Oesophageal adenocarcinoma Dysplasia

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Frequent Ventricular Extrasystole Treated by Needling Neiguan(PC 6)plus Oral Administration of Mexiletine——A Report of 30 Cases

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Journal of Traditional Chinese Medicine 2004年第1期24卷 40-41页

作者：张景祖徐文化陈正秋 The MCH hospital of Changhuan county Henan Province 453400 The TCM hospital of Ningling county Henan Province 476700

Purpose: To observe the therapeutic effect of needling at Neiguan (PC 6) plus oral administration of mexiletine. Methods: 60 cases of frequent ventricular extrasystole were randomly divided into two groups: a treatment group, and a control group. In the control group, mexiletine was orally administered, and in the treatment group needling at bilateral Neiguan (PC 6) plus oral administration of mexiletine were given. 2 weeks of treatments constituted a therapeutic course. Results: Of the 30 cases in the treatment group, 23 cases were markedly effective, 5 cases improved, and 2 cases failed; while in the control group 16 cases were markedly effective, 8 cases improved, 4 cases failed, and 2 cases aggravated. The total effective rates of 90.3% and 80.0%, respectively in the treatment and control groups showed a very significant difference between the two groups (P<0.01). Conclusion: Needling at bilateral Neiguan (PC 6) may enhance the therapeutic effect for frequent ventricular extrasystole.

关键词：室性早搏脉律定中西医结合针灸疗法临床疗效

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Disposable circumcision suture device： clinical effect and patient satisfaction

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Asian Journal of Andrology 2014年第3期16卷 453-456页

作者： Bo-Dong Lv Shi-Geng Zhang Xuan-Wen Zhu Jie Zhang Gang Chen Min-Fu Chen Hong-Liang Shen Zai-Jun Pei Zhao-Dian Chen The First Affiliated hospital of Zhejiang University Zhejiang Hangzhou Departments of Urology The Second Affiliated Hospital of Zhejiang Chinese Medical University Hangzhou Department of Urology People's Hospital of Anji County Huzhou Department of Urology Traditional Chinese Medical Hospital of Deqing County Huzhou Department of Urology Traditional Chinese Medical Hospital of Tongxiang County Jiaxing China

In our experience patients undergoing circumcision are mostly concerned about pain and penile appearances. We conducted a prospective randomized trial to assess the benefits of a new disposable circumcision suture device （DCSD）. A total of 942 patients were equally divided into three groups （conventional circumcision, Shang ring and disposable suture device group）. Patients in the DCSD group were anesthetized with compound 5% lidocaine cream, the others with a 2% lidocaine penile block. Operation time, intra-operative blood loss, incision healing time, intra-operative and post-operative pain, the penile appearance and overall satisfaction degree were measured. Operation time and intra-operative blood loss were significantly lower in the Shang ring and suture device groups compared to the conventional group （P 〈 0.001）. Intra-operative pain was less in the suture device group compared With the other two groups （P 〈 0.001）; whereas post-operative pain was higher in the conventional group compared to the other two groups （P 〈 0.001）. Patients in the suture device （80.57%） and Shang ring （73,57%） groups were more satisfied with penile appearances compared with the conventional circumcision group （20.06%, P 〈 0.05）. Patients in suture device group also healed markedly faster than the conventional group （P 〈 0.01）. The overall satisfaction rate was better in the suture device group （78.66%） compared with the conventional （47.13%） and Shang ring （50.00%） groups （P 〈 0.05）. The combination of DCSD and lidocaine cream resulted in shorter operation and incision healing times, reduced intra-operative and post-operative pain and improved patient satisfaction with the cosmetic appearances.

关键词： circumcision disposable circumcision suture device patient satisfaction penis appearance pre-operative and post-operative pain Shang ring ~

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Assessment of visual outcomes of cataract surgery in Tujia nationality in Xianfeng county, China

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International Journal of Ophthalmology(English edition) 2015年第2期8卷 292-298页

作者： Jing Yuan Xia Wang Li-Qin Yang Yi-Qiao Xing Yan-Ning Yang Eye Center Renmin Hospital of Wuhan University Department of Ophthalmology Xianfeng County Renmin Hospital

AIM: To evaluate the visual outcome and factors influencing visual outcome of manual small incision cataract surgery(MSICS) in the rural area in the Xianfeng ***: Eighty-two eyes of 82 patients who underwent cataract surgery performed by using MSICS technique were identified. Data collected included each patient’s age, gender, the level of education. Uncorrected and corrected distance visual acuity(UDVA and CDVA) at presentation and at 1, 6, 8wk postoperatively, pre-existing eye disease, operative findings and complications, the risk factors were ***: In 82 patients, the average age was 69.6±0.6y, illiterate were 52(63.4%). Of 82 eyes, pseudophakia was present in 77 eyes(93.9%). At 1wk postoperatively,47 eyes(57.3%) had the UDVA of ≥6/18, and 52 eyes(63.4%) had the CDVA of ≥6/18. At 6 to 8wk postoperatively, 50 eyes(61.0%) had UDVA of ≥6/18, and57 eyes(69.5%) had the CDVA of ≥6/18. Postoperative visual status was significantly related to the co-morbidities, such as corneal pathology, glaucoma(P <0.001).Operative complications, such as posterior capsule opacity and cystoid macular edema were main operative cause for the poor visual ***: MSICS provides a good visual recovery in our study but the vision outcome did not fulfill the standards proposed by WHO, which highlights the need for an improvement in local socioeconomic understanding, population education and surgery quality.

关键词： cataract surgery manual small incision cataract surgery visual outcome co-morbidities operative complications

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Several Problems in Acupuncture Treatment of Headache

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Journal of Traditional Chinese Medicine 2004年第1期24卷 49-50页

作者：张平段树民 Songxi county hospital Fujian Province 353500

In clinical practice, it is difficult to treat headache. The author holds that when headache is treated with acupuncture, attention should be paid to the following aspects.

关键词：头痛针灸疗法临床分型取穴血液循环

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Management of symptomatic ureteric stumps laparoscopically

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Asian Journal of Andrology 2001年第2期3卷 147-150页

作者： A.M.Khan S.Jacob Department of Surgery King George Hospital Ilford Essex IG1 2HL UKDepartment of Surgery King George Hospital Ilford Essex IG1 2HL UK

Aim: To study the advantage of excision of the distal symptomatic ureteric stumps with the retroperitoneal laparo-scopic approach. Methods: Four patients who had failed to settle their symptoms with the initial conservative man-agement were included in the study. All underwent excision of the distal symptomatic ureteric stumps with the retroperi-toneal laparoscopic approach and then received prophylactic antibiotics. Results: We have achieved better resultsthan those reported in the literature in terms of operating time (mean 1 h 45 min), blood loss ( hospital stay ( < 48 h). Conclusion; Retroperitoneal laparoscopic excision is asafe, simple and effective method in the management of symptomatic ureteric stumps.

关键词： ureter laparoscopy retroperitoneal space

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