OBJECTIVE:To observe the efficacy and safety of sequential chemotherapy on the basis of 5-FU combined with three-dimensional conformal intensity modulated radiotherapy in the treatment of postoperative advanced gastric cancer. METH-ODS:110 patients with advanced gastric cancer were randomly divided into control group(55 cases)and sequential group(55 cas-es). Control group was given 400 mg/(m2·d) 5-FU injection by intravenous injection,then given 600 mg/m2 for continuous infu-sion 22 h,d1-2+50 mg/d Pirarubicin hydrochloride for injection,intravenous injection,d1+150 mg/d Oxaliplatin for injection,intra-venous injection,d1,three-dimensional conformal intensity modulated radiotherapy was conducted for 2 weeks after the 4th chemo-therapy,and the total dosage was DT40-45 Gy/1.8 Gy/24-25F. sequential group was additionally given three-dimensional conformal intensity modulated radiotherapy;3-week was regarded as a treatment course,and it lasted 6 courses. The total survival rate and progression-free survival rate in 1,2 and 3 years,metastasis rate and incidence of adverse reactions in 2 groups were followed-up. RESULTS:The total survival rate and progression-free survival rate in 1,2 and 3 years in sequential group were significantly high-er than control group,lymphatic metastasis rate and distant metastasis rate in sequential group were significantly lower than control group,the differences were statistically significant (P<0.05). And there were no significant differences in the nausea,vomiting, hair loss and incidence of bone marrow suppression between 2 groups (P>0.05). CONCLUSIONS:Sequential chemotherapy on the basis of 5-FU combined with three-dimensional conformal intensity modulated radiotherapy can effectively prolong the survival time and reduce long-term metastasis rate of patients in the treatment of postoperative advanced gastric cancer,with similar safety.

Objective:To investigate the vasodilatative roles and mechanisms of 17 ? estradiol(E 2) on rat thoracic aortas (TA). Methods:Rings cut from thoracic aortas of female rats were used by in vitro perfusion. The endothelium dependent and endothelium independent vasorelaxing effects of E 2 were measured. Furthermore, it was also observed whether the relaxing effects of E 2 were modulated by tamoxifen, N ? nitro L arginine methyl ester(L NAME),TEA, methylene blue(MB) or Methylene Blue(MB).Results:E 2 caused acute concentration dependent relaxation in TA with endothelium, but not significant without endothelium( P

Objective To investigate the treatment efficacy of capecitabine combined with TACE for hepatic metastases after colorectal carcinoma resection.Methods The clinical data of 94 patients who were treated for hepatic metastases after colorectal carcinoma resection from June 2012 to December 2014 were retrospectively analyzed.The patients were divided into the combined group (48 patients) who underwent combined treatment of transcatheter arterial chemoembolization (TACE) and capecitabine,and the control group (46 patients) who were treated with TACE alone.The drug toxicities induced by chemotherapy in patients of the two groups were noted.The short-term outcomes and serum tumor markers were compared at 3-months after completion of TACE.All the patients were followed up and their overall survival was recorded.Results There was no significant difference in the frequency of TACE between the two groups (P ＞ 0.05).There were significant differences in the short-term outcomes at 3-month after completion of TACE (Z =2.000,P ＜ 0.05).The RR (complete response + partial response) and CBR (complete response + partial response + stable disease) were higher in the combined group than those in the control group [(52.1％ vs.32.0％) and (95.8％ vs.87.0％),respectively],although the differences were not statistically significant (both P ＞0.05).There were greater declines in CEA and CA19-9 levels at 3-month after completion of TACE in the combined group than the control group [(47.1 ± 10.3 vs.35.1 ±8.4) μg/L,(78.7 ± 19.6 vs.65.3 ± 17.0) kU/L],but the differences were not significant (t1 =5.776,t2 =7.849,both P ＜ 0.05).Toxic reactions were more common in the combined group than those in the control group,which included bone marrow suppression (39.6％ vs.30.4％) and peripheral neuritis (47.9％ vs.34.8％).Again,the differences were not significant (P ＞ 0.05).The median survivals were 17.3 months and 13.5 months,and 1-year survival rates were 72.9％ and 52.1％ in the combined group and the control group,respectively (x2 =4.325,P ＜ 0.05).There were significant differences in the survival between the two groups (x2 =4.097,P ＜ 0.05).Conclusions Capecitabine combined with TACE produced better treatment results for hepatic metastases after colorectal carcinoma resection.The short-term outcomes of the combined treatment was suDerior to TACE alone,and the treatment toxicities could be tolerated.

Background: E-waste workers in Hong Kong are handling an unprecedented amount of e-waste, which contains various neurotoxic chemicals. However, no study has been conducted to evaluate the neurological health status of e-waste workers in Hong Kong. This study aimed to evaluate the prevalence of neurobehavioral alterations and to identify the vulnerable groups among Hong Kong e-waste workers. Methods: We recruited 109 Hong Kong e-waste workers from June 2021 to September 2022. Participants completed standard questionnaires and wore a GENEActiv accelerometer for seven days. Pittsburgh Sleep Quality Index and Questionnaire 16/18 (Q16/18) were used to assess subjective neurobehavioral alterations. The GENEActiv data generated objective sleep and circadian rhythm variables. Workers were grouped based on job designation and entity type according to the presumed hazardous level. Unconditional logistic regression models measured the associations of occupational characteristics with neurobehavioral alterations after adjusting for confounders. Results: While dismantlers/repairers and the workers in entities not funded by the government were more likely to suffer from neurotoxic symptoms in Q18 (adjusted odds ratio: 3.18 [1.18–9.39] and 2.77 [1.10–7.46], respectively), the workers from self-sustained recycling facilities also have poor performances in circadian rhythm. Results also showed that the dismantlers/repairers working in entities not funded by the government had the highest risk of neurotoxic symptoms compared to the lowest-risk group (i.e., workers in government-funded companies with other job designations). Conclusion This timely and valuable study emphasizes the importance of improving the working conditions for high-risk e-waste workers, especially the dismantlers or repairers working in facilities not funded by the government.

Objective? To discuss the application effects of Satir model team intervention model among patients after radicalcolorectal cancer surgery. Methods? From November 2017 to May 2018, 70 patients with colorectal cancer in Nanyang Hospital Affiliated to Zhengzhou University were selected by convenience sampling. All the research subjects were divided into intervention group and control group by random number table method, with 35 cases in each. The control group received routine nursing after operation, while the observation group received Satia model team nursing intervention on the basis of the control group. The Family Adaptability and Cohesion Evaluation Scale Ⅱ (FACES Ⅱ), the Social Avoidance and Distress Scale (SADS) and the Self-esteem Scale (SES) were selected to compare the effects. Results? The intimacy and adaptability scores of FACESⅡ in the observation group on the day after the intervention and one month after the intervention were significantly higher than those of the postoperative day and the control group, with statistical significances (P＜ 0.01). The SADS score of the observation group on the day after the intervention and one month after the intervention were significantly lower than those of the control group, with statistical significance (P ＜ 0.01). The SES score of the observation group on the day after the intervention and one month after the intervention were significantly higher than those of the control group, with statistical significance (P＜ 0.01). Conclusions? The Satia model team intervention is helpful to improve family relationship, self-esteem and social reintegration of patients with colorectal cancer after radical operation.

Objective:To evaluate the safety of double and a half layered esophagojejunal anastomosis in radical gastrectomy.Methods:This prospective, multi-center, single-arm study was initiated by the Affiliated Cancer Hospital of Zhengzhou University in June 2021 (CRAFT Study, NCT05282563). Participating institutions included Nanyang Central Hospital, Zhumadian Central Hospital, Luoyang Central Hospital, First Affiliated Hospital of Henan Polytechnic University, First Affiliated Hospital of Henan University, Luohe Central Hospital, the People's Hospital of Hebi, First People's Hospital of Shangqiu, Anyang Tumor Hospital, First People's Hospital of Pingdingshan, and Zhengzhou Central Hospital Affiliated to Zhengzhou University. Inclusion criteria were as follows: (1) gastric adenocarcinoma confirmed by preoperative gastroscopy;(2) preoperative imaging assessment indicated that R0 resection was feasible; (3) preoperative assessment showed no contraindications to surgery;(4) esophagojejunostomy planned during the procedure; (5) patients volunteered to participate in this study and gave their written informed consent; (6) ECOG score 0–1; and (7) ASA score I–III. Exclusion criteria were as follows: (1) history of upper abdominal surgery (except laparoscopic cholecystectomy);(2) history of gastric surgery (except endoscopic submucosal dissection and endoscopic mucosal resection); (3) pregnancy or lactation;(4) emergency surgery for gastric cancer-related complications (perforation, hemorrhage, obstruction); (5) other malignant tumors within 5 years or coexisting malignant tumors;(6) arterial embolism within 6 months, such as angina pectoris, myocardial infarction, and cerebrovascular accident; and (7) comorbidities or mental health abnormalities that could affect patients' participation in the study. Patients were eliminated from the study if: (1) radical gastrectomy could not be completed; (2) end-to-side esophagojejunal anastomosis was not performed during the procedure; or (3) esophagojejunal anastomosis reinforcement was not possible. Double and a half layered esophagojejunal anastomosis was performed as follows: (1) Open surgery: the full thickness of the anastomosis is continuously sutured, followed by embedding the seromuscular layer with barbed or 3-0 absorbable sutures. The anastomosis is sutured with an average of six to eight stitches. (2) Laparoscopic surgery: the anastomosis is strengthened by counterclockwise full-layer sutures. Once the anastomosis has been sutured to the right posterior aspect of the anastomosis, the jejunum stump is pulled to the right and the anastomosis turned over to continue to complete reinforcement of the posterior wall. The suture interval is approximately 5 mm. After completing the full-thickness suture, the anastomosis is embedded in the seromuscular layer. Relevant data of patients who had undergone radical gastrectomy in the above 12 centers from June 2021 were collected and analyzed. The primary outcome was safety (e.g., postoperative complications, and treatment). Other studied variables included details of surgery (e.g., surgery time, intraoperative bleeding), postoperative recovery (postoperative time to passing flatus and oral intake, length of hospital stay), and follow-up conditions (quality of life as assessed by Visick scores).Result:[1] From June 2021 to September 2022,457 patients were enrolled, including 355 men and 102 women of median age 60.8±10.1 years and BMI 23.7±3.2 kg/m2. The tumors were located in the upper stomach in 294 patients, mid stomach in 139; and lower stomach in 24. The surgical procedures comprised 48 proximal gastrectomies and 409 total gastrectomies. Neoadjuvant chemotherapy was administered to 85 patients. Other organs were resected in 85 patients. The maximum tumor diameter was 4.3±2.2 cm, number of excised lymph nodes 28.3±15.2, and number of positive lymph nodes five (range one to four. As to pathological stage,83 patients had Stage I disease, 128 Stage II, 237 Stage III, and nine Stage IV. [2] The studied surgery-related variables were as follows: The operation was successfully completed in all patients, 352 via a transabdominal approach, 25 via a transhiatus approach, and 80 via a transthoracoabdominal approach. The whole procedure was performed laparoscopically in 53 patients (11.6%), 189 (41.4%) underwent laparoscopic-assisted surgery, and 215 (47.0%) underwent open surgery. The median intraoperative blood loss was 200 (range, 10–1 350) mL, and the operating time 215.6±66.7 minutes. The anastomotic reinforcement time was 2 (7.3±3.9) minutes for laparoscopic-assisted surgery, 17.6±1.7 minutes for total laparoscopy, and 6.0±1.2 minutes for open surgery. [3] The studied postoperative variables were as follows: The median time to postoperative passage of flatus was 3.1±1.1 days and the postoperative gastrointestinal angiography time 6 (range, 4–13) days. The median time to postoperative oral intake was 7 (range, 2–14) days, and the postoperative hospitalization time 15.8±6.7 days. [4] The safety-related variables were as follows: In total, there were 184 (40.3%) postoperative complications. These comprised esophagojejunal anastomosis complications in 10 patients (2.2%), four (0.9%) being anastomotic leakage (including two cases of subclinical leakage and two of clinical leakage; all resolved with conservative treatment); and six patients (1.3%) with anastomotic stenosis (two who underwent endoscopic balloon dilation 21 and 46 days after surgery, the others improved after a change in diet). There was no anastomotic bleeding. Non-anastomotic complications occurred in 174 patients (38.1%). All patients attended for follow-up at least once, the median follow-up time being 10 (3–18) months. Visick grades were as follows: Class I, 89.1% (407/457); Class II, 7.9% (36/457); Class III, 2.6% (12/457); and Class IV 0.4% (2/457).Conclusion:Double and a half layered esophagojejunal anastomosis in radical gastrectomy is safe and feasible.

Objective:To evaluate the safety of double and a half layered esophagojejunal anastomosis in radical gastrectomy.Methods:This prospective, multi-center, single-arm study was initiated by the Affiliated Cancer Hospital of Zhengzhou University in June 2021 (CRAFT Study, NCT05282563). Participating institutions included Nanyang Central Hospital, Zhumadian Central Hospital, Luoyang Central Hospital, First Affiliated Hospital of Henan Polytechnic University, First Affiliated Hospital of Henan University, Luohe Central Hospital, the People's Hospital of Hebi, First People's Hospital of Shangqiu, Anyang Tumor Hospital, First People's Hospital of Pingdingshan, and Zhengzhou Central Hospital Affiliated to Zhengzhou University. Inclusion criteria were as follows: (1) gastric adenocarcinoma confirmed by preoperative gastroscopy;(2) preoperative imaging assessment indicated that R0 resection was feasible; (3) preoperative assessment showed no contraindications to surgery;(4) esophagojejunostomy planned during the procedure; (5) patients volunteered to participate in this study and gave their written informed consent; (6) ECOG score 0–1; and (7) ASA score I–III. Exclusion criteria were as follows: (1) history of upper abdominal surgery (except laparoscopic cholecystectomy);(2) history of gastric surgery (except endoscopic submucosal dissection and endoscopic mucosal resection); (3) pregnancy or lactation;(4) emergency surgery for gastric cancer-related complications (perforation, hemorrhage, obstruction); (5) other malignant tumors within 5 years or coexisting malignant tumors;(6) arterial embolism within 6 months, such as angina pectoris, myocardial infarction, and cerebrovascular accident; and (7) comorbidities or mental health abnormalities that could affect patients' participation in the study. Patients were eliminated from the study if: (1) radical gastrectomy could not be completed; (2) end-to-side esophagojejunal anastomosis was not performed during the procedure; or (3) esophagojejunal anastomosis reinforcement was not possible. Double and a half layered esophagojejunal anastomosis was performed as follows: (1) Open surgery: the full thickness of the anastomosis is continuously sutured, followed by embedding the seromuscular layer with barbed or 3-0 absorbable sutures. The anastomosis is sutured with an average of six to eight stitches. (2) Laparoscopic surgery: the anastomosis is strengthened by counterclockwise full-layer sutures. Once the anastomosis has been sutured to the right posterior aspect of the anastomosis, the jejunum stump is pulled to the right and the anastomosis turned over to continue to complete reinforcement of the posterior wall. The suture interval is approximately 5 mm. After completing the full-thickness suture, the anastomosis is embedded in the seromuscular layer. Relevant data of patients who had undergone radical gastrectomy in the above 12 centers from June 2021 were collected and analyzed. The primary outcome was safety (e.g., postoperative complications, and treatment). Other studied variables included details of surgery (e.g., surgery time, intraoperative bleeding), postoperative recovery (postoperative time to passing flatus and oral intake, length of hospital stay), and follow-up conditions (quality of life as assessed by Visick scores).Result:[1] From June 2021 to September 2022,457 patients were enrolled, including 355 men and 102 women of median age 60.8±10.1 years and BMI 23.7±3.2 kg/m2. The tumors were located in the upper stomach in 294 patients, mid stomach in 139; and lower stomach in 24. The surgical procedures comprised 48 proximal gastrectomies and 409 total gastrectomies. Neoadjuvant chemotherapy was administered to 85 patients. Other organs were resected in 85 patients. The maximum tumor diameter was 4.3±2.2 cm, number of excised lymph nodes 28.3±15.2, and number of positive lymph nodes five (range one to four. As to pathological stage,83 patients had Stage I disease, 128 Stage II, 237 Stage III, and nine Stage IV. [2] The studied surgery-related variables were as follows: The operation was successfully completed in all patients, 352 via a transabdominal approach, 25 via a transhiatus approach, and 80 via a transthoracoabdominal approach. The whole procedure was performed laparoscopically in 53 patients (11.6%), 189 (41.4%) underwent laparoscopic-assisted surgery, and 215 (47.0%) underwent open surgery. The median intraoperative blood loss was 200 (range, 10–1 350) mL, and the operating time 215.6±66.7 minutes. The anastomotic reinforcement time was 2 (7.3±3.9) minutes for laparoscopic-assisted surgery, 17.6±1.7 minutes for total laparoscopy, and 6.0±1.2 minutes for open surgery. [3] The studied postoperative variables were as follows: The median time to postoperative passage of flatus was 3.1±1.1 days and the postoperative gastrointestinal angiography time 6 (range, 4–13) days. The median time to postoperative oral intake was 7 (range, 2–14) days, and the postoperative hospitalization time 15.8±6.7 days. [4] The safety-related variables were as follows: In total, there were 184 (40.3%) postoperative complications. These comprised esophagojejunal anastomosis complications in 10 patients (2.2%), four (0.9%) being anastomotic leakage (including two cases of subclinical leakage and two of clinical leakage; all resolved with conservative treatment); and six patients (1.3%) with anastomotic stenosis (two who underwent endoscopic balloon dilation 21 and 46 days after surgery, the others improved after a change in diet). There was no anastomotic bleeding. Non-anastomotic complications occurred in 174 patients (38.1%). All patients attended for follow-up at least once, the median follow-up time being 10 (3–18) months. Visick grades were as follows: Class I, 89.1% (407/457); Class II, 7.9% (36/457); Class III, 2.6% (12/457); and Class IV 0.4% (2/457).Conclusion:Double and a half layered esophagojejunal anastomosis in radical gastrectomy is safe and feasible.