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@# In recent years, the number of lung surgeries has increased year by year, and the number of patients with postoperative cough has also increased gradually. Chronic cough after lung surgery seriously affects patients' quality of life and surgical outcome, and has become one of the clinical problems that clinicians need to solve. However, there is currently no guideline or consensus for the treatment of chronic cough after lung surgery in China, and there is no standardized treatment method. Therefore, we searched databases such as PubMed, Web of Science, CNKI, and Wanfang databases ect. from 2000 to 2023 to collected relevant literatures and research data, and produced the first expert consensus on chronic cough after lung surgery in China by Delphi method. We gave 11 recommendations from five perspectives including timing of chronic cough treatment, risk factors (surgical method, lymph node dissection method, anesthesia method), prevention methods (preoperative, intraoperative, postoperative), and treatment methods (etiological treatment, cough suppressive drug treatment, traditional Chinese medicine treatment, and postoperative physical therapy). We hope that this consensus can improve the standardization and effectiveness of chronic cough treatment after lung surgery, provide reference for clinical doctors, and ultimately improve the quality of life of patients with chronic cough after lung surgery.
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BACKGROUND@#Pre-operative accuracy of subcentimeter ground glass nodules (SGGNs) is a difficult problem in clinical practice, but there are few clinical studies on the benign and malignant prediction model of SGGNs. The aim of this study was to help identify benign and malignant lesions of SGGNs based on the imaging features of high resolution computed tomography (HRCT) and the general clinical data of patients, and to build a risk prediction model.@*METHODS@#This study retrospectively analyzed the clinical data of 483 patients with SGGNs who underwent surgical resection and were confirmed by histology from the First Affiliated Hospital of University of Science and Technology of China from August 2020 to December 2021. The patients were divided into the training set (n=338) and the validation set (n=145) according to 7:3 random assignment. According to the postoperative histology, they were divided into adenocarcinoma group and benign lesion group. The independent risk factors and models were analyzed by univariate analysis and multivariate Logistic regression. The receiver operator characteristic (ROC) curve was constructed to evaluate the model differentiation, and the calibration curve was used to evaluate the model consistency. The clinical application value of the decision curve analysis (DCA) evaluation model was drawn, and the validation set data was substituted for external verification.@*RESULTS@#Multivariate Logistic analysis screened out patients' age, vascular sign, lobular sign, nodule volume and mean-CT value as independent risk factors for SGGNs. Based on the results of multivariate analysis, Nomogram prediction model was constructed, and the area under ROC curve was 0.836 (95%CI: 0.794-0.879). The critical value corresponding to the maximum approximate entry index was 0.483. The sensitivity was 76.6%, and the specificity was 80.1%. The positive predictive value was 86.5%, and the negative predictive value was 68.7%. The benign and malignant risk of SGGNs predicted by the calibration curve was highly consistent with the actual occurrence risk after sampling 1,000 times using Bootstrap method. DCA showed that patients showed a positive net benefit when the predictive probability of the predicted model probability was 0.2 to 0.9.@*CONCLUSIONS@#Based on preoperative medical history and preoperative HRCT examination indicators, the benign and malignant risk prediction model of SGGNs was established to have good predictive efficacy and clinical application value. The visualization of Nomogram can help to screen out high-risk groups of SGGNs, providing support for clinical decision-making.
Subject(s)
Humans , Retrospective Studies , Lung Neoplasms/surgery , Adenocarcinoma , China , Hospitals , Multiple Pulmonary NodulesABSTRACT
@#Hyaluronic acid, also called hyaluronan(HA)is a biocompatible and biodegradable linear polysaccharide which is of interest for tumor targeting through cell surface CD44 receptors. It is widely applied in the field of tumor therapy as an anticancer drug delivery carrier, and has become a hot spot in the research of tumor targeted drug delivery system. In tumor drug therapy, the key to reduce toxicity is to actively target tumors by using anatomical, pathophysiological and microenvironmental differences between malignant tumors and normal tissues. Differentiation cluster 44(CD44)is a high-affinity receptor for HA, which can be marked as a tumor marker or a targeting receptor because it is overexpressed in tumor cells. The overexpression of CD44 receptors was observed in many tumors such as breast cancer, colorectal cancer, liver cancer and pancreatic cancer. The effect of hyaluronic acid drug nanocarriers on various tumors is briefly described, indicating that the overexpression of CD44 receptor is an ideal choice for the treatment of hyaluronic acid-based drug carriers. The CD44 ligand can increase the affinity of the nanocarrier for tumor cells by binding to the nano drug carrier. The HA structure is known for its potent tumor targeting effect due to the inclusion of CD44 ligand, which enhances uptake of tumor cells by the HA-CD44 receptor-mediated endocytosis pathway. The study reviewed the progression of hyaluronic acid nanomicelles in clinical tumor therapy and its release behavior. The percentage of drug release and release rate are the key factors in the overall efficacy of the treatment strategy. Therefore, a great number of studies have focused on inducing drug release in Cytosol by taking advantage of the difference between the internal and external environments of nanostructured micelles or through external stimulation post-treatment applications. The study proved that an acid environment is more favorable to achieve a greater release and drugs can be quickly and completely released in an oxygen-deficient environment. In addition, the great potential of hyaluronic acid nanomicelles in tumor therapy was also further identified in this article. In vitro and in vivo experimental studies have repeatedly shown that hyaluronic acid-based nanomicelles are a drug- and gene-specific targeting tumor delivery method, in combination with passive targeting, this active targeting strategy is a promising approach to providing chemotherapy drugs to CD44 overexpressing tumors. In conclusion, hyaluronic acid-based nanomicelles are biologically safe with great potential to drug release, blood compatibility and systemic tumor targeting which all implied it has good application prospects in clinical tumor treatment.
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Objective To establish a mouse model of lung adenocarcinoma brain metastasis with human luc+-PC?9 cells stably expressing luciferase and to compare the evaluation values of bioluminescence imaging and18 F?FDG ( 18 F?flu?orodeoxyglucose) SPECT/CT in these models. Methods Suspension of luc+?PC?9 cells was injected into the left ventri?cle of BALB/c nude mice to establish a mouse model of brain metastasis from lung cancer. Bioluminescence imaging and18 F?FDG SPECT/CT were used to evaluate the metastasis of tumors as compared with HE?staining pathology as a golden standard. Results The success rate of brain metastases was 85% through injecting luc+?PC?9 cells into the left ventricle. The number of tumor cells was positively related to the intensity of light, with a linear correlation (R2 =0. 96). Fluores?cence was observed in the brain, spine and femur by bioluminescence imaging, and the metastases were confirmed by H&E pathological examination. 18 F?FDG SPECT/CT observed abnormal density collective foci in the spine or femur but not in the brain. Conclusions Injection of tumor cell suspension into the mouse left ventricle is a good method to establish a brain metastasis of lung cancer. Bioluminescence has a higher sensitivity and specificity in detecting brain metastasis and bone metastasis, with advantages of real?time, dynamical and non?invasive detection of tumor metastasis growth. 18 F?FDG SPECT/CT does not have superiority in detection of brain metastases but is suitable for detecting bone metastasis.
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Objective To compare the optical properties and visual quality between Tecnis ZMB00 and AcrySof ReSTOR SN6AD1 multifocal intraocular lens (MIOL) in patients undergoing cataract surgery.Methods A total of 120 patients (130 eyes) who umderwent elective cataract surgery in our hospital from March 2012 to July 2015 were selected prospectively.All patients were treated with diffractive MIOL,and divided into group A (Tecnis ZMB00 group) and group B (AcrySof ReSTOR SN6AD1 group).The uncorrected distance visual acuity (UCDVA),uncorrected near visual acuity (UCNVA),uncorrected medium distance visual acuity (UCIVA),best corrected distance visual acuity (BCDVA) and best corrected near visual acuity (BCNVA) were measured before and after surgery.The defocusing curve was drawn for analysis of the contrast sensitivity,and the postoperative visual function and survival quality questionnaire (VF-14) was used to evaluate the postoperative visual quality.Results At 1 week,1 month and 3 months after surgery,recovery of UCNVA,UCIVA and BCNVA in group A was better than that in group B (all P ＜ 0.05).At 1 week and 3 months after surgery,the recovery of UCDVA in group A was better than that in group B (all P ＜ 0.05).At 3 months after surgery,the spherical equivalent was lower in group A than group B (P ＜ 0.05).The contrast sensitivities under scotopia,photopic glare and scotopic glare of different frequencies in group A were higher than those in group B (all P＜0.05).The VF-14 score in group A at 3 months after surgery was lower than that in group B (P＜0.05).In group A,0.0 D and-2.5 D formed 2 peaks,and from-2.0 D to-2.5 D formed the platform stage,while in group B,only 0.0 D and-3.0 D formed 2 peaks.Conclusion The implantation of Tecnis ZMB00 MIOL after cataract surgery can improve the uncorrected visual acuity of treated eye,contrast sensitivities,postoperative visual function and quality of life of patients.
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Objective To observe the ultrastructure of blood-brain barrier in the nude mouse model of brain me-tastases from lung cancer by transmission electron microscopy using lanthanum nitrate tracing.Methods PC-9 cells (1 × 106/0.1 mL) in logarithmic phase were respectively injected into six nude mice ( model group) selected from eight nude mice randomly via the left ventricle, the other two mice without any treatment as the control group.The general status of the mice was observed after implantation.In the fourth week all the mice were sacrificed and brain tissue samples were taken and prepared for transmission electron microscopic observation using lanthanum nitrate tracing.besides, the lung and brain were removed and stained with HE to detect the presence of tumor metastasis.Results Mice in the model group began to lose weight almost simultaneously in the third week and became moribund slowly, and were all sacrificed at the fourth week when showing clear signs of cachexia.At autopsy, the thoraxes were clear, with normal lungs.Histology showed evidence of brain metastasis in all the six mice.The electron microscopy showed that lathanum nitrate tracer was escaped from the capillaries and diffusely or sparsely distributed in the brain tissues of the model group mice, however lathanum nitrate tracer was still confined in the capillary lumen in the mice of control group.Conclusions The diffuse lathanum nitrate tracer in the brain parenchymal tissue indicates the impairment of blood-brain barrier in the nude mouse model of lung cancer brain metastasis and the formation of these metastases is accompanied with the destruction of blood brain barrier.
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@#Objective To explore the effects of computerized working memory training on working memory and brain functional activition for stroke paitents. Methods 3 stroke patients voluntarily joined in the study, 10 healthy adults were recruited as control group. The patients received computerized working memory training for 4 weeks. Cognitive psychological tests (the n-back task, Stroop task and Raven`s Advanced Progressive Matrices task) and neuroimaging test (task- state functional magnetic resonance imaging) were administered before and after treatment. Results Working memory training significantly improved the working memory, fluid intelligence and attention for each trained patient (P<0.001), and could renovate the abnormal functional activity model and reorganize the functional brain network. Conclusion Computerized working memory could be used as an effective cognitive rehabilitation intervention for stroke patients.
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Objective To explore the effects of computerized working memory training on working memory and brain functional activi-tion for stroke paitents. Methods 3 stroke patients voluntarily joined in the study, 10 healthy adults were recruited as control group. The pa-tients received computerized working memory training for 4 weeks. Cognitive psychological tests (the n-back task, Stroop task and Raven`s Advanced Progressive Matrices task) and neuroimaging test (task-state functional magnetic resonance imaging) were administered before and after treatment. Results Working memory training significantly improved the working memory, fluid intelligence and attention for each trained patient (P<0.001), and could renovate the abnormal functional activity model and reorganize the functional brain network. Conclu-sion Computerized working memory could be used as an effective cognitive rehabilitation intervention for stroke patients.
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Ultra-performance liquid chromatography coupled with quadrupole time-of-flight tandem mass spectrometry (UPLC-Q-TOF/MS) was developed to identify the absorbed parent components and metabolites in rat bile, plasma and urine after oral administration of Radix Paeoniae Alba extract (RPAE). A total of 65 compounds were detected in rat bile, plasma and urine samples, including 11 parent compounds and 54 metabolites. The results indicated that glucuronidation, hydroxylation and methylation were the major metabolic pathways of the components of RPAE. Furthermore, the results of this work demonstrated that UPLC-Q-TOF/MS combined with MetaboLynx? software and mass defect filtering (MDF) could provide unique high throughput capabilities for drug metabolism study, with excellent MS mass accuracy and enhanced MSE data acquisition. With the MSE technique, both precursor and fragment mass spectra can be simultaneously acquired by alternating between high and low collision energy during a single chromatographic run.