The vast majority of thyroid cancers show a good prognosis. However, the treatment of locally advanced thyroid cancer presents a huge problem. The wide application of targeted and immunotherapy in neoadjuvant therapy for locally advanced thyroid cancer has become a new therapeutic direction. This article summarizes the research on neoadjuvant chemotherapy, radiotherapy, and targeted therapy and immunotherapy related to various pathological types of thyroid cancer, with a focus on the recent advancements and thoughts on the application of targeted and immunotherapeutic drugs in neoadjuvant therapy. The results provide additional options for the clinical treatment of locally advanced thyroid cancer.

Objective To investigate the popularization of cardiopulmonary resuscitation(CPR)knowledge and science popularization needs among urban and rural residents in Tonghai County,Yuxi City,Yunnan Province,so as to explore the establishment of an efficient and appropriate science popularization model.Methods A total of 300 residents aged 15-60 years old were selected from Tonghai County,Yuxi City,Yunnan Province using stratified and simple random sampling methods.A self-designed questionnaire was used to conduct an anonymous questionnaire survey.Results Only 20.3%of Tonghai County residents master CPR skills,and 26.2%of Tonghai County residents have never heard of CPR.There is a statistically significant difference in the awareness rate of CPR between rural residents and non-rural residents(P<0.01).There are differences in residents'age and CPR awareness(P<0.01),the age and CPR are inversely proportional.The residents have a higher willingness to perform chest compressions and mouth-to-mouth resuscitation on strangers,66.2%and 68.6%respectively.63.79%of residents have never attended relevant training.But 92.76%of the people said they were willing to participate in the relevant training when they learned the training news.Conclusion Residents in Tonghai County generally lack knowledge of CPR first aid,but the demand for first aid knowledge of residential CPR is high and the attitude towards rescue is positive.It is recommended that relevant departments increase CPR science popularization and training efforts,and popularize CPR into villages.

Due to insidious onset,rapid progress,poor curative effect and poor prognosis,pancreatic cancer is known as a high degree of malignity.the incidence of pancreatic cancer and its clinical detection rate have increased in recent years,and it has become one of the malignant diseases endangering health of people.Therefore,the authors review and summarize the recent important research progress in the diagnosis and treatment of pancreatic cancer.

Objective:To investigate effects of metformin and rosiglitazone in non-obese polycystic ovary syndrome (PCOS) women with insulin resistance.Methods:Totally 200 non-obese PCOS women with insulin resistance in West China Second Hospital of Sichuan University were enrolled into this study from Sep. 2013 to Jun. 2016, and were randomly divided into two treatment groups: metformin group (1 500 mg/d) and rosiglitazone group (4 mg/d). The treatment lasted for 6 months. Their clinical and biochemical parameters were collected and compared.Results:In both groups, menstrual cycles [metformin group (37±4) days, rosiglitazone group (35±4) days] were shorter after treatment for 6 months (both P<0.01). After treatment for 6 months, body mass index [metformin group (21.6±1.6) kg/m 2, rosiglitazone group (21.7±1.7) kg/m 2] decreased in both groups (both P<0.01); decreased LH/FSH ratio (metformin group 1.67±0.80, rosiglitazone group 1.70±0.83) was also observed (both P<0.05). After treatment for 6 months, fasting insulin level [metformin group (13.5±5.1) mU/L, rosiglitazone group (12.7±5.6) mU/L] and homeostasis model assessment-insulin resistance index (metformin group 3.0±1.2, rosiglitazone group 2.8±1.2) were decreased in both groups (all P<0.01). Conclusions:For non-obese PCOS insulin resistance patients, screening of anthropometric and metabolic parameters is necessary. For PCOS with insulin resistance, lifestyle plus insulin sensitizers such as metformin could improve their clinical symptoms, correct the biochemical and metabolic dysfunction.

Objective:To explore the value of convalescent somatosensory evoked potentials (SEPs) in formulating a prognosis for children with severe disorders of consciousness (DOC) caused by brain trauma, infection or hypoxia.Methods:This was a retrospective cohort study of 286 children with DOC children treated between 2013 and 2021. They were divided into a trauma group ( n=103), an intracranial infection group ( n=101), a hypoxia group ( n=42) and an other-causes group ( n=40). Their consciousness status and functional recovery were obtained in follow-up appointments, and their functional condition 1 year after discharge was assessed using the modified Glasgow Outcome scale (GOS). Results:During 8-year follow-up, 16 had died, with 4 deaths within 1 year. Among the 191 cases followed up to 1 year, children with a bilateral N20 SEP had significantly better functional outcomes than those with unilateral or bilateral N20 absence. For the trauma group, the presence of a bilateral N20 signal was a strong indicator of good functional outcome at the 1-year follow-up, with a specificity of 90.9%, sensitivity of 55.6%, positive predictive value (PPV) of 92.6%, negative predictive value (NPV) of 50% and a positive likelihood rate (PLR) of 6.111. However, for the intracranial infection group, the presence of N20 had a low specificity for predicting good outcomes, though the absence of an N20 potential predicted poor functional outcome at 1 year with a specificity of 82.4%, sensitivity of 62.1%, PPV of 75%, and PLR of 3.517. For the hypoxic group, bilateral N20 could not predict a good prognosis, though its absence meant a poor outcome, with a specificity of 87.5%, sensitivity of 63.6%, PPV of 93.3%, and PLR of 5.818.Conclusion:SEPs during the recovery period can help to formulate a prognosis for children with severe DOC. Traumatic brain injury and the presence of bilateral N20 potentials can be used as a good prognostic indicator. For intracranial infection and hypoxic-ischemic brain injury, the absence of an N20 potential indicates a poor prognosis.

Objective: To evaluate the clinical value of the the hypopharynx and chest esophageal carcinoma. Methods: 20 patients surgical treatment data of the hypopharynx and chest esophageal carcinoma from January 2013 to July 2019 were reviewed. Results: The simultaneous hypopharynx and esophageal carcinoma 11 cases. The heterochronic hypopharynx and chest esophageal carcinoma 9 cases. 20 cases are all squamous cell carcinoma. The synchronus operation included total pharyngolaryngo esophagectomy, gastric tube interposition pharyngo gastric anastomic, neck and mediastinal lymph nodes dissection, tracheostomy. The heterochronic operation included the first stage radical hypopharygealectomy, the second stage radical esophagealectomy. Postoperative complications included in hospital death in one, double pneumonia in 3 and anastomosis stricture in one case. Pharynx gastric fistula in 2. Swallowing function were all recovered. Conclusion Although laryngo pharyngo esophagectomy and pharyngogastric anastomoses for the hypopharynx and chest esophageal carcinoma is a simple and acceptable procedure, the quality of life is not satisfactory. And although colon interpasation for esophageal replacement is complicated the quality of life is the best.

Multidrug resistance (MDR) has been considered as a huge challenge to the effective chemotherapy. Therefore, it is necessary to develop new strategies to effectively overcome MDR. Here, based on the previous research of -(2-hydroxypropyl)methacrylamide (HPMA) polymer-drug conjugates, we designed an effective system that combined drug-efflux circumvention and mitochondria targeting of anticancer drug doxorubicin (Dox). Briefly, Dox was modified with mitochondrial membrane penetrating peptide (MPP) and then attached to (HPMA) copolymers (P-M-Dox). Our study showed that macromolecular HPMA copolymers successfully bypassed drug efflux pumps and escorted Dox into resistant MCF-7/ADR cells endocytic pathway. Subsequently, the mitochondria accumulation of drugs was significantly enhanced with 11.6-fold increase by MPP modification. The excellent mitochondria targeting then resulted in significant enhancement of reactive oxygen species (ROS) as well as reduction of adenosine triphosphate (ATP) production, which could further inhibit drug efflux and resistant cancer cell growth. By reversing Dox resistance, P-M-Dox achieved much better suppression in the growth of 3D MCF-7/ADR tumor spheroids compared with free Dox. Hence, our study provides a promising approach to treat drug-resistant cancer through simultaneous drug efflux circumvention and direct mitochondria delivery.

Induction of immunogenic cell death promotes antitumor immunity against cancer. However, majority of clinically-approved drugs are unable to elicit sufficient ICD. Here, our study revealed that mitochondria-targeted delivery of doxorubicin (DOX) massively amplified ICD via substantial generation of reactive oxygen species (ROS) after mitochondrial damage. The underlying mechanism behind increased ICD was further demonstrated to be ascribed to two pathways: (1) ROS elevated endoplasmic reticulum (ER) stress, leading to surface exposure of calreticulin; (2) ROS promoted release of various mitochondria-associated damage molecules including mitochondrial transcription factor A. Nevertheless, adaptive upregulation of PD-L1 was found after such ICD-inducing treatment. To overcome such immunosuppressive feedback, we developed a tumor stimuli-responsive nano vehicle to simultaneously exert mitochondrial targeted ICD induction and PD-L1 blockade. The nano vehicle was self-assembled from ICD-inducing copolymer and PD-L1 blocking copolymer, and possessed long-circulating property which contributed to better tumor accumulation and mitochondrial targeting. As a result, the nano vehicle remarkably activated antitumor immune responses and exhibited robust antitumor efficacy in both immunogenic and non-immunogenic tumor mouse models.

Ventricular Function, Right ; Heart Ventricles/diagnostic imaging* ; Echocardiography