Variants of gene loci on susceptibility genes are the major individual susceptibility factors of esophageal squamous cell carcinoma (ESCC) in China.Some of the gene loci participate in the DNA damage and repair,and some are related with cancer suppressor genes,metabolism enzymes,trace elements and smoking.The single nucleotide polymorphisms of these susceptibility genes are closely correlated with the genesis of ESCC.

Objective To observe the expression of aggrecanase 2 and a tissue inhibitor of metalloproteinase 3 (TIMP-3) in degenerate human lumbar intervertebral discs and their role in degeneration of the nucleus pulposus.Methods Pfirrmann classification was used to class degenerate intervertebral discs observed through MRI.They were divided into three groups:a control group (Pfirrmann grade Ⅰ-Ⅱ),a degeneration group (Pfirrmann grade Ⅲ-Ⅳ),and a severe degeneration group (Pfirrmann grade Ⅴ).A total of 45 cases accepted lumbar spine surgery for removing nucleus pulposus specimens.Each group contained 15 cases.After formalin-fixation and paraffin embedding,immunohistochemistry was used to detect aggrecanase 2 and TIMP-3 expression in the nucleus pulposus cells.Results The percentages of cells positive for aggrecanase 2 were (13.58 ± 7.76) ％,(33.48 ± 13.95) ％ and (56.00 ± 18.39) ％ in the control,degeneration and severe degeneration groups respectively.These differences had statistical significance.The percentages of cells positive for TIMP-3 were (34.78 ± 13.80) ％,(46.77 ± 10.98) ％ and (50.65 ± 16.45) ％,and these differences were again statistically significant.The aggrecanase 2/TIMP-3 ratios were also significantly different.Conclusion As the degree of degeneration of the nucleus pulposus increased,the expression of aggrecanase 2 and TIMP-3 rose,which indicates that both changes were closely connected with the degeneration.Their ratio was correlated with the degree of degeneration of the nucleus pulposus.

Objective To compare the effect of primary suture and T tube drainage of laparoscopic common bile duct exploration(LCBDE) in the treatment of patients with choledocholithiasis.Methods A total of 57 patients with calculus of extrahepatic bile duct were selected and they were randomly divided into observation group(n =25,treated by LCBDE) and control group(n =32,treated by T tube drainage).The operation time,postoperative recovery time of gastrointestinal tract,abdominal drainage time,postoperative hospital stay,hospitalization expenses and postoperative complications were recorded and compared between the two groups.Results All the patients were successfully completed surgery,and no patients had open surgery.The recovery time and postoperative hospital stay of the observation group were (1.7 ± 0.5) d,(5.3 ± 1.6) d,respectively,which were significantly shorter than (2.1 ± 0.3) d,(9.2 ± 1.9) d of the control group (t =11.73,6.27,all P ＜ 0.05),and the cost of hospitalization of the observation group was (6873 ± 2 541)RMB,which was significantly higher than (6 079 ± 2 492)RMB of the control group (t =5.93,P ＜ 0.05).The operation time and drainage time of the observation group were (86.3 ± 19.6) min,(89.7 ± 21.6) h,respectively,which were shorter than (97.1 ± 21.1) min,(98.2 ± 22.7) h of the control group,but the differences were not statistically significant(all P ＞ 0.05).There were 4 cases of postoperative bile leakage and 1 case of common bile duct residual stones in the observation group,and the incidence rate of complications was 20.00％.There were 2 cases of bile leakage,3 cases of common bile duct residual stones and 2 cases of biliary peritonitis in the control group,and the incidence rate of complications was 21.87％.There was no statistically significant difference in the incidence rate of complications between the two groups (x2 =0.15,P ＞0.05).All the patients were followed up for 1 to 2 years,the recurrence rate of stones in the observation group was 12.00％,which was similar to 15.60％ in the control group (x2 =0.36,P ＞ 0.05).Conclusion Primary suture of laparoscopic common bile duct exploration has the advantages such as less trauma,less pain,faster recovery and shorter hospital stay in the treatment of patients with choledocholithiasis,which is worthy of clinical application and popularization.

Cryoablation therapy with explicit anti-tumor mechanisms and histopathological manifestations has a long history.A large number of clinical practice has shown that cryoablation therapy is safe and effective,making it an ideal tumor treatment method in theory.Previously,its efficacy and clinical application were constrained by the limitations of refrigerants and refrigeration equipment.With the development of the new generation of cryoablation equipment represented by argon helium knives,significant progress has been made in refrigeration efficien-cy,ablation range,and precise temperature measurement,greatly promoting the progression of tumor cryoablation technology.This consensus systematically summarizes the mechanism of cryoablation technology,indications for oral mucosal melanoma(OMM)cryotherapy,clinical treatment process,adverse reactions and management,cryotherapy combination therapy,etc.,aiming to provide reference for carrying out the standardized cryoablation therapy of OMM.