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Objective: To compare the incidence of radiation-related toxicities between conventional and hypofractionated intensity-modulated radiation therapy (IMRT) for limited-stage small cell lung cancer (SCLC), and to explore the risk factors of hypofractionated radiotherapy-induced toxicities. Methods: Data were retrospectively collected from consecutive limited-stage SCLC patients treated with definitive concurrent chemoradiotherapy in Cancer Hospital of Chinese Academy of Medical Sciences from March 2016 to April 2022. The enrolled patients were divided into two groups according to radiation fractionated regimens. Common Terminology Criteria for Adverse Events (CTCAE, version 5.0) was used to evaluate the grade of radiation esophagus injuries and lung injuries. Logistic regression analyses were used to identify factors associated with radiation-related toxicities in the hypofractionated radiotherapy group. Results: Among 211 enrolled patients, 108 cases underwent conventional IMRT and 103 patients received hypofractionated IMRT. The cumulative incidences of acute esophagitis grade ≥2 [38.9% (42/108) vs 35.0% (36/103), P =0.895] and grade ≥ 3 [1.9% (2/108) vs 5.8% (6/103), P =0.132] were similar between conventional and hypofractionated IMRT group. Late esophagus injuries grade ≥2 occurred in one patient in either group. No differences in the cumulative incidence of acute pneumonitis grade ≥2[12.0% (13/108) vs 5.8% (6/103), P =0.172] and late lung injuries grade ≥2[5.6% (6/108) vs 10.7% (11/103), P =0.277] were observed. There was no grade ≥3 lung injuries occurred in either group. Using multiple regression analysis, mean esophageal dose ≥13 Gy ( OR =3.33, 95% CI : 1.23-9.01, P =0.018) and the overlapping volume between planning target volume (PTV) and esophageal ≥8 cm(3)( OR =3.99, 95% CI : 1.24-12.79, P =0.020) were identified as the independent risk factors associated with acute esophagitis grade ≥2 in the hypofractionated radiotherapy group. Acute pneumonitis grade ≥2 was correlated with presence of chronic obstructive pulmonary disease (COPD, P =0.025). Late lung injuries grade ≥2 was correlated with tumor location( P =0.036). Conclusions: Hypofractionated IMRT are tolerated with manageable toxicities for limited-stage SCLC patients treated with IMRT. Mean esophageal dose and the overlapping volume between PTV and esophageal are independently predictive factors of acute esophagitis grade ≥2, and COPD and tumor location are valuable factors of lung injuries for limited-stage SCLC patients receiving hyofractionated radiotherapy. Prospective studies are needed to confirm these results.

Objective: To establish an intramedullary transplantation model of primary megakaryocytes to evaluate the platelet-producing capacity of megakaryocytes and explore the underlying regulatory mechanisms. Methods: Donor megakaryocytes from GFP-transgenic mice bone marrow were enriched by magnetic beads. The platelet-producing model was established by intramedullary injection to recipient mice that underwent half-lethal dose irradiation 1 week in advance. Donor-derived megakaryocytes and platelets were detected by immunofluorescence staining and flow cytometry. Results: The proportion of megakaryocytes in the enriched sample for transplantation was 40 to 50 times higher than that in conventional bone marrow. After intramedullary transplantation, donor-derived megakaryocytes successfully implanted in the medullary cavity of the recipient and produce platelets, which showed similar expression of surface markers and morphology to recipient-derived platelets. Conclusion: We successfully established an in vivo platelet-producing model of primary megakaryocytes using magnetic-bead enrichment and intramedullary injection, which objectively reflects the platelet-producing capacity of megakaryocytes in the bone marrow.

Objective: To explore the safety and effectiveness of stereotactic body radiation therapy (SBRT) for oligometastases from colorectal cancer (CRC). Methods: This is a prospective, single-arm phase Ⅱ trial. Patients who had histologically proven CRC, 1 to 5 detectable liver or lung metastatic lesions with maximum diameter of any metastases ≤5 cm were eligible. SBRT was delivered to all lesions. The primary endpoint was 3-year local control (LC). The secondary endpoints were treatment-related acute toxicities of grade 3 and above, 1-year and 3-year overall survival (OS) and progression free survival (PFS). Survival analysis was performed using the Kaplan-Meier method and Log rank test. Results: Petients from 2016 to 2019 who were treated in Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. Forty-eight patients with 60 lesions were enrolled, including 37 liver lesions and 23 lung lesions. Forty-six patients had 1 or 2 lesions, with median diameter of 1.3 cm, the median biologically effective dose (BED(10)) was 100.0 Gy. The median follow-up was 19.5 months for all lesions. Twenty-five lesions developed local failure, the median local progression free survival was 15 months. The 1-year LC, OS and PFS was 70.2% (95% CI, 63.7%~76.7%), 89.0% (95% CI, 84.3%~93.7%) and 40.4% (95% CI, 33.0%~47.8%). The univariate analysis revealed that planning target volume (PTV) and total dose were independent prognostic factors of LC ( P <0.05). For liver and lung lesions, the 1-year LC, OS and PFS was 58.7% and 89.4% ( P =0.015), 89.3% and 86.5% ( P =0.732), 30.5% and 65.6% ( P =0.024), respectively. No patients developed acute toxicity of grade 3 and above. Conclusion: SBRT is safe and effective treatment method for oligometastases from CRC under precise respiratory motion management and robust quality assurance.

Effective removal of dental plaque is a key measure to prevent and control common oral diseases and to maintain the long-term effect of dental prostheses. The methods of oral plaque control are mainly depending on mechanical measures, including regular toothbrushing, interdental cleaning and oral irrigation. Toothbrushing is the most common and effective method for mechanical removal of dental plaque.How ever the effect of toothbrushing alone to remove dental plaque is limited. It is necessary to control the interdental plaque using tools such as dental floss and interdental brushes. Oral irrigation is an assistant method to improve oral hygiene. Toothbrushing combined with the use of oral irrigator can significantly improve the removal rate of dental plaque. The present article reviews the research progress of the mechanical plaque control methods and their application results.

Objective: To analyze the clinic features of isolated myeloid sarcoma (IMS) involving the pleural cavity. Methods: A case of pleural isolated myeloid sarcoma (PIMS) with pleural effusion as the first manifestation was described. The related cases in literatures were reviewed with"myeloid sarcoma"and"pleural effusions"as the keywords to search China HowNet, Wanfang database and PubMed database. Results: A 59-year-old man complained of right chest pain for 2 months and worsening pain with distress and shortness of breath for 2 weeks. The chest CT scan showed pleural effusion on the right side. Flow cytometric analysis of pleural fluid showed that a population of blasts with CD 34 expressing was 37.6% of the total nucleated cells. The pleural biopsy through medical thoracoscopy indicated lymphoproliferative lesions by pathological examination. Immunohistochemistry was performed on pleural histological sections and cell blocks of pleural effusions, which showed CD 34 and CD 117 positive expression. The diagnosis of PIMS was finally made. Two literature papers with 2 complete cases were found and reviewed. The 3 cases were analyzed. There were 2 males and 1 female. The age was 59, 51, 56 years respectively. One case was a patient with 3 weeks of right upper quadrant and epigastric pain, nausea, and weight loss. Cytological examination of the pleural fluid showed numerous poorly differentiated malignant cells. Histology from an open laparotomy in duodenal biopsies, gallbladder, and mesenteric lymph nodes supported the diagnosis of IMS. The other case was a patient with 6 weeks of dyspnea and a large swelling in the upper vestibular region. Thoracentesis showed 82% myeloid blasts in the pleural fluid. A gingival biopsy showed a diffuse infiltration by cells with a blastic appearance and supported IMS. Conclusion: PIMS was a very rare cause of pleural effusions. The cytological and histopathological evidences were useful to diagnose IMS involving the pleural cavity.

Objective: To investigate the correlation between postoperative peripheral blood neutrophil to lymphocyte ratio (NLR) and recurrence and prognosis of patients with hepatocellular carcinoma (HCC). Methods: The clinicopathological and follow-up data of 344 patients with HCC who underwent radical liver resection from May 2010 to April 2014 were analyzed retrospectively. Results: Of the 344 patients, 104 had early recurrence and 84 had late recurrence. Receiver operating characteristic (ROC) curve analysis showed that the NLR predicted area under the curve (AUC) of early recurrence was 0.622 ( P <0.001), the optimal cut-off value was 2.41. The AUC of late recurrence was 0.634 ( P =0.001), the optimal cut-off value was 2.15. Cox multivariate analysis showed the serum concentration of hepatitis B surface antigen ( HR =2.508, 95% CI : 1.311-4.798), microvascular invasion ( HR =2.422, 95% CI : 1.239-4.734), Milan criteria ( HR =2.373, 95% CI: 1.427-3.948) and postoperative NLR ( HR =2.285, 95% CI: 1.379-3.788) were independent risk factors of early recurrence after HCC resection. Postoperative NLR ( HR =2.927, 95% CI: 1.630-5.255), liver cirrhosis ( HR =2.531, 95% CI : 1.291-4.962) and serum concentration of albumin ( HR =2.257, 95% CI: 1.251-4.073) were independent risk factors of late recurrence after HCC resection. The median recurrence-free survival (RFS) of the 344 patients was 45.0 months, and the median overall survival (OS) was 63.2 months. ROC curve analysis showed that the postoperative NLR predicted 5-year survival AUC was 0.689 ( P <0.05), with an optimal cutoff of 2.29. Cox multivariate analysis showed microvascular invasion ( HR =2.247, 95% CI: 1.534-3.291), postoperative NLR ( HR =2.217, 95% CI: 1.653-2.974), and liver cirrhosis ( HR =1.685, 95% CI: 1.168-2.431), Milan criteria ( HR =1.679, 95% CI: 1.238-2.277), serum concentration of hepatitis B surface antigen ( HR =1.623, 95% CI: 1.102-2.392), serum concentration of albumin ( HR =1.43, 95% CI: 1.066-1.918) were independent factors of RFS after HCC resection, while microvascular invasion ( HR =3.862, 95% CI: 2.407-6.197), Barcelona staging ( HR =2.864, 95% CI: 1.600-5.125), postoperative NLR ( HR =2.688, 95% CI: 1.782-4.055), liver cirrhosis ( HR =2.039, 95% CI: 1.184-3.514), serum concentration of albumin ( HR =1.81, 95% CI: 1.204-2.720) were independent factors of OS. Conclusions: For HCC patients who receive radical liver resection, postoperative NLR ≥2.29 implicates poor prognosis. Moreover, postoperative NLR ≥2.41 suggests early recurrence, while NLR ≥2.15 suggests late recurrence.

Objective: To evaluate the efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) from different donors as first-line treatment for children and adolescents with severe aplastic anemia (SAA) . Methods: The clinical data of 79 children and adolescents with SAA diagnosed from January 2013 to December 2016 in Henan Province were retrospectively analyzed. There were 50 males and 29 females, with a median age of 14(4-18) years. 40 cases received matched sibling transplantation (MSD-HSCT), 17 with unrelated donor transplantation (UD-HSCT), and 22 with haploidentical transplantation (haplo-HSCT). Results: The comparison of MSD-HSCT, UD-HSCT, haplo-HSCT groups was conducted and the median times of neutrophils engraftment were statistically significant [12(9-25) d, 14(10-22) d, 16(11-26) d, respectively ( χ 2 =13.302, P =0.001)], but no difference in+30 d engraftment rate [97.3%(36/37), 100%(15/15), 100%(20/20), χ 2 =0.959, P =0.619]. The median times of PLT engraftment were not statistically significant [14(6-34)d, 16(7-32)d, 19(10-34)d, respectively, χ 2 =5.892, P =0.053], and the +30 d engraftment rate had no difference [97.3%(36/37), 100%(15/15), 100%(20/20), χ 2 =0.959, P =0.619]. The post-transplant infection rate showed no statistically significance [35.0% (14/40), 29.4% (5/17), 45.5% (10/22), χ 2 =1.158, P =0.560], as well as the incidences of aGVHD, grade III/IV aGVHD and cGVHD( χ 2 =0.230, P =0.891; χ 2 =2.628, P =0.269; χ 2 =3.187, P =0.203). The two-years OS rate was not statistically significant respectively [(77.1±6.7)%, (70.6±11.1)%, (77.3±8.9)%, χ 2 =0.330, P =0.845]. Severe post-transplant infection ( RR =4.617, P =0.009), grade Ⅲ/Ⅳ aGVHD ( RR =2.707, P =0.048) were independent risk factors for OS. Conclusion: The overall efficacy of MSD-HSCT, UD-HSCT and haplo-HSCT as first-line therapy for children and adolescents with SAA/VSAA is comparable.

Objective: To investigate the molecular-cytogenetic characterization and impact on tyrosine kinase inhibitors (TKIs) therapy in chronic phase of chronic myeloid leukemia (CML-CP) patients with variant Ph chromosome (vPh). Methods: The clinical data of 32 patients with vPh chromosomes were collected and compared with 703 patients with typical Ph chromosome in newly diagnosed CML-CP who were on first-line imatinib (IM) and with BCR-ABL transcript of P210. Results: There was no significant difference in demographic and hematological characteristics between vPh and classic Ph patients. 3(9.4%) of the 32 vPh cases were simple variant translocations. Among the remaining 29 cases with complex variant translocations, 28 cases (87.5%) involved 3 chromosomes, and only 1 (3.1%) involved 4 chromosomes. Except for 8, 15, 18, X, and Y chromosomes, the other chromosomes were involved. The frequency of chromosome 12q(15.5%) and 1p (12.1%) were higher involved. The most common FISH signal pattern was 2G2R1Y (74.1%), followed by 1G1R2F (14.8%), 2G1R1Y (3.7%), 1G2R1Y (3.7%), 1G1R1Y (3.7%). The comparison of complete cytogenetic response (CCyR) ( P =0.269), major molecular response (MMR) ( P =0.391) were carried out between simple and complex mechanisms, without difference. Compared with the classic Ph, the patients with vPh had higher IM primary resistance rate ( χ 2 =3.978, P =0.046), especially primary hematological resistance ( χ 2 =7.870, P =0.005), but the difference of CCyR ( χ 2 =0.192, P =0.661), MMR ( χ 2 =0.822, P =0.365), EFS ( χ 2 =0.509, P =0.476), OS ( χ 2 =3.485, P =0.062) were not statistically significant, and multivariate analysis showed that the presence of vPh did not affect OS ( RR =0.692, 95% CI 0.393-1.765, P =0.658)、EFS ( RR =0.893, 95% CI 0.347-2.132, P =0.126) and PFS ( RR =1.176, 95% CI 0.643-2.682, P =0.703). Conclusion: CML-CP patients with vPh and classic Ph had similar demographic and hematological characteristics. Except for 22q11, 9q34, the frequency of chromosome 12q and 1p were higher involved. The most common FISH signal pattern was 2G2R1Y, and different mechanisms had no impact on TKIs therapy. Compared with cases with classic Ph chromosomes, the patients with vPh chromosomes had higher risk of IM primary resistance, especially primary hematological resistance, which can obtain deeper molecular response quickly after changing to second-generation TKIs and didn't affect long-term outcomes and OS.

Objective: To establish a new scoring system based on the clinicopathological features of hepatocellular carcinoma (HCC) to predict prognosis of patients who received hepatectomy. Methods: A total of 845 HCC patients who underwent hepatectomy from 1999 to 2010 at Cancer Hospital, Chinese Academy of Medical Sciences were retrospectively analyzed. 21 common clinical factors were selected in this analysis. Among these factors, the cut-off values of alpha-fetoprotein (AFP), alkaline phosphatase (ALP) and intraoperative blood loss were evaluated by using a receiver operating characteristic (ROC) curve analysis.The Kaplan-Meier method and Cox regression model were used to evaluate the independent risk factors associated with the prognosis of HCC patients after hepatectomy. HCC postoperatively prognostic scoring system was established according to the minimum weighted method of these independent risk factors, and divided the patients into 3 risk groups, including low-risk, intermediate-risk and high-risk group. The relapse-free survival (RFS) and overall survival (OS) were compared among these groups. Results: The univariate analysis showed that clinical symptoms, preoperative α-fetoprotein (AFP) level, serum alkaline phosphatase (ALP) level, tumor size, tumor number, abdominal lymph node metastasis, macrovascular invasion or tumor thrombus, extrahepatic invasion or serosa perforation, the severity of hepatic cirrhosis, intraoperative blood loss, the liver operative method, pathological tumor thrombus, intraoperative blood transfusion, perioperative blood transfusion were significantly associated with median RFS of these HCC patients ( P <0.05). Alternatively, clinical symptoms, preoperative AFP level, serum ALP level, tumor size, tumor number, abdominal lymph node metastasis, macrovascular invasion or tumor thrombus, extrahepatic invasion or serosa perforation, the severity of hepatic cirrhosis, intraoperative blood loss, the liver operative method, pathological lymphocyte invasion, pathological tumor thrombus, intraoperative blood transfusion, perioperative blood transfusion were significantly associated with the median OS of these HCC patients ( P <0.05). The multivariate analysis showed that AFP ≥20 ng/ml, clinical symptoms, tumor diameter ≥5 cm, multiple tumors, macrovascular invasion or tumor thrombus, extrahepatic invasion or serosa perforation, moderate and severe liver cirrhosis, non- anatomic resection were the independent risk factors of RFS and OS ( P <0.05). The independent risk factor of RFS was intraoperative bleeding loss ≥325 ml ( P <0.05); The independent risk factors of OS were abdominal lymph node metastasis and pathological tumors thrombus ( P <0.05). The respective weight of 11 independent factors was used to establish the scoring system (scores range from 0 to 26). In the score system, 0 to 5 points were defined as the low-risk group (286 cases), 6 to 12 points were determined as the intermediate-risk group (503 cases), more than 13 points were classified as the high-risk group (56 cases). The median RFS of the low-risk, intermediate-risk and high-risk group were 80, 27 and 6 months, respectively. The differences were statistically significant ( P <0.001). The median OS of the three groups were 134, 51 and 15 months, respectively, and the differences were statistically significant ( P <0.001). Conclusion: This new score system provides effective prediction of postoperative prognosis for HCC patients.

Objective: To observe the therapeutic response of radiosynovectomy with p-32 colloid on hemophilic arthropathy, and to assess the effects of radiosynovectomy with Denver Score on hemophilic arthritis staging. Methods: Radiosynovectomy with p-32 colloid was performed on 326 hemophilic arthritis patients (405 joints) , and recorded bleeding before and after treatment. The MRI performance of 102 joints was evaluated by using Denver scoring system, then was divided into 0-6 and 7-10 groups. Finally, the differences between 2 groups were analyzed. Results: Average pain score of all hemophilic arthritis patients at 6 months, 1, 2 and 3 years post treatment decreased from 3.2±2.4 ( n =326) to 1.2±0.6 ( n =285, P =0.021) , 1.7±0.5 ( n =242, P =0.032) , 2.1±1.1 ( n =212, P =0.030) and 2.2±1.6 ( n =176, P =0.037) , respectively. The frequency of bleeding in 405 joints at 1, 2 and 3 years post treatment decreased from 15.1±3.6 to 2.1±0.7, 4.3±0.6, and 4.8±0.8 times per year ( P <0.01) , respectively; Meanwhile, the proportions of significantly ameliorated joints' activities were observed as of 68.50% (248/362) , 58.39% (181/310) , 55.67% (162/239) and 42.61% (75/176) , respectively. The frequencies of haemarthrosis at 1 and 2 years post treatment in patients with 0-6 Denver Score (45 target joints) reduced from 13.0±1.9 to 1.3±0.6 ( P =0.002) and 3.1±0.9 ( P =0.009) times per year, respectively, which also decreased in 7-10 group (57 target joints) from 16.6±2.1 to 3.1±0.9 ( P =0.008) and 5.7±1.1 ( P =0.004) times per year, respectively. There was no statistical difference between 0-6 and 7-10 groups before treatment in the terms of haemarthrosis frequency ( P =0.773) . However, 7-10 group had higher haemarthrosis frequency at 1 and 2 years post treatment compare with 0-6 group ( P =0.028 and 0.042, respectively) . Synovial volumes in 29 joints reduced after 6 month when compared with baseline [ (2 362.15±32.41) mm(3) vs (3 012.40±39.78) mm(3), t =7.621, P <0.001]. Conclusion: Radiosynovectomy with p-32 colloid on haemophilic synovitis was a safe and effective procedure. The patients with Denver Score of 0-7 had lower frequency of haemarthrosis.

Objective: To investigate whether the polymorphisms of insulin-like growth factor-1 (IGF-1) gene and its regulatory regions are associated with extreme high myopia., Methods: A case-control analysis of 302 subjects with extreme high myopia and 401 controls was undertaken. Genomic DNA was obtained from peripheral blood. Seven tag single nucleotide polymorphisms (tSNP) across the IGF-1 gene region were selected to capture the majority of genetic variation. All tSNP were genotyped using the MassArray platform and MALDI-TOF analysis. Genotypic distribution was tested for Hardy-Weinberg equilibrium. Statistical analyses were performed using the SPSS (version 13.0: SPSS Science, Chicago, IL) software. The genotype and allele frequencies were evaluated using the χ(2) tests and performed by Bonferroni corrections for multiple comparisons. The significance of the differences in the estimated haplotype frequencies between the myopia and control groups was examined on Haploview 4.2 using χ(2) tests, and haplotypes were corrected by using permutation test after running 50 000 times., Results: Among seven different IGF-1 tSNP tested, the allele frequencies of four tSNP-rs5742629(A/G), rs12423791(G/C), rs35766 (G/A) and rs1457601(T/A) in the myopia and the control groups were A(56.5%, 62.3%)/G(43.5%, 27.7%), G(70.4%, 77.1%)/C(29.6%, 22.9%), G(33.9%, 28.8%)/A(66.1%, 71.2%), T(72.5%, 77.3%)/A(27.5%, 22.7%), respectively. And they showed significant differences (χ(2) = 4.968, 8.059, 4.250, 4.245, P < 0.05) between the two groups. However, only rs12423791 remained significance after Bonferroni correction. The haplotype GC of rs5742629-rs12423791 was associated with extreme high myopia (P = 0.033) after 50 000 permutations for multiple comparisons as well., Conclusions: The polymorphism of rs12423791 in IGF-1 may be associated with extreme high myopia in the Chinese population.

Objective: To investigate the clinicopathological features and prognostic factors of primary clear cell carcinoma of the liver (PCCCL)., Methods: The clinical data of 41 PCCCL patients who underwent hepatic resection for PCCCL from October 1998 to June 2012 in our department were retrospectively analyzed. There were 31 male and 10 female patients. The median age was 56 years (range, 25 to 80 years), and the diagnosis was confirmed by postoperative pathological examination. The data of 106 well or moderately differentiated non-clear cell hepatocellular carcinoma (HCC) patients and 86 poorly differentiated non-clear cell HCC patients who underwent hepatic resection in the same period in our hospital in the same period were compared. The χ(2) test or Fischer's exact test, as appropriate, was used to compare group frequencies. Survival analysis was estimated by Kaplan-Meier method. Cox proportional hazards model was used in multivariate analysis., Results: The proportion of fibrous capsule formation in the PCCCL tumors (46%, 19/41) was significantly higher than that of the other two groups (P < 0.05), whereas the PCCCL group had a lower rate of intravascular tumor embolus (2/41) and vascular invasion (1/41) (P < 0.05). The median survival time of PCCCL group was 65 months, the 1-, 3-, 5-year survival rates for PCCCL patients were 90.2%, 67.4% and 42.0%, significantly better than that of poor differentiated NCCHCC group's (82.9%, 33.3%, 7.2%, P < 0.01). However, there were no statistic significant differences between PCCCL group and well or moderately differentiated NCCHCC group (84.7%, 55.7%, 34.4%, P > 0.05). Tumor capsule formation was an independent favorable prognostic factor. In contrast, preoperative serum α-fetoprotein (AFP) level and hepatitis B virus infection were independent unfavorable prognostic factors for PCCCL., Conclusions: PCCCL is a rare, low degree malignant pathological subtype of HCC. Surgical resection may achieve favorable prognosis and even long-term survival.

Objective: To investigate the prognostic factors of hepatocellular carcinoma., Methods: The purpose of this study was to retrospectively analyze the surgical outcomes of hepatocellular carcinoma (HCC) in 832 patients who underwent hepatic resection between February 2002 and June 2010 in the Cancer Hospital of Chinese Academy of Medical Sciences. Post-resection prognostic factors were assessed using a univariate Kaplan-Meier analysis and a multivariate Cox proportional hazards model., Results: The overall 1-, 3- and 5-year survival rates were 92.0%, 70.2% and 53.6%, respectively. The disease free survival rates (DFS) were 90.2%, 61.5% and 40.5%, respectively. The univariate analysis showed that a better prognosis for overall survival (OS) was associated with asymptomatic presentation, small tumor, single lesion, high-grade histological differentiation, no vascular tumor embolus, negative serum alpha-fetoprotein (AFP), negative serum alkaline phosphatase (ALP), Child-Pugh class A, no ascites, no/mild cirrhosis, new surgical techniques, no blood transfusion, no regional lymph node metastasis, no major vascular invasion, and no extra-hepatic invasion. The multivariate analysis showed that asymptomatic presentation, small tumor, single lesion, no tumor embolus, negative serum alpha-fetoprotein (AFP), no regional lymph node metastasis, no major vascular invasion, no extra-hepatic invasion, no/mild cirrhosis, and surgical techniques are independent factors for a longer overall survival., Conclusions: The prognosis of HCC after resection is influenced by a number of factors. Therefore, regularly screening and early diagnosis, applying surgical techniques to minimize the liver injury, and preventing the aggravation of cirrhosis are important measures to improve the overall survival of HCC patients. For those patients with high risk factors of recurrence, routine follow-up is one of the best methods to be recommended.

Objective: To study the clinicopathological features of primary splenic histiocytic sarcoma., Methods: Clinicopathological characterstics were analyzed in a case of primary splenic histiocytic sarcoma and related literatures were reviewed., Results: A 69-year old woman had unexplained debility and palpitation after exertion for a month. CT showed splenomegaly with multiple occupancy. The resected spleen measured 28 cm × 18 cm × 10 cm. Histopathological examination demonstrated that the neoplastic cells diffusely infiltrated splenic sinus. The neoplastic cells were characterized by well-defined cell contour, large pleomorphic nuclei, prominent nucleoli, and abundant eosinophilic cytoplasm. Tumor cells with cytoplasmic vacuoles and intense hemophagocytosis were observed. These cells strongly expressed histiocytic markers CD68 and CD163. Immunostaining for LCA, Vim was positive, but negative for CD1a, S-100, CD30, CK, CD20, CD3, CD21., Conclusions: Immunohistochemistry plays a key role in the diagnosis of primary splenic histiocytic sarcoma.

Objective: To analyze the clinicopathologic factors influencing the outcome of surgically treated intrahepatic cholangiocarcinoma (ICC) and to explore the proper treatment choice of ICC., Methods: The clinicopathological data of 43 surgically treated ICC patients in our hospital were retrospectively analyzed. Of the 43 patients, hepatic resection was performed in 40 patients, ethanol injection in 2, and laparoscopic exploration alone in 1. Kaplan-Meier method and Cox regression model were used for the analysis of factors influencing survival after operation., Results: The accumulative 1-, 3- and 5-year survival rates were 64.4%, 30.9%, 25.8% for the whole group, and 74.7%, 33.3%, 27.8% for the 40 patients with hepatic resection, respectively. Univariate analysis revealed that tumor size, carcinoembryonic antigen (CEA) level, lymph node involvement and TNM stage were factors significantly affecting the survival (P < 0.05). Cox multivariate analysis demonstrated that only tumor size and lymph node involvement were the independent factors significantly affecting the survival (P < 0.05)., Conclusion: Our results show that tumor size and lymph node involvement are independent factors affecting the survival. CEA level and TNM stage are important prognostic factors for surgical management. Radical resection is still the optimal treatment for patient with intrahepatic cholangiocarcinoma.

Objective: To explore a computer aided design (CAD) and rapid prototyping (RP) approach for fabrication of complete denture and to develop relevant programs for implementing it., Methods: Automatic crossing section scanner was used to scan artificial teeth and 3D graphic database of artificial teeth that could be aligned with parameters was established. A 3D laser scanner was used to scan upper and lower edentulous jaw casts and rims made in clinic. The vertical and horizontal relations were recorded before scanning with a patient instrument. Based on Imageware 11, tooth-arrangement curves, coordinate system, and landmark points for positioning were created, and construction cure and shape-controlling curve for base plate were constructed as well. Three-dimensional integrated design of complete denture, including artificial tooth automatic arrangement, aesthetic and individualized design of base plate, and artificial gingival, were finished. The programs were developed following the approach and the CAD platform was established. The virtual molds of complete dentures were constructed according to the above data in design and RP technology was used to make the plaster molds. Finally, the teeth were inserted and the complete denture was finished by dental technician., Results: The approach for the complete denture CAD/RP was confirmed and the CAD software platform was developed. A complete denture was manufactured., Conclusions: The rules for complete denture in textbooks were expressed in design process with the CAD program developed by researcher. The 3D data of rims were utilized in design so that the digital, intelligentized and individualized design and manufacture process for complete denture was implemented.

Objective: Investigating the potential of differentiation of human fetal retinal progenitor cells (hRPCs) and brain neural stem cells (hBNSCs) in vitro., Methods: hRPCs and hBNSCs were isolated from human fetuses (8-12 weeks of gestation) and cultured in serum-free DMEM/F12 culture medium with N2 supplement, epidermal growth factor (EGF) and basic fibroblast growth factor (bFGF) or culture medium with 10% fetal bovine serum (FBS) but without EGF and bFGF. Immunocytochemical and immunofluorescence studies were conducted for identification of neural stem cells, retinal progenitors or the subtypes of neurons, astrocytes, retinal ganglion cells and rod photoreceptors with the specific antibodies for Nestin, Pax6, Map2, GFAP, Thy-1 and Rhodopsin, respectively., Results: Both hRPCs and hBNSCs could proliferate and differentiate in DMEM/F12 + N2 with or without 10% FBS and expressed specific markers of immature neuroepithelial cells, retinal progenitors, mature neurons, astrocytes, retinal ganglion cells and rod photoreceptors. hBNSCs easily attached, spread out longer neurites and to form a network when cultured with serum contained medium. hRPCs were more difficult to attach and had only short dendrites., Conclusions: Both hRPCs and hBNSCs can differentiate into retinal specific cell types in vitro. The adherent, migration and differential capacity of hRPCs and hBNSCs are different when these cells are induced by the serum-contained culture medium.

Objective: To analyze secondary abdominal surgery after Stark cesarean section., Methods: A retrospective analysis of the secondary operation after cesarean section was performed. Group A was Stark cesarean section (n = 89), group B was the longitudinal incision cesarean section (n = 212), and group C was Pfannenstiel incision cesarean section (n = 52). Stark cesarean section was compared with Pfannenstiel incision cesarean section and the longitudinal incision cesarean section in abdominal wall scar healing, adhesion of rectus muscles, peritoneum, omentum, and healing or adhesion of visceral peritoneum., Results: The rate of good abdominal incision healing and slender scar was 86.5% (77/89) in group A, 29.3% (62/212) in group B, and 75.0% (39/52) in group C, respectively. The rate of adhesion of rectus muscles was 25.8% (23/89) in group A, 53.8% (114/212) in group B, and 13.5% (12/89) in group C, respectively. The rate of adhesion of omentum was 13.5% (12/89) in group A, 56.1% (119/212) in group B, and 25.0% (13/52) in group C, respectively. The rate of peritoneal adhesion was 15.7% (14/89) in group A, 46.2% (98/212) in group B, and 11.5% (6/52) in group C, respectively. Only one case in group C the peritoneum was not healed. The rate of adhesion of visceral peritoneum was 15.7% (14/89) in group A, 55.2% (117/212) in group B, and 13.5% (7/52) in group C, respectively. Abdominal wall scar healing, adhesion of rectus muscles, omentum, peritoneum, and visceral peritoneum in group A were all better than group B. The difference was statistically significant (P < 0.05). There were no differences between group A and group C (P > 0.05)., Conclusions: The study shows that the Stark cesarean section is better than the longitudinal incision cesarean section in healing of abdominal wall scar, adhesion of rectus muscles, omentum, peritoneum, and visceral peritoneum, but compared with Pfannenstiel incision cesarean section, there is no difference statistically. However, the advantages of the Stark cesarean section lie in short surgical time, few injury, little bleeding, quick recovery, and short hospital stay time, thus it should be further popularized.

Objective: This study was to explore a CAD method for constructing occlusal and proximal surfaces of inlays using reverse engineering (RE) software and to develop a CAD software for the inlay fabrication., Methods: The dentition model of a volunteer with individual normal occlusion was scanned with a 3D mechanical scanner. The scanned objects were prepared teeth with G. V. Black class I, class II and class VI (MOD) cavities, neighbor teeth, intercuspal position (ICP) record, and functional bite record (or functional generate path, FGP). Inlays were constructed based on RE technology using the database of Chinese normal teeth., Results: The technique guideline of inlay CAD was developed based on RE softwares. Inlays designed with CAD technique showed smooth and continuous contours. The occlusal and proximal contacts of inlay met physiologic demands., Conclusions: It is a feasible method to develop a CAD software for inlay fabrication based on RE software.