From January 1977 to December 1988, 279 cases of esophageal carcinoma were proved to be stage Ⅰ andⅡ A after operation. Within 5 years of the operation, 103 cases have failed. The failure was closely related to TNM stages. The regional and esophageal bed failure were obviously related to the site of the original lesion. Twelve of these 279 patients recieved postoperative radiotherapy. The incidence of intra-portal recurrence was lower in those who received postoperative radiotherapy than those who did not, although hematogenous metastasis was similar in these two groups. The 5-year survival rate with no evidence of cancer was higher in patients who received postoperative irradiation.

Objective To detect the serum expression level of Pokemon and explore its clinical value combines with AFP,AFP-L3 or DCP in hepatocellular carcinoma (HCC).Methods In this study,the serum levels of Pokemon,AFP,AFP-L3 and DCP in 30 patients with HCC,34 patients with benign liver diseases and 30 healthy controls were examined by enzyme-linked immunosorbent assay.Then,the clinical significance of Pokemon expression level was analyzed.In the end,the diagnostic evaluation of four serum biomarker alone detection was used to analyze the sensitivity,specificity,the area under the curve and Youden index in the diagnosis of HCC.Results The serum expression level of Pokemon in patients with HCC was (22.63 ± 6.82) ng/ml,which was significantly higher than that in the group with benign liver diseases and healthy controls [(3.54±1.26)ng/ml,t =8.594,P＜0.001;(1.95 ±0.57)ng/ml,t =10.021,P＜0.001].The expression level of Pokemon in HCC patients was correlated to tumor size (t =2.678,P =0.021) and TNM stag (t =2.578,P =0.034).The serum expression levels of AFP,AFP-L3 and DCP in patients with HCC were (774.56 ± 96.52) ng/ml,(26.37 ± 2.54) ng/ml and (93.49 ± 30.45) mAU/ml,which were significantly higher than those in the group with benign liver diseases [(22.21 ± 3.57) ng/ml,(7.05 ± 2.71) ng/ml,(34.68 ± 10.13) mAU/ml] and healthy controls [(14.65 ± 4.45) ng/ml,(3.84 ± 1.09) ng/ml,(25.87 ± 9.01)mAU/ml,F=58.46,P=0.000;F=12.47,P=0.000;F=23.41,P=0.000].The sensitivity and specificity of Pokemon,AFP,AFP-L3,DCP in the diagnosis of HCC were 84.6％ and 87.5％,52.5％ and 78.9％,95.0％ and 80.0％,77.1％ and 87.5％,respectively.Conclusion The enhanced Pokemon serum level,with its sensitivity and specificity higher than AFP,points out Pokemon may be a potentially useful biomarker to diagnose HCC.

Heterotopic ossification is a common complication after acetabular fractures and fractures of the elbow.Heterotopic ossification often leads to severe joint movement disorder,which brings great pain to the patient.This paper reviewed the clinical research,including pathogenesis,clinical diagnosis,prevention,treatment and future directions of heterotopic ossification to investigate the effective method in prevention and treatment of heterotopic ossification.

Objective To investigate the mechanism of Deinococcus radiodurans pprI gene in enhancing mice radioresistance to γ-rays by transfecting it in vivo.Methods The male Kunming mice were randomly divided into control group,irradiated group,pCMV-HA transfected group and pCMV-HA-pprI transfected group.The pCMV-HA-pprI plasmid contained pprI gene was injected into the muscle of mice which were exposed to total 6 Gy of γ-ray irradiation.After injection,the in vivo gene electroporation technology was used to transfect the pprI gene into the cells,and Western blot was used to identify the PprI protein,mammalian homolog protein Rad51 corresponding to recA gene downstream of pprI,and protein Rad52.Results In the muscle of the mice of transfected pCMV-HA-pprI group,the protein PprI expressed significantly at 1 d post-irradiation,but there was no expression of pprI gene 7 d post-irradiation and in other groups.In the mice of transfected with pCMV-HA-pprI,the expression of Rad51 protein was significantly increased in the lungs at 1,7 and 14 d post-irradiation,and significantly increased in the liver at 1 and 28 d post-irradiation and increased in the kidneys at 1 and 14 d post-irradition.However,there was no obvious change of Rad52 protein expression in the lungs and livers of mice in all groups.Conlusions The prokaryotic gene pprI could act on the mammalian homologisation analogues rad51 gene downstream of recA gene and then increase the expression level of protein Rad51 which results in the enhancement of radioresistance.

Objective To study the dosimetry characteristics of VMAT plan in the esophageal carcinoma radiotherapy.Methods Application of 0.6 cm3 ionization chamber and COMPASS threedimensional dose verification system,20 cases of upper and middle chest esophageal carcinoma on the VMAT plans for absolute dose and relative dose verification.Dose volume histogram (DVH) comparison treatment target,lungs,heart,and differences in the spinal cord irradiation dose and volume,and analyses γpass rate of GTV,CTV,PTV and organs at risks.Results The center dose of upper and middle chest esophageal carcinoma accurate rates were above 99％.Thoracic segment esophageal:GTV,PTV and organs at risks of γ pass rate above 97％.D95％ and Dmean of GTV,CTV and PTV were relatively undervalued within 3％.D1％ of spinal cord is 2.21％ overvalued.Left and right pulmonary V5 were slightly overvalued by about 0.5％,V10-D30,Dmean undervalued within 2％.In period of middle chest esophageal carcinoma:the gamma passed rate of GTV,CTV,PTV and organs at risks of above 97％,GTV,CTV,PTV D95％,Dmean were relatively undervalued within 2％.Spinal cord D1％ is 2.04％ overvalued.Left and right pulmonary V5-D30 to V10 as a trend of gradually to be underestimated,at 1.5％.Heart Dmean was undervalued by 2.68％.Conclusion VMAT technology is applicable in the chest esophageal carcinoma radiotherapy.

[Objective]To analyze the prognostic factors of resectable acral melanoma patients ,then develop a novel prognostic model and examined its prognostic value.[Methods]The study retrospectively analyzed clinicopathological characteristics and inflam?matory markers of 232 acral melanoma patients who underwent radical surgical resection between 2000 and 2011 at the Sun Yat-sen University Cancer Center. Kaplan-Meier curves were plotted to estimate overall survival. Significantly predictive factors were identified by multivariate Cox regression analyses and a prognostic model based on these variables was constructed to predict survival.[Results]Cox regression analysis revealed that age,lactic dehydrogenase(LDH),stage,globulin(GLB)and C-reactive protein (CRP)were independently related to survival. After computing these scores ,patients were classified into three risk groups. The new prognostic model identified three categories of patients with different prognoses(P<0.001)and significantly stratify patient prognosis in different tumor stages. The 5-year survival rate was 42.9%,25.7%,and 3.7%in groups 1,2,and 3,respectively. The AUC of new prognostic model is 0.664(95%CI:0.599-0.724).[Conclusion]Age,LDH,stage,GLB and CRP were independently related to survival in our study population,and the prognostic model is useful to stratify patients into different risk groups and it is a useful complement to AJCC staging for Asian patients with acral melanoma.

Objective To develop and validate the Knowledge-Attitude-Practice Scale for Prevention of Occupational Low Back Pain for Nurses (hereinafter referred to as KAP). Methods Based on the knowledge, attitudes and practice theory, a list of 48 potential items were developed by reviewing literatures related to the prevention of occupational low back pain in nurses. The Delphi expert consultation method was used to conduct two rounds of consultation on the items, and the KAP (draft) with 31 items was formed. A total of 269 nurses in a hospital in Guangdong Province were selected as study subjects by convenience sampling method and investigated with the KAP (draft). The list was selected and its validity tested using SPSS 25.0 software. Results The authority degrees of two rounds of expert consultation were 0.919 and 0.922. All of the recovery rates of valid questionnaires were >80.0%, with the coefficients of variation ranged from 0.07 to 0.40 and 0.05 to 0.28. The Kendall's concordance coefficients were 0.198 and 0.274, respectively (all P<0.05). After item selection, five items were removed, resulting in the KAP with 28-item including three dimensions： knowledge, attitude and behavior. The scale-level content validity index/average was 0.976, and the item-level content validity index ranged from 0.833 to 1.000, as assessed by experts. The scale demonstrated 100.0% for convergent and discriminative validity of the three dimensions. The exploratory factor analysis revealed three factors with a cumulative variance contribution rate of 51.0%. Cronbach's alpha coefficients for the overall scale and knowledge, attitude, and behavior dimensions were 0.880, 0.878, 0.895, and 0.877, respectively. Split-half reliability coefficients were 0.922, 0.863, 0.852, and 0.820, respectively. Conclusion The KAP shows good reliability and validity and can be used to assess knowledge, attitude and practice levels related to occupational low back pain prevention among nurses.

OBJECTIVETo observe the curative and adverse side effects of erlotinib in elderly patients with advanced non-small cell lung cancer (NSCLC).

METHODSSeven-two elderly patients with pathologically confirmed NSCLC in advanced stage (III or IV) received treatment with oral erlotinib at the daily dose of 150 mg, and the treatment was discontinued until intolerance of the side effects or the occurrence of disease progression. The clinical effect and adverse side effects of erlotinib were further observed, and the association between clinical characteristics and the response to erlotinib was also analyzed.

RESULTSAmong the 72 patients, 1 patient achieved complete remission, 8 patients had partial remission, 10 had stable disease, and 7 had progressive disease, with a disease control rate of 72.22%. After a median follow-up time of 17 months (4 to 32 months), the median survival time was 14.5 months (6.5-28.3 months), and the median time to progression was 10.6 months (5-16.5 months). Erlotinib resulted in a significantly higher rate of favorable response in female, non-smoking patients with adenocarcinoma than in male, smoking patients with squamous carcinoma (P<0.05). The occurrence of skin rash was not associated with the response to erlotinib in these patients (P>0.05). The most common drug-related adverse events included skin rash, diarrhea, hepatic dysfunction (GPT elevation), nausea and vomiting, but mostly mild and well tolerable.

CONCLUSIONErlotinib is safe and effective in the treatment of elderly patients with advanced NSCLC.

Adenocarcinoma ; drug therapy ; Aged ; Antineoplastic Agents ; adverse effects ; therapeutic use ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; pathology ; Carcinoma, Squamous Cell ; drug therapy ; Disease-Free Survival ; Erlotinib Hydrochloride ; Female ; Humans ; Lung Neoplasms ; drug therapy ; pathology ; Male ; Neoplasm Staging ; Quinazolines ; adverse effects ; therapeutic use

Objective To explore the effect of Wntless ( Wls)-mediated Wnt signaling on the development and energy metabolism of brown adipose tissue (BAT). Methods BAT-specific Wls knockout (WlsMyf5Δ/Δ) mice were generated by Cre-loxP system. The differentiations of BAT in WlsMyf5Δ/Δ knockout mice and Wlsfl/fl control mice were analyzed by histological morphology, immunohistochemistry, real-time PCR, and Western blot. After stromal vascular fraction (SVF) cells in BAT were induced to differentiate, oil red O staining, real-time PCR, and cell respiration experiments were performed for analyzing in-vitro cell differentiation and oxygen consumption. The energy metabolism of mice was monitored by rectal temperature, oxygen consumption rate in BAT, and energy expenditure. The adiposity of mice was evaluated by NMR while the glucose metabolism was analyzed by the glucose and insulin tolerance tests. Results The WlsMyf5Δ/Δ knockout mice appeared smaller body size, lower weight, higher percentage of lean fat, lower size of BAT, with higher body temperature on the back as compared to Wlsfl/fl control mice. The differentiation and thermogenesis of BAT in Wls-deficient mice were relatively augmented, along with an increase in Ucp1 mRNA and protein expressions. SVF cells from BAT in WlsMyf5Δ/Δ knockout mice revealed enhanced brown differentiation. Adiposity was decreased and glucose metabolic capacity was enhanced in the WlsMyf5Δ/Δknockout mice, without significant change in the whole body. Conclusion Wls-mediated Wnt signaling decreases the thermogenesis and glucose metabolism of BAT by suppressing its differentiation.

Objective To explore the protective effect in a model of nicotinamide riboside(NR)against carbonyl cyanide m-chlorophenylhydrazone(CCCP)-induced oxidative stress in R28 cells.Methods 4 μmol/L CCCP was used to induce oxidative stress in R28 cells,and 400 nmol/L NR was used to intervene.The cell viability was quantified by CCK-8 assay.The apoptosis was detected by Annexin-V/PI double staining and flow cytometry.Western blotting was used to examine the levels of Cytochrome C,Caspase-3,and Caspase-9 to evaluate the apoptosis.Tetramethylrhodamine ethyl ester was used to detect the mitochondrial membrane potential(MMP),MitoSOX was used to detect the mitochondrial reactive oxygen species(mtROS)levels,and adenosine triphosphate(ATP)assay kit was used to assess ATP generation ability to evaluate mitochondrial function.Results After CCCP treatment of R28 cells,the cell viability decreased,the apoptotic protein levels and apoptosis rates increased,the MMP decreased,and the mtROS generation increased(P＜0.05).After NR pretreatment,the cell viability increased,the apoptotic protein levels and apoptosis rates decreased,the MMP increased,and the mtROS generation decreased(P＜0.05).Conclusion:NR enhances the cell viability,reduces the expression of apoptotic proteins,and ultimately reduces the apoptosis of retinal ganglion cell by inhibiting oxidative stress response and protecting mitochondrial function.