[Organ preservation in locally advanced colorectal cancer with microsatellite instability-high after immunotherapy]

Neoadjuvant immunotherapy has achieved exciting efficacy with high clinical complete response (cCR) and pathologic complete response (pCR) rates and durable long-term effects. PD-1 checkpoint blockade-based immunotherapy has been highly successful in microsatellite instability high (MSI-H)/mismatch repair deficiency (dMMR) colorectal cancer and has been recommended as the first-line treatment for metastatic colorectal cancer by domestic and international guidelines. Several studies have shown that immunotherapy can be a potentially curable treatment for MSI-H rectal cancer and has even shown promise in organ preservation in colon cancer. In this study, we first clarified the feasibility of the watch-and-wait strategy after PD-1 checkpoint blockade treatment by indirect and direct evidence. Then from the assessment tools (including digital rectal examination, endoscopy, radiology, and lymph node assessment), the viable assessment methods of cCR for immunotherapy and related difficulties are proposed. Finally, the medication choices of immunotherapy, the treatment regimen, and the follow-up strategy are further discussed. We hope that neoadjuvant immunotherapy could be appropriately applied in MSI-H/dMMR colorectal cancer so that more patients can achieve organ preservation.

[Investigation on the awareness of snoring hazard and prevalence of obstructive sleep apnea among civil servants]

Objective: To investigate the awareness of snoring hazard and prevalence of obstructive sleep apnea (OSA) among civil servants. Methods: A cross-sectional survey was conducted to investigate the awareness of snoring hazards among in-service civil servants who had annual medical examination in a Guangdong provincial institution from September to November 2017. The high-risk group for OSA was screened and diagnosed by sleep monitoring. Results: 1 036 of 1 241 civil servants were enrolled in the study for integral data. 60.1% (623/1 036) of the subjects realized that snoring was harmful to health. The most common source to develop OSA awareness was network (59.6%, 371/623), followed by television (48.0%), relatives and friends (46.6%), newspaper (44.5%) and radio (18.9%). The awareness rate of snoring consequences was as follows: decreased sleep quality (71.9%, 448/623), sudden death (52.2%), daytime sleepiness (44.3%), cardiovascular and cerebrovascular diseases (42.9%), hypertension (24.4%) and sexual dysfunction (16.7%). 22.0% (228 / 1 036) of the cases were classified into high-risk OSA. The prevalence of OSA among high-risk group was 46.05%(105/228)and only 0.9% (2/228) of them had been diagnosed with OSA. Conclusion: Civil servants had awareness of snoring hazard to a certain extent. Among civil servants classified into high-risk OSA, the OSA perveance was high but the rate of diagnosis and treatment was very low.

Cardiovascular community control programs in Beijing

Cardiovascular community control program in Beijing started in 1969. In the past 20 years, eleven such programs had been established, covering a total population of 750,000. For those programs that have been operating for over 5-10 years, a marked drop in the mortality and morbidity rates of hypertension, stroke and acute myocardial infarction has been observed. It is proposed that this type of community control program should be further expanded in the next ten years so as to materialize the WHO goal of "Health for all by 2000".

Timed overnight sodium and potassium excretion and blood pressure in steel workers in North China

Three timed overnight urinary sodium (Na), potassium (K) and creatinine measurements, standardized to 8 h, as well as three blood pressures on corresponding consecutive days were obtained on a sample of 90 steel workers (40 men, 50 women) aged 34-56 years in Beijing, North China. For three indices of electrolyte excretion - absolute Na and K output/8 h, Na:K ratio and 8 h creatinine output - the ratios of intra- to inter-individual variations were less than 1.0 for men, but higher for women in contrast to findings for U.S. population groups of similar age. This fact, probably reflecting greater stability of day to day electrolyte intake by Chinese than Americans, enables reasonably precise characterization of dietary electrolyte intakes of individual Chinese, particularly men, with only a few timed overnight urine specimens. With 3-day mean values for each person, nominally significant (i.e. not adjusted for multiple testing) positive simple correlations were found for urinary Na, Na:K and Na:creatinine with blood pressure [both systolic (SBP) and diastolic (DBP)] for men; and women for Na:K with SBP and DBP, but Na:creatinine with SBP only. With control for age, body mass index and pulse in multivariate analyses, only the relationship of Na:K and Na:creatinine to SBP and DBP remained significant for men; a similar, though less strong and consistent, trend was found for women, and K was inversely related to SBP for women. These data are consistent with an association between habitual intake of sodium and risk of hypertension, and also suggest that habitual potassium intake may have a countervailing influence in this regard.

Long term survival of radiotherapy for esophageal cancer: analysis of 1136 patients surviving for more than 5 years

One thousand one hundred and thirty-six patients surviving for more than five years after radiotherapy were studied. The important prognostic factors are: lesion less than 5 cm in length, lesion located in the upper-third segment and lesion that is radiosensitive. The radiation dose given to long term survivors varies greatly, i.e., 2700 to 9300 rad. Yet, for the sensitive type of lesion, doses lower than 5000 rad could also effect a cure. The delivery of an optimum dose determined by serial examinations during radiotherapy could improve the result of treatment. For local recurrent lesions, the value of a second course of radiation is extremely limited and surgery is the only means to offer a cure. For metastasis in the lymph nodes, radiation offers some hope of cure, although the long term outcome may not be satisfactory. For second primary cancer of the esophagus, aggressive radiation still gives encouraging results.