Objective To investigate the treatment outcomes of modified sternocleidomastoid myocutaneous flap with a pedicel containing superior thyroid artery in repairing postoperative hypolaryngeal defect.Methods From Dec.2003 to Sep.2010,the modified sternocleidomastoid myocutaneous flap was used to repair postoperative hypopharyngeal defect for twelve patients with pyriform sinus carcinoma,age ranging from 47 to 72 years old.No patients had treated by radiotherapy before operation.Of 12 patients,5 cases in T2NOM0,5 cases in T3N1M0 and 2 cases in T4N1M0.Results Two cases in T4 with thyroid invasion and 2 cases in T3 with vocal cord fixation had total laryngectomy,and the other 8 cases were conservated with laryngeal functions.To shape flap with middle and lower segment of sternocleidomastoid muscle and with superior thyroid artery as pedicel.All flaps survived after operation.The following-up time was 7 -88 months (median 30 months).Four patients died of recurence or metastasis of tumor during following-up.Conclusions Modified sternocleidomastoid myocutaneous flap with pedicle is easy to hervest,with smaller damage and a higher survival rate,which is a good flap for the repair of the hypopharyngeal defect after resecting tumour.

Objective To explore the development and management of cancer day-chemotherapy ward in Sichuan Province so as to provide a basis for standardized development. Methods From January to November 2018, this study selected totals of 64 Class Ⅱ or Ⅲ hospitals from 21 cities and autonomous prefectures in Sichuan Province by convenience sampling as subjects. All of subjects were investigated with the self-designed Cancer Day-Chemotherapy Ward Management Questionnaire. Frequency and percentage were used to descriptive statistics. Results In Sichuan, there were 15 Class Ⅱ or Ⅲ hospitals with cancer day-chemotherapy service distributed in developed culture and economic areas of Central Sichuan. Patients with clear consciousness, light condition and self-care met inclusive criteria were selected in day-chemotherapy ward by all hospitals, and 40.00％(6/15) hospitals not accepted patients with the initial chemotherapy. Management modes were mainly day-care ward in words-oriented; staffing were mainly professional nurses and rotation doctors. There were 60.00％(9/15) of hospitals installed with the humanistic equipment and emergency area; 40.00％(6/15) of hospitals centralized allocation of chemotherapeutic drugs;80.00％(12/15) of hospitals formulated quality control standards. Conclusions Cancer day-chemotherapy wards are uneven distributed in Sichuan Province. There are differences in the development models, consulting models, management models, staffing, environments,occupational protections and quality control among hospitals. Management needs to be standardized further. Unified basic standards and management rules should be built to promote the development of cancer day-chemotherapy ward.

There is a complex symbiotic relationship between gut microbiota and the host,and a bidirectional communication pathway exists between gut microbiota and the brain,known as the"microbiota-gut-brain axis".Research has found that general anesthetics and the brain can engage in complex two-way communication through the microbiota-gut-brain axis.General anesthetics can alter the composition and metabolism of gut microbiota.This article reviews the effects of common general anesthetics on the microbio-ta-gut-brain axis and their mechanisms,with the aim of providing reference for the related research on anesthesia and the microbiota-gut-brain axis.

This article reviewed the concept of advance care planning, the status, functions, scales, influencing factors and strategies of the participation of advance care planning in families of terminal-stage cancer patients. It is aimed to provide reference for clinical medical staff to promote the participation of advance care planning in families of terminal-stage cancer patients, to improve the quality of agency decision-making, to improve quality of life in patients, and to construct of localized advance care planning.

Objective To acquire,evaluate and integrate the best evidence of perioperative exercise interventions in patients with liver cancer and provide evidence-based references for clinical medical staff.Methods Following the"6S"Evidence Resource Pyramid model,literatures in perioperative exercise interventions published between January 2010 and June 2022 were retrieved from various databases,including BMJ Best Practice,UpToDate,Guidelines International Network,National Guideline Clearinghouse,National Institute for Health and Clinical Excellence,Scottish Intercollegiate Guidelines Network,Medlive,Cochrane Library,JBI,Web of Science,PubMed,Embase,CINAHL,CNKI,SinoMed,Wanfang Data,American Cancer Society,American College of Sports Medicine and International Liver Cancer Association from January 2010 to June 2022.Two researchers evaluated the quality of the retrieved literatures and extracted evidences that met the inclusion criteria.Results A total of 22 articles were included,yielding 26 pieces of evidence across seven themes:the necessity of exercise,evaluation before exercise,preoperative exercise program,postoperative exercise program,exercise monitoring,health education and effect evaluation.Conclusions This study provides a summary of the best evidence regarding perioperative exercise interventions in the patients with liver cancer.The findings offer valuable references for clinical healthcare providers to deliver evidence-based care for the patients with liver cancer.

Objective:To provide a basis for selecting the optimization method for intracavitary/interstitial brachytherapy (IC/ISBT) of cervical cancer by comparing graphical optimization (GO), inverse planning simulated annealing (IPSA), and hybrid inverse planning optimization (HIPO) using dosimetric and radiobiological models.Methods:This study selected 65 patients with cervical cancer who were treated with image-guided IC/ISBT. The afterloading therapy plans for these patients were optimized using GO, IPSA, and HIPO individually, with a prescription dose high-risk clinical target volume (HRCTV) D90 of 6 Gy. The non-parametric Friedman test and the non-parametric Wilcoxon rank test were employed to analyze the differences in duration, dose-volume parameters, and radiobiology between the three types of optimized plans. Results:Inverse planning optimization (IPSA: 46.53 s; HIPO: 98.36 s) took less time than GO (135.03 s). In terms of gross target volume (GTV) dose, the high-dose irradiation V150% (53.66%) was slightly higher in the HIPO-optimized plans, while the V200% (30.29%) was higher in the GO-optimized plans. The GO-optimized plans had a higher conformity index (CI; 0.91) than other plans, showing statistically significant differences. Compared with other plans, the HIPO-optimized plans showed the lowest doses of D1 cm 3 and D2 cm 3 at bladders and rectums and non-statistically significant doses at small intestines ( P > 0.05). In terms of the equivalent uniform biologically effective dose (EUBED) for HRCTV, the HIPO-optimized plans showed a higher value (12.35 Gy) than the GO-optimized plans (12.23 Gy) and the IPSA-optimized plans (12.13 Gy). Moreover, the EUBED at bladders was the lowest (2.38 Gy) in the GO-optimized plans, the EUBED at rectums was the lowest (3.74 Gy) in the HIPO-optimized plans, and the EUBED at small intestines was non-significantly different among the three types of optimized plans ( P = 0.055). There was no significant difference in the tumor control probability (TCP) predicted using the three types of optimized plans ( P > 0.05). The normal tissue complication probabilities (NTCPs) of bladders and rectums predicted using the HIPO-optimized plans were lower than those predicted using the GO- and IPSA-optimized plans( χ2 = 12.95-38.43, P < 0.01), and the NTCP of small intestines did not show significant differences ( P > 0.05). Conclusions:Among the three types of optimization algorithms, inverse optimization takes less time than GO. GO-optimized plans are more conformal than IPSA- and HIPO-optimized plans. HIPO-optimized plans can increase the biological coverage dose of the target volume and reduce the maximum physical/biological exposure and NTCP at bladders and rectums. Therefore, HIPO is recommended preferentially as an optimization algorithm for IC/ISBT for cervical cancer.

Bridging therapy serves as an adjunctive treatment during chimeric antigen receptor T cell therapy(CAR-T)and is specifically im-plemented after the collection of mononuclear cells but before the subsequent infusion of CAR-T cells.This approach can mitigate the pro-gression of large B-cell lymphoma(LBCL)to a certain extent,reduce tumor burden,and facilitate the infusion of CAR-T cells.Bridging therapy includes chemotherapy,radiation therapy,and targeted therapies and ensures effective reinfusion of CAR-T cells and enhances the thera-peutic efficacy of CAR-T cells.This study systematically reviews the significance,methodologies,and characteristics of CAR-T-cell-related bridging therapy for large B-cell lymphoma to provide valuable references for its clinical application.

Objective To investigate the significance of Angiopoietin-1 (Ang-1), Angiopoietin-2(Ang-2) expression in angiogenesis, vessel maturation, progress and prognosis of oral squamous cell carcinoma (OSCC). Methods The expression of Ang-1, Ang-2, vascular endothelial growth factor (VEGF), CD34 and alpha-smooth muscle actin(α-SMA) were studied in 62 human OSCCs, 30 adjacent noncancerous oral tissues and 10 normal oral mucosa by conventional immunohistochemistry. Microvessel density (MVD) and vessel maturation index (VMI) were also assessed with double-labeling immunohistochemistry staining against CD34, a marker of pan-endothelial cells, and that against α-SMA, a marker of mural cells (pericytes/smooth muscle cells). The images were analyzed with BioMias system. Results Ang-1/Ang-2 protein expression ratio were significandy lower in OSCC than that in adjacent noncancerous oral tssues and normal oral mucosa (t were - 5.42 and - 6.234, all P<0.01). There were significantly different Ang-1/Ang-2 protein expression ratio in different tumor' lymph node metastasis status and MVD groups and VMI groups, respectively (t were 3.421, - 3.221, 3.824, all P<0.01). The patients with low Ang-1/Ang-2 protein expression ratio and high VEGF protein expression were found to have a significantly higher MVD when compared to others(t were 2.055, 2.345, 2.985, all P<0.05). Ang-1/Ang-2 protein expression ratio had a tendency to be a prognostic factor (χ2 = 3.383, P = 0.066).Conclusions The reversion of Ang-1 and Ang-2 expression may plays an important role in the development and progression of OSCC. It is closely associated with the angiogenesis, vessel maturation and prognosis of OSCC.

Anastomotic leakage is one of the most severe complications following esophagectomy.Research on predictive factors is crucial for its prevention.Blood markers such as C-reactive protein,white blood cell count,procalcitonin,and albumin levels are widely used due to their accessibility,but they have limitations in distinguishing anastomotic leakage from other postoperative infections.The assessment of blood supply to the anastomotic site,including factors like vessel length and diameter,is also readily obtainable and valuable in predictive models,though there is limited research in this area.The use of indocyanine green offers a more direct evaluation of blood supply,but its application is not widespread,and data acquisition is challenging.Preoperative comorbidities such as diabetes have been shown to delay wound healing and increase the risk of leakage;thus,it is recommended to include these factors in comprehensive studies.Although surgical techniques and the location of the anastomosis have been extensively studied,further exploration of these details is necessary.Researchers should integrate these factors to develop multifactorial predictive models,enabling the identification of high-risk patients preoperatively and the implementation of effective preventive measures to reduce the incidence of anastomotic leakage.

Objective:To investigate the predictive value of inflammatory and nutritional indices for postoperative survival of elderly patients with esophageal squamous carcinoma.Methods:The retrospective cohort study was conducted. The clinicopathological data of 130 elderly patients with esophageal squamous carcinoma who were admitted to Sichuan Cancer Hospital from January 2019 to April 2020 were collected. There were 102 males and 28 females, aged (70±4)years. Mea-surement data with normal distribution were represented as Mean± SD. Measurement data with skewed distribution were represented as M( Q1, Q3) or M(range). Count data were expressed as absolute numbers, and comparison between groups was conducted using the chi-square test. Receiver opera-ting characteristic (ROC) curves were plotted. The area under the curve (AUC) and optimal cut-off values were calculated. The Kaplan-Meier method was used to plot survival curves, and the Log-rank test was used for survival analysis. The COX proportional hazard regression model was used for univariate and multivariate analyses. Results:(1) Postoperative survival of elderly patients with esophageal squamous carcinoma predicted by inflammatory and multitional indices. Results of ROC curves analysis showed that the best cut-off values of preoperative systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and prognostic nutrition index (PNI) for predicting postoperative survival of elderly patients with esophageal squamous carcinoma were 470.71×10 9/L, 1.11, 2.07, 136.24, and 46.28, respectively. (2) Risk factors analysis of postoperative survival of elderly patients with esophageal squamous carcinoma. Results of multivariate analysis showed that preoperative SII ≥470.71×10 9/L, preoperative SIRI ≥1.11, preoperative PNI<46.28, score of preoperative patient-generated subjective global assessment (PG-SGA) ≥4, postoperative pathological stage Ⅳ and post-operative complications were independent risk factors for the overall survival time of elderly patients with esophageal squamous carcinoma ( hazard ratio=3.30, 2.50, 0.36, 4.86, 1.57, 1.97, 95% confidence interval as 1.10?9.88, 1.07?5.88, 0.16?0.81, 1.13?20.87, 1.20?2.06, 1.02?3.82, P<0.05). (3) Follow-up. All the 130 patients were followed up for 39(range, 1?60)months. Of the 130 patients, 81 cases survived, 49 cases died, and the median overall survival time was not reached. The 1- and 3-year survival rates of the 130 patients were 83.85% and 54.62%, respectively. ① The median overall survival time was 25(0,43)months for patients with SII ≥470.71×10 9/L, and unreached for patients with SII <470.71×10 9/L, showing a significant difference between them ( χ2=60.59, P<0.05). ② The median overall survival time was 26(0,44)months for patients with SIRI ≥1.11, and unreached for patients with SIRI <1.11, showing a significant difference between them ( χ2=45.57, P<0.05). ③ The median overall survival time was unreached for patients with PNI ≥46.28, and 38(0,47)months for patients with PNI <46.28, showing a significant difference between them ( χ2=12.53, P<0.05). ④ The median overall survival time was unreached for patients with PG-SGA <4 and ≥4, showing a signifi-cant difference between them ( χ2=14.41, P<0.05). ⑤ The median overall survival time was 25(1,47)months for patients in pathological stage Ⅲ, 12(1,32)months for patients in stage Ⅳ, and unreached for patients in stage 0, Ⅰ, Ⅱ, respectively, showing a significant difference among them ( χ2=58.75, P<0.05). ⑥ The median overall survival time was 33(1,47)months for patients with postoperative complication, and unreached for patients without postoperative complication, showing a significant difference between them ( χ2=14.27, P<0.05). Conclusions:Preoperative SII, SIRI and PNI have good predictive value for postoperative survival in elderly patients with esophageal squamous carcinoma. Preoperative SII ≥470.71×10 9/L, preoperative SIRI ≥1.11, preoperative PNI <46.28, score of preoperative PG-SGA ≥4, postoperative pathological stage Ⅳ, and postoperative complications are independent risk factors for the overall survival time of elderly patients with esophageal squamous carcinoma. Patients with preoperative SII <470.71×10 9/L, preoperative SIRI <1.11, preoperative PNI >46.28, score of preoperative PG-SGA <4, postoperative pathological stage 0, Ⅰ, Ⅱ, and non post-operative complications have better survival.