Rapid Endoscopic Diagnosis of Benign Ulcerative Colorectal Diseases With an Artificial Intelligence Contextual Framework.

BACKGROUND & AIMS: Benign ulcerative colorectal diseases (UCDs) such as ulcerative colitis, Crohn's disease, ischemic colitis, and intestinal tuberculosis share similar phenotypes with different etiologies and treatment strategies. To accurately diagnose closely related diseases like UCDs, we hypothesize that contextual learning is critical in enhancing the ability of the artificial intelligence models to differentiate the subtle differences in lesions amidst the vastly divergent spatial contexts. METHODS: White-light colonoscopy datasets of patients with confirmed UCDs and healthy controls were retrospectively collected. We developed a Multiclass Contextual Classification (MCC) model that can differentiate among the mentioned UCDs and healthy controls by incorporating the tissue object contexts surrounding the individual lesion region in a scene and spatial information from other endoscopic frames (video-level) into a unified framework. Internal and external datasets were used to validate the model's performance. RESULTS: Training datasets included 762 patients, and the internal and external testing cohorts included 257 patients and 293 patients, respectively. Our MCC model provided a rapid reference diagnosis on internal test sets with a high averaged area under the receiver operating characteristic curve (image-level: 0.950 and video-level: 0.973) and balanced accuracy (image-level: 76.1% and video-level: 80.8%), which was superior to junior endoscopists (accuracy: 71.8%, P < .0001) and similar to experts (accuracy: 79.7%, P = .732). The MCC model achieved an area under the receiver operating characteristic curve of 0.988 and balanced accuracy of 85.8% using external testing datasets. CONCLUSIONS: These results enable this model to fit in the routine endoscopic workflow, and the contextual framework to be adopted for diagnosing other closely related diseases.

Expression and immune infiltration studies of IL-33-ST2-NF-κB signaling pathway in prostate cancer.

BACKGROUND: To analyze the expression of interleukin-33 (IL-33), growth-stimulated expression gene 2 (ST2), nuclear factor-kappaB (NF-κB) and immune cell infiltration in prostate cancer, this study aims to provide an experimental basis for the clinical prevention and treatment of prostate cancer. METHODS: The expression of IL-33 in PCa tissues was analyzed using TCGA, TIMER and HPA databases. Using the UALCAN database, the systematic exploration of the relationship between IL-33 and various clinicopathological parameters was conducted. The correlation between IL-33 expression and immune cell infiltration was investigated using TIMER, CIBERSORT and GEPIA databases. To verify these analyses, 22 cases of normal prostate (NP), 76 cases of benign prostatic hyperplasia (BPH), and 100 cases of PCa were recruited. Immunohistochemical staining was performed to examine the expression of IL-33, ST2, NF-κB, and the infiltration of immune cells. Correlations between these factors were then determined. RESULTS: The expression of IL-33, ST2 and NF-κB was significantly lower in PCa tissues compared with NP (p < 0.05). IL-33 was not associated with age in PCa but showed associations with race, molecular characteristics, lymph node metastatic status, TP53 mutation and tumor grade. Furthermore, IL-33 was associated with immune cell infiltration. Positive correlations were observed between IL-33 and ST2 expressions, as well as between IL-33 and CD68+ macrophages in BPH and PCa. CONCLUSIONS: IL-33, ST2 and NF-κB are lowly expressed in PCa tissues, their expression decreases with the increasing malignancy of cancer. IL-33, ST2 and NF-κB are factors associated with PCa immune infiltration. IL-33 has an inhibitory effect on prostate cancer through the IL-33/ST2/NF-κB signalling pathway.

Integrated transcriptomic and metabolomic analyses elucidate the mechanism of flavonoid biosynthesis in the regulation of mulberry seed germination under salt stress.

Seed propagation is the main method of mulberry expansion in China, an important economic forest species. However, seed germination is the most sensitive stage to various abiotic stresses, especially salinity stress. To reveal the molecular regulatory mechanism of mulberry seed germination under salt stress, flavonoid metabolomics and transcriptomics analyses were performed on mulberry seeds germinated under 50 and 100 mmol/L NaCl stress. Analysis of the flavonoid metabolome revealed that a total of 145 differential flavonoid metabolites (DFMs) were classified into 9 groups, 40 flavonols, 32 flavones, 16 chalcones and 14 flavanones. Among them, 61.4% (89) of the DFMs accumulated continuously with increasing salt concentration, reaching the highest level at a 100 mmol/L salt concentration; these DFMs included quercetin-3-O-glucoside (isoquercitrin), kaempferol (3,5,7,4'-tetrahydroxyflavone), quercetin-7-O-glucoside, taxifolin (dihydroquercetin) and apigenin (4',5,7-trihydroxyflavone), indicating that these flavonoids may be key metabolites involved in the response to salt stress. Transcriptional analysis identified a total of 3055 differentially expressed genes (DEGs), most of which were enriched in flavonoid biosynthesis (ko00941), phenylpropanoid biosynthesis (ko00940) and biosynthesis of secondary metabolites (ko01110). Combined analysis of flavonoid metabolomic and transcriptomic data indicated that phenylalanine ammonia-lyase (PAL), 4-coumarate-CoA ligase (4CL), chalcone synthase (CHS), flavonol synthase (FLS), bifunctional dihydroflavonol 4-reductase/flavanone 4-reductase (DFR) and anthocyanidin reductase (ANR) were the key genes involved in flavonoid accumulation during mulberry seed germination under 50 and 100 mmol/L NaCl stress. In addition, three transcription factors, MYB, bHLH and NAC, were involved in the regulation of flavonoid accumulation under salt stress. The results of quantitative real-time PCR (qRT‒PCR) validation showed that the expression levels of 11 DEGs, including 7 genes involved in flavonoid biosynthesis, under different salt concentrations were consistent with the transcriptomic data, and parallel reaction monitoring (PRM) results showed that the expression levels of 6 key enzymes (proteins) involved in flavonoid synthesis were consistent with the accumulation of flavonoids. This study provides a new perspective for investigating the regulatory role of flavonoid biosynthesis in the regulation of mulberry seed germination under salt stress at different concentrations.

MXene enhanced reduced graphene oxide aerogel for high-performance supercapacitors.

Three-dimensional (3D) reduced graphene oxide (rGO)/Ti2CTx MXene hybrid aerogels were effectively prepared by a two-step method involving hydrothermal reaction and freeze-drying. The intimately coupled rGO/Ti2CTx hybrid aerogel combined high electrical conductivity, large interlayer spacing, and excellent mechanical stability of Ti2CTx, which not only effectively prevents the self-restacking of Ti2CTx nanosheets, exposes more active sites exposed, and improves the volume change during the charge/discharge process but also increases the accessibility of ions and promotes the rapid transfer of ions/electrons. As a result, rGO/Ti2CTx 17.5-2.5 as the working electrode of electric double layer capacitors delivers a large specific capacity (107.05 F g-1 at 0.5 A g-1 in a 1M Na2SO4 electrolyte), a high rate capability (maintains 30% of its initial capacitance at 10 A g-1, which is much better than rGO and Ti2CTx), and excellent long-term large-current cycle stability (the initial capacitance remains above 71.1% after 10 000 cycles at 1 A g-1). In addition to providing a high-performance electrode for supercapacitors, this study proposes an efficient and time-saving strategy for constructing 3D structures from 2D materials.

A phase III randomized, double-blind, placebo-controlled trial of the denosumab biosimilar QL1206 in postmenopausal Chinese women with osteoporosis and high fracture risk.

The current study evaluated the efficacy and safety of a denosumab biosimilar, QL1206 (60 mg), compared to placebo in postmenopausal Chinese women with osteoporosis and high fracture risk. At 31 study centers in China, a total of 455 postmenopausal women with osteoporosis and high fracture risk were randomly assigned to receive QL1206 (60 mg subcutaneously every 6 months) or placebo. From baseline to the 12-month follow-up, the participants who received QL1206 showed significantly increased bone mineral density (BMD) values (mean difference and 95% CI) in the lumbar spine: 4.780% (3.880%, 5.681%), total hip :3.930% (3.136%, 4.725%), femoral neck 2.733% (1.877%, 3.589%) and trochanter: 4.058% (2.791%, 5.325%) compared with the participants who received the placebo. In addition, QL1206 injection significantly decreased the serum levels of C-terminal crosslinked telopeptides of type 1 collagen (CTX): -77.352% (-87.080%, -66.844%), and N-terminal procollagen of type l collagen (P1NP): -50.867% (-57.184%, -45.217%) compared with the placebo over the period from baseline to 12 months. No new or unexpected adverse events were observed. We concluded that compared with placebo, QL1206 effectively increased the BMD of the lumbar spine, total hip, femoral neck and trochanter in postmenopausal Chinese women with osteoporosis and rapidly decreased bone turnover markers. This study demonstrated that QL1206 has beneficial effects on postmenopausal Chinese women with osteoporosis and high fracture risk.

Evaluation of a novel disposable esophagogastroduodenoscopy system in emergency, bedside, and intraoperative settings: Pilot study (with videos).

OBJECTIVES: The disposable esophagogastroduodenoscopy (EGD) system is a novel endoscopic device which is highly portable and is designed to eliminate the risk of cross-infection caused by reusable EGD. This study aimed to investigate the feasibility and safety of disposable EGD in emergency, bedside, and intraoperative settings. METHODS: This was a prospective, single-center, noncomparative study. Disposable EGD was used for emergency, bedside, and intraoperative endoscopies in 30 patients. The primary end-point was the technical success rate of the disposable EGD. Secondary end-points included technical performance indicators including clinical operability, image quality score, procedure time, the incidence of device malfunction and/or failure, and the incidence of adverse events. RESULTS: A total of 30 patients underwent diagnosis and/or treatment with disposable EGD. Therapeutic EGD was performed on 13/30 patients, including hemostasis (n = 3), foreign body retrieval (n = 6), nasoenteric tube placement (n = 3), and percutaneous endoscopic gastrostomy (n = 1). The technical success rate was 100%: all procedures and indicated interventions were completed without changing to a conventional upper endoscope. The mean image quality score obtained immediately after procedure completion was 3.72 ± 0.56. The mean (± SD) procedure time was 7.4 (± 7.6) min. There were no device malfunctions or failures, device-related adverse events, or overall adverse events. CONCLUSION: The disposable EGD may be a feasible alternative to the traditional EGD in emergency, bedside, and intraoperative settings. Preliminary data show that it is a safe and effective tool for diagnosis and treatment in emergency and bedside upper gastrointestinal cases. TRIAL REGISTRATION: Chinese Clinical Trial Registry (Trial ID: ChiCTR2100051452, https://www.chictr.org.cn/showprojen.aspx?proj=134284).

An Efficient Virtual Machine Consolidation Algorithm for Cloud Computing.

With the rapid development of integration in blockchain and IoT, virtual machine consolidation (VMC) has become a heated topic because it can effectively improve the energy efficiency and service quality of cloud computing in the blockchain. The current VMC algorithm is not effective enough because it does not regard the load of the virtual machine (VM) as an analyzed time series. Therefore, we proposed a VMC algorithm based on load forecast to improve efficiency. First, we proposed a migration VM selection strategy based on load increment prediction called LIP. Combined with the current load and load increment, this strategy can effectively improve the accuracy of selecting VM from the overloaded physical machines (PMs). Then, we proposed a VM migration point selection strategy based on the load sequence prediction called SIR. We merged VMs with complementary load series into the same PM, effectively improving the stability of the PM load, thereby reducing the service level agreement violation (SLAV) and the number of VM migrations due to the resource competition of the PM. Finally, we proposed a better virtual machine consolidation (VMC) algorithm based on the load prediction of LIP and SIR. The experimental results show that our VMC algorithm can effectively improve energy efficiency.

MLD: An Intelligent Memory Leak Detection Scheme Based on Defect Modes in Software.

With the expansion of the scale and complexity of multimedia software, the detection of software defects has become a research hotspot. Because of the large scale of the existing software code, the efficiency and accuracy of the existing software defect detection algorithms are relatively low. We propose an intelligent memory leak detection scheme MLD based on defect modes in software. Based on the analysis of existing memory leak defect modes, we summarize memory operation behaviors (allocation, release and transfer) and present a state machine model. We employ a fuzzy matching algorithm based on regular expression to determine the memory operation behaviors and then analyze the change in the state machine to assess the vulnerability in the source code. To improve the efficiency of detection and solve the problem of repeated detection at the function call point, we propose a function summary method for memory operation behaviors. The experimental results demonstrate that the method we proposed has high detection speed and accuracy. The algorithm we proposed can identify the defects of the software, reduce the risk of being attacked to ensure safe operation.

Random-forest algorithm based biomarkers in predicting prognosis in the patients with hepatocellular carcinoma.

BACKGROUND: Hepatocellular carcinoma (HCC) one of the most common digestive system tumors, threatens the tens of thousands of people with high morbidity and mortality world widely. The purpose of our study was to investigate the related genes of HCC and discover their potential abilities to predict the prognosis of the patients. METHODS: We obtained RNA sequencing data of HCC from The Cancer Genome Atlas (TCGA) database and performed analysis on protein coding genes. Differentially expressed genes (DEGs) were selected. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment were conducted to discover biological functions of DEGs. Protein and protein interaction (PPI) was performed to investigate hub genes. In addition, a method of supervised machine learning, recursive feature elimination (RFE) based on random forest (RF) classifier, was used to screen for significant biomarkers. And the basic experiment was conducted by lab, we constructe a clinical patients' database, and obtained the data and results of immunohistochemistry. RESULTS: We identified five biomarkers with significantly high expression to predict survival risk of the HCC patients. These prognostic biomarkers included SPC25, NUF2, MCM2, BLM and AURKA. We also defined a risk score model with these biomarkers to identify the patients who is in high risk. In our single-center experiment, 95 pairs of clinical samples were used to explore the expression levels of NUF2 and BLM in HCC. Immunohistochemical staining results showed that NUF2 and BLM were significantly up-regulated in immunohistochemical staining. High expression levels of NUF2 and BLM indicated poor prognosis. CONCLUSION: Our investigation provided novel prognostic biomarkers and model in HCC and aimed to improve the understanding of HCC. In the results obtained, we also conducted a part of experiments to verify the theory described earlier, The experimental results did verify our theory.

Physiological and transcriptomic analyses of mulberry (Morus atropurpurea) response to cadmium stress.

Mulberry (Morus atropurpurea) is an economically important woody tree and has great potential for the remediation of heavy metals. To investigate how cadmium accumulates and its detoxification in mulberry, we assessed the physiological and transcriptomic effects of cadmium contamination and as well as its chemical forms and subcellular distribution. Cadmium significantly inhibited mulberry plant growth and primarily accumulated in mulberry roots. Antioxidant enzymes were induced by cadmium in all tissues of mulberry. Subcellular fractionation analyses of cadmium indicated that the majority was compartmentalized in soluble fraction in roots while it mainly located in cell wall in leaves and stems. The greatest amount of the cadmium was integrated with proteins and pectates in all mulberry tissues. RNA-seq transcriptomic analyses of mulberry roots revealed that various metabolic pathways involved in cadmium stress response such as RNA regulation, hormone metabolism, and response to stress, secondary metabolism, as well as signaling, protein metabolism, transport, and cell-wall metabolism. These results will increase our understanding of the molecular mechanisms of cadmium detoxification in mulberry and provide new insights into engineering woody plants for phytoremediation.

[Research advance in gastric neuroendocrine tumors].

Gastric neuroendocrine tumors are rarely seen in the gastric tumors, because there are few case reports and the clinical diagnosis rate is low. There is no consensus treatment method in the world. However, with the benefit of esophagogastrodenoscopy and widespread use of proton pump inhibitors, the diagnostic rate of gastric neuroendocrine tumors is on the increase, which gives us an updated understanding for the pathogenesis and pathophysiology of the disease. By studying its pathogenesis, scholars have found that hypergastrinemia caused by various causes is closely related to its occurrence. Gastric neuroendocrine tumors are classified into different types or pathological grades depending on the state of progression of the disease and the unique clinical manifestations. Clinically used diagnostic methods include gastroscopy, medical imageology, nuclear medicine, gastrin, CgA, etc. There are also differences in treatments depending on the clinical classification. If the disease progresses rapidly and the grade is high, surgical resection of the lesion plus postoperative adjuvant chemotherapy should be actively performed. Other better treatments are still being explored.

[Progress in study on the treatment of gastric cancer with docetaxel].

Gastric cancer is one of the most common malignant gastrointestinal tumors. Docetaxel alone or combination with other drugs can attenuate the progress of disease, prolong the overall response rate and the median overall survival rate in advanced gastric cancer. However, the incidence of toxicities is high. Moreover, there is no uniform standard for dosage and course for docetaxel treatment. Currently, its efficacy is not definite.

Genetic diversity among mulberry genotypes from seven countries.

Mulberry (Morus alba) is an economically and ecologically important, widespread woody plant. It has served human beings for over hundreds of years, and it is still widely used in pharmaceuticals, food industry and farming nowadays. Using modern techniques, deeper understanding in classification and conservation resources of mulberry leads to higher-efficiency hybrids among populations. Genetic polymorphisms among 42 mulberry genotypes from seven countries over Asia and South America were detected using 17 inter simple sequence repeat (ISSR) primers. A dendrogram was constructed using the similarity matrix among genotypes and a principal component analysis (PCA) was carried out to further identify and cluster the mulberry genotypes. In the 42 genotypes, 175 distinct bands were displayed, among which 169 were polymorphic bands (96.57%). The polymorphic information content of 17 ISSR primers ranged from 0.2921 to 0.3746 with the mean of 0.3494. And Nei's index and Shanon's information index averaged 0.116 and 0.174, respectively, indicating low diversity of mulberry. For further study, cluster analysis and PCA were carried out and the results were similar. 42 genotypes were grouped, showing some hybridized combinations. Additionally, a connection between mulberry diseases and their genotypes was noted, which indicates possible application for ISSR in studying disease resistance of mulberry.

[Research progress in epidemiology, diagnosis and treatment for pancreatic cancer].

Pancreatic cancer is a highly lethal disease in gastrointestinal malignant tumors. The mortality of pancreatic cancer closely parallels its incidence. Most patients with pancreatic cancer remain asymptomatic until the disease reaches an advanced stage. There is no program for screening patients at high risk of pancreatic cancer. Although CT, MRI, positron emission tomography, endoscopic ultrasonography, and endoscopic ultrasonography-guided fine-needle aspiration offer high diagnostic ability for pancreatic cancer, it cannot be found at the early stage easily. Surgical resection is regarded as the only potentially curative treatment and adjuvant chemotherapy is given after surgery. This article reviews epidemiology, risk factors, diagnosis and treatment for pancreatic cancer by summarizing relevant literature.

Immune analysis of expression of IL-17 relative ligands and their receptors in bladder cancer: comparison with polyp and cystitis.

BACKGROUND: Bladder cancer, cystitis and bladder polyp are the most common urinary system diseases all over the world. Our former research results show that IL-17A and IL-17 F contribute to the pathogenesis of benign prostatic hyperplasia (BPH) and prostate cancer (Pca) while IL-17E interacting with IL-17RB might have an anti-tumor effect. RESULTS: Using imunohistochemistry, we systemically compared immunoreactivity of ligands (IL-17A, E and F) and receptors (IL-17RA, IL-17RB and IL-17RC) of IL-17 family, infiltration of inflammatory cells and changes of structural cells (fibroblast cells, smooth muscle and vascular endothelial cells) in sections of bladder tissues from subjects with bladder cancer, cystitis and bladder polyp. Compared with subjects with cystitis, immunoreactivity for IL-17A, IL-17 F and IL-17RC was significantly elevated in the group of bladder cancer (p < 0.01), while immunoreactivity of IL-17E, IL-17RA and IL-17RB, and the infiltrating neutrophils were decreased (p < 0.05). The numbers of infiltrating lymphocytes and phagocytes and CD31+ blood vessels and immunoreactivity of CD90+ fibroblasts were also elevated in patients with bladder cancer compared with those of cystitis. The patterns of IL-17 ligands and receptors, and inflammatory cells and structural cells varied in cystitis, bladder polyp and bladder cancer. In bladder cancer, immunoreactivity of IL-17E and IL-17 F was positively correlated with smooth muscles and lymphocytes, respectively. In addition, immunoreactivity of IL-17A and IL-17E was positively correlated with their receptors IL-17RA and IL-17RB respectively. CONCLUSIONS: The data suggest that changed patterns of expression of the IL-17 cytokine family ligands and receptors might be associated with infiltration of inflammatory cells and structural cells (CD90+ fibroblasts and CD31+ blood vessels), which might also contribute to occurrence and development in bladder cancer.

Expression of IL-17A, E, and F and their receptors in human prostatic cancer: Comparison with benign prostatic hyperplasia.

BACKGROUND: Benign prostatic hyperplasia (BPH) and prostate cancer (PCa) are the most common urological diseases in elderly men. Although studies suggest the cytokine family might be associated with BPH and PCa, there has been no systematic comparisons of expression of IL-17A, E, F and their receptors, infiltration of inflammatory cells, and changes in structural cells in PCa and BPH. METHODS: Immunohistochemistry was employed to evaluate immunoreactivity for IL-17A, E, F and their receptors IL-17RA, IL-17BR, and IL-17CR, infiltration of inflammatory cells, and changes in structural cells including endothelial cells, fibroblasts, and smooth muscle cells in prostate tissues from subjects with PCa or BPH as well as controls. RESULTS: Immunostaining showed that expression of immunoreactivity for IL-17A, IL-17RA, IL-17E, and IL-17F was significantly elevated in prostatic tissue from BPH and PCa compared with that in controls, which was accompanied by increased numbers of infiltrating inflammatory cells and CD31(+) blood vessels. Compared with BPH, PCa was characterized by reduced immunoreactivity for IL-17BR and reduced numbers of CD68(+) macrophages, fibroblasts, and smooth muscle cells, although there was a trend for these changes to correlate with disease severity in both PCa and BPH. CONCLUSION: Our data are compatible with hypothesis that IL-17A acting through IL-17RA, but not IL-17CR contribute to the pathogenesis of BPH and PCa. In contrast, IL-17E interacting with the IL-17BR might have an anti-tumor effect.

Phenotypic and Transcriptomic Analyses of Autotetraploid and Diploid Mulberry (Morus alba L.).

Autopolyploid plants and their organs are often larger than their diploid counterparts, which makes them attractive to plant breeders. Mulberry (Morus alba L.) is an important commercial woody plant in many tropical and subtropical areas. In this study, we obtained a series of autotetraploid mulberry plants resulting from a colchicine treatment. To evaluate the effects of genome duplications in mulberry, we compared the phenotypes and transcriptomes of autotetraploid and diploid mulberry trees. In the autotetraploids, the height, breast-height diameter, leaf size, and fruit size were larger than those of diploids. Transcriptome data revealed that of 21,229 expressed genes only 609 (2.87%) were differentially expressed between diploids and autotetraploids. Among them, 30 genes were associated with the biosynthesis and signal transduction of plant hormones, including cytokinin, gibberellins, ethylene, and auxin. In addition, 41 differentially expressed genes were involved in photosynthesis. These results enhance our understanding of the variations that occur in mulberry autotetraploids and will benefit future breeding work.

Phylogenetic analysis of Cyprinus acutidorsalis (Wang, 1979) from the Hainan population using complete mitochondrial genome.

Cyprinus acutidorsalis (Wang, 1979) is an endemic fish in China that is sparsely distributed in the Hainan provinces and Guangxi Zhuang Autonomous Region (GZAR). In this study, the complete mitochondrial genome of C. acutidorsalis from the Hainan population from the Wanquan River was sequenced, and its phylogenetic relationship was analyzed. The circular mtDNA was 16,581 bp in length, and the overall base composition was A (32.0%), C (27.5%), T (24.8%), and G (15.70%), with a slight bias toward A + T. The complete mitogenome encoded 13 protein-coding genes (PCGs), 22 tRNA genes, two rRNA genes, and a control region. Phylogenetic analysis indicated that the most closely related fish to C. acutidorsalis from the Hainan population was C. acutidorsalis from the Guangxi population. These findings offer basic molecular data and a better understanding of the phylogenetic relationships among the Cyprinus species.

Case report: Cervical brachytherapy technique for locally advanced cervical cancer in a patient with complete bicorporeal uterus.

Purpose: The purpose of this study was to describe an approach to cervical brachytherapy for a patient with a complete bicorporeal uterus and locally advanced cervical cancer (LACC). Materials and methods: The patient was a 53-year-old woman with a complete bicorporeal uterus, diagnosed with stage IIB cervical squamous cell carcinoma due to contact bleeding. The patient underwent concurrent chemoradiotherapy (CCRT), external beam pelvic radiotherapy with 45 Gy/25 fractions, and weekly cisplatin (40 mg/m2). Brachytherapy was administered following the completion of external beam radiotherapy. Results: The brachytherapy, which was CT (Computed Tomography)-guided using two CT-compatible tandems and two CT-compatible ovoids, delivered a prescription dose of HRCTV D90 was 6 Gy*5F, which achieved satisfactory dose coverage. The patient's final HRCTV D90 EQD210 was 84.9 Gy, and IRCTV D90 EQD210 was 63.5 Gy. Rectum D2cc EQD23 was 66.03 Gy, bladder D2cc EQD23 was 75.57 Gy, sigmoid D2cc EQD23 was 63.93 Gy, and intestine D2cc EQD23 was 65.86 Gy. Follow-up at 1 year was CR. Conclusions: For patients with cervical cancer and a complete bicorporeal uterus, using double tandems combined with double ovoids is a feasible treatment method to ensure adequate dose coverage without causing additional damage. This method is also applicable to patients with endometrial cancer.

Modified Endoscopic Submucosal Dissection-An Alternative Modality for the Treatment of Sporadic Duodenal Papillary Adenomas.

Background and Aim: Endoscopic submucosal dissection (ESD) is commonly employed in the treatment of epithelial gastrointestinal tumors, but few studies have explored ESD for treatment of duodenal papillary adenomas (PAs). In this study, we aim to evaluate the feasibility of a modified ESD method as an alternative modality in the resection of PAs. Methods: We evaluated potential advantages of modified ESD for resection of sporadic duodenal PAs through retrospective analysis of 10 PAs resected via ESD compared to paired lesions undergoing endoscopic papillectomy (EP). Results: All lesions undergoing ESD were resected en bloc with negative margins, compared to 60% of lesions undergoing EP. Within the experimental group, there was one case each of melena and pancreatitis compared to four bleeds and one case of pancreatitis in the control group. No recurrence was detected within the ESD group after a mean follow-up time of 11.2 months compared to three recurrences within a mean follow-up time of 27.7 months. Conclusions: From our preliminary experience, ESD is a promising alternative in the treatment of superficial duodenal PAs; however, further investigation is needed.