M2 type of pyruvate kinase (PKM2) is one of the most important regulatory molecules in glycolysis,which at high level is a major feature of tumor cells.Besides,PKM2 also regulates gene transcription and cell cycle,promoting the formation,invasion and migration of tumors.Meanwhile,PKM2 can beregulated by many transcription factors,oncogene proteins,miRNA and intermediate metabolites.Extensive studies indicated that PKM2 plays an important role in the developmental tumor.In view of the significance of PKM2 in tumor cells,it holds promise for diagnosis and treatment benefits.

Objective To assess the local anatomy of the Jing Bi with high-frequency ultrasound, and to evaluate the clinical significance of high-frequency ultrasound in acupuncture. Methods A total of 206 healthy subjects were observed with the high-frequency ultrasound. Two common location points of Jing Bi were selected and acupunctured under guidance of high-frequency ultrasound. The sensation of subjects was observed. Brachial plexus diameter, distance between skin and membrana pleuralis, as well as the brachial plexus and the pleura were measured. Results The filiform needle tip to lung, lung tissue and the brachial plexus were all showed, and the brachial plexus diameter, distance between skin and membrana pleuralis, the distance between the brachial plexus and the pleura were obtained. The patients felt when the needle reached the membrane of brachial plexus. All subjects got feeling within 10 seconds after acupuncture, and no pneumothorax occurred. Conclusion The local anatomy of dangerous acupoints can be accurately observed with high-frequency ultrasound. High-frequency ultrasound has important value and significance for acupuncturing the dangerous acupoints.

OBJECTIVETo compare the short-term efficacy and long-term survival between Sweet and Ivor-Lewis esophagectomy for patients with middle-lower esophageal squamous cell carcinoma.

METHODSClinicopathologic data of 1 308 patients with middle-lower esophageal squamous cell carcinoma undergoing Sweet or Ivor-Lewis procedures in our department from January 2007 to December 2014 were retrospectively analyzed, including 1 021 patients of Sweet operation (Sweet group) and 287 patients of Ivor-Lewis operation(Ivor-lewis group). Lymph node clearance, lymphatic metastasis, postoperative complication morbidity and long-term survival were compared between the two groups.

RESULTSThere were no significant differences in baseline data between the two groups(all P>0.05). There were more lymph nodes resected during the Ivor-Lewis procedure compared with the Sweet procedure (20.8 vs.19.3, P=0.030). Compared with Ivor-Lewis group, the incidence of wound infection in Sweet group was significantly lower[(3.2%(33/1 021) vs. 8.0%(23/287), P=0.000]. Sweet group had a significantly lower rate of delayed gastric emptying[1.9%(19/1 021) vs. 5.2%(15/287), P=0.002] and significantly shorter hospital stay (14.7 days vs. 17.2 days, P=0.029). With respect to other postoperative complications, such as pulmonary complications, cardiac events, anastomotic leakage, vocal cord palsy, chylothorax and pyothorax, the differences between the two groups were not statistically significant. The 5-year survival rate was not significantly different between the two group (54.0% vs. 56.9%, P=0.873). Stratified analysis based on TNM staging showed that no significant difference of 5-year survival rate was found between the two groups in stageI( and stageIII( patients (P>0.05), while the 5-year survival rate of stageII( patients in Sweet group was significantly lower than that in Ivor-Lewis group (56.4%% vs. 70.4%, P=0.039).

CONCLUSIONSFor patients with middle-lower esophageal squamous cell carcinoma, Sweet procedure has certain superiority regarding the incidence of wound infection and delayed gastric emptying compared with the Ivor-Lewis procedure. Ivor-Lewis esophagectomy can harvest more lymph nodes. The 5-year survival rate of these two procedures is similar. Sweet procedure is still valuable in clinical practice, especially for stageI( and stageIII( patients, while it requires thorough considerations for stageII( patients.

Anastomotic Leak ; Antineoplastic Protocols ; Carcinoma, Squamous Cell ; mortality ; surgery ; Esophageal Neoplasms ; mortality ; surgery ; Esophagectomy ; adverse effects ; methods ; Gastroparesis ; etiology ; Humans ; Incidence ; Length of Stay ; Lymph Node Excision ; statistics & numerical data ; Lymph Nodes ; Lymphatic Metastasis ; Neoplasm Staging ; statistics & numerical data ; Postoperative Complications ; etiology ; Recovery of Function ; Retrospective Studies ; Surgical Wound Infection ; etiology ; Survival Rate ; Treatment Outcome

Objective:To investigate the difference of HRCT imaging features between COVID-19 and the ground-glass opacity(GGO) lesion of early-stage lung carcinoma, standardize the diagnosis and treatment process of ground-glass opacity(GGO) degeneration during the epidemic.Methods:A total of 34 patients with diagnosed COVID-19 who confirmed by positive results of the new coronavirus nucleic acid test were collected as observation group 40 patients with pathologically diagnosed early-stage lung carcinoma whose preoperative HRCT examination showed pure ground glass lesions and received surgical intervention were recruited from the Department of Thoracic Surgery (The First Affiliated Hospital of Xiamen University) from January 2018 to December 2019 as the control group. The HRCT imaging features of these two groups of patients were compared and statistically analyzed.Results:The HRCT imaging features of the new type of COVID-19 showed significant difference by characteristics of multiple lesions, lesion rapid variation within 3 days, reticular pattern, vacuolar sign and clear boundary compared to the GGO lesion of early-stage lung carcinoma( P<0.05). The chinical and imaging characteristic the sex, age, with pleural effusion or not and the lesion location showed no significant difference between these 2 groups ( P>0.05). Conclusion:Contrast with inert early lung carcinoma lesions, COVID-19 disease developed rapidly. Imaging dynamic examination can provide evidences to distinguish Novel Coronavirus Pneumonia and early-stage lung carcinoma.