[The relationship between the expression of fibroblast growth factor 19 and insulin-like growth factor 1 in colorectal polyp tissues and the occurrence of colorectal adenomas].

Objective: This investigation sought to delineate the associations among colorectal adenomatous polyps, diabetes, and biomolecules involved in glucose metabolism. Method: Data were collected from 40 patients who underwent endoscopic polypectomy at the Endoscopy Department of Shandong Cancer Hospital between June 2019 and September 2021. This cohort included 27 patients with inflammatory polyps and 13 with adenomatous polyps. We assessed fasting insulin (Fins), fasting blood glucose (FBG), and the mRNA expressions of fibroblast growth factor 19 (FGF-19) and insulin-like growth factor 1 (IGF-1) in the polyp tissues. Both univariate and multivariate logistic regression analyses were employed to ascertain the determinants influencing the emergence of adenomatous polyps. From these analyses, a predictive nomogram was constructed to forecast the occurrence of adenomatous polyps, and evaluations on the discriminative capacity, calibration, and clinical utility of the model were conducted. Results: The adenomatous polyp group exhibited markedly elevated levels of glucose, insulin, FGF-19, and IGF-1, with respective concentrations of (8.67±2.70) mmol/L, (12.72±7.69) µU/L, 2.20±1.88, and 1.36±0.69. These figures were significantly higher compared to the inflammatory polyp group, which showed levels of (5.51±0.72) mmol/L, (5.49±2.68) µU/L, 0.53±0.97, and 0.41±0.46, respectively, P=0.001. Multivariate logistic regression revealed that the relative expression of IGF-1 served as an independent risk factor for the development of colorectal adenomatous polyps (OR=5.622, 95% CI:1.085-29.126). The nomogram displayed a C-index of 0.849, indicating substantial discriminative capability. The calibration curve affirmed the model's accuracy in aligning predicted probabilities with actual outcomes, and the clinical decision curve demonstrated thepractical clinical applicability of the model. Conclusions: There was a significant correlation between the occurrence of colorectal adenomatous polyps and glucose metabolic pathways. Individuals with diabetes showed a higher propensity to develop such polyps.

[Longdan Xiegan Decoction and its interpretation from the perspective of meridians].

By systematically examing through Longdan Xiegan Decoction in medical books of the past dynasties, it was found that the Longdan Xiegan Decoction recorded in Lan Shi Mi Cang mainly targeted men's genital odor at frist. After Xue Ji's addition and subtraction, the scope of the prescription was gradually generalized and expanded, and confusion its name, composition and source of the prescription appeared, which was particularly prominent in Jingyue Quanshu and Yifang Jijie.Doctors used to interpret this prescription from the perspective of viscera. In order to better understand the main treatment rules of Longdan Xiegan Decoction, it is necessary to change the perspective and reinterpreted it from the perspective of meridians.Attributing the symptoms of the perineum to Liver Meridian of Foot-Jueyin,hypochondriac pain, deafness and other symptoms to the Gallbladder Meridian of Foot-Shaoyang, and adding or subtracting herbs according to the specific conditions, is not only conducive to a comprehensive and in-depth understanding of the prescription to achieve accurate clinical syndrome differentiation and medication, but also prompts modern researchers to rethink the important role of meridian theory in the formation and development of the theoretical system of traditional Chinese medicine.

[Value of endobronchial ultrasound-guided transbronchial needle aspiration of enlarged mediastinal lymph nodes and analysis of false negative results].

Objective: To explore the diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the diagnosis of enlarged mediastinal lymph nodes, and to analyze the reasons of false negative results of EBUS-TBNA. Methods: A retrospective analysis of the clinical and imaging data of 389 patients who underwent EBUS-TBNA for sampling enlarged hilar and mediastinal lymph nodes from October 2009 to October 2015 in Shandong Tumor Hospital, to evaluate its significance in the diagnosis of enlarged mediastinal lymph nodes, and to analyze the reasons of false negative results. Results: Among the 389 collected cases, positive biopsy results were obtained in 362 cases, and false negative results in 27 cases. The sensitivity, specificity, positive predictive value and negative predictive value were 92.9%, 100%, 100% and 25.0%, respectively. There was a positive correlation between the size of lymph node and biopsy positive rate (P=0.021). The subcarinal lymph nodes had the highest positive rate (97.7%), followed by the paratracheal lymph nodes (91.2%), with a statistically significant difference (P=0.006). The positive rates obtained by cytology (88.7%) and pathology (92.5%, ) showed no significant difference (P=0.065). The positive rate of EBUS-TBNA was not correlated with pathological types (P=0.932). Needle types (21G, 22G) had no significant effect on diagnosis accuracy (P=0.142). Conclusions: EBUS-TBNA is a practical technology for diagnosis of enlarged mediastinal lymph nodes, with unique characteristics such as minimally invasiveness, local anesthesia, good safety and repeatability. Along with the accumulation of surgical experience, improvement of operative skills, more close cooperation between surgeons, cytologists and pathologists, false negative results will be reduced and positive rate of EBUS-TBNA examination will be further improved.

[A study on growth and development of maxillofacial region with vector analysis]

In order to observe the maxillofacial growth and development quantitatively, the vector analysis was applied in this study to divide Y axis,which is advocated in Downs method,into horizontal section and vertical one,from which the ratio of the facial growth separately in anterior and inferior direction was obtained.75 pieces of x ray films for various dental stages of Shanghaiese with normal occlusion were selected and their angle of Y axis together with their cotangents were measured. The results showed that the cotangent of those with mixed,early permanent and permanent dentition were separately 0.47,0.48 and 0.45 indication that there was a certain relationship between anterior direction and inferior one for the maxillofacial region growth and development.

[Application of the "Wits" approsal in Shanghai children with normal mixed or early permanent dentition]

128 children in Shanghai with normal mixed or early permanent dentition were selected in this servey to gain their normal value of the "wits" approsal.The results showed (1) there was no significant difference of "wits" approsal between the two groups of the children. (2)There was no disparity in "wits" approsal ofthe children with the same nationality and living in different regions. (3) There was a little change in value of the "wits" apporsal during the growth period or the children,which indicated a comparative identical relationship between the upper and lower basal bone.This study suggested that the application of the "wits" approsal be very imnportant in orthodontic clinic because of its expressing exactly the relationship of the jaws.