The TNM staging is the most common tumor staging system of lung cancer.The new revisioned 7th lung cancer TNM staging is published by the international association for the study of lung cancer (IASLC) in the 13th world conference on lung cancer.Accurate clinical staging depends on the multi-analysis from medical histroy,clinical examination,imaging examination and invasive test,which has important significance for guiding the treatment of lung cancer.The 7th lung cancer TNM classification has been revised respectively from the primary focus,lymph node metastasis and remote viscera metastasis,so as to make it more accurately corresponding to the prognosis of patients.

Objective To evaluate the diagnostic and therapeutic status of lower urinary tract symptoms (LUTS) in the elderly outpatients with benign prostatic hyperplasia (BPH) in Guangzhou.Methods The investigation was conducted in outpatient departments for elderly patients in 3 hospitals of Guangzhou. The eligible male patients with LUTS/BPH were chosen from patients who came to the clinic in the process of investigation. Results The 29.7% (1824/6140) of them had history of LUTS/BPH previously or presently. In 134 patients received medical questionnaire, the proportion of LUTS/BPH patients with mild, middle and severe degree based on international prostate symptom score (IPSS) was 24.5%, 72.5% and 3.0% respectively. The abnormal percentage of PSA was 37. 3 %. The most common examinations that patients received were directeral rectun examination (96.8%), PSA (88. 7%) and transabdominal ultrasonography (84.8%). The 44.7% of cases were given the treatment of 5α-reductase inhibitor, and 24.7% of cases received a combination therapy of 5α-reductase inhibitor plus α receptor blocker. The 16.7% of cases were given a combination treatment of 5α-reductase inhibitor plus herbs. The proportion of therapy with α receptor blocker and herbs was similar (6.8% and 7.1% respectively). Conclusions LUTS/BPH is one of the most common diseases in elderly male patients. The examinations conducted by doctors are unreasonable.The doctors are easy to ignore inquirement of patient's history and IPSS. The drugs conducted by doctors are reasonable basically.

Objective To study the effect of the intervention mode of MTP on use of antibacterials in upper respiratory infection.Methods Adopt retrospective method to select randomly prescriptions of upper respiratory infection from July to September in 2006 for baseline investigation in Outpatient Clinic of Respiratory Department of the First People's Hospital of the city of Zhuhai in Guangdong province.Then aim physicians was interfered by MTP and investigation of post-interference was carried out after a month.The process of intervention and investigation was carried out repeatedly until June in 2007.The ratio of antibacterials use,injection use percentage and average drug fee was observed in pre/post-interference.Results The ratio of antibacterials use in upper respiratory infection in our hospital was decreased from 81.33% to 0,and the ratio percentage of injection use and average drug fee decreased by 81.69% and 35.47% respectively after four MTP circulations.Conclusion The intervention mode of MTP is feasible and effective on promoting the rational use of antibacterials on upper respiratory infection in Outpatient Clinic of Respiratory Department of our hospital.

Objective To observe the protective effect of pretreatment with wortmannin against pancreas and liver injuries indued by severe acute pancreatitis(SAP) in rats and investigate its mechanism.Methods Fifty-four SD rats were randomly divided into 3 groups: control group(C group),SAP group(P group) and SAP+wortmannin group(PW group)(n=18 per group). SAP model was induced by retrograde infusion of 50g/L sodium taurocholate into the biliopancreatic duct of rats,except C group in which sodium taurocholate was replaced by normal saline. Serum level of tumor necrosis factor-alpha(TNF-?)、 alanine aminotransferase(ALT)、aspartate aminotransferase(AST)、and nuclear factor-kappa B(NF-?B)in liver were detected. Histopathology of liver and pancreas was studied.Results In P group, serum levels of TNF-?、ALT、AST and NF-?B in liver were significantly elevated(P

Objective To investigate the clinical characteristics and imaging manifestations of AIDS complicated with disseminated Penicillium marneffei (PM) infection. Methods A total of 12 patients with AIDS complicated with disseminated PM infection were collected and the symptoms, signs, laboratory examination results and image manifestations of these patients were analyzed retrospectively. Results (1) The diagnosis of PM infection in all the 12 cases were confirmed by peripheral blood culture.All the 12 cases (100％) had irregular fever (38-41 ℃) and enlarged lymph nodes, 8 cases (66％) had skin rashes; 8 cases (66％) had hepatomegaly; 9 cases (75％) had splenomegaly while 8 cases (66％) had anemia. (2) Imaging manifestation: Five cases manifested bilateral pulmonary disseminated miliary nodular shadows or lattice signs; 1 case showed enlarged hilar lymph node and 2 zases showed patchy shadow with pleuritis. One case presented sub-pleural curve line shadow at the posterior part of the right lower lung,and adhesion between the intestinal wall and intestinal mesentery in mass form in the abdomen by CT examination. Conclusion Patients suffering from AIDS (CD4T lymphocytes ＜50/μ L) with impaired immunity might be susceptible to complication of disseminated PM infection, which presents mainly damage of multiple organs and symptoms such as fever; enlargement of liver,spleen and lymph nodes, as well as specific skin maculopapular rashes. Imaging manifestations in the lungs were revealed as miliary nodular shadows and lattice-like shadows. Intensified abdominal CT might reveal presence of several enlarged postperitoneal lymph nodes and intestinal adhesion in shape of cakes.

Objective To observe the effects of κ-opioid receptor agonist U50,488H on myocardial ischemia and reperfusion injury and related mechanism.Methods Rats were randomly divided into sham operation,myocardial ischemia and reperfusion(I/R,30 min ischemia followed by 120 min reperfusion),and MI/R + U50,488H (1.5 mg/kg) and I/R + U50,488H + selective κ-opioid receptor antagonist Nor-BNI (2 mg/kg,n =8 each).The infarction size and the incidence of ventricular arrhythmias were observed.Real-time PCR and DAB staining were used to define the myocardium Toll-like receptor 4 (TLR4)expression.Myeloperoxidase level,TNF-α induction and the expression of NF-κB were also examined in rats.Results After I/R,the expressions of myocardial TLR4 and NF-κB increased significantly both in ischemia area and area at risk.Compared with I/R,κ-opioid receptor stimulation with U50,488H significantly attenuated the expressions of TLR4 and NF-κB and reduced myeloperoxidase (MPO) levels,myocardial TNF-α production,myocardial infarct sizes and the incidence of ventricular arrhythmias and arrhythmia score (2.9 ± 0.7 vs.4.4 ± 0.9,P ＜ 0.05),above effects of U50,488H were partly abolished by co-treatment with Nor-BNI.Conclusion These data provide evidence for the first time that κ-opioid receptor stimulation could attenuate myocardial L/R injury via downregulating TLR4/NF-κB signaling in rats.

Esophageal cancer is a common malignant tumor of digestive tract.Remarkable regional difference is a prominent feature of the clinical epidemiology of esophageal cancer.They are mainly manifested in incidence rate,incidence type,onset age,and gene mutation.These differences may be related to dietary habits,lifestyle,and environmental factors.In recent years,research on the regional differences in esophageal cancer has gradually deepened.This article summarizes the differences in incidence rate,incidence type,gene mutations,epigenetics,risk factors,and prognosis of esophageal cancer in different regions,including Asia(China,India,Japan,and other countries),Europe,America(the United States),Africa,and other regions.Understanding these differences can help doctors and public health experts understand the risk factors and causes of esophageal cancer and further develop highly effective prevention and treatment strategies to reduce the occurrence and mortality rate of this malignancy.

OBJECTIVETo investigate the influence of mTOR expression on prognosis of early stage NSCLC.

METHODSOne-hundred and thirty-eight patients who underwent radical surgery for early stage NSCLC in our hospital from Janurary 2002 to December 2006 were included in this study. There were 83 males and 55 females, in an average age of 65.8 years, for both genders). The influence of age, gender, tumor typing, pathological grading, pathological staging and mTOR expression on patients' survival were analyzed by univariate and multivariate analyses.

RESULTSThe 5-year survival rate of the 138 cases was 44.8%. Immunohistochemical examination showed that mTOR-positive cases accounted for 101 while mTOR-negative cases accounted for 37. The 5-year survival rate of mTOR-positive patients was 32.7% and that of mTOR-negative patients was 56.4% (P = 0.019). Univariate analysis showed that mTOR expression, pathological staging and N1 lymph node metastasis were identified as significant prognostic factors, and were correlated to prognosis (P < 0.05 for all). Multivaraite analysis showed that pathological staging, mTOR expression, N1 lymph node involvement were identified as independent prognostic factors for patients with early NSCLC (P < 0.05 for all).

CONCLUSIONSOur findings suggest that overexpression of mTOR indicates a poor prognosis for NSCLC. mTOR, pathological stage and N1 lymph node metastasis are independent prognostic factors in early stage NSCLC.

Aged ; Carcinoma, Non-Small-Cell Lung ; metabolism ; pathology ; surgery ; Female ; Humans ; Lung Neoplasms ; metabolism ; pathology ; surgery ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Survival Rate ; TOR Serine-Threonine Kinases ; metabolism

Non-small cell lung cancer(NSCLC)is a prevalent and aggressive global malignancy.Conventional sur-gical treatments,radiotherapy,chemotherapy,and targeted therapies often fall short in halting disease progression due to inher-ent limitations,resulting in suboptimal prognosis.Despite the advent of immunotherapy drugs offering new hope for NSCLC treatment,current efficacy remains insufficient to meet all patient needs.Therefore,actively exploring novel immunotherapeu-tic approaches to further reduce mortality rates in NSCLC patients has become a crucial focus of NSCLC research.This article aims to systematically review the anti-tumor effects ofinterleukin-21 and follicular helper T cells in NSCLC immunotherapy by summarizing and analyzing relevant literatures from both domestic and international sources,as well as exploring the potential for enhancing NSCLC treatment prospects through immune checkpoint regulation via immunotherapeutic means.

Pulmonary blast injury has become the main type of trauma in modern warfare, characterized by externally mild injuries but internally severe injuries, rapid disease progression, and a high rate of early death. The injury is complicated in clinical practice, often with multiple and compound injuries. Currently, there is a lack of effective protective materials, accurate injury detection instrument and portable monitoring and transportation equipment, standardized clinical treatment guidelines in various medical centers, and evidence-based guidelines at home and abroad, resulting in a high mortality in clinlcal practice. Therefore, the Trauma Branch of Chinese Medical Association and the Editorial Committee of Chinese Journal of Trauma organized military and civilian experts in related fields such as thoracic surgery and traumatic surgery to jointly develop the Clinical treatment guideline for pulmonary blast injury ( version 2023) by combining evidence for effectiveness and clinical first-line treatment experience. This guideline provided 16 recommended opinions surrounding definition, characteristics, pre-hospital diagnosis and treatment, and in-hospital treatment of pulmonary blast injury, hoping to provide a basis for the clinical treatment in hospitals at different levels.