Objective:To observe and evaluate the clinical efficacy and safety of albumin-bound paclitaxel as first-line treatment for patients with advanced pancreatic cancer in China, and to explore the prognosis-related molecules in pancreatic cancer based on next-generation sequencing (NGS) of tumor tissues.Methods:From December 2018 to December 2020, patients with locally advanced or metastatic pancreatic cancer were recruited to accept albumin-bound paclitaxel as first-line treatment in the oncology departments of 24 hospitals in East China. The primary endpoints were overall survival (OS) and treatment related adverse events, and the secondary endpoint was progression-free survival (PFS). Adverse effects were graded using Common Terminology Criteria for Adverse Events 5.0 (CTCAE 5.0). NGS sequencing on the primary or metastatic tissue samples of pancreatic cancer obtained through surgical resection or biopsy was performed.Results:This study recruited 229 patients, including 70 patients with locally advanced pancreatic cancer (LAPC) and 159 patients with metastatic pancreatic cancer (mPC). The disease control rate was 79.9% and the objective response rate is 36.3%.The common adverse effects during treatment were anaemia (159 cases), leucopenia (170 cases), neutropenia (169 cases), increased aminotransferases (110 cases), and thrombocytopenia (95 cases), and the incidence of grade 3-4 neutropenia is 12.2% (28/229). The median follow-up time was 21.2 months (95% CI: 18.5-23.1 months). The median PFS (mPFS) was 5.3 months (95% CI: 4.37-4.07 months) and the median OS (mOS) was 11.2 months (95% CI: 9.5-12.9 months). The mPFS of patients with LAPC was 7.4 months (95% CI: 6.6-11.2 months), and their mOS was 15.5 months (95% CI: 12.6-NA months). The mPFS of patients with mPC was 3.9 months (95% CI: 3.4-5.1 months), and their mOS was 9.3 months (95% CI: 8.0-10.8 months). Multivariate Cox regression analysis showed that clinical stage ( HR=1.47, 95% CI: 1.06-2.04), primary tumor site ( HR=0.64, 95% CI: 0.48-0.86), Eastern Cooperative Oncology Group Performance Status (ECOG PS) score ( HR=2.66, 95% CI: 1.53-4.65), and whether to combine radiotherapy ( HR=0.65, 95% CI: 0.42-1.00) were independent influencing factors for the PFS of these patients. The primary tumor site ( HR=0.68, 95% CI: 0.48-0.95), ECOG score ( HR=5.82, 95% CI: 3.14-10.82), and whether to combine radiotherapy ( HR=0.58, 95% CI: 0.35-0.96) were independent influencing factors of the OS of these patients. The most frequent gene mutations in these advanced stage pancreatic patients were KRAS (89.66%), TP53 (77.01%), CDKN2A (32.18%), and SMAD4 (21.84%) by NGS of tumor tissues from 87 pancreatic cancer patients with sufficient specimens. Further analysis revealed that mutations in CDKN2B, PTEN, FGF6, and RBBP8 genes were significantly associated with an increased risk of death ( P＜0.05). Conclusion:Albumin-bound paclitaxel as first-line treatment demonstrated feasible anti-tumor efficacy and manageable safety for patients with advanced pancreatic cancer in China.

Objective:To observe and evaluate the clinical efficacy and safety of albumin-bound paclitaxel as first-line treatment for patients with advanced pancreatic cancer in China, and to explore the prognosis-related molecules in pancreatic cancer based on next-generation sequencing (NGS) of tumor tissues.Methods:From December 2018 to December 2020, patients with locally advanced or metastatic pancreatic cancer were recruited to accept albumin-bound paclitaxel as first-line treatment in the oncology departments of 24 hospitals in East China. The primary endpoints were overall survival (OS) and treatment related adverse events, and the secondary endpoint was progression-free survival (PFS). Adverse effects were graded using Common Terminology Criteria for Adverse Events 5.0 (CTCAE 5.0). NGS sequencing on the primary or metastatic tissue samples of pancreatic cancer obtained through surgical resection or biopsy was performed.Results:This study recruited 229 patients, including 70 patients with locally advanced pancreatic cancer (LAPC) and 159 patients with metastatic pancreatic cancer (mPC). The disease control rate was 79.9% and the objective response rate is 36.3%.The common adverse effects during treatment were anaemia (159 cases), leucopenia (170 cases), neutropenia (169 cases), increased aminotransferases (110 cases), and thrombocytopenia (95 cases), and the incidence of grade 3-4 neutropenia is 12.2% (28/229). The median follow-up time was 21.2 months (95% CI: 18.5-23.1 months). The median PFS (mPFS) was 5.3 months (95% CI: 4.37-4.07 months) and the median OS (mOS) was 11.2 months (95% CI: 9.5-12.9 months). The mPFS of patients with LAPC was 7.4 months (95% CI: 6.6-11.2 months), and their mOS was 15.5 months (95% CI: 12.6-NA months). The mPFS of patients with mPC was 3.9 months (95% CI: 3.4-5.1 months), and their mOS was 9.3 months (95% CI: 8.0-10.8 months). Multivariate Cox regression analysis showed that clinical stage ( HR=1.47, 95% CI: 1.06-2.04), primary tumor site ( HR=0.64, 95% CI: 0.48-0.86), Eastern Cooperative Oncology Group Performance Status (ECOG PS) score ( HR=2.66, 95% CI: 1.53-4.65), and whether to combine radiotherapy ( HR=0.65, 95% CI: 0.42-1.00) were independent influencing factors for the PFS of these patients. The primary tumor site ( HR=0.68, 95% CI: 0.48-0.95), ECOG score ( HR=5.82, 95% CI: 3.14-10.82), and whether to combine radiotherapy ( HR=0.58, 95% CI: 0.35-0.96) were independent influencing factors of the OS of these patients. The most frequent gene mutations in these advanced stage pancreatic patients were KRAS (89.66%), TP53 (77.01%), CDKN2A (32.18%), and SMAD4 (21.84%) by NGS of tumor tissues from 87 pancreatic cancer patients with sufficient specimens. Further analysis revealed that mutations in CDKN2B, PTEN, FGF6, and RBBP8 genes were significantly associated with an increased risk of death ( P＜0.05). Conclusion:Albumin-bound paclitaxel as first-line treatment demonstrated feasible anti-tumor efficacy and manageable safety for patients with advanced pancreatic cancer in China.

Objective:To investigate the clinical application of three-point wiring localization in mandibular angle osteotomy.Methods:A total of 180 patients with mandibular angle long curve osteotomy were selected in Sichuan Friendship Hospital from July 2021 to April 2022, aged 19-45 (mean age 26.0±10.0) years, including 30 males and 150 females. Preoperative bilateral mandible was symmetry as CT showed, and all of them undergo operation of mandibular angle long curve osteotomy by using three-point wiring localization method under tracheal intubation general anesthesia.Results:Bilateral osteotomy bone of mandibular angle was basically symmetrical in all patients, the arc of osteotomy was good, and there were no obvious complications after surgery. The postoperative follow-up was 3-12 months, and all cases had good postoperative face contour and bilateral symmetry.Conclusions:Using three-point wiring localization method at operation of long curve mandibular angle osteotomy can ensure bilateral symmetry, accuracy and safety of the osteotomy.

Objective:To explore a simple and effective clinical method for improving facial sagging while performing maxillofacial contouring surgery.Methods:From October 2020 to October 2021, 50 patients with mandibular angle and malar surgery in the Plastic Surgery Department of Sichuan Friendship Hospital were selected, aged 30-43 years, with the average age of 37 years, including 44 females and 6 males. Maxillofacial contouring surgery was performed under transnasal intubation general anesthesia, the interorgual jaw groove incision was performed with a swing saw for bilateral long arc osteotomy, and the maxillary gingival groove incision and sideburn skin incision were performed for zygomatic osteotomy reduction and zygomatic arch incision. A small incision about 3 mm long was taken 1 cm from the edge of the temporal hair; a special conical cannula stripper was used to perform subcutaneous tunnel peeling to the zygomatic fat pad and masseter muscle ligament, anterior appendage ligament, then a two-way barb line was placed through the casing to lift vertically upwards, pierce above the posterior papillae of the ear, and the excess thread was cut off.Results:Following-up for 3-12 months, all recipients recovered well after surgery, the skin of the middle and lower parts of the postoperative body was lifted to varying degrees, the cheek fat pad was lifted, the jaw contour line was clearer, and the nasolabial fold was significantly improved as compared with that before the operation.Conclusions:At the same time as facial contouring surgery, the use of minimally invasive tunnel separation and lifting technique can effectively improve the skin sagging in the middle and lower parts, and it is simple and effective, and the clinical application effect is good.

Objective:To investigate the application of internal fixation technique using Z-shaped titanium plate during operation of reduction malarplasty.Methods:A retrospective analysis was performed for the clinical data of patients who underwent reduction malarplasty in Sichuan Friendship Hospital from June 2021 to March 2022. The intraoral maxillary vestibular groove mucosal incision and a small incision at the sideburns were used, and according to the height of the zygomatic body to be lowered before surgery, the zygomatic body was inverted F-shaped osteotomy, so that the zygomatic complex anterior was completely loosened. Zygomatic arch anterior to the temporomandibular joint was osteotomy using reciprocating saws and then push inward. The 3-hole titanium plate was bent into a Z-shape, the length of the middle arm of the Z-shaped titanium plate was the distance that the zygomatic arch needs to push inward, for the asymmetry of the zygomatic arch width on both sides, the length of the middle arm of the Z-shaped titanium plate on both sides can be adjusted and fixed with 2 titanium nails. Adjust the anterior zygomatic body so that the osteotomy line was well aligned and fixed with an L-shaped titanium plate. Selected 20 cases with complete three-dimensional(3D) CT data before and 3 months after surgery by random number table, and measured the vertical distance from the outermost point of the zygomatic arch to the median line based on the 3D CT head up position, and the surgical effect was evaluated. SPSS 25.0 software was used to statistically analyze the data, and the quantitative data conforming to the normal distribution were represented by Mean±SD, and the vertical distance from the outermost point of the zygomatic arch to the median line was compared by paired-sample t-test, P<0.05 indicates that the difference is statistically significant. Results:A total of 78 zygomatic plastic surgery patients were enrolled, including 18 males and 60 females, aged 19-37 years old, with an average age of 26 years. All patients’ incision had no complications after surgery, followed up for 3-12 months, the width of the zygomatic arch on both sides was significantly reduced, CT showed that the unilateral zygomatic arch was reduced by 3-8 mm, the transition between the zygomatic and temporal regions was smooth, and the zygomatic arch width on both sides was symmetrical. The difference of the vertical distance from the outermost point of the zygomatic arch to the median line was statistically significant between preoperative and postoperative, on the left side of the patient [(66.5±5.2) mm vs. (61.9±3.2) mm] and [(67.4±4.7) mm vs. (62.1±2.7) mm] ( P<0.05) for the right side. There was no significant difference between the left and right sides after surgery ( P>0.05). Conclusion:The Z-shaped titanium plate internal fixation technique can better control the zygomatic arch internal push distance in reduction malarplasty, and a symmetrical and gentle facial morphology can be obtained after surgery.

Objective:To investigate the application of internal fixation technique using Z-shaped titanium plate during operation of reduction malarplasty.Methods:A retrospective analysis was performed for the clinical data of patients who underwent reduction malarplasty in Sichuan Friendship Hospital from June 2021 to March 2022. The intraoral maxillary vestibular groove mucosal incision and a small incision at the sideburns were used, and according to the height of the zygomatic body to be lowered before surgery, the zygomatic body was inverted F-shaped osteotomy, so that the zygomatic complex anterior was completely loosened. Zygomatic arch anterior to the temporomandibular joint was osteotomy using reciprocating saws and then push inward. The 3-hole titanium plate was bent into a Z-shape, the length of the middle arm of the Z-shaped titanium plate was the distance that the zygomatic arch needs to push inward, for the asymmetry of the zygomatic arch width on both sides, the length of the middle arm of the Z-shaped titanium plate on both sides can be adjusted and fixed with 2 titanium nails. Adjust the anterior zygomatic body so that the osteotomy line was well aligned and fixed with an L-shaped titanium plate. Selected 20 cases with complete three-dimensional(3D) CT data before and 3 months after surgery by random number table, and measured the vertical distance from the outermost point of the zygomatic arch to the median line based on the 3D CT head up position, and the surgical effect was evaluated. SPSS 25.0 software was used to statistically analyze the data, and the quantitative data conforming to the normal distribution were represented by Mean±SD, and the vertical distance from the outermost point of the zygomatic arch to the median line was compared by paired-sample t-test, P<0.05 indicates that the difference is statistically significant. Results:A total of 78 zygomatic plastic surgery patients were enrolled, including 18 males and 60 females, aged 19-37 years old, with an average age of 26 years. All patients’ incision had no complications after surgery, followed up for 3-12 months, the width of the zygomatic arch on both sides was significantly reduced, CT showed that the unilateral zygomatic arch was reduced by 3-8 mm, the transition between the zygomatic and temporal regions was smooth, and the zygomatic arch width on both sides was symmetrical. The difference of the vertical distance from the outermost point of the zygomatic arch to the median line was statistically significant between preoperative and postoperative, on the left side of the patient [(66.5±5.2) mm vs. (61.9±3.2) mm] and [(67.4±4.7) mm vs. (62.1±2.7) mm] ( P<0.05) for the right side. There was no significant difference between the left and right sides after surgery ( P>0.05). Conclusion:The Z-shaped titanium plate internal fixation technique can better control the zygomatic arch internal push distance in reduction malarplasty, and a symmetrical and gentle facial morphology can be obtained after surgery.

PURPOSE: An older female predominance has been reported among chronic cough patients in Western countries, which is considered to be associated with a higher cough sensitivity in females. However, the characteristics of Chinese chronic cough patients remain unclear. This study aimed to explore the age and sex distribution as well as their relationship with cough reflex sensitivity to capsaicin in Chinese chronic cough patients. METHODS: We analyzed the demographic features of 1,882 consecutive chronic cough patients who attended our cough clinic in Guangzhou, China. Cough sensitivity to capsaicin, which was defined as the lowest concentration of capsaicin causing 5 coughs or more (C5), was measured in 539 of the 1,882 patients and 68 healthy volunteers. RESULTS: The mean age of the patients was 43.0 ± 13.7 years and patients aged <50 years accounted for more than two-thirds of the study population. Around 87% of the patients were never-smokers. The proportion of females (51.5%) was almost equal to that of males (48.5%). The pattern of the age and sex distribution was consistently reflected within most common causes of chronic cough, while a female predominance was shown in patients with cough-variant asthma and patients aged ≥50 years. Female patients had higher cough sensitivity to capsaicin than male patients (log C5: 1.58 ± 0.84 vs. 2.04 ± 0.84 μmol/L, P = 0.001), and patients aged ≥50 years had higher cough sensitivity to capsaicin than patients aged <50 years. CONCLUSIONS: In China, patients with chronic cough have a roughly equal sex distribution and a middle-aged predominance, irrespective of a higher cough sensitivity to capsaicin in females and older patients. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02591550
Age Distribution ; Asian Continental Ancestry Group ; Asthma ; Capsaicin ; China ; Cough ; Female ; Healthy Volunteers ; Humans ; Male ; Reflex ; Sex Distribution

OBJECTIVETo analyze the correlation between the genotype and phenotype of 18q deletion syndrome with chromosome microarray analysis (CMA).

METHODSEight cases with 18q deletion syndrome were selected, including two affected fetuses and six children patients. DNA was extracted and hybridized with Affymetrix CytoScan TM 750K arrays following the manufacturer's standard protocol. The data was analyzed with a special software package.

RESULTSCMA analysis identified pathogenic copy number variations (CNVs) on 18q in all cases, which ranged from 6.612 Mb to 22.973 Mb. NFATC1, GALR1, MBP, SALL3 and TSHZ1 are likely to be causative genes for congenital heart disease, psychological, growth retardation, and cleft palate.

CONCLUSIONCMA can precisely locate the breakpoints of 18q and facilitate definition of the genotype-phenotype correlations, which is useful for prognosis.

Child, Preschool ; Chromosome Deletion ; Chromosome Disorders ; genetics ; Chromosomes, Human, Pair 18 ; genetics ; DNA Copy Number Variations ; Female ; Humans ; Infant ; Male ; Microarray Analysis

OBJECTIVE To identify differentially expressed microRNA (miRNA) in peripheral blood mononuclear cells (PBMCs) of anxiety patients and predict their target genes and function by bioinformatics analysis. METHODS The miRNA expression profiles were determined using an Affymetrix array. To validate the results, real-time quantitative polymerase chain reaction (qRT-PCR) analysis in a larger cohort was employed. The targets of the differentially expressed miRNAs were predicted by Target Scan, miRBD, and DIANA-microT-CDS, and the results were analyzed by gene ontology (GO) and KEGG pathway analysis using FunNet. RESULTS MicroRNA microarray chip analysis has identified 7 miRNAs were detected with significant changes in expression in PBMCs of anxiety patients. qRT-PCR analysis has confirmed that the expression levels of 5 miRNAs (has-miR-4484, has-miR-4505, has-miR-4674, has-miR-501-3p and has-miR-663) were up-regulated. Intersecting the genes by Target Scan, miRBD, and DIANA-microT-CDS has predicted 195 targets. GO analysis showed that biological processes regulated by the predicted target genes have included diverse terms. Some terms, e.g., nervous system development, nerve growth factor receptor signaling pathway, neuron migration, dendrite development, regulation of neuron projection development, midbrain development, regulation of excitatory postsynaptic membrane potential, gliogenesis, dendrite morphogenesis, etc. have direct relationship with the central nervous system and brain functions. Pathway analysis showed that a significant enrichment in several pathways related to neuronal brain functions such as glutamatergic synapse, axon guidance, calcium signaling pathway, MAPK signaling pathway, GnRH signaling pathway, Wnt signaling pathway, gap junction, long-term potentiation and VEGF signaling pathway, etc. Among the five microRNAs, has-miR-4484, has-miR-4505, has-miR-4674 and has-miR-501-3p may have more important regulatory functions. CONCLUSION Five miRNAs (has-miR-4484, has-miR-4505, has-miR-4674, has-miR-501-3p and has-miR-663) are up-regulated in PBMCs of anxiety patients and may be closely involved in the pathogenesis of anxiety disorder.
Anxiety Disorders ; genetics ; Computational Biology ; methods ; Gene Expression Regulation ; Humans ; MicroRNAs ; analysis ; Real-Time Polymerase Chain Reaction

Objective To investigate the effect of taurine transporter in the process of protection of brain edema in rats with severe traumatic head injury. Methods A total of 24 Male Sprague-Dawley rats were randomly divided into 4 groups. Except the control rats (Group Sham), all other three groups were subjected to lateral fluid percussion head injury. The TBI (Traumatic brain injury) models (Group TBI) and surgical control rats (Group Sham) were injected with saline through caudal vein after surgery, while the Taurine prevention and Taurine treatment models (Group Pre Tau and Group Tau) were injected with 120 g/L taurine solution before or after surgeries respectively. Water content in each brain, mRNA and protein expres?sion of aquaporin 4 and taurine transporter in the injured rat brain hemispheres were all evaluated over the time course of the study (7 d) in each group. Results Compared with rats in Group Sham, water content in each brain increase, mRNA tran?scription and protein expression of AQP4 were both up regulated but the mRNA transcription and protein expression of TauT were both down-regulated in rats in TBI group. Compared with rats in TBI group, brain water content, mRNA transcription and protein expression of AQP4 all decrease while mRNA transcription and protein expression of TauT all increase in rats in Pre tau and Tau groups. There is no statistical difference of TauT expression between rats in pre-tau group and Tau group. Conclusion Taurine exert its neuron protection role through draining water content from brain and down regulating expres?sion of AQP4 but rising expression of TauT after TBI.