Objective: To explore the relationship between nuclear factor-kappa B subunit 1 (NFKB1) and LIM-homeobox gene 2 (LHX2) polymorphisms and esophageal cancer susceptibility, so as to provide the reference for the prevention and treatment of esophageal cancer. Methods: A total of 100 patients with primary esophageal cancer diagnosed at the Affiliated Tumor Hospital of Xinjiang Medical University from 2019 to 2023 were selected as the case group, and 100 healthy individuals undergoing physical examination during the same period of time were selected as the control group. Demographic information, disease history and lifestyle data were collected through questionnaire surveys. The single nucleotide polymorphisms at the rs28362491 and rs4648068 loci of NFKB1 gene as well as rs10760310 and rs10121751 loci of LHX2 gene were detected using multiplex high-temperature ligase detection reaction technology. The relationship between these loci and esophageal cancer susceptibility were analyzed using a multivariable conditional logistic regression, linkage disequilibrium and haplotype analysis. The impact of the interaction between the above-mentioned loci and environmental factors on esophageal cancer susceptibility using the generalized multifactor dimensionality reduction (GMDR) method. Results: The case group comprised 73 males and 27 females, with a mean age of (64.02±8.90) years. The control group included 73 males and 27 females, with a mean age of (64.54±9.43) years. The genotype distributions of rs28362491, rs4648068, rs10760310 and rs10121751, loci in both groups conformed to Hardy-Weinberg equilibrium (all P>0.05). Multivariable conditional logistic regression analysis showed that rs10760310 and rs10121751 loci of LHX2 gene were associated with the esophageal cancer susceptibility (both P<0.05). The overdominant model of rs10760310 loci of LHX2 gene had the lowest Akaike information criterion value (OR=0.22, 95%CI: 0.10-0.47). GAA haplotypes at rs4648068, rs10760310 and rs10121751 loci were associated with a lower risk of esophageal cancer susceptibility (OR=0.26, 95%CI: 0.13-0.50). GMDR analysis revealed a statistically significant interaction between rs10760310 loci and smoking on esophageal cancer susceptibility (P<0.05, cross-validation consistency coefficient: 10/10). Conclusion The rs10760310 and rs10121751 loci polymorphisms of LHX2 gene may be associated with esophageal cancer susceptibility, and there is an interaction between rs10760310 loci and smoking on the esophageal cancer susceptibility.

Objective To analyze the evaluation value of the standard deviation of erythrocyte volume distribution width(RDW-SD),erythrocyte volume distribution width standard deviation and platelet ratio(RPR)and erythrocyte volume distribution width standard deviation and lymphocyte ratio(RLR)in the de-compensation stage of cirrhosis in primary biliary cholangitis(PBC).Methods The blood routine indexes of 68 patients with PBC admitted and treated in this hospital from January 2019 to June 2021 were retrospective-ly analyzed and divided into the compensation stage(n=36)and decompensation stage(n=32)according to the diagnostic standard.2 mL venous blood was extracted from the patient on an empty stomach in the early morning.The red blood cell(RBC),mean corpuscular volume(MCV),hemoglobin(Hb),hematocrit(HCT),mean erythrocyte hemoglobin content(MCHC),RDW-SD,white blood cell(WBC),neutrophil absolute value(N#),lymphocyte absolute value(L#),platelet count(PLT),mean platelet volume(MPV),platelet volume distribution width(PDW),etc.were detected.The platelet to lymphocyte ratio(PLR),RPR and RLR were calculated.The influencing factors of decompensation stage of PBC cirrhosis were analyzed by binary logistic regression,and the receiver operating characteristic(ROC)curve was used to analyze the diagnostic values of different indicators in the decompensation stage of PBC cirrhosis.Results There were statistically significant differences in age,RBC,Hb,HCT,RDW-SD,L #,PLT,RPR and RLR between the compensation group and decompensation group in PBC cirrhosis(P＜0.05).The binary logistic regression analysis showed that the age[odds ratios(OR)=1.087,95％confidence intervals(CI):1.015-1.165,P＜0.05],RDW-SD(OR=1.144,95％CI:1.030-1.270,P＜0.05)and RLR(OR=1.041,95％CI:1.007-1.075,P＜0.05)were the independent risk factors for progressing to the decompensation stage in the patients with PBC cirrhosis com-pensation stage.The ROC curve analysis showed that the areas under ROC curve(AUC)of RDW-SD,RPR and RLR for the diagnosis alone of decompensation stage of PBC cirrhosis were 0.726,0.778 and 0.798,re-spectively,and the differences were not statistically significant(P＞0.05).Conclusion Combined with the age factor,regular monitoring of RDW-SD,RPR and RLR levels has a high predictive value for the develop-ment of PBC cirrhosis compensation stage to decompensation stage.

Objective:To investigate the mortality burden among permanent residents in Shenzhen from 2014 to 2021 and to provide scientific evidence for establishing precision disease prevention and control strategy.Methods:Based on the cause-of-death surveillance data, we described the distribution of mortality rate, cause-specific rankings, and years of life lost (YLL) for the total population and subgroups in Shenzhen from 2014 to 2021. The seventh national population census data was used as the standard population to calculate the standardized mortality rate. Joinpoint log-linear regression model was used to analyze the chronic trend of mortality burden.Results:From 2014 to 2021, 49 734 deaths among the permanent population were recorded in Shenzhen, with a 140.90/100 000 average crude mortality rate, standardized as 366.77/100 000. Both the crude mortality rate and standardized mortality rate showed fluctuating increases from 2014 to 2016 [annual percent change (APC)=20.72%, P=0.048, APC=28.59%, P=0.016] and fluctuating decreases from 2016 to 2021 (APC=-1.55%, P=0.317, APC=-1.89%, P=0.190). The mortality rates of the <20 and 20- age groups decreased over time, with a statistically significant decrease observed in the <20 age group [average annual percent change (AAPC)=-11.91%, P<0.001]. The mortality rates of the 40-, 60-, and ≥80 age groups increased over time, with an increase observed in the ≥80 age group from 2014 to 2016 (APC=45.25%, P=0.016) and a decrease from 2016 to 2021 (APC=-2.18%, P=0.280). There was no statistical significance in the mortality rate trend for the remaining age groups (all P>0.05). The top three causes of death among permanent residents in Shenzhen from 2014 to 2021 were consistently malignant tumors, cardiovascular and cerebrovascular diseases, and respiratory system diseases, with crude mortality rates of 49.59/100 000, 47.95/100 000, and 7.90/100 000 respectively in 2021. From 2014 to 2021, 1 003 287.43 YLL were observed, with YLL for the total population, males and females all showing an upward trend (all P<0.001). Conclusions:The mortality burden among the elderly permanent residents in Shenzhen displayed a continuously increasing trend from 2014 to 2021. Strengthening the need for substantial efforts and actions to improve the prevention and control of chronic non-communicable diseases.

Objective:To analyze the disease burden in middle-aged and elderly population aged ≥55 in Shenzhen from 2016 to 2030 and provide evidence for the development of healthy aging strategies.Methods:The years of life lost (YLL), years lost due to disability (YLD), and the disability-adjusted life year (DALY) in this population from 2016 to 2022 were calculated. Joinpoint log-linear regression model was used to analyze the time trend. Bayesian age-period-cohort model and grey system model were used to predict YLL, YLD, and DALY in this population in 2030.Results:From 2016 to 2022, the crude DALY rate showed a transient fluctuation in age group 55-74 years, but a pronounced increase in age group ≥85 years. The proportions of YLL and YLD due to non-communicable diseases in all age groups was considerably higher than those due to communicable and nutritional diseases and injuries. In 2022, in all age groups, the YLL due to neoplasms (55-74 years old) and cardiovascular disease (≥75 years old) ranked first, and the YLD due to musculoskeletal disorder ranked first. By 2030, the causes of YLL and YLD ranking first in each age group would be remained, while the ranks of some causes would increase.Conclusions:The age specific characteristics of current and predicted disease burden differed in individuals aged ≥55 years. Therefore, it is necessary to allocate social and medical resources according to the disease burden pattern.

Retroperitoneal liposarcoma is the most common retroperitoneal soft tissue tumor with insidious onset, difficulty in treatment, and easy recurrence. Different subtypes of retroperitoneal liposarcoma differ significantly in pathogenic mechanism, biological behavior, and prognosis. The characteristic molecular event of well-differentiated and dedifferentiated liposarcoma is the amplification of the long arm segment of chromosome 12. The genome of myxoid liposarcoma is characterized by translocations of chromosomes 12 and 16 to form fusion genes. The genomic changes of pleomorphic and myxoid pleomorphic liposarcoma are complex, with multiple chromosomal structural abnormalities. Several signaling pathways related to adipocyte differentiation or lipid metabolism have been found to be involved in the initiation and progression of retroperitoneal liposarcoma. It is unclear whether retroperitoneal liposarcoma originates from naive preadipocytes or dedifferentiated mature adipocytes, and its metabolic characteristics are also poorly understood. The first-line drug treatment for retroperitoneal liposarcoma is anthracycline-based chemotherapy, but patients receive little benefit. Therefore, it is urgent to strengthen the basic research on retroperitoneal liposarcoma to find effective therapeutic targets.

Retroperitoneal liposarcoma is the most common retroperitoneal soft tissue tumor with insidious onset, difficulty in treatment, and easy recurrence. Different subtypes of retroperitoneal liposarcoma differ significantly in pathogenic mechanism, biological behavior, and prognosis. The characteristic molecular event of well-differentiated and dedifferentiated liposarcoma is the amplification of the long arm segment of chromosome 12. The genome of myxoid liposarcoma is characterized by translocations of chromosomes 12 and 16 to form fusion genes. The genomic changes of pleomorphic and myxoid pleomorphic liposarcoma are complex, with multiple chromosomal structural abnormalities. Several signaling pathways related to adipocyte differentiation or lipid metabolism have been found to be involved in the initiation and progression of retroperitoneal liposarcoma. It is unclear whether retroperitoneal liposarcoma originates from naive preadipocytes or dedifferentiated mature adipocytes, and its metabolic characteristics are also poorly understood. The first-line drug treatment for retroperitoneal liposarcoma is anthracycline-based chemotherapy, but patients receive little benefit. Therefore, it is urgent to strengthen the basic research on retroperitoneal liposarcoma to find effective therapeutic targets.

Biliary tract cancers (BTC), a heterogeneous disease with poor prognosis, including gallbladder cancer (GBC), intrahepatic cholangiocarcinoma (ICC), and extrahepatic cholangiocarcinoma (ECC). Although surgery is currently the primary regimen to treat BTC, most BTC patients are diagnosed at an advanced stage and miss the opportunity of surgical eradication. As a result, non-surgical therapy serves as the main intervention for advanced BTC. In recent years, immunotherapy has emerged as one of the most promising therapies in a number of solid cancers, and it includes immune checkpoint inhibitors (ICIs) monotherapy or combined therapy, tumor vaccines, oncolytic virus immunotherapy, adoptive cell therapy (ACT), and cytokine therapy. However, these therapies have been practiced in limited clinical settings in patients with BTC. In this review, we focus on the discussion of latest advances of immunotherapy in BTC and update the progress of multiple current clinical trials with different immunotherapies.

Background::Biliary tract carcinoma (BTC) is relatively rare and comprises a spectrum of invasive tumors arising from the biliary tree. The prognosis is extremely poor. The incidence of BTC is relatively high in Asian countries, and a high number of cases are diagnosed annually in China owing to the large population. Therefore, it is necessary to clarify the epidemiology and high-risk factors for BTC in China. The signs associated with BTC are complex, often require collaborative treatment from surgeons, endoscopists, oncologists, and radiation therapists. Thus, it is necessary to develop a comprehensive Chinese guideline for BTC.Methods::This clinical practice guideline (CPG) was developed following the process recommended by the World Health Organization. The Grading of Recommendations Assessment, Development, and Evaluation approach was used to assess the certainty of evidence and make recommendations. The full CPG report was reviewed by external guideline methodologists and clinicians with no direct involvement in the development of this CPG. Two guideline reporting checklists have been adhered to: Appraisal of Guidelines for Research and Evaluation (AGREE) and Reporting Items for practice Guidelines in Healthcare (RIGHT).Results::The guideline development group, which comprised 85 multidisciplinary clinical experts across China. After a controversies conference, 17 clinical questions concerning the prevention, diagnosis, and treatment of BTC were proposed. Additionally, detailed descriptions of the surgical principles, perioperative management, chemotherapy, immunotherapy, targeted therapy, radiotherapy, and endoscopic management were proposed.Conclusions::The guideline development group created a comprehensive Chinese guideline for the diagnosis and treatment of BTC, covering various aspects of epidemiology, diagnosis, and treatment. The 17 clinical questions have important reference value for the management of BTC.

Objective To observe the clinical efficacy of Redo-Bentall surgery in the reoperation of aortic root lesions.Methods A retrospective analysis was performed on 46 patients who underwent Redo-Bentall surgery for aortic root lesions in our department from June 2010 to April 2022.They were 35 males and 11 females,at a mean age of 43.37±12.79 years,in 4.96±6.76 years since the last operation.General clinical data in perioperative period and during follow-up were collected and analyzed.Kaplan-Meier survival analysis was used to compare the survival rates of each etiological group.Results There were 9 cases of central end otitis,12 cases of Behset's disease,and 25 cases of other causes.After operation,4 cases(8.70％)experienced cardiac arrest,4 cases(8.70％)renal failure,2 cases(4.35％)gastrointestinal bleeding,2 cases(4.35％)new third-degree atrioventricular block and 2 cases(4.35％)permanent pacemaker placement.In perioperative period,3 cases(6.52％)died in hospital.During a mean follow-up of 5.03±3.27 years after discharge,5 cases(11.63％)were lost to follow-up,1 case died(2.33％),1 case had lacunar infarction(2.33％),and no severe bleeding or embolism complications was observed in the rest patients.The long-term survival rate was significantly lower in the endocarditis group(62.3％)and the Behcet's disease group(70％)than the other etiological groups(80％,P＜0.05).Conclusion The application of Redo-Bentall in the reoperation of aortic root lesions is safe and effective,but the survival rate is quite lower in the patients with infective endocarditis and Behcet's disease.

Objective To evaluate the effect of remimazolam for general anesthesia on cellular im-mune function and quality of postoperative recovery in patients undergoing laparoscopic radical surgery for colorectal cancer.Methods Sixty patients undergoing laparoscopic radical surgery for colorectal cancer,36 males and 24 females,aged 18-80 years,BMI 18.5-28.0 kg/m2,ASA physical status Ⅰ or Ⅱ,were en-rolled in this study.The patients were divided into remimazolam group(group R)and propofol group(group P)by using a random number,with 30 patients in each group.Induction of anesthesia was as follows:remimazolam at a dose of 0.2-0.3 mg/kg was intravenously infused(intravenous injection time>1 minute)in group R,propofol at a dose of 1.0-2.0 mg/kg was intravenously infused in group P,and sufen-tanil at a dose of 0.3-0.5 μg/kg and cisatracurium at a dose of 0.15-0.2 mg/kg were intravenously in-fused injected after the patients consciousness disappeared,that is the modified observer's assessment of alertness/sedation score of 1-2 in two groups to complete tracheal intubation.Anesthesia maintenance was as follows:remimazolam at a dose of 1.0-2.0 mg·kg-1·h-1 was intravenously infused in group R,propo-fol at a dose of 4.0-12.0 mg·kg-1·h-1 was intravenously infused in group P,remifentanil at a dose of 0.1-0.2 μg·kg-1·min-1 was intravenously infused in two groups,and intravenous cisatracurium was in-jected intermittently to maintain the BIS value at 40-60 intraoperatively.The two groups percentage of CD3+,CD4+,CD8+T lymphocytes,natural killer cell and CD4+/CD8+ratio were collected before induction of anesthesia,at immediately after the end of the surgery,and 24,72 hours after surgery.The HR,MAP,percutaneous oxygen saturation,and bispectral index were collected before induction of anesthesia,immedi-ately after endotracheal intubation,immediately after surgical incision,immediately after endotracheal extu-bation.The incidence of intraoperative adverse cardiovascular events and utilization rate of vasoactive drugs were collected.The quality of recovery-15(QoR-15)scores before induction of anesthesia,and 24,72 hours after surgery were recorded.The Riker and Ramsay scores at awakening,emergence time,tracheal ex-tubation time,duration of post-anesthesia care unit(PACU)stay,first postoperative expiration time,and postoperative length of hospital stay were recorded.And the incidence of nausea,vomiting and sleepiness in the postoperative period of 24 hours were collected.Results Compared with group P,group R had signifi-cantly higher NK,CD3+,and CD4+cells immediately after the end of the surgery and 24 hours after surgery(P<0.05),significantly faster HR and higher MAP immediately after the end of the surgery(P<0.05),significantly lower incidence of intraoperative hypotension,bradycardia and the utilization rate of vasoactive drugs(P<0.05),and significantly higher QoR-15 scores 24,72 hours after surgery(P<0.05).There were no significant differences in the Riker and Ramsay scores between the two groups.Conclusion Com-pared with propofol,general anesthesia with remimazolam has less impact on the perioperative cellular im-mune function in patients undergoing laparoscopic radical surgery for colorectal cancer,with lower incidence of intraoperative hypotension and bradycardia,and higher quality of postoperative recovery.