Neck dissection(ND)is one of the main treatment methods for oral and maxillofacial malignancies.Although ND type is in con-stant improvement,but intraoperative peal-pull-push injury of the accessory nerve,muscle,muscle membrane,fascia and ligament induced shoulder syndrome(SS)is still a common postoperative complication,combined with the influence of radiochemotherapy,not only can cause pain,stiffness,numbness,limited dysfunction of shoulder neck and arm,but also may have serious impact on patient's life quality and phys-ical and mental health.At present,there is still a lack of a systematic evaluation and rehabilitation management program for postoperative SS of oral and maxillofacial malignant tumors.Based on the previous clinical practice and the current available evidence,refer to the relevant lit-erature at home and abroad,the experts in the field of maxillofacial tumor surgery and rehabilitation were invited to discuss,modify and reach a consenusus on the etiology,assessment diagnosis,differential diagnosis,rehabilitation strategy and prevention of SS,in order to provide clinical reference.

Atherosclerosis is the pathological basis of a variety of cardiovascular diseases,which are still the leading cause of human death worldwide.Ferroptosis is a kind of iron dependent non-apoptotic cell death mode,which is closely related to various physiological mechanisms.Recent studies have found that ferroptosis in macrophages plays an important role in the occurrence and development of atherosclerosis.Based on the imbalance of iron metabolism in macrophages,this paper reviews the correlation between ferroptosis in macrophages and atherosclerosis in terms of the interaction between ferroptosis in macrophages and lipid peroxidation,inflammation,oxidative stress,etc.,in order to provide new ideas for the study of the pathogenesis of atherosclerosis.

Surgical operation is the main treatment of oral and maxillofacial tumors.Dysphagia is a common postoperative complication.Swal-lowing disorder can not only lead to mis-aspiration,malnutrition,aspiration pneumonia and other serious consequences,but also may cause psychological problems and social communication barriers,affecting the quality of life of the patients.At present,there is no systematic evalua-tion and rehabilitation management plan for the problem of swallowing disorder after oral and maxillofacial tumor surgery in China.Combining the characteristics of postoperative swallowing disorder in patients with oral and maxillofacial tumors,summarizing the clinical experience of ex-perts in the field of tumor and rehabilitation,reviewing and summarizing relevant literature at home and abroad,and through joint discussion and modification,a group of national experts reached this consensus including the core contents of the screening of swallowing disorders,the phased assessment of prognosis and complications,and the implementation plan of comprehensive management such as nutrition management,respiratory management,swallowing function recovery,psychology and nursing during rehabilitation treatment,in order to improve the evalua-tion and rehabilitation of swallowing disorder after oral and maxillofacial tumor surgery in clinic.

Cryoablation therapy with explicit anti-tumor mechanisms and histopathological manifestations has a long history.A large number of clinical practice has shown that cryoablation therapy is safe and effective,making it an ideal tumor treatment method in theory.Previously,its efficacy and clinical application were constrained by the limitations of refrigerants and refrigeration equipment.With the development of the new generation of cryoablation equipment represented by argon helium knives,significant progress has been made in refrigeration efficien-cy,ablation range,and precise temperature measurement,greatly promoting the progression of tumor cryoablation technology.This consensus systematically summarizes the mechanism of cryoablation technology,indications for oral mucosal melanoma(OMM)cryotherapy,clinical treatment process,adverse reactions and management,cryotherapy combination therapy,etc.,aiming to provide reference for carrying out the standardized cryoablation therapy of OMM.

Purpose: Cavernous nerve injury induced erectile dysfunction (ED) is a refractory complication with high incidence in person under radical prostatectomy. Studies have shown that relaxin-2 (RLX-2) plays a vital role of endothelial protection, vasodilation, anti-fibrosis and neuroprotection in a variety of diseases. However, whether penile cavernous erection can benefit from RLX-2 remains unknown. The purpose of the experiment was to explore the effects of RLX-2 on ED in the rat suffering with bilateral cavernous nerve injury (BCNI). Materials and Methods: The rats were divided into three groups: Sham group was underwent sham operation, BCNI+RLX group or BCNI group was underwent bilateral cavernous nerve crush and then randomly treated with RLX-2 (0.4 mg/kg/d) or saline by continuous administration using a subcutaneously implanted micro pump for 4 weeks respectively. Then, erectile function was evaluated by electrical stimulation of cavernous nerves. Cavernous nerves and penile tissues and were collected for histological evaluation. Results: Erectile function of rats with BCNI was partially improved after RLX-2 treatment. The BCNI group had lower expression of relaxin family peptide receptor (RXFP) 1, p-AKT/AKT, p-eNOS/eNOS ratios than sham operation rats, but RLX-2 could partially reversed these changes. Histologically, the BCNI+RLX group had a significant effect on preservation of neurofilament, neuronal glial antigen 2 of penile tissue and nNOS of cavernous nerves when compared with BCNI group. RLX-2 could inhibited the lever of BCNI induced corporal fibrosis and apoptosis via regulating TGFβ1-Smad2/3-CTGF pathway and the expression of Bax/Bcl-2 ratio, caspase3. Conclusions RLX-2 could improve erectile function of BCNI rats by protecting cavernous nerve and endothelial function and suppressing corporal fibrosis and apoptosis via RXFP1 and AKT/eNOS pathway. Our findings may provide a promising treatment for refractory BCNI induced ED.

Background Occupational health risk assessment of dust-exposed operations is an important part of occupational health work. However, there is a lack of objective and effective methods for validating the risk assessment results. Objective To explore the application value of chest imaging changes in validating occupational health risk assessment results of dust-exposed operations. Methods Alumina dust-exposed workers in an abrasive manufacturing company were selected as study subjects. The Australian Occupational Health and Safety Risk Assessment model (Australian model), and the Singapore semi-quantitative risk assessment model of occupational exposure to chemical substances (Singaporean model) were used to conduct occupational health risk assessment for the target group. Consistency of the assessment results was compared. The cumulative risk value and cumulative risk level of the subjects were calculated. The subjects were examined and diagnosed by chest radiographs, and the differences in the positive rates of aluminum dust shadows of workers at different job risk levels and different cumulative risk levels were compared. Results The average risk ratios (RR) of selected alumina dust-exposed workers estimated by the Australian model and the Singapore model were both 0.49±0.10, indicating generally medium occupational health risk level. The evaluation results of the two models were obviously consistent (kappa test, k = 0.823, P < 0.001). Among the 192 subjects, 62 (32.3%) were found to have aluminum dust shadows on their chest radiographs, and there were no case of pneumoconiosis. The aluminum dust shadows were mainly classified by shape and size as “s” (30.7%); the profusion of small opacities was mainly "less than 0/1" (31.3%); they were mostly distributed in 2 pulmonary zones (18.8%), and mostly in the right lower lung (18.8%), and none was seen in the two upper lung zones. The positive rate of aluminum dust shadows in the high-risk workplaces (41.7%) assessed by the Australian model was significantly higher than that in the medium-risk workplaces (22.9%) (P < 0.01). The positive rate of aluminum dust shadows in the medium-risk workplaces (42.7%) assessed by the Singapore model was significantly higher than that in the low-risk workplaces (23.3%) (P < 0.01). The cumulative risk levels evaluated by the two models were all atⅠ- Ⅲ levels. With the increase of cumulative risk level by the two models, the positive rates of aluminum dust shadows in the subjects both showed an obvious increase trend (P < 0.05). Conclusion The risk assessment results of the Australian model and the Singapore model are obviously consistent for the target group. They can be jointly applied to the risk assessment of dust-exposed operations. The application of chest imaging changes is of certain value to validate the results of occupational health risk assessment for dust-exposed operations.

Inflammatory myofibroblastoma (IMT) is a rare solid tumor, and its etiology and pathogenesis are unclear. Crohn's disease is a non-specific intestinal inflammatory disease. The clinical manifestations, laboratory examinations, and imaging examinations of IMT are not specific, making diagnosis difficult. A case of Crohn's disease combined with IMT of abdominal wall was admitted to the Department of Gastroenterology at the Third Xiangya Hospital, Central South University, on Nov. 21, 2017. This patient was admitted to our hospital because of repeated right lower abdominal pain for 4 years. A 6 cm×5 cm mass was palpated in the right lower abdomen. After completing the transanal double-balloon enteroscopy and computed tomographic enterography for the small intestinal, the cause was still unidentified. The patient underwent surgery due to an abdominal wall mass with intestinal fistula on Sept. 12, 2018 and recovered well currently. According to histopathology and immunohistochemistry, he was diagnosed with Crohn's disease combined with IMT. Up to July 2020, the patients still took azathioprine regularly, without abdominal pain, abdominal distension, and other discomfort, and the quality of his life was good.
Abdominal Pain ; Abdominal Wall/surgery* ; Crohn Disease/complications* ; Humans ; Intestine, Small ; Male ; Neoplasms, Muscle Tissue/surgery*

Objective: To investigate the clinical value of independently-designed three-demensional printed navigation templates for hepatectomy in hepatic surgical oncology. Methods: A retrospective study was conducted on 45 patients (including 36 males and 9 females, aged from 40 to 70 years) with hepatocelluar carcinoma treated by hepatoctomy from Department of Hepatobiliary and Intestinal Surgery of Hunan Cancer Hospital from June 2016 to June 2018. These patients were divided into observation group (patients conducted with the 3D navigation-template-aided operation, n=25) and control group (patients conducted with regular operation, n=20) according to operation approach. Virtual liver resection volume and actual liver resection volume were calculated in the observation group, and the correlationship between the volume of virtual liver resection and actual liver resection was analyzed by Pearson correlation analysis. The operative time, intraoperative blood loss, intraoperative intrahepatic duct injury and postoperative hospital stay were compared between the two groups. Results: In the observation group, 3D modeling was successfully completed and intrahepatic and extrahepatic duct reconstruction was successful, surgical simulation. There were no statistically significant difference between the virtual and actual resected liver volume in the observation group (P>0.05). The virtual resected liver volume was positively correlated with the actual resected liver volume (r=0.991, P<0.05). Volume of intraoperative blood loss in the observation group was lower than that in the control group [(245.1±22.3) ml vs. (308.6±19.9) ml], and the length of hospital stay was shorter than that in the control group [(7.4±0.2) d vs. (8.6±0.4) d], the difference was statistically significant (P<0.05). There was no accidental injury of intrahepatic duct in the observation group, 1 case of accidental injury of middle hepatic vein and 1 case of accidental injury of secondary branch of right hepatic vein in the control group. The AST of the observation group was significantly reduced compared with that of the control group on the 4 th and 7th days after the operation, and the difference was statistically significant (P<0.05). Conclusions 3D reconstruction of liver based on high quality MR images, can facilitate restoring the adjoint relationship between hepatic duct system and liver tumor. 3D printed navigation templates effectively guide certain kinds of hepatectomy, ensure that the cutting edge at the same time protect the rest of the liver tissue, reduce bleeding and accidental damage, realize accurate tumor resection.

PURPOSE: To study the efficacy of capecitabine or S-1 plus oxaliplatin (CAPOX or SOX) for treating thymidine phosphorylase (TP)- or dihydropyrimidine dehydrogenase (DPD)-positive advanced gastric cancer.MATERIALS AND METHODS: Eighty-six patients with stage IIIC to IV gastric cancer were assessed for TP and DPD expression by immunohistochemistry. The association between CAPOX or SOX efficacy and TP/DPD expression was retrospectively analyzed.RESULTS: There were no significant differences in the objective remission rate (ORR, 52.27% vs. 47.62%; P>0.05), disease control rate (72.73% vs. 73.81%, P>0.05), progression-free survival (hazard ratio [HR], 1.119; 95% confidence interval [CI], 0.739–1.741; P=0.586), and overall survival (OS; HR, 0.855; 95% CI, 0.481–1.511; P=0.588) between CAPOX and SOX. A higher number of stage IV patients showed TP positivity, while DPD-positive patients predominantly showed intestinal type of gastric cancer. In TP-positive patients, the ORRs associated with CAPOX and SOX treatments were 57.14% and 38.10%, respectively; OS was better with CAPOX than with SOX (HR, 0.447; 95% CI, 0.179–0.978; P=0.046). Among DPD-positive patients, the SOX treatment-associated ORR (60.87%) was significantly higher than the CAPOX treatment-associated ORR (43.48%). Furthermore, SOX treatment resulted in better OS than did CAPOX treatment (HR, 2.020; 95% CI, 1.019–4.837; P=0.049).CONCLUSIONS: No significant difference in clinical efficacy was found between CAPOX and SOX. TP-positive patients might respond better to CAPOX while DPD-positive patients may respond better to SOX. Our findings might serve as a guide for personalized chemotherapy for gastric cancer.
Capecitabine ; Dihydrouracil Dehydrogenase (NADP) ; Disease-Free Survival ; Drug Therapy ; Humans ; Immunohistochemistry ; Retrospective Studies ; Stomach Neoplasms ; Thymidine Phosphorylase ; Thymidine ; Treatment Outcome

Omega-3 polyunsaturated fatty acids (ω-3 PUFAs) are a class of bioactive polyunsaturated fatty acids with inhibitory effects on colorectal cancer. Firstly, ω-3 PUFAs can change membrane fluidity and affect cell functions; Secondly, they can affect the activity of important proteins in cell signal transduction pathways and regulate the inflammatory mediators and the functions of immune cells in the tumor microenvironment; Finally, they can change the important molecules in the process of tumor metastasis and inhibit the colorectal cancer via suppressing cell proliferation, promoting apoptosis, enhancing antitumor immunity, and preventing tumor metastasis.
Apoptosis ; Cell Proliferation ; Colorectal Neoplasms ; Fatty Acids, Omega-3 ; Humans ; Tumor Microenvironment