Objective:To analysis the clinical features and prognosis in oropharyngeal carcinoma with secondary primary tumor. Methods:A retrospective analysis was performed on 468 pathologically confirmed oropharyngeal cancer as the primary tumor patients with p16 status, excluded distant metastasis, and admitted to the Chinese Academy of Medical Sciences from January 2010 to December 2020. The clinical features and prognosis of the secondary primary tumor were analyzed. Results:Among 468 patients with oropharyngeal cancer treated at initial diagnosed, 222 cases were P16-negative. With a median follow-up time of 64.3 months, 66 cases developed second primary cancer, with an incidence of 29.3%, among which 63.6%（42/66） were synchronous and 36.4%（24/66） were heterochronous, esophagus was the most commonly involved site. The 5-year OS of p16-negative oropharyngeal carcinoma with synchronous second primary cancer, without second primary cancer and with heterogeneous second primary cancer were 26.3% and 57.3% and 73.2%（P=0.001）; The second primary cancer accounted for 11.2%（12/107） of the deaths in the whole group, among them, the heterochronous second primary accounted for 75.0%（9/12）. There were 246 patients with p16 positive, with a median follow-up time of 52.4 months, 20 patients developed second primary cancer（8.1%）. Among them, 65.0%（13/20） were synchronous and 35.0%（7/20） were heterochronous. Esophagus was the most commonly involved site. The 4-year OS of p16-positive with synchronous, heterochronous and non-second primary cancer group were 51.9%, 80.7% and 83.3%. Secondary primary cancer accounted for 3.8%（2/52） of all deaths in p16 positvie group. Conclusion:The incidence of second primary cancer of p16 positive and negative oropharyngeal carcinoma were different. The esophagus was the most commonly involved site regardless of p16 status. Regardless of p16 status, the survival of patients with synchronous second primary cancer was worse than those without second primary cancer. For p16-negative oropharyngeal carcinoma, the prognosis was better in patients with heterogeneous second primary cancer, the second primary cancer is one of the main causes of death.
Humans ; Carcinoma/diagnosis* ; Oropharyngeal Neoplasms/diagnosis* ; Retrospective Studies ; Neoplasms, Second Primary/diagnosis*

Oropharyngeal carcinoma is one of the most common malignant tumors of head and neck. In recent years, the incidence of Human papilloma virus-associated oropharyngeal squamous cell carcinoma（HPV-OPSCC） has been increasing year by year. With the advancement of minimally invasive surgical techniques, the wide application of intensity modulated radiation therapy, and the demand of patients for organ function protection and higher quality of life, the unique biological behavior and better prognosis of HPV-OPSCC have led to the exploration of a series of attenuated treatment modes. This article reviews the diagnosis and treatment status of oropharyngeal cancer and related research progress based on relevant reports.
Humans ; Papillomavirus Infections/diagnosis* ; Quality of Life ; Squamous Cell Carcinoma of Head and Neck/therapy* ; Head ; Human Papillomavirus Viruses ; Oropharyngeal Neoplasms/therapy* ; Head and Neck Neoplasms

Objective:To evaluate the efficacy and safety of nimotuzumab in the treatment of advanced head and neck tumors by using meta-analysis.Methods:Randomized controlled trials (RCT) of locally advanced head and neck squamous cell carcinoma (LA-HNSCC) treated with nimotuzumab were searched from databases (Cochrane Library, PubMed, Embase, Wanfang Data and CNKI) for meta-analysis. The efficacy evaluation indexes included overall survival, progression-free survival, disease-free survival, objective response rate, and complete response rate. Adverse reactions were analyzed for safety evaluation. The heterogeneity results were evaluated by Chi-square test, the degree of heterogeneity was evaluated by I2, and the literature was statistically analyzed by random effects model. Results:A total of 11 RCT were included, consisting of 1 202 patients (602 in the intervention group and 600 in the control group). Compared with the control group, the overall survival was significantly prolonged, death risk was decreased by 22% ( HR=0.78, 95% CI=0.63-0.95, P=0.014), the progression-free survival was prolonged and the risk of disease progression was declined by 35% ( HR=0.65, 95% CI=0.53-0.81, P<0.01), and the disease-free survival was prolonged and the risk of recurrence was decreased by 29% ( HR=0.71, 95% CI=0.55-0.91, P<0.01), the objective response rate ( RR=1.37, 95% CI=1.20-1.55, P<0.01) and complete response rate ( RR=1.30, 95% CI=1.15-1.46, P<0.01) were significantly improved in the intervention group. In addition, adding nimotuzumab did not increase the incidence of adverse reaction ( RR=0.98, 95% CI=0.93-1.03, P=0.41). Conclusion:Nimotuzumab can significantly prolong long-term survival and improve short-term efficacy with high safety in LA-HNSCC patients.

Cervical lymph metastasis carcinoma from unknown primary tumor (CCUP) accounts for 3% to 5% of all malignant tumors of head and neck. With the development of PET-CT, molecular pathology, endoscopy and other auxiliary examinations and the advancement of radiotherapy technology, the diagnostic and treatment levels of CCUP have been gradually improved. Surgery and radiotherapy are the most important treatment methods of CCUP. However, due to its low incidence and heterogeneity, prospective clinical trial data are still lacking. Hence, the optimal therapy of CCUP remains highly controversial. In this article, research progresses on the diagnosis and treatment of CCUP in recent years were reviewed.

Dyslipidemia is an important risk factor of atherosclerotic cardiovascular disease (ASCVD). Statins delay the occurrence and development of ASCVD, and reduce the risk of cardiovascular events and death. Due to safety concerns, there exist insufficient use of lipid-lowering agents and a high withdrawal rate of the agents in the elderly. To promote the prevention and treatment of ASCVD, this expert consensus is issued and focuses on the management of dyslipidemia of Chinese elderly basing on the clinical evidence of the use of lipid-lowering drugs by the elderly, and the lipid management guidelines and expert consensus recommendations at home and abroad.

On the basis of intensity-modulated radiotherapy (IMRT)-based comprehensive treatment, the 5-year overall survival rate of initially-treated nasopharngeal carcinoma patients without recurrence and metastasis has reached 80%, local regional control rate has exceeded 90%, whereas approximately 10%-15% of patients will suffer from local and/or nodal recurrence after initial treatment. The factors affecting the decision-making of re-treatment mainly include the causes of local and/or nodal recurrence of nasopharngeal carcinoma after initial treatment, selection of re-treatment, side effects and efficacy after re-treatment. This article summarizes the recent progress on these issues above.

Objective To investigate the characteristics of lung ultrasound images in critical care postoperative patients using BLUE-plus protocol . Methods Two hundred and twenty-two patients who were performed lung ultrasound measurements according to the BLUE-plus protocol within 24 hours admitted to the Department of critical care were included in this study . Data was collected and retrospectively analyzed to compare the proportion of different lung ultrasound signs at different speculate regions ,and to compare the lung ultrasound characteristics of patients undergo different surgeries . Results Excluding A lines ,the most common abnormal lung ultrasound signs at the diaphragmatic points were B7 lines (13 .06％ ) ,and the most common abnormal lung ultrasound signs at the posterior blue points were C signs (28 .60％ ) . The rate of C signs was significantly higher in post spinal cord surgery patients than those in other groups ( P =0 .032) . The rate of B3 lines was significantly higher at bilateral PLAPS points in oxygenation index 100-200 group compared with that in oxygenation index>300 group ( P =0 .011) . The rate of C signs was significantly higher at the left posterior blue point in oxygenation index 200-300 group , and at bilateral posterior blue point in oxygenation index 100-200 and <100 groups compared with those in oxygenation index >300 group ( P =0 .011 , P <0 .001 and P =0 .002) . The rate of pleural effusion was significantly higher at the right posterior blue point in oxygenation index 200 -300 group ,and at bilateral posterior blue point in oxygenation index 100 -200 group compared with those in oxygenation index >300 group ( P = 0 .001 , P < 0 .001 ) . Conclusions Screen with the BLUE-plus protocol can help to find abnormal signs including B3 lines ,B7 lines ,C signs and pleural effusion ,therefore instructs individualized treatment for postoperative patients . Pulmonary edema ,lung consolidation and pleural effusion are three main reasons responsible for hypoxemia in postoperative patients . Intensivists should avoid fluid overload , strengthen airway management ,postural therapy and encourage early mobility in postoperative patients .

Objective To develop a novel method for genotyping rs 738409 ( C >G ) single nucleotide polymorphism ( SNP ) , and explore the association between the rs 738409 genotypes and non-alcoholic fatty liver disease ( NAFLD ) .Methods Method establishment and analysis of genetic susceptibility.The principle of amplification refractory mutation system ( ARMS) and combined a TaqMan fluorogenic probe as signal report were used , by monitoring the difference of cycle threshold (ΔCt=C allele-special primer Ct values minus G allele-special primer Ct values ) between the two PCR reactions in a real-time PCR, the method for rs738409 genotyping was established ( ARMS-TaqMan) .618 subjects ( men:401;women: 217 ) , in an annual health check-up program from January 2011 to December 2014 in Aerospace Center Hospital , were performed for rs738409 genotyping by the ARMS-TaqMan assay.Fatty liver was diagnosed based on abdominal ultrasonography .The chi-square test and multiple logistic analyses were used to analyze the relationship of rs 738409 genotypes and NAFLD.Results The ΔCt by ARMS-TaqMan for rs738409 genotyping were -13.1 ±1.4 of CC alleles ( 243 cases ) , 0.01 ±0.45 of CG alleles ( 282 cases), and 12.7 ±1.9 of GG alleles (93 cases), respectively.The GG alleles frequency of rs738409 were significantly higher in patients with NAFLD compared with subjects without NAFLD (21.5%vs 12.3%,χ2=8.677, P =0.003).In comparison to subjects with CC alleles, the OR (95% confidence interval) adjusted for age, gender, total cholesterol, triglyceride, high density lipoprotein-cholesterol, low density lipoprotein-cholesterol, fasting blood glucose and body mass index was 1.35 (0.91-2.00) in subjects with CG alleles and was 2.21 ( 1.32 -3.71 ) in subjects with GG alleles ( P =0.013 ) .Variant rs738409 genotypes were associated with significant increased trend in alanine aminotransferase ( ALT) level from CC alleles, CG alleles to GG alleles (F=8.980, P<0.001), and in aspartate aminotansferase (AST) between GG alleles and CC alleles (F=6.491, P<0.001).Conclusions The novel ARMS-TaqMan assay had the features of accuracy , one step and high-throughput for rs738409 genotyping.The G allele of rs738409 was a risk factor of NAFLD susceptibility and associated with higher level serum ALT and AST .

Carcinoma, Non-Small-Cell Lung ; classification ; therapy ; China ; Humans ; Lung Neoplasms ; classification ; therapy ; Practice Guidelines as Topic ; Receptor Protein-Tyrosine Kinases ; metabolism

A 2-month-old baby girl developed universal keratotic plaques soon after birth. Physical examination revealed well-defined, dark erythematous, keratotic plaques with thick scales and mild infiltration at the periorbital, perioral, perianal and vulvar regions, as well as deep fissures of both hands and feet covered with thick yellowish crusts. Another case was a 24-year-old female, the mother of the baby, who presented with hyperkeratotic plaques at perioral and perianal regions, congenital alopecia universalis, mutilation of fingers and toes with massive thick keratotic yellow crusts and scales. Histopathology of skin lesions from the gluteal region of the baby showed psoriasiform hyperplasia of the epidermis, slight inflammatory infiltration of dermal papillae and superficial dermal perivascular regions. Immunohistochemistry demonstrated the positive staining for acidic keratin (AE1) in the prickle cell layer and granular layer and for CK10 in the upper prickle cell layer and granular layer. Electron microscopy showed increased cell space and decreased tonofilament. Both the baby girl and her mother were diagnosed with Olmsted syndrome.