Concurrent chemoradiotherapy (CCRT) refers to the simultaneous treatment of chemotherapy and radiotherapy, and the effect of radiotherapy is enhanced with low-dose chemotherapy, which can reduce tumor recurrence and metastasis and improve clinical prognosis of patients. At present, the main factors for the increase of radiosensitivity of concurrent chemotherapy is that concurrent chemotherapy prevents the repair of tumor cells, and chemotherapy and radiotherapy act on different cell cycles and have synergistic effects. However, even for patients with locally advanced cervical cancer (LACC) who have undergone CCRT, the 5-year survival rate is only 60%, which is still not ideal. In order to improve the efficacy, researchers have conducted a series of exploratory studies, which consist of the combination of targeted drugs and immunodrugs, and neoadjuvant regimens before CCRT, etc. Although targeted or immunologic drugs are effective treatment of LACC, in view of the lack of large-scale evidence-based medical evidence, multi-center prospective and randomized phase III clinical trials and high-level articles are needed to improve the level of evidence-based medicine. This consensus summarizes several key evidence-based medical studies published recently, especially the clinical research progress in targeted and immunological therapies, providing reference for domestic peers.

Objective:Evidence on potential cardiovascular benefits of personal-level intervention among the elderly exposed to high levels of particulate matter(PM)remains limited.We aimed to assess improvements in surrogate markers of cardiovascular injury in vulnerable populations at risks by using indoor air filtration units.Methods:We conducted a randomized crossover trial for 2 separate 2-week air filtration interventions in 20 households of patients with stable chronic obstructive pulmonary disease and their partners in the winter of 2013,with concurrent measurements of indoor PM.The changes in biomarkers indicative of cardiac injury,atherosclerosis progression and systemic inflammation following intervention were evaluated using linear mixed-effect models.Results:In the analysis,average levels of indoor PM with aerodynamic diameters＜2.5 μm(PM2.5)decreased significantly by 59.2％(from 59.6 to 24.3 μg/m3,P＜0.001)during the active air filtration.The reduction was accompanied by improvements in levels of high-sensitivity cardiac troponin I by-84.6％(95％confidence interval[CI]:-90.7 to-78.6),growth differentiation factor-15 by-48.1％(95％CI:-31.2 to-25.6),osteoprotegerin by-65.4％(95％CI:-56.5 to-18.7),interleukin-4 by-46.6％(95％CI:-62.3 to-31.0)and myeloperoxidase by-60.3％(95％CI:-83.7 to-3.0),respectively.Conclusion:Indoor air filtration intervention may provide potential cardiovascular benefits in vulnerable popu-lations at risks.

Objective:To study the correlation between non-contact anterior cruciate ligament (ACL) injury and functional ankle instability (FAI) in young patients.Methods:A retrospective analysis was conducted of the 102 patients with non-contact ACL injury[61 males and 41 females, with an age of (31.9±6.1) years and a Tegner activity score of (6.1±1.9) points] who had been treated at Department of Orthopedics, Sun Yat-sen Memorial Hospital from January 2017 to March 2020 (injury group). Another 102 citizens without ACL injury from Guangzhou [56 males and 46 females, with an age of (30.3±7.2) years and a Tegner activity score of (6.0±2.1) points] were recruited as a control group. The Cumberland ankle instability tool (CAIT) and the Ankle Joint Functional Assessment Tool (AJFAT) were used to assess whether the subjects had self-conscious FAI or not. A correlation analysis was conducted using the data collected.Results:The 2 groups were comparable because there were no significant differences between them in general data ( P>0.05). By the CAIT score, the incidence of FAI in the injury group [52.9% (54/102)] was significantly higher than that in the control group [32.4% (33/102)] ( P<0.05); by the AJFAT score, the incidence of FAI in the injury group [59.8% (61/102) ] was significantly higher than that in the control group [39.2% (40/102)] ( P<0.05). Pearson correlation analysis showed that diagnoses of FAI by CAIT and by AJFAT were respectively correlated with ACL injury ( r=-0.159, P=0.023; r=-0.215, P=0.002). Conclusions:The incidence of FAI may be high in patients with ACL injury and there is a correlation between FAI and ACL injury.

Objective:The investigate the roles and significance of HIF-1α and CYPJ in tongue squamous cell carcinoma cell (TSCC), and further evaluate the regulatory effect of hyperthermia (HT) on HIF-1α and CYPJ in TSCC cells.Methods:Eighty samples of cancer tissues and adjacent normal tissues from TSCC patients were collected. The expression levels of HIF-1α and CYPJ were detected by immunohistochemistry, Western blotting (WB) and fluorescence quantitative PCR, and the relationship between the expression levels of HIF-1α and CYPJ and clinicopathological characteristics was further analyzed. The expression levels of HIF-1α and CYPJ in Cal-27 cells under normoxic and hypoxic conditions for 24 h when combined with HT (42℃), chemotherapy and both were detected by qPCR and WB. Cell migration was detected by cell scratch test and cell apoptosis was measured by flow cytometry.Results:The expression levels of HIF-1α and CYPJ proteins in the tumor tissues of TSCC patients were higher than those in the adjacent normal tissues, which were significantly correlated with tumor size, TNM stage, differentiation degree and lymph node metastasis in TSCC patients (all P<0.05), whereas they were not correlated with gender or age (all P>0.05). The expression levels of HIF-1α and CYPJ in Cal-27 cells were significantly up-regulated in the hypoxic microenvironment (both P<0.05), which were also significantly enhanced by hyperthermia alone (both P<0.05). Compared with hyperthermia or chemotherapy alone, hyperthermia combined with chemotherapy significantly inhibited the expression of HIF-1α and CYPJ, suppressed cell migration and promoted cell apoptosis (all P<0.05). Conclusions:HIF-1α and CYPJ may be potential biomarkers for TSCC tumorigenicity and prognosis. In addition, tumor recurrence after hyperthermia may be due to the role of hyperthermia in triggering HIF-1α expression, which promotes the growth and survival of tumor cells adaptive to hyperthermia treatment by activating the downstream target genes, while hyperthermia combined with chemotherapy may be a promising treatment for TSCC.

Mitochondrial fission regulator 2 (MTFR2) is associated with mitochondrial fission, while few studies have assessed the associations between MTFR2 expression and clinical characteristics or prognosis of esophageal squamous cell carcinoma (ESCC). In this study, we compared the expression of MTFR2 in 6 ESCC tumors and relative normal tissues by immunohistochemistry (IHC). To assess the effect of MTFR2 expression on clinicopathologic characteristics and survival, 115 paraffin embedded ESCC tissue samples were assessed by IHC staining. Furthermore, the association between clinicopathological properties and MTFR2 expression in patients with ESCC was examined. The survival analysis was performed using the Cox regression models. We found that MTFR2 expression was significantly increased in ESCC tumors compared with normal esophageal epithelial cells. IHC analysis of 115 paraffin embedded ESCC tumor specimens of the patients showed that the expression of MTFR2 was significantly associated with clinical stage (P < 0.001), tumor classification (P < 0.001), histological grade (P < 0.001), and other clinicopathological characteristics. Both univariate and multivariate analyses showed that MTFR2 expression was inversely correlated with the survival of ESCC patients. In conclusion, the expression of MTFR2 is significantly associated with clinicopathologic characteristics and prognosis of ESCC. Thus, MTFR2 expression could serve as a potentially important prognostic biomarker and clinical target for patients with ESCC.

Objective:To observe whether there was a chronic light damage after the irradiation of 650 nm semiconductor laser (power 2 mW) in chicken cone-rich-retina and discuss the safety of this laser for retina.Methods:Sixty 1-month-old chicken reared under natural light were divided into a normal control group, an irradiation 3-min group, an irradiation 6-min group and an irradiation 30-min group by using a random number table and 15 for each group.The chicken eyes were irradiated with 650 nm laser for different duration according to a grouping.Relative retina area was measured with optical coherence tomography (OCT) at 1 month (2-month-old chicken), 3 months (4-month-old chicken) and 6 months (7-month-old chicken) after laser irradiation.Chickens were sacrificed by overdose anesthesia and the histopathology of chiken retina was examined by hematoxylin-eosin staining.The apoptosis of the retinal cells was evaluated by TUNEL staining.Chicken retinal homogenate was prepared, and the content of malondialdehyde and activity of superoxide dismutase (SOD) in the retina were detected by TBA method and NBT method, respectively.Western blot was employed to detect the expression of L/M opsin and rhodopsin in the retina.The use and care of the animals complied with Regulations for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission.Results:In 2-month-old chicken, the molar concentration of malondialdehyde in retina was significantly higher in the irradiation 30-min group compared with the normal control group ( P<0.05). In 4-month-old chicken, the molar concentration of malondialdehyde was statistically higher in the irradiation 6-min group and the irradiation 30-min group in comparison with the normal control group ( P=0.026, 0.003). In 7-month-old chicken, the concentrations of retinal malondialdehyde in the irradiation 3-min group, irradiation 6-min group and irradiation 30-min group were statistically higher than those of the normal control group( P=0.038, 0.032, <0.01). In 7-month-old chicken, the SOD activity and the relative expression of rhodopsin in the retina of the irradiation 30-min group were statistically reduced incomparison with the normal control group (SOD: [140.20±5.99][nmol/s·mg] vs.[160.57±3.13][nmol/s·mg]); Rhodopsin: 0.392±0.065 vs.0.566±0.072) (both at P<0.05). OCT showed that there was no significant difference in relative retinal area within 6 months among the four groups.Histopathological examination showed that the thickness of the retina in each irradiation group was close to the normal control group.TUNEL staining showed that the retinal cells were regularly arranged, and no TUNEL positive staining cells were found in all of the groups. Conclusions:Irradiation of a 650 nm semiconductor laser (2 mW) in chicken's eyes for 6 minutes is safe for retina within 6 months.The lasser irradiation 30 minutes for 6 months results in an increase of free radical content in the retina and a decrease in rhodopsin, suggesting the presence of photo damage.

Brain metastasis has become a major failure pattern with the prolonged survival of patients with non-small cell lung cancer (NSCLC). Prophylactic cranial irradiation (PCI) has been proven to play a significant role in small cell lung cancer, whereas its value in NSCLC is still controversial. Therefore, this article reviewed the role of PCI in NSCLC, high-risk factors of brain metastasis, timing, dose fraction and toxicity of PCI, etc.

Paraneoplastic neurological syndromes (PNS) are a rare group of immune-mediated disorders that affect the central and peripheral neuromuscular system in association with cancer.If the limbal lobe system of the brain is involved,it will show paraneoplastic limbal encephalitis(PLE).The discern of patients with PNS is challenging since tumors causing paraneoplastic neurologic disorders are often asymptomatic and sometimes occult.We report a case of PLE with double positive anti-Hu and Yo antibodies,and further analyze and discuss it in conmbination with relevant literature to improve the understanding of the disease.

OBJECTIVE： To investigate the relationship between ATP-binding cassette subfamily B member 1 （ABCB1） polymorphism and tacrolimus-related adverse drug reactions in renal transplant patients during perioperative period. METHODS： Totally 170 patients who underwent renal transplantation from Nov. 2014 to Mar. 2018 in our hospital as well as were tested for their ABCB1 C1236T （rs1128503）， ABCB1 G2677T/A （rs2032582） and ABCB1 C3435T （rs1045642） genotype were selected in this study. χ2 test was used to compare the incidence of tacrolimus-related ADR among patients with different genotypes. The related adverse reactions included digestive tract reaction， pulmonary infection， renal dysfunction， abnormal liver function， elevated blood sugar， elevated blood lipid and decreased white blood cells. Logistic regression model was used to analyze the unit point risk. The main haplotypes of the above genes were analyzed by PHASE software， and their correlation with tacrolimus-induced ADR was analyzed. RESULTS： Among 170 patients， 21 cases （12.3％） of CC type， 78 cases （45.9％） of CT type and 71 cases （41.8％） of TT type were detected by ABCB1 C1236T （rs1128503）. ABCB1 G2677T/A （rs2032582） test showed that 25 cases （14.7％） were GG type， 95 cases （55.9％） were GA+GT type and 50 cases （29.4％） were AA+AT+TT type. ABCB1 C3435T （rs1045642） test showed that 57 cases （33.5％） were CC type， 82 cases （48.2％） were CT type and 31 cases （18.3％） were TT type. There was no significant difference in the incidence of digestive tract reaction， pulmonary infection， renal dysfunction， elevated blood sugar， elevated blood lipid and decreased white blood cells among patients with different ABCB1 genotypes （P＞0.05）. However， there was significant difference in the incidence of abnormal liver function between ABCB1 C1236T （rs1128503） and ABCB1 C3435T （rs1045642） genotypes （P＜0.05）. There was no significant difference in the incidence of abnormal liver function among ABCB1 G2677T/A （rs2032582） genotypes （P＝0.069）， but P was lower than 0.1. Logistic regression analysis showed that ABCB1 C1236T （rs1128503） CC genotype [OR＝4.959， 95％CI （1.700， 14.468）， P＝0.003]， ABCB1 G2677T/A （rs2032582） GG genotype [OR＝3.500， 95％CI （1.164， 10.524）， P＝0.026] and ABCB1 C3435T （rs1045642） CC genotype [OR＝3.033， 95％CI （1.012， 9.095）， P＝0.048] were risk factors for tacrolimus-related abnormal liver function. ABCB1 CGC haplotype was the main haplotype. There was significant difference in the incidence of abnormal liver function caused by tacrolimus between ABCB1 CGC haplotype and non-ABCB1 CGC haplotype （P＝0.002）， and it was also a risk factor for tacrolimus-related liver dysfunction [OR＝3.173， 95％CI（1.512， 6.656）， P＝0.002]. CONCLUSIONS： The abnormal liver function of ABCB1 CGC haplotype kidney transplantation patients is more likely to occur when tacrolimus is administered during the perioperative period.

Post-stroke depression (PSD) is the most common psychiatric disorder after stroke,and mood disorders are the main manifestations.Clinical investigation shows that the prevalence of PSD is as high as 30％-50％.It seriously affects the lives and work of patients,and brings serious impact and heavy economic burden on individuals,families,and the entire society.The discovery of serum biomarkers of PSD has provided a new direction for its diagnosis and treatment.This article reviews the serum biomarker of PSD.