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BACKGROUND@#With the increase of lung cancer screening, more and more patients have been diagnosed as sub-centimeter (≤1 cm) lung adenocarcinoma. Sub-centimeter lung adenocarcinoma is mostly early stage lung cancer, but the research on sub-centimeter lung adenocarcinoma is still insufficient. This study analyzed the clinical characteristics and prognosis of patients with sub-centimeter lung adenocarcinoma in order to provide the basis for the diagnosis and treatment of such patients.@*METHODS@#A retrospective study was performed to analyze patients with sub-centimeter lung adenocarcinoma who underwent VATS in Peking University People's Hospital from January 2012 to December 2016. Patients were divided into pure ground-glass nodules (pGGN) group, mixed ground-glass nodules (mGGN) group and solid nodules (SN) group according to the features of nodular imaging. The clinical characteristics of the three groups were compared and the subgroup analysis of nodules in different diameter was performed. We also performed multivariate logistic regression analyses to identify the risk factors for sub-centimeter lung invasive adenocarcinoma.@*RESULTS@#The study included 182 patients (57 men and 125 women) with a median age of 54 (27-75) years. Female sub-centimeter lung adenocarcinoma patients had a significantly lower proportion of non-smoking history than males (P5 mm (OR=4.241, P=0.001) were independent risk factors for sub-centimeter lung invasive adenocarcinoma. The median follow-up time was 44 (22-82) months. The 5-year recurrence-free survival rate was 100.0% and the overall survival rate was 98.9%.@*CONCLUSIONS@#Patients with sub-centimeter lung adenocarcinoma have a relatively earlier onset age. Sub-centimeter lung invasive adenocarcinoma patients with 6 mm-10 mm mGGN and 6 mm-10 mm SN may be involved in pleural invasion or lymph node metastasis. Smoking history, previous tumor history, mGGN, SN and tumor diameter >5 mm are independent risk factors for sub-centimeter lung invasive adenocarcinoma. For patients with sub-centimeter lung adenocarcinoma, early detection and appropriate surgical intervention can lead to a good prognosis.
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Abstract: Pellagra is a nutritional disease caused by a deficiency of niacin. It may lead to death if not identified and treated timely. We review the literature and report a female patient presented with clinical features of pellagra as a complication of Crohn's disease.
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Humans , Female , Middle Aged , Pellagra/etiology , Crohn Disease/complications , Pellagra/pathology , Pellagra/drug therapy , Skin/pathology , Biopsy , Crohn Disease/drug therapy , Treatment Outcome , Keratosis/etiology , Keratosis/pathology , Keratosis/drug therapyABSTRACT
Objective To develop an easy-to-use nomogram to assist clinicians in predicting major postoperative morbidity in those non-small-cell lung canccr patients who underwent VATS lobectomy.Methods A perspective multi-center study was developed to analyze the major postoperative complications of 612 non-small-cell lung cancer patients who underwent VATS lobectomy.Muhivariable logistic regression was used to model postoperative morbidity and built the nomogram to accurately predict the major complications.Results There were 606 (99％) survivors and 6 (1％) mortality.A total of 32 patients suffered from major complications.Using logistic regression to predict major complications,preoperative model for ASA score,age ≥70 years and operation time ＞ 150 nin were found to be the significant predictors(P ＜ 0.05) of morbidity and were included in our model.Conclusion We propose a nomogram to enable clinicians to better estimate morbidity in patients with VATS lobectomy.
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Objective Fecal biomarkers have emerged as an important tool for assessing and monitoring disease activity in patients with inflammatory bowel disease ( IBD) .We aimed to investigate the diagnostic value of fecal neopterin and calprotectin in pa-tients with active inflammatory bowel disease and made comparison with that of serum C-reactive protein ( CRP) . Methods A total of 151 consecutive patients with IBD (84 CD and 67 UC) provided 2 gram fecal samples for the measurement of fecal neopterin( FNP) and calprotectin( FCP) concentrations and 2 milliliter blood samples for the serum C-reactive protein measurement before undergoing a colonoscopy.ELISA was applied in the measurement.Clinical disease activities were scored independently according to the Best Crohn′s Disease Activity Index(CDAI) in patients with CD, while the Modi-fied Mayo Scores in patients with UC.Comaprison was made in the relativity of each fecal marker and IBD activity score, the optimum value of diagnosing IBD acitivity as to each fecal marker, as well as sensitivity, specificity, moreover, receiver operating characteristic curve ( ROC) was drawn.50 healthy volunteers who received a normal colonoscopy were also enrolled as the control group and asked to give a 2 gram fresh stool sample. Results The FNP and FCP concentrations in patients with IBD were significantly higher than those in healthy control group(P<0.05).Both FNP and FCP concentrations differed significantly in clinically active IBD when compared with those in patients with inactive disease( P<0.001) .In CD patients, the correlation coefficients of FNP and FCP with CDAI were 0.55 and 0.59, respectively(P<0.001).In UC patients, the correlation coefficients of FNP and FCP with Mayo scores were 0.74 and 0.77, respectively( P<0.001) .The correlation coefficients of serum CRP in CD and UC patients with clinical scores were 0.49 and 0.60, respectively(P<0.001).The area under the ROC curve(AUC) of FNP and FCP for the diagnosis of clinical activity in pa-tients with CD were 0.75 and 0.80, respectively.The AUC of FNP and FCP in UC patients were 0.85 and 0.90, respectively.The AUC of serum CRP in patients with CD and UC were 0.65 and 0.74, respectively.When combined FNP with FCP, the AUC in pa-tients with CD and UC were 0.85 and 0.92, respectively. Conclusion FNP is a novel reliable and non-invasive biomarker to evalu-ate clinical disease activity in patients with IBD as accurate as FCP, It is advisable to combine FNP with FCP to evaluate disease activi-ty in patients with IBD.
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Background:Intestinal permeability plays an important role in the development of ulcerative colitis. Sugar molecular probes is a safe and non-invasive method to measure intestinal permeability,and its correlation with inflammatory factors and claudin-8 is not clear. Aims:To explore the correlation of sugar molecular probes with TNF-α,CRP and claudin-8 in intestinal permeability in colitis rats. Methods:Twenty-four rats were assigned randomly to model group and normal control group. Colitis model was induced by DSS solution. Expressions of TNF-α,CRP were determined by ELISA,and expression of claudin-8 was determined by immunohistochemistry. Sugar molecular probes were determined by high performance liquid chromatography. Correlations of inflammatory factors and claudin-8 with sugar molecular probes were analyzed. Results:Compared with normal control group,expressions of colonic tissue TNF-α and CRP were significantly increased while expression of claudin-8 was significantly decreased in model group(P < 0. 01);secretion of lactulose and sucrolose,ratio of lactulose/ mannitol( L/ M)were significantly increased( P < 0. 01)while mannitol secretion was significantly decreased(P < 0. 01). Secretion of lactulose and sucrolose were positively correlated with expressions of TNF-α and CRP(P < 0. 01),but negatively with expression of claudin-8(P < 0. 01). L/ M ratio and mannitol secretion were negatively correlated with expressions of TNF-α and CRP(P < 0. 01),but positively with expression of claudin-8(P <0. 01). Conclusions:Sugar molecular probes and expressions of TNF-α,CRP,claudin-8 have similar results in predicting intestinal permeability in rats. Sugar molecular probes can be used as a potential method to measure intestinal permeability.
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Background:Abnormal immune response is involved in the pathogenesis of Crohn’s disease( CD),and T lymphocytes are the main players in the immune response. Aims:To investigate the relationship between peripheral blood CD3 + ,CD4 + and CD8 + T cells and inflammation-related markers in patients with CD. Methods:Proportions of peripheral blood CD3 + ,CD4 + and CD8 + T cells were measured by flow cytometry in 26 CD patients( including 14 patients in active stage and 12 in remission stage )and 8 healthy volunteers(control group),and their correlation with inflammation-related markers(including white blood cell count,platelet count,ESR,CRP,albumin and hemoglobin) were analyzed. Results:Proportions of CD3 + ,CD4 + and CD8 + T cells were significantly increased in patients with active CD than those with remission CD and controls( P ﹤ 0. 05),however,no significant differences were found between remission CD patients and controls(P ﹥ 0. 05). ESR and CRP in active CD patients were significantly higher than those in controls(P ﹤ 0. 05),while albumin and hemoglobin levels were significantly decreased(P ﹤ 0. 05);albumin in remission CD patients was significantly lower than that in controls(P ﹤ 0. 05). No significant differences in white blood cell count and platelet count were found between active,remission CD patients and controls(P ﹥ 0. 05). Proportions of CD3 + , CD4 + and CD8 + T cells were positively correlated with CRP,and negatively correlated with hemoglobin( P ﹤ 0. 05);CD3 + and CD4 + T cells were positively correlated with ESR(P ﹤ 0. 05). However,CD3 + ,CD4 + and CD8 + T cells were not correlated with white blood cell count,platelet count and albumin level( P ﹥ 0. 05). Conclusions:Proportions of peripheral blood CD3 + ,CD4 + and CD8 + T cells are increased with the increase of disease activity in CD,and are positively correlated with CRP,and negatively correlated with hemoglobin.
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Objectives:To study the effects of gene therapy with tissue type plasminogen activator(t PA)cDNA on the formation of thrombo embolism in vascular anastomotic sites. Methods:①The cDNA encoding t PA was amplified by RT PCR using the isolated total RNA as the template from the Bowes melanoma cells.②Recombinant plasmid pAdCMV t PA was cotransfected into 293 cells with pJMa 17 ,and the infectious but replication deficient AdCMV t PA was generated.③The rats were randomly divided into the control and treatment groups.11 0 nylone medical suture was applied to perform rat carotid artery end to end anastomoses.In the treatment group,AdCMV t PA solution was injected into the vascular anastomotic site while AdCMV (no containing t PA DNA) solution was injected into the control group. By means of RT PCR and chromogenic plasmin substrates,the following results were obtained. Results:①The t PA cDNA was successfully cloned and its eukaryotic expressing vector was constructed.②When the isolated RNA was performed with RT PCR,1.69 kb band appeared in the treatment group while the band could not be found in the control group.The t PA activity could be detected postoperatively on the 1st,2 nd,3 rd,4 th,5 th,6 th,7 th,10 th and 13 th day of the treatment,but could not be detected in the control group. Conclusions:The t PA gene can produce t PA having biological activity at anastomotic sites, possibly prevent the formation of thrombus embolism effectively and develop the anastomotic patency.