Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) have been widely used for human non-small-cell lung cancer (NSCLC) treatment. However, acquired resistance to EGFR-TKIs is the major barrier of treatment success, and new resistance mechanism remains to be elucidated. In this study, we found that elevated NADPH oxidase 4 (NOX4) expression was associated with acquired EGFR-TKIs resistance. Gefitinib is the first-generation FDA-approved EGFR-TKI, and osimertinib is the third-generation FDA-approved EGFR-TKI. We demonstrated that NOX4 knockdown in the EGFR-TKI resistant cells enabled the cells to become sensitive to gefitinib and osimertinib treatment, while forced expression of NOX4 in the sensitive parental cells was sufficient to induce resistance to gefitinib and osimertinib in the cells. To elucidate the mechanism of NOX4 upregulation in increasing TKIs resistance, we found that knockdown of NOX4 significantly down-regulated the expression of transcription factor YY1. YY1 bound directly to the promoter region of IL-8 to transcriptionally activate IL-8 expression. Interestingly, knockdown of NOX4 and IL-8 decreased programmed death ligand 1 (PD-L1) expression, which provide new insight on TKIs resistance and immune escape. We found that patients with higher NOX4 and IL-8 expression levels showed a shorter survival time compared to those with lower NOX4 and IL-8 expression levels in response to the anti-PD-L1 therapy. Knockdown of NOX4, YY1 or IL-8 alone inhibited angiogenesis and tumor growth. Furthermore, the combination of NOX4 inhibitor GKT137831 and gefitinib had synergistic effect to inhibit cell proliferation and tumor growth and to increase cellular apoptosis. These findings demonstrated that NOX4 and YY1 were essential for mediating the acquired EGFR-TKIs resistance. IL-8 and PD-L1 are two downstream targets of NOX4 to regulate TKIs resistance and immunotherapy. These molecules may be used as potential new biomarkers and therapeutic targets for overcoming TKIs resistance in the future.

Abstract Exposure to fine particulate matter (PM2.5) is linked to lung cancer incidence and mortality. However, the impact of PM2.5 exposure on lung cancer patients after lobectomy, which remains the primary treatment for early-stage lung cancer, is unknown. Therefore, we investigated the correlation between PM2.5 exposure and the survival of lung cancer patients after lobectomy. This study included 3,327 patients with lung cancer who underwent lobectomy procedures. We converted residential addresses into coordinates and estimated individual patients' daily PM2.5 and O3 exposure levels. A Cox multivariate regression model was used to analyze the specific monthly association between PM2.5 exposure and lung cancer survival. Every 10 μg/m3 increase in monthly PM2.5 concentration in the first and second months after lobectomy increased the risk of death (hazard ratio [HR]: 1.043, 95% confidence interval [CI]: 1.019–1.067 and HR: 1.036, 95% CI: 1.013–1.060, respectively). Non-smokers, younger patients, and patients with longer hospitalization durations had worse survival rates when exposed to greater concentrations of PM2.5. High postoperative PM2.5 exposure immediately after lobectomy reduced the survival of patients with lung cancer. Patients living in areas with high PM2.5 should be offered the opportunity to transfer to areas with better air quality after undergoing lobectomies, to prolong their survival times.

目的:以金标准数据集为基准,验证本院融合生存数据集的质量,并建立一种适用于国内的生存终点验证方法.方法:通过肿瘤临床获益指标-总生存期(OS)的多源融合数据库及融合生存数据集质量验证的方法学研究,纳入本院2015年1月～2018年12月4844例晚期非小细胞肺癌(NS-CLC)患者.生存数据包括晚期NSCLC患者的生存状态(死亡或生存)、最后生存日期和死亡日期.以金标准数据集为基准,采用敏感性、特异性、阳性预测值(PPV)、阴性预测值(NPV)和死亡日期一致性等有效性指标评估融合生存数据集的数据质量.采用Kaplan-Meier生存曲线计算OS.结果:与金标准数据集相比,融合生存数据集的敏感性、特异性、PPV、NPV和±30天准确率分别为82.8％、76.8％、71.8％、86.2％和81.4％.金标准数据集和融合生存数据集的中位总生存期(mOS)分别为15.2月和16.0月.结论:多源融合数据库及真实世界证据的对比研究有利于提供高质量的肿瘤患者OS数据,可为医、教、研、防及肿瘤政策制定提供更可靠的数据支持.

探讨肿瘤经血管介入治疗的术式和常见的肿瘤种类,总结归纳每种术式和肿瘤种类的相应编码.肿瘤经血管介入治疗术式包括经导管血管内灌注化疗、经导管血管栓塞术和经导管血管内栓塞化疗.经血管介入治疗的肿瘤类型包括肝肿瘤、肺肿瘤、子宫肿瘤和食管肿瘤等.肿瘤经血管介入治疗ICD-9-CM-3编码,有3个步骤,首先确定治疗的术式,其次确定治疗的血管,然后编码血管造影术.经导管血管内灌注化疗需要编码化疗(99.25),灌注的部位,造影的血管;经导管血管栓塞术需要编码血管栓塞,血管栓塞既要区别栓塞的血管,有时也需要区别栓塞物质,还要编码血管造影;经导管血管内栓塞化疗需要编码血管栓塞、化疗(99.25),灌注的部位,血管造影.

Background: Immunotherapy is recommended by the NCCN (National Comprehensive Cancer Network) guidelines as the standard second-line treatment for advanced esophageal squamous cell carcinoma (ESCC). Patients with advanced ESCC can benefit from immunotherapy, but the overall survival time (OS) is still not satisfactory. Therefore, it is of great importance to select effective prognostic indicators.Methods: A retrospective follow-up study was conducted from January 2018 to January 2020 among 44 patients with advanced ESCC treated with second-line immune checkpoint inhibitors (programmed death -1 blocking agents) in our hospital. The cutoff values of baseline lactate dehydrogenase (LDH), LDH level at week 8, serum albumin, hemoglobin, neutrophils, monocytes, and platelets were obtained by receiver operating characteristic (ROC) curves. The Kaplan-Meier method was used to analyze the relationship between LDH at baseline, LDH level at week 8, and LDH changes during treatment with progression-free survival (PFS) and OS time. The Cox proportional hazards model was used for univariate and multivariate analyses to determine the predictors of OS.Results: In univariate analysis, we found patients with lower baseline LDH levels (cutoff value: 200 U/L) had a better median PFS (8 months vs. 3 months; HR = 2.420, 95% CI: 1.178–4.971, p = 0.016) and OS (14 months vs. 6 months; HR = 3.637, 95% CI: 1.638–8.074, p = 0.004). The level of LDH at week 8 and the changes in LDH during treatment were not significantly associated with PFS or OS. The multivariate analyses showed that baseline LDH was an independent predictor of PFS (HR = 2.712, 95% CI: 1.147–6.409, p = 0.023) and OS (HR = 6.260, 95% CI: 2.320–16.888, p < 0.001), and the monocyte count (HR = 0.389, 95% CI: 0.162–0.934, p = 0.035) was significantly associated with OS.Conclusion: Serum LDH is a powerful independent factor for PFS and OS in advanced ESCC patients treated with anti-PD-1 therapy.

Objective: To compare the efficacy between laparoscopic and open proximal gastrectomy with double-tract reconstruction for Siewert type II and III adenocarcinoma of the esophagogastric junction (AEG). Methods: A retrospective cohort study was conducted. Inclusion criteria: (1) 18 to 80 years old; (2) Siewert II and III AEG was confirmed by preoperative gastroscopy and biopsy, which could not be resected by endoscopy; patients undergoing radical proximal gastrectomy with double-tract reconstruction; (3) contrast-enhanced abdominal CT staging was cT1-2N0M0; (4) Eastern Cooperative Oncology Group (ECOG) physical status score <2 points, American Association of Anesthesiologists (ASA) grade 1 to 2; (5) patients agreed to perform proximal gastrectomy and signed an informed consent. Those who had undergone neoadjuvant radiochemotherapy, suffered from serious mental diseases and had incomplete data were excluded. According to the above criteria, clinical data of 84 consecutive patients with Siewert II and III AEG undergoing surgery at General Surgery Department of The Affiliated Tumor Hospital of Zhengzhou University from October 2010 to December 2018 were collected and analyzed. Of 84 patients, 61 underwent open proximal gastrectomy with double-tract reconstruction (OPG group), while 23 underwent laparoscopic proximal gastrectomy with double-tract reconstruction (LPG group). The perioperative complications and postoperative reflux esophagitis of two groups were compared. A P-value of <0.05 was considered to be statistically significant. Results: Among 84 cases, 74 were male and 10 were female. There were 43 cases of Siewert type II and 41 cases of Siewert type III. There were no significant differences in age, gender, body mass index, comorbidities, Siewert type, and tumor staging between the two groups (all P>0.05). As compared to the OPG group, the LPG group had longer operation duration [(223±21) minutes vs. (161±14) minutes, t=15.352, P<0.001], less intraoperative blood loss [195 (150, 215) ml vs. 208 (192, 230) ml, Z=2.143, P=0.032], and shorter time to flatus [(2.8±0.7) days vs. (3.3±0.9) days, t=2.477, P=0.015]. There were no significant differences in the number of harvested lymph nodes, time to the first meal and postoperative hospital stay between the two groups (all P>0.05). Postoperative complications developed in 2 cases (8.7%, 1 case each for anastomotic leakage and intestinal obstruction) in the LPG group and 5 cases (8.2%, 1 case each for anastomotic leakage, anastomotic bleeding, and anastomotic stenosis, 2 cases of incision infection) in the OPG group (χ(2)=5.603, P=0.231). The median follow-up was 41.2 (12.8-110.5) months. One patient (1.6%,1/61) had obvious reflux symptoms in the OPG group, compared with none in the LPG group (χ(2)=0.644, P=0.422). Esophagitis occurred in 1 case (4.8%, 1/21) in LPG group, compared with 4 patients (7.1%, 4/56) in the OPG group, without significant difference between the two groups (χ(2)=0.505, P=0.477). Conclusion: Laparoscopic proximal gastrectomy with double-tract reconstruction is safe and feasible without increasing the risk of postoperative complication and reflux esophagitis.

本文基于突发公共卫生事件风险评估理论,对病原微生物实验室检测中可能出现的实验活动、实验室围护结构和设备、实验人员、临时进入实验室人员、个人防护装备、清场和消毒、意外事件和处理7个方面的18个生物安全风险点进行了分析,并提出了降低风险的具体措施,以供各生物安全实验室开展风险评估时参考.

ObjectiveTo investigate the serological markers associated with posthepatectomy recurrence in patients with hepatocellular carcinoma, and to establish a prognostic model to evaluate whether palliative hepatectomy is suitable for such patients. MethodsA total of 111 patients with hepatocellular carcinoma who underwent hepatectomy in the Affiliated Cancer Hospital of Zhengzhou University from February 2009 to July 2013 and received follow-up were enrolled. Basic clinical data were collected and the patients were divided into recurrence group and non-recurrence group according to whether recurrence was observed during follow-up. The t-test was used for comparison of normally distributed continuous data between two groups and the Wilcoxon rank sum test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups. Survival curves were plotted using the Kaplan-Meier method, and survival differences were analyzed using the log-rank test. A Cox regression analysis was used to perform univariate and multivariate analyses, and the area under the ROC curve (AUC) was used to evaluate prediction efficiency. ResultsThe Kaplan-Meier survival curves showed that the patients with low alpha-fetoprotein (AFP), alkaline phosphatase, gamma-glutamyl transpeptidase (GGT), and fibrinogen and high CXCL13 had a longer median time to recurrence (P＜0.05). AFP (hazard ratio ［HR］［95%CI］=1.69(1.03~2.79), P=0.039), GGT (HR［95%CI］=1.89(1.14~3.14), P=0.014), and CXCL13 (HR［95%CI］=0.54(0.33~0.89), P=0.015) were independent factors associated with posthepatectomy recurrence. The prognostic index PI=0.526×AFP+0.637×GGT-0.616×CXCL13 established based on these factors had an AUC of 0.87, a sensitivity of 93.75%, and a specificity of 63.64% in predicting recurrence within 0-3 months after palliative hepatectomy, with a significant reduction in prediction efficiency for recurrence within 0-6 months (AUC=0.68) or a longer period of time. The recurrence prediction efficiency of this model for palliative hepatectomy was significantly higher than that for radical resection. ConclusionThe prognostic model established based on CXCL13, AFP, and GGT can be used to evaluate the risk of early recurrence after palliative hepatectomy and thus helps clinicians to make diagnosis and treatment decisions based on patients’ benefits.

目的 了解河南省生物安全柜年检情况及安全性能,为规范生物安全柜管理提供依据.方法 依据YY 0569-2011《Ⅱ级生物安全柜》规定的相关标准对河南省医疗机构、疾控机构等单位委托检测的生物安全柜年检情况和性能检测结果进行分析.结果 737台生物安全柜中未到检测期进行检测的18台,占2.45％;定期年检85台,占11.53％;超过检测期后检测634台,占86.02％.在防护性能方面,737台中有593台合格,总体合格率80.46％.按单位分类,企业合格率最高为93.59％,疾控机构最低,为53.50％.结论 生物安全柜年检率和性能检测整体合格率较低,存在一定的生物安全隐患.相关单位应规范生物安全柜的检测和维修,加强监督管理.

目的 了解、分析实验室生物安全风险评估工作现状,对提高生物安全风险评估能力进行探索.方法 对72家BSL-2(Biosafety Shelter Laboratory-2)实验室进行风险评估现状调查,定性和定量研究相结合,利用Excel 2007软件对数据进行统计描述.结果 实验室生物安全风险评估认知方面,熟悉风险评估目的、明确风险评估内容、有规范风险评估报告的总体符合率分别为77.77％、63.88％和48.61％.生物安全风险点评估方面,配备生物安全柜、设立生物安全委员会和实验室建筑布局与流程符合率最高,危害评估体系、高压蒸汽灭菌器和生物安全柜的定期检测符合率最低.结论 参与调研的实验室对生物安全风险评估已有一定的认识,但还需要在生物安全风险培训、规范管理、建立制度等方面不断加强,同时对生物安全风险评估的数字化进行探索.

Objective: To explore the clinical value of different MRI sequences in differenting the subtype of renal cell carcinoma, and to provide the imaging basis of making treatment plan and determining the prognosis of renal cell carcinoma. Materials and Methods: The clinical data of forty renal cell carcinoma patients proved by post-operation pathology were analyzed retrospectively in our hospital from March of 2014 to March of 2017, which were grouped as clear cell renal carcinoma group (21 cases) and no clear cell renal carcinoma group (19 cases, in which papillary cell type 11 cases, chromophobe cell type 8 cases). All the patients were checked with abdominal 3.0 T MRI and the sequences including routine scan, diffusion-weighted imaging and dynamic contrast enhancement. The occurrence rates of cystic degeneration, hemorrhage, necrosis and vein tumor emboli were statistical analysis, and the difference of apparent diffusion coefficient (ADC) value and tumor-cortical augmentation index in different time were also measured between two groups. Results: Compared with no clear cell renal carcinoma group, the occurrence rates of necrosis and cystic degeneration in clear cell renal carcinoma group were high, and the occurrence rates of hemorrhage were low, all which had significant difference (χ2=17.378, 5.414, 4.043, P=0.00, 0.020, 0.044), but the occurrence rate of vein tumor emboli between two groups was not significantly different (χ2=1.380, P=0.240). Area under the curve (AUC) of hemorrhage, necrosis, cystic degeneration and vein tumor emboli were 0.663, 0.828, 0.680 and 0.585;the ADC value of clear cell renal carcinoma was higher than that of no clear cell renal carcinoma, which was different significantly[ (2.01±0.33) ×10-3 mm2/s vs (1.49±0.13) ×10-3 mm2/s, t=6.269, P=0.00];the tumor-cortical augmentation index of clear cell renal carcinoma groupin different stages were higher than those of no clear cell renal carcinoma (t=4.082, 6.059, 6.083, P=0.00, 0.00, 0.00), and the AUCs of tumorcortical augmentation index in different phases were 0.817, 0.929 and 0.897 separately. The ADC values plus tumor-cortical augmentation index in nephrographic phase was 0.976, and the sensitivity was 0.976, specificity was 1.00. Conclusions: The sensitivity and specificity of ADC values plus tumor-cortical augmentation index were the highest in different 3.0 T MRI sequences, which had clinical reference value definitely.

Aims: To date, curative resection remains to be the most optimal therapeutic choice of hepatocellular carcinoma (HCC), though the overall survival (OS) remains extremely unsatisfactory. To better manage the HCC patients, we evaluated the prognosis predicting values of apolipoprotein B (ApoB) and low-density lipoprotein cholesterol (LDL-C) on the long-time survival of patients who underwent surgical treatment in this study. Methods: A subgroup of 164 patients from our previously described follow-up cohort were enrolled in this study, of whom the pre-surgery ApoB and LDL-C measurements were available. They had been followed until January 2017, with a 19.5 months median survival time. The prognosis predicting values of serum ApoB, LDL-C, and other clinical variables were evaluated through Cox univariate and multivariate analyses, meanwhile, Kaplan-Meier analysis was conducted to obtain the OS curves. Results: Pre-surgery ApoB was an independent prognosis predicting factor with HR as 1.396 (P=0.033), elevated ApoB was associated with worse postsurgery prognosis in HCC patients. Concordantly, Spearman's correlation analysis revealed that value of pre-surgery ApoB was to some extent correlated with tumor size (r=0.355, P<0.001). In line with this, further univariate and multivariate logistic regression analysis revealed that patients with higher ApoB value were more likely to have larger tumor size (>= 5 cm), with the OR value as high as 2.221 (95% CI: 1.288-3.830, P=0.004). Additionally, level of ApoB was found to be highly correlated with the serum level of LDL-C (r=0.686, P<0.001). Conclusion: ApoB could be a valuable novel prognosis predicting marker for HCC patients who underwent curative liver resection. Moreover, elevated ApoB level could indicate worse outcome in HCC patients, which could be explained by the relationship between ApoB and residual liver function.

Purpose . Associations between XRCC1 , XRCC3 , and ERCC2 gene polymorphism and prognosis have been investigated in several cancers. The aim of this meta-analysis was to assess the prognostic value of XRCC1 , XRCC3 , and ERCC2 gene polymorphism in hepatocellular carcinoma (HCC). Methods . A systematic literature search was performed to identify relevant studies in PubMed, Embase, and the Cochrane library up to December 2018. The prognostic values of XRCC1 , XRCC3 , and ERCC2 polymorphisms in HCC were estimated using crude HRs with 95% CIs. Results . Ten studies involving 2687 patients were included in the quantitative analysis. There were no statistically significant associations between XRCC1 rs1799782 C>T, XRCC1 rs25487 G>A, and ERCC2 rs1799793 G>A polymorphisms and overall survival (OS). OS was significantly longer for the ERCC2 rs13181 CC genotype than for AA (CC vs. AA: HR = 0.33, 95% CI = 0.15–0.72). A significantly lower OS was observed for patients with the CT genotype compared with the CC genotype at XRCC3 rs861539 (CT vs. CC: HR = 1.64, 95% CI = 1.11–2.42). Conclusion . The ERCC2 rs13181 A>C polymorphism and XRCC3 rs861539 C>T polymorphism may be predictive markers for prognosis in patients with HCC. Well-designed studies with larger sample sizes are needed to verify our findings.

Many studies have investigated the association between the 3'UTR polymorphism in natural resistance-associated macrophage protein 1 (NRAMP1) and the risk of pulmonary tuberculosis (PTB), Revealing inconclusive results. This study aimed to investigate the correlation between the NRAMP1 3'UTR polymorphism and the risk of PTB. This meta-analysis included 29 case-control studies to better and comprehensively assess this correlation. Pooled odds ratios (ORs) and 95% confidence interval (95% CIs) were calculated to assess the strength of the association. These 29 case-control studies included 4672 cases and 6177 controls. The NRAMP1 3'UTR polymorphism displayed a significant positive correlation with the risk of PTB in 3 models (for del/del vs ins/ins: OR=1.22, 95% CI=1.01-1.47; for Ins/del vs ins/ins: OR=1.19, 95% CI 1.08-1.30; for Ins/del + del/del vs ins/ins: OR=1.25, 95% CI=1.08-1.45). A stratified analysis by ethnicity revealed that the NRAMP1 3'UTR polymorphism was associated with an increased risk of PTB in the Asian population, but not in Caucasian, African, and South American populations. The present results indicate that the NRAMP1 3'UTR polymorphism may be considered a risk factor for PTB in the Asian population.

Esophagus cancer is the seventh cause of cancer-related deaths globally. In this study, we analyzed interleukin 6 (IL-6) gene expression in human esophagus cancer patients and showed that IL-6 mRNA levels are significantly higher in tumor tissues and negatively correlated with overall survival, suggesting that IL-6 is a potential therapeutic target for esophagus cancer. We further demonstrated that apigenin, a nature flavone product of green plants, inhibited IL-6 transcription and gene expression in human esophagus cancer Eca-109 and Kyse-30 cells. Apigenin significantly and dose-dependently inhibited cell proliferation and promoted apoptosis while stimulating the cleaved PARP (poly ADP-ribose polymerase) (C-PARP) and caspase-8 expression. It suppressed VEGF (Vascular endothelial growth Factor) expression and tumor-induced angiogenesis. Pretreatment of cells with IL-6 could completely reverse apigenin-induced cellular changes. Finally, using a preclinical nude mice model subcutaneously xenografted with Eca-109 cells, we demonstrated the in vivo antitumor activity and mechanisms of apigenin. Taken together, this study revealed for the first time that apigenin is a new IL-6 transcription inhibitor and that inhibiting IL-6 transcription is one of the mechanisms by which apigenin exhibits its anticancer effects. The potential clinical applications of apigenin in treating esophagus cancer warrant further investigations.

Background . Several researchers have investigated the relationship between ERCC2 rs13181 and rs1799793 polymorphisms and chemotherapy efficacy in terms of tumour response and prognosis in gastric patients. However, the published data have shown inconsistencies. Methods . PubMed, Elsevier, and Chinese National Knowledge Infrastructure databases were searched for relevant articles published before August 1, 2017. Thirteen studies including 3096 gastric cancer patients treated with chemotherapy were included. Results . For rs1799793, in the overall analyses, no relationships were found between four genetic models and clinical response (AA vs. GG: OR = 1.17, 95% CI, 0.70–1.95; GA vs. GG: OR = 0.94, 95% CI, 0.69–1.27; GA + AA vs. GG: OR = 1.12, 95% CI, 0.85–1.46; and AA vs. GG + GA: OR = 1.24, 95% CI, 0.81–1.92). In stratified analyses, the results remained negative. We also found no relationship between each of the genetic models and overall survival time in the overall analyses. In the stratified analyses, for Asians, the A carrier genotype might be more closely associated with shorter survival time and higher risk of death for patients than the GG genotype (AA vs. GG: HR = 1.77, 95% CI, 1.20–2.6; GA + AA vs. GG: HR = 1.62, 95% CI, 1.26–2.09), but the results were negative for Caucasians. No significant relationships were found between the rs13181 polymorphism and OR or OS. Conclusions . This meta-analysis suggested that the ERCC2 rs1799793 polymorphism might be a predictor of prognosis in gastric cancer patients subjected to platinum-based chemotherapy.

Background: Several epidemiology studies have explored the association between dietary B vitamins' intake and the risk of esophageal cancer (EC). However, the results remain inconclusive. Thus, we conducted a systematic review with meta-analysis to evaluate such association. Methods: Literature retrieval was performed using PubMed (Medline), ScienceDirect, and Cochrane Library electronic databases for all studies published from database inception to December 2017. Results: The meta-analysis included 19 studies and showed an overall decreased risk of EC (OR=0.77, 95% CI: 0.68-0.87) in association with multivitamin B (ie, B1, B2, B3, B5, B6, B9, and B12) dietary intake. In a subgroup analysis based on vitamin B subclass, B1, B3, B6, and B9 vitamins were associated with decreased EC risk (vitamin B1: OR=0.68, 95% CI: 0.56-0.82; vitamin B3: OR=0.70, 95% CI: 0.53-0.94; vitamin B6: OR=0.64, 95% CI: 0.49-0.83; and vitamin B9: OR=0.69, 95% CI: 0.55-0.86). By contrast, no association was detected between dietary vitamin B2 and vitamin B5 intake and EC risk (vitamin B2: OR=0.86, 95% CI: 0.64-1.16; vitamin B5: OR=0.49, 95% CI: 0.20-1.20), whereas a potential non-linear dose-response association was found between dietary vitamin B12 intake and EC risk. A statistically significant, inverse association was observed for an increase of 100 mu g/day in supplemental vitamin B6 and B9 and EC risk (vitamin B6: OR=0.98, 95% CI: 0.98-0.99; vitamin B9: OR=0.89; 95% CI: 0.86-0.94). Conclusion: These findings support that vitamin B may have an influence on carcinogenesis of the esophagus. Vitamin B1, B3, B6, B9 showed a decreased risk of EC, and vitamin B12 showed an increased risk of EC.

Objective To explore the clinical features,treatment and prognosis of malignant solid tumors in the digestive tract in children and adolescents. Methods Sixty-five children and adolescents with malignant solid tumors in the digestive tract from January 1997 to June 2017 were selected,who were treated at the Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital. The tumor site,gender,age,clinical presentations,treatment, follow-up time and their life status by deadline follow-up in 65 children and adolescents were collected respectively, and the clinical features,treatment methods and prognosis were retrospectively analyzed. The follow-up deadline was on December 31,2017. Results The most frequent sites of tumors were liver tumor(36 cases,55. 38%),followed by rectum tumor(11/65 cases,16. 92%),colon tumor(6/65 cases,9. 23%),pancreas tumor(5/65 cases,7. 69%),gas-tric(3/65 cases,4. 62%),esophagus (1/65 cases,1. 54%),gallbladder tumor (1/65 cases,1. 54%),ileum tumor (1/65 cases,1. 54%),and appendix tumor (1/65 cases,1. 54%). The prevalence rate in males and females was 1. 32:1. 00. The age of embryo tumor incidence was smaller,and the age of epithelium cancer incidence was older. The main symptoms included abdominal distension and pain (66. 15%,43/65 cases). Twenty-seven patients (41. 5%, 27/65 cases)was in stageⅣ. Radical and palliative surgery were the main treatment in 50 cases (76. 92%). The 1-year,3-year,5-year overall survival rates were 60. 7%,31. 0%,18. 8%,respectively. The overall survival rate of co-lon and rectal cancer was higher than that of hepatocellular cancer,and the differences were all statistically significant (χ2＝6. 268,P＝0. 012;χ2＝11. 772,P＝0. 001). The overall survival rate of patients who received surgery combined with chemoradiotherapy was the longest and those undergoing chemotherapy only was the shortest,but the differences had no statistical significance among 4 groups of sheer surgery,chemotherapy alone,surgery combined with chemothera-py and surgery combined with chemoradiotherapy(all P＞0. 05). Conclusion The malignant solid tumors in the di-gestive tract in children and adolescents have a poor prognosis. The unspecific presentation makes the diagnosis diffi-cult. It is very important to diagnose early and treat as soon as possible by the combination of surgery,chemotherapy and radiotherapy to improve the overall survival rate.

Aim:To explore the prognostic value of pre-operative neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),monocyte to lymphocyte ratio (MLR),prognostic nutritional index (PNI) in hepatitis B virus (HBV)-related hepatocellular carcinoma(HCC) after radical operation.Methods:A total of 331 HCC patients who had been undergone radical operation were followed up.The clinical and laboratory data of the patients were collected.The values of NLR,PLR,MLR,and PNI were calculated.Kaplan-Meier and Cox regression were used to analyze the risk factors.Results:The optimal cutoff levels of NLR,PLR,MLR and PNI were 2.41,106.80,0.24 and 45,respectively.The patients were allocated into two groups according to the cutoff levels.Multivariate analysis revealed that PVTT,pre-operative AFP,AST,intrahepatic metastasis,NLR and PNI were independent predictors of overall survival for HCC after hepatectomy,andHR(95％CI) were 2.652(1.863-3.776),1.476(1.027-2.120),1.437(1.047-1.972),1.596(1.065-2.390),1.563 (1.077-2.268),and 0.657 (0.468-0.922) (P ＜ 0.05).Conclusion:Pre-operative NLR and PNI were independent predictors of overall survival for HBV-related HCC after hepatectomy.The patients with low NLR and high PNI indicate better prognosis.

Aims: Our study was conducted to explore the efficacy of autologous cytokine-induced killer (CIK) cells in patients with advanced malignant melanoma. Materials & Methods: Here we reviewed 113 stage IV malignant melanoma patients among which 68 patients received CIK cell immunotherapy alone, while 45 patients accepted CIK cell therapy combined with chemotherapy. Results: We found that the median survival time in CIK cell group was longer than the combined therapy group (21 vs 15 months, p = 0.07). In addition, serum hemoglobin level as well as monocyte proportion and lymphocyte count were associated with patients' survival time. Conclusions: These indicated that CIK cell immunotherapy might extend survival time in advanced malignant melanoma patients. Furthermore, serum hemoglobin level, monocyte proportion and lymphocyte count could be prognostic indicators for melanoma.