Objective To evaluate the value of ultrasonic elastography for diagnosis of chronic nonspecific low back pain. Methods From March to September, 2016, 32 patients diagnosed as chronic nonspecific low back pain and other 32 healthy people (controls) were measured lumbar erector spinae with ultrasonic elastography, and calculated Yang's modulus. The correlation between Yang's modulus and Visual Analogue Scale (VAS) or Japanese Orthopaedic Association (JOA) score in the patients were investigated with Pearson's analysis. Re-sults There was no significant difference in Yang's modulus between bilateral lumbar erector spinae in both the patients and the controls (t<1.849, P>0.05), but it was more in the patients than in the controls (t=9.931, P<0.001). The Yang's modulus was positively correlated with VAS score in the patients (r=0.614, P<0.001), but not with the JOA score (r=-0.243, P=0.180). Conclusion Ultrasonic elastography can be applied to differentiate low back pain from the healthy, and measure the intensity of pain.

Objective To investigate the protective effect of CBLB 502 on radiation pneumonitis and pulmonary fibrosis for confirming the feasibility of CBLB502 as a clinical anti-radiation drug release.Methods With a single 20 Gy irradia-tion, C57BL/6J mice was sacrificed on 24 h, 1 month, 3 months and 5 months and lung tissue was assayed by TUNEL method for apoptosis of alveolar epithelial cells and endothelial cells , HE staining showing fibrosis changes , immunohisto-chemistry detecting the expression of specific indicators , as well as pathological changes of the fur and skin radiated site . Results CBLB502 inhibits apoptosis in mice alveolar epithelial cells and vascular endothelial cells after irradiation , slowing the process of pulmonary fibrosis , while reducing the expression of laminin and maintaining the expression of surfac-tant protein B, and the skin inflammation also significantly reduced .Conclusion CBLB502 could alleviate the occurrence of radiation pneumonitis and pulmonary fibrosis as well as radiation-induced skin injury .

Background and purpose:With the improvement of skill of video-assisted thoracic surgery, thoracoscopic anatomic segmentectomy becomes more and more mature. This paper aimed to study the safety, feasibility and clinical features of thoracoscopic anatomic segmentectomy for stageⅠ lung cancer.Methods:Data from 64 patients who was diagnosed as having clinicalⅠ stage lung cancer and received thoracoscopic anatomic pulmonary segmentectomy were retrospectively analyzed from Mar. 2008 to Jan. 2014. There were 28 men and 36 women with a median age of 59 years (39-86 years).Results:Sixty-four patients underwent thoracoscopic anatomic segmentectomy successfully. The median operative time was 120 min (90-240 min). The median blood loss in operation was 50 mL (10-200 mL). The median thoracic drainage time was 3 d(2-7 d). The median postoperative length of stay was 5 d(3-23 d). There was no postoperative mortality or severe complications. There was one conversion to lobectomy but no conversion to thoracotomy. There were 51 patients with ground glass opacity (GGO). Of the 51 patients, postoperative pathology showed invasive adenocarcinoma in 30, adenocarcinoma in situ in 10, minimally invasive adenocarcinoma in 6 and benign lesions in 5.Conclusion:Thoracoscopic anatomic pulmonary segmentectomy is a feasible and safe technique for a skilled doctor. Not only can it be a method of diagnosis, but also it can be a method of treatment for clinical stageⅠ lung cancer, especially for GGO in lung.

Objective To investigate the relationship between lymph nodes count after selective neck lymph node dissection and the prognosis of patients with pathologically lymph node-negative (pN0) hypopharyngeal squamous cell carcinoma (HPSCC). Methods The clinical data of 96 patients with pN0 HPSCC undergoing selective neck dissection (bilateralⅡ-Ⅳregion) from October 1995 to October 2012 in Shanxi Provincial Cancer Hospital were analyzed retrospectively. The optimal lymph nodes count cutoff values were determined by using the X-tile program in different prognostic groups, and the univariate and multivariate survival analysis in different groups were analyzed by using SPSS 19.0 software. Results A total of 2116 lymph nodes were detected in this cohort, with a median number of 22 (3-52). Except for the tumor site (P= 0.011), there were no statistical differences in lymph nodes count of patients with different age, gender, history of smoking or drinking, T stage, and differentiation degree (all P> 0.05). Applying 9 and 23 nodes as the cutoff values determined by using X-tile program, all patients could be divided into the high-risk (13 cases, lymph nodes count 3-9), the middle-risk (37 cases, lymph nodes count 10-22) and the low-risk (46 cases, lymph nodes count 23-52) groups. And the 5-year overall survival (OS) rate was 23.1 ％, 55.9％and 86.0％in the high, middle, low risk groups respectively (χ2= 21.73, P< 0.001). Multiple-factor analysis showed that lymph nodes count, T stage and degree of tumor differentiation were independent prognostic factors in patients with pN0 HPSCC (all P< 0.05). Further analysis showed that when the cutoff value of lymph nodes count was 9, the patients could be divided into two groups with significantly differentprognosis. The 5-year OS rate was 23.1％ in the high-risk group and 73.2 ％ in the low-risk group, and the difference was statistically significant (χ2 = 17.87, P< 0.001). Conclusions Lymph nodes count after selective neck lymph node dissection can be used to predict the prognosis of patients with pN 0 HPSCC. It is likely that 9 is the minimum number of lymph nodes in pN0 HPSCC patients.

OBJECTIVETo study the influence of micrometastasis in lymph node on staging and prognosis of non-small-cell lung cancer (NSCLC).

METHODSIn 39 NSCLC patients, micrometastasis in pathologically negative lymph nodes were tested through immunohistochemical cytokeratin (CK) analysis and the relationship between CK(+) and staging, survival were analyzed.

RESULTSIn these 39 patients, the survival of CK(+) and CK(-) patients were 32 months and 48 months respectively (P = 0.0178). Multivariate analysis of Cox regression model showed: clinical stage (P = 0.0288) and relapse or metastasis (P = 0.0053) affected the prognosis while micrometastasis in lymphnodes (P = 0.7740) did not.

CONCLUSIONThe detection of micrometastasis in the lymphnodes may serve as a supplement to the present staging system for lung cancer. Even though the prognosis of patients with micrometastasis being poorer than those without, micrometastasis in the lymph nodes should not be regarded as an independent prognostic factor.

Adult ; Aged ; Carcinoma, Non-Small-Cell Lung ; diagnosis ; metabolism ; secondary ; Female ; Humans ; Keratins ; metabolism ; Lung Neoplasms ; diagnosis ; metabolism ; pathology ; Lymph Nodes ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis

Objective:To investigate the factors influencing the prognosis of anaplastic thyroid cancer (ATC) and to evaluate the application value of established random survival forest (RSF) model in the prognosis prediction of ATC.Methods:A total of 707 ATC patients diagnosed by histopathology in the Surveillance, Epidemiology and End Results (SEER) database of the National Cancer Institute from 2004 to 2015 were selected and randomly divided into the training set (495 cases) and the validation set (212 cases). Univariate Cox regression risk model was used to analyze the related factors affecting overall survival (OS) of patients in the training set. The multivariate Cox proportional risk model based on the minimum Akaike information criterion (AIC) was used to analyze the above variables and then the variables were screened out. The traditional Cox model for predicting OS was constructed based on the screened variables. The RSF algorithm was used to analyze the variables with P < 0.05 in the univariate Cox regression analysis, and 5 important features were selected. Multivariate Cox proportional risk model was selected based on the minimum AIC. Then the RSF-Cox model for predicting OS was constructed by using screened variables. The time-dependent receiver operating characteristic (tROC) curve and the area under the curve (AUC), calibration curve, decision curve and integrated Brier score (IBS) in the training set and the validation set were used to evaluate the prediction performance of the models. Results:Univariate Cox regression analysis showed that age, chemotherapy, lymph node metastasis, radiotherapy, surgical method, tumor infiltration degree, tumor number, tumor diameter and diagnosis time were factors affecting the prognosis of ATC (all P < 0.05). Multivariate Cox regression analysis based on minimal AIC (4 855.8) showed that younger age (61-70 years vs. > 80 years: HR = 0.732, 95% CI 0.56-0.957, P = 0.023; ≤ 50 years vs. > 80 years: HR = 0.561, 95% CI 0.362-0.87, P = 0.010), receiving chemotherapy (receiving or not: HR = 0.623, 95% CI 0.502-0.773, P < 0.001), receiving radiotherapy (receiving or not: HR = 0.695, 95% CI 0.559-0.866, P = 0.001), receiving surgery (lobectomy, no surgery or unknown: HR = 0.712, 95% CI 0.541-0.939, P = 0.016; total resection or subtotal resection vs. no surgery or unknown: HR = 0.535, 95% CI 0.436-0.701, P < 0.001), and tumor diameter (≤ 2 cm vs. > 6 cm: HR = 0.495, 95% CI 0.262-0.938, P = 0.031; > 2 cm and ≤ 4 cm vs. > 6 cm: HR = 0.714, 95% CI 0.520-0.980, P = 0.037; > 4 cm and ≤ 6 cm vs. > 6 cm: HR = 0.699, 95 % CI 0.545-0.897, P = 0.005) were independent protective factors for OS of ATC patients. Lymph node metastasis (N 1 unknown vs. N 0: HR = 1.664, 95% CI 1.158-2.390, P = 0.006; N 1b: HR = 1.312, 95% CI 1.029-1.673, P = 0.028), more aggressive tumor infiltration degree (group 3 vs. group 1: HR = 1.492, 95% CI 1.062-2.096, P = 0.021; group 4 vs. group 1: HR = 1.636, 95% CI 1.194 - 2.241, P = 0.002) were independent risk factors for OS of ATC patients. Although diagnosis time was not statistically significant (2010-2015 vs.2004-2009: HR = 1.166, 95% CI 0.962-1.413, P = 0.118), the inclusion of it could improve the efficacy of the traditional Cox model. RFS algorithm was used to select out 5 important variables: surgical method, tumor diameter, age group, chemotherapy, and tumor number. Multivariate Cox regression analysis based on minimum AIC (4 884.6) showed that chemotherapy (receiving or not: HR = 0.574, 95% CI 0.476-0.693, P < 0.001), surgical method (lobectomy, no surgery or unknown: HR = 0.730, 95% CI 0.567-0.940, P = 0.015; total resection or subtotal resection vs. no surgery or unknown: HR = 0.527, 95% CI 0.423-0.658, P < 0.001), tumor diameter (≤ 2 cm vs. > 6 cm: HR = 0.428, 95% CI 0.231-0.793, P = 0.007; > 2 cm and ≤ 4 cm vs. > 6 cm: HR = 0.701, 95% CI 0.513-0.958, P = 0.026; > 4 cm and ≤ 6 cm vs. > 6 cm: HR = 0.681, 95% CI 0.536-0.866, P = 0.002) were independent factors for OS of ATC patients. RSF-Cox model was constructed based on 3 variables. The tAUC curve analysis showed that RSF-Cox model for predicting the 6-month, 12-month, and 18-month OS rates were 93.56, 92.62, and 90.80, respectively in the training set, and 93.05, 92.47, and 90.20, respectively in the validation set; in the traditional Cox model, the corresponding OS rates were 89.00, 87.76, 85.24, respectively in the training set, and 86.22, 83.68, 82.86, respectively in the validation set. When predicting OS rate at 6-month, 12-month and 18-month, the calibration curve of RSF-Cox model was closer to 45° compared with that of traditional Cox model, and the clinical net benefit of decision curve in RSF-Cox model was higher than that in traditional Cox model. The IBS of RSF-Cox model (0.089) was lower than that of traditional Cox model (0.111). Conclusions:The RSF model based on chemotherapy, surgical method and tumor diameter can effectively predict the OS of ATC patients.