Study on the Difference of Gene Expression between Central and Peripheral Lung Squamous Cell Carcinoma Based on TCGA Database / 中国肺癌杂志

BACKGROUND@#Lung cancer is a malignant tumor disease with high morbidity and high mortality. The non-small cell lung cancer (NSCLC) is the most common type, among them, lung squamous cell carcinoma own special pathological type and specific treatment, is a subtype of non-small cell lung cancer and can be divided into peripheral type and central type according to clinical phenotype. This study explores the differences in gene levels and their potential values based on clinical differences between central and peripheral in lung squamous cell carcinoma.@*METHODS@#The lung squamous cell carcinoma dataset was collected from The Cancer Genome Atlas (TCGA) database, clinical information and the corresponding gene expression profiles were downloaded. Then we further sort and analyze all these data.@*RESULTS@#In clinical characteristics analysis, result showed that central lung squamous cell carcinoma was more likely to metastasis with lymph node than peripheral lung squamous cell carcinoma (46.2%, 67/145 vs 28.9%, 26/90; P=0.019), while there were no significant differences in gender, age, tumor size, distant metastasis, tumor node metastasis (TNM) stage, and EGFR mutation. Gene expression analysis showed 1,031 differentially expressed genes between central and peripheral lung squamous cell carcinoma, of which 629 genes were up-regulated and 402 genes were down-regulated (peripheral vs central). Further enrichment analysis showed differentially expressed genes were mainly riched in 6 signaling pathways. Among them, the neuroactive ligand-receptor interaction pathway was the main enrichment pathway of differentially expressed genes, and other differential expressed genes were mainly involved in lipid metabolism and glucose metabolism. The analysis of interaction network showed that hepatocyte nuclear factor 1 homeobox A (HNF1A) and cytochrome p450 family, Cytochrome P450 3A4 (CYP3A4) own widely effect in up-regulated genes, while ALB and APOA1 at the key positions of the network in down-regulated genes were CONCLUSIONS: Central and peripheral lung squamous cell carcinoma showed clinical phenotype difference not only reflected in the incidence of lymph node metastasis, but also in gene expression profiles. Among them, HNF1A, CYP3A4, ALB, APOA1 at the key position of the differential gene interaction network and maybe as regulatory factors in the phenotypic difference.

The exploration and analysis of effect for CT guided percutaneous125I particle implanted in patients interstitial with central lung cancer / 中国医学装备

Objective:To discuss the clinical value of CT-guided interstitial implantation of125I radioactive particle through the percutaneous puncture in the treatment of central-type lung cancer.Methods: 63 patients with the central-type lung cancer treated in Renmin Hospital of Wuhan University from November 2013 to July 2016 were randomly grouped (31 cases in the control group and 32 cases in the observation group). Patients in the control group were given the treatment of bronchial arterial perfusion with the chemotherapeutic drugs; while patients in the observation group were given the CT-guided interstitial implantation of125I radioactive particle through the percutaneous puncture. The clinical therapeutic effect and complications were observed of the two groups and the quality of life scores before and after the treatment were summarized between two groups as well.Results: The overall effective rate of observation group was 84.38% (27/32) that was higher than 61.29%(19/31) of control group, with statistical difference (x2=4.259,P0.05); the quality of life score of observation group after the treatment was 84.57±3.27 that was higher than 70.38±3.20 of control group, with statistical difference (t=17.402,P<0.05).Conclusion: CT-guided interstitial implantation of125I radioactive particle through the percutaneous puncture in the treatment of patients with central-type lung cancer has the significant effect, and it can effectively improve the quality of life for patients and have the high degree of safety.

Risk factors of Syncope Symptom in Patients with Pulmonary Embolism by unconditioned logistic regression / 实用医学杂志

Objective To investigate the risk factors of syncope symptom in patients with pulmonary embolism (PE).Methods 457 patients with confirmed pulmonary embolism were recruited in the study.They were divided into two groups:the syncope group (44 patients) and the group without syncope (413 patients).The clinical manifestation,laboratory examination,physical examination,imagingof all patients were analyzed by unconditional logistic regression.Results (1) Single factor analysis,prevalence of syncope was 9.6％ (44/457) in these patients with PE.Those with syncope had some higher risk factors,including age over 60,coronary heart disease,hypertension,stroke and lower limb vein thrombosis history.The proportion of falling pressure chest painand centricity thrombus in syncope group were increasing compared with the groupwithout syncope.Pulmonary embolism severity index (sPESI) score was higher than groupwithout syncope.(2) Multivariate analysis showed that hypertension coronary heart disease and Centricity thrombus were the independent correlates of the presence of syncope in the patients with PE.Conclusions Patients who had histories of hypertension and coronary heart disease may have the higher risk factors of syncope.Blood pressure falling and central localization may be more likely to happen in PE patients with syncope.

Diagnostic value of electronic bronchoscopy intelligent spectroscopic colorimetric technique in central type lung carcinoma / 重庆医学

Objective To investigate the observation effect of Fuji intelligent chromoendoscopy (FICE) in central type lung cancer,to select the optimal wavelength combination and to explore its diagnostic value for central type bronchogenic lung carcinoma. Methods One hundred and forty-six cases of definite histopathological diagnosis by bronchoscopy examination with preserved intact data in the Chongqing Municipal Tumor Hospital from January 2016 to October 2016 were included into this study. The white light bronchoscopy(WLB) and FICE were used to conduct the observation respectively. The capillary morphology was respectively scored by using the 10 wave combinations in FICE. The best wave combination was selected for conducting the forceps biopsy. Finally the pathological results served as the gold standard for conducting the comparative study. Results The difference of lesion observation effect among 10 sets of FICE wave combination had statistical significance (P<0.01), the wave combination 8 [R= 540 (2), G= 505 (4), B= 420 (5), wavelegnth(nm gain value)] was superior to that of other wave combinations in observing lesion vascular texture (Rank% = 9.74). The coincidence rate of FICE for judging the lesion property was 88.4 %. The detection rate of FICE combined with WLB for central type lung cancer was 96.6 %, compared with that of single WLB, the detection rate had statistically significant difference (P<0.01). Conclusion FICE wave combination 8 [R= 540 (2) ,G=505 (4),B=420 (5) ,wavelength(nm, gain value)] is most ideal for observing superficial mucosal capillary vascular morphology of central type lung cancer lesion tissue.

Relationship between short humerus disease and Kashin Beck disease in Kaschin-Beck disease areas in Tibet / 中华地方病学杂志

Three new points of view were reported in this study:1.Found out the distribution of KaschinBeck disease (KBD) in Tibet,the complexity of bone disease composition,and the types of osteopathy coexisted which need to be identified;2.The clinical symptoms of KBD in Tibet were significantly different from those in other areas of our country;3.The new clinical subtypes of KBD were found in Tibet,which had humeral shortness and short stature,but with normal hands and feet.This discovery made us understand KBD more profoundly and comprehensively,and promoted the research and prevention work of KBD.

Psychiatric Symptoms Manifested in Patients with Psychogenic Dizziness / 신경정신의학

OBJECTIVES: This study was aimed to investigate psychiatric symptoms in patients with psychogenic dizziness and compare these findings with those of patients with central and peripheral dizziness. METHODS: A total of 62 patients with dizziness was the subject of investigation, and patients were classified into 32 with central type, 16 with peripheral type, and 14 with psychogenic type. Korean standardized Beck Depression Inventory(K-BDI) State and Trait Anxiety Inventory(STAI) and Korean standardized edition of Symptom Checklist 90 Revised(SCL-90-R)were used for the assessment. Statistically, Pearson's chi-square test and one-way ANOVA with Scheffe's test were used with SPSS/PC for windows 6.0. RESULTS: The results were as follows: 1)The proportion of psychogenic dizziness was 22.6% of the total subjects.2)Total scores of K-BDI were not significantly different among the 3 groups. 3)Total scores of state anxiety and trait anxiety were not significantly different among the 3 groups. 4)In SCL-90-R, psychogenic dizziness group showed significantly higher score of phobic anxiety only(p<0.01)than central dizziness group. And others were not significantly different among the 3 groups. 5)In additional somatic symptoms, pain score was not different among the 3 groups, but gastrointestinal and sexual symptoms scores of central and peripheral dizziness group were significantly higher than those of psychogenic dizziness group(p<0.01) CONCLUSION: These results suggest that psychiatric symptoms in patients with psychogenic dizziness are not different from those of patients with central or peripheral dizziness. Therefore, the more direct and intensive treatment may be necessary regardless of the type of dizziness.

Serum Neuron Specific Enolase in Vertiginous Patients

BACKGROUND: Vertiginous sense means sensation of rotation. Many patients suffer from vertiginous sense and visit emergency room or clinics. It is important to differentiate the vertigo patients into peripheral type and central type, because central vertigo need urgent treatment. Neuron specific enolase (NSE) is a component of specific brain enzyme and consist of 1.5% of total brain protein and is a useful marker to detect brain injury. We evaluated the significance of NSE in vertiginous patients. METHODS: We performed this test in acute vertiginous patients whose attack started within 24 hours. Neurological examination, MRI and vestibular function test were performed. By these results, ten peripheral type vertiginous patients and ten central type patients were selected. RESULTS: The mean NSE level of control was 6.4 +/-3.4 ng/ml, peripheral type patients was 7.6 +/-2.8 ng/ml and central type was 12.0 +/- 3.9 ng/ml. The central type patients group was significantly higher than other group (p<0.05). CONCLUSION: The Neuron specific enolase (NSE) level is significantly higher in central vertiginous patients group than peripheral group and control. NSE can be helpful method to differentiate central vertigo from peripheral one in acute phase.

A Case of Thoracic Disc Herniation Treated by Transthoracic Transpleural Approach

Thoracic disc herniation is uncommon and only represents 0.25% to 0.75% of all symptomatic disc lesions. The difficulty in diagnosis has been the one of the major problems in the treatment of thoracic disc herniation. But at now, the use of computed tomography with or without water soluble contrast media makes the diagnosis more acurate. Recently, we diagnosed a case of T4, T5 disc herniation by computed tomography with iopamidol. Operation by transthoracic, transpleural approach was done with microsurgical technique, and the result was good. The case is reviewed and other surgical techniques on the literature is discussed.