Objective To compare the efficacy of concurrent chemoradiotherapy versus radiotherapy alone for T3-4 N0-1 M0 and T14 N2-3 M0 nasopharyngeal carcinoma (NPC) after induction chemotherapy.Methods From 2002 to 2005,400 patients with stage Ⅲ and Ⅳa NPC were randomly divided into 2 groups :induction chemotherapy followed by concurrent chemoradiotherapy group (IC/CCRT,201 patients),and induction chemotherapy followed by radiotherapy alone group (IC/RT, 199 patients).Subgroup analysis was conducted for 197 patients with stage T3-4N0-1M0 NPC and 203 with stage T1-4N2-3M0 NPC.Results The follow-up rate were 96.2%, with a median followg-up time of 3.9 years.For T3-4N0-1 M0 NPC patients in IC/CCRT group (104 patients) and IC/RT group (93 patients), the 3-year overall survival, disease-free survival, locoregional recurrence-free survival and distant metastasis-free survival rates were 84.0% and 85.9% (χ2=0.08,P =0.780) ,77.0% and 72.0% (χ2=0.44,P =0.510) ,89.5% and 92.3% (χ2=0.65 ,P = 0.420), and 84.9% and 77.0% (χ2= 1.59, P = 0.210), respectively; For T1-4 N2-3 M0 NPC patients in IC/CCRT group (97 patients) and IC/RT group (106 patients), the corresponding rates were 67.4% and 82.2% (χ2=3.48,P=0.060), 61.5% and 68.0% (χ2= 1.86,P=0.170), 86.2% and 87.0% (χ2=0.57 ,P =0.450) and 66.2% and 75.6% (χ2=2.07 ,P =0.150), respectively.Acute sideeffects were similar except more leucocytopenia in IC/CCRT group than IC/RT group.Conclusions Compared with IC/RT, IC/CCRT dose not improve the overall survival in patients with T3-4N0-1 M0 and T1-4 N2-3 M0 NPC.

Objective To evaluate the impact of chemotherapy compliance on the therapeutic efficacy of induction chemotherapy plus concurrent chemoradiotherapy versus induction chemotherapy plus radiotherapy alone for patients with locally advanced nasopharyngeal carcinoma (NPC). Methods Based on intention to treat analysis (ITT) for 400 patients, 314 patients were analyzed by per protocol (PP) analysis. The patients were divided into induction chemotherapy plus concurrent chemoradiotherapy group (IC/CCRT, 127 patients) or induction chemotherapy plus radiotherapy group (IC/RT, 187 patients). The patients who completed 2 cycles of induction chemotherapy and at least 2 cycles of concurrent chemotherapy in the IC/CCRT group and the patients who completed 2 cycles of induction chemotherapy in the IC/RT group were analyzed. Radiotherapy was given by two-dimensional technique with γ-ray, X-ray and electron beams. The chemotherapy regimen was FUDR plus carboplatin for induction chemotherapy and carboplatin alone for concurrent chemotherapy. Results The follow-up rate was 96.2%. 295 patients were followed to at 3 years. Based on PP analysis, Grade 3/4 toxicity was found in 23.6% of the patients in IC/CCRT group and 13.4% in the IC/RT group (χ~2 =5,50,P=0.019). No grade 4 toxicity was found in the IC/RT group. The median follow-up time was 3.9 years, and no significant difference was found between the two groups in 3-year overall survival (78.1% : 84.6% ;χ~2 = 0. 61, P =0. 435), disease-free survival (74.3 % : 70.1% ;χ~2= 0. 12, P= 0.731), Iocoregional relapse-free survival (89.7% : 89.5% ; χ~2= 0. 10, P= 0.748), or distant metastasis-free survival (78.9%:76.5% ;χ~2=0.05,P=0.825). Conclusions With more severe toxicities, the IC/CCRT regimen does not improve the overall survival in locally advanced NPC patients compared with the IC/RT regimen.

Objective To analyze risk factors for metabolic syndrome in Mongolia versus Han nationalities in Xilinhaote city. Methods Using the epidemiology investigation data of health examination,we calculated the prevalence of metabolic syndrome of Mongolia and Han nationalities, then used logistic regression model to explore risk factors of two nationalities. Results The crude prevalence of MS in Mongolia and Han nationality was 34.3%and 24.6% respectively. The multivariate logistic regression showed that male, the meat-rich diets and aging(OR:2.18, 1.92, 1.04 respectively)were the risk factors for Mongolia nationality, and smoking, family history of hypertension, drinking, the meat-rich diets, aging(OR:1.89, 1.84, 1.72, 1.61 and 1.04 respectively)were the risk factors for Han nationality. Conclusions Xinlinhaote population has higher MS prevalence, and different nationalities have different risk factors. We should take preventive actions to control it.

Objective:To investigate the expression of platelet receptor CD62P in septic rats and the anti-inflammatory effect of ticagrelor and its protective effect on myocardial injury in septic rats.Methods:Thirty-two male SD rats were randomly(random number) divided into 4 groups: sham group, cecal ligation and puncture group(CLP), low dose group: the dose of 10 mg/kg, high dose group: the dose was 50 mg/kg, 8 rats in each group. The rats in the sham operation group were only treated with abdominal switch and cecum stripping, and the rats in the sepsis group, the low dose group and the high dose group were treated with CLP method to establish the sepsis model. The rats in the ticagrelor administration group were treated with ticagrelor at a dose of 10 mg/kg and 50mg/kg by gavage, respectively. The sham operation group and the sepsis group were treated with normal saline (1 mL/kg) by gavage. The rats were administrated twice by gavage 12 hours before and 12 hours after surgery. Blood samples were collected from the abdominal aorta 24 hours after modeling and then pathological specimens were collected. The expression of platelet surface receptor CD62P was detected by flow cytometry. The levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were detected by enzyme-linked immunosorbent assay (ELISA). The levels of myocardial injury markers including CKMB and LDH were detected. The levels of transaminase, creatinine and white blood cell were detected. HE staining was used to observe the pathological morphology of myocardial tissue. Cardiomyocyte apoptosis was observed by TUNEL assay.Results:① Compared with sham group, the expression of CD62P in CLP group significantly increased ( P<0.01). Compared with the CLP group, the expression levels of CD62P in the two treatment groups significantly decreased, and the HD group was more significant ( P <0.01).②ELISA results showed that compared with sham group, the level of IL-6 in CLP group was significantly increased ( P<0.05). Compared with the CLP group, the HD group significantly decreased ( P< 0.05). There was no significant decrease in IL-6 level in the LD group. The level of TNF-α in CLP group was significantly higher than that in sham group ( P< 0.01). ③ Compared with sham group, the expression levels of CKMB and LDH in CLP group and two ticagrelor intervention groups significantly increased ( P <0.01). Compared with the CLP group, CKMB and LDH in the treatment group significantly decreased ( P <0.05), and the HD group decreased more significantly ( P<0.01). ④ Compared with sham group, WBC, ALT, CR values in CLP group significantly increased, while after the intervention with ticagrelor, WBC, ALT, CR values in rats significantly decreased ( P <0.05), and the difference significantly related to the dose. ⑤ The pathological results showed that the morphology of myocardial cells in sham group was normal. The CLP group most myocardial cell injury. LD and HD group the CLP group obviously reduce myocardial cell injury.⑥ Tunel staining showed that compared with a small number of positive cells in Sham group, a large number of positive cells were stained in CLP group. The apoptosis of myocardial cells in LD and HD groups significantly reduced compared with CLP group. Conclusions:Sepsis activates platelets and stimulates the overexpression of CD62P, which induces excessive activation of inflammatory response, induces apoptosis and damage of cardiomyocytes, and leads to septic myocardial injury. The cardioprotective effect of ticagrelor may be related to the inhibition of the reduction of CD62p expression after platelet activation, and the expression level of CD62p has a dose-dependent relationship with ticagrelor.

Objective: To evaluate the prognostic value of kinetic changes in minimal residual disease (MRD) status, as well as its relationship with risk stratification, therapeutic response and treatment in patients with newly-diagnosed multiple myeloma (MM) . Methods: A total of 135 patients with newly-diagnosed MM were screened, and 105 patients who achieved VGPR or more as the best responses were included into this study. The MRD status was determined by multiparameter flow cytometry (MFC) at multiple intervals after two cycles of treatment until clinical relapse, death, or last follow-up. The statistical methods included Kaplan-Meier analysis, Cox regression, etc. Results: ①In all 135 patients, 57.8% (78/135) patients achieved MRD negativity (MRD^-) after treatment. In 105 patients who achieved VGPR and thus included in this study, the MRD^- rate was 72.4% (76/105) , with a median interval of 3 months from starting treatment to achievement of MRD^- status. ②The 2-year PFS rate of patients with MRD^- status was significantly higher than that of MRD⁺ status (62.2% vs 41.3%, P=0.001) , while MRD persistence (MRD⁺) was an independent factor for poor prognosis (multivariate analysis for PFS: P=0.044, HR=3.039, 95%CI 1.029-8.974) . ③Loss of MRD^- status (i.e., MRD reappearance) showed inferior outcomes compared with MRD sustained negative ones, the PFS was 18 months versus not reach (P<0.001) and the OS was not reach for both (P=0.002) . ④The 2-year PFS and OS rates of patients with duration of MRD^-status≥12 months were significantly higher than those of the control group (PFS: 77.7% vs 36.7%, P<0.001; OS: 96.4% vs 57.9%, P<0.001 respectively) . Duration of MRD^- status was associated with a marked reduction in risk of relapse or death (univariate analysis for PFS: P<0.001, HR=0.865, 95%CI 0.815-0.918; for OS: P=0.001, HR=0.850, 95%CI 0.741-0.915 respectively) . ⑤Moreover, even in patients carrying high-risk cytogenetic abnormalities (CA) or ineligible for ASCT, MRD negativity remained its prognostic value to predict PFS (high-risk CA medianPFS: not reach vs 19 months, P=0.006; ineligible for ASCT medianPFS: not reach vs 25 months, P=0.052 respectively) . ⑥Last, treatment with the bortezomib-based regimens contributed to prolonged MRD^- duration (median MRD^- duratio: 25 months vs 10 months, P=0.034) . Conclusion Our findings supported MRD⁺ status as an independent poor prognostic factor in MM patients, which implicated that duration of MRD^- status also played a significant role in evaluation of prognosis, while loss of MRD^-status might serve as an early biomarker for relapse. Therefore, monitoring of MRD kinetics might more precisely predict prognosis, as well as guide treatment decision, especially for when to start retreatment in relapsed patients.

Objective To explore the therapeutic effect of pedicled nasal septum mucosal flap on high-flow cerebrospinal fluid leakage in transsphenoidal approach. Methods The clinical data of 31 patients with high-flow cerebrospinal fluid leakage during neuroendoscope transsphenoidal approach from January 2012 to April 2018 were analyzed retrospectively. Among them, skull base of 18 patients was reconstructed with pedicled nasal septum mucosal flap technique (observation group), and skull base of 13 patients was reconstructed with the'sandwich'method (control group). The postoperative cerebrospinal fluid leakage and complications were compared between 2 groups. Results Postoperative cerebrospinal fluid leakage occurred in 6 cases in control group, and 1 case in observation group, and there was statistical difference between 2 groups (P<0.05). Postoperative olfactory loss occurred in 2 cases in control group, and 3 cases in observation group, and there was no statistical difference between 2 groups (P>0.05). Conclusions Multilayer skull base reconstruction with pedicled nasal septum mucosal flap can significantly reduce the incidence of cerebrospinal fluid leakage after transsphenoidal tumor resection, and is a safe and reliable method to treat the high flow cerebrospinal fluid leakage in operation.

With the extensive applications of nuclear energy in the military, scientific research, and medical fields, radiological medicine has developed into a significant discipline. So far, studies of radiology have been conducted mostly using cell and animal models, both of which have limitations. Organoids, as 3D in vitro culture systems derived from tissue stem cells, have filled the gap left by these conventional models. They have been widely applied in review, disease research, drug development, and cancer modeling since their structures, functions, and genetic characteristics are akin to those of primary tissues. This review presents the applications of organoid models of various organ types in radiotherapy, as well as the limitations and prospects of organoids.

Objective:To improve the prognosis stratification, especially early mortality(EM), of elderly patients with newly diagnosed multiple myeloma(NDMM).Methods:In this retrospective study, univariate and multivariate Cox regression analysis were conducted to identify the independent prognostic factors associated with overall survival(OS)and the chi-square test and multivariate Logistic analysis were used to identify the prognostic factors associated with EM in 223 elderly patients(age≥65 years)with NDMM from three centers in the country.Results:Increased NT-pro-BNP(≥300 pg/ml), ECOG-PS≥2 and stage Ⅲ R-ISS were identified as three independent adverse prognostic factors of OS.The rates of EM3, EM6, EM12 and EM24 were 12.1%, 20.1%, 32.2% and 60%, respectively.The most common cause for EM6(particularly EM3)was disease-related complications resulting from ineligibility for treatment due to poor physical performance, severe organ dysfunction or treatment discontinuation due to treatment intolerance, while the most common cause for EM12(particularly EM24)was disease progression or relapse mainly as a result of inadequate treatment.R-ISS staging failed to predict EM, while decreased eGFR, ECOG-PS≥2, and increased NT-pro-BNP were able to estimate the risk of EM, with increased NT-pro-BNP as a common independent factor for EM12( P=0.03)and EM24( P=0.015). Conclusions:R-ISS staging, which primarily reflects MM biology, cannot predict EM.However, factors such as NT-pro-BNP, eGFR and ECOG-PS associated with frailty and impairment of organ functions can be used to estimate the risk of EM, among which NT-pro-BNP may be the most important independent factor for EM.Therefore, incorporation of these frailty-related biomarkers into R-ISS staging may be able to more precisely estimate the prognosis and particularly early death of elderly patients with NDMM.

Objective To understand the status and correlative factors on menarche and first spermatorrhea among children and adolescents,in Chongqing,in order to provide theoretical basis for carrying out sex and health education in this population.Methods By random stratified and cluster sampling,10 498 students (5 372 boys and 5 126 girls),5 to 18 years old and living in Chongqing urban districts,were enrolled.General situation and physical features of the population were studied.Statistics analysis system included logistic regression methods,t-test and chi-square test.Results For urban kids,first experience of spermatorrhea was 0.218 years later than those living in the rural areas (Z=-73.287,P＜0.001),but median age for girls in urban areas was 0.073 years earlier than in rural areas (Z=-71.589,P＜0.001).Except for factor as mother' s education level in the family (x2=21.564,P＜0.001),other family or environment related factors did not show significant difference between the two groups of boys (P＞0.05).However,significant difference appeared in average family income (x2=6.175,P=0.046) between two groups of girls.Data from the logistic analysis showed that BMI,hip circumference,height,weight,number of children in the family,time of sleep and the diet structure were associated with menarche.Correlative factors of boys' first spermatorrhea would include:high-energy snacks,hip circumference,weight,height,school type and mother's education level (P＜ 0.05).Conclusion First spermatorrhea and menstruation of boys and girls were closely related to environment of the family,diet and the time of sleep.

OBJECTIVETo observe the clinical efficacy differences between acupuncture combined with 40-min penetration moxibustion and 60-min penetration moxibustion at back-points for insomnia of insufficiency of heart and spleen type.

METHODSSixty patients of insomnia with insufficiency of heart and spleen type were randomly assigned into a 40-min group and a 60-min group. The two groups were treated with acupuncture at Jueyinshu (BL 14), Xinshu (BL 15), Geshu (BL 17), Pishu (BL 20), Shendao (GV 11) and Zhiyang (GV 9). With moxibustion box, the penetration moxibustion was applied at the back until sweating and redness on the back. The moxibustion was given for 40 min in the 40-min group and 60 min in the 60-min group. The treatment was given once a day, five days per week. Each session was consisted of 5 treatments, with an interval of 2 days between session and totally 4 consecutive weeks were provided. The Pittsburgh sleep quality index (PSQI), TCM symptom scale were observed and recorded before and after treatment in the two groups. The even temperature at raising period, effective period, reducing period, as well as minimum high temperature, comfortable temperature, minimum cold temperature and medication status were compared; also the effect was compared between the two groups.

RESULTSThe total effective rate was 96.6% (28/29) in the 60-min group, which was higher than 89.3% (25/28) in the 40-min group (<0.05). Compared before treatment, the total score of PSQI and sleep quality, sleep time, sleep efficiency, sleep disorder, daytime dysfunction as well as the total TCM symptom score and its drowsiress in the morning, palpitation, amnesia, appetite were reduced after treatment in the 40-min group (all<0.05). After treatment, the total score and each score of PSQI as well as total score and each score of TCM symptom scale were reduced after treatment in the 60-min group (all<0.05). After treatment, the total score and each score of PSQI as well as total score and each score of TCM symptom scale were significantly different between the two groups (all<0.05).

CONCLUSIONSAcupuncture combined with penetration moxibustion can improve the symptomsof insomnia with insufficiency of heart and spleen type, which is more significant in the 60-min group, indicating prolonged time of penetration moxibustion can improve sleep latency.