Objective:To explore the predictive and prognostic value of prognostic nutritional index(PNI)for patients with locally advanced esophageal squamous cell carcinoma(ESCC)undergoing induction chemotherapy combined with immune sequential radiotherapy.Methods:A retrospective analysis was conducted on clinical data from 126 locally advanced ESCC patients who had undergone induction chemotherapy combined with immune sequential radiotherapy at Zhejiang Cancer Hospital between May 2019 and August 2023.Receiver operating characteristic(ROC)curves were used to determine optimal PNI cutoff values within 1 week before induction chemoimmunotherapy,within 1 week before radiotherapy,and at 4±1 weeks after radiotherapy initiation,with subsequent patient stratification.The Kaplan-Meier method was used to generate survival curves and the log-rank test was used to compare overall survival(OS)and progression-free survival(PFS)between groups.Cox regression analysis was employed to identify factors affecting the prognosis of locally advanced ESCC patients undergoing induction chemoimmunotherapy combined with sequential radiotherapy.Results:A total of 126 locally advanced ESCC patients,118 males and 8 females,with a median age of 65 years(44-78 years)were included.The optimal critical values of PNI before induction chemoimmunotherapy,before radiotherapy and during radiotherapy identified using ROC curves were 46.2,48.3 and 37.9.The median OS and PFS were 47.3 and 28.2 months in the group with PNI≥48.3 before radiotherapy,and 18.7 and 15.2 months in the group with PNI<48.3 before radiotherapy,respectively(P<0.01,P<0.05).The median OS was not reached and the median PFS was 25.7 months in the group with PNI≥37.9 in radiotherapy,and the median OS and PFS were 17.0 and 12.5 months in the group with PNI<37.9 in radiotherapy,respectively(P<0.01,P<0.05).The median OS was not reached and the median PFS was 28.4 months in the group with elevated PNI after induction chemoimmunization;the median OS and PFS were 20.4 and 16.0 months in the group with reduced PNI(P<0.01,P<0.05).Multifactorial analysis showed that PNI in radiotherapy[HR=2.292,95%CI(1.264,4.159),P<0.05],and change in PNI after induction of chemoimmunization[HR=2.120,95%CI(1.007,4.463),P<0.05]were factors affecting OS.Conclusion:PNI during radiotherapy and changes in PNI after induction chemoimmunity correlate with patients'treatment efficacy and prognosis,and can be used as important indicators to predict the benefits of induction chemoimmunization combined with sequential radiotherapy for ESCC.

AIM: To observe the effect ofacacia honey (AH) on serum uric acid level and renal function in potassium oxonate modelrats after drinking AH aqueous solution. METHODS: Sixty male SD rats were selected and randomly divided into control group (CON group), potassium oxonate model group (OA model group), 10% fructose group (10% F group) and different concentration honey groups (25%, 12.5% and 6.25% AH groups). All rats were fed with normal diet.The rats in CON group were subcutaneously injected with 5% sodium carboxymethyl cellulose (CMC-Na) solution and drunk sterile water every day, while rats in other groups were injected with 100 mg / kg OA solution suspended with 5% CMC-Na subcutaneouslyand drunksterile water orfructose solution or AH solution of different concentrations every day. Before and during the 4-week test, rats were weighed and blood was taken once a week. At the end of test, urine and feces specimens or kidney tissues were collected and blood was taken from the abdominal aorta. The uric acid content in blood, urine, and feces and the levels of serum creatinine (Cre) and blood urea nitrogen (BUN) or inflammatory factors in kidney tissues were measured. Renal function and histology were evaluated. RESULTS: Compared with CON group, AH could significantly reduce the body weight of rats (P<0.05), increase the kidney organ coefficient, the levels of serum uric acid, and uric acid in urine or feces, and reduce the level of fecal uric acid (FUA) in rats. AH can down regulate the level of tumor necrosis factor alpha (TNF-a) (P< 0.05) and up regulate the expression of monocyte chemoattractant protein 1 (MCP-1) and transforming growth factor β - 1 (TGF - β1) in rats kidneys; AH can cause slight to mild dilatation of renal tubules and mild to moderate basophilic lesions of renal rubules in rat kidney in a dose dependent manner. CONCLUSION: In the doses rang of present study, AH can cause hyperuricemia, renal tubular dilatation and basophilic lesions, and lead to renal function damage in rats.

Objective To investigate the echocardiographic features of complete transposition of the great arteries (TGA)in fetuses.Methods Prenatal echocardiographic data of 9 fetuses diagnosed as TGA by autopsy or postnatal echocardiography during January 2010 to January 2017 were retrospectively analyzed.Results All of 9 fetuses showed normal cardiac axis and atrioventricular connection on four-chamber view.Eight of them showed the baby bird's beak sign on left ventricular outflow tract view.On left and right ventricular outflow tracts view,the two great arteries were parallel in 8 fetuses.Totally 6 fetuses showed just 2 vessels on three vessels and tracheal (3VT) view.On aortic arch view,the radian of aortic arch had increased in different degrees in 7 fetuses.There were 4 fetuses with ventricular septal defect observed by both of four-chamber and left ventricular outflow tract views.Conclusion The echocardiographic features of fetuses with TGA are characteristic in left ventricular outflow tract,left and right ventricular outflow tracts,3VT and aortic arch views,including baby bird's beak sign,2 great arteries' parallel relations,only 2 vessels on 3VT view,and increased radian of aortic arch.Of these features,baby bird's beak sign is the most common.

Objective To summarize prenatal two-dimensional ultrasound examination results of different types of fetal limb deformity,and emphasise on some rare deformity disease such as phocomelia and sirenomelia.To investigate the value of systematic continuous sequence approach in the examination of fetal limb during pregnancy periods.Methods Eighteen thousand seven hundred and eight cases of fetus were selected from September 2014 to August 2016 in the 105th Hospital of Chinese People's Liberation Army,which were screened by routine and systematic ultrasonography.The systematic continuous sequence approach was used to focus on examination of the fetal limb.All fetuses with abnormal limbs were followed up.The ultrasonographic images were compared with the results of pathological examination and X-ray examination to summarize the ultrasonographic features of fetal limb deformities.Results Seventy-six cases of fetal limb deformity were detected by prenatal ultrasotmd system in 18 708 cases.Three cases were detected at 11-13 + 6 weeks of gestation,18 at 14-19 + 6 weeks,38 at 20-27 + 6 weeks,17 at 28-35 + 6 weeks.Types of limb deformities are as fllowing,11 cases of abnormal number of fingers (adactylism,polydactyly,syndactyly),2 cases of cleft hand deformity,45 cases of foot varus,1 case of sirenomelia and 4 cases of short limbs.Thirty-seven cases of fetal limb deformity combined with other system malformations and 12 cases were with multiple system malformations.Karyotypes were abnormal in 11 cases,including 3 cases of trisomy 21,6 cases of trisomy 18 and 3 cases of trisomy 13.One case of prenatal ultrasound diagnosis of twins with sirenomelia.An autopsy of twin fetus indicated that there were epactal toes at the left foot.Prenatal ultrasonography.Conclusions The systematic continuous sequence approach in early and middle pregnancy play the advantages of each pregnancy examination.The fetal limb deformity can be detected early by combining application of systematic continuous sequence approach.

Objective To explore the value of systematic continuous sequence approach combined with two- and three-dimensional ultrasonography in screening of fetal hand deformity. Methods Systematic continuous sequence approach was performed with two- and three-dimensional u1trasonography in 28 541 cases to detect the fetal hand from January 2011 to December 2014 in the 105th Hospital of PLA. Prenatal ultrasonic diagnosis was compared with clinical delivery follow-up and pathology results of induced labour, then prenatal ultrasound features of various fetal hand deformities and the causes of missed diagnosis were analyzed. Results Thirty-four cases of fetal hand deformity were diagnosed out of 28 541 fetuses by prenatal ultrasonography (43 hands). In the 34 cases, there were 5 cases of cleft hand, 13 cases of ectrodactyly with fingers abnormal morphology, 3 cases of forearm and hand dysplasia, 7 cases of wrist or finger abnormal posture and 6 cases of hand absence of abnormal. Three missed cases included 1 case of polydacty, 1 case of middle phalanx and distal phalanx of the little thumb absence and 1 case of middle phalanx of little thumb absence. Hand deformity rate was 0.13%(37/28 541). The detection rate ofprenatal ultrasonography was 91.89%(34/37). The rate of hand deformity complicated deformity with one or more other organ was 52.94%(18/34). The rate of chromosome abnormalities was 13.51%(5/37). Cleft hand showed that fetal hand from the central longitudinal split into two halves. Ectrodactyly with fingers abnormal morphology showed that one or multiple fingers were absent combined with residual finger abnormal morphology. Forearm and hand dysplasia showed that the forearm was abnormally developed, the ulna and radius were short and the structure of the wrist disappeared. Wrist or finger abnormal posture showed that a hook-shaped wrist or half fist shaped hand, thumb adduction flexion, the index finger bending baroclinic on the dorsal of the middle finger and small finger bending baroclinic on the dorsal of the ring finger dorsal. Hand absence showed that no fetal hands. Conclusions Application of systematic continuous sequence approach combined with real time three-dimensional ultrasonography in the diagnosis of fetal hand deformity, such as ectrodactyly with fingers abnormal morphology and wrist or finger abnormal posture, can make up for the shortage of two-dimensional ultrasonography and obtain more diagnostic information.