Objective:To characterize the histopathological subtypes and their clinicopathological parameters of gender and onset age by common, rare and sparse primary esophageal malignant tumors (PEMT).Methods:A total of 272 437 patients with PEMT were enrolled in this study, and all of the patients were received radical surgery. The clinicopathological information of the patients was obtained from the database established by the State Key Laboratory of Esophageal Cancer Prevention & Treatment from September 1973 to December 2020, which included the clinical treatment, pathological diagnosis and follow-up information of esophagus and gastric cardia cancers. All patients were diagnosed and classified by the criteria of esophageal tumor histopathological diagnosis and classification (2019) of the World Health Organization (WHO). The esophageal tumors, which were not included in the WHO classification, were analyzed separately according to the postoperative pathological diagnosis. The χ 2 test was performed by the SPSS 25.0 software on count data, and the test standard α=0.05. Results:A total of 32 histopathological types were identified in the enrolled PEMT patients, of which 10 subtypes were not included in the WHO classification. According to the frequency, PEMT were divided into common (esophageal squamous cell carcinoma, ESCC, accounting for 97.1%), rare (esophageal adenocarcinoma, EAC, accounting for 2.3%) and sparse (mainly esophageal small cell carcinoma, malignant melanoma, etc., accounting for 0.6%). All the common, rare, and sparse types occurred predominantly in male patients, and the gender difference of rare type was most significant (EAC, male∶ female, 2.67∶1), followed with common type (ESCC, male∶ female, 1.78∶1) and sparse type (male∶ female, 1.71∶1). The common type (ESCC) mainly occurred in the middle thoracic segment (65.2%), while the rare type (EAC) mainly occurred in the lower thoracic segment (56.8%). Among the sparse type, malignant melanoma and malignant fibrous histiocytoma were both predominantly located in the lower thoracic segment (51.7%, 66.7%), and the others were mainly in the middle thoracic segment.Conclusion:ESCC is the most common type among the 32 histopathological types of PEMT, followed by EAC as the rare type, and esophageal small cell carcinoma and malignant melanoma as the major sparse type, and all of which are mainly occur in male patients. The common type of ESCC mainly occur in the middle thoracic segment, while the rare type of EAC mainly in the lower thoracic segment. The mainly sparse type of malignant melanoma and malignant fibrous histiocytoma predominately occur in the lower thoracic segment, and the remaining sparse types mainly occur in the middle thoracic segment.

Invasive fungal infections (IFIs) represent a growing public concern for clinicians to manage in many medical settings, with substantial associated morbidities and mortalities. Among many current therapeutic options for the treatment of IFIs, amphotericin B (AmB) is the most frequently used drug. AmB is considered as a first-line drug in the clinic that has strong antifungal activity and less resistance. In this review, we summarized the most promising research efforts on nanocarriers for AmB delivery and highlighted their efficacy and safety for treating IFIs. We have also discussed the mechanism of actions of AmB, rationale for treating IFIs, and recent advances in formulating AmB for clinical use. Finally, this review discusses some practical considerations and provides recommendations for future studies in applying AmB for combating IFIs.

Objective:To optimize the preparation technic of Chuanxiong Rhizoma with vacuum steam method, and to investigate the anti-inflammatory and analgesic activity of Chuanxiong Rhizoma decoction pieces with Central Composite Design-Response Surface Method. Methods:Taking the content of ferulic acid as the evaluation index and the moistening temperature, moistening time and vacuum time as the observation indexes, the moistening technic of Chuanxiong Rhizoma was optimized by Response Surface Method, and selected the optimized plan. The anti-inflammatory and analgesic activities of Chuanxiong Rhizoma were investigated by auricle swelling induced by xylene and writhing induced by glacial acetic acid. Results:The optimum vacuum moistening technic was that the softening temperature was 80 ℃, the softening time was 50 min and the vacuum time was 45 min. The content of ferulic acid in Chuanxiong Rhizoma produced by this technic is highand could decreased the times of wrinkle reaction induced by acetic acid in mice, prolonged the latent period, and obviously or partially inhibitied the ear swelling degree induced byxylene in rats. Conclusions:The Response Surface Method technic of Chuanxiong Rhizoma is easy to operate with high accuracy. The vacuum steam treatment was more obvious than traditional technology group. It provides reference for the subsequent production of Chuanxiong Rhizoma decoction pieces and have the certain value for its promotion and application.

Objective:To determine the compositions of Pingwei microemulsion through the formula screening and optimization, and carry out the pharmacodynamic validation. Methods:Three levels of mixed volatile oil,dregs water extract and glycyrrhizin were determined by single factor investigation. With the ulcer inhibition rate as an indicator,the orthogonal test was carried out to determine the amount of each component in the formula,and the pharmacodynamic validation was performed on the mouse model of gastric ulcer induced by indomethacin and the rat model of ulcer induced by ethanol hydrochloride.Results:The amount of each component in the formula was determined as follows:SFE-CO2mixed volatile oil of Atractylodes Lancea (Thunb.) DC., Magnolia officinalis Rehd. Et Wils. and Pericarpium Citri Reticulatae was 0.8 ml,glycyrrhizin was 60 mg,and the water extract after SFE-CO2extraction of Atrac-tylodes Lancea (Thunb.) DC.,Magnolia officinalis Rehd. Et Wils. and Pericarpium Citri Reticulatae was 2.0 g. Conclusion: The preparation process of Pingwei microemulsion is feasible,and Pingwei microemulsion has a good anti-ulcer effect,equalling to the posi-tive control Sanjiuweitai.

Objective:To elucidate the factors influencing the differences in the survival rates of esophageal squamous cell carcinoma (ESCC) patients between the rural and urban regions in China. Methods:A total of 36,723 ESCC patients derived from the clinical data-bases containing 500,000 esophageal and gastric cardia carcinoma cases (1973-2015) of the Henan Key Laboratory for Esophageal Can-cer Research of the First Affiliated Hospital, Zhengzhou University, were analyzed. Of these patients, 33,625 were from the rural re-gions (91.6%), comprising 20,906 male patients with an average age of 58.98 ± 8.71 years and 12,719 females with an average age of 59.59 ± 8.53 years. The remaining 3,098 were from the urban regions and composed of 2,089 male patients with an average age of 60.84±9.10 years and 1,009 females with an average age of 62.46 ± 9.14 years. All the patients underwent radical esophagectomy, de-tailed histopathological diagnosis, and TNM staging. Chi square test, Kaplan-Meier, Log-rank, and Cox proportional hazards regression model were used to analyze the differences between ESCC patients from rural regions and those from urban regions and among the risk factors in prognosis. Results:Kaplan-Meier and Log-rank analysis results showed that the ESCC patients from the rural regions had significantly higher overall survival than the urban patients (χ2=12.971, P=0.000). Further analysis showed that rural patients≥50 years old and diagnosed with stage IIa and IIb (middle stage) ESCC had higher survival rates than urban patients in males and females (male:χ2=16.188, P<0.001;female:χ2=5.019, P=0.025). However, the survival rates of rural and urban patients with stage 0,Ⅰa,Ⅰb (early stage) and Ⅲa, Ⅲc, and Ⅳ (late stage) were similar (P>0.05). The results of Cox proportional hazards regression model analysis showed that age, gender, and TNM stages were independent risk factors for rural and urban ESCC patients. When the rural and urban ESCC patients were both considered, the Cox proportional hazards regression model analysis results showed that male ESCC patients≥50 years old, urban residence, and TNM stages were independent risk factors. Conclusion:Rural ESCC patients have significantly high-er overall survival than urban patients. Male, age of≥50 years old, urban residence, and TNM stages were independent risk factors for ESCC patient survival.

Objective To evaluate the accuracy of double contrast-enhanced ultrasonography (DCUS) and endoscopic ultrasonography (EUS) in the preoperative N staging of gastric cancer.Methods Between June 2015 and September 2016,a total of 65 consecutive patients who were diagnosed with histologically confirmed gastric carcinoma and underwent surgery in the 2nd Affiliated Hospital of Wenzhou Medical University were enrolled into this study.DCUS and EUS were performed in all patients to estimate lymph node metastasis (N stage) within 5 days before surgery.The findings of the histopathologic examination of resected specimens were considered as gold standard and were retrospectively compared with the results of DCUS and EUS.The sensitivity,specificity and Youden index of DCUS and EUS were calculated.The difference of diagnostic performance between DCUS and EUS was assessed by chi-square test.Results There were 25 N-patients and 40 N + patients confirmed by pathology.Of all 25 N-cases,18 cases were diagnosed correctly by DCUS and 20 cases were diagnosed correctly by EUS;Of all 40 N + cases,32 cases were diagnosed correctly by DCUS and 31 cases were diagnosed correctly by EUS.The sensitivity,specificity and Youden index of DCUS were 80.0％,72.0％ and 0.52 respectively.The sensitivity,specificity and Youden index of EUS were 77.5％,80.0％ and 0.58 respectively.The overall accuracy of DCUS and EUS in N-staging were 76.9％ (50/65) and 78.5％ (51/65).There was no significant difference between two methods (x2=0.044,P=0.833).Conclusions There was no significant difference between DCUS and EUS in overall N-staging of gastric cancers.Either of these two methods had its advantages and disadvantages.When the two methods were combined,the accuracy of preoperative N-staging of gastric cancers could be improved and this improvement may influence treatment algorithms.

Objective:To investigate the clinicopathological characteristics, treatments, and survival of patients with esophageal adeno-squamous carcinoma (EASC). Methods:A total of 494 patients with EASC were selected from the clinical information databases of 500, 000 cases with esophageal and gastric cardiac carcinomas in the Henan Key Laboratory for Esophageal Cancer Research. Among the 494 EASC cases, 361 were males with an average age of 61.47 ± 8.32 years, and 133 were females with an average age of 65.56 ± 8.06 years. SPSS 21.0 software was applied to determine the statistical differences among the different groups. A life-table method was also used to calculate the five-year survival rate. A linear regression model was used to analyze the correlation of changes at different peri-ods. Results:The incidence of EASC in our database was 0.196%(494/251707). EASC occurred predominantly in male patients (male:female=2.71:1.00). The peak age was within 60-69 years in both males and females (39.6%vs. 40.6%). Notably, the incidence of male patients showed a downward trend (R2=0.063), whereas that of female patients showed an upward trend (R2=0.004). The prevalence of EASC was obviously higher in low-incidence areas for esophageal cancer than in high-incidence areas (53.1%vs. 46.9%, P<0.001). Ac-cording to the TNM staging criteria for esophageal cancer, phases II and III patients comprised the majority of cases, which accounted for 40.8%(173/424). The positive lymph node metastasis rate was 47.0%(206/438), and the number of positive lymph node metasta-ses ranged within 1-2 (48.5%, 100/206). In addition, preoperative biopsy was performed in 467 cases, and more than half of the pa-tients (53.96%, 252/467) were diagnosed before the operation. Surgical resection was the predominant treatment method for EASC (88.8%, 419/472). Only 1.9%patients (9/472) underwent radiotherapy and chemotherapy. The five-year survival rate of male patients who were neither smoking nor drinking of alcohol was higher than that of male smokers (26.5%vs. 12.1%). In patients with stagesⅠ,Ⅱ, andⅢ+Ⅳcarcinomas with surgery as lone treatment, the three-year survival rates were 64.7%, 50.9%, and 48.5%, respectively. Correspondingly, these rates were 51.7%, 47.8%, and 33.1%after adjuvant radiotherapy and chemotherapy. Conclusion:EASC is a rare type of esophageal malignant tumor. The preoperative biopsy pathological diagnosis has high misdiagnosis rate. Smoking and drinking of alcohol can influence the prognosis of patients. In EASC patients, lymph node metastasis easily occurs, and a simple surgery is bet-ter than other cancer treatments.

Adenocarcinoma ; metabolism ; pathology ; Humans ; Stomach Neoplasms ; metabolism ; pathology ; alpha-Fetoproteins ; metabolism

Objective To explore the variations and prognostic factors of hyperhomocysteinaemia in ischemic cerebral apoplexy for the youth who administrated vitamin B6,vitamin B12 and folic acid at pretherapy and post-treatment.Methods One hundred and twenty cases of young patients with ischemic cerebral apoplexy in the Pinggu Hospital of Capital University from January 2003 to December 2013 as case group(intervention group,60 cases and 60 cases of non-intervention group),while 120 youth volunteers with the same period and age without neurological diseases as a control group.Both groups patients were detected for hyperhomocysteinaemia,folic acid and vitamin B12.The non-intervention group was administrated basic treatment,while the intervention group administrated vitamin B6,vitamin B12 and folic acid on this basis.The hyperhomocysteinaemia,folic acid and vitamin B12 were detected repetitively after four weeks.Results Compared with control group,the hyperhomocysteinaemia in ischemic cerebral apoplexy group for the youth had increased significantly ((10.2 ± 3.1) μmmol/L vs.(21.3 ± 4.5) μmmol/L,P ＜ 0.05).The hyperhomocysteinaemia,folic acid and vitamin B12 had no significant differences between intervention group and non-intervention group (P ＞ 0.05).After replenished vitamin B6,vitamin B12 and folic acid,the hyperhomocysteinaemia had decreased significantly ((10.5 ± 3.0) μmnol/L) in intervention group.Folic acid ((6.5±2.8)μg/L) and vitamin B12(450.2±155.6) ng/L) had increased significantly(P＜0.05).Conclusion The hyperhomocysteinaemia increased in ischemic cerebral apoplexy for the youth.It is that hyperhomocysteinaemia decreased by replenished vitamin B6,vitamin B12 and folic acid which make for prognosis in ischemic cerebral apoplexy for the youth.

The incidence of hypokalemia and periodic paralysis was retrospectively analyzed in 1225patients with hyperthyroidism. The results showed that 104 patients with hyperthyroidism (8.5%)had hypokalemia, and 82. 7% cases were women, with the potassium levels of 3.10 - 3.42 mmol/L. Periodic paralysis occurred in 60 patients (4. 9% ) and 96. 7% cases were men; 93.3% patients had the potassium levels less than 3. 0 mmol/L. Hypokalemia and periodic paralysis were alleviated after the control of hyperthyroidism.