ObjectiveTo investigate the expression and prognostic significance of human epidermal growth factor receptor 2 （HER-2）， vascular endothelial growth factor-A （VEGF-A）， and programmed death-ligand 1 （PD-L1） in gallbladder cancer， and to provide a theoretical basis for subsequent research. MethodsA retrospective analysis was performed for the postoperative specimens and clinical data of 55 patients who underwent radical cholecystectomy for gallbladder cancer and had pathologically confirmed gallbladder adenocarcinoma in The Affiliated Hospital of Inner Mongolia Medical University from December 2017 to September 2019. Immunohistochemical staining was used to measure the expression levels of HER-2， VEGF-A， and PD-L1 in cancerous tissue and paracancerous tissue. The association between the expression of these three markers and clinical features were analyzed， as well as their impact on the prognosis of patients. The independent-samples t test was used for comparison of normally distributed continuous data between groups， and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups； the chi-square test was used for comparison of categorical data between groups. The Cox regression model was used to perform the univariate and multivariate analyses of clinical factors. The Kaplan-Meier curve was used to analyze the prognosis of patients， and the Log-rank test was used for comparison. ResultsAmong the 55 patients， 15 patients （27.2%） had a high expression level of HER-2 in cancerous tissue， 23 （41.8%） had a high expression level of VEGF-A， and 18 （32.7%） had a high expression level of PD-L1， with significant differences compared with the paracancerous tissue （all P<0.05）. There was a significant difference in tumor location between the groups with different expression levels of HER-2 （P<0.05）； there were significant differences in maximum tumor diameter， degree of tumor differentiation， tumor location， N stage， peripheral organ invasion， and vascular invasion between the groups with different expression levels of VEGF-A （all P<0.05）； there were significant differences in peripheral organ invasion， vascular invasion， and disease stage between the groups with different expression levels of PD-L1 （all P<0.05）. The multivariate Cox analysis showed that preoperative CA19-9 level and HER-2 expression were independent risk factors for overall survival of patients （P<0.05）， and preoperative CA19-9 level， maximum tumor diameter， N stage， VEGF-A， and PD-L1 were independent influencing factors for progression-free survival of patients （P<0.05）. The Kaplan-Meier analysis showed that there were significant differences in overall survival and progression-free survival between the patients with high HER-2 expression and those with low HER-2 expression （P<0.05）. ConclusionHER-2， VEGF-A， and PD-L1 have an important clinical significance for patients with gallbladder cancer and are potential sites for targeted therapy.

Hepatocellular carcinoma （HCC） is one of the most common malignant tumors worldwide， and most patients are in the advanced stage at the time of diagnosis， leading to a poor prognosis and a low survival rate. Traditional treatment methods often have limited efficacy， while gene therapy， as an emerging therapeutic strategy， has shown great potential with numerous challenges. This article mainly introduces the latest advances in the field of gene therapy for HCC and analyzes the key issues that need to be addressed in the future development of this field. Gene therapy has become a research hotspot in HCC due to its advantages of strong targeting， diverse mechanisms of action， and individualized treatment. Although gene therapy is still in the exploratory stage in the treatment of HCC， some preliminary research findings have been achieved. According to the reports in the literature， the combination of gene therapy with other treatment methods， such as chemotherapy and immunotherapy， can improve treatment outcomes and reduce the side effects of monotherapy. With the continuous advances in technology， gene therapy is expected to bring new hope to HCC patients.

Osteosarcoma is the most common malignant bone tumor disease in young children and young people. It usually has strong invasiveness, and conventional treatment cannot achieve the expected results. Therefore, studying the mechanism of tumor cell death and exploring more effective treatment methods is of great significance. As a new form of cell death, ferroptosis has been found to have three main regulatory pathways closely related to tumor cell molecular mechanisms, genes, etc. This provides a theoretical basis for the application of ferroptosis in the treatment of osteosarcoma. This article reviews recent research on the interaction between ferroptosis and osteosarcoma in regulating molecules, genes, and other factors, as well as the application of ferroptosis in the treatment of osteosarcoma.

Purpose To investigate the expression of SMOC2 in papillary thyroid carcinomas(PTC)and its efficacy in joint diagnosis with CK19,Galectin-3,MC and BRAF V600E.Methods Bioinformatics was uesd to analyze the mR-NA expression differences of SMOC2 in PTC and benign thyroid tissues in the Gene Expression Omnibus database and The Canc-er Genome Atlas database.Detection of SMOC2 protein expres-sion in paraffin tissue of 75 cases of PTC and 45 cases of papilla-ry thyroid hyperplasia(PTH)was used by using EnVision meth-od,combined with CK19,Galectin-3,and MC and BRAF V600E for sensitivity and specificity analysis.Results The bioinformatics analysis results showed that the mRNA expression level of SMOC2 in PTC tissue was significantly lower than that in benign thyroid tissue(P<0.05),and the area under the curve(AUC)predicted by SMOC2 for PTC diagnosis was 0.910(P<0.001).The immunohistochemical results showed that the ex-pression of SMOC2 in PTC was significantly lower than that in PTH tissue(P<0.001),and the AUC of SMOC2 for PTC diag-nosis was 0.898(P<0.001).The AUC of SMOC2 combined with CK19,Galectin-3,MC and BRAF V600E in the diagnosis of PTC was 1.000(P<0.001),and the AUC values of the combination of other markers were lower than 1.000.Conclu-sion The expression of SMOC2 in PTC is significantly de-creased,which can be used as an important marker for the diag-nosis and differential diagnosis of PTC.Combined with CK19,Galectin-3,MC and BRAF V600E,the sensitivity and specifici-ty of PTC can be improved to a certain extent.

Exosomes are extracellular microbubbles related to intercellular communication, which have the ability to transport and transfer biological macromolecules. Pain will lead to a sharp decline in the quality of life of patients, and will give patients and society a heavy medical burden. More and more evidences show that the exosomes plays an important role in the pathological process of pain related diseases.Summarizing the exosomes and the biomolecules carried by them under different pain conditions, and identifying the specific exosomes related to the pain state will be helpful for early diagnosis and treatment of pain related diseases. In addition, the ability of exosomes to transmit information and its widespread characteristics in the body indicate that they have broad prospects as a new diagnosis and treatment tool in the field of pain. A better understanding of the relationship between the exosomes and pain will provide a novel and promising treatment for patients with pain.

Objective:To investigate the clinical effect of esophagofundostomy combined with pericardial devascularization in the treatment of upper gastrointestinal hemorrhage caused by portal hypertension.Methods:The clinical data of 108 patients with portal hypertension admitted to the Affiliated Hospital of Inner Mongolia Medical University from Feb 2009 to Feb 2015 were analyzed. Among them 42 patients underwent esophagofundostomy combined with pericardial devascularization as the study group, and 66 patients underwent pericardial devascularization only as the control group. All patients presented with splenomegaly or hypersplenism; the spleen was routinely removed during the operation.Results:The difference of operation time between the study group and the control group was statistically significant [(157±41) min vs. (143±27) min, t=2.81, P<0.05]. The improvement in the esophagogastric varices in the study group within 6 months was significantly better than that in the control group( Z=2.47, P<0.05). In addition, the rebleeding rates of varicose veins within 1, 3 and 5 years in the study group was 2%, 5% and 10%, while that in the control group was 15%, 21% and 26% (χ 2=5.49, 4.27, 4.31, all P<0.05). Conclusions:Esophagofundostomy combined with pericardia devascularization achieves complete devascularization and low rebleeding rate.

Objective:To construct an effective survival nomogram for patients with clear cell renal cell carcinoma (ccRCC) using a large sample sized Chinese dataset, which can be used to predict individual 3- and 5-year overall survival (OS) precisely.Methods:The data of 672 ccRCC patients received operation diagnosed at Xijing Hospital from January 2012 to December 2016 were retrospectively analyzed. There were 467 males and 205 females. Their median age was 56 years old (ranging 23-83 years old). There were 327 patients with tumor on the left kidney and 345 patients with tumor on the right kidney. Clinical stageⅠ, Ⅱ, Ⅲ, Ⅳ were 584, 47, 19 and 22 cases, respectively. At the time of diagnosis, 504 patients were asymptomatic and 168 patients were symptomatic. Preoperative alkaline phosphatase was 80 (41-240) U/L. Preoperative serum albumin was 44.8 (30.5-59.8) g/L. Preoperative neutrophil absolute value/lymphocyte absolute value (NLR) was 2.25 (0.81-9.89). Preoperative platelet count was 205 (82-589)×10 9/L. Preoperative creatinine was 97 (55-230) μmol/L. Radical nephrectomy was performed in 420 (62.5%) patients and partial nephrectomy was performed in 252 patients. Cox multivariate analysis was used to determine the independent predictors of the postoperative OS. Then, the nomogram was constructed using R software, which integrates all independent predictors according to the coefficients in the multivariate analysis. Moreover, the performance of the nomogram was evaluated using the consistency index (C-index) and the calibration plots. Results:Cox multivariate analysis results showed that age at diagnosis ( P<0.001), clinical TNM stage ( P<0.001), preoperative NLR ( P=0.012), preoperative alkaline phosphatase ( P=0.002) and preoperative albumin ( P<0.001) were the independent predictors of postoperative OS in ccRCC patients. The nomogram established by integrating these five factors had a good discriminatory ability (C-index=0.819, 95% CI 0.813-0.825), and the calibration plots showed that excellent agreements between the nomogram prediction and the actual observation were achieved. Conclusions:Based on a large sample sized Chinese dataset, this study established an effective survival model for patients with ccRCC and good performance of the nomogram was demonstrated by internal validation. Our nomogram can help urologists to predict individual 3- and 5-year OS accurately for Chinese ccRCC patients.

Objective: To investigate the independent predictors of inguinal lymph node metastasis (LLM) in patients with penile squamous cell carcinoma (SCCP), and to establish a nomogram for predicting individual LLM risk. Methods: The data of patients with SCCP diagnosed at the department of urology, Xijing Hospital from July 2009 to June 2019 were analyzed retrospectively. A total of 101 patients were included in this study, with age of 55 (26-84) years. There were 25 (24.8%) and 76 (75.2%) patients with and without palpable inguinal lymph node enlargement, respectively. There were 47 cases (46.5%), 40 cases (39.6%) and 14 cases (13.9%) in T₁, T₂ and T₃ stages, respectively; there were 67 cases (66.3%), 21 cases (20.8%) and 13 cases (12.9%) in Broder 1, 2 and 3, respectively. The average value (or median) of fibrinogen was 2.84 (1.72-5.00)g/L; alkaline phosphatase was 80(32±214)U, hemoglobin was 147(81-180)g, platelet count was (193.74±65.68×10⁹/L, absolute value of neutrophils, monocytes and lymphocytes were 3.98(1.19-11.85)×10⁹/L, 0.44(0.17-1.90)×10⁹/L and 1.68(0.58-4.13)×10⁹/L, respectively. The average (or median) value of PLR, NLR and LMR were 113.38(18.80-418.42), 2.42(0.59-10.22) and 3.84 (1.08-9.89), respectively. There were 26 cases (25.7%) with LLM and 75 cases (74.3%) without LLM. The independent predictors of LLM were identified by univariate and multivariate logistic regression analyses. The R software was used to establish the nomogram by integrating all independent predictors, and the bootstrap method was used to internally validated our nomogram, where the value of AUC (area under the ROC curve) was calculated and the calibration plot was drawn. Results: Clinical inguinal lymph node status (P<0.006), T stage (P<0.021), Broder grade (P<0.017) and absolute neutrophil value (P<0.043) were independent predictors of LLM. The accuracy of our nomogram was 0.875 (AUC=0.875, 95%CI 0.859-0.891); Moreover, the risk of LLM predicted by nomogram was in good consistency with the actual LLM rate, and the errors of the nomogram-predicted LLM risks were all within 10%. Conclusions Clinical inguinal lymph node status, T stage, broder grade and absolute value of neutrophils were identified as independent predictors of LLM in patients with SCCP on the basis of single center data. A generic nomogram predicting LLM risk for Chinese patients was developed, which would be helpful to screen SCCP patients who need prophylactic inguinal lymph node dissection.

Objective To understand the current status of medication compliance in the patients with postherpetic neuralgia (PHN)and its influencing factors.Methods The cross-sectional survey method was adopted to investigate the status quo of medi-cation compliance among PHN patients in the pain clinic of the Southwest Hospital of Army Military Medical University from Janu-ary of 2014 to March of 2015.Then the influence factors of medication compliance were analyzed by using the using the Logistic re-gression method.Results A total of 396 PHN patients were included 52.3% of patients had good medication compliance,while 47.7% had poor compliance.The univariate analysis showed that the age,educational level,marital status,living condition,economic status,degree of pain,disease course,medical insurance reimbursement,adverse drug reactions and complicating other diseases were the factors affecting the medication compliance(P<0.05).The multivariate Logistic regression analysis results showed that the age,educational level,marital status,living condition,economic status,degree of pain,disease course,medical insurance reimburse-ment,adverse drug reactions and complicating other diseases were the factors affecting the medication compliance.Conclusion The medication compliance in the patients with PHN is not high,there are many factors affecting the medication compliance.It is recom-mended to carry out the health education,strengthen the psychological intervention of the patients and establish the follow-up medi-cation compliance system for improving the medication compliance.