Mutational Spectrum and Prognosis Analysis of Young Patients with Diffuse Large B-Cell Lymphoma Based on Next-Generation Sequencing / 中国实验血液学杂志

OBJECTIVE@#To investigate the mutational spectrum in young patients with diffuse large B-cell lymphoma (DLBCL) based on next generation sequencing (NGS), and to provide a basis for in-depth understanding of the molecular biological characteristics and accurate prognosis of young DLBCL.@*METHODS@#From March 2009 to March 2021, 68 young DLBCL patients with complete initial diagnosis data from the Department of Hematology, The People's Hospital Xinjiang Uygur Autonomous Region were retrospectively analyzed, and their paraffin-embedded tissues were subjected to targeted sequencing analysis by NGS technology (including 475 Target genes), and the differences in gene mutation profiles and signaling pathways between high-risk patients with aaIPI ≥2 and low-intermediate risk patients with aaIPI <2 were compared.@*RESULTS@#A total of 44 high-frequency mutation genes were detected in 68 young DLBCL patients. By comparing the high-frequency mutation genes in aaIPI high-risk group and low-intermediate risk group, it was found that CARD11 mutation in aaIPI high-risk group was significantly higher than that in low-intermediate risk group (P =0.002), while MGA mutation (P =0.037) only appeared in the aaIPI high-risk group, and SPEN mutation (P =0.004) only appeared in the aaIPI low-intermediate risk group. The high-frequency mutation genes and clinical indicators of the aaIPI high-risk group were included in the survival analysis, and the results showed that TP53 (P =0.009, P =0.027), POU2AF1 (P =0.003, P =0.006) and CCND3 (P =0.040, P =0.014) genes mutations were associated with worse PFS and OS, while B2M was associated with better PFS (P =0.014) and OS (P =0.013). Multivariate COX regression analysis showed that the TP53, POU2AF1 and CCND3 were independent risk factors for PFS（P ＝0.021，P =0.005，P =0.020） and OS（P ＝0.042，P =0.010，P =0.013）.@*CONCLUSION@#The aaIPI staging combination with molecular biology markers is more conducive to accurately judging the prognosis of young DLBCL patients. TP53, POU2AF1 and CCND3 mutations predict worse survival in the patients with the aaIPI high-risk group.

Distribution and prognostic value of LymphGen genotyping in patients with diffuse large B-cell lymphoma / 中华血液学杂志

Objective: To investigate the distribution characteristics of LymphGen genotyping in a diffuse large B-cell lymphoma (DLBCL) population and verify its prognostic value. Methods: We collected the clinical data and paraffin-embedded tumor tissue samples of 155 patients with newly diagnosed DLBCL in the People's Hospital of Xinjiang Uygur Autonomous Region from June 2014 to December 2020. DNA was extracted from tumor tissue and 475 gene mutations were detected by next-generation sequencing technology. We investigated the distribution of LymphGen genotyping in the DLBCL population, patients with different COO genotypes in the Xinjiang region, and their effects on PFS and OS. Results: ①Among 155 patients, 105 patients (67.7%) could be genotyped, including 14 (9.0%) for MCD, 26 (16.8%) for BN2, 10 (6.5%) for N1, 8 (5.2%) for EZB, 27 (17.4%) for A53, and 20 (12.9%) for ST2. ②The distribution of each gene subtype was different in different cell origin (COO) types (P=0.021) . ST2 was dominant in the germinal center type (GCB) group (28.8%) , and A53 and MCD were dominant in the non-GCB group (35.8%, 17.0%) . The BN2 type was the most common in both groups (23.1%, 26.4%) . ③There were statistically significant differences in progression-free survival (PFS) and overall survival (OS) among different gene subtypes (P=0.031 and 0.005, respectively) . N1 and A53 had poor prognosis. The 2-year PFS and OS rates of N1 were both (21.3±18.4) %, and the 3-year PFS and OS rates of A53 were (60.9±11.3) %, (46.8±10.9) %, respectively. ④ The 3-year PFS and OS rates of MCD were the best, but the 5-year PFS and OS rates were worse. ⑤In the ROC curve of LymphGen genotyping for OS prediction, the AUC was 0.66, showing a certain degree of differentiation. Conclusion: LymphGen genotyping in the DLBCL population was different from previous reports and was of great significance for the prognosis of patients with DLBCL.

Treatment of Siewert type II adenocarcinoma of the esophagogastric junction: the perspectives from thoracic surgery / 中华胃肠外科杂志

A greater controversy remains in clinical diagnosis and treatment of Siewert type II adenocarcinoma of esophagogastric junction (AEG), compared with Siewert type I and III AEG. In 2018, the first edition of Chinese Expert Consensus on the Surgical Treatment for Adenocarcinoma of Esophagogastric Junction was published in the Chinese Journal of Gastrointestinal Surgery. In the past few years, the advance in minimally invasive thoracoscopic surgery has been proven to reduce thoracic trauma in Siewert type II AEG. Meanwhile, distal thoracic esophagectomy can achieve more complete resection, and upper abdomen-right thoracic approach can ensure the mediastinal lymph node dissection and improve long-term survival. The concept and practice of endoscopic surgery and the comprehensive treatment also give new supplements to the treatment regimen of Siewert type II AEG. More clinical researches should be conducted to address the surgical residual safety and lymph node dissection issues.

Preliminary study of the relationship between novel coronavirus pneumonia and liver function damage: a multicenter study / 中华肝脏病杂志

To analyze the clinical characteristics of cases of novel coronavirus pneumonia and a preliminary study to explore the relationship between different clinical classification and liver damage. Consecutively confirmed novel coronavirus infection cases admitted to seven designated hospitals during January 23, 2020 to February 8, 2020 were included. Clinical classification (mild, moderate, severe, and critical) was carried out according to the diagnosis and treatment program of novel coronavirus pneumonia (Trial Fifth Edition) issued by the National Health Commission. The research data were analyzed using SPSS19.0 statistical software. Quantitative data were expressed as median (interquartile range), and qualitative data were expressed as frequency and rate. 32 confirmed cases that met the inclusion criteria were included. 28 cases were of mild or moderate type (87.50%), and four cases (12.50%) of severe or critical type. Four cases (12.5%) were combined with one underlying disease (bronchial asthma, coronary heart disease, malignant tumor, chronic kidney disease), and one case (3.13%) was simultaneously combined with high blood pressure and malignant tumor. The results of laboratory examination showed that the alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin (ALB), and total bilirubin (TBil) for entire cohort were 26.98 (16.88 ~ 46.09) U/L and 24.75 (18.71 ~ 31.79) U/L, 39.00 (36.20 ~ 44.20) g/L and 16.40 (11.34- ~ 21.15) mmol/L, respectively. ALT, AST, ALB and TBil of the mild or moderate subgroups were 22.75 (16.31- ~ 37.25) U/L, 23.63 (18.71 ~ 26.50) U/L, 39.70 (36.50 ~ 46.10) g/L, and 15.95 (11.34 ~ 20.83) mmol/L, respectively. ALT, AST, ALB and TBil of the severe or critical subgroups were 60.25 (40.88 ~ 68.90) U/L, 37.00 (20.88 ~ 64.45) U/L, 35.75 (28.68 ~ 42.00) g/L, and 20.50 (11.28 ~ 25.00) mmol/L, respectively. The results of this multicenter retrospective study suggests that novel coronavirus pneumonia combined with liver damage is more likely to be caused by adverse drug reactions and systemic inflammation in severe patients receiving medical treatment. Therefore, liver function monitoring and evaluation should be strengthened during the treatment of such patients.

Influence of proteasome activator γ on iodine uptake capability of anaplastic thyroid carcinoma / 中华核医学与分子影像杂志

Objective To investigate the changes of iodine uptake capability (IUC) and mRNA expression of iodine uptake-related proteins in ARO and WRO thyroid carcinoma cell lines after silence of proteasome activator γ (REGγ),and observe the relation between REGγ and IUC of thyroid carcinoma.Methods The AROshN,AROshR,WROshN and WROshR (shN =blank plasmid,shR =plasmid with silence of REGγ) thyroid carcinoma cell lines were routinely cultured.Low dosage (3.7 kBq) of Na125I was added and then IUC was determined at different time points (5,10,15,20,40 and 70 min).The mRNA expressions of sodium/iodine symporter (NIS),thyroid stimulating hormone receptor (TSHR),thyroid peroxidase (TPO) and thyroglobulin (Tg) were examined by real-time PCR.Paired t test was used to analyze the data.Results After the silence of REGγ,the peak values of IUC in AROshR and WROshR cells were increased from (1 974±12) to (4 502±23) counts/min,and from (2 988±25) to (5 001±16) counts/min,respectively.The increase rates were 128.1％ in AROshR cells and 67.4％ in WROshR cells (t values:17.30,13.20,both P＜0.05).The mRNA expressions of NIS,TSHR,TPO,Tg in AROshR cells were 2.82,1.98,2.65 and 2.31 times higher than those in AROshN cells,and the expressions in WROshR cells were 2.21,1.78,2.51 and 1.78 times higher than those in WROshN cells (t values:13.80-21.93,all P＜0.05).Conclusion Silence of REGγcan increase the gene expressions of the iodine uptake-related proteins and elevate the IUC of thyroid carcinoma cells.

Interpretation of Detection of Intestinal Helminthes—The Kato-Katz Method (WS/T 570–2017) / 中国血吸虫病防治杂志

The criteria for the Kato-Katz thick smear are compiled following the Management Measures for Health Criteria and GBT 1.1–2009 Standardization Working Guidelines. The criteria are composed of five chapters, including the range of application, terms and definitions, equipments, reagent materials, and testing procedures. Three informative appendices (identification of helminth eggs in human faeces, counting method of eggs in Kato-Katz thick smear, and other considerations) are appended. The criteria have been issued by the National Health and Family Planning Commission of the People’s Republic of China, it provides a technical reference for the detection of helminth eggs in human faeces in medical institutions and disease prevention and control institutions.

Interpretation of Detection of Intestinal Helminthes—The Kato-Katz Method (WS/T 570–2017) / 中国血吸虫病防治杂志

The criteria for the Kato-Katz thick smear are compiled following the Management Measures for Health Criteria and GBT 1.1–2009 Standardization Working Guidelines. The criteria are composed of five chapters, including the range of application, terms and definitions, equipments, reagent materials, and testing procedures. Three informative appendices (identification of helminth eggs in human faeces, counting method of eggs in Kato-Katz thick smear, and other considerations) are appended. The criteria have been issued by the National Health and Family Planning Commission of the People’s Republic of China, it provides a technical reference for the detection of helminth eggs in human faeces in medical institutions and disease prevention and control institutions.

Differentiation between tuberculosis and leukemia in abdominal and pelvic lymph nodes: evaluation with contrast-enhanced multidetector computed tomography

PURPOSE: To compare the characteristics of tubercular vs. leukemic involvement of abdominopelvic lymph nodes using multidetector computed tomography (CT). MATERIALS AND METHODS: We retrospectively reviewed multidetector computed tomography features including lymph node size, shape, enhancement patterns, and anatomical distribution, in 106 consecutive patients with newly diagnosed, untreated tuberculosis (55 patients; 52%) or leukemia (51 patients; 48%). In patients with leukemia, 32 (62.7%) had chronic lymphocytic leukemia, and 19 (37.3%) had acute leukemias; of these, 10 (19.6%) had acute myeloid leukemia, and 9 (17.6%) had acute lymphocytic leukemia. RESULTS: The lower para-aortic (30.9% for tuberculosis, 63.2% for acute leukemias and 87.5% for chronic lymphocytic leukemia) and inguinal (9.1% for tuberculosis, 57.9% for acute leukemias and 53.1% for chronic lymphocytic leukemia) lymph nodes were involved more frequently in the three types of leukemia than in tuberculosis (both with p <0.017). Tuberculosis showed peripheral enhancement, frequently with a multilocular appearance, in 43 (78.2%) patients, whereas patients with leukemia (78.9% for acute myeloid leukemia and acute lymphocytic leukemia, 87.5% for chronic lymphocytic leukemia) demonstrated predominantly homogeneous enhancement (both with p <0.017). For the diagnosis of tuberculosis, the analysis showed that a peripheral enhancement pattern had a sensitivity of 78.2%, a specificity of 100%, and an accuracy of 88.7%. For the diagnosis of leukemia, the analysis showed that a homogeneous enhancement pattern was associated with a sensitivity of 84.3%, a specificity of 94.5%, and an accuracy of 89.6%. CONCLUSION: Our findings indicate that the anatomical distribution and enhancement patterns of lymphadenopathy seen on multidetector computed tomography are useful for differentiating between untreated tuberculosis and leukemia of the abdominopelvic lymph nodes. .

A competency model of rural general practitioners: theory construction and empirical study / 南方医科大学学报

<p><b>OBJECTIVE</b>To perform theory construction and empirical study of the competency model of rural general practitioners.</p><p><b>METHODS</b>Through literature study, job analysis, interviews, and expert team discussion, the questionnaire of rural general practitioners competency was constructed. A total of 1458 rural general practitioners were surveyed by the questionnaire in 6 central provinces. The common factors were constructed using the principal component method of exploratory factor analysis and confirmatory factor analysis. The influence of the competency characteristics on the working performance was analyzed using regression equation analysis.</p><p><b>RESULTS</b>The Cronbach 's alpha coefficient of the questionnaire was 0.974. The model consisted of 9 dimensions and 59 items. The 9 competency dimensions included basic public health service ability, basic clinical skills, system analysis capability, information management capability, communication and cooperation ability, occupational moral ability, non-medical professional knowledge, personal traits and psychological adaptability. The rate of explained cumulative total variance was 76.855%. The model fitting index were Χ(2)/df 1.88, GFI=0.94, NFI=0.96, NNFI=0.98, PNFI=0.91, RMSEA=0.068, CFI=0.97, IFI=0.97, RFI=0.96, suggesting good model fitting. Regression analysis showed that the competency characteristics had a significant effect on job performance.</p><p><b>CONCLUSIONS</b>The rural general practitioners competency model provides reference for rural doctor training, rural order directional cultivation of medical students, and competency performance management of the rural general practitioners.</p>

A new gene ontology-based measure for the functional similarity of gene products / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Although biomedical ontologies have standardized the representation of gene products across species and databases, a method for determining the functional similarities of gene products has not yet been developed.</p><p><b>METHODS</b>We proposed a new semantic similarity measure based on Gene Ontology that considers the semantic influences from all of the ancestor terms in a graph. Our measure was compared with Resnik's measure in two applications, which were based on the association of the measure used with the gene co-expression and the protein-protein interactions.</p><p><b>RESULTS</b>The results showed a considerable association between the semantic similarity and the expression correlation and between the semantic similarity and the protein-protein interactions, and our measure performed the best overall.</p><p><b>CONCLUSION</b>These results revealed the potential value of our newly proposed semantic similarity measure in studying the functional relevance of gene products.</p>

Meta-analysis on reconstructions of posterior mediastinal route and anterior mediastinal route after esophagectomy / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of posterior mediastinal route (PR) as compared with anterior mediastinal route (AR) after esophagectomy.</p><p><b>METHODS</b>A systematic literature retrieval was carried out to obtain studies of randomized controlled trials (RCT) comparing PR with AR after esophagectomy before June 2012. Study selection, data collections and methodological quality assessments of retrieved studies were independently performed by two individual reviewers and meta-analysis was conducted using the RevMan 5.0 software.</p><p><b>RESULTS</b>Six RCTs involving 376 patients (PR:197 cases, AR:179 cases) met the selection criteria. Meta-analysis showed that operative mortality (RR=0.49, 95%CI:0.18-1.36), anastomotic leaks (RR=0.95, 95%CI:0.44-2.07), cardiac morbidity (RR=0.51, 95%CI:0.25-1.04), pulmonary morbidity (RR=0.69, 95%CI:0.41-1.15), anastomotic strictures (RR=0.88, 95%CI:0.62-1.25), dysphagia (RR=1.26, 95%CI:0.75-2.11), 6-month body weight after esophagectomy were not significantly different between these two routes of reconstruction (all P>0.05).</p><p><b>CONCLUSION</b>AR should be the choice of reconstruction in view of its potential advantages in the prevention of tumor recurrence within the gastric conduit and avoidance of conduit irradiation when undergoing postoperative radiotherapy. However, further studies are needed to confirm the difference of long-term efficacy between the two routes.</p>

Analysis of the results of two nationwide surveys on Clonorchis sinensis infection in China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To examine Clonorchis sinensis infection in China and evaluate the effectiveness of efforts to prevent and control it, two nationwide surveys were undertaken in 31 provinces, autonomous regions, and municipalities (PAMs) during 1988-92 (the 1990 survey) and during 2001-04 (the 2003 survey).</p><p><b>METHODS</b>During the period 2001-04, two sampling methods were applied. The first method repeated the stratified cluster random sampling used in the 1990 survey; the second method applied two-characteristic stratified cluster random sampling in 27 PAMs-the 2003 endemic area (EA) survey. The Kato-Katz thick smear method was used for the nationwide survey.</p><p><b>RESULTS</b>The infection rates of Clonorchis sinensis in the 1990 and 2003 surveys were 0.311% and 0.579%, respectively. The infection rate was 2.40% in the 2003 EA survey, and it was estimated that 12.49 million people in China were infected with Clonorchis sinensis.</p><p><b>CONCLUSION</b>The 2003 survey showed that the standardized infection rate of Clonorchis sinensis increased by 74.85% compared with the 1990 survey. The infection rate in males was higher than in females; the infection rate among people eating raw fish or eating out frequently was higher than among those who did not.</p>

Association between number of lymphadenectomy and postoperative complication in surgery for esophageal carcinoma / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the association between the number of lymph nodes retrieval and the incidence of postoperative complications in patients with esophageal carcinoma.</p><p><b>METHOD</b>From January 2008 to December 2009, 794 patients with esophageal carcinoma underwent esophagectomy and lymphadenectomy in the Department of Thoracic Surgery at the West China Hospital of Sichuan University. The clinical data, surgeons, the extent of lymphadenectomy and its association with operative morbidity were retrospectively analyzed.</p><p><b>RESULTS</b>There was no operative death. A total of 84 patients with complication(10.6%) were documented. There were 11,770 lymph nodes harvested in total with an average of 14.8. Multivariate logistic regression showed that gender, number of metastatic lymph nodes, level of anastomosis, and surgeons' experience were risk factors associated with postoperative complications (all P<0.05), while the number and group of lymph node resection were not(all P>0.05).</p><p><b>CONCLUSION</b>Within a rational range of lymphadenectomy(<50) following esophagectomy, the postoperative complications are significantly associated with the gender, extent of regional lymph nodes metastasis, site of anastomosis and the expertise of the surgeons, but not associated with the number and group of lymph nodes resection.</p>

Subcarinal lymph node metastasis and strategy of lymphadenectomy in thoracic esophageal carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To assess the metastatic frequency of subcarinal lymph nodes of thoracic esophageal carcinoma and its influencing factors, in order to determine the adequate range of lymph node dissection during esophagectomy.</p><p><b>METHODS</b>The clinical data from a cohort of 782 patients with thoracic esophageal carcinoma who underwent esophagectomy with lymphadenectomy were analyzed retrospectively with respect to the impact of subcarinal lymph nodes dissection or no dissection on the incidence of postoperative complications.</p><p><b>RESULTS</b>The metastasis rate of subcarinal lymph nodes was 17.5%. The metastasis rates in the upper, middle and lower esophageal carcinomas were 8.3%, 19.1% and 16.2%, respectively (P > 0.05). For T1, T2, T3 and T4, they were 0, 4%, 22.2% and 34%, respectively (P < 0.05). The overall incidence of postoperative complications with and without subcarinal lymph nodes dissection was 19.0% versus 14.6% (P > 0.05), and the incidence of pulmonary complications was 10.3% versus 7.3% (P > 0.05).</p><p><b>CONCLUSIONS</b>Thoracic esophageal carcinomas have a high metastasis rate of subcrinal lymph nodes, and subcarinal lymph nodes dissection is not associated with increasing perioperative complications. Therefore, for the thoracic esophageal carcinoma, no matter the tumor site, esophageal cancer length or size, once the tumor invades the outer membrane, routine subcarinal lymph node dissection should be done.</p>

Esophagogastrostomy by side-to-side anastomosis in prevention of anastomotic stricture: a randomized clinical trial / 中华外科杂志

<p><b>OBJECTIVE</b>To compare a side-to-side esophagogastric anastomosis with conventional hand-sewn or stapled esophagogastrostomy for prevention of anastomotic stricture by randomized clinical trial.</p><p><b>METHODS</b>Between November 2007 and September 2008, 160 patients with esophageal carcinoma or gastric cardia cancer were consecutively admitted and underwent surgical treatment. After excluding 5 patients (2 refused to participate in and 3 did not meet inclusion criteria), the remaining 155 patients were completely randomized to receive either a side-to-side esophagogastric anastomosis (SS group), or the conventional hand-sewn (HS group), or a circular stapled (CS group) anastomosis, after the removal of esophageal tumor. The primary outcome measured the incidence of anastomotic stricture at 3 months after the operation (defined as the diameter of the anastomotic orifice <or= 0.8 cm on esophagogram), analyzed by intention-to-treat.</p><p><b>RESULTS</b>There was 1 operative death (in HS group) and 1 simple exploration (in SS group). The anastomotic leakage was observed in 4 patients (2 cervical and 1 intrathoracic leaks in HS group, and 1 intrathoracic leak in CS group). The follow-up rate was 96.1% (1 patient in SS group, 3 in HS group, and 2 in CS group were lost). Finally 45 patients in SS group, 52 in HS group, and 47 in CS group were included in the analysis. The 3 groups were preoperative similar. The anastomotic stricture rate was 0% (0/45) in SS group, 9.6% (5/52) in HS group, and 19.1% (9/47) in CS group, respectively (Fisher exact probability test, P = 0.005). The reflux/regurgitation score among 3 groups was similar (chi(2) = 1.681, P = 0.432).</p><p><b>CONCLUSION</b>The side-to-side esophagogastric anastomosis could prevent stricture formation, without increasing gastroesophageal reflux.</p>

Transperineal laparoscopic nephrectomy in live-donors / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To evaluate the feasibility and safety of transperitoneal laparoscopic nephrectomy in live-donors.</p><p><b>METHODS</b>Two cases of live-donor underwent laparoscopic nephrectomy in May and August 2008 respectively and both were followed up.</p><p><b>RESULT</b>In two cases the operation time was 130, 10 min; blood loss was 50 ml; warm ischemic time was 30 s and 2 min; the length of artery was 4.0 cm and 3.5 cm; the length of vein was 3.0 cm. The grafted kidneys started to produce urine at 30 s and 10 s after blood supply. Renal function of donor returned to normal after two days. The donors were discharged at 7th day after the operation. Renal function of recipient was normal after 3 days.</p><p><b>CONCLUSION</b>Transperitoneal laparoscopic nephrectomy in live-donor is a safe and effective procedure, which provides kidney with satisfactory blood vessels and ureter for graft.</p>

Concurrent chemoradiotherapy versus radiotherapy alone for locoregionally advanced nasopharyngeal carcinoma: a meta-analysis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To determine the value of concurrent chemoradiotherapy in patients with locoregionally advanced nasopharyngeal carcinoma from the mainland of China.</p><p><b>METHODS</b>Data were extracted from randomized trials comparing chemotherapy plus radiotherapy with radiotherapy alone in locally advanced nasopharyngeal carcinoma. Actuarial rates of survival and distant metastases were calculated. The followed electronic databases were searched the Chinese Biomedicine database, Pubmed, Medline, Embase and Cochrane library; Data were extracted by tow reviewers and Review manager 4.1 software was applied for statistical analysis.</p><p><b>RESULTS</b>Eighteen trials with 1993 patients were include according to the including criterion. The 3-year overall survival rate of the chemoradiotherapy group and the radiotherapy group were 68.47% and 56.38% respectively, and the 5-year overall survival rate of the two groups above were 51.91% and 41.09% respectively, while the distant metastases rate of the chemoradiotherapy group and the radiotherapy group were 26.19% and 38.71% respectively. The result demonstrated that chemoradiotherapy increased overall survival by 12% at 3 years, and 11% at 5 years after treatment. After chemoradiotherapy, the rate of distant metastasis was reduce by 12%.</p><p><b>CONCLUSIONS</b>In patients with locoregionally advanced nasopharyngeal carcinoma, chemoradiotherapy significantly improves overall survival at 3 years, and 5 years compared with radiotherapy alone.</p>

Current status of soil-transmitted nematode infection in China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To carry out national surveys for ascertaining the current status and trends of soil-transmitted nematode infections in China, providing scientific basis for further developing control strategies.</p><p><b>METHODS</b>In 1988-1992 (hereinafter abbreriated as "survey in 1990"), a stratified cluster random sampling method was used in the survey. In 2001-2004 (hereinafter abbreriated as "survey in 2003"), in order to compare with the survey in 1990, two-characteristic stratified cluster random sampling method was used and 687 investigation spots were sampled from the 2848 spots selected in the survey in 1990. Kato-Katz thick smear method was used to examine the eggs of soil-transmitted nematodes in fecal samples.</p><p><b>RESULTS</b>The prevalence rates were 53.6% and 19.6% for soil-transmitted nematodes, 14.6% and 6.120% for hookworms, 44.6% and 12.7% for Ascaris lumbricoides, 17.4% and 4.630% for Trichuris trichiura in survey 1990 and survey 2003, respectively. The prevalence rates of soil-transmitted nematodes were higher in 13 provinces than the average level in China in the survey in 1990, and higher in 8 provinces than the average level in the survey in 2003. The prevalence of hookworms, Ascaris lumbricoides, Trichuris trichiura and the overall prevalence of soil-transmitted nematodes were higher in females than in males. It is estimated from the results of survey in 2003 that the number of persons with soil-transmitted nematode infections in the country is about 129 million, less than that in the survey in 1990.</p><p><b>CONCLUSION</b>The prevalence of soil-transmitted nematodes has declined considerably but is still relatively high in some provinces and autonomous regions. Control activities and socioeconomic development may have contributed to the decreased prevalence.</p>

Analysis of lymph node metastasis in the thoracic esophageal squamous cell carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To assess the metastatic frequency in different groups of lymph nodes and its influencing factors of the thoracic esophageal squamous cell carcinoma (ESCC) in order to determine the extent of lymphadenectomy during esophagectomy.</p><p><b>METHODS</b>The clinical data of 730 patients with ESCC who underwent esophagectomy and lymphadenectomy were analyzed retrospectively.</p><p><b>RESULTS</b>Of 730 patients, 166 had metastasis to the para-esophageal lymph nodes (22.7%), 90 to the left gastric artery lymph nodes (12.3%), 67 to the lymph nodes around gastric cardia, and 15 to the subcrinal lymph nodes (2.1%). Univariate analysis showed that metastasis to the subcrinal lymph node was positively correlated with the length and differentiation of tumor (P < 0.05), but it was not correlated with any the above parameters when analyzed by multivariate analysis. The metastasis to the para-esophageal lymph node was positively correlated with the length, invasion depth and differentiation of tumor by univariate and multivariate analysis (P < 0.05). The metastasis to the lymph nodes around gastric cardia and metastasis to left gastric artery lymph nodes were positively correlated with the position and invasion depth of tumor by univariate and multivariate analysis (P < 0.05).</p><p><b>CONCLUSION</b>Lymph nodes of the para-esophagus, gastric cardia and left gastric artery usually have high frequency to harber mestastasis, therefore, it was suggested that the lymph nodes in these groups should be dissected during esophagectormy with two-field lymphadenectomy for thoracic esophageal squamous cell carcinoma. Whereas for those patients with the lesion < 3 cm in length or with tumor invasion confined within the esophageal wall or with a lesion located at the upper or lower third of the thoracic esophagus, the subcrinal lymph nodes may not be necessarily dissected.</p>

Long-term result of total versus partial fundoplication following esophagomyotomy for primary esophageal motor disorders / 中华外科杂志

<p><b>OBJECTIVE</b>To compare the long-term results of total and partial fundoplication on esophagus myotomy.</p><p><b>METHODS</b>From January 1978 to October 1998, 64 patients with achalasia or diffuse esophageal spasm underwent esophagomyotomy and antireflux operation via left thoracotomy. Twenty-one patients underwent Nissen total fundoplication (Nissen group) and 43 patients underwent Belsey Marker IV partial fundoplication (Belsey group). Clinical, radiologic, radionuclide transit, manometric, 24-hour pH monitoring and endoscopic assessments were performed before and after the operation.</p><p><b>RESULTS</b>There was no operative death and major complications for either group. At over 6 years follow-up and compared to Belsey group, patients in Nissen group revealed a higher frequency of dysphagia (P = 0.025) and more radionuclide material retention (P = 0.044). Both operative procedures reduced the lower esophageal sphincter pressure gradient. However, in Nissen group, the esophageal diameter observed on radiology was significantly increased from 3.9 cm preoperatively to 5.5 cm postoperatively (P = 0.012), while it kept the same for Belsey group (from 5.4 to 5.3 cm, P = 0.695). Reoperation in order to relieve the recurrent dysphagia and esophageal obstruction was performed on 8 patients in Nissen group and 1 in Belsey group (P < 0.01).</p><p><b>CONCLUSION</b>When treating achalasia or diffuse esophageal spasm by esophageal myotomy and an antireflux operation, a total fundoplication is not appropriate, whereas a partial fundoplication provides proper antireflux effect without significant esophageal emptying difficulty.</p>