Effect of intubation in the lateral position under general anesthesia induction on the position of double-lumen tube placement in patients undergoing unilateral video-assisted thoracic surgery: study protocol for a prospective, single-center, parallel group, randomized, controlled trial.

BACKGROUND: The double-lumen tube (DLT) is an essential equipment for thoracic anesthesia and the precise position of DLT placement is particularly important for anesthesia and surgery. However, the incidence of DLT malposition remains high and it leads to lung isolation failure and hypoxemia during one-lung ventilation. This trial aims to explore the clinical application and efficacy of intubation in the lateral position under general anesthesia induction to reduce the incidence of DLT malposition in patients undergoing unilateral video-assisted thoracic surgery (VATS). METHODS: In this prospective, single-center, parallel group, randomized, controlled trial, we will recruit 108 patients, aged 18-80 years, scheduled for elective unilateral VATS with DLT intubation under general anesthesia, and they will be randomly assigned to two groups: a lateral DLT intubation group (group L) and a conventional supine DLT intubation group (group C). The left-sided DLT will be used to intubate in patients of both groups. The position of DLT will be confirmed and adjusted by using the fiberoptic bronchoscopy (FOB). The primary outcome is the incidence of DLT malposition observed via the FOB, and the secondary outcomes include the time of intubation, the frequency and duration of re-adjustments of DLT placement under FOB, whether to re-intubate, intraoperative vital signs, and postoperative recovery. DISCUSSION: Accurate DLT positioning is crucially important for thoracic surgery, but the incidence of DLT malposition is still high in the present clinical practice of thoracic anesthesia. This trial aims to investigate whether lateral DLT intubation can reduce the incidence of DLT malposition, with more stable intraoperative vital signs and less postoperative complications. TRIAL REGISTRATION: The study protocol was registered at Chinese Clinical Trial Registry ( http://www.chictr.org.cn ) with registration number: ChiCTR2200060794 on June 11, 2022.

Osimertinib showed efficacy on contralateral multiple ground-glass nodules after segmentectomy for lung adenocarcinoma harboring primary EGFR-T790M mutation: a case report and review of the literature.

BACKGROUND: Multiple ground-glass nodules (mGGNs) in the lung has been defined as synchronous multiple primary lung cancer (SMPLC), it is has been very difficult challenging to differentiate SMPLC from intrapulmonary metastases, and its treatment remains controversial. CASE PRESENTATION: We report a case simultaneously involving mGGNs and lung adenocarcinoma harboring primary EGFR-T790M mutation, in which the patient underwent the radical resection of lesions in the left upper lung, and continued the osimertinib treatment for the residual mGGNs in all lobes of the right lung. These mGGNs displayed different responses to osimertinib. CONCLUSIONS: We reported a successful strategy on the postoperative treatment for mGGNs. For those that cannot be completely resected, the chemotherapy, radiotherapy, stereotactic body radiation therapy, immunotherapy and targeted therapy have been performed instead. The EGFR-TKI therapy strategy showed significant advantages, but how to achieve even better therapeutic effect needs more researches.

Early Stage Finding of an Immune-Enhanced Genetic Subtype of Nonsmall Cell Lung Cancer Related with T-Cell Depletion.

Background: Molecular categorization of lung cancer in medical care is becoming increasingly important on a regular basis. One of the molecular classifications of NSCLC (early-stage NSCLC) supports that tumors of different biological varieties differ in terms of their genomes and clinical characteristics. Methods: Based on published immune cell signatures and early-stage NSCLC gene expression data including cancer genome maps, we used consensus cluster analysis to identify immune molecular subtypes associated with early-stage NSCLC expression subtypes. These subtypes were correlated with early-stage NSCLC expression subtypes. Next, applying a wide range of statistical techniques, we evaluated the link between molecular subtypes and clinical features, immunological microenvironment, and immunotherapy reactivity. Molecular subtypes were defined as a classification of cancerous cells. Results: Multiple RNAseq cross-platform datasets of immune genes were used to identify two molecular subtypes (C1 and C2) of NSCLC, with C1 showing a more favorable prognosis than C2. The results were validated on the CSE datasets. In terms of clinical characteristics, C2 subtype samples with a worse prognosis showed a more advanced tumor stage and higher mortality. C2 showed immuno-infiltrative characteristics but had depletion of T-cells. Biological functions such as EMT were enriched on C2. A low TIDE score in C1 indicated that C1 samples could benefit from taking immunotherapy. C2 were more susceptible to standard chemotherapeutic treatments such paclitaxel, cisplatin, sorafenib, crizotinib, and erlotinib. Conclusion: According to our findings, early-stage NSCLC patients may benefit from receiving treatment with immune checkpoint blockade therapy.

Self-trapped exciton emission in an Sn(II)-doped all-inorganic zero-dimensional zinc halide perovskite variant.

The toxicity of Pb in conventional perovskites impedes the commercialization of their optoelectronic devices. Therefore, the search for comparable Pb-free perovskites is vital and needs urgent attention. Herein, for the first time, we successfully synthesize the Sn(II)-doped Pb-free zinc-based perovskite variant Cs2ZnCl4. The influence of doping is investigated both experimentally and theoretically. Broad bright red emission with a large Stokes shift is observed and attributed to the self-trapped exciton (STE) emission of the doped disphenoidal [SnCl4]2- units in the host matrix, from 3P1 to 1S0. Temperature-dependent photoluminescence (PL) shows a peak split at cryogenic temperature, which is ascribed to the Jahn-Teller effect of the 3P1 state. Theoretical study reveals that the impurity states of Sn2+ shrink the bandgap and localize the band edges, and distortion of [SnCl4]2- under excitation ultimately leads to the STE emission. This work is significant for STE emission studies and will pave a way for Pb-free perovskite variants in illumination applications.

Comparative Study of Red/Green/Blue Quantum-Dot Light-Emitting Diodes by Time-Resolved Transient Electroluminescence.

To understand the electronic processes in quantum-dot light-emitting diodes (QLEDs), a comparative study was performed by time-resolved transient electroluminescence (TREL). We fabricated red, green, and blue (R-, G-, and B-) QLEDs with poly(9,9-dioctylfluorene-co-N-(4-sec-butylphenyl)diphenylamine) as the hole-transporting layer with conventional structures. The external quantum efficiency (EQE) and current efficiency were 19.2% and 22.7 cd A-1 for R-QLEDs, 21.1% and 93.3 cd A-1 for G-QLEDs, and 10.6% and 10.4 cd A-1 for B-QLEDs, respectively. The TREL results for B-QLEDs were remarkably different from those for R- and G-QLEDs because of the insufficient electron injection crossing the type II heterojunction between the emission layer and the electron-transporting layer. We further applied poly(N-vinylcarbazole) as the hole-transporting layer and obtained much better performance for B-QLEDs, with EQE and current efficiency of 15.9% and 15.4 cd A-1, respectively. Concomitant with the increase in EQE are an increase in the turn-on voltage from 2.3 to 3.7 V and a transient electroluminescence spike after voltage turn-off.

Lead-Free Antimony Halide Perovskite with Heterovalent Mn2+ Doping.

Lead toxicity is hindering the applications of conventional lead halide perovskites (PVKs), and antimony (Sb) is a promising nontoxic Pb alternative, showing huge potential in optoelectronic devices. Herein, pure and Mn-doped Cs3Sb2Cl9 crystals are synthesized in a facile route and studied both experimentally and theoretically. All the pure and Mn-doped Cs3Sb2Cl9 crystals show good crystallinity and similar crystal structures, exhibiting visible photoluminescence (PL) characteristics with emission peaks at 422 and 613 nm, respectively. Combined density functional theory (DFT) calculations and experimental analyses reveal that the structure of the host PVK compound Cs3Sb2Cl9 is not influenced by the formation of [MnCl6]4- octahedra and that Mn 3d orbitals generate impurity states in the forbidden energy gap of Cs3Sb2Cl9. Therefore, energy transfer from Cs3Sb2Cl9 to Mn 3d states is observed, resulting in the d-d transition and bright red luminescence. Mn-doped Sb-based PVK can be utilized as a new platform for optoelectronic applications.

Synthesis of large two-dimensional lead-free bismuth-silver double perovskite microplatelets and their application for field-effect transistors.

Two-dimensional phenylethylammonium (PEA, C8H9NH3) Bi-Ag double perovskite (PEA)4BiAgX8 (X = Br, I) microplatelets are synthesized for the first time via a facile self-assembly recrystallization method. Absorption spectra of microplatelets exhibit direct bandgaps and different halide compositions show distinct morphologies and bandgap tunability. Field-effect transistors based on a single (PEA)4BiAgBr8 microplatelet display a p-type semiconducting behavior.

Removal of tetracycline from an aqueous solution using manganese dioxide modified biochar derived from Chinese herbal medicine residues.

Biochar (BC) derived from Chinese herbal medicine residues has been investigated for its performance as a potential adsorbent in tetracycline (TC) removal. In the present study, a chemical co-precipitation method was carried out to prepare manganese dioxide modified biochar (Mn-BC) to increase its sorption capacity. The properties of the modified biochar were characterized for further enhancing TC removal from an aqueous solution. Mn-BC was successfully synthesized and resulted in a much higher specific surface area, total pore volume and pore diameter. The sorption kinetics of TC on Mn-BC was described by the pseudo-second-order model. The sorption data of Mn-BC were fitted by Langmuir and Freundlich models. The study findings revealed a maximum adsorption capacity of Mn-BC (1:10) to TC was up to 131.49 mg/g. The adsorption process was endothermic and spontaneous. The degradation of TC was further enhanced by MnO2 acting as an oxidizer on Mn-BC. Overall, the modified biochar derived from Chinese herbal medicine residues is a superior alternative for the removal of TC from an aqueous solution.

Clinical significance of nuclear localisation of agrin in lung adenocarcinoma.

Agrin has recently been identified as a novel oncogene that is overexpressed in several types of human cancers. However, its role in lung cancer has not yet been investigated. The purpose of the current study was to investigate agrin protein expression in lung cancer and evaluate its clinicopathological and prognostic significance. In this study, A total of 86 lung adenocarcinoma samples paired with adjacent non-tumour tissue samples and eight lung adenocarcinoma non-paired samples were selected for immunohistochemical staining for agrin. Strong staining of agrin in nuclei of lung adenocarcinoma tissues was observed, but not in the nuclei of normal lung tissues (p < 0.001). Consistent with staining in lung adenocarcinoma tissues, the nuclei staining of agrin was also detected in lung cancer cell lines by immunofluorescence. This is the first report demonstrating that agrin is highly expressed in nuclei of lung adenocarcinoma tissues and that it is strongly correlated with lymph node metastasis (p = 0.002), clinical stage (p = 0.024), and poor differentiation (p = 0.022). Agrin-positive nuclear staining of lung adenocarcinoma cells could be used to identify greatly increased risk of metastasis in patients after surgery, which might serve as a valuable prognostic marker.

[Preparation of Two Kinds of Biochar and the Factors Influencing Tetracycline Removal from Aqueous Solution].

In this research, Chinese medicine residue of Evodia lepta and corn stalks were chosen as raw materials to prepare biochar (EIBC and CSBC) at 400, 600, and 800℃, for the removal of tetracycline from solution. The biochar was characterized by elemental analysis, Fourier transform infrared (FT-IR) spectroscopy, X-ray diffraction (XRD), and scanning electron microscopy (SEM). The effects of pyrolytic temperature, biochar dosages, initial concentration, adsorption time, solution pH, ionic strength, and ambient temperature on the removal of tetracycline from solutions by biochar were investigated. The adsorption behavior of tetracycline by biochar was investigated using adsorption kinetics and adsorption isotherms. The results showed that the adsorption capacity of biochar for tetracycline was elevated with increase in the pyrolysis temperature. The biochar prepared from Chinese medicine residue Evodia lepta at under 800℃ (EIBC800) had the best adsorption properties. Biochar dosages, solution pH, ionic strength, and adsorption time had significant effects on the adsorption of tetracycline by EIBC800 and CSBC800. In contrast, the effect of ambient temperature on tetracycline adsorption was a concentration-dependent process. The adsorption kinetics and isotherms of tetracycline onto EIBC800 and CSBC800 were all fitted to pseudo-second order models (R2 0.9540 and 0.8355) and to a Freundlich equation (R2 between 0.8991-0.9579 and 0.9736-0.9946), respectively. The adsorption process was mainly controlled by chemical reaction, and the tetracycline adsorption process was spontaneous and endothermic. Compared with the corn-stalk derived biochar, EIBC800 had better adsorption capacity for antibiotics than CSBC800 did, which indicated that Chinese medicine residue derived biochar had wider prospects for application in the treatment of wastewater containing antibiotic residues.

Retrospective study on video-assisted vs. open mediastinal lymphadenectomy for non-small cell lung cancer: a propensity-matched analysis.

BACKGROUND: This retrospective study is designed to compare the surgical outcomes of mediastinal lymph node (MLN) dissection between the two groups of non-small cell lung cancer (NSCLC) patients underwent lung cancer surgery through video-assisted thoracoscopic surgery (VATS) or thoracotomy, as well as classify the differences and identify the safer method between two groups. METHODS: A total of 497 patients underwent pulmonary lobectomy and systemic MLN dissection were enrolled in this study. They were divided into VATS group (n=242) and traditional thoracotomy (TT) group (n=255). The VATS group received three-port VATS, while the thoracotomy group underwent posterior-lateral or muscle sparing thoracotomy. The range of MLN dissection included groups 2R, 4R, 7, 8, 9 in right-sided lung cancer surgery and groups 4L, 5, 6, 7, 8, 9 in left-sided. The two groups were matched at a ratio of 1:1 using the propensity score matching (PSM) method. RESULTS: Out of 497 patients, 376 cases were matched for PSM, with 188 cases in each group. Baseline date did not get any significant difference between two groups. The average group number of MLN dissection in VATS group and TT group was 4.14 and 3.97, respectively. While the average amount of dissected lymph nodes in both groups were 16.63 and 17.32, respectively. Compare with the lymph node numbers among all the groups in TT group, only the number of group 7 though left approach (7L) in VATS group was statically significant. Besides, the operation time and postoperative length of hospital stay in VATS group were superior to those in TT group (P<0.05). No significant difference had been found in intraoperative blood loss, accessory surgical injury and postoperative complication between two groups. CONCLUSION: Compared with thoracotomy, systemic MLN dissection and pulmonary lobectomy via VATS has quicker recovery, less postoperative complication and length of hospital stay with similar surgical outcomes. Moreover, our findings also suggest thoracotomy has an advantage on the dissection of MLN in group 7L.

Overexpression of miR-1260b in Non-small Cell Lung Cancer is Associated with Lymph Node Metastasis.

Lymph node (LN) metastasis is often an early event in the progression of malignant tumors and it contributes to the majority of cancer mortalities. MiRNAs play key roles in tumor metastasis. This study aimed to investigate the specific miRNAs as putative indicators of metastasis early diagnosis for non-small cell lung cancer (NSCLC). In this study, five NSCLC cases with LN metastasis and four cases without metastasis (NLN) were enrolled for Agilent Human miRNA array. The interested differentially expressed miRNA was validated by quantitative reverse transcription polymerase chain reaction (qRT-PCR) in the LN metastasis (n = 46) and NLN (n = 39) groups. The microarray results revealed that three miRNAs (miR-1260b, miR-423-3p, miR-23a-5p) were differentially expressed in LN metastasis group compared with NLN group. The expression of miR-1260b was tested by qRT-PCR and the mean relative expression fold change (2(-ΔΔCt)) in LN metastasis was significantly higher than that in the NLN group (3.942, 1.743 respectively, P = 1.179E-04). The patients with tumor-node-metastasis (TNM) stage III were identified more frequently in LN metastasis group (P = 1.772E-11) and with a higher expression level of miR-1260b (5.126, P = 1.147E-06). In addition, the LN metastasis cases were associated with a poorly differentiated degree (P = 0.007). The overexpression of miR-1260b in NSCLC with LN metastasis can be regarded as a specific signature for early progression and prognosis of NSCLC.

Upregulation of miR-1280 expression in non-small cell lung cancer tissues.

BACKGROUND: Non-small cell lung cancer (NSCLC) is a prolific and high-mortality disease with few effective treatments. Although the detection and surgical techniques for NSCLC continue to advance, the survival rate for the patients with NSCLC remains poor. Enhanced predictive biomarkers such as microRNAs (miRNAs) are needed at the time of diagnosis to better tailor therapies for patients. This study focused on the expression of miR-1280 in NSCLC tissues and distal normal tissues in order to explore the association between miR-1280 expression and NSCLC. METHODS: A total of 72 newly diagnosed primary NSCLC patients were enrolled in this study. Quantitative real-time polymerase chain reaction (PCR) was performed to identify the expression level of miR-1280 in the NSCLC tissues and distal normal tissues of these patients. RESULTS: The miR-1280 expression was significantly higher in the NSCLC tissues (0.084 ± 0.099) than distal normal tissues (0.014 ± 0.015, P = 0.009). In 54 patients (75%), the miR-1280 expression in the NSCLC tissues was upregulated (2-ΔΔct > 2), and no case showed a downregulation of miR-1280 expression. CONCLUSIONS: The expression level of miR-1280 could be regarded as a biomarker for NSCLC.

Midkine mRNA level in peripheral blood mononuclear cells is a novel biomarker for primary non-small cell lung cancer: a prospective study.

BACKGROUND AND OBJECTIVES: Midkine (MK) mRNA was highly expressed in various human cancer tissues and cells. The present study aimed to investigate whether MK mRNA level in peripheral blood mononuclear cells (PBMC) could serve as a diagnostic biomarker for patients having primary non-small cell lung cancer (NSCLC). METHODS: MK mRNA level in PBMC from 87 patients with primary NSCLC, 35 patients with lung benign lesion (LEL), and 30 healthy volunteers was analyzed by real-time quantitative RT-PCR. The levels of serum carcinoembryonic antigen, carbohydrate antigen 125 (CA125), and neuron-specific enolase were detected by chemiluminescent microparticle enzyme immunoassay. RESULTS: PBMC MK mRNA level was significantly higher in patients with primary NSCLC than that in other groups (P < 0.001), while there was no significant difference between LEL patients and healthy volunteers (P > 0.05). Higher MK mRNA level was correlated with clinical stages (P = 0.026), differentiation (P = 0.025), and lymph node metastasis (P = 0.022) of NSCLC. Using a cutoff of 0.0063, the sensitivity and specificity of MK mRNA levels to differentiate between patients with NSCLC and patients with LEL were 57.47 and 93.33 %,and it were 56.32 and 93.33 % for patients with NSCLC and healthy volunteers, respectively. Furthermore, multivariate analysis indicated that PBMC MK mRNA level above the cutoff value presented a chance of 11-fold higher for NSCLC occurrence. CONCLUSIONS: MK mRNA level in PBMC may be a potential non-invasive molecular marker for the diagnosis of primary NSCLC.