Objective To study the dissection technique of total mesoreetal excision(TME).Method One hundred and twelve eases of rectal cancer underwent TME from January 2000 to August 2008 were retrospectively analyzed.Results All the procedures were conducted sueeessfully,average blood loss was(45±32)ml during the dissection of rectal mesentery,the hypogastrie nerves were preserved in 96 eases,urinary retention occurred in 6 eases and recovered 1 month later.Anastomotie leakage occurred in 1 ease and healed after transverse colostomy.Wound infection in 6 eases and healed by dress changing.There was no ureter injury.There were 14 eases of death,6 eases of recurrence and 15 eases of distal metastasis according to(3.7±1.1)years follow-up in 112 eases.The survival rate of 1,3,5 years was 92.0%(103/112),84.8%(95/112),66.1%(74/112)respectively.Conclusion Anatomical dissection adequate exposure and hemostasis are critical factors for TME.

Objegtive To study the feasibility and clinical effects of enteral nutrition by needle catheter jejunostomy(NCJ)tube in the postoperative adjuvant chemotherapy for patients of staged gastric cancer.Methods Eighty-two patients with staged gastric cancer underwent radical gastrectomy and going to receive chemotherapy were randomly divided into group A(41 cases)and group B(41 cases).All of the patients had been NCJ.Group A received enteral nutrition through the tube during chemotherapy,and group B had been given general diet.A series of parameters were measured post-chemotherapy.And the gastrointestinal complications were carefully observed.Results In post-chemotherapy,the level of hemoglobin,albumin,prealbumin,interleukin-2,natural killer cell activities and CD3+,CDd4+,CD4/CD8 in group A[(106.9±12.0)g/L,(26.2±1.4)g/L,(202.9±32.2)mg/L,(11.9±2.1)μg/L,(21.3±5.2)%,(62.9±3.3)%,(26.1±4.7)%,1.1±0.2]were significantly higher than those in group B(P＜0.05 or＜0.01).The incidences of vomiting in group A(4.9%,2/41)was significantly lower than that in group B (26.8%,11/41)(P＜0.05).The average intake in group A[(1312±114)ml]was significantly more than that in group B[(76.5±186)ml](P＜0.05).No severe enteral nutrition related complications occurred in group A.Conclusions It is safe and feasible to enteral nutrition supported by NCJ tube in chemotherapy for patients of staged gastric cancer.It can improve the nutrition status and immune function in the given patients.

Objective To explore the change in anatomical volume during intensity?modulated radiotherapy (IMRT) for different stages of nasopharyngeal carcinoma (NPC) and its influence on dose distribution, and to assess the necessity to modify the IMRT plan. Methods Twenty?four patients with newly diagnosed NPC who received IMRT and chemotherapy were enrolled in the study, and were divided into early?intermediate group ( 12 cases ) and locally advanced group ( 12 cases ) according to the 2008 staging system for NPC. Each patient had a repeated CT scan at week 5 of radiotherapy, and target volume and organs at risk ( OAR) were contoured. The dose distribution of the original plan shown on CT was calculated. Changes in target volume, OAR anatomical volume, and dose distribution were analyzed, and paired t?test and Spearman correlation analysis were performed. Results In the early?intermediate group, gross target volume of neck positive lymph nodes (GTVnd) was reduced during radiotherapy (P=0. 059), and gross target volume of nasopharynx ( GTVnx ) , high?risk clinical target volume ( CTV1 ) , and parotid volume were reduced significantly during radiotherapy ( P= 0. 001, 0. 012, 0. 002, and 0. 000, respectively) . In locally advanced group, GTVnx , GTVnd , CTV1 , and parotid volume were significantly reduced during IMRT (P=0. 000, 0. 000, 0. 003, 0. 003, and 0. 000, respectively). Compared with the values before radiotherapy, the parotid dose increased significantly in the two groups during IMRT ( P=0. 044, 0. 026, 0. 033, and 0. 026, respectively;P=0. 024, 0. 016, 0. 030, and 0. 015, respectively) , and the increase in GTVnd dose was observed in the locally advanced group ( P= 0. 029 and 0. 049 ) . Conclusions It is recommended to perform another CT scan for patients with locally advanced NPC at week 5 of radiotherapy and formulate a new IMRT plan to maintain target volume dose and guarantee a safe parotid dose.

Objective To investigate the relationship of TNF-αgene promoter 308 locus(TNF-α-308)polymorphism with the susceptibility and severity of central venous catheter-related sepsis(CRS). Methods One hundred and five CRS patients admitted in Kaihua People's Hospital from January 2015 to May 2017 were enrolled in the study.According to whether complicated with multiple organ dysfunction syndrome(MODS), they were divided into CRS complicated MODS group(n=34)and CRS non-MODS group(n=71).Meanwhile,210 patients with no catheter-related infection(case control group)and 105 healthy subjects(healthy control group)were also enrolled in the study.Polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP)was used to genotype TNF-α-308, and the relationship of TNF-α-308 polymorphism with the susceptibility and severity of CRS was investigated.SPSS 16.0 was used to analyze the data.Results There were no significant differences in frequencies of GG, GA,AA genotypes and G,A allele of TNF-α-308 among CRS group,case control group and healthy control group(χ2=2.262 and 0.907,both P>0.05).Compared with CRS non-MODS group,case control group and healthy control group, the frequency of GG genotype was significantly lower and the frequencies of genotype GA and AA of TNF-α-308 were significantly higher in CRS MODS group(χ2=8.809,7.700 and 9.220,all P<0.05).Compared with CRS non-MODS group,case control group and healthy control group, the allele frequencies of G were significantly lower and allele frequency of A allele of TNF-α-308 was significantly higher in CRS MODS group(χ2=9.823, 8.624 and 7.654, all P<0.05).There were no significant differences in genotype frequency and allele frequencies of TNF-α-308(χ2=0.852 and 0.975, both P>0.05)among CRS non-MODS group and case control group,healthy control group(χ2=1.022 and 0.535,both P>0.05).The odds ratio of GA +AA genotype and A allele of TNF-α-308 in CRS MODS group were 2.664(95%CI 1.259-5.639)and 2.440(95%CI 1.326-4.490).Conclusion TNF-αgene promoter 308 locus polymorphism is not a predisposing factor for CRS, but may be associated with complication of MODS in CRS patients.

Head and neck squamous cell carcinoma (HNSCC), as the most common type (>90%) of head and neck cancer, includes various epithelial malignancies that arise in the nasal cavity, oral cavity, pharynx, and larynx. In 2020, approximately 878 ‍ 000 new cases and 444 000 deaths linked to HNSCC occurred worldwide (Sung et al., 2021). Due to the associated frequent recurrence and metastasis, HNSCC patients have poor prognosis with a five-year survival rate of 40%-50% (Jou and Hess, 2017). Therefore, novel prognostic biomarkers need to be developed to identify high-risk HNSCC patients and improve their disease outcomes.
Biomarkers, Tumor/genetics* ; Head and Neck Neoplasms/genetics* ; Humans ; Kaplan-Meier Estimate ; RNA ; Squamous Cell Carcinoma of Head and Neck ; Survival Analysis ; Survival Rate