Objective:To evaluate the clinical efficacy and prognostic factors in patients with stage Ⅲb/c or Ⅳ inoperable advanced gastric cancer.Methods:The clinical data of 33 patients with unresectable locally advanced (stage Ⅲb/c) or unresectable stage Ⅳ gastric cancer were collected from May 2017 to may 2019 in the Department of Surgical Oncology, Anqing Hospital affiliated to Anhui Medical University, Among them, there were 25 males and 8 females with an average age of 65.48±9.00 years. According to the data of patients with conversion therapy efficacy and postoperative pathology and other factors for statistics, using univariate and multivariate analysis method to evaluate its correlation with the prognosis of patients.Results:Of 33 patients, 2 patients were complete remission, 18 patients were partial remission, the objective response rate(ORR) was 60.6%. 20 patients recevied surgical treatment, 17 patients achieved R0 resection. The median overall survival(mOS) of all 33 patients was (18.6±4.5) months. The mOS of patients who underwent surgical treatment was (25.7±10.99) months, which in patients without surgical treatment was (11.2±2.5) months( P=0.004). The mOS of stage Ⅲb/c patients Was (18.9±10.99) months, and of stage Ⅳ patients was (11.3±0.35) months( P=0.568). Univariate analysis showed that preoperative chemotherapy cycle ≥4 weeks had a better prognosis than patients with less than 4 cycles ( P=0.003), TRG score 1/2 patients had a better prognosis ( P=0.001), and positive lymph nodes ≥7 was risk factor. Multivariate analysis showed that positive lymph nodes ≥7 was the only independent prognostic factor ( P=0.013). Conclusion:For patients with stage Ⅲb/c or Ⅳ inoperable advanced gastric cancer, surgical resection after conversion therapy can improve patient survival, adequate preoperative chemotherapy can improve the prognosis of patients with at least 4 cycles of chemotherapy.

Background: Galangin, commonly employed in traditional Chinese medicine for its diverse medicinal properties, exhibits potential in treating inflammatory pain. Nevertheless, its mechanism of action remains unclear. Methods: Mice were randomly divided into 4 groups for 7 days: a normal control group, a galangin-treated (25 and 50 mg/kg), and a positive control celecoxib (20 mg/kg). Analgesic and anti-inflammatory effects were evaluated using a hot plate test, acetic acid-induced writhing test, acetic acid-induced vascular permeability test, formalininduced paw licking test, and carrageenan-induced paw swelling test. The interplay between galangin, transient receptor potential vanilloid 1 (TRPV1), NF-κB, COX-2, and TNF-α proteins was evaluated via molecular docking. COX- 2, PGE2, IL-1β, IL-6, and TNF-α levels in serum were measured using ELISA after capsaicin administration (200 nmol/L). TRPV1 expression in the dorsal root ganglion was analyzed by Western blot. The quantities of substance P (SP) and calcitonin gene-related peptide (CGRP) were assessed using qPCR. Results: Galangin reduced hot plate-induced licking latency, acetic acid-induced contortions, carrageenantriggered foot inflammation, and capillary permeability in mice. It exhibited favorable affinity towards TRPV1, NF- κB, COX-2, and TNF-α, resulting in decreased levels of COX-2, PGE2, IL-1β, IL-6, and TNF-α in serum following capsaicin stimulation. Galangin effectively suppressed the upregulation of TRPV1 protein and associated receptor neuropeptides CGRP and SP mRNA, while concurrently inhibiting the expression of NF-κB, TNF-α, COX-2, and PGE2 mRNA. Conclusions Galangin exerts its anti-inflammatory pain effects by inhibiting TRPV1 activation and regulating COX-2, NF-κB/TNF-α expression, providing evidence for the use of galangin in the management of inflammatory pain.

Background: Galangin, commonly employed in traditional Chinese medicine for its diverse medicinal properties, exhibits potential in treating inflammatory pain. Nevertheless, its mechanism of action remains unclear. Methods: Mice were randomly divided into 4 groups for 7 days: a normal control group, a galangin-treated (25 and 50 mg/kg), and a positive control celecoxib (20 mg/kg). Analgesic and anti-inflammatory effects were evaluated using a hot plate test, acetic acid-induced writhing test, acetic acid-induced vascular permeability test, formalininduced paw licking test, and carrageenan-induced paw swelling test. The interplay between galangin, transient receptor potential vanilloid 1 (TRPV1), NF-κB, COX-2, and TNF-α proteins was evaluated via molecular docking. COX- 2, PGE2, IL-1β, IL-6, and TNF-α levels in serum were measured using ELISA after capsaicin administration (200 nmol/L). TRPV1 expression in the dorsal root ganglion was analyzed by Western blot. The quantities of substance P (SP) and calcitonin gene-related peptide (CGRP) were assessed using qPCR. Results: Galangin reduced hot plate-induced licking latency, acetic acid-induced contortions, carrageenantriggered foot inflammation, and capillary permeability in mice. It exhibited favorable affinity towards TRPV1, NF- κB, COX-2, and TNF-α, resulting in decreased levels of COX-2, PGE2, IL-1β, IL-6, and TNF-α in serum following capsaicin stimulation. Galangin effectively suppressed the upregulation of TRPV1 protein and associated receptor neuropeptides CGRP and SP mRNA, while concurrently inhibiting the expression of NF-κB, TNF-α, COX-2, and PGE2 mRNA. Conclusions Galangin exerts its anti-inflammatory pain effects by inhibiting TRPV1 activation and regulating COX-2, NF-κB/TNF-α expression, providing evidence for the use of galangin in the management of inflammatory pain.

Background: Galangin, commonly employed in traditional Chinese medicine for its diverse medicinal properties, exhibits potential in treating inflammatory pain. Nevertheless, its mechanism of action remains unclear. Methods: Mice were randomly divided into 4 groups for 7 days: a normal control group, a galangin-treated (25 and 50 mg/kg), and a positive control celecoxib (20 mg/kg). Analgesic and anti-inflammatory effects were evaluated using a hot plate test, acetic acid-induced writhing test, acetic acid-induced vascular permeability test, formalininduced paw licking test, and carrageenan-induced paw swelling test. The interplay between galangin, transient receptor potential vanilloid 1 (TRPV1), NF-κB, COX-2, and TNF-α proteins was evaluated via molecular docking. COX- 2, PGE2, IL-1β, IL-6, and TNF-α levels in serum were measured using ELISA after capsaicin administration (200 nmol/L). TRPV1 expression in the dorsal root ganglion was analyzed by Western blot. The quantities of substance P (SP) and calcitonin gene-related peptide (CGRP) were assessed using qPCR. Results: Galangin reduced hot plate-induced licking latency, acetic acid-induced contortions, carrageenantriggered foot inflammation, and capillary permeability in mice. It exhibited favorable affinity towards TRPV1, NF- κB, COX-2, and TNF-α, resulting in decreased levels of COX-2, PGE2, IL-1β, IL-6, and TNF-α in serum following capsaicin stimulation. Galangin effectively suppressed the upregulation of TRPV1 protein and associated receptor neuropeptides CGRP and SP mRNA, while concurrently inhibiting the expression of NF-κB, TNF-α, COX-2, and PGE2 mRNA. Conclusions Galangin exerts its anti-inflammatory pain effects by inhibiting TRPV1 activation and regulating COX-2, NF-κB/TNF-α expression, providing evidence for the use of galangin in the management of inflammatory pain.

Objective:To explore the prognostic factors that may affect the postoperative survival of gastric cancer by analyzing patients with radical gastrectomy.Methods:The data of 525 patients with radical gastrectomy, including 387 male and 138 female with average age (62.5±10.7) years old (ranged from 16 to 89 years), were analyzed retrospectively in Anqing Municipal Hospital between October 2010 to July 2015. The relationship between 33 variables and prognosis was analyzed by a Cox proportionalhazards regression model, meanwhile ROC curve was established in order to explore the risk factor of postopertive survival.Results:The over survival(OS) rate of all patients was 89.3% at 1 year, 68.4% at 3 years and 59.6% at 5 years. The 5-year OS rate was 81.9% at stage Ⅰ, 71.4% at stage Ⅱ and 44.1% at stage Ⅲ. In the multivariate analysis that included these factors, preoperative comorbidity ( HR=1.595, P=0.001), hemoglobin( HR=1.377, P=0.017), CA199( HR=1.618, P=0.004), tumor distribution( HR=1.943, P=0.032), pT stage( HR=1.731, P=0.012), pN stage( HR=2.118, P=0.000), signet ring cell( HR=1.642, P=0.038)and intravascular tumor thrombus( HR=1.391, P=0.039) were independent risk factors associating with postopertive survival.According to ROC curve, the following area (AUC value) could predict survival after radical gastrectomy, including CA199 (AUC=0.568), hemoglobin(AUC=0.586), preoperative comorbidity(AUC=0.554), pT stage(AUC=0.636), pN stage(AUC=0.670)and intravascular tumor thrombus(AUC=0.626)( P<0.05). Conclusion:According to ROC curve analysis, preoperative comorbidity, anemia, CA199, pN stage, pT stage and intravascular tumor thrombus played an role in predicting long-term survival after radical resection of gastric cancer.

Objective:Clavien-Dindo grading system was used to explore the occurrence and related risk factors of early severe complications after radical resection of gastric cancer, and the effect of severe complications on long-term prognosis was analyzed.Methods:The clinical data of 525 patients who underwent radical resection of gastric cancer, including 387 male and 138 female with average age(62.5±10.7)years old (range from 16 to 89 years), were analyzed retrospectively in Department of Surgical Oncology of Anqing Municipal Hospital from October 2010 to July 2015. The occurrence of postoperative severe complications was analyzed according the Clavien-Dindo grade system.The relationship between 18 variables and severe complications was analyzed by univariate and multivariate analysis in order to explore the risk factors of severe postoperative complications, and the relationship between severe complications and long-term prognosis was analyzed by COX survival model. The software of SPSS 17.0 was used to conduct statistic analysis.Results:Five hundred and twenty-five patients with radical gastrectomy, 114 cases had early postoperative complications, including 20 cases of severe complications, 4 cases were performed second surgery under general anesthesia. The results of univariate analysis showed gender( χ2=4.86, P=0.027), the amount of bleeding( χ2=11.11, P=0.001), opertive time( χ2=4.77, P=0.029), the mode of operation( χ2=9.20, P=0.002) and pTNM stage( χ2=4.86, P=0.027) had significant statistical difference. Multivariate analysis showed that the amount of bleeding ( OR=13.05, P=0.013) and the mode of operation ( OR=7.97, P=0.047) were independent risk factors for early and severe complications after radical resection of gastric cancer. The 5-year survival rates of severe complication and non-severe complication were 35.0% and 61.8% respectively, and the difference was statistically significant ( P=0.004). Severe postoperative complications ( HR=1.595, P=0.107) were not independent risk factors affecting the 5-year survival rate. Conclusions:Early severe complications after radical resection of gastric cancer are closely related to intraoperative blood loss and total gastrectomy. Although the 5-year survival rate in severe complication group is significantly lower than that in non-severe complication group, severe complication is not an independent risk factor for long-term survival.

Objective To investigate the modified Clavien-Dindo classification and risk factors for postoperative early complications of radical proctectomy in rectal cancer.Methods The clinical data of 187 patients,including 99 male cases and 88 female cases with the average age (64.5 ± 10.8) years old (ranged from 37 to 87 years),with radical resection of rectal cancer were analyzed retrospectively in Anqing Hospital Affiliated of Anhui Medical University between August 2014 and October 2018,and the occurrence of early postoperative complications was analyzed according to the modified Clavien-Dindo grade system.The relationship between 32 variables and complications in the data was analyzed by single factor and multiple factors in order to explore the risk factors of early postoperative complications.Results One hundred and eighty seven patients with radical proctectomy,54 cases (28.9％,54/187) had early postoperative complications,including 15 cases of serious complications (8.0％,15/187),3 cases were performed second surgeries under general anesthesia (1.6％,3/187).Postoperative modified Clavien-Dindo Grade:12 cases with grade Ⅰ,27 cases with grade Ⅱ,11 cases with grade Ⅲ a,3 cases with grade Ⅲ b,1 case with grade Ⅳ a,no case with grade Ⅳ b and Ⅴ.The results of single factor analysis showed age (x2 =4.788,P =0.029),ASA grade (x2 =26.903,P =0.000),multiple organ resection (x2 =4.749,P =0.029),pT stage (x2 =8.080,P =0.044),pTNM stage (x2 =6.29,P =0.043),total harvested lymph node number (x2 =5.542,P =0.019).The occurrence of early complications after radical proctectomy,multi-factor analysis found that ASA grade (OR =3.539,P =0.000),pTNM stage (OR =1.846,P =0.034) was an independent risk factor for early postoperative complications of rectal cancer.The area (AUC value) under the curve of the prediction of early postoperative complications in patients with ASA grade and pTNM stage was 0.708 (95％ CI:0.625-0.791,P =0.000) and 0.555 (95％ CI:0.469-0.642,P =0.235).Conclusions Early complications after radical resection of rectal cancer are closely related to ASA grade and tumor pTNM staging.ASA grade can be used as a significant predictor of early complications after radical proctectomy in rectal cancer.