Surgery-based multidisciplinary comprehensive treatment is the preferred treatment strategy for local advanced esophageal cancer. Neoadjuvant chemotherapy and neoadjuvant chemoradiotherapy have been recommended by the Chinese Society of Clinical Oncology (CSCO) guideline. With the advent of immunotherapy, neoadjuvant immunotherapy combined with chemotherapy has received much attention, and the first phase Ⅲ study has also confirmed that neoadjuvant immunotherapy combined chemotherapy is a promising treatment option. This article will review the recent advances and hot spots of neoadjuvant immunotherapy combined with chemotherapy.

A variety of facial injection filler materials have been approved for market at home and abroad.The marketing approvals,clinical application literature,expert consensus or clinical application guidelines of facial injection filler products at home and abroad were collected and it was found that facial injection filler materials may cause a number of adverse reactions.The clinical application and adverse reactions of facial injection filler materials were summarized,the pre-market adverse reaction evaluation requirements of such products in the United States and China were analyzed and summarized,aiming to provide reference for relevant product developers and clinical researchers to evaluate the pre-market adverse reactions of facial injection filler materials.

Objective:To explore the diagnostic efficacy of percutaneous lymphatic contrast ultrasound (LCEUS) combined with clinicopathological features in the diagnosis of breast cancer sentinel lymph node (SLN).Methods:A total of 135 breast cancer patients who underwent sentinel lymph node biopsy and axillary lymph node radical resection were prospectively collected in the Affiliated Hospital of Nanjing University of Chinese Medicine from July 2018 to June 2021, and the breast masses and SLNs were evaluated by routine ultrasound, contrast-enhanced ultrasound and LCEUS within one week before surgery. The surgeons recorded the patients′ clinical characteristics before surgeries, and the pathology of the masses and SLNs were recorded after surgeries. Univariate analysis and multivariate Logistic regression analysis were used to explore the correlation between ultrasound clinicopathological features of breast cancer and SLN metastasis, then to establish a model, and evaluate the diagnostic efficacy of the model.Results:Univariate analysis showed that SLN metastasis of breast cancer was associated with age, axillary palpation of enlarged lymph nodes, pathological type of mass, clear hilum of lymph nodes, cortical thickening of lymph nodes, marginal blood flow in lymph nodes, and the appearances of LCEUS(all P<0.05). Multivariate Logistic regression analysis showed age, palpation of axillary lymph nodes and the appearances of LCEUS were independent predictors of SLN properties, the OR values were 6.90 ( P=0.030), 16.06 ( P<0.001) and 12.71 ( P<0.001), respectively. The regression equation was Logit(P)=0.887+ 1.932× axillary lymph node palpation + 2.776× marginal blood flow + 2.542×LCEUS. Conclusions:LCEUS combined with marginal blood flow in lymph nodes and palpation of axillary lymph nodes can help to determine the SLN state.

Objective:To determine the expression of transmembrane protein 45A (TMEM45A) in keloid tissues and fibroblasts, and to evaluate its effect on extracellular matrix (ECM) synthesis by keloid-derived fibroblasts (KFs) .Methods:Samples of surgically excised keloid and normal foreskin tissues were collected from the Department of Dermatology and Department of Urology of Yanbian University Hospital from January 2019 to December 2020, and TMEM45A protein expression was determined in keloid tissues and KFs by Western blot analysis. KFs were divided into TMEM45A-specific small interfering RNA (siRNA) group and control siRNA group to be transfected with the TMEM45A-specific siRNA and control siRNA respectively. Then, Western blot analysis was performed to evaluate the effects of down-regulation of the TMEM45A gene on the expression of myofibroblast marker protein (α-smooth muscle actin) and ECM-related proteins.Results:Compared with normal skin tissues (1.00 ± 0.11) and fibroblasts (1.00 ± 0.20), TMEM45A expression levels significantly decreased in keloid tissues (0.26 ± 0.05) and KFs (0.41 ± 0.09), respectively ( t = 10.76, 4.75, P < 0.001, = 0.009, respectively). The expression levels of α-smooth muscle actin, ECM-related type Ⅰ collagen, type Ⅲ collagen, and fibronectin were significantly higher in the TMEM45A-specific siRNA group than in the control siRNA group ( t = -5.98, -4.57, -4.90, -7.19, P = 0.004, 0.010, 0.008, 0.002, respectively) . Conclusion:Lowly expressed TMEM45A in keloids may play an important role in the pathogenesis of keloids by promoting ECM synthesis.

Objective To analyze the effect of missing data in population based viral load (PVL) survey in HIV infected men who have sex with men (MSM) sampled in 16 cities in China.Methods The database of 3 virus load sampling survey conducted consecutively in HIV infected MSM population in 16 large cities (Beijing,Shanghai,Nanjing,Hangzhou,Wuhan,Chongqing,Kunming,Xi' an,Guangzhou,Shenzhen,Narning,Urumuqi,Harbin,Changchun,Chengdu and Tianjin) during 2013-2015 was used.SPSS 17.0 software was used to describe distribution of the missing data and analyze associated factors.Results A total of 12 150 HIV infected MSM were randomly selected for the surveys,in whom,9 141 (75.2％) received virus load tests,while 3 009 (24.8％) received no virus load tests,whose virus load data missed.The virus load data missing rates in MSM with or without access to antiretroviral therapy (ART) were 11.5％ (765/6 675) and 39.4％ (2 060/5 223) respectively,and the virus load data missing rates were 21.9％ (1 866/8 523) and 28.4％ (959/3 374),respectively,in local residents and non-local residents (migrants).Conclusions The analysis indicated that the data missing occurred in the virus load survey in HIV infected MSM population.ART status and census registering status were the main influencing factors.Data missing could influence the accurate evaluation of community viral load (CVL) and population viral load (PVL) levels in HIV infected MSM in China.

Objective To develop a HIV infection risk assessment tool for men who have sex with men (MSM) based on Delphi method.Methods After an exhaustive literature review,we used Delphi method to determine the specific items and relative risk scores of the assessment tool through two rounds of specialist consultation and overall consideration of the opinions and suggestions of 17 specialists.Results The positivity coefficient through first and second round specialist consultation was 100.0％ and 94.1％,respectively.The mean of authority coefficients (Cr) was 0.86.Kendall's W coefficient of the specialist consultation was 0.55 for the first round consultation (x2=84.426,P＜0.001) and 0.46 for the second round consultation (x2=65.734,P＜0.001),respectively,suggesting that the specialists had similar opinions.The final HIV infection risk assessment tool for MSM has 8 items.Conclusions The HIV infection risk assessment tool for MSM,developed under the Delphi method,can be used in the evaluation of HIV infection risk in MSM and individualized prevention and intervention.However,the reliability and validity of this risk assessment tool need to be further evaluated.

Objective To understand the distribution of population viral load (PVL) data in HIV infected men who have sex with men (MSM), fit distribution function and explore the appropriate estimating parameter of PVL. Methods The detection limit of viral load (VL) was ≤ 50 copies/ml. Box-Cox transformation and normal distribution tests were used to describe the general distribution characteristics of the original and transformed data of PVL, then the stable distribution function was fitted with test of goodness of fit. Results The original PVL data fitted a skewed distribution with the variation coefficient of 622.24%, and had a multimodal distribution after Box-Cox transformation with optimal parameter (λ) of-0.11. The distribution of PVL data over the detection limit was skewed and heavy tailed when transformed by Box-Cox with optimal λ=0. By fitting the distribution function of the transformed data over the detection limit, it matched the stable distribution (SD) function (α=1.70, β=-1.00, γ=0.78, δ=4.03). Conclusions The original PVL data had some censored data below the detection limit, and the data over the detection limit had abnormal distribution with large degree of variation. When proportion of the censored data was large, it was inappropriate to use half-value of detection limit to replace the censored ones. The log-transformed data over the detection limit fitted the SD. The median (M) and inter-quartile ranger (IQR) of log-transformed data can be used to describe the centralized tendency and dispersion tendency of the data over the detection limit.

Objective To compare results of different methods in organizing HIV viral load (VL) data with missing values mechanism. Methods We used software SPSS 17.0 to simulate complete and missing data with different missing value mechanism from HIV viral loading data collected from MSM in 16 cities in China in 2013. Maximum Likelihood Methods Using the Expectation and Maximization Algorithm (EM), regressive method, mean imputation, delete method, and Markov Chain Monte Carlo (MCMC) were used to supplement missing data respectively. The results of different methods were compared according to distribution characteristics, accuracy and precision. Results HIV VL data could not be transferred into a normal distribution. All the methods showed good results in iterating data which is Missing Completely at Random Mechanism (MCAR). For the other types of missing data, regressive and MCMC methods were used to keep the main characteristic of the original data. The means of iterating database with different methods were all close to the original one. The EM, regressive method, mean imputation, and delete method under-estimate VL while MCMC overestimates it. Conclusion MCMC can be used as the main imputation method for HIV virus loading missing data. The iterated data can be used as a reference for mean HIV VL estimation among the investigated population.

Objective To compare the community viral load (CVL) among MSM in 15 cities in China using standardized national reference sources.Methods The study analyzed the existing database of National Major Science and Technology Project of China.The database was established with serial random survey of MSM HIV CVL among MSM in 15 cities from 2013 to 2015.VL tests were conducted in 15 laboratories with different equipment and methods,including RT-PCR,nucleic acid sequence based amplification (NASBA),branched DNA testing (bDNA) and Abbott M2000 RealTime system (M2000).Based on proficiency test for 15 laboratories conducted by National HIV Reference Laboratory,VL test values detected with EasyQ,bDNA and M2000 were converted and standardized into resultant values of TaqMan 2.0.Software SPSS 17.0 was used to produce descriptive statistics for the dataset.Results From 2014 to 2015,the 15 testing sites were found to use a number of different viral load detection techniques.In 2014,the community viral load values were (2.38 ±1.47) and (2.99 ± 1.31) in 15 testing sites,while in 2015 these values were found to be (2.07± 1.34) and (2.72± 1.19).The measurement of community VL was done using standard benchmarks of ≤200 copies/ml,≤400 copies/ml and ≤1 000 copies/ml,that were used for reference for now.Conclusion It is necessary to use standard detection method to improve the comparability of annual results.Using a standardized rate of ≤400 copies/ml or ≤ 1 000 copies/ml for successful control of VL was found with high stability for the result comparison among different areas.

BACKGROUND:Knee osteoarthritis is prevalent among the middle-aged and senior people in Asian countries, however, the epidemiology survey of total knee arthroplasty is rarely reported in China.
OBJECTIVE: To retrospectively analyze the data of patients undergoing total knee arthroplasty from 2008 to 2013 in Hefei City, and explore the distribution of age and gender of these patients.
METHODS: A retrospective analysis among patients undergoing total knee arthroplasty from January 1st 2008 to December 31st 2013 in Hefei City was performed. Data were extracted from the database of Medical Records Room of Relevant Hospitals in Hefei City, including the patient’s gender, age, disease duration, education level, body mass index and surgical site. In addition, more clinical information in one hospital were selected and analyzed, to compare the difference of clinical features between men and women.
RESULTS AND CONCLUSION:From 2008 to 2013, totaly 1 146 patients underwent total knee arthroplasty due to knee osteoarthritis. The rate of total knee arthroplasty increased over the 6 years and was much higher in women than in men. The single-centre registry data revealed that there was no difference in age, disease duration, education level, and body mass index and surgical site between men and women. Our findings indicate that, the rate of total knee arthroplasty is increasing steadily from 2008 to 2013 in Hefei City and is higher in women than in men. Risk factors that account for such disparity in total knee arthroplasty utilization need to be further investigated.