Objective To screen immune-related long non-coding RNAs(LncRNAs)in the TCGA database pancreatic cancer dataset and construct a prognostic risk assessment model with immune-related LncRNAs to explore prognosis-related potential molecular mechanisms.Methods RNA-seq data of 171 pancreatic cancer samples and corresponding clinical information were obtained by The Cancer Genome Atlas(TCGA)database,and two classical immune-related gene datasets(GO0006955/IMMUNE RESPONSE and GO0002376/IMMUNE SYSTERM PROCESS)and gene annotation information were used to identify immune-related LncRNAs.The immune-related LncRNAs associated with pancreatic cancer prognosis were used for univariate and multivariate Cox analyses to establish a model for the assessment of pancreatic cancer prognostic risk based on immune-associated LncRNAs.This risk model was used for survival analysis,clinical correlation analysis,immune cell infiltration analysis,pathway enrichment analysis,and prognostic column line plot modeling.Results We screened 119 immune-related LncRNAs in pancreatic cancer,and five immune-related LncRNAs(AC064836.3,LINC00941,ZNF236-DT,TMEM161B-AS1 and AC068580.2)were identified for the development of pancreatic cancer prognostic risk assessment model.According to the prognostic risk assessment model,pancreatic cancer patients were divided into low-risk group(n=86)and high-risk group(n=85).Compared with the low-risk group,the high-risk group showed a significant negative enrichment trend for immune-related signaling pathways,the 5-year overall survival of pancreatic cancer patients was significantly increased in the low-risk group compared with the high-risk group.The expression of low-risk immune-related LncRNAs(AC064836.3,ZNF236-DT and TMEM161B-AS1)gradually decreased with increasing clinical stage of pancreatic cancer patients.Patient age(P=0.031,risk ratio and 95％CI:1.025/1.002-1.048)and prognostic risk score(P＜0.001,risk ratio and 95％ confidence interval 1.801/1.465-2.215)could be used as independent prognostic risk factors for overall survival in pancreatic cancer.In addition,the prognostic risk assessment model had better predictive efficiency(area under the curve=0.695)compared with the disease predictive ability of common clinical characteristics.Steroid biosynthesis,pentose phosphate pathway,intercellular linkage,cytoskeletal rearrangement and other pathways related to energy metabolism and invasive migration of pancreatic cancer cells were significantly activated in the high-risk group.Meanwhile,pancreatic cancer patients in the high-risk group had lower levels of naive B cells,plasma cells and neutrophils with anti-tumor activity,but their macrophage infiltration levels were significantly higher than those in the low-risk group.Conclusion The prognostic risk assessment model constructed based on five immune-related LncRNAs can effectively predict the survival status,clinical characteristics,molecular pathways,and immune cell infiltration differences of pancreatic cancer patients.Meanwhile,relying on this model,the prognosis of pancreatic cancer patients can be prospectively predicted,which enhances the usefulness of this risk prediction model.

Objective To screen immune-related long non-coding RNAs(LncRNAs)in the TCGA database pancreatic cancer dataset and construct a prognostic risk assessment model with immune-related LncRNAs to explore prognosis-related potential molecular mechanisms.Methods RNA-seq data of 171 pancreatic cancer samples and corresponding clinical information were obtained by The Cancer Genome Atlas(TCGA)database,and two classical immune-related gene datasets(GO0006955/IMMUNE RESPONSE and GO0002376/IMMUNE SYSTERM PROCESS)and gene annotation information were used to identify immune-related LncRNAs.The immune-related LncRNAs associated with pancreatic cancer prognosis were used for univariate and multivariate Cox analyses to establish a model for the assessment of pancreatic cancer prognostic risk based on immune-associated LncRNAs.This risk model was used for survival analysis,clinical correlation analysis,immune cell infiltration analysis,pathway enrichment analysis,and prognostic column line plot modeling.Results We screened 119 immune-related LncRNAs in pancreatic cancer,and five immune-related LncRNAs(AC064836.3,LINC00941,ZNF236-DT,TMEM161B-AS1 and AC068580.2)were identified for the development of pancreatic cancer prognostic risk assessment model.According to the prognostic risk assessment model,pancreatic cancer patients were divided into low-risk group(n=86)and high-risk group(n=85).Compared with the low-risk group,the high-risk group showed a significant negative enrichment trend for immune-related signaling pathways,the 5-year overall survival of pancreatic cancer patients was significantly increased in the low-risk group compared with the high-risk group.The expression of low-risk immune-related LncRNAs(AC064836.3,ZNF236-DT and TMEM161B-AS1)gradually decreased with increasing clinical stage of pancreatic cancer patients.Patient age(P=0.031,risk ratio and 95％CI:1.025/1.002-1.048)and prognostic risk score(P＜0.001,risk ratio and 95％ confidence interval 1.801/1.465-2.215)could be used as independent prognostic risk factors for overall survival in pancreatic cancer.In addition,the prognostic risk assessment model had better predictive efficiency(area under the curve=0.695)compared with the disease predictive ability of common clinical characteristics.Steroid biosynthesis,pentose phosphate pathway,intercellular linkage,cytoskeletal rearrangement and other pathways related to energy metabolism and invasive migration of pancreatic cancer cells were significantly activated in the high-risk group.Meanwhile,pancreatic cancer patients in the high-risk group had lower levels of naive B cells,plasma cells and neutrophils with anti-tumor activity,but their macrophage infiltration levels were significantly higher than those in the low-risk group.Conclusion The prognostic risk assessment model constructed based on five immune-related LncRNAs can effectively predict the survival status,clinical characteristics,molecular pathways,and immune cell infiltration differences of pancreatic cancer patients.Meanwhile,relying on this model,the prognosis of pancreatic cancer patients can be prospectively predicted,which enhances the usefulness of this risk prediction model.

Objective To investigate the effect of nutritional intervention upon the clinical efficacy of chemoradiotherapy in patients diagnosed with esophageal carcinoma. Methods A total of 46 patients who were diagnosed with esophageal cancer in Anhui Cancer Hospital from November 2016 to August 2017 were enrolled in this prospective study. All patients were randomly and evenly divided into the nutritional intervention (NI) and routine treatment (RT) groups. The changes in body mass index (BMI),PG-SGA, serum albumin ( ALB), hemoglobin ( HB), white blood cell ( WBC) and other objective nutritional parameters and the incidence of chemoradiotherapy-induced complications were recorded before and after chemoradiotherapy. Results Prior to chemoradiotherapy,age,sex,BMI,ALB,PLT and clinical staging did not significantly differ between two groups (all P>0. 05).In the NI group,the BMI was (21.52±2. 67) after chemoradiotherapy,significantly higher than (21.13±2. 73) before radiotherapy (P= 0. 000).Moreover,the PG-SGA score after chemoradiotherapy was significantly lower compared with that before chemoradiotherapy (P= 0. 000).In the RT group,the BMI,Hb,ALB,PLT and WBC after chemoradiotherapy were significantly lower than those before radiotherapy, and thePG-SGA score was worse after chemoradiotherapy ( all P<0. 05).In the NI group, the incidence of grade 3 myelosuppression was 4. 34％, significantly lower than 8. 68％ in the RT group ( P= 0. 000 ). Conclusions Patients with esophageal cancer treated with chemoradiotherapy have a high nutritional risk. Nutritional intervention can improve the nutritional status, reduce the incidence of chemoradiotherapy-induced complications,and probably improve the quality of life and clinical prognosis.

Objective To investigate the significance of computed tomography(CT)and 3.0 T magnetic resonance imaging(MRI)in intensity-modulated radiotherapy(IMRT)for esophageal carcinoma. Methods Thirty-five patients newly diagnosed with esophageal carcinoma who received radical radiotherapy in our hospital from November 2013 to April 2015 were enrolled as subjects. Target volume was delineated on the CT images and MRI images(T2-weighted and diffusion-weighted fusion images). The MRI-and CT-based IMRT plans were designed using the same dose prescription and dose constraints for organs at risk(OAR). The target volume,prescribed dose,and doses for OAR were compared between the two plans. Results In the two plans, dose distribution and planning parameters met the clinical requirement. The length of lesion,gross tumor volume (GTV),and planning target volume(PTV)defined by 3.0 T MRI were significantly smaller than those defined by CT(P=0.00,0.03,0.03). There were no significant differences in the D 2%,D 98%,D 50%,homogeneity index,or conformity index for primary GTV(PGTV)and PTV-PGTV between the two plans(all P>0.05). Compared with the CT-based plan,the 3.0 T MRI-based plan had a significantly smaller mean dose to the lungs and an insignificantly smaller actual dose to the lungs(P=0.00;P>0.05).There were no significant differences in maximum doses tolerated by the spinal cord or heart between the two plans. Conclusions In terms of target volume delineation and dosimetric parameters, both CT-and 3.0 T MRI-based plans meet the clinical requirement. The 3.0 T MRI-based plan may provide potential benefits for some OAR due to a smaller target volume compared with the CT-based plan.

Objective To study the application effect of antiskid steel plate internal fixation via exposing lateral and posterior ankle fracture through fibula posterolateral approach in the treatment of Lauge-Hansen supination-eversion ankle fracture.Methods From January 2009 to December 2012,exposed the lateral and posterior ankle fracture through fibula posterolateral approach of 36 patients suffering from the Lauge-Hansen supination-eversion ankle fracture,and fixed the lateral and posterior ankle by the antiskid steel plate.Adopt Olerud-Molander ankle function scoring system to evaluate the postoperative effect of the ankle.Results All the patients were followed up for 7-27 months,with an average follow-up of 19 months.There was no complications such as incision infection and cutaneous necrosis.Only 1 patient occurred with peroneus myotenositis,and the symptom was relieved after taking out the steel plate.The fracture was healed within 16 weeks.Among the 36 cases,22 cases were excellent,9 cases were good,4 cases were medium and 1 case was poor.The fine rate was 86.1％(31/36).Conclusion Using the antiskid steel plate to treat the lateral and posterior ankle fracture through fibula posterolateral approach,can fully expose a single incision,fix the lateral and posterior ankle and reduce the tension in suture,improve the incision healing rate and fracture stability,provide a new method for treating ankle fracture.

Objective To investigate the effects of the treatment of open injury and orthopedic postoperative wound infections with Vacuum Sealing Drainage.Methods Retrospective analysis of the clinical results of 32 patients with open injury or orthopedic postoperative wound infections in our hospital.Results Follow the indications and contraindications strictly and ensure right pressure,all the infection of wounds was controlled,and split skin graft survived.Without the package and pressurized fixation,the wounds healed better.Conclusion Vacuum Sealing Drainage can be considered one of the effective methods to treat the open injury or orthopedic postoperative wound infections and is worthy to be carried out as a routine.For patients with vascular rupture or defect,when there was still skin defects after vascular graft repair,as long as covered vascular anastomosis with the surrounding skin and soft tissue during the operation,there was still can use closed vacuum sealing drainage to cover the wound to prevent infection.