Object To study the antiinflammatory effect of matrine and its active mechanism. Methods The matrine effects on activities of secretory phospholipase A 2 (sPLA 2) in peripheral serum and cytosolic phospholipase A 2 (cPLA 2) in leucocyte were measured with Escherichia coli membrane incorporated by arachidonic acid as the substrate; the Ca 2+ level of leucocyte was determined using Frua2 AM loading method, and the rat plantar swelling test was used to examine the antiinflammatory effect of matrine. Results One hour after ip 30 mg/mL matrine, the inhibitory rate of sPLA 2 activity was (81.9?1.8)% , cPLA 2 (28.4?6.0) %, while Ca 2+ concentration was (157.10?20.56) nmol/L which was 15.3% higher than that of the control. Plantar swelling test showed that matrine had a significant anti inflammatory effect. Conclusion Matrine is a novel PLA 2 inhibitor with anti inflammatory effect.

Objective: To investigate the effect of clopidogrel on antiplatelet therapy in patients with coronary artery disease (CAD) combining chronic kidney disease (CKD) in order to provide a medication reference in clinical practice. Methods: We retrospectively investigated 423 CAD patients with coronary angiography (CAG) conifrmed diagnosis in our hospital from 2014-01 to 2014-09. According to the value of eGFR, the patients were classiifed into 2 groups:CAD+ CKD- group,n=257 patients with eGFR ≥ 90 ml/(min?1.73 m2), including 182 male and 75 female at the mean age of (60.39 ± 11.09) years, and CAD+CKD+ group,n=166 patients with eGFR < 90 ml/(min?1.73 m2), including 107 male and 59 female at the mean age of (65.80 ± 10.84) years. The patients were treated either by aspirin 0.1 g/d with clopidogrel 75 mg/d for at least 7 days, or by PCI operation with the load of aspirin 0.3g and clopidogrel 300 mg. The thrombelastography was conducted to examine and compare the inhibitory rates of ADP receptor and arachidonic acid (AA) pathway in platelet between 2 groups. Results: The inhibitory rate of platelet ADP receptor in CAD+CKD- group (64.9 ± 27.2) % was higher than that in CAD+CKD+ group (56.6 ± 27.4) %,P=0.039. Based on clinical standard of platelet’s ADP and AA inhibitory rates, in CAD+CKD- group, there were 24/257 (9.4%) of patients only insensitive to clopidogrel, in comparison with 25 (9.7%) of patients only insensitive to aspirin,P=0.99. While in CAD+CKD+ group, there were 21/166 (12.7%) of patients only insensitive to clopidogrel, in comparison with 11 (6.6%) of patients only insensitive to aspirin,P= 0.045. Conclusion: Clopidogrel has decreased effect on anti-platelet therapy in CAD patients combining with CKD, such patients have reduced sensitivity to relevant medication.

Objective To study the clinical features of congenital glucose-galactose malabsorption (CGGM),and to improve the understanding of CGGM.Method Clinical manifestations and treatment process of one patient with CGGM in our hospital were retrospectively analyzed.From 1966 to 2016 May,Chinese medical database and PUBMED were searched using Malabsorption syndrome,dehydration,hypernatremia , diarrhea , newborn , carbohydrate metabolism ,andglucose/galactose malabsorption as key words.The clinical features of CGGM reported in literatures were summarized.Result The patient in our hospital was a full-term female infant naturally delivered.The onset of the disease was on the 9th day after birth,and the clinical manifestations included severe diarrhea,severe dehydration,hypernatremia,metabolic acidosis and malnutrition.After intravenous infusion and symptomatic treatment,dehydration,hypernatremia and metabolic acidosis were corrected.However,there was no improvement of diarrhea characterized with watery and acidic stools,and neither was weight gain.Glucose loading test was negative,and fructose loading test was positive.Diarrhea was improved markedly using diagnostic carbohydrate-free formula,so CGGM was diagnosed clinically.SLC5A1 homozygous IVS7-2 A ＞ G mutation was detected which confirmed the diagnosis of CGGM.With carbohydrate-free formula feeding,the body weight of the infant was increased.Followed up for 2 months now,her body length and body weight were at P25 and P22 on growth curve respectively,and no obvious neurological sequela was observed.Our literature review revealed 7 reports including 48 cases of CGGM children.Literature review showed that:most children with CGGM (79.2％) had the onset within 7 days of life;main clinical features included diarrhea (100％),dehydration (100％),and malnutrition (54.2％);22.9％ of patients with carbohydrate-free formula and 27.1％ with fructose matrix formula were fed well;no death was detected,77.1％ had normal weight gain,and 91.7％ had normal development of the nervous system.Conclusion CGGM is rare.The symptoms include severe watery and acidic stools with onset during neonatal period.CGGM is associated with severe complications such as hypertonic dehydration and hypernatremia.The diagnosis is established based upon typical clinical manifestations,sugar loading test and SLC5A1 gene detection.Carbohydrate-free formula feeding is effective.

Paraneoplastic neurological syndromes (PNS) are a rare group of immune-mediated disorders that affect the central and peripheral neuromuscular system in association with cancer.If the limbal lobe system of the brain is involved,it will show paraneoplastic limbal encephalitis(PLE).The discern of patients with PNS is challenging since tumors causing paraneoplastic neurologic disorders are often asymptomatic and sometimes occult.We report a case of PLE with double positive anti-Hu and Yo antibodies,and further analyze and discuss it in conmbination with relevant literature to improve the understanding of the disease.

Lung cancer is a disease with high incidence rate and high mortality rate worldwide. Its diagnosis and treatment mode is developing constantly. Among them, multi-disciplinary team (MDT) can provide more accurate diagnosis and more individualized treatment, which can not only benefit more early patients, but also prolong the survival time of late patients. However, MDT diagnosis and treatment mode is only carried out more in provincial and municipal tertiary hospitals and has not been popularized. This article intends to introduce MDT mode and its advantages, hoping that MDT mode can be popularized and applied.

Non-small cell lung cancer is the main cause of cancer death in the world, and its incidence is increasing year by year, seriously endangering human health. Early non-small cell lung cancer is generally difficult to be detected based on symptoms and signs. Therefore, accurate pathological diagnosis and accurate prediction of prognosis are crucial for formulating the best treatment plan for non-small cell lung cancer patients and improving their survival. The application of artificial intelligence in the diagnosis and treatment of non-small cell lung cancer has shown good performance and great potential effect. This paper introduces the research progress of artificial intelligence in predicting the classification, staging, genomics and prognosis of non-small cell lung cancer.

MicroRNAs (miRNAs) are a class of short, highly conserved, non-coding RNA molecules that regulate gene expression by specific binding to the messenger RNAs (mRNAs). At present, the researches on miRNAs have caused immense global concern, and expression of miR-139-5p plays a significant role in tumorigenesis, metastasis and recurrence, through regulating proliferation, migration, and invasion of cancer cells in lung cancer, esophageal cancer, breast cancer, tongue squamous cell carcinoma, hepatocellular carcinoma, etc. MiR-139-5p has a positive impact on the prognosis of cancer, and it can combine with some chemotherapeutic drugs to reverse resistance and enhance the sensitivity of radiotherapy. It also works in the cells and tissues of other diseases, including nerve cells, and inflammation. This article reviewed the progress of miR-139-5p.

As an emerging technology, artificial intelligence (AI) uses human theory and technology for robots to study, develop, learn and identify human technologies. Thoracic surgeons should be aware of new opportunities that may affect their daily practice by the direct use of AI technology, or indirect use in the relevant medical fields (radiology, pathology, and respiratory medicine). The purpose of this paper is to review the application status and future development of AI associated with thoracic surgery, diagnosis of AI-related lung cancer, prognosis-assisted decision-making programs and robotic surgery. While AI technology has made rapid progress in many areas, the medical industry only accounts for a small part of AI use, and AI technology is gradually becoming widespread in the diagnosis, treatment, rehabilitation, and care of diseases. The future of AI is bright and full of innovative perspectives. The field of thoracic surgery has conducted valuable exploration and practice on AI, and will receive more and more influence and promotion from AI.

Objective    To explore the predictive value of CT signs of mixed ground-glass nodules in the pathological subtype and differentiation of lung adenocarcinoma. Methods    The clinical data of 66 patients with mixed ground-glass nodules pathologically diagnosed as invasive adenocarcinoma (IAC) in the Second Department of Thoracic Surgery, the First Affiliated Hospital of Xiamen University from May to December 2021 were retrospectively analyzed, including 20 males and 46 females, aged 35-75 years. The CT findings were analyzed before operation, and the lesion profile was cut after operation to distinguish the ground-glass and solid components, and the pathological results of different positions were obtained. According to the postoperative pathological results, the patients were divided into a low-risk group (containing adherent type and no components of micropapillary subtype and solid subtype, n=16), a medium-risk group (containing niple or acinar type and no components of micropapillary subtype and solid subtype, n=38), and a high-risk group (containing micropapillary or solid subtype, n=12). The relationships between CT features and the pathological subtype and degree of differentiation were analyzed and compared. Results    In 66 patients with IAC, the infiltration degree of solid components was greater than that of ground-glass components. When the solid component ratio (CTR) was≥25% (sensitivity 90.2%, specificity 64.0%, P=0.005), and the average CT value was>−283.95 HU (sensitivity 82.9%, specificity 64.0%, P=0.000), the histological grade was more inclined to medium and low differentiation. The CTR, Ki-67, average CT value and histological grade of IAC in the medium- and high-risk groups were higher than those of nodules in the low-risk group. Conclusion    The infiltration degree of solid components is higher than that of ground-glass components in IAC mixed ground-glass nodules. The pathological subtype, Ki-67 expression and histological grade of lung adenocarcinoma can be predicted according to its CT characteristics, which has important clinical significance for determining the timing of surgery.

Objective    To explore the efficiency of Ki-67 expression and CT imaging features in predicting the degree of invasion of lung adenocarcinoma. Methods    The clinical data of 217 patients with pulmonary nodules, who were diagnosed as suspicious lung cancer by multi-disciplinary treatment clinic of pulmonary nodules in our hospital from September 2017 to August 2021, were retrospectively analyzed. There were 84 males and 133 females, aged 52 (25-84) years. The patients were divided into two groups according to the infiltration degree, including an adenocarcinoma in situ and microinvasive adenocarcinoma group (n=145) and an invasive adenocarcinoma group (n=72). Results    There was no statistical difference in the age and gender between the two groups (P>0.05). The univariate analysis showed that CK-7, P63, P40 and CK56 expressions were not different between the two groups (P=0.172, 0.468, 0.827, 0.313), while Napsin A, TTF-1 and Ki-67 expressions were statistically different (P=0.002, 0.020, <0.001). The multivariate analysis showed that Ki-67 expression was statistically different between the two groups (P<0.001). Ki-67 was positively correlated with malignant features of CT images and the degree of lung adenocarcinoma invasion (P<0.05). Ki-67 and CT imaging features alone could predict the degree of lung adenocarcinoma invasion, but their sensitivity and specificity were not high. Ki-67 combined with CT imaging features could achieve a higher prediction efficiency. Conclusion    Compared with Ki-67 or CT imaging features alone, the combined prediction of Ki-67 and imaging features is more effective, which is of great significance for clinicians to select the appropriate operation occasion.