Anatomy of lymphatic drainage of the esophagus and lymph node metastasis of thoracic esophageal cancer Yichun Wang,1 Liyang Zhu,1 Wanli Xia,2 Fan Wang1 1Department of Radiation Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui, P.R. China; 2Department of Thoracic Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui, P.R. China The lymphatic drainage of the inner layers (mucosa and submucosa) and the outer layers (muscularispropria and adventitia) of the thoracic esophagus is different. Longitudinal lymphatic vessels and long drainage territory in the submucosa and lamina propria should be the bases for bidirectional drainage and direct drainage to thoracic duct and extramural lymph nodes (LN). The submucosal vessels for direct extramural drainage are usually thick while lymphatic communication between the submucosa and intermuscular area is usually not clearly found, which does not facilitate transversal drainage to paraesophageal LN from submucosa. The right paratracheal lymphatic chain (PLC) is well developed while the left PLC is poorly developed. Direct drainage to the right recurrent laryngeal nerve LN and subcarinal LN from submucosa has been verified. Clinical data show that lymph node metastasis (LNM) is frequently present in the lower neck, upper mediastinum, and perigastric area, even for early-stage thoracic esophageal cancer (EC). The lymph node metastasis rate (LNMR) varies mainly according to the tumor location and depth of tumor invasion. However, there are some crucial LN for extramural relay which have a high LNMR, such as cervical paraesophageal LN, recurrent laryngeal nerve LN, subcarinal LN, LN along the left gastric artery, lesser curvature LN, and paracardial LN. Metastasis of thoracic paraesophageal LN seems to be a sign of more advanced EC. This review gives us a better understanding about the LNM and provides more information for treatments of thoracic EC. Keywords: esophageal carcinoma, lymphatic, lymph node metastasis,lymphadenectomy, radiotherapy

As a new type of pollutant, the harm caused by microplastics (MPs) to organisms has been the research focus. Recently, the proportion of MPs ingested through the digestive tract has gradually increased with the popularity of fast-food products, such as takeout. The damage to the digestive system has attracted increasing attention. We reviewed the literature regarding toxicity of MPs and observed that they have different effects on multiple organs of the digestive system. The mechanism may be related to the toxic effects of MPs themselves, interactions with various substances in the biological body, and participation in various signaling pathways to induce adverse reactions as a carrier of toxins to increase the time and amount of body absorption. Based on the toxicity mechanism of MPs, we propose specific suggestions to provide a theoretical reference for the government and relevant departments.

Colorectal cancer (CRC) is among the main tumor-related causes of death worldwide. The fact that the majority of the patients develop resistance to chemoradiotherapy (CRT) is a major obstacle for the treatment of CRC. In order to develop more effective treatment strategies, it is crucial to elucidate the mechanisms underlying the development of resistance to CRT. Several studies have recently indicated the regulatory effects of microRNAs (miRNAs) in response to antitumor agents. For example, miR-34a attenuates the chemoresistance of colon cancer to 5-FU by inhibiting E2F3 and SIRT1. The miR-34a mimic MRX34 is the first synthetic miRNA to have been entered into clinical trials. miR-21 prevents tumor cell stemness, invasion and drug resistance, which are required for the development of CRC. These findings suggest that miRNAs represent a focus in the research of novel cancer treatments aimed at sensitizing cancer cells to chemotherapeutic drugs. The aim of the present study was to review the functions of miRNAs and investigate the roles of miRNAs in CRC radioresistance or chemoresistance. Furthermore, the potential of including miRNAs in therapeutic strategies and using them as molecular biomarkers for predicting radiosensitivity and chemosensitivity was discussed.

Background: Because of the superficial and infiltrative spreading patterns of esophageal squamous cell carcinoma (ESCC), an accurate assessment of tumor extent is challenging using imaging-based clinical staging. Radiomics features extracted from pretreatment computed tomography (CT) or magnetic resonance imaging have shown promise in identifying tumor characteristics. Accurate staging is essential for planning cancer treatment, especially for deciding whether to offer surgery or radiotherapy (chemotherapy) in patients with locally advanced ESCC. Thus, this study aimed to evaluate the predictive potential of contrast-enhanced CT-based radiomics as a non-invasive approach for estimating pathological tumor extent in ESCC patients.Methods: Patients who underwent esophagectomy between October 2011 and September 2017 were retrospectively studied and included 116 patients with pathologically confirmed ESCC. Contrast-enhanced CT from the neck to the abdomen was performed in all patients during the 2 weeks before the operation. Radiomics features were extracted from segmentations, which were contoured by radiologists. Cluster analysis was performed to obtain clusters with similar radiomics characteristics, and chi-squared tests were used to assess differences in clinicopathological features and survival among clusters. Furthermore, a least absolute shrinkage and selection operator was performed to select radiomics features and construct a radiomics model. Receiver operating characteristic analysis was used to evaluate the predictive ability of the radiomics signatures.Results: All 116 ESCC patients were divided into two groups according to the cluster analysis. The chi-squared test showed that cluster-based radiomics features were significantly correlated with T stage (p = 0.0254) and tumor length (p = 0.0002). Furthermore, CT radiomics signatures exhibited favorable predictive performance for T stage (area under the curve [AUC] = 0.86, sensitivity = 0.77, and specificity = 0.87) and tumor length (AUC = 0.95, sensitivity = 0.92, and specificity = 0.91).Conclusions: CT contrast radiomics is a simple and non-invasive method that shows promise for predicting pathological T stage and tumor length preoperatively in ESCC patients and may aid in the accurate assessments of patients in combination with the existing examinations.

Respiration monitoring is a promising alternative to medical diagnosis of several diseases. However, current techniques of respiration monitoring often require expensive and cumbersome devices which greatly limit their medical applications. Here, we present a fully integrated wearable device consisting of a flexible LCP-copper interdigital electrode, a sensing layer and a wireless electrochemical analysis system. The developed humidity sensor exhibits a high sensitivity, a good repeatability and a rapid response/recover time. The long-term stability is over 30 days at different relative humidity. By integrating the flexible humidity sensor with miniaturized electrochemical analysis system (0.8 cm × 1.8 cm), response current concerning respiration can be wirelessly transmitted to App-assisted smartphone in real time. Furthermore, the fabricated humidity sensor can realize skin moisture monitoring in a touch-less way. The large-scale production of miniaturized flexible sensor (4 mm × 6 mm) has significantly contributed to commercial deployment.

The present study aimed to determine cyclooxygenase 2 (COX-2) and survivin expression levels in glioma tissues, and to investigate their association with clinicopathological factors and patient survival. Immunohistochemistry was performed to evaluate COX-2 and survivin expression levels in paraffin-embedded surgically resected tissues from 70 patients with glioma and 7 individuals with normal brain tissues. The association between COX-2 and survivin expression levels and clinicopathological features was investigated using the χ2 test, and the survival time was analyzed using the Kaplan Meier method with log-rank test. COX-2 and survivin were overexpressed in glioma tissues, and higher expression levels were observed in glioma tissues of histological grades III–IV compared with those in grade I–II tumor tissues (P0.05). There was a significant positive association between the expression levels of COX-2 and survivin in the glioma tissues. Additionally, COX-2 and survivin expression levels were significantly negatively correlated with the rate of survival. In conclusion, COX-2 and survivin expression is positively associated with the pathological grade of a glioma and may contribute to glioma tumorigenesis. Therefore, COX-2 and survivin may be sensitive predictors of a negative clinical prognosis for patients with glioma.