[Surgical management of gastric cancer in the era of immunotherapy].

With the widespread application of immune checkpoint inhibitors, chemotherapy combined with immunotherapy has shown promising efficacy in the treatment of various cancers. Especially gastric cancer, this strategy is gradually expanding from first-line treatment in advanced stages to perioperative management. Compared to neoadjuvant chemotherapy alone, the combined approach not only improves pathological regression but also leads to better downstaging, which is particularly significant in gastric cancer subsets that are HER2-positive, mismatch repair deficient, PD-L1 combined positive score ≥5, or EB virus-positive. This combined treatment has made it possible to reduce the extent of gastrectomy, perform function-preserving surgeries, or even consider non-surgical strategies. Currently, exploring the optimal protocols for combining immune checkpoint inhibitors with chemotherapy, identifying potential indications for function-preserving surgery, improving surgical methods, and developing non-surgical strategies represent key issues in the surgical management of gastric cancer in the era of immunotherapy.

[Taste dysfunction analysis in patients with allergic rhinitis].

Objective:To investigate the taste dysfuction and its features in patients with allergic rhinitis,and to study its influence on quality of life.Method:Three hundred and five consecutive cases were enrolled. Rhino conjunctivitis Quality of Life Questionnaire, visual analogue scale and Lund-Kennedy nasal endoscopy scores were used to assess the taste dysfunction. In addition, taste test with paper strips was used to evaluate the four basic tastes of the twenty patients with severity dysfuction VAS.Result:Taste dysfuction accounted for 18.03% (55/305) in all allergic rhintis, while hypogeusia and hypergeusia were 98.18% (54/55), 1.82% (1/55) respectively. There were significant differences of RQLQ scores in taste dysfuction group compared to no taste dysfunction group, there were positive correlated relationship, but no difference between taste function and nasal VAS scores nor Lund and Kennedy nasal endoscopy scores. Saline taste, bitter taste, sweet taste and sour taste were impaired in AR, thus, saline taste was more diminishes than another three (P< 0.05). Conclusion:Taste dysfunction is common symptom in allergic rhinitis, mainly including hypogeusia, especially saline taste.Taste dysfunction can impact patients'quality of life.

[Investigation on the expression of microvessel pericyte coverage index and lymph vessel density in nasal polyps].

Objective: To investigate the role of lymph vessel density (LVD) and microvessel pericyte coverage index (MPI) in the pathogenesis of nasal polyps. Methods: Using immunohistochemistry and immunofluorescence double staining method, the expressions of albumin, D2-40 and CD34-α-SMA in 11 specimens of normal nasal mucosa, 26 specimens of nasal polyp and 26 specimens of inferior turbinate tissue from patients with nasal polyps were investigated. The counts of microvessel density (MVD), lymph vessel density (LVD) and microvessel pericyte coverage index (MPI) were compared. SPSS 17.0 software was used to analyze the data. Results: The nasal polyp group(0.269±0.096) had more albumin than inferior turbinate tissue group(0.159±0.078) and normal nasal mucosa group(0.138±0.045), the differences were significant (q value was 4.873, 4.446, both P<0.05). The counts of MVD in nasal polyp group (30.52±4.42) were not significantly higher than those in inferior turbinate tissue group (30.33±6.03) and normal nasal mucosa group(28.21±6.84), the differences were not significant (q value was 0.130, 1.147, both P>0.05). The MPI in nasal polyp group (0.291±0.096) was significantly lower than those in inferior turbinate tissue group(0.432±0.101) and normal nasal mucosa group(0.416±0.071), the difference was significant (q value was 5.399, 3.680, both P<0.05). The counts of LVD in the nasal polyp group(0.245±0.073) were significantly lower than those in inferior turbinate tissue group (0.431±0.054) and normal nasal mucosa group(0.470±0.078), the difference was significant (q value was 10.004, 9.328, both P<0.05). MPI expression in the nasal polyp group was negetively correlated to albumin expression(r=-0.889, P<0.05). The LVD expression in the nasal polyp group was negetively correlated to albumin expression(r=-0.901, P<0.05). Conclusion: Different LVD and MIP in nasal polyp tissues and normal nasal mucosa tissues imply that microcirculatory dysfunction plays a crucial role in the pathogenesis of nasal polyps.

[The significance and expression of vascular endothelial growth factor on nasal inverted papillomas].

OBJECTIVE: To determine the expression of vascular endothelial growth factor (VEGF) and its receptor in nasal inverted papillomas (NIP) and to clarify the function of VEGF in the establishment of NIPs. METHOD: VEGF and its receptor, fetal liver kinase-1 (flk-1) expression were examined by immunohistochemistry using SP method in sections of NIPs from 11 patients and inferior turbinates from 6 patients with chronic simple rhinitis. An automatic image analyzer was used to detect the staining results. Gray scale, a half-quantitative parameter, was used to describe the expression of VEGF and flk-1. RESULT: It showed that all the epithelium in NIPs, together with vascular and stroma adjacent to the epithelium, expressed different degree of VEGF. The VEGF expression in epithelium was significantly stronger in NIPs than that in inferior turbinates (P < 0.001). The expressions of both VEGF and flk-1 in vascular endothelium were more intense in NIPs than that in inferior turbinates (P < 0.001, P < 0.001). Flk-1 positive expression was observed in epithelium of NIPs but not in inferior turbinates. CONCLUSION: The results suggest that VEGF participate in the growth of NIPs, part of which shows the characteristics of containing plenty of blood vessels and being bloody in operation. The enhanced expression of VEGF may also play a key role in the development of edematous stroma. The expression degree of VEGF in the epithelium may be identified as one of the parameters of judging the propensity of NIPs' malignant transformation.