Objective:To compare the therapeutic effects by different longitude margins of the gross tumor volume (GTV) based on elec-tive nodal irradiation (ENI) and to investigate the optimization of clinical tumor volume (CTV) in the radical chemoradiotherapy of esophageal squamous cell carcinoma (ESCC). Methods:ESCC patients treated with chemoradiotherapy for the first time in the First Af-filiated Hospital of Xiamen University from May 2009 to November 2012 were retrospectively studied. All patients were treated with ENI for radical radiotherapy, and the patients were divided into two groups:CTV1 group (with longitudinal external expansion length of less than 3 cm) and CTV2 group (with longitudinal external expansion length of more than 3 cm). The survival time and occurrence of side effects in patients were compared. Results:Among the 142 cases of patients, 82 and 61 cases were classified under CTV1 and CTV2, respectively. No significant difference in the overall survival (OS) and local recurrence-free survival (LRFS) rates was observed af-ter 1, 3, and 5 years of treatment between the two groups. The occurrence of side effects, such as bone marrow suppression, radiation pneumonitis, radiation esophagitis, and esophageal fistula, was less than 5%in both groups, and the data show that the side effect oc-currence in CTV1 was significantly lower. Conclusion:In the radical chemoradiotherapy of esophageal cancer using ENI, the OS rate of patients with a delineated CTV according to a 3 cm GTV longitudinal external expansion length is not lower than that of patients with a delineated CTV according to a GTV longitudinal external expansion length of more than 3 cm. The results provide a reference for the optimization of CTV in the radical chemoradiotherapy of ESCC.

Objective The ammonia level in air and heavy metals in drinking water were explored in a cynomolgus monkey feedlot. Methods Air ammonia from different communities and feeding patterns of cynomolgus monkeys were collected at three time-points per day and determined by Nessler's reagent spectrophotometry. Inductively coupled plasma mass spectrometry was applied to detect the level of heavy metals in drinking water from 5 different sampling sites in the feedlot,incluing the outlet of underground water,the water tank,both monkey cages equipped with PVC or iron pipes and sewage lagoon,respectively. Results Air ammonia levels in quarantine inspection flock cages(0.59 ± 0.03 mg/m3)were significantly higher than in the cages of both reproductive flock(0.34 ± 0.03 mg/m3)and sale flock(0.27 ± 0.04 mg/m3). The ammonia level in air in different feeding patterns ranks as following:cage rearing of quarantine inspection flock(0.59 ± 0.03 mg/m3)>cage rearing of reproductive flock(0.48 ± 0.02 mg/m3)>captive bleeding of sale flock(0.30 ± 0.02 mg/m3)>cage rearing of sale flock(0.25 ± 0.01 mg/m3)> captive bleeding of reproductive flock(0.22 ± 0.02 mg/m3). The air ammonia concentrations of both former flocks were statistically higher than the latter three flocks. The highest air ammonia level among different flocks and feeding patterns occurred in the morning, before waste discharge clean-up. The iron concentration in drinking water in the cages equipped with iron pipes was higher than Chinese drinking water standard. Conclusions The air ammonia level was lower than the Chinese air quality standard. The iron concentration in drinking water in the cages equipped with iron pipes was higher than the Chinese drinking water standard.

Objective: To compare the predictive value of PSS, APACHEII, SAPSII and SOFA in the prognosis evaluation of acute poisoning. Methods: Clinical data (including PSS score, APACHEII score, SAPSII score and SOFA score, within 24 hours after admission) of 231 acute poisoning patients admitted to the emergency intensive care unit EICU of our hospital from January 2015 to October 2016 was retrospectively analyzed. The patients were divided into the survival group and the dead group according to the 28-day clinical outcomes, comparing the differences of clinical data in each group. To analyze the correlation between PSS score, APACHEII score, SAPSII score and SOFA score in each group, comparing the value and the area under the ROC curve of four scoring systems and evaluate the predictive value of the four scoring systems. Results: Comparing with the survival group and the dead group, PSS score, APACHEII score, SAPSII score and SOFA score were significantly different (P<0.01) . PSS score, APACHEII score, SAPSII score and SOFA score were significantly positive correlation (P<0.01) , the area under the ROC curve (AUC) of the four scoring systems were 0.833, 0.887, 0.843 and 0.843 respectively. The area under the ROC curve (AUC) of APACHEII score was higher than PSS score, SAPSII score and SOFA score, the difference was statistically significant (z=2.351, 2.317, 2.217; P=0.019, 0.021, 0.027) , there was no significant difference in the area (AUC) between the three scoring curves (P>0.05) . The cutoff value (cut-off) , sensitivity, specificity and accuracy rates of PSS score, APACHEII score, SAPSII score and SOFA score were (2.5, 93.1%, 50.9%, 61.5%) , (14.5, 82.8%, 75.7%, 77.48%) , (31.5, 77.6%, 76.90%, 77.08%) , (5.5, 77.60%, 74.60%, 75.35%) . Conclusion PSS score, APACHEII score, SAPSII score and SOFA score can evaluate the prognosis of patients with acute poisoning, but the APACHEII score is better than the other three scoring systems in evaluating the prognosis for its evaluation ability and accuracy rate.

Objective: To explore the expression of epidermal growth factor receptor(EGFR) protein during benzo(a)pyrene (BaP) induced carcinogenesis. Methods: This study, we firstly utilized immunofluorescence assay and Western-blot to examine EGFR expression of the BaP which was constructed previously by project team induced malignant transformation human bronchial epithelial cell (BTC) and the control (16HBE cell). Then, we selected 36 healthy SD rats, divided into two groups according to simple random method, 18 rats each group. The constructed rat lung neoplasm model induced by pulmonary injection of BaP (10 mg/ml of BaP solution in 0.2 ml corn oil), contrast group use 0.2 ml corn oil, lung tissue was collected and the EGFR expression of lung tissue was detected by immunofluorescence assay and Western blot. T analysis was used to test the different of EGFR between two groups. Results: Immunofluorescence analysis showed that the EGFR expression in BTC was significantly higher than 16HBE cell. Meanwhile, Western blot also was used to confirmed this result, the relative expression of EGFR protein in the rats of the model group the control group were 1.04±0.13 and 2.32±0.12, respectively, and the difference was statistically significance (t=12.39, P<0.001). In vivo, well-defined tumor was found in the rat with pulmonary injection of BaP, and the lung showed diffuse alveolar septal thickening, alveolar wall destruction and pulmonary alveoli fusion, which suggested that the rat lung neoplasm model was constructive successfully. Furthermore, we found the EGFR expression of lung was increased dramatically in the rat lung neoplasm model by immunofluorescence detection and Western blot. The relative expression of EGFR protein in the rats of the model group the control group were 0.21±0.03 and 1.30±0.07, respectively, and the difference was statistically significance (t=12.84, P<0.001). Conclusion Expression of EGFR protein was increased during BaP carcinogenesis, and EGFR may play an important role in the carcinogenesis of BaP.

OBJECTIVETo investigate the effect of poly-ADP-ribosylation in hexavalent chromium Cr(VI) induced cell damage.

METHODSThe study object, poly (ADP-ribose) glycohydrolase (PARG) deficient human bronchial epithelial cells (16HBE cells), was constructed previously by our research group. Normal 16HBE cells and PARG-deficient cells were treated with different doses of Cr (VI) for 24 h to compare the differences to Cr (VI) toxicity, meanwhile set up the solvent control group. On this basis, 5.0 µmol/L of Cr (VI) was selected as the exposure dose, after the exposure treatment, total proteins of both cells were extracted for two dimension fluorescence difference gel electrophoresis (2D-DIGE) separation, statistically significant differential protein spots were screened and identified by matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS/MS), and further validated by Western blot.

RESULTSAfter Cr (VI) treatment, the survival rate of PARG-deficient cells was higher than normal 16HBE cells. When the doses reached up to 5.0 µmol/L, the survival rate of 16HBE cells and PARG-deficient cells were respectively (59.67 ± 6.43)% and (82.00 ± 6.25)%, the difference between which was significant (t = -4.32, P < 0.05). 18 protein spots were selected and successfully identified after 2D-DIGE comparison of differential proteins between normal 16HBE cells and PARG-deficient cells before and after exposure. The function of those proteins was involved in the maintenance of cell shape, energy metabolism, DNA damage repair and regulation of gene expression. The differential expression of cofilin-1 was successfully validated by Western blot. The expression level of cofilin-1 in the 16HBE cells increased after Cr (VI) exposure with the relative expression quantity of 1.41 ± 0.04 in treated group and 1.00 ± 0.01 in control group, the difference of which was statistically significant (t = -18.00, P < 0.05), while the expression level in PARG-deficient cells had no statistically significant difference (t = -8.61, P > 0.05).

CONCLUSIONMost of the identified differential proteins are closely related to tumorigenesis, suggesting that poly-ADP-ribosylation reaction may resist the cytotoxicity of Cr(VI) by inhibiting Cr (VI) induced tumorigenesis, which provides important reference data to clarify the mechanisms of poly-ADP-ribosylation in Cr (VI) induced cell damage.

Bronchi ; Cell Transformation, Neoplastic ; genetics ; Chromium ; Cofilin 1 ; DNA Repair ; Epithelial Cells ; Glycoside Hydrolases ; deficiency ; physiology ; Humans ; Tandem Mass Spectrometry

Objective To investigate the protective effect of Baicalin on inflammation induced by lipopolysaccharide in H9C2 cardiomyocytes and its possible mechanism. Methods H9C2 myocardial cells were cultured and pretreated with baicalin at the final concentration of 10, 20, 30 μmol/L for 12 hours, then stimulated with LPS at the final concentration of 1 μg/mL for 6 hours. The control group was treated with the same amount of saline to collect cell samples. CCK-8 (The Cell Counting Kit-8) was used to detect cell activity, enzyme-linked immunosorbent assay (ELISA) was used to detect the expression levels of interleukin-6 (IL-6), interleukin-1beta (IL-1β), tumor necrosis factor-alpha (TNF-α), Western blot was used to detect the protein expression levels of NF-κB p65, p-NF-κB p65, p38 MAPK, p-p38 MAPK, IκBα and p-IκBα. SPSS 23.0 statistical software was used. Independent sample t test was used for comparison between two groups, and one-way ANOVA test was used for comparison among multiple groups. Results The survival rate of myocardial cells in the control group was (93.67 +1.453)％. Compared with the control group, the survival rate of H9C2 myocardial cells induced by LPS decreased (P< 0.05). In the control group, the expression of IL-6 in H9C2 myocardial cells was (49.33 +2.42) pg/mL, the expression of TNF-α was (86.33 +1.85) pg/mL, and the expression of IL-1β was (28.67 +4.66) pg/mL. Compared with the control group, the expression levels of IL-6, IL-1β and TNF-α in H9C2 myocardial cells increased after LPS induction (P< 0.05), while the levels of p-NF-κ B p65, p-p38 MAPK and p-I κ B α protein increased (P< 0.05), while the levels of I κ B α protein decreased (P< 0.05), while the expressions of NF-κ B p65 and p38 MAPK protein did not change significantly (P> 0.05). Compared with LPS group, the survival rate of H9C2 myocardial cells in baicalin intervention group increased (P<0.05), the expression levels of IL-6, IL-1β and TNF-a decreased (P < 0.05), the levels of p-NF-κB p65, p-p38 MAPK, p-I κBα protein decreased (P< 0.05), and the level of IκBα protein increased (P< 0.05), while the expression of NF-κB p65 and p38 MAPK did not change significantly. (P>0.05). Conclusions Baicalin may alleviate LPS-induced cardiomyocyte inflammation by inhibiting the activation of NF-kappa B and p38 MAPK, and improve cell survival.

Objective This study aimed to describe the sex disparities on cancer incidence and mortality in Jiashan population.Methods All data concerning incident and death cases of cancers were gathered from the database of Cancer Registry in Jiashan county.Data from the 2010 China census was used as the standard population.Sex-specific age-standardized incidence rates (ASIRs),mortality rates (ASMRs) per 100 000 persons for all cancers and types of each cancer were calculated for the years of 1990 to 1999,2000 to 2009,2010 to 2014,and 1990 to 2014.In addition,the corresponding male-to-female incidence rate ratios (IRRs) and mortality rate ratios (MRRs) were also calculated.Results The ASIR of all cancers was 226.13/105 for the whole period of 1990 to 2014,with 266.04/105 for males and 187.22/105 for females,respectivcly.The corresponding IRR was 1.42 (95％CI:1.39-1.46),with significant difference noticed in the incidence rates between males and females (P＜0.05).The ASMR of all cancers was 155.39/105,with 206.55/105 for males and 104.98/105 for females,respectively.The corresponding MRR was 1.97 (95％ CI:1.91-2.03),with significant difference between males and females (P＜0.05).Among all the cancer types,only gallbladder cancer and thyroid cancer showed female predominance in both incidence and mortality,with male predominance in all the remaining cancers.Conclusion Finding from our study suggested that a male predominance in both incidence and mortality for a majority of cancers in Jiashan population.

Objective:To construct an intervention program of sports and medical integration for patients with acute myocardial infarction (AMI) in phase Ⅱ cardiac rehabilitation, so as to provide reference for the effective implementation of physical activity behavior change in AMI patients during phase Ⅱ cardiac rehabilitation.Methods:Before the research, we browsed relevant literature and guidelines published from July 2016 to June 2021, made a retrospective study on the influencing factors of cardiac rehabilitation behavior for AMI patients, and carried out a qualitative interview on cognitive and compliance motivations for AMI patients. Furthermore based on trans-theoretical model, the first draft of the intervention program was developed and and the expert consultation questionnaire was formed. From February to April 2022, Delphi method was used in 16 experts from 10 hospitals and 1 nursing college in 4 provinces. After 2 rounds of expert consultations on the importance and operability of items, the intervention program was finally determined.Results:The effective recovery rates of the 2 rounds of expert consultations questionnaires were both 16/16. The authority coefficient of expert consultation was 0.90, the judgment basis coefficient was 0.96, and the familiarity degree was 0.84. After the second round of expert consultation, the coefficient of variation of the importance of each item was (0.0-13.4)%, and the coefficient of variation of operability was (0.0-18.1)%. The final intervention program of sports and medical integration for patients with AMI in phase Ⅱ cardiac rehabilitation had 37 items, containing precontemplation stage (8 items), contemplation stage (7 items), preparation stage (5 items), action stage (9 items) and maintenance stage (8 items).Conclusions:The construction process of the intervention program of sports and medical integration for patients with AMI in phase Ⅱ cardiac rehabilitation is scientific and feasible. The content is focused on the patient-centred conception and the whole-process management for the exercise rehabilitation of AMI patients in phase Ⅱ cardiac rehabilitation. This intervention program may improve the safety, feasibility, participation and compliance in phase Ⅱ cardiac rehabilitation in patients with AMI. So it is recommended to be popularized and used in phase Ⅱ cardiac rehabilitation.

Colorectal cancer is caused by the interaction of genetic and environment factors. Domestic and foreign scholars have attempted to develop several colorectal cancer risk prediction models, in order to identity risk factors, to screen for high risk population and evaluate the risk of developing colorectal cancer, so as to provide personalized screening protocols for individuals with different risk, and eventually reduce the incidence and mortality rate of colorectal cancer. Currently, the common colorectal cancer risk prediction models were mainly developed based on case-control study and cohort study. Models developed in European and American regions and Asia (excluding China) only include common risk factors, while Chinese models also include hereditary factors on the bases of common risk factors. However, the development and verification of each model are mainly based on local population, whether it can be applied for other population need to be determined. This article reviews the development, validation and evaluation of the risk prediction models, in order to provide a basis for developing more precise risk prediction models for colorectal cancer.
Asian Continental Ancestry Group ; Case-Control Studies ; Cohort Studies ; Colorectal Neoplasms ; Humans ; Incidence ; Risk Assessment ; Risk Factors

Objective: To investigate the assessment and treatment strategy of patients with renal cell carcinoma. Methods: The clinical data of 43 patients with renal cell carcinoma and bone metastases admitted to the First Affiliated Hospital of Nanjing Medical University from January 2006 to December 2018 were retrospectively analyzed. The follow-up time was 6 years, with an average age of 55.4 years (21-87 years). There were 29 males, 14 females, 22 cases of limb bone metastasis, 12 cases of spinal metastasis, 9 cases of multiple bone metastasis, 21 cases of Fuhrman grade 1 and 2, 19 cases of T₁, and 20 cases of N₀. All patients were confirmed by postoperative pathological examination or imaging data suggesting that bone metastasis are from renal cell carcinoma. Forty-three patients underwent primary renal surgery, and molecular targeted therapy was used after the operation. The treatment process was smooth, no obvious discomfort, and postoperative pathology showed clear cell carcinoma.22 patients with limb bones metastasis and 12 patients with spinal metastasis included in the study all met the indications for secondary surgery after the disease assessment. After communicating with the patient, 13 patients with limbs metastasis and 6 patients with spinal metastasis received local treatment, including complete resection of the extremities and spinal fixation, the remaining 15 patients and 9 patients with multiple bone metastasis were treated conservatively. There were 19 patients in the local treatment group, 13 patients with limbs bone metastasis, 6 patients with spinal bone metastasis, the average age was 54.9 years, the average diameter of the primary tumor was 4.7 cm. There were 24 patients in the conservative treatment group, 9 patients with limbs metastasis, 6 patients with spinal metastases and 9 cases with multiple bone metastasis, with an average age of 56 years and a primary tumor diameter of 5.6 cm. Limb metastatic lesions were evaluated according to the patient's general condition, bone pain, fracture risk, and bone metastasis. Spinal lesions were evaluated according to Tokuhashi score, Harrington score, Tomita score, vertebral stability assessment, and molecular targeted therapy. Aminokinase inhibitors, conservative treatment with local radiotherapy and bisphosphonate treatment. Results: During the follow-up period, the 1-year overall survival rate of the local treatment group was 100.0%, the 2-year overall survival rate was 89.4%, and the 5-year overall survival rate was 73.7%. The 1-year overall survival rate of the conservative treatment group was 87.5%, and the 2-year overall survival rate was 62.5%. The 5-year overall survival rate was 16.7%. The 2-year and 5-year survival rates of the local treatment group were statistically different (P=0.044, P=0.000) compared with the conservative treatment group. For patients with limb bone metastasis, the 5-year survival rate was significantly higher in patients receiving topical treatment than in the conservative treatment group (P=0.011). For spinal metastasis, spinal pain in the local treatment group was alleviated to varying degrees. No spinal instability and spasticity were observed after follow-up. In the spine patients who received conservative treatment, 3 patients developed paraplegia, which was statistically different from local treatment (P=0.046). Another 9 patients with multiple bone metastases did not undergo local surgery, and all died after multiple organ failure. Conclusions At the same time of molecular targeted therapy, according to the evaluation results, selective treatment of bone metastases with secondary surgical indications, including complete resection of the extremities and spinal fixation, can significantly improve the survival and quality of life of those patients.