OBJECTIVES: Peripheral whole blood cell counts have been used as prognostic indicators for various cancers, but their predictive value in nasopharyngeal carcinoma remain unclear. This study aims to evaluate the prognostic significance of the pretreatment hemoglobin×lymphocyte/monocyte ratio (HLMR) in non-recurrent, non-metastatic NPC patients undergoing definitive radiotherapy. METHODS: Clinical and follow-up data from 805 NPC patients who completed definitive radiotherapy or chemoradiotherapy were retrospectively analyzed. Pretreatment hemoglobin, lymphocyte count, and monocyte count were collected to calculate HLMR. Receiver operating characteristic (ROC) curves were used to determine the optimal cut-off value of HLMR. Patients were then classified into high and low HLMR groups. The association between HLMR and clinicopathological characteristic was assessed using chi-square tests. Independent prognostic factors for overall survival (OS) and progression-free survival (PFS) were identified using Cox proportional hazards models. A nomogram was constructed based on the independent predictors to estimate patient survival rates, and internal validation was performed using a validation cohort. RESULTS: The ROC curve identified 605.5 as the optimal HLMR cut-off value for predicting 5-year survival. Multivariate Cox regression analysis revealed that T stage (HR=1.886, 95% CI 1.331 to 2.673, P<0.001), N stage (HR=2.021, 95% CI 1.267 to 3.225, P=0.003), Eastern Cooperative Oncology Group (ECOG) score (HR=3.991, 95% CI 1.257 to 12.677, P=0.019), concurrent chemoradiotherapy regimen (HR=0.338, 95% CI 0.156 to 0.731, P=0.006), and HLMR (HR=0.648, 95% CI 0.460 to 0.912, P=0.013) were independent prognostic factors for OS. A nomogram including T stage, N stage, and HLMR in the training cohort was constructed to predict 3-, 5-, and 7-year OS, with a C-index of 0.713. The area under the curves for predicting 3-, 5-, and 7-year OS were 0.744, 0.665, and 0.682, respectively. Calibration curves showed good agreement between predicted and observed survival rates. The above results were further confirmed in the validation cohort. CONCLUSIONS Pretreatment HLMR may serve as a promising prognostic biomarker for patients with nasopharyngeal carcinoma.
Humans ; Nasopharyngeal Carcinoma/mortality* ; Prognosis ; Hemoglobins/analysis* ; Nasopharyngeal Neoplasms/pathology* ; Monocytes/cytology* ; Female ; Male ; Retrospective Studies ; Middle Aged ; Adult ; Aged ; Nomograms ; Chemoradiotherapy ; ROC Curve

Objective:To explore the rejuvenation effect of SMAS (Superficial musculoaponeurotic system) multi-vector suspension in the face and neck.Methods:From December 2019 to March 2023, the Plastic Surgery Department of the Plastic Surgery Hospital of the Chinese Academy of Medical Sciences implemented 34 cases of cheek rhytidectomy and 10 cases of cheek andneck rhytidectomy. Following general anaesthesia, liposuction is performed on the cheek and mandibular margins, and incisions are made anterior and posterior to the ear. At the end of the subcutaneous dissection, the SMAS in the region of the parotid gland is separated, and the SMAS is then secured by purse string multi-vector suture suspension. Intheend, excess skin is removed and the incision is reduced in tension.Results:All patients underwent successful surgeries and were satisfied with the postoperative follow-up results. The sagging soft tissues were effectively repositioned, resulting in natural facial and neck lift. There were no serious complications such as facial nerve injury, subcutaneous hematoma, incision infection, or skin flap necrosis.Conclusions:The utilization of MAS multi-vector suspension can significantly improve the relaxation of cheek and neck tissue, with fewer complications and satisfactory rejuvenation effect.

Objective To explore the clinical application of irradiated homograft costal cartilage (IHCC) granule transplantation for the pyriform aperture sunken and deformity in the facial contour.Methods From August 2016 to November 2017,a total of 29 female patients were received IHCC transplantation to the face contour.The standardized photos were taken before and after the operation and then survey of patient satisfaction was conducted.Results In a total of 29 patients,the postoperative 21 patients were satisfied with the IHCC transplantation.After the operation,5 cases were slightly highlighted and obvious bundles could be touched in the deep.At the early stage of operation,the cartilage particles were smoothed by means of manipulation.3 cases were not satisfied with full effect postoperatively and satisfied after secondary transplantation.Conclusions The IHCC granule transplantation for pyriform aperture sunken and deformity can increase the overall sense of facial coordination and anti-aging,and is a safe and effective treatment.

Objective: To observe the effect of moxibustion on the expressions of tumor necrosis factor-α (TNF-α) and nuclear transcription factor kappa B (NF-κB) proteins in ankle joints of rats with rheumatoid arthritis (RA), and to explore the anti-inflammatory mechanism of moxibustion in the treatment of RA.Methods: Adjuvant arthritis (AA) rat models were induced and used as rat models of RA. Rats were randomly divided into a normal group, a model group, a moxibustion group and a saline group. Rats in the normal and model groups were not treated; rats in the moxibustion group accepted treatment by moxibustion at Zusanli (ST 36) and Shenshu (BL 23) after modeling; rats in the saline group were injected with 0.15 mL saline to the bottom of the left hind paw and had no other treatments. Hematoxylin-eosin (HE) staining was used to observe the histopathological changes of rats' ankle joints under light microscope. Immunohistochemistry was used to observe the expressions of TNF-α and NF-κB in ankle joints of rats.Results: Compared with the normal group, the rats' ankle joints in the model group showed disorganization, joint surface defect, and significantly increased mean optical density (MOD) of TNF-α and NF-κB (allP<0.05). After moxibustion treatment, rats in the moxibustion group showed repaired ankle tissues, smooth joint surface without defects, decreased MOD of TNF-α and NF-κB than those in the model group (allP<0.05). Rats in the saline group had no damage to ankle joints, while TNF-α and NF-κB were significantly different from those in the model group (P<0.05).Conclusion: Moxibustion could down-regulate the expressions of NF-κB and TNF-α protein in ankle joints of RA rats, and produce an anti-inflammatory effect to promote tissue repair.

Objective Based on the different physiological characteristics of the mastoid skin and soft tissue in congenital microtia malformation ,the different ear reconstructivemethod were respectively applied for the individuals with microtia .And the feasibility of personalized treatment to microtia patients was explored in this study .Method Considering different thickness and tightness in mastoid hairless skin and soft tissue,2129 microtia patients were received the skin expansionmethod of ear reconstruction surgery , while 1321 cases were treated with Nagata ' s technique, and 330 cases with skin and fascia expansionmethod . Result With average 10-month follow-up,1944 ( 91.31％) cases using the mastoid skin expansionmethod were satisfied with the outcome of the reconstructed ear including three dimensional position and subunit appearance.305(92.42％)cases using the skin and fascia expansionmethod were satisfied with theresult .1264 (95.69％) cases using Nagata ' s two—stagemethod received satisfactory outcomes .49 ( 3.71％) cases showed partial exposure of the cartilage framework .There were no postoperative complications , such as chest wall deformity or affected normal physical function .Conclusion Based on the different physiological characteristics of the mastoid skin and soft tissue ,it's beneficial to select individualized operationalmethod in ear reconstruction for congenital microtia among Chinese patients .

Objective Based on the different physiological characteristics of the mastoid skin and soft tissue in congenital microtia malformation ,the different ear reconstructivemethod were respectively applied for the individuals with microtia .And the feasibility of personalized treatment to microtia patients was explored in this study .Method Considering different thickness and tightness in mastoid hairless skin and soft tissue,2129 microtia patients were received the skin expansionmethod of ear reconstruction surgery , while 1321 cases were treated with Nagata ' s technique, and 330 cases with skin and fascia expansionmethod . Result With average 10-month follow-up,1944 ( 91.31％) cases using the mastoid skin expansionmethod were satisfied with the outcome of the reconstructed ear including three dimensional position and subunit appearance.305(92.42％)cases using the skin and fascia expansionmethod were satisfied with theresult .1264 (95.69％) cases using Nagata ' s two—stagemethod received satisfactory outcomes .49 ( 3.71％) cases showed partial exposure of the cartilage framework .There were no postoperative complications , such as chest wall deformity or affected normal physical function .Conclusion Based on the different physiological characteristics of the mastoid skin and soft tissue ,it's beneficial to select individualized operationalmethod in ear reconstruction for congenital microtia among Chinese patients .

Objective: To analyze the risk factors of acute kidney injury (AKI) after isolated heart valve prosthesis implantation (HVPI) in relevant patients. Methods: We retrospectively studied 400 patients who received isolated HVPI in our hospital. The demographic characteristics and pre-, intra-, post-operative information were collected to conduct uni- and multi-variantanalysis. Results: The pre-operative serum creatinine level in 400 patients was 85.0 (72.0, 98.0) μmol/L and post-operative level was 104.5 (80.0, 146.3) μmol/L, the elevation was 20.9% (1.6%, 57.9%),P<0.05. Multi Logistic regression analysis indicated that age>50years (OR=2.12, 95% CI 1.13-3.95),hypertension history (OR=4.07, 95% CI1.23-13.47), cardiopulmonary bypass time>180 minutes (OR=5.38, 95% CI 1.63-17.77), post-operative hemoglobin<70 g/L (OR=0.20, 95% CI 0.06=0.74), serum glutamic-pyruvic transaminase>100 u/L (OR=12.10, 95% CI 2.28-64.23), pleural fluid drainage at the day of operation> 500 ml (OR=2.12, 95% CI 1.13-3.95), extubation after 24 hours of operation (OR=3.94, 95% CI 2.07-7.52), combining low cardiac output syndrome (OR=4.64, 95% CI 1.06-20.29) were the independent risk factors for AKI occurrence in patients after HVPI, allP<0.05. Conclusion: Post-HVPI AKI was associated with many factors. At prior operation, it was mainly related to the age and hypertension; during theoperation, it was mainly related to cardiopulmonary bypass time; at post-operation, it was mainly related to delayed extubation, low cardiac outputsyndrome, anemia, increased pleural lfuid drainage and serum glutamic-pyruvic transaminase.

OBJECTIVE: To analyze the impact of β-tubulin-III (TUBB3), thymidylate synthase (TS) and excision repair cross complementation group 1 (ERCC1) mRNA expression on chemoresponse and clinical outcome of patients with advanced gastric cancer treated with TXT/CDDP/FU (DCF) regimen chemotherapy. METHODS: The study population consisted of 48 patients with advanced gastric cancer. All patients were treated with DCF regimen palliative chemotherapy. The mRNA expressions of TUBB3, TS and ERCC1 of primary tumors were examined by multiplex branched-DNA liquid chip technology. RESULTS: The patients with low TUBB3 mRNA expression had higher response rate to chemotherapy than patients with high TUBB3 expression (P=0.011). There were no significant differences between response rate and TS or ERCC1 expression pattern. Median overall survival (OS) and median time to progression (TTP) were significantly longer in patients with low TUBB3 mRNA expression (P=0.002, P<0.001). TS or ERCC1 expression was not correlated with TTP and OS. In the combined analysis including TUBB3, TS and ERCC1, the patients with 0 or 1 high expression gene had better response rate, TTP and OS than the remaining patients (all P<0.001). Multivariate analysis revealed that ECOG (Eastern Cooperative Oncology Group)≥2 (HR=2.42, P=0.009) and TUBB3 (HR=2.34, P=0.036) mRNA expression significantly impacted on OS. CONCLUSION High TUBB3 mRNA expression is correlated with resistance to DCF regimen chemotherapy. TUBB3 might be a predictive and prognostic factor in patients with advanced gastric cancer treated with TXT-based chemotherapy. The combined evaluation of TUBB3, TS and ERCC1 expression can promote the individual treatment in advanced gastric cancer.
Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Biomarkers, Tumor ; metabolism ; DNA-Binding Proteins ; genetics ; metabolism ; Drug Resistance, Neoplasm ; Endonucleases ; genetics ; metabolism ; Humans ; RNA, Messenger ; genetics ; metabolism ; Stomach Neoplasms ; drug therapy ; genetics ; Thymidylate Synthase ; genetics ; metabolism ; Treatment Outcome ; Tubulin ; genetics ; metabolism

ObjectiveTo explore a procedure to correct the multiple facial deformities by using the expanded frontal flap combined with the axial flaps.MethodsAccording to the face deformity we used the rectangle 100-350 ml expanders behind the frontal hairline,after finishing the tissue expanding,adopted two or three axial flaps based on the supraoribital,supratrochlear or temporal vessels. ResultsA total of 13 cases were treated with this approach.7 eases were nose and lip defect reconstruction after burn,in which temporal vessel-based flap was used in 2 cases and supraoribital or supratrochlear vessel-based flaps in 5 cases.The other 6 cases were nasal reconstruction combined with the frontal defect correction by using random flaps,including 2 cases of pigmented nevus,1 neurofibroma,and 3 burn scars.All the flaps survived and satisfactory appearance was obtained.Conclusions The expanded frontal flap combined with axial flap based on multiple vessels is a good approach to correct the multiple facial deformities.

Objective To study the efficacy of radical surgery for the invasion of chest wall by lung cancers and the different methods of chest wall reconstruction. Methods A retrospective analysis of clinical data was conducted in 27 cases of lung cancer with chest wall invasion in this hospital. 24 cases received lobectomy, 3 cases received pneumonectomy, and all cases received wall reconstruction. The size of chest wall defect after resection ranged from 6.5 cm × 5.4 cm × 5.0 cm to 15.5 cm × 12.5 cm ×10.0 cm. The number of rib resection for each patient ranged from 1 to 4. The reconstructive methods were as follows: using polyester fabric to reconstruct costal pleura, using plexiglass, stainless steel wire and grid-like titanium plate to reconstruct bone defect, and using nearby muscle flap and pedunculated muscle flap to reconstruct muscle defect. Results Pathologic diagnosis was non-small cell lung cancer,including 22 cases of squamous cell carcinomas and 5 adenocarcinomas. There were pulmonary infections in 6 cases, chest hemorrhage in 1 case and chest purulence in 1 case. One-year survival was 77. 9 %,3-yearsurvival was 58.3 %, and 5-year survival was 29. 1 %. Conclusion The lung cancer with chest wall invasion is advisable to make active use of radical surgery. The different methods and repair materials are chosen to reconstruct the chest wall defect, supplemented by comprehensive treatments.