A Phase 1b Clinical Trial of Neoadjuvant Radio-immunotherapy for Esophageal Squamous Cell Cancer.

PURPOSE: Neoadjuvant chemoradiotherapy is the recommended treatment for patients with resectable esophageal cancer but is associated with a higher incidence of adverse effects. Given the efficacy of immunotherapy, we propose a chemotherapy-free regimen of neoadjuvant radio-immunotherapy (NRIT) to balance therapeutic efficacy and potential side effects or overtreatment. METHODS AND MATERIALS: In this phase 1b clinical trial, we assessed the safety and efficacy of NRIT in esophageal squamous cell cancer. The enrolled patients received 41.4 Gy of radiation and 4 cycles of 240 mg of toripalimab injection before surgery. The primary endpoint was treatment-related adverse events and the secondary endpoints were pathologic complete response and major pathologic response. Immunohistochemistry and multiplex immunofluorescence staining were used to evaluate the tumor microenvironment before and after neoadjuvant treatment. RESULTS: Of the 22 patients enrolled, 19 underwent R0 surgery. One patient discontinued neoadjuvant immune therapy due to experiencing a grade 3 treatment-related adverse event. Three patients did not undergo surgery due to tumor progression or side effects. Among the patients who underwent surgery, 3 patients experienced serious complications shortly after surgery. Upon pathologic evaluation, the pathologic complete response and major pathologic response rates were 47.4% and 68.4%, respectively. CONCLUSIONS: The NRIT regimen is safe and feasible for patients with esophageal squamous cell cancer.

A prediction model of elderly hip fracture mortality including preoperative red cell distribution width constructed based on the random survival forest (RSF) and Cox risk ratio regression.

An independent correlation between pre-RDW and 1-year mortality after surgery in elderly hip fracture can be used to predict mortality in elderly hip fracture patients and has predictive significance in anemia patients. With further research, a treatment algorithm can be developed to potentially identify patients at high risk of preoperative mortality. INTRODUCTION: Red blood cell distribution width (RDW) is an independent predictor of various disease states in elderly individuals, but its association with the prognosis of elderly hip fracture patients is controversial. This study aimed to evaluate the prognostic value of RDW in such patients, construct a prediction model containing RDW using random survival forest (RSF) and Cox regression analysis, and compare RDW in patients with and without anemia. METHODS: We retrospectively analyzed the data of elderly patients who underwent hip fracture surgery, selected the best variables using RSF, stratified the independent variables by Cox regression analysis, constructed a 1-year mortality prediction model of elderly hip fracture with RDW, and conducted internal validation and external validation. RESULTS: Two thousand one hundred six patients were included in this study. The RSF algorithm selects 12 important influencing factors, and Cox regression analysis showed that eight variables including preoperative RDW (pre-RDW) were independent risk factors for death within 1-year after hip fracture surgery in elderly patients. Stratified analysis showed that pre-RDW was still independently associated with 1-year mortality in the non-anemia group and not in the anemia group. The nomogram prediction model had high differentiation and fit, and the prediction model constructed by the total cohort of patients was also used for validation of patients in the anemia patients and obtained good clinical benefits. CONCLUSION: An independent correlation between pre-RDW and 1-year mortality after surgery in elderly hip fracture can be used to predict mortality in elderly hip fracture patients and has predictive significance in anemia patients.

Electroacupuncture at ST36 acupoint regulates stem cells during experimental autoimmune encephalomyelitis.

BACKGROUND: Electroacupuncture (EA) is given to assist in the treatment of MS, which is an effective therapeutic method. However, the therapy mechanism of EA related to stem cells in the treatment of MS is not yet known. In this study, we used a classic animal model of multiple sclerosis: experimental autoimmune encephalomyelitis (EAE) to evaluate the therapeutic effect of EA at Zusanli (ST36) acupoint in EAE and shed light on its potential roles in the effects of stem cells in vivo. METHODS: The EAE animal models were established. From the first day after immunization, EAE model mice received EA at ST36 acupoint, named the EA group. The weight and clinical score of the three groups were recorded for 28 days. The demyelination, inflammatory cell infiltration, and markers of neural stem cells (NSCs), hematopoietic stem cells (HSCs), and mesenchymal stem cells (MSCs) were compared. RESULTS: We showed that EAE mice treated with EA at ST36 acupoint, were suppressed in demyelination and inflammatory cell infiltration, and thus decreased clinical score and weight loss and mitigated the development of EAE when compared with the EAE group. Moreover, our data revealed that the proportions of NSCs, HSCs, and MSCs increased in the EA group compared with the EAE group. CONCLUSIONS: Our study suggested that EA at ST36 acupoint was an effective nonpharmacological therapeutic protocol that not only reduced the CNS demyelination and inflammatory cell infiltration in EAE disease but also increased the proportions of various stem cells. Further study is necessary to better understand how EA at the ST36 acupoint affects EAE.

The transcription factor masculinizer in sexual differentiation and achieved full functional sex reversal in prawn.

Some Zinc finger (ZnF) proteins are required for masculinization in silkworms. In the present study, a masculinizer gene (Mr-Masc) with multi-tissue expression is identified in the freshwater prawn Macrobrachium rosenbergii. The Mr-Masc is clustered into a separate branch with ZnF proteins from decapoda by phylogenetic tree analysis. Moreover, Mr-Masc silencing in male postlarvae prawn results in functional sex reversal females known as neo-females, which are applied to all-male monosex offspring breeding. This manipulation has been significant in sexually dimorphic cultured species. In addition, several significantly expressed transcripts are enriched and the effects of crucial signal pathways are focused through the comparative transcriptomic analysis in Mr-Masc gene knockdown. The significantly differentially expressed epidermal growth factor, upregulated low-density lipoprotein receptor, flotillin, and sex-lethal unigenes, downregulated heat shock proteins and forkhead box homologs are focused. The finding offers an innovative perspective on Masc proteins' evolution and physiological function.

Superwettable and photothermal all-in-one electrocatalyst for boosting water/urea electrolysis.

Developing multifunctional all-in-one electrocatalysts for energy-saving hydrogen generation remains a challenge. In this study, a simple and feasible thermal phosphorization strategy is explored to rationally construct P-doped MoO2-NiMoO4 heterostructure on nickel foam (NF). The heterointerfaced P-MoO2-NiMoO4/NF can simultaneously realize the integrated all-in-one functionalities, innovatively introducing superwettable surfaces, photothermal conversion capabilities and electrocatalytic functions. The superwettability gives P-MoO2-NiMoO4/NF sufficient electrolyte permeation and smooth bubble detachment. The plasmonic MoO2 with photothermal performance greatly elevates the local surface temperature of in P-MoO2-NiMoO4/NF, which is conducive to improve the electrocatalytic efficiency. The favorable in-situ surface reconstruction brings abundant active sites for electrocatalytic reactions. As an advanced multifunctional electrocatalyst, the superwettable and photothermal P-MoO2-NiMoO4/NF exhibits significantly improved performances in oxygen evolution reaction (OER) and urea oxidation reaction (UOR). More importantly, the highly efficient and stable overall water-urea electrolysis assisted by photothermal fields can be simply achieved by exposing P-MoO2-NiMoO4/NF to near-infrared (NIR) light.

The Relationship Between Parental Burnout and Children's Learning Burnout: A Moderated Chain Mediation Model.

Learning burnout is a continuous negative psychological state experienced by students. According to Cultural contextual risk theory and Ecological systems theory, family and school are important factors that affect students' psychological and social development. The study discusses the relationship between and mechanisms of parental burnout and children's learning burnout, and the moderating role of school factors in this process based on previous relevant theories and existing research. This study used the Parental Burnout Assessment, the Parent-Child Relationship Scale, the Positive Psychology Questionnaire, the Adolescent Student Burnout Inventory, and School Connectedness Scale to conduct a cluster sampling survey of 1439 primary school students and one of their parents (the primary caregiver) in China. The results showed that parent-child relationship and children's psychological resilience played a mediating role between parental burnout and students' learning burnout. School connection played a moderating role between parent-child conflict and children's psychological resilience. The study's results indicate that parental burnout is a critical risk factor for children's learning burnout and school connection can be a protective factor. This finding suggests that in education, schools should support and work with parents to promote students' psychological and social development. However, the family remains the primary factor affecting students' development.

MuLHiTA: A Novel Multiclass Classification Framework With Multibranch LSTM and Hierarchical Temporal Attention for Early Detection of Mental Stress.

Mental stress is an increasingly common psychological issue leading to diseases such as depression, addiction, and heart attack. In this study, an early detection framework based on electroencephalogram (EEG) data is developed for reducing the risk of these diseases. In existing frameworks, signals are often segmented into smaller sections prior to being input to a deep neural network. However, this approach ignores the fundamental nature of EEG signals as a carrier of valuable information (e.g., the integrity of frequency and phase, and temporal fluctuations of EEG components). As such, this type of segmenting may lead to information loss and a failure to effectively identify mental stress levels. Thus, we propose a novel multiclass classification framework termed multibranch LSTM and hierarchical temporal attention (MuLHiTA) for the early identification of mental stress levels. It specifically focuses on not only intraslice (within each slice) but also interslice (between different slices) samples in parallel. This was achieved by including two complementary branches, each of which integrated a specifically designed attention module into a bidirectional long short-term memory (BLSTM) network, enabling extraction of the most discriminative features from interslice and intraslice EEG signals simultaneously. The outputs of attention modules were then summed to obtain a feature representation that contributes to reduce overfitting and more effective multiclass classification. In addition, electrode positions were optimized using neural activity areas under high-stress conditions, thereby reducing computational costs by minimizing the number of critical electrodes. MuLHiTA was evaluated across one private [Montreal imaging stress task (MIST)] and two publicly available EEG datasets [EEG during mental arithmetic tasks (DMAT) and Simultaneous task EEG workload (STEW)]. These were divided into training and test sets using an 8:2 ratio, and the training data were further divided into training and validation sets using a fivefold cross-validation (CV) method, in which the model with the highest accuracy among the five was selected. The model was trained once more with the full training set, and the test data were then used to evaluate its performance. This approach achieved average classification accuracies of 93.58%, 91.80%, and 99.71% for the MIST, STEW, and DMAT datasets, respectively. Experimental results showed MuLHiTA was superior to state-of-the-art algorithms, including EEGNet, BLSTM, EEGLearn, convolutional neural network (CNN)-long short-term memory (LSTM), and convolutional recurrent attention model (CRAM), for multiclass classification. This demonstrates the viability of MuLHiTA for the early detection of mental stress.

Full Functional Sex Reversal Achieved Through Silencing of MroDmrt11E Gene in Macrobrachium rosenbergii: Production of All-Male Monosex Freshwater Prawn.

The freshwater prawn Macrobrachium rosenbergii is one kind of important economic aquaculture species and displays remarkable sexual dimorphism. The molecular mechanism of sexual differentiation in M. rosenbergii has been primarily unraveled through the research efforts of the androgenic gland and its related genes. However, the understanding of conserved genes involved in the molecular mechanism underpinning sex determination and sexual differentiation of M. rosenbergii is still fragmentary. MroDmrt11E is a member of the doublesex and mab-3-related transcription factor (Dmrt) gene family and is prominently expressed in the testis. In the present study, in vivo knockdown of MroDmrt11E at the postlarva stage in male prawn induced a complete and functional sex reversal and achieved the production of an all-male monosex population. Furthermore, a great deal of new information of upregulated and downregulated transcriptions involved in sexual differentiation of MroDmrt11E knockdown was enriched by comparative transcriptomic analysis. The effects of RNAi-mediated gene knockdown of MroDmrt11E on the differentially expressed and sex-related candidate genes, such as transformer, fruitless, feminization, insulin-like androgenic gland gene, Dmrt gene family, were primarily focused on, and their possible molecular regulatory relationships in sexual differentiation were analyzed. Meanwhile, the response of primary Kyoto Encyclopedia of Genes and Genomes (KEGG) biological pathways was investigated to expound the potential roles of MroDmrt11E in male sexual differentiation, which provided a deeper understanding of the molecular regulatory network underlying sexual differentiation of M. rosenbergii. The finding provided a novel sexual manipulation technique through silencing of Dmrt gene family for achieving a complete and functional sex reversal and offered a new insight regarding the mechanism of the Dmrt gene family in the sexual differentiation of crustaceans.

Looking for the Optimal PD-1/PD-L1 Inhibitor in Cancer Treatment: A Comparison in Basic Structure, Function, and Clinical Practice.

Programmed cell death protein-1/ligand 1 (PD-1/L1) targeted immune checkpoint inhibitors have become the focus of tumor treatment due to their promising efficacy. Currently, several PD-1/PD-L1 inhibitors have been approved for clinical practice with several more in clinical trials. Notably, based on available trial data, the selection of different PD-1/PD-L1 inhibitors in the therapeutic application and the corresponding efficacy varies. Widespread attention then is increasingly raised to the clinical comparability of different PD-1/PD-L1 inhibitors. The comparison of the inhibitors could not only help clinicians make in-depth understanding of them, but also further facilitate the selection of the optimal inhibitor for patients in treatment as well as for future clinical research and the development of new related drugs. As we all know, molecular structure could determine molecular function, which further affects their application. Therefore, in this review, we aim to comprehensively compare the structural basis, molecular biological functions, and clinical practice of different PD-1/PD-L1 inhibitors.

[Efficiency and Kinetics of Triclosan Degradation in Aqueous Solution by UV/Sodium Persulfate].

UV activated sodium persulfate was employed to remove triclosan (TCS) in aqueous solution. The effects of several factors such as UV wavelength,UV254 intensity,sodium persulfate dosage,pH value,and HA on TCS degradation were investigated. The second-order rate constants of free radicals (·OH, SO4·-) reacting with TCS and their contributions to TCS removal were determined,respectively. The dominant free radical was also identified. Furthermore, the TCS degradation efficiency in natural water by UV254/SPS and UV254/H2O2 was compared. Finally,the possible pathway and intermediate products of TCS degradation were analyzed with GC/MS. The results indicated that UV254 activated sodium persulfate could effectively remove TCS. The removal rate of TCS could reach 98.15% within 100s under the conditions of UV wavelength of 254 nm,UV intensity of 11.5µW·cm-2,sodium persulfate dosage of 1mmol·L-1,and TCS initial concentration of 275 µg·L-1. TCS degradation followed the pseudo-first-order kinetic model and the pseudo-first-order rate constant was determined to be 0.0392 s-1. Pseudo-first-order rate constant for TCS degradation increased with the increase of UV254 intensity(I)and sodium persulfate dosage within experiment ranges. The effect of UV wavelength on TCS removal was not notable. Neutral condition was detrimental to TCS degradation. TCS removal was inhibited in the presence of HA. The reaction rate constants for·OH and SO4·- reacting with TCS were 7.62×109 L·mol-1·s-1 and 9.86×109 L·mol-1·s-1,respectively. SO4·- was the dominant free radical and its contribution rate to TCS removal was 97.63% in UV254/SPS system. The K value of UV254/SPS was 4.13 times higher than that of UV254/H2O2 process,which demonstrated that UV254/SPS process could remove TCS more effectively than UV254/H2O2. The main intermediate products found were 2,4-DCP and phenol in the degradation process of TCS in Milli-Q water by UV254/SPS.

The association between preoperative serum C-reactive protein and hepatocellular carcinoma recurrence in patients with chronic hepatitis B virus (HBV) infection--a retrospective study.

The prognosis of the patients with hepatocellular carcinoma (HCC) recurrence following curative hepatectomy is usually dismal. Whether preoperative serum C-reactive protein (CRP) can predict the recurrence of HCC in patients with chronic HBV infection is not clear. Total 232 patients with chronic HBV infection were included in this retrospective study. We investigated the association between detailed preoperative serum CRP levels and early (≤ 2 year) and late (> 2 year) HCC recurrence following curative hepatectomy. After adjusting for potential confounders, we found a saturation effect for preoperative serum CRP of 2.1 mg/dl existed for early HCC recurrence (ER). The incidence of ER increased with preoperative serum CRP less than 2.1 mg/dl (OR = 3.5, 95% CI 1.6-7.6, P = 0.001), and higher preoperative serum CRP (>2.1 mg/dl) did not increase the incidence of ER (OR = 0.8, 95% CI 0.2-2.7, P = 0.703). Whereas there is a linear relationship between preoperative serum CRP and late HCC recurrence (LR) (OR = 0.2, 95% CI, 0.1- 0.4) (OR = 1.8, 95% CI, 1.2-2.5, P = 0.002). In addition, the optimal cutoff point for serum CRP level was 1.5 mg/dl, instead of 1.0 mg/dl, in predicting both ER and LR. Patients with higher preoperative serum CRP level (>1.5 mg/dl) had lower recurrence free survival rates and overall survival rates (P<0.01). These results suggest that preoperative serum CRP played different roles on ER and LR following curative hepatectomy, thus further predicting the prognosis in patients with chronic HBV infection.

Prophylactic cranial irradiation improved the overall survival of patients with surgically resected small cell lung cancer, but not for stage I disease.

OBJECTIVES: We conducted a retrospective study to evaluate the role of prophylactic cranial irradiation (PCI) on patients with surgically resected small cell lung cancer (SCLC). PATIENTS AND METHODS: Between January 2003 and December 2009, the records of completely resected patients who were diagnosed with SCLC and definitive pTNM stage on the basis of histological proof were reviewed. According to the therapy modality, patients were allocated to PCI group and non-PCI group. RESULTS: A total of 193 patients were finally included, 67 patients in PCI group and 126 in non-PCI group. The OS rates at 2-year and 5-year in PCI group were 92.5%, and 54.9%, respectively, and those of non-PCI were 63.2% and 47.8%, respectively (p=0.005). The BMFS rate at 2-year and 5-year in PCI group was significantly better than those of non-PCI group (96.8%, 76.6% and 79.4%, 75.5%, respectively, p = 0.014). But PCI could not confer survival benefit in the patients with p-stage I. Multivariate analysis revealed that PCI (HR = 2.339; p = 0.001) was an independent prognostic factor of the overall survival. CONCLUSIONS: PCI could improve the OS of patients with surgically resected SCLC, but not for p-stage I patients.

Risk factors for brain metastases in completely resected small cell lung cancer: a retrospective study to identify patients most likely to benefit from prophylactic cranial irradiation.

BACKGROUND: The role of prophylactic cranial irradiation (PCI) on small cell lung cancer (SCLC) has been established based on the two-stage system of limited versus extensive disease and the treatment modality of chemoradiotherapy. However, the use of PCI after combined-modality treatment with surgery for resectable limited-stage SCLC has not been investigated sufficiently. We conducted a retrospective study to evaluate risk factors for brain metastasis (BM) in patients with surgically resected SCLC to identify those most likely to benefit from PCI. PATIENTS AND METHODS: The records of 126 patients with completely resected SCLC and definitive TNM stage based on histological examination between 2003 and 2009 were reviewed. The cumulative incidence of BM was estimated using the Kaplan-Meier method and differences between the groups were analyzed using the log-rank test. Multivariate Cox regression analysis was applied to assess the risk factors of BM. RESULTS: Twenty-eight patients (22.2%) developed BM at some point during their clinical course. The actuarial risk of developing BM at 3 years was 9.7% in patients with p-stage I disease, 18.5% in patients with p-stage II disease, and 35.4% in patients with p-stage III disease (p = 0.013). The actuarial risk of developing BM at 3 years in patients with LVI was 39.9% compared to 17.5% in patients without LVI (p = 0.003). Multivariate analysis identified pathologic stage (hazard ratio [HR] = 2.013, p = 0.017) and LVI (HR = 1.924, p = 0.039) as independent factors related to increased risk of developing BM. CONCLUSION: Patients with completely resected p-stage II-III SCLC and LVI are at the highest risk for BM.

Abnormal expression of FLOT1 correlates with tumor progression and poor survival in patients with non-small cell lung cancer.

Recent studies have revealed that flotillin-1 (FLOT1) plays important roles in cancer progression. However, the role of FLOT1 in development and progression of non-small cell lung cancer (NSCLC) remains largely unknown. The objective of the current study was to investigate the expression pattern and clinicopathological significance of FLOT1 in patients with NSCLC. Real-time quantitative polymerase chain reaction was applied to examine FLOT1 mRNA expression in 52 pairs of NSCLC tissues and adjacent noncancerous tissues. Immunohistochemistry was performed to examine FLOT1 protein expression in paraffin-embedded tissues from 106 NSCLC patients. Statistical analyses were applied to evaluate the diagnostic value and associations of FLOT1 expression with clinicopathological characteristics. FLOT1 mRNA expression was evidently upregulated in NSCLC tissues compared with that in the adjacent noncancerous tissues. In the 106 cases of tested NSCLC samples, FLOT1 protein level was positively correlated with tumor size, tumor stage, and lymph node metastasis. Patients with higher FLOT1 expression had shorter overall survival time, whereas those with lower FLOT1 expression had longer survival time. Taken together, our findings indicate that FLOT1 may play an important role in NSCLC tumorigenesis. Further elucidation of the molecular mechanisms underlying the role of FLOT1 is warranted.

[Clinical study on improving decreased gastrointestinal motility of post-operative esophageal cancer patients by unblocking the interior and purgation method].

OBJECTIVE: To observe the clinical effect of unblocking the interior and purgation method on improving decreased gastrointestinal motility of post-operative esophageal cancer patients, and to study its mechanisms. METHODS: 60 patients with post-operative esophageal cancer were randomly assigned to two groups, the treatment group and the control group, 30 in each group. Routine therapies were given to the two groups. Chinese drugs with unblocking the interior and purgation action was infused by enteral nutrition tube to patients in the treatment group, while normal saline was infused to those in the control group. The first flatus time, the first defecation time, the bowel tones recovery time after operation, and the total amount of the gastric juice draining between the first day and the third day after operation of all patients were recorded. Plasma motilin (MTL) and vasoactive intestinal peptide (VIP) contents were detected before operation and the fourth day after operation. RESULTS: The first flatus time, the first defecation time, the bowel tones recovery time after operation, and the total amount of the gastric juice draining were less in the treatment group than in the control group, showing statistical difference (P<0.05, P<0.01). The post-operative MTL contents were higher and VIP contents lower in the treatment group than in the control group, showing statistical difference (P<0.05, P<0.01). There was no significant difference in plasmal MTL and VIP contents of the treatment group between before and after treatment (P>0.05). But there was significant difference in plasmal MTL and VIP contents of the control group between before and after treatment (P<0.01). CONCLUSION: Unblocking the interior and purgation method could significantly promote the gastrointestinal motility recovery of post-operative esophageal cancer patients, showing good clinical effect.

[Comparison of the characteristics in recurrence and metastasis between bronchioloalveolar carcinoma and other lung adenocarcinomas].

BACKGROUND & OBJECTIVE: The histological definition of bronchioloalveolar carcinoma (BAC) has been changed recently by the revised World Health Organization (WHO) classification. Although bronchioloalveolar carcinoma is a subtype of lung adenocarcinoma, its biological features are better than those of other lung adenocarcinomas. This study was to analyze differences in metastatic activity between bronchioloalveolar carcinoma and other lung adenocarcinomas. METHODS: The expression of E-Cadherin, Collagen IV, vascular endothelial growth factor receptor-2 (VEGFR-2), matrix metalloproteinase-9 (MMP-9), and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) in 28 specimens of stage I bronchioloalveolar carcinoma confirmed pathologically and 40 specimens of other stage I lung adenocarcinomas were detected by immunohistochemistry. Their correlations to tumor recurrence and metastasis were analyzed. RESULTS: The 5-year survival rate was significantly higher in ths patients with bronchioloalveolar carcinoma than in the patients with other lung adenocarcinomas (88.7% vs. 57.3%, P < 0.05). The intrathoracic recurrence rate was significantly higher and the extrathoracic metastasis rate was significantly lower in the patients with bronchioloalveolar carcinoma than in the patients with other lung adenocarcinomas (75% vs. 33.3%, 25% vs. 66.7%, P < 0.05). The positive rates of Collagen IV, E-Cadherin and TIMP-1 were significantly higher in bronchioloalveolar carcinoma than in other lung adenocarcinomas (78.6% vs. 42.5%, 78.6% vs. 40.0%, 67.5% vs. 42.9%, all P < 0.01). The positive rate of VEGFR-2 was significantly higher in other lung adenocarcinomas than in bronchioloalveolar carcinoma (85.7% vs. 77.5%, P < 0.05). There was no significant difference in the positive rate of MMP-9 between bronchioloalveolar carcinoma and other lung adenocarcinomas (85.0% vs. 78.6%, P = 0.494). CONCLUSION: As compared with other lung adenocarcinomas, stage I bronchioloalveolar carcinoma is less aggressive in clinical behavior and likely to develop intrathoracic recurrence, with less extrathoracic metastases and better prognosis.

[Bronchial and pulmonary arterial sleeve resection and reconstruction in the treatment of central NSCLC].

OBJECTIVE: To evaluate the indications and surgical procedure of bronchial and pulmonary artery sleeve resection for patients with centrally located non-small cell lung cancer, and how to prevent complications. METHODS: From July 1989 to Aug 2000, 32 cases of central NSCLC were treated with bronchial and pulmonary arterial sleeve resection and reconstruction. The results were retrospectively analyzed. RESULTS: The complication rate was 25.0% (8/32), the mortality rate in 30-day postoperation was 6.3% (2/32), the overall 1-, 3- and 5-year survival rate was 82.8% (24/29), 50.0% (11/22) and 33.3% (4/12), respectively. CONCLUSION: Bronchial and pulmonary arterial sleeve resection and reconstruction in the treatment of patients with central NSCLC can not only maximize preservation of functional pulmonary parenchyma and improve patients, quality of life, but also provide an opportunity for those patients with poor pulmonary function to receive surgical resection of the tumor.