BACKGROUNDTo explore the clinical and prognostic values of serum carbohydrate antigen (CA125), neuron-specific enolase (NSE), calcitonin (CT) levels in patients with lung cancer before operation.

METHODSNinety two untreated patients with lung cancer confirmed histologically were studied. Serum CA125, NSE, and CT were detected in 92 lung cancer patients by ELISA before operation. Thirty healthy volunteers were chosen as controls.

RESULTSThe sensitivity of CA125, NSE, and CT for the diagnosis of lung cancer were 48.9%, 21.7%, and 7.6% respectively. The level of CA125 in lung cancer patients was significantly higher than that of control (P < 0.05). The level of NSE in patients with small cell lung cancer was significantly higher than that of control (P < 0.01). The level of CT in lung cancer patients was higher than that of control, but without significant difference. The 3-year survival rate of patients with increased serum CA125 level before operation was 44.4% (20/45), whereas that of patients with normal CA125 level was 66.0% (31/47) (P < 0.05). The 3-year survival rate of patients with increased serum NSE and CT levels was 45.0% (9/20) and 42.8% (3/7) respectively, whereas that of patients with normal serum NSE and CT level was 58.3% (42/72) and 56.5% (48/85) respectively. The 3-year survival rate of patients with increased serum NSE or CT level had no significant difference with that of patients with normal level (P > 0.05).

CONCLUSIONSThe diagnostic values of CA125, NSE and CT are limited. CA125 can be used as an prognostic parameter in patients with lung cancer after operation.

BACKGROUNDTo investigate the diagnosis and treatment of pulmonary sclerosing hemangioma (PSH).

METHODSThe clinical features, radiographic manifestations and treatment of 21 patients with PSH were reviewed.

RESULTSNone of the 21 patients was diagnosed as PSH preoperatively. There were 18 females and 3 males, and the average age was 48.0 years in this group. Twelve patients were symptom free. The plain chest roentgenograms showed a well defined, homogeneous, round or oval nodulous shadow in most cases. All patients received operation. There was no postoperative morbidity and mortality. Postoperative follow-up showed a good prognosis.

CONCLUSIONSPreoperative diagnosis of PSH is quite difficult. PSH should be suspected in middle to old aged female patients who show a well defined, homogeneous, round or oval shadow in plain chest roentgenograms. PSH has a good prognosis if it is treated surgically.

Dry eye affects a large number of people worldwide.A vicious cycle involving multiple factors tends to be implicated in its pathophysiology.Tear secretion is regulated by the sympathetic and parasympathetic nervous systems.Corneal nerve fibers secrete neurotransmitters and neuropeptides, which together participate in the maintenance of ocular surface homeostasis.Abnormal neuromodulation can cause abnormal tear secretion and a disruption of ocular surface homeostasis, leading to dry eye.The persistent abnormal tear film in dry eye can damage the normal repair system of ocular surface and leave the ocular surface and the lacrimal gland in a chronic inflammatory state.The cornea in dry eye patients is more sensitive to temperature change and mechanical stimulation than in healthy individuals.Symptomatic eye pain may be related to the effect of chronic inflammation on the corneal pain signal pathway.In vivo confocal microscopy and corneal esthesiometry can be used to evaluate the corneal nerve morphology and function in dry eye patients.This may ead to a more comprehensive treatment of dry eyes through the use of nerve related factors to nourish the cornea and the stimulation of neural pathways or related neural receptors to increase tear secretion.This study reviewed the relationship between neurosensory abnormalities and dry eye.

Objective:To evaluate the clinical outcome of 3D printing titanium cage combined with Masquelet technology for the treatment of calcaneus infective defect.Methods:Data of 5 cases with chronic calcaneus infectivedefect treated with regional flap, 3D printing titanium cage combined with Masquelet technology with rib autograft from January 2017 to January 2019 were retrospectively analyzed. There were 3 males and 2 females, with an average age of 37 years old (range, 17-52 years). The mechanism of the five patients included two motor vehicle incidents, two high fall injuries and one rolling compaction. All patients were treated by two-stage procedures. First stage included debridement, polymethyl methacrylate (PMMA) filling and regional flap coverage. The soft tissue defect of the 5 cases included 10 cm×8 cm in 2 cases, 8 cm×7 cm, 8 cm×5 cm, and 5 cm×3 cm each in one case. Bone defect included 4 cm×3 cm×2 cm in two cases, 3 cm×3 cm× 2 cm in two cases and 3 cm×1 cm×1 cm in one case. Second stage was 3D printing titanium cage combined with masquelet technology of rib autograft. Time of bone union, morphology of calcaneus, position of implant, Maryland score and AOFAS hind foot score were recorded to evaluate the clinical outcome.Results:All five patients were followed up for an average time of 18.2 months (range, 12-30 months). Infection happened in one patient 2 months after first stage operation and successfully treated by debridement and PMMA replacement. Incision of the rest 4 cases all healed successfully. Germiculture of the five cases included Methicillin-resistant Staphylococcus aureus (MRSA) in three cases, Staphylococcus epidermidis in one case and Bacterium coli in one case. All five patients got calcaneus bone union after second stage operation. The average time for bone union was 4.32 (range, 3-8) month. Bone trabecular were observed in CT scan 13 (range, 10-22) month post-operation. Average Maryland score in 12 months post-operation was 92 (range, 86-98) and average AOFAS ankle hind foot score was 89.8 (range, 83-100).Conclusion:3D printing titanium cage and Masquelet technology maybe an effective treatment for calcaneus infective defect.