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Abstract Background Intestinal duplication cyst is an infrequent congenital malformation that can involve all the segments of the gastrointestinal tract. The cases of intestinal duplication cyst involving the colon, appendix, and ileum in children are particularly uncommon. The symptoms of abdominal pain are similar to other acute abdominal diseases in children, such as appendicitis, intussusception, and intestinal obstruction, so sometimes its diagnosis is challenging and leads to misdiagnosis. Case presentation We report a 4-year-old Asian boy who presented to the pediatric emergency department with abdominal pain and vomiting but no fever, peritonitis, or mass. No abdominal abnormality was found via radiology and ultrasonography. After 2 days’ anti-inflammatory therapy, the patient was discharged with pain relief. A total of 9 months later, he was readmitted to the pediatric emergency department for the same complaint as the first admission. Abdominal physical examination and ultrasound examination were still negative. Barium examination found a large mass in the colon. Colonoscopy was performed before operation to confirm the rare co-cavity intestinal duplication cyst involving the colon, appendix, and ileum. After resection of intestinal duplication and ileocolonic anastomosis, the patient’s abdominal pain and vomiting has not recurred for 5 years postoperatively. Conclusions The diagnosis of intestinal duplication cyst in children is difficult, especially the rare co-cavity and long segmental intestinal duplication, which is easily misdiagnosed. Colonoscopy may be an effective auxiliary diagnostic method, especially for diseases that are difficult to diagnosed clinically, such as recurrent abdominal pain.

BackgroundRetroperitoneal lymphatic malformations (LMs) are rare. Currently, the treatment of retroperitoneal LMs remains challenging. This study aimed to examine the safety and efficacy of laparoscopic-assisted sclerotherapy for retroperitoneal LMs in pediatric patients.MethodsWe retrospectively reviewed patients treated with laparoscopic-assisted sclerotherapy for retroperitoneal LMs in a single tertiary medical center between July 2020 and February 2023. Doxycycline was prepared into a solution with a concentration of 10 mg/ml for use in sclerotherapy. Demographic data, clinical features, details of management, and outcomes were collected and analyzed.ResultsA total of six patients, comprising three males and three females, were identified. The LMs were categorized into four macrocystic and two mixed-cystic types. The mean age and weight were 52.2 months (range, 11–108 months) and 20 kg (range, 12.5–27.5 kg), respectively. Three patients presented with abdominal pain or distension, while the other three patients were asymptomatic. All six patients underwent a total of eight sclerotherapy sessions. Two patients experienced intra-cystic hemorrhage and required a second sclerotherapy session. Only one patient presented with vomiting after sclerotherapy, which resolved spontaneously. Five patients met the complete response criteria, and one patient met the effective criteria. The mean reduction in lesion size was 92.3% (range, 69.9%–99.6%). No further complications or recurrence were recorded during follow-up.ConclusionLaparoscopic-assisted sclerotherapy is a safe and effective approach for treating retroperitoneal LMs. This technique is applicable for both macrocystic and mixed-cystic retroperitoneal LMs.

Surfactant flooding is a pivotal technique for enhancing oil recovery efficiency. The Chang 8 member of the Yanchang Formation in the Ordos Basin exemplifies a quintessential tight oil reservoir. Specifically, 47.9% of wells yield less than 0.1 t/d, 27.0% produce between 0.1 and 0.2 t/d, and 18.8% generate outputs ranging from 0.2 to 0.3 t/d, while only a mere 6.3% exceed production rates of over 0.3 t/d, indicating minimal efficacy of water flooding development in this context. In this study, we conducted an extensive investigation into the geological characteristics of the Yanchang 8 reservoir within the Ordos Basin, leading to the identification and evaluation of three surfactants based on their interfacial tension properties. The optimal injection concentration was determined through on-line displacement nuclear magnetic resonance imaging analysis that refined surface activity conducive to developing the Chang 8 member, ultimately resulting in increased spread volume and enhanced crude oil production from individual wells. The results indicate the following: (1) The interfacial tension of NP-10, FSD-952, and GPHQ-1 at concentrations of 0.05%, 0.1%, 0.2%, 0.3%, 0.4%, and 0.5% exhibited a pattern of initial decrease followed by an increase. The mass concentration corresponding to the minimum interfacial tension for NP-10 is identified as 0.1%, which is also the case for GPHQ-1; however, for FSD-952, this occurs at a concentration of 0.4%. Among the surface-active agents NP-10, GPHQ-1, and FSD-952, GPHQ-1 demonstrated the lowest interfacial tension value at an impressive measurement of 0.0762 mN/m. (2) When the displacement of the 0.1% GPHQ-1 surfactant reaches 10 PV, the displacement efficiency improves from 69.69% to 76.36%, representing an increase of 6.67%. The minimum pore size observed during GPHQ-1 surfactant displacement is 0.01 μm. In contrast, when the displacement of the NP-10 surfactant at a concentration of 0.1% reaches 10 PV, the efficiency rises from 68.32% to 72.02%, indicating an enhancement of 3.7%. The corresponding minimum pore size for NP-10 surfactant displacement is recorded at 0.02 μm. Furthermore, when the displacement of the FSD-952 surfactant at a concentration of 0.4% achieves 10 PV, its efficiency increases from 69.93% to 74.77%, reflecting an improvement of 4.81%. The minimum pore size associated with the activated portion of FSD-952 is noted as being approximately 0.03 μm.

Abstract Background Scrotal and retroperitoneal lymphangioma (SRL) in children is relatively rare and its clinical symptoms are usually difficult to distinguish from other conditions such as hydrocele and incarcerated inguinal oblique hernia. This study aimed to explore the clinical diagnosis and treatment of abdominal scrotal lymphangioma in children, and thus, to increase our understandings of this disease in clinical practice. Method This study enrolled nine boys, aged 1–10, who were admitted to Shanghai Children’s Hospital from January 2019 to December 2020 and who were finally confirmed with lymphangioma in the inguinal area. The clinical manifestations, diagnosis, and treatment of these children were analyzed retrospectively. The length of diagnostic process ranged from 3 weeks to 20 months. We also reviewed other cases of initially misdiagnosed cases of SRL in English publications from 2000 to 2022. Results The nine cases were misdiagnosed as hydrocele, hematoma, or inguinal hernia. Three patients received intracystic injection of bleomycin, three underwent laparoscopic mass resection, and three underwent resection of the inguinal lymphangioma under direct vision. Postoperative pathological analysis of the surgical specimens confirmed the diagnosis of benign cystic lesions and lymphangioma. Meanwhile, among the 14 cases of SRL in literature review, eight were misdiagnosed. Six were initially diagnosed as hydrocele, one as inguinal oblique hernia, and one as testicular tumor, all of which underwent ultrasonography scans. All cases were confirmed as lymphangioma after pathological examination. Conclusion The non-specific clinical manifestations may contribute to the misdiagnosis of scrotal masses in children. A detailed and accurate medical history, careful physical examination, and imaging findings are important factors contributing to the preoperative differential diagnosis of scrotal lumps in children, but the final diagnosis is based on pathological examination.

The vibration parameters during drilling play a critical role in enhancing drilling speed and ensuring safety. However, traditional downhole vibration sensors face limitations in their power supply methods, hindering widespread adoption. To address this challenge, our research introduces a novel solution: a hybrid downhole vibration sensor (HDV-TENG) utilizing triboelectric nanogenerators. This sensor not only enables the measurement of low- to medium–high-frequency vibrations using self-power but also serves to energize other downhole devices. We utilized a self-constructed vibration simulator to replicate downhole drilling tool vibrations and conducted a comprehensive series of sensor tests. The test results indicate that the frequency measurement bandwidth of the HDV-TENG spans from 0 to 200 kHz. Especially, the measurement errors for vibrations within the low-frequency range of 0 to 10 Hz and the high-frequency range of 10 to 200 k Hz are less than 5% and 8%, respectively. Additionally, the experimental findings regarding load matching demonstrate that the HDV-TENG achieves an output power level in the milliwatt range, representing a significant improvement over the output power of traditional triboelectric nanogenerators. Unlike traditional downhole vibration measurement sensors, HDV-TENG operates without requiring any external power supply, thereby conserving downhole space and significantly enhancing drilling efficiency. Furthermore, HDV-TENG not only offers a broad measurement range but also amplifies output power through the synergy of a triboelectric nanogenerator (TENG), piezoelectric nanogenerator (PENG), and electromagnetic power generator (EMG). This capability enables its utilization as an emergency power source for other micropower equipment downhole. The introduction of HDV-TENG also holds considerable implications for the development of self-powered underground sensors with high-frequency measurement capabilities.

Abstract Background Neuroblastoma (NB) is the most common extracranial solid tumor occurring during childhood and high-risk NB patients have a poor prognosis. The amplified MYCN gene serves as an important determinant of a high risk of NB. Methods We performed an integrative screen using public NB tissue and cell line data, and identified that SMAD9 played an important role in high-risk NB. An investigation of the super-enhancers database (SEdb) and chromatin immunoprecipitation sequencing (ChIP-seq) dataset along with biological experiments of incorporating gene knockdown and CRISPR interference (CRISPRi) were performed to identify upstream regulatory mechanism of SMAD9. Gene knockdown and rescue, quantitative real-time PCR (Q-RT-PCR), cell titer Glo assays, colony formation assays, a subcutaneous xenograft model and immunohistochemistry were used to determine the functional role of SMAD9 in NB. An integrative analysis of ChIP-seq data with the validation of CRISPRi and dual-luciferase reporter assays and RNA sequencing (RNA-seq) data with Q-RT-PCR validation was conducted to analyze the downstream regulatory mechanism of SMAD9. Results High expression of SMAD9 was specifically induced by the transcription factors including MYCN, PHOX2B, GATA3 and HAND2 at the enhancer region. Genetic suppression of SMAD9 inhibited MYCN-amplified NB cell proliferation and tumorigenicity both in vitro and in vivo. Further studies revealed that SMAD9 bound to the MYCN promoter and transcriptionally regulate MYCN expression, with MYCN reciprocally binding to the SMAD9 enhancer and transactivating SMAD9, thus forming a positive feedback loop along with the MYCN-associated cancer cell cycle. Conclusion This study delineates that SMAD9 forms a positive transcriptional feedback loop with MYCN and represents a unique tumor-dependency for MYCN-amplified neuroblastoma.

The occurrence characteristic of movable fluid is a crucial index for tight sandstone reservoir evaluation, and the study of the differential occurrence of reservoir movable fluid is vitally important for the exploration and development of tight gas. Therefore, on the basis of casting thin section, scanning electron microscope, X-ray diffraction, high-pressure mercury injection, and nuclear magnetic resonance testing, the differential occurrence characteristics and influencing factors of reservoir movable fluid are analyzed based on the reservoir of Shan 1 reservoir. The results show that the main types of Shan 1 reservoir are lithic quartz sandstone and lithic sandstone, and intergranular solution pores and cutting solution pores are mainly developed in Shan 1 reservoir in Yanchang area. The movable fluid saturation of Shan 1 reservoir is 21.64%~69.62%, and the average of the movable fluid saturation is 35.32%. Most of the T2 spectra are unimodal. According to the pore development, the reservoir is divided into four types, and fluid flow property in reservoir varies with the difference of reservoir pore development. Sandstone types, reservoir porosity, permeability, pore type, pore throat parameters, and cement content affect movable fluid saturation. The pores provide the main space for the movable fluid. The better the development of intergranular solution pores, the larger the average pore throat radius and the higher the movable fluid saturation of the reservoir. The higher the content of the calcite, the more obvious pore loss of the reservoir and the lower movable fluid saturation in the reservoir. The higher the content of illite, the worse the pore evolution and the lower fluid flow property in reservoir.

BackgroundNeuroblastoma is the most common extracranial solid tumor of childhood, arising from the sympathetic nervous system. High-risk neuroblastoma (HRNB) remains a major therapeutic challenge with low survival rates despite the intensification of therapy. This study aimed to develop a malignant-cell marker gene signature (MMGS) that might serve as a prognostic indicator in HRNB patients.MethodsMulti-omics datasets, including mRNA expression (single-cell and bulk), DNA methylation, and clinical information of HRNB patients, were used to identify prognostic malignant cell marker genes. MMGS was established by univariate Cox analysis, LASSO, and stepwise multivariable Cox regression analysis. Kaplan–Meier (KM) curve and time-dependent receiver operating characteristic curve (tROC) were used to evaluate the prognostic value and performance of MMGS, respectively. MMGS further verified its reliability and accuracy in the independent validation set. Finally, the characteristics of functional enrichment, tumor immune features, and inflammatory activity between different MMGS risk groups were also investigated.ResultsWe constructed a prognostic model consisting of six malignant cell maker genes (MAPT, C1QTNF4, MEG3, NPW, RAMP1, and CDT1), which stratified patients into ultra-high-risk (UHR) and common-high-risk (CHR) group. Patients in the UHR group had significantly worse overall survival (OS) than those in the CHR group. MMGS was verified as an independent predictor for the OS of HRNB patients. The area under the curve (AUC) values of MMGS at 1-, 3-, and 5-year were 0.78, 0.693, and 0.618, respectively. Notably, functional enrichment, tumor immune features, and inflammatory activity analyses preliminarily indicated that the poor prognosis in the UHR group might result from the dysregulation of the metabolic process and immunosuppressive microenvironment.ConclusionThis study established a novel six-malignant cell maker gene prognostic model that can be used to predict the prognosis of HRNB patients, which may provide new insight for the treatment and personalized monitoring of HRNB patients.

PurposeWe aim to see incidental appendectomy (IA) was worth or not during the laparoscopic treatment of intussusception.MethodsThis study included forty-eight patients who underwent a laparoscopic procedure for idiopathic intussusception without intestinal resection between April 2014 and April 2021. The Chi-square or Fisher's exact tests for categorical variables and the Student t-test for continuous variables were used to analyze and compare patient characteristics.ResultsIA was performed on 63% (30/48) of patients after surgical reduction, while 18 (37%), did not. Patients who underwent IA had a higher total cost (16,618 ± 2,174 vs.14,301 ± 5,206, P = 0.036), and a longer mean operation duration (59 ± 19 vs.45 ± 21, P = 0.025). The distribution of the PO time, length of hospital stay, PCs, and RI did not differ significantly. The histopathological evaluation of the 30 resected appendices revealed five (17%) with signs of acute inflammation, 20 (66%) with chronic signs of inflammation, and five (17%) with inconspicuous appendices.ConclusionIA is linked to a longer average operation time and a higher total cost. There is insufficient evidence to recommend IA during laparoscopic intussusception treatment. The risks and benefits of IA need further study.

AimTo detect the composition of the gut microbiota in biliary atresia after Kasai surgery.MethodsInfants within six months after the Kasai operation who were diagnosed by cholangiography at Shanghai Children’s Hospital were enrolled in the study. Fecal samples were collected from diapers, placed into sterile tubes in the inpatient department or outpatient department and frozen at −80°C within half an hour. The gut microbiota was detected by 16S rRNA sequences. Then, the patients that were followed up to one year after the Kasai operation who suffered from cholangitis at least one time were grouped into the BAcho group, and the others were grouped into the BAnoncho group.ResultsNine of 18 BA patients were grouped into the BAcho group, and the others were grouped into the BAnoncho group. In the BAcho group, AST, ALT and GGT were significantly increased compared to the BAnoncho group. The number of total OTUs (operational taxonomic units) in feces was more elevated in the BAnoncho group than in the BAcho group. In the BAnoncho group, the Chao index at the OTU level was significantly increased compared to that in the BAcho group (66.37 ± 21.5 vs. 45.64 ± 11.25, p = 0.02

Graft-versus-host disease (GvHD) is a severe complication following hematopoietic cell transplantation (HCT). The clinical manifestations of GvHD can affect multiple systems. Although gastrointestinal (GI) GvHD is common, GI obstruction complications are rare. Here, we present a case of GI-GvHD after HCT for acute myeloid leukemia (AML) in a young girl from China. The patient suffered from watery diarrhea, which progressed to bloody diarrhea 40 days after HCT. She experienced prolonged and repeated mucous or bloody stool after the withdrawal of cyclosporine and the gradual reduction in methylprednisolone. The plain abdominal radiography and computed tomographic (CT) scan showed apparent bowel wall thickening and intestinal stenosis 10 months after HCT. Finally, the patient underwent surgery to remove the small intestinal stenosis at the age of 26 months. The patient recovered with the help of appropriate medical therapies and nutritional support during hospitalization. She remained stable, and there was no recurrence of GI symptoms 16 months after the surgery. In summary, surgery may be an optimal treatment for GvHD patients with persistent bowel obstruction and failure of appropriate immunosuppressive therapies.

BackgroundOne of the most prevalent forms of renal tumors detected among pediatric patients is the Wilms tumor (WT). Teratoid WT is a rare WT subclassification that is characterized by teratoma-like characteristics that include the features of many diverse tissue categories. Less than 70 teratoid Wilms tumor (TWT) cases have been explained up to now.MethodsBetween 2010 and 2020, patients with classical WT and TWT admitted to our hospital were included in this study. Clinicopathological characteristics, intraoperative findings, histopathological parameters, and prognostic outcomes were then compared between classical WT and TWT. To compare these variables, TWT and WT cases were matched at a 1:3 ratio.ResultsA total of 67 total WT cases, i.e., five diagnosed with TWT, were enrolled. While no significant differences in analyzed variables were detected between these groups, tumor volumes were notably larger in the TWT group relative to the classical WT group (203.30 ± 109.89 vs. 104.30 ± 66.97 cm3) despite similar tumor weight values in both groups (471.00 ± 80.65 vs. 432.67 ± 109.25 g). As for five patients diagnosed with TWT, all were alive during the follow-up, while one of them was diagnosed with pelvic metastasis.ConclusionsThis study is the first to our knowledge to have reported on the incidence of TWT among Chinese children, and our results preliminarily suggest that a combination of surgery and chemotherapy may be appropriate for the treatment of patients with WT, although prognostic outcomes varied substantially among patients with different stages of the disease. TWT tumor density may be lower than classical WT tumor density. Further research regarding the basic biological characteristics of TWT and relevant theranostic markers associated with this tumor type is warranted to better guide the development of individualized treatments for this rare cancer type.

Surface damage caused by coal mining is one of the problems perplexing ecological environment restorations in coal mining areas. Accurately evaluating and predicting the degree of surface damage induced by coal mining with reasonable and correct indexes are of great significance to the restoration and treatment of the ecological environment. In this paper, these methods including the unmanned aerial vehicle aerial photography and manual measurement were used to investigate the development characteristics of surface damage caused by 2# coal seam mining in Yangchangwan Coal Mine. The results showed that with the change of mining conditions, the characteristics of surface cracks change obviously, which can be adopted to indicate the degree of surface damage. Thus, based on the results of the investigation, the classification standard of surface damage degree was established based on the evaluation indexes including density of crack, drop height of surface crack, crack width, maximum surface subsidence, and geological disaster caused by cracks and the damage characteristics of buildings. The evaluation method and process of surface damage degree also were given. Based on the ratio of the buried depth to the thickness of the coal seam (H/M), ratio of the thickness of overlying bedrock to the thickness of the coal seam, the thickness of loose layers (Ms), geomorphology, distance to faults, and distance to folds, the prediction model of surface damage degree was built on the GIS platform. The weight coefficient of each prediction index was obtained by the analytic hierarchy process (AHP) method. The surface damage degree map of 2# coal seam in Yangchangwan Coal Mine was divided into four classes: very minor, minor, moderate, and serious, which provides a relatively applicable method for the prediction of surface damage degree in Yangchangwan Coal Mine and its adjacent mining areas.

This study intended to gain new insight into the genetic basis underlying ganglioneuroma (GN), ganglioneuroblastoma (GNB), and neuroblastoma (NB). Three fresh-frozen surgically resected tumor tissues (GN1, GNB1, and NB1) and matched blood samples (GN2, GNB2, and NB2) were respectively obtained from three pediatric patients with GN, GNB, and NB. After exome sequencing, we predicted the somatic single nucleotide variants (SNV) and insertion and deletion (InDel), and screened the predisposing genes. Finally, we detected and filtered the fusion gene using Fusionmap. Exome sequencing identified 815,985, and 884 somatic SNV, and 56, 43, and 34 InDel for GN, NB, and GNB respectively. Total 29, 19 and 37 predisposing genes were identified from GN, GNB and NB samples, such as PIK3CA (GN), MUC4 (GN), PML (NB), TFR2 (GNB), and MAX (GNB). Additionally, four common fusion genes, such as HOXD11-AGAP3 and SAMD1-CDC42EP5, were identified from three tumor samples. Moreover, SAMD1-CDC42EP5 was also a common fusion position in three blood samples. These previously unrecognized predisposing genes, such as PIK3CA, MUC4, PML, TFR2 and MAX, and fusion genes, like HOXD11-AGAP3, and SAMD1-CDC42EP5 may have the potential to impact the progression and development of neuroblastic tumors.

Hepatoblastoma (HB) is a rare disease but nevertheless the most common hepatic tumor in the pediatric population. For patients with advanced HB, the prognosis is dismal and there are limited therapeutic options. Multiple microRNAs (miRNAs) were reported to be involved in HB development, but the miRNA–mRNA interaction network in HB remains elusive. Through a comparison between HB and normal liver samples in the GSE131329 dataset, we detected 580 upregulated differentially expressed mRNAs (DE-mRNAs) and 790 downregulated DE-mRNAs. As for the GSE153089 dataset, the first cluster of differentially expressed miRNAs (DE-miRNAs) were detected between fetal-type tumor and normal liver groups, while the second cluster of DE-miRNAs were detected between embryonal-type tumor and normal liver groups. Through the intersection of these two clusters of DE-miRNAs, 33 upregulated hub miRNAs, and 12 downregulated hub miRNAs were obtained. Based on the respective hub miRNAs, the upstream transcription factors (TFs) were detected via TransmiR v2.0, while the downstream target genes were predicted via miRNet database. The intersection of target genes of respective hub miRNAs and corresponding DE-mRNAs contributed to 250 downregulated candidate genes and 202 upregulated candidate genes. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses demonstrated the upregulated candidate genes mainly enriched in the terms and pathways relating to the cell cycle. We constructed protein–protein interaction (PPI) network, and obtained 211 node pairs for the downregulated candidate genes and 157 node pairs for the upregulated candidate genes. Cytoscape software was applied for visualizing the PPI network and respective top 10 hub genes were identified using CytoHubba. The expression values of hub genes in the PPI network were subsequently validated through Oncopression database followed by quantitative real-time polymerase chain reaction (qRT-PCR) in HB and matched normal liver tissues, resulting in six significant downregulated genes and seven significant upregulated genes. The miRNA–mRNA interaction network was finally constructed. In conclusion, we uncover various miRNAs, TFs, and hub genes as potential regulators in HB pathogenesis. Additionally, the miRNA–mRNA interaction network, PPI modules, and pathways may provide potential biomarkers for future HB theranostics.

Background: Diagnostic delay of pyriform sinus fistula (PSF) continues to challenge clinicians, and the preferred imaging modality is yet to be verified. The purpose of this study was to investigate the preferred imaging modality for PSF and the possible risk factors for a longer diagnostic delay.Methods: Medical records of patients with a surgically confirmed PSF from 2014 to 2018 were retrospectively evaluated. A comparison of the first esophagography timing with a true-positive (TP) result and that with a false-negative (FN) result was made. Data of computed tomography (CT) performed immediately after esophagography were also analyzed. In addition, the factors related to diagnostic delay were analyzed using multivariate regression models.Results: A total of 147 patients ranging in age from 0 to 16 years (median: 5.2 years) were included. The mean time since the symptom onset of the first esophagography with TP result was significantly longer than that of the examination with FN result (95.18 ± 79.12 vs. 52.59 ± 42.40 days, P = 0.032). When the time since the symptom onset was less than 12 weeks, the false-negative rate (FNR) of the first esophagography was declining dramatically with a longer time interval. Among 18 cases with an FN result of the first esophagography, the fistulous tract was finally identified in seven cases using an immediate CT. The mean of diagnostic delay was 12.28 months. Besides, rural residency was an independent risk factor for a longer diagnostic delay.Conclusion: Joint examination of esophagography and an immediate CT is the preferred imaging modality for the diagnosis of PSF in children. It is inadvisable to perform the first esophagography when the time since the symptom onset is less than 12 weeks. Besides, the rural residency is an independent risk factor for a longer diagnostic delay.

Background: Perforation of a choledochal cyst (CC) is not rare, but the pathogenesis of spontaneous perforation has not been established. Pancreaticobiliary maljunction (PBM) is commonly seen in association with choledochal cyst. To explore the relationship between PBM and perforated CC, a retrospective study was conducted.Methods: We analyzed all the patients with CC who underwent surgery in our hospital from 2014.06.01 to 2018.12.31. All patients were divided into two groups: group 1 were patients with perforated CC, and group 2 were patients with non-perforated CC. We recalled all the patients records to identify types of PBM. PBM was divided into four types [(A) stenotic type, (B) non-stenotic type, (C) dilated channel type, and (D) complex type] according to the classification proposed by the Committee on Diagnostic Criteria of the Japanese Study Group on Pancreaticobiliary Maljunction (JSGPM) in 2015.Results: There were 186 patients with CC in all, and 116 patients showed PBM. Twenty patients in group 1 and 96 patients in group 2. There was an extremely higher percentage of type C PBM in group 1 than in group 2 (60 and 17.7%, respectively). More fusiform dilatation cases were found in group 1 (70%) than in group 2 (58.3%). Also there were more type C PBM in fusiform cases and type A PBM were frequently seen in cystic cases (P < 0.01).Conclusions: We found that Type C PBM and fusiform common bile duct maybe relate to the perforation of choledochal cyst. Patients with type C PBM and fusiform common bile duct should be treated more proactively, preferably before they perforate.

Introduction: The aim of this study was to analyze the authors' experience in re-operative surgery for children with pyriform sinus fistula (PSF) who were subjected to attempted but failed operations.Methods: We retrospectively analyzed the medical records of 30 patients with PSF who underwent reoperation (i.e., a revision of the primary performed definitive procedure) from January 2010 to December 2018.Results: There were 19 boys and 11 girls. Twenty-nine cases were left-sided. The median age of the patients when they underwent the primary operation was 5.5 years (range, 15 days−14 years). Five children received two definitive procedures from outside hospitals. The primary operations included traditional open-neck surgery (n = 30), endoscopic-assisted open-neck surgery (n = 4), and endoscopic laser cauterization (n = 1). The median time from primary operation to recurrence was 4 months (range, 1 month−4 years). The reasons for recurrence were incomplete resolution of infection (n = 7), incomplete resection of the fistula (n = 23), cauterization of PSF inner orifice (n = 1), only cyst excision in neonates (n = 2), and unknown (n = 2). All 30 children underwent endoscopy-assisted open-neck surgery. The median age of the children when they underwent reoperation was 8 years (range, 2–17 years). The fistula was detected in 29 cases (96.7%). After reoperation, good outcome was achieved in 27 patients (90%). Wound infection developed in one case. PSF recurred in two cases (6.7%).Conclusion: Most of the recurrences observed by us are preventable. Complete resolution of infection, clear verification, and exact resection of the fistula at a high level are essential for preventing recurrence. Endoscopy-assisted surgery is effective for PSF reoperation.

Hirschsprung disease is a birth defect characterized by complete absence of neuronal ganglion cells from a portion of the intestinal tract. To uncover genetic variants contributing to HSCR, we performed whole exome sequencing on seven members of an HSCR family. With the minor allele frequency (MAF) calculated by gnomAD, we finally filtered a total of 1,059 rare variants in this family (MAF < 0.1%). With the mode of inheritance and pathogenicity scores by bioinformatics tools, we identified an in-frameshift variant p.Phe147del in RET as the disease-causing variant. Further analysis revealed that the in-frameshift variant may function by disrupting the glycosylation of RET protein. To our knowledge, this is the first study to report the in-frameshift variant p.Phe147del in RET responsible for heritable HSCR.

Abstract A 6-year-old girl presented with intermittent abdominal pain, without jaundice and a palpable mass in the epigastrium. Preoperative imaging and upper endoscopy suggested duodenal duplication. During surgery, the patient was diagnosed with a rare type of choledochal cyst—choledochocele (type 3b). The authors emphasize that, in children, choledochocele should be included in the differential diagnosis of cystic lesions located in the duodenal area and the head of the pancreas area, regardless of jaundice or abnormal liver function. Since mucosal histology showing duodenal mucosa did not match the final diagnosis, we suggest that three criteria should be met for the diagnosis of a choledochocele to be diagnosed: (1) a cyst protruding into the duodenal lumen; (2) filling with contrast during cholangiography and (3) a filling defect on X-ray barium meal.

Chang 9 Oil-bearing in the southwest of Ordos Basin shows a favorable exploration potential. However, few studies have been done on the Chang 9 member in the Pengyang-Jingchuan area in the southwest margin of the basin, especially there is a lack of research on sedimentary environment. The paper studies sedimentary characteristics of Chang 9 member in the Pengyang-Jingchuan Area by means of field outcrop, core logging, grading analysis, thin section authentication and so on. The results show: Chang 9 Member in the study area is influenced by the provenance in the southwest and the south and the types of rocks are mainly feldspathic quartz sandstone and lithic quartz sandstone and the lithology is mainly grey-green and grey-white fine sandstone, siltstone, grey-black silty mudstone and black mudstone. In Phase Chang 9, distinctive river delta plain subfacies, delta front subfacies and shallow lake subfacies are mainly developing in the study area. The lake shoreline moves southwestwards from Phase Chang 92 to Phase Chang 9', the area of the shallow lake is continuously expanding and this period is aperiod of lake basin expansion. There may be potential source rocks among black mudstones in the study area. [ABSTRACT FROM AUTHOR]