Survival After Induction Chemotherapy and Esophagectomy Is Not Improved by Adjuvant Chemotherapy

BACKGROUND

It remains unclear whether postoperative chemotherapy improves survival among patients with esophageal squamous cell carcinoma who have undergone preoperative chemotherapy and radical resection.

METHODS

Patients treated between January 2000 and December 2016 were reviewed. Eligible patients were divided into two groups: perioperative chemotherapy (preoperative and postoperative chemotherapy) and neoadjuvant chemotherapy only. The primary endpoint was disease-free survival; the secondary endpoints were overall survival and toxicities attributable to postoperative chemotherapy. To minimize the effect of patient heterogeneity between the two groups, we used propensity score matching. The survival analysis was performed using univariate analysis and a multivariable Cox regression model.

RESULTS

In total, 252 patients were included in the study. Most were men (208 of 252; 82.5%); median age was 59 years. The follow-up rate was 93.3%. Age, performance status, minimally invasive surgery, and Clavien-Dindo classification were statistically different between the groups (P <.05). After propensity score matching, each group had 59 patients. Five-year disease-free survival (52.4% vs 43.6%, P = .372) and overall survival (68.6% vs 62.4%, P = .359) were not statistically different between the neoadjuvant chemotherapy group and the perioperative chemotherapy group. Cox regression identified both pathologic nodal stage and tumor regression grade are independent prognostic factors for disease-free survival and overall survival (P < .05); adjuvant chemotherapy did not influence disease-free survival (hazard ratio 1.049, 95% confidence interval, 0.587 to 1.876, P = .872) or overall survival (hazard ratio 1.297; 95% confidence interval, 0.606 to 2.775, P = .504). In the perioperative chemotherapy group, 8.5% of patients (5 of 59) had grade 3 or greater toxicity.

CONCLUSIONS

Adjuvant chemotherapy is not indicated for patients with locally advanced esophageal squamous cell carcinoma after neoadjuvant platinum-based chemotherapy and surgery.

Erlotinib Versus Gemcitabine Plus Cisplatin as Neoadjuvant Treatment of Stage IIIA-N2 EGFR-Mutant Non-Small-Cell Lung Cancer (EMERGING-CTONG 1103): A Randomized Phase II Study

PURPOSE

To assess the benefits of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors as neoadjuvant/adjuvant therapies in locally advanced EGFR mutation-positive non-small-cell lung cancer.

PATIENTS AND METHODS

This was a multicenter (17 centers in China), open-label, phase II, randomized controlled trial of erlotinib versus gemcitabine plus cisplatin (GC chemotherapy) as neoadjuvant/adjuvant therapy in patients with stage IIIA-N2 non-small-cell lung cancer with EGFR mutations in exon 19 or 21 (EMERGING). Patients received erlotinib 150 mg/d (neoadjuvant therapy, 42 days; adjuvant therapy, up to 12 months) or gemcitabine 1,250 mg/m² plus cisplatin 75 mg/m² (neoadjuvant therapy, two cycles; adjuvant therapy, up to two cycles). Assessments were performed at 6 weeks and every 3 months postsurgery. The primary end point was objective response rate (ORR) by Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1; secondary end points were pathologic complete response, progression-free survival (PFS), overall survival, safety, and tolerability.

RESULTS

Of 386 patients screened, 72 were randomly assigned to treatment (intention-to-treat population), and 71 were included in the safety analysis (one patient withdrew before treatment). The ORR for neoadjuvant erlotinib versus GC chemotherapy was 54.1% versus 34.3% (odds ratio, 2.26; 95% CI, 0.87 to 5.84; P = .092). No pathologic complete response was identified in either arm. Three (9.7%) of 31 patients and zero of 23 patients in the erlotinib and GC chemotherapy arms, respectively, had a major pathologic response. Median PFS was significantly longer with erlotinib (21.5 months) versus GC chemotherapy (11.4 months; hazard ratio, 0.39; 95% CI, 0.23 to 0.67; P < .001). Observed adverse events reflected those most commonly seen with the two treatments.

CONCLUSION

The primary end point of ORR with 42 days of neoadjuvant erlotinib was not met, but the secondary end point PFS was significantly improved.

Preemptive one lung ventilation enhances lung collapse during thoracoscopic surgery: A randomized controlled trial

In routine practice, one lung ventilation (OLV) is initiated upon pleural opening. We conducted a randomized controlled trial to compare lung collapse after preemptive OLV versus conventional OLV in thoracoscopic surgery. A total of 67 patients were enrolled (34 with conventional OLV; 33 with preemptive OLV). Preemptive OLV was conducted by closing the DLT lumen to the non‐ventilated lung immediately upon assuming the lateral position with the distal port closed to the atmosphere until pleural opening (>6 minutes in all cases). Lung collapse was assessed at 1, 5, 10, 20, 30 and 40 minutes after pleural opening using a 10‐point rating scale (10: complete collapse). The primary end point was the duration from pleural opening to satisfactory lung collapse (score of 8). Secondary end points included PaO₂ and hypoxemia. The duration from pleural opening to satisfactory lung collapse was shorter in the preemptive OLV group (9.1 ± 1.2 vs. 14.1 ± 4.7 minutes, P < 0.01). PaO₂ was comparable between the two groups prior to anesthetic induction (T0), and 20 (T2), 40 minutes (T3) after pleural incision, but was lower in the preemptive OLV group at zero minutes after pleural incision (T1) (457.5 ± 19.0 vs. 483.1 ± 18.1 mmHg, P < 0.01). No patients in either group developed hypoxemia. In summary, preemptive OLV expedites lung collapse during thoracoscopic surgery with minimal safety concern.

Predictive values of FAP and HGF for tumor angiogenesis and metastasis in colorectal cancer

This study aims to explore the correlation of hepatocyte growth factor (HGF) and fibroblast activation protein (FAP) expressions with the angiogenesis and metastasis in colorectal cancer (CRC). The immunohistochemical SABC method was used to detect HGF and FAP expressions in 127 CRC tissues, 51 colorectal polyp tissues and 28 normal tissues. HGF and FAP expressions in liver metastasis were detected using western blot to analyze the correlation of their expressions with lymph node metastasis and liver metastasis. Micro-vessel density (MVD) and clinic-pathologic information of CRC patients were recorded and analyzed. In CRC group, HGF and FAP expressions were greatly higher than those in normal group and colorectal polyps group (P < 0.05). Moreover, the positive rates of HGF and FAP expressions in lymph node metastasis were evidently higher than those in non-lymph node metastasis (P < 0.05). In liver metastasis group, HGF and FAP expressions were obviously higher than non-liver metastasis group (P < 0.05). CRC group had much more MVD in comparison with normal group and colorectal polyps group (P < 0.05).When compared with negative group, MVD was significantly higher than that in CRC tissue with positive HGF and FAP (P < 0.05). Spearman rank correlation analysis showed that HGF and FAP were in positive correlation with MVD (r = 0.542, P < 0.001; r = 0.753, P < 0.001). These results indicate that FAP and HGF play an important role in CRC angiogenesis, and their expression levels are valuable to predict CRC liver metastasis and lymph node metastasis.

[Diagnostic Utility of Virtual Bronchoscopic Navigation Assisted Endobronchial Ultrasonography with Guide Sheath for Peripheral Pulmonary Lesions]

背景与目的

虚拟支气管镜导航（virtual bronchoscopic navigation, VBN）联合支气管超声导向鞘技术（endobronchial ultrasonography with guide sheath, EBUS-GS）用于经支气管肺活检术（transbronchus lung biopsy, TBLB），能够减少甚至避免射线暴露。本研究拟评价VBN联合EBUS-GS对肺周围性病变（pulmonary peripheral lesions, PPLs）的诊断价值及安全性。

方法

回顾性分析2016年1月-2017年12月在北京大学肿瘤医院内镜中心接受EBUS-GS-TBLB患者的临床病理资料，评价诊断率及安全性，并对影响诊断率的因素进行分析。

结果

121例患者纳入本研究，男性65例，女性56例；平均年龄（58.8±10.3）岁。108例（89.3%）可在EBUS图像中显示，共有89例（73.5%）经EBUS-GS-TBLB获得明确诊断。EBUS-GS-TBLB对恶性病变的诊断率为82.5%。联合刷检、活检及肺泡灌洗中两种或三种方式取检的诊断率（87.2%）高于仅采用单一方式取检（58.8%）（χ²=6.084, P=0.014）。影响EBUS-GS-TBLB诊断率的因素包括超声探头位于病灶内部（χ²=20.372, P=0.000）、病灶位于肺野内带及中带（χ²=10.810, P=0.001）。1例（0.8%）患者术中出血量较多。

结论

VBN联合EBUS-GS-TBLB是一种诊断PPLs安全且有效的方法。

Quasinormal mode solvers for resonators with dispersive materials

Optical resonators are widely used in modern photonics. Their spectral response and temporal dynamics are fundamentally driven by their natural resonances, the so-called quasinormal modes (QNMs), with complex frequencies. For optical resonators made of dispersive materials, the QNM computation requires solving a nonlinear eigenvalue problem. This raises a difficulty that is only scarcely documented in the literature. We review our recent efforts for implementing efficient and accurate QNM solvers for computing and normalizing the QNMs of micro- and nanoresonators made of highly dispersive materials. We benchmark several methods for three geometries, a two-dimensional plasmonic crystal, a two-dimensional metal grating, and a three-dimensional nanopatch antenna on a metal substrate, with the perspective to elaborate standards for the computation of resonance modes.

Erratum: Observation of D^{0} Meson Nuclear Modifications in Au+Au Collisions at sqrt[s_{NN}]=200 GeV [Phys. Rev. Lett. 113, 142301 (2014)]

This corrects the article DOI: 10.1103/PhysRevLett.113.142301.

[Relationship between 25-hydroxyvitamin D levels and idiopathic benign paroxysmal positional vertigo in female patients]

Objective: To investigate the relationship between serum 25-hydroxyvitamin D[25(OH) D] levels and idiopathic benign paroxysmal positional vertigo (BPPV) in female patients. Methods: A total of 67 women diagnosed with idiopathic BPPV were selected as the study group between January and December 2016 in Ningbo No.2 Hospital, and 95 healthy women without a history of vertigo or dizziness were selected as the control group. The data of height, weight, histories of hypertension and diabetes mellitus were collected, and serum 25(OH) D levels were measured. The number of the recurrence and canalith repositioning maneuvers were recorded during the one-year follow-up. Results: No significant differences of age, body mass index, histories of hypertension and diabetes mellitus between patients with BPPV and healthy controls (all P>0.05) .The serum 25 (OH) D levels were significantly lower in patients with idiopathic BPPV than in healthy controls [(50.56±13.36) nmol/L vs (56.55±16.21) nmol/L, t=-2.485, P=0.014]. BPPV patients with low level of 25(OH) D showed a significant increase in the number of canalith repositioning maneuvers required and the recurrence rate. The regression analyses demonstrated that 25(OH)D deficiency was associated with BPPV with an odds ratio of 2.054 (95% CI: 1.088-3.877, P=0.026). Conclusion: 25(OH) D deficiency may be a risk factor of BPPV.

Effect of cryopreservation of teeth on the structural integrity of dentin

The autotransplantation of teeth after cryopreservation has become an increasingly viable method for whole tooth replacement. While the immediate success rates are quite high, damage introduced by cryopreservation within the dentin or enamel could be detrimental to the durability of these teeth.

OBJECTIVE

to determine whether cryopreservation alters the microstructure of dentin or causes a reduction of its resistance to mechanical failures.

METHODS

Third molars were obtained from young donors (18≤age≤30yrs) and subjected to a cryopreservation protocol involving storage for 10days in cryoprotectant solution at -196°C. After treatment, the mid-coronal dentin was characterized in terms of its elastic modulus, strength and fatigue behavior. Scanning electron microscopy and Raman spectroscopy were used to evaluate the microstructure and integrity of collagen after cryopreservation.

RESULTS

There was no significant difference in the elastic modulus or flexural strength between dentin from the cryopreserved and non-cryopreserved (control) teeth. However, the cryopreservation treatment caused a significant decrease in the fatigue strength of dentin with respect to the controls, with average reduction of nearly 20%. While there were no differences apparent in the collagen matrix or fracture surfaces between the cryopreserved and control groups, the microstructure of dentin from the cryopreserved teeth exhibited unique features and damage that appear to have caused the decrease in durability.

SIGNIFICANCE

Autotransplantation of cryopreserved teeth may be a viable option for whole tooth restorations, but hidden damage within the dentin could render these teeth more susceptible to mechanical failures by fatigue and fracture.

CD56bright natural killer cells induce HBsAg reduction via cytolysis and cccDNA decay in long-term entecavir-treated patients switching to peginterferon alfa-2a

HBV surface antigen (HBsAg) reduction is well observed in chronic hepatitis B (CHB) patients treated with pegylated interferon alpha-2a (PegIFNα). However, the mechanism of HBsAg suppression has not been fully elucidated. Twenty-seven of 55 entecavir-treated CHB e antigen positive patients were switched to PegIFNα treatment (Group A) whereas 28 patients continued entecavir treatment (Group B). The percentage or absolute number of CD56^bright /CD56^dim NK cells, expression of receptors and cytokines were evaluated by flow cytometry for 48 weeks and correlated with treatment efficacy. In vitro, purified NK cells were co-cultured with HepAD38 cells for measurement of HBsAg, apoptosis and covalently closed circular DNA (cccDNA). In association with a reduction of HBsAg, the percentage and absolute number of CD56^bright NK cells was significantly elevated in patients in group A, especially in Virologic Responders (VRs, HBsAg decreased). Furthermore, the percentage of NKp30⁺ , NKp46⁺ , TRAIL⁺ , TNF-α⁺ and IFNγ⁺ CD56^bright NK cells were significantly expanded in Group A, which were positively correlated with the decline of HBsAg at week 48. In vitro, peripheral NK cells from Group A induced a decline of HBsAg in comparison with NK cells from Group B which was significantly inhibited by anti-TRAIL, anti-TNF-α and anti-IFNγ antibodies. Furthermore, apoptosis of HepAD38 cells and levels of cccDNA, were significantly reduced by TRAIL⁺ and TNF-α⁺ /IFNγ⁺ NK cells from Group A, respectively. A functional restoration of CD56^bright NK cells in entecavir-treated patients who were switched to PegIFNα contributes to HBsAg and cccDNA clearance through TRAIL-induced cytolysis and TNF-α/IFNγ-mediated noncytolytic pathways.

Outcomes after neoadjuvant or adjuvant chemotherapy for cT2-4N0-1 non-small cell lung cancer: A propensity-matched analysis

OBJECTIVE

Comparative survival between neoadjuvant chemotherapy and adjuvant chemotherapy for patients with cT2-4N0-1M0 non-small cell lung cancer has not been extensively studied.

METHODS

Patients with cT2-4N0-1M0 non-small cell lung cancer who received platinum-based chemotherapy were retrospectively identified. Exclusion criteria included stage IV disease, induction radiotherapy, and targeted therapy. The primary end point was disease-free survival. Secondary end points were overall survival, chemotherapy tolerance, and ability of Response Evaluation Criteria In Solid Tumors response to predict survival. Survival was estimated using the Kaplan-Meier method, compared using the log-rank test and Cox proportional hazards models, and stratified using matched pairs after propensity score matching.

RESULTS

In total, 330 patients met the inclusion criteria (n = 92/group after propensity-score matching; median follow-up, 42 months). Five-year disease-free survival was 49% (95% confidence interval, 39-61) for neoadjuvant chemotherapy versus 48% (95% confidence interval, 38-61) for adjuvant chemotherapy (P = .70). On multivariable analysis, disease-free survival was not associated with neoadjuvant chemotherapy or adjuvant chemotherapy (hazard ratio, 1.1; 95% confidence interval, 0.64-1.90; P = .737), nor was overall survival (hazard ratio, 1.21; 95% confidence interval, 0.63-2.30; P = .572). The neoadjuvant chemotherapy group was more likely to receive full doses and cycles of chemotherapy (P = .014/0.005) and had fewer grade 3 or greater toxicities (P = .001). Response Evaluation Criteria In Solid Tumors response to neoadjuvant chemotherapy was associated with disease-free survival (P = .035); 15% of patients receiving neoadjuvant chemotherapy (14/92) had a major pathologic response.

CONCLUSIONS

Timing of chemotherapy, before or after surgery, is not associated with an improvement in overall or disease-free survival among patients with cT2-4N0-1M0 non-small cell lung cancer who undergo complete surgical resection.

Measurement of the toroidal radiation asymmetry during massive gas injection triggered disruptions on J-TEXT

Disruptions have the potential to cause severe damage to large tokamaks like ITER. The mitigation of disruption damage is one of the essential issues for the tokamak. Massive gas injection (MGI) is a technique in which large amounts of a noble gas are injected into the plasma in order to safely radiate the plasma energy evenly over the entire plasma-facing wall. However, the radiated energy during the disruption triggered by massive gas injection is found to be toroidally asymmetric. In order to investigate the spatial and temporal structures of the radiation asymmetry, the radiated power diagnostics for the J-TEXT tokamak have been upgraded. The multi-channel arrays of absolute extreme ultraviolet photodiodes have been upgraded at four different toroidal positions to investigate the radiation asymmetries during massive gas injection. It is found that the toroidal asymmetry is associated with plasma properties and MGI induced MHD activities.

Design of a shattered pellet injection system on J-TEXT tokamak

Disruptions have the possibility of causing severe wall damage to large tokamaks like ITER. The mitigation of disruption damage is essential to the safe operation of a large-scale tokamak. The shattered pellet injection (SPI) technique, which is regarded as the primary injection method for ITER, presents several advantages relative to massive gas injection, including more rapid particle delivery, higher total particle assimilation, and more centrally peaked particle deposition. A dedicated argon SPI system that focuses on disruption mitigation and runaway current dissipation has been designed for the Joint Texas Experimental Tokamak (J-TEXT). A refrigerator is used to form a single argon pellet at around 64 K. The pellet will be shaped with a 5 mm diameter and a 1.5-10 mm length. Helium gas at room temperature will be used as a propellant gas for pellet acceleration. The pellet can be injected with a speed of 150-300 m/s. The time interval between injection cycles is about 8 min. The pellet will be shattered at the edge of the plasma and then injected into the core of plasma. The first experiments of SPI fast shutdown and runaway current dissipation have been performed.

Vertical fast electron bremsstrahlung diagnostic on J-TEXT tokamak

Fast electron bremsstrahlung (FEB) emission during Ohmic discharge experiments on the Joint Texas Experimental Tokamak (J-TEXT) has been measured by a recently developed vertical multi-channel FEB diagnostic based on CdZnTe detectors. There are 5 sight lines to observe the vertical emission of fast electrons at the high-field side with a spatial resolution of 5 cm. The FEB emission in the energy range of 30-300 keV can be measured. The generation of fast electrons accelerated by loop voltage has been confirmed during the early phase of discharge by analyzing the signals of FEB emission. The runaway electron beam instabilities have been observed with the FEB diagnostic on J-TEXT.

[Impact of multiple morphological anomalies of the flagella on the outcomes of intracytoplasmic sperm injection for males with infertility]

Objective: To evalute the clinical outcomes of intracytoplasmic sperm injection(ICSI) for infertility male with severe asthenospermia induced by multiple morphological anomalies of the flagella (MMAF). Methods: The clinical data of 15 patient with MMAF were retrospectively analyzed, who underwent ICSI treatment using hyponotic swelling test the "live" sperm in the Department of Reproductive Medicine of Yantai Yuhuangding Hospital from January 2011 to December 2016. Another 30 obstructive azoospermia (OA)patients are matched strictly who also accepted ICSI in the same treatment time. The two groups were compared in the couples'age, the body mass index(BMI), the duration of infertility, the retrieved oocytes, the number of ICSI oocytes, and the rates of fertilization, cleavage, transferrable embryos, good embryos, embryos implanted, clinical pregncncy, early abortion, singleton and twins. Results: After 27 cycles of ICSI, all of the MMAF patients achieved clinical pregnancy, including 11 cases of live birth, 2 cases of spontaneous abortion, and 2 cases of pregnancy maintenance. There were no significant difference between MMAF and OA groups in the couples'age and BMI, or the numbers of retrieved oocytes and ICSI oocytes(P>0.05), but the differences in the infertility duration had statistical meaning(P<0.001). No statistical differences were observed among groups in ICSI fertility rate(92.0% vs 91.6%), clesvage rate(95.4% vs 96.5%), high-quality embryonic rate(56.5% vs 57.5%), good blastocyst rate(23/61 vs 35/94), embryo implantation rate(20/48 vs 35/75), early abortion rate(4/19 vs 8/36), clinical pregncncy rate(15/27 vs 28/50), singleton rate (10/13 vs 20/25)and twinning rate(3/13 vs 5/25)(P>0.05). Conclusions: MMAF may not affect ICSI treatment outcomes, but genetic defects can be transmitted through ICSI. The affected couples should be informed of the necessity of prenatal genetic diagnosis before embryo implantation and the inevitable vertical transmission of genetic problems to the offspring.

[Analysis of Prolonged Hospitalizations (Longer than 7 days): 115 Lung Cancer Patients after Video Assistant Thoracic Surgery (VATS)]

背景与目的

胸腔镜手术已是我科肺癌肺切除手术的主要方式，其特点是创伤小、恢复快，术后7天以内出院患者近90%，但术后并发症仍时有发生；我们对胸腔镜肺癌肺切除术后住院时间 > 7天的患者进行分析，旨在总结并发症的种类及危险因素，提高患者的术后安全性。

方法

数据来源为北京肿瘤医院胸外一科前瞻性肺癌数据库，选取2010年1月-2014年12月行胸腔镜肺癌肺切除手术，且住院时间 > 7天的患者，调查其并发症种类，并按照改良Clavien分级将其分为轻度及重度并发症，分析临床因素与并发症程度之间的关系。

结果

术后住院时间 > 7天者共115例，占同期手术比例为10.3%（115/1, 112）。全组患者轻度并发症81例，占同期手术（1, 112例）比例和术后住院时间延长者比例分别为7.3%和70.4%，重度并发症34例，分别为3.1%和29.6%；因并发症死亡者2例，分别为0.18%和1.7%；术后最常见者为漏气超过5日20例，分别为1.8%和17.4%，肺不张19例，分别为1.7%和16.5%，肺部感染18例，分别为1.6%和15.7%；罕见并发症中支气管胸膜瘘4例（0.36%和3.5%），但危险高，其中2例因并发急性呼吸窘迫综合征（acute respiratory distresssyndrome, ARDS）围手术期死亡；临床因素中仅低肺功能（FEV₁% < 70%）可能是造成术后严重并发症的因素（45.8% vs 23.6%, P=0.038）；轻度并发症组与重度并发症组5年无疾病生存率（52.2% vs 51.9%, P=0.894）及5年总生存率（64.0% vs 53.5%, P=0.673）均无显著差异。

结论

术后持续漏气、肺不张及肺部感染等并发症是延长胸腔镜肺癌术后住院时间的主要原因，而支气管胸膜瘘是最凶险的并发症；术前低肺功能患者更易出现术后严重并发症，但并发症严重程度并不会影响远期预后。

Long non-coding RNA CRNDE is a novel tumor promoter by modulating PI3K/AKT signal pathways in human gastric cancer

OBJECTIVE

Long non-coding RNA CRNDE (CRNDE) recently emerged as a carcinogenic promoter in various cancers including gastric cancer (GC). However, the functions and molecular mechanisms of CRNDE to GC are still largely unclear. The aim of this study was to investigate the clinical significance and functional mechanisms of CRNDE expression in GC.

PATIENTS AND METHODS

The expression of CRNDE was detected by quantitative Real-time PCR (qRT-PCR) in GC specimens and cell lines. The correlation between the CRNDE expression and clinicopathological parameters was investigated. Survival rate was determined with Kaplan-Meier and statistically analyzed with the log-rank method between groups. Subsequently, the significance of survival variables was analyzed using the Cox multivariate proportional hazards model. Then, MTT and Transwell assays were used to assess cell proliferation, migration and invasion capacity. Finally, Western blot analysis was performed to explore the effects of CRNDE knockdown on the PI3K/Akt pathway.

RESULTS

We observed that expression of CRNDE was higher in GC tissues and cells compared with the normal gastric tissue and normal gastric cell lines. High expression of CRNDE was correlated with invasion depth (p = 0.006), TNM stage (p = 0.010) and lymph node metastasis (p = 0.005). Furthermore, high CRNDE expression was associated with shorter overall survival (p = 0.0066) of GC patients. Multivariate analysis confirmed that high CRNDE expression was a significant independent predictor of poor survival in GC. In vitro assay indicated that knockdown of CRNDE inhibited cell proliferation, migration and invasion of GC. Finally, the data of Western blot showed that CRNDE exerted its oncogenic role by affecting PI3K/AKT signaling pathways.

CONCLUSIONS

Our findings indicate that CRNDE plays an important role in promoting GC progression and may represent a novel prognostic biomarker in GC.

[Research Progress of Traffic Accident Reconstruction Technology Based on PC-Crash Software]

With the development of the computer simulation technology and the digital simulation technology, the traditional calculation method has been gradually replaced by the digital method to deal the road traffic accident scene and analyse the process. The PC-Crash software simulation system can reconstruct the traffic accidents within 32 vehicles, and the accuracy of reconstruction has been fully verified, which is widely used by the transport police department and the accreditation agency. In this paper, the research of road traffic accident reconstruction using PC-Crash software is reviewed, and the application of road traffic accident reconstruction technology based on PC-Crash software and some existing problems in forensic practice are discussed, which provides reference for the research and identification of road traffic accident simulation and reconstruction and theoretical basis for accident treatment.

Downregulation of HOXA13 sensitizes human esophageal squamous cell carcinoma to chemotherapy

BACKGROUND

Chemoresistance often develops in esophageal squamous cell carcinoma (ESCC), leading to poor prognosis. HOX genes play a crucial role in embryonic development and cell differentiation. Studies have recently linked HOX with chemoresistance, thus we explored whether HOXA13 is involved in ESCC chemoresistance.

METHODS

One hundred thirty-one ESCC patients who received neoadjuvant chemotherapy were enrolled. HOXA13 expression was examined by immunohistochemistry. RNA interference was used to knock down the HOXA13 expression in KYSE70 and transfected HOXA13 plasmid to overexpress HOXA13 in KYSE510 cells. We examined half-maximal inhibitory concentration of cisplatin, apoptosis, and epithelial-to-mesenchymal transition (EMT) in ESCC cell lines with different HOXA13 expression levels by cell counting kit-8, flow cytometry, and transwell analysis.

RESULTS

The median survival of patients with high HOXA13 expression was significantly shorter than those with low expression (P = 0.027). HOXA13 was associated with worse tumor regression grade (P = 0.009). Low HOXA13 expressed cells decreased the half-maximal inhibitory concentration of cisplatin (P < 0.05), increased cisplatin-induced apoptosis (P < 0.05), and decreased EMT (P < 0.05) compared with high HOXA13 expressed cells. In low HOXA13 expressed cells, cleaved caspase-3 and cleaved PARP expression induced by cisplatin increased, while expression of E-cadherin and Snail protein, markers of EMT, was upregulated and downregulated, respectively. EMT decreased in low HOXA13 expressed cells.

CONCLUSION

High HOXA13 expression was associated with inferior tumor regression grade and poor overall survival in ESCC patients treated with neoadjuvant chemotherapy. HOXA13 increased cisplatin-resistance and promoted EMT in ESCC cells.

Efficacy of postoperative adjuvant chemotherapy for esophageal squamous cell carcinoma: A meta-analysis

Background

Esophageal squamous cell carcinoma (ESCC) is the predominant type of esophageal cancer and most clinically curable patients are diagnosed with locally advanced disease. While the efficacy of preoperative treatment is relatively clear and well characterized, the effect of postoperative treatment, especially postoperative chemotherapy, remains controversial, and its role in the treatment strategy is obscure. We conducted an updated meta‐analysis to include recent developments.

Methods

A comprehensive search in the PubMed, Embase, and Cochrane databases was performed to identify studies published from the inception of each database to February 2018. The overall survival (OS) and disease‐free survival (DFS) rates of patients treated with and without postoperative chemotherapy were analyzed and compared. Hazard ratios (HRs) and 95% confidence intervals (CIs) were used to assess the associations between postoperative chemotherapy and patient survival. Potential publication bias was assessed using Egger's line regression test.

Results

A total of nine studies, including three randomized controlled trials and six retrospective studies, were retrieved from the databases, comprising a total of 1684 cases. The results showed that postoperative chemotherapy could improve OS (HR 0.78, 95% CI 0.66–0.91; P = 0.002) and DFS (HR 0.72, 95% CI 0.6–0.86; P < 0.001).

Conclusions

The current meta‐analysis supports postoperative chemotherapy as an independent favorable prognostic factor for ESCC, which could improve both OS and DFS.

Efficacy of repeated surgery is superior to that of non-surgery for recurrent/second primary lung cancer after initial operation for primary lung cancer

Background

The current study aimed to determine the oncological efficacy and surgical safety of multiple pulmonary resections (MPRs) after prior curative surgery for local regional recurrent or second primary lung cancers.

Methods

All cases of lung cancer included in our prospective database between January 2000 and July 2015 were retrospectively reviewed. The oncological efficacy endpoints for synchronous and metachronous MPR were five‐year overall survival (OS), disease‐free survival (DFS), and progression‐free survival (PFS) rates after the second surgery. The surgical safety endpoints were postoperative mortality and complications (Clavien‐Dindo classification) within 30 days.

Results

In total, 67 MPR cases were identified. There were no significant differences in the five‐year OS and DFS between the synchronous MPR group (n = 50) and the propensity score‐matched solitary major pulmonary resection group (n = 250) (5‐year OS 84.5% vs. 69.0%, log rank P = 0.112; DFS 64.4% vs. 58.0%, log rank P = 0.278). The five‐year OS and PFS of the metachronous MPR group (n = 17) were significantly better than those in the non‐surgical control group (n = 19) (5‐year OS 94.1% vs. 50.7%, log rank P = 0.005; 5‐year PFS 53.9% vs. 10.5%, log rank P = 0.020). No postoperative mortality or severe complications occurred in the MPR group.

Conclusion

The oncological efficacy of MPR is superior to the non‐surgical approach for the management of local regional recurrent or second primary lung cancer, with comparable postoperative mortality and complications.