Interpretation of Chinese experts consensus on artificial intelligence assisted management for pulmonary nodule (2022 version) / 中国胸心血管外科临床杂志

@#The increasing number of pulmonary nodules being detected by computed tomography scans significantly increase the workload of the radiologists for scan interpretation. Limitations of traditional methods for differential diagnosis of pulmonary nodules have been increasingly prominent. Artificial intelligence (AI) has the potential to increase the efficiency of discrimination and invasiveness classification for pulmonary nodules and lead to effective nodule management. Chinese Experts Consensus on Artificial Intelligence Assisted Management for Pulmonary Nodule (2022 Version) has been officially released recently. This article closely follows the context, significance, core implications, and the impact of future AI-assisted management on the diagnosis and treatment of pulmonary nodules. It is hoped that through our joint efforts, we can promote the standardization of management for pulmonary nodules and strive to improve the long-term survival and postoperative life quality of patients with lung cancer.

Feasibility of injecting Fluorescent Agent under the Guidance of Electromagnetic Navigation Bronchoscopy in Pulmonary Nodule Resection / 中国肺癌杂志

BACKGROUND@#It is a great challenge for surgeons to resect pulmonary nodules with small volume, deep position and no solid components under video-assisted thoracoscopic surgery. The purpose of this study is to explore the feasibility and necessity of the localization of pulmonary nodules by injecting indocyanine green (ICG) under the guidance of magnetic navigation bronchoscope and the resection of small pulmonary nodules under the fluoroscope.@*METHODS@#Between December 2018 and August 2019, sixteen consecutive patients with 30 peripheral lung lesions in our hospital received fluorescent thoracoscopic pulmonary nodule resection. Electromagnetic navigation bronchoscope (ENB) was performed before surgery to guide ICG to the target lesion.@*RESULTS@#All patients underwent magnetic navigation-guided pulmonary nodule localization, and surgical resection was performed immediately after localization was completed. The average size of the nodules was (11.12±3.65) mm. The average navigation time was (12.06±2.74) minutes, and the average interval between dye labeling and lung resection was (25.00±5.29) minutes. All lesions were completely resected, the localization success rate was 100.00%, no bleeding and other complications occurred after the localization, the postoperative pathological results confirmed the accuracy of the staining.@*CONCLUSIONS@#Indocyanine green injection under the guidance of magnetic navigation bronchoscope is an effective way to locate pulmonary nodules, which can locate small and untouchable lesions in the lung. This method can help surgeons identify lesions more quickly and accurately. It is practical and worthy of promotion.

Design, synthesis of novel N, N'-bis-(halogenophenyl)-4- methoxybenzene-1, 3-disulfonamides and evaluation of their anti-platelet aggregation activity / 药学学报

Combining the structural features of picotamide and linotroban, a series of N,N'-bis-(halogenophenyl)-4-methoxybenzene-1, 3-disulfonamides were designed and synthesized on the basic principles of drug design. The structures of target compounds were confirmed by IR, 1H NMR and HR-MS, and the in vitro antiplatelet aggregation activity was evaluated by Born turbidimetric method with adenosine diphosphate (ADP) as the platelet aggregation inducers. The assay results showed that twelve compounds (4b, 4f, 4l, 5b, 5d-5g, 5j, 5k, 5m and 5n) were found to have superior anti-platelet aggregation activities than the positive drug picotamide. The preliminary structure-activity relationship (SAR) has been explored.

Retrospective study of clinicopathological characteristics in bronchopulmonary carcinoid / 中国肺癌杂志

<p><b>BACKGROUND AND OBJECTIVE</b>Bronchopulmonary carcinoid (BPC) account for less than 2% of all primary lung malignant tumors, but few related studies were reported. The aim of this study is to analyze this rare disease's clinicopathological characteristics.</p><p><b>METHODS</b>The clinical data of 28 patients with BPC in Cancer Center of Sun Yat-sen University, from January 1994 to June 2009, were enrolled into retrospective analysis. First, the corresponding paraffin blocks reexamined, slice up and stained, multiple pathologists re-consulted, and its subsets (typical carcinoid, TC; atypical carcinoid, AC) defined. Second, the clinical characteristics and immunohistochemical markers and its relationship with prognosis were analyzed.</p><p><b>RESULTS</b>First, the 5-year survival for overall and TC, AC was 56% and 70%, 41% respectively in 28 cases. The markers CD99, Bcl-2 and Ki-67 expression correlated significantly with the BPC subsets (P = 0.017, P = 0.043, and P = 0.033 respectively). Further univariate analysis revealed that advanced TNM staging (P = 0.037), lymph node metastasis (P = 0.001) and Ki-67 nucleolus's positive expression (P = 0.009) are poor prognostic factors. Second, the overall, TC, AC 5-year survival rate was 73%, 83%, 57% respectively in 20 cases underwent the radically surgical resection. Further univariate analysis revealed that AC subset (P = 0.013), lymph node metastasis (P = 0.004) and Ki-67 nucleolus's positive expression (P = 0.006), advanced TNM staging (P = 0.047) are poor prognostic factors in this 20 cases. Third, as univariate analysis, local recurrence and metastasis (n = 4) correlate significantly with Ki-67 nucleolus's and Bcl-2 positive expression (P = 0.027, 0.045, respectively).</p><p><b>CONCLUSION</b>The prognosis of BPC was better than other types of primary lung cancer. Ki-67, Bcl-2 high expression and advanced TNM staging are the poor recurrence and prognostic factors of BPC. The radical surgery remains the treatment of choice for resectable candidates in BPC as NSCLC.</p>

Clinical Study of Lymph Node Metastasis and Optimal Lymphadenectomy for Middle Third Thoracic Esophageal Squamous Cell Carcinoma / 中国肿瘤临床

Objective: To explore the status of lymph node metastasis of middle third thoracic esophageal squamous cell carcinoma and its influence on the prognosis and to seek the reasonable range of lymphade-nectomy. Methods: A total of 129 patients who underwent curative esophagectomy with modern two-field lymphadenectomy of middle third thoracic esophageal squamous cell carcinoma were reviewed. Results: The lymph node metastasis rate was 56.6% and the upper mediastinal lymph node metastasis rate was 43.4%. The lymph node metastasis ratio (positive nodes/total dissected nodes, LMR) was 11.3%. Paraesophageal lymph nodes, lymph nodes near the right recurrent nerve, the left gastric and infracadnal lymph nodes were most commonly involved when the tumor was located in the middle thoracic esophagus. Tumor differentiation, the depth of tumor invasion and the length of tumor were influencing factors for lymph node metastasis. The 5-year survival of N_0, N_1 (LMR≤20%) and N_1 (LMR>20%) patients were 50.4%, 31.0% and 6.8%, respective-ly, with a significant difference among the three groups (P=0.000). Conclusion: LMR was one of the key fac-tors affecting the prognosis, of esophageal cancer. Patients with middle third thoracic esophageal carcinoma should be treated with radical surgery with modern two-field lymphadenectomy.

Risk factor of brain metastasis in locally advanced non-small cell lung cancer after surgery / 中国肺癌杂志

<p><b>BACKGROUND</b>Brain metastasis has become one of the most important factors of the failure of treatment of locally advanced non-small cell lung cancer (LANSCLC). There is no conclusion whether NSCLC patients should receive prophylactic cranial irradiation (PCI) or not. The aim of this study is to analyze the risk factors of brain metastasis of LANSCLC after surgery to find out the sign of PCI for LANSCLC.</p><p><b>METHODS</b>A total of 223 patients with stage III NSCLC who received surgical resection were retrospectively analyzed. The risk factors of brain metastasis were determined to set up a mathematic model for brain metastasis.</p><p><b>RESULTS</b>The median survival time after surgery was 28.0 months. The 1-, 2- and 3-year survival rate was 84.3%, 56.9% and 44.8% respectively. The incidence of brain metastasis was 38.1% (85/223). Patients with extensive mediastinal lymph node metastasis, more node metastasis and non-squamous carcinoma showed significantly higher incidence of brain metastasis than those with limited mediastinal lymph node metastasis, fewer positive mediastinal lymph nodes and squamous carcinoma (P=0.000, P=0.000, P=0.013). The mathematic model of brain metastasis was: logit(P)=8.215-0.903×NPN-0.872×RT-0.714×HG-1.893×LE-0.948×HS-1.034×PC (NPN=No. of positive nodes, RT=resection type, HG=histology, LE=location and extent of mediastinal lymph node metastasis, HS=histologic stage, PC=postoperative chemotherapy). P≥0.44 meant high risk for brain metastasis.</p><p><b>CONCLUSIONS</b>High risk factors of brain metastasis in LANSCLC patients after complete resection of the cancer include non-squamous carcinoma, extensive and more mediastinal lymph node metastasis. P≥0.44 may be considered a sign of PCI in clinical trial.</p>

A prospective randomized study of adjuvant chemotherapy in completely resected stage IIIA-N2 non-small cell lung cancer / 中国肺癌杂志

<p><b>BACKGROUND</b>Recently, results from IALT, JBR10 and CALGB9633 showed that postoperative adjuvant chemotherapy improved survival rate of patients with non-small cell lung cancer (NSCLC) after complete resection. The aim of this study is to evaluate the effect of postoperative adjuvant chemotherapy on survival after complete resection for stage IIIA-N2 NSCLC.</p><p><b>METHODS</b>From Jan 1999 to Dec 2003, one-hundred and fifty patients with stage IIIA-N2 NSCLC were randomly divided into two groups. The chemotherapy group received four cycles of chemotherapy with navelbine or paclitaxel plus carboplatin, while the observation group did not receive chemotherapy after operation.</p><p><b>RESULTS</b>In the chemotherapy group, 86.1% (68/79) of patients finished 4 cycles of chemotherapy, and no one died of toxic effects of chemotherapy; 25% of patients had grade III-IV leukopenia, 2% of patients had febrile leukopenia. The median survival time for the entire 150 patients was 879 days, and 1-, 2- and 3-year survival rate was 81%, 59% and 43%. There was no significant difference in median survival between the chemotherapy and observation groups (P= 0.0527), but there was significant difference in the 1- and 2-year survival rate (94.71% and 76.28% vs 88.24% and 60.13%, P < 0.05). The most common site of recurrence was the brain. Twenty-six percent (39/150) of patients recurred in the brain as their first site of failure, and 22.8% (18/79) for the chemotherapy group, 29.6% (21/71) for the observation group. The median survival time for patients who developed brain metastasis was not significantly different between the chemotherapy and observation groups (812 days vs 512 days, P=0.122), but there was significant difference in the 2-year survival rate (66.7% vs 37.6%, P < 0.01). The median survival was 190 days for the patients since brain metastasis appeared.</p><p><b>CONCLUSIONS</b>Postoperative adjuvant chemotherapy dose not significantly improve median survival among patients with completely resected stage IIIA-N2 NSCLC, but significantly improves the 1- and 2-year survival rate. It also dose not decrease the incidence of brain metastasis but puts off the time of brain metastasis.</p>

Use small incision in artificial femur head replacement in the treatment of senile intertrochanteric fracture / 中国基层医药

Objective To analyze and evaluate the use of small incision in the treatment of senile intertrochanteric fracture in artificial femur head replacement.Method 79～98 years old senile patients suffered from intertrochanteric fracture use small incision and artificial femur head replacement,a total of 18 cases including male 6 cases and female 12 cases,averaged eighty six years old,type of fracture according to Evans classification,type Ⅲ six cases,type Ⅳ eight cases,type Ⅴ four cases.Result 18 cases were followed up for 3～19 months,no case died,joint function in good situation,6～21 days post operation walk with help of tools,the average time was 7 days,use activity rate of hip joint,degree of pain and living self-service situation as criteria,success rate reached 91%,no relaxation or descendent of prosthesis.Conclusion Trauma is relatively small in use small incision and artificial femur head replacement in the treatment of senile intertrochanteric fracture,the result is satisfactory.

早期康复对老年股骨干骨折术后膝关节功能恢复的作用 / 中国康复理论与实践

@#目的探讨老年股骨干骨折术后早期康复对患肢膝关节功能恢复的作用。方法对86例老年股骨干骨折患者术后进行早期康复治疗,包括持续被动运动、主动抗引力运动、关节屈伸运动及关节抗阻力运动、过渡性部分负重行走,直至完全负重行走。结果经康复训练后3个月,膝关节活动功能优48例,良29例,中7例,差1例,优良率89.5%。结论老年股骨干骨折术后行早期康复干预,可减轻肌肉萎缩及关节挛缩,有利于患肢关节功能恢复。