Objective To compare concurrent chemoradiotherapy and sequential therapy effect on serum MMP-2 and TGF-β1 in local advanced non-small cell lung cancer (NSCLC).Methods From 2010 January to 2012 December,64 Ⅱ B and Ⅲ B stage patients with pathologically confirmed NSCLC were randomly divided into concurrent chemoradiotherapy group (group A) and sequential therapy group (group B).Each group had 32 patients.Group A was treated with three-dimensional conformal radiotherapy and concurrent chemotherapy with TC or EP.Group B received TC or EP regimen chemotherapy after three-dimensional conformal radiotherapy.Serum MMP-2 and TGF-β1 on those patients from preradiotherapy,radiotherapy in one month to post-treatment were measured by enzyme-linked immunoabsorbent assay.The dynamic changes of MMP-2 and TGF-β1 were compared.Results The remission rates in groups A and B were 90.6 ％ and 68.8 ％,the effective rate of treatment in group A was better than that of group B (x2 =4.730 0,P =0.029 6).The long-term effect analyzed with Kaplan-Meier method,the median time to tumor progression (TTP) were 9.1 months and 8.2 months,there was no statistically significant difference (P =0.100 3).The overall survival rates between two groups after the Log-rank test had significant difference (P =0.048),the median survival time (MST) were 17.8 and 15.9 months,1 year OS rates were 65.05 ％ and 60.24 ％,2 years OS rates were 49.45 ％ and 43.07 ％.The MMP-2 level of A group and B were (276.5±98.2) μg/ml and (263.9±103.5) μg/ml,there was no significant difference (t =0.499 6,P =0.619 1) before radiotherapy,they were (242.1±53.2) μg/ml and (298.7±68.4) μg/ml after radiotherapy,there was significant difference (t =3.694 9,P =0.005) and after treatment were (60.5 ±24.4) μg/ml and (75.2±30.7) μg/ml,there was significant difference (t =2.120 5,P =0.038 0).The TGF-β1 level of A group and B were (1 624.3±454.2) ng/ml and (1 564.9±517.8) ng/ml,there was no significant difference (t =0.208 6,P =0.835 4) before radiotherapy,they were (1 383.5±469.3) ng/ml and (1 785.3±412.6) mg/ml after radiotherapy,there was significant difference (t =3.637 3,P =0.006 0) and after treatment were (610.5±215.4) ng/ml and (750.3±263.7) ng/ml,there was significant difference (t =2.322 6,P =0.023 5).Conclusions Concurrent chemoradiotherapy could effectively antagonize radiation-induced MMP-2 and TGF-β1 expression increased in locally advanced NSCLC.This study suggests that the concurrent chemoradiotherapy can inhibit abilities of tumor invasion and metastasis through decreasing the MMP-2 and TGF-β1 levels.

Objective:To explore the pathological differences of surgically resected specimens of advanced esophageal squamous cell carcinoma (ESCC) to different neoadjuvant therapies (neoadjuvant radiochemotherapy and toripalimab combined with neoadjuvant radiochemotherapy).Methods:Thirty patients diagnosed with advanced ESCC who underwent surgical operation after neoadjuvant therapy in Jiangsu Cancer Hospital from October 2020 to September 2021 were included. Among them, 15 patients received neoadjuvant radiochemotherapy (radiochemotherapy group) and 15 patients were treated with toripalimab combined with radiochemotherapy (immunotherapy combined with radiochemotherapy group). Surgically resected specimens were collected. The histopathological features of primary esophageal lesions and the responses of involved lymph nodes were analyzed and compared between two groups.Results:The major pathological response (MPR) rate in the radiochemotherapy group was 10/15, and 14/15 in the immunotherapy combined with radiochemotherapy group ( P=0.17). The pathological complete response (pCR) rate of the primary lesions in the radiochemotherapy group was 7/15, and 10/15 in the immunotherapy combined with radiochemotherapy group ( P=0.46). In the radiochemotherapy group, the incidence rate of tertiary lymphoid structure (TLS) was 7/15, and 12/15 in the immunotherapy combined with radiochemotherapy group ( P=0.02). The incidence rate of necrosis in the radiochemotherapy group was 6/15, and 1/15 in the immunotherapy combined with radiochemotherapy group ( P=0.03). In addition, the incidence rate of foam cell infiltration in the radiochemotherapy group was 6/15, and 13/15 in the immunotherapy combined with radiochemotherapy group ( P=0.01). Furthermore, the pCR rate of involved lymph nodes in the radiochemotherapy group was 7/33, and 11/12 in the immunotherapy combined with radiochemotherapy group ( P<0.001). Conclusion:Compared with the radiochemotherapy group, the incidence of TLS and foam cell infiltration is higher, the incidence of necrosis is lower and clinical efficacy of involved lymph nodes is higher in the immunotherapy combined with radiochemotherapy group, prompting that toripalimab combined with neoadjuvant radiochemotherapy exert higher synergistic immune effect.

ObjectiveTo explore the influence of electroacupuncture combined with point bloodletting and cupping for facial nerve function recovery in acute stage of idiopathic facial palsy （IFP）. MethodsEighty patients with IFP in the acute stage were randomly divided into 40 cases each in the treatment group and the control group. In the control group， oral prednisone acetate tablets were administered during the acute stage when the disease duration was less than 10 days； and electroacupuncture and flash cupping were provided during the recovery stage when the disease duration was more than 10 days， five times a week. For treatment group in acute stage， the stellate ganglion， vagus nerve stimulation point in the auricular cavity， Yifeng （TE 17） and Tinghui （GB 2） were needled on the affected side on the basis of the treatment of control group， with Yifeng and Tinghui connecting to electroacupuncture apparatus， once a day； point bloodletting and then cupping in Yifeng 2 times a week； in recovery stage， the treatment was the same as that of the control group. Both groups were treated until the 45th day from onset. The primary outcome was the Toronto facial grading system （SFGS）， and the secondary outcomes included house-brackmann （H-B） grade， facial disability index （FDI） score， and number of H-B grade-Ⅰ cases. Adverse events were recorded in both groups. ResultsThe SFGS scores of the patients in both groups were higher on the 10th， 30th and 45th days after onset of disease compared with those before the treatment （P＜0.05）； the H-B grade was lower on the 30th and 45th days after the onset of the disease compared with those before the treatment （P＜0.05）； and the facial disability index physical function （FDIP） and facial disability index social function （FDIS） scores were higher on the 30th and 45th days after onset of disease （P＜0.05）. SFGS scores of patients in the treatment group were significantly higher than those of the control group on the 30th and 45th days after onset （P＜0.05）； H-B grade was significantly lower than that of the control group on the 30th and 45th days after onset （P＜0.05）； and FDIP scores on the 45th day after onset， and FDIS scores on the 30th and 45th days after onset were significantly higher than those of the control group （P＜0.05）. At the end of treatment， 77.50% （31 cases） achieved H-B grade-Ⅰ in the treatment group， which was more than 55.00% （22 cases） in the control group （P＜0.05）. No adverse events occurred in either group. ConclusionElectroacupuncture combined with point bloodletting and cupping for IFP in acute stage can improve the recovery degree of facial nerve function， improve effectiveness， and show a high degree of safety.

  Objective  To study the demographic and clinical characteristics, correlation of genotype and phenotype and treatment of Blau syndrome to facilitate early diagnosis and timely treatment of Blau syndrome.  Methods  Seventy-two patients with Blau syndrome from 11 centers from May 2006 to April 2022 were retrospectively analyzed, and their general information, clinical data, laboratory examination and treatment medication were collected.  Results  The distribution of patients with Blau syndrome was uniform in geographical north and south of China, and there was no obvious gender bias. The mean age of onset was (14.30±12.81) months, and the age of diagnosis was (55.18±36.22) months. 35% of patients with Blau syndrome happened before 1 year old, and all patients developed before 5 years old. 87.50% (63/72) had granulomatous arthritis, 65.28% (47/72) had rash, 36.11% (26/72) had ocular involvement, 27.78% (20/72) had fever, and 15.28% (11/72) had pulmonary involvement. Arthritic manifestations of Blau syndrome were most at risk, followed by rash, ocular involvement, and fever.The first 25 months of the disease, the risk of developing a rash was the greatest. The risk of developing arthritis was the greatest between 25 months and 84 months. The main mutations were p.R334Q and p.R334W, and patients with p.R334Q mutation had relatively high incidence of fever (35.71%[5/14] vs. 14.29%[1/7], P=0.43) and ocular involvement (42.86%[6/14]vs. 28.57%[2/7], P=0.51). There was a relatively high incidence of rash (85.71%[6/7] vs. 64.29%[9/14], P=0.59) in patients with the p.R334W mutation. Forty-five patients(62.50%)were treated with a combina-tion of glucocorticoid and methotrexate. Twenty-two patients were treated with tumor necrosis factor antagonist in addition to glucocorticoid and methotrexate.  Conclusions  The risk of different clinical manifestations of Blau syndrome from high to low was arthritis, followed by rash, ocular involvement and fever. The main treatment was glucocorticoid combined with methotrexate, to which biological agents could be added.