Objective: To explore the relationship between nuclear factor-kappa B subunit 1 (NFKB1) and LIM-homeobox gene 2 (LHX2) polymorphisms and esophageal cancer susceptibility, so as to provide the reference for the prevention and treatment of esophageal cancer. Methods: A total of 100 patients with primary esophageal cancer diagnosed at the Affiliated Tumor Hospital of Xinjiang Medical University from 2019 to 2023 were selected as the case group, and 100 healthy individuals undergoing physical examination during the same period of time were selected as the control group. Demographic information, disease history and lifestyle data were collected through questionnaire surveys. The single nucleotide polymorphisms at the rs28362491 and rs4648068 loci of NFKB1 gene as well as rs10760310 and rs10121751 loci of LHX2 gene were detected using multiplex high-temperature ligase detection reaction technology. The relationship between these loci and esophageal cancer susceptibility were analyzed using a multivariable conditional logistic regression, linkage disequilibrium and haplotype analysis. The impact of the interaction between the above-mentioned loci and environmental factors on esophageal cancer susceptibility using the generalized multifactor dimensionality reduction (GMDR) method. Results: The case group comprised 73 males and 27 females, with a mean age of (64.02±8.90) years. The control group included 73 males and 27 females, with a mean age of (64.54±9.43) years. The genotype distributions of rs28362491, rs4648068, rs10760310 and rs10121751, loci in both groups conformed to Hardy-Weinberg equilibrium (all P>0.05). Multivariable conditional logistic regression analysis showed that rs10760310 and rs10121751 loci of LHX2 gene were associated with the esophageal cancer susceptibility (both P<0.05). The overdominant model of rs10760310 loci of LHX2 gene had the lowest Akaike information criterion value (OR=0.22, 95%CI: 0.10-0.47). GAA haplotypes at rs4648068, rs10760310 and rs10121751 loci were associated with a lower risk of esophageal cancer susceptibility (OR=0.26, 95%CI: 0.13-0.50). GMDR analysis revealed a statistically significant interaction between rs10760310 loci and smoking on esophageal cancer susceptibility (P<0.05, cross-validation consistency coefficient: 10/10). Conclusion The rs10760310 and rs10121751 loci polymorphisms of LHX2 gene may be associated with esophageal cancer susceptibility, and there is an interaction between rs10760310 loci and smoking on the esophageal cancer susceptibility.

Objective:To investigate the mortality burden among permanent residents in Shenzhen from 2014 to 2021 and to provide scientific evidence for establishing precision disease prevention and control strategy.Methods:Based on the cause-of-death surveillance data, we described the distribution of mortality rate, cause-specific rankings, and years of life lost (YLL) for the total population and subgroups in Shenzhen from 2014 to 2021. The seventh national population census data was used as the standard population to calculate the standardized mortality rate. Joinpoint log-linear regression model was used to analyze the chronic trend of mortality burden.Results:From 2014 to 2021, 49 734 deaths among the permanent population were recorded in Shenzhen, with a 140.90/100 000 average crude mortality rate, standardized as 366.77/100 000. Both the crude mortality rate and standardized mortality rate showed fluctuating increases from 2014 to 2016 [annual percent change (APC)=20.72%, P=0.048, APC=28.59%, P=0.016] and fluctuating decreases from 2016 to 2021 (APC=-1.55%, P=0.317, APC=-1.89%, P=0.190). The mortality rates of the <20 and 20- age groups decreased over time, with a statistically significant decrease observed in the <20 age group [average annual percent change (AAPC)=-11.91%, P<0.001]. The mortality rates of the 40-, 60-, and ≥80 age groups increased over time, with an increase observed in the ≥80 age group from 2014 to 2016 (APC=45.25%, P=0.016) and a decrease from 2016 to 2021 (APC=-2.18%, P=0.280). There was no statistical significance in the mortality rate trend for the remaining age groups (all P>0.05). The top three causes of death among permanent residents in Shenzhen from 2014 to 2021 were consistently malignant tumors, cardiovascular and cerebrovascular diseases, and respiratory system diseases, with crude mortality rates of 49.59/100 000, 47.95/100 000, and 7.90/100 000 respectively in 2021. From 2014 to 2021, 1 003 287.43 YLL were observed, with YLL for the total population, males and females all showing an upward trend (all P<0.001). Conclusions:The mortality burden among the elderly permanent residents in Shenzhen displayed a continuously increasing trend from 2014 to 2021. Strengthening the need for substantial efforts and actions to improve the prevention and control of chronic non-communicable diseases.

Objective:To investigate the epidemiological characteristics, diagnosis, treat-ment and prognosis of gallbladder cancer in China from 2010 to 2017.Methods:The single disease retrospective registration cohort study was conducted. Based on the concept of the real world study, the clinicopathological data, from multicenter retrospective clinical data database of gallbladder cancer of Chinese Research Group of Gallbladder Cancer (CRGGC), of 6 159 patients with gallbladder cancer who were admitted to 42 hospitals from January 2010 to December 2017 were collected. Observation indicators: (1) case resources; (2) age and sex distribution; (3) diagnosis; (4) surgical treatment and prognosis; (5) multimodality therapy and prognosis. The follow-up data of the 42 hospitals were collected and analyzed by the CRGGC. The main outcome indicator was the overall survival time from date of operation for surgical patients or date of diagnosis for non-surgical patients to the end of outcome event or the last follow-up. Measurement data with normal distribu-tion were represented as Mean±SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M( Q1, Q3) or M(range), and com-parison between groups was conducted using the U test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test. Univariate analysis was performed using the Logistic forced regression model, and variables with P<0.1 in the univariate analysis were included for multivariate analysis. Multivariate analysis was performed using the Logistic stepwise regression model. The life table method was used to calculate survival rates and the Kaplan-Meier method was used to draw survival curves. Log-rank test was used for survival analysis. Results:(1) Case resources: of the 42 hospitals, there were 35 class A of tertiary hospitals and 7 class B of tertiary hospitals, 16 hospitals with high admission of gallbladder cancer and 26 hospitals with low admission of gallbladder cancer, respectively. Geographical distribution of the 42 hospitals: there were 9 hospitals in central China, 5 hospitals in northeast China, 22 hospitals in eastern China and 6 hospitals in western China. Geographical distribution of the 6 159 patients: there were 2 154 cases(34.973%) from central China, 705 cases(11.447%) from northeast China, 1 969 cases(31.969%) from eastern China and 1 331 cases(21.611%) from western China. The total average number of cases undergoing diagnosis and treatment in hospitals of the 6 159 patients was 18.3±4.5 per year, in which the average number of cases undergoing diagnosis and treatment in hospitals of 4 974 patients(80.760%) from hospitals with high admission of gallbladder cancer was 38.8±8.9 per year and the average number of cases undergoing diagnosis and treatment in hospitals of 1 185 patients(19.240%) from hospitals with low admission of gallbladder cancer was 5.7±1.9 per year. (2) Age and sex distribution: the age of 6 159 patients diagnosed as gallbladder cancer was 64(56,71) years, in which the age of 2 247 male patients(36.483%) diagnosed as gallbladder cancer was 64(58,71)years and the age of 3 912 female patients(63.517%) diagnosed as gallbladder cancer was 63(55,71)years. The sex ratio of female to male was 1.74:1. Of 6 159 patients, 3 886 cases(63.095%) were diagnosed as gallbladder cancer at 56 to 75 years old. There was a significant difference on age at diagnosis between male and female patients ( Z=-3.99, P<0.001). (3) Diagnosis: of 6 159 patients, 2 503 cases(40.640%) were initially diagnosed as gallbladder cancer and 3 656 cases(59.360%) were initially diagnosed as non-gallbladder cancer. There were 2 110 patients(34.259%) not undergoing surgical treatment, of which 200 cases(9.479%) were initially diagnosed as gallbladder cancer and 1 910 cases(90.521%) were initially diagnosed as non-gallbladder cancer. There were 4 049 patients(65.741%) undergoing surgical treatment, of which 2 303 cases(56.878%) were initially diagnosed as gallbladder cancer and 1 746 cases(43.122%) were initial diagnosed as non-gallbladder cancer. Of the 1 746 patients who were initially diagnosed as non-gallbladder cancer, there were 774 cases(19.116%) diagnosed as gallbladder cancer during operation and 972 cases(24.006%) diagnosed as gallbladder cancer after operation. Of 6 159 patients, there were 2 521 cases(40.932%), 2 335 cases(37.912%) and 1 114 cases(18.087%) undergoing ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) examination before initial diagnosis, respec-tively, and there were 3 259 cases(52.914%), 3 172 cases(51.502%) and 4 016 cases(65.205%) undergoing serum carcinoembryonic antigen, CA19-9 or CA125 examination before initially diagnosis, respectively. One patient may underwent multiple examinations. Results of univariate analysis showed that geographical distribution of hospitals (eastern China or western China), age ≥72 years, gallbladder cancer annual admission of hospitals, whether undergoing ultrasound, CT, MRI, serum carcinoembryonic antigen, CA19-9 or CA125 examination before initially diagnosis were related factors influencing initial diagnosis of gallbladder cancer patients ( odds ratio=1.45, 1.98, 0.69, 0.68, 2.43, 0.41, 1.63, 0.41, 0.39, 0.42, 95% confidence interval as 1.21-1.74, 1.64-2.40, 0.59-0.80, 0.60-0.78, 2.19-2.70, 0.37-0.45, 1.43-1.86, 0.37-0.45, 0.35-0.43, 0.38-0.47, P<0.05). Results of multivariate analysis showed that geographical distribution of hospitals (eastern China or western China), sex, age ≥72 years, gallbladder cancer annual admission of hospitals and cases undergoing ultrasound, CT, serum CA19-9 examination before initially diagnosis were indepen-dent influencing factors influencing initial diagnosis of gallbladder cancer patients ( odds ratio=1.36, 1.42, 0.89, 0.67, 1.85, 1.56, 1.57, 0.39, 95% confidence interval as 1.13-1.64, 1.16-1.73, 0.79-0.99, 0.57-0.78, 1.60-2.14, 1.38-1.77, 1.38-1.79, 0.35-0.43, P<0.05). (4) Surgical treatment and prognosis. Of the 4 049 patients undergoing surgical treatment, there were 2 447 cases(60.435%) with complete pathological staging data and follow-up data. Cases with pathological staging as stage 0, stage Ⅰ, stage Ⅱ, stage Ⅲa, stage Ⅲb, stage Ⅳa and stage Ⅳb were 85(3.474%), 201(8.214%), 71(2.902%), 890(36.371%), 382(15.611%), 33(1.348%) and 785(32.080%), respectively. The median follow-up time and median postoperative overall survival time of the 2 447 cases were 55.75 months (95% confidence interval as 52.78-58.35) and 23.46 months (95% confidence interval as 21.23-25.71), respectively. There was a significant difference in the overall survival between cases with pathological staging as stage 0, stage Ⅰ, stage Ⅱ, stage Ⅲa, stage Ⅲb, stage Ⅳa and stage Ⅳb ( χ2=512.47, P<0.001). Of the 4 049 patients undergoing surgical treatment, there were 2 988 cases(73.796%) with resectable tumor, 177 cases(4.371%) with unresectable tumor and 884 cases(21.833%) with tumor unassessable for resectabi-lity. Of the 2 988 cases with resectable tumor, there were 2 036 cases(68.139%) undergoing radical resection, 504 cases(16.867%) undergoing non-radical resection and 448 cases(14.994%) with operation unassessable for curative effect. Of the 2 447 cases with complete pathological staging data and follow-up data who underwent surgical treatment, there were 53 cases(2.166%) with unresectable tumor, 300 cases(12.260%) with resectable tumor and receiving non-radical resection, 1 441 cases(58.888%) with resectable tumor and receiving radical resection, 653 cases(26.686%) with resectable tumor and receiving operation unassessable for curative effect. There were 733 cases not undergoing surgical treatment with complete pathological staging data and follow-up data. There was a significant difference in the overall survival between cases not undergoing surgical treatment, cases undergoing surgical treatment for unresectable tumor, cases undergoing non-radical resection for resectable tumor and cases undergoing radical resection for resectable tumor ( χ2=121.04, P<0.001). (5) Multimodality therapy and prognosis: of 6 159 patients, there were 541 cases(8.784%) under-going postoperative adjuvant chemotherapy and advanced chemotherapy, 76 cases(1.234%) under-going radiotherapy. There were 1 170 advanced gallbladder cancer (pathological staging ≥stage Ⅲa) patients undergoing radical resection, including 126 cases(10.769%) with post-operative adjuvant chemotherapy and 1 044 cases(89.231%) without postoperative adjuvant chemo-therapy. There was no significant difference in the overall survival between cases with post-operative adjuvant chemotherapy and cases without postoperative adjuvant chemotherapy ( χ2=0.23, P=0.629). There were 658 patients with pathological staging as stage Ⅲa who underwent radical resection, including 66 cases(10.030%) with postoperative adjuvant chemotherapy and 592 cases(89.970%) without postoperative adjuvant chemotherapy. There was no significant difference in the overall survival between cases with postoperative adjuvant chemotherapy and cases without postoperative adjuvant chemotherapy ( χ2=0.05, P=0.817). There were 512 patients with pathological staging ≥stage Ⅲb who underwent radical resection, including 60 cases(11.719%) with postoperative adjuvant chemotherapy and 452 cases(88.281%) without postoperative adjuvant chemotherapy. There was no significant difference in the overall survival between cases with postoperative adjuvant chemo-therapy and cases without post-operative adjuvant chemo-therapy ( χ2=1.50, P=0.220). Conclusions:There are more women than men with gallbladder cancer in China and more than half of patients are diagnosed at the age of 56 to 75 years. Cases undergoing ultrasound, CT, serum CA19-9 examination before initial diagnosis are independent influencing factors influencing initial diagnosis of gallbladder cancer patients. Preoperative resectability evaluation can improve the therapy strategy and patient prognosis. Adjuvant chemotherapy for gallbladder cancer is not standardized and in low proportion in China.

Objectives:To examine the efficacy of terminal branches portal vein embolization(TBPVE) for the increment of FLR in hepatocellular carcinoma (HCC) patients and to introduce its clinical value with transcatheter chemoembolization(TACE) in the treatment of HCC patients without surgery.Methods:One hundred and fifty HCC patients from three clinical centers of china underwent TBPVE technique from December 2016 to May 2021,including 89 males and 61 females. The average age was 51.9 years(range:18 to 79 years).One hundred and one patients were diagnosed with a background of HBV infection,including 27 patients with portal venous hypertension.TACE was performed simultaneously with TBPVE in 102 patients.Fifty-three patients underwent hepatectomy,who were subdivided into HBV positive and HBV negative groups,with TACE and without TACE groups to analyze the increment of future liver remnant (FLR), complications and survival data.These data were also analyzed in other 97 patients without hepatectomy.Results:All the patients reached adequate FLR successfully in 14 days after TBPVE including patients with portal venous hypertension.The average increment rates of FLR was 56.2% in 7 days and 57.8% in 14 days after TBPVE. There was no significant difference neither between HBV positive and HBV negative groups(7 days:(55.0±27.3)% vs.(57.8±20.9)%, t=0.885, P=0.373; 14 days:(57.3±24.6)% vs.(58.3±23.7)%; t=0.801, P=0.447),or between with TACE and without TACE groups(7 days:(62.3±26.3)% vs. (48.8±20.6)%; t=1.788, P=0.077;14 days:(64.4±25.0)% vs.(55.2±23.1)%; t=1.097, P=0.257).The morbidity and mortality rates were 20.8% and 1.9% in patients with hepatectomy.The 1-,3-year overall survival(OS) and disease-free(DFS) rates were 87.5%,64.5% and 64.7%,40.6% for patients underwent surgery.There was no significant difference of 1-,3-year OS and DFS between HBV positive and negative groups,but there were different between TACE and without TACE groups.The 1-,3-year OS for patients underwent TBPVE and TACE but without surgery were 80.1%, 53.7%. Conclusion:TBPVE is a good alternative technique for modulation of FLR for staged hepatectomy even in HBV positive HCC patients and can be applied with TACE procedure simultaneously as an option treatment for patients with no intend to surgery.

Objectives:To examine the efficacy of terminal branches portal vein embolization(TBPVE) for the increment of FLR in hepatocellular carcinoma (HCC) patients and to introduce its clinical value with transcatheter chemoembolization(TACE) in the treatment of HCC patients without surgery.Methods:One hundred and fifty HCC patients from three clinical centers of china underwent TBPVE technique from December 2016 to May 2021,including 89 males and 61 females. The average age was 51.9 years(range:18 to 79 years).One hundred and one patients were diagnosed with a background of HBV infection,including 27 patients with portal venous hypertension.TACE was performed simultaneously with TBPVE in 102 patients.Fifty-three patients underwent hepatectomy,who were subdivided into HBV positive and HBV negative groups,with TACE and without TACE groups to analyze the increment of future liver remnant (FLR), complications and survival data.These data were also analyzed in other 97 patients without hepatectomy.Results:All the patients reached adequate FLR successfully in 14 days after TBPVE including patients with portal venous hypertension.The average increment rates of FLR was 56.2% in 7 days and 57.8% in 14 days after TBPVE. There was no significant difference neither between HBV positive and HBV negative groups(7 days:(55.0±27.3)% vs.(57.8±20.9)%, t=0.885, P=0.373; 14 days:(57.3±24.6)% vs.(58.3±23.7)%; t=0.801, P=0.447),or between with TACE and without TACE groups(7 days:(62.3±26.3)% vs. (48.8±20.6)%; t=1.788, P=0.077;14 days:(64.4±25.0)% vs.(55.2±23.1)%; t=1.097, P=0.257).The morbidity and mortality rates were 20.8% and 1.9% in patients with hepatectomy.The 1-,3-year overall survival(OS) and disease-free(DFS) rates were 87.5%,64.5% and 64.7%,40.6% for patients underwent surgery.There was no significant difference of 1-,3-year OS and DFS between HBV positive and negative groups,but there were different between TACE and without TACE groups.The 1-,3-year OS for patients underwent TBPVE and TACE but without surgery were 80.1%, 53.7%. Conclusion:TBPVE is a good alternative technique for modulation of FLR for staged hepatectomy even in HBV positive HCC patients and can be applied with TACE procedure simultaneously as an option treatment for patients with no intend to surgery.

In order to facilitate the treatment strategies for biliary tract injury, hilar cholangiocarcinoma, bile duct tumor thrombus, cholangiocellular carcinoma and bile duct cystic dilatation, many classifications have been made, even more than 10 types for one disease. Each type is represented by numbers or English alphabet, which are not only confusing but also difficult to remember. The Academician Mengchao Wu divided the liver into five sections and four segments base on its anatomy, this classification is very direct and visual, thus had been using till now. In order to overcome those complicated problems, it is considered to develop a new classification based on actual anatomic location similar to that for liver cancer, which is easy to remember and to directly determine the treatment strategy. All kinds of classifications have their own characteristics and advantages and disadvantages. This practical classifications avoid the complexity and may be useful for clinicians.

Objective To explore the three ultrasonic technologies of two -dimensional ultrasound(2D -US),ultrasonic elastography(UE) and contrast -enhanced ultrasound(CEUS) for the measurement error in breast cancer and the correlation with the expression of ER,PR,VEGF.Methods 50 patients with breast cancer were meas-ured by 2D -US,UE,CEUS preoperatively,and the pathological specimen were measured postoperatively.Then used the immunohistochemistry to detect the expression of ER,PR,VEGF in tumor,and analyzed the correlation with the measurement errors.Results The results of differences between 2D -US,UE,CEUS and pathology were respectively as follows:( -0.59 ±-0.34)cm,( -0.20 ±-0.14)cm,( -0.40 ±-0.31)cm,and the differences were statistically significant(F =20.497,P <0.001).The positive expression rate of ER and PR was high if the difference between UE and 2D -US was less than or equal to 0.44cm.And the positive expression rate of VEGF was low if the difference between CEUS and 2D -US was less than or equal to 0.19cm.Three ultrasonic technologies in the measurement of breast cancer were different,the trend of difference between UE and 2D -US was smaller if the ER and PR were positively expression,and the trend of difference between CEUS and 2D -US was bigger if the VEGF was positively expression.Conclusion There is correlation between different immunohistochemical expression of breast cancer with measurement error in three different ultrasonic imaging technologies.The results suggest that the molecular pathology difference of breast cancer can impact on ultrasonic imaging,which contributes to know the reason and regulation of measurement error in different ultrasonic imaging technology.

Objective To investigate the relation between the balloon occlusion test ( BOT) and the anatomy of the circle of Willis ( CW) , and to explore the role of balloon occlusion test in the treatment of internal carotid artery permanent occlusion. Methods Selected the clinical data of 49 patients (52 sides) who had BOT in our hospital from October 2009 to June 2015,and analyzed the relationship be-tween the occurrence rate of anterior communicating artery ( AcoA) / posterior communicating artery ( PcoA) and the positive rate of BOT retrospectively. Results The occurrence rate of the AcoA was 97. 9%, and the occurrence rate of PcoA in one side was 82. 7%. Negative rate BOT accounted for 92. 3% and AcoA occurred in all, while the positive rate accounted for 7. 7%, including 2 cases of right superior ar-teria cerebri anterior combined with ipsilateral PcoAs absence, 1 case of left superior arteria cerebri anterior combined with ipsilateral PcoAs absence, and 1 case of AcoA and PcoAs absence. Conclusion Before the permanent occlusion of the internal carotid artery, it’ s necessary to clarify the redistribution of the compensatory way of blood flow in the AcoA-absent cases. Implementing permanent occlusion for cases with complete circle of Willis would cause less ischemic risk.

BACKGROUND:It is the key point to choose the right size of the prosthesis, and grasp the direction and thickness for osteotomy during total knee arthroplasty. In order to achieve the goal, accurate preoperative planning is very important.
OBJECTIVE:To compare the accuracy of preoperative templating in total knee arthroplasty using conventional two-dimensional (2D) and computed tomography (CT)-based three-dimensional (3D) procedures (templating on 3D image&surgical rehearsing on rapid prototype technology-models), and to confirm the necessity of 3D evaluation for preoperative planning.
METHODS:A total of 25 patients undergoing primary total knee arthroplasty were randomly selected, including 10 males and 15 females, at the age of 58 and 79 years old. 2D and 3D images were col ected from al patients. Preoperative templating was performed for each total knee arthroplasty using both conventional 2D radiographs and a CT-based 3D image model. Accuracies with regard to the predicted and actual implant sizes were determined for each procedure.
RESULTS AND CONCLUSION:The 3D procedure was found to be more accurate in predicting implant size of 80%femoral and 72%tibial components than those of the 2D procedure (4%femoral and 12%tibial components). Significant differences in the consistent rate of femoral and tibial prosthesis models were detected significantly (P<0.05). Kappa coefficient statistics demonstrated that goodness of fit of prosthesis model was good in 3D preoperative templating. Results confirmed that the superiority of 3D preoperative templating over 2D conventional evaluation is in predicting implant size, and provides more comprehensive information on skeletal anatomy.

Objetive To investigate the effect of Fasudil on the hepatic ischemia repeffusion injury on rats of obstructive jaundice.Methods 160 mature SD rats were randomly assigned into 2 large groups,namely experimental group (Group A) and control group (Group B).While each large group was subdivided into 4 subgroups,including sham operation subgroups(Group A1 and B1),obstructive jaundice model subgroups(Group A2 and B2),ischemia reperfusion model subgroups (Group A3 and B3)and obstructive jaundice plus ischemia reperfusion model subgroups (Group A4 and B4).In Group A2 and B2,obstructive jaundice models were made on rats by double ligating and cutting the common bile ducts.In Group A3 and B3,the ischemia reperfusion injury models were built by blocking the hepatic portal vessel for 30 minutes before reperfusion.In Group A4 and B4,the ischemia reperfusion injury models were built in 1 week after building the obstructive jaundice models.For Group A,10 mg/kg fasudil was intraperitoneally injected at 30 minutes before ischemia.For Group B,equal amount of physiological saline was injected.Samples were gained on zero hour,1 hour,2 hour and 6 hour post reperfusion.The serum indexes for liver function and serum Endothelin 1 level were tested and analyzed through SPSS.Pathological changes of liver were viewed correspondingly.Results Compared to control groups (Group Bs),experimental groups (Groups As) have better liver function,lower Endothelin 1 level (P ＜ 0.05),as well as less severe microscopic histological damage.Conclusion Fasudil can effectively protect rats of obstructive jaundice from hepatic ischemia reperfusion injury.