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This study was a prospective single arm trial conducted in Zhejiang Jinhua Guangfu hospital from February 2018 to June 2020. A total of 39 patients (32 males and 7 females) with esophageal cancer, aged from 44 to 82 (69±9) years were enrolled. Diffusion weighted magnetic resonance imaging(MR-DWI) was implemented to evaluate the changes of apparent diffusion coefficient(ADC) value before and after chemoradiotherapy. The results showed that the ADC value after chemoradiotherapy was higher than that before treatment[(2.03±0.42)×10⁻³ mm 2 /s vs (1.60±0.28)×10⁻³ mm 2 /s], and there was a positive correlation between the increase of ADC value and the prognosis of patients.

Objective: To investigate the effects of duodenal ligation on gastroesophageal reflux and bleomycin-induced pulmonary fibrosis in rats. Methods: Wistar rats were randomized into the control (Ctrl) group, bleomycin (BLM) group, duodenal ligation (GER) group and duodenal ligation plus bleomycin treatment (BLM+GER) group. At day 0 (d0), duodenum ligation was performed in the GER and the BLM+GER group through an open-abdomen surgery at 1.0 cm below the pylorus by about 30% of the circumference. Meanwhile, sham operation was performed in the Ctrl and the BLM group with similar procedures to the above without ligation of the duodenum. At day 14, bleomycin solution (5 mg/kg, for the BLM and BLM+GER groups) or saline (for the Ctrl and GER groups) was intratracheally instilled. Rats were sacrificed at d28 or at d42. HE, Masson's trichrome or TUNEL staining was performed on lung sections of the groups. The levels of hyrdoxyproline (HYP) or malondialdehyde (MDA) were measured respectively by alkaline hydrolysis or thiobarbituric acid colorimetry. The levels of pepsin and cytokines in bronchoalveolar lavage fluid (BALF) samples were assessed by ELISA. Western blot or RT-PCR was used to quantify relative lung expression of proteins or mRNA, respectively. Results: Lungs of the GER group rats were presented with mild inflammatory cell infiltration. Alveolitis and lung fibrosis was prominent in the BLM group but even more severe in the BLM+GER group. Of the Ctrl, GER, BLM and BLM+GER group, the average numbers of apoptotic cells per each magnified field (×200) on d28 lung sections was (5.6±3.0), (6.4±5.3), (15.4±5.3) and (18.4±9.1), respectively ( P =0.008); the proportion (%) of blue-stained area under Masson's trichrome at d42 was (21.5±2.8), (23.4±2.5), (34.0±5.8) and (41.3±2.9) ( P <0.05); the HYP contents (mg/L) at d42 of each group was (0.77±0.01), (1.26±0.01), (2.02±0.01) and (2.39±0.01) ( P <0.01); the BALF levels of MDA (μmol/L) at d42 were (0.51±0.09), (0.87±0.12), (1.40±0.31) and (1.71±0.12) ( P <0.001), and differences of these three indices at d42 reached statistical significance when comparing the Ctrl or GER group with the BLM or BLM+GER group (all P <0.05). The levels of pepsin, pH, interleukin (IL)-1β, transforming growth factor (TGF)-β1 and HYP at d28 and d42 were statistically different between the GER group and the Ctrl group (all P <0.05). As compared with the BLM group, the values of TGF-β1, HYP, p-Smad3, vimentin, p-ERK1/2 and cleaved caspase-3 at d28 and d42 were different in the BLM+GER group (all P <0.05). At both d28 and d42, the BALF levels of pepsin and pH were statistically different between the BLM and the Ctrl group, or between the BLM+GER group and the GER group (all P <0.05). Conclusions: Gastroesophageal reflux is induced through duodenal ligation, which activates proinflammatory and profibrotic signals in the lungs and significantly aggravates bleomycin-induced lung injury and fibrosis. In addition, pulmonary fibrosis may induce or worsen the extent of reflux.

Objective: To study the clinical manifestations, pathological features, diagnosis, differential diagnosis, treatment and prognosis of primary tracheobronchial or pulmonary malignant glomus tumor (MGT). Methods: A case of primary tracheal MGT with lung metastasis diagnosed by pathological analysis admitted to Affiliated Shantou Hospital of Sun Yat-sen University in May. 2015 was analyzed, and the related literatures were reviewed. We searched databases including PubMed, Embase, Ovid, Cochrane, Wanfang and Chinese National Knowledge infrastructure (CNKI), using the keyword "tracheal or bronchial or pulmonary malignant glomus tumor" from Jan. 1975 to Dec. 2016. Results: A 47 year-old male patient was admitted to the hospital because of cough, chest tightness and shortness of breath for 3 days. The chest CT showed a soft tissue mass with a diameter of 2.5 cm in the lower tracheal segment, and the lumen was narrowed. Meanwhile, multiple nodular opacities were shown in both lungs. The admission diagnosis was thyroid cancer with multiple metastases of lung. Electronic bronchoscopic airway tumor ablation and cryotherapy were performed, and then the biopsy of the tumor was conducted and the pathological study confirmed the diagnosis of primary tracheal MGT. After 1 month, the tracheal tumor recurred. Then, electronic bronchoscopic airway tumor ablation and cryotherapy were performed again. The patient declined further therapy such as radiotherapy or chemotherapy and died one month later. A total of 14 literatures including 15 cases were retrieved from databases. In addition of this case, a total of 16 cases were analyzed, including 9 males, 7 females. Age of onset ranged from 9 to 74 years, and the average age was 49 years. These patients' chest CT showed airway mass or lung space occupying lesions, and the clinical manifestations were nonspecific. Conclusions: Primary MGT in trachea, bronchus or lung is a rare disease, which is easy to be misdiagnosed or to miss diagnosis. The final diagnosis depends on pathological morphology, and the main treatment is lobectomy or tracheal segment resection surgery. Due to its high invasiveness, local recurrence and metastasis may occur easily. The primary MGT in trachea, bronchus or lung is of poor prognosis.

Objective: To comprehensively analyze the clinical features of patients with AR by a retrospective study. Method: A total number of 8 102 patients diagnosed with AR were enrolled in Nantong area, and detailed clinical data were documented in all cases. Skin prick tests with standardized aeroallergens were conducted in these patients; The samples were divided into two groups(children and adults group) and the clinical features between two groups were analysed. Result: Children in schoolage were the majority of AR patients in children group. There were 4 581 cases(56.54%) with ocular symptoms, 3 977 cases(49.09%)with lower respiratory tract symptoms. Nasal congestion (97.37%) was the most common symptoms in patients with AR,while eye itching(32.68%) was the most common ocular symptoms in patients with AR, followed by the dacryorrhea(23.57%);and cough(44.72%) was the most common lower respiratory tract symptoms. Dermatophagoides pteronyssinus and dermatophagoides farinae had the highest positivity among all allergens, and the shrimp was the main food allergen. Conclusion: We analyzed the clinical features of patients with AR, that would provide a more scientific basis for prevention,clinical diagnosis, treatment and epidemiological studies for AR., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

There are different names of the fire needle therapy in the Huang di nei jing (Inner Canon of Huangdi) such as Zu-zhen (), Cui-zhen (,), Fan-zhen (), Huo-cui (), Cui (,,), Cuici ,), Fan zhen jie ci (). It is claimed that the lance needle, the round sharp needle and the long needle recorded in this Classic are puncturing tools for the fire needle therapy. In the Eastern Han Dynasty, Zhang Zhongjing expanded the indications for the fire needle therapy and Huo-zhen () firstly appeared in the Jin kui yu han jing(Classic of the Jade Box and Golden Chamber). The application of the fire needle therapy had been further expanded to a lot of internal and external disorders form the Wei-Jin-Southern and Northern Dynasties to the Ming and Qing Dynasties. There are more detailed records on the manipulation and the tools of the fire needle therapy during this period. In the 1970s, Huo zhen liao fa () was proposed and still in use today. However the Bai-zhen (plain needle) in ancient literature is equal to the filiform needle and should not be regarded as the former name of the fire needle.