Objective:To evaluate a nano-carbon lymphatic tracing method for patients with rectal cancer after neoadjuvant radiotherapy and chemotherapy .Method:Retrospective analysis was made on 88 patients of rectal cancer undergoing neoadjuvant chemoradiation at the Department of General Surgery, He′nan Cancer Hospital from Jan 2016 to May 2020.According to whether nano-carbon lymph node was used or not, patients were divided into nanocarbon tracer group (study group) and non-nanocarbon tracer group (control group).Results:There was statistically significant in the number of havested lymph nodes between the two groups [15(11-19) vs.9(5-12), Z=5.227, P<0.001], There was no statistically significant in the number of positive lymph nodes between the two groups [0(0-0.25) vs.0(0-1), Z=1.199, P=0.231]. There were significant differences in the ratio of patients with less than 7 lymph nodes(0/34 vs.18/54, χ 2=14.248, P<0.001) and patients with less than 10 lymph nodes (4/34 vs.29/54, χ 2=15.657, P<0.001). Conclusions:The injection of nanocarbon after neoadjuvant chemoradiotherapy can increase the number of harvested postoperative lymph nodes and the ratio of patients with lymph nodes ≥7 and ≥10, which is more beneficial for prediction of the prognosis of patients.

Objective:To investigate whether adjuvant chemotherapy could be beneficial for patients with pT1N1M0 (stage ⅠB) gastric cancer.Methods:From Jan 2010 to Dec 2016, 185 patients with pT1N1M0 gastric cancer who were surgically resected at Henan Cancer Hospital were retrospectively analyzed. The patients were divided into chemotherapy group ( n=100) and non chemotherapy group ( n=85). Results:For disease-free survival (DFS) analysis, univariate survival analysis showed that age, examined lymph nodes, vascular invasion, nerve invasion and adjuvant chemotherapy were associated with DFS (all P<0.05); multivariate analysis showed that lymph node resection ≥ 16 ( HR=0.363, 95% CI: 0.160-0.827, P=0.016), vascular invasion ( HR=4.117, 95% CI: 1.796-9.436, P=0.001) and postoperative chemotherapy ( HR=4.530, 95% CI: 1.932-10.622, P=0.001) were independent risk factors for DFS. For disease-specific survival (DSS) analysis, univariate survival analysis showed that lymph node resection, vascular invasion, nerve invasion and adjuvant chemotherapy were associated with DSS; multivariate analysis showed that lymph node resection ≥ 16 ( HR=0.344, 95% CI: 0.144-0.822, P=0.016), vascular invasion ( HR=5.113, 95% CI: 2.029-12.887, P=0.001) and postoperative chemotherapy ( HR=4.694, 95% CI: 1.854-11.888, P=0.001)were independent risk factors for DSS. According to examined lymph nodes and vascular invasion , pT1N1M0 patients were divided into three risk categories (high, medium and low). DFS and DSS were significantly different among the three risk groups (all P<0.001, respectively). Conclusion:pT1N1M0 gastric cancer patients are expected to benefit from adjuvant chemotherapy. Patients with less than 16 lymph nodes and vascular invasion may be particularly suitable for adjuvant chemotherapy.

Objective:To investigate the application value of one-stitch prophylactic ileostomy in late ileostomy closure.Methods:The prospective randomized control study was conducted. The clinicopathological data of 141 patients with rectal cancer who underwent low anterior resection combined with prophylactic ileostomy in the Affiliated Tumor Hospital of Zhengzhou University from January 2016 to July 2020 were selected. There were 127 patients being selected after excluding 14 cases who did not undergo ileostomy closure. Patients undergoing one-stitch prophylactic ileostomy were divided into observation group, and patients undergoing traditional ileostomy were divided into control group. Observation indicators: (1) grouping situations of the enrolled patients; (2) surgical situations of ileostomy closure; (3) postoperative situations; (4) follow-up. Follow-up was conducted using outpatient examination and telephone interview once a month after low anterior resection combined with prophylactic ileostomy to detect complication and death of patients. The end point was at 3 months after ileostomy closure. The follow-up was up to July 2020. Measurement data with normal distribution were represented as Mean±SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M( P25, P75) or M (range), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test. Comparison of ordinal data between groups was conducted using the Mann-Whitney U test. Results:(1) Grouping situations of the enrolled patients: a total of 127 patients were selected for eligibility, aged from 31 to 83 years, with a median age of 64 years. Of 127 patients, there were 66 cases in observation group and 61 cases in control group. (2) Surgical situations of ileostomy closure: all patients from the two groups underwent ileostomy closure successfully. The incision length, operation time, volume of intraoperative blood loss, cases with abdominal adhesion degree as slight adhesion or obvious adhesion were 4.25 cm(4.00 cm, 5.00 cm), 48.00 minutes(33.75 minutes, 58.00 minutes), 30 mL(20 mL, 50 mL), 34, 32 of the observation group, versus 7.50 cm(7.00 cm, 8.50 cm), 70.00 minutes(57.00 minutes, 80.00 minutes), 30 mL(30 mL, 50 mL), 13, 48 of the control group, showing significant differences between the two groups ( Z=-9.549, -6.133, -2.758, χ2=12.405, P<0.05). (3) Postoperative situations: cases with incision infection of the observation group and the control group were 5 and 13, respectively, showing a significant difference between the two groups ( χ2=4.917, P<0.05). (4) Follow-up: all the 127 patients were followed up for 6-21 months, with a median follow-up time of 10 months. During the follow-up, 3 cases of the control group had postoperative incisional hernia and were cured after conservative treatment. None of patient had anastomotic leakage related complications or died during the follow-up. Conclusion:The one-stitch preventive ileostomy has the advantage of ileostomy closure, which can reduce the operation time, volume of intraoperative blood loss and shorten the incision length effectively, so as to reduce the incidence of postoperative incision infection related complications.

Objective: To investigate the proportion of achieving the blood lipid control target and its influencing factors among residents at a high risk of atherosclerotic cardiovascular disease (ASCVD), so as to provide insights into management of blood lipid among residents at a high risk of ASCVD. Methods: Residents at a high risk of ASCVD and at ages of 35 to 70 years were sampled using a multi-stage cluster sampling method from 6 counties (districts) in Shaoxing City from May to July 2021. The residents' demographics, smoking, alcohol consumption and medical history of chronic diseases were collected using questionnaires, the height, weight, waist circumference (WC) and blood pressure were measured, and the total cholesterol (TC), triacylglycerol (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and fasting blood glucose were detected. The proportion of blood lipids achieving the control target was analyzed, and factors affecting the proportion of blood lipids achieving the control target were identified using a multivariable logistic regression model. Results: A total of 1 695 individuals at a high risk of ASCVD were enrolled, including 940 men (55.46%) and 755 women (44.54%), with a mean age of (62.56±6.08) years. There were 285 participants that achieved the target of blood lipid control (16.81%). Multivariable logistic regression analysis identified gender (male, OR=1.962, 95%CI: 1.396-2.758), age (OR=1.037, 95%CI: 1.013-1.061), WC (OR=0.979, 95%CI: 0.964-0.995), diastolic blood pressure (OR=0.981, 95%CI: 0.967-0.994), smoking (OR=1.485, 95%CI: 1.034-2.133), alcohol consumption (OR=0.684, 95%CI: 0.498-0.941), hypertension (OR=1.428, 95%CI: 1.006-2.207), administration of hypoglycemic drugs (OR=2.326, 95%CI: 1.720-3.144) as factors affecting the achievement of the target for blood lipid control among residents at a high risk of ASCVD. Conclusions Individuals at a high risk of ASCVD with higher WC, higher diastolic blood pressure and alcohol consumption are less likely to achieve the target for blood lipid control, while male individuals with older age, hypertension and administration of hypogcemic drugs are more likely to achieve the target for blood lipid control.

Objective To explore the risk factors of ulcerative colitis-associated colorectal cancer (UC-CRC).Methods The retrospective case-control study was conducted.The clinicopathological data of 536 patients with ulcerative colitis (UC) who were admitted to the Henan Tumor Hospital from March 2004 to June 2015 were collected.Observation indicators:(1) follow-up results:cases with follow-up,follow-up time,cases of UC-CRC,age of onset,pathological type of UC-CRC;(2) risk factors analysis affecting occurrence of UC-CRC:gender,age of onset,course of disease,severity of disease,disease classification,extent of lesion,smoking history,family history of colorectal cancer,anemia,hypoproteinemia,body weight loss,extraintestinal manifestations,colonic polyps,backwash ileitis,atypical hyperplasia,anxiety or depression,treatment method and regular endoscopy reexamination.Follow-up using outpatient examination and telephone interview was performed to detect prognosis of patients up to April 2017.Patients underwent colonoscopy once every 6 months within 3 years after diagnosis and once every 1 year after 3 years.Measurement data with skewed distribution were described as M (range).The univariate analysis was done using the chi-square test and Fisher exact probability.The multivariate analysis was done using the Logistic regression model.Results (1) Follow-up results:of 536 patients,450 were followed up for 26.0-120.0 months,with a median time of 76.4 months.During the follow-up,16 patients were complicated with UC-CRC,including 9 males and 7 females.Age of onset of colorectal cancer was 14-78 years,with an average age of onset of 44 years.Pathological type:high-differentiated right colon adenocarcinoma was detected in 5 patients,high-and moderate-differentiated left colon adenocarcinoma in 3 patients,left colon signetring cell carcinoma in 2 patients,moderate-differentiated rectal tubular adenocarcinoma in 3 patients,highdifferentiated rectal papillary adenocarcinoma in 2 patients and malignant lymphoma in 1 patient.(2) Risk factors analysis affecting occurrence of UC-CRC:the results of univariate analysis showed that course of disease,extent of lesion,colonic polyps and atypical hyperplasia were risk factors affecting occurrence of UC-CRC (x2 =14.848,18.885,10.554,P＜0.05).The results of multivariate analysis showed that course of disease ＞ 10 years,lesion involving the whole colon,colonic polyps and atypical hyperplasia were independent risk factors affecting occurrence of UC-CRC (OR=12.893,17.847,7.326,19.742,95％ confidence interval:1.726-74.337,1.445-89.793,1.263-43.128,3.625-96.524,P＜0.05).Conclusion The course of disease ＞ 10 years,lesion involving the whole colon,atypical hyperplasia and colonic polyps are independent risk factors affecting occurrence of UC-CRC.

Objective To investigate the application value of the curved cutter stapler device combined with trans-orally inserted anvil (OrVil) in the radical resection of Siewert type Ⅱ adenocarcinoma of the esophagogastric junction (AEG).Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 206 patients with Siewert type Ⅱ AEG who were admitted to the Henan Tumor Hospital between March 2011 and March 2016 were collected.All the 206 patients underwent radical resection and 3-step clock wise total gastrectomy + D2 lymph node dissection.Observation indicators:(1) surgery and postoperative recovery situations:surgical approach,overall operation time,hammer anvil placing time,esophagojejunal anastomosis time,volume of intraoperative blood loss,number of lymph node dissected,time to anal exsufflation,postoperative complications and duration of postoperative hospital stay;(2) postoperative pathological examination and chemotherapy;(3) follow-up and survival situations.Follow-up using telephone interview and outpatient examination was performed to detect tumor-free survival of patients up to April 2016.Measurement data with normal distribution were represented as x±s.The survival rate was calculated by the Kaplan-Meier method.Results (1) Surgery and postoperative recovery situations:all the 206 patients received successful operations,including 85 with abdominal operation,50 with abdominal incision through the diaphragmatic muscle into thoracic surgery and 71 with thoracic-abdominal surgery.Overall operation time,hammer anvil placing time,esophagojejunal anastomosis time,volume of intraoperative blood loss,number of lymph node dissected,time to anal exsufflation and duration of hospital stay were (113.7± 15.4)minutes,(3.5± 1.2)minutes,(10.4±2.9)minutes,(128±25) mL,32± 6,(2.4 ± 0.9) days and (12.3 ± 1.9) days,respectively.Of 206 patients,15 with postoperative complications were cured by conservative treatment,including 6 with implicit anastomotic fistula,3 with dominant anastomotic fistula,2 with pancreatic leakage,2 with intestinal obstruction,1 with anastomotic stenosis and 1 with thoracic and abdominal infection.There was no reoperation due to perioperative complications.(2) Postoperative pathological examination and chemotherapy:postoperative pathological results showed that distance from resection margin of the esophagus to tumor was (5.2±0.4) cm,without cancer cells in the resection margin.Among 206 patients,171 received postoperative chemotherapy by S1 single agent combined with oxaliplatin for 6-8 cycles or oral S1 single agent for 1 year.(3) Follow-up and survival situations:206 patients were followed up for (2.7± 0.3)years,with a tumor-free 3-year survival rate of 58％.During the follow-up,there was no recurrent anastomotic tumor.Conclusion The curved cutter stapler device combined with OrVil in the radical resection of Siewert type Ⅱ AEG can simplify the difficulty of esophagojejunal anastomosis and guarantee the safe resection margin of the lower esophagus.

Objective:To analyze the expression of LETM2 in KYSE150 and ECA109 cell lines and its effect on the proliferation, migra-tion, and invasion of esophageal squamous cell carcinoma (ESCC). Methods:The expression level of the LETM2 protein in 90 paired hu-man ESCC tissues and matched adjacent normal tissues was determined through immunohistochemistry. The expression level of LETM2 in ESCC cell lines was detected by real-time PCR and Western blot. The expression levels of LETM2 in KYSE150 and ECA109 cell lines were knocked down using lentivirus. MTT assays were performed to examine the effect of LETM2 on the proliferation of ESCC cells. Colony formation assay was used to detect the colony formation ability. Flow cytometry was performed to analyze the cell cycle. The effect of LETM2 depletion on the migration and invasion of ESCC cells was determined by Transwell assay. Results:LETM2 expres-sion was frequently upregulated in the ESCC tissues than in the adjacent normal tissues. The suppressed exogenous expression of LETM2 led to the inhibition of cell proliferation and colony formation. However, cell migration and invasion were not affected. The re-sults on the cell cycle distribution revealed that LETM2 knockdown acts as a negative regulator of the cell cycle at the G1 to S phase transition. Conclusion:LETM2 acts as a tumor-driven gene in the development and progression of ESCC. This finding suggests that LETM2 can be used as an efficient prognosis biomarker and a potential therapeutic target for ESCC.

ThisstudywasaimedtoobservetheinhibitoryeffectsofQi-Zhu (QZ)granulesonearlyproteinuria in diabetic nephropathy rats with syndrome of qi-yin deficiency and phlegm blocking collaterals. A total of 44 rats were randomly divided into the blank group, model group, Huang-Kui capsule group, QZ granules group. The rat model of diabetic nephropathy with syndrome of qi-yin deficiency and phlegm blocking collaterals was induced by the combination of unilateral renal artery ligation, diet of high-calorie and high cholesterol, and intraperitoneal injection of low-dose streptozotocin. The medication was given for 8 weeks. The concentrations of protein and creatinine in urine were observed on the 4th week. The blood glucose, blood lipids, liver function and renal pathological changes were observed at the end of the experiment. The results showed that compared with the model group, QZ granules can obvious suppress early proteinuria in diabetic nephropathy, promote creatinine excretion, regulate blood lipid metabolism, protect liver function and improve renal pathological changes. It was concluded that QZ granules had independent inhibition effect on early proteinuria in diabetic nephropathy rats with syndrome of qi-yin deficiency and phlegm blocking collaterals. The effect was independent of lowing blood glucose. It represented the corresponding relation between the syndrome and efficacy in Chinese herb compounds.

Objective:To investigate the clinical significance of MRI dynamic enhancement in defining the upper edge of adenocarcinoma of esophagogastric junction.Methods:The clinical data of 73 patients with adenocarcinoma on the esophagogastric junction operated from Jul 2018 to Aug 2019 in the Affiliated Cancer Hospital of Zhengzhou University were retrospectively analyzed. All patients underwent MRI examination within one week before surgery. First, the T 2WI, diffusion-weighted imaging and dynamic enhanced images of each patient were carefully observed to define the tumor location, size, shape, signal and enhancement mode, then the distances between the upper edge of the tumor and the cardiac incisure on MRI dynamic enhancement were measured independently, and compared with the measured distance in surgical fresh specimens. Results:The mean location of tumor upper edge measured in MRI of 73 patients was (1.75±1.98)cm, while measured in the surgical specimen was (1.72±1.97)cm. There was no significant difference between the two groups ( t=0.572, P=0.569). The intraclass correlation efficient between the two groups was excellent (ICC=0.974, 95% CI: 0.959-0.984, P<0.01). Conclusion:The measurement result of tumor upper edge in MRI is basically consistent with that of surgical specimens. MRI can be used to locate the tumor upper edge for adenocarcinoma of esophagogastric junction before operation.

The editorial board and publication ethics committee of the CEO decided to retract this paper from our journal.