Objective To observe the clinical effect of repairing the defect after extended resec-tion of lower lip cancer by modified lip and cheek fan-shaped flap .Methods Six cases of lower lip cancer were treated .The defect of the lower lip was about 1/3-1/2 after 1 cm of enlarged resection outside the margin of the mass .The defect was repaired with modified lip and cheek fan-shaped flaps . The morphology and function were observed 3-36 months after operation .Results All patients healed in one stage ,and the shape and function of lower lip recovered well without complications .Conclusions Lower lip defect about 1/3-1/2 of patients with modified lip and cheek fan-shaped flap is an ideal method of restoration and reconstruction ,with satisfactory results after surgery .

Objective: To understand the longitudinal changes of refractive errors in adolescent myopia screening in the suburb of Shanghai, and to provide reference for targeted measures of myopia prevention and intervention. Methods: By using the cluster sampling method, 1 346 students were selected from two primary schools in a town in the suburb of Shanghai. Physical development indicators and refractive examination parameters of non ciliary muscle paralysis, and uncorrected visual acuity in 2017 and 2020 were collected from the Shanghai adolescent refractive development file. Longitudinal change of spherical equivalent (SE) refractive were assessed. A linear regression model was used to examine the relationship between the rate of SE change with characteristics of the students. Results: The average annual incidence of myopia was 16.36%, and the SE degrees of the left and right eyes of myopia students decreased by 225 degrees for three years. Girls (right eye Z=-4.33; left eye Z=-3.75, P<0.01), newly-onset myopia and persistent myopia (right eye Z=634.45; left eye Z=638.85, P<0.01) was a key for the rapid progress of refractive power. Conclusion The proportion of students with severe low vision is relatively high, and the apparent shifts toward more hyperopia in myopia students call for effective prevention and control programs based on changes in refractive to slow the progression of adolescent myopia.

BACKGROUNDGenetic polymorphism in metabolic enzymes, which are involved in metabolism of environmental carcinogens, have been thought to be related to susceptibility of lung cancer. The aim of this study is to investigate the cytochrome P450 2D6(CYP2D6) genetic polymorphism distribution in Han population in Sichuan, China, and to evaluate the relationship between CYP2D6 genetic polymorphism and lung cancer susceptibility.

METHODSPCR-RFLP was used to identify CYP2D6ch genotypes among 150 patients with primary lung cancer and 152 healthy controls, in Han population in Sichuan, China, and case-control study was used to analyze the relationship between genetic polymorphism and lung cancer susceptibility.

RESULTS(1) The distribution frequency of CYP2D6ch C and T allele were 39.5% and 60.5% in control group and 46.3% and 53.7% in lung cancer group, respectively. There was no significant difference between the two groups (P=0.089). (2)The distribution frequency of C/C, C/T and T/T genotypes were 18.4%, 42.1% and 39.5% in control group, and 22.7%, 47.3% and 30.0% in lung cancer group, respectively. No significant difference was found between the two groups (P=0.215). (3) The individuals who carried with Non-T/T genotypes had a 2.084-fold increased risk with squamous cell carcinoma (95%CI 1.024-4.244, P=0.043) than those who carried with T/T genotype. (4) The lighter smokers ( < 30 pack-years) who carried with Non-T/T genotypes had a 2.92-fold increased risk with lung cancer (95%CI 1.087-7.828, P=0.033) than those who carried with T/T genotype.

CONCLUSIONSCYP2D6ch Non-T/T genotypes are factors associated mail:zhouqh@mail.sc.cninfo.net) with increased risk of squamous cell carcinoma and also increase risk of lung cancer among lighter smokers.

BACKGROUNDSome studies have supposed that glutathione S-transferases (GSTs) may be involved in detoxification of carcinogens, especially from tobacco smoke. Therefore, polymorphism of GSTs has been considered as potential protectors of individual cancer risk. The objective of this study is to investigate the relationship between genetic polymorphism of GSTT1 and inherent susceptibility to lung cancer in Han population in Sichuan, China.

METHODSA case-control study was carried out to compare the distribution frequency of GSTT1 gene polymorphism between lung cancer (n=150) and control healthy individuals (n=152) with polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method and to analyze the relationship between the GSTT1 gene polymorphism and smoking and the inherent susceptibility of lung cancer.

RESULTS(1) The distribution frequency of GSTT1(-) genotype was 54.7% (82/150) in lung cancer and 38.2% (58/152) in control group respectively (OR=1.681, 95%CI=1.009- 2.803 , P=0.046); (2) GSTT1(-) genotype remarkably increased the risk of squamous cell carcinoma (OR=2.969, 95%CI= 1.511 -5.834, P=0.002) and adenocarcinoma (OR=2.095, 95%CI=1.060-4.140, P= 0.033 ); (3) In smokers, GSTT1(-) genotype significantly increased the risk for lung cancer (OR=4.051, 95%CI=1.959-8.380 , P=0.000); (4) In people with GSTT1(-) genotype, smoking markedly increased the risk for lung cancer (OR=53.885, 95%CI=11.789-246.302, P=0.000); (5) In heavy smokers (≥20 packyears), GSTT1(-) genotype could remarkably increase the risk of lung cancer (OR=4.296, 95%CI=1.649-11.190, P=0.003).

CONCLUSIONS(1) People with GSTT1(-) genotype have significantly increased risk for lung cancer in Han population in Sichuan, China, especially for squamous cell carcinoma. (2) GSTT1(-) genotype interacts synergistically with smoking on lung cancer risk. The more the cigarettes smoke, the higher the risk of lung cancer increases in those people who are smokers with GSTT1(-) genotype.

BACKGROUNDLung cancer is the leading cause of malignant tumor death among Chinese population. It has been known that the development of lung cancer may be associated with genetic po-lymorphism of some lung cancer related genes. The aim of this study is to evaluate the relationship between genetic polymorphism of metabolizing enzymes and susceptibility of lung cancer in Chinese population.

METHODSPolymorphism of CYP2E1 RsaI/PstI and GSTM1 was detected in 99 patients with lung cancer and 66 patients with benign pulmonary disease by PCR-RFLP and PCR. The association between genetic polymorphism and susceptibility of lung cancer was analyzed.

RESULTSNo significant difference in three RsaI/PstI genotype distribution of CYP2E1 was found between lung cancer group and control group (Chi-Square=1.374, P=0.241). (2) The frequency of GSTM1-null genotype in lung cancer group was significantly higher than that in control group (57.6% vs 40.9%, Chi-Square=4.401, P=0.036). (3) The individuals who carried with GSTM1-null genotype had a 1.96 fold increased risk of lung cancer (OR=1.96, 95%CI=1.042-3.689, P=0.037) than those who carried with GSTM1-present genotype. (4) When data were stratified by smoking status, the smokers who carried with c1/c1 genotype had a significantly higher risk of lung cancer (OR=3.525, 95%CI=1.168- 10.638, P=0.025) than those never-smokers who carried with at least one c2 allel. (5) When combination of polymorphism of CYP2E1 RsaI/PstI genotype and GSTM1 genotype was analyzed, compared with individuals who had concurrent present of GSTM1 and at least one c2 allel genotype, the risk of lung cancer for combination of GSTM1 null and c1/c1 genotype was increased significantly (OR=3.449, 95%CI=1.001- 11.886, P=0.050). Considering smoking status, compared with never-smokers who had concurrent present of GSTM1 and at least one c2 allel genotype, the risk of lung cancer for combination of GSTM1 null and c1/c1 genotype was remarkably increased (OR=11.553, 95%CI=1.068-124.944, P=0.044), as well as that for combination of GSTM1 null and at least one c2 allel genotype (OR=13.374, 95%CI=1.258-142.166, P= 0.032).

CONCLUSIONS(1)GSTM1 null genotype is an important factor associated with increased risk of lung cancer. (2) The combination of c1/c1 and GSTM1-null genotype can remarkably increase risk of lung cancer both in smokers and non-smokers.

BACKGROUNDTo investigate the diagnosis and treatment of pulmonary sclerosing hemangioma (PSH).

METHODSThe clinical features, radiographic manifestations and treatment of 21 patients with PSH were reviewed.

RESULTSNone of the 21 patients was diagnosed as PSH preoperatively. There were 18 females and 3 males, and the average age was 48.0 years in this group. Twelve patients were symptom free. The plain chest roentgenograms showed a well defined, homogeneous, round or oval nodulous shadow in most cases. All patients received operation. There was no postoperative morbidity and mortality. Postoperative follow-up showed a good prognosis.

CONCLUSIONSPreoperative diagnosis of PSH is quite difficult. PSH should be suspected in middle to old aged female patients who show a well defined, homogeneous, round or oval shadow in plain chest roentgenograms. PSH has a good prognosis if it is treated surgically.

Objective To evaluate the cognition, attitude, and barriers of family doctor team members in chongming district of Shanghai to pharmacists joining the team and providing community pharmaceutical care. To provide the reference resources for the establishment of community pharmaceutical care management mode with appropriate suburban characteristics. Methods In a cross-section study conducted in 2020, an online questionnaire was provided to family doctor teams in 18 townships in Chongming District through group WeChat. Descriptive statistical data were used to analyze the cognition, attitude and barrier of family physician team members to community pharmaceutical care. Results Among the 555 participants in the study, 351 (63.24%) were female, 187 general practitioners (33.69%), 226 nurses (40.72%), and 142 public health physicians (25.59%). There were statistically significant differences in CPC cognition among the three classes of family doctor team members (P<0.05). 126 nurses (51.22%) and 84 public health physicians (68.85%) claimed never heard of CPC. 11.48% public health physicians and 23.58% nurses were familiar with the work content and responsibilities of community clinical pharmacists. General practitioners showed relatively high proportion of 34.76%. 34.22% of general practitioners held a "disagree attitude" against that "community pharmaceutical care can improve the medication efficacy for patients". "Insufficient investment in the health sector" and "insufficient community pharmacists" were the main obstacles to the development of community pharmaceutical care. Conclusion The attitude of family doctors in Chongming area to community pharmaceutical care was conservative. Public healthcare persons and nurses had a low awareness to community pharmaceutical care. The development of community pharmaceutical care was limited by the lack of financial investment and manpower.