Growth Regularity of Pulmonary Ground Glass Nodules Based on 3D Reconstruction Technology / 中国肺癌杂志

BACKGROUND@#Since the popularization of computed tomography (CT) technology, the detection rate of pulmonary ground glass nodules (GGNs) with imaging follow-up as the main management method has increased significantly. The purpose of this study is to quantitatively analyze the changes of pulmonary GGNs during the follow-up process with three-dimensional reconstruction technology, explore the natural progression of pulmonary GGNs, and provide effective basis for clinical guidance for patients to conduct reasonable management of nodules.@*METHODS@#A total of 115 cases of pulmonary GGNs with regular follow-up in the Combined Outpatient Department of Zhoushan Hospital from March 2015 to November 2022 were enrolled. Quantitative imaging features of nodules were extracted by semi-automatic segmentation of 3D Slicer software to evaluate the growth of nodules and clinical intervention during follow-up.@*RESULTS@#The average baseline age of the patients was (56.9±10.1) yr. The mean follow-up time was (48.8±18.9) months. The two-dimensional diameter of baseline CT scan was (7.9±2.9) mm, and the maximum three-dimensional diameter was (10.1±3.4) mm. The two-dimensional diameter of the last CT scan was (9.9±4.7) mm, and the maximum three-dimensional diameter was (11.4±5.1) mm. A total of 27 cases (23.5%) showed an increase during follow-up, with a median volume doubling time of 822 days and a median mass doubling time of 1,007 days. 32 cases were surgically resected, including 6 cases of invasive adenocarcinoma (IAC), 16 cases of minimally invasive adenocarcinoma (MIA), 8 cases of adenocarcinoma in situ (AIS) and 2 cases of atypical adenomatous hyperplasia (AAH). Five nodules underwent surgical intervention due to the progression of two-dimensional diameter, which was pathologically confirmed as pre-invasive lesions, but their three-dimensional maximum diameter showed no significant change. Nodular morphology, lobulated sign, spiculated sign and vacuole signs all promoted the growth of nodules in univariate analysis. There were significant differences in age, baseline diameter, mean CT value, median CT value, 10% and 90% percentile CT number between the growth group and the stable group (P<0.05). Multivariate Logistic regression analysis showed that age and average CT value were risk factors for nodule growth (P<0.05). Receiver-operating characteristic (ROC) curve analysis results indicated that the age ≥63 years old, the baseline three-dimensional maximum diameter ≥9.2 mm, and the average CT value ≥-507.8 HU were more likely to accelerate the growth of GGNs. The maximum three-dimensional diameter ≥14.4 mm and the average CT value ≥-495.7 HU may be a higher malignant probability.@*CONCLUSIONS@#GGNs show an inert growth process, and the use of three-dimensional measurements during follow-up is of greater significance. For persistent glass grinding nodules ≥63 years old, the baseline three-dimensional maximum diameter ≥9.2 mm, and the average CT value ≥-507.8 HU are more likely to increase. However, most nodules still have good prognosis after progression, and long-term follow-up is safe.

Establishment of the Diagnostic Model in Solitary Pulmonary Nodule Appearing as Ground-glass Nodule / 中国医学影像学杂志

Purpose To explore the independent predictors of malignant solitary pulmonary nodule (SPN) manifesting as ground-glass nodule (GGN),and to establish a prediction model.Materials and Methods The clinical data and CT images of 362 patients (group A) with pathological-confirmed SPN appearing as GGN in Shanghai Chest Hospital Shanghai Jiaotong University from January 2014 to December 2015 were retrospectively analyzed.The independent predictors of malignant SPN were identified,and the clinical prediction model was established.Another 119 SPN patients in Affiliated Zhoushan Hospital of Wenzhou Medical University were selected as group B to verify the diagnostic efficiency of the prediction model.Results Using multivariate Logistic regression analysis,clear border (OR=6.274,P＜0.01),smooth edge (OR=0.391,P＜0.01),lobulation (OR=3.387,P＜0.01),pleural retraction sign (OR=2.430,P＜0.01),and vocule sign (OR=3.076,P＜0.01)were identified as independent predictors of malignant SPN.The area of the model under the ROC curve was 0.859 with 95％ CI (0.804-0.903).The diagnostic accuracy rate,sensitivity,specificity,positive predictive value and negative predictive value were 85.92％,91.03％,81.97％,92.03％ and 73.53％,respectively.Conclusion In this study,the independent predictors of malignant SPN appearing as GGN were identified,and the prediction model was established.The model can accurately identify SPN and provide effective help for early diagnosis of SPN.

Feasibility of qualitative diagnosis of small pulmonary nodules (≤1 cm) using spiral CT scan / 实用放射学杂志

Objective To investigate the feasibility of qualitative diagnosis of small pulmonary nodules (≤1 cm) using multi‐plane reconstruction (MPR) and volume rendering (VR) techniques based on spiral CT scan .Methods The CT images of 190 patients with small pulmonary nodules (≤1 cm) were analyzed retrospectively ,and compared the detection rates of several imaging features among different pathological types of nodules .Results In these 190 patients who were diagnosed as malignance by CT ,168 were confirmed by pathology with an accuracy rate of 88 .4% .The imaging features such as ground glass nodule ,vascular convergence in the benign group were significantly lower than those in the malignant group ,however the solid nodule was observed more frequently in the malignant group (P0 .05) .Except air bronchogram and vascular convergence ,some imaging features (pure ground glass nodule ,part solid ground glass nodule ,solid nodule) showed a decreasing trend ,whereas some others (speculation ,lobulation ,vacuole sign and pleural tag ) were increased among different pathological types of malignant nodules .The linear trend passed the significant test at 0 .017 level .Conclusion CT multi‐plane reconstruction (MPR) and volume rendering (VR) techniques can sufficiently demonstrate the malignant signs in small pulmonary nodules (≤1 cm ) ,can improve to identify different pathological types of such small pulmonary lesions .

Professor HE Tianyou's clinical experience of acupuncture and medicine on intractable facial paralysis / 中国针灸

Professor HE Tianyou's unique understanding and treatment characteristics for intractahle facial paralysis are introduced. In clinical practice professor HE highly values acupoint selection and manipulation application, and integrates Chinese and western medicine to flexibly choose acupoints and formulate prescriptions according to syndrome differentiation and location differentiation, besides, he creates several specialized manipulation methods including "tug-of war opposite acupuncture method" and "tractive flash cupping". Based on strengthening body and dredging collaterals. more attention is given on stimulation to local paralyzed facial nerves; meanwhile acupuncture and medication are combined to improve clinical efficacy. During the treatment, the important role of psychological counseling on patient's anxiety is emphasized, and comprehensive treatment is given physically and psychologically in order to achieve the purpose of total rehabilitation.

CT Features of Solid Components in Pulmonary Mixtured Ground-glass Opacity / 中国医学影像学杂志

Purpose To evaluate the CT features and pathological manifestations of the solid components of mixture ground-glass opacity (GGO) in adenocarcinoma in situ (AIS), minimally invasive adenocarcinom (MIA) and invasive adenocarcinoma (IAC), to analyze the qualitative diagnosis value of solid components of mixture GGO in the diagnosis of AIS, MIA and IAC, to provide reference for the selection of clinical treatment.Materials and Methods Eighteen patients with AIS, 53 patients with MIA and 28 patients with IAC (the maximum diameter smaller than 2 cm) proved by surgery and pathology with CT features appearing as mixture GGO were retrospectively analyzed, CT features of the solid components in three groups were analyzed and compared with pathology.Results The solid components in AIS mainly appeared as punctiform or polygon, with extensive distribution, solid nodules were usually single (17 cases, 94.44%), located in the middle of the lesion (14 cases, 77.78%), with clear binderies (16 cases, 88.89%) and the same density with vessels in the same axis (13 cases, 72.22%); the majority of solid components in MIA appeared as circular or elliptical (33 cases, 62.26%), less than or equal to 5 mm (48 cases, 90.57%), with eccentric or multi-point distribution (45 cases, 84.90%), the boundaries were less sharp (40 cases, 75.47%), with slightly lower density than that of the vasculars in the same level (34 cases, 64.15%); the solid components in IAC mainly appeared as irregular lesions (21 cases, 75.00%), lager than 5 mm (24 cases, 85.71%), with eccentric growth (20 cases, 71.43%) and less sharp boundary (15 cases, 53.57%), the integration of multiple nodules could also be observed. There were statistically significant differences in the CT features of solid components within the lesions among the three groups (P<0.01).Conclusion It is possible to predict the pathological typing and the prognosis of pulmonary mixture GGO in a certain extent according to the different CT features of the solid components in it, and to guide clinical treatment principles.

Effects of miR-429 on the inhibits of cell proliferation in the human lung adenocarcinoma cell line SPC-A1 / 中华胸心血管外科杂志

Objective To assess the impact of miR-429 on lung adenocarcinoma cell SPC-A1 growth inhibition.Methods Pre-miRTM miR-429 precursor was synthesized and transfected to the SPC-A1 cells by liposome; qRT-PCR assay was used to quantify the miR-429 expression levels; The proliferation of SPC-A1 cells was evaluated by Cell Counting Kit-8 (CCK8).The cell apoptosis was evaluated by Annexin V Assay; The cell cycles of each group were assayed by flow cytometry;Western-blot was used to analyze the expression of cylines.Results The expression level of miR-429 was highly induced after transfection (P ＜ 0.001) ;CCK-8 assay showed the cell proliferation activity of pre-miR-429 group was lower than that of blank and control group 48h and 72 h after transfection(P =0.0167,0.0383,P =0.0320,0.0465),whereas the apoptosis rate had no significant difference between pre-miR-429 and control 24h after transfection by Annexin V Assay(P ＞ 0.05) ; The flow cytometry at 48h after transfection showed that miR-429 decreased the percentage of cells in G1 phase,but increased in S phase,indicating the cell cycle arrest at S phase(P =0.0010,0.0010 ; P =0.0068,0.0133) ; however,the expression level of Cyclin E in pre-miR-429 group had no difference compared with control.Conclusion miR-429 could inhibit cell proliferation and promote cell cycle arrest of lung adenocarcinoma cell SPC-A1.miR-429 may play a potential tumor suppressor role in lung adenocarcinoma cell SPC-A1.

Association of iodine nutrition and thyroid health conditions among residents in Zhoushan archipelago / 中华内分泌代谢杂志

Objective To investigate iodine nutrition and thyroid health status among residents in Zhoushan archipelago, and to analyse their relationship.Methods A total of 3 284 residents in Zhoushan archipelago were surveyed by questionnaire and their thyroids were examined by B-mode ultrasound.The levels of urinary iodine and thyroid function were detected.Results The median level of urinary iodine in 3 284 residents was 226.0 μg/L, being 320.7 μg/L in citizens, 188.9 μg/L in farmers, 122.2 μg/L in salt-makers, 193.6 μg/L in fishers, and 271.7 μg/L in buddhist.The prevalence of diffuse goiter, nodular goiter, colloid goiter, thyroid adenoma, thyroid carcinoma, hyperthyroidism, subclinical hyperthyroidism, hypothyroidism, subclinical hypothyroidism, and positve rate of TPOAb were 1.7% ,25.3% ,8.7% ,0.2% ,0.4% ,0.5% ,0.8% ,0.03%,1.0% ,and 9.5% repectively.The prevalence of thyroid diseases was increasing with aging, and higher in women than in men (P＜0.05).There was no significant relationship of the thyroid diseases with seafood, smoking,drinking, and tea (P＞0.05).Conclusions The citizens of Zhoushan archipelago have adequate iodine intake.It is pertinent to discuss Universal Salt Iodization.Excessive iodine intake may contribute to the high prevalence rate of thyroid diseases in Zhoushan.

Expression of stathmin and its influence to anti-microtube chemotheropy in non-small-cell lung cancer / 中华胸心血管外科杂志

Objective To investigate the expression of stathmin and evaluate its influence to anti-microtubule adjuvant chemotherapy in non-small-cell lung cancer(NSCLC).Methods The clinical data and survival status of 78 NSCLC patients were collected,and their paraffin-embedded tissue were detected immunohistochemically with a rabbit anti-human stathmin polyclonal antibody.The clinical significance of stathmin expression and its influence to overall survival rate were analyzed statistically between patients who received paclitaxel or vinblastine adjuvant chemotherapy.Results The positive expression of stathmin could only be observed in the cytoplasm of cancer cells.Among 78 patients,40 (51.3 ％ ) patients were stained stathmin-positive.The positive rate of stathmin was significantly higher in male than female,in central type than peripheral type,in pleura-involved than non-involved,and in dead patients than survival patients ( P ＜ 0.05 ),but showed no significant differences in patients with different age,differentiated grade,pathological type,clinical stage,or lymph-node metastasis status.The expression of stathmin had a significant influence to overall survival rate(x2 =4.348,P ＜0.05 ),and those stathmin-negative patients showed a longer survival time.In stathmin-negative patients,those who received adjuvant chemotherapy with vinblastine exhibited a shorter survival time than those with paclitaxel,but the P =0.06.In stathmin-positive patients,the survival rate or time showed no difference between groups with paclitaxel and vinblastine.The differentiated grade,metastasis to lymph node and expression of stathmin were independent risk factors influencing survival rate.The positive expression of stathmin could only be observed in the cytoplasm of cancer cells.Among 78 patients,40 (51.3 ％ )patients were stained stathminpositive.The positive rate of stathmin was significantly higher in male than female,in central type than peripheral type,in pleura-involved than non-involved,and in dead patients than survival patients ( P ＜ 0.05 ),but showed no significant differences in patients with different age,differentiated grade,pathological type,clinical stage,or lymph-node metastasis status.The expression of stathmin had a significant influence to overall survival rate(x2 =4.348,P ＜ 0.05 ),and those stathmin-negative patients showed a longer survival time.In stathmin-negative patients,those who received adjuvant chemotherapy with vinblastine exhibited a shorter survival time than those with paclitaxel,but the P =0.06.In stathmin-positive patients,the survival rate or time showed no difference between groups with paclitaxel and vinblastine.The differentiated grade,metastasis to lymph node and expression of stathmin were independent risk factors influencing survival rate.Conclusion Our study suggested that the detection of stathmin in resected NSCLC tumor tissues may be helpful for prediction of prognosis,but helpless for making a choice between paclitaxel and vinblastine.NSCLC patients with stathmin-negative,no metastasis to lymph node or good-differentiated grade may have a better prognosis.

Study on relationship between blood supply from pulmonary artery and pathological characteristics of patients with primary bronchogenic carcinoma / 中国肺癌杂志

<p><b>BACKGROUND</b>At present, it has been known that the bronchogenic artery participates in the blood supply of primary bronchogenic carcinoma, but there is controversy about the blood supply from pulmonary artery in primary bronchogenic carcinoma. The aim of this study is to assess the relationship between the blood supply from pulmonary artery and pathological characteristis of patients with primary bronchogenic carcinoma.</p><p><b>METHODS</b>The pulmonary arteries in 43 surgical samples of bronchogenic carcinoma were marked, then the iopromide was used to selective pulmonary arteriography in digital subtraction angiography (DSA). The relationship between tumor with blood supply from pulmonary artery and the pathologic characteristics was observed.</p><p><b>RESULTS</b>There were 34 samples with blood supply from pulmonary artery ( 79.07%) , and 9 samples without blood supply from pulmonary artery (20.93%). The development rate of peripheral lung cancer (100.00%) was significantly higher than that of central lung cancer (64.00%) (P < 0.01) . The development rate of squamous cell carcinoma (91.30%) was remarkably higher than that of adenocarcinoma (61.11%) (P < 0.05). The development rate of poorly differentiated lung cancer (95.00%) was remarkably higher than that of well and moderately differentiated lung cancer (65.22%) (P < 0.05). There was a positive relationship between the tumor size and the development rate (P < 0.05).</p><p><b>CONCLUSIONS</b>In primary bronchogenic carcinoma, the pulmonary artery blood supply exists in most of tumors. There is relationship between the blood supply from pulmonary artery and general type, histopathology, cell differentiation and tumor size of lung cancer. The blood supply from pulmonary artery doesn't relate to tumor stage.</p>

The Expression and Significance of VEGF and MMP-9 in Non-small Cell Lung Cancer / 中国慢性病预防与控制

Objective To determine the expression of Vascular Endothelial Growth Factor(VEGF) and Matrix Metalloproteinases-9(MMP-9) in non-small cell lung cancer(NSCLC) specimens and try to find out the possible roles of VEGF and MMP-9 in the invasion and metastasis of NSCLC.Methods Immunohistochemical SABC method was used to detect the expression of VEGF and MMP-9 in 23 non-cancerous pulmonary diseases tissues,30 normal lung tissues near the NSCLC and 111 NSCLC tissues.Results The expression levels of VEGF and MMP-9 in the NSCLC tissues were significantly higher than those of the control groups(P

Design of Wireless Sickroom Calling System / 医疗卫生装备

Objective To solve the problem that the timely salvation can not be provided to the critical sick when nurses are not in nurse station and can not hear the sound of buzzer. Methods By utilizing SCM and wireless numerical transmission module, the former sick area treatment station calling system was developed. The special information was coded through SCM. The dada were sent and received with wireless numerical transmission module. In this way, a portable calling information receiving machine was designed. Results The reliable receiving distance of receiving machine is in the bound of 800 meters, and it provides 16 channels to use for different floors, having data transmission check function, little power loss, performance steady and credibility. Conclusion With sickroom calling message receiving machine, the nurse on duty can receive the calling message of the sick at any time and in any room, so rapid treatment can be provided on time, improving the satisfaction degree of sick. Besides, the sound of the calling system in the sick area treatment station can be shut down at noon and night, thus providing better circumstance for the sick to rest. The design is suitable for the calling system in any type and makes up the original shortages of the calling system in hospital.

Study on genetic instability of nm23-H1 gene and expression of hMLH1, hMSH2 in sporadic gallbladder carcinoma / 中国病理生理杂志

AIM: To examine the MSI and LOH of locus D17S396 and their influence on the expression of nm23-H1 in gallbladder tumors, and to examine the protein expression of hMLH1/hMSH2, which may provide experimental evidence for the tumor occurrence and metastasis. METHODS: Techniques such as DNA extraction, CR-SSCP, ordinary silver stain were used to study MSI and LOH of locus D17S396. Envision IHC was used to assess the expression of nm23-H1 and hMLH1/hMSH2.RESULTS: ① The frequency of heredity instability of gallbladder carcinoma was 42.55%. The frequency of LOH in liver and lymph node metastasis cases and in stage Nevin IV and V was significantly higher than that without metastasis and stage I, II and III. However, the frequency of MSI showed contrary correlation with some clinicopathologic characteristics. ② The expression of nm23-H1 was 46.81%. The case with lymph node metastasis and Nevin stage IV and V showed significantly lower expression than that without lymph node metastasis and stage I, II and III. ③ The expressions of hMLH1 and hMSH2 were 51.06% and 42.55% respectively. hMLH1 in lymph node and liver metastasis cases and in stage Nevin IV and V were significantly lower than that without metastasis and in stage I, II and III. ④ Positive frequency of hMLH1 in MSI positive group was higher than that in MSI negative group. The positive frequency of nm23-H1 and hMSH2 protein in LOH positive group was lower than that in negative group.CONCLUSION: The heredity instability of nm23-H1 gene may be implicated pathogenesis and progression of gallbladder carcinoma. Both MSI and LOH of nm23-H1 control the development of gallbladder carcinoma independently in different paths. Abnormal expression of hMLH1/hMSH2 may be a molecule marker in early stage of gallbladder carcinoma.