Objective To assess the utility of single source-dual energy CT for distinguishing bladder cancer from hematoma. Methods We retrospectively identified 14 patients with postoperative or follow-up bladder hematoma who had undergone dual energy protocol (40-140 keV)scanning by single source-dual energy CT.The subjective scoring of tumor detection and image quality,the optimal monochrome images and iodine-water images were evaluated by two radiologists who didn’t know the results.The consistency of two observers was analyzed by Kappa test.Mann-Whitney U test was used to compare the difference between the two kinds of diseases and ROC curve was used to analyze the diagnostic efficiency.The statistical differences of image quality scoring among different images were obtained by using Mann-Whitney U test.Results The consistency of the two observers about scoring of lesion detection was good for all groups.There were statistical differences between two groups in non-enhanced phase and arterial phase of mixed-energy images,non-enhanced phase,arterial phase and delayed phase of optimal monochromatic images,and all phase of iodine-water images. The AUC of iodine-water images in the four phases (0.985,1.000,0.955,0.924,respectively)were all higher than that of polychrome unenhanced and arterial phase images (0.909,0.909).The diagnostic efficiency of arterial phase on iodine-water images was the highest.Sensitivity and specificity were both 100% when score was greater than 2.5.There was no statistical difference between two kinds of diseases on non-enhanced phase,delayed phases of mixed-energy or monochromatic images(P >0.05).There were no statistical differences in image quality scoring among the three groups with the same phases (P>0.05).Conclusion Optimal monochromatic images and iodine-water images of single source-dual energy CT are more effective than conventional CT in distinguishing bladder cancer from hematoma.

Objective To assess the value of spectral CT imaging in distinguishing mass type colorectal adenocarcinoma from colorectal adenoma. Methods Forty patients underwent preoperative abdominal dual energy spectral CT scan were analyzed restrospectively, including 17 with colorectal adenomas and 23 with mass type colorectal adenocarcinomas proven by endoscopic and surgical pathology. All patients underwent plain and three-phase enhanced CT scanning. The conventional polychromatic CT value and its pre- and postcontrast CT values, monochromatic CT value of 40 to 100 keV, the slope of spectral curve and iodine(water) concentration were measured, and the maximum diameter of the lesion was recorded. The maximum diameters of the lesions and imaging parameter differences between the adenomas and adenocarcinomas in plain and three-phase enhanced scan were analyzed with independent sample t tests. The data of the parameters with significant differences were further analyzed by ROC curves. Results The maximum diameters of the adenomas and mass type adenocarcinomas were (1.97 ± 0.54), (2.32±0.53) cm respectively, and there was no statistically significant difference (t=-2.011, P=0.051). There was no statistically differences of the conventional polychromatic CT value and its pre-and postcontrast CT values between the two groups in 4 phases (P>0.05). However, in the arterial phase, the CT values of adenomas were significantly lower than those of adenocarcinomas at low (40, 50 keV) energy (P<0.05). The values did not differ significantly between these two groups at other phases (P>0.05). The slope of spectral curve and the iodine(water) concentration both showed significant differences in the arterial phase between the two groups (P<0.05), while they were not significantly different at other phases (P>0.05).The largest area under the ROC curve of the iodine(water) concentration in the arterial phase was 0.757 in differentiating adenomas and mass type adenocarcinomas, with sensitivity of 73.9%and specificity of 82.4%at the cut-off of 21.02 mg/cm3. Conclusion Spectral CT imaging is valuable in differentiating colorectal adenoma from mass type colorectal adenocarcinoma with the parameters of the arterial phase.

Objective To investigate the function of sorafenib on the growth of hepatocellular carcinoma by establishing subcutaneous transplantation tumor model with nude mice.To explore the effect of sorafenib on circadian clock gene expression in hepatoma cells.Methods Mouse tumor model was established by implanting hepatocarcinoma cell (HepG2) subcutaneously in Balb/C nude mice.Sixteen experimental mice were randomly divided into two groups:sorafenib treatment group (n =8) and solvent control group (n =8).The nude mice were treated with sorafenib (100 mg/kg) and DMSO daily by intragastric administration,respectively.The volume of tumors was recorded every 3 days.The expressions level of circadian clock genes (Per1,Per2,Per3,CLOCK,Cry1,Cry2,BMAL1 and CKIε) were detected by real-time polymerase chain reaction (Real-time PCR).The correlations between the size of the xenografts and the expressions of the circadian clock genes were further analyzed.Results Compared with the control group,the tumor size in the sorafenib treatment group were significantly smaller comparing with the control group.Results of Real-time PCR showed that the expression level of Per1,Cry1 and BMAL1 mRNA was remarkably decreased in the treatment group (Per1,P =0.02;Cry1,P =0.002;BMAL1,P =0.035),the differences were statistically significant.Correlation analysis showed that the size of subcutaneous transplantation tumorsin nude mice was negatively correlated with the expressions of Per1,Per2,Cry1 and Cry2 mRNA in control group.While,the size of subcutaneous transplantation tumors was negatively correlated with the expressions of Per2,Per3 and BMAL1 levels in the sorafenib treatment group.Conclusions There is a negative correlation between the expression levels of some biological clock genes and the size of transplantation tumor in nude mice.Sorafenib treatment significantly inhibited the growth of hepatocellular carcinoma in nude mice and down-regulation the expressions of Per1,Cry1 and BMAL1 mRNA in hepatoma cells.

Background and objective Studies on the epidermal growth factor receptor (EGFR) signaling pathways and the therapeutic effects of EGFR-tyrosine kinase inhibitors (EGFR-TKIs) have recently proven that targeted therapy has a major role in the treatment of lung cancer. However, the therapeutic effects of EGFR-TKIs on lung cancers with different EGFR mutation subtypes remain unclear. And if there is a signiifcant difference in the effects of EGFR-TKIs, the mechanisms for the difference remain unclear. hTe aim of this study was to investigate the clinical importance of EGFR mutations in exons 19 and 21 of lung cancer patients and to compare the outcomes of these patients. Methods hTe study recruited 113 patients who had non-small cell lung cancer (NSCLC) with EGFR mutations. EGFR mutations were detected for 47 patients using Real-time PCR or DNA sequencinag. hTe mutations of the remaining patients were determined using xTag-EGFR liquid chip technology. All stages I-III patients underwent radical resection followed by 4 cycles of postopera-tive chemotherapy. Patients with pleural metastases underwent pleural biopsy, pleurodesis, and chemotherapy only. Patients with distant metastases underwent biopsy and chemotherapy only. Collected clinical data were analyzed using SPSS 19.0 sotfware. Results EGFR exon mutations 19 and 21 were found in 56 and 57 patients, respectively. hTe mean age of patients with exon 19 mutations was lower than the age of the patients with exon 21 mutations (57.02±11.31 years vs 62.25±7.76 years, respectively;P<0.05). hTe primary tumors of patients with exon 19 mutations were more likely occur in the right lung. hTere were no signiifcant differences in gender, smoking status, histopathology, level of differentiation, and stage of disease (P>0.05) between the patients with exon 19 and 21 mutations;and survival analysis of 91 (80.5%) patients with complete clinical data found no differences in overall survival. Stratiifcation analysis found out that patients with exon 19 mutations had longer overall survival associated with age>61 years, male gender, ever smoking, and stage IV disease;al-though the differences were not signiifcant. Conclusion Compared to the lung cancer patients with EGFR exon 21 muta-tions, the patients with EGFR exon 19 mutations were younger, and their primary tumors were more likely to occur in the right lung. hTere were no signiifcant differences between the lung cancer patients with exon 19 and 21 mutations for overall survival, gender, smoking status, histopathology, level of differentiation, and disease stage.

Background and objective Mesenchymal stem cells (MSC) are adult stem cells derived from meso-derm. Evidence has shown that MSC could migrate towards tumor tissue and differentiate into tumor associated ifbroblast in tumor microenvironment, which inlfuences tumor growth and metastasis. However, the reports of MSC in non-small cell lung cancer (NSCLC) are few and controversial. hTe aim of this study is to explore the chemotaxis of MSC towards NSCLC and to test the effects of MSC on the proliferation and invasion ability of NSCLC.MethodsTranswell assay was used to test MSC and NSCLC migration and invasion, and hTymidine incorporation assay was adopted to measure NSCLC cells proliferation. hTe expression of interleukin-6 (IL-6), insulinlike growth factor (IGF-1), vascular endothelial growth factor (VEGF) and dickkopf-related protein 1 (DKK1) of MSCs were determined by real time PCR. A549 lung cancer xenogratf animal tumor model was set up to evaluate the MSC effectin vivo.ResultsLung cancer cells could attract MSC tropism. MSC conditioned medium fa-vored lung cancer cell proliferation and lung cancer cells stimulated the expression of IL-6, IGF-1, VEGF and DKK1 on MSCs. In vivo animal study showed that the tumor with MSC injection grew much faster compared to control group.Conclusion MSCs could migrate towards NSCLC cells and favor tumor growth. In turn, NSCLC cells could stimulate the overexpression of cytokines on MSCs which are essential for the tumor growth.

Background and objective Cisplatin-resistance in lung cancer cells is general in clinic, hence it is sig-niifcant to investigate the mechanisms of cisplatin-resistant and develop new methods of reversing drug-resistance. Recent researches showed that miRNA could regulate cell growth, apoptosis, migration and invasion even in drug therapy in cancer by its target gene. hTe aim of this study is to investigate the effects and molecular mechanisms of miR-503 on reversing the cisplatin-resistance in lung cancer DDP-resistant cell line A549/DDP. Methods MTS assay was employed to determine the effect of miR-503 on A549/DDP’ sensitivity to cisplatin. Apoptosis rate and intracellular concentration of rhodamine-123 (Rh-123) were determined by lfow cytometry, the expression of multi-drugs resistant proteins MDR1and MRP1, ERCC1, RhoE, Survivin and Bcl-2 were determined by Western blot and real time PCR. hTe phosphorylation of Akt was analyzed by Western blot, the transcriptional activities of NF-κB and AP-1were detected by dual-luciferase reporter gene systems. Results MiR-503 was able to increase the cisplatin sensitivity of A549/DDP. Atfer treatment with miR-503, the reverse folds (RF) to cisplatin was 2.48 fold, the intracellular level of Rh-123 was 2.49 fold, the apoptosis rate was10.3 fold, the expressions of several drug-resistant related proteins, such as MDR1, MRP1, ERCC1, Survivin and Bcl-2 were downregulated signiifcantly, as shown by WB, in contrast, the level of RhoE was elevated, the mRNA epression of MDR1was18.5%, the mRNA epression of MRP1was 22.3%, the mRNA epression of ERCC1was18.6%, the mRNA epression of Survivin was 42.8%, the mRNA expression of Bcl-2 was 68.1%, the mRNA epression of RhoE was 206.5%, in addition, the phosphorylation of Akt decreased and transcrip-tional activities of NF-κB was 53.7%, AP-1was 47.4%compared with control group. Conclusion MiR-503 was able to reverse the cisplatin resistance of A549/DDP. MiR-503 processed this kind of effect by inhibiting the drug effux, downregulating the expression of drug-resistant related proteins and promoting cell apoptosis.

Metastatic pleomorphic liposarcoma in the mediastinum is rare, and the current treatments are most of the times ineffective. We hereby report a case with relapsed pleomorphic liposarcoma adjacent to the psoas major mus-cle and with mediastinal metastasis, to discuss the clinical features and treatment strategies of pleomorphic liposarcoma. The patient's clinical history, imaging findings, pathological diagnosis, and multidisciplinary treatments were retrospectively analyzed. A 41-year old female patient was diagnosed with pleomorphic liposarcoma adjacent to the psoas major muscle and mediastinal metastasis. After multidisciplinary treatments, including surgery, chemotherapy, and targeted therapy, the patient has survived 65 months until now. Surgical resection is considered as the first choice of the treatment for pleomorphic lipo-sarcoma. Multidisciplinary treatments, including chemotherapy and other medical treatments, are effective to slow the disease progression and to reduce the disease recurrence.

The genomic instability may lead to an initiation of cancer in many organisms. Homologous recombination repair (HRR) is vital in maintaining cellular genomic stability. RAD51 associated protein 1 (RAD51AP1), which plays a crucial role in HRR and primarily participates in forming D-loop, was reported as an essential protein for maintaining cellular genomic stability. However, recent studies showed that RAD51AP1 was significantly overexpressed in various cancer types and correlated with poor prognosis. These results suggested that RAD51AP1 may play a significant pro-cancer effect in multiple cancers. The underlying mechanism is still unclear. Cancer stemness-maintaining effects of RAD51AP1 might be considered as the most reliable mechanism. Meanwhile, RAD51AP1 also promoted resistance to radiation therapy and chemotherapy in many cancers. Thus, researches focused on RAD51AP1, and its regulatory molecules may provide new targets for overcoming cancer progression and treatment resistance. Here, we reviewed the latest research on RAD51AP1 in cancers and summarized its differential expression and prognostic implications. In this review, we also outlined the potential mechanisms of its pro-cancer and drug resistance-promoting effects to provide several potential directions for further research.
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Humans ; DNA-Binding Proteins/metabolism* ; RNA-Binding Proteins/metabolism* ; Lung Neoplasms ; DNA Repair ; Genomic Instability ; Rad51 Recombinase/metabolism*

In recent years, the corona virus disease 2019 (COVID-19) pandemic has had a huge impact on the global medical, political and economic fields. Since the beginning of the COVID-19 epidemic, our understanding of the impact of COVID-19 has grown exponentially. Recently, the COVID-19 epidemic has changed rapidly in China, and there has been controversy over how to carry out surgical operations for patients with lung neoplastic lesions. Some studies have shown that lung cancer patients undergoing surgery are more likely to experience respiratory failure and perioperative death after contracting COVID-19 than the general population, however, delays in cancer treatment are also associated with increased mortality among these patients. In particular, the novel coronavirus Omikron variant has a higher transmissibility and may escape the immunity obtained through the previous novel coronavirus infection and vaccination. In order to minimize the risk of novel coronavirus infection in surgical patients, it is necessary to develop new treatment guidelines, expert consensus and preventive measures. However, the current rapid change of the epidemic situation has led to insufficient time and evidence to develop guidelines and consensus. Therefore, thoracic surgeons need to evaluate specific patient populations at higher risk of severe complications before surgery and weigh the benefit of surgical treatment against the risk of novel coronavirus infection. We try to give some recommendations on lung surgery during the current domestic epidemic situation based on the guidelines and consensus of oncology and thoracic surgery organizations in different regions on lung surgery.
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Humans ; Lung Neoplasms/complications* ; COVID-19 ; SARS-CoV-2 ; Multiple Pulmonary Nodules ; Pandemics/prevention & control* ; Lung