AIM: To observe the effects of Helicobacter pylori (Hp) on the apoptosis of human gingival tissue.METHODS: Gingival tissue samples were taken from 30 patients without chronic periodontitis, and Hp was detected by conventional PCR.The apoptosis of the gingivival cells was detected by terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) to analyze the correlation between Hp infection and apoptosis of the gingival tissues.RESULTS: The Hp positive detections were 12 in the 30 patients without periodontitis, so the positive rate of Hp in the gingival tissue samples was 40%.The gingival tissue showed a large number of apoptotic cells in Hp positive group, and less apoptotic cells in Hp negative group.The apoptotic index in Hp positive group (0.498±0.092) was significantly higher than that in normal group (0.207±0.053) (P<0.05).CONCLUSION: Hp might play a role in the apoptosis of gingival tissues.

Aerenchyrna formation has been described in depth in a number of species at a histological level. But large gaps remain in our understanding of its regulation as a developmental process. It is attempted to analyse essential mineral elements like K, Mg, Cu, Zn, Ca and P in the cell wall of aerenchyma cells in petioles ofS. trifolia at five different developmental stages by CSEM-EDX technique. At early stage, K and Cl concentrations in cell wall were high up to 36% and 4.3% of dry weight, respectively. It supported the hypotheses that aerenchyma spaces are filled with liquid at early developmental stages of aerenchyma in S. trifolia petiole. Mg concentration was high at stage 2, up to 0.86% of dry weight. Zinc and Cu were detected only at rapid expansion stages, during which the concentrations were up to 1.5% and 2.5%, respectively. Calcium was detected in the cell wall only at mature stages, the concentration was high up to 1.3% of dry weight at stages 4 and 5. These results confirmed that the element concentration of aerenehyma cell wall undergoes dynamic changes during different developmental stages, and a low Ca with high Zn and Cu concentration are needed for cell expansion. Copper and Zn deposition in the cell wall showed a significant positive linear correlation, suggesting that these two elements share same or similar uptake and transport mechanism in plants.

In healthy control group(group A),impaired fasting glucose group (group B) and diabetes group(group C),serum ferritin levels gradually raised[(170.7±91.8),(255.2±161.9) and (362.8±298.5) μmol/L].Hemoglobin Was elevated in impaired fasting glucose group,while returned to normal or even lower in diabetes group[group A(141.0±9.5),group B(148.2±11.2),group C(132.3±19.2)g/L].There was no difference in high sensitivity C-reactive protein among the groups.

[ABSTRACT]OBJECTIVETo observe the short term effects and adverse effects of induction chemotherapy with Paclitaxel,Cisplatin and Fluorouracil(TPF) in locally advanced squamous cell cancer of hypopharynx. METHODS78 cases locally advanced squamous-cell cancer of hypopharynx form jan 2011 to oct 2013 for the first time treated by TPF scheme,after 2 cycles,to recheck CT scan and evaluate therapeutic effective.RESULTSAll 78 cases patients achieved 156 cycles chemotherapy,CR was 4 cases (5.1%),PR 55 cases (70.5%),SD 17 cases (21.8%), PD 2 cases (2.6%). Total effective rate (CR+PR) was 75.6%,and with low incidence ofⅢ/Ⅳ grade side effect. Logistic regression analysis shows that there is a significant correlation between effective rate and low differentiation cancer.CONCLUSIONFor locally advanced squamous-cell cancer of hypopharynx patients,the TPF chemotherapy scheme showed good therapeutic effective and safety,could be a choice for the induction chemotherapy treatment in locally advanced squamouscell cancer of hypopharynx. The patients with low differentiation cancer may have benefit from the induction chemotherapy.

OBJECTIVE To explore t he significance of reducing the incidence rate of airway burn of CO2 laser laryngeal surgery by spreading the idea of grading prevention st rateg y. M ETHODS We retrospectively reviewed the data of laryngeal lesions treated by the endoscopic CO2 laser surgery from Feburary 1992 to December 2016. The period was divided into two stages, the first one is from Feburary 1992 to December 2008, and the second one is from January 2009 to December 2016. We will distinguish the difference of airway burn between the two stages. RESULTS Four cases of airway burn were found in the first stage including 3 cases of glottic cancer and 1 case of vocal cord polyp with Reink's edema. But no airway burn happened in the second stage. Two cases of endotracheal intubation cuff broken by laser were found promptly, but with FiO2 decreasing from 70% to 30%, wet gauze filling subglottic region and the endotracheal tube reserved, the laser surgery proceeded till airway burn happened. The endotracheal intubation cuffs of the remaining two cases kept intact intraoperatively, the FiO2 was 70% when airway burn happened. One case had the cervical tracheal stenosis with long-term tracheotomy, The other 3 cases had no postoperative complications. CONCLUSION The grading prevention strategy is helpful for reducing airway burn during the CO2 laser surgery of larynx.

Objective To evaluate the effects and the safety of peroral endoscopic myotomy (POEM) for achalasia (AC).Methods POEM was performed on 7 AC patients from November 2010 to November 2011.Preoperative dysphagia grade,postoperative complications and short-term and long-term efficacy were recorded.Results POEM was performed successfully on all the 7 patients.The operation time were ranging from 46 to 113 minutes,mean 73 ± 20 minutes.Subcutaneous emphysema and mediastinal emphysema occurred in 2 patients,but cured after treatment.The 1-12 month follow-up showed dysphagia of all the patients was obviously improved.Conclusion POEM is efficient and safe to relieve dysphagia of AC patients.

Objective:To investigate the potential prognostic value of cyclin D1 expression in patients with locally advanced oral squamous cell carcinoma (OSCC) and its relationship with taxol (Docetaxel)/cisplatin plus 5-fluorouracil (TPF) induction chemothera-py. Methods:A total of 256 patients with locally advanced OSCC were selected from Shanghai Ninth People's Hospital of Shanghai Ji-ao Tong University School of Medicine between March 2008 and December 2010 as the objects of study in this prospective randomized clinical trial. The effect of TPF induction chemotherapy was investigated. Immunohistochemical staining against cyclin D1 was per-formed in the pretreatment biopsy specimen of the patients. The relationship between cyclin D1 expression and prognostic data of the TPF induction arm and control arm was analyzed. Results:Cyclin D1 expression was detected in 232 out of the 256 patients. Patients with low cyclin D1 expression showed significantly better overall survival (OS) (P=0.001), disease-free survival (DFS) (P=0.003), lo-coregional recurrence-free survival (LRFS) (P=0.004), and distant metastasis-free survival (DMFS) (P=0.001) than those with high cy-clin D1 expression. No significant differences existed in OS, DFS, LRFS, or DMFS between the patients with TPF induction chemother-apy and the control. Cyclin D1 expression levels were not predictive of the benefit from TPF induction chemotherapy in the overall pop-ulation. However, patients with nodal stage cN2 and high cyclin D1 expression, who were undergoing TPF chemotherapeutic regimen, showed significantly higher OS (P=0.024) and DMFS (P=0.024) than cN2 patients with high cyclin D1 expression but undergoing stan-dard surgical treatment. Conclusion:Cyclin D1 can be used as a prognostic biomarker for patients with locally advanced OSCC. Fur-thermore, cN2 OSCC patients with high cyclin D1 expression can receive long-term benefit from the addition of TPF induction chemo-therapy to standard surgical treatment.

OBJECTIVE To study the effect of the free anterolateral thigh myocutaneous flap on the appearance and functions after maxillectomy.METHODS The clinical data of 5 patients with malignant maxillary tumors from June,2016 to June 2017 were analyzed retrospectively.The 5 cases were T3-4N0M0 lesions.All of them received the maxillectomy and then were reconstructed with the free anterolateral thigh myocutaneous flap,and the flap was about 1.25 times of the defect in volume.RESULTS The needed volumes for the reconstruction were from 165 ml to 225 ml and the operation time of reconstruction were between 80-95 minutes.All the free flaps survived after operation.Although the reconstructed side looked swelling obviously in the first month after surgery,the appearance became good and symmetrical after the radiotherapy.No diplopia occurred and the functions of breathing,swallowing and speaking were normal.No movement disorders happened caused by the donor of thigh flap.CONCLUSION The free anterolateral thigh myocutaneous flap as the reconstructive tissue has many merits.The volume is adequate and can be regulated according to the defect.The forward appearance is better than the free anterolateral thigh flap without muscles.So the reconstruction of free anterolateral thigh myocutaneous flap is an ideal material for reconstruction because of the good functions and being easy to operate.

Objective:To identify the prognostic factors in metastatic colorectal cancer (mCRC) patients treated with cetuximab and establish a prognostic nomogram and validate its accuracy.Methods:A retrospective case-control study was conducted. Patients were selected as following criteria: patients with metastatic colorectal cancer(mCRC), which primary site confirmed by pathology and metastatic lesions confirmed by CT or MRI with at least one measurable and evaluable target lesion; patients' expected survival longer than 3 months; Eastern Cooperative Oncology Group (ECOG) score between 0 to 2; patients have signed informed consent; both KRAS and NRAS genes were wild-type; and at least 2 cycles of cetuximab combined with chemotherapy as the first-line regimen. Patients who met the following criteria were excluded: patients with incomplete clinicopathological and follow-up data; patients with severe diseases of vital organs such as heart, brain, lung, kidney, or other advanced malignant tumors; patients without informed consent. According to the above criteria, clinicopathological data of 95 patients with mCRC admitted in the Department of Medical Oncology, the Second Affiliated Hospital, Zhejiang University School of Medicine for first-line treatment with cetuximab from January 2010 to January 2017 were analyzed retrospectively. The Cox proportional hazards model was used to analyze the clinicopathological factors to determine the independent prognostic factors for progression-free survival(PFS). The R software was adopted to establish a prognostic nomogram model. Then, the nomograms of 6-month, 12-month and 18-month progression-free survivals (PFS) were drawn, and compared with the reality. The internal validation and accuracy of the nomogram were determined by the Bootstrap method and also the calculated concordance index (C-index).Results:The median follow-up time was 16.5 (2-43) months and the median PFS was 8.5 months. PFS at 6-,12- and 18-month was 73.7%, 35.8%, and 17.9%, respectively. ECOG score of 1-2 (HR=5.733, 95% CI:2.408-13.649, P<0.001), primary tumor was located in the ileocecal region (HR=5.880, 95% CI:1.645-21.023, P=0.006), Ki-67 index ≥45% (HR=3.574,95% CI:1.403-9.108, P=0.008), baseline D-dimer level ≥345 mg/L (HR=2.536,95% CI:1.531-7.396, P=0.012), NLR≥2.8 (HR=5.573,95% CI:2.107-14.740, P=0.001) and the combined treatment for FOLFOX (HR=0.465, 95% CI: 0.265-0.817, P=0.008) were independent risk factors for PFS of mCRC patients (all P<0.05). These independent risk factors were taken into account to construct a nomogram prediction model. The bootstrap method was used to perform internal validation, and the C-index of the nomogram prediction model in this study was 0.67 (95% CI: 0.64~0.71). The 6-, 12- and 18-month PFS predicted by the nomogram were consistent with the actual values. Conclusion:The nomogram model constructed by ECOG score, primary tumor site, Ki-67 index, baseline D-dimer level, baseline NLR and chemotherapy regimen may predict the prognosis of mCRC patients treated with cetuximab more accurately and individually, which can assist clinicians in making treatment decisions.

Objective:To identify the prognostic factors in metastatic colorectal cancer (mCRC) patients treated with cetuximab and establish a prognostic nomogram and validate its accuracy.Methods:A retrospective case-control study was conducted. Patients were selected as following criteria: patients with metastatic colorectal cancer(mCRC), which primary site confirmed by pathology and metastatic lesions confirmed by CT or MRI with at least one measurable and evaluable target lesion; patients' expected survival longer than 3 months; Eastern Cooperative Oncology Group (ECOG) score between 0 to 2; patients have signed informed consent; both KRAS and NRAS genes were wild-type; and at least 2 cycles of cetuximab combined with chemotherapy as the first-line regimen. Patients who met the following criteria were excluded: patients with incomplete clinicopathological and follow-up data; patients with severe diseases of vital organs such as heart, brain, lung, kidney, or other advanced malignant tumors; patients without informed consent. According to the above criteria, clinicopathological data of 95 patients with mCRC admitted in the Department of Medical Oncology, the Second Affiliated Hospital, Zhejiang University School of Medicine for first-line treatment with cetuximab from January 2010 to January 2017 were analyzed retrospectively. The Cox proportional hazards model was used to analyze the clinicopathological factors to determine the independent prognostic factors for progression-free survival(PFS). The R software was adopted to establish a prognostic nomogram model. Then, the nomograms of 6-month, 12-month and 18-month progression-free survivals (PFS) were drawn, and compared with the reality. The internal validation and accuracy of the nomogram were determined by the Bootstrap method and also the calculated concordance index (C-index).Results:The median follow-up time was 16.5 (2-43) months and the median PFS was 8.5 months. PFS at 6-,12- and 18-month was 73.7%, 35.8%, and 17.9%, respectively. ECOG score of 1-2 (HR=5.733, 95% CI:2.408-13.649, P<0.001), primary tumor was located in the ileocecal region (HR=5.880, 95% CI:1.645-21.023, P=0.006), Ki-67 index ≥45% (HR=3.574,95% CI:1.403-9.108, P=0.008), baseline D-dimer level ≥345 mg/L (HR=2.536,95% CI:1.531-7.396, P=0.012), NLR≥2.8 (HR=5.573,95% CI:2.107-14.740, P=0.001) and the combined treatment for FOLFOX (HR=0.465, 95% CI: 0.265-0.817, P=0.008) were independent risk factors for PFS of mCRC patients (all P<0.05). These independent risk factors were taken into account to construct a nomogram prediction model. The bootstrap method was used to perform internal validation, and the C-index of the nomogram prediction model in this study was 0.67 (95% CI: 0.64~0.71). The 6-, 12- and 18-month PFS predicted by the nomogram were consistent with the actual values. Conclusion:The nomogram model constructed by ECOG score, primary tumor site, Ki-67 index, baseline D-dimer level, baseline NLR and chemotherapy regimen may predict the prognosis of mCRC patients treated with cetuximab more accurately and individually, which can assist clinicians in making treatment decisions.