The left ventricular functions of 72 patients with arrhythmias were studied with a ?-cardiac function device The LVEF was normal in only 11 cases(17.5%) and was reduced in 61 cases(82.5%) The systolic functions including EF,SV,and RCO and the diastolic functions such as PFR were all lower than normal in all the groups of arrhythmic patients,and the difference was significant(P

Objective To investigate the microstructural abnormalities of cerebral white matter in patients with medication-overuse headache with diffusion tensor imaging.Methods Diffusion tensor magnetic resonance imaging (DT-MRI) was carried out in 80 migraine patients with medication-overuse headache (case group) and 80 age-and sex-matched healthy controls (control group).Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were measured and the correlation between clinical characteristics and the changes was examined.Results ① The FA values at the bilateral orbitofrontal cortex,cingulate cortex,splenium of the corpus callosum and the right anterior limb of the capsula interna were significantly lower than those in the controls(P＜0.05).② The ADC values at the right orbitofrontal cortex,left inferior frontal gyrus and anterior cingulate cortex were significantly higher than those in the controls (P＜0.05).③ There were negative correlations between FA values at the bilateral orbitofrontal cortex and right hind legs of the capsula interna and headache course as well as frequency.There was negative correlation between FA values at the left hind legs of capsula interna and headache frequency.④ There were positive correlations between ADC values at the left orbitofrontal cortex and headache course as well as frequency.There were positive correlations between ADC values at the right orbitofrontal cortex and prior cingulate cortex and headache frequency.There was positive correlation between ADC values at the posterior cingulate cortex and headache course.Conclutions There might be an integrity change of neurofibrotic microstructures in the bilateral orbitofrontal cortex and cingulate cortex in patients with medication-overuse headache,FA values are negatively associated with headache course and frequency whereas ADC values are positively associated with headache course and frequency.

Esophageal cancer is the sixth leading cause of cancer-related death worldwide due to its high malignancy and poor prognosis. In recent decades, the applications of new technologies, devices and neoadjuvant therapy lead to the great progress in the diagnosis and treatment of esophageal cancer. However, the five-year survival rate of esophageal cancer remains unsatisfied. Clinical and pathological factors such as the primary tumor (T), regional lymph nodes (N) and distant metastasis (M) and the longitudinal margins of esophageal lesions, lymphatic invasion, peripheral nerve invasion have been identified as important predictors of the prognosis of esophageal cancer. However, the effect of circumferential resection margin on the prognosis evaluation of esophageal cancer is still controversial, and no definite identification of circumferential resection margin of esophageal cancer has been acknowledged worldwide. Therefore, the studies of circumferential resection margin involvement in predicting the prognosis of esophageal cancer are reviewed.

Three-field lymph node dissection improved the postoperative survival and accuracy of pathological staging of patients with esophageal cancer, and reduced the postoperative local recurrence rate of esophageal cancer patients. However, this surgical procedure enlarged the trauma, cansed more complications, prolonged postoperative hospital stays, and seriously impaired the postoperative adjuvant therapy. Therefore, selection of patients who are suitable for three-field lymph node dissection is extremely important. The special anatomical location of recurrent laryngeal nerve lymph nodes is potentially suitable for it to serve as sentinel lymph node for the evacuation of cervical lymph nodes dissection in esophageal cancer. The guiding value of recurrent laryngeal nerve lymph node metastasis in cervical lymph node dissection of thoracic esophageal cancer is reviewed.

Esophageal cancer is one of the most prevalent cancers in China. Lymph node metastasis is one of the most important prognostic factors and severely affect the long-term survival after surgical treatment. Therefore, systemic two-field lymph node dissection including thoracic and abdominal draining nodes of the esophagus during surgery is essential in order to improve the long-term survival for the patients with thoracic esophageal cancer, and it is also the basis for precise staging and postoperative adjuvant treatment regimen- making. As reported in the literature, lymph node metastases along bilateral recurrent laryngeal nerve was the highest, therefore, the lymph node dissection along bilateral recurrent laryngeal nerve is the most important manipulation during esophagectomies, however, it is also the most technically difficult procedure during operation. It usually results in postoperative complications especially the respiratory complications due to paralysis of recurrent laryngeal nerves caused by lymph node dissection. Therefore, the gain and loss of lymph node dissection along bilateral recurrent laryngeal nerve has been a disputed and entangle topic for thoracic surgeons, and the purpose of this paper is to summarize author′s experience and the key technology to prevent the associated complications in lymph node dissection along recurrent laryngeal nerve during esophagectomies for the patients with thoracic esophageal cancer.

Local treatment improves the outcomes for oligometastatic disease, an intermediate state between locoregional and widespread disease. However, consensus about the definition, diagnosis and treatment of oligometastatic oesophagogastric cancer is lacking. The first edition "Definition, diagnosis and treatment of oligometastatic oesophagogastric cancer: A Delphi consensus study in Europe" was published on February 15, 2023 by 65 European medical specialists. In this article, the consensus will be interpreted to provide new idea for the diagnosis and treatment of oligometastatic oesophagogastric cancer for Chinese clinicians.

Pulmonary mucinous adenocarcinoma is a subtype of lung adenocarcinoma, among which invasive mucinous adenocarcinoma (IMA) is the most common subtype and is easily misdiagnosed as pneumonia. Its etiology and pathogenesis are unclear and may be related to gene mutations and other factors. Due to its relative rarity and few related studies, guidelines do not provide advices on its treatment. KRAS mutations are common in IMA patients, and Sotorasib may be effective against KRAS G12C mutated IMA. NRG1 fusion is considered to be an important driver of IMA, and afatinib may be effective in treating IMA with NRG1 fusion/rearrangement. PD-L1 expression is very low in IMA patients, while B7-H3 expression is high, so B7-H3 may be a potential immunotherapeutic target.

Superior sulcus tumor of the lung is a bronchogenic tumor occurred in the apex of the upper lobe of the lung and is a unique clinical subtype of non-small cell lung cancer (NSCLC), which account for less than 5% of all bronchogenic carcinomas. It often involves the first rib, brachial plexus, subclavian vessels, sympathetic chain, stellate ganglion or vertebra. A lot of progress has been achieved in the treatment of superior sulcus tumor over the past decades. Several clinical trials reported in recent years have confirmed that concurrent chemoradiotherapy followed by surgical resection can improve the rate of complete resection, local control and pathological remission of the tumor, and prolong the total-survival time. It has become the most effective treatment mode for the superior sulcus tumor, and recommended as a standard treatment mode for superior sulcus tumor by National Comprehensive Cancer Network (NCCN) and American College of Chest Physicians (ACCP) guidelines. This article reviews relevant literatures at home and abroad, and briefly introduces the advances in surgical treatment and comprehensive treatment of superior sulcus tumor.
.
Combined Modality Therapy ; Humans ; Lung Neoplasms ; drug therapy ; surgery ; therapy ; Molecular Targeted Therapy ; Ribs ; Treatment Outcome

ObjectiveTo explore the safety and efficacy of robot-assisted minimally invasive esophagectomy （robot-assisted minimally invasive esophagectomy， RAMIE） and thoracic laparoscopy combined with minimally invasive esophageal resection （minimal invasive esophagectomy， MIE）. MethodsThe data of 188 patients treated with Da Vinci robot assisted minimally invasive esophageal resection （RAMIE） from April 2021 to December 2022 were analyzed. In the RAMIE group， 69 patients， 49 males and 20 female， age （67.2 ± 7.2）； 119 in the MIME group， respectively， 89 males and 30 female， age （69.1 ± 7.0）. At 1 ∶ 1， including 58 patients in the RAMIE group and 58 patients in the MIE group. The t-test， Wilcoxon rank-sum test， χ² test， and so on. ResultsAfter PSM treatment， the clinical data between the two groups. There was no significant difference in operation time， postoperative tube days， and total number of lymph node dissection between the RAMIE and MIE groups （P <0.05）； the RAMIE group was better in terms of intraoperative bleeding and the MIE group， statistically significant （P <0.05）； the MIE group was better in drainage flow and lymph node dissection for three days （P <0.05）. In terms of postoperative complications， there was no statistical difference between RAMIE and MIE groups （P>0.05）. ConclusionThe recent efficacy of robot-assisted minimally invasive esophagectomy is comparable to that of thoracic laparoscopy and minimally invasive Mckeown esophagectomy； robotic-assisted minimally invasive esophagectomy can reduce intraoperative bleeding and have more advantages in left recurrent laryngeal nerve lymph node dissection.

Acute myeloid leukaemia (AML) is the most common form of acute leukaemia in adults, with increasing incidence with age and a generally poor prognosis. Almost 20% of AML patients express mutant isocitrate dehydrogenase 2 (mIDH2), which leads to the accumulation of the carcinogenic metabolite 2-hydroxyglutarate (2-HG), resulting in poor prognosis. Thus, global institutions have been working to develop mIDH2 inhibitors. SH1573 is a novel mIDH2 inhibitor that we independently designed and synthesised. We have conducted a comprehensive study on its pharmacodynamics, pharmacokinetics and safety. First, SH1573 exhibited a strong selective inhibition of mIDH2 R140Q protein, which could effectively reduce the production of 2-HG in cell lines, serum and tumors of an animal model. It could also promote the differentiation of mutant AML cell lines and granulocytes in PDX models. Then, it was confirmed that SH1573 possessed characteristics of high bioavailability, good metabolic stability and wide tissue distribution. Finally, toxicological data showed that SH1573 had no effects on the respiratory system, cardiovascular system and nervous system, and was genetically safe. This research successfully promoted the approval of SH1573 for clinical trials (CTR20200247). All experiments demonstrated that, as a potential drug against mIDH2 R140Q acute myeloid leukaemia, SH1573 was effective and safe.