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Globally, lung cancer is the leading cause of cancer death. Although survival rates for lung cancer patients have improved over the past few decades, the survival rates have not yet reached the levels of other common malignancies. In recent years, immune checkpoint inhibitors (ICIs) have shown great promise in clinical trials and have been rapidly incorporated into the standard of care for patients with advanced non-small cell lung cancer (NSCLC). However, many patients do not benefit from treatment. Our findings suggest that the heterogeneity of the tumor microenvironment (TME) is closely related to the efficacy of ICIs. Single-cell sequencing is a technology that can specifically analyze cell populations at the genome and transcriptome levels at the single-cell level. This article reviews the potential value of single-cell sequencing technology in predicting immune responses to lung cancer.
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Objective:To investigate the adverse reactions and postoperative inflammatory reactions of Bill-Roth Ⅱ (BⅡ) gastroenterostomy with jejunal anastomosis and jejunal nutrient tube placement using linear cutting and closing device in gastric cancer surgery.Methods:A retrospective case-control study was conducted on 93 patients undergoing gastric cancer surgery in The Affiliated Hospital of North China University of Science and Technology from February 2017 to April 2020. According to 2016 (American Joint Committee on Cancer/Universal Integrated Circuit Card) AJCC/UICC, (Tumor, Node, stage; Tumor lymph node metastasis; Distant metastasis) TNM, there were 11 cases in stage ⅠA, 14 cases in stage ⅠB, 13 cases in stage ⅡA, 15 cases in stage ⅡB, 11 cases in stage ⅢA, 13 cases in stage ⅢB, and 16 cases in stage ⅢC. There were 51 cases of gastric antrum carcinoma, 26 cases of gastric body carcinoma and 16 cases of gastric pylorus carcinoma. There were 27 cases of papillary adenocarcinoma, 26 cases of tubular adenocarcinoma, 22 cases of mucinous adenocarcinoma, 9 cases of signet-ring cell carcinoma, 7 cases of adenosquamous carcinoma, and 2 cases of squamous carcinoma. The patients were divided into experimental group (48 cases) and control group (45 cases) according to whether or not the linear cutting and closing device was added and jejunal anastomosis was performed and jejunal nutrition tube was placed. The gender composition, age, lesion site, pathological type, pathological stage, postoperative hospital stay and postoperative complications were compared between the two groups, and the white blood cell count WBC, C-reactive protein CRP on the 7th day after surgery, erythrocyte Sedimentation rate (ESR), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) inflammation indicators were compared between the two groups.Results:There was no significant difference in gender composition, age, lesion location, pathological type and pathological stage between the two groups (all P>0.05). The incidence of abdominal pain, abdominal distension, nausea, vomiting and pleural effusion in 93 patients were 18.3%(17/93), 21.5%(20/93), 23.7%(22/93), 17.2%(16/93) and 18.3%(17/93), respectively. The complication rates of the above indexes in the two groups were 10.4% (5/48) Compared with 26.7% (12/45), 12.5% (6/48) and 31.1% (14/45), 15.6%(7/48) and 33.3% (15/45), 8.3%(4/48) and 26.7% (12/45), 8.3% (4/48) and 28.9% (13/45) (χ 2 values were 4.11, 4.77, 4.52, 4.27 and 5.27, respectively; P values were 0.043, 0.029, 0.033, 0.039 and 0.022, respectively). There was no significant difference in lower extremity venous thrombosis, anastomotic bleeding, accumulated pneumonia and incision dehiscence between the two groups ( P>0.05). WBC on the 7th day after operation in the experimental group and the control group (7.02±1.83)×10 9/L and (8.39±2.27)×10 9/L ( t=3.22, P=0.002), TNF-α (2.44±0.70) μg/L and (3.56±1.14) μg/L ( t=5.71, P<0.001), IL-6 (235.31±41.72) μg/L and (365.91±73.16) μg/L ( t=10.66, P<0.001) there was significant difference between the two groups. There was no significant difference in CRP and ESR between the two groups on the 7th day after operation ( P>0.05). The postoperative hospital stay between the experimental group and the control group was (13.88±2.81) d and (22.78±2.51) d, the difference was statistically significant ( t=16.07, P<0.001). Conclusion:The application of side-to-side jejunostomy combined with jejunal nutrition tube for enteral nutrition in gastric cancer surgery can reduce the occurrence of adverse reactions such as postoperative abdominal pain, abdominal distension, accumulated pneumonia, nausea, vomiting and pleural effusion, reduce the postoperative hospital stay and reduce the postoperative inflammatory reaction to a certain extent.
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To compare two methods of injecting ropivacaine as an intercostal nerve blocker, and for postoperative pain control after video-assisted thoracic surgery (VATS) in lung cancer patients. Methods: From August 2018 to November 2018, 60 patients who had undergone VATS with a diagnosis of lung cancer, were randomly assigned into two groups: control and test. After the surgery, the control group was injected with an intercostal nerve blocker (0.25% ropivacaine) via the inner thorax by the traditional method, and the test group was injected with ropivacaine via the outer thorax by an improved method. The pain scale was evaluated using the Visual Analogue Scale (VAS) and Prince Henry Pain Scale (PHPS) at 12 h (T1), 24 h (T2), 48 h (T3), and 72 h (T4) after the surgery. The dosage of administered morphine and the adverse effects of ropivacaine after surgery were also evaluated. Results: Injecting ropivacaine to the intercostal nerve by means of both, outer and inner thoracic injection showed satisfied analgesia, as evaluated by VAS and PHPS scores, and there were no significant differences between the two methods at any time point of analysis (T1-T4, P>0.05). The dosage of administered morphine and the time with chest tube were similar (P>0.05) between the groups. However, there were a few cases of subpleural hemorrhage in the test group. Conclusions: Intercostal nerve block with ropivacaine by means of both, outer and inner thoracic injection, showed satisfied analgesia, although, outer thoracic injection is more flexible with fewer complications.
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Objective@#To investigate the chromosomal aberration rate, micronucleus cell rate and the related factors of radiation workers in Changzhou, provide evidence for the occupational health and safety of radiation workers.@*Methods@#Descriptive analysis of the chromosomal aberration rate, micronucleus cell rate and the related factors of 3021 radiation workers who conducted occupational health examination in the Changzhou Center for Disease Control and prevention in 2017, multivariate logistic regression was used to analyze the data.@*Results@#The abnormal rate of chromosome aberration and micronucleus cells of 3021radiation workers in Changzhou were 1.32% and 3.34% respectively. The results of multivariate logistic regression showed that the exposure year (OR=1.501, 95%CI:1.078~2.089, P=0.016) was a risk factor for chromosome aberration. The risk of chromosome aberration in radiation therapy (OR=6.417, 95%CI:1.360~30.280, P=0.019) and interventional radiology (OR=4.598, 95%CI:1.688~12.524, P=0.003) was higher than that of industrial application. the exposure year (OR=1.245, 95%CI:1.007~1.539, P=0.043) is also a risk factor for micronucleus cell rate. The micronucleus cell rate abnormality Risk of nuclear medicine (OR=3.934, 95%CI:1.305~11.858, P=0.015) , radiation therapy (OR=3.802, 95%CI:1.101~13.128, P=0.035) , and interventional radiology (OR=2.953, 95%CI:1.324~6.584, P=0.008) is higher than industrial application.@*Conclusion@#The chromosome aberration rate and micronucleus rate of workers who are exposed to low dose ionizing radiation for long time are related to the exposure year of radiation workers and the occupational categories involved.
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Objective:To explore the feasibility and safety of CT-guided hookwire localization of small lung nodule in video-as-sisted thoracic surgery. Methods: Preoperative localization of small lung nodule was performed using the CT-guided hookwire tech-nique, followed by video-assisted thoracic surgery in the wedge resection. The next mode of operation depends on the results of frozen biopsy. Results:Preoperative localization with CT-guided hookwire was performed in 34 patients between February 2012 and March 2014. The diameter of lung nodule ranged from 5 mm to 22 mm. CT-guided hookwire localization was successful in all patients, with a median positioning time of 23 min. Puncture needles were detached from two of the total patients during the surgery, and three other pa-tients showed pneumothorax by CT scan after localization. Conclusion:Preoperative hookwire localization of small lung nodule is an accurate and safe approach to improve the rate of wedge resection in video-assisted thoracic surgery.
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BACKGROUND: The anterior thoracolumbar internal fixation devices can be divided into two main categories: the stick system such as kaneda,and the plate system such as Z-plate. Both categories have satisfactory biomechanical properties, but the devices of these types are all imported and so expensive that they exceed the affordability of domestic patients:Based on various anterior throacolumbar internal fixation devices and the spinal characteristics of the Chinese people, the author designed a new brand of anterior thoracolumbar internal fixation device for Chinese people:New Ti-plate (NTP).OBJECTIVE: Biomechanical properties of three anterior thoracolumbar internal fixation devices were compared in an attempt to provide a scientific and theoretical basis for clinical applications.DESIGN: A sampling investigation.SETTING: The Department of Orthopaedics of the Second Affiliated Hospital of Soochow University and Department of Radiology of Nantong Hongqiao Hospital.PARTICIPANTS: This study was carried out at the Biomechanical Engineering Research Institute of Shanghai University between May and August 2003. Fifteen fresh spinal samples from the healthy adults (T12-S1) were used in this study.METHODS: Fifteen spinal (T12-S1) specimens were obtained from fresh bodies to induce injuries to anterior and middle columns, which were fixed with Dunn Ⅲ, NTP and Z-plate respectively to compare the strength, rigidity, and the stability of the spine.MAIN OUTCOME MEASURES: Changes of load-straining and loaddisplacement of the three groups of specimens under the conditions of axial decompression, anteflection, post-extention, and lateral flexion.RESULTS: Fifteen fresh adult spinal specimens were involved in this study and all entered the stage of result analysis. Under the maximal load of 500 N,the average straining for Z-plate, NTP and Dunn Ⅲ was 410 uε,430 uε, 477 uε respectively. The average longitude displacement for the above three devices was 2.23 mm, 2.38 mm and 2.85 mm respectively.The thoracolumbar fracture was fixed with three anterior internal fixation devices and it was proved that Z-plate and NTP fixations were better than fixation with Dunn Ⅲ in respect of spinal strength, rigidity and stability (P ＜ 0.05), but the difference between Z-plate and NTP had no statistical significance (P ＞ 0.05).CONCLUSION: NTP and Z-plate devices are conformed to the spinal biomechanical principles and were capable of reconstructing spinal biomechanical stability effectively, and it is a preferable anterior spinal internal fixation device.