This paper is about the clinical trials of preoperative concurrent chemoradiotherapy for advanced adenocarcinoma of the stomach or gastroesophageal junction reported in recent years. The radiation dose of most trials is 45 Gy. Chemotherapy drugs such as 5-fluorouracil, cisplatin and taxol are concurrently used as sensitizers. A number of trials have induction chemotherapy prior to chemoradiotherpy. The validity is evaluated by R0 resection rate, pathological complete response rate and overall survival rate. The safety is assessed by the adverse reaction, treatment related mortality, and its effect on postoperative complications and mortality. The results showed that preoperative chemoradiotherapy can significantly improve the R0 resection rate and benefit the prognosis of the patients. Meanwhile, the security and impact on operations of preoperative chemoradiotherapy is controllable. The recent researches are mostly in phase II, and more randomized controlled studies are needed. To fully accept the preoperative chemoradiotherapy as a standard treatment, more evidence and long-term efficacy index are indispensible.

Adjuvant radiotherapy (RT) can improve the rate of loco-regional control for patients with gastric cancer (GC),while the selection of patients plays a key role.As the research moves along,several relatively comprehensive molecular classifications emerged such as the TCGA classification and the ACRG classification.Studies have demonstrated that molecular classifications are closely related to the clinicopathologic characteristics,prognosis and treatment response.However,there is not recognized molecular classification of GC presently.It is a great challenge for radiation oncologists to make use of the individual bioinformation and accurately select patients who would benefit from RT.Meanwhile,precision RT could also be achieved with the prediction of radiosensitivity,combination of RT with targeted therapy and the application of ctDNA within the field of RT.

Gastric cancer(GC) is a highly heterogeneous malignancy. The present widely used histopathological classifications have gradually failed to meet the needs of individualized diagnosis and treatment. Development of technologies such as microarray and next-generation sequencing (NGS) has allowed GC to be studied at the molecular level. Mechanisms about tumorigenesis and progression of GC can be elucidated in the aspects of gene mutations, chromosomal alterations, transcriptional and epigenetic changes, on the basis of which GC can be divided into several subtypes. The classifications of Tan's, Lei's, TCGA and ACRG are relatively comprehensive. Especially the TCGA and ACRG classifications have large sample size and abundant molecular profiling data, thus, the genomic characteristics of GC can be depicted more accurately. However, significant differences between both classifications still exist so that they cannot be substituted for each other. So far there is no widely accepted molecular classification of GC. Compared with TCGA classification, ACRG system may have more clinical significance in Chinese GC patients since the samples are mostly from Asian population and show better association with prognosis. The molecular classification of GC may provide the theoretical and experimental basis for early diagnosis, therapeutic efficacy prediction and treatment stratification while their clinical application is still limited. Future work should involve the application of molecular classifications in the clinical settings for improving the medical management of GC.
Asian Continental Ancestry Group ; Carcinogenesis ; genetics ; Disease Progression ; Early Detection of Cancer ; Epigenesis, Genetic ; physiology ; High-Throughput Nucleotide Sequencing ; Humans ; Microarray Analysis ; Molecular Epidemiology ; standards ; Mutation ; physiology ; Prognosis ; Stomach Neoplasms ; classification ; genetics

Objective:To explore the rules of Traditional Chinese Medicine (TCM) prescriptions of gastroesophageal reflux disease based on Ancient and Modern Medical Records Cloud Platform.Method:The relevant medical cases from ancient medical case database, modern medical case database, shared medical case database and famous doctors' medical case database in Ancient and Modern Medical Records Cloud Platform (V2.3.8) were selected, and frequency analysis, attribute analysis, association analysis, cluster analysis and complex network analysis were performed on the herbs.Results:A total of 107 medical records were obtained, including 225 TCMs. The core medicines were Radix et Rhizoma Glycyrrhizae, Pericarpium Citri Reticulatae, Rhizoma Coptidis, Poria, and Fructus Evodiae. The drug property was mainly cold and warm, and the herbal tastes bitter and pungent. The meridian tropism of drugs mainly manifested in the spleen and stomach meridians. The core herbal pairs were Radix et Rhizoma Glycyrrhizae and Pericarpium Citri Reticulatae. The core prescription consisted of 17 herbs including Radix Glycyrrhizae, Pericarpium Citri Reticulatae, Rhizoma Coptidis, Fructus Evodiae, Poria, Endoconcha Sepiae, Herba Taraxaci, Fructus Aurantii, Radix Paeoniae Alba, Radix Bupleuri, Jiang Banxia, Rhizoma Cyperi, Radix Aucklandiae, Caulis Bambusae In Taenia, Fructus Aurantii Immaturus, Fructus Amomi, and Rhizoma Atractylodis Macrocephalae. Conclusions:Chinese medicine treatment of gastroesophageal reflux disease is mainly based on Chaihu Shugan Powder, Zuojin Pill, and Wendan Decoction. Moreover, we need to combine with clinical symptoms to add or subtract herbs.

OBJECTIVE: To explore the genetic basis for a Chinese pedigree affected with non-syndromic hearing loss (NSHL). METHODS: Commercialized gene chip was applied to detect common mutations associated with congenital deafness. Whole exome sequencing was carried out for patients for whom gene chip yielded a negative result. Candidate variants were verified by Sanger sequencing. RESULTS: Two patients from the pedigree were discovered to carry compound heterozygous variants of the TRIOBP gene, namely c.3299C>A and c.5185-2A>G. Their parents had normal hearing and were both heterozygous carriers of the above variants. Both variants had co-segregated with the disease phenotype in the pedigree and were unreported previously. CONCLUSION Pathogenic variants of the TRIOBP gene comprise an important factor for NSHL. The novel c.5185-2A>G and c.3299C>A variants discovered in this study have enriched the mutational spectrum of the TRIOBP gene and enabled molecular diagnosis and genetic counseling for the family.
Deafness/genetics* ; Hearing Loss, Sensorineural/genetics* ; Heterozygote ; Humans ; Microfilament Proteins/genetics* ; Mutation ; Pedigree ; Whole Exome Sequencing

Objective To compare and study the two kinds of quality control methodologies related to intelligent quality management system ( iQM) and traditional quality control , and the quality control performance of iQM equivalent to traditional quality control were evaluated , ensuring the accuracy of the results of blood gas testing.Methods Beijing Chaoyang Hospital of Capital Medical University , Beijing Tiantan Hospital of Capital Medical University , Shanghai Longhua Hospital of Shanghai University of Chinese Medicine, and Sichuan Provincial People′s Hospital, these 4 medical institutions were selected to implement this study.During the period from June 2016 to December 2016, in the routine detection of total 3 712 specimen, the iQM and traditional quality control modes were used simultaneously to calculate the mean values of all blood gas parameters quality controls , SD, CV (%) and Sigma values, to evaluate the quality control performance and difference of the two quality control modes .Results During the process of testing blood gas samples from 3 712 specimen in 4 hospitals, iQM process control solution ( PCS) A, B, C ran 1 089, 7 678 and 154 quality control samples respectively , and 732 external quality control samples were run by traditional quality control mode .Considering the most sensitive parameters of blood gas testing pO 2, iQM PCS A, B, C′s Sigma value are higher than 8, however, the traditional quality control′s Sigma value are less than 6; For parameters pCO2, pO2and Na+, there exists significant difference between two quality control methods (P＝0.004 8,P＝0.000 1,P＝0.004 4,P＜0.01), other parameters pH, K+, Ca ++, Glu, Lac and Hct, there exists no significant difference between two quality control methods (P＝0.250 6, P＝0.062 3,P＝0.034 0,P＝0.346 9,P＝0.186 3,P＝0.823 1,P＞0.01).Totally 22 errors detected by iQM, includes 14 micro-clots and 8 interferences samples, which were not detected by traditional quality control .Conclusions The error in blood gas analysis mainly comes from the pre-analytical phase.iQM enhanced specimen inspection capabilities and make up for the inability of traditional quality control to monitor the quality of specimens , enabling full-scale, real-time, and dynamic monitoring of each specimen , powerful error detection capabilities , and automatic error correction capabilities . Besides, automatic documentation saves staff much time.The system can effectively ensure the accuracy of blood gas test results, meet the quality requirements of related laws and regulations and related industry standards , and also can meet the clinical intended use , providing new ideas for POCT quality management and improvement.

Objective: To evaluate the methodological quality of papers that performed meta-analyzed and systematically reviewed acupoint selections for the treatment of functional dyspepsia (FD) and to identify the ideal acupoint combinations for FD. Methods: Chinese databases including China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), China Biology Medicine (CBM), and Wanfang Database, as well as English databases including PubMed, Embase, and Cochrane Library were searched to retrieve papers about meta-analysis and systematic literature reviews on acupuncture for FD. The time span for the paper retrieval was set from the foundation of the databases to April 30, 2022. The Veritas scores of the papers based on their publication year, study type, Assessment of Multiple Systematic Reviews 2 (AMSTAR2), Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), heterogeneity, and publication bias were rated to assess the methodological quality of the included studies. Then, randomized controlled trials (RCTs) were extracted from those meta-analysis papers or systematic literature reviews for analyzing acupoints frequency, meridian frequency, and association rules with the use of R software (V 4.3.1). Results: Eight meta-analysis papers were included in the study after screening. The mean Veritas scores of the papers based on publication year, type of study, AMSTAR2, PRISMA, heterogeneity, and publication bias were 4.50, 8.00, 4.63, 4.63, 4.50, and 6.13, respectively. The analysis of the scores revealed insufficiencies in the reviews pertaining to the methodology, comprehension of the research strategy, detailed list of excluded studies, sources of funding, assessment of potential bias risks impact on meta-analysis results in each study, explanation of heterogeneity, and identification of potential conflicts of interest. Furthermore, a total of 85 RCTs were obtained from the eight meta-analysis papers involving 85 acupuncture prescriptions and 67 acupoints for subsequent data mining. The most commonly used meridian was Stomach meridian of Foot-Yangming (ST). Zusanli (ST36), Neiguan (PC6), Zhongwan (CV12), Taichong (LR3), Tianshu (ST25), Gongsun (SP4), Weishu (BL21), Pishu (BL20), Neiting (ST44), and Yinlingquan (SP9) topped the list of frequently selected acupoints. Additionally, a total of 28 association rules were identified, including 10 second-order, 15 third-order, and 3 fourth-order association rules. The top-ranking association rules in each order were “Neiguan (PC6) → Zusanli (ST36)” “Zhongwan (CV12) + Neiguan (PC6) → Zusanli (ST36)” and “Zhongwan (CV12) + Taichong (LR3) + Neiguan (PC6) → Zusanli (ST36)”, respectively. Conclusion Acupuncture could alleviate the clinical symptoms of FD. However, the quality of methodology applied in the meta-analysis papers on the subject needs to be improved. Through data mining, a combination of Neiguan (PC6), Zusanli (ST36), Zhongwan (CV12), and Taichong (LR3) was identified as an essential acupoint combination for the treatment of FD.

Objective: To explore the blood lead level and its relationship with behavior in school-age children from rural areas of Chongqing. Methods: A total of 697 students from grades 3 to 6 in the fall semester of 2014 from 14 rural townships in one district of Chongqing was selected by using the random cluster sampling method. Blood were sampled to analyze the lead level. Neurobehavioral tests were performed to determine their personal cognitive and memory ability. Questionnaires and physical examinations were administered to obtain the information of confounding factors. All students were divided into Q₁-Q₄ groups according to the quartile of their blood lead level. The relationship between the blood lead level and behavior was analyzed by multivariate logistic regression model and restricted spline regression model. Results: The mean age of 697 students was (10.07±1.36) years old, and the median (interquartile range) of their blood lead level was 44.31 (35.42) μg/L. Multivariate logistic regression model showed that after adjusting for age, gender, body mass index and maternal culture level, compared with Q₁ group, the OR (95%CI) values of high digit symbol substitution test (DSST) scores and high overall memory quotient (MQ) scores in Q₃ group were 1.65 (1.01-2.70) and 2.10 (1.21-3.62), and the OR (95%CI) value of high long term memory (LTM) scores in Q₄ group was 0.53 (0.31-0.92). The results of the restricted spline regression model showed that the dose-response curves between the blood lead level and MQ/LTM test scores were both parabolic (P<0.05). Conclusion The blood lead level of school-age children from rural areas of Chongqing is the same as that from other areas of China, but slightly higher than that from other areas of Chongqing. Children with higher blood lead level have poor long-term memory ability.