Objective This study was to investigate the lymph node metastasis pattern in thoracic esophageal squamous cell carcinoma (ESCC),and analyze the risk factors to provide reference for the delineation of radiotherapy target.Methods A total of 319 patients with thoracic ESCC who underwent surgical treatment at the second hospital of Dalian medical university were analyzed retrospectively.The lymph nodes around esophageal were divided into 20 groups according to the mapping scheme of the American Thoracic Society (ATS) modified by Casson et al.Analyzed the pattern of lymph node metastasis and its relationship with tumor location,tumor length,depth of invasion,pathological grade,and vessel invasion.Results The lymph node metastatic rate was 48.90％ (156/319),while the metastatic ratio of lymph node (LMR) was 15.70％ (562/3 581).The lymph node metastatic rates had gradually increasing trend with tumor sites descending (upper ESCC 35.48％,middle ESCC 47.06％ and lower ESCC 56.43％),but no statistically significance (P ＞ 0.05) was observed.In the whole 20 groups,the higher node metastasis stations of upper thoracic ESCC LMR were 1,2,4,5,7,9 (x2 =27.38,P ＜ 0.05),while the middle thoracic ESCC LMR were 2,4,5,7,8M (x2 =57.77,P ＜ 0.05),and the lower thoracic ESCC LMR were 4,5,7,8L,16,17,20 (x2 =28.88,P ＜ 0.05),with statistically significance.So the main lymph node metastasis stations were paraesophageal nodes,tracheobronchial nodes,paratracheal nodes,aroticopumonary nodes,left gastric nodes,subcarinalnodes and celiac nodes.The univariate analysis revealed that lymph node metastasis was correlated with the tumor length,depth of invasion,pathological grade,and presence of vascular invasion (x2 =6.82,26.04,36.26,4.56respectivcly,P ＜ 0.05).The muhi-variate regression analysis showed that tumor length and depth of tumor invasion were independent risk factors for lymph node metastasis (OR =2.212,2.123,P ＜ 0.05).Conclusions The factors influencing lymph node metastasis in thoracic ESCC include tumor length,depth of invasion,pathological grade,and presence of vascular invasion,which should be carefully considered during the target delineation of radiotherapy for esophageal carcinoma.

To summarize the clinical effect of using boosters for orbital autologous fat injection transplantation.

A retrospective analysis was conducted on the clinical data of patients who underwent orbital fine autologous fat injection and transplantation at the Burn and Plastic Surgery Department of the 940th Hospital of the PLA Joint Logistics Support Force from January 2019 to December 2023. The patients were treated with orbital fine autologous fat injection and transplantation using a self-developed autologous fat transplantation booster with constant pressure and micro controllability connected to a 1 mL injector, and the therapeutic effect was analyzed.

A total of 186 patients who met the inclusion and exclusion criteria were included in this study, including 165 females and 21 males, with the average age of (39.0±7.1) years old (range: 23-71 years old). Of the 186 patients, 58 cases were of upper eyelid depression, 45 cases were of inner canthal depression, 34 cases were of ocular platform flattening, 6 cases were of meibomian depression, and 43 cases were of lacrimal groove depression. The transplantation volume of granular fat was 0.1-10 mL, with an average of 3.5 mL; the injection volume of nanofat was 0.5-2.0 mL, with an average of 0.5 mL. Follow up for 7 days to 4 years showed that 163 cases (87.6%) were satisfied with the results, 15 cases (8.1%) had average results, and 8 cases (4.3%) were dissatisfied. No surgical complications occurred.

The use of a constant pressure and micro controllable electric booster to assist autologous fat injection transplantation could achieve precision in orbital autologous fat transplantation, with high patient satisfaction, meaning that it is worthy of clinical promotion and application.

Objective: To explore the relationship between the changes of plasma levels of resistin with the contemporary body weigh changes in the same population. Methods: The community based epidemiological surveys were carried out in the same population in Shijingshan district of Beijing at the year of 2005 and year of 2010. A total of 943 subjects with the entire information of cardiovascular related risk factors were enrolled including 316 male with the mean age of (58.2 ± 8.5) years and 627 female with the mean age of (59.3 ± 7.5) years. Plasma levels of resistin in both year of 2005 and year of 2010 in all subjects were recorded, and the subjects were divided into 4 groups based on the quartile levels of resistin. Group①, the subjects with plasma level of resistin ≤ (-0.66) mmol/L,n=239, Group②, resistin level (from -0.67 to 0.25) mmol/L,n=233, Group③, resistin level (0.26-1.24) mmol/L, n=235 and Group④, resistin level ≥1.25 mmol/L,n=236. Pearson correlation study with uni- and multi- regression analysis were conducted to investigate the relationship between the changes of plasma levels of resistin with the contemporary body weight changes in the same population.Results: The uni-variate analysis showed that in female subjects, plasma levels of resistin were obviously related to the percentage (%) of body weight changes (correlation coefifcient: 0.1173), body weight index (kg/m2) changes (0.1521), the% of body weight index changes (0.1412), the waist circumference (cm) changes (0.1228) and the % of waist circumference changes (0.1057) respectively, allP<0.05; while the above changes in male subjects were not signiifcant, allP>0.05. Multi-regression analysis indicated that with adjusted baseline variables, in female subjects, the plasma levels of resistin were obviously related to body weight (kg) changes and the % of body weight changes (regression coefifcient: 0.0261 and 0.2916), body weight index (kg/m2) changes and % of body weight index changes (0.2157 and 0.3072), the waist circumference (cm) changes and the% of waist circumference changes (0.0532 and 0.2738) respectively, allP<0.05; while the above changes in male subjects were not signiifcant, allP>0.05. Conclusion: The changes of plasma levels of resistin are signiifcantly related to contemporary body weight changes in female subjects, but not in male subjects.

Objective:The prognosis of cancer patients depends not only on tumor related factors, but also on host related factors, especially systemic inflammatory response. Based on the ratio of neutrophils to lymphocytes (NLR), the ratio of platelets to lymphocytes (PLR) and the ratio of lymphocytes to monocytes (LMR), we constructed a systemic inflammation model to predict the survival time of patients with gastric cancer (GC) after radical gastrectomy.Methods:Two hundred and five patients with GC who underwent radical resection from January 2011 to January 2017 were selected in Qinghai Provincial Communications Hospital and Red Cross Hospital of Qinghai Province. NLR, PLR and LMR were collected before operation. The best truncation values of NLR, PLR and LMR were obtained by ROC curve and systemic inflammatory marker score (SIMS) was constructed. The clinical value of SIMS was analyzed by single factor and multi factor Cox risk proportion model.Results:All patients were followed up for an average of (63.47 ± 10.36) months (range 20 to 65 months). The median survival time was 56 months. The one-year mortality rate was 6.3%, the three-year mortality rate was 26.2%, and the five-year mortality rate was 34.6%. The AUC of NLR, PLR and LMR were 0.745, 0.805 and 0.866 respectively, and the best truncation values were 3.11, 144 and 3.34 respectively. The mortality of patients with NLR > 3.11, PLR > 144, LMR ≤ 3.34 was higher than that of patients with NLR ≤ 3.11, PLR ≤ 114, LMR > 3.34 ( χ2 = 10.491, 14.658 and 38.765; P<0.01); there were differences in survival curves among different groups of NLR, PLR, LMR ( P < 0.05). The survival curves of different scores of SIMS were different ( P < 0.05). Age ( HR = 1.358, 95% CI 1.153 to 1.599), T stage-T 3 ( HR = 2.739, 95% CI 1.200 to 6.248), T stage-T 4 ( HR = 3.013, 95% CI 1.312 to 6.920), N stage-N 2 ( HR = 5.832, 95% CI 2.974 to 11.455), pathological stage Ⅲ ( HR = 2.962, 95% CI 1.835 to 4.646), lymphovascular invasion ( HR = 1.813, 95% CI 1.274 to 3.642), SIMS-1 ( HR = 7.065, 95% CI 4.673 to 10.692), SIMS-2 ( HR = 7.885, 95% CI 4.991 to 12.435), SIMS-3 ( HR = 8.365, 95% CI 5.635 to 3.485) were the independent risk factors of GC patients′ death ( P < 0.05). Conclusions:This study successfully constructs Sims and confirms that preoperative Sims is a relatively easy, easy to obtain and low-cost prognosis index for GC patients, which can be used to evaluate the survival time of GC patients before operation.

Objective: To summarize the clinical effects of meticulous fat transplantation with fat grafts in the treatment of sunken upper eyelid. Methods: From September 2016 to January 2019, 58 patients with sunken upper eyelid were treated in the 940th Hospital of the Joint Logistic Support Force of PLA. There were 2 males and 56 females, aged from 20 to 63 years. Among them, 14 cases were congenital, 30 cases were senile, 8 cases were postoperative, and 6 cases were traumatic. The prepared autologous granule fat was extracted with a 1 ml syringe, which matched with a 1.0 mm diameter needle. The 1 ml syringe was packed into the card slot of a fat graft booster, and the needle was inserted into the orbital fat zone of a depressed upper eyelid to homogenously inject the granule fat. For patients with iatrogenic and traumatic upper eyelid depression, the adhesion was released by small needle knife before injection. For those with aging skin, subcutaneous injection of nano-fat was applied. Results: The amount of granule fat transplantation was 0.5 ml to 3.6 ml, with an average of 1.5 ml. The amount of nano-fat injection was 0.5 ml to 1.0 ml, with an average of 0.7 ml. All patients were followed up for 1 month to 2 years. Except 2 patients with severe traumatic upper eyelid depression, the other patients were satisfied with their full and natural upper eyelids after treatments. Conclusions When the upper eyelid depression was treated with granule fat transplantation by the booster, the small needle knife peeling technique and nano fat transplantation can be combined to correct different types of congenital, aging and surgical derived sunken upper eyelid and traumatic sunken upper eyelid from mild to severe cases. At the same time, the skin of the upper eyelid can be rejuvenated as well.

Objective:To analyze the failure causes and repair methods of conjoint fascial sheath (CFS) suspension in ptosis correction.Methods:From 2021 September to September 2022, 13 cases (5 males and 8 females, aged from 19 to 49 years with an average of 25 years) were collected, and there were 18 eyes of CFS suspension in the Department of Burn and Plastic Surgery Center, the 940th Hospital of the Joint Logistic Support Force of PLA with a failed ptosis surgeries, including levator palpebrae superioris muscle shortening, CFS suspension, and frontalis muscle suspension.Results:Among the 13 patients (18 eyes), the failure causes included a result of the unfamiliar anatomy of CFS, unstable suture fixation, dysplasia of CFS, and improper suture site, CFS suspension failed to correct ptosis. After following-up for 6 to 30 months after reconstructive surgery, 14 eyes were corrected satisfactorily, 2 eyes were relieved of ptosis, and 2 eyes had ptosis recured six months after restorative surgery and a frontalis muscle suspension was used in the recured cases with a satisfactory outcome.Conclusions:According to the patient′s eye condition, mastering the indications, be familiar with the local anatomy and accurate surgical procedures are the key to success.

Objective:To analyze the expression and clinical significance of serum retinol binding protein 4 (RBP4), superoxide dismutase (SOD) and hypersensitive C-reactive protein (hs-CRP) in patients with acute ST-segment elevated myocardial infarction (STEMI).Methods:Seventy-eight patients with STEMI who underwent percutaneous coronary intervention (PCI) admitted to Nanxishan Hospital of Guangxi Zhuang Autonomous Region from January 2017 to March 2019 were enrolled. On the basis of the routine treatment, atorvastatin calcium or rosuvastatin calcium treatment was given. According to the results of coronary angiography, the patients were divided into three groups: single-vessel, double-vessel and three-vessel lesions, and the severity of coronary artery disease score (SYNTAX score) was performed. The serum RBP4, SOD and hs-CRP were measured and compared among different groups before and after treatment. The correlation between the three serum parameters of STEMI patients and the SYNTAX score, risk prediction (STEMI high-risk score) and prognosis were recorded and compared among different groups.Results:There was no significant difference in serum RBP4, SOD and hs-CRP among different groups before treatment. In multivessel (double-vessel and three-vessel) vascular disease group, SYNTAX score was significantly correlated with RBP4 and hs-CRP (double-vessel lesions: r values were 0.616 and 0.489 respectively, three-vessel lesions: r values were 0.423 and 0.357 respectively, all P < 0.05), but had no correlation with SOD ( r values were 0.108 and 0.055 respectively, both P > 0.05), and high-risk score was closely correlated with RBP4 and hs-CRP levels ( r values were 0.581 and 0.623 respectively, both P < 0.01). There was no significant difference in the prognosis of patients treated with different statins. There were 8 and 7 high-risk patients in the atorvastatin calcium group and rosuvastatin calcium group, respectively, and 2 and 3 dead patients respectively (both P > 0.05). Conclusion:Combined detection of serum RBP4, SOD and hs-CRP levels can be used as better indicators to predict the risk of STEMI, which is worthy of clinical application.

Objective:To explore the importance of managing retro-orbicularis oculi fat (ROOF) in double-fold eyelid operation for patients with swollen upper-eyelid.Methods:From January 2018 to December 2020, 76 cases of swollen upper-eyelid were treated with double-fold eyelid operation by PARK method. In operation, an oval shape ROOF was removed from the outside-to the inside, and then appropriate lateral intraorbital fat was also removed. If fleshy orbicularis oculi muscle and anterior tarsus fat affected appearance of double-fold eyelid, both of them might be removed properly.Results:All patients were followed up from seven days to two years, two cases presented with shallowed double-fold eyelid, 5 cases of lacrimal gland prolapse had good lacrimal gland reduction and no recurrence; 4 cases of ptosis had normal corneal exposure and natural appearance after correction; the swollen upper-eyelid was obviously improved in 74 cases, and restoration stage was short, the apperaence and radian of doule-fold eyelid were beautiful, local scar was slight, satisfactory operative effect was achieved.Conclusions:In double-fold eyelid operation by PARK method for patients with swollen upper-eyelid, an ideal effect would be achieved, if transconjunctival route and fleshy orbicularis oculi muscle are appropriately removed in turn according to the reasons to give rise to swollen upper-eyelid.

To summarize the clinical effect of using boosters for orbital autologous fat injection transplantation.

A retrospective analysis was conducted on the clinical data of patients who underwent orbital fine autologous fat injection and transplantation at the Burn and Plastic Surgery Department of the 940th Hospital of the PLA Joint Logistics Support Force from January 2019 to December 2023. The patients were treated with orbital fine autologous fat injection and transplantation using a self-developed autologous fat transplantation booster with constant pressure and micro controllability connected to a 1 mL injector, and the therapeutic effect was analyzed.

A total of 186 patients who met the inclusion and exclusion criteria were included in this study, including 165 females and 21 males, with the average age of (39.0±7.1) years old (range: 23-71 years old). Of the 186 patients, 58 cases were of upper eyelid depression, 45 cases were of inner canthal depression, 34 cases were of ocular platform flattening, 6 cases were of meibomian depression, and 43 cases were of lacrimal groove depression. The transplantation volume of granular fat was 0.1-10 mL, with an average of 3.5 mL; the injection volume of nanofat was 0.5-2.0 mL, with an average of 0.5 mL. Follow up for 7 days to 4 years showed that 163 cases (87.6%) were satisfied with the results, 15 cases (8.1%) had average results, and 8 cases (4.3%) were dissatisfied. No surgical complications occurred.

The use of a constant pressure and micro controllable electric booster to assist autologous fat injection transplantation could achieve precision in orbital autologous fat transplantation, with high patient satisfaction, meaning that it is worthy of clinical promotion and application.

OBJECTIVETo understand the current status of the disease burden of liver cancer in Jinchang cohort.

METHODSAll the liver cancer death data from 2001 to 2013 and medical records of liver cancer cases from 2001 to 2010 in Jinchang cohort were collected for the analyses of the mortality, standardized mortality, potential years of life lost (PYLL) and working PYLL (WPYLL) associated with liver cancer. Spearman correlation and the average growth rate were used to analyze the trends.

RESULTSA total of 207 liver cancer deaths occurred in Jinchang cohort from 2001 to 2013, accounting for 16.68% of total cancer deaths. There were 259 liver cancer inpatients, accounting for 6.79% of the total cancer cases inpatients, in which 83 died (32.05%). Liver cancer death mainly occurred in males, accounting for 88.89%, and the liver cancer deaths in females accounted for 11.11%. The standardized mortality rate was 42.32/100,000 in males and 15.31/100,000 in females. The growth rate of liver cancer mortality was 5.62% from 2001 to 2013. Liver cancer deaths mainly occurred in age groups 60-69 years (26.57%) and 50-59 years (24.15%). The PYLL was 2906.76 person-years, the average PYLL was 14.04 years. The WPYLL was 1477.00 person-years and the average WPYLL was 7.14 years. The direct economic burden of liver cancer was 6270.78 Yuan per person, 301.75 Yuan per day. The average stay of hospitalization was 21.32 days.

CONCLUSIONThe mortality rate of liver cancer is increasing and the disease burden is still heavy.

Aged ; China ; epidemiology ; Cohort Studies ; Cost of Illness ; Female ; Hospitalization ; economics ; statistics & numerical data ; Humans ; Liver Neoplasms ; economics ; mortality ; Male ; Middle Aged