Objective To compare the clinical effect of neoadjuvant chemoradiotherapy (nCRT) and neoadjuvant chemotherapy (nCT) in the treatment of locally advanced esophageal squamous cell carcinoma.Methods The retrospective cohort study was conducted.The clinicopathological data of 156 patients with local advanced esophageal squamous cell carcinoma who were admitted to the Zhongshan Hospital of Fudan University from January 1,2010 to December 31,2015 were collected.Among 156 patients,59 undergoing nCRT were allocated into the nCRT group and 97 undergoing nCT were allocated into the nCT group.Patients in the nCRT group and nCT group respectively received 2 cycles chemotherapy by the TP regimen+40 Gy radiotherapy (2 Gy/d) and 2 cycles chemotherapy by the TP regimen.Patients were evaluated by imaging examinations after 6 weeks neoadjuvant therapy completion,and then underwent abdominal and right chest-left cervico three-incision thoracoscopic surgery.Observation indicators:(1) treatment situations;(2) postoperative pathological examination;(3) follow-up and survival situations.Follow-up using outpatient examination and telephone interview was performed once every 3 months within 2 years and once every 6 months after 3 years up to January 2017.Follow-up included levels of tumor markers [carcinoembryonic antigen (CEA) and SCC-Ag],thoracic or abdominal computed tomography (CT),neck and abdominal ultrasonography and gastroscopy or PET/CT examination if necessary.Measurement data with normal distribution were represented as (x)±s and comparison between groups was analyzed using the t test.Measurement data with skewed distribution were described as M (range) and comparison between groups was analyzed using the nonparametric test.Count data were analyzed using the chi-square test or Fisher exact probability.Comparison of ordinal data was done by the nonparametric test.The survival rate was calculated using the life table method and survival was analyzed by the Log-rank test.Results (1) Treatment situations:all the patients in the 2 groups were able to burden neoadjuvant therapy and thoracic esophagectomy.Six patients in the nCRT group and 15 in the nCT group had conversion to open surgery.Operation time,volume of intraoperative blood loss,cases with postoperative readmission of ICU,cases with complications,cases with perioperative death and duration of hospital stay were (201 ± 25) minutes,(137± 66)mL,5,24 (10 with pulmonary complications,8 with anastomotic leakage,3 with hoarseness,2 with cardiovascular complications and 1 with chylopleura),0,12 days (range,9-93 days) in the nCRT group and (195±20) minutes,(133±58) mL,8,30 (11 with anastomotic leakage,10 with pulmonmy complications,4 with hoarseness,2 with cardiovascular complications,1 with postoperative hemorrhage,1 with delayed gastric emptying and 1 with chylopleura),1,11 days (range,9-78 days) in the nCT group,respectively,with no statistically significant difference between the 2 groups (x2 =0.883,t =0.102,0.692,x2 =0.048,1.541,Z =0.225,P＞ 0.05).(2) Postoperative pathological examination:R0 resection rate was 96.6％ in the nCRT group and 93.8％ in the nCT group,with no statistically significant difference between the 2 groups (x2 =0.589,P＞0.05).Results of postoperative pathological examination showed that G0,G1,G2 and G3 of tumor regression grade were respectively detected in 18,16,7,18 patients in the nCRT group and 4,5,4,84 patients in the nCT group,with a statistically significant difference between the 2 groups (Z=-7.151,P＜0.05).Stage 0,Ⅰ,Ⅱ,ⅢA,Ⅲ B and ⅣA of postoperative ypTNM stage were respectively detected in 16,9,23,4,6,1 patients in the nCRT group and 4,9,37,6,34,7 in the nCT group,with a statistically significant difference between the 2 groups (Z=-4.890,P＜0.05).The down-staging was detected in 48 patients of the nCRT group and 50 patients of the nCT group,with a statistically significant difference between the 2 groups (x2=13.957,P＜0.05).(3) Follow-up and survival situations:of 156 patients,153 were followed up for 12-82 months,with a median time of 36 months.The 1-,3-,5-year overall survival rates were 88.1％,61.4％,34.9％ in the nCRT group and 81.4％,43.8％,23.1％ in the nCT group,with a statistically significant difference between the 2 groups (x2=4.336,P＜0.05).Conclusion The nCRT in the treatment of locally advanced esophageal squamous cell carcinoma can enhance postoperative pathological response rate,down-staging rate and overall survival rate compared with nCT,without increasing incidence of perioperative complications.

BACKGROUND: People have concerned with the effect of fibroblast growth factor biological protein sponge on the repairing effect of traumatic ulcer.OBJECTIVE: To observe the repairing effect of fibroblast growth factor biological protein sponge on the repairing effect of traumatic ulcer and its possible adverse reactionDESIGN: Grouping comparison observation.SETTING: Staff Room of Physiology, Medical College of Jinan University PARTICIPANTS: Totally 40 cases of traumatic ulcer accepted the treatment in the First Hospital of Jinan Univerity between March 2004 and May 2005 were recruited. Patients with diabetes mellitus and infection on the whole body were excluded. Traumatic ulcer lay in the shank. Patients were randomly divided into experimental group and control group with 20 in each group.INTERVENTIONS: In the experimental group (n=20), sterilized fibroblast growth factor biological protein sponge was used and in the control group (n=20), sterilized petrolatum gauze dressing was used on the wound.Change the gauze dressing once per day until the wound healed. Drugs,which affected wound growth, were not used on the whole body and at the local part. Wound healing status was evaluated 1, 2 and 3 weeks after changing the drugs (The secretion of a wound was divided into: nothing, a little, middling, a great deal. frontier reaction of wound was divided into:nothing, slight, middling, severe.). Pigment deposition and scar was recorded after wound healing.MAIN OUTCOME MEASURES: Healing time of ulcer, healing course of the wound and adverse reaction of the patients in the two groupsRESULTS: Totally 40 patients of the two groups entered result analysis.Wound healing status after treatment of the patients in the two groups: The rate of wound healing in 3 weeks in the experimental group was significantly higher than that in the control group [95% (19/20),55% (11/20),χ2=8.533,P ＜ 0.05]. Wound secretion and peripheral inflammatory reaction of the wound in the experimental group was obviously milder than that of the control group; there was no obvious adverse reaction and scar of the wound found in the two groups.CONCLUSION:FGF biological protein sponge can promote the healing of traumatic ulcer; shorten the healing time without scar and adverse reaction.This dressing is convenient, safe, and non-irritative.

Objective To study the association between transforming growth factor-β1 (TGF-β1) polymorphism and type 2 diabetes mellitus in Han population of Shanghai. Methods In this case-control study , 1 234 cases of T2DM patients were recruited and 1 272 healthy individuals were selected as control. Five ml of blood sample was collected from each subject ,from which the whole genomic DNA was extracted.The polymorphism was detected by the Taqman technology. Result Significant association was observed in TGF-β1 T896C genotypes and alleles with T2DM (P = 0.0001 and P = 0.004, OR = 1.18 [1.05 ~ 1.33], respectively). Conclusion The polymorphism of T896C in TGF-β1 gene may be associated with T2DM in Han population from Shanghai.

BACKGROUND: Though there were many experiments addressing repairing osteochondral defects before, faulty restoration occurred at coupling interfaces. OBJECTIVE: To investigate the feasibility of repairing of osteochondral composite defects in rabbit knees with animal-origin osteochondral scaffold combined with bone marrow mesenchymal stem cells (BMSCs)/chondrocytes.METHODS: New Zealand white rabbits were randomly divided into the experimental, control and blank groups and prepared for unilateral knee joint osteochondral defects. Animal-origin osteochondral scaffold combined with BMSCs/chondrocytes, animal-origin osteochondral scaffold and no material was implanted to repair the defects in the experimental, control and blank groups, respectively. Healing condition was evaluated by gross observation, hematoxylin-eosin staining, and toluidine blue staining at 4, 8, and 12 weeks after operation. RESULTS AND CONCLUSION: At 12 weeks after operation, gross observation showed the defects were repaired completely without local depression and the regenerated tissues were fused with surrounding tissues in the experimental group. Hematoxylin-eosin staining and toluidine blue staining revealed that there were many new hyaline cartilages in the cartilage defects in which columnar cells were lined well and cartilage lacuna was obviously, also, there were many bony tissues in the bone defects. The regeneration cartilage, the underlying subchondral bone and host bone were coupled completely. The toluidine blue positive rate and histologic scores of the experimental group were superior to those of the control and blank groups (P < 0.05). It is demonstrated that animal-origin osteochondral scaffold combined with BMSCs/chondrocytes is an ideal method to repair defects between cartilage and the underlying subchondral bone.

BACKGROUND: The development of cartilage tissue engineering provides novel ideas for treatment of articular cartilage defects and implements construction of tissue-engineered cartilage in vivo.OBJECTIVE: To investigate the feasibility of constructing tissue-engineered osteochondral composite through bone marrow stem cells(BMSCs) cultured on the poly(lactide-co-glycolic acid) (PLGA), which was modified with collagen and cellular growth factors.METHODS: PLGA was made by phase separation technique, composited with collagen Ⅱ, basic fibroblast growth factor, and transforming growth factor-β1. The BMSCs of passage 3 were cultured on the above scaffolds. Thirty-six SD rats were randomly divided into experimental, control, and blank groups. These three groups received implantation of BMSCs composited with growth factors and collagen-PLGA, implantation of BMSCs composited with collagen-PLGA, and implantation of collagen-PLGA into the muscle, respectively. At 4, 8, and 12 weeks after surgery, cell directional differentiation and growth were examined by gross observation, hematoxylin-eosin staining, toluidine blue staining, collagen Ⅱ staining, and scanning electron microscope.RESULTS AND CONCLUSION: Gross observation showed that there were many chondroid tissues in the experimental group and fibrous tissues in the control and black groups. Stainings and electron microscope revealed that many chondroblasts and a few osteoclasts appeared in the composite of the experimental group. Toluidine blue and collagen Ⅱ stainings were positive in the experimental group and negative in the control and blank groups. These findings demonstrate that PLGA modified with collagen had a good cellular compatibility. BMSCs cultured on PLGA, which was modified with collagen and cellular growth factors, can construct the tissue-angineered osteochondral composite in rats.

Objective To investigate the trend and related determinants of cigarette smoking on experimental smokers among undergraduate students in Changsha.Methods Stratified sampling method was adopted and 3600 undergraduate students from grade 1 to 3 in Changsha city were investigated through a self-administered questionnaire.All the experimental smokers during the last month were selected and divided into two groups based on the present smoking status.x2 test and logistic regression analysis were used to compare the differences of cigarette smoking among subpopulations and to explore the determinants.Results Among the 1550 experimental smokers of undergraduate students,the prevalence of cigarette smoking was 30.8％(95％CI:28.5-33.1).Students from the second-class(OR=2.367)or the third-class universities(OR=2.562)were more likely to adopt smoking behavior than those from top universities.Students majored in sports or arts(OR=2.456)were significantly more inclined to smoke than the liberal arts students.Students whose father were cadres(OR=1.602)were more likely to become smokers than those whose fathers were workers.Students being males(OR=7.386),having high monthly expenses(OR=1.139),with positive attitude to smoking benefits(OR=1.140)were risk factors for smoking.Number of smoking members in the family(OR=1.801)was significantly associated with the prevalence of cigarette smoking.Knowledge on diseases caused by smoking(OR=0.806)was protecting factor to smoking among the experimental smokers.Conclusion Those experimental smokers among undergraduate students might become smokers and the determinants of cigarette smoking behavior would include:ranking of universities,students' major,gender,father' s occupation,amount of pocket money,number of smoking members in the family,knowledge about smoking,the attitude to the benefit of smoking.

Purpose: Emerging evidence from animal models suggests that intermittent hypoxia due to obstructive sleep apnea (OSA) is a risk factor for breast cancer. Despite their biological plausibility, human epidemiological studies have reported conflicting results. Therefore, we conducted a meta-analysis to delineate this relationship. Methods: We searched the PubMed, Embase, Scopus, and Cochrane Library databases for eligible studies from inception until June 6, 2021. Two reviewers selected randomized trials or observational studies reporting the association between OSA and breast cancer incidence compared with those without OSA. Two reviewers extracted relevant data and assessed the quality of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework and Newcastle-Ottawa Scale (NOS). We pooled the maximally covariate-adjusted hazard ratios (HRs) using a random-effects inverse varianceweighted meta-analysis and performed pre-specified subgroup analyses. Results: We included six studies out of 1,707 records, comprising a combined cohort of 5,165,200 patients. All studies used the International Classification of Diseases codes to classify OSA and breast cancer. OSA patients had a 36% increased breast cancer risk (HR, 1.36; 95% confidence interval [CI], 1.03–1.80; N = 6, I 2 = 96%) compared to those without OSA. Most studies adjusted for confounders, such as age, sex, obesity, diabetes mellitus, alcohol use, and hypertension. Subgroup analyses for studies with (1) multivariate adjustment and (2) at least five years of follow-up yielded HRs of 1.35 (95% CI, 0.98–1.87; N = 5, I 2 = 96%) and 1.57 (95% CI, 1.14–2.18; N = 4; I 2 = 90%), respectively. One Mendelian randomization study suggested a causal relationship, with a two-fold increase in the odds of breast cancer in patients with OSA. Conclusion This meta-analysis suggested that OSA is a risk factor for breast cancer. Future studies should explore the dose-response relationship between OSA and breast cancer, and whether treatment may mitigate breast cancer risk or progression.

OBJECTIVETo discuss the method of functional reconstruction of ischemic contracture in the lower limb and propose a classification protocol for ischemic contracture in the lower limb based on its severity and prognosis.

METHODSA total of 42 patients with ischemic contracture in the lower limb were included in this study. According to different types of disturbance and degrees of severity, surgical reconstructions consisting of nerve decompression, tendon lengthening or transfer, intrinsic foot muscle release and sural-tibial nerve anastomosis were performed in every patient.

RESULTSPostoperatively, all patients were able to walk on flat ground. Drop foot was corrected in 10 patients, and 5 patients still felt some difficulty during stair activity. Split Achilles tendon transfer to flexor hallucis longus tendon was performed in 12 patients, and their walking stability was improved. Seven patients accepted ipsilateral sural-tibial nerve anastomosis, and sensitivity recovery reached to S2 in 2 patients and S3 in 5 patients.

CONCLUSIONSIschemic contracture in the lower limb is a devastating complication after lower limb trauma. The prevention of contracture is much more important than the treatment of an established contracture. Split Achilles tendon transfer to flexor hallucis longus tendon and sural-tibial nerve anastomosis, which was initially implemented by us, could improve the functional recovery of ischemic contracture in lower limbs, and thus provides a new alternative for functional reconstruction of ischemic contracture in the lower limb.

Adolescent ; Adult ; Child ; Female ; Humans ; Ischemic Contracture ; physiopathology ; surgery ; Leg ; blood supply ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; Walking