Objective The aim of the present study was to evaluate the clinical application of 2 μm thulium laser in pulmonary nodules resection under VATS.Methods 61 patients,undergoing thoracoscopic resection of pulmonary nodules in thoracic department of Xuanwu Hospital,were identified between January and December of 2016.Of those,30 underwent 2μm thulium laser dissection and 31 were treated with standard technique by using staplers.In terms of clinical characteristics,including gender,age and smoking history,there is no significant difference between the laser group and the stapler group,but the lesion size was slightly larger in the stapler group compared with the laser group.The lesions of the two groups were almost evenly distributed on the five lobes.Results All the procedures were performed successfully under VATS.The intraoperative evaluation of air leaks demonstrated that less than or equal to 2 grade air leaks were observed in 28 cases in the laser group and in 30 cases in the stapler group.Grade 3 air leaks requiring a rescue treatment were observed in 2 cases in the laser group and in 1 case in the stapler group.There were no significant differences in the postoperative hospital stay and total hospital stay between two groups.Chest tube duration was lower in the laser group compared with the stapler group even if it was not statistically significant (2.71 vs 3.55 days).Hospitalization costs was significantly lower for the laser group.Conclusion The use of 2um thulium laser to prevent intra-and postoperative air leaks and bleeding is effective and makes patients recover quickly,which allows a minimally invasive,accurate and safe application during thoracoscopic resection of pulmonary nodules.

OBJECTIVETo analyze potential mutations of NOTCH3 gene in a Chinese family featuring cerebral autosomal dominant arteriopathy with subcortical infarct and leucoencephalopathy (CADASIL) in order to facilitate genetic counseling and prenatal diagnosis.

METHODSThe proband and related family members and 100 healthy controls were recruited. The NOTCH3 gene was screened for mutations by polymerase chain reaction and direct DNA sequencing. PolyPhen-2 and SIFT software were used to predict the protein function.

RESULTSThe proband and two affected individuals from the family were adult-onset, with main clinical manifestations including recurrent transient ischemic attacks and(or) strokes, cognitive impairment, memory decline, and depression. MRI findings suggested multiple cerebral infarcts and severe leukoencephalopathy. A novel heterozygous missense mutation c.3043T> A (p.Cys1015Ser) located in exon 19 of NOTCH3 gene was identified not only in the proband and two patients, but also in an asymptomatic relative from the family. The same mutation was detected in none of the 100 unrelated healthy controls. Function analysis suggested that this mutation can severely affect the functions of this protein. Multiple sequence alignment revealed that the mutation site was extremely conserved in various species.

CONCLUSIONA novel heterozygous Cys1015Ser mutations in exon 19 of the NOTCH3 gene probably underlies the CADASIL in this family.

Adult ; Aged ; Amino Acid Sequence ; Base Sequence ; CADASIL ; complications ; genetics ; DNA Mutational Analysis ; Exons ; genetics ; Family Health ; Female ; Heterozygote ; Humans ; Male ; Middle Aged ; Molecular Sequence Data ; Mutation, Missense ; Pedigree ; Polymerase Chain Reaction ; Receptor, Notch3 ; Receptors, Notch ; genetics ; Sequence Homology, Amino Acid

Background and objective Primary lung cancer is one of the most common malignancies worldwide. Surgical resection remains the ifrst choice for the treatment of early stage non-small cell lung cancer (NSCLC). Relapse atfer surgery sharply reduces the patient’s life expectancy. hTis relapse is referred to as isolated postsurgical local recurrences or me-tastases (IPSLROM), which can be treated via local therapy to achieve long-term survival or cure. In recent years, radiofrequen-cy ablation (RFA) has been increasingly used as a non-surgical treatment option for patients with primary and metastatic lung tumors. hTis study aims to evaluate the effcacy of RFA among patients with IPSLROM of NSCLC. Methods A total of 20 patients underwent computerd tomograghy (CT)-guided RFA for lung neoplasm with IPSLROM of NSCLC (with unresect-able disease because of poor lung reserve or multifocality) in our hospital between December 2008 and November 2013. hTese patients comprised 15 males and 5 females with a mean age of 69.2 years (range:45-85). All patients exhibited pathological evidence of neoplastic lesion (14 tumors were adenocarcinoma, and six were squamous cell carcinoma). hTe mean size of the lesions was 3.9 cm (range:2.0 cm to 8.0 cm). Treatment complications, progression-free survival (PFS), and survival param-eters were retrospectively analyzed. Results RFA was well tolerated by all patients with an average time of 34.3 min (range:15 min to 60 min). Intraprocedural complications included eight cases of chest pain (40%). No procedure-related deaths occurred in all of the 20 ablation procedures. hTe median PFS was 25 months in all of the patients who received RFA. hTe median overall survival for the entire group of patients was 27.0 months. No differences were observed in the overall survival between patients with IPSLROM. hTe overall survival rates at 1 and 2 years atfer RFA were 92.9%and 57.0%, respectively. Conclusion RFA is a safe and effective procedure in unresectable lung tumors with IPSLROM of NSCLC.

Background and objective Epidermal growth factor receptor tyrosine kinase in hibitors (EGFR-TKIs) is one of the foundamental treatment for non-small cell lung cancer (NSCLC) with EGFR mutation, however some patients might develop locally progression in primary site. The aim of this study is to assess the clinical application of radi of requency ablation atfer locally progression of NSCLC while receving EGFR-TKIs.Methods Twenty-eight eligible NSCLC patients were enrolled. Effcacy and Safety data of radiofrequency ablation followed by EGFR-TKIs or chemotherapy were collected.Results None of patients had died during peri-operation period. hTe average follow-up time was 17.25 months. Locally progression rate was 10.7% (3/28), and locally progression time was 16.6 months. hTe average progression-free survival was (24.55±5.36) (95%CI:14.04-35.05), and the average overall survival was (25.57±5.45)(95%CI:14.88-36.27). Patients were divided into EGFR-TKIs group and chemotherapy group atfer radi of requency ablation. The average progression-free survival of the two groups were (27.82±7.58)(95%CI:12.97-42.68) and (17.88±3.76)(95%CI:10.52-25.25)(P>0.05) respectively. hTe average OS (overall survival) was (29.42±7.68)(95%CI:14.36-44.48) and (18.44±3.87)(95% CI:14.89-36.27)(P>0.05) in two groups. Conclusion Radi of requency ablation combined with EGFR-TKIs or chemotherapy could prolong progression-free survival and overall survival of EGFR mutant NSCLC patients who had developed locally progression in primary site during EGFR-TKIs treatment.

Objective To investigate the impact of SARS-CoV-2 infection on male semen quality through meta-analysis and retrospec-tive study.Methods Literature retrieval was conducted in PubMed,CNKI,Wanfang Database and CBM database.Meta-analysis was performed using Stata 15.0.The male patients meeting the inclusion criteria from our hospital were enrolled as study subjects.General demographic data and semen parameters were collected.Single factor analysis of variance and graphing of semen parameters were con-ducted using GraphPad Prism 9.5.1.The test level was set at 0.05.Results A total of 9 studies involving 267 patients were included in the meta-analysis.There were no significant differences in sperm concentration and survival rate before and after SARS-CoV-2 infec-tion(P＞0.05).Semen volume and percentage of normal morphology significantly increased during 1-3 months after infection(P=0.005,P=0.010),with semen volume recovering to pre-infection level＞3 months later(P＞0.05).Sperm motility and progressive mo-tility increased＞3 months after infection(P=0.046,P=0.045),recovering to pre-infection levels(P=0.099,P=0.098).Sperm DNA fragmentation index may be temporarily elevated within 3 months after infection but gradually decreased＞3 months later.In the retrospective study of 8 cases,there were no statistical differences in semen parameters at different stages compared with pre-infection(P＞0.05),but semen parameters showed a negative trend during＜1 month after infection and recovered to pre-infection levels＞3 months later.Conclusion The results of this laboratory study are basically consistent with the meta-analysis.SARS-CoV-2 infection in males only caused short-term negative effects on sperm morphology,vitality and DNA integrity,but generally recovered to pre-infection levels＞3 months after infection.Due to the limitations of study subjects and sample size,the impact of SARS-CoV-2 infection on male semen quality needs to be further confirmed by long-term large-scale prospective studies.

Background and objective The aim of this study is to explore roles of thyroid transcription factor-1 (TTF-1), CD56, P40 expression and other clinical characteristics predicting response and survival in patients with small cell lung cancer (SCLC).Methods Formalin-fixed, paraffin-embedded biopsy tissues were retrospectively obtained from 198 SCLC patients who were diagnosed first in Xuanwu Hospital. The expressions of TTF-1, CD56 and P40 were detected by im-munohistochemistry. The clinical data including age, gender, cancer stage, Eastern Cooperative Oncology Group (ECOG) score, smoking or not, superior vena cava syndrome (SVCS) due to lung cancer or not were collected.Cox proportional hazard model was used to analyze the relationship between the overall survival (OS) and factors.Results Immunohistochemical staining results showed the positive rate of TTF-1, CD56, P40 were 73.2%, 88.4% and 7.1% respectively. TTF-1 expression (OR=0.665, 95%CI: 0.472-0.937), smoking index ≤400 (OR=1.72, 95%CI: 1.061-2.789) and ECOG=2 (OR=3.551, 95%CI: 2.133-5.914), extensive-stage (OR=2.487, 95%CI: 1.793-3.451) and SVCS due to lung cancer (OR=2.394, 95%CI: 1.49-3.846) were independent prognostic factors for SCLC patients.Conclusion Prognosis of SCLC was related to TTF-1 expression independently after adjusting smoking, ECOG score, stage and SVCS due to lung cancer. Detection of TTF-1, CD56 and P40 expression level might be helpful for predict the prognosis of SCLC.

Background::The CHA 2DS 2–VASc score was initially applied to stratify stroke risk in patients with atrial fibrillation (AF) and was found to be effective in predicting all-cause mortality outcomes. To date, it is still unclear whether circulating long non-coding RNAs (lncRNAs) as emerging biomarkers, can improve the predictive power of the CHA 2DS 2–VASc score in stroke and all-cause mortality. Methods::Candidate lncRNAs were screened by searching the literature and analyzing previous RNA sequencing results. After preliminary verification in 29 patients with AF, the final selected lncRNAs were evaluated by Cox proportional hazards regression in 192 patients to determine whether their relative expression levels were associated with stroke and all-cause mortality. The c-statistic, net reclassification improvement (NRI), and integrated discrimination improvement of the patients were calculated to evaluate the discrimination and reclassification power for stroke and all-cause mortality when adding lncRNA expression levels to the CHA 2DS 2–VASc score model. Results::Five plasma lncRNAs associated with stroke and all-cause mortality in AF patients were selected in our screening process. Patients with elevated H19 levels were found to have a higher risk of stroke (hazard ratio [HR] 3.264, 95% confidence interval [CI]: 1.364–7.813, P = 0.008). Adding the H19 expression level to the CHA 2DS 2–VASc score significantly improved the discrimination and reclassification power of the CHA 2DS 2–VASc score for stroke in AF patients. In addition, the H19 level showed a marginally significant association with all-cause mortality (HR 2.263, 95% CI: 0.889–5.760, P = 0.087), although it appeared to have no significant improvement for the CHA 2DS 2–VASc model for predicting all-cause mortality. Conclusions::Plasma expression of H19 was associated with stroke risk in AF patients and improved the discriminatory power of the CHA 2DS 2–VASc score. Therefore, lncRNA H19 served as an emerging non-invasive biomarker for stroke risk prediction in patients with AF.

Objective:To detect serum Col2-3/4 C-terminal cleavage product of type Ⅱ collagen (C2C) and pyridinoline (PYD) among brucellosis patients at early period, and to provide a better understanding of the changes of bone and joint collagen metabolism in the early stage of brucellosis.Methods:From 2013 to 2016, 61 cases of brucellosis patients at early period (within 6 months) from brucellosisout patient of Qinghai Institute for Endemic Disease Prevention and Control were selected as case group, and 67 cases of healthy volunteers were selected as control group. Serum C2C and PYD levels in all samples were measured simultaneously with enzyme linked immunosorbent assay (ELISA).Results:The median serum C2C of patients with early brucellosis was 83.45 ng/ml and that of the control group was 73.35 ng/ml. There was significant difference in serum C2C between the case group and the control group ( Z = 5.027, P < 0.05). The median serum PYD of patients with early brucellosis was 278.45 nmol/L and that of the control group was 212.75 nmol/L. There was significant difference in serum PYD between the case group and the control group ( Z = 6.967, P < 0.05). Conclusion:Serum C2C and PYD levels of brucellosis patients at early period are increased.

BACKGROUND: When lung cancer screening work extensively developed in recent years, more and more small lung lesions were found in clinic. The aim of this study is to analysis computed tomography (CT) guided percutaneous biopsy for lung small lesions (diameter<2 cm) on results, complications and prognosis. METHODS: Choose CT guided percutaneous lung biopsy were performed in 41 cases of pulmonary peripheral lesions, single lesion in 39 cases, multiple lesions in 2 cases, 5-20 (13.1±5.2) mm in maximum diameter, depth from lung surface 1-45 (16.5±13.7) mm, ground-glass opacity (GGO) components 0%-100% (66.8%±35.2%). RESULTS: 41 patients and 43 biopsies successfully obtained pathological tissue. Atypical adenomatous hyperplasia in 3 cases, squamous carcinoma in 1 case, adenocarcinoma in 37 cases( carcinoma in situ in 7 cases, micro-invasive carcinoma in 5 cases, invasive adenocarcinoma in 25 cases, double primary lung cancer in 2 cases), inflammatory lesions in 2 cases. Except 2 cases of inflammatory lesions are in follow-up, biopsy and surgical pathology alignment (specificity) was 100%. 41 patients occurred complications related to percutaneous biopsy. Pneumothorax were in 22 cases, drainage required in 2 cases. There were 17 cases with hemoptysis, accounting for 39.5% incidence are self-limited. Intracranial air embolism occurred in 2 cases by 4.6% incidence. They were fully recovered. CONCLUSIONS For small lung lesions, CT guided percutaneous biopsy is technically feasible. However, for small lung lesions especially pure GGO biopsy, it is still need to be cautious.
Adult ; Aged ; Biopsy ; Female ; Humans ; Lung Neoplasms ; pathology ; Male ; Middle Aged ; Tumor Burden

Objective     To study the short-term outcome and safety of radiofrequency ablation (RFA) combined with recombinant human endostatin (endostar) for non-small cell lung cancer (NSCLC) patients. Methods     Between December 2013 and December 2014, 80 consecutive patients (50 males, 30 females) with biopsy-proved NSCLC were divided into two groups: a RFA combined treatment group (RFA combined with endostar, 60 patients, 38 males, 22 females, mean age at 67.77±10.43 years) and a RFA alone group (20 patients, 12 males, 8 females, mean age at 67.35±9.82 years). The RFA combined treatment group was divided into three groups according to vascular normalization window of endostar and 20 patients in each group: a combined treatment group 1 (transfusion of endostar after RFA), a combined treatment group 2 (transfusion of endostar for 1 to 3 d before RFA) and a combined treatment group 3 (transfusion of endostar for 4 to 7 d before RFA). The CT scan of the chest was followed up after the treatment, local recurrence and safety was observed. Results    There was a statistical difference in local recurrence time among groups (χ2 = 11.05, P =0.011). The effect of the combined treatment group is better than that of the radiofrequency ablation therapy alone group. And in the recombinant human endostatin of tumor vascular normalization time best combination therapy was observed in the near future effect compared with the radiofrequency ablation therapy alone. In this study common complications were associated with radiofrequency ablation. No recombinant human endostatin related complication was found. There was no satistical difference in safety between the combined treatment group and the radiofrequency ablation therapy  group (χ2= 0.889, P > 0.05). Conclusion     RFA combined with endostar is safe and effective for non-small cell lung cancer.