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Nasogastric tube is widely used in intensive care units. The complications of misplacement are rare but very dangerous for critically ill patients. Accurate localization of the position of the tip of nasogastric tube can effectively decrease complications and ensure the safety of critically ill patients. There are various methods that can be used to verify the location of the nasogastric tube such as radiography, PH measurement, electromagnetic navigator and ultrasound. However, there is a lack of general consensus regarding a standard method. In this review, we found that the accuracy of nasogastric tube placement can be greatly improved by visual technology such as X-ray, sonography and electromagnetic navigator. However, visual technology has not been widely used to locate the tip of nasogastric tube in critically ill patients. Best practice guidelines based on the available knowledge and evidence of current methods are necessary to increase the accuracy placement of nasogastric tube. It is envisioned that development of visual technologies will determine a new standard of care for verification of placement of nasogastric tube.

Background: The Cancer of the Liver Italian Program (CLIP) score is commonly used for prognosis prediction of hepatocellular carcinoma (HCC). The CLIP includes the Child-Pugh grade, which is relatively subjective, for hepatic encephalopathy assessment. A newly developed scoring system called albumin-bilirubin grade (ALBI grade), consists of albumin and bilirubin to assess liver function reserve objectively. Here, we substituted the ALBI grade for the Child-Pugh grade to establish the ALBI-CLIP scoring system and validated its prognostic value in hepatitis B virus (HBV)-related HCC patients treated with trans-catheter arterial chemoembolization (TACE) therapy. Methods: We retrospectively analyzed HBV-related HCC patients who received TACE therapy. Baseline characteristics were collected and evaluated to classify patients according to ALBI-CLIP, CLIP and TNM systems. Univariate analyses using the Kaplan-Meier method and the log-rank test, as well as multivariate analysis using the Cox proportional hazards regression model, were conducted to detect independent prognostic factors for overall survival. Receiver operating characteristic (ROC) curves and a likelihood ratio test (LRT) were both utilized to compare the values of ALBI-CLIP, CLIP and TNM staging systems in predicting survival. Results: With a total of 389 patients included in the current study, 301 (77.4%) and 88 (22.6%) were classified as Child-Pugh grade A and B, respectively. However, 152 (39.1%), 227 (58.4%) and 10 (2.5%) patients were correspondingly classified into ALBI grade 1, 2 and 3. The areas under the curves of ALBI-CLIP, CLIP and TNM systems were 0.804, 0.778 and 0.734, respectively, for predicting 3-month survival; 0.796, 0.778 and 0.733, respectively, for 6-month survival; 0.697, 0.687 and 0.644, respectively, for 1-year survival; and 0.618, 0.612 and 0.569, respectively, for 2-year survival. The LRT indicated that the ALBI-CLIP and the CLIP had similar values of χ2 and Akaike information criterion (AIC) while the TNM system had the smallest χ2 value (χ2 = 12.1, 11.9, 10.5; AIC = 2620.2, 2620.5, 2621.1 for ALBI-CLIP, CLIP and TNM, respectively). Conclusions: In conclusion, our present study suggested that the ALBI-CLIP scoring system retained the prognostic value of the CLIP in HBV-related HCC treated with TACE therapy.

Background: We have previously reported the prognostic value of the albumin-to-alkaline phosphatase ratio (AAPR) for advanced hepatocellular carcinoma (HCC) patients who are not receiving any standard anticancer therapy. However, the prognostic value of the AAPR for HCC patients treated with trans-catheter arterial chemoembolization therapy (TACE) was not investigated. Methods: We retrospectively analysed 372 HCC patients treated with TACE (the training cohort) and applied receiver operating characteristic curves (ROC curves) to identify the best cut-off value for the AAPR in this cohort. Then, univariate analyses by the Kaplan-Meier method and multivariate analysis by a Cox proportional hazards regression model were conducted. Both comparisons of the ROC curves and the likelihood ratio test (LRT) were employed to evaluate the abilities of different factors in predicting the survival of patients in this cohort. Finally, the prognostic value of the AAPR was validated in two cohorts: one included 202 HCC patients treated with supportive care (validation cohort I), and the other included 82 HCC patients treated with TACE (validation cohort II). Results: We identified 0.439 as the best cut-off value of the AAPR by ROC curve analysis. An AAPR > 0.439 was significantly correlated with a lower frequency of Child-Pugh grade B, portal vein tumour thrombus (PVTT), T3-4 and lymph node metastasis (P < 0.05). The median overall survival (OS) of the patients with an AAPR > 0.439 was significantly longer than that of those with an AAPR ≤ 0.439 (58.4 m vs 17.8 m, respectively, P < 0.001). The AAPR was identified as an independent prognostic factor after univariate and multivariate analyses (HR = 0.636, P = 0.003). The independent prognostic value of the AAPR was also confirmed in validation cohorts I and II. Additionally, we substituted the AAPR for the Child-Pugh grade in the CLIP system and integrated the AAPR into the TNM system. We found that the area under the curve (AUC) of the AAPR-CLIP system was significantly larger than that of the CLIP and the TNM when predicting 3-month, 6-month, 1-year and 2-year survival (P < 0.05). There was no significant difference between the AUCs for the AAPR-CLIP and the AAPR-TNM. The LRT suggested that both AAPR-CLIP and AAPR-TNM had significantly larger χ2 values and smaller AIC values than that of their corresponding primary system (P < 0.05). Conclusions: The AAPR was an independent prognostic index for the HCC patients treated with TACE. Both AAPR-CLIP and AAPR-TNM outperformed their corresponding primary system in predicting OS in the current study.

The aim of the present study was to evaluate the ability of seven staging systems to predict 3- and 6-month and cumulative survival rates of patients with advanced hepatitis B virus (HBV)-associated hepatocellular carcinoma (HCC). Data were collected from 220 patients with HBV-associated HCC who did not receive any standard anticancer treatment. Participants were patients at The Third Affiliated Hospital of Sun Yat-sen University from September 2008 to June 2010. The participants were classified according to the Chinese University Prognostic Index (CUPI), the Cancer of the Liver Italian Program (CLIP), Japan Integrated Staging (JIS), China Integrated Score (CIS) systems, Barcelona Clinic Liver Cancer (BCLC), Okuda and tumor-node-metastasis (TNM) staging systems at the time of diagnosis and during patient follow-up. The sensitivity and specificity of the predictive value of each staging system for 3- and 6-month mortality were analyzed by relative operating characteristic (ROC) curve analysis with a non-parametric test being used to compare the area under curve (AUC) of the ROC curves. In addition, log-rank tests and Kaplan-Meier estimator survival curves were applied to compare the overall survival rates of the patients with HCC defined as advanced using the various staging systems, and the Akaike information criterion (AIC) and likelihood ratio tests (LRTs) were used to evaluate the predictive value for overall survival in patients with advanced HCC. Using univariate and multivariate Cox's model analyses, the factors predictive of survival were also identified. A total of 220 patients with HBV-associated HCC were analyzed. Independent prognostic factors identified by multivariate analyses included tumor size, α-fetoprotein levels, blood urea nitrogen levels, the presence or absence of portal vein thrombus, Child-Pugh score and neutrophil count. When predicting 3-month survival, the AUCs of CLIP, CIS, CUPI, Okuda, TNM, JIS and BCLC were 0.806, 0.772, 0.751, 0.731, 0.643, 0.754 and 0.622, respectively. When predicting 6-month survival, the AUCs of CLIP, CIS, CUPI, Okuda, TNM, JIS and BCLC were 0.828, 0.729, 0.717, 0.692, 0.664, 0.746 and 0.575, respectively. For 3-month mortality, the prognostic value of CLIP ranked highest, followed by CIS; for 6-month mortality, the prognostic value of CLIP also ranked highest, followed by JIS. No significant difference between the AUCs of CLIP and CIS (P>0.05) in their predictive value for 3-month mortality was observed. The AUC of CLIP was significantly higher compared with that of the other staging systems (P

// Yan-Fang Xing 1, 2, 3, * , Jin-Xiang Lin 4, * , Xing Li 4, * , Qu Lin 4, * , Xiao-Kun Ma 4, * , Jie Chen 4 , Dong-Hao Wu 4 , Li Wei 4 , Liang-Hong Yin 1, 2 , Xiang-Yuan Wu 4 1 Department of Nephrology, First Affiliated Hospital of Jinan University, Guangzhou 510630, People’s Republic of China 2 School of Medicine, Jinan University, Guangzhou 510632, People’s Republic of China 3 Department of Nephrology, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, People’s Republic of China 4 Department of Medical Oncology, Guangdong Key Laboratory of Liver Disease Research, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, People’s Republic of China * These authors contributed equally to this work Correspondence to: Liang-Hong Yin, email: 13725251458@126.com Xiang-Yuan Wu, email: wuxiangy@mail.sysu.edu.cn Keywords: advance directive, medical decision making, cancer, patients’ preference Received: February 08, 2017 Accepted: March 21, 2017 Published: April 28, 2017 ABSTRACT Background: Advance directives are a sensitive issue among traditional Chinese people, who usually refrain from mentioning this topic until it is imperative. Medical decisions for cancer patients are made by their families, and these decisions might violate patients’ personal will. Objectives: This study aimed to examine the acceptance of advance directives among Chinese cancer patients and their families and patient participation in this procedure and, finally, to analyze the moral risk involved. Results: While 246 patients and their family members refused official discussion of an advance directive, the remaining 166 patients and their families accepted the concept of an advance directive and signed a document agreeing to give up invasive treatment when the anti-cancer treatment was terminated. Of these, only 24 patients participated in the decision making. For 101 patients, anti-cancer therapy was ended prematurely with as many as 37 patients not told about their potential loss of health interests. Materials and Methods: Participants were 412 adult cancer patients from 9 leading hospitals across China. An advance directive was introduced to the main decision makers for each patient; if they wished to sign it, the advance directive would be systematically discussed. A questionnaire was given to the oncologists in charge of each patient to evaluate the interaction between families and patients, patients’ awareness of their disease, and participation in an advance directive. Conclusions: Advance directives were not widely accepted among Chinese cancer patients unless anti-cancer therapy was terminated. Most cancer patients were excluded from the discussion of an advance directive.

Objective: To explore the effect of palliative care on the quality of life of patients with cancer pain. Methods: For May 2015 to May 2016 hospitalized 57 patients with advanced cancer pain carry out palliative care. At the same time, the quality of life questionnaire, including physical function, role function, emotional function, cognitive function and social function, were investigated at the time of admission and 6 weeks after admission. Results: Patients with various functions have significantly improved after palliative care (P < 0.05). Conclusions: Palliative care can effectively improve the quality of life of patients with cancer pain. It is worth in clinical promotion.

Background Cu-Al-Ni shape memory alloys (SMAs) possess two-way shape memory effects, superelasticity, and damping capacity. Nonetheless, Cu-Al-Ni SMAs remain promising candidates for use in biomedical applications, as they are more economical and machinable than other SMAs. Ensuring the biocompatibility of Cu-Al-Ni SMAs is crucial to their development for biomedical applications. Therefore, this study aimed to assess the toxicity of Cu-Al-Ni SMAs using a Probit dose–response model and augmented simplex design. Methods In this study, the effects of Cu2+, Al3+ and Ni2+ metal ions on bacteria ( Escherichia coli DH5α) using Probit dose–response analysis and augmented simplex design to assess the actual toxicity of the Cu-Al-Ni SMAs. Results Extraction and repetition of Escherichia coli DH5α solutions with high Cu2+ ion concentrations and 30-hour incubation demonstrated that Escherichia coli DH5α was able to alter its growth mechanisms in response to toxins. Metal ions leached from Cu-Al-Ni SMAs appeared in a multitude of compositions with varying degrees of toxicity, and those appearing close to a saddle region identified in the contour plot of the augmented simplex model were identified as candidates for elevated toxicity levels. When the Cu-13.5Al-4Ni SMA plate was immersed in Ringer's solution, the selective leaching rate of Ni2+ ions far exceeded that of Cu2+ and Al3+. The number of Cu2+, Al3+ and Ni2+ ions leached from Cu-Al-Ni SMAs increased with immersion time; however, at higher ratios, toxicity interactions among the metal ions had the effect of gradually reducing overall toxicity levels with regard to Escherichia coli DH5α. Conclusions The quantities of Cu2+, Al3+ and Ni2+ ions leached from the Cu-13.5Al-4Ni SMA plate increased with immersion time, the toxicity interactions associated with these compositions reduced the actual toxicity to Escherichia coli DH5α.

Background: Lymphocytes were reported to play a significant part in host anticancer immune responses and influence tumour prognosis. Few studies have focused on the prognostic values of aspartate aminotransferase (AST) to lymphocyte ratio (ALRI), aspartate aminotransferase to platelet count ratio index (APRI) and systemic immune-inflammation index (SII) in hepatocellular carcinoma (HCC) treated with palliative treatments. Methods: Five hundred and ninety-eight HCC patients treated with palliative therapies were retrospectively analysed. We randomly assigned patients into the training cohort (429 patients) and the validation cohort I (169 patients). Receiver operating characteristic (ROC) curves were used to identify the best cut-off values for the ALRI, APRI and SII in the training cohort and the values were further validated in the validation cohort I. Correlations between ALRI and other clinicopathological factors were also analysed. A prognostic nomogram including ALRI was established. We validated the prognostic value of the ALRI, SII and APRI with two independent cohorts, the validation cohort II of 82 HCC patients treated with TACE and the validation cohort III of 150 HCC patients treated with curative resection. In the training cohort and all the validation cohorts, univariate analyses by the method of Kaplan-Meier and multivariate analysis by Cox proportional hazards regression model were carried out to identify the independent prognostic factors. Results: The threshold values of ALRI, APRI and SII were 86.3, 1.37 and 376.4 respectively identified by ROC curve analysis in the training cohort. Correlation analysis showed that ALRI>86.3 was greatly associated with higher rates of Child-Pugh B&C, portal vein tumor thrombosis (PVTT) and ascites (P < 0.05). Correspondingly, ALRI level of HCC patients with Child-Pugh B&C, PVTT and ascites was evidently higher than that of HCC patients with Child-Pugh A, without PVTT and without ascites (P < 0.001). In the training cohort and the validation cohort I, II, III, the OS of patients with ALRI >86.3 was obviously shorter than patients with ALRI ≤86.3 (P

To establish parasite library and database in Fujian Province by integrating information on human-animal coinfecting parasites, vectors and intermediates, in the aim of resource sharing.According to the Standards and Technical Regulation for Preservation of Parasitic Germplasm Resources set by the Resource Sharing Platform for Parasitic and Tropical Diseases(referred to as Germplasm Resource Sharing Platform), the preserved and newly discovered parasitic germplasm resources in Fujian Center for Disease Control and Prevention were categorized, information described, preserved and displayed, and the information sharing was made through the Germplasm Resource Sharing Platform.The library and database on parasites, medical vectors, and hosts were established. The library was comprised of 1 020 parasite specimens, vectors and hosts, including 100 （9.8%） adult worm specimens, 120（11.7%） eggs and larvae, and 800（78.4%） vectors and hosts. Information digitalization was achieved for 61 resources, including 9 species of nematodes, 16 species of trematodes, 7 species of tapeworms, 16 different medical mollusks, and 13 different medical arthropods, resulting in 3 150 pieces of information and 6 300 images. The database was integrated into the Germplasm Resource Sharing Platform for resource sharing.The library and database on parasite gemplasm resources in Fujian Province has been established. Information sharing is made available through the Germplasm Resource Sharing Platform.

The majority of patients with unresectable hepatocellular carcinoma (HCC) undergo trans-arterial chemoembolization (TACE). However, the prognosis of HCC remains poor. In the present study, five staging systems were compared to predict the survival rate of patients with HCC undergoing TACE treatment. A total of 220 patients with HCC were examined according to the model to estimate survival for hepatocellular carcinoma (MESH), hepatoma arterial embolization prognostic score (HAP), modified HAP (mHAP), performance status combined Japan Integrated Staging system (PSJIS) and tumor-node-metastasis (TNM) staging systems. The endpoints of the study were 3-month survival, 6-month survival, 1-year survival and overall survival (OS) rates. Receiver operating characteristic curve analysis indicated that the area under the curve of MESH, HAP, mHAP, PSJIS and TNM was 0.858, 0.728, 0.690, 0.688 and 0.699, respectively, in predicting 3-month survival rates; 0.822, 0.747, 0.720, 0.722 and 0.715, respectively, in predicting 6-month survival rates and 0.725, 0.664, 0.672, 0.645 and 0.654, respectively, in predicting 1-year survival rates. Discriminatory ability, homogeneity, monotonicity and prognostic stratification ability was evaluated using a likelihood ratio test and Akaike information criterion values among the five staging systems, and revealed that the MESH system was the optimal prognostic staging system for HCC. In conclusion, the results of the present study suggest that the MESH system is the most accurate prognostic staging system of 3-month survival, 6-month survival, 1-year survival and OS rates among the five systems analyzed in patients with HCC who have received TACE treatment.

Background This study aimed to assess the prognostic value of the serum albumin to globulin ratio (AGR) in cholangiocarcinoma patients after surgery. Methods We retrospectively enrolled 123 cholangiocarcinoma patients who underwent surgical treatment between June 2003 and September2014 at the Third Affiliated Hospital of Sun Yat-sen University. Univariate and multivariate analyses using the Cox regression model were performed to determine the prognostic value of AGR. Results Univariate analysis suggested that AGR was a predictive factor for (overall survival) OS but not for recurrence free survival (RFS). After adjustment for other risk factors, multivariate analysis showed that AGR remained independently associated with OS. The optimal cut-off point for AGR was determined to be 1.44. Kaplan–Meier curves showed that there was a significantly lower mean survival time in the low AGR group compared to the high AGR group. A low AGR was found to be significantly associated with high alkaline phosphatase, gamma-glutamyl transpeptidase, total bilirubin levels and an advanced American Joint Committee on Cancer TNM stage, but a low hemoglobin level. Conclusion In summary, patients with higher AGRs have better outcomes than those with lower AGRs. Preoperative AGR can be a reliable marker for evaluating the prognosis of cholangiocarcinoma patients.

// Xiu-Rong Cai 1, 2, * , Xing Li 1, 2, * , Jin-Xiang Lin 1 , Tian-Tian Wang 1, 2 , Min Dong 1, 2 , Zhan-Hong Chen 1, 2 , Chang-Chang Jia 2, 3 , Ying-Fen Hong 1, 2 , Qu Lin 1, 2 and Xiang-Yuan Wu 1, 2 1 Department of Medical Oncology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, People’s Republic of China 2 Guangdong provincial Key Laboratory of Liver Disease Research, Guangzhou 510630, People’s Republic of China 3 Cell-gene Therapy Translational Medicine Research Center, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, People’s Republic of China * These authors have contributed equally to this work Correspondence to: Xiang-Yuan Wu, email: wuxiangy@mail.sysu.edu.cn Qu Lin, email: linqu@mail.sysu.edu.cn Keywords: cytokine induced killer cell, liver cancer, adoptive cells therapy, immunotherapy, meta-analysis Received: June 13, 2016 Accepted: November 12, 2016 Published: February 17, 2017 ABSTRACT Background: High recurrence rate after curative treatment is the major problem for hepatocellular carcinoma (HCC). Cytokine-induced killer cells (CIKs) therapy was extensively studied among HCC patients. However, the value of CIKs therapy was controversial. A meta-analysis was performed to investigate the efficacy of adjuvant CIKs after invasive treatments among HCC patients. Methods: We searched online for literatures studying sequential CIKs therapy for HCC patients. Recurrence-free survival (RFS), progress-free survival (PFS) and overall survival (OS) were set as the main endpoints. Both overall and subgroup analysis were accomplished. Results: A total of 12 clinical trials with 1,387 patients were included. The pooled analysis showed a significant improvement of RFS, PFS and OS in CIK group (HR 0.56, 95% CI 0.47-0.67, p

Background & aims: Nutritional interventions for malnutrition in cancer patients can be helpful. However, concise intervention recommendations remain controversial. Thus, the aim of this study was to report on a nutrition intervention conducted by a multidisciplinary team of specialist nurses and to explore the effect of nutritional intervention on cancer patients. Methods: This prospective clinical trial study enrolled 110 colorectal cancer patients undergoing chemotherapy. The patients were evaluated upon admission using the 2002 Nutritional Risk Screening system (NRS-2002). The patients were randomly divided into intervention and control groups including 55 patients each. Patients in the control group were administered a normal diet, while those in the intervention group received individual recipes developed by a team of professional nurses, clinical doctors, dietitian, family caregivers, and the patients themselves. Patient weight and serum albumin and prealbumin levels were compared between the 2 groups at different time points. Results: There was a significant difference in patient weight and serum albumin and prealbumin levels before and after nutrition intervention in the intervention group (P .05). Conclusion: A multidisciplinary team approach for nutrition intervention conducted by specialist nurses improved prealbumin levels in colorectal cancer patients undergoing chemotherapy, with no weight change.

e15634 Background: Cumulative evidence has demonstrated that interaction between tumor and the inflammatory microenvironment plays a critical role in the development and progression of hepatocellular carcinoma (HCC). This study aims to investigate the prognostic value of hemoglobin to red cell distribution width (RDW) ratio (HRR), as a novel and simple biomarker reflecting both the host inflammatory response and nutrition status, in patients with HCC undergoing curative hepatectomy. Methods: We retrospectively analyzed 373 HCC patients treated with hepatic resection between January 2004 and December 2012. Preoperative complete blood counts were used to calculate HRR. The best cut-off for survival analysis was determined by receiver operating characteristics (ROC) curve analysis. Univariate and multivariate analyses were applied to assess HRR and other clinicopathological variables. Results: The optimal cutoff value of HRR was 1.06 with an area under the curve (AUC) of 0.591 (95% CI, 0.540-0.642, p = 0.0072). A low preoperative HRR level ( < 1.06) was significantly correlated with hypoalbuminemia, female sex, the presence of portal hypertension and elevated level of total bilirubin. After a median follow-up of 48.5 months (range, 2-148.2 months), patients with a low HRR had significantly worse 5-year overall survival (OS) (69.2% vs 83.9%, p = 0.002). However, no significant difference was observed between low and high HRR groups with respect to recurrence free survival. The HRR (p = 0.009), histological differentiation (p = 0.003), Barcelona Clinic Liver Cancer stage (p = 0.003), serum alkaline phosphatase level (p = 0.008) and serum alanine aminotransferase level (p = 0.041) were identified to be independent prognostic factors of OS by multivariate analysis. This cox model was validated by bootstrap resampling, confirming low HRR as an independent predictor of shorter OS after adjustment (p = 0.01). Conclusions: Our study demonstrates for the first time that preoperative HRR can serve as an independent prognostic maker in HCC patients after radical surgery. Incorporation of HRR into other indices may provide better prognostic stratification.

e15031 Background: FOLFOX is the one of the most selected chemotherapy regimens for advanced colorectal carcinoma (aCC) patients, which includes oxaliplatin, 5-fu and leucovorin. However, oxaliplatin often causes chemotherapy-induced peripheral sensory neuropathy (CIPN) which is a common treatment-related adverse effect and affects long- term quality of life. The aim of the study is to observe the effect of warmth intervention on patients with advanced colorectal cancer undergoing chemotherapy. Methods: A total of 60 aCC patients were recruited. They were randomized into an intervention group (30 patients) and a control group (30 patients). The intervention group accepted the bundle of warmth care which included wearing cotton gloves and socks, washing hands and taking a bath with warm water, soaking hands and feet before sleep with warm water, reducing exposure to cold and avoiding cold food. The control group was treated with conventional health education which including how to reduce exposure to cold. CTCAE-4.0 was used to evaluate patient, s peripheral sensory neuropathy at baseline, 3 months, 6 months and 6 months after chemotherapy terminate. Results: At baseline, there was no peripheral sensory neuropathy in two groups. In 3 months, incidence of peripheral sensory neuropathy of intervention group and control group were 26.67%(Ⅰ:20.00%,Ⅱ:6.67%) VS 83.34% (Ⅰ:46.67%,Ⅱ:30.00%,Ⅲ:6.67%)(χ2= 22.289,p = 0.000). In 6 months, incidence of peripheral sensory neuropathy of two group were 36.67% (Ⅰ: 26.67%,Ⅱ: 10.00%) VS 93.34%(Ⅰ:46.67%,Ⅱ:30.00%,Ⅲ:16.67%) (χ2= 23.398,p = 0.000). 6 months after chemotherapy terminate, incidence of peripheral sensory nerve damage of two group were 13.33%(Ⅰ:10.00%,Ⅱ:3.33%) VS 33.34%(Ⅰ:6.67%,Ⅱ:10.00%,Ⅲ:6.67%) (χ2= 4.283,p = 0.233). Conclusions: Bundle of warmth care reduced oxaliplatin-related peripheral sensory neuropathy on patients with advanced colorectal cancer undergoing chemotherapy.

e15622 Background: Many HCC patients are diagnosed as locally advanced and loco-regional therapies improved the prognosis of these patients. Survival rates of these patients vary differently. We want to research on the prognostic factors and establish a new prognostic model based on total tumor volume(TTV) to predict the survival rate in locally advanced hepatocellular carcinoma patients who receive loco-regional therapy. Methods: 214 locally advanced HCC patients who received TACE or PEJ were retrospectively studied. Univariate and multivariate analyses were used to assess the variables. A new prognostic model based on TTV was developed with independent prognostic factors. The predictive value was evaluated using receiver operator characteristic curve (ROC) analyses. Results: The median survival is 23.4 months. Univariate and multivariate analyses showed that total tumor volume (TTV), child-pugh garde, protal vein thrombosis and antivirus therapy were independent factors of overall survival. A risk model was establsihed and it is consisted of 4 factors mentioned above. 214 patients were classified into 5 stages by the new staging system. We researched on the predictive value of the new prognostic system by comparing it with CLIP, BCLC and TNM. When predicting 1-year OS, AUC of the new prognostic system, CLIP, BCLC and TNM is 0.620, 0.735, 0.527 and 0.655, respectively; CLIP is best when predicting 1-year os. When predicting 2-year OS, AUC of the new prognostic system, CLIP, BCLC and TNM is 0.623, 0.671, 0.516 and 0.577, respectively;The new prognostic system is as good as CLIP. When predicting 3-year OS, AUC of the new prognostic system, CLIP, BCLC and TNM is 0.623, 0.645, 0.504 and 0.593, respectively; The new prognostic system is as good as CLIP and is better than BCLC(P < 0.05). Conclusions: Total tumor volume is independent prognotic factors of locally advanced hepatocellular carcinoma patients who received locoregional therapies.The new prognostic system based on TTV is as good as CLIP in predicting 2-year OS and 3-year OS. A new prognostic system based on TTV TTV(CM3) < 22.5(0) ≥22.5(1) Antivirus therapy No(0) Yes(1) Child pugh Grade A(0) B(1) Portal vein thrombosis No(0) Yes(1)

10107 Background: Most patients suffer from cancer pain, especially breakthrough pain. The overall incidence of breakthrough pain is estimated to be 65%. Self-management makes patients actively participating in the use of drugs, transforming their roles and adjusting their moods in order to better cure their own diseases. Therefore, the aim of the study is to discuss the effect of reducing cancer pain patients' breakthrough pain through self-management based on pain control diary. Methods: From October, 2015 to October, 2016, a total of 200 patients treated with opioids for cancer pain were randomly divided into groups. Patients in the control group were given general management including the Standard "the three steps analgesic ladder treatment for cancer pain", the traditional form of health education and psychological care; While the intervention group in addition to conventional cancer pain management, self-management based on pain control diary was applied. Through repeated intensive training, patients learned how to do self-assessment, to master the feature of their own pain, problem-solving skills and formal report to their oncologists in charge. Results: After six weeks of intervention , 10% patients in the intervention group had suffer breakthrough pain compared with 54% patients in the control group (P < 0.05). The whole processing management model is a whole process, specialization and humanization Care model for patients with advanced cancer pain management, can effectively improve patient medication compliance, reduce the cancer breakthrough pain's incidence, improve the patients,s life quality with cancer pain. The medication compliance of the intervention group was significantly higher than that of the control group(X2= 46.606, P2= 44.148, P

124 Background: The top issue in the field of myeloid deprived suppressor cell (MDSC) was lack of specific markers. Lox-1 was reported to be a novel marker for polymorphonuclear MDSC (PMN-MDSC) in whole blood of head and neck cancer and lung cancer patients. The present study is aimed to detecting the lox-1 PMN-MDSC in whole blood. Methods: In the present study, a series of 24 hepatocellular carcinoma (HCC) patients and 12 healthy donors were analyzed investigating frequencies of PMN-MDSC (Lox-1+CD15+) in whole blood. The immunosuppressive function of MDSC were evaluated using T cell proliferation and activation tests. The underly mechnisms were determined using inhibitors, genes expression and activity tests. The association between MDSC and clinical parameters were determined retrospectively. Results: Patients presented significantly higher level of PMN-MDSCs. In order to confirm immune suppressive capacity of PMN-MDSCs in HCC patients, circulative PMN-MDSCs and T cells were purified using flow sorting and cocultured. T cell proliferation was abrogated by the addition of PMN-MDSC with a dosage dependent manner, as well as the production of IFN-γ. Besides, the suppression on T cell proliferation and IFN-γ production was partially reversed by reactive oxygen species (ROS) inhibitor and Arginase inhibitor. The ROS level were higher in PMN-MDSC than their normal controls. The mRNA level of NOX2, the key protein complex responsible for ROS productin in MDSC, and Arginase I were higher in PMN-MDSCs. Finally, the frequencies of PMN-MDSCs was positively associated with tumor volume. Conclusions: The present study found that Lox-1+CD15+ were novel markers for PMN-MDSCs in whole blood and very easily to be standardized between institutions.

To compare the efficacy of dioctahedral smectite and iodine glycerin (DSIG) cream with topical mouth rinse (composed of saline, gentamicin and Vitamin B12) in treatment of chemotherapy induced oral mucositis (OM).A total of 130 intensive chemotherapy or stem cells transplantation induced OM patients were recruited. Among these patients, 67 patients received topical mouth rinse and 63 patients received DSIG cream treatment. The OM would be treated on the OM appearance and sustained for 5 days. OM severity was measured daily using The American Oncology Nursing Society recommended Oral Assessment Guideline (OAG) score system.Compared with topical mouth rinse treatment, a significant lower OAG score was observed in DSIG cream treated patients. Specifically, the OAG scores were respectively 12.1 ± 1.1, 12.0 ± 1.2, 11.3 ± 1.3 and 10.4 ± 1.3 from day 2 to day 5 in topical mouth rinse treatment subgroup. Correspondingly, the OAG scores were respectively 10.2 ± 1.0, 9.3 ± 0.9, 8.5 ± 0.6 and 8.0 ± 0.2 for DSIG cream treatment subset (all P0.05). Importantly, compared with topical mouth rinse treatment, the DSIG cream significantly shortened OM repair time (4.68 ± 0.98 vs. 8.76 ± 1.80 days, P0.001). After 5 days treatment, 54 patients (85.7%) obtained complete regression with an OAG score ≤8, and 7 patients (11.1%) had partial regression with an OAG score of 9-10 in DSIG cream treatment subgroup. However, only 2 patients (3.0%) obtained completed regression and 32 patients (47.8%) had partial regression in topical mouth rinse treatment cohort. Moreover, no serious side-effect was observed in both cohorts.Compared with topical mouth rinse, DSIG cream significantly lowered the OAG score and shortened OM duration.

237 Background: Many HCC patients are diagnosed at advanced stage and loco-regional therapies improve their prognosis. Transarterial chemotherapy with or without concomitant embolization(TACE) and percutaneous ethanol injection(PEJ) are two common loco-regional therapies.Overall survival(OS) of these patients varies differently. It is very important to identify who benefits most from loco-regional therapies. We research on five current staging systems’ predictive value. Methods: Our research analyzed 220 advanced HCC patients. They received TACE or PEJ and did not receive radical surgery, chemotherapy or target therapy. At first diagnosis all patients were classified according to CLIP (Cancer of the Liver Italian Program), Advanced Liver Cancer Prognostic System (ALCPS), Japan Integrated Scoring (JIS) system, Barcelona Clinic Liver Cancer Classification (BCLC) and model for end-stage liver diseases (MELD) score. 6 month OS, 1-year OS, 2-year OS and OS were the end points. Results: The median survival is 23.8 months. When predicting 6 month OS, AUC of CLIP, ALCPS, JIS, BCLC and MELD is 0.847, 0.724, 0.710, 0.521 and 0.509,respectively;When predicting 1-year OS, AUC of CLIP, ALCPS, JIS, BCLC and MELD is 0.872, 0.689, 0.693, 0.503 and 0.552,respectively; When predicting 2-year OS, AUC of CLIP, ALCPS, JIS, BCLC and MELD is 0.855, 0.683, 0.669, 0.503 and 0.553,respectively;AUC of CLIP is significantly higher than other four staging systems in predicting 6 month OS, 1-year OS, 2-year OS(P < 0.05), while AUC difference between ALCPS and JIS does not have statistical significance in predicting 6 month OS, 1-year OS, 2-year OS(P > 0.05). When predicting OS, likelihood ratio test shows χ2 of CLIP, ALCPS, and JIS is 90.2,13.1 and 16.5 respectively. AIC of CLIP, ALCPS and JIS is 1338, 1415 and 1411 respectively. CLIP has the highest χ2 value and the lowest AIC value. As for discriminatory ability, homogeneity and monotonicity, CLIP performs best. Conclusions: The best staging system in predicting 6 month OS, 1-year OS, 2-year OS and OS for advanced HCC patients who received loco-reginal therapies is CLIP.

e15609Background: Many researches indicate that cancer triggers a systemic inflammatory response, causing changes in circulating inflammatory cells. These inflammatory cells are important in the gr...

e21615Background: Enteral nutrition in advanced colorectal carcinoma patients with palliative chemotherapy is performed to prolong survival, alleviate tumor-associated symptoms, and maintain or imp...

To establish a PCR assay for detecting the third-stage larvae of Angiostrongylus cantonensis in Pomacea canaliculata.Polymerase chain reaction primers were designed by the software Lasergene, based on the specific cDNA of the third-stage larvae of A.cantonensis in Genbank. The total RNA was prepared from the third-stage larvae of A.cantonensis and of the snails by TRIzol one-step protocol. Amplification by RT-PCR was carried out following the kit protocol.RT-PCR assay revealed a clear differentiation between infected and negative snails. When a mixture of the total RNA from the negative snails and the third-stage larvae of A.cantonensis was tested by the PCR assay, the detectable level was 128 pg RNA, a concentration close to one third-stage larva of A.cantonensis, minimum concentration that could be found by naked eyes. The minimum detected total RNA concentration of the third-stage larvae of A.cantonensis was 105 pg by PCR assay.A PCR assay has been developed for detecting A.cantonensis larva in Pomacea canaliculata.

To study the impact of dormancy of Pomacea canaliculata on the growth-development and infectivity of Angiostrongylus cantonensis.The intermediate host snails (P. canaliculata) were infected with the first stage larvae of A. cantonensis from the laboratory. One day after infection the snails were kept dormant under 25.0-25.5 degrees C, and a sample of the snails was selected and dissected to examine the larval growth-development at various interval. Twenty days after infection, they were placed in room with natural winter conditions. Every 10 days a sample of the snails was dissected for larval activity. The third-stage larval infectivity from each group was identified by infecting SD rats. Meanwhile the survival and weight change of snails in the two groups were recorded, and were compared with those snails cultured in water under the corresponding temperature conditions mentioned above.The time for first-stage larvae of A. cantonensis in dormant snails to develop to third stage was shorter than that in the snails in aquarium. All the third stage larvae at various degree of activity recovered from snails in winter room conditions, including dormant snails and active snails in water, infected rats successfully. The dormant snails in winter room conditions stopped growing with decreased weight, but the survival rate was significantly lower than that of the snails in aquarium with the same condition along with an extending time of dormancy.The development of A. cantonensis larvae has not been affected when snails are kept dormant under 25.0-25.5 degrees C. The third stage larvae from snails at natural winter room temperature or in aquarium were all infective. As of the overwintering ways, it is better to keep the infected snails dormant than in the aquarium.

OBJECTIVE To study the susceptibility of Pomacea canaliculata of different developmental stages to Angiostrongylus cantonensis infection.P. canaliculata snails breeding at laboratory were divided into four rank (I-IV) according to the weight, and infected with the first stage larvae of A. cantonensis from Fujian Province. Their mortality, infection rate, worm burden, and the size, development and distribution of larvae in snails were examined.Snails at different developmental stages were readily infected with A. cantonensis. The infection rate was between 76% and 100%, with no significant difference among the groups (P0.05). Snails at earlier developmental stage showed higher mortality. The heaviest worm burden and the largest number of snails harboring more than 100 larvae were found in snails of rank III. In general the larvae in snails showed a synchronous development in the groups. Sizes of the third stage larvae in snails of various ranks were homogeneous. The period before the third stage larva emergence and the time for a peak percentage of the larvae exhibited no significant difference among the four ranks. The larvae widely distributed in various parts of snails, with more in the lung and foot, and larvae from snails of different ranks could all infect rats successfully.P. canaliculata of the four ranks can all be infected by the first stage larvae of A. cantonensis. Rank III snails may be better for studying the relationship between P. canaliculata and A. cantonensis. The potential role of young snails in angiostrongyliasis transmission should be recognized.

To understand the prevalence of important human parasitic diseases in Fujian province.According to the national guidelines, clustered random sampling was made for the survey. Modified Kato-Katz thick smear was applied to examine helminth eggs for soil-transmitted nematodes and Clonorchis sinensis. Cellophane and swab technique was applied for detecting Enterobius vermicularis eggs in children under 12. Questionnairing, skin test, serological test and eosinophil examination were carried out for Paragonimus infection. Questionnairing and serological test were used for Taenia infection and cysticercosis. Retrospective investigation was conducted with the data on outpatient and hospitalized cases with parasitic diseases.45,736 people at 73 spots of 24 counties were investigated and 14 species of parasites were found. The overall infection rate of intestinal helminth infections was 36.15%. The prevalence of Ascaris lumbricoides, hookworms and Trichuris trichiura was 9.55%, 19.73% and 11.48% respectively. The infection rate of Enterobius vermicularis and Clonorchis sinensis was 22.06% and 0.60% respectively. The positive rate of skin test and serological test among skin test positives for Paragonimus infection was 7.07% and 9.23% respectively. The serology positive rate for cysticercosis was 2.28%, only 3 cases of taenia infection were found from 16371 persons investigated. Human infections with Angiostrongylus cantonensis, Diphyllobothrium latus, Taenia saginata, and Gnathostoma spinigerum were found for the first time in the Province. Metorchis orientalis and Echinostoma aegyptiaca infections in human were first recorded.The overall prevalence of soil-transmitted nematodes has decreased significantly in the province, although still highly prevalent in social-economically less developed areas. Meanwhile, attention should be paid to the food-borne parasitic infections in human population.

To provide the basis for the differentiation with similar species of intestinal flukes through observing the figure of Haplorchis pumilio.Adults of H. pumilio were collected from the intestine of the cat which was infected with the encysted cercariae of H. pumilio for 45 days. The worms were observed after staining. Eggs and metacercariae of H. pumilio were collected and examined for their shape, size and morphological characteristics. Pseudorasbora parva, the fish host, was examined for the parasitized sites of metacercariae.The principal characteristics of the adults is the acetabulum degradation. There are only the genital sucker with 44-48 hamuli. The average measurement of eggs is 31.2 x 16.7 microns with a smooth shell. Its aceromion is not evident. The average diameter of metacercariae is 168.5 microns. There are squamous spines on metacercaria. The metacercariae only parasitize in the muscle between the basis of the fin and the fish body. The average measurement of metacercaria cyst is 445 x 95 microns, with squamous spines on the body surface. Hamuli are found on the genital sucker of metacercaria cyst.The morphological figures and parasitic sites of metacercaria, the genital sucker of the adult, and the number and form of the hamulus on the genital sucker provide basis for distinguishing H. pumilio from other intestinal flukes.

To make etiological and epidemiological investigation on the infection of Angiostrongylus cantonensis in 8 pupils in Changle City.1. CSF of patients was examined with the conventional method to detect pathogens and eosinophiles. 2. The fecal samples of wild rodents were collected from the spot and examined microscopically to discover the first stage larvae of A. cantonensis. 3. Snails (Pila gigas) were collected in the spot. The smashed head tissue was examined for the third stage larvae of A. cantonensis. 4. The patient's clinical symptoms and physical signs were recorded with an emphasis on central nervous system.1. Two larvae of the third stage of A. cantonensis were found in CSF of one patient. Eosinophiles occupied 68% of the cell number in average (ranged from 47% to 83%) in CSF of the 8 patients. 2. The infection rate of the first stage larvae of A. cantonensis was 39.3% (44/112) in feces of the rodents. 3. The infection rate of the third stage larvae of A. cantonensis was 40.0% (82/205) in the snails. 4. Major clinical manifestations in the 8 patients included: severe headache(8/8), dizziness(8/8), nausea(8/8), vomiting(8/8), lethargy(7/8), lower limb hypodynamia(7/8).The confirmation of severe infection of A. cantonensis in 8 child patients demonstrated that a natural nidus of angiostrongyliasis is present in Chengle City.