Cancer treatment has been continuously improved in recent year. Genetically targeted therapy has played a significant role in tumor reduction and local control. Genetic heterogeneity of colorectal cancer affects not only tumor development and progression, but also the selection and efficiency of targeted drugs, thus may become a breakthrough towards tackling the bottleneck in personalized medicine.

Objective To explore the role of night waking in the cognitive development of infants and young toddlers. Method A total of 116 infants aged 2 to 30 months were randomly selected in Yiwu, Zhejiang from December 2011 to February 2013. Social-demographic factors were investigated through questionnaire;sleep information were collected via the Brief Infant Sleep Questionnaire (BISQ);Cognitive development was assessed in all infants using Baley development scale. Results The mean age was 12.99 month-old. 50.86%(59/116) were males. Ocassional night waking was reported in 5.26%, one night waking in 29.82%, multiple night waking accounted in 64.91%of children under one year old. Ocassional night waking was reported in 32.20%, one night waking in 45.76%, multiple night waking in 22.03%of children over one year old. The frequency of night waking was signiifcantly different between children under one year old and children over one year old (P<0.01). The average duration of waking was 0.49±0.31 h in children under one year old, and 0.31±0.48 h in children older than one year old, and the difference was signiifcantly different (Z=4.35, P<0.001). In children over one year old, the more frequent night waking, the lowered MDI scores (F=3.98, P=0.024). The waking duration was negatively correlated with MDI scores in children over one year old (r=-0.26, P=0.035). Neither night waking duration nor night waking frequency had signiifcant correlation with MDI scores in children under one year old. Multivariable linear regression conifrmed that night waking was an independent inlfuential factor of MDI and PDI scores in children over one year old. Conclusions Persistent night waking should warrant attention.

The microorganism in human body is related to human health and disease,which plays a significant role in the exclusion of pathogen invading,participation of immune regulation and occurrence and development of the tumors.Studies have indicated that dysbacteriosis is often detected in cancer patients;especially,enteric dysbacteriosis can promote the occurrence and development of the tumors by influencing homeostatic balance of intestinal tract,gut metabolite and immunological function.Moreover,proportion detection of intestinal flora can be used as a non-invasive screening method and a diagnostic indicator for early detection of the malignant neoplasms.This review summarizes the recent studies on the associations of intestinal flora with human diseases and the possible mechanisms causing tumorigenesis,which may provide a novel research paradigm for cancer prevention and treatment.

Objective:To establish an in vivo model of acute radiation esophagitis in Wistar rats based on a small animal precision radiotherapy platform (SARRP). Methods:Thirty-six Wistar rats were randomly divided into control group, 40, 60 and 75 Gy groups. Based on MRI images, the esophageal target area of rats was outlined and the radiotherapy plan was formulated. The rats were respectively irradiated with 0, 8, 12 and 15 Gy per day for 5 consecutive days. The changes of body weight, food intake, esophageal pathology and magnetic resonance imaging were observed.Results:The body weight of rats in 75 Gy group decreased significantly on the 6th day after irradiation (IR) ( P<0.05). The esophageal tissue of rats in each IR group was thicker than that in control ( F = 14.20, P < 0.05). HE staining showed that the formation rate of radiation-induced esophagitis in 40 Gy and 60 Gy groups were 4/5 and 5/5, respectively, mainly mild. In 75 Gy group, the incidence of radiation-induced esophagitis approached to 5/5, of which 3/5 was severe at 9 d post-IR. The pathological injury scores [ M( Q1, Q3)] of rats in each group were 0, 1.0 (0.5, 2.5), 1.0 (1.0, 2.5) and 4.0 (1.5, 6.0) on the 9th day after IR. There was significant difference between the 75 Gy group and the control group ( H=12.69, P<0.05). After dynamic monitoring of neck MRI images, it was found that the esophageal signal of rats in each IR group increased and widened at 9 d post-irradiation. Conclusions:The animal model of acute radiation-induced esophagitis in rats was successfully established based on a small animal precision radiotherapy platform combined with MRI. 75 Gy was the best irradiation dose and the 9th day was the best observation time point.

Objective To explore the relationship between different statuses of vitamin D and parathyroid hormone (PTH) during pregnancy with glucose metabolism and the risk of gestational diabetes mellitus (GDM). Methods A total of 4138 pregnant women who had antenatal care in 3 hospitals of Hefei from March 2015 to December 2017 were recruited during 21-24 weeks. Baseline questionnaires were performed and serum 25-hydroxyvitamin D [25(OH) D] and PTH levels were measured in fasting venous blood. Glucose tolerance tests were performed during 24 to 28 weeks. Multivariate linear regression model and multivariate logistic regression model were applied to analyze the differences of glucose metabolism index and GDM risk among pregnant women at different statusesof25(OH)DandPTH.Results Theaveragelevelof25(OH)Dinthesecondtrimesterwas(39.8±16.6) nmol/L, with the median PTH 10.7 (6.9, 16.7) ng/L and the detection rate of GDM 20.4％. Covariance analysis showed no statistically significant association of vitamin D and PTH levels with glucose metabolism indexes. Pregnant women with high PTH and vitamin D deficiency had higher 1h postprandial plasma glucose ( 1hPG) , the area under the glucose curve ( AUCglu ) levels, and GDM risk compared with pregnant women with middle/lower PTH and vitamin D deficiency ( control group, all P<0.05) , and higher PTH accompanied with vitamin D non-deficiency ( Group 2, all P<0.05) . However, significant changes in glucose metabolism indicators and GDM risk were not observed in low-level PTH-pregnant women with vitamin D deficiency ( group 1) and group 2 pregnant women compared with control group. Conclusion There is an interaction between vitamin D/PTH levels and glucose metabolism during pregnancy. Vitamin D deficiency with elevated PTH level is associated with abnormal glucose metabolism.

Radiotherapy is one of the important cancer therapy methods that can lead to tissue damage including radiation lung injury,radiation esophageal injury,radiation skin damage and abnormal changes in hemopoietic system and immune system.Epigallocatechin-3-gallate (EGCG) is the most abundant catechin in green tea.It has been demonstrated that EGCG has biological effects of antiinflammatory,antioxidant,anti-apoptosis and regulating immunity.Recently some studies of cell and animal models suggest that EGCG has radioprotective effect,but few clinical research was reported.In this review,the studies about EGCG in preventing and treating radiation injury were summarized from antiradiation mechanism in order to enhance the understanding of the potential clinical application of EGCG.

Objective: To investigate the current bedtime routine among Chinese children less than 3 years of age and explore its dose-dependent association with sleep duration and sleep quality. Method: Healthy full-term born children aged 0-35 months were selected by stratified cluster random sampling method from 8 provinces in China following the "Hospital of Province-City-County" sampling technical route during 2012-2013.Brief Infant Sleep Questionnaire(BISQ) was used to assess sleep conditions of these children.Children′s personal and family information was obtained by Shanghai Children′s Medical Center Socio-demographic Questionnaire.Both of these questionnaires were filled in by parents. The effects of bedtime routine on children′s sleep duration and quality were analyzed by multivariate analysis of variance. Result: The children′s average age was(12±10) months(n=1 304), of whom 689 were males (52.8%, 689/1 304). There were 48.5%(632/1 304)of the parents reported that their children had not established regular sleep routines. There was a consistent dose-dependent association between bedtime routine and sleep duration, as well as other indicators for sleep quality (all P<0.05). The more regular the sleep routines, the longer the sleep duration, the earlier the children went to sleep, the shorter the sleep onset latency, the fewer the nighttime wakeup and the shorter the nighttime waking.The nighttime sleep duration was significantly longer for those with a bedtime routine 'every night’ than those who 'never’ had a bedtime routine (9.5(95%CI: 9.4-9.6)vs. 8.9(95%CI: 8.6-9.3)h, t=3.345, P=0.001). Compared with children who never had bedtime routines, children with regular bedtime routines had fewer night wakeup (1.3(95%CI: 1.2-1.4) vs. 2.4( 95%CI: 2.0-2.9), t=3.182, P=0.001) and shorter night waking duration(16.6(95%CI: 14.6-18.8) vs. 59.2 (95%CI: 47.0-72.7)min, t=6.383, P<0.01). Conclusion The percentage of children who have established regular bedtime routine is low in China. There is significant dose-dependent association between regular bedtime routine and sleep outcomes, especially sleep quality. The more regular the sleep routines, the better the sleep quality.

Objective: To analyze the effect of epigallocatechin-3-gallate (EGCG) in radiation induced esophagitis of model rabbit. Methods: Thirty male New Zealand rabbits were randomly divided into EGCG group, saline group, blank group. The rabbits in EGCG and saline groups were irradiated with 6 MV X-rays. The blank group did not receive radiation. After irradiation, rabbits were given with 440 μmol/L EGCG or saline three times a day in continuous 5 days. The scores of pathological changes of esophagus were observed by optical microscope.The serum levels of interleukine-1 beta (IL-1β), interleukine-6 (IL-6), transforming growth factor-β (TGF-β) and tumor necrosis factor-α (TNF-α) were detected by enzyme linked immunosorbent assay. The expression levels of 67KD laminin receptor (67LR) was detected by immunohistochemistry. Results: After treatment, the scores of pathological changes of esophagus in blank group, saline group, EGCG group were 0, 3.9±1.10 and 2.80±0.92, respectively. At different time points after drug treatment, the levels of serum inflammatory factors among three groups were significantly different (F=23.66-236.32, P<0.05). The expressions of 67LR in esophageal tissue of 3 groups were also significantly different (F=585.38, P<0.05). Conclusions EGCG reduced radiation-induced esophagitis in rabbits by decreasing the levels of serum inflammatory factors, which may be related to the expression of 67LR protein.

Objective: To explore the relationship between the vitamin D levels and lipid metabolism during second trimester. Methods: A total of 1 875 pregnant women who were in the second trimester and had antenatal care in 3 hospitals in Hefei of Anhui province from March 2015 to February 2018 were included. Baseline questionnaire survey was performed, and fasting venous blood samples were collected from the pregnant women to detect serum 25(OH)D, cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL-C) and low-density lipoprotein (LDL-C) levels. Cubic non-linear model and linear regression model were used to analyze the linear relationship between vitamin D levels and lipid metabolism indicators in the second trimester. Results: The vitamin D deficiency rate was 75.3% (1 412/1 875) in the pregnant women. The mean levels of lipid metabolism indicators TC, TG, HDL-C and LDL-C were (233.22±38.87), (226.24±83.88), (79.04±12.77), and (109.54±25.95) mg/dl respectively. Multivariate linear regression model results showed, compared with Q5 of the 25(OH)D, the TC and TG levels of Q1-Q4 groups significantly increased, and the LDL-C of Q1 and Q2 groups significantly increased. The highest difference between TC, TG and LDL-C was observed in Q1 group. (TC: β=16.88, 95%CI: 10.50-23.26; TG: β=34.92, 95%CI: 21.32-48.53; LDL-C: β=9.06, 95%CI: 4.77-13.35). No significant differences in HDL-C level among the 5 groups were observed. When stratified with vitamin D deficiency the results showed that, when 25(OH)D was <50 nmol/L, TC, TG and LDL-C levels decreased by 3.53 (95%CI: 1.30-5.75), 7.42 (95%CI: 2.41 to 12.44) and 2.08 mg/dl (95%CI: 0.60-3.57) along with a 10 nmol/L increase of 25(OH)D, the difference was statistically significant, and when 25(OH)D was ≥50 nmol/L, no significant correlation was found between 25(OH)D level and TC, TG and LDL-C levels. No significant relationship between 25(OH)D level and HDL-C level was observed regardless of vitamin D deficiency. Conclusions There was a nonlinear relationship between vitamin D levels and lipid metabolism indicators in the second trimester. There was a significant negative correlation between 25(OH)D level and lipid metabolism indicators only in the deficiency of vitamin D.

【Objective】 To conduct a retrospective study of the population characteristics, efficacy and influencing factors of rheumatoid arthritis (RA) patients who received iguratimod (IGU) treatment for at least 6 months from July 2015 to October 2020 and had more than 3 follow-up records. 【Methods】 In this study, 105 patients with RA were enrolled, and all the patients received IGU treatment for at least 6 months and were followed up three times. We observed their clinical manifestations before and after treatment, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), disease activity index (DAS28), rheumatoid factor (RF), anticyclic citrullinated peptide (ACPA), immunoglobulins (IgG, IgA, and IgM), lymphocyte subsets, and observed and recorded adverse reactions. 【Results】 The course of disease and the positive rate of ACPA were significantly lower in IGU group than in the group of IGU combined with (MTX) treatment (P<0.05). The DAS28-ESR of the patients in IGU group was significantly lower than that in the IGU+MTX treatment group and IGU+leflunomide (LEF) treatment group (P<0.05). After 6 months of continuous treatment, visual analogue scale/score (VAS), CRP and DAS28 (ESR/CRP) in IGU group were significantly reduced. As the treatment time was extended to one year, the above indicators further improved, and the number of joint swelling (SW) and the number of joint tenderness (TEN) also significantly improved. After one year’s continuous treatment, the incidence of adverse reactions in IGU group was 32.3%(10/31). 【Conclusion】 For RA patients with early onset, short-course, and antibody-negative, IGU is an effective therapeutic drug and a treatment option for RA patients with interstitial lung disease. IGU is well tolerated and is also an effective and a safe combination therapy option.