【Objective】 To investigate the differences in efficacy and long-term prognosis between locally progressive low and intermediate rectal cancer patients receiving fluorouracil-based neoadjuvant chemotherapy alone (mFOLFOX6/CapeOX) and neoadjuvant radiotherapy, and to compare the therapeutic efficacy in the two groups. 【Methods】 We retrospectively analyzed the clinicopathological data of 118 patients with locally progressive low and intermediate rectal cancer who received neoadjuvant therapy from January 2019 to December 2021 at The First Affiliated Hospital of Xi’an Jiaotong University, including gender, age, body mass index (BMI), and other clinicopathological parameters. The t-test, Mann Whitney test, chi-square test or Fisher’s exact test were used to compare the differences between the two groups of patients who received neoadjuvant chemotherapy alone or neoadjuvant radiochemotherapy in terms of short-term efficacy, lymph node manifestations and long-term prognosis, respectively. Survival rates were calculated and survival curves were plotted using the Kaplan-Meier method. 【Results】 In terms of efficacy, patients in the neoadjuvant radiotherapy group achieved better tumor regression (Z=-2.05, P=0.04) and solid tumor efficacy (Z=-2.42, P=0.015), but the difference between the two groups in terms of downstaging effect of clinical stage was not statistically significant. The number of lymph nodes detected was significantly lower in the neoadjuvant radiotherapy group (neoadjuvant chemotherapy vs. neoadjuvant radiochemotherapy, 13.19±3.83 vs. 9.55±4.00, t=5.02, P<0.001), but the two groups did not differ significantly in the number of lymph node positives and lymph node positive ratio. In terms of long-term prognosis, there was no statistically significant difference in the overall survival rate or disease-free survival rate of the two groups. 【Conclusion】 Compared with neoadjuvant chemotherapy alone, neoadjuvant radiotherapy showed better short-term efficacy in patients with locally progressive low and intermediate rectal cancer, but there was no statistically significant difference between the two treatment regimens in terms of long-term prognosis.

Objective:To evaluate the application value of three-dimensional shear wave elastography(3D-SWE) with quantitative parameters and qualitative analysis of stiff rim sign in differentiating benign and malignant breast masses.Methods:One hundred and seventeen female patients (121 breast masses) admitted to the First Affiliated Hospital of Soochow University from January 2020 to February 2021 were examined by conventional ultrasound, two-dimensional shear wave elastography (2D-SWE) and 3D-SWE. Surgical or puncture pathology were used as the gold standard, the ROC curves of 2D-SWE and 3D-SWE were drawn to obtain the optimal qualitative and quantitative indicators. Afterwards, BI-RADS category was adjusted according to the optimal indicators, which could be used to evaluate the diagnostic value in differentiating benign and malignant breast masses.Results:The area under ROC curve (AUC) of BI-RADS category was 0.846, the sensitivity and specificity were 89.6% and 79.6%, respectively. The AUC value of mass-to-fat elasticity ratio(Eratio) of coronal plane was 0.869, which was the highest among all quantitative parameters and was significantly higher than that of 2D-SWE ( P<0.05). In addition, the AUC value of stiff rim sign of coronal plane was significantly higher than those of 2D-SWE, sagittal plane and transverse plane (All P<0.05). The AUC of combination of stiff rim sign of coronal plane and conventional US was 0.901, which was significantly higher than that using conventional ultrasound alone( P<0.05). Conclusions:Compared with 2D-SWE, Eratio and stiff rim sign of coronal plane of 3D-SWE yield better diagnostic efficiency.Adjusting stiff rim sign coronal plane to BI-RADS category can effectively improve the diagnostic efficiency.

Purpose: Seroma formation is a common complication in breast cancer patients undergoing mastectomy, and it negatively affects patient recovery after surgery. The present study aimed to evaluate a simple method using fascia suture technique to fix the flap and reduce the incidence of seroma. Methods: A single-center, prospective, randomized controlled trial was carried out among 160 patients who had undergone mastectomy from May 2018 to September 2019. All patients were randomly divided into the fascia suture group (n = 80) or control group (n = 80) and were followed up for at least 3 months for the assessment of immediate and late complications after surgery. Results: No significant differences were observed between the 2 groups with regard to the basic characteristics. Duration of surgery in the fascia suture group was longer by about 6 minutes compared with that in the control group (114.93 ± 13.67 minutes vs. 108.81 ± 15.20 minutes, p = 0.008). The fascia suture group had a shorter duration of drain placement (10.99 ± 3.26 days vs. 13.85 ± 5.37 days, p < 0.001), a smaller volume of the total drainage (460.95 ± 242.92 mL vs. 574.83 ± 285.23 mL, p = 0.007), and the first 3-day drainage (224.96 ± 101.01 mL vs. 272.3 ± 115.47 mL, p = 0.006), compared with the control group. The incidence of seroma formation (G2 or G3) was significantly lower in the fascia suture group compared with the control group (28.8% vs. 12.5%, p = 0.033). Besides, there was no statistical difference between the 2 groups in the assessment of other complications, including postoperative pain, hematoma, surgical site infections, flap necrosis, and skin dimpling (all p > 0.050). Conclusion The fascia suture technique is a simple and effective method for reducing seroma formation and should be used to prevent seroma formation after mastectomy.

OBJECTIVE： To provide reference for rational use of estradiol （E2） preparation in clinic. METHODS： The medical records of outpatients receiving assisted reproductive technology （ART） and E2 preparation [Estradiol valerate tablets （EV）， Complex packing estradiol tablets/estradiol and dydrogesterone tablets （EP）， Estradiol gel （EG）] were collected from the reproductive medicine center of a hospital during Jan. 2016-Mar. 2017. Taking drug instruction as standard， the rationality of medical records was evaluated from aspects of indication， route of administration， contraindication， usage and dosage， treatment course， etc. At the same time， these patients were followed up by telephone or outpatient service， and their pregnancy outcomes and ADR were summarized. RESULTS： A total of 12 646 prescriptions were collected， and 7 222， 3 912， 181 and 1 331 prescriptions used EV， EP， EG and EV+EP， respectively. The types of off-label use included over-indication， over-route and over-contraindication， and the rates of off-label use rates were 100％， 11.73％ and 43.60％， respectively. A total of 5 868 ART patients were involved； 439 patients received fresh embryo transplantation， and 5 429 patients received frozen-thawed embryo transplantation， involving 720 and 11 926 prescriptions， respectively. The rates of off-label use of above E2 preparations were 100％ （except for fresh embryo transplantation patients using EG）. As of Feb. 2018， the infant-holding rates of ART patients using EV， EP， EG and EV+EP were 85.29％， 85.37％， 86.36％ and 85.45％， respectively. No relevant ADR and neonatal birth defect was found. CONCLUSIONS： The phenomenon of off-label use of E2 preparations is widespread in the reproductive medicine center of the hospital. Although there is no indication of related safety risks， evidence-based evaluation should be carried out by enlarging the sample size in clinical practice， and careful use.

Objective Application of near-infrared fluorescent thoracoscope in visualizing thoracic sympathetic ganglions,to explore the effectiveness and safety of the technique.Methods Patients received near-infrared fluorescent thoracoscopic surgery was continuously in rolled from September 2015 to September 2016.The patient was infused indocyanine green 5 mg intravenous 24 hours before surgery.The thoracic sympathetic ganglions were observed under white and fluorescence model during surgery.The videos and photos were analyzed and the relationship between sympathetic ganglions and ribs was recorded.Results 31 patients was in rolled,including 12 males and 19 females.The average age was 47 years.The sympathetic ganglion of each patient was well visualized under fluorescence model.The signal to background ratio was 1.67.As we found that 48.8％ ganglions located in the upper edge of lower rib.Besides,26.9％ of T2 ganglions and 23.1％ of T3 ganglions located on the rib.Conclusion Near-infrared fluorescent thoracoscope was effiective and safety to visualize the thoracic sympathetic ganglions.The sympathectomy of palmar hyperhidrosis could be done by near-infrared fluorescent thoracoscope more precisely.

Objective To investigate the current situation of Chinese non-small cell lung cancer( NSCLC) surgical treat-ment in different centers.And to compare the differences of patient characteristics and treatment patterns .Methods Data of 5060 NSCLC patients out of 8387 patients from 14 provinces, 17 third-grade class-A hospitals was obtained .All included pa-tients were stage ⅠtoⅢ, and were treated with curative-intent surgeries during the years of 2013 and 2014.Patient character-istics, preoperative examinations, surgical treatment patterns and pathology et al.were analyzed.Results There were 3204 males and 1856 females.The patients' age was among 19~86(59.7 ±9.11)years old.Mean preoperative FEV1 was(2.23 ± 0.67)L, and mean FEV1/FVC was 81.8%.64.6% patients accompanied with at least one comorbidity.The mean diameter of tumor was(3.28 ±1.94)cm.Duration of surgery was(181.1 ±71.0) minutes.Pathology confirmed 59.8% as adenocarcino-ma, and 30.2% as squamous carcinoma.The ratio of adenocarcinoma/squamous cell carcinoma was 1.03:1 in all male pa-tients.And the ratio is 16.4:1 in female patients.Among all the patients that underwent lobectomies, 50.1% patients under-went micro-invasive surgeries(VATS or mini-incision surgery).The rate of micro-invasive surgery is among 8.3% to 90.2%. The number of lymph nodes stations harvested in lobectomy was 5.9(mean 3.0 -7.4).Mean hospital cost was 53830.8 ( mean 42205-100113 ) yuan.Conclusion The Chinese NSCLC patients who underwent surgeries own unique patient charac-teristics.The baseline characteristics, surgical treatment patterns and hospital cost varied among different centers.

Objective To explore the effect of a new organ preservation solution with HOE642 on the apoptosis of the donor lung from a modified lung transplantation model of rabbits.Methods 24 male rabbits were divided into two groups [low potassium dextran (LPD) group and HOE group],established rabbit models for next 2-h reperfusion using LPD solution or new organ preservation solution.Detected the levles of apoptosis index and caspase-3,the expression of Fas/Fas-L and Bcl-2/Bax.Results Compared with LPD group,HOE group revealed significant lower level of apoptosis index and caspase-3 (P＜0.05),lower expression of Fas/Fas-L and Bax,and higher expression of Bcl-2 (P＜0.05).Conclusion The potential donor lung protective mechanism offered by the new organ preservation solution with HOE642 might be the inhibition of apoptosis via both intrinsic and extrinsic pathways.

OBJECTIVETo observe the intervention effect of electroacupuncture (EA) on small intestinal motility in the rats of postoperative ileus (POI) at perioperative stage and explore the mechanism on the regulation of interstitial cells of Cajal (ICC) in the treatment of POI.

METHODSSixty heathy male SD rats were randomized into a sham-operation group, a model group, an EA group and a sham-EA group, 15 rats in each one. Except the sham-operation group, POI modeling was done in the rest groups. In the EA group, separately, 48 h, 24 h and 0.5 h before modeling, during modeling and 6 h, 12 h and 24 h after modeling, EA was given bilaterally to "Zusanli" (ST 36), 5 Hz, 1-2 mA, for 30 min. The sham-EA stimulation was given in the sham-EA group at the same time points. The same fixation was the only intervention in the model group. No intervention was applied in the sham-operation group. Five rats were selected randomly from each group 6 h, 12 h and 24 h after modeling for the determination of small intestine motility and they were sacrificed. Afterwards, the small intestinal muscular layer was collected for the determination of c-kit and P2X7 mRNA. In 24 h of modeling, the immunofluorescence test was done for c-kit determination.

RESULTSIn 6 h, 12 h and 24 h of modeling, in the model group, the EA groupand the sham-EA group, the small intestine motility was apparently lower than that in the sham-operation group at the same time points (all<0.01). In 6 h and 12 h of modeling, the small intestine motility in the EA group was not different significantly as compared with that in the model group (both>0.05). In 24 h of modeling, the small intestine motility in the EA group was better than that in the model group and the sham-EA group at the same time points (both<0.05). The difference was not significant between the sham-EA group and the model group (>0.05). In 6 h, 12 h and 24 h of modeling, c-kit mRNA expression of small intestine muscular layer was reduced apparently in the model group (all<0.01) and P2X7 mRNA expression did not change apparently (all>0.05). In 24 h of modeling, as compared with the model group and the sham-EA group, c-kit mRNA expression and positive cell area in the small intestine muscular layer were increased in the EA group (all<0.01).

CONCLUSIONSEA effectively increases the small intestinal motility in POI rats, shortens the recovery time, which is probably closely relevant with the increase of ICC count in small intestinal muscular layer.

CRISPR-Cas Systems ; Embryo, Mammalian ; Gene Editing ; methods ; HEK293 Cells ; Humans ; Polycomb Repressive Complex 1 ; genetics ; Zygote

OBJECTIVETo compare the efficacy between the multi-directional stimulation technique and routine needling technique in the range of motion (ROM) of the lower limbs in patients of post-stroke spasmodic paralysis.

METHODSSixty patients were randomized into a multi-directional stimulation technique group and a routine needling technique group, 30 cases in each one. In the two groups, Biguan (ST 31), Fengshi (GB 31), Yang-lingquan (GB 34), Xiyangguan (GB 33), Zhongfeng (LR 4), Jiexi (ST 41), Qiuxu (GB 40), Kunlun (BL 60) and Xuanzhong (GB 39) on the affected side, scalp acupuncture sites and the acupoints on the upper limb of the affected side were selected. The even needling technique was used in the routine needling technique group and the multi-directional stimulation technique was used in the multi-directional stimulation technique group. The treatment was given once daily, 5 days a week, for 4 weeks totally. Before and after treatment, Fugl-Meyer function and Berg balance were scored. The three-dimensional gait analysis was adopted to analyze ROM of hip, knee and ankle joints.

RESULTSFugl-Meyer function score and Berg balance score were improved significantly after treatment as compared with those before treatment in the two groups (all<0.01). The scores in the multi-directional stimulation technique group were all higher than those in the routine needling technique group (<0.01,<0.05). The abduction and adduction of hip joints and flexion-extension ROM were all improved after treatment as comparedwith those before treatment in the two groups (all<0.05). The maximum flexibility and flexion extension ROM of knee joint were improved after treatment as compared with those before treatment in the two groups (all<0.05), and the changes in extension of knee joint were not apparent (both>0.05). After treatment, the maximal flexion and the flexion-extension ROM of knee joint in the multi-directional stimulation technique group were improved significantly as compared with those in the routine needling technique group (both<0.05). The maximal dorsal flexion of ankle joint in the multi-directional stimulation technique group after treatment was increased as compared with that before treatment (<0.05), and the change was better than that in the routine needling technique group (<0.05).

CONCLUSIONSAcupuncture effectively increases the maximal adduction angle and flexion-extension ROM of hip joint, and reduces abduction of hip joint. The multi-directional stimulation technique contributes to the flexion of knee joint and dorsal flexion of ankle joint and the maintenance of limb balance. The efficacy of it is better than that of routine acupuncture stimulation technique.