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PURPOSE To ascertain if preoperative short-term radiotherapy followed by chemotherapy is not inferior to a standard schedule of long-term chemoradiotherapy in patients with locally advanced rectal cancer. MATERIALS AND METHODS Patients with distal or middle-third, clinical primary tumor stage 3-4 and/or regional lymph node–positive rectal cancer were randomly assigned (1:1) to short-term radiotherapy (25 Gy in five fractions over 1 week) followed by four cycles of chemotherapy (total neoadjuvant therapy [TNT]) or chemoradiotherapy (50 Gy in 25 fractions over 5 weeks, concurrently with capecitabine [chemoradiotherapy; CRT]). Total mesorectal excision was undertaken 6-8 weeks after preoperative treatment, with two additional cycles of CAPOX (intravenous oxaliplatin [130 mg/m2, once a day] on day 1 and capecitabine [1,000 mg/m2, twice a day] from days 1 to 14) in the TNT group and six cycles of CAPOX in the CRT group. The primary end point was 3-year disease-free survival (DFS). RESULTS Between August 2015 and August 2018, a total of 599 patients were randomly assigned to receive TNT (n = 302) or CRT (n = 297). At a median follow-up of 35.0 months, 3-year DFS was 64.5% and 62.3% in TNT and CRT groups, respectively (hazard ratio, 0.883; one-sided 95% CI, not applicable to 1.11; P < .001 for noninferiority). There was no significant difference in metastasis-free survival or locoregional recurrence, but the TNT group had better 3-year overall survival than the CRT group (86.5% v 75.1%; P = .033). Treatment effects on DFS and overall survival were similar regardless of prognostic factors. The prevalence of acute grade III-V toxicities during preoperative treatment was 26.5% in the TNT group versus 12.6% in the CRT group ( P < .001). CONCLUSION Short-term radiotherapy with preoperative chemotherapy followed by surgery was efficacious with acceptable toxicity and could be used as an alternative to CRT for locally advanced rectal cancer.

Background: The effect of age on long-term mortality and net survival benefit of radiotherapy (RT) for early-stage follicular lymphoma (FL) was not evaluated. Methods: 8,803 patients with early-stage FL in the Surveillance, Epidemiology, and End Results (SEER) database (2000-2015) were identified for this study. Primary therapy included RT (27.0%), chemotherapy (CT, 29.3%), observation (24.1%), and other/unknown treatments (19.6%). Inverse probability of treatment weighting (IPTW) was conducted to balance the treatment arms. Relative survival (RS), the standardized mortality ratio (SMR), and transformed Cox regression were used to compare survival differences between treatments.Results: The risk of dying from FL and other causes varied over time, dependent of patient age. RT had significantly higher 10-year OS (77.2%) and RS (96.1%), but lower SMR (1.77), compared with CT (65.2%; 82.6%; 2.92; PPPP=0.136; 2.05, PPPinteraction=0.305) or OS (Pinteraction= 0.272), indicating similar survival benefits across all-ages patients.Conclusions: RT was associated with long-term OS and net survival benefits in early-stage FL.

To observe the clinical effect between orbital septum incision and classical incision of double eyelid plasty.We retrospectively analyzed 381 patients who underwent double eyelid blepharoplasty in the Department of Plastic and Laser Cosmetology of Hunan Provincial People's Hospital from January 2019 to December 2019. The patients were divided into two groups according to different surgical methods: group A (n = 146) received the classical method and group B (n = 235) received the orbital septum method. The incidence of early postoperative complications, scar depression from 6 months to 1 year after the operation, the condition of 'meat strip' (the accumulation of soft tissue in front of the tarsal plate after double eyelid surgery, including skin, muscle, and fascia fat, results in a hypertrophic appearance of the upper eyelid) below the double eyelid line, and the symmetry of double eyelids were analyzed and evaluated.The total number of early postoperative complications in group A was seven cases (incidence rate: approximately 4.80%), and the total number of early postoperative complications in group B was two cases (incidence rate: approximately 0.85%), with a statistically significant difference (P0.05). The degree of scar depression in group B was significantly lighter than that in group A from 6 months to 1 year after the operation (P0.05). The score of 'meat strip' below the double eyelid line in group B was significantly lighter than that in group A (P0.05). The symmetry of double eyelids in group B was better than that in group A (P0.05) CONCLUSION: Compared to the classical double eyelid method, the orbital septum method has the advantages of reducing early postoperative complications, reducing the severity of the scar, slighting the 'meat strip,' and improving symmetry, which results in higher postoperative satisfaction LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors https://www.springer.com/00266 .

PURPOSE No randomized trials have compared hypofractionated radiotherapy (HFRT) with conventional fractionated radiotherapy (CFRT) after breast-conserving surgery in the Asian population. This study aimed to determine whether a 3.5-week schedule of HFRT is noninferior to a standard 6-week schedule of CFRT in China. PATIENTS AND METHODS Patients from 4 Chinese institutions who had undergone breast-conserving surgery and had T1-2N0-3 invasive breast cancers participated this study. Patients were randomly assigned (1:1) using a computer-generated central randomization schedule, without stratification, to receive whole-breast irradiation with or without nodal irradiation, followed by tumor-bed boost, either at a dose of 50 Gy in 25 fractions over 5 weeks with a boost of 10 Gy in five fractions over 1 week (CFRT) or 43.5 Gy in 15 fractions over 3 weeks with a boost of 8.7 Gy in three daily fractions (HFRT). The primary endpoint was 5-year local recurrence (LR), and a 5% margin of 5-year LR was used to establish noninferiority. RESULTS Between August 2010 and November 2015, 734 patients were assigned to the HFRT (n = 368) or CFRT (n = 366) group. At a median follow-up of 73.5 months (interquartile range, 60.5-91.4 months), the 5-year cumulative incidence of LR was 1.2% in the HFRT group and 2.0% in the CFRT group (hazard ratio, 0.62; 95% CI, 0.20 to 1.88; P = .017 for noninferiority). There were no significant differences in acute and late toxicities, except that the HFRT group had less grade 2-3 acute skin toxicity than the CFRT group ( P = .019). CONCLUSION CFRT and HFRT with a tumor-bed boost may have similar low LR and toxicity.

Limited evidence supports the use of early endpoints to evaluate the success of initial treatment of extranodal NK/T-cell lymphoma (ENKTCL) in the modern era. We aim to analyze progression-free survival at 24 months (PFS24) and subsequent overall survival (OS) in a large-scale multicenter cohort of patients. 1790 patients were included from the China Lymphoma Collaborative Group (CLCG) database. Subsequent OS was defined from the time of PFS24 or progression within 24 months to death. OS was compared with age- and sex-matched general Chinese population using expected survival and standardized mortality ratio (SMR). Patients who did not achieve PFS24 had a median OS of 5.3 months after progression, with 5-year OS rate of 19.2% and the SMR of 71.4 (95% CI, 62.9–81.1). In contrast, 74% patients achieved PFS24, and the SMR after achieving PFS24 was 1.77 (95% CI, 1.34–2.34). The observed OS rate after PFS24 versus expected OS rate at 5 years was 92.2% versus 94.3%. Similarly, superior outcomes following PFS24 were observed in early-stage patients (5-year OS rate, 92.9%). Patients achieving PFS24 had excellent outcome, whereas patients exhibiting earlier progression had a poor survival. These marked differences suggest that PFS24 may be used for study design and risk stratification in ENKTCL.

The purpose of this study was to investigate the potential of cell-free DNA (cfDNA) as a prognostic factor for non-small cell lung cancer (NSCLC). Patients with NSCLC (n = 154) treated with gefitinib were recruited over a 5-year period for this study, and served as the observation group (79 males and 75 females, mean age = 53.74 ± 10.86 years). The control group (normal healthy individuals) consisted of 30 males and 22 females, aged 44 – 64 years (mean age = 54.12 ± 9.83 years). The follow-up lasted 5 years, or until the patient relapsed and died. The plasma level of cfDNA was determined in patients 1 day before treatment, 3 days after treatment, and on the 28th day of treatment.Based on the cfDNA expression level, NSCLC patients were subdivided into high-expression and low-expression groups, and differences in survival were compared. Univariate and multivariate analyses were performed on factors affecting patients survival using COX. Total effectiveness was significantly higher in observation group (49.35%) than in control group (13.95 %) (p

With the remarkable achievements made in the treatment targeted at tumor immune checkpoints, more and more new immunotherapy drugs have been applied to the malignancies treatment. Camrelizumab (AiRuiKa) is a novel human immunoglobulin G4 (IgG4) monoclonal antibody (mAb), which can target the programmed death 1 (PD-1) and block its binding to the programmed death ligand 1 (PD-L1), so as to restore the body's immune function and achieve anti-tumor effect. The drug was officially approved by National Medical Products Administration (NMPA) on May 29, 2019 for use in patients with recurrent or refractory classical Hodgkin's lymphoma (cHL) who are treated with at least second-line systemic therapy. In addition, the drug showed good anti-tumor activity in esophageal squamous cell carcinoma (ESCC), hepatocellular carcinoma (HCC), nasopharyngeal carcinoma (NPC), non-small cell lung cancer (NSCLC), and gastric cancer (GC) and gastroesophageal junction cancer (EGJC). The research progress of camrelizumab on mechanism of action, pharmacodynamics and pharmacokinetics, clinical studies, adverse reactions etc. were reviewed in present paper. DOI: 10.11855/j.issn.0577-7402.2020.06.16

Derived from our original nomogram study by using the risk variables from multivariable analyses in the derivation cohort of 1383 patients with extranodal NK/T-cell lymphoma, nasal-type (ENKTCL) who were mostly treated with anthracycline-based chemotherapy, we propose an easily used nomogram-revised risk index (NRI), validated it and compared with Ann Arbor staging, the International Prognostic Index (IPI), Korean Prognostic Index (KPI), and prognostic index of natural killer lymphoma (PINK) for overall survival (OS) prediction by examining calibration, discrimination, and decision curve analysis in a validation cohort of 1582 patients primarily treated with non-anthracycline-based chemotherapy. The calibration of the NRI showed satisfactory for predicting 3- and 5-year OS in the validation cohort. The Harrell’s C-index and integrated Brier score (IBS) of the NRI for OS prediction demonstrated a better performance than that of the Ann Arbor staging system, IPI, KPI, and PINK. Decision curve analysis of the NRI also showed a superior outcome. The NRI is a promising tool for stratifying patients with ENKTCL into risk groups for designing clinical trials and for selecting appropriate individualized treatment.

The prognosis of patients with postmenopausal breast cancer (PBC) could be improved by the early detection of intraocular metastases (IOMs). However, serum biomarkers for IOMs in PBC remain elusive. In the current study, we investigated patients with PBC, and compared serum parameters in an IOM and a non-IOM group, and then differentiated the risk factors related to IOMs. A comparison between an IOM and a non-IOM (NIOM) group was performed using Student t-test and a Chi-Squared test. After constructing a Poisson regression model to identify risk factors, we plotted receiver operating characteristic curves to evaluate the predictive value of significant risk factors in detecting IOMs. The incidence of IOMs in PBC was 1.16%. The histopathology results were not significantly different between the 2 groups. The levels of serum carbohydrate antigen 125 (CA-125), carbohydrate antigen 15-3 (CA15-3) and alkaline phosphatase were significantly elevated in IOMs compared with NIOMs (P = .082, P

To investigate the effects of fatty acid synthase (FASN) on proliferation, migration and invasion of bladder cancer UMUC3 cell lines and possible mechanism.The expression levels of FASN protein in 30 cases of bladder cancer and 15 cases of normal bladder tissues were detected by Immunohistochemistry. FASN siRNA and nonsense siRNA were transfected into UMUC3 cell lines by lipofectamine 2000 respectively, and the stable siFASN and siControl cell lines were successfully obtained after screening and identification for several times. The siFASN cell lines were set as the experimental group, while the siControl cell lines were set as the control group. The expressions of FASN protein and mRNA in the experimental group and the control group were detected by Western blot and real-time quantitative PCR (RT-PCR) respectively. Cell proliferation activities in two groups were detected by MTT assay and cell invasion and migration in two groups were detected by cell scratch test and Transwell invasive assays respectively.FASN protein was overexpressed in bladder cancer tissues, and it was closely correlated with pathological stage and grade (P＜0.05). Compared with the siControl group, the expressions of FASN mRNA and protein in the siFASN group cell lines were decreased significantly (P＜0.05). The cell proliferation ability, the migration ability and the number of transmembrane cells of siFASN group cell lines were reduced significantly (P＜0.05).The FASN overexpression may play an essential role in the development and progression of bladder cancer. Down-regulation of FASN expression can inhibit the proliferation, migration and invasion of bladder cancer cells, and inhibition of FASN expression is expected to be a new treatment for bladder cancer.

We aimed to determine the survival benefits of chemotherapy (CT) added to radiotherapy (RT) in different risk groups of patients with early-stage extranodal nasal-type NK/T-cell lymphoma (ENKTCL), and to investigate the risk of postponing RT based on induction CT responses. A total of 1360 patients who received RT with or without new-regimen CT from 20 institutions were retrospectively reviewed. The patients had received RT alone, RT followed by CT (RT + CT), or CT followed by RT (CT + RT). The patients were stratified into different risk groups using the nomogram-revised risk index (NRI). A comparative study was performed using propensity score-matched (PSM) analysis. Adding new-regimen CT to RT (vs RT alone) significantly improved overall survival (OS, 73.2% vs 60.9%, P < .001) and progression-free survival (PFS, 63.5% vs 54.2%, P < .001) for intermediate-risk/high-risk patients, but not for low-risk patients. For intermediate-risk/high-risk patients, RT + CT and CT + RT resulted in non-significantly different OS (77.7% vs 72.4%; P = .290) and PFS (67.1% vs 63.1%; P = .592). For patients with complete response (CR) after induction CT, initiation of RT within or beyond three cycles of CT resulted in similar OS (78.2% vs 81.7%, P = .915) and PFS (68.2% vs 69.9%, P = .519). For patients without CR, early RT resulted in better PFS (63.4% vs 47.6%, P = .019) than late RT. Risk-based, response-adapted therapy involving early RT combined with CT is a viable, effective strategy for intermediate-risk/high-risk early-stage patients with ENKTCL in the modern treatment era.

The present study investigated the survival benefit of non–anthracycline (ANT)-based vs ANT-based regimens in a large-scale, real-world cohort of patients with extranodal natural killer (NK)/T-cell lymphoma, nasal type (ENKTCL). Within the China Lymphoma Collaborative Group (CLCG) database (2000-2015), we identified 2560 newly diagnosed patients who received chemotherapy with or without radiotherapy. Propensity score matching (PSM) and multivariable analyses were used to compare overall survival (OS) and progression-free survival (PFS) between the 2 chemotherapy regimens. We explored the survival benefit of non–ANT-based regimens in patients with different treatments in early-stage disease and in risk-stratified subgroups. Non–ANT-based regimens significantly improved survivals compared with ANT-based regimens. The 5-year OS and PFS were 68.9% and 59.5% for non–ANT-based regimens compared with 57.5% and 44.5% for ANT-based regimens in the entire cohort. The clinical advantage of non–ANT-based regimens was substantial across the subgroups examined, regardless of stage and risk-stratified subgroup, and remained significant in early-stage patients who received radiotherapy. The survival benefits of non–ANT-based regimens were consistent after adjustment using multivariable and PSM analyses. These findings provide additional evidence supporting non–ANT-based regimens as a first-line treatment of patients with ENKTCL.

Lung cancer is the leading cause of cancer-related deaths worldwide, and non-small-cell lung cancer (NSCLC) accounts for about 80% of all cases, which is the major subgroup of lung cancer. G protein-coupled receptor kinase 5 (GRK5) has been demonstrated to play pivotal roles in both development and progression of several pathological conditions including cancer. Here, we found that GRK5 expression was significantly increased in 539 NSCLC cancerous tissues than that in 99 normal non-cancerous tissues by immunohistochemistry analysis; we also showed intensive higher positive staining percentage in female and adenocarcinoma (ADC) NSCLC patients than that in male and squamous cell carcinoma (SCC) patients, respectively. In addition, GRK5 high expression NSCLC patients had a worse overall survival rate than the low expression patients. We provided evidence showing that both the mRNA and protein expression levels of GRK5 were increased in NSCLC cancerous cell lines (GLC-82, SPC-A-1, H520, H838, H358, A549, and H1299) comparing with that in normal human bronchial epithelium cell line (BEAS-2B), and identified many GRK5 mutations in NSCLC cancerous tissues. In addition, we found that depletion of GRK5 inhibited NSCLC cancerous cell proliferation, migration in vitro, and xenograft tumor formation in vivo. Furthermore, GRK5 knockdown promoted cell cycle arrest at G2/M phase and induced cellular apoptosis. In summary, our data reveal an oncogenic role of GRK5 in NSCLC progression, indicating that GRK5 could be used as a new therapeutic target in future.

Relatively well crystallized and high aspect ratio Mg-Al layered double hydroxides (LDHs) were prepared by coprecipitation process in aqueous solution and further rehydrated to an organic modified LDH (OLDH) in the presence of surfactant. The intercalated structure and high aspect ratio of OLDH were verified by X-ray diffraction (XRD) and scanning electron microscopy (SEM). A series of poly(propylene carbonate) (PPC)/OLDH composite films with different contents of OLDH were prepared via a melt-blending method. Their cross section morphologies, gas barrier properties and tensile strength were investigated as a function of OLDH contents. SEM results show that OLDH platelets are well dispersed within the composites and oriented parallel to the composite sheet plane. The gas barrier properties and tensile strength are obviously enhanced upon the incorporation of OLDH. Particularly, PPC/2%OLDH film exhibits the best barrier properties among all the composite films. Compared with pure PPC, the oxygen permeability coefficient (OP) and water vapor permeability coefficient (WVP) is reduced by 54% and 17% respectively with 2% OLDH addition. Furthermore, the tensile strength of PPC/2%OLDH is 83% higher than that of pure PPC with only small lose of elongation at break. Therefore, PPC/OLDH composite films show great potential application in packaging materials due to its biodegradable properties, superior oxygen and moisture barrier characteristics.

Air pollution has been classified as Group 1 carcinogenic to humans, but the underlying tumorigenesis remains unclear. In Xuanwei City of Yunnan Province, the lung cancer incidence is among the highest in China attributed to severe air pollution generated by combustion of smoky coal, providing a unique opportunity to dissect lung carcinogenesis of air pollution. Here we analyzed the somatic mutations of 164 non-small cell lung cancers (NSCLCs) from Xuanwei and control regions (CR) where smoky coal was not used. Whole genome sequencing revealed a mean of 289 somatic exonic mutations per tumor and the frequent C:G → A:T nucleotide substitutions in Xuanwei NSCLCs. Exome sequencing of 2010 genes showed that Xuanwei and CR NSCLCs had a mean of 68 and 22 mutated genes per tumor, respectively (p, Highlights • Somatic genomic mutations of air pollution-related lung cancer were characterized. • Mutations in air pollution-related lung cancers were 3 times as high as lung cancers from control regions. • 167 of the 2010 genes had higher mutation rates in patients from highly polluted region than those from control regions. • The mutation rates of 70 genes were associated with patients' lifetime benzo(a)pyrene exposure.

The objective was to investigate the clinical effect of an adjustable pulse width Pulsed Dye Laser (PDL) vs an adjustable pulse width PDL combined with fractional COFifty-six patients (56 sites)were randomly divided into a treatment group and control group. The control group was treated with the 595 nm PDL at a fluence of 7-15J/cmThe total VSS score, as well as the score for melanin, height, vascularity, pliability in both groups, showed an obvious decrease following the treatments. There were statistically significant differences between before treatment and after treatment (P .05); however, the total score of the VSS, and score of the melanin, height, vascularity, and pliability in the control group decreased more than that of treatment group, and there was a statistically significant difference (P .05).The 595 nm adjustable pulse width PDL combined with the fractional CO

For the problem of poor transmission stability in HF channel, we builted a frequency optimization model based on the HF dynamic frequency optimization technology with working frequency, communication distance and time as dynamic elements ,with the type of antenna, the sunspots as static elements, choose the best working frequency set for communication according to the geographical location information, avoid interference channel effectively by real-time monitoring, and make sure communication service has always been on the best working frequency. Further enhancing the the validity and reliability of HF channel transmission.

The status and development of the seasonal natural ice storage technology was introduced, and its technical feasibility was explored. It has not only advantages of energy saving and environmental protection, but also some limiting factors. The seasonal natural ice storage technology has a good prospect in some cold area and hot summer and cold winter area by calculation of cool energy balance in typical buildings.

The discharge of the shower wastewater is not only caused energy waste, but also caused a certain thermal pollution to the environment. The thermoelectric heat pump system, compared with the electric heating device, has a more effective output of heat energy. By recycling heat of shower wastewater, it can be both energy-saving and environmental. With a growing ratio of the energy consumption of hot water, the thermoelectric heat pump system may give us a new perspective in the area of waste heat recovery and energy efficiency in buildings.

According to Compressive Sensing (CS) algorithms and the Ghost imaging (GI) model, the CS was applied to the GI system to complete the CS reconstruction of an image. The feasibility of CS applied in GI was firstly validated by a simulation experiment. By using Peak Signal to Noise Ratio(PSNR) as the measure, the restructured images based on CS and traditional GI correlation algorithms were quantified respectively. The simulation experiment results indicate that both the restructured images are getting better with the increase of the number of measurements, however, the PSNR of CS reconstruction image is above 20 dB higher than that of the traditional correlation reconstruction method at the same number of measurements. Furthermore, the CS was applied in an actual two-arm GI experiment. The experiment results indicate that the CS can achieve the image reconstruction of two-arm correlation imaging equipment, but its reconstruction quality is hard to be better than that of the GI correlation algorithm. For this special confliction phenomenon, the paper gives some reasonable interpretations from the two-arm symmetry perspective and then fully validates the interpretations by using the actual speckle pattern from the experiment. Finally, it proposes a solution scheme.

On the basis of analysis of the principle of thermoelectric refrigeration and the research on the thermoelectric refrigeration technology and the thermal theoretical analysis of electronic components by domestic and foreign scholars, research on thermoelectric cooling of the uniform heat packaging surface from both the surface integral heat radiating and the local hot spot cooling of the chip by finite element numerical simulation and cooling both the chip and the heat from the whole surface of the local hot spots, using the finite element method of numerical simulation techniques Package uniform surface heat thermoelectric cooling study found the thermoelectric cooling hot surfaces in a uniform local cooling effect and temperature distribution, and pointed out that the chip thermoelectric cooling and thermal design layout surface will be in the future to improve the electroniccomponents of a hot heat important research direction.

Objective. The aim of this study is to systematically evaluate the clinical efficacy and safety of the traditional Chinese medicine prescription Jade Screen combined with desloratadine in the treatment of chronic urticaria. Methods. Two researchers independently conducted literature searches. The extracted data were analyzed using Rev Man 5.2.3 software. The established retrieval time range of the various databases was up to 15 March, 2017. Results. Sixteen randomized controlled trials were included in this study. The results of the meta-analysis showed that the total effective rate of using Jade Screen and desloratadine in combination to treat chronic urticaria was higher than that with desloratadine alone (P