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@#Objective To analyze the correlation between folate receptor-positive circulating tumor cells (FR+CTC) and the benign or malignant lesions of the lung, and to establish a malignant prediction model for pulmonary neoplasm based on clinical data, imaging and FR+CTC tests. Methods A retrospective analysis was done on 1 277 patients admitted to the Affiliated Hospital of Qingdao University from September 2018 to December 2019, including 518 males and 759 females, with a median age of 57 (29-85) years. They underwent CTC examination of peripheral blood and had pathological results of pulmonary nodules and lung tumors. The patients were randomly divided into a trial group and a validation group. Univariate and multivariate analyses were performed on the data of the two groups. Then the nomogram prediction model was established and verified internally and externally. Receiver operating characteristic (ROC) curve was used to test the differentiation of the model and calibration curve was used to test the consistency of the model. Results Totally 925 patients suffered non-small cell lung cancer and 113 patients had benign diseases in the trial group; 219 patients suffered non-small cell lung cancer and 20 patients had benign diseases in the verification group. The FR+CTC in the peripheral blood of non-small cell lung cancer patients was higher than that found in the lungs of the patients who were in favorite conditions (P<0.001). Multivariate analysis showed that age≥60 years, female, FR+CTC value>8.7 FU/3 mL, positive pleural indenlation sign, nodule diameter, positive burr sign, consolidation/tumor ratio<1 were independent risk factors for benign and malignant lung tumors with a lesion diameter of ≤4 cm. Thereby, the nomogram prediction model was established. The area under the ROC curve (AUC) of the trial group was 0.918, the sensitivity was 86.36%, and the specificity was 83.19%. The AUC value of the verification group was 0.903, the sensitivity of the model was 79.45%, and the specificity was 90.00%, indicating nomogram model discrimination was efficient. The calibration curve also showed that the nomogram model calibration worked well. Conclusion FR+CTC in the peripheral blood of non-small cell lung cancer patients is higher than that found in the lungs of the patients who carry benign pulmonary diseases. The diagnostic model of clinical stage Ⅰ non-small cell lung cancer established in this study owns good accuracy and can provide a basis for clinical diagnosis.
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@#Objective To analyze the characteristics and risk factors of lymph node metastasis in thoracic esophageal squamous cell carcinoma (ESCC). Methods The clinical data of 407 patients with ESCC who underwent radical resection of esophageal carcinoma from December 2012 to October 2018 in our hospital were retrospectively analyzed. There were 390 males and 17 females with a median age of 63 (38-82) years. Esophageal lesions were found in 26 patients of upper thoracic segment, 190 patients of middle thoracic segment and 191 patients of lower thoracic segment. Results Among the patients, 232 (57.0%) were found to have cervical, thoracic and/or abdominal lymph node metastasis. The lymphatic metastasis rates of cervical, upper, middle, lower mediastinal nodes and abdominal nodes were 0.7%, 8.8%, 21.4%, 16.7% and 37.1%, respectively. The adjacent lymph node metastasis alone occurred in 50.0% patients, and the multistage or skip lymph node metastasis accounted for 29.3% and 20.7%, respectively. Multivariate analysis showed that the length of esophageal lesion, T stage, degree of tumor differentiation, vascular cancer embolus and nerve invasion were independent risk factors for lymph node metastasis. Conclusion The rates of lymph node metastasis are similar in the upper, middle and lower thoracic ESCC. The main pattern of lymph node metastasis is the adjacent lymph node metastasis, followed by multistage and skip lymph node metastases. The length of esophageal lesion, T stage, degree of tumor differentiation, vascular cancer embolus and nerve invasion are independent factors for lymph node metastasis. The operation and dissection range should be selected according to the location of tumor and the characteristics of the lesion.
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Objective:To analyze the predictive factors of GGU between biopsy and radical prostatectomy pathology based on 2014 ISUP grouping system, then establish and evaluate nomogram.Methods:Patients undergoing radical prostatectomy in Shanghai Ruijin Hospital from March 2012 to March 2019 were reviewed, and the clinical and pathological information were collected. Age(68.1±7.2), body mass indes(BMI) (24.2±3.2)kg/m 2, prostate specific antigen(PSA) 11.5(6.7-20.4)ng/ml, prostate specific antigen destiny(PSAD) 0.35(0.20-0.66). Before March 2017, the number of biopsy cores were 6 to 8; After then, all patients toke 12 cores systemic biopsy. Based on 2014 ISUP grouping system, the differences between biopsy and radical prostatectomy grades were counted. The independent predictors of GGU were analyzed by univariate and multivariate logistic regression analysis, then the nomogram for predicting GGU were established and evaluated. Results:429 patients were enrolled. There were 161 (37.5%) patients in GGU group and 268 (62.5%) patients in non-GGU group. After multivariate logistic regression analysis, body mass index (BMI)>28 kg/m 2( OR=2.54, P=0.021), prostate specific antigen density (PSAD)( OR=1.65, P=0.018)and 2014 ISUP grouping sysyem ( OR=0.53, P<0.001) of biopsy specimen were independent impact factors of GGU. The predicting model was established according to BMI, PSAD and 2014 ISUP grouping system. The area under the ROC cure of the model was 0.735 (95% CI 0.681-0.789). The nomogram model was well calibrated, with the mean absolute error of 6.7%, which means the prediction of GGU is fairly consistent with the actual situation. Conclusions:Based on the 2014 ISUP grouping system, BMI>28 kg/m 2, PSAD and 2014 ISUP grouping of biopsy specimen were independent predictors of GGU. The nomogram model for predicting GGU has a good statistical significance.
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In recent years, the incidence and detection rate of lung cancer have gradually increased, and segmentectomy has been increasingly used to treat early non-small cell lung cancer. Some scholars believe that segmentectomy is more conducive to the preservation of postoperative lung function than lobectomy. Some studies have found that the two surgical methods have little difference in postoperative cost retention. This article deals with segmentectomy and lobectomy. A review of related studies on postoperative pulmonary function changes. .
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Humans , Lung , General Surgery , Lung Neoplasms , General Surgery , Pneumonectomy , Methods , Recovery of FunctionABSTRACT
Objective To evaluate the performance of the Sendai Guidelines,Fukuoka Guidelines and Pancreatic Cystic Lesions Management Guidelines (Chinese guidelines) in predicting malignant mucinous pancreatic cystic neoplasms (PCN).Methods A retrospective analysis of 196 patients,who received surgery and were pathologically identified as PCN or intraductal papillary mucinous neoplasms (IPMN),underwent surgical resection in Ruijin Hospital affiliated with Shanghai Jiao Tong University from January 2003 to April 2017 was performed.The differences on clinical and pathological parameters between malignant mucinous and benign mucinous PCN were compared.The accuracy,sensitivity,specificity,positive predictive value (PPV)and negative predictive value (NPV) of the indications for surgery in the Sendai,Fukuoka and Chinese Guidelines in predicting malignant mucinous PCN were calculated.Results Of 196 patients,39 patients (19.9％) were confirmed as malignant tumors and 157 patients (80.1％) were confirmed as benign tumors by pathology.There were significant differences on age,symptoms (abdominal pain,jaundice or pancreatitis),tumor solid composition,pancreatic duct diameter,tumor site,tumor diameter ＞3 cm,and serum CA199 level between malignant and benign patients (all P ＜0.05).But there were no significant differences on gender distribution,tumor diameter,mural nodules and the proportion of mucinous cystic neoplasm (MCN)and intra-ductal papillary mucinous neoplasm (IPMN).165 patients (84.2％) met the Sendai Guidelines,153 patients (78.1％) met the Chinese guideline,and only 61 patients (31.1％) met the Fukuoka Guidelines.All 39 patients with malignant tumors met the indications in Sendai Guidelines and Chinese guidelines,and only 35 patients had the indication for surgery in the Fukuoka Guidelines.The accuracy,sensitivity,specificity,PPV and NPV of the Fukuoka Guidelines for predicting the malignancy were 84.7％,89.7％,83.4％,57.4％ and 97.0％,compared to 35.7％,100％,19.8％,23.6％ and 100％ for the Sendai and 41.8％,100％,27.4％,25.5％ and 100％ for the Chinese guidelines,respectively.Conclusions The performance of the Chinese guideline is slightly better than the Sendai Guidelines,while both of them can lead to a larger number of patients undergoing unnecessary surgical resection.Though the rate of missed diagnosis could reach 10.3％,the Fukuoka Guidelines gets the highest accuracy.
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Redox state indicated by reactive oxygen species (ROS) level is a cellular physiological feature.Redox status is exactly controlled by conserved system.Its alterations consequently modulate various biological activities and play important roles in cells and organism under physiological and pathological conditions.Hence detection of redox state is deemed as an important technique both in basic and clinical researches.The present article reviews the principle and current applications of fluorescent probes or sensors for redox detection.With comparison of properties of various probes,especially genetic coding fluorescence probes,much understanding will be gained.And the review helps us to understand how to apply the redox probes on the biological and clinical researches and eventually look forward to new applications in the cell and whole animal level.
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Objective·To test the application of flow cytometry technique to detect the redox status with genetically encoded fluorescent probe roGFP2,to compare it with laser scanning confocal microscope (LSCM),and to demonstrate the diversity of cellular redox status in HeLa and Pane-1 cell populations.Methods·Time lapse imaging with LSCM was performed in single cell transfected with roGFP2 probe to detect the dynamic changes of 405 nm/488 nm ratio (405/488 ratio).Flowcytometry technique was also performed in HeLa cells transfected with roGFP2 probe to detect the dynamic alterations of 405/488 ratio.The global cell population was analyzed and the subpopulations of different redox status were dissected.Flowcytometry technique was further applied in Panc-1 cells with different CD24 or CD44 marker to detect the dynamic alterations of 405/488 ratio of roGFP2 and identify the different redox status.Results·Thne lapse imaging with LSCM showed that 405/488 ratio of roGFP2 dramatically changed in response to H2O2in dose and time dependent manner at a single cell level.When dozens of cells were chosen,the average ratio showed increased and dynamic trend.Compared to LSCM,flow cytometry could detect the average of 405/488 ratio of roGFP2 as well.Meanwhile,with the application of flow cytometry the cell population can be divided into three subpopulations based on 405/488 ratios,most in oxidized and medium redox status,few in reduced status.Using flow cytometry,CD24+/CD44+ Panc-1 ceils,pancreatic cancer stem ceils,can be found to have overall lower 405/488 ratio and more percentage of subpopulation of reduced status under resting and stress condition.Conclusion·Flow cytometry technique can be applied to detect roGFP2 and has advantage in application to show the overall as well as diverse redox status in cell population.Flow cytometry detection of cellular redox status with genetically encoded probe can be a useful tool in tumor cell biology and developmental biology research.
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WHO 2015 Lung Tumor Histologic Typology presents spread through air spaces (STAS).Before,some scholars have realized this pathological feature.STAS is considered associated with the prognosis of lung cancer patients.This article reviews the progress of STAS and prognosis of patients with lung cancer.
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Redox state indicated by reactive oxygen species (ROS) level is a cellular physiological feature. Redox status is exactly controlled by conserved system. Its alterations consequently modulate various biological activities and play important roles in cells and organism under physiological and pathological conditions. Hence detection of redox state is deemed as an important technique both in basic and clinical researches. The present article reviews the principle and current applications of fluorescent probes or sensors for redox detection. With comparison of properties of various probes, especially genetic coding fluorescence probes, much understanding will be gained. And the review helps us to understand how to apply the redox probes on the biological and clinical researches and eventually look forward to new applications in the cell and whole animal level.
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Objective· To assess the clinical outcome of catheter ablation guided by remote magnetic navigation(RMN) for ventricular arrhythmias (Vas) including ventricular tachycardia (VT) and ventricular premature complex (PVC) originating from ouflow tract (OT). Methods · A total of 42 patients with idiopathic VT/PVC originated from outflow tract were enrolled. All the patients underwent catheter ablation guided by RMN and 3D Carto mapping system. OT-Vas were divided into two groups:right ventricular outflow tract(RVOT) group and left ventricular outflow tract(LVOT) group. Vas arising from LVOT were mapped and ablated by transaortic retrograde and/or transseptal puncture approaches. The primary study endpoint was acute success rate. The secondary study endpoints were procedure-related parameters, including operator X ray time, ablation time, procedure time and complications. Vas recurrence was detected by Holter electrocardiograph (ECG) which was followed-up at 3 months, 6 months and 1 year after ablation. Results · 74% (31/42) Vas arised from RVOT. 93% (39/42) OT-Vas were achieved acute success. The acute success rate was not different between Vas from RVOT and LVOT (30/31 vs 9/11,P=0.160).Compared to LVOT group,the ablation time and fluoroscopic time of RVOT group were significantly reduced s by 31%(P=0.020) and by 33% (P=0.004). There was no major complication in two groups. Within the 11 cases of LVOT-Vas, 4 LVOT-Vas cases which were ablated by tansaortic retrograde with failure were transferred to transseptal approach and ablated successfully. At one-year follow-up, frequent PVCs recurred in 2 out of 39 patients with acute success. Conclusion · Catheter ablation using RMN for OT-Vas is safe and effective with relatively short operator's X-ray time. For LVOT-Vas, mapping and ablation guided by RMN through transseptal approach can improve the acute success rate.
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@#ObjectiveTo explore the influence of breath muscles functional training on convalescent patients with chronic obstructive pulmonary disease(COPD).Methods56 COPD patients had breath muscles functional training for 1 year and clinical indexes,including cold time,time in hospital,hemoglobin,blood gas analysis and hemorheology were observed.ResultsAfter breath muscles functional training,the cold time and time in hospital had shortened;hemoglobin,blood gas analysis and hemorheology of patients had ameliorated obviously(P<0.01).ConclusionBreath muscles functional training has affirmatively effect of boosting up corporeity,ameliorating lack of oxygen,adjusting internal environment on convalescent patients with COPD.
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0.05).The CC10 levels in lung homogenate of the allergic asthma group were significantly decreased than that of control group(P0.05).Conclusion The CC10 levels in lung homogenate is decreased,and has negative correlation with AIPs,which suggests that CC10 may take part in the onset of asthma,and work as an important endogenous anti-inflammatory factor.