Objective To explore the efficacy of neoadjuvant chemoradiotherapy (CRT) followed by surgery for locally advanced esophageal squamous cell carcinoma (ESCC),and to investigate the correlation between a clinical complete response (cCR) and a pathologic complete response (pCR).Methods One hundred and fifty-eight patients with locally advanced thoracic ESCC from 2001 to 2013 were retrospectively analyzed.All patients received concurrent chemoradiotherapy followed by surgery.Platinumbased chemotherapy regimens were adopted in chemotherapy and a prescribed dose of 40 Gy in 20 fractions,5 fractions per week,was used in radiotherapy.The overall survival (OS) and disease-free survival (DFS) rates were calculated using the Kaplan-Meier method,and pairwise comparisons and univariate prognostic analyses were performed using the log-rank test.Multivariable prognostic analyses were performed using the Cox regression model.Results The pCR rate was 41.1％ in all patients.After the treatment with neoadjuvant CRT,32(72.7％) out of 44 patients with a cCR had a pCR,but only 33(28.9％) out of 114 patients with a non-cCR had a pCR (P =0.000).The sensitivity,specificity,positive predictive value,and negative predictive value of a cCR in predicting a pCR were 49.2％,87.1％,72.7％,and 71.1％,respectively.The 3-year sample size was 91.The 3-year OS and DFS rates in all patients were 53.9％ and 48.6％,respectively.Patients with a cCR had significantly higher 3-year OS and DFS rates than those with a non-cCR (P =0.012;P =0.026),while patients with a pCR had significantly higher 3-year OS and DFS rates than those with a non-pCR (P =0.000;P =0.000).The multivariate analyses demonstrated that the pathologic response after CRT and chemotherapy regimen were the influencing factors for OS.The most common grade ≥3 acute adverse reaction was leucopenia (34.2％).Conclusions With a high pCR rate and tolerable adverse reactions,neoadjuvant CRT followed by surgery is a safe and effective option for locally advanced ESCC.The cCR rate after CRT is closely correlated with the pCR and OS rates.

Objective To compare and analyze the advantages and disadvantages of the application of self-fixing and plain polypropylene mesh in open inguinal hernia repair.Methods A study of 83 patients who underwent open inguinal hernia repair patients from June 2014 to June 2016 in the Department of General Surgery,AnHui No.2 Provincial People's Hospital Patients were divided into two groups according to the use of different patches,42 cases were applicated self-fixating mesh (observation group) and 41 cases were applicated the ordinary polypropylene patch (control group).The operation time,average postoperative hospitalization time,postoperative complications and Visual Analogue Score of postoperative pain were compared.The measurement data were expressed by mean standard deviation (~ ± s),and using t test,Count data were represented by frequency and percentage,and chi-square test was used for comparison between groups.Results The operation time of the observation group and the control group was (49.9 ± 6.4) minutes and (67.9 ± 6.1) minutes,and there was significant difference(P ＜ 0.05).The postoperative hospitalization time of observation group and control group was (2.5 ± 1.4) days and (2.6 ± 1.8) days,there was no significant difference (P ＞ 0.05).In the complications of the two groups,there were 1 case of scrotal edema in the observation group,and 2 cases of scrotal edema in the control group,the difference was no statistically significance.The Visual Analogue Score in two groups was (4.0 ± 0.8) score and (4.1 ± 0.7) score,there was no significant difference between the two groups (P ＞ 0.05) within 12 hours after operation.The Visual Analogue Score was (2.6 ± 0.7) score,(1.4 ± 0.5) score within 24 hours and 48 hours after operation in the observation group,and was (3.1 ± 0.6) score,(2.7 ± 0.5) score in the control group.There was a significant difference between the two groups (P ＜ 0.05).There was no obvious local pain for the observation group and had a better sense of comfort in one month follow-up after the operation.Conclusions The application of self-fixing suture free patch can reduce the operation time of patients and relieve the discomfort of postoperative pain,and has a high clinical value.