To evaluate the features of carotid web (CW) by ultrasonography.

A total of 66 patients with CW were retrospectively enrolled from January 2018 to June 2019 at Xuanwu Hospital, Capital Medical University. All patients were examined by both ultrasonography and CTA, and were divided into either a<50% stenosis group (54 cases) or a ≥50% stenosis group (12 cases). The ultrasonographic characteristics of CW, including the length, thickness, direction (forward or backward to the flow), acute angle between the web and carotid wall, and thrombus between the web and carotid wall were compared between the two groups. The stenosis degrees of carotid artery were compared between patients with and without ischemic stroke.

Forty-two (42/66, 63.6%) patients were diagnosed with CW by initial CDFI examination, of whom 21 (21/66, 31.8%) were diagnosed with ulcerative plaque and 3 (3/66, 4.5%) were diagnosed with carotid dissection at first but confirmed by second examination. There were no differences in the web length, thickness, direction, or thrombus detected between the two groups (P>0.05). The angle between the web and carotid wall in the<50% stenosis group was significantly smaller than that of the ≥50% stenosis group (median angel 39o vs 73o, P=0.002), and the percentage of patients with an angle≤ 60o in the<50% stenosis group was significantly higher than that of the ≥50% stenosis group (74.1% vs 41.7%, P=0.042). The diameter of the residual carotid artery at CW location in the<50% stenosis group was significantly larger and peak systolic velocity was significantly higher in the<50% stenosis group than in the≥50% stenosis group (P<0.001). The stenosis degrees of carotid artery were not statistically different between patients with and without ischemic stroke (P=0.321).

Ultrasonography can be used to evaluate the characteristics of carotid web in 2D and color mode. When the angle between the CW and carotid wall is large, the carotid artery stenosis ≥ 50% is more likely to happen, but carotid artery stenosis is not the main cause of ischemic stroke.

The aim of the present study was to evaluate the efficiency of sling exercise, therapeuticultrasound, therapeuticultrasound and sling exercise in patients to alleviate pain and improve lumbar function with lumbar disc herniation.

Individuals were selected from a list of patients being followed at the department of Rehabilitation in the third hospital of Hebei Medical University. 30 patients who were diagnosed with lumbar disc herniation were collected, the diagnoses were established upon medical history, physical examination, and results of imaging studies. The patients were randomly divided into three groups: therapeuticultrasound group received 14 sessions of ultrasonic therapy to the lumbar region, Sling exercise group received 14 sessions of sling exercise, and therapeuticultrasound and sling exercise group received therapeuticultrasound and sling exercise therapy 14 sessions of therapeuticultrasound to the lumbar region,7 sessions per week, 2 weeks. The VAS and ODI were compared with the assessment of the patients before and at the end of the therapy.

At the end of treatment, three groups VAS scores (F=3.069, P=0.043) and ODI scores (t=12.676, P<0.001) was lower than that at the beginning of treatment (P<0.05), at the end of treatment the VAS scores (F=59.400, P<0.001) and of the ODI scores (t=12.737, P<0.001) of ultrasonic and sling exercise therapy group was lower than the other group, the difference is significantly.

All three groups could reduce pain and improve lumbar function, and the ultrasonic and sling exercise therapy was most effective for lumbar disc herniation treatment in the three groups.

To analyze the treatment of different types of traumatic cerebral infarction in children, and explore its pathogenesis in combination with literature so as to improve the cure rate and reduce disability rate.

The clinical data of 42 cases of traumatic cerebral infarction in children were retrospectively analyzed in The Hospital of 81^st Group Army PLA from January 2015 to December 2019. The diagnosis of traumatic cerebral infarction in children was made by CT scan and MRI scan. According to different conditions, children with traumatic cerebral infarction were classified, and different treatment strategies were selected. Children with lacunar infarction were treated with calcium antagonists and neurotrophic drugs, supplemented by hyperbaric oxygen and exercise rehabilitation. The children of focal cerebral infarction and complex cerebral infarction treated by junior dehydrant and hormone also included the calcium antagonist and nutritional nerve drugs. The therapeutic regimen perhaps adjusted by the evolution of the disease. The children of extensive cerebral infarction underwent emergency cranial decompression, and was treated by reducing intracranial pressure and preventing complications after operation. The treatment results and recovery were observed.

In 42 cases of traumatic cerebral infarction in children, 35 cases (83.3%) were good recovery, 4 cases (9.5%) were moderate disability, 2 cases (4.8%) were severe disability, 1 case (2.4%) died, and no vegetative state. The good recovery rate of lacunar infarction was 100%, that of focal cerebral infarction was 62.5%, that of mixed cerebral infarction was 60%, and that of extensive cerebral infarction was 50%.

It is of great significance to improve the therapeutic effect and prognosis of children with traumatic cerebral infarction to adopt different treatment schemes for different types of cerebral infarction.

To characterize the patients with supratentorial hypertensive intracerebral hemorrhage (ICH) in the Tibetan Plateau over an altitude of 4000 meters.

A total of 68 cases with supratentorial hypertensive ICH were retrospectively included in Ali Regional People’s Hospital from January 2017 to September 2018. The clinical and laboratory data were collected. A simple linear correlation analysis was applied to analyze the correlation between the amount of bleeding and sex, age, nationality, time from onset , systolic blood pressure (SBP), diastolic blood pressure (DBP), hemoglobin (Hb), serum triglyceride (TG), and cholesterol. According to computed tomography (CT) findings, 68 cases were divided into the basal ganglia ICH group (33 cases) and the lobar ICH group (35 cases). The characteristics between two groups were analyzed using t-test or χ² test.

The data of sex, age, nationality, time from onset, SBP, DBP, Hb, TG, and cholesterol of 68 cases on admission did not show any definitive correlation with the hematoma volumes (P＞0.05). The SBP and DBP of patients in the basal ganglia ICH group were significantly higher than that in the lobar ICH group, respectively [(184.9±28.5) mmHg vs (164.6±24.4) mmHg; (113.0±18.1) mmHg vs (103.0±18.4) mmHg] (t=0.499, 0.486; P=0.002, 0.033).

The relevant factors of hematoma volumes in patients with ICH in plateau area were not yet clear. Diastolic and systolic blood pressure of patients in the basal ganglia ICH group was higher than that in those in lobar ICH group.

To compare the efficacy evaluation of electrospun composite biomaterials and a porcine small intestine submucosa mesh for hernia repair.

A randomized, single-blind, controlled multicenter trial was performed in 3 hospitals in Shanghai. Eligible adult patients with primary unilateral reducible groin hernias were randomly assigned (1∶1) to electrospun composite biomaterials (experimental group) or porcine small intestine submucosa (control group) mesh groups. Patients were treated with the tARB technique and assessed at 1,3 and 6 months after the surgery. The primary endpoint was hernia recurrence. The secondary endpoints were postoperative complications including groin pain and operative site infections.

172 patients were assigned to experimental (n=86) and control (n=86) groups. At 6 months follow-up, postoperative complications occurred in 5 patients (5/86, 5.95%) and 2 (2/86, 2.35%) patients in the control and experimental groups, respectively (P>0.05). There was no significant difference in VAS or SVS score between the two groups.

We demonstrate that electrospun composite biomaterial mesh can be used as a ideal choice for inguinal hernia repair. Electrospun composite biomaterial has the characteristics of low recurrence rate, absorbability and long-term comfort.It can be further applied in clinical practice in the future.

Pancreaticoduodenectomy(PD)remains one of the most complicated hepatobiliary operations. The development of minimally invasive surgery for PD has always been an hot spot. Laparoscopic pancreaticoduodenectomy(LPD) has not been widespread carried out due to its difficulty and long learning curve. LPD accounts for 9% of all PD, according to the National Cancer Data base. Compared with laparoscopic surgery, robotic surgery system has significant advantages in the field of minimally invasive PD, including stereotactic amplified vision, filtering hand tremor and simulating the wrist. The article would review the surgical techniques and notes, which could provide clinical reference for other surgeons.

To investigate the application value of donor-site perfusion via turbocharging in immediate deep inferior epigastric perforator (DIEP) flap breast reconstruction following breast cancer surgery.

A retrospective analysis was conducted on the clinical data of 12 female patients with breast cancer who underwent nipple-sparing mastectomy followed by immediate DIEP flap breast reconstruction perfused by turbocharging (turbocharged DIEP) in the Shenzhen Hospital of Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College between January 2024 and December 2025. There were 3 cases of stage Ⅰ, 8 cases of stage Ⅱ and 1 case of stage Ⅲ. Preoperative computed tomography angiography (CTA) was performed in all patients to accurately locate the number and anatomical positions of DIEP. The number of donor perforator vessels, the diameters of arteries and veins, and the number of vessels used for turbocharging anastomosis were systematically recorded during surgery. Postoperative follow-up was conducted to assess flap survival rate and the incidence of complications, and the BREAST-Q Questionnaire was used to quantitatively evaluate patient satisfaction with reconstructed breast appearance and functional recovery of the donor and recipient sites.

Double-pedicle DIEP flap transplantation was successfully performed in all 12 patients. The flap harvest area ranged from 12.0 cm×24.0 cm to 14.0 cm×30.0 cm, with an average weight of (759.17±99.91) g and operative time of (487.67±97.21) min. Intraoperative anatomical dissection identified 3 perforator vessels in 8 cases and 4 perforator vessels in 4 cases; among them, single-artery turbocharging was used in 8 cases and double-artery turbocharging in 4 cases. The diameter of turbocharged arteries was (0.75±0.19) mm, and the venous diameter was (0.94±0.12) mm. All patients were followed up for 3.0-14.5 months with a median follow-up of 6.3 months. All transplanted flaps survived completely, with no perioperative complications such as flap necrosis, hematoma or infection. The mean BREAST-Q score was (91.83±2.52), indicating high patient satisfaction with the appearance of reconstructed breasts and the functional recovery of donor and recipient sites. No local recurrence or distant metastasis occurred during the follow-up period.

Under strict patient selection, turbocharged-DIEP breast reconstruction has good safety, feasibility and aesthetic effects, which can be used for immediate breast reconstruction after breast cancer surgery.

To evaluate the feasibility and short-term safety of domestic single-port snake-arm robot in transaxillary robot-assisted nipple-sparing mastectomy combined with immediate prepectoral implant breast reconstruction (rNSM+IBR) .

A prospective study enrolled on the clinical data of 23 breast cancer patients who underwent rNSM+IBR from March 2025 to April 2026, including 9 patients in the Huashan Hospital, Fudan University and 14 patients in the International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine. The following parameters were recorded: pathological findings, surgical procedures, operative duration, and perioperative complications.Primary endpoints were surgical feasibility and early postoperative safety;secondary outcomes included operative parameters, postoperative recovery, and learning-curve characteristics. The cumulative sum (CUSUM) curve was adopted to characterize the surgeon's learning curve.

All 23 patients successfully completed the procedure via transaxillary incision, without conversion to open surgery or additional incisions. The operative time was 260 (170, 290) min. No Clavien-Dindo grade Ⅲ or higher complications occurred within 30 days postoperatively. No skin flap necrosis, nipple-areolar complex necrosis, severe infection, or prosthetic displacement was observed. Operative time decreased with experience, and the CUSUM analysis confirmed a stable learning curve within 10 cases.

The use of domestic single-port snake-arm robot is feasible and safe for transaxillary rNSM+IBR, with favorable perioperative profiles and a manageable learning curve.

To explore the efficacy of indocyanine green (ICG) fluorescence navigation for assessing the pedicled omental flap in endoscopic breast-conserving plastic surgery.

A retrospective analysis was performed on the clinical data of 70 breast cancer patients who underwent endoscopic breast-conserving plastic surgery with a pedicled omental flap at the Department of Breast Surgery, Zhujiang Hospital of Southern Medical University between August 2021 and August 2025. The patients were divided into the ICG group (35 patients) and the control group (35 patients) based on whether ICG fluorescence guidance was used during surgery. The control group comprised 35 patients treated between August 2021 and May 2024, in whom flap perfusion was assessed intraoperatively by the surgeon's naked-eye observation alone, without imaging guidance. The ICG group comprised 35 patients treated between June 2024 and August 2025, who received preoperative intravenous ICG injection and intraoperative fluorescence endoscopy employed for real-time visualization of the omental vascular anatomy and blood flow patterns to precisely guide the resection of the omental flap. The operative time, postoperative hospital stay, incidence of upper abdominal discomfort at 3 days postoperatively, incidence of omental flap necrosis at 2 weeks postoperatively, incidence of omental flap sclerosis at 1 month postoperatively, and breast aesthetic outcome at 3 months postoperatively were compared between the two groups. Breast aesthetic outcomes were evaluated at 3 months postoperatively using the Harris criteria. Continuous variables were analyzed using the independent samples t-test or Mann-Whitney U test; categorical variables were analyzed using the χ² test or Fisher's exact test; multivariate logistic regression was employed to adjust for confounding factors.

There were no statistically significant differences in baseline characteristics between the two groups (all P>0.05), except for N-stage. Surgery was completed successfully in both groups. Compared with the control group, the operative time was significantly shorter in the ICG group [(343.89±83.84) min vs (274.57±79.75) min, t=−3.544, P=0.001], and the postoperative hospital stay was significantly reduced [(8.97±2.15) d vs (6.74±0.74) d, t=−5.801, P<0.001]. The ICG group also showed significantly lower incidences of upper abdominal discomfort (CTCAE ≥ grade 2) at 3 days postoperatively (14.29% vs 51.43%, χ²=10.944, P=0.001) and omental flap sclerosis at postoperative one month (22.86% vs 60.00%, χ²=9.950, P=0.002) compared with the control group. No significant difference was observed in the incidence of omental flap necrosis at 2 weeks postoperatively (5.71% vs 0, P=0.235). Multivariate logistic regression analysis identified ICG fluorescence navigation as an independent protective factor against upper abdominal discomfort (adjusted OR=0.156, 95%CI: 0.047-0.521, P=0.003) and omental flap sclerosis (adjusted OR=0.171, 95%CI: 0.056-0.527, P=0.002). At 3 months postoperatively, breast aesthetic outcomes evaluated by the Harris criteria were excellent in all 35 patients (100%) in the ICG group, compared with 29 excellent (82.86%), 4 good (11.43%), and 2 fair (5.71%) in the control group, indicating superior outcomes in the ICG group (Z=-2.541, P=0.011).

ICG fluorescence navigation provides real-time, intuitive imaging guidance for assessing omental flap perfusion during endoscopic breast-conserving oncoplastic surgery with a pedicled omental flap. It can shorten operative time, reduce perioperative complications, and improve postoperative breast aesthetic outcomes, demonstrating favorable clinical application value.

To explore the application value of the Yokohama reporting system in rapid on-site evaluation (ROSE) of touch imprints from core-needle biopsy (CNB) of breast masses, and to evaluate the clinical significance of patient triage management based on ROSE classification according to this reporting system.

According to the inclusion and exclusion criteria, the data of 1 475 patients who underwent ultrasound-guided CNB for breast masses at the Baoji Central Hospital from January 2024 to December 2025 were enrolled in this prospective study. Touch imprints were simultaneously prepared from biopsy specimens for ROSE. ROSE interpretation was performed with the Yokohama reporting system by the International Academy of Cytology as the classification standard, and the results were divided into benign lesion, atypical lesion, suspicious for malignancy and malignant tumour. Using histological diagnosis as the gold standard, the concordance between ROSE classification results based on the Yokohama reporting system and histological diagnosis was compared and analysed. The Kappa consistency test was adopted to evaluate the diagnostic efficacy of ROSE for breast masses, and patient triage was guided according to the classification results.

Among the 1 475 specimens, ROSE classifications based on the Yokohama reporting system showed 770 benign lesions, 74 atypical lesions, 43 suspicious malignancies and 588 malignant tumours. The diagnostic accuracy compared with histological diagnosis was 99.5% (766/770), 55.4% (41/74), 93.0% (40/43) and 100% (588/588), respectively. The sensitivity, specificity and overall accuracy of ROSE classification based on the Yokohama reporting system against the histopathological gold standard were 94.58% (628/664), 99.63% (808/811) and 97.36% (1 436/1 475), respectively. The positive predictive value and negative predictive value were 99.52% (628/631) and 95.73% (808/844). The ROSE classification of breast masses had good consistency with histological diagnosis (κ=0.946, P<0.05). All 770 patients with ROSE classification of benign lesion received day-case surgery. Intraoperative frozen pathology revealed 3 cases of malignancy and 1 case of desmoid fibromatosis, for which extended surgery was subsequently performed. The remaining 766 patients consistent with ROSE results were discharged on the next day. Patients with ROSE results of atypical lesion, suspicious malignancy and malignant tumour waited for the final histological report on the following day. Patients with histologically confirmed benign lesions underwent minimally invasive surgery; patients with borderline tumours received extended surgery; patients with malignant tumours received neoadjuvant therapy, modified radical mastectomy or breast-conserving surgery.

The Yokohama reporting system can be applied to ROSE of touch imprints from CNB of breast masses. The categories of benign lesion, suspicious malignancy and malignant tumour demonstrate high concordance with histological diagnosis. This system exhibits high diagnostic efficacy in evaluating the nature of breast masses and helps optimise the diagnosis and treatment workflow for patients with breast masses.

To compare the effects of totally implantable venous access port (TIVAP) and peripherally inserted central catheter (PICC) on the quality of life in breast cancer patients undergoing chemotherapy, and analyze the overall satisfaction, psychosocial status, and procedural pain.

A retrospective cohort study was conducted, enrolling 153 breast cancer patients who received chemotherapy in the Fourth People's Hospital of Sichuan Province between March 2023 and August 2024. Patients were divided into the TIVAP group (n=91) and the PICC group (n=62) based on catheter type. Baseline characteristics, catheter-related parameters and complication rates were recorded and the quality of life was assessed via the Quality of Life Assessment for Venous Devices (QLAVD) questionnaire. For between-group comparisons, independent samples t test was used for normally distributed continuous variables, and χ² test or Fisher's exact test was used for unpaired categorical variables.

The TIVAP group demonstrated significantly higher overall satisfaction scores than the PICC group (8.99±0.97 vs 7.85±1.38, t=5.603, P<0.001). After adjusting for age, BMI, chemotherapy type, and chemotherapy cycle using multiple linear regression, the between-group difference remained statistically significant (β=-1.354, 95%CI: -1.788 to -0.921, P<0.001). Regarding psychosocial dimensions, the TIVAP group showed significantly lower proportions of patients affected in terms of clothing adaptability (17.6% vs 67.7%, χ²=39.417, P<0.001), daily showering (11.0% vs 59.7%, χ²=41.074, P<0.001), and exercise (18.7% vs 41.9%, χ²=9.869, P=0.002). Additionally, fewer patients in the TIVAP group reported appearance-related distress (13.2% vs 27.4%, χ²=4.863, P=0.027) and unwanted attention from others (12.1% vs 33.9%, χ²=10.579, P=0.001). However, TIVAP insertion was associated with greater procedural pain (2.99±1.08 vs 1.74±1.07, t=7.037, P<0.001). The overall complication rate in the TIVAP group was significantly lower than that in the PICC group (3.3% vs 16.1%, χ²=7.810, P=0.005).

For breast cancer patients receiving chemotherapy, TIVAP offers distinct advantages in improving quality of life and reducing complications; although the insertion procedure is more painful, overall acceptance is higher.

乳腺癌不同分子分型在激素依赖、HER-2信号、干性维持和微环境依赖方面存在差异，这些差异会影响类器官的形成、扩增和表型稳定。患者来源乳腺癌类器官可保留部分来源肿瘤的组织结构、受体状态和药物反应，已被用于机制研究、药物筛选和治疗反应评估。本文围绕Luminal型、HER-2阳性型和三阴性乳腺癌的培养需求，归纳不同分子分型乳腺癌类器官的建模难点、质控指标和优化方向，并分析样本代表性、微环境缺失和标准化不足对后续应用的影响。

To explore the clinical application value of a novel domestic peroral cholangioscopy in the diagnosis of intraductal papillary neoplasms of the bile duct (IPNB).

A retrospective analysis was performed on the clinical data of 12 patients diagnosed with intraductal papillary neoplasm of the bile duct (IPNB) who underwent domestic peroral cholangioscopy between January 2020 and December 2025, including 11 patients from the Digestive Endoscopy Center of Jiangsu Provincial Hospital of Chinese Medicine and 1 patient from Nanjing Drum Tower Hospital..Abdominal imaging examinations (CT/MRI) revealed biliary duct dilation or space-occupying lesions in all patients. All patients further received ERCP combined with domestic peroral cholangioscopy.Endoscopic manifestations, biopsy pathological results and complications were recorded.

Among the 12 patients, there were 5 males and 7 females, aged 55 to 84 years old with an average age of (67.9±8.9) years.The main clinical manifestations included right upper abdominal pain (7 cases), right upper abdominal pain complicated with fever (4 cases), jaundice (1 case).Imaging examinations all indicated intrahepatic and/or extrahepatic bile duct dilation, among which filling defects or soft tissue shadows in the bile duct were observed in 6 cases. The morphological findings under peroral cholangioscopy were fish-egg-like lesions (4 cases), papillary lesions (5 cases) and waterweed-like lesions (2 cases), with mucus secretion identified in 8 patients.Lesions were located in hilar bile duct (5 cases), left hepatic duct (2 cases), right hepatic duct (1 case), hilar combined with left hepatic duct (1 case), upper segment and lower segment of common bile duct (1 case each), and the lesion site was unclear in 1 case.Endoscopic biopsy was performed in 10 patients.Pathological diagnoses included IPNB with carcinogenesis (2 cases), IPNB with high-grade intraepithelial neoplasia (2 cases), IPNB with low-grade intraepithelial neoplasia (3 cases), simple IPNB (1 case), chronic mucosal inflammation (2 cases), and no biopsy was conducted in 2 cases.No severe complications occurred after cholangioscopy.Two patients developed hyperamylasemia and one patient suffered from biliary tract infection, all of whom recovered within 48 hours.

Domestic peroral cholangioscopy can directly observe the morphological characteristics of intraductal biliary lesions, and can achieve accurate diagnosis of IPNB combined with biopsy pathology. It features favorable safety and possesses important clinical application value.

To explore the efficacy of radiofrequency ablation combined with biliary endoscopy in treating restenosis after metal stent implantation for malignant biliary obstruction.

A total of 100 patients with restenosis after metal stent implantation for malignant biliary obstruction admitted to the Department of Endoscopic Surgery, Cangzhou Central Hospital of Hebei Province from January 2021 to December 2022 were enrolled as research subjects.Patients were divided into combination group and control group according to treatment regimens, with 50 cases in each group.The combination group received radiofrequency ablation combined with cholangioscopy-guided debridement and stent recanalization, while the control group underwent conventional balloon dilation and stent recanalization.Observation indicators: Primary outcome: clinical success rate; Secondary outcomes: technical success rate; stent patency rate; incidence of adverse events; perioperative indicators.This is a retrospective observational non-randomized study.Baseline balance was achieved only at the statistical level, and selection bias may still exist.

Compared with the control group, the operation time of the combined group was longer and the intraoperative blood loss was lower, and the difference was statistically significant (P<0.05); there were no statistically significant differences in gender, age, body mass index, jaundice duration, Child-Pugh classification, obstruction site, surgical success rate, hospital stay, tumor type, stent diameter, and stent length between the two groups (P>0.05); Compared with the control group, the biliary tract patency rate at 3 months (94%) and 6 months (86%) after surgery in the combined group increased, and the difference was statistically significant (P<0.05), while the patency rate at 1 month after surgery was not statistically significant between the two groups (P>0.05); The complication rate of the control group was 16%, and that of the combined group was 4%, and the difference was statistically significant (P<0.05); The total effective rate of treatment in the control group was 76%, and that in the combined group was 92%, and the difference was statistically significant (P<0.05).

This study only reflects the true clinical effect differences between the two complete clinical intervention schemes.Due to the confounding effect of the dual intervention of biliary endoscopy and radiofrequency ablation, it cannot be determined that the therapeutic advantage is solely caused by radiofrequency ablation alone.The combined radiofrequency ablation and biliary endoscopy direct vision scheme performs better in increasing the overall clinical effectiveness rate and prolonging the biliary patency time, and does not increase the risk of complications, and thus has clinical reference value.

To explore the associations between lesion severity and lesion location, prior treatment history of achalasia (AC) in patients with AC combined with esophageal neoplastic lesions, and provide evidence for risk stratification and endoscopic surveillance of AC patients.

A single-center retrospective study enrolled patients diagnosed with AC combined with esophageal neoplastic lesions hospitalized in Chinese PLA General Hospital from January 2014 to December 2023.Patients were divided into prior AC treatment group and non-prior AC treatment group based on whether AC intervention was performed before lesion detection.Esophageal lesions were dichotomized into low-grade lesions (low-grade intraepithelial neoplasia, LGIN) and high-grade/invasive lesions(high-grade intraepithelial neoplasia HGIN/Tis+ invasive esophageal cancer).Fisher′s exact test was used to compare categorical variables; independent sampletest or Mann-Whitney U test was adopted for measurement data according to data distribution.Two-sided P<0.05 indicated exploratory statistically significant difference.

A total of 18 eligible patients were enrolled, including 5 cases of LGIN, 2 cases of HGIN/Tis, and 11 cases of invasive esophageal cancer. Nine patients had received AC intervention (prior AC treatment group), and 9 had no AC treatment history (non-prior AC treatment group).Lesions in prior AC treatment group were predominantly located in the lower esophagus (77.8%), including 5 LGIN and 4 HGIN/Tis or invasive cancer.Lesions in non-prior AC treatment group mostly occurred in the middle esophagus (66.7%), all presented as HGIN/Tis or invasive esophageal cancer with an esophageal dilatation rate of 88.9%.Distribution differences between groups: lesion location Fisher P=0.036, prior AC treatment Fisher P=0.029, esophageal dilatation Fisher P=0.099.No obvious distribution difference was observed between dysphagia duration and lesion severity.

Exploratory distribution differences exist between lesion severity and lesion location, prior AC treatment history in AC patients with esophageal neoplastic lesions. Lesions in lower esophagus or patients with AC intervention history are mostly low-grade intraepithelial neoplasia, while patients with middle esophageal lesions and without AC treatment are prone to high-grade and invasive lesions.Long-term endoscopic surveillance is recommended for AC patients with long disease duration, middle esophageal mucosal abnormalities, advanced age, male gender and alcohol drinking history.

To explore the application value of imaging examinations and digestive endoscopy in the diagnosis and treatment of gastrointestinal foreign body in children, especially in complicated cases with unclear history and protracted course.

Two cases of esophageal stenosis in children with dysphagia and no clear history of foreign body ingestion were reported, and the diagnosis and treatment process was shared.The specific application of imaging and endoscopic techniques in diagnosis and treatment was analyzed, providing ideas for clinical diagnosis and treatment.

Both cases were ultimately diagnosed with esophageal foreign bodies via electronic gastroscopy, which revealed impacted foreign bodies at the stricture sites (the parents later recalled histories of foreign body ingestion over 6 months and 2 years prior, respectively).Both children underwent endoscopic foreign body removal in the operating room.Intraoperatively, hook knives were used for gradual radial incisions, and snare devices were employed to piecemeal resect locally hyperplastic granulation tissue.After dissection and exposure of the foreign bodies, they were successfully removed using foreign body forceps combined with guidewires.In Case 1, esophageal perforation and pneumothorax were detected during the procedure, and closed thoracic drainage with placement of a covered retrievable esophageal stent was performed for perforation sealing.In Case 2, esophageal perforation and ulceration were complicated, and a nasogastric feeding tube along with an esophageal drainage tube was inserted. Postoperatively, both patients received regular endoscopic treatment for secondary esophageal strictures.To date, both patients are able to eat normally via the oral route and show satisfactory growth and development.

Esophageal foreign body impaction is a common cause of acquired esophageal stenosis in children.For cases with unclear history of foreign body ingestion, long time of impaction, and high risk of complications, attention should be paid to the detailed evaluation of imaging and digestive endoscopy to obtain key diagnostic clues and assist in making the optimal treatment decision.Multidisciplinary preoperative evaluation and precise endoscopic operation during surgery can help effectively deal with complications and avoid unnecessary surgical operations.At the same time, public health education should be strengthened to raise awareness of gastrointestinal foreign bodies in children and promote early diagnosis and treatment.

To systematically summarize the risk factors for hypoxemia and related adverse events in older patients undergoing gastrointestinal endoscopy under sedation or anesthesia, and to provide evidence for preprocedural risk stratification and perioperative prevention.

A systematic review was conducted in accordance with PRISMA 2020. PubMed, Web of Science, Cochrane Library, Embase, CINAHL, and major Chinese databases were searched from inception to August 23, 2026. Observational studies reporting extractable data on risk factors were included. Study quality was assessed using the Newcastle-Ottawa Scale (NOS), and meta-analysis was performed with RevMan 5.3.

Ten studies involving a total of 8, 284 participants were included, with NOS scores ranging from 7 to 9. Pooled analyses showed that advanced age (OR=2.99), higher body mass index (BMI; OR=3.54), hypertension (OR=1.73), a history of smoking (OR=2.58), and a history of alcohol consumption (OR=1.41) were associated with an increased risk of the outcome. Pulmonary disease/chronic obstructive pulmonary disease (COPD; RR=2.41), a history of snoring (OR=3.53), and higher American Society of Anesthesiologists (ASA) physical status (OR=3.11) were also significantly associated with increased risk. Sex (OR=1.17, P=0.07) and diabetes mellitus (random-effects OR=1.30, P=0.16) were not significantly associated with the outcome.

Current evidence suggests that advanced age, higher BMI, a history of snoring, hypertension, smoking, alcohol consumption, pulmonary disease/COPD, and higher ASA physical status may increase the risk of hypoxemia or related adverse events during gastrointestinal endoscopy under sedation or anesthesia in older patients. These factors should be considered in preprocedural assessment and individualized oxygenation and airway-management strategies. Because some included studies used composite adverse-event outcomes and several risk factors showed substantial heterogeneity, these findings require further confirmation in high-quality prospective studies.

Acute biliary pancreatitis (ABP) is a major type of acute pancreatitis in China, with high incidence and rapid progression.Improper management can lead to severe complications. Endoscopic retrograde cholangiopancreatography (ERCP) is a primary therapeutic approach for ABP.It enables the management of intrahepatic and extrahepatic bile duct stones, thereby reducing the occurrence of ABP and improving patient outcomes.This review elaborates on the current application of ERCP in ABP, including the indications, optimal timing for intervention, and associated complications.