Gastric cancer (GC) is a common malignant tumor of the digestive tract in China. It is characterized by high morbidity, mortality, and proportion of patients in advanced stages. In the past years, chemotherapy was used as the main treatment for GC. Subsequently, targeted therapy with trastuzumab was approved to treat HER2-positive GC. However, the progress of drug development and clinical studies has been limited by the high heterogeneity of GC. In recent years, research on immunotherapy and new targets for therapeutic exploration in GC has made great strides. Herein, we provide a brief review of the progress of the research on targeted therapy and immunotherapy for GC.

Background: Hypothermia is a crucial environmental factor that elevates the risk of cardiovascular disease, but the underlying effect is unclear. Objectives: This study examined the role of cold stress (CS) in cardiac injury and its underlying mechanisms. Methods: In this study, a chronic CS-induced myocardial injury model was used; mice were subjected to chronic CS (4°C) for three hours per day for three weeks. Results: CS could result in myocardial injury by inducing the levels of heat shock proteins 70 (HSP70), enhancing the generation of creatine phosphokinase-isoenzyme (CKMB) and malondialdehyde (MDA), increasing the contents of tumor necrosis factor-α (TNF-α), high mobility group box 1 (HMGB1) interleukin1b (IL-1β), IL-18, IL-6, and triggering the depletion of superoxide dismutase (SOD), catalase (CAT), and glutathione (GSH). Multiple signaling pathways were activated by cold exposure, including pyroptosis-associated NOD-like receptor 3 (NLRP3)-regulated caspase-1-dependent/Gasdermin D (GSDMD), inflammation-related toll-like receptor 4 (TLR4)/myeloid differentiation factor 88 (MyD88)-mediated nuclear factor kappa B (NF-κB), and mitogen-activated protein kinase (MAPK), as well as oxidative stressinvolved thioredoxin-1/thioredoxin-interacting protein (Txnip) signaling pathways, which play a pivotal role in myocardial injury resulting from hypothermia. Conclusions These findings provide new insights into the increased risk of cardiovascular disease at extremely low temperatures.

Pituitary metastasis is a rare tumor complication, and papillary thyroid carcinoma is a tumor with low hematogenous dissemination tendency. Here we report a rare case with pituitary metastasis from papillary thyroid cancer. This patient was 43 years old and was admitted to our hospital because of " blurred vision in the right eye" . She had partial thyroidectomy because of thyroid nodule 8 years ago, and was diagnosed as papillary thyroid carcinoma, but without any further treatment onwards. After admission, MRI revealed a pituitary mass protruding through the sella turcica into the right sphenoid sinus. Neuro-endoscopic transsphenoidal resection was performed to relieve visual impairment. Pathological result was papillary thyroid carcinoma pituitary metastasis. She underwent thyroidectomy 2 months later. Because tumor of the left lobe invaded the esophagus, it was resected palliatively, and adjuvant therapy with radioactive iodine was performed subsequently. This case suggests that long-term management of papillary thyroid carcinoma should be strengthened to reduce the risk of recurrence and metastasis, additionally radioiodine therapy is an important complementary treatment.

Objective:To explore the clinical manifestations, diagnosis, treatment and prognosis of maxillofacial adipocytic neoplasia in children.Methods:The clinical data of 8 children with maxillofacial adipocytic neoplasia admitted to Shanghai Children′s Hospital from August 2014 to July 2019 were retrospectively analyzed, including 6 males and 2 females, aged from 8 months to 8 years 11 months, with an average age of 44 months. The clinical characteristics, imaging findings, treatment methods and effects of 8 patients were analyzed.Results:Among the 8 patients, 5 were lipomas and 3 were lipoblastomas; 4 were in the masseter muscle region of the parotid gland, 2 were in the parapharyngeal space and 1 was in the submandibular and nasal areas separately. The clinical manifestations were mainly painless maxillofacial masses, sleep snoring and pharyngeal foreign body sensation. All of 8 patients underwent surgical treatment without complications such as infection, facial paralysis, and salivary fistula. No recurrence was observed during a follow-up of 6 months to 5 years.Conclusions:Lipoma and lipoblastoma are the main tumors of maxillofacial adipocytic neoplasia in children. The appropriate surgical incision and surgical method can be selected according to the characteristics of the area of the tumor combined with preoperative imaging examination. The prognosis of the disease is good and recrudescence is rare.

Objective To assess the efficacy and safety of 100 mg or 200 mg yimitasvir phosphate combined with sofosbuvir in patients with non-cirrhotic chronic hepatitis C virus ( HCV) genotype 1 infection who were treatment-na?ve or had a virologic failure to prior interferon-based treatment.Methods A multicenter, randomized, open-label, phase 2 clinical trial was conducted.The patients were randomly assigned to yimitasvir phosphate 100 mg+sofosbuvir 400 mg group (Group 100 mg) and yimitasvir phosphate 200 mg+sofosbuvir 400 mg group ( Group 200 mg) in a 1∶1 ratio with the stratified factors of " treatment-naive" or"treatment-experienced" for 12 weeks and followed up for 24 weeks after the end of treatment.During the clinical trial, HCV RNA was tested in all patients.Resistance of virus in patients who didn′t achieved sustained virological response (SVR) was monitored.Safety and tolerability were assessed by monitoring adverse events , physical examination , laboratory examination, electrocardiogram, and vital signs during the study.The primary end point was SVR12 after the end of therapy.Descriptive statistics were used for categorical variables and eight descriptive statistics were used for continuous variables.Descriptive statistics were used and summarized according to HCV genotypes and treatment groups.Safety data were presented using descriptive statistics and summarized according to treatment groups.Results A total of 174 subjects were screened from July 31, 2017 to September 26, 2018.One hundred and twenty-nine patients were successfully enrolled and received treatment , and 127 completed the study.There were 64 patients and 65 patients assigned to Group 100 mg and Group 200 mg, respectively.Among the 129 patients who underwent randomization and were treated , 18.6% were treatment-experienced and: 100%were HCV genotype 1b infection.The total SVR rate was 98.4%(127／129), with 98.4%(63／64, 95%confidence interval [CI]: 91.60%-99.96%) in the Group 100 mg, and 98.50%(64／65, 95%CI: 91.72%-99.96%) in the Group 200 mg.There was no significant difference between the two groups (χ2 ＝0.000 2, P＝0.989 2).The SVR rates in treatment-naive group and treatment-experienced group were 98.10%(95%CI: 93.29%-99.77%) and 100.00%(24／24, 95%CI: 85.75%-100.00%), respectively.Virological failure during treatment ( including breakthrough , rebound and poor efficacy) and relapse after treatment did not occur during the trial.By Sanger sequencing , 11.6%(15／129) patients had baseline NS5A Y93H／Y or Y93H resistance-associated substitutions ( RAS), 1.6%( 2／129) patients had baseline NS5A L31M RAS.No mutation was observed in NS5B S282 at baseline.There was no S282 mutation in HCV NS5B.A total of 100 (77.5%) subjects had adverse events.No adverse events ≥Grade 3 or severe adverse events related to the study treatment.No patient prematurely discontinued study treatment owing to an adverse event.No life-threatening adverse event was reported.Conclusion Twelve weeks of yimitasvir phosphate 100 mg or 200 mg combined with sofosbuvir 400 mg daily is a highly effective and safe regimen for patients without cirrhosis with HCV genotype 1b infection who had not been treated previously or had a virologic failure to prior interferon-based treatment.

Objective To compare sinus tarsi approach(STA) and extensile L shape approach (ELA) in the surgical treatment of calcaneal fractures. Methods A total of 51 cases of calcaneal fractures treated from May 2014 to December 2016 were enrolled. Twenty of them were performed ORIF via the sinus tarsi approach, while the other 31 cases were performed ORIF via lateral extensile L shape approach. X-ray films were taken postoperatively to record the changes of B?hler angle and Gissane angle. The AOFAS, VAS and SF-36 scores were adopted to assess the therapeutic effect. Results The average follow-up period of STA group was 15.5 months. And patients in ELA group were followed up for an average period of 18.4 months. All the fractures in the series had a boney union at or before the final follow-up. The final correction of B?hler angle (34.60 ± 2.91)° , and Gissane angle (114.45 ± 2.91)° was significantly increased in the STA group; and the final correction of B?hler angle (33.55 ± 2.73)° , and Gissane angle (112.81 ± 4.15)° was also significantly increased in the ELA group; while there was no significant difference between the two groups. The final AOFAS scores , VAS scores and SF-36 scores of the STA were (83.56 ± 7.13), (1.78 ± 0.89), (88.95 ± 4.31) scores, while those in ELA group were (81.91 ± 9.89), (2.01 ± 1.33) and (86.65 ± 4.95) scores. There was no significant difference between the two groups (P>0.05). No wound problem happened in STA group, but there were 2 cases who had wound complications in ELA group. Conclusions No significant difference is found between the two groups in the short-term efficacy of the treatment for calaneal fracture. However, STA has the advantages of lower soft tissue complication rate.

Objective To compare the complication and cost-effectiveness of the deep inferior epigastric perforator(DIEP) flap and transverse rectus abdominis myocutaneous(TRAM) flap.Methods From January 2000 to December 2014,all patients who underwent DIEP flap and TRAM flap in the People's Hospital of Tangshan and the Affiliated Hospital of North China University of Science and Technology, were selected.Eleven patients underwent immediate breast reconstruction with TRAM flaps and 19 patients with DIEP flaps.The treatment cost,length of hospitalization, and complication in the two year after surgery for each group were compared.Results For the major complications,there were 5 cases appeared fat necrosis in TRAM group, and 1 case in DIEP group,the differences was statistically significant(P=0.016).One case appeared flap loss in TRAM group,and DIEP group was zero,both of the two group had no abdominal wall hernia, there was no significant difference (P ＞ 0.05).For the minor complications, there were 4 cases appeared postoperative hematoma in TRAM group, and 1 case in DIEP group, the difference was statistically significant(P =0.047).Two cases appeared wound dehiscence in TRAM group,and DIEP group was 1 case, 1 case happened infection in TRAM group,there was no statistically significant difference(P＞0.05).The treatment costs were (14 133.12±1 546.88)yuan for the TRAM group and (16 838.94± 3 006.05)yuan the DIEP group, the difference was statistically significant (P =0.010).The hospital stay was (17.28± 2.08)days for the pedicled TRAM group and (18.39±2.87) days for the DIEP group,the different was not statistically significant(P＞0.05).Conclusion The DIEP flap has a better clinical outcomes,but more expensive.

OBJECTIVEIn this study, we investigate the relationship between HSP70 and lung function injury. To study on the feasibility of HSP70 genes polymorphisms as biological marker of the damage of pulmonary dysfunction susceptibility.

METHODS183 cock-oven workers were selected as exposure groups and 143 workers unexposed workers were selected as control groups. We investigated their general information with uniform questionnaire. Pulmonary dysfunction indicators were determined using portable spirometer. HSP70-1 G190C, HSP70-2 A1267G, HSP70- hom T2437C genotypes were analyzed by using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. The haplotypes were calculated using PHASE 2.0 software.

RESULTSVC%, FVC%, MVV%, FEV(1.0%) in exposed group were lower than in non-exposure group, the difference were significantly (P < 0.05). VC%, FVC%, MVV%, FEV1.0% in exposed group with HSP70-1, HSP70-2, HSP70-hom genotypes were lower than in non-exposure group (P < 0.05); FVC% in exposed group with HSP70-hom T/C genotypes were lower than that with HSP70-hom T/T genotypes, MVV% were lower than that with HSP70-hom T/T, C/C genotypes. There's no difference in pulmonary dysfunction index of HSP70-1, HSP70-2 genotypes (P>0.05), but significant difference between the exposed group with HSP70-1, HSP70-hom genotypes; The adjust OR (95%CI) of exposed group with HSP70-1 G/C genotypes and HSP70-homT/C genotypes were 2.516 (1.012 ∼6.252) and 2.284 (1.033∼5.053). Exposed group with CGT haplotype pulmonary dysfunction were significantly higher than in non-exposure group (P < 0.05).

CONCLUSIONCoke oven exposure may increase pulmonary dysfunction injury, Coke oven workers who have the HSP70-1 G/C genotypes, HSP70-hom T/C genotypes and CGT haplotypes may increase the susceptibility of pulmonary dysfunction. There must be some relationship between HSP70-1, HSP70-hom gene polymorphisms and lung function injury of Cock-oven Workers.

Coke ; Disease Susceptibility ; Genotype ; HSP70 Heat-Shock Proteins ; genetics ; Haplotypes ; Humans ; Lung ; physiopathology ; Occupational Exposure ; adverse effects ; Polymorphism, Genetic ; Surveys and Questionnaires

OBJECTIVEThrough comparative study on pulmonary function damage of coke oven workers exposed to coke oven emissions with the same group before and after five years, and further explore the relationship between the coke oven emissions and injury in pulmonary function of coke oven worker.

METHODSSelect a coking plant in Shanxi 165 coke oven workers (exposed group) and 52 auxiliary workers (control group) for the study, using a uniform questionnaire to collect workers' personal information. Fixed workplace air samples collected periodically. Air samples of benzo (a) pyrene concentrations was measured by high pressure liquid chromatograph. Pulmonary function of research object was measured by portable spirometer respectively in 2009 and 2013, and comparative analysis on it.

RESULTSThe concentration of B(a)P was no significant difference in the same area between 5 years in 2009-2013. Compared with 2009, 2013 control workers lung function index and the abnormal rate had no significant difference (P > 0.05). But FVC%, FEV1.0%, MVV%, VC% and FEF25% of exposed workers in 2013 was significantly lower than in 2009, FVC%, FEV1.0%, VC% and FEF25% pulmonary dysfunction rate in 2013 was also significantly higher than in 2009, difference was statistically significant (P < 0.05). Workers emerging pulmonary function abnormalities mainly distributed in furnace roof and side. furnace roof group FVC%, FEV1.0%, VC% additional abnormal number (rate) was significantly higher than furnace floor and the control group (P < 0.05), and furnace side groop was significantly higher than the control group, the difference was statistically significant (P < 0.05). Multivariate Logistic regression analysis showed that after 5 years FVC%, FEV1% and VC% of abnormal lung function emerging adjusted OR of furnace roof workers were 7.939, 5.966 and 4.956. For abnormal of FVC%, FEV1%, VC% and MVV%, the contacting coke seniority is a risk factor. There is a positive interaction between contacting coke seniority and furnace roof (P < 0.05).

CONCLUSIONCoke oven workers lung function damage associated with exposureing to coke oven emissions, coke oven emissions exposure level and exposure time are the main factors of coke oven workers in lung function damage, there is a positive interaction between the two factors.

Air Pollutants, Occupational ; adverse effects ; analysis ; Benzo(a)pyrene ; adverse effects ; analysis ; Cohort Studies ; Coke ; Humans ; Lung ; drug effects ; physiopathology ; Occupational Exposure ; adverse effects ; Respiratory Function Tests ; Risk Factors ; Surveys and Questionnaires