Objective To investigate the clinical value of tumor-stroma ratio (TSR) in combination with KRAS, BRAF, NRAS, and microsatellite status for prognostic assessment of patients with colorectal cancer. Methods A total of 51 colorectal cancer cases meeting the inclusion and exclusion criteria were enrolled in this study. TSR levels were evaluated through optical microscopy. The KRAS/NRAS/BRAF mutation profiles and microsatellite status were determined in accordance with genetic testing results. Clinical data, pathological characteristics, and survival outcomes were systematically recorded. Results Among the 51 patients with colorectal cancer, 19 (37.3%) were categorized into the low stromal group and 32 (62.7%) into the high stromal group. Statistically significant differences were observed between the two groups in drug resistance, M stage, TNM stage, neural invasion, and microsatellite status (P<0.05). Compared with patients exhibiting high TSR, those with low TSR demonstrated significantly increased recurrence rates (5 vs. 21 cases, P=0.007), shortened disease-free survival (34.21 vs. 14.34 months, P=0.001), and reduced overall survival (38.79 vs. 23.09 months, P=0.021). Multivariate Cox regression analysis identified N stage, M stage, TNM stage, neural invasion, lymphovascular invasion, and TSR as independent risk factors for disease-free survival. N stage, M stage, neural invasion, lymphovascular invasion, and TSR emerged as independent prognostic factors for overall survival (P<0.05). Although the combined models of TSR with KRAS, NRAS, BRAF, and microsatellite status, respectively, demonstrated overall statistical significance (P<0.05), none of the dummy variables in these models reached individually statistical significance (P>0.05), and therefore cannot be considered independent prognostic factors. Conclusion TSR serves as an independent predictor of poor prognosis in advanced colorectal cancer, with patients exhibiting low TSR demonstrating a significantly higher risk of recurrence and metastasis than those with high TSR. For patients with colon cancer undergoing first-line palliative chemotherapy after postoperative recurrence, histopathological assessment of TSR in primary tumor sites holds prognostic value and may serve as a relevant factor for evaluating treatment resistance in clinical management.

ObjectiveBy starting with the combination of Os Draconis， Bupleuri Radix， and Ostreae Concha， the role of mineral medicine Os Draconis in the combination of the Bupleuri Radix-containing tri-herbal medicines was preliminarily explored from the perspective of supramolecular system formation. Method① The appearance and Tyndall phenomenon of single decoction of Os Draconis， Bupleuri Radix， and Ostreae Concha， as well as co-decoction of Bupleuri Radix-Os Draconis， Bupleuri Radix-Os Draconis-Ostreae Concha， and Bupleuri Radix-Ostreae Concha were observed， and the average particle size， dispersion coefficient， and Zeta potential of suspension particles in each decoction were determined. The micromorphology of supramolecular structures was observed by scanning electron microscope （SEM）. ② The pH of different compatibility systems， liquid viscosity coefficient， liquid surface tension， freeze-dried powder yield rate， and other physical properties were determined， and the interaction of different compatibility systems was detected by infrared absorption spectroscopy （FTIR） and UV-visible spectrophotometry （UV-Vis）. ③ The composition and content difference of different compatible systems were determined by high-performance liquid chromatography （HPLC） and ultra-performance liquid chromatography-quadrupole-time of flight mass spectrometry （UPLC-Q-TOF-MS）. ResultCompared with the single decoction， the co-decoction had more obvious turbidity and Tyndall phenomenon. The particles in the co-decoction suspension were smaller and more evenly distributed， and the Zeta potential was reduced， indicating a more stable system. Under SEM， Bupleuri Radix was irregularly lamellar， and Bupleuri Radix-Os Draconis and Bupleuri Radix-Os Draconis-Ostreae Concha were mainly spherical nanoparticles. Bupleuri Radix-Ostreae Concha was irregularly lamellar， with a small number of spherical nanoparticles. The pH of the single decoction of Bupleuri Radix and co-decoction increased， and the viscosity coefficient increased. The liquid surface tension decreased. The freeze-dried powder yield rate of the Bupleuri Radix-Os Draconis co-decoction was the highest， followed by Bupleuri Radix-Ostreae Concha decoction and Bupleuri Radix-Os Draconis-Ostreae Concha decoction， and the yield rate of Bupleuri Radix single decoction was the lowest. The main change of FTIR was the stretching vibration of -OH， and the co-decoction moved to the low-frequency direction obviously. UV-Vis showed that the maximum absorption occurred at 295.8 nm for all groups， and the absorption intensity was different （Bupleuri Radix-Os Draconis>Bupleuri Radix-Os Draconis-Ostreae Concha>Bupleuri Radix-Ostreae Concha>Bupleuri Radix）. The components of Bupleuri Radix were used as the indexes， and the content of methanol extract determined by HPLC was higher than that of water extract， and the components of Bupleuri Radix single decoction were mainly saikosaponin a （SSa） and saikosaponin c （SSc）， which were slightly higher after co-decoction compatibility. UPLC-Q-TOF-MS could identify 37 compounds in both single decoction and co-decoction. ConclusionThe combination of Bupleuri Radix， Os Draconis， and Ostreae Concha can form a smaller， more uniform， and stable nano-sized supramolecular system， which is conducive to the dissolution of the main components of Bupleuri Radix， and the Os Draconis contributes the most in this process.

Objective To evaluate the risk of cardiac adverse events in patients with malignant tumors after chemotherapy by using a combination of acoustic cardiography and blood indices.Methods A total of 171 patients with malignant tumor who received chemotherapy were included.They were divided into cardiac adverse event group and non-cardiac adverse event group in accordance with whether cardiac adverse events occurred after chemotherapy.The general data,blood indices before chemotherapy,and acoustic cardiography-related indices in the early stage(1-3 cycles)of chemotherapy of the two groups were analyzed.The possible influencing factors were determined by binary logistic regression analysis,and the nomogram was drawn.The receiver operating characteristic(ROC)curve was used to evaluate the prediction ability of the nomogram.Results Cardiac adverse events occurred in 44 of 171 patients with malignant tumors after chemotherapy,and the incidence of cardiac adverse events was 25.73%.Binary logistic regression results showed that age,red blood cell distribution width(RDW)before chemotherapy,activated partial throm-boplastin time(APTT),and electromechanical activation time(EMAT)at the early stage of chemother-apy were independent predictors of cardiac adverse events in chemotherapy patients.The area under the ROC curve of the nomogram was 0.768(95%CI:0.693-0.843,P<0.001).Conclusion A nomogram based on age,pre-chemotherapy RDW,APTT,and EMAT at the early stage of chemotherapy is useful for early assessment of the risk of cardiac adverse events in chemotherapy patients.

Objective To analyze the diagnostic efficacy of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) combined with diffusion-weighted imaging (DWI) in prostate cancer (PCa). Methods A total of 94 patients with prostate diseases were selected as study subjects, and divided into PCa group (n=41) and benign prostatic hyperplasia (BPH) group (n=53). The general information of the two groups was compared. The diagnostic efficacy of DCE-MRI and DWI examination parameters in PCa and their correlation with serum prostate-specific antigen (PSA) were analyzed. Results There were statistically significant differences in total prostate-specific antigen (tPSA), free prostate-specific antigen (fPSA)/tPSA, prostate volume (V), prostate-specific antigen density (PSAD), plasma volume fraction (V_p), reflux rate constant (K_ep), volume transfer constant (K^trans), extracellular extravascular volume fraction (V_e) and apparent diffusion coefficient (ADC) between the two groups (P < 0.05). The area under the curve for the combined prediction of PCa using DCE-MRI and DWI examination parameters was 0.924, which was greater than that for individual predictors or the combination of DCE-MRI examination parameters. K^trans, K_ep and V_e were positively correlated with tPSA and negatively correlated with fPSA/tPSA, while V_p and ADC were negatively correlated with tPSA and positively correlated with fPSA/tPSA (P < 0.05). Conclusion The combination of DCE-MRI and DWI has high diagnostic value for predicting PCa, and K^trans, K_ep, V_e, V_p and ADC have certain correlations with tPSA and fPSA/tPSA.

Objective The aim is to establish a new analytical method of relationship between injury and disease in forensic clinical identification of post-traumatic tooth loss.Methods 25 cases of post-traumatic tooth loss were collected.The main factors that affect the judgment of the relationship between injury and disease were selected and weighted.And the method was verified by 18 case from CNKI.Results A total of five indicators were selected and weighted,including the missing mode,the root number of missing teeth,the fracture of alveolar bone,the damage of soft tissue and the degree of periodontal disease.The interval of the score is used to determine the results of relationship between injury and disease.Conclusion The method is accuracy and acceptable,and can be used to evaluate the relationship between injury and disease of post-traumatic tooth loss.

Objective:To evaluate the fixation with a locking fibular intramedullary nail for treatment of extra-articular distal tibial fracture complicated with fibular fracture (AO/OTA 43A).Methods:A retrospective study was conducted to analyze the data of 31 patients who had been treated by fixation with a locking fibular intramedullary nail for extra-articular distal tibial fracture complicated with fibular fracture at Department of Orthopaedics, The 909th Hospital of Joint Logistics Support Force between January 2018 and December 2021. There were 20 males and 11 females; (41.5±15.7) years in age; AO classification of the distal tibial fractures: 10 cases of type 43A1, 10 cases of type 43A2, and 11 cases of type 43A3; 11 open fractures and 20 closed fractures. Fracture healing, fibular alignment, tibiotalar angle, and incidence of complications were regularly followed up and recorded after surgery. At the last follow-up, the ankle joint function was assessed using the Olerud Molander ankle score (OMAS) and the ankle-hindfoot score of American Orthopaedic Foot and Ankle Society (AOFAS).Results:All the 31 patients were followed up for (17.5±3.3) months after surgery. All of them achieved fine fracture union. The union time was (3.9±0.8) months for tibial fractures, and (3.6±0.9) months for fibular fractures. No internal fixation failure was observed. The last follow-up revealed the following: the fibular alignment was 1.8°±1.3° and the ankle tibiotalar angle 9.1°±2.3°; no fibular rotation, shortening, or separation displacement happened; the OMAS score was (88.3±6.2) points, and the AOFAS ankle-hindfoot score (87.4±6.0) points. Two patients required removal of the distal locking screw of the fibular intramedullary nail due to soreness around the lateral malleolus caused by screw loosening. There were no other related complications.Conclusion:Fixation with a locking fibular intramedullary nail is an effective treatment for extra-articular distal tibial fracture complicated with fibular fracture, demonstrating advantages of firm fixation, limited complications, minimal trauma and soft tissue irritation, and good clinical efficacy.

OBJECTIVE: To investigate the effectiveness of compression screw combined with Buttress plate through direct axillary approach for Ideberg typeⅡ scapular glenoid fractures. METHODS: A retrospective analysis was conducted on 11 patients with Ideberg type Ⅱ scapular glenoid fractures treated with compression screws combined with Buttress plate fixation through the direct axillary approach between January 2014 and June 2022. There were 7 males and 4 females, aged from 34 to 75 years, with an average of 56.0 years. The causes of injury included 4 cases of falling from height injury, 4 cases of heavy object injury, and 3 cases of traffic accident injury. The time from injury to operation was 2-5 days, with an average of 3.8 days. The operation time, intraoperative blood loss, hospital stay, complications, and fracture healing time were recorded. The Constant-Murley score, American Society of Shoulder and Elbow Surgeons (ASES) score, and shoulder joint flexion, abduction, external rotation (neutral position), and internal rotation (neutral position) range of motion were used to evaluate shoulder joint pain and function. RESULTS: The operation time was 45-105 minutes, with an average of 79.0 minutes; the intraoperative blood loss was 80-200 mL, with an average of 99.2 mL; the hospital stay was 3-8 days, with an average of 5.8 days. One patient had poor wound healing after operation, and the wound healed after strengthening dressing change; the rest wounds had primary healing, and no axillary nerve paralysis occurred. Except for 1 patient lost follow-up, the remaining 10 patients were followed up 10-54 months, with an average of 26.4 months. The postoperative X-ray film examination showed that the fractures healed well within 8-15 weeks, with an average of 11.0 weeks. There was no complication such as fracture displacement, internal fixator failure or fracture during follow-up. At last follow-up, the patient's shoulder joint flexion, abduction, external rotation (neutral position), and internal rotation (neutral position) range of motion, Constant-Murley score, and ASES score significantly improved when compared with those before operation ( P<0.05). CONCLUSION Compression screw combined with Buttress plate through direct axillary approach is an effective way to treat Ideberg typeⅡ scapular glenoid fracture, with advantages of small trauma, concealed incision, and good effectiveness.
Male ; Female ; Humans ; Retrospective Studies ; Blood Loss, Surgical ; Fracture Fixation, Internal ; Treatment Outcome ; Shoulder Fractures/surgery* ; Bone Screws ; Bone Plates

Purpose: We aimed to explore whether the prognosis of patients treated with capecitabine and oxaliplatin (XELOX) or S-1 and oxaliplatin (SOX) regimens who received fewer cycles of chemotherapy after D2 radical resection for gastric cancer (GC) would be non-inferior to that of patients who received the standard number of cycles of chemotherapy. Materials and Methods: Data on patients who received XELOX or SOX chemotherapy after undergoing D2 radical resection at Harbin Medical University Cancer Hospital between January 2011 and May 2016 were collected. Results: In patients who received 4, 6, and 8 cycles of chemotherapy, the 5-year overall survival (OS) rates were 59.4%, 64.8%, and 62.7%, respectively. Compared to patients who received 4 cycles of chemotherapy, those who received 6 cycles (hazard ratio [HR], 0.882; 95% confidence interval [CI], 0.599–1.299; P=0.52) or 8 cycles (HR, 0.882; 95% CI, 0.533–1.458; P=0.62) of chemotherapy did not exhibit significantly prolonged OS. The 3-year disease-free survival (DFS) rate of patients who received 4, 6, and 8 cycles of chemotherapy was 62.1%, 67.2%, and 60.8%, respectively. Compared to patients who received 4 cycles of chemotherapy, those who received 6 cycles (HR, 0.835; 95% CI, 0.572–1.221; P=0.35) or 8 cycles (HR, 0.972; 95% CI, 0.606–1.558; P=0.91) of chemotherapy did not show significantly prolonged DFS. However, the 3-year DFS and 5-year OS rates of patients who received 6 cycles of chemotherapy appeared to be superior to those of patients who received 4 and 8 cycles of chemotherapy. Conclusions For patients with stage III GC, 4 to 6 cycles of XELOX or SOX chemotherapy may be a favorable option. This study provides a rationale for further randomized clinical trials.

Objective: To investigate the expression of myocyte enhancer factor 2B (MEF2B) in mantle cell lymphomas (MCL), and to analyze the correlation between the expression of MEF2B and pathological subtypes, structural subtypes, SOX11 expression and its clinical significance. Methods: Paraffin-embedded tissues were stained with HE, immunohistochemistry (EnVision method) and fluorescence in situ hybridization (FISH) , in addition, the clinical and pathological data of 60 cases of MCL were collected at Sun Yat-sen University Foshan Hospital and Sun Yat-sen University Cancer Center from January,2002 to May, 2019 for analysis. Results: Of the 60 MCLs, males is predominant (M∶F=3∶1). Histologically, the typical MCL is the majority (classical MCL: variant type MCL=48 cases:12 cases) . Fifty cases were classified into non-complete FDC meshwork type MCL, and the remaining 10 cases were classified into the complete-FDC meshwork type MCL group. Patients with classical MCL were more than 60 years old. The coexistent lesion sites both node and extranode in pathological subtype or structural subtype was the most common lesion sites. SOX11(+) MCL was common in classical MCL (P=0.040) and tended to be complete-FDC meshwork type MCL (P=0.086). The expression rate of MEF2B in MCL was 60.0%(36/60). This rate of MEF2B in classical type, complete-FDC meshwork type and SOX11(+) MCL was significantly higher than that variant type, no complete-FDC meshwork type, SOX11(-)MCL (P<0.05), respectively. There was no difference in clinical characteristics of MCL between MEF2B positive and negative groups. Compared with SOX11(-)MCL, the percentage of MEF2B expressed in tumor cells of SOX11(+)MCL was significantly higher (P=0.027). The expression of MEF2B was not related to the proliferation of tumor cells (P=0.341). There was no significant difference in the survival rate between different expression groups of MEF2B and SOX11 (P=0.304 and P=0.819, respectively). Only the mortality of variant type (blastoid/pleomorphic) MCL within 2 years was significantly higher than that of classical type MCL (P<0.05). Conclusions The expression of MEF2B in MCL is related to the pathological subtypes, structural subtypes and the expression of SOX11, but not to the proliferation and prognosis. The high mortality rate within 2 years is only found in variant MCL. However, the role of MEF2B in MCL needs to be further studied.

Objective:To detect the expressions of chemokine receptor 6 (CCR6), CC chemokine ligand 20 (CCL20) E-cadherin and vimentin in tissues of colorectal cancer and their paired liver metastases, and to investigate the possible mechanism of CCR6 in liver metastasis of colorectal cancer.Methods:A total of 62 cases (54 cases of colon cancer and 8 cases of rectal cancer) of primary colorectal adenocarcinoma resection with wax lumps were selected from the First Hospital of Shanxi Medical University and Shanxi Oncology Hospital from 2009 to 2017 with complete data, including 20 samples of colorectal cancer resection with liver metastasis during the same period. The expressions of CCR6, CCL20, E-cadherin and vimentin in colorectal cancer and liver metastases tissues were detected by immunohistochemistry, and the relationships between the expressions of CCR6, E-cadherin and vimentin and the clinicopathological features of patients were analyzed. Logistic multivariate regression was used to analyze the relationship between liver metastasis and clinicopathological features, CCR6, E-cadherin and vimentin. Spearman correlation was used to analyze the correlations between CCR6 and E-cadherin and vimentin.Results:The positive expression rate of CCR6 in colorectal cancer tissues was 66.1% (41/62), 85.0% (17/20) in colorectal cancer with liver metastasis and 70.0% (14/20) in liver metastasis tissues. The positive expression rate of CCL20 in colorectal cancer tissues was 83.9% (52/62), 90.0% (18/20) in colorectal cancer with liver metastasis and 90.0% (18/20) in liver metastasis tissues. The positive expression rate of E-cadherin in colorectal cancer tissues was 67.7% (42/62), 50.0% (10/20) in colorectal cancer with liver metastasis and 65.0% (13/20) in liver metastasis tissues. The positive expression rate of vimentin in colorectal cancer tissues was 79.0% (49/62), 85.0% (17/20) in colorectal cancer with liver metastasis and 90.0% (18/20) in liver metastasis tissues. The expression of CCR6 was closely related to lymph node metastasis ( χ2=11.142, P=0.001), liver metastasis ( χ2=4.694, P=0.030) and TNM stage ( χ2=21.785, P<0.001). E-cadherin was closely related to lymph node metastasis ( χ2=4.694, P=0.030), liver metastasis ( χ2=4.253, P=0.039) and TNM stage ( χ2=7.867, P=0.005). Vimentin was closely related to lymph node metastasis ( χ2=7.293, P=0.007) and TNM stage ( χ2=5.712, P=0.017). CCR6, E-cadherin and vimentin were independent of gender, age, tumor site, tumor size and differentiation degree of colorectal cancer patients (all P>0.05). Logistic regression analysis showed that the expressions of CCR6 ( OR=6.812, 95% CI: 1.206-38.474, P=0.030) and E-cadherin ( OR=0.256, 95% CI: 0.069-0.945, P=0.041) were independent factors affecting the liver metastasis of colorectal cancer. Spearman correlation analysis showed that CCR6 was associated with E-cadherin expression ( r=0.454, P=0.044) and vimentin expression ( r=0.509, P=0.022) in 20 iver metastasis tissues of colorectal cancer. Conclusion:CCR6 may promote colorectal cancer progress and liver metastasis by part of epithelial-mesenchymal transition.