Objective:To explore the value of serum inflammation-related indicators in predicting the effect of neoadjuvant chemotherapy and postoperative disease-free survival (DFS) of triple-negative breast cancer (TNBC) patients with axillary lymph node metastasis.Methods:A retrospective case series study was conducted. The data of 99 TNBC patients with axillary lymph node metastasis who underwent surgery after EC-T regimen (sequential docetaxel followed by epirubicin and cyclophosphamide) neoadjuvant chemotherapy at Suzhou Municipal Hospital and Xiangcheng People's Hospital from June 2016 to May 2022 were collected. All patients were required to collect peripheral blood samples within one week prior to puncture, and platelet, neutrophil and lymphocyte counts were analyzed using the blood analyzer. C-reactive protein level was analyzed using the fully automated biochemical analyzer, and neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and immune inflammatory index (SII) were further calculated. Patients were divided into pathological complete remission (pCR) group and non-pCR group based on postoperative Miller Payne score, and the levels of various serum inflammation-related indicators before neoadjuvant chemotherapy were compared between the two groups; non-pCR patients were divided into high and low groups based on the median level of each indicator. Kaplan-Meier method was used to analyze the postoperative DFS status of each group. The impact of serum inflammatory-related indicators before neoadjuvant chemotherapy on postoperative DFS of patients was analyzed using Cox proportional hazards model for univariate and multivariate analyses.Results:The median age [ M ( Q1, Q3)] of 99 patients was 50 years old (39 years old, 64 years old); 47 cases were human epidermal growth factor receptor (HER2)-, 33 cases were HER2+, and 19 cases were HER2++ and fluorescence in situ hybridization-negative; there were 22 cases of pCR patients and 77 cases of non-pCR patients. Twenty-nine patients experienced recurrence or metastasis after surgery. The platelet count, PLR and SII of pCR group before neoadjuvant chemotherapy were lower than those of non-pCR group, and the differences were statistically significant (all P < 0.05). Among non-pCR patients, the DFS of high lymphocyte count before neoadjuvant chemotherapy group was better than that of low lymphocyte count group, while the DFS of high CRP, NLR, PLR, and SII groups was worse than that of low CRP, NLR, PLR, and SII groups, and the differences were statistically significant (all P < 0.05). Univariate analysis showed that lymphocyte count, NLR, PLR, CRP, and SII before neoadjuvant chemotherapy were all influencing factors for postoperative DFS in TNBC patients with axillary lymph node metastasis after neoadjuvant chemotherapy (all P < 0.05). Multivariate analysis showed that SII was an independent influencing factor for postoperative DFS in TNBC patients with axillary lymph node metastasis after neoadjuvant chemotherapy ( HR = 2.406, 95% CI: 1.147-5.617, P = 0.024). Conclusions:Serum inflammation-related indicators before neoadjuvant chemotherapy can serve as predictive factors for the efficacy of neoadjuvant chemotherapy and postoperative DFS in TNBC patients with axillary lymph node metastasis.

Objective:To explore the efficacy of ansa cervicalis anterior root-recurrent laryngeal nerve (RLN) anastomosis in the treatment of unilateral vocal fold paralysis (UVFP) and to analyze the effect of different pathogenic factors on efficacy.Methods:From January 2010 to January 2022, 428 patients (187 males and 241 females) at Changhai Hospital with UVFP who underwent ansa cervicalis anterior root-RLN anastomosis due to thyroid surgery, thoracic surgery, idiopathic vocal ford paralysis or high cranial base injury were analyzed. The course of nerve injury ranged from 6 to 24 months. Videostroboscopy, auditory perceptual evaluation parameters (GRBAS including Grade, Roughness, Breathiness, Asthenia, Strain), Voice Handicap Index (VHI-10), acoustic analysis including Jitter, Shimmer and noise to harmonic ratio (NHR), maximum phonation time (MPT) and laryngeal electromyography were used to evaluate the surgery efficacy, and the therapeutic difference of the above 4 different etiology patients receiving the operation was compared. Data processing was performed using SPSS 26.0 statistical software, and Wilcoxon signed rank test was used. Kruskal Wallis one-way ANOVA was used for those with equal variance.Results:At 12 months after operation, the affected vocal ford position, vocal ford edge, glottal closure, symmetry and regularity of vocal ford vibration were significantly improved in all four groups ( P<0.01). G, R, B, A, S, VHI-10, Jitter, Shimmer and NHR were significantly lower than those before operation, while, MPT was significantly longer ( P<0.01). Also, the maximum voluntary motor unit recruitment (VMUR) in the affected thyroarytenoid muscles and posterior cricoarytenoid muscles was significantly improved after surgery ( P<0.01). However, the results of thyroid surgery group, thoracic surgery group and idiopathic vocal ford paralysis group were better than those of high cranial base injury group respectively, and the differences were statistically significant ( P<0.05). Conclusion:Ansa cervicalis anterior root-RLN anastomosis has an obvious efficacy on the recovery of phonatory function in UVFP patients with different causes, but the high cranial base injury is significantly worse than that of vocal ford paralysis caused by other causes.

Objective:To explore the value of serum inflammation-related indicators in predicting the effect of neoadjuvant chemotherapy and postoperative disease-free survival (DFS) of triple-negative breast cancer (TNBC) patients with axillary lymph node metastasis.Methods:A retrospective case series study was conducted. The data of 99 TNBC patients with axillary lymph node metastasis who underwent surgery after EC-T regimen (sequential docetaxel followed by epirubicin and cyclophosphamide) neoadjuvant chemotherapy at Suzhou Municipal Hospital and Xiangcheng People's Hospital from June 2016 to May 2022 were collected. All patients were required to collect peripheral blood samples within one week prior to puncture, and platelet, neutrophil and lymphocyte counts were analyzed using the blood analyzer. C-reactive protein level was analyzed using the fully automated biochemical analyzer, and neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and immune inflammatory index (SII) were further calculated. Patients were divided into pathological complete remission (pCR) group and non-pCR group based on postoperative Miller Payne score, and the levels of various serum inflammation-related indicators before neoadjuvant chemotherapy were compared between the two groups; non-pCR patients were divided into high and low groups based on the median level of each indicator. Kaplan-Meier method was used to analyze the postoperative DFS status of each group. The impact of serum inflammatory-related indicators before neoadjuvant chemotherapy on postoperative DFS of patients was analyzed using Cox proportional hazards model for univariate and multivariate analyses.Results:The median age [ M ( Q1, Q3)] of 99 patients was 50 years old (39 years old, 64 years old); 47 cases were human epidermal growth factor receptor (HER2)-, 33 cases were HER2+, and 19 cases were HER2++ and fluorescence in situ hybridization-negative; there were 22 cases of pCR patients and 77 cases of non-pCR patients. Twenty-nine patients experienced recurrence or metastasis after surgery. The platelet count, PLR and SII of pCR group before neoadjuvant chemotherapy were lower than those of non-pCR group, and the differences were statistically significant (all P < 0.05). Among non-pCR patients, the DFS of high lymphocyte count before neoadjuvant chemotherapy group was better than that of low lymphocyte count group, while the DFS of high CRP, NLR, PLR, and SII groups was worse than that of low CRP, NLR, PLR, and SII groups, and the differences were statistically significant (all P < 0.05). Univariate analysis showed that lymphocyte count, NLR, PLR, CRP, and SII before neoadjuvant chemotherapy were all influencing factors for postoperative DFS in TNBC patients with axillary lymph node metastasis after neoadjuvant chemotherapy (all P < 0.05). Multivariate analysis showed that SII was an independent influencing factor for postoperative DFS in TNBC patients with axillary lymph node metastasis after neoadjuvant chemotherapy ( HR = 2.406, 95% CI: 1.147-5.617, P = 0.024). Conclusions:Serum inflammation-related indicators before neoadjuvant chemotherapy can serve as predictive factors for the efficacy of neoadjuvant chemotherapy and postoperative DFS in TNBC patients with axillary lymph node metastasis.

Objective:To explore the efficacy of ansa cervicalis anterior root-recurrent laryngeal nerve (RLN) anastomosis in the treatment of unilateral vocal fold paralysis (UVFP) and to analyze the effect of different pathogenic factors on efficacy.Methods:From January 2010 to January 2022, 428 patients (187 males and 241 females) at Changhai Hospital with UVFP who underwent ansa cervicalis anterior root-RLN anastomosis due to thyroid surgery, thoracic surgery, idiopathic vocal ford paralysis or high cranial base injury were analyzed. The course of nerve injury ranged from 6 to 24 months. Videostroboscopy, auditory perceptual evaluation parameters (GRBAS including Grade, Roughness, Breathiness, Asthenia, Strain), Voice Handicap Index (VHI-10), acoustic analysis including Jitter, Shimmer and noise to harmonic ratio (NHR), maximum phonation time (MPT) and laryngeal electromyography were used to evaluate the surgery efficacy, and the therapeutic difference of the above 4 different etiology patients receiving the operation was compared. Data processing was performed using SPSS 26.0 statistical software, and Wilcoxon signed rank test was used. Kruskal Wallis one-way ANOVA was used for those with equal variance.Results:At 12 months after operation, the affected vocal ford position, vocal ford edge, glottal closure, symmetry and regularity of vocal ford vibration were significantly improved in all four groups ( P<0.01). G, R, B, A, S, VHI-10, Jitter, Shimmer and NHR were significantly lower than those before operation, while, MPT was significantly longer ( P<0.01). Also, the maximum voluntary motor unit recruitment (VMUR) in the affected thyroarytenoid muscles and posterior cricoarytenoid muscles was significantly improved after surgery ( P<0.01). However, the results of thyroid surgery group, thoracic surgery group and idiopathic vocal ford paralysis group were better than those of high cranial base injury group respectively, and the differences were statistically significant ( P<0.05). Conclusion:Ansa cervicalis anterior root-RLN anastomosis has an obvious efficacy on the recovery of phonatory function in UVFP patients with different causes, but the high cranial base injury is significantly worse than that of vocal ford paralysis caused by other causes.

In 2011, the FDA approved ipilimumab, the first immune checkpoint inhibitor(ICI), targeting CTLA-4, opening the field of immune checkpoint therapy (ICT). ICIs can induce durable clinical responses and improve survival in selected population. However, significant challenges still remain, including mechanisms of resistance, patient selection, management of serious immune-related adverse events, and rational therapeutic combinations. This review surveys the current understanding of response and resistance to ICIs and proposes a path forward to improving efficacy and minimizing toxicities.

Objective:To study the regulatory effect of Wumen-Yiji powder on 5-hydroxytryptamine (5-HT) signal transduction system in intestine and hypothalamus of diarrhea irritable bowel syndrome (IBS-D) model rats. Methods:Sixty male SD rats were randomly divided into blank group (10 rats) and diarrhea irritable bowel syndrome group (50 rats). The diarrhea irritable bowel syndrome group formed the diarrhea irritable bowel syndrome model after 2 weeks of senna leaf gavage and restraint stress. They were randomly divided into model group, deshute group (1.5 mg/kg), low, medium and high dose group of Wumen-Yiji San (6, 12, 24 g/kg), with 10 rats in each group. After continuous administration for 2 weeks, the contents of 5-HT in serum, colon and hypothalamus were detected by ELISA; HE staining was used to observe the pathological changes of colon in each group. The protein and mRNA levels of tryptophan hydroxylase 1 (TPH-1), serotonin receptor 3 (5-HT3R), serotonin receptor 4 (5-HT4R), serotonin transporter (SERT) in colon and hypothalamus were detected by Western blot and RT-PCR, respectively. Results:Compared with the model group, the pathological morphology of colon in each treatment group was improved. Compared with the model group, the level of 5-HT in serum and colon significantly decreased ( P<0.05), and the level of 5-HT in hypothalamus of rats in the low, medium, high dose group of Wumen-Yiji San significantly increased ( P<0.05). The expression of TPH-1, 5-HT3R and 5-HT4R protein significantly decreased ( P<0.05), and the expression of SERT protein in the medium, high dose group of Wumen-Yiji San significantly increased ( P<0.05). The expression of TPH-1, 5-HT3R and 5-HT4R protein in hypothalamus increased ( P<0.05), and the expression of SERT protein in the high dose group of Wumen-Yiji San significantly decreased ( P<0.05). The mRNA levels of TPH-1 (4.778 ± 0.604, 3.278 ± 0.668, 1.670 ± 0.361 vs. 6.877 ± 0.148), 5-HT3R (3.807 ± 0.463, 2.697 ± 0.455, 1.132 ± 0.136 vs. 6.322 ± 0.778), 5-HT4R (4.521 ± 0.234, 2.801 ± 0.351, 1.331 ± 0.142 vs. 6.741 ± 0.293) in colon tissue of low, medium and high dose groups of Wumen-Yiji San decreased ( P<0.05). The level of 5-HT4R mRNA (0.616 ± 0.208, 0.726 ± 0.226 vs. 0.521 ± 0.062) increased ( P<0.05), and the level of SERT mRNA (1.563 ± 1.023 vs. 2.612 ± 1.035) in medium, high dose group of Wumen-Yiji San decreased ( P<0.05). Conclusion:The result showed that Wumen-Yiji San could regulate the expression of 5-HT signaling system relating proteins and mRNA in the colon and hypothalamus of IBS-D rats within a certain dose range, so as to improve the symptoms of IBS-D.

Objective:To explore influence on physical development of children aged 18 months from HIV-positive mothers for prevention mother to child transmission of HIV (PMTCT) in Guangxi Zhuang autonomous region, and provide evidence for the improvement PMTCT program.Methods:This retrospective case control study was conducted in 554 HIV negative infants aged 18 months whose HIV positive mothers had received PMTCT services reported through PMTCT system database from January 1, 2010 to December 31, 2017 and 1 109 healthy infants born in 2017, whose mothers were healthy, in Lingshan, Luzhai, and Hengxian counties, ranking top three counties with high HIV infection prevalence, in Guangxi. PMTCT data and physical development data such as height, weight and head circumference of children aged 18 months were collected. The physical dysplasia in the infants was defined as at least one of the three main indicators of height, weight and head circumference below the normal range.Results:The number of HIV-positive mother and their infants in the case group were 667 and 554 respectively, and the PMTCT rates were 91.15 % (608/667) and 96.57 % (535/554) respectively. HIV positive rate, mortality rate and mother to child transmission rate of the infants aged 18 months were 1.44 % (8/554), 3.07 % (17/554) and 1.91 % (8/418) respectively, and the physical examination results of the infants aged 18 months showed that the physical dysplasia rate was 30.51 % (169/554). Among the 1 109 infants in the control group, the physical dysplasia rate was 9.83 % (109/1 109). The difference between the case group and the control group was significant ( P<0.01). Conclusion:The PMTCT rates of HIV positive mother and their children were more than 90.00 %, respectively. However, poor physical development rate of infants aged 18 months were more than 30.00 %. The possible influence of PMTCT on physical development of the infants aged 18 months of HIV positive mother’s needs to be further studied.

Objective: To understand the characteristics of HIV/AIDS epidemic in Guangxi Zhuang Autonomous Region (Guangxi) with a purpose to accurately provide scientific basis for prevention and control measures, 2010-2017. Methods: Data were retrieved from case reporting cards of Guangxi during 2010 to 2017 through National HIV/AIDS Comprehensive Response Information Management System. Data was analyzed using epidemiological methods such number of cases, proportion and rate. χ² test was used for statistical analysis. Results: The HIV positive rate was 12.53 per ten thousand (85 182/67 959 000) in Guangxi during 2010 to 2017. The number of newly diagnosed HIV/AIDS cases and the number of death yearly respectively increased by 22.34%(2 602/11 648) and 32.83% (952/2 900) in 2011 compared with 2010, and both showed a six-year continuous downward trend (the number of newly diagnosed cases respectively 12 229 cases, 10 877 cases, 9 460 cases, 9 190 cases, 8 848 cases, 8 680 cases, and the number of death respectively 3 888 cases, 3 316 cases, 2 914 cases, 2 717 cases, 2 595 cases, 2 600 cases) from 2012 to 2017. But proportion of late discovery remained above 50.00% (50.53%-57.06%) for eight-years continuously. The ratio of male and female was 2.47 ∶ 1 (60 639/24 543). The ratio of males and females aged 50 and over was 2.71∶1 (28 654/10 557). Proportion of the cases in 25-49 years old group and 50 years old group accounting for 47.40%(40 377/85 182) and 46.03% (39 211/85 182) respectively. The occupation was farmers accounting for 68.40% (58 262/85 182), housekeeping, housework and unemployment accounting for 11.21% (9 546/85 182), student accounting for 0.86% (729/85 182). Heterosexual transmission accounted for 90.60% (77 171/85 182, homosexual transmission accounted for 3.13% (2 669/85 182), injection drug use transmission accounted for 4.60%(3 924/85 182) and mother-to-child transmission accounted for 0.73% (619/85 182). Conclusions The number of newly diagnosed cases and the number of death yearly showed a continuous downtrend for six-years from 2012 to 2017. However, proportion of late discovery remained above 50.00% for eight-years. The major route of infection was heterosexual transmission. With the change of HIV/AIDS newly epidemic mode in Guangxi, there are many new challenges for HIV/AIDS prevention and control work. Strategy of targeted intervention modes should be innovated for a new breakthrough.

Objective: To evaluate the efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for elderly patients with advanced myeloid neoplasm. Methods: From September 2014 to September 2017, 30 consecutive hospitalized 50-plus-year-old myeloid neoplasm patients were retrospectively analyzed. At the time of transplantation, 6 patients reached complete remission and the others remained no remission after treatment. The donors were identical sibling (12), matched unrelated (6) and haploidentical family member (12), respectively. 18 patients received RIC while 12 patients received MAC conditioning regiments consisted of Busulfan, cytarabine, fludarabine or clarithromycin±TBI, respectively. Results: Five patients died early in the conditioning stage, 24 patients successfully engrafted. The median time of neutrophil engraftment was 14(10-18) d, whereas platelet engraftment was 15(10-19) d. Six cases (25%) experienced aGVHD grades Ⅱ, 8 cases (32%) cGVHD, including moderate to severe cGVHD in 2 cases (8%). Seven, 7 and 5 cases developed CMV viremia, pneumonia and herpeszoster, respectively after transplantation, but no patients died of infections. The median follow-up time of the patients was 7(0.5-38) months. Twenty-one patients were still alive. The estimated 2 years OS and LFS were 62.5% (95% CI 39.2%-85.8%) and 59.2% (95% CI 26.9%-91.5%), respectively. Univariate analysis showed that HCT-CI was the only factor influencing OS. Conclusion Allogeneic hematopoietic stem cell transplantation could improve the survival of elderly patients with myeloid neoplasm.

OBJECTIVETo explore the material basis of conduction along meridian.

METHODSSixty SD rats(30 males,30 females) were randomly assigned into a normal group,an acupuncture group,a verapamil blocking group and a 0.9%NaCl blocking group(control group),15 rats in each one. Fluo 3-AM(calcium fluorescence probe) was injected at the observation part in femoral stomach meridian of foot-(meridian part) and the approaching femoral meridian part(non-meridian part) in the normal group and the acupuncture group,and then incubation was applied. In the verapamil blocking group,verapamil was injected at local meridian part and non-meridian part,and in the control group 0.9%NaCl was injected. Then Fluo 3-AM was injected at the meridian part and non-meridian part in the two groups,and incubation was implemented. Caimaging changes in cells were recorded for more than 20 min after injection of every part in each group respectively. After the above operations in the last three groups,acupuncture was used at "Zusanli"(ST 36) immediately,with electroacupuncture for one min,then Caimaging changes in cells at the meridian and non-meridian parts were recorded for more than 20 min.

RESULTSIn the normal group, Cafluorescence intensity at the meridian part was higher than that at the non-meridian part. In the acupuncture group,after acupuncture Cafluorescence intensity at the meridian part was obviously higher than before,but the change before and after acupuncture was not apparent at the non-meridian part. After verapamil blocking local calcium channel and acupuncture,the Cafluorescence of the meridian part did not strengthen,and the change of that before and after acupuncture at the non-meridian part was not obvious. In the control group,after injecting 0.9%NaCl at local part,Cafluorescence intensities of the meridian and non-meridian parts showed no obvious change,so was that before and after acupuncture.

CONCLUSIONSThe voltage-gated calcium channel at the meridian part is highly correlated with its tissue cells exciting conduction.