Invasiveness assessment by CT quantitative and qualitative features of lung cancers manifesting ground-glass nodules in 555 patients: A retrospective cohort study / 中国胸心血管外科临床杂志

@#Objective     To explore the correlation between the quantitative and qualitative features of CT images and the invasiveness of pulmonary ground-glass nodules, providing reference value for preoperative planning of patients with ground-glass nodules. Methods    The patients with ground-glass nodules who underwent surgical treatment and were diagnosed with pulmonary adenocarcinoma from September 2020 to July 2022 at the Third Affiliated Hospital of Kunming Medical University were collected. Based on the pathological diagnosis results, they were divided into two groups: a non-invasive adenocarcinoma group with in situ and minimally invasive adenocarcinoma, and an invasive adenocarcinoma group. Imaging features were collected, and a univariate logistic regression analysis was conducted on the clinical and imaging data of the patients. Variables with statistical difference were selected for multivariate logistic regression analysis to establish a predictive model of invasive adenocarcinoma based on independent risk factors. Finally, the sensitivity and specificity were calculated based on the Youden index. Results     A total of 555 patients were collected. The were 310 patients in the non-invasive adenocarcinoma group, including 235 females and 75 males, with a meadian age of 49 (43, 58) years, and 245 patients in the invasive adenocarcinoma group, including 163 females and 82 males, with a meadian age of 53 (46, 61) years. The binary logistic regression analysis showed that the maximum diameter (OR=4.707, 95%CI 2.060 to 10.758), consolidation/tumor ratio (CTR, OR=1.027, 95%CI 1.011 to 1.043), maximum CT value (OR=1.025, 95%CI 1.004 to 1.047), mean CT value (OR=1.035, 95%CI 1.008 to 1.063), spiculation sign (OR=2.055, 95%CI 1.148 to 3.679), and vascular convergence sign (OR=2.508, 95%CI 1.345 to 4.676) were independent risk factors for the occurrence of invasive adenocarcinoma (P<0.05). Based on the independent predictive factors, a predictive model of invasive adenocarcinoma was constructed. The formula for the model prediction was: Logit(P)=–1.293+1.549×maximum diameter of lesion+0.026×CTR+0.025×maximum CT value+0.034×mean CT value+0.72×spiculation sign+0.919×vascular convergence sign. The area under the receiver operating characteristic curve of the model was 0.910 (95%CI 0.885 to 0.934), indicating that the model had good discrimination ability. The calibration curve showed that the predictive model had good calibration, and the decision analysis curve showed that the model had good clinical utility. Conclusion     The predictive model combining quantitative and qualitative features of CT has a good predictive ability for the invasiveness of ground-glass nodules. Its predictive performance is higher than any single indicator.

Research progress on the correlation between imaging characteristics and pathological invasion degree of early lung adenocarcinoma / 中国胸心血管外科临床杂志

@#With the development of multi-slice spiral computed tomography (CT) technology and the popularization of low-dose spiral CT screening, more and more adenocarcinomas presenting ground-glass nodule (GGN) are found. Pathological invasiveness is one of the important factors affecting the choice of treatment strategy and prognosis of patients with early lung adenocarcinoma. Imaging features have attracted wide attention due to their unique advantages in predicting the pathologic invasiveness of early lung adenocarcinoma. The imaging characteristics of GGN can be used to predict the pathologic invasiveness of lung adenocarcinoma and provide evidence for clinical decisions. However, the imaging parameters and numerical values for predicting pathologic invasiveness are still controversial, which will be reviewed in this paper.

Advances in the Study of Invasive Non-mucinous Adenocarcinoma with Different Pathological Subtypes / 中国肺癌杂志

Lung cancer is the leading cause of cancer death in the world today, and adenocarcinoma is the most common histopathological type of lung cancer. In May 2021, World Health Organization (WHO) released the 5th edition of the WHO classification of thoracic tumors, which classifies invasive non-mucinous adenocarcinoma (INMA) into lepidic adenocarcinoma, acinar adenocarcinoma, papillary adenocarcinoma, solid adenocarcinoma, and micropapillary adenocarcinoma based on its histological characteristics. These five pathological subtypes differ in clinical features, treatment and prognosis. A complete understanding of the characteristics of these subtypes is essential for the clinical diagnosis, treatment options, and prognosis predictions of patients with lung adenocarcinoma, including recurrence and progression. This article will review the grading system, morphology, imaging prediction, lymph node metastasis, surgery, chemotherapy, targeted therapy and immunotherapy of different pathological subtypes of INMA.
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Research progress in diagnosis and treatment of multiple primary lung cancer / 中国胸心血管外科临床杂志

@#With the changes in the disease spectrum and the advancement of examination technology, the detection rate of multiple primary lung cancers (MPLC) is gradually increasing when multiple nodules and masses in the lung are examined clinically. MPLC has significant distinction with other types of lung diseases or lung cancers in the treatment and prognosis. In most cases, patients would be recommended to undergo the surgery as soon as possible which means that the accurate diagnosis should be made before surgery or during treatment. The newly developed molecular and genomic methods are more likely to better determine the relationship between multiple lesions. Artificial intelligence can be used as a related diagnostic aid to show more accurate and objective results in the diagnosis of multiple pulmonary nodules. This review summarizes the latest MPLC diagnostic research (including pathological analysis, imaging), analyzes surgical treatment methods, and looks forward to the future research direction of MPLC diagnosis and treatment, in order to provide reference for MPLC research.

Cancer Screening Program in Urban Kunming of Yunnan: Evaluation of Lung Cancer Risk Assessment and Screening / 中国肺癌杂志

BACKGROUND@#Lung cancer is the most common neoplasmas with a poor prognosis and a low 5-year survival rate. Early screening is an important measure for the prevention and treatment of lung cancer. At present, different countries have issued corresponding lung cancer screening guidelines, but China still lacks guidelines based on Chinese population research. Therefore, the National Cancer Center launched a Multi-center Cancer Screening Program in Urban China. This study analyzed the evaluation of lung cancer risk assessment model and screening effect in urban China of Yunnan, so as to explore the evaluation model of high-risk lung cancer population suitable for China's national conditions and develop lung cancer screening guidelines for Chinese.@*METHODS@#A questionnaire survey and lung cancer risk assessment were conducted on 165,337 people in 36 street offices in 4 main urban areas of Kunming, Yunnan Province, using cluster sampling method from January 2015 to December 2019. People with high-risk of lung cancer conducted low-dose computed tomography (LDCT) screening of chest. What's more, all participants were followed up by active or passive follow-up.@*RESULTS@#There were 264 patients were diagnosed lung cancer by pathology, and the overall incidence of lung cancer was 0.16% (264/165,337). The high-risk group (0.31%, 116/37,914) was higher than the non-high-risk group (0.12%, 148/127,423), and the difference was statistically significant (P<0.001). The incidence of lung cancer in the high-risk group was higher than the non-high-risk group among the male, female, and lower 50-year-old or more than 50-year-old subgroups, with statistical differences (P<0.001), but there was no statistical difference in the group without LDCT screening (P=0.73). The sensitivity of the lung cancer high-risk population assessment model was 43.94% (116/264) and the specificity was 77.10% (127,275/165,073). The early diagnosis rate of the screening group was 72.97% (54/74), which was significantly higher than that of the non-screening group [28.48% (43/151)].@*CONCLUSIONS@#The lung cancer high-risk population assessment model of National Key Public Health Program: Cancer Screening Program in Urban China can detect high-risk populations and improve the early diagnosis rate of lung cancer effectively.

Progress in Survival Prognosis of Segmentectomy for Early-stage Non-small Cell Lung Cancer / 中国肺癌杂志

Surgery is currently the most appropriate treatment for early-stage non-small cell lung cancer (NSCLC). Increasing unilateral or bilateral multiple primary lung cancer being found, segmentectomy has attracted wide attention for its unique advantages in the treatment for such tumors. Ground glass opacity dominant early-stage NSCLC is associated with a good prognosis and can be cured by segmentectomy, however, the treatment of solid-dominant NSCLC remains controversial owing to the invasive nature. With the in-depth study on the lymph node metastasis pathway, radiological characteristics and molecular biology of NSCLC, a large part of solid nodules with certain characteristics can also be cured by segmentectomy. This paper reviews the research status and progress about the indication of segmentectomy.
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Results of Lung Cancer Screening among Urban Residents in Kunming / 中国肺癌杂志

BACKGROUND@#Lung cancer screening is an effective measure to reduce lung cancer mortality. Currently, lung cancer screening is recommended internationally and nationally. China had launched a large-scale early diagnosis and early treatment of rural and urban lung cancer in 2009 and 2012. Yunnan Province participated in related projects in 2009 and 2014, but the results of large-scale lung cancer screening have not been reported in Yunnan Province. In this study, we participated in the National Key Public Health Program, Cancer Screening Program in Urban China and analyzed the results of lung cancer screening in 10,154 urban residents in Kunming, Yunnan Province from 2014 to 2018, and evaluated the screening effect of early diagnosis and treatment of lung cancer in urban.@*METHODS@#A total of 31,824 people with high risk of lung cancer were evaluated with 40-74 year-old population in Kunming. A high-risk group underwent low-dose spiral computed tomography (CT) scan of the chest, and analyze the high risk rate and detection rate. A total of 150,535 questionnaires were completed in 5 years, and 31,824 people with high risk of lung cancer were evaluated.@*RESULTS@#The high-risk rate was 21.14%. A total of 10,154 low-dose spiral CT screenings were performed, with a participation rate of 31.91%. The detection rate of intrapulmonary nodules was 22.28% (2,262/10,154), of which the detection rate of <5 mm solid/partial solid nodules was 11.30% (1,332/10,154) and the detection rate of <8 mm non-solid nodules was 2.20% (219/10,154). The positive nodule detection rate was 7.00% (711/10,154), the suspected lung cancer detection rate was 0.60% (59/10,154), and the lung cancer detection rate was 0.27% (27/10,154). The detection rate of the positive nodules, <8 mm non-solid nodules and suspected lung cancer in male were significantly higher than that in female, and the positive nodules, <5 mm solid nodules, suspected lung cancer and confirmed lung cancer detection rate increased with age.@*CONCLUSIONS@#Low-dose spiral CT is suitable for screening of high-risk populations of lung cancer, which is helpful for early detection of positive nodules and related diseases in the lungs. It is necessary to pay attention to the screening of lung cancer in people over 60 years old. Understand the lung health status of residents in Kunming. Raise awareness of lung cancer prevention and treatment among residents, and improve the rate of early diagnosis and treatment of lung cancer.

Survival in Lung Cancer among Female Never-smokers in Rural Xuanwei and Fuyuan Counties in Eastern Yunnan Province, China / 中国肺癌杂志

BACKGROUND@#Lung cancer rates among women in rural Xuanwei and Fuyuan counties in eastern Yunnan province, China, are among the highest in the world, even though almost all women are non-smokers, and they tend to develop lung cancer at a younger age than other locations by roughly 5 yr-10 yr. This study investigated the survival of lung cancer patients among female never-smokers.@*METHODS@#The female never-smokers, who had lived for many years in Xuanwei and Fuyuan counties, with lung cancer newly-diagnosed between July 2006 to March 2010, were followed up through the end of 2016. Age-standardized relative survival for all cases was calculated using local life table. The Kaplan-Meier method and Log-rank test were used to analyze the relationship between the variables and the prognosis in univariate analysis. Cox regression analysis was employed in the multivariate analysis.@*RESULTS@#Among 1,250 total subjects, 1,075 died and the remaining 175 were censored during the follow-up, with a median follow-up period of 69 months (95%CI: 61.9-76.0). Overall, the mean age was (54.8 ±10.9) yr, with variable clinical stages: 3.5% of cases were stage I, 8.7% stage II, 20.7% stage III, 29.7% stage IV, and 37.4% stage unknown. The 645 patients(51.6%) with cyto-histological diagnosis contains 303 with Squamous cell carcinoma, and 231 with adenocarcinoma, 24 with small cell, 43 with other specified type and 39 with unknown histological type. Only 215 (17.2%) patients received surgery, 487 (39.0%) were treated without surgery, and 548 (43.8%) did not receive any specific anticancer therapy. The 5-year observed survival rate and age-standardized relative survival were 8.9% (95%CI: 7.0-10.6), and 10.1% (95%CI: 3.7-20.5) respectively, with a median survival of 13.2 months. The 5-year survival rates were 41.1% for stage I, 22.4% for stage II, 5.3% for stage III, 1.3% for stage IV, 11.2% for missing stage, 17.9% for adenocarcinoma, and 5.6% for squamous cell carcinoma respectively. Surgery significantly improved 5-year survival rate compared with non-surgery (34.8% vs 3.2%, P<0.001). The patients with non-treatment, aged 65 years and older, living in rural areas and farmer with low socioeconomic status had poorer survival, whereas the patients treated in provincial hospitals and chest X-ray screening had better survival. Cox multivariate analysis further showed that stage of tumor-node-metastasis (TNM), treatment status, hospital-level, and X-ray screening were factors correlated with survival.@*CONCLUSIONS@#Patients with lung cancer among female never-smokers in Xuanwei and Fuyuan experience poorer survival, because they are less likely to be diagnosed at early stage, as well as less likely to receive surgery and comprehensive treatment. Furthermore low socioeconomic status and poor health security are also responsible for the low survival.

Analysis of colorectal cancer screening results in Kunming from 2014 to 2017 / 中华预防医学杂志

This study analyzed the distribution of high-risk population, the compliance and detected lesions of colorectal cancer screening from the Cancer Screening Program in urban areas of Kunming,Yunnan Province from 2014 to 2017. A total of 127 960 residents were included,of which 14 791 (11.70%) cases were diagnosed with high risk of colorectal cancer by the National Cancer Center High Risk Population Assessment System. A total of 3 484 cases completed colonoscopy clinical screening and the rate of participation was 23.55%. The screening results showed that 592 positive cases were detected, and the positive rate was 17.17%. The detection rates of polyps,adenomas,advanced adenomas,precancerous lesions and colorectal cancer were 16.27%,13.12%,7.18%,7.63% and 0.26%, with 567, 457, 250, 266 and 9 cases, respectively.

Screening of colorectal cancer in Kunming urban residents from 2014 to 2017 / 中华胃肠外科杂志

Objective@#To explore the screening efficiency of colorectal cancer in urban residents of Kunming, China.@*Methods@#Using the method of cluster sampling, from October 2014 to October 2017, residents of the three jurisdictions of Xishan, Guandu and Chenggong Districts of Kunming city were investigated. The inclusion criteria: (1) resident (for more than 3 years) population of Kunming city aged 40-74 years old; (2) voluntarily participating and receiving colonoscopy; (3) signing informed consent. Based on the Harvard Cancer Risk Index, the questionnaire was built on the consensus of more than 20 years of common cancer epidemiology in China. Through the consensus reached by the multidisciplinary expert panel discussion, a comprehensive evaluation system for cancer risk in China was designed. The high-risk group of colorectal cancer was determined by preliminary screening of the questionnaire, and a free colonoscopy was performed for the appointment to the gastrointestinal endoscopy department of the Yunnan Cancer Hospital. All polypoid lesions and ulcers found by colonoscopy must be biopsied to confirm the diagnosis. χ2 test or Fisher exact probability method was used to compare the detection of colorectal cancer in 4 groups of 40-49 years old, 50-59 years old, 60-69 years old, and ≥70-years old. Detection of colonoscopy, compliance, pathological examination, pathological diagnosis, and morbidity of colorectal cancer were analyzed.@*Results@#A total of 127 960 people from 40 to 74 years old of urban residents in Kunming city participated in the preliminary screening of the questionnaire, including 59 748 (46.7%) males and 68 212 females (53.3%) with mean age of (53.6±8.6) years old. The 40-49 years old group had the largest number of participants (48 044, 37.5%), followed by the groups of 50-59 years old (42 473, 33.2%), 60-69 years old (34 111, 26.7%), and ≥70 years old (3332, 2.6%). Till October 2017, a total of 14 971 people were screened as at high risk of colorectal cancer, with the high-risk detection rate of 11.7%, and the high-risk detection rate of women was significantly higher than that of men [13.4% (9 109/68 212) vs. 9.8% (5 862/59 748), χ2=386.947, P<0.001]. The highest high-risk detection rate was in the 50-59 years group in both gender [men: 11.1% (2202/19 831), women: 15.3% (3034/22 642)]. A total of 3449 people among the high-risk population received colonoscopy examination. The compliance rate of colonoscopy was 23.0% (3449/14 971), and the male compliance rate was 19.8% (1162/5862), which was significantly lower than that of females [25.1% (2287/9109), χ2=56.175, P<0.001]. The highest compliance was observed in the 50-59 years group [25.4% (1438/5668)], followed by 40-49 years and 60-69 year group [22.1%(1091/4931) and 22.0%(891/4048), respectively], and the compliance of ≥70 years old group was the lowest [9.0% (29/324)]. Colonoscopy examination revealed 606 cases with lesions, the detection rate of lesions was 17.6%, and the male detection rate was significantly higher than that of females [26.9% (313/1162) vs. 12.8% (293/2287), χ2=106.140, P<0.001]. The detection rate of lesions increased with age [40-49, 50-59, 60-69, ≥70: 10.9% (119/1091), 17.5% (252/1438), 25.0% (223/891) and 41.4% (12/29), respectively, χ2=79.010, P<0.001]. A total of 584 cases underwent endoscopic excision and pathological diagnosis, and 465 cases (13.5%) of precancerous lesions were detected. The prevalence of precancerous lesions in men was higher than that in women [21.3% (247/1162) vs. 9.5% (218/2287), χ2=90.801, P<0.001], the precancerous lesion detection rate increased with age [40-49, 50-59, 60-69, ≥70: 8.0% (87/1091), 14.3% (206/1438), 18.1% (161/891) and 37.9% (11/29); χ2=58.109, P<0.001]. A total of 4 patients with colorectal cancer were detected, including 3 males and 1 female. The detection rate of male colorectal cancer was 258.2/100 000, and the female was 43.7/100 000, whose difference was not statistically significant (χ2=1.488, P=0.223). There was no significant difference in the detection rate of colorectal cancer among 4 age groups [40-49, 50-59, 60-69, ≥70: 91.7/100 000 (1/1091), 69.5/100 000 (1/1438), 224.5/100 000 (2/891) and 0, respectively, P=0.696].@*Conclusions@#Screening for colorectal cancer is an important measure to control the onset and death of colorectal cancer. Through the questionnaire risk assessment plus colonoscopy, two-step screening method can improve the screening efficiency and greatly reduce the screening cost.

Effect of tumor metabolism on tumor immunity / 国际肿瘤学杂志

Tumor metabolism is closely related to tumor occurrence,development and the behavior of tumor immune escape.The local nutrient consumption (such as glucose metabolism,amino acid metabolism and oxygen metabolism) of tumor metabolism and the effect of metabolites on immune cells are the hotspots in the field of tumor immunology and it can also guide the research of new anticancer drugs related to tumor immunity.

China National Lung Cancer Screening Guideline with Low-dose Computed Tomography (2018 version) / 中国肺癌杂志

BACKGROUND@#Lung cancer is the leading cause of cancer-related death in China. The results from a randomized controlled trial using annual low-dose computed tomography (LDCT) in specific high-risk groups demonstrated a 20% reduction in lung cancer mortality. The aim of tihs study is to establish the China National lung cancer screening guidelines for clinical practice.@*METHODS@#The China lung cancer early detection and treatment expert group (CLCEDTEG) established the China National Lung Cancer Screening Guideline with multidisciplinary representation including 4 thoracic surgeons, 4 thoracic radiologists, 2 medical oncologists, 2 pulmonologists, 2 pathologist, and 2 epidemiologist. Members have engaged in interdisciplinary collaborations regarding lung cancer screening and clinical care of patients with at risk for lung cancer. The expert group reviewed the literature, including screening trials in the United States and Europe and China, and discussed local best clinical practices in the China. A consensus-based guidelines, China National Lung Cancer Screening Guideline (CNLCSG), was recommended by CLCEDTEG appointed by the National Health and Family Planning Commission, based on results of the National Lung Screening Trial, systematic review of evidence related to LDCT screening, and protocol of lung cancer screening program conducted in rural China.@*RESULTS@#Annual lung cancer screening with LDCT is recommended for high risk individuals aged 50-74 years who have at least a 20 pack-year smoking history and who currently smoke or have quit within the past five years. Individualized decision making should be conducted before LDCT screening. LDCT screening also represents an opportunity to educate patients as to the health risks of smoking; thus, education should be integrated into the screening process in order to assist smoking cessation.@*CONCLUSIONS@#A lung cancer screening guideline is recommended for the high-risk population in China. Additional research , including LDCT combined with biomarkers, is needed to optimize the approach to low-dose CT screening in the future.

Analysis of epidermal growth factor receptor gene T790M mutation in plasmatic ctDNA samples of pa-tients with non-small cell lung cancer / 实用医学杂志

Objective To investigate epidermal growth factor receptor(EGFR)gene T790M mutation in plasmatic ctDNA samples from 171 patients with non-small cell lung cancer and analyze the relationship between EGFR T790M mutation and the clinical factors. Methods The EGFR T790M mutation was detected in 171 cases by super amplification refractory mutation system(Super ARMS)in this paper. Rusults The EGFR gene T790M mutation was identified in 7.60%(13/171)plasmatic ctDNA samples which mostly came from patients withⅢb~Ⅳstages of lung cancer. The EGFR T790M mutation rate was identified in 2.05%(3/146)plasmatic samples of pa-tients who did not received treatment of EGFR-TKIs,which was lower than 40.00%(10/25,P<0.05)plasmatic samples of patients who received treatment of first generational EGFR-TKIs. The EGFR T790M mutation rate was identified in 75.00%(3/4) and 60.00%(6/10) plasmatic samples of patients who have received TKI for 6 to 10 months and more than 10 months,which was higher than 9.10%(1/11,P < 0.05)plasmatic samples of patients who have received TKIs for less than 6 months. Conclusions This article demonstrated that EGFRT790M muta-tion was more common in lately NSCLC patients who have received TKIs treatmentover 6 months,meanwhile the EGFR T790M mutation dynamical detective technology will effectively guide the clinic treatment.

Correlation analysis between expression of NF-κB and quartz's deposit in non-small cell lung cancer in Xuanwei , Yunnan province / 肿瘤研究与临床

Objective To evaluate the relationship between quartz's deposit and expression of NF-κB in non-small cell lung cancer (NSCLC) lung tissues in Xuanwei, Yunnan Province, and to clarify the role of quartz in Xuanwei NSCLC's carcinogenic mechanism. Methods As research objects, the lung tissues of NSCLC and lung benign lesions after surgical resection were collected from July 2009 to September 2015 at the Third Affiliated Hospital of Kunming Medical University. Firstly, the transmission electron microscopic (TEM) with energy dispersive X-ray analyzer (EDS) was used for observation of crystalline deposit and local pathological changes. Secondly, expression level of NF-κB had been analysed and a correlation analysis with particle size of SiO2 crystal in the same lung sample was made. Results The occurrence rates of quartz in Xuanwei NSCLC lung tissues were above non-Xuanwei NSCLC and benign lung tissues (P0.05). The expression level of NF-κB was generally increasing when quartz 's size became smaller. Conclusion Quartz 's deposit may play a certain role in carcinogenic mechanism of lung cancer in Xuanwei, the smaller the particle size, the greater the cytotoxicity.

Research progress on the interaction between Candida albicans and common bacteria / 国际生物医学工程杂志

Candida albicans is the most prevalent fungal species of the human microbiota.Many nosocomial Candida albicans infections are polymicrobial.The interaction between Candida albicans and other bacteria can be synergistic,antagonistic,and one side benefit,which cause damage of host in different way.Co-infections influence the biochemistry and polybiofilm among pathogenic microorganisms,and then change the drug resistance,response host immunity,and virulence.This makes co-infections more difficult to be cured than mono-infections.The coinfection of Candida albicans and other bacteria has a high incidence rate and mortality rate,which is a serious problem faced by clinicians.The mechanism of interaction between Candida albicans and other bacteria has an important significance in diagnosis and co-infection treatment.In this paper,the research progress of interaction between Candida albicans and Staphylococcus aureus,Pseudomonas aeruginosa,Streptococcus mutans,as well as Lactobacilli was reviewed.

Analysis of epidermal growth factor receptor gene T790M mutation in plasmatic ctDNA samples of pa-tients with non-small cell lung cancer / 实用医学杂志

Objective To investigate epidermal growth factor receptor(EGFR)gene T790M mutation in plasmatic ctDNA samples from 171 patients with non-small cell lung cancer and analyze the relationship between EGFR T790M mutation and the clinical factors. Methods The EGFR T790M mutation was detected in 171 cases by super amplification refractory mutation system(Super ARMS)in this paper. Rusults The EGFR gene T790M mutation was identified in 7.60%(13/171)plasmatic ctDNA samples which mostly came from patients withⅢb~Ⅳstages of lung cancer. The EGFR T790M mutation rate was identified in 2.05%(3/146)plasmatic samples of pa-tients who did not received treatment of EGFR-TKIs,which was lower than 40.00%(10/25,P<0.05)plasmatic samples of patients who received treatment of first generational EGFR-TKIs. The EGFR T790M mutation rate was identified in 75.00%(3/4) and 60.00%(6/10) plasmatic samples of patients who have received TKI for 6 to 10 months and more than 10 months,which was higher than 9.10%(1/11,P < 0.05)plasmatic samples of patients who have received TKIs for less than 6 months. Conclusions This article demonstrated that EGFRT790M muta-tion was more common in lately NSCLC patients who have received TKIs treatmentover 6 months,meanwhile the EGFR T790M mutation dynamical detective technology will effectively guide the clinic treatment.

Research and Design of an Experimental Apparatus Based on the "Open Fireplace" in Xuanwei District / 生物医学工程学杂志

Xuanwei district in Yunnan Province of China has pretty high incidence of lung cancer in China, even a- round the world. Studies have shown that there exists a close relationship between lung cancer and local indoor air pollution caused by Bituminous coal. Considering that the indoor air pollution in Xuanwei District is caused by "open fireplace", an indoor air pollution simulation system was designed, and an F344 rats lung damage model was estab- lished for this indoor air pollution fireplace. The model is based on indoor air pollution simulation system with signal multiplexer control and multi-channel acquisition, and mining PID algorithm was used for polynomial fitting to each test point, and a relatively constant PM2. 5 air pollution status was simulated. The results showed that the system could simulate a variety of states of air pollution, provide a new test method for evaluation of human injury caused by indoor air pollution and a new idea for the study of the incidence of lung cancer in Xuanwei district and other places.

Value of EBUS-TBNA in diagnosis of lung cancer and its complications / 实用医学杂志

Objective To investigate the value of EBUS-TBNA (endobronchial ultrasound-guided trans-bronchial needle aspiration) in diagnosis of lung cancer and analyze its complications. Methods A retrospective study was carried out in our hospitalfrom March 2013 to March 2015. A total of 171patients received C-TBNA (Con-ventional transbronchial needle aspiration) first and got negative results. Therefore, they received EBUS-TBNA next. Weanalyzedthe sensitivity, specificity, accuracy of malignancy with EBUS-TBNA and positive (malignant) lymph node sites biopsied with EBUS-TBNAand the incidence of its complications. Results Lung cancer was proven in 107 patients who had received EBUS-TBNA, while 16 were benign cases. Thirty-onenegative patients received CT guided needle biopsy or surgeryfor finally pathology. Based on above statistical data , we calculated EBUS-TBNA′s sensitivity, specificity and accuracy in 88.42%, 100.00%and 94.21%respectively. A totalof 818 lymph nodes were punctured by EBUS-TBNA, 408 were malignancy. The rate of diagnosis for malignancy was 49.88%. The complica-tioncontained 1 in hemorrhage, 1 in infectionand no life-threatening conditionandno death. Conclusion The value ofdiagnosis in lung cancerisrelatively high with EBUS-TBNAin safety and efficient.

Analysis of the Clinical Characteristics of Malignant Chest Tumor Patients with Nosocomial Mixed Fungal-Bacterial Mixed Infection / 昆明医科大学学报

Objective To explore the clinical characteristics of and to provide help to the prevention and treatment of malignant chest tumor with nosocomial mixed fungal-bacterial infection.Methods From July 2007 to June 2015,pathogenic bacteria in sputum,blood,urine,chest incision,thoracic and abdominal fluid,and implantable medical biological material were cultivated in 5067 patients with malignant chest tumor suspected with infection.The clinical characteristics,source of specimen and pathogenic bacteria,the types of diseases,medical intervention activities of 142 cases detected with mixed fungal-bacterial infection were retrospectively analyzed.Fesult In 142 patients,104 patients at clinical stage Ⅲ-Ⅳ accounted for 73.2％,and 94 patients used antibiotics more than 14 days (66.2％);104 cases had implanted biological materials (74.7％);96 cases died (67.6％).A total of 167 strains bacteria were isolated.Sixty-one strains of G+ bacteria accounting for 36.5％ were mainly Epidermis staphylococcus and Staphylococcus aureus;106 strains of G-bacteria accounting for 63.5％ were mainly klebsiella pneumonia,Escherichia coli and baumanii;172 strains fungus mainly of Candida albicans were isolated (77.3％).Pathogenic bacteria sources were mainly sputum specimens + pharynx strip,blood culture and medical implant materials.In 72 lung cancer patients,squamous carcinoma and small cell carcinoma were 52.8％ and 33.3％ respectively,higher than adenocarcinoma (12.5％);In 42 esophageal cancer patients,postoperative patients were 42.9％.Parenteral nutrition patients with more than 10 days were 80.9％ higher than that of parenteral nutrition in patients with less than 10 days (19.1％).Conclusion Among malignant chest tumor patients with nosocomial mixed fungal-bacterial infection,the bacteria were found in staphylococcus aureus,klebsiella pneumoniae and E.coli and the fungus was Candida albicans.For clinical stage Ⅲ-Ⅳ,patients with parenteral nutrition for more than 10 days,having history of chemo or radiotherapy,with antimicrobial use for more than 14 days,and with implanted biological materials,should be warned about nosocomial mixed fungal-bacterial infection.

Biomaterial implantation associted infection and related gene regulation of biofilm formation by Staphylococcus epidermidis / 国际生物医学工程杂志

Staphylococcus epidermidis is a commensal bacteria which inhabits on the surface of human skin and mucous membrane.It has been demonstrated that staphylococcus epidermidis is a major opportunistic pathogen that can cause clinical biomaterial related infection and plays an important role in biomaterial implantation associated infections.The main pathogenic factor is the formation of the bacterial biofilm on surface of medical biomaterial.The formation of bacterial biofilm can resist the defense reaction and antibiotic treatment effectively so that leading to the biomaterial implantation associated infection which is difficult to cure thoroughly,and make the infections become chronic,persistent and repetitive.Nowadays,the infections caused by Staphylococcus epidermidis have caused high clinical mortality.Staphylococcus epidermidis biofilm formation,the regulations of intercellular adhesion gene (ica) operon and accessory gene regulator (agr) gene on the formation of biofilm and their functions in clinical biomaterial related infections are reviewed in this article.