Objective:To investigate the radiation dose and fractionation regimens for limited stage small cell lung cancer (LS-SCLC) in Chinese radiation oncologists.Methods:Over 500 radiation oncologists were surveyed through questionnaire for radiation dose and fractionation regimens for LS-SCLC and 216 valid samples were collected for further analysis. All data were collected by online questionnaire designed by WJX software. Data collection and statistical analysis were performed by SPSS 25.0 statistical software. The differences in categorical variables among different groups were analyzed by Chi-square test and Fisher's exact test. Results:Among 216 participants, 94.9% preferred early concurrent chemoradiotherapy, 69.4% recommended conventional fractionation, 70.8% preferred a total dose of 60 Gy when delivering conventional radiotherapy and 78.7% recommended 45 Gy when administering hyperfractionated radiotherapy.Conclusions:Despite differences in LS-SCLC treatment plans, most of Chinese radiation oncologists prefer to choose 60 Gy conventional fractionated radiotherapy as the main treatment strategy for LS-SCLC patients. Chinese Society of Clinical Oncology (CSCO), National Comprehensive Cancer Network (NCCN) and Chinese Medical Association guidelines or expert consensus play a critical role in guiding treatment decision-making.

Objective:To investigate the molecular genetic and clinical characteristics of MEF2D-BCL9 fusion gene-positive acute B-cell lymphoblastic leukemia (B-ALL), and to provide the reference for the diagnosis and treatment of the disease.Methods:The medical record and experimental examination data of a 18-year-old female MEF2D-BCL9 fusion gene-positive B-ALL patient were retrospectively analyzed. The clinical manifestations and biological characteristics of MEF2D-BCL9 fusion gene-positive B-ALL were summarized.Results:This 18-year-old female patient was treated in a local hospital in December 2018 and was diagnosed as B-ALL. She achieved complete remission after chemotherapy and recurred at 6 months after the initial onset, and then she was admitted to Hebei Yanda Ludaopei Hospital in the 9 months after the initial onset.MEF2D-BCL9 fusion gene was detected through RNA-sequencing (RNA-seq) and verified by using polymerase chain reaction and Sanger sequencing. Bone marrow cell morphology was similar to mature B cells with vacuoles but without characteristic chromosome karyotype abnormalities. The patient achieved remission after VLD regimen chemotherapy, chimeric antigen receptor T-cell (CAR-T) therapy and bridged to allogeneic hematopoietic stem cell transplantation (allo-HSCT). She has maintained complete remission for 2 years at the last follow-up in February 2022.Conclusions:MEF2D-BCL9 fusion gene-positive B-ALL is characterized with high risk, early relapse and poor prognosis. These patients may benefit from CAR-T and allo-HSCT. It further emphasizes the importance of taking MEF2D-BCL9 fusion gene into the detection or identification by using RNA-seq, particularly for those newly diagnosed B-ALL patients in children and adolescents with specific bone marrow morphology.

OBJECTIVE: To detect fusion gene with pathological significance in a patient with refractory and relapsed acute B cell lymphoblastic leukemia (B-ALL) and to explore its laboratory and clinical characteristics. METHODS: Transcriptome sequencing was used to detect potential fusion transcripts. Other laboratory results and clinical data of the patient were also analyzed. RESULTS: The patient was found to harbor TCF3 exon 17-ZNF384 exon 7 in-frame fusion transcript. The minimal residual disease (MRD) has remained positive after multiple chemotherapy protocols including CD19-, CD22- targeted chimeric antigen receptor T cells immunotherapy. The patient eventually achieved complete remission and sustained MRD negativity after allogeneic hemopoietic stem cell transplantation (allo-HSCT). CONCLUSION Transcriptome sequencing can effectively detect potential fusion genes with clinical significance in leukemia. TCF3-ZNF384 positive B-ALL has unique laboratory and clinical characteristics, may not well respond to chemotherapy and immunotherapy, and is more likely to relapse. Timely allo-HSCT treatment may help such patients to achieve long-term disease-free survival. TCF3-ZNF384 positive B-ALL is not uncommon in pediatric patients but has not been effectively identified.
B-Lymphocytes ; Basic Helix-Loop-Helix Transcription Factors/genetics* ; Child ; Hematopoietic Stem Cell Transplantation ; Humans ; Laboratories ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy* ; Trans-Activators/genetics* ; Transcriptome

Objective:To evaluate the clinical effect of free peroneal artery perforator flap (FPAPF) for reconstructing defects of total glossotomy and subtotal glossotomy.Method:A retrospective analysis of the clinical data of the patients with tongue cancer was performed. The patients were admitted to the Department of Oral and Maxillofacial Surgery of the First Affiliated Hospital of Bengbu Medical College from January 2017 to January 2019. All the patients underwent total tongue and subtotal tongue resection and one-stage repair with FPAPF. The function of swallowing, speech and chewing were evaluated with the water swallow test, the speech intelligibility test and the screening and weighing method at 3 months, 6 months, and 12 months after the operation. Use t-test to analyze the data and P< 0.05 was considered statistically significant. Results:A total of 20 patients were selected, including 16 males and 4 females, aged 46 to 68 years, with an average of 54.1 years old. The area of the peroneal artery perforator flap was 6.0 cm×7.0 cm—6.5 cm×8.0 cm, and the length of the pedicle was 6.0 cm—7.0 cm. The overall survival rate of the flap was approximately 95.0%(19/20). The survival rates of 1, 2, and 3 years after operation were 95.0%, 73.7%, and 64.3%, and the tumor-free survival rates were 95.0%, 63.2%, and 57.1%. With the prolongation of postoperative time, the functions of swallowing, speech and chewing gradually improved, and there was a statistically significant difference in 6 months after operation compared with 3 months after operation ( P<0.05). Speech was improved 12 months after operation compared to 6 months after operation.The difference was statistically significant ( P<0.05). Conclusions:The research showed that the peroneal artery perforator exhibited a constant anatomic location, and its diameter and length were more suitable for the preparation of free perforator flaps. The posterolateral tissues of lower legs are abundant, which is beneficial for repairing full tongue and subtotal tongue defects. The recovery of functions such as swallowing, speech intelligibility and chewing was ideal.

Objective:To evaluate the clinical effect of free peroneal artery perforator flap (FPAPF) for reconstructing defects of total glossotomy and subtotal glossotomy.Method:A retrospective analysis of the clinical data of the patients with tongue cancer was performed. The patients were admitted to the Department of Oral and Maxillofacial Surgery of the First Affiliated Hospital of Bengbu Medical College from January 2017 to January 2019. All the patients underwent total tongue and subtotal tongue resection and one-stage repair with FPAPF. The function of swallowing, speech and chewing were evaluated with the water swallow test, the speech intelligibility test and the screening and weighing method at 3 months, 6 months, and 12 months after the operation. Use t-test to analyze the data and P< 0.05 was considered statistically significant. Results:A total of 20 patients were selected, including 16 males and 4 females, aged 46 to 68 years, with an average of 54.1 years old. The area of the peroneal artery perforator flap was 6.0 cm×7.0 cm—6.5 cm×8.0 cm, and the length of the pedicle was 6.0 cm—7.0 cm. The overall survival rate of the flap was approximately 95.0%(19/20). The survival rates of 1, 2, and 3 years after operation were 95.0%, 73.7%, and 64.3%, and the tumor-free survival rates were 95.0%, 63.2%, and 57.1%. With the prolongation of postoperative time, the functions of swallowing, speech and chewing gradually improved, and there was a statistically significant difference in 6 months after operation compared with 3 months after operation ( P<0.05). Speech was improved 12 months after operation compared to 6 months after operation.The difference was statistically significant ( P<0.05). Conclusions:The research showed that the peroneal artery perforator exhibited a constant anatomic location, and its diameter and length were more suitable for the preparation of free perforator flaps. The posterolateral tissues of lower legs are abundant, which is beneficial for repairing full tongue and subtotal tongue defects. The recovery of functions such as swallowing, speech intelligibility and chewing was ideal.

OBJECTIVE: To evaluate the effect of using free double- leaf perforator flap posterolateral calf peroneal artery in anatomical reconstruction of the oropharyngeal structure after ablation of advanced oropharyngeal carcinoma. METHODS: Twenty-six patients with oropharyngeal defects after ablation of oropharyngeal malignancies were recruited, including 12 with carcinoma in the tongue base, 5 in the latenral pharyngeal wall and 9 in the soft palate. Between July, 2016 and July, 2018, the patients underwent surgeries for reconstruction of the oropharyngeal defects using flaps. The areas of tissue defects repaired by double-leaf perforator flaps ranged from 40.5 to 72.5 cm. Reconstruction was performed for oropharyngeal defects in the soft palate, pterygopalate, parapharyngeal, pterygo- mandibular, and tongue base tissues. The patients' outcomes including mouth opening, functions of deglutition, linguistic function, restoration of palatopharyngeal anatomical structure and postoperative survival were evaluated, and their quality of life was assessed using FACT-H&N scale (Chinese Edition). RESULTS: All the 26 patients with transplantation of the free flaps survived. Six months after the operation, the oropharyngeal function and anatomical structure of the patients were basically restored. The questionnaire survey showed that the patients' physical, social/family, emotional and functional conditions, the total score of the core scale, items scores for the head and neck, and the total score of the scale all improved significantly after the operation compared with those before the operation ( < 0.05). CONCLUSIONS The free peroneal artery bilobate perforator flap in the posterolateral crus, which seldom has anatomical variations of the blood vessels, allows flexible design and contains rich tissue volume to facilitate defect repair with different approaches and ranges. The application of this flap, which is an ideal perforator flap for reconstruction of the oropharyngeal structure and function, can improve the quality of life of patients following operations for advanced oropharyngeal cancer.
Arteries ; Free Tissue Flaps ; Humans ; Oropharyngeal Neoplasms ; Perforator Flap ; Quality of Life ; Reconstructive Surgical Procedures ; Skin Transplantation ; Soft Tissue Injuries

Objective:To investigate the therapeutic effect of Tongxinluo capsule combined with atorvastatin in the treatment of angina pectoris and its effect on the expression of matrix metalloproteinase-9 (MMP-9), endothelin-1 (ET-1) and high sensitive C-reactive protein (hs-CRP).Methods:From September 2017 to September 2019, 174 patients with coronary heart disease and angina pectoris in the First People's Hospital of Hangzhou were divided into control group and treatment group according to the random digital table method, with 87 cases in each group.The treatment group was treated with Tongxinluo capsule and atorvastatin, while the control group was treated with atorvastatin.The course of treatment in both two groups was 12 weeks.The number of angina pectoris attack, angina pectoris attack time, MMP-9, ET-1 and hs-CRP levels were compared between the two groups before treatment and 12 weeks after treatment.Results:The number of angina attacks in the observation group was (2.17±0.67)times/week, which was lower than that in the control group [(3.41±0.52)times/week] ( t=13.637, P<0.05). The duration of angina pectoris in the observation group [(1.72±0.43)min/time] was lower than that in the control group [(2.89±0.56)min/time] ( t=14.457, P<0.05). The plasma MMP-9[(236.21±37.49)μg/L], ET-1[(43.57±8.10)ng/L] and hs-CRP [(2.64±0.41)mg/L] in the observation group were lower than those in the control group [(328.39±45.21) μg/L, (58.73±5.46)ng/L and (3.82±0.56)mg/L] ( t=14.693, 14.476, 15.858, all P<0.05). The total effective rate of the observation group (91.95%) was higher than that of the control group (78.16%) (χ 2=6.511, P<0.05). The incidence of adverse reactions in the observation group (8.05%) was lower than that in the control group (20.69%)(χ 2=5.652, P<0.05). Conclusion:Tongxinluo capsule combined with atorvastatin is effective in the treatment of angina pectoris of coronary heart disease.It can reduce the levels of MMP-9, ET-1 and hs-CRP in plasma, and has no obvious adverse reactions.

The new wave of artificial intelligence pushed by deep learning algorithms has dramatically promoted the development of big data analysis technology. On the other hand, advances in life sciences represented by high-throughput genome sequencing have provided massive medical data. Artificial intelligence technology has also provided a powerful tool for hematological malignancy research. This article introduces related research progress in the 61st American Society of Hematology Annual Meeting.

Objective:To investigate the application effect of bilobed skin flap with peroneal artery perforation in repairing postoperative defects of tongue cancer and oral floor cancer.Methods:Six patients with oral squamous cell carcinoma (4 males and 2 females, aged 28-72 years) admitted to the Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Benbu Medical College from May 2017 to December 2019 were repaired with the peroneal artery perforator bilobed flap, one lobe repaired the tongue, and the other repaired the floor of the mouth. The donor area is directly closed and sutured. Postoperative follow-up was conducted to observe tumor recurrence and metastasis, and the patient’s appearance, mouth opening, swallowing function, speech function and lower limb recovery were evaluated.Results:All the 6 flaps survived. One of the patients had a single flap because the pedicle of the perforator vessel was not long enough. The other 5 cases were repaired with bilobed leaf flap. All the flaps survived and the wound surface healed in the first stage. One case was infected with effusion after operation, which was healed by washing and dressing change. The donor area can be sutured directly. No tumor recurrence or metastasis occurred 6 months after surgery. Speech, swallowing and lower limb movement basically returned to normal, facial morphology was basically symmetrical, and the degree of opening Ⅱ-Ⅲ. Six months after the operation, 5 patients with bilobed valve returned to a nearly normal state with a degree of opening Ⅱ-Ⅲ. One patient with single lobe recovered moderately, but speech and swallowing were still restricted. In 6 cases, the donor scar was concealed and the lower limb was basically normal.Conclusions:The bilobed flap with peroneal artery perforation can be used to repair postoperative defects of tongue carcinoma and floor of mouth carcinoma.

Objective:To investigate the application effect of bilobed skin flap with peroneal artery perforation in repairing postoperative defects of tongue cancer and oral floor cancer.Methods:Six patients with oral squamous cell carcinoma (4 males and 2 females, aged 28-72 years) admitted to the Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Benbu Medical College from May 2017 to December 2019 were repaired with the peroneal artery perforator bilobed flap, one lobe repaired the tongue, and the other repaired the floor of the mouth. The donor area is directly closed and sutured. Postoperative follow-up was conducted to observe tumor recurrence and metastasis, and the patient’s appearance, mouth opening, swallowing function, speech function and lower limb recovery were evaluated.Results:All the 6 flaps survived. One of the patients had a single flap because the pedicle of the perforator vessel was not long enough. The other 5 cases were repaired with bilobed leaf flap. All the flaps survived and the wound surface healed in the first stage. One case was infected with effusion after operation, which was healed by washing and dressing change. The donor area can be sutured directly. No tumor recurrence or metastasis occurred 6 months after surgery. Speech, swallowing and lower limb movement basically returned to normal, facial morphology was basically symmetrical, and the degree of opening Ⅱ-Ⅲ. Six months after the operation, 5 patients with bilobed valve returned to a nearly normal state with a degree of opening Ⅱ-Ⅲ. One patient with single lobe recovered moderately, but speech and swallowing were still restricted. In 6 cases, the donor scar was concealed and the lower limb was basically normal.Conclusions:The bilobed flap with peroneal artery perforation can be used to repair postoperative defects of tongue carcinoma and floor of mouth carcinoma.