Objective:To analyze the expression of serum thymidine kinase 1 (TK1), interleukin-22 (IL-22) and IL-6 in patients with breast cancer and their relationship with postoperative recurrence.Methods:100 patients with breast cancer from Jan. 2021 to Jan. 2023 were included as the observation group, and 30 healthy women who underwent physical examination in the First People’s Hospital of Jiande during the same period were included as the control group. Serum TK1, IL-22 and IL-6 levels were compared and local recurrence was followed up after surgery. Patients were separated into the recurrence subgroup and non-recurrence subgroup according to postoperative recurrence. The levels of serum TK1, IL-22, IL-6 and clinicopathological features were compared, and the influencing factors of postoperative recurrence of breast cancer were analyzed by multivariate Logistic regression. Receiver operating characteristic curve (ROC) was drawn to evaluate the predictive efficacy of serum TK1, IL-22 and IL-6 in postoperative breast cancer recurrence.Results:Serum TK1, IL-22 and IL-6 levels in the observation group were significantly higher ( t=15.91, 21.99, 9.17, P<0.05); Among the 100 patients with breast cancer, 22 recurred and 78 did not recurred. The proportion of lymph node metastasis, the proportion of postoperative chemotherapy, the proportion of postoperative radiotherapy, serum TK1, serum IL-22 and serum IL-6 levels in the recurrence subgroup were significantly higher than those in the non-recurrence subgroup ( χ2/ t=8.09, 4.74, 4.76, 4.24, 4.43, 5.31, P<0.05); Stepwise Logistic regression showed that lymph node metastasis, high TK1, high IL-22 and high IL-6 were risk factors for postoperative recurrence of breast cancer patients, and standard postoperative chemotherapy and postoperative radiotherapy were protective factors (Wald χ2value =13.424, 4.689, 4.631, 7.334, 8.925, 5.855, P<0.05); The area under the curve (AUC) of TK1, IL-22, IL-6 and combined detection for predicting postoperative recurrence of breast cancer patients were 0.779, 0.739, 0.816 and 0.893, respectively ( AUC=0.779, 0.739, 0.816, 0.893, P<0.05) . Conclusions:Serum TK1, IL-22 and IL-6 levels increase in patients with breast cancer. High TK1, IL-22 and IL-6 levels are risk factors for postoperative recurrence of breast cancer, and combined detection has a good predictive effect on postoperative recurrence of breast cancer.

Objective To evaluate the efficacy of myopia progression control over a one-year period for defocus in-corporated multiple segments lenses(DIMS),peripheral defocus modifying(PDM)lenes and single vision spectacle lenses(SVL)in a real-world cohort.Methods A total of 188 cases in the DIMS group,116 cases in the PDM group,and 373 ca-ses in the SVL group,all diagnosed with refractive errors and aged 6-16 years,were enrolled in Department of Ophthal-mology,Fujian Provincial Hospital from July 2019 to June 2022.A 1∶1 propensity score matching(PSM)of covariates was used to balance factors between the groups.The changes in spherical equivalent(SE)and axial length(AL)in each patient before and 1 year after wearing glasses were compared without other interventions.The myopia control effects of different groups were compared through the changes in SE and AL.Results After PSM,92 cases were matched between DIMS group and PDM group,163 cases were matched between DIMS group and SVL group,and 99 cases were matched between PDM group and SVL group.The changes in SE and AL in the DIMS group were less than those in the PDM and SVL groups,with statistically significant differences(all P＜0.05).However,there were no statistically significant differences in the changes in SE and AL between the PDM and SVL groups(all P＞0.05).In the age subgroup analysis,in the younger age group(6～＜13)and the older age group(13～16)the changes in SE and AL in the DIMS group were less than those in the PDM group and SVL group,with statistically significant differences(all P＜0.05).In the younger age group,the changes in SE and AL in the PDM group were less than those in the SVL group,with statistically significant differences(all P＜0.05);while in older age group,there were no statistically significant differences in the changes in SE and AL between the PDM and SVL groups(all P＞0.05).Conclusion The myopia control efficacy of DIMS is superior to that of PDM and SVL.In younger children,the myopia control efficacy of PDM is superior to that of SVL.

Objective:To analyze the expression of serum thymidine kinase 1 (TK1), interleukin-22 (IL-22) and IL-6 in patients with breast cancer and their relationship with postoperative recurrence.Methods:100 patients with breast cancer from Jan. 2021 to Jan. 2023 were included as the observation group, and 30 healthy women who underwent physical examination in the First People’s Hospital of Jiande during the same period were included as the control group. Serum TK1, IL-22 and IL-6 levels were compared and local recurrence was followed up after surgery. Patients were separated into the recurrence subgroup and non-recurrence subgroup according to postoperative recurrence. The levels of serum TK1, IL-22, IL-6 and clinicopathological features were compared, and the influencing factors of postoperative recurrence of breast cancer were analyzed by multivariate Logistic regression. Receiver operating characteristic curve (ROC) was drawn to evaluate the predictive efficacy of serum TK1, IL-22 and IL-6 in postoperative breast cancer recurrence.Results:Serum TK1, IL-22 and IL-6 levels in the observation group were significantly higher ( t=15.91, 21.99, 9.17, P<0.05); Among the 100 patients with breast cancer, 22 recurred and 78 did not recurred. The proportion of lymph node metastasis, the proportion of postoperative chemotherapy, the proportion of postoperative radiotherapy, serum TK1, serum IL-22 and serum IL-6 levels in the recurrence subgroup were significantly higher than those in the non-recurrence subgroup ( χ2/ t=8.09, 4.74, 4.76, 4.24, 4.43, 5.31, P<0.05); Stepwise Logistic regression showed that lymph node metastasis, high TK1, high IL-22 and high IL-6 were risk factors for postoperative recurrence of breast cancer patients, and standard postoperative chemotherapy and postoperative radiotherapy were protective factors (Wald χ2value =13.424, 4.689, 4.631, 7.334, 8.925, 5.855, P<0.05); The area under the curve (AUC) of TK1, IL-22, IL-6 and combined detection for predicting postoperative recurrence of breast cancer patients were 0.779, 0.739, 0.816 and 0.893, respectively ( AUC=0.779, 0.739, 0.816, 0.893, P<0.05) . Conclusions:Serum TK1, IL-22 and IL-6 levels increase in patients with breast cancer. High TK1, IL-22 and IL-6 levels are risk factors for postoperative recurrence of breast cancer, and combined detection has a good predictive effect on postoperative recurrence of breast cancer.

Objective To evaluate the efficacy of myopia progression control over a one-year period for defocus in-corporated multiple segments lenses(DIMS),peripheral defocus modifying(PDM)lenes and single vision spectacle lenses(SVL)in a real-world cohort.Methods A total of 188 cases in the DIMS group,116 cases in the PDM group,and 373 ca-ses in the SVL group,all diagnosed with refractive errors and aged 6-16 years,were enrolled in Department of Ophthal-mology,Fujian Provincial Hospital from July 2019 to June 2022.A 1∶1 propensity score matching(PSM)of covariates was used to balance factors between the groups.The changes in spherical equivalent(SE)and axial length(AL)in each patient before and 1 year after wearing glasses were compared without other interventions.The myopia control effects of different groups were compared through the changes in SE and AL.Results After PSM,92 cases were matched between DIMS group and PDM group,163 cases were matched between DIMS group and SVL group,and 99 cases were matched between PDM group and SVL group.The changes in SE and AL in the DIMS group were less than those in the PDM and SVL groups,with statistically significant differences(all P＜0.05).However,there were no statistically significant differences in the changes in SE and AL between the PDM and SVL groups(all P＞0.05).In the age subgroup analysis,in the younger age group(6～＜13)and the older age group(13～16)the changes in SE and AL in the DIMS group were less than those in the PDM group and SVL group,with statistically significant differences(all P＜0.05).In the younger age group,the changes in SE and AL in the PDM group were less than those in the SVL group,with statistically significant differences(all P＜0.05);while in older age group,there were no statistically significant differences in the changes in SE and AL between the PDM and SVL groups(all P＞0.05).Conclusion The myopia control efficacy of DIMS is superior to that of PDM and SVL.In younger children,the myopia control efficacy of PDM is superior to that of SVL.

Objective To investigate the effect of Kaixinsan(KXS,a traditional Chinese medicine formula)for alleviating adriamycin-induced depression-like behaviors in mice bearing breast cancer xenografts and explore the pharmacological mechanism.Methods Forty female BALB/c mice were randomized equally into control group,model group,and low-and high-dose KXS treatment groups,and in the latter 3 groups,mouse models bearing orthotopic breast cancer 4T1 cell xenografts were established and treated with adriamycin along with saline or KXS via gavage.Depression-like behaviors of the mice were assessed using open field test and elevated plus-maze test,and the changes in serum levels of depression-related factors were examined.RNA-seq analysis and transmission electron microscopy were used and ferroptosis-related factors were detected to explore the mechanisms of adriamycin-induced depression and the therapeutic mechanism of KXS.The results were verified in SH-SY5Y cells using ferroptosis inhibitor Fer-1 as the positive control.Results KXS significantly alleviated depression-like behaviors and depression-related serological changes induced by adriamycin in the mouse models.RNA-seq results suggested that KXS alleviated chemotherapy-induced depression by regulating oxidative stress,lipid metabolism and iron ion binding in the prefrontal cortex.Pathological analysis and detection of ferroptosis-related factors showed that KXS significantly reduced ferroptosis in the prefrontal cortex of adriamycin-treated mice.In SH-SY5Y cells,both KXS-medicated serum and the ferroptosis inhibitor were capable of attenuating adriamycin-induced cell ferroptosis.Conclusion KXS alleviates adriamycin-induced depression-like behaviors in mice by reducing ferroptosis in the prefrontal cortex of breast cancer-bearing mice.

Objective To investigate the effect of Kaixinsan(KXS,a traditional Chinese medicine formula)for alleviating adriamycin-induced depression-like behaviors in mice bearing breast cancer xenografts and explore the pharmacological mechanism.Methods Forty female BALB/c mice were randomized equally into control group,model group,and low-and high-dose KXS treatment groups,and in the latter 3 groups,mouse models bearing orthotopic breast cancer 4T1 cell xenografts were established and treated with adriamycin along with saline or KXS via gavage.Depression-like behaviors of the mice were assessed using open field test and elevated plus-maze test,and the changes in serum levels of depression-related factors were examined.RNA-seq analysis and transmission electron microscopy were used and ferroptosis-related factors were detected to explore the mechanisms of adriamycin-induced depression and the therapeutic mechanism of KXS.The results were verified in SH-SY5Y cells using ferroptosis inhibitor Fer-1 as the positive control.Results KXS significantly alleviated depression-like behaviors and depression-related serological changes induced by adriamycin in the mouse models.RNA-seq results suggested that KXS alleviated chemotherapy-induced depression by regulating oxidative stress,lipid metabolism and iron ion binding in the prefrontal cortex.Pathological analysis and detection of ferroptosis-related factors showed that KXS significantly reduced ferroptosis in the prefrontal cortex of adriamycin-treated mice.In SH-SY5Y cells,both KXS-medicated serum and the ferroptosis inhibitor were capable of attenuating adriamycin-induced cell ferroptosis.Conclusion KXS alleviates adriamycin-induced depression-like behaviors in mice by reducing ferroptosis in the prefrontal cortex of breast cancer-bearing mice.

Entinostat plus exemestane in hormone receptor-positive (HR+) advanced breast cancer (ABC) previously showed encouraging outcomes. This multicenter phase 3 trial evaluated the efficacy and safety of entinostat plus exemestane in Chinese patients with HR + ABC that relapsed/progressed after ≥1 endocrine therapy. Patients were randomized (2:1) to oral exemestane 25 mg/day plus entinostat (n = 235) or placebo (n = 119) 5 mg/week in 28-day cycles. The primary endpoint was the independent radiographic committee (IRC)-assessed progression-free survival (PFS). The median age was 52 (range, 28-75) years and 222 (62.7%) patients were postmenopausal. CDK4/6 inhibitors and fulvestrant were previously used in 23 (6.5%) and 92 (26.0%) patients, respectively. The baseline characteristics were comparable between the entinostat and placebo groups. The median PFS was 6.32 (95% CI, 5.30-9.11) and 3.72 (95% CI, 1.91-5.49) months in the entinostat and placebo groups (HR, 0.76; 95% CI, 0.58-0.98; P = 0.046), respectively. Grade ≥3 adverse events (AEs) occurred in 154 (65.5%) patients in the entinostat group versus 23 (19.3%) in the placebo group, and the most common grade ≥3 treatment-related AEs were neutropenia [103 (43.8%)], thrombocytopenia [20 (8.5%)], and leucopenia [15 (6.4%)]. Entinostat plus exemestane significantly improved PFS compared with exemestane, with generally manageable toxicities in HR + ABC (ClinicalTrials.gov #NCT03538171).

Achalasia is a primary esophageal motility disorder manifested by dysphagia and chest pain that impair patients’ quality of life, and it also leads to chronic esophageal inflammation by food retention and increases the risk of esophageal cancer. Although achalasia has long been reported, the epidemiology, diagnosis and treatment of achalasia are not fully understood. The current clinical dilemma of achalasia is mainly due to its unclear pathogenesis. In this paper, epidemiology, diagnosis treatment, as well as possible pathogenesis of achalasia will be reviewed and summarized. The proposed hypothesis on the pathogenesis of achalasia is that genetically susceptible populations potentially have a higher risk of infection with viruses, triggering autoimmune and inflammation responses to inhibitory neurons in lower esophageal sphincter.

Objective:To investigate the feasibility and efficacy of retroperitoneal laparoscopy combined with lower abdominal incisions in the surgical treatment of upper urinary tract urothelial cell carcinoma.Methods:The clinical data of 52 patients with renal pelvic and ureteral cancer, who received radical nephrectomy using the retroperitoneal laparoscopy combined with a lower abdomen incision approach in Hubei Provincial General Hospital of Armed Police Force from April 2005 to December 2016, were retrospectively analyzed. All 52 patients had unilateral renal pelvic and ureteral cancer but with no lymph nodes or distant metastasis. During general anesthesia in a healthy side-lying position, patients underwent retroperitoneal laparoscopic radical nephrectomy. The affected ureter was clamped but not disconnected. Renal blood vessels were clamped with Hem-o-lock clips. Renal arteries and veins were cut off. Then the kidney was completely isolated. Three laparoscopic incisions were sutured. After taking the patients to be in the supine position, a 5-6 cm-long incision was made in the lower abdomen on the affected side. The lower ureter was dissociated from the bladder. A 1.5 cm-long bladder wall was dissected in the sleeve manner. The affected kidney and ureter were completely removed from the lower abdomen through the made small incision. A rubber drainage tube was inserted in another incision made at the lower end of the prior incision.Results:Operations were successful in all 52 cases. No cases were converted to open surgery, had blood transfused, or needed secondary surgery. There were no complications such as urinary leakage, incision infection, or massive bleeding. Postoperative pathology reported 41 cases of renal urothelial carcinoma and 11 cases of ureteral urothelial carcinoma. Forty-eight patients provided follow-up data, and four did not because of being lost. One patient died of a cardiovascular accident 13 months after surgery. Cystoscopy revealed that 47 cases had no bladder tumor, local or distant metastasis.Conclusion:The retroperitoneal laparoscopy combined with lower abdominal incisions approach is suitable for radical resection of renal pelvic or ureteral cancer owing to ease in operation, few requirements for surgical instruments, minimal invasion, and rapid recovery.

Objective:To investigate the characteristics and management of the emergency patients with orthopaedic trauma during COVID-19 epidemic.Methods:A retrospective analysis was performed of the 32 emergency inpatients at Department of Orthopedics, Nanfang Hospital from January 20 to February 26, 2020. They were 23 males and 9 females, aged from 4 to 66 years (mean, 35 years). The causes for their injury included traffic accident in 14 cases, sharp cutting (e.g. by a kitchen knife) in 6 cases, heavy object crushing in one, machine crushing in one, fall in 2, and machine twisting in one. High energy injury occurred in 13 cases and low-energy injury in 9 cases. The injury involved the upper limb in 7 cases and the lower limb in 15 cases. Grade Ⅱ protection was adopted during the diagnosis and treatment for the one emergency patient who had not undergone nucleic acid screening for 2019-nCoV while grade Ⅰ protection for the other 21 patients. 2019-nCoV infection was recorded in the patients and medical staff as well. The measures and experience were reviewed in the management of orthopaedic emergencies during the COVID-19 epidemic.Results:During the diagnosis and treatment of 22 emergency patients with orthopaedic trauma, none of the medical staff or patients was infected with COVID-19. As the one emergency patient was treated as a suspected case and protected by grade Ⅱ measures, COVID-19 infection was ruled out after surgery.Conclusions:During the COVID-19 epidemic, front-line medical staff dealing with traumatic emergencies faced a higher risk of infection. The emergency orthopaedic traumas were mainly caused by a traffic accident or a machine, and those in the elderly patients by a sharp cutting or a fall. The incidence of COVID-19 infection could be reduced by COVID-19 screening before admission, appropriate anesthesia and surgical methods, protection of perioperative medical staff, postoperative wards care and psychological counseling.