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We evaluate the prognostic value of chemotherapy and other prognostic factors on overall survival among colon patients with deficient mismatch repair (dMMR), and determine the optimum time to start chemotherapy after surgery. Data of 306 colon cancer patients with dMMR who received radical surgery were collected from three Chinese centers between August 2012 and January 2018. Overall survival (OS) was assessed with the Kaplan–Meier method and log-rank. Cox regression analysis were used to assess influencing prognosis factors. The median follow-up time for all patients was 45.0 months (range, 1.0–100). There was a nonsignificant OS benefit from chemotherapy for patients with stage I and stage II disease, including high-risk stage II disease (log-rank p: 0.386, 0.779, 0.921), and a significant OS benefit for patients with stage III and stage IV disease for receiving post-operation chemotherapy (log-rank p = 0.002, 0.019). Stage III patients benefitted from chemotherapy regimens that contained oxaliplatin (log-rank p = 0.004), and Starting chemotherapy with oxaliplatin treatment earlier resulted in better outcomes (95% CI 0.013–0.857; p = 0.035). Chemotherapy regimens containing oxaliplatin can prolong the survival time of stage III and IV dMMR colon cancer patients. This beneficial manifestation was more pronounced after starting chemotherapy treatment early post operation. High risk stage II dMMR colon patients including T4N0M0 cannot benefit from chemotherapy. [ABSTRACT FROM AUTHOR]

Background: With the extended life expectancy of the Chinese population and improvements in surgery and anesthesia techniques, the number of aged patients undergoing surgery has been increasing annually. However, safety, effectiveness, and quality of life of aged patients undergoing surgery are facing major challenges. In order to standardize the perioperative assessment and procedures, we have developed a perioperative evaluation and auxiliary decision-making system named "Aged Patient Perioperative Longitudinal Evaluation-Multidisciplinary Trial (APPLE-MDT)".Methods: We will conduct a perioperative risk evaluation and targeted intervention, with follow-ups at 1, 3, and 6 months after surgery. The primary objective of the study is to evaluate the effectiveness of the "Aged Patient Perioperative Longitudinal Evaluation-Multiple Disciplinary Trial Path" (hereinafter referred to as the APPLE-MDT path) in surgical decision-making for aged patients (≥75 years) undergoing elective surgery under non-local anesthesia in the operating room. The secondary objectives of the study are to evaluate the postoperative outcome and health economics of the APPLE-MDT path applied to the surgical decision-making of aged patients (≥75 years) undergoing elective surgery under non-local anesthesia and to optimize intervention strategies for aged patients undergoing surgery to reduce the occurrence of postoperative complications and improve the quality of life after surgery.Discussion: It is necessary to formulate a reliable, effective, and concise evaluation tool, which can effectively predict the perioperative complications and mortality of aged patients, support targeted intervention strategies, and allow for a more comprehensive risk and benefit analysis, thereby forming an effective senile perioperative surgery management path. It is expected that the implementation of this protocol can reduce the occurrence of postoperative complications, improve the postoperative quality of life, shorten hospital stay, reduce hospitalization expenses, reduce social burden, and allow the elderly to have a good quality of life after surgery.Trial Registration: ChiCTR, ChiCTR1800020363 , Registered 15 December 2018. [ABSTRACT FROM AUTHOR]

Objective: To investigate the role of the supraorbital ethmoidal cell（SOEC） in identifying the frontal sinus ostium（FO） and the anterior ethmoidal artery（AEA） in endoscopic sinus surgery, and to evaluate the clinical significance of a proposed endoscopic classification of AEA. Methods: The clinical data of 116 patients with chronic rhinosinusitis were collected. Thirty-six patients（47 sides） with SOEC and DraftⅡA frontal sinusotomy were included. The radiological-anatomical relationship between SOECs and FO, AEAs were recorded. Endoscopic classification of AEA was proposed according to the relationship between the AEA and the ethmoidal roof（EF）: type 1, the AEA prominence did not extend beyond the lateral one-third of the EF; type 2, that exceed the lateral one-third but not beyond two-thirds of the EF; type 3, that exceed the lateral two-thirds of the EF. Results: The incidence of SOECs was 26.1%（47/180） of the DraftⅡA operating sides. On computed tomography images, seven sides of FO were occupied by supra agger frontal cells or supra bulla frontal cells; the other 40 sides（85.1%） were immediately anterior to the SOECs. The AEAs were 100% located near the posterior margins of SOECs with 6（12.8%） running under the EF and 41（87.2%） low-lying distant from the EF. Under endoscopy, the identification rate of SOECs was 89.4%（42/47）, and five（10.6%） SOECs were not confirmed due to edematous mucosa, bleeding, and other reasons. The identification rate of the AEA was 76.6%（36/47）, of which type 1, type 2 and type 3 accounted for 41.7%（15/36）, 38.9%（14/36） and 19.4%（7/36） respectively. After removing the frontoethmoidal cells, all the FO were located anteriorly or anteromedially to the SOECs. All the identified AEAs were located in the posterior boundary of the SOEC openings at the level of the anterior ethmoidal foramen. Conclusion: The SOEC is a reliable landmark for locating the FO and the AEA in endoscopic sinus surgery. The new endoscopic classification of AEA helps the surgeon dissect the frontoethmoidal region precisely., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)