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The liver is a highly proliferative organ. As the liver injured, the hepatocytes can quickly enter the cell cycle to restore the volume and function of liver. Liver regeneration involves complex processes that depend on the interaction of many different cell types. As limited by the average cell change level in tissues, traditional sequencing methods can only acquire the average genetic information reflecting dominant cell subpopulations, but ignore the secondary cell subpopu-lations, which leads to the loss of cellular heterogeneity information. Single-cell sequencing tech-nology can analyze the biological behavior of single cell, which helps to better understand the distri-bution, interaction and cell heterogeneity of different cells during liver regeneration. The authors review the application of single cell sequencing technology in liver regeneration.
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@#Objective To investigate the prognostic survival status and influence factors for surgical treatment of esophageal squamous cell carcinoma (ESCC) in pathological stage T1b (pT1b). Methods The patients with ESCC in pT1b undergoing Ivor-Lewis or McKeown esophagectomy in Lanzhou University Second Hospital from 2012 to 2015 were collected, including 78 males (78.3%) and 17 females (21.7%) with an average age of 61.4±7.4 years. Results The most common postoperative complications were pneumonia (15.8%), anastomotic leakage (12.6%) and arrhythmia (8.4%). Ninety-three (97.9%) patients underwent R0 resection, with an average number of lymph node dissections of 14.4±5.6. The rate of lymph node metastasis was 22.1%, and the incidence of lymph vessel invasion was 13.7%. The median follow-up time was 60.4 months, during which 25 patients died and 27 patients relapsed. The overall survival rate at 3 years was 86.3%, and at 5 years was 72.7%. Multivariate Cox regression analysis showed that lymph node metastasis (P=0.012, HR=2.60, 95%CI 1.23-5.50) and lympovascular invasion (P=0.014, HR=2.73, 95%CI 1.22-6.09) were independent risk factors for overall survival of pT1b ESCC. Conclusion Esophagectomy via right chest approach combined with two-fields lymphadenectomy is safe and feasible for patients with pT1b ESCC. The progress of pT1b ESCC with lymph node metastasis or lymphovascular invasion is relatively poor.
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Objective:To evaluate the efficacy of artificial intelligence assisted pulmonary nodule diagnosis system in detection pulmonary nodule and predicting the malignant probability of pulmonary nodule.Methods:A retrospectively analyze the clinical data of 199 patients with lung nodules in the Thoracic Surgery Department of Lanzhou University Second Hospital from May 2016 to July 2020. The preoperative chest CT was imported into the artificial intelligence system to record the detected lung nodules, to measure nodal diameter and density classification and malignant probability prediction value of each nodule. The detection rate of pulmonary nodules by artificial intelligence system was calculated, and the sensitivity, specificity, positive likelihood ratio and negative likelihood ratio of artificial intelligence system in the differential diagnosis of benign and malignant pulmonary nodules were calculated and compared with manual film reading. and the sensitivity and specificity in the differential diagnosis of benign and malignant pulmonary nodules under the condition of different size and density of pulmonary nodules.Results:A total of 204 pulmonary nodules were pathologically diagnosed by surgical resection, and the detection rate of pulmonary nodules by artificial intelligence system was 100%. The artificial intelligence system can distinguish benign and malignant pulmonary nodules with a sensitivity of 95.83%(95% CI: 0.8967-0.9883), specificity 25.00%(95% CI: 0.1717-0.3425), and a positive likelihood ratio of 1.27(95% CI: 1.14-1.44), negative likelihood ratio 0.17(95% CI: 0.06-0.46), Manual reading for the differentiation of benign and malignant pulmonary nodules has a sensitivity of 87.36%(95% CI: 0.7850-0.9352), specificity 72.17%(95% CI: 0.6214-0.8079), and a positive likelihood ratio of 3.14(95% CI: 2.26-4.37), the negative likelihood ratio is 0.18(95% CI: 0.10-0.31). 5mm≤diameter of pulmonary nodule<10 mm, sensitivity 100%(95% CI: 0.6637-1.0000), specificity 50.00%(95% CI: 0.01258-0.98740), 10 mm≤diameter of pulmonary nodule <20 mm, sensitivity 94.29%(95% CI: 0.8084-0.9930), specificity 29.83%(95% CI: 0.1843-0.4340), 20 mm≤ diameter of pulmonary nodule ≤30 mm, sensitivity 96.15%(95% CI: 0.8679-0.9953), specificity 18.37%(95% CI: 0.0876-0.9953), sensitivity of subsolid lung nodules: 100%(95% CI: 0.9051-1.0000), specificity 20.00%(95% CI: 0.0051-0.7164), solid lung nodule sensitivity 93.22%(95% CI: 0.8354-0.9812), specificity 25.24%(95% CI: 0.1720-0.3476). Conclusion:The artificial intelligence assistant diagnosis system of pulmonary nodules has a strong performance in the detection of pulmonary nodules, but it can not meet the clinical requirements in the differentiation of benign and malignant pulmonary nodules. At present, the artificial intelligence system can be used as an auxiliary tool for doctors to detect pulmonary nodules and assist in the diagnosis of benign and malignant pulmonary nodules.
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Objective:To evaluate the effect of postoperative adjuvant therapy on patients with locally advanced pathologic T3N0M0 (pT3N0M0)esophageal squamous cell carcinoma(ESCC).Methods:In this retrospective study,we evaluated patients who underwent esophagectomy at Lanzhou University Second Hospital.Patients were divided into 4 groups:surgery-alone(S),surgery+radiotherapy group(S+RT),surgery+chemotherapy(S+CT),and surgery+chemoradiotherapy(S+CRT)groups.Both the clinicopathologic informa-tion and the long-term follow-up results were analyzed.Results:From January 2010 to April 2014,a total of 177 patients with a medi-an age of 61 years(range 43-78),were enrolled into the study.Among them,79 received surgery alone;the remaining 98 patients re-ceived adjuvant therapy,of whom 28 patients received adjuvant radiotherapy,38 received adjuvant chemotherapy,and 32 received ad-juvant chemoradiotherapy.Overall survival and disease-free survival were better in Group S+Adjuvant than in Group S(P=0.012,P=0.007,respectively).Comparisons among the four groups showed that the overall survival was higher in Group S+CRT than in Group S (P=0.031).Group S+RT was associated with better overall survival and disease-free survival than Group S(P=0.038,P=0.011,respec-tively).Conclusions:Patients with pT3N0M0 ESCC could benefit from adjuvant radiotherapy and chemoradiotherapy,as radiotherapy could help achieve better locoregional control.
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Objective To explore the clinical characteristics and perioperative treatment of chronic obstructive pulmonary disease (COPD) in patients with non-small-cell lung cancer (NSCLC) in department of thoracic surgery,and to guide the clinical diagnosis and treatment. Methods From January 2013 to December 2016,patients with newly diagnosed NSCLC treated in the thoracic surgical department of Lanzhou University Second Hospital were reviewed retrospectively. The patients were divided into the COPD group and non-COPD group. The clinical data,including the incidence and clinical characteristics of COPD in non-small-cell lung cancer,pulmonary complications after surgery,COPD diagnosis and perioperative pulmonary rehabilitation were analyzed retrospectively. Results A total of 726 NSCLC patients were reviewed,six hundred and seventy-five cases who took the full lung function test were included in the study,of which 95 cases received bronchial diastolic test,86 cases were accorded with COPD diagnosis and were included in incorporated COPD group,and 589 cases were in the non- incorporated COPD group. The proportion of men (69 cases,80. 2%,χ2 = 24. 032), age ≥65 (51 cases,59. 3%,χ2 = 6. 784),smoking history (55cases,64. 0%,χ2 = 29. 474) and a large number of smokers (43 cases,50. 0%,χ2 = 5. 802) and lung squamous cell carcinoma(47 cases,54. 7%,χ2 = 6. 241) in the incorporated COPD group were higher than those in differences were statistically significant (P<0. 05); the incidence of pulmonary complications after radical resection of lung cancer in the incorporated COPD group was 23. 9% (16/ 67),which was significantly higher than that in the unincorporated COPD group(13. 7% (78/568)) (χ2 = 4. 894,P<0. 05). The incidence of pulmonary complications in the lung rehabilitation group was 13. 5% ( 5/37) , lower than that of the non-lung rehabilitation group ( 36. 7% ( 11/30 ) ) (χ2 = 4. 886, P<0. 05);Among the 86 cases (12. 7%) of incorporated COPD,only 6 cases (8. 9 ‰) were diagnosed with COPD at the time of admission, and 23 cases ( 3. 4%) at discharge. No COPD guidelines were given. Conclusion NSCLC often combined wtith COPD,especially in males,elders (≥65 years old) ,smokers, squamous cell carcinoma patients. At present,the diagnosis and treatment of co-morbidity of COPD is seriously inadequate,which needs to be paid much attention to by the thoracic surgeons,in order to improve the diagnosis and treatment of COPD,and improve the prognosis of the patients with NSCLC and COPD.
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Objective To summarize the clinical experiences of video-mediastinoscopy followed by stenting procedure in treating the superior vena cava syndrome (SVCS),and to investigate their application significant.Methods Nine patients with SVCS without clear histologic diagnosis before procedure were reviewed retrospectively,who were admitted into hospital from November 2007 to October 2013.All of 9 patients were received video-mediastinoscopy and they did not performed pathological check.They were placed the endovascular stent.Results Video-mediastinoscopy followed by stenting procedure 6 cases,parasternal TN mediastinoscopy 2 cases,joint neck and parasternal TV mediastinoscopy 1 case.Nine cases have received a clear pathological diagnosis.There was no death case in-hospital.The operative complication was hemorrhage of 1 case.The cubital venous pressures were (18.6±5.1) cmH2O at stending,(13.5±3.3) cmH2O,(11.3±2.5) cmH2O,(10.3± 2.0) cmH2O at 24,48,72 h after stending,and down to the normal at 72 h (F =67.245,P ＜0.01).The clinical symptoms were obviously relieved.All of them were remained free from SVCS during the follow-up.Conclusion The hybrid procedure of video-mediastinoscopy followed by stenting placement is a highly effective and safe treatment.It can accurately provide informations on diagnosis and treatment.
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Objective To explore the CT manifestations,incidence,etiology and clinical significance of hyperostosis frontalis in-terna (HFI).Methods CT features of 243 cases HFI were analyzed retrospectively.Based on the maximum thickness of the inner table of the frontal bone,HFI was classified into 4 grades as follows:GradeⅠ─ thickness of 2.8-6.0 mm,GradeⅡ─ thickeness of 6.1-10.0 mm,Grade Ⅲ ─ thickness of 10.1-14.0 mm,Grade Ⅳ ─ thickness of greater than 14.1 mm.According to the in-crassating direction,HFI was classified into inward,outward and intermediate type.Results The inner table of the frontal bone was incrassated in all cases (n=243).The thickness ranged between 2.93 mm and 14.64 mm,including GradeⅠin 68 cases (28.0%), GradeⅡin 71 cases (29.2%),Grade Ⅲ in 69 cases (28.4%)and Grade Ⅳ in 35 cases (14.4%).There were inward type in 82 ca-ses (33.7%),outward type in 59 cases (24.3%)and intermediate type in 102 cases (42.0%).The incidence of HFI was 5.47% in postmenopausal women,with 7.14% in overweight and 9.09% in obese women respectively.Conclusion HFI is common in the postmenopausal women,and CT manifestations of HFI are characteristic.