Clinicopathological features and prognostic nomogram of giant cell carcinoma of the lung: A population-based study.

BACKGROUND: Due to its rarity, the features and prognosis of giant cell carcinoma of the lung (GCCL) are not well defined. The present study aimed to describe the clinicopathological features and prognostic analysis of this rare disease, compare it with lung adenocarcinoma (LAC), further determine the prognostic factors and establish a nomogram. METHODS: Patients diagnosed with GCCL and LAC were identified from the SEER database between 2004 and 2016. The features and survival between GCCL and LAC were compared in the unmatched and matched cohorts after propensity score matching (PSM) analysis. Univariate and multivariate Cox analyses were used to identify the prognostic factors, and a nomogram was constructed. Area under the curve (AUC), C-index, calibration curve and decision curve analysis (DCA) were used to confirm the established nomogram. RESULTS: A total of 295 patient diagnosed with GCCL and 149 082 patients with LAC were identified. Compared with LAC, patients with GCCL tend to be younger, male, black and have pathological Grade III/IV GCCL, more proportion of AJCC-TNM-IV, T3/T4 and distant metastases. The 1-, 2- and 5-year OS rates of the patients with GCCL were 21.7%, 13.4% and 7.9%, respectively. The median OS and CSS were 3 and 4 months, respectively. Patients with GCCL had significantly shorter OS and CSS than those with LAC in the unmatched and matched cohorts after PSM. Multivariate Cox analysis demonstrated that T, N and M stages and use of chemotherapy and surgery were independent of survival. Furthermore, we constructed a prognostic nomogram for OS and CSS by using independent prognostic factors. The C-index of OS-specific nomogram is 0.78 (0.74-0.81), and the C-index of CSS-specific nomogram is 0.77 (0.73-0.80). The calibration curve and ROC analysis showed good predictive capability of these nomograms. DCA showed that the nomogram had greater clinical practical value in predicting the OS and CSS of GCCL than TNM staging. CONCLUSION: GCCL have distinct clinicopathological characteristics and significantly worse clinical outcomes. Prognostic nomograms for overall survival (OS) and CSS were constructed.

Ultrasound Radiomics-Guided Iliac Fascia Block on Postoperative Cognitive Dysfunction in Elderly Patients Undergoing Hip Surgery.

Objective: Elderly patients with hip surgery are prone to postoperative cognitive dysfunction (POCD), leading to health management difficulties. This study is aimed at investigating the effect of ultrasound radiomics-guided iliac fascia block on POCD. Methods: A total of 67 cases of patients who had undergone hip joint surgery were divided into a training set (n = 47) and a validation set (radiomics-guided group, n = 20). The patients were intervened with ultrasound radiomics-guided iliac fascia block, and the maximum relevance minimum redundancy sifts out the image omics features obtained from 2D ultrasound images of patients. Another 20 patients undergone general anesthesia served as control. The incidence of POCD, the total amount of fentanyl, the visual analogue score (VAS) at different time points, and the levels of CRP and NSE in plasma were compared between the two groups. Results: The AUC on the training and validation sets were higher than 0.940. The incidence of POCD in the radiomics-guided and general anesthesia group was 5% and 30%, respectively (P = 0.037). Compared with the general anesthesia group, the dosage of fentanyl in the radiomics-guided was lower, the VAS score at 6 h, 1 d, and 2 d after operation was smaller, and the levels of CRP and NSE were lower (all P < 0.05). Conclusions: For elderly patients with hip surgery, the ultrasound radiomics-guided iliac fascia block can reduce the incidence of POCD and improve the effect of nerve block.

Light transmission characteristic analyses of a laser screen in clear water based on the Monte Carlo method.

In order to optimize the design of underwater light screens, the transmission process of the light beam in water is analyzed with the Monte Carlo method. The trajectories and power attenuation of emitted photons, propagating in different types of water from the light source towards the receiver with different initial light powers and transmission distances, are simulated and calculated. The output power can then be obtained to calculate the transmission ratio quantitatively. According to the simulated data, by using the curving fitting method, the exact expression of transmission ratio is derived, which is in the same form as the Beer-Lambert-Bouguer law. Meanwhile, experiments are conducted in a light screen with a vertical line beam laser in clear water to verify the simulations. The experimental results are in agreement with the simulated results, and the differences between them are within ±0.04. The presented results give insight into the design of underwater laser screens.

Effects of dexmedetomidine pretreatment on rats with sepsis-induced acute kidney injury and miR-146a expression.

The current research aimed to study the effects of dexmedetomidine (DEX) pretreatment on rats with sepsis-induced acute kidney injury (SAKI) and miR-146a expression. The model of SAKI was established through the tail vein injection of lipopolysaccharide (LSP). We used an automatic biochemical analyzer to detect serum urea nitrogen (BUN) and creatinine (Cre) levels. The expression levels of urine KIM-1 and NGAL and serum IL-1ß and IL-6 were analyzed by enzyme-linked immunosorbent assay (ELISA). The content and activity of superoxide dismutase (SOD) were detected by the xanthine oxidase method. The content of malondialdehyde (MDA) was determined by the thiobarbituric acid (TBA) method. Reactive oxygen species (ROS) was detected by fluorescent probe DCFH-DA. Catalase (CAT) was detected by potassium permanganate titration. The expression level of miR-146a in the renal tissue and serum was detected by RT-PCR. The expression levels of Nrf2 and HO-1 proteins were detected by Western blot. Compared with those in the model group, rats in the DEX group had significantly lower expression levels of serum BUN, Cre, IL-1ß, and IL-6, and oxidant markers MDA and ROS, but significantly higher expression levels of miR-146a and antioxidant markers SOD and CAT. DEX pretreatment could improve the kidney morphology, injury severity, and Nrf2 and HO-1 proteins of rats with SAKI. In conclusion, DEX can improve oxidative stress and inflammatory responses in rats with SAKI, reduce the severity of the renal injury, and up-regulate the expression level of miR-146a.

Sevoflurane Effect on Cognitive Function and the Expression of Oxidative Stress Response Proteins in Elderly Patients undergoing Radical Surgery for Lung Cancer.

OBJECTIVE: To investigate the effects of sustained inhalation of sevoflurane on cognitive function and the expression of oxidative stress response proteins such as NADPH oxidase subunits NOX2 and NOX4 in elderly patients undergoing radical surgery for lung cancer. STUDY DESIGN: An experimental study. PLACE AND DURATION OF STUDY: Department of Anesthesiology, Suzhou Kowloon Hospital, Shanghai Jiao Tong University School of Medicine, China, from February 2016 to October 2017. METHODOLOGY: Elderly patients who underwent radical surgery for lung cancer were divided into the sevoflurane group and the propofol group, with 52 cases in each group. Sustained inhalation of sevoflurane and propofol was administered to maintain anesthesia in the respective groups. Cognitive function and lung function parameters were compared between the two groups. Serum S100 β levels and expression of NOX2 and NOX4 proteins in peripheral blood mononuclear cells of the two groups were determined. RESULTS: At 24 hours after surgery, the lung function indices of the sevoflurane group such as FEV1, FVC and VC were higher than those of the propofol group (p<0.001, p=0.008 and p=0.002, respectively). At the end of the surgery and at 24 hours after surgery, the MMSE scores of the sevoflurane group were higher than the propofol group (all p<0.001). S100 levels were lower than the propofol group (p=0.003 and p<0.001, respectively). Levels of NADPH oxidase subunits NOX2 and NOX4 proteins in peripheral blood mononuclear cells of the sevoflurane group were lower than the propofol group (p=0.033, p<0.001, p<0.001and p<0.001, respectively). CONCLUSION: Compared with intravenous anesthesia with propofol, general anesthesia with sevoflurane inhalation has little effect on the short-term cognitive function in elderly patients undergoing radical surgery for lung cancer, and can effectively improve lung function. The mechanism may be related to the reduction of the expression of NOX2 and NOX4 proteins.

Hydrolysis behavior of regenerated celluloses with different degree of polymerization under microwave radiation.

This work studied the hydrolysis behavior of regenerated celluloses (RCs) with different degree of polymerization (DP) by using the catalyst of dilute acid under microwave radiation. Results showed that the DP had a considerable influence on hydrolysis of cellulose. The reactivity of RCs was significantly improved when DP was lower than 51. The highest sugar yield of 59.2% was achieved from RC with lowest DP of 23 at 160 °C for 15 min. But the lowest yield of 32.6% was obtained when RC with highest DP of 132 was used. Recrystallization of cellulose was found to hinder the further hydrolysis particularly with the high DP. The effect of recrystallization can be reduced by the decrease of DP of RCs. This research demonstrates that the DP of RCs plays a crucial role on hydrolysis and it provides a preliminary guide based on DP to find a suitable pretreatment method for cellulose hydrolysis.

Activation of corn cellulose with alcohols to improve its dissolvability in fabricating ultrafine fibers via electrospinning.

Water and four small molecular alcohols are respectively used to activate corn cellulose (CN cellulose) with the aim to improve the dissolvability in DMAc/LiCl. Among all these activated agents, monohydric alcohols are found to produce the optimal effect of activation in the whole process including of activating, dissolving, and electrospinning of CN cellulose. Meanwhile, well distributed fibers with the diameter of 500nm-2µm are fabricated in electrospinning. Understanding the activation effect of monohydric alcohols with water and polyhydric alcohols, the most effective activated agent is ascertained with the characteristics of small molecular size, low viscosity, and single functionality. This work is definitely initiated to understand the critical principle of CN cellulose in dissolving. Accordingly, a feasible methodology is also established to prepare ultrafine cellulose fibers with good morphology in electrospinning.

Responsive behavior of regenerated cellulose in hydrolysis under microwave radiation.

This work studied the responsive behavior of regenerated cellulose (RC) in hydrolysis under microwave radiation. Four types of RC with different crystallinity (Cr) and degree of polymerization (DP) are produced to evaluate the reactivity of RC by step-by-step hydrolysis. Results show Cr is the key factor to affect the reactivity of RCs. With hydrolysis of amorphous region and the formation of recrystallization, the Cr of RC reaches a high value and thus weakens the reactivity. As a result, the increment of cellulose conversion and sugar yield gradually reduces. Decrease of the DP of RC is helpful to increase the speed at the onset of hydrolysis and produce high sugar yield. But, there is no direct influence with the reactivity of RC to prolong the time of pretreatment. This research provides an accurate understanding to guide the RC preparation for sugar formation with relative high efficiency under mild reaction conditions.

A novel facile two-step method for producing glucose from cellulose.

A two-step acid-catalyzed hydrolysis methodology is established to effectively hydrolyze cellulose to glucose with high yield and selectivity under mild conditions. In multi-steps hydrolysis, the difficulty of cellulose can be effectively reduced under mild conditions. In the first step, microcrystalline cellulose was depolymerized in phosphoric acid to cellulose oligomer at 50°C. Then the oligomer was precipitated by ethanol and hydrolyzed with dilute sulfuric acid in the second step. 87.7% total reducing sugars and 57.8% glucose was released from the two-step hydrolysis process. In addition, with the assistance of microwave in the second step, the yield and selectivity of glucose can be improved to 73.3% and 80.1% by only 5 min hydrolysis. The two-step hydrolysis exhibits an effective process to produce glucose in cellulose hydrolysis. The enhancement of hydrolysis reactivity is considered to be controlled with the decrease of crystallinity and degree of depolymerization of cellulose.