Objective:To evaluate the prognosis of non-small cell lung cancer (NSCLC) patients with pleural dissemination after differ-ent surgical interventions. Methods:We retrospectively reviewed clinical and survival data of 153 NSCLC patients with pleural dissemi-nation who were diagnosed and treated in our hospital from May 2002 to May 2011. Results:The overall 3-and 5-year survival rates of all the patients are 38.5%and 24.2%, respectively, with a median survival time (MST) of 29.0 months. A total of 122 patients accept-ed primary tumor resection whereas the remaining 31 received pleural biopsy. The 5-year survival rate of the primary tumor resection group was 26.2%with a MST of 29.0 months and 16.1%for the pleural biopsy group with a MST of 24.0 months. The survival analysis showed no significant differences in the prognosis between the primary tumor resection and pleural biopsy groups (P>0.05). In the pri-mary tumor resection group, different surgical interventions (with or without lymph nodes dissection, with or without metastatic nod-ules resection, lobe, or partial lobe resection) had no effect on prognosis (P>0.05). Conclusion:Patients with pleural dissemination had poor prognosis. Different surgical interventions showed no survival benefits for patients with NSCLC regarding pleural dissemination. The role of surgery was to rule out or confirm pleural dissemination. The definite value of surgery still needs further exploration.

Objective To evaluate the impacts of comprehensive diabetes intervention to provide evidence for effective diabetic control in rural communities.Methods Diabetic patients from four communities at Wujin District of Changzhou City were selected.One hundred and seventy-three patients from two communities received comprehensive intervention,including medication therapy,diabetes education,and diet.exercise,and behavior instruction(intervention group);142 patients from the other two communities got medication therapy only (control group).All the participants were interviewed with structured questionnaire and phyrsical examination.The second epidemic investigation was conducted at 4 years to evaluate the effects of the intervention.Results At the end of the intervention,the awareness rates of normal fasting plasma glucose,major diabetes risk factors,healthy diet,and therapeutic strategies in the intervention group were 90.8%.74.6%,89.6%,and 59.5%,respectively,which were significantly higher than those in the control group (all P<0.05).For the intervention group,the rates of diet behavior or physical exercise change were 68.8% and 58.4%.respectively.which were much higher than those of the control group(all P<0.05).The average levels of systolic pressure,diastolic pressure,fasting plasma glucose,and total cholesterol were (130.6±10.4)mm Hg(1 mm Hg=0.133 kPa),(78.4±7.5)mm Hg,(6.2±3.1)mmol/L,and (4.5±0.9)mmol/L,respectively,in the intervention group,which were lower than those in the control group(all P<0.05).Conclusion Comprehensive intervention shows significant effects on rural community patients with diabetes.

Objective To investigate the prevalence and influencing factor of metabolic syndrome(MS)in rural elderly population. Methods With randomized cluster sampling,investigations including questionnaires,physical examination,fasting plasma glucose,blood lipids were performed in rural population aged over 60 years in Changzhou city in 2004-2005. Results A total of 4976 elderly people were enrolled in the study.The prevalence of MS was 24.1%,and 10.3%in men,34.3%in women by international diabetes federation(IDF)2005 definition.86.2%individuals had one or more of the metabolic disorders.Logistic regression analysis showed that sex,smoking,sweetmeat,family history of essential hypertension(EH)and tea drinking were influencing factors of MS. Conclusions The prevalence of MS is high in rural elderly population,especially in females.

Objective The application of intraoperative evoked EMG monitoring during lumbar pedicle screw fixation and to find new stimulus threshold criterion.Methods The validity of the evoked EMG monitoring in detecting the malposition of the pedicle screws was tested again by animal experiment.Nineteen patients was inserted pedicle screws with persistent evoked EMG monitoring via tap stimulator,and the electric current was set at 30% of bone threshold of the same pedicle,all patients were ohecked by CT scan to prove the outcome.Results Thirty-two pedicles of six dogs were inserted Kirchner wires.The stimulate thresholds of mal-position wires had significant difference with those of normal-position wires.During clinical trial,122 screws were inserted in to nineteen patients.Four screws were positive during intraoperative evoked EMG monitoring.Of which one screw was confirmed as mal-position during operation and was then adjusted;another screw was found to be mal-positioned by CT scan post-operation;the other two screws were found normal by CT scan.The sensitivity of this technique was 100% and the specificity was 98%.Conclusion Intraoperative evoked EMG monitoring during lumbar pedicle screw fixation can detect the mal-positioned screws and to protect the nerve roots.The stimulate current may set at 30% of the bone threshold of the relevant pedicle.

Background Researchers showed that posterior capsule opacification (PCO) may be associated with the materials of intraocular lenses (IOLs).However,there have long been controversies about the influence of IOLs materials on PCO pathogenesis.Objective This study was to compare the capsule biocompatibility of different materials of IOLs by observing the biological behavior of human lens epithelial cells (LECs) on the surface of IOLs,including adhesion,proliferation,epithelial mesenchymal transition (EMT) and the secretion of transforming growth factor-β2(TGF-β2),interleukin-6 (IL-6),matrix metalloproteinase-2 (MMP-2) and MMP-9 in vitro.Methods Human lens epithelial cell line (HLE-B3) was cultured on the surface of hydrophobic acrylic (Acrysof SA60AT) IOLs,silicone (Crystalens HD) IOLs and polymethyl methacrylate (PMMA) IOLs for 6 hours and 24 hours,respectively.The number and morphology of HLE-B3 cells on the surface of IOLs were observed under the optical microscope.The proliferation states of the cells on the IOL surface were detected with cell counting kit-8 (CCK-8).The expression of α-smooth muscle actin (α-SMA),a mesenchymal cell marker,in the cells was detected by immunofluoreseence technology,and the EMT rates of HLE-B3 cells were calculated.The contents of TGF-β2,IL-6,MMP-2 and MMP-9 in the medium of IOL surface were measured by ELISA assay.The examination results were compared among different IOLs.Results Six hours after cultured,attached cells showed polygon and round in shape on the surface of Acrysof IOLs and Crystalens IOLs,while those on the PMMA IOLs showed the fusiform.Twenty-four hours after cultured,the cells extended obviously.On the surface of Acrysof IOLs and Crystalens IOLs,the adherent cells showed less cobble-stone like and more spindle shape;while those on the PMMA IOLs showed the typical fiber and some cells clustered the pearl rolls.The number of the cells on the Acrysof IOLs,Crystalens IOLs and PMMA IOLs was 0.238 4 ± 0.007 1,0.178 1 ±-0.006 6 and 0.158 9 ± 0.006 9 respectively,showing a significant difference among the three types of IOLs (F =475.947,P =0.000),and the number of the cells was much more on the Acrysof IOLs than that on the Crystalens IOLs or PMMA IOLs (both at P＜0.001).The EMT rats of the cells on the Acrysof IOLs,Crystalens IOLs and PMMA IOLs were (9.99±3.80) ％,(17.33±5.71) ％ and (84.16±10.48) ％,with a significant difference among them (F =127.411,P =0.000),and the EMT rates of the cells on the PMMA IOLs were significantly higher than those on the Crystalens IOLs and A.crysof IOLs(both at P＜0.001).There were significant differences in the contents of TGF-β2,IL-6,MMP-2 and MMP-9 in the medium on the Acrysof IOLs,Crystalens IOLs and PMMA IOLs (F =0.846,0.947,0.255,0.922,all at P ＞ 0.05).Conclusions The hydrophobic acrylic IOLs have the best capsule biocompatibility followed by the silicone IOLs and then the PMMA IOLs.

Exosomes are membranous vesicles secreted by a variety of cells, including tumor cells, with stable characters, which can reflect the physiological/pathological state of the source cells, indicating good sources of biomarkers for early diagnosis and prognosis of tumors. Urine exosomes are directly derived from the urinary system and play a more direct role in the diagnosis and prognosis of urinary system tumors. This paper reviews the recent advances in urinary exosomes as molecular markers for the early diagnosis of genitourinary tumors.

Objective ToexploretheMSCTandpathologicalfeaturesofsarcomatoidhepatocellularcarcinoma(SHC)inorderto improvetheaccuracyofpreoperativediagnosis.Methods TheMSCT,clinicalandpathologicaldataofall25caseswithpathologically provenSHCwerereviewedretrospectively.Results (1)TheaveragediameterofSHCwas(64.70±40.15)mm.OnplainCT,thelesions showedround-likehypodensityby89.3% (25/28).Thelesionsshowedcompletelycysticdegenerationby14.3%(4/28),unclear boundaryby85.7% (24/28),andheterogeneousdensityby78.6% (22/28),mainlyrepresentingcysticlowdensity.(2)Oncontrast-enhanced CT,thelesionsshowedheterogeneousenhancementby85.7% (24/28).The marginsandinternalsolidsegmentsofthelesions showedirregularmildtomoderateenhancementonarterialphase,andobviousenhancementonportalanddelayedphasesby28.6%(8/28).57.1% (16/28)ofthelesionsshowedobviousenhancementonarterialphase,andwash-outonportalanddelayedphases.The cysticwallandseptumofthecysticlesions (14.3%,4/28)weremildto moderateenhancementonarterialphase,andobvious enhancementonportalanddelayedphases.32.1% (9/28)ofthelesionsshowedhepaticarterybloodsupply,and17.9% (5/28)ofthe lesionshadpseudocapsulesign.(3)ImmunohistochemistryshowedthatVimentinand CD34 werepositiveexpression,meanwhile CK19,HepatocyteandEMA werepartlypositive.Conclusion SHChascertaincharacteristicssignsatMSCT.Lesionsshowhypo-density masseswithlargevolumeandunclearboundaryintheliverparenchyma,andinhomogeneouslymildtomoderateenhancement.Thediagnosis shouldbeconsideredespeciallywhenthelesionhaslargecysticnecrosis.

The postoperative pathological staging system (pTNM) has become an important reference for the selection of various tumor treatment strategies and prognosis evaluation at a global scale, and is a powerful predictor of the prognosis of a variety of solid tumors, but the prognosis is still different in patients with the same pTNM staging. In recent years, studies have confirmed that the negative lymph nodes count (NLNC) is related to the prognosis of a variety of solid tumors. Higher NLNC can improve the prognosis of cancer patients, and NLNC can reduce staging migration, which is expected to be a supplement to the pTNM staging system. This article reviews the value of NLNC in the prognosis of solid tumors.

Objective To explore the influence of negative lymph node count (NLNC) on the prognosis of patients with gastric signet ring cell carcinoma (GSRC) and develop a prognostic nomogram based on NLNC. Methods On the basis of the SEER database, 2 101 patients diagnosed with GSRC were collected and randomly divided into the modeling group and validation group to test the relationship between clinicopathological characteristics and the prognosis of GSRC. The multivariate Cox proportional hazard regression model was used to analyze the independent risk factors affecting overall survival and establish a prognostic prediction model. The consistency index (C-index), calibration curve, net reclassification index (NRI), integrated discrimination improvement (IDI), and decision curve analysis (DCA) were used to evaluate the accuracy and clinical applicability of the nomogram. Results All patients were divided according to the ratio of 7:3, with 1 473 in the modeling group and 628 in the validation group. NLNC > 10 (HR=0.578, 95%CI: 0.504-0.662, P < 0.001) was a protective factor for the prognosis of patients with GSRC, and the nomogram model was established based on multivariate Cox proportional hazards model. The C-index values of the nomogram were 0.737 (95%CI: 0.720-0.753) and 0.724 (95%CI: 0.699-0.749) in the modeling and validation groups, respectively, showing good discrimination. The calibration curves showed high consistency of the model. NRI=17.77%, continuous NRI=36.34%, and IDI=4.2% indicated that the model had positive returns compared with the traditional model. The DCA was far from the baseline, indicating that the model had good clinical applicability. Conclusion The increase in NLNC is a favorable factor for the prognosis of patients with GSRC, and a relatively accurate nomogram was established to predict the prognosis of patients with GSRC and help clinicians conduct individualized prognostic evaluations.

Objective To observe the effect of brain-derived microvesicles (BDMVs) on cytoskeleton in human umbilical vein endothelial cells (HUVECs).Methods BDMVs were prepared in vitro and identified by transmission electron microscopy and particle size identification.HUVECs were co-cultured with PKH26-1abeled BDMVs for 0.5,1,and 2 h;flow cytometry was used to detect the phagocytosis of HUVECs for BDMVs at different time points.HUVECs cultured in vitro were divided into control group,BDMVs treatment group and nimodipine treatment group;cells in the BDMVs treatment group were given 1.5× 107/mL BDMVs;cells in the nimodipine treatment group were pretreated with 2 μg nimodipine (0.2 mg/mL) for 10 min,and then,given 1.5×107/mL BDMVs.After being stained with rhodamine-labeled phalloidin,the fluorescence intensity and number of stress fibers of fibroactin in HUVECs were observed by laser confocal microscopy.Results BDMVs had complete membrane structure with a diameter of 100-1000 nm under transmission electron microscopy.The proportion of cells phagocytizing BDMVs increased significantly with prolonged incubation time,enjoying significant differences (0.5h:22.7％±1.2％;1 h:52.3％±1.3％;2h:71.6％±1.9％,P＜0.05).Laser confocal microscopy showed that,as compared with the control group,the fluorescence intensity ofcytoskeletal protein was obviously increased and the number of stress fibers increased was obviously larger in the BDMVs treatment group.As compared with those in the BDMVs treatment group,the fluorescence intensity of cytoskeletal protein was decreased and the number of stress fibers was obviously smaller in the nimodipine group.Conclusion The role of BDMVs in phagocytosis of HUVECs becomes stronger as time being prolonged,and BDMVs phagocytosis leads to cytoskeletal remodeling,which can be partially blocked by nimodipine.