Circulating microRNAs (miRNAs) is a class of non-coding small RNA molecules.As tumor biomarkers, circulating miRNAs deregulation is associated with the initiation and progression of human cancer.Studies indicate that circulating miRNAs have great potential in the early diagnosis and prognosis of primary or metastatic tumors (colorectal, breast, prostate, hepatocellular and ovarian cancer and other epithelial cancer).

Objective:To investigate the efficacy of re-treatment for cervical lymph node recurrence in nasopharyngeal carcinoma patients after radiotherapy and to explore the prognostic factors.Methods:Eighty-two patients who received therapy due to cervical lymph node recurrence after deftnitive radiotherapy were reviewed.The relevant factors including sex.the interval between radiotherapy and recurrence,rN stage,recurrence site,treatment modalities,and treatment efficacy were analyzed.Subgroup analysis was performed to review the relevant factors including the involvement in the adjacent tissues,the number of positive nodes and surgical range.Kaplan-Meier method,Log-rank test and Cox method were used for statistical analysis.Results:The 1-,3-and 5-year local control rates were 58%,39.0%,and 39.0%,respectively.The 1-,3-and 5-year overall survival rates were 82.9%,47.6%.and 25.0%,respectively.The 1-,3-and 5-year overall survival rates in the radiotherapy-based treatment group were 80.8%,37.1%and 19.1%,respectively.The 1-,3-and 5-year overall survival rates in the surgery-based treatment group were 86.7%,66% and 34.2%,respectively.The efficacy of surgery-based treatment was superior to that of radiotherapy-based treatment.In the multivariate analysis,tumor recurrence site was an independent prognostic factor.Conclusion:Radical neck dissection-based treatment can achieve satisfactory efficacy for cervical lymph node recurrence after radiotherapy in nasopharyngeal carcinoma patients.

Objective To investigate the effect of vitamin D on pulmonary function in patients with chronic obstructive pulmona-ry disease,and to explore its possible mechanism.Methods Patients with chronic obstructive pulmonary disease admitted in the hospital were randomly divided into 2 groups,one group of patients were given regular COPD treatment (control group,30 cases), the other group of patients were given vitamin D on the basis of conventional therapy(experimental group,30 cases).Pulmonary function test and C reaction protein (CRP)determination in the 2 groups were performed,the contents of PaO2 ,PaCO2 were also determined.Results Compared with the control group,lung function improvement in experimental group were more obvious,and the the number of acute attack significantly reduced(P <0.05).The concentration of CRP in experimental group was significantly lower after treatment than before treatment(P <0.05),while the concentration of CRP in control group didn′t change significantly (P >0.05).Conclusion Vitamin D contributes to the improvement of pulmonary function in patients with COPD,and its mecha-nism might relate to the reduction of inflammatory reaction.

ObjectiveTo investigate the ability of three-dimensional(3D) speckle tracking imaging (STI) for assessing left ventricular (LV) strain,and measure the value and angle of myocardial main strain vector.MethoodsLongitudinal,circumferential and radial strain of LV were measured in 31 healthy adults by 3D-STI and two-dimensional(2D) STI.The main strain vector and the angle between main strain vector and the LV short-axis plane were calculated from longitudinal and circumferential strains.Results The global longitudinal,circumferential strains and strains at basal,middle,apical level of LV by 3D-STI were significantly smaller than those by 2D-STI,whereas radial strain showed an opposite trend.The 3D strains presented significant difference between different levels of LV,longitudinal,circumferential and radial 3D strains were greater at middle level than at basal and apical level of LV,meantime 2D stain didn't show such obvious trend.Calculated from three-dimensional longitudinal and circumferential strain,the main strain vector was greatest at middle level of LV,whereas the angle between main strain vector and LV short axis plane didn't show any significant difference between three levels of LV.Conclusions3D-STI provides us a new and reproducible method for the evaluation of LV regional function by measuring LV strains.

Objective To investigate in vitro porcine myocardial shear modulus using real-time shear wave elastography.Methods Shear wave elastography was used on four in vitro porcine hearts.The probe was placed parallel to the long or short-axis of the heart on the anterior wall of the left ventricle,and myocardial shear modulus were measured in subepicardial,middle,subendocardial layers,respectively.Results Shear modulus of subepicardial,middle,subendocardial myocardium were (46.04 ± 17.07)kPa,(87.70 ± 29.67) kPa,( 115.73 ± 30.04) kPa,respectively,when the probe was placed parallel to the long-axis of the heart; whereas those were (78.71 ± 26.48) kPa,(77.08 ± 34.00)kPa,(70.69 ± 41.38) kPa,respectively,when the probe was placed parallel to the short-axis of the heart.Conclusions By using realtime shear wave elastography,the shear modulus values measured in subepicardial,middle,subendocardial myocardium of the left ventricle are different,even myocardium in the same location appears different shear modulus values when the probe orientation are different.

Objective To investigate left ventricular (LV) strain in patients with hypertension (HT)and myocardial hypertrophy using three-dimensional speckle tracking echocardiography.Methods Myocardial movement was analyzed in 37 primary HT patients with myocardial hypertrophy and 27 healthy volunteers.LV longitudinal,circumferential,radial and area strains were measured.The correlation between each global strain parameter and LV ejection fraction (LVEF) was analyzed.Results LV global longitudinal strain(GSL),global radial strain (GSR) and global area strain (GSA) of HT patients with myocardial hypertrophy were significantly lower than the contrast group,whereas global circumferential strain(GSC) showed no significant difference between the two groups.Longitudinal,radial and area strains were decreased in LV basal and middle levels,while decreased circumferential strain was detected only in basal level.There were significant correlations between LVEF and GSL,GSC,GSR,GSA.Conclusions Impairment of LV regional myocardial contractility can be detected by three-dimensional speckle tracking echocardiography.

Objective To assess the systolic function in left ventricular subendocardial myocardium , midmyocardium and subepicardial myocardium in patients with hypertrophic cardiomyopathy (HCM ) by two‐dimensional speckle tracking echocardiography .Methods A total of 32 patients with HCM and 32 healthy adults were included in the study .All standard measurements were obtained from the left ventricular short‐axis views at the levels of mitral annulus ,papillary muscle and apex ,and apical four‐chamber ,two‐chamber ,and long‐axis views .Two‐dimensional speckle tracking imaging was employed .The global peak systolic radial strain ,peak systolic longitudinal strain and circumferential strain of each layer of the left ventricle were measured .Results In patients with HCM and the control group ,the peak systolic longitudinal strain and circumferential strain reduced from subendocardial myocardium to subepicardial myocardium .The global peak systolic radial strain in patients with HCM was significant lower than that in the control group . And in patients with HCM ,peak systolic longitudinal strain in subendocardial myocardium ,midmyocardium and subepicardial myocardium was significant lower than those in the control group .Conclusions Peak systolic longitudinal strain and circumferential strain are reduced from subendocardial myocardium to subepicardial myocardium .Myocardial systolic function is impaired in patients with HCM .In patients with HCM ,longitudinal strain of each layer is lower ,but circumferential strain is mainly reduced in midmyocardium and subepicardial myocardium compared with that in the control group .

Objective The aim of the present study was to evaluate the efficacy of three different modalities in treatment of lung oligometastases from nasopharyngeal carcinoma ( NPC) after radiotherapy and to identify a more appropriate treatment modality.Methods The clinical data of 87 cases of lung oligometastases from NPC were analyzed retrospectively.Among them, 33 patients underwent local small-field irradiation+/-chemotherapy, 28 underwent whole-lung irradiation+chemotherapy, and 26 underwent simple chemotherapy.The survival rates were calculated using Kaplan-Meier analysis.The differences among the modalities were evaluated using the log-rank test.Cox univariate and multivariate analyses were performed to determine the influencing factors.Results The 3-year lung metastasis survival ( LMS) rates of patients with lung metastasis undergoing the three treatment modalities ( local small-field irradiation +/-chemotherapy, whole-lung irradiation+chemotherapy and chemotherapy alone) were 89.3%, 72.7%, and 72.4%, respectively, showing a significant difference between the groups ( P=0.003 ) .Further subgroup analysis showed that the 5-year LMS rate was significantly higher in the local small-field irradiation+/-chemotherapy group than that in the whole-lung irradiation+chemotherapy group and chemotherapy alone group (P=0.001).The 2y-ear progression -free survival (PFS ) rates of the three groups were 571.%, 25.8%and 3.8%, respectively, showing significant intergroup differences ( P=0.002 and P<0 .001 ) . Multivariate analysis indicated that compared with the whole lung irradiation group and the chemotherapy alone group, the local irradiation+/-chemotherapy is an independent favorable prognostic factor for LMS and PFS (P<0.05). Conclusion Local radiotherapy combined with systemic chemotherapy is the best therapeutic modality for lung oligometastases derived from NPC after radiotherapy, improving the LMS and prolonging the PFS.

Objective The aim of the present study was to evaluate the efficacy of three different modalities in treatment of lung oligometastases from nasopharyngeal carcinoma ( NPC) after radiotherapy and to identify a more appropriate treatment modality.Methods The clinical data of 87 cases of lung oligometastases from NPC were analyzed retrospectively.Among them, 33 patients underwent local small-field irradiation+/-chemotherapy, 28 underwent whole-lung irradiation+chemotherapy, and 26 underwent simple chemotherapy.The survival rates were calculated using Kaplan-Meier analysis.The differences among the modalities were evaluated using the log-rank test.Cox univariate and multivariate analyses were performed to determine the influencing factors.Results The 3-year lung metastasis survival ( LMS) rates of patients with lung metastasis undergoing the three treatment modalities ( local small-field irradiation +/-chemotherapy, whole-lung irradiation+chemotherapy and chemotherapy alone) were 89.3%, 72.7%, and 72.4%, respectively, showing a significant difference between the groups ( P=0.003 ) .Further subgroup analysis showed that the 5-year LMS rate was significantly higher in the local small-field irradiation+/-chemotherapy group than that in the whole-lung irradiation+chemotherapy group and chemotherapy alone group (P=0.001).The 2y-ear progression -free survival (PFS ) rates of the three groups were 571.%, 25.8%and 3.8%, respectively, showing significant intergroup differences ( P=0.002 and P<0 .001 ) . Multivariate analysis indicated that compared with the whole lung irradiation group and the chemotherapy alone group, the local irradiation+/-chemotherapy is an independent favorable prognostic factor for LMS and PFS (P<0.05). Conclusion Local radiotherapy combined with systemic chemotherapy is the best therapeutic modality for lung oligometastases derived from NPC after radiotherapy, improving the LMS and prolonging the PFS.

Lung squamous cell carcinoma with intratracheal diffuse leukoplakia as the main manifestation is very rare in clinic. The clinical data of a patient with pulmonary squamous cell carcinoma with intratracheal diffuse leukoplakia admitted to the Affiliated Hospital of Jining Medical University in December 25, 2021 were retrospectively analyzed in order to improve the understanding of this special manifestation. The patient was a 73-year-old male with clinical manifestations of cough, sputum, and blood-stained sputum. Chest CT indicated patchy high-density shadow on the upper right lung, whole-course thickening of trachea and bronchial walls, and bronchoscopy showed diffuse trachea-bronchial mucosa congestion and edema, with a large number of leukoplakia on the surface. The clinical effect was stable after 2 cycles of chemotherapy. Lung squamous cell carcinoma accompanied by diffuse leukoplakia in the trachea is a rare presentation. Chest CT can show thickening of the tracheal and bronchial wall, while the lesion and tumor signs of the primary lesion are not obvious. Electronic bronchoscopy as soon as possible can avoid missed diagnosis.